Editor’s Note: Wonder what Operational Stress Control looks like in a combat zone? Hospital Corpsman Michael Pilati served in Helmond
Province, Afghanistan, from January to September 2010 and shares
one of his experiences with Mindlines.
By HM3 (FMF) Michael V. Pilati
Behavioral Health Technician
Naval Medical Center Portsmouth
A patient comes in, special forces fellow, a 20-year-old USMC. He’s a linguist, works for intel – real smart. He’s detached from reality. Sees dead bodies everywhere, blood, constant vivid nightmares. Why?
He has seen and done quite a bit. When he went home on R&R, he discovered the body of his cousin, who had committed suicide. He returns to Afghanistan and goes out on a mission where he watches two of his best friends die. Bled out. No air.
Pain. Hate. Regret. Numb. Disconnected. Empty. No affect and no emotion.
Doc tells me, “He needs temp, vitals, meds, then bring him back here.”
From pharmacy to vitals then back to our tent I spoke with this Marine for 12 minutes.
I sat him down and drew a stick figure on paper with a large cloud above it. I wrote along the perimeter of the cloud “relationship problems,” “depression” and “self- esteem.”
“What can you add to this?” I asked. Hate, numb, regret, he said. All written along the perimeter of the cloud leaving the inside blank.
“What’s the one thing that has you down – the most weight that bears on you?” I asked. “Empty,” he said.
In the center of the cloud I wrote “empty emotions.”
I then explained how it all ties in: Regret so you hate, which makes you angry, which affects your self-esteem and makes you depressed, which causes problems with relationships, family, friends and co-workers. All because you weren’t there to help save, to react faster, so you feel… “empty and numb.”
This made an impact, and I then asked him about coping skills. He said he liked music and writing, and told me he played guitar.
“Do you want to play now?” I asked.
“Yes,” he replied.
I went to get a guitar that had been sent in a USO box. He began to play and I knew that for those moments, he forgot about his buddies dying before him, his cousin’s suicide, his abuse as a child.
I went to the provider's office and waved him out. "Sir, you have to see this. Check out your guy."
"What did you do to get him to play?" the doc asked me later as he shook my hand. I explained what I did from the pharmacy tent to the guitar.
"Strong work." Then he said, "Do know what I did after I saw him play? I went to my office and sat down and cried."
He began to play and I knew that for those moments, he forgot about his buddies dying before him.
"You're joking, pulling my leg, sir." I smiled.
As tears began slowly descending from his eyes, he said, "No, I sat there and cried."
So I got my notebook and I wrote:
"The patient was medivaced to us for suicidal ideations with firm concern that he would make an attempt. We did medivac the patient stateside to receive further care that could not be obtained at the present time in theater. No psych-related patients died on our watch. Hoorah."
Pilati also gave a powerful presentation at this year's COSC Conference.
(First published in Summer 2011)
Leadership From The Ground Up