Music Credit: “Desolation” composed and performed by Todd Barton, used courtesy of Valley Productions.

Music Up

Fred Foote: “Bonded” is about two soldiers who were friends as civilians and they joined the same unit to go to war together and ended up with the following. “Bonded”: “Loader and gunner, brothers from boot-camp days, they came in one platoon to the shock of the war. Daily they clung together for strength and grace. Each promised to bring the other home once more. Now, both return two versions of amputee. It’s back to Lejeune, driving the truck with one hand, learning the truth about girls. Will they tend and cleave or turn with regret to find an unblemished man? The road treks hard through rehab, shrinks the VA, edged nights that dream of friends who couldn’t be saved. The hale will dance and run. Few will know what to say, and pity’s worse than contempt to the souls of the brave.”

Jo Reed: That is poet, doctor, and retired Navy Captain Fred Foote, reading his poem, "Bonded"...it's from his collection Medic Against Bomb and this is Art Works, the weekly podcast produced at the National Endowment for the Arts. I'm Josephine Reed.

Fred Foote served 29 years in the U.S. Navy as a neurologist. Apart from 6 years at sea, he spent much of his career at The National Naval Medical Center (now the Walter Reed National Military Center).  His focus was healing the “invisible wounds” of the Iraq/ Afghan wars, brain injury and posttraumatic stress disorder.

Although Fred Foote retired from the Navy in 2009, he still continues to work with service members through the Walter Reed Arts Program,  the Warrior Poetry Project, and the Green Road Project, the nation’s largest hospital-based healing garden.  He also continues to explore the capacity of the arts and nature to heal trauma as a Scholar at the institute for Integrative Health.

It's little wonder that Doctor Foote's holistic healing practices focuses on the arts.  He himself has been writing poetry his entire life and knows first-hand its healing power as he recalled his own experiences on a hospital ship taking care of wounded Americans and Iraqis.  His poems about that time have been gathered into a collection called Medic against Bomb: A Doctor's Poetry of War. Medic Against Bomb is a n important work that is both honest and compassionate. Searingly written, it honors the valor of the people who serve without shying away from horrible damage that war inflicts on everyone in its wake.

I spoke to Fred Foote recently just at the book was getting published. Here's what he told me about the writing  of Medic Against Bomb.. 

Fred Foote: Well, first of all, poetry’s been my first love ever since I was a kid, and I’ve been writing pretty seriously and publishing since 1995, but one of the big experiences of my poetry was going to the Iraq War with the hospital ship Comfort in 2003, and that-- we took care of both American wounded and Iraqi wounded, interestingly, and it was a tremendous, powerful, emotional experience that drove me to write the poems in “Medic against Bomb.” So I started writing in 2004, other projects came and went, but I couldn’t let go of it. New types of poetry kept coming, and it’s only a year ago that I finished the book and submitted it to a publisher. It won a prize and we’ve already sold out of the first printing, even before the publication date, so I have just received my second run.

Jo Reed: Congratulations on the prize. Congratulations on selling out of your first run. That is really cool. Did you come to medicine first or the military?

Fred Foote: It was all at once. What happened to me was I was a military child, so these are my people, and I was just going to be a poet when I was a teenager, but I had an emergency appendicitis operation at the hospital where I now work, then Bethesda Naval Hospital, now Walter Reed National Military Medical Center in Washington. And I was stuck for three weeks with a bad abdominal infection on a ward with 39 shot-to-pieces Marines from Vietnam. This was 1967.

Jo Reed: How old were you?                    

Fred Foote: I was 16. I had never thought of going into medicine, but the suffering and the terrible wounds and injuries on that ward drove in to enlist myself as a medical corpsman, a Navy medic, and that’s what led me into medicine. So you could say not only did this sort of military experience make me a physician, but it actually made me a physician at the hospital where I spent most of my career, Walter Reed National Military Medical Center.

Jo Reed: Fred, you’re a neurologist, from the first Iraqi war in 1991 to 2003 when you were last over there, how have the injuries changed?

