Fictions of Rehabilitation
By Mark Whalan, PhD

Cover of Dr. Whalan's recent book, World War One, American Literature, and the Federal State

Fictions of Rehabilitation
Bu Mark Whalan, PhD

My recent  book examines the Homefront in the US in World War One, and specifically how American literature engaged with the fierce debates that roiled US society over the rights and responsibilities of citizenship in wartime, and over what the state was empowered to do in moments of national emergency. As the US state expanded into new areas of American life—through conscription, the nationalization of the railways, and the control of information flow and the mass manufacture of propaganda, for example—authors considered what this meant for the experience of everyday life, and how they could imagine the new communities and identities expanded state power had seemingly brought into being. One of the most interesting arenas this happened in was government-run healthcare, as WWI saw a complete transformation in the ideas and institutions the government deployed to assist wounded veterans. These changes revolutionized customary ideas about disability, and about male citizenship—changes often taken up and contested by authors of the era, some of whom were wounded veterans themselves.

My analysis drew heavily on two recent works of history—Beth Linker’s War’s Waste: Rehabilitation in World War One America and John M. Kinder’s Paying with their Bodies: American War and the Problem of the Wounded Veteran. Linker and Kinder discuss the War Risk Insurance Act, or WRIA, which passed in 1917 and broke decisively with the pension system used to support Civil War veterans, a system which by 1917 was a byword for bloated government spending and political clientelism. It’s hard to believe now, but before WWI the US was infamous for having a lavish, and even bloated, welfare state, a reputation entirely due to its expenditure on Civil War pensions. By 1915, the U.S. had spent more on Civil War pensions than it had on prosecuting the war itself. In consequence, it became a target for Progressive reformers keen to reduce budgetary “waste” and eliminate political cronyism.

WWI Amputees at a Red Cross Event in 1919. Image source: http://www.thehistoryblog.com

In anticipating a new generation of wounded veterans, the WRIA sought to reform this system. It aimed to provide maximalist medical cures to wounded veterans rather than pensioning them off, an ambition hitched to the expectation that disabled veterans should undergo medical rehabilitation treatment and then re-join the workforce. As Kinder observes, rehabilitation was “an integrated program of physical and social reform combining orthopedics, vocational training, psychological counseling, and industrial discipline” that became the cornerstone of how the US government would frame its obligations to the disabled veterans of World War One and in all subsequent wars (117). The government undertook a massive hospital building program in support of this effort, building 58 general and specialized hospitals nationwide controlled by the new VB, and also established an enduring “ethic of rehabilitation,” in Linker’s words, which proposed that “medicine can cure disability and, more important, solve the social problems brought about by a war that fundamentally disrupts the lives of its citizens” (180). Yet this ethic also meant that soldiers were no longer heroic simply by the fact of being wounded. Now, full male citizenship was only achievable through a successful return to the workplace, ideally in work that supported a wife and family who stayed at home. Retirement and subsistence on a pension—being a “home slacker,” in the parlance of the time—was increasingly seen as infantilizing or feminizing. The WRIA had the government pay in full for disabled veterans’ medical care for the first time, but it also made rehabilitation mandatory, refusing honorable discharges for those servicemen who rejected it.

Such sweeping changes necessitated a government media offensive. Consequently, the “ethic of rehabilitation” was loudly and diffusely promoted across the Progressive press, and especially in the kind of public information apparatus of state-funded magazines and publicity bureaus that was such a hallmark of Wilsonian Progressivism. Most interesting to me was Carry On: A Magazine on the Reconstruction of Disabled Soldiers and Sailors, produced by the Office of the Surgeon General and which ran for ten monthly issues, beginning in June 1918. Aimed at veterans, a general public, and medical professionals alike, it presented a mix of essays, speeches, feature articles, photographs of rehabilitated veterans, fiction, cartoons, and even comic sketches. In general it promoted a vision of veterans enacting a smooth transition from war disability to success in the workplace and in the marital home, through the agency of rehabilitative medicine and vocational training. 

Carry On published pieces by Woodrow Wilson, Theodore Roosevelt, Samuel Gompers, Charles M. Schwab, and John Galsworthy. From its March 1919 issue onward, the magazine’s frontispiece was the “Creed of the Disabled”: “Once more to be useful--to see pity in the eyes of my friends replaced with commendation--to work, produce, provide, and to feel I have a place in the world--seeking no favors and given none--a MAN among MEN in spite of this physical handicap.”

Cover of Magazine, Carry On. Image courtesy of Mark Whalan.

