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  Discussing his experience in two ships, he said, " O n e was sunk after surviving more than two hundred raids and the whole of the first Libyan campaign. T h e other was in four major actions in addition to many raids at sea and in harbour, and twice sustained actual damage." Yet the incidence of psychiatric casualties was almost nonexistent. "There were more than five hundred m e n in the two ships and of these only two came to me about their nerves."

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  After World War II the fields of psychiatry and psychology attempted to find out why, and again they suggested gain through illness. The sailor obviously had nothing to gain by becoming a psychiatric casualty and therefore did not elect to do so.

  The idea that modern sailors had nothing to gain through becoming a psychiatric casualty is simply absurd. The sick bay of a warship is traditionally placed in the safest and most secure heart of the ship. A sailor standing in the open, firing a deck gun at an attacking aircraft, has much to gain by making for the relative safety of sick bay. And even if his psychiatric symptoms can't get him completely away from this battle, they can most assuredly get him away from future ones.

  So why don't these sailors suffer from the same psychiatric ailments that their brothers on land do? Modern sailors suffer and burn and die just as horribly as their land-bound equivalents.

  Death and destruction fall all about them. Yet they do not crack.

  Why?

  The answer is that most of them don't have to kill anyone directly, and no one is trying to specifically, personally, kill them.

  Dyer observes that there has never been a similar resistance to killing among artillerymen or bomber crews or naval personnel.

  "Partly," he says, this is due to "the same pressure that keeps machine-gun crews firing, but even more important is the intervention of distance and machinery between them and the enemy."

  They can simply "pretend they are not killing human beings."

  Instead of killing people up close and personal, modern navies kill ships and airplanes. Of course there are people in these ships and airplanes, but psychological and mechanical distances protect the modem sailor. World War I and World War II ships often fired their weapons at enemy ships that could not be seen with the naked eye, and the aircraft they fired at were seldom more than specks in the sky. Intellectually these naval warriors understood that they were killing humans just like themselves and that someone wanted to kill them, but emotionally they could deny it.

  A similar phenomenon has occurred in aerial combat. As previously noted, World War I and World War II pilots, in relatively slow-moving aircraft, could see enemy pilots, and thus large 60

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  numbers of them failed to fight aggressively. Desert Storm pilots, fighting an enemy seen only on a radar scope, had no such problems.

  Fear and Patrols Behind Enemy Lines

  Another circumstance that is free of the usual psychiatric casualties associated with the battlefield involves patrols behind enemy lines.

  Although highly dangerous, such patrols are by their very nature a different kind of combat, and in wars throughout this century they have had some common characteristics.

  As an infantry company commander and an army Ranger, I have been trained by the U.S. Army to plan and conduct such patrols and have done so in training on many occasions. The majority of patrols are usually reconnaissance patrols. On a recon patrol a small, lightly armed body of men is sent into enemy territory with specific orders not to engage the enemy. Their mission is to spy on the enemy, and if a recon patrol runs into an enemy force it will immediately break contact with the enemy. The essence of a recon patrol is not to be found or seen, and there is not enough firepower with such a patrol to support any kind of offensive operation.

  Thus, although recon patrols are dangerous, and the information produced may result in many enemy soldiers being killed, the mission itself is a very benign operation. It is an operation completely free of any obligation or intention to directly confront or kill the enemy. Sometimes there is a requirement to capture a prisoner, but even this is a relatively limited engagement with the enemy. What could be psychologically less traumatic than being ordered to run from enemy aggression?

  If a patrol is not a recon patrol, it is usually on an ambush or a raid, in which a select group of men will attack the enemy at a planned point. Just as in a recon patrol, a combat patrol will immediately break contact with the enemy if it is spotted while moving to or from its objective. The killing actions of a raid or ambush are focused on one particular spot for one brief period of time; at all other times the patrol, which depends on surprise for its success, will run from the enemy.

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  A raid or ambush patrol is carefully and thoroughly planned and rehearsed prior to leaving friendly lines, and the time in which killing takes place will be extremely brief, and very much like that practiced in rehearsal. The psychologically protective power of (1) hitting a precise, known objective and of (2) conducting such exact rehearsals and visualizations prior to combat (a form of conditioning) is tremendous. Thus, by their very nature, such combat patrols involve far less random killing and are therefore less conducive to psychiatric casualties.

  An additional factor to consider here is — as Dyer points out —

  that the extremely rare "natural soldiers" who are most capable of killing (those identified by Swank and Marchand as the 2 percent predisposed toward aggressive psychopathic tendencies) can be found "mostly congregating in the commando-type special forces

  [units]." And it is just such units as these that are usually given the mission of conducting combat patrols behind enemy lines.

  Here too gain through illness has been used to explain the absence of psychiatric casualties during patrols behind enemy lines, and again it is demonstrably wrong. Aside from the fact that men in combat go mad regardless of whether or not it will do them any good, such soldiers have much to gain by becoming psychiatric casualties.

