Why Our Special Forces Are Losing the Silent Battle

[00:00:00] One of America's finest soldiers, a Special Forces medic with an impeccable military resume, an outstanding civilian career, and a loving family standing by him. Trained to take care of everyone in the world, but couldn't take care of himself. Today we're talking to Joe as part four of our ongoing series discussing suicide in the veteran community and his story as a veteran finding himself at a point of catastrophe.

[00:00:24] Now these are stories by veterans for veterans. No attempt has been made to either sensationalize or water down their experiences. If you or someone you know is in a crisis situation, please reach out to the National Suicide and Crisis Hotline at 988. With that, let's get to Joe. Well, hey, Joe. Welcome, man. Welcome to the podcast. How are you doing today, brother? Yeah, I'm doing really good, Scott. Thanks a lot for having me, brother.

[00:00:49] No, it's a pleasure to have you here. For folks who don't know, can you introduce yourself in your own words to the audience? Absolutely. Yeah, so my name is Joe Stabley. I was an Army medic for most of my career and ended up getting medically retired in 2021. Now I work as a PA, physician assistant in a multitude of different areas, psychiatry addiction, men's health, things like that.

[00:01:15] And most recently, I joined the national campaign team for Wounded Warrior Project. Really in an effort, you know, our topic today is so near and dear to my heart. It's been kind of one of the themes throughout my life over the past decade. And joining Wounded Warrior Project and being able to, you know, represent them for everything they've done for me, that's kind of the biggest thing going on in my life right now. And, you know, these opportunities are coming up more and more.

[00:01:43] So I'm grateful for having me on here. No, it's awesome to have you. So you get medically retired in 2021. I got medically retired in 2022. So we're about a year off from each other. And my wife's not a PA, but she's an NP. So I'm very familiar with the provider world and everything that goes on there and those dynamics. Yeah, great. What fields does she work in, if you don't mind me asking?

[00:02:07] Oh, I'm going to butcher this. She runs the PAT clinic at a hospital that has asked me not to say their name on camera. So it was a paleooperative care, preoperative care, pre-admissions testing. But there's like a fancier name for it. She does that stuff. Gotcha. Okay, great. Awesome. Well, I appreciate the work she does too. Love her at peace. I keep convincing, like, you can just go off and have your own practice.

[00:02:34] I'll do the admin, like we can do our own little thing, but she actually really likes working in the hospital setting. So I have not been able to talk her out of it yet, but the work continues. Yeah, there you go. But I mean, it's a versatile career. I mean, PA and NP are both phenomenal. I've bounced all over the place. So, you know, the bottom line, as long as she's happy where she is, then that's really what matters is you'll learn today when I'm sharing a little bit of my story. And I probably bounced around more than any PA in the first 10 years of their career.

[00:03:02] Then, I don't know. I'm curious to see who owns the record for that. I think I might have it. You might. You might. She bounced around a lot, but mostly because she was buried to me while I was in the military. So that's more of a me problem than her problem. She just put up with it. But yeah, let's start with the story because it's a really interesting one. Because Cliff notes here, and then we'll go back to the beginning. Very successful guy. I mean, you're an 18 Delta Special Forces medic.

[00:03:28] For folks who don't know, like that is one of the most challenging jobs in the military. I'll just say it and people can be mad about it. It is harder to become an 18 Delta. And I trust 18 Delta is more than anyone who's gone through med school. Full stop. And there are stats out there to back it up. People can be mad about it. So incredibly demanding, high-performing career field. You do that. You get out. You're a PA. You're making good money. And at some point, you make the decision that you want to kill yourself.

[00:03:59] That is not the typical veteran sob story that folks are familiar with in the media. So if we trace this all the way back, my understanding is you get a very, very long career in the military. Where, I mean, like what in your military experience puts you in a spot where you're thinking about this 30 some odd years later? Yeah. Yeah. So I really, it started off pre 9-11 actually before the wars.

[00:04:29] And my first deployment, I was a 101st Airborne Division guy. You know, the 1st and 502nd Infantry. I know a little bit of your background too over there at 10th Mountain. So we got a friendly little rivalry there. It's not a rivalry. 10th Mountain is better. I'll just say it. I'll just say it. It's all right. Yeah. I only spent about two and a half, three years in 101st. And then I moved on from there. But, you know, I've had a lot of friends come from 10th Mountain, man.

[00:04:58] And, you know, there's some of the baddest dudes on the planet. A lot of them went SF also. So kind of similar to yourself. But really, if you're familiar with the Multinational Force and Observers rotation to the Sinai, 18th Airborne Corps had that rotation pre 9-11, right? It was 10th Mountain, 101st, 82nd, and 25th ID that would do six-month rotations to the Sinai Peninsula.

[00:05:26] Paid vacation on the beach. Just living the dream. You know, I'm a 19-year-old kid. Get to Egypt for my first deployment as a line medic. And I couldn't be happier. I'm like, this is why I joined the military. To travel, see the world. You know, we're going to the pyramids. I mean, all this cool stuff. And, you know, I had a buddy named Jason Curry. And, again, this is pre 9-11, man.

[00:05:56] So there's no wars going on. There's no reason to even think about suicide at all. But Jason took his life on one of the observation posts. I was the medic that had to respond to that. You know, he was a 23-year-old kid. A little bit of college. She had a daughter. And the guy liked to party. And, you know, we spent a lot of time hanging out before the deployment. So I got to know him pretty good.

[00:06:22] And know that, you know, life wasn't that easy. And that's all I knew. And I knew he wasn't in his daughter's life as much as he'd like. But, you know, I've told this story a million times. It never gets easy. But, yeah, he took his 9-millon pistol and shot himself in the head. Buddies kept him alive.

[00:06:51] You know, combat lifesavers that we trained kept him alive. I was about 45 minutes from the site. And we drove out there. And I got on scene and did what I can, you know, for about 10, 15 minutes or so before Medivac came. So Medivac was about an hour away. We were like 45 minutes. So they sent me over there. You know, I worked on the guy. He was alive. And he, you know, he passed away en route to the hospital in Israel.

