WEBVTT 00:08.566 --> 00:11.066 [Dramatic music] 00:11.066 --> 00:14.032 [War Department Official Training Film] [Misc. 1197, Army Service Forces] 00:14.033 --> 00:18.533 [Produced by: Army Pictorial Service, Signal Corps] 00:18.533 --> 00:23.233 [Combat Exhaustion] 00:26.000 --> 00:31.200 [Stately music] 00:31.200 --> 00:33.400 [October 20, 1943] 00:33.400 --> 00:37.400 [Early recognition and treatment of neuropsychiatric conditions in the combat zone.] 00:37.400 --> 00:48.033 [Circular letter no. 176 scrolling on screen] 00:48.033 --> 01:07.833 [Music continues] 01:07.833 --> 01:19.966 [Explosions] 01:19.966 --> 01:23.632 [Armillary shell explodes near troops] 01:23.633 --> 01:29.299 [Army combat-zone clearing station] 01:29.300 --> 01:30.633 [Doctor examining injured soldier] 01:30.633 --> 01:31.966 [Doctor:] Lacerated wound. 01:31.966 --> 01:33.099 Give him another shot of morphine 01:33.100 --> 01:34.600 and take him to the surgical tent. 01:34.600 --> 01:35.433 [Combat medic] Yes, sir. 01:35.433 --> 01:37.066 [Doctor:] Put on another dressing. 01:37.066 --> 01:38.166 You'll be all right. 01:38.166 --> 01:40.432 [John Clemens:] Oh my God. 01:40.433 --> 01:42.099 Oh. 01:42.100 --> 01:46.766 [Sobbing] 01:46.766 --> 01:48.232 [Corporal:] They found him in a fox hole like this. 01:48.233 --> 01:49.766 They had to pull him out. 01:49.766 --> 01:52.166 [Medic:] He can't walk, but we can't find a scratch on him. 01:52.166 --> 01:53.566 [Doctor:] Take hold of yourself, soldier. 01:53.566 --> 01:54.632 What's your name? 01:54.633 --> 01:56.833 [Sobbing] 01:56.833 --> 01:58.633 John H. Clemens 01:58.633 --> 01:59.699 [Airplane roar overhead] 01:59.700 --> 02:02.966 [Screams] 02:02.966 --> 02:07.032 [Injured soldier:] Get that guy out of here. He's driving me nuts. 02:07.033 --> 02:08.399 [Doctor:] All right, get him out of here. 02:08.400 --> 02:11.300 [John Clemens:] [Sobbing] 02:11.300 --> 02:14.333 [Doctor:] Shell shock-- evacuate. 02:14.333 --> 02:18.399 [Triage, EMT tag] 02:18.733 --> 02:20.133 [Whimpering] 02:20.133 --> 02:21.166 [Station Hospital sign] 02:21.166 --> 02:23.632 [Music] 02:23.633 --> 02:31.533 [Army ambulance approaches] 02:31.533 --> 02:33.399 [Major:] And now we have this patient here 02:33.400 --> 02:37.466 in our hospital two months after the breakdown occurred. 02:37.466 --> 02:40.699 The variety of neurosis which he exhibits 02:40.700 --> 02:44.366 is not an unusual one on the battlefield. 02:44.366 --> 02:47.666 Many errors have been made in his case. 02:47.666 --> 02:52.766 For one thing, his EMT tag is labeled "shell shock." 02:52.766 --> 02:57.199 The army choice of term is exhaustion. 02:57.200 --> 02:59.466 And this term will be used exclusively 02:59.466 --> 03:03.166 for all forms of neurosis in the echelons forward 03:03.166 --> 03:05.966 of the evacuation hospital. 03:05.966 --> 03:07.999 The reason is obvious. 03:08.000 --> 03:12.633 Soldiers read their tags, and long involved medical terms 03:12.633 --> 03:16.833 serve only to confuse an already disturbed mind. 03:16.833 --> 03:20.466 Now, placing yourself in the situation 03:20.466 --> 03:24.099 of this medical officer at the clearing station, 03:24.100 --> 03:27.733 what would you have done for John Clemens? 03:27.733 --> 03:30.399 [Medical officer 1:] I don't see what else the officer could have done. 03:30.400 --> 03:32.033 There seems no point in keeping a patient 03:32.033 --> 03:33.499 like this on the battlefield. 03:33.500 --> 03:35.300 [Major:] Any other comments? 03:35.300 --> 03:36.266 [Medical officer 2:] Major, we're going to be busy 03:36.266 --> 03:38.632 out there are patients who are really shot up, 03:38.633 --> 03:42.033 and we won't have time to monkey around with guys like that. 03:42.033 --> 03:44.066 [Medical officer 3:] Major, I'm a surgeon. 03:44.066 --> 03:47.499 It looks to me like this is a job for a psychiatrist. 03:47.500 --> 03:50.466 [Medical officer 4:] That soldier must have been a misfit from the start 03:50.466 --> 03:52.299 to break down like that. 03:52.300 --> 03:53.800 [Major:] The medical record shows 03:53.800 --> 03:56.933 that the solider was a healthy, normal individual 03:56.933 --> 03:58.666 before he underwent the experience that 03:58.666 --> 04:01.232 caused his illness. 04:01.233 --> 04:05.733 High school graduate, played an end on the football team, 04:05.733 --> 04:08.433 had a creditable job in a Pittsburgh steel mill 04:08.433 --> 04:11.666 after he left school at the age of 18. 04:11.666 --> 04:14.266 In brief, he displays the picture 04:14.266 --> 04:19.366 of a typical American boy, and now he's sick. 04:19.366 --> 04:21.632 And unless we do something for him, 04:21.633 --> 04:25.899 he may remain sick for an indefinite period of time. 04:25.900 --> 04:30.866 Gentlemen, you are not requested to treat these patients. 04:30.866 --> 04:33.699 You are directed to do so. 04:33.700 --> 04:35.900 May I equate you with a few statistics 04:35.900 --> 04:37.800 from recent campaigns? 04:37.800 --> 04:41.266 The size of the problem will startle you. 04:45.200 --> 04:47.633 These figures from Italy seem to indicate 04:47.633 --> 04:50.799 that 20% of all the nonfatal battle 04:50.800 --> 04:52.600 casualties were not wounded. 04:52.600 --> 04:55.366 They were suffering from neurosis. 04:55.366 --> 05:00.566 In Sicily, the overall figure for the entire campaign 05:00.566 --> 05:05.266 was 14.9%. 05:05.266 --> 05:08.766 When you add up the easy and the hard days of the Tunisian 05:08.766 --> 05:15.332 campaign, you will find that 16% of all the nonfatal casualties 05:15.333 --> 05:18.933 were suffering from neurosis. 05:18.933 --> 05:25.066 In prolonged engagements where the going is really tough, 05:25.066 --> 05:28.966 we find that 30% to 50% of all men 05:28.966 --> 05:32.166 coming under your care in the divisional area 05:32.166 --> 05:36.832 are suffering from combat exhaustion. 05:36.833 --> 05:40.099 Gentlemen, that means that one out of three, 05:40.100 --> 05:43.066 or even one out of two, of all soldiers 05:43.066 --> 05:46.632 coming under medical canvas does not have a drop of blood 05:46.633 --> 05:48.333 on him. 05:48.333 --> 05:55.466 Now, don't get the idea that the American GI is the only soldier 05:55.466 --> 05:58.366 that develops neurosis. 05:58.366 --> 06:01.666 Parallel statistics of the armies of our allies 06:01.666 --> 06:06.699 and enemies show that they are faced with the same problem. 06:06.700 --> 06:09.866 You are members of the medical department, 06:09.866 --> 06:13.799 and to you is entrusted the care all the sick. 06:13.800 --> 06:17.800 There are no specialists on the battlefield. 06:17.800 --> 06:20.733 If you say that you are a surgeon 06:20.733 --> 06:23.833 and can handle only the surgically wounded, 06:23.833 --> 06:26.966 you have failed in your mission. 06:26.966 --> 06:30.532 Out in the mud, you've got to be a medical soldier 06:30.533 --> 06:32.899 and meet all comers. 06:32.900 --> 06:35.533 In the folder issued to you, you will 06:35.533 --> 06:38.433 find a copy of this chart depicting 06:38.433 --> 06:41.333 the various forms of neurosis. 06:41.333 --> 06:46.733 Hysteria, anxiety state, reactive depression, 06:46.733 --> 06:48.766 and the terror state. 06:48.766 --> 06:53.432 This will act as a guide to us as we visit the wards where 06:53.433 --> 06:55.999 we can observe actual cases. 06:56.000 --> 07:00.066 [Chart, Anatomy of Combat Exhaustion] 07:00.066 --> 07:02.666 [Treatment facility] 07:02.666 --> 07:05.866 [Soldier calling men to attention] 07:05.866 --> 07:08.599 [Major:] At ease, men. 07:08.600 --> 07:11.100 Will you hold this, please? 07:12.600 --> 07:13.833 You may be seated. 07:16.366 --> 07:17.332 Good morning, McKennon. 