A Strange Perspective: Naval Psychiatry in the Vietnam War Around 1968, Part I

• Published in: Military medicine 2017-11, Vol.182 (11), p.1738-1741
• Main Authors: Connor, J T H, Rhode, Michael G
• Format: Article
• Language: English
• Subjects: Archives & records; Armed forces; Behavior disorders; Hospitals; Humans; Medicine; Mental disorders; Military history; Military medicine; Military Psychiatry - methods; Military Psychiatry - standards; Physicians - psychology; Psychiatrists; Psychiatry; Psychiatry - methods; Psychiatry - standards; Psychosis; Ships; Surgeons General; United States; Vietnam Conflict; Vietnam War
• ISSN: 0026-4075; 1930-613X
• DOI: 10.7205/MILMED-D-17-00384

First Blood, Apocalypse Now, The Deer Hunter, Platoon, Full Metal Jacket, Born on the Fourth of July, and Good Morning, Vietnam, along with many other likeminded films, convey a dark message of this conflict that overpower the victorious themes of more traditional "war movies" (John Wayne in The Green Berets, for example).2-4 From the vantage point of the present it is almost inconceivable to envisage a time when the war in Vietnam was apparently under control, appeared winnable, and military personnel, including doctors, were generally confident and hopeful. During her two tours in the South China Sea, about 23,000 patients had been admitted (over one-third of whom were WIA- wounded in action); the overwhelming majority survived and were either returned to full duty, or evacuated to landbased hospitals for further treatment in the Pacific region or the continental United States.10,11 In September 1967, Navy psychiatrists LCDR Robert E. Strange and CDR Ransom J. Arthur published a brief article reporting their psychiatric experience aboard the USS Repose during her first seven months of operations in Vietnam beginning in February 1966.12 This report was the first to describe the activities of a U.S. hospital ship in a combat zone since the Korean War. Arthur (1925-1989) graduated MD in 1951 from Harvard then practiced family medicine in Hawaii; later he undertook specialist training in psychiatry in both Honolulu and the US Naval Hospital in Bethesda and became a medical officer first at Oakland Naval Hospital then at the Navy Medical Neuropsychiatric Research Unit at San Diego where he eventually became Commanding Officer; he retired from the Navy in 1974.13,14 Strange and Arthur described the Repose's psychiatric quarters noting its 48-bed complement; that it was an "openunlocked unit" in which patients were allowed "freedom of movement about the ship commensurate with their degree of illness and responsibility" and that it was staffed by one physician, one psychiatric nurse, and nine hospital corpsmen. In July 1968, SKF which had a monopoly on Thorazine®, produced a marketing brochure for this product that was a facsimile reprint of the Strange and Arthur piece retitled as "A Report from Viet Nam-Hospital Ship Psychiatry in a War Zone" and with a front cover illustration of the USS Repose and back covers emblazoned with the SKF corporate logo and full prescribing information and technical details for Thorazine® described as a tranquilizer, potentiator,