TERRY GROSS, HOST:
This is FRESH AIR. I'm Terry Gross. On this Veterans Day, we're going to talk about an injury many veterans face that goes largely unacknowledged - moral injury. My guest David Wood says it's a relatively new concept that describes what many veterans of war feel - a sense that their fundamental understanding of right and wrong has been violated and the grief, numbness or guilt that ensues. It's an injury that's been described as a bruise on the soul. Wood wrote a three-part series on moral injury for The Huffington Post. He's their senior military correspondent and won a Pulitzer Prize two years ago for his series on severely wounded veterans of the wars in Iraq and Afghanistan. Wood has covered the military for over three decades and has reported from several war zones. He embedded with U.S. troops during four trips to Iraq and five to Afghanistan. David Wood, welcome back to FRESH AIR.
DAVID WOOD: Thank you, Terry.
GROSS: You write that the signature wound of this generation of veterans is moral injury. I'd like you to describe what that is.
WOOD: It's a very broad term that describes the deep emotional and moral discomfort or pain that people experience in wartime. We have widely described veterans as suffering from PTSD - posttraumatic stress syndrome - there are people who do suffer from PTSD. But I think that almost everyone who returns from war has suffered some kind of moral injury. And I do not mean by that that they have done something wrong, only that they have seen or experienced things which violate their own sense of who they are, their own sense of right and wrong, their own sort of moral compass.
GROSS: Give us an example.
WOOD: I wrote about a young Marine named Nick Rudolph, who was 22 years old. It was his second combat tour in Afghanistan. Found himself in a firefight - a bad firefight - in which there was a lot of casualties on both sides, the Marines and the Taliban. At one point, he saw a figure coming around the corner of this adobe farm compound where the Taliban were shooting at them. This figure he saw out of the corner of his eye was shooting at him, he raised his M4 carbine, got the figure in his sites, realized it was a 13-year-old boy, hesitated for a second and then shot him dead. Now, in that circumstance, the perfectly correct and moral thing to do is that he was protecting himself and his fellow Marines from a threat. But now Nick Rudolph is back home in Philadelphia and the circumstances are different. He killed a child, and that's not OK. In fact, it's one of the worst things you can do. So this dual moral code, where something you are required to do, even rewarded for doing in combat, back in civilian life, it's not OK. And Nick struggles with that. He thinks about it a lot. It's obviously not something he's proud of and so it's a moral wound.
GROSS: I want to quote a military physician who you quote in one of your articles in your series on moral injury. And he says most people enter military service with the sense that they are good people and doing this for good purposes. But things happen in war that are irreconcilable with the idea of goodness and benevolence. And that's where, like, the confusion and the agony come in. That last sentence was mine not the military physicians. But would you tell us another story that illustrates the kind of suffering caused by what is now described as moral injury?
WOOD: Sure. I got to know the story of a young man named Joey Schiano, who was 22 years old in Afghanistan. He was a member of a battalion whose - many of whose members I've come to know, 1st Battalion, 2nd Marines, commonly known as 1-6. And he was in, again, a bad firefight, they were pinned down in a gully in Afghanistan taking fire from an adobe farm compound, which is so often the case in Afghanistan. And they couldn't move forward, they couldn't move back. They were just stuck there. And finally, the combat commander said to Joey Schiano, put a rocket in that building. This is a shoulder fired weapon, that fires a pretty big charge. And it's used to destroy tanks. Against an adobe compound it's devastating. So Joey put the launcher on his shoulder, took aim, pulled the trigger, and it blew away much of the building. In the chaos that ensued from that, they could all hear people yelling and screaming and their interpreter said they want to bring out the wounded. And when they started to bring out the wounded, they found that most of them were women and children who had been herded into that corner of the building that Joey Schiano's rocket had destroyed. He was devastated of course. It was war. It was an enemy target. He did the right thing. But again, he was responsible for the deaths of women and children - or he felt he was responsible. He had to finish out his combat tour. He came home, got out of the Marine Corps. And eventually died in a traffic accident, which may or may not have been suicide, we'll never know. But we do know that he had nightmares about those women and children for the rest of his life.
GROSS: We're using the term moral injury to describe the kind of suffering many soldiers and veterans face after doing something that they feel terrible about, like killing a child who had a weapon or following orders and blowing up the building and finding out you've killed women and children. So we're using the term moral injury - is that like a medically accepted term now? Is it an official diagnosis?
