PTSD Part 2

About 3 months after getting home from Afghanistan, the flashbacks from my deployment were persisting. It all seemed like a broken record. Why could I not just forget about it all? As a physician, it was clear to me that I was suffering from PTSD. I had learned about it in my training and had dealt with a number of military patients with PTSD. But, those of us in healthcare are not always good patients. I was in no hurry to seek counseling. Undoubtedly, it requires some humility to ask for help no matter what the situation. I certainly was not ashamed that 2 deployments had affected me. But, my pride was telling me that I was okay. It kind of goes without saying that we return at least a little different after an intense experience in a combat zone. But, would I allow my war experience to dominate my life? Absolutely not! I turned to Dr. K for help.

We are lucky to have Dr. K at Charleston Air Force Base. He is a civilian psychologist who moved to Charleston after many years as a police psychologist. He has specialized training in PTSD therapy. Dr. K has a reputation for being a bit unorthodox. I was curious to see what his therapy was all about. He started by showing me a video about Eye Movement Desensitization Reprocessing (EMDR). It involved a psychiatrist working with a veteran suffering from PTSD. The patient was taken back to the traumatic event by closing his eyes and visualizing in his mind's eye exactly what happened. Upon opening his eyes, he was asked to follow the hand the of the therapist as it was moved quickly back and forth through his vield of vision for a short period of time. The therapy is designed to "unlock" the memory that is causing the PTSD. Often, there are many "memories" that must be explored, visualized, and reprocessed. It is a powerful therapy that has shown to be quite effective in many veterans. Its efficacy is not fully proven, but a good number of patients have been helped by it.

So, there I was in Dr. K's office discussing my symptoms and my time in Afghanistan. I had recognized about a half dozen incidents that I had been thinking about frequently. We started by discussing something that occured in my first few weeks at Bagram. A load of trauma patients arrived in the middle of night. It was my first week on night call. The third patient through the door was my responsibility. He was a young marine who was injured by a roadside bomb. His left leg was badly broken. He was talking and seemed okay at first. Literally within seconds of moving him from the stretcher to the gurney, he went into hemorragic shock. The next 5 minutes seemed like an eternity. I called for help. He was intubated and put on a ventilator. The largest bore IV we had available was inserted into his subclavian vein, then 2 units of blood were literally pumped into him via a high speed pump. He went to the operating room STAT. I remember standing there in a state of shock after all this. It all happened so fast! I felt powerless. I felt inadequete. I was scared that someone was going to die because I was not a good enough physician. After all, I needed 2 other physicians, 2 nurses, and 3 technicians to help me save this marine, right?

Dr. K had me visualize this incident and quickly I felt like I was transported back to the trauma hot box at Bagram. I could practically feel the sweat beeding up on my forehead. It seemed like I could reach out and touch the patient. His leg was bleeding out. The extensive dressing was soaked through with blood. His eyes were open and he told me he was from Idaho. Then, he was unconscious. Controlled chaos ensued. I ran the code. Yes, that's correct. I was in charge. That is what really happened. His heart was racing and his blood pressure was dropping. I knew what he needed. We got him everything he needed right away. We could not wait even a moment. He needed life saving interventions NOW! The patient got them. He lived. The next day he was alive. In fact, he was awake and alert. He called his parents from Bagram to tell them he was okay... I opened my eyes and Dr. K moved his right hand back and forth. I concentrated deeply for the next minute only on his hand. I took a deep breath. My first experience with EMDR was now finished. I felt better. That night I slept better than I had in 100 days.

My therapy with Dr. K lasted just 4 sessions. EMDR was used to "unlock" some of my deepest and darkest memories. I could make sense of it all to a certain degree now. I realized that as a family physician I was simply one member of the medical team at Bagram. Every single one of us was needed there to provide the best health care possible for our very sick patients. We all did the best we could. There was little that could be said about some of the things we saw. A limbless soldier barely alive is just plain sad. Taking care of the enemy all shot up by our own troops is just insane. Working 5 months in a row without a day off is beyond exhausting. But, none of this was going to dominate my life any longer. It is all in past. Mankind will continue to kill one another. War is hell. But, I am okay. Yes, I am okay.