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Invisible scars Commonwealth military psychiatry and the Korean War (1950-1953)
Fitzpatrick, Kathleen Meghan
Awarding institution: King's College London
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Invisible Scars: Commonwealth Military Psychiatry and the Korean War (1950-1953)
Dissertation Submitted for: Doctor of Philosophy in War Studies
Kathleen Meghan Fitzpatrick Department of War Studies King’s College London April 2014
Note: The copyright of this thesis rests with the author and no quotation from it or information derived from it may be published without proper acknowledgement.
1 Table of Contents
Abstract……………………………………………………………………………………...4
Map of Korea………………………………………………………………………………..5
Abbreviations……………………………………………………………………………...... 6
List of Illustrations………………………………………………………………………....10
Acknowledgements………………………………………………………………………...14
Chapter 1 Introduction……………………………………………………………………………...…16
Chapter 2 A Sign of the Times: The Transformation of the Royal Army Medical Corps and the Royal Canadian Army Medical Corps (1945-1950)………………………………………………38
Chapter 3 Together We Stand: 1 Commonwealth Division Organisation and Administration (1950- 1953)…………………………………………………………………………………..…...73
Chapter 4 Weathering the Storm: Mental Health and Psychiatric Practice (1950-1953)…………....109
Chapter 5 For the Common Good: Divisional Morale (1950-1953)…………………………...……159
Chapter 6 Forever Changed: Korean War Veterans and the Pensions’ System……………………..199
Chapter 7 Soldiering On: The Post Korean War Development of the Royal Canadian Army Medical Corps and the Royal Army Medical Corps…………………………………………….....231
Chapter 8 Conclusion………………………………………………………………………………...280
Illustrations…………………………………………………………………………..……291
Appendices………………………………………………………………………………..320
2 Appendix A Chronology of Important Events………………………………………………………….321
Appendix B Organisation of the 27th British Commonwealth Brigade and 29th British Independent Infantry Brigade Group…………………………………………………………………...328
Appendix C 1st Commonwealth Division Order of Battle, 1st August 1951…………………………...333
Appendix D 1st Commonwealth Division Pertinent Medical Staff………………………………….....338
Bibliography………………………………………………………………………………340
3 Abstract
Over the past several decades, both the academic community and the public at large have become increasingly interested in the development of modern military psychiatry. Work on this subject has enriched our understanding of the psychological impact of war and the overall human toll of conflict. However, very little research has been conducted on the Korean War (1950-1953). A brutal conflict, Korea produced roughly 4 million casualties. Nearly 145,000 Britons, Canadians, Australians and New Zealanders served in the Far East as members of the 1st Commonwealth Division. While many suffered physically, others grappled with significant mental health problems. Psychiatric casualties accounted for roughly 1 in 20 wounded or sick Commonwealth soldiers. This dissertation examines the psychiatric care system in place both during and after the war. ‘Invisible Scars,’ represents the first comprehensive study of Commonwealth medical or psychiatric practices and is intended to act as a foundation upon which future studies can build. Chapters are organised both chronologically and thematically and review topics such as organisation, treatment, morale and pensions.
I conclude that army doctors were largely successful in treating men with mental health problems in the short term. Return-to-unit rates ranged from 50% to 83%. Those men who could not return to their units were re-employed in less strenuous occupations. Treatment was designed to be practical and focused on rest and reassurance. Only 5% to 7% of patients were evacuated to Japan for further hospitalisation or repatriated for the purposes of long term care. Be that as it may, the Commonwealth countries failed to put long-term support systems in place for vulnerable veterans. There was little available in terms of either compensation or counselling. Ex-servicemen also found applying for a pension to be a difficult and bureaucratic process. They were generally ill supported by veterans’ organisations and in some cases they were turned away by individual branches. The Korean War brings up important questions about the military’s duty of care and the long-term needs of ex-service personnel. It also highlights the role that public commemoration can play in the healing process. While Korean War veterans share many similarities with veterans of other twentieth century conflicts, they are a unique group worthy of further study.
4 Map of Korea
Source: Mark Jameson Smith, Map of Korea (1950-1953), Map, The Royal Canadian Regiment, last modified 1998, http://theroyalcanadianregiment.ca/individual_submissions/Hill187.html
5 Abbreviations
AACS Australian Army Canteen Service ACPMH Australian Centre for Posttraumatic Mental Health ACS Army Council Secretariat (United Kingdom) ADA Psych Assistant Director of Army Psychiatry (United Kingdom) ADMS Assistant Director of Medical Services (1 Commonwealth Division) AG Adjutant General AKC Army Kinema Corps (United Kingdom) AMA American Medical Association AMD Army Medical Department (United States of America) AORG Army Operations Research Group (United Kingdom) APA American Psychiatric Association BCCZMU British Commonwealth Communications Zone Medical Unit BCFK British Commonwealth Force Korea BCGH British Commonwealth General Hospital BCOF British Commonwealth Occupation Force BGH British General Hospital BKVA British Korean Veterans Association BMA British Medical Association BMJ British Medical Journal BOAC British Overseas Airways Corporation CASF Canadian Army Special Force CBC Canadian Broadcasting Corporation CCF Cooperative Commonwealth Federation (Canada) CF Canadian Forces CFHS Canadian Forces Health Service CFMS Canadian Forces Medical Service CFMSTC Canadian Forces Medical Service Training Centre CIA Central Intelligence Agency (United States of America) CIGS Chief of the Imperial General Staff (United Kingdom) CMA Canadian Medical Association CMAJ Canadian Medical Association Journal CWMC Central Medical War Committee (United Kingdom) CO Commanding Officer COS Chiefs of Staff CSI Cornell Selection Index CSR Combat Stress Reaction DAP Directorate of Army Psychiatry (United Kingdom) DA Psych Director of Army Psychiatry (United Kingdom) DCMH Department of Community Mental Health (United Kingdom) DDMS Deputy Director of Medical Services (1 Commonwealth Division) DGAMS Director General of Army Medical Services (United Kingdom)
6 DGMS Director General of Medical Services (Canada) DHH Directorate of History and Heritage (Canada) DND Department of National Defence (Canada) DRB Defence Research Board (Canada) DPM Diploma of Psychological Medicine (United Kingdom) DPS Directorate of Personnel Services (Canada) DSM Diagnostic and Statistical Manual DVA Department of Veterans Affairs (Australia) ECAC Executive Committee of the Army Council (United Kingdom) ECT Electroconvulsive Therapy EFI Expeditionary Forces Institute (United Kingdom) FARELF Far Eastern Land Force (United Kingdom) FDS Field Dressing Station FST Field Surgical Team FTT Field Transfusion Team GAC Geronotological Advisory Council (Canada) GDO General Duty Officer GDP Gross Domestic Product GOC General Officer Commanding GP General Practitioner GSO General Staff Officer GSW Gun Shot Wound HMAS Her Majesty’s Australian Ship HMCS Her Majesty’s Canadian Ship HMHS Her Majesty’s Hospital Ship HMS Her Majesty’s Ship IAMS Indian Army Medical Service ISAF International Security Assistance Force ISCJT Inter-Service Committee on Joint Training (Canada) ISMC Inter-Service Medical Committee (Canada) IWM Imperial War Museum (United Kingdom) JCC Joint Concealment Centre (United Kingdom) JRAMC Journal of the Royal Army Medical Corps (United Kingdom) JSIU Joint Services Interrogation Unit (United Kingdom) KOSB King’s Own Scottish Borderers KSLI King’s Scottish Light Infantry LAC Library and Archives of Canada MAOI Monoamine Oxidase Inhibitors MASH Mobile Army Surgical Hospital MMPI Minnesota Multiphasic Personality Inventory MO Medical Officer MoD Ministry of Defence (United Kingdom) MPAB Medical Procurement and Assignment Board (Canada) MPNI Ministry of Pensions and National Insurance (United Kingdom)
7 MRCP Membership of the Royal Colleges of Physicians (United Kingdom) NAAFI Navy, Army and Air Force Institute (United Kingdom) NATO North Atlantic Treaty Organisation NBPI National Board for Prices and Incomes (United Kingdom) NCO Non Commissioned Officer NDMC National Defence Medical Centre (Canada) NHS National Health Service NKPA North Korean People’s Army NRMA National Resources Mobilisation Act (Canada) NS National Service (United Kingdom) NVRP National Veterans Resource Project (United States of America) NZ New Zealand OFP Ordnance Field Park OR Other Ranks OSI Operational Stress Injury clinics (Canada) OTSSC Operational Trauma and Stress Support Centre (Canada) PAC Psychiatric Advisory Committee (United Kingdom) PIE Proximity, Immediacy, Expectancy PMC Personnel Members Committee (Canada) PO Personnel Officer POC Psychological Operations Centre (United Kingdom) POW Prisoner of War PSO Personnel Selection Officer (Canada) PPCLI Princess Patricia’s Canadian Light Infantry PTSD Post Traumatic Stress Disorder PULHEMS Physique, Upper Limbs, Locomotion, Hearing, Eyesight, Mental Functioning, Stability PX Post Exchange (United States of America) QARNNS Queen Alexandra’s Royal Naval Nursing Service (United Kingdom) R&R Rest and Relaxation RAAF Royal Australian Air Force RAChD Royal Army Chaplain’s Department (United Kingdom) RADC Royal Army Dental Corps (United Kingdom) RAEC Royal Army Education Corps (United Kingdom) RCL Royal Canadian Legion RL Royal Legion (United Kingdom) RAAMC Royal Australian Army Medical Corps RAEC Royal Army Educational Corps (United Kingdom) RAMC Royal Army Medical Corps (United Kingdom) RAOC Royal Army Ordnance Corps (United Kingdom) RAP Regimental Aid Post RAR Royal Australian Regiment RASC Royal Army Service Corps (United Kingdom) RCASC Royal Canadian Army Service Corps
8 REME Corps of Royal Electrical and Mechanical Engineers (United Kingdom) RCAF Royal Canadian Air Force RCAMC Royal Canadian Army Medical Corps RCASC Royal Canadian Army Service Corps RM Royal Marines RMC-D Royal Military College, Duntroon (Australia) RMC-K Royal Military College, Kingston (Canada) RMO Regimental Medical Officer RNZASC Royal New Zealand Army Service Corps RNZEME Royal New Zealand Electrical and Mechanical Engineers RRU Reserve Reconnaissance Unit (United Kingdom) RSL Returned & Services League (Australia) RTU Return to Unit RUSI Royal United Services Institute RVH Netley Royal Victoria Hospital Netley R22er Royal 22e Régiment (Canada) R2MR Road to Mental Readiness (Canada) SAS Special Air Service (United Kingdom) SSAFA Soldiers, Sailors and Air Force Association (United Kingdom) TCA Tricyclic Antidepressants TNA The National Archives (United Kingdom) TRiM Trauma Risk Management (United Kingdom) UK United Kingdom UN United Nations UNC United Nations Command USA United States of America USO United Service Organisation (United States of America) USSR Union of Soviet Socialist Republics VAC Veterans Affairs Canada VAD Volunteer Aid Detachment VD Venereal Disease VIP Veterans’ Independence Programme (Canada) VRMHP Veterans and Reserves Mental Health Programme (United Kingdom) VVAW Vietnam Veterans Against the War (United States of America) VVCS Vietnam Veterans Counselling Service (Australia) WHO World Health Organisation WO War Office (United Kingdom) Warrant Officer WOSB War Office Selection Board (United Kingdom) WPC War Pensions Committee WRAC Women’s Royal Army Corps (United Kingdom) WVS Women’s Voluntary Service (United Kingdom) 16 NZ Fd Regt 16 New Zealand Field Artillery Regiment 25 FDS 25 Canadian Field Dressing Station
9 List of Illustrations
Illustration 1: Canadian demobilisation process…………………………………..……291
Illustration 2: National Servicemen………………………………………………….….291
Illustration 3: Captain AJM Davis of the RCAMC lecturing a service audience on mental health………………………………………………………………………………..……292
Illustration 4: A Cold War era RAMC recruiting poster…………………………..……292
Illustration 5: Task Force Smith……………………………………………………..….293
Illustration 6: Her Majesty’s Australian Ship Bataan…………………………….…..…293
Illustration 7: Ray Morgan, Red Butler, Ken McOrmond, Vern Roy and Roland pose for a photo in Sudbury, Ontario before heading to Chorley Park in Toronto to enlist in the Canadian Army……………………………………………………………………..…….294
Illustration 8: Australian recruitment depot…………………………………………..…294
Illustration 9: Royal Australian Regiment………………………………………...….....295
Illustration 10: Princess Patricia’s Canadian Light Infantry………………………….....295
Illustration 11: 16th New Zealand Field Artillery Regiment………………………….....296
Illustration 12: Lieutenant General Sir Horace Robertson…………………………..…..296
Illustration 13: Canadian troops at Camp Borden…………………………………..…...297
Illustration 14: 60th Indian Field Ambulance………………………………………..…..297
Illustration 15: British Commonwealth General Hospital…………………………..…..298
Illustration 16: 1st British Commonwealth Division Headquarters…………………...…298
Illustration 17: General AJH Cassels, Commander 1st Commonwealth Division……....299
Illustration 18: Major General Frank Kingsley Norris, Colonel Nye, Brigadier Taylor and Colonel Anderton………………………………………………………………………....299
Illustration 19: 25 Canadian Field Ambulance……………………………………….…300
10 Illustration 20: 25 Canadian Field Dressing Station…………………………………….300
Illustration 21: 25 Canadian Field Dressing Station in Seoul………………….………..301
Illustration 22: Nursing Sister Marie Guimond of the RCAMC attends to a patient at the British Commonwealth Communications Zone Hospital………………………...………301
Illustration 23: Private Vic Arsenault and Private Russ Sutherland…………………….302
Illustration 24: American soldiers……………………………………………………….302
Illustration 25: US medic attends to wounded British soldier…………………………..303
Illustration 26: Aerial view of the forward section of 25 Canadian Field Dressing Station………………………………………………………………………………...…..303
Illustration 27: Former prisoners of war Paul Dufour, George St Germain, Joseph Binette, Ernie Taylor, Len Badowich, Jim Gunn, Barry Gushue, Victor Percy and Red Cross worker Ina McGregor travel to 25 Canadian Field Dressing Station………………………..……304
Illustration 28: Royal Australian Regiment Regimental Aid Post………………………304
Illustration 29: Private Heath Matthews of the Royal Canadian Regiment……………..305
Illustration 30: An example of a field ambulance in Korea……………………….…….305
Illustration 31: Lance Corporal Wally Jones, Private Alan Markus and Private Doug McCallum from the Royal Canadian Regiment rest after an attack by Chinese troops……………………………………………………………………………………...306
Illustration 32: Her Majesty’s Hospital Ship Maine…………………………………….306
Illustration 33: No. 6 Convalescent Training Depot…………………………………….307
Illustration 34: Patients from the British Commonwealth General Hospital on a trip to an animal park………………………………………………………………………………..307
Illustration 35: A Commonwealth patient being loaded onto a plane for evacuation…...308
Illustration 36: Royal Victoria Hospital Netley………………………………………....308
Illustration 37: Ste-Anne-de-Bellevue Hospital…………………………………………309
11 Illustration 38: Republic of Korea Service Corps unloading American C-4 and C-6 rations for the Royal Australian Regiment…………………………………………………….…309
Illustration 39: Australian soldiers read their mail………………………………………310
Illustration 40: Navy, Army and Air Force Institutes Mobile Canteen serving a group of soldiers……………………………………………………………………………………310
Illustration 41: The snack bar at the Empire Club in Hiro, Japan……………………….311
Illustration 42: British soldiers pose with a sailor in front of the Kookaburra Club…….311
Illustration 43: Soldiers from 38 Canadian Field Ambulance compete in a tug of war…312
Illustration 44: Canadian troops play hockey on the Imjin River……………………….312
Illustration 45: A group of soldiers work on an iceboat…………………………………313
Illustration 46: Australian soldiers Trevor Williams and TE Powell recording a Christmas message at Crown Radio………………………………………………………………….313
Illustration 47: Private William Alfred Smith of the Royal Australian Regiment at work in the camp cinema…………………………………………………………………………..314
Illustration 48: French-speaking singer Lorraine McAllister and accordionist Karl Karleen perform for the Royal 22e Régiment……………………………………………………..314
Illustration 49: Chaplain Clout delivers a service to the Royal Australian Regiment…..315
Illustration 50: Allan Minette, Gerald Patenaud, Roy Temple and Henry Graveling of Lord Strathcona’s Horse celebrate the end of the Korean War…………………………...315
Illustration 51: Trooper Richardson greets family at Southampton……………………..316
Illustration 52: Australian soldiers in Vietnam……………………………………….....316
Illustration 53: Anti-Vietnam War protest in Australia…………………………………317
Illustration 54: Lieutenant General Roméo Dallaire…………………………………….317
Illustration 55: National Defence Medical Centre………………………………………318
Illustration 56: Dr Donald Olding Hebb……………………………………………...…318
12 Illustration 57: An image comparing pre and post deployment briefings to the stops needed during a road trip……………………………………………………………...…..319
Illustration 58: British mental health nurse attends a patient……………………………319
13 Acknowledgments
Over the past four years, I have been fortunate enough to work alongside, interview and speak with many extraordinary people. This dissertation would not have been possible without their kindness. Many thanks must first go to my supervisors Professor Edgar Jones and Dr Helen McCartney for helping me to navigate the perilous experience of the PhD. They offered advice and criticism when they were needed but always allowed me to find my own path. The staff and students of the Departments of War Studies and Defence Studies have also proved an invaluable source of support.
I have had the pleasure of interviewing and corresponding with Korean War veterans. They have been exceedingly generous with their time and candid in sharing their memories. Thanks go to Dr David Oates, who assisted me in contacting veterans and arranging interviews. I must also thank former ambulance orderly Bill Trevett and former medical officer Kenneth Davison for inviting me into their homes and helping me to better understand life in a warzone. Dr Fraser and Dr Leslie Bartlett both served as National Servicemen and psychiatrists during the war. I am indebted to them for answering my questions and allowing me to read their letters. Thanks also go to Anthony Rosie; whose father Brigadier Robert J Rosie served as British Director of Army Psychiatry in the early 1950s. He allowed me to gain a clearer impression of his father’s career and achievements.
It is always challenging to take on a project of multi-national dimensions. However, the difficulties have been more than manageable with a little guidance. I must thank the staff of the Canadian War Museum and the Library and Archives of Canada for helping me to find the right materials within a very tight timeframe. I am also obliged to Professor Thomas Nesmith of the University of Manitoba and Dr Tim Cook of the Canadian War Museum, who arranged research assistance when I needed it. Masters student Michel Legault of Carleton University kindly located and photocopied records on my behalf. Thanks also go
14 to Douglas Chalke, whose father Major FCR Chalke acted as divisional psychiatrist in 1952. Mr Chalke graciously responded to my letter and I am grateful to have learnt more about an exceptional doctor and father. Throughout the past few years, I have also had the joy of corresponding with Leslie Peate of the Korea Veterans Association of Canada and Vic Dey of the Korean Veterans Association of Australia. Without the help of both associations, I would not have been able to answer vital questions.
Finally, I need to thank my circle of supporters for their encouragement. Thanks go to my close friends Kim Brice and Frank O’Donnell, who always listen to my worries and manage to make me laugh. Since my undergraduate days, Dr Robert Young and Dr Kathryn Young have encouraged my love of history and provided a model of what I hope to achieve in my career. I have spent many hours in their company discussing books and all manner of subjects. Last but not least, I must thank my mother and father, Cheryl and Michael Fitzpatrick. They deserve more praise than I can possibly convey. I thank them for helping me to pursue my studies so far away from home, for tolerating early morning phone calls and reading countless drafts of the dissertation without complaint. Most importantly, I thank them for believing in me before anyone else did and inspiring me to become the best version of myself.
15
Chapter 1 Introduction
16 Nations customarily measure the, ‘costs of war,’ in dollars, lost production, or the number of soldiers killed or wounded. Rarely do military establishments attempt to measure the costs of war in terms of individual suffering. Psychiatric breakdown remains one of the most costly items of war when expressed in human terms.1 Richard Gabriel, No more heroes: Madness and psychiatry in war
During the past decade, the subject of military psychiatry has become increasingly popular amongst both journalists and academic writers. In recent years, Western troops have been deployed to conflicts in the Middle East and around the world. As service personnel return home, many have experienced psychiatric difficulties and related problems. This has long term implications for the public healthcare system and the planning of future military operations. It has also generated interest in the historical role of the uniformed psychiatrist. Difficulties reported by veterans in seeking to adjust to civilian life suggest that the mental health of service personnel will continue to draw public attention and debate. Therefore, it is more important than ever to understand the history of military psychiatry and war-related trauma.
In writing about the development of modern military psychiatry, authors have primarily chosen to focus on one of three conflicts: World War I, World War II or the Vietnam War. However, ‘Invisible Scars’ focuses on events during the Korean War (1950-1953) and the participation of the 1st British Commonwealth Division. While there are numerous books and articles on war and mental health in reference to other twentieth century conflicts, there is nothing comparable for Korea. Moreover, the activities of the Commonwealth have received very little attention from the academic world. Korea represents a missing piece of the puzzle.
1 Richard A Gabriel, No more heroes: Madness and psychiatry in war (New York: Hill and Wang, 1967). 2 Richard Whelan, Drawing the Line: The Korean War, 1950-1953 (London: Faber & Faber, 1990), 373. 3 Max Hastings, The Korean War, Pan Grand Strategy Series (UK: Pan Macmillan Books, 2000), 17 The Korean War was a brutal conflict that produced roughly four million casualties.2 In the early hours of 25 June 1950, Communist North Korea launched an invasion of South Korea in a bid to forcibly unify the two countries. The attack was widely unforeseen but the United Nations (UN) responded quickly to an assault on one of its member states.3 US Army troops were immediately deployed to the region to defend South Korea. Initially overwhelmed, the Americans were compelled to retreat to the coastal city of Pusan.4 Ground, air and naval forces from seventeen other countries soon arrived to support their efforts. 5 Under the command of American general Douglas MacArthur, UN forces managed to successfully regain the initiative and push the North Koreans back over the border by October 1950. Despite this early success, the war was far from over.6 Fearing an American invasion of Chinese territory bordering Korea, the People’s Republic of China entered the war as an ally of North Korea in November 1950.7 When truce negotiations began in the summer of 1951, hostilities settled along a static front line. Over the following two years, North Korean, Chinese and UN forces waited for a peace to be concluded.8
2 Richard Whelan, Drawing the Line: The Korean War, 1950-1953 (London: Faber & Faber, 1990), 373. 3 Max Hastings, The Korean War, Pan Grand Strategy Series (UK: Pan Macmillan Books, 2000), 45-48. Lieutenant Colonel Herbert Fairlie Wood, Strange Battleground: The Operations in Korea and their Effects on the Defence Policy of Canada (Ottawa: Queen’s Printer and Controller of Stationary, 1966), 10-12. 4 Tim Carew, The Commonwealth at War (London: Cassell & Company Limited, 1967), 13, 27, 71. Jeffrey Grey, The Commonwealth Armies and the Korean War: An Alliance Study (Manchester & New York: Manchester University Press, 1988), 172. Wood, Strange Battleground, 42. Hastings, The Korean War, 7, 438. 5 Grey, The Commonwealth Armies, 172. 6 Ibid., 77. 7 Brigadier Cyril Nelson Barclay, The First Commonwealth Division: The Story of British Commonwealth Land Forces in Korea, 1950-1953 (Aldershot, UK: Gale & Polden Limited, 1954), 12, 34. 8 General Sir Anthony Farrar-Hockley, The British Part in the Korean War, Vol. I: A Distant Obligation (London: Her Majesty’s Stationery Office (HMSO), 1990), 136-138. Ian McGibbon, New Zealand and the Korean War, Vol I: Politics and Diplomacy (Auckland, New Zealand: Oxford University Press in association with the Historical Branch, Department of Internal Affairs, 1992), 41-47. Barclay, The First Commonwealth Division, 110. Grey, The Commonwealth Armies, 77.
18 Roughly 145,000 troops from Canada, Australia, the United Kingdom and New Zealand were deployed to the Far East. In July 1951, they officially formed a new and unified division. Working more closely together than ever before, 1 Commonwealth Division was an experiment in integration and inter-allied cooperation.9 The Korean War represents the third largest deployment of Commonwealth forces in the twentieth century. The country’s rugged terrain, lack of basic infrastructure and extreme climate made daily life and military operations difficult to conduct.10 According to journalist Max Hastings, troops, ‘suffered privations of almost Crimean proportions.’11 Moreover, the reasons for the war were often unclear; peace negotiations dragged on and public support waned over time.12 During active hostilities, psychiatric casualties accounted for 1 in 20 wounded or sick Commonwealth soldiers. 13 They suffered from a range of conditions including: psychoneurosis, character disorders and battle exhaustion.14
9 Wood, Strange Battleground, 257 Richard Trembeth, A Different Sort of War: Australians in Korea 1950-53 (Melbourne: Australian Scholarly Publishing, 2005), 1. Anon, ‘Commonwealth Forces’ Record in Korea: A Successful Experiment,’ Times, 21 July 1953. 10 Paul M Edwards, The Korean War, American Soldiers’ Lives: Daily Life Through History (USA: Greenwood Publishing Group Incorporated, 2006), 92-94. Lieutenant Colonel Howard N Cole, NAAFI in Uniform (UK: Navy, Army and Air Force Institute, 1982), 175. Bill Trevett, Interview by author; Trowbridge, Wiltshire, UK, November 2010. 11 Hastings, The Korean War, 95. 12 United States Army Survey, quoted in Stanley Sandler, The Korean War: No Victors, No Vanquished (USA: University of Kentucky Press, 1999), 131-132. Alex Easton, Interview by Remembering: Scotland At War, 2009, http://www.rememberingscotlandatwar.org.uk/Accessible/Exhibition/182/Korea-Wheres-that Robert J O’Neill, Australia in the Korean War 1950-1953, Volume II: Combat Operations (Canberra: Australian War Memorial and the Australian Government Publication Service, 1985), 239. McGibbon, Politics and Diplomacy, 301. 13 Captain JJ Flood, ‘Psychiatric Casualties in United Kingdom Elements of Korean Force: December 1950—November 1951,’ Journal of the Royal Army Medical Corps 100, 1 (Jan. 1954): 41. Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, Library and Archives of Canada/ Bibliothèque et Archives Canada (hereafter cited as LAC): RG24-C-3, Volumes 18395- 18397. 14 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397.
19 Despite the privations and challenges that Commonwealth troops encountered, authors writing about the Korean War have largely neglected the medical and psychiatric aspects of the subject. There are only a handful of authors that explore Commonwealth psychiatric practice in depth.15 Shortly after the war, several articles appeared reviewing the healthcare arrangements made for Commonwealth forces. In 1954, Captain JJ Flood of the Royal Army Medical Corps (RAMC) outlined the initial provisions made for British troops and the nature of early casualties.16 A year later, Colonel JE Andrew and Brigadier Ken A Hunter related the Canadian version of events in a short piece for the Journal of the Canadian Medical Association.17 Little else has been written over the ensuing decades. Redmond McLaughlin only briefly mentions the Korean War in his 1972 official history of the Royal Army Medical Corps. GWL Nicholson is similarly sparing in detail in his 1977 book on the Royal Canadian Army Medical Corps.18 A short article on Australian medical officers by military historian Dr Darryl McIntyre appeared in 1988.19 Bill Rawling of the
15 There are also very few secondary sources that look at American medical or psychiatric practice. Albert E Cowdrey’s The Medics’ War is the only book dedicated to the subject. There are several articles available by authors such as psychiatrists Colonel Albert Julius Glass and Colonel Elspeth Cameron Ritchie. Albert E Cowdrey, The Medics’ War (Washington, DC: Centre of Military History, 1987). United States Army Medical Department, Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950-1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954). Colonel Albert Julius Glass, ‘Psychiatry in the Korean Campaign: A Historical Review.’ United States Armed Forces Medical Journal 4, No. 10 (October 1953): 1387-1401. , ‘Psychotherapy in the Combat Zone.’ American Journal of Psychiatry 110, No. 10 (1954): 725-731. Colonel Elspeth Cameron Ritchie. ‘Psychiatry in the Korean War: Perils, PIES and Prisoners of War.’ Military Medicine 167, No. 11 (2002): 898-903. 16 Flood, ‘Psychiatric Casualties in United Kingdom Elements,’ 40-47. 17 Colonel JE Andrew and Brigadier Ken A Hunter, ‘The Royal Canadian Army Medical Corps in the Korean War,’ Canadian Medical Association Journal/Journal de l’Association médicale canadienne, 72 (1 Feb. 1955): 178-184. 18 Redmond, McLaughlin, The Royal Army Medical Corps, The Famous Regiment Series, ed. Lieutenant General Sir Brian Horrocks (London: Leo Cooper Limited, 1972). GWL Nicholson, Seventy Years of Service: A History of the Royal Canadian Army Medical Corps (Ottawa: Borealis Press, 1977). 19 Darryl McIntyre, ‘Australian Army Medical Services in Korea,’ in Australia in the Korean War 1950-1953, Vol. II, Combat Operations by Robert J O’Neill (Canberra: Australian War Memorial and the Australian Government Publication Service, 1985), 570-585.
20 Canadian Directorate of History and Heritage discusses psychiatry alongside other medical developments in Death Their Enemy: Canadian Medical Practitioners and War published in 2001 and his 2004 Myriad Challenges of Peace: Canadian Medical Practitioners Since the Second World War.20
Professor Edgar Jones is the only academic author to have studied Commonwealth psychiatric practice in some detail. Since 2000, he has co-authored several articles on the subject. Jones and RAMC psychiatrist Dr Ian Palmer wrote, ‘Army Psychiatry in the Korean War: The Experience of 1 Commonwealth Division,’ for the journal Military Medicine.21 Alongside Dr Simon Wessely, Jones has also addressed the matter in the article, ‘Psychiatric battle casualties: an intra- and interwar comparison,’ and in the book Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War.22 In each of these publications, he outlines Commonwealth psychiatric policy, treatment methods and the most common mental health problems.
Upon the formation of the division, the Canadians and British were assigned joint responsibility for providing medical and mental healthcare. A divisional psychiatrist was posted in the field in order to attend cases as close to the front lines as possible. From December 1950 to November 1951, Captain JJ Flood recorded that amongst the UK
20 Bill Rawling, Death Their Enemy: Canadian Medical Practitioners and War. (Quebec: AGMV Marquis, 2001), 252-253. Bill Rawling, The Myriad Challenges of Peace: Canadian Forces Medical Practitioners Since the Second World War (Ottawa: Canadian Government Publishing, 2004), 69-73. 21 Edgar Jones and Ian Palmer, ‘Army Psychiatry in the Korean War: The Experience of 1 Commonwealth Division.’ Military Medicine 165, No. 4 (2000): 256-259. 22 Edgar Jones and Simon Wessely, ‘Psychiatric battle casualties: an intra- and interwar comparison,’ British Journal of Psychiatry 178 (Mar. 2001): 242-247. Edgar Jones and Simon Wessely, Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War (London: Taylor & Francis Group/Psychology Press, 2005), 119-127.
21 contingent around 35 men per 1,000 were admitted for mental health problems.23 Jones argues that, ‘The initial peak in psychiatric casualties owed something to the nature of the troops that had been deployed.’24 Many were volunteers, veterans and reservists rather than regular soldiers. Thereafter, the number of patients fell steadily. Although soldiers suffered from a range of disorders, they were most often admitted for anxiety and fatigue states. As the war stabilised along a static front line, behaviour and character problems became increasingly common. Following treatment, the majority of troops returned to duty and the divisional psychiatrist regularly reported return to unit (RTU) rates of over 50%.25 Over the course of the war, 1 Commonwealth Division had a relatively low rate of psychiatric illness. As medical officers became more experienced, fewer patients appeared. However, Jones has also argued that some psychiatric cases went unrecorded. In Shell Shock to PTSD, Jones and Wessely note that, ‘unexplained medical symptoms were a feature of the Korean War.’26 For example, the division suffered a significant number of cold injuries during the winter of 1950-1951. Jones and his co-author hypothesize that some soldiers may have exposed themselves to cold injury either consciously or unconsciously in response to, ‘situations of intolerable stress.’27 They further illustrate their case by pointing to the most common reasons for admission to hospital. Throughout the war, servicemen were primarily admitted to base hospital for skin reactions, gastrointestinal and respiratory problems. Jones and Wessely maintain that, ‘it is likely that some of these cases represented a somatic expression of psychological distress.’28 The arguments that Jones presents are compelling. Be that as it may, he leaves many questions unanswered and many ideas unexamined. Due to the brevity of the articles, he has little time to fully explore the issues that he raises. Furthermore, his arguments are based on a limited number of secondary and primary sources. All of his archival materials are drawn from the British National Archives at Kew.
23 Flood, ‘Psychiatric Casualties in United Kingdom Elements,’ 40-47. Jones and Wessely, Shell Shock to PTSD, 121. 24 Jones and Wessely, Shell Shock to PTSD, 121. 25 Ibid.,121-123. 26 Ibid.,125. 27 Ibid., 127. 28 Ibid., 126.
22 While the British sources are important, they are but one part of the story. The Canadians also played a vital role in divisional medicine and psychiatry. Between July 1951 and July 1953, three out of four divisional psychiatrists were officers of the Royal Canadian Army Medical Corps. Moreover, the division’s psychiatric ward was attached to 25 Canadian Field Dressing Station. However, Jones and his co-authors do not make use of Canadian war diaries, unit records, policy documents or medical files.29
‘Invisible Scars,’ represents the first attempt to provide a comprehensive account of Commonwealth Division psychiatry in Korea. The dissertation centres around three principle questions. Firstly, how were soldiers treated for psychiatric disorders in the field and at hospital? Secondly, how successful were Commonwealth doctors in treating the mentally ill in both the short term and the long term? Finally, what effect, if any, did the Korean War have on the evolution and further development of military psychiatry? Throughout this study, I have focused on Commonwealth ground forces rather than naval or air force elements. Although both sailors and airmen made significant contributions to the UN war effort, Korea was primarily a conflict fought by the infantry. As the British and Canadian contingents were responsible for the bulk of medical personnel, both the RAMC and RCAMC feature heavily in every chapter.
The dissertation can be roughly divided into two sections. The first four chapters review and analyse events prior to and during the war. Chapter 2 explores how the RAMC and RCAMC evolved organisationally in the aftermath of World War II. I examine the effects of demobilisation, the advent of peacetime conscription and the emergence of the welfare state. The British and their Canadian counterparts struggled to adapt to the challenges posed by the Cold War era. Was either party prepared for a deployment of the size and scale of
29 Jones and Palmer, ‘Army Psychiatry in the Korean War,’ 256-260. Jones and Wessely, ‘Psychiatric battles casualties,’ 242-247. Jones and Wessely, Shell Shock to PTSD, 241-269.
23 Korea? Chapter 3 looks at how Commonwealth forces were organised both before and after the formation of the division. It explores the reasons why the division was originally created and how its contributing members divided responsibilities between themselves. The multinational composition of the unit presented unique opportunities and challenges for commanders at every level. In addition, I review how the medical services were structured and run on a daily basis. What impact, if any, did inter-allied relations have upon the efficiency of operations and the quality of healthcare?
Chapter 4 investigates how the division organised its front line psychiatric services. The incidence of casualties, the most common mental health problems and the composition of the patient population are all explored. This is followed by a review of treatment methods and the major challenges that psychiatrists encountered. The Korean War was a pivotal turning point for military medicine. The employment of new surgical techniques and helicopter evacuations appreciably lowered the mortality rate. Did military psychiatry make similar advances as a discipline? Secondly, how did Commonwealth practice compare with techniques used during World War II and contemporary American methods? Finally, divisional psychiatrists claimed to have returned over 50% of patients to some form of duty.30 Are these numbers valid or do they belie the truth? Were there any unrecorded psychiatric casualties, as Edgar Jones has argued? By all accounts, the division was an efficient and well-motivated force. Chapter 5 assesses how leadership, limited tours of duty, policies that fostered group cohesion and the provision of reliable welfare services all contributed to high levels of morale. While psychiatrists play an important part in the maintenance of good mental health, welfare and other morale boosting measures are equally vital. In this chapter, the relationship between individual mental health and group morale is considered.
30 Jones and Wessely, Shell Shock to PTSD, 123-124.
24 The final two chapters focus on events from 1953 to the present time. Chapter 6 looks at how Korean War veterans were treated upon their return home. I outline what pensions were available to the physically and mentally disabled and the nature of the care system. What challenges did veterans face in pursuing compensation and in seeking medical treatment? The remainder of the chapter explains how the pensions’ system has evolved and developed since the 1950s. Chapter 7 follows the post-Korean War development of the RCAMC and RAMC. In responding to the economic, social and political demands of the era, both organisations were transformed. It was also a period of revolutionary change for the medical profession and the discipline of psychiatry. This chapter looks at how the Canadians and British responded to these developments and whether or not the Korean War influenced the direction of psychiatric policy and planning.
My work is primarily informed by the research of numerous historians such as Anthony Babington, Peter Leese, Peter Barham, Hans Binneveld, Ben Shephard, psychotherapists like Edgar Jones and psychiatrists like Simon Wessely.31 Scholars in both the humanities and the sciences have made significant contributions to the development of the field. Over the past several decades, they have laid the foundations necessary for this project. As previously indicated, the majority have chosen to write about World War I, World War II or the Vietnam War. English language scholarship usually centres on the activities of
31 Books by these authors include: Anthony Babington, Shell Shock: A History of the Changing Attitudes to War Neurosis (London: Leo Cooper, 1997). Peter Leese, Shell Shock: Traumatic Neurosis and the British Soldiers of the First World War (London: Palgrave Macmillan, 2002). Peter Barham, Forgotten Lunatics of the Great War (USA: Yale University Press, 2004). Hans Binneveld, From Shell Shock to Combat Stress: A Comparative History of Military Psychology (Amsterdam: Amsterdam University Press, 1998). Ben Shephard, A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century (Cambridge, MA: Harvard University Press, 2001). Edgar Jones and Simon Wessely, Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War (London: Taylor & Francis Group/Psychology Press, 2005).
25 countries like the United States and the United Kingdom.32 This extensive groundwork is summarised as important context for the detailed study of the Korean War.
As early as December 1914, the British Expeditionary Force (BEF) reported that 7% to 10% of its officers and 3% to 4% of other ranks were suffering from nervous illnesses.33 They exhibited a bewildering variety of symptoms from anxiety and heart palpitations to functional hemiplegia and hysterical blindness. Throughout World War I, doctors on both sides of the conflict struggled to understand the aetiology and nature of such disorders.34 Initially doctors explored the hypothesis that some symptoms resulted from the concussion following exploding ordnance and the popular term ‘shell shock’ was adopted in medical publications.35 However, by early 1916 a significant group of military physicians believed that these conditions were largely psychological in origin. Treatment regimes varied widely
32 There are few books and articles about the history of military psychiatry in the other Commonwealth countries. Terry Copp and Bill McAndrew’s Battle Exhaustion: Soldiers and Psychiatrists in the Canadian Army 1939-1945 is one of the only academic studies of Canadian practices. Hardly anything is available on either Australia or New Zealand. Joy Damousi’s 2001 book, Living With the Aftermath: Trauma, nostalgia and grief in post-war Australia and Alison Parr’s 1995, Silent casualties: New Zealand’s unspoken legacy of the Second World War are amongst the only books that address the long term impact of war-related psychiatric trauma on their respective countries in any detail. Published in 2010, Combat Stress in the 20th Century: The Commonwealth Perspective by Terry Copp and Mark Osborne Humphries is the first book to analyse the development of military psychiatry throughout the Commonwealth as a whole. Terry Copp and Bill McAndrew. Battle Exhaustion: Soldiers and Psychiatrists in the Canadian Army 1939-1945 (Montreal, QC and Kingston, ON: McGill Queens University Press, 1990). Joy Damousi, Living with the Aftermath: Trauma, nostalgia and grief in post-war Australia (Cambridge, UK: Cambridge University Press, 2001). Alison Parr, Silent Casualties: New Zealand’s Unspoken Legacy of the Second World War (New Zealand: Tandem Press, 1995). Terry Copp and Mark Osborne Humphries, Combat Stress in the 20th Century: The Commonwealth Perspective (Kingston, ON: Canadian Defence Academy Press, 2010). Kathleen Meghan Fitzpatrick, review of Combat Stress in the Twentieth Century: The Commonwealth Experience by Terry Copp and Mark Osborne Humphries, Canadian Military History, 15 Sept. 2012, http://www.canadianmilitaryhistory.ca/review-of-terry-copp-and-mark-osborne-humphries-combat- stress-in-the-20th-century-the-commonwealth-perspective-by-kathleen-meghan-fitzpatrick/. 33 Shephard, War of Nerves, 21. 34 Ibid., 56-57, 66. 35 Babington, Shell Shock, 46.
26 and could include anything from psychoanalysis to the employment of electric shocks.36 The principles of forward psychiatry were first introduced and developed on the Western Front at French and then British neurological centres.37 They were subsequently summed up in the acronym PIE, which stands for proximity, immediacy and expectancy. Patients should be treated quickly and as close to the front lines as possible. Furthermore, the patient should expect to return to some form of active duty.38 After the armistice in 1918, many veterans went home bearing the permanent psychological scars of their experience. Be that as it may, there were limited options in terms of long term counselling. It has been estimated that, ‘in March 1939, there were about 120,000 [British] pensioners who were still in receipt of pensions or had received final awards for primary psychiatric disability.’39 While these figures may be somewhat inflated, they underline the widespread impact of war-related mental health problems.40
During World War II, the British, Americans and their allies all instituted various forms of screening and selection programmes for recruits. They believed that, ‘improved selection and allocation procedures would substantially reduce [the number of] those who might succumb to post combat disorders.’ In the 1959 book, The lost divisions by E Ginzberg, JK Anderson, SW Ginsburg and JL Herma, the authors estimated that roughly 9.4% or 1,686,000 Americans drafted into the armed forces during WWII were rejected because of ‘low intelligence’ or for ‘neuropsychiatric reasons.’41 Studies conducted in the late 1940s
36 Binneveld, From Shell Shock to Combat Stress, 107-136. Shephard, War of Nerves, 87-110. Babbington, Shell Shock, 54. Leese, Shell Shock, 76. 37 Jones and Wessely, Shell Shock to PTSD, 28-33. 38 Ibid., 233. 39 RH Ahrenfeldt, ‘The army psychiatric service,’ in Medical Services in War, The principal medical lessons of the Second World War, eds. Salusbury McNalty and W Franklin Mellor (London: HMSO, 1968), 108. 40 Jones and Wessely, Shell Shock to PTSD, 152. 41 E Ginzberg, JK Anderson, SW Ginsburg, and JL Herma, The lost divisions (New York: Columbia University Press, 1959).
27 suggest that attempts to predict how individuals would respond to combat were unsuccessful and many men were rejected who would later serve with distinction.42 The principles of forward psychiatry were rediscovered during the Western Desert campaign in 1941 and were employed during the latter phases of the war. Throughout the conflict, experiments were conducted in the use of new treatment techniques both physical (insulin coma, electroconvulsive therapy, the use of sedatives and amphetamines and even leucotomy for severe cases) and psychological (group therapy, occupational therapy and programmes designed to assist adjustment).43 Throughout both world wars, the aetiology of war related psychiatric disorders was largely connected with a man’s pre-enlistment history of mental health rather than events during the war itself.44
Over the course of the Vietnam War (1961-1975), American psychiatrists used many of the same therapeutic techniques that their predecessors had employed. In the short term, they succeeded in returning an unprecedented number of men to duty. Only around 2% of American casualties were of a psychiatric nature. 45 Despite these early victories, a substantial number of ex-servicemen developed mental health problems upon their repatriation to the United States. Attributing their ill health to the war, they campaigned vigorously to have their symptoms recognised as a distinct psychiatric disorder. The American Psychiatric Association first included Post-Traumatic Stress Disorder (PTSD) in its Diagnostic and Statistical Manual III released in 1980. Following the Vietnam War, issues surrounding veterans’ mental health garnered greater attention. In the increasingly
Jones and Wessely, Shell Shock to PTSD, 106. 42 JR Egan, L Jackson and RH Eanes, ‘A Study of Neuropsychiatric Rejectees,’ Journal of the American Medical Association 145 (1951): 420. Norman Q Brill and Gilbert W Beebe, ‘Psychoneuroses: Military Applications of a Follow-up Study,’ United States Armed Forces Medical Journal 3 (1952): 15-33. A Ellis and HS Conrad, ‘The Validity of Personality Inventories in Military Practice,’ Psychological Bulletin 45, No. 5 (Sept. 1948): 385-426. 43 Shephard, War of Nerves, 205-227, 257-277, 44 Simon Wessely, ‘War and Psychiatry: A Story in Three Acts,’ Lecture, Global History Seminar, The London Centre of the University of Notre Dame, 27 Mar. 2013. 45 Jones and Wessely, Shell Shock to PTSD, 128.
28 liberalised environment of the late 1970s and early 1980s, veterans no longer received the lion’s share of blame if they broke down psychologically. The war itself was to blame rather than the individual.46
The literature on the development of modern military psychiatry provides the context for my own work. Moreover, the authors in question have established that the story has followed certain patterns over the course of the twentieth century. When it comes to psychiatry, the military suffers from a certain degree of organisational amnesia and there is a perennial need to relearn the lessons of the past. Treatment is shaped by a focus on manpower considerations and the needs of the Army take precedence before those of individual patients. The question than arises as to whether events during the Korean War followed the same pattern? It took several years for the Commonwealth countries to establish a functioning psychiatric care system during World War II. Coming on the heels of World War II, did they respond any faster in Korea? With fewer casualties and a lower mortality rate, were manpower considerations still central to Commonwealth psychiatric policy? These are important questions, which I pose throughout the dissertation.
The writers who have inspired this study differ in professional background but they share a similar methodological and philosophical approach to the subject. They argue that while combat stress reactions can be viewed as universal, they cannot be separated from their, ‘specific socio-cultural context.’47 The socio-cultural setting determines how mental health problems are interpreted and treated. In other words, we can better understand the interaction between military and psychiatric actors through proper contextualisation.48 ‘Invisible Scars,’ fits neatly into this tradition. As a historian, I am also interested in the evolving relationship between psychiatry, as a medical discipline and the military as a
46 Wessely, ‘War and Psychiatry: A Story in Three Acts.’ 47 Copp and Humphries, Combat Stress in the 20th Century, xi. 48 Ibid.
29 social institution. When the military and medical professionals interact, they often have competing agendas. An officer’s aim is to win battles. Meanwhile, doctors are focused on the preservation of life and optimum health. How do these two parties come together within the confines of the military establishment and how do they respond to the realities of war? In addition, ‘Invisible Scars,’ fills a significant gap in the existing literature. As previously noted, many books and articles have been written about the role of psychiatrists and mental health during WWI, WWII and Vietnam. However, Korea remains the ‘forgotten war.’ If we are to properly understand the development of military psychiatry, it is important to study all major deployments.
While the dissertation is heavily influenced by the literature on the development of modern military psychiatry, it is also informed by historical accounts of the Korean War and Commonwealth participation in particular. There is a fairly substantial body of publications about the Korean War. Be that as it may, they have chiefly been written about the activities of the US Army. As the Americans were the largest contingent in theatre, they have drawn the greatest attention from academic and popular authors alike. Classic accounts include TR Fehrenbach’s 1963 This Kind of War, David Ree’s 1968 Korea: The Limited War and William Whitney Stueck’s 1995 The Korean War: An International History.49 While they discuss the Commonwealth countries very little, these accounts are nonetheless important. The Commonwealth Division fell under the control of US I Corps and many of the authors provide detailed descriptions of the military operations in which the division participated. They also explain the political considerations behind American decisions that affected the division as a whole.50
49 Theodore R Fehrenbach, This Kind of War (USA: Bantam, 1963). David Rees, Korea: The Limited War (London: Macmillan & Company Limited, 1964). William Whitney Stueck The Korean War: An International History (Princeton, NJ: Princeton University Press, 1995). 50 Ibid. Ibid. Ibid.
30 The literature about the Commonwealth Division itself is significantly more restricted. The official histories have acted as a starting point for this study. Shortly after the armistice of July 1953, the British government issued several published accounts of the war. Eric Linklater’s Our Men in Korea and Brigadier Cyril Nelson Barclay’s The First Commonwealth Division: The Story of British Commonwealth Land Forces in Korea both appeared in 1954. Canada’s Army in Korea: The United Nations Operations, 1950-1953, and Their Aftermath was released a few years later in 1956. These books are largely celebratory accounts of Commonwealth success and prowess in battle. Regardless, they provide important information about how Commonwealth troops were organised both before and after the formation of the division.51
A series of more thorough studies have appeared over the subsequent decades. Lieutenant Colonel Herbert Fairlie Wood’s Strange Battleground: The Operations in Korea and Their Effects on Defence Policy in Canada was published in 1966. An expanded version of the 1956 study, Fairlie Wood’s book was less triumphal in tone and represented the first serious critique of Commonwealth combat performance.52 The Australian, British and New Zealand official histories were all published throughout the 1980s and the early 1990s.53
51 Historical Section, General Staff, Army Headquarters, Canada’s Army in Korea: The United Nations Operations, 1950-1953, and their Aftermath (Ottawa: Queen’s Printer and Controller of Stationery, 1956). Eric Linklater, Our Men in Korea (London: HMSO, 1952). Barclay, The First Commonwealth Division. 52 Wood, Strange Battleground. 53 In order of publication date, the official histories published in the 1980s and 1990s include: Robert J O’Neill, Australia in the Korean War 1950-1953, Vol I: Strategy and Diplomacy (Canberra: Australian War Memorial and the Australian Government Publication Service, 1981). Robert J O’Neill, Australia in the Korean War 1950-1953, Vol II: Combat Operations (Canberra: Australian War Memorial and the Australia Government Publication Service, 1985. General Sir Anthony Farrar-Hockley, The British Part in the Korean War, Vol I: A Distant Obligation (London: HMSO, 1990).
31 Each consists of two volumes, one of which focuses on diplomatic and strategic considerations and what effect politics had on the course of the Korean War. The other volumes review the activities of the Army, Navy and Air Force. British troops made up over 50% of Commonwealth Division strength and the UK contingent played a central role in the division’s organisation and its daily operations.54 Consequently, General Sir Anthony Farrar Hockley’s The British Part in the Korean War is the most important of the books in question.55
In reference to combat operations, Farrar Hockley and the other official historians primarily focus upon the actions of infantry. Apart from a small article on medics featured at the end of Robert O’Neill’s Australia in the Korean War, there is barely any mention of the medical services.56 While artillery, air power and naval forces made key contributions, the authors stress that Korea was a war dominated by the infantry. In general, they argue that
Ian McGibbon, New Zealand and the Korean War, Vol I: Politics and Diplomacy (Auckland, New Zealand: Oxford University Press in association with the Historical Branch, Department of Internal Affairs, 1992). General Sir Anthony Farrar-Hockley, The British Part in Korean War, Vol II: An Honourable Discharge (London: HMSO, 1995). Ian McGibbon, New Zealand and the Korean War, Vol II: Combat Operations (Auckland, New Zealand: Oxford University Press in association with the Historical Branch, Department of Internal Affairs, 1996). 54 Farrar-Hockley, A Distant Obligation, ix. 55 Apart from Ian McGibbon, all of the official historians have spent time in uniform. Eric Linklater and Brigadier CN Barclay were both veterans of World War II. Lt. Col. Wood commanded the 3rd Battalion Princess Patricia’s Canadian Light Infantry and General Farrar-Hockley was the adjutant for the Gloucestershire Regiment during the Korean War. Australian author Robert O’Neill served as an infantry Captain in Vietnam. William Cameron Johnston, A War of Patrols: Canadian Army Operations in Korea. (Vancouver: University of British Columbia Press, 2003), xvi. Dan van der Vat, ‘Obituary: General Sir Anthony Farrar-Hockley.’ Guardian, 15 Mar. 2006, http://www.theguardian.com/news/2006/mar/15/guardianobituaries.military Frank Jackson, ‘Robert John O’Neill: Citation for an Honorary Degree,’ last modified 28 Sept. 2001, http://about.anu.edu.au/__documents/committees/honorary_degrees/oneillcitation.pdf Barclay, The First Commonwealth Division. McGibbon, New Zealand and the Korean War. 56 O’Neill, Combat Operations, 570-585.
32 the Commonwealth countries were universally unprepared for deployment to the Far East. Political considerations were behind the decision to send ground troops to Korea. The first servicemen to arrive lacked training and had been hastily assembled in order to meet the emergency.57 Throughout the final months of 1950 and early 1951, troops from Canada, Australia, New Zealand and the United Kingdom worked together in a loose formation. They eventually joined together as a division for reasons of economy and manpower. Moreover, the Americans were in favour of such a formation. Although they had fought together on many previous occasions, the Commonwealth countries had never been required to work so closely together. The official historians point out that national differences could lead to conflict but they generally stress the cordiality and intimacy of relations. Britain and the Dominion countries compromised with one another and shared resources for mutual benefit. Commonwealth combat performance is described in positive terms.58
Academic authors have largely reiterated the arguments presented in the official histories. In The diplomacy of constraint: Canada, the Korean War, and the United States, published in 1974, Denis Stairs makes many of the same arguments as Lt. Col Wood in reference to the political reasons behind Canada’s participation in the war.59 The same could be said of John Melady’s 1983 Korea: Canada’s Forgotten War.60 Very few authors have attempted to analyse the Commonwealth Division as a unified unit. In Michael Hickey’s 1999 The
57 O’Neill, Strategy and Diplomacy, xv-xvi. McGibbon, Politics and Diplomacy, 41-47. Farrar-Hockley, A Distant Obligation, 116. 58 Farrar Hockley, An Honourable Discharge, 212. McGibbon, Combat Operations, 158-159. O’Neill, Combat Operations, 173, 286. 59 Denis Stairs, The diplomacy of constraint: Canada, the Korean War, and the United States (Toronto: University of Toronto Press, 1974). FH Soward, review of The diplomacy of constraint: Canada, the Korean War, and the United States by Denis Stairs, Pacific Affairs 47, No. 3 (Autumn 1974): 407-408. HS Ferns, Review of The diplomacy of constraint: Canada, the Korean War, and the United States by Denis Stairs, International Affairs 50, No. 3 (July 1974): 502-503. 60 John Melady, Korea, Canada’s Forgotten War (Toronto: Macmillan, 1983).
33 Korean War: The West Confronts Communism and Brian Catchpole’s 2000 The Korean War, both historians are ostensibly writing about the Commonwealth as a whole. However, they primarily focus on the activities of the British contingent.61 Australian scholar Jeffrey Grey and British writer Tim Carew are the only historians who have managed to write a more balanced portrayal of all of the Commonwealth partners. Carew and Grey offer nuanced and critical appraisals of the division in their respective books on the Korean War. Although they present many of the same facts as other writers, they place greater emphasis on the differences between the Commonwealth countries and the arguments they had with one another. Cooperation and success were by no means assured.62
Over the past ten years, the war’s fiftieth and sixtieth anniversaries have generated public interest. Several histories have been published that revise our understanding of the war and Canada’s participation in particular. For instance, historians David J Bercuson, William Cameron Johnston and Brent Byron Watson have all recently argued that earlier books portray the Canadian Army Special Force unfairly.63 They accuse Lt. Col. Wood of being unduly harsh of the Canadian commander Brigadier John Meredith Rockingham and the quality of the first Korean War volunteers. Wood was a Regular officer during the war and
61 It is worth noting that both Michael Hickey and Brian Catchpole are veterans of the Korean War. Hickey served as a member of the Royal Army Service Corps and Catchpole was completing his time as a National Serviceman. Brian Catchpole, ‘The Commonwealth in Korea,’ History Today 48, No. 11 (1998), http://www.historytoday.com/brian-catchpole/commonwealth-korea Michael Hickey, ‘The Korean War: An Overview,’ BBC History, last modified 21 Mar. 2011, http://home.comcast.net/~lionelingram/403W_BBC_The%20Korean%20War.pdf. 62 Grey, The Commonwealth Armies and the Korean War. Carew, The Commonwealth at War. 63 David J Bercuson, Blood on the Hills: The Canadian Army in the Korean War (Toronto: University of Toronto Press, 1999). Johnston, A War of Patrols, 2003. Brent Byron-Watson, Far Eastern Tour: Canadian Infantry in Korea, 1950-1953 (Montreal, QC and Kingston, ON: McGill Queen’s University Press, 2002).
34 Bercuson, Johnston and Watson believe that this interfered with his sense of objectivity.64 A number of recently published memoirs have also challenged the established story. For example, veteran Hub Gray has recently revised our understanding of the Battle of Kapyong in his 2003 study, Beyond the Danger Close.65
The available secondary sources provide key background information for the present study. Medicine and psychiatry are mentioned only in passing. Nevertheless, the authors establish how the division worked, how the Commonwealth countries interacted with one another and the challenges with which they had to contend. There are differences of historical opinion, especially in reference to the performance of Canadian infantrymen. Nevertheless, most writers present the same picture of the Commonwealth Division. Many of these issues are reviewed in this thesis. For instance, I explore the dynamics of inter-allied relations and the impact that disagreements and disunity could have on the ground. Like cogs in a machine, the different branches of the division had an impact on one another. Having said that, I primarily examine subjects that have been ignored in the past. Medicine, mental health and welfare issues have been largely ignored in favour of politics, strategy, and tactics.
As the pool of secondary literature on the Commonwealth Division is relatively small, this thesis is principally founded upon primary source materials. I have been able to build a
64 William Allison, Review of War of Patrols: Canada’s Army Operations in Korea by William Cameron Johnston, Canadian Historical Review 85, No. 4 (2004): 805. Johnston, War of Patrols, 371-376. Watson, Far Eastern Tour, 13-17. Bercuson, Blood on the Hills, 35-59. 65 Hub Gray, Beyond the Danger Close: The Korean Experience Revealed, 2nd Battalion Princess Patricia’s Canadian Light Infantry (Calgary: Bunker to Bunker Books, 2003). Major Andrew B Godefroy, Review of Far Eastern Tour: The Canadian Infantry in Korea, 1950- 1953 by Brent Byron Watson and Beyond the Danger Close: The Korean Experience Revealed, 2nd Battalion Princess Patricia’s Canadian Light Infantry by Hub Gray, Canadian Military Journal, http://www.journal.forces.gc.ca/vo4/no4/book-livre-04-eng.asp
35 picture of events in the Far East with the help of medical records, casualty reports, unit war diaries and other documentation. The majority of my research work was conducted at the British National Archives at Kew and the Library and Archives of Canada in Ottawa. My arguments and conclusions are largely based upon the information that I have gathered from Army and government files. Relying upon official sources is both beneficial and problematic. On the one hand, official documents are essential to any historical study and provide an intimate first-hand account of events. Away from public scrutiny, officers and policy makers candidly discuss casualties, the development of medical policy and the challenges that the division faced. On the other hand, there is always the possibility that the documents may be misleading. For example, unusual events are more likely to have been recorded than the habitual. Without further investigation, readers could be left with a biased impression.
While relying upon archival sources presents unique problems, these challenges are far from insurmountable. In line with good historical practice, I have carefully evaluated each of my sources in regards to authorship, intended audience and the document’s purpose. Moreover, I have been able to corroborate most of the evidence. Commonwealth medicine was an inter-allied venture and psychiatry was the joint responsibility of Canada and the United Kingdom. By comparing Canadian and British records against each other, a balanced picture of the Commonwealth Division begins to emerge. I have also made use of newspapers and other contemporary publications like the British Medical Journal and The Lancet. These sources have been useful in drawing comparisons between civilian and military medicine. In addition, I have conducted interviews with a number of British veterans, who served as ambulance orderlies and medical officers. Furthermore, I have corresponded with representatives of the Korea Veterans Association of Canada and the Korean Veterans Association of Australia. Finally, I have read the published and unpublished memoirs of nurses, doctors, support troops and combat soldiers held at the British Library, Imperial War Museum, Liddell Hart Centre for Military Archives and the
36 Wellcome Library and Archives. Human memory is far from perfect. As historian John Tosh has noted, memories are, ‘filtered through subsequent experience. They may be contaminated by what has been absorbed from other sources (especially the media); they may be overlaid by nostalgia (‘times were good then’) or distorted by a sense of grievance.’ 66 Nonetheless, witnesses have been key in clarifying confusing and contradictory records and providing insights into the realities of life in Korea.
This is a story about the human dimension of war. Psychiatry and mental health are both subjects that attract stigma. Within the context of the military, the mentally ill challenge concepts of courage, cowardice, masculinity and normality. By exploring the history of military psychiatry, we can better understand the short and long-term impact that war has upon the individual and society at large. The Korean War and the Commonwealth Division have received little academic attention over the past sixty years. Only a handful of authors have written about Commonwealth medical or psychiatric practices. However, this does not mean that these subjects are less worthy of attention. In fact, the opposite is true. Korea was an exceptionally challenging campaign, in which allies were called upon to work closely together despite their differences. Hostilities were protracted and political manoeuvring consistently frustrated peace negotiations. Nonetheless, the division was successful and psychiatric casualties were relatively low. It is important to understand why this was the case. The history of military psychiatry is increasingly well documented but Korea remains underrepresented. In, ‘Invisible Scars,’ I begin to redress this omission and lay the groundwork for future studies. While the world has changed considerably since 1953, there are still many lessons to be learnt from the Korean War.
66 John Tosh, The Pursuit of History: Aims, methods and new directions in the study of modern history, Revised 3rd Edition (UK: Longman, 2002), 303-304.
37
Chapter 2 A Sign of the Times: The Transformation of the Royal Army Medical Corps and the Royal Canadian Army Medical Corps (1945-1950)
38 Introduction The years between 1945-1950 represent a period of transformation. As World War II ended and the Cold War began, government and military authorities alike were faced with new and complex problems like demobilisation and economic austerity. From 1939-1945, the Canadian and British Armies had both contributed significant manpower and resources to the war effort. When hostilities ended, they were forced to revaluate their role in the world and reorganise themselves for the future. On both sides of the Atlantic, change was a difficult and painful process. During this period, the Royal Canadian Army Medical Corps (RCAMC) and the Royal Army Medical Corps (RAMC) faced exceptional obstacles. They were dogged by funding cuts and recurring manpower shortages. However, the greatest trial was yet to come.
In the summer of 1950, troops from Australia, Canada, New Zealand and the United Kingdom were deployed to fight in the Korean War (1950-1953). They eventually formed a unified Commonwealth Division. The Canadians and the British were jointly responsible for providing medical and mental healthcare services. Was either party ready to meet the challenges of war? In order to fully understand what happened in Korea, it is necessary to examine events between 1945 and 1950. Throughout the following chapter, I look at how the post-war landscape transformed the quality of Army medical and psychiatric care. By the end of World War II, military psychiatry had developed substantially as a discipline. Army psychiatrists were routinely involved in the clinical care of service personnel, the process of officer selection and consulted in disciplinary matters. Did the following years witness sustained growth or the contraction of mental healthcare services? The answers had implications for thousands of Commonwealth troops.
