"War Neurosis" in the 1920s (Part III)

Francis's hospitalization

(The third of six stories set in Spring 1928.)

The next morning Carmen and I motor back over to the Colorado Psychopathology Hospital.  Francis has been assigned a psychiatrist named Percy and a medical doctor named Weld, and they are joined by Francis’s nurse.  “I’m Doctor Carmen Evans,” Carmen says in greeting all three of them.  As she shakes their hands, she looks at Dr. Percy and asks, “May I look at Francis’s chart?” 

“Of course, Doctor Evans,” Dr. Percy says, and hands it to her.  She and I glance at the seven-part “list of major symptoms” under a general diagnosis of “temporary insanity”:

“Neurasthenia”

“Hysteria”

“Transient Derangement”

“Tremulous Limbs and Extremities”

“Restless Motor Delirium”

“Paroxysmal Attacks of Maniacal Excitement”

“Fugal Automatism”

Carmen gives no sign of her reaction as she hands the chart back to Dr. Percy.  “He’s in a terrible state,” the psychiatrist tells us.  “As I entered his room, he was passing his hand across his forehead, as if he was witnessing some horrifying sight.  When I began to talk with him he made for the door, as if he was trying to get away from a disturbing situation.”

“When I went in,” the nurse tells us, “he was moving his head quickly from side to side, as if he was avoiding a projectile.”

“You’ve heard of the dodging reflex, Doctor Evans?” Dr. Percy asks Carmen.

“Yes,” she replies.

“At other times,” Dr. Weld adds, “he lies curled up, his head bent on his chest, his arms flexed, his thighs flexed, in the fetal position.”

“Francis must stay, day and night, in a padded room,” Dr. Percy insists.

“Why?” Carmen asks.

“So he doesn’t injure anyone,” Dr. Percy replies, “or injure himself.”

“You see no alternative?” asks Carmen.

“The alternative is worse,” Dr. Percy informs her.  “To restrain him in his bed 24 hours a day.”

“Is he suicidal?” Carmen asks.

“No,” says Dr. Percy.

“Homicidal?”

“No.”

“Hallucinating?”

“Yes, but not in a manner that is consistent with psychosis,” Dr. Percy tells her.  “At this point, unlike last night, he knows that they are hallucinations.”

“Thank you for everything you’re doing to care for him, Doctor Percy,” Carmen says.  “If it works for all three of you, my husband and I will spend some time with him now.”

“Very well,” says Dr. Percy.

Carmen and I enter Francis’s room.  He is crouched up, holding his legs tight to his chest.  When he sees us he relaxes a bit.

“Brother,” Carmen says softly, “may I hug you?”  Francis nods, he uncurls his body, and she embraces him.  “Do you remember what happened last night, Francis?”

“Well,” he struggles to recall, “yesterday the trembling in my arms was getting worse.  I read a magazine article about the War that riled me up.  You know how I get jumpy and over-react to sudden noises.  That got worse.  Then I was sleeping, and I was being shot at, and the Germans were grinning at me, and then I broke down and I lost myself for a while.”

“All right, sweetie,” Carmen says.  “It’s not your fault.  And it’s good that you’re remembering.”

Francis remains apprehensive.  He’s fidgety, shaky, with knee-jerks and a strong tremor in his hands.  His whole body is quaking.         

“Do you remember any of your actions, Francis?” Carmen asks.

“No,” Francis says.  “What did I do?”

“You aimed a gun at a neighbor and then aimed the gun at police officers,” Carmen tells him.  “You’re lucky you’re still alive.”

“I vaguely remember,” Francis says.  “First I thought the neighbor was a German soldier.  Then I thought the police officers were German snipers.”

“You did more than think, my dear brother,” says Carmen.  “You believed it.  You lived it out as if it was real.  Do you know the difference between reality and the products of your dreaming mind?”

“Last night I didn’t,” Francis admits. 

“More than last night, my dear sweet Francis,” Carmen says.  “This has been going on for years.  And it’s getting worse.”

“What’s wrong with me?” Francis asks her plaintively.

“Brother, they have put seven medical terms under your diagnosis already,” Carmen tells him.  “But the simple answer is that you’ve been suffering from traumatic neurosis.”

“Will I be able to be cured of it?”

“For the next couple weeks, at least, Francis, you’ll need to be here in the psychiatric hospital,” she says.  “You can’t be treated while you’re in and out of stupors.”

“And then?” he asks.

“Look, mi hermano, I’m a doctor, but I’m not your doctor,” Carmen responds.  “It’s not my place to say.  You have a disorder of your central nervous system.  When you suffered traumas in Europe your brain needed temporary relief.  So it repressed all memory of the traumatic experiences.  But those memories keep emerging from your unconscious mind and taking over your sleeping mind.”

“Sometimes day-dreams as well,” Francis adds.

“Yes,” Carmen assents.  “The cure, Francis, would be that you regain full memory of these experiences of shock that your mind has repressed or from which it’s dissociated.  Until then your mental health will remain highly unstable.  Your mind will continue arousing defensive reactions to imaginary or half-remembered enemies or threats.”

“So there’s hope, Carmen?” Francis asks.

“Absolutely,” she declares with a smile. 

“Carmen,” Francis says.

“Yes, Francis?” she replies.

“You’re the only person on Earth who can heal me of my war neurosis.”

Carmen thinks for a moment.  “Riis and I will always be with you, brother.  You will never be alone.”  Francis’s body relaxes a bit more.  “One other thing, Francis.”

“Yes.”

Carmen’s clearly not pleased by what she has to tell him.  “We need to shut down your veterinary clinic for the rest of 1928.”

“All right.”

We leave the room and walk back over to Francis’s psychiatrist.  “Doctor Percy, I have only one request of you.  For the rest of the Spring of 1928, I don’t want Francis to be certified permanently insane.”

“Why not?”

“He spent four years serving humanity in France during the Great War,” Carmen says.  “What he did was altruistic.  Saintly, even.  The least we can do is to respect his dignity.  Give him some time.  And give ourselves some time.  To consider all the options.”

“Sounds fair and reasonable, Doctor Evans,” Dr. Percy tells her.  “I’ll hold off doing so.”

“Thank you, Doctor Percy.” 

As we motor back home, I tell Carmen that “I see now how important psychiatric care is.  I’m totally committed to the restoration of Francis’s well-being.”