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News & ArtsSaturday, August 7, 2010
Health / City Working Inpatient Psych at the VA with the Blue Angels
Posted by Jonathan Golob on Sat, Aug 7, 2010 at 1:07 PM
Last Seafair, I was assigned to work the inpatient psych unit at the Seattle VA. The Blue Angels tastefully used the VA building as a landmark on their strafing aerobatic runs over I-90. The psych unit is on the top floor. My ambivalence about the Angels was spent by the end of the long weekend of close passes.
Let's talk Shell Shock (nee Post Traumatic Stress Disorder). It starts with something awful. You're an enlisted servicewoman, a loadmaster on C130 cargo planes. (I can't talk about specific patients, so this is a mixture of several stories.) Your job is to help load wounded soldiers into the back of this rugged prop plane. You have no medical training. As the plane takes off, you stand and look through a little window in the tail of the plane. If you see (an American made and donated) surface-to-air missile approaching, you press a button and release chaff. (It happened on more than a few takeoffs, with the denotation of the warheads close enough to knock you around.) You then help tend to your dying fellow soldiers. Repeat.
You complete your tour, and come home. At the oddest moments, the memories of these terrors fill up your mind—like horror movie ooze slowly rising from the floor. Nothing you can do stops the rise. You begin to notice triggers. If you drove trucks, it's traffic on I-5 that does it. If you were on planes, that faint flicker of silver in the sky from Seatac does it. You begin to avoid these triggers. Soon, you're not just in terror of the memories, but of things that can bring the memories back. Nighttime is your enemy, where your dreams become an endless loop of the worst moments. You become irritable, jumpy, your heart bounds and leaps like you're right back where you once were. Things start to fall apart.
A typical patient on that weekend had gone camping—deep into the woods if possible—on the preceding July 4th weekend. Combat memories and fireworks don't mix. But, you're new to Seattle. You don't know of the Blue Angels and Seafair. This is one trigger of the memories you didn't plan for. The horror starts to rise. You panic.
This sounds wishy-washy; it isn't. There is real neuroscience behind shell shock. The sound of the F/A-18's F404 engines is more than enough trigger for those struggling to put away their demons. So, no, I'm not the biggest fan of the Blue Angels.
2
Our windows have been shaking intensely all morning. Old house + central district + PTSD + Blue Angels = hellish visions of building imploding. Even my psychologically undamaged roommate was freaked out by the last flyover.
5
Mother Nature raining on their parade seems to have only made it worse: according to the P.I., they'll be flying lower than usual.
http://blog.seattlepi.com/thebigblog/arc…
This fucking plane that keeps buzzing my West Seattle neighborhood is completely bumming me out.
http://blog.seattlepi.com/thebigblog/arc…
This fucking plane that keeps buzzing my West Seattle neighborhood is completely bumming me out.
6
City Hall does track these things, apparently some years less than 20 complaints get recorded.
Contact the mayor (http://www.seattle.gov/mayor/citizen_res…)
and your city council people
http://www.seattle.gov/council/councilco… .
http://www.capitolhillseattle.com/2010/0…
Contact the mayor (http://www.seattle.gov/mayor/citizen_res…)
and your city council people
http://www.seattle.gov/council/councilco… .
http://www.capitolhillseattle.com/2010/0…
7
One thing that's usually more entertaining than the Blue Angels is listening to all of you pussies complain about it. I hear more noise in a single day from the recycling truck that dumps its load of glass outside my window than I hear from the Angels in an entire year. Maybe a compromise can be made where the Angels go away but all of the whiners can still get their gripe on... everybody wins!
8
This would be immensely more sad and heartbreaking if shell shock was something new. Every single war has produced this illness. What the fuck do these people expect when they go off to war? If you don't care to educate yourself about situations you plan to put yourself in (like fucking war), don't be surprised when you can't sleep without having night terrors or any of the many symptoms PTSD presents. Fuck war. Nothing good comes of it.
9
It's not just the noise per se, it's the death machines. Anywhere else in the world, these machines rain death and destruction; here, they're celebrated summertime fun. Something is seriously wrong with our culture that we glorify these things.
10
@9: Do you seriously think that this is an American thing? Airshows all over the world feature military aircraft. Unless I've experienced mass hallucinations at Le Bourget, etc...
