John Jackson and Hazel Diaz

00:03 My name is Hazel Diaz. I'm 33 years old today's date is May 17th, 2019, and we are in Nashville, Tennessee at Nashville Public Radio, and I am here with my interview partner. John Thompson. John Jackson age 48 today's date is May 17th, 2019. And where Nashville, Tennessee.

00:25 Sorry about that. Let's start with talking about where you grew up John. Where are you from group in Cookeville? Tennessee wasn't born there, but that's been a majority of my childhood between there and Charleston, South Carolina.

00:41 And why did you leave between two places to live in Charleston initially and my grandparents and my dad was still in Charleston? So when I move to Cookeville go back and forth. Do you have summer spend most of my summers in the marsh and then come back for you know the rest of the year in Cookeville. Can you tell me about your time in service? What branch of the military was in the Army? And I've doing the reserves and 2000 guess it was.

01:12 2001 join the reserves. I was actually in training at the time for the become a psychiatrist in Colorado joined.

01:21 And then

01:25 Came back to Nashville to do a fellowship Child and Adolescent Psychiatry and some point went down officer basic and volunteered to do a tour sounds like I'd like to say it's cuz I was so excited and brave and want to get out there, but it's actually because I was going to start a job and want to get it to her out of the way so that I could have a year of working without it interfering with my my career.

01:46 And so 2004 after I went to basic they essentially tagged me for a rack a few months after that.

01:57 Can you tell me about your time in Iraq and some of the difficulties of your face while you were there? So I guess so to not to not to take over. It was kind of talking to you earlier. I wanted to come here to to say for the archives and anywhere and anyone that wants to listen to it that Tim came to talk about a hard subject at which is PTSD as a psychiatrist treated it for years and came back with a wreck with it. And that's today actually talking to you. The first time I've ever actually said it out loud never said it to my wife or anyone else.

02:35 I've always said I came back with symptoms but if accumulation of symptoms is a diagnosis and I've never never said I had PTSD. So the time in Iraq, it's a little in a part of me never talking about it. Just want to send you say well doctor shouldn't have PTSD coming out of Iraq, but you know the job that we did was called I work for combat stress team and my job was in prevention, which was spending a lot of time on the road going to various fobs to debrief folks after a traumatic event traumatic events were always always somebody killed in action.

03:16 So in 2004 was kind of a tough time over there lot indirect stuff. We took a ton of orders coming in to fob warhorse smaller smaller post and a lot of time on the road and then the course secondary trauma of debriefing folks on on just these awful awful events. So when I came home, I didn't want to go to a lot of details of my to work cuz I don't think that's the important part but when I came home

03:49 I didn't know I had symptoms, you know, I had trouble sleeping. The one thing as a psychiatrist somebody that you know, we talked about PTSD and Smits have night sweats believe it or not a psychiatrist. I thought well that doesn't make any sense physical symptoms not possible and I won't say every night but I would say on two occasions. I woke up just soaking wet and had night sweats and nothing helps. You understand a diagnosis like having it. Is there something something about experiencing PTSD after treating it for a long time that really surprised that mean you have like the citizen-times right? You have physical symptoms of PTSD and kind of things that you maybe didn't expect Cimorelli to the night sweats for you really going to take the beer that connected through something surprising about you. You know, you helped you with PTSD for years before you experience it yourself.

04:49 I would say yes in the I think like a lot of people with PTSD. I didn't think I had it as a dump truck in intellectualize. You know, I could just was just a symptom. You know, you don't have PTSD you just have a symptom so I didn't believe in any of that. I don't think I had PTSD in like say it's it's it it's in hindsight that you can say. I had PTSD. Yeah. Do you think that that you had an expectation of yourself going in that since you are a doctor and your person that has worked around PTSD for a long time that you are kind of like above The Fray and you were you know, excluded from this like a very human reaction to severe trauma and secondary trauma because of your your experience or because you're a doctor because of your education. What do you think attributed most to you kind of feeling like you weren't susceptible to this kind of

