A Sunrise in Prescott

I was sitting at a coffee shop in Prescott, Arizona. The sun was just rising above the eastern sky, turning the desert hills from purple to pink to gold. It was a beautiful morning. The smell of wild weeds, dust, and a faint smell of diesel from semi-trucks driving suddenly took me back to a time when I talked with a battle buddy of mine while stationed at Fort Irwin, California. Perhaps it was the sound of semi-trucks, diesel, the distant rumbling of traffic, or the early morning dew after a night of rain that made the desert air sweet and succulent, that prodded my memory.

I walked into a local coffee shop, “Good Morning.”

The cashier was super friendly. “Good morning. What can I get for yu?” Her enthusiasm was contagious. She had a big smile, near-perfect teeth, gayly big brown eyes, short pixie cut hair, a long thin frame, and a pale complexion that reminded me of an old battle buddy of mine.

“Ah yes, venti iced latte, whole milk, with whipped cream, please.”

When my order was complete, I walked outside and sat at a table just outside the building. I took my first sip and my mind zipped back to a conversation we had shortly before I left the Army.

It was a quiet Sunday morning. I walked to the local coffee shop, ordered my coffee, and sat by the window watching the sun creep over the deserted hillside and the smell of wild weed, blooming cacti, and morning dew filled my nostrils. Sounds of military vehicles rumbled in the distance, though the sounds were faint – they were methodical and strangely soothing. Perhaps it was their normalcy that felt comforting, or perhaps it was the subtle feeling of safety and security that they represented. The morning walk was refreshing, especially in the summer; the 118-degree temperatures force families and their children inside. I sat down at a table just outside the coffee shop to enjoy the cool summer breeze. Not long after, a battle buddy whom I will call SPC Mitch joined me. She was in the process of medical discharge when we last talked. Our conversation moved from casual talk about the weather, the Army, and the nuances of life on active duty to deeper conversations about trauma and the negative perceptions about self and others that result from it.

“I had an appointment with a medical examiner recently.” She said calmly. Her eyes seemed to fade off into the distance, her eyebrows furrowed, and her shoulder sank. She sighed and took a deep breath, holding it, before slowly letting it go. “It didn’t go well.”

I sat quietly, waiting for her to speak, and watched the steam from my coffee seep from my cup.

“I always heard stories about medical care for soldiers and Veterans. I often heard going to a military or VA hospital as going to ‘that place’ where people die, almost die, or have remarkable disfigurement from some military doctor or VA intern. I’d like to think I am an optimist, that it really can’t be that bad and the dreadful stories are like ghostly legends–you don’t know anyone personally who experienced this and the stories are all second-hand accounts. Until it’s you.”

“What happened?” I asked as I watched as she leaned forward, clasped her hands together, took a deep breath, and tensed her body as if to gather all the negative energy into one place in her mind–before releasing it.

“I have posttraumatic stress disorder–which is why I am getting out of the Army. I am sure everything that I experienced in that appointment is my messed-up brain playing tricks on me. I want to think that this doctor cared and wanted what was best for me. But the longer I talked, the more I couldn’t help but think the doctor wasn’t listening to me, didn’t care, and it was all in my head.” She looked at the ground, shuffled her shoes on the pavement, and took a deep breath. “I went to the ER for what I thought was a heart attack and when I talked to my doctor about it, she kept talking about dehydration. I had to explain the difference between symptoms and the reason for my ER visit was because my symptoms looked like a heart attack. Then I finally got an appointment with a cardiologist who thought my chest pain was because I had a posttraumatic stress episode. The doctor didn’t even look at my medical history.”

Tears poured from her eyes. “I can’t make sense of this confusion. I don’t know why the appointment bothered me so much.” She wiped the tears from her eyes using her shirt sleeve. “I suppose sitting across the room from a doctor who already knows what they are going to say, rehearse it, and try to sound confident in their recommendations; it’s almost scripted, and here is my recommendation. ‘Doc, did you even hear what I said? I am saying, let’s look at the bigger picture here. I am saying this is the problem. You are not even addressing the problem.’ The doctor said, ‘Maybe you are having a panic attack because you have posttraumatic stress disorder.’ I was so mad. Like, seriously, this guy is going to throw my PTSD in my face?” She said with a huff.

“First, I am sorry to hear this is your experience. Both doctors should have addressed your experiences and concerns.” I said, taking a sip of my coffee and looking at the sunrise that crept across the horizon. “You talked about this situation and suggested it resulted from your messed up brain. I am curious. Is it the doctor that is the problem, or is it you that is the problem?” I asked boldly. My candid approach caught me and Mitch off guard. “I mean, is it the doctors’ lack of care and concern? Or is it that your psychological problem was part of the assessment? Or both?”

She stopped and looked at me with a puzzled expression on her face. “I don’t know.” She wiped her nose, sniffed, and let out a deep sigh. “I just know that I feel like I am going crazy. And maybe all this is triggered by me getting out of the military.”

