The Cost of War—Then and Now: Commentary on “Neuro Psychiatry 1943”

In his essay “Neuro Psychiatry 1943: The Role of Documentary Film in the Dissemination of Medical Knowledge and Promotion of the U.K. Psychiatric Profession” Edgar Jones provides a detailed case study of a single movie that was made under unusual wartime conditions. From this case, he builds a general analysis of the interpretation and portrayal of scientific expertise that shaped the production, distribution, and reception of this genre of documentary. The paper provides a fresh perspective for the historical analysis of film documentaries, while remaining highly topical and germane to present-day issues in medicine and health care.

The film that Jones studied was produced in a British hospital where war victims (mostly soldiers) were treated for war neuroses. The filmmakers documented the therapies employed and the apparently successful posttreatment reintroduction of patients into military service and civilian work. They hoped to convince informed audiences, especially those outside Britain in the United States and Canada, about the effectiveness of the British Health Care Service in meeting the challenge of casualties and psychological trauma from war. Jones found, however, that the optimistic portrayal of therapeutics in the film belied contemporary research on the results of such treatment, placing propagandistic goals above the obligations to convey an accurate record of the work. While exploring the promotional purposes of the documentary format, the paper also effectively raises questions about the nature and relevance of apparent historical continuities in the war-related illness.

Jones’ discussion will inevitably remind readers of current debates about soldiers returning from Iraq or Afghanistan with psychological distress. Yet, Jones takes care to note the historical distinctiveness of the conditions prevailing in 1943. The care for war neurosis, the diagnostic categories in use, and the debates over outcomes in the Second World War reflected and referred back to earlier discourses about neurasthenia and shell shock during the First World War. Jones shows that particular historical contingencies, including the motives and political objectives of the movie producers, the concerns of health officials, and the influence of military oversight, affected how the film presented psychological illness and its treatment in 1943. The paper captures well the conditions of the war, describing the institutional setting of the hospital, the situation of the actors and filmmakers, and the social context of health care at the time.

Despite seventy years of intervening debate and analysis, the scenes from 1943 resonate strongly with present-day discourse about the psychological consequences of warfare, including posttraumatic stress disorder (PTSD). We could consider these semblances a coincidental link between two distinct historical periods, with similar basic questions and concerns about the effects of war arising in different institutional and public contexts. Alternatively, we might see strong continuities here, with issues that remained powerfully affecting and relevant over more than a century of modern warfare, with the First World War and the Second World War as focal points. Jones’ analysis provides exemplary historiography to bridge between discrete historical moments of related anxieties and reassurances, while resisting the temptation to draw facile comparisons between the events and ideas of the past and the world that we experience today. Yet, the reader does not escape the cumulative impression that some of these subjects are timeless and that we will not soon be finished with our struggle to respond humanely and effectively to the psychological toll of warfare.

Jones offers a fresh attempt to address persisting questions about medical responsibilities for wartime psychological suffering, the formulation of postwar psychiatric conditions as distinct from general psychiatric conditions, and the tensions between popularizing science and presenting unbiased scientific results. But perhaps most compelling is the attempt to excavate deep anxieties over the interdependent instrumentalization of aesthetics and science, and more specifically to understand the cinematic dramatization of scientific expertise. Thus, in my opinion, Jones’ narrative may best serve as a springboard for further study of the diachronically changing experience of scientific expertise by the documentary audience and the targeting of that experience in film production. Important databases, such as “The Public Health Film Goes to War” (http://www.nlm.gov/hmd/digicolls/phfgtw/index...