It’s taken two years of being “normal” to return to the VA Medical Center. “Normal” is what the psychotherapist told me. One year out of the military, inactive, and treatment felt like a healthy choice. Two years later, it feels like a necessity.
The automatic doors to the VA lobby slide open and the shower of cold air chills my skin. But it’s the hallways that keep my attention, like vanishing points where white lab coats and wheelchairs appear and vanish in an off-white hue. And the smell, stale and lifeless as potted silk. The intercom, clear as a bell, calls for a doctor’s attention.
This time the patients look even younger, more veterans in their thirties and twenties, fresh from discharge, some still in high-and-tight haircuts, reviewing their paperwork, ready to take advantage of two years of free VA healthcare. With constant deployments and such long occupations in Afghanistan and Iraq, I see the number of young veterans seeking affordable medical care reaching numbers too difficult to handle well.
The clinic handles patients by appointments, and sometimes they also take emergencies, but I never see where they take them. I see the EMTs careering through Baldwin Park on the way to the clinic, but I never see where they send their patients, and I’ve never seen the stretchers roll by. It’s as if they warm their sirens and do laps around the clinic for fun.
I follow the signs leading to each clinic: Cardiology, Surgery, Prosthetics, Mental Health. Second floor, the elevators in alcoves, hidden away from the flow of flat hallways and offices, large enough to move bed-bound patients from floor to floor.
The doors slide open and I find my way to the Mental Health waiting area: two dozen stuffed chairs crammed into the middle of two hallways, with a lemonade stand for a reception desk. Packed seats with veterans filling out packets of paper on metallic clipboards. The rest rock in their seats and sit on their hands until someone tells them what to do.
At the desk, a nurse with wide-framed glasses scribbles on her own clipboard, busy enough not to notice me standing in front of her. Middle-aged, silver hairs swirling in her receding brown dye. Her nametag says Maureen. She looks like a Maureen.
“Hi there, is this where—”
“Stand behind the line, please.” Maureen doesn’t lift her head from the clipboard when she says this, just points to the floor: a black line of electrical tape surrounds the kiosk. I take a step back and point my feet behind the line, with no one in front of me. Now she lifts her head.
“You’d like an assessment?” she asks. I don’t know what that means for sure.
“Yes, I think so.”
“It’s a PTSD assessment, right? Do you have insurance? Your VA identification card?”
“Just your driver’s license, please.”
I hand her my license and she scribbles my information down on her pad, then rifles through her folders and hands me another clipboard with a stack of sheets on it.
She says, “You’ll need to read and fill these out before seeing the therapist. Give it back to me once you’re done.”
I nod and find a seat next to another man in a black t-shirt and jeans, his arms folded and the rest of his body propped like a plank across the seat. I flip through the pages: basic wavers, permissions, acknowledgements, and three pages of checklists and charts. Many questions I’ve answered before, but I don’t remember this many forms. Last time it was a simple consultation with a psychiatrist in his office, a mental check-up and well-wishing. Now I have to talk to a clipboard first. Drug-related questions, reoccurring-memories questions:
How many drinks do you have a month?
Drinking isn’t an issue and I know plenty who drink more than me and function on both feet. No, I’ve had drinking binges, but those are miles apart. I’ve broken enough club fights, detained enough violent drunks, and fished enough Marines out of gutters who had been paralyzed by drinking on their own. I don’t need to join them, but a dozen or so drinks is more than enough to sustain me for the month. So, fifteen.
Do you have thoughts about harming yourself and/or others?
There’d been fits, momentary irrational rages on myself, on objects in the room, holes through walls, through doors, and the scars on my hands to prove them. Thoughts of slamming complete strangers into traffic, beating them senseless. An hour won’t go by without them. Yes.
Do you have reoccurring dreams of a service-related experience?
They mean nightmares, flashbacks, and no, the dreams don’t come on their own, not shocked to life, not in the way the paper wants it. Fantasies and memories, yes, but not a jump into them, the sharp stab of instinct, being in the moment, a pedestrian world burnt away to reveal a flaming desert underneath. Fear and anger can control posture, but not what I see, not what I hear. Just what I feel, the compression of fluids through the body, waves of pressure collapsing my chest into bone chips, punctured by white sparks burning through my limbs. Where torches blast at a concert’s first song, where crowds bury the exits, where families celebrate their freedom by bombing the sky, that’s where it lives, and I am grateful it’s left my dreams years ago. The answer is no.
