Stress God and Disorder

By Ronald M. Chase, M.D.

Ronald M. Chase, M.D.
During the Vietnam War at the height of the Tet Offensive (1968) he took a residency in psychiatry at the National Naval Medical Center, U.S. Naval Hospital, Bethesda, Maryland; child psychiatry at Walter Reed Army Medical Center and St. Elizabeth’s Hospital, Washington, D.C. for chronic persistent mental illness. He had early exposure to the internationally acclaimed psychoanalyst, Harold F. Searles, M.D. who inspired Dr. Chase's entire career.
He became a Fellow of the Academy of Psychosomatic Medicine and fellowship in psychosomatics followed at the Chicago Medical School mentored by Hyman Garner, M.D. Chair, Department of Psychiatry. Dr. Chase was appointed to head the psychiatric liaison program for hemodialysis and oncology programs for Cook County, Chicago, Illinois in 1973.
At Veterans Administration, VAMC, Lyons, New Jersey he developed the first Vietnam Veterans Inpatient Unit for the treatment of Post-Traumatic Stress Disorders.
For three years he was a staff psychiatrist at the Department of Corrections at Rikers Island stationed at the OBCC, “the Bing” for refracted inmates some of which were HIV cases.
In 1984, Department of Veterans Affairs, VAMC, Lyons he became a whistleblower challenging the Veterans Administration to end the corruption and abuse of power at that facility. In fact, he organized a patient strike at the hospital's main gate which got exposure only in the local media. The national press was disinterested in the issues that plagued that antiquated system.
In 2008 his concern for the inordinate number of suicide deaths among soldiers returning from deployments in Iraq and Afghanistan prompted him to take a position with the U.S. Army as Psychiatrist Contractor, Winn Army Community Hospital, Third Infantry Division, Ft. Stewart, Georgia.
He became Assistant Professor of Psychiatry, New York Medical College (1985) when his interests turned to the plight of patients who succumbed to HIV/AIDS. Later, at an HIV/AIDS Coalition of Gays and Lesbians in Greenwich Village he met Peter Duesberg, Ph.D., molecular and cell biologist, and author of "Inventing the AIDS Virus." From their first discussions Dr. Chase became motivated to investigate the conundrum of retro-viruses and the dogma of government's rule in science. He immersed himself in studying the history of medicine and how viruses came to be known since at least the beginning of time, 1335 B.C.
"Jake's Place" was the improvised site of an interview Chase filmed with Dr. Duesberg, and their esteemed colleague Dr. Peter Capainolo from the American Museum of Natural History, which tried to replicate the format of radio personality Barry Gray holding court at Sardi's in NYC addressing the evolution of the “AIDS virus” in its various iterations when the subjects of virus creation and technology came up.
Would creation of the universe not be attributed to God? The Ontological Postulates from the Greek philosophers and St. Anselm could speak to the issue. For more spice we add the Summa Theologiae of Thomas Aquinas (c. 1225). That could be the lineup card that speaks to the belief system, God.
Any analogy with events of virus epidemics or pandemics and a belief system in God is not accidental.
The news and entertainment industries have cast a pall over our nation by suggesting disease symptoms, unending statistics of death and dying, and trial medications that are invariably toxic in the absence of ability to create an actual vaccine.
The question is, "do viruses really exist?"
Stress, God and Disorder was conceived both as a primer on the treatment of PTSD, and to provoke interest in the controversies and dogma that surround the CDC, NIH, and WHO, institutions that masquerade as success and truth.

• Language: English
• Publisher: Ronald M. Chase, M.D.
• Release date: May 2, 2019
• ISBN: 9780463870846

Ronald M. Chase, M.D.

