Healing the Soldier,Restoring the Nation: Representations of Shell Shock in the USA During and After the First World War

Praising Woodrow Wilson as the facilitator of peace at the Paris Peace Conference in 1919, New York Times journalist Charles Grasty wrote, ‘It was largely his extraordinary capacity as a man of affairs … that enabled him to win in the screaming confusion of shell-shocked and hysterically apprehensive Europe.’ ¹ In Grasty’s formulation, shell shock was a metaphor for the devastation Europeans felt in the aftermath of the First World War. It also served to separate the European experience from that of the United States. Woodrow Wilson was the ‘man of affairs’ who could set a ‘hysterical’ continent aright. The American President symbolized healing and recovery as he confronted wounded Europe.

Many historians have written about how shell shock became a metaphor in Europe for the seemingly incurable wounds (of war) suffered both by populations and nations during and after the First World War. ² This study, drawing upon medical discussions, popular films, works of literature, magazines, and newspapers from 1915–40, traces the cultural representations of shell shock in the USA, where the term took on quite different meanings. Specifically it argues that in stark contrast to Great Britain, scientific and popular representations initially portrayed shell shock as a temporary, curable injury. It analyzes how this understanding framed not only American views of returning veterans but also the strong global position that the United States enjoyed at the end of the war. During the 1920s in the United States, the figure of the uncured shell-shocked veteran took on new meanings, as the wound of shell shock became part of larger debates over the nature of mental illness and the government’s responsibility to care for its veterans. Specifically after the stock market crash of 1929, the term helped to create a new language deployed in connection with global economic hardship and governmental economic assistance.

British physician Charles S. Myers first used the phrase ‘shell shock’ in a 13 February 1915 article in the Lancet to give medical definition to a specific type of war injury that was plaguing the British Expeditionary Forces. Naming the term after what he believed to be the injury’s cause, he explained that the impact of an exploding shell could impair the senses – hearing, sight, smell and taste. ³ By the middle of the war, Myers, along with other physicians, began to recognize that the term was misleading. Many cases occurred among men who had never even been near a shell explosion. ⁴ In fact, doctors found that emotional disturbance alone was enough to cause the symptoms attributed to shell shock and shell shock’s perceived symptoms became so varied they could include nearly any malady other than a physical wound. From paralysis to insomnia, blindness to poor appetite and agitation, shell shock became a blanket diagnosis and explanation for any number of abnormalities. ⁵ By September of 1918, the American Expeditionary Force’s Surgeon General had concluded that shell shock was no longer a useful diagnosis. Ordering American doctors to cease using the term, he explained it had become little more than ‘military slang.’ ⁶

Estimates of officially diagnosed US shell shock cases vary widely from 15,000 to 76,000. ⁷ Differing diagnostic criteria among hospitals, the re-diagnosis of soldiers upon their transfer, and a lack of documentation regarding individuals treated while on the front lines add to the difficulty of estimating how many American troops were diagnosed with shell shock. Whatever the total, it is clear that American numbers pale in comparison to those in Europe. Yet they remain culturally significant. American symbols of shell shock were prevalent, and it is precisely because the American experience provides such a contrast to Europe that it deserves close examination.

The ambiguity regarding the meaning of shell shock extended beyond medical circles to American soldiers on the Western Front and to writers, film producers, and medical professionals on the American home front. The flexibility inherent in the term’s definition allowed it to take on entirely new, and sometimes even contradictory, meanings. In a special edition of the Journal of Contemporary History on shell shock in 2000, Jay Winter asserts that shell shock often took on a ‘quicksilver and shifting character.’ ⁸ It became part of a language that, as Winter describes, reveals ‘the richness of different national traditions and perceptions within the overall cultural history of the Great War.’ ⁹ Analyzing how Americans molded shell shock to fit their cultural environment reveals this richness, opening windows into First World War US military culture, American discussions about war recovery, and symbolism about America’s international position at the end of the war and during the interwar era.

Although the United States did not enter the First World War until 6 April 1917, American newspapers had closely followed the international medical discussions concerning shell shock since its first official use in 1915. By the time the USA entered the war, Americans had already developed their own understanding of this seemingly new consequence of war. Although British discussions often focused on shell shock’s origins and portrayed it as a form of hysteria or malingering, American portrayals tended to validate shell shock as an injury of war. ¹⁰ American psychiatrists, the American Expeditionary Force (AEF), and images in US popular culture represented shell shock within the progressive, scientific language of healing and recovery.

