December 2017 Philadelphia Chapter of Pax Christi U.S.A.
During my private practice seeing civilian patients I frequently worked with couples and families. As often as possible I tried to interview both members of a marital pair. There is always value in obtaining another view of a clinical problem. I followed the same procedure while working with service members. Sometimes both spouses were service members. On rare occasions both spouses had been deployed to the same location at different times. Such was the case with the Smiths. Sarah Smith went first and John went second.
Within her leadership position, Dr. Sarah Smith was exposed to a lot of trauma. As a trauma surgeon she worked in the emergency room and intensive care unit. Most of her contact with patients was short term. Injuries were triaged. What injuries she could repair, she did. What injuries she could not resolve were evacuated. She had no long term contact with injured individuals. She returned to the United States, retired, and continued caring for her family.
Her husband, John Smith, deployed a month after his wife’s return and was sent to the location where she had been a military surgeon. Sarah told her husband not to worry about this deployment. There was a great deal of combat nearby but he would be safe. Despite the frequent shelling and bombings, John remained physically safe. Shortly after arrival, he learned a college classmate had committed suicide. Somewhat later one of his deployed colleagues killed herself. Midway through his deployment, a field grade officer on the verge of promotion took his own life. John was unnerved by these events. He began thinking a great deal about the value of a life.
Dr. John Smith had intimate contact with his patients — many of whom were our soldiers and many enemy soldiers. He ran a rehabilitation center, focusing on occupational and physical therapy. Some of the enemy were “high value” prisoners. He was obligated to take good care of them — in part because of the information they might provide. His care involved daily physical and emotional contact. He developed personal relationships and was concerned about their welfare. When rehabilitated and debriefed, these enemy combatants were sometimes released. Smith knew that the rehabbed prisoners might be assassinated by their colleagues as soon as they left the compound. Some were. These enemy soldiers often begged not to be let go. They knew, as did Dr. Smith, the enemy would consider the patient debriefing as a betrayal of the enemy. Dr. Smith had no control over their release.
Upon his return home, his wife found John to be a different person - emotionally distant, hyper vigilant, avoiding crowds, experiencing nightmares, and frequently anxious. He was sleepy in the daytime and wished that somehow he would die. Pressed by his wife to discuss his deployment, he became tearful. She knew what the deployment had been like, she had been there, but it was not what her husband was describing. Sarah had not been there in the same way John had and she could not understand his reaction. Marital conflict ensued, compounding his condition.
Two soldiers, one marriage, deployed in the same place experienced totally different reactions. Medically it might be easy to explain away these differences as genetics, life history, different physiology or different time frames. I told them, however, that I thought a major factor in their conflict was the different relationship they each had with their enemy.
A soldier appearing in the PBS Burns and Novicks' series, “The War in Vietnam” summed it up best by saying the opposite, “I did not kill any humans only Gooks.” After one dehumanizes the enemy, the rest of the war is easier.
1
John Smith was unable to dehumanize the enemy. He literally cared for the enemy and was concerned about his or her welfare. Emotionally metabolizing the experience was fraught with conflicting feelings. This problem was not shared by his wife who had no such long term personal relationship with the enemy.
His reaction was similar to a North Vietnamese soldier quoted in the PBS series. The enemy soldier said the Americans seem like us: courageous, loyal, and really concerned about one another. Americans do not abandon their fallen soldiers. They go back for them — a behavior that we also show.
Caring about the enemy is not new to the wars in Vietnam, Iraq, and Afghanistan. The behavior is part of a long tradition. Perhaps the most famous example of mutual caring for the enemy was the World War I Christmas truce. Along the Western front on Christmas Day, 1914, over 100,000 British, Belgian and French troops mixed with German soldiers. It began in the trenches first with the Germans singing Christmas carols, then the British or Belgians sang from the other side, and then finally a joint singing of “Oh Come All Ye Faithful” was sung in English and Latin. Graham Williams of the Fifth London Rifle Brigade said, “Well, this is really a most extraordinary thing — two nations both singing the same carol in the middle of a war.”
During The American Civil War over 630,000 individuals died. President Lincoln spoke as the war was coming to an end, “With malice toward none, with charity for all, with firmness in the right as God gives us to see the right.” One nation, a house divided, at war which tried to find a way to live with one another.
Dr. Smith has found it helpful to know that his care and concern for the enemy, the behavior complicating his current life, is part of a long and honorable tradition. He is not alone. Not everyone finds it easier to dehumanize our fellow enemies. As John understands himself better, so does his wife. Perhaps even we, our nation, may understand better some of war’s complexities as well.
Ted Beal
Edward W. Beal, MD, Psychiatrist, Department of the Army, Department of Tele-Health, U. S. Army Medical Department Activity, Fort Meade
2