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Monday, June 02, 2008

Tennessee Caregivers 'Healing the Hidden Wounds' at Nashville Summit

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bna2008_02On May 21, Nashville Public Television, National Alliance on Mental Illness-Tennessee, and YMCA/Restore Ministries hosted a day long summit amidst the backdrop of magnificent Foundren Hall. The weather and the charm of the Scarritt Bennett Center grounds couldn't have been any more inviting. And those gathered couldn't have been any more gracious or interesting or sharp.

"Healing the Hidden Wounds," a symposium on veterans and combat related depression united the area's stakeholders for a day of networking, brainstorming, and drafting plans for actions taken after the event. Efforts like these are welcomed and go a long way in supporting the mental health and successful reintegration of returning veterans and their families.

bna2008_20Both television special and conference help to raise awareness; individuals and groups also form new networks and relationships, sharing resources and knowledge.

Attending were caregivers of all types and stripe, former veterans galore, law enforcement and military support types.

The intimate, face-to-face setting and well-thought out program offered everyone the chance to get lot of work done in a short period of time. A very successful summit by all counts I'd like to share with you.

Quick sidebar: My camera has been in Nikon's hands for repairs now for nearly two months. Once again here, relying on the kindness of strangers -- now, newfound friends -- for providing some great event photos to share with you.

Photos: (c) Kathy Edson and Kenny Allred.

My keynote address:

bna2008_27Thank you to Nashville Public Television – most especially Kathy Edson who was kind enough to extend an invitation to me to share this day with you today – NAMI Tennessee and YMCA/Restore Ministries for organizing this incredible summit of great hearts and minds. It’s an honor to be asked to say a few words today, but most especially I’m excited about the chance to learn from you as well.

Thank you so much for your service.

As we’ve just last Saturday celebrated Armed Forces Day, and this coming weekend we prepare to observe Memorial Day, I’d like to commend you for your vital service to our military families and to the nation as a whole.

My biggest inspiration in life has been my father. As a young boy growing up in Hungary, he witnessed WWII and the Nazi occupation from his family farm in the Hungarian countryside. As a teenager, after the conclusion of the war, he then had to live under repressive Soviet rule.

He was conscripted into the Hungarian Army when he was 20, and served in antitank artillery for two years beginning in 1953. But it would be 1956 that would change his life’s direction – and mine – when he picked up arms and joined others in a quest for freedom on the streets of Budapest. The Hungarian Revolution had begun.

Without hesitation, my father joined his fellow countrymen and women in liberty’s cause. My father and mother later fled to the West, after the Soviet Union put down the revolt, with a wave of others landing on the shores of America.

He again became a soldier in 1958.

This time, he wore a United States Army uniform. Imagine. Within a brilliant burst of 5 years, my father went from living a life of modest opportunity and great oppression to serving in the greatest military on earth as a combat engineer, stationed in Germany – with Elvis Presley no less.


At 28, his two years of service behind him, he came home.

To America.

bna2008_33He was proud to wear the American uniform, he was proud to have been able to serve this country, his country. And even as a young girl I remember sneaking into the special closet in our home that contained his pressed and preserved uniforms and looking at them with wonder. I even slipped into them once (don’t tell my dad), and I remember the power that the uniform possessed.

As a current, obviously nontraditional older student attending Northern Illinois University, last Veterans Day I had the pleasure of hearing the school’s ROTC Department of Military Sciences Chairman LTC Craig Engel speak about the special aura of the United States military uniform. He said this that day:

“The act of donning a military uniform is a deeply symbolic act. It always has been, and it likely always will be. It is an act that experiences a deep and selfless commitment to the idea we call America. When ordinary men and women step into the uniform of this nation, they commit themselves to the performance of an extraordinary duty, which may entail the highest and most fearsome call.”

We as citizens must never forget this: That while we may not wear the uniform, those who do are serving not only the country we call America – but they are also forwarding all of her possibilities in doing so as well.

Those who answer the call as so many of you here have, selflessly sacrificing time with family and friends, putting the safety of your body and the peace of your mind on the line for all of us, deserve more than simply words of thanks. Civilians who reap the rewards of those personal sacrifices must honor those gifts and pay down that debt – if it is ever even possible -- with our attention, our respect, but mostly our actions on your behalf.

