Operator Syndrome: The Hidden Cost of Service feat. Dr. Chris Frueh | Ep. 16 - The Clay Travis and Buck Sexton Show

Episode Transcript
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Speaker 1 (00:04):
Today's a day that hits me like a ton of bricks.
It hits me in a way that it's really difficult
to put into words. It's a thousand cuts across my heart.
It's swimming through a river of glass in my mind,

(00:28):
and it's being tied to a cinder block, being drowned
in a sea of tragedy and sorrow. And that's what
Memorial Day is for me, because as I imagine all
of my close friends and teammates that have died over

(00:52):
the last twenty plus years in the g WATT, it's
the memory of those men and what they've meant to
me is inescapable as is their death. Now to compound that,
it's also profoundly impactful that I think about all of

(01:17):
my friends that have ultimately killed themselves as a result
of their experiences fighting for this country, and I look
at their tragic loss as almost identical or even more
catastrophic than the men who actually died on the battlefields.
And so, as I welcome today an individual on the show,

(01:41):
doctor Chris Free, I want you to realize that this
man has been personally responsible for my ability to manage
that sorrow and that heartache, and he hasn't just done
it for me, He's literally done it for hundreds of
other men women that are affiliated with fighting for your freedoms. So,

(02:05):
without further ado, I'm so privileged and honored to welcome Chris,
doctor Chris Free to the show today to discuss Memorial Day,
operator syndrome and what we can do to help our veterans.

Speaker 2 (02:23):
So welcome Chris, Thank you, Thank you David. Great to
be here. Great to see you again and be continuing
this conversation we've been having now for man nine years,
ten years.

Speaker 1 (02:38):
Going up about nine about in twenty sixteen.

Speaker 2 (02:41):
Yep, yea.

Speaker 1 (02:44):
Before we jump into all the aspects of the impacts,
the specific medical and behavioral health impacts on veterans, and
your expertise on managing, treating and we're helping guys work
through those coaching them. How does Memorial Day impact you

(03:06):
and what does it make you feel? Because I know
you have some deep ties to within your family as well.

Speaker 2 (03:14):
I remember my great great great great great grandfather Brocklebank,
who was killed in the literally in the fifteen hundreds
in the King Philip Indian War. His progeny, my great
grandfather served in the Battle of San Juan Hill in
Cuba in eighteen ninety eight, and he lived, survived that battle,

(03:35):
came home, and I knew him. He lived to be
almost one hundred years old, so I knew him when
I was fourteen years old. He died when I was
about fourteen, so I knew him quite well as a
child and knew his story. And it was a profound
impact on me, not just his service, but how he
was received and helped when he came home to back

(03:57):
to the US after the immediately after the war. And
I don't know how deep you want to go onto
those stories, but the essence of it is is he
was not doing well. None of the men were. They
all had mosquito borne illnesses. And they were dumped at
a hastily built camp up at the tip of Long Island,
and they were all sick with mosquito born illnesses. And

(04:20):
it was this muddy field. It was a national disgrace.
The President the United States went up to see what
was going on there, and to the end of his life,
my great grandfather always said that it was a civilian
woman who saved his life who went up. A wealthy
woman from New York City went up in her horse
drawn carriage with her butler, picked up four or five

(04:43):
six guy it was five or six guys, took them
to her home in the city and nursed them back
to health for six or seven weeks, and then gave
them train fair to get home to wherever their home was.
And so that was at a time when soldiers were
we're taken care of by civilians. There was a civilian

(05:06):
contribution to that, a recognition of a civilian duty to
honor and take care of and help out our veterans.
And I think we've lost that a little bit today.
I mean, we thank service members for their service on airplanes,
we do some fairly wrote kabuki things here and there.

(05:28):
But I do hope more Americans are thinking this month
and this this Memorial Day, are thinking about those who
made the sacrifices and the ultimate sacrifice on their behalf,
because I think it gets lost in the in the
barbecues and the and the social events too often. I'm sorry,

(05:49):
go ahead, Well, We're just going to add My father
was a Vietnam veteran, and so I grew up. He
was a physician, not a combatant, but he was in
the Air Force, and so he was in Vietnam, and
I think sixty eight, nineteen sixty eight, and so in
the early seventies I grew up, you know, as an
adolescent kind of in the shadow of that war, his

(06:12):
perspectives on it. I knew many of the Vietnamese I
don't even know what to refer to, how to describe it.
There was a large Vietnamese expat community in Columbia, Missouri,
at the University of Missouri that my father kind of
engaged with to help them with their graduate studies, and

(06:33):
so I had an awareness of that. And my father
helped a man named mister Long who was working on
a dissertation and something I don't even know what. But
in return, mister Long babysat for us. He was our babysitter,
and he was our favorite babysitter. However, tragically, he went

(06:53):
back to Vietnam in nineteen seventy five after the fall
of Saigon, hoping to find his wife and his two
children and to bring them to the US, and he
was scooped up and summarily executed by the North Vietnamese government.
And so that had a profound impact on my childhood.
So part of my story is that was that became

(07:14):
my why, that became my goal. I've never served. I
was raised primarily in a Quaker faith with a kind
of a conscientious objector encouragement. But I went to graduate
school in nineteen eighty seven to become a political psychologist
with the goal of working with veterans.

Speaker 1 (07:32):
I mean specifically, that's that's exactly what you wanted to do.
And what was it was it to? I mean, obviously,
you know, I think I we all. I think if
people take a moment and they they allow their lives
to kind of be pressed on, put on plause or
all their own problems, their own turmoils, and they stop

(07:56):
and they engage in you know, these really intense stories
about sacrifice and dying and overseas, and you know, and
you process the numbers and you process the impact of war,
and it's uh the tributaries of suffering that it it
ensue that ensue from it. You know, I think it does.

(08:20):
It certainly sparks a generational idea to go back in
and to serve, and it sparks other people to acknowledge
that support. But you know, to really lend to ignite
a desire in a career in your field, why why
was it?

Speaker 2 (08:40):
Like?

Speaker 1 (08:40):
What what about did you think that you were going
to able to do for for vets?

