One of the hardest things about coming back was the slow pace of life back home. We were so busy in Afghanistan all the time, and trying to slow down was hard for me. I started taking long walks with my husband, and doing other things that were enjoyable for both of us. We started going to the movies, going out to dinner. My husband made suggestions of things we could do to stay busy, but they were enjoyable things. They were things we could both look forward to. I rediscovered golf and tennis after I came home. We also started playing bridge with some friends.

I would tell the young nurses who have not deployed yet, to know themselves, know their faults, know how they handle stress, and to have outlets besides work. My outlet was getting back into church while I was deployed. I went to church with one of my roommates, and it was very exhilarating to go to a nondenominational church with coalition forces and government aid workers from about 30 other countries. It was a truly spiritual experience. But, they need to find that outlet whether it is going to church, or writing in a journal, or working out, or playing sports, or taking courses online or by correspondence. You also have to have someone you can vent to in a deployed environment. Someone you can go to each week and have a cup of tea with, and talk about what is on your mind and what is bothering you.

My husband and I are both doing navy health professions recruiting now. We are not in the same office, but we work for the same command. I’ve done everything I’ve been asked to do in the navy. Now, this is my selfish choice so my husband and I can be together. It gives me a break from clinical work, and gives us some time to start a family. We are both still active duty, and we plan to stay in the navy as a career. I’m finishing my master’s in nursing management, and my husband will be going to school full time with navy sponsorship for a DNP [doctor of nursing practice] after he finishes his recruiting assignment. We are looking forward to our future as career naval officers.

They need to know about being a woman deployed with hordes of men from all these countries. No one was real aggressive with me, but you are like a piece of meat on a stick. You are like one percent in a population of 40,000 men. There were like maybe 4,000 women in theater. Anytime you walk anywhere, there are just so many eyes on you. Most of the guys you knew were very helpful and were always giving us women free stuff. But the experience over there was still that you felt like a piece of meat. They weren’t physically trying to touch you, but they constantly did things to try to get your attention. You were “a chick in a uniform,” and that was kind of difficult for me since I’m an officer. The Afghan men always stared, and they don’t respect women. They’d say things like “What is she doing here?” and “How is it that she is an officer?” It was different when the Afghan women came in for care. The men always accompanied them, but the men hung outside the ER with their own group. If you’ve ever seen a cartoon with a dog salivating over a piece of steak, that is the look the Afghan men gave us female nurses. The Afghan men prisoners who were brought in for care were the worst. The way they looked at us was as if we could be a trophy for them. It was very chilling the way they stared.

Sometimes, because there were only a few of us navy personnel with this multinational force, we felt forgotten by our administration. We had some of the navy hierarchy visit, and some said they didn’t know we were at our base with the other forces. I thought, that is really strange because you folks signed our deployment orders.

I know for myself, I know more about myself now, than I did before I deployed. I know what my triggers and issues are. I took care of myself, and I was proactive about going for counseling. It wasn’t my command checking up on me, because no one ever asked officially how I was doing. My boyfriend and my other friends asked, but no one in the official chain of command, except my director of nursing service, ever asked. One night my nursing director came by and asked, “Are you doing OK? Whatever you want to do, just let me know. Whatever you need, just let me know.” She cared about her nurses. I sometimes worry about the younger corpsmen who might not have their senior officer looking out for them. I was pretty assertive about getting the mental health help I needed, but I don’t think some of the younger folks have that insight. They do a post-deployment medical and mental health assessment, but that is usually just with a PA or a senior corpsmen, and people are just checking boxes on a form. There is no real in-depth assessment. No one ever really sat down and made sure I was OK. I went through the “One-Source” system to find a counselor in town, it wasn’t through the active military. I think that people assume that because we are nurses, we are used to seeing trauma and blood. However, it is not a normal occurrence for most nurses to see this kind of terrible trauma on a daily basis and to see all the seriously injured and dead children. It does something to you. I feel like we saved a lot of people, but at the same time we saw a lot of people die.

