With Veterans Day this month, my thoughts turn to a presentation made recently at the Veterans Administration Medical Center in Salem. A nurse practitioner and specialist in hospice care for former military service men and women, Deborah Grassman, spoke on “Wounded Warriors: Their Last Battle.”
“The battle” represents the bad memories of real battles which for some men –fewer women–come back to haunt them as the end of their life approaches. Medical personnel like Grassman, an age contemporary of some Vietnam conflict vets, are now seeing how even after 70 years or more World War II soldiers and Marines especially are re-living the horrors they experienced long ago.
Speaking especially for people like chaplains and nurses who work in facilities for aging vets, Grassman said Post Traumatic Stress Disorder (PTSD) is most likely to show up in those who killed someone face to face. In Vietnam especially where guerilla warfare was evident, the possibility of being killed without warning caused almost constant fear, she related.
And now with casusalties from America’s latest war since 2003 some of the same conditions — unexpected and seemingly senseless death or permanent maiming of a buddy–are almost certain to fill hospitals for years to come.
It’s important, said Grassman, for spouses, parents and siblings of such casualties to accept the mental trauma for what it is — a disabling condition in some ways as bad as the loss of a leg.
The hospice nurse, who has worked with war casualties at a Florida veterans’ hospital for 26 years, pointed out that when men are subjected to such sights as children and other innocent civilians being killed –perhaps by their own weapons–they react in three ways.
Some can face the reality, can talk about it at the time and learn wisdom from the experience. Grassman said they may eventually see some grace in what happened.
Another group acts out their trauma in anger and bitterness which might turn into violence. In World War I such soldiers were regarded as “shell shocked.” Other names have been given,for in all wars the guilt and terror feelings are the same.
A third group of traumatized vets are those who have buried their guilt and terror so deeply –for fear of being thought cowards — that it is not recognized until they themselves are facing death.
How should a loving relative deal with such late-life terrors? Grassman suggested asking the patient if he was ever in danger while in the military. If they show some interest in telling a story, encourage them by listening carefully and noting especially feelings. Asking if anything is worrying them now may encourage the veteran to participate in prayer for forgiveness and healing.
And when this takes place, Grassman said she has seen remarkable relief and even joy expressed in the final days of life.