战争创伤后遗症：带着愧疚活下去

November 2004， against a shattered wall in south Fallujah in Iraq， with video rolling， I conduct a battlefield interview with US Marine Corporal William Wold. He has just shot six men dead inside a room adjoining a mosque and is juiced with a mix of adrenaline and relief.

“I was told to go the room，” he says，“and my first Marine went in… he saw a guy with an AK， I told him to shoot the guy， then I shot the six guys on the left… and my other Marine shot two other guys.”

Wold grew up near Vancouver in Washington State. A high-school linebacker， he had a college football scholarship waiting for him， but gave it up to join the Marines.

“My fiancées worried that Im not going to come back the same. Ill never tell her what things I did here. Ill never tell anybody， cause Im not proud of killing people. Im just proud to serve my country. I hate being here， but I love it at the same time.”

Wolds fiancée was right. He wouldnt come back the same. He thought his war was over， but a few months later， back in the safety of his childhood home， surrounded by his adoring family， the dark secrets and all the guilt emerged from his mind—like the Greeks from their hollow wooden horse， unrelenting in their destruction of ancient Troy.

A recent study by the US Department of Veterans Affairs （VA） shows that nearly two-dozen veterans are killing themselves every day， nearly one an hour. This attrition， connected at least in part to combat-related post-traumatic stress disorder （PTSD） and other war-related psychological injuries， is an enormous price to pay for avoiding the subject. So great， in fact， that the total number of US active duty suicides in 2012 （349） was higher than the number of combat-related deaths （295）.

“When a leader destroys the legitimacy of the armys moral order by betraying ‘whats right，” writes psychiatrist Jonathan Shay， an expert in combat trauma， in his book Achilles in Vietnam （1994）， “he inflicts manifold injuries on his men.”

This could be what happened to Corporal William Wold. Wolds mother Sandi said he was fine for a while when he first got home， but after a few months the darkness seeped out. He couldnt eat and he never slept.

The transgression that bothered him most wasnt the carnage in the mosque， but another， even more disturbing incident， an accidental killing at a vehicle checkpoint in Iraq. The vague description Sandi gave to a local television reporter is horrifying： “A vehicle came through that hadnt been cleared，” she said. “The lieutenant says：‘Take them out. He took them out. They went to the van—it was a bunch of little kids. And he had to take their bodies back to the family.”

Instead of killing an armed enemy， Wold had， through the orders of an officer， killed several children. The accidental killing of civilians in the Iraq War， as in all wars， is much more common than you can imagine. Numbers are so high it wouldnt benefit the military to keep accurate tabs； rigorous documentation would just fan the public relations nightmare and boost the propaganda value of those deaths for the other side.

Wold， like many combatants， was able to contain his guilt while still in Iraq. But when he returned home， he brought the Trojan horse with him. It was there， in the calm of these“safe” surroundings， that his guilt and shame overwhelmed him. He became addicted to the pain medication prescribed for an injury he had suffered in a roadside bomb attack and augmented that with methadone that he scored on the street.

One night a couple of friends came to visit Wold there. They went out together to see a movie and get tattoos. When they returned to his room， Wold couldnt remember if he had taken his medication or not—so he took it again， in front of his friends.

The next morning， the friends found Wold in bed， in the same position he had been when they had left him the night before. Only now he wasnt breathing. He was pronounced dead at 9：35am.

Sandi felt the Marines had failed her son. But she knew he had loved the camaraderie of the corps and had him buried in his dress blues. She also knew that the uniform was just the surface of a much more complex story， a story of belief， duty and honor yes， but also about how guilt over killing in the pursuit of those ideals could lead to ruin.

I met Lance Corporal James Sperry， like Wold， during the Battle of Fallujah in Iraq in 2004. I videotaped him after he had been wounded during the first day of fighting. Like Wold， Sperry came home with a head battered from war and filled with guilt. But Sperrys guilt wasnt over killing； it was over not being killed， survivors guilt. His unit suffered some of the highest casualty rates of the war.

