Combat Loss and PTSD – Part 4: Preparing for Death

This is a paper about how infantrymen in the United States Marine Corps handle combat deaths. It was researched and written by Stephen Smith, Th.M., in partial fulfillment for a seminary course on Death and Dying. While Steve has never experienced the dark side of man, his twin brother – me – has. Together, we offer this paper in eight parts. Footnotes follow at the end of each section. Part 1 dealt with the physical and psychological casualties of the wars in Iraq and Afghanistan, ending with the question of whether there is a causal link between combat and PTSD. Part 2 demonstrated a clear link between combat experiences and PTSD, particularly because of the Potentially Traumatic Events witnessed by infantrymen, and asked the question about how Infantry Marines prepare to handle death. Part 3 explored some of the techniques, both formal and informal, used to teach Marines to overcome the social taboo of killing another human being.

This post, Part 4, describes some of the methods used by the Marine Corps to help desensitize Marines to the deaths of their fellow Marines, in order to allow them to continue on with the mission.

Part 1: Post 9-11 Casualties

Part 2: The Link Between Combat and PTSD

Part 3: Learning to Kill

Part 4: Preparing for Death

Part 5: When the Metal Hits the Meat

Part 6: Memorials and Unit Healing

Part 7: When the War Continues – PTSD

Part 8: Conclusion and Bibliography

Desensitization to Incurred Death: Exposure to Trauma

Training Marines to become desensitized to the death of an enemy combatant is one thing; training them to function despite the death of a friend is quite another. And while the Marine Corps seems to have done an effective job at the former task, the latter is much more difficult. Marines spend months and years together training in small units, sharing miserable conditions in the field, enduring the petty slights and grievances of life in a military machine, drinking together after hours, and, ultimately, depending on each other to stay alive. Marines are more than just friends; they are brothers (or, in the case of some officers, father figures).

To understand how the Marine Corps attempts to desensitize its men to the death of a fellow friend/brother/father, we need look no further than Camp Pendleton, California.

Marines evacuate a "casualty" in an urban mock up.

Marines evacuate a “casualty” in an urban mock up.

Here, the Marine Corps has instituted a new level of realistic training in the last few years, complete with sound and smoke machines, simulated IEDs, machines which pump out the smell of rotting trash or decomposing bodies, and simulated casualties gushing fake blood. By desensitizing Marines to the sights and sounds of battle, the Marine Corps hopes to increase their effectiveness and decrease their risk of PTSD.[1] This new training is called “resiliency” training, and psychologists hope that it will inoculate Marines to PTSD.

The same is true of Marine officer training. Officer training is a sharp funnel, starting at Officer Candidate School (OCS), narrowing to The Basic School (TBS), and then for those few (10-15%) who are assigned to infantry billets, the Infantry Officer Course (IOC). The goal of OCS is not to train men but rather to weed out men the Corps judges mentally or physically weak.[2] The Basic School, as its name suggests, teaches Marine officers basic leadership and military skills and helps sort out which military occupational specialty (MOS) an officer is suited for. For those who elect (and earn) an infantry (03) MOS, the Marine finishing school is the Infantry Officer Course (IOC). IOC is renowned for its difficulty, challenging both the mental and physical aptitude of young lieutenants and pushing them to the maximum of stress. Since these officers will lead Marine infantrymen in combat, they are given special preparations to handle the shock of seeing combat casualties.

One of the preparations is to expose IOC candidates to the concept of death. Fick remembers sitting in a lecture called “Killology,” taught by a local psychiatrist nicknamed “Dr. Death.”[3] The man had a military background and stated that his nickname was unfortunate, because his job was to help the officers bring their men back alive. Part of that task was maintaining the psychological integrity of Marines in combat. Officers could do this, the doctor stated, by making sure that Marines got adequate sleep; had confidence in their team; practiced open communication; practiced emergency medical training; and did after-action critiques to address the shock of combat and killing. “Trust me, gentlemen,” the doctor said, “it will be a shock.”[4]

To allay the shock of seeing combat trauma, Fick and his other IOC lieutenants were shown a gruesome slideshow of men killed or wounded during Vietnam combat. Lt. Colonel Busch also recalled being shown the same grim slideshow, but he believes it was designed to intimidate weak men and leave only those with strong mental and intestinal fortitude:

One day they showed us slides of lieutenants killed in Vietnam. They were taken by coroners for records of some kind, and the images were macabre. Just dead men laid on a white cloth somewhere. The pictures were flashed as a slide show given near the week when candidates were allowed to quit. The images were meant to scare us, and they should have. An instructor paced as the dead appeared on the screen behind him. “This is the consequence of your job,” he began. “These Marine lieutenants were all leading their platoons, and this was their reward. You should expect no better. There’s a bullet waiting for every one of you . .  . and it’s up to the one shooting it to miss, because you can’t dodge it when it comes. You’ll be in front. First to go and last to know.” An image came up of a man who had been hit in the face with an RPG, a softball-sized hole clean through the middle of his inflated head, his cartoon features ballooned to each side of it. “His last words were, ‘Follow me,’ and those will be yours, candidates.” The mangled bodies continued to appear, one with a young peaceful face that showed no trauma. He looked to be asleep and unharmed. Below his shoulders, there was no body.[5]

Then, to further desensitize them to blood and gore, young officers at IOC are sent in pairs to a local hospital ER to observe the carnage that comes through the doors at night. The

Second Lieutenants at the Infantry Officer Course are required to observe hospital emergency rooms like this one, in order to gain some desensitization against physical trauma.

Second Lieutenants at the Infantry Officer Course are required to observe hospital emergency rooms like this one, in order to gain some desensitization against physical trauma.

officers see victims of stabbings, beatings, and shootings.[6] And as the doctor had predicted to Nathaniel Fick, many officers do find the broken bodies shocking. But not all. Former Marine Captain Nathan Smith remembers that the hospital ER was relatively quiet (and thus unhelpful for its purpose) the night he attended. “Plus,” he says, “those weren’t my guys lying on the gurneys. They were strangers. It’s an entirely different experience when you see one of your men who has been killed or wounded in combat. Nothing prepares you for that.” [7]

[1] Former infantryman Brian Mockenhaupt describes such training at the Marine Corps Base in Camp Pendleton: “This village—complete with plastic fruits and vegetables in the market stalls, scent machines that can pump out the stench of singed hair and rotting trash, and bomb victims gushing fake blood—represents one of the most noticeable shifts in military training over the past decade. By running mock scenarios that introduce mental and physiological strain, trainers can help troops adjust faster and perform better in the real situation, and make them less likely to be overwhelmed by chaotic or ambiguous events. This is inoculation, same as a flu shot: a dose of stress now can stave off more-severe effects later.” A State of Military Mind From June 18, 2012. Accessed 11/15/12.

[2] “We were not being trained, we were merely being thinned out. The instructors probably had a feeling of diminished returns on their time. But they played their role, and we never knew how much of it was an act. He stood and did an impersonation of the instructor in Full Metal Jacket. ‘What makes the grass green?!’ At the top of our lungs, and with true elation we screamed, ‘Blood, blood, blood!’” – Busch, Benjamin (2012-03-20). Dust to Dust: A Memoir (pp. 235-236). Harper Collins, Inc.. Kindle Edition.

[3] Ibid., p.50.

[4] Ibid.

[5] Busch, Benjamin (2012-03-20). Dust to Dust: A Memoir (p. 234). Harper Collins, Inc.. Kindle Edition.

[6] Ibid., pp.51-52.

[7] From a personal interview with the author, 11/16/12.

About Nate

A 2003 graduate of the Virginia Military Institute and former Marine infantry officer, Nate is the Chief Operating Officer of Hire Heroes USA, a nonprofit organization that helps veterans get jobs. He holds a Master's in Public Administration from the University of Georgia. Nate lives with his wife and dog in Alpharetta, Georgia.
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5 Responses to Combat Loss and PTSD – Part 4: Preparing for Death

  1. Pingback: Combat Loss and PTSD – Part 5: When the Metal Meets the Meat | The Soldier's Load

  2. Troy Todd says:

    Steve and Nate, I am a chaplain working on a Th.M After two tours with Marines I am writing a thesis on their difficulty admitting the need for help when they have the symptoms of PTSD. Nate, you are amazing and no one knows what it is like to walk in your shoes.
    I have enjoyed reading your joint work for Steve’s Th.M thesis.
    Blessings to you both!

    • Nate says:

      Troy, thank you for your kind words and for your service as spiritual caretaker for my fellow Marines. My best for your success and happiness as you complete your degree.

  3. Pingback: Combat Loss and PTSD – Part 6: Memorials and Healing | The Soldier's Load

  4. Pingback: Combat Loss and PTSD – Part 7: When the War Continues – PTSD | The Soldier's Load

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