Dr. Richard Clark Sr.

Soldier's Heart, Shell Shock, War Neurosis, Post Traumatic Stress Disorder

May 1944 - South of the Gothic Front, Italy

Dr. Clark sits at his desk. A single incandescent bulb and drab office lamp illuminate little more than the papers before him. It is long after lights out and with blackout rules in effect, he does not want to risk turning on the overhead lights that would make the desk part of this job easier.

All day he has seen patients, hundreds of them, men shipped from the Front in Cassino, men with wounds he’d never seen back in Boston, the wounds of war. Now, long after chow and long after dark he has his reports, requisitions and recommendations for treatment--the paperwork part of his job as a doctor in a war zone.

Outside his office he hears two young men, soldiers, in an animated discussion. One of them is clearly upset, the other encouraging him to knock on the door, to see the doctor, on the edge of giving orders but for some reason unwilling to do so.

“Gentlemen,” the doctor hollers, “Come in here.”

The two enter the office. One is a sergeant. He is the older of the two but likely no older than twenty-two. The other is a private, maybe twenty, with blond hair and handsome but clearly distraught. His eyes are red and teary, his face flush, his shoulders hunched forward. The sergeant pushes the private forward, gently but firmly.

“Sir,” the sergeant says, “I am in the same room as the private and I have been up all night trying to calm him down. I tried making him come down here last night but he wouldn’t do it. Sir, the man needs your help. He just can’t go on this way.” And with that the sergeant removes his hand from the soldier’s back with a reaffirming pat, then turns and leaves, closing the door behind him, leaving no doubt that the soldier is not leaving with him.

Dr. Clark waits a moment as the private looks blankly at a space somewhere between his feet and the doctor’s gaze. The doctor then asks the private to take a seat in the only other chair occupying the small office. The private sits, his eyes still not meeting the doctor’s. For the next hour, the private talks and the doctor listens, speaking only when necessary to keep the conversation moving.

The private tells the doctor that he came overseas a little over a year ago, early in 1943, and joined a division last December in combat headed toward Cassino. At first he had been, as he modestly referred to himself, a superior soldier, always volunteering for the most dangerous missions and patrols, never knowing what it was to be afraid. He had been wounded but the medics treated him so he never left the front. Then, about two months ago, at the Gothic line, his buddy was badly wounded and had to be sent to the rear for recovery. It was then that the private realized he was the only man in his original company who had not been either killed or wounded and sent home.

“Doc,” he says, “my luck’s been damn good, but how long can it last?”

Since that time he’d found himself hitting the mud even when shells were landing in the distance. Other men laughed at him but those men were young and naive. They were the same young recruits that he had been a year ago. They hadn’t seen what he’d seen. Soon he grew to resent the other soldiers as they laughed and questioned his courage. Were these men right? Was he a coward?

Stomach cramps, vomiting and inability to eat followed. Ashamed to talk to anyone, he suffered at the front. His commanding officer eventually sent him to the medics who in turn sent him to an evac hospital where he spent ten days recovering. The doctors at the hospital wanted to keep him for further observation but he insisted on returning to the front with his outfit where he fought for another ten days. Then, while on leave and visiting a small town away from the front, he developed painful cramps, and went immediately to the hospital where he was diagnosed with appendicitis. An emergency appendectomy was performed, but problems persisted. Days later, before being sent back to the front, he went to a local theatre to see a movie. A whistling sound from the speakers sent him to the floor. Later in the chow line a burner made a small explosion and he hit the floor again. Others asked him what the hell the matter was. “It’s just a sudden cramp,” he told them.

“Doc, I’m due to return to the front day after tomorrow and I’m afraid I’ll be no good to the boys there. I could get killed and I could get them killed. I’ve got a baby daughter at home, Doc, born just after I shipped out.”

Dr. Clark listens, hands clasped on his desk. The private pauses, taking his dog tags between his thumbs and index finger, turning them, worrying them between his fingers.

The doctor says nothing.

He waits.

The private’s breathing slows. Outside the office an orderly shuffles by, pushing a cart. They hear the orderly approach and then pass.

“Doc, everyone in my family is part of this war effort. My fathers, my brothers, my wife’s brothers. Doc, my wife and my mom both have victory gardens and both collect cans and save their gasoline rations to help their boys overseas. If you send me home they’ll think I am a coward. If you send me to the front I fear I’ll go crazy and take off and then everyone will call me yellow. Seems the best way out is to die a hero, but Doc, I just don’t know if I can do that.”

There is a long pause. Finally Dr. Clark asks “Private, how long has it been since you slept?”

“Not sure, Doc, maybe two, three days.”

The doctor rises and walks toward the door, indicating to the private to follow him. The doctor finds him one of the few, unoccupied beds in the now hushed hospital. At the doctor’s instructions he removes his jacket, his boots, his pants and shirt, and in his skivvies and undershirt he crawls under the single sheet resting his head on the pillow. The doctor speaks to a nurse who returns with a small metal tray, on it a syringe and a small glass vial. The doctor reads the label on the vial and, satisfied, inserts the needle into the vial to draw a good dose. He finds a vein and injects Pentathol into the private’s arm. In minutes, the private’s breathing is more relaxed, and before long he sleeps comfortably for the first time in days.

In the days that follow, the private remains ordered to bed rest. He is soon reassigned to a non-combat position away from the front. His stomach cramps, vomiting, and inability to eat ease over the next few weeks.

In a moment of relative calm, weeks after their meeting, the doctor types a letter to his wife Kay back in the States. He hasn’t written in ages, but tonight he has a few moments to himself.

From our experience we have pretty well learned that a man who has been through a lot of combat and finally breaks, as [the private] did, will not make a successful combat comeback. If sent back to the line he would almost certainly crack again within a few days and would be of little, in any, value. … In passing, our other job is to assure him that he really is not by any means a yellow belly, that he has nothing to be ashamed of, and that he has done his job well….

Many of the cases we see are sent back primarily through psychiatric channels for disposition. Others filter back as this man’s, masquerading in the guise of organic disease. …

Fortunately many of us [doctors] are too old to have to worry about working out on the front proper, but after our sessions and discussions of this chaos the question is often asked just how long any of us would hold out and last up there with shells flying all hours of the day and night, with no decent rest except found in a mud hole, and now with snow and ice to boot, just to mention a few of the little matters. I fear I shall be in favor of giving the combat veterans any bonuses or anything else they may ask for as long as they live.