Ideas - Why moral suffering can be a good thing

Episode Date: June 19, 2026

It's tempting to think suffering should be avoided at all costs, but moral suffering has its own distinct standing. It signals a moral conscience. Every day people consume real time violence, grief, war and genocide through screens and experience moral upending. Without a moral compass there’s no motivation to address necessary issues.Guests in this episode:Cynda Rushton is a nurse and a professor of nursing and bioethics at Johns Hopkins University.Robert Meagher is an emeritus professor at Hampshire College in Amherst, Massachusetts.Thea Lim is a novelist, culture writer, and creative writing teacher in Toronto.

I am an actor, fresh out of theater school with big dreams and an even bigger drug habit. But things are pretty good. That is until my best friend is set up on a date with David Lee Roth. Yeah, from Van Halen. If you know, you know. From CBC's personally, this is Discount Dave and the Fix. The true-ish story about how a fake rock star led me to a real trial that held up a mirror to me. And okay, let's just say that not everyone in this story is who you think they are.

Personally, discount Dave and the Fix. Available now on CBC Listen or wherever you get your podcasts. This is a CBC podcast. Welcome to Ideas. I'm Nala Ayyed. I cared for a young child who had had a very serious anoxic brain injury and was left in a persistent vegetative state. At that point in time, the parents, parents, when they were informed of her condition, really felt that sustaining her body with

machines and ventilation was not what they wanted for their child. And they asked the clinical team to discontinue those. At that particular time, the clinical team did not feel that that was an appropriate response and refused their request. And as a result, this child was cared for in our intensive care unit for almost a year. And over that period of time, only had reflexes. The parents stopped visiting, and so we became the primary caregivers for this child. It really raised some questions in our own minds as nurses. you know, why were we doing this?

What was the goal of our intervention other than to sustain the bodily function of this child who had no awareness at all and whose parents really did not want their child's life to be sustained in this state? And so at the time, there really was no word for what we are experiencing. And so that was really the beginning of my journey to try. try to find a name for it. And then, you know, later after really spending a lot of time trying to describe the kinds of situations that produce what we would call moral distress or moral suffering, I really began to wonder what else was possible. But now there is a word for the guilt, shame, and betrayal we experience when we violate for whatever reason a deeply held value.

That term is moral injury. Moral injury is, first of all, a moral injury. It's a wound to conscience, to our moral compass, to our soul, to identity. It's when a person perpetrates, witnesses, or fails to prevent any act that transgresses our own moral beliefs, our core values, our ethical codes of conduct, our humanity. My brother was drafted and went off to Vietnam with the first air cavs and came back shattered. And I didn't understand why the man, my brother, who had came back to me was a different person from the one who left. And I felt I had lost him in various ways I had lost him.

For decades, moral injury was a term reserved exclusively for soldiers returning from war. But in recent years, the conception of it has expanded. We now know that moral injury can also be produced by everyday experience. I think some of the ways that we get ourselves into trouble is when we make up a story about the emotions that we feel, that kind of create an abstraction of the concrete situation, so that we don't have to feel those bad feelings or so that we can rationalize them away. There's a kind of moral stress that arises when we're confronted with a situation where,

you know, we have to make a hard choice between two options. And often, to me, it begins sort of with that feeling in our gut that something's not quite right here. Not quite right. a sign that we've entered into morally dangerous terrain. What does it mean for us to see people who are suffering, right? What does it make us want to do? How do we think about these in really concrete terms? Ideas producer Nahed Mustafa explores the landscape of moral injury

and the often hidden toll exacted by guilt whenever we don't or can't act on what we believe is right. So to me the moral stress is kind of, of the beginning of the process where it alerts us to there's values at stake here and we have to make a hard decision and in some cases you know just that moral stress allows us to identify where that tension's coming from and sometimes we can even resolve it so to me that's kind of the beginning of the continuum if that can't be resolved at that point and You know, a situation continues to unfold. Then we may find ourselves in a situation where we're

actually doing something that we think is not in alignment with our values, that we know what we should do, but for some reason, usually either internal or external constraints, we can't do the right thing. And that leaves us feeling a sense of what I would call moral distress. And then, you know, beyond that, if that moral distress really isn't relieved, and there's some kind of moral adversity that overwhelms our capacity to feel that we can be a whole person, that our integrity is intact, then we often experience what is referred to as moral injury. Moral injury shares some features with PTSD, post-traumatic stress disorder, but a key difference is while PTSD is driven by fear, moral injury is driven by guilt.

