debridement
on moral injury, and its effects
cw: violent injury, death
Last year, one of my little nephews, a feisty almost-three-year-old with the strength of an ox and an underdeveloped risk awareness, pulled a freshly-poured cup of tea from a kitchen counter all over himself. The boiling hot water got into his clothes and burned down his left hand side; his torso, down his hips and onto his leg; under his armpit, it burned two holes down to the muscle. It necessitated several days in a hospital, and an operation, and traumatised not only him but his poor parents as well. My auntie still has a scarred upper arm from when she, too, pulled a pan of boiling water all over herself as a child. Seeing these scars, or the fresh wounds, I can’t help but feel a frisson of sensation across my skin, a very physical abject fear. Burning is an assault on the physical body, a destruction of the barrier that separates us from the world.
I’ve been thinking of both of these things a lot over the last few days, as my mind tries to make sense of a video that we have, probably, all seen; the video of 25-year old American airman Aaron Bushnell calmly and resolutely burning himself to death in front of the Israeli embassy in Washington DC. Streaming live to Twitch, he explained his reasoning, then set his phone down; from a flask he poured flammable liquid all over himself, then, struggling slightly, set himself on fire.
The video, which quickly spread across all platforms, was, mercifully, blurred. But as a policeman pulled a gun on the burning man on the floor, the man—whose actions, whose self-consecration makes the very presence of the gun risible—continued to scream one phrase until his body could no longer do so:
Free Palestine. Free Palestine. Free Palestine.
There is nothing that can be discussed about a self immolation. I am very aware of the difficulties of writing about suicide, about the heavily ethical burden inherent in any attempt to write about self-injury. It is both fruitless and disgusting for this to become a point of discourse, which, of course, has not stopped it becoming exactly that. I have seen the wildest ‘takes’ in the last few days, judgements laid down from all corners by people for whom activism is posting a graphic or complaining online, people who presume to know what the Palestinian response to this action will be, even when it stands in diametric opposition to what Palestinian groups have actually said. Comments on the act sweep across traditional media, where it is ritually stripped of its context, its intended meaning. The character of the man is discussed and dissected, the history of this kind of act hidden. Still, the act has not changed. It happened. This, alone, is concrete.
Social media has, in many ways, destroyed the way we engage with each other. These platforms that once gave voice to the voiceless are increasingly manipulated by their billionaire owners, encouraging the worst uses of them; the bile, the lying, the insistence that everyone must have a ‘take’, that every moment of your life, all your business and the business of those around you, must be projected to the world. Thoughtfulness gives way to knee-jerk reactions and nonsense critique; we do not climb down from opinions that are illformed, but dig deeper into them, because we have made them public, and now must save face. We see thousands, millions of people commenting, and we feel we must comment too; it is demanded, by some, and derided by others. Social media is a reaction machine, where anything can be fed in, to be consumed, to be ripped apart by its teeth. What we learn is that performative reaction is a normal response to the world. Of course, it is not.
But social media has also changed everything. Now everyone has a camera and a direct line to the rest of the world. No longer do we have to wait for press photographers to arrive in war zones, to send photos and videos that will be selected, censored, highlighted at will by editors. There are no gatekeepers on reporting, because now everyone is a potential reporter. This makes fact checking close to impossible for the average reader, especially when media manipulation is rife. It also means that those suffering can show their suffering immediately, and without censor. For the first time, we do not wait to see what it happening, what crimes our governments are committing in other parts of the world. The victims can tell us, can show us, themselves. We can no longer claim not to know. The moral rot at the heart of our politics is laid bare.
As Bushnell himself said in the moments before he set himself alight, his act, and the video evidence of it, fades in comparison to the unrelenting brutality we have all seen occurring Gaza since the start of October. I have seen things that I will never be able to forget. These things, these unutterable horrors, are woven into the fabric of our regular days. We open up Instagram and, while eating our morning toast, see the bodies of children hanging from walls, the wriggling muscle of legs blown apart, the grey hands of people trapped under buildings that have been levelled by Israeli bombs. Lying in the bath, we see the starving faces of children the same ages of our daughters and sons, our nieces and nephews. We see grandparents murdered, entire families laying dead. We can watch, over and over again, how a sniper bullet tears through someone searching for grain, for a morsel of food to feed their dying relative. We see the leader of the opposition, a supposed human rights lawyer, say that the aggressor has every right to commit this massacre. We watch the days flick by; another week, another month of this indescribable suffering. We can watch as a whole culture is burned, burned, burned to the ground.
