| This book is to be neither an accusation nor a confession, and least of all an adventure, for death is not an adventure to those who stand face to face with it. It will try simply to tell of a generation of men who, even though they may have escaped its shells, were destroyed by the war.
All Quiet on the Western Front
Erich Maria Remarque [1928] |
War Neurosis was largely ignored until World War I when it flowered in epidemic proportions in the trenches of France and Belgium. It was intitially called Shell Shock based on the fallacious notion that is was the neurologic consequence of exposure to exploding shells. A British physician, Harold Wiltshire, who actually interviewed the afflicted soldiers noted that they rarely had physical wounds, and often reported that their symptoms began after seeing some particularly graphic scene of the carnage of war rather than during the fray itself. It was, indeed, a psychological disorder.
Remarque’s autobiographical novel and Robert Graves’ biography Good-bye to All That give compelling examples of the breakdown typical of the neuroses of that war. By the end of the war, physicians defined two types: the acute illnesses that developed in battle and a more insidious form seen in troops who had spent a long time in the trenches. During the war, there was intense debate between those focused on keeping the soldiers fighting and those who wanted to treat their ilnesses. After the war, there was another debate between those who wanted to help the large cadre of the afflicted, and those who saw them as opportunizing on the war motivated to receive government benefits.
When World War II came along, they’d learned a few things. Good training for the conditions of war decrease the incidence of acute breakdowns. The buzz phrase was ‘Combat Fatigue’ which is a real thing. Prolonged combat drives people crazy. Poorly supplied or unsupported troops are also vulnerable. Preventing war neurosis became part of campaign planning. A program of early detection and treatment got soldiers back to battle and did seem to decrease the number of chronically disabled soldiers. But nothing eliminates war related illnesses. It is part and parcel of war – no matter what one does. Viet Nam was a disaster in this regard. Unsupported troops fighting an unseen enemy is an unforgiving jungle is the most fertile circumstance yet devised for war-related illnesses [though a desert where anyone might be a suicide bomber may turn out to be even more toxic].
In the inevitable debates that follow wars, the two sides line up quickly. One side are usually people who are in direct contact with the afflicted soldiers, who see the magnitude of their illnesses, and legitimize them. The other side are people less directly connected with the soldiers who focus on the cost of their care and suggest that they have ‘compensationitis.’ The truth is that there is no uniforn grouping of the soldiers who return from war. Certainly there are some who haunt the VA looking for handouts. Certainly there are many who are quite ill and will struggle with their war experience at some level for the rest of their days. There are also those whose preexisting mental ilness was made decidedly worse by their war experience.
In yesterday’s Washington Post, we read the beginning of what will be a stream of debates about our returning soldiers. The cost of treating them is going to be staggering, no matter what happens. Differentiating the seriously afflicted from the opportunists will be as impossible as it always is. There will be people who suggest they are all one thing or another. There will be people like Sally Satel, a psychiatrist at the American Enterprise Institute [‘think tank’ of the neoconservatives], who will imply that War Neurosis is not a ‘real’ illness but a creation of liberal society. There will be politicians like our current Administration of people who personally avoided the wars of their youth who will suggest that the soldiers should be like in the movies and get over it after the welcome home parade. There will also be people who will use the issue of War Neurosis to forward their strong antiwar sentiments.
But as the debate that doesn’t need to happen plays out, it will have no real impact on the simple truth that war leaves an enduring imprint on the people who fight. For many, it leads to a daily struggle that requires our deepest and enduring attention. There is no reason that people who carry the psychological wounds of fighting for our country should have to fight to be cared for when they come home. No reason at all…
Though not directly related to the psychological topic above, since you’re just starting this new blogsite, though this link belonged here more than on 3oldmen; at any rate, here is a link to a Mark Shields column on CNN.com that has some interesting statistics on things that have happened since Bush has been in office, particularly since 9/11: http://www.cnn.com/2005/POLITICS/12/26/shields.terror/index.html