It also can happen clinically when we are in a situation where we don't have any moral authority to choose how we respond. My name is Cinda Rushden. I am a nurse and a professor of nursing and bioethics of the Downs Hopkins University. And one of the examples of that during the COVID pandemic was, you know, people came into hospital settings. People needed care. And under other circumstances, we might have been able to provide that care for them. But because of the, you know, intense limitations on resources, we weren't able to do that. And so that left people feeling as if they had done something wrong. And, you know, in one way, it wasn't their fault. there clearly were limitations on what was available.

But yet, I think a lot of clinicians felt responsible for the outcomes that honestly they had no control over to a large extent. So to me, it's a different magnitude and intensity of moral suffering that often is not even recognized in the moment. It's often recognized retrospectively. You know, it's kind of like at the end of COVID, We look back and we go, oh, wow, I can't believe I participated in these activities, or I can't believe my actions caused harm to others.

And then, you know, it begins to erode our sense of who we are as a person, our moral identity. I remember nurses saying to me, am I still a good nurse? because I've participated in these things that have resulted in, you know, bad outcomes for patients. And some of them were unavoidable, but there's still that nagging question in people's minds of, you know, to what extent am I responsible for those outcomes? And so, you know, it really begins to leave a scar on their conscience and their view of themselves and their, you know, sort of co-referred. of who they really are. When nurses experience this moral injury, like through COVID, for example, what is the remedy?

Well, it's an interesting question. I mean, in our work, actually, before COVID, we began to ask the question, so what else is possible? You know, is it the case that these situations are inevitably going to dismantle our, our integrity, our sense of who we are, and there's no way forward. And that was really when we began to develop the concept of moral resilience, which is really the ability to preserve or restore our integrity in response to some kind of moral adversity. And there's endless possibilities in terms of what kinds of moral adversities everyday people are experiencing, but clinicians in particular.

And what we have done is we actually have developed, you know, sort of a conceptual framework that includes, you know, a real grounding in personal and relational integrity, but also includes elements like our ability to be buoyant, our ability to self-regulate and to be able to manage the inevitable situations that we're in with a little less cost. to ourselves as human beings to develop a sense of moral efficacy that actually I have choices in these circumstances and I can use tools that help me clarify, you know, how can I, to the greatest extent possible, act in accordance with my values? And then another important piece is this idea of self-stewardship, of being able to see ourselves as worthy as human beings, not because of our roles or our titles, but because of our humanity, that we can know ourselves well enough to know what nourishes and what depletes us and how to choose things that actually are life-giving instead of life-draining.

So I think a lot of our work is about restoring a sense of agency, because one of the features of both moral distress and moral injury is a feeling of powerlessness. And when you feel powerless, you don't feel as if you have any choices. And some of those choices might be that, you know, I can stay and participate in system change in this organization or not. And to me, both of those are viable options, but it's particularly important that they arise from a place of clarity and groundedness rather than just reaction, so that people really can see what they're choosing, understand the consequences of either going or staying, and then to me that creates a foundation where people can live with the choices that they make.

Signs of moral injury can include guilt and shame, anger, and disgust. A person can feel intense self-criticism and feelings of betrayal. The symptoms of moral injury are really natural responses. It's not a mental disorder. It's a very appropriate response to evil. Evil that we have seen, evil we have witnessed, evil we ourselves have committed, or which we have been unable or unwilling to prevent in others. So it's a soul injury, a moral injury.

Moral injury has very distinct symptoms of its own. Sorrow, grief, regret, shame, alienation. My name is Robert Maher. I'm a retired professor, emeritus professor at Hampshire College in Amherst, Massachusetts. Robert has spent decades working with veterans and writing about moral injury. How did I get into this? actually, I witnessed and became involved in moral injury from my very early childhood.