About the author- RONALD M. CHASE, M.D.Born in Brooklyn, New York and attended James Madison High School. He later attended the University of Louisville, Kentucky, graduating with Bachelor of Arts degree in 1959 having majored in Philosophy and Chemistry. He later attended La Sapienza, Universita’ di Roma, Italia for didactic work in medicine and the Universita’ di Bologna, Italia for his clinical work in medicine. His post graduate studies continued with an internship at University of Florida University Hospitals.During the Vietnam War he took a residency in psychiatry at the National Naval Medical Center, U.S. Naval Hospital, Bethesda, Maryland; child psychiatry at Walter Reed Army Medical Center, Washington, D.C. and St. Elizabeth’s Hospital, Washington, D.C. His early exposure to the internationally acclaimed psychoanalyst, Harold F. Searles, M.D. inspired his entire career. Dr. Chase was promoted to Lieutenant Commander, Medical Corps, United States Navy (1968 to 1973). He became a Fellow of the Academy of Psychosomatic Medicine in 1973 during the tenure of Wilfred Dorfman, M.D.Dr. Chase was later stationed at U.S. Naval Hospital, Orlando, Florida as Chief of psychiatry and psychiatric consultant to the U.S. Air Force, McCoy AFB, Orlando, Florida. In 1973 he began a fellowship at the Chicago Medical School in psychosomatic medicine being mentored by Hyman Garner, M.D. Chair, Department of Psychiatry. Under Dr. Garner’s tutelage he was appointed to head the psychiatric liaison program for the dialysis and oncology programs in Cook County, Chicago, Illinois.Further experience included work at Veterans Administration Hospitals where he developed the first Vietnam Veterans Inpatient Unit for the treatment of Post Traumatic Stress Disorder, PTSD. He was involved with the State of New York, Office of Mental Health in forensic services, Division of Parole, and other correctional facilities in Florida and New York’s Department of Corrections at Rikers Island. He had been a psychiatric consultant for the District Attorneys in the New York City area and Assistant United States Attorney, Eastern District, as expert witness in capital offense cases. In 1994 he was asked to appear on national television, “Inside Edition” as forensic psychiatrist in review of the O. J. Simpson case.In 2008 his concern for the inordinate numbers of suicide deaths among returning soldiers from deployments in Iraq and Afghanistan prompted him to take a position with the U.S. Army as a Psychiatrist Contractor stationed at Winn Army Community Hospital, Behavioral Health Center, Third Infantry Division, Ft. Stewart, Georgia.Dr. Chase continues to be involved with veterans issues and has written numerous articles and letters regarding PTSD. He recently authored his second book, “Aftermath A War Of Memories” and is working on a documentary regarding his clinical work with PTSD.

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STRESS, GOD, AND DISORDER

The Diminishing Universe of Viruses

RONALD M. CHASE, M.D.

Published by Ronald M. Chase, M.D. at

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Copyright 2019 Ronald M. Chase, M.D.

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DEDICATION

The tragic death of my daughter Kristen in the wilds of Utah June 26, 1990 became my spiritual imperative to write and share this work as a personal catharsis, and to encourage others to explore and express the feelings stress and the reality of loss covered over.

Inscribed on her tombstone: Creativity is a gift of God, expression its only value.

.

ACKNOWLEDGMENTS

I owe a debt of gratitude to my dear friend Peter Capainolo, author, Senior Scientific Assistant, American Museum of Natural History, New York, for his contributions, inspiration and support.

A special thanks to Peter Duesberg, Ph.D., Professor of Molecular and Cell Biology, University of California at Berkeley, for his ability to recognize an invention when he sees one.

My editor Jeanne Rejaunier, author, actress and friend, for her editorial assistance, insights, and advice.

Loving thanks to my father for convincing me there was no future in becoming a professional athlete, and to my mother, who only wanted me to be happy.

Thanks to my loving sons, David and Robbie, who stood in the wings and shook their heads. But they knew all along, because they loved me.

Thomas Bellino, Ph.D., for your support since the days of Bethesda.

My wife, Wendy Paradise-Chase, who supported my persistence.

In Memoriam: Harold F. Searles, M.D., my mentor at Bethesda; Frances Nadeau, R.N., and Earl Nadeau, my dearest friends.

.