05:48 You know diagnosis, you know Cockiness. I mean I'd say that's exactly right though. I was over there and you know, it's signing up for it getting ready for it. All of that would have never thought anyone likes it when I got home. I was like no problems. But meanwhile, I'm arguing with one of my best friends in the world. I drive my wife nuts, you know, it's like I was the crazy uncle at the table, you know, it's like at the time again, I wouldn't get into politics kind of stuff but you know, it's pretty pretty frustrated with with the rationale I guess in and I would tell anyone who didn't want to hear about it. So I was in a really

06:28 Kind of ugly to a lot of folks and didn't mean to you to look back psycho. They should have done that. And do you think that it's made you a better doctor and it's made you absolutely out of your patients, I think.

06:41 Working at the VA when a patient comes in and they know you were there to put somebody's I think you know, they frequently say nobody understands that's like to be there for him. So I think it makes a big difference seasoned a trust you more I think I do.

07:01 Can you tell me how the VA is working to build trust among veterans and

07:09 Where is doing? Everything can take care of these guys? I think you know we get a bad rap. I think a lot of times and I think it's probably to be honest with you. I mean the bad stories a lot lot more interesting than than a good story sometimes, you know, we do a lot of good things mean.

07:25 Mbrx, you did nice things. They did story on our you know, some of our programs like Tai Chi for veterans wheelchair. So I guess that mean that's nice but nothing sells a paper or commercial like VA is not taking care of veterans and it's just not true most the time so I can say there's always exceptions or you know, so many people at work. I think yeah, you can find find exception any rule but the rule here is that we do a pretty good job, but Temp and I think that's why I'm there like say I got drawn back to it as a child psychiatrist laughter tour in Iraq kept getting drawn back to the veterans.

08:02 So after

08:06 Starting to work with PTSD and kind of helping the VA reach out and really is providing services to veterans in a number of ways. I would assume I know that you're the kind of mental health in your kind of, you know overseeing this entire thing. How do you think

08:29 How do you think you had your position of your time with the VA has helped push that kind of?

08:37 That did not go forward or the things that you've been put, you know a place.

08:44 I would say that.

08:48 My time in the VA. I felt sort of urgency like a race against the clock got to fix things.

08:55 Got to make it better. I got to kind of do a better job and I think that

09:01 AutoZone are but two

09:05 There's improvements to be made and once again, I think that it's it's a great place for veterans to get well, it's the place where veterans help veterans we have mostly better in working for us. I think people come in I think veterans heal by helping veterans to be honest with you and until you'll find a lot of veterans work at the VA and I think that's the rationale. I think they to get drawn in and take care of one another.

09:30 I think that's why I'm there.

09:34 What do you wish people would understand about veterans in their Journeys back from from combat and all of Texas? I mean, there's other PTSD to the sexual trauma that comes if you know what I mean and and other things that come with service, what do you wish people would understand already take one of the misconceptions are about veterans of Jesse Hutch who are veterans with trauma before service that never served in a combat zone. I mean, we have theirs PTSD from everything and I think I think everybody

10:08 How is tell people that my career is is either Griefer or loss I guess with a smattering of Epsom primary psychotic disorders, but for the most part I grief and loss is a big one and then it's sort of a lot of things come out from that Weatherby childhood grief or loss or or what-have-you that time. I think there's a lot of people actually out there that understand it pretty well probably are suffering with some similar problems from there any our lives were all cumulation of everything we got. So I think that some people do understand it pretty well. I think PTSD actually looks pretty similar in a lot of places. I mean sleep anger all these things that you know

10:48 You know, I think that you'll see some similarities but I think what's important now is it says it's something people can't see yourself as I kind of said that there's symptoms that I didn't as a physician thought well, I don't know how you could have this.

