He Lie On the Ground Covered with a Tarp

“Have you seen ‘Saving Private Ryan’? What do you think about soldiers searching for a soldier to bring him home?” asked my patient. Of course, I’ve seen Saving Private Ryan. I told him that I couldn’t imagine what that war would have been like – the sights, the sounds and seeing the loss of lives. I also responded that any loving mother would want her children to be safe. “Even if lives of searchers are lost?” asked my patient. I responded that I hadn’t really thought of it that way. I didn’t really have a thought out response because I realized what he was really asking was whether it was worth it to risk the lives of others for the life of one.

We’ll call my patient George…. I’ve treated George off and on over the last 7 years. He’s a Vietnam War veteran who experiences back pain every day. I’ve never really been very helpful with assisting him with relieving his symptoms. He’s on high doses of narcotics and has been since his return from the war. He has always been quiet… every visit I try my best to somehow connect with him. I’ve failed miserably episode after episode.

This episode seems different. I’ll give my daughter the credit. This summer our daughter has been employed as my office manager. George definitely warmed up to her. The ice was broken and the connect changed one day a couple off weeks ago. He asked my daughter if she had a knife. My daughter looked at him and without missing a beat responded, “I have scissors which are 2 knives put together,” as she proceeded to hand them to him. That was the first time I ever saw him smile.

George’s long-term goals are to be no longer dependent on narcotics for pain control. This episode of care is for hip pain. His body language indicates hopelessness, lack of confidence and depression. He never looks me in my eyes. He’s got a lot on his mind about the future. He was recently diagnosed with Parkinson’s (related to his exposure to Agent Orange while in the Army during the Vietnam War). He owns a business in town and knows he needs to either close the doors or sell. He’s just not ready to do that yet.

After all these years George has begun opening up to me. Toward the end of his tour in Vietnam, he had a new “boss” giving orders. The boss demanded that the troops under his supervision needed to change their tactics and do everything by the book. I have no military background, so I don’t understand ranks or titles. George was supposed to lead his men through an area to clear some village. When the village was cleared, air support would be contacted. “Doing it by the book” meant that he would no longer be in the lead position as what had been common practice. He would be mid-pack next to someone with a communication device. The “lead” would be a young soldier. I could hear the anguish in George’s voice. He did not believe his boss was correct; he knew that for safety of all the men, he needed to lead the group through the grass. Seconds before disaster happened, George saw a flash of a line, but before he could do anything, the young leader triggered a trip wire which set up a chain of explosives. Everyone died except for George.

Under_a_tarp

George was told that the fighting was intense. The helicopters above were ordered to leave… and all but one did. The team in one helicopter refused – that team was not leaving anyone behind. The team landed in monsoon like rain. The scene on the ground was horrible: body parts and boots. George was lying on the ground, face up. He remembers rain hitting his face. He couldn’t move or talk… and then, he remembers the dark: someone covered him with a tarp. That was the last he remembered. For some reason, he was not brought to safety at that time. A couple of days later, while under fire, a team was sent to rescue any soldiers still alive. He was told that it was by chance that someone uncovered him and actually assessed him. He was the only surviving soldier… and during the mission that rescued him, 5 soldiers died.

I believe George gave me the greatest gift: insight into him. I understand most of the pain science recommendations. George has seen many specialists. I don’t have the heart to “educate” him about pain… I think, now that I have a glimpse into who he is as a person, that there may be something far more important to tell him.

My impression: George has been living with guilt for a very long time. Every life he was responsible for that day died under his command. He knew his “boss” to be very wrong, yet he did as he was commanded to do. And then… after losing every soldier that day, 5 more lives were lost saving his life. I feel that in a way he’s been punishing himself. I plan on opening my heart next week… my messages: #1) God loves him. #2) forgive himself. I am hoping that George may find peace and as he does that his pain begins to subside.

Until next time,

~selena

9 responses to “He Lie On the Ground Covered with a Tarp

  1. Terry Brown says:

    Beautiful insight and true compassion. The ability to heal comes always from within.

  2. Taylor Kurtz says:

    Great read Selena, feel confident in spreading that message.

  3. Mark Luttrell says:

    This is an incredible story, and I can certainly appreciate you sharing. I do, however, have to disagree with your final 2 messages . First, you have certain religious implications that, while may be helpful to you in your life, should not ever be implied or proselytized upon others, ESPECIALLY in a professional environment and relationship with our patients. This is not to say I don’t respect your views or beliefs – indeed I or your patients may very well agree with many of them. This may also certainly be the case with George, and you may be comfortable with discussing God or other religious aspects as a result. I would contend, however, that regardless of that, we cannot and should not be inserting such beliefs in our plan of care.

    Finally, telling him to forgive himself may certainly help. It may also be quite offensive. As Physical Therapists, even those whom are well versed in Pain Science and the biopsychosocial model of pain, are we truly well trained enough in the behavioral sciences to make such decisions comfortably? Again, your relationship with George may entail you enough comfort to do so, but implying to the reader of this avenue, I feel, should be done with considerable caution.

    1. Selena Horner says:

      Hi Mark,

      Thank you for your comment. God is always in my plan and God is always helping me.

      Now, with regard to George: God is also important to him. George is very sure that he is alive because of Divine intervention.

  4. Robert Vaughn, PT says:

    Selena,

    Thanks for the post, this is an amazing story. I do have a concern, with the caveat that you obviously know this patient, and I don’t, and you know what is appropriate in your clinic setting. But is a PT telling a patient that God loves them appropriate, unless you have a personal or spiritual connection with this patient? I would personally be very unhappy if any health care provider of mine said that to me. I’m not comfortable with bringing religion into the clinic.

    Robert

    1. Selena Horner says:

      Hi Robert,

      Thanks for your perspective.

      As I grow wiser, I realize that people have a certain amount spirituality that is part of who they are. I decided years ago that this component is not something that I will choose to ignore.

      I make it a point to definitely have a personal connection with every patient.

      Hopefully, as I continue my career, I don’t make a patient feel very unhappy with what I say or my genuine thoughts that are directed at being helpful for them.

      Thank you for giving me something to reflect upon.

  5. Donna Tegethoff,PT says:

    Selena, Amazing story. I think mentioning God is very appropriate and not”religious” at all as some of the above commentators have said. Is it so offensive to say God? How cold and sterile some professionals have become. This is NOT proselytizing .

  6. Joe Miller says:

    Thank you for sharing. I am a Physical Therapist and spent 23 years as a Marine and Soldier. I have seen men and boys die and do wonderful things. George may have guilt, but every soldier knows that we so what we do for our fellow soldiers just as much as our country. The men that came for him did it for him and he would do the same. You can let him know that I would do that for him if I was in that situation.

    1. Selena Horner says:

      Thank you, Joe. My conversation with him made my heart break. He blames himself for their deaths… doesn’t believe any of the families (if they knew would forgive him). I know he heard my message from the tears in his eyes. I don’t know if I helped… I pray he forgives himself and finds peace after all these years.

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