TABLE OF CONTENTS

DEDICATION

ACKNOWLEDGMENTS

PREFACE

Chapter One

Chapter Two

Chapter Three

Chapter Four

Chapter Five

Chapter Six

Chapter Seven

Chapter Eight

Chapter Nine

Chapter Ten

Chapter Eleven

Chapter Twelve

Chapter Thirteen

Chapter Fourteen

Chapter Fifteen

Chapter Sixteen

Chapter Seventeen

Chapter Eighteen

Chapter Nineteen

Chapter Twenty

Chapter Twenty-One

Chapter Twenty-Two

Chapter Twenty-Three

Chapter Twenty-Four

Chapter Twenty-Five

Chapter Twenty-Six

EPILOGUE

ABOUT THE AUTHOR

PREFACE

Every war forces us to focus on that war’s aftermath and its collateral damage.

The cost in human emotional suffering following any war is incalculable and far greater than the immediacy of physical damage. Loss, grief, mourning, and enduring emotional pain are recognizable consequences which inevitably manifest in emotional conditions that interfere with psychological functioning and later adaptation if not addressed. The condition known as Post Traumatic Stress Disorder (PTSD), identified in recent years, has been with us for generations under different names: battle fatigue, shell shock, and traumatic neurosis.

If we know the consequences of war’s aftermath, why has there not been a psychological exit strategy for soldiers when we return our troops from the battlefield? How can the PTSD treatment needs of those afflicted be met? Our military hospitals were not designed for long term treatment of the emotional wounds of war, which was one of the primary functions of the Veterans Administration since the days of Abraham Lincoln.

The Veterans Administration gets its marching orders from the National Institute of Mental Health (NIMH), National Center for PTSD as to evidence based methods for treating PTSD. Their methods have become the gold standard for treatment, yet so many of our veterans do not respond favorably, nor has their treatment significantly reduced the suicide rates among returning combatants. Neither the VA nor the military, Department of Defense, is able to adopt established therapies that are not sanctioned by the NIMH.

There is no difference which war we talk about; World War II, Korea, Vietnam, Gulf War, Iraq, or Afghanistan, the emotional symptoms are always the same, equally traumatic to the combatant and survivors of overwhelming stress. But an enormous obstacle to the psychiatric treatment of veterans has been the Department of Veterans Affairs itself. The antiquated Veterans Administration’s system was built on a foundation of corruption and a culture immutable to creative ideas. The system lacked accountability and answered to no one, while senior administrators created kangaroo courts to cover-up and affix blame to preserve their executive positions and receive productivity bonuses for failures masquerading as success!

I pioneered the first PTSD treatment program for veterans at the time of the Tet Offensive at Bethesda Naval Hospital, Maryland in 1968. I was recruited to establish the first dedicated PTSD treatment program at VAMC, Lyons, New Jersey some fifteen years later. In 2008 at Winn Army Community Hospital, Ft. Stewart, Georgia, I discovered the administration had no interest in comprehensive treatment programs for returning combat soldiers.

Unfortunately, the government pays lip service to mental health programs that do not deal with the core issues. Neither the Department of Defense nor Department of Veterans Affairs wants any part of treating broken assets! There were no programs to treat PTSD and the tragedies of the families involved. Yet, there was research money earmarked for studying the genetic causes of PTSD as though that was a core reality.

I was a military psychiatrist and I learned by hands-on experience from the best Korean, Vietnam, Iraq and Afghanistan combat soldiers and marines ever. I was proud of my mission and of ultimately becoming Lieutenant Commander, Medical Corps, USN, sworn in by Donald Custis, M.D., Surgeon General of the United States Navy.

It is with the heartfelt hope that change is possible. Thank you for your service need not be an empty phrase. May God have mercy and help those combat veterans that experienced PTSD and subsequent findings of Agent Orange and HIV diseases that added to their wounds.

I believe my experience in learning to understand the history of virus diseases and the immune-compromised patient will be enlightening. Above all, my intent is to impart knowledge and stimulate creative thought to challenge the existing pseudoscience and dogma. We must question and advocate for physical and mental health solutions that are founded in common sense.

Chapter One

One day in the fall of 1982 Corporal Scott Williamson, USMC, telephoned his Vietnam combat brother Master-Sergeant Colin Murray, Sarge, to ask for a ride to downtown Washington, D.C. The only issue in doubt was when. The two had established a bond early in their military combat, when they began to experience atrocities of war going down in Vietnam. These they held in secret, repulsed by the very mention.

