July-August - Air Defense Artillery

To Colonel Koontz:
I see that you have been up to your
old tricks, picking on the psychiatrist,
and I read with interest your article,
"Psychiatry in the Korean War." You
know how strongly I feel on this subject
and how I concur in your remarks, and
particularly in your last paragraph.
Psychiatry is unquestionably a specialty
of medicine but the psychic and the
somatic of the human being are so completely
interwoven that you cannot tear
the parts away from each other without
losing something of each. We know that
the old-time country physician was a
psychiatrist in his way, perhaps in the
over-aU, equalled by few modem psychiatrists.
He knew all of the tricks
'which brought the psychic into line so
that the somatic might get well.
RICHARD H. EANES
Colonel, USA, Retired
Chief Medical Officer SSS
To the Editor:
I was shocked by Colonel Koontz' article
in the March-April issue of the
AA JOURNAL. As a psychologist and a
onetime combat soldier, I find this bit
of theory fraught with errors, some quite
grievous. Colonel Koontz suggests that
there are three reasons for the 100% increase
in psychiatric war casualties in
World War II over World War I: 1)
"the blight to our patriotism," resulting
from an "insidious, creeping, socialistic
philosophy," which presumably makes
the American soldier soft and ready to
succumb to war's rigors; 2) a widespread
public knowledge of the facts of certain
psychiatric conditions leading to many
prearranged attempts to fake one of these
conditions; 3) a callowness and lack of
experience on the part of psychiatrists
which induces a "credulous attitude" on
their part making for the ultimate success
of the feigned ailment.
One might conclude from the colonel's
speculations that premorbid experience,
family history, combat conditions and
other factors play no part in the combat
neurosis. One might also conclude that
there were no physiological symptoms of
this ailment, and that its onset guarantees
the soldier a long rest somewhere in
the rear areas. None of these conclusions
v\.'Ouldbe true.
The facts of the matter are that combat
fatigue (or neurosis) has certain
physical symptoms such as trembling,
incessant swallowing, sweating, paling
70
and Hushing, etc., which cannot be
feigned; that between 37 and 52% of
the cases in the last war had a positive
family history; and that the condition
has an excellent prognosis and short
duration if caught in time so that most
of the sufferers returned to duty in a
short time. Furthermore, these soldiers
underwent prolonged fear, exhaustion,
and deprivation, and often experiences so
horrifying that the consequent breakdown
would be no surprise even to a layman.
So I am astonished to find a psychiatrist
(although perhaps Col. Koontz
is not a psychiatrist) who feels that these
pitiful cases are malingerers simply because
he cannot see any Hesh tom by hot
metal.
As far as the colonel's second supposition
goes, it is not necessary to argue the
relative sophistication of the public. Most
psychiatrists believe that true, conscious
malingering is rare, and not hard to
detect in any event. Thus even if a soldier
was possessed of some psychiatric
knowledge, and was impelled in some
way to fake an ailment (knowing the
American soldier, I would be extremely
cautious about such an accusation-it's
most likely not accurate), he would still
be detected with ease.
It has become fashionable nowadays
to take advantage of the current international
tension, and blame any disliked
circumstances, whether imaginary or
othervvise, on "foreign ideas" or "socialism."
The dynamics of the infiltration are
seldom specified; Col. Koontz has not
offered any.explanation of how this "insidious"
drug changes the American citizen
from a patriotic, self-reliant, freedomloving
individual, into the milksop who
cannot stand the first tribulation. Nor
has the colonel delineated the contents
of this "socialistic philosophy." Perhaps
the colonel is implying that the members
of one political party make better soldiers
than the men of another party. Certainly
if "socialism" makes for weaklings,
than we have nothing to fear from Russia,
her satellites, or Red China. With
their philosophy, they should be breaking
down right and left.
But as far as I know, the American
citizen still works eight hours a day to
pay for bread, butter, and rent. And he
pays taxes; ask the average man if the
Government is supporting him, then
duck quickly.
Col. Koontz has somehow overlooked
the basic reason for the increased inci-
dence of combat neuroses in the last war,
the explanation generally accepted by
psychologically trained personnel. In the
first \Vorld \Var, diagnostic methods
were too undewloped to recognize many
psychiatric cases for what they were. The
more precise techniques of the last decade
simply discO\'ered more ailments in
more soldiers, but not because there were
more ill soldiers in World War II than
in 1. The tremendous improvement in
psychiatry in those 25 years enabled
clinicians of the last war to screen cases
that would have passed unnoticed in
'1917. There is no evidence that any of
that 100% increase was due to any other
factor save this improvement in diagnosis.
So much for the colonel's hypotheses.
The layman believes that anything
that is published in a scientific journal
must be unvarnished truth. Those of us
who read these periodicals regularly
know that a surprising amount of pure
hogwash gets printed in them. With
this consideration in mind, I ask the combat
veteran, the soldier who has had
combat fatigue, or has seen the unmerciful
wreck that war can make of a man's
mind, not to think that Col. Koontz
speaks officially for psychiatry or psychology.
I assure you that he does not. To
those men who have not yet, but who
some day may, face combat-psychiatry is
with you, not against you.
EUGENE E. LEVITT
1st Lt., Arty, NYNG
[Colonel Koontz is a surgeon, not a
psychiatrist. However, as a medical student
at Johns Hopkins he studied psychiatry
for two years under Dr. Adolph
Meyer, a foremost authority. In World
War II Colonel Koontz served 1940-42
as the Medical Director of Selective
Service in Maryland with experience in
the psychiatric handling of cases incident
to induction. Later he served 43 months
in the Pacific where he commanded
hospitals (one the 18th General-a
Johns Hopkins unit) and served finally
as Surgeon for the U. S. Army Forces in
the South Pacific. There he had responsibility
for the handling of psychiatric
battle casualties.
Our files include expressions of concurrence
from reputable surgeons and
combat commanders. Colonel Eanes,
Medical Director of the Selective Service
System, quoted above, has directed extensive
research in this field. He also
ANTIAIRCRAFT JOURNAL