Navy Seeks To Address Combat Stress Through Graphic Novel

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WASHINGTON, DC—The Navy is seeking to help prepare its hospital corpsmen to deal with the psychological stresses of war through a new novel.

USM_12-10-docs.jpgThe 200-page graphic novel produced by the Naval Health Research Center in San Diego, The Docs, depicts the lives of four fictional corpsmen who have deployed to theater and are grappling with personal and combat-related stresses.

It became clear that a tool was needed to reach hospital corpsmen, who are at risk for developing psychological injuries due to the unique role they play on the battlefield, explained Jerry Larson, PhD, chief scientist for behavioral health in the Behavioral Science and Epidemiology Department at the NHRC. Corpsmen serve as not only healers, but also at times as fighters, he said. “They are exposed to a very high level of combat relative to the other sailors that we send into the war zones. That combat exposure comes as a function of them going outside the wire with the marine corps units they are attached to … They are actually going out on conveys, getting shot at, and in some cases having to pick up a rifle and become a combatant.”

According to the Navy Bureau of Medicine and Surgery, 40 hospital corpsmen have died in the line of duty in the current conflicts.

The “dual role” they play can be very difficult at times, said Heidi Kraft, PhD, a clinical psychologist who serves as a consultant for the Navy’s combat stress control program and is one of the authors of the novel. “They are effectively combatants out on every single mission acting the same way as their marine patients, until one of those patients get hurt and then everything changes in that one instant.”

Graphic Novel Details Combat Stressors

Larson, who served as one of the authors and project managers for the novel, said that in late 2007 and early 2008 they were mulling over how they could address combat stress issues that hospital corpsmen face. The idea to use a graphic novel as a vehicle to educate and prepare the corpsmen through story telling was chosen as the way to go about doing this. “We know that graphic novels have exploded in popularity and actually are now the source of many movies being made. It involves story telling, rather than just presenting people with facts that they are supposed to memorize.”

While graphic novels tell a story like a novel, visually they have a comic-book style that utilizes dialogue contained in bubbles.

The content for The Docs draws upon the experiences that Kraft, a former lieutenant commander who served as a Navy psychologist in Fallujah in 2004, learned about from her patients when she was deployed. “Much of the stories were based on things I experienced and observed and things that my patients have told me as a clinician during the war and since the war. It is based on real exposure that corpsmen have.”

The novel begins predeployment with fictitious hospital corpsmen, 19-year-olds Jason Banks and Derek Jackson, 22-year-old Erica Mendez, and 38-year-old John Wallace. Each of these fictitious characters has different personal issues to deal with and all are faced with life and death situations in the war zone.

The novel even includes a storyline about one of the corpsman dying in battle and how another corpsman grapples with that death. The novel also portrays how the corpsmen and their fellow servicemembers relate with one another and deal with the stigma of seeking mental healthcare. The novel ends by bringing each of the individual stories to a conclusion.

Kraft said that the authors felt it was important to portray and address the stigma that corpsmen might feel in seeking mental healthcare. “It is a very large stigma that our military forces feel, and we thought it was important to have these four characters come face-to-face with that.”

Deploying the Graphic Novel

While some of the events in the book are specific to the conflict in Iraq, the authors stated that the novel is not intended to depict any specific time period or conflict, but is designed to be timeless. The novel was a team effort between the NHRC authors and Research Triangle International. Developing the story lines, drawings, and bringing the stories in the novel to a satisfactory close was a “long process,” Larson said.

So far, 5,000 copies of the book have been printed. Larson said they intend to work with the medical training battalions that prepare corpsmen to deploy to get the novel in the hands of corpsmen. “We are still in the rolling out phase of the novel. It is likely that corpsmen who have already deployed would benefit from this as well. We are now getting requests from Afghanistan to send copies into theater for the corpsmen who are currently deployed.”

A pdf of The Docs can be downloaded at http://www.med.navy.mil

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