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I Work With Dying Veterans. Here’s Why I Don’t Automatically Thank Them For Their Service.

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James shifts nervously from one foot to the other, sweat glistening on his forehead and his muscles tense. A smiling intern approaches with a flag pin intent on thanking him for his military service whether he likes it or not. That’s when he bolts for the door. I take off after him; there’s no way I’m letting him tear onto the highway with his nervous system flashing red. Visions of a high-speed collision flash in my mind as I jog through the parking lot trying to catch him.

Earlier that morning, I noticed James standing apart from the milling crowd gathered for a workshop on terminally ill veterans who have “combat-related psychological challenges” like post-traumatic stress disorder, moral injury and complicated bereavement. With his straight back and hair cut in the style of a Marine, James was a stark contrast to the business card-exchanging group of social workers and psychologists with whom I’d been chatting.

I had gone over and struck up a conversation. He’d told me he worked for a “street program” focused on helping veterans struggling with drugs, homelessness and issues like depression, suicidal thoughts and PTSD.

He’d recently applied to graduate schools with a vision of becoming a psychologist. “I want to be there for my Iraq War brothers and sisters,” he’d said. “We were all betrayed, every one of us. Moral injury and PTSD, that’s just the tip of the iceberg.”

“Betrayed by who?” I’d asked.

“Politicians, military brass, the majority of people in this country who don’t give a shit what really happened to me and my buddies and who don’t want to hear about it.” He’d stared into my eyes as though expecting me to be uncomfortable with his candor.

“I’ve heard that from lots of vets,” I’d said, nodding. “Not just the ones who fought in Iraq; going way back.”

“That’s the dirty little secret about war,” he’d said, extending his hand. “It’s always an act of betrayal.”

Later, we’d grabbed seats together at a table with three others. The trainer started with moral injury ― what it is, what it looks like, why it matters. He played poignant excerpts from recorded interviews of veterans talking about the psychologically and spiritually painful impact of witnessing or committing actions that violated their sense of morality or that had shattered their trust in those they’d relied on to act in their best interest.

The trouble had started after lunch when the trainer asked attendees who were veterans to raise their hands. A half-dozen or so complied, but James hesitated. I’d given him a nod and whispered, “You don’t have to do this if you don’t want to.”

He gave a forced smile and raised his hand. Then the trainer asked the veterans to stand and announced that an intern would be making rounds with a box of flag pins.

James had quickly sized up the well-intentioned ritual coming his way. The trainer would speak directly to each veteran, asking them what branch they’d been in and where they had been stationed. Then he would thank each of them for their “service” while the intern pinned a flag to their shirt and the audience clapped.

Sweating profusely, James had scanned the room looking for the nearest exit and anything or anyone that might get in his way. That’s when he’d bolted.

“James,” I call out as he unlocks a beat-up Ford Mustang. He doesn’t respond as he flings the door open and fumbles with the seatbelt, his hands shaking. I step between the open door and the car’s frame. I know it’s tricky, maybe even dangerous, getting in his space when he’s feeling threatened, but I’m determined to help him settle before he revs the engine.

“Five minutes,” I say holding up five fingers. “Just give me five, James. After that you can forget you ever met me.”

His respirations are rapid. I take a deep breath, trying to cue him to do the same. He taps the steering wheel rapidly with one of his fists as though thinking, then motions to the passenger seat. “Clock’s ticking,” he says.

I sit in the passenger seat, leaving the door open. We stare ahead avoiding eye contact. I wait for him to speak.

“Service,” he finally says. “They have no idea.”

He lowers his head.

“They call what happened over there service? Do they think we were serving fucking French fries? What I saw, what I did. What my buddies did. What we had done to us. It wasn’t any kind of service. It was pure hell and I’m still living it. Now they want to pat me on the head and jab me with a cheap flag pin?”

“You’re right,” I respond. “They have no idea.”

“They don’t want to know,” he shoots back. “They want us all to shut the hell up and go along so they don’t have to take any responsibility themselves. Didn’t I tell you we were all betrayed? It never stops.”

“’What I saw, what I did. What my buddies did. What we had done to us. It wasn’t any kind of service. It was pure hell and I’m still living it. Now they want to pat me on the head and jab me with a cheap flag pin?’”

He gives me a sad look. “I watched friends get their guts blown out. You ever seen bodies of women and kids splattered across the ground knowing you and your buddies are the ones who did it?”

