Media - TV - M*A*S*H*
M*A*S*H* may be one of the most interesting media to look at in terms of its handling of PTSD, because unlike any other media I am looking at this semester, episodes and conversations about PTSD, or as it was more likely known then, Battle Fatigue, change in real time over the course of the series.
The TV show, while set in the 3 year conflict dividing Korea, became synonymous with the Vietnam war, in part thanks to the timing of its release in the final years of the engagement. When the show began in 1972, the war was still 3 years from ending and after 16 years of high intensity battles and violence, psychologists were inundated with massive populations of traumatized veterans with no diagnosis. Post Traumatic Stress Disorder would not be given its name until 1978, and it would not be included in medical journals until 1980. M*A*S*H* began in 1972 and did not air its final 2 and a half hour episode until 1983.
Because of these timelines, M*A*S*H*'s episodes dealing with PTSD and trauma are treated extremely differently between its first appearance in season 3 and the final episode.
Season 3: Episode 13 - Mad Dogs & Servicemen
"Mad Dogs & Servicemen," an episode that premiered at the very end of the Vietnam war, demonstrates an understanding of trauma, and uses some of the latest research available at the time it came out. This episode is very interesting in that it goes out of its way to explain that the treatment for battle fatigue is completely experimental at this point.
In the Episode, a soldier, Corporal Travis, has come to the unit with no appearent physical wounds, yet complains of being completely paralyzed. Frank, deciding he is a shameful "Shell Shock" case, wants to send him off to a hospital in Tokyo, while both Hawkeye & Trapper want to keep him around and try out an experimental technique that their friend (and psychologist) Dr. Sidney Freedman has been using to get soldiers back to the front. After calling Sidney on the camp phone, Hawkeye is briefly talked into performing the method himself, a somewhat odd choice as Hawkeye is a master surgeon, never professing to have any skills in psychology.
The methodology used to try and force Corporal Travis out of bed and standing seems cruel and unhelpful by today's vantage point, and even Hawkeye and Trapper feel like the method is mean and aggressive. Corporal Travis is denied any type of meal until he can get to the mess tent on his own, at one point crawling his way there. They then have Trapper go in and play the proverbial "goodcop" to Hawkeye's "bad cop", and after Travis finally admits that he froze and did nothing while his whole unit got taken out by tanks, the Corporal is finally able to stand up. He shakes Trapper and Hawkeye's hands and goes cheerfully back to the front lines, miraculously healed for good.
The episode treats the methodology with a bit more nuance and tact than I have laid out here, but with the information we know now, its easy to tell that there is a lot here that would be considered useless now. The one really positive thing we can say for the episode is that moments that described what would become PTSD later on are shown, and that mental health, particularly for war veterans was finally being discussed openly in media.
Season 6: Episode 5 - War of Nerves
One of the oddest convergences between War of Nerves and Mad Dogs & Servicemen was the fact that it uses the same actor (Michael O'Keefe) to play the traumatized soldier - in this case named Tom. This time the episode barely focuses on the patient with PTSD (again referred to as "Battle Fatigue") as a part of the B-Plot. Of what is there, some is similar or the same, and some has mild changes in it. The first big difference is that instead of having Hawkeye and his fellow doctors try and administer the psychological techniques, Dr. Sidney Freeman himself arrives with the other casualties to do the work himself. His patient, Tom, is not paralized, but instead has had surgery on his wounded legs after a shell exploded near his foxhole while Sidney had been checking up on his mental state.
If this episode does anything truly different with its relationship to trauma, it is that Dr. Sidney Freeman is shown checking in with his trauma patients, rather than suggesting trauma related mental illness can be easily cured. The episode also makes a point to show how his patient can be triggered by the Doc's presence, as he is able to speak normally with Hawkeye and BJ, yet freezes or flies into a rage when Sidney tries to talk with him. The episode ends differently from the prior PTSD episode; Tom says he can never forgive Dr. Freeman, and Freeman watches sadly as he is carted away, saying that maybe Tom will be ok because he can direct his anger at him instead of at himself now.
