Fixing Hell (16 page)
Colonel Matson had lost sight of the fact that we had many soldiers at Abu Ghraib who needed mental health services. The killings, the carnage, sexual assaults, depression, and fear were abundant at Abu Ghraib and the officer responsible for coordinating services at the compound failed to see the need for these services to be offered there. I had to try to appeal to the soldier in my friend.
“Kerry, you’re forgetting one thing. Back home, that soldier can hop in a car by himself or with a buddy and go to the doctor. In Abu Ghraib, getting that one soldier to Baghdad requires a convoy of three armored Humvees. That’s a total of nine soldiers to deliver one patient to the Army hospital in Camp Victory. You really think that’s a good way to get mental health services to these folks?”
It took a bit more back-and-forth, with some arguing about how many soldiers really would need to take that dangerous convoy, but I won the debate, for the moment at least, when Colonel Matson gave in. This was only one small victory; there was plenty more to be done, and over the next few weeks my friend drove me up the wall by saying no to every request, every suggestion for improving mental health care.
Colonel Matson wasn’t just trying to be obstinate when my efforts were resisted. She was in turn being pressured by the senior physician in Baghdad, the commanding general of the 322nd Medical Brigade, Brigadier General Thomas Huck. Huck believed that it was not his mission to provide mental health care to detainees. One reason Matson was being pushed around was that, although a brilliant mental health officer, she lacked the squared-away appearance required of all good military officers—a perfect uniform and an attitude to match. Matson’s uniform was never quite right, just like her posture and the way she carried herself. It was all close enough to be technically compliant, but the West Point graduates in Baghdad instantly spotted any shortcomings. Without a real military bearing in her appearance and attitude, Colonel Matson might be considered a good mental health officer but would never be seen as “one of the boys” in a combat zone. But I also knew that her appearance wasn’t the only explanation for why she was seen as an outsider. Her boss, the commanding general, wasn’t respected much either, and that undercut her authority with the troops. Her boss was a squared-away type, but the troops questioned him for entirely different reasons related to his job performance.
After a while, it became apparent that I wasn’t going to make much progress with Colonel Matson, nor the leadership at the 322nd Medical Brigade. I decided to work around these folks and go right to General Miller on this one. General Miller had little respect for the commanding general of the 322nd Medical Brigade, so he was receptive to my ideas. My staff and I wrote up a detailed report on the mental health needs at Abu Ghraib.
During one of our regular meetings a few days later, I went over my argument for why we needed a large complement of mental health staff, ready to make the case with some passion if necessary. But General Miller just listened to my explanation and said, “Tell me what we need, Larry, and I’ll get it.” The timing was perfect because there was a debate back in Washington, D.C., at the Office of the Surgeon General, that centered on medical resources at Abu Ghraib. Many felt that the prison was going to close any day now, so why put resources into it? But as long as the issue was being debated, General Miller said, there was an opening to make our case for better medical services. My belief was that we had soldiers on the ground and it was the largest prison population in Iraq. These were the imperatives one needed to justify the resources, I thought. I explained to General Miller that the limited medical and mental health resources at Abu Ghraib were completely inadequate for this population. I told him we needed a team of psychologists, psychiatrists, and psych nurses to meet the need there. General Miller called the Army surgeon general that night and told him we needed more medical and mental health resources. The next day, Miller reported to me that by the end of July staff from the new 115th Field Hospital would start rolling into Abu Ghraib. And with it would be a complement of about thirty psychologists, psychiatrists, psych nurses, and psych techs.
Most of my medical colleagues in the region hated me for this. It would mean that some of them would have to leave the comfort and safety of their offices in the Green Zone in Baghdad by the U.S. embassy. Perhaps, just maybe, one or two of them would have to perform their medical duties in Abu Ghraib and risk getting shot at, or worse, not be able to watch TV. Let’s just say I didn’t shed a tear over their plight.
