Sheepdog Tip of the Day, After Combat tip 109
The evacuation syndrome is the paradox of combat psychiatry. A nation must care for its psychiatric casualties, since they are of no value on the battlefield indeed, their presence in combat can have a negative impact on the morale of other soldiers and they can still be used again as valuable seasoned replacements once they've recovered from combat stress. But if soldiers begin to realize that insane soldiers are being evacuated, the number of psychiatric casualties will increase dramatically. An obvious solution to this problem is to rotate troops out of battle for periodic rest and recuperation this is standard policy in most Western armies - but this is not always possible in combat. Proximity or forward treatment and expectancy are the principles developed to overcome the paradox of evacuation syndrome. These concepts, which have proved themselves quite effective since World War I, involve (1) treatment of the psychiatric casualty as far forward on the battlefield as possible that is, in the closest possible proximity to the battlefield, often still inside enemy artillery range and (2) constant communication to the casualty by leadership and medical personnel of their expectancy that he will be rejoining his comrades in the front line as soon as possible.
Lt. Col. Dave Grossman, On Killing
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