Crawl Through the Sewer By Tommy Cheis In the Acute Care Unit at Miami’s Jackson Behavioral Health Hospital, my patients are locked behind three doors to prevent their escape. Inside, the individual rooms are molded plastic and rubber. Bed, desk, bookshelves—all are built-in. Sharp edges and anything that can hold a rope are rounded and flattened to prevent suicide. That morning, I, Dr. Jimmy Panther, MD, took a breath and buzzed into my first patient’s room. Waiting there was Philo Outis, 28, a descendant of Greek sponge divers from Tarpon Springs Philo was also a combat medic with three Iraq deployments. Diagnosed with PTSD, he acknowledged previous alcohol abuse, chronic pain, and adverse childhood experiences. No surprise. What shocked me was what landed him in ACU. According to a letter from the Department of the Army, Sergeant First Class Philo Outis, after being denied conscientious objector status, received orders to Afghanistan. Philo refused to deploy, then refused an administrative discharge that would have separated him from the Army without punishment. After two weeks’ cajoling and threatening, the Army branded Philo a deserter, convened a court-martial, and appointed me to a three-member Board to determine whether he was sane. The Army’s psychiatrists, chaplains, and brass said Philo suffered only from guilt and shame—symptoms not of mental illness but of a personality disorder and, worst of all, bad character. Philo’s own defense lawyer said he was nuts. As an expert on veteran psychiatry, I’d served on Sanity Boards, but I’d never assessed a soldier accused of the most serious of military crimes. Desertion carried a possible death sentence, and Sanity Boards, often rubber stamps for commanders, find fewer than one defendant in 200 not responsible due to mental illness. The Board’s neuropsychologist and neurologist would review witness statements, examine medical records, and test him to decide if Philo was lying about psychiatric symptoms to “earn” an insanity determination. As Board psychiatrist, I would decide whether, at the time he refused to deploy, Philo suffered from a serious mental illness that prevented him from understanding the wrongfulness of his conduct. If I found Philo “insane” when he went AWOL, he would face a reduced sentence or even a dismissal of the desertion count. If the latter, he would receive treatment and, once restored to wellness, be discharged from the Army. If I found him “sane” but unfit to stand trial, he would be sequestered in my care to restore his mental health—if possible. Either way, Philo would benefit. As a firm opponent of the death penalty, I was determined, if ethically possible, to find him insane. By court-martial rules, I had six weeks. I took a deep breath and buzzed into Philo’s room. On my entry he stood at attention. He bore himself as a Homeric hero. Tall, athletic, alert, determined. Philo had gravitas. “I’m Dr. James Panther. At ease, Sergeant Outis.” “Please call me Philo.” “James is fine.” We shook hands. My face flushed. I pulled up a chair and asked him to sit. “Your secrets are safe with me. Psychiatrist-patient privilege attaches. Anything you tell me will not be used against you in court-martial.” His grey eyes slitted with suspicion. “Is this a ruse?” “No trick. My only purpose is to facilitate a diagnosis and treat you.” “I don’t care if you tell the world everything I share. In fact, please do.” He was warm and sincere, with none of the glib superficial charm, shallow affect, and remorselessness of psychopaths I’d treated. But we’d barely begun. “That’s if I tell you anything at all. You know I’m sane, right?” “What sane person isn’t a conscientious objector?” Philo chuckled. “Problem is, if everyone’s a CO we can’t have a war. Doc, I’m not willing to kill, but I’m willing to die.” “Tell me about that.” “I changed my mind. I think I’ll stay mum.” “The status quo puts you before a firing squad. Doesn’t that upset you?” “Ha! You’re a learned man, James, but you’re no vet. I’ll keep my own counsel.” “Sure. Many veterans won’t speak to a non-veteran. It’s true that the closer a psychiatrist is to his patient in experience and background, the greater the potential for transference.” And counter-transference, although I didn’t mention that. “But I am a—” Philo waved me off. “The modern battlefield is brutal beyond description. No civilian psychiatrist can comprehend it.” “I understand you’ve suffered.” He scoffed. “I won’t tell war stories to a voyeuristic civilian. Combat is a cascading rape of the soul. One innocent of war has neither lived nor died. Actually, he never existed.” “Yet I’m here. And I’ve read your chart. And I’m strong enough to hear your story without becoming injured myself, and without denying your reality and experience. And I’m ready