I grew up in the 1940s. I was born during World War II. And as I was becoming more and more conscious at the age of three and four and five, I was surrounded by those who were really suffering from moral injury. His Chicago neighborhood was filled with people who'd witnessed and suffered wartime horrors. It had at that point in time the highest percentage of Holocaust victims of anywhere in North America. And I knew a lot of these victims as they were trying to recover their lives and make new lives for themselves. and also I was surrounded by World War II veterans,

my family and my neighborhood and my friends' dads. I was enamored of war, thrilled by war, had dreams about war as a five and six- and seven-year-old, used to play war constantly. One day, Robert and his friends were playing war when a young man in the neighborhood, a former soldier whom Robert and his friends knew and liked, saw the boys imagining themselves as soldiers.

When he saw us playing war, he came out and was angry. It was the first time I had ever seen him angry at us. And so he said, I want to tell you all something. War is not a game. And he said, I want you to know about war. So he began to tell us what he had done in the war. war. And this was to, you know, to five, six, seven-year-old children. The war stories he told were not censored. There was no trigger warning for them. And as he began, as he told these stories,

he began to tremble. His lips began to quiver. And he found it more and more difficult to talk. Eventually, the man's wife saw his distress and came over to take him home. Before he got up, he looked at us and he said, remember, I wanted you to make a promise. And the promise is that you will never go to war. Never, for any reason, will you go to war? My next entry into work with moral injury was when my brother was drafted and went off to Vietnam with the first aircalf. and came back, shattered. And I didn't understand why the man, my brother,

who had came back to me, was a different person from the one who left. And I felt I had lost him in various ways I had lost him. And I wasn't sure how to reconnect. He would never talk about the war. He wouldn't describe anything that he had done or experienced that would explain why he had been so transformed, so shattered by this war. And so I began to research. I began to study.

I began to look for anything I could look to tell me what he had experienced, what he had suffered, what he had done. that possibly account for the transformation that I was witnessing in him and the loss of him as my brother. Losing his connection with his brother led Robert Maher to work with veterans. On the professional side, his academic work included years spent translating the plays of ancient Greece into English. This is the juncture where his personal story informed his professional work. You wrote a book called Heracles Gone Mad, Rethinking Heroism in the Age of Endless War. Can you tell me about this book? What is its relevance to this understanding of moral injury?

Ancient Greek tragedy only existed for 100 years, the 5th century, 5th century BCE. And that century for ancient Athens, the motherhouse, as it were, of ancient Greek tragedy, was born there, was performed there in Athens. Ancient Athens in the fifth century was engaged in constant warfare, very much like the United States in the 20th and 21st century. what has been called the American century was a century of war, as was the fifth century for Athens. These plays grew out of that time. As I began to study them so conscious of the work I was doing with moral injury and the awareness I'd had since a child of the invisible, the terrifying and destructive, invisible wounds that warriors were bringing back and living with for the rest of their lives.

As I was doing both side by side, I realized that Greek tragedy, the Greek tragedies were transparent to the Greek history of the day. Nowhere is in more dramatic than in the Euripedean tragedy, Heracles. In Euripides' version, Heracles comes home after, he's performed his 12 labors, a series of epic tasks in the service of his king. Robert sees Heracles as a returning veteran, morally injured from what he's seen and done. He himself is shattered. He himself is in some ways the shadow of the man who left, and certainly nothing like the inflated notion they have as a result of the heroization of all his labors.

surely he's going to make his own city a safer, better place upon his return. Instead, when he engages in a ritual that involves the slaying, the sacrifice of an animal, he experiences a disassociative episode, which is in the play described as or attributed to Lissaucative episode, which is in the play described as or attributed to Lissa in Homer and so on that word Lissa refers to battle madness to raving to a kind of rabid behavior of a bloodthirsty war driven warrior and so what he he suddenly hallucinates and sees his own wife, sees his own family, sees his own children as enemies, those who he has been killing as his greatest opponents in war,

and he chases them down, enslays them. So he murders his own family and then collapses, collapses into unconsciousness. When he wakes, Heracles sees the death and destruction around him and asks his father what happened. His father replies, My son, I know only this. There is nothing of yours that you didn't ruin. The temple precinct in which the Greek tragedies were performed,

the Theater of Dionysus in Athens was heavily politicized. And the Greek festivals, during which the plays were performed, were profoundly connected to the military. to the city and to the experience, experience of war. The plays were preceded, the ritual of the theater in ancient Athens, or the tragic festivals, were preceded by military activities, military rituals. In ancient Athens, every male citizen was conscripted into the military at age 17.

