Psychiatric Quarterly, Vol. 76, No. 4, Winter 2005 (
Combat Psychiatry: From the Battle Front to the Home Front
COL Elspeth Cameron Ritchie, M.D., M.P.H.
Tonight I worked out in the gym at Walter Reed. I have been doing that
intermittently for nineteen years, so that is not unusual. What was
different was the number of other Soldiers working out without arms
or legs. Earlier, I had lunch in the cafeteria. Again familiar ground,
since I did my psychiatry residency there. Now there are numerous
very young Soldiers in wheelchairs.
Much attention is being paid to those who have lost limbs. We are
taking care of them, both physical and psychologically. Less well-known
is the care we are giving to our other soldiers who are suffering the other
psychological reactions of war.
This section hopes to outline the broad range of psychiatry practiced
in the military today. This is an enormous and complex subject, and
so areas most pertinent for civilian and VA psychiatrists will be high-
lighted. The speciﬁc focus will be on Operation Iraqi Freedom (OIF),
soldiers returning from that conﬂict, and their families.
In the Combat Zone, “Treatment of the Stress Casualty during
Operation Iraqi Freedom One” is written by two Army psychiatrists who
deployed early in OIF. The subjects that they discuss include challenges
to the service members, access and delivery of care issues, and suitable
medications for use in theater. Deﬁciencies in care are exposed, which
have since then been largely corrected.
The Long Way Home for the Wounded, “Psychiatric Interven-
tions with Returning Soldiers at Walter Reed” focuses on the mental
health issues of the wounded soldier as they pass through Landstuhl
and Walter Reed. There have now been thousands of seriously wounded
soldiers and Marines returning from the Gulf, usually via Landstuhl in
Germany to either Walter Reed Army Medical Center in Washington
2005 Springer Science+Business Media, Inc.