The V.A. Made Me Vomit. And That Was a Good Thing.

The psychiatrist was bald, with kind eyes, a silver goatee and the air of exhaustion that follows a person who works hard in a difficult field. It was March 2019, and having let an old prescription expire months earlier, I had gone to the Veterans Affairs hospital in Manhattan — my first time at a V.A. — hoping to get antidepressants.

In a small, sparsely decorated office, the doctor and I faced each other across a wide desk. He told me about various V.A. programs — counseling, group therapy, a veterans’ yoga class, each accompanied by a flier — and described at length the V.A.’s crisis hotline. I appreciated his care, but I wasn’t there to break any new emotional ground; I really just wanted a prescription and to be on my way. I answered briskly as he worked through the questions any mental health worker asks you on a first visit. Did I have a history of anxiety or depression? Yes. Had I had thoughts of hurting myself or of suicide? Not really. Did anyone in my family have a history of mental health issues?

Suddenly, my brain went foggy and my thoughts failed to connect. My speech slowed, and I began struggling to form sentences. Weird, I thought. I hadn’t felt sick. I worried the doctor might think he’d hit a nerve, when in fact I had answered questions like these many times before, including in post-deployment health evaluations in the Navy. My vision blurred. Eyes aflutter, I motioned to the doctor to give me a minute. I think I laughed.

With the calm dispassion of a man who’s seen it all, the doctor picked up a phone beside him: “I’m going to need some help,” he said. “He’s about to pass out. . . . Yeah, he looks like he might throw up.”

I swallowed hard. I tried not to.

“Yeah, he just threw up.”

I was awake for only a few more seconds, but it was enough time to see that I had covered the doctor’s desk and, in tiny flecks and splatters, the doctor. In that brief moment, I didn’t feel humiliated so much as fascinated by the spectacle: It was an awful lot of vomit. Then everything went black.

I came to on my back in the hallway, where the doctor and a handful of nurses stood over me, concerned. I suppose they had helped me stumble there, half conscious. When it was clear I wasn’t dying, the doctor flashed a warm smile, as if to say: Didn’t see that coming. I stuttered useless apologies — “I swear this never happens” — and the staff helped me into a hospital gown and bed. Now I felt humiliated. The doctor puzzled at what had happened. A bug? Something I ate? Not clearly, no. Until that moment, I really had been fine. Hadn’t I?

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As soon as you join the military, everyone always tells you that when you get out you’ll miss the people. I left the Navy in 2017, and I discovered they were right. For seven years, I had worked as an intelligence officer. I deployed with special operations units to Afghanistan and East Africa and spent my last two years in Japan, near Tokyo, which I loved.

I had always wanted to pursue screenwriting after the Navy. But when the moment finally arrived, I couldn’t picture it. I imagined long days alone with my computer in Los Angeles and felt certain I would miss the collective sense of purpose I’d come to enjoy in the military. Journalism appealed to me as a step between worlds — storytelling as public service — so I enrolled in the graduate program at Columbia University.

I never considered myself the military type, but still I found civilian life strangely coded. In the military, community had been easy to come by. With people coming from all backgrounds, crammed into tight quarters, there was little choice but to seek the best in each other; friendship was assumed and often intense. Now it felt judging and transactional. My peers were clearly practiced in a kind of assured individualism that was difficult for me to reflect back. At the same time, many seemed poised to take offense. Jokes that I intended as friendly — the sort of teasing that was common in the military — were interpreted as attacks. And it was bewilderingly easy to fail social litmus tests. (I once lost friends because I did not find the movie “Roma” sufficiently problematic.) I found some refuge with other students who were veterans — they were also having trouble — but over time I grew uncharacteristically quiet. I felt on edge.

The V.A. gets a bad rap, as a slow and sloppy system steeped in bureaucracy.

I began a fellowship at a magazine, and that anxiety escalated to a sense of alienation. Military workplaces are loud and collaborative. Now when I spoke up, I always seemed to be disrupting something. I constantly found myself on the wrong side of unspoken rules, many of which I was never able to put a finger on. (Some I was: One co-worker was not shy with the belief that military service was “immoral.”) It all felt like navigating a cluttered room in the dark. I became paranoid and afraid, guard up, always trying to predict and prevent my next misstep. That only made things worse.

Through all of this, I was drinking too much, exercising too little. I ignored aches and pains and the obvious (also blurry) fact that I needed new glasses. Sleep came in fidgety spurts, and many nights I lay awake gripped with aimless, full-body panic.

I saw a psychiatrist briefly, but then my insurance changed, and I lost coverage with the doctor. I tried halfheartedly to find someone new, but either wait times for an appointment were outrageous or voice mail I left went unreturned. I soon gave up and quit the medication that the first doctor had put me on. I was loosely aware that I qualified for care from the V.A., but the idea of it felt out of the question to me. I had changed careers to get away from the government, I told myself. I was a civilian now, and if that meant paying hundreds of dollars a year for health care too difficult to use, so be it.