He sent me an email six years after Fallujah， thanking me for helping carry his stretcher that day and asking if I had any photos of his comrades killed in action. “I was wondering if you had taken any photos of me during that time of injury and any of my fallen friends. I have lost 20 friends in this war and would like to get as many pictures as I can.”

That note came during a dark period of Sperrys life， when he was struggling with cognitive impairment and debilitating migraines from his physical injuries and a host of psychological issues consistent with moral injury. He met nearly all of its criteria， including purposelessness， alienation， drug and alcohol use， and even a near-suicide attempt （he went as far as to sling a rope over the rafters of his garage）.

His recovery， which took years， was not the result of a single act， but encouragement from family and friends， ongoing determination and a groundbreaking program from the Shepherd Center in Atlanta， which specializes in helping those with brain and spinal cord injuries.

Corporal Wold and Lance Corporal Sperry are just two of millions. According to US Department of Defense data， since 2001 about 2.5 million Americans went to war in Afghanistan and Iraq， with more than 800，000 deploying more than once. Nearly 700，000 of those veterans have already been awarded disability status， with another 100，000 pending， according to the VA.

They all need support. As Jonathan Shay wrote in Achilles in Vietnam： “When you put a gun in some kids hands and send him off to war， you incur an infinite debt to him for what he has done to his soul.”

2004年11月，在伊拉克的费卢杰南部，我靠着一堵千疮百孔的墙，在摄像机前对美国海军陆战队下士威廉·沃尔德进行了一次战地采访。他刚刚在一座清真寺旁的一间房间里射杀了6名男子，现在内心感到既激动又如释重负。

“我受命进入那个房间，”他说道，“我前面的那个队友进去了……看见有人拿着一把AK步枪，我让他开枪射杀那人，然后我就射左边的那六个……我另一名队友射杀了另外两个。”

沃尔德在华盛顿州毗邻温哥华的地区长大。高中时他是橄榄球队的线卫，本来获得了一所大学的橄榄球奖学金，但是他为加入海军陆战队放弃了奖学金。

“我的未婚妻担心我回去的时候就变了。我绝不会跟她说我在这儿所做的事。我绝不会告诉任何人。因为我不为杀人而自豪。我只为自己能为国效力而自豪。我讨厌待在这里，但同时又热爱置身其中。”

沃尔德的未婚妻是对的。他回去的时候就不再是原来那个人了。他以为他的战争结束了，但数月之后，当他回到安全的儿时家乡，回到挚爱的家人身旁，那深藏内心的阴暗秘密和愧疚便一涌而出——就如同希腊人从空心木马中涌出，毫不留情地将古特洛伊城摧毁一样。

美国退伍军人事务部最近的一项研究表明，每天有二十多名退休军人自杀，平均约一小时就有一名。造成这一损失的原因至少部分在于由战争引起的创伤后应激障碍和其他与战争相关的心理创伤，这是我们为逃避杀戮这一话题所付出的巨大代价。事实上，问题严重到在2012年美国现役军人的自杀总人数（349人）比因战争牺牲的军人总人数（295人）还要高。

精神病学家乔纳森·谢伊是一名战争创伤方面的专家，他在其1994年出版的著作《阿喀琉斯在越南》中写道：“当一位军事领导背叛‘正确之事，破坏军队的道德理性，他就会在很多方面对其部下造成伤害。”

这可能就是发生在威廉·沃尔德下士身上的事。沃尔德的母亲桑迪说，他刚回家那会儿状态还很好，但是几个月后，他内心的黑暗不断渗出。他开始吃不下饭，睡不着觉。

最折磨他的罪行并不是那次在清真寺中的大屠杀，而是另一起事件，一起更加令人不安的事件：在伊拉克的一个车辆检查站的一次误杀。桑迪向当地一名电视台记者模糊描述的情形令人震惊：“一辆车开过了检查站，但是没有经过安检。”她说，“上尉说：‘把他们干掉。他就照做了。然后他们走向那辆小货车——里面是一群小孩子。他还不得不把他们的尸体送回各自的家。”

