Page 131 - JSOM Winter 2024

effectively and efficiently appropriate these medical-martial plot-lines similar to the collective loss experienced, helps to
activities as a means of imputing deeper shared meaning about decelerate the team’s collective energy. Concomitant discus-
the impact of death-stacking. sion allows the medical-martial performance space to contract
by placing the interpretive focus on the movie (characters,
Within this grief process, communally cleaning blood in the plot, actors, etc.), not the details of the mass casualty. In other
ER/OR after a mass casualty helps decelerate the team’s collec- words, judgement and meaning-making, good or bad, is di-
tive energy, contract the medical-martial performance space, rected toward the performance achieved in the movie, not the
and elicit palpable awareness of human carnage. Having held effectiveness and efficiency of how medical-martial skills were
back the broader deployment performance space, refitting utilized amid mass casualty. The team uses this activity to hold
gear allows the team to create a safe space in which individ- back the immediate details of the mass casualty, which creates
ual medics are able to hold interior space for reflection on a safe space for individual reflection and group discussion.
personal pain, whether or not it is explicitly discussed. This
tactical, dynamic pause allows the gravity of human loss to This tactical, dynamic pause saturates the performance space
permeate the team’s contracted performance space, which en- with an awareness that grief is not unique to individual SOF
hances short-term unconventional resilience. Creating a sacred medics or teams, which enhances short-term unconventional
space in situ supports long-term unconventional resilience by resilience by sharing loss through the collective act of re-
providing a shared space of meaning that emerges from the framing the mass casualty. Creating a sacred space postmor-
team and/or organization’s lived experience. As such, the SOF tem supports long-term unconventional resilience by eliciting
medic, team, and/or organization can revisit the metaphorical ongoing reflection on loss as part of the human condition. As
isometric hold achieved in this grief process to ritually memo- such, the SOF medic, team, and/or organization can revisit
rialize collective loss and personal pain. the metaphorical isometric hold achieved in this grief process
develops a more nuanced understanding of the relationship
The second grief process that optimizes unconventional resil- between collective loss and personal pain.
ience is dramatization of mass casualty (i.e., performing recre-
ation after catastrophic injury exposure). This delayed process Degradation of Unconventional Resilience
takes place in the aftermath of death-stacking: The first grief process that degrades unconventional resilience
is fortification against embodied rest (i.e., performing death
We would watch a lot of movies or television shows. We disassociation after catastrophic injury exposure). Within this
created an intricate fantasy that allowed us to explore the process, death-stacking is privatized, causing the individual
situations we had just experienced from a distance and medic to ignore personal pain in favor of fostering a pub-
through a different lens. Interestingly, on my second de- lic-professional image of hyper-achievement:
ployment, we bonded by watching episode after episode
of a television series about the mass destruction of hu- When we got back, the team spoke to leadership and
manity. We had some downtime together and watching said, “If this pace continues without time to reflect, it will
TV redirected our attention from what was going on right destroy human beings.” Saying that was met with push-
in front of us to the plot. We would talk about everything back, which was difficult. One commander said, “If you
imaginable while we watched these shows: politics, team don’t know how to deal with death, you should find a new
members, the actors, the characters in the show. Gener- profession.” Plus, our schedules are nonstop so there is
ally, we would evaluate how the situations described in no time to engage these intense experiences. It was to-
the shows were like ours. It also prompted conversations tally disheartening and felt like everyone wanted us to just
about other random things. One time we discussed the lock down our emotions and ignore all the loss. It’s not
chaos of being human and tried to figure out humanity’s the most resilient thing to do because at some point we
position in the solar system. This practice allowed us to need to face our skeletons, but most of us keep pushing
think about the tumultuous situations in which human be- forward, non-stop. To do so, we have to hide all the pain,
ings exist and what we had just gone through after seeing which means each of us carry around a graveyard full of
so much human carnage. skeletons from the patients we’ve taken care of who have
died. My graveyard is not small. It’s gotten to a level where
The grief process described above illustrates a set of practices I’m not able to easily keep all the pain buried anymore.
developed around a familiar form of Western entertainment These skeletons are starting to impact myself and others.
that is traditionally engaged as a means of diversion—individ- Everyone is supposed to go through the stages of grief,
ual and social—from everyday life. The domestic activity of but we are not allowed any time or space to thoroughly
gathering socially and watching television is familiar, commu- wash these experiences of extreme loss out of our bodies.
nal, unitive, focused, and deflective, which allows individual
SOF medics and teams to effectively and efficiently appropri- The grief process described above illustrates a set of prac-
iii
ate this activity as a means of abstracting the immediate poi- tices that excise collective loss from the medical and military
gnancy of personal pain associated with death-stacking. professions and deny death-stacking. By naively misaligning
efficiency and effectiveness with an individual SOF medic’s
Within this grief process, the act of communally watching the willingness to overextend focus on military as well as medical
portrayal of human stories with themes, narrative arcs, and activities and underextend focus on personal pain, this grief

iii. We use this word explicitly to mean cut off. It is interesting to note, that excise has two meanings which relate to two different etymologies
of the word. Excise can also mean to levy a tax on a good or commodity. The former meaning is directly derived from a Latin morphology
into English, while the latter meaning morphologically moves from Latin through Dutch into the English. While both words are spelled the
same, they have radically different meanings, both meanings amplify our point about death-stacking. Namely, when loss is excised from the
collective, it places a private excise tax on the individual who must pay to maintain their status as a legitimized military-medical professional.

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