End of the Road

After nearly 7 months since my original departure for pre-deployment Army training, I was in the final days of my Middle Eastern escapade. I was in a transient housing tent, which was essentially an Iraqi homeless shelter, for the remaining few days. And I couldn’t have been happier to be homeless. If all worked out as planned, I was going to be home in time to be hammered for the 4th of July.

Our whole deployed crew was absolutely giddy. People were singing in the halls of the clinic, high-fived each other in passing, did mid-air chest bumps, laughed uncontrollably, and urinated rainbows all over the place. I asked one of my coworkers what was the first thing he planned on doing when he finally got home. His obvious response was “I am going to make passionate love to my wife.” My follow-up question was “OK, what is the second thing you are going to do?” He paused thoughtfully and said, “I guess I’ll drop my bags.”

It was difficult to live in the moment when the near future appeared so bright and wonderful. Everyone had essentially abandoned their work-outs and dieting. I had even given up monitoring my hydration status. It had become apparent that all of the exercising and healthy eating was done as a strategy to pass the time rather than for any real health benefits or fitness goals. After I achieved my goal weight about one month prior to leaving Iraq, I resumed my napping and chocolate chip cookie consumption while leaving my goal weight several pounds off in the distance.

I looked back at my time there and wondered how I survived in that cornucopia of sand and heat. I still don’t understand how that barren wasteland served as the cradle of civilization. The land between two rivers my ass! Where were the rivers? I hadn’t seen a single natural body of water the entire time I was there.

It was averaging 110 °F and it was still technically spring. I had Iraq’s most powerful air conditioner in my office. I knew it was the most powerful because it required a remote to operate. The remote had numerous buttons as if the air conditioner came equipped with DVR (digital video recording). I just pressed a button and presto: hurricane force Arctic winds swept through my office, freezing everything in its path. I was the envy of all.

As my time there waned, I thought about what I saw and did in the past 7 months. If I helped just one patient, then the deployment was worth it. There were some memories I look fondly on and there were some memories that haunt me today. There are not enough words to describe the dangers that existed there. Even if there were, they wouldn’t do justice.

Some of you called me a hero. Although that word is very humbling, I graciously declined that title. I usually enjoyed working with patients anyways, but my work seemed even more meaningful in the deployed environment. Not to sound overly sappy and patriotic, but the men and women in those combat units were true heroes. Literally every day, something bad happened to them while they were performing their missions. But they kept pressing forward despite the very real hazards. We may not all agree on the politics behind the war or the ultimate endpoint of it all, but those soldiers made daily sacrifices which dwarfed anything I had ever been asked to do.

The time came to say adieu, and I left my Sharpie® for the next psychiatrist.

Deployment is an unfathomable experience that can have a profound effect on service members and their families. Warzone mental health has similarities with mental health practiced stateside but also has unique challenges that require a flexible and adaptive approach to ensure service members can continue to perform their duties, with the ultimate goal of keeping our nation secure from our enemies.

Dr. Kaustubh G. Joshi is a former Air Force forensic psychiatrist. This chapter focuses on his deployment as a psychiatrist on an Army mission during Operation Iraqi Freedom from December 2007 to June 2008.

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