Shay Jonathan
Boston Department of Veterans Affaris Outpatient Clinic.
Daedalus. 2011;140(3):179-88. doi: 10.1162/daed_a_00107.
Privation and disease have mainly killed soldiers until very recently. Now that enemy action predominates, faster and better control of bleeding and infection before and during evacuation spares ever more lives today. This essay focuses on psychological war wounds, placing them in the context of military casualties. The surgeon's concepts of 'primary' wounds in war, and of would 'complications' and 'contamination', serve as models for psychological and moral injury in war. 'Psychological injury' is explained and preferred to 'Post-Traumatic Stress Disorder', being less stigmatizing and more faithful to the phenomenon. Primary psychological injury equates to the direct damage done by a bullet; the complications - for example, alcohol abuse - equate to hemorrhage and infection. Two current senses of 'moral injury' equate to wound contamination. As with physical wounds, it is the complications and contamination of mental wounds that most often kill service members or veterans, or blight their lives.
直到最近，匮乏和疾病一直是导致士兵死亡的主要原因。如今，敌人的行动成为主要因素，在撤离前和撤离过程中更快、更好地控制出血和感染，使得更多生命得以挽救。本文聚焦于心理战创伤，将其置于军事伤亡的背景下进行探讨。外科医生对于战争中“原发性”伤口以及伤口“并发症”和“污染”的概念，可作为战争中心理和道德创伤的模型。文中对“心理创伤”进行了解释，并认为它比“创伤后应激障碍”更可取，因为它较少带有污名化色彩，且更忠实于这一现象。原发性心理创伤等同于子弹造成的直接伤害；而并发症——例如酗酒——等同于出血和感染。“道德创伤”目前的两种含义等同于伤口污染。与身体创伤一样，精神创伤的并发症和污染最常导致军人或退伍军人死亡，或毁掉他们的生活。
