Image from Thank You For Your Service
During the American invasion of Baghdad in April, 2003, a Marine unit was battling Iraqi forces near the city center when two Mercedes and a white pickup truck burst through the U.S. roadblock. After commands to stop went unheeded, Kenny Toone and Lu Lobello, among other Marines, opened fire. Bullets riddled the vehicles’ windshields and sides, forcing them to a halt. When the Marines approached, they discovered that the vehicles contained members of an extended family. A young woman and her mother had survived; all three men—the father and two brothers—had been shot dead. The family members were not insurgents. They lived nearby and were trying to escape the city’s escalating violence. In the confusion, they didn’t hear the stop commands.
"The next few days is when the pain started for me," Toone says in Thank You For Your Service, a new documentary about mental trauma in war veterans. "I’m so proud of how we did our jobs but I’m so ashamed of what we did. What do you do with that?”
Toone suffered nightmares after the shooting: he dreamed it had been his own family in the cars, and he had killed them all. Lobello was also devastated, constantly replaying the shooting in his mind. The film follows both men as they return from combat very different people than when they deployed.
Thank You For Your Service, directed by Tom Donahue, is about how war changes the men and women we send to fight, and it examines how—and if—these traumatized veterans can fully recover. According to the Department of Veterans Affairs, twenty veterans commit suicide every day. Thank You for your Service is also a powerful critique of the military’s insufficient mental health services: with a budget of roughly $700 billion between the Department of Defense and Veterans Affairs, the military still has not hired enough mental health professionals or established a behavioral health corps.
In the film we’re shown a montage of newspaper stories, some from as early as 2004, warning of a mental health crisis among veterans. Yet there are few signs that even now urgent action is being taken. Thank You For Your Service attempts to shine light on the driving factors behind the crisis. There are interviews with military brass, clinicians, advocates, veterans and their families, and emotional stories of trauma and recovery.
The most heart-rending aspect of the film is its exploration of a newly identified type of war trauma called “moral injury.” Kenny Toone suffered from moral injury when he returned from Iraq. Long considered part of PTSD, moral Injury is now recognized as a separate condition. Where PTSD is about fear—the flashbacks and hypervigilance associated with believing you’re always in combat—moral injury consists of the guilt and shame some soldiers feel after witnessing or taking part in an act they felt violated their deepest moral beliefs. It has been identified in soldiers who have killed civilians and tortured prisoners as well as in soldiers who have handled human remains and witnessed their fellows dying. After the Baghdad shooting, Toone’s guilt proved so debilitating that he “couldn’t integrate with society too well.”
In June, I traveled to Fort Worth, Texas, to research moral injury. I met with Dr. Rita Nakashima Brock, the director of the Soul Repair Center at Brite Divinity School, a program dedicated to moral injury research and education. Brock arranged interviews for me with several veterans, whose stories were similar to those told by men in the film.
A Vietnam veteran I spoke with who suffers from moral injury told me it angers him when citizens thank him for his service because “they have no idea what I did there.” In the film, Toone echoes these sentiments.
“After 2003 I was going insane inside of my own head,” Toone says. “I couldn't make sense that I wasn't a murderer. It would actually make me upset when people would come up to me and say, 'Thank you for your service, welcome home.’ . . . I'd be like, 'What do you know about . . . coming back from a war and living with these memories?"
Toone’s efforts to come to terms with what he’d done in Baghdad were a failure. After admitting to feeling suicidal, he was sent to a corpsman whom he “didn’t know, didn’t trust, and he was asking very personal questions.” The situation was so uncomfortable, Toone says, that he lied and said he was fine. After he returned from Iraq, Toone spent months in a mental health ward where he was given therapy and put on eight medications. But the therapy “wouldn’t click for me,” he says. When he left the ward, he went to live in the mountains.
Brock told me that standard PTSD treatments, including medication, usually do not help with moral injury because moral injury is not fear-based. In fact, no standard recovery program yet exists. One treatment regimen that has shown success is providing vets with a benevolent authority figure who can talk them through their suffering. Forgiveness is key, so support from family and friends and a spiritual connection can help. Brock views moral injury as a normal human response to extreme situations, not as a disorder or an illness. (This view is bolstered in the film.) Thus, she does not believe that “treatment” is the sole answer.
“You really can’t fix moral injury,” Brock said. “There are forms where you can integrate it so it doesn’t completely destroy your sense of who you are. But there are other forms where you melt down and feel like you don’t deserve to live. In that case, treatment can help.” She added: “But treatment is not a complete recovery process, rather an intervention that can begin a process.” That process, she said, involves an ongoing dialogue with a trusted friend or authority figure, such as a chaplain or fellow soldier.
In Thank You For Your Service, the recovery process is the dramatic highpoint, and we see how the approaches Brock presents can help veterans heal. The film argues that there are unique aspects to our current wars that increase mental trauma. Multiple deployments and extended tours result in much more combat exposure, says one Army psychiatrist. General Peter Chiarelli blames the “non-linear” fighting in which soldiers “can’t escape the enemy at any time.” But what about morally confounding situations that increase the risk of moral injury?
When I posed the question to Brock, initially she said no, that moral injury was “as old as the Bible, as old as Homer.” But when I asked about civilians being caught up in the fighting, as with the Baghdad shooting, she reconsidered.
“The problem is when you’re not fighting an army, you’re fighting a country,” she said. “There’s the issue of children and other civilians being used by insurgents to stop convoys so soldiers are told to just to keep going. Can you imagine being a father or a mother and told, ‘No, don’t stop, run over that kid. You’re going to get people killed if you stop’?” After a pause, she added: “There’s no good choice.”
Jake Whitney is a journalist based in New York.