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Home » Vision » January-February 2020 » Dying veteran confronts moral injury as ALS worsens

Dying veteran confronts moral injury as ALS worsens

By Natalie O’Loughlin

The biblical story of the lost sheep always reminds me of veterans. First, veterans would never leave one of their own behind. Secondly, God is searching out the lost for a relationship in this parable. Sadly though, many veterans worry about how God sees them. In hospice care, they often say, “I wonder if God will forgive me,” or “I’m afraid God cannot forgive me for what I have done.”

Many veterans have trust issues because of physical, emotional and spiritual harm done to them, a frequent consequence of moral injury. The Department of Veterans Affairs defines this condition as “the damage done to one’s conscience or moral compass when the person perpetrates, witnesses, or fails to prevent acts that transgress one’s own moral beliefs, values, or ethical codes of conduct.”

Moral injury causes one to question their very identity and the meaning of their life. Sufferers feel they are not worthy of being loved. The feeling of not believing that you can be loved by anyone, including God, must be a very empty, lonely and fearful place. Love is the foundation we need to say, “This is who I am.” As Matthew 7:24 says, we need to hear God so we can have a foundation built on rock. If one does not feel able to be loved by God, where is their foundation? The combination of war and disease has a way of crumbling foundations.

I have seen veterans on the hospice unit afraid to die because of the moral injuries they have suffered — now that their lifespan has a definite time frame, they have a true fear of God, and the shame that has been part of their lives comes to the very forefront. One veteran in particular struggled with the idea of who God was, and how God handed out punishment. This Vietnam veteran, diagnosed with ALS (Lou Gehrig’s disease), had kept himself in excellent physical shape and worked in the government and law enforcement after his honorable discharged from the Marines. He was highly respected and well educated. When he came into the VA for hospice, he was angry at everyone, including God. I worked with him for three months as his disease progressed rapidly.

Moral injury causes one to question their very identity and the meaning of their life. Sufferers feel they are not worthy of being loved.

When I first walked into his room, I wasn’t sure what would happen. The man told me he had no religion but believed in “some God,” and he voiced his anger. “How could God do this to me? I have been a good man. I did the right things for my family. What kind of God would do this to a good person? I fought the war I was asked to fight.” He had space to be angry and space to lament, and I sat with him in his anger. After all, chaplains do not have the answers and I was not there to fix anything.

In that small hospice room, we delved into what God looked like for this veteran. Eventually, I posed a thought to him: “What if God did not do this to you but is walking with you in this disease?” He stopped and looked at me and said, “I never thought of God walking with me.” I let him sit with that. Over time, we talked about a God of love. We were able to explore what love looks like, and the trust we built also allowed him to reveal broken relationships with his children. War tends to disrupt family relationships. Moral injury causes a veteran to have trouble with relationships when trying to integrate back into society, especially those closest to him or her. A veteran does not want to traumatize family by speaking the horrors of war to them.

My patient and I took baby steps. We talked about how Vietnam veterans came home from the war and were treated with disrespect and seldom thanked. We talked about how war changes people and you are “never the same.” We talked about ALS and what it was doing to him physically, emotionally and spiritually. We spoke of the meaning of his life, past, present and future. We talked about his life, traumas, troubles, family, friends and how God has been with him through all of this. He was able to see himself as a lost sheep. The sheep God went after.

Over the course of these conversations, the veteran’s disease grew worse. His voice became weak, and it was difficult for him to breathe. He was not able to reach for a drink of water, and I had to be aware of when he needed one. Some days he had good days, and other days were bad and I could not visit.

It was very difficult to sit and watch this horrible disease take the life of a proud Marine. It was difficult to sit and hear parts of horrific stories and the questions of the aftermath. But I was amazed at the beauty of God’s work in his life. I was amazed at the healing power of God in the midst of ALS, in the midst of questioning the meaning of one’s life journey. The lost are looking to be safe, looking for someone to trust and wanting to be truly loved. God loves his sheep. God also helps to rebuild foundations.

Veterans are strong, resilient men and women who have endured much. Let’s thank all our brothers and sisters who have paid a great price, so we are able to live with all our freedoms.

Natalie O’Loughlin is a chaplain at UPMC Magee-Women’s Hospital in Pittsburgh.


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Ministry to Veterans: Unique experiences, unique challenges

NACC embraces new, official role in ministry to veterans – by David Lichter, Executive Director

Memories of discipline define the veteran experience – by John Paul Stangle

Prayer ritual helps cancer-stricken vet resolve moral injury – by Rev. Alejandro De Jesus

Military sexual trauma may scar veterans’ lives – by Rev. Alejandro De Jesus

Horses and dogs help re-integrate veterans into society – by Maggie Finley

Chaplains offer safe space to veterans with PTSD and addiction – by Anne Millington

Dying veteran confronts moral injury as ALS worsens – by Natalie O’Loughlin

Hospitals honor veterans’ service in life and death – by Connie Foster

Social workers help meet veterans’ inner and outer needs – by Jodie Ellis-Hart

VA medical center offers hope and healing across generations – by Susan D. Decker

Honoring the health care needs of our nation’s veterans – by Sr. Georgeann Roudebush

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