Returning home from D-Day when PTSD did not exist

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For most of us, what we know of D-Day – with its images of men wading ashore amidst a storm of gunfire from German troops – is taken from books or movies in which the end is known from the beginning: America triumphed, despite the loss of 9,000 soldiers.

It is a very different thing to have lived through that kind of carnage. Because the men who did live through it had to put their psyches through paces most of us, God-willing, never will have to experience.

Back in 1944, the term post-traumatic stress disorder (PTSD) did not even exist.  The notion of being “shell shocked” certainly did, but that term was too often associated with an underlying weakness of character – as though the walls of one’s psyche were always a little thin or a little too easily breached by combat.

Of course, no one who goes to war is showing weakness – and nothing could be further from the truth about the men of D-Day.  They had to eschew safety and perform acts that could well lead to their deaths and the bereavement of those they would be leaving behind. They had to contemplate the calls and letters to loved ones, who might well hear that they would never return home. They had to kill enemy soldiers they had never met, whose life stories they did not know, who bled just like them, and whose wives and children would suffer just as their families would.

I sat with a few of these men when I worked at the Boston Veteran's Administration Hospital and listened to them share searing memories.  I empathized with them, and I encouraged them to say more.  But I never pretended I could know the depths of what they knew, or what they saw.

To do what they did, they had to withstand crashing waves of the fight-or-flight neurotransmitters norepinephrine and dopamine. Yet they ultimately had to control their fears, with millions of neurons in their brains pouring out substantial amounts of the calming neurotransmitter serotonin.  If their minds were made of muscles, theirs were running the equivalent of a full marathon.

Yet there could be no rest, no retreat and no comfort.

At a time when anyone else would turn and run in the opposite direction from the guns on the beach, they used their guts and hearts to march forward. Such dichotomies, I will tell you, can shred the mind and tear the soul. They can also turn a person’s heart to steel and lock it shut, closing it off from anyone and everyone – sometimes forever.

And for the soldiers who survived, they had to try to make sense of the chaos of the universe: How a bullet finds one man’s heart and misses another man’s head, maybe by less than an inch; how a husband and new father is taken when a single man survives; how a hero can be felled in the last seconds of a battle leading to triumph.

These are moments beyond reason, moments of almost unutterable impact, and they can leave the brain and mind reeling – causing soldiers to relive the paralyzing sights and sounds of war 20 years later. How does one find understanding after seeing the inexplicable unfold? How does one believe that tomorrow is likely, for oneself or one’s child, when the next instant was unknown on that bloody beach? How does one go to a baseball game and cheer for their home team, when victory or defeat once meant safeguarding your country and upholding its freedoms?

Today, we have miraculous medicines, such as the serotonin reuptake inhibitors Prozac and Viibryd, which can restore some of the neurochemical balance disrupted by the horrors of war.  We have benzodiazepine tranquilizers like Klonopin and major tranquilizers like Seroquel.  We have new healing technologies like repetitive transcranial magnetic stimulation (rTMS).  We now know that ketamine can be stunningly effective in literally rebuilding shattered synapses.

But, back in 1944, we had none of those.

Although the overuse of psychiatric medication can be a serious problem, without these drugs, millions of people would be consigned to a lifetime of psychiatric suffering.  Now, 70 years later, it is almost unimaginable to think of anyone returning home from war and having none of psychiatry’s most modern, powerful tools available.

But return they did – to towns and cities and families and jobs. And the effort to live as mere mortals, seeing what they had seen, doing what they had done, could be its own trauma. To return to everyday life after having confronted unimaginable horrors is a lifetime journey. It never ends. Not ever.

This, and no less, is what the men of D-Day gave willingly to keep us free.