Satisfied With My Best Effort (Syndrome of Survival)

This last Saturday I failed to finish my second attempt at a 100 mile race.

As I winded through the repeated switchbacks on the TARC 100 from mile twenty five to thirty I became increasingly aware that I was more and more disoriented. After three years of ultra running I had manage the first 85 degree day of the year as well as any central Maine resident could. Because of the heat I started cramping at ten miles, and I troubleshooted it with extra water, electrolyte pills and more calories than I could stand in the heat. I was strong physically but every time I ran I would heat up and cramp, but after I hit the marathon mark I started getting disoriented. Heat cramps were rapidly turning into heat exhaustion, but if I could only make it to the night I might have a chance...

My Ranger brain was on point, I was outside myself worrying about my weakening cognition. My limbic system in was kicking ass despite my cortex being massacred by the heat. I was both dizzy, less aware of my location on a map, as well as outside of myself and increasingly aware that failing to make it to the next aid station might be dangerous. In other situations I might have tried to take a more direct course towards support,  but I knew that I was not reliable enough to do my own navigation. I was paradoxically disoriented and present at the same time. In my miserable state I had enough composure to know that I could no longer trust myself to do anything but keep moving on the course. Despite being delirious at thirty miles they were able to drop my core temp, by spraying me with a hose, and after sitting for five minutes drinking all I could and being offered ice (which was only available for medical issues). I ran some more.

I had trained hard, and instantly picked up my pace passing several runners that transitioned better in the aid station. However, I drank my water bottles so fast that I was out of water more than a mile away from the next aid station. I kept saying to myself "when are the fifty miler runners going to pass me" but everyone was crippled by the same heat. This mile and a quarter took thirty minutes, and the dizziness returned. Dehydrated I tried to rally again, but I couldn't seem to cool down. When a medic cooled me down I nearly went into hypothermia, and was advised to call it a day. I obliged without regrets.

In  the days that have followed I have not been disappointed because, when you give your best effort and fail, there is nothing to be unsatisfied about. My Fitbit sensor recorded 4690 ft of elevation gain and 35 miles of running. My worst day was ten hours of running, and was still something to be proud of. Subsequently looking at the stats also made it apparent that I ran precisely according to my plans, based on my steps per minute. Typically I would have covered 42-5 miles and would have arrived at aids stations more rapidly.

I am not a fan of PTSD as an excuse, but taking diarrhetic medications for PTSD and mTBI has make heat especially hard for me to regulate my temperature in the summer.  I also have a history of heat injuries of high dosages of antibiotics in Ranger School for cellulitis, and the high heat of swamp patrol, made me pass out with heat exhaustion during a long movement in Florida. On my second ultra I had similar issues only to spend three days in the hospital with rhabdo. PTSD is also linked to inflammation that compounds heat regulation. This is not an excuse, it is something that makes me proud to have fought so hard for the thirty five miles I managed to complete rather than disappointed about the sixty five miles that never could have been on a day like that. This year it did not heat up until my rest period so there was no way to employ my more typical stadium run for heat management, though in the winter I trained inside with maximum gear to train for the June race. I hiked easy for ten miles in Acadia last Saturday and walked Darby during the hottest part of the day (there were streams and rivers for him) all week, but my acclimatization did not help at all.

Still to have the maturity to listen to my body, recognize a bad day and make a stronger attempt in the fall, or winter when it is more healthy. Being confident and aware of my limitations is as important never accepting those limitations as permanent immovable burdens. Letting my lesson be that I need to try in the winter and start with smaller distances in the summer is not giving up finishing a race on my worst days, rather for me it is learning my limits and moving forward.

Most importantly when I was on the edge of passing out with heat exhaustion my overly capable limbic system reminded me the ways that all the stigmatized "PTSD Symptoms" are so useful in times of real danger. PTSD or as I like to call it the Syndrome of Survival still works when your life is on the line. I wouldn't wish those moments on anyone so please learn my lesson, and let my miserable failed attempted at 100 miles remind you that PTSD ultimately kept us alive when we needed it too. All of that of our baggage comes from strengths and is still a resource during an actual crisis. You don't have to be as crazy as I am by running ultra distances to learn how to yield the fruits of trauma as well as the sorrow.

Iraq Did Not Create the Fort Hood Shooter

There is an increasingly troubling narrative that essentially argues that service in Iraq and Afghanistan explains the criminal behavior at Fort Hood. This is an over simplification of most veterans with PTSD who will never commit a crime, but moreover a profound misunderstanding of the nature of counterinsurgency in Iraq. By doctrine we were deescalators of violence not perpetuators and we most often recognized that our best weapons "did not shoot." Any Iraq or Afghanistan veteran will tell you, if you take a couple of minutes to talk to them from time to time, that most tense situations in combat were dangerous situations caused by unidentified enemies and US forces refrained engagement because of a lack of positive identification. Units that departed from this course committed crimes, and were the exception.

The most tense moment for me occurred in just this way, and I have been hesitant to publicly discuss the night of my worst concussion because the situation got heated and there was some understandable personal tensions going on, though only momentary, and that I may seem like I am criticizing other people. That is not the case, I am going to describe an awful situation when everyone had the right intentions, and calmer heads prevailed. This will emphasize my roll because of the limits of my own memory, but I will assure that just as many or more times other soldiers, non commissioned officers of superiors played similar roles. You might assume the situation to be exceptional, but I think that day gets to the marrow of the US Army's, at company level, propensity to deescalate violence rather than perpetuate it in Iraq. The argument that we are more violent is a profound misunderstanding of what we did in Iraq, and more often we chose non violence. Anyone using our war as an excuse is exploiting a popular idea base on very little material evidence.

My worst of moment of Iraq was after a suicide bombing, but the second worse occurred after and IED blew up and convoy of Bradley's while my platoon was set in over-watch to prevent just such an attack. I have not now, nor will I ever feel like a greater failure, than watching a piece of dirt that I had personally been observing for six hours with multiple soldiers pulling rotations blow up right in front of me. In the moment I could not even see it. The force of the blast was faster than my brain's ability to process the image and I was thrown down a stairwell by over pressure. I fell face down and I came to face up, as if it were glitch in the matrix. It could not have been a second but I lost some consciousness. I was dizzy, very confused, but a Lieutenant with eyes on IED. The platoon of Bradley's was from another battalion passing through our area so they had no idea that Americans were occupying our building and mechanized and airborne units use different night optics. Concussed or not we could all die if we did not immediately mark our position in every way possible. Their fire discipline saved our lives, but we we would be tested the same way very quickly.

Local Iraqi Army or Policemen ran to to occupy a road block to the north of the attack, but their winter cloths made them hard to identify. Balaclavas and no helmets made friendly force identification nearly impossible, and created very tense moment with a few of my soldiers fearing an insurgent attack. Simultaneously on my radio, my company commander was very unhappy that bomb blew up right in may face. Why wouldn't he be. I certainly was not happy about it and to this day I second guess myself about that night. So while dealing with dizziness, disorientation and terrible situation I was simultaneously getting my ass chewed and preventing soldiers who wanted to fire on what they thought was a very legitimate threat to our security. These soldier were woken from sleep by bomb less that 50 meters away, so anger was par for the course, but the enemy did not usually sit in the middle of the street and gaggle up like Iraq soldiers so I wanted to take the time for confirmation. Everyone was angry from the lowest private to the battalion commander and tempers were hotter than they should have been on the radio, mine included. Not hotter than human beings woken up by a bomb at 4 AM though. However, despite all of anger and frustration everyone's actions were exemplary. My soldiers wanted to fire, but headed orders, I kept command and control until my platoon sergeant got on top of things and until a my commander was on the ground. After they were on top of it I actually put microphone up because I was getting really loopy and having trouble grasping the basic geographic layout.

