#rip man

So.

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So as I mentioned in my previous post, this one is a little different. Leckie talked about being in the hospital numerous times during his time in the Marines- from malaria, to the enuresis, and of course, to him being wounded. His military file confirms this- out of everybody I've looked into, this man has a legit whole section for his hospital visits I won't post any of these- as I mentioned before, even if the man has been dead for 20-30 years, still feels a little odd to do so.

Instead, I wanted to use what Leckie experienced to talk a bit more about the experience in the Pacific and the numerous hardships Marines like him (and others fighting) went through. Please take this as a research starter- I've researched it best I can, but this is not an authoritative source, nor am I a medical/mental professional of any sort. That out of the way- let's get started!

March 1944- malaria time. He describes just how bad it was in his memoir- in fact, it's mentioned in his medical notes that the man had to be carried by stretcher, and that he had it 6-7 times by May '44. Malaria is no joke! Malaria is a parasite spread by mosquitos- in the South Pacific, primarily Anopheles minimus flavirostris. They thrived in these islands so no wonder malaria was such an issue. Now, malaria can only be spread by mosquitos- ie, one mosquito bites an malarial person, then bites a healthy one- the parasite is in the blood and can spread that way. So it's not like Leckie could just cough on a nurse and give it to her- but a mosquito might bite him and then bite her and she could get it that way. It can include fevers, chills, aches, headaches, vomiting, diarrhea (among others), and can reoccur in the form of malaria 'attacks' for years after you initially recovered. for Example, RV Burgin got malaria in 1945, but suffered attacks all the way to 1947. Now malaria in the Pacific was devastating. People knew how to prevent and control; it's just doing that in war was difficult. Supply issues and lack of doctors who specialized in tropical medicine contributed to the problem. Plus, as you might hear in a Marine's memoir, Atabrine needed to be given regularly to be at all effective (which even then, it wasn't 100% fool proof) but many men avoided it due to its bitter taste, real and imagined side effects. Quinine- the traditional drug- had effectively been cut off due to Japanese and German conquests.

Malaria wasn't usually fatal for American soldiers, but due to the compounding nature of infection, how quickly it could take a man out for a prolonged period of time, it could greatly reduce the strength of a unit, division, or regiment. For example, in the defense of the Phillippines, about 24,000 of the 75,000 American/Filipinos were infected. That's against 57,000 healthy Japanese soldiers. It's hard to say if Malaria really turned the tide of battle (so, so, so many factors here) but it sure did not help. Only with concerted efforts to fight Malaria, including the introduction of DDT in 1943 (first tested on soldiers with the typhus epidemic in Italy being very effective), was the Army able to turn the tide by the end of the war. Japanese meanwhile became more and more harder hit, with probably around 90% of troops having malaria in the last days of the war as they encountered supply struggles. Source 1, Source 1

May 1944- the enuresis. So Leckie would not be the first nor the last GI to suffer this malady. Psychologists- mostly Freudians like the one he meets- would have seen enuresis as part disability but also as a sign of mental unfitness. Even after clear battle trauma, enuresis might've just been a sign that the patient had been secretly unfit all along. Remembering the large mental casualties of World War I, the recruitors tried their best to weed out potential mental issues- or those they deemed mentally weak and likely to crack. Despite their efforts, soldiers, Marines, sailors, and airmen continued to suffer from trauma and breakdowns in such large amounts that it showed that all men could potentially be affected by PTSD, not just simply as a result of some inherent cowardice, mental weakness, or flaw in their masculinity. Later, connections would be made recognizing enuresis as a potential symptom of trauma and stress. In 1947, psychiatrist Kyril B Conger in the Bulletin of US Army Medical Department, observed that "under combat and emotional stress"- a condition sometimes known as "buzz bomb bladder" would appear (enuresis). It is quite possible that in Leckie's case, his was related to combat stress and trauma- only appearing during Guadalcanal, New Britain, and upon his leaving Melbourne, ruling out, I believe, possibility of infection. No mention of infection exists in his medical files, though it is noted that while on the 'Canal, "lived on what he could gather up or steal," as well as being "somewhat restless and tense,". Enuresis would and continues to remain an issue for many veterans due to stigma and trouble getting benefits, whether related to mental distress, or the after affects of Agent Orange cancer surgery (because the Vietnam vets just did't have it hard enough). Source 1, Source 2

September 16, 1944- blast concussion. In the initial days of the Peleliu campaign, Leckie is wounded- blown up by a mortar shell which hits an ammunition dump- so a little different than the show, but pretty much the same result. Leckie gets what's called a blast concussion- along with some back stiffness- in modern days, we'd call this a Traumatic Brain Injury (TBI). TBIs usually result from a violent jolt to the head/body- but can also be caused by something going through the brain tissue (think a bullet or metal fragment). Depending on the severity of a TBI, symptoms can range from headaches, nausea, loss of balance and problems with speech, to the memory, concentration issues, mood swings, and the more severe loss of consciousness, inability to speak, loss of coordination, weakness or numbness, profound confusion, unusual behavior, or comas. It can also cause repeated long-term issues such as seizures depending on severity and how much it happens. Even mild TBIs (mTBIs) can be problematic if repeated again and again. So, safe to say- Leckie wasn't having a good time.

TBIs have a long history in US military medicine- dating back to the Civil War. In WW1, this was often recognized as shell shock, with later understanding that sometimes there wasn't a clear distinction between combat-related PTSD and blast TBIs. However, with improved medical knowledge, survival rates from head injuries had gone up dramatically in WW2, leading to more need for rehabilitation.This had been due to penicillin, but also the innovation of mobile neurosurgical units by battle zones, and redesigned helmets. The WW1 dough-boy helmet did not protect the wearer's back neck, and so prior to the war, redesigns had been made with "visor and skirt-like extensions were added to protect the back and sides of the skull, and a suspension system and adjustable liner elevated the helmet from the head"- that's what Leckie and other American servicemen wore. Now, with the modern War on Terror conflicts such as Iraq and Afghanistan, improved body armor helps survival, and medical understanding increases, but blast-related TBIs have nonetheless become the most common injury faced by servicemen and women- creating a situation one of my sources likened to the aftermaths of British offensive of Somme, July 1916. Source 1, Source 2, Source 3

So that's the three most notable things that Leckie undergoes. I really wanted to highlight them as they have both historical revelance during World War II, and continued revalance for Leckie's modern counterparts in the military. Again, please note- I am not a medical professional. Please take this as a research starter and more about providing a medical history rather than a diagnosis or professional understanding of these conditions.