By Rev. Alejandro De Jesus
Pedro was a Hispanic Navy mechanic in his early twenties, working as an assistant in the ship’s air-conditioning and refrigeration equipment area during the Vietnam War in the early 1970s. On his first voyage, after almost two months at sea, he was sexually assaulted by six shipmates. He was tied to a table face down and naked, while his rapists took turns penetrating him. His screams of pain were muted by the noise of huge machines and air-conditioning equipment.
Pedro lay sick and in pain for days. His supervisor, after hearing from him what transpired, even threatened Pedro with reprisal if he squealed. Pedro began to isolate himself from the rest of the crew, often in deep thought or shock, often jumpy and on edge especially when he worked alone. He entertained a lot of suspicion and felt deep anger and resentment. These were all telltale signs of military sexual trauma, abbreviated as MST.
Combat exposure is a general term that refers to events with potentially traumatic effects on military personnel on active duty. This may include witnessing death and injury, being involved in vehicular accidents, or handling human remains. By 2004, after over a decade of continuous investigations and dialogue, MST was added as a “duty-related hazard” in a similar category as combat exposure.
One out of four servicewomen, and one out of a hundred men, report they have experienced MST. While the percentage is lower for men, they are numerically more, simply because of the much higher male population in the military. Also, other data reveal that only 6% of women and 1% of men report it. Both sexual contact and sexual harassment fall under the concept of MST, which includes inappropriate sexual jokes and lewd comments, unwanted physical contact that makes one uncomfortable, repeated sexual advances as well as quid pro quo exchange for sex.
Soon after his rape, Pedro was discharged dishonorably due to incidents including a fist fight in the ship, insubordination, and not following safety instructions. For the next thirty years, Pedro intermittently got into trouble with the law, abused alcohol, drugs and marijuana, and once attempted suicide. In between these events, he was married and divorced twice, while also having two children with his first wife.
Sometime around 2010, with the help of a nonprofit lawyers’ group, he was able to secure a court decision to overturn his dishonorable discharge and receive benefits for MST and other mental health problems. He went through a 28-day rehab treatment program, then another 90-day long-term rehab that included support to gain and maintain work.
Then, in his 60s, Pedro was diagnosed with liver cancer, metastasizing into his other organs. As a palliative patient, all the symptoms of MST resurfaced with a vengeance, especially his depression, extreme range of emotions and combativeness, as well as the inability to trust and the tendency to isolate himself from family and friends as well as from the staff. Pedro had initial difficulty relating and believing in his medical team. The chaplain likewise faced the difficulty of regaining Pedro’s trust in God, whom he blamed for his fate. Is this what he deserved after cherishing his faith when he was a kid?
The chaplain spent many visits listening to Pedro, slowly allowing him to share what he could while assuring him of compassionate support. The chaplain likewise applied the HOPE method. First, the chaplain asked Pedro to identify his sources of Hope, meaning, comfort, strength, peace and love. From where did he draw his internal support, and what sustained him during those desperate moments? Pedro realized that at his lowest point, he would turn to his guitar and start to sing, and that would provide him some respite and even calm from his struggles.
Next, the chaplain asked what Organized religion Pedro recognized, or what aspects of his religion or spiritual community did he find helpful? Pedro loved his second wife’s stubborn reliance on God and church attendance. That, he shared with the chaplain, introduced him back to participating in her local church, and the memories of those years with the church choir gave him the resolve to find God again in his life, as he was then grappling with dying.
Questions about his Personal practices of spirituality similarly indicated to Pedro that he had spiritual insight, that his simple practices of bedtime prayers and occasional church visits and attendance emanated from his deep personal spirituality. This touched on a sensitive part of many veterans’ lives: support systems, family, and friends. Is there a need to reconnect or reunite with any loved one? Is closure a desired goal, and how does the veteran feel about doing it? Would he like the chaplain and other providers to make that possible for him?
Accepting the limitations and burdens of his condition, Pedro realized the Effects of faith on his struggle to find meaning with death and dying. He had come to terms with the tragedies and disappointments that littered his life by laying no blame on God or anyone, least of all himself. Part of his spiritual care plan was to be able to rewrite his life’s story, which is to say to stop viewing his life from the angle of darkness, bitterness and despair, and to see it from the perspective of light, forgiveness and joyful expectation.
Alejandro De Jesus, PhD, BCC, is certified in the NACC, NCVACC, and NAVAC and has specialty certification in hospice and palliative care and in mental health. This article is adapted from a talk at the Fourth Annual Integrative Medicine and Mental Health Conference at UCLA on March 9, 2019.