Only one day on deployment did I break down. The special forces commander came into the ER to see one of his troops who had a back injury, and looked right into my eyes and said to me, “Lieutenant, how are you doing? You have a job where probably no one asks you, and you are so busy asking everyone else. I don’t know how you do what you do, because I couldn’t do it.” And I thought, here’s this commander who goes out in harm’s way every day, and he thinks our jobs in the hospital are so tough. He was the first person that validated for me that our jobs are so important, and that what we do is so valued by the troops in the field. Some other guys always say that it must be so nice to work in the hospital and to live in a tent with running water and flush toilets. Talking with this commander was a seminal moment for me. It validated a lot for me.

You feel like you don’t have the same purpose with work in the States. You are serving a purpose back home, but you view your purpose in Afghanistan as more important. You feel like what you were doing before had so much more meaning than what you are doing now. It’s harder to be tolerant of all the idiosyncrasies and the trivialities of people. You have to remember that everyone’s perceptions are different. The general lack of realization from the general public of what we do and that we are still over there doing it, bothered me when I came home. All of a sudden, you are taking care of a 20-year-old or even an 18-year-old who 5 minutes ago had all of his limbs and was fine and was joking with his buddies. And now, he’s unconscious and is missing three of his limbs. And another 18-year-old back in the U.S. would be saying, “Who’s having a party tonight?” Or, “Where am I gonna be going to school after I graduate?” Or, “What color hair looks better?” We’re talking about very different priorities. And I don’t know if people are aware enough of what is going on over there. People just don’t think. Most know that we have troops over there. But if doesn’t affect their personal life, it is very distant from their consciousness. When you come back, it’s like, “So what’s up?” People know that there is a war going on and that we have troops over there, but they think collectively, not about the individuals. Life continues to be pretty normal for most of the American people, so why shouldn’t it be for you when you come back? They just don’t realize what you saw and what you did over there. Now, with time, I’ve put all this in proper perspective. It took me time to do this. I can’t realistically expect everyone to have my perspective because they didn’t have my experiences. I’m a wiser and more tolerant person now.

I did some proactive things while I was deployed which I think helped with my reintegration. One of the biggest things to help was to go to school. I was actually in graduate school while I was deployed. I was taking grad school courses while I was in Afghanistan. I continued that while I was over there. So, basically, I did my regular work in the operating room, then I did school work. I kept myself busy and focused. My graduate program was online. It kept me occupied. I’m not like a lot of people and was probably not into networking and socializing as much as some people. I had my few people I could vent to. Others visited different country compounds. I was either at work or doing school work or at the gym. It was nice to have a distraction like school work. I also wanted to plan for the future, and having a graduate degree in nursing administration would certainly help as a Nurse Corps officer. School in a way was therapy for me. It was one more positive step toward my future.

I would do it again. No matter how well you know yourself, you are not going to know how you would be in a given situation. I volunteered, and most of us volunteered, but I don’t think we really knew what we were in for until we experienced it for the first time. Even if 10 people told me about their experiences, I would still have had that initial shock. That first trauma really does come true. It could be compared to a pregnant woman with 20 people telling her what their labor and delivery experience was like. But the woman would really have to experience it for herself. It’s different for everybody.

My transition back definitely went smooth. I didn’t have any issues with that. However, the care we deliver back here in the States is mostly to retired older people with cardiac problems, and you have to deal with the families as well. I just miss the action and challenges that I faced in my wartime environment. I think I found my niche in trauma ICU nursing, and I really miss it now. The active duty patients were so motivated and enthusiastic. They might have just gotten shot or blown up, and they want to get back out there to fight. They are upset that they and their buddies have to be hospitalized. They are just so energetic and motivated. Coming back to the States and my ICU, I’m taking care of these older patients, patients in their 80s who have open heart surgery, and they don’t want to get out of bed, and they don’t want to walk, and they are just not motivated at all. So, it kind of makes my job more difficult because it is hard to motivate these older folks.

