Archive number: 1751
Preferred name: Tony
Date interviewed: 27 April, 2004
Consultant psychiatrist to Army HQ
Consultant psychiatrist to Surgeon General for Army, Navy and Air Force
You are listening to the interview audio
Tony if we could just start with what I talked to you about before, if you would put your life in point form, starting from your childhood?
Where I was born? I was born in Sydney in Mosman in 1939, the eldest of five boys. My father was,
during the war was in the air force in the intelligence. When he came back from the war he went from being a Clerk of Petty Sessions to studying law and then we moved about quite a bit so I went to quite a number of different primary schools. Then went to Canterbury Boys’ High School for the first three years of high school, same school as John Howard [Prime Minister of Australia],
then North Sydney Boys’ High School for the last two years and then I got a commonwealth scholarship to go to Sydney University where I studied medicine. It was whilst I was at Sydney University that the first of the last two national service schemes had come in and I was called up and went into the army, and in fact when my national
service obligation finished, I stayed in what was then called the CMF, the Citizens Military Forces, now the army reserve and so that’s when I graduated in medicine. I, in fact, was a lieutenant in the infantry. Now following graduation in medicine I did my first two years at the Royal Prince Alfred Hospital in Sydney and during
that period of time I transferred from the infantry to the medical corps and I was a reserve medical officer in a field hospital in Sydney. Then I went to Concord Hospital for two years. At that stage I was planning to become a specialist physician and it was during my second year at Concord, that’s my fourth year out from medicine, that
the battle of Long Tan occurred in Vietnam and the sergeant general at the time, I think it was the sergeant general, came around and interviewed all the single reserve medical officers to see if they could recruit more Australian medical staff and in fact that happened. I did some brush up on anaesthetics and work like that and then I joined the 7th Battalion
for a year and helped prepare it to go to Vietnam and then went with it, as its regimental medical officer, to Vietnam. Then when I came back I started studying psychiatry which I again did in Sydney, and on completion of my studies in psychiatry, I then worked in the
community setting in Sydney where I met my current wife. We got married and then I, in 1974 I think it was, yeah, I obtained a, I was awarded a World Health Organisation fellowship to go to the States where I studied for my masters in public health at Yale University for twelve months, then came back. Then over the next few years we had our children.
In the early ‘80’s, at this stage I was still working in the public service, in fact continued working in the public service until I was, till I retired. In the early ‘80’s for two years we went to Botswana as the, I was the consultant psychiatrist to the government there and that was under the Australia Aid program and then when
I came back I continued my part time work with the army. Morrie Sainsbury recruited me to do a clinic at Holsworthy which I continued to do, or Ingleburn then and later Holsworthy, until two years ago and I still now see patients for the ADF [Australian Defence Force] and my final posting with the army was as the
consultant psychiatrist to the surgeon general, so I finished up with the rank of colonel in the army and in ’97 I retired from the public service position I had. I was the director of the New South Wales Institute of Psychiatry which is a postgraduate training unit, and just continued doing part time clinical work. I’m still involved, as I mentioned, in seeing army patients.
I’m a ministerial appointment on the National Advisory Committee on the Vietnam Veterans Counselling Service and I’m the senior civilian consultant to the Australian Centre for Post Traumatic Mental Health in Melbourne and I also supervise on a regular basis the counsellors at the Vietnam Veterans Counselling Service in Sydney. During this period I’ve also done quite a lot of work with the World Health Organisation and
Australian Aid and I still regularly each year go up to Papua New Guinea for training and exam work. And during this period of time our children have grown up, finished school and we’re still living in the same house.
That’s perfect, fantastic.
So you see the dot to dots on?
Yeah, no that’s absolutely perfect thank you. So now we’re
going to go right back to the beginning. Your dad was in World War II, tell us about what he told you?
Well he actually never told me a lot. In fact he passed away in the early 80’s and I’ve probably found out more from my mother but from what I know, he was in the naval reserve before the war broke out and
when the war broke out, he offered to go in full time service and the navy at that time wasn’t taking any more people and because he was fluent in Japanese, he learnt Japanese at school, Fort Street Boys High School, he joined, the air force accepted him and he went into the intelligence and so he served with the intelligence in the air force. I know he was in Darwin around the time
of the bombing and I know he was in the islands, particularly Papua New Guinea, and then he was in the occupation forces at the end of the war and he finished up with the rank of squadron leader, then when the war finished he, as I mentioned, he stayed on in the occupation forces for a while and then came back to Australia. He was a Clerk of Petty Sessions
and he then embarked on studying law and he ended up being a solicitor.
What was your childhood like, what was Mosman like in the ‘40’s?
Well I was born I think in Mosman or around there but most of my childhood was in Rhodes and we lived with
my grandparents. I don’t remember much of my father. I remember once going to meet him at Rhodes railway station with one of my brothers and when he got off the train, ran away, frightened because I didn’t recognise him and then I remember when he came
back but, you know, I think we just lived a fairly quiet sort of life. I mean you drive through Rhodes nowadays and it’s quite different to what it was then. There was a big dump. It was regularly on fire. You could smell the dump and it was a pretty quiet sort of suburb.
What kind of games did you play with your four brothers?
We used to build, I know we used to build cubby houses and we had a sandpit, played in the sandpit. We had a dog,
pretty basic sort of things I think, you know.
Being the eldest of five, did you have particular responsibility?
Well I think so. I know when my father came back apparently I was a bit of a behavioural problem and I used to be sent to the country to friends’ properties. I actually didn’t like going but I’ve since found out that
my behaviour was interpreted, I was the top dog and I had to be knocked off the perch a bit, to mix a metaphor, if you like.
What did you do in the properties in the country?
I used to help with the sheep dipping and just general rouseabout work. I mean I was then about probably eight or nine. It was quite, looking back I think it was quite a good experience.
What was it at the time that you didn’t like about it?
I think being away from home and it was pretty isolated.
It sounds like you moved around schools a lot when you were younger, what was your education like?
Well I was educated in state schools. I think it was fairly disrupted because
in two ways. One was every time I’d make friends, we’d move and I’d have to make new friends so I’ve actually got no lasting friends from my childhood and high school days. They’re more now from university days and that mightn’t be uncommon I guess, but also I know that, I mean for example when I went from Canterbury Boys High School to North Sydney Boys High School, I moved from the top classes into the bottom classes because North Sydney
Boys High wouldn’t recognise Canterbury Boys High School’s marks so I had to, I sort of felt I had to prove myself academically each time. I think that made it difficult, however it didn’t stop me going to university.
Was North Sydney Boys School a selective school at the time?
Both were, both Canterbury Boys and North Sydney Boys were selective schools.
How stiff was the competition to get into them?
Quite stiff. The education system at that stage had a series of,
for boys, selective high schools, non selective high schools, technical high schools and intermediate high schools and the selective high schools were at the top.
What subjects did you take in high school?
In both schools languages were compulsory so
Canterbury Boys High School I did the three languages that most people did, French, German and Latin, then maths and geography and history. Then at North Sydney Boys High School you had to select which way you wanted to go, however you had to keep a language, so I kept French and then did physics, chemistry, English and general
maths, and in fact it was the first year general maths had been introduced into a selective high school and I remember the deputy headmaster making disparaging comments, about it was really a home science subject for girls and nevertheless I kept doing general maths.
Well how old were you when you finished your high school education?
And what did you do after that?
I went straight to university
so I turned seventeen half way through first year at university which wasn’t uncommon in those days. I mean it wouldn’t happen now and looking back I think it was probably too young to go.
You said you got a scholarship, how did that come about?
Well they had a system of commonwealth government scholarships where,
and I’m a bit vague on how it worked, but I think probably three quarters of the students were on a scholarship but I’m just not clear about that.
I didn’t ask you before, how did your mum handle your dad being away?
Well I think she found it fairly difficult, but it’s more talking to her now and I think
she had the supportive network of some of her friends whose husbands were also in the war and I think they were quite mutually supportive.
Getting back to your university education, what did you start studying when you first got to Sydney Uni?
And what was it like?
Well first year medicine,
because anyone who matriculated could get into university and there was no selection as there is now, first year medicine, I think we had about nine hundred and fifty in first year medicine of which under two hundred went into second year cause that’s where the selection actually took place then so it was a pretty hard slog cause you knew
that only a small proportion would actually get through that hurdle of the exams at the end of first year so I remember studying quite hard.
Of your North Sydney Boys High School fellow students, how many would you say went on to university?
That’s a hard question. I’d be guessing.
With the peer group that I moved in most, most did, but then interesting just looking at the reunion, couple of reunions I’ve been to, it’s fairly clear to me that a lot of the people who turn up at the reunions who’ve been fairly successful, didn’t go to university
so I’m just not sure.
Did you live on campus at Sydney uni?
You commuted each day from home?
Yeah I lived at home.
What kind of hours were you spending studying in classes there in the first year?
Well the course was full time and I think I probably studied as hard in first year as I did for the leaving certificate so that would have been
some study a few hours each day and at least one day on the weekend.
What was the university like then, I don’t know if you’ve been back recently but it’s fairly built up and a huge space, what was it like when you were studying there?
Much more open, a lot more open space.
Where did you do your socialising at the uni?
this might sound funny but there were different lawns in the university that people would sort of have lunch on and the lawn that I had lunch on, and I don’t know how this started, used to have the people from North Sydney Boys High and Sydney Grammar, used to be not mixing together but we used to sit on that lawn and have our lunch so that was, I mean seems
quite distant now to say that and so you’d make your way up there for lunch and just chat to people.
Which lawn was that, do you remember its name?
I know where it was. If you came up the main drive towards the great hall, it was on the right of the great hall before the arch.
I know where you mean.
It might have been called Botany lawn but I’m not sure.
When were you called up for your compulsory military service?
That was in the beginning of second year and because the national service was almost universal, second year at university didn’t start until April because the
army had three months full time to recruit training. With the air force and the navy they had six months. I’m not sure how that fitted in with the university. Maybe they did it in two lots of three months, I don’t know, but with the army it was three months full time and then part time over the next three years so the full time I did with the 13th National Service
Training Battalion which was out at Ingleburn and then when I finished the three months full time, then I was posted to the Sydney University regiment to do the rest of my training.
What did that involve?
Going to a camp each year and regular parades with the university during the evening and weekends but because I
went for promotional and skill courses, I in fact would have done more than the basic.
What was your initial training, your first camp as part of the CMF?
With the university regiment? It would have
been at Singleton.
Do you remember what you did?
I remember it was cold.
OK you were telling us about your first camp at Singleton?
Yes I remember it was very cold and they had a troop train so we all went up by train from Central railway and I remember trudging around through the bush and
freezing at night. That’s about it.
Did you enjoy it?
Initially I didn’t but then I started making friends and gradually got to like it, yeah.
At the time what did you think of compulsory military service for Australians?
It was part of life. I don’t think anyone questioned it. I can’t remember anybody questioning it. Maybe they did.
Do you remember the end of the Second World War when you were a child?
No. Things I can remember about the war were the
camouflage on the buses and the blinds in the buses and then I can remember there was a broadcast where King George the Sixth broadcast to the empire and I can remember my mother and the other women crying during the broadcast. It must have been a rallying type of broadcast and
they’re about the sorts of things I can remember. I actually don’t remember any celebrations or anything like that.
After the war had finished, do you remember ration restrictions on your family at all?
Yes I remember going to the shops and I had little coupons to get butter and stuff like that and I used to get milk. It used to cost a penny
and I used to go up to the shop and get a glass of milk but I don’t remember, other than that, I don’t remember it.
How was it balancing your university with your responsibility in the CMF?
Wasn’t a problem. A lot of students had part time work, and it was part time work,
it was the equivalent part time work for me in the sense that it paid and it also was a social outlet as well as the military side so that I felt I was able to juggle it reasonably well.
So you said the social outlet, tell us a bit more about that?
Well I was
in the, I specialised in signals and so that we used to regularly have reunions where we’d go out and have a few drinks and a meal and that sort of thing, used to play tennis and then later on when I was commissioned, we used to, the regiment used to supply
the bachelors for the debutantes so we were taught dancing and used to go to the balls so that was the social side of it.
Being a signaller, what were you taught?
How to use radio, how to send messages
and it would start from a fairly, as a basic signaller you’d just carry a radio and be part of the communication and as you got further up, you then had to plan, if there was an exercise or something, what frequencies were going to be used and what sort of equipment was going to be taken, that sort of thing. I mean it was, at the time we thought it was sophisticated but it’s not
as sophisticated as it is now.
Did you learn Morse code?
How was that taught to you?
I actually can’t remember because we learnt it but didn’t use it. It was learnt as a backup if the voice failed so I can just remember sitting in classes with this little thing, tapping it
but not using it when we were out in the field. We always used the voice.
What were the radios like that you were carrying in the field, can you describe one?
Just little boxes on, most of it was a battery and then there’d be the various dials for the frequencies and then the earphones.
What else were you carrying with you on those exercises?
The basic camping equipment plus the weapons.
Were you using live ammunition?
No, no live ammunition was used on exercises. The only time live ammunition was used was when you went to the firing range and actually did supervised practise at the firing range where you had to reach
a certain score to qualify.
Qualify for what?
I’m not sure now. I know you were expected to get a certain score but I’m not quite sure what was done with it. I think they entered it in your records.
What kind of a shot were you?
How comfortable were you holding a gun?
the guns that we used were the old Lee Enfield 303’s and they were a very heavy gun so if you’re talking about physical comfort they were heavy and to fire them you could end up being quite bruised from the recoil. In terms of psychological comfort, I had no
worries about that.
Were there any people you knew of at university or otherwise, who got out of the compulsory national service?
Not that I knew of and I don’t actually know whether there was an alternate civilian
service. There could have been but I’m not sure now. It’s quite a long time ago.
Were you ever tempted to go into the air force like your father did, rather than the army?
I was but I wouldn’t have been able to do the six months training, so I didn’t.
Ok and the university regiment
what kind of arrangement was that?
In what way?
Did you meet on the grounds of the university or elsewhere?
Yeah the university regiment had its own building and an armoury and they used the ovals for the parades and then they’d use certain rooms in the university for classes and that sort of thing. In those
days there were a lot of people in the regiment. I mean we’re talking about the university regiment probably having well over a thousand people in it.
Who was teaching you then?
In the regiment? Would have been non commissioned and commissioned officers who were within the regiment or who
were brought in. I mean for example with the courses I did for promotion, they would be run by officers and non commissioned officers from the regiment. For the courses I did in signals, I would have had to have gone to other places where the signals corps would have run those courses because it was a specialised area.
Why did you choose signals?
Probably an accident, I don’t remember.
I think the idea of doing signals probably appealed more to me than being a, just a foot soldier.
When did you start to think about actually pursuing a career in the armed forces?
Well I didn’t actually pursue a career in the armed forces as such. Hang on, that’s probably not quite true. It never, to me I never saw it as a full time option.
I saw it as something that I could do part time and so I was a private soldier for a couple of years in the university regiment. Then I was a corporal, then a sergeant and then a second lieutenant when I graduated and so I made enquiries about the medical corps and transferred
across to the medical corps and I found that quite interesting because there I was involved in quite a lot of teaching of other ranks and people on the medical side so I found that that was quite interesting work, doing the teaching at the same time I was training myself as a doctor.
Tell us about your commission?
In what way?
When were you commissioned?
It would have been 1961 I think, give or take, cause I was in fifth year medicine and it would have, I think that’s correct and so I became a second lieutenant and
because of my background in signals I in fact became what was called the sig subaltern which was the second in command of the signals platoon in the university regiment.
What extra responsibilities did that involve?
It involved quite a bit of teaching. If we’re going to camp or going somewhere, quite a bit of administration, getting prepared for it.
At the camp itself, if there was an exercise going on, coordinating the signals support for the exercise and actually taking part in the exercise itself.
In fifth year medicine were you doing residency stints in hospital?
Can you tell us about those?
Now in fifth and six year
I did residency stints, as a student, in surgery, obstetrics. I think we did some for casualty as well where we’d live in the quarters in the hospital and there was a sort of pecking order at Prince Alfred where that
the top floor of the residence quarters, the junior residents, the first year residents, they were there. Then the next floor was the second year residents, the third floor was the registrars and female residents and underground were the students and that’s where we lived, pretty spartan conditions but it was a lot of fun and we’d be up all night
whether it was obstetrics or the surgery or the accident and emergency, you know, being part of whichever place we were in, doing odd jobs under supervision.
What kind of odd jobs?
Mainly holding things, like in accident and emergency, if the physiotherapist put a plaster on, you’d hold the arm. While the physiotherapist did that or someone went to theatres, they’d let you hold the retractors or if there was a delivery
they’d let you sort of be involved as an assistant. It was very much like an apprenticeship sort of model. There was no responsibility.
What was it like seeing a baby being born for the first time?
Did you ever feel out of your depth doing the work that you were doing?
As a student, no but if you ask me as a
resident, that’s a different question.
When did you start residency?
Well that was after I finished my sixth year of training and then I, again like in those days, like the high school education system, the hospital system was the same. The teaching hospitals took the higher marked, students with higher marks. It’s a different system now and I got second class honours at
graduation so I got to Prince Alfred. That was my first choice cause that’s where I’d been a student and it was very heavy work the first year because in those days you had to live in and you were on every night of the week at midnight for your own ward and the only time you were, you had to work Saturday morning and if you were off the weekend, that Saturday night and
that Sunday night were the only nights you had off so that people worked very long hours and it was very tiring.
What kind of work were you doing then?
Well I rotated through general medicine, surgery, orthopaedics, casualty and obstetrics.
They’re the terms I did in first year.
What did you enjoy the most?
What did that involve?
Well in those days it was mainly people with ulcers, people who had heart attacks, people with endocrine, hormonal disorders. It was not as sophisticated as it is now. We still had the big Nightingale wards in the hospital
so you’d walk into the ward and the beds were just all stretched down each side and the resident, the first year resident’s job, you’d have to collect the bloods in the morning, do the admissions, do the rounds with the specialists. It was mainly a clerking sort of job but you were learning the whole time that you were there but the
obstetrics of course you’re actually doing the confinements and in the surgery you’d be involved in assisting the surgeons and then accident and emergency you’d be under supervision treating the people who were being brought in by ambulance or who turned up at the emergency department.
What was it about this first year of residency that made you feel out of your depth?
Well at times you’d be so tired. I remember once
listening to a lady’s, pregnant lady’s, baby’s heartbeats with those little funny things and falling asleep on her abdomen and she actually woke me up and that made me feel very embarrassed. She thought it was quite funny but other times in the accident and emergency I can remember things happening that I thought, you know, I thought really the situation was just far beyond me.
Can you think of an example of that?
Not off the cuff, no.
And what were the living conditions like as a resident doctor in the RPA [Royal Prince Alfred]?
Well I was lucky to get a single room. Some of them didn’t. Those that didn’t get single rooms, some of them shared at Prince Alfred. Sydney Hospital they were four to a room and
you had a basic bed. You had a little side table with a mirror and a cupboard and that was it and then communal showers and communal toilets and the Prince Alfred residents block used to share the water with St John’s College which was next door and if you got up late the hot water had gone off so you’d have to have a cold shower even in winter and it
was pretty spartan and then we had our own dining rooms downstairs and a lounge and they were quite reasonable.
What did you do with your time off?
Mostly slept, however having said that I can remember on the holidays I went up to Queensland with a friend of mine who was a resident there and we
used to go out with nurses to parties and things like that, but a lot of the time I slept.
Interviewee: Anthony Williams Archive ID 1751 Tape 02
Growing up in Rhodes, you mentioned it was quite a different place to what it is now. Do you remember if there was more industry around in those days?
There was quite a lot of industry and the area that’s now parkland as you drive through Rhodes going up to Ryde on the right was a major dump and it was always smouldering and occasionally it would catch fire and the smell
would go over the whole suburb.
That must have been a great public health issue?
I don’t think it was then but I think nowadays it would be, yes.
You must have grown up fairly close to Concord Hospital, ironically enough?
Yeah, you could see it, yes, across the water.
Were you aware of its military connections?
Yes. I can remember going
out there when my father was in there actually and I can remember they had a pebble, big red cross in one of the courtyards probably near where the RAAF [Royal Australian Air Force] wards are, that was, it would be been enormous, a bit bigger than this house, which I presume was to alert Japanese if they came over, not to bomb it. I would have thought it would have made
a good target.
