Calm down, dear, it’s only a drama!

We are now three weeks into the six-week run of The Crimson Field, BBC 1’s Sunday night drama set in a First World War ‘field hospital’ ‘somewhere in France’.  The quotation marks around ‘field hospital’ may give some indication as to my opinion of the programme.  It is one of a number of small inaccuracies that, like lice in a uniform, have been driving me (and a number of other historians of British medical care in the First World War) a bit nuts.

In fact, ‘field hospital’ was a term used very little after the Boer War.  I have come across a Territorial medical unit which used the term in relation to the hospital where they trained recruits before they were sent overseas as a field hospital, but the hospitals along the lines of communication were, by 1916, when The Crimson Field is ostensibly set, known as either Casualty Clearing Stations (what would formerly have been referred to as field hospitals) or Stationary or Base Hospitals (of which this appears to be one).

Is this sort of criticism too nit-picky?  Certainly, one of the reactions on Twitter to this type of comment (which I have been making a fair amount of over the past three weeks) has been ‘It isn’t a history lesson, it’s a drama!’ with the implication that criticizing the historical accuracy of the depiction is both unfair and detracts from others’ pleasure in watching.  Essentially, this reaction is a version of ‘If you have nothing nice to say, don’t say it.’

At one level, this is fair enough.  The Crimson Field is a drama rather than a history lesson, and I don’t have any problem with cosy Sunday evening historical dramas.  I actually have a soft spot (as well as remarkably high tolerance for a historian) for such dramas, having recently enjoyed The Musketeers and Call the Midwife, and even, once I had properly suspended disbelief, still relish a good episode of Downton Abbey.  But the BBC itself is creating a block to the sort of suspension of disbelief that I have achieved with Downton by attempting to locate The Crimson Field within its own narrative of historical commemoration.  The programme is part of the ‘World War One’ season and there are regular tweets and links to related factual content on the BBC’s website.  In other words, the BBC is presenting this as both drama and history, even though they are getting quite a lot of that history wrong.

Which brings me to the other reason I have problems with the ‘It’s drama, not history’ criticism.  Because a great deal of my criticism actually is of the programme as a drama.  Having started out quite well, introducing several strong female characters with the potential to develop into interesting individuals opening up new perspectives on the popular understanding of the First World War, the dramatic arc has all too rapidly declined into a series of mythic clichés enacted by stock figures who simply represent modern ideas rather than having any real personality, historic or otherwise.  As Amanda Vickery has pointed out, the plot predominantly involves the imposition of 21st-century ideas and concerns on characters placed rather than fully located in 1916. It is unsurprising, therefore, that the drama feels clichéd and inauthentic as it tries to crowbar issues of class, race and sexuality into story lines that use endless accusations of cowardice as a shorthand for reactions to the horrors of war or attempts to deal with the complicated question of Irish politics in part of one sixty-minute episode.  In other words, The Crimson Field is not only poor history, but also not very good drama, by whatever standards you judge it.

So why do I keep watching?  Why not give it up as a bad job and let those who are enjoying the drama enjoy it in peace?  Two reasons, one superficial, one (I hope) rather less so.  The superficial reason is that, whatever the quality of the drama, the casting is, on the whole, very good.  It is not simply that I would watch Hermione Norris and Suranne Jones in pretty much anything they appeared in, however terrible, but also that they are good enough to bring depth to their parts.  Norris, in particular, has created a believably restrained and awe-inspiring matron, thankfully setting off the bizarre characterization of the hospital CO as a weak and deeply un-awe-inspiring figure.  I will probably keep watching to the end for her alone.

There is, however, a more important reason for why I will keep watching and, for that matter, keep tweeting as I do so.  It might be described as the ‘teachable moment’ excuse, to use a truly abominable American phrase.  Because I am trying to do is not merely criticize for the sake of finding fault, but to explain, insofar as 140 characters lets me, what my research has taught me about the historic reality of medical care in the First World War.  I can not only complain about the representation of a shell shock sufferer in the first episode, but also point out that he would most likely have been treated in isolation for the sake of general morale. Nor is the process only one way.  So far, questions I have had or points I have made have led to interesting discussions of how laundry was done at Base hospitals and the date at which female radiographers began working overseas.  I have thus learned something indirectly from the programme as well as, I hope, giving a little more historic depth to the understanding of a few viewers.

