We opened this series on mental illness with Hermine Hull’s touching piece about her struggles with depression (bit.ly/HHDepression). Martha’s Vineyard Times contributor Jonathan Burke, who lives with mental illness himself, has been writing about Islanders who have suffered from schizophrenia, bipolar disorder, anxiety disorder, and eating disorders (bit.ly/MVMentalillness). At that link, you can also find Dr. Charles Silberstein’s monthly column, “On My Mind,” which addresses mental health questions and issues.
Island veterans affairs administrator JoAnn Murphy estimates that there are 350 veterans on Martha’s Vineyard, and about 30 are being cared for at the Island Counseling Center for PTSD.
This is one man’s story.
The bunker is a cozy one.
There is a full-size bed in the corner of the room. A happy four-legged creature is nestled into the quilt. Opposite the bed, on the other side of the room, is a worktable. The table is built into and runs the length of the wall. The walls of the bunker are of exposed pine.
Steve and his wife have a house on their property on the Vineyard with modern amenities such as running water and insulated walls. But they sleep in the bunker. In the 25 years of owning their home, Steve, who was a combat medic in Vietnam 50 years ago, has not slept a single night there. He does not feel safe sleeping outside of his bunker, and sits at his worktable during our interview. His instruments — his guitars and banjos — stand in a semicircular arrangement around him and the work table. Since his return from Vietnam, he has suffered from post-traumatic stress disorder (PTSD). The importance of the safety of a bunker and a secure perimeter has not left him.
The war — both during and after — troubled him deeply. He felt the war was fought on a bogus rationale. The death of civilians in the war troubled him the most. Every mission, he said, was questioned: “Why are we continuing to put ourselves in danger when all of us know … that it’s immoral?” he asked. The “intense horror” of the war, he says, rewired him.
“In Vietnam, in combat situations, you go from A to Z [snaps his fingers] like that, in terms of modulating one’s emotions and reactions … You can go from serenity to rage, from relative calmness to intense hostility, aggression and anger.”
After Vietnam, he carried with him the emotions of the war. For three years, he was unable to hold a job. Inevitably, something would cause him to lapse back into Vietnam. He would become angry and lash out. Often, the trigger was a moral issue.
In one instance, he confronted a boss who was misusing funds intended for a program for people with disabilities. “I was pretty loud and pretty clear,” Steve said. “There was no room for negotiation. It wasn’t a discussion. It was an accusation backed up by observation.” His boss fired him.
This happened a few times.
“I guess it had a lot to do with my experience in Vietnam,” he says. “Being told to do things by people who had not really thought it through … I was sensitive to that … having to do things that I considered to be unethical.”
There was, he said, a certain satisfaction from the outbursts when back home.
The war was over, and he had his morality back. He no longer had to do whatever he was told, and to participate in things he considered unethical. Now he could object.
As a medic, he often was called in to “dust off” civilian casualties. Civilian casualties were considered “the wages of war.” In missions to clear a bridge or a village where the VC were hiding, such casualties were inevitable.
In one instance, when he was new in country, he helped carry a stretcher with a wounded villager off a helicopter. It was 3:30 in the morning. The man had a head wound, and part of his skull fell to the ground. Steve had to pick it up and put it back on the stretcher. It was clear the man was dead. The wounded man’s daughter was standing off to the side: “I went to try and console her, and that’s where I learned we had no business doing what we were doing because we didn’t understand the whole nature of the Vietnamese people …”
The war became personal to Steve. The war to him was not about keeping the world safe from Communism. It was “human to human, not ideology to ideology.” The Vietnamese people — all they wanted to do was to grow their rice and raise their ducks with their pigs and their water buffalo — “what I considered to be a peaceful spiritual existence.”
Instead, the civilians were pawns for both sides of the war.
“It just became unbearable,” he says.
Steve blames himself for the death of a fellow soldier.
As a medic, he sometimes was given the task of evaluating soldiers with possible psychological issues. There was pressure from command not to excuse from duty soldiers who were regarded as malingerers — those that just wanted out from combat. Steve felt that pressure.
In one instance, he cleared a soldier for duty. “[I] Interviewed him and got to know him a little bit, and determined he was fit for duty … he told me he did not know how he got to Vietnam, and I did not really pick up on that. My judgment was that he was scared and anxious like me, and eventually he would adjust at some level. But that night on guard duty, he took an M16 and shot himself in the head.”
His decision haunts him.
