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Casualty of war: Drugs and alcohol were the ammunition she used to dull the pain

Jun. 7, 2014 - 06:00AM   |  
Operation Enduring Freedom
(Lance Cpl. Dexter S. Saulisbury / Marine Corps)
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LETTER: A CASUALTY OF WAR

Her name was Cat. As a Marine Corps officer serving as a Disability Evaluation System advisor, I knew her as Master at Arms 2nd Class Catherine Mattei, USN. But to her friends and family, she was “Cat.”

I met her on a Friday, the day her election-of-options for her disability ratings were due. A worried Navy chief brought her into my office with her disability findings and asked: “Sir, would you take a look at this. I think there is a problem.” There was.

She had been advised to accept the disability ratings. And in a zombie-like trance, that is what she intended to do. Initially, she was hesitant to talk with me. One more officer. One more doctor. One more disappointment. But she opened up after learning I was well-versed with the type of duties she had held.

She had served as a prison guard at Guantanamo Bay. She also served as an individual augmentee with an Army female engagement team in Afghanistan. And she had been diagnosed with PTSD. She could not remember if she had any awards, but she thought there were some. There were more than some. An Army Commendation Medal; commendation and achievement medals from the Navy; citations from the Marine Corps; and, unusual for a female – and Navy — service-member, a Combat Action Ribbon.

I had seen her type of injuries before. Although the substance of what she described to me was not unique, there was something very different in its sound. The same deadened tone was there. Before, however, the stories had always come haltingly from a quiet masculine voice. This pitch was different. It was a woman’s voice describing the emotional turmoil, the detachment, the guilt; the first female service-member I had met with combat-arms PTSD. And it had a severe impact upon this young warrior. The ratings were wrong.

The chief agreed to stall the board regarding her findings. But we needed to work quickly to ensure that a proper appeal could be submitted. I asked her to provide a statement that I could use regarding what we discussed. Often, these statements have therapeutic value in themselves. But with grunts, it is usually necessary to revise, edit and extrapolate their statements to articulate what is occurring within their inner worlds. MA2 Mattei’s statement required little editing, and it eerily echoed similar sentiments I had heard before. This is what she sent to me:

“My life has changed so much since I came back from Afghanistan. I don’t even recognize myself in the mirror. I am a shell of what I used to be, filled with so many negative emotions and true sadness.

“I have an extremely hard time leaving the house now. Shear panic sets in. Crowds are unbearable to me. Crowds to me mean danger, and I avoid them at all cost. I become completely overwhelmed and my brain spins in circles as I scan everyone over and over, waiting to find something or someone plotting something.

“The enemy always targets crowds to get the most kills. All I think is, ‘How am I supposed to save everyone this time? I must save everyone.’ But I could not save everyone in Afghanistan and it haunts me every day, my every nightmare. I look down at my hands and have a hard time not seeing them stained with blood. I wash them constantly to rid the memory. If I can’t save everyone, that makes me a failure. I no longer let people close to me for fear of them getting hurt or killed. It just hurts too much. Why wasn’t it me? It should have been me. I struggle with this guilt daily, which makes it almost impossible to get out of bed in the morning. Most of the time I still wish I didn’t wake up, but I know I have to push on so the enemy doesn’t win twice.

“The mission for me in Afghanistan is over. It’s crazy how a place that can mess you up so bad is the only place I want to run back to. To fix everything, but I can’t. I’m left here not even being able to carry a gun. My purpose in life is over. I no longer have one. I feel like a complete waste of space with nothing to offer anyone.

“I no longer enjoy anything. Trust me I try, I can only hold a fake smile for so long. I live in complete isolation, trying to fight it everyday, but I feel like the depression I face is beating me down with a club. I don’t feel I should be allowed to be happy. I’m trying so hard in therapy, groups, rec therapy, research. I’m trying everything, and I cannot just find peace.

“I have become two extremes. One is completely numb, which is how I handle most days, and the other is a complete wreck, holding back my tears over nothing and rage over minor things. Avoidance has become a new way of life for me, I avoid people, places, conversations, daylight.

“I am completely overwhelmed by life and am teetering on the edge everyday. I wish for your reconsideration on my rating so I can truly and deeply get the care I seek so badly. Please help me regain the life I once had.”

Several weeks later I saw her smile for the first and only time. She sought me out to thank me as her ratings had been increased. And she was very happy about it. She believed that the extra benefits provided the necessary cushion to live without financial worries in order to put her life back together. I was very happy for her. With false pride, I considered her a “success” story.

I do not fully remember the outburst of rage. But the pain in my foot, marks to my desk and scattered papers confirmed the anger when I read the email regarding MA2 Mattei’s death. Her mother had accessed her email account and found the personal statement that her daughter sent to me. And her mother thought I should know that she had died. When I called for details, she informed me that a coroner ruled that a lethal combination of alcohol and prescription drugs resulted in accidental death.

Perhaps. But at what point does suicidal intent even matter when a person self-medicates pain away to the point of death? This death, however, would not show up as a war casualty. And it would not show up as another veteran suicide. It was “accidental.”

Her mother informed me of the condolences that she received from service-members with whom MA2 Mattei had served. And how they had expressed that there were many people, service-members and civilians alike, living today because of her daughter. Ultimately, however, it never matters how many one saves. It is only the one that you believe that you failed that matters.

Her name was Cat. She died in service to her country. And she was a hero. I just thought someone should know.

Marine Lt. Col. Robert Marshall

Naval Medical Center San Diego

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