Michael, my brother, was the first person I told. Except for R, but that was only because he was in the room with me when I got the call. As I write that, I know it’s not the truth. At that time I still sought solace in R. I suppose I still do, though it’s harder now. Then, solace was still possible in the company of others. But twelve years is a long time to be broken.

Michael was the first person I called. I chose him not just because we are close. I chose him because he would know.

The first thing he said was, well, shit. Then he told me a joke. Something sadly appropriate. Something about a guy waking up with one leg cut off.

*

Wandering through the aisles, hoping to remember what else I need, my eyes fall on rows and rows of cans of soup, and my feet are cemented in front of them. Nausea rises into my chest, displacing the air in my lungs. The bright colored labels become a kaleidoscope through a blur of tears. Sweat cascades down my back and arms, and drips off my fingers as my body seems to be trying to empty itself of fluid. But my feet are immovable, and I cannot look away.

I don’t even eat canned soup. But I did then.

Post-traumatic stress is characterized by flashbacks, nightmares, hearing or seeing things that aren’t there, intense physiological reactions, such as sweating, difficulty breathing, or other panic responses. It may lead to trouble sleeping or self-destructive behavior like drinking too much. People suffering from post-traumatic stress may have difficulty maintaining close relationships.[1]

It was supposed to have been found early. It was not.

There would be surgery and chemo – lots of it. Killing my body without killing me. And radiation – as much as my body could stand. And more chemo. And drugs. And procedures. And tests. And more drugs.

Before each chemo treatment, not knowing what, if anything, I would want to eat, I would wander up and down the aisles of the grocery store, looking for anything that might appeal to me in a few days when my body was electric with the current of the life-prolonging elixir, and my stomach refused all sustenance. What appealed would change from week to week. Sometimes it was a plain bagel, sometimes just juice. Sometimes it was kale, other times ice cream. Once it was bacon. But it was never beef – the smell of raw meat, and how it clung to the air nauseated me.

Soup often worked. Canned soup. Soft, squishy vegetables. Soft, squishy pasta. Soft smell; soft soup.

It was during this time that I developed super powers. Well, one super power. Not the I-can-shoot-laser-beams-from-the-palms-of-my-hands kind of super power when I would spike a high fever, but a real one. I developed super smelling power. Scents danced before me with an intensity that seemed almost more palpable than olfactory. I would wander through the autumnal woods, smelling the funk of decaying leaves, the redolent pinch of coyote urine sprayed on a tree trunk, overwhelmed by the dizzying cacophony of scents. I would climb up onto a rocky ridge, put my nose down to the ground, and breathe in the warm, flinty bouquet of the sun-toasted rock. As stimulating as this super power was in the woods, it was less thrilling on a crowded New York subway during a post-summer heat wave.

Olfaction – smell – is one of the oldest senses in terms of evolution. Smell is primal. New research has shown that the brain centers for emotion and olfactory processing, which are side by side in the brain but normally do not interact, become intertwined under stress. This “cross-talk” causes neutral odors to become negative, which reinforces negative sensations and feelings. Thus, scent can fuel a feedback loop, leading to heightened distress and anxiety.[2]

I saw Michael when he was in New York for some television interviews, he and his fellow former Army Rangers. With the world going to war, reporters wanted to hear again about their battle – the Battle of Mogadishu. Black Hawk Down. America’s deadliest recent battle. Urban warfare. Desert camouflage.

I was sick that morning so was a little late to meet him. I and my bald head slipped into the back of the room mid-interview. Awash in bright lights sat men – not the boys they had been – older, some fathers, some fatter – talking about history. Michael stared at me over the television cameras with a look more gentle than I had ever seen from him.

After, we went out. He and his buddies – I knew some from his wedding – did not talk about the past, did not talk of heroes. They told jokes darkly. They bought a round of drinks for the fresh, smooth-faced recruits who walked into the bar – the first wave in what would become an ocean. Then they stared into the distance, into nothing. The smell of stale beer on the floor of the bar and the still-smoldering air was deafening to me.

When we were alone, I told Michael that the Bee Gees were living in my head now. During my first chemo infusion I had a visitation. R had gone to feed the parking meter, and the nurses were attending patients in other rooms. I closed my eyes to concentrate, trying to picture myself healthy (everyone told me I should do that). I was doing deep breathing exercises when suddenly I heard: “Ah, ha, ha, ha, stayin’ alive, stayin’ alive ....” I opened my eyes – no, the nurses had not changed the music; Kenny G was still playing. I closed my eyes, annoyed with myself – Damn it, Julie, concentrate. This is important! I took some deep breaths. There it was again – louder: “Ah, ha, ha, ha, stayin’ alive.” I could not make it stop. I started to giggle. I opened my eyes to see R and the nurses staring at me from the doorway. I almost threw up from laughing so hard, to the sound of the Bee Gees. They had been living in my head since then. I had told no one but R.

My brother looked embarrassed for me. I decided not to tell him about my super power.

Michael never told me it would all be OK. He knew sometimes it is not. He never told me I was brave. He never called me heroic. He knows heroes are mostly make believe; he knows we’re all just struggling to keep moving, even when every path is impassible. We never spoke of death. We didn’t speak of what we see when we stare into that stygian schism in the dark middle of the night moments when fear eats our breath. There would be no point.

