Friday, May 14, 2021

Military Musings – “Arthritis” in the Head is worse than Arthritis in the Knee


In earlier times – Senior Military and Naval Officers were on the “healthier side” – stout, podgy, rotund – call it what you like – and – by today’s standards they would have been considered overweight – or even “physical unfit” – and maybe – they would have been put in low medical category and their promotions would have been stopped.

One may recall the stockily-built Admiral N Krishnan 

Admiral Krishnan was undoubtedly one of India’s greatest maritime heroes who saw action in World War II in several theatres  Arctic Ocean, North Sea, Norwegian Campaign and Indian Ocean and was awarded a gallantry medal, the Distinguished Service Cross (DSC), for his bravery in action – then commanded INS Delhi in the Goa Operations – and later – as the Flag Officer Commanding in Chief (FOC-in-C) Eastern Naval Command (ENC)  he was the principal architect of the Naval Operations, in the Bay of Bengal, in the 1971 War – for which he was awarded the Padma Bhushan. He wrote in his autobiography: “I have always believed that if force has to be used there has to be no pusillanimous or half-hearted measures. Preponderant force used to good effect always produces the quickest results.” He was a true war hero. 

I had the opportunity of seeing him from close quarters in 1977 in Cochin and also his pictures on INS Vikrant during the 1971 War  and  of course  you cannot miss Admiral Krishnan – the short stocky figure in whites with his cap at a jaunty angle in the famous surrender ceremony picture of Lt Gen A.K. Niazi surrendering to Lt Gen Jagjit Singh Aurora, in December 1971 at Dacca. 

By today’s standards  where only the “lean and mean” are considered physically fit – he would have been considered overweight (and unfit) – despite his mental robustness and proven record of bravery in war and leadership in combat.

On the other hand – we see superbly physically fit officers who are mentally and morally weak – and display un-officer-like traits like sycophancy and yes-man behaviour. Though they are physically fit – they are not mentally robust – and they lack the moral courage and mental toughness to stand up for their men, the service, and to uphold moral and ethical principles. One can observe their subservience, servility and obsequious behaviour in front of politicians, bureaucrats and their seniors in service. 

Physical fitness and mental robustness are two different attributes. Physical fitness does not automatically guarantee mental robustness. While no one underestimates the importance of physical fitness – mental robustness is as important – in fact – it is more important – especially for senior officers. 

The detrimental effects of overemphasis on physical fitness and neglect of mental fitness are visible among the military leadership.

Which is better – superbly physically fit sycophants – or – mentally robust officers...?

Isn’t mental robustness more important than physical fitness – especially at senior levels of leadership – where one has to be morally and mentally tough while dealing with the powers-that-be...?

While it is certainly desirable to be physically fit – one must remember that physical fitness and mental robustness are two different attributes – and – physical fitness does not automatically guarantee mental robustness. Examples of this are visible – don’t we see so many sycophants and yes-men who are superbly physically fit  and – on the other hand – mentally robust officers who may not look perfectly slim and trim (like Admiral Krishnan).

Here is an article I wrote on the subject a few years ago...

Is Mental Robustness more important that Physical Fitness...? 

Musings of a Veteran


In his autobiography  A SOLDIER’S STORY  General Omar Nelson Bradley (the renowned American General who commanded the 12th Army, the largest army in World War II, during the invasion of Europe) recounts an incident.

During the war  one of the best Corps Commanders,  General Troy H Middleton  suffered an arthritic disability in the knee and it was suggested to General Marshall (the US Army Chief) that Middleton be sent home rather than be given command of a army corps in the field which was engaged in active combat.

General Marshall retorted: 

I would rather have a man with arthritis in the knee than one with arthritis in the head. Keep Middleton there.”

General Marshall was proved right.

In Europe, as a part of Patton’s 3rd Army, Middleton commanded VIII Corps with distinction and successfully led it throughout the European Invasion all the way from Normandy to the Elbe.

Middleton was a seasoned campaigner, having commanded 45th Infantry Division in the Sicilian Campaign in II Corps (commanded by Patton and later by Bradley).

He was then promoted to command VIII Corps in Patton’s Third Army during the invasion in Europe, when he was struck by an attack of Arthritis.

