Authors: Ronald J. Glasser
A sudden terrified look swept over Dienst’s face.
“You’ll be able to go back,” Kohler said. “I know it, and so do you.”
“Gentlemen, once the symptoms were admitted and the guilt placed elsewhere, these symptoms persisted, maintained by an ever-deepening inability of the men to admit their failure, a failure that grew deeper and more pernicious as the distance from the battlefield grew and the original terror was forgotten. Right or wrong, warfare is a very manly thing; to fail at it, even in its most subtle forms, is to challenge one’s whole masculinity. Failure is difficult for an adult to handle, and for an adolescent, impossible. Unfortunately this is not just rhetoric; even today, fifty years later, there are still old men who, because of a few hours or days of cumulative fear and exhaustion and a misdiagnosis, have been consigned by their doctors, families, and even themselves to hobble uselessly about hospital floors.
“The psychiatry of the First World War missed a very important point—the fixation of symptoms. These troopers were ill—but it was their guilt and unconscious feelings of failure that fixed their symptoms and turned what should have been circumscribed reactions into lifelong debilitating conditions. A few psychiatrists, though, some of the front-line French and German physicians, saw what was happening to these men once they were removed from the fighting and published papers showing that the evacuation of shell-shocked cases to rear areas only produced chronic disability.”
That evening Kohler was working in his office when a 122-mm rocket hit in the middle of the grounds. It landed fifty meters from the operating room, blowing in the door and killing a corpsman and a nurse. Everyone waited for a second one. All through the rest of the compound, doctors, medics, and patients stopped, waiting for the next rocket. Kohler, sitting alone in his office, waited like everyone else, chewing nervously on the end of his pencil. Nothing came. Either there had only been one or the others hadn’t gone off. Sighing, he went back to work and a few minutes later the phone rang.
“Good. Just let him crawl there. I know, he’s trying to embarrass us. Yeah, he’s just showing the world how little we understand and how brutal we are. Just let him crawl. He’s testing us and himself. The important thing is that he’s moving. I don’t care what the nursing supervisor thinks,” Kohler said angrily. “He has to crawl before he can walk. I’ll see him in the morning. Oh, and listen; get him some new fatigues when he gets back. I want him to know we know what he’s doing.”
“Between World War I and World War II an attitude developed among the Freudians that analysis would be to mental illness what penicillin had been to infectious diseases. In their enthusiasm to heal the world they forgot that at best the world is a difficult place. Just delve long enough and deep enough, sweep away the defenses, uncover the conflicts, bring them to light, resolve them in an adult way, and the suffering will disappear. They presented the people with a Freudian right not to suffer. In its own way this idea was as blinding to the psychiatrists of the Second World War when it broke out as the organic theories had been to the psychiatrists of the First.
“In 1941 there were fewer than twenty fully trained psychiatrists in the whole Army. During the early days of mobilization, these men, like so many other career officers, were transferred to command and administrative positions, leaving the responsibility of the every-day practice of military to the newly inducted psychiatrists. The war struck, and the Newmans—right out of their analytic training—fell headlong into it.
“There was no more nonsense about shock waves and concussions. When you went under in 1941 to 1945 it was not because of shock waves rattling your brains, but the sudden surfacing of emotionally unresolved, though persistent conflicts. The soldier who broke did not break so much from the fear of having someone trying to kill him or even from the harrowingness of battle, but from some neurotic tendency, deep-seated, that had always been there eating him away, or ready to eat him away.
“The Newmans had been trained to address themselves to the eradication of psychiatric symptomatology, to intrinsic psychopathology, to the symptoms of conflict within the patient. Armed with what were essentially individual theories and techniques, they were suddenly presented not with one or two patients, who, subjected to the normal stresses of living, had decompensated, but thousands who had been exposed to the unique and terrifying prospect of war. Viewed from the outside, the Newmans’ reactions to this flood of patients was either to withdraw into the spotty use of intensive psychotherapy or simply to wring their hands and abandon the mass of patients to the V.A. system as treatable only if more psychiatrists were provided, which of course they weren’t.”
