“Heath? There’s a big difference between feeling hopeless and a situation being hopeless, and I promise you, yours isn’t hopeless.”

The recently-discharged Marine Corps officer sat there staring into space before he quietly said, “You have no idea.”

The psychiatrist replied, “No. I don’t know the details of your specific case. But I’ve worked with enough soldiers and Marines with PTSD to know there are similarities. No matter how different the things you saw and experienced may be from someone else—anyone else—the brain’s reactions to them are always similar.”

She slid her wheeled chair a little closer then said, “I can help you, Heath. But only if you’ll talk to me.”

Heath Thomas was 26 years old and had spent 16 months of his 3 1/2 years on active duty in Afghanistan. He was now a civilian again because his PTSD was so out of control he could no longer function effectively on active duty.

It wasn’t just that he could no longer lead Marines. That was true, but it was much worse than that. His personal life was spinning out of control, as well, and lately, he often wondered if what he called ‘checking out’ might not be a rational option. That he still knew it wasn’t was the only hopeful sign in an otherwise miserable existence.

He also knew his doctor was right. He had to talk about it. But the last thing he wanted to do was say out loud what he’d seen after living with it 24/7 for well over a year. It had even invaded his dreams, the one place he used to be able to go to find some relief. But for the last year or so, and specifically since the second ‘incident’, even peaceful sleep had eluded him.

The former first lieutenant had been turned over to the VA for treatment since his discharge four months ago. While he knew he should be grateful, Heath was angry and resentful about being there. The only redeeming aspect of his first visit had been the psychiatrist herself. She was a 30-something woman who was very attractive, and Heath found himself mildly aroused for the first time in months. It was barely noticeable, but by her presence alone she was able to take maybe 10% off the edge of the PTSD, and while that wasn’t much, any relief was welcome.

She reached out and touched his arm then said, “I’ve been here long enough to have talked to people who’ve seen it all. So believe me when I tell you there is almost nothing you can tell me that I haven’t heard before. So I hope you won’t think being female or a civilian somehow makes me weak.”

“I don’t think you’re weak,” he said, finally breaking the silence. “It’s just so…fucking hard to talk about, you know?”

This was progress, and the doctor said very quietly, “I do know.”

Before he said just those few words, the images came to him again in stark, vivid detail. The first happened two months into his first tour. A Humvee hit an IED, and after being blown 15 feet up and 20 feet to its right, there was a second explosion as the vehicle landed on its wheels.

Heath was just two vehicles back in the convoy and watched it all unfold as though it happened in slow motion. He also knew the secondary explosion was the anti-tank round every Humvee carried.

He was one of the first to approach the burning vehicle just seconds later as other Marines exited their vehicles and set up security in the event of a post-explosion attack.

Rounds were still cooking off, and the smart thing to do was stay away. But Heath couldn’t wait. He’d take an ass chewing from the company commander later, but he had to know if anyone was still alive.

As he reached the driver’s side, what he saw through the thick, black smoke something that nearly made him vomit. The second Marine looked inside and hollered, “Jesus fucking Christ!” before puking his guts out.

“They’re gone. Let’s get the fuck away from this thing—now!” Heath hollered as the flames got hotter and higher before eventually engulfing the Humvee, causing any remaining ammo to cook off along with the three dead human beings inside.

Heath had managed to compartmentalize the gruesome sight until the second event when it, along with what he’d seen with his own eyes, returned with a vengeance.

He was five months into his second and final tour when his company encountered the largest enemy force since Iraq; a force no one knew existed let alone was operating anywhere near them. There were roughly 200 Marines in a defensive position with nearly 600 jihadists preparing for an attack.

Heath heard the company commander on the radio informing the Task Force commander, and Army lieutenant colonel who was back at their joint base camp, of their situation. The captain made it clear they needed reinforcements, massive air support, or they’d have to pull back.

The reply stunned not only Heath, the company executive officer or XO, making him second in command, but the company commander as well.

