From No Medical Reason
Corporal Paulsen’s battalion was still in Iraq when he came to my care. He had been injured several weeks earlier, was sent home by medevac to his family and was referred by his surgeon. The corporal displayed total paralysis of his legs, but there was no medical reason for it. When I entered the waiting room before our first appointment, the young man with the blond crew cut saw my dark green Marine Corps utilities and desert boots. As a Navy clinical psychologist assigned to a Marine operational unit, I was authorized to wear their uniform. The corporal rolled forward in his wheelchair and shook my hand firmly.“You have no idea how great it is to see that uniform, ma’am,” he said with a grin.
Once in my office, knowing I would need to start slowly, I pulled my chair up next to his wheelchair and leaned back. Before I spoke, I noticed he was looking at the pictures from the war on my bulletin board. Most were of the colleagues I’d served with during my seven-month deployment to Iraq in 2004 while part of a team providing mental health care for thousands of Marines. One of my photos framed the mosque on our base within multiple circles of razor wire.
The corporal seemed focused on that photo.
“That’s Al Asad,” he exclaimed.
I nodded.
He looked at me. “So, ma’am … you were there.”
“Yes,” I said. “I was there.”
The corporal knew that his doctors could find no objective reason for his inability to move his legs. “It’s called conversion disorder,” he told me expertly. “I guess it means that my mind is messing with my legs.”
I smiled. He was right. That was exactly what it meant.
Names and identifying characteristics have been changed to protect privacy.
Tremendous Guilt
He started talking. He told me of the closeness of his unit and of his tremendous guilt about being home while they still fought in Iraq. He told stories of literal hand-to-hand combat, of the day he killed a man with his Ka-Bar knife when he was too close to use his rifle. He described the day he was shot.“We were on the roof of a building. I was standing next to my lieutenant. I don’t really know what happened—just this huge impact. And I fell.”
“Off the top of the building?” I asked.
“Yes, ma’am. And a bunch of rubble fell on me, and I was pinned. My rifle dropped away during the fall, and when I could see through the dust, I realized I was stuck and couldn’t reach it. I couldn’t actually see the bad guys, but I knew they’d be coming soon.”
I stared. “What happened?”
“I yelled up to my platoon to get their asses down there, and they yelled back for me to hold tight. It was pretty damn scary, ma’am. Pardon my language.”
“No problem. So obviously they got down to you.”
“Yeah, they did. You know what’s amazing? You know the body armor we wear? It stopped two AK-47 slugs. They’re actually stuck in the plate. I asked if I could have it back. They said I could.”
“That is amazing.” I made a note to go back to that story another time.
I noticed that the corporal’s skin was graying, that beads of sweat were forming on his forehead. “Anyway, I guess I passed out,” he continued, “because the next thing I remember was the hospital.”
“No damage to your spinal cord?” I asked. “After a fall and having something fall on you that was heavy enough to actually pin you?”
“That’s what the MRI says, ma’am. See for yourself. Says my back, legs, neck—everything—are fine. Guess it’s just my head that needs help.”
“You know, combat can be really traumatic,” I said. “People who have been through it sometimes experience a slow recovery from that trauma. It’s normal.”
“Yeah, but most of them don’t end up in a wheelchair, do they, ma’am?” He smirked at me. “I figure my body is trying to tell me something. And now it’s up to you to figure out what it is.”
I smiled at him, stood up, shook his hand and held the door open for the wheelchair. “Actually, that’s up to you. I’m just here to watch it happen.”
Best Friends
Three times a week for the next six weeks, Corporal Paulsen came to see me in conjunction with his physical therapy appointments. I spent the first several meetings just listening, hoping to gain his trust. And then one day, he told me.“A good friend of mine from when I was a kid—everyone called him Mule because he was stubborn and ornery—showed up at my battalion right before we left for Iraq. I could not believe it. He asked me what I’d been up to since graduation, and I said I had joined the Marines. He said he’d joined the Navy. He was our corpsman. You know, don’t you, how we feel about our docs?”
I nodded.
His eyes misted over, but he went on. “Mule and I were always together from that moment on. We were best friends. We carried each other’s letters when we went in country.”
He bowed his head. I knew we were getting somewhere. The usually effusive corporal now visibly struggled to find and express his thoughts.
I waited through a long silence.
At last, he looked up, but not at me. Glassy and unfocused, his gaze appeared thousands of miles away as he spoke.
“One day, we were on patrol. I was on point, and behind me were the lieutenant, Mule and another Marine. We approached a brick wall, where we waited while another fire team entered a building. They immediately took fire from bad guys on the roof who were shooting down at them. One of them was hit, and someone yelled, ‘Corpsman, up!’”
He inhaled deeply and seemed to hold his breath. I watched him.
“Mule came around the lieutenant and grabbed me by the shoulders, pulling me back and rounding the corner in front of me, not giving me a chance to cover him while he ran for the building. The guys on the roof lit him up. They shot him 45 times while I watched. When we finally carried his body to the helo, I could see daylight through him. He had this surprised look on his face. I closed his eyes so I wouldn’t have to look at it anymore.”
The corporal sighed heavily. Big tears lingered in his eyes. I reached out and placed one hand on top of his, breaking one of my own rules of therapy. “I’m so sorry for the loss of your friend,” I whispered.
“Thank you, ma’am.”
We sat in silence together.
I did not speak another word and let him cry.
In Spite of Pain
Two days later we met again.“That was pretty intense last time,” he started.
“Yes.”
“I haven’t told anyone that story. It felt good to tell you.”
“Have you thought any more about what it might mean?”
“Like what?”
“Well, I was thinking about you and Mule. And I was wondering, What feelings do you have now about his death? Other than grief at the loss of your friend?”
“Anger, I guess.”
“Go on.”
“Well, I’m pissed off that he didn’t let me cover him. I’m pissed off at the bad guys for killing him. Mostly, I’m pissed off that there was nothing I could do.”
I nodded. “Anything else?”
“Guilt.”
“Why guilt?”
“It should have been me.”
I waited.
“I mean, I was point. I should have gone first.”
“And if you had gone first?”
“Mule would be alive. He’d be the one delivering my letter to my dad.”
“Tell me, if Mule had not gone around you—if he’d waited for your signal—what would you have done?”
“I would have moved my team out, around the corner,” he said.
“How would you have moved out?”
“Ma’am?”
“What would you have done physically, to move out?” I asked.
“Well, it’s called a creep, kind of like a walk-run, which we do when we’re moving around with weapons. I’m not sure if you’ve ever seen it …”
“Sure. And this walk-run: What exactly does it involve? What is the logical progression of the parts of your body in order to creep?”
“I would have just stepped forward, ma’am—taken two or three steps forward, and they would have killed me.”
“Right. Two or three steps forward. How?”
“With my feet.”
“Exactly.”
He looked at his motionless legs and then back at me. Suddenly, he smiled.
Four days later, I cut through the pharmacy on my way to the psychiatric ward. As I approached the hospital’s main passageway, the raucous cheer of voices filled the air.
I rounded the corner and froze.
Corporal Paulsen was walking. He had exited the door of physical therapy with a walker, flanked by therapists, physical therapy techs and his father. Just before he saw me, he had released his hands from the handles and taken a step unassisted.
I drew in my breath.
He grinned widely. “Hey, ma’am! Look at me.”
“Look at you, Marine! You are a sight for sore eyes.” I felt my smile spread across my entire face.
“I guess my wheelchair had a purpose. But it doesn’t seem to anymore.”
“Sure looks that way to me.”
The corporal would survive. His experience would always be with him, and he would survive in spite of it.
Even, some days, because of it.