Initially, British physicians like Charles S. Myers influenced American understandings of shell shock as a direct physical injury of war. As early as 25 January 1915, an article in the New York Times explained that the British had discovered how the air pressure that accompanied exploding shells could cause death. An article in 1915 in the Los Angeles Times quoted a British physician who described shell shock as a ‘psychic knockout’ caused by air pressure. The author explained that an explosion could tear blood vessels, creating internal injuries unidentifiable to the naked eye. ¹¹ In these articles shell shock indicated how the soldier’s injury was produced. The ‘shell’s shock’ disabled the soldier. Just as a shell could inflict outer physical wounds, it could also inflict internal ones.

By 1916, reports from prominent American psychiatrists and British soldiers on the front began to alter American media discussions concerning shell shock. Authors suggested that soldiers’ witnessing of the horrors of industrial warfare caused shell shock, a type of psychological trauma. On 2 September 1916 in an article in The Living Age, published in New York City, a British soldier expressed to American readers how the War caused ‘trench nerves’ among his comrades. An American psychiatrist reporting back to the United States from the European front wrote about shell shock within the context of mental trauma. He argued that the war caused emotional strain on both mentally stable and unstable soldiers. ‘This wreckage of men’s souls’ he concluded, ‘seemed to me to mirror more vividly the horror of war.’ ¹² First a term used to explain a physical injury of war, shell shock became an expression for psychological injury. Both versions of the term, however, depicted an injury that resulted directly from exposure to modern industrial warfare and specifically the World War in Europe.

Intense debate regarding the causes of shell shock occurred throughout the war and after. Yet with US entry into the war these two contradictory definitions – one emphasizing the physical and one the mental – converged in conversations among prominent American psychiatrists whom the AEF enlisted to help prevent and treat shell shock among US soldiers. In devising and enacting their approach to shell shock, American psychiatrists and the AEF created a language that legitimized shell shock as an injury of war, bypassing distinctions between physical and mental. Furthermore, they distanced themselves from their British counterparts’ attention to shell shock’s causes by reorienting their focus towards developing new scientific treatments for their soldiers’ recovery.

American psychiatrists boasted that, unlike their European counterparts, they were prepared for shell shock cases. Norman Fenton, an American psychiatrist and assistant in psychiatry to Sidney Schwab, the Medical Director of Base Hospital 117 in France, wrote that the AEF’s method for caring for shell shock cases:

was perhaps the best organized and the most carefully recruited of all those in the armies at war. The last to be organized, the first to be perfected in advance by research and investigation, it proved its value almost at the outset under the battle conditions for which it was prepared. ¹³

American policymakers' preparation set the foundation for an extensive medical treatment program.

Although occasionally discussed, policy makers saw few links between the traumas of the Civil War and the war occurring in Europe. Only a handful of publications existed on Civil War soldiers with mental and nervous injuries. ¹⁴ The official medical and surgical history of the Civil War dedicated merely a few pages to their treatment, and First World War era psychiatrists argued that the number of soldiers in Civil War studies were too small and neuropsychiatry too undeveloped to provide useful guidance for their own work. ¹⁵ Perhaps more importantly, US doctors, like many of their European counterparts, came to believe that shell shock was unlike traumas created by previous wars. Endless shell bombardments, the slaughter of machine guns, and unannounced mine explosions created a stress-intense environment in which the soldier’s bravery and skill no longer ensured his survival. ¹⁶ This injury of modern warfare required modern understanding and treatment separate from the experiences of the past.

Rather than referring to past American experience, US preparation relied heavily on evaluation of soldiers suffering in Europe. Observations began with American psychiatrist Thomas Salmon’s visit to the European Front in early 1917. His assignment was to make recommendations to the US Army that would help prevent shell shock from disabling as many American troops as it had the British. ¹⁷ Following Salmon’s advice, the AEF instituted mental health examinations for recruits. ¹⁸ Additionally, the US Army Surgeon General organized a Neuropsychiatric Division responsible for creating specific treatment facilities for US shell shock cases in Europe. ¹⁹

The AEF’s policies on shell shock reflected the US military’s larger understanding of the injury. Screening suggested that the development of shell shock might be connected to hereditary insanity or mental instability. It implied that the conditions of war merely triggered shell shock in those already predisposed to psychological illness. Yet the decision to create the Neuropsychiatric Division and establish treatment facilities acknowledged that genetics alone could not explain or prevent shell shock. The AEF saw shell shock as a result of a soldier’s exposure to the conditions present in trench warfare, and unlike soldiers with hereditary insanity those with shell shock could be cured.