39 The Canadian and British Armies (1945-1950) On Victory in Europe Day (VE Day) on 8 May 1945, around 700,000 Canadians and 5,000,000 Britons were serving as members of the armed forces. As World War II came to an end, the majority of servicemen and women were eager to leave their lives in uniform behind. There was significant public pressure for the authorities to demobilise the armed forces quickly and efficiently.67 As early as 1941, plans were formulated as to how the demobilisation process would work.68 Planners eventually agreed that soldiers should be organised into staggered groups based on a calculation of age and length of service. The oldest and longest serving troops would be released first.69 Professional groups like miners, teachers and builders were eligible for early release by virtue of their value to post-war reconstruction and economic development.70 However, they represented a rare exception to the rules. In an article on demobilisation, historian Rex Pope has noted that, ‘The virtues of this arrangement were its obvious justice (long service promised early release) and its simplicity. It was easily understood and not readily open to manipulation.’71 Canadian authorities were particularly concerned that the demobilisation system be perceived as transparent and fair. In the aftermath of World War I, Canadian troops had rioted while
67 Bryan Burlotte, ‘Visions of Grandeur: Planning for the Canadian Post-War Army 1944-1947’ (MA diss., Carleton University, 1991), 5. Alan Allport, Demobbed: Coming Home After the Second World War (New Haven, CT and London: Yale University Press, 2009), p. 23. 68 Allport, Demobbed, 23. Colonel Charles Perry Stacey, ‘The Development of the Canadian Army,’ Canadian Army Journal 6, no. 4 (July 1952): 19. Rex Pope, ‘British Demobilisation after the Second World War,’ Journal of Contemporary History 30, No. 1 (Jan. 1995): 67. 69 Dean F Oliver, “Awaiting Return: Life in the Canadian Army’s Overseas Repatriation Depots, 1945-1946,” in The Veteran’s Charter and Post World War II Canada, eds. JL Granatstein and Peter Neary (Montreal: McGill Queen’s Press, 1998), 36-38. Pope, ‘British Demobilisation,’ 69-71. 70 Oliver, ‘Awaiting Return,’ 36-38. Jeffrey R Rivard, ‘Bringing the Boys Home: A Study of the Canadian Demobilisation Policy After the First and Second World Wars’ (MA diss., University of New Brunswick, 1999), 168. 71 Pope, ‘British Demobilization,’ 67.
40 awaiting repatriation and release from the armed forces. No one wanted to repeat the mistakes of the past.72
Elections held in the summer of 1945 factored strongly in how both countries addressed the demobilisation problem. Under the leadership of wartime Prime Minister Mackenzie King, the Canadian Liberal party had swept back into power. In Britain, Clement Attlee had led the Labour party to a landslide victory over the Conservatives.73 During the campaign, both parties had been acutely aware of the importance of the military vote. Despite their success at the polls, the Liberals had consistently failed to curry favour with Canadian soldiers. Amongst troops stationed in North West Europe, they had trailed behind the Cooperative Commonwealth Federation (CCF) party by nearly 10,000 votes.74 Due to a strong military turnout, Prime Minister King had lost his seat as a Member of Parliament for Prince Albert.75 Soldiers and veterans held more political power than ever before. Neither the Liberals nor Labour could afford to ignore their demands if they wished to seek re-election in the future. Both parties hoped that rapid demobilisation would attract public praise.76
72 Peter Neary, introduction to The Veteran’s Charter and Post World War II Canada, eds. JL Granatstein and Peter Neary (Montreal: McGill Queen’s Press, 1998), 4. Historical Section of Army Headquarters, ‘Army Headquarters Report No. 97: A Study on Demobilisation and Rehabilitation of Canadian Armed Forces in the Second World War, 1939- 1945,’ Library and Archives of Canada/ Bibliothèque et Archives Canada (Hereafter cited as LAC): RG24, Volume 22327, File No. HQS-9072-2-6, p. 17. 73 Labour had last been in government from 1929-1931. Following nearly a decade in opposition, Labour had joined a Conservative led coalition government during WWII. Allport, Demobbed, 32. JL Granatstein, Canada’s War: The Politics of the Mackenzie King Government, 1939-1945 (Toronto: University of Toronto Press, 1990), 412. Historical Section of Army Headquarters, ‘Army Headquarters Report No. 97: A Study on Demobilisation and Rehabilitation of Canadian Armed Forces in the Second World War, 1939- 1945,’ LAC: RG 24, Volume 22327, File No. HQS-9072-2-6, p. 17. 74 In North West Europe, the Liberals captured around 27,904 votes and the Progressive Conservatives received 24,607. Granatstein, Canada’s War, 412. 75 Ibid., 411. 76 Rivard, ‘Bringing the Boys Home,’ 90.
41 In addition to the political situation, financial concerns played a pivotal role in determining the speed at which British demobilisation proceeded. While Canada was economically stable in 1945, seven years of war had taken their toll on the British economy. During the war, the country had suffered heavy financial losses and amassed huge foreign debts. For example, the Americans had loaned the United Kingdom nearly $4.3 billion in 1945 alone.77 In this climate of austerity, no government department could expect to emerge unscathed and defence was no exception. The War Office, Admiralty and Air Ministry were spending nearly £100 million per week to maintain the armed forces.78 The prompt demobilisation of troops would reduce spending significantly and return productive labour to work. This in turn would restore the country’s industrial base, increasing tax revenues and exports.79 For the British government, fast demobilisation was an economic necessity.
Between 1945 and 1946, 447,000 Canadians and four million Britons were demobilised from the Army. Collectively, they represented the largest mobilisation of able-bodied manpower in history.80 As the Cold War began, it appeared that both armies would return to their historic roots as small, professional organisations rather than remain as large conscript forces. Conscription had only proved necessary during periods of total war. These expectations were largely fulfilled in the case of Canada.
77 Susan Howson, ‘The Origins of Cheaper Money, 1945-7,’ Economic History Review, New Series 40, No. 3 (Aug. 1987): 433. 78 Allport, Demobbed, p. 30. 79 LV Scott, Conscription and the Attlee Governments: The Politics and Policy of National Service 1945-1951 (Oxford, UK: Clarendon Press, 1993), 15. 80 In August 1945, the Canadian Army was demobilising troops at a rate of 50,000 per month. Burlotte, 1991, p. 8. Robert Bothwell, Ian Drummond and John English, Canada Since 1945 (Toronto: University of Toronto Press, 2001), p. 45. Desmond Morton, 1945: When Canada Won the War, Historical Booklet No. 54 (Ottawa: The Canadian Historical Association, 1995), p. 11. Allport, Demobbed, 47-48.
42 By 1950, the Canadian Active Force was made up of 25,000 soldiers, of which only 7,000 ‘belonged to the combat trades.’81 Defence planning took shape around this reality. From 1945-1950, the Army’s raison d’être became the protection of Canadian territory. Despite the escalation of the Cold War, commitments abroad were kept proportionately small. These were not unexpected projections when one considers that Canadian policy historically avoided foreign entanglement. 82 The political temper of the country also precluded the maintenance of a peacetime force comparable in size to its WWII counterpart. Continued conscription was untenable in light of the tensions that existed between French and English speakers. During WWII, the National Resources Mobilisation Act (NRMA) had provided for compulsory enlistment or conscription. However, conscripted soldiers could only be posted within Canada. This was largely the result of a compromise between the English-speaking majority in parliament and French Canadian politicians. While most Anglophones supported Canada’s involvement in the war and viewed Britain’s cause as their own, this was not the case for French Canadians. By and large, the Francophone community saw WWII as a European conflict and opposed the deployment of Canadian soldiers overseas.83 They saw conscription as an unnecessary and destructive measure.84 Despite their objections, the NRMA was amended in 1942 to provide for the possibility of sending conscripts aboard. In November 1944, the federal
81 Brent Byron Watson, Far Eastern Tour: The Canadian Infantry in Korea, 1950-1953 (Montreal QC and Kingston, ON: McGill Queens University Press, 2002), 3. Burlotte, ‘Visions of Grandeur,’ 82. 82 Anon, Demobilisation and Rehabilitation: Summary of Proposals Recommended by the General Advisory Committee on Demobilisation and Rehabilitation with Comments of Demobilisation Planning Section (Adjutant General Branch), 28 Dec. 1943, LAC: RG24, Volume 58, File 9072. Desmond Morton, A Military History of Canada: From Champlain to the Gulf War (Toronto: McClelland & Stewart, 1992), 234, 238. 83 T Stephen Henderson, ‘Angus L Macdonald and the Conscription Crisis of 1944,’ Acadiensis 27 (Autumn 1997): http://journals.hil.unb.ca/index.php/Acadiensis/article/view/10858/11691. Burlotte, ‘Visions of Grandeur,’ 33-34. Robert Bothwell, Ian Drummond and John English, eds., Canada, 1900-1945 (Toronto: University of Toronto Press, 1987), 325. Philip Buckner, ed., Canada and the British Empire, The Oxford History of the British Empire Companion Series (Oxford: Oxford University Press, 2010), 107. 84 A 1942 Gallup poll indicated that nearly 90% of French Canadians were opposed to sending conscripts overseas. Bothwell, Drummond and English, Canada, 1900-1945, 325.
43 government was forced to implement the policy due to the increasing demands of the war effort.85 This decision led to significant political upheaval and divided politicians and the public alike. The crisis over conscription eventually culminated in the dismissal of the Minister of National Defence, JL Ralston, who had been strongly in favour of sending NRMA troops to Europe.86 Events during WWII underlined domestic problems. Within this context, it is clear that conscription was far too divisive to be maintained in peacetime. Canada would have to rely upon a small volunteer Army instead.
While the British could ill afford high levels of defence spending, they were resolved to maintain a large standing Army.87 The United States had eclipsed the United Kingdom as an economic, political and military power. Be that as it may, the British were determined to play a leading role in world affairs.88 As the Cold War deepened, their international security commitments continued to grow and evolve. Meanwhile, the Army struggled to recruit the necessary personnel.89 In July 1947, parliament responded by passing the National Service
85 The act was amended by the passage of Bill 80. This allowed conscripts to be sent overseas if it was deemed ‘necessary,’ by the federal government. Ibid. 86 Daniel Byers, ‘Mobilising Canada: The National Resources Mobilization Act, the Department of National Defence, and Compulsory Military Service in Canada, 1940-1945,’ Journal of the Canadian Historical Association/ Revue de la Société historique du Canada 7, no. 1 (1996): 202. 87 Martin S Navias, ‘Terminating Conscription? The British National Service Controversy 1955- 1956,’ Journal of Contemporary History 24, No. 2, Studies on War (Apr. 1989): 195. 88 David Reynolds, ‘From World War to Cold War: The Wartime Alliance and Post-War Transitions, 1941-1947,’ Historical Journal 45, No. 1 (Mar. 2002): 213. Peter Weiler, ‘British Labour and the Cold War: The Foreign Policy of Labour Governments, 1945- 1951,’ England’s Foreign Relations, Journal of British Studies 26, No. 1 (Jan. 1987): 57. Robert Frazier, ‘Did Britain Start the Cold War? Bevin and the Truman Doctrine,’ Historical Journal 27, No. 3 (Sept. 1984): 715-727. George Q Flynn, “Conscription and Equity in Western Democracies, 1940-1975,’ Journal of Contemporary History 33, No. 1 (Jan. 1998): 11. Navias, 1989, p. 195. 89 When India was granted independence in 1947, the British armed forces lost another significant source of manpower. During WWII, the country had supplied, ‘four fifths of the British defence effort east of Suez.’ Anita Inder Singh, ‘Keeping India in the Commonwealth: British Political and Military Aims, 1947- 49,’ Journal of Contemporary History 20, No. 3 (July 1985): 472.
44 Act to extend wartime conscription. Under its provisions, healthy young men between the ages of 17 and 21 were required to serve 12 months as a member of the armed forces and five years in the reserves.90 Over the following decade, National Service ensured that the United Kingdom was able to meet its defence obligations.91 However, the Army was often disappointed by the quality of National Service recruits. On 21 April 1949, Adjutant General (AG) Sir James Steele wrote to the Executive Committee of the Army Council (ECAC) to air his concerns. He expressed distress at the number of National Servicemen, ‘whose mental standard [was] below that which [could] be usefully employed.’92 Of the 120,000 National Servicemen inducted into the Army every year, he calculated that 5,000 were ‘mentally substandard’ and 2,000 were ‘mentally unstable.’93 On other occasions, National Servicemen were criticised for wilful misconduct and other disciplinary infractions.94 Although most conscripts served without incident, many regarded service as an interruption rather than as a career. The Army had little time to convince them otherwise or to transform them into the efficient soldiers that they required.
Correlli Barnett, Britain and Her Army 1509-1970: A Military, Political and Social Survey (London: Allen Lane/The Penguin Press, 1970), 480. 90 The period of active service was extended to 18 months in 1948 and two years in 1950. War Office, Report on the Health of the Army 1949-1950, 27 March 1953, The National Archives at Kew (Hereafter cited as TNA): WO 279/610. Roger Broad, Conscription in Britain 1939-1964: The Militarisation of a Generation, British Politics and Society (New York: Taylor & Francis, 2006), 117. SJ Ball, ‘A Rejected Strategy: The Army and National Service 1946-60,’ in The British Army, Manpower and Society into the Twenty-First Century, ed. Hew Strachan (London: Frank Cass, 2000), 39. 91 National Servicemen accounted for roughly 50% of the British Army between 1948-1960. For example, historian George Q Flynn has noted that in 1951, ‘the strength of the British Army stood at 433,000, of whom 224,000 were conscripts.’ Flynn, ‘Conscription and Equity,’ 11. 92 Adjutant General Sir James Steele to the Executive Committee of the Army Council, Standard of National Service Soldiers in the Army, 21 Apr. 1949, TNA: WO 163/108. 93 Ibid. 94 Adjutant General Sir James Steele to Executive Committee of the Army Council, Memorandum: Discharge of Soldiers for Misconduct, 14 May 1948, TNA: WO 163/108. Anon, Note for the Secretary of State: The Army’s Manpower Requirements 1949-1951, 4 Oct. 1948, TNA: WO 163/108. Army Manpower Committee, Final Report, 15 Feb. 1949, TNA: WO 163/108.
45 Throughout the late 1940s, the British government regarded defence as an unavoidable and important expense. Nonetheless, it was difficult to maintain an Army of over 400,000 men in light of the country’s continued financial struggles.95 In 1947, severe winter weather damaged British industrial and agricultural interests and the economy faltered in the wake of the convertibility crisis.96 As the government struggled to recover, it became increasingly difficult to justify the size of the Army’s budget. Defence expenditures experienced a steep decline over the following years. At the end of WWII, the defence budget had accounted for over 50% of gross domestic product (GDP). By 1950, it accounted for roughly 7% GDP.97 While defence spending was by no means insignificant, the British had a wide range of international obligations. The Army was expected to fulfil its role as an imperial police force and, ‘[assume] the commitment to provide in peacetime the major land forces for the defence of Europe.’98
The Canadian and British armed forces were transformed by the events of 1945-1950. In the aftermath of WWII, both experienced severe manpower shortages as a result of the demobilisation process. Neither found the transition from total war to Cold War easy. Be that as it may, Canadian defence planners took account of the Army’s new recruitment problems and financial limitations. The Canadian Active Force shrank in size and defence commitments were kept to a minimum. In contrast, the British Army was pulled in all directions. The demand for a low budget directly contradicted the size and range of duties
95 Flynn, ‘Conscription and Equity,’ 11. 96 In the summer of 1947, the British government made sterling convertible to other currencies. Sterling reserves soon ran low and the economy suffered as a result. Broad, Conscription in Britain, 111. 97 ‘Time Series Chart of UK Public Spending,’ last modified Jan. 2011, http://www.ukpublicspending.co.uk/spending_chart_1900_2011UKp_12c1li011lcn_30t 98 Peter Tsouras, Changing Orders: The Evolution of the World’s Armies, 1945 to the Present (London: Arms Armour Press, 1994), 21, quoted in Joseph Paul Vasquez III, ‘More than Meets the Eye: Domestic Politics and the End of British Conscription,’ Armed Forces & Society 000 (2010): 5.
46 that the Army was expected to perform. Peace was proving to be as much of a challenge as war had ever been.
The Royal Canadian Army Medical Corps and Royal Army Medical Corps (1945- 1950) In 1945, the Royal Canadian Army Medical Corps and the Royal Army Medical Corps were large and complex organisations. They were designed to accommodate the health needs of thousands of troops deployed around the world. Demobilisation signalled the beginning of a period of volatile change. Like the rest of armed forces, the RCAMC and RAMC faced two central problems: manpower shortages and funding cuts. These changes affected both the quantity and quality of Army medical and mental healthcare.
Like their colleagues in the other branches of the armed forces, Medical Officers (MOs) were demobilised on the basis of age and length of service. Despite their professional qualifications, they were not exempt from the demobilisation system or eligible for early release.99 While many Canadian and British doctors had volunteered for war service, they were now eager to return to civilian practice. In June 1945, the Canadian Medical Association enthusiastically declared that, ‘The last five and a half years have shown with what steadfastness the profession has devoted itself to the duty of the occasion,’ and noted that, ‘the demands of the coming changes [would] be met in the same spirit.’100 Medical
99 Throughout WWII, the Medical Procurement and Assignment Board (MPAB) had been responsible for mobilising Canadian doctors. Its British equivalent was the Central Medical War Committee (CMWC). They both played a central role in the demobilisation process. ‘Editorial Comments: A Health Survey of Canada,’ Canadian Medical Association Journal/Journal de l’Association médicale canadienne 50, no. 4 (Apr. 1944): 364. Central Medical War Committee, Demobilization of Doctors: Memorandum by Secretary 2/1943- 1944, 8 Oct. 1943, TNA, MH 79/547. ‘The End of the European War,’ Canadian Medical Association Journal 52, No. 6 (June 1945): 614. 100 ‘The End of the European War,’ 614.
47 authorities in both countries also believed that a fast demobilisation would be in the interests of public health.
World War II had put the civilian healthcare system under significant pressure in both Canada and the United Kingdom. As early as 1942, disturbing reports began to surface across Canada about hospital staff shortages. The problem was largely attributed to the increasing number of medical graduates and young physicians enlisting in the armed forces. 101 Writing to the editors of the Canadian Medical Association Journal, an anonymous correspondent expressed his concerns about the state of hospital care. He wrote, ‘We all know how hospital staffs have been drained of their strength and are still being drained. To carry on the routine of work throws on the reduced staff a strain which is nearly intolerable.’102 Across the Atlantic, British hospitals were also suffering. On 3 November 1943, the secretary of the British Hospital Association, JP Wetenhall wrote to Member of Parliament Sir William Jowitt.103 As former Solicitor General and a government advisor on post-war reconstruction, the Labour MP was an influential figure.104 Wetenhall pleaded with Jowitt to press for quick demobilisation when the war ended. He doubted that British hospitals could continue to function in their current state. Year after year, the war was taking its toll.105 By 1945, a third of Canadian doctors were in uniform and nearly 58.3% of those remaining were over the age of 45.106 The ratio of general practitioners (GPs) to
101 GH Agnew, ‘The Shortage of Hospital Beds,’ Canadian Medical Association Journal 46, no. 4 (Apr. 1942): 373. 102 HEM, ‘Editorial Comments: Nursing Service Problems in Hospitals,’ Canadian Medical Association Journal 47, no. 2 (Aug. 1942): 157. 103 JP Wetenhall to the Right Honourable Sir William Jowitt, KC, 3 Nov. 1943, TNA: MH 79/547. 104 Thomas S Legg, Marie-Louise Legg, ‘Jowitt, William Allen, Earl Jowitt (1885–1957),’in Oxford Dictionary of National Biography, Oxford University Press, 2004; online edn, Jan. 2011, http://www.oxforddnb.com/view/article/34246 105 JP Wetenhall to the Right Honourable Sir William Jowitt, KC, 3 Nov. 1943, TNA: MH 79/547. 106 ‘Editorial Comments: A Health Survey of Canada,’ 364.
48 patients was 1:3,000 in urban centres and 1:2,400 in rural areas of the United Kingdom. In contrast, the British Army employed six doctors for every 1,000 men.107
In planning the demobilisation of doctors, Canadian and British authorities tried to strike a balance between the interests of the public and the Army. Be that as it may, the political pressure to demobilise doctors was intense and military concerns no longer took precedence over public health.108 For example, the new British Labour government had promised extensive welfare reforms and the creation of a comprehensive healthcare system during the elections of 1945. Over the following months, they were expected to deliver on those promises.109 On 8 November, Prime Minister Clement Attlee met with members of his Cabinet to discuss manpower and the release of doctors from the armed forces. The government had originally planned to demobilise 31% of medical officers between June- December 1945.110 Attlee now proposed increasing the number in the interests of the British public. The Secretary of State for War and the First Lord of the Admiralty warned against such a decision. Based on their assessment of current and future military
107 Central Medical War Committee, Demobilisation of Doctors: Memorandum by Secretary 2/1943-1944, 8 Oct. 1943, TNA, MH 79/547. Offices of the Cabinet and Minister of Defence, Meeting Concerning the Demobilisation of Doctors, 2 Sept. 1945, TNA: MH 79/547. 108 GWL Nicholson, Seventy Years of Service: A History of the Royal Canadian Army Medical Corps (Ottawa: Borealis Press, 1977), 254-255. Offices of the Cabinet and Minister of Defence, Meeting Concerning the Demobilisation of Doctors, 2 Sept. 1945, TNA: MH 79/547. 109 The Report of the Inter-Departmental Committee on Social Insurance and Allied Services or Beveridge Report was published in 1942. In the report, the authors outlined a series of social reforms, which included the creation of a comprehensive healthcare system. From 1945-1951, the Labour government used the Beveridge Report as the starting point for many its reforms. In 1946, Minister of Health Aneurin Bevan introduced the National Health Service Act in parliament. The National Health Service was officially created in 1948. David Childs, ‘The Cold War and the ‘British Road,’ 1946-1953,’ Journal of Contemporary History 23, No. 4 (Oct. 1988): 553-554. Robert Heys, ‘Views and Reviews: Medical Classics--The Beveridge Report,’ British Medical Journal 345, No. 5428 (13 Aug. 2012), http://211.144.68.84:9998/91keshi/Public/File/38/345-7870/pdf/bmj.e5428.full.pdf 110 Offices of the Cabinet and Minister of Defence, Meeting Concerning the Demobilization of Doctors, 2 Sept. 1945, TNA: MH 79/547.
49 requirements, they believed that proceeding too quickly would have a detrimental effect on the armed forces.111 Despite the validity of their concerns, the service ministers were overruled. The majority of Cabinet members strongly supported the Prime Minister’s proposal. Secretary of State for Dominion Affairs, Christopher Addison noted that, ‘There was good reason to believe that the services of doctors were wastefully used in the Forces.’112 Addison and his colleagues agreed to the release of a further 15% of RAMC doctors by January 1946. They were confident that the Army would no longer require such a high number of doctors.113 After all, the war was over.
Psychiatrists were as anxious for demobilisation as other medical officers. During WWII, leading clinicians from the Universities of McGill and Toronto, the Maudsley Hospital and Tavistock Clinic had all enlisted in the armed forces.114 They had cared for patients, screened recruits, helped to select officers and consulted on disciplinary cases.115 The war had presented unique opportunities for clinical innovation and advancement. However, the armistice signalled a return to normality. During the immediate post-war years, the majority of Army psychiatrists departed quickly in favour of more comfortable civilian appointments. 116 As authors Edgar Jones and Simon Wessely have noted, ‘Civilian
111 Ibid. 112 Ibid. 113 Ibid. 114 Terry Copp and Bill McAndrew, Battle Exhaustion: Soldiers and Psychiatrists in the Canadian Army, 1939-1945 (Montreal, QC and Kingston, ON: McGill Queen’s University Press, 1990), 8. Edgar Jones and Simon Wessely, Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War, Maudsley Monographs (Hove and New York: Taylor and Francis Group/Psychology Press, 2005), 68-69. 115 Copp and McAndrew, Battle Exhaustion, 5-10, 149-159. Jones and Wessely, Shell Shock to PTSD, 67-69, 78-79, 89-97, 103-105. Shephard, War of Nerves, 325-338. 116 In 1945, the RCAMC conducted a survey of 119 Army psychiatrists. When asked about their post-war career plans, the majority said that they would look for a position at a mental hospital or return to university for further training. Very few indicated an interest in remaining in the armed forces. Copp and McAndrew, Battle Exhaustion, 155-156.
50 psychiatrists, who had volunteered in a sprit of patriotism, were keen to re-establish themselves.’117 The impact of this exodus was most noticeable at the senior leadership level. Men like Albert Moll, Jack Griffin and Brock Chisholm had been the architects of Canadian military psychiatry.118 Shortly after the war, Moll left the Army in order to take up an appointment at the Allan Memorial Institute in Montreal.119 Griffin became the General Director of the Canadian Mental Health Association and, ‘is credited as one of the first Canadian psychiatrists to undertake peer review funded research.’120 Brock Chisholm also went on to great success as the first director of the World Health Organisation (WHO).121 Consultant psychiatrist Ken A Hunter was the only notable wartime figure who
Lieutenant Colonel JN Crawford to the Director General of Medical Services, 10 Dec. 1948, LAC: RG24, Volume 19, 466, File C-3848-1. 117 Jones and Wessely, Shell Shock to PTSD, 115. 118 During WWII, Brook Chisholm was the senior officer in the Directorate of Personnel Services (DPS). Jack Griffin had served as the DPS’ Chief Psychiatrist and Chisholm’s subordinate. Albert Moll was an area psychiatrist in the United Kingdom and was later posted to a Canadian exhaustion unit on the continent. Copp and McAndrew, Battle Exhaustion, xx-xxi, 93-94. WR Feasby, Official History of the Canadian Medical Services, 1939-1945, Vol. II, Clinical Subjects (Ottawa: Queen’s Printer and Controller of Stationery, 1953), 57. 119 Ibid. Ibid. 120 John DM Griffin (1906-2001) graduated from the University of Toronto Faculty of Medicine in 1932 and received a Masters in Psychology in 1933. Following WWII, he became a well-known academic and clinician. ‘In Memoriam,’ Canadian Psychiatric Journal/La revue canadienne de psychiatrie (Jan. 2010), http://ww1.cpa-apc.org/Publications/Archives/CJP/2001/September/memoriam.asp ‘Remembering & Celebrating a Good Life: John DM Griffin, OC, MD, MA, DPM(E), FRCP(C),’ Canadian Medical Health Association, Ontario Branch, last modified Jan. 2010, http://ontario.cmha.ca/files/2013/04/jack_griffin_brochure.pdf 121 George Brock Chisholm (1896-1971) was a noted and, ‘highly controversial…psychiatrist.’ Serving as an infantryman during World War I, he went on to qualify as a doctor and psychiatrist during the interwar period. From 1939-1945, he rose through the ranks of the Royal Canadian Army Medical Corps. By the end of the war, he had become the Director General of Medical Services. Chisholm became president of the World Health Organisation in 1948. During his tenure in office, Chisholm was often a figure of controversy. He had strong views on issues such as family planning and religion. John Farley, Brock Chisholm, the World Health Organisation, and the Cold War (Vancouver: University of British Columbia Press, 2008), 1-3. Terry Copp and Mark Osborne Humphries, Combat Stress in the 20th Century: The Commonwealth Experience (Kingston, ON: Canadian Defence Academy Press, 2009), 135.
51 chose to remain in the Army. Rising through the ranks, Hunter became Canada’s first Surgeon General in 1959 and was an influential figure in the military until his retirement.122
There was a similarly high turnover of senior staff in Britain. From 1945-1948, there were three different Directors of Army Psychiatry (DA Psych) and four Assistant Directors (ADA Psych).123 The RAMC lost many of its most experienced officers like Brigadier HA Sandiford, who had served as DA Psych since 1942.124 Colonel Alfred Torrie succeeded him in 1946.125 While, ‘Torrie had practised at a base hospital during the Western Desert campaign, at Northfield [military psychiatric hospital] and ended the war as command psychiatrist of London district, he was not an innovative clinician or researcher and was chosen for his administrative skills.’126 In December 1948, Brigadier Robert James Rosie was appointed to replace Torrie.127 Although Rosie was a seasoned medical officer, he had never served as a front line psychiatrist in the manner of his predecessors.128 Each succeeding DA Psych had less first hand experience of combat and forward psychiatry. There was no one who could replace Sandiford or many of his prominent wartime
122 JA MacFarlane, Speech to the Canadian Medical Association, 18 June 1954, LAC: Volume 2, 325.009 (D315). 123 Directors included Brigadiers HA Sandiford, Alfred Torrie and Robert James Rosie. Assistant Directors included Lieutenant Colonels N Copeland, GA Fitzpatrick, JC Penton and HED Flack. Army Psychiatric Advisory Committee, Committee Minutes, 16 Feb. 1946, 2 Jan. 1947, 10 Dec. 1948, 1 Apr. 1949, TNA: WO 32/13462. 124 Jones and Wessely, Shell Shock to PTSD, 76. Army Council Secretariat to Director General of Army Medical Services, 8 July 1948, TNA: WO 32/13462. Brigadier Sandiford to Army Council Secretariat, 16 Feb. 1946, TNA: WO 32/13462. 125 Anon to Director General of Army Medical Services, 8 July 1946, TNA: WO 32/13462 126 Jones and Wessely, Shell Shock to PTSD, p. 117. 127 Director of Army Psychiatry to Army Council Secretariat, 10 Dec. 1948, TNA: WO 32/13462. 128 Robert James Rosie was born in 1901 in the Orkney Islands. Following in the footsteps of his father, Rosie qualified as a doctor in 1923. Looking for adventure, he decided to join the Royal Army Medical Corps. Throughout the 1920s, he served in West Africa and India. He trained as a psychiatrist in the 1930s. During WWII, he worked as a psychiatrist at the Royal Victoria Hospital Netley and Northfield Hospital. From 1948 until his retirement in 1954, he served as Director of Army Psychiatry. Professor Anthony J Rosie, email message to author, June 2010.
52 colleagues like Brigadier John Rawling Rees and Lieutenant Colonel Tom Main. Rees had acted as consultant to the Army and played a key role in the formulation and direction of psychiatric policy. While he remained a key advisor to the Army over the next decade, Rees largely focused his professional attentions elsewhere. In 1946 he helped establish the Tavistock Clinic of Human Relations and in 1948 he served as the first president of the World Federation for Mental Health.129 Tom Main had served as an advisor to the 21st Army Group and was, ‘responsible for training Army psychiatrists and medical officers in the handling of acute psychiatric casualties and planning for the demands on psychiatric services in the Normandy campaign.’130 He had also worked at Northfield Hospital. By 1946, Main had left the RAMC to become the Medical Director of the Cassel Hospital in Surrey.131
The end of WWII was a pivotal turning point in the history of the Royal Canadian Army Medical Corps and the Royal Army Medical Corps. Demobilisation had a measurable and irreversible impact on both the Canadians and their British counterparts. The mass release of medical personnel resulted in a huge loss of manpower and organisational knowledge. Nonetheless, the RCAMC and RAMC were positive about their prospects for the future.
129 Upon his death in 1969, John Rawling Rees was widely considered, ‘one of the elder statesmen of international psychological medicine.’ Qualifying as a doctor during WWI, Rees joined the Royal Army Medical Corps and served as a medical officer in Mesopotamia, France and Belgium. Following the war, he qualified as and began to work as a psychiatrist. As medical director of the Tavistock Clinic, Rees was an influential figure throughout the 1930s. From 1939-1945, he re- joined the RAMC as the consultant psychiatrist to the Army at home. While Rees was demobilised in 1945, he remained an advisor to the Army. During the last years of his life, Rees was a prolific author and lecturer. ‘Obituary: JR Rees, CBE, MA, MD, FRCP, DPH,’ British Medical Journal 2, No. 5651 (26 Apr. 1969): 253. 130 JDT, ‘Obituary: Thomas Forrest Main, formerly Medical Director, Cassel Hospital, Surrey,’ Psychiatric Bulletin 14 (1990): 637-638. 131 Thomas Forrest Main (1911-1990) was a prominent figure in psychiatry and psychoanalysis throughout his life. Receiving his medical degree in 1933, Main began to practice psychiatry. During his service with the RAMC, he formulated his concept of, ‘the institution as a therapeutic environment.’ As Medical Director of the Cassel Hospital (1946-1976) he continued to develop his ideas. JDT, ‘Obituary: Thomas Forrest Main,’ 637-638.
53 The Cold War presented different challenges than those that they had faced during WWII. Defence planners focused on reinventing military medicine for the post-war period. In planning for the future, they aimed to create forward thinking and scientifically managed organisations. Committees convened to consider the matter concluded that fewer doctors would be required in future.132 Non-medical officers could be employed to undertake administrative tasks that had previously been the remit of doctors.133 Early in 1946, the Nathan Committee estimated that the British Army would need only 1,310 doctors for a force of 320,000 British soldiers and 55,000 colonial troops.134 Meanwhile, the Canadians were quietly confident that they would require no more than a few hundred medical officers to meet their requirements. 135 However, the following years would prove that their predictions had been far too optimistic.
Even with reduced staffing requirements, the RCAMC and RAMC were plagued by manpower problems throughout the late 1940s and early 1950s. Medical students and young doctors were not attracted to a career in the peacetime Army.136 There were many
132 Nicholson, Canada’s Nursing Sisters, 254. Working Party on Revised Establishment of Medical Officers: Memorandum by AMD1, Royal Army Medical Corps: Peace Establishment Officers, 1953, TNA: WO 32/10383. Brooke Claxton, Canada’s Defence: Information on Canada’s Defence Achievements and Organization, 1947, LAC: RG24, Box 5 File Part 1, p. 9. David Spencer Whittingham, Royal Canadian Army Medical Corps Study Papers Volume I, 1951- 1953, Canadian War Museum (Hereafter cited as CWM): 58C 3 22.1. 133 David Spencer Whittingham, Royal Canadian Army Medical Corps Study Papers Volume I, 1951-1953, CWM: 58C 3 22.1. 134 Working Party on Revised Establishment of Medical Officers: Memorandum by AMD1, Royal Army Medical Corps: Peace Establishment Officers, 1953, TNA: WO 32/10383. 135 Defence Medical and Dental Services Advisory Board to the Minister of National Defence, the Honourable Brooke Claxton, 28 Nov. 1950, LAC: RG 24, Acc 1983-1984/215, File C-1225-M1, Volume III. 136 Canadian Inter-Service Medical Committee, 4 Sept. 1946, Minutes of a Meeting of the Inter- Service Medical Committee, LAC: RG 24, 83-84/167, Box 7717, 20-1-1, pt. 1 in Bill Rawling, The Myriad Challenges of Peace: Canadian Forces Medical Practitioners Since the Second World War (Ottawa: Canadian Government Publishing, 2004), 34. Colonel GL Morgan Smith, ‘The Royal Canadian Army Medical Corps of Today,’ Canadian Services Medical Journal 10, No. 1 (July/Aug. 1954): 20.
54 disadvantages to a life in the services. In October 1950, Department of Labour official, Mr Morrison, was dispatched to Montreal to speak to medical students and ascertain their feelings about the armed forces. Reporting back to his superiors, Morrison explained that the students were generally negative about a career in the military. They felt that medical officers had few opportunities for professional advancement and were forced to live an itinerant lifestyle.137 Moreover, Morrison was forced to admit that medical officers had a poor reputation amongst the general medical community. He explained that, ‘There [was] a general idea that the calibre of doctors in the Service [was] below the general average.’138 British students and physicians had similar concerns. Throughout 1951, a series of articles entitled, ‘Future Medical Officers for the Army: Some Suggestions,’ appeared in the Journal of the Royal Army Medical Corps.139 The writer, Colonel RH Robinson outlined the many reasons why civilian doctors were deterred from enlisting. Robinson recognised that service life involved, ‘social and domestic,’ sacrifices that most physicians were unwilling to make.140 He also noted that a career in the Army involved an, ‘unavoidable loss of professional experience and skill due to the limitations of peacetime military medical practice.’ 141 Robinson and numerous other authors saw pay as the greatest deterrent against joining the forces.142
Working Party on Revised Establishment of Medical Officers: Memorandum by AMD1, Royal Army Medical Corps: Peace Establishment Officers, 1953, TNA: WO 32/10383. 137 Mr Morrison to Department to Labour, 27 Oct. 1950, LAC: RG 24, Acc 1983-1984/216 GAD, Box 2491, Volume I, File 801-M90, ATIP A2010-0042. 138 Ibid. 139 Colonel RH Robinson, ‘Future Medical Officers for the Army,’ Journal of the Royal Army Medical Corps 96, No. 2 (Feb. 1951): 130-136. Colonel RH Robinson, ‘Future Medical Officers for the Army Part III: Some Suggestions,’ Journal of the Royal Army Medical Corps 96, No. 3 (Mar. 1951): 182-191. Colonel RH Robinson, ‘Future Medical Officers for the Army,’ Journal of the Royal Army Medical Corps 96, No. 4 (Apr. 1951): 225-228. 140 Robinson, Feb. 1951, p. 131. 141 Robinson, Mar. 1951, p. 183. 142 Canadian Inter-Service Medical Committee, 4 Sept. 1946, Minutes of a Meeting of the Inter- Service Medical Committee, LAC: RG 24, 83-84/167, Box 7717, 20-1-1, pt. 1 in Bill Rawling, The Myriad Challenges of Peace: Canadian Forces Medical Practitioners Since the Second World War (Ottawa: Canadian Government Publishing, 2004), 34. Morgan Smith, ‘The Royal Canadian Army Medical Corps of Today,’ 20.
55 Although they fielded a similar clinical workload, Canadian and British medical officers were not well paid in comparison to their civilian colleagues. On 4 September 1946, the Canadian Inter-Service Medical Committee (ISMC) met to discuss the problems surrounding pay and compensation. In their report, the members of the committee, ‘noted that salaries offered by municipalities [and other governmental departments] ranged from $4,000 to 6,000 annually.’143 While the ISMC did not specify how much medical officers were paid, they indicated that it was much less than that which was available elsewhere.144 Several years later in 1951, little had changed. An ad hoc committee was assembled to study manpower and recruitment in the RCAMC. They concluded that, ‘The most valid proof that Service rates of remuneration for the medical profession are below the civilian average is the fact that there is a serious shortage of doctors in the armed forces.’145
British Medical Officers were no better off than their Canadian peers. Repeated requests for better pay were summarily rejected on the grounds that the current economic climate precluded the possibility of increases.146 In April 1950, the War Office launched an enquiry into the matter, which finally resulted in a modest pay increase. Pressure from the British Medical Association (BMA) had finally prompted the government into action. Throughout the late 1940s, representatives from the BMA had pestered Members of Parliament, Ministers and officials from the War Office over how poorly medical officers were paid. During the early months of 1950, they had informed the government that the next British Medical Journal would feature a harsh critique of Army policy. Recognising that this would be, ‘politically embarrassing,’ the Standing Committee of Service Ministers was
Working Party on Revised Establishment of Medical Officers: Memorandum by AMD1, Royal Army Medical Corps: Peace Establishment Officers, 1953, TNA: WO 32/10383. 143 Canadian Inter-Service Medical Committee, 4 Sept. 1946, Minutes of a Meeting of the Inter- Service Medical Committee, LAC: RG 24, Acc 1983-1984/167, Box 7717, 20-1-1, pt. 1. 144 Ibid. 145 Chair Ad Hoc Committee to Secretary of Personnel Member’s Committee, 9 May 1951, LAC: RG 24, Acc 1983-1984/167, Box 7717, 20-1-1, pt. 3, A/C F.G. 146 Director General of Army Medical Services, Royal Army Medical Corps Officers—Rates of Pay: Review Consequent on the Danckwerts Award, 1952, TNA: WO 32/15673.
56 convened. They decided in favour of an immediate pay increase.147 However, the changes were not lasting and events soon turned against the RAMC. On 25 March 1952, Minister of Health Harry Crookshank announced that general practitioners in the National Health Service (NHS) would receive a significant salary increase.148 For the past few years, GPs had protested that they were not compensated well for the high number of patients that they were expected to treat. As the cost of living was increasing, they argued that wages should do so as well.149 Lord Justice Harold Danckwerts was appointed by the Lord Chancellor to investigate the matter. He eventually concluded that doctors in the NHS were not remunerated fairly for their services and decided that they should be awarded £10,000,000 more per annum.150 For the average GP, this signalled a salary increase of £300 to £500 per year.151 The ruling did not apply to doctors serving in the Royal Army Medical Corps. Once again, a gap opened up between civilian and military medicine. 152
While the RCAMC and RAMC made every effort to recruit new medical officers, the manpower crisis only continued to worsen throughout the period in question. Every department experienced shortages and the problem extended to nurses, orderly staff and technicians. In Canada, the deficiencies were at their most severe amongst general duty officers (GDOs), who were responsible for carrying out the majority of routine tasks.153 In
147 Ministry of Defence, Appendix A to ACS/B/3224, 10 Apr. 1950, TNA: WO 32/13369. Standing Committee of Service Ministers, Increases of Pay for Services Medical Officers, 25 Apr. 1950, TNA: WO 32/13369. 148 ‘Forty Million Pounds,’ British Medical Journal 1, No. 4760 (29 Mar. 1952): 697-698. 149 40th Parliament, Debates, House of Commons (5th Series) (30 October 1952) Vol. 505, 2109- 2115. Director General of Army Medical Services, Royal Army Medical Corps Officers—Rates of Pay: Review Consequent on Danckwerts Award, Minute Sheet, 21 Aug. 1952, p. 1, TNA: WO 32/15673. 150 Ibid. Ibid. 151 Ibid. Ibid. 152 Ibid. Ibid. 153 Rawling, The Myriad Challenges of Peace, 34-36.
57 Britain, the problem centred on medical specialists. As a group, they could look forward to more rewarding and lucrative careers as consultants in the National Health Service.154 On average, a 35-year-old RAMC specialist earned £500 less per annum than his civilian equivalent and by the age of 40 he could expect to earn nearly £1,000 pounds less.155 By training a proportion of its GDOs as specialists, the RAMC hoped to alleviate the problem. Despite their best efforts, the programme was largely ineffective in both the short term and long term. It took over three years to train a junior specialist and nearly seven for his senior equivalent.156 Not all general duty officers were suitable candidates for such education. All new RAMC MOs were required to take the Junior Officers course early in their careers. Only those students who scored over 70% on the final exam were eligible to pursue specialist training. There were far too few experienced candidates to fill the number of empty positions available.157
RCAMC and RAMC recruiters resorted to increasingly inventive tactics in order to attract the best and brightest medical students and doctors. They tried to lure recruits with the promise of financial incentives and funded postgraduate programmes. From 1946 onwards, the Canadian Forces sent representatives overseas to countries like the United Kingdom. They hoped to entice young men looking for the chance of adventure and those dissatisfied with working conditions in the NHS.158 The RAMC began to offer recruits the option of signing up for a short service commission. Under its terms, doctors could join the Army for four years of active duty and four in reserve. At any point in time, they could switch to a
Army Medical Advisory Board, Minutes of Meeting, 19 May 1950, TNA: WO 32/13465. 154 Ministry of Health, Demobilization of Doctors, 1945, TNA: MH 79/547. 155 Ibid. 156 Anon, Interim: Training of Regular Medical Officers of the Royal Army Medical Corps, June 1957, TNA: WO 32/16498. Medical Services Coordinating Committee Broadening of Experience of Service Medical Officers—Facilities Made Available by the Service Departments, 24 July 1961, TNA: WO 32/16498. 157 Ibid. Ibid. 158 Rawling, The Myriad Challenges of Peace, 31.
58 regular commission of five years of active service and seven in reserve. The short service programme was designed to be flexible and attract individuals who may not have considered a career in the forces otherwise.159 While their efforts were creative, neither the Canadians nor the British were successful in recruiting the number of men they needed. Most of the British medical students who enlisted in the Canadian Forces joined the Royal Canadian Air Force (RCAF) rather than the Royal Canadian Army Medical Corps. The RCAF generally offered more attractive terms of service and postings than the Army could.160 By 1951, the RAMC had only managed to fill 154 out of 461 possible short service commissions.161
During the late 1940s and 1950s, the Royal Army Medical Corps relied heavily upon National Service in order to meet its manpower requirements. From 1948-1960, over 50% of medical officers were conscripts.162 Under the provisions of the National Service Act, medical students had the choice of enlisting before they began or after they completed their education.163 While numerically useful, conscription proved problematic as a long-term solution. The RAMC was desperate to recruit specialists but National Servicemen were either newly or recently qualified doctors. Members of the Army Council lamented that they were, ‘unable to provide more than a sprinkling of specialists. Moreover their limit of
159 War Office, Report on the Health of the Army 1949-1950, 27 Mar. 1953, TNA: WO 279/610. Army Medical Advisory Board, Meetings 1 July 1949-1954: Deficiency of Medical Officers in the RAMC, 1 July 1952, TNA: WO 32/13465. 160 Harold M Wright, Salute to the Air Force Medical Branch on the 75th Anniversary, Royal Canadian Air Force (Ottawa, 1999), 195. Paul Alfred Turner Sneath, Report of Five Year (1954-1959) Survey of Sources of Supply, Professional Attainments and Wastage Medical Officers of the Canadian Forces, 1960, LAC: MG31-J7, Volume 1. 161 War Office, Report on the Health of the Army 1949-1950, 27 Mar. 1953, TNA: WO 279/610. Army Medical Advisory Board, Meetings 1 July 1949-1954: Deficiency of Medical Officers in the RAMC, 1 July 1952, TNA: WO 32/13465. 162 Army Medical Advisory Board, Meetings 1 July 1949-Sept. 1954, 8 Dec. 1950, p. 4, TNA: WO 32/13465. 163 ‘Annual Report of the Council, 1946-1947,’ supplement, British Medical Journal 1, No. 4503 (26 Apr. 1947): 84.
59 two years in the Army precludes their being trained as specialists.’164 On 19 May 1950, the Army Medical Advisory Board met to discuss the scale of the problem. Director General of Army Medical Services Sir Neil Cantlie informed the board that of the Army’s 357 specialists, only 43% were fully qualified consultants. He estimated that the RAMC would need 98 more doctors to meet minimum requirements.165 The specialities in most dire need included anaesthesiology, otology, radiology, psychiatry and surgery.166 Staff shortages put an immense strain upon medical officers and affected the speed at which they were able to treat patients. For example, nearly 353 soldiers were awaiting surgery or orthopaedic treatment on 1 May 1950 alone.167 Commanders at the highest level were well aware of the gravity of the situation. Over a year earlier, the Standing Committee of Service Ministers had recognised that because of the RAMC’s continued struggle to recruit, ‘the soldier will receive medical care which is of a lower grade than he would receive in civil life.’168
The years from 1945-1950 represent a dark period in the history of the RCAMC and the RAMC. Funding cuts and staff shortages severely affected the efficiency of operations and
164 Adjutant General Sir John Crocker, Deficiency of Medical Officers in the RAMC: Paper for Consideration by the Army Council at a Future Meeting, 17 Apr. 1953, TNA: WO 32/13465. 165 Army Medical Advisory Board, Minutes of Meetings 1 July 1949-Sept. 1954, 19 May 1950, TNA: WO 32/13465. 166 Specialities with the greatest deficiencies (1950) *Based on the Army’s minimum requirements **The statistics are based on the required number of consultants as opposed to trainee and graded specialists: May Establishment on 1 July No. % No. % Anaesthetists 17 37.7 22 48.8 Otologists 9 50 11 61.1 Radiologists 13 54.1 13 54.1 Psychiatrists 12 34.2 17 48.5 Surgeons 24 34.2 30 42.8 Army Medical Advisory Board, Minutes of Meeting, 19 May 1950, TNA: WO 32/13465. 167 Army Medical Advisory Board, Minutes of Meeting, 19 May 1950, TNA: WO 32/13465. Standing Committee of Service Ministers, Specialists in the Royal Army Medical Corps, Annex A to ACS/B/3023 168 Standing Committee of Service Ministers, Specialists in the RAMC, Annex A to ACS/B/3023 Requirements of Specialists for the Army, 26 July 1949, TNA: WO 32/13369.
60 the quality of medical care. The RAMC was particularly desperate to attract new doctors because of the size of the British Army and scale of its international commitments. Several months prior to the outbreak of the Korean War, the Secretary of State for War John Strachey explained to his fellow ministers that he, ‘feared that, unless effective steps were taken…in the near future, a public scandal would develop.’169 Uniformed psychiatrists in both countries were equally affected by these developments. As practitioners of a young and often controversial speciality, psychiatrists frequently found it difficult to secure funding or support for their activities. However, Canadian and British authorities took very different approaches to the matter.
On 23 September 1946, the Canadian Director General of Medical Services (DGMS), Brigadier Thompson responded by letter to an official from the American Psychiatric Association (APA). He informed Dr GH Hutton of the APA that after demobilisation was complete, the RCAMC neuropsychiatric division would be dismantled.170 During WWII, Canadian psychiatrists had formed an integral part of the medical team. According to historian WR Feasby, psychiatrists had played a key role in, ‘conserving manpower, in building morale, in developing treatment units and [disposing] of difficult cases.’171 Be that as it may, their services were no longer required. Thompson explained to Hutton that the Canadian Army would no longer employ full time psychiatric staff or provide mental healthcare facilities in military hospitals.172 He reasoned that such arrangements were no longer necessary as, ‘the strain of battle no longer exist[ed] and it [was] probable that army
169 Secretary of State for War, Shortage of Specialists Royal Army Medical Corps: Extract from the Minutes of the 8th (50) Meeting of the Standing Committee of Service Ministers, 16 May 1950, TNA: WO 32/13369. 170 Brigadier CS Thompson to Dr GH Hutton, 23 Sept. 1946, NA, RG 24, Vol. 19, 466 in Terry Copp and Bill McAndrew, Battle Exhaustion: Soldiers and Psychiatrists in the Canadian Army, 1939-1945 (Montreal, QC and Kingston, ON: McGill Queen’s University Press, 1990), p. 157. 171 Feasby, 1953, p. 93. 172 Major FCR Chalke to Senior Consultant, 20 Nov. 1952, LAC: RG24, Volume 19, 466, File C- 3848-1. Lieutenant Colonel JN Crawford to Director General of Medical Services, 10 Dec. 1948, LAC, RG 24, Volume 19, 466, File C-3848-1.
61 life in peacetime [was] no more hazardous than many civilian occupations.’ 173 Appropriately trained personnel selection officers could also replace psychiatrists who had previously been employed in screening recruits. While the decision to cut the programme was surprising, it was not without logic. From 1945-1950, Canadian troops were largely deployed within Canadian territory and were much less likely to engage in combat. Furthermore, the Army no longer included conscripts but was solely composed of volunteers. In peacetime, it was much less likely that psychologically troubled individuals would enlist in the armed forces. Finally, the RCAMC was under pressure to reduce wasteful spending. In comparison to medical specialities like surgery, the results and benefits of psychiatric treatment are less obvious. For the Director General of Medical Services and his staff, the psychiatric programme was an obvious place to begin spending cuts.174
Within a year, it became apparent that the RCAMC’s initial confidence in terminating the psychiatric programme had been misplaced. Medical officers from across the country began to report growing, ‘behavioural and morale problems,’ amongst Canadian troops.175 They complained that they were unable to access, ‘expert [psychiatric] advice,’ in order to quell the problem.176 Moreover, there was an overwhelming consensus that personnel selection officers were failing to recognise mentally substandard or unstable recruits. Assistant Director of Organisation, Lieutenant Colonel GD Dailley wrote a paper entitled, ‘Memorandum on Psychiatry in the Canadian Army,’ early in 1948. In it, he explained that, ‘[personnel selection officers] had been called upon to assume responsibilities, for which they are not equipped by training and experience in connection with the assessment of
173 Brigadier CS Thompson to Dr GH Hutton, 23 Sept. 1946, NA, RG 24, Vol. 19, 466 in Terry Copp and Bill McAndrew, Battle Exhaustion: Soldiers and Psychiatrists in the Canadian Army, 1939-1945 (Montreal, QC and Kingston, ON: McGill Queen’s University Press, 1990), 157. 174 Director General of Medical Services Brigadier WL Coke to Command Medical Officer, Headquarters Central Command, 4 Dec. 1951, LAC, RG 24, Volume 19, 466, File C-3848-1. 175 Copp and McAndrew, Battle Exhaustion, 159. 176 Director General of Medical Services Brigadier WL Coke to Command Medical Officer, Headquarters Central Command, 4 Dec. 1951, LAC: RG 24, Volume 19, 466, File C-3848-1.
62 emotional fitness.’177 Later that year, complaints had become so widespread that the DGMS was forced to appoint a psychiatric advisor. Major Franklin Cyril Rhodes Chalke was chosen to advise the RCAMC on matters of, ‘personnel selection and allocation, operational treatment and handling, and mental hygiene.’178 In short, he was appointed to help reconstruct the Canadian Army’s psychiatric programme. An experienced medical officer and WWII veteran, Chalke had only qualified as a psychiatrist in 1946. Throughout the late 1940s, he undertook postgraduate studies and worked as a resident at the famous Menninger Clinic in Topeka, Kansas.179 In the months before Canadian troops were deployed to Korea, Chalke was only just beginning to assume the full range of his duties.180
Despite considerable financial pressure, the Royal Army Medical Corps never took the drastic step of cutting its psychiatric programme. Since the end of WWII, British troops had
177 Assistant Director of Organisation Lieutenant Colonel GD Dailly, ‘Memorandum on Psychiatry in the Canadian Army,’ 20 March 1948, LAC: RG 24, Volume 19, 466, File C-3848-1. 178 Copp and McAndrew, Battle Exhaustion, 159. Inter-Service Medical Committee to Dr CW MacCharles, Medical Section of the Defence Research Board, 20 Nov. 1952, LAC: RG 24, Volume 19, 466, File C-3848-1. 179 Anon, List of Royal Canadian Army Medical Corps Regular Officers and a list of Royal Canadian Army Medical Corps Officers SOS from Oct. 1946 to date 1960, 1960, Directorate of History and Heritage, Department of National Defence (Hereafter cited as DHH DND): 000.8 (D96). Anon, Department of National Defence: Army Hospital Monthly Progress Report, Kingston, Ontario, 10 Dec. 1945, DHH DND 361.003 (D1) ‘Medical Societies,’ Canadian Medical Association Journal 63, No. 3 (Sept. 1950): 304. 180 Born in 1916, Franklin Cyril Rhodes Chalke grew up in Winnipeg, Manitoba. He studied for his medical degree at the University of Manitoba and obtained a Masters of Science from Queen’s University. Chalke joined the RCAMC in 1940 and served as a medical officer throughout WWII. Qualifying as a psychiatrist after the war, Chalke continued to serve in the RCAMC during the 1950s. After his retirement from the Army, he opened a private practice in Ottawa. During the remaining years of his career, Chalke was a highly influential figure in Canadian psychiatry. He served as President of the Canadian Psychiatric Association and, ‘was one of the founders of the Royal Ottawa Psychiatric Hospital.’ Furthermore, he worked as a professor at the University of Ottawa Medical School and was one of the, ‘founding editors of the Canadian Psychiatric Journal.’ In a letter to the author, his son noted that he, ‘was a remarkable person. He was a Renaissance man, and read extensively. He was well known and universally highly respected. He was easy to talk to and most people who knew him really liked him.’ Douglas Chalke, email message to author, 3 Nov. 2011.
63 been deployed to Europe, the Far East and many other theatres around the world. There was no reason why the Directorate of Army Psychiatry (DAP) should close its doors. Instead, the RAMC focused upon reorganising the DAP in order to make it more economically efficient. All departments of the RAMC were expected to economise and the DAP was no exception. During the planning process, admirable efforts were made to ensure that the quality of Army psychiatric care remained high.181 Be that as it may, changes in policy often had unintended repercussions.
Throughout World War II, the Royal Army Medical Corps had relied heavily upon full time psychiatric consultants to act as administrators in each theatre of combat. As experienced clinicians, they were entrusted with the direction of wartime policy and were instrumental to the DAP’s success as an organisation.182 In July 1945, the Director of Army Psychiatry Brigadier Sandiford wrote to Director General of Army Medical Services Major General Sir Alexander Hood. With demobilisation approaching, Sandiford recognised that the majority of the army’s senior psychiatric staff would return to civilian practice. He suggested employing civilian consultants as replacements. 183 By order of the Army Council, a seven member Psychiatric Advisory Committee (PAC) was formed in the summer of 1945.184 In the early years of the committee, members included RAMC veterans such as Brigadier GWB James, who had served as a consultant to the British Army in the Middle East during WWII and Brigadier John Rawling Rees. They were joined by
181 Army Council Secretariat, Meeting of the Standing Committee of Service Ministers, 26 July 1949, TNA: WO 32/13369. Director of Army Psychiatry Brigadier HA Sandiford to Army Psychiatry Advisory Committee, 5 July 1945, TNA: WO 32/13462. David S Richards, A Report on the Organization of the Army Medical Directorate and Proposals for its Reorganization, 24 Mar. 1944, TNA: WO 32/10917. 182 Army Psychiatric Advisory Committee, Committee Minutes, 31 July 1946, TNA: WO 32/13462. 183 Director of Army Psychiatry Brigadier HA Sandiford to Director General of Army Medical Services Major General Alexander Hood, 5 July 1945, TNA: WO 32/13462. 184 Director of Army Psychiatry Brigadier HA Sandiford to Director General of Army Medical Services Major General Alexander Hood, 5 July 1945, TNA: WO 32/13462. Joint Secretary of the Army Council Secretariat, Register No. 24, Sept. 1945, TNA: WO 32/13462.
64 prestigious academics like Professor DK Henderson of the University of Edinburgh and Dr Aubrey Lewis, who was the clinical director of the Maudsley Hospital.185 Functioning as impartial observers, the committee members were tasked with advising the Army on developments in psychiatric medicine and suggesting directions for future policy.186
Initially, the Psychiatric Advisory Committee appears to be an efficient and inexpensive substitute for the Army’s senior wartime consultants. However, there were many problems with the plan. Firstly, the members of the committee were not employed by the War Office but acted in a voluntary capacity. Consequently, they did not receive a salary for their efforts and were only compensated for their travel expenses. Due to other professional and paid obligations, meetings were held infrequently.187 Secondly, committee members did not regularly interact with troops and were often unable to see the practical implications of their suggestions. 188 Finally, the committee did not have any executive authority. While committee members could make suggestions and table proposals, they did not have the power to put programmes into effect or change the direction of policy. Despite including many eminent psychiatrists, the PAC was not an effective replacement for wartime consultants. As a consultative body, it was limited by circumstance and by design.189
Economic considerations also had a significant effect on the RAMC’s psychiatric training programme. Recognising the poor state of recruitment figures, Assistant Director of Army
185 Joint Secretary of the Army Council Secretariat, Register No. 24, Sept. 1945, TNA: WO 32/13462. Director of Army Psychiatry Brigadier Sandiford to Director General of Army Medical Services Major General Alexander Hood, 5 July 1945, TNA: WO 32/13462. 186 Army Psychiatric Advisory Committee, Committee Minutes, 31 July 1946, TNA: WO 32/13462. 187 Ibid. 188 Army Psychiatric Advisory Committee, Committee Minutes, 15 Dec. 1956, TNA: WO 32/13462. Medical Services Co-ordinating Committee: Standing Subcommittee, Civilian Consultants: Note by the DDG, Army Medical Services, 22 Feb. 1949, TNA: DEFE 10/93. 189 Army Psychiatric Advisory Committee, Committee Minutes, 15 Dec. 1956, TNA: WO 32/13462.
65 Psychiatry Lieutenant Colonel N Copeland wrote to his superiors in 1945 to propose the construction of a school of Army psychiatry. There was no such institution at the time. In light of the Army’s post-war requirements, Copeland believed that it would be necessary for the RAMC to train its own personnel rather than rely upon civilian recruitment.190 Over the following two years, extensive plans were drawn up for the new school. Attached to a 300-bed hospital near Aldershot, the school would offer postgraduate courses for officers specialising in psychiatry and training for GDOs. Mental health nurses and orderlies would also receive their training here. Senior RAMC officers were insistent that the new school was a necessary expense. 191 They argued that, ‘no civil institution can teach the prophylactic side of Psychiatry, which is the essence of Army Psychiatry.’192 Regardless of their support, the Executive Committee of the Army Council decided against building the school.193
On 6 June 1947, members of the ECAC met to consider proposals for new medical training facilities. The psychiatric school was only one of many ideas that the RAMC put forward. Others included a School of Health, School of Physiotherapy, School of Dispensing, Field Training School and School of Hygiene.194 During their discussions, committee members debated over the expense of such projects and criticised the RAMC for being, ‘too
190 Assistant Director of Army Psychiatry Lieutenant Colonel N Copeland, Post-War Army Schools, 20 March 1945, TNA: WO 32/11971. 191 Assistant Director of Army Psychiatry Lieutenant Colonel N Copeland, Post-War Army Schools, 20 Mar. 1945, TNA: WO 32/11971. Assistant Director of Army Psychiatry Lieutenant Colonel JC Penton to the Deputy Director General of Army Medical Services, School of Army Psychiatry, 14 June 1947, TNA: WO 32/11971. Adjutant General Sir James Steele, Medical Schools and Training Establishments in the Post-War Army: Memorandum by AG for consideration by the Executive Committee of the Army Council in a future meeting, 6 Aug. 1947, TNA: WO 32/11971. 192 Assistant Director of Army Psychiatry Lieutenant Colonel JC Penton to the Deputy Director General of Army Medical Services, School of Army Psychiatry, 14 June 1947, TNA: WO 32/11971. 193 Executive Committee of the Army Council, Minutes of Meeting, 6 June 1947, TNA: WO 32/11971. 194 Ibid.
66 ambitious.’195 With regards to psychiatry, they expressed the view that it was, ‘a young science and its basic principles were still being explored by the medical profession.’196 Instead of opening a dedicated school, they decided that, ‘It would be cheaper to pay the cost of such instruction by way of fees (at civilian institutions).’197 While defence spending remained low, the committee would not consider the expansion of Army psychiatry. Limited training would continue to be available at the Royal Army Medical College but officers who wanted to pursue further education would have to do so elsewhere.198 Many other proposals were similarly rejected.199 For example, the Royal Army Dental Corps (RADC) had requested funds to establish a surgical training programme and facility. The application was dismissed because dentistry, like psychiatry, was seen as a subject that could be learnt more economically at a civilian medical school.200 The ECAC’s decision severely restricted the Directorate of Army Psychiatry’s capacity to train its own personnel and represented a significant blow to the Royal Army Medical Corps as a whole.
There is also evidence that prejudice played a role in how psychiatrists were treated in the military. On occasion, the DAP’s efforts to maintain or expand the scope of psychiatric activity in the Army were undermined. During WWII, War Office Selection Boards had been responsible for selecting appropriate candidates for officer training. Consisting of a
195 Ibid. 196 Ibid. 197 Ibid. 198 Ibid. 199 While the Executive Committee of the Army Council approved funding for several schools and programmes, this was not a guarantee of success. The RAMC’s continued struggle to recruit also factored strongly in the outcome. The X-Ray School never produced the number of technicians needed for skin therapy at military hospitals. The anaesthesia-training programme also faltered. While the convenors originally only admitted regular officers, they were forced to accept short service and National Service recruits in order to meet requirements. In the Report on the Health of the Army 1949-1950, the authors noted that this been a mistake and had resulted in a, ‘slight rise in morbidity,’ during surgical procedures. War Office, Report on the Health of the Army 1946-1948, 1952, TNA: WO 279/610. War Office, Report on the Health of the Army 1949-1950, 27 Mar. 1953, TNA: WO 279/610. 200 Executive Committee of the Army Council, Minutes of Meeting, 6 June 1947, TNA: WO 32/11971.