Williamson never would have called unless he had a good reason to get his buddy involved. He was on a mission, and his combat brother would oblige, as though it was an order written in blood. Both knew that once out of ‘Nam, if they made it out alive, they would be living on borrowed time.

In the early evening hours not long after Williamson’s phone call, a black Camaro stopped to pick up a passenger. Two men drove to an area adjacent to the Washington D.C. Vietnam Veterans Memorial, called the Wall. It had been raining for about two hours in the District. The streets were still glistening and slippery at the time the car discharged its passenger and sped off to park in an alley near Georgetown.

An unidentified figure of a man could be discerned, standing silently, motionlessly, in the rain. His silhouette was mirrored by the facade of the granite black etched wall inscribed with the names of fallen combat soldiers. The figure was ominously clad in camouflage fatigues; empty bandoliers crossed his chest and waist. A floppy olive-colored rain drenched hat dripped, as though tears were trailing down its chin strap. The figure stood there, lost and in despair. With piercing eyes, he searched the wall. He was without clear focus, as the rain waters pooled and swirled in the etchings of the names.

The figure turned mechanically, slowly, as if the cadence of an Albinoni adagio were in the background. He proceeded to wade through the puddles of rain water that washed at his worn combat boots. Sacrilegiously discarded litter was strewn here and there, as though nobody even cared so many years after the war. The man’s boots trampled an occasional fallen poppy while en route to an area where stood an adjacent statue of three American soldiers in camaraderie. The figure’s piercing eyes scanned the statue and began to choke down tears that kept mingling with the rain trails on his cheeks. His face was otherwise immobile. This was a man who appeared to be searching, lost in his mission, or looking for a reason to continue life.

Rain began to pour harder, cascading from atop the statue to its base, as energy was transmitted from the statue, gathering through the earth and into the man. The man stood frozen in time. He gazed fixedly, as though he knew the three statue subjects personally. He remained silent and still, undaunted by the pooling rain and chilling wind. Lightning and thunder crashed to interrupt the eerie silence of the evening.

The man began to walk away, making his way through to the glistening cobblestone alley of an area in Georgetown. His stalking cadence resounded as to foreshadow his presence. Vacant street-side kiosks were now closed from the daily business traffic. The man continued amid a row of Asian restaurants flashing their bright neon letterings, until a dim-sim restaurant became the figure’s final destination.

A black limousine stopped in front of the restaurant to discharge its passengers. Under the watchful eye of the rain-drenched figure, the limousine driver rushed out and fumbled to open an umbrella, while running around the rear of the vehicle in an effort to shield one of his passengers from the drizzle.

The passenger, Telli Yesrebi, Ph.D., a distinguished appearing man dressed in formal black attire, emerged from the vehicle. Yesrebi was the National Health Czar and key appointee to oversee the National Institutes of Health (NIH) and Centers for Disease Control (CDC). Dr. Yesrebi gruffly cast the protective umbrella aside with his arm, thus parrying the kind gesture offered by his chauffeur. He hurriedly entered the restaurant, where his coat was promptly taken by the waiting maître d’.

Tables and diners were crowded together in festive enjoyment of Asian cuisine. Customers eating with small rice bowls in hand enthusiastically poked their chopsticks into morsels on central dishes, repeatedly returning their sticks for coatings of more rice they hastily shoveled up. The participants appeared to be well-heeled and successful Asian and Middle Eastern business types with their families.

Pulling out a concealed weapon, the stealthy figure lurking across the street systematically adjusted it. His face was intense with directed passion. He wrapped the weapon’s strap around his forearm in further readiness, and ran into the street behind the parked limousine, where he crouched. Suddenly, the glass door of the Asian establishment was violently kicked open by the combat attired intruder, who rushed in.

Quickly identifying his victim, he began to fire round after round from his AK-47, targeting the table where Dr. Yesrebi sat. A massacre ensued. The physical structure of the restaurant was destroyed by frantic repeated weapon firing. People scattered in various positions of death. The figure, amid screams of panic, fled into the street. The body of the acclaimed scientist was left lying on the floor, his head immersed in a background of spilled fluids and debris. And then there was silence.