Fred Foote: This war’s unique, because the enemy uses bombs instead of bullets, and we don’t have many bullet wounds. Plus we have body armor. The wounds of this war are very new, and they are brain injury from having your brain shaken by bombs and also post-traumatic stress disorder, where we have very high rates. And probably, although we can’t be 100 percent sure, it’s related to how many times people have had to deploy to the warzone. In past you might go once, but many of our troops go three, four, even five times to the war. So this really puts an added strain, and for brain injury and PTSD, pills and surgery don’t work all that well. That’s our conventional medicine. So as we built the new Walter Reed flagship hospital in the last 10 years, we’ve had to invent a new kind of medicine that we call holistic care, and that’s not pills or surgery but things like nutrition, exercise, stress management, alternative medicine, things of that sort that in the past used to be considered kind of touchy-feely, but we’re learning that these things are what heal brain injury, PTSD. And, most notably, I’ve done several projects at Walter Reed on healing wounded soldiers with art and music and with gardens. We have created a major arts program with 15 salaried artists and several, many volunteers and several paid coordinators at Walter Reed, and just about all our wounded soldiers now are making music, learning to play, making art or some other art, and it’s getting them better in a way that pills and surgery has not done. I’ve been involved with that, and part of my book is to get that message out and encourage the civilian sector to adopt arts programs for warriors with PTSD in a way that communities can take care of their own vets right at home.

Jo Reed: I just want to be clear. You have retired from the military. When did you retire?

Fred Foote: I retired in 2009, but I essentially just kept on with the same work for less pay. But, I don’t speak for the federal government here. I am employed by a nonprofit. I’m a retired doctor, and so my words are not those of the government.

Jo Reed: And which nonprofit are you a part of?

Fred Foote: It’s the Institute for Integrative Health in Baltimore, which is kind of a think-tank for holistic care, one of the most advanced and best in the country.

Jo Reed: I want to backtrack just a bit here. When did you first begin to become involved with holistic healing? Because, let's face it, the old M.O. used to be you went to war, you came home and you shut up, and that was what was expected in some ways. And obviously it didn't work but that didn't change for a very, very long time.

Fred Foote: I had an interest in some of the holistic care, the healing buildings for example, is one element of holistic care because it treats the whole body. So is family centered care as it treats the whole person in a social media. So  I had been working on some of those things for Walter Reed hospital from 2000 onto 2003. The I went out to the wars for a couple of years. All of a sudden a new hospital project emerged that we were going to combine Walter Reed and Bethesda Navel on the campus of Bethesda with multi-billion dollar funding. And we wanted it to be the kind of place that really could treat PTSD and brain injury, so I was kinda yanked back to Washington by some admirals who trusted me, I guess, and I was set up to be some sort of advisor on holistic care as we built the new hospital from 2006 'till the present. Didn't have any authority over anything and that was probably a relief to most people but I was able to put some ideas into the mix that I think were helpful.

Jo Reed: And when did you begin to see that art and music could and should be a part of this?

Fred Foote: We always felt it in our hearts when we did little pilots. The big programs, the Walter Reed Arts Program, was created between 2008 and 2011, and it’s now been flying pretty well for two, three years. And then the garden project is-- we built a number of smaller gardens. We saw great results from being in nature, and the big Green Road project will open next year. So we’re seeing the advanced research that is going to give us very, very clear data of how much this helps.

Jo Reed: Well, you’re involved in many ways with veterans and art. You are the poetry editor of “Zero Dark Thirty,” and you’re also the poetry editor of the Veterans Writing Project, and you’re one of the founders of the Warrior Poetry Project.

Fred Foote: Yes, and the Warrior Poetry Project is just gathering staff and warriors and everyone at Walter Reed for weekly poetry classes and workshopping, and we’ve gotten a lot of our poets published, and I just had my first one retire from the Army and go into an MFA program in New Orleans. So I’m very pleased with that. I want to put in a little plug for the Veterans Writing Project, which was founded by my good friend Ron Capps. They hold workshops across the nation to help wounded warriors and others under stress express themselves through writing and heal themselves through writing. “Oh Dark Thirty” is the literary magazine. We are always looking for submissions. I’m the poetry editor, and we want any kind of literary work from a veteran or first-degree family member of a veteran.

Jo Reed: So, just to have a happy recap, the Warrior Poetry Project is situated physically at Walter Reed.

Fred Foote: Yes, it is.

Jo Reed: The Veterans Writing Project is national.

Fred Foote: That’s correct.

Jo Reed: And “Zero Dark Thirty” is the magazine, the online magazine that comes out of the Veterans Writing Project.

Fred Foote: It is.

Jo Reed: Well you mention Ron Capps, your collegue at the Veteran's Writing Project. I was lucky enough to have him as a guest on this show and he said, “You own the story or the story owns you.”

