“Hammerhead sharks feasting on the dead make a unique sound.”
So says William, a disabled Navy veteran and survivor of a horrifying incident that occurred in the Persian Gulf.
At the age of twenty, William enlisted in the Navy and served for six years, working on radar and weapons systems. On 18 November 2001, he was part of a team from the destroyer USS Peterson that boarded the Samra, a suspected oil smuggler sailing under the UAE flag. The Samra capsized on the port side, and William spent the night clinging to debris, waiting to be rescued, and listening to the sounds of sharks devouring those who hadn’t made it.
“There is only one sound like a bone being crunched through,” William notes. “And that’s a bone being crunched through.”
Gutted: Polypharmacy and the epidemic of suicide among post-9/11 veterans:Part 1: • Feasting on the deadPart 2: • 20 suicides a day
Afterwards William found himself suffering from PTSD, although he was not diagnosed as such and never availed himself of the services of Navy psychiatrists. Instead he tried self-medicating with alcohol. “I was crawling into a bottle almost every night,” he recalls.
Nevertheless, William managed to make it through his hitch in the Navy. After he returned home, his mother suggested he get help. The VHA psychiatrist who diagnosed William with PTSD never offered therapy or counseling, although he did suggest William try some veterans support groups. William says he did attend a few meetings, but decided they weren’t helping.
Meanwhile, the psychiatrist prescribed citalopram for William. At first the citalopram made him feel better, but it soon stopped working. The psychiatrist tried increasing the dose, and when that didn’t help, this was the beginning of an iatrogenic cascade that led to William’s undoing. The VHA docs tried drug after drug – Zolpidem, trazadone, mirtazapine, aripiprazole, hydroxyzine, buspirone, quetiapine, omeprazole, gapapentin, olanzapine, and prazosin, along with nicotine gum for his tobacco addiction (William says he continues to smoke). In addition, for shoulder and back injuries sustained in the wreck of the Samra, the VHA doctors prescribed hydrocodone, diclofenac, oxycodone, piroxicam, meloxicam, cyclobenzaprine, and methcarbamol.
William developed a number of physical disorders which are known toxic effects of these drugs, and for these his doctors prescribed a whole new slate of medications: Lisinopril and hydrochlorothiazide for hypertension, atorvastatin for hypercholesterolemia, insulin, glucagon, glipizide, and Metformin for diabetes, ranitidine for ulcers, and dicyclomine for irritable bowel syndrome.
The PTSD did not get better, and William experienced worsening depression, anxiety, balance disorders, cognitive problems, and uncontrollable rage. “I’ve had to seclude myself from just about everyone,” he says.
William decided to go to university, enrolling in a demanding undergraduate program in astrophysics, but he dropped out after two years, after quarreling with a professor in one of his humanities electives. The VHA declared him partially disabled, and two years ago he went on full disability. But, he says, he never became suicidal until a civilian psychiatrist prescribed Primidone, which triggered suicidal thoughts he never had before: “Step in front of a bus. Jump off a building. Pull the trigger on a gun.” William dropped off the unused pills at a police station, and he says he has since put all thoughts of suicide out of his mind.
“If I go,” he explains,” “My mom and son are on the street, and I can’t do that to them.”
Like William, David Cope is also a disabled naval veteran, and like William, he has extensive experience with US government psychiatrists. David graduated from the Naval Academy in 2007 with a degree in Ocean Engineering and served as a Division Officer on the destroyer USS Farragut. After a whirlwind tour of Latin America including stops in Mexico, Brasil, Chile, Argentina, and Peru, he entered a three-year graduate program in Naval Engineering at the Massachusetts Institute of Technology, fully funded by the US Navy. In his spare time he became an avid competitive sailor and enjoyed hiking, climbing, and skiing in the nearby White Mountains of New Hampshire.
But David hit a bit of a rough patch. He was going through a rocky period with his then-girlfriend, his first serious romantic relationship, and feeling anxious about the demanding academic program at MIT. He saw a campus psychiatrist, who after a twenty- or thirty-minute consultation prescribed Zoloft, Zyprexa, and Ativan.
David says he was not told that Zyprexa was an antipsychotic; he took the drug only once and stopped because it made him feel nausea. He took the Zoloft for a month and then stopped, partly because it didn’t seem to be helping and partly because the Ativan seemed to be working so well – at first.
