Think of it as a small miracle of sorts.

This country has now been at war continuously for 18 years, ever since President George W. Bush and his top officials announced a “Global War on Terror” within days of the 9/11 attacks and, not long afterward, launched the invasion of Afghanistan. Iraq, of course, followed. And Somalia. And Yemen. And Libya. And Syria. And drone strikes that have never ended across a vast region of the planet. And the building up of a Special Operations force of 70,000 -- bigger than the militaries of many countries -- and the creation of an Africa Command (AFRICOM) after which the war on terror spread across that continent, too. And so it’s gone, and continues to go, as hundreds of thousands die and millions are displaced. And that “war” (an ever-more complicated and unsettling set of conflicts) has in its own way come home, too, not just in the arming of America’s police with weaponry straight off those distant battlefields or the creation of militarized SWAT units across the country, but in those endless ceremonies “honoring” the troops at sporting events of every sort, in the constant growth of the national security state, and the continual padding of the Pentagon budget.

Despite all of this, Americans have generally done a remarkable job of ignoring those grim wars. Since the invasion of Iraq, almost no Americans have taken to the streets in protest. The costs of the war on terror are seldom discussed. Those ever-spreading conflicts -- and their never-ending nature -- are generally an unacknowledged background fact of American life, which is why the Costs of War Project at Brown University is indeed a small miracle of sorts.

Visit its website and you can actually check out estimates of the true costs of America’s forever wars (at least $6.4 trillion that didn’t go to infrastructure repair, health care, or anything else that matters domestically) or an accounting of deaths of every sort from those conflicts (approximately 800,000 soldiers, civilians, journalists, contractors, etc.), and so much more. It’s an eye-opening accomplishment in a country that would rather look the other way and we at TomDispatch are proud that we’ve published articles by its co-director, Stephanie Savell, exploring the never-ending costs of those wars. And we’re no less proud today to feature a piece by one of that project’s founders, Andrea Mazzarino, the co-author of a new book on the subject of their costs, War and Health: The Medical Consequences of the Wars in Iraq and Afghanistan. Today, she writes about how they have come home to her, not just as a researcher but as a military spouse and a mother. It’s a reminder that America’s twenty-first-century wars, while fought thousands of miles away, are also far closer at hand than we like to think. Tom

I am also married to a submarine officer in the Navy. We are so fortunate in so many ways. We have two beautiful children, pets, loving friends, and extended family. We both have graduate degrees. While our finances take hits from relocations without adequate job and childcare support, we don’t face the continuous fears that many military families experience when a loved one is sent into a war zone. In many respects, my family’s life does not look like that of most American military families profiled in my book.

I am the co-editor with Catherine Lutz of War and Health: The Medical Consequences of the Wars in Iraq and Afghanistan , a new volume of social science research from Brown University’s Costs of War Project . At the same time, I am a practicing therapist-in-training and I specialize in working with veterans who have post-traumatic stress disorder, or PTSD. Through the scholarly research I review and the veteran clients I have seen, I am committed professionally to bearing witness to the human costs of America’s forever wars, and to alleviating suffering where I can.

There is some incongruity between my role as an editor of a book about the costs of America’s wars and my identity as a military spouse. I’m deeply disturbed at the scale of human suffering caused by those conflicts and yet I’ve unintentionally contributed to the war effort through the life I’ve chosen.

During one of my husband’s deployments, I was relieved to hear our 2-year-old son talk about war in a way that, despite his innocence, was more nuanced than the usual tales of “sacrifice,” “honor,” and “fighting terror” that one hears routinely in the mainstream media and in local command newsletters.

It was spring 2017 and we had just seen Kim Jong-un displaying one of North Korea’s new missiles on the TV news. Our son asked me what a war is. I gave my best explanation and his reply, undoubtedly garnered from preschool discussions about conflict resolution, was: “They don’t use words? They hit?”

Sort of, I told him. I did my best to explain what a weapon was, a description I suspect that many of my liberal mom friends would balk at. In our military community, however, such imagery is all around us. Real missiles and replicas are, for instance, often used as decorations lining the streets of naval bases or as lampposts or even wall hangings in military family households.

My son did his best to take it in. Later, at the waterfront near our home, he tossed a piece of his donut into the ocean and told me it was for his father who, he insisted, was under the water “playing hide-and-seek.” Of course, he doesn’t connect the relentless training and deployments characteristic of our military life with the fighting of war itself, though our family feels the strain and implicit sense of danger in our daily lives.

In writing my recent book on the costs of this country’s post-9/11 wars, I learned about Afghan war widows who use heroin to make it morally possible to live amid grief and poverty after seeing their spouses and children killed; about NGO workers who leave their own families, facing threats of kidnapping and death, to aid refugees in the Pakistani-Afghan borderlands. And I read about the experiences of the million war-wounded, ill, or traumatized American combat veterans, the sorts of patients my therapy will someday (I hope) help, who have sought health care and social support and so often come up desperately short.

