Fixing Hell (24 page)
Clearly, Joe was one of those taxi drivers who liked to explore the world through impromptu chats with their fares. “Hmmm . . . Doc, I got a question for you,” he said. “Why did it take a whole team of you guys to decide if Jeffrey Dahmer was crazy or not?”
“What are you talking about, man?” I asked. “Jeffrey Dahmer, that serial killer who ate his victims?”
“Yeah, that one,” he said with a big grin. “Doc, that guy was drugging young guys, tying them up, raping ’em, then the crazy nut would cut up their bodies, stew ’em in a pot, and eat the bodies. Doc, you mean to tell me you really need to have a committee of shrinks to decide if that fucker was crazy? Man, it ain’t shit a normal dude would do.”
I was stunned to get this question out of the blue, and I just laughed it off without giving Joe a good answer. But it got me to thinking about the same question with some of the Muslim extremists who employ terrorism. Do we need a new mental illness diagnosis for the terrorists? Are they mentally ill?
I had many debates and conversations with other psychologists, often using the American terrorist Timothy McVeigh as an example. He’s the former Army soldier who blew up the government center in Oklahoma City in 1995, and was executed in 2001. A colleague of mine by the name of Dr. Harry Jackson told me, “Larry, the guy was perfectly normal.”
I responded by saying I didn’t see how he could be. “Harry, let me see if I understand your logic,” I said. “McVeigh was pissed at the government, so he went out and blew up a building and killed or injured a couple hundred people, correct? Harry, how in the hell is that a normal, rational thought process?”
Dr. Jackson believed that because McVeigh was not hearing voices, seeing little green men, and he knew that his actions were wrong, he was “normal.” Of course, I disagreed and told Dr. Jackson that our field needs to rethink what we classify as normal and a mental illness.
Even before I went to Abu Ghraib, I had many conversations with psychologists around the country about the mental state of terrorists. Of course, many loudmouthed, know-it-all PhD “experts” from around the country would say that these terrorists are perfectly normal. Now, mind you, most of these clowns had never sat in a room and looked in the whites of a terrorist’s eyes. I have, on many occasions. Major Leso and I, while he was still in Cuba with me, had many long discussions about this. John was of the belief that the desire to kill all “nonbelievers” was cultural and not unique to Muslim extremists. He cited the example of Japanese suicide bombers in World War II and asked if I thought they were mentally ill.
“John, I don’t have the answer,” I told him. “But it is clear that the mind of the modern-day terrorist is unlike anything we have ever seen before.”
Even aside from the question of the terrorist mentality as a new mental illness, I was dealing with plenty of the standard, old-fashioned, unquestionable mental illness among our detainees at Abu Ghraib. No one in the White House ever expected that the rates of true mental illness would be such a problem with this new enemy. We had a significant number of depressed patients and schizophrenic patients, but we did not have the hospitals in place to manage and take care of them. We also had a large proportion of the enemy whose belief structure was so illogical, rigid, and factually incorrect that it appeared to be delusional—the ones who thought the earth was flat or that Iraq was the most advanced nation on earth. Add to this the 10 or 20 percent of their population who were simply dumb as a box of rocks, and we had a real challenge in how to handle these people. Collectively, such an enemy yielded a new battlefield.
Our rates of mental illness such as depression, psychosis, and anxiety at Gitmo and Abu Ghraib actually matched the rates of mental illness in U.S. prisons. So it wasn’t that the Iraqi or Afghani population produced more mental illness. It probably produced about the same rate as the United States, but even that was problematic because the prison system back home had some resources, limited as they may be, to deal with those mental illnesses. We had virtually nothing of the sort in Iraq when I arrived. We had to build an inpatient psych unit in Abu Ghraib, just as I had done in Gitmo, and by September we were seeing how much impact those resources could have on these patients. We now know that in future wars we must plan to manage and treat at least 3 to 15 percent of all the prisoners we capture for a psychiatric condition while they are in our custody. Likewise, as this war goes on we will have to plan on fighting an enemy who has many soldiers who are ignorant and cannot read and write and/or may very well be mentally ill.
As a doctor and a soldier, I saw this challenge as a unique opportunity to merge my skills and my professional goals. We have to be ready to treat mental illness in the prisoners we pull off the battlefield, but we also must assess whether we are facing an entirely new mental illness diagnosis in the form of the terrorist whose devotion to jihad is so extreme, so one-dimensional that it may cross a line into a disorder that can be defined and studied. Treating this enemy like any enemy of old would be a mistake.
