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The conclusion returns to, and completes, the story of Anne Gudis and Sam Kramer, whose fitful epistolary courtship was explored in earlier chapters. It also suggests why the Dear John letter has proven to be such a durable emblem of female betrayal in wartime, despite profound changes in US society and in American war-waging over the past century. Soldiers‘ and veterans‘ stories of abandonment and betrayal by female romantic partners are more than simply outlets for hurt feelings or bruised egos. They also underscore the chasm that many servicemen have felt between civilian society and those in uniform. As such, Dear John story-telling has elevated veterans‘ perceptions that men who jeopardized their lives for their country have been misunderstood and maltreated – not just by the women they loved and lost, but by the nation writ large.
This article uses a linked sample of World War I Army veterans from the state of Missouri to study the impact of vocational rehabilitation on labor market outcomes for men wounded and disabled during the war. Veterans’ military service abstracts are linked to the 1940 US Census and a subset are linked to rehabilitation records. This creates a new dataset that contains information on military service, rehabilitation, and labor market outcomes. I find that 70 percent of veterans that were both wounded in action and disabled when discharged from the army participated in the rehabilitation program. These same veterans had significantly better labor market outcomes, which can be attributed to the rehabilitation program under certain assumptions.
To examine socioeconomic disparities in use of electroconvulsive therapy (ECT) among homeless or unstably housed (HUH) veterans with mental illness.
National data from medical records in years 2000 to 2019 on 4 to 6 million veterans with mental illness, including 140 000 to 370 000 homeless veterans served annually from the U.S. Department of Veterans Affairs (VA) healthcare system, were analyzed to examine ECT utilization and changes in utilization over time.
ECT utilization was higher among HUH veterans (58–104 per 1000) than domiciled veterans with mental illness (9–15 per 1000) across years with a trend toward increasing use of ECT use among HUH veterans over time. Among HUH and domiciled veterans who received ECT, veterans received an average of 5 to 9 sessions of ECT. There were great regional differences in rates of ECT utilization among HUH and domiciled veterans with the highest overall rates of ECT use at VA facilities in the Northeast and Northwest regions of the country.
ECT is commonly and safely used in HUH veterans in a comprehensive healthcare system, but geographic and local factors may impede access to ECT for veterans who may benefit from this treatment. Efforts should be made to reduce barriers to ECT in the HUH population.
Through the comparative reading of Italian literature of the Great War (letteratura di guerra) published between 1915 and 1940, it will be shown that both among veterans of the conflict and civilian writers there existed a standardised image of falling ‘beautifully’ in combat that entailed specific components relating to location, time, final gestures and last invocations, and which aimed to make death in battle more militarily and culturally palatable for Italian audiences. At the same time, the letteratura di guerra presented naturalistic descriptions of the anonymous mass death of peasant soldiers and, thereby, created a pathos of beauty and suffering that made the Italian literature of the Great War prototypical for a new kind of spiritual realism that became one of the mainstreams of cultural expression in Fascist Italy.
The conclusion examines two stories from 2016 that reflect broader themes of veterans returning to Việt Nam. The appointment of Vietnam veteran and alleged war criminal Bob Kerrey to Chair of Fulbright University Vietnam revived the now-familiar narrative about American redemption in Việt Nam, while the pilgrimage of thousands of Australians to Việt Nam for the 50th anniversary of the Battle of Long Tan demonstrated a profound sense of entitlement to Vietnamese spaces. The conclusion summarizes that veterans returned in search of resolution or peace, which manifested in nostalgia. Upon return, many returnees found a measure of peace, but were challenged by the erasure of their wartime presence. Veterans negotiated this displacement by drawing from wartime narratives and performing nostalgic practices to reclaim their sense of belonging in Việt Nam. Yet the 2016 stories indicate that veteran influence in the country will decline as Việt Nam moves on from war.
Chapter 8 examines how veterans worked to reassert their wartime connection to peacetime Việt Nam. Many veterans returned to Việt Nam with strong feelings of diasporic connection to the physical space of the country, feelings that were often challenged by local practices, national memories, and the effects of the passage of time. This chapter explores how veterans negotiated that challenge by engaging in nostalgic practices – such as recreating “bar culture,” expressing nostalgic discontent at the corruption of peacetime Việt Nam, and establishing hierarchies of diasporic belonging among the expatriate communities – before turning to explore how veterans justified their presence in Việt Nam, showing how they harnessed Australian and American wartime culture, values, and knowledge in order to establish their authority. This chapter concludes by analyzing how Australian and US returnees made sense of their return to Việt Nam as living legacies of war.