That’s what our father taught my sisters and me.

bna2008_34Ralph Waldo Emerson was right when he said, “Every man is a hero and an oracle to somebody.” On my present endeavor, Seattle Weekly reporter Rick Anderson was mine when he penned a piece called “Home Front Casualties.” It was the first such article I’d ever run across, listing a cluster of some 6 or 7 incidents that had occurred at Ft. Lewis.

This is what he wrote in 2005:

“Altogether since 2003, there have been seven homicides and three suicides on Western Washington soil involving active troops or veterans of Iraq … Five wives, a girlfriend, and one child have been slain; four other children have lost one or both parents to death or imprisonment. Three service members have committed suicide – two of them after killing their wife or girlfriend … No one can say if the killing can be directly connected to the psychological effects of war. But most involve a risk factor distinctive to the military – armed men trained to kill – and some killers carry the invisible scars of war.”

I began wondering...

• Why was there seemed to be so little news of this in the public sphere?
• Were the incidents rare -- or were there others?
• If so, what was our military and government doing to ease the problem?
• Finally, what could I do to help?

Within months of beginning my search for answers, the ePluribus Media PTSD Timeline, a first-of-its kind online database designed as a starting point for further research, reporting and discussion of PTSD, was created alongside my online journal – PTSD Combat: Winning the War Within – which all eventually led to a small New York City publisher asking if I would write a book on combat PTSD.

With my vast amount of experience in the field, who was I to say no?


There are some good things about being a new-comer to a subject. I started at the beginning, reading all of the military definitions and best books and studies on the matter I could find and reaching out to the real medical experts and veterans and advocates for advice and direction. I received some of the very best help and the greatest of embraces by those already working in this area – a true reflection of the high caliber and class and heart of the people working in this field.

About halfway through my education, it dawned on me that – depending upon the book or study in my hand presently – there were a lot of different terms for what we simply today refer to as PTSD.

I began jotting them down on a list.

Most of us are familiar with the more notable of these terms:

• The Civil War era brought us nostalgia, irritable or soldier’s heart
• WWI christened their PTSD as shell shock, obviously reflecting the era’s powerful new quick-firing artillery piece and machine guns.
• WWII’s broad and prolonged conflicts renamed it again to battle or combat fatigue
• The Vietnam era called the reintegration problems veterans had, not very poetically, post-Vietnam syndrome

But there are dozens and dozens more labels pointing to essentially the same combat stress umbrella used and abused over the years. While being merely an aside to my main focus, in six months I’d amassed some 80 such terms.

I’ve listed them in the notes section in the back of Moving a Nation to Care, on page 161: railway spine, disorderly action of the heart, traumatic neurasthenia, gross stress reaction, Old Sergeant Syndrome, in-country effect, simple continued fever, lack of morale fibre...

What does all of this mean?

One generation after another “rediscovers” and “relabels” the post-war malady, depending upon their own particular needs at the time and if they can nail down an acceptable definition that can justify its existence.

Comedian George Carlin, someone who I had the pleasure of serving on three separate occasions during my 15-year career as a flight attendant (see, I served in uniform, too) [laughter], is known for his combative delivery and razor-sharp examination of the English language. Probably no one comes closer to showing our dysfunctional relationship with PTSD than Carlin, so I hope he doesn't mind if I share it with you in full:

I don't like words that hide the truth. I don't like words that conceal reality. …Americans have trouble facing the truth, so they invent the kind of a soft language to protect themselves from it, and it gets worse with every generation. …

There's a condition in combat. Most people know about it. It's when a fighting person's nervous system has been stressed to its absolute peak and maximum. …In the first world war, that condition was called shell shock. Simple, honest, direct language. Two syllables, shell shock. Almost sounds like the guns themselves.

That was seventy years ago. Then a whole generation went by and the second world war came along and very same combat condition was called battle fatigue. Four syllables now. Takes a little longer to say. Doesn't seem to hurt as much. Fatigue is a nicer word than shock. Shell shock! Battle fatigue.

Then we had the war in Korea, 1950. Madison avenue was riding high by that time, and the very same combat condition was called operational exhaustion. Hey, we're up to eight syllables now! And the humanity has been squeezed completely out of the phrase. It's totally sterile now. Operational exhaustion. Sounds like something that might happen to your car.

