戰(zhàn)爭(zhēng)創(chuàng)傷后遺癥：帶著愧疚活下去

November 2004， against a shattered wall in south Fallujah in Iraq， with video rolling， I conduct a battlefield interview with US Marine Corporal William Wold. He has just shot six men dead inside a room adjoining a mosque and is juiced with a mix of adrenaline and relief.

“I was told to go the room，” he says，“and my first Marine went in… he saw a guy with an AK， I told him to shoot the guy， then I shot the six guys on the left… and my other Marine shot two other guys.”

Wold grew up near Vancouver in Washington State. A high-school linebacker， he had a college football scholarship waiting for him， but gave it up to join the Marines.

“My fiancées worried that Im not going to come back the same. Ill never tell her what things I did here. Ill never tell anybody， cause Im not proud of killing people. Im just proud to serve my country. I hate being here， but I love it at the same time.”

Wolds fiancée was right. He wouldnt come back the same. He thought his war was over， but a few months later， back in the safety of his childhood home， surrounded by his adoring family， the dark secrets and all the guilt emerged from his mind—like the Greeks from their hollow wooden horse， unrelenting in their destruction of ancient Troy.

A recent study by the US Department of Veterans Affairs （VA） shows that nearly two-dozen veterans are killing themselves every day， nearly one an hour. This attrition， connected at least in part to combat-related post-traumatic stress disorder （PTSD） and other war-related psychological injuries， is an enormous price to pay for avoiding the subject. So great， in fact， that the total number of US active duty suicides in 2012 （349） was higher than the number of combat-related deaths （295）.

“When a leader destroys the legitimacy of the armys moral order by betraying ‘whats right，” writes psychiatrist Jonathan Shay， an expert in combat trauma， in his book Achilles in Vietnam （1994）， “he inflicts manifold injuries on his men.”

This could be what happened to Corporal William Wold. Wolds mother Sandi said he was fine for a while when he first got home， but after a few months the darkness seeped out. He couldnt eat and he never slept.

The transgression that bothered him most wasnt the carnage in the mosque， but another， even more disturbing incident， an accidental killing at a vehicle checkpoint in Iraq. The vague description Sandi gave to a local television reporter is horrifying： “A vehicle came through that hadnt been cleared，” she said. “The lieutenant says：‘Take them out. He took them out. They went to the van—it was a bunch of little kids. And he had to take their bodies back to the family.”

Instead of killing an armed enemy， Wold had， through the orders of an officer， killed several children. The accidental killing of civilians in the Iraq War， as in all wars， is much more common than you can imagine. Numbers are so high it wouldnt benefit the military to keep accurate tabs； rigorous documentation would just fan the public relations nightmare and boost the propaganda value of those deaths for the other side.

Wold， like many combatants， was able to contain his guilt while still in Iraq. But when he returned home， he brought the Trojan horse with him. It was there， in the calm of these“safe” surroundings， that his guilt and shame overwhelmed him. He became addicted to the pain medication prescribed for an injury he had suffered in a roadside bomb attack and augmented that with methadone that he scored on the street.

One night a couple of friends came to visit Wold there. They went out together to see a movie and get tattoos. When they returned to his room， Wold couldnt remember if he had taken his medication or not—so he took it again， in front of his friends.

The next morning， the friends found Wold in bed， in the same position he had been when they had left him the night before. Only now he wasnt breathing. He was pronounced dead at 9：35am.

Sandi felt the Marines had failed her son. But she knew he had loved the camaraderie of the corps and had him buried in his dress blues. She also knew that the uniform was just the surface of a much more complex story， a story of belief， duty and honor yes， but also about how guilt over killing in the pursuit of those ideals could lead to ruin.

I met Lance Corporal James Sperry， like Wold， during the Battle of Fallujah in Iraq in 2004. I videotaped him after he had been wounded during the first day of fighting. Like Wold， Sperry came home with a head battered from war and filled with guilt. But Sperrys guilt wasnt over killing； it was over not being killed， survivors guilt. His unit suffered some of the highest casualty rates of the war.

He sent me an email six years after Fallujah， thanking me for helping carry his stretcher that day and asking if I had any photos of his comrades killed in action. “I was wondering if you had taken any photos of me during that time of injury and any of my fallen friends. I have lost 20 friends in this war and would like to get as many pictures as I can.”

That note came during a dark period of Sperrys life， when he was struggling with cognitive impairment and debilitating migraines from his physical injuries and a host of psychological issues consistent with moral injury. He met nearly all of its criteria， including purposelessness， alienation， drug and alcohol use， and even a near-suicide attempt （he went as far as to sling a rope over the rafters of his garage）.

His recovery， which took years， was not the result of a single act， but encouragement from family and friends， ongoing determination and a groundbreaking program from the Shepherd Center in Atlanta， which specializes in helping those with brain and spinal cord injuries.

Corporal Wold and Lance Corporal Sperry are just two of millions. According to US Department of Defense data， since 2001 about 2.5 million Americans went to war in Afghanistan and Iraq， with more than 800，000 deploying more than once. Nearly 700，000 of those veterans have already been awarded disability status， with another 100，000 pending， according to the VA.

