“Nothing.”
“I can’t help you without some history about what has happened.”
“I told you. I don’t want your help.” His unbroken gaze penetrated the space between us. He was no longer smiling.
“Okay, fair enough. Let’s talk about something else. What can you tell me about shouting at your Ka-bar [the Marine Corps–issued knife] in the shop the other day?”
“She pissed me off. I later apologized.”
“Your Ka-bar pissed you off?”
“Yeah. But these things happen.” He began stroking the muzzle of the M16 on his lap. “She understood. Just like this one — she does, too. It’s not a good thing, you know?”
“What’s not a good thing?”
“The sun. If it’s allowed to penetrate directly, it can actually derail a train.”
“We were talking about your Ka-bar.”
“Don’t you think I know that?” he said angrily, the volume of his voice increasing. “Of course I do. It’s all just a matter of timing.” He jerked his head and stared at the far corner of the ceiling. I followed his gaze.
“Are you looking at something up there?”
He refocused on me. “No.” He chuckled. “You think that’s what this is about, don’t you? It’s not like I never sang in the church choir, okay?”
“Okay. Do you mind if we talk about your Ka-bar again? I am having a difficult time understanding what you are telling me.”
“You are making fun of me.” He narrowed his icy eyes.
“No, Private. I am absolutely not making fun of you. I am trying to understand, Private.” I used his rank often in an attempt to defuse his obvious agitation, to remind him he was a U.S. Marine. It appeared to work. The boot he had been tapping on the deck stopped for a moment.
Just then, Petty Officer Patacsil knocked. I asked the patient to excuse me and closed the door as I exited the room.
“Ma’am,” Patacsil said in hushed tones. “I talked to the hospital. He was admitted last year, right after he got to his first unit. He remained on the psych ward for — get this — two weeks. His working diagnosis was schizophrenia, but the records show he was returned to duty.”
Schizophrenia is a psychiatric diagnosis that refers to psychotic symptoms such as hallucinations, delusions, and other disorganized thinking.
“How strange,” I mused. “He must have made a full recovery without meds, and they must have changed their minds about their original diagnosis. Maybe it was due to a head injury or drugs. Any mention of other collateral information?”
“No, ma’am.”
“Okay, thanks. Hey, hang around out here, all right?” He nodded. I was thankful to know he was right outside.
I re-entered the room. The patient was tapping his foot again and grinding his teeth so loudly I could hear them.
“What was that about?” he snapped. “I know what you’re trying to do. You want to fillet me, like a fucking hamster.”
“My corpsman called the hospital to find out about your stay there, Private. They said you were there fourteen days, not three.”
As quickly as it had arrived, the look of agitation left his face, replaced by unnerving calm. He smiled without showing teeth.
“Does your husband ever forget your birthday?”
“I beg your pardon?”
“People forget things. It’s anything but an admission of guilt; I just want you to know that.”
“Private,” I began softly. “I have to be honest with you. I am concerned that you are having some difficulties out here that require medical attention.”
He squinted maliciously at me. The volume of his voice rose with each word until he was shouting. “What are you talking about? I never asked for this. My Ka-bar is fine. And you — you only wanted to fillet me anyway. None of this makes sense. I want to leave now.”
“I would like you to come into the hospital,” I stated firmly. “We can make sure that you are safe there.”
He stared at me, unblinking.
“Private, please, let me help you.”
In one fluid motion, my patient swung his M16 around on his lap so that it pointed almost, but not quite, directly at me. In an instant, I noticed that the magazine was inserted and his finger was resting above the trigger.
“I want to leave now,” he repeated, teeth clenched.
“Sure. Sure, go right ahead.”
The rifle remained pointed in my direction as he stood up and moved away. He opened the door, swung the weapon over his shoulder, and nonchalantly walked out past Petty Officer Patacsil, who was hovering there.
I sat motionless in my chair for a moment, stunned by what had just transpired. As I replayed the session in my head, I remembered my Management of Violent Patients course during internship, where we learned how to subdue and restrain psychiatric patients, if needed. There was never any mention of what to do if a patient aims a loaded rifle at you, I thought.
I walked into the passageway, amazed that I could force my weak knees to move. I asked the Gunny to brief his CO that the Marine needed to be restrained and brought to the hospital. I asked Patacsil to tell the medevac team that I would be sending a psychotic patient out of country as soon as they could get a helicopter.
The four hours it took for the private’s unit to deliver him to the hospital felt like weeks. He arrived unarmed and subdued, and walked quietly to the ward. Jason assumed his care at that time, to avoid the possibility of agitating the patient with my presence.
I happened to be in the ward as the medevac arrived and the patient was escorted out to the waiting helicopter. I sat in the nurses’ station and waited.
The roar of the rotor blades increased as the helicopter lifted off. The private would return home, where a team at the naval hospital was waiting for him. He would be treated and then medically retired from the Marine Corps, with Veterans Administration disability for a psychotic break on active duty.
I sat down for a moment and closed my eyes. They stung mercilessly. The night before, we had crossed out day 112 on Jason’s wall calendar with a bold red X. According to our conservative estimate, we were exactly halfway through the deployment.