This chapter offers a critical reading of Macbeth as a play preoccupied with war, including civil war and border warfare. Macbeth is arguably the greatest example of a character whose brutality is condemned so soon after being celebrated. There is an exploration of doublethink in a play that holds up savagery as heroism in its opening act in the shape of the severed head of a rebel and holds up the head of the executioner, a hero-turned-villain, in its closing scene. Working at the intersection of military history and medical humanities, this reading of the play tracks the effects and aftereffects of war and wounding, examines modern responses to the play by soldiers and psychiatrists that raise issues around care and control of veterans, addresses the politics of remembering and remembrance, and reflects on recent responses to Macbeth as a drama depicting the consequences of post–traumatic stress disorder.
Chapter 5 examines the dynamics in veterans’ meeting with Vietnamese. A common goal of returnees was to meet “the enemy,” and the solidarity they found with fellow soldiers in Việt Nam became a key theme in veterans’ narratives. This chapter unpacks a near-uniform claim made by veterans that the Vietnamese bore no grudge for the war and welcomed veterans back to Việt Nam wholeheartedly. Because many American veterans positioned themselves as atoning for wartime participation, they viewed this reaction as forgiveness. Australian veterans, conversely, drew from Australia’s national mythology to argue that the Vietnamese welcomed them back because they loved and respected Australian soldiers. This chapter situates veterans’ claims about forgiveness, solidarity, and belonging in Việt Nam in the context of Vietnamese diplomacy, examines the inclusion and exclusion of different Vietnamese groups from veterans’ solidarity narratives, and explores concealed hostility on both sides.
Chapter 1 examines the first era of veterans’ return journeys. Between 1981 and 1994, a trickle of Australian and American Vietnam veterans returned to Việt Nam on journeys of reconciliation. As Western war commemorations and popular culture representations allowed veterans to reflect on their wartime experiences, some returned to Việt Nam to address lingering questions they had about the people, the country, and the war. Others returned in reaction to contemporary political issues, while major economic changes within Việt Nam acted as a cue for veterans who had long dreamed of returning. For some veterans, returning marked a turning point that challenged them to atone for the war, while others found new opportunities and relationships. These first returnees discovered a place that had seemingly moved on from war, which brought them a measure of peace. Many became advocates for formal reconciliation with and restitution for the Vietnamese.
Chapter 3 examines the third era of veterans’ return journeys, from 2006–16. This final period was defined by war commemoration. As Vietnam War commemoration surged in Australia and the United States, increasing numbers of Australian veterans chose to mark a string of major war anniversaries in Việt Nam, while the cultural militarization that paralleled the unfolding War on Terror led anti-war American veterans to reflect on their service. Việt Nam’s tourism industry tapped the growing Western market by turning toward kitsch reproductions of war that hinged on American memories. Organized tours became more popular as returnees became more diverse and reached retirement. Australian veterans strongly preferred commercial battlefield tourism and private troop reunions, while Americans favored peace- or healing-oriented returns. Among both groups, tours were refined and contained over the years to expatriate areas, increasingly marketing nostalgia tourism and secluding returnees from the realities of postwar Việt Nam.
Chapter 7 examines veterans’ reflections on key war legacies in light of their return journeys. After the war, veterans grappled with complex and politically charged narratives about the war that shaped how they viewed their individual experiences. Those that returned to Việt Nam faced new stories and memories about the war that challenged these narratives. Rather than challenging their views, the experience of returning to Việt Nam often reinforced their existing values and beliefs, and many returnees drew from return experiences to support their existing views. This chapter situates returnees’ views in broader historiographical debates on four key issues: perceptions of defeat (or victory) in Vietnam, the anti-war movement, the association between “their” war and war crimes, and the justness of the war. The majority of veterans raised these key legacy issues in their interviews without prompting, indicating how polarizing and contentious the Vietnam War continues to be.