June was flying by quickly as I assembled a biscuit team of two psychologists in addition to myself and two enlisted psych techs. This was not easy. At this point there was neither a training course for a psychologist to acquire expertise in this area nor much that one could read. So Colonel Banks and I identified two solid reserve clinical psychologists who were willing to put their lives on the line and come to this hellhole. One of the officers was a senior ranking psychologist within the Federal Bureau of Prisons. The other was well trained as a psychologist. I told Colonel Banks, “Just send me two good officers and I’ll do the rest.” He did exactly that. The enlisted techs who were selected had both worked for me previously; one at Walter Reed and the other at Gitmo. I trusted them to serve as my eyes and ears with the enlisted soldiers. Now that we were fully staffed we were able to be present at the intel center twenty-four hours a day and seven days a week. The orders from the general, myself, and the intel center director were crystal clear: if the biscuit was not present, there were to be no interrogations. The additional benefit of having a full staff allowed me to spend a great deal of time walking the compound and grasping just what in the hell had led to the abuses at Abu Ghraib and the looming level of despair that was ever-present.
One of the first things I noticed was that these soldiers, who probably arrived in excellent physical condition, were starting to look like couch potatoes. I learned a long, long time ago as a psychologist that one of the worst things for a patient who is depressed is to be inactive and lie on the sofa most of the day, just hiding away from the world. We had a lot of that going on at Abu Ghraib, or at least the combat-zone equivalent of lying on the sofa. Most of the soldiers at Abu Ghraib gained ten, fifteen, or twenty pounds during their deployment. Many of them were attempting to hide and use food as their elixir. I knew that activity is one of the keys to getting a depressed patient turned around in the right direction. We got busy with putting together a physical fitness program, and I requested more equipment for the gym.
There were plenty of examples of how things had gotten so bad at Abu Ghraib. In addition to the lousy oversight by superior officers, the prison population posed challenges that would have been daunting even back in the States, with all the best resources available and without the fear of mortars coming at you. One day in early July, I was asked to see a teenage Iraqi soldier, a boy, who had been arrested for firing an RPG (rocket-propelled grenade) at some soldiers. This kid was apparently suicidal. I went to see him and once again my heart dropped at the sight of such a young boy in our custody. I knew, though, that being held by the U.S. Army was not this child’s only problem.
His name was Abid, and though he was about fifteen years old, he could have passed for much older. He looked disheveled, smelled of feces, and wore tattered, torn clothes. He looked and smelled as bad as a sixty-year-old man living on the street in Washington, D.C. Through the aide of an Arabic interpreter, I learned that he had been kidnapped from his home by a local gang lord. Like most other teenage boys in his country, he was indoctrinated at a local mosque and believed that it was his duty to kill Americans and all other infidels. Also, he was angry because he felt that U.S. soldiers had wrongly captured his father and placed him in prison. The boy’s father, a truck driver, had lost his business and their home because he was locked up for eight months. It was apparent to me that Abid was very ill and the translator explained to me that the boy complained of a stomachache as well as wanting to kill himself. I called the camp physician to examine him. While we were waiting I chatted casually with the prisoner, with the aid of the interpreter, Harim. Eventually I got him laughing about how ugly his first girlfriend was.
“Hey, if you’re locked up here, at least you don’t have to see her in your hometown, right?” I waited for the translator, and then I saw a small grin creep across Abid’s face. He spoke softly to the translator, who then interpreted for me.
“He says he’s hoping the girl’s father will arrange for her to marry someone else while he is locked up,” Harim said. I looked at Abid and we both laughed out loud.
Seeing Abid laugh was some solace. In a way, even after my duty at Gitmo I was still sort of unprepared for this type of prisoner. Seeing a child in prison never seems right. But still, it’s not every day in the United States that you meet a teenager who was arrested for trying to blow the head off a policeman.
The living conditions were inhumane at Abu Ghraib, and it was particularly wrong for any youth to be housed in such filth. I needed to develop a rehabilitative plan for these young boys who were in our prison, to include their psychological, medical, academic, religious, and athletic needs. Our military was equally ill-prepared (medically, academically, in facilities/logistical planning, and in terms of mental health services) to manage the juvenile enemy combatant. No one was prepared for the large number of teenage terrorists we would encounter in Afghanistan and Iraq.