The fatigue, or that blast furnace of a summer wind, was starting to take its toll.
The Best We Could
Early one morning in the week before Memorial Day, a brown Humvee skidded around the corner near the hospital and screeched to a halt in front of the building. The driver leaped out and sprinted inside, tripping and falling with a crash at the front desk. His anguished, screamed words echoed through the passageways of the facility.
“Someone help me!”
Within seconds, five of our corpsmen stood at the rear entrance to his vehicle and carefully lifted a young Marine onto a gurney. The patient’s desert uniform was soaked with blood. Our litter bearers moved through the front door, one of them starting CPR as they progressed down the hall to the SST. A crimson trail dripped behind them, marking their path.
Several minutes later, three men and one woman emerged from the Humvee, moving as if in a trance toward the hospital. The woman’s hands were completely red. She stopped in the front lobby, saw the blood on the deck, and raised her hands to her face. She paused a moment and then ran her fingers through her light brown hair.
All four were covered with blood. Surgical company corpsmen ushered them toward the sick call area. Despite the dramatic stains on their uniforms, none of them was injured. My combat stress team was called soon after.
When Petty Officer Gob and I arrived, the corpsmen at the front desk of the surgical company filled us in on what had transpired. We moved into the triage area and found the three men and one woman sitting together on a cot in the passageway, all of them staring vacantly at the deck. We introduced ourselves and escorted them to the small waiting area near the OR, providing cold bottles of water and rolls of toilet tissue.
They drank. A few poured water onto their hands and splashed it on their faces. The woman,
whose cheeks and eyes were streaked with bloody fingerprints and whose hair was matted in wet red clumps, made no move to rinse off. She gazed at her boots with unblinking eyes. Her collar insignia identified her as her unit’s corpsman.
Our company commander touched me lightly on the shoulder then, whispering that the Marine in the SST had passed away. She said that the surgeons were still with other patients. Could I handle telling the group? Stunned, I said nothing. She took that as a yes.
I peered in the doorway at the foursome. One of them was a junior officer, a chaplain. We made eye contact, and I asked him if we could speak outside.
“Chaplain, I’m sorry to tell you, but the Marine you brought in today has died.”
He gasped slightly, biting his lip. His eyes immediately filled with tears. “Oh no,” he said. “No. Not this boy.”
“I am very sorry for your loss,” I whispered. He nodded.
“We are a reserve unit,” he explained, tears streaking his dirty cheeks. “Some of our members have been together almost twenty years, including — including this boy’s uncle, who is out here too.”
My eyes widened. “What a loss for your unit. It sounds like you’re very close.”
He nodded.
“Chaplain, would you like to tell your colleagues the news of your Marine’s death, or would you like me to do it?”
He straightened his shoulders. “I’ll do it. It should come from me.”
Gob and I entered the room with him. The two Marines and the corpsman looked up. The chaplain started to talk, but his words became tangled in the sob that burst from his throat. “You tell them,” he whispered, and he crumpled into a chair, lowering his face to his hands.
I faltered, realizing I did not even know the Marine’s name. I started speaking empty words, stating that although we had tried very hard to revive their colleague, his injuries were too serious . . .
I did not finish my sentence. There was no need.
They began to cry. The three men rose from their chairs, moved to the corpsman, and kneeled on the hard tile beside her. They wrapped their arms around her tightly as she wailed in despair. Gob and I slowly backed out of the room.
I walked to the lobby to make arrangements with our front-desk clerk to meet the reserve unit’s CO when he arrived. As I started to return to the waiting room, a movement caught my eye.
Petty Officer Tomat, a corpsman from our company, jumped down from the back of the Humvee still parked in front of the hospital. I watched as she carefully lifted a large bucket from the vehicle’s open hatch and proceeded to dump it out in the sand. The water was dark red. She walked to the entrance of the hospital and began to fill the empty bucket with sponges and towels, preparing to put them away. I approached her.
“Petty Officer Tomat, did someone ask you to clean this vehicle?”
“No, ma’am.”
“Why did you do it?”
She shrugged. “I just didn’t want those guys who lost their friend to have to do it.”
She picked up the bucket and stripped off her gloves.
“They’re all our Marines, ma’am. It’s just what we do.”
I returned to the OR waiting room. The four of them still sat together, weeping softly. Gob hovered in the passageway. His eyes told me he was standing by but that his services had not been requested.
As the two of us moved away from the door, pulling it closed to allow them some privacy, the four people inside moved together, arms wrapped around one another, to form a tight circle. All four heads leaned in to touch in the center. As the door clicked shut, we heard one of the men repeating the same words over and over.
Although I knew he spoke specifically about their situation, I found myself strangely comforted by his words. After all, they applied to us, too.
“We did the best we could.”
HOME
I met Margy and Colette in flight surgeon school, and they became my best friends in the Navy. All three of us fell in love with Marine officers. This was a source of constant entertainment for the men in our lives.
Margy’s husband, Hunter, a Hornet pilot, had deployed with a Marine ground combat unit as an air officer during the initial invasion of Iraq in early 2003. (Marine Corps avi-ators regularly serve with ground units to coordinate air and ground combat operations.) After several long, dark months of no communication with him and constant worry, we were tremendously relieved when he came home.
