 Six
years ago, Toronto neuropsychiatrist Dr Anthony Feinstein
received a peculiar referral from the neurology department
at Sunnybrook and Women's College Health Sciences Centre.
The patient in question had been having sudden episodes
of a mysterious illness that caused heart palpitations,
extreme agitation, incoherent speech and fainting spells.
A CAT scan and a battery of tests revealed nothing.
"The physical examination is normal;
the laboratory results are normal. I have therefore
concluded there is nothing wrong with the patient,"
wrote the neurologist-in-chief in his referral letter.
"I wonder if it has anything to do with her work? You
may recognize the name. She is a war reporter."
The neurologist's hunch was exactly
right. In talking to her about her work, he learned
that horrors unimaginable to most people were part of
her daily grind. She witnessed, and had brushes with,
death on a regular basis. Shortly before her illness
struck, she'd witnessed the death of her cameraman by
mortar shell while covering a war in Africa.
A diagnosis quickly became obvious
to Dr Feinstein: post-traumatic stress disorder (PTSD).
He'd seen plenty of cases before.
BAPTISM
BY FIRE
Dr Feinstein, who is originally from South Africa, had
his first encounter with PTSD when he was fresh out
of med school in the early 80s. "I got conscripted against
my will and sent as a medical officer to the war in
Angola," he told a Crimes of War Project seminar a couple
of years ago (he published his Angola diary, In Conflict,
in 1998). PTDS was common among the young soldiers he
served with, many of whom, like him, had grown up in
the sheltered suburbs of Johannesburg. "It wasn't difficult
to diagnose," he recalls. "There was a particular uniformity
to the presentation: nightmares, intrusive recollections,
intense anxiety and sleep disturbance. But there was
very little I could do at the time."
But that was in the 80s, when PTSD
was in its infancy as a recognized psychiatric disorder.
What shocked Dr Feinstein most about his war reporter
patient was that, in all of her years spent on battlefields
and in disaster zones, no psychiatric services had been
offered to her by her employers. On further investigation,
the doctor learned that this was no aberration —
it was a gaping hole that stretched across the news
industry. "I went to do a literature search on the subject
and didn't come up with a single publication," he says.
"It's practically unheard of. Someone's always been
there before you in medicine."
UNCHARTED
TERRITORY
Dr Feinstein decided to chart this territory himself.
With grants from the Freedom Forum and the Guggenheim
Foundation and cooperation from CBC, BBC, Reuters, CNN,
the Associated Press, ITN and the Rory Peck Trust of
freelance journalists, he conducted an extensive study
of the habits and psychological conditions of journalists
reporting from conflict zones. Dr Feinstein found war
correspondents to have a higher rate of PTSD than police
officers, and about the same rate as combat veterans.
The journalists in the study admitted
that it was a combination of pride, guilt and shame
that kept them from seeking help. At a discussion on
the topic hosted by the Freedom Forum, London Times
reporter Janine DiGiovanni explained her unwillingness
to get counselling after being shot at and subjected
to a mock execution in Bosnia. "To me it seems incredibly
indulgent, because it is the people who have been raped,
the people who have had their villages destroyed, the
amputees in Sierra Leone who are traumatized," she says.
"We go there voluntarily and we can leave, but they
don't."
TRAUMA
REMEMBERED
But as Dr Feinstein conducted surveys of 170 of the
world's preeminent war journalists, interviewing 28
of them face-to-face in great depth, he encountered
surprisingly little reluctance to bring things out in
the open. "I was fortunate to find some very experienced
journalists who were very honest in expressing their
feelings and experiences," he says. "Some didn't want
their names quoted, others didn't mind, but the majority
seemed happy to pull out of the closet things that had
been under wraps throughout their careers."
Last year Dr Feinstein published
Dangerous Lives: War and the Men and Women
Who Report It, which includes many of their stories.
It makes for harrowing reading. In one section, London
Times correspondent Anthony Lloyd tells of an unforgettable
encounter he had in Chechnya, where he was approached
for help by a hysterical woman dragging the torso of
her dead husband in a sleigh and clutching one of his
disembodied legs in her hands. In another, photographer
Jon Jones recounts the time a shell was launched into
his bedroom in Sarajevo, blowing him through a wall
into the next room. "What struck me was that these people
didn't have just one horrifying story to relate," Dr
Feinstein recalls. "Each of them seemed to have had
a number of extraordinarily traumatic experiences."
CONSERVATIVE
CROSSWIND
Not all journalists were pleased to see this can of
worms opened, however. The doctor has faced some hostility
from more conservative quarters of the profession. "My
book got a bad review from [CBC] broadcast journalist
Ann Medina, for example," explains Dr Feinstein. "She's
from a generation that thinks that everyone's fine,
that this sort of thing is a lot of psychobabble. Well,
they're not fine," he says, his voice rising
indignantly. "I see the ones who aren't."
Despite the conservative crosswind,
Dr Feinstein's effort has hit its key target —
the war correspondents themselves and their bosses,
and the topic is as relevant as ever in these war-torn
times. The back of Dangerous Lives boasts enthusiastic
blurbs from Tony Burman, Editor-in-Chief of CBC News,
CNN President Chris Cramer and Robert Giles of Harvard
University's Nieman Foundation for Journalism. "The
media needs to know that a flak jacket cannot protect
our feelings," writes Mr Cramer, who suffered PTSD himself
as a young reporter after being held hostage by Iranian
terrorists in London.
CNN, along with the BBC, have led
the way in establishing psychiatric services for war
reporters, and have been followed by organizations including
Reuters, the Associated Press, the CBC, the prime American
networks ABC, NBC and CBS, and the New York Times.
The key to the success of these programs is that the
journalists are guaranteed complete confidentiality.
Though he doesn't go so far as
to visit conflict zones himself —"I'm a married
man with three children," he says a little tersely —
Dr Feinstein remains actively involved in the programs,
offering advice to both journalists and administrators.
"Changing corporate culture is a long, slow process,"
he explains. "But they've come to understand that there
will be journalists who from to time develop emotional
difficulties."
And when he meets journalists who
shrink from seeking treatment for fear it will tarnish
their macho reputations, Dr Feinstein has this to say:
"I have never heard of anyone's reputation being ruined
by counselling, but I have seen lives ruined by lack
of treatment."
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