to experience terror, rage, and grief with you without judgment or laying blame.” Philo grimaced. “You can’t. And I don’t want your compassion or admiration. And I don’t want to explain jargon or acronyms.” “What do you want?” He tugged a lock of dark curly hair but said nothing. I threw up my hands in frustration. “You want the government to kill you. Put that aside. Let’s build rapport. You’ll be surprised how well I speak your language.” “Ha. Look at you. Insulated from hardship. Lacking experience of tragedy. Jimmy Panther, I bet you’ve never been in a fistfight.” “As it so happens—” “Doesn’t matter. Tell me everything about you. Then I’ll decide.” I started with the relevant bona fides. University of Miami undergrad. Harvard Medical School and psychiatric residency. Hired by Dr. Demi Diaz to research and run the vet clinic I founded. Hearing it come from my mouth bored me too. Rightly, Philo poo-pooed it. “I couldn’t care less. I thoroughly distrust credentials and institutions. I respect only the ability to listen and get it. You’ll probably exploit me for your own advancement. Research. Writing. Grants.” He paused. “Trust is earned, James.” he paused, then spoke again. “Did you know that a psychiatrist is worth many men put together?” I wondered if Philo was having a psychotic break. But he pressed on. “Jimmy, will you crawl through the sewer with me?” “By the sewer, you mean your experience of war?” He nodded. “Philo, not only will I crawl in, but I’ll help you crawl out.” His eyes slitted. “You haven’t helped everyone, have you?” I felt naked. “I lost one patient to suicide, Philo. What are you really asking?” “Will you take care of me?” “I could tell you I’ll try, but what if my friendly manner is a trick to better exploit you?” “You’re a reverse psychiatrist, are you? Whatever. My life’s been an odyssey.” “Philo, you’re the expert. I’m a listener. Teach me your life and times. I’ll laugh, cry, and honor your story. I’ll be the hole in the floor into which you shit what you don’t want to carry. If you don’t want to talk, OK. This world needs less chatter and more action. Let me shepherd you to an appreciation of your service and your humanity.” “What a mouthful. What do you ask in return?” “Total honesty.” He smiled as if I’d confessed a belief in Santa Claus. “Telling the truth is a bad habit if you want to get ahead in this world.” “But it’s easier that sustaining a lie.” “Don’t declare me mentally unfit for duty. Find me sane so I can go to court-martial and be shot. Promise me.” “I can’t make that promise.” “That’s my condition for us to work together.” My stomach fluttered. “If I find you sane, you’ll be sent back to battle.” “Nah. They’ve already hand-picked the firing squad.” “Philo. We’ve all had civilizational inhibition drilled into us, but you can still finish your enlistment honorably. I’ll help you.” “Like Siegfried Sassoon? Never.” “I’ll work with your lawyer to explain it. The Army would prefer to see you cope with trauma, find meaning in loss, and persevere. You’re the first soldier to face death for desertion since Private Eddie Slovik. It’s terrible for public relations and recruiting.” “There’s a principle at stake.” “You have better options than death. Have you no ambitions?” He shook his head. “A home then, Philo? A car? A woman? A man?” “I’ve foresworn my possessions. And I’m monastic.” I sensed, in addition to anhedonia, he might have pervasive depression. “Are you loveable?” “Once. No longer.” “Do voices order you around?” He denied it. “Do you think of killing yourself or others?” “I lack the energy.” “Do you take prescription medicines?” “Come on. I’m saner than you. I’ll prove it.” “What’s sanity? What’s crazy? We don’t use the terms in psychiatry. Both are fleeting conditions. Let’s get you dinner.” Philo stood and shook my hand. He was captivating. “So we’re partners, Jimmy?” “Yes. But we’ll go where the evidence takes us.” “As long as we go together. What more can I ask of a brother? It’s not just the destination. It’s the journey.” I worried about him for the next forty-eight hours. When we met again in the dark windowless cave of his lockdown room, the first thing I did was pose this question. “Why desert now? You couldn’t introspect in the adrenaline, noise, and heat of battle? You couldn’t afford the luxury of thinking about the war until you were safe? Or reflection deepened and hostile self-judgments tormented you only once you returned home?” “All the above,” Philo said, clapping his hands. “Impressive, for someone who’s never seen the elephant.” “What elephant?” “Combat. Why do you ask all the questions while I give all the answers? You have no idea what combat’s like.” “The truth is, we’re all shrinks. Some have formal training and paying patients. Others don’t. But writing peer-reviewed