Combat Fatigue

[TomVrille]

Originally Posted by bill1

Know Bill Lambert suffered a breakdown and there also was one French ace (name?) Any other documented cases?

The French ace you are referring to may have been Jean Navarre. After surviving Verdun, who could blame him for getting a bit batty??

[Scott Powell]

would you perhaps count Roy Brown amoungst those with combat disorders?

[NeilE]

In terms of Guynemer, look at the last photos of Georges Guynemer - he does not look well - physically or psychologically. As for that famous quote, one wonders if he said it or whether it was apocryphal, or the product of a inventive sub-editor or reporter.

Any exposure to combat will lead to trauma reactions. The individual's resilience will determine how that will manifest itself. The further you go on in an combat career, and the more death or wounding are perceived to be obvious products of chance, the less resilient you are likely to become.

Jean Navarre was an obvious example of severe fatigue. His tragedy was that he was allowed to fly again which led to his death.

Whilst the stereotypes of the nihilistic, trembling, drunkard, old hand pilot is mono-dimensional, there are elements of truth in this portrayal.

Does anyone know of any specific material on the treatment of "combat fatigue" in air crew personnel? The information exists in regard to the treatment of infantry fatigue casualties but it would be interesting to see if aircrew were treated differently or the same.

An interesting point to is in regards to actually catorgorising what we are talking about here. Are we talking about Post-Traumatic Stress Disorder, Combat Fatigue, Anxiety Disorders, Disassociative Disorders, Neurasthenia, Shell-Shock, or what? The presentation of each may be different, yet similar. And individuals may exhibits symptoms across a range of disorders also, making diagnosis, and thus treament, challenging.

Regards

Neil

[NeilE]

Originally Posted by Scott Powell

would you perhaps count Roy Brown amoungst those with combat disorders?

He would seem to be amongst those with some sort of combat disorder - didn't he develop stomach ulcers to the point he often couldn't eat and had to take regular breaks ftom flying?

Cheers

Neil

[Elfen]

Charles Nungesser comes to my mind. So does Werner Voss when you look at his last photo. He looks aged and tired when compared to his 2 brothers.

I remember an old history teacher telling me back in high school that the generals would go into feild hospitals and start yelling at pilots who had shell shock to get back to their planes. But he also added that many of these pilots were suffering from diaherria and dehydration, caused from ingesting the slimey remains of the burnt off caster oil in the exhaust from their engines. Bad enough getting the stuff on your goggles and needing to wipe it off. Worst is getting the stuff sprayed all over your face and some into your mouth. Castor oil by itself was a power laxitive that one can still buy at some stores.

[Doc]

The cases mentioned previously in this thread are of course the worst-case and most well-known cases. However, in spite of these obviously unfit pilots being allowed (or forced) to continue flying, the problem was of much greater importance than these few pilots. "Combat fatigue" in pilots was recognised by the Allied medical authorities during WWI. Unfortunately, other than rest and recouperation, there was not much available in the way of treatment. Often, what we would call "combat fatigue" was attributed to too many hours with inadequate oxygen, and was called "oxygen want" syndrome. At least the Brits and the Americans had special hospitals or wards set up to deal with pilots--- The post-war American aeromedical manual ("Air Service Medical"-- 1919) noted: "The flier who is suffering from want of oxygen is far from normal, He may be exhilerated, he may be simply dull and sleepy, or if he is in a position of danger, he may fail to take the measures necessary for the safety of himself and those with him, even when he is well aware of the danger. This extraordinary impairment of judgement if extrememely characteristic, the person himself being totally unaware of it and quite confident that his mind is perfectly clear. ... These symptoms, some trivial, some marked, are the signposts to flying fatigue within whose habitat one loses the energy, the will, and the ability to fly. A striking example of this was noted during and inspection by one of our officers to a certain hospital in France. One ward was devoted to the carre of fliers suffering from "oxygen want". During the week in which he was present, there were observed 22 such cases. The entire group of men from all appearances looked perfectly healthy. Here was a ward full of young, active men with no apparent illness, not a single man was injured in body or limb, and according to usual medical standass and usual methods of examination each one of thes men would be considered perfectly fit for service. As a matter of fact, not a single man was fit for service. They were unable to fly. Their chief complaints on attempting to fly were headache, vertiog, and "lack of confidence". There were two causes-- mental strain from long-continued service and the cumulative effect on the nervous system of an insufficient supply of oxygen." From the point of view of a current-day aviation medicine specialist, I have to point out that these men all were suffering from combat-related stress, and the "oxygen want" probably had nothing to do with it. While of course lack of oxygen can cause many of these symptoms, they tend to disappear upon return to ground level, and do not persist. These hospitalised pilots clearly were suffering from combat stress --I am unaware of any readily available statistics to show how many pilots were removed from combat due to this cause, but a persistently-reported statistic is that during the first year of the War 80% of British pilot losses were due to mental or physical failure rather than materiel failure or enemy action. Many of these pilot losses were probably due to "combat fatigue", "flying fatigue", or whatever other terminology we want to use to describe it. Doc

[Mr_Flibble]

Originally Posted by Elfen

I remember an old history teacher telling me back in high school that the generals would go into feild hospitals and start yelling at pilots who had shell shock to get back to their planes.

One of the reasons General George S. Patton Jr. wasn't the Commander-in-Chief for the D-Day invasion and the battle in North-West Europe in WW2. In Sicily he had struck a soldier who was suffering from combat fatigue. They nearly sent him home for that.

[retread]

Recently completed reading Henri Bordeaux's 1918 book "Guynemer- Knight of the Air" . Compared to Jacques Mortaine's biography of the same year he is much more forthcoming regarding Guynemer's hospitalizations and absences from the front. What Mortaine identified as "some sort of poisoning" Bordeaux describes as "nervous exhaustion" or simply "nerves".

[MattyBoy]

Hi Doc,

An excellent book is Air Service Medical. I bought it from ebay on the cheap.
Unfortunately I am not medically minded, so only the first 50-odd pages were within my grasp.
However, I really liked the ear test written on page 122.
Very clever.
Matt.

[Doc]

Matt, which edition of the book do you have? I can't find a good ear test on page 122 of the 1919 edition, other than what is really a vestibular test. I think we may be looking at a different editions. As far as physical testing goes, my favorite is the (possibly apochryphal) needle and gun test for "nervous stability". A needle is held between the finger and thumb (points to the tissue, not held by the sides), and the doctor walks behind the pilot. Without warning, he fires a pistol beside the pilot's head-- lack of blood around the needle shows good nervous stability. Not sure if it was ever really done, but it certainly appears lots of times in the old literature. Doc