Fixing Hell (20 page)
I pulled the soldier aside and told her to let me work on it, that I would see what I could do. I was never able to arrange for these two married soldiers to work the same shift and live together, but we were able to arrange weekend passes to Baghdad for them.
Sex was a complicating factor in much of our work at Abu Ghraib. I came to know several single women at Abu Ghraib who got pregnant, received adverse legal action, and were sent home. Private Jeni Nelson was a short, fat, seriously ugly young lady. She looked as though she was crying all the time. Nevertheless, she got a boyfriend, got pregnant, and was promptly sent home by her company commander. Did she do it on purpose to get out of Abu Ghraib? Probably, and I’m sure she wasn’t the first.
I couldn’t help but have very bad memories of a conversation with a colonel at Gitmo back in 2003. I had walked into the little mini-mart during the lunch hour and Colonel Clements was bitching out the cashier for having condoms on the shelf. He was yelling, “Sex is not authorized in my camp!” and the cashier was stammering something about how he didn’t decide what to put on the shelves. Later, outside in the parking lot, I stopped Colonel Clements and asked what the hell that was about.
“Colonel, why would we not want these boys and girls to practice safe sex?”
He was pissed at me! “Safe sex? All sex here is safe because there ain’t supposed to be no fucking sex on this damn post!”
With a grin, I told him, “Colonel, if you put a boy monkey in a cage and the boy monkey in the cage is swinging on the vine with the girl monkey, sooner or later, you’re gonna have little baby monkeys in the cage. It’s only natural, Colonel. We would never try to outlaw sex on a college campus, now would we, Colonel?”
I could begin to see steam rise from his collar. He mumbled something, got in his car, and drove away. Colonel Clements didn’t speak to me for a month after that, but I began to see condoms in the mini-mart again even though he had ordered the store clerk to remove all condoms from the shelf. We went through pretty much the same sort of debate at Abu Ghraib, and then in the middle of the summer the same change began to occur at the Abu Ghraib mini-mart. Condoms appeared, and before long we saw an overall improvement in the morale among the soldiers. I began to hear people laughing, telling stories, watching movies together, and simply having fun again.
Even though I was making slow progress in turning things around, I did not fathom that my biggest challenge still lay ahead of me. This one was an internal struggle, one that I would have to solve on my own. Now I was facing every day as a doctor in a combat zone, and I would soon have to determine, once and for all, whether I could be both a doctor and a military officer.
Is This the Day?
Late August 2004
L
ord, is this the day I will take the life of another human to save my own life or to protect the life of my soldiers? Is this the day I will die in combat?
After a couple months in Iraq I was asking myself these questions as I awakened each day. I was a combatant, not a healer, at Abu Ghraib. But still, I had taken an oath to “do no harm.”
I asked myself these questions usually after having “the dream,” as I came to call it. The demons would come for me nearly every time I went to sleep. No matter how well I felt as I lay down to sleep, I awoke with nightmares. Night after night, I woke up in a panic, startled and confused, my heart racing. I always calmed down quickly, but in the early days I rarely had a good idea what had frightened me so much.
What am I so upset about? I would ask myself. What is my struggle?
I had asked these questions off and on since arriving in Iraq, but now they went round and round in my head each night, after I awakened soaking wet from sweat. I knew it had something to do with the psychological impasse of pain, a moral dilemma I could never seem to resolve in Iraq’s dark abyss. Oddly, my nightmares were never about the sights and awful events, like seeing a soldier’s guts blown out and lying on the ground, a charred body, or an Iraqi terrorist with his torso ripped open, blood pouring out. They were about me making the right decisions, finding a way to do the right thing in a wrong situation. My moral compass during the night seemed to be stuck in these nightmares, my mind stuttering like a VHS tape perpetually on pause at the critical juncture in a movie. As I considered the nightmares more, trying to piece together the bits I remembered as I lay in bed trying to catch my breath, their subject became clearer to me. They all tied in to the question that had been bothering me, in a much more conscious way, for some time now: how could I, as a doctor, a healer, knowingly kill another man? I was an Army officer in a combat zone. I might, at any moment, need to kill another human being. How could Dr. Larry James do that?
