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In Phil Klay’s acclaimed book Redeployment, the author creates the character Jenks for a chapter entitled “War Stories.” Jenks is a badly wounded Iraq War veteran who is introduced to Sarah, an actress working with a veterans writing project. Sarah wants to hear Jenk’s story. Seemingly to prompt him, she says that IEDs (Improvised Explosive Devices) cause TBI (Traumatic Brain Injury), the signature wounds of the war. “I don’t have a TBI,” Jenks replies. “There’s PTSD, too,” the narrator adds, “if you believe The New York Times.”
The narrator’s qualifying “if” caught my eye. The link between PTSD’s validity and the visibility given it by The Times read as if to say the very existence of PTSD might be more dependent on a news organization than medical science. That was not a new idea to me. In fact, I made the same connection in my 1998 book The Spitting Image. I recalled for readers that in 1972 there had been no psychiatric nomenclature covering war trauma, and clinicians were frustrated by the reluctance of professional organizations to recognize post-war maladies presented by veterans. One of those frustrated psychiatrists was Chaim Shatan who later said the breakthrough to new language came in 1972 when The New York Times ran his op-ed column advocating for attention to the unsettledness of Vietnam veterans as a mental health issue. That decision by the Times, Shatan said years later, began the path leading to the inclusion of PTSD as a diagnostic category in the Diagnostic and Statistical Manuel (DSM III) in 1980.
The New York Times also led the way to new discourse that pathologized veterans’ activism against the war. When members of Vietnam Veterans Against the War (VVAW) rallied to Miami Beach, Florida in 1972 to protest the Republican Party’s renomination of Richard Nixon as its candidate for President, the Times filled its front-page coverage with mental-health terms such as “psychiatric casualty,” “emotional illness,” and “mental breakdown.” Thenceforth, veterans’ protest would be understood as a form of catharsis, a kind of acting-out to relieve the stress of their war trauma. It was a text-book example of “psychologizing the political” or what sociologists Peter Conrad and Joseph Schneider referred to as “medicalizing dissent.”
With the “damaged goods” imagery dominating the representation of war veterans in the news and forms of popular culture like film, it was no surprise that the next generation of veterans, those home from the first Persian Gulf War of 1991, returned with symptoms soon packaged as Gulf War Syndrome. Men complained of mysterious ailments like fluorescent vomit and blistering semen. U.S. ground troops had been involved in virtually no combat in the Gulf, however, making the psychosomatic nature of the “invisible wounds” coming home seem fairly obvious. The Times, nevertheless, reported in December 2012, with no acknowledgement of the numbers’ implausibility, that nearly half of the 700,000 veterans of the Gulf War had filed disability claims with more that 85% of those being granted benefits.
Jenks, Phil Klay’s character, knew that Traumatic Brain Injury (TBI) also has a clichéd-standing in the national home-from-Iraq narrative; he knew that Sarah would assume he suffered from it so he preempted her question and said he didn’t have it. Klay could have added some punch to his narrator’s point by including TBI with PTSD as another category brought to the fore by The New Times for its cultural value. Perhaps Klay did not know that history.
Prior to The New York Times coverage of the so-called Central Park Jogger case in 1989, there were only a few scattered references to traumatic brain injury as a lower-case, incidentally-used phrase in the news media and professional literature; it had never been associated with war veterans and would not be until 2006. Like with PTSD, battlefield events and medical science would be only tangential to the foregrounding of TBI as mental health category: when it came, TBI would be propelled into prominence by a kind of double-helix of news about the news wrapping around a celebrity news-figure with a war injury.
In January 2006 ABC news reporter Bob Woodruff was wounded by an IED in Iraq. The incident got front-page coverage by the Times the next day and several more stories in the following days. None of those stories mentioned TBI. That changed on February 27, 2007 when a press conference promoted an upcoming ABC documentary based on a new book co-authored by Woodruff and his wife Lee. Speaking to the press, Woodruff headlined his struggle to overcome TBI—and with that, the new term was in play.
The month before the press conference The New York Times carried two news stories mentioning TBI, neither about war veterans. But the paper’s report on the news conference about Woodruff’s wounding in Iraq mentioned TBI four times; in the following month, nine Times stories made the TBI-veterans connection. The most important of the nine was retired General Paul D. Eaton’s March 6, 2007 opinion piece that was a virtual sequel to the 1972 op-ed written by psychiatrist Chaim Shatan that led to the acceptance of PTSD. Now, despite there having been virtually nothing beforehand about war-related TBI in the press or medical journals, Eaton, a retired general, declared TBI to be “the signature malady of this [Iraq] war.” Five days later, Times reporters Susan Sontag and Debora Alvarez moved “the signature malady” phrase off the opinion pages and into mainstream news, writing as a matter of that that “TBI has become a signature wound of this war” (italics added).
For the antiwar movement, TBI weighed on the side of its campaign to show the unacceptable costs of the war. Coming at the time it did, however, it also occluded the political viability of Iraq Veterans Against the War, just as Vietnam veterans in the streets as protesters were eventually reimaged through the lens of PTSD.
On January 13, 2008, Sontag and Alvarez set the media and medical worlds abuzz with a 5,600-word front-page Sunday Times story about 121 veterans of the Iraq and Afghanistan wars arrested for homicides after their return home. Many of the murder victims were wives, girlfriends, and children. Accompanied by a montage of individual portraits, the legal cases described had the earmarks of troubled masculinity all over them but the Times reporters weren’t seeing that—for them, the violence perpetrated by the veterans was less important as evidence of their crimes, or arrested adult development, than symptoms of their trauma.
By this time, the country was awash in news reports on veterans home with mental health issues. Riding the wave of interest created by coverage of the Bob Woodruff saga, virtually all major newspapers and television news organizations did their own series and feature stories on the new generation of warriors carrying the “invisible” and “hidden wounds of war,” phrases to be read as code for PTSD and TBI. The Times, having mainstreamed the very trauma discourse it had been instrumental in constructing, extended that imprimatur to its influential Book Review pages where a PTSD-themed book as curious as Jennifer Percy’s Demon Camp about the religious exorcism of veterans’ troubles could be praised.
. . .
A fictional character can have a powerful impact. If Jenk’s snarky sendup of the Times’s zealotry for PTSD had gotten highlighted for us as a reason to read Phil Klay’s Redeployment, it might have been a game-changer. But the Times itself dominates the book world so on March 9, 2014 when its own reviewer, Dexter Filkins, unsurprisingly ignored Jenks words and force-fitted the rest of Klay’s book into the outlines of the established post-Vietnam War story-lines—even with the obligatorily favorable (but inaccurate, in this case) comparison with Tim O’Brien’s The Things They Carried—that chance was lost.
And so, the beat goes on. The Times’s April 13, 2014 Sunday Review section gave front-page billing to columnist Nicholas Kristof’s lamentations for the PTSD/TBI stricken veterans of Iraq and Afghanistan who are under-cared for by the Veterans Administration, prone to suicide, and forgotten by the Americans who sent them off to war.
It’s a sad and shameful call-to-care that we need to hear, but a call that would be all the more compelling were it not for Jenks’s “if” hanging on the bugle.
Jerry Lembcke is Associate Professor Emeritus of Sociology at College of the Holy Cross in Worcester, Mass. He is the author of The Spitting Image: Myth, Memory and the Legacy of Vietnam and Hanoi Jane: War, Sex, and Fantasies of Betrayal. His newest book is PTSD: Diagnosis or Identity in Post-empire America? He can be reached at firstname.lastname@example.org.