Pre- and Post-Deployment Health Assessments: Modern Deployment Exposures and Experiences From an Iraq Veteran Perspective

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Last week, I heard back from the VA.  Yet again, they don’t consider my chest pains to be service-connected.   This reality kind of floored me.  I actually opened up to them in my December 2016 claim and while it might sound silly to say such a thing, in 2007, I kept things simple.

I didn’t tell them about Captain Brock dying.  I didn’t tell them about my kind of work.  I didn’t emphasize my exposure to mortars, although that information was part of what I listed in my records about different types of exposures while in the Marine Corps.  Back then, I was dealing with chest pains and I knew I didn’t have them before I served.  They started at the tail end of my first deployment, continued after I returned, and remained a part of my life through separation.  I just needed the VA to understand at my point of separation the chest pains were still ongoing and I felt they were related to my service in Iraq in OIF 2-2.

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If I had realized what a miserable experience it is dealing with the VA on the disability compensation side of the house, I think I would have pushed harder to find the right medical support while I was in.  For the few times I was willing to subject myself to medical about this condition, every person wrote ‘non cardiac origin’ for the pains but no one wrote in a diagnosis or suggested getting additional feedback on my situation.  What’s more infuriating is the parts where it reads ‘exercise induced stitch.’  Seriously, in the twelve years I’ve dealt with these pains only the primary care provider I’ve dealt with most recently has delved further into this issue and offered different suggestions because the pains were getting to the point they were destroying my quality of life during waking hours and would interrupt my sleep.

For over a year now I’ve wanted to have a conversation with you all about the Pre-and Post-Deployment Health Assessments and I think with this other VA encounter, I have the right foundation for this discussion.

The VA does not know our deployments the way we do and part of the problem is also the way the system requires ticking off boxes, ineffectually asking and not asking the right questions.  The forms we complete do not necessarily represent the types of situations we may encounter; let’s be honest here, the VA will never have records from the Marine Corps and/or the US government that 175 United States service members died during my deployment and these numbers best represent the information I was feed every day as part of my work in our operations center. I only know this information because I was determined to find a way to discuss my deployment, to shed light on other aspects of war no one seems to look closely at but is an important job all the same. I am only privileged to know this much of the extent of my deployment thanks to Military Times data.

In cases like mine my work was classified secret so how was I suppose to honestly fill out the forms?  As well, even if I could be honest, there also is not a sense of privacy to complete the forms properly not that I would have trusted completely it in full disclosure.  On my first deployment, I was the only woman on my team so I felt implied pressure to not be the “weak link” and during the second deployment a lot of stress from the first deployment crept up that I was not willing to discuss with my command.  Nor was my situation helped by the fact my chest pains occurred on deployment and yet again, no real resolution came out of getting them checked out.

My apologies I currently do not have snapshots of my first deployment paperwork.  eBenefits is being quite a disappointment and again not allowing me access to my military records.  The next time it’s available, I’ll try to download all my copies so I can share those details with you.  For now though, we can press forward using information from my second deployment documentation, the pre-and post-deployment health assessments.

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This form was filled out on July 11, 2006
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It’s kind of funny I still had my maiden name on my pre-deployment health assessment.  I was already married by then.

I’ve cut off segments of the documentation as my copies contain my Social Security Number but for greater clarity on this issue, below are fuller snapshots of the pre-deployment health assessment form that existed during my period of service.

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Below is the updated version of the Pre-Deployment Health Assessment Form:

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The revamp of the Post-Deployment Health Assessment is also of great concern to me, and I think all veterans of this era should consider how the inadequacies of the earlier form shape what sort of service/deployment experience is considered valuable, dangerous, and potentially traumatic.  The forum in which service members were offered to complete their forms is equally as important.  I can remember completing the first form in a classroom with a number of guys, classroom style as though we were taking an examination for a grade.  It was really a matter of “everyone’s got to do it”.  You fill out your form by hand and turn it back in.  You don’t want to get called out for your answers and you just want to make it back home.

