Some Wounds Don't Bleed: An Examination of Unresolved Trauma in Vietnam Veterans and Its Ethical Implications through the Lens of One Man's Story and Beyond

By Spence, Mikhaile; Rose, David et al. | Ethical Human Psychology and Psychiatry, October 1, 2014 | Go to article overview

Some Wounds Don't Bleed: An Examination of Unresolved Trauma in Vietnam Veterans and Its Ethical Implications through the Lens of One Man's Story and Beyond


Spence, Mikhaile, Rose, David, Tucker, James A., Ethical Human Psychology and Psychiatry


The Vietnam War left in its wake not only physical casualties but psychological ones as well. Among the most significant features of the war's aftermath are numerous and well-documented cases of posttraumatic stress disorder (PTSD). Despite having been observed by writers, scholars, and others as early as biblical times, it was not until the emotional and psychological aftereffects suffered by Vietnam veterans became too numerous and significant to ignore that medicine, psychology, and the U.S. military undertook serious study of the disorder. David Rose, himself a veteran, shares his personal PTSD journey, having been diagnosed some 45 years after his return from Vietnam. David's story and poetry paint a picture that is both deeply personal and yet all too common among veterans of military conflict. Through David's story, we explore the questions of what PTSD is and how it has been addressed by the military as well as those charged with providing treatment. Also explored is the concept of moral injury and the ethical implications of exposing service members to circumstances, which inevitably bear psychological consequences.

Keywords: PTSD; veterans; Vietnam; poetry; moral

Some Wounds Never Heal

Lots of ways to be wounded in war

Bullets, grenades, rockets and so much more

Some are mortally wounded and die right away

Take a big hit and don't last the day

Others are wounded but survive

Takes some time but they revive

There is one type of wound that you can't see

Just ask a few questions and you will agree

This wound stays with you for life

Infects, festers and causes real strife

Some survive it

Some commit

Regardless of the type wound you receive

War will kill you eventually I believe. (Rose, 2014, p. 67)

VIETNAM AND THE HISTORY OF POSTTRAUMATIC STRESS DISORDER

Some 60 years after it began, the Vietnam War remains-we would like to think-an anomaly in the history of the United States' involvement in international conflicts.

No event in American history is more misunderstood than the Vietnam War. It was misreported then, and it is misremembered now. Rarely have so many people been so wrong about so much. Never have the consequences of their misunderstanding been so tragic. (Nixon, 1985, p. 9)

Following Ho Chi Minh's rise to power, conflict arose between his communist regime in North Vietnam and South Vietnam, whose chief ally was the United States. As the war drew on, the United States committed more and more troops and resources to the cause, culminating with the deployment of combat forces in March of 1965. The costly conflict lasted from 1954 until 1973, when President Richard Nixon ordered withdrawal of the last U.S. troops from the region. By then, the number of American troops killed or missing in action exceeded 58,000 (History Channel, 2009). One out of every 10 Americans who served in Vietnam lost their lives in the war (McCaffrey, 1993). Long hailed as the most divisive and deadliest of U.S. wars, the impact of the Vietnam War and its aftermath remain prevalent to this day.

Among the many unique factors, which set it aside from other wars, Vietnam bears the dubious distinction of spawning the highest and most well-documented incidences of posttraumatic stress disorder (PTSD) among veterans. Although the term PTSD was not coined until its inclusion in 1980's Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III; American Psychiatric Association, 1980), the concept of ongoing impairment as a result of exposure to trauma appears in literature dating as far back as The Bible, where the Book of Job describes in great detail the turmoil and emotional distress experienced by Job following the loss of his material wealth and family. Ancient Greek literature furthers the connection of trauma to impairment with numerous references to PTSD-like symptoms of soldiers in combat (Anders, 2012). …

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