“Major Kohler.”
“Yeah?” Kohler said, looking up at the corpsman without bothering to take his feet off the nearby chair. The doctors across the table stopped talking.
“Another chopper’s in. The ward just called. Seems like you got a real winner.”
Kohler put his glass down on the edge of the table. “What’s wrong?”
“Black power. Apparently he took on half his base camp. They sent him here with four citations, under armed guard—and in a strait jacket.”
“Did Harold see him?”
“Yes, sir. He’s the one who told me to find you.”
“Is the kid lucid?”
“Yeah, I guess.”
“OK. Tell Harold to take off the cuffs and jacket. Well, go tell him,” Kohler said, sitting up. “I’ll be right there.”
“What about these fellows?” one of the doctors asked.
“Huh?”
“What about these Negro troopers?”
“What do you mean, what about them?”
“Are they...? I mean, do they carry their own weight?”
“How long have you been here?” Kohler asked dryly.
“Two months.”
“Why don’t you wait about six more. Nothing like long-term reality to rid us of our foolish little prejudices.”
Without waiting for an answer Kohler got up from his chair and left the room.
The ward was quiet. “Where is he?” Kohler asked the ward master.
“In the treatment room, sir,” Harold said. “He didn’t want to move, so we left him there.”
“OK. What do you know about him?”
“Name’s Leroy Washington. Medic—25th Division...”
“And,” Kohler interrupted, “got taken away from his unit and rotated back to a base camp, was there for about ten days, and just got freaky as hell.”
“Well, a bit more, sir. He took on a lieutenant and broke a captain’s jaw and then went after a couple of hundred MP’s.”
“Drugs?” Kohler asked.
The ward master shrugged.
“And what about Dienst?”
“He’s getting tired of crawling.”
“I’ll see him this afternoon. I’d better see Washington now.”
Kohler went to the treatment area and, pulling aside the curtain, walked inside. The trooper, a short, stocky Negro, his right eye battered shut, was sitting sullenly on a cabinet. The straitjacket was lying on the floor. Kohler gave him a quick, appraising look.
“We won’t need that anymore,” he said. “Nobody makes it through six months as a field medic and then goes goofy unless somebody pushes him, does he?”
“Gentlemen, not only were the Newmans sending these combat neurosis patients home, but they were also losing these same men to their units and ultimately to the war. The Army simply could not tolerate the losses. They wanted these men back to duty.”
“The ward master tells me this morning he gave you an order and you essentially told him to go fuck himself.”
Washington remained seated, expressionless.
“I’m white,” Kohler said, “but let me tell you what I think’s bothering you. It’s not that captain you cut down or the ward master or even me. It’s that you go through all that shit, risking your life for white or black, for God and country, and then they take you out of it and it’s the same shit that you left. If it was me, I’d be angry too, angry as hell. Angry at the United States, angry at my officers, but most of all angry with myself for being so fucken stupid as to think anything would change. Believing that if I did my job it wouldn’t be the same. Yes, angry at myself for believing all that bullshit about comradeship and equality, angry with myself that, despite all my willingness, not only to join in but to put my life on the line, it’s still the same fucken mess it always was. I’d be furious, man, furious.”
Washington was stunned, and Kohler could see that he was stoically fighting not to let any part of him show. He watched the clear, smooth adolescent face twist on itself, saw the sadness and the depression underneath.
Come on, he thought, come on. Let it out. Let it out.
“The idea that the interpersonal aspects of adaptation had to be considered as well as the intrapsychic began to catch hold, and be pushed by Army psychiatrists. Then, more and more civilian psychiatrists began to think that it might be inappropriate to think of personality development solely in terms of resolved intrapsychic conflicts. The thought developed that no matter how mentally ill a patient might seem to be or indeed was, there were still areas of his ego that had been left intact, and that if one dwelt on the ill fraction, the conflict-ridden part of the ego, supporting only that part of the personality to the exclusion of the rest, you might very well be fooling yourself as to how sick the person really was and, quite simply, merely be prolonging the whole affair. With a little experimentation, a few military psychiatrists who, in desperation, had operationally taken up these new ideas, began to get remarkable results. In its simplest form, their success had to do with expectation.”