I don’t recall completing the Post-Deployment Health Assessment at the end of my second deployment but most of the handwriting is distinctly mine; there are only a few segments where the medical personnel filled in information.  Coming home was very rushed that time.  I can remember meeting my husband and his mother and sister at the Sheridan, Wyoming airport but I cannot remember who picked me up in California.  I remember having issues with my military gear being stuck on the conveyer belt and an older gentlemen picking up my pack like it was nothing, hoisting it up so I could tuck my arms into the shoulder pads and settle it on my back.  (To everyone who was part of my transition home, I do not make this statement about not remembering your support lightly.  Coming home was that much of a blur.  I didn’t have a moment to catch my breath and will still say that process didn’t start until I left 3rd MAW in late May 2007 for terminal leave.)

My chest pains are the only thing I shared with the VA as a serious issue in 2007 and again, I am making the choice to share so much personal information because I don’t necessarily see our system getting better if there is a significant gap between what people expect their service to be like and the reality of the experience.  I hope by cracking open an issue like poorly constructed pre-and post-deployment health assessments provides a lenses for organizations like the VA to understand where they must also take a step back and learn from veterans what deployments are like.  I also hope current service members look at their needs before the needs of the organization they serve; at some point, we all leave the service and our personal health cannot take a back seat because we didn’t want to look like malingers/didn’t want to lose camaraderie/didn’t want to let down the team when a medical issue should have prevented us from deploying.

When I also decided to share with the VA this go around the fact I’ve dealt with tinnitus in the last few years and for a shorter duration, moments of hearing loss, I expected to have them listen.  I thought it was fairly reasonable to be ‘heard’ since I have recorded mortar exposure in my records but never sought treatment because I didn’t notice anything wrong at the time.

Right now my hearing is not to the point where I’ve lost full functionality and I sincerely hope it doesn’t degrade further but the hearing loss does scare me. (The tinnitus, on the other, is mostly annoying and only occasionally causes pain.)  These issues make me realize I cannot continue to take my hearing for granted and I should plan more for down the road if it degrades to the point where hearing aids might be needed.  For now though, I am pretty good about asking people to repeat themselves when I need them to and I remind my daughter to come into the same room if she wants to talk to me.  (She tries to yell from upstairs but I’m going to miss a lot of what she’s jabbering about so I make her come down and talk to me anyways.)

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I am already past my bedtime (Seriously, it’s 10:45 pm!!!) but in closing, take a moment to look at the October 2015 form.  It is much more inclusive.  (Please excuse the fact I cannot obtain a good snapshot that shows on each page the form is not to be handwritten.)

I will continue my saga with the VA another day.

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The Final Reveal: An Alternative View of Operation Iraqi Freedom

I am very proud to say my applied project is complete.  Revisiting the American casualty information, the most painful part of the research process, took nearly the whole semester.  I cannot begin to tell you how many times I had to step back from the process.  Before building this applied project, I never spent a substantial amount of time looking at the narratives of my fallen comrades.  Given my past work on activity reports for our area of operation, I spent 12 hours a day, 7 days a week viewing data on killed and wounded personnel (friendly forces, civilian, and enemy).  While I’ve previously talked to you all about Captain Brock I forced myself to sort through the data for the total 553 American military personnel killed from August 13, 2004 to February 25, 2005.  The images below are courtesy of MilitaryTimes Honor the Fallen.  One of the hardest stories to learn, when I investigated the issue further was the death of Corporal Paul Holter because he died by the thoughtless actions of a fellow Marine.

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I intentionally looked for information on individuals who died specifically within the Al Anbar Province; units would have sent us this casualty data along with the number of wounded persons in the same incident.  For this reason, the American service member casualties represents the most accurate reality of the deployment because I could sort through each narrative to find the right dates and province. Eight individuals who were wounded in the Al Anbar province died outside this area (one passed away in Baghdad, 2 passed away in Germany, and 5 passed away stateside) and so were not included in my applied project.  There are a number of deaths that read as potential suicides although the cause of death is not stated as such.  While I do not mean to come across as insensitive to the families, there is such a struggle maintaining intra- and intercultural conversations regarding suicide and each time we hide the circumstances surrounding our loved ones’ passing, we further exacerbate the social stigma.  For the most part I did not label any service member’s death by circumstance in my presentation because many simply state ‘enemy action’ as the cause of death, particularly for the Marine Corps, whereas more of the Army narratives list a specific weapon type.  I do not know how to make any useful connection (or know if there is one) about this difference.

