Casualties.

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.

From an unlicensed philosopher: reflections on brain, mind, society, culture--each other's environments with equal "ontologic standing".

Philosophic conclusions drawn from work with psychologically and morally injured combat veterans include that brain, mind, society, and culture "co-evolved." The four encompass the complete human phenomenon, but not all are reducible to the physical brain. None of the four are "ontologically prior" to the others, when viewed over the entire lifecycle. All four are what I call "each other's environments," with obligatory cross-boundary flows--each with each in both directions. Rigorous, but nonreductionist interdisciplinary research, in the vein of "evo-devo" in embryology, is called for in the study of the human phenomena. On the basis of these conclusions, I offer a few practical comments on clinical work with psychologically and morally injured combat veterans.