Meredith L. Perry, DO, fell asleep happy on Oct. 25, 2009. Although she was stationed in southern Afghanistan as a Navy flight surgeon and sharing a tent with 20 Marines, her mood was elevated because her favorite football team, the Pittsburgh Steelers, had just beat the Minnesota Vikings, her commanding officer’s team. The two had been trash-talking each other for weeks.
But Dr. Perry’s thrill at the victory—a bright spot in what had otherwise been an intense and stressful deployment nearing six months—was shattered at 4 a.m. She was woken and told a midair collision between two helicopters during a training exercise had killed four of her patients in the squadron and wounded two others.
“Our world turned upside down within a few hours,” she says. “It makes you quickly realize what’s actually important, and it’s clearly not a football game.”
All the injured were friends of Dr. Perry’s, the bonds between them strong from the months they spent together in Afghanistan. The two survivors received emergency care at the nearest medical facility. In the meantime, as the squadron’s senior flight surgeon Dr. Perry was tasked with identifying the dead as well as investigating and ruling out possible medical causes of the crash.
“I had to go through all the personal effects of the dead, which was probably one of the least pleasant things that I’ve ever had to do,” she says. “One of the pilots who died was expecting a baby. He had all kinds of ultrasounds and letters from his wife. Another one was recently engaged. Another one was from Alaska, and he had been flying an Alaskan flag in Afghanistan to send back to his family. It was just absolutely heart wrenching.”
Two weeks later, Dr. Perry was on a plane, her deployment over. She flew to Bethesda, Md., to visit the two surviving Marines from the accident, who were getting further treatment for their injuries. One was paralyzed by the accident.
“It was the first time I had seen them since the crash,” she says. “And I realized that this was way bigger than me. As a medical professional, I knew what PTSD was, and I knew what the symptoms and signs were. I saw that I needed some help.”
Now a medical resident in urology at Detroit Medical Center, Dr. Perry says her military experience and personal struggle with posttraumatic stress disorder have shaped the way she treats patients now. She also seeks to raise awareness of veterans and PTSD by speaking to groups about her accident, her illness and recovery, and her transition to civilian life.
“If telling my story can help one person, then something good came from that terrible night,” she says.
What made the loss more difficult, Dr. Perry and her commanding officer agree, was that there was no time for them to grieve. Everyone in the squadron had to keep working.
“Our pilots were still flying, despite the fact that their friends had just passed away,” she says. “The mission still went on. A lot of people figure that things like this happen and you pretty much shut down. But you don’t. You have to protect the guys on the ground, you have to keep your helicopters in the air.”
Retired Lt. Col. Tom Dolan, Dr. Perry’s commanding officer and the squadron leader, says he could not have presented a brave face to his troops were it not for Dr. Perry’s assistance.
“Dr. Perry helped me lead the squadron in getting over the tragedy and continuing on with the work that we had to do. For us, there was no shutting down operations,” he says. “She kept a positive mental attitude about everything and pressed on.”
Dr. Perry’s resilience was particularly impressive considering her deep friendship with the men who had died or were wounded, Dolan says.
“Dr. Perry went from identifying the bodies to finding the flight schedule to have guys continue flying three hours later,” he says. “That’s hard, especially when you know the people. Every one of our patients she was peers with.”
According to Dolan, Dr. Perry did a stellar job handling the accident. But over time, the graphic scenes she witnessed and the emotions she had felt started to affect her. She began to have nightmares and flashbacks. She was crying more often than usual. She had trouble making decisions, even after returning to the U.S.
“I had a moment in a Target when I needed socks,” she says. “And I couldn’t pick any because there were just too many choices. I freaked out and had to leave.”
Dr. Perry first tried talk therapy, but decided that continuing to rehash the accident was not helping her at the time.
“I realized that the more I talked about it, the less it got better,” she says. “So I started looking into other treatment options.”
She tried eye movement desensitization and reprocessing (EMDR), a psychotherapy technique that helps PTSD patients process and cope with their traumatic memories. The treatment alleviated her flashbacks and nightmares, but she still had problems. For example, the smell of barbecue food continued to trigger flashbacks.
“The smell from the barbecue was something I couldn’t handle,” she says. “So I basically just forced myself to stand next to barbecue grills, and I sort of did my own immersion therapy. I would stand there for as long as I could, and then I would leave. Now I can stand next to a barbecue without any trouble.”
