APPENDIX E
Annual Medical Service Activities Report, 82d Airborne Division, 1965
1. GENERAL:
a. This report covers the activities of the Division Psychiatric Section in the Dominican Republic, from May 1965, to November 1965.
b. From 3 May 1965, to 4 September 1965, the Division Psychiatrist and one Social Work Specialist were attached to the 15th Field Hospital, except for two 2-week periods in June and August when they were in CONUS. This location was decided upon, in order to be available to all U.S. Army elements in the Dominican Republic, at the point of evacuation to CONUS.
c. From October 1965, to November 1965, the Division Social Work Officer was in the Dominican Republic with the 307th Medical Battalion, and saw psychiatric referrals from Division only.
2. PSYCHIATRIC ACTIVITIES:
a. The attached report is a resume of the patients seen from May-August 1965, and includes patients from all U.S. Army elements present in the Dominican Republic. The Navy and Marines utilized their own chain of evacuation, but on one occasion the Division Psychiatrist was asked to examine a Navy enlisted man.
The Social Work Officer saw approximately 20 patients, which was the major part of the case load during the first three weeks of his tour. Had his services been extended to Corps and Support Elements, the patient load would have been much higher.
The total number of cases seen is much less than the average for garrison, probably because of considerably fewer board (208/209) cases being processed.
b. The statistics indicate certain trends in the casualties seen. The following table compares the number of cases falling into the various diagnostic categories during May-August in the Dominican Republic, and during another four month period in garrison (January-April 1965).
|
CLASSIFICATION |
DOMINICAN REPUBLIC (May-August)
|
GARRISON (January-April)
|
|
No Psychiatric Disorder 10No Psychiatric Disorder |
10
|
20
|
|
Acute Situational Maladjustment |
8
|
4
|
|
Character & Behavior |
46
|
188
|
|
Psychoneurotic |
10
|
5
|
|
Psychotic |
12
|
1
|
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Then it can be concluded that the various stresses involved led to an increased incidence of symptomatic disorders, in the categories of Acute Situational Maladjustment, Psychoneurosis and Psychosis.
c. The Psychiatrist saw only one patient which fell into the category of combat exhaustion. This occurred in the first few days of the encounter, when the fighting was most intense. In general, exposure to life-threatening situations and physical deprivation were never sustained enough to give rise to the conditions known to precipitate classical cases of combat exhaustion.
d. It should be noted that most of the cases of acute psychosis did not occur under conditions of fire. Most of them occurred in the period after hostilities were reduced to a minimum (after May), but when there continued to be heavy restrictions of activities, and a great deal of uncertainty as to who and where the enemy was.
e. Not included in the statistics is a group of cases which were seen only on an emergency basis, or heard of via the unit surgeons. These were cases of pathological intoxication, in which, under the influence of alcohol, bizarre or violent behavior occurred. There were a considerable number of such cases, which were handled by sedation. Situational stress undoubtedly played a role in the development of these cases, and they were generally ready for duty the next day.
3. OTHER MEDICAL ACTIVITIES:
a. From 6 May 1965, to 20 May 1965, the Division Psychiatrist and Social Work Specialist assisted various medical units operating in Santo Domingo with civilian medical aid, by working at sick call each morning.
b. From 8 July 1965, toll August 1965, the Division Psychiatrist functioned also as Battalion Surgeon for the 1/325 and 2/325, while the respective surgeons returned to CONUS.
c. From 15 August, to 4 September, the Division Psychiatrist also functioned as acting Division Surgeon, during the absence of the Assistant Division Surgeon.
4. OBSERVATIONS OF A GENERAL NATURE:
a. During the week prior to the arrival of the Psychiatrist in the Dominican Republic, there were several "psychiatric casualties" evacuated to Womack Army Hospital, including Marines and Army Personnel, whose conditions were actually not severe enough to warrant evacuation. The psychiatrists at WAN remarked at the sharp decline in such evacuees when the psychiatrist reached the objective area. This would seem to indicate the utility of having psychiatric personnel on the scene as soon as is practical.
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b. The Social Work Officer`s experiences during the later stages of the operation indicated the value of his being assigned with forward elements during operations where the division has some of its units operating away from Division Main for extended periods.
5. PROBLEM AREAS:
a. Psychiatric
(1) The communication of information from the unit level to the psychiatrist often left much to be desired. This situation could be improved by assigning the Social Work Specialists to work in their respective clearing companies, and obtain the necessary information from accompanying aid men.
(2) It would have been useful for the psychiatrist to have been more mobile, so that he could make first-hand observations to the forward situation, and consult with unit surgeons regarding the handling of cases.
b. Other Medical Problems
(1) Having been located at the 15th Field Hospital, certain problems were evident in the areas of inter-facility cooperation.