articles and observing strangers doesn’t differentiate me from you. Ask anything you like. I’ll answer, but later. For now, please continue.” I never assume what I hear when I start treating a patient is all there is. Pain is an iceberg. Much of it is beneath the water line. Most patients shade the truth when recounting their agonies if they believe they behaved shamefully. Most offer a minor episode to break the ice. Ugly stuff pours out later. Not so with Philo Outis. He divulged the worst childhood abuse I’d ever heard. Jerked from beds. Beaten by drunken foster fathers. Raped by an older foster brother. Broken bones. Concussions. Knife scars. Relentless terror. But he’d poured himself into school and sports and earned scholarships to college. The attack on the World Trade Center jolted him off that path. He’d enlisted as a combat medic only after the recruiter guaranteed him he’d not be obliged to carry weapons. During basic training at Fort Sill, he realized he’d been duped. Cadence calls glorifying war, meant to desensitize recruits, reinforced his moral conviction that killing another person was abominable. Yet when his unit deployed to Iraq, he was still thoroughly committed to building a stable democracy by winning hearts and minds. His morals and the mission were still commensurable. Battle transformed Philo Outis. His company was the main effort. They deployed via Bradley Fighting Vehicles into the Battle of Wadi as-Salam Cemetery in Najaf, then attacked on a quarter-mile frontage to destroy the Mahdi Army lurking in catacombs, unleashing ambushes on U.S. forces. Then-PFC Otis, in desert camouflage and body armor, toting his aid bag, dismounted into a hurricane of red tracers, shrieking rocket-propelled grenades, and whistling mortars. The onslaught pulverized graves, dislodged rotting flesh, and tossed bones into flight. His platoon lost lateral contact and over-advanced into a three-hundred-sixty-degree close-quarter battle. “My call sign was Trauma Two, Jimmy. I was busy. All while pinned down under fire. I called for medevac but it was too hot to get a bird in. I decided who got treated and who didn’t.” “Triage is a terrible responsibility.” “And for each wounded man there was someone for whom he was her whole life. A wife, girlfriend, mother.” “Or father, brother, partner.” He winked and gave me a familiar smile. “First a sucking chest wound. Guy from Montana. Gray pallor. His lung collapsed and his ribs were bone meal. I could only massage his heart and jab him with two extra morphine hits. He asked if he was going to die. I pretended I couldn’t hear him. Wasn’t a stretch. Mortars were bursting fifteen feet away.” “Keep going.” “One-by-one, the enemy waxed our Brads. Guys got shredded. I was a blur with hemostats, syringes, bandages, trying to keep blood in my guys. Roll, jab morphine, roll back. Repeat.” “With discipline. As you’d been trained.” “I was a priest at the altar of blood and death.” “Do you believe in God?” “No. I told you I’m sane. Where was I? They’d get shot again. I’d start an IV but the patient got drilled in the dome. Or the arm where I’d put a line would get blown off. Shrapnel cracked a guy’s skull like an egg. He went into convulsions but took twenty minutes to croak. Another was paralyzed at C2. Goddamn shooting gallery. An RPG every ten seconds. A mortar every thirty.” “Your left cheek is scarred.” “Bone shrapnel from a patient. Skull slivers. And a round through my arm. Endorphins surged and I felt nothing until later.” “That happens. Keep going. You picked up a weapon and fired at the enemy.” “How did you know?” “It came in a flash. Did you—?” “Yes. I don’t want to talk about it. Yet.” “I’m sorry. I shouldn’t have asked.” “When I couldn’t keep fluid going, I radioed for help. ‘MEDEVAC KIA AND WIA!’” “And the chopper arrived but couldn’t put down.” “The incoming fire was so great.” Philo looked at me askance. “It’s like you were there.” “How could I have been?” “Hmm. Casualties were IDed by radio. Attrition went on. It was 130 degrees in the shade. I’d give the dying water from my canteen, but it burned their lips and throats. Mama. That’s what they’d say right before they died. If there was time. Mama.” “Often our thoughts turn to our mothers in moments of great strife or loss.” “I never knew mine.” “Nor I mine. Strange coincidence. Carry on.” “Special Forces snipers fought into our encirclement. They punched lots of tickets, including jihadis in the Imam Ali mosque which was officially off limits. For a time, I thought we’d break out. But counter-snipers wasted most of the Green Berets.” “It was quite the fight as I recall.” “Now I’m out of ammo, caked with sweat and flesh. My guys and bodies vaulted from tombs by explosions. I’m spinning in circles trying to put an eye into a corpse’s