The Evil Hours (16 page)

Rivers was fifty-one and serving as an army physician at Craiglockhart Hospital in Scotland when he treated his most famous patient.
In July 1917, a few weeks before arriving at Craiglockhart, Siegfried Sassoon, a decorated infantry officer and celebrated poet, had published a statement in a newspaper denouncing the war, and it had been read aloud in the House of Commons. The declaration ended by saying that “on behalf of those who are suffering now I make this protest against the deception which is being practised on them; also I believe that I may help to destroy the callous complacence with which the majority of those at home regard the continuance of agonies which they do not share, and which they have not sufficient imagination to realize.” That Sassoon was speaking (and continued to speak) for many soldiers went without saying; from the point of view of the army, he was dangerous, and after some deliberation, they declared him shell shocked and had him sent to Craiglockhart, where he was soon under Rivers's care.

It was a meeting of the minds that became the stuff of legend: two noted intellects clashing over
the
question of their time. Whether or not Sassoon was technically suffering from shell shock is open to doubt (he suffered from nightmares, and at one point left the front claiming to suffer from “trench fever”), but in the long run such a technical question is almost irrelevant.
What the Sassoon–Rivers dyad came to address was nothing less than the central questions of trauma, questions that continue to echo today: How does one reconcile the self with the often inhumane demands of society? How does one communicate to society the conditions that constitute the underworld of trauma? How does one face death with dignity and authenticity?

At first, it seemed far from an ideal match. Sassoon, aware of how the army was attempting to marginalize him with the shell-shock label, was indignant, even truculent, toward Rivers. Sassoon had a tendency toward snobbishness, and he scorned the other patients at Craiglockhart, referring to the place in his letters to friends as “Dottyville.” Rivers met Sassoon's rebellion with an avuncular tone that he had probably perfected in dealing with Cambridge undergraduates. Rivers's method, such as it was, seemed to be a sort of medically guided social conversation. They spoke as peers. As Sassoon would later write in his heavily autobiographical novel,
Sherston's Progress:

 

One evening I asked whether he thought I was suffering from shell shock.

“Certainly not,” he replied.

“What
have
I got, then?”

“Well, you appear to be suffering from an anti-war complex.” We both of us laughed at that. Rivers never seemed elderly; though there were more than twenty years between us, he talked as if I were his mental equal, which was very far from being the case.

 

Rivers had been influenced by Freud, but he was no Freudian.
He saw little use for Freud's theories on infantile sexuality in treating war neuroses. Nevertheless, he looked at dream analysis as an important part of understanding the workings of the mind. Whatever his theoretical leanings, he took an individualized approach with Sassoon. They saw each other every day at first, and then Rivers cut it down to three times a week. It wasn't long before Rivers was trying to convince his patient to return to the front as a means of strengthening his argument about the war's injustice.

The director of Craiglockhart believed in the therapeutic value of sport, and daytime saw the officer-patients playing tennis, croquet, and cricket, a curriculum that lent the place a buoyant atmosphere. The ever-aloof Sassoon took to the links, brooding his way over the Scottish countryside. The nights were a different story. As Sassoon saw it, the place was divided into two spheres, the enforced bonhomie of the day followed by the dismal night, a division no doubt familiar to many veterans today. “By day the doctors dealt successfully with these disadvantages and [Craiglockhart] so to speak, ‘made cheerful conversation.' But by night they lost control and the hospital became sepulchral and oppressive with saturations of war experience. One lay awake and listened to feet padding along passages which smelt of stale cigarette smoke . . . One became conscious that the place was full of men whose slumbers were morbid and terrifying—men muttering uneasily or suddenly crying out in their sleep. Around me was that underworld of dreams haunted by submerged memories of warfare and its intolerable shocks and self-lacerating failures to achieve the impossible.”
In time, Rivers began to win Sassoon over.

