This eloquent statement against the madness of war is the first novel in a trilogy that includes The Eye in the Door (1993) and finally The Ghost Road (1995), which was awarded the Booker prize. The story is closely based on the publications and annotated literary papers of three real men who met at Craiglockhart in 1917: psychiatrist W.H.R. Rivers (1864-1922) and two poets: Siegfried Sassoon (1886-1967) and Wilfred Owen (1893-1918). Owen wrote some of the most moving war poetry and the knowledge that he would be killed in action at age 25 simply adds to the poignant sense of futility.  

Pat Barker (b. 1943) probed the tenacious role of class within the military hierarchy, while the society, which the military purports to defend, is rapidly being transformed by the converging lives of domestic servants and aristocrats. Her descriptions are powerful: the yellow skin of women who work in the munitions factory; the surgeon who can no longer bear the sight of blood; the young soldier who cannot eat because his nose and mouth had once been filled with rotting flesh when he was hoist by a grenade into the decomposing belly of a dead German. Rivers helps the men to recall and to understand the origins of their ailments by gentle, patient conversation–a treatment that he described in Lancet, 2 Feb 1918. 

Regeneration
Pat Barker
London: Viking Press
New York: Plume
1991, 256 pages)

From the Vault: In these times, certain works of literature seem to be as relevant to us now as when they were published — possibly more relevant than the times that they depict. From the vault of the now closed Literature, Arts and Medicine Database, we will pluck a few items for their power and timeliness. 

Web image by  National Library of Medicine

Charles Glass is a news correspondent who has written several books. His latest, Soldiers Don’t Go Mad: A Story of Brotherhood, Poetry, and Mental Illness During the First World War gives an account of a remarkable bit of history. Craiglockhart, a hospital near Edinburgh that had previously served the “worried wealthy,” is requisitioned in 1916 for the treatment of victims of “shell shock.” Although the facility operates as Craiglockhart War Hospital for only thirty months, during that time it treats 1801 officers. Two of those men, Wilfred Owen and Siegfried Sassoon, meet and become friends there and go on to be remembered by posterity as the two most celebrated British World War I poets. 

The author makes it clear that, at the time, the very idea of treating shell shock (nowadays PTSD) is revolutionary. The condition is barely known, but as the result of new weapons and means of waging battle, it has quickly escalated into an epidemic. As a result, only four months into the war the British Army has lost 10% of officers and 40% of enlisted men. The situation is not helped by the widely held perception that those with symptoms are malingering. Desertion is punishable by death. Many “treatment” facilities dispense nothing but electric shocks and verbal abuse “to eradicate what [the doctors there] define [ ] as cowardice rather than mental illness” (p. 238). In contrast, it is the aim of the psychiatrists at Craiglockhart to adapt Freudian psychoanalytic methods for use with this population, and to show that humane treatment yields superior results. (Albeit that the measure of those results is how quickly a soldier could be returned to the front.) 

In 1917, Wilfred Owen arrives at Craiglockhart. He has witnessed horrors, and he suffers from “trembling limbs, halting voice, and confused memory” (p. 77). He has only written a few poems, but within two months he becomes editor of the hospital’s literary journal The Hydra. A few weeks later, Second Lieutenant Sassoon is admitted. He has already made a name for himself as a poet and has been decorated with the Military Cross for bravery. 

At first Owen puts Sassoon on a pedestal, while Sassoon dismisses the less experienced poet as “a rather ordinary young man” (p.154). As each thrives in his therapy, their friendship blossoms, they critique each others’s work, and their poetry rises to extraordinary heights. At first, Owen’s “bellicose dreams” (p. 146) are filled with “images of caves, bulging eyes, demons, and blood” (p.179). After he manages to harness this imagery for his writing, his psychiatrist observes that “he fears them no longer” (p.181), and he produces the landmark poem “Anthem for Doomed Youth.” 

Owen’s return to the front has been repeatedly denied by the medical boards. Once he is transformed from “a trembling shell-shocked subaltern [to] a self-confident officer capable of leading men in battle” (p. 216), he finally gets the approval. He is killed at the age of 26; in a sad irony, his mother receives the “dreadful telegram” (p. 276) on Armistice Day. 

The subject matter of Soldiers go Mad is a fascinating chapter in the history of psychiatry, and the book provides a convincing example of the healing power of poetry. 

The celebrated novel Regeneration by Booker Prize winning author Pat Barker (1991) was also based on Craiglockhart and features many of the same characters. 

The building that was formerly Craiglockhart Hospital is now a part of Edinburgh Napier University. One can visit the War Poets Collection and see original issues of The Hydra: https://www.napier.ac.uk/about-us/our-location/our-campuses/libraries-and-heritage-collections/heritage-collections/war-poets-collection. 

Penguin Press, New York, 2023,  352 pages