socket. Fumbling in the dark. Gathering fingers, toes, and testicles to stuff them in a bag.” “You were in deep shock.” “The other platoons have withdrawn, all my guys are KIA, and the enemy’s advancing on my position. I’m surrounded. The cordon’s shrinking. They’re firing as they come. I’m dead.” “But yet you’re here.” “The surviving Green Beret—a good-looking guy—grabs his .50 cal and starts shooting. I leveled my rifle and joined in.” “To what effect?” “We popped them like balloons at the county fair. Maybe twenty, until our ammo went black. But I received no stuffed bear.” “What did you feel?” “Then, just recoil into my shoulder. And gratitude for my friend. I’d have died but for him.” “Raise a glass when you’re discharged. Go on.” “But our shooting hardly made a dent. The jihadis move in. The SF guy bites out the throat of the first guy to engage, then cooly calls division artillery on our position.” “You were dead either way. And then?” He shrugged. “An AC-130 shows up. I dive into an open tomb. She unleashes her chain guns and 40 mike mike. It’s like one of those Mongolian BBQ joints where the chef tosses ground lamb on a grill. Later, dogs came to eat the dead. No food wasted.” “You have a morbid sensibility.” “Let’s back up. In a prior engagement, the enemy’s kids planted IEDs and carried ammo.” “Converting them from noncombatants to targets.” “A kid, maybe ten years old, fired at me. Without thinking, I shot him between the eyes.” “How did you feel?” “Pride in my marksmanship. Later, shame. I also shot a jihadi holding a baby in one arm.” “Did he hold the baby or did you? Whose arm was hit? Sorry. Injecting levity. The jihadi made the kid a human shield. His fault.” “Everything ran together. In some dusty shithole village right around Najaf, my truck was hit by an RPG. Twelve grunts burned for nine hours. My SF battle buddy carried me to safety, then we lost touch. I’ve foresworn meat since. Sorry. I’m scattered.” “Need a break?” “No. Around then, I asked my battalion CO permission to treat wounded kids. He said our supplies were insufficient, refused medevac, and ordered me to waste them and their wailing mom.” “No.” “Don’t ask.” “You were following orders.” “I wasn’t when I shot a passel of Iraqis raping boys for sport.” “That was morally justified. You freed the catamites. Killing can be like amputating a diseased limb. It hurts and it takes guts but it’s the least bad option. Bonhoeffer would laud you.” “The Lutheran priest guillotined for resisting Hitler? He’s entitled to his opinions, as I am to mine: I committed war crimes.” “There are three exceptions to every rule. The rapists needed to die. If you hadn’t killed them, who would have stopped them?” “That’s how I saw it.” “Rightly so. Some moral dilemmas can’t be understood by civilians, Philo.” “Yet here you are, understanding well.” “And there you were in the crashing immediacy of battle. No one who wasn’t is entitled to judge you. Not legal scholars. Not military lawyers. Not philosophers nor theologians. To whose version of morality should you have to answer? Your battalion commander’s? An Article 32 panel’s? Or God’s, who let those boys be raped? Or the boys themselves? Bad things happen in war.” “From the actions of evil people.” “And sometimes by the actions of good folks setting things as right as they can set them.” “But killing kills the killer.” “By that you mean nothing prepares one person for killing another? True. Only an extreme sociopath would feel no remorse after taking human life. Yet soldiers like you were promoted and decorated for their actions.” “There are guys doing life in Leavenworth who did less than I.” “Proving that the difference between a Silver Star and a court-martial can be as little as whether the on-call JAG is offended.” “For a civilian, you’re quite invested in the moral chess of the battlefield.” “Some things I just can’t countenance.” “Don’t we share a common humanity with our fellow soldiers?” “Soldiers, yes. Rapists, no.” “A good person doesn’t take the law into his own hands. I did. Ergo, I’m a bad person.” He shrugged as if to brook no further comment. “I want to be prosecuted as a war criminal.” “We’re regressing. Philo, you’re a warrior who served your country honorably. Iraq was a land without science, law, or literature, run by a brutal dictator. You delivered democracy and freed the oppressed. You’re a model citizen. Why throw yourself away?” My patient belly-laughed. “What is achieved through improper means is first contaminated, then annihilated, then desecrated.” “Explain.” “The most sacred sanctuary of my being. I violated it by my transgressions.” “Aspirations to law in war ended with the machinegun and mustard gas. You targeted no innocents. You’re guilty of nothing.” “Wrong. My bad acts violated my