No medium articulated the notion of shell shock as a legitimate, curable war injury more clearly than the Stars and Stripes, the AEF’s newspaper published in France during 1918 and 1919. The newspaper validated shell shock as an injury of war by distinguishing it from civilian psychological disorders and including it in lists of illnesses and injuries that could wreak havoc on the troops. One article, for example, praised the medical specialists of the AEF and stated they could treat the ‘eyes ears, throat, abdomen, shell shock, or mental derangement.’ ²⁰ Other articles made clear that the specific environment of war produced shell shock. One writer described how a group of children suffered shell shock after being exposed to fighting near their home. Even carrier pigeons could become shell-shocked when they flew through gas and shellfire. ‘They suffer from shell shock, too,’ the Stars and Stripes writer asserted, ‘and from all the other ills that afflict the two-legged creatures who surround them.’ ²¹ Oftentimes soldiers described as having shell shock were those who had fought most valiantly in battle. They even received special praise for continuing to fight despite their condition. ²² In the Stars and Stripes shell shock represented a valid war injury; any person – or animal – could become subject to shell shock upon experiencing the world of modern industrial warfare. The soldier’s willingness to endanger his mind as well as his body added to his heroism. What made the male soldier heroic was his willingness to sacrifice even his mind for the war.

Like American psychiatrists, Stars and Stripes articulated a language of prevention and care. In the newspaper, soldiers found advertisements for earplugs that promised to protect them from injury due to gunfire and shell shock. A satirical comic strip featured a soldier who prevented shell shock by burying his head in the sand like an ostrich. In terms of healing, the newspaper emphasized that the AEF had high rates of recovery. According to one article, 95 per cent of soldiers diagnosed with shell shock improved and were able to return to active duty. ²³ Shell shock was a valid and serious injury but one the AEF could master through prevention and treatment.

Away from France and on the American home front, the AEF’s mental screening of recruits did raise questions about shell shock as a war injury. An article in the New York Times referred to the screening as a ‘test of men’s courage.’ Another stated that shell shock would not affect those soldiers who were ‘physically sound.’ ‘The man who suffers from shell shock,’ the writer contended, ‘is a man who is at the outset imperfectly and nervously adjusted.’ ²⁴ Such discussions questioned the notion of shell shock as a legitimate and curable war injury as articulated by American psychiatrists and the AEF.

Despite the connections some writers made between shell shock and hereditary insanity, most wartime representations in the USA portrayed shell shock as a curable war injury. Writers reaffirmed shell shock’s legitimacy by referring to it as the cause of injury and death in casualty listings. Like the Stars and Stripes, US newspapers explained how the specific environment of the war induced shell shock. Some articles explained how dogs and horses became shell-shocked after their exposure to the battle zones of the Great War. Others reaffirmed commanders’ praise of soldiers who became shell-shocked because of their persistence in standing firm and fighting valiantly against the enemy. ²⁵ As one article in Scribner published in August of 1918 asserted, ‘Modern warfare subjects the soldier to a form of emotional strain previously unknown and these fits of terror occur in men who have shown great bravery.’ ²⁶ Nothing other than warfare itself created shell shock. The soldier who suffered from it was not a coward, but a hero marked by war.

American news portrayed shell shock as curable. Dozens of articles in US newspapers praised the often collaborative efforts of state governments, federal agencies (such as the Federal Board of Vocational Training), the American Red Cross, and private donors who helped to finance and equip state hospitals and private camps aimed at aiding the recovery of returning shell-shocked veterans. Attempting to create peaceful, serene environments, these facilities provided a ‘paradise for the soul-weary men from the front.’ Articles made clear that the aim of such efforts was not to produce permanent housing for the shell-shocked but rather to ensure the veterans’ recuperation. Using the latest scientific treatments including occupational therapy, these facilities promised to ‘remake cripples’ and aid soldiers in re-entering civilian life. They were, as one newspaper headlined, ‘Healing the Hurts of Disabled Men.’ ²⁷

US print sources often described specific techniques that would ensure recovery. An article in the Scientific American Supplement aimed at therapists emphasized the importance of breathing exercises using the diaphragm. ‘In mute cases,’ the author claimed, ‘if we can recover [the diaphragm’s] use all is likely to go well.’ ²⁸ The New York Times asserted that music helped the shell-shocked. At least two articles claimed that a yellow painted room, as opposed to red or blue, promoted healing. Those who were shell-shocked, another writer contended, could find relief through the calm of country life and farming. Taking these successes to a personal level, some authors described individuals who recuperated through various forms of occupational therapy. The soldier, such discussions concluded, would ‘begin to take an interest in things’ again if given the proper treatment. ²⁹