Why was your dad in there?
I think he had malaria or something like that.
At what point in your education did medicine look good to you?
Well it’s interesting, it didn’t. I had, my
grandfather was a stock inspector, this is my mother’s father, in the Riverina and he had done veterinary science and that was one of the things I was interested in doing and my mother said she didn’t want me to do veterinary science so then I thought I’d do dentistry and so I went and had a look at the old dental hospital
and dentistry went right out the window once I’d seen that, so I went and saw one of the commonwealth scholarship advisers and he said, “Have you ever thought of doing medicine?” and I said, “Well not really.” He said, “Well your profile fits the,” you know, “the subjects you’ve done and the interests that you’ve shown would fit medicine,” so I said, “Well can I change?” so I in fact changed at the last minute to do medicine.
What was it about the dental hospital that put you off?
The smell and just seeing actually what went on. That was too much.
What went on that was?
The noise of the drills and in those days drills were not the high powered drills we’ve got now. It was a grinding noise and the smell of the disinfectant and I thought, “No.”
How prevalent at Sydney Uni were females when you were there?
In the faculty of arts, very, I think their numbers would have been probably equal, in botany, science. In medicine they were a minority.
Interesting you use the medical term prevalent.
OK, so what sort of socialisation went on with the girls while you were at university?
Mainly in a group. I mean this might sound funny but in second year and third
year in anatomy we were formed into groups that did everything together in terms of the study and my group was all the people from S to Z because it was all in alphabetical order, so you got to know the people in your group and the group used to do things together. Then in the clinical years when we went into the hospitals, cause the first three years
weren’t clinical, is quite different to nowadays of course, then we started socialising with the nurses as well.
Was there a strict hierarchy between doctors and nurses?
In the hospital? There was and there was even stricter hierarchy between the senior nurses and the junior nurses but with the students,
the students we used to mix quite, socially, quite freely with the trainee nurses cause the nurses, they’re not trained in the hospitals in an apprenticeship system and in fact some of the nurses that I met then, we’re still very good friends this far down the track. His godmother, Simon you met, his godmother was one of the nurses I
used to socialise with.
What was the status of psychiatry when you were studying medicine?
It was only, we only had a few lectures in psychiatry and it
was almost like another world, that we just, I mean the form of teaching it then, most of us didn’t like it and looking back on it I think it was pretty terrible but they’d bring a patient out onto a stage and interview the patient on the stage in front of the whole year and looking back on it, I mean we were very uncomfortable then about it and looking back on it
now I think it’s appalling and so it had, other than studying to get through it as a subject, cause you had to pass it, it didn’t have a very high status at all. In fact it was quite marginalised.
Was, medicine being a fairly empirical type of discipline, was psychiatry regarded as
magic or pseudo science or?
Yeah and I think most of us, I can remember being on call at night at Prince Alfred and having to go down to the psych ward and not having a clue what to do and just do a sort of doing something would be a short gap to keep things going till the staff came on the next day.
So in the hospitals in those days how well served
was mental health?
Well it was a different system because you had the mental hospitals, the state mental hospitals, where we never went near them, from doing your residency and then the teaching hospitals had psych units and they tend to be for more
specialised sorts of people that that particular unit may have had an interest in. I think the Prince Alfred unit then which was quite a small unit had an interest in depression so you tended to have people coming in, this is from memory and I could be a little bit wrong on that but you certainly didn’t get into those units if you had a major psychiatric disorder. You went to one of the state hospitals.
What about politics in university in those days, was there a lot of political activism?
There was but it tended to be I think more idealistic. I mean you had the Labor club and you had the Liberal club but this
tended to be causes. I mean for example one year people got involved in raising money to buy a plane for the flying doctor service. Another year the money was raised to bring an aboriginal student, cause there were no aboriginal students, to get a scholarship. That was the sort of, there was a big demonstration one year to get traffic lights
put across Parramatta Road. They were the sorts of issues so a bit more idealistic rather than political, if that makes sense.
When you were first called up for your national service, how much interest did you have in it?
First? All I could think of was how long would it take before I got out. I’d never been in a
situation of such intense ongoing discipline. I’d been in a situation of some discipline because I was in the police boys in primary school but I’d never been in a situation where for three months if you didn’t like something you couldn’t leave it but I gradually got used to it, in the sense you learnt to play the game, if that makes sense and
all the people virtually in the national service battalion that I was in, were university students because it was the first intake in the year and they took university students in and I think the non commissioned officers who were looking after us, I think we probably caused a lot of people to get high blood pressure and coronary heart disease. I think we were difficult.
Did the regiment have a bit of a silvertail reputation?
University regiment or the national service battalion?
Yes, well the university regiment that you later became part of?
Yes it did I think, yeh.
You obviously got more interested in it as you went along though?
I think that’s true.
Why do you think that was?
I think it was a stimulus
that it was a situation where you were learning but it wasn’t medical learning and I think that’s what attracted me to stay in and I think looking back the sort of camaraderie and that sort of thing was probably important as well.
You mentioned that as a young officer you were often seconded into a debutante
escorts, what did that involve?
Going to the dancing lessons and then turning up at the ball.
Who were these girls, where were they from?
That’s an interesting question. I can remember one year it was a Roman Catholic
girls school, not, would it be girls school? No, and it was a Roman Catholic group, another, there probably would have been about four or five occasions and they were quite different groups but they tended to be more the well heeled, if you like, members of the community and I think that to have us come along in the dressed uniform, I think that was just what the Mums and Dads wanted.
We didn’t get paid for that by the way but we got the food for free.
No payment in kind?
Did you meet any real dragon mothers?
No. We were kept strictly under control in those events.
How did your transfer to the medical corps come about?
I graduated in medicine, I had to look seriously, was I going to stay in the then CMF and if I was, what should I do and I knew there were some doctors who’d kept on in the infantry and I felt there was a conflict, a moral conflict, to do that and
so when I thought it through, I thought, “I should transfer to the medical corps as a non combatant.”
Did any promotion go with that?
Yeah, I was promoted to captain and then I had to pass the exams to become a substantive captain.
What sort of things were you teaching?
First aid, medical tactics. The first aid was to people who were coming into the reserve who were privates and other ranks. The medical tactics, we’d have to study up and then when we got on camp, you’d be setting up a field hospital or a aid post or something as part of a larger exercise.
By medical tactics
I take it you mean dealing with potential casualties or how to set up or?
Both, where’s the best place to set something up, how it should be defended and then what sort of equipment you’d need for the sort of operation that was being planned.
Under the rules in those days were medical personnel carrying weapons?
We used to carry a pistol and so I had to learn to use a pistol and the sort of regulation was that that was for defensive use, not offensive so it was to be used to defend the medical facility or the patients, that sort of thing.
How much of a
commitment in time was it being captain in the medical corps?
One two week camp a year and then probably one weekend every couple of months and then at least two week nights a month.
And what sort of financial reward did that bring to you?
I know it was tax free but it would have been, I mean for example the salary of a junior medical officer then was four hundred pound a year. This is in ’63.
It was probably in today’s buying terms was probably enough to sort of go out to dinner a few times and maybe take a brief weekend away. It wasn’t very much.
But it did enable you a bit of pocket money I guess?
At this point what were your career ambitions?
Well as a first year and second year resident I wasn’t sure what I wanted to do and I was interested in anaesthetics in my second year. I did a term of anaesthetics but then I decided I wanted to be an internal, be a specialist physician and so I went to Concord as a registrar in medicine
and that’s where I started studying to be a physician. That was in my third and fourth year.
And what did that involve, those third and fourth years at Concord?
Well it meant I was rostered through the medical wards so it meant I did no more surgery and Concord had specialised medical wards and general
medical wards and it also had a psych ward and I did one psych term when I was there.
What did you know of the Vietnam War at this stage?
it preceded the Vietnam war, if I could just go through those four years.
Yeah I’ve just realised I’ve got out of chronology there yes, sorry, go on?
In, I think it was in 1965 or ’64 the confrontation occurred with Indonesia and people who were in the reserve were
given the opportunity to resign because we were told that if the situation deteriorated, Australia might end up sending troops and they’d call up the reserve. Then, so that was in I think in my second year. I could be wrong, out a bit in timings here but I think that was in my second year. Then my third year
and it was during that period too the [HMAS] Voyager disaster occurred because when I was at Concord and I did a psych term, I was actually looking after a couple of sailors who’d survived the Voyager disaster and had psychiatric complications and Vietnam I think really didn’t start becoming an issue until
’65, ’66. I think that would have been it and then, as I mentioned earlier, the battle of Long Tan happened early in the year. Actually I’ve just forgotten the date but that was after the battle of Long Tan that I was interviewed about whether I’d come on into full time duty.
What was the nature of
the problems the guys from Voyager had?
Well looking back on it now, if you’re talking about depression and post traumatic stress disorder, with the psychiatric knowledge of the time there was no appreciation of the degree of what was happening so you had opinions ranging from,
it was hysterical, to just personality disorder and I think that the people, the psychiatric services were actually out of their depth in that sort of thing.
Were you aware of any casualties coming back from the confrontation?
So yes, go through those
years leading up to the point of Long Tan, you were just doing general medicine?
Yes. Concord was a good place to work, had a good morale. There was very good teaching. It had a high success rate for the specialist exams in medicine and surgery and it also had a, because it was a
repatriation hospital then, it had a close relationship with the armed forces so that it was very generous in what leave it would let you have to continue in the services and be fair to say, probably most of the senior specialists there were in the reserve so it had those links which were, it was quite convenient.
Now as Vietnam began to come onto the radar, what did you know about it?
I guess I followed it in the press and just kept abreast of what was happening. At that stage there was no, I mean national service had come in but I was way past, that’s the new national service, not the one I did
although that’s an anachronism because there’s been a national, I heard on Margaret Crosby the other morning, there’s been national service since the turn of last century in various forms but the national service that occurred after the war had stopped. People were in the new national service and I was aware of some of the controversies around that, but until Long Tan I didn’t really see
any of it really affecting me personally and it was only after the Long Tan when I think people here realised how potentially serious the conflict was, or not how potentially serious, how serious it was and then I became aware that the medical hierarchy were concerned
of the standard of medical care of the troops we had there because the Americans were handling a lot of the, or the people from the United States and there was, my understanding was there was some concern that the Australian casualties in services would be better handled by Australian medical personnel.
I think, and this is going on memory, that the information that we were told, was that the Americans tended to see people just as numbers so they were more likely to amputate rather than treat more conservatively and that the Australians would do better if they were managed in Australian hospitals with
Australian doctors and nurses, than in hospitals managed by medical personnel from the United States. I wasn’t part of that decision making process I mean so I’m just sort of, I could be incorrect in some of that.
Was Concord hospital handling any casualties?
I think it was but they would have gone on the surgical side and I was working on the
At this point did you have any idea that it might be your destiny to go to Vietnam?
At which point?
At the point just leading up to the battle of Long Tan, were you?
No, I didn’t, no.
Even though you were in the reserves?
Yes because I guess the general prevailing view
was that the regular army and the national service were handling that campaign and the reserves were not involved. That was probably quite naïve that view because had I thought it through, I mean a lot of the engineers that were going and other specialties, were in fact reservists.
Tell us about why you ended up
volunteering to Vietnam, how it came about with the surgeon general and so on?
Well he had a meeting in Sydney and I actually can’t remember the full details of this meeting but I know I went to it and there would have been half a dozen of us and he talked about this change in plan of what I just mentioned about increasing the
military medical presence and asked us to think about it and then it was followed up by contacts and then my understanding then was that they wanted us to go and work in the hospital so I was sent as part of a Concord thing with Dawes Park, which is the repat hospital in South Australia. I was actually working in the
cardiac unit in Concord and I went down to Dawes Park to help set up their cardiac unit whilst their registrar there came up to Concord to be trained and the army medical corps arranged for me to start doing anaesthetics down there so I was doing half a day’s anaesthetics a week to prepare me to go in to work in the hospital, and in fact
at the end of the year, then Concord granted me leave and I joined the army, full time, I mean, and turned up and was told on the day I turned up I wasn’t going to the hospital at all, I was going to a battalion and I can remember saying, “Well what about all this anaesthetic practise I’ve been doing?” and they said, “You’ll be able to use that in the battalion as well,” so it was a sense, I was not quite dragged kicking and screaming but I
got quite a shock when they said, because I actually hadn’t prepared myself to be a regimental medical officer of a battalion whereas the army medical people said, “Because you’d been in an infantry regiment, the university regiment, you’re actually quite well trained to go to a battalion,” and looking back on it, I think that was true.
What was the nature of your engagement as far as contract in this full time service?
and then I’d go back into the reserve.
What did you know about battlefield medicine and all these things to be an RMO [Regimental Medical Officer]?
Very little, I think looking back, very little. Aside from the fact I had been, I mean in the training that I’d done at Prince Alfred and my work in accident and emergency
I had some experience there and then the training that I did with the reservists, in training them how to deal with fractures and put up drips and, you know, stop bleeding and that sort of thing, I think I probably had had a fair amount of training but it was still daunting to actually think, “Well I’m going to the, and it’ll be the real thing.”
How old would you have been at this stage?
From a medical facilities and training point of view, how well prepared was 7th Battalion?
The battalion had just been formed in Puckapunyal in Victoria at the end of, I get these years mixed
up. Anyhow the year before they went to Vietnam, must have been ’65, they’d just been formed and so that the medical platoon was fairly naïve so it had a stretcher bearer section who were infantry soldiers and then it had medical corps personnel who actually fairly reasonably trained
but the stretcher bearers had not had a lot of training.
So what was the infrastructure in the battalion medically then?
The medical platoon was in the, in what’s called administration company. The platoon commander is a doctor. Then it had three sergeants, regimental aid post sergeant, a hygiene
sergeant and the stretcher bearer sergeant. Then it had medical corps personnel who were at a company level who could work with a company and in the RAP [Regimental Aid Post] and then it had a whole lot of stretcher bearers. Now we had the problem that my stretcher bearer sergeant, who was quite good, was killed in a motor vehicle accident just before we left so in fact
I had to take over the role as well as being the regimental medical officer, of training and administering the stretcher bearers.
Can you describe to us the difference between a stretcher bearer and a medical corps person as you describe at company level?
The stretcher bearers are basically infantry soldiers who had extra training in medical, a little bit like when I said I was a private in the Sydney University Regiment and I had training in
signals. My basic skills was an infantry soldier but then I was specialising in that sort of field.
So what sort of procedures or first aid would those stretcher bearers be able to carry out?
When I first me them, very basic. They could put a splint on. They could stop bleeding. They could manage a fever but they wouldn’t
have been able to do much more than that.
And I assume they would have had very little experience in doing any of that?
Except in theory.
Now at company level what was the medical personnel doing?
Well they would have been, they were either lance corporals or corporals in the medical corps so they’d have done a fair bit of training in the whole,
you know, in basic anatomy, physiology and basic resuscitation, that sort of thing. In those days, not now, but in those days, they probably would have been equivalent to ambulance officers.
So what did you do to get your battalion worked up in a medical
sense of preparing to go to Vietnam?
Well there were probably a number of areas that I had to cover. The first was preparing the battalion itself to go and that meant everyone had to be medically examined and they had to be inoculated against the infectious diseases, which I had to and I was responsible for their,
signing off their international health certificates for the inoculations that they had and vaccinations and part of that was the regimental medical officer of a battalion is in a fairly unique position because he’s the personal adviser to the commanding officer on matters medical so I had to establish a working relationship with the commanding officer to advise him on those sorts of things.
Then the second area was the training of the platoon which took a major part of my time so I got the stretcher bearers, we got oranges in and we got the injections and I taught them how, they all practised
injecting in an orange. Then when the parade came for the vaccinations, there they were and I just threw them straight into it so I had the first parade, I had three of my stretcher bearers collapse when they gave their first injection. It was a nightmare. Someone screamed out, “Who trained this bloke?” I’ll never forget this. “Sir, you can’t allow this. You can’t have these blokes giving injections.” I said, “Yes they can,” and they did. They actually did a good job
but I had to do the smallpox cause the smallpox had to be done by a doctor, and then we gradually moved to training them how to use morphine which they’re not allowed to do in Australia, and then on the ship on the way to Vietnam I had them just virtually full time and that’s where they, I taught them how to put up drips and so
their level of sophistication rose enormously.
Do you think that training you gave them was above average for the forces at that time?
It’s hard to know. It’s interesting, at a recent reunion last year, we had a medical platoon reunion for the first time and I had over half the
platoon turned up and one of the things a number of the guys said to me was that the level of training I gave them, when they’ve talked to other people, was much higher and that looking back they felt that they, the level of training they had made them far more effective than they could have been, like, but I’ve got no way of knowing how true that is or not.
What was the standard operational procedure regarding how these men were attached and worked
with different platoons and companies?
Well one of the things I did on the ship was said, I made the decision after discussing it with the commanding officer that we wouldn’t use the term stretcher bearer and it stopped being used and they would be called platoon medics and the procedure up till then was that if an operation happened then the company
medic would go with the company and the platoon medics would be rostered out to the platoons and I thought this was actually not a good idea. I thought that it would be safer for the medic in terms of his protection that if he knew the platoon and better for the platoon if they knew the medic and he knew their problems, if that makes sense, so in fact they were all posted to
the platoons and the CO [Commanding Officer] warned me that it’d mean I’d have less control over them but in fact I think it worked and I think it meant that it was much more efficient and what I do, in between operations, I bring them in for retraining and discussion. It also meant I had a very good network which I might talk about later. We had
a major crisis with malaria in the November and because I had medics that I trusted in the various platoons, I was able to establish very clearly that it wasn’t because the guys weren’t taking their anti malarials or taking their precautions so that was what we did and I don’t think the other battalions did it.
What was your objection to the term stretcher bearer?
Thought it was old fashioned and I thought it was a little bit like saying, “Oh, he’s the stretcher bearer. He’s the bandsman.” It had that sort of connotation whereas platoon medic I thought actually identified very much with the prevailing language use, if you like. I mean stretcher bearer is an old term and in fact they rarely
carried people on stretchers.
Interviewee: Anthony Williams Archive ID 1751 Tape 03
What was the hardest thing did you find about being a teacher?
I think what’s hard is that doctors are expected to be able to teach but they’re not really trained to do it and I think that’s the
for me been the hardest thing. In fact what’s been interesting, as part of my training in the army when I was trained to be a corporal and a sergeant, part of the training is training formally how to develop a lesson plan and that was some aspect of my army training that I actually took into the,
and I’ve used all my life now, is when I’ve been teaching.
While we’re on the subject of training, when you were doing your officer training, what else did you learn apart from dancing classes?
Well tactic, there are a number of different subjects you have to do, weaponry, so you had to be familiar
with the, as I was doing training the infantry, the infantry weapons which meant you had to be able to, as well as answer the theoretical questions about how the weapons worked, you had to as part of the exams demonstrate that you could disassemble and then assemble the weapon. Then
there was tactics and then military law.
What was involved in tactics?
Well for a lieutenant it was fairly basic tactics at the platoon and company level of safety and movement of troops, map reading, how to handle
ambushes, how to handle tactics, that sort of thing.
And what about military law?
Well that was, that involved studying the hand books and then you’d be asked questions. The exam was a written exam and you’d be asked questions. I mean for example the weaponry exam was mainly practical. You’d
go round this bullring and you’d have ten or fifteen minutes at each site where you had to do something practical or answer questions about the weapons. The tactics involved taking you out into the bush and you actually had to do things out in the bush with a compass and demonstrate this and that and the law, you actually sat down with the book
and they gave you a series of questions of what was the correct procedure to do for this or that or something else.
What did you teach when you were an officer at the university regiment?
That would have been signals stuff, yeah.
Purely signals at that stage?
Well it was except I used to take part in the exams
so that, I mean I can remember one exam where I was at the Bren gun stop so that the soldiers coming round would actually have to take the Bren gun to pieces and show me how it worked and reassemble it so that that was an exam situation but I never actually taught on it. It’s a few years ago you’re asking me to remember.
OK so prior to departure for Vietnam, do you remember what you were thinking about going into conflict?
Well I was apprehensive about it because it was very much
somewhat an unknown situation however we were I think fairly thoroughly briefed about what it was going to be like. We had an exercise in far north Queensland where we actually went through a sort of situation, we had an enemy and that sort of thing in tropical
conditions and like all the other people who went, I, myself had to go through the jungle training school at Canungra in southern Queensland plus we were having lectures and that on the Vietnamese culture and the history and the politics so there was an attempt over those few months before we went to get us as, have
as much understanding as they thought at the time and looking back I think we did have a reasonable understanding although I had never met a Vietnamese person before we went there.