67 president, military testing officer and medical specialist, WOSBs also included a psychiatrist from 1941 onwards. If unavailable, they could act in an advisory capacity and were consulted when a panel was unsure as to a candidate’s mental capacity or stability.201 From 1945-1946, several investigative committees were assembled to consider making psychiatrists permanent members of the boards. 202 On 4 December 1946, DGAMS Alexander Hood wrote to Adjutant General Sir Richard O’Connor in support of the idea. He explained that: Assessment of psychological fitness and capacity to bear strain is essentially psychiatric since through his [the psychiatrist’s] professional training and experience he is concerned with strains which cause breakdown and their psychological mechanisms. His training and approach is Scientific [sic] and from this follows that he is specifically equipped to advise a selection board on the capacity of candidates to bear strain.203
He also pointed out that on average WOSBs without a psychiatrist on staff overlooked one in three suitable candidates.204
In spite of Hood’s endorsement, the Army Council Secretariat (ACS) ultimately voted against the idea. There were a number of reasons for this decision. Due to a shortage of
201 Director General of Army Medical Services Major General Alexander Hood to Adjutant General Sir Richard Nugent O’Connor, Work of Psychologists and Psychiatrists in the Services, 4 Dec. 1946, TNA: WO 32/11974. Army Council Secretariat, Brief for Secretary of State: Prepared by Army Council Secretariat in Consultation with Adjutant General and Permanent Under-Secretary, 31 Mar. 1945, TNA: WO 32/11974. Army Council Secretariat, Ministerial Committee on the Work of Psychologists and Psychiatrists in the Services: Report of Expert Committee, TNA: WO 32/11974. 202 Army Council Secretariat, Brief for Secretary of State: Prepared by Army Council Secretariat in Consultation with Adjutant General and Permanent Under-Secretary, 31 Mar. 1945, TNA: WO 32/11974. Army Council Secretariat, Ministerial Committee on the Work of Psychologists and Psychiatrists in the Services: Report of Expert Committee, TNA: WO 32/11974. Advisory Committee of Psychologists, Record of a Meeting, 9 Nov. 1946, TNA: WO 32/11974. 203 Director General of Army Medical Services Major General Alexander Hood to Adjutant General Sir Richard Nugent O’Connor, Work of Psychologists and Psychiatrists in the Services, 4 Dec. 1946, TNA: WO 32/11974. 204 Ibid.
68 psychiatrists and psychologists in the Army, remaining staff could ill afford to take on additional duties. Moreover, there was limited financial support for such a venture.205 The members of the ACS also indicated that there was a, ‘widespread distrust in the Army of the function of psychologists and psychiatrists,’ and that they had taken this into account during their deliberations. 206 The Adjutant General agreed wholeheartedly with his colleagues on the council. Responding to a letter from the DGAMS, he stated, ‘It is unquestionable that there is a mistrust of these officers in the Army…I do not think, therefore, that they should be restored for the present, at any rate until this mistrust has been removed.’207 He even recommended referring to psychiatrists as special selection officers in order to encourage a greater sense of trust in their abilities. It is unclear as to whether or not ‘mistrust’ was as widespread as the Adjutant General and Army Council Secretariat contended. The War Office’s Advisory Committee of Psychologists angrily protested that this was not the case and argued that the decision had been unfair.208 Be that as it may, the ACS refused to reverse its decision. Throughout WWI and WWII, psychiatry and the military had made uneasy bedfellows. Referred to derogatively as ‘trick cyclists,’ psychiatrists were often viewed negatively by Army officers and fellow doctors. While significant progress had made to dispel misconceptions, psychiatry remained misunderstood by many and maligned by some. The stigma surrounding mental illness and mental health professionals continued to play a role in the decision making process.209
Recruitment figures for psychiatrists continued to decline dramatically from 1945-1950. The RAMC could not compete with the NHS in terms of pay and opportunities for professional advancement. On 20 March 1945, ADA Psych Lt. Col. Copeland wrote a letter in which he noted that the DAP currently employed 197 psychiatrists and estimated that the
205 Advisory Committee of Psychologists, Record of a Meeting, 9 Nov. 1946, TNA: WO 32/11974. 206 Ibid. 207 Adjutant General Sir Richard Nugent O’Connor to Army Council Secretariat, 5 Dec. 1946, TNA: WO 32/11974. 208 Advisory Committee of Psychologists, Record of a Meeting, 9 Nov. 1946, TNA: WO 32/11974. 209 Jones and Wessely, Shell Shock to PTSD, 116-117.
69 peacetime Army would need to retain the services of 80 psychiatrists in order to meet minimum global requirements. Several months later, Director of Army Psychiatry Brigadier Sandiford made similar estimates.210 Five years later in May 1950, the RAMC had only 12 consultant psychiatrists on staff. This represented a deficiency of nearly 66%.211 While the DGAMS predicted that this figure would rise to 17 by July, the numbers were still far below establishment.212 There was no short-term solution to the problem. Only 40% of general duty officers qualified annually to study for specialist qualifications and even fewer chose to train in psychiatry.213 Moreover, short service commissions had failed to attract the necessary recruits and conscription only applied to recently qualified doctors rather than experienced clinicians. The RAMC could not rely upon nurses and orderlies either as too few members of staff were specially trained in mental health.214
Although there were fewer psychiatrists in the RAMC, there was an ever-increasing demand for their services. Beginning in 1947, the British armed forces adopted a new recruit screening system. Developed by the Canadian military during WWII, PULHEMS stands for physique, upper limbs, locomotion, hearing, eyesight, mental functioning and stability. Personnel selection officers assessed troops in each category and awarded points accordingly.215 Intelligence and psychological fitness formed an important part of the
210 Assistant Director of Army Psychiatry Lieutenant Colonel N Copeland, Post-War Army Schools, 20 Mar. 1945, TNA: WO 32/11971. Director of Army Psychiatry Brigadier HA Sandiford, Minutes of Psychiatric Advisory Committee, 5 July 1945, TNA: WO 32/13462. 211 Army Medical Advisory Board, Minutes of Meeting, 19 May 1950, TNA: WO 32/13465. 212 Ibid. 213 Adjutant General Sir John Treddinick Crocker, Paper for Consideration by the Army Council: Deficiency of Medical Officers in the Royal Army Medical Corps, Apr. 1953, TNA: WO 32/13465. 214 In Shell Shock to PTSD, Edgar Jones and Simon Wessely have also noted that, ‘In the ten years from 1948, at a time when the British Army grew from 418,000 to 450,000, the number of military and civilian psychiatrists employed was cut from 82 to 42.’ Jones and Wessely, Shell Shock to PTSD, 117. 215 The British Army used a modified version of the PULHEMS system called PULHEEMS. Eyesight was measured and scored for the left and right eyes independently. While the British first
70 overall evaluation process.216 A proportion of recruits were sent for further tests when the examiners deemed it necessary. Every month, around 17% or 1,800 recruits were sent to see a psychiatrist.217 The advent of National Service meant that there was always a steady stream awaiting an appointment. This was a significant workload for the decreasing number of qualified psychiatrists and the rising number of mentally ill troops only compounded the situation. In the Report on the Health of the Army 1949-1950, the authors indicated that since the end of WWII, ‘psychiatric disorders [had become] a major source of manpower wastage.’218 They noted that, ‘This is certainly the feature of post-war discharges which contrasts most strikingly with the pre-war invalidings, when the total discharges were averaging about half the present level, and the rate for psychiatric discharges was about 1.3 per 1,000 as against six or eight times that number now.’219 In 1949, psychiatric discharges rose to a staggering 10.74 per 1,000 men.220 The authors of the report attributed this rise to, ‘an increasing awareness of the psychiatric element in many diseases.’221 They explained that, ‘many men formerly discharged through administrative channels as unsatisfactory soldiers [were] now discharged on medical grounds as psychiatric cases….The tempo of the modern scientific army is such that it is less able to tolerate individuals of lowered
began to use this system in 1944, they also employed a number of other testing and screening methods. In 1947, they decided to apply PULHEEMS universally. Anon, Pulheems--Army Administrative Pamphlet, 30 Sept. 1946, TNA: WO 32/10957. Command Psychiatrist Lieutenant Colonel Robert James Rosie, Comments for the Interdepartmental Committee on the Standardization of Medical Categories for Fighting Services, 14 June 1948, TNA: WO 32/10957. Major RG Fletcher, Loose Minute: Pulheems Examinations, 23 Dec. 1947, TNA: WO 32/10957. Deputy Assistant Director of Army Health Major RG Fletcher, Loose Minute: Army Publications-- The British Army System of Medical Categorization, 8 May 1947, TNA: WO 32/10957. 216 Deputy Assistant Director of Army Psychiatry Jenkins, The Application of the Pulheems System of Medical Classification to the Army, Part II: Administrative, 11 Oct. 1946, TNA: WO 32/10957. Anon, The Application of the Pulheems System of Medical Classification to the Army, March 1947, TNA: WO 32/10957. 217 Standing Committee of Service Ministers, Specialists in the Royal Army Medical Corps, Annex A to ACS/B/3023, 26 July 1949, TNA: WO 32/13369. 218 War Office, Report on the Health of the Army 1949-1950, 27 Mar. 1953, TNA: WO 279/610. 219 Ibid. 220 Ibid. 221 Ibid.
71 intelligence or with the lesser degrees of mental deficiency.’222 There was no indication that the figures would decline in the near future. While the demand for psychiatrists had increased, the supply was far from adequate.
Conclusion When the Korean War erupted, neither the RCAMC neuropsychiatric division nor the RAMC Directorate of Army Psychiatry was prepared. The years from 1945-1950 had not been kind. Due to an unforgiving economic climate, both countries had cut defence spending significantly. This undermined the quality of programmes throughout the Canadian and British forces. In addition, peacetime recruitment proved to be more difficult than first anticipated. It was especially taxing for highly specialised sections of the military, such as the medical corps. Peace did not offer the pay or clinical opportunities, which had attracted doctors into service throughout WWII. Consequently, neither the RCAMC nor the RAMC were able to attract the quantity or quality of personnel that they required. In the United Kingdom, the conscription of young physicians only served to further undermine the standard of available care. National Service medical officers lacked the expertise that the RAMC so dearly needed. By 1950, military medicine was in a state of disrepair on both sides of the Atlantic, as was Army psychiatry. Since WWII, important leadership had been lost and mental healthcare services had contracted significantly. It had been impossible to avoid the funding and recruiting difficulties endemic in the post-war defence community. Be that as it may, these conclusions were of little consolation in 1950. For the next three years, Commonwealth troops faced dangerous and difficult conditions in Korea. Their lives now depended on the RCAMC and RAMC’S ability to adapt to the exigencies of the Korean battlefield.
222 Ibid.
72
Chapter 3 Together We Stand: 1 Commonwealth Division Organisation and Administration (1950-1953)
73 Introduction On 21 July 1953, an article entitled, ‘Commonwealth Forces’ Record in Korea: A Successful Experiment,’ appeared in The Times. A correspondent for the newspaper praised the division, reporting that, ‘history will record that this 1st British Commonwealth Division was an experiment well worth making. It has acquitted itself valiantly in the Korean fighting.’223 For over two years, soldiers from Canada, Australia, New Zealand and Britain had worked together in an integrated division. While they had fought together before, the Commonwealth countries had never cooperated so closely with one another. By the end of hostilities, they had, ‘achieved an outstanding reputation.’224 Throughout the war, American commanders frequently chose Commonwealth units for dangerous and important assignments. 225 Commonwealth medics had a similar reputation to their combat counterparts. Mortality rates dropped from 66 per 1,000 wounded during World War II to 34 per 1,000 in Korea.226 Psychiatric casualties accounted for around 5% of wounded or sick Commonwealth soldiers.227 The efficiency of soldiers and medical officers on the
223 ‘Commonwealth Forces’ Record in Korea: A Successful Experiment,’ Times, 21 July 1953. 224 Max Hastings, The Korean War, Pan Grand Strategy Series (UK: Pan Macmillan Books, 2000), 286. Robert J O’Neill, Australia in the Korean War 1950-1953, Vol. II, Combat Operations (Canberra, Australia: Australian War Memorial and the Australian Government Publication Service, 1985), 173-174, 239. Major P Devine, ‘La Belle Alliance—Lessons for Coalition Warfare from the Korean War 1950- 1953,’ Australian Defence Force Journal No. 118 (May/June 1996): 56. 225 David French, Army, Empire and the Cold War: The British Army and Military Policy, 1945- 1971 (Oxford: Oxford University Press, 2012), 141. General Bruce C Clarke, interview by Jerry N Hess, 14 January 1970, Harry S Truman Library and Museum, date accessed 20 Apr. 2013, http://www.trumanlibrary.org/oralhist/clarkeb.htm 226 Ted Barris, Deadlock in Korea: Canadians at War 1950-1953 (Toronto: Macmillan Canada, 1999), p. 110. Eric Linklater, Our Men in Korea (London: Her Majesty’s Stationery Office, 1952), 66. Lieutenant Colonel Herbert Fairlie Wood, Strange Battleground: The Operations in Korea and their Effects on the Defence Policy of Canada (Ottawa: Queen’s Printer and Controller of Stationary, 1966), 258-259. 227 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, Library and Archives of Canada/ Bibliothèque et Archives Canada (Hereafter cited as LAC): RG24-C-3, Volumes 18395- 18397. Captain JJ Flood, ‘Psychiatric Casualties in UK Elements of Korean Force: Dec., 1950—Nov., 1951,’ Journal of the Royal Army Medical Corps 100, 1 (Jan. 1954): 46.
74 ground is often determined by the decisions and actions of their superiors. In this chapter, I explore how Commonwealth forces were organised both before and after the formation of the division in July 1951. I review the reasons why the division was created and how the countries in question divided operational and administrative responsibilities between themselves. In particular, I look at how the medical services were organised and run on a daily basis. What were the positives and negatives of such close inter-allied cooperation? By the early 1950s, the Commonwealth countries were becoming increasingly independent of each other. What effect, if any, did inter-allied relations have upon the efficiency of operations and the quality of divisional healthcare? Finally, how did they succeed in compromising with one another and working together?
Caught Unawares (25 June 1950-28 July 1951) When the North Korean People’s Army (NKPA) invaded South Korea in the early hours of Sunday, 25 June 1950, the world was largely caught unawares.228 Few had expected that fighting would erupt in the Far East.229 The invasion represented a major challenge to international security and the first time that the Cold War turned hot.230 Several days later, the United Nations (UN) called upon its member states to, ‘furnish such assistance to the Republic of Korea [South Korea] as may be necessary to repel the armed attack and to restore international peace and security in the area.’231 Four divisions of American troops were immediately despatched to Korea from occupation duties in Japan as part of Task
228 Hastings, The Korean War, 45-48. Wood, Strange Battleground, 10-12. 229 General Sir Anthony Farrar-Hockley, The British Part in the Korean War, Vol I: A Distant Obligation (London: HMSO, 1990), 210-211. 230 Peter N Farrar, ‘Britain’s Proposal for a Buffer Zone South of the Yalu in November 1950: Was it a neglected opportunity to end the fighting in Korea?’ Journal of Contemporary History 18, No. 2 (Apr. 1983): 327. William TR Fox, ‘Korea and the Struggle for Europe,’ Journal of International Affairs 6, No. 2 (1952): 130-131. Farrar-Hockley, A Distant Obligation, vii, 32, 113. 231 83 (1950), Resolution of 27 June 1950 [S/1511], as quoted in, Evan Luard, A History of the United Nations: The Years of Western Domination 1945-55, Volume I (London and Basingstoke: The Macmillan Press Ltd., 1982), 241-242.
75 Force Smith.232 Shortly thereafter, General Douglas MacArthur of the United States Army was appointed as Commander-in-Chief of the United Nations Command (UNC).233
The United Kingdom, Canada, Australia and New Zealand were also quick to respond to the UN’s call for help. They were eager to support the United Nations in its effort to promote collective security. In addition, each country wished to foster closer political, economic and defence relations with the United States. 234 Australia was the first Commonwealth country to announce that it would dedicate naval forces to Korea. The destroyer Her Majesty’s Australian Ship (HMAS) Bataan and the frigate Her Majesty’s Australian Ship Sholhaven arrived in Japanese waters on 1 July 1950.235 In the days and weeks that followed, ships from the United Kingdom, Canada and New Zealand all sailed for the Far East.236
232 Tim Carew, The Commonwealth at War (London: Cassell & Company Limited, 1967), 13, 27. Hastings, The Korean War, 7. 233 Hastings, The Korean War, 438. Jeffrey Grey, The Commonwealth Armies and the Korean War: An Alliance Study (Manchester and New York: Manchester University Press, 1988), 27. David Smurthwaite and Linda Washington, Project Korea: the British soldier in Korea, 1950-1953 (London: National Army Museum, 1988), 14. 234 Robert J O’Neill, Australia in the Korean War 1950-1953, Vol. I, Strategy and Diplomacy (Canberra: Australian War Memorial and the Australian Government Publication Service, 1981), xv-xvi. 235 Royal Australian Navy ships sent to Korea between 1950-1953 include: Frigates: Her Majesty’s Australian Ship (HMAS) Shoalhaven, Condamine, Murchison and Culgoa Destroyers: HMAS Warramunga, Anzac, Bataan and Tobruk Aircraft carriers: HMAS Sydney Australian War Memorial. ‘War at Sea: the Royal Australian Navy in Korea,’ last modified 2013. http://www.awm.gov.au/exhibitions/korea/ausinkorea/navy/ Farrar-Hockley, A Distant Obligation, 53. 236 The Royal Canadian Navy Ships sent to Korea included: Destroyers: Her Majesty’s Canadian Ship (HMCS) Athabaskan, Cayuga, Crusader, Haida, Huron, Iroquois, Nootka and Sioux The Royal Navy Ships included: Destroyers: Her Majesty’s Ship (HMS) Concorde, Cockade, Comus, Consort, Constance, Cossack, Crusader and Charity Cruisers: HMS Belfast, Ceylon, Birmingham, Newcastle, Jamaica, and Kenya Fleet carriers: HMS Ocean, Triumph, Unicorn, Theseus and Glory
76 By early August, American troops were forced to retreat in the face of overwhelming enemy opposition and withdraw to a perimeter around the city of Pusan on the south coast of Korea.237 Author Tim Carew has noted that, ‘by the first week in August the United States Army in Korea had suffered…15,000 casualties.’238 The officers and men of Task Force Smith were neither well equipped nor well prepared for the intensity of combat that they would encounter in Korea. The majority of American troops were members of the Japanese occupation force and had grown accustomed to comfortable living conditions.239 In comparison, the North Korean soldiers were initially much better prepared for the privations of an active campaign. Many were veterans of the recent Chinese civil war (1946-1950).240 As American casualties climbed, the Commonwealth countries came under
Sloops/Frigates: HMS Hart, St Brides Bay, Opossum, Cardigan Bay, Sparrow, Blackswan, Alacrity, Amethyst, Mounts Bay, Whitesand Bay, Morecambe Bay, Crane, and Modeste Fleet Supply Ships: Royal Fleet Auxiliary (RFA) Wave Premier, Wave Prince, Wave Baron, Wave Sovereign, Wave Chief, Wave Knight, Brown Ranger and Green Ranger Hospital Ships: HMS Maine Depot Ships: HMS Tyne Submarines: HMS Telemachus Royal New Zealand Navy Ships included: Frigates: Her Majesty’s New Zealand Ship (HMNZS) Pukaki, Tutira, Taupo, Hawea, Rotoiti, and Kaniere Gordon L Rottman, Korean War Order of Battle: United States, United Nations and Communist Ground, Naval, and Air Forces, 1950-1953 (Westport, CT: Greenwood Publishing Group, 2002). Farrar-Hockley, A Distant Obligation, 52-53. General Sir Anthony Farrar-Hockley, The British Part in Korean War, Vol. II, An Honourable Discharge (London: HMSO, 1995), 295-329. Veterans Affairs Canada, ‘Canadians in Korea: Air and Naval Support,’ last modified 11 February 2013. http://www.veterans.gc.ca/eng/history/koreawar/valour/airnaval André Kirouac, ‘The Korean War and the Royal Canadian Navy,’ Naval Museum of Québec, last modified May 2012, http://www.navy.forces.gc.ca/navres/NMQ_MNQ/recherchestheKoreanWar_laGuerreDeCoree/inde x-eng.asp. ‘Post-war operations-Royal NZ Navy,’ New Zealand History Online, last modified 7 Feb. 2013, http://www.nzhistory.net.nz/war/royal-new-zealand-navy/post-war-operations 237 Carew, The Commonwealth at War, 71. Fairlie-Wood, Strange Battleground, 42. Hastings, The Korean War, 96-115. 238 Carew, The Commonwealth at War, 27. 239 Ibid., 13. 240 Lee Jong-Seok, ‘Struggling through times of darkness and despair: Korean Communists from the anti-Japanese resistance to the Chinese Civil War,’ in Foreigners and Foreign Institutions in
77 increasing pressure to dedicate ground troops and on 26 July 1950, announcements were finally made to that effect in London, Canberra and Wellington.241 The British government agreed to send a brigade to the region as soon as possible.242 Australia and New Zealand both promised to recruit men for the purposes of a, ‘special volunteer force…for Korea and for service in any other area to which the conflict might spread.’243 The Canadian Cabinet originally rejected the idea of deploying ground troops to the Far East for reasons of economy and manpower. However, they soon reversed their decision in light of political considerations and the tide of public opinion. Prime Minister Louis St Laurent announced the recruitment of a Canadian Army Special Force (CASF) for Korea on 7 August.244
The British 27th Brigade was the first Commonwealth contingent to land at Pusan on 28 August 1950. Commanded by Brigadier Basil Aubrey Coad, the unit included troops from the 1st Battalion of the Argyll and Sutherland Highlanders and the 1st Battalion of the Middlesex Regiment.245 In the summer of 1950, the brigade was, ‘on active service defending the frontier of [Hong Kong] with China.’246 According to British historian General Sir Anthony Farrar-Hockley, ‘Almost three quarters of the brigade were national service officers and soldiers, many of whom had been posted from basic training just prior to embarkation. It was thus a relatively raw force.’247 Therefore, it came as a surprise when
Republican China. Chinese Worlds. eds. Anne-Marie Brady and Douglas Brown (New York: Routledge, 2013), 263. 241 ‘Australian Force to go to Korea,’ West Australian, 27 July 1950. 242 Ibid. 243 Ibid. 244 Wood, Strange Battleground, 22. 245 Farrar-Hockley, A Distant Obligation, 116. Franklin B Cooling, ‘Allied Interoperability in the Korean War,’ Military Review 63, No. 6 (June 1983): 28. Smurthwaite and Washington, Project Korea, 14. Brigadier Cyril Nelson Barclay, The First Commonwealth Division: The Story of British Commonwealth Land Forces in Korea, 1950-1953 (Aldershot, UK: Gale & Polden Limited, 1954), 12. 246 Farrar-Hockley, A Distant Obligation, 125. 247 Ibid., 126.
78 Coad and his colleagues were informed on the evening of 18 August that 27 Brigade should prepare to depart for Korea. The British government had originally intended to send the 29th Independent Infantry Brigade Group, which was based in Colchester and better provisioned for a major deployment. However, the Americans urgently needed assistance and 27 Brigade was in a better position to travel to Korea quickly.248 Upon arrival in theatre, the unit had to wait for its transport to arrive and was, ‘sadly understrength.’ 249 The government would not allow National Servicemen under the age of 19 to accompany their comrades to Korea. Consequently, volunteers from the King’s Scottish Light Infantry (KSLI), King’s Own Scottish Borderers (KOSB), the Royal Leicestershire Regiment and the Staffordshire Regiment were hastily assembled to act as their replacements.250 29 Brigade finally reached Korea several months later in November. In contrast to 27 Brigade, it was supported by, ‘armour, artillery, field engineers, signals and the administrative services--supply and transport, ordnance, a medical and dental element for the recovery and treatment of casualties, and electrical and mechanical engineers for the recovery and repair of the brigade’s hardware.’251
The remaining Commonwealth countries began preparing ground troops for Korea throughout August and September. The Canadian, New Zealand and Australian armed forces had shrunk substantially since 1945.252 While the latter two countries both had national service training schemes in place, legislation and widespread public opposition precluded the use of conscripts overseas. Therefore, there was no option but to recruit the
248 Ibid., 126-127. 249 Carew, The Commonwealth at War, 43. 250 Farrar-Hockley, A Distant Obligation, 116, 126, 128-129. Grey, The Commonwealth Armies, 34-35. Michael Hickey, The Korean War: The West Confronts Communism 1950-1953 (London: John Murray, 2000), 65. Smurthwaite and Washington, Project Korea, 9. 251 Farrar-Hockley, A Distant Obligation, 116. 252 Wood, Strange Battleground, 16-17. Richard Trembeth, A Different Sort of War: Australians in Korea 1950-53 (Melbourne: Australian Scholarly Publishing, 2005), 19.
79 necessary soldiers.253 The number of men who volunteered for service in Korea initially overwhelmed authorities in all three countries. Over 10,000 Canadians, ‘were…enlisted under the Special Force terms of service, the vast majority of these during the hectic first two weeks.’254 New Zealanders and Australians were similarly eager in their rush to the colours. Thousands of volunteers, ‘thronged the desks of recruiting offices,’ in order to join 16 New Zealand Field Artillery Regiment (16 NZ Fd Regt) and the Royal Australian Regiment (RAR).255 Nearly 6,000 New Zealanders joined Kayforce, which was roughly six times the number required.256 Australians were so enthusiastic to sign up that the Army could afford to reject three out of four men who volunteered to fight.257 A large proportion of the volunteers were veterans of World War II. For example, around 45% of CASF members had seen action between 1939-1945 and 42% of New Zealand’s Kayforce had previous military service.258
As Commonwealth units arrived in Korea, they were placed under the command of 27 Brigade. The 3rd Battalion Royal Australian Regiment (3RAR) was the first to land on 28 September 1950. They were eventually joined by the 2nd Battalion Princess Patricia’s Canadian Light Infantry (2PPCLI) in December and 16 New Zealand Field Artillery
253 O’Neill, Strategy and Diplomacy, 31. Grey, The Commonwealth Armies, 90. Trembeth, A Different Sort of War, 19. Malcolm van Gelder and Michael J Eley, ‘Anzacs, Chockos, and Diggers: A Portrait of the Australian Enlisted Man,’ in Life in the Rank and File: Enlisted Men and Women in the Armed Forces of the United States, Australia, Canada, and the United Kingdom, eds. David R Segal and H Wallace Sinaiko (USA: Pergamon-Brassey’s International, 1986), 17. 254 Brent Byron-Watson, Far Eastern Tour: Canadian Infantry in Korea, 1950-1953 (Montreal QC and Kingston, ON: McGill Queen’s University Press, 2002), 27. 255 O’Neill, Combat Operations, 18. McGibbon, Politics and Diplomacy, 41-44. 256 McGibbon, Politics and Diplomacy, 41. 257 Trembeth, A Different Sort of War, 91, 94. 258 Wood, Strange Battleground, 32. McGibbon, Politics and Diplomacy, 45.
80 Regiment in January.259 Despite intense preparations, none of the units from Australia, Canada or New Zealand had completed their training when they sailed for Korea. They continued to drill while in transit and ran a series of training exercises when they disembarked at Pusan.260
Throughout 1950 and early 1951, Commonwealth troops were under the operational control of American commanders. However, administrative control rested with Lieutenant General Sir Horace Robertson. Since 1946, Robertson had been in command of the British Commonwealth Occupation Force (BCOF) in Japan, which included personnel from the United Kingdom, New Zealand and India, as well as soldiers from his own home country of Australia.261 The Australians were the only remaining contingent in theatre when the Korean War erupted in June 1950. While the Australian Joint Chiefs of Staff (COS) had planned to withdraw BCOF, the plans were quickly cancelled. Over the following months, Robertson and his team supplied and provided logistical support to an ever-expanding number of Commonwealth troops bound for Korea. BCOF headquarters was the Japanese coastal town of Kure.262 Located on, ‘the southern tip of the main…island of Honshu,’ Kure was ten miles from the city of Hiroshima and a day’s journey by ship to Pusan.263
Medical support was patchy during the early months of the war and Commonwealth medical units were slow to arrive. Regimental medical officers (RMOs) accompanied 27
259 Grey, The Commonwealth Armies, 67, 73. O’Neill, Combat Operations, 101, 105. Wood, Strange Battleground, 47-48, 53. 260 McGibbon, Politics and Diplomacy, 41-47. Grey, The Commonwealth Armies, 77. 261 Eiji Takemae, The Allied Occupation of Japan (New York: The Continuum International Publishing Group Incorporated, 2003), 131-137. 262 Ibid., 133. 263 Wood, Strange Battleground, 134.
81 Brigade, 3RAR, 2PPCLI and 16 NZ Fd Regt.264 The 26th British Field Ambulance was the first medical unit of any size to travel to the Far East. Accompanying 29 Brigade, the 26th Field Ambulance was commanded by Captain WJ James of the Royal Army Medical Corps (RAMC) and had 13 officers and 125 men on strength.265 Shortly thereafter, the 60th Indian Parachute Field Ambulance joined 27 Brigade. The unit represented India’s only contribution to the Commonwealth war effort in Korea. 266 Under the leadership of Lieutenant Colonel AG Rangaraja of the Indian Army Medical Service (IAMS), the staff of the 60th Field Ambulance were universally well-regarded by Commonwealth troops during the war.267 Around the same time, 130th Australian General Hospital was converted into No. 29 British General Hospital. Located at the occupation force’s headquarters in Kure, the hospital was ideally located to receive and treat casualties. Originally commandeered from the Japanese Navy, the buildings had been in use by the Australian Army since
264 Darryl McIntyre, ‘Australian Army Medical Services in Korea,’ in Australia in the Korean War 1950-1953, Vol. II, Combat Operations by Robert J O’Neill (Canberra: Australian War Memorial and the Australian Government Publication Service, 1985), 570-571. Simon C Gandevia, ‘An Australian army doctor--Bryan Gandevia,’ in War Wounds: Medicine and the Trauma of Conflict, eds. Ashley Ekins and Elizabeth Stewart (Wollombi, NSW: Exisle Publishing Limited, 2011), 110-115. Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, The National Archives at Kew (Hereafter cited as TNA): WO 308/21. O’Neill, Combat Operations, 237. McGibbon, Politics and Diplomacy, 76. 265 Farrar-Hockley, An Honourable Discharge, 427. 266 To preserve peaceful relations with the Chinese, the Indian government did not dedicate ground troops to the war in Korea. William Whitney Steuck, The Korean War: An International History (Princeton, NJ: Princeton University Press, 1995), 156, 196. 267 Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. Hub Gray, Beyond the Danger Close: The Korean Experience Revealed: 2nd Battalion Princess Patricia’s Canadian Light Infantry (Calgary: Bunker to Bunker Books, 2003), 19. O’Neill, Combat Operations, 85-88, 286-287. Grey, The Commonwealth Armies, 96. Barclay, The First Commonwealth Division, 39, 44, 160, 184. Linklater, Our Men in Korea, 65. Farrar-Hockley, An Honourable Discharge, 427.
82 1945.268 Prior to the Korean War, the hospital had been a small 200-bed facility that performed an average of only four operations per month. Between November and December 1950, it was expanded to accommodate 400 patients and meet the needs of troops in Korea.269 The hospital was the: ...first integrated unit of its kind in the United Nations Command, staffed by British, Canadian and Australian personnel. The commanding officer, a principal matron and registrar were all normally provided by the British Army. The Canadian and Australian components each had their own matron and administrative officer. The wards were staffed on an integrated system, with the specialist being of a different nationality from the ward sisters. A full complement of specialists was also present.270
The Commonwealth countries initially relied upon the US Army and US Army Medical Corps to supplement their resources and make up shortfalls in supplies, transport and manpower.271 For example, if a Commonwealth unit could not attend to a patient, American medics took responsibility for treating and evacuating the soldier. 272 While this arrangement was convenient, it was also problematic. Besides the Commonwealth countries: Colombia, Belgium, France, Greece, Ethiopia, the Netherlands, Luxembourg, the
268 The buildings had been in use as a Japanese naval hospital since the late nineteenth century. Located in a mountainous region, the hospital was built on large rollers to accommodate for earthquake tremors. Dr Kenneth Davison, interview by author; Newcastle-upon-Tyne, UK, 17 Nov. 2010. David Oates, ‘Memories of Kure Japan: A Personal Experience,’ Memories of Kure Japan: A Medic in the Korean War, http://www.kurememories.com/page4.htm. 269 JC Watt, Surgeon at War (London: George Allen & Unwin, 1955), 147. ‘Discussion on Military Medical Problems in Korea,’ Proceedings of the Royal Society of Medicine 46 (10 June 1953): 1037. McIntyre, ‘Australian Army Medical Services in Korea,’ 571. 270 McIntyre, ‘Australian Army Medical Services in Korea,’ 571. 271 McGibbon, Politics and Diplomacy, 76. Hickey, The Korean War, 92. 272 Albert E Cowdrey, The Medic’s War: The United States Army in Korea (Washington, DC: Centre of Military History, 1987), 150-250. Colonel Geoffrey Anderton, ‘The Birth of the British Commonwealth Division Korea,’ Journal of the Royal Army Medical Corps 99, No. 2 (Jan. 1953): 47. Lieutenant Colonel Bernard LP Brosseau, ‘Notes From Korea: Medical Services,’ Canadian Army Journal 8, No. 1 (Apr. 1953): 119. Barclay, The First Commonwealth Division, 87.
83 Philippines, Turkey and Thailand all contributed ground troops to the United Nations Command. Without exception, the US Army provided these units with logistical and medical support.273 As new contingents arrived in Korea, the Americans struggled to meet the requirements of their allies. They had neither the personnel nor the bed space to accommodate the rising number of sick and wounded. Consequently, many soldiers from Canada, Britain, Australia and New Zealand were evacuated from Korea to Japan for minor illnesses and injuries. The Americans often failed to notify Commonwealth authorities of the evacuation and it could take days or weeks to locate an individual casualty.274
Lieutenant General Charles Foulkes, Chief of the Canadian General Staff, was the first to suggest the idea of a Commonwealth division on 18 July 1950.275 The government of New Zealand, ‘was the first to raise the proposal for serious consideration with the other members of the Commonwealth,’ a little over a week later on 26 July.276 Despite Foulkes’ endorsement, Canadian Prime Minister St. Laurent and Secretary of State for External Affairs Lester B Pearson were strongly opposed to the suggestion.277 In late August, ‘The Canadians communicated their views to the rest of the Commonwealth in the form of an aide-mémoire to the British government, copies of which were circulated to the other Dominions by the British.’278 While the Canadians were more than willing, ‘to serve alongside their comrades from the United Kingdom and other Commonwealth nations as they had been accustomed to do in the past,’ they were against the idea of a division.279 As historian Jeffrey Grey has noted, the Canadians, ‘wished to stress the UN character of the
273 Grey, The Commonwealth Armies, 172. 274 Deputy Director of Medical Service, British Commonwealth Occupation Force, Minutes of Conference at British Commonwealth Occupation Force Medical Headquarters, 15 Aug. 1950, Australian War Memorial (Hereafter cited as AWM), File 417/20/32, part I: Medical Policy. Anderton, ‘The Birth of the British Commonwealth Division, 47. McIntyre, ‘Australian Army Medical Services.’ 572. 275 O’Neill, Strategy and Diplomacy, 224. 276 Ibid., 78. 277 Wood, Strange Battleground, 43-44. 278 Grey, The Commonwealth Armies, 92. 279 Ibid.
84 operations to the maximum extent possible.’280 They were open to the formation of a unit that included other non-Commonwealth countries. Failing this, the Canadians would agree to participate in a Commonwealth division as long as it was not labelled as such and suggested the title of 1st United Nations Division.281 Since the 1930s, the Canadians had been distancing themselves from Britain and cultivating closer economic and political ties to the United States. Canadian politicians were keen to highlight the country’s sovereignty and independence from the United Kingdom. 282 In 1944 and 1946, Prime Minister Mackenzie King rejected proposals for centralised defence cooperation between the Commonwealth countries by arguing that any close ties to Britain, ‘might prejudice defence discussions vis-à-vis the United States.’283 The Canadians feared that the creation of a Commonwealth division would suggest that the country was still a British satellite. Consequently, they continued to obstruct discussions concerning the matter throughout the autumn of 1950. As UN forces broke out of the Pusan perimeter and won a series of significant victories against the NKPA, it appeared that the war would be over soon and there would be no need to further consider the creation of a division.284
Any hopes that the war would be short-lived were dashed when the Chinese government decided to intervene. On 1 October 1950, UN forces advanced across the border between
280 Ibid. 281 Directorate of History and Heritage, Department of National Defence, Canada and the Korean War (Canada: Art Global, 2002), 38. 282 David Reynolds, ‘From World War to Cold War: The Wartime Alliance and the Post-War Transitions, 1941-1947.’ Historical Journal 45, No. 1 (Mar. 2002): 212-215. JN Hitsman, Report No. 90: Canada’s Post-War Defence Policy, 1945-1950, 1961, LAC: RG24-C- 6-o, Volume 6928, File No. 90. John Darwin, ‘Imperial Twilight, or When Did the Empire End,’ in Canada and the End of Empire, ed. Philip Buckner (Vancouver: University of British Columbia Press, 2005), 21. John Hilliker and Greg Donaghy, ‘Canadian Relations with the United Kingdom at the End of Empire, 1956-1973,’ in Canada and the End of Empire, ed. Philip Buckner (Vancouver: University of British Columbia Press, 2005), 26. 283 JN Hitsman, Report No. 90: Canada’s Post-War Defence Policy, 1945-1950, 1961, LAC: RG24- C-6-o, Volume 6928, File No. 90. Grey, The Commonwealth Armies, 92, 96. 284 Grey, The Commonwealth Armies, 77.
85 North and South Korea, which was commonly known as the 38th parallel. Throughout October, they continued to march northwards towards the Yalu River and the Sino-Korean border. Fearing that the Americans were planning to invade China after they had subdued North Korea, officials in Beijing decided to act.285 Moving only at night, Chinese troops began to cross the Yalu River and march southwards in late October and on 1 November, ‘they struck with overwhelming force against US troops…and sent them into retreat.’286 Although Chinese Premier Zhou Enlai had warned the UNC that China would intervene if UN forces advanced towards the border, the attack had come as a surprise to the Americans and their allies.287 By mid-November, there were approximately 250,000 Chinese troops in theatre and more were arriving by the day.288 Despite launching several offensives, UN forces suffered heavy casualties and were forced to abandon their positions. China’s entry into the war was a devastating blow to the UNC and a decisive turning point.289
As Chinese troops streamed into Korea, the Americans pressed Canada and the other Commonwealth countries to dedicate more ground troops and form a division. On 15 November, Lieutenant General Robertson reported to the Chiefs of Staff in Melbourne, Wellington and London. He wrote that, ‘General Walker commanding Eighth Army expressed to me the opinion that it would help him greatly…if we would form a British Commonwealth Division which would take care of all British Commonwealth military units.’290 Robertson pushed his superiors to come to decision with regards to the division,
285 Barclay, The First Commonwealth Division, 3. Farrar-Hockley, A Distant Obligation, 269, 273, 276. 286 Australian War Memorial, ‘Korean War, 1950-1953,’ http://www.awm.gov.au/atwar/korea.asp 287 Callum MacDonald, Britain and the Korean War, Making Contemporary Britain Series, eds. Anthony Seldon and Peter Hennessy (Oxford: Basil Blackwell, 1990), 38. 288 Peter Lowe, ‘An Ally and a Recalcitrant General: Great Britain, Douglas MacArthur and the Korean War, 1950-1,’ English Historical Review 105, No. 416 (July 1990): 635. 289 Barclay, The First Commonwealth Division, 34. 290 Commander-in-Chief, British Commonwealth Forces Korea, Lieutenant General Sir Horace Robertson to Chief of General Staff, Melbourne, Chief of General Staff, Wellington, Chief of Imperial General Staff, London, Cipher Message, 15 Nov. 1950, National Archives of Australia (Hereafter cited as NAA): CRS A5954, Box 1661, file 4.
86 explaining that, ‘The Americans are so used to us managing our own affairs that they cannot understand our present piecemeal organisations and from the top down I get the feeling that they hope we will take over all our own affairs.’291 The Canadians finally agreed to a Commonwealth division shortly thereafter in December 1950.292 Be that as it may, fresh obstacles to the union soon emerged. The British government was reluctant to dedicate additional troops and resources to the Korean War. When the Canadians announced on 21 February that they would send the 25th Infantry Brigade Group to Korea, the War Office saw an opportunity, ‘to form a two brigade division and thus recover 27 Brigade.’293 However, it was impossible to withdraw 27 Brigade without serious political and diplomatic repercussions. In March 1951, General MacArthur highlighted the importance of British troops in his discussions on the subject with Robertson. He explained, ‘I would be recreant to realities… if I did not say that the command in Korea is woefully outnumbered and fighting under the severest handicaps and hazards. Its needs and necessity is for reinforcement and steps to the contrary would not fail to increase its difficulties and jeopardy.’294 With this in mind, the British agreed to keep 27 Brigade in the field until the 28th British Commonwealth Infantry Brigade Group could relieve it in April. As 28 Brigade and 25 Brigade landed at Pusan, negotiations for, ‘the formation of a Commonwealth Division of three brigades,’ finally moved forward without any further objections.295
291 Ibid. 292 Anon, Formation of Commonwealth Division for Korea, c 1950, TNA: WO 216/341. O’Neill, Strategy and Diplomacy, 93. Grey, The Commonwealth Armies, 100-101. 293 Farrar-Hockley, An Honourable Discharge, 64. 294 Chief of Imperial General Staff to Lieutenant General Sir Horace Robertson, 12 Mar. 1951, TNA: DEFE 11/209. 295 Farrar-Hockley, An Honourable Discharge, 66. O’Neill, Combat Operations, 166.
87 Shoulder-to-Shoulder: 1st British Commonwealth Division, United Nations Forces (28 July 1951-July 1953) On 28 July 1951, ‘The Commonwealth division flag was formally hoisted [for the first time] at a ceremony,’ attended by representatives of each of the contributing countries.296 The festivities were held at the division’s forward headquarters at Tokchong, which was located close to the front line.297 The new division included 28 British Infantry Brigade, 29 Independent Infantry Group and 25 Canadian Infantry Brigade Group. Commonwealth forces were under the operational control of US I Corps and Lieutenant General John W O’Daniel, who was affectionately known by his troops as ‘Iron Mike.’298 British officer Major General James Archibald Halkett Cassels was appointed as General Officer Commanding (GOC) of the division.299 As the largest contributors to the division, the Canadians and the British provided the majority of staff officers.300 Nevertheless, the Australians and New Zealanders were also represented at headquarters.301 Lieutenant General Robertson remained in administrative control of British Commonwealth forces in Korea (BCFK).302 From Kure, Robertson and a team of Australian officers provided the division with supplies and facilitated the movement of Commonwealth troops.303
296 Farrar-Hockley, An Honourable Discharge, 214. 297 O’Neill, Strategy and Diplomacy, 227. 298 Barclay, The First Commonwealth Division, 86. 299 Smurthwaite and Washington, Project Korea, 17. 300 Anderton, ‘The Birth of the British Commonwealth Division,’ 44. Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. Colonel JS McCannel, Study on Commonwealth Medical Services in Korea, 12 June 1954, Directorate of History and Heritage, Department of National Defence, Canada/La Direction-- Histoire et patrimoine, Ministère de la défense nationale, Canada (Hereafter cited as DHH DND): 681.013 (D48). Hastings, The Korean War, 104. 301 India also contributed several staff officers to the division headquarters in Korea. Anderton, ‘The Birth of the British Commonwealth Division,’ 45. 302 Australian Lieutenant General W Bridgeford succeeded Robertson as commander of British Commonwealth Forces Korea in November 1951. Takamae, The Allied Occupation of Japan, 133. 303 Robertson’s staff also included officers from Britain and New Zealand. Although South Africa did not contribute ground troops to the Commonwealth Division, two South African officers were attached to headquarters in Kure.
88 Like staff positions, chief medical appointments were primarily divided between the British and the Canadians. The Royal Army Medical Corps and Royal Canadian Army Medical Corps (RCAMC) had agreed to provide the bulk of medical support.304 Be that as it may, the first Deputy Director of Medical Services (DDMS) was Colonel CW Nye of the Royal Australian Army Medical Corps (RAAMC). The DDMS was the highest medical authority in theatre and responsible for the overall direction of policy.305 Prior to his appointment, Nye had served as, ‘senior administrative medical officer with BCOF,’ and Assistant Director of Medical Services (ADMS) to Commonwealth forces from January to July 1951.306 The selection of Nye was largely due to Australia’s generous contribution of medical supplies and the divisional hospital. 307 However, the Australian was also a knowledgeable and respected officer. In a newspaper article, he was described by colleagues as a, ‘wise…and willing co-operator.’ 308 While DDMS became a British appointment after May 1952, Nye was a natural choice for the first deputy director.309 Colonel Geoffrey Anderton of the Royal Army Medical Corps filled the position of Nye’s
O’Neill, Combat Operations, 173. Farrar-Hockley, An Honourable Discharge, 207. Grey, The Commonwealth Armies, 105. 304 Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. Colonel JS McCannel, Study on Commonwealth Medical Services in Korea, 12 June 1954, DHH DND: 681.013 (D48). Brigadier CW Nye, Report of visit to Korea, 17-21 Apr. 1951, WO 32/21831. 305 Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. 306 ‘High US Honor for Australian,’ Barrier Miner, 28 Mar. 1951. 307 Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. 308 ‘High US Honor for Australian,’ Barrier Miner, 28 Mar. 1951. 309 The following officers filled the post of DDMS: Brigadier CW Nye, RAAMC, July 1951-May 1952 Colonel JE Snow, RAMC, September 1951-December 1951 Brigadier Francis Joseph O’Meara, RAMC, May 1952-March 1953 Brigadier Franklin, RAMC, March 1953- Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21.
89 second in command as Assistant Director of Medical Services.310 Based at the division’s headquarters in Korea, Anderton was responsible for ensuring that orders were properly issued and executed by officers in the field.311 In addition, he played an instrumental part in positioning medical units and could move them when and where he thought advisable. On a daily basis, he organised everything from the transport of casualties and supplies to the further training of medical officers.312 Anderton had been commissioned into the RAMC in 1927 and served in places such as North Africa, Europe and India. Canadian officers Colonel GL Morgan Smith (May 1952-April 1953) and Colonel JS McCannel (April 1953- April 1954) succeeded him. Both were equally experienced and well regarded by their peers.313
In the summer of 1951, there were four major Commonwealth medical units in Korea: 25 Canadian Field Dressing Station (25 FDS), 25 Canadian Field Ambulance, 26 British Field
310 Grey, The Commonwealth Armies, 105. Farrar-Hockley, An Honourable Discharge, 207. 311 Anderton and his successors held bi-weekly conferences at 25 Canadian Field Dressing Station to inform officers of changes in policy and to address any problems. Anon, Assistant Director of Medical Services War Diary, 1951-1953, TNA: WO 281/886-888. Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397. 312 Anon, Assistant Director of Medical Services War Diary, 1951-1953, TNA: WO 281/886-888. Major General RD Cameron, ‘The British Army Divisional Medical Organisation,’ Journal of the Royal Army Medical Corps 96, No. 3 (Mar. 1951): 237-241. Colonel GL Morgan Smith, Assistant Director of Medical Services Monthly Liaison Letter Serial 14—July 1952, TNA: WO 281/887. Anon, ADMS War Diary 1952-1954, TNA: WO 281/887-889. Davison, interview by author. 313 The following officers filled the post of ADMS: Colonel G Anderton (RAMC) July 1951-May 1952 Colonel GL Morgan Smith (late RCAMC) May 1952-May 1953 Colonel JS McCannel (RCAMC) May 1953-May 1954 Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. Colonel JS McCannel, Study on Commonwealth Medical Services in Korea, 12 June 1954, DHH DND: 681.013 (D48).
90 Ambulance and 60 Indian Field Ambulance.314 Landing in Korea on 8 July 1951, 25 FDS was commanded by Major WR Dalziel (RCAMC) and admitted its first patients on 21 July.315 Initially housed in a school building in Seoul, the unit was originally established to, ‘deal with the minor sick and wounded.’316 During the course of the war, it became, ‘a general hospital in all but name,’ and the centre of Commonwealth medicine in Korea.317 The unit could accommodate 122 medical, 44 psychiatric, 20 surgical and 11 venereal disease patients.318 A wide range of medical specialists were based at the field dressing station and medical symposia and conferences were regularly held there.319 At any one
314 Colonel JS McCannel, Study on Commonwealth Medical Services in Korea, 12 June 1954, DHH DND: 681.013 (D48). 315 The following officers commanded 25 Canadian Field Dressing Station: Major WR Dalziel 5 June 1951-6 January 1952 Major RC Hardman 7 January 1952-15 May 1952 Major JS Hitsman 16 May 1952-12 October 1952 Major JR Arsenault 15 October 1952-28 July 1953 Major LS Glass 29 July 1953-7 January 1954 Major LH Edwards 8 January 1954-28 June 1954 Major GL Stoker 29 June 1954-9 November 1954 Fairlie Wood, 1966, p. 275. 316 Anon, 25 Canadian Field Dressing Station War Diary, Aug. 1951, LAC: RG24-C-3, Volume 18395. Colonel JS McCannel, Study on Commonwealth Medical Services in Korea, 12 June 1954, DHH DND: 681.013 (D48). Anon, 25 Canadian Field Dressing Station War Diaries, 1953, LAC: RG24-C-3, Volume 18397. Anon, Assistant Director of Medical Services War Diaries, 1951-1953, TNA: WO 281/886-888. Barclay, 1954, p. 184. Bill Rawling, Death Their Enemy: Canadian Medical Practitioners and War (Quebec: AGMV Marquis, 2001), 68, 240, 250-1. 317 25 FDS was unusually large for a field ambulance, which usually consisted of only 100 beds. Both 25 Canadian Field Surgical Team (FST) and 25 Canadian Field Transfusion Team (FTT) were attached to the field dressing station throughout the war. GWL Nicholson, Canada’s Nursing Sisters, Historical Publications 13, ed. John Swettenham (Toronto: Samuel Stevens, 1975), 217. Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397. Cameron, ‘The British Army Divisional Medical Organisation,’ 241. 318 Major WR Dalziel, Monthly Progress Report August 1951, 1 Sept. 1951, LAC: RG24-C-3, Volume 18395. 319 Anon, Assistant Director of Medical Services War Diary, 1951-1953, TNA: WO 281/886-888. Captain NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, Mar. 1953, Personal Letters of Dr NG Fraser, Glasgow, UK.
91 time, three field ambulances, each of which consisted of a headquarters and three self- contained forward units, were also in theatre. The forward units or sections typically included a doctor, sergeant, corporal, several lance corporals and privates. Touring the front line, they transported casualties from regimental aid posts (RAPs) to field ambulance headquarters or larger medical units like 25 FDS.320 While every effort was made to ensure that Commonwealth medical units attended to Commonwealth patients, this was not always the case. Casualties were occasionally transported to the Norwegian or American Mobile Army Surgical Hospital (MASH) units, who specialised in areas such as cardiac surgery.321
Throughout the summer and autumn of 1951, the Commonwealth division’s Japanese headquarters and No. 29 British General Hospital continued to expand exponentially. Roughly 4,000 troops from Canada, the United Kingdom, Australia, and New Zealand lived and worked in Kure at any one time.322 In December, No. 29 BGH was renamed the British Commonwealth General Hospital (BCGH) in an effort to reflect its multinational composition. The hospital was ‘spartan’ in appearance but was equipped with all the
Colonel Bryon L Steger, ‘Medical Societies in Korea,’ Medical Bulletin of the United States Army Far East 1, No. 6 (May 1953): 92. Lieutenant NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, 4, 22 Jan. 1953, Personal Letters of Dr NG Fraser, Glasgow, UK. Captain NG Fraser, Monthly Psychiatric Report July 1953, 2 Aug. 1953, LAC: RG24-C-3, Volume 18397. 320 Deputy Director of Medical Services, British Commonwealth Occupation Force, Minutes of Conference at British Commonwealth Occupation Force Medical Headquarters, 15 Aug. 1950, AWM, File 417/20/32, part I: Medical Policy. Bill Trevett, interview by author; Trowbridge, Wiltshire, UK, Nov. 2010. McIntyre, 1985, p. 572. 321 Avinder Gobindpuri, ‘The Forgotten War: Medicine in Korea,’ (BSc diss., University College London, Wellcome Trust, 2005). Colonel JS McCannel, Study on Commonwealth Medical Services in Korea, 12 June 1954, DHH DND: 681.013 (D48). Farrar-Hockley, An Honourable Discharge, 210. Barclay, The First Commonwealth Division, 87. 322 Dr WS Stanbury, The Canadian Red Cross in the Far East, July 1952, Canadian War Museum/Musée canadien de la guerre (Hereafter cited as CWM): 58C 3 22.1. Oates, ‘Memories of Kure Japan,’ http://www.kurememories.com/page4.htm. Davison, interview by author.
92 necessary diagnostic, medical and surgical equipment.323Boasting 1,000 beds, it included personnel from all four of the division’s major contributing countries. Colonel JE Snow of the Royal Army Medical Corps served as BCGH’s first commandant and Director of Medical Services.324
The Positives and Negatives of Inter-Allied Command The benefits of an inter-allied division were immediately apparent. As an integrated formation, the Commonwealth countries had greater political clout and could act in unison in matters of importance.325 By sharing resources, they could solve a variety of previously insurmountable, ‘logistic and operational problems.’326 The British contingent benefited the most from the new status quo. For instance, the Royal Australian Air Force (RAAF) and Royal Canadian Air Force (RCAF) provided the air power needed to transport Commonwealth patients from forward locations like Seoul to BCGH in Japan beginning in July 1951.327 The Dominion countries also proved to be useful allies when supplies were scarce. Based in Singapore, the British Army’s Far Eastern Land Force (FARELF) was responsible for providing the RAMC in Korea with medical stores and equipment. In the spring of 1951, FARELF fell behind rates of consumption and the situation continued to
323 Davison, interview by author. Brigadier JE Snow, War Establishment—British Commonwealth General Hospital, May 1952, TNA: WO 281/892. 324 Anon, 29 General Hospital Summary of Events and Information, Oct. 1951, TNA: WO 281/1278. Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. Headquarters British Commonwealth Forces Korea to the Under Secretary of State War Office, Annual Report on Medical Coordination in Overseas Commands, 3 Dec. 1952, TNA: DEFE 3/317. Brigadier JE Snow, 29 General Hospital—Monthly Liaison Letter, Nov. 1951, TNA: WO 281/1278. Main Administrative Headquarters British Commonwealth Forces Korea, Establishment of British Commonwealth General Hospital, 12 Nov. 1951, TNA: WO 281/1278. 325 O’Neill, Combat Operations, 166. 326 Ibid. 327 Anderton, ‘The Birth of the British Commonwealth Division,’ 47. Andrew and Hunter, ‘The Royal Canadian Army Medical Corps,’ 180.
93 worsen over the following months. The Canadian and Australian contingents were in a position to help and procured the necessary supplies from their sources.328
In spite of the advantages of working together, the Commonwealth Division suffered from manpower problems throughout the war. The manning of British infantry battalions, ‘fell consistently short of establishment by up to twelve per cent.’ 329 British defence commitments were widespread and the Army was forced to rely on a combination of regulars, reservists and National Servicemen who were 19 years of age or older. In 1952, Chief of the Imperial General Staff, Field Marshal Sir William Slim lamented, ‘we have not nearly enough infantry battalions and have had to accept gaps in Germany and the loss of a strategic reserve in this country,’ in order to meet our obligations in the Far East.330 General Michael Montgomerie Alston-Roberts-West, who succeeded General Cassels as GOC of the division, wrote to Adjutant General Sir John Crocker on 29 October 1952.331 He too complained about the issue of manpower. West pointed out that, ‘when a British battalion relieves an Australian or Canadian one it has too few men to fill the holes.’332
The medical services were equally affected by the staff shortages that plagued the rest of the division. Between 1945 and 1950, both the Royal Army Medical Corps and Royal Canadian Army Medical Corps had found it difficult to attract new recruits. The Army was not an appealing employer in the years immediately following World War II. Civilian doctors were better paid and had greater chances of advancement than the average medical
328 Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. 329 Farrar-Hockley, Combat Operations, 375. 330 IM Hurrell, Internal Memorandum, 26 Aug. 1952, TNA: FO 371/99613. 331 General Alston-Roberts-West was known to most of his colleagues as General Mike West for the sake of simplicity. Farrar-Hockley, Combat Operations, 366. 332 General Michael Montgomerie Alston-Roberts-West to Adjutant General Sir John Crocker, 29 Oct. 1952, NAA: CRS A2107.K1.05 (supplement).
94 officer. Therefore, neither the British nor the Canadians were ready for a major deployment when war erupted in the summer of 1950.333 While a staggering number of Canadians volunteered to serve as infantrymen in Korea, very few doctors came forward. The Army struggled to find the personnel necessary to staff 25 Canadian Field Ambulance and 25 Canadian Field Dressing Station. Doctors and nurses were reassigned from various RCAMC units stationed across Canada and Europe.334 The Royal Army Medical Corps was forced to rely upon conscription. Over 50% of British regimental medical officers (RMOs) that served in Korea were National Servicemen who had only recently graduated from medical school.335 The British Commonwealth General Hospital in Kure was the, ‘only source of replenishment of…personnel for the medical units and battalions,’ serving in the Far East.336 Addressing the Royal Society of Medicine in June 1953, Major General AG Harsant (RAMC) noted that matters were further complicated by, ‘the varying length of service of medical officers from the different Commonwealth…countries.’337 Depending on their nationality, medical officers served a tour of between three and six months. As a result, there was a high turnover of staff and levels of experience varied.338
333 Canadian Inter-Service Medical Committee, 4 September 1946, Minutes of a Meeting of the Inter-Service Medical Committee, LAC: RG 24, 83-84/167, Box 7717, 20-1-1, pt. 1 in Bill Rawling, The Myriad Challenges of Peace: Canadian Forces Medical Practitioners Since the Second World War (Ottawa: Canadian Government Publishing, 2004), 34. Colonel GL Morgan Smith, ‘The Royal Canadian Army Medical Corps of Today,’ Canadian Services Medical Journal 10, No. 1 (July/Aug. 1954), 20. Working Party on Revised Establishment of Medical Officers: Memorandum by AMD1, Royal Army Medical Corps: Peace Establishment Officers, 1953, TNA: WO 32/10383. 334 Rawling, The Myriad Challenges of Peace, 48-49. 335 Army Medical Advisory Board, Meetings 1 July 1949-September 1954, 8 December 1950, p. 4, TNA: WO 32/13465. 336 Davison, interview by author. Brigadier JE Snow, War Establishment—British Commonwealth General Hospital, May 1952, TNA: WO 281/892. 337 ‘Discussion on Military Medical Problems in Korea,’ Proceedings of the Royal Society of Medicine 46 (10 June 1953): 1038. 338 Ibid.
95 Manpower shortages restricted the mobility of Commonwealth medical units throughout the war. For example, 25 Canadian Field Dressing Station was originally based 35 miles behind the division’s front line in the South Korean capital city of Seoul. Assistant Director of Medical Services, Colonel Anderton believed that this was too far back.339 It could take hours to transport patients along Korea’s roads, which were described by a correspondent for The People as, ‘churning nightmares of mud.’340 However, 25 FDS was responsible for controlling the air evacuation of patients from nearby Kimpo airstrip. Anderton considered assembling a new unit to replace 25 FDS but there were not enough doctors and nurses available. For over a year, the field dressing station remained in the same location.341 Between June and September 1952, 25 FDS was temporarily split into two sections in an attempt to solve the problem. An 80-bed forward section moved into position in the Tokchong-Uijongbu area on 18 June, which was approximately 15 miles behind the division’s frontline.342 Meanwhile, headquarters stayed behind in Seoul. Early in August, a party of officers from the British Commonwealth General Hospital finally arrived in Korea to assess the feasibility of a forming a new unit to replace 25 FDS.343
The British Commonwealth Communications Zone Medical Unit (BCCZMU) opened on 16 September 1952 under the command of Major RA Smillie of the Royal Canadian Army Medical Corps. Multinational in composition, the unit was staffed by British, Canadian and
339 Lieutenant Colonel A MacLennan, (Officer Commanding 26 Field Ambulance) 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, Wellcome Library and Archives (Hereafter cited as WLA): Royal Army Medical Corps Muniments Collection, 761/4, Box 158. 340 Arthur Helliwell, ‘Untitled,’ People (1952) quoted in Tim Carew, The Commonwealth at War (London: Cassell & Company Limited, 1967), 259. 341 Anon, British Commonwealth Communications Zone Medical Unit War Diary 1952, TNA: WO 281/898. Major RA Smillie, Royal Canadian Army Medical Corps, British Commonwealth Communications Zone Medical Unit Situation Report, September 1952, TNA: WO 281/898. 342 Anon, 25 Canadian Field Dressing Station War Diary, 1953, LAC: RG24-C-3, Volume 18397. 343 Ibid.
96 Australian doctors and nurses.344 The majority of personnel had been reassigned from the British Commonwealth General Hospital, 25 Canadian Field Dressing Station and 26 British Field Ambulance.345 Housed in the same school buildings as 25 FDS had previously occupied, BCCZMU had room for roughly 100 patients.346 Although the school was in need of repairs and bedding was often in short supply, staff member Captain Elizabeth B Pense (RCAMC) maintained that morale was, ‘extremely high.’ BCCZMU quickly proved its worth.347 During the summer months, evacuations from Korea to Japan had averaged at 458 men per month. By October, evacuations had fallen to an average of 279 per month.348 Freed of its prior responsibilities, 25 FDS was able to relocate to a more advantageous location and focus on the treatment of patients.
While manpower shortages were a significant problem for the Commonwealth countries, national differences presented the greatest challenge. The 1st British Commonwealth Division was a marriage of convenience. Following World War II, the United Kingdom and its former colonies had progressively divergent interests. However, shared political concerns and economic necessity had brought them together again. In a highly pressurised environment, national interests were bound to conflict.
344 Anon, British Commonwealth Communications Zone Medical Unit War Diary 1952, TNA: WO 281/898. 345 Ibid. 346 Ibid. 347 Ibid. 348 The following chart shows the average daily holdings and number of evacuations from Korea from June to October 1952. It demonstrates how evacuations dropped once the British Commonwealth Communications Zone Medical Unit was formed. June July August September October Average holdings in Korea 172 205 237.6 266.2 278.3 Evacuations from Korea 479 473 424 274 285 Anon, Assistant Director of Medical Services Monthly Liaison Letter Serial No. 17, Oct. 1952, TNA: WO 281/887.
97 As the Dominion countries became increasingly independent of the United Kingdom, they were eager to be recognised as equal partners. Throughout the Korean War, Canada, Australia and New Zealand expected to be treated in a manner that reflected the changing nature of their relationship with Britain. Regardless of the repercussions, the British government often acted insensitively in dealing with its allies. Non-operational control of BCFK rested with Lieutenant General Robertson and the Australian contingent. In addition, Robertson was responsible for representing the division in dealing with the Americans and the United Nations Command.349 Despite this, the British appointed Air Vice Marshal Cecil Arthur Bouchier as their special liaison officer in Tokyo. He represented the Chiefs-of-Staff and was encouraged to foster a, ‘special relationship,’ with the Americans.350 Over the course of his career, Lieutenant General Robertson, ‘had never been popular with Whitehall. He was too independent and too ready to assert the rights of the Dominions.’351 By appointing Bouchier, ‘The Foreign Office, and, to a lesser extent, the War Office attempted to undermine and isolate [Robertson] and, in the process demonstrated that the inability to recognise the sovereign rights of the dominions which had characterised British attitudes during the Second World War had not changed.’352 The Australians were vocal in their displeasure and insisted that the appointment, ‘was not in harmony with the established principles for co-operation in British Commonwealth Defence.’353 In spite of their protests, the British continued to maintain an independent representative after Bouchier had completed his tour in the Far East. Major General Steven Newton Shoosmith was appointed as Deputy Chief of Staff to the Commander-in-Chief of UN forces in July 1952. While Shoosmith did not officially speak on behalf of the Chiefs-of-Staff, he maintained close contact with London.354 Uncomfortable with the idea of an Australian general representing British interests, officials in Whitehall had taken matters into their own hands. However, the Dominions were no longer willing to accept unilateral decisions
349 O’Neill, Combat Operations, 105. 350 Grey, The Commonwealth Armies, 121, 131. 351 Ibid., 58-59. 352 Ibid. 353 Ibid., 65. 354 Ibid., 126-127.
98 from London. The appointment of Bouchier and Shoosmith inconveniently highlighted Commonwealth disunity.
