From Baghdad To America (12 page)

Lava is not just this way with dogs. He can sense fear and trepidation in people, too. One of my best friends, whom I'll call Otis, is not a dog lover by any stretch of the imagination, so when he first met Lava you can imagine it wasn't a meeting of the mutual admiration society. Lava was not particularly gracious when Otis finally came through the door. Next thing I knew, Lava's sitting next to his chair at ramrod attention and actually guarding him. Just like a real protection dog. The moment Otis so much as twitched a finger, Lava curled his lip and emitted a low but very threatening and intimidating growl. I told Otis not to move a muscle while I pulled Lava from the room. It was almost like a scene from a cartoon where the massive, snarling dog is chasing a person down the street, all the while snapping and growling. For some reason, Otis agreed to try again, and he joined us on a ski vacation with Lava. The trip ended with Otis having to leave the townhouse we'd rented through the ground-floor bedroom window, throwing his luggage in front of him.

By that time, Graham was regularly seeing Lava and seemed to be making progress. He was genuinely interested in helping. I think he wanted to show the world that I wasn't crazy for having brought him back. Graham told me he wanted “the public to see the good in Lava.” (I would have settled for just my close friends recognizing this.) The classes, the private training, it all seemed to help a little, but it was as much about training me as training the dog. Lava knew how to push my buttons like the finest of best friends, and I always rose to the occasion. Graham didn't have that problem. He could use physical posturing to show Lava some submission but not too much, and he'd keep his composure at all times.

I decided to check into the idea of medication after Lava “attacked” my friend Mark. It was late one morning and I was walking the dogs. I had my son Mattox (at the time about four months old) in the stroller. Now, if Lava is protective of me, he's insanely protective of my kids. Mark, who has two great dogs as well, began to play with Lava. They were just kind of roughhousing, I guess, but ended up doing so a little too close to the stroller, and that's when it happened: Lava laid into Mark three times in rapid succession, managing to lay back a nice flap of skin on his thumb and putting a couple of puncture wounds in his arm. Fortunately, none of these injuries required sutures, but they were bleeding pretty badly. We walked to my house so I could clean and bandage the wounds for Mark, and I had to put Lava in the garage before Mark could come into our yard. Lava was clearly still agitated and his behavior, unpredictable.

One of the most embarrassing episodes, however, occurred one day in the park. We saw a young couple sitting on a blanket enjoying the warmth of the sun and basking in the beautiful San Diego weather. Everything seemed to be going great. Lava and Koda were playing, chasing each other around the park and seemingly oblivious to the couple on the blanket. All seemed to be idyllic—until Lava happened. You know, like the saying, shit happens? Well, that's how it is with Lava sometimes. He just “happens.” He strolled over to the pair on the blanket, pretended to have just a passing interest, and then—as he was walking away—paused. I'm thinking,
Oh shit! Lava, noooooo . . . !
Before I could even utter his name, Lava hiked his leg and peed on their blanket.
Hey, it's my park, and you didn't check with me first to see if you could relax here.
And that's just how it goes.

Lava makes a pretty good case for himself as suffering from something. PTSD? As they say, if it walks like a duck, quacks like a duck, and smells like a duck, chances are . . . Should I take under advisement the army's warning that family and friends can deal with the postwar veteran's anger or violent behavior by going “to a safe place and call[ing] for help right away”? Not sure that would work in Lava's case, unless I wanted to watch him being hauled away by animal control while I huddled behind a tree. The brochures also suggest that your friends and family learn to communicate better. Certainly a good idea, but Lava's methods of barking and licking his private parts don't translate as well as I'd like. Still, he's somehow always gotten through to me.

Am I ever afraid that he would attack the children? Never. He always, always protects family members. It was love at first sight for my stepson, Sean, when he met Lava. Since my marriage, Lava has slept in Sean's bed every night and never displayed any aggression toward him. In fact, Lava connects with kids in general. Graham has boarded Lava when I've gone out of town, and he has a young son. “Lava was scratching at my son's door one night,” Graham says, “and I decided to let him in to see what he wanted. He immediately ran to my son's bed, jumped up, and curled up by his feet. Lava gave a huge sigh of relief, like “
Now I can finally relax.
” He also adds, however, that when Lava heard his wife's footsteps in the hall outside the bedroom, he began his low growl. I guess that's what you call high-level resource guarding.

