APRIL 28, 2015, by Jim Hinton – One of the unfortunate legacies of war are the countless numbers of veterans who come home with medical ailments. The battles on the battlefield are often only the start for the soldiers and sailors who fought the war, as life after the war can be just as much of a struggle. Rather than focusing on the wars themselves, let’s take a moment to focus on the battles the soldiers fought after the war by examining the biggest health battles veterans fought after the war.
The Spanish-American War (1898)
Though it was fought before the start of the 20th Century, the Spanish-American War can be viewed as the first war of the 20th Century. The unimaginative name more or less tells the story. During three and a half months of fighting ~300,000 U.S. soldiers and sailors, along with 200,000 Cuban and Philippine rebels, took on 350,000 Spanish soldiers and sailors. The U.S. won, resulting in the acquisition of a large number of colonies in the Caribbean and Pacific.
The number of U.S. dead was relatively small, with just under 3,000 killed in combat or by disease. The aftermath of the war, however, was one with a lasting legacy. While Typhoid is often overlooked as a chronic illness, many soldiers returned home as carriers of the disease, spreading it in the U.S. after the war and suffering relapses. More important were diseases such as Malaria and Dysentery, both of which could linger for years.
One particular legacy was the first beginning of a recognition that veterans sometimes suffered from some sort of psychological disruption. These included unreasonable agitation and difficulties with sleeping. Though it had been discussed to various degrees as early as the 1600s, Freud was the first to formally describe what he referred to as “War Neurosis”. Addiction to Morphine was also being recognized as an issue veterans faced.
World War I 1914-1918
“The Great War” as it was called was far from great for those who endured it, and unfortunately the suffering didn’t end once the Armistice was signed. Although the U.S. did not enter the war until 1917, many Americans served with foreign militaries from the start. In the end, 4,000,000 Americans served in the war, suffering 110,000 casualties.
Many of the old, familiar faces cropped up after World War I. Typhoid and Dysentery both ran rampant. However, the sheer scope of things added new wrinkles to some of the old twists. Hundreds of thousands of men came home having suffered amputations or disfigurements that would require long term care after the war, prompting the creation of the “Veteran’s Bureau”, now known as the Department of Veteran’s Affairs.
Two particular issues of note came out of WWI in terms of veteran health issues. The first was the chronic health issues suffered by victims of gas attacks. Many of the victims of gas attacks who survived the war spent the rest of their life fighting near constant bronchitis and pneumonia. The other was further recognition of Freud’s “War Neurosis”. Suspected to be the result of mild brain injuries caused by repeated artillery attacks, it became widely known as “Shell Shock.”
World War II 1939-1945
Once again, the U.S. was a bit of a latecomer to WWII, technically only joining two years after the war started. Realistically, the “neutral” U.S. Navy was engaging U-boats as part of convoy duty as early as April 10th, 1941, seven months before Japan’s declaration of war. 16,000,000 Americans would serve during the war, with 290,000 killed in action and 670,000 wounded. An additional 117,000 would die of accidents or illness.
World War II added a few new entries to the list of long term health issues veterans faced after coming home from the war. The most immediate of these was exposure to nuclear radiation. Initially limited to those participating in occupation duty in Hiroshima or Nagasaki, the post war years would add to the list of those in danger of cancer and tumors from exposure.
A new wrinkle would be the late recognition of an inadvertent health risk. Numerous veterans, particularly navy engine repairers fighting in some of the largest sea battles in history, would be exposed to the slow-to-be-recognized risks of asbestos. It would only be in the 1970s that the various asbestos related diseases would be acknowledged by the government as having been related to the service of U.S. veterans.
Shell Shock would see little change in how it was viewed or treated, and simply be re-branded as “combat fatigue”.