nature.” “Philo, you’re no perpetrator. You’re hero and victim.” “In other words, thank you for your service. How perverse. Is that your best effort?” “Show me the soldier who never fell short of the warrior’s code in battle.” “Show me a field other than war upon which the wicked maximize their potential. Let me reckon with my wrongdoing.” “Do you believe yourself to be evil, Philo?” “I do.” “That can spark an irreversible spiral into darkness.” “I’m darker than dark already.” “Do you trust yourself to make moral decisions?” “No. But others can and must. I demand to be judged.” “Cut the arrogant virtue-signaling. You were put in an untenable moral quandary. Die, or kill someone else to remain alive. Think of the parent who leaves a small child in a hot car, then runs into a store to get milk. The parent returns and the kid’s asphyxiated. Can’t we forgive that along with the unintentional killing of a civilian?” “Once, maybe. Twice, no. But the exemplar isn’t apt. I shot said rapists with malice aforethought. I’m ashamed by my military service.” I changed tacks. “What percentage of the blame for your malfeasance do you assign yourself?” “One hundred percent.” “What culpability do you assign the rapists?” “Zero.” “Incredible. How about the insurgency itself?” “Zilch.” “And the U.S. government.” “Less than nada.” “Next you’ll say vets should picket Congress demanding reparations for Iraqi and Afghan victims of an unjust American war.” “Now there’s a thought. Marvelous, Jimmy.” “Sergeant Outis, the Board makes me inquire every session: will you drop your insistence on a court-martial and return to duty?” “No. And I won’t let you use medication or your prodigious wit to compel me in that direction. Not that I think you’re the sort of shrink who would treat me in furtherance of any political objective. If I did, I wouldn’t divulge my dirty deeds.” “I’m glad you trust me. Philo, describe yourself.” “I’m a spent, embittered veteran. I live in a world where everything’s slow, flat, and dull. Without you, I’d be insufferably lonely.” “Have you ever been in a bar fight?” “A baker’s dozen. Fearlessness is the only virtue left to me.” “I’m revising your diagnosis. PTSD is the result of unmanaged fear. It’s threat-based. Veterans with PTSD are victims treatable with talk-based therapy. You don’t have PTSD.” “I told you I was sane.” “You misunderstand. One can have PTSD and be sane insofar as sanity’s definable.” “So I’m insane because I engage in self-criticism rather than shiver in terror?” “You misunderstand. You have severe moral injury.” “What part of my body is affected?” “It’s not corporeal. Moral injury’s an existential wound caused by high-stakes transgressions of deeply-held moral values. You’re hurt in mind, body, and soul.” “Many guys in my unit walked away from war like it was a pickup basketball game.” “But your damage began before you signed enlistment papers. In childhood. Your parents failed to afford you security and safety.” “I’m more than the sum of my history and symptoms.” “How do I explain it? Moral injury occurs when, during an event in which death occurred, your sense of what’s right and just in the world is egregiously violated.” “Go on.” Who was the psychiatrist? Who was the patient? “When a person suffers moral injury, the discrepancies between the Self as he knew it and the Self as he has come to understand it cause cognitive dissonance.” “How can A be true if Not A is also true?” “Exactly. Moral injury is an accusation leveled against the Self for its failures. My Self is evil for not spotting the sniper who killed my friend. My Self is evil for killing innocents. My Self is evil for deserting comrades and surviving when they died.” “You’re onto something.” “You were innocent. Childhood fractured your ideals about what was legitimate, natural, and binding. War blew them away.” “Keep going, Doc.” “That caused moral pain exceeding your ability to cope. Now you’re in existential crisis and doubt your right to live.” “I’m worthless. I’m unlovable. Let me convince you to hate Philo.” “This belief leads you to engage in self-handicapping behavior, such as doing everything you can to be put to death.” “It’s better that way, Jimmy. When I’m not in pain, I feel anaesthetized. I’m not even sure what I believe anymore. Or what’s right and what’s wrong.” “You’ve lost faith in people and in the sacred. Your relationships have degraded.” “Faith is gratitude mixed with delusion. The world’s an evil place. No one’s any good. And you’ll quit on me soon enough.” “You’re stuck in a miasma of moral pollution that you think banishes you from humanity.” “Yes. I’m so lonely. What’s the point in forging on?” “Philo, your heart isn’t as dark as your worst moment. You can be forgiven. And treated.” “Treatment’s a waiver of individual accountability, and