He also took to Cheddar the cat, forming a strong bond across species. So no, I don't worry about Lava and anyone in our house. My mother is another story—Lava will allow her to pet him when she's sitting down, but when she stands or goes into the kids' rooms, he gets very protective of the children.

Lava and I know firsthand how easily life can be taken away if you're not paying vigilant, constant attention. (Even that is not always enough.) So maybe I'm not a “normal” person, especially if Lava and his actions—like being protective of his family, for example—are a reflection of my own. Okay, I don't just arbitrarily assault other people when I see them at the dog park. And as far as I know, I haven't tried to hump anyone in public as a display of my dominance. It's just that from time to time, I still think about the things I saw and experienced during our time in Fallujah. At the risk of repeating myself, I don't think I suffer from PTSD—at least not in the classic sense—but there's something there just beneath the surface that I can't quite put my finger on.

Maybe I owe it to myself and my family to talk to someone more equipped to evaluate my mental health. If I'm suggesting that other people go, maybe I owe it to everyone else to at least check out the couch. Hey, Tony Soprano sucked it up. Maybe I can, too.

“Nobody wants to be that guy who says, ‘I got counseling this afternoon, Sergeant, '” he said, mimicking a whining voice.

—FROM AN INTERVIEW WITH AN IRAQ COMBAT VETERAN CONVICTED OF MANSLAUGHTER
¹³

When I think about actually making that call to announce
that I'm thinking about . . .
therapy
. . . it just makes me want to dry-heave. Every father gets annoyed with his kid at one time or another; does it mean I need therapy? Oh sure, I'm the one who, on duty in Iraq and completely on edge all the time, waiting to be blown up while making a supply run or taking a piss or killing or watching friends be killed, noted in my first book, “It feels normal. Despite the bombs and the insurgents and the rubble, it feels like I belong here.” I felt at home in the middle of all the mayhem, death, and destruction that war renders. Does that make me psycho? Crazy? A mumbling vet, packing heat in the middle of a summer's day?

I suppose one incentive to go is that every time I drive past the intersection leading to the VA hospital, I see one or another homeless veteran standing on the corner with a cardboard placard proclaiming his homelessness and hunger and willingness to work for food (but always more than happy to receive a free “Jackson” or “Benjamin” in lieu of same). I am haunted by thoughts of not being able to support my wife and child. The homeless, hungry vet is clearly deranged, in my clinical and professional opinion . . . and he could be me were it not for the love of a dog who, through no planned effort on his part, brought me the love of a woman. In other words, there but for the grace of God go I, babbling and raging into the Western sunset.

I have the goods to talk about. I've seen some stuff. You tell me what you think. How about this: Combat doesn't happen the way
Hollywood
portrays it in the movies. People don't die slowly in my experience. There's no last “Tell my wife/mother I love her” as a soldier closes his eyes and lets his head loll gently to one side.

No, death in combat is usually violent and sudden, and the new dearly departed is lucky if he even has a head from which a final breath can be emitted. In combat, moaning and screaming accompany death. And the injuries—not only the fatal ones—are the most disturbing you'd ever want to see.

One day after a particularly ferocious firefight, in which our one UAH (Up-Armored Humvee) is nearly destroyed and we take three casualties (walking wounded, fortunately), we manage to get to the field aid station where the wounded are brought to be triaged and sorted before being transferred to one of the surgical or trauma units in Fallujah or, if necessary, flown to Baghdad or Balad. I finish giving our vehicles a good once-over—the gun truck has taken multiple rounds from a 12.7mm heavy machine gun and is out of commission until we can find a replacement windshield—and go to check on our wounded.

