戰爭創傷后遺癥：帶著愧疚活下去

November 2004， against a shattered wall in south Fallujah in Iraq， with video rolling， I conduct a battlefield interview with 1）US Marine Corporal William Wold. He has just shot six men dead inside a room adjoining a 2）mosque and is juiced with a mix of 3）adrenaline and relief.

“I was told to go the room，” he says，“and my first Marine went in… he saw a guy with an AK， I told him to shoot the guy， then I shot the six guys on the left… and my other Marine shot two other guys.”

Wold grew up near Vancouver in Washington State. A high-school 4）linebacker， he had a college football scholarship waiting for him， but gave it up to join the Marines.

“My fiancée’s worried that I’m not going to come back the same. I’ll never tell her what things I did here. I’ll never tell anybody， ’cause I’m not proud of killing people. I’m just proud to serve my country. I hate being here， but I love it at the same time.”

Wold’s fiancée was right. He wouldn’t come back the same. He thought his war was over， but a few months later， back in the safety of his childhood home， surrounded by his adoring family， the dark secrets and all the guilt emerged from his mind—like the Greeks from their hollow wooden horse， unrelenting in their destruction of ancient Troy.

A recent study by the US Department of Veterans Affairs （VA） shows that nearly two-dozen veterans are killing themselves every day， nearly one an hour. This 5）attrition， connected at least in part to combat-related 6）post-traumatic stress disorder （PTSD） and other war-related psychological injuries， is an enormous price to pay for avoiding the subject. So great， in fact， that the total number of US active duty suicides in 2012 （349） was higher than the number of combat-related deaths （295）.

“When a leader destroys the 7）legitimacy of the army’s moral order by betraying ‘what’s right’，” writes psychiatrist Jonathan Shay， an expert in combat trauma， in his book Achilles in Vietnam （1994）， “he 8）inflicts manifold injuries on his men.”

This could be what happened to Corporal William Wold. Wold’s mother Sandi said he was fine for a while when he first got home， but after a few months the darkness seeped out. He couldn’t eat and he never slept.

The 9）transgression that bothered him most wasn’t the carnage in the mosque， but another， even more disturbing incident， an accidental killing at a vehicle checkpoint in Iraq. The vague description Sandi gave to a local television reporter is horrifying： “A vehicle came through that hadn’t been cleared，” she said. “The lieutenant says：‘Take them out.’ He took them out. They went to the van—it was a bunch of little kids. And he had to take their bodies back to the family.”

Instead of killing an armed enemy， Wold had， through the orders of an officer， killed several children. The accidental killing of civilians in the Iraq War， as in all wars， is much more common than you can imagine. Numbers are so high it wouldn’t benefit the military to keep accurate tabs； rigorous documentation would just fan the public relations nightmare and boost the 10）propaganda value of those deaths for the other side.

Wold， like many combatants， was able to contain his guilt while still in Iraq. But when he returned home， he brought the Trojan horse with him. It was there， in the calm of these“safe” surroundings， that his guilt and shame overwhelmed him. He became addicted to the pain medication prescribed for an injury he had suffered in a roadside bomb attack and augmented that with 11）methadone that he scored on the street.

One night a couple of friends came to visit Wold there. They went out together to see a movie and get tattoos. When they returned to his room， Wold couldn’t remember if he had taken his medication or not—so he took it again， in front of his friends.

The next morning， the friends found Wold in bed， in the same position he had been when they had left him the night before. Only now he wasn’t breathing. He was pronounced dead at 9：35am.

Sandi felt the Marines had failed her son. But she knew he had loved the 12）camaraderie of the corps and had him buried in his dress blues. She also knew that the uniform was just the surface of a much more complex story， a story of belief， duty and honor yes， but also about how guilt over killing in the pursuit of those ideals could lead to ruin.

I met Lance Corporal James Sperry， like Wold， during the Battle of Fallujah in Iraq in 2004. I videotaped him after he had been wounded during the first day of fighting. Like Wold， Sperry came home with a head battered from war and filled with guilt. But Sperry’s guilt wasn’t over killing； it was over not being killed， survivor’s guilt. His unit suffered some of the highest casualty rates of the war.

He sent me an email six years after Fallujah， thanking me for helping carry his stretcher that day and asking if I had any photos of his comrades killed in action. “I was wondering if you had taken any photos of me during that time of injury and any of my fallen friends. I have lost 20 friends in this war and would like to get as many pictures as I can.”

That note came during a dark period of Sperry’s life， when he was struggling with cognitive 13）impairment and 14）debilitating 15）migraines from his physical injuries and a host of psychological issues consistent with moral injury. He met nearly all of its criteria， including purposelessness， 16）alienation， drug and alcohol use， and even a near-suicide attempt （he went as far as to sling a rope over the rafters of his garage）.

His recovery， which took years， was not the result of a single act， but encouragement from family and friends， ongoing determination and a groundbreaking program from the Shepherd Center in Atlanta， which specializes in helping those with brain and 17）spinal cord injuries.

Corporal Wold and Lance Corporal Sperry are just two of millions. According to US Department of Defense data， since 2001 about 2.5 million Americans went to war in Afghanistan and Iraq， with more than 800，000 deploying more than once. Nearly 700，000 of those veterans have already been awarded disability status， with another 100，000 pending， according to the VA.

They all need support. As Jonathan Shay wrote in Achilles in Vietnam： “When you put a gun in some kid’s hands and send him off to war， you incur an infinite debt to him for what he has done to his soul.”

2004年11月，在伊拉克的費盧杰南部，我靠著一堵千瘡百孔的墻，在攝像機前對美國海軍陸戰隊下士威廉·沃爾德進行了一次戰地采訪。他剛剛在一座清真寺旁的一間房間里射殺了6名男子，現在內心感到既激動又如釋重負。

“我受命進入那個房間，”他說道，“我前面的那個隊友進去了……看見有人拿著一把AK步槍，我讓他開槍射殺那人，然后我就射左邊的那六個……我另一名隊友射殺了另外兩個。”

沃爾德在華盛頓州毗鄰溫哥華的地區長大。高中時他是橄欖球隊的線衛，本來獲得了一所大學的橄欖球獎學金，但是他為加入海軍陸戰隊放棄了獎學金。

“我的未婚妻擔心我回去的時候就變了。我絕不會跟她說我在這兒所做的事。我絕不會告訴任何人。因為我不為殺人而自豪。我只為自己能為國效力而自豪。我討厭待在這里，但同時又熱愛置身其中。”

沃爾德的未婚妻是對的。他回去的時候就不再是原來那個人了。他以為他的戰爭結束了，但數月之后，當他回到安全的兒時家鄉，回到摯愛的家人身旁，那深藏內心的陰暗秘密和愧疚便一涌而出—就如同希臘人從空心木馬中涌出，毫不留情地將古特洛伊城摧毀一樣。

美國退伍軍人事務部最近的一項研究表明，每天有二十多名退休軍人自殺，平均約一小時就有一名。造成這一損失的原因至少部分在于由戰爭引起的創傷后應激障礙和其他與戰爭相關的心理創傷，這是我們為逃避殺戮這一話題所付出的巨大代價。