People say that no one trains you for days like that, but the truth is I was trained precisely for days like that. My service in Iraq was more often events when I was attacked and had no clear enemy to engage so I waited for better opportunity rather than risking the lives of innocent people. So I cannot by any stretch of the imagination understand how Iraq, and the war I fought could be a source of anything, but level headed others centered decision making under the most adverse, frustrating and enraging situations. Frankly I am sick and tired of being compared to criminals because I have PTSD from all the days that I made the emotionally draining, but the ultimately least violent decisions only to be characterized as some non thinking killer with no human agency or power over my situation in Iraq and its aftermath. I was then and I am now, like the vast majority of other veterans, making the best of a far from ideal situation, and I am beyond frustrated that every-time another mass murder happens all people with mental illnesses are lumped together with an incredible minority of violent criminals. Especially in the wake of war of occupation and counterinsurgency that stressed nonviolent outcomes whenever they could be attained.

The OIF/OEF Cocktail: Shell Shock or mTBI and PTSD

I am often frustrated when people mistake mTBI and PTSD because they can be so different. Admittedly PTSD is the hardest thing I face from day to day, but that is because of mTBI. Anatomically speaking PTSD is the over stimulation or use of the Hypothalmic Pituitary Adrenal (HPA) Axis. There is no simple way to describe neurology, but I will do my best at explaining my experiences in relation to my limited understanding of brain anatomy. The HPA is a apart of the limbic system which is one of the oldest traits in the human body. Our dogs and horses are some of the best aids to PTSD because we share this structure even if our cortex functioning is very different. The HPA and limbic system creates a stress response by emitting the chemical cortisol (often called adrenaline) which gives you energy (anger), pulls the blood out of your extremities in preference to organs (you will simply feel tingling or numbness in your limbs), and activates a larger part of your brain making you hyperaware. Think of the golden hour a casualty has to get into surgery, and to get fresh blood and coagulants before they start to crash. That is the final aspect of the limbic system's response to stress: the crash that inevitably comes after your body works at such high levels. That feeling of extreme fatigue and the inability to sleep is a direct result of cortisol, and also why battle fatigue was one of the first terms for PTSD.

PTSD is the persistence of this complex stress response into non dangerous situations. This interplay works with the cortex because the limbic system will provide the stressors to your consciousness so that you can more quickly respond to similar situations in the future. The HPA cortex relationship is a two way loop that can be instinctually triggered, by the older limbic system or by the cortex's memory of previously stressful events. I can see the way that anatomy and social construction works together in my memory of soldiers saying that sooner or later we are going to jump when a car back fires just like all these other guys, already favoring the stress responses of previous groups of veterans through a learned behavior, as well as reflexive reactions to triggers common to the tactics of insurgents in Iraq and Afghanistan. I was blown up in a stairwell so I hyperventilate in stairwells to this day. The anatomy of stress, the events themselves and the way that others have responded socially all effect the way we experience danger as well as the way we choose to process our memory.

But this is a post about mTBI and PTSD. How does this matter?

mTBI is actually a lot less complicated neurological than PTSD, though the experience is incredibly complicated, the concussive nature of high explosives as well as hitting ones head generally damages the brain and most effects the frontal cortex. The brain's protective coating is damaged by concussion and the cortex gets slammed into your skull. This generally erodes your whole brain functioning, but has one set of symptoms that makes PTSD a lot harder to manage. Cortex injuries limit a person's impulse control, and when a person has been exposed to serious life or death situations they are more likely to have a cortex that always fires up the limbic system's response to any stressor. Hence why for me the graduate seminar table and public speaking will often trigger panic attacks. Also the anger I felt in battle is worse because my cortex is not as capable as it was prior to concussions or repeated exposures to explosions. Everything is worse because you have eroded impulse control and every part yourb rain as a system is not your own. Your body is literally not yours to control. The WWI and WWII crack ups were not solely PTSD, but also damage to the cortex from shelling, because as Jonathan Shay as observed, PTSD is actually useful in combat. You always want to fight or fly, but you fight better as a unit so your trained to stick to the plan, that is until blasts and concussions add to this mix and make it harder to control the stress impulse.

You crash because we are only designed to go that hard in brief instances: the golden hour. You become depressed because you are exceeding the capability of human anatomy, and because you are losing control of your impulses. Worse cortisol damages the conscious memory when it is overused and the center of your brain that is self aware is consistently damaged. Kurt Vonnegut referred to scouts, himself included, as people that were controlled by their spinal column, shared location with the limbic system, because he understood the human brain in a profoundly human and intellectual fashion, but when the cortex is damaged it is nearly impossible to stop this life or death impulsivity.

I can remember my first nightmare and flashback like it was yesterday. I had just shot an RPG gunner in Mosul, I had a flashback that day and a nightmare that night. I knew it was PTS and I didn't care, I managed it and was upfront with the Physician Assistant about it. It was war, of course it was going to be terrible, but it was important for me to continue to do my part. However, when I got a concussion I could no longer see what was going on as natural and I got way to stuck in my limbic system. Everything was extreme and everything remains life or death because no matter how smart I can make myself my cortex doesn't have the impulse control that I once had. I can know something, but not feel something, because the emotional stress response is more powerful than my ability to control that impulse. I perform amazing feats because I am running on an extreme and then I crash because I am going way to hard all the time. I know this, but it is almost impossible to control the powerful impulse. I just hope I never lose the ultimate battle to the natural and constant ups and downs that come with the OIF/OEF cocktail.

My Case for the Syndrome of Survival

A popular argument to fight the stigma of PTSD is to abandon it as a disorder. There have also been cases for calling PTSD an injury because of damage to the hippocampus, but this is perhaps the worst piece of evidence because this scarring occurs in bi polar disorder and the entire spectrum of anxiety disorders: some caused by trauma, some not. The injury moniker's most problematic issue is that it seems to create an acceptable male, or females living up to male ideals, non mental illness. Even rape survivors are said to "have MST" instead of PTSD caused by rape in the military (why there is any effort to sterilize rape in the military continually blows my mind). However, the worst thing about injury or trauma titles is their omission of how paradoxical and complicated PTSD, Shell Shock, and Civil War Nostalgia have always been. Injuries are often a lot more simple: rest, ice elevate does very little to your identity. War alters our identity and what we have is a persistent illness, disorder or syndrome. Yet, anyone who truly understands PTSD grasps how it is the persistence of survival skills into non survival situations. Those survival skills ultimately saved our lives, but makes the mundane and routine parts of life harder to manage.

Syndromes are often permanent and the damage to our brain was not instant, it takes years of overuse of the limbic system to damage the brain's declarative memory and create the scaring identified by injury advocates. Moreover, calling it a syndrome of survival also will explain the deep longing and even nostalgic memory of war. We are damaged, but most of us possess some longing to return, and even miss combat or trauma. When we act like PTSD is solely an injury, we confuse injuries and disorders, all because of stigma. Assholes will be assholes whatever title is used, but calling PTSD what it is with respect to trauma's paradoxical complexity will help us accept what war, and survival have done to us. It will also, help war survivors recognize what they have in common with rape survivors, and that their persistent problems are extremely difficult and life altering, but they ultimately come from a place of strength, not weakness. We are all survivors and we should have a better title.

I know that this is a controversial topic that many well informed and capable people will disagree about, but as both a historian and combat veteran I have never been able to feel comfortable with any of the other popular titles. The syndrome of survival seems to captures all the complexity of survival as well as addressing lasting syndrome. Survival is a universally respected, even celebrated, aspect of the human experience and connecting our troubled lives to this ultimately positive fact will also encourage growth in all of those affect by trauma. We also need a title that people who suffer are more willing to bear publicly so that the conversation shifts, becomes broader and more substantive. A title that should come with a stronger sense of corporate pride and empathy from non survivors. A title that expresses a collective appreciation for what people have survived and the baggage that comes from it. No other title does that in the way that one crafted around survival. Survivor is a moniker  that captures the fact that we are not leaves blow about by circumstances. We survived through merit and resilience, and we can also survive the way that those original experiences have changed us, maybe even let our survival motivate us to be something better than we would have been without our horrible experiences.

Helping Others Tell Their Stories

Darby being awesome!

I hope all of our readers have enjoyed all of our regular posts, but you might not know that Scott, Travis Martin, Michelle Monte, and myself all spend a lot of our time helping others tell their own stories. Writing helps us a lot so we try and take time to help others do the same. If you enjoy the regular posts here then there is no reason why will not enjoy our Blue Nostalgia.