What were you taught about the country’s history and culture?
It was mainly, if I remember correctly, the history involved in the latter part
so leading up to the, like the French colonisation, then what happened during the Japanese occupation during the Second World War, then the French coming back in, then the war of independence and then what had happened since then with the demarcation into north and south so it was more the recent history, not the history going back, you know, over a thousand or more years.
And what were you told in those lessons and lectures about the culture of the Vietnamese people?
That it was very traditional. Now I’ve got to be careful here because I’ve had so much exposure to people from south east Asia and Vietnam since then, I might be getting mixed up with what I’ve learnt since and putting that on. I think basically it was the
traditional nature of the culture and the fact that most of the people lived in the villages and that sort of thing.
What about your jungle training, can you tell us what was involved in that?
I just remember that it was hot. There were weapons firing, people shouting and I was glad when it was over.
That’s, I don’t remember, I remember I had to go up on a plane because I was one of the last to go through and I remember I surrendered my pistol at the airport cause it was a civilian plane I went on, so the captain had to carry my pistol in his cabin and it was mainly you had to fire live fire
in a situation where it was quite humid and they were trying to simulate a jungle setting but other than that I can’t remember much more about it except that I did it.
Did you have any particular extra duties as the medical officer then?
Yeah in the jungle training there?
No, in the jungle training I was, that was just being trained individually
to survive in the jungle.
So how prepared did you feel when you left Australia about training and the lectures behind you?
I felt fairly prepared as much as one can in a situation where you don’t really know what’s going to happen. Even with all the briefings in the world, you can never be exactly sure what’s going to happen.
How apprehensive were you?
I think in the lead up to it I was
too busy to get too apprehensive. I mean on the way over on the aircraft carrier, the [HMAS] Sydney, each day I’d do a sick parade, sharing the sickbay with the naval medical officer and then after that I’d have a series of lectures. I was not only involved in training the medical platoon. I lectured every platoon in the battalion on issues
‘round public health so it was pretty busy.
Apart from VD [venereal disease] lectures, what other lectures did you give?
It was on tropical diseases and basic first aid.
What kind of tropical diseases were you familiar with that you were telling the troops about?
I think I was very naïve on the way across because none of us were prepared for the high
casualty rate we’d have from tropical diseases but I mainly talked about the issues of keeping as clean as possible, precautions against mosquitos, if you got cuts, to keep the cuts clean. It was like basic primary public health in a tropical setting. I didn’t go into the diseases in any great deal.
What was life like aboard
the aircraft carrier on your way to Vietnam?
Crowded. I’ve never been on a ship before. It was very different, a very different experience.
What were your living, well where were your living quarters?
I shared a small cabin with a major and we had two bunks and I had the
asbestos pipe going across me on top of me so in fact I was actually virtually touching asbestos the whole way across and it was a tiny little cabin. You could get in, there was hardly enough room to move and presumably it was converted from some storage. When they did the refit, they went through converting a lot of storage areas for an aircraft carrier into cabins
and so you spent, the only time you spent in the cabin was sleeping.
Where did you spend the rest of your time?
Well, I think I’ve explained, a lot of time in the day was busy. There was no privacy. In fact talking to sailors, I gather that’s normal on a ship anyhow. There’s very little privacy.
How did you handle that?
I think fourteen days was enough.
I don’t know how people at sea can handle it, people in the navy all the time.
What kind of aircraft were on the deck of the carrier?
Well there must have been some aircraft but I don’t remember. I think there were some helicopters. There were ambulances on it. There
were a lot of trucks. I think there were more vehicles on it that were going to be used in the country than there were aircraft. I think there were two navy helicopters if I remember correctly but that’s, yeah, but I know there were helicopters. There were no, I don’t remember any fixed wing aircraft being on it.
Did you get seasick?
Yes, others did, yes.
Did you have to treat them?
How do you treat someone with seasickness?
I asked the navy doctor what he did and followed what he did and I don’t remember what it was now but I know I asked him what to do and he told me.
What was the route that you took to Vietnam from Sydney?
You’ve got me there. I did know but I’ve got a feeling it was
up through the Indonesian archipelago and as direct as possible. I honesty can’t remember any more than that. I remember we, obviously I remember crossing the equator but the exact route, I would have known but I can’t recall.
How did you mark crossing the equator?
There was a big ceremony on the, I’ve even got a certificate signed by King Neptune
and I was dunked in this big pond of water on the top of the ship.
Did you find the navy guys particularly superstitious or different from the army guys?
There was very little mixing. Other than the naval doctor who I worked quite closely with,
who incidentally was in the same year as I was as an undergraduate and I’ve seen him from time to time since then but I had very little to do with the navy personnel. Sometimes on the deck at night you’d go up and just have a bit of a chat with the person on night watch but other than that the two groups were fairly separate.
In what way did you work closely with the navy doctor?
Well it was good to have another doctor onboard for second opinions so he’d ask my opinion about a case or I’d ask him. When there was a procedure to be done that needed any anaesthetic or that sort of thing, one of us would give the anaesthetic and it was just, I actually found it quite supportive to have a colleague there
just to discuss things.
Why did you have that set up that one doctor would give the anaesthetic and the other would treat, why’s that?
That’s just fairly normal if you’ve got two doctors, just allows you more flexibility.
Does having someone under anaesthetic require a lot of attention?
Mm, I mean we didn’t do anything major but fractures and things like that.
As a doctor who seemed to be developing an interest in psychiatry as you got older, how did you find the mood on the ship the closer you got to Vietnam, amongst the army troops?
There was an element of apprehension, I think an excitement. When we got there it was almost a relief, “We’re finally here,” and then we were
flown by helicopter straight from the harbour up to the base camp in the big American, what they call Chinook helicopters. It would take a whole lot of people and so we were only there for a matter of hours in the harbour and next thing we were up in the base camp.
What were your first impressions of Vietnam coming into the harbour?
The heat and humidity
and how normal it looked, just a tropical harbour.
Which harbour was it?
It’s the old, it was called Port St Jacques under the French and it was a fairly significant harbour which had a port city at the harbour, Vung Tau, and then a whole lot of fishing villages all around it
and that particular city was the holiday resort area for the French when they were there and it had all these villas, quite an attractive city and so there it was sitting there. We could see it.
What kind of activity was going on there when you arrived?
Well we didn’t go, we went over the top of it so I only saw it subsequently when I’d come down there
cause that’s where the logistic base was for the Australian forces where the hospital was, that sort of thing.
What was your first ride in a Chinook helicopter like?
Noisy I suppose, yeah, that’s about all I can say, that it was crowded and noisy.
What were you carrying with you at that stage up to base camp in the aircraft carrier?
We had trucks which had all our clothing and stuff in it and we also had a kitbag and my memory is that we
took our kitbags and weapons with us but, I’m a bit vague on that, and the trunks arrived later.
So where was base camp?
For us, there’s a little mountain complex called Nui Dat which is up from Vung Tau, which is the port city I mentioned, quite some kilometres up so
it was more in the centre of the province which the Australians had and so there was the port city, then you’d go through the marshes. Then there was the capital city of the province and then further on up the road was this mountain complex where there was an airstrip and that’s where the Australian taskforce was so that’s where the artillery was and the battalions and the engineers were up there.
What were your first impressions of Nui Dat?
Well it was in a rubber plantation where we took over from the 5th Battalion and they’d set up the base camp and my first impression was how organised it was. It had dirt roads and signposts and those army huts,
tents and all the rubber trees.
What did you do when you first arrived?
Well there was a changeover period from the 5th Battalion to our battalion. I mean it was happening to all the other units as well but I can only talk about the unit I was attached to and so
there would have been probably five or six days changeover and I spent quite a lot of time with the medical officer of the 5th Battalion gaining as much information as I could about what he’d been doing and what the 5th Battalion had been doing. In fact I probably learnt more about what was going to happen in those five days than I had in all the previous period of time
and I went through all the stocks, the medical stocks that he had, the medical procedures that were being used. I did a tour of the whole battalion. I went up and there was a small medical unit at Nui Dat with about half a dozen beds and went up and had a look at that and then they went.
the medical officer of the 5th Battalion tell you?
Basically he talked about the sorts of medical issues they’d seen, the work that had started on the help they were giving to the civilian, like to the villagers and how the
procedures worked for evacuation of casualties, that sort of thing.
What were the facilities like there for you?
I had a hut, sorry, a metal, like a Nissen hut had been set up. There was a waiting area out the front. There was a rack where they could put their weapons, then you came inside
and there was a general administration treatment area. Then on one side at the back there was an office, my office. On the other side there was an office for the sergeant and then we had a big storeroom at the back and then adjacent to that I had a tent which was my living quarters.
Did you have
diggers knocking on your tent window flap in the middle of the night?
No, there were fixed times for sick parades and the only time that would have happened is if there’d been an emergency.
So what was your daily routine like at Nui Dat?
Well there were a number of different sorts of days.
If I was in base there’d be the formal sick parade where they’d be brought in by the company medics who’d already screened them and then I just worked through them one by one. That used to take some hours. Then there’d be
regular hygiene inspections that I’d do with the hygiene sergeant, checking the kitchens and toilet and other facilities. Then there’d be planning groups and meeting groups about coming operations or debriefing when people come in from operations and then the occasional lecture. That’d be the sort of
the camp life. Then when the battalion went out on operations I’d go out with the battalion and I’d travel with the battalion headquarters and then I used to use a helicopter then to visit the companies quite regularly. In fact I had, I notched up when I was there, the second largest number of hours in the air to the second in command. He notched
up the greatest number of hours and I notched up the second and then I had a system, they had two, this went back to my signals days. They had two nets, radio nets an administrative net and a command net and I’d talked the commanding officer into allowing me in the early evening when we were out on operations, that I could have the admin net so I’d
get each of the companies on the net and talk to the company medics about some of the problems they were having and that sort of thing and I’d do that each day so that when I was out in the bush on operations, I’d probably, a lot of the time moving around. There were other times when I’d just be sitting and particularly like when they laying the mines and that sort of thing. I’d just stay in one place,
sitting, whilst they were doing it and then the other thing I did outside the camp was I used to go to the villages and do sick parades of the surrounding villages and then I also did, used to look after the local South Vietnamese army unit which was up the road, so I’d go up regularly and do their sick parade so, and then occasionally I’d go down to Vung Tau
to see any of our soldiers that might be in the hospital. I don’t think I’ve left anything out.
When you first arrived in Vietnam, what were the most common complaints that you remember?
People having problems with the heat, initially I think, yeah and then the first case, and then the people coming down with VD
from their last few nights in Sydney and it was mainly, the first, when I first got there the sick parades weren’t very big.
What kind of problems did they have with the heat?
Rashes, some people used to get like a prickly thing where it’s actually quite uncomfortable and
in fact what was interesting, I was warned before we went that anyone who had any acne condition on their back or that that they should be failed medically to go. Anyhow the commanding officer called me up to his room and said, “What’s this about my driver can’t go to Vietnam?” and I said, “Well he’s got acne on his back,” so, as he can, he overruled
my decision and within two weeks we had a major problem with his driver, with the acne spread all over his back and he ended up having to go back to Australia.
How did that, the acne spreading over his back, affect his work?
Because of the discomfort and particularly sitting in a vehicle, I mean it’d be sweating all the time and it was,
when I saw him, I said, “Oh no,” you know. I’ll never forget this and I actually felt quite guilty because I thought, “Oh, this bloke shouldn’t have come,” but some of the skin conditions were quite uncomfortable and particularly if you were going out on operations, you had to have the people as fit as possible and they couldn’t be scratching and, you know, in discomfort from a skin problem. In fact skin problems would have been one of our
major problems. I learnt more about dermatology there and in fact it’s interesting I went into psychiatry. After my experience in Vietnam, the medical officer from the 5th Battalion who I took over from went into dermatology so I think that says something about the two issues that can come up.
What treatment did you give for the
dermatological problems you saw?
A lot of them would clear up fairly quickly if you kept them in the base because when they went out on operations they couldn’t wash so they might be out five, six, seven days and they wouldn’t have been able to wash properly so if you kept them in base, kept them in loose clothing, got them to just shower and
look after their cleanliness using powders and that sort of thing, that often helped. The more serious ones, it didn’t.
What would indicate a more serious case?
Where a person becomes quite disabled from the itching and sweating and often they’d get this cycle of sweating, itching, scratching. That’d make it worse and I remember one fellow
they had, we sent him down to the hospital in Vung Tau because the operating theatre and the recovery room were air conditioned and sent him down and put him in the air conditioned recovery room for five days. That cleared it up, cause we didn’t have any air conditioning where we were, at all.
What was the climate like there in Nui Dat?
All the time it was hot.
In the dry season, you were sweating the whole time. In the wet season you were wet the whole time from the rain, was just torrential. It’s difficult to explain. I mean you get used to it but it was, the whole time you were sweating.
In fact we used to have sweat rags made out of wool that were sort of that loose stitch and people soon woke up to the fact if you had a sweat rag you could wipe your face and your neck all the time and it would make a big difference.
What about VD in those early days, what did you see?
Was mainly either non specific urethritis or gonorrhoea and the odd case of syphilis.
What would you do with those patients?
Syphilis went to hospital. The NSU [Non Specific Urethritis] and the gonorrhoea, once you’d worked out which one it was, they’d be treated on duty and in fact it’s interesting, it became a major issue.
The company commanders wanted to know who in their companies had VD cause it was a chargeable offence and I went to the commanding officer and said I didn’t think this was reasonable and it was an invasion of privacy, and he said, “Well what’s your alternative?” and I said, “Well I’ll produce a health chart that
shows all the diseases with,” and I’ve got it here still, and he said, “That won’t do.” Anyhow as the health chart progressed, every time there was, the VIPs [Very Important Persons] come, the commanding officer would bring them down to my RAP and he’d say, “Look, this is where we are with the skin diseases. This is where we are with the chest diseases and this is where we are here,” and I mean he treated it as if it was his own idea but that stopped
any of that and so the company commanders would ring up and say, “Well what’s happening with the VD?” and I’d say, “Well it’s not broken down by company,” which in fact it was. I did have it broken down by company but not on display, “But you can come down and see what’s happening with the battalion.” Most of them came once and never came again but the VD wasn’t a real issue in terms of
disability or that sort of thing. I mean if someone had VD, someone had, not syphilis, but if someone had gonorrheae or an NSU, that didn’t stop them from going out on patrol. I’d give the antibiotics to the platoon medic and the platoon medic would supervise the antibiotics.
Was there any kind of shame associated with VD then?
Depends on the rank.
If the regimental sergeant major, and I’m not saying he did, but if the regimental sergeant major rang and said, “Look, could I see you privately at three o’clock this afternoon?” you’d know it’d be one of two things. He was developing psychological problems or he had VD. I mean I just knew and mostly it was VD.
When you had the one on one consultations with anybody and
in that time initially in Nui Dat, did they talk to you about their mental state in general conversation?
At a sick parade it was an in out, very quickly. If I picked up, and this didn’t start happening till we’d been there a little while, if I picked up that there were other issues that needed looking at, then they’d get an appointment at the end of the day and come back
and this was for two reasons. One, the volume of the sick parade was such that you had to get through it fairly quickly but the other was if you had someone in there for some time the people waiting would think, “Now hang on, what’s wrong with this bloke?” and I didn’t want people to, other people to know that someone had been seeing me for
some sort of personal issue which would take more than three or four minutes and so they were offered to come back later.
What, in those three or four minutes of the consultations in sick parade, what would indicate to you to invite somebody to come back later, what kind of symptoms?
Well firstly they’d all been screened before they saw me. They would have been screened by the company medic
and they would have been screened by the sergeant or one of the senior medics that was in the RAP so they might alert me and the company medics often knew them best and the company medic would come down with his little group or the particular soldier might say something and I’ll say, “Look,” you know, “perhaps now’s not the time to talk about it, do you want to come back later?” and
that’s how it happened. The parade itself was fairly mechanical.
Would the company medic talk to you directly about his concerns on anybody’s mental health?
Didn’t have to go through the sergeant.
When would you have the opportunity to talk to the medic?
On a daily basis if we were in camp because they’d come down.
I mean it sounds a bit formal but they’d march them down and the company medic would come in first and tell me who he’d brought down and I had an arrangement with the RAP sergeant that if there was specific privacy issues, the company medic would talk to me direct without having to go through the sergeant, because the normal chain of command would be the company medic would go to the sergeant and the sergeant would come to me.
seeing evidence of some kind of emotional disturbance in those short consultations, what other reason would prompt you to ask someone to come back?
If there was a number of physical complaints starting to appear and there was no obvious cause
for them, I’d bring them back to see whether there was some sort of psychological issue behind it.
Can you think of any example of physical complaints that might not have an obvious cause?
Yeh, the sorts of things people who might complain of headache, excess sweating, you know, a combination of symptoms which were a bit odd or
I mean more the symptoms you might expect with anxiety.
What did you know of anxiety then?
Not much. I mean we knew, I’d done that psych term at Concord so that had helped. I had some understanding of the relationship between stress and anxiety, stress and depression.
The understandings then of post traumatic stress disorder was minimal but there was an understanding that psychological problems can be linked to stressors and bearing in mind that we’re dealing with a population that were fit and young, you wouldn’t expect virtually anyone to have had previous psychiatric problems.
Interviewee: Anthony Williams Archive ID 1751 Tape 04
I want you to describe for us your regimental aid post where you worked, as far as what facilities were there and how it was laid out?
It was pretty basic. There was a front verandah out the front on the road with benches for people to wait and then a rifle rack for people to put their weapons cause I wouldn’t let people bring their weapons into the RAP
and then when you came in there was like an administrative desk where I had a platoon medic who registered everybody and I was very lucky. He was a national serviceman, a public servant and he was excellent at red tape and registration. Then I had various
treatment benches, then a resuscitation area which had the drips and everything all set up so that if someone was brought in, you could just put them in and then on another wall I developed the snake collection and so I had rows of snakes that had been killed and brought in and
we were identifying the snakes as venomous or non venomous. Then my office had a desk and two chairs, examination couch and then some of my procedural stuff was in there as well for any minor procedures and then I had a bedroom for the person on duty
because we had someone on duty twenty four hours, an office for the sergeant, like my own, and then the whole back was a storeroom.
I had a number of things in there. I had spare kits for people to take out into the field. I had spare instruments, then all the
medications and bandages and intravenous fluids and that sort of stuff.
The snake collection, was that a standard thing for an RMO to be doing?
No, that was me but there were so many snakes around the place and people were scared of them and we didn’t know whether they were venomous and then the idea came to me, when people would be bitten or thought they
might be bitten, they’d bring in the snake and they’d say, “Do you know what this is?” and I had no idea what it was so then I let it be known around the battalion that we’re going to collect the snakes, which we did, and then I’d get the local villagers to identify whether they were, or the interpreters, to identify as much as they could, whether they were venomous or not and so I guess I had two things that were different.
I had the disease chart and the snake collection.
Were snake bites a common thing?
No, but snakes were common. I think the snakes try to keep out of people’s way.
Must have almost looked like an old witch doctor’s consulting room?
Well I hope it didn’t. I hope it had a degree, an air of professionalism.
What were you capable of dealing with at that RAP?
Most of the day to day complaints, infections, skin infections, chest infections, bowel infections, fevers or eventually fevers, minor dislocations and fractures, minor
suturing, could be dealt with there. Then if people needed to be resuscitated, that could be done there but then they’d have to be evacuated out. I actually didn’t have beds. With the battalion, clearly you couldn’t, so if I was evacuating, if someone was actually quite debilitated but needed a few days off, I’d send them to the little field hospital at Nui Dat
and that’s where I had my pathology done as well for VD and that sort of thing and if they were more serious they’d get sent down to the hospital at Vung Tau.
The field hospital at Nui Dat, what was that equipped to handle?
A bit more than what I had, but they could stay overnight so it was pretty basic. It had one doctor and a few medics.
Where were your stores coming from, I mean your medical supplies?
I think they came from various places. The army ordered en masse the stores and I think they contracted out to various places so that some of them came from Australia. I think some of them came from other countries.
