SIGNATURE WOUNDS

A challenge to conventional wisdom about the military ignoring PTSD, traumatic brain injury, and suicide among troops who have served in Iraq and Afghanistan.

Kieran (History, American Studies/Washington & Jefferson Coll.; Forever Vietnam: How a Divisive War Changed American Public Memory, 2014, etc.) never denies the seriousness of PTSD, TBI, and suicide among active and discharged veterans. However, he contends that critics of the military and federal bureaucracy often downplay the complexities of understanding the problems and finding effective solutions. In fact, he contends, implacable anti-war critics have unfairly used the psychological injuries for political ends. “In a climate in which anti-war sentiment was often dismissed with assertions that critics were not supporting the troops,” writes Kieran, “pointing out how the wars were harming those troops facilitated broader policy critiques.” Before the wars in Iraq and Afghanistan, research about PTSD, TBI, and suicide was based on the premise that deployments would be brief and that the same troops would not be ordered to return to the same war zones multiple times. When the nature of war changed, the military and the Veterans Administration had to recalibrate their policies and their research to react to new realities. As the author points out, those recalibrations take time and don’t usually conform to the urgent needs of combat veterans. Kieran’s research takes readers inside the medical arm of military services and civilian government bureaucracies, showing dedicated researchers and administrators trying to reach consensus about how to treat—and perhaps even prevent—serious mental damage and suicide. The author stresses that the disagreements about how to proceed derive from compassionate advocates relying on science-based research. Kieran rejects the commonly held belief that those in charge of warfare are dismissive of effective treatments for veterans. Throughout, the author provides memorable individual case studies. Much of the book, however, relies on dense academic research and a scholarly writing style, so general readers will need to pay close attention to digest the author’s arguments.

An intriguing study for students of military culture and mental health.