TBI is claiming the hearts and minds of too many vets
By Diane Cole
The Long Walk: A Story of War and the Life That Follows
By Brian Castner
Doubleday. 222 pp.
This past July, the U.S. army suicide rate reached a grim new high: more than one per day. Shortly before that statistic was released, the Pentagon announced that suicide had become the leading cause of military deaths outside of combat; whereas in 2005, suicide accounted for 10 percent of army deaths, by 2011, the figure had risen to 20 percent. As for why returning soldiers would attempt suicide after leaving foreign conflicts behind, the answer found by researchers at the National Center for Veterans Studies probably won’t come as a surprise to psychotherapists who’ve treated veterans suffering from post-traumatic stress disorder (PTSD) or from the not yet well understood impact of blast-induced traumatic brain injury (TBI): they kill themselves to put an end to their intense psychological suffering and pain.
What it means to live with that vast interior landscape of pain is the subject of military veteran Brian Castner’s incisive memoir The Long Walk: A Story of War and the Life That Follows. Page by page, Castner chronicles the inside story—the story inside his head. “The first thing you should know about me is that I’m Crazy,” he begins. “My Crazy is a feeling. It’s the worst, most intolerable feeling I’ve ever had. And it never goes away.” He carries this feeling with him all the time, along with the feel of a rifle strapped to his back, the growl of Humvee engines amid the riot of people screaming in a language he doesn’t understand, and the stink of splattered human remains. It’s with him as he runs in the suburbs where he currently lives, as he attempts to sleep in his wife’s arms, as he cares for his young children.
Part of his quest in writing this memoir is to figure out when the Crazy started and why it’s so hard to shake—why, despite fighting against it as hard as he can, “The Crazy is winning.” Castner tells his story jigsaw-puzzle style, going back and forth in time, piecing together episodes dating from before, during, and after his deployment to Iraq. The jaggedness of the narrative mirrors the interior fragmentation that shatters his life. Throughout, the writing is as edgy and insistent as the internal experience he relates.
It’s a particularly gripping—and terrifying—experience. As an officer in the United States Air Force from 1999 to 2007, Castner was twice deployed to Iraq, where, in 2005 and 2006, he commanded explosive ordnance disposal units. To translate the military euphemism, he and his team did essentially what the characters in the multiple Oscar–winning 2008 film The Hurt Locker did. They defused and disassembled bombs known as IEDs (improvised explosive devices) before they blew up; searched out the bomb makers and cleared out their bombs before they were planted; and cleaned up and investigated in the aftermath of explosions. All too often, these activities meant mopping up, counting, and collecting stray body parts of enemies and comrades alike. He writes about an intact intestine found in the debris that “lay there like I had just removed it from the organ bag in the gut of a Thanksgiving turkey.”
In retrospect, Castner believes, the first inklings of Crazy may have begun upon his return from Iraq (after leaving the Air Force, he became a consultant and contractor, training Army and Marine Corps units before their tours in Iraq and Afghanistan), with the initial shock of American consumer indulgence. But for him, the greater problem was not so much returning to the home life that had once passed for normal: it was that the hypervigilant siege mentality imprinted by his bomb-squad experience seems to have overridden the muscle memory of ordinary stateside routine, leaving him little foundation to return to. Added to this is the seeming erasure of long-term memories that he’d once cherished, and Castner finds himself trapped in an unending fear-and-anxiety feedback loop of his nights and days in Iraq.
Having prepped his body to stay constantly alert, awake, on guard, waiting for the phone call to respond to the next bomb emergency that could come at any time, Castner has lost the rhythms of individual days and nights and the passage of time. What he hasn’t lost is the expectation of disaster—a focus that excludes any thought that’s extraneous to immediate survival. This is another reason why, as he explains to his bewildered wife, he needs no written diaries to maintain total recall of every bomb encounter, every detail of which might help him avert future disaster, yet he can no longer remember their children’s births or their first steps, even with the help of photographs.