11
...and there have been deadly accidents at airshows. The Paris airshow is not held above Notre Dame and the Eiffel Tower. OK, you need the Blue Angels? How about having them doing their thing above some speedway 20 miles outside of the city?
16
Oh, boy. I'm so sorry. Brought back not just the intriguing responses of the folks my dad would introduce me to when he was in Providence for a "tuneup." but of the sorrowfulness of the staff there.
18
Hmm that's a really thought provoking post, but on the other hand... fighter planes are fast and loud and totally awesome!
Quit being such hater nimbys Slog.
Quit being such hater nimbys Slog.
19
Where do we send in questions to "Ask the Deepwater Horizon oil spill?" I'd like to hear its take on this.
20
I wouldn't bitch about the Blue Angels were it sufficient for them to be here for an afternoon and then go back from whence they came. But four or five days of Phew!Crack!Boom! (yeah, I signed up for the Slog comment thread last year around this time) over the city while I'm trying to, y'know, get work done, or take a nap, or eat a nice dinner is asking too much. Thus, I bitch.
21
I don't like the Blue Angels either, but what's your argument here? Should we cancel all loud noises in Seattle? Maybe we should do it nation wide: no jets, no cars, no fireworks, no stereos, no yelling, no running, no toy guns, no war movies...?
22
Yeah, screw those vets. It's not like they suffer as a direct result of their war service or anything...
23
I get how the patients have no idea the Blue Angels are coming. But what about their doctors? Do their doctors not know the Blue Angels are coming, every year. Year after year, sure as the sun comes up? In spite of all those who complain about them year after year? They come every year even when none other than Dan Savage brings his mighty influence to bear against them.
Do their doctors, with all their knowledge of shell shock, and their awareness that the Blue Angels are coming -- same as they did last year and the year before and the year before -- just sit there and do nothing? That's some damn fine doctoring.
It just seems like if you knew these jets were coming and your and everyone else's efforts to keep them away have failed, a doctor with a shred of imagination could maybe take some steps to head off problems. Spend time in the basement. At least get some earplugs. If it's really as bad as you say, put the patients on a bus and send them out of town for the weekend.
Do something. Don't just sit there and join the chorus of whining. Doctors are supposed to be more resourceful than just kvetching.
Do their doctors, with all their knowledge of shell shock, and their awareness that the Blue Angels are coming -- same as they did last year and the year before and the year before -- just sit there and do nothing? That's some damn fine doctoring.
It just seems like if you knew these jets were coming and your and everyone else's efforts to keep them away have failed, a doctor with a shred of imagination could maybe take some steps to head off problems. Spend time in the basement. At least get some earplugs. If it's really as bad as you say, put the patients on a bus and send them out of town for the weekend.
Do something. Don't just sit there and join the chorus of whining. Doctors are supposed to be more resourceful than just kvetching.
24
@elenchos: What would you have me do? Pump patients full of benzos (many of whom are already alcoholics) and antipsychotics so they can make it through a glorified (and enormously wasteful) talent show?
Earplugs don't quite cut it. And, how many bed (let alone empty) inpatient psych beds do you think exist in the entire region? And of those, how many aren't immediately surrounding I-90. I'll give you a hint: The majority are in Harborview and the Seattle VA. Are you volunteering to pay for the transport? Or facilitate it?
Look, I get that people like their high tech dog and pony shows. Particularly insecure chickenhawks, it seems. Bread and circuses. To me, all this veneration of military tech seems about as tasteless as partying outside prison when they're executing of a prisoner. The cost of this show is the mental health of people who have actually sacrificed a part of themselves for this country. Fucking earplugs can't stop that.
Earplugs don't quite cut it. And, how many bed (let alone empty) inpatient psych beds do you think exist in the entire region? And of those, how many aren't immediately surrounding I-90. I'll give you a hint: The majority are in Harborview and the Seattle VA. Are you volunteering to pay for the transport? Or facilitate it?
Look, I get that people like their high tech dog and pony shows. Particularly insecure chickenhawks, it seems. Bread and circuses. To me, all this veneration of military tech seems about as tasteless as partying outside prison when they're executing of a prisoner. The cost of this show is the mental health of people who have actually sacrificed a part of themselves for this country. Fucking earplugs can't stop that.
26
@23: Seriously. Implying that we should dope up veterans who actually may have flown planes in combat so we can be amused is pretty fucking offensive. A BUS? Christ. Why not just move the planes and let people go somewhere else to watch the spectacle.
