Reviewed by: Courage and Air Warfare: The Allied Aircrew Experience in the Second World War Robert J. Ursano Mark K. Wells. Courage and Air Warfare: The Allied Aircrew Experience in the Second World War. Cass Series: Studies in Air Power. London: Frank Cass, 1995. xiv + 240 pp. Ill. $40.00. Military psychiatry has a long history, perhaps most often dated from Salmon’s recommendations in World War I on how to treat combat casualties. Yet rarely has there been a description of the stresses and traumatic experiences facing [End Page 177] aircrews in times of war. The glory of flying is often what is heard, both from its participants and from those who write about the experience. Colonel Wells has added a substantive piece to the history of military warfare and, in particular, to the history of the combat environment in the air. Using historical documents, he writes about the stress, morale, and “moral fiber” of the U.S. Air Force in World War II. As a psychiatrist, I recognize accurate observation, meticulously sequenced in time and identifying patterns of concern. Those who define history in a similar way will find this volume to be a highly enjoyable and highly informative read. Courage and Air Warfare describes the process of aircrew selection and classification, and the impact of combat on fliers and their units. By late 1944, the School of Aviation Medicine of the U.S. Army Air Force (USAAF) had developed an intensive psychiatric evaluation, intended to identify the “robust” emotional constitution seen as necessary for success. The problem of establishing the validity of such screening was important and remains important now. Men who had hoped for years to become pilots were at times rejected seemingly arbitrarily—including one whom the astute reader will notice was a relative of the author. The management of emotional casualties has been of great concern to the armed forces. Even without attention to such casualties, other medical care teams are often overwhelmed. Wells accurately details that it was not just worry about personal death or injury that caused fear in airmen from both Air Forces (the Royal Air Force, Bomber Command, and U.S. 8th Air Force): they also feared for their friends, dreading having to deal with wounded and dying men on board their own aircraft, or with the results of aircraft accidents on take-off or landing. As the war endured, authorities and medical experts recognized that emotional breakdown could happen to anyone, not just “the weak” and predisposed. Yet despite this recognition, the continued bias against those who showed emotional breakdown extended for many years. Only in the early 1980s was the diagnosis “Post-Traumatic Stress Disorder” created by the American Psychiatric Association, and even then, much of the initial research was based on reevaluating and reinvestigating the relationship between the severity of traumatic exposure and the probability of breakdown. Our awareness of this most important lesson of combat and trauma is continually eroded by the social need to stigmatize and separate those who break down in order to reinforce the society’s sense of safety and feeling that “it could not be me.” Our military institutional memory must constantly be revived to assure that this lesson stays in the forefront of our thinking, for it is a major influence on training, leadership, and, of course, medical planning. Wells has made an outstanding contribution to the understanding of war and its effects on aircrews. Writing in an area in which little has been documented for the broad readership, including historians and medical scientists, he has presented in a well-written and systematic volume information from World War II that has not previously been pulled together in one place. His book is an excellent source for understanding the stress of air combat, developing an appreciation of the leadership needed in aircrews and air units, and understanding [End Page 178] how nations struggled with the horror of war and its effects on those who must fight in a combat that all saw as devastating, destructive, and necessary. Robert J. Ursano Uniformed Services University of the Health Sciences Copyright © 1997 The Johns Hopkins University Press
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