Speaker 2 (08:46):
My father talked about the psychological cost of war a
lot when I was a child, and I'm never really
sure how much of his own experience he was talking
about he but he certainly talked out kind of the
toll on men's psyche who'd been to war and come home.

(09:06):
And so nineteen eighty seven, when I started graduate school,
I had never heard of PTSD. It was not a
it was a disorder that had just been added to
the psychiatric nomenclature in nineteen eighty so it's a brand
new disorder. There was almost no research on it. I

(09:28):
learned about it early in graduate school, and I was like,
I want to you know, that's what I want to do.
I want to study that. I want to get involved
in that. But I would say even before that, just
had a sense that there were profound effects on the soul,
which I today would refer to as existential. Existential you know,
thoughts and concerns that have powerful impacts, not necessarily psychiatric

(09:55):
symptoms even and I think that maybe something we could
get into today. But I don't like the idea of
turning every everything into a psychiatric symptom. You know, you
have grief about the men you lost, the brothers, the
comrades you lost. I don't view that as necessarily a
psychiatric symptom. You have thoughts about, you know, humanity and

(10:18):
the horrors you've seen, the you know, the incredible feats
of bravery and honor that you've seen, and you know
all of that. I don't think of that as psychiatric
symptoms necessarily. We talk about shame, guilt, survivor's guilt. The
phrase moral injuries is often used today. Are those psychiatric symptoms?

(10:38):
I'm not so sure that they are. Maybe maybe there's
a then diagram overlap, and maybe they kind of move
into it for many many people. But I don't think
it's as simple as as we've come to believe. And
so maybe just to put this right here at the
very beginning of our conversation. While I am considered by
many to be a so called expert in PTSD, and

(11:01):
I've done published hundreds of research studies on PTSD, I
think we have way over relied on this diagnosis to
the detriment of so many other things. And in part
that detriment is about once we identify you as having PTSD,

(11:23):
we think we immediately have the answer for what's needed,
and we prescribe you and it's like it's like a
depressant medication, psychiatric medications. We assign you to therapy or
we refer you to therapy, and then we kind of
stop there. We don't test your blood for hormonal levels.

(11:43):
We don't necessarily do a sleep study. We don't necessarily
go deep on the chronic pain that you're likely to
be experiencing in your body. We don't necessarily ask you
or talk to you or work with you about perceptual
impairments to vision and hearing balance. We may not we
may not go deep or even at all into cognitive dysfunctions, headaches,

(12:06):
things related to traumatic brain injury. And so maybe I'll
take a breath there. That's kind of where that's kind
of where I'm at today, and that that's kind of
where I started early on in my career.

Speaker 1 (12:20):
It's well, I mean, when you think about when I
hear the term PTSD, and and then I think about
the iliad, or I think about the stories from World
War One and shell shocker, I think about you know,
similar uh stories from the Battle of the art ends.
You know, these ideas within combat have been are eternal, right,

(12:45):
there is there as old ass combat, as old as
combat itself. And so what I what what I love
about how your assessments have emerged. And we'll get to
the specificity of of how that took place with your
coaching and your counseling. But it's like, it's like and
this is something that I've really been thinking a lot

(13:08):
about over the last you know, a couple of years,
in particular, as after I lost one of my closest friends,
Dan Cirillo, died of a heart attack at fifty, I
was like, well, you know, why is my life so
perpetually infused with death? And I get it, I understand

(13:28):
that death is an inevitability for us all, but we
really have this concept, this idea, this culture of death
that we exist in it and it's relative to the
training we go through, the mission sets that we go on,
the experience of war itself, what takes place afterwards around it,

(13:50):
you know, this culture of death. And I was wondering
if if you could just you know, talk a little
bit about that as as you know, you reference that
you know, a lot of the subsequent challenges that that
we we suffer from are are not definitive psychiatric diagnosis

(14:12):
or or they can't be shoved into some type of
of of paragraph in the D S M. Five or
whatever it is. These are These are much broader and
and that culture of death is is a much larger thing.
Could you could you just talk about that a little
bit and then perhaps lead into what you learned when

(14:33):
after you actually let's just talk about that first.

Speaker 2 (14:36):
Yeah, okay, Well, can I read a Can I read
a sentence first? Please? And this is this is from
a book that I wrote last year that you that
you know well, to my brothers. This is the quote
to my brothers, the season of death is again upon us,
and once again it is incumbent on us to thwart
its grasp. Those are your words, brother, you wrote though,

(14:59):
would you wrote at it the in the forward to
the book. And I think this has been I mean,
we are talking about a generation of men and women
when we talk about the global War on Terror, and
specifically about military special operators who have had you know,
many of whom have had ten twenty years in the war.

(15:21):
But of course not only not only operators and I
use the word operator a little bit loosely. We have intelligence, paramilitary,
we have SWI, swift boat you know, operators, we have
EOD technicians, we have all of those who served in
the combat arms and did most tours of duty and

(15:43):
trained with you know, anything that exploded and made loud booms.
And so we've we've had a generation of men and
women at war for over twenty years now, which is unprecedented,
a word I don't like to hear very often, but
in this case, it's actually true, and it's probably true,

(16:03):
certainly true for Americans, and it's probably true for you know,
if we look back through the history the ages of
our of humankind. Twenty years at war is just you know,
it's just a massive thing. So that the level and
the amount of death that you and your comrades have
seen have been a part of training deaths, combat deaths,

(16:29):
and then the deaths of men and women who died,
you know, after they came home, after they were done
with their service. Some of that is suicide, a lot
of suicides. We've had far more suicides than we've had
combat deaths in the Global War on Terror. Or we're
losing six thousand American veterans a year, which is just

(16:54):
an ultimate tragedy. We're losing people to substance abuse, We're
losing people to just know Dan Cirillo, he died of
a massive heart attack. I mean, then you think about
the incredible level of stress and anguish and physical pain
he had been living with up to that point. Can

(17:15):
we call that that death up? You know, and it's
you know, a result of his combat I you know,
I don't think I don't think you could argue against that.
We were at a funeral a few years ago Tyler
Black died after died of a blood clot after a
routine knee surgery. But you go, well, that's not combat related,
except that it was his twentieth orthopedic surgery. You know,

(17:38):
he rolled the dice so many times, and his orthopedic
injuries certainly came from his as military career. So the
death is ever present, and it's continuing. We're losing men
every every day, every week, every month, every month, I
hear I get a phone call from from a friend,

(17:59):
from a come from somebody I've talked to work with.
No well, and they're calling because they're at a service
or they're driving to or from a service. I think
twice in the last ten years I've called you randomly
out of the blue and you were at a service
or I want one. You were in you were in

(18:19):
the funeral progression in the funeral, you know, progression for
Scottie Wurtz, and another time you had just come out
of a service for for Dave Hall who had taken
his life. It's just zever present and it's massive.

