Thursday, September 27, 2012

Army Surgeon Shares PTSD Struggles to Help Others



By Lisa Daniel
American Forces Press Service

WASHINGTON, Sept. 27, 2012 – As the Army conducts a worldwide stand-down today to draw attention to preventing suicide within the force, those who have survived attempts to take their own lives may take notice. One is Dr. Tara Dixon.

Army leaders and military officials, overall, say there are multiple reasons why service members commit or attempt suicide. Some are combat-related, but at least half are not. Many involve personal problems with love, money and the law, some that simmered for years before they even entered the military. The problems are complicated by each person’s coping abilities, or resilience, and other factors, they say.

Dixon’s story is less complicated; it is the story of one soldier’s struggle with post-traumatic stress disorder that eventually left her feeling so hopeless that death seemed the only way out.

Dixon, 38, of Georgia, was in her medical residency to become a trauma surgeon when she enlisted in the Army Reserve in 2004 after hearing that the military needed surgeons in the wars in Iraq and Afghanistan. She deployed as a trauma and critical-care surgeon to Iraq with forward-deployed units in 2008 and 2010 -- “me and some guys in a tent,” she said as part of a Sept. 13 panel discussion at the annual Warrior-Family Symposium, sponsored by the Military Officers Association of America and the National Defense Industrial Association.

“We got bombed routinely,” she said. “This was not a Geneva Convention war. We had to take the big red cross off the top of our tent because that’s where [insurgents] aimed.”

Dixon described the stress of treating “the guy I had breakfast with that morning” for critical injuries, and of having to make split-second decisions about whether to amputate a limb or risk transporting a soldier hours away to a Baghdad hospital. Then there were the abused Iraqi children brought in as decoys for insurgent attacks on the unit and the female soldiers who needed treatment for sexual assaults -- crimes she was legally bound not to report at the victims’ request, she said.

Dixon said she coped with the stress through the only outlet she had: running, sometimes 80 miles each week.

Still, she said, “It messes with your mind a bit.” And even though she felt the strain of post-traumatic stress from her first deployment, she soon returned for a second one.

Dixon returned to the United States in the fall of 2010, but the war was still with her. Among the many problems, she said, was returning as a reservist to a city without a military base and no means of support. “I was very much an outcast, and I felt very much alone,” she said.

She described the frustration and embarrassment of post-traumatic stress, of dropping her bags and running to pick up patients at the sound of a helicopter, only to realize she was at her local grocery store.

“It was very embarrassing and frustrating to me that I was nervous in crowds, that helicopters bothered me,” she said. “When you get back to a normal place, somehow your body and your brain don’t shut off” from the survival instincts of war.

“If we didn’t hit the ground when we were in Iraq, if we didn’t duck when someone shoots at us, we would be dead,” she said.

Even when she was fully aware of being thousands of miles from the war, Dixon said, she couldn’t stop from reacting instinctively. “If someone drops the communion plate in church and you hit the ground, that one part of your brain knows you’re in church, but you’re still going to react,” she said.

Dixon said she sought counseling, but her problems seemed only to get worse. Six months after returning from Iraq, she tried to end her life with an overdose of pills.

“I felt lost,” she said. “I was without hope.”

After struggling to find an inpatient facility through TRICARE and the Department of Veterans Affairs, Dixon said her family found a private treatment center where she would spend the next nine months recovering from PTSD. “They gave me my life back,” she said. “They gave me hope back.”

Today, Dixon says she is much improved. She has learned to understand PTSD as “a normal reaction to an abnormal situation.” And she has learned important tactics in treating flashbacks, skills known as “dissociation” and “reorienting.”

“In treatment, they teach you to look around,” she said in an interview with American Forces Press Service from Ocala, Fla. “Here in Florida there are big, beautiful oak trees. There are no oak trees or anything lush in Iraq.” Similarly, she said, “If you hit the ground and you look around and see Starbucks, you know you’re not in Iraq.”

Dixon is processing out of the reserves, and is using some of her medical skills as a veterans service liaison for The Refuge -- A Healing Place, in Florida, where she works with veterans and their families and helps them find treatment. She gets lots of calls for help, she said, including Vietnam War veterans who still struggle with flashbacks and nightmares and even a World War II veteran whose post-traumatic stress surfaced more than 60 years after he left the battlefield.

“Sometimes it helps knowing others have been through the same thing,” she said.

Dixon said she hopes her work will prevent the 9/11 generation of war fighters to not repeat the hard times so many Vietnam War veterans have had with post-traumatic stress.

As for her own struggles, Dixon said, “I’d like to say it’s curable and it’s done and it’s fine,” but she said she doesn’t know when she might stop reacting to things like fireworks.
“I know it’s a lot better,” she said.

Dixon is proud of her work in combat. “I never lost a coalition force in two tours,” she said. But the PTSD has made her career as a surgeon uncertain.

“I really enjoyed what I did,” she said. “It’s something I was very good at. That part is sad to let go. We’ll just have to see how time progresses.”

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