It is free to read and free to join Military Experience & the Arts online writing workshops.  We are always accepting new submissions and you will never be turned down without someones helping you finish your writing. The most impressive thing about this issue is not how many views it has already received in less than forty-eight hours, but how everyone of the writers wants to continue participating in the online community. Even those whose writing never makes it online, often take advantage of online support groups and being apart of a community of veterans all going through the same things. I often think about the Military Experience & the Arts's online community as this generations version of the WWI expatriate writing community in Europe. We may not live up to that generation's legacy, but there is the same sense of community, and we are always welcoming and training a new generation of trauma writers. For me it is an honor to know all these people let alone playing a key role.

Managing the Low Points "Come on Joe, Let Yourself Have a Good Day" (Thriving)

Fa thump, fa thump, fa thump was the sound of my forefoot and mid sole strikes echoed by the rhythm of my breathing ha whoo, ha whoo, ha whoo and finished with the feeling of my heart beating kwa fump, kwa fump, kwa fump. It is hard for the rhythm of contact with the land, lungs and heart beat to synchronize so effortlessly, but that was how I felt as I powered through the thirtieth mile of the JFK 50 miler. That is the point when I know I can finish, but something different occurred this year. I was having an amazing day with nothing noteworthy to complain about. My legs hurt, but I had no heat cramps, I was tired, but extremely motivated, my brain was so taxed that I could not remember the names of the people around me, but somehow I was managing the math for all my mileage splits in my head. Everything was as it should have been for the strongest run in my life.

Usually this point is a reckoning and the finish my sole motivator, but this year I went into beast mode. I grunted in a primal desire to push forward. I was right where I wanted to be, still very tired, but from worthy effort and I repeated a mantra that had gotten me to mile thirty so strong physically and mentally. "Let yourself have a good day." Sometimes it is hard for me to have positive outlook. It is hard to believe that I can have good days. Sometimes in races like this my worry over an unmanageable low point will sap my energy, slow my pace down, and make something I love to do burdensome. People tried to pull me out of my race though.

"If your were in track club you would definitely run intervals and you could run sub 9 hour pace... I usually run that pace."

I am always annoyed with people who tell you they are having a bad day when you pass them. I could have got in my own head, but I waited for a rugged downhill, pulled away and said:

"Well, I run trails, mountains and stairs because that helps with me PTSD. My biggest issue is preventing panic attacks on runs so I focus on that. I seem to be doing great today, and I am just happy that all the causes of my panic attacks left me with my life, arms and legs. I am lucky to have days like today." He was apologetic, but I was too focused on the trail to acknowledge it. I did enjoy nothing-ing his attempt to correct his previously callous statement.

Most of the time I think it is in poor taste to over share these sorts of personal details with some random person on the trail, but in this case I was pissed off. However, like my injury at Bradbury Mountain in August I had earned a great day through all my hard work. Just because that guy ran harder last year didn't give him a pass on this year's lower level of training. I thanked Chick Hill again for all the rugged 7 minute mile paced rocky downhills that made this separation so easy and a conversation that could have been unsettling gave me a lot of confidence. It was a real battle this year to shave 55 minutes off of last year's finish. It took so much focus and discipline to run the first leg of the Appalachian Trail (AT) in a way that maxed my ability to climb with the fact that an elevated heart and the thick fall air were common triggers for me.

I ran on the razor's edge between hard effort and the prevention of a panic attack. I could do this because I trained myself on the terrain that most reminded me of combat and the explosion that gave me mTBI that inevitably made me a civilian. I wasn't going so far as criticizing someone's performance, but I had worked so hard and through real adversity. I wasn't going to have some track club split counter tell me how to train and run my race. On my second ultra I has used that style of training plan, but it landed me in an Intensive Care Unit for three days, so nothing was taking me off my plan.

PTSD and panic attacks were becoming a bit of an advantage. Running your best race without burning yourself out is a similarly difficult balancing act. A life that revolves around managing my anxiety was actually making me better on race day. But it was more than that.

I seemed to be gliding along effortlessly on the first section of the AT and the pace was not difficult until the late forties. I continued to run effortlessly on the first half of the C&O Canal. My deep longing to transcend and merge into the place I live in Maine had made my greatest strength running on rough and rocky trails. My feet slammed into rocks several times at JFK, but my balance kept me on my feet. On the single track trail my movements were light and I passed people with ease. The whole year I needed those rough trails because they were the only place I could stay in the moment. People kept complaining and I held my tongue until the last section of the AT.

"I love this shit so much... I am so happy to be here."

This made me look a like sadist, but it was true and this attitude was helping set the conditions for a great day. It had been hard and my biggest problem was consuming enough calories to keep going strong. I would eat PowerBar apple sauce and get sick for a few minutes while my digestion was competing with my quadriceps for energy. This would be worth it when the more slowly released applesauce carbohydrates paid dividends late in the race.

28.4 miles in at Antietam Aqueduct

I was running my race plan perfectly. Get off the AT (15.5)  a little behind on pace and make it to Antietam Aqueduct on pace. I came of the AT at 12:49 pace and by Antietam I was at 11:49 splits, 14 seconds under 12 minute mile 10 hour pace. I gained about 5 minutes and I was so pumped. I recognized my pace earlier in the day, but I would wait till the last twenty miles to really grind at max effort. I can't describe the joy that comes when you do something as hard as run fifty miles in under 10 hours, and how amazing it feels to still have the fortitude to push harder in the last twenty miles. I invite anyone who thinks PTSD is a syndrome of the weak to line up with me next year and call me weak on the back twenty. At this point going that hard simply maintained my pace at 11:49. I was outside of myself, though the last 8 miles of road and high winds was miserable. I was tired, cold and on cloud nine. I kept a run down hill and straightaways, and walked uphill until I reached the last mile and a half. I must have clocked a 10 minute last mile because the finish line came quickly. I looked at the clock and it was 9:50(:32).



My wife was waiting for me and we were so excited. I let out a guttural yell, as if I was some medieval knight after vanquishing all my foes. I waited for, one of my living heroes and founder of Team Red, White and Blue, Mike Ervin to cross and as I cheered his equally amazing accomplishment. I never thought I would ever be able to stay in front of such amazing runners and leaders on veterans issues, it is still hard to believe that the day was not something I imagined.

http://teamrwb.org/

When life is miserable it is so much easier for me get stuck, but it is often what I do in the low points that sets the conditions for when I feel stronger. Its hard to run my race, suck down my applesauce and just let my legs keep going. Having PTSD feels like running on a gnarly, rocky and mountainous trail when everyone around you is on a smooth surface. Yet when I am on rocky trails I am in my element, and everything feels easier when I recognize how much harder life is for me. I need that perspective. At the JFK 50 Miler most the people around me left the AT demoralized while I left fired up, and easily made up my pace before my toughest push. I had time in the bank and chipped away a little more time in the last ten miles. PTSD keeps me in the doldrums a lot more than others and I often have to say things like, "just manage this low point Joe." Sometimes when I am in the toughest place on my path and its important to let those momentary set backs be momentary setbacks. Sometimes I struggle because the path is rocky, but when I manage my low points I sometimes find myself at Antietam Aqueduct with time in the bank, feeling amazing and surging forward because I did everything I could when the path was harder and everything was a lot more difficult. The contextually accurate positive self talk that guided me to an amazing day was just a representation of a coping mechanism that I have developed over months of practice. Managing PTSD is extremely difficult but it has taught me how to thrive in some of the most challenging of circumstances.

*Ultra Runner Geoff Roess is known for focusing on the low points on 100 mile races. It keeps me going every time I have a rough day.

I Wasn't Ready for the Smell...

This describes violence and will trigger PTSD symptoms. In the Terrible Moments I purposefully omitted smell because it was too much to write in one installment. I will return to it in the following post.