There is also an element of ‘Know thy enemy’ to this.  Yes, I despaired when the one fully-formed orderly character was revealed to be gay in the most historically unlikely of circumstances.  But this particular bit of trite 21st-century plot does provide an opportunity to explain that, while the masculinity of medical orderlies might be (and often was) impugned, it was, as far as I have been able to uncover, never in terms of suspect or criminal sexuality, but rather in terms of age and physical health.  Homosexuality as a pathology affecting war service was an accusation more commonly (although still not very often) leveled at men who failed to enlist or were diagnosed with shell shock, another symptom of an inherent physical and moral insufficiency which signified male degeneracy.  Exploring these distinctions in masculinity is a key element of my research project; finding and exploiting the opportunities to disseminate my research and analysis more widely, in whatever unlikely form, is thus part of my professional remit.  In other words, I watch and critique because it is my job.

This is, of course, fundamentally the same defense for using Blackadder as a teaching tool about the history of the First World War.  The drama or comedy is the starting point, not the destination, and they probably have  more to tell us about the social and cultural context in which they have been created than about the historic realities of the period that they represent.  Using them in this way is not always comfortable.  For historians it means tackling popular historical misconceptions head on and sitting through the itchy discomfort of historically inaccurate dramas to find out what, exactly, has been portrayed and how.  For non-historians who wish to engage, it can mean having assumptions and beliefs punctured and deflated. At the very least, it means being forced out of a comfortable Sunday night of suspended disbelief.  Not everyone wants to spend their Sunday evening leisure engaging critically with what they are watching, and that of course is their prerogative. No one has to either watch and critique or read critical commentary if they choose not to. But I have to admit to enjoy bringing my practice of critical analysis to The Crimson Field of a Sunday, so I will carry on. And maybe in doing so I can also make a not very good drama at least a slightly better history lesson.

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The $64,000 question

When I posted last month about all the topics that I was planning forthcoming posts on, the one that the overwhelming majority of readers (well, three) wanted to know more about was why shell shock is not ‘what we now know as PTSD’.  In fact, one reader was so keen to know more that she emailed me, asking me for a one-line summary to discuss with a student.  After some thought, I replied that the soundbite answer is that PTSD is a medical diagnosis, while shell shock is a cultural idea.

It is, of course, more complicated than this, although being forced to summarize my rather disparate ideas on the subject was a useful discipline and I hope that my reader and her student found enough meat on those rather bare bones to chew over in the interim.  But it is just a sound bite, so the question remains, why don’t I think that PTSD and shell shock are different terms for the same thing?

I will start with PTSD, the condition that I know rather less about but which I understand primarily as a medical diagnosis.  It has been part of public consciousness since 1980, when it was first officially recognised and appeared in DSM III, the Diagnostic and Statistical Manual.  DSM V has recently been published, including a revised, hotly contested definition of PTSD which complicates the ‘constellation of symptoms’ that are classified as defining the condition.  Indeed, PTSD has never not been contested.  As Ben Shephard has pointed out, the recognition of the condition was viewed by some from the outset as politically driven, to improve state benefits for Vietnam veterans.  He also notes, however, that the recognition of PTSD in DSM III gave a previously ‘vague and emotive “post-Vietnam syndrome” … real intellectual authority.’ [1] This is an authority that the term has, despite much argument, maintained for over thirty years. It is not only ‘the overriding diagnosis for the psychiatric disorders of war’, [2] it is also a legally and medically recognized response to civilian traumas, diagnosed in victims of crime, industrial accident and medical traumas.

So how does this differ from shell shock? Shell shock was, after all, a term coined by a doctor attempting to diagnose a constellation of inexplicable symptoms which are now recognized as those associated with psychological wounding. The problem is that, as a medical concept, ‘shell shock’ was originally used in relation to the theory that shell blast (and burial alive caused by shell fire) resulted in microscopic neurological damage which in turn caused the more visible and seemingly inexplicable symptoms on display. Although an idea that continued to have its supporters throughout the First World War, it was one which did not stand up to scrutiny and, by mid-1916, shell shock was generally discredited as a medical term. Indeed, Charles Myers, credited with coining the term, would later write that it was ‘a singularly ill-chosen term; and in other respects … has proved a singularly harmful one’, [3] distracting, as it seemed to Myers, from a proper understanding of the psychic damage men were suffering from in response to the traumas of danger, pain and, above all, fear. At the same time, the British military authorities, concerned that the vibrant phrase was encouraging an epidemic of incurable nervous responses and convinced that the weakness it appeared to expose was contagious, with one shell-shocked soldier within a unit causing others to suffer, or pretend to suffer, from the condition as well, forbad its use in favour of more bureaucratic terms such as ‘Not Yet Diagnosed (Nervous).’