11:08 If you experience that you know, but they're said disbelief cuz you can't see and so I think that that's probably one of the bigger problems I was just talking to a veteran today that said people don't understand how angry I am and why and I said well

11:24 I said you're going to have to you're gonna have to come to terms with that because the only way you can make him understand that is to get yourself in trouble. So it's one of those things I think people with PTSD can come get the help and I think it's important that we do a lot of Outreach to the community to help people understand what they're dealing with, you know, the anger Outburst on okay, like say I did several of myself in public places that tub probably should've been arrested. Once that I think is is something that

11:58 If you do it though, and you get arrested you're going to jail. Do you know and so I think it's important kind of keep it from happening for the veterans, but then the community it also understand it and not encourage it that if people you know, you don't do Pokemon.

12:12 Let's talk about suicide prevention with CPA and it was in the veteran community and kind of how I'm some things you can talk about some things that are really working at the VA and some things that could use Improvement outside or inside the VA. Whichever you prefer to address your feel. Like I'm doing a commercial on my story because this is stuff. I actually love I'm in the VA mental health of minutes. I think you said you were in the Marines if you ever needed it's the best mental health in the country. I mean nobody if Xfinity had any any idea how good it is. I mean when you walk in, you know, you talked about I want to get a psychiatrist Google psychiatry in Nashville, you'll get a psychiatrist. If you're lucky in three months, if you're lucky it's good chance of cash only because nobody wants to fool with the insurance company's it's not because of the greedy it's cuz it's difficult to get reimbursement. And then it's a lot of overhead you're paying people to do your billing. So a lot of them do cash-only VA. There's none of that so the VA if you want an appointment and you

13:12 Walking until your primary care. I'm feeling a little depressed not suicidal not anything else. I'm feeling a little depressed would like to talk to somebody will see that day. So if you're into primary care, it's same-day access to we have mental health people in the primary care clinics.

13:28 If it's more severe to that, you need priests care or more significant medications, they'll move you into hard or general mental health clinics are the same day to within I think it's about 25 days. We'll have you seen by our regular Care Clinic.

13:43 If you do that and you're on the medication, so I start medications that might interfere with conduction to a heart right? So when you get an EKG, I can send you in our hospital I go get this EKG it goes into chart are cardiologists reset. I've got all the information right at my fingertips. If you need substance treatment, I can get you into their programs. If you need to be impatient. I can get you there residential programs. I can get you there if your homeless we can get your house. If you don't have a job will get you a job at the VA has all of the services all in the same place. We have the ability to communicate General mental health teams. When I was in private practice, I would call a therapist about a patient and it'll why you calling me and say what we share the patient there said. Well, we know that but psychiatrist don't call us as well. I do so you'd want to have a little communication with a patient therapist in the prescriber that doesn't happen in Community Urgent Care Clinics. They get together twice a week to discuss patients. I mean they get together as a team with a nurse everybody's in the same room discussing patient it is it is the model of what I can.

14:43 Or mental health care in the world doesn't know about it and we talked about how tough it is at the VA, but this is great stuff. I mean it really is and I'd love I love for everybody to know it cuz I think if the community knew they would demand this. I mean, holy cow with everybody and wanted this good it's good stuff. I don't know if it if I don't know if we can roll out into another model, but suicide prevention week out of Suicide Prevention team. They go out into the community as you'll see us at event going out to agent Davies and Community Center meeting out with folks. They they have we have a list of patients that we considered high risk. If you're talking about suicide we put you on this list they call you will make sure you get visits. You're at least contact at least four times a month is our bare minimum. I mean when I say this is a suicide prevention team reaches out to you. They send Christmas cards out to check on the veterans. How you doing? You know, it's a tough time of year. We know it is just know that suicide prevention's here for you.

15:43 And it's I don't know. I don't know if I'm being defensive because I think the VA is greater or just really bragging on it. I don't know but it really does a good job.

15:55 Are you guys were talking about the two suicides you experienced while they're so the suicides are actually yeah, they're in my private practice. And then yeah. Yeah. Cuz I say each one of the ones now I own them all.