[00:07:22] And, again, pre-9-11, man, we didn't talk about it much at all. You know, there was a couple check-ins. But, really, from that point on, I had no idea what had just happened. All I knew was that I had to get better. Because, as a 19-year-old kid, very impressionable, very naive. You know, when you go through MediCorps, not the 18 Delta course, but the MediCorps, they tell you that medics play God.

[00:07:51] And you're going to keep everybody alive, right? That was the mentality pre-9-11. And that didn't happen. So, you know, let's just say I, as a 19-year-old kid, that's when I started smoking Marble Reds and drinking vodka because we were overseas. And alcohol was everywhere. And you were in the infantry. And that's what you did. So, you know, suicide has always been on my mind since that moment.

[00:08:20] Not necessarily taking my own life, but the weight that I carried was there. The survivor's guilt. The moral injury, thinking I could do more. And I carried that with me through my entire career. Kind of set the tone for why afterwards I tried to become, or tried to, I did become a flight medic and then N18 Delta and then a PA. I lost a lot of people along the way.

[00:08:44] And each time it drove me to pursue something higher because I never wanted to let it happen again. But, you know, for the sake of this podcast, man, there's a lot more to it. But essentially that was the defining moment that set the tone for my career. Lots of ups and downs. I've lost more friends. Another one pre-9-11 in Korea who drowned in an incident.

[00:09:14] And, you know, a lot of questions were just raised around both of their deaths. And I didn't know how to process that. And we didn't process that. I never saw, I don't even recall sitting down with a therapist once. It was kind of like a check-in with these guys like, hey, you doing okay? A little pat on the back and, all right, let's go smoke one and let's go drink more. And then the worst kicked off. You know, this is after I went to selection, became an SF medic.

[00:09:42] I went to 10th group, ODA 054, back when we were three numbers, ODAs. ODAs? Back in the day. Back in the days. Yeah. And first deployment was OIF-5 in Baghdad in 2007. So shortly after the surge started. And without getting into too much detail, you know, that was probably part of the height of the entire global war on terror.

[00:10:09] If, you know, anybody wants to look up the stats and look, but 2007 in Iraq was one of the deadliest times in the war. We're losing over a hundred just U.S. military personnel a month. So it was a long summer. We treated women, children, civilians, soldiers. Another part of the country, I lost my roommate, my brother, Rob Pirelli in Dayala province. And, you know, guys were just dropping left and right.

[00:10:38] Guys I went to the Q course with, dying in Afghanistan, dying in other parts of Iraq. The whole time we're in Iraq and I'm trying to process this stuff, but there's no time because, I mean, literally find out about another friend dying. And next thing you know, you're going up on the rooftop and, you know, defending your fob or going out on a hit. So, you know, slam a monster, go break down, cry real quick in the corner behind closed

[00:11:07] doors for about 30 seconds, shake it off, slam or what did I say? Slam a monster, slam or rip it and go kick doors in. And, again, never got to process that stuff until much, much later. The suicide ideation and everything really didn't happen when I was serving. Obviously, you know, a lot of this stuff happens when time slows down after transition and

[00:11:36] had a really weird transition. Let's make this more of a conversation, man, because I can just go off because there's so many side stories and I really don't want to do that. But let's just say the driving force really behind my own suicidal ideation and wanting to take my life was just a ton of survivor's guilt, moral injury, seeing the worst of humanity, not being able to do as much as I'd like to.

[00:12:04] And then getting to the states, the single biggest problem in the common theme with my multiple midlife crises and downfalls and psychiatric hospitalizations have been working in the U.S. health care system and feeling like my hands are tied, not singling out the VA. That's just one aspect of it. I've had great experiences with them, but, you know, well, I think we're going to delve into that a little bit later.

[00:12:32] But, you know, essentially trying to go from kicking doors in and battlefield medicine and flying in helicopters to the same kind of chaos in an emergency department. But yet these aren't my hands now. The nurses are doing all the work. My hands belong on the computer with systems, technology failing.

[00:13:00] And that's what keeps me in fight or flight to this day. We'll delve into that. But my biggest enemy has been trying to provide care for human beings that need it, that want it, that deserve it. And I'm fighting battles with technology, with bureaucracy, with insurance companies, pharmaceutical companies, the big U.S. health care system to me is great of a thing as it is.

[00:13:27] And I'm not knocking modern medicine because I absolutely love it and it's necessary. But we'll be honest, the system is so broken and it's evident with the amount of money that we spend and where our health is like. So, you know. Well, there's a lot there to go through. Let's go back and walk through a little bit. I'm sorry about that. I was kind of a big fan. No, you're good, man. And that was me holding back. So. All right.

[00:13:56] Let's go back and start walking through a bit of that. What jumped out to me was, you know, your first traumatic experience, we can call it, you know, dealing with the soldier who killed himself while you're on a peace time deployment in a Sinai, parting it up with your buddies in the desert as a 19-year-old kid. It's really interesting because the narrative around suicide in the veteran community right now is that it's all a result of the global war on terror.

[00:14:25] Implied there is that it's all combat related. And I know one of the most shocking things when I was 23 showing up as a lieutenant at Fort Drum in charge of soldiers is my first experience, like in the real army, you know, as a platoon leader. Like, I think through about the amount of funerals I went through in the decade starting then and after that, none of them were combat related. It was all training accidents. It was all overdoses. There was some suicides involved.

[00:14:53] Um, it's like the military life itself is just brutalizing to people. And I wonder, you know, given your experience, do you think combat actually made any of that worse? Or is it just another variable in the mix? So everybody has their own lives when they start out, when they're born. And, you know, you have the genetic components from both your mother and your father. You have your childhood.

[00:15:22] And then you have your time in service. So during the time of, of, of neurodevelopment when you're growing up and, you know, there's a lot of, uh, research to back this up, but a lot of guys that end up getting PTSD that end up having suicidal thoughts, psychiatric hospitalizations have struggled before even getting into combat and seeing things during the war.

[00:15:46] Again, the worst of humanity, having that on top of what they've been through and then now transitioning into a world that is difficult to make sense of the, the combat really just, I don't want to say it's icing on the cake, but it's a catalyst really that drives something deeper in humanity that people go through, you know, often on their entire lives.

