In this undated photo provided by Maj. Gen. John Cantwell, the general poses for a formal portrait. The troops Cantwell was fighting alongside in the Gulf War had used bulldozing tanks to bury the man alive. This hand - so jarringly human amid the cold mechanics of bombs and anonymous enemies - was about to wedge itself, the Australian man would write decades later, "like a splinter under the skin of my soul." It would lead, along with other battlefield horrors, to the splintering of his mind and to a locked psychiatric ward. (AP Photo/Maj. Gen. John Cantwell, Sergeant Neil Ruskin) EDITORIAL USE ONLY
Saturday, December 29, 2012 8:23 am
General's battle with PTSD leads him to the brink
By KRISTEN GELINEAUAssociated Press
John Cantwell could see the ridges and calluses of the skin, and the pile of desert sand that had swallowed the rest of the Iraqi soldier. The troops Cantwell was fighting alongside in the Gulf War had used bulldozing tanks to bury the man alive.
This hand - so jarringly human amid the cold mechanics of bombs and anonymous enemies - was about to wedge itself, the Australian man would write decades later, "like a splinter under the skin of my soul." It would lead, along with other battlefield horrors, to the splintering of his mind and to a locked psychiatric ward. And it would lead to the abrupt end of a 38-year military career that saw him ascend to remarkable heights as the commander of Australia's 1,500 troops in Afghanistan.
In the process, Maj. Gen. Cantwell would become two people: a competent warrior on the outside. A cowering wreck on the inside.
He hid his agony to survive, to protect his loved ones and - he admits it - to pursue professional glory. But in the end, the man with two selves found he had lost himself completely.
A disheartening number of veterans suffer post-traumatic stress disorder. What made Cantwell so extraordinary was his ability to hide his escalating pain for so long, while simultaneously soaring through the military's ranks - eventually taking charge of an entire nation's troops in a war zone.
But the higher he climbed, the farther he fell into the abyss of mental illness.
"I became an excellent actor," he says, 20 years into his battle with PTSD and going public for the first time with the release of his autobiography, "Exit Wounds."
"It did, though, come at a price. It was like pressure building in a hose and you finally release the tap."
And when that tap was opened, Cantwell nearly drowned.
He had practically begged his way onto the battlefield.
In 1974, he joined Australia's Army as a 17-year-old private, after a childhood spent worshipping Vietnam veterans and poring over military-themed comic books. He ended up on exchange with the British Army, and two years later, the Gulf War erupted. Cantwell hounded his superiors for his first chance at combat. "Be careful what you wish for, John," one warned him. But on Dec. 17, 1990, he said goodbye to his wife and two sons and headed to the Persian Gulf.
It was exciting at first - the strategizing, the explosions, the sense of being part of something big. He whooped with victory alongside his comrades when bombs blew apart Iraqi artillery.
Then came the hand.
Cantwell stared at it as his tank rolled past. He had been unnerved by the plan for American troops to bulldoze over a network of trenches hiding Iraqi soldiers, but had said nothing. Now he wondered: Had the soldier been reaching for help when he was entombed?
The U.S. Defense Department would later defend the operation as a necessity of war, arguing that the Iraqis who were killed had chosen to stay in the trenches and fight. The Defense Department's former spokesman, Pete Williams, told reporters at the time: "There is no nice way to kill somebody in war. War is hell."
On the battlefield, there was no time to process it. Cantwell was a warrior, and this was war. He pushed forward.
The horrors piled up. He saw the twisted, charred remains of men. He fought to stay calm when several small bombs exploded under his vehicle. Inside a blood-and-excrement-smeared torture chamber in a former Iraqi headquarters, he saw a drill, hammers, pliers and rope. He imagined the screams of the victims.
Through it all, he knew he must remain focused. That was what he had been trained to do, and he did. But there were moments when he felt something gnawing at him.
He was looking for survivors near a blown-out truck when he spotted the first head lying in the sand. A second head lay nearby, one eye staring back at him, a scarf still wrapped around the remains of the neck.
Cantwell felt an overwhelming compulsion to put the men back together.
With sweaty hands, he lifted the second head by the scarf and carried it over to its former body. He grabbed the other head by the hair and placed it alongside the shoulders to which it had once been attached.
Then he climbed into his tank, and got back to the business of war.
Cantwell was falling apart.
The nightmares arrived swift and brutal upon his return to Australia. In them, the hand summons him. He falls to his knees, helpless as the hand yanks him into the ground toward certain death.
He awoke to his own screams.
The nightly torment was relentless. He dreamed of being blown apart by land mines, of the decapitated heads. Mornings brought exhaustion and flashbacks. In public, he scanned crowded areas for exits, convinced an attack was imminent. Lightning made him jump.
The nightmares grew worse. One night, he shoved his wife Jane out of bed, pinned her against the wall and held his arm across her throat. Jane was terrified. When her husband woke up, so was he. What if he had hurt her?
He suffered alone. At the time, Australia hadn't experienced battle since Vietnam, so he was an anomaly. He hid it from his sons, wanting to protect them. He confided in Jane, but only to an extent. He worried his fear would contaminate her.
He began to live behind a mask. Every morning, he dragged himself out of bed and ruthlessly quarantined his fear into a tiny box inside his mind. He showered, shaved, slapped on a smile and adopted a confident tone: This is the John Cantwell the rest of the world will see.
The double life was exhausting. He consulted a psychiatrist, who offered a cold dismissal: Get on with your job and your life. Stop fixating on bad memories.
He slid further into depression. A year later, a psychologist diagnosed him with PTSD. Cantwell took sleeping pills at night to try and find peace.
It never came.
