Hidden Wounds: Healing after a soldier's homecoming
The idea that war gives meaning to life is troubling to many of us, especially now as we think about our soldiers coming home from long years at war. Drawing from his own war experience, Ernest Hemingway spoke to the worry: “Certainly there is no hunting like the hunting of man, and those who have hunted armed men long enough, never really care for anything else thereafter.”
But as I talk to scores of soldiers returning from the grinding ground wars of the past decade, few are hankering for killing or being killed—if that is what Hemingway meant by war’s ultimate intoxication. Most simply want to find an equable peace with what they did and suffered in war. And they know that this involves understanding the moral implications of their individual wars. Indeed, finding meaning after war is in large part about finding moral meaning in war. And the keyed-up tempo of war, the hypervigilance and emotional disconnection—each its own kind of intoxication—make coming to understand the moral meaning even harder. Yet that is critical for healing.
Typical is the remarkable story of Joshua Mantz. On April 21, 2007, Capt. Josh Mantz died in Baghdad and came back to life after flatlining for 15 minutes—long past the time doctors routinely mark as the cutoff point for lifesaving measures, given the likely damage to the brain without vital signs. Not only did Captain Mantz survive; he returned to his unit five months later to resume his platoon command. Yet despite the remarkable revival and media tour as the resilience poster boy for the Department of Defense, Captain Mantz emotionally crashed four years later. “It’s the moral injury over time that really kills people,” he told me recently. “Soldiers lose their identity. They don’t understand who they are anymore.” And he added, “Society is oblivious to what soldiers go through.”
What specifically weighs on Captain Mantz is that he survived, but his staff sergeant, Marlon Harper, did not. The details are wrenching: Captain Mantz was guiding his troops near the Shiite rebel stronghold of Sadr City when a sniper’s bullet penetrated Staff Sgt. Harper’s left arm, severing his aorta. The hot molten round fused with Sergeant Harper’s armor plate forming a projectile the size of a human fist that ricocheted into Captain Mantz’s upper right thigh, severing his femoral artery. Injured and dazed, Captain Mantz administered first aid to Sergeant Harper as he waited for medical assistance. A young medic arrived and immediately went to work on Captain Mantz, not Sergeant Harper, probably because an aortal wound is less viable than a femoral wound. Having died and returned “didn’t bring me closer to God,” Captain Mantz says. “‘Ah, He must have great plans for you,’ people say. But what about Staff Sgt. Harper? I ask.”
In The Untold War I write about the moral injuries soldiers endure. Some are like those with which Josh Mantz struggles, feeling the guilt of survival, of having luck, miraculous luck and state-of-the-art medical interventions on one’s side and yet experiencing that good luck as an awful betrayal of one’s buddies. But as Captain Mantz’s story makes clear, moral wounds demand moral healing. Experts in military and veterans’ mental health are now trying to articulate just what that healing would look like and how treatments overlap with or are critically different from those routinely used to treat post-traumatic stress. But the general issue of moral healing from moral combat injury is not just for experts.
For 2.2 million service members deployed over the past 10 years to Iraq and Afghanistan, of whom thousands are re-entering civilian life this year, moral injuries will be part of that re-entry. Unlike lost legs and arms and missing eyes, these wounds will be invisible, and soldiers may keep them hidden. Many will not talk to one another or to civilians about the moral hurt or the incidents that caused such anguish; some cannot easily process what happened; others will feel shame, which they will cover with a respectable sense of guilt; still others will feel guilty for not feeling the guilt their buddies experience. Some will self-medicate with alcohol or drugs. Others may just go numb until something snaps and stops the numbness from being protective.
In Captain Mantz’s case, the real psychological recovery began only after he realized that he was alive but emotionally dead. The emotional withdrawal was killing him. Downrange it made for survival; it allowed him to operate with fearlessness, with an almost stoic indifference to whether he lived or died. He did not become reckless but was freed from unproductive worry about whether he would come home. “The moment you stop caring about living, there is a great sense of freedom,” he tells me. It is that liberation, “operating as above life and death,” that allows you to “operate in and control chaos.” You have two options, he said, when patrolling streets in East Baghdad “lined with cinder blocks of trash as far as the eye can see,” each the possible site of a homemade bomb. “You either stop at every rock and call E.O.D. [Explosive Ordinance Disposal] and wait for four hours until they go and check it out, which is unfeasible. Or you just say, ‘Screw it’ and you drive forward and you accomplish your mission. That’s what we all end up doing, all the good units anyway.” But that same indifference to life and death is also indifference to social connection. “That restriction that comes with caring is no longer upon you any more,” says Captain Mantz. “But it is also the point where emotional contact is severed.”
In short, numbness to fear is also numbness to living with zest, passion, commitment and connection—the very elements of “embrace” necessary for finding meaning in life. But finding meaning in life, about which Susan Wolf has written well recently in Meaning in Life and Why It Matters, involves both feeling engaged and believing one’s activities are worthwhile and worthy of esteem. For some soldiers, this requires reconciling a past and the realization that they have wasted lives or engaged in futile efforts. Futility is essentially meaninglessness; without some resolution, it bleeds into the present and can leave a person with little taste for living.
Army Major Jeff Hall has struggled with that emptiness. He served as an infantry commander during two tours in Iraq in 2003 and 2005. Though trained to engage and destroy the enemy, shortly after the occupation of Baghdad, Hall (a captain at the time) found himself deep in the softer warfare of counterinsurgency operations. During one deployment, he was in charge of an area that included 250,000 people. “I was essentially the mayor, concerned with their security, their sewers, their water, their medical needs.” But what he was ordered to do was often inadequately supported. He felt betrayed and forced, in turn, to betray those who depended on him. Referring to his post-traumatic stress disorder, he said: “You have to understand. My P.T.S.D. had everything to do with moral injury. It was not from killing or seeing bodies severed or blown up. It was from betrayal, moral betrayal.”
