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

Based on the author’s doctoral thesis completed at Yale University and an impressive range of research in national, regional, and local archives, this book is not merely the latest contribution to the ever-growing body of scholarship on disabled soldiers and their rehabilitation. It is one of the most important and readable studies to appear in recent years, and it is especially timely given the approaching centenary of the Great War. Beth Linker, currently associate professor in the University of Pennsylvania’s Department of History and Sociology of Science, deserves kudos.

Linker’s focus is squarely the history of the ethic and practice of rehabilitation in America as it took shape in the Progressive Era, when reformers—who both looked to the nation’s recent past and paid attention to European precedents—“encouraged the Wilson administration to institute programs in rehabilitation, providing injured soldiers with long-term medical care and vocational training in order to drastically reduce—and potentially erase—cash payments made out to veterans” (p. 2). What made this effort unique was the fact that, during the runup to America’s entrance into the Great War, “[it] was known to have the most generous veterans pensions system worldwide” (p. 5), as a function of its experiences of the Civil War. How the resulting War Risk Insurance Act and related efforts were administered, led, and ultimately negotiated among and between a variety of groups is the main focus of this study, which sits well at the intersection of medical history, American history, and disability and gender studies. In this regard, War’s Waste plainly deserves to become core reading among scholars and to be read by a wider, non-academic audience interested in learning about the social and cultural history of America during the Great War.

Linker’s best and most important chapters are her third and fifth. In the former, she draws in part upon her undergraduate studies and subsequent experiences in the field of physical therapy to document the rise of physiotherapy as it emerged following the executive order signed by Army Surgeon General William C. Gorgas, which authorized the hiring of “women war workers” to assist the Army’s Division of Special Hospitals in its contributions to the rehabilitation enterprise. In documenting the key role of these women in “defining the intent and practice of rehabilitating male soldiers” (p. 61), Linker offers valuable analyses of the differences between wartime physical therapy aides and occupational therapy aides (pp. 70ff). Scholars have too often overlooked these differences and their implications, making Linker’s approach here an especially welcome one. In a similar way, her fifth chapter, “The Limb Lab and the Engineering of Manly Bodies,” situates the well-documented, pre-war and wartime history of artificial limb manufacturing in the broader history of rehabilitation, to show how, “by masking the disability through mandatory limb wear, rehabilitators aimed to delegitimize the disabled veterans’ claim to federal assistance once rehabilitation was complete” (p. 101). Here, Linker is at her best as she examines the aesthetic and ideological assumptions that drove the mission and work of the Limb Lab to reveal that change was rooted as much, if not more, in cultural and social concerns of the day as it was strictly in the field of medicine or amputation care (p. 119).

The excellence of Linker’s fifth chapter extends through the rest of her book to her epilogue, “Walter Reed, Then and Now,” where she effectively argues that the “same normative assumptions” of World War I America “permeate the thinking of [Defense Advanced Research Projects Agency] and rehabilitation officials today” (p. 181). The very expectation today that “there is no human cost of war—that there is no ‘waste’ in war,” that bodies disabled in war should in principle and practice be able, is “because the ethic of rehabilitation, established almost a century ago, lives...