This quandary held me in a motionless pause each night, yet the nightmares spurred me to face this dilemma head-on in my waking hours, forcing me to cope with a predicament that I had always considered theoretical, something I could push to the back of my mind. I could not run from this question in Abu Ghraib, and unlike back home, sleep was not the customary respite period from such worries. Slumber catapulted me each night into a dialogue with my moral compass. In my head and in my heart, I was stuck on pause. I couldn’t get past this.
For two months I had awoken each morning at about 5 or 5:30 a.m., showered, and then headed to the chow hall, for breakfast and to visit with soldiers. By the time I returned to my hooch at night at about 6 or 7 p.m., I would simply be flat-out exhausted. I showered again, cleaned my weapon, reloaded it, got on my knees and said my prayers. Within a minute I fell into a deep sleep. I slept deeply and soundly. But the nightmares still came, and after a few weeks in which I made a point of trying to remember them and analyze them, “the dream” became more consistent and clearer to me.
In this dream, it was as though I was up in the clouds on a beautiful sunny day—but I was hovering over Arlington National Cemetery in Washington, D.C., watching my own funeral. I could see soldiers from the Old Guard firmly raise the American flag from my coffin. Though it was gloriously sunny up in the sky where I was, my wife sat with the other mourners in the quietness of a dreary, cloudy, rainy day. Taps played and the bugler’s sound echoed in the chill of the Arlington sky. I vividly saw the painful agony, the sadness in my wife’s face, heard her cries and almost tasted the loneliness upon her lips. Surrounded by friends, family, and loved ones, she found difficulty in doing the simplest of things on this day. Then the color guard sergeant did an about-face, faced my wife, and slowly, in a deliberate manner, walked toward her with the American flag from my coffin. He extended his arms and, gently, with the flag in his hands, moved toward her with pensive steps. He stopped exactly one step in front of her, methodically and slowly leaned forward, and said, “Ma’am, from a grateful nation,” as he extended his hands and presented her with the American flag from my coffin. He came to attention, saluted my wife, my flag, and returned to his post with the color guard.
The color guard sergeant, now back at his post, called everyone to attention. As the soldiers fired a volley from their rifles for the twenty-one-gun salute, my wife collapsed. That is the moment where, in a frenzied terror, I would awake gasping for air as though I were drowning. I sat up in my bed, drenched, soaking wet with sweat, heart racing, and tried to find my bearings in the darkness of my room. My watch would read 3 a.m. It would be a long time, almost three years after my return from Abu Ghraib, before I learned that my soul mate of thirty-one years also carried the burden of this same dream with her each night. Like me, my wife was never awakened with the image of her husband blown apart, nor visions of her double-amputee husband trying to walk again at Walter Reed. Rather, just as with my own nightmare, she would awaken at the moment the last volley was fired from the twenty-one-gun salute. As the sound from the rifle reverberated across the Arlington sky, she would awake in a night terror, gasping for air. I would learn that her panic was caused by a fear for my safety. My terror, on the other hand, was driven not by my potential death, but by my potentially doing the morally wrong deed as a doctor.
As time went on, I actually began to welcome the nightmares. They became my moral compass: as long as I had nightmares I knew that I was struggling with the wrongness of what I saw and the notion of how any psychologist could torture a human being. Better to struggle with doing the right thing than to blithely go about your business and not even wonder, never giving yourself a gut check about what you were doing.
But seeing the meaning behind my nightmares was for the daytime, in the light, when I could calmly assess them as I would for a patient. In the dark night, all alone, they were simply terrifying. When the demons came for me, I would reach for my weapon and check to ensure that it was loaded with the safety off. Then, after calming myself, I would drift back into the darkness of night, only to soon find myself haunted all over again by another nightmare. The second nightmare was usually different from the one about my funeral. It would involve an all-out attack on Abu Ghraib in which the perimeter walls had been breached by the enemy. Once again, in this dream I would find myself at the moral crossroads, standing with my M16 rifle with the safety off. As I leave the building to get in the fight, I see an enemy soldier stop, face me, and put his hand on the trigger of his AK-47, ready to blow my brains out. I position myself to kill the enemy and I squeeze the trigger. As the bullet leaves the gun’s barrel, I awake again in a cold sweat.
