Book Review
You Can't Change Rule Number One
RULE NUMBER TWO: Lessons I Learned in a Combat Hospital
By Dr. Heidi Squier Kraft
Little, Brown and Company, New York, 2007
ISBN 0316057903
243 pp.
$23.99 (Member $21.59)
reviewed by LCDR Joseph D. Haines, MC, USN
When reviewing a book for the Marine Corps Gazette, I always ask myself the question, why would a Marine line officer want to read this book? At first glance, a book by a Navy psychologist treating combat stress victims may not seem particularly relevant. However there are several important lessons Rule Number Two: Lessons I Learned in a Combat Hospital can provide to the warfighter.
The author, former Navy clinical psychologist Dr. Heidi Squier Kraft, is also the wife of a Marine pilot and the mother of twins. Her children were 15 months old when she deployed for 7 months to Al Asad Airbase in 2005. On one level the book is a memoir to her children. On another level it is a tribute to the Marines she cared for. And at still another level it is not surprisingly a cathartic process for the author.
For Marines who have served in Iraq and Afghanistan, the descriptions of the detritus of war will seem familiar. However the focus on the emotional casualties of war by a mental health professional provides some unique insights. A medical officer’s role is simply to support the combatant commander and his Marines in their goal of accomplishing their mission. As Dr. Kraft illustrates, mental health can be as important as physical health in maintaining readiness.
There are numerous lessons combatant commanders can learn from “shrinks.” First, Marines with a history of mental illness should never be deployed. Dr. Kraft describes two poignant examples of a previously diagnosed schizophrenic private who suffered a psychotic break in theater and a depressed sergeant who became suicidal. Commanders and their surgeons should carefully screen out all Marines with mental illness from deployment.
Second, just as we have preventive medicine units to establish proper sanitation and hygiene to prevent physical illness, mental hygiene must also be a priority. A combat stress “platoon” of 4 members (like Dr. Kraft’s) to serve 10,000 Marines in a combat zone is woefully inadequate. Combat stress is not a new disorder, and competent commanders should not only anticipate its occurrence but must minimize its impact by assuring that their Marines are encouraged and not stigmatized for seeking mental health care.
Third, mental health providers need someone to care for their combat stress. The providers can’t care for Marines as effectively if their emotional needs are not addressed. Mental health professionals are a vital asset to the combat teams and require proper maintenance just like a trusted weapon.
Some Marines who read this book may feel uncomfortable with descriptions of commanders in tears and the display of raw emotions. But as Dr. Kraft reminds us, we’re all human, we’re in this war together, and we’ve got to take care of each other.
This book reaffirms two constants—war is here to stay and combat stress is its inevitable consequence. We ask our warfighters to violate the ultimate social taboo—the taking of another human life. The least we can do is to help those who suffer both the physical and emotional consequences of combat.
>LCDR Haines is a family physician who just completed a tour on Okinawa with the 3d Marine Division where he was deployed to Indonesia and Laos.