Marshall’s insistence that “I would rather have a man with arthritis in the knee than one with arthritis in the head”  was proved right as Middleton performed brilliantly as a leader especially in the  Battle of the Bulge   (described below):

“Had not Middleton, egged-on by Patton, ordered unrelenting attacks against the assaulting Nazis  and  had not his infantrymen and tankers risen to highest levels of gallantry  the Germans certainly would have overcome the 101st’s resistance and been able to re-establish their supply lines leading to Bastogne”

Following this battle  Middleton led VIII Corps in its relentless push across Germany right into Czechoslovakia when Germany surrendered and the war ended.

Before the Battle of the Bulge  his leadership in Operation Cobra led to the capture of the important port city of Brest, France  and for his success he was awarded a second Distinguished Service Medal by General George Patton.

Middleton was recognized by both the Supreme Allied Commander Eisenhower and Army Commander Patton as being a corps commander of extraordinary abilities.

General Patton had recommended that if he became a battle casualty  then General Middleton should succeed him as commander of the 3rd Army.

Despite being “physically unfit” due to arthritis  General Middleton spent over 1200 days in war conditions in the field  ever since departing from America in January 1942.

Middleton logged 480 days in actual combat during World War II  more than any other American General Officer.

General Troy H Middleton achieved this remarkable and most spectacular military success despite have been stricken by arthritis in the knee.

(In India  he would have probably been declared a Low Medical Category (LMC) and he would have been invalided out of the Army on medical grounds – so powerful are our Army Doctors – they can ruin career prospects of competent officers by the dreaded weapon of medical category)

This true story  of the arthritis afflicted General Middleton narrated above  exemplifies the importance of mental fitness for a military officer  especially in senior ranks.

Mental fitness is certainly as important as physical fitness  if not more.

For Senior Officers – mental agility and moral robustness may be more relevant to providing leadership – than running cross-country races. 

In some cases  especially for senior officers  mental fitness is much more important than physical fitness.

The importance of mental fitness over physical fitness is exemplified in the words of General Eisenhower (when it was repeatedly recommended to him by doctors that General Middleton should be sent back to America after his success in Africa and the Sicilian Campaign, as General Middleton as afflicted with Arthritis and he was not physically fit for the forthcoming Invasion of Europe). 

General Eisenhower remarked about General Middleton: 

“I don't give a damn about his knees  I want his head and his heart. And I’ll take him into battle on a stretcher if we have to.” 


General Marshall supported General Eisenhower’s opinion

I would rather have a man with arthritis in the knee than one with arthritis in the head. Keep Middleton there.”


Military history is replete with examples of this – during World War II, Fredendall  was replaced by  Patton after American Forces suffered a reverse at  Kasserine Pass  Auchinleck was replaced by Montgomery after defeat in the first battle of El Alamein  and even during the 1962 Sino-Indian conflict – a move was made to replace Kaul with Harbaksh Singh (decision reversed with disastrous consequences but  finally  Kaul was replaced by Sam Manekshaw  but by then  it was too late  as the war was over. 

Will it not be apt for the Indian Armed Forces  obsessed with medical categories”  to mull over these words on the importance of mental fitness in senior officers.



In the Armed Forces (Army Navy Air Force) – is mental fitness considered to be as important as physical fitness...?

YES – and – NO 

In the beginning (at the time of recruitment): 

Yes – for Officers  both Physical and Mental Fitness are evaluated in the initial selection process.

In India, the selection process for an officer in the armed forces (army, navy and air force) includes assessment of both physical fitness and mental fitness.

Physical fitness is tested at the Services Selection Board (SSB) followed by a thorough medical examination at the Military Hospital (MH).

Mental fitness is analyzed by various psychological tests, group tasks and interviews at the SSB.

Thus  both physical and mental fitness are confirmed before selection.

Thereafter – physical fitness is evaluated and confirmed every year by an Annual Medical Examination (AME) and Physical Evaluation Test (PET).

If an officer does not meet the specified standards  the officer’s medical category is downgraded – and his career is adversely affected  as the officer is considered unfit for combat duties.


Physical fitness is not taken for granted.

This is because it is felt that physical fitness of a person can change over the years depending on one’s health and the attention one pays to maintaining oneself.


However  mental fitness is never evaluated during your entire military career once you have been commissioned as an officer.

Mental fitness is taken for granted.

It is assumed that mental fitness does not change and there is no need to “examine” and confirm an officer’s mental fitness every year.

