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Surviving PTSD & moral injury: How an Afghanistan veteran breaks the silence on mental illness
Life and death in the operating room in Kandahar, Afghanistan - An honest story of loss, moral dilemma, survival and hope.
In the summer of 2007 Erik Krikke is deployed to Afghanistan as a military operating room nurse. The war is in full swing. Day in, day out people do all they can to save lives and limbs at the NATO Role 3 MMU hospital at Kandahar Airfield. This is an underexposed side of war.
All the experiences get under Erik’s skin. Performing surgery on the many severely wounded military personnel, police officers and civilians, under primitive conditions, turns the aid worker into a victim. His toughest battle would start years later though. As a veteran he has to confront and fight his PTSD, but above all, himself.
"Round the clock assisting in war surgery got to him. He went from aid worker to victim when he was confronted by his PTSD some years later. This realistic book shows his battle and how he got back up after he hit rock bottom. I am proud of him." General Tom Middendorp, Netherlands Chief of Defence (ret.)
In the summer of 2007 Erik Krikke is deployed to Afghanistan as a military operating room nurse. The war is in full swing. Day in, day out people do all they can to save lives and limbs at the NATO Role 3 MMU hospital at Kandahar Airfield. This is an underexposed side of war.
All the experiences get under Erik’s skin. Performing surgery on the many severely wounded military personnel, police officers and civilians, under primitive conditions, turns the aid worker into a victim. His toughest battle would start years later though. As a veteran he has to confront and fight his PTSD, but above all, himself.
"Round the clock assisting in war surgery got to him. He went from aid worker to victim when he was confronted by his PTSD some years later. This realistic book shows his battle and how he got back up after he hit rock bottom. I am proud of him." General Tom Middendorp, Netherlands Chief of Defence (ret.)
264 pages, Paperback
Published November 15, 2017
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Displaying 1 - 4 of 4 reviews
February 5, 2018
Krikke’s memoir weaves through his experiences as a nurse in the operating rooms of a third world war hospital. The hospital in Kandahar where he worked was barely equipped with proper measures to ensure the degree of sanitation we expect in Western society operating rooms, and this opened my eyes to a world of war that many of us even forget exists.
We often see and focus on images the front lines or the devastation from bombings and shootings which affect innocent civilians in (sometimes remote) villages and cities. We then hear stories from those who survive these vicious attacks, with the trauma and sometimes even missing limbs. What we don’t see or hear about is what happens when the injured are taken to the place where there are teams of people equipped and ready to make sure they survive. We don’t hear about the medical teams who are among the first people to hear about attacks, those injured, and ultimately casualties who sometimes don’t even make it to the hospitals prepared to treat them.
What Krikke’s offers readers in the first half is an actual retelling of the experiences of someone who has been there. Krikke shares days in surgery that most of us would never expect to ever hear about, sometimes with lengthy and graphic detail for which I was admittedly not prepared for. Through his recollections, from his early days to the thick of his deployment, we are offered a glimpse into the mind of a person at war: not only the tangible war they are physically part of, but the war that is raging inside their own mind.
In the second half of the book, Krikke brings to light the pieces of his puzzle that lead to a PTSD diagnosis and his treatment. What was really important for me was to see that the compassionate and therapeutic resources that he was offered seemed to be available and useful because he sought them out.
This story is so important. Krikke was lucky to have been able to recognize that something wasn’t right with the help of his family, friends, and therapists. I hope that his story will open the conversation up for more people who come home from war-torn countries and experience similar things.
I was kindly given a Kindle version of this book for review by the publisher. Opinions are my own.
We often see and focus on images the front lines or the devastation from bombings and shootings which affect innocent civilians in (sometimes remote) villages and cities. We then hear stories from those who survive these vicious attacks, with the trauma and sometimes even missing limbs. What we don’t see or hear about is what happens when the injured are taken to the place where there are teams of people equipped and ready to make sure they survive. We don’t hear about the medical teams who are among the first people to hear about attacks, those injured, and ultimately casualties who sometimes don’t even make it to the hospitals prepared to treat them.
