Policy Doesn't Work

The front-page article titled “Psychiatrists May Soon See More Combat Veterans” in the November 4, 2005, issue begins with Col. Cameron Ritchie's cheerful news that the Pentagon is putting “lessons from other conflicts to use.” But her next sentence restates one of the failed strategies of World War II, about placing treatment facilities “as close to the battlefield as possible so that troops can return to service quickly.”

During that war, this doctrine, in almost the same words, was proclaimed throughout the Army Medical Corps. Its effect, according to my observations during three years in the Southwest Pacific, was to increase the number of psychiatric casualties. We Army psychiatrists soon found that a soldier returned to combat duty after convalescing from what would now be called PTSD would break down again, sooner and with more severe symptoms than was the case on his first admission. Many of these unhappy soldiers were rehospitalized and recycled through this process again and again until they were mercifully returned to the United States for discharge from military service.