Battle Mind

They are not your typical psychiatrists, social workers, and mental health nurses. The 883rd Medical Company, Combat Stress Control is a reserve unit tasked with overseeing mental health care for soldiers on deployment. Headquartered in Boston, part of the unit is now in southern Afghanistan. <br/><br/> Mental health care in a combat zone requires a complex balancing act. Stress in a life-threatening environment is a normal, and even highly adaptive, response- "a normal reaction to abnormal events." The trick is maintaining it at manageable levels. The Army used to refer to this as maintaining the appropriate "Battlemind."... Faced with the seemingly contradictory tasks of providing care for their soldiers, while "keeping them in the fight," requires a level of empathy and commitment not often demanded in the civilian world. It requires an understanding that the great majority of soldiers want to stay with their units; a willingness to travel by dangerous routes, to dangerous places, and the recognition that sometimes, despite this care, or, perhaps, because of it, a soldier may lose their life. None of this comes without cost. You try to support the soldier, but the soldier still has to continue their mission... I've had clients, I worked with them for a while, they went out, did their thing, they were good for a couple months, and then--it was just an unfortunate day...and its difficult to be that provider, and put that soldier back together, after they're a complete mess, and you build them back up, and then they go out, and they don't come back. That's the hardest thing for me....It's hard. It's a tough job. It's a very, very tough job. <em>Michelle's a single mother. Her daughter (pictured) joined the military five years ago, and is on her second tour as an MP sergeant in Iraq. When Michelle's son graduated high school and became independent, she joined the military herself. She's been in one year. As a PFC, is outranked by her daughter.</em><br/><br/> I just thought, I've done so many things, and this would be a new path for me. I was trying to find myself, now that the kids had grown. My whole life really was trying to just raise the kids. ...Well, you have to picture it. You have to picture a bunch of these young, high-speed death machines out there trying to do their job, and something really shitty happens, somebody gets killed. More often than not it makes it worse because these poor kids can't do anything about it. This isn't a conventional war. I mean, people get shot at, but they are more likely to be blown up. So there's no enemy around. There is no retribution. ... I consider a catastrophic event when there's only a photo at somebody's funeral. <br/><br/> I don't want people to go home with this stupid crap ...in their heads, in their hearts and sweating it, because there's just no point in it.<br/><br/> We're in mental health. There's something wrong with us. It's not as bad as it used to be, but I don't think everybody wants to be a behavioral health tech. [It's hard] taking some reservists and getting them to go from civilian to full time soldiers. Many of them aren't ready. Many of them haven't been deployed before. Many of them haven't been on active duty. Some are young. And you tell them, "Listen, you're going to be part of the big green machine now." And you're going to be that way 7 days a week, 24 hours a day. <em>Colonel Gomez had been in the reserves 20 years when he was sent retirement papers in 2001. He never sent them back. He was forcibly retired due to age in 2009, but requested, and was granted, an exemption. The normal tour of duty for a practicing physician in the reserves is 3-4 months. He's been in Afghanistan 17 months.</em><br/><br/> Human beings have limitations. That, even if they feel that [the soldier] is very resilient, there comes a time when stress overcomes them... and so you have all these emotional reactions--depression, anxiety, irritability, sleeplessness, anger. There I was at my active duty unit. I got my orders, and my NCOs were like, "I'm so sorry that we're sending you with reservists. I hope you make it back alive. Cause they don't know anything." ...That's the stigma...What are they sending me into?<br/><br/> But I was astonished by this unit... As we were training...what I noticed was they had more military knowledge than I did... they had all this military training and knowledge. And honestly, they were more equipped and ready to deploy than I was. [I see] Soldiers who were blown up by IEDs and soldiers who were with them and having to witness just the horrible trauma that was inflicted on these soldiers. I mean, I've heard from soldiers where guys have gotten blown sixty feet into the air, in pieces.<br/><br/> I let them talk. I always hope that I'll have something profound to say but I never do. A lot of times they just need somebody to listen. I've cried with soldiers in here. And given all of the sacrifices that [the soldiers] make, this is allowing someone to do something for them as payback. Receiving treatment could be considered a gift. Someone is giving yourself the gift of support. You...give, give, give, sacrifice, sacrifice. So take the time to receive. In the beginning, before I'd ever gone out, I didn't want to go, because I was scared. How can I do my job if I don't really know what they're going through? And so, I went on my first convoy, I made it through that, no problem. But the biggest thing for me was the look on the gunner's face, because the gunner was actually one of our patients, who had had a really hard time. And when he saw me getting into his vehicle he kind of just said, "Oh, my god." And I said, "What?" And he's like, "Why are you going with us? Are you crazy?" And I said, "I guess that makes me pretty crazy." <em>CPT St Cyr was born in Haiti and educated in the US. In his civilian job, he works at a VA medical center as a psychotherapist in their post-traumatic stress clinic. He works with veterans of World War II, Korea, Vietnam, Iraq and Afghanistan.</em><br/><br/> The symptoms [of PTSD] are the same, regardless of the type of war. The experiences veterans relive are pretty much the same.<br/><br/> World War II, for example, After 65 years some of those veterans, who are now in the 80s, are now coming forward with full blown PTSD. And the symptoms are the same with the veterans who just returned from the Iraq or Afghanistan war. One time I was going to do a funeral detail, and I was in my dress uniform and I was taking the T--the red line--I was going to South Station. I'm wearing my dress uniform and I've got all my decorations on. And one man said to me "I don't think we should be in Iraq." And everyone on the train looked at me. And I looked at that man and I said to him, "I don't recall seeing you there." So you get a mixed reaction. Some people are supportive, some are not. It's their right... ...I don't make foreign policy. I go where I'm sent and do the best job I can. The reality is that nobody signs up to do this job knowing what it actually is. And the people who persist, in spite of finding out what it is, there is something very valuable to us all in their existence. They're not out here playing soldiers. They're out here fulfilling a commitment in a way that is very painful and costs them a great deal.<br/><br/> It's our job to make it cost just a little bit less.