Then of course, came the war in Viet Nam, which has only been over for about sixteen or seventeen years, and thanks to the lies and deceits surrounding that war, I guess it's no surprise that the very same condition was called post-traumatic stress disorder. Still eight syllables, but we've added a hyphen! And the pain is completely buried under jargon. Post-traumatic stress disorder. I'll bet you if we'd of still been calling it shell shock, some of those Viet Nam veterans might have gotten the attention they needed at the time. I'll betcha. I'll betcha.

All of this indecision and back and forth has made it difficult for us to expand our knowledge base of the condition over the years. We seem to be forever in this dance of “does it really exist or not?” and if it does, what do we call it? Certainly this is something entirely new and unexpected.

We fell right in line with our behavior during the Afghanistan and Iraq war years. Today veterans and counselors can be heard saying that the term PTSD falls short in this way or that – that “psychological injury” or “deployment-related stressors” better describe what they’re experiencing. ‘Disorder’ – unlike injury - is too stigmatizing, too condemning of anyone to want to accept and so it should be dropped from the lexicon.

All of this may be valuable to consider and essential to doing, but we're back to dancing again while history keeps repeating itself.

bna2008_35Studies have shown that a certain and sure percentage of war veterans will have some psychological and physical fallout from their experiences in the years following their return home. Some may become strengthened by their experience, some may have to work a bit harder to get to that point.

But, veterans from all wars have found this to be so. For example, in February 2006, the Archives of General Psychiatry contained the findings of a University of California-Irvine study that reviewed the pension and health records of Civil War-era veterans.

• 15,000 Union soldiers
• 44% reported post-war mental/”nervous” problems
• Companies suffering highest casualties were at a higher risk for:
o Cardiac
o Gastrointestinal
o Nervous diseases

Not much has changed for our generation of veterans. We have, however, lost some of our protective cultural rituals that used to be provided by society to warriors returning home from battle. Our troops are returning from deployments, but the wars go on. There doesn't make it easy to making peace and finding closure to all they've been through. So, we have to find other ways to support their journey home to our civilian world.

When they first return home, we have a unique window of opportunity to reach out and help troops with their processing of war. This was our great lesson post-Vietnam. If society checks out and absolves itself of its responsibilities and attention, no one wins. Not the veterans, surely – and not the larger fabric of society, either.

We know from PTSD research, that the first months and first year are especially important in laying down positive coping mechanisms and skills. Previous cultures seemed to have understood this more. They had cleansing rituals in place for their returning warriors that went far in washing their guilt and trauma and possible disillusion away.

Native American tribes, for example, put their returning warriors in the middle of community – they did not relegate them to their own hospitals and centers, far away from society. They also had community and individual rituals [returning warrior sent into the forest to place a gash on young tree].

But it's not just what we can do for's also what they can do for us.

For the past few years, I’ve been fortunate to be able to write a lot about issues that concern our troops returning from Afghanistan and Iraq and their families. I’ve found that those who aren’t tied to the military in a direct way often wonder what significance veterans’ experiences have to their own peaceful lives at home. We at home often don’t realize the full value of our returning veterans.

While some of us know we should be there for them as they return to us after deployment, many of us don’t realize that they are equipped to help us, too. Their knowledge and presence are more important to us as a civilian population than we realize. No matter where one is these days, one thing is certain: We are living in violent times.

We are surrounded by a warrior culture – even in such places as a Midwestern rural college campus nestled amongst cornfields that should offer a peaceful and safe respite amidst the din of the scarier world outside. But, when a lone gunman violated our quiet campus that February day, killing 5 students before turning the gun on himself, he proved that we are indeed vulnerable everywhere.

Veterans, of course, understand this. They can understand the pain and loss we at NIU felt that day. I returned home that afternoon to a concerned call from a friend who is a local Vietnam veteran. Asking how I was doing, he said, “Well, you’re one of us now. You’ve just survived your first IED [improvised explosive device] attack.” Our experience on campus that day – as brutal and violent as it was – of course, can’t possibly be measured in the same terms as those experienced by our troops patrolling enemy streets in the Middle East. But I understood what he was trying to say.

But there were other remarkable connections that revealed themselves to me in the days that followed the shooting. For example, one of the students killed that day was 32-year old Julianna Gehant. She was said to have loved children and was studying to be a teacher. She was also a 12-year Army veteran who'd served in Bosnia and Korea before returning to school to get her teaching degree.