WOOD: No, it's not. Moral injury is not recognized by the Defense Department and the VA - there are people in the VA who acknowledge it and study it and treat it, but overall, the VA doesn't recognize it either. It's not surprising because how could the government recognize that sending people to war inevitably causes them harm? So that the treatment, and even the recognition, even a therapist explaining to somebody why they may feel bad is sort of hit and miss. There are really good therapists around the country who are doing this kind of work. There is a growing body of research which pinpoints what moral injury is and how people who are suffering from moral injury can be helped. But by and large, I think most veterans who feel some kind of moral injury go untreated.
GROSS: Who came up with the term?
WOOD: I think it was Jonathan Shay. He was a VA psychiatrist at the VA Medical Center in Boston. And he worked with Vietnam veterans. And it took him a long time to realize and to more precisely define why they were so agitated, uncomfortable, angry, depressed. And it wasn't PTSD; it was something different. And he coined the term moral injury to describe a sense of betrayal that people go into war thinking they are good people and this is a good cause and good things will come out of it, and inevitably they find none of those things are true. Well, almost none of them, I should say. A lot of people come out thinking I am a good person, but I still did bad things, or I was forced to do bad things, or I took part in bad thing.
GROSS: And even if the war is ,you know, a just war, or a war that you think needed to be fought, there are still going to be things probably that a soldier is called on to do or ends up doing in a split-second decision that they will feel guilty and torn about.
WOOD: That's true. But I also should say that a lot of people experience good things in war. For example, the incredibly tight camaraderie that people under high stress linked together in a cause can feel and often do. I've talked to many, many combat soldiers and Marines who say that they are closer to the men in their fire team, or their squad, or their platoon than they are to their own wives. They share so much together and undergo so much together. And one of the things I've come to see as moral injury is when they leave the service, they leave behind the people they love most in the world. And even if they, you know - apart from whatever happened on the battlefield, their sense of grief and sorrow and loss when they leave the service and leave behind their buddies is immense and, I think, way underestimated. And of course, they all say, well, we'll get together and we'll have reunions, but it's never quite the same. So imagine a veteran coming home and he's, again, he's lost the people that he loves most in the world. He's back with his family. He feels guilty about having left them to go to war, two or three times perhaps. And his wife says, honey, what's wrong, you know, you seem angry, and anxious and depressed? How is he going to tell her, you know, I lost the people I love most in the world? It's a thing that I think almost everybody who comes back from war carries on into civilian life. And it's not a disabling moral injury, but it's a bruise on the soul nonetheless and one that they carry, I think, for a long time.
GROSS: My guest is David Wood, senior military correspondent for The Huffington Post. We'll talk more after a break. This is FRESH AIR.
GROSS: This is FRESH AIR. My guest is David Wood, senior military correspondent for The Huffington Post. He wrote a three-part series on moral injury, a relatively new concept that describes what many veterans of war feel. A sense that their fundamental understanding of right and wrong has been violated, leading to grief, numbness or guilt.
For the mental health workers who are trying to deal with what we're describing as moral injury, how does the treatment compare to treating posttraumatic stress disorder?
WOOD: Posttraumatic stress disorder is a reaction to a terrifying experience - a life-threatening experience. So it could be a car crash, it could be being wounded in battle. And you know that when you're faced with a scary situation your heart rate speeds up, you start to perspire, adrenaline floods your system, your eyesight gets better, your hearing becomes more acute. All those things would help you through that crisis. The problem with PTSD is that when people are no longer in a life-threatening situation, something can trigger that physical reaction. So that a veteran with PTSD may walk into Walmart and something might trigger - who knows, you know, two shopping carts slamming together, or a noise, or a smell or something triggers his reaction. And all of the sudden, he's like honey I've got to leave. I can't go through this. And she's like what's wrong? And he's just sweating and breathing deep and sort of freaked out. So that's PTSD. And the treatment for that is to get people to anticipate when their symptoms might be triggered and to overcome through various means to dampen the response - the physical response - to that.
Moral injury is very, very different. It's not caused by a life-threatening situation. And it's not physical. So, that the treatment is very different. And some of the best treatment I've seen involves helping the person to see that he or she is not completely responsible.
