Exodus Trekkers: Moral Wounds: Elusive Curse of Our Combat Soldiers

Not Exactly Your Usual PTSD

By Robert R. Schwarz

At the Megong Delta, Vietnam. Capt. Mukoyama in rear ( with
helmet ). Photo by Shunsuke Akatsuka .

Moral Injury stems from the participation in acts of combat

that conflict with a soldier's deeply held principles. This

unseen impairment leads to a sense of guilt, shame, and

grief which can manifest itself as self-harm or suicide if

not addressed. (Military Outreach USA)

You learn to kill, and you kill people, and it’s like, I don’t

care. I’ve seen people get shot, I’ve seen little kids get shot.

You see a kid and his father sitting together and he gets shot…

And once you’re able to do that, what is morally right anymore?

How good is your value system if you train people to kill

another human being, the one thing we are taught not to do?

When you create an organization based around the one taboo

that all societies have?” ( Comments from a veteran with a

moral wound, quoted by David Wood in the Huff Post )

Our service members in combat are confronted with split

second life and death decisions every day. The enemy is

often dehumanized , and there are unconventional terrorist

actions disregarding all rules of human decency that often

result in an attitude among our military that forces a strict

concentration on accomplishing the mission to protect

one's fellow unit members regardless of one's moral code .

( Fr. Matt Foley, church pastor and former Army chaplain who

served in Afghanistan )

Veteran suicides due to Post Traumatic Stress Disorder ( PTSD)

and its related moral wounds may be as high as 22 a day, according

to a 2012 VA Suicide Data Report, which also reported that suicide

rates are difficult to track and get revised from time to time.

On last September 19, a retired U.S. Army general, a clinical psychologist, a church pastor, and the executive director of Military Outreach USA met in Chicago to discuss what they believe is an elusive and often life-threatening casualty of American combat veterans: the so-called moral wound.

A small audience of veterans and family members along with various health-care professionals crowded the Pritzker Military Museum and Library auditorium to prompt some answers about moral wounds for which there is no Purple Heart and which has existed and been largely ignored for centuries. Strictly speaking, this is not Post Traumatic Stress Disorder ( PTSD). A moral injury can go undiagnosed for 30 years , according to several published research studies.

Leading the panel discussion was Major General Jim Mukoyama ( ret ) , a Vietnam veteran who the narrowly survived a moral wound and went on to become a highly decorated soldier and the then youngest Army general and its very first Asian-American to command an Army division. Soon after his retirement, Gen. Mukoyama founded Military Outreach USA , a national not-for-profit, faith-based organization focused on caring for veterans with moral wounds and educating the public about them. [ www.militaryoutreachusa.org ]

[ A separate article describing the firefight with which Gen. Mukoyama was confronted in Vietnam appears at the end of this article. ]

Major Gen. Mukoyama, then the youngest Army
general and first Asian-American to command
an Army division.

Other panel members were John Patrick Bair, clinical psychologist with the mental health and stress disorders program at the Captain James A. Lovell Federal Health Care Center ; Joseph Palmer, executive director of Military Outreach USA and author of the book "They Don't Receive Purple Hearts " ; and Fr. Matt Foley, pastor of St. James Catholic Church in Arlington Heights, Illinois. [ This event will televised Dec. 4 on WYCC channel 20 at 11 a.m. ]

Prayer, Forgiveness, Counseling Needed

For years, Gen. Mukoyama has maintained that "the main approach for moral injury is not a medical doctor with prescription drugs, but rather one that includes the forgiveness and grace of a moral authority , a loving God, the counseling of clergy and a sensitive therapist, and the fellowship of a spiritual community . " The church has a major role in healing veterans of moral wounds, " he says . Recalling how his own church welcomed him back from Vietnam with "open arms " , he stressed that " one should never underestimate the power of prayer. "
Himself an active Christian worker since childhood, the general explained that the best—and perhaps only—way for the aging veteran who has been struggling for years with unresolved guilt from killing someone in combat, lies in service to other people , and in becoming part of a forgiving community . The general believes that in the church this veteran can not only regain the devastating loss of his or her self-worth but can find forgiveness , if not resolution and healing of his wound. He said that when a soldier "does a terrible act , the soldier believes he is worthless , that nobody can love them, that God can't love them. In fact, they get mad at God . "

