Pain (5 page)

Rather than championing the disabled and dependent, Eisenhower (like many Americans) chose to valorize those who fought through the worst distress. Marine Private Alford McLaughlin was one of many men the president celebrated. Attacked by hostile forces in Korea and faced with enemy artillery fire in September 1952, McLaughlin received special commendation from Ike during his first year in office. “Although painfully wounded,” the president stated, “he bravely fired the machine guns from the hip until his hands became blistered by the extreme heat from the weapons and, placing the guns on the ground to allow them to cool, continued to defend the position with his carbine and grenades.” All the while McLaughlin stood up straight and in full view, shouting “words of encouragement to his comrades above the din of battle.” This was the image many Americans upheld—of men overcoming agony and distress with “indomitable courage … and a valiant fighting spirit in the face of overwhelming odds.” And even if people did not know McLaughlin's story, they would recognize the type from comic books and popular films. Many would also know the story of Homer Parrish—the character played by paraplegic veteran Harold Russell—who was one of the lead figures in the 1946 film
The Best Years of Our Lives
. Along with the McLaughlin ideal, Parrish's struggle to return from war and adjust to the stigma of prosthetic limbs loomed large in American views of heroism and disability.
¹⁸

Veterans' disability continued to be a political flashpoint for Eisenhower, putting him in between two fierce constituencies: doctors emboldened by his victory and veterans who saw Ike as one of them. At Eisenhower's inaugural address to Congress in early 1953, the president declared his compassion for veterans and the nation's generosity to fallen men as well as their widows and children.
¹⁹
If government had one role
in these times, it was to continue its commitments. Properly caring for those in uniform and appreciating their service, he said, was an honest responsibility of the government. Yet Eisenhower also knew that such commitments could not be without limits and ought not to be extended beyond veterans to the general population. It was a difficult balancing act. On the left, Eisenhower had New Deal Democrats in control of Congress and intent on expanding hard-fought social commitments and pushing for just such an expansion. Complicating matters further, on his right he had two angry groups opposing one another on the disability front—the AMA railing against socialized medicine and veterans' groups, and cold warriors assuring soldiers in Korea that they would receive whatever care they needed at public expense, should they need it, when they came home.

The doctors and the vets—ordinarily united in their support of the Republican Party—were at an angry standoff, one that reflected the broader postwar debate over liberal government. Veterans' groups insisted that disability benefits were not “welfare” payments but justly earned compensation based on a contractual relationship. The Military Order of the Purple Heart laid out the argument: “Holders of the Purple Heart Decoration became disabled because of wounds received in combat with an enemy of the United States. As such we are the recipients of a contractual obligation, between the Wounded Veteran and the Government. This was created, when our Nation, called the boys into the Service and told them that should they become disabled, they would be taken care of, as well as their wives and families.” To renege on the contract would be a travesty; the last time it was done, veterans organized a “bonus march” on Washington in the 1930s. Leaders of Disabled American Veterans (DAV) pointed to the nation's involvement in three wars since 1917—two world wars and the Korean War. Maintaining a large military force abroad and providing medical and surgical treatment, insurance, and “compensation for those who were disabled in line of duty” was “part of the cost of war,” the DAV insisted.
²⁰

The AMA did not see disability this way, taking on veterans' groups with increasing vigor. VFW officials were infuriated that the “disgusting … ruling hierarchy” of the AMA had attacked veterans' hospitalization programs and accused war veterans (in McCarthy-like fashion) of being creeping socialists and a threat to free enterprise. The AMA spoke
for the political Right—a wing of Republicans alienated by Eisenhower's moderation. In 1955, the doctors' organization decried what they saw as socialism by stealth: “continued Federal encroachment into private affairs cannot be advocated logically and consistently by those who, at the same time, voice their opposition to socialism.” Veterans' organizations were taken aback by the claim that they were “unwittingly planting the seeds of socialism.” The American Legion shot back, blasting the AMA as a “cash-conscious” group who placed “devotion to dollars” over “care for human suffering.” VFW leader Wayne Richards had a simple message for the AMA, broadcast in the newspapers: “Lay off.” “Instead of exaggerating a few cases of featherbedding” for political advantage, he said, the AMA should leave the VA and the compensatory benefits it provided to veterans out of its war against socialized medicine.
²¹
But the AMA would not “lay off” and pressed its case against the expansion—focusing its ire on non-service-related veterans' care and compensation. The VA system in all of its dimensions—hospitalization, disability benefits, and treatment for non-service-related ailments—was under extreme demographic, political, and ideological strain.

