Commentary: Sometimes our patients are the best teachers

I came from Colombia, where I learned the extent to which Homer and Freud added substantively to our understanding of those suffering from mental illness throughout the centuries.

I graduated with degrees in medicine and surgery in 1974, the same year that Peter Benchley wrote his novel “Jaws.” During my rotating internship in Virginia Beach, I saw the movie “Jaws,” which was playing during the summer of 1975. One of the scenes that I will always remember in the movie occurs by nightfall, when the fishermen who are trying to kill the shark retire to the boat’s cabin, and the character Quint relates his experience with sharks as a survivor of the sinking of the warship USS Indianapolis in the Pacific Front of World War II in 1945.

Just as Quint’s story served as a history lesson, so do the stories of many of our patients who have served in the military. Listening to these stories can help our patients heal and can enlighten us at the same time.

One of my first patients was Mr. G., an elderly man who has been a sailor in the HMS Irresistible, the fourth British Royal Navy ship of the name. The ship was a formidable-class pre-dreadnought battleship commissioned in 1902. Mr. G. had been a gunner of the 12-inch (300-mm) guns. They could be loaded at any bearing and elevation, and had a split hoist with a working chamber beneath the turrets to reduce the chance of a cordite fire spreading from the turrets to the shell and powder-handling rooms and to the magazines.

Mr. G. had survived the sinking, explosion of the magazines, and shark attacks. Mr. G. was sent to a hospital in Malta, and later back to England in what he described as horrible sea voyages. After the war, he took a more pleasant crossing of the Atlantic, his last one, when he immigrated to the United States. He lived most of his quiet life around the Norfolk (Va.) Naval Base. On the 60th anniversary of his ordeal, Mr. G. began presenting with nightmares, depressed mood, and suicidal ideation, which prompted a psychiatric hospitalization.

During my conversations with him, I happened to mention the movie I had just seen. Mr. G. shared with me memories long forgotten of his dreadful experiences. Mr. G. taught me that the Dardanelles Campaign and the Gallipoli campaign had been the greatest naval and military disaster in the entire history of the British Empire. He also taught me that the underestimated “Johnny Turk” had smashed the British Forces, had kept the central powers longer in the war, and had doomed the Russian Empire. Had the English Navy forced the Dardanelles, it would have taken Turkey out of the war, crippled Germany, avoided the Bolshevik Revolution of 1917, World War II, and the Cold War, Mr. G. said.

Mr. G. was happy to tell his story to someone who would listen without bias, and he got better with the treatment and the medication he received to the point that he stopped being suicidal.

Later in my career, during the summer of 1995, I saw another elderly patient, Mr. I., in the emergency department because of suicidal ideation. When I asked if he were a veteran, Mr. I. related that he was a survivor of the USS Indianapolis and that he had joined the Navy during World War II. He said he had done boot camp in Newport, R.I., and attended radar school at the Norfolk Naval Base, where he attained an MOS as a Radarman. Mr. I. had served in the Pacific Theater in the USS Indianapolis as a Radarman. He related his experiences as “the ship carrying toilet paper for Gen. Douglas MacArthur in the Philippines, and that the ship’s captain should not have been court-martialed for the sinking, which triggered the captain’s suicide.”

The USS Indianapolis was the flagship of the Fifth Fleet in battles across the central Pacific. Her sinking led to the greatest single loss of life at sea in the history of the U.S. Navy. On July 30, 1945, after delivering in secret the atomic bombs to the U.S. air base at Tinian, in the Northern Mariana Islands, the ship was torpedoed by a Japanese submarine, sinking in 12 minutes. Of 1,196 crewmen aboard, about 300 went down with the ship (Left for Dead [New York: Delacorte Books for Young Children], 2003).

The remaining 900 faced exposure to the sun, dehydration, sea water intoxication, and shark attacks while floating with no food or water. The Navy learned that the survivors who had been left for dead were spotted 4 days later by the crew of a plane on routine patrol. Mr. I. was one of the only 317 who survived the ordeal. When I asked about his experiences, Mr. I. replied that he had been sworn to secrecy and did not wish to relate details of his mission.