The night before I left for Iraq, Hunter gave me his leather pistol holster, along with words of advice and concern that could only have come from someone who had been there. And one day in early June, he wrote to me.
From what I’ve heard, things have heated up again. I’m sure you understand now what I was trying to tell you before you left. The hardest thing is to retain your composure when Marines get killed or badly injured. I know how you feel.
It was the most challenging thing to me to force myself to keep it together when I felt like I was going to lose it and say, “Is this worth it?”
Just know that it is. The junior Marines and Sailors around you are looking to you for strength and positive guidance. Our colonel was great at keeping everything in perspective. I hope there is someone of that caliber there with you to help guide you in the right direction.
I can’t tell you how appreciative Margy and I are of what you are doing. We talk about you every day and pray (I don’t do that very much) for your speedy and safe return. I wish you were not there, but at the same time, I’m very glad that you are. The Marines need someone like you there. You are their “mom” for lack of a better term. I know it has a very positive impact.
Margy and I just got back from our Memorial Day retreat to (of all places) Joshua Tree. I hadn’t been camping in the desert enough, so off we went. It was like old times, except no one was shooting at me.
Keep your head down and your Kevlar on. XOXO, Hunter.
Hero,
Part II
One day in mid-June, I found some time to get to the Internet café and check my e-mail. The from line of one of my messages caused me to freeze at the keyboard.
It said Deb Dunham (Jason’s Mom).
I paused for a long minute before opening the e-mail. It was written to both Karen and me, and started Dear Ladies, my name is Deb Dunham. Corporal Jason L. Dunham is my son.
I drew in a sharp breath and felt the tension in my fingers as they gripped the mouse. I was aware of a sensation of two large hands gripping my intestines and squeezing. I read on.
I received a copy of the letters that you sent to Mike Phillips. As Jason’s mom, I need to thank both of you remarkable women. The reason I am writing one letter to both of you is — I don’t think I can write this more than once.
She continued, describing her worry about Jason’s deployment and the discussion she and her husband had had with their son when he was home at Christmas regarding his wishes should he be injured in Iraq. She shared the details of the night they received the call with the news that Jason was in critical condition. She told me that she started out praying he would be all right, but then suddenly, in the middle of the night, changed her prayer to ask God that her son not be alone or afraid.
To the both of you, I will never be able to thank you enough for taking such good care of my son. I could not hold his hand, talk to him or help him in any way. I thank you for doing what I wanted to do for my son as his mother, but was not able to do.
She described seeing her son at Bethesda. She told me that they considered it a great gift to be present to witness the “peace on his face once the pain left his body.”
Tears flooded my eyes and blurred the letters. I closed my eyes tightly for a moment and then refocused on her final words.
Some reporter asked my husband if we were not proud of our son for dying a hero . . . Heidi and Karen, you are definitely my heroes and I will be thanking God every day for the rest of my life for the part you played in taking care of my son.
Much love t
o you, Deb Dunham.
I clasped my hands together in my lap. They were trembling violently. My chest shuddered with every breath. My attempts to keep my tears unnoticed by the Marines sitting around me were useless. Several of them stared. I sat frozen for a long minute and sobbed silently. From that moment forward, I knew — as I closed the e-mail, gathered my things, and left the room to find Karen — I would never be the same again.
HOME
I wrote an e-mail to my group of family and friends in late June to share the wonderful news. In the middle of my clinic that morning, my radio had crackled: “Oscar Four Kilo, this is Oscar Four Bravo.”
“Go ahead,” I said.
“Just wanted to tell you that Rhys has arrived.” The elation in Jason’s voice was obvious, even over the radio. I squealed in delight and told him I’d be right there. I ran the whole way.
He had been calling his wife after breakfast every possible day for the past month, I wrote to my e-mail group. This morning she did not answer the home phone, so he called her cell. She was at the hospital, in labor. He stayed on the phone the entire time, even hearing the baby’s first cry.
In my e-mail home, I described our baby shower celebration. Bill, Steve, and I ordered an outfit from Baby Gap, and we hung IT’S A BOY streamers around their barracks room. Blue balloons, paper plates, and Hostess cupcakes with candles stuck in them created a small but happy party in honor of Jason’s new son.
Jason smiled at us with genuine thanks. But I saw the pain in his eyes. My babies were not babies anymore; they were twenty-one months old, but I felt it nonetheless. And I understood.
A baby shower in Iraq. Once again, I wrote that day, two concepts — like combat and mental health — that seemed mutually exclusive.
The Optimists
Our Independence Day was celebrated in Iraq with a small barbecue and no fireworks. Since then, the scorching days dragged on, bad copies of one another, with each morning’s intelligence report including the same weather forecast: “Hot, windy, and a high of one hundred thirty-two.” Despite my best attempts to stay in the shade, the thick sleeves of my uniform occasionally did come between my arms and the sun. I remained as motionless as possible at those times, hoping the cotton would not touch my skin. I could almost hear the sizzle if it did.
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