The thwap-thwap-thwap of rotary wings above triggered an intense reaction in Army trauma surgeon Dr. (Maj.) Tara Dixon.
The sound rippled downward from a helicopter descending to land on the nearby rooftop hospital landing pad in Charlotte, North Carolina. The familiar, rhythmic thumping of the rotors elicited an emotional and physiological response, sending jolts of adrenaline through Dixon’s gut. She had been conditioned—after two combat tours in Iraq, one of which she served as chief of trauma and critical-care surgery—to mentally prepare for a helicopter full of catastrophically wounded soldiers.
Dixon’s shoulders tensed; she started wringing her hands and fidgeting, clearly agitated by something. “Let’s jump in the car,” I suggested. Dixon turned on the air conditioner and radio, both full blast, to drown out the thumping.
A native of southern Georgia, Dixon, 39, is an accomplished (trained at Johns Hopkins and University of California) critical-care and trauma surgeon and decorated combat veteran who is now classified as jobless and homeless.
She was raised on a peanut farm in southern Georgia. As a child, she was a victim of molestation and abuse. To escape that tough reality, Dixon sought and won a full scholarship to Berry College, a work-study-oriented program, and graduated at the top of her class as an athlete and scholar. She often worked multiple jobs at a time, including tutoring, carpentry, mowing highways, waiting tables, and clerking. She was a top graduate in medical school and was selected as chief resident during her general-surgery residency. After completing civilian training, Dixon then volunteered with the Army Reserve to serve two Iraq tours. On both deployments, she served in hostile territory and her base was frequently hit by small-arms fire and rocket attacks.
The sound of the helicopter as we stood talking in a peaceful residential neighborhood took her thousands of miles away, back to Iraq where she would drop everything at the sound and run to the operating room to prepare to save lives. As chief surgeon, Tara managed a trauma team and bore the immense responsibility of making life or death decisions for soldiers with catastrophic wounds, deciding whether to amputate one or more limbs, or risk transporting a critically injured soldier hours away to a Baghdad hospital. Quite often, the injured were soldiers she knew well or Iraqi children.
The pressure in the operating room in Iraq was immense, but combat casualties were not all Dixon faced. She was part of the “war within,” treating female U.S. soldiers who were victims of military sexual assault, stitching up wounds to their genitalia. Dixon was legally bound to not report the assaults at the victims' requests, in abidance with physician-patient privilege. Dixon herself had been a victim of molestation and rape in her youth and again in medical school; she knew too well the psychological yet invisible wounds assault leaves. She found having to treat Americans assaulted by other Americans in the war zone sickening. A 2013 report by the Pentagon estimates 26,000 military sexual assaults occurred in 2012 although fewer than 3,400 were reported. The prevalence of military sexual assault has been called an epidemic.
Dixon came back from Iraq with post-traumatic stress (PTS). Loud noises, reminders of shelling in Iraq, triggered her “hit the ground” instinct even in public places. The instinct to run when hearing an overhead helicopter provoked anxiety, as happened when we spoke on that peaceful evening in North Carolina. Crowds made her nervous. The grief from tragic loss of friends who had died in battle rattled her emotions. Visions of her colleagues’ blown-off limbs haunted her daydreams and nightmares. And ultimately, she carried so many “invisible wounds” of war, which often leave the deepest scars. Seemingly hopeless, Dixon tried to commit suicide in 2011. (One active-duty soldier a day commits suicide, and one veteran commits suicide every 80 minutes.)
At the time of Dixon’s 2011 return, the Army had no inpatient support for female (suicidal) PTS patients. Still in debt from medical school, Dixon spent her savings and raided her IRA to pay for inpatient mental-health treatment at a civilian facility in Florida. Three years after returning to the United States, Dixon's claim for VA support is still in a backlog line of more than 800,000 claims.
Today, however, Dixon is in transition from being jobless and homeless. And in spite of personal and professional challenges, including the unlikelihood of returning to practicing medicine due to anxiety, Dixon also has experienced post-traumatic growth, finding new meaning by sharing her stories to empower others. “I am so grateful that some Americans remember that we are still at war,” she writes.
She hopes to galvanize change in the system. Her ultimate goal? Eliminate the stigma of PTS and mental-health care.
As Dixon says, "I may have scars, but I am not my scars."
Mentoring Dixon as she seeks a new place to land is Charlotte Bridge Home, a model public-private partnership, community-based organization that connects veterans with jobs, education, housing, and mental-health transition assistance. She joined a veterans-run speaker's bureau and has begun speaking across the country to the civic organizations and physicians' networks about the burdens of war including combat medicine, PTS, and military sexual trauma. Charlotte’s Patriot Charities awarded Tara a $10,000 grant for a temporary apartment. Two former military officers, now private-sector attorneys, provided VA claims assistance through Charlotte Bridge Home. Purple Heart Homes, co-founded by a local Iraq War double leg amputee, has accepted her request for housing assistance. Carolina health-care providers have proposed medical consulting positions. Dixon also has accepted positions as executive board member and medical adviser for the All Veteran Parachute Team's "Therapy in the Air" program through which she provides support to wounded warriors who skydive from 14,000 feet with elite former Army Golden Knights. She also is considering a memoir.
There are an estimated 22 million living veterans, including the 1.4 million veterans of operations in Iraq and Afghanistan. Another 1 million soldiers will leave the military during the next five years. Charlotte anticipates another 10,000 exiting military personnel and their accompanying families as the military draws down. Dixon’s experience in Charlotte is a symbol of what communities can—and should—do to help with transition so those who have served don’t become a statistic.
As we celebrate America's 237th birthday on the Fourth of July, we should also celebrate the patriots who selflessly protect the freedoms we cherish: the men and women of the armed services as well as the communities that support them.