It was equally as important to look for information on wounded American service members.  While I don’t know what types of injuries qualified for record purposes, I did not make an analysis about that lacking data in my applied project write up.  Once again, in providing the human toll of war, my purpose was to align the numbers that might represent what we would have “seen” coming across our desks.  For this reason, the data is incomplete for my purposes but provides greater context because it is not limited by day or province.  However, I reigned the numbers back in by only showing Army and Marine Corps data since these branches made up the majority of our area of responsibility.  iCasualties.org provided the necessary data for this segment of the applied project.  Unlike the American deaths, it was not a struggle to collect this information.

The more I moved away from American data and my experiences, the easier it was to review the hard data.  Iraqbodycount.org provided the second most substantial amount of data and also the second most accurate representation of that deployment reality. However, I have more work to do in understanding the individuals who made such a site possible.  We all carry our own biases and while I may question who is listed as a civilian, their assessment–from the construction of the site and language utilized–lends itself more to who do we count as our enemy?  From this site, I gathered information that was only specific by month and year.  For this reason, my applied project included more data than I had planned for but I could not break it down into daily numbers as was available for the MilitaryTimes casualty information.  I wasn’t able to find Iraqi civilians wounded from the same time period through Iraqbodycount.org.  I think it’s very important that Iraqbodycount.org acknowledges why this issue is complex.  A 2003 article on their site, Adding Indifference to Injuries, is just one such online article that addresses this problem.  Outside of my research for this project, I do know there are many others trying to undo this marginalization, like the Costs of War Project.

The gaps in piecing together the data cannot be overlooked but they can be explained. None of the numbers alone on any side though reflects accurately on the war.  The connections between social systems, the breakdown of such systems, and learning another culture’s values on the fly shape our perceptions of war and incidents of all scales and frequency happen out of emotional responses and intentionality.   (I would say this statement is true of all matters not just war.) These are not the only intersecting factors, but as narratives become known, these issues are more visible.  I would highly recommend  the HBO mini-series Generation Kill as a good representation of pulling these issues together.  There are not a lot of war genre shows or movies that I can tolerate about Iraq;  however, this one shows aspects of Marine Corps culture that I appreciate.  Additionally, I appreciate how concern for Iraqi civilians is represented and how those individuals who do not express concern for Iraqi civilians is also represented.  We must be willing to acknowledge that both types of individuals exist not only in our military but also in our nation.

It is also important to mention I am not pro-War or anti-War.  I think to say something as controversial as war is 100% right or wrong in all situations is not an educated statement.  While it is not my place to tell others what opinions to have, I will work to respect both sides of the spectrum so long as individuals throughout the spectrum understand a difference of opinion is a difference of opinion.  Opinions are neither right or wrong.

One of the last pieces of information which was the most difficult to find was that for insurgent forces killed and wounded.  Again, like the data for American wounded, Iraqi civilians killed and wounded, I am confronted with the reality none of this data is transparent enough for me to correlate it with my deployment.  For this reason, it is impossible to say I’ve truly given my audience the knowledge they need to understand the enormity of the situations specific to the deployment.  Instead, I’ve given the next available answers.  From a 2007 USAToday article, I found this last piece of the deployment puzzle.  A 2007 Stars and Stripes article shows this information broken down more clearly. I would recommend checking out the latter article as I’ve had trouble on numerous occasions with getting the USAToday article to display properly.

My journal entries which are significant to understanding the deployment are embedded throughout the applied project.  I do apologize for the fact the ones at the latter part of the presentation might seem exceedingly long.  I was concerned the longer entries might be hard to read if they were shown for a shorter period of time but several individuals mentioned they could read faster than the pace of the presentation.  While I won’t make every entry I’ve ever written public, there are strong conversations from my past that will always be worth remembering.  The journal entries I shared were carefully chosen for what they mention about the violence in Iraq with respect to my work and the indirect fire we experienced on base; my positive and negative responses to the dangers; and my feelings about my friends, family, and my place in the Marine Corps.

