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Shell Shock Described and National Sock Day

December already…jeesh, just last week it was November…where does the time go…?  But 4 December is an auspicious day indeed, for it marks the death of Persian poet Omar Khayyam in 1123 (yes, there really was a guy by that name); the end of the Council of Trent (after sixteen years) in 1563; Pere Marquette building the first dwelling in what is now Chicago in 1673 (wonder if he had a permit for it); George Washington’s farewell to his officers a Fraunces Tavern in New York in 1783 (so he wouldn’t have to pay that bar tab); the Electoral College declared James Monroe President of the United States in 1816; merchant brigantine Marie Celeste was found off the Azores in 1876, abandoned by passengers and crew (a mystery that persists to this day); Woodrow Wilson became the first sitting president to leave the county on this day in 1918 when he boarded SS George Washington for France; and Gemini VII was launched from Cape Canaveral in 1965.  But today we talk about one of the worst horrors of war, and socks.

Rivers and other practitioners had treated men who, in the eyes of the military establishment, were simply cowards. 

On 4 December 1917, Dr. WIlliam H. Rivers committed heresy.  For his crime, he was terminated from his post because, well, the Army can’t have heretics treating fighting men. River’s heresy was embodied in a report he submitted to the Royal School of Medicine entitled The Repression of War Experience, which was based on his work at the Craiglockhart War Hospital for Neurasthenic Officers in Scotland. There, Rivers and other practitioners had treated men who, in the eyes of many in the military establishment, were simply cowards.

…the “slackers” started to exhibit behaviors other than just being unable or unwilling to go to the front: panic, fearfulness, wakefulness, babbling, diarrhea, starting at loud noises, dizziness, amnesia.

Since the beginning of organized warfare, military organizations had treated those who, for whatever reason, refused to fight after the battles had begun and they had participated, as simply slackers. In the mid-to-late 19th century, as explosive artillery became more commonplace, range increased and soldiers were in contact longer, the “slackers” started to exhibit behaviors other than just being unable or unwilling to go to the front: panic, fearfulness, wakefulness, babbling, diarrhea, starting at loud noises, dizziness, amnesia. As medical science began to get itself organized, there were some clinicians in the Second Boer War (1899-1902) who looked at medical records and notes from older conflicts, including the Crimean War (1853-1856), and the American Civil War (1861-1865) to see a pattern of sorts: these symptoms appeared after the sufferers had been exposed to high noise level explosions, such as artillery bombardments of some duration. While the medical profession in general either ignored these findings or discredited them, they did not go away.  Indeed, after 1914 they became more prevalent.

As the numbers of these “malingers” increased in the British Army the leadership became alarmed, and actively suppressed any findings related to the phenomenon. 

By the end of 1914, as much as 10% of British officers and 4% of the enlisted men were complaining of one or another of the signs of what was labeled “shell shock” (which in this essay it shall be called regardless of current fashion) in a 1915 article in The Lancet. There were other symptoms by then, including neurasthenia, mutism and fuge. At the time these were regarded as related to head trauma, but many of the patients showed no head injury. As the numbers of these “malingers” increased in the British Army the leadership became alarmed, and actively suppressed any findings related to the phenomenon.  But scientists resisted such manipulations, and began comparing notes by proxy with German, Austro-Hungarian, and even Ottoman clinicians through neutrals, including Scandinavia and the United States, and found that all of them were reporting similar cases.

Rivers and several other neuropsychiatrists came and went, with no supervisor lasting more than a few months before they were sacked because they simply kept their patients too long. 

Grudgingly, British military leaders had decided that a simple rest cure should be sufficient for an officer to recover his wits and spine: perhaps two or three weeks should do.  In 1916, a disused hydrotherapy hospital at Craiglockhart in Scotland was opened to study the phenomenon in British officers, and give them a good long rest. When Siegfried Sassoon and Reginald Owen were sent there in 1917, it was quickly dubbed “Dottyville.” Rivers and several other neuropsychiatrists came and went, with no supervisor lasting more than a few months before they were sacked because they simply kept their patients too long.

Humans can only take so much exposure to these things, and everyone has a different limit.

After the end of WWI, clinicians from all over the world began to talk about the phenomenon called shell-shock, and found that no nation, no culture, no rank or society was immune. The Americans looked at cases as far back as Mexico; the Russians found indications not just in the Crimea but before, as early as 1812, especially among artillerymen. Even Japanese doctors could find an occasional mystery-coward (executed in their case) who simply could neither speak nor stand after fighting in Korea in 1892.  It was called “bullet wind,” “soldier’s heart,” “irritable heart,” and “operational exhaustion” to name but a few of many score titles observers have given it through the ages. But the military was slow to recognize the phenomenon–officially–and had to wait until the 1930s, when the profession of psychoanalysis became socially acceptable. But failure to recognize the side effects of prolonged exposure to high-intensity noise, extreme sound and air pressure, fear, horror, long hours of wakeful alertness and uncertainty on human beings at all levels lingered as late as George Patton’s famous “slapping incidents.” Humans can only take so much exposure to these things, and everyone has a different limit.

The moniker “post-traumatic stress disorder” or PTSD has been adopted since the 1970s to describe the phenomenon, but it too has been abused to the point where it has become meaningless.

For some peculiar reason, the victims of shell shock or any other name given to those whose minds have been affected to one extent or another by warfare, puts medical professionals on edge, and on their guard. Since the 1930s, the collective phenomenon of shell shock has been shuttled around by the medical profession and the insurance industry like a live grenade. Sufferers are often medicated, talked to, given “strategies” that sometimes work and sometimes don’t, and generally treated like a fungus that won’t go away. The moniker “post-traumatic stress disorder” or PTSD has been in use since the 1970s to describe the phenomenon, but it too has been abused to the point where it has become meaningless. The short, technical-sounding catchall term “PTSD” does, however, make it much easier to write up in clinical notes, and easier to pass of to the next poor schlemiel to try to put the sufferer back together and at least be able to function.

The medical profession does not trouble itself, however, to explain how an abused spouse, a bullied school kid, and a combat veteran can all fall under the same label.

To be clear, I personally know no one who suffers–clinically defined–from this horrid affliction, and I don’t–clinically defined–suffer from it, but there are degrees of such trauma.  I have been under fire, and I saw people torn apart by gunfire. I sometimes have nightmares about it, and I sometimes can’t sleep because of it.  It was more than four decades ago, but still…I’m convinced that the condition is difficult for anyone who has never been shot at or exposed to such horrors as war can make to understand. The insistence of many overtrained and underqualified ignorami who want to put all of these conditions and more under the general heading of PTSD is beyond any and all understanding to those who have to deal not just with symptoms and with the patients, but with the record. The medical profession does not trouble itself, however, to explain how an abused spouse, a bullied school kid, and a combat veteran can all fall under the same label.


Today is also National Sock Day, an observance that, according to the founders of National Sock Day, Pair of Thieves, is on 4 December because of two events.  On 4 December 1954 the final curtain fell on “On Your Toes,” a unique Rodgers and Hammerstein ballet/musical that had run since 1936. The second was in 1991, when the Judds “that kept toes two-stepping” performed their final concert together in Murfreesboro, Tennessee.  Okay, whatever…

The folks over at National Day Calendar also tell us that it’s a day that “recognizes the rarest of all lasting unities, the marriage of matched socks.”  Now, not to be a killjoy (OK, I will), I never have trouble with matched socks because, well, I buy all the same socks.  And yes, I do my own laundry.

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