War's Waste: Rehabilitation in World War I America by Beth Linker (review)

What debt, if any, does a state owe to a soldier once he returns to civilian life? If there is a debt, for how long is it owed? Does that debt change based on whether the soldier was conscripted or volunteered for duty? What if he was injured? During and just after the American Civil War, answers to these questions seemed relatively straightforward (at least for Northerners): given the patriotic and selfless nature of their service, the United States was obligated to provide financially for an injured Union soldier, or the family of a deceased Union soldier, in perpetuity. Over the years this financial obligation was extended to all men who served the Union honorably during the war and not just the injured. By the end of the century, though, the United States began to realize a significant problem with this gratitude—soldiers lived too long and, consequently, cost a lot to care for as they aged.

With the rise of the Progressives at the beginning of the twentieth century, America started to take a different view toward its wounded veterans, seeing them not as warriors valiantly wounded in battle and deserving of remuneration for their sacrifice, but as a drain on the state and a representation of a corrupt, inefficient, and bloated government. America's preparation for and subsequent entry into the First World War, then, came at a crucial time in a re-thinking of the United States' responsibilities for its wounded veterans. This crucial period serves as the central focus of Beth Linker's War's Waste.

Linker examines why rehabilitation—physical and social—instead of financial benefits became the main response to the needs of the Great War's veterans. She establishes from where the call for rehabilitation came and then discusses the ways in which various social groups went about crafting a place for themselves within a new rehabilitation ethic. The account is structured thematically, looking at: the creation and later modification of the national pension system; the rise of orthopedic surgeons and their role in shaping rehabilitation; discipline formation among a new female workforce committed to restoring the wounded; architectural and technological transformations to hospitals to accommodate therapeutic needs; the development of Walter Reed's Limb Lab and attempts at standardizing and mass-producing prostheses; representations of the male and his emasculation; and, finally, the expansion of veteran programs into mainstream America for industrial workers and others, along with an analysis of the cost of rehabilitation compared to the pension system. Her approach demonstrates aptly how recovery and independence became the central tenets of America's treatment of the war-wounded, and also the ways in which rehabilitation helped to shift the path of funding for post-traumatic care from individual payments to patients to the support of burgeoning medical (public and private hospitals) and medical-industrial (device manufacturers) complexes of the early twentieth century.

Though each chapter contributes to Linker's overall argument, the relationship of one chapter to another is not always direct: it seems as if Linker's social groups were all working independently for the same cause and had only infrequent interactions with each other. For example, chapter 3 addresses the creation and deployment of a new female workforce focused on "physical therapy" for wounded soldiers. These working women make only brief appearances in other chapters of the manuscript even though they were working with soldiers as the men were working through their ideas of masculinity, as prosthetic manufacturers were creating limbs for soldiers, and as the American polity debated the role of such women in the broader rehabilitation schema. While each chapter is well-researched, well-argued, and superb on its own, it would be interesting to see the ways in which politics, economics, disciplines, and technologies interacted with each other more broadly as they all pursued the principle of rehabilitation.

Overall, War's Waste works well as a complement to other excellent studies of the ways...