Outside, the startled chauffeur, bursting from the waiting vehicle, took out his service revolver and fired in the direction of the fleeing assassin. Two chambers resounded, and the night air was punctuated with small plumes of smoke. The assassin escaped into the night, to the shrill echoing sounds of his hard leather boots pounding on the wet pavement.

Sarge, the forward observer, arrived back at the parked vehicle in seconds and cranked the ignition. Corporal Williamson quickly followed behind him and disappeared behind the tinted glass windows. The two blended unnoticed into the nighttime drizzle and District of Columbia traffic.

*********

Shortly after I came aboard at Veterans Administration hospital, I became so wrapped up in getting a program for the treatment of combat traumatic stress off the ground that I barely had time to breathe. My home life was deteriorating. I was smoking some four packs of cigarettes a day and almost never slept the whole night through. There was no way I could take a day off as the action came fast and furious at the hospital. I needed support from the hospital staff which, though promised by the administration, was never forthcoming. I relied on the radio for the day’s news headlines and resented that my girlfriend Danielle, with whom I cohabitated, avoided listening to all news programs.

I had probably experienced firsthand more mental suffering of wounded combat marines, soldiers, and their families since 1968 than most people. Throughout the years I lost a brotherhood of over a hundred combat veterans whom I knew personally and professionally. Yes, I knew them personally and treated them professionally with a caring passion. I did not consider them patients in a traditional sense. They were servicemen and women and we were together on a military mission within a shared therapeutic brotherhood.

The National Naval Medical Center, U. S. Naval Hospital, Bethesda, Maryland appeared quite impressive, with all the flags and people running about in uniforms saluting one another. It was March 17, 1968 and St. Patrick’s Day was not being celebrated. Ambulances were pulling up to the facility, discharging marines and soldiers into an area where gurneys took the injured to their destined area of the hospital. These young men had been wounded in combat, combat in Vietnam. An occasional helicopter landed at an adjacent area to distribute the more critically wounded combat veterans.

I had to learn fast how to treat the emotional wounds of war. It was my job and there was no instruction manual to follow. I was on a mission for three years to perfect my skills in psychiatry. It was a frightening and emotionally stressful experience at first. Actually, it became quite easy to develop relationships with these brave troops by just listening and encouraging them to express whatever they had on their minds.

Early intervention following exposure to traumatic physical and emotional events on the battlefield was most beneficial. Putting into words and feeling expressions after overwhelming traumatic sights, sounds, and smells associated with the actual events experienced was the best way to help, and led to emotional recovery.

I owed a debt of gratitude to U.S. Navy Corpsman Ted Stevens, who assisted me in the PTSD program I created at Bethesda. Ted’s careful group process notes helped me understand how catharsis and abreaction were two key goals of therapy which would ultimately determine victory over the emotional aftermath of war.

One day I must thank U.S. Navy Chaplain CDR Fitzgerald for requesting to visit one of my therapy groups. The Chaplain lasted about 15 minutes listening to the members’ recounting personal combat experiences before literally running out of the room in tears, his handkerchief poised to his mouth preparing to express his revulsion.

I will always wonder what happened to these combat veterans after the Vietnam War. Their names remain with me to this day. I dare not look for their names on the Wall.

Of one of our sessions, Corpsman Stevens wrote: Fromme, Goodwin, Swigert, Morton, Mello, Shiflett, and Johnson were present, and new patients were introduced. I felt the group empathy begin approximately ten to twenty minutes after group began. I think the spirit was established after Dr. Chase asked patients Fromme, Swigert and Shiflett to describe some of your combat experiences with us."

"Fromme played typical combat bravado initially, then gradually started to react to the conversation which involved mutilated bodies, wounds, lack of consideration for the dead, and on. Fromme was biting his fingernails, rocking in his chair as he spoke. Morton was staring at the wall without blinking his eyes for long periods of time. He talked of the dependence he had on the other members of his squad, and how the noises and figures in the dark frightened and confused him, how they become imagined enemies.

Swigert spoke of guilt over a friend’s death, helplessness in a combat situation, anger at his friend’s squad for not having saved his friend. Fromme seems detached from therapist until he is asked to explain his feelings. He becomes defensive. This subsides and he appears to look for support from the therapist. Shiflettt appears fearful of therapist but admits he could examine his feelings better now and is beginning to verbalize with more ease in the group.