Speaker 1 (18:35):
There was a point where you had decided that you
weren't going to work with the VA anymore, and you
kind of moved away from them, and then you started
coming back you wanted to work. Can you can you
describe kind of that those transition points, one walking away

(18:56):
from the VA and then two the coming back to
wanting to serve veterans again.

Speaker 2 (19:02):
Well, okay, so I started. I finished my degree in
nineteen ninety two, and my first job was right there
at the VA in Charleston, South Carolina, not at Queen Vers,
South Carolina. I was a full time clinician there and
a PTSD clinic for seven years. A little bit of research.
At about the seven year mark, I applied for and

(19:22):
was awarded a federal NIH research grant to do more research,
and that shifted the allocation of my time more towards research,
although not one hundred percent towards research. So for the
next eight years I continued to be a part time
therapist and largely doing research related to trauma and PTSD.

(19:44):
So I had fifteen years at the VA and I
left in two thousand and six. And at the time
I left and the reasons I left, a lot of
it's been chronicled in a book titled Wounding Warriors. How
policy makes is making veterans sicker and poorer, and that
that really explains why I left. There's several chapters in

(20:06):
the book that just little bitter about my own experience.
But much of my research was showing the ways in
which the VA itself was harming veterans at the policy level.
So we have policies that were harmful. We had, you know,
just hr policies at the level of every employee where

(20:29):
accountability was not was not good. I had colleagues that
I worked with immediately around me who were phenomenal, and
so I want to give give that shout out. I
worked with great, terrific people. I loved working with my patients,
but the system was brutal, and it was so much bureaucracy,

(20:51):
so much waste of time, so much nonsense, and I
could see it. It was just it was harmful to
the to the veterans who are our patients. And at
the point where my research was coming under scrutiny by
Central Office of the VA and the powerful machine that

(21:11):
the PTSD industry is, and it is a powerful machine.
There's a small cabal of so called scientists who run
the PTSD national centers. They hold a lot of power
in terms of their immediate budgets, but they also are
decision makers who make decisions about what treatments are going

(21:31):
to be allowed in the VA, what research is going
to be supported. And although I was very successful, I've
got hundreds of research. I got a thing yesterday from
GPS scholar congratulating me that I'm the twenty eighth ranked
all time PTSD researcher in terms of my research all
time ever.

Speaker 1 (21:51):
Congratulations.

Speaker 2 (21:52):
Well give a shit about that. But my point is
I was an insider from one perspective, and at the
same time they were slapping me. I was being slapped
around for questioning the system, and I was being threatened.
I had had a very powerful colleague who's at one
of the leaders of one of the national centers, who
called me said, if you publish this paper, well we'll

(22:14):
throw you under the bus. Your scientific He literally threatened
my career. Your career will be over. We'll make sure
you never get grants, that your papers are never never accepted,
et cetera. And that's when I decided to leave. And
I by leaving, I was then able to speak because
I had had a basically a block. The VA had

(22:34):
blocked me from being allowed to speak to the media
and the less I had permission from them, and that
required having a PR handler name was Tanya, present at
every interview, and she had She had the anointed ability
to strike questions that were posed to me by journalists
as well as the ability the power to strike any

(22:57):
answer I gave after the fact. And that's when it
is just untenable. So I left two thousand and six,
and I probably was away from being very active in
veterans research for about eight years and then and then
slowly came back, not in a research capacity. I came back,

(23:18):
and I say came back. I made some friends in Houston.
You know, I had a job at Baylor Colls of Medicine,
and there was a small foundation there called Quick Reaction Foundation,
and so it was set up four operators. By it
was by operators for operators, not a specific branch. And
so through that, just through going to some of their

(23:39):
events and meeting with guys, I started meeting and talking
with guys who weren't doing well, and I, you know,
I think maybe a part of the story is even
at that point, I still had this arrogant idea that, oh,
I'll be able to help these guys. It's probably pist.
We'll figure that out, We'll get them help, and they'll
be doing they'll be doing better. You know what. Guess

(24:01):
what it was? Not PTSD. No, that's not what they
were struggling with. The things they were saying were very
vague complaints. I don't feel well, I don't feel right.
Something's wrong with me. I don't know what it is.
I can't put my finger on it. Most of these
guys had recently separated or retired. They were late thirties,

(24:22):
early forties, and over the course of several months, maybe
six months or so, it became trial and errors. I
was like, holy cow, they don't have PTSD. Not even close.
No fear reactivity, no avoidance. Yeah, some nightmares at times,
but not the debilitating nightmares that you see in the

(24:43):
movies or that you hear about. They weren't bothered by fireworks.
They were not avoiding things related to military service. They
could talk about their experiences very easily without getting you know,
the rapid physiological arousal on such. I guess what they
did have and you and you know because as we

(25:06):
found it with you as well. They had low testosterone.
They had sleep app Yeah, every single one of them
had sleep app they had So these are things I
was not prepared for. I was not expecting these in
young fit men. And they certainly all had chronic pain, headaches,

(25:27):
cognitive impairments. And the big whammy is that we really
came to appreciate was traumatic brain injury. Yes, and none
of them had been blown up per se. They didn't
have the big, you know, the signal event where they
were in an ied explosion and were out, you know,
unconscious for an hour or so. It was from training,

(25:48):
last exposures, breaching training, shoulder fire, rockets training, the diving,
the thousands and thousands of rounds of rifle fire and
just came to realize that we've injured these men, and
these men, mostly men, but some women as well in