As a platoon leader I was ready to lead my soldiers, even in the most trying of circumstances, but when I arrived to the aftermath of a suicide bomber detonated on a crowd of civilians I wasn’t prepared for the smell. In my experience blood doesn’t have a smell at first, although it is very visible, tends to flood your memory and when it stains clothing that smell imprints itself on the memory event as it were there in the moment. In honesty that street corner mostly smelled like dirt and dust, because the explosion had picked it up off of the ground. The smell of explosives was present, I was used to those smells, but the smell of burning flesh was much more apparent and different then anything I had ever experienced (still this was muted by the overwhelming smell of scattered dirt and dust). The smell of burned flesh was like smell of burnt hair, yet exponentially grown by the scale of that terrible day in northern Iraq. This mixed with the smell of burning meat, though completely unappetizing and unseasoned. The only way I can describe the smell of peoples skin is that it was as if leather was left out in the rain long enough to fester slightly, and then it was burned, or at least how I image that would smell. The addition of the burnt clothing created an earthy smell, which was a mixture of burning leaves and grass/marijuana.

Still, no matter how traumatic the stench of death and violence was I mostly inhaled the terrible smell common in the urban centers of Iraq created by the burnt trash, raw sewage flowing through the streets, and the awful smell that the dirt and dust made as it lodged itself into your nasal passages. A not so insignificant part of the awful smell of Iraq was my body odor, because I lived in an outpost and showered weekly at best. Only that day the smell of Iraq was amplified by an explosion that wafted it through the air. Despite the stench, I refused to throw away my flesh stained boots, because I would spend a lifetime, if necessary, walking that smell away. After nine years and thousands of miles it is still there in my boots, so are the bloodstains, and the barbwire scratches I got rushing to that intersection on another night. That smell has also stained my very being as an unmovable and unalterable weight on my memory. Even during exercise my sweat pours more profusely than it did before and rather than overpowering the stench of that day the sweat contributes to it as if my every pore was endeavoring to recreate the smells of that moment. Stress sweat is more pungent than normal thermal regulatory perspiration. My body remains attached to the muted ammonia smell of muscle deterioration that comes with the body's processing of the stress chemical cortisol. I have smelled fresh cow brands and had a terrible panic attack. Anytime I smell burning hair, unseasoned meat, grass, warm sewage in a portable toilet, marijuana or the dust of the desert I am back there again: only naked, unarmored, helpless, and alone. My heart races and I can't seem to breath.

The stench combined with the chaotic sights, sounds, my internal dialogue, and physical sensations, though the smell was by far the worst of all my sensations that day (well that and feeling the weight and limpness of a dead flesh). Smells today are forever different and can send me into PTSD symptoms, often simply sicken me, or worst give me terrible migraine headaches. A lifetime of therapy and doing the right things to manage PTSD will never make that memory less burdensome. Although, I am still proud that I have refused to get rid of those boots because they are like my tattoos, a symbol of my commitment to deal with the violence I witnessed: to face my PTSD. Preserving my boots, even if they still smelled like that day in the hopes of walking them clean, was the first gesture of my efforts to face my burdensome memories no matter how terrible, with as much honor and strength as possible. The smells are certainly less pungent now, and the memory is too, at least with every attempt to understand and accept them. As if taking the time to remember that awful stench, or any sensation for that matter as it was, or as they were, reduces their terrible grasp on my life.

Ty Carter's Advocacy in Context

The most recent Medal of Honor recipient has perhaps one of the most impressive citations in the War on Terror. As a participant in a battle that nearly overwhelmed a small Combat Outpost (COP) named Keating, Army Staff Sergeant Ty Carter repeatedly braved danger, injury and certain death to aid fellow wounded soldiers. When running to the assistance of wounded comrades his fellow soldiers attempting to aid others were killed. Carter provided first aid and ammunition so the wounded could maintain a desperate stand, Carter stated that the outpost lacked water, necessary medical supplies and ammunition. Despite hunger, thirst, and injuries and, in some cases mortal wounds, they continued to fight. In a battle that carried multiple valor citations, Carter’s performance carried the most accolades....

See full post on Khronikos here.

(Thriving) Chick Hill

The Peaked Mountain and Little Peaked Mountain faces.

On a hot, but manageable August Sunday I found myself in Bradbury Mountain State Park running the toughest race of the year. The course's 1450 ft elevation gain and equal loss in only 9 miles makes it one of the most challenging in Maine without factoring all of the roots, rocks, and New England rock-wall obstacles you traverse to get to the finish. Ian Parlin is a sadist in the way that any good trail race director should be. He decided to cut out some downhill switchbacks to add about 400 more feet of gain and let us all know that at the starting line. That's why I run his races. So while getting to the boundary road with the addition of a strong climb I was excited about my pace without any panic attacks. After two days of rain  the course was wet and slippery, and I was still in a large crowd of people. As we started the first real climb (on the old course that is) my left foot landed on a rock was deceivingly wet and slippery. My left leg slipped, and from the bruising it appeared to have slammed into another rock or stump: a fact I was oblivious of at the time. What I was intimately aware of was the movement of my leg.

I have broken my ankle before, and I have never felt my leg move like it did at Bradbury. The ankle rolled so extremely that my knee snapped by the strain. I was instantly sickened in the way that you feel when ice breaks underneath you. "Fuck! Its time for six months of rehab." My brother-in-law was behind me and he later said that he thought I broke my leg. For a few seconds I knew that I broke my leg. The pain and nauseous feeling put me into a walk before my mind even fully reacted. I needed to walk as far as I could with the adrenaline I had because I was in the most remote place on the course (another runner passed out nearby and it took hours to get him off the course). "How was I walking though, my leg was broken right? It had to be." I walked up the hill. It hurt but my leg was working. "How was it working?" Sick and crying from the shock and the pain I started to run. I didn't know how I still could, but I'd worked too hard to run my best time. I deserved this and it might be my last run of the year, and I knew that, for some reason, my body takes three to five hours to swell up. Let's go! (Oh By the way Let's Go is the modo of my of my Airborne Infantry Regiment. Glider up son!)

The view from Little Peaked Mountain.

Chick Hill is not actually the title of the mountain that I have been climbing a lot lately, but it is what here everyone calls Peaked Mountain, which is situated near Chick Hill. I like that about Peaked Mountain. A lot of people climb it, but few really know its actual name. Even fewer truly appreciate it. Most of its trails are overgrown, its rocky road up to the cell phone tower is the only thing that is, albeit reasonably, well maintained. Its older, perhaps better, ridge-line trail has been absorbed into the forest. The fire break/road like surfaces are as technically difficult as any trail in the area. This would be where I would reconnect to my strongest mentality. The drive to Clifton Maine has become an obsession of mine lately. The whole week I am be excited about my sole foray to the mountain. I read maps, look at Google imagery to try and find new trails to run. I was working out, exploring and fusing with the place.

Birds eye view of Acadia National Park.

Peaked Mountain felt right, it was poorly managed, in places grossly clear cut, in others the forest had claimed the trail, and it was small and underrated. It felt like me, and I was building a relationship with a place. Not the tired and common unrealistic anthropomorphizing of a space, rather I was falling in love with its flaws as well as its charms. I'd come home covered in its tall unchecked grass, at times bleeding with little bits of mountain inside my knee and palms. Weeks later I would vacuum little bits of mountain from under the door mat for almost 10 minutes. I've bled and swet into the place and carried a little of it home with me with every trip. Too many people try to shape the land, or possess it, but few are shaped by it and let themselves be possessed by the space they live in. Even fewer would feel that way about a place with a man made road, a large cell phone tower, and beer bottles strewn about at the summit. Not me, I loved the place because that felt more like me. I could see Acadia to the south and the larger peaks to the west. Running goals that this place would help me meet, but I was deeply attached to the imperfections of the space. This was life and space that defied narrative: imperfectly appropriate. It was so much more like myself, in its beauty, its unkept and unfinished nature, yet at its summit was one of the most beautiful scenes in vacationland (Maine). Peaked Mountain had recharged me in ways that I haven't felt since I went to war.

Check the wince. Image Credit Maine Running Photos.

Bradbury was decidedly frustrating because of the sprained ankle, but I'd been here before. I'd sprained my ankle at my first 100 mile attempt and I went 29 miles on it before deciding it wasn't worth it to risk worse injury (my main effort that year was JFK and I wanted to get to the line uninjured). I'd sprained my ankle early on Bradbury's 12 mile Bruiser and finished. In Ranger school I had the worst sprain of my life on the march to Darby and made it through the whole phase (I recycled because I was too weak with that ankle). My wife says,"if Joe's gonna sprain his ankle its gonna be in the first two miles and he's gonna finish;" she just gets me. I was frustrated because I was doing so well and I thought that I wasn't going to have an improved time.