It was 2006, and the Iraq war was raging when Cantwell landed in Baghdad. Australia had sent 2,000 troops to support the U.S. and the British, and Cantwell, by then a brigadier, was deployed to coordinate operations across the country.
Despite his PTSD, he'd lobbied hard for this job. Maybe he could help, he told himself. And maybe if he returned to the place where his torture began, he could find a way to move on.
This time, though, his decisions determined whether his soldiers lived or died.
One day, he had to choose which of two groups of soldiers would travel with the only available explosives-clearing team. The group he sent out with the team had no trouble. The group he sent out alone hit a roadside bomb.
Three soldiers died. Cantwell wanted to vomit.
The violence left him in despair. He was visiting a neighborhood when a car bomb exploded. Cantwell stared at brain matter and blood sprayed across a wall. Two tiny pink sandals lay on the ground below the stain. One floated in a pool of blood, the wind turning it in a circle.
Cantwell knew the dead child's sandals would join the hand in his nightmares.
He grew bitter and disillusioned. The job left little time for sleep. When he did, the nightmares were grislier than ever.
An officer asked one morning if he was OK. Cantwell assured him: "I'm fine."
He wasn't. But before he left Baghdad, he was promoted to major general and appointed Deputy Chief of the Australian Army.
Jane was stricken by her husband's appearance when he returned home. He was exhausted and sick.
The guilt of the soldiers' deaths from the roadside bomb was eating at him. Jane tried to assure him he was not responsible. He ignored her. In his mind, it would always be his fault.
He quietly visited another psychiatrist who put him on medication. It did little to help.
The pressure of pretending was almost unbearable.
Cantwell stared at the two flag-draped caskets before him. Inside lay the first Australians to die in Afghanistan since Cantwell had taken command of Australia's forces in the Middle East.
They had been his responsibility. Now they were dead, torn apart in an explosion.
At their memorial, he spoke of bravery and sacrifice. Many in the audience cried. He strangled his own misery into silence.
After the service, he climbed on board the plane bound for the morgue and sat next to the caskets, thinking about the men inside. His warrior self tried to reject the nagging feeling that they had died because of him. He tried to think rationally: He had done his best.
But the line between his two selves was disintegrating. He began to cry. A friend on board asked if he was OK.
Cantwell could not answer.
He wondered if all the bloodshed was worth it.
He was at the beach on vacation with Jane. But he was detached from everyone and everything.
There were rumors he was up for a promotion to Chief of the Army when he was summoned to the nation's capital to give his debrief on Afghanistan.
He donned the warrior mask one last time. He appeared calm, made jokes.
When it was over, his superior asked him how he was really doing.
Cantwell surrendered. He said: I am not OK. I am not sleeping. I am not who you think I am. Please tell the chief of the defense force.
Cantwell told the chief himself that he could not take the job. The chief understood.
His truth exposed, Cantwell hoped the worst was over. It was not. On a train, he was so startled by the conductor calling out for tickets that he shouted in terror. The other passengers laughed. He cried.
A psychiatrist finally asked: Had he thought of suicide?
He answered: Yes.
The pressure that had been building for 20 years was at bursting point.
Cantwell let go.
A pajama-clad woman in the psychiatric ward asked the general why he was there.
He wondered, too.
He had checked himself into this hospital, knowing he was broken. Still, he argued with himself: What is a major general doing here?
The doctors changed his medication, and he attended regular counseling sessions. One night, he only had one horrible dream - an improvement.
He left after a week of intense treatment. A few months later, he retired. He and Jane moved to a peaceful coastal community, where he continues his therapy.
He doesn't regret his career. Australia's Defense Chief Gen. David Hurley said Cantwell's courageous decision to go public has already encouraged other members of the military to come forward with their own struggles.
But speaking out isn't easy. Military personnel often fear the stigma of mental illness will ruin their careers, and they worry that people will think they are not fit to lead, says Matthew Friedman, executive director of the U.S. Department of Veteran's Affairs National Center for PTSD.
To Cantwell, soldiers are simply not conditioned to expose their pain.
"We've instilled in them this idea of physical and mental toughness - that's how they win battle, that's how we win wars," Cantwell says. "We expect that same person with the self-image of a warrior - someone who is tough and imperturbable and able to shrug off pain and difficult environments and horror and get on with their job - suddenly we expect them to turn around and open up? It just doesn't work."
He sits at his computer and reaches for the mouse. There is a click as a button attached to the bracelet he wears hits the table. He wove it out of parachute cord as a reminder of the 10 men who died under his command in Afghanistan.
He insists the bracelet is not a punishment but a mark of respect.
Maybe it is both.
How are you feeling today, John?
His answer is now honest: Not good.
His sleep has been tormented by the usual nightmares. Upon waking, he sees the headline that another Australian soldier has died in Afghanistan.
His stomach drops. He knows these feelings may never go away. He hopes he can eventually forgive himself for the men who died under his command. But he never wants to forget.
"One day I'm hoping to be able to touch on these emotions, experience them and yet not let them get their hooks into me," he says. "That'll come one day. One day."
Until then, he will focus on rebuilding himself - his real self. He wants to learn to sail and scuba dive. He wants to write and paint and draw ("something a bit creative rather than destructive," he says with a chuckle.) Maybe he'll work with veterans, or become a mental health advocate.
Not long ago, he turned 56. He wanted to celebrate with a trip to the beach, but driving a car brings flashbacks of car bombers in Iraq. So he and Jane hopped on his motorcycle and roared down the road. At a surf club, they grabbed seats on the deck. The general clutched a cold beer.
"Life is pretty good," he thought, watching the waves roll in. "Despite everything - life is pretty good."