The Wounded Generation

Chapter 1.

The Return of the Wounded

During the first two years of the war, close to one million American service members were returned to civilian life, almost half of them with disability discharges. These men and women, who had engaged in campaigns and battles in the Pacific, North African, Mediterranean, and European theaters of war, had suffered physical wounds and illnesses that would not heal. Not yet veterans, but of no further use to the military, they were transported to regional or specialty hospitals or VA facilities for further treatment or sent home to their families.

Among the first to be repatriated were the more than ten thousand marines who on August 7, 1942, had landed on Guadalcanal in the South Pacific to prevent the Japanese who had invaded the British protectorate in May 1942 from establishing a stronghold and cutting off communications and access to Australia, New Zealand, and the South Pacific.

The initial reports were celebratory; the American invasion had been uncontested. And then, on the evening of August 8 through the early hours of August 9, the Japanese navy attacked the ships that had supported the landing, sinking four cruisers and damaging a fifth and two destroyers. With the marines onshore deprived of air and sea support, the Japanese were able to reinforce the island with fresh troops. "All but abandoned by the vessels which brought them there," wrote the future bestselling author William Manchester in his 1980 war memoir, "reduced to eating roots and weeds, kept on the line though stricken by malaria unless their temperature reached 103 degrees, dependent for food and ammo on destroyers and fliers who broke through the enemy blockade, always at great risk, they fought the best soldiers Tokyo could send against them."

The Japanese would be routed, but the cost of victory was steep-not only in the number of Americans and Japanese killed in battle, but in the daily suffering of those who survived the never-stilled, murderous discord of war. "Everyone was firing, every weapon was sounding voice; but this was no orchestration, no terribly beautiful symphony of death, as decadent rear-echelon observers write. Here was cacophony; here was dissonance; here was wildness . . . here was booming, sounding, shrieking, wailing, hissing, crashing, shaking, gibbering noise. Here was hell," Private Robert Leckie, 2nd Battalion, 1st Regiment, 1st Marine Division, recalled of his time on the island. It was impossible to escape the shelling from the sea, the detonating projectiles from the air, the dive-bombers and torpedo bombers and strafing fighters overhead.

The Americans on Guadalcanal and elsewhere in the Pacific fought not only the Japanese but the unfamiliar jungle terrain and climate. "You looked at that island, and it was beautiful," the former marine Theodore "Ted" Cummings recalled in an oral history. "Once we were there, it was the most diseased place on earth, I think. Everything rotted, including your body. . . . And the heat and rain were constant. . . . And everything rotting. Jungle rot was the order of the day. . . . Every scratch was infected."

The marines were attacked by flying and crawling centipedes, spiders, crabs, locusts, scorpions, leeches, and malaria-transmitting mosquitoes. Rare was the man who was not debilitated by malaria, which was regarded as a nuisance, not a cause for recall from the front lines. "The typical Marine on the island ran a fever," wrote William Manchester almost four decades later, "wore stinking dungarees, loathed twilight, and wondered whether the U.S. Navy still existed. He ate moldy rations and quinine. He alternately shivered and seared. If he were bivouacked near [the airfield taken from the Japanese], he spent his mornings filling in craters left by enemy bombers the night before. If he was on his way back to the line, he struggled through shattered, stunted coconut trees, scraggy bushes, and putrescent jungle, clawing up and down slopes ankle-deep in mud, hoping he would catch a few hours of uninterrupted sleep in his foxhole. Usually he was disappointed. Even when there were no Jap bayonet charges, every evening brought fireworks."

Most painful of all for the marines trapped on Guadalcanal was the sense that you were surrounded by an enemy set on killing you and there was little you could do to escape; that in war, as Robert Leckie put it, "men are the most expendable of all. Hunger, the jungle, the Japanese, not one nor all of these could be quite as corrosive as the feeling of expendability." For many, that "feeling" would follow them home and haunt them for the rest of their lives.