When Steve returned stateside to the Oakland airport after his tour, the first thing he did was throw away his uniform and change into dungarees. He was very aware of the stigma of the war. He flew from Oakland to Minneapolis, and on to Philadelphia. He took a cab all the way to the town in New Jersey where his wife and kids lived. The cab driver wanted to talk about the war. Steve was ashamed of his participation, and did not want to have any conversation about Vietnam.
On returning home, he had trouble sleeping. He had flashbacks all the time, and horrible dreams. He did not feel safe. The war, as much as he wanted otherwise, would not leave him.
He was in survival mode. He built a room in the basement of the house with a brick wall around his bed.
“Basically a bunker,” he said; “mattresses on the floor, books on the sides. That’s where my head was.”
He was unable to interact with his family.
“Physically and emotionally — I would come home from whatever job I had. I would be worked up and stressed out. I would have something to eat and then go to my bunker, and people would not see me till the next day. So there wouldn’t be any involvement.”
He was unable, he said, to ask his three kids or his wife about their day.
One night, three or four years after Vietnam, he had a nightmare, and he woke up pulling his wife out of their bed by her feet. She insisted he go to the VA.
At the VA, the counselors showed Steve and his wife a pamphlet on PTSD and its symptoms. “We went over it that night, and I had them all. That was tremendous relief … it was like a validation … there was something going on that I did not understand. That began treatment,” said Steve.
He spent three months as an inpatient at his local VA. He had counseling and medication and group therapy. It was the beginning of a lifelong recovery.
Counseling has been a big help. It has taught him he needs to live in the present. He needed to let go of Vietnam. He needed to learn to pay attention to his family and the community. He had to learn to relate to people again, and the importance of friendships. He had to learn tolerance — not everyone had shared his experience.
It has not been easy — Vietnam was the prism through which he saw the world: “The majority of people I would encounter had not a clue of what was going on in the world … If you haven’t seen or experienced some of the things I’ve seen, and you’re talking about something that I consider to be meaningless and frivolous issues — I have zero tolerance of that.”
He was unable for a long time to wrap his head around everyday life events.
His kids’ sporting events lacked meaning, and were frivolous. “I could sort of understand them at the time, but I couldn’t see how people could do that. Sit there … I couldn’t understand why people weren’t depressed like me.”
Steve said he felt contaminated. He had seen people at their worst, including himself. He did not want to spread the contamination. Steve had regular counseling at the VA.
His relationship with his family started to improve. He could hold jobs a little longer — though still only about three or four months. He continued to have internal angst and outbursts of anger and frustration.
“A basic existential malaise … hung over me,” he says.
Trying to find his faith on return from Vietnam was ‘brutal.’ He had been brought up as a conservative Protestant, and a Massachusetts churchgoer who believed in God: “That pretty much vanished in Vietnam.”
He tried lots of different religions on his return — evangelical Christianity, Mormonism, Hinduism, Buddhism, some esoteric types of things. He took his family with him on these various retreats. “My kids still to this day kid me about all that,” he says.
His family was supportive. They understood, he said, his need to reconnect and find something spiritual and a place in the world which was lost in Vietnam.
Steve left his basement bunker and moved to the Island with his family 25 years ago. The move was a great help. The Island was a much safer and less stimulating environment for him, and more conducive to his needs. He would continue his recovery on the Island.
The emotions of Vietnam remain, though. He is still on alert. Without fully realizing what he was doing, he built a number of sheds around the perimeter of the main house. There are five or six of them. One of those sheds houses his present-day bunker.
Fifty years later, he has still horrible dreams. He has intense anxiety. The memories are strong. “It’s become greener now [that it was spring], just beginning,” he says. “It is typically a hard time for me, because when I drive down the street … other people are seeing trees. I drive down the street and I see, ‘This would be a great place for an ambush.’”
He checks exits at restaurants, and sits with his back to the wall so he can see what’s going on. He was eating a cheeseburger in a restaurant in Saigon once, after transporting a casualty, when someone threw a grenade in. “At some level, unconsciously, I’m pretty much aware that … there’s bad guys out there, and I have to be on my toes.” Any unexpected noise or smell freaks him out. “I was so frightened for so long, for a year, 360 some-odd days … it’s hard to shake some of those things.”
He generally is uncomfortable in social situations. He does not like going out at night — most fighting was done at night in Vietnam.
A lot of hard work though has taught him to reality-check. He does not dwell anymore. He takes a few minutes to acknowledge the feelings, and then moves on: “That was then. This is now.” He can accept the feeling of fear and then recognize the fact that there is no one waiting in ambush at the end of the road.
