Jackson rolled around the corner into view in his electric wheelchair. He has been in that chair since returning from Afghanistan without his legs, but with a constant headache that cycles between something he can deal with and crushing pain. Pain that leaves him crying, sensitive to light. Bill has cared for Jackson in the emergency room more than once. Two things about him seemed to mark Bill’s interactions with Jackson; he has been easy to care for, accepting redirection from pain focus without much difficulty, he has been receptive to following directions in order to feel some relief. The other constant has been his increasing bitterness over his injuries, his “lot in life”.
Today, there is something different, perhaps apprehension on Jackson’s part; uneasiness rises in Bill’s mind as he tries to determine what is causing him to feel so apprehensive. Jackson had positioned himself between the patient rooms and the staff area, looking very angry, defiant, like maybe he had reached a decision to do something.
Then it dawns on him, Wait, he thinks. The chair looks different…”Not a goddamn one of you move! No calls, no nothing!!” he yells as he rolls on to the nursing station.
“I have this rigged to blow when I press this!” indicating a small, round, white button near his waist. His left hand hovers near it, thumb hooked into the belt, or strap.
Bill can feel the blood drain from his face, his stomach feels like a bag of knots. He, too, had served in that sandy shithole, but had never seen an IED. What he had seen was the damage that one could do to the human body and spirit. He had helped to stabilize many wounded warriors during his time in theatre, many who left for Germany to survive physically broken, many who left in the black bags. And the many who came back like Jackson; unable to accept and adapt to this new reality, feeling abandoned by God, country, and family. The rest of the staff froze, too shocked to fully take in what was happening; unable to fully process the implications.
This emergency room barely earned the name. Accepting mostly overflow from primary clinics with frequent cardiac crises, Bill and the rest of the staff were familiar with everything from splinters and fishhooks in the hand to patients who had been found unconscious, “down” they called it, and were technically dead on arrival. The ER crew was seasoned to stress, long years nursing, plus a couple had served in the latter stages of Vietnam, while two more had served the ER and OR on one of the Afghan bases. Another of the nurse technicians had served a full career as combat medic.
All of that experience with stress barely helped Bill keep it together when faced with the prospect of an active bomb. Struggling to keep his voice normal, “Why have you done this? Why come here?”
“You goddamned well know that! You of all of these KNOW why! You have seen what is happening to me! Don’t fucking act like one of those motherfucking shrinks!”
Bill replied, “Jackson, you’re right that I know something about why you’re so angry. I have taken care of you here many times. We’ve talked a lot about what’s been going on with you.”
“Talk is all anyone ever does around here. Delay, deny, and hope that I die. That’s the VA way! Well, partner, the wait is over. Today I get the attention and the action that I have been demanding.”
Bill began talking him down, de-escalating was the parlance. All of the nursing and physician staff had been trained several times in how to do this. Never had it mattered more.
So Bill said,” I understand some of what you feel. I hate the memories that I have, the field pickups with screaming, bloody boys that beg for relief, that beg for their mothers, neither of which I can really pull off until they are in the emergency care. It still sickens me, haunts me, at night.”
Jackson appeared wild-eyed, like he was trapped. In a way, he certainly was trapped. The only option now was jail with some sort of care afterwards. No guarantee this would play out like the man intended, thought Bill.
“What do you expect to happen today? How do you see this working out for you? Plus, let us get these other veterans out. Let the others move them to safety. Then you and I can work through this.” Seeing that facility police had responded, but not intervened yet, Bill said, “The police are behind you.” At this, Jackson jerked around in the chair, his hand too close to that switch.
“Stay the hell back! I got a bomb here! You fuckers try anything and we all go to see God!” Jackson was visibly more disturbed, so Bill stood, letting the police see him. He raised his hands.
“Jackson!” he raised his voice, getting the man’s attention along with the two policeman further back, “Listen! I am asking again that you allow us to evacuate everybody except me! I will stay with you. We can resolve this without hurting any of your fellow veterans, without hurting any of these nurses. Some of them have seen the shit, too, and these older guys were in World War 2. So, let’s give them a break, okay?”
Jackson seemed to mull it over a few minutes, closed his eyes, reached for the switch. “I can’t do that. I can’t let this be any better.”
He pressed the switch, everyone saw the flash, and then it was over.
The clinic was destroyed along with the two floors above. Final tally on victims: Twenty-three dead, ten wounded. The veteran was only identified much later with DNA analysis. The media had an incomplete story. The What, When, and Where, but no Who until later. And never a Why, only speculation and bureaucratic stonewalling.