The Effects of War
Crystal Green, "Soldier At Funeral," photograph, 2007, PRP CO Smyrna Detachment collection, Al Fallojah, Iraq.
One aspect of WWII medical care that was, to say the least, not up to speed was the area of psychiatric care. The care of neuropsychiatric wounds were ultimately oversaw by the Army surgeon, although there were psychiatrists employed in the different echelon station levels. How often do you think these patients got the first priority? Often at the echelon 1 and 2 stations psychological issues were handled by administering mild sedative and approximately 40% were then returned to battle. Those who were progressed on to echelon 3 stations generally stay 5-8 days and approx 20% of those returned to battle. So approximately 60% of neuropsychiatric patients were returned to the battle field. This type of standard of care in the field of psychological care was published in 1949 well after the war. So you can see we still had a long way to go.
In today’s battlefield the “invisible war” is still an understudied and under par area of care. The main issues at hand is Post Traumatic Stress Disorder (PTSD), anxiety disorders, major depression, or traumatic brain injury (TBI). Today there are many psychiatrists employed at every level of battlefield care and psychologial injuries are at least acknowledged. But, it wasn't until the 1970's that Post Traumatic Stress Disorder was formally defined and adopted. Since 2001 1.6 million U.S. soldiers have deployed to Iraq and Afghanistan (Tanialian et al 2008). Early evidence is showing that the several deployments without much break is taking a greater toll on our troops than physical injuries (Tanialian et al 2008). At least 26% of returning troops are testing for psychological disorders yet many troops fail to disclose any issues they are experiencing when leaving a combat zone. Maybe out of fear of delaying their trip home. In a recent survey reason’s given for not reporting psychological issues ranged from distrust in professionals to fear of harming career with mental illness diagnosis. Attempts have been made in improving our system of caring for returning troops. President Bush through the President’s Commission on Care for Returning Wounded Warriors has made benefits more available, increased funding for programs, and called on VA to increase level of care. Not only the government lies at fault. As earlier stated it is ultimately up to the soldier to seek care and to follow up. There is huge room for improvement mainly in the continuum of care in providing psychologically wounded soldiers with the care needed to have greatest healing impact.
You don’t have to see a soldier in distress or a traumatic picture for you to see the great things our soldiers need in the way of medical care. But, it is the best way to get the message across and influence action. In the words of Commander Ruff in “Ruff’s War,”“the sights we witnessed were haunting, and the smells of this Hell invaded our senses and penetrated deep into our very souls,” you get a good feeling for the hell that is burned into our troops. It is shown that troops who are exposed to smells of death or have witnessed deaths of comrades have a 30% greater chance of being psychologically effected as opposed to the troops who are injured themselves or have engage in hand to hand combat (Tanielian et al 2008). When you see these types of statistics who comes to mind as being possibly the most impacted group? Could it be the medical group sent to care for the troops? Today’s medical sciences provide a better understanding than ever before on the effects of war but the gaps still exists. Suggesting we still have a long road ahead. Maybe there is not a best care for healing psychological trauma. Maybe that is simply an unavoidable injury of wartime and a diagnosis is an incurable stigma that will continue to forever keep troops from accurately reporting injury and receiving adequate medical attention. But as a society we should still strive to try every avenue for those who have given so much for us.
I am sure there are good lessons that come from war time as well. You may say what good can come from a trip to Hell. But, there is always an upside. Even if it is so slender you have to have a microscope to see it. Coming to grips with your mortality could inspire a sense of who you really are. Seeing the unspeakable could drive you to figure out what most people only learn on their death bed. That life is short, you have to get out there let people know who you are and what you can do. Be who you want to be. I think that is what life is supposed to be about. So many young marines I know that return from deployment are seen as reckless or unattached. But, so many of them I can just see this I want to just live attitude that makes life great for them. While only an approximate 10-12% suffer psychological trauma there are 80-90% that come home with a renewed appreciation for life (Taniallian et al 2008).
Ruff, Cdr. Cheryl Lynn; Roper, Cdr. K. Sue. Ruff’s War A Navy Nurse on the Frontline in Iraq(MD: Naval Institute Press, 2005), 73-200.
Tanielian, Terri; Jaycox, Lisa H.;et al. Invisible Wounds Of War Summary and Recommendations for Addressing Psychological and Cognitive Injuries(CA: Rand Corporation, 2008), 1-42.
Historical Division, Office of the Surgeon General. Combat Psychiatry, Methods of handling Neuropsychiatric Casualties in Theaters of Operations. 1949