I worked closely with the camp physician and leadership to form the nucleus for a rehab team. We put in an order to improve the facilities with air-conditioning, and we made plans for adding recreational and educational activities. General Miller brokered a deal with the Iraqi minister of education to provide us with Iraqi tutors for the teenagers, and that helped us make tremendous progress with their rehabilitation.
I thought a lot about Abid while I was in Iraq. He could appear cheerful, kind, and engaging as long as you didn’t talk about why he wanted to kill Americans. That was when you realized you didn’t really want this kid hanging around your neighborhood. Whenever anyone asked him about shooting at soldiers, building weapons and IEDs, or bombmaking factories, he would sit up in his chair and the pupils of his brown eyes would dilate. He went from likable teenager to homicidal terrorist in an instant, like you had flipped a switch. He would begin each sentence with “It says in the Koran,” but he could never tell the Arabic translator where in the Koran it said so. He couldn’t read a lick! This was a common strategy of the Iraqi and Afghani leaders: deny people the ability to read. Illiteracy enslaved them in that they would have to rely on the Koran’s interpretation from the gang lord or the tribal leaders. They couldn’t read it for themselves and realize those people were feeding them a lot of bullshit to suit their own agenda. I learned that this was why so many schools in Afghanistan had minefields around them—to keep the children out of schools, to keep them dumb, to keep them useful.
The translator Harim would sometimes try to enlighten the young man about how he had been led astray by people who lied to him about the Koran. One afternoon he told Abid, “Islam is a peaceful religion. A good Muslim never hurts anybody with his hands or his mouth.”
“Kill all nonbelievers!” Abid shouted in response, full of intense rage. It was almost like the mental rigidity of many delusional patients I had seen over the years. I couldn’t help but ask myself on many occasions,
Is Abid crazy? Can this be more than just a wrongheaded dedication to his cause? Is he thinking this way because of a delusional disorder?
These were questions our country was not prepared to answer, and even more so as they related to juvenile enemy combatants. The closest we had ever come to waging war against an enemy with a similar mind-set was when we fought the Japanese in World War II. The kamikaze suicide bombers would sign up for missions that required them to crash their planes into U.S. ships. We had never seen this prior to World War II—and the very idea of young people sacrificed by their leaders, and willing to be sacrificed, freaked us out at the time. The thought of such unstoppable fanaticism probably unnerved American servicemen even more than the actual damage wrought by the suicide attacks. That was terrorism. This time around in the global war on terrorism, we were unnerved by the idea of these teenage terrorists coming at us in such large numbers. Like the Japanese suicide bombers, the JECs are rarely talked out of their mind-set of “kill all nonbelievers.” In some regions, 10 to 20 percent of the Muslim fighters are teenagers. As the global war on terrorism spreads, we will have to dissect and analyze this issue. If we are to be effective in this war, we will have to ask, “Is this part of a mental delusion?”
The question has to be asked and the problem of teenage terrorists and their possible mental disorder has to be addressed. The first suicide bomber who walks into Madison Square Garden or Union Station may very well be a twelve- or thirteen-year-old with a backpack filled with C-4 explosives. I’m sure Abid would have been willing to do it.
Abid and the other JECs were constantly on my mind through June and July as I struggled to figure out how we should handle them, how I could care for their psychological needs as a doctor while fulfilling my duty to my country as a U.S. soldier. That was the type of question that often troubled me as I settled into operations in Abu Ghraib. I could never get away from the human suffering in this place. The screams and desperate faces of those young boys, and the smells of their filthy cages, came to me in my sleep, and they still do. And to this day, when I least expect it, I see the image of that young female interrogator being psychologically tortured by the terrorist in the late night of my first twenty-four-hour period at Abu Ghraib. Sometimes I can clearly see her face and hear her gasping for air as though she were standing right next to me. If I could pick the one thing that was perhaps the most broken about Abu Ghraib, it would be those sailors, soldiers, and marines abandoned when night fell upon them. Rarely would there be any officers or senior enlisted soldiers providing oversight, supervision, or guidance to interrogators in the late-night hours. I knew that it would be an uphill battle to convince many of the supervising interrogators to come out of their cement buildings, stand over the shoulders of these young interrogators, and provide 100 percent supervision at all times.