The Aftermath Exclusion: Why the Crown Only Honours Our Sanity After We’re Dead

When the nightmares get too loud, I still sometimes yearn for the whiskey that kept them quiet. My last sip was more than eight years ago, traded in for warm mugs of tea instead — I wish I could say the same of those awful dreams.

I’ve been thinking about a cold Edmonton night. A short time after I traded my camouflage in for the high-visibility striping of a civilian paramedic uniform. Same job, different clowns; just a lot more pavement and lonely nights and perhaps fewer people screaming about honour.

If you leave the army without a deployment under your belt, you carry this quiet, gnawing phantom ache where your pride is supposed to be. You trained for the sandbox. You watched your brothers pack their kit, you drank with them the night before they shipped out to some makeshift runway in the arid landscape of Kandahar, and then you stayed behind on the green side of the grass. When some of them came back in boxes draped in flags, you carried the corners of the steel tomb. You stood at attention while the bagpipes gutted the sky and silenced the birds. And then you took off the uniform, put on a civilian paramedic shirt, and told yourself you were moving on.

At least, that’s my story, anyway.

Except the cold, hard reality is that war doesn’t care about your career change. Or your desire to keep things drenched beneath a sea of bourbon and other poor coping mechanisms. Instead, it teases you with a perverse sense of humour and a timeless reach.

On this particular frigid nightshift in the city, my supervisor pulled me aside with that solemn, tight-lipped gravity higher-ups get when the next words out of their mouth are going to be sopping in weighted responsibility.

A flight was coming in from Overseas. Injured soldiers out of Afghanistan, returning before they had ever intended to. Critical ones. They’d be touching down at the Edmonton inner-city airport and needing street transport to their respective trauma centres. Because the universe loves a good, twisted irony, they handed my partner and I the keys to the bariatric unit — the massive, heavy-duty ICU on wheels — and assigned my partner and me to the worst of the lot. A kid on a ventilator, coming off the tarmac with a full military trauma flight team, a doctor and a nurse sewn to his life support.

I watched the plane come in. Staring at it so God damned hard that I almost bore a hole through the metal plating. All I could think about was my brothers and sisters who were, at that time, in Afghanistan. Braving the heat and fighting the odds just to see another morning.

When the pane came to a stop, personnel made themselves visible, and started gesticulating for myself and my partner to move in.

We did.

Each step that brought me closer to the plane was one I was unsure I could make. I felt like my limbs were made of lead and my stomach churned as if hamsters on wheels were throwing a party.

Stepping onto the belly of that aircraft is something tea will never wash out of my sinuses. Before I even observed the stretchers, the smell bullies my senses. It was a thick, suffocating wall of silver sulfadiazine burn cream, hot medical plastic, stale sweat, and the tinny-metallic tang of seared human tissue.

All of this becomes a touch worse when understanding that scent and smell are as a result of physical particulates making contact with your nose and tongue. As I inhaled the wounds of these young men, I scanned them to see if I knew any of them.

I didn’t.

But someone knew me…

“Heneghan…you look good in paramedic garb.”

A baritone voice broke the sterile silence. One of my former commanding officers. A high-ranking physician entrusted with keeping these boys alive from war-torn lands to the sleet-soaked tarmac of Edmonton.

“Happy to see it’s you — now I know they’re in good hands.”

Quite the compliment. Especially with the reality being that mine were shaking beneath my gloves.

My patient; a man no older than a boy with bilateral chest-tubes, intubated and sedated. Plastic eye shields to stop him from scratching at them during moments of semi-lucid terror. His body was swaddled by white medical bandaging that was stained with varying yellows of plasma seepage, dried blood and other remnants of weeping wounds. Any skin that was visible was sickly looking; charred and sore.

To move him from their stretcher to ours was an ordeal. A well choreographed movement of medical professionals coming together in a most serious moment. Once he was on our bed, they had to disconnect the machines from their powered units, meaning he was on battery power — and if anything should fail, it could mean that death is closer than life.

We had to move quickly, but purposefully. Somehow, by the grace of God or some other divine power, I was able to perform with skill and precision.

We brough him to the hospital, and before we made to his room, I could see a small gathering of people waiting at the end of the hallway we were navigating. A woman rushed us. Normally, our paramedic instincts would have prevented such a thing. But neither me nor Ryan did anything. We knew it was the mother. Somehow, some way, we just knew.

She flung her upper body over the railing and began to wail loudly.

“Matthew! Oh my, Matthew!”

Her son’s name…

There’s a certain frequency to grief. It’s an oration not easily forgotten. No matter the passage of time.

We allowed her a few moments before gently ushering her away. She followed us to his room.

We handed over care and went back to rig, turned over the engine and listened to the murmur of idling diesel before pulling back out onto the road. We returned the bariatric unit and reclaimed our assigned ambulance.

Back in service.

I don’t know what happened to that young man. But I know what happened to me that night…I grew up. I got older. My view of the world changed, irrevocably.

Wars don’t stop because papers are signed and politicians pose for photos. Those who went and those who felt consequence by proxy never truly come home. Because home is never really the same, is it?

Remembrance Day lands on a single day. For veterans and combat veterans, remembrance is every day. Sometimes it’s late at night when the whole house is sleeping and you lay awake, inhaling burned skin, singed hair, and charred tissue.

Medics get the short end of the stick when it comes to honours and recognition. Why do I say that? Because, when examining Chapter 9, Annex J, Appendix 2 and 3 of the CF Honours Policy Manual, the flaw in this policy becomes indefensible:

The “Aftermath” Exclusion Punishes Medics: Appendix 2 explicitly disqualifies “medical personnel arriving on site to treat victims… hospital and morgue staff” who deal with the aftermath of hostile action rather than the kinetic blast itself. By design, the institution tasks medics and casualty personnel with absorbing the physical and emotional shrapnel of war, and then uses their job description to disqualify the resulting injuries from formal recognition.

The Posthumous Contradiction: Under Appendix 3, if a CAF member dies as a result of a mental disorder “directly attributable to military service,” they are eligible for the Sacrifice Medal posthumously—without the requirement of direct hostile action. Yet, while a member with a 5/5 service-attributed mental injury remains alive, fighting daily to survive the exact same condition, the Crown refuses to recognize that wound as a sacrifice.

You will never convince me that sacrifice of sanity is not a sacrifice. And you will never convince the army that it is.

Lest we forget.