For me, when serving as an Army trauma surgeon in Vietnam, the question was: Is the Hippocratic Oath rewritten in a combat zone when abiding by the moral code of war, not peace?
I witnessed first hand the devastating effects of war on body, mind and soul. The mystery was: Why are some combatants killed, others severely wounded, some slightly wounded and most not touched at all.
The fact is the warriors and treating physicians existed in a moral limbo, vacillating between both the moral codes of peace and war. In Vietnam, when I triaged a mass causality in the ED, I condemned the very most seriously wounded, who may have been salvageable, to death in order to preserve resources to treat others with a better prognosis. Because I was “on call” one day, I had to actually surgically “cut” a soldier in half (Hemicorporectomy) in an attempt to efficiently treat his disastrous wounds.
These encounters certainly challenged and repositioned my moral compass. Yes, I was changed forever and sometimes I react to my environment with PTS in control.
I am convinced that there is a positive effect in relating history when the writer was actually a participant in the events. Experiencing years of introspection coupled with retrospection also allowed me a more objective, refined and informed approach.
Our nation inducts young citizens (average age twenty-two years), with brains that still respond to adolescent impulses, into the military and exaggerate their natural lack of control through indoctrinating the military culture and pursuing training that creates the worlds best and most effective warriors.
The problem lies in the fact that our country does nothing to rehabilitate the returning veteran in assisting his attempt in re-entering a peaceful society.
Remember all of who serve suffer to varying degrees from PTS; it’s to be expected when thrown in to such an extraordinary life changing experience.
The veterans body may be back home but his psychology of coping is still defined by the military culture and war zone experience. His unit is disbanded and therefor, all support mechanisms. The veteran is discharged to “sink or swim.” The result of this approach covers a spectrum from veterans who have the ability to hold it together and those who suffer overt PTS to the victims who chose suicide as the best alternative to achieve relief from his overwhelming demons.
My wish is to relate a truthful accounting of war, through empathetic and sometimes humorous story-telling, and equip the reader to better understand war's devastating effects on body, mind, and soul and how easily we in recent decades have ignored these and other historical lessons.
I also present a hypothesis for the etiology of military PTS(D) and an effective preventive measure, prior to discharge, to help mollify the development of a warrior’s PTS(D). The US Air Force has successfully implemented a similar program; it’s the Deployment Transition Center in Ramstein, Germany.
Is not the prevention of a disease more acceptable both for humanity and incurred economic expenditures than chasing a cure for that same illness after it is established?
Ninety-six photographs reinforce the written word. Some images are quite graphic.
