21
Carrie Saunders’s office was located close to the Mental Health Service. Her name – simply ‘Dr. Saunders’ – was etched on a plastic plate by her door, and when I knocked the door was opened by a woman in her mid-thirties, with short blond hair and the build of a lightweight boxer. She was wearing a dark t-shirt over black business slacks, and the muscles on her forearms and shoulders were clearly defined. She was about five-seven, and sallow skinned. Her office was small, and maximum use had been made of all available space: there were three filing cabinets to my right, and to my left there were bookshelves lined with assorted medical texts and cardboard document storage boxes. On the walls was framed evidence of qualification from the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and from Walter Reed. One impressive piece of paper indicated a specialization in disaster psychiatry. The floor was covered in hard-wearing gray carpet. Her desk was neat and functional. There was a disposable coffee cup beside the phone, and the remains of a bagel.
‘I eat when I can,’ she said, clearing away what was left of her lunch. ‘If you’re hungry, we can get something at the canteen.’
I told her that I was fine. She gestured to the plastic chair at the opposite side of her desk, and waited for me to sit before doing so herself.
‘How can I help you, Mr. Parker?’
‘I understand that you’re conducting research into post-traumatic stress disorder.’
‘That’s right.’
‘With a particular emphasis on suicide.’
‘On suicide prevention,’ she corrected. ‘May I ask who told you about me?’
It was probably my natural antipathy toward authority, especially the kind of authority represented by the military, but it seemed a good idea to keep Ronald Straydeer out of this for now.
‘I’d prefer not to say,’ I replied. ‘Is that a problem?’
‘No, just curious. I don’t often get private detectives requesting to see me.’
‘I noticed that you didn’t ask what this was about when we spoke on the phone.’
‘I did some checking up on you. You’ve got quite the reputation. I could hardly turn down the prospect of meeting you.’
‘My reputation is inflated. I wouldn’t believe everything that you read in the papers.’
She smiled. ‘I didn’t read about you in the papers. I prefer to deal with people.’
‘Then we have that in common.’
‘It may be the only thing. Tell me, Mr. Parker, have you ever been in therapy?’
‘No.’
‘Grief counseling?’
‘No. Are you hustling for business?’
‘As you noted, I’m interested in post-traumatic stress.’
‘And I seem like a candidate.’
‘Well, wouldn’t you agree? I know about what happened to your wife and child. It was appalling, almost beyond countenance. I say “almost” because I served my country in Iraq, and what I saw there, what I endured there, changed me. Every day, I deal with the consequences of violence. You might say that I have a context into which to place what you’ve gone through, and what you may still be going through.’
‘Is this relevant?’
‘It is if you’re here to talk about post-traumatic stress. Whatever you learn today will be dependent on your understanding of the concept. That understanding may be commensurately greater if you can relate to it personally, however peripherally. Are we clear so far?’
Her smile hadn’t gone away. It managed to stay just the right side of patronizing, but it was a close-run thing.
‘Very.’
‘Good. My research here is part of an ongoing effort on the part of the military to deal with the psychological effects of combat, both on those who have served and have been invalided out, and on those who have left for reasons unrelated to injury. That’s one aspect of it. The other relates to pre-empting trauma. At the moment, we are phasing in emotional resiliency programs designed to improve combat performance and minimize mental heath difficulties, including PTSD, anger, depression, and suicide. These symptoms have become increasingly recognizable as soldiers undertake repeated deployments.
‘Not every soldier who experiences trauma will suffer from post-traumatic stress, just as individuals in civilian life react differently to, say, assault, rape, natural disasters, or the violent death of a loved one. There will be a stress response, but PTSD is not an automatic consequence. Psychology, genetics, physical condition, and social factors all play a part. An individual with a good support structure – family, friends, professional intervention – may be less likely to develop PTSD than, say, a loner. On the other hand, the longer the delay in developing PTSD, then arguably the more severely it will be experienced. Immediate post-traumatic stress usually begins to improve after three to four months. Delayed PTSD may be more long-term, up to a decade or more, and is therefore harder to treat.’ She paused. ‘Okay, that’s the lecture part over with for now. Any questions?’
‘None. Yet.’
‘Good. Now you get to participate.’
‘And if I don’t?’