At first David took the Ativan occasionally, as needed. But as the anxiety attacks increased in both severity and frequency, he found himself taking Ativan more frequently as well. In addition to worsening anxiety, he was beset by muscle twitches and cognitive deficits. Neither he nor the campus psychiatrist suspected the Ativan could be exacerbating his problems.
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In spite of all this, David somehow managed to make it through the program, and in June 2012 he was stationed at the Puget Sound Naval Shipyard in the State of Washington. There he found his anxiety and cognitive problems getting worse. He saw a DoD psychiatrist who diagnosed him with generalized anxiety disorder, and also informed David that the Ativan he had been taking for the past year and a half was never intended for long-term use. At his new doctor’s behest, David stopped the Ativan abruptly, without any tapering period at all.
“My symptoms all of a sudden got exponentially worse,” David recalls. “I started experiencing a constant ripping kind of anxiety, a lot of physical tension, headaches, dizziness.” The DoD psychiatrist prescribed Paxil and Adderall XR.
David’s condition continued to worsen – sedation, sleep disturbances, sexual dysfunction, memory loss, hypomania, aggression, irritability, emotional numbness, fatigue, bruxism, myoclonic jerks. The aggression and irritability became worse and worse over the months of taking the combination. Meanwhile, from time to time, David’s psychiatrist would add other meds to the mix – Effexor, Cymbalta, Concerta, Celexa, Lexapro.
In the summer of 2014, on his doctor’s advice, David tapered off the Paxil, although he was still taking the Adderall XR. His condition got even worse – brain zaps, extreme nausea, muscle weakness, exhaustion, increased irritability, worsening sexual dysfunction, and worsening cognitive problems. This young man who had made it through a demanding graduate program in engineering at MIT now had problems remembering where he lived or the names of colleagues he had worked with for years. While driving, he couldn’t remember which color traffic light meant go and which meant stop.
In the summer of 2015, at his doctor’s behest, David abruptly terminated the Adderall XR, again without any tapering period. David subsequently experienced severe depression, along with intrusive persistent suicidal thoughts the likes of which he had never known: “Go hang yourself. Go drive the car into the wall at 90 miles and hour. You need to end this now.” Finally, one day he was driving and felt an overpowering urge to ram the car into an embankment. He pulled over to the side of the road and called his wife, who took him to the Madigan Army Medical Center Inpatient Psychiatric Unit, where the doctors re-started him on Ativan, the same drug that initiated his iatrogenic cascade in the first place.
“They would give me an Ativan,” David recalls, “and then six hours later the level of anxiety would be ten times what it was prior to taking the Ativan.” David tried to explain to his doctors the Ativan was making his condition worse, but they dismissed his concerns.
David decided he needed to get out of the hospital by any means necessary. He told the doctors his suicidal ideation had disappeared (although these thoughts were still as strong as ever) and in August 2015, his doctors pronounced him well enough to be released. At the same time, David left the Navy.
David has refused all contact with VHA psychiatrists, although since leaving the Navy he has consulted a number of civilian practitioners. All recommended more drugs, with ECT and transcranial magnetic stimulation sometimes thrown into the mix as well. All denied that his symptoms could be effects of the drugs he was given. One told him that his problems stemmed from long suppressed childhood trauma. David has refused all their drugs and other treatments.
David continues to suffer from chronic headaches and emotional numbness. “My cognitive abilities have been decimated,” he adds. Prior to his discharge, he had arranged to take a civilian position at the shipyard, comparable to the one he had with the Navy, but he was in no shape to do that kind of work any more. Now he works a much less demanding part-time job at the same shipyard, for a much lower salary. The VHA has classified him as 90% disabled and he expects that level to rise to 100%. He and his wife have separated, and he still has very strong suicidal thoughts.
“My life has slipped away,” he says.
Part 2: 20 suicides a day
“Hammerhead sharks feasting on the dead make a unique sound.”
So says William, a disabled Navy veteran and survivor of a horrifying incident that occurred in the Persian Gulf.
At the age of twenty, William enlisted in the Navy and served for six years, working on radar and weapons systems. On 18 November 2001, he was part of a team from the destroyer USS Peterson that boarded the Samra, a suspected oil smuggler sailing under the UAE flag. The Samra capsized on the port side, and William spent the night clinging to debris, waiting to be rescued, and listening to the sounds of sharks devouring those who hadn’t made it.
“There is only one sound like a bone being crunched through,” William notes. “And that’s a bone being crunched through.” 
