Casualties: On the Western Front

Abstract

The front line relationship between war-traumatized soldier and medical officer vexed both parties throughout the war. Many soldiers avoided their medical officer because they knew they would be judged by the requirements of discipline and fighting fitness more than their personal welfare; some found that social background and rank meant their sickness claims were taken more seriously. Many doctors were practically-oriented and empirically-minded, favouring organic, not psychological explanations and treatments for mental disorders; they took less notice of changing medical opinion and research than the strategic requirements of the Army. When patient and doctor met, the medical gaze could soften or harden. These gradations of judgement decisively influenced how the casualty was diagnosed, how quickly his sickness claim was given official validation by the Army bureaucracy, as well as how and where he was treated. So while it is necessary to refer to the Army’s changing administrative policy and its administrative reorganization of treatment to explain how shell shock came into being, it is in the confrontation between soldier and doctor serving on the Western Front, and in the relationship of medical officer to commanding officer, soldier to soldier, and soldier to friend and family, that the medical and social discovery of shell shock took place.