I shake my head silently.

He grips his steering wheel so tightly the sinews in his forearms look like tightened cables.

“Service,” he says with acid sarcasm.

His face softens and tears well in his eyes. “How can they start in with the flag pins without even asking me what my experience was? It’s like they’re trying to push a lie down my throat.”

“What lie?” I ask.

He looks up as though searching for words. “That whatever we do is some kind of service to humanity. That we never commit atrocities and cover them up; that we’re always helping the weak and protecting democracy. I found out fast we were killing and getting killed for money and power.”

“What’s it like having people thanking you for your service everywhere you go, James?”

He shakes his head as though I wouldn’t understand. I remain silent, giving him time to either respond or switch the subject.

“You know what it’s like?” he finally says. “You might think this is an exaggeration but you asked. It’s an act of violence.”

“Help me understand that one,” I say.

“Imagine you’re hurting like hell and all you want to do is tell your friends and family what happened, hoping they’ll understand, hoping maybe they’ll tell you they’re sorry about what you had to go through and reassure you that you’re not some kind of monster. But all they do is pretend what you did was great and parrot a bunch of lame horse shit about being a hero. It’s like you’re being choked to death from the inside and you look to others for help and they just smile and look away.”

“Psychological and emotional violence,” I say.

I look at the clock and mention that it’s been five minutes.

“You kept your part of the deal, James. I’ve got time if you want to talk more but I want to keep my end. It’s your call.”

His hands are steady now and his breathing is normal. “Thanks for coming after me. I’m good now.”

He reaches out his hand. He squeezes mine tight and says, “Thanks for not thanking me for my service when we met.”

As he drives off I think about the hundreds of terminally ill combat veterans I’ve worked with as their hospice social worker. Most were, as combat veteran Tim O’Brien puts it, “carrying stuff.” Stuff many ― maybe most ― civilians wouldn’t understand. That’s probably why so many of these veterans had locked it up inside and hidden it from view.

Long days in a hospital bed, though, have ways of dredging stuff up. It’s normal for patients approaching death to look back on their lives and take stock. When you’re looking back on a life that includes the cataclysmic violence and horrific loss and grief of war, this life review process can be psychologically and spiritually complex ― even painful.

Many of the combat veterans I’ve known had spent decades trying not to think or talk (at least not with civilians) about what they’d seen and done. Many suppressed undigested grief for friends who’d been killed or struggled silently with survival guilt, anger or feeling unsafe in the world. Some struggled with explosive tempers, anxiety or depression related to the scars of war; others with emotional numbness, alcohol and/or drug addictions, or feeling disconnected from others.

Some had polished up a handful of well-rehearsed war stories sanitized of blood, gore or moral ambiguity, which they’d offered family and friends so as not to upset them. Others simply kept quiet. But as death approaches, it can claw up stories and memories that have been suppressed.

These memories can be fragmented and poignant with details of war’s horror ― the smell of burning bodies, the eyes of a dead buddy gazing up at the sky, the numb immersion day after day after day in violence, killing and death. Sometimes they are laced with moral pain and shame ― the killing of civilians, lifeless bodies of “the enemy” being desecrated in the rage of a battle’s aftermath.

“When you’re looking back on a life that includes the cataclysmic violence and horrific loss and grief of war, this life review process can be psychologically and spiritually complex ― even painful.”

As I walk back to the training, I think about a B-17 pilot who participated in bombing raids during World War II intended to incinerate German cities. The point had been to kill every man, woman and child ― every dog and flea unlucky enough to be on the ground. He’d done his duty and returned from war assured that he’d helped save the world from fascism.

But humans, despite misguided notions about war being part of the “human condition,” are not wired to kill each other however just the cause may seem. As an old man, he was haunted by the belief that he was a mass murderer. He was convinced he was going to go to hell after he died and there he’d feel the kind of fiery torture he believed he’d inflicted on others.

Like James, he had winced at reflexive expressions of thanks for his “service.” The message he heard was: We believe that you were performing a service, standing up for freedom, protecting the weak, saving democracy. You’re a hero. That’s our story and we don’t want to hear your story if it makes us uncomfortable or challenges us in any way.

He didn’t want someone else’s story shoved down his throat; he wanted someone with whom it was safe to tell his own without being judged or rejected. He wanted to unpack some of what he’d been carrying and find compassion for the 20-year-old young man he’d been when thrust into the bloody savagery of war. He wanted to begin to heal before he died.

