Soldiers Don’t Go Mad

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From The Wall Street Journal:

Two of England’s finest poets of World War I—Siegfried Sassoon and Wilfred Owen—met in a mental hospital in Scotland in 1917. Craiglockhart War Hospital, near Edinburgh, is the subject of “Soldiers Don’t Go Mad,” Charles Glass’s brisk, rewarding account of the innovative doctors and their “neurasthenic” patients who suffered unprecedented psychological distress (and in unprecedented numbers) on the Western Front. By 1915, the second year of the war, over half a million officers and enlisted personnel were admitted to medical wards for “deafness, deaf-mutism, blindness, stammering, palsies, spasms, paraplegia, acute insomnia, and melancholia”—hallmarks of what at the time doctors termed “shell shock” or, as it has become known, post-traumatic stress disorder (PTSD). Modern warfare overwhelmed countless young soldiers: “For the first time in history, millions of men faced high-velocity bullets, artillery with previously unimaginable explosive power, modern mortar shells, aerial bombardment, poison gas, and flamethrowers designed to burn them alive,” as Mr. Glass, a former chief Middle East correspondent for ABC News, recounts.

Craiglockhart, originally known as the Edinburgh Hydropathic or “The Hydro,” opened as a hospital in October 1916 for “officers only.” Its château-like main building, elaborate gardens and sweeping lawns were more elite health club than mental ward. Low-impact activities available to patients—“carpentry, photography, debating, music, and writing”—may well have confirmed the suspicions of “most senior officers, including many Medical Corps physicians, [who] regarded shell shock as nothing other than malingering or cowardice that demanded not treatment, but punishment.” To the pioneering physicians at Craiglockhart, however, the damage that trench warfare inflicted on the psyche was painfully real, often giving rise to a soldier’s “trembling limbs, halting voice, and confused memory.”

Wilfred Owen, 24, had exhibited these very symptoms in France, after surviving the blast of a trench mortar shell and spending several days unconscious, sprawled amid the remains of a fellow officer. The Army Medical Board declared Second Lt. Owen unfit for duty and consigned him to Craiglockhart for treatment. His physician there, Arthur Brock, had developed a work-based approach to recovery he called “ergotherapy,” as a counter to the popular rest cure of “massage, isolation, and a milk diet.” Brock fostered activity and community, and, when Owen expressed an interest in literature, he “encouraged him to write poetry, essays, and articles” as part of his therapy. Owen took over editorship of the Hydra, the hospital’s literary journal, in which some of the most memorable poems of the war appeared, including those of his newest acquaintance, the 30-year-old Second Lt. Siegfried Sassoon.

Sassoon took a different route to Craiglockhart than Owen, with army politics playing a role as much as mental health. Sassoon had acquired the nickname “Mad Jack” for his forays into that part of the battlefield known as No Man’s Land. Enraged at the death of his training-camp roommate, David Cuthbert Thomas (“little Tommy”), Sassoon charged the enemy line for 18 days, with what some suspected was a death wish: “They say I am trying to get myself killed. Am I? I don’t know.”

But Sassoon’s raids on No Man’s Land—brave, unhinged or both—did not precipitate his review by the medical board. That followed, instead, from the outspoken officer’s criticism of the “political errors and insincerities for which the fighting men are being sacrificed.” Following a medical furlough, occasioned by a bullet wound to the shoulder, Sassoon refused to return to duty. Rather than court martial the dissenter, who had been awarded the Military Cross for “conspicuous gallantry,” the board sent him to Craiglockhart. Was he in fact suffering from PTSD? His friend and fellow poet Robert Graves came to think so, though Sassoon’s doctor, the renowned psychiatrist W.H.R. Rivers demurred. “What have I got then?” Sassoon asked Rivers, to which he laughingly replied, “Well, you appear to be suffering from an anti-war complex.”

Rivers was “a polymath with notable achievements in neurology, clinical psychiatry, medical research, anthropology, and linguistics,” and—even more than Sassoon and Owen—he is the protagonist of Mr. Glass’s account of Craiglockhart. He founded England’s first psychology laboratories in London and Cambridge, where he was a fellow of Saint John’s College. (A dynamic portrait of Rivers may also be found in Kay Redfield Jamison’s recent “Fires in the Dark: Healing the Unquiet Mind,” in which Rivers’s fascination with religion, ritual and myth is shown to have contributed importantly to his treatment of mental illness.) But the physician was also a soldier, and his brief was not only to cure patients but also to fortify them for return to combat, often with predictably dire outcomes. Though Rivers was devoted to Sassoon, who came to see him as his “father confessor,” Sassoon’s pacifism put Rivers in a difficult position.

Sassoon had been at Craiglockhart for three weeks before Owen worked up the courage to introduce himself. By way of entrée, he brought several copies of Sassoon’s collection “The Old Huntsman and Other Poems” for him to sign. They talked for a half hour, during which Owen expressed his admiration, and Sassoon concluded that he “had taken an instinctive liking to him and felt that I could talk freely.” Though both were homosexual, the two men came from completely different worlds. The aristocratic Sassoon, whom Owen described as “very tall and stately, with a fine firm chisel’d . . . head,” was educated at an upper-crust “public” school and Cambridge. Owen, the son of a railway inspector, attended a local “comprehensive” school and missed the first-class honors necessary for a scholarship to University College London.

Link to the rest at The Wall Street Journal