Aside from the British, the Canadians presented the most serious threat to inter-allied cooperation. When 25 Canadian Infantry Brigade arrived in Korea in April 1951, Brigadier John Meredith Rockingham was given very specific instructions in regards to his new command. Most importantly, he was reminded that, ‘The principle of the separate entity of the Canadian Force shall at all times be maintained.’355 From the beginning, the staff of 25 Brigade acquired a reputation for keeping to themselves and, ‘officers of other nationalities…soon came to leave liaison with the brigade to the Canadians among them.’356 When Lieutenant General Robertson suggested that divisional headquarters in Kure should be integrated like divisional headquarters in Korea, the Canadians, ‘declined to participate.’357 In addition, the Canadian government maintained an independent military mission in Tokyo throughout the war. Like Bouchier, Lieutenant General FJ Fleury represented his government in its dealings with the Americans.358
In a 1954 study of Commonwealth medicine, ADMS Colonel JS McCannel (RCAMC) outlined the major challenges that the division had faced between 1950 and 1953. Similarly to officers in other branches of the division, he cited, ‘nationalistic feeling,’ as one of the primary obstacles to cooperation.359 National differences had an effect on how efficiently the medical services operated on a daily basis. For example, each contingent insisted upon the maintenance of separate medical records. Moreover, British, Canadian, and Indian medical units all recorded patient admissions, transfers and discharges differently. For
355 Canadian Joint Staff, Washington DC to Colonel CP Stacey, DHH DND: 112.3H1.009 (D113). 356 Grey, The Commonwealth Armies, 151. 357 Ibid., 105. 358 Wood, Strange Battleground, 41. 359 Colonel JS McCannel, Study on Commonwealth Medical Services in Korea, 12 June 1954, DHH DND: 681.013 (D48).
99 reasons that are unclear, the Canadians did not share their records with the Deputy Director of Medical Services in Japan. Instead, they forwarded these documents to the Assistant Director of Medical Services and to the pertinent authorities in Ottawa. The maintenance of separate records frustrated communications and made it difficult for the DDMS and his staff to gain an overall appreciation of divisional health.360
‘Nationalistic feeling,’ also further restricted the mobility of Commonwealth medical units. In a 1955 article for the Canadian Medical Association Journal, Brigadier Ken A Hunter and Colonel JE Andrew of the Royal Canadian Army Medical Corps reviewed the events of the Korean War. The authors noted that, ‘Throughout the two Great Wars, in which Canada has played a large part, it has been the policy of the Canadian Army to provide Canadian medical attention for Canadian casualties at all levels where such attention is necessitated.’361 They explained that: This…has been based on the fact that the Canadian soldier expects treatment by Canadian doctors whenever it is possible to provide such treatment. This…does not cast a reflection upon the professional ability of doctors and nurses other than those of Canadian origin but rather is based on a sentimental and natural desire of the wounded man for contact with people from his own homeland.362
The RCAMC vigorously defended and enforced this policy throughout the Korean War. Canadian medical units were always positioned within relatively close proximity to Canadian infantry battalions. In all but a few exceptions, RCAMC doctors and nurses were neither cross-posted nor attached to British, Indian or Australian medical units. The Canadians even considered erecting their own hospital in the spring of 1951 but were
360 Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. Major JH Cater, Minutes of Assistant Director of Medical Services Conference, 2 Feb. 1953, TNA: WO 281/888. Lieutenant Colonel A MacLennan, (Officer Commanding 26 Field Ambulance) 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, WLA: Royal Army Medical Corps Muniments Collection, 761/4, Box 158. 361 Andrew and Hunter, ‘The Royal Canadian Army Medical Corps,’ 180. 362 Ibid.
100 forced to abandon the plan in light of economic circumstance. The RCAMC’s insistence that Canadian medics should treat Canadian troops was popular with the politicians and the public at home.363 However, it significantly limited the mobility of major Commonwealth medical units like 25 FDS and 25 Canadian Field Ambulance. These units were not ideally located because of manpower and resource shortages and Canadian policy only served to further exacerbate the problem.364
Compromises and Cooperation Despite the many obstacles that the Commonwealth Division faced, by all accounts it was a highly efficient force. In his book, Army, Empire and the Cold War, historian David French concludes that, ‘The British and Commonwealth ground forces who fought in Korea gained a good reputation in the eyes of American commanders,’ who considered the division to be reliable and disciplined. 365 US Army medics had a similar appreciation of their Commonwealth counterparts with whom they worked closely during the war.366 Once again, the question arises as to how the division achieved this level of success. The British, Canadian, Australian and New Zealand contingents faced innumerable challenges and struggled to work together. How did they succeed in compromising with one another?
363 Anon, Report of the visit of the Assistant Director of Medical Services to Korea, 17-21 Apr. 1951, TNA: WO 32/21831. Colonel Geoffrey Anderton, 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, WLA: Royal Army Medical Corps Muniments Collection, 761/4, Box 158. 364 Colonel GL Morgan Smith, Assistant Director of Medical Services Monthly Liaison Letter Serial No. 13—June 1952, TNA: WO 281/887. Lieutenant Colonel A MacLennan, (Officer Commanding 26 Field Ambulance) 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, WLA: Royal Army Medical Corps Muniments Collection, 761/4, Box 158. 365 French, Army, Empire and the Cold War, 141. 366 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397.
101 A large part of the Commonwealth Division’s success is attributable to the nature of the Korean War. From July 1951-July 1953, hostilities were largely static and, ‘the campaign became one of limited set-piece attacks, supported by heavy artillery bombardments, and restricted fighting in which patrolling, field works, [and] barbed wire played a prominent part.’ 367 As a result, the Commonwealth Division was never overwhelmed by an unmanageable number of casualties. Safe from enemy harassment, it was possible to stockpile supplies and house 25 FDS in more permanent buildings. 368 Although Commonwealth medical units were habitually understrength and lacked flexibility, this never seriously compromised the health of the troops. If the Korean War had remained mobile, the division may not have been able to cope so well.
The second key to the division’s success was the close links between its contributing members. Soldiers from Canada, Australia and New Zealand were organised in the same manner as their British counterparts. They were divided into distinct regiments, shared traditions and had worked closely together in the past.369 In the early 1950s, they continued to use the same equipment and operate, ‘with the benefit of common doctrinal and organisational assumptions.’370 The Dominion countries sent officers every year to study at the Imperial Defence College and other British military schools.371 Moreover, Canada’s
367 Barclay, The First Commonwealth Division, 44. 368 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. 369 Lieutenant Colonel John C Blaxland, ‘The Armies of Canada and Australia: Closer Collaboration?,’ Canadian Military Journal (Autumn 2002): 46. 370 Grey, The Commonwealth Armies, 190. Devine, ‘La Belle Alliance.’ 51. 371 JL Granatstein, ‘The Development of the Profession of Arms in Canada,’ in Conference of Defence Associations Institute 15th Annual Seminar Proceedings, The Profession of Arms in Canada: past, present and future, ed. Robin Corneil (Ottawa: Conference of Defence Associations Institute, 1999) 23. Allan D English, Understanding Military Culture: A Canadian Perspective (Canada: McGill Queens, 2004), 90. Grey, The Commonwealth Armies, 15. O’Neill, Combat Operations, 286.
102 Royal Military College, Kingston (RMC-K) and Australia’s Royal Military College, Duntroon (RMC-D) were both influenced by the British Army. In an article on the post- 1945 history of the Canadian Forces, author Adrian Preston noted that, ‘Although RMC-K was inclined to borrow its essential structural features from West Point rather than Woolwich or Sandhurst, it was nevertheless wholly British in administration and professoriate, was commanded by a British Army officer until the 1920s, and subscribed to the teaching of British strategic and tactical doctrine.’372 Like Kingston, Duntroon, ‘was modeled on the US Military Academy.’373 Nevertheless, the college retained links to the United Kingdom and instructed cadets in the British way of war.374
There were also long-standing ties between the Royal Canadian Army Medical Corps and Royal Army Medical Corps. Throughout the first half of the twentieth century, Canadian doctors commonly studied in the United Kingdom. There were very few medical schools in Canada and British universities were widely considered to be prestigious.375 Canadian Army medical policy was also heavily influenced by British ideas. In the late 1940s and early 1950s, the Canadians were in frequent contact with their colleagues in the UK and were keen to encourage further cooperation. Captain WG Clever (RCAMC) explored the relationship between the two countries in a 1954 article for The Canadian Army Journal. While the Canadians were beginning to take note of developments in the US Army Medical Corps, Clever stressed the continued intimacy of Anglo-Canadian relations. To illustrate his
372 Adrian Preston, ‘The Profession of Arms in Postwar Canada, 1945-1970: Political Authority as a Military Problem,’ World Politics 23, No. 2 (Jan. 1971): 195. 373 Jeffrey Grey, Australian Brass: The Career of Lieutenant General Sir Horace Robertson (Cambridge: Cambridge University Press, 1992), 3. 374 Officers from New Zealand were also commonly educated at Duntroon. Roland Wilson, Official Year Book of the Commonwealth of Australia No. 37: 1946 and 1947 (Canberra: Commonwealth Bureau of Census and Statistics, 1948): 1148-1149. Christopher Clark-Coulthard, Duntroon: The Royal Military College of Australia, 1911-1986 (Sydney: Allen & Unwin, 1986). Grey, Australian Brass, 3. 375 Captain WG Clever, ‘A Brief History: British Canadian Military Medical Services,’ Canadian Army Journal 8, No. 4 (Oct. 1954): 148. Gray, Beyond the Danger Close, 121.
103 argument, he pointed out that, ‘The RCAMC field organization was amended in 1947 to conform with…British post-war policy. The changes included the adoption of one type of field ambulance…the allotment of one field dressing station, reduced in size and function, to each infantry division; and the reinstitution of RCAMC other ranks in battalion establishments.’376 Writer GWL Nicholson has also underlined the post-war links between Canada and Britain in his book, Seventy Years of Service: A History of the Royal Canadian Army Medical Corps. The Canadians continued to use British training pamphlets and study materials to educate their officers. Like the RAMC, the RCAMC increased the number of non-medical officers and other technical personnel from 1945 onwards. When the British made a change in policy or organisation, the Canadians usually followed suit.377
Officer selection is the final reason why the Commonwealth countries were able to cooperate and compromise with one another during the Korean War. The interplay of personalities played an important role in smoothing over national differences. The senior officers chosen to serve in Korea were selected for their experience and ability to work with officers from other countries. Major General Cassels, the division’s GOC, was well suited to command a multinational force. As historian Jeffrey Grey has commented, ‘A man better qualified to head the composite Commonwealth Division and deal with potentially troublesome dominion forces would have been hard to find.’ 378 Cassels, a Seaforth Highlander, had joined the armed forces in 1926. Throughout his career, ‘he had served on the North-West Frontier…and had a knowledge of the Indian Army and spoke some Urdu.’379 During World War II, he had risen through the ranks to become, ‘the youngest divisional commander in the British Army.’380 As the commanding officer of the 51st
376 Clever, ‘A Brief History,’ 150. 377 Nicholson, Canada’s Nursing Sisters, 254-255. David Spencer Whittingham, Royal Canadian Army Medical Corps (RCAMC) Study Papers Volume I, 1951-1953, CWM: 58C 3 22.1. 378 Grey, The Commonwealth Armies, 105. 379 Ibid. 380 Ibid.
104 Highland Division in 1944-1945, he had collaborated closely with the Canadians.381 Preceding his appointment as GOC of the Commonwealth Division, he had served as Head of the United Kingdom Services Liaison Staff in Canberra and made close friends with many Australian officers.382 Cassels’ successor, General Alston-Roberts-West was also thoroughly prepared for the challenges he would face in Korea. Commissioned into the Army in 1925, he had served in India during the 1930s and had, ‘commanded an infantry battalion and two brigades in the Second World War.’383 CIGS Field Marshal Slim chose Alston-Roberts-West to succeed Cassels because he, ‘had a good record as an infantry soldier and knew how to get on with all sorts of people.’384
The British, Canadians, Australians and New Zealanders were equally very careful in their selection of brigade and battalion commanders. All were decorated veterans and had experience of working with other Commonwealth officers. At 46 years of age, Brigadier Thomas Brodie of 29 Brigade, ‘had seen a good deal of active service, including command of a Chindit formation in Burma during the Second World War.’385 Brigadier General John M Rockingham of 25 Brigade had been born in Australia and immigrated to Canada as a young man. Throughout his service career, he had attended the staff course at Camberley and commanded British and Canadian troops in action.386 Lieutenant Colonel Francis George Hassett of 3RAR had served in North Africa and the Pacific during WWII and was
381 Ibid. Farrar-Hockley, An Honourable Discharge, 210. 382 Farrar-Hockley, An Honourable Discharge, 210. 383 Ibid., 366. 384 Field Marshal Sir William Slim, quoted in General Sir Anthony Farrar-Hockley, The British Part in Korean War, Vol. II, An Honourable Discharge (London: HMSO, 1995), 366. 385 Farrar-Hockley, A Distant Obligation, 115. 386 David J Berucson, Blood on the Hills: The Canadian Army in the Korean War (Toronto: University of Toronto Press, 1999), 35-39. Brent Byron Watson, Far Eastern Tour: Canadian Infantry in Korea, 1950-1953 (Montreal, QC and Kingston, ON: McGill Queen’s University Press, 2002), 7.
105 a graduate of Duntroon and the British Army Staff College at Haifa.387 The commanding officer of 16 New Zealand Field Artillery Regiment, Lieutenant Colonel JW Moodie, was also a distinguished and decorated veteran with extensive experience of working with Britons, Canadians and Australians.388
Many of the division’s senior medical officers also had significant experience of operating in a multinational environment. 1 Commonwealth Division’s first Deputy Director of Medical Services, Brigadier CW Nye had served alongside officers from Britain, New Zealand and India as a BCOF officer. Colonel Geoffrey Anderton (RAMC), who was Assistant Director of Medical Services from June 1951 to May 1952, had worked with Dominion officers throughout his long career in Europe, North Africa and India.389 His successor, Canadian officer Colonel GL Morgan Smith (May 1952-April 1953) had commanded a Canadian Army hospital in WWII. He had been attending the Australian Staff College in Queensliffe, Victoria when he learned that he would be sent to Korea.390 Morgan Smith’s replacement, fellow RCAMC officer Colonel JS McCannel (April 1953- April 1954) had commanded the 24th Canadian Field Ambulance in Italy from 1944-1945. Prior to embarking for Japan, he had been attending a staff course in the United Kingdom.391 Colonel Ambrose NT Meneces (RAMC), who was Commandant of BCGH from May 1952, was equally worldly. Maltese by birth, Meneces had commanded British
387Australian War Memorial, ‘People Profiles: General Francis George (Frank) Hassett, AC, KBE, CB, DSO,’ http://www.awm.gov.au/people/8445.asp O’Neill, Combat Operations, 172. 388 McGibbon, Politics and Diplomacy, 48. 389 ‘High US Honor for Australian,’ Barrier Miner, 28 Mar. 1951. Liddell Hart Centre for Military Archives, ‘Summary Guide: GB99 KCLMA Anderton,’ last modified 8 Aug. 2005, http://www.kcl.ac.uk/lhcma/summary/an30-001.shtml 390 ‘Canadian For Australian Army Course,’ Cairns Post, 19 Dec. 1950. 391 ‘News of the Medical Services: Canadian Armed Forces,’ Canadian Medical Association Journal/Journal de l’Association médicale canadienne 62 (Mar. 1950): 297. Harold Russell, ‘24th Canadian Field Ambulance, Royal Canadian Army Medical Corps,’ Canadian Military History 8, No. 1 (Winter 1999): 69-70.
106 and Indian medical units in Burma during World War II.392 Described as a, ‘very nice, very cultured chap,’ Meneces was widely respected by his close colleagues and hospital staff.393
Conclusion On 28 July 1951, the GOC of the Commonwealth Division, General AJH Cassels issued a Special Order of the Day to all formations and units. Cassels celebrated the accomplishments of the past year and praised the fighting spirit of his troops. Recognising the challenges that they would face in the days ahead, he wrote, ‘It is now incumbent on us all to see that the reputation and deeds of the…division earn…high acclaim. I would ask you to remember that it is only by working as a team that this can be achieved. The old saying, ‘All for one and one for all,’ must be our motto.’394 Over the following two years, the officers and men of the 1st British Commonwealth Division faced many obstacles together. Infantry battalions often arrived in Korea understrength and ill-prepared for the privations of battle. Throughout the war, medical units encountered similar difficulties. The division had too few medical officers and there was a high turnover of doctors and nurses. This significantly restricted the mobility of major units like 25 Canadian Field Dressing Station. In addition to manpower problems, the United Kingdom, Canada, Australia and New Zealand struggled to cooperate with one another. The end of World War II marked the end of an era and the beginning of a new phase in Commonwealth relations. The Dominion countries were no longer willing to play the part of Britain’s silent partner, as they had done in the past. National differences and conflict had a measurable impact upon the efficiency of divisional healthcare. For example, the Canadian Army’s insistence that RCAMC doctors should attend to all Canadian casualties further limited the mobility of medical units.
392 JH Gorman, JS Logan and DAD Montgomery, ‘Historical Review: The evacuation of Burma: fifty years ago,’ Ulster Medical Journal 61, No. 2 (Oct. 1992): 169. 393 Davison, interview by author. 394 General AJH Cassels, Special Order of the Day, 28 July 1951, LAC: RG24-C-3, Volume 18395.
107 Despite the many problems that the Commonwealth countries faced in Korea, the division was a resounding success and its troops were held in high esteem. The health of the division was generally excellent and there was a low rate of both physical and psychiatric casualties. There are several factors that contributed to this level of success. Firstly, the Korean War was a static conflict from July 1951 until the signing of the armistice on 27 July 1953. As peace negotiations proceeded, neither side was willing to risk lives unnecessarily. The fighting that took place along the 38th parallel was characterised by daily patrols, minor skirmishes and brief battles. Medical units remained in the same locations for prolonged periods of time and were able to stockpile supplies. With the luxury of time, it was possible to remedy mistakes that may have been more costly in a mobile campaign. Secondly, there were long standing links between the division’s major contributing members: the United Kingdom, Canada, Australia and New Zealand. Organised along similar lines, they shared the same approach to matters of doctrine, strategy and tactics. Finally, the division’s senior officers were carefully selected for their prior experience of working alongside international allies. This facilitated cooperation and compromise on a daily basis. The achievements of the Commonwealth are, perhaps, best summarised by a correspondent for the divisional journal, Crown News. Writing only a day after the armistice, the author wrote, ‘more important than our success in battle we have learnt that we can rely on one another. To all of us who have had the honour of serving in this Division, the Commonwealth is no longer an abstract and vague idea culled from the text books and newspapers, but a reality.’395
395 Anon, The Crown News: Journal of 1 Commonwealth Division, Two Years in Action, 28 July 1953, AWM: AWM85, Item No. 3/5.
108
Chapter 4 Weathering the Storm: Mental Health and Psychiatric Practice (1950-1953)
109 Introduction In a warzone, doctors encounter serious physical trauma on a daily basis. The first hours and days of treatment are vital and have long-term consequences for both the patient and the military as a whole. Army psychiatrists carry the same burden of responsibility in caring for those who bear the invisible scars of battle. Like previous generations of soldiers, Commonwealth troops confronted danger and hardship throughout the Korean War (1950- 1953). Every man faced the potential of physical or psychological injury. Very little research has been published about the nature of the psychiatric problems encountered in Korea or the medical provisions that were made for mentally ill soldiers. In this chapter, I provide a comprehensive review of Commonwealth psychiatric practices in Korea and Japan. As little statistical data has survived for the period prior to July 1951, I focus on events after this date. I address issues such as organisation, staffing, common mental health problems and the composition of the patient population. Following this, I examine front line treatment in Korea and hospital-based care in Japan. Throughout the chapter, I focus on answering several key questions. Firstly, what was the nature and scope of the Commonwealth Division’s psychiatric problems? For nearly three years, servicemen faced extreme weather, challenging terrain, endless patrols, and a dangerous and bold enemy. What impact did this have on troops? Secondly, how did psychiatrists care for the mentally ill and how did their methods compare with those employed during previous conflicts? The Korean War is popularly associated with medical innovation and advancement. Mobile Army Surgical Hospital (MASH) units were developed in Korea and significantly increased the chances of survival for seriously wounded soldiers.396 The war also represents the first time that helicopters were systematically used to evacuate casualties from the front lines.397 Did comparable developments occur in psychiatry? Thirdly, how effective were psychiatrists in treating patients and returning them to duty in comparison to their US Army counterparts? American and Commonwealth soldiers lived and worked in very similar
396 Avinder Gobindpuri, ‘The Forgotten War: Medicine in Korea,’ (BSc diss., University College London, Wellcome Trust, 2005). 397 Ibid.
110 conditions. Did nationality make a difference in the outcome of medical treatment? Finally, what obstacles did doctors encounter and how did they address them?
Organisation and Resources Prior to the formation of the Commonwealth Division on 28 July 1951, the United Kingdom, Canada, Australia and New Zealand worked together in a loose formation. As new units arrived in theatre, they were attached to either the 27th British Commonwealth Brigade or 29th British Independent Infantry Brigade Group.398 In the early months of the war, no psychiatric personnel were deployed to the Korean peninsula.399 It was widely believed that the war would be over quickly. Furthermore, all of the Commonwealth countries were short on manpower and resources. Consequently, it was policy to evacuate all psychiatric casualties from Korea for treatment in Japan throughout 1950 and early 1951. 400 The majority of soldiers were sent to No. 29 British General Hospital at Commonwealth headquarters in the port city of Kure.401 Opened in November 1950, the hospital included a small psychiatric ward of 30 beds commanded by Captain JJ Flood of
398 Colonel Geoffrey Anderton, Assistant Director of Medical Services, 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, Wellcome Library and Archive (Hereafter cited as WLA): Royal Army Medical Corps Muniments Collection, 761/4, Box 158. Brigadier Cyril Nelson Barclay, The First Commonwealth Division: The Story of British Commonwealth Land Forces in Korea, 1950-1953 (Aldershot, UK: Gale & Polden Limited, 1954), 44. 399 Edgar Jones and Ian Palmer, “Army Psychiatry in the Korean War: The Experience of 1 Commonwealth Division.” Military Medicine 165, no. 4 (2000): 256. Edgar Jones and Simon Wessely, Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War (London: Taylor & Francis Group/Psychology Press, 2005), 120. Captain JJ Flood, ‘Psychiatric Casualties in United Kingdom Elements of Korean Force: December 1950—November 1951,’ Journal of the Royal Army Medical Corps 100, 1 (Jan. 1954): 41. 400 Ibid. Ibid. Ibid. 401 No. 29 British General Hospital was renamed the British Commonwealth General Hospital in December 1951 in order to better reflect the multinational composition of the unit. Anon, 29 General Hospital Summary of Events and Information, Oct. 1951, The National Archives at Kew (Hereafter cited as TNA): WO 281/1278. Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21.
111 the Royal Army Medical Corps (RAMC). Existing documentary evidence suggests that American medics also treated a proportion of patients. Before the formation of the division, the Commonwealth countries relied heavily upon the US Army Medical Corps for assistance. It is more than likely that patients were sent for treatment in Tokyo, which was home to a number of large US Army medical centres like 361 Station Hospital.402 Large and well-equipped, the hospital was widely considered to be the hub of American neuropsychiatry in the Far East. Staff included a psychiatrist, neurologist and, ‘several enlisted psychological and social work assistants.’403
As the largest contingent in theatre, the Americans were much better equipped to meet the challenges of Korea than the Commonwealth. The United States Army Medical Corps had access to greater resources and could afford to invest more heavily in psychiatry. Under the guidance of veteran psychiatrist Colonel Albert Julius Glass, ‘US divisional psychiatry became operational within eight weeks of the beginning of hostilities and by December 1950 a three-tier system of treatment (forward psychiatry, hospitals in Korea, and two convalescent units in Japan) was in place…’404 During WWII, it had taken the US Army over two years to develop a system of equal complexity.405 Nevertheless, the, ‘steps to prevent and salvage psychiatric casualties were taken after the need [had become] glaringly apparent.’406 Due to a lack of bed space in Korea, the Americans initially evacuated the
402 Colonel Geoffrey Anderton, ‘The Birth of the British Commonwealth Division Korea,’ Journal of the Royal Army Medical Corps 99, No. 2 (Jan. 1953): 47. Barclay, The First Commonwealth Division, 87. Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. 403 Colonel (Ret) Albert Julius Glass and Franklin D Jones, Psychiatry in the United States Army: Lessons for Community Psychiatry, eds. Franklin D Jones, Linette R Sparacino and Joseph M Rothberg (Bethesda, MD: Uniformed Services University of the Health Sciences, 2005). 404 Jones and Wessely, Shell Shock to PTSD, 122. 405 Ibid. 406 Colonel Albert Julius Glass, ‘History and Organization of a Theatre Psychiatric Service Before and After 30 June 1951,’ in Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950-1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954).
112 majority of mentally ill men to Japan.407 As Commonwealth doctors would similarly discover, this was a mistake. The further that soldiers were evacuated from the front line, the less likely it was that they would return to duty. From July to early September 1950, ‘only 50% of [American] psychiatric patients were salvaged,’ for either combat or non- combat duty.408
The 1st British Commonwealth Division became operational in the summer of 1951. While the new division included medical units from Australia and India, the Royal Army Medical Corps and Royal Canadian Army Medical Corps (RCAMC) were principally responsible for healthcare. A divisional psychiatrist was immediately appointed in an attempt to staunch the flow of psychiatric evacuees from Korea. The job entailed organising and overseeing all psychiatric care in theatre and duties included the supervision of field/hospital based treatment and advising command on matters of discipline and morale.409 Throughout the war, the divisional psychiatrist was based at 25 Canadian Field Dressing Station (25 FDS).410 Originally located in Seoul, the unit could accommodate around 44 psychiatric patients at any one time.411 The divisional psychiatrist, an assisting clinical officer and a small team of specially trained nurses were responsible for the daily
407 Albert E Cowdrey, The Medics’ War: The United States Army in Korea (Washington, DC: Centre of Military History, 1987), 93, 155-156. 408 Glass, ‘History and Organization.’ 409 Anon, Psychiatric Classifications and Criteria, 1958-1967, Library and Archives of Canada/Bibliothèque et Archives Canada (Hereafter cited as LAC): RG24, Acc 1983-1984/167 GAD, Box 7985, File No. C-2-6720-1. Colonel Geoffrey Anderton, Role of 25 Canadian Field Dressing Station, 9 Aug. 1951, LAC: RG24-C-3, Volume 18395. Major RG Davies, Monthly Psychiatric Report, 7 Aug. 1953, LAC: RG24-C-3, Volume 18397. 410Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397. Lieutenant Colonel Herbert Fairlie Wood, Strange Battleground: The Operations in Korea and their Effects on the Defence Policy of Canada (Ottawa: Queen’s Printer and Controller of Stationary, 1966), 275. 411 The number of beds in the psychiatric ward was reduced to 11 after the war ended in July 1953. Major WR Dalziel, Monthly Progress Report August 1951, 1 Sept. 1951, LAC: RG24-C-3, Volume 18395. Captain NG Fraser, Monthly Psychiatric Report, Aug. 1953, LAC: RG24-C-3, Volume 18397.
113 running of the ward. 412 From 1951-1953, the position of divisional psychiatrist was primarily a Canadian appointment. Major RJA Robitaille (July 1951-March 1952), Major Franklin Cyril Rhodes Chalke (March 1952-October 1952) and Major JL Johnston (October 1952-May 1953) were all career RCAMC officers and veterans of World War II.413 British officers, ‘with psychiatric qualifications were [generally] not deployed to Korea but kept in Germany, the UK and other long term postings.’414 Be that as it may, a British officer replaced Major Johnston when he had to return home unexpectedly in May 1953. Captain NG Fraser was a National Serviceman, who had served as Johnston’s
412 Clinical officers in psychiatry included: Captain RG Godfrey (RAMC) August 1951-December 1952 Lieutenant/Captain NG Fraser (RAMC) December 1952-May 1953 *(Promoted to Captain in February 1953) The clinical officers in psychiatry were generally more junior psychiatrists. For example, ‘Although not a qualified specialist [Lieutenant RG] Godfrey had eight months’ experience working in an adult psychiatric assessment unit in East London and had spent a further two months working with [Major JJ] Flood at the Japanese base hospital.’ Lieutenant NG Fraser had recently graduated from medical school at Aberdeen and was in Korea as a National Serviceman. Jones and Wessely, Shell Shock to PTSD, 120. Captain NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, Feb. 1953, Personal letters of Dr NG Fraser, Glasgow, United Kingdom (UK). 413 War Office, Report on the Health of the Army 1951-1952, TNA: WO 279/610. Anon, Assistant Director of Medical Services War Diary, 1951-1952, TNA: WO 281/886-7 Anon, 25 Canadian Field Dressing Station War Diary, Oct.-Dec. 1952, LAC: RG24-C-3, Volume 18396. Anon, 25 Canadian Field Dressing Station—Monthly Progress Report, May 1953, LAC: RG24-C-3, Volume 18397. Anon, Assistant Director of Medical Services Conference, 12 Jan. 1953, TNA: WO 281/888. Major Franklin Cyril Rhodes Chalke, Monthly Psychiatric Report—May 1952, 13 June 1952, TNA: WO 281/887. Major JS Hitsman, Appreciation of the Movement of 25 Canadian Field Dressing Station, May 1952, LAC: RG24-C-3, Volume 18395. Brigadier JE Snow, 29 British General Hospital, Monthly Liaison Letter March 1952, 11 Mar. 1952, TNA: WO 281/892. ‘Canadian Armed Forces: News of the Medical Services,’ Canadian Medical Association Journal/Journal de l’Association medicale canadienne 63 (Sept. 1950): 304. ‘Canadian Armed Forces: News of the Medical Services,’ Canadian Medical Association Journal 63 (Dec. 1950): 612-613. ‘News Items,’ Canadian Medical Association Journal 50 (Apr. 1944): 394. Brigadier CS Thompson to Dr GH Hutton, 23 Sept. 1946, LAC: RG 24, Vol. 19, 466 in Terry Copp and Bill McAndrew, Battle Exhaustion: Soldiers and Psychiatrists in the Canadian Army, 1939- 1945 (Montreal, QC and Kingston, ON: McGill Queen’s University Press, 1990): 157. 414 Jones and Wessely, Shell Shock to PTSD, 120.
114 assistant during the previous months. A recent graduate of the University of Aberdeen’s medical school, Fraser was divisional psychiatrist for the remainder of the war. Fellow Aberdeen classmate, Lieutenant Leslie Bartlet succeeded Fraser in November 1953.415
While Commonwealth resources were concentrated in one location, the Americans fielded multiple psychiatric units in Korea. Major medical centres like 121 Evacuation Hospital included dedicated neuropsychiatric sections.416 The US Army Medical Corps also created travelling psychiatric detachments (KO teams) to help augment existing services. 417 Concentrated in areas with the greatest number of casualties, KO teams were, ‘100 percent mobile, with trucks, jeeps, and enough tents for…staff and a few patients.’418 Equipped with the latest diagnostic technology, the units generally consisted of a psychiatrist, psychologist and social workers. The majority of American personnel had around one or two years of, ‘professional training in their speciality.’419 According to authors James Ashworth Martin, Linette R Sparacino and Gregory Belenky, KO teams, ‘could roll into a
415 Anon, Minutes of Assistant Director of Medical Services Conference, 4 Jan. 1954, TNA: WO 281/889. ‘Supplement,’ London Gazette, 1 Mar. 1955. Captain NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, Feb. 1953, Personal letters of Dr NG Fraser, Glasgow, United Kingdom (UK). Captain NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, 3 May 1953, Personal Letters of Dr NG Fraser, Glasgow, UK. Dr Leslie Bartlet, email message to author, 22 Sept. 2011. JCB Whycherley, Roll of Officers Filling Vacancies in, or posted surplus to the unit (including officers gone since the date of the last month), For the month ending 31 January 1952, TNA: WO 281/892. Brigadier JE Snow, British Commonwealth General Hospital, Monthly Liaison Letter March 1952, 11 Mar. 1952, TNA: WO 281/892. Leslie Bartlet, ‘A National Service Psychiatrist’s Story,’ Journal of the Royal Army Medical Corps 156, No. 4 (Dec. 2010): 273-275. 416 Glass, ‘History and Organization.’ 417 KO is not an acronym but ‘simply a military alpha designation of the unit.’ Raymond Monsour Scurfield, A Vietnam Trilogy, Veterans and Post Traumatic Stress: 1968, 1989, 2000 (USA: Algora Publishing, 2004), 17. 418 James Ashworth Martin, Linette R Sparacino and Gregory Belenky, The Gulf War and Mental Health: A Comprehensive Guide (Westport, CT: Greenwood Publishing Group Inc., 1996), 10. 419 Glass, ‘History and Organization.’
115 medical clearing company to give it expertise in battle fatigue restoration or reconditioning, and perhaps even take it over and make the medical clearing company into a…neuropsychiatry centre.’420 Responsible for a much larger population, the US Army Medical Corps would prove an important ally for the Commonwealth over the next few years.421
Common Mental Health Problems During the Korean War, psychiatric casualties accounted for 1 in 20 wounded or sick Commonwealth soldiers.422 Numbers were at their highest during the first year of the war, when hostilities were at their most mobile and United Nations’ (UN) forces suffered the greatest number of battle casualties.423 From December 1950-November 1951, Captain JJ Flood recorded that amongst the UK contingent around 35 men per 1,000 were admitted for
420 Ashworth, Sparacino and Belenky, The Gulf War and Mental Health, 10. 421 Anon, 25 Canadian Field Dressing Station War Diary, 1951, LAC: RG24-C-3, Volumes 18395. Anon, Assistant Director of Medical Services War Diary, Feb. 1952, TNA: WO 281/887. Captain NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, 22 Mar. 1953, Personal Letters of Dr NG Fraser, Glasgow, UK. 422 Flood, ‘Psychiatric Casualties in UK Elements,’ 46. Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397. 423 Between June and September 1950, the United States Army suffered an exceptionally high rate of psychiatric casualties. Roughly 250 men per 1,000 were admitted for psychiatric reasons. The first Commonwealth troops (1st Battalion Middlesex Regiment and 1st Battalion Argyll and Sutherland Highlanders) arrived in Pusan, Korea in August 1950. Over the subsequent months, further British troops landed and soldiers from Canada, Australia and New Zealand were deployed. There are few surviving records from this period. Consequently, it is impossible to compare Commonwealth figures for these months to American rates. Lieutenant Colonel Elspeth Cameron Ritchie, ‘Psychiatry in the Korean War: Perils, PIES and Prisoners of War,’ Military Medicine 167, No. 11 (2002): 898. Hans Pols and Stephanie Oak, ‘War & Military Mental Health: The United States Psychiatric Response in the 20th Century,’ American Journal of Public Health 97, No. 12 (Dec. 2007): 2136. Franklin B Cooling, ‘Allied Interoperability in the Korean War,’ Military Review 63, No. 6 (June 1983), 28. Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. Cowdrey, The Medics’ War, 91-92, 128.
116 mental health problems.424 American rates similarly hovered between 32 to 36 men per 1,000 between July and October 1951.425 These rates are comparable, ‘to many theatres of World War Two.’426 Admissions in Korea continued to decline as the front line stabilised and the division suffered fewer casualties. 427 Throughout 1952-1953, psychiatric admissions to Commonwealth field medical units commonly ranged between 5% and 9% of total patients.428 American rates also declined, ‘As the battle lines stabilized,’ and, ‘medical support for the UN forces became more uniformly and systematically applied with less of the improvised procedures that were made necessary by the previous erratic tactical situations.’429 Regimental medical officers (RMOs) became more experienced in dealing with psychiatric casualties and evaluating which cases merited evacuation. 430 Commonwealth soldiers suffered from a wide range of mental health problems. Be that as it may, the majority of men fit into one of three diagnostic categories: psychoneurosis, character disorder or battle exhaustion.431
424 Flood, ‘Psychiatric Casualties in UK Elements,’ 42-47. 425 From June 1950 to November 1951, US battle casualties peaked at 460 per 1,000. Frank A Reister, Battle Casualties and Medical Statistics: United States Army Experience in the Korean War (Washington, DC: The Surgeon General, Department of the Army, 1973), http://history.amedd.army.mil/booksdocs/korea/reister/reister.html Jones and Wessely, Shell Shock to PTSD, 121. 426 Eric T Dean Jr., Shook over hell, post-traumatic stress, Vietnam and the Civil War (Cambridge, MA: Harvard University Press, 1997), 40. Jones and Wessely, Shell Shock to PTSD, 121. 427 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. 428 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. 429 Glass, ‘History and Organization.’ Cowdrey, The Medics’ War, 248. Lieutenant Frank B Norbury, ‘Psychiatric Admissions in a Combat Division in 1952,’ Medical Bulletin of the United States Army Far East 1, No. 8 (July 1953): 131. 430 Norbury, ‘Psychiatry Admissions in a Combat Division,’ 131. 431 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397.
117 Over 50% of Commonwealth psychiatric patients were diagnosed as psychoneurotic.432 Since the early twentieth century, Army psychiatrists had commonly used the word as a generic term for anxiety conditions. As a diagnostic label, it was applicable to a variety of patients. Contemporary RCAMC and RAMC teaching manuals broadly defined psychoneurosis as a, ‘disorder resulting from the exclusion from consciousness of powerful emotional charges.’433 The condition was primarily characterised by, ‘anxiety…either free floating and unbound or directly felt and expressed.’434 Distinguished psychiatrists Sir David K Henderson and Dr Robert D Gillespie were equally vague in their description. In the 1950 edition of Henderson and Gillespie’s famous Textbook of Psychiatry for Students and Practitioners, the authors simply referred to psychoneurosis as, ‘an indication of mental conflict,’ and one of the, ‘commonest modes of faulty response to the stresses of life.’435 Like their predecessors, psychiatrists in Korea used psychoneurosis as a catchall term for anxiety-related disorders. During the war, cases of psychoneurosis ranged from the acute to the chronic but were largely mild in severity.436
Roughly 10% to 17% of the division’s psychiatric casualties were admitted for character related disorders.437 In contrast to psychoneurosis, problems of this nature were not distinguished by, ‘mental or emotional symptoms,’ but rather behavioural difficulties.438 Writing to Command Medical Officers in September 1947, Acting Canadian Director of Medical Services, Colonel Stanley Gerald Umphrey Shier highlighted that, ‘Such disorders are characterised by developmental defects or pathological personality structure, with
432 Ibid. 433 Anon, Psychiatric Classifications and Criteria, 1958-1967, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1. 434 Ibid. 435 Sir David K Henderson and Dr Robert Dick Gillespie, A Textbook of Psychiatry for Students and Practitioners, 7th ed. (London: Oxford University Press, 1950), 146. 436 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. 437 Ibid. 438 Anon, Psychiatric Classifications and Criteria, 1958-1967, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1.
118 minimal subjective anxiety, and little or no sense of distress. In most instances, the disorder is manifested by a life-long pattern of action or behaviour (acting out)…’439 Patients usually included disciplinary offenders, alcoholics, drug addicts and immature personality types. The number of admissions for character/behavioural problems invariably increased when the division was in reserve. The Americans experienced a similar phenomenon. While acute anxiety was common in combat, ‘during quiescent periods with less artillery fire, the cases were predominantly characteriological.’440 In failing to adapt to the combat zone, servicemen could find themselves in conflict with their fellow soldiers and their superiors.441
439 Acting Director of Medical Services Stanley Gerald Umphrey Shier to Command Medical Officers, 9 Sept. 1947, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1. 440 Franklin D Jones, ‘Military Psychiatry Since World War II,’ in American Psychiatry After World War II (1944-1994), eds. Roy W Menninger and John C Nemiah (Washington, DC: American Psychiatric Press, 2000), 13. 441 The US Army had an especially difficult time dealing with drug addiction. Many American soldiers became addicted to opiates like heroin, which were freely available in Korean cities such as Pusan. In a 2002 article entitled, ‘Psychiatry in the Korean War: Perils, PIES and Prisoners of War,’ Lieutenant Colonel Elspeth Cameron Ritchie has noted that, ‘In some units, as many as half the soldiers were believed to be addicted.’ There is no indication that the Commonwealth contended with this scale of drug addiction. The records include no references to drugs or drug related problems. Ritchie, ‘Psychiatry in the Korean War,’ 901. Captain Simon L Feigin, ‘Neuropsychiatric Casualties as a Result of Combat Involving Hill 266 (‘Old Baldy’),’ Medical Bulletin of the US Army Far East 1, No. 8 (July 1953): 134-136. Captain Robert J Lavin, MC, 7th Division Neuropsychiatrist, Neuropsychiatric Report: United States Army 7th Infantry Division, 1952, National Archives and Records Administration (Hereafter cited as NARA): RG 112, Records of the United States Army Surgeon General, 7th Infantry Division, Annual Reports, 1950-1953, Box 221. Lieutenant Colonel Douglas Lindsey, ‘Evacuation and Speciality Centres,’ in Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950- 1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954). Glass, ‘History and Organization.’
119 Throughout the first half of the twentieth century, battle exhaustion had been the source of, ‘considerable losses of effective manpower among Commonwealth and US troops.’442 Since WWI, battle exhaustion has been known by many names such as shell shock and combat fatigue.443 Doctors and psychiatrists alike have struggled to define and understand the condition.444 When the Korean War erupted in 1950, it was generally regarded as an anxiety disorder resulting from direct combat exposure with symptoms including, ‘weariness, apathy, jumpiness [and] disinterest.’445 The Commonwealth Division did not keep detailed records of the number of battle exhaustion cases suffered during the early stages of the war. However, between May 1952 and July 1953, ‘only 37 cases…were reported in the context of 2,026 casualties, giving an average of 18 per 1,000, although in September 1952 it rose to 24 per 1,000 and between January and March 1953 no cases were referred to the FDS.’446 Rates of exhaustion were generally low. In reviewing the medical provisions made in Korea, members of the Canadian Defence Medical and Dental Advisory Board attributed this to, ‘the nature of the fighting in which battles were of short duration
442 Anon, The Royal Canadian Army Medical Corps Study Papers: Medical General Series— Psychiatric Casualties in Battle, Canadian War Museum/Musée Canadien de la Guerre (Hereafter cited as CWM): Textual Records 58C 3 22.1 443 In May 1952, a patient was admitted to 25 Canadian Field Dressing Station for the treatment of, ‘post-traumatic syndrome.’ This represents one of the first times that the term was used in reference to battle exhaustion. Anon, 25 Canadian Field Dressing Station War Diary, May 1952, June 1952, LAC: RG24-C-3, Volume 18397. Bill Rawling, Death Their Enemy: Canadian Medical Practitioners and War (Quebec: AGMV Marquis, 2001), 251. 444 Anthony Babington, Shell-Shock: A History of the Changing Attitudes to War Neurosis (London: Leo Cooper, 1997). Dave Grossman, On Killing: The Psychological Cost of Learning to Kill in War and Society (New York: Back Bay Books, 1996). Peter Leese, Shell Shock: Traumatic Neurosis and the British Soldiers of the First World War (London: Palgrave Macmillan, 2002). Peter Barham, Forgotten Lunatics of the Great War (USA: Yale University Press, 2004). Terry Copp and Bill McAndrew, Battle Exhaustion: Soldiers and Psychiatrists in the Canadian Army 1939-1945 (Montreal, QC and Kingston, ON: McGill Queens University Press, 1990). 445 Anon, The Royal Canadian Army Medical Corps Study Papers: Medical General Series— Psychiatric Casualties in Battle, CWM: Textual Records 58C 3 22.1 446 Jones and Wessely, Shell Shock to PTSD, 123.
120 and the fatigue factor was not operative.’447 Furthermore, the division suffered a declining number of casualties during the static phase of the war (July 1951-July 1953). Academic studies indicate that levels of battle exhaustion are directly tied to the number of killed and wounded.448 The British Second Army recorded rates as high as 200 per 1,000 at the height of the Normandy campaign between July and September 1944.449 During the Korean War, Commonwealth and American numbers were manageable and only rose in periods of heavy combat. For example, from 2-5 October 1951 Commonwealth troops, ‘advanced some 6,000 yards to capture and establish a new line north of the River Imjin,’ as part of Operation Commando.450 Beginning late that month, Chinese and North Korean forces attempted to recover the ground that they had lost. Throughout October and November, Commonwealth psychiatric admissions increased measurably. Around 240 men were admitted to 25 Canadian Field Dressing Station for treatment during the operation, which represented a 60% rise in admissions over the previous two months.451 In his report for November 1952, divisional psychiatrist Major JL Johnston clearly linked the rising number of casualties to the position in which the division found itself. During the following months, referrals dropped as the intensity of fighting declined.452
The American experience of battle exhaustion closely mirrored that of 1 Commonwealth Division. For example, the United States Army 7th Infantry Division participated in Operation Showdown from 14 October-25 November 1952. In attempting to gain control of
447 Paul Alfred Turner Sneath, Papers Related to Defence Medical and Dental Services Advisory Board Part III, LAC: MG31, 17, No. 87. 448 Ben Shephard, A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century (Cambridge, MA: Harvard University Press, 2001), 327. Christopher G Blood and Eleanor D Gauker, ‘The Relationship between Battle Intensity and Disease Rates among Marine Corps Infantry Units,’ Military Medicine 158, No. 4 (2000): 340-341. 449 Jones and Wessely, Shell Shock to PTSD, 123. 450 ‘Commonwealth Forces’ Record in Korea: A Successful Experiment,’ Times, 21 July 1953. 451 Anon, 1 Commonwealth Division Periodic Report, 16 Oct. 1951—15 Feb. 1952, TNA: WO 308/28. Anon, 25 Canadian Field Dressing Station War Diary, 1952, LAC: RG24-C-3, Volume 18396. 452 Anon, 25 Canadian Field Dressing Station War Diary, 1952, LAC: RG24-C-3, Volume 18396.
121 an important hilltop position, the division suffered heavy casualties. Prior to Showdown, the division’s neuropsychiatrist Captain Robert J Lavin had reported that rates of battle exhaustion were negligible and admissions were primarily confined to cases of anxiety, character and behavioural problems. Throughout October and November, he noted that over 50% of the division’s psychiatric admissions were cases of exhaustion.453 As the tempo of operations increased, so too did the number of exhausted soldiers.
Somatisation The Commonwealth Division’s mental health problems were by no means limited to the psychiatric ward of 25 Canadian Field Dressing Station. Scholars Edgar Jones and Simon Wessely have pointed out that, ‘As in previous conflicts, post combat syndromes typified by unexplained medical symptoms were a feature of the Korean War.’454 Between April 1952-June 1953, ‘the chief causes of admission to the base hospital were respiratory (10%), gastrointestinal (2.7%) and skin reactions (10.3%).’455 The commanding officer of the Canadian Section of the British Commonwealth General Hospital (BCGH), Lieutenant Colonel NH McNally reported in June 1952 that, ‘The manpower wastage…due to evacuation of such patients has been enormous.’456 While he was convinced that the majority of cases were genuine, McNally also recognised that, ‘psychological factors,’ played an important role.457 When prompted, many patients revealed that they were experiencing domestic difficulties or had other underlying concerns.458 Several months later, Assistant Director of Medical Services (ADMS) Colonel GL Morgan Smith issued
453 Captain Robert J Lavin, MC, 7th Division Neuropsychiatrist, Neuropsychiatric Report: United States Army 7th Infantry Division, 1952, NARA: RG 112, Records of the United States Army Surgeon General, 7th Infantry Division, Annual Reports, 1950-1953, Box 221. Feigin, 1953, p. 134. 454 Jones and Wessely, Shell Shock to PTSD, 125. Edgar Jones and Simon Wessely, ‘Hearts, guts and minds: Somatisation in the military from 1900,’ Journal of Psychosomatic Research 56 (2004): 425-429. 455 Ibid., 126. 456 Lieutenant Colonel NH McNally, Canadian Section British Commonwealth General Hospital, June 1952, LAC: RG24-C-1-c, Volume 35954, File No. 2001/812/BC. 457 Ibid. 458 Dr Leslie Bartlet, email message to author, 22 Sept. 2011.
122 Medical Administrative Instruction Serial No. 12, in which he called on medical officers to be wary of evacuating patients with unexplained physical symptoms. Morgan Smith reminded doctors that conditions of this kind were often, ‘bodily responses to anxiety, resentment or low morale.’459 Somatic reactions were a way of relieving anxiety, ‘by channelling the originating impulses through the autonomic nervous system into visceral organ symptoms and complaints.’460 British and Canadian records do not indicate the percentage of patients who fell into this category. However, The American Journal of Psychiatry published a study of US Army orthopaedic patients in January 1951, in which the authors concluded that, ‘psychiatric symptoms were present in…56%,’ of patients.461 It is likely that the Commonwealth figures were comparable. American and Commonwealth soldiers worked closely together and endured similar privations.
Cold Injuries Around 8,000 UN soldiers were treated for conditions like frostbite, trench foot and immersion foot during the winter of 1950-1951.462 Many Commonwealth troops fell victim
459 Colonel GL Morgan Smith, Medical Administrative Instructions, Serial No. 12 (Instructions 53- 62), 3 Aug. 1952, TNA: WO 281/1952. Colonel ANT Meneces, British Commonwealth General Hospital: Monthly Liaison Letter—June 1952, 27 June 1952, TNA: WO 281/892. 460 Anon, Psychiatric Classifications and Criteria, 1958-1967, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1. 461 The study in question was conducted at, ‘the US Naval Hospital, Bethesda, Maryland, and the Walter Reed General Hospital, Washington, DC.’ The majority of patients, ‘had sustained compound fractures and other serious injuries that required prolonged treatment and sometimes repeated operations.’ The sample size was relatively small and involved only 75 men. Douglas Noble, Marion E Roudebush, and Douglas Price, ‘Studies of Korean War Casualties, Part I: Psychiatric Manifestations in Wounded Men,’ American Journal of Psychiatry 108, No. 7 (1 Jan. 1952): 495-496. Jones and Wessely, Shell Shock to PTSD, 126. Anon, Report of Director General of Medical Services: Representative on Attendance at American Psychiatric Association Meeting, 7-10 May 1951, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1. 462 The most common cold injuries suffered in Korea included frostbite, trench foot and immersion foot. According to a 2008 British Ministry of Defence publication on cold injuries, frostbite, ‘usually affects the extremities and occurs as a consequence of acute freezing of tissues with microvascular occlusion and subsequent tissue anoxia.’ The same publication notes that, ‘The terms
123 to the cold.463 In an article for the British Medical Journal, a correspondent wrote that, ‘The number of [British troops admitted] to hospital for the period November, 1950, to February, 1951, was 120, of which 66 were diagnosed initially as frostbite, 37 as trench foot, and 22 as exposure conditions.’464 While the number of cold injuries was partly attributable to improper clothing and equipment, there were concerns that some cases were, ‘self inflicted by men who had removed their boots or neglected to take proper precautions.’465 In a study of American servicemen entitled, ‘Cold Injury in Man: A Review of its Etiology and Discussion of its Prediction,’ HE Hanson and RF Goldman, ‘…estimated that the number of cases reported during combat was greater than would have been predicted based solely on temperature and wind-chill.’466
Both the Americans and the British despatched research teams to the Far East in the winter of 1951-1952 to investigate what, ‘had given rise to the incidence of cold injury in the military operations of the previous winter.’467 Physiologist Major JM Adam of the Royal Army Medical Corps and Senior Medical Research Officer and Director of the British Army’s Hot Climate Physiological Research Unit, WSS Ladell arrived in Korea in January 1952. Over the following two months, Adam and Ladell studied 700 frontline infantry
‘trench foot,’ and ‘cold immersion foot (or hand),’ were coined to describe injuries sustained in wet conditions at non freezing temperatures.’ Adrian Roberts, Synopsis of Causation: Cold Injury (London: Ministry of Defence, Sept. 2008), 3- 4. ‘Cold in Korea,’ Lancet 260, No. 6727 (2 August 1952): 233. 463 Simon C Gandevia, ‘An Australian army doctor--Bryan Gandevia,’ in War Wounds: Medicine and the Trauma of Conflict, eds. Ashley Ekins and Elizabeth Stewart (Wollombi, NSW: Exisle Publishing Limited, 2011), 111-112. 464 ‘Cold Weather Clothing For Korea,’ British Medical Journal 2, No. 4745 (15 Dec. 1951): 1457. 465 Jones and Wessely, Shell Shock to PTSD, 126. 466 Ibid. HE Hanson and RF Goldman, ‘Cold Injury in Man: A Review of its Etiology and Discussion of its Prediction,’ Military Medicine 134, No. 11 (Oct. 1969): 1307-1316. 467 Major JM Adam, Royal Army Medical Corps and Senior Medical Research Officer, WSS Ladell, Department of the Scientific Advisor to the Army Council: Report of Field Studies on Troops of the Commonwealth Division in Korea, Winter 1951-1952, 28 June 1954, TNA: WO 348/117.
124 troops from the Commonwealth Division in order to gauge how they responded to cold weather. They compared their sample against men who had been hospitalised for cold injuries at either the British Commonwealth General Hospital or in one of several American hospitals. In their findings, the British team laid great emphasis on the role of stress, morale and the individual’s mental state in the incidence of cold injury.468 Samuel C Bullock, Luther L Mays and Albert N Berenberg of the US Army Medical Research Laboratory came to the same conclusion. They compared 110 frostbitten American soldiers to 20 other troops who had been hospitalised for conditions other than cold injury.469 The group argued that the frostbitten men, ‘had a lower drive for prestige, took fewer precautions against the cold and exhibited a greater range of hypochondriacal beliefs.’470 Physical injuries like frostbite may, ‘have served as a defence against psychiatric disorders in situations of intolerable stress.’471
Commonwealth and American commanders went to great lengths in order to prevent further cold injuries. The rates declined as strict policies were enforced in regards to hygiene and other preventative measures. Commonwealth medical units reported only 35 admissions for cold injury during the winter of 1952-1953. The division was better clothed, fed and equipped for life in Korea than ever before.472 In addition, the nature of the fighting
468 Ibid. 469 Samuel C Bullock, Luther L Mays and Albert N Berenberg, ‘A Study of the Personality Traits of Frostbite Casualties,’ in Cold Injury--Korea 1951-1952 (Fort Knox, KY: Army Medical Research Laboratory, 1953): 664-735. James B Sampson, ‘Anxiety as a Factor in the Incidence of Combat Cold Injury: A Review,’ Military Medicine 149 (Feb. 1984): 89. 470 Jones and Wessely, Shell Shock to PTSD, 126-127. Lieutenant Colonel Kenneth D Orr, ‘Developments in Prevention and Treatment of Cold Injury,’ in Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950-1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954). 471 Jones and Wessely, Shell Shock to PTSD, 127. 472 Major PM Bretland, ‘The Principles of Prevention of Cold Injuries: Notes on the Problem as Encountered, and the Methods used, in Korea,’ Journal of the Royal Army Medical Corps 100, No. 2 (Apr. 1954): 96.
125 had changed measurably. During the first year of hostilities, UN forces had been constantly on the move and were forced to retreat on many occasions. From 1951 onwards, the war stabilised and troops were able to build better and more permanent shelters. Servicemen were also more consistently and thoroughly briefed about the dangers of cold weather and how to prevent injury.473 Finally, divisional policy was less forgiving of such casualties. In December 1952, the ADMS reported that, ‘The Division has reached a stage when one should treat every case of cold injury within our lines as a self-inflicted wound.’474
Self-Inflicted Wounds In addition to cases of frostbite, Commonwealth medical units admitted an increasing number of accidentally wounded soldiers throughout 1951. The Americans also experienced an increase in the number of patients who required treatment for accidental burns and gun shot wounds (GSW).475 Events came to a head in early February 1952, when the British Director General of Army Medical Services (DGAMS), Sir Neil Cantlie toured the Commonwealth General Hospital in Kure. During his visit, Cantlie was disturbed to find that 24 out of 83 patients admitted to the hospital that day were being treated for accidental GSWs. Upon examining the men in question, he became convinced that they had
Colonel JS McCannel, Study on Commonwealth Medical Services in Korea, 12 June 1954, Directorate of History and Heritage, Department of National Defence, Canada/La Direction-- Histoire et patrimoine, Ministère de la défense nationale, Canada (Hereafter cited as DHH DND): 681.013 (D48). ‘Discussion on Military Medical Problems in Korea,’ Proceedings of the Royal Society of Medicine 46 (10 June 1953): 1044. 473 Lindsey, ‘Evacuation and Speciality Centers.’ Bretland, ‘The Principles of Prevention of Cold Injuries,’ 88-98. 474 Assistant Director of Medical Services Colonel GL Morgan Smith, Monthly Liaison Letter, Dec. 1952, TNA: WO 281/887. 475 Colonel Albert Julius Glass, ‘Psychiatry in the Korean Campaign,’ United States Armed Forces Medical Journal 4 (1953): 1387-1401. Major General Archibald James Halkett Cassels to Chief of the Imperial General Staff Field Marshal Sir William Slim, 19 Mar. 1952, TNA: WO 216/515. Anon, ‘Discussion on Military Medical Problems in Korea,’ Proceedings of the Royal Society of Medicine 46 (10 June 1953): 1044.
126 injured themselves. He immediately contacted his superiors in the United Kingdom.476 Shortly thereafter, the Chief of the Imperial General Staff (CIGS) Field Marshal Sir William J Slim wrote to the commander of the Commonwealth Division, Major General Archibald James Halkett Cassels.477 On 19 March 1952, Cassels responded to Slim’s enquiries and was quick to reassure him. While he acknowledged that, ‘a great number of…accidental wound cases…were self inflicted,’ he also felt it necessary to explain that the division had suffered, ‘a number of genuine accidental wounds.’478 Although it was difficult to prove whether or not a wound had been self-inflicted, Cassels informed Slim that any suspicious cases would be thoroughly investigated.479 He explained that: It is standard procedure in all contingents in the division that any accidental wound is immediately investigated…All medical officers understand that they must report, to the unit commanding officer (CO), any case of accidental wounding. If there is a shred of evidence that it was self-inflicted all COs are only too keen to court-martial the man and I am completely certain that no CO in this division would try or wish to hide any case. In many cases where self-infliction cannot be proved the man is charged with negligence and punished as far as is possible.480
Cassels was largely positive about how Commonwealth troops were coping with a protracted campaign and noted that the number of accidents had not had an effect on morale. He remarked that ‘When one remembers the very wide front we are holding and the extreme cold at night it puts a very great strain on the individual and, in my view, it says a
476 Director General of Army Medical Services Sir Neil Cantlie to Adjutant General Sir John Crocker, Feb. 1952, TNA: WO 216/515. 477 Chief of the Imperial General Staff Field Marshal William J Slim to Major General Archibald Halkett Cassels, 3 Mar. 1952, TNA: WO 216/515. 478 Major General Archibald James Halkett Cassels to Chief of the Imperial General Staff Field Marshal Sir William Slim, 19 Mar. 1952, TNA: WO 216/515. 479 In his letter to Field Marshal Sir William J Slim, Cassels explained that, ‘to obtain evidence to convict any man [for self-inflicted wounds] is practically impossible. The men are living in their own little dug-outs and they shoot their toe or finger off when they are alone.’ He also said that, ‘So far [since July 1951] we have only been able to produce…sufficient evidence to justify two court martial charges.’ Ibid. 480 Ibid.
127 very great deal for the soldiers as a whole that they have performed so well and have kept in such good spirits.’481
Despite Cassels’ letter, Field Marshal Slim sent the Commander-in-Chief of Far Eastern Land Forces General Sir Charles Keightley to make further enquires in Japan and Korea. Keightley toured divisional medical units throughout the following month and reported to Slim on 22 April 1952. He wrote that while, ‘There are certainly a surprisingly large number of accidental wounds in hospital at present,’ he did not, ‘believe that the problem is really as serious as it appears.’482 Keightley believed that most of the accidents were genuine and listed several contributing factors. Accidents could be the result of: The intense cold, which makes fingers slip. The inherent unreliability of Stens [9mm submachine gun]. Jumpiness in night fighting against Chinese who are apt to appear in any direction. Lack of practice in handling weapons with so many National Service men seeing war for the first time.483
Although a proportion of accidents were self-inflicted, there was no need for alarm. Keightley agreed with Cassels that, ‘Morale was uniformly good and the bearing of men smart and alert. This was especially creditable in view of the very difficult time battalions are having; static wars are always such a test in this way.’484 Throughout the remaining months of the war, concerns about self-inflicted injuries diminished. Nevertheless, Commonwealth authorities continued to monitor the situation and carefully investigate any accident. Soldiers who wounded themselves were not dealt with benevolently as psychiatric casualties. In his letter to Field Marshal Slim, Cassels referred to such men as, ‘weaklings who [had] taken the easy way out.’485 He promised Slim that, ‘if and when we…catch one
481 Ibid. 482 Commander in Chief Far Eastern Land Forces General Sir Charles F Keightley to Chief of Imperial General Staff Field Marshal Sir William J Slim, Note on Self Inflicted Wounds, 22 Apr. 1952, TNA: WO 216/515. 483 Ibid. 484 Ibid. 485 Ibid.
128 he will certainly be dealt with most severely.’486 Despite his zeal to prosecute self-inflicted wound cases, it appears that Cassels had little chance to punish offenders. Due to the difficulty of gathering evidence, only a handful of Commonwealth soldiers were ever charged for self-inflicted injuries.487
Hysteria and Truce Exhaustion By the spring of 1953, it appeared that peace was on the horizon. After protracted discussions, Chinese, North Korean and UN negotiators were finally on the verge of agreement and it seemed that an armistice was imminent. Around the same time, divisional psychiatrist Captain NG Fraser noticed a significant change amongst his patients. For over two years, most servicemen had fit neatly into one of several diagnostic categories. However, this was no longer true. In May 1953, Fraser reported that hysteric patients comprised 39% of the division’s total psychiatric caseload and a month later, this figure had risen to 43%. Prior to this point in time, only a handful of Commonwealth servicemen had been diagnosed or treated for this disorder.488 Hysteria is classified as a conversion reaction, where an, ‘impulse causing anxiety…is converted into functional symptoms in organs or parts of the body, mainly under voluntary control.’489 Its symptoms can include
486 Ibid. 487 There are no Commonwealth records that indicate whether or not anyone was successfully prosecuted for a self-inflicted injury during the Korean War. Registrar Judge Advocate General, Courts-Martial in Korea for Cowardice, Desertion and Mutiny-- Parliamentary Questions, January 1954, TNA: WO 93/59. 488 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. Anon, 25 Canadian Field Dressing Station Monthly Progress Report May 1953, 1 June 1953, LAC: RG24-C-3, Volume 18397. Major LS Glass, 25 Canadian Field Dressing Station Monthly Progress Report June 1953, 6 July 1953, LAC: RG24-C-3, Volume 18397. Anon, 25 Canadian Field Dressing Station Monthly Progress Report July 1953, 7 Aug. 1953, LAC: RG24-C-3, Volume 18397. 489 Anon, Psychiatric Classifications and Criteria, 1958-1967, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1.