Religious faith also played a role in discussions of prevention and healing. According to New Thought religious leader Horatio Willis Dresser, a man’s own mind had enough power to cure him if he would simply call it into use. ³⁰ Catholic Reverend John S. Zybura suggested that the best cure for shell shock was confession. Using the science of modern psychiatry, Zybura explained the dangers of emotional ‘repression’ for one’s mental health and the ability of confession to serve as a release for secrets that might otherwise crush the soul. ³¹ Protestant publications placed emphasis on the individual’s capacity to overcome shell shock through faith in Christ. Medical missionary Peter Hugh James Lerrigo described how a soldier could ward off evil depressing his soul through faith in the spirit of Christ. ³² Alexander Smellie, a widely read Reverend in the Christian church, discussed how the power of the Spirit could heal abruptly, and ‘startle into fuller life the slumbering faculties of our souls.’ ³³ Buttressing the notion that shell shock could be healed, Quaker Rufus Jones, founder of American Friends Service Committee, argued that such faith healing occurred often among shell-shocked troops. ³⁴

In American discussions the one factor that stood paramount as essential to recovery was the devotion and proper support of the soldier’s family. During the war families were encouraged to send their soldiers letters to help prevent shell shock. Once the soldier returned home after treatment in a state hospital or private camp, the family became responsible for his recovery. ‘In the reconstruction of soldiers suffering from shell shock,’ an article in Touchstone magazine asserted, ‘everything may depend upon the intelligent understanding of his trouble by his family [sic].’ American women played the most central and crucial role. The wife, or mother, or sister had to realize the soldier’s suffering, dedicate herself to his care, and maintain a ‘cheerful expectation’ that he would recover. ³⁵ Recovery necessitated ‘a special gentleness,’ which only women possessed. ³⁶ The New York Times sometimes included engagement stories that described how a nurse’s love for a shell-shocked patient had not only cured him, but also led to a romantic relationship and marriage. ³⁷ Shell shock was merely temporary. With the help of his government, community, and especially the love and dedication of his family, the soldier’s recovery was all but certain.

American works of literature and films likewise depicted shell shock as a short-term wound of courageous soldiers, and women in their role as mothers, wives, and nurses as important facilitators of male healing. Kathleen Wallace’s novel Madam, I’ll Give You provides a representative example of such depictions. The novel follows the romance of a young woman and a shell-shocked veteran. ³⁸ As the story opens, Jenny, the main character, doesn’t recognize the man sitting across from her who was shell-shocked and blinded in the war. Becoming a volunteer at Crossways, a private care home for the ‘physically or mentally shattered,’ Jenny spends every day nursing this man, Michael Kennedy, back to health. As Michael’s shell shock begins to diminish, Jenny discovers he is a world-renowned archaeologist and a perfect lover and friend. Sacrificing her promising career as a dress shop owner and putting aside her love of the city, Jenny chooses to marry Michael and move with him to the countryside. There, the author explains, both Jenny and Michael find happiness.

Characters like Michael, who at first appear physically and mentally unstable and then recover, were prevalent in American stories in the years following the First World War. A poem titled ‘Shell Shock,’ for example, describes an honorable soldier who begins to heal after talking with a psychiatrist. ³⁹ Numerous silent films between 1918 and 1930 also portray the shell-shocked soldier as an honorable, brave man temporarily disabled by war. ⁴⁰ The film Shootin’ for Love (1923) opens with a father who considers his shell-shocked son a coward. As the son begins to heal and regain his senses, the father slowly discovers that his son is a war hero and worthy of respect. In a similar fashion, local townspeople in The Trembling Hour (1919) accuse a shell-shocked veteran of committing a murder. Despite his strange habits, he is eventually cleared of the crime and ultimately regains his fellow citizens’ trust. The shell-shocked character remained merely temporarily injured and nearly always regained his status as a respectable war veteran.

Much like Jenny’s dedication to Michael in Madam I’ll Give You, film representations suggested that restoring the soldier depended on the dedication of a woman. In The Unknown Soldier (1926), a victim of shell shock regains his wellbeing when he is reunited with his young wife. In Three Live Ghosts (1921), one shell-shocked man finally begins to heal when his wife finds him and takes him under her care. Missing (1918) tells a similar story of a young wife whose determination allows her to find her missing husband and restore him to health. In Closed Gates (1927) a nurse’s persistent commitment and love helps a veteran overcome his illness. Films in the United States suggested the necessity of women – and the subordination of their needs and aspirations – to the restoration of American manhood.