*

For two months, each night, I heard a voice in my sleep. A loud, long wail unlike anything I recognized in waking life. Not a human sound. Not entirely animal. Full of all pain and fear. When I was able to get out into the world again, I began to hear it while awake. In the background. Inside my head.

I was outside when Milton, my cat, caught the chipmunk he’d been stalking. He carried it to the patio, shook it, and dropped it, then quickly lost interest. The chipmunk was alive, but mortally wounded. His front legs pawed lightly at the air. His mouth opened and closed as he gasped. Strange sounds – tiny wails – rose from his dying body. I knew this sound.

Milton stared impassively. I cried out, my moans matching the sounds I had carried with me for months. I clutched at my body. I could not speak, could not form words. Only moans.

I picked up a board and smashed the chipmunk.

Before I had cancer, before I began dreaming in moans, I had been run down by a taxi on my way to play a Broadway show. Tossed aside as I crossed the street, nullifying the strength and purpose of my spine. Left to lie moaning in the middle of Ninth Avenue during rush hour.

People often talk of seeing their life flash before their eyes, sometimes even when only recounting surprising, but non-lethal events like cutting a finger or getting lost on a hiking trail. They don’t realize that it doesn’t happen that way. They don’t know.

A year of physical therapy, surgery, and some hardware in my neck left my body healed. But the dreams and terrors continued. A Sufi mystic told me my soul was wounded. It had fled. I was broken.

My rational mind does not put much stock in mystics and psychics and what they know. But part of me does.

*

In my dreams – not the percocet-hazed dreams while being evacuated, where the walls were crawling with spiders the size of dinner plates – I’m in the hanger. The wind off the waves brings the slight smell of salt, but the air is dry – nothing but sand and dust. They’ve launched an assault; we’re all rushing out to fight. Except I’ve forgotten my boots. Must go back. Now out to fight. Except I don’t have my body armor. Must go back. No matter how many times I start out to help, I can’t get there. I must go back. I can’t help.

My brother’s Ranger unit had been in Somalia less than two months. During those months they read, slept, wrote letters – or thought about writing letters – to girlfriends or wives or parents, all to a soundtrack of Metallica, Pearl Jam, Geto Boys, and Public Enemy. They obsessively played Risk. “Fight the power, We got to fight the powers that be,” while bent on world domination, or at least domination of the board. And there were missions. Coming down with the full might of Delta Force and the Rangers, their missions had mostly netted low-level targets or just goats having sex in an empty courtyard.

But in real life – then – we made a switch in our heads. This was not like other missions – no goat porn now. It all just switched to getting out. We were the good guys – we don’t shoot women or kids or old people. But then the rules of engagement changed. You shoot at us, we shoot at you. It all just changed.

Twenty years later, when Michael talks me through that day and night, and the days and nights that followed, he describes their first kill with a precision and clarity as though it happened yesterday. The man, maybe in his 20s, thin, long limbs like sticks, white shirt billowing, running down the road, turning toward them, glimpse of a gun. Firing, mother fucker, dropping, AK at his side, white shirt now soaked dark in blood. Wondering aloud if they should administer medical aid, not yet realizing that all of them had unloaded multiple rounds into him, the finality of it sinking in slowly – dead.

It’s the smell I remember. Don’t know why, but I had them keep my bloody shirt, stuck it in a garbage bag. It baked in there for about four or five days, until I was in the hospital in Germany. I opened the bag and it hit me – the smell. Took me right back there – the blood, the burned flesh, piss, sweat – fear. Smelled like dead deer. Road kill – that’s all we are.

Once they were rescued and safe in the U.N.-controlled soccer stadium, soldiers set about sorting out the dead and wounded. Everyone asked or told about who they had seen: Pilla? Ruiz? What about Smitty, anybody seen Smitty? – questions that would be echoed by the rest of us less than a decade later: Your people? Safe? Has anyone seen ...?

My brother’s best friend found him lying wounded, wrapped in a blanket, drinking hot tea and shivering in the African sun. His friend turned and walked away, certain Michael was about to die, unable to watch, having already seen too much death for one day.

Throughout centuries, a cluster of symptoms associated with war or traumatic events has had a variety of names. Nostalgia, Soldier’s heart, Shell shock, Combat fatigue. Maladie du pays in French. Heimweh in German. The Spanish have called it Estar Roto – to be broken.[3]

Post traumatic stress disorder – PTSD – as it’s now known, was only recognized as a legitimate diagnosis by the American Psychiatric Association in 1980. The current term may be more clinically precise, but perhaps is less descriptive and proper than earlier phrases. Recent research has begun to focus specifically on the moral injury of war. In 2009, the Veterans Administration completed a study that found a distinct moral component to the traumatic stress of combat veterans, leading to damage to their very humanity.[4]

We were only in-country fifty-four days, though. It was only one bad firefight. I mean, it’s not like we were Viet Nam vets.