GROSS: Can you expand on that?
WOOD: Yeah. So one of the very simple therapies I've come across involves the therapist asking the veteran to describe the situation in which he felt morally injured. So let's take Nick Rudolph, who shot the 13-year-old child. In therapy, for a person like that, he or she is asked to write down all the people or powers that had agency that played in that situation. So that, you know, Nick Rudolph himself, the Taliban, the boy, various other people had some influence on what happened there. And to each person or power you assign a percentage of responsibility. So what's important in this therapy is to acknowledge that wrong was done. Nick Rudolph shot a child. That's not OK. And you can't undo the harm that was done. It's just - it's done, and you have to acknowledge it. So the therapist might say, Nick, let's give you 20 percent responsibility. Who else? You know, the boy who was shooting at you, let's give him 20 percent. The Taliban and who taught the child to carry a gun and to shoot it at Americans, let's give them 30 percent. Who else? Well, perhaps the squad leader or the combat commander who was there at the time who got them into the firefight. And so on and so on and you add them all up. And Nick Rudolph can come to see that, OK, well, what I did was wrong, but I'm not solely responsible. And it doesn't have to define me for the rest of my life. I am not totally that person that shot a child.
GROSS: So did you talk to anybody who went through that kind of therapy of dividing the responsibility for the action? And realized, like, yes, you're responsible, but only partly responsible. There are other factors that made that scenario inevitable. So did you talk to anybody who actually found that helpful?
WOOD: Yes, I have. I found several people who found that kind of thing helpful. But the biggest thing that they told me was that they're carrying around this horrible idea that they are bad people because they've done something bad. And they can't ever tell anybody about it or they don't dare tell anybody about it, and may not even be able to admit it to themselves. And one of the most healing things they have found is to stand in a group of fellow veterans and say this is what happened. This is what I saw. This is what I did. And to have their fellow veterans nod and say I hear you. I hear you. And just accept it without saying well, you know, you couldn't help it, or you're really a good person at heart. But just hearing it and accepting it and not being blamed or castigated for whatever it was that you're feeling bad about. It's that validating kind of listening that is so important to all the therapies that I've seen. And again it's a lesson for those of us out in the civilian world - if we can learn to listen to veterans in a validating way that makes them feel like I'm not crazy, and I'm not a bad person. And, you know, it's the unspoken secret that veterans know and that we in the civilian world try not to know, which is that war is bad for human beings. It's just - bad stuff happens. And we try to pretend that it doesn't. And they're unable to talk about it. And so the awkwardness that can happen between a returning veteran and civilians in an airport where somebody will say thank you for your service. But it's awkward because we civilians don't know what the veteran did and they know that we don't know what they did. And so there's this vast ground of incomprehension between us and veterans. And I think this is why we need to learn not only to hear their stories, but to understand in a validating way what has been done to them in wartime.
GROSS: You were mentioning the importance of listening. And how one of the therapies is kind of like vets talking to each other about actions they've done during wartime that they feel bad about, that they feel guilty about. There's a battlefield ritual that you describe in one of your articles that was conducted by a chapel in a ritual for cleansing and forgiveness. Would you describe that?
WOOD: So this was in 2007. It involved a National Guard Infantry Battalion from Pennsylvania. And they were - spent a year outside of Ramadi in Iraq and it was a terrible year. There were a lot of casualties; a lot of bad stuff happening. Civilians being tortured by the Iraqi rebels - al-Qaida, actually, in that part of Iraq, just horrible, horrible, horrible stuff. And at the end of the year the chaplain gathered the Battalion and he asked everyone to write down on a piece of paper something that they saw that disturbed them, or that they felt bad about, or guilty about, or something that they had done or not done, things that they had seen that they'd rather forget. And they all wrote those down on little pieces of paper and then they gathered them in a cement baptismal font, like a big sort of birdbath. And this was in the evening outside of Habbaniyah. And it was a lovely, soft evening when the heat was fading, and there was a slight breeze. And the chaplain gathered them all - all the pieces of paper - and lit them on fire. And they all watched as the smoke and embers rose into the sky. And then they went home. And the chaplain - what he had in mind was something that he'd read about cleansing rituals that, for example, have been developed by African villages in response to their children being kidnapped and forced to become child warriors. And then after several years coming home having done horrible things. And there needed to be some kind of a cleansing or healing or forgiveness ritual to enable them to take up their life in the village again. And this was his attempt to sort of do that kind of thing. Now, I'm not suggesting that everyone who comes home from war needs to be forgiven. I do not think that's the case. And again, I don't want to overstate the issue of moral injury. Lots of people have good experiences at war. Among them, the camaraderie that develops. There are good things done. There are moments of incredible heroism. The selfless sacrifice that I've seen among combat soldiers, and Marines and those who are in the other military services is incredible and we should honor that. But we should also recognize that as one Marine told me you can be doing everything right, everything by the book, everything by the moral code and bad things still happen.