Fr. Foley answering questions for two audience members

The panel discussion at Pritzker also pointed out that throughout history of warfare, soldiers were exposed to moral wounds . Cited were examples as the battle of Midian (mentioned in the Biblical book of Numbers 31:19-24 ; Moses commanding his soldiers returning from battle to "purify" themselves by a harsh cleansing of their clothing and other articles; and knights returning from the Crusades who could not participate in the church's holy sacraments until they performed acts of penance and confession of sins they committed as warriors .

Gen. Mukoyama's organization provides free resources, training, and education to houses of worship. The goal of Military Outreach USA is to increase its current national network of 400 churches to 20,000. " Churches can be the beacons of light and demonstrate God's love, " he said.

Just before undergoing heart surgery, the general (also wounded by Agent Orange in Vietnam ), when asked by the doctor leaning over him how he felt, his patient replied: " Since you asked…I am a Christian, Christ is my savior. You are a skilled surgeon, your nurses are skilled. But God's in charge, and whatever He decides, I'm, okay with it. " The doctor nodded and smiled.

Moral Justification to Kill ?

The moral justification of killing in warfare— a multi-faceted, debatable topic —often took center stage .

" A moral wound breaks down the best of our thinking, " VA clinical psychologist John Patrick Bair told the audience. Dr. Bair, a Unitarian, annually treats nearly 300 veterans with PTSD and moral wounds at his federal health care center in North Chicago. Patients normally remain there for seven weeks.

Former Army Ranger Lt. Colonel Dave Grossman writes in his book , "On Killing " (Open Road Integrated Media, Inc., New York, copyright 2009 ) that "the vast majority of soldiers are loath to kill in battle " but then adds, " unfortunately, modern armies, using Pavlovian and operant conditioning, have developed sophisticated ways of overcoming this instinctive aversion."

The soldier learns a " warrior code " says Gen. Mukoyama. " You don't have to be the one who pulls the trigger. You might be a witness or someone who could have prevented [ a killing ] . But in combat, one does not have time to reflect on this, and so you repress it . Later, you have more time on your hands to think, and then the moral injury bubbles up to the surface. Almost 70 percent of veteran suicides are of vets older than 50. The suicide rate among our veterans is at epidemic levels. We have lost more veterans due to suicide in one year than all the combat deaths since 9-11. "

Fr. Foley , who served five and a half years as an Army chaplain in Afghanistan and has since counseled several veterans with moral wounds, said in a later interview that a soldier in a firefight with the enemy "can't hesitate. " Firing his weapon at the enemy "is an instinct ", he said. He noted that the military can't talk about Christian values due Constitutional provisions about the relationship church and state. More than anything else he remembers about moral wounded veterans is " their incredible pain and inability to remember the act that caused this pain. "

A Problem for the Military

Two questions that were begged that evening at Pritzker ( and not answered clearly ) were: (1) how should the military deal with a young soldier with Christian values and a moral code going into battle and not wanting to kill one of the enemy ? and (2) how would our government deal with a possible future situation where several thousand of our military had to quickly prepare for an aggressive attack on the enemy when the majority of them had very strong moral codes against killing ?

( The panelists, from left : Joseph Palmer, John Bair, Fr. Foley,
and Gen. Mukoyama (ret ).

In a telephone conversation after the panel discussion, Joseph Palmer asserted that the military should have trained the soldiers for this battle. He also asserted the clarity of the Commandment Thou Shall Not Kill . " It is perfectly permissible to defend your country in a 'just war' and to save someone's life . In defense of your country, saving someone's life is neither a sin nor a crime. "

What about WWI Hero Sgt. York ?

Military historian Col. Douglas V. Mastraino last October told an Army veteran audience how the World War hero Sgt. Alvin York ( depicted by Gary Cooper in the 1941 movie "Sergeant York " ) unsuccessfully resisted being drafted into the Army after being converted to Christianity. According to Col. Mastriano, who spent 12 years researching his book, "Alvin York: A New Biography of the Hero of Argonne ", York replied to the Draft Board, "Okay, I'll serve but not kill. " York, however, when seeing his fellow soldiers being killed by German machine gun fire, shot dead several of the enemy and heroically captured 132 German soldiers. He was awarded the Medal of Honor.