Yet the phrase did not disappear. Almost as soon as it was coined it took on a life of its own, moving, as Jay Winter has argued, ‘from the medical to the metaphysical’ and turning ‘from a diagnosis into a metaphor.’ [4] From soldiers who, on seeing their comrades suffering from psychological wounds commented, ‘there was such a thing as shell shock’ to contemporary usage where to be shell-shocked by something is the common rhetorical response to almost any unexpected event, the term has become deeply embedded in the English language. Beyond this, shell shock has, for many years, been the symbolic wound of the war, the condition which all men suffered from and which was the clearest expression not only of their suffering and silencing (hysterical mutism was one symptom of the condition), but of the madness of war itself. It is not for nothing that the image of Blackadder with underpants on his head and pencils up his nose, feigning insanity as the only way out of an insane situation, is one of the two most iconic of the final episode of Blackadder Goes Forth. (The other, of course, is the final fade from men charging over the top to a poppy field, with death being the only other exit from the insanity of warfare.) Shell shock, then, has come to represent the psychological damage that war inflicts on men in a way that was not only not intended originally but also in ways that go far beyond any medical understanding of the psychological trauma of war.

Yet it is not simply that shell shock is, in one way, far more wide-ranging as a term than PTSD. Because in another way it is a far narrower term. PTSD did not merely refashion pre-existing ideas, as Allan Young has argued. [5] It also forged ‘A bridge … between “war neurosis” and the victims of civilian trauma that had never really existed before …. [In doing so it] helped to create a new, unitary kind of “trauma”.’ [6] Despite the almost reflexive use of ‘shell shock’ in moments of not-necessarily-traumatic shock, shell shock remains primarily a metaphor for the trauma and madness of warfare. By comparison, PTSD encompasses the psychological responses to a far greater variety of traumas. Amanda Holden may recently have expressed surprise at being diagnosed with PTSD following the traumatic birth of her daughter, claiming that she associated the condition primarily with the battlefield, but PTSD is regularly diagnosed in women who have had traumatic births, as well as victims of domestic violence and civil catastrophes such as railway accidents, taking it back to one of the earliest formulations of responses to psychological trauma, the 19th century condition ‘railway spine’.

Is PTSD becoming a cultural idea, then, through its use to define responses to traumas beyond the battlefield? I don’t think so. The framework within which it is used are still primarily medical, or medico-legal, and seek to limit the definition of those suffering from the condition, rather than expand it. No one has ever claimed of PTSD, as has been claimed of shell shock, that an entire generation suffered from it, and I doubt anyone will.

So no, PTSD is not simply ‘what we now call shell shock’, although it is possible to identify the condition initially termed as shell shock as an ancestor of what is now known as PTSD. But, as Hazel Croft argues, ‘Although each configuration of psychiatric injury draws on previous concepts, trauma has to be situated in the particular social, cultural and political circumstances … in which it is interpreted.’ [7] It is still possible to contextualised much of what is defined as PTSD this way; I am not sure the same can be said about the range of meanings that, today, the idea of shell shock is asked to encompass. It is not only that PTSD encompasses a potentially more sophisticated understanding of psychiatric disorder but that shell shock is not, and never really has been, a diagnostic term.  It is far, far more than that.

Disclaimer: All of the above refers exclusively to my reading of the history of shell shock in Britain and the resonance of the term in British culture.  The formulations of the meaning and significance of PTSD and shell shock as both terms and ideas in other cultures and other languages are different but are beyond my current competence and the scope of this post.

[1] Ben Shephard, A War of Nerves: Soldiers and Psychiatrists 1914-1994 (London: Pimlico, 2000), p.367.

[2] Hazel Croft, ‘Gendered Diagnostics from Shellshock to PTSD, 1914-2010’ in Ana Carden-Coyne (ed.), Gender and Conflict Since 1914 (Basingstoke: Palgrave Macmillan, 2012), p117

[3] C.S. Myers, Shell Shock in France 1914-1918 (Cambridge: Cambridge University Press, 1940), p.26

[4] Jay Winter, ‘Shell-shock and the Cultural History of the Great War’, Journal of Contemporary History , 35(1), 2000: 7.

[5] Allan Young, The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton: Princeton University Press, 1997).