  Patrols behind enemy lines are extraordinarily dangerous, and only one or two casualties (psychiatric or otherwise) en route can result in aborting the mission completely. Even if the mission is not aborted, the wounded and incapacitated can be spared much of the danger involved in a patrol by remaining at a secure location where rucksacks, rations, and equipment are kept under the guard of a few men while the mission is completed. Above all else, indications of psychiatric stress by a soldier on patrol would ensure that the soldier would not go on subsequent missions.

  Soldiers on patrols behind enemy lines — like civilians suffering from strategic bombing, prisoners of war receiving artillery or bombs, and sailors in modern naval combat — generally do not suffer psychiatric stress because, for the most part, the element that is most responsible for causing combat stress is not present: they are not obligated to engage in face-to-face aggressive activities 62

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  against the enemy. Even though these missions are highly dangerous, danger and the fear of death and injury are quite obviously not the predominant cause of psychiatric casualties in battle.

  Fear among Medical Personnel:

  "They Take Not Their Courage from Anger."

  In a vision of the night I saw them,

  In the battles of the night.

  'Mid the roar and the reeling shadows of blood They were moving like light . . .

  With scrutiny calm, and with fingers

  Patient as swift

  They bind up the hurts and the pain-writhen

  Bodies uplift . . .

  But they take not their courage from anger That blinds the hot being;

  They take not their pity from weakness;

  Tender, yet seeing . . .

  They endure to have eyes of the watcher

  In hell and not swerve

  For an hour from the faith that they follow,

  The light that they serv
e.

  Man true to man, to his kindness

  That overflows all,

  To his spirit erect in the thunder

  When all his forts fall, —

  This light, in the tiger-mad welter,

  They serve and they save.

  What song shall be worthy to sing them —

  Braver than the brave?

  — Laurence Binyon, World War I veteran

  "The Healers"

  There is a significant body of evidence that indicates that nonkilling military personnel on the battlefield suffer significantly fewer T H E R E I G N O F FEAR

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  psychiatric casualties than those whose j o b it is to kill. Medical personnel in particular have traditionally been bulwarks of depend-ability and stability in combat.

  Lord Moran, writing about his military experiences in Anatomy of Courage, is one of many such nonkillers who have recorded that they had never experienced the physical symptoms of fear. He experienced great emotional trauma and he felt that certifying his unit as fit, which was his responsibility, was "like signing the death warrant of two hundred men. And I might be wrong."

  He concludes by saying that "even n o w after twenty years my conscience is troubled. . . . Was it right that I should hold such m e n to the trenches and if they were killed were they or I to blame?" Yet despite all his experiences, he marvels at his o w n ability to "stick" for so very long while the soldiers around him broke beneath the psychological burdens of combat. In Moran's case he felt that his lack of psychiatric symptoms during his long years of continuous combat in the trenches of World W a r I was because, as a medical officer, looking after the wounded gave him something to do. This may be true, but perhaps a large part of the answer is that he simply was not obliged to kill.

  T h e medic takes not his courage from anger. He runs the same or greater risks of death and injury, but he, or she, is given over on the battlefield not to Thanatos and anger, but to kindness and Eros. And when it comes to the psychological well-being of its avatar, Thanatos is a far harsher master, and whereas one World War I veteran-poet understood the nature of Eros on the battlefield and communicated it to us in " T h e Healers," another understood and spoke of the nature of Thanatos on the painful field: Efficient, thorough, strong, and brave — his vision is to kill.

  Force is the hearthstone of his might, the pole-star of his will.

  His forges glow malevolent: Their minions never tire To deck the goddess of his lust whose twins are blood and fire.

  — Robert Grant, World War I veteran

  "The Superman"

  T h e psychological distinction between being a killer or a helper on the battlefield was clearly made by one remarkable veteran I 64

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  interviewed. He had served as a sergeant in the 101st Airborne Division at Bastogne, was a Veterans of Foreign Wars post commander, and a highly respected member of his community. He seemed to be deeply troubled by his killing experiences, and after World War II he served in Korea and Vietnam as a medic on a U.S. Air Force air-rescue helicopter. His harrowing adventures rescuing and giving medical aid to downed pilots, he quite freely admitted, was a relief from, and a very powerful personal penance for, his relatively brief experience as a killer.

  Here, the one-time killer became the archetypal medic, ministering to the wounded soldiers and carrying them off on his back.3

  Fear among Officers

  Very similar to the psychologically protected position of medics is the position of officers. Officers direct the killing but very seldom participate in it. They are buffered from the guilt of killing by the simple fact that they order it, and others carry it out. With the possible exception of rare self-defense situations, most officers in combat never fire a shot at the enemy. Indeed, it is a generally accepted tenet of modern warfare that if an officer is shooting at the enemy, he is not doing his j o b . And even though line-officer casualties in most wars are consistently much higher than those of their men (in World War I, 27 percent of the British officers w h o served on the western front were killed, compared with 12 percent of the men), their psychiatric casualties are usually significantly lower (in World War I, the probability of a British officer becoming a psychiatric casualty was half that of the men).

  Many observers feel that the lower incidence of psychiatric casualties among officers is due to their greater sense of responsibility or the fact that they are highly visible, with greater social stigma associated with breakdown. Undoubtedly the officer has a greater understanding than his men of what is going on and his place and importance in it. And officers get more recognition and psychological support from military institutions, such as uniforms, awards, and decorations.