*

It was a while after we were back. Raleigh and I were driving on base, along this road with a wall of pine trees beside. The windows were down. We heard a Black Hawk coming in low – screaming down. I was looking out the window, but couldn’t see it. I pulled over, stuck my head out the window to see it. Couldn’t get a fix on it. I was looking all over – couldn’t figure out where it’s coming from. Gotta get a fix. Where is it? It’s right overhead, but I can’t get a fix. I have to get a fix on it.

Then it’s gone.

I’m gripping the steering wheel, digging my fingers in. I’m shaking. No thoughts, only sensation. I look over at Raleigh, and he’s staring out the window, too – sweating, breathing hard. We look at each other, kinda laugh. Take a deep breath and start driving.

Later, when Michael was out of the army and back in college, he started seeing a therapist. He still has a box of the therapist’s notes. Feelings of isolation. Quick to anger. Feelings of helplessness. No one understands. She never mentioned PTSD to him. Around that time he also saw a psychic. The psychic told him that he had ridden with Genghis Khan. She also told him he had been a beautiful and very successful French courtesan.

We went to the movies. They were in Viet Nam. Bullets start flying; it’s an ambush. Tracers whizzing past. My heart starts racing. I back up in my seat, gripping the armrests. I’m breathing hard. Whoa! Yeah, they got that scene pretty right. Shit.

Take it easy – don’t have a fucking panic over Forrest Gump.

*

Steele came in. Told us to shoot at anyone coming through the door without yelling “Ranger, Ranger.” I knew what that meant. That meant if anyone came through our door, the rest of them were already dead. Then he left us – the wounded – alone in the dark with our own thoughts.

Yeah, I made bargains – everybody does. I had about fifteen rounds left; I thought about keeping one bullet for myself. And that’s a bad place when you’re thinking about that.

We never discuss the choices and decisions made, Michael and I. We never talk about how death can color our choices still. There is no need. We know that choices made while embraced by death can be surprising. And are made alone.

*

Prolonged stress changes the brain. Two major changes take place: the hippocampus – the land of factual memory and spacial navigation in the brain – gets smaller, and the amygdala – the brain’s center of emotions – gets larger. Scientists at the National Centre for Biological Sciences in Bangalore, India, found that, in addition to changes in size of the two regions of the brain, electrical activity in those areas also changes. Electrical signals in the hippocampus, associated with factual memories, weakens, while signals from the amygdala to the hippocampus grow stronger.[5]

Even after so many years of not being dead, the dreams live. The sounds and the smells startle me yet. The smell of alcohol preps still makes me nauseous. And still the dark sometimes steals my breath from within me. Well-meaning people tell me that everything is fine, that it’s all behind me now. But they don’t know.

Edward Tick writes about the isolation, the “otherness,” of post-traumatic stress in his book, War and the Soul, Healing Our Nation’s Veterans from Post-traumatic Stress Disorder. There is a feeling by those who suffer PTSD that they no longer fit in the world; their world and its assumptions have been shattered. There is a separateness. A before and after. And after is never the same.

Michael did not wait for me to return to normal. He did not expect me to put it behind me.

We never talk about being broken. There would be no point. Even after all these years. Estar roto.

*

I am walking to the beach with R. To sit in the shade of a tree and enjoy the relative emptiness of mid-week. And read a book.

Three generations of a family sit in beach chairs, armed with magazines, lotions to shield them, water guns, plastic swords, and other weapons of mass destruction. A young son sleeps on a blanket in the shade.

Tiny, motionless hand.

Silence engulfs me. I hear my breath stop. The sound of my toes clenching in the sand is thunderous.

There is another tiny hand. And another. Attached to other apparently lifeless bodies. But they are not lifeless. Not yet. Only drugged. They will not survive for long.

I stand against the wall as they pass. Cold wall. Shivering slightly in nothing but a hospital gown. Lights overhead glint off stainless steel.

The blue of my tattoos, the red of my burns, the white of my blistered skin is answered by the wire masks encasing their tiny heads. A silent conversation of radiation.

I clutch myself to myself, shaking in anger.

This tinnitus of my senses is interrupted by an errant frisbee landing, kicking up sand on me and waking the child – collateral damage.

I am at the beach. To sit in the shade of a tree and enjoy the relative emptiness of mid-week. And read a book.

 

[1] National Institutes of Mental Health, Health & Education, Post-Traumatic Stress Disorder (PTSD), http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml.

[2] E. A. Krusemark, W. Li. From Early Sensory Specialization to Later Perceptual Generalization: Dynamic Temporal Progression in Perceiving Individual Threats. Journal of Neuroscience, 2013; 33 (2): 587

[3] Edward Tick, War and the Soul: Healing Our Nation’s Veterans from Post-traumatic Stress Disorder (Wheaton, Il: Quest Books, 2005), 99-100.

[4] Brett Litz et. al., “Moral Injury and Moral Repair in War Veterans: A Preliminary Model and Intervention Strategy,” Clinical Psychological Review, December 2009.

[5] Vyas A, Mitra R, Shankaranarayana Rao BS, Chattarji S. “Chronic stress induces contrasting patterns of dendritic remodeling in hippocampal and amygdaloid neurons.” J Neurosci. 2002 Aug 1;22(15):6810-8.