GROSS: David Wood will be back in the second half of the show. He's the senior military correspondent for The Huffington Post, where his three-part series on moral injury was published. I'm Terry Gross and this FRESH AIR. Coming up, more with David Wood about the moral injury many veterans contend with. And we'll talk about why Wood has spent years as a war correspondent in spite of his Quaker background and his status as a conscientious objector during the Vietnam War. Also, Kevin Whitehead reviews the new album by the Oliver Lake Organ Quartet.
GROSS: This is FRESH AIR. I'm Terry Gross, back with David Wood, senior military correspondent for The Huffington Post. He won a Pulitzer Prize two years ago for his series on severely wounded veterans of the wars in Iraq and Afghanistan. This year, he wrote a three-part series on moral injury, a relatively new concept that describes what many veterans of war feel - a sense that their fundamental understanding of right and wrong has been violated, leading to grief, numbness or guilt. I think what we're describing as moral injury is probably as old as war itself. But now there's a name for it and there's a way of, you know, explaining what it is and therapies being created for helping people who suffer with this. What's changed? Why do you think we're coming up with, like, a name, a diagnosis and, you know, a way of addressing it now?
WOOD: I think, Terry, for two reasons. One is these are long wars that we've been through and people have been exposed to war over and over and over again and the effects are cumulative. And so that's one thing. The other thing is that both the war in Iraq and the war in Afghanistan were fought not to kill and vanquish the enemy, but to do good to build new societies. You know, President Bush used to say as the Iraqis stand up, we'll stand down. It was all about building something better. I really wonder if you could do that with war. But I think what many people experienced was a sense of disappointment and betrayal that, you know, they went over there - many people signed up for the military after 9/11 - and really deeply believed in the mission, which was to help people build better society's against extremists. And many people didn't find that to be true when they went to war. One Marine told me that after two combat deployments, he said we're not helping these people, we're hurting them. And not only that they hate us. They're trying to kill us. It's terrible. He said I just feel awful about the whole thing. So there was no clear victory to be had. And so I think people came back feeling vaguely dissatisfied, at least, that what they'd done, what they'd given up several years of their lives to do, what they left their wives and children to do wasn't actually so noble in the end. And let me say a word about this whole idea of just war, which if you've spent any time on the battlefield you realize is a total sham. There's no just war. It's, you know, it's basically saying well, if we think our cause is just then you can go ahead and kill on our behalf. Oddly enough, in the Quran they have the same idea. It says you can kill if your cause is just. Well, you know, how do you - how do you justify the situation that Nick Rudolph got in? Tell Nick Rudolph that he shot that child and it's OK because his cause was just. It doesn't wash. And so many things happen in wartime that are unjust that I think the whole idea of a just war is something that should make us back home feel better about sending people into war. But the people we send to war struggle with it and they don't feel better.
GROSS: I should point out here something that we talked about the last time you were on the show, which is although you spent decades as a military reporter, you're a conscientious objector.
WOOD: I started - I grew up in a Quaker family and was a conscientious objector during the early years of Vietnam War. And I did two years of civilian service instead of going into the military. And then I became a war correspondent, much to my mother's chagrin. And I spent decades covering wars, being in wars, being embedded with U.S. and other troops. And it took me a long time to realize that - I mean, I loved it. You know, I honored the people who I was with. You know, they are the best of this country, I think. They are, you know, what I call the working-class military. The people who are the trigger-pullers and the wrench-turners and the patrol walkers and the aircraft mechanics and the flight crews and, you know, the people who actually do things. They are just delightful. They're smart and they're ambitious and they're funny and their sense of self-sacrifice and discipline are amazing and they are unerringly generous and honorable. And one hates to see what happens to them, and it's sort of driven my desire to learn more about moral injury and try to explain it so that we can do a better job of relating to them.