Following the initial landing on the island, home front newspapers, newsreels, and radio, advised and briefed by military public relations officers (PROs), reported only good news, ignoring the difficulties the marines encountered. On September 1, 1942, in an editorial titled “How We Licked the Japs,” the Chicago Daily Tribune declared that “the successes achieved by the marines . . . have been magnificent both as an achievement and as a promise for the future.” The newsreels broadcast the same message, amplified by rousing music in the background and illustrated with endless files of marines marching fearlessly toward the enemy. “Once the little men of Nippon were in complete control here,” the voice-of-God narrator reports. “Now they are on the run. Plunging into malaria-infested jungles, the marines steadily, doggedly enlarge their hold on the island.”

Despite the early predictions of victory and abundant stories of dead "Japs" and heroic marines, Guadalcanal was not "liberated" from Japanese control until February 1943, six months after the landing. "The fighting itself," the military historian Gerhard Weinberg would write of Guadalcanal, "would be remembered by the survivors as one long nightmare; it took a full year's rehabilitation before the 1st Marine Division could again be committed to battle."

The army and navy medical corps were totally unprepared for what they discovered at Guadalcanal-and would later encounter in every theater of war. They knew how to treat tropical and parasitic infections, repair fractures and dislocations, amputate limbs, treat burns, and tend to men and women with a variety of diseases. What they had not expected was that one-third or more of the casualties who appeared in their tents and hospitals were suffering from psychiatric disorders. The officers on the front lines had been assured that those under their command, having been approved for service by Selective Service System physicians and psychiatrists, were psychologically stable. Yet here they were, breaking down in large and growing numbers. With manpower in short supply, commanding officers demanded that those diagnosed as neuropsychiatric (NP) be returned to the front lines. The one psychiatrist on the island reluctantly agreed to do so, but predicted that "psychos" returned to duty "would soon break down again."

When they did, they were transferred off the island to an army general hospital in Fiji where they were treated by Dr. Theodore Lidz, the only psychiatrist in residence there. "The sight of them remains unforgettable. They were bedraggled and emaciated youths with frozen expressions on their aged faces and a far-off stare in their eyes. The exhaustion had been relieved but not dissipated by the few days on the hospital ship. The stories they told, perhaps now commonplace by repetition and faded by time, were harrowing beyond all anticipation. Symptomatically the bulk of the patients suffered from anxiety and depression in varying proportions. Anxiety symptoms varied from tension symptoms to recurrent attacks of intense panic; depressive symptoms from preoccupation and hopelessness to complete disregard of the surroundings. Headaches, anorexia, frequency, tremors, insomnia, nightmares, palpitation, were individual symptoms or could all be present in one man. Aside from the few patients who were mutely inert, extreme restlessness prevailed. . . . The only patient who appeared moderately happy was obviously manic."

The volume and intensity of the psychoneurotic cases from Guadalcanal and the other Solomon Islands was more than the general hospitals in Fiji, New Zealand, or Australia could handle. Many were evacuated to the United States. Lieutenant Commander E. Rogers Smith, a navy psychiatrist, examined and treated them at the naval hospital on Mare Island, outside San Francisco. He reported his preliminary findings at the July 1943 meeting of the American Psychiatric Association (APA). "We are not sure whether we are seeing a new disease entity. . . . We do believe, however, that never before in history has such a group of healthy, toughened, well-trained men been subjected to such conditions as the combat troops of the U.S. Marine Corps faced during the days following August 7, 1942. The strain and stress experienced by these men produced a group neurosis that has not been seen before and may never be seen again."

Among those evacuated from Guadalcanal was Private First Class Leon Frank Jenkins. After six weeks on the island, with little to eat except barley and rice, under constant shelling, after killing his first and then several other Japanese in close combat, he found himself in a hospital in New Hebrides, with no memory of what had occurred or why he was there. Only after reading his medical chart-"Diagnosis-Psychoneurosis, War Nervous-Blast injury, Migraine Headaches"-did he conclude that "something must have happened the day the bomb hit close to me." After brief stays in hospitals in Auckland, New Zealand, and Sydney, Australia, Jenkins was transported by hospital ship to San Francisco and discharged with a diagnosis of psychoneurosis. According to his family, he never fully recovered. For the rest of his life he would be plagued by symptoms of post-traumatic stress disorder, which went unrecognized for more than four decades after his return to the United States.