The sergeant and I would go through the list of things that we could get each month and order. We weren’t ourselves involved in any contracting. We would order from the stores in Vung Tau.
How did the climate affect storage?
It wasn’t really a problem. We had a
fridge there. The only thing is that with some of the tablets and things like that, if they weren’t, like for example if someone was on some of the antibiotic tablets and they went out bush and they didn’t keep them in a sealed container, they’d often just disintegrate in the humidity so we had to be pretty careful that they were kept dry and that sort of thing.
What would the platoon medics carry with them?
Basic resuscitation equipment, narcotics, that’s about it, so they’d have, what I did before we left is I went down with the sergeant to the stores in Melbourne because we were in Puckapunyal and we had the original sort of canvas
bags that the army traditionally had which I thought would be hopeless and I’d heard they’d got these bags in moulded on the American model and we went down and we actually ordered to take on the ship so we had quite a good backpack if you like where they could put the bandages and the injections and the other things in it and obviously for a lot of the medications they’d order, if they were out in the bush and
they needed something, they’d tell them I’d find out from the company medic on the admin net and they could be sent out with the supply helicopters or if they were in base of course they’d just come down to the RAP and get what they needed but they wouldn’t do any treatment in the platoon area in base or the company area. It would come down to the RAP.
In times when the battalion was in base, what sort of injuries would you see commonly?
The sorts of things you’d see from football plus there were injuries that happened when people were firing weapons. It was more like sports injuries and that sort of thing, that people mucking around or building something and they had an accident, that sort of thing.
When you went out with the battalion when it was conducting operations, how would your job change or the procedure of what you were doing, change?
Well there weren’t the big sick parades. There’d be time spent going to the various companies. A lot of that was morale boosting, just to make, you know, I think the people thought that if the doctor came
everything would be safe, I’m not quite sure. If the padre went in they used to think that something terrible’s going to happen but if the doctor came in, I think they felt safe. It was an interesting sort of ethos but I’d spend quite a bit of time with the commanding officer or the senior officers monitoring what was happening and there’d be a lot of time just sitting around, but when things blew up, I mean all hell would break loose
so you had to be just ready for that sort of thing.
When did you see your first battle casualties?
Probably fairly early on. If I was in the base then the casualties would by-pass me and go down to Vung Tau. I mean we had a very efficient
system of evacuation. If I was in the field, then I’d often go in or if there was a particularly difficult situation where there was triage needed then I’d go in to do the triage. Now just which was the first one I just can’t recall. I think the first one was one that I had to come in by helicopter where there’d been a contact and people,
there was, killed in action and quite a number of people wounded and I had to help get them out and that was I think probably in the first couple of months.
That must have been quite an ordeal for a young doctor who hadn’t really seen this before?
Yes it was because when you went in you had no idea what to expect and things would go wrong and there were a couple of times I
went in when the area wasn’t really that secure and so you’d be a bit apprehensive but you’d be pretty focussed too on what you were going to do, worried you hadn’t brought enough stuff. That’d be my major worry I think, that I haven’t got enough stuff with me.
Can you describe what it’s like going in under those circumstances?
I guess the first thing is you have a lot of trust in the system, that it’s going to get you there and look after you when you’re there and get you back out and I did have a lot of trust in the army pilots and air force pilots.
There were some situations where I wasn’t very happy at all about it but others, I mean with that particular one I think I was telling you about then when we came in. I said to the helicopter, “Can’t you land?” He said, “No.” He said, “I’m not sure what’s underneath,” so I had to jump out of the helicopter into the rice paddy and so actually when I got to the
area where the contact had been, I was soaking wet and covered in faeces from the water buffalo and I felt most ill prepared to do anything but I just went ahead and did it. There are other times where it was much more dangerous where I had to be winched in and I was actually quite frightened in those situations.
Because of the altitude or because of the enemy?
Both, and particularly there was one night winch in where I was winched in at night through a tree canopy and I kept on hitting the trees and they’d have to pull the winch back up and then let me down again and the contact was still going on, some distance away, and that was quite worrying. Also I’ve got a fear of heights as well so that didn’t
You mentioned needing to go in, in situations where there was triage needed, can you expand on that?
Well that was one. That was a major contact I was just talking about where one of our companies came in contact with a large enemy force and I was actually in the base camp. Anyhow the CO called me up and he said, “Look, something
pretty bad’s going on there and I think we need to send you out,” so I went out and I don’t know, it probably was early evening. It was dark and so I came in and they had a series of little torches so that I could be winched in and then they brought all the, they were bringing the injured in and then I was triaging them and then we were using the same helicopters
to put them on, in these wicker stretchers and winch them out and I think we probably sent about eight or nine out and the rest didn’t need to get winched out. They could have come out in the day and so the last one to go out was me. I went back up again.
What sort of injuries were there?
Horrific. There were serious head injuries,
compound fractures, blood loss. They were very, very bad injuries.
Had you seen things like that before?
There I had, yeah but not, I’d seen injuries in Australia for car accidents, that sort of thing but not to the degree of messiness where you’d think, “Gee,” you know, “How are they going to save this limb or,” because of the,
all the wounds were dirty, if I can use that, you know what I mean by, you know, mud or everything else on them.
Treating in the field like that, major trauma, is a long way removed from a sanitised brightly lit casualty ward?
What are the difficulties you’ve got in those field situations?
You’ve got difficulty in
firstly making an adequate assessment. Then you’ve got difficulty in, once you’ve made the assessment, can you actually stabilise that person? If you can stabilise them, will that stability last till they get to the hospital. You’ve got the pain management issue and then you’ve got the fact that you’re not just you there with the body. You’ve got the mob
watching and it’s one of their friends so you’ve got this level of intense anxiety and concern from the people round that, I mean this incident we’re talking about when I had to, with the triage I had a major decision. It was fairly clear to me one of the people wasn’t going to live very long and you normally wouldn’t send that person out
and I had a morale issue that they all thought that this guy needed the most help, which he did in one way but the most help wouldn’t have helped, so in the end I made a decision to winch him out, knowing that he was taking the place of someone who had a greater chance of survival but I sort of weighed up in my own mind, “If I don’t send this bloke out, they’ll all
guess he’s going to die,” you know, that sort of decision and in fact I think subsequently he didn’t die but you’ve got that sort of situation and there was another time when I was winched in and by mistake, this was a mine accident, they actually winched me into the minefield
so there I was in the right place to treat the person but the wrong place in terms of what was all around me and mine injuries are some of the worst of all but then I had the problem, how was I going to get out of the minefield and that took a long time because we had to get people who’d lain the minefield to get a way for us to get out. Now that certainly affects your judgement if you know
you’re in a situation where it’s not safe for yourself as well.
So it’s not only clinical pressure you’re under, there are other factors that you’ve got. What sort of persona would you need to project as a medical officer in those situations?
I think you need to show that you’re in control, even when you’re not, and that can be quite hard. I mean
sometimes people have said to me during that period over there, “Gee, you were quite calm during that thing,” and I actually thought I was the last thing but calm but it must have been the way I just projected it and it was interesting. When I came back from that winch in job, went up the CO to brief him on what happened. He said, he opened the whiskey bottle, cause you weren’t supposed to drink in the lines.
He opened the whiskey and poured me a whiskey and it was, that’s, I mean, cause I can remember I came in and I was starting to tremble, my hands were starting to sort of, you know, and he recognised what it was. He was an old Korean vet, poured the whiskey and that sort of settled it down. Now that’s, you might say, “Well that’s not the best way to handle that sort of thing,” but certainly the debriefing I had with him, as well as giving him information, cause I was
the first person he spoke to in person that had come out so as well as me giving him the tactical information, it also helped me to be able to talk through what had just happened.
Did you ever have to treat men in a position that was under fire?
Well that one, the firing was still going on in the background. The other situations when I went in, they may have secured the perimeter
where you’d come in but the area around wouldn’t be secure, so you’d come in and there’d be people on high alert so the firing might have stopped but the only area that was secure would have been the area you’d just gone into or were coming into but you couldn’t ask questions about that. You’d just look quickly and see what was going on and then.
In the dark and in the mud and confusion and the
amount of equipment a soldier’s carrying, it must be easy to miss things sometimes?
That was a worry, yeah and the first thing you’d do in that sort of situation is get off everything that wasn’t necessary off the body to try and ascertain just how severe the injuries were.
How would you be able to illuminate things safely?
You couldn’t, at night, no.
I remember, I mean this is an entirely different thing and it has its sort of funny attitude but we were out on one operation and this bloke, they crawled him up to where I was sleeping and some sort of earwig or something had got into his ear. It was actually sitting on his eardrum and he was in I mean
excruciating pain. I mean you imagine something scratching your eardrum and anyhow the officer that was there said, “Look, for God’s sake, do something,” you know so I had a little pencil torch and I wasn’t allowed to make too much light so I was under a blanket with this little pencil torch and I had an ordinary syringe and a needle and I had a thing to look in the ears so I had to pass
a little syringe down as close to the drum as I could get and the minimal light under this blanket and in the end I did syringe this thing out of his ear. Now, you know, if you talk to people back here about doing something like that, they say, “Oh no, it couldn’t have happened,” but in fact even on little things like that you’re operating under conditions which are, well, not optimal.
Treating soldiers out in
the field for battle injuries, what was the objective of your treatment?
Stabilisation and pain relief, nothing further. Stabilise them as quickly as possible, get the pain under control and get them out and in fact I think that’s why overall our health services were as good as they were because that was the doctrine that
in fact people jokingly said, “You’re better off in Vietnam if you get hit than you are in the streets of Sydney.” Now I’m not quite, I mean that’s a relative statement but then once the area was secured, people were got out very quickly.
If you could get somebody out, what were their survival chances?
You’d have to look at the statistics on that.
I mean it’s interesting. The helicopter has become the symbol of the Vietnam War and it’s interesting cause the symbol in most people’s minds of the First World War is Simpson’s horse [donkey] and that’s a medical sort of symbol. It’s got to be complemented by the fact that firstly
they were got out quickly. Sorry, firstly, we had a highly trained medical corps people who in a sense could stabilise very quickly. We could get them out quickly but we also had a proper operating theatre and everything else as soon as the helicopter got there so there are a number of things I think would have contributed to survival.
But if they did get back to a hospital, then their chances would have been pretty good if you’d had them stabilised?
Yes, I’d have thought so.
You mentioned before that mine injuries were particularly hard for you to deal with, why?
They were very dirty and because the mines were designed to cause maximal
damage to the lower limbs, then you’d have a situation where the blood loss and damage would just be enormous in the first few minutes so that people would bleed to death virtually very quickly and they would have been the most horrific
that I saw. Thank God I didn’t see too many of them.
Were they usually our mines or their mines?
Ours unfortunately, so they happened two ways, accidents when they were being laid or
the Viet Cong got very adept at coming into minefields and removing the mines and then placing them in booby traps.
What sort of wounds do you think soldiers feared the most?
Disfiguring wounds, yeah, I’d have thought disfiguring and painful wounds, yeah
although one of the things that can happen, if a person’s been fairly seriously injured, with the blood loss that happens and the shutting down of the circulatory system, often they won’t feel the pain to the extent that they can be felt until the resuscitation’s well under way and their systems open up, if that makes sense, so that
some people would say, “Look, when it first happened I felt this bang and,” you know, “I don’t remember much about it but when I got to the hospital and they started to put the blood in, that’s when the pain really hit them,” but disfigurement, I think disfigurement was one of the things that
Anecdotal kind of stories would say that injury or loss of testicles and so on was a worry for some men?
Yes and that would be the mine situation that primarily would cause that. I can remember one soldier who I was talking about, I was counselling, who’d witnessed one of the mine injuries sort of said, was terribly upset about the fact that his friend’s genitals had gone and for me, I was just stunned
because I was coming to terms with the fact that this guy had lost both his legs and the friend wasn’t worried about the legs. It was the male genitals and you can, I mean that fits in with your anecdotal story.
How did you feel about losing men that you had treated?
and there were people I’d treated who died in situations where I wasn’t involved in their resuscitation so you get, as well as people I may have treated at the scene, there would be people who I’d be seeing for some other condition, so I was very involved in what was happening
and then they go out on an operation and then they’d be killed so there was that double sort of thing. I mean people, you never get used to it.
What do you think the soldiers thought of you?
It’s hard to know.
It’s only, I mean since the welcome home parade when a lot of the communications started opening up and people had been, and I’ve joined my association, the 7th Battalion Association, the number of phone calls I’m now getting from people to discuss this problem or that problem, would make me think that they still see me, even though it’s so many years ago and they haven’t seen me for so many years,
they still see me as someone they can talk to so I suggest that’s an indication that I guess there must have been a good sort of therapeutic, not therapeutic, but a good doctor/patient relation if you can say that because it’s, you’re in an interesting situation in a unit like that, that they have no choice over who their doctor is and you have no choice over who you can see, so you’re in a system
where like it or lump it, you’ve got to work with that group of people.
That must enable some privileges in terms of following cases over a period of time?
Well that’s even more so in the clinical work I’ve been doing as a psychiatrist with the army at Holsworthy. It means you can actually follow the
psychiatric cases right through and which is quite different to ordinary practise where you may, I mean for instance my ordinary other practise where sometimes people don’t turn up or they go somewhere else, you never know what happens. You can actually follow people right through and see whether they do well or not so well.
Did you ever encounter resentment from friends of men who’d been wounded or hurt that you hadn’t been able to do much for?
No, distress but not resentment. A lot of stress but I can’t remember any resentment. I mean for example when I was a second year resident I went and did a country term which we all had
to do and this young guy was brought in with an asthma attack and I couldn’t save him and he perished. Now two of the family members attacked me, they were so angry and blamed me for not saving him, so I never experienced that sort of situation. I think that’s what you’re talking about. No, I never experienced that situation,
and I have experienced it, so I know what it’s like.
Yeah I asked that because it’s my understanding that in the period we’re talking about, doctors were much more revered by ordinary people as being almost God-like in their powers but you found that diggers accepted the outcome of battlefield injuries?
Well they saw how serious they were. I think
that’s, I mean for example, getting back to this asthma case. The family had ignored the pleas of the sufferer to take him to hospital. He looked better than he was so to them there was the guilt of not taking him to hospital and then they realised they should have but also he didn’t look as bad as he was, whereas when you talk about the battle case, at least people
can see that’s it’s a very serious thing that’s happening, or sorry, happened. In fact it was the opposite thing happened in a sense. They had a hand grenade practise in the base camp and I think somehow it wasn’t thrown far enough or something happened and a bit of shrapnel hit
one of the blokes on the head so they brought him down on a stretcher, one of the rare times I think a stretcher was used and I had a look at him and of course there was brain coming through the wound and so I got the sergeant over and we cut the hair and everything off and then I put some antibiotic on the brain
tissue and then bandaged it and then called for a dust-off, which is the name for getting a helicopter in and there was outrage. Everyone was saying, “What do you mean dust-off? This bloke’s just got a scratch on his head,” and in the end I had to ring the commanding officer and say, “If you’d like to come down with the company commander and show him, if you’ve ever seen a live brain before?” you know. I was actually quite angry too. Well they got the dust-off in and he was
taken away and he survived but that’s the only time I think people, cause they thought the guy wasn’t as seriously hurt as he was.
The platoon medics must have been under a lot of stress being out there all the time, what particular problems do you think they had in dealing with this all the time?
I think they dealt with it very well. I think the problems they’ve had are since then. With my own platoon having chased up over three quarters of them now, there’s only two of them who are not TPIs [Totally and Permanently Incapacitated pensioners] and I had no idea until working towards this reunion we had last year, how many of them were TPI and
in fact when I put the notice in about the reunion in the newsletter to see if there was going to be enough interest and I put a little thing in about the medical platoon had a foot in both camps. They had to be an infantry soldier and a medical person and this put a lot of strains on people and I just put something in to alert them to the fact and then when they all turned up and most of them had had stories that they’d been
able to work until near the end of their working life and then the psychological symptoms surfaced and I guess that’s the penalty and I think it’s been a longer term thing rather than a short. I think in the short term they did cope. I think the group cohesion and everything else was quite helpful.
Why do you think they might all be TPI now as far as, what’s caused that?
I think it’s the trauma they were exposed to, cause as well as seeing the trauma, they had to directly be involved in the treatment of the trauma which I think adds that double thing. As well as being horrified and distressed by what they saw, they had the sort of self responsibility of getting the person fixed up and then the worry about, “was the person going to be OK
subsequent to that?” I mean I’m theorising now but I would suspect that that’s a greater trauma than just, well not just seeing something, but I think it adds to the trauma.
When you’re treating a man in a battlefield situation I imagine that he’s not just lying there still and taking it, do you have instances of shock or distress that’s making him physically hard to restrain?
No, most of the time not because the blood loss
is such that they’re in pain and so they’ll collapse. The person who’s more likely to be like that is the person who’s not so seriously wounded but is in significant pain or discomfort from the wound they’ve got. I mean the people who’ve been hit by a claymore or machinegun fire or a mine going off lose a lot of blood very quickly and that puts them into a state of shock
where they’re less likely to be like you’re describing.
How do you, if somebody is less seriously wounded then and is resisting treatment, how do you do it?
I used to just let them go until they’d settled down a bit. I mean that’s not meant to sound callous but you’re not in a very good position to restrain people and
usually their mates will talk them down, say, “Look, settle down, let the doc have a look at it,” or, you know, so in fact one of the interesting things in the, when you speak to people who’ve been medical personnel, my nickname was doc, the corporal’s nickname was doc, platoon medic’s nickname was doc. Everyone’s nickname was doc so they all saw the, even the private soldiers
who were, I shouldn’t say even, the private soldiers who were platoon medics were still the ‘doc’ to that platoon.
Interviewee: Anthony Williams Archive ID 1751 Tape 05
Tony why didn’t you allow weapons into the RAP?
That’s a good question. I thought you were going to ask that. It was a regulation, and I think, for there were a number of reasons. One, in case someone was disturbed and brought a weapon in, but I think more likely, if the place was attacked
people wouldn’t be running around inside the RAP looking for their weapon which might be sitting on the floor or up against something but they were all sitting in a rack so you could run out and just grab it and I think that was probably the reason. Similarly you couldn’t take weapons into a mess. You had to leave them outside. I think probably the same reason.
Any other places where you couldn’t take your weapon?
Into the hospital. There probably were, the chapel, couldn’t take them into the chapel. Again you left them outside. There probably were more that I haven’t thought of.
Where did you keep your weapon?
In my tent.
How accessible was your tent to you while you were working?
About five paces, ten paces, wasn’t very far.
And how accessible was the entrance to your tent to other people if your weapon was unattended then?
It wasn’t unattended. Sorry, it was unattended but it wasn’t sitting in the open air. In fact I had two weapons. I had a pistol which was the issue to officers but if you wore a pistol in the field it clearly showed the enemy you’re an officer
so I used to carry a machine carbine in the field, the same as other soldiers carried.
Why did you do that?
I didn’t want to be a target.
For the enemy?
Mm because they could, if there was an ambush or
someone was sniping and they could pick who the officers were, they’d go for them first cause that would knock out the command structure so for example in the field, we never wore rank in the field either so everyone was dressed the same. I mean you knew who the officers and the sergeants were and
the only medical thing I wore in the field which was I suppose a little fetish of mine, is I got hold of one of these snake on a stick things, little cloth one and I just sewed it onto my bush hat at the front but you couldn’t see it from a distance.
What weaponry did the other officers have in the field with them?
So if say the battalion was in the field and they were being observed, they couldn’t tell who would be the commanding officer. They couldn’t tell who would be a signals officer, artillery officer, the medical officer, a platoon sergeant, by looking at them. Their
uniforms would all be the same.
What were the uniforms in the field?
Green. The army hadn’t gone to the camouflage. You’ve seen those cams. They were wearing jungle greens.
What about on their feet?
Black lace up boots which had metal plates in the soles
and that was because of the panji traps. It was a thing that the Viet Cong had developed where they would, on trails and that they’d dig a little pit and then put bamboo spikes in the pit and then put grass over the top and the spikes were so sharp that a weight of a human body, it would pierce an ordinary boot and go through your feet so they developed the boots
with the metal in them specifically for that.
Did you ever see injuries of a bamboo spear in a person’s foot?
No but I saw panji traps that people had found so I knew they were there.
Can you describe one for us?
Yeah, it was like if you’re walking along here, someone had just dug a little trench.
How big, about what size?
About half that size.
So two or three feet long?