As this blog progresses further, I will continue to provide you all with comparisons between 2006 and 2016 and 2007 and 2017 to show how my life has changed as my Marine Corps career ended and my current life looks now.  I cannot promise a lot other than a continued interest exploring and discussing today’s military culture, especially as the role of women changes.  I am equally interesting in conducting more research about the broader implications of Operation Iraqi Freedom and sharing my finds with you all.  Lastly, because my schedule has opened up significantly, I am looking to read more academic articles and popular books about our military.

I want to thank you all for following along on this journey so far and I look forward to sharing more again soon.  If you are interested in looking at some of the articles I used for toward the applied project, they are listed below.  All were accessed through ASU’s libraries using JSTOR.

Tina Mai Chen’s (2004) Introduction: Thinking Through Embeddedness: Globalization, Culture, and the Popular

Liam Corley’s (2012) “Brave Words”: Rehabilitating the Veteran-Writer

Liam Kennedy’s (2009) Soldier Photography: Visualising the War in Iraq

 

Sincerely,

Cheryl

 

 

At Work, At Home, At Play: What’s Revealed in Service Member Photography

Good morning, everyone!!!  Ahhh…quick breather.  January is almost over. In the brief span of time that’s transpired since the term began, I have made substantial progress focusing on my applied project.  This progress is due, with great thanks, to Dr. Beth Swadener, who has facilitated a writing seminar; my peers in Dr. Swadener’s course; Dr. Rose Weitz for her continued support and acceptance on my applied project committee; Nancy Dallett for being a wonderful sounding board and constant companion in my work life; my peers in my SST course this semester; and most certainly, my friends and family who stand by me during this crazy adventure, both academically and through this blog.

Today’s blog is built on one of the materials that will find its way into my applied project. Recently, I found Liam Kennedy’s 2009 article, Soldier Photography: Visualising the War in Iraq.  The article is available through the following stable URL:

http://www.jstor.org/stable/40588076

If you do not have access to this resource via an academic library, like I do with ASU, the download costs $34 or you can read it online by registering for a JSTOR account.

Getting back to today’s discussion, I think Mr. Kennedy brings up some excellent points about why service member (my preferred term versus his term, ‘soldier’) photography is aiding a better global discourse on the understanding of war.  Below is a great insight he adds to how the communication process regarding ‘war’ has changed over the decades:

“The Vietnam War was the first televised war, the first Gulf War was the first satellite war (CNN’s war’) and the wars in Afghanistan and Iraq are the first digitised wars” (Kennedy, 2009, p. 819).

So, why is the change in communication important?

In a nutshell, the answer to this question is this correspondence teaches us the reinforcement of cultural perspective and operational burden in war, both operational security and trauma sustained by service members (Kennedy, 2009).

For many reasons, I have taken for granted the ‘freedom’ I enjoyed to share my deployment experiences with friends and family members with almost instantaneous feedback.  On many occasions, it took me several saved drafts on MySpace to craft a post for my loved ones but the next time I logged in, I would have some responses to my situation.  These messages sustained me when snail mail was lacking.  I knew my family cared for me, despite their beliefs about war–in general–and about my war, specifically.  One of the best benefits to this freedom was corresponding with loved ones who also operated in different areas of Iraq, at the same time.  I cannot discount how important it was to know friends were safe despite being located in close proximity to indirect and direct forms of combat engagement.

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Kennedy, 2009, p. 827

With respect to both deployments, I didn’t take a significant amount of photos.  I used several disposable 35mm cameras for Operation Iraqi Freedom 2-2 (1st Marine Division deployment) and had both disposable cameras and a digital camera my husband sent over for the second deployment, Operation Iraqi Freedom 5-7 (3rd Marine Aircraft Wing where I deployed with Marine Aircraft Group-16, known as MAG-16).  I would aptly agree with Kennedy that ‘tourist’ photography describes the majority of photos I took for both deployments, like many of my peers’ photographs.  The landscape is different, the ‘feel’ of the base, while it retains aspects of American culture, is a smaller version of American consumerism.  Camp Blue Diamond had a small internet cafe crafted out of a trailer with plywood dividers to give individuals some sense of private conversations.  A PX (Post-Exchange) also crafted out of a trailer provided a small array of necessary items, like service chevrons, and coveted items, like snack foods.

