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The months of June and July are punctuated by holidays that elicit increasingly rare emotions in the U.S. – feelings of national pride and patriotism (minus the vitriol). On June 6, we and our allies in the U.K., Canada, and other countries marked the 80th anniversary of D-Day, the day historians often refer to as "the beginning of the end" of World War II.

The massive, highly complex D-Day invasion landed an estimated 156,000 soldiers on the beaches of Normandy, France. Well-entrenched German troops killed more than 4,000 Allied soldiers and left many more wounded that day. But, despite this unimaginable toll, the Allies pressed on to liberate northern France by August 1944 and to defeat the Germans by the following spring.

Like many of my fellow "Boomers," I grew up in a "patriotic" household where discussions about D-Day and World War II were a natural part of family conversations. I was only 9 years old, but I vividly remember watching a 1965 CBS Special documentary with my late father. It featured quintessential reporter Walter Cronkite riding in a jeep with retired general (and former President) Dwight Eisenhower on a revisit to Normandy's beaches. The discussion was about fighting for what is right; Eisenhower reasoned that the unprecedented invasion was really a battle for "freedom."

Last month, my wife and I joined a Brown University Alumni Tour of Normandy. Even though I'd done considerable reading, I found actually being there a profoundly moving experience. One thing that is impossible to grasp from the old newsreel snippets of the invasion is the magnitude of the "beach" – there were five points of attack along a 50-mile stretch of beach! While standing on Omaha Beach where a colleague's father helped win the battle, I collected a small scoop of sand to bring to my colleague in a commemorative glass container.

Imagining the logistical problems of D-Day and the battles that followed was mind-boggling. Weather forecasting was nascent at best. There were no computers to track and manage the hundreds of ships and landing craft that carried tens of thousands of troops. There was no easy and certain way to notify French citizens in advance of the invasion. And, once Allied troops had overwhelmed the Germans at the beaches, reconnaissance was severely compromised by "hedgerows."

Since Medieval times, French farmland has been demarcated by these densely planted earthen "walls" with large boulders for reinforcement. Even today, they are impossible to see through and impenetrable without modern tanks. (The Allies' "low-tech" solution to identifying German troops hiding near the hedgerows was to follow the ever-curious French cows.)

What have we learned from D-Day and WWII from a population health perspective? One lesson that continues to resonate today is a recognition that the debilitating effects of post-traumatic stress disorder (PTSD) require intense ongoing medical treatment. D-Day historian Stephen Ambrose noted that 25% of casualties were uninjured physically but experienced symptoms like shaking and inability to hear or speak.

Typically diagnosed as having "battle fatigue" or "shell shock," these soldiers were frequently returned to the battle front. We've learned that in situations of armed combat, approximately 10% of people who experience traumatic events will develop serious mental health problems; another 10% will develop behaviors that hinder their ability to function effectively.

Depression, anxiety, and psychosomatic problems are the most common effects of PTSD, and those who are particularly susceptible to its consequences include: civilians within a targeted homeland, soldiers on both sides of a conflict, and individuals exposed to images, videos, and audio of the war through social media, television/radio, and the Web. In the U.S., we're continuing to identify and address long-term effects of PTSD on our soldiers and veterans who experience more homelessness, high suicide rates, higher overall medical complications than other populations, more dysfunction within their families, higher unemployment rates, and more substance use than other populations.

Retired U.S. Army general Michael Garrett recently reflected on D-Day that "the dual outcome of victory and tragedy remains unique in human history." I sense a parallel as I reflect on the dual outcomes of the recent COVID pandemic: the resounding victory over virus that for a time threatened all humanity versus the tragedy (unprecedented loss of lives and livelihoods, collapse of the healthcare delivery systems, etc.).

The enduring message here is clear. Do we have the same sense of purpose to repair our broken healthcare system that those soldiers displayed when they liberated Europe from Nazi tyranny? We owe those brave youngsters nothing less.

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