Elisa A Escalante/ LCSW/ 5-26-2024
“How many people can say that they know the look in the eyes of someone who is already dead? Ready to end it all, ready to hopefully go to Heaven. And then he did. I will NEVER not blame myself.” -EaE
On a random day while working at the combat stress clinic in Afghanistan, 2012, one of the social workers told me that they would be flying out on a training mission and I would need to reschedule all of their clients for the next couple of days. “Great!!!!” I thought. “I just loved giving mental health patients the bad news ….” (sarcasm) as the receptionist. I tried to get a hold of as many of them as I could for rescheduling, not all of them answered. One particular patient showed up for his appointment, and I had to tell him the bad news.
He looked very disappointed about missing counseling that day. More distraught than usual. I asked him if he needed to talk to the other social worker in the clinic. He hesitated but then declined. He had a look in his eyes that caused me to think twice. “Are you sure?” I asked. “yes…” he said. Then I rescheduled him and he went about his day.
The next morning I woke up to a note slid under my door. I felt a drop in my stomach the moment I saw it. I opened it up to a sentence from my social work colleague: “come in the clinic, we need to talk”. The moment I walked through the door of the combat stress clinic the social worker pulled me aside to talk. ‘What exactly was the conversation you had with ______ (keeping name confidential) yesterday?” As I started to try to talk, she informed me that he was found after completing suicide, with a gunshot wound to his head. He was found that same night in his room. The same day he was rescheduled.
I tried very hard to keep my composure, as I usually did. Very rarely did people see me cry, especially in the military. The social worker was very calm and nice about it. She assured me it was not my fault and that they just needed to gather as much information as they could about the incident to include an Audit of the patient’s social workers notes. The psychiatrist of our team was an angry man who often insulted me. But even he also assured me later in the day it was no one’s fault. They were kind, but it did not matter. I was already blaming myself.
The very next day, they did a Memorial for the soldier and Did a flag draped coffin, they carried him to the C17 aircraft, and it flew away. I do remember gun shots, saluting, Taps. Thankfully, I did not attend this with anyone I knew. Tears were streaming down my face through the whole thing. You may be thinking “So what? That’s normal!” But, in the military Stoicism is important. Especially in war, you cannot afford to ‘fall apart”. So, like many other things in my life, I buried it. I compartmentalized, I had plenty more days ahead of me in Afghanistan, many more patients, many more missions. More attacks on the base; mortars, gunfire, KIA’s, WIA’s and many more patients that needed us (combat stress team).
I felt like a failure from a military standpoint and a mental health worker standpoint. This is what is known as a ‘Moral Injury’, when something traumatic happens to us that also leads us to question our own morals. “Was it right to let him walk out of the office when my gut told me to worry?” “Was it right to even be in war? What are we fighting for? Is it worth it? Everyone around me is hurting and suffering and for what?” “Is it right to try to help people be ‘okay’ enough to stay at war and keep fighting? Knowing that long term, they will suffer the longer they stay here?”
I grieved the loss of this soldier and I grieved for every patient we had that lost someone. Mental health workers and medical workers that deploy, often experience both direct trauma as well as an extreme amount of secondary trauma through the stories or injuries of our clients. We get exhausted and burnt out from the job, but we don’t stop caring. You would have to be a robot or a sociopath not to care. Naturally, I did not get therapy for this incident or many other hard traumatic grievances. I did not get into a therapy room until 5 years later, and I avoided talking about trauma through my first three therapeutic experiences. Now, 12 years after my deployment, I am on my fourth therapist and finally ready to start talking about it.
Trauma and grief are the ultimate silencers. Because it’s hard to talk about what my current therapist calls ‘The unexplainable’. Look at what the Memorial day ‘Holiday’ actually brings? People that want to be happy, host Memorial day Sale’s at stores, or do some shopping and host BBQ’s. But underneath the façade is a bunch of people with fear. Fear to acknowledge the traumatic grief that war has cost us, as well as all of the other emotions that will come out.
“To grieve feels like a betrayal to the ones that celebrate, but to celebrate feels like a betrayal to the ones we have lost.” EaE
Functionally Mental 