Moral Injury

Laura is a perfectionist and extremely capable air ambulance doctor. As part of the ethics committee at the hospital, she is also the person who chooses whether critical care patients live or die. She's worked hard to get here. And then, one night, life overturns in a moment and the past threatens to shatter everything they hold dear in the present. Can even those we trust with our lives be dangerous in the right circumstances? And is there a limit to what we would do for those we love?

Most Americans are now familiar with post-traumatic stress disorder (PTSD) and its prevalence among troops. In this groundbreaking new audiobook, David Wood examines the far more pervasive yet less understood experience of those we send to war: moral injury, the violation of our fundamental values of right and wrong that so often occurs in the impossible moral dilemmas of modern conflict.

In this quick-hitting thriller set in Baltimore, during the waning years of the Cold War, Lussi Sim, a Norwegian physician, is the medical director of a newborn intensive care unit. Lussi had practiced pediatrics near her parents in Oslo until her father suffered a stroke. Growing up, Lussi experienced chronic mental trauma in the self-assigned role of her mother’s bodyguard. Ironically, her father’s stroke removed the physical threat to her mother and enabled Lussi to pursue her long-suppressed goal to train as a newborn intensive care subspecialist in the United States.

Offering examples of how to make medicine better for the healers and those they serve, If I Betray These Words profiles clinicians across the country who are tough, resourceful, and resilient, but feel trapped between the patient-first values of their Hippocratic oath and the business imperatives of a broken healthcare system. If I Betray These Words confronts the threat and broken promises of moral injury—what it is; where it comes from; how it manifests; and who’s fighting back against it. We need better healthcare—for patients and for the workforce. It’s time to act.

Armies know all about killing. It is what they do, and ours does it more effectively than most. We are painfully coming to realize, however, that we are also especially good at killing our own ''from the inside out,'' silently, invisibly. In every major war since Korea, more of our veterans have taken their lives than have lost them in combat. The latest research, rooted in veteran testimony, reveals that the most severe and intractable PTSD - fraught with shame, despair, and suicide - stems from "moral injury".

After serving in a scout-sniper platoon in Mosul, Tom Voss came home carrying invisible wounds of war - the memory of doing or witnessing things that went against his fundamental beliefs. This was not a physical injury that could heal with medication and time but a "moral injury" - a wound to the soul that eventually urged him toward suicide. Desperate for relief from the pain and guilt, Voss embarked on a 2,700-mile journey across America with a fellow veteran. Listeners walk with these men as they meet other veterans, Native American healers, and spiritual teachers.

Hazard’s a military kid, best known for his prowess at football, and his short fuse. His dad’s been in Afghanistan, third tour. The worry and the pressure over school and his dad are getting to Hazard until one day, the fuse sets off and the repercussions have him benched for six games and assigned to go to therapy. Which is where his dad is as well, at Walter Reed Medical Center, because he’s home now—well, most of him. Hazard’s dad’s now learning to walk with a prosthetic, but that’s not his primary injury.