129 anything from partial paralysis and tremors to blindness and deafness.490 The rise in hysteric patients was worrying. Be that as it may, the number of admissions had dropped abruptly by early August. Fraser connected the change to the end of the war and the signing of the armistice on 27 July 1953. Writing to his superiors a little over a week later, he explained: Although fighting on many sectors of the front was very fierce just before the cessation of hostilities, the Commonwealth front was relatively quiet. Correlating the increased front line psychiatric casualties with the decreased activity we can assume that tension in the minds of the men must have been higher and the fear of being killed just at the last moment greater.491 In the months following the armistice, 1 Commonwealth Division became an occupation force. Both combat and support troops took on new duties and were expected to fulfil different roles. The transition was not without its difficulties. In August 1953, a condition called truce exhaustion began to appear amongst infantry soldiers in, ‘sufficient numbers to be regarded as a specific clinical entity.’492 Since the beginning of the war, only a small number of non-combat troops had presented with the same symptoms.493 Captain Fraser reported in August 1953 that the disorder usually effected those with, ‘several months Korea service.’494 A typical case, ‘…complain[ed] of gradually increasing irritability—felt the country itself was getting him down—that he could no longer tolerate the boredom (or its opposite—excessive drilling)—that if he was allowed to go on ‘something inside will give’ and he would not be responsible for his actions.’495 Patients were, ‘…often…of the roving mildly psychopathic type, show past histories of inability to settle down to one occupation and have thinly veiled or moderately controlled aggressive tendencies with low frustration tolerance.’496 During the war, they had been able to channel their aggression. As
490 Ibid. 491 Captain NG Fraser, 25 Canadian Field Dressing Station Monthly Psychiatric Report July 1953, 2 Aug. 1953, LAC: RG24-C-3, Volume 18397. Anon, 25 Canadian FDS War Diary, 1953, LAC: RG24-C-3, Volume 18397. 492 Captain NG Fraser, 25 Canadian Field Dressing Station Monthly Psychiatric Report August 1953, 2 Sept. 1953, LAC: RG24-C-3, Volume 18397. 493 Ibid. 494 Ibid. 495 Ibid. 496 Ibid.
130 Fraser explained, ‘combat activity or [the] persistent prospect of combat was sufficient to hold in check or allow canalisation of underlying aggressive energy into useful channels in front line work.’497 This was no longer possible after the armistice had been concluded. Truce exhaustion was associated with behavioural problems, which in some cases led to, ‘actual physical violence against superiors.’498 Command was understandably concerned about the potential impact that truce exhaustion could have upon the division as a whole. With hindsight, they need not have been troubled. Like hysteria, truce exhaustion proved a short-lived phenomenon and was far less damaging than originally predicted. No patients were admitted to 25 Canadian Field Dressing Station for truce exhaustion after December 1953.499 A possible explanation may lie in the area of welfare provision. Throughout the autumn of 1953, there was a substantial increase in the number of canteens, roadhouses and entertainment facilities for soldiers in Korea and Japan. In addition, the division went to great effort to entertain the troops more often by holding concerts and screening movies. These changes played an important part in maintaining and boosting morale.500
Patients The men admitted to 25 Canadian Field Dressing Station and other medical units for psychiatric treatment represented a wide cross-section of the military. They included officers, other ranks, veterans and young recruits.501 As in previous wars, newly rotated
497 Ibid. 498 Ibid. 499 Anon, 25 Canadian Field Dressing Station War Diary, 1953, LAC: RG24-C-3, Volume 18397. Anon, Assistant Director of Medical Services War Diary, 1954, TNA: WO 281/890-891. 500 Adjutant General British Commonwealth Force in Korea, Six Monthly Report: 1 Apr.--30 Sept. 1954, TNA: WO 308/7. Anon, Headquarters British Commonwealth Forces Korea Periodic Report No. 5, 1 Oct. 1953-- 31 Mar. 1954, TNA: WO 308/1. Anon, Korean Campaigns: Welfare and Entertainment, TNA: WO 308/6. War Office, Report on the Health of the Army 1955, 3 July 1959, TNA: WO 279/617. 501 Shephard, War of Nerves. Grossman, On Killing. Leese, Shell Shock. Barham, Forgotten Lunatics.
131 troops were amongst the most vulnerable in theatre. In the first few months following deployment, they had to acclimatise to new surroundings and the dangers of living on the front line. Under the stresses and strains of battle, health problems quickly became apparent. For example, many of the first Canadian troops sent to Korea presented with previously undiscovered conditions like, ‘chronic bronchitis, flat feet, atrophy of the leg muscles, cardiac palpitation [and] hypertension,’ upon arrival in the Far East.502 In the first six months, nearly 20% were sent back to Canada because of, ‘disciplinary, attitudinal, and psychiatric problems.’503 The high rate of psychiatric illness can be attributed to several factors. Firstly, the recruitment of the Canadian Army Special Force for Korea had been carried out hastily throughout the summer and autumn of 1950. The number of recruits initially overwhelmed military depots across the country. Consequently, many new servicemen did not undergo a thorough medical examination.504 Furthermore, historians such as Brent Byron Watson and David J Bercuson have argued that the members of Special Force did not receive proper training before deployment.505 The, ‘training syllabi were virtually the same as those used by the Canadian Army during the Second World War,
Copp and McAndrew, Battle Exhaustion. Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. Major Burdett H McNeel and Major Travis E Dancey, ‘The Personality of the Successful Soldier,’ American Psychiatric Journal 102, No. 3 (Nov. 1945): 338. 502 Copp and McAndrew, Battle Exhaustion, 158. Colonel JE Andrew and Brigadier Ken A Hunter, ‘The Royal Canadian Army Medical Corps in the Korean War,’ Canadian Services Medical Journal (July/Aug. 1954): 5-15. Anon, Adjutant General’s War Diary, LAC: RG 24, Volume 18, 221. Anon, Account of Recruitment Process--No. 6 Personnel Depot, Toronto, DHH DND: 112.3H1.001 (D9). 503 Ibid. Ibid. Ibid. Ibid. 504 Wood, Strange Battleground, 30-33, 41, 44, 67. David J Bercuson, Blood on the Hills: The Canadian Army in the Korean War (Toronto: University of Toronto Press, 1999), 39-59. 505 Brent Byron-Watson, Far Eastern Tour: Canadian Infantry in Korea, 1950-1953 (Montreal, QC and Kingston, ON: McGill Queen’s University Press, 2002), 18-25. Fairlie Wood, Strange Battleground, 43-53. Bercuson, Blood on the Hills, 51-59.
132 modified only slightly to meet what was known about the special circumstances of geography, climate, and the enemy’s tactics in Korea.’506 Finally, the tempo of training was too slow. Early in the autumn of 1950, Canadian authorities believed that the fighting would soon end and failed to institute an appropriate training schedule. When the Chinese entered the war in November, the Canadians were caught off-guard.507 The soldiers of the 2nd Battalion Princess Patricia’s Canadian Light Infantry (PPCLI) had not completed their training when they arrived in Pusan on 18 December 1950.508 Over the following years, Commonwealth admissions rose periodically when new units rotated into theatre. For instance, between April and June 1952 fresh battalions of the 1st Royal Australian Regiment (RAR), 1st Royal Canadian Regiment (RCR) and the 1st Royal 22é Régiment (R22er) landed in Korea.509 During this period, psychiatric admissions nearly tripled over the previous few months. Divisional psychiatrist Major FCR Chalke reported that most of his patients were members of the recently rotated units.510 The number of admissions from 1RAR, 1RCR and 1R22er fell steadily over the course of the summer, as the new arrivals adjusted to circumstance.
Infantry troops who rotated into theatre as individual replacements were also considered to be at an elevated risk of psychiatric breakdown. In general, Commonwealth soldiers were
506 Bercuson, Blood on the Hills, 54. Anon, ‘Notes on Fighting in Korea--25 August 1950,’ 18 Sept. 1950, DHH DND 112.3M2 (D347). 507 Bercuson, Blood on the Hills, 58-60. 508 Ibid., 60. 509 The following units first engaged the enemy on the dates listed. 1st Battalion, Royal 22é Régiment, Royal Canadian Infantry Corps--24 April 1952. 1st Battalion, Royal Canadian Regiment, Royal Canadian Infantry Corps--25 April 1952 1st Armoured Regiment, Royal Canadian Horse Artillery--6 May 1952 1 Royal Australian Regiment --1 June 1952 2nd Armoured Regiment, Lord Strathcona’s Horse--8 June 1952 Directorate of History and Heritage/ La Direction--Histoire et patrimoine, Historical Report No. 72: Canadian Participation in the Korean War Part II (Ottawa: Government of Canada, 1955). 510 Major FCR Chalke, Monthly Psychiatric Report May 1952, 13 June 1952, TNA: WO 281/887. Colonel GL Morgan Smith, Assistant Director of Medical Services Monthly Liaison Letter Serial 13, June 1952, TNA: WO 281/887.
133 rotated in battalion sized groups of between 600 to 800 men.511 However, this was not the case for members of the 3rd Battalion Royal Australian Regiment. In contrast to other Australian units, the troops of 3RAR were replaced individually throughout the war.512 According to historian Robert O’Neill, this system presented many problems and was the reason that, ‘Army headquarters in Melbourne…decided it was preferable to replace whole units after twelve months service in Korea,’ and abandoned individual rotation altogether, ‘in later commitments such as the Malayan Emergency, the Indonesian Confrontation and the Vietnam War.’513 The arrival of untried strangers disrupted the group dynamic of units and could have an impact upon their combat effectiveness. There were, ‘many complaints from the battalion about the suitability of some of the soldiers selected for reinforcement drafts.’514 It soon became apparent that, ‘Some of these men would not have been accepted for war service by a unit training as a whole to go to Korea, because their weakness would have been revealed in exercises before embarkation.’515 In his May 1953 report, Captain Rutherford of 3RAR pointed out that there had been an increase in the number of soldiers on sick parade, many of whom presented with psychosomatic and purely psychological complaints. He was quick to identify the source of the problem. Rutherford stated that, ‘the battalion suffers to some degree from the results of inadequate screening, physical and psychological, of the reinforcements which it receives under the system of individual relief.’516
511 James V Arbuckle, Military Forces in 21st Century Peace Operations: No job for a soldier? (New York: Routledge, 2006), p. 61 512 Robert J O’Neill, Australia in the Korean War 1950-1953, Vol. II, Combat Operations (Canberra: Australian War Memorial and the Australian Government Publication Service, 1985), 131, 219, 267. 513 Ibid., 219, 267. 514 Ibid., 267. 515 Ibid. 516 Captain Rutherford, 3rd Battalion Royal Australian Regiment War Diary Medical Report, May 1953, Australian War Memorial (Hereafter cited as AWM): AWM85, Item No. 639175.
134 The US Army experienced similar difficulties. Like the troops of 3RAR, American soldiers were rotated as individuals rather than as members of a particular unit or group. Problems arose when new soldiers arrived in theatre and as experienced men approached the end of their tour.517 In reviewing American policy shortly after the war, Colonel Albert Glass indicated that, ‘The most pertinent defect of rotation…arises from the disruption of the sustaining power of group identification which occurs when the combat soldier is notified or becomes aware that soon he will go home.’518 Glass further explained that, ‘The increase of tension that follows as the [soldier] shifts his feelings for the group to concern for himself often makes battle fear unbearable. In some cases there is inability to function, with temporary breakdown. For most individuals, anxiety is noticeably increased in the last days of combat, as if it were now more dangerous to tempt fate.’519
As the largest national contingent in the Commonwealth Division, the British suffered the highest number of psychiatric casualties overall. While patients were drawn from a variety of backgrounds, they were generally Regular soldiers rather than National Servicemen. In the monthly psychiatric report of January 1953, Major Johnston recorded that 26 out of 30 British patients were Regulars and noted that this, ‘large preponderance…[was] consistent with findings of previous months.’520 In his book The Call Up: A History of National Service, author Tom Hickman notes that, ‘Just over half [of British troops] were national servicemen--nearly three-quarters of infantry battalions in the final year.’521 Despite the large number of National Servicemen in theatre, Regulars remained overrepresented
517 Glass, ‘History and Organization.’ 518 Ibid. 519 The Americans generally referred to cases of this kind as, ‘short-timer syndrome.’ Ibid. 520 Major FCR Chalke, Monthly Psychiatric Report, Jan. 1953, TNA: WO 281/888. Colonel GL Morgan Smith, Assistant Director of Medical Services Monthly Liaison Letter Serial No. 20, January 1953, TNA: WO 281/888. 521 Tom Hickman, The Call Up: A History of National Service (UK: Headline, 2005), 100. Jason Timothy Fensome, ‘The Administrative History of National Service in Britain, 1950-1963 (PhD diss., University of Cambridge, 2001), 15, 57-58.
135 amongst psychiatric casualties. There are a number of reasons as to why this was the case. Between 1950 and 1953, the British government was forced to recall the, ‘A and B sections of the Regular Reserve,’ to meet the emergency in the Far East.522 The men in question, ‘had served through the Second World War, and many had only a short period of reserve obligation left when they were recalled.’523 As historian Jeffrey Grey has pointed out, ‘They were by definition likely to be settled family men with jobs or businesses to run, and their resentment at this disruption to their lives can be imagined.’524 Although re-enlisted men had signed up willingly, their service was also problematic. In a January 1950 article for the Journal of the Royal Army Medical Corps, Lieutenant Colonel Harry Pozner revealed that there was a, ‘high and increasing incidence of psychiatric breakdown,’ amongst re-enlisted personnel.525 He postulated that these men had been prompted to re- join the Army after WWII because of an inability to cope with civilian life. Pozner believed that veterans hoped to regain a sense of stability in the forces and recapture the camaraderie of their previous service. However, the British Army had changed dramatically since 1945 and many were disappointed by what they found. While Regular soldiers had the benefit of experience, they also carried a heavy burden.526
Prisoners of War From 20 April to 3 May 1953, the first Commonwealth prisoners of war (POWs) were released from captivity in Operation Little Switch. After protracted discussions, both sides had agreed to the exchange of injured and sick prisoners. Several months later, the remaining POWs were released during Operation Big Switch. Roughly 1,036 Commonwealth soldiers had been taken prisoner during the course of the Korean War. The
522 Jeffrey Grey, The Commonwealth Armies and the Korean War: An Alliance Study (Manchester and New York: Manchester University Press, 1988), 39. 523 Ibid. 524 Ibid. 525 Lieutenant Colonel Harry Pozner, ‘Some Aspects of Post-War Army Psychiatry,’ Journal of the Royal Army Medical Corps 94, No. 1 (Jan. 1950): 44-45. 526 Ibid.
136 majority had fallen into enemy hands between September 1950 and June 1951.527 Over the following years, they suffered severe deprivation and brutal treatment at the hands of their captors.528 Throughout the summer of 1953, 25 Canadian Field Dressing Station was temporarily transformed into Camp Britannia for the purposes of Operation Homeward Bound or the repatriation of Commonwealth prisoners.529 There was widespread concern as to POW physical and mental health. Be that as it may, the men were largely in good condition and high spirits. While many were malnourished, very few appeared to have suffered irreversible damage.530 Divisional psychiatrist Captain NG Fraser assisted in most of the physical examinations in order to, ‘obtain a general impression of the POW’s mental attitude as this was thought to be preferable to a routine ‘frankly psychiatric examination interrogation so soon after release.’531 Fraser and his colleagues were largely satisfied with the mental stability of the POWs that passed through Camp Britannia. Nevertheless, they recognised that, ‘the sheer joy of release may be covering up any existing psychiatric conditions.’532 Furthermore, during, ‘routine [physical] examination it is possible to detect numerous complaints which are of probable psychogenic aetiology.’533 However, Fraser did
527 Number of Commonwealth Prisoners of War (POWs): British 977 Canadian 32 Australian 26 New Zealand 1 Walter G Hermes, Truce Tent and Fighting Front, United States Army in the Korean War (Washington, DC: Office of the Chief of Military History, 1966). 528 Neither North Korean nor Chinese forces recognised the 1949 Geneva Conventions on the treatment of prisoners of war. Commonwealth troops were subjected to ill treatment including but not limited to solitary confinement, denial of toilets and denial of clothing and bedding. Throughout the war, attempts were made to indoctrinate POWs with Communist ideology. Prisoners were often punished if they resisted this process. Ministry of Defence, Treatment of British Prisoners of War in Korea, 1955, TNA: ADM 1/25760. Jonathan FW Vance, Objects of Concern: Canadian Prisoners of War Through the Twentieth Century (Vancouver: University of British Columbia Press, 1994), 217-234. 529 Captain NG Fraser, Monthly Psychiatric Report August 1953, Sept. 1953 LAC: RG24-C-3, Volume 18397. 530 Ibid. 531 Ibid. 532 Ibid. 533 Ibid.
137 not have time to investigate or treat any of the men about whom he might have harboured concerns. Commonwealth POWs were processed and repatriated as quickly as possible.534
Field Treatment Addressing his colleagues at a conference following the Korean War, American psychiatrist Dr Hyam Bolocan stated that, ‘The major function of the Division and Army psychiatrist is the conservation of manpower.’535 Bolocan’s words ring true. While an Army psychiatrist may have personal reservations about returning a man to duty, he is obligated to send as many soldiers back into the field as possible. In the article, ‘Ethical Challenges for the Psychiatrist during the Vietnam War,’ Dr Norman M Camp explained that: …the combat psychiatrist’s foremost military responsibility is that of stemming the flow of individuals who manifest a psychological incapacity or reluctance to soldier, he may be obligated to deny a psychologically traumatised soldier’s expectation of medical exemption from further exposure to combat…to conform to the military’s expectation that the soldier be returned to the environment.536
Since the early twentieth century, military psychiatric treatment has been guided by manpower considerations and the Korean War was no exception. Treatment was based upon the principles of PIE, a philosophy originally developed during World War I. The
534 According to Australian historian Jeffrey Grey, POW de-briefings were held in Tokyo. They, ‘were conducted by a small team of British officers commanded by a major. The majority of interrogating officers were young subalterns. A Dominion officer was present during the questioning of Dominion personnel, and all sessions conformed to the same general format. They were designed to elicit information about the circumstances of the subject’s capture and his experiences as a prisoner, the names and circumstances of other prisoners encountered in the camps, especially if the subject knew or believed them to have died in captivity, and the identities and conduct of enemy personnel and Western visitors to the camps.’ Most of the Australian and British prisoners were questioned and around half of the Canadians attended sessions. Some of the de- briefing records are publicly available at the National Archives of Australia. However, the files at the British National Archives, ‘have been embargoed for 100 years.’ Jeffrey Grey, ‘Commonwealth prisoners of war and British policy during the Korean War,’ Royal United Services Institute Journal 133, No. 1 (1988): 74. 535 Hyam Bolocan, ‘Functions of a Psychiatric Consultant to a Division, and to an Army,’ in Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950-1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954). 536 Norman M Camp, ‘Ethical Challenges for the Psychiatrist During the Vietnam Conflict,’ in Military Psychiatry: Preparing in Peace for War, eds. Franklin D Jones, et al. (USA: Government Printing Office, 2000), 134.
138 acronym stands for proximity, immediacy and expectancy. Mentally ill soldiers are treated as quickly and as closely to the front lines as possible.537 Hard won experience indicated that patients worsened when treatment was delayed or delivered at a rear echelon medical unit. In addition, it was important to treat patients like soldiers rather than as victims. Doctors avoided the suggestion that men were seriously ill or would benefit in any way from their condition. Patients were expected to return to duty.538 Regimental Medical Officers were the first to attend all Commonwealth casualties. They could provide soldiers with basic first aid and pain relief. However, the majority of Commonwealth medics had little training in psychiatry. American RMOs were issued a guide to combat psychiatry upon arrival in theatre and were continually provided with reading material on the subject throughout the war. While Commonwealth doctors were initially briefed about mental health problems, divisional authorities did not take similar educational measures.539 RAMC medics were particularly ill equipped to attend psychiatric patients. Over 50% of British RMOs were National Servicemen, who had only recently qualified as physicians.540 Be that as it may, the Regimental Aid Post (RAP) was a refuge for anxious and exhausted troops who were expected to recover within 24 hours. Within the confines of the RAP, soldiers could be sedated and provided with a respite from the strain
537 Flood, ‘Psychiatric Casualties in UK Elements,’ 41. Hans Binneveld, From Shell Shock to Combat Stress: A Comparative History of Military Psychology. (Amsterdam: Amsterdam University Press, 1998), 137. 538 Binneveld, From Shell Shock to Combat Stress, 137, 157-159. Shephard, War of Nerves. Colonel Donald B. Peterson and Brigadier General Rawley E. Chambers, ‘Restatement of Combat Psychiatry,’ American Journal of Psychiatry 109, No. 4 (Oct. 1952): 249-254. Colonel Albert Julius Glass, ‘Psychotherapy in the Combat Zone,’ American Journal of Psychiatry 110, No. 10 (1954): 725-731. 539 Anon, Royal Canadian Army Medical Corps Study Papers Volume I, Tactics Series—Précis 3, 1952, CWM: Textual Records 58C 3 22.1 Montgomery, Questionnaire on Korean Campaign Answers, 1952, Wellcome Library and Archives (Hereafter cited as WLA): Royal Army Medical Corps Muniments Collection, 761/4, Box 158. Ritchie, 2002, p. 898. 540 Army Medical Advisory Board, Meetings 1 July 1949-September 1954, 8 December 1950, p. 4, TNA: WO 32/13465.
139 of war.541 Patients who presented with more severe or protracted symptoms were generally evacuated by field ambulance. At any one time, there were three such units on duty in Korea. They consisted of a headquarters and several, ‘self contained sections,’ that were responsible for transporting casualties.542 The divisional psychiatrist visited each field ambulance once a week in order to assess patients and make decisions in regards to their treatment. Servicemen who required further attention were transported to 25 Canadian Field Dressing Station. 543 These visits served an important purpose, as they allowed the psychiatrist to, ‘obtain first-hand information of combat psychological problems.’ 544 Consequently, ‘His recommendations then display[ed] a more practical appreciation of the difficulties involved in combat adaptation.’ 545 It was also vital that the divisional psychiatrist gain the trust of his fellow colleagues and soldiers. As American psychiatric consultant Colonel Glass recognised, ‘The divisional psychiatrist who remains in the rear is resented as one who fears to share their [front line soldiers’] hardships, even briefly, and is therefore an impractical, theoretical person who does not belong in their world of deprivation and trauma.’546
Upon admission to 25 FDS, the majority of patients were sedated using a barbiturate such as sodium amytal.547 Throughout the first half of the twentieth century, barbiturates were
541 Colonel G Anderton, Assistant Director of Medical Services 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, WLA: Royal Army Medical Corps Muniments Collection, 761/4, Box 158. Anon, Royal Canadian Army Medical Corps Study Papers Volume I, Tactics Series—Précis 5, Part 4, 1952, CWM: Textual Records 58C 3 22.1 542 Director General of Medical Services, Royal Canadian Army Medical Corps Study Papers: Volume I—A/Capt.—Capt., January 1952, CWM: 58C 3 22.1. 543 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397. 544 Glass, ‘History and Organization.’ 545 Ibid. 546 Ibid. 547 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397. Flood, ‘Psychiatric Casualties in UK Elements,’ 43.
140 the, ‘most widely used of all sedative drugs.’548 Developed by the Eli Lilly Company in the 1920s, sodium amytal was first used by psychiatrists to help calm psychotic patients.549 During WWII, doctors continued to employ the drug to sedate soldiers and help them to communicate freely. For example, well-known British psychiatrists Dr William Sargant and Dr Eliot Slater used sodium amytal to treat British servicemen who had been evacuated from Dunkirk following the defeat of France in June 1940.550 By immediately sedating patients, Sargant and Slater believed that it was possible to stop, ‘neurotic pattern[s] of thought or behaviour from remaining fixed in the patient’s brain.’551 Patients could be sedated for weeks at a time in order to interrupt destructive thought processes. In Korea, sodium amytal was employed in a more conservative fashion. Both Commonwealth and American psychiatrists used the drug to allow acutely anxious patients to sleep for a day or two and regain their composure. At a field medical unit, it was not feasible to sedate patients for a prolonged period.552 Servicemen subsequently faced a thorough physical and psychiatric examination. If the doctors at 25 FDS were unsure as to a diagnosis, they would occasionally send patients for further testing at 123 American Holding Company in
Newman, ‘Combat Fatigue,’ 926. 548 I Philips Frohman, ‘The Barbiturates,’ American Journal of Nursing 54, No. 4 (Apr. 1954): 432. 549 Wilbur R Miller, ‘Sodium Amytal: Its Use in Mental Disease,’ American Journal of Nursing 31, No. 6 (June 1931): 677. 550 Shephard, War of Nerves, 209-210. William Sargant, ‘Physical Treatment of Acute War Neuroses,’ British Medical Journal No. 2 (1942): 574-576. 551 William Sargant, The Unquiet Mind: The Autobiography of a Physician in Psychological Medicine (London: Heinemann, 1967), 114, quoted in Terry Copp and Mark Osborne Humphries, Combat Stress in the 20th Century: The Commonwealth Perspective (Kingston, ON, Canada: Canadian Defence Academy Press, 2010), 128. Shephard, War of Nerves, 207-208. ‘Psychiatry: Condensed from an Article Written by Brigadier A Torrie, MB, and Major RH Ahrenfeldt,’ Journal of the Royal Army Medical Corps 90, No. 6 (June 1948): 332. 552 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397. Captain Richard L Conde, MC, Division Neuropsychiatrist, United States Army 7th Infantry Division, Annual report of Neuropsychiatric Services, 1 Jan. 1951-31 Dec. 1951, NARA: RG 112, Records of the United States Army Surgeon General, 7th Infantry Division, Annual Reports, 1950- 1953, Box 221. Flood, ‘Psychiatric Casualties in UK Elements,’ 43. Norbury, ‘Combat Fatigue,’ 131.
141 Seoul.553 During the war, Commonwealth medical personnel had developed a close and friendly relationship with their US Army counterparts. Early in 1951, a group of American medical officers had founded the 38th Parallel Medical Society. The group hosted fortnightly conferences on subjects relevant to the Korean/Japanese theatre. Many Canadian and British officers were members of the society and regularly attended the conferences in order to consult with their colleagues in the US Army. The Americans encouraged Commonwealth medical staff to make use of their resources when necessary.554 Divisional psychiatrist Captain NG Fraser commented on the beneficial nature of this arrangement in a July 1953 letter to his mother and brother. He noted that, ‘It is…very useful to know them [US Army psychiatrists] as they have the facilities for doing all sorts of mental tests on patients that we don’t have.’555
Following diagnosis, Commonwealth patients generally attended several brief sessions of psychotherapy. These appointments presented an opportunity for the divisional psychiatrist to further evaluate his patients and assess whether or not they could return to duty. During these sessions, issues such as family background and the circumstances surrounding the patient’s admission were touched upon briefly.556 However, neither of these subjects was
553 Anon, 25 Canadian Field Dressing Station War Diary, 1951, LAC: RG24-C-3, Volume 18395. Anon, Assistant Director of Medical Services War Diary, Feb. 1952, TNA: WO 281/887. Captain NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, 22 Mar. 1953, Personal Letters of Dr NG Fraser, Glasgow, UK. 554 Anon, Assistant Director of Medical Services War Diary, 1951-1953, TNA: WO 281/886-888. Captain NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, Mar. 1953, Personal Letters of Dr NG Fraser, Glasgow, UK. Colonel Bryon L Steger, ‘Medical Societies in Korea,’ Medical Bulletin of the United States Army Far East 1, No. 6 (May 1953): 92. Lieutenant NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, 4, 22 Jan. 1953, Personal Letters of Dr NG Fraser, Glasgow, UK. Captain NG Fraser, Monthly Psychiatric Report July 1953, 2 Aug. 1953, LAC: RG24-C-3, Volume 18397. 555 Captain NG Fraser to Mrs CC Fraser and Mr Rupert Fraser, 10 July 1953, Personal Letters of Dr NG Fraser, Glasgow, UK. 556 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397.
142 discussed in any depth.557 In his 1954 article, ‘Psychotherapy in the Combat Zone,’ Colonel Glass explained the reasons for avoiding topics of this nature. He explained that:
…any therapy…that sought to uncover basic emotional conflicts or attempted to relate current behaviour and symptoms with past personality patterns seemingly provided patients with logical reasons for their combat failure. The insights obtained by even such mild depth therapy readily convinced the patient and often his therapist, that the limit of combat endurance had been reached as proved by vulnerable personality traits. Patients were obligingly cooperative in supplying details of their neurotic childhood, previous emotional difficulties, lack of aggressiveness and other dependency traits, or any information that displaced onus for the current combat breakdown to remote events over which they had no control and therefore could not be held responsible.558
Patients, who developed such a ‘defeatist and fatalistic attitude,’ were difficult to return to their original units or duty of any kind.559 There is no evidence that physical treatment methods like electroconvulsive therapy (ECT) and insulin coma were used in the field.560
Dr Leslie Bartlet, email message to author, 22 Sept. 2011. Flood, ‘Psychiatric Casualties in UK Elements.’ 557 It appears that exploratory therapeutic methods like abreaction were used only with the most resistant and difficult cases. After being sedated using sodium amytal, men were asked to relive traumatic events in order to confront the memory and rid themselves of anxiety. Abreaction had fallen out of vogue amongst civilian psychiatrists but remained in use by the British Army after WWII. There is no evidence as to whether or not abreaction was successfully used in Korea. Be that as it may, there are occasional references to this practice in Canadian and British records. Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. Dr Leslie Bartlet, email message to author, 22 Sept. 2011. Flood, ‘Psychiatric Casualties in UK Elements.’ 558 Colonel Albert Julius Glass, ‘Psychotherapy in the Combat Zone,’ American Journal of Psychiatry 110 (1 Apr. 1954): 727. 559 Ibid., 728. 560 Electroconvulsive therapy (ECT) was first developed and employed by psychiatrists in the late 1930s. Patients are sedated and a series of shocks are administered in order to produce convulsions. In the early 1950s, ECT was largely used to treat depression in combination with other drugs and therapy. Insulin therapy was also first used as a psychiatric treatment during the 1930s. Patients are put into a series of comas using insulin over a prolonged period (e.g. days or weeks). The treatment was primarily used to treat psychotic patients and had already begun to fall out of favour by the 1950s. Henderson and Gillespie, A Textbook of Psychiatry, 422-427. JA Hadfield, ‘Traumatic Neurosis and Electro-Shock,’ British Medical Journal 2, No. 4680 (16 Sept. 1950): 679.
143 Techniques of this kind required close supervision and highly attentive nursing and in the midst of a war, it was impossible to accommodate patients in this fashion.561 Furthermore, the use of physical treatment could convince patients that they were seriously ill and interfere with their recovery. Rather than rely on physical methods, Commonwealth psychiatrists remained firmly focused on the basics. The central goal was to eliminate an individual’s symptoms and restore his ability to function as an effective soldier.562
Return to Unit Rates Divisional war diaries indicate that over 50% of psychiatric casualties were returned to some form of duty. Return to unit (RTU) rates peaked at a high of 83% in the months preceding the Korean armistice.563 The Americans similarly estimated that between 65%
Edward Shorter, A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (New York: John Wiley & Sons, 1997), 160-238. GW Fitzgerald, ‘Neuropsychiatry and Medicine,’ Canadian Medical Association Journal 60 (Feb. 1949): 125-126. M Carnat, FJ Edwards and Elizabeth I Fletcher, ‘The Treatment of Certain Psychoneuroses by Modified Insulin Therapy,’ Canadian Medical Association Journal 58 (Jan. 1948): 22. Dr Leslie Bartlet, email message to author, 22 Sept. 2011. Lieutenant Colonel JFD Murphy, ‘An Insulin Coma Therapy Unit in a Military Psychiatric Division,’ Journal of the Royal Army Medical Corps 99, No. 5 (Oct. 1953): 232-243. 561 Lieutenant Colonel J McGhie and Major DJ McConvell, ‘A Survey of Service Psychiatry in the Far East during 1951,’ Journal of the Royal Army Medical Corps 99, No. 4 (July 1953): 173-180. Lieutenant Colonel J McGhie and Brigadier JT Robinson, ‘Original Communications: Endocrinological Investigations of the Psychiatric Casualty in the Army,’ Journal of the Royal Army Medical Corps 101, No. 2 (Apr. 1955). Henderson and Gillespie, A Textbook of Psychiatry, 407-439. 562 Anon, Psychiatric Classifications and Criteria, 1958-1967, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1. Captain HCJ L’Etang, ‘A Criticism of Military Psychiatry in the Second World War: Part III Historical Survey,’ Journal of the Royal Army Medical Corps 97, No. 5 (Nov. 1951): 326. Hyam Bolocan, ‘Functions of a Psychiatric Consultant to a Division, and to an Army,’ in Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950-1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954). Newman, ‘Combat Fatigue,’ 926. Rawling, Death Their Enemy, 252. 563 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397.
144 and 90% of patients returned to duty from 1952-1953.564 The Commonwealth Division did not keep records as to the number of men who were admitted for mental health problems on more than one occasion.565 However, US Army returns from 1951-1952 suggest that, ‘5 to 10% were ‘Neuropsychiatric Repeaters.’’566 In a 1954 article for the Journal of the Royal Army Medical Corps, Captain JJ Flood claimed that the nature of Korean combat accounted for this level of success. During the war, there had been a, ‘distinct absence of enemy shell fire and aerial bombing,’ which contributed to greater recovery rates.567 Furthermore, battles were of short duration and mass psychiatric casualties were never a problem. Although Flood’s arguments are plausible, RTU rates should be treated with caution. Throughout WWI and WWII, psychiatrists had struggled to be accepted by their military and medical colleagues.568 Following World War II, military psychiatrists on both sides of the Atlantic continued to face professional obstacles. The British Directorate of Army Psychiatry experienced significant staff shortages and budget cuts. The Canadian Army cut its neuropsychiatric division altogether in 1946 and was in the process of rebuilding the programme in the early 1950s. Similarly to their WWII predecessors, psychiatrists
War Office, Report on the Health of the Army 1951-1952, TNA: WO 279/610. 564 Ritchie, ‘Psychiatry in the Korean War,’ 900. Norbury, ‘Psychiatric Admissions in a Combat Division,’ 131. 565 No records were kept of the number of men who returned to their original units. Commonwealth RTU figures are only indicative of the number of men who returned to some form of active duty (e.g. combat, support roles). Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. Anon, Assistant Director of Medical Services War Diaries, 1951-1953, TNA: WO 281/886-888. Colonel G Anderton, Assistant Director of Medical Services 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, WLA: Royal Army Medical Corps Muniments Collection, RAMC/761/4. Colonel JS McCannel, Assistant Director of Medical Services Monthly Liaison Letter Serial No. 26, July 1953, TNA: WO 281/888. 566 Ritchie, ‘Psychiatry in the Korean War,’ 900. 567 Flood, ‘Psychiatric Casualties in UK Elements,’ 47. 568 Shephard, War of Nerves, 325-327. Jones and Wessely, Shell Shock to PTSD, 88. Copp and Humphries, Combat Stress, 153.
145 deployed to Korea were under pressure to produce results.569 In discussing American sources, author Ben Shephard has pointed out that, ‘The literature on Korea…was written by…professionals with records to protect.’570 This is equally true in reference to the Commonwealth. Doctors may have somewhat exaggerated their results. Nevertheless, existing documentation indicates that only 5% to 10% of evacuations to the British Commonwealth General Hospital in Japan were psychiatric. While many soldiers did not return to the front lines, it is clear that the majority of men remained in Korea following treatment.571
If a psychiatric casualty could not return to his original unit, this did not necessarily signal evacuation. Whenever feasible, troops were re-employed along the division’s line of communications in Korea or in more, ‘sheltered conditions,’ in Japan.572 The Americans had adopted the same policy early in 1951 after a rash of unnecessary evacuations.573 For both the US Army and the Commonwealth Division, manpower was a precious commodity as replacements could take weeks or months to reach theatre. Therefore, it was vital to retain any man who could still be useful. The Australians were the only national contingent to which this policy did not apply. If an Australian soldier was not passed fit for combat
569 Secretary of State for War, Shortage of Specialists Royal Army Medical Corps: Extract from the Minutes of the 8th (50) Meeting of the Standing Committee of Service Ministers, 16 May 1950, TNA: WO 32/13369. Brigadier CS Thompson to Dr GH Hutton, 23 September 1946, NA, RG 24, Vol. 19, 466 in Copp & McAndrew, Battle Exhaustion, 157. 570 Shephard, War of Nerves, 342. 571 Anon, Assistant Director of Medical Services War Diary, 1951-1953, TNA: WO 281/886-888. Anon, 25 Canadian Field Dressing Station War Diary, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397. Anon, 29 British General Hospital and British Commonwealth General Hospital War Diaries, 1950- 1953, TNA: WO 281/892, 281/1274-1278. 572 Anon, 29 British General Hospital: Situation Report—UK Troops, Fortnight ending 22 Dec. 1950, WO 281/1274. 573 Colonel Albert Julius Glass, ‘Psychiatry in the Korean Campaign: A Historical Review,’ United States Armed Forces Medical Journal 4 (1953): 1563-1583.
146 duty following psychiatric treatment, he was immediately repatriated.574 In September 1952, clinical officer of psychiatry Captain RG Godfrey wrote that most of his Australian patients, ‘could have been employed in less exposed positions in the Division, and their evacuation rendered unnecessary, were it possible to downgrade them in Korea in a similar manner to the British and Canadians.’575
Hospitalisation and Evacuation Korea’s harsh terrain and climate made transporting casualties a daunting prospect and patients travelled to the British Commonwealth General Hospital in a variety of ways.576 The most severely injured casualties were evacuated by helicopter and airlifted to Japan by the Royal Australian Air Force (RAAF). Based in the small town of Iwakuni, the RAAF base was only a short distance from the hospital in Kure.577 Less urgent cases were moved by rail or by jeep ambulance.578 Despite the best efforts of the Royal Engineers, Korea had little established infrastructure and road journeys often proved challenging.579 RAMC ambulance orderly Bill Trevett recalled that in many cases, ‘you had to tie the patients on [to the stretchers]. If they were unconscious you had to strap them in. They would just roll
574 Captain RG Godfrey, Monthly Psychiatric Report—September 1952, 9 Oct. 1952, TNA: WO 281/887. 575 Ibid. 576 Rawling, Death Their Enemy, 242-243. Bill Trevett, interview by author; Trowbridge, Wiltshire, UK, Nov. 2010. Dr Leslie Bartlett, email message to author, 22 Sept. 2011. Dr WS Stanbury, The Canadian Red Cross in the Far East, July 1952, CWM: 58C 3 22.1. 577 Eric Taylor, Wartime Nurse: One Hundred Years from the Crimea to Korea, 1854-1954 (London: Robert Hale, 2001), 202-203. 578 Rawling, Death Their Enemy, 242-243. Trevett, interview by author. Dr Leslie Bartlett, email message to author, 22 Sept. 2011. 579 Lieutenant Colonel Howard N Cole, Navy, Army and Air Force Institute in Uniform (UK: Navy, Army and Air Force Institute, 1982), 175. Major BD Jaffey, Casualty Evacuation in Korea, 37 Canadian Field Ambulance, Sept. 1952, RG 24, Volume 18, 385.
147 out of stretchers because the ambulance went all over the place sometimes.’580 Upon arrival in Pusan, patients were loaded onto hospital ships bound for the Japanese coast.581
Former troop carriers like the Maine were refitted to act as hospital ships during the Korean War.582 Sailing back and forth between Pusan and Kure, Her Majesty’s Hospital Ship (HMHS) Maine was staffed by, ‘one principal medical officer, four [subordinate] medical officers, one matron, four nursing sisters, six naval [members of the] Volunteer Aid Detachment (VAD), one wardmaster and thirty-six sick berth staff…’583 For patients, the conditions on-board could be oppressive. As retired Queen Alexandra’s Royal Naval Nursing Service (QARNNS) Matron Ruth Stone described: The water-line Wards required that the portholes be secured when at sea and as the temperature there registered 90-116°F since these wards were actually situated over the main generators and…did not have either air conditioning or washing facilities, you can imagine the resemblance to Dante’s Inferno as we descended the ramp to cope with some 80—100 battle soiled and dehydrated walking wounded. But in spite of the lack of normal, basic nursing conditions, the wounded were so grateful just to be able to lie down in comparative safety and sleep. Numerous large jugs of water and lime-juice were placed in strategic positions and all…battle-fatigued patients were sedated to spite the noise of the all too near ship’s engines below.584
BCGH’s ward 17 was home to the division’s most serious and protracted psychiatric cases. Staffed by a psychiatrist and a small team of nurses, the unit was a dedicated in-patient facility. The psychiatrist in question acted as both an administrator and physician. He was responsible for managing the ward, treating patients and consulting on cases throughout the
580 Trevett, interview by author. 581 Taylor, Wartime Nurse, 194-196. 582 Ibid., 194. Ruth Stone, ‘Nursing Aboard Her Majesty’s Hospital Ship Maine,’ in British Forces in The Korean War, eds. Ashley Cunningham-Boothe and Peter Farrar (West Yorkshire, UK: British Korean Veterans Association, 1989), 114. 583 Taylor, Wartime Nurse, 194. 584 Stone, ‘Nursing Aboard Her Majesty’s Hospital Ship Maine,’ 117.
148 hospital.585 The unit’s first director was the experienced and well-respected Captain JJ Flood of the Royal Army Medical Corps, who served in this capacity from 1950-1951. In the early months of 1952, his colleague and fellow countryman Major RG Davies succeeded him as the hospital’s resident psychiatrist. When Davies was reassigned to duties in Korea, divisional psychiatrist Major JL Johnston replaced him.586 From 1953-1954, the post in Kure alternated between several British officers: Major JJ McGrath, Captain NG Fraser and Lieutenant Leslie Bartlet. Each man spent time working within the hospital and out in the field.587
Roughly 5% of BCGH’s patients were admitted for psychiatric reasons. While acute anxiety conditions were common in Korea, they were rare amongst the patients sent to
585 Colonel ANT Meneces, British Commonwealth General Hospital: Monthly Liaison Letter—July 1952, 15 Aug. 1952, TNA: WO 281/892. Anon, 29 British General Hospital: Situation Report—UK Troops, Fortnight ending 22 Dec. 1950, WO 281/1274. Anon, 25 Canadian Field Dressing Station War Diary, 1951, LAC: RG24-C-3, Volume 18395. Dr Kenneth Davison, interview by author; Newcastle-upon-Tyne, UK, 17 Nov. 2010. 586 Flood, ‘Psychiatric Casualties in UK Elements,’ 40-47. Brigadier JE Snow, 29 General Hospital—Monthly Liaison Letter Mar. 1951, TNA: WO 281/1276. Anon, 25 Canadian Field Dressing Station War Diary, Oct.-Dec. 1952, LAC: RG24-C-3, Volume 18396. Anon, Minutes of Assistant Director of Medical Services Conference, 4 Jan. 1954, TNA: WO 281/889. Anon, Assistant Director of Medical Services War Diary, May 1953, TNA: WO 281/888. Captain NG Fraser, Letters to Mrs CC Fraser and Mr Rupert Fraser, March-August 1953, Personal Letters of Dr NG Fraser, Glasgow, UK. Dr Leslie Bartlett, email message to author, 22 Sept. 2011. FCR Chalke, Monthly Psychiatric Report—May 1952, 13 June 1952, TNA: WO 281/887. JCB Whycherley, Roll of Officers Filling Vacancies in, or posted surplus to the unit (including officers gone since the date of the last month), For the month ending 31 Jan. 1952, TNA: WO 281/892. Major JS Hitsman, Appreciation of the Movement of 25 FDS, May 1952, LAC: RG24-C-3, Volume 18395. 587 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397.
149 Kure.588 They presented with unexplained somatic symptoms, schizophrenia, alcoholism, drug addiction, epilepsy and a range of other illnesses. Many suffered from complex and comorbid disorders.589 Be that as it may, BCGH staff treated patients using techniques like sedation and psychotherapy. Like their colleagues in the field, hospital personnel did not employ physical treatment methods.590
Neither the physically nor the mentally ill were allowed to monopolise hospital resources for long.591 For instance, in February 1953 the average servicemen spent only 11 days at BCGH before being discharged.592 Patient turnover was high and only the most gravely ill were admitted for an extended period. If troops required further recuperation, they were sent to one of several convalescent facilities in the area. Opened in 1951, No. 6 Convalescent Depot could accommodate 300 men and was located at division headquarters
588 Psychiatric evacuations to BCGH ranged from 2% to 15% of all Commonwealth evacuations to the hospital. However, the numbers were usually around the 5-7% mark. Anon, 25 Canadian Field Dressing Station War Diary, 1951, LAC: RG24-C-3, Volume 18395. Anon, 25 Canadian Field Dressing Station War Diary, 1952, LAC: RG24-C-3, Volume 18396. Anon, Weekly Returns of UK Patients transferred to BCOF General Hospital from Korea via US Medical Units, 1951, TNA: WO 281/892, 1275-1278. War Office, Report on the Health of the Army 1951-1952, TNA: WO 279/610. 589 Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. Anon, 29 British General Hospital War Diary, 1951, TNA: WO 281/1275-1278. Anon, British Commonwealth General Hospital War Diary, 1952, TNA: WO 281/892. Anon, British Commonwealth Forces in Korea Periodic Report No. 3, 1 Oct. 1952-31 Mar. 1953, TNA: WO 308/60. Captain NG Fraser, Letter to Mrs CC Fraser and Mr Rupert Fraser, 3 May 1953, Letters of Dr NG Fraser, Glasgow, UK. War Office, Report on the Health of the Army 1951-1952, TNA: WO 279/610. 590 Anon, 29 British General Hospital War Diary, 1951, TNA: WO 281-1275-1278. Anon, British Commonwealth General Hospital War Diary, 1952, TNA: WO 281/892. Anon, British Commonwealth Forces in Korea Periodic Report No. 3, 1 Oct. 1952-31 Mar. 1953, TNA: WO 308/60. 591 Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21. Anon, 29 British General Hospital War Diary, 1951, TNA: WO 281/1275-1278. Anon, British Commonwealth General Hospital War Diary, 1952, TNA: WO 281/892. 592 Lieutenant Colonel EH Ainslie, Canadian Section British Commonwealth General Hospital War Diary, February 1953, LAC: RG24-C-1-c, Volume 35954, File 2001-812/BC.
150 in Kure.593 In the unit’s war diary, commanding officer Major R Fuller (RAMC) noted that, ‘The aim of the Convalescent Depot [was] to bridge the gap between the period of Hospital inpatient treatment and the return to full duty of the individual soldier who may have been admitted to Hospital for a variety of reasons.’594 Through a daily regime of drill and exercise, Fuller and his team transformed the wounded and ill back into soldiers. When the depot was full or over capacity, servicemen were sent to a smaller unit on the nearby island of Miyajima (Itsukushima). Psychiatric patients were treated in the same fashion as their physically injured counterparts.595 The US Army ran a series of comparable convalescent camps throughout Korea and Japan. Recovering American soldiers were required to wear fatigues and, ‘participated in an active daily program of calisthenics, supervised athletics, marches and other training activities.’596 A psychiatrist was attached to each of the camps to address any emergencies and guide struggling patients. This was not the case in Kure or Miyajima. The Commonwealth Division did not have the money or the manpower to make similar arrangements. Psychiatrists and mental health nurses had to be concentrated in locations where they would be most utility to the division as a whole.
In order to, ‘qualify for repatriation, a wounded man had to be incapable of returning to duty within 120 days.’597 Medical evacuations took place once a month. Former operating theatre technician, Dr David Oates remembered that, ‘Ambulances transported patients to Kure railway station (5 minutes from the hospital) and then by ambulance train to
593 Anon, No. 6 Convalescent Training Depot, Royal Army Medical Corps War Diaries, 1951-1952, TNA: WO 281/906-907. Anon, Historical Notes: Medical Services British Commonwealth Forces Korea, 1953, TNA: WO 308/21. 594 Major R Fuller, No. 6 Convalescent Depot, Royal Army Medical Corps War Diary, Appendix No. 2, 19 July 1951, TNA: WO 281/906. 595 Anon, British Commonwealth Forces Korea Periodic Report No. 8, 1 Apr. 1955-30 Sept. 1955, TNA: WO 308/61. Anon, 29 British General Hospital War Diary, 1951, TNA: WO 281/1275-1278. Dr WS Stanbury, The Canadian Red Cross in the Far East, July 1952, CWM: 58C 3 22.1. 596 Glass, ‘History and Organization.’ 597 Anon, Evacuation Policy: Korean Theatre of Operations, 23 May 1951, LAC: RG 24, 1983- 1984/048, Box 2153, File 5835-I, Part I.
151 Iwakuni.’598 A nursing sister accompanied the men at all times. At this juncture, patients were carefully loaded onto waiting planes and secured for the subsequent flight. In Salute to the Air Force Medical Branch, author Harold M Wright explains that:
The aircraft in use at the time was the Douglas C-54 Skymaster, a four-engine passenger cargo plane that could take twenty-eight patients, and the Douglas C-57 Liftmaster, a larger four-engine troop cargo carrier that could accommodate as many as sixty-nine patients. Patients were accommodated on canvas stretchers stacked along the side walls of the fuselage and five high along the centre of the cargo bay. The centre stacks were two deep, requiring nursing staff on both sides…Regardless of their degree of mobility, all casualties had to be on litters because of the duration of the flight and the limited walking space around the plane’s interior.599
No matter the destination, the journey home was a lengthy and arduous one. For example, flights from Tokyo to North America stopped at the, ‘Kwajalein Atoll in the Marshall Islands, Wake Island, and Midway,’ before landing at Hickam Air Force Base in Hawaii.600 After refuelling, flights continued onwards to Los Angeles. Upon arrival, patients were off- loaded and re-loaded onto planes bound for other American and Canadian cities.601
When they landed, patients were funnelled into an extensive service medical system. During World War II, a large number of military hospitals had been built to respond to the
598 David Oates, ‘Memories of Kure Japan: A Personal Experience,’ Memories of Kure Japan: A Medic in the Korean War, http://www.kurememories.com/page4.htm. 599 Lieutenant Colonel Harold M Wright, Salute to the Air Force Medical Branch on the 75th Anniversary of the Royal Canadian Air Force (Ottawa, 1999), 206. 600 Bill Rawling, The Myriad Challenges of Peace: Canadian Forces Medical Practitioners Since the Second World War (Ottawa: Canadian Government Publishing, 2004), 79. 601 Ibid.
152 number of long-term casualties. By the early 1950s, many were still in operation.602 However, only a select few were dedicated to and designed for the treatment of the mentally ill.603 All British psychiatric cases were sent to the Royal Victoria Hospital (RVH) Netley near Southampton, Hampshire. RVH Netley had been equipped for the treatment of psychoses and neuroses since the late nineteenth century.604 Throughout the 1950s, Netley admitted around 1,000 men each year as inpatients.605 P Wing was a closed ward for the care of psychotic soldiers and E Wing was an open ward for the treatment of psychoneurotics.606 A 1956 Board of Control report characterised the Hampshire facility as a, ‘progressive and active unit.’607 Patients could undergo various physical treatments like deep insulin, modified insulin coma, continuous narcosis and electroshock. Moreover, they were required to participate in individual and group therapy sessions while in residence. Men awaiting discharge from the military were offered additional vocational guidance.608 On average, servicemen spent four to six weeks in treatment at the Royal Victoria
602 Ibid., 122-123, 247-249, 259. Colonel for Vice-Adjutant General to the Secretary, Medical Services Coordinating Committee, 30 Oct. 1958, TNA: Ministry of Pensions and National Insurance (PIN) 14/44. Committee Examining Ministry of Defence/National Health Service Collaboration, Use of Service Hospitals for War Pensioners, 15 Sept. 1978, TNA: PIN 59/483. World Veterans Federation, Social Affairs Rehabilitation, Comparative Report: Legislation Affecting Disabled Veterans and Other War Victims WVF-DOC/830 (Paris, France: World Veterans Federation, Sept. 1955), 7-10. 603 Queen Alexandra’s Royal Army Nursing Corps, ‘Information and History about Netley Royal Victoria Military Hospital,’ last modified 2012, http://www.qaranc.co.uk/netleyhospital.php. Veterans Affairs Canada, ‘Ste Anne’s Hospital—Our History,’ last modified 1 Oct. 2011, http://www.veterans.gc.ca/eng/steannes/stannehis5. Stephen Garton, The Cost of War: Australians Return (Melbourne: Oxford University Press, 1996), 167-169. 604 Queen Alexandra’s Royal Army Nursing Corps, ‘Information and History about Netley Royal Victoria Military Hospital,’ 605 NC Croft Cohen, Commissioner of the Board of Control, Report on Netley, 10 Dec. 1957, TNA: MH 95/34. 606 EN Butler, Commissioner of the Board of Control to Anon, 30 Aug. 1951, TNA: MH 95/34. 607 Commissioner of the Board of Control to Anon, 10 December 1956, TNA: MH 95/34. 608 Cyril MT Hastings, Commissioner of the Board of Control, Report on Netley, 20 May 1959, TNA: MH 95/34. EN Butler, Commissioner of the Board of Control to Anon, 30 Aug. 1951, TNA: MH 95/34. EN Butler, Commissioner of the Board of Control to Anon, 14 Oct. 1952, TNA: MH 95/34. Commissioner of the Board of Control to Anon, 10 June 1955, TNA: MH 95/34.
153 Hospital.609 Roughly 70% of psychoneurotics were able to return to their units without further treatment and only 8% of total admissions were certified.610
Functioning in the same capacity as Netley, Ste Anne de Bellevue treated Canadian troops. Since its foundation in 1917, Ste Anne has specialised in, ‘general medicine and psychiatry.’611 By the mid-twentieth century, the hospital was considered to be a leader in the field of mental healthcare.612 Staff and patients alike benefited from a close relationship with McGill University and the medical community in nearby Montreal, Quebec.613 In 1954, around half of the hospital’s 1,078 patients were admitted for psychiatric reasons.614 It is uncertain as to where troops from Australia and New Zealand were treated when they returned home. Nevertheless, it is clear that their options were limited. As in the United Kingdom and Canada, specialist inpatient care was concentrated to a number of major centres.615 Upon discharge from hospital, soldiers either returned to some form of active duty or sought civilian employment.
609 Commissioner of the Board of Control to Anon, 27 Feb. 1950, TNA: MH 95/34. EN Butler, Commissioner of the Board of Control to Anon, 23 Sept. 1953, TNA: MH 95/34. 610 EN Butler, Commissioner of the Board of Control to Anon, 14 Oct. 1952, TNA: MH 95/34. 611 Veterans Affairs Canada, ‘Ste Anne’s Hospital—Our History,’ Canada, House of Commons Standing Committee on National Defence, 13 Mar. 2008 (Ms Rachel Corneille Gravel). 612 Ibid. Ibid. 613 Ibid. Ibid. 614 Ibid. Ibid. 615 It is more than likely that Australian veterans would have been treated at one of the Repatriation General Hospitals that were located in major cities like Sydney, Brisbane and Melbourne. GJ Downs, ‘Australia,’ Journal of International and Comparative Social Welfare 10, No. 1 (1994): 15, 23.
154 Challenges to Treatment On a daily basis, Commonwealth doctors faced the challenge of practicing medicine in a war zone. They successfully prevented the spread of disease and continually improved upon the speed and efficiency of treatment. The Korean campaign presented few problems that the Canadians and their British opposites could not solve. Psychiatry was no exception. In three years of war, the divisional psychiatrist encountered only a handful of major dilemmas. Problems principally centred on logistics and the abuse of medical channels.
From July 1951-September 1952, 25 Canadian Field Dressing Station was located in Seoul, which was roughly 35 miles behind the division’s front line. As discussed in Chapter 3, this was widely thought to be too far back.616 However, 25 FDS could not be moved, as it controlled the air evacuation of patients from Seoul.617 In the summer of 1952, the commanding officer of BCGH, Colonel Ambrose NT Meneces wrote a report in which he explained why the positioning of the field dressing station was ill advised. He pointed out that as patients travelled further away from the front, they developed a destructive, ‘backward looking attitude.’618 This was especially problematic for psychiatric cases. By the time patients reached 25 FDS, Meneces felt that many had resigned themselves to the prospect of evacuation and men who could have been rehabilitated in Korea were unnecessarily sent to Japan.619
616 Lieutenant Colonel A MacLennan, (Officer Commanding 26 Field Ambulance) 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, WLA: Royal Army Medical Corps Muniments Collection, 761/4, Box 158. 617 Anon, British Commonwealth Communications Zone Medical Unit War Diary 1952, TNA: WO 281/898. Major RA Smillie, Royal Canadian Army Medical Corps, British Commonwealth Communications Zone Medical Unit Situation Report, Sept. 1952, TNA: WO 281/898. 618 Colonel ANT Meneces, British Commonwealth General Hospital Monthly Liaison Letter June 1952, 27 June 1952, TNA: WO 281/892. 619 Ibid.
155 Between June and September 1952, 25 FDS was temporarily divided into two units in an attempt to solve the problem. Operating 15 miles behind the front line, a quarter of the forward section’s 80 beds were for psychiatric patients. Travelling back and forth from one unit to the other, the divisional psychiatrist was constantly on the move. While this represented an improvement, Meneces and his colleagues at BCGH were still dissatisfied. Early in August, Meneces and a party of officers arrived in Korea to assess whether or not a new unit should be formed to replace 25 FDS in Seoul.620 Around a month later, the British Commonwealth Communications Zone Medical Unit (BCCZMU) became operational and the two halves of 25 FDS were reunited. With room for 100 patients, BCCZMU was a multinational unit staffed by British, Australian and Canadian doctors and nurses.621 In the following months, evacuations from Korea to Japan dropped dramatically. There is no indication that the efficiency of psychiatric treatment improved as a direct result of this relocation. Nevertheless, the divisional psychiatrist was in a much better position to attend to patients quickly and tour the front lines regularly.622
While logistical problems were easily solved once conditions had changed, other challenges remained constant. Throughout the war, doctors at 25 FDS regularly complained that officers attempted to dispose of troublemakers via medical channels. In July 1953, Captain NG Fraser reported that, ‘It would appear that the principal reason for this [was] that administrative modes of disposal [were] so ponderous, or knowledge of them so lacking that it [was] thought simpler and quicker to present men as psychiatric cases.’623 When routine examination revealed the ruse, the man in question was sent back to his unit. However, this was not the end of the matter. Corresponding with the author, former
620 Anon, 25 Canadian Field Dressing Station War Diary, 1953, LAC: RG24-C-3, Volume 18397. 621 Anon, British Commonwealth Communications Zone Medical Unit War Diary 1952, TNA: WO 281/898. 622 Ibid. Major RA Smillie, British Commonwealth Communications Zone Medical Unit Situation Report, Sept. 1952, TNA: WO 281/898. 623 Captain NG Fraser, Monthly Psychiatric Report, July 1953, LAC: RG24-C-3, Volume 18397.
156 divisional psychiatrist Dr Leslie Bartlet described what would frequently happen in these situations. He explained that, ‘…the units would be disappointed. They would simply love to get rid of them and would often protest, ‘How can you say this guy is normal?’’624 Bartlet noted that some officers would insist upon sending men back for further examination, which helped to fuel a vicious cycle that wasted both time and resources. The divisional psychiatrist could only respond by doggedly enforcing the rules and rejecting cases that should be disposed of administratively. Although abuses of this kind continued periodically, the firm approach taken by medical staff ensured the situation remained manageable. American doctors also had to be vigilant. In, ‘Functions of a Psychiatric Consultant to a Division, and to an Army,’ psychiatrist Dr Hyam Bolocan indicated that, ‘Busy and harassed officers are likely to [take advantage of medical channels]…if encouraged by lax medical discipline.’625 Like their Commonwealth colleagues, American medics had very few options. They were simply instructed to follow and enforce the rules. Conclusions Every war presents its own set of challenges to the Army psychiatrist. Be that as it may, medical officers were generally familiar with the psychiatric illnesses they encountered in Korea. Conditions like psychoneurosis, character disorder and battle exhaustion were old and oft encountered foes. The Commonwealth Division also benefited greatly from the static nature of Korean warfare. As battles were generally short, doctors were never overwhelmed by mass psychiatric casualties, as had been the case during WWI and WWII. The division never faced a major problem that it could not surmount.
Commonwealth psychiatric treatment was entirely consistent with practises developed during World War I and World War II. While significant developments were made in specialities like surgery, this was not case with regards psychiatry. 626 As manpower
624 Dr Leslie Bartlet, email message to author, 22 Sept. 2011. 625 Bolocan, ‘Functions of a Psychiatric Consultant.’ 626 Babington, Shell Shock, 54 Shephard, War of Nerves, 26, 227.
157 considerations were of paramount importance, front line treatment was designed to be practical. The soldier’s ability to function was prioritised over restoring his previous state of mental health.627 Canadian medical officer, Dr John Beswick, best summed up the realistic tenor of Korean medical policy when he commented, ‘People get squirrelly in war. There is nothing the matter with the guy who draws ducks on the wall. However, when he starts to feed them, you have trouble.’ 628 Commonwealth psychiatrists were largely successful in treating and returning psychiatric casualties to duty. While they operated on a restricted budget and were limited in terms of resources, the Commonwealth Division reported similar RTU rates to the Americans. They regularly returned over 50% of troops to some form of active duty and if they were no longer fit for combat, soldiers were reemployed in a support capacity. Very few servicemen were evacuated to Japan or repatriated for further psychiatric treatment. 629 While Assistant Director of Medical Services GL Morgan Smith sharply criticised other units, he had nothing but admiration and praise for the divisional psychiatrist and his staff. In one of his numerous reports, he wrote, ‘We have been well-served with a good psychiatric service.’630 Throughout 1950, none of the Commonwealth countries had the money or the manpower to invest in psychiatry. Standing alone, they had to rely upon the generosity of the US Army Medical Corps. As a united division, they successfully met every challenge.
627 Anon, Psychiatric Classifications and Criteria, 1958-1967, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1. Rawling, Death Their Enemy, 252. L’Etang, ‘A Criticism of Military Psychiatry,’ Nov. 1951, 326. 628 Dr John Beswick, former RCAMC, quoted in John Melady, Canada’s Forgotten War (Toronto: Macmillan, 1983), 152. 629 Anon, Minutes of Assistant Director of Medical Services Conference, 7 July 1952, TNA: WO 281/887. Captain RG Godfrey, Monthly Psychiatric Report—Sept. 1952, 9 Oct. 1952, TNA: WO 281/887. Colonel GL Morgan Smith, Assistant Director of Medical Services Monthly Liaison Letter Serial 15—Aug. 1952, TNA: WO 281/887. Anon, 29 British General Hospital and British Commonwealth General Hospital War Diaries, 1950- 1953, TNA: WO 281/892, 281/1275-1278. 630 Colonel GL Morgan Smith, Assistant Director of Medical Services Monthly Liaison Letter Serial 15, Aug. 1952, TNA: WO 281/887.
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Chapter 5 For the Common Good: Divisional Morale (1950-1953)
159 Introduction Army psychiatrists are not the only professionals responsible for the maintenance of a soldier’s psychological health. A whole team is required. From commanders to welfare officers and chaplains, everyone plays their part. Throughout the twentieth century, the military has become increasingly aware of the key role that morale plays in protecting troops from mental illness. Soldiers and civilian commentators alike have struggled to understand the concept of morale. The word is difficult to define but generally refers to the collective attitude of a group. Scholars have recognised that, ‘[it] is a powerful variable in a military force or unit, which has a substantial effect upon operational effectiveness.’631 Measuring morale is problematic, as it is not directly quantifiable.632 Be that as it may, as Australian Major General HJ Coates has pointed out: …while accepting that it is hard to quantify, we have…given it dimensions. We regard morale along with firepower and manoeuvre, as an essential element of combat power. Firepower and manoeuvre are the physical elements of manpower, weapons and equipment; morale is developed from the psychological state of man.633
Moreover, historian and psychotherapist Edgar Jones has noted that, ‘most authors are agreed that [military] units which perform efficiently…manifest good morale.’634 If one measures in terms of efficiency, the 1st British Commonwealth Division was an outstandingly motivated force. Without exception, annual reports indicated high levels of morale and both senior and junior officers regularly corroborated these findings. The United Nations Command (UNC) frequently chose Commonwealth units for dangerous and
631 Patrick Mileham, Richard Lane, David Rowland and Philip Wilkinson, ‘Panel—Morale in the Armed Forces,’ Royal United Service Institute Journal 146, No. 2 (2001): 46. 632 Ibid., 51. David R Segal and Mady Wechsler Segal, ‘Change in Military Organization,’ Annual Review of Sociology 9 (1983): 151-170. Kevin R Smith, ‘Understanding Morale: With Special Reference to the Morale of the Australian Infantryman in Vietnam,’ Australian Defence Force Journal No. 52 (May/June 1985): 53-61. Lieutenant Colonel JG Shillington, ‘Morale,’ Royal United Service Institute Journal 95, 578 (1950): 254-256. 633 Major General HJ Coates, ‘Morale on the Battlefield,’ Australian Defence Force Journal No. 45 (Mar./Apr. 1984): 6. 634 Edgar Jones, Morale, Psychological Wellbeing of UK Armed Forces and Entertainment: A Report for The British Forces Foundation (London: King’s College London Institute of Psychiatry at the Maudsley, January 2012), 12-13.