Couple of feet, yeah and it would just be across the track about that deep and the bamboo coming up and then it’d be camouflaged on the top so that you couldn’t see it was there and a very effective trap if you walked into it so that’s why the boots had the metal in them.
What other devices if you like were developed by
the Australian army to protect from particularly Vietnam War traps such as that or obstacles, booby traps?
Well the other thing that we wore which was not particularly developed for there, similar to what you saw John Howard wearing when he went to see the troops in Iraq, a flak jacket which has got lead in it. I think it’s lead or some metal anyhow to help
you if shrapnel hits or, it won’t protect you from a direct bullet but it certainly protects you from fragments from a grenade or shrapnel or that sort of thing and we used to use those if we were going on convoys. If you were sitting in a vehicle, you had one of those on.
How comfortable are they to wear?
Heavy and hot in that climate to the point that a lot of people
wouldn’t like to wear them so that if you were caught not wearing one when you should have, you’d have been charged as an offence and fined for not doing it.
As endangering yourself?
Yeah because if you do something that could potentially endanger yourself, in a military situation that puts the whole group that you’re moving with at risk because if you become a casualty, then they’re bogged down
to look after you.
Back to on the aircraft carrier on the way over, I just wanted to know what routine inoculations the diggers received from you?
On the carrier?
Before they got to Vietnam?
None. It was all done before we left.
What did you give them?
Now you’re testing my memory again.
They had to have smallpox because smallpox was still around, tetanus, typhoid and cholera. Yes I think they were, yeah.
What kind of side effects did they experience as a result of the inoculations?
Fairly minimal. I mean aside from the psychological one of collapsing and fainting particularly at the sight of the needle
or it going in, and that was common, some people got a bit of a fever. The most common though was sort of a tenderness and painful reaction at the injection site that would pass off so we made quite sure that everyone had had all their inoculations well before they went
and of course the smallpox, they had to be read as well, so if you inoculated them, they had to come back and you had to read to see if the inoculation had taken place, by seeing that the scar had formed.
So that’s the sign is it?
If there’s no scar it hasn’t, anyone that’s had smallpox, if you know where to look, you’ll see a little patch, you know, where the inoculation took place and it’s, so we never had,
I guess in all I’d have inoculated or vaccinated for smallpox and inoculated for the others, probably over a thousand troops and no-one had a serious, adverse reaction although it potentially can occur. I mean smallpox you can. It would be the one that would worry you the most because, rarely, you can get
encephalitis from it so it potentially is the most risky. The other ones, it’s more likely to be an allergic reaction to the substances that are in the, you know, what you’re injecting.
Why does that little round disc of discoloured skin appear with the smallpox injection?
Because it forms a small scab which is actually like
the smallpox itself. If people have had smallpox, you’ll see the pock marks all over their face and body. What this does is form a smallpox scar. It’s not smallpox. It’s related to it and then when, sorry, a small scab. Then when the scab falls off it takes off the outer layers of the skin and so you’re left with that scar. There you go.
I always wondered about that?
OK, when you called a digger back for an afternoon consultation, what was the structure of that appointment, how long would you have with them and can you explain for us what you’d do then?
Well I’d usually say to them that it’s not structured in terms of time. I’d say that it’s confidential unless there’s some risk of harm to themselves or someone else and that
any notes that I took on it, they’d be able to see what was in the file and then I’d just sort of handle it in a, I mean the morning interviews would be very direct questioning, “When did this happen, how long has it been there?” you know, that sort of thing, whereas the afternoon sessions would be much more open ended so you’d just say, “Well look, what seems to be the problem?” or, “Can you tell us what’s been
going on?” and take it from there.
Ethically how different was the army from say general practise in terms of confidentiality?
It is different because if you go to see a general practitioner, you’re paying him or her so that person is contracted to you.
If you’re in a military situation, the patient is not paying you for the service. You’re being paid for by the employing authority so that your responsibility, as well as having responsibility for the person you’re seeing, you’re also responsible to the paying authority and the,
in a battalion, the medical officer is responsible to the commanding officer for the health of the battalion, so if the medical officer becomes aware of a situation that may threaten the health, then the rules of confidentiality can be broken.
In what circumstances would you break those rules of confidentiality?
If a person
developed an infectious disease that was potentially, you know, serious, not a common cold or that sort of thing but a serious infectious disease that potentially could affect the unit, then you’d notify, but you have to do that anyhow in a public health, that didn’t happen and in fact that’s one of the reasons, when I mentioned to you some of the company commanders wanted to know who had VD. My
response to that, “Well, why do you need to know?” and the commanding officer backed me on that. If someone’s psychotic and that’s obviously a danger, could be a danger to themselves or somebody else and in, if someone
was not taking their anti malarial medication or anti mosquito precautions, then that was a chargeable offence.
Why wouldn’t they take their anti malarial medicine?
Well I’m speculating here but I suppose the most obvious reason would be slackness but the other would be to, if they didn’t want to be in a place,
you could in fact get the infection if you didn’t take it and that would get you evacuated.
How often did you see that happen, how often did you evacuate because of malaria?
It was very common particularly in the wet season, in November, at the end of the year, first year that they were there. I mean it was almost like we had a regular ambulance service going to and from.
In fact there was an enquiry into why we had so much malaria and it was a very difficult time for the CO and myself because we were both blamed for not taking the appropriate measures to stop the attack actually happening and I guess it was, you’re looking at it with hindsight now and that, well sorry, I’ll go back.
At the operation’s planning meeting I warned the CO that we had a high risk of malaria because of the area we were going into and we knew that malaria was in the population of the people that were living around that area. He thought, and at that time with good reason, that if we were taking the precautions that there wasn’t a
high risk of a large number of casualties, which proved wrong and so I then conducted an enquiry through my own medics who, they were responsible for making sure people took the anti malarials and also for checking to make sure people had their sleeves down and everything else at the time when mosquitos were more likely to bite and for people having adequate netting and that
sort of thing and my enquiry satisfied me that they had been taking the precautions and where we had a problem was the battalion that was working alongside us, on the other side of the highway, didn’t get the malaria and so the medical authorities said, “Well how come they didn’t get it and we did?” but in fact they weren’t moving through the sort of wet area that we were. Theirs
was a drier area so I made a recommendation that looked into they should do some research to see whether or not there was a resistant strain of malaria developing and which didn’t happen until some time later after I’d gone and our unit had gone and they did investigate it
and we were vindicated. There was a resistant strain there and that led to two things. One, they changed the anti malarial but secondly it led to the setting up of the military malaria research unit and I didn’t find out about we’d been exonerated until the medical history came out and I’m in the medical history of this whole saga, which was very difficult because we were, in a sense, we were disgraced
that we weren’t doing our job properly and that sort of thing and the finger’s not pointed at the battalion. The finger’s pointed directly at the commanding officer of the battalion and the medical officer, the commanding officer for not making sure the malaria discipline was carried out and the medical officer for not making sure that he was checking that it was being carried out, so there were those sorts of little sagas went on,
as well as the other routine things we’ve been talking about.
You said earlier that you saw a couple of examples of psychotic episodes, can you tell us about them?
Well firstly it was, psychotic episodes in military personnel are rare and I can explain that a bit later, or later, if you wish. Secondly they can be,
as these both were, quite unexpected. The first one was someone that wandered into the RAP at night when I was doing some book work or something and asked to see me and I thought something was wrong when he came into my office and he had his rifle with him and when I looked at it, it was loaded and cocked and so I immediately
thought, “There’s something very seriously wrong here,” and then he started talking about how people were talking about him behind his back and he was hearing voices to tell him to kill people and so within five minutes it was very clear to me he was psychotic. I had no idea why, and so it then took me about thirty five minutes of quiet talking to get the weapon off him
and I went outside and the sergeant was there and I said, “Why didn’t you knock, why didn’t you come in?” He said, “Well your sessions usually take thirty five, forty minutes, so we thought it was still going on,” and they had no idea so we got the weapon off him and then locked him in the cell that the regimental police had. We had no anti psychotics. I did have some
anti emetics, anti nausea drugs, which will sedate people, so I gave him that and then he was sent down to Vung Tau and evacuated to Australia and the second one that happened, he had a machinegun and he developed a paranoid, what’s called a paranoid psychosis, similar sort of situation and he actually fired his machinegun through the tents
and fortunately the people were in bed and of course the sandbags went up to a certain height and the sandbags prevented anyone from actually being hit and so with him, when I saw him, of course he was dragged in by the military police, handcuffed. They’d got him and so he was evacuated too. They were the only two psychotic episodes and
when I’ve talked to other RMO’s who were over there or even in the, like Timor or that sort of thing, they all report, they’ve all reported to me it’s very rare, hardly ever see it.
You mentioned just a few minutes ago that psychotic episodes are very rare in the military, can you explain that?
Because if a male’s going to have a first psychotic episode, on the average, not always
it’s going to happen before they’re twenty one and usually, or commonly, they’re precipitated by either drugs or stress, something like that, on top of a predisposition to having it and if they’re going to break down, they usually break down in their recruit training and if they get through the stress of the recruit training then it’s unlikely that they’ll have an episode. The later forms
that can develop later on in the thirty’s, of course they will develop if they’re going to but the more acute forms in the younger people, it’s not commonly seen.
How did those episodes affect you?
Well the first thing, when the first one happened, I was totally unprepared for it. It just never crossed my mind that something like that would happen. Once it happened once,
then I was on the lookout that it could happen again and I’d briefed the military police on how to handle the situation if it did happen.
What did you tell them to do?
There’s a paranoid form where they can be dangerous and I mean you’re in a situation where people have got access to loaded weapons. If someone develops that sort of condition, they can be quite a menace to themselves and to others.
How did your interests in psychiatry develop during your time in Vietnam?
Well I did see quite a number of
psychological or psycho-social problems if you like. Initially when we got there they related to separation from family and that, you know, missing home, that sort of thing but as time went on, I started seeing people who were becoming distressed or developing symptoms associated with some sort of
critical incident, like what we were talking about earlier with the battle casualties and that sort of thing and commonly that would present with the person being distressed, not sleeping, anxious, having intrusive memories of what they’d seen or been involved in and they’d usually present either to me or one of
their medics would say, “Look, so and so’s having a bit of a hard time, will you see him?” and when I say him, it’s always him, because they were all men. Well I did see some women but I’ll talk about that later. So they’d come in and they’d usually respond to a couple of sessions of just talking to them and restricting them from going out in the field and if that didn’t work, then what I’d do is
bring them in to be my personal assistant and look after me when I was doing things and gradually sort of, if I went out into the field, they’d come out with me and then as they, and I’d usually use some milder sedation with them and then as they improved I’d get them on sort of guard duty around the battalion headquarters, then they’d go back to their individual platoon
and that seemed to work for most of them. Now whether or not that subsequently helped prevent post traumatic stress disorder or something else, no-one knows at the moment and most of them seem to accept that and I was in the, I suppose unique position that I had a, cause officers
of captain and above are entitled to have what’s called a ‘batman’, which is your own servant, and so I had a batman who doubled as a driver and then he said that he didn’t want to do it any more. So then I got another chap and turned out he had a criminal history and he was more trouble than it was worth. So then I approached the company commander and said, “Look,
rather than have my own batman, what if I start using people who might have some psychological problems and they can look after me and get their confidence back,” and that’s what I did for the rest of the tour and it seemed to work reasonably well, cause looking after the doctor was seen as a cushy job but also it was seen as having a bit of status because if there was a conference on, the doctor would go to the conference and come back and the batman would be the first one to hear about what happened
at the conference, so he’d be the one who could pass on information to his mates about, “Oh the doc said this is going to happen or that’s going to happen,” and they seemed to like that and in the field all they had to do was look after my radio. If I was out visiting a company or on the move, pack up my stuff so that it went with the rest of the stuff. When I came back at the end of the day, help cook the meal up and then do a few things
whilst I was on the radio at night, so it wasn’t an erroneous job but it was seen as one where it had some status.
What was your relationship like with the guys who were your batmen?
I felt comfortable with it. I thought it was OK.
Did you confide in each other as mates?
With the batman? No.
Who were your mates in Vietnam?
Well the doctors are in a sort of difficult situation in that sense. They’re all a bit like the padres or the CO, that you actually don’t have many people, I mean you, there’s very few people you can talk to. Now occasionally I’d
meet up with the RMO’s, cause there were two other battalions there when I was thereand then there was the artillery and that had a medical officer as well so in the field force units there were four and then at the headquarters in Nui Dat, with the little hospital thing I was telling you about, there was one there. He was a major. The rest of us were captains
so we used to try and meet up occasionally just to have a bit of a meal or a drink together just as a little supportive network, which I think was successful. That would have only happened probably four or five times when I was there. With the field hospital in Vung Tau the relationship between the medical staff there and the medical staff in the field was very poor.
So if I went down there to visit the soldiers, most of the time I’d just cop criticism and so the field medical officers would visit the hospital the least number of times they could because of the attitude of the staff there,
and I don’t know why it was like that, but I think that they, I think basically they had no understanding of what a field force doctor would do and what they didn’t realise was that the field force doctors knew exactly what they’d be doing because we’d all worked in hospitals in Australia and I think it was just an unfortunate situation and from what I understand, it just
wasn’t when I was there. It was all the way through.
How did that manifest itself?
Poor communication I think would be the main one, cause they were miles away from where we were so we didn’t see each other, but it even got to the stage of being quite petty that because I was the medical officer for the battalion
the commanding officer asked if I’d wear the battalion lanyard, you know how you see the coloured things people wear, so and of course the battalion lanyard is a different colour to the medical corps lanyard so when I went down to Vung Tau I had the battalion lanyard on and
I had my peaked cap which had the medical corps badge on it and the commanding officer of the hospital pulled me up in public and said that I wasn’t properly dressed and I mean that’s the level of pettiness that you had to deal with and of course from my point of view it was just like water off a duck’s back. I just ignored it but it wasn’t very pleasant to have that sort of behaviour.
So on these visits down to Vung Tau how long would you stay?
They used to want me to sleep over but I was fortunate the CO had said, “I don’t want you out of the camp any night,” so I had an excuse. I’d come down and back in the same day.
I imagine it would have been enormous pressure to have the health of a whole
battalion resting on your shoulders, how did you handle that stress?
Well at the time I saw it as part of the job, the same as the signals officer was responsible for all the signals for the battalion. The forward officer for the artillery was similar for the artillery support. I saw that we were the specialised officers
in the battalion that had a certain responsibility. I think looking back now I can see that I probably tended to put that sort of concern aside and just get on with the job, if that makes sense.
So getting back onto emotional and mental disorders within the army in Vietnam, what kind of things did you see and how did you identify them?
Well firstly, as I said, we’re basically dealing with a healthy, physically and emotionally, healthy population. At one end of the spectrum
the psychotic disorders were extremely rare. I mean to have two breakdowns in a thousand people is pretty rare and the more common that came to me were the stress related, anxiety type disorders that I’ve just mentioned that might be precipitated by seeing or being involved
in something pretty awful. Now I would presume that a lot of those didn’t come to me but they were handled amongst their peer group, people just talking about it and supporting each other and that sort of thing but certainly, I mean it’s interesting in the work I’ve been doing more recently with the army, one of the medical officers who
went to Timor with one of the battalions, was very psychologically aware. This is during the INTERFET [United Nations sanctioned International Force in East Timor] we’re talking about, you know, when they first went across and so he had a number of sessions with me about what to look for and what to do. The other medical officer, when I offered him those sorts of ideas, he said, he wasn’t particularly interested in that side of things, and the battalion that had the medical officer
that was aware, had the greater referral for psychological issues to see a psychiatrist or a psychologist, than the other battalion and I think that means that people were picked up earlier because I can’t believe the two battalions were different in the sorts of issues they presented with because their roles were fairly similar during that first period after independence so
now I’ve lost the point. Yeah, I think if the word gets around that the doc’s prepared to listen and in a closed system like that, words get around, then I think people will put their hand up.
What did they talk to you about?
A lot of the time it was the incident itself and the trouble they were having coming to grips with it. There might be guilt feelings about what happened or there might be shame feelings, feelings about being upset, angry feelings that, you know, sorts of emotions that could happen around an event, depending on what the person’s role was in that event.
I mean commonly people would, well not commonly, but one of the things that often came up was they felt guilty they couldn’t do more to help the person, that sort of thing or they’d get troubled by nightmares of what they’d seen. One chap that I saw, he couldn’t explain
why he was getting so upset when he was doing certain things or going to certain places so I told him to map out what he was doing and take notes and that and after a number of sessions he came and he said, “I know what it is. Every time we flew over or went near the place of the contact where my best friend was killed, that’s when the symptoms would come up,” he said, “but I blocked out that’s where it had happened and it wasn’t until I started doing this, that things
fitted into place,” and his symptoms then settled down. I’m not saying that everything was as simple as that but it was interesting that what was triggering his attacks was the visual cues of the area where this contact had happened but because the events were so horrific for him, he was subconsciously picking up the cues but consciously ignoring the fact that that’s where it happened. Does that make sense?
Were they coming
to you asking for help or just wanting to talk to you?
What help could you give them as a doctor?
If they weren’t sleeping then I’d give them a short course of sleeping tablets and if I did that, then I’d stop them obviously going out on patrol or handling weapons
or that sort of thing, whilst they were on the medication and then I’d use the talking, just sessions where they could debrief and discuss things and they would, that was all the skills I had at my fingertips and so they’re the ones that I used.
Interviewee: Anthony Williams Archive ID 1751 Tape 06
We’ll keep on the psychiatric for a moment?
I thought you were going to leave the psychiatric.
No, seeing as it’s there, we’d better keep going, you mentioned,
You’ve got to realise, I was not a psychiatrist there and the training I’d had in psychiatry is what you’d expect a medical officer would have had in the early ‘60’s.
Yeah, I understand that but seeing as we’ve started on that last tape, we’ll just go on a little bit?
You mentioned the psychotic episodes, yes it’s very clear that they needed to go, what about, what referral mechanisms were there for you in other less urgent cases of psychiatric disorder?
It was very difficult. The psychology corps in those days was involved in recruiting and education but
not in treatment and so we had no psychological support either by psychologists or psychiatrists in country and the couple of times that I did want a psychiatric opinion, it took at least a week to get the person up into an American hospital, get an opinion,
and when it came back it was full of psychoanalytic jargon which in fact wasn’t very helpful at all and culturally wasn’t appropriate for our services. One of the recommendations that myself and other medical officers made during that period and subsequent, was that we should have an Australian psychiatric presence, and in fact that indeed did happen
and I think Doctor Sainsbury was the first one to go, which would have been some two years after I was there, and what they did was they rotated reserve psychiatrists on a six monthly basis through the country, but we didn’t have that when I was there.
So in the case of somebody who was disturbed
yet not psychotic, there wasn’t a lot you could do?
Probably it wasn’t so much there wasn’t a lot you could do. You had to rely on your own resources so that what you did probably wouldn’t have been optimal in the treatment strategies of those days bearing in mind that psychiatric treatment in those days was more limited than what it is now.
Was there any possibility of evacuating anybody for psychiatric disorder?
Well the two I mentioned were.
Which were extreme cases?
Yeah. The one I sent for an opinion ended up being evacuated. The others we handled administratively by moving them from a field force unit to a non field force unit so that they were out of the stressful
situation, which you wouldn’t call it so much treatment, as environmental manipulation and just how much that worked I’m not sure but that’s what we did and there would have been a number of people that that happened to.
How prevalent or at what rate were you doing psychiatric consultations?
There’d probably be a few a month. I could check it on the thing there, but there weren’t…
If you saw a hundred men, how many of them would be psychiatric?
Probably one or two, but the amount of time I spent with them was much more than,
so that one or two would be much more work than the others.
I guess the reason I was asking that was to try and get some sort of a statistical basis, in asking you whether you saw any correlations in the psychiatric disorder and ,say, rank?
Well the problem you’ve got there is you’ve got one lieutenant colonel. You’ve got half a dozen majors. You’ve got
about twice as many captains so your numbers are so small when you get up to the ranks.
That’s why I was asking you about the sample size.
The sample size wouldn’t handle it.
What about a correlation between at what point the men were into their tour?
There was a point in the tour, round about six months in, where I felt
I was seeing a significant number and when I say, I’m not talking about hundreds, of stress related cases so I approached the commanding officer to see what we could do about getting them out of the camp for a period so he devised this plan where we trucked them down to Vung Tau to spend half a day on the beach.