I said, “The quality of care and bedside manners are in the shitter, and patient-centered care is subpar. We all hear stories about military doctors. But how much of this is the doctor, and how much of this is your beliefs about yourself, your medical condition, and the circumstances that surround them?”

After a long silence, she spoke. “When I was getting ready to go on deployment, I was at Fort Hood, Texas. There was a soldier who was… super creepy. He kept saying inappropriate comments, telling me I was going to be his bitch, or he was going to ‘do’ me in the back of a Humvee when we deployed to Iraq. The comments got worse and worse. It was like this every day. I told my commander that a situation was going on. I said I was getting harassed by a soldier in my unit, and he looked at me and asked me what I was doing to cause it. My commander minimized my complaint by saying, ‘All you women are the same. You act a certain way and don’t like it when the guys treat you the way you deserve.’ My commander didn’t hear me. Didn’t care. And the situation for me got worse. Much worse. Ultimately, I got out of the deployment and I changed duty stations because I couldn’t handle it.”

“Has that happened before? In terms of other areas of your life?”

“Yeah. My whole life. I felt like I was the little girl screaming in an empty hollow room. No one sees me, hears me, or believes me. It’s all in my head, and I’m the crazy one. I hate feeling that way. I hate feeling crazy.” She paused a moment, took a sip of her coffee, and continued, “I remember, when I was a little girl, I told my parents I had chickenpox one morning before school. My parents laughed and told me to go to school anyway and it’s all in my head. I cried all the way to school. The next morning, I had red bumps all over my body and I exposed my entire class to chickenpox. After the entire class got it and recovered, I got beat up during lunch for passing it on to one of the class bullies. I know it’s a silly story, but my voice was silenced. Just like it was when the commander said it was all in my head, and just like when the doctor said, maybe my symptoms are because I have PTSD.”

As the sun began warming the sidewalk, we inched our way closer to the building to keep cool in the shade. As the sun began heating the pavement, a warm breeze slowly replaced the morning cool morning air. The dew that clung to the tips of nearby bushes evaporated, and that sweet morning smell of desert flowers faded.

“I think what makes me angry is when no one hears me. It is worse than anything. It is one thing to be going through something horrible, but another thing when you are going through that alone. That is how I felt in the doctor’s office. I am alone and my problem is just a PTSD problem.” She sighed. “Then everyone becomes my enemy, and no one is my friend. Then I feel like I need to fight for myself because no one else will. I hate that feeling. Being alone.”

“Anyone would feel that way if they were in your situation. I know I would. I also believe that what you really wanted was to be heard and validated.” I looked at Mitch and said, “You know, PTSD is complex because it has many faces. PTSD is not just a condition that causes people to be hyperreactive and have nightmares and flashbacks. PTSD is a condition that creates barriers. It is there to guard and protect you and keep you alive. It is the source of all-or-nothing thoughts, feelings, and beliefs. In your case, Mitch, no one hears you and no one cares. Everyone is your enemy, and no one is your friend. Your doctor isn’t looking out for you, he’s just checking boxes.” I took a sip of my coffee and reached out for my friend’s arm and gently squeezed it. “PTSD is a lonely disorder. It is the king of making lonely lives lonelier. You are a soldier. The Army trained you to fight, kill, protect, and defend a country. You are told to rely on your chain of command and your battle buddies. When there is a breach of trust, there is a sense of abandonment that comes when you aren’t being heard and fighting your chain of command for validation and justice. When they don’t believe you, it causes a fracture in your psyche, which results in negative thoughts, feelings, and beliefs. Those places and people who are supposed to be safe – aren’t. With the doctor, perhaps it is the same thing. You want to be believed, heard, your physical condition validated, and your plan of treatment clear. When you feel you are getting the opposite, that feeling of safety goes away, resulting in a ‘me against the world’ mindset.”

Over the years, I’ve heard many stories like hers throughout my military career. Traumatic experiences that lead to posttraumatic stress disorder are like adopting an overprotective big brother. To keep a person safe, negative thoughts help establish boundaries, negative beliefs help reinforce those boundaries, and defensive behavior becomes the physical act of separation to ensure all things and all people are at a safe distance—all in the name of personal safety and security. The objective? To be fortified, invulnerable, and safe, no matter the cost. However, this is a false sense of safety. For trauma victims, there is always loneliness and aloneness. There is always a threat. There is always a reason to be invulnerable.

I am reminded of a quote:

“What we are today comes from our thoughts of yesterday, and our present thoughts build our life of tomorrow: our life is the creation of our mind. If a [person] speaks or acts with an impure mind, suffering will follow [the person] as the wheel of the cart follows the beast that draws the cart. If a [person] speaks or acts with a pure mind, joy follows [the person] as [one’s own] shadow.” ~ Gautama Buddha ~

Our experiences, whether good or bad, shape the way we think, feel, believe, and experience the world. For Mitch, childhood experiences that were reinforced by the actions of others during her adult life led her down the path of separation from the military.