The Introduction explains that veterans returned to Việt Nam in search of resolution, or peace, in their personal relationships with the war. This search manifested in nostalgia for “Vietnam,” with returnees acting as a diasporic community forged in war. While many returnees found a measure of peace upon return, they were also challenged by the erasure of their wartime presence. Veterans drew on wartime memories and performed nostalgic practices to recapture their sense of belonging in Việt Nam. Outlining three distinct eras of returnees, this chapter shows how a comparative, transnational perspective reveals stark differences in American and Australian war memories, narratives, and imaginings of “Vietnam.” This chapter presents a review of the existing scholarship on the topic of returning veterans, situating the book in broader literature on the war and its legacies; explains the book’s oral history methodology and analytic approach; and outlines the broader structure of the book.
Chapter 6 examines how veterans responded to Vietnamese war memory at four key sites: the War Remnants Museum, Hỏa Lò Prison Museum, Sơn Mỹ Memorial and Museum, and Long Tân. When veterans returned to Việt Nam, they discovered that the Vietnamese narrative of the “American War” rendered them perpetrators of atrocities or, at best, passive victims of imperialist warmongering nations. While some returnees embraced Vietnamese war memory, others rejected or challenged it, and many struggled with the tensions and contradictions between different versions of the war. Across national and ideological lines, veterans displayed a selective acceptance of Vietnamese war memory, isolating elements that corroborated their memories of war and rejecting the legitimacy of others. This chapter also considers varied response to the Vietnamese erasure of veterans’ wartime allies and concludes by examining how Australian returnees increasingly approached the site of Long Tân through the Australian tradition of “Anzac” pilgrimage.
Chapter 2 examines the second era of veterans’ return journeys, from 1995–2005. This era of return was characterized by “normalization”: the establishment of diplomatic relations between the United States and Việt Nam offered security to tentative veterans who had watched the reconciliation process from afar. Lifted travel restrictions and a growing tourism industry provided returnees with more latitude in their returns, resulting in a more diverse return group. Increasingly, veterans from both countries returned on “healing journeys,” approaching Việt Nam as the locus of their trauma. A discourse of trauma emerged in their narratives, mirroring the rising popularity of therapy and psychoanalysis in Western cultures, with the majority of normalization returnees describing their returns as therapeutic. Many of the normalization returnees became engaged in reconstruction activities as a form of atonement in Việt Nam, reshaping early returnees’ reconciliation processes into personal healing projects.
Chapter 4 examines how veterans responded to the presence and absence of war remnants in Việt Nam. Returning veterans often engaged in battlefield pilgrimage as a way to reflect on the past, encountering or visiting war remnants in the form of battle locations or military bases. However, for the Vietnamese, the remnants of war were not limited to battlefields and military architecture. This chapter takes a broad view of relics and remnants, considering alongside military battlefields and bases the ecological, social, and individual effects of war on those who lived through it and those born in its aftermath. These more subtle remnants were obvious to some returnees, but to others, they were invisible. Exploring veterans’ reactions to the presence or absence of war remnants in these forms illuminates further remnants of war: the biases and other lingering effects of wartime ideologies of the Australians and Americans who returned.
Between 1981 and 2016, thousands of American and Australian Vietnam War veterans returned to Việt Nam. This comparative, transnational oral history offers the first historical study of these return journeys. It shows how veterans returned in search of resolution, or peace, manifesting in shifting nostalgic visions of 'Vietnam.' Different national war narratives shaped their returns: Australians followed the 'Anzac' pilgrimage tradition, whereas for Americans the return was an anti-war act. Veterans met former enemies, visited battlefields, mourned friends, found new relationships, and addressed enduring legacies of war. Many found their memories of war eased by witnessing Việt Nam at peace. Yet this peacetime reality also challenged veterans' wartime connection to Vietnamese spaces. The place they were nostalgic for was Vietnam, a space in war memory, not Việt Nam, the country. Veterans drew from wartime narratives to negotiate this displacement, performing nostalgic practices to reclaim their sense of belonging.