At Julianna’s funeral service, Rev. James E. Kruse spoke of the decorated soldier’s life and the circumstances of her death. He speculated about Julianna: Was she the woman students heard calling for others to run from a shooter as he reloaded and prepared to strike again?

“I don’t know for certain, but she’s a hero in my mind,” Kruse said at the Holy Cross Church service.

I's also heard in the days after the shooting that at least one former veteran on campus rushed in to come to the aid of students who were wounded, dragging some of them out and giving them medical attention.

When I learned the name of the medic, an Iraq War veteran and former Navy corpsman and veteran of Kosovo, Afghanistan and Iraq, now NIU student who I'd been playing phone tag with since the previous fall?

It was Jeff that had gone back to class and warned others to lock down. He ran towards Cole Hall. He – who’d told his wife not long before the incident that it was nice to be somewhere people weren’t shooting at him – came to the aid on campus.

I met with Jeff a couple of weeks later and gave him a big hug. He was humble and showed little signs that his heroism was anything special. He and Julianna embody what it means to be the very best of citizens. They showed us that day how valuable our veterans are to our communities far and wide in such dark times.

Their efforts on campus that cold February day are far from anomalies, although they don’t seem to get as much attention in our media. I’d like to close with another recent example of the value our veterans have for us right here at home.

Just last month, another recently-returned veteran – this one a Marine who was coping with PTSD and had been warned by doctors to avoid stressful situations, like motor vehicle accidents, because of their ability to trigger flashbacks, etc.

As fate would have it, Jeremy Lepsch, found himself in the vicinity of just such a scene on April 7, when he came upon an injured motorcyclist lying on the side of the road bleeding to death. As reported in the New York press, Jeremy stopped his car and got out, dodged traffic to get to the injured man and placed a lifesaving tourniquet on his mangled left leg. He also reassured the man that he was a veteran and would help him, a federal border officer, as they waited for the EMTs to arrive. The border guard said a feeling of calm immediately washed over him. And Jeremy later explained that he believed the incident may eventually help him process his own survivor's guilt and pain from his days in Iraq.

While he couldn’t do anything to save his fellow battle buddies, stepping from his car that April day in New York Jeremy realized he wasn’t helpless anymore. He rushed to the aid of another in dire need, with very little concern for himself, and in the process may have taken the first step to save himself, too.

Earlier this month, he received a Humanitarian Award for his actions that day. But why does it seem we need to wait for tragedies to take place to find ways to show our veterans how valuable they are?

Yes, our veterans need us to help them to transition back into our communities.

But we fail ourselves and them miserably if we neglect to understand and show just how badly we need them, too. Let’s work to find ways to tap into the important resources that our veterans are – not only in times of community or personal crisis, but in our everyday lives as well.

I salute all of those who wear or have worn that magical military uniform that is no less wondrous to me today as an adult than it was to me when I was a child peering into my father’s special closet.

Our veterans are among our greatest national assets. Let’s be there for them.

But let’s let them be there for us, too.

bna2008_50As you can see, I try to do a lot for our veterans.

That's fellow keynote speaker and enigmatic Iraq veteran and reporter Rick Scavetta with his sleeves rolled up immediately after the day's summit, Navy wife and NAMI-TN's Carol Roy giving the hard-working guy a back rub, and me in the back making sure Rick's jacket doesn't get dirty. NAMI-TN's Kenny Allred snapped the photo and added real muscle to the flat-tire changing operation -- just as you'd expect from another veteran.

NPT's Nashville conference was a companion to a PBS special airing that evening, "Depression: Out of the Shadows," our summit was the brainchild of the great folks at Nashville Public Television. As NPT's Kathy Edson explained with a smile, "We're not only on TV." The "multi-dimensional PBS project explores the complex terrain of depression, to help people understand this debilitating disease -- and find reasons for hope."

An introductory clip (watch in full online):

I will write a more thoughtful piece on what we learned at the gathering and plan to submit it to NAMI-TN for possible publication. In the meantime, enjoy some more photos courtesy of Kathy and Kenny...thank you all so much for planning and hosting such a remarkable event.

Tennessee is doing some remarkable things.

So glad to have had the chance to join with you and watch your plans take shape, bloom and hopefully grow.

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