Shook over Hell: Post-Traumatic Stress, Vietnam, and the Civil War

Rating:
Summary: Good research
Review: I have been reading more about the Civil War over the past three years, and took a short survey course on the topic which first introduced me to Eric Dean's book Shook Over Hell, a discussion of post traumatic stress disorder during the Civil War. I found it a very interesting topic, particularly the discussion of the experiences of military surgeons and nurses. Having grown up with the TV series Mash, and being myself a nurse, I found the Civil War experiences surprising similar to those of the Mash staff, and even to some extent to my own in ICU (though of course the ICU is a more controlled environment, and I am not subjected to the same exhausting routines).

The character of the volume suggests the published form of a doctoral dissertation, and indeed Dr. Dean had only just received his doctorate in history from Yale when the book was published (1997). The fashion these days is very much toward introducing statistical methods into the social sciences in an effort to give them a "legitimacy" through quantization and to "extract" as much information from the data as possible. This is in an effort to put them on an "equal" footing with the "hard" sciences. Having done a statistical project myself in a social science (industrial relations) and having seen the effects of this fashion on my present profession, the practice of nursing, I usually find myself frankly unimpressed with the results. Fortunately the author limits his statistical manipulations of the data to the final chapters of the book, where he attempts, among other things, to determine whether the victims of post war psychological problems were characteristic of veterans of the war in general. He very honestly points out the caveats of treating the patchy and scant information in this way, and in fact is able to come up with only very little of statistical significance. The demographics of the patient population he investigates is, however, very suggestive, as are some of the diary entries. The latter are indicative of the attitudes of teenage veterans toward war prior to combat and of their reaction to the reality of it on the battle field.

The work seemed a little labored at points by virtue of it's attempt to discuss both the experiences of the Viet Nam veteran and the Civil War veteran with respect to the traumas of their war experiences. To some extent I felt that Dean had some sort of soap box mission in his treatment of the Viet Nam veteran, though I'm not quite sure what it was, since the discussion seemed all over the place at times. To the degree that post traumatic stress was defined by our own times and that the modern veteran and his treatment is a model of that definition, I see the information as pertinent, otherwise it seems intrusive.

As long as the author remained on his topic of Civil War soldiers, the research was very impressive. He must have spent some considerable time delving in libraries and public archives to bring so much personal data together. The men whose lives he describes are solid individuals; though information was obviously limited, it was well and carefully selected and makes their experiences very real for the reader.

I also was a little surprised to find a non-health care person take up a subject that is to some extent a medical problem. His understanding of psychology and it's confusing array of theories and course changes through its history is quite good, but I suspect he is not quite as aware of some of the more recent biochemical theories of human behavior. These theories might far better explain the symptoms of his veterans. To the extent that any theory of human behavior is a social construct, Dr. Dean's veterans-or at least their families-received a surprising degree of support for the time.

An interesting book on the psychological effects of the Civil War on the veteran.

Rating:
Summary: Is Post-Traumatic Stress Disorder new?
Review: The author demonstrates convincingly that not only did the Civil War soldier suffer maladies hauntingly similar to Vietnam vets', but suggests, by extension, that these may be a consequence of war from time immemorial.
Dean, in his careful attempts to define and delineate the problem, notes that the character and dimensions of PTSD are not clear, and that there are powerful interests, with monetary incentives and ideological agendas, to encourage continued attention to, and perhaps promote, the problem. His research is impressive (Dean seems to have read everything ever written on the subject); his writing clear and compelling, and the flaws inconsequential. It might have been instructive to learn whether "McNamara's Hundred Thousand" (a cohort of draftees of low mental ability) are significantly represented in the prevalence of PTSD, and a formal bibliography would be useful, even though extensive source notes are provided. These are quibbles: Dean's work is highly recommended for anyone interested in the effects of war on the individual.

(The "score" rating is an ineradicable feature of the page. This reviewer does not "score" books.)