When I was deployed, I found something that I am really passionate about, trauma nursing, and coming back to my stateside ICU I’m finding that I’m clinically frustrated with the pace and the lack of challenge for my ICU skills. On deployment, you just did your job; you fixed them, and you knew you were doing your very best to help these young injured soldiers. We tried to get in touch with unit commanders to let them know how their troops were doing, but once we did, it was up to the unit chain of command to get in touch with their command back in the U.S. who would reach out to the families.

When you get back from Afghanistan, you are so grateful for everything that you have; your house, your car, being able to take a shower [laughing]. We went back to church as a family and started praying nightly together as a family. The prayer that I said to them: I want us each to say three things that we are thankful for and each person would say their three things, and then we’d pray for the rest of our family and friends. Every night we prayed for my friend who was an Afghan midwife, and for her daughters. She was divorced and came to work for the coalition and was in constant danger. We’d pray for her safety, and that she would get a visa. We wanted to get her and her daughters to the U.S.

If my daughters were wasteful, I’d say, “The kids in Afghanistan don’t even have shoes.” After a couple of months, my oldest daughter said to me, “Mom, I’m really glad that you are back from Afghanistan, and I know that it was a very important experience for you, but I am sorry you deployed because now everything is about being thankful because of what you saw.” [She laughs as she tells me this.] She was completely blunt and honest. I said, “Honey, I’m not gonna apologize for that and you’re gonna keep hearing it, but I understand where you are coming from” [laughing]. Being thankful has made a big impact on me and our family. As an individual, I really try not to take things for granted. We connect as a family with the things we are thankful for. Being deployed made me realize how fortunate we are in the U.S. because there are so many in this world who go without the bare necessities. They don’t have access to health care, and they don’t have running water.

My husband, he basically just listened. If I was feeling sad or stressed or anxious or guilty, he would listen. Sometimes he would just hold my hand. He let me talk. He would be open to that. For my first 6 to 8 weeks home, he continued to take the brunt of child care. They were in a routine with school, dinner, and grocery shopping. I was just there. I could take part, but I didn’t have to take control. Some of the things I wanted to take control of, and these were some of the functions of the household. I would be a little angry; I would say I want some of this back, and he’d say, “OK, but I don’t want to push anything onto you.” Then I’d say, “I can handle this,” and he’d say, “OK.” Now, I think, “What an amazing man! He’s a good guy.”

I did notice with the pace of life, he continued his active duty job during the whole course of my deployment and had to travel a few times and had to bring my dad in to help out with the kids. He became much more regimented, more serious. I could see his patience was thinner. I gently pointed this out to him. When I was gone, both he and my dad used the Naval Support Center and went for some counseling. The girls had gone for some counseling, too. I guess it was anger focused, but I don’t know why. I’ll have to ask a little more about that. I remember seeing this thermometer magnet on the refrigerator that was basically to measure mood. My husband and my oldest daughter are very similar in their temperaments, and they would both utilize the thermometer magnet. I would tease them a little about it [laughing]. They would go and take 10 seconds to cool off. Also, initially my husband was defensive when I’d try to help. He’d say, “This is how it had to be when you were gone.” I’d say, “Yes, I understand.” I knew how it was to a certain extent because he had deployed before, and I’d be home alone with the girls. We could communicate about how it was to be the parent at home with the girls. He and I would talk about it. He got to decompress a bit when I got home. I’d remind him that we could share the parenting and the household chores. It wasn’t all on his shoulders anymore. We were a team. I’d tell my daughters, too. It made me feel good to be part of it, and it made home feel more relaxed because he realized he had a partner to share things with. I’ve talked with friends and coworkers who deployed, and we agree that it is hardest when people feel like they have to face the day alone, with no one to share things with.