07:17.333 --> 07:19.199 How are you feeling now? 07:19.200 --> 07:21.133 [McKennon:] I don't know, sir. 07:21.133 --> 07:24.533 I'm afraid you'll have to give me up as a bad job. 07:24.533 --> 07:26.099 I'll never get well. 07:26.100 --> 07:29.266 [Major:] Oh, it isn't as bad as all that, is it? 07:29.266 --> 07:33.966 [McKennon:] I can't stop from crying like a damn fool baby. 07:33.966 --> 07:36.032 The blues, I guess. 07:36.033 --> 07:38.933 [Major:] You did pretty well before the war, didn't you? 07:38.933 --> 07:41.266 [McKennon:] I did all right, I suppose. 07:41.266 --> 07:43.899 [Major:] This man has an excellent background. 07:43.900 --> 07:48.766 He averaged $400 a month as an automobile salesman in Chicago. 07:48.766 --> 07:50.866 Why did they send you here, McKennon? 07:50.866 --> 07:55.032 [McKennon:] We got stuck out in Casserian Pass. 07:55.033 --> 07:58.833 They had to send up reinforcements. 07:58.833 --> 08:01.966 The new CO had no use for me. 08:01.966 --> 08:05.099 Thought I was a sad sack. 08:05.100 --> 08:06.300 I don't blame him. 08:06.300 --> 08:08.366 [Major:] Well, you'll feel better in a week or so. 08:08.366 --> 08:10.632 Take my word for it. 08:10.633 --> 08:14.033 McKennon went through most of the North African campaign. 08:14.033 --> 08:17.966 The death of his CO, plus the loss of many of his friends, 08:17.966 --> 08:21.166 plus prolonged physical fatigue have 08:21.166 --> 08:23.266 produced a reactive depression. 08:23.266 --> 08:24.766 [Medical officer 5:] Well, lots of other fellows 08:24.766 --> 08:26.432 have been through the same thing. 08:26.433 --> 08:28.433 Maybe a pick and shovel and a little discipline 08:28.433 --> 08:29.633 would fix him up. 08:29.633 --> 08:32.266 [Medical officer 2:] What does usually happen in these cases, Major? 08:32.266 --> 08:36.666 [Major:] Unless properly treated, suicide may occur. 08:38.800 --> 08:41.166 These gentlemen are medical officers, Sergeant, 08:41.166 --> 08:43.366 and they're interested in your story. 08:43.366 --> 08:45.866 Would you mind telling us what's the matter with you? 08:45.866 --> 08:47.932 [Kosciuszki:] Well, sir, I just can't 08:47.933 --> 08:50.333 seem to get my strength back. 08:50.333 --> 08:52.199 I feel all in. 08:52.200 --> 08:55.566 They get me up for chow, but I can hardly make it to the line. 08:55.566 --> 08:57.266 [Major:] How long has this been going on? 08:57.266 --> 08:58.766 [Kosciuszki:] Well, I noticed it first 08:58.766 --> 09:00.299 on the boat coming to England. 09:00.300 --> 09:02.100 [Lieutenant:] When did you arrive from the States? 09:02.100 --> 09:04.400 [Major:] Oh, I don't think you understand, Lieutenant. 09:04.400 --> 09:07.066 This man has just arrived from Sicily. 09:07.066 --> 09:09.166 Did you see much action, Kosciuszki? 09:09.166 --> 09:11.566 [Kosciuszki:] Well, sir, we took a terrible shellacking 09:11.566 --> 09:13.299 at Randazzo. 09:13.300 --> 09:15.700 I lost a lot of my buddies there. 09:15.700 --> 09:18.300 [Medical officer 6:] Did you stand up pretty well during that campaign? 09:18.300 --> 09:20.300 [Kosciuszki:] Well, sir, except having the jitters 09:20.300 --> 09:22.566 once, I stood up as well as anybody else. 09:22.566 --> 09:25.099 [Medical officer 6:] In what way do you feel your weakness? 09:25.100 --> 09:27.866 [Kosciuszki:] Well, sir, it's all over, mostly in my chest. 09:27.866 --> 09:28.966 Got pains. 09:28.966 --> 09:29.866 I get out of breath. 09:29.866 --> 09:31.366 Maybe I got TB. 09:31.366 --> 09:34.366 [Major:] Oh, I'll bet 100 to 1 against that. 09:34.366 --> 09:38.266 This is also a depression with accent on the physical 09:38.266 --> 09:44.632 rather than the emotional side, as in the first case. 09:44.633 --> 09:46.299 Would you mind showing us your foot? 09:46.300 --> 09:48.366 It's all healed up, isn't it? 09:48.366 --> 09:51.232 [Corporal:] Yes, sir. 09:51.233 --> 09:54.233 They fixed it up in the surgical ward. 09:54.233 --> 09:55.999 [Major:] Tell us how it happened. 09:56.000 --> 09:59.866 [Corporal:] I was cleaning my gun in the bivouac area 09:59.866 --> 10:02.832 and it went off accidentally. 10:02.833 --> 10:05.199 [Major:] That was outside of Troina wasn't it? 10:05.200 --> 10:06.166 [Corporal:] Yes, sir. 10:06.166 --> 10:09.466 [Major:] Didn't you try to save one of your men? 10:09.466 --> 10:11.632 [Corporal:] Oh, that. 10:11.633 --> 10:15.133 That was after we'd landed in Sicily. 10:15.133 --> 10:19.299 Our company had to retreat. 10:19.300 --> 10:23.500 One of our men couldn't keep up with us, and he was wounded. 10:23.500 --> 10:26.600 We lost sight of him. 10:26.600 --> 10:28.866 Another fellow and myself asked the CO 10:28.866 --> 10:32.566 if we couldn't go back and get him. 10:32.566 --> 10:35.299 We got him, all right. 10:35.300 --> 10:38.966 As we started back, a Jerry spotted us 10:38.966 --> 10:41.099 and laid down a barrage of mortar fire 10:41.100 --> 10:44.733 that it was like all hell breaking loose. 10:44.733 --> 10:46.599 We had to leave him behind. 10:46.600 --> 10:49.266 [Major:] What happened to him? 10:49.266 --> 10:51.999 [Corporal:] He died out there. 10:52.000 --> 10:54.100 [Medical officer 7:] How soon after that did you have your accident? 10:54.100 --> 10:56.033 [Corporal:] About a week or so. 10:56.033 --> 10:57.466 [Medical officer 8:] What shape were you in? 10:57.466 --> 10:58.599 [Corporal:] Jittery. 11:01.166 --> 11:03.932 Couldn't sleep much. 11:03.933 --> 11:07.399 Kept thinking about that day. 11:07.400 --> 11:08.700 [Major:] Thank you, Corporal. 11:08.700 --> 11:10.200 [Medical officer 7:] Is that a common occurrence 11:10.200 --> 11:12.233 in depression, Major? 11:12.233 --> 11:14.733 [Major:] In the battle of Bautzen Lutzen, 11:14.733 --> 11:17.666 there were 3,000 cases like that. 11:17.666 --> 11:21.099 The commander asked his chief surgeon to investigate. 11:21.100 --> 11:23.466 He found that they were self-inflicted. 11:23.466 --> 11:26.099 [Lieutenant:] Bautzen Lutzen, That's a German name. 11:26.100 --> 11:27.200 Who was the commander? 11:27.200 --> 11:29.200 [Major:] Napoleon. 11:32.066 --> 11:33.766 At ease, Peters. 11:33.766 --> 11:35.532 You're in the air corps, aren't you? 11:35.533 --> 11:38.333 Would you mind telling us about yourself? 11:38.333 --> 11:38.999 [Peters:] No, sir. 11:39.000 --> 11:40.533 Don't mind a bit. 11:40.533 --> 11:42.199 I just refuse to fly. 11:42.200 --> 11:44.100 [Medical officer 9:] Were you scared? 11:44.100 --> 11:46.400 [Peters:] No, I don't think so, sir. 11:46.400 --> 11:48.433 See, I'm a waist gunner on a bomber. 11:48.433 --> 11:52.166 And bombers cruise just like a football team. 11:52.166 --> 11:54.299 One fellow keeps fumbling the ball all the time, 11:54.300 --> 11:56.533 a lot of good guys are on the losing team. 11:56.533 --> 11:59.366 [Major:] Tell us what happened that you refused to fly. 11:59.366 --> 12:02.499 [Peters:] They briefed us to go to Berlin that morning, 12:02.500 --> 12:05.733 and I was feeling terribly nervous and shaky. 12:05.733 --> 12:08.066 I hadn't slept for about three nights. 12:08.066 --> 12:10.599 And as we were walking over towards the ship, 12:10.600 --> 12:14.600 I felt the butterflies in my stomach worse than ever. 12:14.600 --> 12:16.900 So I just told them it didn't make any difference to me 12:16.900 --> 12:19.066 whether they busted me or not. 12:19.066 --> 12:21.466 A guy in that shape just shouldn't go up. 12:21.466 --> 12:25.266 [Medical officer 9:] Do you always get butterflies when you go up? 12:25.266 --> 12:26.832 [Peters:] No, I think that started when 12:26.833 --> 12:30.099 we were shot up over the drink. 12:30.100 --> 12:33.600 We ditched out there, and the pilot and the rear gunner 12:33.600 --> 12:35.300 were both killed. 12:37.466 --> 12:39.799 Took them about three days before they finally 12:39.800 --> 12:43.433 fished us out, and I don't think I've ever been the same since. 12:43.433 --> 12:47.233 [Major:] How do you feel about going back to flying? 