160 difficult assignments. 635 This level of success seems all the more exceptional when considered in context. The majority of Commonwealth units had not completed their training before they arrived in Korea and were initially unprepared for the privations that they would face in the Far East. As peace negotiations dragged on, operations on the ground were increasingly dictated by political events. While there had been an initial swell of enthusiasm for intervention in Korea, public support declined as the months passed.636 Few people understood the reasons for the war or even where the troops had been deployed. For example, a 1951 poll of New Zealanders found that, ‘nearly half of those questioned [were] unable to describe Korea’s geographical location,’ and, ‘Few could list its neighbours.’637
Despite the many forces working against them, Commonwealth troops were motivated and worked well together. The question then arises as to how the division achieved this level of success? Amongst experts on the subject, there is great debate as to what contributes to high morale of this nature. In a 1968 article, Professor Ernest Andrade Junior aptly
635 General Bruce C Clarke, interview by Jerry N Hess, 14 January 1970, Harry S Truman Library and Museum, date accessed 20 Apr. 2013, http://www.trumanlibrary.org/oralhist/clarkeb.htm David French, Army, Empire and the Cold War: The British Army and Military Policy, 1945-1971 (Oxford: Oxford University Press, 2012), 141. Max Hastings, The Korean War. Pan Grand Strategy Series (UK: Pan Macmillan Books, 2000), 286-287. 636 General Sir Anthony Farrar-Hockley, The British Part in the Korean War, Vol. I, A Distant Obligation (London: Her Majesty’s Stationery Office (HMSO), 1990), 136-138. Brigadier Cyril Nelson Barclay, The First Commonwealth Division: The Story of British Commonwealth Land Forces in Korea, 1950-1953 (Aldershot, UK: Gale & Polden Limited, 1954), 110. Ian McGibbon, New Zealand and the Korean War, Vol. I, Politics and Diplomacy (Auckland, New Zealand: Oxford University Press in association with the Historical Branch, Department of Internal Affairs, 1992), 41-47. Jeffrey Grey, The Commonwealth Armies and the Korean War: An Alliance Study (Manchester and New York: Manchester University Press, 1988), 77. 637McGibbon, Politics and Diplomacy, 301.
161 described morale as, ‘a rope of many strands.’638 I believe that several factors contributed in the case of the 1st British Commonwealth Division: effective leadership, limited tours of duty, the formulation of policies that encouraged strong group cohesion and the reliable provision of welfare services. British, Canadian and Australian records indicate that these subjects were discussed frequently and officers at every level were eager to protect and provide for the troops. In this chapter, I will explore what affect each element had in fostering and promoting morale throughout the war. The role of the welfare services in promoting morale has received very little attention in the literature on modern conflict. Therefore, I will discuss this particular subject in some depth. How were basic amenities (clothing, rations, post) provided and what was available in terms of recreation and entertainment in Korea and Japan? What forms of social support were on hand for those in distress? Finally, what challenges did welfare officers face in executing their duties? Commonwealth troops fought a long and protracted war under difficult and trying circumstances. Throughout this chapter, I attempt to better understand how they coped.
Leadership While there is disagreement as to what personality traits characterise an, ‘effective leader,’ modern observers of the military are in consensus as to the importance of leadership in general.639 Authors writing in the early 1950s were equally confident in the value of leadership and believed that it had a tangible effect on morale and the individual soldier’s
638 Ernest Andrade Junior, review of Morale: A Study of Men and Courage: The Second Scottish Rifles at the Battle of Neuve Chapelle, 1915 by John Baynes, Military Affairs 32, No. 2 (Oct. 1968): 91. 639 Sergio Catignani, ‘Motivating Soldiers: The Example of the Israeli Defence Forces,’ Parameters (Autumn 2004): 113-114. LH Ingraham and FJ Manning, ‘Psychiatric Battle Casualties: The Missing Column in a War Without Replacements,’ Military Review 60, No. 8 (1980): 19-29. Colonel Reuven Gal, ‘Unit Morale: From Theoretical Puzzle to an Empirical Illustration—An Israeli Example,’ Journal of Applied Social Psychology 16, No. 6 (1986): 555. Developing Leaders: A Sandhurst Guide, (Camberley, UK: Ministry of Defence, 2012), 1-91. Keith Grint, The Arts of Leadership (Oxford: Oxford University Press, 2001): 1-34. Victoria Nolan, Military Leadership and Counterinsurgency: The British Army and Small War Strategy Since World War II (London: IB Tauris, 2012).
162 state of mind.640 For example, in a February 1951 article for the Journal of the Royal Army Medical Corps, medical officer Major Martin Lewis underlined the importance of leadership or man management in preventing unnecessary psychiatric casualties. 641 Lieutenant Frank B Norbury of the US Army Medical Corps similarly cited leadership as one of the, ‘sustaining forces in maintenance of emotional adjustment in combat,’ in an article on American psychiatric practices.642 Lecturer of international relations, Dr Sergio Catignani has described the leader as a ‘protector’ who works on behalf of those men under his command.643 During the Korean War, there is ample evidence that Commonwealth officers defended their troops from unnecessary harm. This helped to nurture a sense of trust between officers and other ranks. Australian historian Robert O’Neill has highlighted that, ‘One of the most important factors in the maintenance of the morale of the fighting troops was their commanders’ insistence that men’s lives must not be wasted.’644 He has argued that: In their determination to see that casualties were suffered only for a significant result, senior Commonwealth commanders adopted a different approach from their American and South Korean, or, for that matter, their Chinese and North Korean, counterparts who continued to conduct operations in which hundreds and thousands of men died in order to hold or gain a small outpost or to capture prisoners.645
Commonwealth officers were not willing to accept orders that would endanger their men without question or argument.
640 Brigadier James A Ulio, ‘Military Morale,’ American Journal of Sociology 47, No. 3 (Nov. 1941): 323. 641 Major Martin Lewis, ‘The Promotion and Maintenance of Mental Health in the Military Community: Part II,’ Journal of the Royal Army Medical Corps 96, No. 2 (Feb. 1951): 102-103, 110. 642 Lieutenant Frank B Norbury, ‘Psychiatric Admissions in a Combat Division in 1952,’ Medical Bulletin of the US Army Far East 1, No. 8 (July 1953): 132. 643 Catignani, ‘Motivating Soldiers,’ 114. 644 Robert J O’Neill, Australia in the Korean War 1950-1953, Vol. II, Combat Operations (Canberra: Australian War Memorial and the Australian Government Publication Service, 1985), 240. 645 Ibid.
163 Before deploying to the Far East, divisional commander Major General AJH Cassels and the, ‘commanders of the three brigades fielded by the Commonwealth [were each] issued with…instructions which charged them with maintaining the safety of their commands.’646 If an officer felt that accepting orders would imperil, ‘the safety of [his] troops to a degree exceptional in war,’ he had the right to, ‘appeal to the Commander in Chief of British Commonwealth Forces Korea,’ Lieutenant General Sir Horace Robertson.647 Robertson was then responsible for presenting the case to the British, Australian and Canadian chiefs of staff.648 While none of the Commonwealth commanders ever invoked their directive during the war, they frequently used it as a bargaining tool in dealing with one another. For instance, when the 2nd Battalion Princess Patricia’s Canadian Light Infantry (2PPCLI) arrived in theatre in December 1950, they received orders to join 27 Brigade immediately. The Canadian government had furnished battalion commander Lieutenant Colonel Stone with a similar directive and he had the authority to refuse orders until such a time as he thought his troops prepared for battle. As 2PPCLI had not completed training, Stone used this directive to negotiate with Brigadier Basil Aubrey Coad of 27 Brigade. Although Coad was eager for the Canadians to begin active operations, he agreed to allow them to finish their training for the sake of good inter-allied relations. As UN forces retreated south and abandoned Seoul for the second time in six months, the Patricias completed a series of exercises in the hills surrounding the Commonwealth base at Taegu, approximately 90km northwest of Pusan. Joining the brigade in mid-February, 2PPCLI was finally ready for action.649
646 Grey, The Commonwealth Armies, 106. 647 O’Neill, Combat Operations, 240. 648 Ibid. 649 Lieutenant Colonel Herbert Fairlie Wood, Strange Battleground: The Operations in Korea and their Effects on the Defence Policy of Canada (Ottawa: Queen’s Printer and Controller of Stationary, 1966), 59-69. O’Neill, Combat Operations, 105-107.
164 Commonwealth officers were also quick to defend their troops from the worst excesses of American command. Throughout the war, the division was part of US I Corps, which was commanded by Lieutenant General John W O’Daniel. Coming from different doctrinal and strategic schools of thought, relations between O’Daniel and Major General Cassels were often tense.650 In October 1951, Cassels informed his superiors in London that he had considered invoking his directive on five separate occasions over the past three months. He reported that: On many occasions I was ordered, without any warning, to do things which I considered militarily unsound and for which there was no apparent reason. Eventually, I asked the Corps Commander for an interview where I put all my cards on the table. I pointed out that we worked quite differently to them, and that it was impossible to expect that we could suddenly change our ways to conform with American procedure. I then asked that, in the future, we should be given our task, the reasons for the task, and that we should then be left alone to do it in our own way without interference from Corps Staff. The Corps Commander could not have been more helpful and, since then, things have been much better and both sides are happier.651
Within the division, ‘this process of consultation and compromise…became known as waving the paper.’ 652 Despite considerable improvement in communications, Cassels continued to negotiate with the Americans when he considered the orders he had been given to be unreasonable. Believing firmly in the deterrent power of his directive, he was not afraid to argue his case, much to the chagrin of the officers on O’Daniel’s staff.653 For example, in May 1952 Lieutenant General O’Daniel, ‘directed Cassels to capture at least one prisoner every three days,’ and instructed him to use up to a battalion in order to reach this target.654 Writing to Lieutenant General Bridgeford, who had replaced Robertson as BCFK commander, Cassels angrily reported that the, ‘raids have had to go a long way to
650 Grey, The Commonwealth Armies, 135-141. 651 Major General Archibald James Halkett Cassels, 1 Commonwealth Division Periodic Report, 1 May-15 October 1951, National Archives of Australia (Hereafter cited as NAA): CRS A2107, item K11.09. 652 O’Neill, Combat Operations, 241. 653 Ibid., 240-242. 654 Ibid., 242.
165 find the enemy…[and] have been comparatively costly.’655 Shortly thereafter, he ordered that they should be suspended altogether. Although the raids eventually recommenced, they were no longer as frequent or as ambitious as they had been prior to Cassels’ intervention.656
Relations between Cassels’ successor, Major General Michael West and O’Daniel’s successor, Lieutenant General PW Kendall were initially more cordial. Kendall was, ‘widely recognised as being a very different personality type from his predecessor,’ and was praised for his abilities by Supreme Commander General Mark Clark.657 However, disagreements were inevitable and West was as eager as his predecessor to represent the division well. Like Cassels, he was prepared to use his directive to bargain with the Americans as to how Commonwealth troops were employed in the field. On numerous occasions, he complained about, ‘the renewed pressure to produce prisoners, and of high- level interference in such low level matters as the number of patrols to be sent out by forward battalions.’658 He worked diligently to prevent any unnecessary casualties, which brought him into increasing conflict with his colleagues from the US Army. This clash of personalities eventually led to Kendall’s dismissal. On 10 April 1953, Lieutenant General Bruce C Clarke was forced to replace him after, ‘he had publicly rebuked West in a divisional commanders’ meeting and had made a number of disparaging remarks about the British.’659 By strategically employing the directive, both Cassels and West acted as staunch defenders of those on the sharp end.
While junior officers could not refuse orders in the same manner as their superiors, they too were encouraged to take initiative and attend to the welfare of their men. Upon his return
655 Ibid. 656 Ibid. 657 Grey, The Commonwealth Armies, 142. 658 Ibid. 659 Ibid.
166 from the Far East, British platoon commander 2nd Lieutenant MF Reynolds outlined what he considered to be the main responsibilities of an officer. He wrote, ‘A man’s welfare is your primary duty. Never neglect a foot, body or weapon inspection and most important of all…the time your men want you with them is not only when the sun is shining and there’s no danger, but when everything is at its worst and you feel like looking after yourself first.’660 Although the experience level and quality of officers varied, Commonwealth troops were generally well led. Many of the non-commissioned officers (NCOs) were veterans of World War II and, ‘helped the younger soldiers to cope.’661 They also kept the men busy and enforced strict discipline at all times. As the peace negotiations dragged on, both senior and junior officers demonstrated a remarkable commitment to service. For example, in his book, Army, Empire and Cold War, military historian David French has noted that, ‘In the 1st Black Watch the commanding officer (CO) helped to integrate every newly joined soldier by introducing himself and speaking to each of them individually.’662 Decades later, Black Watch veteran RJ Carriage recalled that, ‘There was a great love of our Colonel. We used to call him Colonel Davey and he was everywhere and his concern was the Jocks. Look after the Jocks.’663 Captain Reg Saunders of the 3rd Battalion Royal Australian Regiment (3RAR) received similarly high praise for his skills commanding a rifle company. He, ‘quickly established himself and won wide respect for his abilities as a platoon commander, particularly his determination when leading patrols far from the battalion’s main position.’664 On a daily basis, men like Davey and Saunders were a vital
660 2nd Lieutenant MF Reynolds, Korea: battle experience questionnaire, The National Archives at Kew (Hereafter cited as TNA): WO 231/90. 661 G Paterson, interview, Imperial War Museum Sound Archive (Hereafter cited as IWMSA): Accession No. 19094, reels 1, 4. 662 French, Army, Empire and the Cold War, 142. 663 Colonel Davey was a nickname for Lieutenant Colonel David Rose. RJ Carriage, interview, IWMSA: Accession NO 18267/3, quoted in David French, Army, Empire and the Cold War: The British Army and Military Policy, 1945-1971 (Oxford: Oxford University Press, 2012), 142. Remembering: Scotland at War, ‘It was easier to put me in the Black Watch,’ http://www.rememberingscotlandatwar.org.uk/Accessible/Exhibition/87/It-was-easier-to-put-me-in- the-Black-Watch-National-Service 664Australian War Memorial, ‘Captain Reg Saunders,’ http://www.awm.gov.au/exhibitions/korea/faces/saunders/
167 source for support for the men under their watch. Good leadership at platoon, battalion and division level played a pivotal role in boosting and maintaining morale during both the mobile and static phases of the war.
Limited Tours of Duty When the Commonwealth Division was initially formed in July 1951, its constituent members decided to implement a series of measures designed to ensure that units functioned as efficiently as possible. Without hesitation or dispute, they all agreed to set limited tours of duty.665 Throughout the Korean War, infantrymen spent a minimum of twelve months and a maximum of eighteen months in the Far East. Artillery and support troops were relieved after a year and a half on duty. No matter the unit, no man was allowed to stay in Korea for more than 17 weeks of winter, which was defined as the period from 1 December-31 March. Battalions generally spent three months at a time in the division’s front line and the subsequent month and a half in reserve.666 All servicemen were granted five days of leave for every four months service in Korea, which they could spend at the Divisional Rest Centre at Inchon, headquarters in Kure or in the Japanese capital city of Tokyo.667
665 Anon, Welfare in the Canadian Army, 13 November 1952, Library and Archives of Canada/ Bibliothèque et Archives Canada (Hereafter cited as LAC): RG 24, 1983-84/167, Box 4903, File 3125-33/29, Volume 3. Brian Catchpole, ‘The Commonwealth in Korea,’ History Today 48, No. 11 (Nov. 1998): http://www.historytoday.com/brian-catchpole/commonwealth-korea Hastings, The Korean War, 369. Albert E Cowdrey, The Medics’ War (Washington, DC: Centre of Military History, 1987), 146. Barclay, The First Commonwealth Division, 3. 666 Anon, Infantry Liaison Letter, 2nd Battalion The Royal Australian Regiment, July 1953, Australian War Memorial (Hereafter cited as AWM): AWM85, Item No. 3/5. Tom Hickman, The Call Up: A History of National Service (UK: Headline, 2005), 83. 667 Anon, 1 Commonwealth Division Periodic Report, 1 Apr. 1953—1 Aug. 1953, TNA: WO 308/65. Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Catchpole, ‘The Commonwealth in Korea.’
168
The establishment of limited tours of duty was a significant development and crucial in maintaining morale for a number of reasons. First and foremost, the aims of the war were ambiguous and there was little external motivation to fight for the average soldier. A survey conducted late in 1950 found that, ‘US troops…repeatedly raised two questions about the war: ‘Why are we here?’ and ‘What are we fighting for?’668 Servicemen from Britain, Canada, Australia and New Zealand were equally perplexed by the reasons behind their deployment. In a 2009 interview, British veteran Alex Easton remembered, ‘…the thing about it was Korea…I mean bloody Korea. Where’s Korea? I’d never even heard of it!’669 On 21 January 1951, General Matthew B Ridgway of the US Eighth Army felt compelled to issue a statement on the matter. Writing to all of the units under his command, Ridgeway briefly answered the question as to why Western troops had been despatched. He explained, ‘We are here because of the decisions of the properly constituted authorities of our respective governments.’670 In response to why they were fighting, Ridgeway gave a more detailed answer. He wrote: The real issues are whether the power of Western civilization…shall defy and defeat Communism; whether the rule of men who shoot their prisoners, enslave their citizens, and deride the dignity of man, shall displace the rule of those to whom the individual and individual rights are sacred…The sacrifices we have made, and those we shall yet support, are not offered vicariously for others, but in our own direct defense. In the final analysis, the issue now joined right here in Korea is whether communism or individual freedom shall prevail.671
In spite of Ridgeway’s attempt to inspire the men, many continued to experience frustration and confusion as to why they were in Korea. This was compounded by the disrespect in which both North and South Koreans were generally held. Casual racism was common amongst both American and Commonwealth troops and was widely accepted at the highest
668 United States Army Survey, quoted in Stanley Sandler, The Korean War: No Victors, No Vanquished (USA: University of Kentucky Press, 1999), 131-132. 669 Alex Easton, Interview by Remembering: Scotland At War, last modified 2009, http://www.rememberingscotlandatwar.org.uk/Accessible/Exhibition/182/Korea-Wheres-that 670 Lieutenant General Matthew B Ridgeway, 3rd Battalion Royal Australian Regiment War Diary, 21 January 1951, AWM: AWM85, Item No. 2/11. 671 Ibid.
169 levels.672 According to author Hugh Deane, a British Cabinet member visiting the ‘strife ridden’ prisoner of war camps on the island of Koje-do characterised the Koreans as, ‘prone to violence.’673 President Truman similarly described the people of Korea as the, ‘inheritors of Genghis Khan and Tamerlane, the greatest murderers in the history of the world.’674 As the peace negotiations dragged on, there were few concrete reasons to fight. Throughout the, ‘last nineteen months of the war,’ troops from Canada, Australia, Britain and New Zealand, ‘were…required to risk their lives constantly, not to win the war or even to gain any significant advance on the ground, but simply to maintain pressure on the Chinese and North Korean Governments so they might modify their negotiating position.’675 Limited tours of duty provided Commonwealth soldiers with a point of reference and something to which they could look forward. While the war might continue, they were guaranteed of returning home after a set period of time.
The second reason why the Commonwealth countries agreed to limited tours was the extremes of the Korean climate. The brutality of Korean winters has been well documented by both veterans and historians. Throughout the winter of 1950-1951, temperatures habitually dropped below -30°C and vehicles and equipment regularly broke down. Hands froze to weapons and it was almost impossible to get warm.676 There were even reports that medics were forced to place plasma and morphine ampoules under their armpits or in their mouths to keep them fluid.677 In the dead of winter, US Marine surgeon Captain Hering observed that, ‘The only way you could tell the dead from the living was whether their eyes
672 Hugh Deane, The Korean War, 1945-1953 (Canada: China Books & Periodicals Incorporated, 1999), 29-30. 673 Ibid., 29. 674 President Harry S Truman, quoted in Hugh Deane, The Korean War, 1945-1953 (Canada: China Books & Periodicals Incorporated, 1999), 29. 675 O’Neill, Combat Operations, 239. 676 Paul M Edwards, The Korean War, American Soldiers’ Lives: Daily Life Through History (USA: Greenwood Publishing Group Incorporated, 2006), 92-94. Bill Trevett, interview by author; Trowbridge, Wiltshire, UK, November 2010. 677 Eric Taylor, Wartime Nurse: One Hundred Years from the Crimea to Korea, 1854-1954 (London: Robert Hale, 2001), 204.
170 moved. They were all frozen stiff as boards.’678 No man could be expected to march through deep piles of snow and to endure the long hours of darkness and icy winds for more than a season. The one winter policy was a prudent and humane measure that had been taken for the benefit of all concerned.
Past experience also informed the division’s policy in regards to tours of duty and rotation. British studies conducted during World War II suggested that infantry soldiers were combat effective for an average of 400 aggregate combat days. After this point in time, they began to experience greater levels of anxiety and were more prone to psychiatric breakdown.679 The Americans, who rested their troops less regularly, arrived at much lower estimates of between 200 to 240 days.680 Although they disagreed as to how long the average soldier could continue fighting, experts on both sides of the Atlantic agreed that there were clear limits to combat endurance. In a 1949 article for The Bulletin of the US Army Medical Corps, Major Raymond Sobel referred to this problem as ‘old sergeant syndrome.’681 He noted that, ‘This syndrome, a fairly consistent constellation of attitudes occurred in well- motivated, previously efficient soldiers as a result of the chronic and progressive breakdown of their normal defenses against anxiety in long periods of combat.’682 Sobel also pointed out that, ‘A large number [of the men in question] had received citations,
678 Captain Hering, quoted in, Eric Taylor, Wartime Nurse: One Hundred Years from the Crimea to Korea, 1854-1954 (London: Robert Hale, 2001), 204. 679 Colonel Bernd Horn, ‘Fear,’ in The Military Leadership Handbook, eds. Colonel Bernd Horn & Robert W Walker (Canada: Dundurn Press and Canadian Defence Academy Press in cooperation with the Department of National Defence, and Public Works and Government Services Canada, 2008), 291. 680 Mark Johnson, At the Front Line: Experiences of Australian Soldiers in World War II (Cambridge: Cambridge University Press, 1996), 54. Office of the Surgeon General, USA, Memo 330.11 for CG AGF: Prevention of Manpower Loss from Psychiatric Disorders, 16 Sept. 1944, National Archives and Records Administration (Hereafter cited as NARA): Army Ground Forces Statistical Section Files, 330.11 (S). Robert R Palmer, The Procurement of Enlisted Personnel: The Problem of Quality (Washington, DC: United States Government Printing Office, 1948), 228. 681 Major Raymond Sobel, ‘Anxiety-Depressive Reactions After Prolonged Combat Experience--the ‘Old Sergeant Syndrome,’’ Bulletin of the United States Army Medical Department (1949): 137. 682 Ibid.
171 awards, and medals for outstanding conduct and devotion to duty.’683 This research factored heavily in the Commonwealth Division’s decision to set clear time limits to tours in the Far East. In contrast to practices employed during WWII and American policies in Korea, the Commonwealth did not use a complicated points system to determine who could go home and when.684 After a serviceman had spent between 12 and 18 months in Korea, he was rotated out of theatre without exception.
Policies that fostered strong group cohesion In addition to good leadership and limited tours of duty, policies that fostered a sense of group cohesion were vital to Commonwealth morale. Although the meaning of the term cohesion can be debated, it can be generally defined as, ‘the bonding together of members of an organisation/unit in such a way as to sustain their will and commitment to each other, their unit and the mission.’685 Eminent Israeli clinical and social psychologist, Dr Reuven Gal has observed that, ‘The strength of unit cohesion has been shown, time and again, to be a key factor in soldiers’ level of morale and combat effectiveness.’686 Furthermore, he has noted, ‘…it has been shown to play an unequivocal role in the onset and extent of psychiatric reactions during combat.’ 687 Since World War II, British and American literature on the subject has focused on the importance of fostering the loyalty between men rather than to a particular cause.688 As historian Professor Hew Strachan has underlined,
683 Ibid. 684 James L Stokesbury, A Short History of the Korean War (USA: W Morrow, 1988): 212. 685 William D Henderson, Cohesion: The Human Element in Combat (Washington, DC: National Defence University Press, 1985), 4, quoted in Sergio Catignani, ‘Motivating Soldiers: The Example of the Israeli Defence Forces,’ Parameters (Autumn 2004): 110. 686 Gal, ‘Unit Morale,’ 559. 687 Ibid. Ingraham and Manning, ‘Psychiatric Battle Casualties,’ 19-29. 688 Morris Janowitz, The Professional Soldier: A Social and Political Portrait (USA: The Free Press, 1960), 21. Frederick J Manning and Larry H Ingraham, ‘An Investigation into the Value of Unit Cohesion in Peacetime,’ in Contemporary Studies in Combat Psychiatry, Contributions in Military Studies No. 62, ed. Gregory Belenky (New York: Greenwood Press, 1987), 49.
172 ‘The core assumption concerning morale in the British Army is that soldiers fight less for their country and more for their comrades.’689 This was especially important during the Korean campaign, when operational aims were in a constant process of evolution. In Korea, the Commonwealth mainly encouraged group cohesion at the level of the battalion and of the regiment.
As discussed in Chapter 4, Commonwealth troops were primarily rotated in and out of theatre in battalion sized groups. Joined together by a common combat experience, servicemen developed close ties to the other members of their unit. For over a year, they lived, trained and fought together. The 3rd Battalion Royal Australian Regiment was the only group to operate using an individual replacement system and proved to be one of the most problematic units in the Commonwealth Division. During his tenure as a medical officer, Captain Rutherford of 3RAR repeatedly complained about the quality of reinforcements. As inexperienced soldiers arrived in theatre, they often disrupted previously efficient combat units.690 In May 1953, Rutherford lamented that; ‘The overall effect is to place a heavy burden on the trained few, to their detriment, and ultimately to the battalion as a whole.’691 The Australian Army abandoned individual rotation in the midst of the Korean War in light of 3RAR’s disappointing performance.692 The Americans, who also adhered to an individual replacement system, experienced similar difficulties in nurturing and strengthening group cohesion at the battalion level. Soldiers would grow increasingly risk-averse as they approached their rotation date and the other members of the unit would
Field Marshal Montgomery, Morale in Battle (1946), quoted in Major General HJ Coates, ‘Morale on the Battlefield,’ Australian Defence Force Journal No. 45 (Mar./Apr. 1984): 9. 689 Hew Strachan, ed., The British Army, Manpower and Society into the Twenty-First Century (London: Frank Cass, 2000), xvii-xviii. 690 Captain Rutherford, 3rd Battalion Royal Australian Regiment War Diary Medical Report, May 1953, AWM: AWM85, Item No. 639175. O’Neill, 1985, pp. 131, 219, 267. 691 Captain Rutherford, 3rd Battalion Royal Australian Regiment War Diary Medical Report, May 1953, AWM: AWM85, Item No. 639175. 692 O’Neill, Combat Operations, 219, 267.
173 attempt to spare the serviceman in question. So called, ‘short timer syndrome,’ would continue to plague the US Army in subsequent conflicts such as the Vietnam War.693
While scholars such as David French have recently contested the value of the regiment, senior Commonwealth officers believed firmly its power as an organisational construct and source of support.694 Regiments, which vary in size, have their own distinct history and members often come from the same geographic area. By identifying with a particular group, individual soldiers develop a sense of belonging to something larger and understand their own service in the context of regimental history.695 Numerous commentators have
693 The effectiveness of the US Army’s individual rotation policy has been sharply criticised. Noted military sociologists Paul L Savage and Richard A Gabriel have argued that individual rotation had a negative impact on the well being of troops, particularly in Vietnam. No definitive statistics exist to confirm or disprove this controversial thesis. Paul L Savage and Richard A Gabriel, ‘Cohesion and Disintegration in the American Army: An Alternative Perspective,’ Armed Forces & Society 2 (1976): 341. Anthony Kellett, ‘Combat Motivation,’ in Contemporary Studies in Combat Psychiatry, Contributions in Military Studies No. 62, ed. Gregory Belenky (New York: Greenwood Press, 1987): 208. Gregory Belenky and Franklin D Jones, ‘Introduction: Combat Psychiatry—An Evolving Field,’ in Contemporary Studies in Combat Psychiatry, Contributions in Military Studies No. 62, ed. Gregory Belenky (New York: Greenwood Press, 1987), 4. Franklin D Jones, ‘Military Psychiatry Since World War II,’ in American Psychiatry After World War II (1944-1994), eds. Roy W Menninger and John C Nemiah (Washington DC: American Psychiatric Press, 2000), 10. James Griffith, ‘Measurement of Group Cohesion in US Army Units,’ Basic and Applied Social Psychology 9, 2 (1988): 152. Segal and Segal, ‘Change in Military Organisation,’ 156. Colonel Albert Julius Glass, ‘History and Organization of a Theatre Psychiatric Service Before and After 30 June 1951,’ in Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950-1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954) 694 David French, Military Identities: The Regimental System, the British Army, and the British People, c. 1870-2000 (Oxford: Oxford University Press, 2005). John Ferris, ‘Regimental Rhetoric,’ review of Military Identities: The Regimental System, the British Army, and the British People, c. 1870-2000 by David French, Humanities and Social Sciences Net Online, last modified July 2006, http://www.h-net.org/reviews/showrev.php?id=11979. 695 Gwyn Harries-Jenkins, ‘Role Images, Military Attitudes, and the Enlisted Culture in Great Britain,’ in Life in the Rank and File: Enlisted Men and Women in the Armed Forces of the United
174 described the regiment as a ‘family’ or ‘tribe,’ and in the early 1950s, it was still perceived as one of the best ways to cultivate morale.696 Prior to the Chief of the Imperial General Staff Conference in October 1951, the British Director General of Military Training issued a public statement characterising the regimental system as the, ‘cornerstone of good morale.’697 To the officers of the 1st British Commonwealth Division, the regiment was not an abstract concept but an essential feature of military life. Late in January 1951, Lieutenant General Robertson suggested temporarily combining undermanned battalions of the Middlesex and Argyll & Sutherland Highlander regiments to, ‘form one strong British battalion.’698 Brigadier Coad of 27 Brigade and Chief of the Imperial General Staff Field Marshal William J Slim roundly rejected the plan because it would, ‘strike hard at the strong regimental spirit in each battalion.’699 Although, ‘such an amalgamation had taken place for short periods in past wars following extraordinary losses,’ they refused to countenance such a measure at this time.700 The integrity of the regiment was more important than alleviating serious manpower shortages. For the remainder of the war, Commonwealth officers continued to use the regiment as an organisational tool to encourage a sense of pride and military professionalism. Moreover, they actively nurtured a friendly spirit of competition between units to boost morale.
States, Australia, Canada, and the United Kingdom, eds. David R Segal and H Wallace Sinaiko (USA: Pergamon-Brassey’s International, 1986), 255. Kevin R Smith and JCM Baynes, ‘Morale: A Conversation,’ Australian Defence Force Journal No. 64 (May/June 1987): 46. Kellett, ‘Combat Motivation,’ 208. 696 Hugh McManners, The Scars of War (London: Harper Collins Publishers, 1994), 31. 697 Director General of Military Training, Statement issued in advance of Chief of the Imperial General Staff Conference, 17 Oct. 1951, TNA: WO 33/2710. 698 General Sir Anthony Farrar-Hockley, The British Part in Korean War, Vol. II, An Honourable Discharge (London: HMSO, 1995), 63. 699 Ibid. 700 Ibid.
175 Welfare Services As previously mentioned, the role of the welfare services in promoting morale has received relatively little attention from military historians and other scholars. However, welfare can play a central part in sustaining the fighting spirit of military units during protracted campaigns. This was especially true throughout the Korean War. Prior to the formation of the Commonwealth Division, welfare services were organised on an ad-hoc basis and each country had the responsibility of providing its troops with basic amenities (clothing, rations, post). Welfare officers, chaplains and educational officers accompanied each of the contingents to the Far East. Unfortunately, there is hardly any mention of their work in the available archival records. Be that as it may, surviving British, Canadian, and Australian war diaries and reports suggest that there was little available in terms of amenities, recreation, entertainment or social services before the summer of 1951.
After the division became operational, each contingent continued to provide its soldiers with basic amenities rather than work in tandem with the other Commonwealth nations. Naturally, there were differences in the quality of service delivered by each country and levels of satisfaction varied amongst servicemen. In terms of clothing and rations, the Canadians were the envy of the division. The winter parkas and boots issued to Canadian troops were well suited to the cold and windy Korean climate and rations were normally generous.701 Moreover, the Canadians had a close relationship with the Americans and were able to draw heavily from US stores in order to supplement their own resources.702 The Canadian Army Special Force (CASF) was regularly supplied with both American hard and fresh rations. An average American C7 ration pack included:
701 Bob Ringma, MLBU Full Monty in Korea (Canada: General Store Publishing House, 2004). Brian Catchpole, The Korean War, 1950-1953 (London: Constable, 2000), 280. Brigadier John Meredith Rockingham, Report on Welfare—25 Canadian Infantry Brigade, 24 December 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. 702 Ringma, MLBU. Barclay, The First Commonwealth Division, 3. Brigadier JM Rockingham, Report on Welfare—25 Canadian Infantry Brigade, 24 December 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3.
176 …several varieties of main course, for example, ham and lima beans, pork and beans, frankfurter chunks and beans, meatballs and corned beef hash…There were also tins of fruit, salted crackers, biscuits, chocolate, chewing gum, cigarettes, coffee and dried milk, toilet paper and a tiny tin opener.703
They also frequently included, ‘such items as turkey, pork chops, steak, chicken noodles…and fruit cocktail.’704
In contrast to the Canadians, the other Commonwealth countries occasionally struggled to provide their troops with the same standard of care.705 For example, during the winter of 1952, the War Office failed to supply the British contingent with a sufficient number of coats and other items of appropriate clothing. Moreover, many of the coats were too small and better suited to dry European winters rather than the damp cold of Korea. On the 6 January 1952, the headline, ‘Korea Scandal: Report That Will Shock You!,’ appeared on the front page of the Sunday Dispatch.706 In the article, a correspondent for the paper attacked the government for its failure to provision troops suitably for the cold weather.707 While the reports were greatly exaggerated, it was eventually found that, ‘the Quartermaster General’s staff had showed some want of urgency in pressing procurement from the previous summer and were negligent in supplying the sizes required.’708 Under the pressure of public scrutiny, the situation was quickly remedied and the required coats and
703 Ashley Cunningham-Boothe and Peter Farrar, eds., British Forces in The Korean War (West Yorkshire, UK: British Korean Veterans Association, 1989), 12. 704 Hickman, The Call Up, 80. 705 Ibid., 78. 706 ‘Korea Scandal: Report That Will Shock You!,’ Sunday Dispatch, 6 Jan. 1952. 707 Ibid. 708 Farrar-Hockley, An Honourable Discharge, 355.
177 assorted items of clothing were secured.709 With respect to rations, the British, Australians and New Zealanders all survived on a combination of American and Commonwealth provisions.710 Veteran Les Peate remembered that they largely ate, ‘US C rations in the line…Australian and locally purchased fresh rations and British compo rations in reserve.’ 711 British packs were ordinarily less generous than Canadian and typically consisted of, ‘little more than tinned bully beef, steak and kidney or frankfurters, tinned potatoes and hardtack biscuits.’712 No matter your nationality, cooking was a challenge in Korea. As writer and journalist Tom Hickman points out in The Call Up: A History of National Service, ‘whatever was cooked in winter froze as it left the frying pans…[and] could be almost inedible,’ which led to the inevitable grumbling.713 Nonetheless, it appears that the quality of the food had little impact on the overall state of morale and most soldiers accepted unappetising rations as a regrettable part of service life.
Each national contingent was also responsible for organising its own independent postal system and the evidence indicates that the Canadians, British, Australians and New Zealanders were all well served by prompt mail delivery. For the most part, surface mail was shipped via troop or freight carrier and took between six to eight weeks to arrive. Air
709 Once the needed clothing became available, a typical British soldier wore, ‘a string vest, long johns, under-trousers, trousers, parka with a wired hood, and thick rubber-soled boots,’ during the winter months. Cunningham-Boothe and Farrar, British Forces in the Korean War, 13. Major Bretland PM, MB, ChB, ‘The Principles of Prevention of Cold Injuries: Notes on the Problem as Encountered, and the Methods used, in Korea,’ Journal of the Royal Army Medical Corps 100, No. 2 (Apr. 1954): 92. 710 Les Peate, ‘Korean War: Food for Thought,’ Esprit de Corps, Mar. 1997 http://findarticles.com/p/articles/mi_6972/is_9_5/ai_n28701146/ Brigadier HL Cameron to Mr TD Anderson, General Secretary of Canadian Legion, 1 October 1952, LAC: RG 24, Acc 1983-1984/167, Box 4912, File 3127-33/29 Pt. 2. 711 Ibid. Ibid. 712 Hickman, The Call Up, 80. Barclay, The First Commonwealth Division, 184. 713 Hickman, The Call Up, 80.
178 shipments were usually processed within a week to nine days.714 Between 1951 and 1953, the division relied upon a combination of military aircraft and commercial couriers like the British Overseas Airways Corporation (BOAC), Canadian Pacific and Quantas Empire Airlines to deliver the mail. Letters, parcels and packages from North America, Australia and New Zealand arrived in Korea three times a week and British mail was delivered biweekly. Christmas greetings cards and gifts were sent to the Far East at no cost to the sender.715 Although Commonwealth troops were issued with 20 cigarettes a day and could buy up to 800 a month in theatre, packs of cigarettes were a popular gift for family and friends to send overseas at any time of the year. Shipped free of charge, there was no limit to the number that could be posted. Charitable organisations and private companies were also encouraged to purchase cigarettes and many did so as an expression of support for servicemen. The Canadian Legion, Red Cross, Imperial Order Daughters of the Empire and the province of Ontario all sent bulk shipments to Korea.716 Magazines were another item
714 Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Anon, 1 Commonwealth Division Periodic Report No. 3, 1 Oct. 1952—31 Mar. 1953, TNA: WO 308/60. Anon, Headquarters British Commonwealth Forces Korea Periodic Report No. 5, 1 Oct. 1953 to 31 Mar. 1954, TNA: WO 308/1. Anon, 1 Commonwealth Division Periodic Report No. 9, 1 Oct. 1955—30 June 1956, TNA: WO 308/62. Anon, Korean Campaigns: Welfare and Entertainment, TNA: WO 308/6. Cunningham-Boothe and Farrar, British Forces in the Korean War, 13. 715 Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Anon, 1 Commonwealth Division Periodic Report No. 3, 1 Oct. 1952—31 Mar. 1953, TNA: WO 308/60. Anon, Headquarters British Commonwealth Forces Korea Periodic Report No. 5, 1 Oct. 1953--31 Mar. 1954, TNA: WO 308/1. Anon, British Commonwealth Force Korea Periodic Report No. 9, 1 Oct. 1955—30 June 1956, TNA: WO 308/62. 716 Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, 1983-84/167, Box 4903, File 3125-33/29, Volume 3. Adjutant General, Headquarters British Commonwealth Force Korea, Six Monthly Report, 1 Apr.-- 30 Sept. 1954, TNA: WO 308/7.
179 commonly donated by charities. While the division subscribed to periodicals like Newsweek, Time, Reader’s Digest, MacLean’s, Atlantic Monthly and Harpers, donations were always welcome.717 Arriving around two months after publication, magazines were purchased from the US Special Services in packs of twenty for groups of eighty men.718 Reliable postal delivery was a constant and vital source of support for the members of the Commonwealth Division. Serving far away from home, the regular exchange of correspondence and gifts allowed servicemen to keep in touch with loved ones. As Lindsey Koren of the Smithsonian Institute has noted, ‘mail call is a moment when the front line and home front connect. Letters, news and packages from home unite families, boost
Colonel John Wallis, Welfare—Donations by Benevolent Organisations—Shipment at Public Expense, 5 Dec. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume III. Tuckett Limited to Colonel John Wallis, 27 Feb. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4912, File 3127-33/29 Pt. 2. Mr CK Hogan to Colonel John Wallis, 21 Oct. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4912, File 3127-33/29 Pt. 2. Mr GL Austin to Colonel John Wallis, 17 Dec. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4912, File 3127-33/29 Pt. 2. Colonel John Wallis to Mr EJ Young, 23 Nov. 1953, LAC: RG 24, Acc 1983-1984/167, Box 4711, File 3127-1, Part 1. Mr GL Austin to Colonel John Wallis, 8 Jan. 1953, LAC: RG 24, Acc 1983-1984/167, Box 4912, File 3127-33/29 Pt. 2. 717 The Commonwealth Division also subscribed to a large number of newspapers. Japan News and Stars and Stripes had the widest distribution. The former was a regional English-language publication and the US Army produced the latter. During the war, they reached a peak circulation of 26,000 and 75,000 respectively. Crown News was the division’s own newspaper. Produced by officers from the Royal Army Educational Corps, it featured regional news from each of the Commonwealth countries and boasted a French language section. By 1953, nearly 4,500 copies of the paper were distributed daily. Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Anon, British Commonwealth Force Korea Periodic Report, 1 Apr. 1953—1 Aug. 1953, TNA: WO 308/65. 718 Director of Administration, Colonel TA Johnston to Commander, Canadian Military Mission, Far East, San Francisco, 1 Mar. 1956, LAC: ATIP, RG 24, Acc 1983-1984/167 GAD, Box 4904, File 3125-33/29/15. Directorate of Administration, Rundown of Canadian Troops--Far East--Welfare Amenities, 14 Apr. 1955, LAC: ATIP, RG 24, Acc 1983-1984/167 GAD, Box 4904, File 3125-33/29/15. Anon, Talk with Captain Fenny on Welfare in the Far East, 21 May 1952, LAC: RG 24, Acc 1983- 1984/167, Box 4903, File 3125-33/29, Volume 3.
180 morale and in wartime, elevate the ordinary to the extraordinary.’719 It is also important to remember that in the 1950s, ‘letters remained the sole means of international communication,’ for troops deployed abroad.720
The Adjutant General’s Branch While the system for supplying basic amenities remained largely unchanged throughout the war, the delivery of other welfare services was organised on a more systematic basis after the creation of the division. Working in concert with officers from the other Commonwealth countries, the British Adjutant General’s Branch or A Branch took responsibility for providing troops with recreational facilities, entertainment and social services like chaplaincy, counselling and education. For the purposes of organisation, the Korean/Japanese theatre was divided into three geographic zones: sub areas north, south and Tokyo. Welfare officers were appointed to each of these sectors to coordinate and administrate activities in that area.721 Historically, military welfare work had been the purview of charitable groups like the Red Cross, the Royal Legion and Knights of Columbus. During WWI and WWII, these charities had operated successfully in Europe
719 Lindsey Koren, ‘Smithsonian Traveling Exhibition Offers Fascinating Look at Military Mail and Communication,’ Mail Call, Smithsonian Institution Traveling Exhibition Service, last modified 2011, http://www.sites.si.edu/exhibitions/exhibits/mailCall/#press 720 Jeffrey A Keshen, Saints, Sinners, and Soldiers: Canada’s Second World War (Vancouver: University of British Columbia Press, 2004), 124. 721 Anon, Historical Notes: A Branch Including Chaplains, Provost & Education, TNA: WO 308/9. Anon, British Commonwealth Force Korea Periodic Report No. 8, 1 Apr. 1955—30 Sept. 1955, TNA: WO 308/61. Brigadier JM Rockingham, Report on Welfare—25 Canadian Infantry Brigade, 24 Dec. 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Local Army Welfare Officer, ‘Six Years of Army Welfare,’ Royal United Services Institute Journal 91, No. 561 (1946): 52-55. Major General WHS Macklin, Welfare—25 Canadian Infantry Brigade, 12 July 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Major WHS Macklin to Brigadier JM Rockingham, 21 Nov. 1951, LAC: RG 24, Acc 1983- 1984/167, Box 4903, File 3125-33/29, Volume 3.
181 and many other theatres.722 Be that as it may, there was a certain degree of, ‘overlapping, competition and waste of effort and scarce materials.’723 In order to guarantee the quality of welfare provision in future, the British Army took greater direct control of the process from the late 1940s onwards.724
Recreational Facilities Since the early twentieth century, canteens have been a staple of military life and Korea was no exception.725 A ubiquitous sight in the Far East, they were popular amongst both American and Commonwealth troops. Between 1951 and 1953, the Navy, Army and Air Force Institutes (NAAFI) ran the majority of establishments that divisional personnel frequented. Originally founded in 1921, NAAFI was created to sell British soldiers fairly priced goods while they were serving overseas. Before its creation, canteens had been primarily run by private companies and were well known for extortionate prices. At the height of the Korean War, NAAFI employed nearly 400 staff members in theatre, who were all commissioned or attested members of the Royal Army Service Corps (RASC) or the Women’s Royal Army Corps (WRAC).726
722 Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Brigadier JM Rockingham, Report on Welfare—25 Canadian Infantry Brigade, 24 Dec. 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Local Army Welfare Officer, ‘Six Years of Army Welfare,’ 52-55. 723 Michael Francis Snape, God and the British Soldier: Religion and the British Army in the First and Second World Wars (London and New York: Routledge, 2005), 222. 724 Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Colonel John Wallis, Memorandum: Welfare—Far East, 25 Sept. 1952, LAC: RG 24, Acc 1983- 1984/167, Box 4903, File 3125-33/29, Volume 3. 725 Anon, Basic Facts About the Navy, Army and Air Force Institutes, 1958, TNA: DEFE 7/21. ‘Commonwealth Forces’ Record in Korea: A Successful Experiment,’ Times, 21 July 1953. Captain Donald Anderson, ‘Navy, Army, and Air Force Institutes in War and Peace,’ Royal United Services Institute Journal 85, 537 (1940): 64-65. Meyer Scolnick and Joseph L Packer, ‘Evolution of the Army and Air Force Exchange Service,’ United States Air Force Judge Advocate General Law Review 8, No. 5 (1966): 19-36. 726 Anon, 1 Commonwealth Division Periodic Report, 1 Apr. 1953—1 Aug. 1953, TNA: WO 308/65.
182 Beginning in 1951, NAAFI canteens were built at Seoul, Tokchong and Teal Bridge.727 Sited within close proximity of the division’s front lines, they sold basic groceries, cigarettes, beer, hard liquor and a range of recreational items like cameras, darts and cards.728 By 1953, the staff had even managed to set up a, ‘flourishing gift and sports shop.’729 As it was difficult to find building materials or experienced labour to construct the canteens, the division also had to rely upon the services of 14 mobile units. Housed in vans, they toured forward and rear echelon areas.730 Both the permanent and mobile canteens were supplied by the main NAAFI depot at divisional headquarters in Kure, which had a staff of over 100 military personnel and Japanese civilians. The depot was regularly responsible for processing a huge volume of goods. For example, nearly 10,000 cases of beer were shipped from Japan to canteens in Korea on a weekly basis. Consequently, the staff in Kure were periodically called upon to work long hours for weeks at a time in order
Celebrating 90 Years of NAAFI: Serving the Services (UK: the Navy, Army and Air Force Institutes, 2010). Anon, Basic Facts About the Navy, Army and Air Force Institutes, 1958, TNA: DEFE 7/21. Lieutenant Colonel Howard N Cole, NAAFI in Uniform (UK: Navy, Army and Air Force Institute, 1982). Anderson, ‘Navy, Army, and Air Force Institutes in War and Peace,’ 67. 727 Seoul was roughly 35 miles behind the division’s front lines. Tokchong, which served as the division’s headquarters, was in the area of Uijongbu and around 15 miles from the front. Teal Bridge was six and a half miles southwest of the juncture of the Imjin and Han Rivers. It was also close to the front. William R Farquhar Junior and Henry A Jeffers Junior, Building the Imjin: Construction of Libby and Teal Bridges During the Korean War (October 1952-July 1953), Studies in Military Engineering No. 5 (Fort Belvoir, VA: United States Army Corps of Engineers, 1989), 7. Lieutenant Colonel A MacLennan, (Officer Commanding 26 Field Ambulance) 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, Wellcome Library and Archives (Hereafter cited as WLA): Royal Army Medical Corps Muniments Collection, 761/4, Box 158. 728 Anon, Talk with Captain Fenny on Welfare in the Far East, 21 May 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. 729 Anon, 1 Commonwealth Division Periodic Report No. 7, 2 Aug. 1953—1 May 1954, TNA: WO 308/31. 730 Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3.
183 to ensure that shipments were delivered promptly.731 The purpose of NAAFI was to ensure that, ‘little luxuries [were] available at low cost, right up the line.’732 While Commonwealth personnel were welcome to shop at American canteens or Post Exchanges (PX), the majority chose to spend their money at NAAFI shops. In contrast to World War II, NAAFI did not have to contend with wartime austerity measures or prolonged shipping disruptions. Easily accessible and reasonably priced, the organisation was widely praised for its dependability and quality of customer service.733 However, the greatest admiration was reserved for the mobile canteen drivers, who often put themselves in danger to deliver shipments to the front. Writing home in 1951, NAAFI employee Robin McKechney recalled that: A few weeks ago, one of our mobile vans approached a forward unit from the front and, being in full view for two miles as it lumbered down the road, it narrowly escaped being shot at by a section of Canadian tanks until someone, through binoculars, recognised the name on the front. When he arrived, the mobile driver coolly explained that he had come round the front way because the road surface was better and he did not want to bounce his stock about.734
In addition to canteens, NAAFI also set up a series of clubs or roadhouses. First pioneered during the Western Desert campaign (1941-1943), roadhouses included rest areas, games rooms and small restaurants or cafes. Positioned along the division’s line of communications, the Newmarket, Newcastle, Northlands and the Ship Inn were built in a: …picturesque old world pub style, and had timbered ceilings, thatched roofs (rice straw from the local paddy fields), brick and tiled fireplaces—a welcome change from the smelly oil stoves that heated the tents—gaily painted window frames and
731 Cole, NAAFI in Uniform, 178. 732 ‘Commonwealth Forces’ Record in Korea: A Successful Experiment,’ Times, 21 July 1953. 733 Brigadier JM Rockingham, Report on Welfare—25 Canadian Infantry Brigade, 24 Dec. 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Anon, ‘Commonwealth Forces’ Record in Korea: A Successful Experiment,’ The Times, 21 July 1953. Anon, 1 Commonwealth Division Periodic Report, 1 Apr. 1953—1 Aug. 1953, TNA: WO 308/65. Anon, 1 Commonwealth Division Periodic Report, 1 Nov. 1952—1 Apr. 1953, TNA: WO 308/30. Brigadier JM Rockingham, Report on Welfare—25 Canadian Infantry Brigade, 24 Dec. 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. 734 Robin McKechney, quoted in, Lieutenant Colonel Howard N Cole, NAAFI in Uniform (UK: Navy, Army and Air Force Institute, 1982), 176-177.
184 doors. [They] were surrounded by vehicle parks and gardens where, in summer, brightly coloured umbrellas stood amongst the seats.735
Roadhouses were a popular destination for Commonwealth servicemen and attracted guests from the other United Nations’ units. American, Danish, French and Thai troops were all visitors throughout the war.736
Across the Korea Strait in Japan, the Australian Army Canteen Service (AACS) and charities like the Canadian Red Cross operated most of the canteens and clubs that Commonwealth soldiers visited while on leave. Originally deployed as part of the British Commonwealth Occupation Force (BCOF), the AACS ran the Anzac Club in Kure, the Empire Club in nearby Hiro and the Kookaburra Club in Tokyo. They also owned and operated the Ebisu Leave Centre. Located in a leafy and quiet suburb of Tokyo, Ebisu was a common destination for visiting Commonwealth troops.737 The Canadian Red Cross managed several similar clubs for the members of 25 Canadian Infantry Brigade.738 The Commonwealth Club in Hiro and the Maple Leaf Club in Tokyo boasted lounges, writing and reading rooms, snack bars, canteens and games rooms. They also included information desks where staff could direct soldiers towards, ‘good restaurant and theatre locations, the best place to shop, and even where to swim, fish or get oneself tattooed.’739 As they were prohibited from working in Korea, both the AACS and the Red Cross made an effort to employ female staff. These women helped to divert soldiers, listened to their worries and generally brought a touch of home to unfamiliar surroundings.740
735 Anon, Headquarters British Commonwealth Forces Korea Periodic Report No. 5, 1 Oct. 1953-- 31 March 1954, TNA: WO 308/1. Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Cole, NAAFI in Uniform, 178-180. 736 Ibid., 180. 737 Anon, Headquarters British Commonwealth Forces Korea Periodic Report No. 5, 1 Oct. 1953-- 31 Mar. 1954, TNA: WO 308/1. Brigadier JM Rockingham, Report on Welfare—25 Canadian Infantry Brigade, 24 Dec. 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3.
185 Living conditions for the Commonwealth troops serving in Korea were very difficult. Infantrymen commonly lived in makeshift trenches and bunkers that could fill with smoke from improvised stoves during the winter months. Exposed to the elements, servicemen frequently went for weeks without washing and often had to share their quarters with countless mites and rodents.741 Veteran Rex Sheppard described his own encounter with the local Korean wildlife in a recent interview with the Legasee Archive. He remembered: We had…several nasty lodgers. They were the most enormous rats, which had been attracted by, probably…food or dead bodies or whatever. The most horrific experience, I was laying in a bunker one night on a bed…During the night, I was conscious that there was a weight on my chest and I gingerly looked down and the biggest damn rat I’d ever seen was laying inside my sleeping bag. It had got in there for warmth. My reaction, as I can remember it now, was I just…ripped the sleeping bag open and threw the whole thing away.742
Anon, British Element Ebisu Leave Camp War Diary, Jan. 1952, TNA: WO 281/1002. Anon, Korean Campaigns: Welfare and Entertainment, TNA: WO 308/6. 738 The Canadian Red Cross also ran 25 Canadian Infantry Brigade Recreation Centre or Maple Leaf Park in Korea. It included, ‘a gymnasium, hobby centre, library, theatre, lounge, dry and wet canteens, writing rooms and a gift shop.’ Anon, 1 Commonwealth Division Periodic Report No. 7, 2 Aug. 1953—1 May 1954, TNA: WO 308/31. Anon, Reduction of Forces in Far East, 24 Nov. 1954, LAC: RG 24, Acc 1983-1984/167, Box 4904, File 3125-33/29/15. Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Anon, Rundown of Canadian Troops—Far East—Welfare Amenities, 14 Apr. 1955, LAC: RG 24, Acc 1983-1984/167, Box 4904, File 3125-33/29/15. Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Betty Wamsley, Maple Leaf Club Opens in Tokyo, Undated, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. 739 Betty Wamsley, Maple Leaf Club Opens in Tokyo, Undated, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. 740 Adjutant General, Headquarters British Commonwealth Force in Korea, Six Monthly Report, 1 Apr.--30 Sept. 1954, TNA: WO 308/7. Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Cunningham-Boothe and Farrar, British Forces in the Korean War, 51-52. Frances Martin Day, Phyllis Spence and Barbara Ladoceur eds., Memoirs of the Canadian Red Cross Corps (Vancouver: Ronsdale Press, 1998), 343-352. 741 Hickman, The Call Up, 78-79. 742 Rex Sheppard, interview by Legasee: The Veteran Archive, last modified 2012, http://www.legasee.org.uk/the-archive/rex-shepherd/
186
Sheppard’s experience was not exceptional and many other men were forced to live alongside rats, mice and poisonous snakes. Whether they were from Britain, Canada, Australia or New Zealand, canteens and clubs provided Commonwealth soldiers with a much-needed respite from the strains of front line life. The average soldier could look forward to the arrival of the NAAFI van, a trip to a nearby roadhouse or rest and relaxation (R&R) in the more comfortable surroundings of Japan. The promise of relief helped soldiers to keep fighting even in the direst of circumstances.
Entertainment In a 2012 study entitled, ‘Morale, Psychological Wellbeing of UK Armed Forces and Entertainment: A Report for The British Forces Foundation,’ Professor Edgar Jones explored the place of entertainment in military life. Reviewing the events of the past century, Jones states that, ‘Evidence gathered from both World Wars…showed that entertainment is a morale sustaining factor.’743 Entertainment was equally, if not more important during the Korean campaign. From July 1951-July 1953, the fighting was characterised by long, monotonous patrols punctuated by terrifying night-time assaults by North Korean and Chinese forces. Throughout the long stalemate, the officers of A Branch went to great lengths to entertain and divert soldiers when time and circumstance allowed. The four most common forms of entertainment in Korea were sports, radio, film and live concerts.
Easy to organise and stage, sporting competitions were widespread during the Korean War. For British soldiers in particular, the popularity of sport was at a fever pitch during the national service years (1946-1963) and troops competed against one another in games like
743 Jones, Morale, Psychological Wellbeing of UK Armed Forces and Entertainment, 43.
187 rugby, cricket and football on a regular basis.744 Over the course of the winter, the Canadian contingent converted frozen sections of the River Imjin into a rink for ice hockey tournaments, which was affectionately known as Imjin Gardens.745 The river was also an ideal place to race iceboats. The small crafts, first developed by a group of enterprising British officers, were equipped with blades and fitted with large sails. During the colder months, aspiring sailors would challenge each another to iceboat contests.746 Attracting large crowds, games of this nature provided soldiers with an opportunity to socialise and cheer on their favourites. Participation in physical recreation also helped to foster a healthy sense of rivalry between the opposing teams and further encouraged group cohesion at the battalion level.
Positioned along a nine mile long front, radio was another convenient way in which to communicate with and amuse Commonwealth troops. Beginning early in 1951, British, Canadian, Australian and New Zealand units were all equipped with radios that could receive signals for US Army stations in Japan and a number of commercial providers like the Canadian Broadcasting Corporation (CBC).747 The division’s own station, Crown Radio opened the following year in March 1952 and aired news and entertainment programmes every evening. Staffed by members of the Royal Army Educational Corps (RAEC), the station experienced transmission problems during its first months of operation.748 However,
744 Hickman, The Call Up, 142. Anon, Headquarters British Commonwealth Forces Korea Periodic Report No. 6, Apr. 1954—30 Sept. 1954, TNA: WO 308/2. Anon, 1 Commonwealth Division Periodic Report No. 9, 1 Oct. 1955—30 June 1956, WO 308/62. 745 Anon, 1 Commonwealth Division Periodic Report No. 9, 1 Oct. 1955—30 June 1956, WO 308/62. 746 Ibid. 747 Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, 1983-84/167, Box 4903, File 3125-33/29, Volume 3. 748 Anon, Historical Notes: A Branch Including Chaplains, Provost & Education, TNA: WO 308/9. Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64.
188 these difficulties were eventually resolved and Crown Radio expanded its line-up of shows exponentially in the months preceding the July 1953 armistice.749
As movie going was at its height in the early 1950s, A Branch also organised a divisional film library. Run by the Army Kinema Corps (AKC), the library included a wide range of American pictures and a smaller selection of British, Canadian and Australian productions. Films were typically screened outdoors during the summer. Be that as it may, several hutted theatres were constructed and drew crowds of 300-400 men during the winter of 1952.750 No matter the time of the year, cinema attendance figures were consistently high. For example, from April-August 1953, the Commonwealth film library issued over 700 films a month with an average monthly attendance figure of 120,300.751
Despite the excitement of sport, the convenience of radio and the escapist attraction of the movie theatre, live concerts and performances had their own distinct allure. In contrast to other forms of entertainment, ‘The live show brings direct human contact and spontaneity.’752 During World War II, famous performers like singers Vera Lynn and Gracie Fields had travelled to entertain and amuse regular servicemen. Throughout the Korean War, this tradition continued uninterrupted. Each of the division’s contributing
749 An additional station, Radio Maple Leaf, was opened after the armistice in December 1953 to entertain Canadian troops in Korea on occupation duties. Canadian Armed Forces in Korea, 3 Dec. 1953, LAC: RG 24, Acc 1983-1984/167, Box 4925, File 3130-32/29. Anon, 1 Commonwealth Division Periodic Report, 1 Apr. 1953—1 Aug. 1953, TNA: WO 308/65. 750 Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Anon, 1 Commonwealth Division Periodic Report, 1 Nov. 1952—1 Apr. 1953, TNA: WO 308/30. Anon, 1 Commonwealth Division Periodic Report, 1 Apr. 1953—1 Aug. 1953, TNA: WO 308/65. 751 Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Anon, 1 Commonwealth Division Periodic Report, 1 Nov. 1952—1 Apr. 1953, TNA: WO 308/30. Anon, 1 Commonwealth Division Periodic Report, 1 Apr. 1953—1 Aug. 1953, TNA: WO 308/65. 752 Jones, Morale, Psychological Wellbeing of UK Armed Forces and Entertainment, 42.
189 members sent four concert parties to the Far East every year. Sponsored by private companies, concert parties were variety shows that typically featured six different performers. For an average of seven weeks, they visited Commonwealth units across Korea and Japan and were often called upon to put on additional shows. The American United Service Organisation (USO) also had a number of well-known travelling productions.753 From 1950-1953, the Commonwealth Division played host to the likes of: British comedian Frankie Howerd, Australian actor Al Thomas, Canadian comedy duo Wayne & Shuster and American variety performers like Danny Kaye and Jack Benny.754 Years later, British singer and radio host Carole Carr recalled how appreciative troops were of live performers. Of a 1952 visit, she noted: One of my most vivid memories is the show I did for the Welch Regiment in a rainstorm. They were getting soaked, so I asked them if they wanted me to carry on. They yelled YES, but they had the last laugh. Suddenly the canvas roof over the stage caved in and I was drenched…to a wave of cheers and whistles.755
753 Ibid., 22-32. Major General WHS Macklin to the Minister of Defence Brooke Claxton, 12 Aug. 1953, LAC: RG 24, Acc 1983-1984/167, Box 4914, File 3128-33/29, Pt. 4. Adjutant General, Report to Treasury Board, 3 Sept. 1953, LAC: RG 24, 1983-84/167, Box 4914, File 3128-33/29, Pt. 4. Anon, Headquarters British Commonwealth Forces Periodic Report No. 5, 1 Oct. 1953 to 31 March 1954, TNA: WO 308/1. Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Claude F Luke, ‘The Work of the Navy, Army and Air Force Institutes Entertainment Branch,’ Royal United Services Institute Journal 86, 541 (1941): 88-94. Patrick B O’Neill, ‘The Halifax Concert Party in World War II,’ Theatre Research in Canada/Recherches Théâtrales au Canada 20, No. 2 (Fall 1999): http://journals.hil.unb.ca/index.php/TRIC/article/view/7086/8145 754 Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Anon, 1 Commonwealth Division Periodic Report No. 3, 1 Oct. 1952—31 Mar. 1953, TNA: WO 308/60. Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Major General WHS Macklin to the Minister of Defence Brooke Claxton, 12 Aug. 1953, LAC: RG 24, Acc 1983-1984/167, Box 4914, File 3128-33/29, Pt. 4. 755 Carole Carr, quoted in Tom Hickman, The Call Up: A History of National Service (UK: Headline, 2005), 83.
190 Social Services While the Adjutant General’s Branch was responsible for providing the division with light relief, it also fulfilled a more serious function. The Royal Army Chaplain’s Department (RAChD), counselling services and the Royal Army Educational Corps all fell under the control of A Branch. Supplementing the work of welfare officers, chaplains, personnel officers (POs) and teachers were a key point of contact for those men experiencing distress or wishing to better themselves. A steady presence in theatre, these officers helped to bolster flagging spirits and were an additional source of support for those in need.