for two years, the 17th and 18th year of their lives, were given over to military training. At the end of that time, those completed or those graduating recruits were processed into the theater of Dionysus to take an oath to the city, to give their lives and commit their lives to leaving the city stronger, freer, and better than they found it, than they were born into it. They were pledging their lives. And in the theater itself, the amphitheater itself, in the theater of Dionysus in Athens, the audience were all those who are returning from war or from active duty or going out. So many of the plays were transparent to what.

what they had witnessed. And the aim, the purpose of theater in Athens, as Aristotle describes in the poetics, or as he states in the poetics, was catharsis. Catharsis meant a healing, a purification, a cleansing, a renewal that was enacted in the ritual in the theater itself. So this was a place where veterans came together

to experience what the eminent psychiatrist and healer of veterans, veterans Jonathan Shea called communalization. And so this, the purpose of theater in Athens, the purpose of these tragedies was to provide soldiers, provide Athenian veterans, Athenian active duty military, the communalization of their sufferings, of their terror, their wounds, and their moral injuries. And it was a therapeutic community, as it were group therapy. for a nation, a city, a nation state, a city state at war. Athens is fighting for its life and yours eventually.

The Athenian army is facing the Persian Hort at Marathon alone. The life of Athens depends on you. Athens asks you to help her fight. So all of the playwrights themselves were soldiers. If we read the history of the 5th century in which Sopakles wrote his plays and served in the military, can be argued from texts that Sophocles could have committed war crimes. Euripides, who was clearly from his plays a very anti-war Athenian and was eventually exiled.

We know that he also served in the military. Escalis, when he dictated his own epitaph that was to be carved on his tombstone, never mentioned the fact that he was a playwright. only had carved into his tomb throne the fact that he was a soldier and that the enemies of Athens feared him in battle. So these were the playwrights, the musicians, the actors, the dancers, all of them, as well as all the audience, formed a military community, as it were, a city at war. Beneath this stone lies Escalis, son of Euphorion, the Athenian, who perished in the the wheat-bearing land of Jaila. Of his noble prowess, the grove of Marathon can speak,

and the long-haired Persian knows it well. The epitaph of Escalis found in the Greek anthology by Richard Francois Philippe Brunck and Frederique Jacobs. This is Ideas. I'm Nala Ayyed. Since the dawn of time, humanity has been at war. It has shaped the world around us, And if it somehow feels like we've been here before, it's because we have. I'm David Boris. I'm a military historian. And on my new podcast, Hostile History, I take us inside history's most defining wars and rebellions. From Genghis Khan to the war in Iran, find out how the past can explain the present.

Search for and follow hostile history on Spotify, Apple Podcasts, Amazon Music, or wherever you find your favorite podcast. I helped make Mexico safer American oil interests in 1914. I helped make Haiti and Cuba a decent place for the National City Bank Boys to collect revenues in. I helped in the raping of half a dozen Central American republics for the benefits of Wall Street. I helped purify Nicaragua for the International Banking House of Brown Brothers in 1909 to 1912. I brought light to the Dominican Republic for American sugar interest. in 1960. In China, I helped see to it that Standard Oil went its way unmolested. Looking back on it, I might have given Al Capone a few hints. The best he could do was to operate his racket in three

districts. I operated on three continents. Major General Smedley Butler was a United States Marine Corps officer. What I just read is an excerpt from his book, War is a which he wrote a few years before his death in 1940. Over time, he'd become disillusioned and felt duped serving as a soldier. He came to see his military career as service for business interests. Butler spent his remaining years channeling his feelings of betrayal and working through his moral injury by giving public lectures on war profiteering and the threat of emerging fascism in the U.S.

I'm Tayalim. I'm a novelist. I'm a culture writer and I'm a creative writing teacher and probably have to think about morality and moral injury in all those facets of work. When I first reached out to you about doing this interview, you said in your email, you probably think about moral injury every day. Why? I think it's because of where I live. I live in downtown Toronto, actually, on the way here today. I rode my bicycle and I passed. you know, multiple places where unhoused people are living, shelters where people are in distress, where people on the streets. I saw multiple people perhaps in the process of an opioid overdose. It's very difficult to live in Toronto, but also potentially to live anywhere in the global north and not be conscious of the fact that, you know, I myself am at the end of a long supply chain of human suffering. What I specifically am talking about is something strong.