(26:09):
ways we didn't even realize. And then a year or
two after that point, when I'm still struggling to understanding
of this is brilliant paper came out in twenty sixteen.
It gave a name to the type of brain injury
that blasts cause. And this is still not on the
radar for very many people, including VA clinicians. But blast

(26:32):
exposures don't cause the same kind of damage that a
concussion causes. They have a shearing effect, goes through the
soft tissue, including the brain, and they scar the glial cells.
So this was named interface astro glial scarring. Glial cells
are the support cells in the central nervous system. They

(26:55):
hold the neurons in place, they insulate them, they protect them,
they carry out the toxins, and their scar they're messed up,
they're not working properly. So we have this constellation of
physiological injuries that lead to a whole range of impairments
in functioning. But it's the physiological and I think that's

(27:16):
what my entire field of psychology and psychiatry has completely
missed the boat on for since nineteen eighty or since
forever since World War One, probably when we probably had
it right when we called it shell shock. That was
probably the vast most appropriate conceptualization of what was happening

(27:37):
at that time, and we kind of went backwards since then.
Now we're coming back around, I hope.

Speaker 1 (27:45):
When how many guys had you worked with, you know,
and overwhelming majority of the individuals that you've had these
talks with, you know, can you describe you know, how many?
And then the wave that started approaching you and and
what you started when you finally started to go, oh

(28:08):
my god, there's patterns, there's a pattern to this. There
it's and then what did you do and who did
you do it with? To really start to open up,
Oh wow, we need to talk to a cardiologist. We
need to talk to neurologists, we need to talk to
we need to talk to endochronologists. When when did that

(28:28):
kind of tipping point happen?

Speaker 2 (28:29):
For you?

Speaker 1 (28:33):
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(28:56):
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(29:20):
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Speaker 2 (29:43):
Yeah. Well, at first it was just me having informal
conversations with some guys over coffee, over a beer, over pizza,
and then is they started to feel better and do better,
then it was their friends. So it was one hundred

(30:05):
percent word of mouth, and that's how we met right Tyler. Yeah,
I met you through Tyler, and I met Tyler through
through this group. And so it was all word of mouth.
And I wasn't charging people, I wasn't filing paperwork, I
wasn't billing anybody, and I'm not in any command structure.
So what happened pretty quickly was I was talking to

(30:29):
a lot of guys who had never really opened up
to anybody. In part, I was safe. I was not
within the system, and I had a credibility you know,
from from having you know, from my from my academic work,
I had some credibility that that that lended itself to this.
And so I'd say over the last decade, I've I've

(30:50):
probably worked with three hundred three fifty individuals operate, mostly
operators and and some related you know, swick E, O, D,
S PARA military. And then in addition to that, I've
I've worked more formally with about three hundred private defense contractors,

(31:13):
a majority of whom are either operators where their former
law enforcement SWAT types. Also, a lot of private defense
contractors were are were Iraqi or Afghani interpreters or cultural liaisons.
So I had the privilege to do quite a bit
of work with maybe I don't know, forty or fifty

(31:33):
of them, some still in their home country, some some
in the US. And now I would say the last
five years some of my consultations have been with law
enforcement firefighters, and so the operator syndrome framework that I
guess we haven't even mentioned that word yet. Really it

(31:56):
relates to them as well, right, And so some of
the some of the law enforcement tactical, law enforcement, especially
swat dea tactical, FBI tactical, but even cotrol, patrol, police,
and certainly firefighters have a similar constellation of TBI. Hormonal disruption,

(32:18):
sleep disruption, pain, headaches, cognitive impairments, psychological addiction issues, and
these all go together. They're very physiological. And for the
first responder community, we see the same thing as we
do in military and veterans. It's oh, it's hit that
big red easy button that says PTSD, we go boom,

(32:38):
and then now we're done. Now we can just give
pills and therapy ills and that's it, and that's it.
And so in twenty so, I guess, just to say
a little bit more about kind of the progression of things.
One of the other things that I started doing probably
circus twenty fifteen sixteen seventeen, was starting to talk to

(33:02):
and meet with some of the other medical providers in
the community. There was a really good group of psychologists
and social workers out of Virginia Beach working with the Seals.
And I mean they were Navy, they were Navy naval
officers providing mental health services, and so I got to
know some of them and learn from them. They even

(33:26):
started referring to some of their active guys, so guys
that they didn't feel like they could help for a
variety of reasons, fitness for duty being one of them.
Everybody knows you know a soldier that says, hey, I've
got an issue. They're going to be taken off the line,
they're going to be pulled out of training, they're going

(33:47):
to not go on the next deployment potentially, so they
don't talk. So I got a handful of referrals there,
some from Fort Bragg. So when I say I've worked
with probably three hundred and three fIF the operators, that
includes a lot of active duty and it includes Canadian operators.

(34:07):
I've done got a fair bit of work there. So
what happened was is I was just in a learning
steep learning curve. What emerged was this pattern that I
kept seeing over and over and over again. It was
just every single guy had similar TBI low testosterone sleep apnea.

(34:29):
And now it's just like you assume it. You assume it.
It's inevitable given the type of training, the damage that
blasted caused, the damage, that circadian disruption of working at night,
traveling across time zones, the sleep deprivation, the physicality on
the body of running, rocking, diving, jumping, falling, tactical driving.

(34:54):
Even it's inevitable.

Speaker 1 (34:59):
You know for me, I mean as I as we
our friendship grew and grew, and you know, I kept
referring people to you, We kept having the conversations, and
then you know, that really magic moment was when when
you and a look and the other authors of the

(35:19):
paper kind of put this thing in and wrapped it
together under that term operators syndrome. Was was was that, Uh,
it wasn't an it doesn't seem like it was probably
an aha moment, but it was. It was it a
seminal moment for you because it was a way to

(35:39):
be able to discuss this now that would potentially make
sense for those who were suffering.