沃尔德没有杀死武装的敌人，反而在长官的命令下杀了数名孩子。不光是伊拉克战争，在所有的战争中误杀平民的情况都相当普遍，已远远超过你的想象。误杀的数字太大，所以准确地记录下来对军方而言并没有什么好处。严格的文件记录只会给公关工作带来噩梦，还会为敌军就这些死亡人数增添了宣传价值。

沃尔德就像许多战士一样，在身处伊拉克时还可以控制住自己的愧疚。但是当他回到家乡，他就把那只特洛伊木马也一同带了回去。正是在那里，在这种“安全”环境的平静氛围里，他的愧疚和耻辱压垮了他。他开始对一种止痛药上瘾——那是他在一场路边炸弹袭击中受伤时医生给他开的药，而且他还变本加厉从街上买来镇痛药美沙酮一起吃。

一天夜里，沃尔德的几位朋友前去看望他。他们一起去看了场电影，还文了身。当他们回到他的房间时，沃尔德不记得自己是否吃过药——所以他当着朋友们的面又吃了一次。

第二天早上，朋友们发现沃尔德躺在床上，姿势和前一晚他们离开时一模一样，只是此时他已经没了呼吸。9点35分，医生宣布他死亡。

桑迪认为海军陆战队辜负了她儿子。但是她知道，他热爱军队的战友，于是就让他穿着蓝色的军服下葬。她还知道，在这套军服背后有着一个更为复杂的故事。没错，那是一个有关信念、责任和荣耀的故事，但它同时也告诉我们，为了追求那些理念而杀人所引发的愧疚是怎样带来毁灭的。

就像我和沃尔德的相遇那样，我和准下士詹姆斯·斯佩里也相识于2004年伊拉克的那场费卢杰战役。他在第一日的战斗中受了伤，我把他的情形拍摄了下来。就像沃尔德一样，当斯佩里回到家乡时，他的脑袋因战争而受了重伤，内心充满了愧疚。但斯佩里并不是因为杀了人而愧疚，而是因为自己没有被杀，因为自己活了下来而感到愧疚。他所在的小队在那场战役中的伤亡率几乎是最高的。

在经过费卢杰战役六年之后，他给我发来了邮件，感谢我那天帮忙给他抬担架，还问我有没有他那些战死的战友的照片。“我想知道，在我受伤的时候，你是否给我或者我那些倒下的战友拍过照。在那场战争中，我失去了20名战友，我希望尽可能多地收集到他们的照片。”

邮件发来时，斯佩里正处于生命中的黑暗时期。那时，由于身体上的创伤以及许多与道德创伤相吻合的心理问题，斯佩里正与认知障碍以及日益加剧的偏头痛做着斗争。他符合几乎所有的道德创伤标准，包括无目的感、疏离感、滥用药物、嗜酒、甚至还曾试图自杀（他甚至都将绳子挂上车库的椽木了）。

几年之后，他终于康復了，但这并不是一方努力的结果。家人和朋友给了他鼓励，再加上他自己坚持不懈的决心，以及来自亚特兰大指导中心的一项开创性的康复计划——该中心致力于帮助那些大脑或脊髓损伤的病人。

沃尔德下士和斯佩里准下士只是几百万退休军人中的两个代表而已。根据美国国防部数据统计，2001年至今，大约有250万美国人投身阿富汗和伊拉克战争，超过80万士兵不止一次参与部署。美国退伍军人事务部指出，这80万退伍军人中，有70万人已经获得了伤残证明，而剩下的10万人仍有待处理。

他们都需要帮扶。正如乔纳森·谢伊在《阿喀琉斯在越南》中写到的那样：“当你将一把枪置于一个孩子手中，然后将其送往战争，那你会给他背上无穷的罪过，因为他的所作所为已使他的灵魂残破不堪。”