GROSS: As a reporter who's covered war for so many years, were you ever in a situation where you feel you faced the possibility of moral injury?
WOOD: Yeah, very early in my career. In fact, the first time I was under fire, it was in Ethiopia during a silly little war between Somalia and Ethiopia. But it wasn't silly where I was. And it was my first time as a former conscientious objector, a pacifist and, you know, a kid from the white suburbs who wandered into becoming a war correspondent with no - no training, no special equipment or knowledge or anything, just sort of Mr. Magoo at war. And there was an air strike and a lot of people were killed. There were a lot of casualties. It was a terrifying noise, and I was just catatonic with fear. And there was a man who was wounded who was dragged on a blanket to a tree where I was - I had my back up against the tree. And the people dragged him there and just left him there and he died in front of me. And it was the first time I'd seen someone die violently. And he needed a drink of water. And I was too scared to get up and get it for him, and so he just died. And I didn't feel sorry for him or guilty or anything; I just felt numb. And, you know, thinking back, I mean, it's a very minor thing, but it helped me understand what people go through in wartime when they do something or fail to do something that they know is right and they should have done but they didn't. And that was - that sort of - that experience helped me understand a little bit of what people go through in wartime.
GROSS: In what way was that experience that you just described a minor thing?
WOOD: Well, I didn't - I didn't kill a civilian. I mean, look, people that we send to war face extreme stress and situations of extreme moral and physical danger. I don't count that experience as part of that. It was just something that I should've done. I sort of knew it at the time. I was too scared to do it. I felt guilty about it many decades later. I could've given this young man a drink of water before he died and I didn't because I was too selfish. I was too worried that if I got up and moved I'd get shot or killed or something bad would happen. So as I say, it's a minor thing in retrospect, but it did help me understand what other people have gone through.
GROSS: If you're just joining us, my guest is David Wood. And he's a senior military correspondent for The Huffington Post. He won a Pulitzer Prize two years ago for his series on severely wounded vets in the wars of Iraq and Afghanistan. David, let's take a short break then we'll talk some more. This is FRESH AIR.
GROSS: My guest is David Wood, senior military correspondent for The Huffington Post. He's covered the military for over three decades and embedded with U.S. troops during four trips to Iraq and five to Afghanistan. You're a conscientious objector and during the Vietnam War you served two years of civilian service, as an alternative to fighting. When you've been in war zones over the years, embedded with the working military, did you mention that to the soldiers who you were - who you were following? And I'm wondering what kind of conversations that led to.
WOOD: In a couple of instances I did. I once embedded with a Marine battalion for a year. And there was a Sergeant major in that battalion who I knew hated journalists and pacifists - woah. This guy was a big scary guy. And I could see him occasionally glaring at me from a distance. And one day, about eight months into the year, we were on a combat operation actually and we came to sort of a pause. And he came striding over to me. I thought, oh, here it comes. And he said, I understand you're a conscientious objector. I said, yes, Sergeant major. He said, and you were out protesting the war in Vietnam, while I was there fighting and a lot of my guys were dying. I said that's right, Sergeant major, I was. And he looked at me for a long time and he said that's where I should've been with you protesting that damn war instead of being there in that needless bloodletting. I was astonished. I was really astonished. But it's not uncommon for people who have the most experience at war to recognize this is not a good idea, that even though war is a vehicle sometimes for extraordinary acts of selflessness and heroism and courage and sacrifice, that overall, war is a bad business and we shouldn't be doing it. And I think a lot of combat veterans come to that realization.
GROSS: So do you consider yourself a pacifist or were you just, like, an objector to this specific war in Vietnam?
WOOD: No, I grew up pretty well convinced that that war was a bad idea. And I was very taken with the idea of nonviolent action as a way to achieve social and political goals rather than killing each other. And I think I've come back to that idea. And of course you're always going to need military forces just as you always need police forces. But I think we need to be way more judicious in the way we employ our military forces, recognizing that we are sending people into grave danger, and the physical and moral and emotional damage can be huge. I'm not so much against using military force as I am against using it thoughtlessly.
