"Medicine is a science of uncertainty and an art of probability" ~ William Osler

Bruce Kelly tells a story about stories - a creative writing program for Vietnam Veterans

    Writing programs for veterans have existed since the Second World War to help veterans make sense of their military experience and honor the voices inside calling to be heard.

     Quoting Ron Capps of the Veterans Writing Project, “not everyone is a story teller, but everyone has a story to tell”. He reminds us that for veterans with PTSD “either you control the memory or the memory controls you”.

     Writing about the experiences and impact of combat can help organize what’s banging around inside, softening the grip that holds power over those who’ve seen the horrors of war.

     It didn’t take me long as a primary care physician at our VA to realize how many veterans in my care were still carrying wounds from service in Vietnam. It was hard to accept knowing they were but a fraction of the estimated 250,000 men still living with PTSD from their time in country some 50 years later.

     They told me what the war had done to their emotions, behaviors, sleep, dreams, and moods … to their relationships with family, friends, to their careers … about their avoidance and addictions … how it was still hard to go out in public, to have normal conversations. They told me it was hard to trust that the world was a place where they could feel safe … where they could love and be loved.

     They told me about battles fought, comrades lost, regrets they couldn’t shake … about anger at being on the losing end of a war despite winning all the battles. They spoke to their treatment on returning home … the shame and rage that was triggered by an ungrateful nation who sent them to serve on its behalf.

     I learned from a 2015 VA study that despite available treatment most Vietnam veterans with PTSD showed “surprisingly little improvement” in their symptoms. I came to learn about moral injury, defined as “extreme guilt and shame from something done or witnessed that goes against one’s values”.

     I wondered why it would ever surprise us that sending moral individuals to a world defined by death and destruction would lead to emotions coming unglued, to neurons going awry. I wondered how anyone could come through unscathed, and came to understand few really did. It was just a matter of degrees.

     As I listened to these veterans it was now up close and personal, sitting to my left … the men often avoiding eye contact, their voices cracking, often holding back tears. They  were often afraid to speak what was on their minds, rightfully feeling abandoned to carry their wounds alone with little hope beyond the reality they’d been forced to live.

      Listening to their stories I came to understand the weight of the burdens they carried, each in their own way but with so many common threads. Most out of necessity had buried what they carried, having no way to reconcile or leave the war behind.

     I wasn’t the only one who felt an obligation to do more. Former North Carolina Poet Laureate Joseph Bathanti, a Professor at Appalachian State University, spent two years leading writing workshops for veterans across the state. He understood as I the importance of veterans being able to tell their stories in a safe, non-judgmental setting. We both believed the work had the potential to help heal what remained wounded.

     In 2014 with the blessing of VA leadership, grants from the North Carolina Arts and North Carolina Humanities Council’s, and support from the community, Professor Bathanti was named Writer-in-Residence at Charles George. We eagerly began planning a creative writing program for Vietnam veterans with PTSD that we hoped would help restore a sense of their humanity and foster some degree of recovery. 

     As I recruited men during routine medical visits, I began to see more deeply how remarkable each of them were, all heroes in their own right who needed to unburden themselves in ways they may or may not had yet recognized.

     They told me they were reluctant to bring the war back up, that creative writing or poetry seemed like a cockamamie idea, that they couldn’t write, had trouble w spelling, bad experiences with groups, and more. But they too gradually spoke more about the wounds that haunted them and were often ready to try anything that might help.

     I was able to tell them there are writing programs at Walter Reed, and is the standard of care at the affiliated National Intrepid Center of Excellence. All veterans with PTSD and TBI from the recent wars participate in arts and humanities programming there. I was able to tell them that work in these fields had been successful enough for Congress to appropriate over 2 million dollars to develop similar programs at 12 military bases around the country, Camp Lejune being one of them.

     Professor Bathanti, the veterans and I were all nervous when we met at the VA for the first time in Classroom B. It was new and untried for all of us. As these men’s physician I was maybe more uneasy than any, knowing how hard they worked day in and day out to control what haunted them. I knew they were anxious not only about the writing, but about opening up in very personal ways to a group of strangers.

     There’s an image from the first evening I’ll never forget.

     After my introduction I turned the session over to Joseph and went to the back of the room where I could watch the men’s expressions and body language to gauge how they were doing, ready for anything, including some getting up and walking out.

     You could sense the apprehension among us. Yet, when the men were finally asked to begin writing it was as if it had been choreographed … all of them without a moment’s hesitation, in unison, picked up their pencils, opened their notebooks, put their heads down, and immediately started to write. We knew then we were going to be ok. Though they might not all be storytellers they were all ready to tell their stories.