12:47.233 --> 12:50.233 [Peters:] Well, the 8th means a hell of a lot to me. 12:50.233 --> 12:54.266 If my nerves clear up, I'll do everything they want me to. 12:54.266 --> 12:56.732 I think I'm washed out now. 12:56.733 --> 12:58.699 Don't ever let me fly again. 12:58.700 --> 13:01.433 [Major:] Well, let's cross that bridge when we come to it. 13:01.433 --> 13:04.099 Sit down, Peters. 13:04.100 --> 13:08.033 You may call him a goldbrick if you want to, but take 13:08.033 --> 13:09.499 a look at this. 13:09.500 --> 13:14.266 He's had 20 missions and he's been decorated four times. 13:14.266 --> 13:16.599 This is another form of exhaustion 13:16.600 --> 13:20.166 known to the air corps as operational fatigue. 13:22.900 --> 13:25.800 We now come to an extremely common variety 13:25.800 --> 13:27.933 of the anxiety state. 13:27.933 --> 13:29.866 At first glance, this patient might appear 13:29.866 --> 13:31.866 to have Parkinson's disease. 13:31.866 --> 13:34.866 But in reality, he's suffering from exhaustion. 13:34.866 --> 13:38.099 Note the rhythmic tremor of his lips, 13:38.100 --> 13:47.733 or his hands, or his knees, or his feet. 13:47.733 --> 13:50.599 He was pinned down by enemy mortar fire 13:50.600 --> 13:52.566 and cut off in an observation post 13:52.566 --> 13:54.632 for the better part of four days. 13:54.633 --> 13:57.266 [Soldier trembles] 13:57.266 --> 14:01.999 He was flown into us this morning from the combat area. 14:02.000 --> 14:07.200 Speech is difficult, so we won't burden him with questions. 14:07.200 --> 14:09.066 Treatment will begin immediately. 14:09.066 --> 14:10.132 [Nurse:] Yes, sir. 14:15.200 --> 14:17.933 [Major:] Here we have a variety of anxiety and neurosis 14:17.933 --> 14:19.333 with visceral dysfunction. 14:19.333 --> 14:20.666 How is your stomach? 14:20.666 --> 14:22.232 [Patient:] I vomited again, sir. 14:22.233 --> 14:23.966 [Major:] At ease, soldier. 14:23.966 --> 14:25.999 How long has this been going on? 14:26.000 --> 14:29.633 [Patient:] It started when I was in action about six weeks ago. 14:29.633 --> 14:31.299 [Major:] Have you lost any weight? 14:31.300 --> 14:33.866 [Patient:] About 30 pounds, so they tell me. 14:33.866 --> 14:36.232 [Major:] We'll soon make that up for you here. 14:36.233 --> 14:37.899 Any other complaints? 14:37.900 --> 14:41.600 [Patient:] Well, everything seems torn to pieces. 14:41.600 --> 14:43.666 My heart beats awfully fast. 14:43.666 --> 14:47.899 My stomach-- I just can't seem to get over my diarrhea. 14:47.900 --> 14:49.733 [Major:] How do you sleep? 14:49.733 --> 14:52.366 [Patient:] It would be all right if it weren't for those dreams. 14:52.366 --> 14:54.866 [Major:] Do you dream about anything in particular? 14:54.866 --> 14:56.866 [Patient:] Terrible stuff. 14:56.866 --> 15:01.832 A barrage, strafing, being stuck out in a foxhole. 15:01.833 --> 15:03.633 Memories, sort of. 15:03.633 --> 15:05.066 [Major:] Does noise bother you? 15:05.066 --> 15:06.966 [Patient:] I want to jump out of bed every time 15:06.966 --> 15:08.466 a plane goes overhead. 15:08.466 --> 15:11.532 I've been so nervous and jittery, I can't even write. 15:11.533 --> 15:12.499 Lookit here. 15:12.500 --> 15:14.466 [Letters] 15:15.633 --> 15:16.299 [Major:] Mm-hmm. 15:16.300 --> 15:19.400 [Paper crumpled] 15:19.400 --> 15:21.633 Well, don't worry too much, soldier. 15:21.633 --> 15:24.966 You'll be better soon. 15:24.966 --> 15:27.666 And now we come to a case of back pain 15:27.666 --> 15:30.466 with no organic basis. 15:30.466 --> 15:33.032 Just where is the pain? 15:33.033 --> 15:36.133 [Patient 2:] It's right here between my shoulder blades, sir. 15:36.133 --> 15:38.833 [Major:] How long has it been going on? 15:38.833 --> 15:42.466 [Patient 2:] Well, it's been worse through the past couple weeks, 15:42.466 --> 15:45.399 since I strained it lived in a GI camp. 15:45.400 --> 15:49.833 But I've had this trouble ever since I was about 8 years old, 15:49.833 --> 15:52.866 when I fell off a wagon and hurt my back. 15:52.866 --> 15:54.166 My heart is bad. 15:54.166 --> 15:56.666 It gives me a lot of trouble. 15:56.666 --> 15:59.732 And my nerves are bad, too. 15:59.733 --> 16:02.599 [Major:] How do you feel about going back to duty? 16:02.600 --> 16:04.033 [Patient 2:] I don't know, sir. 16:04.033 --> 16:06.899 My back, it doesn't get any better. 16:06.900 --> 16:09.433 And my heart still gives me trouble. 16:09.433 --> 16:12.466 And you can see my nerves are no better. 16:12.466 --> 16:13.799 [Major:] All right, soldier. 16:13.800 --> 16:14.900 That's all. 16:14.900 --> 16:15.966 Thank you. 16:18.600 --> 16:23.666 No organic basis has been found for his complaint. 16:23.666 --> 16:27.999 Gentlemen, this is a type of constitutional inadequacy 16:28.000 --> 16:32.366 in which there is a fixed somatic complaint in addition 16:32.366 --> 16:35.099 to diffuse anxiety symptoms. 16:35.100 --> 16:38.333 He has brought his complaint with him into the Army. 16:38.333 --> 16:41.333 His chances of rehabilitation are slight, 16:41.333 --> 16:44.266 and he should be weeded out as quickly as possible, 16:44.266 --> 16:48.499 because he would be one of the first to break down in combat. 16:48.500 --> 16:50.833 If you will look at your chart, you 16:50.833 --> 16:53.733 will find that we have dealt with the various forms 16:53.733 --> 16:58.299 of reactive depression and the anxiety state. 16:58.300 --> 17:02.700 There are other types of combat exhaustion. 17:02.700 --> 17:06.666 The terror state of panic and stupor 17:06.666 --> 17:09.399 and the hysterical state of amnesia 17:09.400 --> 17:14.266 are seldom met with in hospitals this far from the front. 17:14.266 --> 17:16.466 However, we do have an interesting patient 17:16.466 --> 17:20.732 in the ward who went through an episode of hysterical amnesia 17:20.733 --> 17:25.299 with wandering, or "fugue", as it is called. 17:26.733 --> 17:29.399 Sit down, Kelly. 17:29.400 --> 17:31.400 Would you mind telling these medical officers 17:31.400 --> 17:33.533 something about that lapse of memory you had? 17:33.533 --> 17:35.233 [Kelly:] Oh, you mean the time I went over 17:35.233 --> 17:37.899 the hill down in Africa and didn't know anything about it? 17:37.900 --> 17:38.566 [Major:] Yes. 17:38.566 --> 17:40.132 Weren't you wounded down there? 17:40.133 --> 17:41.733 [Kelly:] Oh, that was long before that, 17:41.733 --> 17:44.733 near Matruh. A Jerry sniper got me in the arm. 17:44.733 --> 17:46.099 [Major:] That's right. 17:46.100 --> 17:47.600 They patched you up in a hospital 17:47.600 --> 17:50.300 and sent you to an outfit near Matruh. 17:50.300 --> 17:51.566 What shape were you in? 17:51.566 --> 17:52.932 Did you feel fit? 17:52.933 --> 17:54.166 [Kelly:] Hell, no. 17:54.166 --> 17:56.399 I was jittery, and couldn't get my strength back. 17:56.400 --> 17:58.400 But the African campaign was over, 17:58.400 --> 18:02.033 so we just hung around doing problem and stuff like that. 18:02.033 --> 18:04.099 [Major:] And now, tell us what happened on that problem 18:04.100 --> 18:07.300 when they were using live ammunition. 18:07.300 --> 18:09.033 [Kelly:] Well, we were out on a problem 18:09.033 --> 18:12.199 and we went to take a hill and shoot 105. 18:12.200 --> 18:13.666 Some of them fell short. 18:13.666 --> 18:15.432 They were busting right over us. 18:15.433 --> 18:17.333 Enough to give anyone the jitters. 18:17.333 --> 18:19.433 Then, one busted right over my head. 18:19.433 --> 18:20.833 I ducked. 18:20.833 --> 18:22.566 Next thing I remember, I found myself 18:22.566 --> 18:25.932 beside a side-street in Algiers, several days later. 18:25.933 --> 18:28.066 I looked at myself, and it looked like I'd 18:28.066 --> 18:30.066 been on a three-week drunk. 18:30.066 --> 18:33.632 I was pretty dirty, so I ducked into a barber shop, 18:33.633 --> 18:35.266 got a shave and a brush-up. 18:35.266 --> 18:36.599 Then I called on the MPs. 18:36.600 --> 18:37.500 [Laughter] 18:37.500 --> 18:39.500 [Major:] And what did the MPs do? 18:39.500 --> 18:41.866 [Kelly:] Well, nobody believed my story, 18:41.866 --> 18:43.299 so they tossed me in the clink. 