Philadelphia Medicine Summer 2019 - 10

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The Suicide Menace
for Veterans...
By: Alan Miceli, Editor

uring Retired Sergeant Major Nicholas "Chip" Gilliland's
three-year tenure as assistant adjutant general for the
Pennsylvania National Guard, one of his jobs was to attend
the funerals of servicemen and women who died.

Life at home was chaos. He became a heavy drinker. He spent his
days in mental anguish and didn't know how to confront it. In May
of 2012, only five months after coming home, he wrote a letter to his
parents and younger brother and sister, apologizing for being weak.

During that time, he went to 22 funerals. Five of those who
died were killed in action in Afghanistan. One died of cancer. The
rest of the funerals - 16 in all - were for service members who took
their own lives. He told the Veterans Suicide Prevention Summit at
the Philadelphia County Medical Society in April, "And 16 times
I was asked the question - how does this happen? And 16 times I
had to tell a parent I didn't know."

"The plan was to go out drinking with my friends just as I
had been doing since I came home. Then come home and take a
bottle of pills."

Each day about 20 veterans commit suicide. Their rate of
suicide is about one and a half times more often than those who
have not served in the military. The vast majority of veterans who
die by suicide are not seeking services.
Speakers at the summit attended by dozens of health care
professionals, and current and retired military officials, painted a
complicated and often bleak portrait of why veterans kill themselves.

Many Come Home Numb and Confused
Ex-Marine Andrew Einstein came within a handful of pills of
taking his own life. The New Jersey native described at the summit
why he ended up wanting to kill himself. He suffered a traumatic brain
injury during a grenade attack while serving in Afghanistan in 2011.
He returned home and resumed work part-time, as a police officer.
"I found that I missed the war. I missed the guys. I missed
having that sense of purpose and responsibility that I had overseas."

But the next morning, his parents woke a confused and angry
Einstein, who was disappointed and upset that his plan had not
worked. But the failed attempt drove home to his parents, the deep
psychological wounds Einstein was suffering. They began to seek
help for him. One of the first things he received was a guide dog
named Gunner.
"He gave me a purpose and a responsibility that I had not had
since I left Afghanistan," Einstein told the summit members as he
petted Gunner. The dog didn't solve all of Einstein's problems, but
he was a a step removed from depression and hopelessness. And
Einstein finally realized it was okay to seek help. He started getting
the counseling he needed. During his bumpy road to recovery, which
included his partner in the police force getting killed in the line
of duty, Einstein came upon Operation Enduring Warrior. A few
months later, as part of that program, he parachuted out of a plane.
"After 25 jumps I got my license and soon after that took over
the program. And now I send guys 14,000 feet in the air to find
freedom."

Einstein's Crisis is all too Common
Einstein's crisis at home that almost ended in suicide is similar
to what many veterans go through. Dr. Anthony Machiavelli, a
West Point graduate, psychiatrist, and current medical director of
the hospitalist program medical service line of the Atlantic Care
Regional Medical Center, has seen many cases similar to Einstein's.
At the summit he ticked off the risk factors health care professionals who deal with veterans should be looking for - traumatic
brain injury, excessive drinking, use of heroin or other drugs, loss
of a job, depression, bipolar disorder, chronic medical conditions,
post traumatic stress disorder, anxiety, chronic pain.
"These are all red flags we need to think about. They all put
a patient at risk."

10 Philadelphia Medicine : Summer 2019

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Philadelphia Medicine Summer 2019

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