I OWE a debt to colleagues and friends in the Department of Social Studies of Medicine and the Department of Psychiatry at McGill University: I thank Don Bates, Alberto Cambrosio, Margaret Lock, Faith Wallis, George Weisz, and Laurence Kirmayer for their invaluable advice. I owe a similar debt to Atwood Gaines and Ronnie Frankenberg, who read and commented on earlier drafts. Arthur Kleinman has shown me many kindnesses, both intellectual and professional, while I prepared this book. I am grateful for these favors, but most of all for his sympathetic understanding of my overall project. I am likewise grateful to Ian Hacking for his advice, and I hope that the influence of his ideas on my book will be obvious to my readers. I also want to thank Mark Micale for many helpful suggestions, particularly in connection with the historical sections.
The ethnographic segment of this book would have been impossible without the many favors shown to me by Jack Smith, Glenn Davis, David Lebenthal, and Susan Johnson. I am likewise grateful for the consideration given to me by both the patients and staff whom I met and was permitted to listen to at the Veterans Administration medical unit described in the following pages. It would be difficult to exaggerate my special obligation to Paul Emery. He has been a friend and a mentor. He has been generous with his time and his knowledge and has treated me with a measure of kindness that will always place me in his debt.
I thank William Schlenger, Terrence Keane, and John Fairbank for the valuable information they provided in connection with the National Vietnam Veterans Rehabilitation Study. I also want to express my gratitude to the Veterans Administration Medical System for its material assistance during my field research. McGill University has generously provided me with a faculty research grant to support the preparation of the final manuscript.
I also want to thank Mary Murrell for her expert opinion, patience, and encouragement, and Vicky Wilson-Schwartz for her meticulous attention to my manuscript. The infelicities and obscurities that remain are entirely my own.
The research for this book began in 1986. In the intervening years, I presented drafts of chapters at seminars and conferences in Canada, the United States, the United Kingdom, and Germany. I am grateful to the colleagues who were present on these occasions for their many helpful suggestions. I apologize for failing to express my gratitude to them individually.