which is the fact that I own property, right, so that my way of life is enabled by the fact that I own something whose value needs to stay up. And so long as its value needs to stay up, I'm going to see things in my neighborhood. Like, you know, there's a church down the street from my house, St. Stevens in the field, where the churchyard has been fenced and filled with cinder blocks to prevent people from pitching tents there because they have nowhere else to live, right? So I can look at that and I can think have this incredible amount of distress. And it's also just so kind of absurdist in a way. And then I can also recognize that technically I need that to be that way in order for myself in a very direct way, in order for myself to have the resources that I have. It both helps us to understand the ways in which we are entangled and maybe what it would mean to kind of find a path out of those things. So thinking about those things, I think, opens our eyes to ways that we can actually be more strategic and ways that we can maybe affect change.

You know, the churn that we're feeling is that merely because there's more churn to sort of feel because there's so much more happening? Or do you think that that marks some kind of change for better if we think of moral distress as a good thing as a sign of action? Yeah, yeah. I think it's all. I think it's all those things. Are we living in more injurious times? Potentially, just in the sense that, right, global supply chains are far more networks than they ever were, right? We are enmeshed with each other in this kind of like degradation of natural resources, including human workers. I think in a way that we haven't been before, right? Like this kind of enmeshment has been happening since the Industrial Revolution, but I think it's now happening at an intensity that has never happened before in a way. continue on in that way. I think now we have the words and the names for it. I think definitely like pathologizing and therapeutizing ourselves has been in vogue at least for the past 30 years probably. But I think what you also say is even more of a desire to elevate ourselves out of the pain. You know, I myself think that one of the hallmarks of white supremacy,

you know, and I think all of us who actually live in this part of the world have some connection to white supremacy, whether or not we're white, is that it really, really needs to present itself as good, right? And that's why when you talk about the colonization of the Americas, they came because they were going to convert everyone to, you know, to Christianity. There always had to be something good about it. It wasn't just like a land grab, even though that's a civilizing mission. Exactly, right? So there always is sort of, and that's one of the hallmarks of it. but it really needs to see itself as good, even as it is doing, you know, the most kind of carrying out war crimes and doing the most heinous things, right? So I think that's where I feel like worried about the conversation about moral injury and moral distress. If it becomes a pathway for us to properly label what's happening within us, right, and to heed, right, that interior call to do something differently, then it's a really positive thing. If it becomes a way to sort of say, like, I have to take a sick day because I'm morally injured, I need to lie. down, then I think, well, I need to lie down for too long and then do nothing about what's happening in my neighborhood, then I think it really becomes very alarming. I don't know. I think as a civilization, it feels like we are constantly at a crossroads in which we are offered

like a good choice and a terrible choice. And it seems as if we are constantly always doing both, right? And that's why we remain, you know, in these terrible times. And nonetheless, there are still people all around us, right, who are working to try to make things, you know, less atrocious. I think what's always important to remember is that moral distress is great, actually. You know, it means that we're human beings. It offers us an opportunity to do something about the terrible things that we see. And that moral distress only becomes moral injury after we repeatedly ignore that call. And we repeatedly find a way to sort of storyify and rationalize our way away from that emotion.

So talk to me about that process of storifying, as you call it, of the moral pain that we feel when we encounter this. What are the ways in which we placate ourselves? Well, I think because we are so steeped in moral distress, because we are, you know, at the end of the supply chain of human suffering. And because those problems feel so overwhelming, it can be natural to try to say, because I feel this way, therefore I'm a good person. So that's all I need to do is feel bad. there's also so many imperatives and so much encouragement in this part of the world to de-center the experiences in the humanity of people who are not in this part of the world or people maybe who are in this part of the world like my neighbors who live in tents or who simply have nowhere to live and to say well they're not part of our group right they're not part of something that we should care about or be interested in when I first began to think about moral injury and moral distress I became like a little bit worried about the way that the constant of itself, especially for example, we're thinking about soldiers, maybe kind of erase the actual victims of war from the picture, right? We're so focused on the suffering of soldiers. We're not thinking about the people who have died, right, in the war. In the same way, we can become so focused on our own distress, on our own unhappiness so that we don't think about the people who actually, right, don't have somewhere to live, who are actually suffering in terrible ways, like on our very

doorstep. I think, I think that's what I actually really want my children to think. about, right, is that when we feel upset, it's not actually about us. It's sort of our like, whatever you want to call it, you can call it a conscience, you can call it our human nature, you can call it some kind of meter, encouraging us to do a little bit better. And we have to be very careful to not make ourselves the main character of that story, which I think sometimes these concepts threaten to do. It's also this idea that moral injury or moral distress isn't, isn't all. often seen as a pathway to something else, it's seen as the thing in itself. And so now, you know, now we need to grapple with the moral injury of large swathes of society, rather than saying, what is this telling us about the road that we're on. So how do you, how do you do that?