One of the Marines from another unit, a kid no more than twenty or twenty-one, is lying on a stretcher, morphine dripping through an IV line into his arm. I squat down beside him to comfort him at least a little bit—he's scared, it's there in his eyes, but he doesn't want it to show—and I can see his wound as I hold his hand and tell him everything will be all right. Where his right thigh quadriceps should be, there's only a cavernous, gaping wound extending the entire width of his thigh down to the bone. It's just a bloody, pulpy mess of muscle, fat and god-only-knows-whatelse where a hunk of shrapnel, not much bigger than a small rock, nearly severed his leg. Incredibly, they'll be able to save his leg, and after some physical therapy he'll be up and running. Probably straight back to Iraq or Afghanistan for a second, third, or fourth tour.

I've been to the naval hospital at Bethesda twice to visit our wounded troops. It's amazing that some of these kids are alive considering the severity of their wounds—concave skulls, missing limbs, filleted organs. How can you be entirely the same again after witnessing this? You nearly break down and cry when you visit one of the Marines you sent to Iraq as part of a transition team, and who just two weeks later is a twenty-five-year-old with no legs. His attitude is so unbelievably positive. He can't wait to get fitted with his prostheses so he can be up and running again. But you want to scream because it's so goddamn unfair.

I've begun to look more closely at my own behavior; having kids also made me more aware of how I present myself to the world at large. I don't want to always be looking over my shoulder, expecting to lose everything that's good in my life. That's why I agreed to give therapy a try. I'm also doing it for the good of the people who will read this book—the veterans and their families and friends who might benefit from overcoming all that macho bullshit and getting help. It can't
hurt
anyone to talk, either. Have I convinced you? Lava is laughing his head off at me, so his vote is in.

On January 2, 2008, I call the VA hospital here in San Diego to set up an appointment. Everyone who knows I'm doing this is thrilled. Even though I keep reminding them that I'm a journalist in this situation. Everyone but me, that is. I'm not so thrilled about the prospects of being “in the system,” as they say, and even less excited about being referred to something called the Mood Disorder Clinic and having to answer the questions on the Beck Depression Inventory, a survey of twenty-two questions that the head shrinkers use to determine if you're depressed or not. My mind immediately races with thoughts of Xanax, Prozac, mood-altering chemicals—and worse. I picture myself going in as a perfectly functioning normal adult and coming out a veritable zombie after undergoing electroshock convulsion therapy, a black rubber block wedged between my teeth and held in place by a leather strap wound under my chin and over my head, the clamps leading to a car battery attached to my testicles.

They can't get me in for almost a month, so I'll have plenty of time to think about the torture that awaits. But then I get the opportunity to speak with a Navy psychiatrist about some of the work being done for veterans with PTSD. I ask him to recommend good candidates to interview for this book; he gives me a bunch of names—several of whom, he points out, “could provide you with medication should you need it.” I don't know why, but that kind of pisses me off. Here I've barely spoken with the man and he's suggesting I need to be on mood stabilizers?

If the VA is wondering why more vets don't call them up for help, maybe they should think about the phrase
mood disorder.
If
disorder
in the medical sense means a disturbance of normal functioning in the body or mind, then does
mood disorder
mean that your mood is not functioning normally? Being disturbed by what we saw in Iraq actually
is
normal, to my thinking. Then again, if I say I'm not disturbed, does
that
mean I have PTSD? It's a lot easier to diagnose my dog.

I'm grumbling about this out loud one morning and Lava just looks at me long and hard. “Hey, buddy,” I tell him, “I know you're juiced, but you were just a puppy. You didn't have the training I had. You're a dog. I'm a man. I'm supposed to be able to cope without chemical help.” It's pretty ironic that Lava's to some degree responsible for where I am today, and yet anyone would agree that he's ten times more wacko than most creatures, human or canine. I guess instability loves company.

There are a lot of ways to treat PTSD, or generalized anxiety/ depression/anger/whatever, stemming from military experience in a combat zone. Many of them are the same things you're supposed to do for a dog with PTSD. Okay, not the talking cure, but the cognitive therapy, where you replace your negative thoughts (human) or actions (dog) with something positive. Or you can purposefully focus on the bad thing that happened (human) or actually relive it in a safe way (dog) so that you become less afraid of that memory. Finally, there are the drugs (human) and the drugs (dog) that can take the edge off and help you use the various therapies out there. I don't want or need medication. Lava had no choice. It's helped him enormously, though. Graham told me that medication has actually saved dogs' lives; without it, they are just too hard to rehabilitate.