The language of recovery accompanying American discussions on shell shock among psychiatrists, the American Expeditionary Forces, and in news and popular culture suggests that American discourse differed sharply from that of Europe and Great Britain specifically. In Great Britain shell shock became a metaphor for the wound of the nation. ⁴¹ As British psychiatrist Grafton Elliot Smith wrote, shell shock had become a ‘public[sic] wound.’ Smith argued that Great Britain continued to treat shell shock with ‘apathy, superstition, helpless ignorance and fear,’ when the real solution to shell shock could only be found in science. ⁴² Just as shell shock had become symbolic of a much larger public wound in Great Britain, scientific treatment and recovery symbolized that wound’s very absence in the United States.

Americans, too, often used the language of shell shock to articulate their feelings of distinction from Europe. Nowhere is this clearer than in descriptions of Woodrow Wilson’s participation in the Paris Peace Conference and his attempt to forge what he had promised would be a lasting peace. According to the New York Times, Wilson went to Europe and found a people ‘emaciated, shell-shocked and feverish.’ One writer called Europe ‘The Shell-Shockt Continent,’ explaining that the war had exhausted Europe’s energies. The treaty, the writer described, was made in a time of ‘world demoralization – “shell shock” – it represents the fears and greeds of the nations.’ Within this framework President Wilson became a heroic savior, taking up the task of rebuilding Europe alone. An altruistic Wilson stood apart from a ‘shell-shocked people trying to reach for everything in sight.’ Wilson, according to the Los Angeles Times, was the ‘sole disinterested moralist’ fighting against Europe’s ‘unreasoning panic.’ ⁴³ Shell shock represented the inability of Europe to recover on its own and the need for Wilson to bring the scientific advancements of the USA that enabled healing to the torn, shell-shocked European continent.

Wilson’s own ‘nervous breakdown’ as reported in the press on 3 October 1919 paralleled the narrative of heroic self-sacrifice and recovery. Wilson, supportive journalists suggested, had sacrificed even his mental health in order to bring peace to Europe and the world. Like the shell-shocked soldier he too would recover. Merely days after his collapse, newspapers began reporting his progress towards healing. ⁴⁴ With his wife by his side, this ‘deliverer’ of ‘wounded hearts’ reluctantly followed doctors’ recommendations to rest and regain his strength. ⁴⁵ This image ultimately proved fleeting. But in this moment, supporters drew on the recuperative rhetoric associated with shell shock to hold out hope that Wilson’s sacrifice and recovered strength would prove enough to ensure American commitment to the League of Nations.

Healing – not the wound – became the dominant frame through which Americans saw themselves at the end of the First World War. Such understanding not only structured how they viewed shell-shocked soldiers and their treatment, but also underscored the role of faith and women in aiding the recovery of veterans. It additionally provided a much larger language with which Americans could articulate their understanding of their global positioning as a nation-state after the First World War. Europe lay spiritually broken, unable to recover. Wilson’s strength, dignity, and reason at the Paris Peace Conference signified a modern, scientific and compassionate nation-state prepared to help Europe with its own healing.

Despite American understandings of shell shock as a curable war injury at the end of the First World War, the optimism that had separated the USA from Europe concerning American capabilities to heal began to fade not long after US soldiers returned home. Wilson’s failure to recover from his own illness and secure congressional support for the League of Nations paralleled the failure of the shell-shocked soldier to recover from war. ⁴⁶ New representations of shell shock emerged in the 1920s and 1930s that questioned the government’s dedication to curing shell shock as well as American abilities to recover from another kind of trauma – economic depression. It also increasingly undermined internationalist visions of America’s role on the world stage.

US federal governmental policy towards shell-shocked soldiers after the War reflected US medical-military understandings of shell shock. First, medical personnel believed shell shock was a short-term injury that needed intensive treatment only in the first few months after diagnosis. American policy makers thus assumed that shell shock would not be a concern after the war because the environment of trench warfare that produced it would no longer exist. These assumptions about shell shock formed the foundation for the management of nearly all psychologically injured soldiers after the war. Upon arrival in the United States soldiers with unseen or psychological wounds were re-evaluated. If determined ‘incurable’ they were sent to St. Elizabeth’s, the Army’s asylum, or other public asylums under federal contract to accept returning soldiers. If deemed ‘curable,’ as most were, they were redistributed to Army hospitals with special neuropsychiatric wards for a maximum of four months of special treatment. ⁴⁷ After four months, the Army ceased efforts to cure the soldier and handed him over to the Bureau of War Risk Insurance (BWRI) to be sent either to a federally operated hospital or public asylum for long-term accommodation. Soldiers who developed the symptoms of shell shock in the years after returning home often did not receive any specialized treatment, but instead were sent directly to state asylums. ⁴⁸