As I do this, there’s always a low buzz of guilt somewhere in my gut, even about my own voluntary, unpaid work in support of other military spouses, even after I’ve relinquished travel assignments in my work as an activist that would have compromised my husband’s security clearance, even as I abide by harsh security restrictions in my personal life. I worry, in other words, about aiding the very military that, 18 years after the 9/11 attacks, still continues to rack up war’s costs without an end in sight.

The Costs of War at Home

I see firsthand trends affecting all military communities in the United States. Deployments during these wars have come more frequently and often last longer than in past American wars. The specter of death by suicide hangs over all our lives, because everyone in such communities knows someone who has died that way or has threatened to do so.

In 2012, for the first time in our history, American service members began to die by suicide at higher rates than civilians. Today, they are more likely to take their own lives than to perish in combat. As anthropologist Kenneth MacLeish points out, military suicides are most prevalent among those who have deployed to our war zones just once or not at all, or who left the military involuntarily with a “bad paper discharge” or other than honorable discharges of some kind. Moreover, mental illness is rampant among active-duty military service members. According to the nonprofit National Alliance on Mental Illness, in 2014 roughly one in four active-duty service members showed signs of mental illness, including mood and trauma disorders such as PTSD, depression, and anxiety (though this figure is conservative, given that the study did not include the prevalence of traumatic brain injuries among combat vets. Many soldiers seek relief from the stresses of training and combat through alcohol and other drugs and, in our military community, it’s common knowledge that seeking professional support for such problems can place you at risk of social stigma.

And don’t forget military families either. Training and fighting both take a toll on us, too. What modest figures we have on the subject make the point. For example, as anthropologists Jean Scandlyn and Sarah Hautzinger point out in our book, among servicemembers who entered the military between 1999 and 2008, the more months spent deployed, the more likely they are to divorce, with the vast majority of such divorces occurring soon after returning from deployments.

Local reports of domestic violence in military communities suggest that the problems leading to such divorces are only growing, though documentation on the subject is unreliable. It wasn’t until 2018 that, under pressure from Congress, the military made domestic violence a crime under its own legal code. Deployments of nine months or longer or frequent redeployments leave spouses at greater risk of depression, anxiety, and sleep problems, which, in turn, often affect the mental and physical health of their children as well.

Young children with deployed parents visit the doctor more frequently for behavioral health issues than those whose parents have not been deployed. Yet, as many spouses like me have discovered, community-based physicians are often unprepared to help in such situations, tending instead to blame the behavioral and mental-health issues of children on their parents or even on the children themselves, while not making referrals to services that could help (often, sadly, because there are none in the community).

“They Were as Hard Off as Me and I Was Killing Them”

Such collective problems are, of course, experienced individually and I’ve felt many of them in my own life. My spouse, for instance, departed for sea tours at moments when most of our family’s ducks were anything but in a row, whether it was a matter of childcare, work schedules, my health needs, or our other family obligations. Our son, for instance, has trouble sleeping because he was sad and scared for his dad, given what he hears in passing about Syria, North Korea, and -- from other well-meaning military spouses and our own extended family -- his own father’s attempts to “keep us safe” from unnamed others who might want to harm us.

I’m edgy and uneasy, knowing that my husband’s commander, a combat vet, has been angry at our family because I refused at one point to volunteer to work with a spouses group. When our house gets broken into, mid-deployment, and I’m alone with our toddler and pregnant, I wonder briefly if payback could have been involved before I dismiss the thought.

After I have our second child, a woman from the base with no mental-health or social-work training calls me weekly to ask about my baby’s health and safety. When I request that she stop, she refuses, telling me the same commander has ordered her to check in on each new mother in his command during deployment. I receive capitalized, hysterically punctuated emails from this woman warning all spouses not to jeopardize national security by talking to anyone about the submarine’s movements or, for that matter, emailing anything to our partners that they might find “distressing,” even details about a family member’s illness. Repeatedly, I am reminded that the U.S. is fighting a war on terror and our individual problems should never get in the way of that.

Things aren’t exactly a cakewalk between deployments either. It seems that, wherever I go, I find stigma, not support. For example, shortly after giving birth, I consulted a psychiatrist for help with post-partum depression. He was the only psychiatrist within 30 miles of our town who accepted military health insurance. Upon meeting me for the first time, he asked me to sign paperwork allowing him discretion to commit me to a psychiatric hospital “because military spouses often get psychotic during deployments.” I decided to tough it out rather than see him again.

And I try to keep in mind that my problems don’t add up to much, given the true costs of war out there. As a start, it’s a stretch to draw comparisons of any sort between an educated, white millennial family here and those who directly pay war’s costs like combat vets or, above all, civilians in Afghanistan, Iraq, and other American war zones. As my co-editor Catherine Lutz and others have shown, though, combat and the home front are connected in unexpected ways.