Bloodied compression socks. TRWB

No, I was ready for this and I could still do it! I'd spent too many days on Peaked Mountain and I'd earned an excellent performance. That was different, for the first time in years I felt like I owed myself a victory. I was worth it, and I might have even owed it to Peaked for all the time I spent on it. More pragmatically the way I'd run Peaked Mountain prepared me. On my toughest 8 miler, I started by climbing the grade 8, 1.5 mile, 800 ft gain, category 3 climb up to the summit. After catching a toe I scraped up my knee and it was initially bleeding pretty bad. I pulled my compression socks over it to stop the bleeding and ran down the mountain. Halfway down the mountain I checked my leg and the bleeding had stopped. Let's go! I wanted to add some to speed to my total pace so I turned unto a firebreak that led to the actual Chick Hill. I took a left hand turn down what, I guess, was a logging road that wasn't on the map and didn't make it to Chick Hill. The initial climb made my calves all but useless so I had to rely on my quadriceps to ensure that I could hike up the summit and still be at a good ultra pace (12 minute miles).

I was busting my butt (literally) and quads to maintain nine minute miles so that my ending split would still be at running pace with all the hiking involved. I pushed up Little Peaked Mountain's summit at a good hike and ran up Peaked again. My pace on that 1900 ft total climb was faster than last years Breaker. I began to realize that I needed both the climbing calves and quads to manage the terrain at the Chick area so I started adding faster flatter running with my dog Darby and my mountain days got better and better. I felt awesome, and fulfilled.

More importantly I'd hiked so much at racing pace. Just minutes after my sprain came the south ridge of Bradbury Mountain. I was not feeling up to running that kind of grade just yet so I leaned forward put my hands on my knees and hiked. To my surprise my walking wasn't only keeping pace, but gaining on most of the runners around me. The descents were more difficult. I had my ankle fully extended when it twisted so it seemed to only really be acting up on steep downhill terrain. The down hill was easier physically, but I couldn't shred and gain speed. It was frustrating to basically lose all the calf strength I gained climbing Peaked, but I'd also focused on hiking and quad strength. Two out of three wasn't bad.

Last climb. Ian Parlin in left corner. Image Maine Running Photos.

On the descents I just kept telling myself "10 minute miles, push with quads. Run with quads on the flats, don't waste a second when your ankles don't matter." Still I was very practical about my climbs. The summit trail is foolish to run anyway. Its 200 ft gain in maybe a tenth of a mile. I just ate an Espresso Love Gu, hands on knees hiking, and I lost very little on the worst climbs. There is about a mile of descent afterwards and I would hold onto the others as long as I could and then back to my ten minute mantra. When I saw the top of the last climb I was ecstatic. I ran up ignoring the pain. I held my pace on this descent, "who cares about pain in the last mile. The pain will subside a lot more when I stop running right?" At the beginning of the last climb I'd looked at my watch and saw that I was at about an hour twenty. My best finish was 1:51:20 so I think I was also charged by what I'd done. I ran at full speed, ten minute pace be damned at that point, and caught two who closed up on me after the last descent. 1:42:21 was my finish nine minutes faster than my best time.

Where's the medic?

"I can't believe you finished the race" was how my brother-in-law greeted me. He'd beaten me and I didn't want to steal his thunder by complaining about the sprain, and imply that he'd won by default because I think he would have prevailed regardless. We made our way to a fireman who checked to see if I'd broken my ankle. Apparently I hadn't broken it and as I sit here drafting this post icing my swollen ankle, I am surprised at how well it is healing. I have subsequently ran my fastest two splits to the the top of the mountain, back to back with only time to refill my bottle so it seems like I've recovered. At Peaked I'd gotten better at small quick steps and the only good thing about the sprain was that I hadn't fell. A quick small step pulled my leg up before all of my weight was placed on my precarious ankle and it was relieved of a break or worse injury. In remembering those moments when I felt like I owed myself a great race regardless, I am reminded of why it is I race on trails. It reminds me of how tough I can be in a crisis.

No matter how much writing, research, and advocacy I do for PTSD I still deep down feel weak. Races like Bradbury, and days like on Peaked when I hurt myself, but still pushed on, remind me of how I respond to injuries. They remind me that I finished the Darby Queen a day after a minor surgery once and another time without all the skin on one of my heals. They remind me that I am excellent at finishing physical challenges even when I am injured. They remind me that all the stereotypes and perceived stigma about PTSD being a result of weakness are bullshit. I don't know how to be a tougher person than I am (sure there are tougher) and I have PTSD. I am both the 90% disabled vet and the guy who finished one of the toughest races in Maine despite an injury. Better, perhaps even tougher, runners called it quits for the same kind of injury that day. Physical injuries are so much easier for me, because they are concrete and have time tested solutions. Rest, Ice, elevate, and compress. With every sprain, fall, cut, and painful day on the trail I am reminded the value of recuperation, and it helps me value and manage my invisible injuries a little better. I also feel like I owed it to Peaked/Chick for what I'd learned and becoming closer to a space is helping me with all my triggers in ways that I wouldn't have expected. By getting attached to this space I am having an easier time remembering that it is not Iraq, and that helps a lot. Transcendence for me comes with effort that pays dividends in every facet of my life, but it also helps me see a place for what is is and not idealize it in ways that are unrealistic. Home was never the ideals I shaped in my mind to escape the the hell that is war, and it takes time, for me miles, and effort to recreate my sense of safe space. I'll still sprain ankles, get bloodied and bruised in my safe spaces, but every-time is an opportunity to get a little stronger, push a little harder, and value the same recovery from the wounds no one else can see.

(Thriving) The Stigma in Me: Remembering that My Strength Ultimately Caused My Disorder

My climb includes 5 total climbs and 6 of the lower section.

I have very little patience for people who believe that lessor people suffer from mental illness, especially scholars, but if I am honest with myself then must I recognize how my shame has shaped my homecoming. Lately, I have been working really hard to reintegrate the training techniques I used prior to going to war. For the last four years I'd been avoiding my old training regimen as if there was something wrong with it. A good friend of mine turned me onto ultra/mountain runner Anton Krupicka's blog and it reminded me that I was at my fastest when I lived and ran in the mountains everyday. I used to run hills exclusively, do a lot of two-a-day workouts, take few supplements, I did very little with my nutrition, save for good wholesome meals, and run in the worst environment possible, like rain, heat and cold with as little cloths as I could stand. I've never been faster than with that mentality, yet I was reluctant to re-embrace them because, at least subconsciously, I felt like my invisible wounds were the result of my weakness. I also felt like after three tours in Iraq, Ranger and Jumpmaster school that I had nothing to prove. I might have nothing to prove to the world, but I still have a lot more to prove to myself. Recently, I have been employing those older strategies and I am beginning to see some of the chains that were holding be back on runs fall off, and, more importantly, it has reminded me how my courage, strength and determination brought about my PTSD: not my weakness.

Care of Maine Running Photos.

As a kid I was always happiest playing sports. I especially loved summer street hockey and soccer because I had games on the same day. I was a halfback in soccer and forward in hockey, so those days included a great deal of running and skating. My soccer games would come first, so the first few minutes of the hockey game were the toughest. All the fresh skaters were difficult to keep up with. I could usually hold my own until the heat of the day wore on every player. Georgia summers are particularly hot, and the black top courts amplified the heat significantly, yet every game I would get a surge of energy when sweat began to cloud my eyes. Though I was certainly suffering, this would signal to me that others were as well and that is when I played the hardest. I came to remember this on Monday the 15th of July. It was the day after a PR finish (despite two pretty shitty panic attacks) at the first race of the Bradbury Mountain trail running series. Proud, but unsatisfied with my performance, I was climbing the Alfond Stadium at the University of Maine. When I began my workout no one was there, but as I continued the football team started to do some sprints.