Four years later, Dr. Perry is a third-year urology resident in Detroit, and she brought four years of active-duty military experience to the job.
Dr. Perry came into the program with leadership skills and maturity well beyond those of a typical first-year resident, says Adam W. Ylitalo, DO, Dr. Perry’s former chief resident. He attributes this, in part, to her military background.
“Even though she was brand-new to the program—many people take a backseat and spend time just observing and finding out exactly how things work—she jumped right in and took initiative to make sure that her educational needs and the needs of the program were high priorities,” says Dr. Ylitalo, who is now a urologist in Waco, Texas.
“And she was very regimented in her work-up of patients,” he says. “She understood how a process in general works and that a lot of things are step-oriented—that following that basic standard would eventually lead you to the right diagnosis. I think she understood that better than a lot of people do.”
Dr. Perry says her time in the military and her struggle with PTSD have also directly affected the way she works with patients.
“I take more time to talk to my patients than I did in the past because I’ve realized that a lot of things are not outwardly visible,” she says. “You can’t look at me and say, ‘She was dealing with PTSD.’ But the more you talk to me, the more you might realize that there was something going on deep down inside. The more I talk to my patients, the more I realize the etiology of what could be going on with them.”
Her experiences have also raised her awareness of how patients respond emotionally to physical symptoms, Dr. Perry says. As a urology resident, she treats patients who have prostate cancer, which can have psychologically distressing physical effects, as well as those with erectile dysfunction.
“You really have to talk to these guys and see how they’re doing because a lot of people will say they are fine when you ask them how they are doing,” she says. “That’s what I did for a long time. Was I fine? No. But the more you talk to them, the more you get out of them.”
Her time in the military taught her not to make assumptions based on appearance, Dr. Perry says, and to take patients’ social history—including military background—seriously. She advises other physicians to do the same, noting that you can’t always tell who’s a veteran by sight alone. Physicians should be in the habit of asking their patients if they’ve ever been in the military, she says.
“If a patient has a military background, there’s a possibility that there’s something there that he or she doesn’t want to talk about that could be affecting him or her physically or mentally.”
“As osteopathic physicians, we pride ourselves on treating the whole person,” she says. “Military service can be a big part of a patient’s history and their psyche, and it’s a big part you don’t want to miss.”
Military service is certainly a significant part of Dr. Perry’s history. She’s proud of her service—she keeps all her medals and ribbons on a shelf in her home. But transitioning from the military to civilian life was difficult for her. Women in the military get used to operating in a more masculine, male-dominated environment, Dr. Perry says, and often have a hard time readjusting when they leave it.
In 2011, Dr. Perry joined Fatigues to Fabulous, an organization that helps female veterans find employment and transition to the civilian world.
A colleague in the organization asked her to speak about the accident and her recovery from PTSD at a Society for Women’s Health event. Since then, Dr. Perry has spoken to other audiences. She will keynote the Michigan Osteopathic Association’s spring conference next year.
“Dr. Perry has been extremely inspiring to other women veterans by talking about how to work your way through the transition and how to reach out for help,” says Ronnie Denn, the president of Fatigues to Fabulous. “She’s a hero.”
Many physicians are reluctant to publicly acknowledge their own mental illness. But Dr. Perry says doing so was important to her recovery and that she wanted to help others who may have similar problems but are afraid to talk about it.
“The Marine Corps family is very tight-knit,” she says. “When I was talking with my military ‘brothers’ and ‘sisters,’ I realized that my struggle isn’t something that should be held inside. If you keep it inside, it just becomes this abscess. You need to express it, and you need to share it. I’m not the only person in the world who is dealing with bad things.”
One recent speech, Dr. Perry notes, morphed into an impromptu town hall meeting.
“Everybody in the audience sort of opened up and started talking about their issues and patients that they’ve had or personal experiences that they’ve had that they haven’t been able to move past or have been struggling with,” she says. “We all just powwowed and talked about problems and issues and solutions.”
One man had recently lost his son and was having difficulty moving on. Dr. Perry talked with him about the treatments she had used and how she recovered. Another woman said she had been raped as a teenager, but had never talked to anyone about it before. She didn’t know where to start. Dr. Perry gave her some resources.
“If I can take my experience and share it, and it helps someone else to finally open up and get treatment and get help, then that’s the best thing,” she says.