[00:16:13] And yet we don't know a lot about people unless they're open, uh, about it. Right. So, um, it's just, it's one variable now. Don't get me wrong. That's not everybody. I can't really say that's, you know, um, all people. Cause there's definitely people who have had great lives, went to war, had some bad experiences and ended up having suicidal ideation or, you know, that, uh, took their own life.

[00:16:39] Um, so it's so complex that every single human being has their own story and there's multiple chapters within that story and being in fight or flight in a combat zone. Um, you know, your sympathetic nervous system is almost always on overdrive, whether you're kicking doors in or whether you're just going to the, you know, to the fob, to the PX, to go get a little, you're lickies and chewies, right?

[00:17:07] Um, you're always at a low level fight or flight. Um, just vigilant, right? Not necessarily the hyper vigilance, but what it comes down to is there's things from people's life. The brain is so complex and we're just scratching the surface and getting to understand it within these last really two decades. Um, and what I've seen that going to trauma retreats, working in addiction and psych and

[00:17:32] first responder and all these things that people are carrying a lot. And when you put combat on top of that, um, it's absolutely enough to kind of push people over the edge afterwards when they're trying to sort it all out of their minds. And that's exactly what, um, you know, a big part of my own story was.

[00:17:55] So, yeah, if we go back to the Sinai, you know, you had that experience that stuck with you. You talked about how it wasn't processed at the time. Um, fast forward to, you know, my time in service in the middle of global war on terror, you know, suicide was a huge talking point. Mental health was a huge talking point. There was a lot of emphasis from the chain of command on addressing it. A lot of it wasn't very well intentioned.

[00:18:23] Techniques weren't really in place, but there was at least an effort. Um, do you think we've gotten better at that? Do you think that actually improved in the global war on terror in a meaningful way? Or was this a problem that compounded through time and eventually folks had to at least start talking about it? At any point in your military service, do you think things got better than when you were 19? Absolutely better. Yes.

[00:18:52] I mean, we've, yeah, 100%, absolutely better. Um, again, it's still just so complex and so many in each individual person, um, has their own timeline. Um, but, uh, you know, when it comes down to it as a whole, yes, it's better. But if you take an individual person and you zoom in and see the day-to-day things they go through, there's a lot that we just can't capture, right?

[00:19:21] It's not like somebody's living their entire life out on social media. I mean, some people do, right? But, um, ones that take their lives, a lot of people aren't doing that kind of thing. And, you know, there's no cameras everywhere. It's not the Truman show where you can see every little move this makes and what these people go through. And, um, you know, we wear a lot of masks, so there's no telling. I mean, triggers are everywhere. Catalysts are everywhere.

[00:19:48] And stress on top of stress, if you're not regulating your nervous system and if you have unprocessed things, uh, suicidal ideation can pop up like that. And sometimes it just takes the, the, the perfect storm, you know, um, substances being involved is a huge part of it, right? Like we're doing a lot. There's always more we can do, but then it comes down to zooming in on that individual,

[00:20:15] um, and not just the programs and services, but being able to find out exactly what's going on and, and, and train people and teach people how to help themselves and really hold us accountable for our own mental health. Um, really, I think self-advocacy is huge. And if we're not doing that and we retreat off, there's not much anybody could do. And that's the unfortunate thing.

[00:20:43] And I've, I've been there and I'm very guilty of that myself and I know better. And man, I still do it. Um, so you're 19 years old. Okay. And Jason kills himself in a tower. You show up, you work on him as a medic. It's a validating experience in a lot of way. You get to use your skills and then he flies away and he dies. So immediate downer.

[00:21:13] Do you think that one experience on its own was enough to put you in a spot where years later you're having these intense suicidal ideations to the point where you've actually made a plan and are about to execute it? Um, or do you think other experiences in your military service had to compound on top of that to get there? Absolutely. That one, um, it, it would have just been that event, you know, granted it stuck with

[00:21:37] me and it, but it drove me to, man, I dedicated my entire life, adult life to medicine and it, I can't even separate it anymore. To tell you the truth, my personal life, my professional life and my, my, my mission. Um, but it, it took so much more losing more and more friends again, seeing some of the worst types of combat casualties, civilians, uh, us soldiers.

[00:22:07] Um, but even after that, like I went through a trauma retreat called save a warrior and I learned mindfulness and meditation down community. I was doing really, really good. And again, it's when you're trying to do more and you're constrained by a system is when the

[00:22:32] stressors and the anger and the, the, the, the, the, the emotions really just start getting overwhelming because yes, I could look back and know that when, when, when that happened to Jason, um, now I, you know, I realized that there's nothing I could have done, right? Absolutely nothing I could have done. Um, but now working as a PA and all these different systems and fighting these battles,

[00:23:02] something like getting denied a, um, you know, some paperwork to do a review, to get, keep somebody in treatment for alcoholism, for example, that triggers me. It's like a daisy chain of explosions in your brain, man. It triggers all the people that I've lost originally going back to Jason, but not to dive too far deep

[00:23:32] into the childhood stuff, but I lost my dad at five years old. Um, when I was four, I actually saw him have a seizure and get taken off to the hospital, went in a coma and he died after shortly after my fifth birthday. Um, so the, the, the childhood, the adverse experiences are there. Um, you know, I had a friend that got stabbed in high school that I wasn't there to be able to help

[00:23:57] and working with the psychiatrist and, and lots of therapists over the years made me realize like not being able to save people is, it's kind of my downfall. Um, and the reason why I keep on getting the way I do just the events themselves. I have enough love and enough good things in my life. I've have a, I have an amazing life.

[00:24:23] Um, and you know, just having family and friends and I know how to take care of myself. Like I, I, I do this every day. I know what health looks like, what wellness looks like. Um, but when it's something as simple as even trying to send in a medication refill and it getting denied because some paperwork, like that's a trigger for me, man. And that's, what's hard about doing this work.