I mean, you know, it's also not always possible to say the suffering that you're having, that that is not the important thing. The important thing is what are you going to do about it now. It isn't always easy to turn the conversation, though. And so how do you think about that, turning it away from people's own inner moral distress to turning it outward to mean something more? I mean, I do think that sometimes where, you know, I think we have, as a culture, we have generalized anxiety disorder. And I think that that actually comes from not having those bad feelings. So there actually is, I think, a great value in sitting with the bad feelings. And feeling in not trying to, and neither trying to sort of wallow in it, which I think is sort of what I was

talking about earlier, but also not trying to sort of tamp it down or turn away from it, the more. And I think actually, you know, when you ask sort of what's happening when I walk down the street, for many of us, and often for me what's happening is that as soon as I have the thought of distress, I push it away because I got things to do, you know? I think that that's a very normal thing to do. But the more that we do that, I think the more that we have that kind of like ambiance of anxiety because something is wrong and we won't look at it. So I think there actually is a value to kind of feeling those emotions and really sitting with them and sitting with that unhappiness and that distress.

I think where it becomes a problem, it's sort of like we said, when it's the thing that we focus on as a thing that needs to be cured and fixed instead of taking the opportunity to think about where it comes from. And I think the reason why there is an impulse to focus on the emotion is because part of the way that, you know, our dominant systems protect themselves is to try to reflect things that are systemic as individual. So we have a systemic problem. We have a systemic problem as a culture we have decided that making sure that everybody has a safe place to live is not as important, right, as protecting property values. that can very easily be converted into an individual problem if all we're thinking about, right, are the bad emotions that homeowners or people who are like safe in their tenancy feel. That just makes it about it's something between, you know, me and myself, or it's something between me and the person that I'm having coffee with.

Instead, right, the way out is to actually think about these systems, as complicated as they are, these are systems that we have created, You know, they were not given to us by some deity. And so that means that there are also things that we can dismantle. It's tempting to think that moral injury is something we should avoid, just as we avoid anything that hurts and causes us pain. But moral injury has its own distinct moral standing. You've written that in the quest for answers around moral injury,

quote, it became apparent that some level of moral suffering in the nursing profession is not only expected, but it is necessary. Why do you think it's necessary? Well, you know, if you think about a world where there is no moral compass at all, where there is no awareness that there are values at stake and when those values are compromised, to me, our moral suffering is a signal of our moral conscientiousness. that we actually care about these values of things like compassion and dignity and justice.

And if we don't experience that sense of tension or conflict, then we're probably not even going to notice when those kinds of conflicts occur. And to me, that suggests a world without any kind of moral conflict. at all. And I think that, you know, it's a motivation that is necessary for us to actually take action to address those very issues. We should be grateful for a moral injury in the sense that it is testimony to the fact that we have consciences and the violation of who we are is deeply and sometimes enduringly and sometimes unbearably painful to us. I think, something that I grapple with in my work a lot of the time is that looking or witnessing,

especially if we're talking about something like a genocide, whether I'm talking about the genocide in Palestine, whether I'm talking about the genocide that happened, you know, on the very land that we're in to indigenous people in Canada. There's no point to it, right? It doesn't actually prevent any of the atrocity in the horror. And nonetheless, it is something that we must do, right? Why must we do it? I think it's actually something almost like spiritual, right? Or metaphysical. It's something that we have to do. Otherwise, we're not really people anymore.