“You look a bit sad,” the ward master said.
“Well, maybe I am,” Kohler said. “Tell me, Harold, why the hell do the blacks come into the Army anyway...?”
“They get drafted.”
“I know. But why do they show up for induction?”
“It’s their country.”
“You want to tell Washington that?” Kohler said.
“I mean, they think it’s their country. You know, most of these kids are middle-class. No, I mean it. They’re not extremists. They’re told to do something, and they do it, just like anybody else. But,” Harold said quickly, “there is something else. You’ve never been in a ghetto, have you, Major?”
“No, I haven’t.”
“Well, it’s not very good living, and it’s not just the way Middle America thinks of it. I had an apartment once, on Indiana Avenue in Chicago. It had holes and rats all the time and hot water every now and then. I worked like hell to fix it up—painted the walls, covered the holes. And when it was all done, the landlord jacked up the rent. I couldn’t pay it, and since it was the nicest apartment on the block, he had no trouble finding a tenant who’d pay the higher rent. So, how do you cope with a situation like that? The Army comes along and, despite their misgivings, the ghetto kids go. At least they get three meals a day and have a little money to spend. For some, Doctor, it is the first time in their life they have enough without having to do something wrong or going hungry. Besides, their brothers are here. Compared to what they’re used to, the Army ain’t that bad.”
Kohler got up to leave. “I’m learning, but I’ll tell you this. The only way the Army is going to learn is when the squads start coming back from patrol all white or all black.”
“Label a soldier as mentally ill, support that illness, show him that it is what interests you about him, and he will be ill and stay ill. Expectation, gentlemen, expectation.”
“Anger, Leroy,” Kohler said, “anger’s a funny thing. It can be a way of hiding things from ourselves. Tell me a little about your growing up, what you remember about it—about being black.”
Washington shook his head, as if to say what’s the use.
“You know, Leroy, the black psychiatrists who deal with black children report that a child experiences his first prejudice as early as two years. How old are you?”
“Eighteen.”
Washington talked slowly at first, but later more and more animatedly—swinging into his words and concerns, not complaining so much as just talking about being a black child in a white world.
“And then you went into the medics,” Kohler said, “and you weren’t black any more. You were a healer, a savior, a medic—you could put everything aside for a while. And then it was over and you were back to being black again.”
“Yeah,” Washington said grimly, “I sure was.”
“You see, Leroy, there’s another side to your anger. It hurts a man to be called a nigger.”
“The idea spread that perhaps the important thing about a soldier who cracked was not his illness, but his health. That perhaps when a trooper did come apart—no matter how bizarre the disruption—there was still a central pillar of personality left intact and functioning, a central core that could, be dealt with at the same time that the illness was being treated. Prodded by the military, the psychiatrists began to use some of these “perhaps” operationally, and they found that central core and began to understand the astounding effects that guilt had on the fixation of symptoms. It became obvious that the evacuation of combat neurosis from the front was not a cure—but part of the disease; that it was best to treat these boys as far forward as possible; that their unit identification should be maintained and, above all else, the treatment should always include the unwavering expectation, no matter how appearingly disabling the symptoms, that these boys would be returned to duty as soon as possible.”
The phone rang.
“Major, there’s a Mr. Tamni here from the Criminal Investigation Division.”
“What does he want?”
“He’s here about your patient, Leroy Washington.”
“OK. Send him in. You’d better go,” he said to Harold. “Criminal investigation, for Christ’s sake.”
A moment after the ward master had left the office there was a knock at the door and a brisk, pleasant-looking man in civilian clothes walked in. “Hello, Major. My name’s Tamni. I’m assigned to the 529th Military Intelligence Detachment.”
Kohler motioned him to a chair.
“It’s about your patient, specialist fifth-class Washington. He’s under investigation for assault and battery.” Kohler waited for him to go on. “We’d like to know your feelings about his mental status.”