Science  /  Retrieval

Neuro-Psychiatry and Patient Protest in First World War American Hospitals

Though their wishes were often overshadowed, soldier-patients had voices.

In August 1919 over two hundred neuro-psychiatric soldier-patients wrote in protest to the Secretary of War about their treatment at U.S. Army General Hospital No. 30 in Plattsburgh, New York. Their joint statement accused the military of holding them against their will longer than necessary and stated that they believed their “further tenure of service is due entirely to the mal-administration of affairs and not to any cause of circumstances.” The men argued that they had fulfilled their contract and should be honorably discharged.

The patient protest at Plattsburgh highlights a broader pattern of inefficiency in treating psychiatric wounds of the First World War in stateside hospitals. These stories of protest also help to incorporate patient voices into the myriad histories of First World War medicine and disability, narratives that often overshadow individual experiences. Wounded soldiers were not passive recipients of military medicine, but agents within politically infused systems of healing; neuro-psychiatric patients were no exception.

Official estimates after the Great War put American psychiatric wounds at almost 70,000. The Surgeon General ruled that the term “shell shock” wasn’t a sufficient enough diagnosis for these men, who were usually classified in varying degrees as “neuro-psychiatric patients” or cases of “neurosis,” “psycho-neurotic,” or simply “insane.” Soldiers presented with symptoms including, but not limited to, nervous tics, hysterical blindness, anxiety, deafness, depression, vomiting, and confusion.

Most met a medical-policy atmosphere more hospitable than that in Europe because “curative discourse uniquely framed… American medical policy,” meaning American physicians saw neurological injury as capable of being fixed rather than seeing it as a form of cowardice. Yet despite guidelines outlining neurosis as something that could be fixed, the lasting complexity of psychiatric wounds challenged the usefulness of “curative” treatment. And personnels’ lack of understanding often led to mistreatment, as soldier-patients with neurosis regularly returned to encounter inhospitable ideas about mental health and prolonged stays in wards. Soldiers responded by protesting in ways available to them.

They initially faced long and uncomfortable journeys to their respective hospitals in the United States. Soldiers arriving in New York City showed signs of neglect, as many were kept “in parts of the ship unsuitable for any class of sick soldiers, enduring close confinement and under armed guard” that in many cases aggravated symptoms. According to the director of the National Committee for Mental Hygiene, Thomas W. Salmon, poor treatment was due to the Navy’s “lack of appreciation” of “this class of patients.” For a group of officer-patients on the U.S.S. Manchuria, conditions were so horrific they signed a protest upon arrival in New York City.