The moderate Eisenhower faced an impossible political quandary. How would he thread this needle? With one hand, the president warned Americans that citizenship involved a degree of suffering and sacrifice; yet, as an old soldier himself, with the other hand, he insisted that fighters who became disabled in battle had earned the right to relief. Then, to veterans whose injuries had nothing to do with battle, Eisenhower flatly declared that the nation owed them nothing no matter how infirm they became. Vetoing a 1953 bill granting relief to one single Spanish-American War veteran who fell outside the established rules of medical support for a non-war-related disability, Eisenhower voiced compassion but bluntly rejected such “exceptional and preferred treatment.” Had the man's case been isolated, the president said, he would not hesitate to approve the bill, but this man was one of “twenty million veterans” whose eligibility for care in federal hospitals was subject to various restrictions. There were “many, many others [who had] been denied similar relief.” The toll of infirmity was heavy; if all veterans' ailments were blamed on war, the danger of the system being overrun would be great. To open the doors to all such men would court disaster. “Yielding to compassion or special
pleas would eventually destroy the effectiveness of the program,” Eisenhower concluded.
²²
Thus did Eisenhower portray himself not as the New Deal's nemesis but as its preserving champion.

Pressured hard from both left and right to rethink his disability stand, Eisenhower did what presidents often do amid political turmoil—he found temporary political cover by naming a commission in 1955 to study the problem of veterans' care and compensation. Its goal would be a “constructive reappraisal” of the liberalization of veterans' benefits. He named a trusted military compatriot, General Omar Bradley, to chair the Commission on Veterans' Pensions. Looking back over the past fifteen years of the program, Eisenhower wrote to Bradley, “In 1940 there were only 4 million veterans. There are now nearly 21 million, and the number is increasing rapidly.”
²³
The prospective burden on government was unsustainable, particularly because of how Democrats in Congress (and Truman) had liberalized services during and after the war to include compensation for non-service-related injuries. Eisenhower tasked General Bradley and his Commission on Veterans' Pensions with finding a new balance.

Eisenhower's appointment of General Bradley to chair the commission acknowledged that the veteran's place in civilian society had become a bellwether political issue. Democrats in Congress, including Senate majority leader Lyndon Baines Johnson and the first-term senator from Massachusetts, John F. Kennedy, were proposing to build on veterans' legislation by extending Social Security disability to all elderly disabled. On the other side, the AMA and their conservative supporters stood firm, charging that non-service-related disabilities were “superfluous care” for veterans and that disability coverage for the elderly was an extravagance.
²⁴
Many observers, then, understood the question of whether the soldier's continuing chronic pain was a true disability to be political and ideological. Every symptom, each ache and worry, every pain-inducing ailment, whether chronic or acute, was now subject to intense scrutiny. Here was the crux of the politics of pain. For liberals looking to the New Deal as a continuing model of governance, the veteran's complaints could become a platform on which broader commitments could be built. But the topic split the Right, with the doctors and veterans squared off for an ideological fight.

At issue was the meaning of “liberalism.” Speaking to journalist John Gunther in 1950, Eisenhower claimed to be both liberal and conservative, even as he expressed disdain for both terms. “You know, it's a hard thing these days for a man to believe earnestly and sincerely as I do in what … used to be called liberalism, progressivism, political action for the benefit of all, and at the same time not to go whole hog for what are claimed to be panaceas for our ills … Then [if he takes that position], he … becomes accused of being a darned conservative with no feeling for the people.” In contrast to Ike's definition of a conservative as someone who had no feeling for others, Gunther offered another definition—a “liberal is someone who wants to liberate; a conservative is someone who wants to conserve”—and noted that every president had aspects of both in his agenda. Later in the discussion, Eisenhower confessed, “I've gotten so that I hate both terms because those two terms mean all things to all people.”
²⁵

