PTSI

My review last month of events during the fall of Saigon forty-three years ago led me to speak of Post-Traumatic Stress Injury (PTSI). Readers have been asking for more basic information about the malady and how and why it affected me. At the risk of repeating data presented here earlier, here’s my answer.

The Mayo Clinic defines PTSI as “a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it.” It affects not only combatants but anyone who has lived through a great horror. The best-known sufferers other than those who have experienced combat are women who have been subjected to rape.

I call it “injury” rather than “disorder” because it is an externally inflicted wound, not an internal disfunction. Several writers call it a wound to the soul. I want to stress that reacting with horror to events like combat or rape is healthy. Not responding reflects, in my view, a lack of healthy humanity.

I knew men in Vietnam who enjoyed combat and looked forward to killing. It was obvious to me that these men lacked the full range of human emotion—they were stunted human beings. The clear majority of us hated combat and endured it because it was our duty to our country, our fellow citizens, and, most of all, to our fellow combatants. In other words, we fought first and foremost for the guy standing next to us. When we witnessed the brutal killing of our combat buddy, we were permanently damaged.

My sense is that Americans who have never gone through combat think that the killing is clean and quick, e.g., a bullet through the brain resulting in instant and painless death. Nothing could be further from reality. The killing is grisly—everything from being burned alive to being ripped apart. The deaths and woundings I witnessed were so hideous that I still can’t speak of them today. And the victims were men I loved.

More tomorrow.

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