Jonathan said it all better, but it's worth reiterating: It's insane that we might make a ward full of people who've sacrificed themselves for this country decompensate just for some bullshit tradition.
Jonathan said it all better, but it's worth reiterating: It's insane that we might make a ward full of people who've sacrificed themselves for this country decompensate just for some bullshit tradition.
27
@7 guess what a-hole, the recycling truck is doing a job..what exactly are the blue angels accomplishing?
28
When my grandpa was in the hospital for heart surgery, one of the guys in his ward who'd also just had open heart surgery and was a Vietnam vet freaked out at the sound of the helicopter ambulance landing on the roof in the middle of the night. The guy leaped out of bed and ripped out his IV and all his stitches. :(
29
No, I'm sorry. You're being obtuse.
You can rail against the Blue Angels all you want. People have bitched about them for years and what has that gotten them? Doodly squat is what they have to show for it. So maybe you think now you've hit upon the magic formula that will finally drive the Blue Angels away from Seattle? "Think of the veterans!" Sure, go ahead and try. Maybe it will work. If it works, more power to you; congratulations.
But history and common sense says it won't work and that means the doctors at the VA have a year to figure out what they can do.
And honestly, I'm a little confused about one thing. The Blue Angels have done this almost every year since 1972. So for some 38 years -- 38 years! -- the VA doctors have sat around scratching their heads watching everyone in the psych ward freak out during Seafair. And 38 years all they've managed to do about it is sit around and cluck that they wish those darn planes didn't keep coming back.
Does that make sense? Not to me. It doesn't add up.
You can rail against the Blue Angels all you want. People have bitched about them for years and what has that gotten them? Doodly squat is what they have to show for it. So maybe you think now you've hit upon the magic formula that will finally drive the Blue Angels away from Seattle? "Think of the veterans!" Sure, go ahead and try. Maybe it will work. If it works, more power to you; congratulations.
But history and common sense says it won't work and that means the doctors at the VA have a year to figure out what they can do.
And honestly, I'm a little confused about one thing. The Blue Angels have done this almost every year since 1972. So for some 38 years -- 38 years! -- the VA doctors have sat around scratching their heads watching everyone in the psych ward freak out during Seafair. And 38 years all they've managed to do about it is sit around and cluck that they wish those darn planes didn't keep coming back.
Does that make sense? Not to me. It doesn't add up.
30
(And Jigae, care to quote the supposedly offensive thing I said about doping up anybody? You're imagining things. And I have no idea what is so offensive about riding the bus; it's a safe, comfortable and efficient form of transportation. You prefer your Lincoln Navigator or what? You think they'd rather be in a helicopter or a jet? Just who is doped up here?)
31
Dude, you're an asshole. I know you're a favored commenter, but the suggestion of putting a bunch of mentally-ill veterans on a bus and moving them to another location for a week because a city is too selfish to make small adjustments to the traditional flight path is beyond the pale. You suggested the doctors intervene and as I said above this "IMPLIES doping up" because a large scale troop transfer isn't feasible. So short of moving the Blue Angels, a pharmacological intervention is the only real option they have.
33
One last thing, and I'm done. I'm going to assume you haven't worked with the elderly, mentally ill or dementia patients. For these populations any deviations from normal routines can cause huge losses in their level of function. I have worked at nursing homes where most residents LOVE the Blue Angels because despite their hearing loss they can still feel/hear the roar of the jets. But for some patients this causes severe trauma that can last beyond the actual event.
If you had worked with them, you would realize the idea of putting them on a bus would not work and might make things even worse. Any paranoid delusions would kick into overdrive and there would be intense anxiety about where they were going, especially if they were veterans. The reason the MDs haven't come up with a solution isn't because they're not trying. It's because there really isn't one, short of moving the Blue Angels or redoing the cash-strapped VA to be utterly sound proof.
I'll admit I've never been a fan of the Angels, but I've seen enough in the last two years working with these populations in both in-patient and out-patient settings to know that this isn't just a problem for "whiny, NIMBY, out-of-towners." They're a real disruption for people the event ostensibly celebrates. It's a shameful show of insensitivity towards people who have sacrificed for their country. The veterans aren't straw-men or rhetorical devices, they're living breathing people, many of whom suffer for our enjoyment.
