All I Could Be

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“Riveting and enjoyable reading…  A powerful story.”
- Colonel Paul L. Ladd, USMC (Ret)

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Reintegrating Vets Need Acceptance: A letter to my dentist as a call for community action

Dear Doctor,

I’ve been coming to your office for probably a decade now, for my bi-annual cleanings and some other minor dental work. I’m fortunate to have a good smile and few issues. One of my first visits there was after coming home from Iraq. I talked to you about the yellowish stains on my teeth—the result of taking an antibiotic for a year, one of the many pills, vaccines and precautions that are prescribed during deployment.

I don’t know if you noticed, but I was nervous as hell at that appointment. You see, doctors make me nervous, so do bright lights. Your exam space is efficient, but a tiny bit claustrophobic for me, and the chair facing the window? Well, that’s not tactical at all. People continuously walked and talked in the hallways at my back—my “fighting position” was useless. A good indicator of enemy activity is the watching the locals. So in you came wearing a perpetual smile. You were then, and have been since, kind, personable and professional. So I assumed there was nothing real to fear; your office was “all clear.”

Then, maybe two summers ago, my post-traumatic stress injury flared up and I had what I’d characterize as a “disgruntled vet” moment in my car in your office parking lot. I was screaming into my cell phone and possibly banging on my steering wheel. I was for a moment, very distressed. And what that all looked like or sounded like (if in fact, anyone at all saw or heard me), is hard for me to know. But I have noticed that the short, brown-haired lady in your office that makes my appointments and checks me in has never treated me the same since. She seems cold toward me, very unfriendly in fact, and in a hurry to rush me from the counter. Could I be imagining this? It’s possible. After all I’ve seen, I believe anything is.

My point in writing to you is this: to raise community awareness of reintegrating veterans. Your receptionist probably doesn’t think I look like a veteran or a soldier; hell I get that everyday. But most of us out of uniform can’t be identified accept by some old and inaccurate stereotypes. Only 1% of the American population currently wears a military uniform, yet there are about 10,000 Guardsmen and women in Iowa alone and as close to Camp Dodge as your office is, I imagine several of them are your patients. For women vets, well, nationwide nearly 300,000 of us have deployed to the Middle East since 2001.

The Veterans Administration cannot give returning veterans everything we need to find our way back home and neither can the military-family community. It’s the people in our workplaces and businesses we visit each day that make such a critical impact.

You see, I got a lot of bars of soap in Iraq in troop care packages. And the fact that I didn’t have to arrange a trip to the Post Exchange to get them was truly a gift. Communities should keep doing that. But if that’s where it ends, we’re failing to take care of those that protect our way of life. I was only deployed for 14 months of my life; I will hopefully have 40 or more years to live.

The lather of this letter is this. If you as a professional doctor, as a businessman, as a community leader, or Iowan, or American patriot want to “Support the Troops,” then what veterans and service members need is respect and compassion in your office, in our neighborhoods, in all the places we meet the non-uniformed citizen. It is, really what each of us owes one another as decent human beings, regardless of veteran status. I think, however, putting it through the “Support the Troops” lens magnifies both the need and the call for action. No one really knows who a veteran is, and no one can tell what each of us has been through and if we’re triggered by something that reminds us of our past in your presence, we don’t want to be judged or stigmatized or ignored. Reintegration is dependent on acceptance. Should your receptionist have witnessed me melt down, she simply could have asked, “Are you ok? Is there anything you need?” And we both would have marched on with our days.

It has been my experience, as an injured veteran and veterans’ advocate that the simplest reasonable accommodations can keep a good day going well, or take a bad day and turn it around. You see, an unfortunately high number of us are still “fighting” everyday and 22 of us each day lose that battle to suicide but, we can all stand up and be counted for doing our best where we’re at to be a part of the cause. If every business leader had this conversation with his or her employees and thought of reasonable accommodations they could activate if needed, can you imagine how communities could be serving those that made a great sacrifice? I think about this all the time.

It’s as simple as asking. Some things you can change, others maybe not. Many veterans with post-traumatic stress injury have light and sound sensitivities. They may need to wear sunglasses or headphones or have an appointment time when the fewest number of patients are being seen. They may need to sit up and take a break in the middle of a cleaning. I don’t know all the solutions—every veteran is unique and most don’t have post-traumatic stress or a traumatic brain injury. Some vets could take offense to being offered an accommodation, even when accepting it may reduce their stress level because we are hard-wired to suffer through a lot of physical and psychological pain. That “toughness” is one of our weaknesses and it makes it difficult for us to seek the help we need.