[00:24:51] Um, I've been told many times to just step away from medicine altogether and I've tried, but. It sounds like as a lay person listening in, you know, you're a young kid, you lose your dad, very important in a boy's life. You end up in the military, which is full of surrogate father figures of one stripe or another.

[00:25:21] Yeah, absolutely. You have this very intense experience as a 19 year old, still kid essentially, where you've been trained and equipped to save a life. You're given the opportunity to do it. It didn't work out. And now they're really messed up circumstances. And then you get hooked on this idea that I need to do everything I can to save every life possible. And this is my new sense of self-worth. This is the measuring stick by which I judge my existence. Yeah. Is that a fair?

[00:25:50] You're fucking spot on, man. Okay. Yeah. So let's look at the point where you're a medic, you join special forces, become an 18 Delta, badass shit. Yeah. Get medically retired, which, you know, I remember going through the medical retirement process in third group. Actually, there's this really cool program called Meta. I think it's Medical and Education Transition Assistance for folks going through the med board process. But I remember one of the shocking stats they told us.

[00:26:19] And I'm hearing this like I'm 32. I'm getting med boarded after 10 years. Like it is what it is. So it's a bit different for me, but I did just get back from Afghanistan. My friend Dan did kill himself when we got home, which was shitty. I can tell you, I'm still fucking mad at Dan, you know, five years later or yeah, five years later now. That is what it is.

[00:26:42] But the interesting stat they told me is, all right, Green Berets, make sure you put in for life insurance before you get your results from the VA back. Because once you get your results from the VA back, you will be uninsurable. And oh, by the way, your average life expectancy as a Green Beret is 57 years old. And the average isn't brought down by combat. It's brought down by two big things, suicide and cancer.

[00:27:08] And no shit, I'm sitting next to my buddy who was on the freefall team, whose buddy on his team. I forget the guy's name, but shit. But yeah, a guy died of colorectal cancer from, they think, from the malaria medication that they gave us for Africa, which is very effective for malaria. But like you're not supposed to take it for six months straight. That's a whole other story is there. So you go through that whole process, which is its own mind fuck.

[00:27:37] And now you're off in the civilian world and you're trying to be a PA. I guess. How long from transitioning out of the military was it before you started having suicidal ideations? So my ideations, so I get a really weird career. So just a quick bird's eye view, almost 11 years active duty.

[00:28:03] And when I got back from that first deployment to Iraq, again, losing friends. And, you know, I decided before I turned 30, like I need to have a family. Right. You know, Rob was engaged. Rob Pirelli was engaged and to get married. And, you know, obviously they never got to get married and have kids. Shortly after coming back from that deployment.

[00:28:33] While at a service in Boston, we all, after the deployment, we all came home. It was three of us, four of us that lived in my house in Colorado Springs. And three of us came home and Rob didn't. And his team, ODA072. We were all invited to go to Boston, Franklin, Massachusetts, right outside of Boston to meet Rob's family.

[00:29:00] And to partake in some events and welcome home events and some dedications to service through his university. While we were there, we lost another friend, Pat Kuchbach, another 10th group guy. So these are two guys that I went through the Q course with and became very good friends with. Again, one was my roommate. Pat went to Germany to 110 and was killed in Afghanistan.

[00:29:26] While we were home after a deployment, you know, celebrating Rob's life. And trying to make sense out of that was, again, really kind of messed me up. Because from there, we drove down to Pittsburgh to be with Pat's wife and child. Pat actually was married and had a little boy. And they're actually doing really good now.

[00:29:55] You know, the kid's like a pilot now. Nice. And, you know, being there for and having to process that, be with his family. Again, they fast forwarded the service. They sent everybody down. And, you know, I had to go back to 10th group to get my dress uniform and come back. Because we were still wearing greens.

[00:30:23] And then I was the one that had to present the flag to the, God, I think he was a four star. I can't remember which general it was. But I had to pass him the flag to pass to his wife and child. Trying to make sense of that. And it really messed me up, too. So coming back, I wanted nothing more than to have my own family.

[00:30:50] I mean, we literally pinned silver wings on, you know, on Baston's chest while playing the song at his funeral. Like that, you know, Ballad of the Green Berets, that's a very special song to us. And to do it at a funeral service was just unreal. So I knew that there was more to life than just kicking doors. As much as I wanted to go back.

[00:31:20] I mean, we weren't set to go back for another year and a half anyways. So I had a lot of, like, I'm going to go find me a wife and have my own kids before, you know, it's too late. And I did. And I met my wife and we're still married to this day for 17 years. Two beautiful children.

[00:31:37] And, you know, I think I'm getting lost in thought, man. Sorry. No, you're good. But how does a guy who's married with two kids, who's making good money, who had a badass military career.

[00:32:03] How does that guy get to a point where he wants to kill himself? Yeah. No, thanks for keeping me on track. PA school. PA school. Those motherfuckers. Okay. Right. Education is dangerous, folks. God damn. Yeah. Yeah. Don't go to PA school. But it's actually. E&NP. No. Right. Yeah. But, hey, you know. Well, iPad, you've probably, you know, talked to some guys that went through the inter-service physician assistant program.

[00:32:33] So I left active duty, joined the National Guard. You know, I'm like, I want to have a family. I want to have a kid. I want to have a normal life. Let's. What am I going to do? Am I going to go be a contractor? You know, am I going to go back and forth? Like, no, I'm. I left SF to create a family because I knew at some point I was going to come back into SOF and it was going to be as a PA and it was going to be in the National Guard. And I did. But more on that. PA school. First semester, not terrible.

[00:33:04] Second semester. Once you start getting into. Six months, eight months over a year of death by PowerPoint, like, you know, not knocking the military PA school is great. It's one top 10 program in the country, you know, credentialed the University of Nebraska Medical Center. But you go from a free fall team and kicking doors in and just being able to move.

[00:33:30] You know, and not be confined to a desk like that's enough to drive a lot of guys crazy. And actually had some conversations. Some of my classmates were 18 series guys. Had a 160 flight medic in my class. A couple of Rangers. And every now and then, man, we we didn't talk about it much yet. Yeah. But there were some conversations that unfolded during study sessions or during breaks during class that really got you thinking like.

