This was my final research paper for Dr. Jenny Dean’s Communication and Rhetoric class during the Fall 2018 semester.
Thomas T. Moore
The Cost of War
America’s military involvement in the middle east in the last two decades has given mental health professionals further insight to the stresses experienced by soldiers coming back from war. Dr. J.M. DaCosta, a clinician working with civil war soldiers had first described what we know now as PTSD as “irritable heart syndrome.” DaCosta was one of the first doctors to see the how mental stress could affect the body physiologically. He noted that the mental anguish, combined with the physical stress of being in the Army during that time took a toll on a man’s health, including heart palpitations and high blood pressure in addition to depression and feelings of fear and malaise. During the world wars this was called “shell shock” and we know it now as PTSD.
The purpose of this study is to better understand the cost of war on soldiers and civilians in war zones in order to understand how to better mitigate harm against non-combatants in conflict zones. Understanding the effects of combat on line troops will help sustain combat readiness for those who have experienced trauma downrange while easing the transition into civilian life once combat is over. Further exploring PTSD and the ultimate human cost of warfare will help the mitigate the mental health need in this country and can lead to a better quality of life for those who have taken the oath of service and experienced psychological trauma as a result.
LTC Dave Grossman, author of On Killing acknowledges a soldier’s natural fight of flight response when faced with danger. While most are familiar with the fight or flight response, most are not familiar with the posture or submit aspect. An example of posturing in combat would be the bagpipes played in battle by Scottish units preceding an attack during WWI. Bugles and drums used by both sides during the American Civil war are another example, although they served as a means of communication before the advent of radio technology. Grossman cites another example during the American Civil War:
We read of regiments [in the Civil War] blazing away uncontrollably, once started, and continuing until all ammunition was gone or all enthusiasm spent. Firing was such a positive act and gave the men such a physical release for their emotions, that instincts easily took over from training and from the exhortations of officers.
Grossman’s research found that posturing on the battlefield can effectively scare the opposing force into a flight response. If armies then had cared only about the effectiveness of killing on a battlefield, the musket would have been substituted for a much more accurate weapon. The advent of gunpowder had created a weapon that was not only effective at firing projectiles, but also giving soldier’s an additional psychological edge on the battlefield.
Modern military training doctrine was created with the intent to override those natural responses. During WWII, BG S.L.A. Marshall, through numerous after-action reports and oral interviews with line troops had found that only 15-20% of line soldiers had fired their weapon with the intention of killing the enemy. Marshall found that there is some internal resistance to killing another human intentionally on the field of battle. His findings during WWII would set US Army training doctrine for generations of future soldiers to become effective killers on the battlefield.
Acknowledging PTSD and the symptoms that lead up to it is an important factor to bring up. According to Dr. Roy L. Swank and Dr. Walter E. Marchand, their studies of US troops in Normandy after the invasion had showed that an average combat soldier can only last for 28 days in combat before succumbing to the psychological effects of combat fatigue. These symptoms are manifested in periods of overconfidence, a hyper reactive state, and ends with an emotionally exhausted end state. Grossman contends that the best treatment for combat exhausted soldiers is to simply remove them from combat. While this seems to be an easy solution, during combat operations, this is not always a realistic task. The long-term effects of the trauma suffered in combat are deeply rooted and require much more than a trip to the rear lines for a few days.
Grossman states that psychological casualties of war do not come about by the fear of being killed or maimed, but by fear of letting one’s buddies down or by being seen as a coward by one’s peers. Grossman found that there was a distinct difference between support systems in WWII vs. Vietnam vets upon the arrival home from the battlefield. While most WWII infantrymen had experienced significant trauma, killing the enemy at a close distance or had a buddy die in one’s arms, there was a distinct difference in the homecoming reception between WWII’s veterans and Vietnam’s. The biggest factor being the time between leaving combat and returning home. Most WWII veterans had left the battlefields of Europe and the Pacific by way of boat, giving soldiers ample time to decompress. They also came home to overwhelming support from friends and family. Vietnam veterans had experienced the opposite. Since air travel had shortened travel time, soldiers were home in a matter of hours rather than weeks from a combat zone. With support for the war in Vietnam waning domestically, Vietnam veterans came home to protests and an American public that had vilified them regardless of their conduct overseas. According to HUD, of the 40,056 homeless veterans, over half are Vietnam era veterans. Homeless veterans are usually male, single, and live in urban areas. These veterans struggle with a substance abuse sometimes paired with PTSD, according to the National Coalition for Homeless Veterans.