What happened to the troops on Guadalcanal prefigured what was to come. The conditions under which the marines and GIs lived and fought on Guadalcanal and in the Solomon Islands in 1942 and into 1943 were extreme by any measure. And yet the number and proportion who required treatment for psychoneurotic disorders were not dissimilar from those in subsequent campaigns in Africa, Europe, and the Pacific.

On November 8, 1942, three months after the marines first landed on Guadalcanal and ten thousand miles away, sixty-five thousand American and British troops disembarked on the beaches of Algeria and Morocco in North Africa, the first step toward an invasion of the European mainland. Though the climate, terrain, and enemy were different, the results were similar. As at Guadalcanal, "the early and adverse phase of the Tunisia Campaign produced a flood of psychiatric casualties. . . . From 20 to 34 percent of all nonfatal battle casualties were psychiatric."

As Dr. Lidz on Fiji as well as the military psychiatrists in North Africa who treated the psychiatric casualties observed, those who were judged unfit for duty and removed from duty "were not . . . basically unstable." Their inability to continue in combat resulted from a mixture of hopelessness, sleeplessness, hunger, debilitating disease, lack of faith in their leadership, the long days and nights waiting for relief and replacement that never came, and the stench and reality of death.

The army, navy, and VA doctors, who encountered those with symptoms of what would later be diagnosed as post-traumatic stress disorder, were unsure as to how to proceed and whether the men they treated would ever fully recover. "Our ideas are as yet vague," E. Rogers Smith wrote in an article for The American Journal of Psychiatry published in July 1943. Most of the GIs and marines evacuated from Guadalcanal with psychic disorders would, he hoped, "be able to return successfully to civilian life," but he could not "say as yet whether they will be as useful and successful as they were before their combat experience. It is possible that some may be more emotionally unstable, more irritable, more impulsively reactive to sudden stimuli." What that would mean for the veterans and their families, employers, and the society at large was yet to be determined.


By the early spring of 1943, the defeat of the German and Italian armies in North Africa was complete and preparations for the invasion of Sicily and then mainland Italy were under way. Medical departments increased staff, supplies, and facilities to care for the wounded and evacuate those who were no longer fit for service; efforts were made to assure the folks back home that all troops, if wounded or injured, would be well cared for. A May 19, 1943, press release from the Office of War Information (OWI) in Washington declared boldly and unequivocally that “never before in the history of the world has the fighting man had available the medical care and equipment the United States now furnishes its defenders.” To back up its claim, it provided a detailed thirteen-page description of the resources available to treat the wounded in the field, in evacuation hospitals, and, if necessary, at home. Newspapers across the country, large and small, from Salem, Oregon, to Freeport, Illinois, to Manchester, New Hampshire, to The Washington Post dutifully parroted the press release and emphasized its major theme, “the wounded don’t die.”

On June 13, 1943, Waldemar Kaempffert summarized the OWI findings, without referencing his source, in a Sunday New York Times Magazine feature. "Never has there been a military organization quite like this; never have wounded and sick soldiers received such care. . . . Blood enough will be shed and cripples enough will limp to their work in the years to come. But the soldier of today who leaps into action or fires a machine gun in a foxhole has less reason to fear death from wounds or a crippling injury than ever before in history."

Brigadier General Frank Hines, head of the Veterans Administration, acknowledged in an interview with Elizabeth Henney of The Washington Post in February 1944 that more veterans would be returning home with missing arms or legs than in previous wars. This, he added, was good news: The men were still alive. Rapid care, field amputations, drugs to prevent infection, and transfusions unavailable in World War I were saving lives.

The daily press, the magazines, and the newsreels, encouraged by the OWI and the military public relations officers, featured story after story about recovering, smiling amputees and their loved ones. The February 1, 1944, edition of Fox Movietone News included a segment titled "Legless Heroes Get Artificial Limbs" that showed a sailor being fitted for his new leg, then dancing a jig, and sailors with artificial legs playing volleyball, kicking a ball around, and riding bicycles.

To help the amputees adjust to civilian life, the War Department published Helpful Hints to Those Who Have Lost Limbs in March 1944 and followed it with a documentary, Meet McGonegal, about a World War I amputee who used his hooks to shave, tie his shoes, get dressed, feed himself, read the morning newspaper, drive to work, type, make a phone call, and sign his name to a document. The final shot was of McGonegal shooting pool.