Last Seafair, I was assigned to work the inpatient psych unit at the Seattle VA. The Blue Angels tastefully used the VA building as a landmark on their strafing aerobatic runs over I-90. The psych unit is on the top floor. My ambivalence about the Angels was spent by the end of the long weekend of close passes.

Let's talk Shell Shock (nee Post Traumatic Stress Disorder). It starts with something awful. You're an enlisted servicewoman, a loadmaster on C130 cargo planes. (I can't talk about specific patients, so this is a mixture of several stories.) Your job is to help load wounded soldiers into the back of this rugged prop plane. You have no medical training. As the plane takes off, you stand and look through a little window in the tail of the plane. If you see (an American made and donated) surface-to-air missile approaching, you press a button and release chaff. (It happened on more than a few takeoffs, with the denotation of the warheads close enough to knock you around.) You then help tend to your dying fellow soldiers. Repeat.

You complete your tour, and come home. At the oddest moments, the memories of these terrors fill up your mind—like horror movie ooze slowly rising from the floor. Nothing you can do stops the rise. You begin to notice triggers. If you drove trucks, it's traffic on I-5 that does it. If you were on planes, that faint flicker of silver in the sky from Seatac does it. You begin to avoid these triggers. Soon, you're not just in terror of the memories, but of things that can bring the memories back. Nighttime is your enemy, where your dreams become an endless loop of the worst moments. You become irritable, jumpy, your heart bounds and leaps like you're right back where you once were. Things start to fall apart.

A typical patient on that weekend had gone camping—deep into the woods if possible—on the preceding July 4th weekend. Combat memories and fireworks don't mix. But, you're new to Seattle. You don't know of the Blue Angels and Seafair. This is one trigger of the memories you didn't plan for. The horror starts to rise. You panic.

This sounds wishy-washy; it isn't. There is real neuroscience behind shell shock. The sound of the F/A-18's F404 engines is more than enough trigger for those struggling to put away their demons. So, no, I'm not the biggest fan of the Blue Angels.