a process essential to making war. Why waste your time, Jimmy? Curing me won’t make me rejoin the fray.” “Whether you return to duty is your choice. But I can’t cure you. Some soldiers with moral injury improve, some stay the same, some worsen. I don’t how much recovery you should expect.” “I have no expectation. Treat me however you like provided you find me sane.” “You may feel worse before you feel better.” “Good. Question. You used the word, honor. What did you mean?” “The value of a person in his own eyes. And social acceptance of his claim to decency.” “Ah. Then I have no honor and deserve less.” “That’s the core of your problem. We’ll address it next time.” Another forty-eight hours later, we did just that. When I entered his room, he was batting out pushups. Hearing my entry, he bounded up, dried himself with a towel, and took my hand. “I didn’t think you’d return, Jimmy.” “I promised I would.” “Still.” He inspected me like I was a horse at auction, then seemed satisfied I’d be a good addition to his stables. “I’ve given what you said much thought.” “About moral injury?” He waved his hand. “The culpability of the U.S. government.” He sat on his bed and nodded at the plastic chair. Huddling face-to-face with patients and hashing through the hard facts of life was my greatest joy. “Philo, let’s back up.” “Where you go, I’ll follow.” “In our last session, you told me you deserved punishment for your conduct in war. A war in which you served by choice.” “I’m part of the tiny fraction of Americans who volunteered. But I’ve had an epiphany. I’m not entirely to blame.” “What a quick volte face.” “You persuaded me.” “My intention was merely to encourage you to consider another point-of-view.” “I did. And I now assign eighty-two percent of the blame to the USA.” “The other day you wanted to face a firing squad sans blindfold.” “Since our last meeting I achieved moral clarity. I’m not perfect, but I’m not a bad person.” I was thrilled, but the worst moral injury arose not from regret over our own conflicted actions but from the social devaluation wrought by individuals and institutions that betray us. Humiliation evokes anger. Anger sparks a desire for vengeance. The work ahead required a different treatment method than I’d planned. “That’s right, Philo. You’re a good person. Repeat that while looking into a mirror. Let no one, including yourself, demean you. Can you explain the rapid shift in your moral calculus?” “You dispelled the fog of war. I reflected. Call it a conversion on the road to Baghdad.” “OK. Please elaborate.” “The war was illegal, immoral, and violated international law.” “Because it was an aggressive war in violation of the just war doctrine?” “Precisely.” “You reject the claim that the U.S. is a force for good in a violent world, and thus your service in Iraq was moral and lawful?” “Yes. Show me one Muslim country upon which we’ve not dropped a bomb, apart from those blessed with oil. America was founded on violence. Case in point: the genocide and land theft committed against the Seminole and Chiricahua.” “You’re a student of history.” He laughed. “I was ignorant before the war. I believed America, guided by General John Wayne and General Jesus Christ, was incapable of martial sin. My article of faith was that when the Army slayed our barbarian foes we did God’s work. To love God was to love war. We fought only to punish evil and make peace. Every American war was holy. Every American soldier was a hero.” “Your only obligation was to do and die. And win, of course.” “It’s as if you’d served.” I shrugged. “The Army chaplains said any soldier who questioned this was a blasphemer and an enemy of the state. The Army psychiatrists said any soldier who disagreed was crazy and gave him drugs to fix it. But I’ve learned some things.” “Tell me more.” “All our wars are for power and cash. Iraq had no weapons of mass destruction. Saddam Hussein and bin Laden weren’t friends. Iraq was harmless. Fuck every warmongering politician, corrupt military leader, and media moron who pretended otherwise.” “The custoDians of themis.” “I used to trust the authorities responsible for justice, law, and order. Now I know so many of them are radically evil.” “That carved a wound in your soul that’s suppurating into cold fury and bitterness.” “Those bastards ought to have declared war against rapists and child abusers instead. Someone who deserved it, right?” “But you lost the power to choose the wars you fought and the enemies you faced once you swore your oath of enlistment.” “That was the greatest mistake in my life.” “Your schema’s been rent. You’re morally injured. Can I help you come to see you bear no personal responsibility for what you did in Iraq no matter how unjust the war may have been?” “On the ground that I was told