The period from 1930 to 1990 saw an extraordinary development in the use of Gothic and horror to tell narratives about war and combat, mainly for two main purposes: first, to reveal and accentuate the horrific damage caused to bodies by combat, usually in order to denounce and demystify war; and second, figuratively to depict the less visible ways in which combat and war violence affect soldiers and civilians on a psychological level, especially through fear and trauma. A third form of War Gothic involves the dehumanisation of enemies by portraying them as monsters. All three forms are concerned with the ways in which war robs humans of their humanity, though the first two are largely critical of war while the third is basically a form of militaristic jingoism. This chapter focuses on a selection of texts from the first Hollywood zombie film, White Zombie (1932), to Jacob’s Ladder (1990), focusing especially on the Second World War and its veterans, and the literature and cinema of the Vietnam War. It ends with a brief discussion of War Gothic in the film and video game representations of the First Gulf War.
The aim of this study was to compare primary care appointment disruptions around Hurricanes Ike (2008) and Harvey (2017) and identify patterns that indicate differing continuity of primary care or care systems across events.
Primary care appointment records covering 5 wk before and after each storm were identified for Veterans Health Affairs (VA) facilities in the greater Houston and surrounding areas and a comparison group of VA facilities located elsewhere. Appointment disposition percentages were compared within and across storm events to assess care disruptions.
For Hurricane Harvey, 14% of primary care appointments were completed during the week of landfall (vs 33% for Hurricane Ike and 69% in comparison clinics), and 49% were completed the following week (vs 58% for Hurricane Ike and 71% for comparison clinics). By the second week after Hurricane Ike and third week after Harvey, the scheduled appointment completion percentage returned to prestorm levels of approximately 60%.
There were greater and more persistent care disruptions for Hurricane Harvey relative to Hurricane Ike. As catastrophic emergencies including major natural disasters and infectious disease pandemics become a more recognized threat to primary and preventive care delivery, health-care systems should consider implementing strategies to monitor and ensure primary care appointment continuity.
The practice of military psychiatry is, in part, a function of the size and role of a nation’s armed forces. The end of National Service in 1960 and cuts to defence budgets saw the British Army contract by two-thirds, with reductions to its medical services. Despite suffering psychological casualties in the Falklands War and the sustained challenge of counter-insurgency operations in Northern Ireland, no research was conducted into PTSD experienced by British forces until the mid-1990s. The focus on Gulf War syndrome diverted attention from common mental illnesses towards hypotheses of toxic exposure. A Strategic Defence Review conducted by the Labour government in 1998 defined a broader global role for the UK military to enhance the country’s international influence, and deployments to Iraq and Afghanistan followed. Women, integrated within all three services from 1992, joined in rising numbers but reported elevated rates of mental illness and may have been exposed to greater risk of military sexual trauma. A class action for negligence in the detection and treatment of PTSD in 2002 encouraged the Ministry of Defence to fund research into psychological illness and develop services for trauma-related injury.
Varied longitudinal courses of suicidal ideation (SI) may be linked to unique sets of risk and protective factors.
A national probability sample of 2291 U.S. veterans was followed over four assessments spanning 7 years to examine how a broad range of baseline risk and protective factors predict varying courses of SI.
Most veterans (82.6%) denied SI at baseline and all follow-ups, while 8.7% had new onset SI, 5.4% chronic SI, and 3.3% remitted SI. Compared to the no-SI group, chronic SI was associated with childhood trauma, baseline major depressive and/or posttraumatic stress disorder (MDD/PTSD), physical health difficulties, and recent traumatic stressors. Remitted veterans had the highest risk of a prior suicide attempt (SA) compared to no-SI [relative risk ratio (RRR) = 3.31] and chronic SI groups (RRR = 4.65); and high rates of MDD/PTSD (RRR = 7.62). New onset SI was associated with recent stressors and physical health difficulties. All symptomatic SI groups reported decrements in protective factors, specifically, social connectedness, trait curiosity/exploration, and purpose in life.
Nearly one-in-five veterans reported SI over a 7-year period, most of whom evidenced new onset or remitted SI courses. Chronic and remitted SI may represent particularly high-risk SI courses; the former was associated with higher rates of prospective SA, and psychiatric and physical distress, and the latter with increased likelihood of prior SA, and isolation from social and mental health supports. Physical disability, MDD/PTSD, and recent stressors may be important precipitating or maintaining factors of SI, while social connectedness may be a key target for suicide prevention efforts.