Fred Foote: Very true, and we do hear from vets that when they write the story, they get a measure of control over it, and another veteran said to me that, “You know what? I feel like if I write this down, the memory becomes something I can put in a drawer along with the written paper and close that drawer, and I only have to open it when I want to.” So, it’s a mystery how art heals trauma, but we know that it does heal trauma, and we’re developing advanced research that will prove that over the next few years.

Jo Reed: Well, here’s another poem I do want you to read that speaks in some ways to that, “Doctor’s Amnesia.”

Fred Foote: As I said, we did have some Iraqi patients, and in modern war a lot of the wounded are-- even with an army like ours that tries terribly hard to avoid civilian casualties, in modern warfare the women, children and old men get hurt. And this is one poem called “Doctor’s Amnesia” about something that actually happened to me personally related to seeing a Discovery Channel show about the ship, so “Doctor’s Amnesia.” “It can’t be rare these days. After the wars, watching Discovery Channel safe at home I saw a back I knew from angled mirrors. Those pinched, frenetic features were my own. And then the blow of memories return, unbearable burns, charred from the waist on down, scrubbing so fast my fingers seemed to blur. The speech that cries immediate yet far were all as if you viewed them on TV. I saw the things prime time would never see, caught by the cameraman beside the bed. The child was just the age of my own son.”

Jo Reed: And tell us how you came to write that poem?

Fred Foote: Discovery Channel had a cameraman on our hospital ship, and I was sitting at home watching a Discovery Channel program on the ship and it was showing our emergency room, and I said, “Wait a minute. That doctor there working on that child looks kind of familiar,” and then I realized it was me. See, the war medicine is so traumatic that you suppress the memories of things that’re really painful, and many, many memories like that will be locked away until something triggers your recall.

Jo Reed: And that’s where perhaps poetry, music, art of some kind can be a way of controlling that memory so that it doesn’t control you.

Fred Foote: Yes, absolutely true. And so there wasn’t any doubt with that poem for me personally was cathartic, and it helped me separate the memory from me and make it be something that I could use instead of that overwhelmed me.

Jo Reed: I would think for a doctor it becomes even more complicated, because your entire profession is to heal people, and here you are in an arena where things are being blown up all the time.

Fred Foote: Exactly. And from a personal level, I think most of my colleagues would agree. It’s the most toughest and most painful experience of their whole medical career, because there’s really never a good day. They’re bringing in so many wounded and hurt people, usually you’re at the top of your game. You’re doing miracles. You’re doing better stuff than you ever dreamed. But the sheer amount of ruin and disaster is so great that it’s like you’re throwing a handful of sand in the ocean as far as what you were able to rescue from it. My book does celebrate many of the miracles wrought by our healers, and maybe I’ll read another poem, if you want.

Jo Reed: Please do.

Fred Foote: So this is another one about the Iraqi wounded, and the Iraqi wounded on our hospital ship were terribly-- they were simple villagers whose lives had been shattered, their homes destroyed, their children killed, themselves wounded, all their clothes blown off and then flown to this very strange environment of Americans, where, actually, no one spoke their language. We had only one interpreter for a while. So, they were very shattered people. They were like people who had lost their soul. One of the great works of healing was done by a Navy doctor named Commander Pat McKay, who was a hand surgeon, and this just tells about the work of healing that she did for the Iraqi women, and it’s called, “You Gave the Iraqis Their Scarves.” “When limbs are lost, who stops to think of clothing thrown away? Who knows the shame of sheltered girls on sudden public display? And so within the noncombatants ward, they neither prayed nor shrank from pork but showed their skin with vacant-eyed sangfroid, knowing that since the world had burned alive, it didn’t matter. You came out of the OR night after night and wrote your orders just as the men would do, but then, instead of clumping off to bed or getting drunk on bootleg DVDs, you’d find a place no one could observe, bring out an ancient Singer sewing machine and squares of silk left over from a quilt the nurses made to celebrate our work, and there each night, like the breath of a word, you’d sew, quietly sew, as the ocean weaves a reef together after a storm, binding polyps with tiny fish, bringing grass back together with stone, with overflowing largesse of patience. The day you brought the scarves down, they pressed your hands, and those not maimed tied scarves around the heads of friends who couldn’t move, silk to die for, new to those dust-colored homes only the F-18s had deemed worth bombing. Those who thought they could no longer weep wept to feel the touch of simple cloth, and they were once again sacred women.”