By March of last year, though, I had reached a low. The panic I felt at night had bled into my days, and everywhere I went — work, restaurants, the park — an overriding feeling of dread followed. A friend encouraged me to get help, and I finally did.

The V.A. hospital in Manhattan is a brick fortress filling two blocks in the East 20s, across from Lego-block apartments and a stone’s throw from the East River. In a spacious lobby, old men with bent backs and canes exchanged familiar laughter, clad in all manner of veterans’ paraphernalia — tattered bomber jackets, overlarge ball caps, God-knows-how-old dog tags. I arrived at 9 a.m., but already the place had the vibe of a V.F.W. post at happy hour.

The V.A. gets a bad rap, as a slow and sloppy system steeped in bureaucracy. But whatever skepticism I carried in with me quickly evaporated. After a short registration, the building was mine to wander. Momentarily forgetting the antidepressants, I gave myself over to a shopping spree of self-care and in no time had appointments with a psychiatrist, a general care physician and an optometrist. I felt wholly in my element. Sure, the place was bureaucratic. But it was a familiar bureaucracy — something about the military I was shocked to realize I’d missed.

The walk-in psychiatrist in the mental health clinic wasn’t available, but helpfully there was another on call in the E.R.: the kind-eyed man on whom I would soon puke. I hadn’t seen a regular doctor since leaving the Navy, so before he and I got started, the psychiatrist recommended a short physical and a blood draw: No time like the present to check for any surprises, he said, and I agreed. As my blood squirted into tiny plastic vials, I breathed easy. It was nice to feel taken care of. Minutes later, in the psychiatrist’s office, I was doubled over vomiting and collapsing out of my chair. On the bright side, there are worse places for this to happen than an E.R.

The panic I felt at night had bled into my days, and everywhere I went — work, restaurants, the park — an overriding feeling of dread followed.

In the hospital bed, my face was pale, and my blood pressure was low — alarming, because during the physical it had been high. An hour passed, though, and I didn’t get any sicker, so the incident in the doctor’s office was chalked up more or less to a mystery. I was discharged, with an antidepressant prescription in hand. Then, in the V.A. pharmacy, I fainted again.

Back in the E.R., I was put on an IV and fell deeply asleep. When I woke up, a young doctor with shoulder-length hair asked about my lifestyle and how things had been going lately. My voice wavered when I said, yes, I had been very stressed; it felt indulgent to say so plainly. Then she asked how I’d felt in the hours before I fainted. Relieved, I said. Relaxed for the first time in a long time.

There was no saying for sure, but she suggested that my body had gotten used to operating at an extremely high stress level. At the hospital, I dropped my guard, and that stress diminished rapidly. Combined with the blood draw, this may have triggered a kind of system crash — what would be called a vasovagal response. Put simply: I became so relaxed so quickly that I puked.

I was discharged a few hours later and this time successfully made it out of the building. I slept well that night, in my bedroom that was always scattered with uniform items, because after my move from Japan, I had simply never known what to do with them.

As a person who never expected to spend a career in the military, I had always assumed the transition out would be seamless — a course correction, as if the Navy had been a mere diversion. So when I faltered, I gave little thought to what all that stress and panic and social difficulty had to do with the military. Nothing, I probably would have said before my visit to the V.A.

I never wanted to be a stereotype, the kind of veteran who is always invoking his service and who never really lets go. But by turning my back entirely on the military, I now realize, I also turned my back on seven years of lived experience and, ultimately, on myself. I wanted too badly to stick the landing, to show that I could stride into this next chapter all on my own. Even on the floor in the hospital, half-covered in puke, I hadn’t wanted anyone’s help. But the comfort I felt in that hospital bed — back in the system, if only for a moment — helped me see how fundamental the military had become to me after all. Transitions out are never easy. But by acting as if mine should be, I ensured it was difficult. I had tried to leap into civilian life rather than bridge the gap, only discovering on the way down that the distance was too far.

I’m more relaxed these days, and I feel centered. I make it a point to catch up often with Navy friends, and I’ve spent more time reflecting on what those years meant and how they shaped me. I look forward to my V.A. appointments now, as an opportunity to touch ground amid the sometimes stressful, sometimes mundane day to day. I watch all those old men shuffling around the facility on slow feet, calling one another to attention and saluting sharply, even though their bodies have grown stiff and frail. On my first visit, I took for granted that we had nothing in common. Now I see that they’ve embraced something that I hadn’t yet: that their service remains a part of them and is good cause for connection with one another. Most of them surely haven’t worn a uniform in decades. But we’re all in a place we belong.

Andrew McCormick is a U.S. Navy veteran and an independent journalist in New York. His work has appeared in The Atlantic, The Nation, and Columbia Journalism Review, among other publications.

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