After the second nightmare was over, I would climb out of my rack and get a drink of water, calm myself, and get down on my knees and pray the same prayer I prayed many nights. “Heavenly Father, thank you for not having me kill another human being today. Please wrap your gentle arms around me, keep me safe and calm at all times with a good heart, a steady hand, and a stable mind. Father, I would also ask that you not have me take the life of another human being tomorrow. In the event that you decide that on the battlefield I must take the life of another human being in the course of performing my duties, please forgive me.”
In a way, this prayer would absorb my pain, soothe my disquiet for the moment, and calm the turmoil deep in my soul. I would get up to my knees, check my weapon, make sure the safety was off, get back in bed, and drift away into a deep, sound sleep all over again.
Early in my tour, I often wondered what it would feel like to get shot. What was it going to feel like if I got a leg blown off or had to spend the rest of my life with half of my skull blown apart? Would I find new strengths in order to function if I became blind from having my eyes blown out during an intense firefight? Would I recover? Would I be a better human being? Those thoughts had begun running through my head on the Air Force C-130 from Kuwait into Baghdad and in my early days at Abu Ghraib. But by late August I rarely thought about getting killed, shot, or blown up myself; I thought more about whether I would have to kill someone else. It was clear to me that I was no longer a doctor but rather a combatant with the sole purpose of helping the Army kill or capture the enemy. I knew that was appropriate in a combat zone, but it still troubled me as a doctor.
What’s the difference now? I would ask myself. I’ve been a military officer for over twenty years. Why is it so difficult this time?
In many ways the reason was simple. This was perhaps the first time in our nation’s history where hundreds or thousands of doctors and nurses were put on the front lines in this manner. Doctors and nurses had been in combat before but most likely not in the same manner and with the large number of health care professionals we had far, far forward in the fight. In particular, for mental health professionals it was indeed a change. Simply because of their proximity to the front lines and being smack dead in the middle of the fight, the options were clear and the choices few: kill or be killed. On a convoy, all soldiers were soldiers and the enemy bullets didn’t care if I was a doctor or a Green Beret, nor could they discern the difference.
On one August convoy to Camp Victory for some meetings and other work, I saw a good example of how some medical professionals can take a while to realize what became clear to me in my first weeks at Abu Ghraib. After my work at Camp Victory, I was getting ready to join the convoy back to Abu Ghraib. We had about five new doctors and nurses who asked to ride with us back to Abu Ghraib. Staff Sergeant Jackson from Boone, North Carolina, was going from vehicle to vehicle prior to our departure to check the weapons of the medical personnel and field their questions. The Humvee in front of mine had a female nurse and a male physician in it. Neither had locked and loaded their weapons. The sergeant couldn’t help but notice that the nurse didn’t even have her 9mm pistol with her. It was at the bottom of her backpack.
“Where’s y’all’s weapons?” Sergeant Jackson asked.
The nurse replied in a condescending tone, “I try to never touch that thing. It’s too heavy. We won’t need it, anyway.”
Without hesitation, this young soldier looked them both in the eyes and spoke plainly. “Ma’am, sir, with all due respect, you need to get the fuck out of my goddamn convoy because when the shooting starts, you shoot back or you’re dead. Or even worse, people around you may get their goddamn heads blown off because of your moral dilemma. These hajis, frankly, don’t give a shit if you’re a doctor or nurse. All they know is they want to put a bullet right between your eyes. So you either lock and load your weapon or keep your butts out of my convoy.”
They both got their pistols and loaded them.
We convoyed from Baghdad back to the compound at Abu Ghraib without a gunfight, but there was one incident that got my attention. A group of ten- to thirteen-year-old kids threw rocks and bottles at our vehicles as we drove by—not an unusual occurrence, but this time it triggered a question for me. As I watched one of the little bastards throw a rock, I asked myself,
Suppose that thirteen-year-old kid was throwing a hand grenade at your vehicle. Would you be able to shoot that child?
I decided that if it meant saving my life or the lives of my fellow soldiers, Colonel Larry C. James could shoot the boy and would. But Dr. Larry C. James couldn’t. If it actually ever happened, both the colonel and the doctor would be haunted by it for the rest of my life. I was terrified by that scenario and it occurred to me that I was never prepared psychologically, nor emotionally, to deal with this possibility, let alone cope with the reality of shooting a child. When the convoy arrived I went back to my hooch and dropped off my gear. It was now about 5 p.m., suppertime.