16:12 Let's talk about the first one. How long have you been to your patient before the incident? I was in training probably a few months and then he kind of disappeared for quite some time and I got a call from this partner. And once again, this is one of those things where he was on a lot of pain and was on narcotic pain treatment and the pain clinic cut him off and he barricaded himself in a room and overdosed. I hadn't seen him in a long time, but you can look back and think why can't I reach out to him. What can I do more, you know as a provider you think what could have done better? There's always hindsight and

16:58 But at any rate, it's one of those where I couldn't even couldn't bring myself to go to go to the funeral even though I desperately wanted to to get some closure.

17:12 Is there any lessons you took away from that being that you were kind of a young provider and and it was very early in your career that you really apply to your work a suicide is a provider makes you acutely aware this life-and-death you think about mental health? A lot of people go into it, you know, it's like surgery they do with it everyday, you know, you've got somebody, you know heart in your hand or whatever kind of surgeon you are you're you know, removing the tumor. What have you that every day that have a patient open anything could go wrong mental health. We see a lot of patients that are that are anxious or depressed but the chance of something tragic happening or actually kind of low but there's a there's a life-and-death in mental health and it's it's clear spit a day and veterans.

18:01 It's a it's a cop killer across the across the Spectrum.

18:06 What was significantly different tell me about the second suicide and kind of how that affected you differently than the first so I can one was an adolescent that committed suicide and it was.

18:24 I think that one's I think they're both really tough. But I think it's really hard when it's an adolescent and this is one that

18:34 It's it's hard to continue with child psychiatry after something like this because you don't trust any of them because they come in I'll tell you everything is fine here in a few weeks. There's a suicide and I say you go back and you scrub and you think can dance like what could have happened?

18:51 And are you see some possible signs, but nothing perfectly clear, you know the kids hers act and let me know about it. And if you know who I still haven't recovered from that, I guess it's one of those you just carry.

19:08 How do you take care of yourself doctor Jackson?

19:14 I think just about like at the health and physically your keep saying you're responsible for all of them now and that's a lot of weight for one man to carry do it. Like every other doctor. We're probably our worst patients. We would just assume, you know, we treat ourselves and you know, once again if you treat yourself your you've got a fool for a doctor, but 10

19:41 Not much, you know, I I guess I I work too much that kind of thing. I don't know. I don't I don't do enough. I think I can stay after.

19:52 I got in a fight in a upscale restaurant in northern California. I actually saw a psychiatrist briefly, but even refused meds and refuse to believe I have PTSD at the time so it was so I guess if I'm a terrible patient.

20:14 Let's talk about your journey in joining the Army. What kind of Drew you to service? What was your your call to service and wants the first time you thought about joining the military and what were some of the reasons that you decided to to join?

20:31 I thought about it is a kid a quite a bit and didn't and I can't I can't really say, you know, there's always sort of a piece in the back of my mind. I think a lot of people say well back to the Revolutionary War. My great-great can't say that I think my mom would tell you we come from a long line of cowards. We left on hungry so that they can avoid conflict maybe on my dad's side. I guess if my grandfather was actually in that World War II had a Purple Heart Naval guy that wasn't, discussion, you know that we weren't military family so to speak so I don't know.

21:13 Some part of me wanted to join for a long time and then it happened in in my training. I guess my training director in Colorado was he was a colonel in the reserves and tell me about it said yeah boy.

21:28 Nothing, nothing interesting about it. Think about being in the reserves. I don't know I wouldn't real good at it throughout my life. I've been sort of resistance to Authority kind of guy and so, you know as much as often as I thought about the military and I don't know if my personality was the best fit actually think I probably did the best in the military in Iraq because I was sent off to a post with a team of three and everybody left us alone out. There is my sergeant used to say it's always better being away from the flagpole. So the further you are from the man that happy you are and I think he was probably a little bit right?

22:09 What is your favorite thing about working at the VA?