     Thanks to ongoing Charles George, grant and community support we’ve now held five 8-week sessions involving 51 veterans. We’ve met monthly at the VA with 25 of the men, halting only due to the pandemic. We stay in constant email, phone and personal contact to support them wherever they are in their journey.

     The time together hasn’t always been easy. There have been difficult sessions. Not all the men have continued. There have been tears at some point for all of us. Mine come often in feeling their pain, hearing their losses, in admiration for the courage and clarity of their writing, and from gratitude in watching their healing unfold. For most of the men, and many of their spouses, it’s been transformative in ways we never could have imagined.

     Though those of us who’ve led the work didn’t see their courage in country, we have seen it in Classroom B. Their commitment, honesty, and writing has taken our breath away again and again. It often feels like church from the work of the soul they’re engaged in and reverence we all feel for service, sacrifice, and one another.

     Each of them has found an ability to articulate memories, losses, and triumphs in their own unique voice. We’ve watched a sense of brotherhood evolve and been witness to the men reclaiming a sense of the humanity that was taken from them in an increasingly forgotten war.

     In August 2016, 18 of the men agreed to participate in a staged reading of their work titled Brothers Like These at Asheville Community Theatre. We shortly after did a second at Appalachian State to a standing room only crowd of students and teachers, and again at the community theatre in 2017 and 2019.  

     On each occasion the audience was deeply touched, many at some point in tears but always leaving with a new understanding and respect for all who served in Vietnam, and by proxy in combat zones wherever they may be. The men have felt honored, empowered, and a long overdue sense they are indeed heroes of their own stories. The readings have provided a platform for the welcome home they never received.

     Many of the men have read at countless local and regional events and been interviewed on the radio. Their writing has been published as a chapbook entitled Brothers Like These, now St. Andrews Press all time best seller. We’ve had readings in Franklin, Old Fort, Durham, and the Outer Banks.

     A local elementary school used one of the men’s stories as the basis for a skit that won a state, and then national “Torchbearer” award. They’ve presented their skit at the VA. Videos of five of the men reading one of their pieces and interviewed for Veterans Day by the Asheville Citizen-Times was picked up by USA Today for national distribution. The Memorial and Veteran’s Day celebrations at the VA and in the community always now include several of them reading.

     In 2020, now considered a ‘best practice’ by our VA leadership, we reached out to VA’s across the country to elicit interest in spreading the work. 17 facilities across 12 states signed on to participate in a funding proposal to the VA’s Innovation Network. We were funded for 5 in North Carolina and Virginia. A ‘primer’ based on lessons learned was created to support these and has been shared with several other VA’s. Regrettably the pandemic prevented completion of the 12-week groups intended to help build the first ever evidence base for the work.

     The veterans themselves have become passionate emissaries for the work. Some have formed a non-profit, the North Carolina Veterans Writing Alliance to lead education, advocacy and fund raising in support of programs locally and beyond. They’ve raised funds to hold additional writing groups, reaching out to Post 911 as well as women veterans, evolving to Brothers and Sisters Like These. They’ve held monthly Zoom calls, created a series of podcasts, their own website, with additional fund raising and outreach underway.

     A mini documentary about our program has just been completed as part of a national Take Care initiative. https://takecare.org/inspiration/brothers-like-these/

      What carries us all are the relationships we’ve been privileged to build with wounded veterans who’ve been willing to write and share their remarkable stories, building ‘community’ in so many ways. Their courage and dedication have captivated and inspired thousands. It’s catalyzed change not only in their lives but the lives of their families, locales, region, and beyond.

     We collectively remain committed and want all Vietnam veterans, all veterans with PTSD to know you’re not forgotten, and that your stories matter. Through them we hope to support your healing journey.


About the author:

Bruce Kelly is a newly retired physician after 42 years of practice in Asheville, North Carolina. He's worked in a wide variety of settings including private practice, hospice/palliative care, and adult developmental medicine among others. He completed his career at the Charles George VA Medical Center as Assistant Chief of Primary Care. He led a host of arts and humanities initiatives locally and beyond at Charles George, steadily referencing Osler's strong belief in their value to the practice of medicine. In 2014 he created and co-led with Joseph Bathanti, former North Carolina Poet Laureate, a creative writing program for Vietnam veterans with PTSD." 


His only regret is not being able to implement his (approved) proposal for a formal Charles George Medical Humanities Program before retirement, one of countless casualties of the pandemic. The launching point was to have been monthly literature based 'Osler Rounds' for the medical staff to honor his legacy and help reclaim the soul of our profession. If interested in helping start a medical humanities program in North Carolina, reach out to Dr Kelly: brucekelly52@gmail.com









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