[00:34:01] What happened to us? You know, we're supposed to be going through PA school now and going to become officers and go back to the force and, you know, continue to save lives. But man, death by PowerPoint almost became death by PowerPoint. So I struggled so much. And keep in mind, this is undiagnosed PTSD, undiagnosed sleep apnea, chronic pain. And you're sitting in a chair. For PowerPoint, right?

[00:34:29] Like no, no amount of anything is going to keep you from at least losing it a little bit. Even the most sane people have been pushed to their limits. But it was a great program. And, you know, during the program, it was my wife and kid had to go back to Colorado early. I was National Guard by then and work out the housing situation.

[00:34:55] So actually, during a class, I remember clearly I had my first panic attack while in uniform in PA school. And it was during a course where the surgeon was talking about training airways on burn victims. And talk about the ultimate trigger. Like I didn't see it even coming out of left field.

[00:35:19] But she was telling a story about, you know, training burn victims and how their airways slowly diminish if there's inhalation injury. And well, during OIF-5, you know, I had a situation like that. And, you know, it was a conventional army guy that was next door to us on the same firebase. And they were getting blown up and shot up all the time.

[00:35:49] And we came out unscathed. But me and my senior medic, we were going next door to help those guys out. It almost seemed like multiple times a week. It was multiple times a week, at least during summer of 2007, treating different people. And, you know, I had a... We saved a lot of people. And that medic team and that PA that was there were just shit hot, man. They were amazing. They saved so many lives. And we came in and helped out in any way possible.

[00:36:16] But, you know, I had a situation where I had a guy that literally that's what happened, though. You know, blown up, burns on 100% of his body and inhalation injury. And he was coming in, like, trying to get off of the litter to go back and get in the fight. I'm like, that's a warrior. Like, this guy just got blown up and he's worried about his buddies.

[00:36:40] Anyways, we had to do something called rapid sequence intubation and put him down because the PA knew that he was going to lose his airway. And, you know, it came down to intubate. And when I went in to intubate, his airway was shot and I couldn't see vocal cords. I couldn't visualize. And you hear the helicopter coming. I mean, medevac's quick. It's like 15 minutes on site, 15 minutes to Baghdad Hospital, to the IZ Hospital.

[00:37:07] And, you know, I heard the blades churning and I'm like, they're like, well, you just have to intubate him. There's nothing there. So, you know, the fog of war, you know, in that very, in that micro moment, I put the tube down his throat and he vomited. And we had to do a crike, give him a surgical airway. He flew off and didn't die in route, made it all the way back to Longstool, made it back to the States and died a few weeks later in San Antonio.

[00:37:36] And at BAMC, where a lot of guys were getting medevaced after Longstool, especially at the burn unit over there. And now here I am at Fort Sam Houston. Hearing this story. And. Literally going back to that moment, like, OK, now I'm in the place in a classroom. Where this guy actually made it, but then died later of infections and wounds, you know, from 100% burns.

[00:38:07] Like, that's going to trigger. The worst things to happen. And I remember, man, I just got up out of class and walked into the bathroom and had my first panic attack. And then again, man, you shake it off and you go back into class and you just pick up like nothing happened. What was the progression like after that? Did things start getting worse?

[00:38:30] Yeah, because I went and saw mental health and, you know, I was having trouble studying and consuming over 500 milligrams of caffeine a day. Had a deviated septum, so it was already hard to breathe. Undiagnosed sleep apnea and just crushing caffeine like nobody's business. I mean, I was putting pre-workout into my Nas energy drinks just to sit down and focus.

[00:38:59] Wait, we're not supposed to do that? Yeah, that's a normal thing, right? So. Yeah, I mean, I. Yeah. Pre-workout, I would do all-nighters, baby. What's up? That's a bad. OK, do not mix. I'm writing this down. Do not mix pre-workout with energy drinks. Got it. That's the health tip of the day. If I could say one thing, because, you know, talk about like if you're trying to regulate your nervous system, which I wish I would have known more about yoga and meditation and mindfulness and all these things.

[00:39:27] I would have done P.A. school totally different, but I didn't. So when I get there, you know, they I get to mental health. No PTSD diagnosis. And it's like classic PTSD. ADHD. Here's some Adderall. Carry on. So I did. Congratulations. You got problems. We're going to give you new drugs to try. And it worked. Oh, OK. Temporarily. Temporarily. It worked.

[00:39:56] It got me through P.A. school like nobody's business. Less caffeine focus. I ended up crushing it, you know, did did great on P.A. school. And I was ready to put that bottle of Adderall away for the final time after graduating. Like, I don't need this stuff anymore. And then I went to refill or I went to see mental health for the final time, you know, right before graduating. And it was like, well, let's refill your medication just in case. Here's some more. So now I got excess. Um, you know.

[00:40:26] An addiction. I was never an addict, man. Yeah. I did some stupid stuff as a kid. I smoked some weed and, you know, whippets and all the dumb stuff that high school kids do. Um, but, uh, addiction was never a thing. Substance abuse. Absolutely. Substance use disorder. Absolutely. But pure addiction, physiological dependence on a substance never happened until the Adderall. And it kept me going. And when I got to phase two of school thinking, oh, it's going to be mostly clinicals.

[00:40:55] I'll be fine. I'm still battling still undiagnosed sleep apnea, undiagnosed PTSD. Um, and by the way, you know, we had a brand new baby, uh, um, sorry, we had a toddler going through PA school. The brand new baby came during phase two of PA school. Uh, so, you know, there goes sleep again. I'm already not sleeping and I'm, I'm just popping pills and drinking caffeine, trying to

[00:41:23] get through phase two of clinicals. So I could just reach the, you know, the, the, the finish line. What I think is the finish line. Once this is done, life's going to be great. I'm going to, again, throw the pills away and be able to get a world, uh, get a job, civilian job, go back to special forces, raise my family. And, you know, life's going to be great. Um, again, man, for this, for this thing from the truth. So the, the stress, that was my transition.

