Military Psychiatrist Goes Ballistic

On Thursday afternoon November 5, 2009, 39-year-old Major Nidal Malik Hasan, an army psychiatrist who was awaiting deployment to Afghanistan at Fort Hood, Texas, the country’s largest military base, armed himself with two guns and opened fire on the grounds, killing 13 and injuring 38. He was brought down by two civilian officers who shot him at least four times. Initially believed to have been shot dead, Hasan is in stable condition at a hospital.

Hasan was trained by the army as a psychiatrist to help soldiers returning from abroad deal with the mental stress of combat. By some reports, however, the horror stories he heard and Post-Traumatic Stress Disorder (PTSD) he witnessed first hand ultimately changed him too. Hasan reportedly turned against the wars in Iraq and Afghanistan and was becoming a more devout Muslim. In the coming months, Hasan’s life will be dissected, his computers searched to see whether he was the author of posts likening suicide bombers to heroic army soldiers who give their lives to save others.  Prior to being sent to Fort Hood to await deployment to Afghanistan, Hasan had spent six years at Walter Reed Hospital, where he was described as being a quiet, polite, yet lonely man, and he received a poor performance evaluation.

Ironically, the massacre occurred only miles from Kileen, Texas—where  Hasan lived in an apartment—and  which was the scene of one of the most deadly shootings in American history when George Hennard crashed his truck into a Libby’s cafeteria and began randomly shooting people in 1991. In all, Hennard killed 23 people and wounded 20. Also ironic is the report that Hasan spent some time at Virginia Tech, the site of an April, 2007 massacre in which 32 people were killed and many others wounded by senior English major Seung-Hui Cho.

Psychiatrists and other mental health providers who deal with people who have suffered a serious tragedy or been in lengthy highly stressful, even life-or-death, situations are often affected deeply by their clients’ ordeals. Psychiatry as a profession has one of the highest rates of suicide, alcoholism, and substance abuse among its practitioners than most professions.

In an August 2007 article in the journal Psychotherapy and Psychosomatics, the author states that, because of the stress of their work, mental health providers are more likely than others to experience depression and other disorders. The article points out, however, that most depressed psychiatrists would not seek the help of a fellow psychiatrist but are more likely to self-prescribe antidepressants. Studies of depressed persons have unequivocally concluded that a combination of antidepressants and psychotherapy (“talk therapy”) is the best method for treating most depression. However, depressed psychiatrists do not want to seek out mental health care from another psychiatrist for a number of reasons, particularly to keep a clean record for malpractice insurance rates and to avoid the stigma of being labeled as having a mental illness. After all, what mentally-ill patient would want to be treated by a psychiatrist with depression or other mental disorder?

Never was the saying “Physician heal thyself” more appropriate than in this case, especially when considered with the medical profession’s Hippocratic Oath, which admonishes healers, “First, do no harm.” My heart goes out to the families of the killed soldiers and the wounded soldiers who thought that nothing could be safer than being on the biggest military base in the United States.

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