However  like physical fitness can change with time  similarly  mental fitness can also change over the years depending on life experiences.



Physical toughness and mental robustness are two different attributes.

Physical toughness does not automatically guarantee mental robustness.

Yes, it may not always be true that all physically tough persons will necessarily be mentally robust as well.

In the army, physical toughness may be more important for junior officers, but for senior leadership it is mental robustness that matters.

In his book  The Unfought War of 1962”  the author JR Saigal cites the example of his Brigade Commander who was physically tough but mentally weak-willed.

As a junior officer, he had suffered harrowing experiences as a prisoner of war during the Second World War and was determined not to become a prisoner again.

The Brigade Commander became so jittery when he heard of the advancing enemy that he abandoned his troops and fled from the battlefield even before the attack was launched by the enemy.

The author says that a person with such a vulnerable mental make-up should not have been posted anywhere near an operational area.

Yet such a shaky and mentally unfit officer was posted to a crucial command appointment – and that too in war.



In the Navy too  I have seen many officers  who were mentally robust in their younger days  become mentally soft and lose their boldness as they become senior – due to their fervent ambition and fanatical obsession to get promoted to higher rank.

In their quest for promotion at any cost  these officers fall victim to the “ACR Syndrome” – since promotion is solely dependent on the all important ACR (Annual Confidential Report).

I once saw a Commanding Officer become a nervous wreck in his quest to earn an “outstanding” ACR – there were 10 other highly ambitious Commanding Officers in the Fleet of the same rank competing with him for promotion, and, he knew that the vacancies were very few, so the cut-throat competition was very tough.

I was astonished by the change in the mental makeup of this officer, since the same officer had been a robust happy-go-lucky carefree individual in his younger days.

It seemed that zero error syndrome coupled with his extreme ambition had made him fearful and lose his mental robustness.

Instead of enjoying his command, he was stressed out, since, due to his obsession for an “outstanding” ACR, he was doing a few things which he knew were wrong.

It is quite ironical, that instead of becoming more and more mentally forceful as they become senior, some highly ambitious officers start becoming spineless, due to their servility to the powers-that-be, as they crave for career-success and even yearn for post-retirement sops.

Thus, by the time they reach high rank, long years of submissiveness severely compromises their mental robustness and this may affect their command capability, especially in a crisis.

You cannot expect an officer to be a “dog in obedience” and “lion in action” at the same time.

Similarly  once an officer who was a “lion in action” gets slowly converted into a “dog in obedience” – it is very difficult to instantly re-convert the “dog in obedience” back into a “lion in action”.




One solution to alleviate this problem is to have an Annual Psychological Examination (APE) to assess the current “Mental and Emotional Fitness” of an officer and ascertain his suitability for leadership in combat situations.

In today’s world, modern tools and techniques are available to conduct such psychological tests.

All that needs to be done is to include an Annual Psychological Examination (APE) along with the Annual Medical Examination (AME).

It is as simple as that.

The APE will ensure that the military will have officers at the top who are as mentally robust as they are physically tough.

Hopefully – the Annual Psychological Examination (APE) will ensure that those with “arthritis in the head” will be weeded out – and only mentally robust officers are promoted to high ranks. 

Dear Reader – if you don’t agree with me – please answer the moot question: 

Why do we see so many superbly physically fit officers who are mentally and morally weak – who display un-officer-like” traits like sycophancy and yes-man behaviour – who lack the moral courage and mental toughness to stand up for their men, the service, and to uphold moral and ethical principles – and who display subservience, servility and obsequious behaviour in front of politicians, bureaucrats and senior officers (top brass)...?

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1. These are my personal views based on my observations and life experiences and the stories and examples quoted may be apocryphal.
2. All stories in this blog are a work of fiction. Events, Places, Settings and Incidents narrated in the story are a figment of my imagination. The characters do not exist and are purely imaginary. Any resemblance to persons, living or dead, is purely coincidental.

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1 comment:

Aditya Pratap Bhuyan said...

Cmdr Karve, I always appreciate many of your articles. One humble suggestion Sir, as a very well read person and with huge knowledge about military history and heroes, why don't you write about them in Wikipedia. In wikipedia we could see mentions about other ranks of US Armed Forces, but in India we don't find heroes in public forums.