18:43.300 --> 18:44.566 [Laughter] 18:44.566 --> 18:47.366 While I was there, a medical officer saw how jumpy I was, 18:47.366 --> 18:49.166 so they shipped me here. 18:51.766 --> 18:54.366 [Major:] Although nobody would believe his story, 18:54.366 --> 18:57.166 you may bet on it as a true one, because it 18:57.166 --> 19:00.732 is so typical of what is encountered on the battlefield. 19:00.733 --> 19:02.833 Rather strange, don't you think? 19:02.833 --> 19:05.133 He went through a half a dozen battles 19:05.133 --> 19:08.199 and then broke down on a maneuver. 19:08.200 --> 19:11.133 And now we come to the case that was under discussion 19:11.133 --> 19:12.266 in the classroom-- 19:12.266 --> 19:13.766 John Clemens. 19:13.766 --> 19:14.999 May I have his record? 19:15.000 --> 19:16.233 [Paper rustle] 19:17.500 --> 19:20.433 He represents another of the hysterias-- 19:20.433 --> 19:23.499 the conversion type. 19:23.500 --> 19:26.600 Since no definitive treatment has been given to him, 19:26.600 --> 19:29.700 you will find that his clinical condition has not 19:29.700 --> 19:33.500 changed between the time he left combat and his arrival 19:33.500 --> 19:37.200 here a few days ago. 19:37.200 --> 19:40.800 And now, Clemens, we want to see you walk. 19:40.800 --> 19:41.766 [John Clemens:] Yes, sir. 19:41.766 --> 19:43.766 Only I'll have to have some help, sir. 19:43.766 --> 19:46.932 [Major:] Will you help him, Sergeant? 19:46.933 --> 19:48.799 Now walk down that way. 19:48.800 --> 19:52.600 [Footsteps] 19:52.600 --> 19:54.700 I think you can walk by yourself, Clemens. 19:54.700 --> 19:55.700 Try it. 19:58.000 --> 20:00.566 Go ahead. 20:00.566 --> 20:01.766 That's it. 20:03.733 --> 20:04.799 Now back. 20:08.600 --> 20:09.400 That's it. 20:09.400 --> 20:10.366 Come along. 20:14.766 --> 20:16.732 All right. 20:16.733 --> 20:20.533 Now bend forward as far as you can. 20:20.533 --> 20:22.066 Is that as much as you can bend? 20:22.066 --> 20:23.666 [John Clemens:] Yes, sir. 20:23.666 --> 20:25.199 [Major:] Now bend back. 20:27.433 --> 20:28.999 Is that as far as you can bend? 20:29.000 --> 20:32.066 [John Clemens:] I'm afraid so, sir. 20:32.066 --> 20:33.999 [Major:] Careful diagnostic studies 20:34.000 --> 20:36.400 have been made on this patient. 20:36.400 --> 20:40.400 No orthopedic or neurologic disease is present. 20:40.400 --> 20:43.266 X-rays are negative. 20:43.266 --> 20:48.732 This is a conversion phenomenon known as camptocormia, 20:48.733 --> 20:52.133 which is Greek for bent back. 20:52.133 --> 20:54.099 Will you bring him a chair, Sergeant? 21:02.066 --> 21:04.932 Now, Clemens, will you tell these gentlemen 21:04.933 --> 21:08.699 all you can remember of the way this started? 21:08.700 --> 21:11.766 [John Clemens:] There's not much I can remember, sir. 21:11.766 --> 21:14.232 I was on the side of a mountain lane lair one night 21:14.233 --> 21:16.333 when Jerry opened up with everything he had. 21:16.333 --> 21:19.533 So I dove for the nearest foxhole. 21:19.533 --> 21:21.333 And then I don't know. 21:21.333 --> 21:23.299 It's all hazy. 21:23.300 --> 21:25.600 I was scared. 21:25.600 --> 21:27.766 I'm sorry, sir. 21:27.766 --> 21:31.199 I just can't think of much more. 21:31.200 --> 21:34.000 And suddenly I felt people pulling me out. 21:34.000 --> 21:35.466 I was all twisted up. 21:35.466 --> 21:36.299 [Major:] Oh, yes. 21:36.300 --> 21:39.666 You told us about the medics pulling you out. 21:39.666 --> 21:43.699 And that's all of his story that he remembers. 21:43.700 --> 21:48.833 And now, gentlemen, we come to the subject of treatment. 21:48.833 --> 21:50.566 The other patients you've just seen 21:50.566 --> 21:56.132 will be treated by prolonged deep sleep or narcosis therapy. 21:56.133 --> 22:01.066 But we are going to treat this patient with chemical hypnosis. 22:01.066 --> 22:04.132 This should restore his normal posture. 22:04.133 --> 22:06.099 Chemical hypnosis produces a state 22:06.100 --> 22:09.166 of semi-sleep, or twilight state, 22:09.166 --> 22:12.366 in which suggestibility is increased, 22:12.366 --> 22:15.199 as it is in true hypnotism. 22:15.200 --> 22:20.166 By using this suggestibility and by inducing ab reaction, 22:20.166 --> 22:24.666 a cure of his condition can be brought about. 22:24.666 --> 22:27.032 If you will follow me, the treatment of this patient 22:27.033 --> 22:28.866 will be demonstrated. 22:28.866 --> 22:38.966 [Everyone moves to another room] 22:38.966 --> 22:41.232 Major, will you take over, please? 22:41.233 --> 22:43.366 [Major at clinic:] Yes. 22:43.366 --> 22:44.899 While we are waiting for the patient, 22:44.900 --> 22:48.500 let us review some of the drugs used in narcosis therapy 22:48.500 --> 22:50.800 and chemical hypnosis. 22:50.800 --> 22:54.566 The drugs of choice are the barbiturates. 22:54.566 --> 22:57.866 The most practical one for producing and maintaining 22:57.866 --> 23:02.699 narcosis is this one, sodium amytal. 23:02.700 --> 23:07.866 There is an ample supply of it in your number two chest. 23:07.866 --> 23:13.466 On the average, 9 to 12 grains will produce adequate narcosis 23:13.466 --> 23:17.032 for from seven to eight hours. 23:17.033 --> 23:19.933 When he wakes up, the patient can be fed and taken 23:19.933 --> 23:21.899 to the latrine. 23:21.900 --> 23:24.466 This dose of amytal may then be repeated, 23:24.466 --> 23:28.066 and the narcosis thus continued as long as necessary. 23:28.066 --> 23:31.699 Patients with fully developed varieties of combat exhaustion 23:31.700 --> 23:36.633 will require a minimum of 24 hours of continuous narcosis. 23:36.633 --> 23:41.033 Some will require 48 to 72 hours. 23:41.033 --> 23:44.699 A second barbiturate with an action almost identical 23:44.700 --> 23:49.266 with that of sodium amytal is nembutal. 23:49.266 --> 23:55.432 4 and 1/2, to six grains, every seven or eight hours. 23:55.433 --> 23:57.433 You will note that in combat exhaustion, 23:57.433 --> 24:02.066 massive doses of these drugs are needed in therapy. 24:02.066 --> 24:06.432 A third barbiturate is the familiar drug, phenobarbital. 24:06.433 --> 24:09.399 Tablets are 1/2 grain. 24:09.400 --> 24:14.066 4 and 1/2 grains will usually produce adequate narcosis, 24:14.066 --> 24:18.999 but on occasion, six grains may be necessary. 24:19.000 --> 24:21.233 You can expect sleep for longer periods 24:21.233 --> 24:25.233 than with sodium amytal or nembutal. 24:25.233 --> 24:28.533 Its action may be estimated at 10 to 12 hours, after which you 24:28.533 --> 24:33.166 may proceed as with the first two drugs. 24:33.166 --> 24:37.899 Another drug available to you is sodium bromide. 24:37.900 --> 24:43.066 Its use is suggested only when others cannot be obtained. 24:43.066 --> 24:46.199 Dosage is extremely variable. 24:46.200 --> 24:49.066 Its action is inconstant, and it tends 24:49.066 --> 24:55.199 to pile up in the bloodstream so that toxic states may develop. 24:55.200 --> 24:59.666 In an emergency, inhalation anesthetics, such as ether, 24:59.666 --> 25:02.832 may be used to put a struggling, panicky patient 25:02.833 --> 25:04.399 to sleep quickly. 25:06.733 --> 25:10.033 Drugs may also be used intravenously. 25:10.033 --> 25:14.299 A 10% solution of sodium amytal may be administered 25:14.300 --> 25:16.866 with orthodox technique. 25:16.866 --> 25:21.266 The rate of administration is one cubic centimeter a minute. 25:21.266 --> 25:23.366 The average patient will go to sleep 25:23.366 --> 25:26.899 after the administration of 5 to 8 cc's 25:26.900 --> 25:31.833 and will remain asleep for seven to eight hours. 25:31.833 --> 25:35.766 In our case, however, we will use another intravenous drug, 25:35.766 --> 25:37.432 pentothal. 