After they wrecked a whole lot of structures and we got the bill, that plan fizzled. What we forgot to do was stop them drinking when they were down there, having this half day’s rest and I have this vision of them lying in the sun and playing cricket and swimming. That’s not what they were doing at all. They hit the grog [alcohol] as soon as they got there and then fights
started and so that was the end of that, but there were, people had two periods during the twelve months they were there. One was R and C, rest and convalescence, which was in Vung Tau for five days and the second was five days, or I think it was seven days in a place they could nominate which was selected from, I mean you could come back to Australia. You could go to Hong Kong,
Bangkok or Singapore and that was what people were given the opportunity to do. Now whether that, how successful that was I don’t know.
Any correlation in psychiatric consultation and before and after their R & R [Rest and Recreation] for example?
Sample size not big enough.
Fair enough. What about the job, I imagine people who were spending a lot of time as forward scouts
might be a little more tense?
A colleague I worked with quite closely on, cause I’m a member of the National Advisory Committee on the Vietnam Veterans Counselling Service, he was a forward scout and he and I have discussed this at length because I’ve had a particular interest in this. He says that he loved the job,
I mean and that it took a particular personality to want to do that sort of, what most people would regard as highly, highly dangerous. I mean if you think of what the forward scouts did and what the engineers did when they went down the tunnels. They’re two jobs that I feel would rank pretty high up on the stress level, but we don’t have enough numbers.
I mean there is, if there is any correlation, my understanding is that in people going through the PTSD [Post Traumatic Stress Disorder] programs that Veterans’ Affairs funds, the field force units have a higher representation in the programs than the non field force units. That’s the closest I could come to answering that I think.
What about psychiatric consultation which was really malingering, did you see any of that?
Yeah because I’ve been asked that before and if I did, I didn’t pick it up and certainly the people that were moved
or evacuated, there was no doubt in my mind or any of the other people who were with them, that it was fair dinkum, to use that old term.
How do you think the diggers themselves regarded mental problems, was there a stigma?
I think the first thing about this conflict is that approximately fifty percent of the diggers were national servicemen and fifty percent were regulars and they would have tend to have been drawn from different socioeconomic groups. Having said that, you couldn’t tell who was a national serviceman and who wasn’t just by
looking at them, clearly so unless you asked, now obviously a very young person wouldn’t be a national serviceman. They would have been a regular, whereas the national servicemen were all around twenty one years of age. I think there was quite a stigma and I think the stigma continues very much today amongst particularly the field force units.
How do you think the two groups, national servicemen and professional soldiers, dealt with stress and it manifested amongst them?
Well it’s interesting, cause again I’ve looked at this question with the Australian centre and they’ve looked at the statistics of people going through the PTSD programs and they’re pretty equal so that would tend,
OK it’s looking at it retrospectively but it tends to indicate that whichever way they handled it, the end result was not that much different for both groups.
The episode with you being confronted in your RAP, a man with a loaded gun that he was fiddling with, how did you talk him down out of that?
Very carefully and very quietly I think probably is
the best way to put it. I never took my eyes off him, faced him the whole time, didn’t let fear, or as far as I knew, didn’t let fear show on my face and tried to draw him back to the here and now from his paranoid delusions. Looking back on it, that’s how I, I haven’t had to do that very
often. That’s how I can remember what happened then.
You mentioned the somewhat disastrous half day’s recreation on the beach that you organised. Let’s talk a bit about substance abuse. What did you see of it in Vietnam?
The alcohol was used regularly and it seemed to me to be a military, perhaps
unwritten, policy that if a company or a platoon had been through a particularly harrowing experience, it would be stood down and they’d be allowed unlimited grog. Talking to older soldiers, this seems to have been a practise going right back to the Great War and I think in some ways it took a lot of people who would have been,
if I can use the term, alcohol naïve, in the period of developing their life, taught them to use alcohol to reduce stress which, in the short term, it’s quite successful, in the short term, and I think this is possibly an explanation as to why there’s such a high co-morbid rate of substance abuse, particularly alcohol and post traumatic stress disorder amongst Vietnam veterans,
which is not the case with the peacekeepers. As I mentioned earlier, the research coming out is tending to show that they’re abusing other drugs, either licit or illicit as well as alcohol, more so than the Vietnam vets.
Did you see evidence of other drug abuse in Vietnam amongst Australian soldiers?
No. I mean
in Vung Tau the local tradesmen had trays upon trays of marijuana sitting out there if people wanted to buy it. I was aware when I was there, cause I visited the American troops a couple of times, that they had a significant problem with narcotic use and marijuana use but our population I think tended to reflect a lot of what
was happening in Australia at the time. Narcotics were not a big issue in Australia at that time and if people used marijuana it wouldn’t have been picked up.
Did you yourself have any R and C or R and R while you were there?
What did you get up to?
What did I get up to? The first time I went to Hong Kong and then for the R and C,
I was actually feeling pretty stressed around the time when I was due to have my R and C and I didn’t want to go to Vung Tau cause I thought I’d get bored so I talked my way onto a plane and ended up in Bangkok and so I had two out-of-country ones. Normally, in fact when I got back from the second one, the commanding officer said, “Well what did you do down in Vung Tau?” I said, “I didn’t go to Vung Tau.” He said, “Where’d you go?”
and I said, “Bangkok.” He said, “How the hell did you get there?” I said, “I just used my pass.” He said, “But the Americans wouldn’t have let you on the plane,” and I said, “Well, they questioned the pass and I said, “No we don’t have the same passes as you do. This is an Australian pass,” and they let me on the plane,” so that’s what I did.
And how did you blow off your stress?
Both times I immersed myself
in cultural and other things like that, visiting museums. I particularly enjoyed Bangkok and I also slept a lot of the time and then went out for drinks with some of the blokes, cause there were a hell of a lot of service persons there. Went to nightclubs and bought a lot of stuff. I think every
soldier I knew came back from one of the overseas posts, bought so much silk, dressing gowns, pictures of this, and I was no different and from Bangkok I brought my reel to reel tape deck. I brought that back so, you know, I think it was, it went well. The only problem was, it relates back to the question
you asked before. I actually felt on both occasions quite lonely because I went by myself, so to speak, so I actually didn’t know anyone of my peers and a number of people I know said the same thing, they wish they could have gone with a group rather than being, cause clearly they couldn’t let all the doctors go at once.
I imagine Bangkok in that period with lots of servicemen on leave must have been a pretty swinging scene?
Would you care to elaborate?
Well I mean there was, they had, I’m not sure whether they had this in Hong Kong or not, but in Bangkok the hotels had arrangements where people could contract
to have a girl for the whole time. Well they didn’t have to do that if they didn’t want to because they’d just go down into the bar and there’d be a large number of people. There were touts outside the hotels. I mean not everyone availed themselves of that but a significant number did and a significant number of those who did, ended up coming to see me after the R and R, not for psychological issues but
I mean you do things you do, I went to a nightclub one night and ended up being hypnotised on the stage and I’ve never done that before and I probably would never do it again and apparently I was a star, even doing a striptease act on the stage and afterwards I was with a couple of Americans and all the Thais kept on coming up and touching me and I said, “Do you know why they’re touching?” and they said,
“Good luck. They’ve just seen something really out of the ordinary and they want to touch you because it will give them good luck,” so there are those sorts of things.
OK we might move back to Vietnam now. I just want to ask a couple of questions to fill the gaps. You mentioned before wearing body armour?
Yeah OK, flak jackets. The Australians,
when you were out with them, did they wear helmets, you mentioned yourself that you only had a bush hat on?
No I don’t think they did. I don’t think I ever saw a helmet. If they did, I can’t remember it.
To the best of my knowledge, most Australian units didn’t wear
helmets in Vietnam, I just wondered if there was a correlation with head injuries?
I don’t ever recall seeing a helmet. Now it might be a mental block but I don’t ever recall seeing one.
I also guess you were there too early to have seen any use of chemical defoliant?
No, it was being used when I was there.
I think it was. It had just been introduced about the time I was there.
Did you ever see any incidents of friendly fire?
There was an instant of friendly fire when I was there. Hang on, two sorts of friendly fire.
There was a tragedy when I was there when one of our own soldiers had an accidental discharge and shot the person in front of him on a patrol and that person perished but there was an instant where the Americans wanted to demonstrate fire power and because of the reputation they had, our
CO declined to have the battalion watch the demonstration and the battalion that watched it, the firepower actually went into the battalion. That was the only major incident I was aware of and I wasn’t, I had no involvement with it.
The reputation the Americans had?
They had a reputation of being a bit sloppy.
On the couple of times I visited United States bases, I was appalled at the lack of hygiene, lack of security. It was just so different from how our forces behaved. I actually felt quite uncomfortable there. That’s the only thing I saw myself.
Did you ever treat any
enemy Vietnamese troops?
Officially or unofficially?
I mean men that had been wounded in battle that had been evacuated?
No, but when I was there, there were some people who, some enemy troops who were evacuated back to the
hospital in Vung Tau. Civilians, the Australians had four hospitals in South Vietnam. There were three civilian hospitals and one military. There was one military and one civilian hospital in Vung Tau. There was a civilian hospital west
of Saigon at Binh Ba and there was a civilian hospital in the delta. I’d evacuate civilian casualty or civilian ill to the civilian hospital in Vung Tau. There were Viet Cong who were evacuated, who were wounded, who were evacuated to our hospital because I saw them in the hospital when I went down there but unofficially, I actually did a sick parade for
the North Vietnamese regiment, not by mistake. It was by their careful planning but, cause I went up, one of the villages I used to do a clinic in was a village that was regarded as not being safe, so I had a whole platoon escort me up to this village and about half way through the sick parade I became very concerned at how many young men there were
in the sick parade and, cause there shouldn’t have been any sick young men. They should have either been in the government forces or on the other side and a lot of them had skin complaints and chest complaints so at the end I asked the interpreter to interpret with what
clearly to me was an officer with his bearing and everything else and in the end I dropped the interpreter and spoke in French, which I can speak reasonably well and it turned out I was doing the sick parade for the North Vietnamese battalion because their doctor was sick and he told me the doctor was sick, so I gave him a present to give to the doctor and I knew it was a female. As they had the intelligence to know that I was coming up there,
we had the intelligence to know that the medical officer of this battalion was a female and it sounded like she had hepatitis so I gave him some vitamin B and other stuff there what I had and in return he assured me of a safe trip back to the battalion, which we had. Soon as we got back I raced up the intelligence officer and he raced me into the CO and we looked at all, and the CO said, “You’re correct. That’s what would have happened and,”
he said, “You’re very lucky,” and I said “Well, he did promise,” so that, the answer to that question is yes, but unofficially, so I would have treated probably about thirty five to forty of their soldiers.
It must have been a bit of a chilling realisation when it suddenly dawned on you?
The most chilling thing was when I came to the realisation of what we were doing and I looked around to see what our blokes were doing.
They were playing with all the kids. They’d sussed the situation out as being quite safe and so they were relaxing and giving handouts and playing ball and all the rest, cause our soldiers were overall very good with the Vietnamese civilians and I just thought, “What am I going to do?” and I thought, “I’ve got to play this alone,” so I didn’t say a word until our mob, until we were well out of it and then
I told the sergeant and his response was, “Jesus is that where all those young blokes came from? I wondered where they were from,” and I said, “They weren’t from the rice paddies,” and so that was a very, I mean it’s just one of those extraordinary things that can happen in a situation like that, that you sort of think, “Well there it was.”
Your interpreter must have realised what was going on pretty quickly?
The interpreter looked like he was going to have an attack of acute diarrhoea. I mean the interpreter near the end was terrified, just terrified and it was a Vietnamese interpreter I had, not one of our Australians who could speak Vietnamese, cause he mightn’t have picked it up. Yeah the Vietnamese interpreter knew.
What condition were those enemy sick in?
Was very similar to one of my sick parades
and in fact that’s what I think initially twigged. Not the number of young males but the fact that I was seeing the same sorts of conditions that I was seeing in our soldiers back in camp and I thought, “Well hang on, this is not the usual sort of village clinic,” and it was that, the profile, the illness profile and then starting to realise these are young
males that I’m seeing, not adolescents, young male adults and then it clicked who they must be and they were too well organised and this was later reinforced by the intelligence officer, to be Viet Cong. They were obviously regular army soldiers from the north.
What about their state of nutrition?
And as I
understand from your story, their officer basically confessed at some point who they were?
Confessed is probably not the word, admitted, that because he thanked me for doing the clinic and told me his doctor, because I said to him, “I believe your doctor is ill,” and he said, “Yes she is,” so
I didn’t say, “Are you from D four four five?” which was the name of the regiment, their regiment. I asked him about the doctor and so he acknowledged that and that was, it was just unspoken admission that that’s who they were.
That cordiality between enemies is not something we usually associate with Vietnam?
although having said that, veterans I know who’ve been back to Vietnam and spoken to Vietnamese and I went back myself in 1992, they’ve held the Australians in quite high respect so.
I wonder if it would have happened in an American situation?
Well one can speculate on that. I don’t know.
When you were doing those clinics in native villages, what sort of conditions were you presented with?
Well a lot of quite tragic conditions of untreated infections, abscesses that had gone bad,
deformities, which I’d send down to the hospital. Not like what you’d see in a general practise say here in Sydney. It’d be far worse and a very different picture to what I was seeing in that, going back to that village so that you’d be treating a lot of children with infectious diseases or deformities like cleft palate,
people that developed terrible abscesses in their jaw so that, you know, there was a big abscess and then there’d be women who had had complications after childbirth and then older people and with the village clinics we’d take the medications with us and then leave the medications that were left over
with the village nurse or whoever was there, so she had them.
And you mentioned before that in some cases you could evacuate back to a civilian hospital?
Normally we’d get them to take the family to organise it by public transport or road transport and give them
a note. I’d write, you know, a referral note because I knew that the doctors at the hospital were Australian so I’d just write the referral note and down they’d go.
What was the point of all this?
With the civilians? You could argue it on a number of levels. I mean on the political level it was to help secure the province and I think
get the province, assist the province’s infrastructure cause I think the medical things have to be seen in context with the engineering things that were being done and the road building and all the rest of it, so that it gave them, the government, an infrastructure. On the other side it was felt there was a moral obligation because most
of the South Vietnamese health personnel, doctors, were in the army so they were very short on adequate health facilities so that was more a morale side to it and one of the things I was always very careful of, and a couple of times we got caught out on this, was that there’d be an aid sort of handout and it’d be quite disgusting where
the vehicle would pull up and there’d be like blankets being thrown and this and that and everything else and I like to think that ours was more professional, that we were working, cause I’d always do the clinic with the interpreter and the local health workers, if there was one, and handle it as a proper profession, or try to handle it as a proper professional visit.
Do you think this hearts and minds stuff reaped benefits for the Australians where you,
where they were?
Well that’s a very subjective -
I’m asking your opinion?
I can’t be sure. I mean you’d go through a village and they all, the kids would all be yelling out, “Look daloy number one,” you know, and everything else and it used to make the troops feel good
and I think they did it to help make the troops feel good. Certainly overall in the villages, the Australians when they were in the villages, seemed to get on reasonably well with the local people in a situation it was quite difficult because what could appear to be a friendly situation could turn unfriendly very quickly but to know whether or not there was an appreciation, it’s hard to
Why were you treating ARVN [Army of the Republic of South Vietnam] soldiers?
Because I was the nearest medical specialised resource and they were allied, we were allied with them. It was just a…
They didn’t have their own doctor?
Any difference in the complaints suffered by ARVN troops compared to Australians?
The same skin conditions?
Less of the skin conditions. I think they were more, they had a life time to get used to the climate but otherwise basically the same sorts of things.
The skin conditions that the Australians were getting, what could happen to them in extreme cases?
Well the worst ones I saw were like a prickly itch that got the whole body, where the person was just in gross discomfort, sweating and itching and a rash all over. That’s the worst I saw. Otherwise it was more like thrush, tinea sorts of things which you bring them back into base, get them cleaned up, get the rash cleaned up.
They’d go back out again. As soon as they’d come in, they were back with the same complaint and that was a more fungal sort of thing. I’m not a dermatologist.
I imagine a lot around the groin area and armpits?
Do they wear underpants, the troops?
Some did, some didn’t. The problem if they, in base camp, most of them would have
worn underclothing but when they went bush, the underclothing would become so dirty that it was probably cleaner not to, so many didn’t and then they’d come back in and they’d just chuck all their greens into the, go down to the laundry and then clean up and then change into fresh greens and underclothes but I would have thought it was usual not to wear underclothes.
what tropical diseases did you see evidence of?
Scrub typhus, the proverbial PUO [pyrexia of unknown origin] which meant we didn’t know what it was and there were, what is it? I’ve just forgotten its name. It’s a mite thing that can get under the skin and tracks up under the skin.
That was quite common, very painful.
Like jiggers in Africa or?
I’m not sure. I’ve never seen it anywhere else and what I used to have to do was anaesthetise the local area and then dig the thing out. It’s like a tiny little, maybe it is like that, I’m not sure, so there were the fevers, the malaria and the
viral fevers, the ones we didn’t know what caused them and then these sorts of skin things.
What about gastrointestinal complaints?
Not that common. I’d have lost my job if there’d have been too many but we had a hygiene sergeant and a hygiene section that looked after inspecting the kitchens and the latrines
and our purchasing officers were very careful when they went into the, cause they got the vegetables and things from the capital, and Baria, and the meat from there and they were very careful that everything was cooked so like we had a, where I saw it, in fact you asked me about, or mentioned about females. I treated a number of the female entertainers that came up. They got it and they got it from when they were staying in the hotels
when they went to Saigon.
Interviewee: Anthony Williams Archive ID 1751 Tape 07
Talking about I used to do a clinic with the ARVN unit up the road at Binh Ba and often we’d go up by road but this particular time they were mining the roads, not our side, so it was not safe to go up by road so we went up by helicopter and anyhow the helicopter came
in and you’ve got about fourteen seconds to get off the helicopter with everything before the helicopter takes off so we all got off the helicopter and as we walked up, I had the two soldiers carrying the medical pannier, everything was draped in red. There were red flags everywhere and I thought, “Oh no,” you know, “Something terrible’s gone wrong,” cause that, to our mind, meant one thing. It was communist
and so the sergeant said, “What do we do sir?” and I said, “Well, the helicopter’s gone. It’s not coming back till four o’clock. Let’s just carry on,” so all these bloody red flags are fluttering everywhere and we went through the gate and soldier presented arms as we went through and that looked all right. Then when we got in, it was the Feast of the Assumption, of
the Blessed Virgin Mary and they were having a mass and they’d unfurled all the flags because it was a celebration and we got in there and the mass was in progress and the sergeant again said, “Well what do we do now sir?” I said, “Well you take off your hats and you kneel at the back and wait till the mass is finished and then we’ll do our clinic,” and that was my fun story.
How did the civilians receive you when you went to do sick parade?
Quite well, very orderly, very patient. They’d wait for hours and we always made sure, even with people who I couldn’t find anything wrong with, I always made sure that they got something that they could take away. I had a lot of sugar tablets but no, they
were very polite, very cooperative and I used to find the clinics quite enjoyable. With the clinics that I used to do with the military compound, at the end of the clinic the officers would come out and they’d have their bottle of Johnny label red, scotch whiskey and we’d all have a whiskey together, then I’d go back to my camp.
What did you
find the most satisfying and enjoyable about the work you did in Vietnam?
I felt that, to me, just seeing the professional job that our forces were doing and the way they went about it, I found quite satisfying.
I think the thing that got to most of the officers and quite a lot of the other ranks was it became, as time went on there, we came to realise that the politics was, that this wasn’t a war to stop the communists taking over this whole south east Asia, that we in fact were
backing a side in a civil war and I think that that realisation, which was happening about the same time as the population in Australia was starting to protest against the war, I think that was the downside and that maybe we shouldn’t have been there.
So when did that public disapproval within Australia about Australia’s presence in Vietnam, kick in for you?
I wasn’t too, we weren’t so aware of it over there but
the realisation amongst the people I was with there I think happened independently of what was happening in Australia. This is when we started to see things for ourselves and to see that this was a war of nationalism in Vietnam rather than a communist takeover of the whole of south east Asia. That was the feeling we were getting and that
maybe we shouldn’t be there, that we should let the Vietnamese people work out what they want to do, but just how much that had to do with what was happening in Australia, I mean there were letters obviously going backwards and forwards and certainly when we got back we were aware of the political opinion in
Australia was moving in a direction that did not support the war.
