The Inherent Sadness of Low-Lying Areas

A play about an older divorced couple that explores what it’s like for an average person to have PTSD — and what it’s like to care for someone who has it.

Runtime: about 35 minutes. Requires two actors, flutist, violinist, cellist, pianist, and Foley artist. Music by J.S. Bach, Luciano Berio, Leoš Janáček, Sergei Prokofiev, Kaija Saariaho and Erwin Schulhoff.

Commissioned by New World Symphony, Michael Tilson Thomas, artistic director. World premiere February 3, 2018 at 7:30 PM with Kel Haney (director), Joel Leffert (actor), June Ballinger (actor), Elizabeth Lu (flute), Roman Yearian (violin), Alan Ohkubo (cello), Michael Daley (Foley artist), Elizabeth Dorman (piano). Produced in collaboration with The Playwrights Realm.

An early rehearsal.

Author’s Note

It’s gone by many names: nostalgia, soldier’s heart, railway spine, shell shock, battle fatigue, traumatic neurosis, combat hysteria and, more recently, Post-Traumatic Stress Disorder. If you know anything about PTSD you might associate it with war – for good reason. The incidence rate among Iraq veterans is between 11-20% within a given year, and an estimated 30% of Vietnam veterans have had it over the course of their lifetime*.

You may not know that PTSD occurs in the general population as well. Ten percent of women and 4% of men develop it over the course of their lifetime from a wide range of causes: physical and sexual assault, neglect, even witnessing a calamity that leaves you otherwise unscathed, such as a car accident or natural disaster. Charles Dickens got it from a railway accident, not from bodily injury, but from tending to the carnage. Samuel Pepys got it from witnessing the Great Fire of London. The comedian Darrell Hammond from childhood abuse. Lady Gaga from assault. Whoopi Goldberg from witnessing a plane crash.

PTSD is serious business. Symptoms can emerge years after an event, clustering around intrusive thoughts, a permanent state of arousal, emotional numbing, and avoiding reminders of the trauma. Unchecked, it can put you in a downward spiral. If you have a reaction on an overcrowded subway, for example, you might stop taking the subway. If you’re wary of strangers because you learned, the hard way, that you can’t always read body language, you might meet fewer and fewer people until you realize, at some point, that you know very few people at all. Since you can’t tell what will trigger a reaction, mundane activities like going to the grocery store can feel fraught. So you order online. You ask your spouse to get something. You realize, at some point, that you haven’t left the house in a while.

I was first diagnosed with PTSD after a violent mugging in 2008, though I’d shown symptoms since childhood. Since then I’ve become aware of how often this disorder is portrayed in war literature, from The Red Badge of Courage to Catch-22, from Apocalypse Now to The Hurt Locker. Looking further back we can see symptoms in Gilgamesh, Achilles, Ajax, Odysseus, and Shakespeare’s Pistol and Henry IV. (In case you’re wondering, the first commonly acknowledged description of these symptoms comes from the battle of Marathon, described by Herodotus, in 490 B.C.E.)

All of these examples – all of them – recount challenges specific to the warrior class. But where is the literature that describes how the rest of us experience it? I was grateful when New World Symphony gave me the chance to portray what PTSD might feel like to an everyday person. For some of us, courage doesn’t mean taking a hill from the North Vietnamese. It means braving a park on a crowded summer afternoon to order a hot dog. Though I only have one perspective to offer on what PTSD feels like – mine – I hope it might be added to a growing body of literature

* All figures from the National Center for PTSD.

A view of insomnia: Mitch (Joel Leffert) tries to sleep while Roman Yearian plays the highly dissonant Sequenza VIII for solo violin by Luciano Berio.

Photo by Gregory Reed for New World Symphony.