[6] Shephard, p.367

[7] Croft, p.110.

Very well then, I contradict myself…

Last Friday, I went to the final showcase for the Legacies of War Leeds Stories of the Great War project.  I haven’t had a huge amount to do with this project, so it was both a surprise and a delight of an event, with results (many of them ongoing) of six exciting community projects on display.  Of the six, two stood out, the year 11 students from Roundhay School who produced two films, one silent, one a pastiche news bulletin, inspired by the history of Belgian refugees in Leeds, and Urban Sprawl theatre company, Leeds’ sole homeless theatre company, who came up with a touching, funny, vulgar music hall riff on the theme of enlistment.  All the projects were moving, informed and passionate, but these two groups stood out for their creativity and humour that, in the case of Urban Sprawl, was true enough to the spirit of the times they evoked that it had me referencing Frederick Manning’s Her Privates We.

Which brings me to another First World War event from last week, this one a launch rather than a culmination.  14-18 NOW, which launched officially on 27th March, is an Arts Council and Heritage Lottery Fund funded series of events, hosted by the Imperial War Museum and taking place around the country.  Projects range from a Royal de Luxe production telling the story of the Accrington Pals using giant puppets in the streets of Liverpool to 1914 told day-by-day through cartoons.

The reactions have been almost as varied as the proposed artistic outputs.  The first response on Twitter was, in general, a rather patronising, ‘These people need to learn some “real” history.’  The mainstream media tended to pick up on the project to paint warships using First World War-era ‘Dazzle’ camouflage techniques, sparking this bizarre but somehow predictable response from the Guardian.  By the weekend there were some more detailed, considered response emerging on blogs, most notably those of George Simmers and Jonathan Boff. More recently, Gary Sheffield has pitched in with this interesting discussion of why the idea of turning off lights to mark the start of the war is historically uninformed.

By rights, I should be in complete agreement with these posts, and to some extent I am, having done my fair share of fulminating about luvvies voicing ill-informed opinions about how the war should be commemorated.  I agree that Stephen Fry’s letter to an unknown soldier, as well as several of the projects on 14-18 NOW, are deeply clichéd.  And yet overall I find myself intrigued and excited by the majority of ideas on display, and particularly by the Letter to Unknown Soldier soldier project.

Part of this is due to a huge personal affection for the Charles Jagger memorial sculpture honouring the dead of the Great Western Railway on platform 1 of Paddington Station, the Unknown Soldier of the title.  Reading his letter from home, he forms the cover of my monograph on writing wartime masculinity, in stunning a photograph by my brother, photographer Sebastian Meyer. Men of War coverAnything that makes people more aware of this particular statue is liable to get my attention and my approbation.

But I also keep coming back to those amazingly creative responses to the history of the war on display last week.  The Letter to the Unknown Soldier invites similar creativity from participants.  I doubt it will come from well-known artistic or creative figures, given the evidence so far available.  But I love the idea of a busy commuter, looking for the first time at that beautiful, powerful face, being inspired to engage with the history of the First World War enough to write their own letter, an act of commemoration speaking not only to Jagger’s vision but also that of Eliot and Auden.  Or maybe it will be a local homeless person who, like the clients of Urban Sprawl, locates a sense of identity and community in this imagined figure of the past.  Yes, these will be the projection of 21st-century ideas, concerns, aspirations on to an image almost a century old.  But in looking to the wider public, there is the potential for an artistic engagement with history beyond the clichés that, so often, have dominated Britain’s commemorations. It is an artistic response, certainly, but given the richness and complexity of artistic responses across the past century, responses which have led to their own branch of academic study, this too will be ‘real’ history.

At the heart of my unease at the response to 14-18 NOW, however, is, I realise after a week of thinking about it, actually very similar to the annoyance I felt at the luvvies’ letter (see above).  I resent, deeply, being told how to commemorate the First World War, whether it is by artists or historians.  Both groups have important contributions to make to the way in which the war is remembered.  At their best, the disciplines can combine in extraordinary and unexpected ways that enlighten the past anew, as was perfectly demonstrated at the Tetley last Friday night. As a historian, not only do I think that there is potential for the continuation of artistic commemorations that have been part of British culture since the war years in the 14-18 NOW project, but I hope that, given the opportunity to contribute through active engagement rather than holding aloof or, in the worst cases, simply sneering, my discipline may enable these artistic events to have real resonance throughout the centenary.  On which note, I am off to write my own letter to the unknown soldier of platform 1.