Speaker 2 (35:47):
Yeah, yes, there was no name for this, but it
was a clear pattern that we were seeing over and
over again. And to reinforce an important point here, it's
very physiological and all of our physiological systems in our body,

(36:08):
you know, our neuro neurological, our nervous system, our endocrine system,
our metabolic system, our skeletal, muscular system, all of our
systems are connected. They're all working together. So you affect
one system, you're affecting every other system in some way.

(36:28):
And what became really clear was this fit the pattern
of a syndrome, meaning it's not just one diagnosis. We
can't just go PTSD and stop it's PTSD. They are
a little bit more prominent on the psychological side of
things with depression, anger, general anxiety. When we put all
this together and seeing it in operators, which was really

(36:50):
the only group I was directly working with at the time,
the phrase operator syndrome just came into my mind and
it was it was just what I had, what I
was calling it in my head, and I met other
people along the way. There were others that had that
that had a similar phrase or the same phrase. Kirk
Parsley who'd been working with seals for years. In his head,

(37:13):
he was calling it seal syndrome. We put this together
in a descriptive paper that had originally been something that
lived on my laptop for for years. And it was
something that at first it was a one page document
that I probably gave to you and said, here's a
sleep man, you read this and we'll talk about it.

(37:34):
And it has some of these things in there. And
as I was learning, I just kept adding to it.
And then after several years, somebody that I showed it
to said, man, you ought to publish this and share
it with everybody, share it with the world. So we did. We,
you know, some of the people I was talking and
working with, we took it. We fixed it up. There
was some you know, the team of authorship on it

(37:56):
included included one operator who was in a doctoral program
a neuroscience PhD program at the University of Texas. Helped out.
He's now in Congress. Former Navy seal Morgan Latrelle, who
you know, well, he was a co author on this
and that got published in twenty twenty. And you know,

(38:20):
one of the things that happens for us nerds and
science is you publish a paper, and usually you kind
of forget about it and you go on to the
next paper, and you hope some other scientists read your paper.
And what happened in twenty twenty for me was completely unanticipated. Unexpected.

(38:41):
It essentially did the equivalent of going viral in the
operator community suddenly. I think in the first three months,
I got about four hundred requests for the paper, and
so eventually we just took the PDF and we put
it up. It lives on the Internet in a variety
of places. Anybody that wants to see it can find it.
And because it's just a simple description, descriptive paper, it's

(39:02):
pretty easy to read anybody. You don't need there's not
a lot of medical jargon in it. You can download it,
read it, and share it and educate your family, yourself,
your own doctors who probably don't know how to how
to approach your complicated medical problems. And then it also
got picked up by law enforcement, firefighters, and so I

(39:26):
was twenty twenty and then last year we published.

Speaker 1 (39:30):
And let me just interrupt, the thing that really got
me was, I mean, this was the seminal moment that
for us, it was like, oh my god, there's a
way to psychologically manage and label this perpetual sensation of

(39:52):
low performance, right, our inability to operate at the level
we once operated. But it happened right in the middle.

Speaker 2 (40:00):
Of COVID and.

Speaker 1 (40:03):
So as soon as this thing the rest.

Speaker 2 (40:06):
Of the beginning same month that the world's shut down.

Speaker 1 (40:10):
That's right, Yeah, that's right. And so I believe that
that muted the potentiality of what this ultimately has been doing.
But it's been this slow, gradual thing. And so could
you discuss that that the gradual nature of of it,

(40:33):
and maybe some of the challenges that you've confronted and
what ultimately drove you to write the book and released
the book a year ago.

Speaker 2 (40:41):
Okay, well, yeah, I don't even where to start there.
We can talk about that for hours. One thing that
happened was I got a lot of a lot of messages.
A lot of people reached out to me. So I
was getting a lot of validation. People were reaching out
to me, Oh, holy moly, this really this is me?

(41:02):
And I get that every time I present. I presented
last week over at Pearl Hicckham on Oahu and to
a summit of Air Force senior enlisted Explosive Ordnance Disposal
technician c o DS talk for an hour. At the
break five five or six guys came up to me.
It was like, you just described me in my life.

(41:23):
How did you know? I get that all the time,
and in fact I may can I read as another
quote from the book, this is so emblematic of things.
So this is the book that that you and I wrote.
You wrote, you wrote a powerful forward to it. And
so this is a quote at the top of chapter
one from Clay Jensen, a US Army Master sergeant retired

(41:49):
Special Operation Team seven Special Forces Groups CIA contractor. And
I won't read his whole whole quote, but this is
what he said. Every time I see a new primary
doctor civilian, they're completely overwhelmed by the sheer number and
severity of the different medical issues I have. Nobody knows
how to treat me, completely different from any other patient

(42:10):
they've had. For over ten years, I struggled understand why
I am the way I am and to know what
was really wrong with me. Then I came across an
article on operator syndrome, and I was like, quote, holy shit,
I'm normal. Most quote. I went from feeling totally alone
to being part of the tribe again. And then I

(42:30):
put that at the start of the book just because
it's so emblematic. Guys are suffering in silence, They're suffering alone.
They think they're the only ones. There's this often, this
shame of all my brothers are crushing life. But I'm
sitting here in despair, in pain, with low testosterone, not sleeping,

(42:52):
drinking too much, and I can't get my act together.
And but I can't tell anybody because it doesn't make
any sense. And so part of I think the message
here is these physiological injuries are inevitable for combatants, for
first responders, for anybody who has one of these high

(43:13):
risk professional careers, for you know, especially for multiple years,
for decades.

Speaker 1 (43:21):
Well, I think that the critical thing I also want
to bring up is that as as you have really
kind of taken this and run, and you know, obviously
there's been some negative reactions within the different units. You know,
I think you've you've confronted multiple senior ranking people, right,

(43:42):
Is that is that correct?

Speaker 2 (43:44):
What? What?

Speaker 1 (43:45):
What was what was their points they were trying to
make to you?