[00:41:51] Transitioning from active duty to the guard was phenomenal. I didn't give a shit about a service connected disability. I don't have these diagnoses. I got a hot wife. We're going to have a baby and I'm going to PA school. Like that was my go mentality. And afterwards, you know, when I started crumbling in phase two of PA school, realizing the load now of now for the first time in my life, I'm not going to have a decent paycheck.

[00:42:18] And I have a wife and two kids and we're moving to California, which isn't cheap. So a little bit of stress, um, a little bit of pressure there. And again, just, man, my son, I love him to death. He's, he's my little guy, but he was, he was the infant from hell. Um, our daughter was like this angel and he was just, he just cried probably a hundred times more than my little girl did. But, uh, you know, he's, he's great now, but it was rough and keeping me in fight or

[00:42:46] flight just from that alone while trying to finish PA school and my body saying, Hey, remember Adderall that stuff worked great. Let's let's stay on that. So yeah, I, uh, got out and we pack up. Everybody's saying like, Hey, take your test, like relax, go study for a while, you know, then take your boards, you know, maybe in a couple months, make sure you're ready. I'm like, no, I got to hit the ground running.

[00:43:14] I crammed for a week, probably slept a total of 10 hours in a week with an infant next to me. Um, studied for my boards, took it, signed off, finished packing the U-Haul and drove out to California. And life was temporarily really good because I didn't have the pressure of trying to save lives. And it was just, Hey, let's get back on my feet. So we moved in with my mom for like a month just to transition, uh, bought a home in

[00:43:44] Irvine, California, consistently ranking one of the best cities in America to live in. Again, beautiful family, master's degree, going back to SF in the guard, get a job in the emergency department and urgent care. Cause I'm like, well, now I got to make more money to make up for all this stuff. And that's when the big spiral came. Like I was able to tread water and keep my head above the entire time, my entire life until I got into the ER.

[00:44:15] And my, my schedule was two weeks of day shift, two weeks of night shift. That was my first month. The second month was day shift, day shift, night shift, day off, night shift, night shift, day shift. It was like this and I'm popping pills to stay awake. I'm drinking vodka to go to bed every single day is completely dysregulated from the baby crying to the chaos in the ER. And I absolutely loved working in the ER, man.

[00:44:45] It was great. I felt like I was back in war, like dropping tubes, treating trauma, working codes. But this little device that we're talking to right now and their systems and their wifi and their technology and what you had to do just to move a patient. I couldn't wrap my head around it because in the military, it's go, go, go, right? Stop the bleeders, open your, get them off and go.

[00:45:14] So that's the mentality I had and like, okay, you're going to be in the ER. Cool. Let's get people going. And no, it was like, Hey, people are piling up. Go treat that person, that person, that person come back, chart on that, discharge these three. And the transition from going back and fighting the computer system to people suffering that I was just trying to be present for and help was not a good combination, man.

[00:45:43] I didn't last two months in the emergency department because of the sleep cycle and one time on shift. Another flashback, right? And this is what I really want everybody to take home from the message on the suicide epidemic. Triggers are everywhere and you don't know what a person's been through. And a trigger can happen at any time, any moment, any place. And again, it happened in the ER for me. Not intubating. I crushed all my intubations. I was suturing people up.

[00:46:13] Like, I felt like a freaking 18 Delta. I felt like a PA that was like ready to take a battalion and go back to war. But the computer system, my brain was so dysregulated. And when we're in fight or flight and our prefrontal cortex isn't functioning and it's just you're in survival mode. And typing under pressure and having to think and navigate systems, multiple systems for something I used to just scribble paper on and go. So I couldn't make the connection at all.

[00:46:42] And I was spending so much time coming back, charting at all hours of the night, charting in the morning, trying to clean up my charts so I don't get sued, you know, making everything look perfect. And, yeah, I couldn't keep up. So on shift one day before coming in. And this is my first true suicidal moment. I showed up to work two hours early. Like, I just had to get out of the house. The boy was crying.

[00:47:12] I love him to death, but I just couldn't take it, you know, the night before. And it was a night shift. And the night before, I got off at like 3 a.m. And crushed half a bottle of Jack and Coke just to sleep. And by the way, now benzos are in the picture. And Adderall to keep up, right?

[00:47:31] So I was regulating my own nervous system and my own life with pills and alcohol, trying to treat other people and save their lives and battle technology. Yeah, my brain didn't like that at all. So I show up on shift and I'm just in a lot of different surreal moments, revisiting my entire life and everything that happened at this point. I found myself behind the hospital.

[00:48:00] This is Santa Ana, California, Western Medical Center, Santa Ana. And it's now known as Orange County Global. But I went to the back of the hospital and I just really, truly contemplated. But let's just say I was, I almost hopped over the fence on the hill to the freeway overpass and ended it right there. But again, wife and kids. So it's not an option. It's just not a fucking option.

[00:48:28] So had another breakdown there, panic attacks, battling depression, pop another Adderall. All right, let's go back into work because that stuff was magical for me. Like it like just put me back in almost into flow, you know. And this is stuff I wanted to get rid of and try to get rid of, but couldn't. So now we're back in the ER. And I literally remember I had a patient who had a crushed finger.

[00:48:54] It wasn't even anything intense close to what I'd seen my entire life or in that ER. Crushed finger. It was kind of bruising in purple. And there goes another flashback. And now I'm picturing Jason and the raccoon eyes that he had from, you know, shoot himself in the head from head trauma from the gunshot wound. And then I'm thinking of Rob Pirelli, who I never got to see. You know, my roommate, my friend who died in another part of the country.

[00:49:23] He got shot in the head, but it was by enemy forces. And, you know, now I'm linking this with Rob with a bruised finger. And for the first time in my life, I froze a little bit here and there. You know, you kind of like maybe before jumping out of an airplane, you get that little freeze hesitation and go. But when they say fight, flight or freeze, that was the first freeze I experienced. And I was checked out, man, in the ER on shift.

[00:49:53] I couldn't talk. I couldn't speak. I couldn't move. And I went and told my supervising physician, I can't be here. He recognized it. Surprisingly, I felt bad for this guy because he didn't even normally work at this hospital. He worked for the company and he's covering a shift. But he got it, man. He saw it in my, he saw suffering in my eyes. And he pulled me aside like, you're done. And like, you're off shift.