If you spend 18 years fighting wars you grossly underestimated how to pay for, if you embark upon those wars without first considering alternatives like diplomacy, if you assume that social support for this country’s wars and those fighting them will come from military families that are patriarchal ideals from the white 1950s, and if you imagine an enemy -- terrorism -- that could be anywhere at all any time at all, then you’re already in a battle that’s going to prove unwinnable and morally unnerving for everyone involved.

I obviously can’t speak for how people from groups in this country more vulnerable than mine think about our never-ending wars and their costs, but my guess is that at least some of them feel connections to those in the war zones far more intimately than I do, no matter how hard I try. I will never forget a neighbor of ours, a Mexican-American Vietnam vet whom I would find smoking on our street when I completed my daily runs. One evening, when we were chatting, he told me that what haunted him most was how many of the rural, poor Vietnamese he’d shot at looked more like him than most of the American officers in his unit. “They were as hard off as me and I was killing them,” he suddenly said, tears in his eyes. Among veterans, he’s not alone in feeling an affinity for those on the other side.

On Bearing Witness

When Catherine Lutz, Neta Crawford, and I first founded the Costs of War Project at Brown University in 2011, we took a close look at the kinds of public assumptions we wanted to upend. As a start, we wanted to show that, contrary to the Bush administration’s stated rationales for invading Afghanistan and then Iraq, Washington had not effectively protected human rights -- not to safety, liberty, or for that matter freedom of speech -- nor brought “democracy” with us into those distant lands. Instead, by then, those countries had already seen spikes in gender-based violence and the deterioration of the most basic protections that led to everything from the collapse of prenatal care to the killing of civilians to the kidnapping of journalists, aid workers, and academics.

We wanted to go beyond the Pentagon’s focus on the deaths of American soldiers and focus instead on the tens of thousands of Afghan and Iraqi military deaths that had taken place and especially the soaring death rates of civilians in those lands. And, of course, we wanted to show that our grim wars should not be described in sterile terms via the usual imagery of families embracing upon a smiling service-member’s return or the by-then-familiar photographs of neat coffins draped with flags being carried out of planes by uniformed service members as spouses (usually white, female, and non-disabled) looked on sadly.

That, we knew, was not the essence of America’s already ongoing war on terror. My colleagues and I wanted people in this country to refocus on the staggering death and injury rates that only grew as the years passed, the ever-more-crippling ways in which all sides learned to kill and injure, and the long-term mental-health effects of arduous family separations.

A therapist mentor once taught me that, when working with veterans who have PTSD, I should, as he put it, “Ask them to start their story a little before they think it began and have them keep going even after they think it’s over.” My colleagues and I wanted to do that when it came to our wars, focusing not just on the obvious newsworthy photographs that tended to appeal to the American psyche, but on the missing context in which those photographs were taken. That’s the best way I can think of to describe the purpose of our new book (and our future work). None of us should stop trying to refocus in that way, not until America’s war story is declared over -- and not even then, given how long the costs of war are likely to take to play out.

One sunny afternoon in May 2011, as Catherine Lutz and I sat in her office in Brown’s Anthropology Department sifting through media images for the initial launch of the Costs of War website, we happened upon a video of a screaming young Iraqi child with open burn wounds covering his face and body, a relative clutching him in her arms as they hustled through a crowd. Gunshots and explosions were audible in the background. The before, the after, the neighborhood where the violence was taking place, the weapons used, who was even fighting whom -- none of that was evident from the clip.

For years, that image and the sound of that child has haunted me. Who was he? Did he get to the hospital? Was there even a hospital for him to get to? Would he ever go to school or play again? Who was the woman and what had her life been like before the American invasion of Iraq in 2003? What was it like now? What services could she access? Was she safe?

I think of this image when I wake up at night, when I hear patients describe the screams of children in war zones, when I hear my own children scream during tantrums. It’s like a nightmarish echo that spurs me to keep working because all of us, regardless of where we are, should be bearing witness to the costs of war until somebody in power decides to end the suffering.

Andrea Mazzarino co-founded Brown University’s Costs of War Project. She is an activist and social worker interested in the health impacts of war. She has held various clinical, research, and advocacy positions, including at a Veterans Affairs PTSD Outpatient Clinic, with Human Rights Watch, and at a community mental health agency. She is the co-editor of the new book War and Health: The Medical Consequences of the Wars in Iraq and Afghanistan.

Follow TomDispatch on Twitter and join us on Facebook. Check out the newest Dispatch Books, John Feffer’s new dystopian novel (the second in the Splinterlands series) Frostlands, Beverly Gologorsky's novel Every Body Has a Story, and Tom Engelhardt's A Nation Unmade by War, as well as Alfred McCoy's In the Shadows of the American Century: The Rise and Decline of U.S. Global Power and John Dower's The Violent American Century: War and Terror Since World War II.

Copyright 2019 Andrea Mazzarino