Fixing Hell (15 page)

When Smithon saw me, he obviously realized who I must be. He grabbed me firmly and said, “Sir, I’m so goddamned glad to see you. I’ve been pinch-hitting as the post shrink since I got here. I have no idea what I’m doing. I medicate most of the psychotic patients and suicidal patients so they’re not a danger to themselves or us.”

“Is the post psychiatrist or psychologist not very helpful to you?” I asked.

He replied, “Shit, sir, there ain’t none here.”

For the umpteenth time that day/night, I was flabbergasted. “What is the population on this post, Major?” I asked.

“Well sir, we have about six to eight thousand prisoners, sometimes it’s hard to tell because the numbers change every day, plus we have about two thousand soldiers and marines here as well, sir.”

“Are you telling me, Major, that we have ten thousand people on this post and mental health services are not available?” My voice was rising despite my attempt to remain calm.

“Yes sir, that’s exactly what I’m telling you,” he replied. “The 322nd Medical Brigade sends a psychologist and a chaplain here once in a while, but that’s only to see U.S. soldiers and marines.”

“Well, why don’t the psychologist and chaplain treat the prisoners while they’re here?”

“Sir, they tell me that they were ordered by the commanding general of the 322nd Medical Brigade to not provide any services to prisoners. Their general thinks it ain’t his mission to provide mental health care to prisoners.”

I stood speechless. I struggled for words that appropriately described my emotions and none came. This wasn’t even a conflict between my roles as doctor and soldier. Certainly in my position as a psychologist this offended me, but it outraged me just as much in my role as an Army officer. Deliberately withholding mental health care from prisoners—when they clearly needed it and the help was available—was inexcusable. I was filled with a rage and a deep sense of shame for my country that I had never before felt. At that moment, it occurred to me, I had just walked into a new mission.

On top of guiding the intel center out of the abyss of shame, I would need to build a mental health system for the prisoners as well as the soldiers. This would be a daunting task: nowhere in the entire country of Iraq could you find extra psychiatrists, psychologists, or social workers simply standing around with nothing to do. I was on my own in these early days, with no biscuit staff to share the workload.

But I did have support. From the first meeting I had with General Miller after arriving, he emphasized that he was behind me. This took care of Step 1 of my plan right away—have the commanding general be my only boss. He also stressed that he expected me to come up with the solutions that would set Abu Ghraib right. He made it clear to the leadership on post that I had open access to anything I needed to accomplish the mission. I was tasked with putting together for him a plan for what we needed to do in order to improve morale, interrogations, the work done by the MPs, facilities, health care for the detainees and the staff, post security, and how I would manage the overarching psychological despair at Abu Ghraib.

The second day I was in Abu Ghraib, I introduced myself to the commanding officer of the Combat Support Hospital. Their mission was providing medical services for the roughly eight thousand prisoners and the approximately two thousand soldiers and marines at Abu Ghraib. The commanding officer of the Combat Support Hospital was a disheveled-looking, elderly colonel who was the senior physician of the medical team at Abu Ghraib. Colonel Barksdale was a well-respected physician back home in Fresno, California, but in this combat zone his soft-spoken style, depressed personality, and schizoid tendencies served neither the mission nor his team of doctors, nurses, and medics very well. Some would refer to him as a “quiet and distant leader.”

That was a nice way of saying that the man’s brain and heart were fried. The instant I looked into his eyes and shook his hand, I saw that empty combat stare—a stare that allowed me to see his pain, almost like a reflective mirror into his soul. I could see the deep, vast emptiness in his emotional reserve tank. I knew that Colonel Barksdale had become engulfed in the “fog of war.” It’s called a fog because it is like trying to navigate in a thick fog; a lack of clear vision and poor judgment were common and poor decisions would be made. Colonel Barksdale had become an ineffective combat leader and I needed to do whatever I could to help him. His eyes had that “deer in the headlights” stare, which was not a good look for the person in charge of the post hospital. He had a scruffy look about him with his hair uncombed and his uniform a mess. His words rolled off his lips from the side of his mouth in a mumble most of the time. He was angry and I would come to learn why. He felt abandoned by the commanding general of the 322nd Medical Brigade, who was living in luxury back in Baghdad’s Green Zone. Like for Major Smithon, Colonel Barksdale’s requests for additional staff, basic medical supplies, and support were denied or caught up in motionless bureaucratic red tape. It was as though the Abu Ghraib medical staff were either an inconvenience or an embarrassment for the medical leadership in the lavish Green Zone.