22:14 Being able to help like I say right now. I mean, I love love being a doctor, you know, I think about it and and just grateful to have the opportunity to to take care of folks miss one of the things that I think

22:27 It's one of those jobs at the end of the rewards feel endless. But now to be a that where you build programs every time something great. You know, we just we just redesign the inpatient unit kind of funny yet. I started my chief of Psychiatry and I covered for Christmas. So we were short-staffed and they didn't have enough coverage. So I said, I'll do two weeks. Everybody can take a vacation Christmas time. So I went dead 2 weeks then came out and it's kind of famous for her now, I guess around with us, but look at the Chiefs like

23:01 You know, I went up there thinking to see all these guys getting well and see all the program and I said all I see it is a bunch of guys hanging out in pajamas watching television. I said, you got to fix this for me. She's I brought your boss. So she goes out puts together a big team and we get some of the I think some the smartest folks we have we're working on this team Pharmacy psychology Social Work Psychiatry. Everybody's getting together and sort of put together program. And now we've got this multi-tracked treatment Focus program. That's incredible. I'll be proud to have any family member there and I tell people I think it's the best in state and maybe you know, we had central office in Washington DC came down and took a look at it and said, you know, I think you guys are looking at a best practice here. So, you know, so we continue to roll it out. I expect to see it national.

23:50 Is there anything you don't like about working at the VA?

23:52 Well, I was just saying I've resisted to Authority and they're certainly you know, I'll say if there's a bureaucracy there. There is everywhere. I was at Vanderbilt and there was a baroque bierocracy to any large program. So private practice that I would say is where I was my own boss. So I was the only one yelling at me the bigger though the system I think you find it. Sometimes you have to be a little more flexible to to navigating to be able to do the good things you are and so I've got good people around me that if I seem to be getting kind of rigid or tents, they sort of an elusive me up and say now it's moving a better Direction here.

24:32 You talked about how important it is for a veterans to help.

24:39 What do you have if you have any patients who?

24:44 Particularly affected you or like to commute to talk about maybe a patient to most of it's tough because of you. No privacy. I don't you know, it's you know, I still see better instead of said before I came over here when the reason says running late was so they turn this morning and so it's not something I can let go of I was at the VA until 2011 by doing some you know, I was in charge of compensation pension. So another program where I was in charge of something I wasn't seeing patients.

25:19 And I love the job but I needed to see patients. I left went private practice and then go take him back in 2016 just to be a psychiatrist and then see patients and then the entire leadership of mental health, you know, I don't I don't know the rationale but it was it was very close to sort of everybody left at the same within a few months. Of time. And so it's a little bit. It's unfortunate every kind of thought, you know, they're planning, you know, you make lives for your plans for your life and it was all sort of sort of fell into place all at the same time and so is a little bit rudderless except kind of what I got into being the chief again.

26:00 Is there anything else you'd like to discuss?

26:03 Yeah, if it were if it were to get on the radio kind of thing.

26:12 That

26:15 Eras, I mentioned I didn't come here to talk about me having PTSD cuz I really wanted to I think my mouth goes dry and come here and swallowing. There's things that happened in interactive still, you know can really sort of frustrate me or tear me up. I can say I came back and argued with family members annoyed my wife and I guess I got no.

26:43 Honestly got in a fight in the girl in The Fig if you've ever heard of it, it's open in Northern California wine country my wife and I were up there and

26:50 Doing them like a big brawl, but I eventually shut the guy over a small table and it's going over to beat the Phoenix to death and his friend came in like it's his birthday and I live alone and I kind of realized what happened. The other part of PTSD is these if you do get to the the Saenger there's an adrenaline rush that young people say, they see red or whatever. I mean, I wasn't thinking about going over there beat this poor guy. He was he was really drunk but

27:21 After it all ends and you stopped and the place is quiet and every staring at you and this isn't there and everywhere else cuz she get these adrenaline rushes that when it ends if you feel awful, I mean that when that adrenaline comes out of your system, holy cow, and then you just sitting there and it's a quiet restaurant every staring at you gives through a guy over a table. It's crazy and likes it but that you don't even have to be the event where that happens. You can get that frustration. You know, that that anger that you know, they'll get road rage.