This new enemy does not want to just go to war with U.S. soldiers, sailors and marines. This new enemy wants to go to war with every American man, woman, and child, to kill them all. As Joe the taxi driver would say, that’s not normal.
I’m Broken
November–December 2004
L
ife goes on back home while soldiers are away at wars. Wives and husbands sometimes cheat, teenage daughters get pregnant, sons get arrested, jobs are lost, and thousands of homes are foreclosed on while we’re away serving our country. Too often, while we’re right in the thick of fighting our nation’s wars, death finds the soldier in a combat zone—on the battlefield, by the death of his parents, or perhaps by the death of an innocence he once had.
I left Iraq on October 31, 2004, Halloween night. As I headed to the military air terminal in Baghdad, I mourned the small measure of innocence I still had when I arrived in this place. I was kind of anxious about getting on the plane because of an experience I had two months earlier, when I had to fly into Kuwait to pick up my 9mm pistol that was confiscated when I arrived on a civilian flight without all the right paperwork to bring my weapon into the country. On that flight, the remains of a dead soldier were loaded onto the C-130. As the truck with the coffin approached, the crew chief asked us all to exit the plane and form two lines, one on each side of the huge truck. All activity on the entire runway and military air terminal stopped at that moment. As the coffin was slowly removed from the truck, the order “present arms” was yelled out. We all came to attention and saluted our fallen comrade who had died on the battlefield. An Army chaplain positioned himself in front of the coffin and said prayers as he led the coffin into the C-130.
Most often, planes heading out of a combat zone are filled with chatter, laughter, joy, and fun as troops head home. But not on that day. It was a somber occasion that reminded us all of how lucky and how fortunate we were, and that one soldier on the flight had made the ultimate sacrifice for his country.
The images of that flight kept running through my mind as I boarded the Air Force C-130 cargo plane for the first leg of my flight out of Iraq. Unlike all of my previous flights to and from Baghdad, I was the only passenger this time. Usually there would be dozens of us stuffed in this hot plane like sardines, breathing diesel fumes and each other’s stink. Having the plane to myself this time didn’t make it much more comfortable, however. I overheard one of the crew members say that it was 145 degrees on the flight line. Once we were squared away and ready to go, we sat in place with the propellers running for forty-five minutes. Why? I have no earthly idea. All I know is that I was soaking wet with sweat down to my underwear. Finally we got the go-ahead for departure and the plane began to roll quickly down the runway. Even though I had done this drill many times, I was still surprised to see how fast this big-ass C-130 could take off, and in such a short distance. I sat up straight, strapped in with a seat belt, and braced myself for the combat takeoff maneuvers that I knew were coming, the departure equivalent of the same wild ride that I had taken when landing in Iraq the first time. Within an instant it seemed as though we were facing straight up. As the big plane went vertical, twisted, banked, and yanked left and right, I was almost lying down sideways from the force. Then the plane’s engines howled, we banked down with a sharp turn to circle the airport, leveled out, and headed south to Kuwait City. I was able to sit up again as the plane flew straight and level. The air became cool as we gained altitude, and my sweating stopped.
After the takeoff-induced adrenaline surge wore off, a sense of calmness fell upon me. As I dozed off to sleep, the loud rumble of the C-130 providing a constant din that helped block out everything but my inner thoughts, I kept wondering who I would be after this experience.
Will I be different when I get back home? Will I get post-traumatic stress syndrome? Am I gonna have nightmares?
For the moment I decided to enjoy the bliss of being at 10,000 feet, safe, out of harm’s way, and heading home. I drifted off to sleep.
We landed safely at Camp Doha Air Force Base right outside Kuwait City. A couple of young soldiers were nice enough to help this old colonel carry his gear to the VIP quarters where I would reside for approximately the next two weeks. These VIP quarters were very much different from the VIP tents in Baghdad. The VIP tents in Baghdad were like all the other tents, filled with cots and large air-conditioning units that worked on occasion. The only real upgrade for the Baghdad VIP tents was the sign on the outside of it that said “VIP.” The Camp Doha VIP quarters, on the other hand, were significantly better than any accommodations in Baghdad and the standard tents in Doha. These quarters were in a large structure that had tin roofs and tin doors. The rooms had regular beds with linen, a TV, refrigerator, a phone, and, most importantly, regular showers and toilets. After spending time in Baghdad, these quarters looked like a five-star hotel.