  These factors are probably all part of the equation, but the officer also has a far smaller burden of individual responsibility for killing T H E R E I G N OF FEAR 65

  on the battlefield. T h e key difference is that he doesn't have to do it personally.

  A Fresh Look at the Reign of Fear

  It would appear that, at least in the realm of psychiatric casualty causation, fear does not reign supreme on the battlefield. T h e effect of fear should never be underestimated, but it is clearly not the only, or even the major, factor responsible for psychiatric casualties on the battlefield.

  The deaths, destruction, and fear experienced by those w h o survived months of bombing in England and Germany did not produce anywhere near the psychological breakdown suffered by soldiers in combat. The Rand Corporation studies outlined earlier make it clear that just as the distance involved helped the pilots and bombardiers to partially deny that they were personally killing thousands of innocent civilians, so too did the circumstances and distances involved buffer civilian and P O W bombing victims, sailors, and patrols behind enemy lines from the Wind of Hate (which we will examine shortly) and permit them to successfully deny that anyone was personally trying to kill them. They simply didn't take it personally. Indeed, one might think that the civilians' and the P O W s ' inability to fight back would be a source of stress, but just the opposite appears to be true: most bomber crews and artillery crews would eventually sustain psychiatric casualties, while the noncombatants they attacked generally did not.

  During World War II, bomber crews generally had the highest casualty rates of any combatants among the Allied forces. In the British Bomber Command, out of every one hundred men only twenty-four survived. Such figures, faced day after day without respite, appear to have been sufficient to result in the tremendous psychiatric casualty rates suffered by these crews. This fear was intermingled with a comparatively small quantity of horror and some burden of responsibility — one Vietnam-era bomber pilot claimed it was the killing of civilians, even at a distance, that eventually drove him to drink and troubled him the most in subsequent years. But fear may have been the predominant psychological enemy in this particular circumstance. The point is that 66

  K I L L I N G AND C O M B A T T R A U M A

  fear is only one of many factors, and it seldom, if ever, is the sole cause of psychiatric casualties.

  The magnitude of the exhaustion and the horror suffered by combat veterans and victims of strategic bombing is generally comparable. The stress factors that soldiers experienced and bombing victims did not were the two-edged responsibility of (1) being expected to kill (the irreconcilable balancing of to kill and not to kill) and (2) the stress of looking their potential killers in the face (the Wind of Hate).

  Chapter Three

  The Weight of Exhaustion

  The first quality of a soldier is constancy in enduring fatigue and hardship. Courage is only the second. Poverty, privation and want are the school of the good soldier.

  — Napoleon

  Exhaustion as Inoculation in Training

  The impact of true physical exhaustion is impossible to communicate to those who have not experienced it. I remember sitting in the mud in a state of exhaustion, picking up small frogs from
the surrounding swamp, swallowing them one by one, and rinsing them down with water from my canteen. I had not eaten or slept for five days. We were beginning week eight of the eight-week U.S. Army Ranger school, and my peers and I had endured this kind of physical deprivation for seven weeks. At this point swallowing live frogs seemed a very reasonable course of action. And although we were handpicked officers and sergeants in the finest possible condition upon beginning the course, by this time most of us had lost well over twenty pounds of body tissue.

  Sunken cheeked and hollow eyed, we were in a state of total starvation-enhanced exhaustion that caused many of us to have repeated hallucinations. These were incredibly vivid dreams that we would experience while wide-awake. To those who 68

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  experienced them, these hallucinations (which were usually about food) seemed to be real. We carried forty-pound rucksacks over the mountains of Georgia and Tennessee and through the swamps of Florida on endless tactical operations while constantly being assessed on our leadership ability. The mind teetered on the brink of madness, and anyone could drop out at any time simply by failing to perform or asking to quit. Only pride and determination kept us going. For weeks after graduation many of us awoke in panic and disorientation in the middle of the night.

  Elite soldiers from all over the world participate in this remarkably effective initiation rite, and fewer than half pass. It is probably the only school in the U.S. Army about which there is no stigma for having failed. "At least," they say, "you had the guts to try."

  And the graduates of this school — and, to varying degrees, the U.S. Navy SEAL and Underwater Demolitions School, the U.S.

  Army Special Forces (Green Berets) and Airborne (paratrooper) courses, and U.S. Marine boot camp — are respected by soldiers around the world as individuals who can be trusted to maintain their cool in stressful situations.

  T h e point of such remarkable exercises in self-flagellation is to introduce the combat leader to an intense degree of stress and thereby inoculate him against psychological trauma. United States Army lieutenant colonel Bob Harris explained h o w Ranger school had done this for him before going to Vietnam: It is worth noting that my experiences as a platoon leader convinced me absolutely of the value of Ranger training. While I didn't have occasion to use all of the techniques and skills I was taught, I did use many. More important was the knowledge I had gained of myself in Fort Benning, and in the north Georgia mountains and in the Florida swamps; the understanding that limits are mostly in the mind and can be overcome; the knowledge that I could keep going and be an effective leader in spite of fear, fatigue, and hunger.