But it doesn't, I think, take the place of material action. I think that something that sometimes I find a little bit troubling about my fellow artists is that there's this sense that if we talk about, you know, the terrible things and we deconstruct them in our art, then we don't also have to stand in our positions as neighbors or stand in our positions as workers, right? or as people with public platforms were sort of absolved with those things and I actually think that that's really not true these kinds of power operate across different planes right so as artists we can engage with that stuff in our work and then we also have to think about

well what systems are we colluding with in getting our work across right and how can we stop doing that we can also think about it in our lives as neighbors like what am I participating in in my neighborhood that actually goes against what my deep held moral beliefs are and what can I actually do to stop For many, many years, I've spoken of the United States, of my own country, as a wounded nation.

And for one thing, warriors, when they go to war, bring their war back with them. Wars are never over when they're over. They're just imported. It's always been an illusion that there is this moat, as it were, between the war zone and the homeland. And if war doesn't touch our nation, if we keep it isolated, if we keep the civilian population isolated, and if we keep the veterans silent, and if we can somehow enable them to live with their wounds so that the miasma or the disease that they have suffered by being in war is not contagiously brought over into the civilian population, we can go on waging wars with impunity. That has all been shattered, I think, in recent years. And anyone with open eyes, I think, in open consciences and hearts knew that veterans bring their war home with them. And we have been a severely, profoundly wounded nation for my entire lifetime.

HECUBah's outcry in the play, Euripedean play, Hakebe, that I've outlived the world I knew. And moral injury is now epidemic. It's absolutely true that in the work that I do with nurses even and doctors is how difficult it is for people to name what is your moral compass. What is it that, you know, when the rubber hits the road, what are the values, not your preferences, but core. values that apply to everybody that you will defend no matter what. And people look at me with, I don't know what you're talking about because we've not actually cultivated this, you know, inquiry into who you are. What do you stand for? And why is that important? Is because if you don't

have that kind of grounding, then you're kind of rudderless when you're confronted with these kinds of issues. I think that's why I keep coming back to the idea that we shouldn't be trying to cure our moral distress, because the more that we're trying to cure it, the more that we'll think, by helping, I didn't feel better. Therefore, there must be no reason to help, right? Therefore, I fall into despair. We have to get comfortable with despair in the same way, probably, that we have to get comfortable with moral distress, the more that it becomes about trying to figure out how we can be good, right? How we can make ourselves good. how we can cleanse ourselves of our complicity or whatever it is that we get from being associated with this part of the world,

the more that it's about our sort of internal mission, which is sort of like Christian, right, this idea of like cleaning our spirit. The more we're not going to get anywhere. But the more we kind of make a friend of that emotion, as awful as it is, because that's the emotion that if we read it correctly, it's telling us what to do. It's telling us as we have agency. It's telling us that there's something that we can do. the more that we can start to look at the systems and look at them, yeah, not because we're ever going to be cured, right, of this distress or this guilt. And I think the word guilt is very interesting too because I think usually guilt is the price we pay for doing something bad because if you don't want to feel guilty, either you say, well, I did my best or you say, I'll make a better decision next time. Often guilt is sort of the thing that you pay in order to get away with the bad thing that you.

you did. But the more that we recognize that we're not going to feel better, the less that becomes a goal for making change. And instead, the point of making change is to actually improve things for other people who we have the ability to help. We've been listening to Nehid Mustafa's documentary about moral injury. Thank you to our guests. My name is Sinda Rushden. I am a nurse and a professor of nursing and bioethics of the Downs Hopkins University. My name is Robert Maher. I'm a meritist professor at Hampshire College in Amherst, Massachusetts. I'm Taye Lim. I'm a novelist. I'm a culture writer and I'm a creative writing teacher. This episode was produced by Nahid Mustafa. Our web producer is Lisa Ayuso. Technical production, Danielle Duval,

Will Yarr and Emily Kiervasio. This senior producer is Nikola Luchic. Greg Kelly is the executive producer of ideas, and I'm Nala Ayyad. Ron Kovac is a guy who, in a lot of ways, he's a lot like me. He was in the Cub Scouts. He loved baseball. He had his baseball idols. He wanted to be a good guy.

He loved God. He loved his country. He loved President Kennedy. He wanted to be a hero. He decided. He wanted to join the Marines and fight because he had fought a lot as a kid with toy guns and machine guns and so forth. Top it all off, he was born on the 4th of July, so that every 4th of July when the country was celebrating his birthday, Ron Kovac was celebrating his birthday as well. The country was celebrating its birthday.