Corpsman Stevens concluded, I feel an important thing which is happening in this group is the development of trust between patient and patient, and patient and therapist. As the patients talk of how they can’t trust anyone in Vietnam, how they transferred this mistrust to their lives now, they’re explaining these feelings and many more to the other people in the room. They are beginning to trust again.

My interest in combat veterans never faded after I first met wounded combat forces air-evacuated to U.S. Naval Hospital in Bethesda, following the Tet Offensive in 1968, my first year of military training and residency in psychiatry. I treated the wounded veterans and collateral damage of their families. War created the emotional devastation for 18 year old kids who had gone to defend our nation from the evils of communism in Vietnam. Some of them returned as broken old men within months of combat duty. For others, the transformation was more gradual in the manner in which traumatic stress exacted its emotional toll. Vietnam veterans lacked trust in the government because of the manner in which the Vietnam War was prosecuted and the many government promises of care that were broken.

Through my experiences I realized that in the military there were three tenets: the battlefield saved the living; home treated the wounded; and God watched after the dead. The rationale rested in the fact that in battle those who were not seriously wounded could continue as assets to defend and prosecute the war. Those seriously wounded and unable to continue warfare were sent home. God was presumed to be benevolent. What followed were divisions of those having future value and those no longer an asset to the military. The latter needed to be honorably discharged from active duty and given compensation. But where would these broken emotional beings go to find healing?

The truth of the matter was that no focused treatment programs for PTSD existed in the military’s Department of Defense or at the V.A. (later to become the Department of Veterans Affairs), during the Vietnam War. Every once in a while somebody would take an interest in a veteran and spend time to speak of the unspeakable horrors of war and let the guy cry his guts out to a human being. Now, that was real therapy! However, there was no cost effective way of doing that in the military or V.A. – you just couldn’t speak to everyone on an individual basis.

The National Center for PTSD published information on the subject, offering the best medical evidence, information which included the sanctioned Cognitive Behavior Therapy (CBT) and other recognized therapy forms like Eye Movement Desensitization and Reprocessing (EMDR), Exposure Therapy, and acupuncture. If this agency was accountable for promulgating the types of therapy available, why did they not provide any relevance in the transparency of treatment failures? I concluded they were unable to understand the underlying nature of combat stress.

They should have looked at the established psychodynamics of traumatic neurosis and developed treatment for PTSD in the predicates that already existed. The evidence would not have indicated a disruption of a chemical somewhere in the brain that would necessitate a medicine to be invented or vaccine developed, as suggested in a research protocol for the treatment of PTSD supported by Texas Senator Kay Bailey Hutchison, which would theoretically become the panacea.

I knew the Department of Veterans Affairs would not have an answer for effective treatment for our veterans of any war let alone the skyrocketed suicide rate among returning combat veterans. By firsthand experience I understood because I was also staff psychiatrist with the Veterans Administration in 1973 and again in 1983 when PTSD became the official nomenclature which created the Disorder with all its later repercussions. It was the year the former Veterans Administration became a Cabinet level, Department of Veterans Affairs. It was the time The Wall in honor of Vietnam veterans was completed on the Great Lawn in D.C. Those were powerful years for me, for I remember these events quite vividly, along with the veterans and families whose lives it impacted.

1984 was an insensitive time when corrupt politicians were exposed by whistle-blowers for marching in lock-step with their puppet masters and war protestors, ignoring the needs of veterans in government hospitals. Many senior hospital administrators were involved in cover-up operations and turned a blind eye to the needs of staff members while retaliating against those who documented clinical observations and contributed to the betterment of the veterans they served.

The Staff Director of the Senate Committee on Veterans Affairs, Mr. Anthony Principi, was notified in writing concerning conditions which impacted adversely on patient care at Lyons VAMC. The Under-Secretary for Health, Assistant Attorney General, Members of Congress, Inspector General, and Chairman, Committee on Veterans Affairs failed to directly confront and investigate patient abuses, unethical practices and abuses of power by senior administrators at the veterans' hospital.