GROSS: So, I mean, this is just a real paradox of your life, that you're a conscientious objector who has spent more time in wars zones than most soldiers have because you've been covering wars for, you know, three decades. So you've spent a lot of time with combat troops. So there must be something within you that wants to be there.
WOOD: Oh, sure. I mean, it's thrilling in a way. Apart from being a journalist, just being part of a large adventure like that is very, very compelling and for a journalist, a very rich experience in the sense that things happen which are primal - violence, courage, greed, betrayal - all of that plays out, you know, right in front of your eyes. And I especially like writing about, again, what I called the working class military, a term that I use fondly to describe the people who are not back at staff headquarters, but the people who are out there, you know, actually doing the work. Being with them is just thrilling, and I love telling their stories. And I learned a lot from them. I always stand up straighter when I'm with them. I always try to dig down to my own sense of humor when I'm with them. They're just inspiring people. And that's why when they've come home and become veterans and civilians once again, it's so important to me personally that we don't let them drift, that we welcome them back in whatever way we can.
GROSS: Since there's likely to be a debate in Congress soon about ISIS and what military action we should take, what would you like to see us do as a country in reflecting on that before we make a decision?
WOOD: Well, two things - one is that it would be nice if we acknowledged up front that the more people we send into the war zone the more we are going to owe them when they come home. And that means fully funding the VA and expanding the VA programs. It also means making more money available to the 43,000 local community nonprofits that serve veterans around the country. An absolutely astonishing thing that I didn't realize until recently, that there were that many organizations in which, you know, which need money and volunteers. So that's one thing. The second thing is I think we need to realize that war is hard on human beings and that if we're going to send a lot of people into - or any people - into combat, we need to account for the emotional and moral burden that will place on them.
GROSS: So the war in Afghanistan is ending. And there's going to be a lot of veterans coming home at the same time. But what are some your thoughts about that?
WOOD: There are 1.9 million American military personnel who served in Iraq or Afghanistan. Because many of them went two, or three, or more times, I think the total number of deployments is about 2.3 million. But in any rate, it's a lot a people. And they're coming home now and trying to figure out how to get on with their lives. Many of these veterans, Terry, are - have never been civilians before. You know, they grew up, went to high school and then enlisted. And so their adult experience is entirely within the military. I've been talking to business leaders about this and they're astonished at how many people are coming out of the military who have never had a job interview, never written a resume, have never held a civilian job, have no clue, are sort of terrified of the prospect of putting themselves out there in a very alien kind of environment in many ways. So there are all these people flooding back and the thing that strikes me is that they are used to taking a lot of responsibility. They have a lot of self-discipline. They are smart and ambitious people. They have huge life experiences under their belts. They have been leaders. They have been teachers. The responsibilities that they held in the military are huge. You know, someone who's 22 years old is a combat leader leading men in combat - men or women. And when they come back into civilian society they've lost that responsibility and lost that stature. I was on a combat patrol once with a 21-year-old Marine. He was so good. I felt totally protected in his care. He was careful. He was knowledgeable. He was smart. And they are of such incredible value to our society that I hope that we continue to welcome them home and not, as we did after Vietnam, just ignore them. We're doing a better job of that. There's a huge amount of public goodwill towards people in the military and we need to sustain that and remember that they are, in many ways, struggling to figure out how to fit back in. And we can help them in all kinds of ways.
GROSS: Are there any special things you do on Veterans Day?
WOOD: Yeah. I often very, very early in the morning on Veterans Day - I live in Washington - so I go down to the Korean War Memorial in Washington, which is one of my favorite places. I don't know if you've ever been there, but it's a platoon of soldiers - slightly larger than life size sculptures - and they're just walking on a combat patrol and it seems to be raining. And they're carrying heavy loads and there they are. They're just there and at war. And the burden of war is written on their faces - fatigue and maybe fear and alertness. It's just a beautiful place. And I like to go there early in the morning when no one else is there and then I leave.
GROSS: Well, David Wood, thank you so much for talking with us and thank you for your reporting.
WOOD: It's been a pleasure. Thank you, Terry.
GROSS: David Wood is senior military correspondent for The Huffington Post. You'll find a link to his series on moral injury on our website freshair.npr.org. This is FRESH AIR.