Jo Reed: I’ve read that. It’s such a beautiful poem.

Fred Foote: Thank you. It’s a favorite.

Jo Reed: It’s lovely and a beautiful moment.

Jo Reed: Very good. I do want to talk to you about the way you read your poems. You don’t read them; you recite them. Tell me why.

Fred Foote: It’s partly because I feel I owe it to the poem. A poem comes as a gift, so I must earn it. I must earn the gift whenever I say it, and the way I do that is to put myself through the labor of saying the poems over and over and over again until I am able to say them from memory. That’s part of it, and basically the other part of it is that poetry is never safe, and by always going up without a script, I put myself in a risk situation. I can always screw up. In fact, I lost a couple lines the ones I said for you already, but I covered it up. And this just teaches me that poetry can never be safe. There is no safe position. It is always risk that help keep you honest as a poet. Society is going to criticize you if you’re a true poet. The government may not always like what you do as a poet, and poetry itself can turn and bite you like a snake in a most astonishing way. But if you’re committed to poetry, you love that risk. You take that risk. And so, speaking from memory is one way that I keep myself kind of in that mode.

Jo Reed: And you’re also more performative than many poets, and I don’t mean that in a derogatory sense at all; I like it a lot. Tell me why you do this.

Fred Foote: I’m actually very shy, but, number one, my emotions are so stirred by the poems I love that I can’t help pouring it out. And so I try to do as much of that as I can with my own poetry. In a broad audience, there’s a lot of folks who like to hear some very emotional declaiming of poetry. It adds something. And then nowadays there are so many ways to enhance poetry. I do many events, and I’m launching this book now with events, and usually I will take photographs of the wounded and project them on the walls along with the words of the poem and kind of recite them in the darkness. That’s how multimedia can be very, very powerful. To take advantage of multimedia is a tremendous way to augment poetry and of course hip hop is all about that, right? I am far from being a rap artist, and my efforts and workshops to do rap have been greeted with laughter, deservedly, but nonetheless we can learn a lot from hip-hop art in the area of emotion, of use of other media and creating a powerful performance.

Jo Reed: When did you begin to write about your own experiences?

Fred Foote: Probably I began with the war poetry in 2004, after getting back from the cruise of the hospital ship Comfort, where we actually took care of the patients.

Jo Reed: Another issue with this war is that because such a small percentage of people are affected in a firsthand way by the war, there is a sense of the rest of us just not really getting it.

Fred Foote: Exactly, and only about one percent of U.S. families have a close family member in the military, so there is a gap in understanding. It’s kind of hard for the civilians to understand what being a wounded warrior’s like, and that can make people hesitate before they try to help the wounded warriors. Part of the mission of my book is to bridge that gap. Because poetry is very concentrated and emotional and focused, and that really does help them to understand what our soldiers put up with and ya know we're using that to raise money for both the arts program at Walter Reed and for our 4 million dollar Green Road garden project which is the Nation's largest healing garden. So it really does seem to help people to bridge the gap and helps them to engage and inspires them to engage.

Jo Reed: Well, if that isn’t a lead-in to a poem, I don’t know what is.

Fred Foote: So this is a poem from the book and it’s called “The Man in the Wound.” “Quiet the ward. Quiet the dressing cart now. Quiet the morphine drip. Blest is your pain. Turning his head as I pass, he says, ‘Hi, Doc,’ asks if I’m workin’ too hard. I look beat, overstrained. His wound came at Nassaria, and I was not there to shield him from bullets in flame, being safe in the rear, yet his thought is always of me, the nurse or the friend, sometimes even the enemy soldier he glimpses or hears. With arms laid waste, he finds no reason to hate. His comrades now are all who grieved and withstood, just as the wound proclaims the hell all have made. The man in the wound is raised, shown peaceful and good.”

Jo Reed: That poem makes me mindful about another factor in this war, and that more and more people are surviving horrendous injuries that would have killed them 20- 25 years ago, and obviously there is much to be thankful for there but it also opens up a whole raft of issues as well. Can you talk about that?