What effect do you think that had on post war stress?
I think it had a marked effect because I think when people came back, the reception they got,
I think that the reception that the forces received as the war went on, from the population and their perception of that reception, because it’s a two sided thing, I think that was detrimental to the psychological health
of the Vietnam veterans and in fact a lot of the, as you probably know, a lot of the Vietnam veterans are very concerned that with the divided opinion in Australia about the Gulf War that the Gulf veterans don’t have the same thing happen to them when they come home. I don’t think it will but, cause a lot of Vietnam veterans feel, have felt, very alienated from society
and really I think the fact that a welcome home parade wasn’t held until, what, the late ‘80’s, is a symbol of that or a sign of that. I mean I’ll give you a very concrete example. When I came back I went to Bloomfield Hospital in Orange to start my psychiatric training and I went
to an Anzac Day ceremony and one of the RSL [Returned and Services League] guys came up and said, “Where’d you get those Mickey Mouse medals? We don’t want your sort of people in here,” and I left and that was quite common, that sort of experience and I mentioned this to the interviewer on the phone. With my psychiatric training,
the political opinion in the psych hospitals was more left of centre, than right of centre, so there was a lot of involvement in the protesting and everything else. Now they used to say to me, “Are you going to come along?” and I’d say, “No, no.” Most of them never knew I was a Vietnam veteran. I just kept it quiet cause I just didn’t want to get involved in any highly personal issues and a lot of veterans did the same thing. They kept
very quiet about the fact they were veterans so their family and immediate friends knew but outside that, people didn’t know and I think that had a deleterious affect on a lot of people’s reintegration into society and the supports they could have got. Now there’s no strong research evidence to back this but there’s a lot of anecdotal and impressionistic evidence
to back that that’s probably true.
Just back slightly, how did you feel that the American jargon and assessment of mental health cases was inappropriate for Australian army guys?
The psychological framework or paradigm if you like that was used, was more a psychoanalytic
approach which actually when I read it, it just sounded like nonsense. It just talked about how he had unresolved conflicts with his mother and various things like that and that may have been true but certainly I couldn’t see how it related to his current problems, which are intense anxiety.
What kind of
solutions were offered by Americans?
Psychotherapy. We had no psychologist or psychiatrist and I know that all the psychiatrists that went to Vietnam, none of them were psychotherapists anyhow. They were more general psychiatrists.
And how did the American camps and bases differ in standards of living and hygiene, from Australian’s?
Well I only saw two
so those two may not have been reflective of what all the American camps were like but the thing that struck me was the sloppiness in the dress of the soldiers, the lack of discipline in the soldiers, the lack of basic cleanliness and public health standards around the camp.
I mean the difference would be like, this might be a bit extreme, but what it’s like going into the Domain after there’s been a concert and seeing everything lying around or going there the next day after it’s all been cleaned up. I mean our bases were immaculately clean, or as clean as you can be in a tropical,
dusty environment but it just seemed to me that they had no concept of how to keep a place clean and, well, we know in the States they can do that, and I saw it as a reflection on their morale and leadership, that the camps were like they were.
Can you give us
a more detailed explanation of how you’d treat diggers who were struggling in the combat zone and take them out, what would they do with you at the RAP?
Just act as my personal assistant. There’d be quite menial tasks of going and picking up stores that had come in, taking messages, answering
the phone, just a sort of general dog’s body [person who does menial tasks] but doing something all the time and if I’d go somewhere, they’d come with me. If I went on a trip out in a vehicle, they’d come as my escort, gradually building up what they could do, depending on their level of confidence and in those days we had a minor tranquilliser that had come on the market. I’m just trying to think of its name,
it’s just escaped me, which I used to use in small doses to help take the edge off their anxiety.
How long roughly would this treatment take before you then introduced them back?
A week, maximum ten days. If it hadn’t settled by then, I’d be starting to think, “Well it’s not going to work.”
guys know why they were there?
And how was it received by the other diggers?
That’s an interesting question. I had the approval of the hierarchy in the battalion to do it. I never was aware of anyone who went through this process being criticised
or ostracised and in fact I tried to make the whole thing look as normal as possible and that they were occupying a legitimate position and there was a position there for somebody and they were in it so it’s not as if they were supernumerary, you know the difference? I mean and so I think it was, I had the overall feeling it was accepted but having said that,
I didn’t publicise around the whole battalion what I was doing.
How would you then slowly introduce them back into their role in the platoon?
Well we had, when the battalion headquarters would move, the mortars would go, like it moves with what’s called support company and the support company had a number of specialised platoons like mortars,
assault pioneers and they would be around the periphery of where the headquarters was located so it’d be an easy matter to say to the platoon commander, “Look, can you take Private Jones in as a supernumerary for a few days to see how he goes?” Now they’d be quite happy to do that because always there’d be someone on sick
leave or R and R or something like that, so every platoon had, at all stages, numbers down, so you could easily do that and it wouldn’t be oversupply and then you’d check with the sergeant or the officer that they were with, how they were going, ask them how they were going and if everything seemed to be OK, say, “Well what about it, how do you feel, mate, about going back to your own section?” and if they felt up to it, back they went. I mean I’d liaise with
the company and platoon medic to let them know what was happening.
How effective do you think that treatment was?
Well, like I said earlier, in the short term, with most people I put through that program, I thought it was successful. Whether or not it was successful in preventing long term problems like PTSD or serious depression
down the track, I don’t know.
Did any of the men who came to see you for a longer consultation, break down and say they just wanted to go home?
In the early phases? Yes, “Hated the place, want to go home.” That was quite common.
What did you do in that situation?
Well as gently as I could
just point out the reality. The situation was that I couldn’t go and they couldn’t go, that that might be what we wanted but that was it and just help them come to see the reality of the situation they were in and there were people there who were very severely homesick or didn’t like being there cause it wasn’t a holiday and I’m not saying that in a disparaging sense.
I mean one of the jokes amongst some veterans now is, they’ll say, “Oh, it was the first holiday I’ve ever had and only holiday I’ve ever had, at government expense and South East Asia. The problem was it was twelve months.” Well that’s a joke on what it was but there were certain realities that had to be faced.
How did it come about that
you left, were you there for the full twelve months?
No, because my contract was for twelve months so that included two months getting the battalion ready, so at the end of the twelve months which started at that beginning, that was the end of my twelve months tour of duty. There was a twelve month contract.
How did you get home?
I was going to say I hitched a ride but no,
there were people coming and going all the time and so I came back by Qantas. It was a military flight from Saigon.
What was landing back in Australia like for you?
It was I think a sense of great relief to get home. I had the first taste of what it was going to be like with the population because we were treated very badly by Customs.
I was body searched to make sure I wasn’t carrying any illicit drugs. The reel to reel tape deck that I brought back, they took the back off, took it to pieces, to see if I had anything hidden in it. It was, that was quite unpleasant and quite insulting and but then the family was there so
that sort of made up for it.
How long were you detained by customs for?
Three quarters of an hour, I think. It certainly wasn’t two or three minutes and I made a bit of a joke of it when I came out but that wasn’t how I was feeling about it.
I mean I didn’t expect that they’d wave us all through but I also didn’t expect that sort of somewhat over the top treatment.
As servicemen in uniform, do you think you were singled out for that?
Well they were only servicemen coming through because the plane
coming back only had service personnel on it. Hang on, it could also have had entertainers or people from the civilian team. I mean you couldn’t buy a, I suppose you could, but I don’t think people could have bought a ordinary ticket on that plane so that the people coming through customs were all in uniform at that point.
And were all of you
No, it was because they asked me what I did and I said I was a doctor and they decided they’d search me I suppose. I don’t believe I had anything that looked any different from what other people were carrying through. I don’t think I would have stood out, if you know what I mean.
How was your reception from the general public?
Well the first general public I saw after that was the family and that was quite good. In fact I remember my father said, “What do you want, do you want a beer, mate?” and I said, “A milkshake.” That was the thing I wanted, I hadn’t had, was a milkshake so we had a milkshake and then
I went on leave and then I joined the training scheme in psychiatry and then it was soon after that I had that experience I told you about with the RSL club. It wasn’t all negative like that. I mean the Red Cross in the local area had me as one of their
keynote speakers to talk about the Red Cross and the role of Red Cross in the current conflict, which was quite a positive thing and there was another function that the mayor held for veterans and that went quite well but there were other instances that were negative which were unpleasant.
What did your training in the school of psychiatry involve?
It was, then it was three years and the first year I spent in the country and then the second and third years were in Sydney and I was following the prescribed curriculum of what different terms
you had to do and we attended lectures two days a week in the second and third year in Sydney and then sat for the exams. It was fairly intense course but it was very much an apprenticeship model with academic input.
Did you know that you wanted to concentrate on PTSD when you went in to do it?
Where did you think that psychiatry might take you?
Well I think I had an interest in public health medicine because I stayed in the public health system, cause when I finished my training in psychiatry I then became very involved
in the development of some of the community psychiatric programs and then, as I mentioned earlier, I went to the States to do my masters in public health. When I came back from that I don’t think they quite knew what to do with me because they thought I’d done an administrative degree. In fact I’d done sociology and social anthropology and mental health planning but that kept me in the public
health field but I gradually got more and more interested in the effects of trauma so that with the migrants and refugees coming, I was involved in the setting up of the torture and trauma service that was started in Cabramatta and I was
on the initial committee that did the planning for it and then I was on its board when it was set up and I actually was the supervisor of a Cambodian bilingual worker for about four years and that was starting to get me interested in the area of trauma and reading about trauma and also during that period I’d started doing a clinic
with the army at, firstly Ingleburn, then the hospital moved from Ingleburn to Holsworthy, but that clinic was more like a general clinic in those days because there were no real peacekeeping missions happening so there wasn’t much traumatic work, if you like, traumatic work’s probably not the right, work with trauma, in that period but then
I started seeing more and more cases of military personnel that were related to trauma so I started getting more interested in I guess the two areas, the refugee trauma and military trauma and the only area that I really didn’t get involved in was the domestic violence and sexual abuse trauma side and that’s an area I’ve never got
involved in, but I’ve kept up the refugee and the military interest and then after the enquiry that was held into the Vietnam Veterans Counselling Service, or one of the many enquiries I think, in the late’80’s, early ‘90’s I should say, then I became a supervisor at the VVCS, initially in Harris Park, then it moved to Parramatta
so I was actually doing quite a bit of work in that area and I was able to do that because the position I held in the government, I was the director of a postgraduate training unit, so I was able to work out what clinical interests I had, the job description allowed me to have a certain amount of time a week doing other clinical work outside the administration and that’s how I was able to do the army
clinic and the other stuff.
How would you describe the manifestation of PTSD?
Do you want another day? It, firstly the person has to have been through a traumatic incident or incidents and it’s got to have been one that’s really horrified them,
filled them with terror or fear or loathing or something like that, a very negative emotion and then you get symptoms in, it’s a cluster of symptoms you can get that are in three areas. The first area is like the intrusive memories and thoughts about the incident, so they can get nightmares. They can get flashbacks. They can have intrusive
memories during the day. The second area is they can become quite avoidant of situations that might remind them of the trauma and often there’s a numbing of the personality that can go with that and then the third area is the hyper arousal area where they can easily irritable, easily become enraged,
can be hyper vigilant, get a startle response, so the symptoms fall into those three areas and in fact you’ve got to meet the criteria for those three areas as well as had the exposure before a person can make the diagnosis that this particular individual has post traumatic distress disorder.
How did or what evidence did you see of the
effect that post traumatic distress disorder had on the patients nearest and dearest in their relationship?
You mean currently or?
While you were treating them, when you first started treating them?
Well the most common reaction was that the nearest and dearest can’t work out what’s going on and they’ll
commonly say, “Look, we knew something was wrong when he came back,” or, “When she came back, they’d changed,” and they’ll usually describe the person becoming more irritable, difficult to get on with, having trouble with closeness, restricted interests. That’s the sort of thing they may observe. They may not observe or know about the intrusive
memories and that sort of thing cause they’re not so obvious, but the sort of irritability, agitation, cutting off, they’re the things that the people who know the person will observe and they’ll often say, as I mentioned that, “Look, we knew something was wrong but we didn’t know what it was,” and it’s very difficult to live with someone who’s got that level of
symptomatology and in fact I’m quite amazed sometimes at how some of the spouses have stayed with the Vietnam veteran husbands as long as they have, and what we’re noticing amongst the peacekeepers and I think it’s a new generation, that a lot of the spouses or the partners are saying, “I’m not staying around with this. I’m not going to put up with this,” and they leave
whereas I think the people into Vietnam was in a generation that had a different value system of staying together and I’m not sure for some of those wives whether that’s been the best thing for them, to have had to put up with it.
Put up with what?
Well the anger, the irritability, the drinking, in many cases, abuse. The lack of sharing and doing things together.
It’s quite, often these women have had to move and there are women with the Vietnam veterans, these women have had to move more into a carer role, looking after someone or had to cope with a person who’s become a workaholic. That’s a common thing that they’ll do to cope with the symptoms and that and it’s, they’ve had to live a separate life, then when the person starts cracking up near the end of their working career,
they’re having to put up with this person’s become quite difficult to live with.
You said it was the wives of Vietnam, I know I’m jumping a long way forward here but with peacekeeping now, is it both men and women who are affected?
Mm, well having said that, that’s not, because women,
there’s now no longer special areas for women. I mean in Vietnam the women, the nursing corps were women. Now women serve in many units but they don’t serve in the field force units, which are the ones more likely to be exposed to traumatic
events but having said that, if you look at the women who went to the Vietnam war, from the Australian forces, you’ve got the nurses who worked in the field hospital who worked with the trauma coming in all the time. Many of those have got PTSD. If you look at what happened with the Timor situation in the INTERFET, the women tended not to be in the areas where they were dealing with
the atrocities or the events, you know, the aftermath of the atrocities so that you wouldn’t expect to see the same rate of PTSD developing in women as in men, however there are more and more women coming into situations where they could be exposed. Does that make sense?
Does PTSD manifest itself differently in women from the way it does in men?
Not really, no except I think
there’s probably less co-morbid substance abuse in women. Certainly the literature from the United States would tend to indicate that women, and here we’re talking more about women who’ve been victims of violent assault or rape, can develop quite severe symptoms of PTSD but they tend to respond better to treatment
and maybe that’s because it’s a single episode, whereas people who’ve been exposed to multiple episodes, maybe it’s more difficult to treat. I mean this is a lot of theoretical discussion.
What kind of treatment, when you first started treating diggers when you were back in Australia, army personnel, for PTSD, how would you treat them?
Well the first cases that I would have started treating for
PTSD would have been in the early ‘90’s and I tended to follow a model, which has now developed more since then, it’s like a step model of, and usually the first interview will take over two sessions where the partner comes to the second session, which
is done with the assessment, I try to engage the person in the assessment, so that they feel that they can trust myself and at the end of that I sort of will talk to them about the fact, “Well this looks like maybe a traumatic stress disorder that you’ve got.” I’ve got a,
I didn’t have this then, but now I’ve got a video which I get them both to go and have a look at and a book and so the first period of treatment is more education so that they have some understanding of what it’s about. At the same time if there’s significant depression, I’ll start treating the depression as well because if they’re very depressed that will make the PTSD worse and
the PTSD getting worse makes the depression worse. If you can lift the depression you can often help the PTSD symptoms quite a bit and then I start looking at them with their lifestyle and stress management and look at working with them that where are they going to get some fairly intense psychological treatment, cause they do need more intense psychological treatment, so that I’ll commonly,
if they’re service personnel, get them to see one of the psychologists attached to the services or attend the VVCS whilst I’m working with them in a sort of supervisory role and most of the ones who are, who by the time have become entrenched, are at the point where they’re not really going to get better enough to stay in the services, so you’ve got to start working with them
about their discharge and what they’re going to do.
How common was depression as a contributing factor to PTSD or is, how common is that factor?
Well it’s not really, I wasn’t saying it’s a contributing factor. I was saying it was a co-morbid, very common. I mean PTSD is one of what we call an anxiety disorders, like a phobia or
obsessive compulsive disorder. The difficulty with PTSD is that it has the highest rate of co-morbid conditions of any anxiety disorder but in many cases you’ve got two co-morbid conditions. You may have depression and you may have alcohol or substance abuse and you see it much more in PTSD than in the other anxiety disorders and it can become very chronic.
Interviewee: Anthony Williams Archive ID 1751 Tape 08
I just have one more, quick question about your time in-country in Vietnam. You mentioned treating Australians, local soldiers, local people, was it only humans that you ever had under your medical attention?
No I used to look after tracker dogs. We had tracker dogs there. They were beautiful Labradors and, you know, I was their attending physician.
What sort of things were you treating the dogs for?
I was never quite sure actually but it had to be empirical. If they looked like they had a fever, I gave them antibiotics. I just, if they looked like they had a skin fungus problem, I gave them, I didn’t have any veterinary drugs, so they used to get the human drugs.
So you became a vet after all?
Of sorts, de facto yes, that’s right.
You talked about the fact that you got on a plane, came home, had a milkshake, your military service was over. That would have been a similar experience to many of the reservists or national servicemen. Do you think that was a contributing factor in their Vietnam or post Vietnam experience?
Well firstly, in my case it wasn’t over because I was back into the reserve.
I mean it’s a difficult question because when you speak to a lot of people who stayed on in the army, and some national servicemen actually stayed on, they’ll tell you they thought the military environment acted as sort of protection for them and a support, and that they didn’t have the psycho-social issues that we’ve been talking about, with the general population and that sort of thing, that those that got out
had. I think that the continuing in the military had a sort of a supportive effect for a lot of people. I mean I’ve been surprised at how many, how few I should say, people that I saw
in my military clinic who are Vietnam veterans with psychological problems, until just prior to discharge but I don’t think we’ve got good statistics on that.
Is there any limit to how long you can stay in the army and not be PTSD affected and then come out and have it happen?
How do you mean?
Well I mean staying in two years, five years
thirty years, does it make a difference in how long you can go before PTSD might manifest?
When you, actually that’s a very interesting question because some years ago, DVA [Department of Veterans’ Affairs] wouldn’t accept PTSD if it didn’t come on fairly soon after the traumatic experience. They’ve now, it’s now well documented that
various things can protect you, if you like, from de-compensating with the symptoms but when you look at the lifestyle of the person, it’s been there. If I could just give you an example of what I’m talking about. My, most of my experience with military PTSD is with the peacekeepers, not with Vietnam veterans. Now all the people I’ve seen
who went to Timor during INTERFET, who’d developed PTSD, all except one had had a previous deployment and they were all either Cambodia, Somalia or Rwanda and when you go into their histories, they came back from those deployments,
they underwent a personality change, they increased their alcohol intake and that controlled the symptoms. They went to Timor and they all said, “Timor wasn’t as bad as Rwanda,” or whatever, “But I just couldn’t cope,” and then they de-compensated after that and the one person who hadn’t, and we’re talking now about twelve or thirteen patients that I’ve seen. The one person who hadn’t
been deployed before, had only recently joined the army and he’d been sexually abused by a school teacher when he was in early adolescence and then prior to joining the army, his best friend was killed in front of him in a motor vehicle accident and in fact he joined the army to get away so it’s interesting that I think the, it can be years before
the symptoms develop and what’s happening now with the research that’s being done with peacekeepers and fire fighters, is showing that the average time of presentation is over six years after the-
Sorry we’ve taken your glasses off now, go on? Six years you said was an average diagnosis presentation?
That means you’ve got people who are going to develop with eighteen months or twelve months and the people who are going to develop
much longer, but that’s when they present. Most of them have been medicating, and whatever, themselves to control the symptoms for some time.
Well with your personal experience in Vietnam and then your professional experience with later deployments, what have you seen change in the way that the armed forces deals with
this issue over the decades?
I think there’s been quite significant change in two areas and perhaps I’ll deal with the armed forces first. The level of awareness in the armed forces at the command level is higher and there’s now a mental health directorate in the armed forces, which there wasn’t before.