Military historian Col. Douglas Mastriano

"The truth of your moral character comes out in battle, " Col. Mastriano told the veterans

—most of them having served with the lst Infantry Division— and their wives at Cantigny Park, Illinois , a large garden and military museum complex . " A hero is someone who has built his moral character all this life. "

Lt. Col. Grossman in his book referenced the Bible ( Romans 13: 4 ) , that governing authorities do not bear the sword for nothing; for it is a minister of God, an avenger who brings wrath upon the one who practices evil. He also reminds readers of Jesus' words (John 15:13), that Greater love has no one than this, that one lay down his life for his friends.

Fr. Foley told fellow panel members that his warfare experience in Afghanistan showed him that killing to save the life of one's buddy in combat will override any other moral code of a soldier.

A 2004 study of Vietnam veterans by Ilona Plvar, now a psychologist with Dept. of Veterans Affairs, found that grief over losing a combat buddy was comparable , more than 30 years later, to that of a bereaved spouse whose partner had died in the previous six months.

As Fr. Foley and I walked out of the Pritzker museum that night , we agreed that moral injuries are regularly inflicted upon people in their ordinary , daily lives. " Such as?" I asked. "Such as abortion, " he replied with conviction. We sort of summed up the recent panel discussion by admitting War , indeed, is Hell. I went home and thought about what my Christian faith had explained to me decades ago about why we still have wars when so many on this planet, especially governments, plead and even pray for peace: An explanation came to me from James 4:3: You ask and do not receive, because you ask with wrong motives.

The End

All comments are welcome.

rrschwarz7@wowway.com

The Vietnam battle scene for which the then Captain Mukoyama was awarded a purple heart and narrowly avoiding a moral wound .

Note: The following article was written after an earlier interview with Gen. Mukoyama.

' Serving God Is My Greatest Commission '

How a Retired U.S. Army General Is Helping

To Heal the Moral Wounds of War

By Robert R. Schwarz

Something had hardened my heart, where only moments earlier these were live human beings , children of God ; they had families, they had loved ones, they had emotions, and yet I was treating them like they were bumps on a log. Then I remembered Jesus' Sermon on the Mount, where He told us to pray for our enemies. So in the middle of all this stuff going on, I just said a silent prayer for the three Vietcong and their families—and for myself . [ The words of Gen Mukoyama , who today will tell you that in that prayerful moment he avoided being wounded morally. It was a grace that shaped the rest of his life. ]

Jim Mukoyama, then a captain in June 1969
at a fire support base danger at My Tho.

In June of 1969 in the 14th year of the Vietnam War, 150 American soldiers of Company B, 4th Battalion of the 39th Infantry, 9th Division, are led silently through the Mekong Delta jungle in search of their Vietcong enemy. Their three platoons are being led by Capt. James Hidefumi Mukoyama, Jr. , who will became one of the youngest major generals in the U.S. Army .

Each man carries from 25 to 30 pounds of gear, which includes hand grenades and M16 semi- automatic rifles ; Capt. Mukoyama's weapon is an AR15, a modified version of his men's rifles. The enemy they are about to encounter kills with the Russian-developed , semi-automatic and gas-operated AK-47 (also known as the Kalashnikov ).

Since early morning, Company B has moved in a fan-shaped patrol with fox-like alertness. This particular enemy are guerrillas who operate in small units of perhaps 27 men who have shed military uniforms. They attack by ambush. Their strategy is simple—but always violent—to disrupt operations of larger American units and then to flee quickly.

