The Challenge Veterans Are Quietly Facing

A lot has been written about Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) associated with military personnel returning from Afghanistan or Gulf War theaters. The Anxiety and Depression Association of America defines Posttraumatic stress disorder as “a serious potentially debilitating condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, war, violent personal assault such as rape, or other life-threatening events.

The Mayo Clinic’s defines TBI as occurring “when an external mechanical force causes brain dysfunction.  Traumatic brain injury usually results from a violent blow or jolt to the head or body. An object penetrating the skull, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.”

Through our EN-Abled Vet program, we’ve seen veterans who come to us with PTSD or TBI. Our goal is to help them and their families transition to careers in healthcare IT. In three years, we’ve had a fair degree of success; 25 veterans have found jobs through our program, and through the generosity of Epic Systems, some veterans have achieved certification through the free program.

Our experience has shown us that PTSD veterans can find employment as the condition is managed through medication and other therapies. To look at them, you would never know the shocking experiences they have gone through. And some won’t tell.

TBI, however, is another story. While veterans who have suffered from this may seem fine, their ability to retain information is significantly compromised. We have yet to have a successful placement to date, but we won’t stop until we do!

While it’s important to increase awareness of these conditions, the purpose of this blog is to discuss something you may not have heard of: veterans with Moral Injury.

According to experts at the Syracuse University’s Moral Injury Project, “Within the context of military service, particularly regarding the experience of war, moral injury refers to the emotional and spiritual impact of participating in, witnessing, and/or being victimized by actions and behaviors which violate a service member’s core moral values and behavioral expectations of self or others. Moral injury is damaging to the soul of the individual. War is one of, but not the only thing that can cause this damage. Abuse, rape, and violence cause the same type of damage. ‘Soul repair’ and ‘soul wound’ are terms already in use by researchers and institutions in the United States who are exploring moral injury and paths to recovery.” One researcher spoke of “a deep soul wound that pierces a person’s identity, sense of morality and relationship to society.”

Let’s think about moral injury for a moment. A young person who deploys overseas has spent, say, 20 years of his or her life building certain beliefs. They may be religious, social, political, or have learned behavior through school or adult/peer modeling. Whatever has been developed is now taken to a horrific warzone where everything you have ever learned is overtaken by the need to accomplish a mission as well as survive. You are on constant edge as your life could be snuffed out any second. You know this because you have seen it first hand with those serving side by side.

Moral injury stems in part through a feeling of isolation and being cut off from a civilized society where those 20 years of values are safely kept. Moral injury can come about in such ways as giving orders that resulted in deaths, guilt, following illegal orders, harming civilians — whether intentional or not, or a number of other things.

Then one day the veteran leaves the war zone and returns to a civilized society that he or she can no longer relate to. What mattered then doesn’t matter now, because the morals and values developed over the first 20 years of life are either gone or buried very deep.

It took me awhile to figure this out, but now I think I know why some military personnel go back for a second, third, or fourth deployment. Some go back despite being an amputee. A number of veterans told me that they went back because they can’t adjust to society. Many have told me that the original deployment overseas was easier than the trip home.

Can you imagine that?

While awareness is key, there are tremendous challenges for our healthcare community. Perhaps we can heal a heart or brain, or provide medication for anxiety, but does anybody know how to heal and treat a soul?

While the ‘thank you for your service’ is always appreciated, this Veterans Day, I ask you to do something more. Read up on what is happening with our returning veterans and see if there is some way you can help. If nothing else, perhaps commit a few minutes of your time to help understand.

Jaime Parent is associate CIO and VP of IT Operations at Rush University Medical Center, and is actively involved in the EN-Abled Veteran Program, which was established to provide help and support for veterans facing the challenges of life after deployment. Parent served as Lt. Col. in the Air Force for 20 years. To learn more about EN-Abled Veteran program, click here or send an email [email protected].