Fred Foote: See, these are ironies, right, and war is full of irony. And one of them is that the more miracles you do in saving, the more suffering the person has when they return home, because they have more disability. And in particular, our great body armor that we’ve developed for this war has saved people from bullet wounds, only to leave them vulnerable to brain injuries that cause even more suffering. Other ironies: As a military physician, my job was to get people better, yes, but largely to get them better so that they can go back to war again. And many of the investments, even in holistic care, may have that outcome, because the sooner you can get a soldier back to good health, he’s immediately going to want to go back to the war. We’ve sent more than 50 troops, Marines and soldiers and others, back to the war to combat with amputations, and they’re working out. They do great. The prosthesis is so good. So these are some of the strange ironies, and then for me the biggest irony is that in times of peace, medicine just kind of ticks along. You keep on doing what you’re used to. Most of the great advances of medical art have occurred from wars, when it’s a crisis situation. You got to get people better in a hurry. The current tremendous increase in the power of holistic care, including art and nature, would never have flowered if we had not had the war and the need to be able to treat brain injury and PTSD with new types of therapies. So, to live in this world is to live in a world of paradox.

Jo Reed: I'm curious about the writing and poetry workshops. Is it difficult for veterans to be in a room of strangers? They all might be veterans but they don't know each other, and they don't know you really. Are they reluctant to write and read their poetry to one another? I mean it's so personal.

Jo Reed: And what about the warriors themselves? Is it difficult to be in this room with people-- they might be veterans, but they don’t know them. They don’t know you, really, and to then write and read their poetry? I mean, it’s so personal.

Fred Foote: And that’s where our camaraderie thing comes in, because in the military we all kind of live for each other, and our troop are just totally used to gathering in groups of 8 or 10, shooting the breeze, helping each other get over tough experiences. That’s how they live their lives. That’s what an infantry squad is. So I think we get some military dynamic in our writing workshops and other arts engagements that if you get a few vets together, they kind of help each other and they feel very comforted by each other’s presence.

Jo Reed: And I would also think that one veteran's poetry could trigger a memory in another vet.

Fred Foote: Trauma is trauma no matter who gets it, and it never goes away completely. The goal of helping folks is to get them functional, that they’re not crippled by their memory, and to give them a way that they can turn it into beauty and into meaning. So, very definitely civilian audiences also may identify a lot with some of the poems and have powerful experiences based on that. One take on message would be, hey, if you have a civilian person with PTSD, a victim of trauma, it’s probably going to be very helpful for that person to make art, learn to play music or build a garden.

Jo Reed: It just seems like good advice for us all, frankly. Make art. Build a garden. It’s a good way to live.

Fred Foote: It is, and for the medical land, taking pills and surgery can cause harm sometimes, but not too many get harmed by making art and music or by building a garden, this is a very safe and very inexpensive and very effective form of medicine, and it will join the medical armamentarium officially very soon.

Jo Reed: I think we are going to need a final poem from you. What about, "Blood Brothers?"

Fred Foote: "Blood Brothers," ok, “Blood Brothers.” “The fight swirled down from the roof where the troops went in, and somehow amid confusion and acrid haze, these two fell down together. A beardless Marine poured out on a young Mujahedeen killed by grenades. The air still rings that this is what we give to attain our ends, but where their comrades grieve on sandaled feet or armored knees, there lying thus, beneath the guise of those who guide but don’t draw aim, renders them clear in ways the fire creators can’t conceive. Not dead for freedom, love will build that another way. Not dead for faith, denier of all misdeeds. The evil is never the necessary. Each one killed is a ruin of peace.”

Jo Reed: And that’s where I think we’ll leave it. So, Fred Foote, thank you so much. It really is a tremendous book of poetry, and the work you’re doing is phenomenal.

Fred Foote: And may I give my e-mail in case anyone has a response to this?

Jo Reed: Absolutely.

Fred Foote: My e-mail is Fred.Foote@comcast.net. Sometimes I hear from folks after a radio broadcast, and I would love any of your listeners to talk to me.

Jo Reed: Thank you. Thank you so much for coming. I really appreciate it.

Fred Foote: It’s always a pleasure, Jo.           

Jo Reed: Thank you.

That was poet, doctor, and retired Navy Captain Fred Foote we were talking about his recent collection Medic Against Bomb: A Doctor's Poetry of War.

 You've been listening to Art Works produced at the National Endowment for the Arts. 

To find out how art works in communities across the country, keep checking the Art Works blog, or follow us @NEAARTS on Twitter.

For the National Endowment for the Arts, I'm Josephine Reed. Thanks for listening.

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