They all need support. As Jonathan Shay wrote in Achilles in Vietnam： “When you put a gun in some kids hands and send him off to war， you incur an infinite debt to him for what he has done to his soul.”

2004年11月，在伊拉克的費(fèi)盧杰南部，我靠著一堵千瘡百孔的墻，在攝像機(jī)前對(duì)美國(guó)海軍陸戰(zhàn)隊(duì)下士威廉·沃爾德進(jìn)行了一次戰(zhàn)地采訪。他剛剛在一座清真寺旁的一間房間里射殺了6名男子，現(xiàn)在內(nèi)心感到既激動(dòng)又如釋重負(fù)。

“我受命進(jìn)入那個(gè)房間，”他說道，“我前面的那個(gè)隊(duì)友進(jìn)去了……看見有人拿著一把AK步槍，我讓他開槍射殺那人，然后我就射左邊的那六個(gè)……我另一名隊(duì)友射殺了另外兩個(gè)。”

沃爾德在華盛頓州毗鄰溫哥華的地區(qū)長(zhǎng)大。高中時(shí)他是橄欖球隊(duì)的線衛(wèi)，本來獲得了一所大學(xué)的橄欖球獎(jiǎng)學(xué)金，但是他為加入海軍陸戰(zhàn)隊(duì)放棄了獎(jiǎng)學(xué)金。

“我的未婚妻擔(dān)心我回去的時(shí)候就變了。我絕不會(huì)跟她說我在這兒所做的事。我絕不會(huì)告訴任何人。因?yàn)槲也粸闅⑷硕院?。我只為自己能為?guó)效力而自豪。我討厭待在這里，但同時(shí)又熱愛置身其中?！?/p>

沃爾德的未婚妻是對(duì)的。他回去的時(shí)候就不再是原來那個(gè)人了。他以為他的戰(zhàn)爭(zhēng)結(jié)束了，但數(shù)月之后，當(dāng)他回到安全的兒時(shí)家鄉(xiāng)，回到摯愛的家人身旁，那深藏內(nèi)心的陰暗秘密和愧疚便一涌而出——就如同希臘人從空心木馬中涌出，毫不留情地將古特洛伊城摧毀一樣。

美國(guó)退伍軍人事務(wù)部最近的一項(xiàng)研究表明，每天有二十多名退休軍人自殺，平均約一小時(shí)就有一名。造成這一損失的原因至少部分在于由戰(zhàn)爭(zhēng)引起的創(chuàng)傷后應(yīng)激障礙和其他與戰(zhàn)爭(zhēng)相關(guān)的心理創(chuàng)傷，這是我們?yōu)樘颖軞⒙具@一話題所付出的巨大代價(jià)。事實(shí)上，問題嚴(yán)重到在2012年美國(guó)現(xiàn)役軍人的自殺總?cè)藬?shù)（349人）比因戰(zhàn)爭(zhēng)犧牲的軍人總?cè)藬?shù)（295人）還要高。

精神病學(xué)家喬納森·謝伊是一名戰(zhàn)爭(zhēng)創(chuàng)傷方面的專家，他在其1994年出版的著作《阿喀琉斯在越南》中寫道：“當(dāng)一位軍事領(lǐng)導(dǎo)背叛‘正確之事，破壞軍隊(duì)的道德理性，他就會(huì)在很多方面對(duì)其部下造成傷害?！?/p>

這可能就是發(fā)生在威廉·沃爾德下士身上的事。沃爾德的母親桑迪說，他剛回家那會(huì)兒狀態(tài)還很好，但是幾個(gè)月后，他內(nèi)心的黑暗不斷滲出。他開始吃不下飯，睡不著覺。

最折磨他的罪行并不是那次在清真寺中的大屠殺，而是另一起事件，一起更加令人不安的事件：在伊拉克的一個(gè)車輛檢查站的一次誤殺。桑迪向當(dāng)?shù)匾幻娨暸_(tái)記者模糊描述的情形令人震驚：“一輛車開過了檢查站，但是沒有經(jīng)過安檢?！彼f，“上尉說：‘把他們干掉。他就照做了。然后他們走向那輛小貨車——里面是一群小孩子。他還不得不把他們的尸體送回各自的家?！?/p>

沃爾德沒有殺死武裝的敵人，反而在長(zhǎng)官的命令下殺了數(shù)名孩子。不光是伊拉克戰(zhàn)爭(zhēng)，在所有的戰(zhàn)爭(zhēng)中誤殺平民的情況都相當(dāng)普遍，已遠(yuǎn)遠(yuǎn)超過你的想象。誤殺的數(shù)字太大，所以準(zhǔn)確地記錄下來對(duì)軍方而言并沒有什么好處。嚴(yán)格的文件記錄只會(huì)給公關(guān)工作帶來噩夢(mèng)，還會(huì)為敵軍就這些死亡人數(shù)增添了宣傳價(jià)值。