What Krikke’s offers readers in the first half is an actual retelling of the experiences of someone who has been there. Krikke shares days in surgery that most of us would never expect to ever hear about, sometimes with lengthy and graphic detail for which I was admittedly not prepared for. Through his recollections, from his early days to the thick of his deployment, we are offered a glimpse into the mind of a person at war: not only the tangible war they are physically part of, but the war that is raging inside their own mind.
In the second half of the book, Krikke brings to light the pieces of his puzzle that lead to a PTSD diagnosis and his treatment. What was really important for me was to see that the compassionate and therapeutic resources that he was offered seemed to be available and useful because he sought them out.
This story is so important. Krikke was lucky to have been able to recognize that something wasn’t right with the help of his family, friends, and therapists. I hope that his story will open the conversation up for more people who come home from war-torn countries and experience similar things.
I was kindly given a Kindle version of this book for review by the publisher. Opinions are my own.
March 5, 2018
In 2007 Lt. Erik Krikke was deployed to Afghanistan for three months as an operating room nurse. Like so many soldiers sent to combat zones, he was mentally unprepared to deal with the horrific realities of war and even less prepared to deal with his return home while mentally still in full combat mode. Hoping to help others dealing with PTSD, Erik bares his soul.
Erik is assigned to the NATO hospital at the Kandahar Airfield. The hospital policy is that wounded coalition forces will be stabilized and then evacuated to a higher level of care. Only the vital urgent surgery will be performed on coalition members. Most of their surgical cases will be Afghan soldiers and police and civilians. He is aware of stories of people experiencing PTSD after deployment. But it won’t happen to him. He will basically be doing the same work in Afghanistan as he does at home. But the circumstances will be so different.
He writes of the devastation gunshot wounds and blast injuries have upon the human body. Time after time he questions if they are really helping an Afghan patient (whether an Afghan soldier, policeman, or child) when they amputate their legs, thus sentencing them to a life of begging. They will not be able to work and support his family. Patients beg the doctors to kill them rather than amputate their legs. He describes how blood collects under the operating tables, how they shove amputated limbs into red plastic bags and store them in a container along with all the other amputated limbs. He asks himself “Has the desensitizing started now that I don’t find this situation strange anymore?” He is starting to feel numb to the patients and their injuries.
Erik knows he needs to talk to someone about his growing tension, his anger, his irritability, the shock of losing coalition members and being totally helpless to do anything for them. He tries to tell his wife but is not able to load her down with his horror stories. At one point he made the observation that “It goes against everything I consider to be normal”. PTSD is a normal reaction to an abnormal situation. The brain is like a recorder that then tries to piece together fragments of an abnormal situation into something “normal”.
Upon his return home he seeing everything differently. People get upset so such minor issues. People are fighting for their lives in Afghanistan while a women is complaining coffee. While he once loved his job at the hospital he now dreads going to work and eventually resigns. He becomes more and more isolated, preferring to be on his own. He does not sleep well and has flashbacks. Typical signs of PTSD. He does not want to bother others He has always been the type that could always be counted on to be there for others while neglecting himself. This is true of many soldiers. Suicide becomes awfully appealing to him. It took five years before he finally confronted himself and admitted that he could not do it on his own.
The term “moral injury” was new to me. He defines it as “the psychological damage military personnel develop during their deployment because of traumatic experiences in combination with moral dilemmas.” As he says, “I have done things that go against my own values.”
Fortunately Erik had the inner strength, whether he recognized it or not, to recognize that something wasn’t right. He was destroying himself and his family. He had grown up with the typical attitude that he was man enough to handle any situation on his own. We are fortunate that Erik turned to writing down his experiences and the associated feelings. While this was a painful yet cathartic process for him, it produced an amazing book that should be available to all combat zone personnel, military or civilian, and to their loved ones. Perhaps it can help people get past that notion that to ask for help is a weakness. Erik was able to recognize that he could not do it on his own and turned to others for help. That is the true sign of bravery.
This book appealed to me because at one time I did Critical Incident Stress Debriefings with people either already suffering from PTSD or those having been exposed to an incident that if ignored could result in PTSD. I have also spent time in Baghdad as one of the Security Assistance personnel and am aware of the environment – the constant dirt and dust, the heat, the mud, the anticipation of the incoming alert, the constant alertness one must maintain. I know how just a smell, a sound, a sight can trigger an episode of anxiety, sweating, fear, trembling.