The psychology corps has moved from recruitment education into active treatment particularly of traumatic stress issues and the armed forces are making more use of psychiatrists who have some experience working with institutions such as the ADF, you know, the armed forces. Together with that, there’s been the
funding by DVA of the Vietnam Veterans Counselling Service so I think the treatment options, community treatment options that are available now did not exist before the 1980’s. The other thing is that the repatriation system has been basically dismantled from a provider to a purchaser-
provider system and so that you’ve got quite sophisticated private units all over Australia who’ve got specialists who work in this area so that you can now be offered a combination of private inpatient or outpatient or public, I mean the VVCS and the ADF which means you can actually offer quite a spectrum.
So the establishment of the VVCS, what has that meant to veterans?
To Vietnam veterans it’s meant the result of years of lobbying to get a service for them and an undoing of what they saw as the cold shoulder they were being given by the health system at the time, rightly or wrongly, but that’s how they saw it. It’s also
allowed the development of a body of clinical expertise in this area which we didn’t have before.
What opposition to veterans’ mental health has been given by World War II and World War I veterans?
You talking about to the Vietnam veterans?
Well I’ve heard it said by the World War II veterans that they weren’t
made to feel welcome by the World War I veterans. I know from my experience as a Vietnam veteran, the Vietnam veterans feel that about the World War II veterans. The Korean veterans go one better, cause they say no-one even thinks about them, they’re forgotten. The current peacekeepers are saying, “Well what, can we go to the Vietnam Veterans Counselling Service, why haven’t we got one, is it just for them?” so I’m sure how much of this is a generational
thing and I’m making light of it but I know one thing. I think the Vietnam veterans were the only group who had the public, or got caught up in the public antipathy towards the Vietnam War. I don’t think any other service personnel have had that experience.
I’ve heard a lot of World War II diggers especially say PTSD, it’s all bullshit, these guys are just whingers.
Is that a common attitude?
Amongst World War II veterans, or their spouses?
Amongst World War II veterans, particularly referring to Vietnam veterans?
Well I can tell you what I’ve equally heard. Yes, I’ve heard that. I’ve equally heard the spouses of World War II veterans or the war widows saying, “If these services that you’ve got here now for Vietnam veterans existed
when my husband came home from the war, I wouldn’t have had to put up with forty years of hell,” and I’m involved in the accreditation of PTSD programs and there are now a number of programs that have been developed for older veterans, who are the World War II veterans, and the spouses that you meet at the feedback are all saying that, “Why did we have to wait all these years for treatment?” and of course it wasn’t called PTSD then.
It was a war neurosis and I know, I mean speaking personally, my mother, she’s talked to me about my father and all his friends who were in the air force and the navy and the army. I think they’d meet the criteria for PTSD if they were examined today so I think some of that’s an attitudinal thing, not,
In the past what were spouses etcetera told about how to deal with their men coming home and if they were exhibiting signs of neurosis?
Very little, very little and to go to Concord or Heidelberg into a psych ward there, would have been pretty stigmatising.
There’s a very interesting book that’s just been produced by a lawyer in the United States who studied psychology, called Shock Over Hell and what he’s done, and I’m reading the book at the moment. He’s gone through the records of the asylums in the States that admitted soldiers from both sides of the civil war into the
then asylum so we’re talking about, what, the 1860’s I think it would be and he’s gone through their case histories and most of the people that were in there that he’s examined, if you used the modern criteria, would be diagnosed as having PTSD. I mean they didn’t have that diagnosis then, they used other ones but, so it’s not a new thing at all.
However its acceptance has changed?
Its acceptance has changed, yes.
What difference in stress could be experienced by troops on peacekeeping missions as compared to an outright war like you were in?
I think one of the major stresses is the
variation in rules of engagement and how ambiguous the situation can be and I think in the Vietnam War there were some of this but not the extent you’re seeing in the peacekeeping missions, where the, it depends on which mission it is and under which United Nations authority it
comes, but the restrictions placed on people for what they can and can’t do, my understanding is that the research that’s being done in Canada and in Belgium where there’s a lot of experience in this area, is that it places enormous stress on the individual, however as well as that, the other thing that’s happening with peacekeeping missions is that a lot of countries, their troops are actually going from one peacekeeping mission
to the next, to the next, so they’re having multiple exposures to different theatres with different rules of engagement.
Do you think Australia’s one of those countries?
I think it’s heading that way very quickly, yes.
What particular problems does that bring up?
I think it places people under enormous stress. I mean with the Vietnam War, unless you were in the regular army,
you only went once, that with Rwanda in that period, you probably went once. Now you’re talking about people who have been to Timor, up to Bougainville, off to Iraq, Solomon’s in between and it’s placing enormous stresses on the families and also the whole infrastructure.
You’ve done a lecture about Rwanda, is that right? You gave a talk about Rwanda, there’s something in the notes we thought were provided by our researcher to say you’d delivered a lecture?
No, I delivered a lecture. The Australian Centre for Post Traumatic Mental Health runs a course for ADF personnel on
traumatic stress for the doctors and psychologists and some nurses and I gave a talk on the role of a medical officer in a theatre of war or conflict and there were people who’d been to Rwanda in the audience and the issue came up of the difficulty the medical officers had of treating people who’d been to Rwanda who had psychological issues and they asked me, “How did I get on treating Vietnam
veterans?” and I said, “I don’t,” and they said, “Why?” I said “It’s too close to home.” Now that’s what, I think that’s what they’re referring to.
A peacekeeping mission like Rwanda, how do you think, what sort of fallout do you think we’re going to have from Rwanda and Timor in years to come?
Well I mean every theatre’s different. I think Rwanda was, I don’t think they were, when they went, I don’t think they realised what they were walking into so I think the state of preparedness was not the same as with Timor, where there was a lot of publicity in Australia of what was happening in Timor, a lot of sympathy for the Timorese. I think the troops were much better prepared when they went, however they still
saw the results of atrocities but not on a scale that was in Rwanda. I think what’s happening with Rwanda though is that people who have been to Rwanda and we’re talking only about six hundred people, they, I think they’ve got better access to services and I think they’re being followed up better. Now whether that means there’s going to be earlier intervention, which
we all hope there will be, and whether that will have better effects long term, remains to be seen.
How come young, fit people can be so badly affected?
Well I think it’s probably a combination of things. Firstly, most people who are exposed to traumatic events, get upset
but do not go on to develop post traumatic stress disorder and I think that’s often forgotten and even amongst Vietnam veterans, most Vietnam veterans, most, don’t have PTSD, however there’s a significant minority that do. Now the literature now is looking at antecedence and such things as abuse when they’re younger,
youth, pre-existing psychiatric disorder, preparedness for the trauma, the nature of the trauma, the follow up when the trauma’s over and then the homecoming and the reception and community support so these are all felt to be fairly significant factors in whether or not a person will develop PTSD. Certainly
exposure to atrocities where children are involved is seen to place people at much greater risk than if it’s adults.
So Rwanda would be a big deal in that respect?
A very big deal and Cambodia with the children with all the amputations from the mines and then you speak to guys who, and women, who’ve been to Cambodia and say, “What’s the memory you bring back the most?” and they’ll say,
“The low value of human life and the number of kids on the streets with no legs.” That’s their living memory, if you like.
These days the armed forces are almost hyper professional in their training and their environment. Do you think that’s a good or a bad thing as far as vulnerability to mental disorder goes?
I don’t know about vulnerability but
it’s a bad thing if you get a mental disorder because the tolerance in the armed forces now to any mental problems is zero, so whereas fifteen years ago someone developed PTSD or someone developed chronic depression, you could move them into a store job or a clerical position here or a catering position there. Now, with the outsourcing, all those things are gone and with the new readiness policy
that everybody has to be capable of being deployed, you’ve lost that ability to be able to keep people in the system and keep their valuable experience, because they’re kicked out for medical reasons and as a colleague of mine once said, “The sergeants that we had in national service,” this is the original national service, and the more recent one, “When you look back on them,
a lot of them had PTSD. They were burnt out. They were alcoholic. They were bastards but they knew how to work the system and they taught us well.” They wouldn’t be in nowadays. They’d be gone and I think that’s a loss.
We’ve talked about the issue there of people maybe doing too much active service in the military. Do you also get problems with people in the military who’ve never been able to do anything just
because of the luck of where they’ve been placed?
Well there may be those people. I haven’t seen them but there may be, I don’t know about that.
I think there’s an awful lot of frustrated infantrymen somewhere that have never got to deploy anywhere?
May well be, yeah, there may well be.
At the time when you were in Vietnam, what do you think could have been done better at the time psychiatrically?
I think that, well two things. I think one was, well just off my head, the first thing is there was no preparation for homecoming and people just came home and were expected to go back to
their ordinary lives and there was no preparation for the problems there might be to resettle. Second thing I think was there could have been more done to have networking available for the people when they came back, that if they needed help they could have got assistance and that wasn’t made available. In terms of the psychiatric sophistication,
we weren’t living in a very psychiatrically sophisticated period compared to now. That might be a bit concrete but it might be an sort of end of the day answer that one.
OK well what do you think it was about the Vietnam War then that changed our perceptions about psychiatry and the military?
I think that, I mean it’s an interesting thing. When you look at history, at the end of the First World War, they developed quite sophisticated techniques to deal with psychiatric problems. Then all that information seemed to have got lost. Then the Second World War, again they built up quite a sophisticated understanding of psychiatric
issues, for the time, then that seems to have got lost but I think what happened with Vietnam, because they became politically active and because of I guess the guilt about how they’d been treated, I think that changed things and I mean if you look at what happened after the First World War, the setting up of the RSL changed the welfare
of returned service personnel. I think that was a major thing that happened. I think the Vietnam veterans and their anger about how they were treated has changed the mental health side of it, but that’s just a personal view.
If you were to say to somebody over the phone, “Oh yeah,” without them seeing you, “I’m a Vietnam veteran,” what do you think their immediate images would be?
Can I answer that with a story? Last year, no the year before last, when they had the rededication of the Vietnam veterans memorial in Canberra, my brother who runs a motel in Yass, I said, “Look, could you book, would you take a couple of my battalion mates?” and there was a bit of a silence on the phone and I said, “They were in the medical platoon.”
So he reluctantly, I thought reluctantly, agreed, then one of them ended up staying there with his family. Afterwards when he’d gone he said, “Gee, he seemed all right,” and I think that might answer your story. I think there’s a general feeling in the population that they’re a bit crazy.
Do you think sometimes that public image almost
creates its own reality amongst Vietnam veterans?
Yeah, I think it does, yeah, unfortunately.
You haven’t felt any need to conform to that image?
I’d like to ask what you were doing in Botswana?
I was the consultant psychiatrist for the government in Botswana.
Which government, sorry?
The government of the Republic of Botswana and
because Botswana’s a front line, then was a front line state, it was receiving a lot of aid from different countries and they were developing a community based psychiatric service and so I went over there to assist in doing that and so I was there for a period of two years.
Can you give me some more detail about exactly what that job involved then?
Yeah, the country’s about the same size as France and it’d be about the same height, it’s mainly a plateau, about the same height above sea level as Medlow Bath here and most of it’s fairly arid so on the eastern belt there’s a sort of fairly fertile ground and then in the north west there’s the Okavango delta
and it’s got about a million people and most of whom are Swana but there’s also a lot of Swana lived in what was one of the banter stands, by Botswana in South Africa and through aid they developed, every village had a school and every village had a health centre
and so they developed a primary health care system across the whole country and that system, by the time I’d got there, had finished the vaccination, inoculation of the children and the whole public health side of things and were moving to grafting a specialised mental health service on it and that was located in the major towns,
they were putting psychiatric nurses in the major towns. There was a small mental hospital in the south of the country and then I was based in the north and it basically involved doing clinical work there and massive field trips where I’d visit the villages and do clinics and education. That was it.
And you’ve also done a lot of work in New Guinea I believe?
Yeah, that’s since I’ve come back from there.
Initially I was involved in the undergraduate training program with the University of Papua New Guinea and then more lately I’ve been involved in the training of the psychiatric registrars, they’re specialists, and I’ve been involved now in training five who’ve come down here for a year and then going up and doing their exams but I’ve also been involved in working in this area of trauma in running workshops in Papua New Guinea,
in Port Moresby and Madang, in this area, and so I’m usually up there every twelve months doing something.
What contact have you had with memories of World War II up in New Guinea amongst the people and the places you’ve been there?
Well most contact was, well two places. One I was involved
in a World Health Organisation workshop in Aitape where there was a tsunami tidal wave and I actually went there on the second anniversary of the tidal wave and of course what was interesting, Aitape was a big base in Second World War and my father was there in the Second World War and the mob in Aitape found out from, I mean I was asked on the first day I got there. This chap walked up and
said, “Hey, hey, you, what you doing here?” you see, so I told him I was up there for the workshop and he said, “Oh yeah,” and it turned out his father was in Aitape during the Japanese occupation and he was telling me about this and then I said, “Well my father was up here too,” you see and no, it was his grandfather, so he must have then told all the people that my Dad had been there and so I think that altered the reception I had at the workshop
and one of the interesting things I found out was that our special air services and other services, also trained there to go to Vietnam and I hadn’t realised that before and then the other place, just a year ago, I was invited to give the keynote address at the PNG [Papua New Guinea] Medical Association conference which was in Milne Bay, which was another area where there’d
been a lot of fighting and another area my father had been but I didn’t mention then my father had been there but the Australian servicemen are held in quite high esteem by the older population there who can remember them or who’ve heard about them from their fathers.
Do you then think of yourself as having something of an ANZAC [Australian and New Zealand Army Corps] tradition?
I hope we all have something of an ANZAC
tradition if we look at what it means in the broader sense, yeah. Yes I do.
What’s been your history then since Vietnam with your own service in the reserves?
Well initially I was with a number of reserve units and then I did my overseas, couple of overseas things and then when I came back I
moved into the consulting area, so out of the hospitals and that sort of thing so I became a consultant psychiatrist to what was then Eastern Command in New South Wales and then started in the clinic at the military hospital and then I became a consultant psychiatrist to the army office and then the final reserve posting I had was the consultant psychiatrist to the surgeon general and those positions
were mainly policy, advisory, difficult cases that complemented my clinical work and then I retired. I reached the compulsory age to retire so I retired.
Your experience of Vietnam, do you have regrets about going?
Why do you think it’s such a clear
answer from you then?
I guess because I see it now as part of my life and I mean I won’t say it was all fun and games. That wasn’t what you asked. I think it, I felt I did something there and I think I learnt something there and I think that it probably
in a way was a major influence, although I didn’t see it at the time, in my developing interest in cross cultural psychiatry. I think because of my working with the Vietnamese people and being in the country for twelve months, even though not living in the villages, or ten months I should say, although not living in the villages, I came to get an understanding of another culture and I think that did influence me.
Well for instance getting into the torture and trauma work here and the WHO [World Health Organisation] work and going to Botswana and all that.
What experiences as a physician and as a future psychiatrist do you think Vietnam gave you that just couldn’t be replaced in civilian life?
The ability to work in a population that you lived with and did things with
every day for a continued period of time. I think that’s an experience is invaluable.
It almost seems like the old tradition of a country or village doctor in an isolated community?
Yes in some ways, yes, but not the older, I was much younger then but yes.
I mean old as in
periods gone passed?
Yes I know, I know what you mean, yeah.
Have you done any work in the consultative way with special forces soldiers?
That’s blown the next question. What examples of improvisation did you see in medicine while you were in Vietnam?
Not a lot. I certainly saw a lot of examples of the traditional Asian medicine, the cupping and that sort of thing, amongst the population. Other than that, no.
I was also kind of asking as well in the field what sometimes would you have to do that would not necessarily be orthodox back in a hospital?
Well it wasn’t hospital practise that I was doing
so I guess I was using my skills in a open air setting, if you like, but I can’t think of anything in particular.
Have you ever read Catch 22?
No I haven’t. Everyone else has but I haven’t.
I’ve never met a military psychiatrist that has, it’s a shame. We’ve talked a lot about how PTSD and
other mental illnesses have been recognised a lot more in the military, since Vietnam do you ever think the pendulum has swung too far in the other way now?
In terms of?
Well in terms of the fact that say after World War II it wasn’t recognised at all and now it’s being recognised very, very often?
I think that’s been encouraged by, I mean, well
meaningly, but perhaps mistakenly, encouraged by DVA making it easier for people to get PTSD accepted as a psychological sequela trauma rather than depression and other psychological conditions which in fact are more common and I think that that has influenced the way people are going to put their claims in, in a way that has probably pushed it more than it should be,
however there’s no doubt that once PTSD develops, it’s quite a chronic condition.
But you do think that sometimes people use that as a loophole for disability pensions?
Well the people that I’ve seen, who’ve been mainly peacekeepers, there’s been two that I’ve seen that I thought were fakes, out of the many
that weren’t and the fakes were obvious. Now what’s happening out in the broader psychiatric community, I can’t really speak for.
Interviewee: Anthony Williams Archive ID 1751 Tape 09
OK Tony why is the prognosis for recovery not so good in cases of severe PTSD in peacekeeping missions?
Well I don’t think they differ from any other forms of war related or combat related PTSD. I think
that the problem is that once it becomes full entrenched, it becomes, it almost feeds on itself in that it becomes chronic. The avoidant behaviour means that they avoid getting into situations that might help them confront what’s happened and that’s the most comfortable way to deal with it but it doesn’t help the condition because the only way, not the only way, but
a main way, of dealing with the condition is to actually confront the traumatic memories which is very difficult because of the intense anxiety those memories arouse.
What do you think is the importance of psychiatry and psychiatric treatment in war?
Well there’s two sides to that question. One is the ethics of if a person’s been traumatised, should you try and treat them to get better, to go back to be exposed to further trauma, with the knowledge that further trauma’s going to make the original trauma sequelae worse
as I illustrated earlier with the Rwanda, Timor stories and there’s quite a debate going on at the moment that there are a lot of people who say that with PTSD they should be able to continue serving and there are equally a number of people saying, “If you develop PTSD, enough’s enough and you should be
out of the military.” Now having said that, I might have bypassed your question a bit. I think that having psychiatry in the military, it’s like what psychiatry can offer fire fighters and ambulance personnel, people who get traumatised. It can offer early intervention to try and get the person
on the road to recovery but, as I just mentioned, the ethics comes in then, should they still stay in that situation if they’ve had that response to trauma, bearing in mind that most people exposed to trauma do not get PTSD. We’re talking about the ones who do and I don’t know whether that’s quite answered your question.
That’s OK. What skills did you learn during your experience in Vietnam that
stood you in good stead for your subsequent medical career?
I think one of the skills I got there was working as a doctor with a population that was primarily normal and I think it helped me in my own mind of working out what’s normal and what’s not normal,
cause most of, well virtually all your training in medicine and your work in hospitals, you’re dealing with people who are sick, whereas I was dealing with a population that I had to see everybody to examine them to see how fit they were and then I saw those who became patients and I think I got a better perspective of the breadth of human symptomatology, if I can use that word. That’s probably not the right word to use but
the way individuals can express discomfort and that sort of thing and what resolves without being interfered with or intervened and what does need intervention. I think it helped me come not to fully understand it, but to come to some understanding of what it’s about.
What did you think your role and contribution to the war effort was?
Well I think it was a fairly minor role. I think that I was in a position to help assist keep the battalion healthy. I think the civil aid work that we did helped that population during that period. I think that’s about it.
Bearing in mind that you’ve been quite involved in subsequent conflicts and peacekeeping after Vietnam?
Not in the conflicts, but with the people.
Do you think that Australia as a nation has managed peacetime well militarily?
In, do you mean in deployment issues or training issues or?
In Australia’s role, I suppose what I’m asking is do you think that Australia’s military involvement overseas, particularly in Timor and Rwanda has been worthwhile?
In terms of training of our military, yes I do. In terms of assisting those countries
again I do. I mean any military engagement is going to have its cost and I don’t mean financial. I mean on people’s physical, mental health. I think that actually has helped us to learn to cope with it better but that doesn’t mean I feel that cost is worthwhile necessarily.
Do you have any regrets of the time you spent serving the army?
While you were talking to Matt [interviewer] before you said that you think if we thought about it, every Australian would have an Anzac tradition of some kind. What do you consider the Anzac tradition to be?
That’s a good question. I think it’s seeing one’s self
as belonging to this country, having some pride in what the country can do, giving people a fair go, allowing us to debate and have a democracy. These are the sorts of values I see in it.
And if you had a message for future Australians who might be watching this tape about serving
one’s country, what would you say?
Do the best you can in whatever field you have the expertise, and it doesn’t need to be in the armed forces.