Some have proposed that soldiers with psychological injuries should receive the Purple Heart. While many have supported this proposal, it has also generated such strong opposition that the Pentagon currently does consider these injuries in awarding the Purple Heart. This decision should not be surprising because most people — soldiers and civilians alike — still have a hard time seeing psychological injuries as real. Earlier known as “Soldier’s Heart” and “Combat Fatigue,” psychological injury is slowly making its way into popular consciousness as an illness worthy of treatment. The many names used for this condition suggest the difficult time we have in according it a status equal to wounds that result in bleeding. Psychological injuries have also been called “post-traumatic stress disorder” (PTSD).
Consider for a moment some of the other complications involved in awarding the Purple Heart. The signature wound of the Iraq War is traumatic brain injury, or TBI. This injury is sometimes difficult to diagnose and often goes untreated until long after it has occurred. When TBI happens together with other physical injuries that cause bloodshed, there is no need to consider TBI for a Purple Heart. But if TBI happens without other injuries, the Purple Heart is awarded without the need for visible proof of injury. We accept TBI as a physical wound even though it may lack an obvious physical manifestation.
Injuries caused by so-called “friendly fire” often involve bloodshed but are not caused by enemy action. Victims of these injuries receive the Purple Heart because it is often impossible to trace the cause of the injury.
A soldier sickened by exposure to Agent Orange or chemicals used during the Gulf War has a physical ailment, but it is one that often does not become apparent until long after the wound has been inflicted. With increasing exposure to uranium-tipped, armor-piercing ammunition used by US forces during the Gulf War, it is likely that more and more soldiers will suffer illnesses that are not immediately traceable to combat action.
What soldiers care about is that all injuries — psychological as well as physical — receive prompt treatment. Most soldiers would rather have proper care than all the medals the military has to offer. Yet often the soldier’s reluctance to ask for help is among the obstacles to treatment. In the idealized Hero Culture that surrounds military service, heroes don’t need help and don’t ask for it.
We understand that psychological injury is just as debilitating as a physical wound. Yet we denigrate psychological injury when we make it ineligible for the Purple Heart. In this way we contribute to the problem of soldiers failing to seek help for psychological injury. We need to look at the big picture. Society’s understand of psychological injury has evolved substantially since George Washington awarded the first Purple Heart.
John Merson – January 29, 2009
John Merson speaks on the subject of war at universities, churches, and veterans groups. His topics include the effects of war on foot soldiers and civilians in war zones, war crimes, and ways to prevent war.