I got to my room, put my gear away, took my 9mm pistol from its case, and removed the clip that held the bullets before I locked it away. I headed for the shower and took a hot soak for what seemed to be an eternity. While walking back to my room, it seemed as though the weight of being in a combat zone had been quieted by the hot shower. I got dressed and called my wife to tell her that I had survived the perils of Abu Ghraib and had arrived safely in Kuwait. She cried that night, as did I, thanking the Lord for allowing me to return without the loss of life or limb like so many other brave soldiers. I would soon be in the comfort of her arms again. Afterwards, I called my eighty-one-year-old mother, wanting to assure her that I was all right and also to thank her for steadying me on that first terrible night in Abu Ghraib.
She didn’t sound good. Her voice and spirit had been weakened from the forty-year battle of being an insulin-dependent diabetic. Neither I nor my sisters knew it then, but she was dying.
I lay down on my bed to just unwind before I headed to the chow hall for the midnight meal. I was overcome by exhaustion and slept for three hours. At 3 a.m., I heard a loud bang—BAM!—followed by voices in the hallway outside of my room. Groggy and disoriented in the utter darkness of my room, with no lights to help me find my bearings, I responded as I would have in Abu Ghraib.
We’re under attack!
With one quick, fluid motion, I rolled out of my bed onto the floor, got to my feet, and managed to find my flashlight. Hurriedly, I found my way to my 9mm pistol, locked and loaded it, and turned the safety off. The voices outside of my room grew louder. Now sweating, a voice in my head was screaming at me.
Hurry, Larry! They’re coming for you! They know you’re here and they’re coming for you! Get ready to engage!
With my loaded pistol in my right hand, I quietly eased my way to the door.
BAM! The loud noise came again in the night, making me flinch and crouch lower to the floor.
Damn, was that another mortar?
My heart was racing as I eased open the doorknob with my left hand while keeping my right index finger on the 9mm pistol trigger. I opened the door, 100 percent ready to engage, and saw two sixty-year-old American women standing outside my room laughing and talking. One of the ladies saw me there, crouched and ready to blow her fucking head off. She either didn’t realize what the look in my eyes meant or she was trying to defuse the tension, because she didn’t react like someone in the line of fire.
“Shucks, son, sorry we woke you up,” she said softly, very gently, and with a bright smile. “Son, just go on back to sleep. You look exhausted.”
The look on her face and her gentle tone immediately slowed my racing heart, and after a moment in which I just stared at her, trying to understand what was happening, my thoughts slowed and the fear eased. As I lowered my weapon, I heard another BAM! and turned toward the sound just in time to see a door closing behind someone. Every time someone opened the tin doors at the entryway to the building, they slammed shut with a sound much like that of a mortar’s impact into the side of a building at Abu Ghraib.
I got up and hurled myself back into the bed, still clutching my pistol. I lay there trying to understand what had just happened, and at that point it was clear that my psyche had served notice: I was not the same man, nor would I ever be. Even though I was able to quiet my mind again, I knew that the anxiety would reappear. Intellectually, I realized I was safe and out of Iraq, but some part of me still questioned the safety of my surroundings.
It was just a door this time, Larry, but that doesn’t mean you’re out of harm’s way. You’re still on the list. They still want to find you.
I placed the pistol on my nightstand and slid my bayonet within arm’s reach under my bed. Assured that I had my weapons within reach, I dozed off back to sleep. Then I had a horrible nightmare. I dreamed that I was on a convoy, hot as hell in the 130-degree heat, soaking wet with sweat, and sitting directly behind the driver, when my Humvee got a flat tire. As we pulled over to the side of the road, my driver got shot in the head. His blood and brain matter splattered my goggles and face as I sat there behind him. In the ensuing frenzy to defend ourselves, my M16 jammed and I dropped my 9mm pistol. I hurriedly found my sidearm, and as I looked up with my 9mm ready to fire, I could clearly see the eyes of a fifteen-year-old Iraqi boy ready to shoot his AK-47 at the soldier standing to my right. Instantly reliving every moment of doubt and moral debate that I had pondered over this moment, I nonetheless pointed my weapon at the boy, pulled the trigger to save the life of a fellow soldier . . . and then I awoke in a panic, chilled in cold sweat, in the quietness, the utter darkness of my room.