I have also found that those veterans who suffer the most painful survival guilt are primarily those who served as corpsmen or medics. These unfortunate veterans were trained for a few months to render first aid on the actual field of battle. The services they individually performed were heroic. With a bare amount of medical knowledge and large amounts of courage and determination, they saved countless lives. However, many of the men they tried to save died. Many of these casualties were beyond all medical help, yet many corpsmen and medics suffer extremely painful memories to this day, blaming their “incompetence” for these deaths. Listening to these veterans describe their anguish and torment… seeing the heroin tracks up and down their arms or the bones that have been broken in numerous barroom fights… is, in itself, a very painful experience.
Another less destructive trend that I have noticed exists among a small number of Vietnam combat veterans who have become compulsive blood donors. One very isolated and alienated individual I interviewed actually drives some 80 miles round-trip once every other month to make his donation. His military history reveals that he was one of 13 men out of a 60-man platoon who survived the battle of Hue. He was the only survivor who was not wounded. this veteran and similar vets talk openly about their guilt, and they find some relief today in giving their blood that others may live.
Anxiety Reactions
Many Vietnam veterans describe themselves as very vigilant human beings; their autonomic senses are tuned to anything out of the ordinary. A loud discharge will cause many of them to start. A few will actually take such evasive action as falling to their knees or to the ground. Many veterans become very uncomfortable when people walk closely behind them. One veteran described his discomfort when people drive directly behind him. He would pull off the road, letting others pass, when they got within a few car lengths of him.
Some veterans are uncomfortable when standing out in the open. Many are uneasy when sitting with others behind them, often opting to sit up against something solid, such as a wall. The bigger the object is, the better. Many combat veterans are most comfortable when sitting in the corner in a room, where they can see everyone about them. Needless to say, all of these behaviors are learned survival techniques. If a veteran feels continuously threatened, it is difficult for him to give such behavior up.
A large number of veterans possess weapons. This also is a learned survival technique. Many still sleep with weapons in easy reach. The uneasy feeling of being caught asleep is apparently very difficult to master once having left the combat zone.
Sleep Disturbance and Nightmares
Few veterans struggling with post-traumatic stress disorders find the hours immediately before sleep very comfortable. In fact, many will stay awake as long as possible. They will often have a drink or smoke some cannabis to dull any uncomfortable cognition that may enter during this vulnerable time period. Many report that they have nothing to occupy their minds at the end of the day’s activities, and their thoughts wander. For many of them, it is a trip back to the battle zone. Very often they will watch TV late into the mornings.
Finally, with sleep, many veterans report having dreams about being shot at or being pursued and left with an empty weapon,, unable to run anymore. Recurrent dreams of specific traumatic episodes are frequently reported. It is not unusual for a veteran to reexperience, night after night, the death of a close friend or a death that he caused as a combatant. Dreams of everyday, common experiences in Vietnam are also frequently reported. For many, just the fear that they might actually be back in Vietnam is very disquieting.
Some veterans report being unable to remember their specific dreams, yet they feel dread about them. Wives and partners report that the men sleep fitfully, and some call out in agitation. A very few actually grab their partners and attempt to do them harm before they have fully awakened. Finally, maintaining sleep has proven to be a problem for many of these veterans. They report waking up often during the night for no apparent reason. Many rise quite early in the morning, still feeling very tired.
Intrusive Thoughts
Traumatic memories of the battlefield and other less affect- laden combat experiences often play a role in the daytime cognitions of combat veterans. Frequently, these veterans report replaying especially problematic combat experiences over and over again. Many search for possible alternative outcomes to what actually happened in Vietnam. Many castigate themselves for what they might have done to change the situation, suffering subsequent guilt feelings today because they were unable to do so in combat. The vast majority report that these thoughts are very uncomfortable, yet they are unable to put them to rest.
Many of the obsessive episodes are triggered by common, everyday experiences that remind the veteran of the war zone: helicopters flying overhead, the smell of urine (corpses have no muscle tone, and the bladder evacuates at the moment of death), the smell of diesel fuel (the commodes and latrines contained diesel fuel and were burned when filled with human excrement), green tree lines (these were searched for any irregularity which often meant the presence of enemy movement), the sound of popcorn popping (the sound is very close to that of small arms gunfire in the distance), any loud discharge, a rainy day (it rains for months during the monsoons in Vietnam) and finally the sight of Vietnamese refugees.
A few combat veterans find the memories invoked by some of these and other stimuli so uncomfortable that they will actually go out of their way to avoid them. When exposed to one of the above or similar stimuli, a very small number of combat veterans undergo a short period of time in a dissociative-like state in which they actually reexperience past events in Vietnam. These flashbacks can last anywhere from a few seconds to a few hours. One veteran described an episode to me in which he had seen some armed men and felt he was back in Vietnam. The armed men were police officers. Not having a weapon to protect himself and others, he grabbed a passerby and forcefully sheltered this person in his home to protect him from what he felt were the “gooks.” He was medicated and hospitalized for a week.
Such experiences among Vietnam veterans are rare, but not as uncommon as many may believe. Many veterans report flashback episodes that last only a few seconds. For many, the sound of a helicopter flying overhead is a cue to forget reality for a few seconds and remember Vietnam, reexperiencing feelings they had there. It is especially troublesome for those veterans who are still “numb” and specifically attempting to avoid these feelings. For others, it is just a constant reminder of their time in Vietnam, something they will never forget.