[00:50:23] Okay. Let's get you some help. Blah, blah, blah. And then he just like that, just disappeared back into the chaos, back into the ER. And I was just sitting there just contemplating what happened and then really thinking about going back up to that freeway overpass and doing it again. But again, thinking about my wife and kids.

[00:50:44] But really, you know what really kept me from doing it was having to clean up the mess after Jason shot himself in the talk. And knowing that if I jumped off the freeway overpass that other people, you know, we're going to have to clean that up. That's enough for me to have to do it. Like, I'm not going to put other people through that, you know. So, so I didn't. And I went home and life as usual.

[00:51:15] I never walked back into the ER. Like, I don't know how my brain got to that point. But that was my first true bout with suicide. The ideation was there. It's been there for a while. But like, standing on the edge of a freeway overpass. So, yeah. Did we disconnect now? Nope. Nope. Sorry. Pause for a second. Okay. All right.

[00:51:41] Do you think being a medical provider yourself actually made it harder to identify what was going on with yourself? While in it, yes. But after truly sitting with it and contemplating and then finally getting help, like, yeah, I went to mental health in PA school. And here's some Adderall, right? But I didn't do therapy or counseling or anything or anything to process all this shit.

[00:52:08] And then I finally said, okay, you know, for a while I didn't even tell my wife I quit. I'm like, I'm going on shift and I would just drive around trying to figure it out. Just doing a lot of self-reflection and thinking. So, I decided, okay, I need to, like, get help. I need to raise my hand. This is, what am I doing? Like, why am I not asking for help? So, I reached out to the VA and started that process.

[00:52:35] Started seeing therapists at vet centers in North Orange County, vet center, South Orange County, vet center. I was all over the place trying to find the right therapist. But then I started telling these stories and they started coming out more. And it started getting easier. And then I started bonding with other guys who had been through shit. And two of my therapists were combat veterans at one point. So, that really helped too because they got it. And they were able to help me unpack all this stuff and figure it out.

[00:53:05] So, I started doing a lot better. And, you know, until I stayed in medicine and, you know, the pattern kept repeating. So, that pattern has repeated off and on for the past decade. And each time it's different. Each time it's a different, you know, a lot of the same triggers. Fighting the system, fighting technology. My sleep spirals. I start drinking and trying to cope.

[00:53:33] And not doing anything. All my wellness stuff that I've learned. All my self-care. My PT. Everything's out the window. And all I do, I just get obsessed with studying and learning and popping more pills just to get better. What can I do to get better? And finding the next job and where I'm going to do that. And maybe it'll be better. But ultimately, after leaving the ER, I knew I needed a day job. And I couldn't do night shift.

[00:54:02] I refused to do a night shift anymore anywhere. At least with medicine. And I took a month off. Got a lot of help. And the first job when I started looking like, oh yeah, I need a paycheck. I'm a civilian or I'm a weekend warrior now. So, uh, found a job with, uh, psychiatry and addiction medicine. And after going to the VA, here's a few more pills. Now I'm on Welbutrin, Cymbalta, and Gabapentin. The Adderall we put aside.

[00:54:33] Which it'll, it'll make an entrance later on. Um, but, uh, now I'm on three psych meds. And I need a job. And I really remember being fascinated with psychiatry, with neurology, with the human brain. And then now that I'm seeing more therapists and psychiatrists, um, really just wanted to get in this and figure myself out. So I did, dove in headfirst to psychiatry and addiction medicine.

[00:55:00] And from day one, connected with almost every single one of my patients. And these are good. Yeah. So, so for the past 10 years, I mean, the suicidalizations and planning for it, this isn't like a one-off occurrence that you recovered from. This is a chronic condition that you're managing in real time. Yes. To this day. Yeah. Okay.

[00:55:25] You know, we're getting close on time, but for folks listening to this, what advice would you give a veteran who might be going through some stuff and they realize they need help? Or perhaps they're going through some stuff and they don't realize they need help. Like what, what do you wish you had known about or addressed sooner? Like, what do you wish someone had tapped you on the shoulder and said to you?

[00:55:56] Exactly what that ER doctor did to me and just look me in the eye and say, like, you're not okay. You need to, you're done. Pull me in. I mean, that's what needs to happen with guys like us. You know, we're, we're, we're stubborn and we're going to push the limits every single time. Sometimes I just want to slap myself and say, what's wrong with you? Like, go get help. And then I do. And then I get back into this, the, the, the, we'll just call it the churn, right? The, the, the, the U S healthcare system and me trying to find my place in it.

[00:56:26] But people absolutely need to identify when anything is off. If you're even thinking about something that's abnormal, like just reach out, just call a friend, call, do something. Don't be alone and don't use substances because those two things right there are catastrophic. And obviously if, you know, not to get too much into the firearms conversation or everything like that, but I mean, access to weapons is a big thing with our veteran community.

[00:56:56] So much that, you know, I went to one event and the VA is literally handing out gun locks, which I still have to this day. But like nobody can carry this shit alone. It's impossible. If you try, you're going to hit a wall again, right? Like you got the rest of your life ahead of you just because you get through this one moment, whether alcohol helped you through it or, you know, uh, some other type of maladaptive behavior or whether it was a great,

[00:57:24] you know, therapist or, uh, a medication that helped anything. You still got to wake up the next day and the next day and the next day. I've put a lot of this past to rest. So much of the trauma has been put to rest and it's dormant, but it's always going to be there. And as long as we put ourselves in stressful situations, the possibility to open up that Pandora's boxes is very real.

[00:57:51] And, you know, I, I, I really wish that I'd say I, I, I finding my purpose and I am, I'm still on that journey, right? Like it's not over at all. So part of this podcast, I mean, is to really get this stuff out and this is probably the most raw conversation I've had on a podcast before. Everything else was really scratching the surface. Um, but, uh, don't even try to do it alone. Like there's, there's somebody out there. I mean, I've called the veteran crisis line three times.