Season 11: Episode 16 - Goodbye, Farewell & Amen
The final episode of the series, 3 years after PTSD has been added to the DSM-III, takes a vastly different approach from previous attempts at understanding trauma. First and formost, the biggest difference here is that the trauma does not come from a 3rd party outside source such as Corporal Travis or a random soldier named Tom. This time the audience sees Hawkeye's fragmented flashbacks as he fights against a surpressed memory that led him to substance abuse, panic attacks and irrational thoughts.
The episode does not tell us right away what is wrong with Hawkeye. What we know going in is that Hawkeye has been taken away from the 4077 M*A*S*H* unit to a psychiatric evaluation facility after almost driving a jeep into the operating room while intoxicated. Dr. Sidney Freeman, who we have never before seen at odds with Hawkeye, is evaluating him, dealing with his friend lashing out at him for trying to help. In the first arch, Sidney spends his time with Hawkeye asking about what happened to him on a bus trip back from the beach that took place a few weeks prior. At first, Hawkeye tells the story completely skipping over the traumatizing ending. The surgical team had gone to the beach to let off some steam as the truce of the Korean War approaches. Digging further, Sidney finds out that Hawkeye remembers that on the bus ride back they had to stop to let on some soldiers and refugees, and that they had to be quiet due to the possibility of an attack on the road back to the 4077. Around this time, Hawkeye gets a visit from his friend BJ, but scares the man off after he flies into a rage because he does not feel as though he needs to be away from his unit. Through a time based montage, we see Hawkeye becoming agitated and flying off the handle at the sound of people loudly arguing or the sound of chickens and roosters. Finally he tells Sidney that while on the bus, at a pivital moment that they had to stay perfectly silent, he could hear the echoing cries of a chicken at the back of the bus, being held in the arms of a refugee woman. As he is talking Hawkeye is sweating and shaking, and he remembers aggressively whispering to the woman to "shut that thing up."
A quick cracking sound is heard and Hawkeye, looking broken, explains that the refugee woman had broken the neck of the thing in her arms right after he spoke to her. It is then revealed that it was not a chicken in her arms, but a baby.
Hawkeye blames himself for the murder of that baby. He is ashamed that he told her to keep the baby quiet, while wrestling with the fact that they could have all been killed if the baby had been allowed to cry freely. It is clear that this episode was heavily researched with the most up to date information they had on veteren trauma, as this section not only shows Hawkeye's narrative as fragments but focuses on the root cause of his trauma: the actions Hawkeye took that left him trapped, vulnerable, and deeply ashamed.
While this revelation does cause something of a break through for him and he is able to be sent back to his unit, Hawkeye's issues with PTSD are not cured. While the episode moves on to other things and bigger endings, they have Sidney tag along back to the 4077 unit to make further observations. Hawkeye seems himself at times, but at others it is clear that he has not fully gotten passed his trauma. He describes working in the OR as like "falling off a cliff" due to the level of adrennalin and anxiety coursing through him, when it used to feel like "falling off a log." He is unable to stay at a birthday party the unit holds for one of the Korean children, as he would rather avoid children altogether.
In some ways, the most important aspect of how the finale handles Hawkeye's PTSD lies in how it does not; they never give the audience a resolution to Hawkeye's mental state, they simply show that Sidney will be around to help him from time to time but that largely this is something now a part of Hawkeye's every day life. What started out as a sitcom about definitive outcomes - life or death - has now reached the impasse of mental illness. Here, it says, is a grey area, one that cannot be given a concrete fix, just something that must be dealt with.
The nuance in this last episode is an incredible adjustment from the earlier episodes, which can only be accounted for by acknowledging that the show did its research to try and accurately portray methods of psychology during a time it was growing rapidly. This is not a feat that can be repeated, but it does give a lot of insight into how media can change and grow as new information about the world is presented to it.