Although compulsory church parades had been abandoned throughout the Commonwealth in the late 1940s and the number of military chaplains greatly reduced after World War II, religion remained important in the early 1950s and was an active force in Korea.756 Religious radio programmes were amongst the most popular shows broadcast by Crown Radio and many units built small chapels and other places of worship over the course of the war. The number of soldiers who attended church on a weekly basis increased considerably every year.757 Reporting to his superiors in the War Office in December 1953, Deputy Assistant Chaplain General MS James noted that, ‘Confirmation services held both in battalion positions and in Seoul Cathedral and elsewhere were attended by large numbers of troops of every nation.’758 In terms of education, the RAChD offered, ‘courses of religious instruction,’ to those with an interest and spiritual retreats for groups of up to thirty men at the Divisional Rest Centre at Inchon. 759 Maintaining a close relationship with their
756 Anon, Historical Notes: A Branch Including Chaplains, Provost & Education, TNA: WO 308/9. 757 Anon, 1 Commonwealth Division Periodic Report No. 3, 1 Oct. 1952—31 Mar. 1953, TNA: WO 308/60. Anon, 1 Commonwealth Division Report No. 5, 1 Oct. 1953 to 31 Mar. 1954, TNA: WO 308/1. Anon, Historical Notes British Commonwealth Forces Korea: Britcom Forward Maintenance Area/Sub Area North, TNA: WO 308/17. 758 Deputy Assistant Chaplain General WS James to Deputy Assistant Adjutant General, Historical Review--Royal Army Chaplain’s Department, Korean Theatre, Dec. 1953, TNA: WO 308/9. 759 Adjutant General, Headquarters British Commonwealth Forces Korea, Six Monthly Report 1 Apr.—30 Sept. 1954, TNA: WO 308/7.
191 American counterparts, they also helped to host, ‘many joint conferences for study and worship,’ at the headquarters of the US Eighth Army.760 While a variety of Christian denominations were represented, the majority of British and Dominion chaplains were Roman Catholic, Anglican or Presbyterian. 761 In addition to their other duties, they routinely visited all of the division’s medical units, including 25 Canadian Field Dressing Station. According to a historical review of religious work in Korea, ‘As is traditional, the relationship between Chaplains and doctors was at all times close. Visitation of the sick through Medical Evacuation Channels often proved arduous and lengthy but repaid every effort.’762 Comforting the sick and wounded, chaplains were seen as trusted and welcome advisors by the patients and staff alike. If a soldier’s problems were psychiatric in nature, they were encouraged to refer the matter on to the doctor in attendance. There is no record as to how many men received counselling from or were referred to psychiatrists by the division’s clergy. Nevertheless, chaplains offered another outlet through which to discuss the challenges of front line service.763
While chaplains provided spiritual counsel and succour, personnel officers were primarily trained to help troops contend with domestic problems and issues surrounding resettlement. Soldiers experiencing marital discord, dealing with family illness or other personal difficulties were actively encouraged to seek advice from a PO. They were in a position to contact families, and in extreme circumstances, they could arrange for a serviceman to be
760 Deputy Assistant Chaplain General WS James to Deputy Assistant Adjutant General, Historical Review--Royal Army Chaplain’s Department, Korean Theatre, Dec. 1953, TNA: WO 308/9. 761 Anon, Historical Notes: A Branch Including Chaplains, Provost & Education, TNA: WO 308/9. Anon, British Commonwealth Force Korea Periodic Report No. 8, 1 Apr. 1955—30 Sept. 1955, TNA: WO 308/61. 762 Deputy Assistant Chaplain General WS James to Deputy Assistant Adjutant General, Historical Review--Royal Army Chaplain’s Department, Korean Theatre, Dec. 1953, TNA: WO 308/9. 763 Anon, 25 Canadian Field Dressing Station War Diary, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397. Captain RC Nunn, Report of Protestant Chaplain, 1951, LAC: RG24-C-3, Volume 18395.
192 sent home.764 Resettlement counselling was also available to men in need. Designed to provide those who planned to leave the military with insight as to their future career options, counselling sessions were available in both Korea and Japan. All personnel were obliged to attend at least one such interview in their final six months on tour.765 POs could organise enrolment in one of 97 different pre-release programmes, which were created to help soldiers train as qualified tradesmen.766
In addition to pre-release programmes, the Royal Army Educational Corps organised and administered a vast array of secondary and post-secondary level courses. It was possible to learn Japanese, Russian, French and a wide selection of other languages while on service in the Far East. Moreover, one could take correspondence courses from Oxford and Cambridge, the City and Guilds Institute, the Institute of Civil Bankers, the University of Melbourne or the Institute of Bankers in Scotland. Based in Kure, the RAEC offered classes throughout the year. Their headquarters was equipped with classrooms, a dark room and equipment for handicrafts like woodworking, leatherwork and model making.767 One could borrow course reading materials and other literature from 41 Command Library, which was only a short walk away. Opened in August 1952, the library initially held 4,762 books and by 1955 this number had risen dramatically to 9,932. Largely assembled through public donation, the collection included an array of fiction and non-fiction books. The library offered a mail order borrowing service and distributed book catalogues to facilitate
764 Florence Bell, quoted in Memoirs of the Canadian Red Cross Corps, eds., Frances Martin Day, Phyllis Spence and Barbara Ladoceur (Vancouver, BC: Ronsdale Press, 1998), 346. Brigadier JM Rockingham, Report on Welfare—25 Canadian Infantry Brigade, 24 Dec. 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. 765 Adjutant General, Headquarters British Commonwealth Forces Korea, Six Monthly Report 1 Apr.—30 Sept. 1954, TNA: WO 308/7. 766 Ibid. 767 Adjutant General, Headquarters British Commonwealth Forces Korea, Six Monthly Report: 1 Apr.--30 Sept. 1954, TNA: WO 308/7. Anon, Historical Notes: the Role of the Royal Army Educational Corps in the Korean War 1950- 1953, TNA: WO 308/9. Anon, British Commonwealth Forces Korea No. 9, 1 Oct. 1955-30 June 1956, TNA: WO 308/62.
193 the process. On average, 41 Command Library issued around 72 books per day through this system. When possible, several mobile libraries would visit the front.768
Challenges to Welfare Provision Korea was a singularly challenging environment in which to work. As author Lieutenant Colonel Howard N Cole has pointed out: No worse terrain could be imagined for a fast moving mechanised army, the roads…were little better than ditches of glutinous mud, which later dried into long ribbons of thick dust which, as convoys moved, billowed up in clouds as dark as London ‘pea soup fog.’ So dark, it was, on occasions that drivers were ordered to keep their headlights on even in the middle of the day.769
Nevertheless, there was a strong sense of esprit de corps amongst welfare officers and the majority, ‘set about giving…a vital service to the men facing the enemy.’770 With the help of the Royal Engineers and other support troops, welfare officers were largely able to contend with the elements and meet, if not exceed expectations. Consequently, morale remained high during a static and frustratingly long campaign.771 There were few major
768 Anon, Headquarters British Commonwealth Forces Korea Periodic Report, Apr. 1954—30 Sept. 1954, TNA: WO 308/2. Adjutant General, Headquarters British Commonwealth Forces Korea, Six Monthly Report, 1 Apr.- -30 Sept. 1954, TNA: WO 308/7. Anon, Historical Notes, Headquarters British Commonwealth Forces Korea, A Branch, TNA: WO 308/9. Anon, 1 Commonwealth Division Periodic Report No. 8, 1 Apr. 1955—30 Sept. 1955, TNA: WO 308/61. Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. 769 Cole, NAAFI in Uniform, 175. 770 Ibid. 771 Anon, 1 Commonwealth Division Periodic Report, 2 May 1951—15 Oct. 1951, TNA: WO 308/27. Anon, 1 Commonwealth Division Periodic Report, 16 Oct. 1951—Feb. 1952, TNA: WO 308/28. Anon, 1 Commonwealth Division Periodic Report, 15 Feb. 1952—30 June 1952, TNA: WO 308/29. Anon, 1 Commonwealth Division Periodic Report, 1 Nov. 1952—1 Apr. 1953, TNA: WO 308/30. Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64.
194 difficulties that they could not surmount and those concerns that did arise emanated from command rather than the soldiers themselves.
Throughout the Korean War, senior Commonwealth commanders were consistently worried about the morality of entertainment choices available to the troops. They were anxious about the moral welfare of the division and wanted to ensure that soldiers spent their free time in a constructive manner.772 In November 1951, Canadian Adjutant General WHS Macklin wrote to the commanding officer of 25 Canadian Infantry Brigade, Brigadier John M Rockingham. He reminded his subordinate that, ‘the educational and cultural level of a substantial percentage of our recruits during the past two years is such that they require definite guidance during their leisure hours.’773 Macklin’s colleagues across the Atlantic were similarly concerned. As the war dragged on, British battalions increasingly included a large proportion of national servicemen, who were generally in their late teens and early twenties. The author of a War Office circular distributed at the time noted that these: …young men…are immature in knowledge and experience…not prepared for the temptations which are intensified as a result of their separation from steadying home influences and are not fully aware of the great importance of maintaining a code of behaviour which will secure for them and the British nation whom they represent the high regard of the peoples among whom they are stationed.774
The welfare services were expected to monitor both the quantity and the moral quality of the entertainment.
Anon, 1 Commonwealth Division Periodic Report No. 3, 1 Oct. 1952—31 Mar. 1953, TNA: WO 308/60. Anon, 1 Commonwealth Division Periodic Report, 1 Apr. 1953—1 Aug. 1953, TNA: WO 308/65. 772 Anon, 1 Commonwealth Division Periodic Report No. 3, 1 Oct. 1952—31 Mar. 1953, TNA: WO 308/60. War Office, Report on the Health of the Army 1955, 3 July 1959, TNA: WO 279/617. 773 WHS Macklin to Brigadier JM Rockingham, 21 Nov. 1951, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. 774 War Office Circular, as quoted in Michael Francis Snape, The Royal Army Chaplains’ Department 1796-1953: Clergy under Fire (Woodbridge, UK: The Boydell Press, 2008), pp. 349- 350.
195 Within Korea, it was relatively easy to control how troops behaved. The country’s infrastructure had been largely destroyed by the war and its cities were few and far between. Moreover, the activities that A Branch organised were the only entertainment options available. However, this was not the case in Japan. When on leave, the majority of Commonwealth servicemen travelled to Tokyo for rest and relaxation. The city presented numerous temptations, chief of which was prostitution. Following World War II, many Japanese women had fallen into poverty and were forced to sell their bodies as a way of making money. In the early 1950s, there were nearly 80,000 prostitutes in Tokyo and the surrounding areas alone. A high proportion these women were infected with venereal diseases (VD) and passed them on to visiting soldiers. 775 In 1951, 387 per 1,000 Commonwealth troops were infected with venereal diseases like gonorrhoea, chlamydia and syphilis.776 At a 1952 meeting of the Canadian Defence Council, a committee member noted that the rate, ‘was roughly ten times as high as it was during the Second World War.’ 777 Although rates of infection declined from 1952 onwards, VD remained an embarrassment for the Commonwealth Division. 778 The Adjutant General’s Branch provided a host of entertainment alternatives to those on leave in Japan but this had little effect on the number of men seeking out female company. VD can be interpreted as a welfare problem; however, the blame cannot be assigned to A Branch alone. It was divisional policy not to punish or discipline those men who contracted VD. In fact, Korea was the only British theatre of operations where men could not be charged for becoming infected.779 The Army had come to this decision because, ‘every man was needed to fight
775 Hickman, The Call Up, 195. 776 War Office, Report on the Health of the Army 1951-1952, TNA: WO 279/610. 777 Extract from the Minutes of the 58th Meeting of the Defence Council, 27 May 1952, LAC: RG 24, 1983-1984/167, Box 7717, 20-1-1, pt. 4, as quoted in Bill Rawling, The Myriad Challenges of Peace: Canadian Forces Medical Practitioners Since the Second World War (Ottawa: Canadian Government Publishing, 2004), 56. 778 The annual rate of VD throughout the Commonwealth Division in 1952 was 262.0 per 1,000 and 174.3 per 1,000 in 1953. War Office, Report on the Health of the Army 1951-1952, TNA: WO 279/610. War Office, Report on the Health of the Army 1953, 31 July 1956, TNA: WO 279/614. 779 Hickman, The Call Up, 202.
196 the war.’780 Furthermore, by the early 1950s most infections could be painlessly and effectively treated with a round of antibiotics.781 In other words, there were few deterrents to stop men from frequenting brothels.
While the levels of infection may have distressed senior officers, there is no indication that morale was any lower as a result. Apart from VD, discipline was well maintained. Even during the most intense periods of combat, levels of morale were high amongst infantry and support troops alike. Furthermore, the division remained an effective fighting unit and was frequently posted to difficult sections of the front line by American commanders.782
Conclusions Korea was a long and difficult campaign. Between 1950 and 1953, the men of the 1st British Commonwealth Division fought a war with ambiguous aims and were forced to contend with extreme weather and terrain. Be that as it may, the division gained a reputation for combat efficiency and high morale. When asked by an interviewer in 1970, which foreign soldiers he would, ‘classify as the fiercest fighters,’ American General Bruce
780 Ibid. 781 Lieutenant DK Mylrea, Administrative Officer, Canadian Section, British Commonwealth General Hospital Part I Orders No. 3, January 1953, LAC: RG 24, Acc 1983-1984/167, File No. 2001-812/BC, Volume 35954. Lieutenant Colonel A MacLennan, 1 Commonwealth Division, Questionnaire on Korean Campaign Answers, 1950-1952, WLA: Royal Army Medical Corps Muniments Collection, RAMC/761/4. 782 Anon, 1 Commonwealth Division Periodic Report, 2 May 1951—15 Oct. 1951, TNA: WO 308/27. Anon, 1 Commonwealth Division Periodic Report, 16 Oct. 1951—Feb. 1952, TNA: WO 308/28. Anon, 1 Commonwealth Division Periodic Report, 15 Feb. 1952—30 June 1952, TNA: WO 308/29. Anon, 1 Commonwealth Division Periodic Report, 1 Nov. 1952—1 Apr. 1953, TNA: WO 308/30. Anon, 1 Commonwealth Division Periodic Report, 1 July 1952—31 Oct. 1952, TNA: WO 308/64. Anon, British Commonwealth Force Korea Periodic Report No. 3, 1 Oct. 1952—31 Mar. 1953, TNA: WO 308/60. Anon, British Commonwealth Force Korea Periodic Report, 1 Apr. 1953—1 Aug. 1953, TNA: WO 308/65.
197 Clarke responded, ‘I think probably the best troops I had among the foreign troops were the Commonwealth Division; British and Canadians, Australians, New Zealanders, they were good troops. They’re stolid but they’re steady.’ Although many factors contributed to their success, several elements were key. Firstly, the division was blessed with reliable and industrious senior officers like Major General Cassels and Major General West, who used all the resources at their disposal to protect the division from unnecessary risk. Secondly, the division’s constituent members all agreed to limited tours of duty. Commonwealth troops were rotated out of theatre after between 12 and 18 months in the Far East. In the absence of any other clear motivation, the rotation date provided many with a goal towards which they could work. Thirdly, the division formulated a number of policies that helped to foster and strengthen a strong sense of group cohesion at the battalion and regimental level. Men were rotated alongside their comrades and encouraged to see themselves as part of a regimental family. Finally, welfare services were provided in a reliable fashion. The division was generally well provisioned in terms of basic amenities and well served in regards to recreation, entertainment and sources of social support. While medical and psychiatric staff play a part in developing an environment in which high morale and good mental health can flourish, they are only one part of a much larger machine.
198
Chapter 6 Forever Changed: Korean War Veterans and the Pensions’ System
199 Introduction During the Korean War, most mentally ill servicemen recovered and returned to duty quickly. The Commonwealth Division regularly recorded return to unit (RTU) rates of over 50%.783 Once in the hands of medical professionals, the majority of soldiers responded well to a treatment regime of sedation and brief psychotherapy. Be that as it may, this was not the case for a minority of patients. For them, the field medical unit was the first step in a long journey home. While comparable figures are not available for the other Commonwealth countries, an average of only 7% of British troops were evacuated from the Korean/Japanese theatre to the United Kingdom between 1950 and 1953 for psychiatric reasons. 784 Following repatriation, patients strove to deal with the psychological consequences of war and to recover sufficiently to rejoin their comrades. As veterans, they would face new but equally great challenges. In this chapter, I look at what was available to Korean War veterans in terms of pensions, allowances and medical care. Upon discharge, to what were veterans entitled? How were a new generation of disabled men treated in comparison to their predecessors of World War I and World War II? Since the 1950s, the pensions system has evolved in response to surrounding social, political and economic change. I will conclude the chapter with a discussion of what effect these changes have had on Korean War veterans and the current state of veterans’ affairs.
Veterans’ Rights Across the Commonwealth, Korean War veterans were entitled to the same pensions and medical care as their WWII counterparts.785 Pensions were seen as a material recognition of
783 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, Library and Archives Canada/Bibliothèque et Archives Canada (Hereafter cited as LAC): RG24-C-3, Volume 18395- 18397. War Office, Report on the Health of the Army 1951-1952, The National Archives at Kew (Hereafter cited as TNA): WO 279/610. 784 War Office, Report on the Health of the Army 1953, 31 July 1956, TNA: WO 279/614. 785 World Veterans Federation, Social Affairs Rehabilitation, Comparative Report: Legislation Affecting Disabled Veterans and Other War Veterans WVF-DOC/830 (Paris, France: World Veterans Federation, September 1955), 4-49.
200 the sacrifices that soldiers had made in defence of their respective countries.786 Over the previous fifty years, whole government departments had been established and developed to attend to veterans’ affairs.787 Generally, there were two types of pension available to applicants. Service pensions were awarded to men who had served overseas in an active conflict but were means tested and granted only to those in financial need.788 The amount of the award was based upon the length of service and the rank attained while in uniform.789 Disability pensions were granted to ex-servicemen whose impairment resulted, ‘from injury or disease or aggravation thereof incurred during military service.’790 In a 1950s study of Canadian pension and rehabilitation schemes, the word disability was broadly defined as, ‘the loss or the lessening of the power to will and do any normal mental or physical act.’791 The level of compensation depended on the severity of the handicap and how it impinged
786 Stephen Garton, The Cost of War: Australians Return (Melbourne: Oxford University Press, 1996), 80. 787 Across the Commonwealth, the government departments responsible for pensions were: United Kingdom Ministry of Pensions and National Insurance Canada Department of Veterans Affairs (presently Veterans Affairs Canada) Australia Department of Repatriation (presently Department of Veterans Affairs) New Zealand Department of Veterans Affairs Anon, Report on War Pensioners for the year 1955, 1956, TNA: Ministry of Pensions and National Insurance (PIN) 19/277. GJ Downs, ‘Australia,’ Journal of International and Comparative Social Welfare 10, No. 1 (1994): 7, 10. World Veterans Federation, Social Affairs Rehabilitation, 4-6. 788 Anon, Pension and Rehabilitation Schemes of Dominions, Colonies and Other Countries (New War) CANADA, 1950s, TNA: PIN 15/3069. Anon, Report on War Pensioners for 1964, July 1965, TNA: PIN 18/500. World Veterans Federation, Social Affairs Rehabilitation, 15-33. 789 Commonwealth of Australia, House of Representatives, 26 Sept. 1956 (Mr Bryant Gordon), http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;adv=yes;orderBy=_fragment_numbe r,doc_daterev;page=0;query=bryant%20gordon%20%2B%20repatriation%20bill%201956%20Dec ade%3A%221950s%22;rec=2;resCount=Default Commonwealth of Australia, Senate, 16 Sept. 1959 (Sir Walter Cooper), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansards80/1959-09 16/0045/hansard_frag.pdf;fileType=application%2Fpdf 790 Anon, Pension and Rehabilitation Schemes of Dominions, Colonies and Other Countries (New War) CANADA, 1950s, TNA: PIN 15/3069. 791 Ibid.
201 upon the veteran’s earning capacity.792 One’s degree of disability could range anywhere from 5% to 100%.793 With this system in mind, it was often very difficult to assess psychiatric cases. While physical problems can be measured, the impact of poor mental health is not directly or easily quantifiable.794 In each country, disability pensions were adjusted for the cost of living and issued regularly rather than in a lump sum.795 Veterans in the UK and New Zealand were paid weekly. Meanwhile, Australians received their pensions on a fortnightly basis and Canadians were compensated monthly.796
792 Ministry of Pensions and National Insurance, Allowance for Lowered Standard of Occupation: Memorandum for the Information of Members of War Pensions Committees, 1964, TNA: PIN 59/84. 793 Anon, Notes on War Pension Schemes of Great Britain, Canada, Australia, New Zealand and South Africa, Sept. 1945, TNA: PIN 15/3069. Anon, Report on War Pensioners for 1964, July 1965, TNA: PIN 18/500. Australian Government—Department of Veterans’ Affairs, Pensioner Summary, December 2011. 794 Garton, The Cost of War, 167-169. 795 There were some exceptions to this rule. If the veteran had a relatively minor disability, he would receive compensation in one payment. However, the Commonwealth countries varied in what they considered to be a ‘minor’ disability. In the United Kingdom, veterans with 20% disability or less qualified. Whereas, Canadian veterans were only eligible if they were less than 5% disabled. World Veterans Federation, Social Affairs Rehabilitation, pp. 32-33. 796 Prisoners of war (POW) were entitled to the same pension options as all other ex-servicemen. They were not subject to any special treatment. However, Canada became the only Commonwealth country to offer a, ‘POW specific compensation pension,’ in the 1970s. In 1971, the government awarded a, ‘minimum disability of 50% of the full…disability pension to all POWs of the Japanese in WWII who had an assessed disability and had been imprisoned for a year or more.’ Under the terms of the 1976 Compensation for Former Prisoners of War Act, they were awarded, ‘an additional 30 per cent pension.’ All, ‘other Second World War and Korean War POWs [were] pensioned at three rates: 10 per cent for those who had been in captivity between 3 and 18 months; 15 per cent for those imprisoned between 18 and 30 months; and 20 per cent for anyone detained more than 30 months.’ Peter Yeend, Compensation (Japanese Internment Bill, Bills Digest No. 6 (Canberra: Commonwealth of Australia, 2001), 7. Jonathan FW Vance, Objects of Concern: Canadian Prisoners of War Through the Twentieth Century (Vancouver: University of British Columbia Press, 1994): 217-234. Alice Aiken and Amy Buitenhuis, Supporting Canadian Veterans with Disabilities (Kingston, ON: Defence Management Studies Program, School of Public Policy, Queen’s University, 2011), 4. Les Peate, Korean Veterans Association of Canada, email message to author, 16 June 2012. World Veterans Federation, Social Affairs Rehabilitation, 32.
202 In addition to service and disability pensions, there were a number of other compensation schemes open to ex-servicemen. Due to their loss of earning capacity, severely disabled veterans (100% disablement) were entitled to unemployment, marriage and child benefits. Furthermore, they could receive constant attendance allowance for any home nursing care they would require.797 The other payments available to veterans were designed to help them re-enter the job market or adjust to civilian life. Education and vocational training was offered in all of the Commonwealth countries. However, the schemes varied widely in their generosity.798 Former British servicemen were only entitled to six months of free vocational training through the Ministry of Labour and National Service.799 Canadians could spend as many months in training as they had spent in the military or if they decided to attend university, they were eligible for limited government funding. 800 New Zealand and Australia had the most liberal policies. New Zealanders were welcome to spend up to three years in vocational training.801 Under the Commonwealth Rehabilitation Scheme, former Australian soldiers could receive, ‘university education, or technical and apprenticeship training, with the aid of generous scholarships, sustenance, and training allowances,’ for a maximum of two years.802 Ex-servicemen in each country also qualified for home and business loans. Land settlement programmes were popular in the rural areas of Canada, Australia and New Zealand.803 Self-sufficiency was the order of the day. Government planners believed that those capable of working should be actively employed. Allowances
797 Anon, Notes on War Pension Schemes of Great Britain, Canada, Australia, New Zealand and South Africa, September 1945, TNA: PIN 15/3069. Downs, ‘Australia,’ 7, 10. World Veterans Federation, Social Affairs Rehabilitation, 22-23. 798 Commonwealth of Australia, House of Representatives, 22 Apr. 1959 (Sir Wilfrid Kent Hughes), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansardr80/1959-04- 22/0109/hansard_frag.pdf;fileType=application%2Fpdf World Veterans Federation, Social Affairs Rehabilitation, 38-41. 799 World Veterans Federation, Social Affairs Rehabilitation, 40. 800 Ibid. Veterans Affairs Canada—Canadian Forces Advisory Council, The Origins and Evolution of Veterans Benefits in Canada (Ottawa: Veterans Affairs Canada, 2004). 801 World Veterans Federation, Social Affairs Rehabilitation, 40-41. 802 Garton, The Cost of War, 98. 803 Downs, ‘Australia,’ 20. World Veterans Federation, Social Affairs Rehabilitation, 47-49.
203 and benefits were designed with this ethos of independence in mind.804 The centrality of work is made clear in an Australian poem of 1919. In, ‘The Wounded Man Speaks,’ an anonymous veteran proclaims: They busted me up like a mangled pup But –THEY DID NOT BUST MY NERVE And no pussy footing sissy Shall grab my one good hand… Just to make himself feel grand For I’m damned if I’ll be a hero And I ain’t a helpless slob After what I’ve stood, what is left is good And all I want is—A JOB.805
Written in the aftermath of World War I, the poem is equally applicable to veterans of WWII and Korea. Pensions and other forms of compensation were not meant to encourage reliance upon government funds. Fit and capable disabled men were expected to support themselves if possible. As citizens, they had an economic duty to contribute rather than act as a drain upon public resources.806
The process of applying for a disability pension or benefits began either by post or at a local government office.807 Once a claim had been filed, events moved quickly. Service medical records were gathered and a panel of physicians assembled to examine the
804 Aiken and Buitenhuis, Supporting Canadian Veterans, 6. Garton, The Cost of War, 80-81. 805 ‘The Wounded Man Speaks,’ 1919, quoted in Stephen Garton, The Cost of War: Australians Return (Melbourne: Oxford University Press, 1996), 107. 806 Aiken and Buitenhuis, Supporting Canadian Veterans, 6. 807 The British Ministry of Pensions and National Insurance, Canadian Department of Veterans Affairs, Australian Department of Repatriation and New Zealand Department of Veterans Affairs were all organised regionally and had local offices where staff were employed to help veterans file applications. Anon to Miss Carr, May 1957, TNA: PIN 15/4084. Garton, 1996, p. 84. World Veterans Federation, Social Affairs Rehabilitation, 4-6.
204 applicant in question.808 Following this, a war pensions committee (WPC) was assigned to assess the veteran’s claim. WPCs varied in size and composition from country to country but typically consisted of three to four appointed persons. Committee members were usually prominent members of the community and in Australia they were required to be veterans themselves.809 In New Zealand, one position was always reserved for a member of the medical profession.810 When all the required documentation had been gathered, a meeting was convened in order to consider and decide upon the petition. If denied compensation, veterans had the right to an appeal. Pensions appeal tribunals could review cases several times before they were finally dismissed.811 All appellants were given the benefit of the doubt and ‘the legal onus of proof’ to show that a disability did not relate to service rested with the government.812 There was no time limit for applications made in Canada, Australia or in New Zealand. British veterans were required to apply within seven years of discharge. After seven or more years had elapsed, the onus of proof switched to the
808 Anon, Pension and Rehabilitation Schemes of Dominions, Colonies and Other Countries (New War) CANADA, 1950s, TNA: PIN 15/3069. Commonwealth of Australia, Senate, 16 Sept. 1959 (Sir Walter Cooper), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansards80/1959-09 16/0045/hansard_frag.pdf;fileType=application%2Fpdf 809 Government of New Zealand, War Pensions Act, 1954. Commonwealth of Australia, Senate, 16 Sept. 1959 (Sir Walter Cooper), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansards80/1959-09 16/0045/hansard_frag.pdf;fileType=application%2Fpdf. Stephen Uttley, ‘New Zealand,’ Journal of International and Comparative Social Welfare 10, No. 1 (1994), 46. 810 Uttley, ‘New Zealand,’ 46. 811 Anon, Report on War Pensioners for 1954, June 1955, TNA: PIN 19/275. Anon, Report on War Pensioners for 1964, July 1965, TNA: PIN 18/500. Commonwealth of Australia, Senate, 16 Sept. 1959 (Sir Walter Cooper), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansards80/1959-09 16/0045/hansard_frag.pdf;fileType=application%2Fpdf 812 AEW Ward to Mr Dennys, Royal Warrant—Onus of Proof, 3 July 1956, TNA: PIN 59/2. Commonwealth of Australia, House of Representatives, 13 Oct. 1955 (Mr Kim Beazley), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansardr80/1955-10- 13/0093/hansard_frag.pdf;fileType=application%2Fpdf Law Commission, A New Support Scheme for Veterans: A Report on the Review of The War Pensions Act 1954 (Wellington, New Zealand, May 2010), 78. Commonwealth of Australia, Senate, 16 Sept. 1959 (Sir Walter Cooper), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansards80/1959-09 16/0045/hansard_frag.pdf;fileType=application%2Fpdf
205 veteran and greater evidence was necessary to make a successful claim.813 By the mid fifties, all four Commonwealth countries were paying out close to two million pensions to veterans of WWI, WWII, Korea and several other conflicts.814 As Britain and Canada were responsible for over 80% of Commonwealth Division strength, they also had the largest proportion of Korean War veterans.815 However, only a small number of these men were receiving compensation at this time. For the year 1956, only 3% of those Britons and Canadians who had served in Korea were collecting a service or disability pension.816
War pensions committees encountered many challenges in assessing disability claims. Chief amongst these problems was a lack of medical expertise. While committees in New Zealand always included a physician, this was not the case in the other Commonwealth countries. Appointees were welcome to seek medical opinion but were themselves drawn from a range of professions. 817 Despite this, they were asked to evaluate complex conditions and understand a bewildering range of disabilities.818 In a December 1957 letter
813 AEW Ward to Mr Dennys, Royal Warrant—Onus of Proof, 3 July 1956, TNA: PIN 59/2. World Veterans Federation, Social Affairs Rehabilitation. 814 Anon, Report on War Pensioners for the year 1955, 1956, TNA: PIN 19/277. Commonwealth of Australia, House of Representatives, 13 Oct. 1955 (Mr Malcolm McColm), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansardr80/1955-10- 13/0076/hansard_frag.pdf;fileType=application%2Fpdf Stephen Uttley, ‘New Zealand,’ 47. Veterans Affairs Canada, The Origins and Evolution of Veterans Benefits in Canada. 815 General Sir Anthony Farrar-Hockley, The British Part in the Korean War, Vol. I, A Distant Obligation (London: HMSO, 1990), p. ix. Colonel Charles Perry Stacey, ‘The Development of the Canadian Army,’ Canadian Army Journal 6, no. 4 (July 1952): 19. William Cameron Johnston, A War of Patrols: Canadian Army Operations in Korea (Vancouver: University of British Columbia Press, 2003), 373. 816 Anon, Report on War Pensioners for the year 1955, 1956, TNA: PIN 19/277. Veterans Affairs Canada, The Origins and Evolution of Veterans Benefits in Canada. 817 United Kingdom, House of Commons, Debates, 14 Mar. 1960, Hansard, Series 5, Volume 619, cc. 923-924. 818 Anon, Pension and Rehabilitation Schemes of Dominions, Colonies and Other Countries (New War) CANADA, 1950s, TNA: PIN 15/3069. Uttley, ‘New Zealand,’ 46. World Veterans Federation, Social Affairs Rehabilitation, 15-20.
206 to a colleague, a Ministry of Pensions and National Insurance (MPNI) official remarked that, ‘It is exceedingly doubtful whether the War Pensions Committees as they are constituted are really competent to judge the medical issues in the cases which now come before them…’819 Although well intentioned, many WPC members lacked the basic medical education that they needed to judge applications fairly.
The imprecise nature of pension legislation was another major shortcoming of the application process. Throughout the Commonwealth, ‘the central criterion for entitlement to a war disability pension was an incapacity arising out of, or aggravated by, ‘active service,’ in war.’820 Australian author Stephen Garton has rightly noted that ‘the terms arising and aggravated are vague,’821 and that while, ‘it seems clear that legislators intended that pensions should be for those conditions that were a ‘direct’ consequence of service…the ambiguity in the terms they used to frame the legislation points to the difficulty in any such determination.’822 For war pensions committees, it was particularly hard to establish the origins of a psychiatric disorder. Who was deserving of compensation? Could those men with a long-term history of mental health problems blame their current condition on war service? Canadian authorities doubted that WPCs could answer these questions effectively. In addition, they were convinced that regular pension payments were harmful and would encourage veterans to prolong their symptoms.823 Therefore, policy dictated that, ‘unless positive proof of definite exaggeration of symptoms during service exists, the illness is termed, ‘pre-enlistment in origin,’ and compensation is refused.’824
819 Thomas to Mr Trew, 20 Dec. 1957, TNA: PIN 2894. 820 Garton, The Cost of War, 109-110. 821 Ibid. 822 Ibid. 823 Travis E Dancey, ‘The Interaction of the Welfare State and the Disabled,’ Canadian Medical Association Journal 103 (1 Aug. 1970): 274-277. . ‘Treatment in the Absence of Pensioning for Psychoneurotic Veterans,’ The American Psychiatric Journal 107 (1950): 347. 824 Dancey, ‘Treatment in the Absence of Pensioning,’ 347.
207 Patients suffering from conditions termed, ‘purely functional or hysterical,’825 were denied. Funds were only awarded if the serviceman in question underwent psychiatric care at a recognised institution and treatment subsequently failed.826 Within the pensions system, the mentally ill were at a distinct disadvantage. Physical disabilities are visible but psychological problems are hidden and can arise for multiple reasons. The Canadian example underlines the problems inherent in the pension process and the stigma that still attached itself to the mentally ill.
For the veteran population as a whole, applying for a pension could be an equally rewarding and infuriating process. By its very nature, the pension system was ‘adversarial.’827 Governments had to balance the needs of veterans with the limitations of public spending. Ex-servicemen were often very grateful for the help they received but could also encounter resistance to their requests for compensation. For instance, the Australian ‘Repatriation Department received numerous letters of gratitude.’828 However, it also got its fair share of complaints. Many veterans felt that, ‘they were treated as ‘criminals’ and ‘malingerers,’ and sometimes openly abused as ‘drongos’ and ‘hypochondriacs’ by officers of the department.’ 829 Representing the Korea Veterans Association of Australia, Ivan Patrick Ryan recalled that applying for and appealing a pension could be a, ‘complicated [and] demeaning,’830 process. Across the Commonwealth, bureaucrats and veterans worked together and opposed one another. Individual experiences
825 Anon, Notes on War Pension Schemes of Great Britain, Canada, Australia, New Zealand and South Africa, Sept. 1945, TNA: PIN 15/3069. Anon, Pension and Rehabilitation Schemes of Dominions, Colonies and Other Countries (New War) CANADA, 1950s, TNA: PIN 15/3069. 826 Ibid. Ibid. 827 Garton, The Cost of War, 88. 828 Ibid. 829 Ibid. 830 Ivan Patrick Ryan, Korea Veterans Association of Australia, email message to author, 24 May 2012.
208 varied greatly depending on the nature of the veteran’s disability and the pensions’ officials he encountered.
Veterans’ Medical Care Disability pensioners were universally entitled to free hospital treatment for any health problem related to service. Under legislation, veterans were considered to be priority patients. 831 Although ex-servicemen could be admitted to either military or civilian hospitals, they were increasingly the responsibility of the public healthcare system. In the 1950s, governments across the Commonwealth slowly began to close military hospitals. Budgetary restrictions in the 1960s and the 1970s helped to further speed this process.832 The smaller, professional armies of the Cold War did not require the large and dedicated network of medical facilities that had been developed during World War II.
Mentally ill veterans were treated in a range of institutions that included private care homes, general hospitals and asylums. While outpatient care was becoming more widespread, inpatient treatment was still common. 833 The majority of veterans were
831 Anon, Report on War Pensioners for 1964, July 1965, TNA: PIN 18/500. Committee Examining Ministry of Defence/National Health Service Collaboration, Use of Service Hospitals for War Pensioners, 15 Sept. 1978, TNA: PIN 59/483. 832 Rawling, The Myriad Challenges of Peace, 122-123, 247-249, 259. Colonel for Vice-Adjutant General to the Secretary, Medical Services Coordinating Committee, 30 Oct. 1958, TNA: PIN 14/44. Committee Examining Ministry of Defence/National Health Service Collaboration, Use of Service Hospitals for War Pensioners, 15 Sept. 1978, TNA: PIN 59/483. World Veterans Federation, Social Affairs Rehabilitation, 7-10. 833 Atkinson, Memorandum—Decentralisation of Action—Other Rank Pensioners Receiving Psychiatric Treatment, TNA: PIN 59/216. FJ Marcham, Norcross Awards: Report on the Service Patient Scheme for Mental Cases, Apr. 1959, TNA: PIN 15/4084. Commonwealth of Australia, Senate, 22 June 1950 (Sir Walter Cooper), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansards80/1950-06- 22/0085/hansard_frag.pdf;fileType=application%2Fpdf Garton, The Cost of War, 167-169.
209 admitted as service patients. Service patient programmes were first developed following WWI and were designed to ensure that veterans receive a higher standard of care than was generally available for psychiatric patients at the time. There was a stigma surrounding the mentally ill and the hospitals that treated them. It was untenable that former soldiers should be treated in the same fashion.834 If admitted to a hospital or to an asylum, veterans were treated on separate wards, wore distinctive clothing and received pocket money.835 In the United Kingdom, rank played an additional role in determining the quality of care that an individual could expect. As a rule, former officers were admitted to private homes and other ranks were sent to public institutions. Furthermore, ex-officers were allowed to handle their own finances with the approval of the attending physician. No matter how stable they proved, other rank patients were not trusted with their own money.836
Dancey, ‘The Interaction of the Welfare State and the Disabled,’ 275-277. World Veterans Federation, Social Affairs Rehabilitation, 7-10. 834 ‘Teaching Mental Health: Discussion by the Royal Medico-Psychological Association,’ Lancet 265, No. 6861 (26 Feb. 1955): 449. Duncan Macmillan, ‘Recent Developments in Community Mental Health,’ Lancet 281, No. 7281 (16 Mar. 1963): 567-568. Liam Clarke, ‘The opening of doors in British mental hospitals in the 1950s,’ History of Psychiatry 4 (1993): 527-551 Lord Stonham, House of Lords Official Report, 16 July 1959, TNA: PIN 19/202. 835 Anon to Mr Birtles, 17 Oct. 1957, TNA: PIN 15/4084. Anon to the Secretary, Mental Hospital Management Committee, 9 Jan. 1951, TNA: PIN 59/216. Commonwealth of Australia, Senate, 22 June 1950 (Sir Walter Cooper), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansards80/1950-06- 22/0085/hansard_frag.pdf;fileType=application%2Fpdf Garton, The Cost of War, 167-169. Dancey, ‘The Interaction of the Welfare State and the Disabled,’ 275-277. Dancey, ‘Treatment in the Absence of Pensioning,’ 348-349. 836 Anon to Mr Birtles, 17 Oct. 1957, TNA: PIN 15/4084. Anon, Report on War Pensioners for the year 1955, 1956, TNA: PIN 19/277. Anon to the Secretary, Mental Hospital Management Committee, 9 Jan. 1951, TNA: PIN 59/216. FJ Marcham, Norcross Awards: Report on the Service Patient Scheme for Mental Cases, Apr. 1959, TNA: PIN 15/4084.
210 Vocational and industrial rehabilitation schemes were established to help patients re-engage with the working world following their release from hospital.837 However, the system was not specifically designed for the mentally ill. In accommodating for the physically impaired, rehabilitation projects often failed to adequately address the needs of recovering psychiatric patients.838 Specialised programmes were exceedingly rare. The British Ex- Services Mental Welfare Society was one of the few organisations that catered solely for psychiatric pensioners.839 It ran a small residential scheme in Surrey, where men were hired to, ‘[assemble] cardboard boxes for blankets made by [company] Thermega Limited.’840 Charity employees were housed in a nearby hostel for the duration of their stay. Despite the value of the Society’s work, there were limits to the number of patients they could accept.841 In the battle to recover, many veterans were left to their own devices.
There are no reliable statistics as to the number of Korean War veterans who were discharged from the military for mental health problems. Pension and welfare records often include the Korean War in the same category as World War II and other post-1945 conflicts such as Malaya. Moreover, individual medical files remain closed to the public. Consequently, it is difficult to establish how many men applied for compensation or received medical treatment. Nonetheless, anecdotal evidence suggests that Korean War
837 Anon, Draft of Notes: Facilities for Rehabilitation Available through the Ministry of Labour and National Service, 1959, TNA: PIN 15/2730. Garton, The Cost of War, 80. World Veterans Federation, Social Affairs Rehabilitation, 44-45. 838 Anon to EL Trew, 19 June 1959, TNA: PIN 15/4084. Remploy, ‘Who we are,’ last modified 2013, http://www.remploy.co.uk/about-us/whoweare.ashx. World Veterans Federation, Social Affairs Rehabilitation, 45. 839 The British Ex-Services Mental Welfare Society is now known as Combat Stress. 840 Norcross to Mr Beavan, 17 Nov. 1955, TNA: PIN 15/3144. 841 Combat Stress, ‘About Us: The History of Combat Stress,’ last modified 2012, http://www.combatstress.org.uk/pages/history.html Norcross to Mr Beavan, 17 Nov. 1955, TNA: PIN 15/3144. R Atkinson to Mr Taylor, 2 June 1964, TNA: PIN 15/3144.
211 veterans were generally ill informed about their healthcare options.842 Canadian author Ted Barris has argued that the continued stigma of mental illness deterred the majority of ex- servicemen from stepping forward. Like previous generations, men were encouraged to address their problems privately with the support of family and friends.843 While many veterans managed to recover and thrive, others struggled to leave the war behind. Private Arthur Marion served as a reinforcement with the 2nd Battalion of the Princess Patricia’s Canadian Light Infantry (PPCLI) during the Korean War.844 Prior to his deployment, he was neither a, ‘public smoker or drinker,’845 but when he returned from the Far East he was a ‘changed man.’846 Decades later, he remembered, ‘I was a nervous wreck…If Mom dropped a spoon on the floor I was down under the table in a second.’847 He began smoking and drinking heavily in order to quell his nerves. During the subsequent years, Marion never approached a doctor or psychiatrist for help. As an elderly man, he confessed that, ‘I still wake up at night, moaning and groaning. I’m still fighting that war.’848 Other veterans suffered with similar problems involving depression, anxiety, and substance abuse. Mary McLeod’s husband Keith served with the Royal Australian Air Force in Korea and Japan. She noted that the war had a ‘profound and long lasting,’ impact upon her husband.849 In an interview, she recalled, ‘He was never the same again…if you take a gentle man and make him kill, he’ll never be the same again.’850
842 Joy Damousi, Living with the Aftermath: Trauma, nostalgia and grief in post-war Australia (Cambridge: Cambridge University Press, 2001), 135-140. Ivan Patrick Ryan, Korea Veterans Association of Australia, email message to author, 24 May 2012. Les Peate, Korean Veterans Association of Canada, email message to author, 16 June 2012. 843 Ted Barris, Deadlock in Korea: Canadians at War 1950-1953 (Toronto: Macmillan Canada, 1999), 286-306. 844 Arthur Marion, quoted in Ted Barris, Deadlock in Korea: Canadians at War 1950-1953 (Toronto: Macmillan Canada, 1999), 288. 845 Ibid. 846 Ibid. 847 Ibid. 848 Ibid. 849 Damousi, Living with the Aftermath, 140. 850 Ibid.
212 Organisations like the Royal Legion and the Returned & Services League (RSL) have long offered an alternative source of support to ex-servicemen. Throughout the twentieth century, they have campaigned tirelessly on behalf of veterans. Moreover, they have acted as a network for old comrades and a venue in which to relive old memories and vent present frustrations. Korean War veterans were equally entitled to membership and the benefits of such an association. 851 However, local branches were not universally welcoming. Don Flieger of the Royal Canadian Army Service Corps (RCASC) was evacuated from Korea in February 1952 after contracting epidemic haemorrhagic fever. When he was released from hospital, he returned to his home depot in Fredericton, New Brunswick.852 He later recalled, ‘That night, I went to the Legion. I was in my uniform. But they wouldn’t let me in. Said I wasn’t a veteran. I told them my story, but they said,’ That doesn’t cut it here.’853 Flieger’s experience may appear extreme but it was not unique. Other veterans recall meeting with similar hostility. In conversation with the author, members of the Korea Veterans Association of Australia recalled that the Returned & Services League was generally unsupportive of their membership.854 The opposition that they encountered was largely the result of public perception. During the 1950s, the Korean War was characterised as a relatively minor, ‘police action.’ The troops deployed to the Far East were primarily volunteers and served limited tours of duty. Furthermore, the scale of public involvement was limited in comparison to previous conflicts. Veterans’ organisations like the Legion were chiefly composed of men who had fought in either World War I or World War II. Events in Korea contrasted sharply with their own experiences of war and how they understood the term veteran.
851 Department of Health and Social Security—Central Advisory Committee on War Pensions, Minutes of the 97th Meeting, 18 Nov. 1981, TNA: PIN 88/90. Downs, 1994, p. 12. Les Peate, Korean Veterans Association of Canada, email message to author, 16 June 2012. Garton, The Cost of War, 89, 92, 170-172. 852 Don Flieger, quoted in Ted Barris, Deadlock in Korea: Canadians at War 1950-1953 (Toronto: Macmillan Canada, 1999), 288. 853 Ibid. 854 Ivan Patrick Ryan, Korea Veterans Association of Australia, email message to author, 24 May 2012.
213 Adapting to Change Over the past six decades, the pension system has changed and adapted in accordance with the needs of its clientele. Governments have had to accommodate for the increasing cost of living and an aging veteran population.855 The clinical practice of psychiatry has been similarly transformed. Custodial care and closed wards have been largely replaced with outpatient treatment and community-based programmes. Psychotropic drugs are now commonly prescribed to treat disorders like depression, anxiety and schizophrenia.856 At the time of the Korean War, there were few treatment options for the mentally ill and physicians could offer little in terms of prevention or cure. Since the nineteenth century, psychiatric patients had been primarily housed and cared for in large public asylums.857
855 Anon, Improvements in War Pensions since September 1945, 1960s, TNA: PIN 59/13. Anon, Report on War Pensioners for 1954, June 1955, TNA: PIN 19/275. Anon, Report on War Pensioners for the year 1955, 1956, TNA: PIN 19/277. Anon, Report on War Pensioners for 1964, July 1965, TNA: PIN 18/500. Anon, World Veterans Federation Conference, 1967, TNA: PIN 47/100. Downs, ‘Australia,’ 10-11. Ivan Patrick Ryan, Korea Veterans Association of Australia, email message to author, 24 May 2012. Law Commission, A New Support Scheme, iv, 15, 63, 118, 144, 146. Canada, Parliament, House of Commons Standing Committee on National Defence, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 22, 29 Apr. 2008 (Mr Darragh Mogan), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=darragh&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False&arpic e=True&arpicl=13177&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Language =E&Mode=1&Parl=41&Ses=1&arpicpd=3455971#Para1078985 Commonwealth of Australia, Senate, 28 Sept. 1955 (William Ashley), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansards80/1955-09- 28/0079/hansard_frag.pdf;fileType=application%2Fpdf Commonwealth of Australia, Senate, 24 Sept. 1958 (Justin O’Byrne), http://parlinfo.aph.gov.au/parlInfo/genpdf/hansard80/hansards80/1958-09- 24/0097/hansard_frag.pdf;fileType=application%2Fpdf Uttley, ‘New Zealand,’ 44, 48-50, 53. 856 Sylvia Wrobel, ‘Science, Serotonin, and Sadness: The Biology of Antidepressants,’ Journal of the Federation of American Societies for Experimental Biology 21, No. 13 (Nov. 2007): 3404-3417. 857 Thomas A Ban, ‘Fifty Years Chlorpromazine: A Historical Perspective,’ Neuropsychiatric Diseases and Treatment 3, No. 4 (Aug. 2007), 495-500. JL Crammer, ‘Comment: Britain in the fifties: leucotomy and open doors,’ History of Psychiatry 5 (1994): 394. Edward Shorter, A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Canada: John Wiley & Sons Inc, 1997), 33-68.
214 However, the 1950s represented a period of medical innovation and the beginning of a revolution. Antibiotics, better blood transfusions and new surgical techniques were all pioneered over the course of the decade.858 Comparable developments were made in psychiatry. In the wake of World War II, progressive ideas about open wards; community care and prevention became increasingly popular and entered the mainstream medical discourse. As medicine advanced, doctors were optimistic that they could combat mental illness. Legislation around the world began to reflect the new zeitgeist.859 For example, the 1959 British Mental Health Act supported the closure of large asylums in favour of the development of outpatient programmes. It also encouraged the mentally ill to seek voluntary treatment at an early stage.860 Exciting developments in psychopharmacology served to buoy a growing sense of confidence.
Early in 1951, French Army surgeon Henri Laborit was looking for a way in which to counter surgical shock. Laborit began experimenting with the drug chlorpromazine, which had been developed as an antihistamine by the company Rhône-Poulenc.861 He discovered that it was a highly effective sedative and immediately recognized the psychiatric value of such a drug. 862 Over the following months, Laborit pressed colleagues to prescribe chlorpromazine to their psychotic patients. He eventually convinced psychiatrists Jean Delay and Pierre Deniker to trial the drug at Ste. Anne’s Hospital in Paris. The results were
858 Edgar Jones, discussion with author, 2012. 859 Canadian Mental Health Association, ‘History of the Canadian Mental Health Association,’ last modified 2013, http://www.ontario.cmha.ca/inside_cmha.asp?cID=7620. Clarke, ‘The opening of doors,’ 527-551. 860 FJ Marcham, Norcross Awards: Report on the Service Patient Scheme for Mental Cases, Apr. 1959, TNA: PIN 15/4084. Ministry of Pensions and National Insurance, War Pensioners’ Welfare Service: Welfare Officers’ Guide, 1971, TNA: PIN 14/44. 861 C Alamo, P Clervoy, E Cuenca, F López Muñoz and G Rubio, ‘History of the discovery and clinical introduction of Chlorpromazine,’ Annals of Clinical Psychiatry 17, No. 3 (2005): 113-135. Ban, ‘Fifty Years Chlorpromazine,’ 495-500. 862 Gina Bari Kolata, ‘New Drugs and the Brain,’ Science, New Series 205, No. 4408 (24 Aug. 1979): 774.
215 astounding. For the first time, violent and uncontrollable patients were calm and could communicate clearly with their doctors.863
Chlorpromazine was the first effective anti-psychotic and transformed the lives of patients and psychiatrists alike.864 Doctors from across Europe and North America were quickly able to replicate Delay and Deniker’s results.865 By 1954, nearly two million patients were prescribed the drug in the United States alone. 866 The success of chlorpromazine encouraged the development of other anti-psychotics and psychopharmaceuticals. Antidepressants like the monoamine oxidase inhibitors (MAOIs) and tricyclics (TCAs) were tested and developed in the late 1950s and early 1960s. Their arrival on the market was greeted enthusiastically.867 In the manner of other medical specialists, psychiatrists could now offer targeted treatments for specific disorders.868 As Dr Thomas A Ban has noted, the emergence of these drugs, ‘turned psychiatrists from caregivers to full fledged physicians who [could] help their patients and not only listen to their problems.’869
863 Ban, ‘Fifty Years Chlorpromazine,’ 495-500. Heinz E Lehmann, ‘Introduction of Chlorpromazine Treatment of Mental Illness in North America,’ Canadians for Health Research, http://www.chrcrm.org/en/salute-excellence/introduction-chlorpromazine-treatment-mental-illness- north-america. 864 Joanna Moncrieff, ‘An Investigation into the precedents of modern drug treatment in psychiatry,’ History of Psychiatry 10 (1999): 475-490. 865 Ban, ‘Fifty Years Chlorpromazine,’ 495-500. Lehmann, ‘Introduction of Chlorpromazine.’ 866 Andrew Scull, ‘Psychiatrists and historical ‘facts’ Part One: The historiography of somatic treatments,’ History of Psychiatry 6 (1995): 235-236. 867 Robert Golden, Jeffrey A Lieberman, Joseph McEvoy and Scott Stroup, ‘Drugs of the Psychopharmacological Revolution in Clinical Psychiatry,’ Psychiatric Services 51, No. 10 (1 October 2000): 1254-1258. Moncrieff, ‘An Investigation,’ 475-490. Shorter, A History of Psychiatry, 255-272. Wrobel, ‘Science, Serotonin and Sadness,’ 3404-3417. 868 Ban, ‘Fifty Years Chlorpromazine,’ 495-500. 869 Ibid., 498.
216 Like other psychiatric patients, mentally ill veterans benefited from advances in drug treatment and the liberalisation of public attitudes.870 Since WWI, British legislation had discriminated against ex-servicemen with psychological problems. When a single man was admitted to hospital for a pensionable psychiatric illness, his pension was revoked and replaced by an allowance. Further deductions were made from this allowance if he remained in hospital for more than five years.871 The deductions in question were more, ‘severe than those made for any other type of patient in receipt of treatment allowance.’872 In addition, the quality of treatment varied depending on rank. Former officers were entitled to significantly better facilities and treatment options. When the Ministry of Pensions and National Insurance reviewed its existing procedures in 1971, it was clear that policy did not meet modern standards nor was it in line with public sentiment.873 Civil servant Mr R Windsor lamented that the situation was, ‘acutely embarrassing,’874 and that, ‘there [was] little internal consistency and some of our practices in terms of contemporary standards [were] not merely indefensible but positively offensive.’875 MPNI practices were no longer politically viable in the social climate of the 1970s. Distinctions that had previously been regarded as natural were eliminated quickly and quietly. Other Commonwealth governments made similar accommodations for public feeling and veterans benefited accordingly.876 However, the greatest changes were yet to come.
870 Ivan Patrick Ryan, Korea Veterans Association of Australia, email message to author, 24 May 2012. Les Peate, Korean Veterans Association of Canada, email message to author, 16 June 2012. Uttley, ‘New Zealand, 46-47, 51. 871 Anon, Paragraphs on War Pensions Proposed by the Mental Welfare Commission for Scotland for Inclusion the Forthcoming Report, Apr. 1971, TNA: PIN 18/616. 872 Ibid. 873 Anon, Note of a Meeting to Consider the Position of War Pensioners in Hospital, 13 July 1971, TNA: PIN 18/616. L Errington to Miss Riddelsdell, War Pensioners in Hospital, 28 July 1971, TNA: PIN 35/416. RG Cope to Mr Pagdin, 8 July 1971, TNA: PIN 18/616. 874 R Windsor to Mr Overend and Mr Errington, War Pensions and Industrial Injuries, 2 July 1971, TNA: PIN 18/616. 875 Ibid. 876 Anon, Paragraphs on War Pensions Proposed by the Mental Welfare Commission for Scotland for Inclusion the Forthcoming Report, April 1971, TNA: PIN 18/616. Anon, Note of a Meeting to Consider the Position of War Pensioners in Hospital, 13 July 1971,
217 The Vietnam War (1961-1975) was one of the most controversial and politically contentious conflicts of the twentieth century. It has also been cited as a key turning point in the history of military psychiatry.877 In regards to mental healthcare, Vietnam was initially considered to be a success story. US Army, ‘psychiatric casualties were reported as being ten times lower than in World War Two, and three times lower than in Korea, smaller than ‘any recorded in previous conflicts.’’878 These unparalleled results were, ‘commonly ascribed to the widespread use of forward psychiatry,’ as well as, ‘the less intense nature of the fighting…shorter tours of duty and the better links with home.’879 Soon thereafter, a different picture began to emerge.
Upon their return home, many American veterans appeared to struggle to adjust to civilian life. They suffered from long-term psychological problems, which they linked to service in Vietnam.880 Groups like Vietnam Veterans Against the War (VVAW) and the National Veterans Resource Project (NVRP) began to campaign vigorously on behalf of mentally ill ex-servicemen.881 They were convinced that, ‘the war had left a psychological scar on all
TNA: PIN 18/616. 877 Ben Shephard, A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century. (Cambridge, MA: Harvard University Press, 2001), 355. 878 Edgar Jones and Simon Wessely, Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War (London: Taylor & Francis/Psychology Press, 2005), 128. 879 Ibid. 880 Early academic studies about the psychological health of Vietnam veterans appeared to overwhelmingly link later mental health problems to the war. However, it is important to be critical of these projects. The research conducted was on a small scale and involved limited sample populations. Jones and Wessely, Shell Shock to PTSD, 129. Studies included: C Figley, ed., Stress disorders among Vietnam veterans: Theory, research and treatment (New York: Brunner/Mazel, 1978). CR Figley, ‘Symptoms of delayed combat stress amongst a college sample of Vietnam veterans,’ Military Medicine 143 (1978), 107-110. MJ Horowitz and GF Solomon, ‘A prediction of delayed stress response syndromes in Vietnam veterans,’ Journal of Social Issues 31 (1975): 67-80. 881 Shepherd, War of Nerves, 355-357.
218 who fought in it.’882 In the charged atmosphere of the late 1970s, a spark had been lit. Post Traumatic Stress Disorder (PTSD) was first recognised as a distinct diagnostic entity in the 1980 edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual-III (DSM).883 The DSM is widely employed by doctors as a clinical tool for the classification of psychiatric conditions.884 Before 1980, veterans had rarely succeeded in obtaining pensions for cases of long term or delayed trauma. It had been nearly impossible to link mental health problems directly to earlier war service. Moreover, pensions’ officials could argue that a veteran had a prior history of psychiatric illness. By including Post Traumatic Stress Disorder in DSM-III, the American Psychiatric Association set an important precedent. They acknowledged that symptoms of trauma could lie dormant for many years before becoming noticeable. Furthermore, the traumatic event itself was to blame as opposed to the veteran’s pre-enlistment history and early psychological development. For veterans, this was a paradigm shifting moment.885
882 Ibid., 357. 883 Carol MacDonald, Kerry Chamberlain and Nigel Long of Massey University have described the nature and symptoms of PTSD. They note that: ‘Within the DSM-IV [the most recent edition of the publication], PTSD is listed as an anxiety disorder on Axis I alongside disorders such as panic disorder, agrophobia [sic], and generalised anxiety disorder (American Psychiatric Association, 1994). The essential feature…is the development of characteristic symptoms following exposure to an extreme trauma. This may involve direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s personal physical integrity; or witnessing an event that involved death, injury or threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate. In addition, the person’s response to the event must involve intense fear, helplessness, or horror. The characteristic symptoms resulting from the exposure to the extreme trauma include persistent re-experiencing of the traumatic event, persistent avoidance of stimuli associated with the trauma and general numbing of responsiveness, and persistent symptoms of increased arousal.’ Carol MacDonald, Kerry Chamberlain and Nigel Long, ‘Posttraumatic Stress Disorder (PTSD) and its effects in Vietnam veterans: The New Zealand experience,’ New Zealand Journal of Psychology 24, No. 2 (Dec. 1995), 63. 884 Jones and Wessely, Shell Shock to PTSD, 129-132, 234-238. Shorter, A History of Psychiatry, 304-305. 885 Simon Wessely, ‘War and Psychiatry: A Story in Three Acts,’ lecture, Global History Seminar, The London Centre of the University of Notre Dame, 27 Mar. 2013. Garton, The Cost of War, 109-110. Dancey, ‘The Interaction of the Welfare State and the Disabled,’ 274-277.
219 Roughly 60,000 Australian soldiers were deployed to Southeast Asia throughout the 1960s and 1970s.886 As in the United States, the war in Vietnam was highly controversial in Australia and veterans were similarly politicised by events.887 The government was sharply criticised for how it treated ex-servicemen and demand grew for better and more accessible care options. The Vietnam Veterans’ Counselling Service (VVCS) opened in 1982 with offices in Canberra, each of the state capitals and the cities of Albury, Launceston, and Townsville.888 For the first time, serving personnel, veterans and their families could access long-term counselling. They could attend both individual and group therapy sessions with trained psychiatrists and clinical psychologists.889 Since 1982, the Department of Veterans Affairs (DVA) has continued to expand its mental health programming.890 The Australian Centre for Posttraumatic Mental Health (ACPMH) was established in 1995 with the aid of DVA funding. In partnership with the department and the University of Melbourne, ACPMH conducts specialised research into PTSD and other forms of trauma.891 DVA officials have also collaborated with scholars at Monash University to examine the long- term health consequences of service life. As of 2008, 18% of the department’s clients were treated for psychiatric problems every year. Spread across the country, they represent an important segment of Australia’s veteran population.892
Dancey, ‘Treatment in the Absence of Pensioning,’ 347. 886 Australian War Memorial, ‘Vietnam War 1962-1975,’ last modified 2013, http://www.awm.gov.au/atwar/vietnam.asp. 887 Department of Veterans Affairs, ‘Australia and the Vietnam War: Public Opinion,’ last modified 2013, http://vietnam-war.commemoration.gov.au/public-opinion/index.php. 888 Downs, ‘Australia,’ 15-17, 22-24. 889 Ibid. 890 Department of Veterans Affairs, Factsheet HSV133: Psychology and Other Mental Health Services for Veterans--Information for the Veteran Community (Canberra: Government of Australia, Jan. 2001). 891 Australian Centre for Posttraumatic Mental Health, ‘Our History,’ last modified 4 Nov. 2010, http://www.acpmh.unimelb.edu.au/about/our_history.html. 892 Canada, Parliament, House of Commons Standing Committee on Veterans Affairs, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 93, 3 June 2008 (Mr Adam Luckhurst), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=luckhurst&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False&arpi ce=True&arpicl=13177&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Languag e=E&Mode=1&Parl=41&Ses=1&arpicpd=3545201#Para1155707
220 Australia was the first Commonwealth country to appreciate the importance of Post- Traumatic Stress Disorder and its implications for the pension system. Events in Vietnam acted as a catalyst for change. Other major Commonwealth countries like New Zealand, Canada and the United Kingdom were much slower to react. From 1964-1972, over 3,000 members of the New Zealand Defence Force were sent to Vietnam. However, the New Zealand government failed to develop a comparable counselling service until the early 1990s. With a much smaller veteran population, the public demand did not exist. Canadian and British policy started to move in the same direction in the late 1990s and early 2000s. Although both countries recognised PTSD and related disorders, their mental healthcare provisions were far from systematic. Neither country had deployed forces to the war in Vietnam or experienced the resulting political upheaval. Subsequent events would change their perspective.
The 1990s represented a period of increased operational tempo for both Canadian and British troops.893 In 1991, each country contributed ground forces to the Gulf War. Following their return from the Middle East, veterans began to present with a variety of health problems that ranged from fatigue and headaches to cancer. While the aetiology of Gulf War Syndrome has never been properly explained, it drew significant public attention to matters of military health. It also highlighted the shortcomings of existing pensions legislation and how veterans were treated for mental health problems. The cracks in the system were becoming increasingly obvious.894 By the late 1990s, events in Canada had reached a critical point. In 1999, the government established the Croatia Board of Inquiry (Sharpe Inquiry) to investigate claims that Canadian soldiers had been exposed to
893 The Canadian Forces participated in the Gulf War from 1990-1991. Canada also contributed peacekeepers to UN missions to Bosnia and Croatia (1992), Rwanda (1993-1994), East Timor (1999-2001), and Sierra Leone (1999-2005). British Army troops were deployed to the Gulf War from 1990-1991, to the Balkans from 1992 onwards, and to Northern Ireland throughout this period. 894 Khalida Ismail and Glyn Lewis, ‘Multi-Symptom Illnesses, Unexplained Illness and Gulf War Syndrome,’ Philosophical Transactions: Biological Sciences 361, No. 1468, The Health of Gulf War Veterans (29 Apr. 2006): 543-544, 548-549.