The military ensured most shell-shocked soldiers received specialized care, including occupational therapy, for four months upon arrival in the United States. Yet despite their efforts, many men remained unhealed. Sergeant Norman Fenton, who had worked at Base Hospital 117 for neuropsychiatric injuries during the war, acknowledged this situation when he conducted studies in 1919 and 1924 for the Medical Department of the US Army on the reintegration of shell-shocked soldiers into American life. ⁴⁹ Shell-shocked veterans benefited from the public assistance they received from the government when they returned to the USA. Fenton found ‘a marked tendency for improvement among the men.’ ⁵⁰ Still, Fenton recognized that the most severe cases remained uncured. Those shell-shocked veterans constituted a large percentage of the total population of unhealed veterans. A survey taken in February 1927 revealed that ex-service men with neuropsychiatric disabilities constituted 46.7 per cent of all patients receiving hospital treatment as beneficiaries of the United States Veterans’ Bureau. It is important to note that much of the later care these men received was not in an Army hospital; instead it took place in state facilities where the veteran’s identification as a man with a war-related injury no longer awarded him specialized treatment.

Pension policies complicated matters further. Anticipating that veterans would seek monetary payment for permanent injuries, progressive reformers had restructured US veteran benefits to discourage what they saw as veteran dependence on government handouts. ⁵¹ The War Risk Insurance Act, passed in 1917, was designed after industrial compensation laws and made gaining benefits for permanent wartime injuries difficult. Federal lawmakers and officials defined disability narrowly, and veterans had to prove their injury to federally employed physicians before benefits would be granted. ⁵² Amendments to the War Risk Insurance Act passed in 1921 and 1924 attempted to mitigate veterans’ frustration with the system. The 1921 Amendment, for example, established presumption, which meant that veterans suffering from neuropsychiatric injuries and tuberculosis within two years of the war’s end were presumed to have been healthy upon entry into the military and their injury a result of wartime experience. ⁵³ The World War Veterans Act of 1924 removed examination by a VA physician as a prerequisite for approval of benefits. ⁵⁴ Still, these Amendments came too late for some veterans, and failed to overcome regional, class, and racial biases that remained inherent in the administration of benefits. ⁵⁵

Mainstream media’s attention to the plight of uncured shell-shocked veterans rose in the 1920s as these veterans became increasingly associated with crime, suicide and unpredictable behavior. One shell-shocked veteran frightened Red Cross workers in New York when he impulsively stormed through their building. In the Los Angeles Times neurologist Dr. S.M. Marcus explained one veteran’s tendency to steal as an ‘uncontrollable impulse’ that resulted from his shell shock. Unable to control his impulsive behavior another veteran murdered the owner of a gas station. Unhealed shell shock also served as the explanation for a rise in veteran suicides. According to war-acclaimed psychiatrist Dr. Thomas Salmon, by July 1921 400 mentally unstable ex-soldiers in New York state alone had committed suicide. ⁵⁶ Veteran suicides peaked in the mid 1930s with two veterans committing suicide each day. Some allegedly shell-shocked veterans killed their wives before killing themselves. News reports reiterated that shell-shocked men were not healed. Instead they remained mentally unstable and even dangerous. ⁵⁷

In the US Army Surgeon General’s office, the continuance of shell shock created questions about whether or not shell shock was a war injury that could be cured. The US Army Surgeon General faced a decreasing budget and shortage of personnel throughout the 1920s, and the office’s Annual Reports demonstrate how heightened mental screening became increasingly attractive to policy makers as an alternative to the expensive treatment of neuropsychiatric soldiers and veterans. By 1929 the US Army Surgeon General’s office chose to abandon treatment altogether, reasoning that better screening in the future could negate the problem of shell shock entirely. ⁵⁸ Language added to Army Regulations regarding Recruiting Personnel made recruiting officers financially responsible for the mentally unstable men they allowed to enter the Army. ⁵⁹ Strict guidelines, which emphasized screening, signaled a significant shift in thinking. It suggested that contrary to previous belief, shell shock could not be treated or cured. It was the result of pre-existing mental illness.