The heat was incredible because the aluminum bleachers absorbed and reflected the sun's rays as if I was running in a sauna. It was one of the hottest couple of days in Maine this year and many people were hospitalized at races the day before. When I looked down at the all the younger football payers I was impressed with their vigor, youth and ability, but I was most captured by their impression of me. All of these athletes, in their prime, looked at me at me with respectful head nods, and were questioning why this crazy thirty year old asshole was climbing the stadium during the hottest hours of the hottest day of the summer. These were all stronger, and in most cases tougher athletes than me, but not that day. Again the reflection of the sun off of the aluminum, the salty sweat and sunscreen combined to blur my vision, but I was on cloud nine. I was the kid playing hockey again. I began to love every minute of that misery. I became even more confident when the football team, left and I was still climbing stairs. On my last lap, I was wiped out, tired, and what I like to call wobbly (ultra runners more commonly refer to this as bonking because when your body runs out of fuel you start feeling loopy and hypoglycemic, but I think wobbly better captures how I feel), but in that almost delirium haze I knew that I'd gone as hard and as long as I could: then a little bit farther.

Somewhere in all the diagnoses and medical treatment I'd lost some of the key aspects of who I was. Sure I have been running ultras to reconnect to who I am, and in many ways I am tougher than I ever was, but I'd lost my old mentality. I just remembered running ten milers at Bragg, full out the whole time at sub seven pace without recognizing what philosophy and training regimen brought that ability. I thought I was tougher after war, but I was tough because of who I was preceding war and my mentality is what brought me through. For some reason I'd come to believe that I was weak before war and that is why I was taken out by invisible wounds. Nothing could be further from the truth. I was tough and that is why I endured so much trauma and still sought to be on the line fighting the war. My resilience is helping now, but it also caused a much more severe syndrome. I realized that I have PTSD because I am tough, not because I am am weak. It stems from my character not my weakness.

 

One handed summit pic with 2 liter hydration pack.

It is at the juncture between who I was before war and who I am now that I can see the nuance in my life that has changed. Recognizing this change is a vehicle for my growth. I still like to run as minimally as possible, but I sweat more because of PTSD and dehydrate faster because of medications. I carry a lot more water now, and I use sugar to to keep my muscles going in ways I wouldn't have when I was younger. This is a disadvantage sometimes that also helps me stay more self aware when I run. Now I am more in the moment, and that helps me appreciate doing something I love as long and as hard as I can. This is more than a metaphor for my writing, it is the same, it is fuel, and a constant reminder of who I am. More specifically, the elevated heart rate and heavy breathing triggers panic attacks, and my quest for longer runs at a faster pace forces me to stay on top of my treatment.

I get better at managing my PTSD with every improved time, longer and harder run because it helps me face the panic attacks that I suffer on runs, and it has also been my mechanism for grief. Most importantly, it reminds me of how, who I was before and who I am now, are different, yet my mentality prior to war has had a lot of bearing on how I survived. After seeing all the death and loss I have in Iraq I'll never fully regain that child I once was, nor would I even want to be that naive again. However, because of PTSD I'd abandoned all of who I was because I felt like I'd done something wrong to have mental illness. In remembering that sweat in my eyes, the love of climbing everyday, and wearing as little as possible I've been able to reconnect to a mentality that will surely help me grow with PTSD. Probably the mentality that saved my life in Iraq and at home.

Honeymoon Piton summit with Piton Lager. My wife has the same drive to climb mountains and run races together.

I'd ask all the readers to try and remember those moments in the time prior, to your service in combat or traumatic experiences, that inspired you to push on, work harder and generally be a better person. Though our younger naive selves may have been lost to the battlefield, at the hands of rapists or in experiences that rocked the very nature of ourselves, that doesn't mean we must lose the aspects of ourselves that helped us survive those terrible days. In our process of grief we all tend to blame ourselves, and we lose sight of what we did right. While re-embracing my own mentality I've come to realize how valuable it has been to my survival, and I would urge you all to find your stadium at the heat of the day, your mountainside, or canvas. That thing that makes you want to feel the pain of becoming better and put in the time it takes to be great. By recognizing the strength you abandoned because of PTSD you might see the ways that stigma has seeped into your life as well. Shame and blaming yourself is natural stage in growth that we'll continually deal with, but by understanding it we can find a way to climb past it when it impedes our progress. Just don't be ashamed of who you were, because those who have PTSD have suffered and survived. The aspects of your life before PTSD helped you survive and there is a lot more merit in our pre PTSD selves than naivety. Re-embracing the positive aspects of your life, before trauma, that you have abandoned afterwards will help you move forward by helping you to recognize the stigma that has creeped its way into your own outlook. At least that has been the case for me.
   

Thriving

My view of Acadia during a trail run.

The other day I was speaking to my friend and editor of the Blue Falcon Journal, Dan Buckman, about incorporating more of my life beyond the PTSD narrative into the blog. After discussing this further with Scott Lee, we've decided to start a new series called "Thriving" that will highlight everything positive in our lives. My part in the series will showcase the hobbies, activities and professional success I enjoy in order to challenge the preconceived notions about people with war's invisible injuries. My hope is that the combination of this series with our more typical posts about confronting PTSD will illustrate that we here at PSTD: A Soldier's Perspective are not solely pessimistic. We take the good with the bad. So in the same month I might post about suicidal idealization, survivor guilt and triggers as well as the hiking, trail running, beer brewing, publishing articles, presenting papers and other crazy things I do to make myself feel worthwhile.

In most cases, people with PTSD did everything right and they still do all they can to be happy, but continue to struggle with a very challenging condition. It is a myth that those who don't suffer are more resilient and that those who have PTSD are less mentally tough. I have certainly pushed myself to longer and tougher physical challenges after suffering PTSD than I have before. I hope that by incorporating all the positive things I do to keep myself happy, and to lead a life worthy of the gift I have in surviving in concurrence with the daily slog that is PTSD and mTBI that it will become apparent that even the best of us struggle and thrive at the same time. If we wait for all of our issues to subside, for all our baggage to disappear, and for our weights to be lifted; then our lives will pass us by before we ever move forward.

I know its blurred. I think it better captures trail running.

My greatest hope is that people struggling will realize that they can still feel joy and happiness even as we suffer from a difficult and painful disorder. We can have great days even when they are filled with triggers, panic attacks and nightmares. We won't be able to shed those issues, but that doesn't prevent us from living our lives to the fullest. The future of PTSD and mTBI is not predetermined, it is what we do that matters. If you think the groups that should help you the most, will provide all the help you need then you obviously don't read the newspaper, or haven't filed any claims. The more we do to make our own lives better the more we will enjoy our lives. We certainly can't sit on our butts waiting for the military and Veterans Administration to get better. It doesn't make it right that we have to do it ourselves, but that doesn't change the fact that we do. Thriving with PTSD and not despite it is ultimately our own choice. A choice that will bring as much pain, and more difficulty, as it does joy, but all meaningful joy comes from effort: PTSD or not.

If anyone reading this has anything great going on in their life please tell us in the comments. If you're on twitter, use the #ThrivingwithPTSD Hashtag whenever you meet with some success, or let me know and I will tweet about it for you.

I Feel Both Grateful and Guilty to be Alive: the Both Matters

In June 18th 2005 Lieutenant Noah Harris's Humvee was attacked by a Rocket Propelled Grenade and he died of wounds. Days later one of his Infantry Officer Basic Course classmates, the author of this post, got the news and did not know what to do. He started by running Forest Gump style. He had been out the last night being an infantryman, drinking to hard and staying up too late. Getting shot done by women, and being OK getting told no. The heat seared into his being. He sweat profusely, but he still pushed on until he felt heat cramps. He turned off of the Fort Bragg firebreak and headed home. A Mortar live fire exercise was clearly off target because he had to push it the last two miles because he knew damned well rounds were striking within the minimum safe distance. His body was bone tired but he felt nothing except anger so he slammed some water, threw on a camel back and jumped on his mountain bike.

I spent five hours on the trail bitter and angry, pushing on despite a terrible headache and being hung over.  I'd recently survived my first tour of duty, and had shot and RPG gunner- if circumstances were a little different I'd have likely lost my life too. I felt guilty for shooting the gunner when I did, and influencing his miss. Perhaps the serendipity that made me raise my weapon prior the gunner's exposure could have helped Noah. As if some sort of national karma preserved my life, but allowed him to die. I ran because I was angry. I was mad at the world, but mostly at myself. Mad because I'd survived and better soldiers died. I was angry because he had a wife and I didn't.