The sun is much higher than when Company B started out and has likely drawn the Fahrenheit up to 90 and the humidity to a Delta average of 84 degrees. Their captain has a report that " the enemy is in the area " and keeps the patrol moving aggressively through the dense jungle of palm trees and impenetrable walls of bush-thickets. If anything diminishes the men's mission focus, it is the sudden , occasional monkey screeches and exotic bird squawks. Nearby are the Delta rice paddies and near them, disease-ridden swamp waters with snakes, leeches, and malarial mosquitoes. Here and there the Vietcong have placed a skull and crossed bones on a sign it to warn their own men of a booby trap. But Company B has discovered that some of the signs falsely indicate booby traps and purposely exist to detour this American patrol closer towards harm's way . But after ten months of combat in this delta, Capt. Mukoyama's men are hardened to the environment and know how to cope with any threat.

Capt. Mukoyama would later recall that the constant pumping of his adrenaline left little room for fear or doubts about the value of this patrol's mission. Freedom is not free, he would tell himself. Yet , as the men now neared the likelihood of a firefight, some of them, no doubt, experienced , if for a split second , a vivid flashback of a past firefight. For their captain, it was the memory of that ground-concealed hand grenade booby trap that exploded, mortally wounding one of his men and piercing Capt. Mukoyama's arm with shrapnel . And there was that tripped booby trap which wounded six of his men , killing one of them , the only fatality suffered by his company in Vietnam.

Suddenly, one of the platoon point men shouts " Enemy !" No more than 50 yards ahead is an encampment of maybe 25 Vietcong guerrillas caught by surprise. Both sides began firing at the same time; for several seconds no human voices are heard. Capt. Mukoyama instinctively acts: He keeps his men advancing while he stays in contact with his platoon leaders and makes sure all three platoons are engaged in the fight. The fight moves with the rapid precision of a professional football team . It is permanently etched in the captain's mind .

(In 2015 , this captain will edit the publication , "They Don't Receive Purple Hearts" , ©2015 Military Outreach USA . In the publication , he and Joseph Palmer, another veteran and the manual's author, share their first-hand knowledge about a soldier's moral injury and the knowledge they gleaned from 79 experts and other sources. )

The military culture, like any other culture, has its own sets of

rules and codes. What makes the military culture different ,

however, is that it teaches, trains, encourages, and rewards

the killing of other human beings….Service members, of any

military, are conditioned to act without considering the moral

repercussions of their action; they are enabled to kill without

making a conscious decision to do so. In and of itself, such

training is appropriate and morally permissible. ..( from "They

Don't Receive Purple Hearts " )

The men of Company B keep firing and advancing until they are about 20 yards away from the guerrillas , who soon retreat. The firefight lasts 10, maybe 15 minutes at most. There are no American casualties—this time. Three dead, bloodied Vietcong bodies lie at the feet of Capt. Mukoyama . He would later admit that he stood over them for a moment or two without any compassion, seeing them as lifeless animals .

( more from "They Don't Receive Purple Hearts ) Conscience

can be overridden or suppressed by circumstance or emotional

condition. …."The rush of battle " may cause conscience to be

" blanked out". It may be only after the battle is over that one's

conscience will play on the mind and begin to cause guilt or

shame.

The young captain quickly shouts orders to his platoon leaders: " Reorganize your units! Take care of any wounded ! Redistribute ammunition! " Then , aware that in the wake of a combat victory is when soldiers are most at risk of a counter-attack, he leads his troops away...

In Vietnam, Captain Mukoyama is awarded the Bronze Star by
a general

Decades later , Capt. Mukoyama recalls this scene during our interview, especially what happened immediately after his evacuation orders to his men… " I'm saying all this stuff, and then I stop and look at those three bodies at my feet and realize that something had happened to me. Something had hardened my heart, where only moments earlier these were live human beings , children of God ; they had families, they had loved ones, they had emotions, and yet I was treating them like they were bumps on a log. Then I remembered Jesus' Sermon on the Mount, where He told us to pray for our enemies. So in the middle of all this stuff going on, I just said a silent prayer for the three Vietcong and their families—and for myself. I didn't make a big ceremony out of this. I didn't get on my knees. All of this maybe lasted 45 seconds,but it remained me with me for the rest of my life. "

That captain today at age 71 will joyfully tell you that in that prayerful moment he avoided being wounded morally. He would also say it was a grace that shaped the rest of his life….

