This article, “what is RD-4895 and how does this relate to trauma and PTSD,” contains spoilers regarding the Amazon original series The Terminal List season 1.
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A significant subplot of The Terminal List is exactly what is RD-4895? This ties into the theme of trauma and post-traumatic stress disorder (PTSD) in the military. A little-known fact to the public is that trauma often has a definition with some ambiguity. According to the Center for Health Care Strategies (2016), there is no universal definition for trauma. The most widely used and respected definition came from the Substance Abuse and Mental Health Services Administration (SAMHSA) which states that an “Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being” (Center for Substance Abuse Treatment, 2014).
In fact, trauma was not officially introduced in The Diagnostic and Statistical Manual of Mental Disorders (DSM) until 1980 (Short, 2015). That is, give or take, one or two generations and AFTER the Vietnam War and two World Wars. Yet, still, the introduction of the subject of trauma was controversial at the time. It was not until 2013 that PTSD was even greater defined when PTSD was introduced in a new category – Trauma and Stressor-Related Disorders. (Pai et al., 2017)
According to the National Center of PTSD (2022), for every 100 veterans, 30% have experienced PTSD during their lifetime, 12% of Gulf War veterans, and up to 20% of Operation Iraqi Freedom and Enduring Freedom have the condition within any given year. This does not even cover the financial burden. The Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder (2012) estimates that the cost of PTSD in the Department of Defense is 294 million dollars and Veteran Affairs a stunning $3 billion (about $9 per person in the US) on PTSD retired veterans and military.
The Terminal List season 1 – what is RD-4895 and how does this relate to trauma and PTSD?
The drug RD-4895 is an inotrope designed to mute the pathway between the hippocampus (essential for memory) and the amygdala (the core process of grey matter in each hemisphere processing fearful and threatening stimuli). In other words, Nubellum and Capstone Industries want to put to sleep that connection. This is an optimization so soldiers can be immune to trauma that can lead to PTSD.
Does RD-4895 work?
No, it does not. In fact, in The Terminal List, the blind study performed on the Navy SEAL team has unintended consequences. Of what exactly? The drug causes terminal cancer in their subjects. This makes the theme of trauma, PTSD, and treating the conditions so prevalent in The Terminal List. Commander Reece often has nightmares, flashbacks, and hallucinations (symptoms of PTSD) of the ambush to catch Kahani. He uses the scene of the starling crashing into the window as avoidance (another sign) of his family’s death. The most trustworthy way to treat trauma and PTSD is through trauma-informed care. This is where trust and rapport begin to build between the mental health professionals and the patient.
Here, Steve Horn and Secretary Hartely want a quick fix to cut costs on mental health care and other factors. Such as, they will be able to lower the troop count to a record number. How? There will be fewer active soldiers because there will be less need to replace the ones suffering from mental health trauma. This will also considerably cut down the cost of the 3.3 billion dollars it costs to cover mental health. The blind test violates the trust. This is a therapeutic alliance between the patient and medical professionals. This is essential to place the patient back on the right path.
The idea was a quick and cost-effective fix. However, this puts less of a premium on veterans as people and more as monetized products.
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