Mind Field

The "shell shock" afflicting some World War I veterans was thought to be physical, a lingering effect of blast waves. World War II veterans reporting "battle fatigue" were diagnosed with psychological problems, but some researchers classified nausea, shakes and involuntary bowel movements as normal reactions to combat. Limited studies done by the Centers for Disease Control, the American Legion and Columbia University found that Vietnam veterans suffered mental illness related to problems readjusting to civilian life.

For MacNair, Vietnam was the perfect petri dish: It involved close-quarters combat with soldiers who came face to face with those they killed.

At UMKC, MacNair solicited a copy of the National Vietnam Veterans Readjustment Study, the largest and most comprehensive statistical analysis of soldiers' reactions to war. Congressionally mandated in 1984, the study was performed by an independent survey firm and released by the Department of Veterans Affairs in 1990.

Tom Murtaugh, who coordinated the study, tells the Pitch that the data settled the question of whether vets' psychoses were real or peacenik propaganda.

After interviewing almost 1,700 American armed-forces veterans, researchers found that 50 percent of Vietnam vets suffered from mental problems. The rate of PTSD and other psychological problems was "often dramatically higher" among those directly exposed to combat. From the study came what is now the U.S. military's party line, that neurosis is a form of collateral damage. "[T]hose who were most heavily involved in war are those for whom readjustment was, and continues to be, most difficult," the report read.

MacNair decided to crunch her own numbers, breaking responses to the government's survey question ("Did you ever kill or do you think you killed someone in or around Vietnam?") into two categories: former soldiers who said they might have killed and those who said they hadn't.

Then, she looked at the percentage of PTSD-like symptoms each group reported. Her numbers showed that soldiers who said they had killed seemed much more likely to suffer psychological harm that those who said they had not, regardless of the battle intensity both groups had experienced.

MacNair concedes that researchers know of numerous wartime triggers for PTSD, but her theory is that killing someone is the most severe.

Murtaugh calls MacNair's work "groundbreaking" and has asked her to help design a follow-up study. And her efforts lured a standing-room-only crowd at an American Psychiatric Association meeting in August 2000, where MacNair shared a conference-room stage with two other PTSD authorities, Lt. Col. David Grossman (a Vietnam veteran and West Point psychologist) and William Chamberlain (who runs anger-management sessions for the VA's PTSD unit in New York).

Grossman's 1995 book On Killing cites a study by World War II historian Samuel Lyman Atwood Marshall, who interviewed troops after battle and concluded that only 15 percent to 20 percent of the men on the front lines had fired their weapons and that those who did often aimed high to avoid killing. Marshall said the reason wasn't cowardice; the men had stood their ground and performed other battle duties unwaveringly.

Grossman's position was similar to MacNair's. "Looking another human being in the eye, making an independent decision to kill him, and watching as he dies due to your action combine to form the single most basic, important, primal, and potentially traumatic occurrence in war," he had written in his book.

By Vietnam, troops had been retrained to shell entire battle areas rather than just to fire at specific targets. Ninety percent of men discharged their weapons -- supposedly at a ratio of 50,000 bullets for every one enemy soldier killed. MacNair discussed that evolution in combat strategy in her own book, Perpetration Induced Traumatic Stress: The Psychological Consequences of Killing, put out by Praeger Publishers, a textbook publishing company, in 2002. Recapping her research, she noted that such traumas have existed everywhere, in every culture and time period, not just in war. There are other risk groups to consider, she writes -- police officers who kill in the line of duty, prison executioners, abortion practitioners, even bullfighters and veterinarians who practice euthanasia. She supported her argument with a loosely connected series of anecdotes, referring to an NBC Dateline story about a police officer who committed suicide and to historical notes about the mental deterioration of Nazis after they had slaughtered Jews in concentration camps. She cited PTSD allusions from Dostoevsky's Crime and Punishment, Poe's The Tell-Tale Heart, Shakespeare's Macbeth and an episode of Star Trek Voyager.

"It shows that it's not some modern idea. It's been there throughout history," she says of the PITS concept. That her theory presented the foundation for a wide-scale platform against violence was no surprise. Before enrolling at UMKC, MacNair had made a career of confrontational activism.

MacNair has other statistics -- on her rap sheet. She has been arrested for civil disobedience 17 times -- 7 for protesting nuclear armament, 5 for protesting nuclear power plants and 5 for protesting an abortion clinic.

She was raised on political doctrine. Her father was a preacher and theologian, as was her grandfather (who was arrested at a civil rights sit-in in Alabama) and her great-grandfather (who proselytized in Thailand). Her mother heard Martin Luther King Jr. give his "I Have a Dream" speech in Washington, D.C., in 1963. MacNair spent her early childhood bouncing throughout the Midwest as her father chased lectern and pulpit work; MacNair's parents divorced in the late '60s, and she and her mother moved to Kansas City, settling in a bungalow with a big front yard near the Nelson-Atkins Museum of Art. MacNair's mother told her she could be whatever religion she wished.