The Korean War 1950-1953
Sometimes referred to as the Forgotten War, this may be the only true 20th century war the U.S. was not fashionably late to. Within two months of the start of the war, the U.S. would have troops on the ground, and it would remain in Korea to this day. An armistice would end the fighting of the war in July of ’53, though no peace treaty has ever been signed to this day. A little over 325,000 Americans would serve, suffering slightly more than 36,000 dead, 100,000 wounded, and not quite 8,000 MIAs.
The Korean War would bring no fresh new illnesses to the litany of the horrors of war that had already been created by wars past. It did, unfortunately, add a forgotten generation of new victims, one barely removed (and often outright intermixed) with the veterans of WWII.
Unfortunately, the “lack of creativity” of the Korean War would not hold true for the war in Vietnam. Getting involved three years after the war started, the U.S. would ultimately commit a total of 530,000 troops. Over 58,000 would be killed and over 300,000 wounded. A largely unpopular war, many veterans would come home to a somewhat hostile population whose concern for their long term health was lackluster at best.
The veterans of Vietnam came home with two new maladies to be concerned with, in addition to the previous list. It would take years for either of them to be identified by medical science, and so the veterans of ‘Nam spent one to two decades suffering from illnesses that often went unrecognized or whose treatment was unknown. Eventually, however, scientists would identify some of these issues as stemming from the blood-borne illness Hepatitis C. For the remainder of those suffering illnesses of at that time unknown origin, it wouldn’t be until 1991 that the government would acknowledge a link with the heavy use of Agent Orange and begin offering compensation.
The war would prove to be a watershed moment for those suffering ill mental effects from war, however. Shell shock or combat fatigue, enough official attention was being placed on it for the redubbed “Combat Neurosis” would finally receive a formal description. Though still nascent in many ways, the research would describe the symptoms as including anxiety, insomnia, nightmares, flashbacks, and a reduction in mental acuity.
Operation Desert Storm 1990-1991
Popular known now as the First Gulf War, a coalition lead by 540,000 Americans pushed Iraq out of Kuwait. American losses were incredibly light, with only a total of 292 dead and 776 wounded. Despite its very short duration and extremely low casualties, Desert Storm brought with it a whole host of new issues.
A significant number of soldiers who served during the war began suffering from significant chronic effects, including fatigue, joint pain, digestive difficulties, and (possibly) birth defects in their children. Popularly referred to as “Gulf War Syndrome”, the VA is actively investigating it using the preferred term “Chronic Multisymptom Illness”. Unlike with the previous bugbears of veteran’s health, CMI was quickly acknowledged and acted on.
Another issue specific to the Gulf War was a new wrinkle on an older specter. Tank-killing ammunition used by coalition forces included extensive use of Depleted Uranium. Although the radiation effects of DU are minimal, an unknown number of troops ingested trace amounts. These exposures have all the potential to create a toxic effect typical for heavy metals. While the military took steps during the war to reduce exposure, there are still some risks.
By now “Combat Neurosis” was a much better understood threat. Though still subject to a certain degree of stigmatization, the dangers of what was now called “Post-Traumatic Stress Disorder” were actually a part of operational planning. When questioned on why he chose not to storm the beaches of Kuwait, coalition head Gen. Norman Schwarzkopf specifically cited the long term effects of his own experiences in Vietnam.
The 21st Century
The 21st century has been no kinder to soldiers than the last. Though warfare on the scale of the World Wars has not broken out, numerous smaller wars have seen long deployments of American troops across the globe. Since Sept 11th, 2.5 million Americans have become veterans, many of them seeing service in Afghanistan, Iraq, Somalia, the Trans-Sahara, and beyond. America’s dead, including civilians, hovers at around 10,000, with nearly 70,000 injured.
Many of the issues recognized during the wars of the 20th Century continue to be seen in our new veterans. CMI continues to be seen in newer veterans, along with a host of unexplained respiratory illnesses. Even James Hinton is a former army aviation soldier who earned his combat patch in Afghanistan. Since his ETS he has spent his time advising other former soldiers on the transition to civilian life and boring his daughters with stories about army cooking.