25:37.433 --> 25:41.499 Lieutenant, will you prepare this? 25:41.500 --> 25:45.600 Pentothal is not a good drug for narcosis therapy. 25:45.600 --> 25:49.166 It will put your patient to sleep quickly and effectively, 25:49.166 --> 25:52.432 but its action is extremely short. 25:52.433 --> 25:55.299 For our purposes, the chief value of pentothal 25:55.300 --> 25:58.166 is in producing chemical hypnosis, 25:58.166 --> 26:02.932 a form of semi-narcosis, or twilight state. 26:02.933 --> 26:06.399 We will use a 2% solution of pentothal. 26:06.400 --> 26:10.100 Pre-medication with atropine has been given. 26:11.300 --> 26:14.866 Our patient is ready now. 26:22.900 --> 26:26.666 Clemens, this medicine will relax your muscles completely 26:26.666 --> 26:30.232 and help your back. 26:33.433 --> 26:37.966 The rate of administration is 2 cc's per minute. 26:37.966 --> 26:41.299 Major, will you keep time, please? 26:41.300 --> 26:42.966 You'll feel the prick of the needle now. 26:45.933 --> 26:46.899 There you are. 26:46.900 --> 26:48.800 [Rubber snaps] 26:52.600 --> 26:54.566 Do you feel any effect? 26:54.566 --> 26:55.666 [John Clemens:] No, sir. 26:55.666 --> 26:58.632 Only my head's swimming a bit. 26:58.633 --> 27:00.366 [Major keeping time:] One minute. 27:03.300 --> 27:05.433 [Major at clinic:] We continue the administration of the rate 27:05.433 --> 27:07.066 of 2 cc's per minute. 27:10.633 --> 27:13.633 How do you feel now, Clemens? 27:13.633 --> 27:17.766 [John Clemens:] Getting kind of drunk, like a keep jag. 27:17.766 --> 27:20.299 [Major at clinic:] Don't you mind. 27:20.300 --> 27:22.900 One of the early effects of pentothal administration 27:22.900 --> 27:24.400 is this feeling of well-being. 27:27.400 --> 27:29.233 [Major keeping time:] Two minutes. 27:33.200 --> 27:37.433 [Major at clinic:] Now say Methodist Episcopal for me, Clemens. 27:37.433 --> 27:40.066 [John Clemens:] Methodist Episo-pal. 27:41.400 --> 27:43.800 [Major at clinic:] You will notice the slurring of speech. 27:43.800 --> 27:46.800 He is beginning to have difficulty with enunciation. 27:46.800 --> 27:48.666 This shows that the drug is having effect. 27:53.100 --> 27:54.733 [Major keeping time:] Three minutes. 27:57.366 --> 28:01.232 [Major at clinic:] We have now injected 6 cc's of the solution. 28:03.800 --> 28:06.200 How are you feeling? 28:06.200 --> 28:08.800 [John Clemens:] I'm beginning to feel awful drunk, sir. 28:08.800 --> 28:10.733 [Major at clinic:] Don't let that bother you. 28:10.733 --> 28:12.933 That just shows it's taking effect, doesn't it? 28:12.933 --> 28:15.199 [John Clemens:] Yes, sirree. 28:15.200 --> 28:17.366 [Major at clinic:] This is great stuff for your back. 28:17.366 --> 28:18.599 It'll help you straighten out. 28:22.200 --> 28:24.666 [Major keeping time:] Four minutes. 28:24.666 --> 28:26.132 [Major at clinic:] We have now almost reached 28:26.133 --> 28:28.366 the level of chemical hypnosis. 28:28.366 --> 28:30.166 [John Clemens:] What the hell does that mean? 28:30.166 --> 28:33.799 [Major at clinic:] That means we're really going to fix you up. 28:33.800 --> 28:36.300 There is a very simple test for the determination 28:36.300 --> 28:39.400 of the optimum level of chemical hypnosis. 28:39.400 --> 28:42.466 We'll have the patient count backwards from 100, 28:42.466 --> 28:44.099 and when he becomes confused, we'll 28:44.100 --> 28:46.933 know he is at the right stage. 28:46.933 --> 28:50.933 And tomorrow, he won't remember having counted at all. 28:50.933 --> 28:54.899 At this level, he will be extremely suggestible. 28:54.900 --> 28:56.633 [Major keeping time:] Five minutes. 28:56.633 --> 28:59.666 [John Clemens:] I'm getting awful sleepy. 28:59.666 --> 29:01.332 I think I'm going to pass out. 29:01.333 --> 29:03.433 [Major at clinic:] Hey, don't you go to sleep on me. 29:03.433 --> 29:05.033 I want you to count backwards. 29:05.033 --> 29:07.366 Count backwards from 100. 29:07.366 --> 29:20.632 [John Clemens:] 100, 99, 98, 87, 86. 29:24.333 --> 29:25.899 [Major at clinic:] Now we can remove the needle. 29:30.733 --> 29:32.333 Let's straighten him out in bed. 29:32.333 --> 29:34.199 Put him on his back. 29:34.200 --> 29:39.066 [John Clemens:] [Shrikes] 29:39.066 --> 29:44.799 [Artillery shells whirring and exploding] 29:44.800 --> 29:47.333 I'm shot-- 29:47.333 --> 29:48.833 Something hit me. 29:50.533 --> 29:52.099 Burning. 29:52.100 --> 29:54.833 [Panting] 29:54.833 --> 29:55.666 [INAUDIBLE] 30:00.033 --> 30:02.033 Damn mortar-- 30:02.033 --> 30:03.999 I've got to get out of here. 30:11.933 --> 30:13.899 I'm bleeding. 30:13.900 --> 30:15.400 I can't move. 30:15.400 --> 30:20.000 [Explosions and aircraft engines] 30:20.000 --> 30:21.500 Who's that running by? 30:24.000 --> 30:25.133 Must reach out to the boys. 30:25.133 --> 30:27.499 They've got to help me out of here. 30:27.500 --> 30:33.366 [Gunfire] 30:33.366 --> 30:34.899 They are retreating. 30:34.900 --> 30:37.433 They're leaving. 30:37.433 --> 30:40.066 Medics always left the guys who die go. 30:40.066 --> 30:42.732 A guy just gets left behind to die. 30:42.733 --> 30:44.466 Why don't they stop and look? 30:44.466 --> 30:47.432 Can't they see somebody's stuck in a fox hole? 30:47.433 --> 30:50.399 Where the hell are those damn medics? 30:50.400 --> 30:52.133 Please, somebody. 30:52.133 --> 31:00.466 [Explosion, machine gun firing] 31:00.466 --> 31:03.832 Got to push myself up. 31:03.833 --> 31:04.733 Save me. 31:04.733 --> 31:06.899 Oh, my back. 31:06.900 --> 31:09.666 [Explosion, machine gun firing] 31:09.666 --> 31:11.099 It's busted. 31:11.100 --> 31:13.466 Oh. 31:13.466 --> 31:15.866 [Crying] 31:15.866 --> 31:17.332 Oh, my back. 31:17.333 --> 31:29.199 [Explosion, machine gun firing] 31:29.200 --> 31:31.100 Burn in hell, Nazis. 31:31.100 --> 31:35.266 Why don't those sons bitches come out and fight like men? 31:35.266 --> 31:37.532 Always retreating to a higher hill. 31:37.533 --> 31:39.533 Always looking down our throats. 31:39.533 --> 31:44.466 [Explosion, machine gun firing] 31:44.466 --> 31:47.166 I can hear their feet sloshing through the mud. 31:47.166 --> 31:48.766 A German. 31:48.766 --> 31:49.699 Oh, no. 31:49.700 --> 31:50.933 I'm sure it's a German. 31:50.933 --> 31:53.099 If I could only turn around and see what he's doing, 31:53.100 --> 31:54.300 I could stick him in the back. 31:54.300 --> 31:55.766 But I can't move. 31:55.766 --> 31:57.032 He's pulling me. 31:57.033 --> 31:57.799 Oh. 31:57.800 --> 31:58.933 Oh, my back. 31:58.933 --> 32:02.966 Let go. Let go. 32:02.966 --> 32:05.166 Let go. You're breaking my back. 32:05.166 --> 32:08.632 [Crying out in pain] 32:08.633 --> 32:09.433 Let go. 32:09.433 --> 32:10.766 You're breaking my back. 32:10.766 --> 32:11.799 [Major at clinic:] Take it easy, soldier. 32:11.800 --> 32:13.466 Take it easy. 32:13.466 --> 32:16.099 Your muscles are relaxed now. 32:16.100 --> 32:18.066 Lie quietly and rest. 32:18.066 --> 32:20.032 Your back is all straight. 32:24.200 --> 32:28.133 This, gentleman, was the phenomenon of ab reaction. 32:28.133 --> 32:30.933 Sometimes it is necessary to coax the patient 32:30.933 --> 32:34.299 to relive the emotional stresses of the events which produced 32:34.300 --> 32:36.966 his hysteria, but it is more common for it 32:36.966 --> 32:40.699 to happen spontaneously, as it did here. 32:40.700 --> 32:42.566 Now he has it off his chest. 32:42.566 --> 32:45.732 And this is the time for suggestive therapy. 32:45.733 --> 32:49.066 Remember that pentothal increases the suggestibility. 32:51.100 --> 32:54.066 Your back is straight and strong. 32:54.066 --> 32:56.566 Your back is fine and straight. 32:56.566 --> 32:57.432 [John Clemens:] Really. 32:57.433 --> 32:58.466 [Major at clinic:] Of course. 