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Introspection   |    
"Are You Going To Be Different?"
Eugene H. Kim, M.D.
Am J Psychiatry 2010;167:628-629. doi:10.1176/appi.ajp.2010.10010112
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The views expressed here are those of the author and do not reflect the official position of the Department of Defense or the Department of the Army.

Address correspondence and reprint requests to Dr. Kim, eugene.h.kim@us.army.mil (e-mail). Introspection accepted February 2010.

Accepted February , 2010.

Copyright © American Psychiatric Association

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Nine time zones away, here in Afghanistan, I found an opportunity to call home to my wife this evening. She mentioned listening to the news over the last several weeks. "I've heard a lot of stories about soldiers coming back..., not being the same..., having problems. When you come back, are you going to be…different too?"

What do I say to that? Here I am. Afghanistan. Away from my family. My children, just toddlers, are busy exploring the ever-expanding boundaries of their universe. We recently moved from Hawaii, where I had hoped to grow roots before being slingshot over to this side of the world.

Calling home is mostly a good thing. But just as the marvels of modern technology allow you to catch up on the good days, these innovations expose you to the bad days as well: kids sick with the flu, parents acting up, car breaking down. There's nothing much I can "do" 7,000 miles away. So I listen, and get better at sitting on my hands.

Prior to this deployment, I spent the majority of my life looking off into the distance, planning and anticipating. "I can't wait until I finish high school," "Just need to get through plebe year," "One more exam and organic chemistry is over," "Twenty-seven days until graduation," "I just need to make it to MS-II year," "When am I going to be a doctor?" "Three more calls and I'm board eligible!" "Please let me pass the oral boards." Needless to say, this incessant looking ahead affected my family, as my wife would routinely remind me to "RELAX! You are driving me nuts!"

But since being here, I've spent far less time persev­erating about the future and more time being in the here and now. With the relative lack of creature comforts, absence of family, risk to life and limb, I suppose I could count down the days until homecoming. But being here is like living in the movie Groundhog Day. Each day seems like the last, repeating itself over and over. And like the movie's protagonist, I needed a while to figure out the real value of just taking one day at a time.

For example, one day I caught a ride in the back of a mine resistant ambush protected vehicle (MRAP) needing to get to a neighboring base. Sitting in the back, I could see the windshield of the driver's compartment, exposing the dusty road ahead. It is an otherwise claustrophobic compartment of steel, composite material, and electronics. As the rear hatch sealed us in for the ride, I experienced a bizarre mix of fear, given the risk of leaving the wire (i.e., the security of a forward operating base), and comfort, from being in the belly of this rolling steel tub. As our convoy moved out, I strained to look ahead from my position in the rear compartment. Every time a truck passed us, a quiet but sharp thought popped into my head: "S**t, is this it?" After passing the seventh truck or so, I found I was doing myself little good. So I made a concerted effort to focus on the world inside the MRAP instead. The fear did not disappear, but trying to anticipate what lay ahead did not help either. My life was in the hands of others: the driver, the gunner, the convoy commander, and plain chance that there was not an explosive-laden vehicle or roadside bomb lying in wait for us that day. I found solace in the moment, engaging the soldiers who shared this cramped space with me. We passed the time shouting above the din of the engine, cracking jokes and telling stories until we arrived at our destination.

I don't know if I'm going to see tomorrow. I hope so, but I haven't a clue. Is this a "sense of foreshortened future"? Is it a symptom? Or perhaps a blessing?

I believe I have changed as a result of this and similarly uncomfortable experiences. But I've also been affected by the many other salient moments of this year away from home. Savoring the taste of fresh locally baked flat bread wrapped in newspaper. Waking to a crisp autumn morning with the sunrise breaking over snow-capped mountains. Running the flight line at dusk with the glowing orange ball sinking behind the ridgeline, while jet aircraft roar overhead. Acknowledging the gratitude on my patients' faces with a smile in return, regardless of which "side" they're on. Appreciating bodily function humor, which is truly funnier here than stateside. Sharing a hot meal with my teammates at the day's end. Breaking open a care package. Seeing my kids online. Watching my patients, teammates, and friends grow and shine in an austere environment.

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