War's desolation, then and now

During World War I, they called it neurasthenia or shell shock, the condition we now call PTSD. Somewhere on the web that I've lost track of, in some discussion of what wars do to those sent to fight them, I came across a recommendation to read Robert Grave's memoir Good-Bye to All That: An Autobiography.

The prolific novelist and biographer Graves knew all about PTSD. Enlisting in 1914 at the outbreak of war, fresh out of an elite private high school (his class standing made him automatically an officer), he quickly found himself leading men into horror and death in the futile, inconclusive, deadly struggle that was trench warfare.

The war broke men down. Here's how he describes what happened to soldiers:

Having now been in the trenches for five months, I had passed my prime. For the first three weeks, an officer was of little use in the front line; he did not know his way around, had not learned the rules of health and safety, or grown accustomed to recognizing degrees of danger. Between three weeks and four weeks he was at his best, unless he happened to have any particular bad shock or sequence of shocks. Then his usefulness gradually declined as neurasthenia developed. At six months he was still more or less all right; but by nine or ten months, unless he had been given a few weeks rest on a technical course, or in hospital, he usually became a drag on the other company officers.

After a year or fifteen months he was often worse than useless. Dr W. H. R. Rivers [a psychiatrist who became well known for treating shellshock cases] told me later that the action of one of the ductless glands -- l think the thyroid -- caused this slow general decline in military usefulness, by failing at a certain point to pump its stimulating chemical into the blood. Without its continued assistance the man went about his tasks in an apathetic and doped condition, cheated into further endurance. It has taken some ten years for my blood to recover.

Officers had a less laborious but a more nervous time than the men. There were proportionately twice as many neurasthenic cases among officers as among men, though a man's average expectancy of trench service before getting killed or wounded was twice as long as an officer's. Officers between the ages of twenty-three and thirty-three could count on a longer useful life than those older or younger. I was too young. Men over forty, though not suffering from want of sleep so much as those under twenty, had less resistance to sudden alarms and shocks.

The unfortunates were officers who had endured two years or more of continuous trench service. In many cases they became dipsomaniacs [alcoholics]. I knew three or four who had worked up to the point of two bottles of whiskey a day before being lucky enough to get wounded or sent home in some other way. A two-bottle company commander of one of our Line battalions is still alive who, in three shows running, got his company needlessly destroyed because he was no longer capable of making clear decisions.

Graves was severely injured, so much so that his commander wrote his parents that he'd been killed. But, patched together, he insisted on returning to his unit as soon as possible. The war zone was the only place he felt himself.

Dr Dunn asked me, with kindly disapproval, what I meant by returning so soon. I said: 'I couldn't stand England any longer.'

He was lucky enough to contract severe bronchitis before his unit was again subjected to serious fighting and was sent home as an invalid. (Now there's scary word!) He greeted the Armistice that ended the fighting not with the joy felt by English civilians but with melancholy:

The news sent me out walking alone along the dyke above the marshes of Rhuddlan (an ancient battlefield, the Flodden of Wales), cursing and sobbing and thinking of the dead.

When we send troops to war, we break human beings. No one who serves is unmarked. For a contemporary account of how troops come to be deployed over and over even though they know they've reached their mental limit, read this blog post.

When do we stop doing this?