Speaker 2 (43:49):
Well, you know, I think I'll put it in terms
of COVID you had. You had a powerful guest on recently,
doctor Robert Malone, who talked about the COVID, the way
in which the COVID narrative was presented, and anybody who
criticized it, questioned it was silenced. They were chilled, they

(44:13):
were denounced. Uh, they were deplatformed, they were shadow banned,
they were excluded. Uh. And they were also you know,
attacked in ad hominem ways. Their character were, you know,
their reputations were were gossiped about. And I've experienced all
of that. I experienced all of that in the early

(44:34):
two thousands when I was still at the VA, with
my critique of the VA as a system, and and
and and again. You know, more recently with operator syndrome,
it's it's not been picked up by the VA broadly,
although I'm starting to talk to people in the VA
who are listening, who are already who are using it.

(44:58):
I'll give a shout out to to Jane Adams at
Palo Alto Via who set up a program out there.
He's a psychologist and research director of their program treating
operators using this framework. Would be a good guest for
this show someday. I've given one invited presentation to one VA,
the Orlando VA, their mental health program, just you know,

(45:21):
at a local level, just said would you come do
a would you do a zoom presentation to us? Which
I did, And that's been about it. Wow, I've been
I won't say I've been harassed, but I've certainly been ignored.
When I have had a couple of meetings, I've been
told that some of the leadership at the PA has

(45:42):
said to me, pretty openly or pretty pretty frankly, we
don't think what you have to offer is meaningful. It's
really just PTSD. And anybody, any soldier who says they
don't have PTSD, they're in denial and so they're ignoring
the physiological aspect of things. I did present at a

(46:03):
closed door meeting of one of the large foundations for operators,
and a retired officer who had previously had three stars
on his shoulder stood up and denounced me. He said,
and this was just a year ago. He started by saying,
I have not read your book, and then he proceeded

(46:25):
to tell me all the reasons he thought my ideas
were dangerous and wrong and off base, and really what
his concerns came down to is worried that it would
hurt recruitment, and worry and the concern or the accusation
almost that I'm not a real scientist. I'm not part
of the scientific club, and I need to be listening

(46:48):
to the real scientists. And he had He was in
a room that had a lot of you know, Ivy
League neurologists and psychiatrists in the room, and he clearly
didn't know that my background, my academic publication record probably
surpassed that of everybody in the room that he was
referring to. So it feels like, and I think it

(47:10):
is similar to the COVID we have our narrative. Shut up,
stay in your lane. We're not going to entertain your
ideas because we don't have to. We already know the answers,
so we're not listening. What's beautiful And you know, I'm
I've kind of done my piece now, and you help
me with this book, which is a book for not

(47:33):
for the medical community, but for operators, for the responders,
for the combatants, for those in the combat arms. It's
a practical book, it's a guide. It's a short book.
Guys and gals can read, spouses can read to say, okay,
this helps understand me, understand what's going on, and here's
all the solutions, most of which are not being provided

(47:54):
by VADOD or organized medicine. We have soul many good
treatments now that we're not really providing to people. And
so now I think what I see happening, I think
you share this view probably is it's no longer about
what the military leadership, VA leadership, the people who are

(48:18):
at the top of the medical field or psychiatry or
psychology fields are thinking. It's about what's coming from the
ground up. It's about it's about that that dea agent
who's hurting and going coming forward and say I need
enough of this. I don't need therapy for PTSD, I
need to have my hormones treated. It's the EODS, it's

(48:40):
the retired Seals. The Seal Future Foundation has created an
entire program run by Seals for Seals using the Operator
Frame Syndrome framework and providing treatments that are consistent with,
you know, with what's needed to address these injuries. And
so there's other foundations out there, the Marine Recon Foundation,

(49:04):
the All Secure Foundation, There's just there's so many of them.
Now there's many really good ones. Oh yeah, wait, isn't
there another foundation that may be young, new on the scene.
There is the Operator Syndrome Foundation.

Speaker 1 (49:23):
You know, I can there's so many different angles to approach,
you know. One my first comment is to the guys
who have the stars on their shoulders, to the bureaucrats
at the VA, we are not trying in any way,

(49:45):
shape or form to alter, reduce, or change the necessary
training profiles in order to get the individual from the
time they roger up and raise their hand, and because
they want to serve this nation, because of the heritage
of those that have come before, because of those who

(50:06):
have died, for the patriotism that founds this which is
the cornerstone of America. You know, you know, they have
to go through what they have to go through. We
do not want to change it. I have not talked
to a single operator that suffers from operator syndrome from

(50:27):
OS that wants to change anything they had to do.
Maybe put some gaps in between you know, the the
breaching charges they do per week, or you know, the
shoulder fire rockets or whatever it might be. Maybe they
you know, they actually can take some medications that stabilize

(50:51):
the metabolic imbalance. Maybe they can address their orthopedic injuries
with better physical therapy in the midst or go do
high barracks after a deployments. That's what we want, right
We don't want to stop operator from young men becoming
on young men and women coming operator at all. What

(51:12):
we want to do, though, is we want to make
sure that the next time we ask these people to
go down range and to possibly you know, sacrifice their lives,
but definitively to sacrifice their health and mental health in
the future, that there's a program prior to a predicate

(51:35):
something for transition and then, as you had suggested, the
various programs that are out there to help them. To
give an estimation to the audience of the numbers and
what's taking place, can you describe how many phone calls
the Seal Future Fund receives annually once they discover the

(51:58):
potential the frame work which with which they can be
helped through their system.

Speaker 2 (52:05):
I can't give you an exact number, but I think
within the in the last three years they have served
twenty percent of the entire Navy seal community, every among
every seal not the active. They don't work too much
with the active, but all the retired seals, all the
all the separated seals were now veterans. I think they've

(52:25):
served twenty to twenty five percent of them in the
last three years.

Speaker 1 (52:29):
That's that's massive.

Speaker 2 (52:30):
That's just not up every year. So the next two
years they'll they'll probably serve another twenty twenty five percent.