Most of Carry On’s pieces echoed this creed, and rejected what it characterized as the culture of dependency that the Civil War pension system had fostered. It was full of pieces on what disability scholars term “supercrips,” individuals lauded for “triumphing” over disabilities to win extraordinary success. Theodore Roosevelt, perhaps the most famous American to have “overcome” a disability, was the subject of an early, lavish puff piece of this kind. In addition, the more extreme of the magazine’s editorializing suggested that successful re-integration to the workplace was largely a matter of individual willpower. As one editorial writer put it, “the only hopeless cripple is a deliberate shirker.”  Yet just as important to the magazine as this kind of high-handed exhortation to wounded veterans about their ongoing medical obligations were its attempts at “reconstructing the public,” in the words of Assistant Editor Arthur H. Samuels. This broader public campaign aimed to encourage well-meaning wives and mothers not to let their wounded husbands and sons “languish” in the family home under their care, but to engage with the professionalized and institutionalized practices of rehabilitation on offer from the government. It also criticized employers for well-entrenched practices of discriminatory hiring that excluded disabled men from the industrial workplace. Accordingly, the magazine boldly imagined itself as leading a wide-scale social transformation of attitudes toward war disability and male citizenship. Yet I was interested in how, even in the pages of Carry On, not all authors entertained such ambitions. In particular, some fiction writers were loath to abandon sentimental narratives about the potential of feminized, emotional care to restore wounded American men. Edna Ferber’s short story, "Long Distance," is one example.

Cartoon in Carry On Magazine. Image courtesy of Mark Whalan 

Set in an American rehabilitation hospital in England, it focuses on an incapacitated A.E.F. veteran and brawny Chicagoan who has lost his memory from shell-shock. It pokes fun at what it calls this “he-man” doing the dainty work of making tiny toy chickens in occupational therapy. In the end, what snaps him back to his normal self is not the wonders of modern rehabilitative medicine but a letter from his sweetheart at home.

The story, therefore, endorses well-entrenched ideas about the gendering of disability and therapy that Carry On elsewhere worked hard to overturn. The story mocks occupational therapy as infantilizing and effeminizing. Such condescension was in sharp contrast to the regular featuring of occupational therapy in the magazine, which occupied 1,200 women in American reconstruction hospitals in 1919. Similarly, Carry On took a stern attitude to the place of feminized “sentiment” in the practice of rehabilitation. It often characterized female compassion and sympathy as hindering wounded soldiers’ motivation to return to the workforce, and as repeating the mistakes of the Civil War system, which, they asserted, encouraged pension-dependent men to languish, unproductively, in the family home.

First page of story,"When a Feller Needs a Friend" in Carry On magazine. Image courtesy of Mark Whalan.

The rehabilitation program actively trained their occupational therapists to avoid sentimental attachments, and it discouraged excessive sympathy among wives and mothers of disabled veterans. Yet writers of popular fiction were less keen to relinquish the idea that women in the home had a unique curative power, an idea which had long been a staple of sentimental fiction. Instead, fiction writers frequently characterized sympathy or emotional connection from sweethearts, mothers, wives, or fiancées as carrying an unparalleled therapeutic value. “Long Distance” is one such example, but there were many others at the time, including several novels by Zane Grey and stories by Sinclair Lewis. American writers, therefore, tasked the new institutions of rehabilitation not to abandon the languages and the spaces of sentimentality, which were so deeply embedded in cultural scripts of how to restore disabled veterans to full vocational and marital achievement.

Veterans’ fiction also forcefully pushed back against the new ethic of rehabilitation. It often countered rehabilitative rhetoric’s optimistic account of willpower and discipline triumphing over embodied damage by forcefully identifying the stubbornness of injuries which refused to heal. And, it spotlighted the most glaring absence in the rhetoric of rehabilitation, namely pain. Pain was a word rarely found within Carry On’s cheerful accounts of rehabilitation—indeed, there were only ten uses of the word across its entire run. And partly in consequence, pain was wielded as a rebuke to such rehabilitative rhetoric in the work of several veterans who wrote about the process of coming home. In work by William March, Ernest Hemingway, and especially Laurence Stallings, pain becomes the center of both everyday experience and the practice of citizenship.

Yet what was most interesting to me was that few of these fictions completely rejected the new rehabilitation program. Instead, they tended to urge more complex accounts of how and where care occurred, and sought more embodied, experiential accounts of what it meant to suffer injury and receive medical treatment. As such, we can see these fictions of rehabilitation not just as attempts to understand new state institutions, but also as attempts to shape them.

To watch a CSPAN interview with Dr. Whalan about his book, The Great War and the Culture of the New Negro, click here.

To read further about WWI American literature, the services of African Americans, and the post-war treatment of WWI veterans in American, see Keith Gandal's post on WWrite, "War Isn't the Only Hell: 100 Years Later Telling the Truth About America and Lost Generation Experiences."

Author's bio

Mark Whalan is Robert and Eve Horn Professor of English at the University of Oregon. He is author of The Great War and the Culture of the New Negro (2008), American Culture in the 1910s (2010), and most recently, World War One, American Literature, and the Federal State (2018).