Page 132 - JSOM Winter 2024

process appropriates threads of Western capitalism that reduce The grief process described above illustrates a set of practices
human value to productivity. 19–21 Because practices associated that quarantine collective loss gained from military experiences
with splitting professional from personal focus are: encultur- and attempts to reform personal pain through a medical expe-
ated, uncomplicated, chronic, accepted, and far- reaching, in- rience, defining death-stacking as an individual pathology. By
dividual SOF medics are compelled to increasingly take on intentionally maligning an individual SOF medic’s willingness
more medical-martial duties to maintain professional legit- to express personal pain in public, this grief-process appro-
imacy. Since personal pain is severed from the organization priates an extreme form of Western self-reliance. 22–25 Because
and/or team’s readiness to acknowledge death-stacking, indi- practices associated with assigning death-stacking to a disease
vidual SOF medics are also unable to construct deeper shared category are: generalized, proceduralized, unquestioned, jus-
meaning. tified, and universalized, the individual SOF medic’s personal
pain is interpreted as an elective category of human experi-
Within this grief process, communal rejection of personal pain ence. Since emotional expression of collective loss is seen as
proliferates the assumption that a task-saturated performance contagious to the organization and/or team’s readiness, the in-
space is essential to the medical-martial profession. Conse- dividual SOF medic’s personal pain must be cured to maintain
quently, the SOF medic’s individual energy accelerates as the social acceptance.
medical-martial performance space becomes distended due to
corporate indifference. Opening the performance space to in- Within this grief process, seclusion of personal pain prolifer-
clude the entire spectrum of medical-martial activities prevents ates the assumption that an impassive performance space is
the organization and/or team from creating a contemplative essential to being an effective fighting force, and medicine is
safe space in which individual SOF medics are able to hold its conservation. Consequently, the SOF medic’s individual en-
interior space for reflection on personal pain. The result is that ergy is pacified as the medical performance space subsumes
the entire performance space collapses on the individual SOF martial experiences of loss due to a societal fear of emotional
medic. Palliating personal pain becomes a private responsibil- honesty. Enlarging the medical performance space prevents
ity, which must be isolated from the team and/or organization. the organization and/or team from creating a communal safe
space in which individual SOF medics are able to hold inte-
The hypermotility involved in this grief process diffuses the rior space and make personal meaning of their pain. The result
gravity of human loss by under-extending the value of per- is that the personal meaning of pain collapses into pathology
sonal pain, which produces emotional rigidity and wastage, and palliation becomes a clinical responsibility, which must be
reducing short-term unconventional resilience. Appropriating performed by authorized individuals in a setting peripheral to
the value of individual productivity into the over-extended the team and/or organization.
goals of a medical-martial industrial complex, forecloses any
opportunity to create a safe-space that emerges from a collec- The hypomotility involved in this grief process distills the grav-
tive appreciation of personal pain, which degrades long-term ity of death-stacking into medical diagnosis that under-extend
unconventional resilience. the personal meaning of pain, which produces emotional flac-
cidity and suppression, reducing short-term unconventional
The second grief process that degrades unconventional re- resilience. Appropriating the meaning of personal pain into
silience is alienation of mourning (i.e., performing pathol- over-extended clinical categories, forecloses any opportunity
ogy after catastrophic injury exposure). Within this process, to create a space that is set apart from daily activities and re-
death-stacking is medicalized, causing the individual SOF served for the cultivation of shared meaning within the team,
medic to question the value of public expression of personal which degrades long-term unconventional resilience.
pain, while simultaneously relegating grief to individual illness:
Bag Sets as Meaningful Metaphor: Grief­Processing
During deployment we see blown up, mangled people
for days on end, which weighs on a person after a while. Tactical Function of Social Determinant: Grief-Processing
Once I came home and went to a hockey game with my Disability is a central component of bag sets because neurolog-
family, the National Anthem started playing with a flag ical injury can initiate a cascade of secondary insults, quickly
waving on the screen. I broke down and cried uncontrol- becoming catastrophic. Within bag sets, grief-processing met-
lably in this arena. My family told me to get help. So, I aphorically carries the weight of the disability component, 26–28
did. The counselor was new to the military, had never de- which assists in assessment and initiation of neuroprotective
ployed, and had no idea about how I was feeling or what I measures through the use of a pen-light, cervical collar, Glas-
had experienced. This counselor tried to tell me what was cow Coma Scale (GCS), and neuro-pharmacological med-
wrong with me and that crying was a trauma trigger. I said icines. Critical, neurological injuries are easily overlooked,
“You can go through your textbook, but these medical because they are internal and do not present as gruesome in-
categories don’t mean a whole lot. My tears mean more jury patterns that distract focus during a trauma assessment.
than just trauma. I’ve seen the sacrifice our service mem- Similarly, personal pain associated with death-stacking can be
bers make. I’ve seen the worst of the worst in what war easily overlooked and lead to a cascade of secondary insults
brings. I feel emotional because it resonates within me to performance. The metaphorical function of the pen-light
when the National Anthem plays. Grieving isn’t a disease. simply establishes whether grief-processing is able to orient
It’s normal.” These attitudes that try to make my sadness around death-stacking (optimal) or not (degraded).
a sickness are completely exhausting. I’m tired of dealing
with them. Sometimes being understood by anyone out- Optimized grief-processing, like disability in a trauma assess-
side of my team feels like a futile aspiration and I just want ment, recognizes the inevitable reality that personal pain exists
to give up. It’s definitely safer to avoid talking to anyone from death-stacking. The organization functions like the cervi-
about the loss I experienced in deployment. cal collar—it limits the team’s range of motion by contracting

130 | JSOM Volume 24, Edition 4 / Winter 2024