Ron Kovac went to Vietnam and served not one but two tours of duty. And the second tour of duty, as you may already know, he was shot twice, once in the foot, and the second time, I think through his back, shattered his spinal cord, and he, Ron Kovac, was paralyzed from the chest down. I believe that all of us grew up with John Wayne, with whole movie, cinema image, the toy guns, the Mademitell submachine guns that we got every Christmas. The whole generation was prepped and hyped and conditioned by our culture, which is so violent and which so romanticizes war.

We were ready to go. We were ready to fight. We thought that the war was going to be like the John Wayne. movies, but it wasn't. It was different. And when we came home and tried to tell the American public about the reality of the Vietnam War, that it wasn't a war to help people, but it was a crime against humanity and against the Vietnamese people, and they didn't listen to us. They threw us in jail. They called me a traitor. They spit my face. I never thought that I would ever come back paralyzed. I never thought that I would ever come back from the war, not being able to

have sex again, and not being able to feel my body. I could never envision that. I romanticized that I would come home. Remember Henry Fleming and the Red Badge of Courage and the classic by Stephen Crane? How Henry Fleming, in the beginning of the book, pondered how he would act in comment, what it would like, what would it be like for Henry Fleming to be wounded? And I would ponder and I would think about what it would be like coming home.

And I always pictured myself, limping back to my hometown of Massapego Long Island, and all the girls running up to me and hugging me and kissing me, said, Ron, you're a great hero, and getting into the Cadillac and being cheered, and the mayor of Massapeco are pinning a medal on my chest, but never once, Bill, did I ever think for a moment that I would come back from that war without a body, a living dead man, as I stated in the beginning of my book. I never thought for a moment. And I guess you could say that for all the young men that went to that war. We had an image of war that had been brought to us by the media, by the television, by the movies. There were three events that led up to the moment when I got shot.

The first event was that people were demonstrating in the streets of America after I came back from my first tour of duty. I considered them traitors and volunteered and went back for a second tour duty. You really wanted to show them. I wanted to prove to them and set an example as an American that I was right and that we were right and that we were really defending democracy in Vietnam. That was one.

Two, I went back for the second tour of duty and while on the night patrol, I shot and killed an American soldier from Georgia accidentally, which suddenly traumatized me and I just felt incredible pain. The third was following that,

there was a night ambush, and I really wanted to make up for killing the corporal, and I really wanted to make up for the fact that I had volunteered to go back a second time. Here, I had been trained for months and months

in the Marine Corps of boot camp to shoot at a silhouette 500 meters away and I've been taught who the enemy was and now I had killed an American. And the next thing that happened was I went out on a night ambush. I volunteered to go out. I wanted to make up for killing the American.

I mean, I couldn't believe that this had happened to me and I couldn't sleep at night. I walked around. I watched people look at me and I, I mean, I was completely tormented. So I went on patrol and what happened? Children and Vietnamese were killed and shot and maimed and I had to pick up the body of a young man

and pick up his foot and put him on a helicopter with tears streaming down my face, another crushing trauma and tragedy. So finally, when January 20th, 1968 came, I couldn't, once I was shot in the foot, I couldn't back up. I had tried to be an American hero. I had tried to serve my country. He was still wanting to be the hero at that point, more than ever. And I had killed, I had participated in the killing of these children and Vietnamese people, innocent killing.

I had participated in the killing of an American, and here I was out in the open, and my foot had just been shot, and part of me wanted to turn around and run and save my life, and another part of me felt so crushed and so frustrated, so desperate. I honestly believed at that moment that I was going to die, and as I wrote in Born on the Fourth of July at the very end,

at that very moment, what I felt was, if you don't mind, I said, go. I felt that everything from my chest down was completely gone. I waited to die. I threw my hand back and felt my leg still there. I couldn't feel them, but they were still there. I was still alive. And for some reason, I started believing.

I started believing I might not die. I might make it out of there and live and feel and go back home again. I could hardly breathe, and I was taking short little sucks with the one lung that I still had left. The blood was rolling off my black jacket from the hole of my shoulder, and I couldn't feel the pain in my foot anymore. I couldn't even feel my body. I was frightened to death.

I didn't think about praying. All I could feel was cheated. All I could feel was the worthlessness of dying right here in this place at this moment for nothing. For more CBC podcasts, go to cbc.ca.ca. Podcasts.