The only reason I gave the book four stars (more like 4.5 stars) versus five stars is because the book could have used better editing and translation. But the message of the book gets through loud and clear.
Erik is assigned to the NATO hospital at the Kandahar Airfield. The hospital policy is that wounded coalition forces will be stabilized and then evacuated to a higher level of care. Only the vital urgent surgery will be performed on coalition members. Most of their surgical cases will be Afghan soldiers and police and civilians. He is aware of stories of people experiencing PTSD after deployment. But it won’t happen to him. He will basically be doing the same work in Afghanistan as he does at home. But the circumstances will be so different.
He writes of the devastation gunshot wounds and blast injuries have upon the human body. Time after time he questions if they are really helping an Afghan patient (whether an Afghan soldier, policeman, or child) when they amputate their legs, thus sentencing them to a life of begging. They will not be able to work and support his family. Patients beg the doctors to kill them rather than amputate their legs. He describes how blood collects under the operating tables, how they shove amputated limbs into red plastic bags and store them in a container along with all the other amputated limbs. He asks himself “Has the desensitizing started now that I don’t find this situation strange anymore?” He is starting to feel numb to the patients and their injuries.
Erik knows he needs to talk to someone about his growing tension, his anger, his irritability, the shock of losing coalition members and being totally helpless to do anything for them. He tries to tell his wife but is not able to load her down with his horror stories. At one point he made the observation that “It goes against everything I consider to be normal”. PTSD is a normal reaction to an abnormal situation. The brain is like a recorder that then tries to piece together fragments of an abnormal situation into something “normal”.
Upon his return home he seeing everything differently. People get upset so such minor issues. People are fighting for their lives in Afghanistan while a women is complaining coffee. While he once loved his job at the hospital he now dreads going to work and eventually resigns. He becomes more and more isolated, preferring to be on his own. He does not sleep well and has flashbacks. Typical signs of PTSD. He does not want to bother others He has always been the type that could always be counted on to be there for others while neglecting himself. This is true of many soldiers. Suicide becomes awfully appealing to him. It took five years before he finally confronted himself and admitted that he could not do it on his own.
The term “moral injury” was new to me. He defines it as “the psychological damage military personnel develop during their deployment because of traumatic experiences in combination with moral dilemmas.” As he says, “I have done things that go against my own values.”
Fortunately Erik had the inner strength, whether he recognized it or not, to recognize that something wasn’t right. He was destroying himself and his family. He had grown up with the typical attitude that he was man enough to handle any situation on his own. We are fortunate that Erik turned to writing down his experiences and the associated feelings. While this was a painful yet cathartic process for him, it produced an amazing book that should be available to all combat zone personnel, military or civilian, and to their loved ones. Perhaps it can help people get past that notion that to ask for help is a weakness. Erik was able to recognize that he could not do it on his own and turned to others for help. That is the true sign of bravery.
This book appealed to me because at one time I did Critical Incident Stress Debriefings with people either already suffering from PTSD or those having been exposed to an incident that if ignored could result in PTSD. I have also spent time in Baghdad as one of the Security Assistance personnel and am aware of the environment – the constant dirt and dust, the heat, the mud, the anticipation of the incoming alert, the constant alertness one must maintain. I know how just a smell, a sound, a sight can trigger an episode of anxiety, sweating, fear, trembling.
The only reason I gave the book four stars (more like 4.5 stars) versus five stars is because the book could have used better editing and translation. But the message of the book gets through loud and clear.
November 30, 2017
This book is just great. Very much respect for you Erik Krikke. I"m proud of you !!!!
November 19, 2017
Moving and above all honest memoir of a Dutch veteran who assisted with live and limb saving surgery in the operating room in Kandahar (Afghanistan), and returned home with PTSD. We read about his battle to overcome PTSD and moral injury. After years of struggle, he can now call himself 'cured', although he will never be the same again. Highly recommended.
Displaying 1 - 4 of 4 reviews