A Veteran's True Battle: Staying Sane After Returning Home
Playboy Magazine US|April 2016

Can a single injection save thousands of soldiers suffering from severe PTSD? An Afghanistan combat vet goes under the needle to find out if there really is a cure for war.

Matt Farwell

I would be pissed I didn’t get this shot earlier if I weren’t so grateful I got it at all. I haven’t been quite right since the war, posttraumatic stress and all. Nothing I did in seven years of trying to get back to normal—therapy, meds, madcap schemes—really helped. It turns out a big part of the cure was under my nose the whole time. Well, six or seven inches under my nose and a couple of inches back and to the right, in a cluster of nerves by the spinal column called the stellate ganglion. Two injections of a couple of local anesthetics— lidocaine, the same thing dentists use, and bupivacaine—into that part of the neck and I was pretty much back to my old self.

Dr. Eugene Lipov, the man who administered my shot and who has pioneered the use of the so-called stellate ganglion block for PTSD, tells me the Navy SEALs call it the God shot. Well, SEALs have their sea stories. Here is mine.

I came back from Afghanistan in the spring of 2007, developed insomnia that was eventually diagnosed as PTSD in 2008 and every few months for the next five years had either a major legal or psychological issue—the kind that led to hospitalization or jail time. As hard as I had to fight in Afghanistan, I had to fight doubly hard to get here, a place where I’m celebrating two years without getting locked in a loony bin or a cell.

During my 16 months as a U.S. Army combat infantryman in Afghanistan, the enemy lived outside the wire and had no face. He hid in plain sight and used IEDs or indirect fire. Back in the States, the enemy also hid in plain sight. The thing is, he wore my face and occupied my brain. This isn’t a war story. This is a postwar story.

Let’s break it down by the numbers. America has been at war for more than 14 years since September 11, 2001. This is the longest war in American history and the least debated. Most of the U.S. isn’t really at war. It is spaced-out in front of glowing rectangles. At any given time, only about one half of one percent of Americans are in the military. That’s about the same number who identify as New Age or Hindu. This number includes all members of the military—from stateside desk jockeys to foul-smelling infantry privates—and most are serving in soft jobs, whether or not they’re deployed. The infantry makes up only 15 percent of the Army; by comparison, elderly people make up 14 percent of the general population.

Of post-9/11 veterans, 20 percent suffer from PTSD. Only 50 percent say the war in Afghanistan was worth it. And in 2012, 45 percent of the 1.6 million veterans of Afghanistan and Iraq applied for disability benefits from the Department of Veterans Affairs.

“The mental health of our troops is very much a national security issue,” says Dr. Elspeth Ritchie, a former military psychiatrist who held the top mental-health job in the Army. “If we don’t take care of our veterans, people aren’t going to want to sign up and join the military.”

Of the approximately 2.7 million Americans who have been deployed to Iraq or Afghanistan, 17,000 earned Combat Medical Badges, 78,000 earned Combat Infantry Badges and 121,000 earned Combat Action Badges— signifying that these soldiers have faced a degree of  mortal danger. As with any award, these numbers may be somewhat inflated, but they still serve as a good metric: About eight percent of those deployed overseas are actually “in the shit,” as they say in the movies. So what happens when they come home? I can only go by my own experiences and what I know from the guys in my old unit, but man, are we fucked-up.

My friend Charlie killed himself a year ago, four days before Christmas. There was no life insurance, nothing to take care of his wife and children after his death. Then there was Kris, a super-squared-away platoon sergeant I knew in Afghanistan. He shot himself in the heart last year so he could still have an open-casket funeral; he left a note for his mother to make sure he was wearing his dress uniform in the casket. Mike overdosed on pills, booze and heroin when I was still in the Army. Those are the first three men who come to mind, but there are many more. Roughly 30 out of 100,000 recent veterans commit suicide, nearly double the civilian rate. It’s one of the top problems facing vets, among other serious issues, including chronic homelessness.

I tried to kill myself in 2009. I was drunk as hell and driving my brother’s immaculately maintained 1988 Jeep Comanche, which he’d left in my safekeeping while he was stationed in Germany. I tried to flip the truck into a river, make it look like an accident. It didn’t work, and I wound up in jail for three days (I’d been difficult for the police to subdue) and then the psych ward on the fifth floor of the Naval Medical Center Portsmouth for 12 days. One day in group, they asked why I’d tried to kill myself.

I asked if I could use the whiteboard. I drew a simple utility graph: This line represented living; this line represented dying. The benefits of dying outweighed those of living. I felt only anger, rage and shame and that I wasn’t doing anything but hurting other people. They put me on suicide watch for the rest of the day.

I would have spent more time in the locked ward but for the intervention of Baddr, a friend from college who was in med school and by sheer coincidence serving his psych rotation on my floor. The first thing he said to me was “Matt,

when I said we should get lunch, I didn’t mean here and I didn’t mean every day.” After 12 days of wearing scrubs and working on puzzles, I was finally discharged. It was Baddr who turned the tide. He told the doctors, who were reluctant to release me, that if I said I wouldn’t try to kill myself again, I was telling the truth. I haven’t attempted suicide since.

For a long time, though, I wished my attempt had been successful. Here I was, a trained killer, and I couldn’t even manage to kill myself.

I bounced around for a couple of years, living a less than stable life. The last time I was psychiatrically hospitalized was at a civilian psych hospital in Idaho, from December 25, 2013 until just after New Year’s. On Christmas Eve I had jumped out of my dad’s truck while he was driving it 45 miles per hour just north of Jackpot, Nevada. ER doctors treated me for light abrasions and wanted to send me to the VA hospital in Boise, but my dad insisted I be taken to Canyon View, the local psychiatric ward in Twin Falls, Idaho. I’d spent the previous month unraveling spectacularly in Berkeley, California, where my ex-girlfriend was a student. When she’d had enough, she called my dad, and he wanted answers.

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