what to do, that I harbored no rancor or cruelty, and I abhorred my labors?” “And that you rendered service not as an individual but as an agent of the state.” “I refuse that out. And the Iraqis didn’t have it coming. Culpability lies elsewhere, too. Why was there no anti-war movement?” “Cindy Sheehan doesn’t count? Or the several NGOs that wrote sharply-worded letters?” Philo scoffed, got up, and paced. “There are two kinds of people. Those who serve, and those who expect to be served. I got my hands dirty as did you. Fuck all Americans who questioned nothing, voted for the ringleaders, and paid the taxes that funded the shit show. Most of them don’t know anyone who knows anyone who served. We were at war; they were playing video games.” “What should they have done?” “Think. Question. Act. Engage in civil disobedience instead of becoming mindless drones.” “Isn’t it a lot to ask the average civilian to ape Thoreau?” “They should be bound by the same principles we were. Duty. Courage. Self-sacrifice. I want to smash the face of every civilian who mumbles thank you for your service.” “The desire to kill those we feel dishonored us is common to moral injury. But isn’t your rejection of civil society harsh?” “No. Civilians are purposeless, clueless, amoral individuals who live miserable lives buying stuff to fill holes in their souls. They don’t know what we go through on their behalf and couldn’t care less. In some ways civilians aren’t even people.” “Why do you draw that conclusion?” “American manhood has disintegrated. On every street corner is a pack of punks who think they can flap their mouths with impunity. Not so long ago, our culture made them back it up. They had to deliver or absorb an asswhipping. Now they can trash talk and just snivel off. Amazing that women allow them to breed. Lesser men should defer to their betters.” “Such as you?” “And you. We’re an ancient elite brotherhood. We learned about ourselves and the world.” “I didn’t—” “We were once Spartans marching to Thermopylae, thrilled to meet our impending deaths.” “You’re talking philia. You need to know who you can trust in the face of danger. And you want your death to mean something.” “Yes! No civilian comprehends that.” “Let’s summarize. You lost faith in the basic goodness of humanity and feel betrayed by your government and your people? And you blame those holding legitimate authority for compelling you to transgress your moral boundaries?” “Emphatically. And the sheeple who made it possible. I propose to transfer the noose of guilt around our necks to theirs.” Great steps already. Wonderful. “How?” “With a code that restores trust to the social compact. Rules and punishments. I’m working it out. Bad acts demand the consequences justice mandates. Can we end our session? I’m drained.” “I’m sorry, Philo. I’ve pushed you hard.” “I’m grateful for you.” He searched my face. “You said you might not be able to cure me.” “I didn’t rule out the possibility.” “But you’re hedging.” “After incurring moral injury, true happiness isn’t always possible. Insight doesn’t always lead to joy. The past pursues us. And upon its back, truth rides. Truth can be ugly. The more truth we see, the more troubled we become.” “Yes! You get it! But why the trouble?” “Our mistakes are transmuted into others’ pain. Too often there’s no way to undo them.” Philo embraced me. “I love you. Will you help me, Jimmy?” “I started the instant we met. Our raw Socratic dialogue challenges your maladaptive cognition. We must drag you away from myopic self-condemnation into clear-eyed lamentation.” “You say ‘we.’” “A figure of psychiatry-speak. You’re the patient. I’m the—” “—benevolent authority figure winnowing out my secrets to refine my moral judgments?” “It’s like you read my publications. We’ve progressed, Philo. Your locus of blame is shifting. We’ll keep on until you no longer feel shame and the need to isolate.” “Baby steps, Doc. That’s over the horizon.” “Then we’ll help you believe in a better future, then work towards self-forgiveness and assuaging your moral pain.” “I’m too angry. I need to atone. Justice needs doing first.” “It always will. The world’s morally imperfect. Maybe you can have justice in small measures.” “I don’t know if I believe that.” “Do you trust me?” “With my heart and my life.” “Given what you’ve suffered, that’s a staggering act of courage.” “But what if I’m beyond your ability to save?” I tried to find something he could cling to for hope. This is all I had. “Maybe all we can do is talk to our friends. Or pray. Or just stay on the right side of the dirt. Rest now.” I patted his broad back. “We’ll meet again Thursday.” Philo burst into tears. “Let it go,” I told him. “Tears are sacred.” My own strained my cofferdam. “So is laughter. So are rituals.” *** Somewhere during