I've survived so much and I can't for the life of me figure out why. It doesn't seem to be merit, although on occasion it has been. I am proud to have endured so much, but I am also ashamed that I am here and others are not. But like that 1st Lieutenant who lost his friend to an event that he had recently survived, I think that I am mad at myself because I am trying to mourn. It is just hard to when no one else around me is too. The loss of other lives and my survival exist together paradoxically. I can't seem to balance my willingness to trade my life for theirs, with my powerlessness to do so. So I run, angry and in pain, but mostly because that pain is the easiest thing to feel. Its negative, but its how I feel. More importantly, when I push through that pain I am reminded that I can do it.

Flash forward to the 23rd of June 2013. I was running on the isthmus off of Quoddy Head State Park (the Eastern most point of the United States) and I could see the mouth of the Bay of Fundy and Lee Brice's "I drive your truck" played. I generally hate all of the MERICA country music because it is so idealistic and it rarely captures the realities of service rather it just glorifies war. But, that song is such a great message about mourning. When I was running in this truly amazing and beautiful place I felt a wash with guilt, gratefulness and mourning. I was doing something truly challenging and in an one of kind place. I was living my life on my own terms the way I always wanted too. I was following my heart and my dreams, and as happy as it made me I felt guilty because of all those I knew who couldn't be there. It was affirming because I felt like I owed them days like this, and I knew that I was leading a life that recognized what I'd survived. Still I was here and they were not: so I was angry.

While most authors would simply describe the positive aspects of this event and place it into a triumphant narrative: I will not. It doesn't capture the conflict and paradoxical nature of both my gratefulness in that moment, but also the guilt I felt for being there and living my life while others can't. A few miles later I realized that I'd forgotten to take my hydration supplements and I started having heat cramps. The medicine I take for PTSD and mTBI dehydrates me at a much faster rate, and an excellent race, at a great pace, and the first without a panic attack in years became the most difficult race of my life. This for some reason felt better, and I felt less guilty. Joy in moments like on the isthmus is always accompanied by suffering, and guilt, so the misery of 18 miles of heat cramps felt more authentic.

More importantly, I was going to finish. I wouldn't die trying, but I could work my nutrition and hydration in a way that would not injure myself again. I'd be miserable, but I could get to the line. When you can find contentment in suffering the word has no prisons. I was hurting, but alive and that felt more natural. It felt right. I got through with my worst marathon time. But, I failed to finish my last 26.2 race, because of panic attacks, so all the exposure therapy seems to be working. The supplements would have helped, but my legs have to work harder now that I am not stopping to rally during panic attacks. It was hard and my worst race, but it happened because my life was moving forward positively. The but matters, because it demonstrates paradox and conflict. Like other vets I get mad when people tell me at least I survived. That is correct, but it is half correct. We survived and we feel guilty for it.

All the physiological steps forward aside it is more important that this weekend demonstrates how much I have grown emotionally. When Noah died all I felt was anger and guilt. Now I feel those things, but I also feel grateful. Feeling grateful to have survived when others didn't used to make me feel even more guilty. In war you see so many people killed, and so many innocent maimed that there is not a funeral service that can help with all that loss. Families take years to recover from the loss of one of their members, and it can take a lifetime to mourn loss on the scale of war. Few join to take lives rather than save them, and coming home when others did not is bitter sweet. Allowing the moments like on the isthmus to represent both gratefulness and grief is important. I for one am lucky to have found strength in suffering this weekend. That suffering made me better and happened because I am getting stronger, both physically and emotionally. I feel both amazing emotionally because of it, but at the same time it is a shame that I could not step in to save all the people who I have loved and lost. I am OK with that paradox, and I just wish society would be too, and let me feel conflicted instead of all the careless and blind thank yous for my service that only serve to pick at an old complicated wound. Maybe say sorry for your loss and thank you at the same time, because that would be more authentic.

Why the Mount Dessert Island Historical (MDI) Society Matters for PTSD: Another Fundraising Opportunity

As I have indicated before, I use running to manage my anger, to keep my weight down while taking miztazapine, to help me stay present, and to connect with others who like to push themselves further everyday. Occasionally I am asked to run in order to raise money for a worthy charity and I am compelled to do what I can. Also, it is great to support established charities in order to gain more experience fundraising. I hope I can carry the lessons learned into fundraisers for the The Military Experience and Arts and Team Red, White and Blue in the future. With all the cognitive problems I have with mTBI, I need to practice things a few times before I can get the hang of them and these charities both help worthy causes and teaching me the ropes of fundraising.

In addition to my running I try to hit the trail every weekend with my wife and our dog Darby, because I think making new memories and observing beauty is as valuable as therapy. I used to think you could replace old memories with new ones, but I think that is impossible with trauma. However, getting out on mountains, pushing myself physically and being rewarded with their beautiful summits centers me as well as anything else. Living less than two hours away from Acadia National Park, has made MDI one of the most significant places in my life and for my family. I proposed to my wife on Cadillac Mountain, we were married in Northeast Harbor, and out favorite post hike restaurant knows us by name-it helps to bring a giant Rhodesian Ridgeback every visit.

Darby on Cadillac Mountain

While it is great that this location is significant for my life and my renegotiation of place following Iraq, it may seem unimportant to others suffering from PTSD, and the family members that support them. Nothing could be further from the truth. My colleague, Tim Garrrity, who works there is exploring a topic vital to our understanding of the difficulties suffered by military spouses. His research explores a spike in women's deaths during the Civil War and popular notions of death as a result of broken hearts. While MDI's population was far to small to justify general claims about military spousal deaths after Civil War it provides local context for a phenomenon that could have occurred more broadly. His small study, if emulated by other scholars, has a lot of potential to broaden our understandings of the difficulties suffered by military spouses. This coupled with the research of Erick Dean Jr, and Diane Miller Sommerville on Nostalgia and Confederate suicides as a forerunners to PTSD has the potential to provide deeper understanding of how trauma affected Civil War actors.

My wife is raising funds too.

For me it was a no brainer to support this cause. I love local history, I think the exploration of war's affect on the home is as important as its affect on the fighters, I love MDI, I love running, and I love helping out friends when they ask for it. For you it may be harder to justify helping the MDI Historical Society, but history is important and there is such a narrow field of scholars, and a slimmer number of historians, that value the study war's affect on the home. These posts can average over 500 views and if everyone gave a couple of dollars it would reach the society's goal and really make a difference. I know money is tight for vets, but just $2.62 (donate here) from several people will go along way to support such a worthy cause led by a scholar committed to studying women's history in relationship to war. If you can't support it financially share the post with others and maybe others can help. For me I have found that supporting worthy causes reminds me that my life was always committed to service, and that I should not change just because of the burdens caused by previous service. If nothing else find a cause to support and raise some money for it or give it your time and effort. Giving makes you feel good no matter how hard life gets. Sometimes I get so stuck on my own baggage that I forget to do the basic things that bring you the most joy, like charity and helping others.

Did Not Finish: Accepting Failures is Key to Growth (Volume 1)

"Time Jumpmaster! You are a sequence violator. You placed your fingers inside the rim of the ballistic helmet during the rear head tilt on the first and second jumper...." Those were the words that brought my failure of the fifth parachute inspection during my first iteration of Jumpmaster school. I had recycled both Darby and Rudder phases of Ranger school, but this was the first course I ever failed. I lost it for a second, I let down my platoon, my unit, myself and I thought I would never get another opportunity. My senior parachutist wings and hard earned Jumpmaster armband tell a different story, but for a few hours I thought I lost the opportunity of a lifetime.

Jumpmaster Armband

A few hours later I walked into my company commander's office with my head held low. "Sir, I failed on a sequence violation. It was a petty gig, but I should have done it right and there is no excuse." My commander Captain (now Major), Joe Blanton was outstanding. "Well Lieutenant Miller, you're in good company." He began listing company commanders in my battalion who failed Jumpmaster school on their first and sometimes second attempt. The First Sergeant gave me a lecture on how my platoon was going to be without a Lieutenant for another three weeks and that I better not waste six weeks at Jumpmaster school because officers needed to pull their weight on airborne operations. I have often forgot about this major failure between my first and second deployment, in regards to how I judge mistakes that I make at home.