If you had worked with them, you would realize the idea of putting them on a bus would not work and might make things even worse. Any paranoid delusions would kick into overdrive and there would be intense anxiety about where they were going, especially if they were veterans. The reason the MDs haven't come up with a solution isn't because they're not trying. It's because there really isn't one, short of moving the Blue Angels or redoing the cash-strapped VA to be utterly sound proof.
I'll admit I've never been a fan of the Angels, but I've seen enough in the last two years working with these populations in both in-patient and out-patient settings to know that this isn't just a problem for "whiny, NIMBY, out-of-towners." They're a real disruption for people the event ostensibly celebrates. It's a shameful show of insensitivity towards people who have sacrificed for their country. The veterans aren't straw-men or rhetorical devices, they're living breathing people, many of whom suffer for our enjoyment.
34
Jesus you guys are the biggest whiners ever today. The Blue Angels were flying here since Seattle was a blue-collar company town before your frail asses even moved here. In your quest to make Seattle fun-free, I can't believe they've even last this long.
35
You know, we tried the whole, "Seafair without the Blue Angels" thing back in the mid-90s. Guess what? The Canadian Snowbirds sucked (and Thank God they vowed never to return). I mean, it's 4 freaking days a year. And we know EXACTLY when they're coming. Get a grip, people, because they're not going anywhere.
36
Thanks for your post, Jonathan, and for your comments, Jigae. I think it is incredibly important for people to be informed of all the ways that PTSD has an impact in everyday life.
It's bad enough knowing that we've spent who knows how many millions over the years on the war porn star whose stage name is Blue Angel, but knowing that in addition to the every day annoyance and the occasional broken window for regular folks, they also cause severe pain to vets makes it all the harder to accept.
PS Elenchos, you are a wanker on this one. The more you know.
It's bad enough knowing that we've spent who knows how many millions over the years on the war porn star whose stage name is Blue Angel, but knowing that in addition to the every day annoyance and the occasional broken window for regular folks, they also cause severe pain to vets makes it all the harder to accept.
PS Elenchos, you are a wanker on this one. The more you know.
38
So let me get this straight... because a very, very small fraction of the population has a bad reaction to the noise from the Blue Angels, they should stop performing in Seattle?
I'm willing to bet a larger part of the population has a bad reaction to the sound of ambulance and police sirens (in fact, I've known people who were terrified by the sound after experiencing their own trauma). Should we ban them too? Just because police and aid cars are doing a service, while the Blues are performing, doesn't mean the people are any less traumatized. I had a friend who would panic every time someone walked up the stairs in her apartment after living through the Northridge earthquake. We should probably ban stairs and loud walkers too. My cat is terrified of thunder. Can we ban that as well? I don't like rap music... get where I'm going?
I'm willing to bet a larger part of the population has a bad reaction to the sound of ambulance and police sirens (in fact, I've known people who were terrified by the sound after experiencing their own trauma). Should we ban them too? Just because police and aid cars are doing a service, while the Blues are performing, doesn't mean the people are any less traumatized. I had a friend who would panic every time someone walked up the stairs in her apartment after living through the Northridge earthquake. We should probably ban stairs and loud walkers too. My cat is terrified of thunder. Can we ban that as well? I don't like rap music... get where I'm going?
39
Jigae, you can't read. You really can't. I think you're getting carried away because you're one of those who thinks you're free to spout bullshit and not get called on it if you are hiding behind our sacred veterans.
This reminds me of Sarah Vowell's comparison of John McCain getting baited into losing his shit in the 2000 primary when one of his opponents suggested he didn't care about his dear veterans. Just like in The Godfather. It's in Take the Canoli.
Anyway, I never said any of the nonsense I'm being accused of. I don't care all that much whether the Blue Angels come back or not. But it's obvious they're going to keep coming back, if for no reason then the histrionic disarray of those aligned against them.
But I understand why you would get so angry at me. You think you can use injured veterans as a tool in your personal grudge against the Blue Angels show. You think acting like you care so much about them is your shield against any questioning of your reasoning. But you can't use them that way. If you actually care about them, then you'd be more interested in doing something to help them. Instead, the more the patients at the VA suffer, the more points you can score against the air show.
Shame.
This reminds me of Sarah Vowell's comparison of John McCain getting baited into losing his shit in the 2000 primary when one of his opponents suggested he didn't care about his dear veterans. Just like in The Godfather. It's in Take the Canoli.