Speaker 1 (52:37):
When when we you and I have had these discussions
about all right, how many so at any one given time,
I think in SOCOM there's roughly seventy seventy five thousand
people or some some number. It's around it's it's that high, right,
and I think it actually flexed and was bigger during
the gap, might be bigger now. But but you know,

(52:58):
within that you have have a dedicated group of door
kickers what they're called, right, people that are going downrange
doing the work out of that last the GWATT. Can
you give an estimation in your mind of how many
guys are are afflicted right with I mean, I think

(53:25):
everybody's got some semblance of operators syndrome in something, right,
But what is your rough estimate of how many veteran
operators are struggling, really struggling with these this collective group
of challenges. Once again, I apologize for the interruption, but

(53:48):
I just wanted to remind you that this Saturday, on
May thirty first, at eleven am Eastern Standard Time on Patreon,
I will be giving a live motivational event. I'm going
to be discussing the thirty years that I have really
been trying to understand the human condition through all of

(54:08):
my incredible experiences as a Seal, a CIA contractor in
a World Championship performance coach. Please join us by visiting
our Patreon account at David Rutherford Show. It's a two
dollars monthly subscription fee. I'll be given a one hour
presentation about the core Frog logic concepts, and then I'll
be doing a one hour Q and A. So if

(54:30):
you want to enjoy this, please join us at our
Patreon account at the David Ruthers Show this Saturday, eleven
am Eastern Standard time. Thank you.

Speaker 2 (54:40):
Back to the show man. There there is no epidemiological
studies right that have been published or that I even
know of, so it's really impossible to answer that question.
I would say, however, I would say an operator syndrome,

(55:03):
like every medical condition, can be occur on a continuum,
not everybody had the same experiences or the same training exposures.
Not everybody has the exact same manifestation of symptoms and effects.
But if you if you go, well, we have seventy
thousand working at SOCOM right now, plus you know a

(55:27):
third of them of the d D is combat arms,
and so that's a you know what is that another
I don't know, half million men and women. Then you
add up all the firefighters and all of the law
enforcement officers. I think it becomes you know, we're talking

(55:47):
you know, we're not talking about a small number of people.
We're talking about a couple of million, three four million
people even maybe if we when we add veterans in there,
and then it's on a spectrum. And part of that
spectrum is the nature and the intensity of the training
and the deployments, as well as the number of years.
So I met last week, I my host Jason twenty

(56:11):
seven years in the Air Force. As an EOD twenty
seven years, he's going to have things that somebody who's
only five years in isn't going to have yet. So
I think an important piece about the Operator Syndrome framework,
and that's what it is. It is a framework just
to understand. It can be used from the beginning of

(56:32):
a career as a way as a perspective to help
pay attention to monitor developing injuries and impairments as well
as to mitigate them, and then downstream it can be
a framework for treating more acute, severe injuries. So if

(56:53):
I'm talking to a twenty year old soldier in the
combat arms or who's is going, you know, planning a
career in special operations, get a baseline on your hormones.
Do it now, know what your hormone baseline is. Track
it every few years, Pay attention to where it is.

(57:14):
After certain you know, guys come back from a six
month deployment or a year deployment, or or a three
even a three month deployment, we're seeing the entire platoon
or the entire units testosterone has gone way down. Now,
that doesn't mean they need replacement therapy, time, rest, you know,

(57:34):
making some changes and bring it back. It will come
back up naturally. If they're young. The older they get,
the harder that that becomes, and the more evolutions of
that of those trainings and deployments, the harder it becomes
for it to restore itself naturally. But that would That's
just one example. And if I were, you know, somebody
asked me recently, what are the like, what are the

(57:56):
three four things that I would recommend to every buddy?
So this is just by way of practical solutions. Can
I can I give you that those place things now?
So first of all, the two things that are just easy,
they're just assessments. Get a sleep study if you snore
or you have sleep problems or fatigue problems. Get a

(58:19):
hormone check, check your hormones. Men and women should be
tracking to get their hormones checked. A third is an
intervention that is not well known about but is powerful
clinical benefits, and that's stelic Ganglian block. That's a very simple,
five minute outpatient procedure. It involves injecting medicine into the

(58:41):
sympathetic nervous system. What it does is it just brings
down that fight or flight physiological arousal. Just brings it
down from a baseline of you know, eight nine down
to two or three. And it will last four months,
two months, six months, eighteen months even And that opens
the or because guys feel immediately more relaxed. Gals two,

(59:06):
they are able to concentrate better because they don't have
all that noise in their physiological system. They sleep better,
which just brings a whole cascade of amazing benefits. Sleep
is so important, they're nicer, their families like them. Again,
I've heard spouses refer to it as the as the

(59:26):
anti asshole treatment, and it can save lives and marriages
and families. And then the fourth thing I would put
on the list is dial in your own habits, your
own lifestyle habits, prioritize sleep, learn what good sleep habits mean.
There's programs that can help teach you that and develop

(59:47):
those habits, and then develop an anti inflammatory lifestyle, meaning
reduce alcohol and tobacco or eliminate altogether. Eat whole food diet,
don't eat processed foods, jung foods, fast foods. Hot saunas.
Hot saunas is a very powerful anti inflammatory for the body.

(01:00:10):
Anything that reduces inflammation is going to be good for
every part of the system. It will help reduce pain,
it'll help with the neuroinflammation in the brain associated with TBI,
so it's a brain healer. If you do those four things,
you know and do them from the beginning of a career,
all the way to the end of life. You know,

(01:00:32):
track track, your sleep track, your hormones were a sleep
monitor something, some kind of fitness tracker to figure out
to pay an engineer sleep massive gains. And then from there, Yeah,
there's therapy. There's maybe psychiatric medications if you need it,
but hyperbaric oxygen therapies, the stibular therapy, transcranial magnetic stimulation therapy,

(01:00:57):
psychedelic plant medicine, not microdosing, that's not what I'm talking about,
but a true medically supervised journey, powerful, powerful interventions that
we have. So we're not giving these treatments to people
very very often, we're not allowing people even to know
about them. Your average psychologists or psychiatrists has never referred

(01:01:21):
a patient to get a hormone check, has never referred
a patient to get a stelle a ganglion block if
they may not even know most probably don't even know
what stelle a ganglion is.