“Negative! Hold your position.”

Their position was just another worthless patch of sand with no tactical meaning which meant there was no reason to stay and fight. But orders were orders. The truth was, even if they held off the attack, Marines would die, and many more would be wounded. The company commander reiterated his concerns in no uncertain terms, and again, he was ordered to ‘hold at all costs’.

“Son of a bitch!” the captain said as he looked at Heath.

“Looks like we’re defending this oasis, sir,” he remembered saying with a grim smile.

“All right. Get the word out,” the commander said as he barked instructions to his lieutenants who would in turn, pass them on to their platoons.

As the enemy massed for a suicidal frontal assault reminiscent of Pickett’s Charge at Gettysburg on the 3rd of July in 1863, the Marines dug in as best they could and prepared for battle. There was no air support available for at least another hour, but in less than half that amount of time, a hell of lot of people would be dead or dying.

The attack began with the enemy firing a few ill-aimed mortar rounds from maybe a half mile away that did no real damage. As the large group of enemy soldiers began running toward them wildly firing AK-47s and RPGs, Marine machine gunners opened fire, and riflemen began taking well-aimed shots as the ‘martyrs’ continued moving in mass toward them.

Evidently, these fanatics truly believed that dying in battle with the infidel was a ticket to Paradise, and a lot of them were going to go there (or somewhere south of heaven) very quickly.

Heath watched as the attackers fell by ones or twos here and there all across the front. At about a hundred yards away, the jihadis began sprinting and screaming, and Heath, who’d been firing his rifle along with everyone else, laid his 9mm next to him as the enemy closed the gap.

Things went into slow motion again as three bad guys came directly at him. He shot one of them at five yards and another as he was diving into the small ‘hole’ Heath had dug in the sand, intent on killing the young Marine.

The man fell dead, almost on top of him, just as the third ran ran by screaming in Arabic. With no threat to his direct front, Heath turned just as the third man stopped and spun around. He reached for his pistol, and as he was about to fire, another Marine shot the attacker from the side.

When he collapsed, Heath turned back around and saw several more ‘men in black’ heading his way. He laid the pistol back down and grabbed his rifle and began firing. Between him and the Marines firing on his right and left, all three of them went down.

And that’s when he heard someone literally scream, “LIEUTENANT! BEHIND YOU!”

Heath rolled over and just as he did, he saw that the man who’d been shot was back on his feet. He was staggering toward lieutenant who grabbed his 9mm again. As he did, the enemy soldier raised his rifle and pointed it at Heath. Without hesitation, Heath shot the man twice in the chest. He not only didn’t get knocked backward, he took one more step toward his enemy then fell just inches away from him on the opposite side of his dead comrade. Unbelievably, the man was still alive.

To this day, Heath clearly recalled the man’s eyes; eyes that were wide open. Eyes filled with a hatred Heath had never before seen. The dying man had dropped his rifle but saw Heath’s a foot or so from his head and tried reaching for it. As he did, Heath placed the pistol’s barrel between the man’s eyes and pulled the trigger from just inches away from his own body.

The next thing he recalled was the corpsman asking him questions.

“Lieutenant. What the fuck happened? Are you okay?” the ‘doc’ asked him as he looked for wounds among the blood and body tissue from the dead jihadist.

Physically, Heath Thomas was fine. He didn’t have a scratch on him. But mentally he was a changed man. This time, he couldn’t compartmentalize what he’d seen. And what he saw every waking moment of every day were those eyes and…where they once were after he pulled the trigger.

He’d been able to function well enough to finish out the tour, but by the time he got back to Camp Lejeune, North Carolina, he began having serious issues.

He could no longer focus. His ‘hard drive’ was at near capacity continuously reliving the events of the suicidal frontal assault as well as the Marines he’d watched be incinerated after seeing the driver who’d been decapitated by the follow-on blast.

Things got so bad he was removed from the company and put on the battalion staff. But even there he struggled to the point that his battalion commander referred him for counseling after learning what he’d seen while in-country.

