Why We Call Someone Who is Insane a “Basket Case”

trench-warfareToday I found out how the phrase “basket case” came to mean “someone who is insane.”

At first, “basket case” didn’t mean someone who was crazy. Instead, it referred to someone who had a physical disability.

The phrase has its origins in World War I. Funny enough, one of the earliest known documented instances of the phrase was actually in denial that “basket cases” actually existed, as found in a bulletin issued in March of 1919 on behalf of the United States Surgeon General:

The Surgeon General of the Army… denies…that there is any foundation for the stories that have been circulated…of the existence of basket cases in our hospitals.

But just what was the Surgeon General referring to when he said “basket case”? When this bulletin came out, many newspapers felt the need to define the phrase for their audiences, so apparently the phrase wasn’t widely used at this point. They defined it as “a soldier who has lost both arms and legs and therefore must be carried in a basket.” (The Syracuse Herald, March of 1919)

Whether they were literally carried around in baskets as the newspapers stated or the phrase originally was just referencing the then common colloquial idea of associating baskets with beggars or helplessness, given the grisly nature of the First World War and anecdotal reports, it seems plausible enough that there probably were at least some “basket cases,” despite the Surgeon General’s denial.

As you can imagine, the original meaning of “basket case” was never incredibly common. It wasn’t until World War II that the phrase prominently resurfaced. Near the end of the war in May of 1944, once again, the Surgeon General attempted to deny that there were any basket cases:

…there is nothing to rumors of so-called ‘basket cases’—cases of men with both arms and legs amputated.

After World War II, the original meaning fell out of favor altogether, likely due to the lack of literal basket cases. However, for a while the phrase expanded to mean someone with a physical disability who was unable to get around by themselves easily.

Today, of course, it has further evolved to mostly be a slang phrase for someone with a mental disability, or someone who seems to have been moved to act in a crazy fashion for whatever reason.

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Bonus Facts:

  • Another slightly less well-known usage of the phrase today is to describe a business or organization that has been rendered helpless in some way—such as becoming wrapped up in a court case or filing for bankruptcy.
  • The band Green Day has a song called “Basket Case” which was written by vocalist Billie Joe Armstrong. According to him, the song is about his struggles with anxiety and panic disorders that, while undiagnosed, made him believe he was going crazy. In that case, the song is aptly named after the modern meaning of the phrase.
  • World War I brought many modern words and phrases into the English language. The war threw people of all backgrounds and ethnicities together in the trenches, meaning local dialects melted together. The British and American soldiers also adapted French and German words into their everyday language, which then left the trenches via letters (and in person by those soldiers who survived). The soldiers also sometimes made up words—like “lousy” and “crummy”. There were even some new items that hadn’t been named yet—like the “trench coat.”  (That coat in particular was developed to help officers fend off the cold, wet conditions in the trenches. The lower ranks simply had to make do.)
  • “Nose dive” originally referred to the WWI pilots’ tendency to sneak up and pounce on the enemy from above. Now, of course, it means any downward spiral, from “the stock market took a nose dive” to “her grades took a nose dive.”
  • “Pipsqueak” was a type of small German gun used in the trenches during the war, as well as a term used to refer to a second lieutenant. Now it refers to a small, usually mildly annoying person or someone without significance.
  • “Fleabag,” as in “a fleabag hotel,” refers to grimy and unsuitable sleeping arrangements. The word comes from slang used by soldiers in the trenches referring to their sleeping bags, which were often infested with fleas.
  • To go “over the top” once meant to jump out of the trenches and toward the enemy. Its use was popularized by a World War I account by Arthur Guy Empey.
  • One of the most popular French words that was commonly used by English speakers after World War I was “souvenir,” which quickly overtook “memento” in popularity.
  • The Germans contributed “kaput,” from the German “kaputt,” which meant “done for.” Today it means something that’s broken or ruined. They also gave us “ersatz,” which originally referred to substitute foods and materials
  • In Australia, a popular term developed from World War I is “Anzac” which refers to the Australian and New Zealand Armed Corps. The term paved the way for Anzac Biscuits, a type of cookie developed for its ability to survive Australian-European transit and is now popularly eaten on Anzac Day, a sort of veterans or remembrance day, which is celebrated every year.
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  • OED and others cite the first usage of pipsqueak (alt. pip-squeak) to 1910, and most sources agree that it is onomatopoeic, that is a word that is formed from a sound associated with what is named. For example, a baby bird might make noises that sound like a “pip” and “squeak” (squeak itself being an onomatopoeic). So, while I can accept that Allied soldiers may have given a small German artillery piece the nickname, I think it would be fair to say that its meaning has pretty much always been “something small or weak.” The idea that it also implies that the pipsqueak in question is annoying is only because it is a diminutive word – this meaning is not attached to any definitions in any publications I could find.

    • 2Lts in most Commonwealth armies have a single Star of Bath (also called a ‘pip’ in military jargon) on their rank insignia.

  • Early wheel chairs were often woven reed/wicker material and resembled a “basket”

  • I grew up understanding a “basket case” was someone in an institution for the mentally ill who was taught and practiced basket-weaving for therapeutic reasons.

  • The WW I usage of ‘basket case’ is described, mostly without the term per se, in an excellent novel about WWI that includes action in a hospital detachment.
    In that setting there were casualty patients who had lost, or lost control of limbs to the point that they were literally placed in wicker baskets and hung in them, rather than in cots.
    I read this book, one of the best about the war that I know of, decades ago. But I don’t remember the title or author.

  • The term ‘basket case’ is from the use of hanging wicker baskets to hold battlefield casualties in WW I hospitals.
    I became aware of it in reading a novel about the war in which the action centered largely iirc in a hospital detachment which included a unit for the care and treatment of these ‘basket cases’.
    I read the book many years ago, it seemed that it was well known, and I thought is very good, but I cannot recall the title or author.