Colonel Barksdale’s appearance and attitude were troubling, but I was gratified to see that he was not giving up on his mission. Even though the colonel and his medical staff were mentally fried, they continued to drive on and do the best they could with few resources from senior medical leaders. They regularly saw the horrors of war but their needs were constantly shunned by the medical leadership in Iraq. In spite of this, they still managed to save many lives and care for many prisoners and soldiers. As I saw them struggle on despite the circumstances, I felt privileged to know them.

Colonel Barksdale and his people were kept busy because, as I was constantly reminded, Abu Ghraib was a dangerous place. He told me about how one night before my arrival, Iraqi insurgents started aimlessly firing mortars into the Abu Ghraib compound. Rather than killing American soldiers, these mortars landed inside the prison camp that housed many Iraqi prisoners. On that night, twenty-nine Iraqi prisoners were blown up by their own people in that senseless attack. Colonel Barksdale and his medical team worked all night in the emergency room and surgery units of the Combat Support Hospital, saving many lives. Guts, brains, eyes, limbs, and raw human flesh peppered the prison camp ground. The Joint Intelligence and Debriefing Center, which bordered the prison camp, was almost overrun by prisoners running through barbed-wire fencing fleeing the mortar carnage. That seemed to be the turning point psychologically for both the medical staff and many at the intel center, the point at which their minds started sliding downhill fast. By the time I arrived, it seemed as though they were still performing their medical duties, but they had the facial expressions of firemen whose buddies had died when a burning roof collapsed from above as they all watched. Like these firemen, often their only choice was to stand and watch others die.

My days were packed with meetings, walking around the Abu Ghraib post, consulting with the military police, interrogators, and medical staff. In addition, I had to find two other psychologists in the United States and some enlisted psych techs to build a biscuit team. My goal was to fix hell—this place called Abu Ghraib—and it would require intense effort to not only build a team for the biscuit but to get the mental health resources that were needed for the detainees and the soldiers on the post. Frequent power outages, mortar attacks, broken computers, and crappy phone connections slowed the progress.

I spent several hours a day building relationships with suspicious interrogators as well as the military police leaders. They all wondered, “What is a psychologist doing here and how can he help me?” To this end, I had many cups of coffee with the more experienced officers on the post as well as the young men and women stuck in this place—the eighteen- to twenty-year-old privates. Soon we were able to start forging a policy and doctrine on how to manage detainees in a safe and humane way, and how to do interrogations without any abuse.

My mission frequently required me to convoy from Abu Ghraib to Baghdad, which could be an all-day affair. Traveling in Iraq was always risky business. Once you left the relative safety of the Abu Ghraib prison or any other American base, anything could happen. Even the folks back home had heard plenty about IEDs—improvised explosive devices—and knew that a great proportion of the American deaths in Iraq were caused by these bombs. The devices were usually hidden along the road and an Iraqi was hiding somewhere nearby, ready to set them off remotely when a military convoy passed by. Often improvised from standard bombs, mortars, and other ordnance, the bombs could produce a huge blast that would tear through even an armored Humvee. In addition, you were always at risk of being ambushed, particularly when the convoy had to slow or stop for any reason. Those dangers meant that traveling from Abu Ghraib to Baghdad, or anywhere else, was never as simple as hopping in a truck and driving off. It always required a convoy of Humvees in which every passenger was armed and ready to fight. When there was trouble, Army policy was to just keep going and drive through the kill zone as long as your vehicle was still operational. The Marines, on the other hand, would stop their convoy and go after the fucker who tried to kill them, even if it meant they might lose someone in the process.

Even though it should have been a thirty-minute drive to Baghdad, it often turned into an all-day event. You could get stuck out on the highway after an ambush or a bomb had been discovered. In these situations, the roads would be shut down and the bomb disposal units would take all day to find and dispose of the bomb.

