“You ever work with vets?” asks the young man sitting across from me in the hospital waiting room.

He’s been sitting there all morning. So have I. Since 5:30 a.m., my father-in-law, 88, has been undergoing surgery to remove a tumor in his lung. The surgeons just sent word that they’ve finished, and my wife and her mother have gone to the post-op room to see him.

Waiting for them to return, my wife’s sister and I have been talking about her son, who’s thinking of joining the Airforce.

“Warn him about the recruiters and their shiny promises,” I say. “Tell him they’re all a bunch of liars.”

“That’s for damn sure,” the man says.

We smile at each other and chat for a bit, then my sister-in-law starts messing with her cellphone, opting out of the conversation.

The man tells me that he was in the army for 20 years, including combat tours in Iraq and Afghanistan.

As we talk, he says things like “You know all about that, don’t you?” and “You know how the army works.”

“I’ve never been in the military,” I say. He looks surprised.

“What do you do?”

“I’m a hospice social worker.”

That’s when he asks whether I work with vets.

“Lots of them,” I answer.

“Combat?”

“Yeah.”

“Do they talk about it?”

“Some do, some don’t.”

He gives me a hard look. “Bet you’ve heard some bad shit, eh?”

I nod.

He looks around to make sure no one is listening. My sister-in-law is absorbed in her cellphone. An older guy snores in the corner.

The man leans toward me. I see he’s starting to sweat; his hands are getting shaky. He’s carrying something, wondering if it’s safe to share it.

“You’re right, I’ve heard lots of rough stuff,” I say. “But it can help to talk with someone who knows how to listen.”

“I have a counselor at the VA,” he says, skepticism edging his voice. “I tell the guy the same stuff every time I go in … I don’t know why I can’t shake those memories.”

“Traumatic memories are different from ordinary memories,” I say. “Is talking with your counselor helpful?”

“I don’t know,” he says. “Funny thing is, the stuff that eats me up the most is more about what didn’t happen than what did.”

I ask if he’s talked with any of his buddies about it. He says no, only his counselor. “I think he thinks I’m nuts.”

“What do you think?” I ask.

He looks around again, feet nervously tapping the floor like he’s ready to bolt.

“Can I tell you something?”

I nod and inwardly start grounding myself, so I can hear whatever’s clawing to get out of him. If he senses that I can’t handle it without flinching or judging, the moment — and maybe an opportunity for some kind of healing — will be lost.

The story he tells isn’t what I’m expecting.

“I was a gunner for a Humvee crew,” he says. “We were bringing up the back of a caravan that was running through a stretch of desert. I saw the dust cloud of a car that was racing toward us.”

He tells how he trains his gun on the car and starts praying for it to veer away. He calculates how close to let it get before he opens up with his 50-caliber machine gun. He waves the car away, shouting, “Back!”

It keeps coming.

He feels his finger tighten across the trigger, watches the car cross that invisible line where his training kicks in and tells him to blow it away. But he doesn’t. He holds fire, then sees the driver’s face — it’s a woman. She suddenly realizes what danger she’s in and slams on the brakes, sending a couple of kids in the back seat tossing forward.

When he gets done talking, he’s rocking back and forth, sweating and tapping a fist into his thigh. I’m puzzled, wondering what’s got him so jacked up.

I lean toward him, take a deep breath, then say, in a way that could be taken as either a statement or a question: “It’s as intense now as it was then?”

He nods. “Can’t shake it. Think about it all the time.”

As we unpack it, he acknowledges that things worked out. He and his buddies were safe; the woman and her kids were safe.

“Why do you think it keeps hooking you?”

“If I’d followed my training, I’d have killed them. I didn’t do my duty.”

“If you’d followed your training,” I say, “the woman and her kids are dead, and you’ve got another kind of memory chasing you day after day.”

He pauses, then says: “My buddies were counting on me. I could’ve gotten them killed. I let them down.”

As we talk, it becomes clear that he walks around with a near-constant awareness that life — everything he knows — can change in a heartbeat. Maybe you have time to act. Maybe you don’t. Even if you have time to act, there are things you cannot know, control or predict. If the car had been carrying attackers, holding fire might have gotten him and his buddies killed. But if he’d opened fire, there’d have been a horrific bloodbath.

Some might explain his hesitation as intuition or some kind of providential intercession; others might chalk it up to nerves. For this guy, the whole thing is arbitrary.

“The dice roll one way, you’re screwed,” he says. “They roll the other, and your life goes on. I was lucky that time, that’s all. Maybe next time my luck will run out.” Clearly, the incident has seared into his mind how quickly the bottom can fall out of everything.

“I have lots of other stories,” he adds. “One time a mortar shell landed right next to me, but it turned out to be a dud. Another time, a guy I knew was sick on the day when his unit got ambushed. Several of them got killed — including the guy who was working the radio in his place. It’s a game of inches, man. It can all change, just like that.” He snaps his fingers for emphasis. “The life you know could be gone.”

Saying this last line, he motions toward post-op. I turn and see my wife and mother-in-law heading our way.

We stand up, still talking, then reach out and shake hands. As we do, he says, nervously, “My wife’s in surgery right now. It’s not good.”

He looks worried. I feel my throat clench.

I think about saying, “These folks here are a crack team, man. Everything they can control, they will. She’s in good hands.”

But I don’t. On one level, it’s true; on another, it’s the kind of easy reassurance people offer to keep from admitting that he’s right — there are always things we can’t control.

I want him to know that he’s not carrying it alone: When I walk away, I’ll be taking some of it with me. So, rather than saying anything, I give him a knowing look.

He holds out his arms. We hug, then I walk off with my family to meet with the surgeon who’ll tell us what he found during the operation.

As we head down the hall, I think about my father-in-law and wonder which way the dice will roll.

Scott Janssen is a social worker. This piece was originally published in Pulse — voices from the heart of medicine. 

Image credit: Shutterstock.com