PRINCE GEORGE'S COUNTY, Md. - As a critical care nurse, Air Force Lt. Col. Mary Carlisle's focus always has been on helping others. It wasn't until a harrowing deployment to Iraq that the tables turned, and she became the one in need of aid.
Carlisle described her battle with post-traumatic stress disorder and the healing she eventually found at the 2010 Military Health System Conference held at the National Harbor here.
Carlisle, then a major, deployed to the Air Force theater hospital at Balad Air Base in 2007. She worked the night shift, when most of the casualties seemed to come in, she said, and took care of U.S. service members, as well as Iraqi soldiers, women and children.
"I knew from Day 2 that this was going to be stressful -- the combination of heat, sleep deprivation, noise ... [and the] inundation of helicopters coming in one right after another," she said Jan. 26 during an interview at the conference. "And you just knew that they had casualties on them."
The wounds were like nothing the seasoned critical care nurse had ever seen. "These were just horrific," Carlisle said. "People with no arms, no legs, people that by all rights shouldn't even be alive, and they were."
The health care team did everything they could to save each patient, but often all they could do was provide comfort in the inevitability of death, she said.
While they saved many lives, Carlisle said, she could focus only on the lives that were lost. "I thought I failed -- that I didn't do enough," she said.
In the midst of the chaotic everyday pace in Balad, one incident remains a sharp memory, she said. A young Marine had suffered a gunshot wound to the back of his head, and he wasn't expected to survive.
"When you at looked at his young, 20-something-year-old, angelic face, you just thought he was sleeping," she said.
Carlisle gave him pain medication and stayed by his side until he took his last breath. After preparations for his departure, Carlisle, as the highest-ranking officer in the room, called the room to attention as the body was wheeled out, a custom referred to as a Fallen Angel ceremony.
All activity in the bustling intensive care unit came to a halt as every service member in the room snapped to attention and saluted until the body left the room.
"That will follow him wherever he goes," Carlisle said, "all the way down to his trip ... when he is removed from the plane at Dover [Air Force Base, Del.]. From the moment of his death, I was the first one to do that. I will always remember that."
After five months at Balad, Carlisle returned to her home station at the Royal Air Force base in Lakenheath, England, as the chief of a family practice clinic and an emergency room. Her staff often asked her questions about her deployment, questions she said she wasn't sure how to answer. She was angry at the world, she said, and that came across in her responses.
"Some things I said, I think, kind of shocked them," she said. "So I stopped talking about it."
Carlisle said she buried her feelings then and continued to do so after she was promoted to her current job as the chief nurse at the Bolling Air Force Base clinic in Washington, D.C. It wasn't until she attended some leadership conferences that her emotions threatened to get the best of her. At the conferences, videos were played showing the Balad hospital, and Carlisle immediately recognized the scenes.
"They were from my deployment," she said. "It just brought everything back, all of those emotions back."
Carlisle revealed her overwhelming stress, anger and depression to her friends, and they encouraged her to get help. She self-referred to behavioral health and finally faced the emotions she'd been squelching for so long.
Her counselor helped her to re-experience her deployment and to find the healing she so desperately needed. Even as she healed, ever the caregiver, Carlisle discovered a desire to help others battling the same issues.
She reached out to the Real Warriors campaign, which features stories of service members who have sought treatment and continue to maintain successful military or civilian careers. This initiative, launched by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, is aimed at combating the stigma associated with seeking psychological health care and treatment, according to the Real Warriors Web site.
Her video profile now is featured on the site, she said, and she has no regrets about going public with her story.
"I hope this inspires others to go and get treatment, and at the same time, inspires their leaders, their supervisors, to look them in the eye and really say, 'Are you OK?'"
Carlisle next is headed to a squadron commander job at Misawa Air Base, Japan. She's ready for the new position and for the other more difficult challenges that may lie ahead, she said.
"I feel so good now -- content, relieved and at peace," she said. "And I'm ready to deploy again."