From Wounds, Inner Strength

At Walter Reed Army Medical Center, Eric DeSarme adjusts a prosthesis for Hilbert Caesar, who lost a leg in Iraq.
At Walter Reed Army Medical Center, Eric DeSarme adjusts a prosthesis for Hilbert Caesar, who lost a leg in Iraq. (By James A. Parcell -- The Washington Post)
By Michael E. Ruane
Washington Post Staff Writer
Saturday, November 26, 2005

As Hilbert Caesar told his harrowing war story one night recently in the living room of his apartment, he patted the artificial limb sticking from a leg of his business suit. "This, right here," he said, "this is a minor setback."

Eighteen months after Caesar's right leg was mangled by a roadside bomb near Baghdad, and after weeks of coming to terms with what he thought was the end of his life, the former Army staff sergeant believes he has emerged a richer person -- wiser, more compassionate and more appreciative of life.

Asked whether he would endure it all again, he replied: "The guys I served with were awesome guys. . . . I would go through it again -- for the guys that I served with. Yes. Absolutely. I wouldn't change it for the world."

Although the shattering psychological impact of war is well known, experts have become increasingly interested in those who emerge from combat feeling enhanced. Some psychiatrists and psychologists believe that those soldiers have experienced a phenomenon known as "post-traumatic growth," or "adversarial" growth .

Although war left him with a leg of plastic and steel, Caesar, 28, of Silver Spring, appears to be among those who return home with psyche intact and a sense that they are in some mysterious way improved.

"I'm the same person," he said, "but I'm a different person now."

Combat's potential to inflict psychic wounds has been recognized as far back as the ancient Greeks, but so has its ability to exhilarate, intoxicate and instruct those who experience it, experts say.

"If you think about all of the heroes and heroines in cultures across the world . . . all of them, in one sense or another, faced some sort of a dragon," said Matthew J. Friedman, director of the National Center for Post-Traumatic Stress Disorder and a professor of psychiatry at Dartmouth Medical School. "The transformation from that encounter has been celebrated from antiquity."

University of North Carolina psychologists Lawrence G. Calhoun and Richard G. Tedeschi, who have studied post-traumatic growth for 20 years, said they are careful in describing what occurs.

"We're talking about a positive change that comes about as a result of the struggle with something very difficult," Calhoun said. "It's not just some automatic outcome of a bad thing."

Calhoun said their studies suggest that for growth to occur the trauma must be severe. "We tend to use the metaphor of an earthquake."

He said the person first ponders the details of what happened. "And then there's a much more abstract process of finding some higher meaning . . . in what has transpired," he said.

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