Shell Shock was Misdiagnosed Combat Brain Injury
By Attorney Gordon Johnson
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While this issue may in fact be prehistoric, the dilemma as to whether the radically different emotions and behaviors of the returning vet were the result of injury or psychic stress was an important theme of post World War I thought. World War I, like Vietnam, (and now our occupation of Iraq) was a war without decisive battles, where returning soldiers returned home with little thoughts of glory, and severe difficulty adapting to civilian life. As World War I and Vietnam were fought repeatedly over the same turf, there was little drama in the successes and failures in the field. There were no great battle movies like the Battle of the Bulge or Midway to come out of those conflicts. Instead, we got All Quiet on the Western Front, Apocalypse Now and The Deerhunter.
The literature of the time focused on the futility and horror of the conflict. It may be that such “treading water” kind of war, results in either more psychic stress or more non-fatal closed head injury. It may be a combination of the two. But both wars resulted in a mushrooming of anti-war literature, focused on the ravages of such conflict on the minds of its veterans. Listening to the shell shocked voices of that periods fictional characters provide diagnostic clues of what we would today diagnose as Post Concussion Syndrome.
The literature after World War I as it pertained to “shell shock” reflected the struggle for society to accept that its brave soldiers could be “weak” enough to be haunted by the psychological horror of war. It is claimed that the British resisted such labels, instead looking for physical injuries which could explain the major change in the personality of its returning veterans.
“In order for the condition to seem more valid, the stigma of psychological disorder had to be surmounted – a significant obstacle to a society in which the mentally ill were considered outsiders. Therefore, it could not be attributed to fear or nervous breakdown due to the atrocities of war; medical experts had to assert that shell shock was caused by proximity to an exploding shell. ” Kara S. Harton paper on The Return of the Soldier.
While French and German medical experts more easily accepted the psychological explanation, the British medical experts shifted the focus to the more tangible explanation that proximity to an exploding shell, explained the change. However, even the British fell far short of truly appreciating the brain injury that occurred as a result of those blast injuries.