32:58.466 --> 33:00.399 Let's sit up. 33:00.400 --> 33:01.533 [John Clemens:] But I can't, sir. 33:01.533 --> 33:03.333 [Major at clinic:] We'll help you. 33:03.333 --> 33:04.833 Of course you can. 33:04.833 --> 33:05.999 There you are. 33:06.000 --> 33:06.933 [John Clemens:] But it hurts. 33:06.933 --> 33:08.266 [Major at clinic:] That's only those muscles you 33:08.266 --> 33:09.932 haven't used for a long time. 33:09.933 --> 33:11.633 Let's bend forward. 33:11.633 --> 33:14.599 Way down. 33:14.600 --> 33:16.866 Now back. 33:16.866 --> 33:18.032 There you are. 33:18.033 --> 33:19.299 [John Clemens:] It is better. 33:19.300 --> 33:19.900 [Major at clinic:] Of course. 33:19.900 --> 33:20.566 Now backward. 33:22.900 --> 33:24.766 Why, you do it as well as any of us. 33:24.766 --> 33:26.866 Wouldn't you like to see how well you can walk? 33:26.866 --> 33:28.332 [John Clemens:] But I'll fall, sir. 33:28.333 --> 33:28.899 [Major at clinic:] Oh, no. 33:28.900 --> 33:29.900 We'll help you. 33:32.266 --> 33:34.032 Your back's all right now. 33:34.033 --> 33:37.499 [A corporal assists Clemens] 33:37.500 --> 33:39.200 Walk by yourself, soldier. 33:39.200 --> 33:46.933 [Clemens walking unassisted] 33:46.933 --> 33:52.499 [Clemens pauses due to dizziness] 33:52.500 --> 33:53.833 [John Clemens:] Where am I? 33:53.833 --> 33:54.899 What's happening? 33:54.900 --> 33:56.533 [Major at clinic:] We straightened your back for you. 33:56.533 --> 33:58.166 See? You're walking straight. 33:58.166 --> 34:00.299 Turn around. 34:00.300 --> 34:02.266 Throw back your shoulders. 34:02.266 --> 34:04.166 Now let's see you walk like a soldier. 34:07.233 --> 34:08.066 Come back. 34:10.666 --> 34:13.366 [John Clemens:] Gee. 34:13.366 --> 34:15.799 [Major at clinic:] Treatment is not complete in this case. 34:15.800 --> 34:18.800 Clemens will now go through a general reconditioning program 34:18.800 --> 34:21.900 which will give him confidence and which will complete what 34:21.900 --> 34:23.633 we started here this morning. 34:23.633 --> 34:24.766 OK. 34:28.533 --> 34:30.833 [Lieutenant:] What kind of treatment will he get, Major? 34:30.833 --> 34:32.866 [Major:] That question can best be answered 34:32.866 --> 34:35.832 by giving you a summary of the operational plan 34:35.833 --> 34:37.366 of this hospital. 34:37.366 --> 34:40.166 It is divided into three sections-- 34:40.166 --> 34:45.232 admission, treatment, and rehabilitation. 34:45.233 --> 34:47.999 Shortly after his arrival, each patient 34:48.000 --> 34:51.233 is given a complete physical examination in order 34:51.233 --> 34:54.033 to ascertain the cause of his illness. 34:54.033 --> 34:58.233 This includes dental survey, and any necessary laboratory 34:58.233 --> 34:58.766 studies. 34:58.766 --> 35:01.599 [Music] 35:01.600 --> 35:04.333 These are followed by intelligence tests 35:04.333 --> 35:06.566 and complete mental examinations. 35:06.566 --> 35:09.199 [Music] 35:09.200 --> 35:12.833 If necessary, specialized psychiatric studies 35:12.833 --> 35:17.699 such as the Rorschach technique or other personality tests 35:17.700 --> 35:20.666 are made. 35:20.666 --> 35:23.799 After careful summary of these findings, 35:23.800 --> 35:26.900 treatment is based upon the physical and psychological 35:26.900 --> 35:32.433 background of the patient and the symptoms he presents. 35:32.433 --> 35:35.999 Narcosis therapy or continuous sleep treatment 35:36.000 --> 35:40.100 have proved of great value in a large series of cases. 35:40.100 --> 35:44.200 Many patients showing marked anxiety, tension, 35:44.200 --> 35:47.566 inability to sleep, chronic fatigue, 35:47.566 --> 35:51.732 or emotional instability respond to this treatment. 35:51.733 --> 35:55.899 By giving them sodium amytal or other barbiturates, 35:55.900 --> 35:59.700 the patients are kept to sleep 18 to 20 hours per day 35:59.700 --> 36:01.733 for several days. 36:04.100 --> 36:07.666 In other wards, narcosis and modified insulin therapies 36:07.666 --> 36:09.232 are combined. 36:09.233 --> 36:13.066 Insulin is given in the morning and narcosis is carried out 36:13.066 --> 36:15.399 in the afternoon and evening. 36:15.400 --> 36:18.933 As Ward Mitchell found in the American Civil War, 36:18.933 --> 36:22.299 soldiers with combat exhaustion almost invariably suffer 36:22.300 --> 36:24.333 great loss of weight. 36:24.333 --> 36:27.533 The insulin treatment consists of the administration 36:27.533 --> 36:31.999 of from 40 to 100 units each morning before breakfast. 36:32.000 --> 36:35.100 With this chemical stimulation of appetite, 36:35.100 --> 36:37.800 the patient eats on an average 12 and 1/2 36:37.800 --> 36:41.966 pounds of food per day, which is more than twice the amount 36:41.966 --> 36:43.666 normally consumed. 36:47.433 --> 36:50.399 By means of this combination of therapies, 36:50.400 --> 36:53.333 symptoms of acute tension are relieved, 36:53.333 --> 36:55.133 and the restoration of weight can 36:55.133 --> 37:00.566 be expected at the rate of 1/2 to 1 pound per day. 37:02.633 --> 37:06.099 Careful attention to diet is an important part 37:06.100 --> 37:08.433 of the therapeutic program. 37:08.433 --> 37:11.866 Balanced meals are planned for high caloric value 37:11.866 --> 37:15.599 and proper vitamin content. 37:15.600 --> 37:19.200 Patients who show marked symptoms of reactive depression 37:19.200 --> 37:22.333 may be given electrical shock treatment in addition 37:22.333 --> 37:25.333 to the combination insulin and narcosis therapy. 37:28.066 --> 37:32.432 As previously demonstrated, narcoanalysis and hypnosis 37:32.433 --> 37:35.533 are used to eliminate amnesiac symptoms. 37:35.533 --> 37:39.733 Suggestion, either direct or in the form of hypnosis, 37:39.733 --> 37:44.499 or narcosuggestion, is employed in conversion hysteria. 37:46.433 --> 37:49.233 During the therapeutic period, patients 37:49.233 --> 37:52.533 go through a program of exercise designed 37:52.533 --> 37:55.899 to maintain physical fitness. 37:55.900 --> 37:58.400 Individual or group reeducation is 37:58.400 --> 38:01.233 undertaken so that patients may understand 38:01.233 --> 38:03.133 the cause of their illness. 38:05.666 --> 38:08.832 After patients have completed their treatment, 38:08.833 --> 38:11.399 they are placed in a training company. 38:11.400 --> 38:13.233 Here, they live in a barracks and are given 38:13.233 --> 38:15.433 a review of military training. 38:15.433 --> 38:30.366 [Marching cadence] 38:30.366 --> 38:39.399 Tent-pitching, short hikes, detail work, 38:39.400 --> 38:43.233 sensible occupational therapy projects 38:43.233 --> 38:46.199 leading to constructive ends and of a type 38:46.200 --> 38:50.366 consistent with the job of a field soldier. 38:50.366 --> 38:54.499 Sports are included for physical hardening, coordination 38:54.500 --> 39:00.233 of muscle, and the fostering of team spirit. 39:00.233 --> 39:04.499 During the training company period, a series of discussions 39:04.500 --> 39:07.133 is undertaken to review for the soldier 39:07.133 --> 39:09.833 the reasons why we fight. 39:09.833 --> 39:13.133 All serve to rehabilitate the soldier, 39:13.133 --> 39:16.133 observe him under military conditions, 39:16.133 --> 39:19.733 prepare him once more for Army life, 39:19.733 --> 39:23.466 and ultimately return him to active duty. 39:23.466 --> 39:24.866 Are there any questions? 39:24.866 --> 39:26.266 [Medical officer 2:] What percentage of cases 39:26.266 --> 39:28.599 are you returning to active duty from this hospital? 39:28.600 --> 39:31.000 [Medical officer 8:] Major, we're all proud of what we've seen. 39:31.000 --> 39:32.300 You've got a swell set up here. 39:32.300 --> 39:33.233 Everything you need. 39:33.233 --> 39:35.166 [Medical officer 5:] Yes, but what about us in the combat 39:35.166 --> 39:38.932 area, with our hands full and not a thing to work with? 39:38.933 --> 39:41.466 [Major:] I was coming to all that, gentlemen. 