沃爾德就像許多戰(zhàn)士一樣，在身處伊拉克時(shí)還可以控制住自己的愧疚。但是當(dāng)他回到家鄉(xiāng)，他就把那只特洛伊木馬也一同帶了回去。正是在那里，在這種“安全”環(huán)境的平靜氛圍里，他的愧疚和恥辱壓垮了他。他開始對(duì)一種止痛藥上癮——那是他在一場(chǎng)路邊炸彈襲擊中受傷時(shí)醫(yī)生給他開的藥，而且他還變本加厲從街上買來鎮(zhèn)痛藥美沙酮一起吃。

一天夜里，沃爾德的幾位朋友前去看望他。他們一起去看了場(chǎng)電影，還文了身。當(dāng)他們回到他的房間時(shí)，沃爾德不記得自己是否吃過藥——所以他當(dāng)著朋友們的面又吃了一次。

第二天早上，朋友們發(fā)現(xiàn)沃爾德躺在床上，姿勢(shì)和前一晚他們離開時(shí)一模一樣，只是此時(shí)他已經(jīng)沒了呼吸。9點(diǎn)35分，醫(yī)生宣布他死亡。

桑迪認(rèn)為海軍陸戰(zhàn)隊(duì)辜負(fù)了她兒子。但是她知道，他熱愛軍隊(duì)的戰(zhàn)友，于是就讓他穿著藍(lán)色的軍服下葬。她還知道，在這套軍服背后有著一個(gè)更為復(fù)雜的故事。沒錯(cuò)，那是一個(gè)有關(guān)信念、責(zé)任和榮耀的故事，但它同時(shí)也告訴我們，為了追求那些理念而殺人所引發(fā)的愧疚是怎樣帶來毀滅的。

就像我和沃爾德的相遇那樣，我和準(zhǔn)下士詹姆斯·斯佩里也相識(shí)于2004年伊拉克的那場(chǎng)費(fèi)盧杰戰(zhàn)役。他在第一日的戰(zhàn)斗中受了傷，我把他的情形拍攝了下來。就像沃爾德一樣，當(dāng)斯佩里回到家鄉(xiāng)時(shí)，他的腦袋因戰(zhàn)爭(zhēng)而受了重傷，內(nèi)心充滿了愧疚。但斯佩里并不是因?yàn)闅⒘巳硕⒕危且驗(yàn)樽约簺]有被殺，因?yàn)樽约夯盍讼聛矶械嚼⒕?。他所在的小?duì)在那場(chǎng)戰(zhàn)役中的傷亡率幾乎是最高的。

在經(jīng)過費(fèi)盧杰戰(zhàn)役六年之后，他給我發(fā)來了郵件，感謝我那天幫忙給他抬擔(dān)架，還問我有沒有他那些戰(zhàn)死的戰(zhàn)友的照片?！拔蚁胫?，在我受傷的時(shí)候，你是否給我或者我那些倒下的戰(zhàn)友拍過照。在那場(chǎng)戰(zhàn)爭(zhēng)中，我失去了20名戰(zhàn)友，我希望盡可能多地收集到他們的照片?！?/p>

郵件發(fā)來時(shí)，斯佩里正處于生命中的黑暗時(shí)期。那時(shí)，由于身體上的創(chuàng)傷以及許多與道德創(chuàng)傷相吻合的心理問題，斯佩里正與認(rèn)知障礙以及日益加劇的偏頭痛做著斗爭(zhēng)。他符合幾乎所有的道德創(chuàng)傷標(biāo)準(zhǔn)，包括無目的感、疏離感、濫用藥物、嗜酒、甚至還曾試圖自殺（他甚至都將繩子掛上車庫(kù)的椽木了）。

幾年之后，他終于康復(fù)了，但這并不是一方努力的結(jié)果。家人和朋友給了他鼓勵(lì)，再加上他自己堅(jiān)持不懈的決心，以及來自亞特蘭大指導(dǎo)中心的一項(xiàng)開創(chuàng)性的康復(fù)計(jì)劃——該中心致力于幫助那些大腦或脊髓損傷的病人。

沃爾德下士和斯佩里準(zhǔn)下士只是幾百萬退休軍人中的兩個(gè)代表而已。根據(jù)美國(guó)國(guó)防部數(shù)據(jù)統(tǒng)計(jì)，2001年至今，大約有250萬美國(guó)人投身阿富汗和伊拉克戰(zhàn)爭(zhēng)，超過80萬士兵不止一次參與部署。美國(guó)退伍軍人事務(wù)部指出，這80萬退伍軍人中，有70萬人已經(jīng)獲得了傷殘證明，而剩下的10萬人仍有待處理。

他們都需要幫扶。正如喬納森·謝伊在《阿喀琉斯在越南》中寫到的那樣：“當(dāng)你將一把槍置于一個(gè)孩子手中，然后將其送往戰(zhàn)爭(zhēng)，那你會(huì)給他背上無窮的罪過，因?yàn)樗乃魉鶠橐咽顾撵`魂殘破不堪。”