[00:58:21] I've woken my wife up in the middle of the night. I've, my own daughter has came to me and see me crying and just a hug from her when she was 11 years old was able to help. Just don't find yourself alone. You're not alone. And if you're going to continue to do these maladaptive behaviors or put yourself in situations, um, let's call it what it is. Self-sabotage.

[00:58:44] Like if you want to be on this planet and you deserve to be on this planet, you have a lot more to offer the world. Cause I know I do and I'm doing it every single day, but now we're fighting new battles and fuck dude. They're harder than, they're harder than dodging bullets and driving past IEDs, right? Like dealing with finances and life insurance, health insurance.

[00:59:10] I have a whole story on life insurance, um, and multiple stories on financial struggles. Um, you know, I, one thing, and I, and I definitely, you know, in an official capacity for Wounded Warrior Project, I have to say like during another psych hospitalization, the third one, um, you know, my buddy, Chris, who was a prior therapist back in Orange County.

[00:59:40] He was, then he became a VA psychologist. He actually took my guns for a period of about seven months or so. I met him at the VA and he's like, dude, why don't you just call Wounded Warrior Project? Like, when'd you get involved with them? He's like, well, no, I'm still with, you know, I'm still with the VA, this and that, but I did a retreat to Joshua Tree and a little camping trip. And he's like, man, they're doing some good things.

[01:00:02] And, you know, I'd heard about Wounded Warrior Project and I'd worked with other nonprofits before, but I always saw them as like, you know, the VA of the nonprofit world. Like, oh, they're so big and they had their drama in the past and, you know, I'm sure they're doing great things, but I'm going to stick to, you know, uh, the VA just because it's here. And I don't want to have to deal with this other stuff, but man, he got me on the phone with Wounded Warrior Project, sat me down for, um, an hour or so while I did my intakes in processing.

[01:00:31] Um, they helped me get to a hundred percent service connection. By then, a lot of my triggers were battling the VA disability system and going from 30% to 50% to 70% to 90%. Ultimately, three strikes, 90% trying to get a hundred through my own means, through other VSOs. And despite telling some of these same stories, not getting to a hundred percent service connection.

[01:00:59] And I could give a shit about the, the, the hundred percent, but now it's like I'm losing all these jobs and there's a lot more squeezed into this entire stuff. But, you know, I need some type of financial cushion to be sure that my family is going to be okay. So finally people were basically smacking me, telling me like, dude, go get a hundred percent. There's people that are a hundred percent that just, you know, never even deployed and sprained their ankle in basic training.

[01:01:28] Like, okay, I'll try, but Wounded Warrior Project got me there. Like the, my VSO that I had, um, Michael Shry, dude's, you know, he's a old, uh, gunnery sergeant. And he basically said, my entire job is to throw, take the paperwork and put it in such a way and, and collect your stories and testimonies and, and all these results and paint a picture for them. Like this person to live, deserve to be a hundred percent.

[01:01:55] And it took multiple psychiatric hospitalizations, over 11 psych meds, um, trauma retreats, losing, uh, getting fired, walking away from jobs. Um, it took all that to get to a hundred percent. Like that blows my mind, especially when I hear nowadays, how there are a lot of companies out there who are like, Hey, pay us, you know, your first, uh, months, first months after you get to a hundred percent, we'll get you there. And all right, you got a little back pain and sprained ankle, like, bam.

[01:02:25] Oh, a hundred percent. Like that absolutely blows my mind. And you know, to each their own, I'm not here to bash any of that stuff, but my path was difficult to get there. And Wounded Warrior Project was the one who literally threw me on their back and fucking carried me. So that's when I decided like, Hey, I want to give back to these guys.

[01:02:50] And as I started sharing a little bit more, I ended up in talking to Walt, Walt by it. Uh, meeting him through a mutual friend. And he's like, well, what do you want to do for the organization? Like I'm telling, I want to help. I'm like, well, I, sir, I got some stories. And next thing you know, he's sending me down the line and I'm interviewing with, with at least four or five different people.

[01:03:15] And found myself now on the national campaign team, got through warrior speak training and, um, you know, did my first live event actually, uh, a couple of weekends ago. And it was this, it was the, the, the carry forward 5k. And I'll tell you, man, that Wounded Warrior Project is yes, they're big and they're decentralized. But man, when you can find a small tribe, which I'm still working on trying to find my local Wounded Warrior Project tribe, um, they're there.

[01:03:44] And, uh, you know, we're planning a get together soon, but like you need a tribe. You need, you need other people who get it and who can just take you and shake you, maybe slap you if they need to and say, go get help. Cause that's what it takes. People were stubborn. Veterans are stubborn and we will say anything just to keep from having to go back through another VA process or, you know, talk to another therapist. Just like stop being stubborn.

[01:04:13] If you want to live and offer something to the world and, and, and really truly thrive in this life, like get real help, maintain your tribe, find your purpose and great things will happen. Um, and that's what really Wounded Warrior Project has done for me. And that's why I'm so passionate. I'm like, Hey, I want to speak on behalf of these guys and tell the world. Nice. Well, hey, Joe, really appreciate you taking the time to talk with us today. Really glad you're still around.

[01:04:43] Hopefully we get to do this again sometime. So, you know, to please don't kill yourself. We were happy that you're here. No plans on it, man. No plans on it. I've, I've learned so much over the years and I have a support system, um, in multiple support systems, multiple safeties in place. Uh, I got a lot to offer the world. And again, that's what I want to tell everybody else, like what you're doing right now, Scott. I mean, just providing this platform. Um, you know, I've looked at your bio.

[01:05:09] I've, uh, you know, heard some, you know, listen to your podcast with Walt Pipe last night. Actually, um, you're doing good stuff in the world, man. And keep it up cause you're worth it. And, you know, um, we all are right. And we got to police each other up. Absolutely. Thank you. Thank you, Scott. Appreciate it, brother. Thank you for watching part four of the five-part series.

[01:05:31] In our next installment, we're going to be speaking to Lindsay, another clinician, about how do we muster resources at scale to try to address this problem and put a dent in it. Thank you so much for joining us. And again, if you or someone you know is in a crisis situation, please reach out to the National Suicide and Crisis Hotline at 988. See you next time.