A Matrix for Healing: Understanding the Psychic and Moral Wounds on Clinicians During Wartime by Michael Brown, OD

    Michael Brown is an optometrist who has practiced with the U.S. Department of Veterans Affairs for over 25 years and served as an adjunct clinical professor at the University of Alabama at Birmingham School of Optometry. His piece, " Red Line Rising ," appears in the the Spring 2018 Intima: A Journal of Narrative Medicine

Michael Brown is an optometrist who has practiced with the U.S. Department of Veterans Affairs for over 25 years and served as an adjunct clinical professor at the University of Alabama at Birmingham School of Optometry. His piece, "Red Line Rising," appears in the the Spring 2018 Intima: A Journal of Narrative Medicine

Unlike Dr. Jeffrey Brown who rushed into a densely seeded mine field in an effort to save a mortally wounded soldier, I have little to fear during my typical workday. At the most, I might have to dodge a delivery van or step over a few oil spots in the clinic parking lot on the short walk from my car.

Dr. Brown, in his evocative and poignant essay “The Moral Matrix of Wartime Medicine,” (Intima, Fall 2015), describes his experiences as a young physician during the Vietnam War and both the immediate and long-term effects of the psychic and moral wounds he and other military medical personnel accrued while serving in combat zones.

I recount a different kind of “shell shock” in my story “Red Line Rising” (Intima, Spring 2018) that occurred while fighting in “the primary care trenches of America” to save the sight of a homeless man, and military veteran, who is lost in the labyrinth of the so-called U.S. healthcare “system.”

Still, as I read our pieces I realize that our stories, while not sharing identical DNA, do possess some common traits. War-induced post-traumatic stress disorder (PTSD) and professional burnout are at least distant cousins.

Both our stories are grounded in and emerge from periods of great confusion and chaos that cause us to realize the vast chasm between “the way things are” and “the way things ought to be.” Dr. Brown writes, “Our matrix for morality was once painted in the clarity of primary colors. Now it was a kaleidoscopic jungle of moving parts.”

I employ similar language in venting my frustration with the disjointedness of the U.S. healthcare system, describing it as “a million-piece jigsaw puzzle that has spilled onto the floor.” For both of us, objects that might in another context provide us with pleasure, kaleidoscopes and puzzles, become instead metaphors denoting misery.

Dr. Brown’s phrase “professional terror” describes exactly my emotions at the end of that long day as I grieved over the loss of my patient and poured my glass of wine, “the red line rising full to the rim.” Neither of us had the resources needed to adequately fulfill idealized expectations of our professional responsibilities. Our adjustment of those expectations, in his words for our “psychological survival,” nonetheless comes with considerable cost to our souls.

However, in the telling of our mutual stories and the ensuing exchange between them, we discover a matrix for healing—the ancient call-and-response of narrative, which is older than war itself.


Michael Brown is an optometrist who has practiced with the U.S. Department of Veterans Affairs for over 25 years and served as an adjunct clinical professor at the University of Alabama at Birmingham School of Optometry. He contributes a regular column to Optometry Times and serves on its Editorial Advisory Board. His creative nonfiction work has also appeared in The Huntsville Times and Arkansas Times. For him, writing is a two-way lifeline that enables him to extend better care to hispatients and to receive encouragement and hope from their stories. He lives in Huntsville, Alabama. His piece, "Red Line Rising," appears in the the Spring 2018 Intima: A Journal of Narrative Medicine