Also at Craiglockhart was another troubled infantry officer and poet, Wilfred Owen.
He had fought with the Manchester regiment and been blown up by an artillery shell near Fayet. Dazed and unresponsive, he was eventually sent back to England. Seven years younger, Owen was as yet unpublished, and after hearing that Sassoon was at Craiglockhart, he went to his room and sought his writing advice. Stammering out his admiration for the older officer, Owen asked him to autograph a book of his poetry. Over the course of their residence at Craiglockhart, Sassoon mentored Owen, helping to polish the work that would become the defining poetry of the war. Many of Owen's greatest poems were written during this period, including “Anthem for Doomed Youth” and “Dulce et Decorum Est.” The two agreed about a number of things, including the “apparent indifference of the public and press” toward the war.

If Sassoon was expecting a kind of martyrdom at Craiglockhart, he was to be disappointed. Over the course of their time together, Sassoon went from sparring ineffectively against Rivers to seeing him as a kindred spirit, despite Rivers's lack of combat exposure. Years later, he would describe him as a “dream friend.” Ashamed by the comforts of the hospital, by the end of the summer Sassoon seemed to accept his fate, saying, “Reality is on the other side of the Channel, surely.” In an extraordinary act of sublimation, Sassoon came to believe that offering up his life to the pacifist cause in the trenches was the proper course. In November, Sassoon appeared before an army medical board and was declared fit for general service.

It was never entirely clear how Rivers was able to alter the trajectory of Sassoon's life, apart from simply talking thoughtfully with him about his predicament. On a certain level, there seemed to be something curative about the respect Rivers accorded him, an act of creative compassion that seems almost magical, considering the pressure both men were under. Sassoon later wrote, “Shutting the door of his room for the last time, I left behind me someone who had helped and understood me more than anyone I had ever known. Much as he disliked speeding me back to the trenches, he realized that it was my only way out. And the longer I live the more right I know him to have been.”

By May, Sassoon was back in France.
Returning to friendly lines after an incredibly risky two-man reconnaissance of a machinegun position, he was shot in the head by a British soldier who mistook him for a German. Despite his protests, he was evacuated back to England. After the war, he lived as a lettered country gentleman and continued to write poetry, though his style was much changed. The war was never far from his mind, and decades later he would continue to dream of returning to the front, echoing the experience of other veterans, such as Ivor Gurney, a Great War poet and composer who died in a mental hospital in 1937 convinced that the war was still going on.

Owen's luck was of a different sort. He was killed in action a week before peace was declared. Word of his death reached his parents as church bells announced the Armistice on November 11, 1918.

For all its pathos and drama, World War I represents something of a lost opportunity for the cause of trauma. The war took an unspeakable toll on soldiers' minds, and for a time, the world sat up and noticed. In Britain alone, there were twenty shell-shock hospitals and numerous “Homes for Recovery” by the end of the war.
Shell shock was the first instance of a trauma-caused mental disorder being acknowledged, and while the term itself became confusing, it offered a chance of recognition, of adding to the store of knowledge about post-traumatic stress.

Oddly, no veterans movement ever coalesced in Great Britain.
Prominent veterans of the war, such as Harold Macmillan and Clement Attlee, were known to reminisce about the war “at the drop of a hat,” but they did so as individuals, never as members of any kind of movement. Some have argued that the issue broke down as a matter of class. The most high-profile sufferers of shell shock were anything but inclined to make a political cause out of it. Sassoon is again useful as an exemplar: always somewhat aloof, he wrote extensively about the war, but the idea of agitating for what amounted to a psychiatric issue was simply not in the cards. After the war, Rivers returned to his academic work at Cambridge; his research on physical immobility and trauma was scarcely read.

 

Across the Atlantic, the American Legion, established in 1919 by veterans who had fought in France, became a powerful voice for the treatment of returned soldiers, though like the Grand Army of the Republic, the dominant post–Civil War veterans organization, the Legion focused on pensions and the funding of local veterans hospitals rather than on a mental health agenda. The political meaning of the veteran experience was a dominant motif in the interwar politics of Germany, France, and Italy (Mussolini used veteran support when he took power in 1922), but the trauma narrative itself was politicized in a way that rarely served the psychological needs of the individual veteran.