39:41.466 --> 39:43.699 Early treatment in the combat zone 39:43.700 --> 39:46.200 does not require elaborate facilities 39:46.200 --> 39:49.066 and would eliminate most of our setup here. 39:49.066 --> 39:53.632 We, in the communication zone, despite all the facilities, 39:53.633 --> 39:56.699 can return only a very small percentage of patients 39:56.700 --> 40:01.800 to actual combat duty, whereas you, out in the forward area, 40:01.800 --> 40:07.433 can, by getting at them early, send 70% to 80% back to duty 40:07.433 --> 40:09.533 in the frontline. 40:09.533 --> 40:12.233 You have been shown around this hospital in order 40:12.233 --> 40:14.833 to acquaint you with the principles underlying 40:14.833 --> 40:16.766 the treatment of combat exhaustion. 40:16.766 --> 40:19.999 Treatment in the forward area is based 40:20.000 --> 40:22.533 on identical principles, modified 40:22.533 --> 40:24.233 to meet the tactical demand. 40:24.233 --> 40:26.699 [Army ambulance approaches] 40:26.700 --> 40:29.733 When patients arrive at the clearing station, 40:29.733 --> 40:33.633 it is of primary importance to separate the exhaustion cases 40:33.633 --> 40:35.099 from the physically injured. 40:35.100 --> 40:40.133 [Army ambulance unloaded] 40:40.133 --> 40:41.233 [Soldier:] Let me go. 40:41.233 --> 40:42.233 What are you trying to do to me? 40:42.233 --> 40:43.099 Let me go. 40:43.100 --> 40:44.133 What are you doing to me? 40:44.133 --> 40:44.733 Let me out of here. 40:44.733 --> 40:45.166 Let me go. 40:45.166 --> 40:46.499 They're going to shell this place. 40:46.500 --> 40:47.433 We got to get out of here. 40:47.433 --> 40:48.699 Even the other side said so. 40:48.700 --> 40:50.233 Let go of me. 40:50.233 --> 40:51.233 What are you trying to do to me? 40:51.233 --> 40:51.899 [Medical officer:] Take it easy, soldier. 40:51.900 --> 40:53.533 You're in a protected area. 40:53.533 --> 40:54.533 Where's your MP tag? 40:54.533 --> 40:55.233 [Soldier:] Mortars. 40:55.233 --> 40:56.366 Can't you hear them? 40:56.366 --> 40:57.166 Let me out of here. 40:57.166 --> 40:59.099 They're going to shell this place, I tell you. 40:59.100 --> 41:00.266 You're all crazy. 41:00.266 --> 41:01.966 [Medical officer:] Mark him exhaustion. 41:01.966 --> 41:03.966 Take him to tent five right away. 41:03.966 --> 41:05.499 We'll get the rest of the information 41:05.500 --> 41:06.200 after he's had treatment. 41:06.200 --> 41:08.500 [Interposing voices] 41:08.500 --> 41:09.866 [Rumbling] 41:09.866 --> 41:10.632 [Soldier:] Let me go. 41:10.633 --> 41:12.133 I got to get to a fox hole. 41:12.133 --> 41:12.699 The fox hole. 41:12.700 --> 41:13.600 Let them get it. 41:13.600 --> 41:14.766 Those 88s. 41:14.766 --> 41:15.732 Let me go. 41:15.733 --> 41:16.566 Don't put your hand. 41:16.566 --> 41:17.332 Let me go. 41:17.333 --> 41:20.866 [Interposing voices] 41:20.866 --> 41:22.666 [Medical officer:] Take off his helmet. 41:22.666 --> 41:24.399 [Soldier:] Don't you take my helmet off. 41:24.400 --> 41:25.133 Get off. 41:25.133 --> 41:26.333 I got to get out of here. 41:26.333 --> 41:27.833 You're all crazy. 41:27.833 --> 41:28.933 They're going to shell us. 41:28.933 --> 41:30.633 Even the other doc said so. 41:30.633 --> 41:31.366 Hey, you guys. 41:31.366 --> 41:32.332 Get out of here. 41:32.333 --> 41:33.833 I don't get this place. 41:33.833 --> 41:35.799 They're trying to smother me. 41:35.800 --> 41:36.733 [Medical officer:] That's either-- 41:36.733 --> 41:38.133 you'll be all right. 41:38.133 --> 41:38.666 Take it easy. 41:38.666 --> 41:41.332 You're all right. 41:41.333 --> 41:42.266 Take it easy. 41:42.266 --> 41:44.266 Take it easy. 41:44.266 --> 41:45.566 Take it easy, soldier. 41:45.566 --> 41:46.432 You're in a hospital. 41:46.433 --> 41:47.699 [Soldier:] You're smothering me. 41:47.700 --> 41:48.233 Let me go. 41:48.233 --> 41:48.899 Let me go. 41:48.900 --> 41:50.333 [Medical officer:] You saw the Red Cross outside. 41:50.333 --> 41:52.099 That means you're in a hospital. 41:52.100 --> 41:53.333 [Soldier:] That doesn't say anything. 41:53.333 --> 41:54.566 Let me go. 41:54.566 --> 41:55.666 [Medical officer:] You're in a tent. 41:55.666 --> 41:56.599 Take it easy, soldier. 41:56.600 --> 41:57.566 You're all right. 41:57.566 --> 41:58.799 Just relax. 41:58.800 --> 42:00.066 Take it easy. 42:00.066 --> 42:01.466 That's right. 42:01.466 --> 42:02.366 Take it easy. 42:02.366 --> 42:03.699 You're in a tent. 42:03.700 --> 42:04.933 Nothing will hurt you now. 42:04.933 --> 42:06.033 We'll take care of you. 42:10.100 --> 42:11.200 That'll hold him. 42:11.200 --> 42:12.933 He'll be quiet now. 42:12.933 --> 42:14.366 Better put him in a pack, though, 42:14.366 --> 42:16.566 in case he's excited when he wakes. 42:16.566 --> 42:18.999 Take him and put him in the end space over there. 42:19.000 --> 42:27.566 [Medics move soldier on litter] 42:27.566 --> 42:28.966 [Another soldier enters] 42:28.966 --> 42:31.799 Sit him down on this litter. 42:31.800 --> 42:33.800 Bring him some soup. 42:40.000 --> 42:44.366 Campbell, put 7 and 1/2 grains sodium amytal in a syringe. 42:48.500 --> 42:52.833 [Soldier given soup cup] 42:52.833 --> 42:54.933 [Another soldier enters] 42:54.933 --> 42:56.799 [Footsteps] 42:56.800 --> 42:58.300 Sit on this chest, soldier. 43:00.700 --> 43:02.166 Take off your pack. 43:02.166 --> 43:05.899 [Rustling] 43:05.900 --> 43:08.666 What's your trouble, soldier? 43:08.666 --> 43:10.199 [Soldier:] I'm all tired out. 43:10.200 --> 43:11.166 My head aches. 43:11.166 --> 43:12.699 I ache all over. 43:12.700 --> 43:14.600 [Medical officer:] Are you wounded anywhere? 43:14.600 --> 43:15.433 [Soldier:] No, sir. 43:15.433 --> 43:16.733 That's just it. 43:16.733 --> 43:18.499 I never was a goldbrick. 43:18.500 --> 43:21.000 Now I don't even want to clean out my gun. 43:21.000 --> 43:22.933 Can't understand it. 43:22.933 --> 43:23.899 [Medical officer:] Oh. 43:23.900 --> 43:25.500 You're from that outfit that had hell 43:25.500 --> 43:27.700 shot out of it a while back. 43:27.700 --> 43:29.600 [Soldier:] Yes, sir. 43:29.600 --> 43:31.300 [Medical officer:] That's your trouble. 43:31.300 --> 43:33.133 You're just worn out. 43:33.133 --> 43:35.933 What you need is some rest and some food. 43:35.933 --> 43:38.333 Bring me 12 grains of amytal, Campbell. 43:38.333 --> 43:44.266 [Campbell prepares medication] 43:44.266 --> 43:46.266 [Campbell brings medication and water] 43:47.166 --> 43:48.166 That's right. 43:48.166 --> 43:48.932 Take them all. 43:52.533 --> 43:53.866 That's fine. 43:53.866 --> 43:56.366 You'll feel better now. 43:56.366 --> 43:58.966 Bring him some soup and some blankets. 43:58.966 --> 44:02.232 Pick up your pack, soldier. 44:02.233 --> 44:04.233 Put him in the third space. 44:04.233 --> 44:05.999 Drink that soup, soldier. 44:06.000 --> 44:08.166 Get some sleep and you'll be all right. 44:08.166 --> 44:13.799 [Footsteps] 44:13.800 --> 44:15.833 Now we can take care of you. 44:18.200 --> 44:20.066 Just lie back, soldier. 44:22.633 --> 44:25.433 Roll up his sleeve, Campbell. 44:25.433 --> 44:28.033 Swab off his arm. 44:28.033 --> 44:32.233 What I want you to realize that you're exhausted. 44:32.233 --> 44:34.666 The strain has worn you down. 44:34.666 --> 44:37.366 This strain causes muscle tension. 44:37.366 --> 44:41.799 It's this muscle tension that makes you shake like that. 44:41.800 --> 44:44.000 Don't worry about that. 44:44.000 --> 44:46.433 I'm going to inject some medicine that 44:46.433 --> 44:51.166 will work through your entire body, relax your muscles. 44:51.166 --> 44:55.699 When the muscles are relaxed, the shakes will be gone. 44:55.700 --> 44:57.700 Don't move now. 44:57.700 --> 44:59.200 You'll feel a little stick. 45:01.933 --> 45:04.266 You can breathe easier now. 45:04.266 --> 45:05.766 Take a deep breath. 45:05.766 --> 45:06.832 Try it. 45:06.833 --> 45:08.666 [Breathing] 45:08.666 --> 45:11.066 That's it. 45:11.066 --> 45:12.732 Look at your hand. 45:12.733 --> 45:14.599 It's not shaking anymore. 