Anyway, I never said any of the nonsense I'm being accused of. I don't care all that much whether the Blue Angels come back or not. But it's obvious they're going to keep coming back, if for no reason then the histrionic disarray of those aligned against them.
But I understand why you would get so angry at me. You think you can use injured veterans as a tool in your personal grudge against the Blue Angels show. You think acting like you care so much about them is your shield against any questioning of your reasoning. But you can't use them that way. If you actually care about them, then you'd be more interested in doing something to help them. Instead, the more the patients at the VA suffer, the more points you can score against the air show.
Shame.
41
@39: You're definitely right. Military planes going fast are super cool!
The point is that you expect that MDs to come up with a solution but you don't know what it is, but obviously there must be one that they just haven't thought of yet. Why haven't they thought of it? You can't answer that and you can't answer what it would be, and yet you are SO CERTAIN you are correct.
Meanwhile people in the psych and medical fields are offering knowledgable commentary and you are completely unwilling to listen to it. What part of this is logical?
I want the help them (and have) but can't do anything about this situation because I can't think of another solution. I'd love to hear about the work you've done for mentally ill veterans. Can you tell us more about it?
The point is that you expect that MDs to come up with a solution but you don't know what it is, but obviously there must be one that they just haven't thought of yet. Why haven't they thought of it? You can't answer that and you can't answer what it would be, and yet you are SO CERTAIN you are correct.
Meanwhile people in the psych and medical fields are offering knowledgable commentary and you are completely unwilling to listen to it. What part of this is logical?
I want the help them (and have) but can't do anything about this situation because I can't think of another solution. I'd love to hear about the work you've done for mentally ill veterans. Can you tell us more about it?
42
And I read Take the Canoli[sic]. I quite enjoy Sarah Vowell, although I prefer the Asasination Vacation. Get off your fucking high horse.
43
See, I said I don't much care whether they come back or not, and you said "Military planes going fast are super cool!" You can't read. Or you're deliberately misreading because you can't frame a coherent argument any other way.
Nobody from the psych field has commented on the Blue Angels in Seattle -- not in any real publication. If you only want to count these anonymous blog comments, well, that says a lot, doesn't it? Golob interned there for a brief time, and walked away thinking he knew better than all the doctors there, and the whole rest of the world too. As usual.
Because these planes have been doing this for 38 years, and yet only in 2010 has anybody brought up the VA hospital. Why is that? Golob's story does not add up.
Nobody from the psych field has commented on the Blue Angels in Seattle -- not in any real publication. If you only want to count these anonymous blog comments, well, that says a lot, doesn't it? Golob interned there for a brief time, and walked away thinking he knew better than all the doctors there, and the whole rest of the world too. As usual.
Because these planes have been doing this for 38 years, and yet only in 2010 has anybody brought up the VA hospital. Why is that? Golob's story does not add up.
44
I sympathize with the plight of the shell-shocked vets, but I am willing to bet that the people who go to these types of shows, and enjoy the hell out of them, are like 80% veterans. I know my Air Force vet dad adores them. For what it's worth.
45
@44: I know vets who love the show and vets who it traumatizes. I imagine there are more who enjoy it triggers some people badly.
@43: I don't get why this matters to you. I care because it effects me, people i care about, and people I've worked and volunteered with, on a pretty deep psychological level. If you REALLY don't care about the Blue Angels coming back, then what's your investment in this besides being right?
I'm attributing thoughts and motivations to you because otherwise what you're saying and doing just doesn't make sense to me. I'm fighting (debating, whatever) about something I care deeply about, but you're just fighting because you think in your layman's opinion that we're wrong or being disingenuous?
@43: I don't get why this matters to you. I care because it effects me, people i care about, and people I've worked and volunteered with, on a pretty deep psychological level. If you REALLY don't care about the Blue Angels coming back, then what's your investment in this besides being right?
I'm attributing thoughts and motivations to you because otherwise what you're saying and doing just doesn't make sense to me. I'm fighting (debating, whatever) about something I care deeply about, but you're just fighting because you think in your layman's opinion that we're wrong or being disingenuous?
46
@44 The airshow down in Tucson was chock full of vets and active duty service people of all generations. They are so into it down there you can board the jets, hang out with air craft specialists, climb in a Chinook, meet the Blue Angel pilots, etc. The air events down there at Davis Monthan AFB are huge and filled with military families.
http://www.dm.af.mil/library/aerospace&a…
http://www.dm.af.mil/library/aerospace&a…
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