It’s my pleasure to welcome Patrick Thibeault, certified registered nurse practitioner and former combat medic to our blog. Patrick is the author of MY JOURNEY AS A COMBAT MEDIC. He comes to us with a wealth of experience and I must say I really enjoyed this interview. Please leave a question or comment for Patrick at the end of the blog.
You entered the Army as a teenager and everything seemed exciting. What changed over the years?
I grew older and learned from errors I made in my youth. Some things will always be exciting as I am a natural adrenalin junkie. The first time I jumped out of an airplane for the Army, I was excited and scared at the same time. When I made my last jump years later, I was still excited as I was the first time I jumped out of a plane, except that my back hurt from too many hard landings. Every time I would go to the weapons range to shoot different weapons, it was exciting to hit the targets. I had an exciting twenty years of service.
As a combat medic in Afghanistan what was the hardest task or most difficult situation you encountered?
The most difficult mission I was on involved a little girl from Afghanistan who ingested some insecticide. My unit was embedded with the Afghanistan Army trying to train and fight with our counterparts. We were mentoring the medics in the Afghanistan Army. I guess they didn’t operate the medical aid station that they had because it was locked up for the night. This little girl was my responsibility. I was serving as a Army medic , but I had my bachelors degree in nursing, so I knew a little bit of what had to be done to help stabilize her.
It was difficult because I was not used to managing pediatrics. The medication dosing has to be calculated precisely and the response to that medication has to be monitored. I worked on a medical surgical floor as a RN back home and we only had adults in my unit. It was a challenge because I had the basic book knowledge of what to do, but I didn’t have the practical experience. This is one reason why I decided to go to nurse practitioner school and become a Family Nurse Practitioner, because I would learn a little bit about all the age groups as a generalist provider. Yes It was a challenge, I was afraid that this little one would die in the back of my ambulance as I stabilized her, and managed her airway while we got our infantry soldiers and went on a convoy to the local hospital in the town we were close to.
How did you help soldiers deal with their emotions when they lost their limbs?
Honestly, we didn’t spend too much time with them after this happened. I worked as a medic with a combat unit and called in a medical evacuation to ship them out as soon as possible. I say that not being unsympathetic, but I did not work in a hospital unit where we had time to spend with patients like that. The priorities are to stabilize the bleeding and airway and prevent shock.
Many soldiers talk about a sense of letdown when they come home because they have been in a heightened state for so long. What bothered you most?
I think letdown is a different word than I would choose. You know the thing that bothered me the most was that I didn’t have my weapon on me anymore when I came home from the war. I was used to sleeping with my weapon, I carried it everywhere I went. Even months after returning from the war, I would instinctively feel for my weapon and then freak out for a second before remembering that I was home. I still deal with this state of heightened awareness to this day. I am more careful about being able to have my back to the wall of a room if I am in a public place. I have learned to avoid triggers that exacerbate my PTSD such as fireworks on the 4th of July. Most importantly, I have learned to try to not let little things in life bother me and not to sweat the small stuff.
Did it seem life didn’t matter in the same way because of the life and death situations you once were in daily?
No, the opposite actually, I learned to appreciate life and realized how much even more precious that life really is. I think that is why I enjoy working as a nurse practitioner in the urgent care and primary care setting. I believe I can make the most difference in helping others.
Is it common for veterans to feel they don’t fit in when they return? Was that your experience? What things got in the way if any?
The issue that bothers me is how people like to stereotype combat veterans. We all don’t end up doing drugs and succumbing to alcohol as a means to deal with the issues that we have to deal with. When people tell me “ Thank you for your service” and then the next question they ask me is “ how many people did you kill.” It irritates me. I explain to these people that I was a medic and then some people start to tell me how much they are opposed to the war. I then have told some people that I volunteered for the service and going to war is something that might happen and when our nation is attacked like it was on 9/11 that our nation was obligated to respond the way it did in Afghanistan. I want them to understand that no one likes going to war, but sometimes it is something that has to be done and I am proud to have put my life on the line. In that respect many veterans do not fit in with society, but that is also why many veterans become more involved in veteran groups like the Veterans of Foreign Wars and Iraq and Afghanistan Veterans of America.
You went back to school when you returned from combat. Is it common for some vets to feel aimless or purposeless when they return?
I went to school and became a Family Nurse Practitioner. It is actually the opposite effect. Many combat veterans have been to war, to hell and back and it makes us realize how good we have it. Aimless and purposeless are two words that I would not use when I describe the motivation of combat veterans who come home. Many go to college and learn and become leaders in their professions, others come home and resume the same professions they had before they left. Sadly, a few veterans struggle when they come home and sadly some of them of committed suicide.
There are many who say their inner life is dedicated to dealing with the residue of their experience of witnessing killing and the caring for those in the aftermath of the worst kinds of combat injuries. When you came back these memories didn’t stay buried like other memories do did they?
I went to war, sadly war is a part of my psyche. I wouldn’t want to change it either because I have grown as a person dealing with PTSD and it has given me compassion when I deal with patients who suffer from PTSD, Depression and other conditions that I encounter in my primary care setting. I don’t spend my inner life just dealing with the residual scars of PTSD, but I do deal with these scars. That is one of the main reasons why I wrote My Journey as a Combat Medic. I have these scars, but you know what ? I would not trade in these scars for anything. I have learned it is not healthy to bury these memories, but to acknowledge what I deal with and then try to carry on in life and be as successful and happy in life as a man can aspire. I also want to inspire other combat veterans who deal with PTSD that hope is not lost.
Could you explain the physical responses you experience with PTSD?
In My Journey as a Combat Medic, I wrote a chapter exclusively about PTSD. It is an important subject. Many combat veterans deal with PTSD. I wanted to shed light on PTSD for that reason. The rage is something that I feel, utter rage like fire coming out of my hands and fingers. I have flashbacks and nightmares from time to time. It is not something that is pretty and is even making my heart race as I type these words right now.
During my research for PTSD, two fairly new treatments were described– use of rapid eye movements (Eye Movement Desensitation/Reprosessing) and using stellate ganglion blocks. Using EMDR lessens the effects of the episode. Stellate ganglion blocks are said to give 6 months relief from PTSD. Are you familiar with these treatments?
I have read about EMDR, but I personally doubt the effectiveness of this therapy because is it so speculative. I am saying this as a medical professional evaluating my own therapy and knowing myself. I have also read about immersion or exposure therapy, but to be honest I would not be a good candidate for exposure therapy because I am afraid that with exposure like this, I would become very agitated and potentially violent. It is the same reason why I have learned to avoid triggers that can cause me to have a flashback.
Thank you so much for this interview and good luck to you in your profession. Your patients are lucky to have such a dedicated practitioner.
Don’t forget to leave a comment or question for Patrick.