So, as hard as he tries, the Crazy comes, unbidden. Triggers are everywhere and unpredictable. As he walks to his gate at an airport, he’s mentally transported to siege mentality, imagining enemy snipers everywhere. Passengers waiting to board meld with horrific memories of threatening crowds. Just standing in a grocery line, he writes, “reminds me that now I’m just a stupid Crazy vet with a blown-up brain. I’m jealous of the unaware masses I stand with. . . . When I get sick of standing in a grocery line, I make a detailed plan to kill those I’m surrounded by, allowing me to leave the store.” The one bomb this expert bomb defuser can’t disarm is the one that exists within his brain.
To help keep his brain (and himself) from exploding, he turns to a counselor at the Department of Veterans Affairs, but months spent rehashing the past and going over his obsessive ruminations yield little relief. He and his wife had already consulted an ineffective couples therapist, who’d smugly declared, “Why is the war still in your house? Get it out of your bed.” As if it were easy to remove what Castner describes as the “bed full or rifles and helicopters and twitching eyes” that have slept beside him since the night he came home.
Castner may be crazy, but these well-meaning counselors are clueless.
Fortunately, he’s referred to another psychotherapist, who jump-starts his progress by asking him point-blank: “Are you going to kill yourself, Brian?”
He responds, “No one has ever asked me that before. . . . I have to really think about it.” Maybe the question itself is what allows him to answer, “No, I don’t think so. Maybe before, but I’m not going to now.”
She also recognizes that Castner’s symptoms—his memory gaps, inability to focus, bouts of intense fatigue, indecisiveness bordering on confusion, and sudden emotional states—bear less resemblance to PTSD than to blast-induced traumatic brain injury (TBI), suffered by perhaps one in five deployed soldiers returning home from Iraq and Afghanistan. That statistic is why TBI research is being aggressively pursued at many medical institutions, although treatment remains elusive.
Only recently have we begun to understand how the damage occurs. “When a blast wave enters the head, it speeds up at each threshold, through the skin and the skull and the bag of cushioning fluid that surrounds the two main lobes of the brain,” Castner explains. “Then the wave encounters tiny nerve endings, neurological fibers, and slight synapses. Faced with a couple of billion density junctions, it shears, strains, rips and tears its way to the back of the skull and out the other side.” Because the damage is sustained within the brain, it’s usually not until later, when symptoms surface and don’t go away, that soldiers begin to realize that even though their bodies have no visible wounds, they’re far from OK.
“Inside your head, nerve connections that used to exist have been torn and broken,” Castner writes. “You may have lost parts of high school geometry, the coordination needed to tie flies for your fishing reel, or the ability to make decisions at the supermarket about what to buy. . . . your son’s first steps or the night you asked your wife to marry you.”
If there’s any good news about TBI, says Castner, it’s that “your brain can regrow paths and you can reclaim skills you’ve lost.” But because those new pathways are longer and more complex, they require more energy to use, and relearning what you once knew can feel like an educational marathon.
Will Castner ever get rid of his Crazy? His therapist helps him focus more on the future, rather than remaining stuck in the past. Her approach is simultaneously direct and sympathetic. She encourages him to accept the fact that he isn’t crazy, but merely human. For his part, Castner adopts a variety of strategies for coping, such as going on daily (and sometimes twice daily) runs. He’s taken up yoga and engages in meditation and mindfulness practice. He writes this book and starts a blog. He lives his life as best he can.
Ultimately, we’re left with the sense that Castner’s long walk home is ongoing, a work in progress. He’s done double service for his country—in war and now in peace, with this compelling record of war’s aftermath. The Long Walk forces us to accompany him on the journey, and challenges us to find ways to support him and his fellow veterans along the way.
Diane Cole, author of the memoir After Great Pain: A New Life Emerges, writes for The Wall Street Journal, among other national publications. She can be reached at firstname.lastname@example.org.