the next two days, our treatment imploded. When I entered his room, Philo sprinted over and grabbed my lapels. “I worked it through,” he said robotically, as if his thinking had warped. “My code for political and military leaders.” I sat down with him. “Let me guess. They won’t be allowed to lie. They can only take America to war if the country is truly threatened. They can only assign missions if they have the means to accomplish them. And they must follow the law of war and punish violators. Am I close?” “No. It’s hot in here. Can you fix it?” “I’ll ask the building engineer.” “Good. You smell like the Everglades.” “I haven’t been recently.” “There is only one rule, Jimmy. Win.” “What do you mean?” “You see? The idea of the U.S. winning a war trenches on the fantastical. We haven’t since 1945, and that’s debatable.” “Given the rapid onset of the Cold War?” “Had Eisenhower sent Patton gas, the Stars and Stripes would have flown over Moscow. The craven bureaucratic decision not to fight spawned the Korean and Vietnamese imbroglios, which prefigured our humiliation in Iraq and Afghanistan. Patterns are difficult to amend. I always thought American leaders would tell us the truth and do what’s right. But the longer the war endured, two things crystallized. One. Politicians gave no shits about who died at their behest.” “Second?” “They should have dispatched the Peace Corps instead.” “Yet our country isn’t occupied, our women haven’t been dumped in rape camps, and our way of life hasn’t been overturned.” “Yet. But I feel disturbance in the air.” “Can you describe it?” “I will soon. Meanwhile, what we fought for has been torn asunder. Our sacrifices were wasted. We were stabbed in the back.” He sounded like the Austrian corporal. I reframed things. “You suffered social betrayal.” “Either potentates fight to win our wars or they dissolve our allegiance. Who are you?” “Dr. James Panther. You were stressing the importance of winning in war.” “And when the United States doesn’t win, there must be accountability.” “What form should that take?” “A realignment. A rewriting of the future. Some call it regime change.” “By way of elections?” “The ballot box is indirect. Try the bullet box.” “Civil war?” “I recommend a more proportional response. A judgment that limits collateral damage.” “Assassination?” “Yes. Direct revenge upon the perpetrators.” “The President and Vice President?” “And the SecDef. And the heads of congressional committees. Maybe a Justice. All the Pentagon paper-pushers who risked nothing worse than eyestrain and paper cuts. The euphemisms they spun destroyed confidence in our language. You look queasy, Jimmy.” “I’m flabbergasted. There’s no other suitable remedy?” “Nothing else restores institutional and state legitimacy.” “Laws proscribe what you advocate. You’re reasoning’s illucid.” “Succeed and we’re heroes. Fail? We’re murderers and dupes. I just want to kill the motherfuckers who dropped the ball.” “An eye-for-an-eye?” “Lex talionis. If we don’t lop off crowned heads, nothing makes cosmological sense. We’re here for a reason. Survival.” “What’s the threat?” “They’ll do something wretched. Walls are collapsing. Get me out of here so I can prep.” “I’m concerned by what you’re saying.” “Don’t be. You have complete control over an arrow before its release, but none after.” “Keep going with that.” “I’m excited about the future now. Just not in the way you wanted.” “Because your goal is vengeance rather than an ordinary habitual life?” “Absolutely.” “Philo, there’s no utopia. In life, repetition and order are necessary or a man goes insane.” “But I have a path to tread.” I felt a rush. “Have you changed your mind about the court-martial? You can’t pursue your goal if you’re dead.” “True that.” “Do you still want to be executed for desertion?” “No way. There’s important work for us to do.” “Then you don’t want me to find you sane?” “Sane. Insane. What’s the difference? Bad things are coming. Please release me.” “I can’t.” “Turn the tables. What are your hopes, Jimmy? Write more books? Mate like snakes with a beautiful gal? What a horror.” “A good partner and some courage are enough to overcome most psychological problems. It helps to have a lover who’ll listen to everything you reveal and say, ‘I love you anyway.’” “I heard sex, home cooking, and wine restore a haggard spirit, but what would you or I do with a good woman? Please.” “New topic. Start a journal as an enduring lamentation of your loss. Writing transcends memory. It’s for you and other veterans to connect with your experience and common humanity.” “I’d rather write my obituary.” “Can you at least promise you won’t harm yourself or anyone else?” Philo held his hand over his heart. “I will, but for the next two weeks. After that, all bets are off. I want revenge.”