The setting of the poem contributes greatly to the meaning. The title, “Casualty-Mental Ward” is essential to understanding the setting. I personally think that the setting takes place in a mental ward itself and that the speaker is a patient there. This can be seen by looking at line 16, “As all eyes close, they gather around my bed.” The fact that the speaker is in a bed surrounded by others, makes it seem as if he is at mental unrest. It is almost as if the speaker is being strapped down and watched over constantly.
The fact that the whole poem takes place in a mental ward can be further proven through Scannell’s use of diction. The words “they” and “their” are used frequently throughout. These words refer to two different sets of people. The more obvious group of people is the dead people themselves. More specifically, they are the dead soldiers, the ones that the speaker has seen die during the war. Lines 9 and 10 read, “I hold long conversations with the dead. Their presence comforts and sustains like bread.” The use of the word “their” in this case is an indication that the speaker is crazy. The speaker feels comfort in talking to the dead just as much as we feel comfort in eating food. The conversations with the dead are like sustenance for him, the last thing that is keeping him from going completely crazy.
The words “they” and “their” however, does not only refer to the dead, but also the doctors in the hospital. Please look at the lines following the ones I just read (lines 11 to 13): “When they don’t come it’s hard to be resigned; Something has gone wrong inside my head. They know about the snipers that I dread.” In these lines, the “they” is referring to the doctors. The speaker finds it hard to remain calm when the doctors aren’t near him, something that is common with many mentally ill people. Also, the doctors are well aware of the speaker’s situation, they know that he is traumatized after being in war, and the snipers and mines that he dreads.
Lines 9-13 clearly show how lost and crazy the speaker is. As I said before, in the fourth stanza, the speaker mixes up whom he is referring to. On line 10, he says, “Their presence comforts me like bread” (referring to the dead soldiers), and on line 11, he says, “When they don’t come it’s hard to be resigned” (referring to the doctors). The fact that the reader is mixing up personas even in the same stanza shows how unstable his state of mind is. It is unclear what he is talking about, another common trait of a mental patient.
Finally, in the last stanza, the two sets of personas – the dead people and the doctors – seem to come together. This is shown through the use of the word “all” in line 16 of the last stanza. “As all eyes close, they gather around my bed and whisper consolation.” At this point, it is not clear whom the speaker is referring to. It could be both the doctors that are comforting him as well as the dead soldiers. This quatrain shows both the coming together of the lines, “Something has gone wrong inside my head” and “I hold long conversations with the dead”, as well as connecting the two groups of personas. This, in turn, creates a kind of creepy effect, showing the intensity of this man’s insanity.
The form of this poem is parallel to the theme itself. In a villanelle, the first line and the third line of the poem are repeated constantly. No matter what else the speaker says, he ultimately goes back to the lines “Something has gone wrong inside my head” and “I hold long conversations with the dead.” This creates a circular effect in a way, as the poem starts with the same lines and ends with the same lines. Also, there are only two rhymes in the poem, rhyme A and rhyme B. The poem begins with rhyme A (head) and finishes with rhyme A (dead), again creating this circular form. The circular form of the poem is parallel to the roundabout thinking of the speaker. The speaker constantly repeats himself over and over again, starting with the same thought and ending with the same thought, unable to escape the effects of war.
The circular form in the poem is similar to the chapter “Speaking of Courage” from Tim O’Brien’s The Things They Carried. In that chapter, it is evident that Norman Bowker is struggling to get over war, struggling to move on and live a new life. He goes around the lake several times over and over again, the thoughts of war constantly circling through his mind as well. The death of Kiowa haunts him deeply and he cannot stop thinking about it. Just like the speaker in the poem “Casualty-Mental Ward”, Bowker does not communicate his feelings with normal conversation. Instead, he has to imagine possible conversations with people, wishing that he could talk to his dead friend Max Arnold – the one person Bowker felt actually understood him. Similarly, the speaker in the poem cannot communicate his emotions with the people around him, relying on the comfort of the dead soldiers.
It can be seen from this poem that war has a detrimental effect on its soldiers. Some people, like the speaker in this poem, can never forget the atrocities of war and can hence, never move past it. The setting of the poem, at first, seems like it is in a war scene as on line two it says, “The sappers have left mines and wire behind.” However, the setting is not at war. Rather, it is the thoughts of the speaker that is still at war. Even though the speaker is in a mental hospital, he keeps imagining war scenes. This makes it clear how insane the speaker is. Lines 7 and 8 read, “Not just the sky but grass and trees are red. The flares and tracers – or I’m color blind.” The speaker sees peaceful things in nature, such as grass and trees, and sees them in the gruesome, bloody color red. Despite being trapped and held down in a mental ward, the speaker does not stop thinking about death and war.