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After all these years, I still have my M & M’s bag. Look at the production and best by dates.
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My view heading over to Camp Ramadi (2004).

When it comes to photographs of my self, I have very few.  Because it is significantly still a taboo subject to date in a combat zone, I only had one photograph using my cameras of my boyfriend and I together on my first deployment the day I left Blue Diamond, February 25, 2005.  The others I have of us relaxing with Marines from his work were taken by him or members of his unit.  For my second deployment, the best photos of me at work and at play were compiled into a unit video.  Unfortunately, my computer does not take good snapshots from the video.  I will try to find another way to acquire those photos to share.  There was a great one of me in one of the chairs in the palace in Baghdad and I look incredibly tiny.  See…again…that tourist tendency.

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Bringing new meaning to paper money.
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I tried not to infringe on the privacy of my peers, so these are the few photos inside our barracks (Camp Blue Diamond).
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Rules of engagement…in case you were interested.

I do regret not taking more photos because there is so much to learn from those experiences.  Camp Al Asad was essentially a small city unto itself (and likely, retains some of those features).  We had a Subway, coffee shop, Pizza Hut, and Burger King, a barber shop, and many trinket shops, just on our side of the base alone.  I was too nervous to travel the rest of the base by myself.  Instead, I spent much of my second deployment walking to the internet cafe set up in the operations center.  My (mostly) solitary walks provided me the opportunity to appreciate the natural beauty that is Iraq, with its limited infrastructure.  Sunrises and sunsets are incredible.

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However, as important as it is to discuss our visual representations at war, we must equally discuss coming home.  Below are some brief snapshots to show how transition is discussed (as of 2005).

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Additionally, please enjoy a small peek at what my barracks life looked like in early 2005.  It was a pretty spartan existence compared to the 1,400 sq. foot home I occupy with nearly 10 years’ worth of furniture, artwork, scrapbooks, etc. that make up my current life. I lived in one of the barracks on the Camp Margarita area of Camp Pendleton near the Subway.

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The Marine Corps blanket covers my bed.  It was given to me by a former substitute teacher, who served previously as a Marine officer.
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With some of my first deployment earnings, I purchased my first desktop computer.
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Ah, the spartan life.

 

 

 

 

 

 

Homecomings: Snapshots & Realities

Hmmm…so lots of good things went down last week, but the short work week was insanely busy.  I added more social events to my weekly plans than I would normally accommodate, which meant I’m recovering from sleep deprivation this week.

Devin Mitchell made himself at home when visiting Memorial Union--it was so great meeting him!
Devin Mitchell made himself at home when visiting Memorial Union–it was so great meeting him!

I had a great time meeting Devin Mitchell, photographer for Veteran Vision Project, for starters.  I promise once my photo is finished, I will share it with you all.

Ehren Tool treated us to a show--he made several cups on site out of a 25lb. block of clay!
Ehren Tool treated us to a show–he made several cups on site out of a 25lb. block of clay!

I also met Ehren Tool who came to ASU recently.  Please know I will devote a whole entry to him here soon–probably this weekend.  I checked out his gallery talk and there’s so much I want to digest before sharing my thoughts.

Last week was also Marine Week!!!  My family went to the exhibits at Mesa Riverview Park.  I am proud of all the Marines who worked the event–their efforts were flawless.  While I love all my Marines, I especially love seeing the Silent Drill Platoon perform.  However, the exhibits started at ten and by noon, my five-year old had enough of the heat.  She didn’t care the Marines performed without talking–that they tossed rifles in the air–she just wanted to leave.

IMG_7581 IMG_7582IMG_7592I mention my–happily–busy week because I enjoyed being a participant of each but also because they touch on different aspects of homecoming for me, in literal and figurative ways.

Today, I came across the image below (and many others) through MSN and it made me realize I’ve wanted to discuss the notion of ‘homecoming’ for awhile–scraping below the surface meaning of the word.