Drawing upon the strong wartime discourse of heroic recovery, some veterans organized through the American Legion together with psychiatrist Thomas Salmon, who had been instrumental in forming the AEF’s initial response to shell shock, attempted to reassert the image of the shell-shocked veteran as a war hero and blamed the federal government for not providing the necessary resources to ensure these men’s recovery. In a statement referring to the mentally wounded veterans, the National Commander of the American Legion, F.W. Galbraith, Jr. said, ‘We, who are their comrades, know that [they] are still the nation’s heroes, not merely its charges.’ ⁶⁰ As Caroline Cox argues, ‘The Legion identified [shell-shocked veterans] as men of honor to whom the nation had an equally honorable obligation.’ ⁶¹ Speaking to Congress on 7 January 1921 and writing in the American Legion Weekly, Salmon strongly voiced his opinion that shell shock was a war injury and curable with proper treatment. The condition persisted because of improper placement in insane asylums, which lacked the resources to assist recovery. ⁶²

Salmon was not alone in his belief that the government could do more to help its veterans. Some veterans suicides were attributed to inadequate hospital treatment. An extensive article written by a recovered shell-shocked veteran in Atlantic Monthly similarly described how the government had abandoned veterans like him after the war. The government’s neglect, the man asserted, ‘burns in the minds of thousands of men who at this very moment are living their broken lives in almshouses, jails, insane asylums, and hospitals, or wandering, hopeless, about the streets.’ The veteran’s testimony conveyed his bravery as a wounded survivor of a shell attack in which many of his fellow comrades perished. He recounted his experience of returning to the USA only to be improperly treated and told by three doctors that he ‘would most likely die or become permanently insane.’ Working hard and successfully recovering on his own, he asserted that, ‘[The shell-shocked veteran] will win some day. All he needs is a little help.’ ⁶³ The veteran’s story reinforced the notion of shell shock as an injury of war and discredited notions of shell shock being hereditary or permanent. It was entirely curable; responsibility for treatment rested in the hands of the federal government.

In a similar echo of the wartime recuperative discourse, some stories suggested that shell-shocked veterans remained uncured because their mothers or wives failed to provide the proper support necessary for their healing. An article in Life, for example, described how a shell-shocked automobile thief had been abandoned by three wives and recently experienced the death of a fourth. A shell-shocked veteran whose wife left him after the war robbed a grocery store. One veteran with shell shock reached recovery, but relapsed with the death of his mother. ⁶⁴ Articles that connected family instability to the failed recovery of the veteran were rare. Yet those that were published mirrored the gender expectations for women apparent in portrayals of successful veteran recovery in popular culture. At their heart, these articles raised the question of how the lives of these men might have been different had they benefited from the gentle love and dedicated support of a woman.

The representation of shell-shocked veterans as abandoned by their government took on special significance in American discourse after the stock market crash of 1929, as mainstream writers began to address how veterans, especially those with shell shock, were suffering from neglect. Stories attempted to help victims of amnesia find their families. Others told of how veterans with shell shock had difficulty finding jobs. One, for example, described how a shell-shocked veteran had collapsed due to malnutrition while searching for work. In 1931, a ‘Victim of Shell Shock’ was case number 66 in the New York Times’ annual list of the ‘100 Neediest Families in New York City.’ The article explained that due to his wartime experiences this veteran had relapsed into shell shock and was unable to work because of his ‘nervous and fainting spells.’ With an ailing wife and two children, the veteran was in desperate need of assistance. ⁶⁵

References to shell-shocked veterans played a prominent role in newspapers’ reports of the Bonus March of 1932, when thousands of veterans gathered in Washington, D.C. to press the government to advance them payment on their service bonds, not scheduled for withdrawal until 1945. ⁶⁶ In stories of this event, newspapers again portrayed shell-shocked soldiers as a symbol of the government’s failure to care for its war heroes. In one instance, the New York Times emphasized that a shell-shocked veteran ‘did most of the talking’ at one rallying event for the march. When some of the men forced out of Washington D.C. by federal troops found their way to a camp just outside Charleston, South Carolina, they were welcomed with open arms. Speaking on behalf of the community surrounding the camp, the Mayor of Charleston asserted that ‘These men, anyway the majority of them, are shell-shocked veterans who saw real service …. They are crippled, mentally and physically. What more could we do for them than to build them back to health?’ Calling their rehabilitation a ‘worth-while undertaking,’ the Mayor explained shell shock as a curable war injury, and expressed his belief that caring for the suffering men was a ‘governmental and societal obligation.’ ⁶⁷

Public concern over the government’s failure to care for its shell-shocked was part of a larger discourse that brought attention to the government’s neglect of all its veterans. And public interest in the plight of veterans was at least partly due to the fact that many Americans saw the veterans’ struggle as similar to their own. They believed Hoover could do more to quickly increase government services and lessen the hardships being faced by the American people wounded by the shock of economic collapse. ⁶⁸ Songs such as ‘My Forgotten Man’ in the film Golddiggers (1933) sought to emphasize how the government had sent men to war and then abandoned them – as well as their families – in the midst of economic crisis afterwards. Franklin D. Roosevelt acknowledged these concerns in 1932 when he argued that the USA needed government plans ‘that put their faith once more in the forgotten man at the bottom of the economic pyramid.’ ⁶⁹

