66. IMMOVABLE HEART

I guess that’s just part of loving people: You have to give things up. Sometimes you even have to give them up.

 - Lauren Oliver, Delirium

A common misconception about Post-Traumatic Stress Disorder in the military is that only frontline soldiers in combat are at risk. The reality, is that anyone can be injured.

Take Chris Linford for example, a trauma nurse in the Canadian Armed Forces who deployed to Rwanda in 1994. Over a 100-day tour in a field hospital amid a genocide that killed 800,000 people, Chris’s team saw 44 children die in their care among hundreds of others¹. With a small team and a near-continuous stream of severely injured patients, some of whom were brutalized or starving, it was simply impossible to save everyone and the memories of those who could not be saved linger with Chris to this day.

The problem that Chris and his team faced is what the field of economics would call satisfying infinite demands with finite resources. In the context of a hospital, patients arrive at an emergency room with various problems, each of different urgency and seriousness, and the doctors and nurses have limited time and resources with which to treat everyone. At the best of times, with a slow, steady, inflow of patients, the emergency room never gets overwhelmed. This was the theory behind ‘flattening the pandemic curve²,’ or, keeping the number of COVID-19 infections below the level that would surpass hospitals’ ability to treat patients.

At the worst of times, the emergency room might not be able to help everyone. If there are more patients than staff, or if there are several patients with life-threatening injuries that need immediate treatment, then decisions have to be made about who gets treated and in what order because there aren’t have enough resources to go around.

One consideration nurses and doctors make when deciding who gets treated is whether a prospective patient is hurt so bad they might die anyways, regardless of treatment. In this case, the time and equipment used on that patient might be better spent on someone else with a better chance of survival if they receive treatment right away.

To work through this mismatch of supply and demand, the medical staff conducts triage, which is, ultimately, the process of deciding who lives and who dies. In a strange twist, however, the patients the doctors and nurses most remember after this process often aren’t the ones they helped, but the ones they couldn’t. They remember the ones who were lost, who died, and they remember because of the pain that comes from knowing it was impossible to help everyone.

Like Chris Linford’s unit in Rwanda. 

Any life of service carries this risk, this dilemma of not being able to help everyone. Our choices may not be as stark as those faced in an Emergency Room, however, we’ll still all face the same difficult choice about who to help. Some will even refuse help, although they might be the easy ones since that’s their choice. The others, the ones we can’t help because there are only so many hours in a day, those ones will cause pain and suffering because we’ll know we could have done something, but chose not to.

The risk from this dilemma is that to protect ourselves, we’ll stop caring, and caring for others, especially the vulnerable, is a defining quality of our species³. In other words, the risk of going back into the cave to serve others is that we’ll be hurt by those we couldn’t help, because at some point, that hurt will cause us to lose our humanity.

I wasn’t taught any of this as a soldier. Instead, I was told that to serve my country,  I needed courage and discipline and fighting spirit. I was told I needed to be relentless in the pursuit of excellence, to not kid myself about how I viewed the world. That I needed to be ready to order soldiers under my command to their deaths if that’s what was needed, and, to be ready to face death myself. I came to believe these values could only be lived as a soldier, that their fullest expression required me to be in a profession with the job description to, ‘close with and destroy the enemy.’

After the birth of my second daughter, I realized I’d confused being a solder with being a warrior, and, even then, my understanding of both was shallow. I’d taken the parts about martial prowess and missed the deeper connection to putting others ahead of yourself. In most warrior traditions, the ideal warriors weren’t those who killed without regard for their adversary. They weren’t the automatons who regulated all aspects of their lives in subordination to the glory of battle.

True warriors were those who understood the shortness and fragility of life⁴. They took lives, yes. But they also understood both the terrible cost of doing so, and how easily their own life might be taken from them. To help bear this terrible burden, they protected themselves through service to a higher good so that when they had to kill, they did so for a cause more important than themselves. Just as importantly, they protected themselves by embracing life, performing each deed as if it were their last, because to do otherwise would be to lose one’s humanity.

Many of the values of a life of service are common, no matter how our separate lives of service play out. Having the courage to leave every part of ourselves on the table, the clarity of mind to see the world for what it is, and the self-discipline to make hard decisions are all valuable qualities that will make it easier for us to help our communities become more resilient.

There is one more quality, however, which brings all these others together, which is that those who choose to serve others must have an immovable heart. It must be ruthless and clear-seeing so we have the decisiveness to choose where our limited time and energy will have the greatest impact. It must be forged of hardened steel so that we have the strength to withstand the pain that comes from not being able to help everyone. And it must be resilient to help us bounce back when we want to give up in the face of rejection, or disappointment, or failure.

At the same time, however, our heart must be soft enough to allow us to feel. It must be supple and flexible so it can preserve and nourish the spark of our humanity. If not, then over time, our hearts will simply become cold and hard. And if we allow that to happen, if we let ourselves feed the wolf of pain and anger and become one of those who place themselves ahead of others, then what’s the point? We might as well let climate change run unchecked because human society won’t be worth saving anyways.

1. Christina Stevens, ‘Former Canadian Forces trauma nurse speaks out about PTSD,’ Global News, November 13, 2014.  https://globalnews.ca/news/1670741/former-canadian-forces-trauma-nurse-speaks-out-about-ptsd/ accessed 13 Oct 2021.

2. Brandon Specktor, “Coronavirus: What is ‘flattening the curve,’ and will it work?” LiveScience, March 16, 2020, https://www.livescience.com/coronavirus-flatten-the-curve.html, accessed 8 June 2020.

3. Samuel Paul Veissiere, “Caring for Others is What Made Our Species Unique,” Psychology Today, October 28, 2015, https://www.psychologytoday.com/ca/blog/culture-mind-and-brain/201510/caring-others-is-what-made-our-species-unique, accessed 8 Jun 2020.

4. Robert Moore and Douglas Gillette, King, Warrior, Magician, Lover: Rediscovering the Archetypes of the Mature Masculine, New York, HarperCollins Publishers: 1990.