For that "rest' of his life", read on …

The General's March from Cub Scout to 2-Star General, 1953-1995

Some of the 200 veterans whom Gen Mukoyama
addressed on Veterans Day in 2015 in Arlington Heights, IL.

Forty-six years later, this captain is a highly decorated, 71-year-old retired major general now standing before an estimated 200 veterans in a church auditorium with new "marching" orders. He is there to tell them , among other encouraging things, how he himself avoided a moral wound and how they and/or their veteran buddies can heal their these wounds.

The occasion is the Annual Arlington Heights ( IL ) Veterans Breakfast , and General Jim Mukoyama is now president and chief executive officer of Military Outreach USA (www.militaryoutreachusa.org ) , a national, faith-based nonprofit ministry he recently founded to help veterans and their families recover from moral injuries. On his Army dress jacket are more than 20 military decorations and badges, including the Distinguished Service Medal, Silver Star, Legion of Merit, Bronze Star Medal with two Oak Leaf Clusters, the Purple Heart, and four decorations from the Republic of Vietnam. When asked for a description of the events which earned him these honors, the general replied modestly, " Let me just say that I was in the wrong place at the right time and had great non-commissioned officers who made me look good. "

To his audience, he makes no mention of having been a victim of Agent Orange (the deadly defoliation spray used against the Vietcong ) , which eventually led to his heart attack, a kidney transplant, and his current 80 per cent veteran disability. Nor will the veterans here learn about his B.A. in English literature from the University of Illinois or that his retirement resume includes so much activity with financial services and charitably agencies , that it begs the question if he ever slept.

He also participated for 15 years in the Military Ministry of CRU (formerly Campus Crusade for Christ) and as a volunteer instructor at the U.S. Navy Great Lakes Recruit Training Center.

One soon notices that this retired soldier , however, does not fit the Hollywood movie profile of a combat general. Those who interacted with him earlier at breakfast saw a bespectacled , five-foot-four-inch man with smiling brown eyes and a genuinely cheerful and warm personality.

He takes his audience back to that Mekong Delta fire fight and sums it up with : "The concept is that when you have a moral injury in combat , you don't have time to address it and think about it. So what do you do ? You suppress it, and it becomes unresolved grief. Often it does not bubble up until these veterans are 55 or retired, and then [ for the moral wound to heal], they must have coping skills such as performing a service for others, church involvement, or confession ."

He emphasizes the importance of the morally wounded veteran (or anyone wounded morally) to rebuilding a sense of worthiness , of self-worth. The absence of this , Jim Mukoyama cautions, has proven to be a factor in suicide among veterans and also among men, women , and children who have "no moral compass " or have discarded it and now have given up hope.

Helping Homeless ' Move In '

During one month early in 2016, Military Outreach USA helped more than 2,000 homeless veterans move into decent living quarters by providing them with full-size beds with linens and items such as cleaning materials, utensils, toilet paper, and towels. It prompted the Secretary of Veterans Affairs, Robert McDonald, to have signed a Memorandum of Agreement in January , 2016 that recognized Military Outreach USA as a contact for all VA centers nation-wide.

General Mukoyama has formally stated: " As a Christian organization, we integrate scriptures and religious references, but as we are ecumenical and serving anyone who has worn the uniform of the Armed Forces of our nation and their family members, we do not force our religious beliefs on others or have a religious criteria for our services. Our goal is to demonstrate God’s love through our words, actions, and serving. "

How the General's 'Moral Compass' Was Formed

The "moral compass" which Gen. Mukoyama believes defines one's life , likely defined

him while growing up in a lower-middle class family in Chicago's Logan Square

Fr. Foley, a former Army Chaplain, and the general . Both belong
to Military Outreach USA, which Gen. Mukoyama founded.

neighborhood. Then, with nostalgia , he describes how he led the life depicted in the still-celebrated paintings of Americana by Norman Rockwell . "Every Sunday we'd put on our best Sunday clothes and walk—as a family—to church . I was baptized and confirmed and sang in the choir. " He was a Cub Scout and Boy Scout , had a newspaper route, attended Schurz High School , and played the saxophone and clarinet at Polish weddings. ( At a guest appearance in 2015 at Schurz, he admonished the students: "Complete your education and compete in life. ")