I came back to Jumpmaster school the next Monday, and the instructor who failed me walked up to me and asked me "are going to try an cheat this time?" Another Lieutenant told me couple of tricks to make parachute deficiencies stand out. I owned up to my mistake. He responded "well hopefully you learned your lesson and you have already paid the price. Trust the training we are giving you, don't cut corners and you will get through. Your instructor should have warned you, but don't do it again or I will make sure you fail." Two and a half weeks later I passed with the same instructor. He saw me take the lesson to heart and use my extra training to help the other people in my squad pass. He was excited because he helped me become a strong Jumpmaster, but, more importantly, I gained a life lesson about failure. Don't forget failures own them, learn from them, and don't waste your mistakes.

When we try to moralize success we also unwittingly demonize failures. We forget that we all fail and accepting our failures regardless of the causes is the first step towards growth. PTSD and mTBI can be a valid reason for any of us to fail to meet our own goals. We tend to also equate all of our failures as life or death when they are not. Even if we have made mistakes that cost lives, that was not always because of moral failings, but because we are human beings who make mistakes. I know that if I lost a soldier for every mistake I made in combat, then I would have lost legions of soldiers. This process of moralizing or systematically preventing mistakes helped us cope in combat not by actually eliminating failure, rather it was a way to assure ourselves that we did everything we could have after a traumatic event. We all drop balls, but you know when you have given your all and when you have not. It would be burdensome task to catalog every minor error in your life, rather than ones that taught you the most. When we demonize our failures, we reject their potential utility to make us better people. Worse, when we moralize success and failure we become defensive about our most obvious flaws.

Instead of tossing the shirt I wrote DNF and traded the 5 for a 4

This last year I experienced a few failures, and I am trying really hard to learn the right lesson. PTSD is often difficult because of the vast comorbidity of other mental illnesses and physiological responses, associated with it. One of the most frustrating aspects is figuring out what setbacks are just natural and which ones stem from PTSD. I run marathons and ultras in order to manage anger, stay my kind of fit, and to manage the high amounts of weight gain that comes with the anti-depressants I take. On two races I DID NOT FINISH (DNF) and in another race I finished at thirty miles rather than my goal of one hundred. It is important to note that on two DNFs that I inevitably did the right thing. I made the right long term decision at the cost of short term disappointment. I tend to try and Ranger through things. You can't pass Ranger school without driving on with an injury: you often cause more harm to yourself than good. It has been a real struggle to figure out when I am going too hard, and my tendency to be a stubbornly stoic Army Ranger goes too far. I am still failing at this, but I have been moving forward.

"Mr. Miller I am pretty sure you're going to be on a ventilator before night is over. You have the highest toxicity that we have ever seen and we have another patient in renal failure with much lower stats.” To be continued....

This will be the first post in a series on my relearning to embrace failures in relationship to the guilt of survival that comes with PTSD, obviously I have survived last year's ordeal.

Seconds Away From Suicide: Readily Will I Display...

On the 5th of April, I burned my wrist pretty badly while making some home-brew. My wife had the car at the time, but, before I would even call for help, I had to clean the wort off the floor (wort is beer before yeast is added). I saved all of the wort so I could finish that batch. The Ranger creed may seem like a silly mechanism to discuss suicide, but the Ranger creed is what saved my life when I had loaded gun in my hand. This example of me cleaning up my mess before even calling someone in order to go to the emergency room illustrates just how the sixth stanza of the Ranger is webbed into fabric of my being. It is what prevented me from taking my own life.

Readily will I display the intestinal fortitude required to fight on the the Ranger objective and complete my mission, though I be the lone survivor. Rangers lead the way.

After I came home from the Surge, I could no longer conceal the problems I had for years. In crowds, I got so overwhelmed that I would almost pass out. I had to stop driving because I almost ran off the road twice, when I thought there were IEDS. Panic attacks almost made me lose consciousness. The mTBI symptoms were worse then, limited spatial awareness and vertigo characterized my life. When my neurologist recommended an inpatient program, my battalion executive officer told the personnel officer that he did "not have time to deal with a Captain with PTSD and mTBI," while I sat outside his office. I was the most battle tested officer in that battalion, and I felt like Boxer from Animal Farm: once I was used up, my battalion was happy to ship me off to the glue factory. My doctor stuck to his guns and I went to an inpatient program in Richmond, Virginia, and then in Salisbury, North Carolina. During my hospitalization my ex-wife decided that her chemistry professor was a better choice.

Needless to say, life was not going well and I was leaving the Army just days after getting out of a hospital. I was packing up my home to put it on the market when I looked at a Beretta pistol. Why not end it all right now? The unit I fought in for years thought I was a piece of shit, my family had not even seen me after I came home, and my wife was shopping around for a replacement. I still had the hospital bracelet on and now I was about to be on the street alone. No pay, no purpose, no family, no support at all. Just alone in my thoughts. I cocked the gun, but before I could lift it up my Ranger brain took to action.

The flood of the, stress chemical, cortisol, was something I had become accustomed to using in combat. In most cases you use the surge of cortisol to fight or fly, but as an officer I employed it to think through outcomes. When I held that gun in my hand I thought through what would happen. The Army would do nothing... I would just be another number. Maybe friends might find out, and be more sensitive when they had soldiers struggling with PTSD.  Probably not though, they always had their soldiers' best interests at mind. My mother would be devastated, but my father would just write my suicide into his latest narrative of war making me a sinner, and turning me against God.

Serendipitously, my boots from Ranger school were in my eye-line and reminded me of what I was capable of handling. Sure I wanted all of that to end, but I felt that way in Ranger school too. I used to say to myself, "I don't want to quit, I just want this to end." When you're walking in the middle of a swamp no one is coming in with a jungle penetrator to take you home. I would just make it to the next rest halt. This was the same, but what was the point? What was my purpose anymore? I left the Army because I wanted to make a difference with my pen. All of my "disabilities" were going to make that nearly impossible. So you're saying there is a chance. I was never a smart Ranger anyway, I was always a tough one. Everyday I was at sick call getting something drained, taking crazy low distribution antibiotics, getting all the skin taken of the bottom of my foot, yet everyday I would smile while humming the Ranger school hymn, "I'll Fly Away."

I knew how to find my way in misery; without thought I dropped the magazine, removed all the rounds and threw them into the woods. At the time I had no idea of what my mission was, but I was damn sure going to fight onto that objective. The whole world seemed to have turned on me, but, so what, just hum that hymn, drive on and somewhere in the process I will figure out how to get better, or learn how to enjoy the suck. I kept one Ranger school boot on my desk and one on my dresser so I would always be able to remember what I was capable of overcoming.

I can't tell you why things got so bad for me, but what I do know is that I did nothing to cause it or deserve it. I certainly am not weaker than I was before. If anything I am tougher mentally than my body is physically, and I should take it easier when my body is giving me queues like "Hey stupid, your wrist has second degree burns on it... someone else can clean the floor later on."  More importantly, when you have stepped up to save your own life, every milestone gets a little sweeter. My relentless mission focus is, more often, an annoying characteristic that pushes me way too  hard, but it also brought me through the most difficult time in my life. A time when I had no support at all. Now when I hold my wife, play with my dog, drink with my friends, and work with my colleagues, I am so grateful for the man that pushed on when there was no indication that I could never make a positive impact on the lives of others again.

You can see my burn and Darby's awesomeness

When we were kids we never think that, "seconds away from suicide," would end up on our bucket list, but I am so happy that I had the courage to live on unashamed. I have been lucky enough to put more on my bucket list after that day than I would have had the courage to dream of as a child. I hated Ranger school, but, like in combat, its ideals have never let me down when the world becomes dangerous or chaotic. It is often said that the Army never trained us for coming home, and that is generally correct, but it did teach us values. Learning to translate core values into a life out of uniform saved my life, and I would be lost without things like the Army Values, Warrior Ethos, and the Ranger creed. The road home is not easy and it sucks more often than not, but that doesn't mean that its is not something you can't enjoy or find fulfilling. It certainly beats Ranger School.