In contrast to the European theater, Sledge's memoir gives a perspective on the Pacific campaign. His memoir is a front-line account of infantry combat in the Pacific War. It brings the reader into the island hopping, the jungle heat and rain, the "banzai attack" or full frontal assault used by his enemies. Sledge wrote starkly of the brutality displayed by American and Japanese soldiers during the battles, and of the hatred that both sides harbored for each other. In Sledge's words, "this was a brutish, primitive hatred, as characteristic of the horror of war in the Pacific as the palm trees and the islands."
Sledge describes one instance in which he and a comrade came across the mutilated bodies of three Marines, including one Marine whose genitals had been cut off and stuffed into the corpse's mouth. He also describes the behavior of some Marines towards dead Japanese, including the removal of gold teeth from Japanese corpses (and, in one case, a severely wounded but still living Japanese soldier), as well as other disturbing trophy-taking.
Sledge describes in detail the sheer physical struggle of living in a combat zone and the debilitating effects of constant fear, fatigue, and filth. "Fear and filth went hand in hand," he wrote. "It has always puzzled me that this important factor in our daily lives has received so little attention from historians and is often omitted from otherwise excellent personal memoirs by infantrymen." Marines had trouble staying dry, finding time to eat their rations, practicing basic field sanitation (it was impossible to dig latrines or catholes in the coral rock on Peleliu), and simply moving around on the pulverized coral of Peleliu and in the mud of Okinawa.