There wasn’t supposed to be any shame in seeing a ‘shrink’, but the thought of other Marines knowing an officer needed it only added to the growing mental chaos.

And then the nightmares came. And with each passing week, they grew worse and worse, often resulting in waking up at some ungodly hour drenched in sweat.

Heath had thought about staying in for a career, but it was clear he was in no condition to even serve as a commissioned officer. In fact, he was soon recommended for discharge, which was characterized as ‘honorable under medical conditions’, and as of a four months ago, he was no longer on active duty.

He was now back home in Orlando, Florida, living with his parents who were deeply concerned about their son; a son they were powerless to help.

As Heath recounted everything that had brought him here to this particular psychiatrist at the VA hospital, he forced himself to look up at her. He took a deep breath then began speaking.

“This all began on my first tour when one of our vehicles hit an IED,” he said so quietly she could barely hear him.

A few minutes later, Heath was wrapping up his mental nightmare by explaining how he’d ended up being discharged and sent home.

“First let me tell you how important it was for you to say those things out loud,” the female doctor told him. “From there, please know that what I told you earlier applies to you, too, Heath. We can work through this. You can feel better again.”

She smiled then told him, “And you can get your life back. You’re a smart, well-educated man. And, this isn’t personal, it’s just an observation, you’re a very handsome guy. There’s a wife, and a family, out there somewhere just waiting for you, Heath. In order for you to find her, we need to stay focused on your treatment. So don’t give up no matter what. Okay?”

Three months later, Heath told her after yet another session of therapy, “I’m sleeping a little better, and I’m able to stay focused on simple things again. And I’m not…thinking about ‘checking out’ anymore.”

“That’s good, right?” the attractive doctor said.

“I guess,” Heath responded. “I mean, anything is better than the mental hell I created for myself.”

She could see he had more to say so she sat and waited.

Heath looked over at her then said, “But I still can’t find any purpose in life, you know?”

She knew he’d once been at least somewhat religious but after all he’d been through there was nothing left of his former spiritual life, and it wasn’t her place to provide that anyway. He wasn’t one for causes or political activism, either, so, as far as she was concerned, some deeper meaning or purpose could wait.

For now, the doctor was very pleased with the progress he was making, and she wanted to really hone in on these small successes and build from there.

But when no further progress came after another two months of three-times-per-week counseling, she became very concerned.

“Heath? Let me prescribe something else for you,” she suggested.

He’d been adamant about not taking anything, but she’d convinced him to try a drug that had proven very effective on PTSD patients. After five months, and no further improvement, she wanted to try something different.

“What’s the point?” he said, his eyes and voice hollow.

“Getting better is the point,” she said gently.

She continued speaking, but Heath didn’t hear a word she said, and at some point he just started talking over her without realizing he was doing it.

“All I’ve done is…take life. I’ve killed quite a few people, and one of them was just inches away from me. What the hell value is there in going on when I haven’t done a damn thing to make the world a better place?”

Now very concerned, she asked if he planned on ‘hurting’ himself.

“No. Not anytime soon, anyway,” he told her in a way that convinced her he wasn’t in imminent threat to himself.

“So…you’re not…”

“Suicidal? No. I…I just feel so…empty,” he replied quietly.

“What do you think could help ‘fill the hole’?” she asked him.

Heath shook his head then said, “I don’t know. I guess if I could…be the first man to have a baby, I’d feel like I’d done something.”

And for the first time since she’d known him, he laughed. It only lasted for a moment, but something in what he’d said had given him a moment of hope.

The doctor sat there for a moment and thought about options outside the normal treatment regimen then recalled a paper she’d read recently an alternative therapies. The idea was to give the patient something to serve as an anchor. Something that would capture their interest along the lines of religious conversions where people reported going from drug-addicted to ‘changed men’ overnight. She wanted to start out small, and recalled a specific recommendation.

“Heath? Have you considered doing something positive like donating blood?”