The antidepressants that Lava takes are similar to the ones humans use—kind of like Prozac. Perhaps you've heard of it? It's part of a class of drugs called selective serotonin reuptake inhibitors (SSRIs) and I'll tell you, I've seen it in action and it works. Chemicals in your brain can cause you to act in certain ways (anxious, depressed, aggressive) so the thinking is that these drugs can rebalance the chemicals that are out of whack so that you can behave in a more socially acceptable way. There are numerous studies that show these medications help people suffering from full-on PTSD. They've been popular in the States for almost twenty years—for both dog and human.

To Lava's veterinarian, it was a no-brainer. He said he doesn't prescribe it too often, but that with a dog with Lava's background, there were bound to be issues that couldn't be helped by behavior modification alone. The intense separation anxiety and overprotective personality needed an extra boost. The SSRIs are considered incredibly safe. They also give me a chance to try and reassure Lava that he's safe. He can relax and let down his guard, and begin to realize that the mailman isn't delivering anything explosive.

All that said, activity interests me more than medicine, so I'm especially interested in learning about the Virtual Reality Medical Center (VRMC) in San Diego. Psychiatrists, psychologists, and researchers there use VR as treatment for anxiety and panic disorders, social phobias, and PTSD. The program is currently a pilot (or test) project funded by the Office of Naval Research (ONR). It's pretty wild—they simulate different combat experiences so thoroughly it's like you're really there, but instead of actually being killed by insurgent fire you just
think
you're dead. (Somehow that doesn't sound as cool as it plays. But it works.) You're wearing a headset and all you can see and hear is the simulated scene. The army originally created much of this stuff to train soldiers. Now it's using VR to
re
train us.

If someone comes back with PTSD, reliving the moment when his Humvee was blown up by an improvised explosive device during a convoy can actually make him stop flashing back to the scene, because it allows him to realize that it's not really happening. The sessions are designed to push each individual's trigger, and if things get too intense, or the patient becomes too anxious, they can go somewhere else in the scenario or simply remove the headset. All the while, the subjects are sitting in a controlled environment in the safety of an office here in the United States. It's a little counterintuitive, and it has to be done right, but the results are impressive: More than 90 percent of participants claim to be much more comfortable in their daily activities than before treatment. But it doesn't happen overnight.

If a dog survives being hit by a car and is then scared to death of walking even on a sidewalk alongside the road, you're supposed to gradually sensitize him back to the sound of traffic. If you just shove him by the curb and hold him there, he's only going to become more skittish. You have to go slow and be really supportive. That's what the team at the VRMC do. They recommend eight to twelve sessions. (Don't try treating yourself at home with
Call of Duty 4, Halo 3,
or
Turok
on your Xbox 360. The VR environment was created by recycling virtual graphic assets initially built for the U.S. Army-funded combat tactical simulation scenario, and the Xbox game,
Full Spectrum Warrior
.
¹⁴
I kid you not.)

I want to find out more, so I call the first name on the list. Dr. Dennis Wood plays a big role in the VRMC. He's a retired Navy captain, having served a combined reserve and active-duty obligation of thirty-four years, and he does not have the ability to prescribe, so hopefully I'll avoid that issue on day one. In addition to the work he does with the VRMC here in San Diego, he's also a psychologist in private practice in Coronado. He offers to talk to me sooner rather than later. Our initial phone conversation is collegial. We have a great discussion about the wonders of VR as a way to treat veterans diagnosed with or exhibiting PTSD. I explain that I want to do some research for this book; if I find out anything about myself in the process, all the better.

Full disclosure: My publisher got in touch first with Dennis and talked to him about the book. He wasn't that surprised, considering that the large majority of his clients are brought in by their family or friends, or by an enlisted man's commanding officer. Very few veterans of recent wars voluntarily walk into a clinic.