As someone who works with dying veterans, I’ve learned to never automatically thank them for their service. I realize many are justifiably proud of their time in the military, of friendships forged, courage shown and service given. I know that most appreciate expressions of thanks and that these expressions are often genuine and heartfelt on the part of those offering them. But I would rather disappoint those who expect me to join the chorus of thanks than close the door on a single veteran like James who needs someone who won’t flinch or look away if they choose to share what they have been carrying.

Refusing to lead with the culturally sanctioned chant “Thank you for your service” sends the message to veterans like James that I’m not pushing a story that denies their experience. It’s safe to talk. I can be trusted to listen without judging.

Those veterans who have noticed and asked about my lack of obedience to the social custom of using the euphemism “service” have generally understood and appreciated my reasons once we discussed them. Several shared things with me during those conversations they would not otherwise have shared. Things they, too, had been carrying.

But there’s another reason I never give automatic thanks or use the word service.

It’s an easy out for the rest of us. It lets civilians like me off the hook when it comes to taking any responsibility for what we have allowed political and military leaders to do in our name. It allows us to wash our hands of any culpability for how they, and we, have used our troops.

That’s part of what I think James meant when he said all wars are acts of betrayal. Calling the sum of actions taken in war “service” is a convenient way for the rest of us to deny what our warriors have been asked to do. It makes it easy for us to turn away from or to deny the burning anguish, grief and regret many carry. Insidiously, it also allows us to avoid asking awkward questions: Were we really justified in using violence to kill so many other human beings? Why are we so desperate to idealize those who have done the bloody, heartbreaking work of war? Who profits ― politically or financially ― from all this division and violence? What are we so damned afraid of?

“There’s another reason I never give automatic thanks or use the word service. It’s an easy out for the rest of us. It lets civilians like me off the hook when it comes to taking any responsibility for what we have allowed political and military leaders to do in our name. It allows us to wash our hands of any culpability for how they, and we, have used our troops.”

The “service” euphemism has become so prevalent that it is now part of a cultural trance state that shuts down honest conversations about these and other questions. Automatically thanking a veteran for his or her service can inadvertently telegraph to those whose experiences fly in the face of our well-rehearsed storyline that we don’t want to hear what really happened ― that we don’t care about what they might be carrying. This not only reinforces our collective conceit that our own hands are clean, it ensures that we will not have to carry anything ourselves.

Euphemism piles upon euphemism. Hiding the slaughter of war behind the innocuous word “service” allows us to call the children James saw killed “collateral damage.” Calling bombs “smart bombs” and calling it “precision bombing” when we unleash them on others allows us to conceal those children from our awareness as well as the pangs of grief in those left behind. It even allows some of us to vilify those Americans who dare dissent or protest the dropping of bombs as “unpatriotic” or “un-American.”

When American troops are killed, we are protected, as though we are children, from any images of their charred and mangled corpses. Once more we are slathered in reassuring euphemisms. Our “fallen heroes” and their “brave sacrifice” are lauded by a ratings-obsessed media and politicians vowing revenge on an enemy also in thrall to the delusion that they are providing a service by killing young American men and women.

If we really want to “honor the ultimate sacrifice” our soldiers have made, if we really want to ensure that they have “not died in vain,” we need to stop lying about war by hiding behind socially enforced rituals, platitudes and euphemisms. If we really want to help those who have survived and carry the wounds of war, we need to stop hiding from and denying war’s cruel brutality. We must make sure it is safe for veterans who have been in the military during a time of war ― regardless of whether they were directly exposed to combat ― to speak for themselves and to speak the truth. And we need to listen to all of them, not just the ones whose stories make us feel good about ourselves.

Note: Names and some details have been slightly altered to protect the privacy of the individuals discussed in this essay.

Scott Janssen is a hospice social worker and writer. He has written extensively about providing trauma-informed care for patients who are terminally ill and has spoken nationally about ways to better support veterans who are nearing the end of their lives. His work has appeared in dozens of publications including Social Work Today, Psychotherapy Networker, American Journal of Nursing, Reader’s Digest and The Washington Post. His novel “Light Keepers” is a visionary adventure about the transformational power of kindness and love when the world appears lost in anger, conflict and fear.

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