How else can you begin to fathom why this highly-trained medical doctor and psychiatrist started blindly shooting innocent young soldiers at close range on yesterday afternoon at Fort Hood, Texas – the largest military base on U.S. soil.
I'm not making excuses for his unspeakable behaviour. But what happened? Was he sleep-deprived? Why? This is bewildering so many of us.
Stress has been uppermost in my mind this week and if anything illustrates the staggering power of stress on the human mind, body, spirit and soul, surely this horrifying catastrophe does. Thirteen people died. Twenty-eight others are seriously wounded. Hundreds of families and friends are in shock and grieving, desperately in need of counsel and support. A whole country is mourning.
Perhaps Major Nidal Hasan desperately needed but didn't have any support because of the nature of the harrowing emotional demands of his profession.
Surely, what happened to him to cause him to act out as he did had to be related, in part, to the mounting stress, anxiety and fear he must have been feeling at the prospect of his imminent deployment to Afghanistan on November 28.
But I have another thought.
Remember, he's a psychiatrist specializing in "disaster and preventive psychiatry." Post Traumatic Stress in a specific demographic – veterans of war.
He has been treating soldiers returning from intense, active combat in Iraq and Afghanistan – shattered emotionally, spiritually, mentally and physically – after fighting in these two endlessly gruesome, fruitless wars. When his patients unburdened themselves on him, confided in him, vented on him, where did this single, 39-year-old man go to get help for himself. How did he manage to shoulder all that pain?
How do psychiatrists deal with stress?
"Doctors, who ought to be in the best position to help the public, are not distinguished by their own ability to help one another or themselves," psychologist and prolific writer Kay Redfield Jamison wrote in her groundbreaking book Night Falls Fast – Understanding Suicide, published in 2000.
"They are, to start with, twice as likely to kill themselves as other people are," writes Jamison, who has lived with bipolar disorder since her teens and has seriously attempt suicide. "Doctors, more often than not are left alone to struggle with their suffering. Many find it hard to ask for help, or, indeed, to acknowledge needing it: they are trained to be independent, to be accountable for decisions that cost or save lives, and to assume an undue portion of the miseries of others. They function within a closed system that too often discourages seeking treatment ..."
I'm sure the military would be especially tough here.
This morning, I sent an urgent request for help with this question to my muse, friend, mentor and polymath, Tufts University clinical psychiatrist and professor of psychiatry Dr. Ron Pies. He answered quickly, admitting candidly that he didn't have "any profound or learned comments, except to recognize that mental health professionals and physicians of all stripes are under extraordinary levels of stress, a great deal of the time."
He wrote to me, understandably briefly, because he was "on the road," as he often is, adding that "without prejudging anybody, I think it is fair to say that the horrific shootings at Ft. Hood represent a terrifying illustration of how one's emotional turmoil can be fuelled by a specific set of environmental factors. If not detected early, and followed by timely clinical intervention, the results can often be tragic."
Then Dr. Pies added a more personal perspective.
"I have always found it important to have many interests, supports, and creative outlets, beyond my profession as a psychiatrist. I always worry about colleagues who say, "Psychiatry is my life!" and who spend every waking hour thinking about nothing else.
"Balance and perspective are great stress-busters, and I have always found these in areas such as literature, philosophy, and creative writing. Others will find relief and solace in sports, music, or spending time with family.
"The important point is that all of us need to find ways of monitoring our levels of stress, and to provide ourselves with fulfilling activities that help us achieve emotional balance."
So, I leave you with these wise words on stress from my dear friend, Dr. Pies.
Think balance. Perhaps that's what was lacking in the tragic, tormented life of U.S. Army Major and psychiatrist Nidal Malik Hasan. Who will ever know for sure?
This, however, I do know.
From now on, every weekend, my husband and I plan to take a few hours to do something for ourselves. Nothing major. A movie. A walk in the park with the dogs. Just a little something to divert ourselves from the ongoing pressures of our work – we both teach at community colleges.
Because nothing. No job. No deadline. No pressure. No virus. Nothing is worth sacrificing one's emotional, spiritual, physical and mental health and well-being. One's psyche. One's hope.
Take care and enjoy this brisk, November weather!