While on a convoy I had plenty of time to sit in the Humvee, my weapon at the ready, and just think. I used this time to gather myself, my thoughts, my bearings. I began to realize the scope of my mission in Abu Ghraib. It was much bigger than just the interrogation cell. This undertaking would test every fiber of my moral compass. Each day, to remain sane, ethical, and moral, the challenges of Abu Ghraib would come to force a true north compass check. My beacon out of this darkness would be the question I asked myself over and over again:
Which road would a decent human being take?

That question ran through my mind every time I talked with soldiers at Abu Ghraib who had been through so much already but seemed so unlike those we had seen abusing detainees in the pictures on CNN. One of those soldiers who had been through hell before my arrival was a seasoned Army warrant officer named Betty Patterson, whom I met on my tenth day in Abu Ghraib. This was no innocent young recruit or a soft desk jockey who’d never seen a moment of stress in the field. Warrant Officer Patterson was experienced and tough even before she arrived in Abu Ghraib, but she told me about how this place had nearly broken her. On Christmas Day 2003, she told me, thirty-three mortars landed inside the Abu Ghraib compound.

“Colonel, I sat in my room all day and night on Christmas Day with my helmet and body armor on. I just sat on my bed and rocked back and forth all day and night. It was fucking terror in my head I ain’t never seen before.”

What a way to spend Christmas, sitting on your bed wondering if the next mortar would kill you. She told me about another mortar barrage she had endured.

“Two Army interrogators who were friends of mine were killed standing right outside the interrogation booths,” she said, her eyes getting that distant look as she relived the moment in her mind. “Sir, I heard the howling, screeching sound of an incoming mortar. The ground shook. I fell to the ground and heard my buddies screaming. The next thing, we were kneeling down and saying a prayer. They were gone. They were two very fine Americans. I still see their faces at night sometimes.”

Betty spoke vividly of how she came to feel that she had no control over her fate, what social scientists have described as “learned helplessness.” Learned helplessness is what happens to a person’s mind when no matter what you do, or which way you turn, you get shocked or hurt emotionally or physically. I learned about this condition in graduate school through an experiment that involves placing a lab rat on an electrical hotplate that has a maze on top of it, then letting the rat try to find the route that does not yield an electrical shock. If the rat gets shocked no matter which way it goes in the maze, it will soon just stop and roll over and stop trying to determine its fate—the situation has convinced the rat that it is helpless, that there is no use trying. Learned helplessness is what Warrant Officer Patterson as well as many others I knew from Abu Ghraib described to me. No matter which way they turned in the Abu Ghraib maze, they were shocked with horror, death, poor leadership, inadequate facilities, and foul living conditions unfit for humans.

What can I do to fix this?
I asked myself. “We need a hospital with not only a large staff, but well-resourced, fresh staff and with the necessary mental health services,” I wrote down on the back of a
Stars & Stripes
newspaper. (I needed to learn to carry a notepad with me. My great thoughts were accumulating on airplane napkins and old newspapers.) So far it had been a battle to convince the medical leadership in Baghdad that the mission at Abu Ghraib warranted a large field hospital. It would have been easier talking to a camel out in the barren desert.

One of the roadblocks was Colonel Kerry Matson, the senior mental health officer in Iraq. Colonel Matson, an old friend of mine, was assigned as the coordinator for all mental health services and staffing in Iraq. She had been a mental health officer for nearly twenty-five years, yet I could not get her to see the need to have a permanent mental health team assigned to Abu Ghraib and the other prison way south, Camp Bucca. Colonel Matson just didn’t want to hear it. She believed that it was a waste to send a full complement of mental health services to Abu Ghraib. I trusted Matson and saw this officer as a confidante and friend, but I disagreed with Kerry on the battle plan for mental health services at Abu Ghraib. We often had lunch together when I convoyed to Camp Victory in Baghdad, where Matson was stationed in relative comfort and with nearly everything the Army could offer at her disposal. Colonel Matson argued that if a soldier at Abu Ghraib needed services, we could just load him up in a Humvee and drive him twenty-seven miles to Baghdad to see a psychiatrist. After all, driving twenty-seven miles to see a psychiatrist wouldn’t be considered unreasonable back home in the States, right? I couldn’t help but think that Colonel Matson was seeing this issue purely as a health care professional, rather than through the eyes of a soldier. Colonel Matson didn’t have a problem with loading one soldier up in a Humvee and sending him back to Camp Victory for a brief appointment with a psychiatrist. It was a dumbass idea and outright dangerous.