I got off active duty in July 2011, and I am in the reserves. I struggled when I tried to transition to the active reserves, they didn’t have a billet for me, and they still don’t. They are overmanned at my rank. I really felt like my identity would be compromised because I’ve been an active duty nurse and nurse practitioner. I felt like I lost a bit of my identity. When you wear the uniform, you garner that immediate recognition and respect. There is respect that goes with your rank. I actually went back to work last year as a contractor at an air force base clinic in civilian clothes. I wear a lab coat. No one would ever know that I was active duty, and I feel a need to tell them. I try to work it into a conversation. I guess part of it is the need for recognition, but it is also a need for connection. I know the stress of being active duty and being a nurse. Some of my patients are back from deployment. I ask them about their deployment, and I tell them that I was in Ghasni. They are surprised. I want them to realize that I can relate to them because I was active duty, and I was deployed.

I want to tell you about the Afghan midwife. I keep in touch with her to this day. We call each other sisters. I am her American sister, and she is my Afghan sister. I feel like it was important for me to make a connection with a real Afghan. Being there, it was about so much more than combat. It was about real people. She, to me, was the epitome of a real person. She is an Afghan woman who just wants to provide for her children. She just wants food and water for her children. She is currently in Norway. I keep telling myself that we were there for a purpose. I don’t know if we’ll make any significant changes that will benefit the country. But I think we tried. It can’t be a safe haven for the Taliban. We can’t allow women and children to be oppressed.

Decision making in the grocery store was tough. You have too many options. They want you to make a decision from a whole aisle of laundry detergents. I remember thinking, “I just need detergent; I don’t care which one.” That becomes intense for a while, but then it fades away. It takes a bit of time.

I remember both of us coming off deployments, and we did a lot of stuff together, and we would talk about things. It was spur of the moment talking, not planned talking. We certainly talked a lot about our experiences and situations, and the things we saw. I kept a journal, an e-mail journal back and forth about things we saw and did, and that was really therapeutic and helpful for me. My boyfriend was in Iraq and Afghanistan. He got home 4 months before I did. We’re both in the navy. Reintegration and routines, I remember thinking that life seemed so fast for a while and wanting things to slow down. I feel very fortunate that I didn’t have a lot of problems coming back. Some people seem to think you will. And yes, some people do have significant problems, but I didn’t. My boyfriend, who is now my husband, and I did not have a lot of crazy troubles. Yes, anxiety sometimes. It may have been a little more challenging for him. I remember maybe crying with him, but it was pretty normal at the time after our deployments.

I am an energetic kind of person. I learned to cope with anxiety and breathe. It was more intense initially. Also, I was coming from Japan and had lived there for almost 2 years. Japan is a totally different way of life. Then, I went to Afghanistan; so, I had been away from the U.S. for a while. It was more like a “coming home” experience. There was a ton of stuff. I was away for more than 2 years; one place was the trauma of a war zone, and the other place was a culture unlike ours, so far from ours. I was 45 miles south of Tokyo.

My husband, who was my boyfriend at the time, got deployed twice when he was stationed in Sicily; once to Iraq and once to Afghanistan. We did manage to see each other over the 2 years. I toured around Italy with him, and it was fantastic. Then, he came to Japan, and we went scuba diving. These were the two times we saw each other during the 2 years. Indirectly, we’ve been a support system for each other when we got back. Even to this day, he is helpful. He’s been deployed five times. We’ve lost people. He lost a very close buddy when I was living in Japan, and that was really tough. We got married in 2011, and then he deployed one final time to Afghanistan. I was back in the States when he got deployed. During that time, a very close friend of mine who was married to a navy nurse was killed in Afghanistan. I went to the funeral in San Diego when my husband was still in Afghanistan. We’ve lost some close people. We’ve been able to work through these things together and talk about them and remember things and honor the people. Those experiences are easier to go through with someone who understands. To this day, we talk about those guys, and we go and visit Bethesda. My husband has a bunch of buddies who have gone through there because they got blown up. We visit them. I have girlfriends who are still in the navy and we talk. My husband and I take part in veterans’ things here in Virginia. He is president of the military association here. I am very involved with him in that, just to foster support. We talk a lot about what we saw and did. It is just a common foundation of knowing what deployment has been like.