Born in Japan, his father immigrated here in 1918 and moved to Chicago in the early 1930's ; his mother , of Japanese descent, was born in Madison, Wisconsin. In Chicago, the senior Mukoyama opened a retail gift store , which after 30 years became unprofitable due to the nearby large chain-owned stores that had sprung up. "My father could have easily declared bankruptcy but he didn't for the sake of family honor and his integrity, " the general says. His father belonged to the local chamber of commerce and to a committee to help settle Japanese Americans who had been interned on the West Coast during the World War II and had come to Chicago "with nothing" . All of this, he says, " Is a lesson I'll never forget. " Both his parents and grandparents remained married for 55 years.

After that, he rose fast through the ranks and, in 1986 , became the then youngest general in the Army; and two years later, he was the first Asian-American in United States history to command an Army division. When asked later in life what his biggest challenge had been , Jim Mukoyama said, " I really don't think there's been a lot of challenges. I've always felt that if I worked hard and studied hard enough, I'd be successful in life. "

At Last, His 'Greatest Commission '

And we know that God causes all things to work

together for good to those who love God, to those

who are called according to His purpose…

(Romans 8:28, and what the general believes )

With uncharacteristic emotion , Jim refers his founding of Military Outreach USA as "my greatest commission. " He describes its unique effectiveness this way: " The main prescription for moral wounds is not a doctor or medical drugs but forgiveness from a loving God, Christian counselors , and the fellowship of a spiritual community . Big government is not the answer; it's the local community. The good news is that there's a church in every local community. We provided a lot of help, it's free of charge ! "

After a year of Jim Mukoyama's leadership, the military outreach is active in 80 churches, and today more than 400 churches in 40 states have signed on to its national network. Civic organizations such as Lions Clubs have also joined . The goal of Military Outreach USA and its cadre of volunteer workers is to enlist 20,000 thousand churches who reach out to veterans and their families with near-comprehensive help that includes help for homeless veterans. "When I was in Vietnam my church members were sending me packages and praying for me…. A lot of Vietnam vets who came back were spit on and called 'baby killers. ' My church welcomed me with open arms . "

Reflecting back on his entire life, Jim says, "All these things God has woven together. I came to Christ when I was nine years old at the Moody Bible summer day camp. I still have the Bible cover from that camp. As a teenager I wanted to become a minister. But I also loved the military. I finally said to God, ' I guess you don't want me to do the ministry thing, so I'll just move on with the military thing. ' "

His Constant Battle Cry through the Years: 'Cling to Your Faith '

We sat down and continued talking. When asked if the military code of behavior had ever hampered the religious callings he had had since youth, Jim exclaimed, "Not at all! I remained active in church. " He said he encouraged his soldiers to stay fit physically, professionally, attitudinally ( i.e., positive thinking ) , and spiritually.

" As I went higher in rank, I was able to talk more to the troops about my spirituality, but without proselytizing anyone. I only mentioned the name of Jesus if I was personally asked about my own faith. When I did, one or more soldiers would later tell me , 'We're happy you said that . ' "

Minutes Before Heart Surgery: ' Every Day Is a Great Day'

What makes him happy ? " When I see God being glorified, like in nature such as a sunrise, a baby being born , seeing people serving others. A dozen times a day I say, Every day is a great day!" He recalled how he said this even when his wife was driving him to the hospital after his heart attack four years ago. "When I had that heart attack and was being wheeled into the operating room, I asked myself, 'Can you say today is a great day?' My answer was an unequivocal 'Yes, I can.' I had been given 40-plus years of borrowed time since Vietnam, when many of my comrades died, and today I have a wonderful wife and children , live in the finest country in the world and , most importantly, a relationship with my God through my faith. " Those words remain his life's mantra .

Just before his surgery and after the doctor had asked Jim some routine questions , Jim repeated what he had told himself minutes ago. It prompted the surprised physician to ask Jim , " What is your faith ? "

Jim expressed it this way: " Since you asked… I am a Christian, Christ is my savior , you are a skilled physician, your nurses here are skilled. But God's in charge, and whatever He decides I'm okay with it. So, let's get on with it. "