One incident, from his first deployment, still sears. He was charged to find and comfort the relatives of a family killed as they were driving home from church. Their car was caught in the cross-fire of a U.S. attack on a high-value target in the Mansour District of Baghdad. He eventually found the surviving daughter and uncle and over many cups of chai assured them that condolence money would be offered and that he would personally help recover the bodies for a proper burial. But the compensation money offered by his command turned out to be a mere $750. He endured endless delays and bureaucratic nightmares trying to secure the bodies for interment (during which time, unembalmed, they rotted in the scorching summer heat and became unrecognizable). The final indignity came when the death certificates were stamped with the word “ENEMY” in bold red letters. Hall was in disbelief: “Can’t you give me something without ‘Enemy’ on it,” he pleaded with the Iraqi Ministry of Health officials, partnered at the time with the American coalition: No, they insisted, “They are considered enemies.”
Without much of his usual arsenal as a warrior in this mission, Hall needed to be able to trust his own goodness to help civilians who had already suffered grievously at the hands of Americans. It had become an intimate, personal duty, not just a soldier’s obligation to ameliorate collateral damage. But his command betrayed him and compromised his character. He felt far more powerless and captive than he had ever felt in facing enemy fire. “What really hurts,” he tells me as he reflects on the futility of missions such as these, “is that I had to make my soldiers believe in something that I didn’t believe in.”
How to Heal
So how does someone like Maj. Jeff Hall or Capt. Josh Mantz heal? What role can civilians play in that healing? There are no easy answers, and compassionate understanding is not enough in the absence of well-funded programs, both governmental and nongovernmental, to support the physical and mental health care of service members and assist their families with education, housing, jobs, nonpredatory loans and much more.
But even so, civilians should not underestimate their role in a civilian-veteran dialogue. At the heart of such dialogue should be safe places to talk, whether in classrooms or public libraries around shared readings, for instance, or in town meetings where civilians and veterans watch and react to a drama with war, contemporary or ancient, as the theme. One such play is “Ajax,” by Sophocles, which has been performed in military and civilian venues around the country in the past few years by a troop called The Theater of War. Ajax, a great and fabled Athenian warrior, “the bulwark of the Achaeians,” as Homer calls him, is profoundly dishonored by his command when denied the prize of Achilles’ shield. The disgrace triggers his own madness and missteps, and in an unparalleled moment in Greek tragedy on stage, he takes his own life. It was after watching a performance of “Ajax” that Major Jeff Hall first told me about his shame, which nearly led him too to suicide.
Shame and guilt need social healing, but they also need self-healing. Self-empathy is critical in order to surmount the corrosive effects of self-loathing and self-reproach at the core of those emotions. One of my students, Tom Fiebrandt, a former Army sergeant and intelligence analyst stationed in Tal Afar, Iraq, taught me something about self-exoneration. For months he was rattled by his inability to prevent the death of a buddy, Lt. William A. Edens, who was gunned down by sniper fire while trying to block an egress route out of Tal Afar in preparation for a door-to-door raid planned for the next day. Sergeant Fiebrandt was out of the country, away from his unit, on command-ordered rest and recreation in Qatar when he learned the news.
What bothered me was that it was in an area that I knew very well. It was in a part of the city that you really had to see in order to visualize. And I had this lurking suspicion that my soldiers, who had never actually, personally been there didn’t really have a grasp on all the information that I felt I did. In some way, I almost felt responsible for not being there to provide them with the information that may have potentially resulted in a different outcome. So it is rough. It is a difficult thing for me to process…. So here I was sitting by a pool, and I hear this. It was—I don’t even know how to describe it. It was—devastating.
He is sure that if he had been there when the raid was being planned, he would have recommended that Eden not take that road. So he felt responsible for having knowledge that could have prevented Eden’s death. Yet he realized that he could not have known in advance that that particular bit of information—about that street on that night—would become relevant and somehow should have been conveyed to his team before he left.
Once home, over a beer with his older brother, he began to talk about the incident for the first time, reframing the situation in a way that made it possible for the guilt to start to dissipate. He realized that as an intelligence analyst, there would always be “gaps in his knowledge,” as he later put it to me. “I couldn’t be the person that was there all the time. I could only be in one spot at a time. I was never going to be the one-stop intel analyst for the whole Army. Maybe my role was actually very small.”
What healed Mr. Fiebrant, in part, was self-compassion and fairness. It was not softness or mercy or clemency. He came to realize that the sentence he had imposed on himself simply did not fit. Reconstructing what happened in a conversation with me, he thought he was probably more like an off-duty cop who had some relevant knowledge but was not there to give it than he was like a negligent parent who never got around to putting up a fence around a backyard pool and then discovered that a child had wandered into the pool one day and drowned.
Mr. Fiebrant came to self-empathy, sustained by trust in others and a belief that they could listen to what he was about to say. This is where civilian support enters. It is not easy to tell those who have not been to war about war. It is not easy to tell the details, not only because it may involve blood and gore but because it involves shame and feelings of helplessness. The more safe places we can create for soldiers to speak, the more we will help them to heal. We will also be honoring our own moral obligations in sending them to war.
View video interviews with Nancy Sherman.
Denis Demers, PhD, LMSW