The one exception to this vast amnesia was an American who never saw the war firsthand, Abraham Kardiner.
A sometimes obsessive man, Kardiner's long medical education culminated with a personal analysis by Freud himself in Vienna. In 1922, he began work at No. 81 Veterans' Bureau Hospital in the Bronx. Over a four-year period, he saw over a thousand war-related neuroses. He later described the experience as “the most instructive and the most dramatic” of his entire career, but also very disturbing. There was nothing in the medical literature to explain the “tortures and discomforts” he was attempting to treat.

In 1939, as war was again breaking out across Europe, he began work on a comprehensive theoretical study,
The Traumatic Neuroses of War
, in which he noted the episodic amnesia that dominated the field, saying, “The subject of neurotic disturbances consequent upon war has, in the past 25 years, been submitted to a good deal of capriciousness in public interest and psychiatric whims. The public does not sustain its interest, which was very great after World War I, and neither does psychiatry. . . . In part, this is due to the declining status of the veteran after a war.”

The book would be almost completely ignored for over thirty years.
Kardiner's message was one that no one wanted to hear: for war-damaged men, unless active, systematic treatment was undertaken, the prospects for recovery were slim. In the 1970s, as American medicine confronted an epidemic of mental disorders among Vietnam veterans, Kardiner's work was the only resource psychiatrists could turn to. His predictions about the capricious public interest in war neurosis proved all too accurate.

4

I
N TREATING SHELL-SHOCKED
soldiers, doctors during World War I were at first inclined to address the ailment strictly as a physiological phenomenon, as if the concussive force of the shell had damaged something in the body of the sufferer. While people suffering post-traumatic symptoms may experience their distress as forms of somatic dysfunction, they are just as often experienced as paranormal, uncanny phenomena or compulsive returns to the past.
Survivors look back and see messages written into the world. Warnings, omens, sermons in the form of premonitions. Clues. Survivors look back and remember the unanswered email, the curious out-of-the-blue remark from a stranger, the way the traffic aligned the moment before impact, putting five red cars together in the same lane. The unused plane ticket, the trees whose leaves were out of season, the freakish weather, the odd journal entry. What is it to be a person who notices such things, to become a detective of one's own life? What is it about terror that makes us into creatures so lacking in normal faith that we begin looking for a deeper order in the world, drifting into a kind of gnostic wonder? What happens at the moment of horror that makes us so lonely that we begin to see the world as haunted, to keep such details as company? Does terror in its total mystery awaken some need for pattern making, some more ancient way of understanding the world?

What is it that makes us want to believe that a traumatic event has a life of its own? That it is searching for a place in time to express itself, to make itself known to the world?

The day before I hit an IED in Baghdad, I went out on a patrol with some soldiers who couldn't believe that I had never been blown up before.
A month before that, while waiting for a helicopter to Dora in a cooling hut next to the flight line at Camp Fallujah, I had what I believed at the time to be an intimation of death. It came in the form of a man whom I recognized even though we'd never met.

He was waiting, like me, for a helicopter out of Anbar, beginning the endless journey home or, like so many other citizens of the war—contractors, retired shooters, wanderers, and mercenaries—making their way from one assignment to another, hitting the line of bases strung along the Euphrates like old frontier towns. I was on my way to the latest in a series of embeds and filled with a fatigue that seemed to stretch back into childhood, making me feel that I might spend the rest of my life trying to get on the other side of it. It was the sort of fatigue that went beyond simply making you feel exhausted and took on an aggressive character, actually causing you to question certain fundamental principles in your life.

I'd been living hand to mouth with the infantry for months, and opening my eyes after a nap inside the cooling hut, my heart froze. There I was, stretched out a few feet away on the filthy plywood floor, eerily still, head resting on a backpack, immersed in a book whose title I couldn't make out. The floor seemed to turn to liquid beneath me. It was impossible: my double in brown-canvas utility trousers.