Speaker 1 (01:01:32):
Well, that's all That's what I found. I mean, I
started working with veterans charities in two thousand and twelve
or thirteen, and you know, it's like, all right, how
do I give back? How do I how do I
you know, support veterans friends of mine, you know, because
I realized we started feeling the suicides around two thousand

(01:01:52):
and eight nine, they started picking up, and you know,
by by fifteen or sixteen, we're just exploding. And so
I was like, all right, I want to contribute. But
what I ended up finding is that a lot of
the charities that I was affiliated with, we're not going
after these targeted and specific treatment modalities, right, these very

(01:02:13):
specific things that we're going to address the full spectrum.
And I think, you know, that's why organizations like you know,
the ones you had mentioned in particular, what what are
what we started in terms of Operator Center Foundation one,
as you know we started you and I, we wanted
it to be education, so offering a free education course

(01:02:34):
for anybody who wants to learn about this in detail,
and some ideas and suggestions and all that. But then
obviously at more Blake we just kind of I mean,
I know, I got sick of the organization, you know,
having all of this be so separated, to try and
figure out how to quarterback this for the individual. And
you know, I think that's why, really, why you know,

(01:02:57):
what spawned you know, John and I with your health
to initiate, you know, this pilot program for these five
different guys from five different units, but really all suffering
from the same thing and in different stages of their.

Speaker 2 (01:03:10):
Careers, you know.

Speaker 1 (01:03:12):
But it's it's focusing on metabolic stabilization, right, it's focusing
on neurogenic you know support, behavioral health support, and then
orthopedic you know, managing pain, and and it's it's nice
that that we have identified, but the real problem that

(01:03:32):
I still see is that it's still so fractionalized. It's
still so different. You have to go to like you said,
you walk into your primary healthcare doctor and he looks
at you and he's like and you ask him, do
you understand blast wave exposure? And he looks at you,
like what are you talking about? Are then you go
into someone else and it's like, oh, I've I've got

(01:03:55):
this from all of this, and they're like, well, wait,
what do you mean all on our stand all of this,
and and then like and then I'll never forget, you know,
I I went, uh, you know. We're working with Kevin Lace,
who's a PA in Pennsacole, Florida, and tried at medicine
with our metabox stabilization aspect. And I remember my first

(01:04:17):
panel I went in was thirty six vials of blood right,
And I remember the technician being like, I've never seen
anybody get this many. What's wrong with you? And I
was like, you ever heard operator syndrome?

Speaker 2 (01:04:29):
And they're you know? And they're like, no, you know.

Speaker 1 (01:04:32):
And and so I think the challenge is now, how
do we how do we teach people out there to
help quarterback? So people that are suffering.

Speaker 2 (01:04:44):
So the excellent question an excellent point. Yeah, so just
to kind of recap, medicine is ignorant and arrogant. We
already have all the answers. We don't deviate from what
the algorithm of our field tells us to do. We're
a fraction. We're fragmented. You know, your psychiatrist never talks
to your sleep doctor, never talks to your primary care doctor,

(01:05:07):
never talks to your oncologist or whatever. Maybe they look
at the medical record and go, oh, yeah, this diagnosis
is there and these medications are there, but there's never
really any deep thought about all of that. So there's
no recognition that all of these physiological systems are interconnected.
So education is critical. We the operator Syndrome Foundation has

(01:05:31):
an online training program or online curriculum, so that's free.
That's available. The Seal Future Foundation has a website titled
the Operator Health Index. You can go to the Seal
Future Foundation's website. It's free. Anybody can access that. The
Operator Syndrome Medical Paper is on the internet. If you

(01:05:51):
just put into your search engine and operator syndrome medical Paper,
it'll come up. What I often tell people is printed
off on paper, go through with a highlighter circle the
things that are relevant to you. Take that to your doctors,
take that to your prime to your providers, your primary
care docs, whoever educate them. Oftentimes people say, well, my

(01:06:13):
doc won't give me a hormone blood panel. When they
take that paper in with that circled, it usually changes
the story. So that's one effective way to kind of,
I won't say manipulate, but educate your providers. And then
we also have this book that is literally a thin, easy, quick,
practical read, practical guide to learn to understand as well

(01:06:37):
as to understand not just the injuries and the impairments,
but the solutions, the treatments, the lifestyle habits that can
be developed. So there's a lot of ways to learn
about this. You're right learning about it, and I would
say spreading the word because you're listening to this and
you've learned about it, and I don't. This isn't meant

(01:06:58):
to be all about self promotion. But share with your
buddies because they probably haven't heard for sure.

Speaker 1 (01:07:05):
Well, Chris, you know, just uh, I can't thank you
enough from not only from from the bottom of my
heart and the immediate friends of mine that you've you've
saved their lives, but to all the other work that
you're doing, and the and the tireless you know, banging

(01:07:26):
on doors and giving zoom calls and and the more
importantly those middle of the night calls of guys in crisis.
I just can't thank you enough. And hopefully when people
listen to this, you know, you'll recognize that, you know,
the toll of warfare is is is much much much
deeper than just you know, the the war story or

(01:07:50):
the sacrifice on the battlefield. It reverberates UH for generations
across families, across UH units, across UH doctors who treat
and people and physicians and nurses and all of those
people at impacts as it comes across you know the
impact of that, that higher level sacrificial service. So thank

(01:08:11):
you for everything you've done, and you know, just wish
you all the best.

Speaker 2 (01:08:16):
Man.

Speaker 1 (01:08:17):
Where where can people go to buy the book and
how can they pay attention to what you're doing in
your life.

Speaker 2 (01:08:22):
Well, the book's easy to find. It's on Amazon, operator
syndrome it is. You can get it directly from the publisher,
Ballast Books. They published. They've got a whole suite of
really terrific books written by by military. It's kind of
I wouldn't say it's all military, but it's got a
strong patriotic focus. I do have a website Chris free

(01:08:42):
dot com. See if you know how to spell my name,
and I'm not on social media. I did that for
a year to support the book and hate every minute
of it. So I disappeared from social media a few
months ago. Awesome, Yeah, thank you brother, This was great conversation.

Speaker 1 (01:09:00):
God bless you. Thank your brother.

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Operator Syndrome: The Hidden Cost of Service feat. Dr. Chris Frueh | Ep. 16

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Operator Syndrome: The Hidden Cost of Service feat. Dr. Chris Frueh | Ep. 16