The debate over language illuminated political tensions at the heart of the Eisenhower presidency about the direction of U.S. society. For veterans' groups, government aid aimed to liberate the soldier; disability benefits were akin to the GI Bill and prosthetic devices, allowing men to pursue normal life after the war. Yet even supporters of veterans worried about conserving traditional institutions and values (not only hard work, enterprise, and freedom from government oversight but also the viability of existing government programs). Opponents of liberalizing VA benefits objected that adding more claimants to the VA or Social Security systems would threaten those who already depended upon these programs. Of course, medical opponents had a different, more far-reaching criticism. For them, the term
liberalism
stood in for a range of postwar assaults against their profession and society. As historians like Lisa McGirr have observed about groups coalescing under the banner of conservatism in this era, the term “conservative” came to mean not only defense of “tradition” but also hostility toward welfare, confidence in free enterprise, and deep disdain for expanding government and the coddling dependency they believed followed.
²⁶
As the Bradley Commission began its work, such skeptics (particularly those in medicine) were conditioned to look askance at disability and to judge the pain complainant not as a man in true need but as a liberal Trojan horse.

If public relief for the ailing veterans at the VA provoked controversy, so too did private relief—the kind of relief offered by the booming marketplace in drugs and medical specialization and avidly consumed by a hungry populace. The postwar years were a high point of faith in medical advancement, with specialization and the burgeoning drug market offering new hope to the chronically ailing. A powerful array of sedatives, synthetic opiates, antibiotics, and painkillers had arrived in the war years. Enthusiasm and ambivalence greeted such products, for not everyone, even within the medical profession, thought that those drugs were a godsend. If the 1950s saw rising tensions over public relief, so too did private market relief provoke worries.

The pharmaceutical industry emerged from the war as a major player in American relief, offering a powerful new armamentarium of drugs (Percodan, Demerol, sedatives, tranquilizers, and so on) for the ailing GI, the suffering citizen, and the hard-pressed doctor. Penicillin had been developed in the war and was widely hailed for “performing some unbelievable act of healing on some far battlefront.” As one advertisement noted, “Thousands of men will return home who otherwise would not have had a chance … When the thunderous battles of this war have subsided to the pages of silent print in a history book, the greatest news of World War II may well be the discovery and development [of] penicillin.”
²⁷
Now such products were being put to miraculous civilian uses. Other innovations (Atabrine for malaria, blood plasma preserved and transported to the warfront for transfusion, and painkillers from Percodan to Demerol) were also coming home. The new synthetic painkiller oxycodone, marketed as Percodan by the Endo pharmaceutical company and approved by the Food and Drug Administration (FDA) in 1950, bluntly promised to be less addictive than morphine, thus representing a revolution in pain care. Production of Percodan skyrocketed.
²⁸
But, as in the public sector debates around government relief, skepticism also greeted those who promised private sector relief via aggressive surgery or new drugs. Aggressive marketing and rising consumption filled doctors, politicians, and consumers with hope but also with their own Trojan
horse anxieties. Were drugs “miracle workers” in a world in need of relief? Or was this just another guileful promise?

“During the last ten years,” announced one journalist in 1960, “the nation has been on an aspirin binge. Consumption of the pain-easing pills has increased four times as fast as the population growth.” As he saw it, one reason for the binge was “the general long-term rise in the standard of living. Another is the increased health-mindedness of the American people.” Affluence, economist John Kenneth Galbraith observed in 1959, had created new consumption trends—with drug consumerism leading the way out of the Depression and wartime economies into an era of newfound prosperity. This prosperity accounted for aspirin's allure—as if a generation long impoverished, hardened by want, and resigned to wartime rationing and sacrifice had been unleashed to apply salves to its minor hurts. On television and radio, in newspapers and magazines, few Americans could miss the aggressive savvy marketing of relief. Relief was now within easy reach for young and old: “the pill makers have placed their emphasis on speed—fast, fast, FAST, the television commercials insist.” Many of the new products overpromised fast relief from anxiety, stress, and grave pain without the fear of drug addiction and dependence often associated with opiates. Many doctors and pharmacists did not quite know what to make of these optimistic promises; others prescribed the new pain remedies, Percodan and so on, enthusiastically. But as Boston psychiatrist Frank Ervin put it later in the decade, “The relief of pain is obviously one of the main functions of physicians … Ironically, it's one of the things we do least well—partly because we don't understand it.”
²⁹