Living Combat and Dealing With The Afterwards: Part 1

With the conflict in Afghanistan coming to an end for Canada, an alarming percentage of combat veterans suffer from operational stress injuries (OSI) due to combat related events. In fact, about a quarter of the Canadian soldiers who deployed to Afghanistan have some sort of OSIs.

I was diagnosed with PTSD with heavy anxiety in early 2010, after a 7-month deployment to Kandahar with the Afghan National Army (ANA). During that deployment, our 8-man team was involved in more than 200 firefights, resulting in about 30 Afghans, including soldiers and civilians, who were wounded by both the Taliban and our own assets.

Now let’s come back to today. To be able to get through some sort of daily routine, I take 5 pills every night before I go to bed. I am awaiting my medical discharge from the Canadian Forces and I will be granted a permanent disability due to my heavy anxiety. I am 30 years old, been in for 14 years (I joined the army reserve at the age of 16, and then switched to the regular forces later on). Almost half of my life was devoted to serving my country and now I am soon to be “retired.” Let’s get something straight here: I am lucky to have the opportunity, but it is very hard to leave what I thought would be my career this way.

Here in Canada, we have access to a superb mental health program where we will be treated really well and looked after. But PTSD is still a very delicate subject, and most of the soldiers will see it as a weakness. Having PTSD doesn’t automatically mean that you will be discharged from the Canadian Forces,But there is a pretty good chance it will. Unfortunately this mental health programs is severly lacking care providers. Although the system is very good, it is getting harder and harder to have decent services and our routine appointments are pretty much stretched out. I use to see my shrink every week or whenever I needed but now it can take up to 2 months.

The system is well-made. You have the possibility of having two temporary medical categories of six months each to give you time to get help and work on your symptoms. While you are on these, you cannot deploy or leave your base. It has been created so you can receive the treatment you need without having to go somewhere else. If you are not feeling better after those two categories, you will be placed on a permanent medical category where the decision of keeping you or discharging you will be taken.

My whole process from the first temporary category to my discharge date is about 2.5 years. If at any time during those categories you start feeling better, there is no problem for you to be put in a ‘’fit’’ category and have the ability to deploy again.

Is PTSD really a weakness? I don’t think so. When people ask me how I got PTSD, I tell them that it’s because I cared too much about what was going on. I strongly believe in that, as well! Every time I had a patient, who was either a civilian or a soldier, I took it very seriously and gave them all the care I could. As a TCCC  (Tactical Combat Casualty Care), it was hard for me since I was an infantryman and not a medic. I only lost three patients who died in my arms. The remaining were put on the medevac bird alive. Unfortunately, we weren’t able to do a follow up to get their status.

The event that started it all is when one of our ANA engineers stepped on an IED and was blasted about 20 feet in the air. I saw the whole situation with my own eyes from start to finish. Every morning we would be doing a 13 km road sweep to ensure that no IEDs were placed during the night. Mirage was the first engineer of the company, and he was the one sweeping the culverts and the roadside. But one morning he decided that he would be going fast. It was his last day on earth. As he was moving towards one of the culverts he had to sweep, he stepped on a PMN with 4×1 gallon jugs of homemade explosives, HME. Both his legs and his right arm were gone in a pink mist. When he landed, he was already dead. The ANA dragged him towards one of our MRAPs so we could put him in a body bag. I will not elaborate on what was left but you can imagine…

It took almost a year of heavy treatment before I stopped having nightmares about it. But the worst were the civilians, because they were mostly at the wrong place at the wrong time. I had to deal with about 10 children who were injured by shrapnel, gunshot wounds, and even one who got hit by a truck at 80 km/h right in the bazaar beside our COP. The worst part is that they were not even crying like our kids would do. The reason I was given is that crying would show a sign of weakness and it wouldn’t get the pain away. Put yourself in that situation: you have a 6-year-old boy who has one of his testicles chopped off by a piece of shrapnel, and he is not even crying. This, I tell you, affected everyone who was beside me while I treated him. We are used to seeing them cry when they got hurt and by not doing so, I think it is harder for us to process these situations.

Even now, after more than three years of therapy, I still have issues about it. I keep telling myself that I could’ve done more and that I should’ve saved the lives of the three who died in my arms. I had about 30 casualties in seven months, but I only think about those three.

Our TCCC training prepared us well to deal with the casualties. It is a two-week training course that focuses on trauma,a and you practice different scenarios four times a day. But even with that training, we were told that nothing would prepare us to see it live. The only way we could get through it was by detaching ourselves from the reality. When I had patients, I never saw them as human beings but only as a body that I needed to fix.

While I was in Afghanistan it worked well, but when I came back to a more ‘’normal’’ life, it hit me right in the face. The emotional detachment works well, but it will always come back to haunt you one day. The best thing to do about this is to accept it and get some help.

I was awarded the Chief of Defense Staff Commendation for saving numerous lives, often under fire. But as of today, I am still struggling and I feel guilty about losing those three, and I don’t even know if it will go away. I still sometimes feel like a complete loser and a weak soldier because I am getting medically discharged because of PTSD.

(Part 2 of this 3 part article series will focus on our firefights and how we would react through them. It didn’t affect me as much as the wounded Afghans, but it did leave some bad habits in me. Part 3 will be about how I now deal with my symptoms on a daily basis.)