Steve sees a counselor a couple of times a month. He participated in a local veterans group for about 15 years. He still goes off and on, but not as much. He is more comfortable now.
Music is a very important part of his life. He works on his music nearly every day. He composes, and he switches off playing guitars and banjos.
“Already today I’ve played two hours,” he says during our 1 pm interview. “Typically, I play three to five hours a day. And that’s OK … I feel better. I feel a sense of accomplishment. It’s also really good focus for a long period of time.”
He meditates — a therapy he learned at the VA — and he reads, and tries to eat right. He does not eat wheat, sugar, or dairy. His injuries from Vietnam have degenerated into pretty serious arthritis, and there is less pain when he eats more healthily.
For years and years, he took regular medication. He no longer does, as he did not feel like himself on the meds, and he does not feel that he needs them as much anymore. Periodically, he still will take medicine for nightmares and anxiety. It works, but he tries to avoid it, as it makes him drowsy the next day and interferes with his music.
Things have been good on the Vineyard: His relationship with his kids continues to improve. His absence in their formative years was regrettable, he says. He did not go to their school or sporting events. He realizes the importance now, and tries to set aside his anxiety. He shares with them.
He has done better, he says, with his five grandkids.
His grandkids are on-Island all the time. He makes a concerted effort to spend a lot of time with them and do things with them that he did not do enough of with his kids. He writes songs with his granddaughter.
“My job now is to be a better husband and better community member … and a grandparent,” he says.
He has a routine. He goes to bed about 7 pm. He reads for an hour and maybe watches a movie. He goes to sleep thinking: “I can’t wait to be up in the morning to play music.” In the morning, he will play for five hours, dividing the time between his instruments and working on his songs.
“I know what my limits are, and I have to watch that and overextending myself in any particular way. And if I find myself doing that … I sort of know what I have to do to maintain an equilibrium,” he says.
He does not talk about the war. “There was no element of pride, even though I received numerous accolades and promotions and medals,” he says.
He received a combat medic badge and an Army medal for doing a commendable job in adverse circumstances. He sent the badge and medal to President Richard Nixon and received a letter back. The letter thanked him for his service and acknowledged how he felt.
“That letter I received back from Richard Nixon is something I am proud of. I’m not proud of the medals. I’m proud of the letter.”
PTSD on M.V., and treatment options
Variously called “shell shock” or “combat fatigue” in earlier wars, the definition of PTSD was not formulated until 1980, when the American Psychiatric Association (APA) added PTSD to the third edition of its “Diagnostic and Statistical Manual of Mental Disorders” (DSM-III). The key shift was to assign the cause of the symptoms to an external cause (a traumatic event) rather than an inherent weakness (“traumatic neurosis”). In the mid-1980s, “vet centers” were set up across the country. These are funded by the Department of Veterans Affairs, but are separate from VA hospitals. The Cape and Islands are served by the center in Warwick, R.I.
Tom Bennett, associate executive director of Martha’s Vineyard Community Services and its senior clinical advisor, is a Vietnam-era Air Force veteran. Bennett finished his active-duty enlistment in 1968. A native of Martha’s Vineyard, he has been working with veterans here since 1970. Bennett and his colleagues set up satellite programs on the Island, based at the Island Counseling Center, part of Martha’s Vineyard Community Services.
Jo Ann Murphy, the county’s veterans agent, estimates that there are 350 veterans on the Island. In Bennett’s programs, there are about 30 local veterans with “readjustment problems” from serving in combat zones. These are people who have returned from active duty, but have been unable to resume their former lives. They find Bennett through outreach programs, and are also sent his way by Murphy. (Murphy, who won an award for being the best veterans agent in the commonwealth, handles all claims to the Veterans Administration made by county residents.)
There is no cure per se for PTSD; the symptoms — flashbacks, being constantly on guard, startling easily, and irritability — may never go away. Men and women with the disorder replay the traumatic events and re-experience the feelings associated with them, over and over. “I help them develop a different narrative,” said Bennett in an editorial The Times published on Veterans Day 2016, “and help them fit it into their lives instead of having it run their lives. I try to get them to make meaning out of it, and integrate that into caring for themselves, their families, and the community.
“Vets feel like they’re different,” he said. “And they are different, because of what they’ve been through.”
For more information: Bill Stafursky is the coordinator for the Veterans Outreach Program at Community Services. His number is 508-693-7900, ext. 223, and his email address is firstname.lastname@example.org.