He looked up again then said, “No. Why?”

“I’m trying to find something to help you find a sense of purpose. A cause that’s…bigger than yourself. I was just kind of thinking out loud.”

She saw another glimmer of hope when the glassy look in his eyes went away.

“I’d never thought about that,” he replied as though he were suddenly very interested.

“It’s called ‘the gift of life’ for a reason,” the doctor told him. “And it’s renewable. You can donate regularly and help a lot of people.”

“Renewable. Too bad my brain can’t be renewed,” he told her, a smile almost appearing on his lips.

“No, unfortunately the only organ that can renew itself is the liver,” she told him with a smile of her own.

“What?” he asked, now actually very interested.

“Seriously?” he further asked in a way that told her he was interested in what she’d just said.

“Well, yes. Just 25% of a liver in a patient needing a new one will grow into a full liver in just a few months. And the same goes for the donor whose liver will completely regenerate.”

“I knew you could live with just one kidney, but I wasn’t aware the liver could do that.”

“It most definitely can,” she told him, wondering where this was going.

She sat there watching him and could tell he was thinking. Normally, he was just eaten up by the trauma he’d endured, but he was definitely thinking about something.

A minute or so later, he asked, “And that would save someone’s life, wouldn’t it?”

“Yes. Living donors account for just 5% of all liver transplants and are in great demand at all times, so anyone healthy enough to do so, and who’s also a match, would absolutely save someone’s life.”

Heath sat up in his chair thens asked, “So I could donate a kidney and part of my liver, right?”

“Not at the same time, and, well, I’m not sure you’re ready for that kind of stress just yet anyway. The surgery itself is potentially life-threatening, and then there’s the recovery time. All of that takes a huge toll, Heath. Physically and mentally.”

For the first time in what seemed like forever, Heath felt a spark of hope. He could not only save someone else’s life, there was a chance he might not survive the ordeal, and that would solve a whole host of problems, too. Or so he told himself.

“I would strongly recommend you try donating blood, and try this other medication. Then, after another couple of months, we can explore other options.”

The doctor had no intention of trying to get her patient to do something as radical as an organ donation, but if the thought of doing so gave him any increased sense of purpose, it was something she could use in promoting his overall recovery.

“Yeah. Um…maybe I will,” he told her as he became aware their session time was up. Another little flicker of hope on a much smaller scale.

That evening, Heath did something he almost never did. He spoke to his parents during dinner.

His mother was so happy she had to use her napkin to dry her eyes.

“I…I think that’s very…noble,” she said when he brought of the idea of being a donor. She wanted to tell him it was insanely risky and foolish, but just seeing her boy engage in a conversation was such a rare treat she didn’t want to spoil it.

Even her husband managed not to say something like ‘how ridiculous the idea was’. She knew he wanted to, but she’d given him the same look he’d seen so many times he knew better than to even mention it.

“I’m not saying I’m gonna do this. I’m just telling you it’s something that makes me feel like my life might…matter…again,” Heath told them.

“Your life matters plenty,” his father said rather gruffly. But as he glanced at his wife, he got the look again and softened his tone. “I guess it couldn’t hurt to at least look into it a little.”

This time he got an approving smile, and nothing more was said during dinner, but just those few moments were priceless to Jan Thomas.

He further cheered her up when, after finishing his meal, said, “That was really good, Mom.”

He’d tried smiling, too, but it didn’t quite happen. Nonetheless, she felt herself tearing up again as she told him she was glad he liked it.

“If you don’t mind, I’m gonna go do some research online,” Heath said as he stood up.

Jan had always been very proud of her only child. He’d been so smart in school, and Heath had been a very good athlete in high school, lettering in two sports. He also had his father’s handsome face, and although he’d lost weight during his battle with PTSD, he was still tall and strong, and as a mother, all she wanted was for her son to find the enjoyment in life he’d always had before the war. So if this idea of his was the ‘way back’, she would do whatever she could to support her son.