The term ‘shell shock’ also became a metaphor for emphasizing American citizens’ own feelings of extreme economic distress. Writers stated that businessmen in the USA experienced ‘economic shell shock.’ Columnist Walter Lippmann explained that people were ‘too frightened, too hysterical and too distracted’ to think reasonably about options to solve the economic crisis. Industry was ‘paralyzed.’ At a Salvation Army fundraising luncheon, Winthrop W. Aldrich, president of the Chase National Bank, declared, ‘no feature of the depression was of greater importance than its psychological effects.’ For many, the ‘shell shock’ of the depression seemed even worse than that of the war. As an article in the Chicago Defender stated, this time it was not just Europe but the world as a whole that was ‘suffering from the effects of shell shock.’ Furthermore, this ‘shell shock’ affected an even higher percentage of the population. As one author described, ‘In depression, wives and children are in the front line trenches as well as the men themselves.’ ⁷⁰

Representations of the soldier with shell shock as well as Americans’ emotional state provided dual metaphors with which individuals described both their feelings of government abandonment and their alarm at the extent of the economic crisis. Shell shock never lost its power to describe feelings of ultimate devastation—for which there should be a cure. Politicians, writers, and filmmakers articulated the Great Depression through the language of a war wound – a wound difficult to see, more difficult to explain, and nearly impossible to cure without governmental assistance.

Shell shock, a term born out of the First World War, took on significance throughout the Western world, but particular meanings emerged within the specific wartime and postwar context of the USA. Shell shock became a language with which Americans articulated first an optimism about US recovery from war and later a desire for governmental assistance in promoting recovery from economic catastrophe.

The optimistic representation of shell shock as a scientifically curable war injury is not wholly unexpected. The small number of actual US shell-shocked veterans compared to their high visibility in Europe certainly aided a positive portrayal in the United States. ⁷¹ Such a notion also complements David Kennedy’s assertion in Over Here that because American soldiers suffered fewer casualties and Americans at home remained spatially and economically distanced from much of the war’s destruction, many Americans could still look back to ‘shimmering wartime memories’ after the First World War. ⁷² These memories stood in stark contrast to Europe where, as many historians have argued, the war became an unforgettable nightmare.

Still, the American experience is worth examining. It calls into question the notion of shell shock as a universally emasculating experience. Shell-shocked veterans’ weak and unstable bodies visibly challenged notions of masculine strength and self-control. Yet American popular discourse demonstrates how this veteran could be symbolically represented as a superior, courageous war hero because of his sacrifice to the nation. The emphasis on women’s responsibility to help restore this mentally shaken body served to strengthen the Victorian ideology of domesticity and women’s submission to their husbands’ greater needs. ⁷³ Such discourse foreshadows US culture of the Second World War era when women were told to become submissive in order to encourage their husbands’ recovery from war. ⁷⁴

Analysis of American representations beyond the timeframe of the war demonstrates how constructions of shell shock remained powerful while continually changing. Soldiers’ inability to recover from war and economic depression challenged men’s identities as courageous war heroes and breadwinners. Recognizing such concern and the way in which it was expressed – through the language of a deep, terrifying war wound only curable with government help – adds important context to governmental programs enacted by Franklin D. Roosevelt. The nation’s ‘shell shock’ required the expansion of the Federal government to aid citizens, and continuing problems with veterans drew awareness to the need for increased governmental assistance after the Second World War. ⁷⁵

Finally, extending analysis of shell shock beyond the nation-state not only magnifies the diversity in representations of shell shock that existed during the First World War, but also reveals how these differing representations played into international political discourse. The development of advanced medical methods, aided by US late entry into the war, ultimately contributed to international representations of American technological and scientific strength – and superiority-over Europe. During the immediate post-First World War era, medical discourse worked to justify US international authority and power. In the same way, US inability to ‘cure’ all cases in the late 1920s and the devastation of world economic depression provided the context for this same medical discourse on shell shock to challenge American exceptionalism.

Studying shell shock uncovers the language that a generation built and utilized as it made sense of a devastating war and shocking economic collapse. It sheds light on the memories that generation referenced in constructing new narratives and actions as they re-entered the world of industrial warfare with the Second World War. The United States was not immune to such discussions, but in fact actively engaged in them. The cultural and political meanings imbedded within the term ‘shell shock’ remained powerful even beyond the nation-states that most directly experienced the immediate, traumatic impact of the First World War.