I am now retired and conducting research on killing in combat zones. I served as a medic in the Air Force at Andrews Air Force Base (AFB) in the emergency room of Malcolm Grow hospital. I served from Nov. 1969 to Nov. 1973. There I was, also part a team who started to process prisoners of war (POW) airmen. I also served temporary duty (TDY) at Lackland AFB treating airmen who were transferred out of Vietnam and presenting with substance use disorder (SUD). I never served in Nam. Upon discharge and with the GI Bill, I obtained my advanced degrees in clinical social work and psychology.

During my 1977 through 2000 stint at the Altoona Hospital as a BHC clinician, I had the privilege of conducting psychotherapy in our outpatient clinic and treated some of my comrades referred to us from our local veteran affairs (VA) center. I did therapy with the armed combatants who killed and some of the field medics and corpsmen that killed; but far more importantly, could not save some of their brothers from death.

Prior to my military service, I studied psychology in college. I paid some attention to the Vietnam War and was comforted by my deferment from the draft. The day I graduated from college, my protection ended. I did not go into teaching and would have had an additional deferment.

During my time in college, I had serious reservations about Vietnam and war in general. Though others protested Vietnam, I never did because of my respect for all men and women in the military. I detested those who protested as they directly, maybe not willingly, were supporting our enemy. So, once I lost my deferment protection, I enlisted in the Air Force mainly because my chances of having to kill someone were greatly reduced.  After completing basic, I enrolled in medical training at Sheppard AFB. By the grace of God, my first and only duty station was Andrews.

A number of my maternal uncles served either during WW2 or Korea. Two of my paternal cousins graduated from military academies and both made the military a career. Both were combat pilots in Vietnam. They were older than me and I really had limited contact with them.

My wife’s uncle, Mike, was killed during the Battle of the Bulge. He is buried at Arlington. My father-in-law served in the Navy during WW2 on a combat destroyer in the Pacific Ocean theater. He was part of a large flotilla the day the Japanese surrendered. He tells us he slept right through this historical event! He very rarely talked about his military service with any of us.

My older brother served in the Marine Corps, fortunately during “peacetime” as part of a howitzer platoon. My younger brother got drafted in the Army during Vietnam in a non-combat role, and did not serve “in country”.

In retirement, I now serve as a volunteer at our local VA Center. With four other fellows, we serve as sentries and guardians to what we refer to as “The Wall That Heals”. It is one of a few Vietnam traveling memorials that is now retired. It honors the legacy of all who served in Vietnam, including those who died, were killed or were wounded there. Soon I will be “deployed” to our on-site branch health clinic (BHC).

I am deeply indebted to the significant work in Lt. Col. Dave Grossman’s On Killing. And I am deeply inspired by the revelations of Marine Sgt. TJ Brennan and Finbarr O’Reilly in Shooting Ghosts. So here are some of my clinical observations about the impact of combat and its ensuing trauma:

1. War and combat are extreme expressions of insanity. Those who serve are not insane!
2. You killed due to a deep regard for self and others. I have two published articles on Brain Blogger about killing in combat and the other on aggression and violence in which I describe 6 types of aggression that I have encountered in my clinical work. The two that apply here are defensive and affiliative.
3. No kind of training can prepare you for the sheer horror and terror of combat!
4. Very few combatants enjoy killing!
5. In combat zones you have no time to grieve your multiple losses. When you return home, you now have to face them!
6. I am now very sure that I could kill under these extreme circumstances!

In conclusion, I am deeply moved by your experiences and don’t feel completely worthy to speak about your experiences. To you who are Marines, in the AF we called you “Gyrenes”. We are not worthy to unfasten your combat boots, and I readily admit that I served in the “cub scouts” of the armed forces as one ex-marmine observed when visiting The Wall!

Richard G Kensinger, MSW

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