I have been thinking for the last four months about the term ‘moral injury’, a phrase coined by American psychiatrist Jonathan Shay some time in the 1990s. The term was first used to describe the specific type of trauma, seen most often in combat veterans, arising from committing or witnessing actions that go against our ethical values—or as Shay puts it, the ‘betrayal of 'what's right' in a high-stakes situation by someone who holds power’.
Other psychologists (Litz et al., 2009) have elucidated; moral injury occurs when someone is:
perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations [which] may be deleterious in the long-term, emotionally, psychologically, behaviourally, spiritually, and socially.
For the Vietnam War veterans that Shay worked with extensively, this moral injury occurred when they were forced to confront their very active role in a largely pointless American aggression against a predominantly civilian population; whether conscripted or volunteering, many were confronted by the realities of US violence, and their place within the war machine. But it was just not returning servicemen that felt these injurious truths; the Vietnam war was the first to be televised, on film developed in Tokyo and flown to the US to by shown on the news. This largely uncensored footage showed civilians, for the first time, the realities of war in (close to) real time. It was no longer happening ‘somewhere else’; it was happening in front of their very eyes.
On June 11th 1963, as the US escalated its activities in Vietnam, Buddist monk Thích Quảng Đức died by self-immolation in protest at the persecution of Buddhists by the US-aligned South Vietnamese president Ngô Đình Diệm. That morning, the international press had been briefed that something momentous would happen outside the Cambodian embassy in Saigon. The photographs taken by the US correspondents were published around the world.
I think about the term moral injury when I talk to friends about the things we have seen, the things that are happening in Gaza; I think about it when another person tweets that they have just witnessed, in high definition, something that they will never be able to wipe from their memory. Many of us who have seen these things march alongside our neighbours in the tens of thousands most weekends; we write to our politicians, we stage sit-ins, we do whatever we can do shout our dissent from what our governments are supporting. But our governments, our structures of justice will not allow for dissent; they will not name, nor stop, what is happening every day in Gaza. We find ourselves powerless. And still, we witness.
I will no longer be complicit in genocide, said Aaron Bushnell before embarking on his final project. This is what our ruling class has decided will be normal. For this man, an American serviceman, the destruction of a people, done in his name, was too much to bear. Whatever we may have to say about it is moot. A moral injury was felt in the most acute way. The moral rot here is festering, and this is happening in one way or another, to all of us, whether we we have numbed ourselves to it, or whether we feel it in the many layers of our skin.
I have been thinking a lot about the gun and the flames. About how the military-industrial complex and its domestic arm, the police force, know only aggression. To pull a gun on a man burning himself to death is literally pathetic; miserably inadequate, as the dictionary puts it. How can you threaten a man who has already killed himself? But it is also what the system knows; when there is dissent, the response is always violence. Even when the dissenter is dead.
It is undeniable that something has shifted in the soul of the UK this last four months. If Vietnam was the first televised war, Gaza has been the first live streamed genocide, the first atrocity in which the victims have been speaking directly to us, showing us their horrors, the horrors our governments are helping to commit. While we have witnessed these atrocities, we have also seen our elected representatives stand up, over and over, in support of Israel and its right to commit them. The usual lies about the situation of Palestinians have been cracked and broken; the truth, and our role in it, is there for us all to see.
The treatment for severe burns is a painful but effective one: debridement. The removal of necrotic tissue, of bacteria and rot. Through an often agonising process, the rotting tissue is removed from the site of the injury, giving the skin the ability to heal, to make itself better. Without debridement, the necrotic tissue causes even greater infection, creating even greater pain and injury, leading to complications that can plague the victim for life.
My nephew’s burn has already faded to a milky mark; as he ages, it will heal completely. My aunt’s burn marks still remain, six decades after the fact. Debridement is incredibly effective—but only if you can treat the injury quick enough. If you leave it too long, the rot sets in, and then, we are all scarred.
Thank you for writing this piece Debridement - what a cruel and necessary healing.
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