45:14.600 --> 45:18.533 That's because the muscles are relaxed. 45:18.533 --> 45:20.899 I'll give you the rest of the medicine 45:20.900 --> 45:23.833 and you will go sound asleep. 45:23.833 --> 45:27.599 When you wake, the shakes will be gone. 45:27.600 --> 45:30.300 You will feel well. 45:30.300 --> 45:31.366 You hear me? 45:31.366 --> 45:33.599 The shakes will be gone. 45:33.600 --> 45:35.533 You feel well. 45:35.533 --> 45:37.899 You feel perfectly well. 45:37.900 --> 45:40.200 [Medical officer removing injection needle] 45:43.966 --> 45:44.932 He's asleep now. 45:44.933 --> 45:46.599 You can cover him up. 45:50.033 --> 46:00.599 [Patient Pat appears exhausted] 46:00.600 --> 46:02.100 [Medical officer:] Just a minute, Pat. 46:02.100 --> 46:03.300 How are you feeling? 46:03.300 --> 46:05.500 [Pat:] The pain my chest seems gone, sir. 46:05.500 --> 46:07.500 I feel a little dizzy, though. 46:07.500 --> 46:09.133 [Medical officer:] That pain is gone. 46:09.133 --> 46:12.066 The dizziness will wear off in an hour or two. 46:12.066 --> 46:12.799 How are the shakes? 46:12.800 --> 46:14.266 Let's see your hands. 46:14.266 --> 46:15.466 [Pat hold hands outstretched] 46:16.666 --> 46:17.532 Put on your helmet. 46:17.533 --> 46:18.999 Let's go outside. 46:19.000 --> 46:23.600 [Footsteps] 46:23.600 --> 46:26.900 Now, Pat, I'd like to find something for you 46:26.900 --> 46:28.900 to do until we get transportation 46:28.900 --> 46:30.033 back to your outfit. 46:30.033 --> 46:31.966 [Pat:] OK. I'll do what I can. 46:31.966 --> 46:33.832 [Medical officer:] Good. Come with me. 46:33.833 --> 46:35.633 [Men move to back of a truck] 46:35.633 --> 46:36.899 [Soldiers salute] 46:36.900 --> 46:38.833 Sergeant, when are you pulling out? 46:38.833 --> 46:40.166 [Sergeant:] This afternoon, sir. 46:40.166 --> 46:41.799 [Medical officer:] Need some help with the loading? 46:41.800 --> 46:42.400 [Sergeant:] Yes, sir. 46:42.400 --> 46:44.333 [Medical officer:] Good. Here's your man. 46:44.333 --> 46:45.966 Report back to me when you're finished. 46:45.966 --> 46:47.799 I'll find something else for you to do. 46:47.800 --> 46:48.333 [Pat:] Yes, sir. 46:48.333 --> 46:50.566 [Medical officer:] That will be all. [Soldiers salute] 46:52.133 --> 46:56.233 [Pat helps load truck] 46:56.233 --> 46:57.066 Soldier. 46:57.066 --> 46:58.932 [Mechanic:] Good afternoon, sir. 46:58.933 --> 46:59.899 [Medical officer:] Don't get up. 46:59.900 --> 47:01.033 How are you feeling? 47:01.033 --> 47:02.033 [Mechanic:] Fine, sir. 47:02.033 --> 47:04.033 Haven't had any more trouble with my hand. 47:04.033 --> 47:05.366 It's good as new. 47:05.366 --> 47:08.099 But I keep on wondering why it went bad on me. 47:08.100 --> 47:09.500 I wasn't hurt. 47:09.500 --> 47:13.533 [Medical officer:] Well, here's one way it could have happened. 47:13.533 --> 47:16.666 When the bomb struck, your hand was buried in the dirt. 47:16.666 --> 47:18.199 You couldn't move it. 47:18.200 --> 47:21.133 You made a mistake and thought it was injured. 47:21.133 --> 47:23.499 [Mechanic:] I believe you're right, sir. 47:23.500 --> 47:25.700 That sounds kind of fishy, doesn't it? 47:25.700 --> 47:27.033 [Medical officer:] Not at all. 47:27.033 --> 47:31.199 When you're scared, and we all get scared on the battlefield, 47:31.200 --> 47:33.366 you imagine a lot of things. 47:33.366 --> 47:36.466 Then, too, when your mind is tired, 47:36.466 --> 47:38.499 you're liable to make mistakes. 47:38.500 --> 47:40.133 That's what happened to you. 47:40.133 --> 47:42.566 You had treatment in your hand as well. 47:42.566 --> 47:44.366 You're ready to return to duty now. 47:44.366 --> 47:45.866 [Mechanic:] Sure glad of that, sir. 47:45.866 --> 47:46.699 [Medical officer:] Good. 47:46.700 --> 47:49.000 There's an outfit going up in just a few minutes 47:49.000 --> 47:50.966 near where your old outfit is. 47:50.966 --> 47:51.899 Think you can make it? 47:51.900 --> 47:53.466 [Mechanic:] I'll be with you in a moment, sir. 47:53.466 --> 47:54.799 [Medical officer:] Get your stuff. 47:54.800 --> 47:55.900 [Lieutenant Burke:] So long, Major. 47:55.900 --> 47:57.366 [Medical officer:] Just a second, Lieutenant. 47:57.366 --> 47:58.299 You're going forward. 47:58.300 --> 47:59.666 I've got a passenger for you. 47:59.666 --> 48:00.866 [Lieutenant Burke:] We'll have to hurry. 48:00.866 --> 48:02.532 The old man wants me. 48:02.533 --> 48:04.833 [Medical officer:] Report immediately to the disposition tent. 48:04.833 --> 48:07.033 I'll clear your papers in a few minutes. 48:07.033 --> 48:08.799 [Lieutenant Burke:] After that, report to Sergeant Might. 48:08.800 --> 48:09.466 [Mechanic:] Yes, sir. 48:09.466 --> 48:10.432 [Soldiers salute] 48:11.666 --> 48:13.532 [Lieutenant Burke:] He's an exhaustion case, isn't he? 48:13.533 --> 48:14.333 [Medical officer:] Yes. 48:14.333 --> 48:17.133 That's why I want you to pay special attention to him. 48:17.133 --> 48:19.066 See that he gets an even break. 48:19.066 --> 48:22.666 Too often, line officers confuse cowardice with fear. 48:22.666 --> 48:23.699 [Lieutenant Burke:] That's true. 48:23.700 --> 48:24.866 [Medical officer:] Keep an eye on him. 48:24.866 --> 48:26.899 See that he gets his old assignment 48:26.900 --> 48:29.166 without preferential treatment. 48:29.166 --> 48:30.232 Good luck. 48:30.233 --> 48:31.033 [Lieutenant Burke:] Thanks. 48:31.033 --> 48:31.733 [Soldiers salute] 48:32.933 --> 48:35.899 [Lieutenant Burke enters tent] 48:35.900 --> 48:37.300 [Lieutenant Burke:] Sir, Lieutenant Burke. 48:37.300 --> 48:38.500 [The old man:] All packed, Lieutenant? 48:38.500 --> 48:39.133 [The old man:] Yes, sir. 48:39.133 --> 48:40.866 Ready to leave now. 48:40.866 --> 48:42.066 [The old man:] At ease. 48:42.066 --> 48:45.699 Now, that's an important job out there, especially right now. 48:45.700 --> 48:47.633 I guess you know the tactical situation. 48:47.633 --> 48:48.399 [Lieutenant Burke:] Yes, sir. 48:48.400 --> 48:50.000 I've just been to S3. 48:50.000 --> 48:51.033 [The old man:] Good. 48:51.033 --> 48:53.333 The thing I want to go over with you 48:53.333 --> 48:57.099 is the fact that those troops up there have been driving hard 48:57.100 --> 48:59.433 for a long time now, and they're beginning 48:59.433 --> 49:02.533 to show evidence of combat exhaustion. 49:02.533 --> 49:05.899 I want you to catch them before this develops. 49:05.900 --> 49:09.433 The prodromal stage is the time to treat these men. 49:09.433 --> 49:11.899 Watch for the early signs. 49:11.900 --> 49:15.333 The most prominent of these are poor physical coordination, 49:15.333 --> 49:20.933 slowing of mental processes, excessive reaction to noise, 49:20.933 --> 49:25.466 inability to relax or rest even when there is opportunity, 49:25.466 --> 49:28.699 and outbursts of temper over trivial matters. 49:28.700 --> 49:30.766 [Soldier kicks machine gun] 49:30.766 --> 49:32.399 [Medic:] Hey, what's the trouble, soldier? 49:32.400 --> 49:34.166 [Frustrated soldier:] I'm fed up with the whole damn thing. 49:34.166 --> 49:35.732 [Medic:] Been getting any sleep lately? 49:35.733 --> 49:37.433 [Frustrated soldier:] You can't sleep around here. 49:37.433 --> 49:40.833 [The old man:] You have the facilities of sedation and reassurance. 49:40.833 --> 49:41.666 Use them. 49:41.666 --> 49:43.466 [Medic hands soldiers pills] 49:43.466 --> 49:47.266 See that he gets a wash, a hot meal, 49:47.266 --> 49:49.166 [Music] 49:49.166 --> 49:53.499 a good night's rest. 49:53.500 --> 49:55.833 Such treatment prevents casualties [Explosions] 49:55.833 --> 50:00.599 from combat exhaustion, prevents long evacuation, 50:00.600 --> 50:03.733 and preserves fighting strength. 50:03.733 --> 50:07.166 [Rousing music] 50:07.166 --> 50:08.399 [The End] 50:08.400 --> 50:11.200 [M-1197, 1943] 50:11.866 --> 50:13.432 [Fade to black]