The human cost of war can be measured in terms of public health as well. Dr. Sandy A. Johnson’s study of the impact the Sri Lankan civil war had on civilians living near a combat zone. Johnson’s findings measured public health infant mortality rates (IMR) and in maternal mortality ratios (MMR) on the district/provincial level. The data showed that there was obviously an immediate impact on public health in districts where combat happened. After the 26-year civil war, life expectancy in Sri Lanka had peaked at 72 years and the economy grew at 3.47% during the war. However, those numbers do not give an accurate depiction of the long-term effects of war had on the people of Sri Lanka. When Johnson had examined the levels of growth during the war versus before and after, she found that while the IMR had decreased, it decreased at a much slower rate due to the civil war. Her data showed that while Sri Lanka had made strides in developing despite the civil war, the growth had been much slower than it would have been in the absence of the conflict.
IMR and MMR had been worse in districts that were poorer and that had economies centered around agriculture. Johnson’s data mirrors the HUD’s data on homeless veterans in that those who were affected by poverty were most at risk of the effects of conflict. What is most concerning regarding data across both studies is that the burden of conflict is carried most by those who are poor, during and after the conflict. Despite the draft that was instituted during the Vietnam conflict, 76% were from lower middle class/working class backgrounds. According to a 1997 VFW public information office press release.
The brutal nature of conflict and its consequences show that political and military leaders must weigh all options when considering the use of military force. While the immediate effects are obvious such as in military and civilian casualties, the other consequences reach much further than what was previously thought. As the wars in Afghanistan and Iraq are nearing the twenty-year mark, there is an entire generation of children that have grown up knowing nothing but conflict. With family members dying at the hands of coalition forces, the social impact can undermine the US war effort. While everyday life under Al-Queda or the Hussein regime was brutal, the rise of extremist groups to fill the power vacuum have proved to be more ruthless than the last through. Social media has proved a vital tool to these groups, aiding in the effort to radicalize those who feel the need to strike back at the invaders.
Conflict has existed as long as humans have walked the earth. Now with modern studies, academics and policy makers have the tools to truly understand the long-lasting impacts of war. Modern military doctrine and current rules of engagement downrange must reflect the best way possible to mitigate the ill effects of war on civilians and combatants alike. While modern military technology evolved at a faster rate in the 20th century than it did ever before, the support system for those affected by conflict must catch up in order to facilitate the most effective transition for those affected after long after the bullets stop flying.
Works cited
Al-Obaidi, A. K., & Piachaud, J. (2007). While adults battle, children suffer: Future problems for Iraq. Journal of the Royal Society of Medicine,100(9), 394-395. doi:10.1258/jrsm.100.9.394
Chambers, J. W., II. (2003). S. L. A. Marshall’s Men Against Fire: New Evidence Regarding Fire Ratios. Retrieved November 20, 2018, from http://www.theppsc.org/Grossman/SLA_Marshall/Bad-Firing-Data.htm
Clark, G. E. (2008). The Human and Social Costs of War. Environment: Science and Policy for Sustainable Development,50(2), 3-3. doi:10.3200/envt.50.2.3
Costa, J. D. (1951). On irritable heart. The American Journal of Medicine,11(5), 559-567. doi:10.1016/0002-9343(51)90038-1
Gelpi, C., Feaver, P. D., & Reifler, J. (2009). Paying the Human Costs of War. Princeton University Press. doi:10.1515/9781400830091
Grossman, D., & Sittle, B. K. (n.d.). Killology | Psychological Effects of Combat. Retrieved November 20, 2018, from https://www.killology.com/psychological-effects-of-combat
Grossman, D. (1995). On killing: The psychological cost of learning to kill in war and society. Boston: Back Bay Books/Little, Brown.
Johnson, S. A. (2017). The Cost of War on Public Health: An Exploratory Method for Understanding the Impact of Conflict on Public Health in Sri Lanka. Plos One,12(1). doi:10.1371/journal.pone.0166674
National Coalition for Homeless Veterans. (n.d.). Retrieved November 20, 2018, from http://nchv.org/index.php/news/media/background_and_statistics/#facts
Vietnam War Statistics. (n.d.). Retrieved November 20, 2018, from http://history-world.org/vietnam_war_statistics.htm
Thomas T. Moore 