Do you sometimes fantasize about suicide?
No, not exactly, but when traffic stops and cars limp in feet and yards, why not get out of the car? Why not? Find him, the lynchpin holding back the rest of the rush hour crowd, and mash his mouth into the curb, and when the cops come, you know, you’ve been trained to know, that if their guns aren’t ready when you cross that line and become a threat, they won’t be by the time you reach them. Pure attack, flood them until your limbs fall to pieces, and die with their skin between your teeth. No, there has to be another name, not suicide. Self-detonation. But still, a no.
I answer the rest of the questions they want to ask, lengthier than they are difficult. Maureen sits where I left her, wading through her sea of papers. I stand on the line until she waves me closer, and I hand her the list.
“Please have a seat and we’ll call you once the therapist is ready to see you.”
Half an hour rolls by before another lady in white, glasses, and fading brown hair visits me at my seat.
“Hi…Alejandro?” She pronounces it with an English J, like January. “Hi, my name is Dr. Patterson.” She offers her hand, we shake. “Could you come with me, please?”
I follow Dr. Patterson to an office a few yards away: marble-style linoleum, a collection of diplomas in a huddle around one of the mint-green walls. There are two puffy chairs on my side of her desk. Group counseling must be one of her responsibilities, too.
“Please, have a seat.” She looks over the papers in her hand with a serious frown. After a moment, “So, you’ve been out for three years?”
I nod. “That’s right.”
“And when were you deployed? Iraq? Afghanistan?”
“Yeah, Iraq in 2003, February to September.”
She sucks in her teeth and flips back and forth between the pages. I wonder how the usual evaluations work and if the human plank in the waiting room will be judged in the same way. Or maybe he’s already been judged and is standing by for the next leg of treatment. Does every veteran have to go through this type of questioning, or do some look so at-risk on paper that they skip this entire process and go straight to counseling?
“Good, so one tour to Iraq?”
“Yes, that’s right.” Thank goodness. Along with base patrol back in the states, one tour was enough.
“Do you get along with your family?”
“Yeah, pretty well,” I say. “We spend Sundays together. My parents are separated, but they live nearby and my brother and I visit them every weekend or so. My brother and I live together.”
“That’s very good. So,” she continues, “How do you feel about your drinking? It says fifteen for the month. Does that seem like a lot to you?”
This feels like a trick question. It’s not a lot to me, but to her that might be pushing it. There’s a margin of relativity to it, right? Does she know that it’s not a lot for me? Nevermind, just answer honestly.
“No, it doesn’t seem like a lot,” I tell her. “Sometimes I might even have more.”
What the hell did I just say? Did I just brag to a doctor about how much I can drink, and then tell her I can drink more?
“I see.” She’s scribbling. What is she scribbling? Defining mental illnesses? Future prescriptions for Paxil?
After a few more basic questions, she puts her papers down, takes her glasses off, squeezes the bridge of her nose, and puts them back on.
“From what we have on here, and what we’ve been discussing, it doesn’t look like you have PTSD, not really.”
This doesn’t make sense, not the complete prognosis I was ready for. Not really, like a pseudo-syndrome, almost treatable. Sorry, but your symptoms fall outside of our psychotherapeutic jurisdiction.
“You might have related symptoms, but not the major concerns to consider for extensive treatment. You’re not suffering from flashbacks or hallucinations, for example. Again, it might be adjustment disorder. We do offer scheduled one-on-one therapy sessions and group sessions. I wouldn’t recommend those, but you could visit the group sessions, if you feel they’d be helpful. Do you really feel like that’s something you’d like to do?”
It’s not so much what she said but how she said it, her tone, like I was inconveniencing her, like a professor eager to go home early, but there’s one student in the front row who still has questions. And her eyes, the way she tilts her head to ask this, as if I shit in her chair. Should I join them, or should I wait and improve on my own? From her tone, I know I am not a solid fit.
I remember one Vietnam veteran confessing to me that he needed to pull the bottle from his hand and the gun from his mouth. Men like him need this and I feel too young, too connected to fall out of sight. There are veterans with deeper, darker wells than mine.
“No, that’s alright,” I tell her. “I’ll be okay.”
Back down the hallways and through the lobby, I feel relief that I’m better off than some, but there’s even less that I know now than when I came. I’m leaving with so many questions and now I don’t know who to ask.