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In the simplest sense “returning home” is a neutral and somewhat vague concept.  It can apply to a person and/or group; it also doesn’t matter–in the context of the definition–where the individual (or group) had been but their destination–home–has social value.  Home can also encompass many different places, depending on the individual or group.  The definition is also a little less vague in the fact it limits homecoming to a singular event.  Lastly, and I want to hinge on this key point, homecoming is overwhelmingly used to describe the occasion in the positive.  The four insights I just gave you for ‘homecoming’ provide some talking points about why homecoming is a difficult term to associate with military service.

Home–as a destination–is what matters.

I love the concept of ‘home’ but it’s different once you leave, potentially good and bad.  The landscape will change over time, the people will change over time, the social setting will change over time.  Will ‘home’ still feel like home after weathering these changes? In my situation, home has a short lifespan of feeling comfortable.  I can weather home (Rhode Island) for about a week before feeling antsy for my normal routine.  My physical home is enjoyable when I’m not reminded of the slew of chores to maintain my residence.  I feel incredibly embarrassed to complain about having a roof over my head knowing that so many do not.  I should find more simple joy in what is, even when it does not live up to my standards.   I also think the current Syrian refugee crisis added a further layer to the conversation: what if you never get to go home?  It’s difficult to watch so many people treat these refugees (and refugees, in general) as less than human.  There is so much space in this world and so much potential for peace, prosperity, and creativity if people opened up their ‘home’ nations so that others may have a safe place to call ‘home.’

What is home?

Home can be a place/feeling/a person.  I often fail at captivating my audience about why Iraq will always feel like home to me.  I saw so little of it and yet, in my heart, I feel it is a beautiful nation undergoing years and years of great tragedy.  It is also home because of a love/respect/deep friendship that happened there.  The reality of my situation is I left ‘home’ then and returned to the States, a place that no longer felt like ‘home.’  When I describe home now, I typically use the word in two ways.  I describe Rhode Island as home; it’s where the majority of my family lives.  I describe my residence as home because that’s where I live.  Iraq is my past home and I’m bothered that terrorism is still rampant there.

Homecoming as a ‘singular’ event.

I’ve had many homecomings, usually in the sense of high school dances but also trips back east and returns to the States, once after a trip to Cape Verde and twice from deployment.  Homecoming in the military sense would describe my arrival back at Camp Pendleton after the first deployment and my arrival in Sheridan, Wyoming after the second deployment.  Those happenings were less positive (see focus on this issue below) than portrayed say in the images above.  Homecoming–for me–has been a process and not a single event here and there.  In October, I can add another lenses to the notion of homecoming when I attend training in Nashville, Tennessee.  More to follow on that issue later.

Homecoming-facing the past, present, and ‘pain points’

I mentioned earlier homecomings are thought of as positive events, but what about when they aren’t?  Your story–pain and all–is marginalized in history.  Not too long ago I watched Fort Bliss per one of my professors’ recommendation.  There are tough moments in the film, which I will discuss one day, but this story provides a truer glimpse that homecomings are not always beautiful singular events.  Not everyone is greeted by their families; in familial units torn by divorce, as depicted in the film, who knows is your child will embrace you or be present when you step off the bus?  I didn’t have my family waiting for me when I came home from the first deployment, but my unit was there–they were my family–but even my social network there was incomplete.  Returning from the second deployment, I was embraced by my husband and his family, but once again, my family wasn’t there.  Sometimes, it’s very difficult being the adventurer in the family.  Everyone stays in their comfort zone in Rhode Island.  I journey home time and time again, bearing the financial burden and emotional toll of not seeing my actions reciprocated.  In the last few years, especially as I recovered financially from unemployment, I haven’t made the journey home.  I don’t want to cough up $2,000 or more for flights, hotel rooms, meals, and so on because I know it’s a huge dent to my savings and I have zero desire to put those expenses on a credit card, unless it was an emergency.

I know I’ve given you more to digest today than I normally do and in odd fashion, started on a positive note and ended on more serious thoughts.  There is always a happy thought in my day, despite my seriousness.  To prove it though, please enjoy the cute Prickly Pear image. below.  I use these stickers all the time on Facebook; Prickly Pear stickers are my stickers of choice for Facebook messenger.  They always put a smile on my face.

~C

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