The most notorious Veterans Administration Medical Center (VAMC) was Lyons, New Jersey!

******

It was a typical day when former Marine Corporal Scott Williamson awaited admission to the newly formed Vietnam Veterans Unit. Williamson was one of our veterans disabled from the Vietnam War who survived his wounds and made it safely back to the States in 1969. His service in the Marine Corps was not exactly exemplary, for he was busted in rank twice, although serving honorably to defend our nation. He had two Purple Hearts, several ribbons attesting to his courage, and the all too familiar 70% service connected disability rating from the government to show for his efforts.

Since his military discharge, Cpl. Williamson had been in and out of hospitals for the treatment of post-traumatic stress and his drug addiction. He had been in a vicious cycle of getting off intravenous opiates only to experience increased nervousness, irritability, nightmares, and raw anger which again caused his picking up drugs. He claimed to have been hooked on opiates he started using in Vietnam as part of his drug stash in case a corpsman could not get to his wounds fast enough. He was hardly the only brother to have had a stash or continuing alcohol and drug habit.

Scotty, as they called him, had telephoned me that he was being released from drug rehabilitation. He indicated he urgently needed to speak to me and could not wait. He had been sent to a 90 day detoxification program and hoped to return to the Vietnam Veteran’s Unit at the hospital. He was on the waiting list, and I hadn’t had the opportunity of significantly working with him prior to his administrative transfer to detoxification as a condition of being readmitted.

I was shocked when Scotty walked into the office unannounced. He looked frightened. No doubt he could read the surprised expression on my face. I knew he was now in the methadone program and family counseling was helping to reintegrate and resolve marital conflicts. He smiled, seemingly pleased to be back. Immediately he blurted out, I can’t take it no more. I’m jumping out of my skin, Doc.

I asked what had changed since I first saw him several months ago.

They put me on these HIV meds. They said I got AIDS.

I was not expecting him to say that. It was difficult enough for me to treat a combat veteran with traumatic stress let alone one with drug addiction. Veterans with combat stress, Agent Orange exposure, and having a child born with birth defects, were among those impossible combinations to configure for therapy. I wondered how any human being could sustain life with so many destructive insults. Scotty at least had a loving family that stayed with him for all these years. The saving grace may have been that his two adolescent boys were born healthy.

Scotty immediately shut the door behind him. We stood fixed in our places. He kept reiterating he didn’t want to die and that he loved his kids. He said he was doing well in the rehab program, but now being diagnosed with this new disease, AIDS, he was scared to death. He was afraid of going back to the streets for drugs and felt uncomfortable being around his family. He didn’t want to relapse, and kept saying he loved his kids too often. He appeared apprehensive and desperate for answers.

I asked about his children’s welfare. Are the kids ok…are they in any danger? I tried to ask in a non-threatening soft general manner. My concern was the fear that Scotty's protestations of love for his boys could be ominous.

His response to me was unnerving, even if it was expressed with protective intentions. I would kill anyone who tried to harm them!

It was a good thing Williamson had returned to the Vietnam Veterans Unit where he would be with the brotherhood of combat veterans with whom he could relate. The veterans were supportive of each other, to the chagrin of the hospital staff, who disliked the outspoken nature of those veterans on the PTSD Unit.

I inquired, What is distressing you the most at this time, Scotty?

He replied, The thought -- I don’t know if it’s in my head or what.

A thought, I repeated.

It’s like a whole damn dream, with voices, images, violence.

Try to put your thoughts into words, Scotty. What happens …when?

Scotty began, It was evening…a black car picked up a hitch hiker and drove to The Wall.

You mean in D.C.?

Yeah, rain and all… near Georgetown.

Go on.

There was this guy standing in the rain. Water puddled and soaked his jungle boots. Flowers were floating everywhere.

Scotty paused for a moment to collect his thoughts. He appeared transfixed.

I quizzically interrupted in a hushed tone, What are you thinking right then?

There was this restaurant…tables and people crowded together… laughing.

Beads of perspiration appeared on Scotty’s forehead. He was having a difficult time expressing himself. I didn’t want to interrupt and have the story change from what he was actually experiencing right then and there.

"A glass door got smashed in…glass everywhere.