27:53 Winnett Road, when that sort of dissipates there's there's a true sadness to it as the best way to describe you just feel terrible. I mean just physically drained you're tired actually found myself Dawning frequently as well since I kind of noticed that would blow up feel terrible and then feel really tired. I don't know almost see you for like, I guess so coming here and talking about you know, these kind of things is it stuff and I have you know, certainly don't mind I can an archived but if there's if there's veterans out there that are not getting the help are the reason I want to say look can happen all of us.

28:33 I think family member is kind of make us get the help before we even figure we need to help and we ignore I'm going to think a lot of guys and gals get divorced before they actually come to that point because they're just not going to buy it and I get tired of it and spouse funds that we don't seek the help that we need to

28:49 So the va's a kind place again. I want people to come in. I want to see him like say six six of the 20 a day to commit suicide or enrolled in a VA. We get the other 14. I think that number is coming down.

29:09 It was after the cuz after the incident in Northern California that I came home.

29:18 And say my training director Vanderbilt still at work with her and she kind of probably best psychiatrist. I know says, I don't know if I told you or not, but I think it was misbehaving enough to where people noticed and she gave me the name of a good psychiatrist in town. I'd say the psychiatrist wouldn't put me on meds and I'm sure I was just as frustrating as some of my patients frustrate me and I refuse to do medication and it's a psychiatrist when you know, you have something that can help people and they refuse

29:53 Got it's maddening. And I just messaged her and thank you note I get frustrated because it's like I've got a tool that I helped you and they refused it but I did same damn thing. So sorry but really just normalize in the symptoms this what what made me feel better and I would go in for a while. I could spit vinegar or what I need to do in there. And I found that I wouldn't wouldn't quite so hot but home. I'm your person that can tolerate it and allowed it was was really helpful. So it's

30:28 Why would you why did you refuse the medication? Cuz I didn't think I'd PTSD.

30:39 Add small recently. Like I say, I mean all these symptoms that sounds terrible and all that but they did was off. I mean it was one of those things where

30:49 When I got home, you know, it's kind of way I swear to describe it is so it's hot, you know, it's like everything like I was on the edge all the time and you after the first month back, I'm like cool man. I was hot when I got back feel better now and then the next month you like. I thought I was back a month ago. But now I'm finally back and a breakdown at 3 months later. You look back and say oh my God, I didn't realize I wasn't better but I'm better now and you keep telling yourself this and you are getting better as the thing you have time to this amazing therapist, but it took a long time till it stop happening where I would look back and think oh my gosh. No, I wasn't better yet, but it's been years and years and years now now I can say, you know,

31:30 Oh hell 8 to 10 years now. I can look back and say well nothing. You know, I'm as good as I'm getting us Post cuz it's not changing anymore and too stubborn to see a psychiatrist I guess but don't let that stuff anybody else. I need I need everybody's come and get help.

31:46 Do you have any advice for family and friends of somebody who has PTSD to help help them give that person the house with their our greatest Ally I'm telling you. That's why I see most of the patients that were acting like me and like I said, I think my wife did a great job and you know, I'm painting this terrible picture of mean people PTSD there's you know their symptoms, but then there's other times and everybody in this thing just like themselves and that's no prep maybe even a majority of the time but then there's a certainly some changes.

32:19 Just continuing to help him to recognize a Google the symptoms. See no call the VA yourself and say I'd like to get some help and you know how I pick up the phone a lot of times and call Veterans just cuz I guess I sometimes the veteran veteran it goes a long way.

32:39 I don't think so miss is when she took a lot more time than I thought we would.

32:51 Okay, perfect. Thank you so much for coming in. Dr. Jackson. Thank you for

32:57 Sharing your story and your time with us. No, appreciate you guys. Give me the opportunity.