So, there it is Doc. Writing this letter has kept me up several nights so now your receiving it will have reduced my stress over you knowing these things prior to my next appointment.

Still serving,
Miyoko Hikiji

(Outside the dental chair I am a freelance writer and the author of All I Could Be: My Story as a Woman Warrior in Iraq, the Project Director for the Military Sexual Trauma Initiative at the non-profit group Veterans National Recovery Center and a speaker with the National Women Veterans Speakers Bureau. The folks at Stars and Stripes, Marie Claire, USA Today, Armed Forces Radio and NPR have been kind enough to share my message around the world).

Rising Veteran Suicide Rates, Part of an American Trend

A recent article by Frederick Reese in the Mint Press News alerted me to some staggering statistics from the CDC (Centers for Disease Control and Prevention):

–Suicide is the #4 cause of death in America, after cancer, heart disease and accidental death.

–There has been a 30% increase in suicides between 1999 and 2010.

–There were 38,364 suicides in 2010–105 per day.

Find the complete story here:

Why the increase?  Experts in the article suggested the current economic downturn and a significant decline in mental health services as key contributing factors.

After a year-long tour in Iraq, as I passed through Kuwait on my way home to Iowa, I was confronting with the reality of suicide.  One soldier, headed in the opposite direction, back into Iraq for a second deployment, killed himself in one of the recreation tents near my company area.

Currently, 33 military personnel or veterans attempt suicide daily with 22 veterans and 1 active duty soldier dying from that attempt.  Because suicide is closely connected to post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), both prevalent in the veteran population and often untreated or poorly treated, insufficient mental health care could certainly be a key factor in veteran suicides also.

My senior undergraduate thesis in psychology at Iowa State University was on PTSD.  My experiment consisted of self-report surveys on college students on three scales: 1) exposure to traumatic event 2) stress level 3) presence of social support network.  My findings were statistically reliable, showing that exposure to trauma alone does not predict PTSD in an individual, but had to include high stress levels and/or lack of social support.
Veterans often feel as if no one understands their experiences.  This feeling can leave them disconnected from the sources of healing: community veteran organizations, support groups, family and friends.  But I believe these loving, intimate  relationships are vital to coping and healing deep psychological wounds.  The experience of combat and a long deployment (or multiple deployments) are difficult experiences to unpack and decompress.  But, veterans cannot receive what they do not ask for.
If you are connected to a military member, you can help by providing her or him a safe, non-judgemental, listening-focused environment.  Veterans, speak up!  It is difficult, painful even, but if you’re Stateside right now then you’ve already been through the worst of it.  The war over there is done; The war inside begins.
Some new ROE (Rules of Engagement):  1) SPEAK UP!  If you get burned or have a bad talk, try someone else.  People care about you.  Don’t give up, ever.  2) TRY DIFFERENT FORMS OF TREATMENT (You’re unique.  Your therapy regimen will be too.  Consider medication, veteran support groups, cognitive behavioral therapy, transcendental meditation, specialty  yoga programs … )  3) DO THE WORK.  You won’t see results if you don’t do the work over time.  4) LOOK FOR OPPORTUNITIES TO THRIVE, NOT JUST SURVIVE  In other words, help someone else.  It doesn’t have to be a person with PTSD, in fact, that may be too much pressure on you during treatment.  But use one of your strengths to make a positive impact on another.  Too much self-focus can become a downward spiral, exhausting your energy and inhibiting your progress.  Give yourself breaks, from yourself … why do you think I’m writing this?
There are a lot of resources available, but I want to highlight two that I’ve recently come in contact with in my own wellness journey: 1) Welcoming Your Soldier Home Project (WYSH Project) started by Army veteran and PTSD suicide survivor Andrew O’Brien.  He wrote a guide to help families understand the transition period for their soldier after deployment.  Find him on Facebook and Twitter @WYSHProject  2) Gallant Few, dedicated to mentoring veterans and promoting an anti-suicide message, founded by retired Army Ranger Karl Monger.  Find him on Facebook and Twitter @gallantfew.  And I encourage all veterans to copy this link, make the call, and take the Spartan Pledge:
Be well, warriors!


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All I Could Be All I Could Be
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“Reading this tribute to those who serve in combat only reinforces the respect I have for this soldier turned author.  This book is exactly how I recall the dedication, candid atmosphere, and unselfishness I grew to respect from the author long before Hikiji’s deployment.  I would have expected nothing less and congratulate her for this undertaking.” Michael A. Gardner Colonel, Ret, US Army
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