221 environmental toxins while on deployment to the Balkans. A large number of veterans were exhibiting health problems similar to those experienced by their Gulf War counterparts. Sharpe’s mandate was soon expanded to look at how troops with medically unexplained symptoms were treated by the military and Veterans Affairs.895 The problems inherent in the Canadian system were further underlined in 2000 when high-ranking officer, Lieutenant General Roméo Dallaire attempted to commit suicide. His suicide attempt shocked the country and helped galvanize public opinion in favour of reform.896
Over the past decade, the treatment options open to Canadian veterans have improved measurably. Veterans Affairs Canada (VAC) has established a network of Operational Stress Injury (OSI) clinics across the country.897 Modelled on the Vietnam Veterans’
895 Brigadier General (retired) GE Sharpe, ‘The Sand Beneath Our Feet: The Changing Mandate in the Croatia Inquiry,’ Veteran’s Voice, last modified 2011, http://veteranvoice.info/ARCHIVE/info_11may_Paper_ShiftingSands_byBGen_Sharpe.pdf Veterans Health Administration, VHA/DoD Clinical Practice Guideline for the Management of Medical Unexplained Symptoms: Chronic Pain and Fatigue (Washington, DC: US Department of Defense, July 2001), 1. 896 Lieutenant General Roméo Dallaire was commander of the United Nations Assistance Mission to Rwanda from 1993-1994. After witnessing atrocities in Rwanda, Dallaire became increasingly depressed. Parliament of Canada, ‘Roméo Dallaire—Senate Biography,’ last modified 2013, http://www.parl.gc.ca/SenatorsMembers/Senate/SenatorsBiography/isenator_det.asp?senator_id=27 72&M=M&Language=E 897 There are currently nine OSI clinics across Canada. They are located in: -Fredericton, New Brunswick -Quebec City, Quebec -Ste-Anne-de-Bellevue, Quebec -Ottawa, Ontario -London, Ontario -Winnipeg, Manitoba -Calgary, Alberta -Edmonton, Alberta -Vancouver, British Columbia Veterans Affairs Canada, ‘Mental Health: Network of Operational Stress Injury Clinics,’ last modified 9 Nov. 2012, http://www.veterans.gc.ca/eng/mental-health/support/osi-clinics-support#clinics-list Canada, Parliament, House of Commons Standing Committee on Veterans Affairs, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 93, 3 June 2008 (Mr Adam Luckhurst),
222 Counselling Service, these clinics are, ‘staffed by multidisciplinary teams of psychiatrists, psychologists, mental health nurses, social workers, chaplains and addiction specialists.’898 According to a North Atlantic Treaty Organisation (NATO) report on operational stress injuries, the clinics, ‘are responsible for providing assessment and treatment of [veterans] who present with psychiatric symptoms related to military operations.’899 Additionally, veterans can access the services of over 900 private mental health professionals that have been approved by the VAC.900
The events of the last decade have also proved eventful across the Atlantic. In 2003, the High Court of England and Wales, ‘handed down judgement in what has come to be known as the Ministry of Defence (MoD) post-traumatic stress disorder case.’901 For the first time in years, significant public attention was focused on the long-term psychological health of British veterans. A group of over 2,000 ex-service personnel sued the MoD for http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=luckhurst&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False&arpi ce=True&arpicl=13177&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Languag e=E&Mode=1&Parl=41&Ses=1&arpicpd=3545201#Para1155707 Canada, Parliament, House of Commons Standing Committee on Veterans Affairs, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 46, 5 June 2007 (Mr Pierre Allard), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=pierre+allard&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False& arpice=True&arpicl=13177&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Lang uage=E&Mode=1&Parl=41&Ses=1&arpicpd=3006340#Para712089 898 Kathy Darte, Lieutenant Colonel Stéphane Grenier, Alexandra Heber and Donald Richardson, ‘Combining Clinical Treatment and Peer Support: A Unique Approach to Overcoming Stigma and Delivering Care,’ in Human Dimensions in Military Operations—Military Leaders’ Strategies for Addressing Stress and Psychological Support, ed. anonymous (Brussels, Belgium: North Atlantic Treaty Organisation, 2006), 2. 899 Ibid. 900 Canada, House of Commons Standing Committee on National Defence, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 18, 13 Mar. 2008 (Mr Raymond Lalonde), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=raymond+lalonde&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=Fa lse&arpice=True&arpicl=13195&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False& Language=E&Mode=1&Parl=41&Ses=1&arpicpd=3364791#Para993126 901 Tristan McGeorge, Jamie Hacker Hughes and Simon Wessely, ‘The MoD PTSD decision: a psychiatric perspective,’ Occupational Health Review 122 (July/Aug. 2006): 21.
223 compensation and claimed that the ministry had been, ‘negligent in failing to take measures to prevent, detect, or treat the development of psychiatric illness in general and PTSD in particular.’902 The claimants ultimately lost their case but succeeded in attracting the intense scrutiny of the media.
Presently, the National Health Service (NHS) is the primary care provider for veterans in the United Kingdom. They can be assessed for service-related psychological problems under the Veterans and Reserves Mental Health Programme (VRMHP). VRMHP is, ‘available to veterans who have deployed since 1982 and are experiencing mental health challenges as a result of military service.’903 Under the provisions of the programme, ‘a full mental health assessment [is conducted] by a Consultant Psychiatrist with accompanying guidance on care and treatment for the veteran’s local [NHS] clinical team.’ 904 While public awareness of veterans’ health has increased measurably, Britain continues to lag behind the other Commonwealth countries. The NHS is not designed to cater to a military clientele nor do the majority of NHS physicians have extensive experience or expertise in treating ex-servicemen. There are few options for those veterans who choose to seek treatment outside of the public system. The charity Combat Stress offers both inpatient and outpatient services. However, there are limits to the number of veterans that Combat Stress can accept for treatment.905 The British government has not invested in the development of veteran-specific services under the premise that, ‘there is little evidence that veterans
902 Ibid. 903 British Army, ‘Veterans and Reserves Mental Health Programme (Formerly the Medical Assessment Programme), last modified 2013, http://www.mod.uk/DefenceInternet/AboutDefence/WhatWeDo/HealthandSafety/GulfVeteransIllne sses/TheMedicalAssessmentProgramme.htm 904 Ibid. 905 Combat Stress, ‘About Us,’ Combat Stress, last modified 2012, http://www.combatstress.org.uk/about-us/
224 generally suffer different mental health disorders from the rest of the community nor that these require different treatments.’906
The younger generation of veterans have been the main beneficiaries of the improving pension and care system. Nonetheless, traditional veterans (e.g. WWII and Korea) have been impacted as well. Significant funds have been invested in designing specialised services for the elderly.907 Canada’s Gerontological Advisory Council (GAC) was founded in October 1997, to advise…on policies, programs, services and trends impacting Canada’s aging veteran population.’908 The GAC’s flagship project is the Veterans Independence Programme (VIP). First established in 1981, VIP is designed to keep older veterans self- sufficient by providing homecare services. Both Australia and New Zealand have made similar provisions.909 Funding is available for, ‘domestic assistance, personal care, safety related home and garden maintenance, respite care and social assistance.’910
906 Veterans UK, ‘Veterans Health—Community Veterans Mental Health Service,’ last modified 2007, http://www.veterans-uk.info/mental_health/faq.html 907 Canada, Parliament, House of Commons Standing Committee on Veterans Affairs, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 93, 3 June 2008 (Mr Adam Luckhurst), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=luckhurst&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False&arpi ce=True&arpicl=13177&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Languag e=E&Mode=1&Parl=41&Ses=1&arpicpd=3545201#Para1155707 Downs, ‘Australia,’ 16. 908 GAC programmes include, ‘caregiver initiatives, alternative housing, long-term and continuing care, health promotion and rehabilitation, departmental research,’ and ‘dementia research.’ Veterans Affairs Canada, ‘What is the Gerontological Advisory Council?’ last modified 20 Aug. 2012, http://www.veterans.gc.ca/eng/councils/gac. 909 Veterans Affairs New Zealand, ‘Case Management Information Sheet,’ last modified 6 Oct. 2012, http://www.veteransaffairs.mil.nz/info-sheets-forms/case-management.html Department of Veterans Affairs, Factsheet HCS01: Veterans Home Care (Canberra: Government of Australia, 2013). 910 Department of Veterans Affairs, Factsheet HCS01: Veterans Home Care (Canberra: Government of Australia, 2013).
225 In Australia and Canada, older veterans have also been actively encouraged to seek compensation and treatment for long-term psychiatric conditions like PTSD.911 Ste. Anne de Bellevue Hospital in Montreal continues to act as a hub for psychiatric research and care. Specialising in geriatrics and psychogeriatrics, it attracts experts from across North America and around the world.912 The Older Veterans Psychiatric Unit at Heidelberg Hospital, Melbourne serves the same purpose. According to the Korea Veterans Association of Australia, at Heidelberg:
Every effort is aimed at tender, loving care and home care, whenever possible. The younger doctors and nurses are better educated in their field, than in the past. Assistance is available—physiotherapy, gymnasium/swimming pool for physical activity, occupational therapy, hydrotherapy, as well as socialisation sessions during mental health treatments.913
In 2007, the government of Canada estimated that 2,000 traditional veterans die every month. Great strides have been made in improving the health of those who remain. Be that as it may, there are limits to what can be done for the surviving veterans of the Korean War. 914 The elderly are often unaware of how they can benefit from legislative developments and changes to the care system. While governments can easily engage younger veterans via the Internet, this is not the case with their older equivalents.
911 Ivan Patrick Ryan, Korea Veterans Association of Australia, email message to author, 24 May 2012. Les Peate, Korean Veterans Association of Canada, email message to author, 16 June 2012. 912 Canada, House of Commons Standing Committee on National Defence, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 18, 13 Mar. 2008 (Ms Rachel Corneille Gravel), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=ste+anne&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False&arpi ce=True&arpicl=13195&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Languag e=E&Mode=1&Parl=41&Ses=1&arpicid=3368755&arpicpd=3364791#Para992831 913 Ivan Patrick Ryan, Korea Veterans Association of Australia, email message to author, 24 May 2012. 914 Canada, Parliament, House of Commons Standing Committee on Veterans Affairs, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 46, 5 June 2007 (Mr Pierre Allard), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=pierre+allard&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False& arpice=True&arpicl=13177&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Lang uage=E&Mode=1&Parl=41&Ses=1&arpicpd=3006340#Para712089
226 Furthermore, magazine and newspaper advertisements can only reach a minority of subscribers and regular readers.915 Moreover, Korean War veterans are part of a generation for which mental illness remains a taboo subject. Despite the liberalisation of public attitudes, many prefer to address psychological health problems privately. In an interview with historian Tom Hickman, British veteran Smyttan Common noted that it was better to, ‘Keep the demons under lock and key.’916 If veterans choose to claim compensation, they often present with complex and chronic psychiatric conditions that have worsened over time.917 A Monash University study conducted in 2005 surveyed 81% of Australia’s remaining Korean War veterans.918 The authors concluded that they were, ‘five to six times more likely to meet the criteria for PTSD,’ than men of a similar age and, ‘one and half times more likely to meet the criteria for current hazardous alcohol consumption.’919 Comparable studies have not been carried out in any of the other Commonwealth countries.920 Nevertheless, the Australian example is telling.
915 Canada, House of Commons Standing Committee on Veterans Affairs, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 16, 6 Mar. 2008, http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=les+peate&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False&arpi ce=True&arpicl=13177&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Languag e=E&Mode=1&Parl=41&Ses=1&arpicpd=3339549#Para980500 916 Smyttan Common, quoted in, Tom Hickman, The Call-Up: A History of National Service (UK: Headline, 2004), 271. 917 Canada, House of Commons Standing Committee on National Defence, Minutes of Proceedings, 2nd session, 39th Parliament, Meeting No. 18, 13 Mar. 2008 (Mr Doug Clorey), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=doug+clorey&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False& arpice=True&arpicl=13195&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Lang uage=E&Mode=1&Parl=41&Ses=1&arpicpd=3364791#Para993202 918 The Department of Veterans Affairs (DVA) funded the Monash University study. Monash researchers were able to track remaining veterans through service and government records. Like all research, the Monash study has its limitations. For example, the authors had no contact with study participants. Instead, veterans were asked to fill in questionnaires and report their own symptoms. Malcolm Sims, Jillian Ikin and Dean McKenzie, Health Study 2005: Australian Veterans of the Korean War (Australia: Department of Epidemiology and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 2005), 11-12. 919 Ibid. 920 No comparable studies have been carried out on Commonwealth veterans or POWs. However, there is a small body of literature on American veterans. Like the Monash University report, these articles suggest heightened levels of PTSD and other mental health problems. However, the
227 Conclusions Throughout the twentieth century, mentally ill servicemen have faced significant challenges and Korean War veterans are no exception. While few men were evacuated from the Korean/Japanese theatre for psychiatric reasons, many more came home with lasting problems. As veterans, they had the right to seek compensation and medical treatment. However, the pension/care system was not designed for the mentally ill and was inherently antagonistic. Pension rates were calculated on the basis of physical disability and loss of earning capacity. Moreover, legislation was framed for the same purpose. Neither government nor pension committees could easily come to grips with war related trauma. In terms of medical care, little could be done at the time of the Korean War and the stigma of mental illness loomed large. Furthermore, ex-servicemen were denied many of the traditional forms of support upon which their predecessors had relied. Veterans’
majority of studies only involve a small number of men. Moreover, participants usually responded to advertisements in order to take part in the research. Consequently, they were not randomly chosen but were self-selected individuals. Examples include: GW Beebe, ‘Follow Up Studies of World War II and Korean War Prisoners, II: Morbidity, Disability and Maladjustments,’ American Journal of Epidemiology 101 (1975): 400-422. Dudley David Blake, Terence M Keane, Pamela R Wine, Catherine Mora, Kathryn L Taylor and Judith A Lyons, ‘Prevalence of PTSD Symptoms in Combat Veterans Seeking Medical Treatment,’ Journal of Traumatic Stress 3, No. 1 (1990): 15-27. Lawrence R Herz, Natasha B Lasko, Roger K Pitman and Scott P Orr, ‘Psychophysiological Assessment of Posttraumatic Stress Disorder Imagery in World War II and Korean Combat Veterans,’ Journal of Abnormal Psychology 102, No. 1 (1993): 152-159. Patricia B Sutker and Albert N Allain Junior, ‘Assessment of PTSD and Other Mental Disorders in World War II and Korean Conflict POW Survivors and Combat Veterans,’ Psychological Assessment 8, No. 1 (1996): 18-25. Brian Engdahl, Thomas N Dikel, Raina Eberly and Arthur Blank Jr., ‘Comorbidity and Course of Psychiatric Disorders in a Community Sample of Former Prisoners of War,’ American Journal of Psychiatry 155, No. 12 (Dec. 1998): 1740-1745. Edward M McCranie and Leon A Hyer, ‘Posttraumatic Stress Disorder Symptoms in Korean Conflict and World War II Combat Veterans Seeking Outpatient Treatment,’ Journal of Traumatic Stress 13, No. 3 (2000): 427-439. Cynthia Lindman Port, Brian Engdahl and Patricia Frazier, ‘A Longitudinal and Retrospective Study of PTSD Among Older Prisoners of War,’ American Journal of Psychiatry 158, No. 9 (Sept. 2001): 1474-1475.
228 organisations did not welcome the new generation with open arms. Korea was not a popular conflict but a distant war with vague aims. In short, it lived in the shadow of WWII.
The intervening decades have witnessed steady changes and improvements to the pensions/care system. From the late 1950s-1970s, psychiatry matured as a medical speciality and was revolutionised by the introduction of new psychopharmaceuticals and progressively tolerant attitudes. However, further experiences of war (e.g. Vietnam, Gulf War) have had the greatest impact on how mentally ill veterans are treated. The state’s, ‘duty of care,’ has become a subject of passionate public discussion and debate. As the military has become professionalised, a younger generation has come to expect more with regards pensions and medical treatment. Korean War veterans have largely missed out on these developments. Nonetheless, they have finally managed to achieve a degree of public recognition. Since 1996, Korean War memorials have appeared in Canada, Australia, the United Kingdom and New Zealand.921 Significant anniversaries have drawn the attention of the media and the public at large. On 8 January, the Canadian government proclaimed 2013 the year of the Korean War veteran. Senator Yonah Martin noted that, ‘In the years that followed, Korean War Veterans have diligently strived to respectfully commemorate the sacrifices of so many of their fellow [soldiers]. This year, our nations will pay special tribute to their sacrifices.’922
921 In the aftermath of the war, a United Nations Memorial Cemetery was established in Pusan. A number of other Commonwealth memorials were erected throughout Korea. While the war has long been recognised on national monuments across the Commonwealth, the first dedicated Korean War memorial was not built until 1996. Commemorative sites include: Location Dedication Date Korean War Memorial Wall Brampton, Ontario, Canada 1996 Korean War Memorial Canberra, Australia 1999 Veterans Memorial Garden Alrewas, Staffordshire, England 2000 Korean War Memorial Belfast, Northern Ireland 2010 922 Jennifer Morse, ‘Year Of The Korean War Veteran Announced,’ Legion Magazine, 12 Mar. 2013, http://legionmagazine.com/en/index.php/2013/03/year-of-the-korean-war-veteran-announced/ Veterans Affairs Canada, ‘Minister Blaney Announces 2013 as the Year of the Korean War Veteran,’ last modified 8 Jan 2013,
229
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230
Chapter 7 Soldiering On: The Post Korean War Development of the Royal Canadian Army Medical Corps and the Royal Army Medical Corps
231 Introduction The latter half of the twentieth century was an era of exceptional change for the Royal Canadian Army Medical Corps (RCAMC) and its British counterpart, the Royal Army Medical Corps (RAMC). They faced significant obstacles and were forced to adapt to circumstances. Staffing shortages, financial difficulties and the challenges of Cold War defence planning consistently plagued both organisations.923 How did the RCAMC and the RAMC evolve in the decades following the Korean War and what role did psychiatry play during this period? While both countries were presented with very similar problems, each responded differently to adversity. Throughout this chapter, I examine the nature of that response. After 1953, neither Canadian nor British medical officers (MOs) were deployed in large numbers for nearly thirty years. Korea represented the last major operation upon which medics could draw for practical knowledge and guidance.924 Did the war have any measurable impact on the development of either general medicine or psychiatry? In order to answer this question, I look at policy, everyday clinical care and the long-term formulation of defence medical research. Since the end of the Cold War, the Canadian and British forces have continued to modernise and undergo substantial reorganisation. The chapter concludes with a short discussion of the events of the past twenty years and the current state of military psychiatry on both sides of the Atlantic.
923 Bill Rawling, The Myriad Challenges of Peace: Canadian Forces Medical Practitioners Since the Second World War (Ottawa: Canadian Government Publishing, 2004), 325. 924 The first major deployment of British troops after the Korean War was the Falklands War in 1982. Roughly 28,000 British servicemen and women from across the Army, Navy and Air Force were deployed to the South Atlantic. The Gulf War of 1991 represented the first significant tour of operations for their Canadian counterparts. Over 4,000 Canadians were sent to the Gulf from 1990- 1991. Surgeon Commander AR Marsh, ‘A short but distant war--the Falklands Campaign,’ Journal of the Royal Society of Medicine 76, No. 11 (Nov. 1983): 972. Veterans Affairs Canada, ‘The Canadian Forces and the Persian Gulf War,’ last modified 22 June 2012, http://www.veterans.gc.ca/eng/history/canadianforces/factsheets/persiangulf.
232 Royal Canadian Army Medical Corps/Canadian Forces Medical Service (1953-1990s) The 1950s represented a ‘golden age’ for the Canadian defence community. 925 The country’s population was youthful; the economy buoyant and there was more than enough money to go around. Defence spending first started to rise during the Korean War and continued to do so in the years immediately following.926 The Canadian government invested heavily in the military, new equipment and numerous experimental projects so as to respond to the vague and ever-shifting threats of the Cold War.927 Despite this, the Royal Canadian Army Medical Corps struggled to recruit doctors, nurses and technical personnel. Since 1945, recruitment had been a perennial difficulty for the RCAMC. Low pay, lack of clinical variety and the inconveniences of service life all discouraged civilian doctors and medical students from considering the forces as a serious career option.928 To encourage the reluctant, the corps offered recruits short-term commissions and large emoluments of up to $6,000.929 However, these measures were far from convincing and the RCAMC was forced to employ civilians on a part time basis in order to meet requirements. By 1958, the Army’s medical manpower problems had become grave. In a memo to the Joint Services Medical
925 Rawling, The Myriad Challenges of Peace, 85. Desmond Morton, A Military History of Canada: From Champlain to the Gulf War (Toronto: McClelland & Stewart, 1992), 236. 926 Morton, A Military History of Canada, 236, 245. 927 For instance, the Canadian government invested hundreds of millions in the development of supersonic aircraft like the CF-105 Avro Arrow. Julius Lukasiewicz, ‘Canada’s Encounter with High-Speed Aeronautics,’ Technology and Culture 27, No. 2 (Apr. 1986), 223-226. 928 Inter-Service Medical Committee, Minutes of Meeting, 4 Sept. 1946, Library and Archives of Canada/ Bibliothèque et Archives Canada (Hereafter cited as LAC): RG 24, Acc 1983-1984/167 GAD, Box 7717, 20-1-1, pt. 1. Defence Medical and Dental Services Advisory Board, Minutes of the Second Meeting, 12 October 1950, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7717, 20-1-1, pt. 2. Director General of Army Medical Services WL Coke, Establishments Royal Canadian Army Medical Corps, LAC: RG 24, Acc 1983-1984/167 GAD, Volume 19, 181, File 2140-1/8. Adjutant General WHS Macklin to Minister of National Defence Right Honourable Brooke Claxton, Recruitment of Medical Officers—Army, 27 June 1951, LAC: RG 24, Acc 1983- 1984/216, Box 2491, File 801-M90, Volume II. Lois Clarkin to Paul Martin, Minute, 28 Feb. 1955, LAC: RG 24, Acc 1983-1984/167, Box 7718, 20-1-1, pt. 7. 929 Anon, 29th Meeting of the Canadian Forces Medical Council, 3 Mar. 1965, LAC: RG 24, Acc 1983-1984/167, Box 7789, 2-6030-110/M1-1, pt. 7.
233 Board, Brigadier KA Hunter noted that the state of affairs was, ‘alarmingly critical,’ and that if they wished to avoid disaster, ‘action must be taken at once to improve the situation.’930 Soon thereafter, the decision was made to amalgamate the medical services of the Army, Navy and Air Force into a single unified body.
The new Canadian Forces Medical Service (CFMS) officially came into being on 15 January 1959. Headed by a Surgeon General, the CFMS was optimistically touted as a model of modernisation and a shining example of tri-service cooperation.931 Drawing upon the strengths of its constituent parts, the CFMS would be capable of responding to the increasingly dynamic needs of the Canadian military at home and overseas.932 During the 1960s, the military planned to slowly phase out redundant posts and establish a centralised chain of command.933 In the meantime, the old RCAMC School and Training Depot at Camp Borden was closed and replaced by the Canadian Forces Medical Service Training Centre (CFMSTC).934 In addition, a new National Defence Medical Centre (NDMC) was opened to great acclaim in Ottawa. From its infancy, the NDMC provided, ‘surgical and medical diagnostic services, out-patient treatment and casual and definitive care to Service personnel,’ and, ‘acted as a centre for the clinical investigation of special categories of
930 Brigadier Ken A Hunter to Chair of the Joint Services Medical Board and Chair of Personnel Members Committee, 20 Aug. 1958, LAC: RG 24, Acc 1983-1984/167, Box 7718, 20-1-1, pt. 12. 931 Anon, Minister’s Tri-Service Information Book, 1960, LAC: RG 24, Acc 1983-1984/167, Box 7719, 20-1-1, pt 18. Personnel Members Committee, Minutes of the 53rd Meeting, 25 Sept. 1945, LAC: RG 24, v.7755. Adjutant General Major General EG Weeks to Secretary of the Personnel Members Committee, 15 Feb. 1946, LAC: RG 24, Acc 1983-1984/167, Box 7717, 20-1-1, pt. 1. 932 Anon, Minister’s Tri-Service Information Book, 1960, LAC: RG 24, Acc 1983-1984/167, Box 7719, 20-1-1, pt 18. 933 Surgeon Rear Admiral TB McLean, Surgeon General to Chair of Personnel Members Committee, 22 June 1962, LAC: RG 24, Acc 1983-1984/167, Box 7719, 20-1-1, pt. 22. 934 Lieutenant Colonel WA Todd, Secretary to the Vice Chiefs of Staff Committee to the Secretary of the Personnel Members Committee, 28 June 1959, LAC: RG 24, Acc 1983-1984/167, Box 7719, 20-1-1, pt. 15. Surgeon General, Supporting Data for Personnel Members Committee, 29 June 1959, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7719, 20-1-1, pt. 15. Air Vice Marshall JG Kerr, Chair of the Personnel Members Committee to Minister, 26 Oct. 1959, RG 24, Acc 1983-1984/167 GAD, Box 7719, 20-1-1, pt. 16.
234 patients.’935 Over time, the hospital would become the largest military medical centre in the country and an important teaching hospital.936 Newly minted CFMS officers were positive about the future.
However, their confidence had been misplaced. Despite the benefits of amalgamation, the CFMS was as bedevilled by manpower problems as its predecessor. As had been the case in the 1940s and 1950s, civilian doctors had little interest in the military. The Canadian economy was growing and there were lucrative job possibilities elsewhere.937 Statistics from the Tri-Service Information Book indicate that the CFMS already had a 16% deficit of medical officers, 20% deficit of non-medical officers, and was 5% below strength in terms of other ranks in 1960.938 After only a year, the CFMS had fallen short of expectations. The new organisation was also failing to keep up with the pace of medical development. During the era in question, medicine was becoming an increasingly specialised profession both in Canada and internationally.939 By 1961, nearly 34% of Canadian doctors were specialists as compared with only 14% of Canadian Forces medical officers.940 Military medicine did not reflect civilian nor was it of the same standard. Many service hospitals had fallen into disrepair and were not well equipped to receive patients. Members of the Canadian Forces Medical Council lamented in December 1960 that, ‘The hospitals at Valcartier and Petawawa are in a particularly deplorable condition, being housed in wartime temporary
935 Colonel CA VanVliet, Commandant to Distribution, 31 Aug. 1970, LAC: 1998-00220-2, Box 1, 1901-0. 936 Ibid. 937 Robert Bothwell et al, Canada Since 1945: Power, Politics and Provincialism (Toronto: University of Toronto Press, 1981). 938 Anon, Minister’s Tri-Service Information Book, 1960, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7719, 20-1-1, pt 18. 939 General Charles Foulkes, 7 Aug. 1956, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7719, 20- 1-1. Rawling, The Myriad Challenges of Peace, 136. 940 Canadian Forces Medical Council, Minutes of 23rd Meeting, 11 May 1962, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7789, 2-6030-110/M1-1.
235 huts in a poor state of repair.’941 Money had been directed towards the construction of barracks rather than the renovation of old hospitals and the financing of new facilities in Churchill and Gagetown.942 These problems were further compounded in 1962 when the Canadian dollar took a serious fall and dropped by over five cents in comparison to its American equivalent.943 While the Canadian government continued to invest in the armed forces, defence expenditures had started to decline by the early 1960s. Between 1955 and 1965, military spending dropped from 6% to 3% of Canadian gross domestic product (GDP).944
Appointed in September 1960, the Royal Commission on Government Organisation, also known as the Glassco Commission, was created to, ‘inquire into and report upon the organisation and methods of the departments and agencies of the Government of Canada and to recommend…changes [which] would best promote efficiency, economy, and improved service.’945 The five-volume report was first released to the public in July 1962.946 Amongst a long list of recommendations, commission members encouraged the government to make extensive funding cuts to the armed forces. They criticised the CFMS for its failure to economise and suggested that the majority of Canadian service hospitals close. With the advent of the public health system, there was no reason why soldiers could not receive treatment from civilian doctors while stationed on home soil.947 Surgeon General Rear Admiral TB McLean vehemently disagreed with the Glassco Commission’s
941 Canadian Forces Medical Council, Minutes of 21st Meeting, 12 Dec. 1960, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7789, 2-6030-110/M1-1, pt. 7. 942 Ibid. 943 Bothwell et al, Canada Since 1945, 228. 944 Bill Robinson and Peter Ibbot, Canadian Military Spending: How does the current level compare with historical levels?...to allied spending?...to potential threats? (Canada: Project Ploughshares, Mar. 2003), 9. 945 Canada, Report of the Royal Commission on Government Organisation, Volume I (Ottawa, 1962), 8. 946 Ibid. 947 Surgeon Rear Admiral TB McLean, Surgeon General, Supporting Data for the Personnel Members Committee, 16 Sept. 1963, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7720, 20-1-1, pt. 27.
236 advice. On 16 September 1963, McLean expressed his dismay in a long letter to the Personnel Members Committee (PMC) on the subject of service hospitals. He believed firmly in the value of such institutions and thought that if they were closed the CFMS would be see a, ‘rapid regression to clinical impotence.’948 As centres of education, they played a vital role in equipping medical officers properly for their duties.949 While most service hospitals remained open in the 1960s, the Glassco Commission left a lasting impression on the CFMS. Every year, medical officers could expect further belt tightening.950
The Canadian Forces Medical Service spent the next two decades fighting for survival.951 Budget reductions made in the 1970s and 1980s were the legacy of the Glassco Commission and several other government committees. Vital resources were scarce and difficult to acquire.952 Although recruitment remained problematic, the situation finally began to stabilise. In 1973, the CFMS only had a 6% deficit of medical officers and 2% deficit of nurses. 953 Significant shortfalls were confined to a number of technical
948 Ibid. 949 Ibid. 950 Defence Medical Association, Proceedings of Annual Meeting, 15-16 Nov. 1973, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2. Defence Medical Association, Proceedings of Annual Meeting, 7-8 Nov. 1974, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2. Chairman Canadian Forces Medical Council, Report to Defence Medical Association, 7-8 Nov. 1974, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2. 951 Rawling, 2004, pp. 250-251. 952 Defence Medical Association, Proceedings of Annual Meeting, 15-16 Nov. 1973, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2. Defence Medical Association, Proceedings of Annual Meeting, 7-8 Nov. 1974, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2. Chairman Canadian Forces Medical Council, Report to Defence Medical Association, 7-8 Nov. 1974, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2. Defence Medical Association, Proceedings of Annual Meeting, 19 Sept. 1975, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2. 953 Defence Medical Association, Proceedings of Annual Meeting, 15-16 Nov. 1973, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2.
237 professions and trades like pharmacy, which was 21% below strength at the time.954 The CFMS was largely able to address these issues by training medical assistants in a wider variety of tasks and to a higher level of competency.955 Furthermore, they began to recruit female physicians on a regular basis and employ them in posts from which they had previously been barred.956
The end of the Cold War signalled the beginning of a new phase in the evolution of the Canadian Forces Medical Service. For over forty years, CFMS had equipped itself for one purpose and was now presented with a dramatic change in circumstance. Planning had been based on the premise that hostilities would most likely erupt in Europe and Canada would be asked to contribute as a member of the North Atlantic Treaty Organisation (NATO).957 Throughout the 1990s, the CFMS would have to respond to new and varied threats. As historian Dr Bill Rawling has noted, ‘…the challenge for the medical service was even greater after the fall of the Soviet Union, for with the Warsaw Pact no longer the single clear raison-d’être for the Canadian Forces, medical practitioners and supporting staff
954 Ibid. 955 Surgeon General’s Advisory Committee on Medical Assistant Training, Minutes of Meeting, 26- 27 Apr. 1977, LAC: RG 24, v.23, 763, 1150-110/S77. Directorate of History and Heritage, Canadian Forces Medical Service Annual Historical Report, 23 February 1981, Directorate of History and Heritage, Department of National Defence/Histoire et patrimoine, Ministère de la défense nationale, Canada (Hereafter cited as DHH DND): 1326-2676, pt. 4. 956 Although female doctors served in the military throughout the Cold War, they were long considered inappropriate for many senior appointments and transfers outside of Canada. As late as 1965, the Canadian Forces limited the number of women allowed in the military. Females were only allowed to constitute 1.5% of the total force. The position of servicewomen improved in 1970, when the Royal Commission on the Status of Women recommended significant changes in policy. For the first time, women were admitted to military colleges and enlisted on the same basis as men. The marriage bar was also eliminated. Department of National Defence, ‘Women in the Canadian Forces (CF),’ last modified 16 Oct. 2012, http://www.forces.gc.ca/site/mobil/news-nouvelles-eng.asp?id=3675 Defence Medical Association, Proceedings of Annual Meeting, 15-16 Nov. 1973, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2. Defence Medical Association, Proceedings of Annual Meeting, 7-8 Nov. 1974, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt. 2. 957 Rawling, The Myriad Challenges of Peace, 275.
238 needed to prepare for a wide range of missions.’958 By the end of the decade, both the National Defence Medical Centre and the majority of service hospitals had been shut. Moreover, budgetary restrictions continued to be a concern.959 In spite of these difficulties, the CFMS largely responded well to change. The medical services underwent major reorganisation as a result of the increase in operational tempo. While the CFMS had been incapable of sending a field hospital abroad during the Cold War, it was now possible to deploy medical units at a moment’s notice.960 At the turn of the millennia, the CFMS was a smaller and more flexible organisation that reflected the values of the greater Canadian defence community.
The Canadian Armed Forces and Psychiatry From the 1950s to the 1990s, psychiatry and psychology slowly grew to play a bigger part in the RCAMC and its subsequent incarnation as the CFMS. As disciplines, both psychiatry and psychology were undergoing revolutionary changes. The advent of effective psychopharmaceuticals and a growing trend toward outpatient and open-ward care helped to bring mental health issues into mainstream medicine.961 So as to keep pace with this
958 Ibid. 959 Ibid., 259. 960 Ibid., 367. Colonel (Retired) Peter Green, Colonel (Retired) Frank Kellerman, Lieutenant Colonel (Retired) Christiane Charron and Chief Warrant Officer Michael McBride, Canadian Forces Medical Service: Introduction to its History & Heritage (Ottawa: Director General Health Services, Department of National Defence, Government of Canada, 2003), 12. 961 Sylvia Wrobel, ‘Science, Serotonin, and Sadness: The Biology of Antidepressants,’ Journal of the Federation of American Societies for Experimental Biology 21, No. 13 (Nov. 2007): 3404-3417. Thomas A Ban, ‘Fifty Years Chlorpromazine: A Historical Perspective,’ Neuropsychiatric Diseases and Treatment 3, No. 4 (Aug. 2007): 495-500. Edward Shorter, A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Canada: John Wiley & Sons Inc, 1997): 33-68. Canadian Mental Health Association, ‘History of the Canadian Mental Health Association,’ last modified 2013, http://www.ontario.cmha.ca/inside_cmha.asp?cID=7620 Joanna Moncrieff, ‘An Investigation into the precedents of modern drug treatment in psychiatry,’ History of Psychiatry 10 (1999): 475-490. Andrew Scull, ‘Psychiatrists and historical ‘facts’ Part One: The historiography of somatic treatments,’ History of Psychiatry 6 (1995): 235-236.
239 increasing level of sophistication, CFMS officers appreciated the need to expand available services and better the postgraduate training of service physicians.962 Noticeable steps forward had been made by the mid-1960s. On 26 July 1966, CFMS consultant and Korean War veteran Major FCR Chalke wrote to Surgeon General Rear Admiral Elliot. In his letter, he describes some of these advances and mentions a growing number of, ‘well trained psychiatrists,’ who were establishing, ‘psychiatric services in military hospitals,’ nationwide.963 Not long thereafter, the growth of psychiatry was mentioned positively at a meeting of service medical advisors. Amongst those in attendance were former Surgeon General KA Hunter and the head of psychiatry at the National Defence Medical Centre, Wing Commander J Rassel.964
While progress was made, psychiatrists and psychologists were confronted with a number of setbacks. Like their colleagues throughout the CFMS, they had to contend with economic misfortune. As early as 1959, the Inter Service Committee on Joint Training (ISCJT) presented a proposal for the expansion of postgraduate education in clinical psychology. The Personnel Members Committee readily supported the project.965 Be that as it may, the Treasury Board and Civil Service Commission chose to reject the proposal for reasons of expense. Funding for the ISCJT’s plan was refused on several other occasions for the same reason.966 A few years later, the trouble surrounding clinical psychology had
Robert Golden, Jeffrey A Lieberman, Joseph McEvoy and Scott Stroup, ‘Drugs of the Psychopharmacological Revolution in Clinical Psychiatry,’ Psychiatric Services 51, No. 10 (1 Oct. 2000): 1254-1258. 962 Canadian Forces Medical Council, Minutes of 24th Meeting, 11 May 1962, LAC: RG 24, Acc 1983-1984/167, Box 7789, 2-6030-110/M1-1, pt. 7. 963 Major FCR Chalke, Consultant in Psychiatry, Canadian Forces Medical Services to Rear Admiral W Elliot, 20 July 1966, LAC: RG24, Acc 1983-1984/167 GAD, 2-6500-P51. 964 Anon, Minutes of a Meeting to Discuss the Employment of Clinical Psychologists in Canadian Forces Medical Service Units, 5 Aug. 1966, LAC: RG 24, 1983-1984/167 GAD, 2-6500-P51. 965 Personnel Members Committee—Sub Committee on Personnel Selection and Classification to JA Sharpe, 29 June 1962, LAC: RG24, 1983-1984/167 GAD, Box 7034, 2-490-50. Inter-Service Committee on Joint Training, Minutes of the 111th Meeting, 21 Aug. 1961, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7034, 2-490-50. 966 Ibid.
240 failed to dissipate. Although Major Chalke’s 1966 letter to Rear Admiral Elliot had been positive with regards psychiatry, he had expressed concern about the, ‘lack of clinical psychology service,’ in military hospitals.967 The CFMS had filled the empty posts with Personnel Selection Officers (PSOs) and civilian psychologists.968 Chalke feared that this solution would soon fail to be a viable option. He recognised that, ‘the applied fields of psychology [were] becoming more divergent and specialised both in practice and training and it [would] be harder…to switch personnel from education, selection, or experimental psychology into clinical work without further training, even if those in the first three categories were in abundance in the Service.’969 Shortly after this letter was written, financing was finally approved for the expansion of training in clinical psychology. The NDMC Department of Psychiatry was given permission to introduce a new postgraduate course in tandem with a selection of neighbouring universities. Within a few years, the NDMC was well equipped to meet the growing needs of the medical corps.970
Changing attitudes towards the mentally ill was perhaps the greatest challenge for CFMS psychiatrists during the Cold War. In the masculine environment of the military, it was a daunting task to foster a more gentle and liberal approach towards those suffering from psychiatric disorders. Institutional change was slow to come and the military generally lagged behind the civilian world. As a hierarchical organisation, the Canadian Forces were always concerned with maintaining discipline. When decisions and changes in policy were made, the needs of the individual often lost out to those of the group. For example, the
Ibid. 967 Major FCR Chalke, Consultant in Psychiatry, Canadian Forces Medical Services to Rear Admiral W Elliot, 20 July 1966, LAC: RG24, Acc 1983-1984/167, 2-6500-P51. 968 Anon, Minutes of a Meeting to Discuss the Employment of Clinical Psychologists in Canadian Forces Medical Service Units, 5 Aug. 1966, LAC: RG 24, Acc 1983-1984/167 GAD, 2-6500-P51. 969 Major FCR Chalke, Consultant in Psychiatry, Canadian Forces Medical Services to Rear Admiral W. Elliot, 20 July 1966, LAC: RG24, Acc 1983-1984/167 GAD, 2-6500-P51. 970 Anon, Minutes of a Meeting to Discuss the Employment of Clinical Psychologists in Canadian Forces Medical Service Units, 5 Aug. 1966, LAC: RG 24, Acc 1983-1984/167 GAD, 2-6500-P51. Rawling, The Myriad Challenges of Peace, 136.
241 CFMS long failed to acknowledge alcoholism as a medical or psychiatric issue and only recognised it as such in 1973.971 The World Health Organisation’s Expert Committee on Mental Health first acknowledged that alcoholism was a health problem in 1951.972 The American Medical Association and American Psychiatric Association followed suit in 1956 and 1965 respectively.973 Meanwhile, the Canadian military chose to deal with addicts administratively. Members of the Defence Medical Association later conceded that this, ‘meant that an alcoholic serviceman with many years service could be released [for] misconduct or as unsuitable for further service with a very reduced pension entitlement.’974 Public attitudes towards substance abuse and the treatment of addiction had softened sufficiently by the early 1970s that the Department of National Defence (DND) was finally forced to abandon its position. After this decision was made, treatment centres were slowly opened and a more sympathetic approach taken in dealing with addicted servicemen.975
The Korean War does not appear to have had any tangible short or long term effects on clinical care as practised in the CFMS. In April 1954, American medical officers held an exhaustive conference on the lessons of Korea at the US Army Medical Service Graduate School. They examined all aspects of the medical care delivered in an attempt to determine what they had done well and how they could improve in the future.976 Canadian officials
971 Defence Medical Association, Proceedings of Annual Meeting, 15-16 Nov. 1973, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt 2. 972 World Health Organisation Expert Committee on Mental Health, Alcoholism Subcommittee, World Health Organisation Technical Report, No. 48 (Geneva, Switzerland, 1952). 973 American Medical Association, ‘Our History: 1940-1960,’ last modified 2013, http://www.ama-assn.org/ama/pub/about-ama/our-history/illustrated-highlights/1940-1960.page. H Thomas Milhorn, Drug and Alcohol Abuse: The Authoritative Guide for Parents, Teachers and Counselors (USA: Da Capo Press, 1994), 249. 974 Defence Medical Association, Proceedings of Annual Meeting, 15-16 Nov. 1973, LAC: RG 24, v.21, 832, FMC 1050-100/M1, pt 2. 975 Rawling, 2004, pp. 266-268. 976 The American conference, held in April 1954, was titled, ‘Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950-1953.’ Papers delivered on psychiatry included: Lieutenant Colonel Douglas Lindsey: ‘Evacuation and Speciality Centres’
242 were well aware of the event but felt no need to hold a comparable meeting north of the border. To the CFMS, Korea did not reveal anything startling or new about the management of traumatised soldiers. On the contrary, the war had served to underline the validity of conclusions made during WWI and WWII. As they had previously deduced, therapy was most effective when delivered promptly and as closely to the front lines as possible. Wartime psychiatric treatment should be practical, reassuring and focus on the relief of symptoms rather than the underlying condition.977 For the remainder of the Cold War, CFMS clinicians had little chance to further refine their skills in field care. Unlike the Americans, Canadian troops were not deployed in large numbers again until the 1990s. As a result, several generations of CFMS MOs had little experience of war upon which to draw in their daily work.
While the Korean War had little impact on the daily lives of clinicians, it had a significant impact on the direction of defence medical research. First established in the spring of 1947, the Defence Research Board (DRB) was designed to provide the best science to inform the military. Research staff came from a wide variety of backgrounds and scientific specialities.978 During the Korean War, a panel of psychiatry was added to the DRB’s
Hyam Bolocan: ‘Functions of a Psychiatric Consultant to a Division and to an Army’ Colonel Albert J Glass: ‘Drug Addiction and Alcoholism-Psychiatric Considerations’ ‘History and Organization of a Theatre Psychiatric Service Before and After 30 June 1951’ Anon, Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950-1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954). 977 Anon, Psychiatric Classifications and Criteria, 1958-1967, LAC: RG24, 1983-1984/167 GAD, Box 7985, File No. C-2-6720-1. Captain HCJ L’Etang, ‘A Criticism of Military Psychiatry in the Second World War: Part III Historical Survey,’ Journal of the Royal Army Medical Corps 97, No. 5 (Nov. 1951): 326. Major Richard A Newman, ‘Combat Fatigue: A Review to the Korean Conflict,’ Military Medicine (Oct. 1964): 926. 978 Surgeon General Rear Admiral TB McLean to Chair of Defence Research Board, 11 Sept. 1961, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7719, 20-1-1, pt. 21. Vice Chair Vice Chiefs of Staff Committee JE Keyton, 22 Nov. 1961, LAC: RG 24, Acc 1983- 1984/167, Box 7719, 20-1-1, pt. 22.
243 Medical Advisory Committee to look into topics such as selection, motivation, psychiatric rehabilitation and battle exhaustion.979 The board’s experimental psychology programme garnered considerable attention and funding in the following years. 980 Subjects like acclimatization to cold weather, troop selection and brainwashing were of particular interest to the Department of National Defence. The inspiration for these projects can easily be traced back to the Korean War.
Korean winters were notorious: troops had to contend with temperatures below freezing, exceedingly damp living conditions and fierce winds. The Commonwealth Division’s one- year troop rotation policy was born of necessity. No man would be subjected to Korea’s brutal winter weather for more than a season.981 At all times, officers and men alike had to be vigilant in their efforts to combat the cold. Strict policies were enforced that dictated
Rawling, The Myriad Challenges of Peace, 198-200. 979 Anon, Psychiatric Research under the aegis of the Panel of Psychiatry of the Medical Advisory Committee to Defence Research Board, LAC: RG 24, Acc 1983-1984/216, Box 2492, HQ 801- M91. Dalbir Bindra, Chair of the Associate Committee on Experimental Psychology to Members, 30 Jan. 1963, LAC: RG 24, Acc 1983-1984/167, Box 7355, 170-80/A70. Dalbir Bindra, Chair of the Associate Committee on Experimental Psychology to Members, 19 Feb. 1965, LAC: RG 24, Acc 1983-1984/167, Box 7355, 170-80/A70. 980 Ibid. Ibid. Ibid. 981 Major JM Adam, Royal Army Medical Corps and Senior Medical Research Officer, WSS Ladell, Department of the Scientific Advisor to the Army Council: Report of Field Studies on Troops of the Commonwealth Division in Korea, Winter 1951-1952, 28 June 1954, The National Archives at Kew (Hereafter cited as TNA): WO 348/117. Anon, Welfare in the Canadian Army, 13 Nov. 1952, LAC: RG 24, Acc 1983-1984/167, Box 4903, File 3125-33/29, Volume 3. Brian Catchpole, ‘The Commonwealth in Korea,’ History Today 48, No. 11 (Nov. 1998), http://www.historytoday.com/brian-catchpole/commonwealth-korea. Max Hastings, The Korean War, Pan Grand Strategy Series (UK: Pan Macmillan Books, 2000), 369. Albert E Cowdrey, The Medics’ War (Washington, DC: Centre of Military History, 1987), 146. Brigadier Cyril Nelson Barclay, The First Commonwealth Division: The Story of British Commonwealth Land Forces in Korea, 1950-1953 (Aldershot, UK: Gale & Polden Limited, 1954), 3.
244 soldiers change their socks and clean their feet frequently in order to avoid developing frostbite, trench foot and other similar conditions.982 Commanding officers were even expected to inspect their men’s feet on a daily basis to ensure that there were no unnecessary casualties.983 Major Bretland of the Royal Army Medical Corps described the daily routine of Commonwealth troops in a 1954 article entitled, ‘The Principles of Prevention of Cold Injuries: Notes on the Problems as Encountered, and the Methods used, in Korea.’ He stated that: Each man, once a day, preferably in the late afternoon or evening is brought into a warm place and removes his boots and socks. The inspecting officer asks him if he has any foot trouble, checks his boots, socks and insoles and examines his feet. Any deterioration in the condition of the feet is noticed and the man referred to the MO. The man then washes his feet in warm water, dries them carefully, powders them and put on a clean dry pair…of socks. Insoles are also changed.984
Although complaints like frostbite never constituted a major problem, medical officers recognised that men were sloppier about guarding against cold injury if morale was low.985 Research into the physical and psychological effects of cold was of especial interest to the Canadian Forces, as its soldiers were so often stationed in the Arctic and equally hostile environments.986 While studies had been conducted on the effects of cold before the Korean War, experiences in the Far East helped to encourage the further development of the field. Projects in the 1950s and 1960s looked at, ‘the selection of personnel to serve in the Arctic, psychological aspects of acclimatization to conditions in the north,’ and ‘the effect of
982 Major PM Bretland, ‘The Principles of Prevention of Cold Injuries: Notes on the Problem as Encountered, and the Methods used, in Korea,’ Journal of the Royal Army Medical Corps 100, No. 2 (Apr. 1954), 96. 983 Ibid. 984 Ibid. 985 Kenneth D Orr, ‘Developments in Prevention and Treatment of Cold Injury,’ in Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950- 1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954). Edgar Jones, ‘Army Psychiatry in the Korean War: The Experience of 1 Commonwealth Division,’ Military Medicine 165, No. 4 (2000), 259. JB Sampson, ‘Anxiety as a factor in the incidence of combat cold injury,’ Military Medicine 149, No. 2 (1984), 89-91. 986 Rawling, The Myriad Challenges of Peace, 211.
245 rigorous winter conditions on soldier performance.’ 987 The DRB received 45 grant applications for experiments in 1963 alone and nearly 100 such petitions were made to the National Research Council two years later in 1965.988 Conditions in Korea had contributed to the growth of a burgeoning field.
Troop selection was another important area of research for both the DRB and the CFMS. During WWII, the Canadians had been obsessed with the potential of wide-scale recruit screening.989 They had attempted to screen troops for both ‘military suitability,’ and psychological vulnerability.990 They were relatively successful in using psychological and intelligence testing to select recruits for particular trades and occupations. However, they largely failed to predict how men would react to combat.991 Throughout the late 1940s and early 1950s, several American studies were published that examined why screening programmes of this kind were unsuccessful. In, ‘A Study of Neuropsychiatric Rejectees,’ JR Egan, L Jackson and RH Eanes, ‘followed up 2,054 men rejected by the Selective Service System on psychiatric grounds, but later inducted into the army.’ 992 They concluded that around, ‘1,922,950 men had been unnecessarily rejected for military
987 Ibid. 988 Dalbir Bindra, Chair of the Associate Committee on Experimental Psychology to Members, 30 Jan. 1963, LAC: RG 24, Acc 1983-1984/167, Box 7355, 170-80/A70. Dalbir Bindra, Chair of the Associate Committee on Experimental Psychology to Members, 19 Feb. 1965, LAC: RG 24, Acc 1983-1984/167, Box 7355, 170-80/A70. 989 Terry Copp and Bill McAndrew, Battle Exhaustion: Soldiers and Psychiatrists in the Canadian Army, 1939-1945 (Montreal, QC and Kingston, ON: McGill Queens University Press, 1990), 25-28, 35-36, 157. Terry Copp and Mark Osborne Humphries, Combat Stress in the 20th Century: The Commonwealth Experience (Kingston, ON: Canadian Defence Academy Press, 2009), 125-155. 990 Edgar Jones, Kenneth Craig Hyams and Simon Wessely, ‘Review: Screening for vulnerability to psychological disorders in the military: an historical survey,’ Journal of Medical Screening 10, No. 1 (2003), 40. 991 Copp and Humphries, Combat Stress, 125-155. 992 Jones, Hyams and Wessely, ‘Screening for vulnerability,’ 42. JR Egan, L Jackson and RH Eanes, ‘A Study of Neuropsychiatric Rejectees,’ Journal of the American Medical Association 145 (1951): 420.
246 service…during World War II.’ 993 The Department of National Defence’s senior psychiatric advisors also expressed serious reservations about the value of screening programmes.994 While Major FCR Chalke was a personnel selection expert, he doubted that the Army could consistently predict the potential for psychiatric breakdown. After attending a conference on stress at the US Army Medical Service Graduate School in March 1953, he reported that, ‘Prediction of ability to stand stress at recruit level is still being viewed most critically by discerning psychiatrists and psychologists in the United States, and at present time no authority there is prepared to place much hope on this approach to increasing manning efficiency of the Army.’995 When solicited for their opinions, former Army psychiatrists like Dr FH Van Nostrand and Dr Jack Griffin gave voice to similar doubts.996
Despite negative feedback, the DND continued to be fascinated by intelligence tests and other blanket screening methods. During the early phases of the Korean War, 20% of Canadian troops had been repatriated for, ‘disciplinary, attitudinal and psychiatric problems.’997 Although rates had declined quickly, officials within the DND were keen to prevent problems in future. Numerous systems were trialled during the 1950s and the early
993 Ibid. Ibid. 994 Other notable studies on screening include: Norman Q Brill and Gilbert W Beebe, ‘Psychoneuroses: Military Applications of a Follow-up Study,’ United States Armed Forces Medical Journal 3 (1952): 15-33. A Ellis and HS Conrad, ‘The Validity of Personality Inventories in Military Practice,’ Psychological Bulletin 45, No. 5 (Sept. 1948): 385-426. 995 Major FCR Chalke to Army Medical Department 8, Report Liaison Visit to Conference on Stress, Army Medical Service Graduate School, 16-18 Mar. 1953, LAC: RG 24-B-2, Acc 1983- 1984/167 GAD, Box 7954, File No. C-2-6597-P5. 996 Colonel JE Andrew to Army Medical Department 8, Report of Liaison Visit, 9 July 1953, LAC: RG 24-B-2, Acc 1983-1984/167 GAD, Box 7954, File No. C-2-6597-P5. 997 Copp and McAndrew, Battle Exhaustion, 158. Colonel JE Andrew and Brigadier Ken A Hunter, ‘The Royal Canadian Army Medical Corps in the Korean War,’ Canadian Services Medical Journal (July/Aug. 1954), 5-15. Anon, Adjutant General’s War Diary, LAC: RG 24, Volume 18, 221. Anon, Account of Recruitment Process--No. 6 Personnel Depot, Toronto, DHH DND: 112.3H1.001 (D9).
247 1960s. For example, 4,000 recruits were tested in the spring of 1953 using the Minnesota Multiphasic Personality Inventory (MMPI). 998 Designed to assess individual psychopathology and personality, the MMPI was first developed in 1940 by psychologist Dr Starke R Hathaway and psychiatrist Dr JC McKinley at the University of Minnesota.999 Roughly 10% or 400 of the recruits in question were rejected on the basis of their MMPI scores.1000 Lieutenant Colonel WRN Blair of the Personnel Selection Service calculated that had they been allowed to enlist, these men would have cost the military an estimated $2,000,000. 1001 Blair was hesitant about the accuracy of the MMPI but ultimately recommended its adoption in conjunction with other tests.1002
In addition to investigating new screening methods, the Canadian Army attempted to further refine its existing manpower classification schemes. The Canadian Army had introduced the PULHEMS system during World War II. Measuring physical and mental functioning, PULHEMS had worked well for the Army.1003 Be that as it may, the DND was
998 Lieutenant Colonel WRN Blair, Enrolment Processing: Effect of Minnesota Multiphasic Personality Inventory, 13 July 1953, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7954, File No. C-2-6597-P5. 999 James N Butcher, ‘Historical Highlights on the Empirical Method Underlying the MMPI/MMPI- 2 and MMPI-A,’ University of Minnesota, last modified Dec. 2012, http://www1.umn.edu/mmpi/documents/Highlights%20in%20the%20Empirical%20Method%20and %20the%20MMPI.pdf 1000 Lieutenant Colonel WRN Blair, Enrolment Processing: Effect of Minnesota Multiphasic Personality Inventory, 13 July 1953, LAC: RG 24, 1983-1984/167 GAD, Box 7954, File No. C-2- 6597-P5. 1001 Ibid. 1002 Ibid. Major JL Johnston, Psychiatric Aspects of Manpower Conservation: Present Status, 21 June 1954, LAC: RG 24, 1983-1984/167 GAD, Box 7954, File No. C-2-6597-P5. 1003 The letters of the acronym PULHEMS stand for the following: P Physique U Upper Limbs L Locomotion H Hearing E Eyesight M Mental Functioning S Stability
248 interested in finding a system that would produce uniform results for all three services.1004 The DRB was commissioned to look at variations on the PULHEMS system.1005 Special attention was devoted to the measurement of emotional stability, which was defined as, ‘…the ability of the individual to adjust himself to changing adverse environmental conditions without development of crippling psychological or psychosomatic disorders or manifesting anti-social behaviour.’1006 In order to gauge a recruit’s stability, psychiatrists conducted five to ten minute clinical interviews to review each man’s medical, educational and employment history. 1007 Such tests produced inconclusive results and did not dramatically improve Canadian methods of troop screening or selection.1008 The formula for a successful soldier remained elusive.
Without a doubt, brainwashing was the Defence Research Board’s most controversial area of research. According to Dr Bill Rawling of the Department of History and Heritage, ‘Chinese success in converting to their cause American and British prisoners captured in Korea,’ was of great concern to Canadian authorities both during and after the war.1009 American, British and Canadian representatives first met privately in June 1951 to discuss
Executive Committee of the Army Council, Final Report of the Interdepartmental Committee on the Creation of a Uniform System of Medical Categorization for the Fighting Services, 16 May 1947, TNA: WO 32/12403. 1004 Anon, Uniform System of Manpower Classification, 7 Sept. 1954, LAC: RG 24, Acc 1983- 1984/167 GAD, Box 7971, Volume I, File 2-6640-2. 1005 Ibid. 1006 Department of National Defence, Plumsheaf Instruction Manual: Experimental Copy, 1954, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7971, Volume I, File 2-6640-2. 1007 Ibid. 1008 Anon, Uniform System of Manpower Classification, 7 Sept. 1954, LAC: RG 24, Acc 1983- 1984/167 GAD, Box 7971, File 2-6640-2, Volume I. NW Morton to Personnel Members Committee, 12 Oct. 1954, LAC: RG 24, Acc 1983-1984/167, GAD Box 7971, File 2-6640-2, Volume I. Major FCR Chalke, ‘Psychiatric Screening of Recruits: A Review,’ Department of Veterans Affairs Treatment Service Bulletin 9 (June 1954): 273-292. 1009 Rawling, The Myriad Challenges of Peace, 211.
249 Chinese interrogation methods and mind control.1010 They concluded that research was needed to understand, ‘the mechanisms of brainwashing,’ and how it could be prevented in future.1011 The DRB subsequently financed several groundbreaking studies into the areas of isolation and sensory deprivation. Dr Donald Olding Hebb of McGill University was one of the primary recipients of government funding.1012 Over a period of two years, he conducted research for the DRB at his clinic in Montreal. In his 1972 Textbook of Psychology, Hebb described the experiment in detail. He explained that: College students were paid $20 a day to do nothing, lying on a comfortable bed with eyes covered by translucent plastic (permitting light to enter, but preventing pattern vision), hands enclosed in tubes (so that the hands could not be used by somesthetic perception, though they could be moved to prevent joint pains), and ears covered with earphones from which there was a constant buzzing except when the subject was being given a test.1013
While participants were allowed to eat and use the toilet, few could stand more than a day or two in the isolation room. Out of 22 subjects, 11 refused to stay after only 24 hours and no one lasted more than 131 hours.1014 Without regular stimulation, Hebb demonstrated that, ‘mental function and personality deteriorate.’1015 Many of the volunteers could not think coherently and began experiencing auditory and visual hallucinations.1016 When they were released, their ‘general IQs were temporarily lowered and reaction times were
1010 Opinion of George Cooper, QC, Regarding Canadian Government Funding of the Allan Memorial Institute in the 1950s and 1960s (Minister of Supply and Services Canada, 1986), Appx 23, OM Solandt, Chair of Defence Research Board to Minister, 25 Jan. 1954, quoted in Bill Rawling, The Myriad Challenges of Peace: Canadian Forces Medical Practitioners Since the Second World War (Ottawa: Canadian Government Publishing, 2004), 213. Anne Collins, In the Sleep Room: The Story of the CIA Brainwashing Experiments (Canada: Lester & Orpen Dennys Publishers, 1988), 47-49. 1011 Rawling, The Myriad Challenges of Peace, 215. 1012 Ibid. 1013 Donald Olding Hebb, Textbook of Psychology (Philadelphia: Saunders, 1972), 212-213. 1014 Collins, In the Sleep Room, 50-51. 1015 Opinion of George Cooper, Appx 22, DO Hebb, W Heron, and WH Bexton, Annual Report Contract DRB X38, nd., quoted in Bill Rawling, The Myriad Challenges of Peace: Canadian Forces Medical Practitioners Since the Second World War (Ottawa: Canadian Government Publishing, 2004), 215. 1016 Collins, In the Sleep Room, 50-51.
250 slow.’1017 Hebb had proved that simple deprivation could have a startling effect on the adult human mind. Furthermore, he had provided the DRB with useful insights into the experience of prisoners of war (POWs) during the Korean War.
Dr Hebb’s experiments for the Canadian Forces were conducted as ethically as possible and with the informed consent of participants. There is no evidence that the military ever sanctioned illegal or morally questionable research into mind control.1018 However, Hebb’s work was an inspiration to those with fewer scruples. In the early 1960s, disgraced psychiatrist Dr Donald Ewen Cameron was still a respected doctor and one of the administrators of Montreal’s celebrated Allan Memorial Clinic. A highly ambitious man, Cameron developed a controversial treatment plan to cure schizophrenia called depatterning. Patients in drug-induced comas received several treatments of electroshock each day and were forced to listen to a looped tape of their interviews.1019 A former colleague later explained that the, ‘idea was to clear the brain of all psychotic thoughts and feelings…and rebuild a new and healthy personality for the patient.’1020 While Cameron may have been well intentioned, he carried out his experiments without the informed consent of his patients or their families. Moreover, it was discovered that the American
1017 Ibid., 51. 1018 Defence Research Board, Application for Grant for Research, Dec. 1947, LAC: RG 24, v.4117, 2-1-87-56. Don Gilmor, I Swear by Apollo: Dr Ewen Cameron and the CIA Brainwashing Experiments (Montreal: Eden Press, 1987), 25. 1019 JDM Griffin, ‘Review Essay/Note critique: Cameron’s Search for a Cure,’ Canadian Bulletin of Medical History/Bulletin canadien d’histoire de la médicine 8 (1991): 121-126. D Ewen Cameron, JG Lohrenz and KA Handcock, ‘The Depatterning Treatment of Schizophrenia,’ Comprehensive Psychiatry: Official Journal of the American Psychopathological Association 3, No. 2 (Apr. 1962): 65-76. Robert A Cleghorn, ‘The McGill Experience of Robert A Cleghorn, MD: Recollections of D Ewen Cameron,’ Canadian Bulletin of Medical History/Bulletin canadien d’histoire de la médicine 7 (1990): 53-76. Charles G Roland, ‘Note,’ in Robert A Cleghorn, ‘The McGill Experience of Robert A Cleghorn, MD: Recollections of D Ewen Cameron,’ Canadian Bulletin of Medical History/Bulletin canadien d’histoire de la médicine 7 (1990): 53. 1020 Griffin, ‘Review Essay,’ 122.
251 Central Intelligence Agency (CIA) had funded his research activities. The CIA was not interested in curing the mentally ill. They were more concerned with gaining insights into the human mind that would allow the development of better methods of interrogation.1021
Ethical concerns not only limited Canadian research into brainwashing but severely restricted work on combat stress reactions like battle exhaustion. Studying troops on active deployment without interfering with the mission was problematic and conducting trials at home presented equally formidable obstacles. Defence analyst WF Cockburn was aware that both the UK and US governments had staged experiments where subjects were exposed to, ‘real psychological stress by introducing a situation, which apparently poses a real threat to life and limb, but is in fact under the control of the experimenter.’1022 DRB personnel refused to cross the same line. The Chief Superintendent of the Defence Research Medical Laboratories explained their opposition. He wrote to his superiors that: The moral implication of putting men in such a situation and then generating a crisis so that some deserted their post is, in our opinion, unforgivable. The men who disobeyed orders and deserted their post cannot be accused of cowardice because the whole situation was designed to make them vulnerable. Telling them that it was all a joke does not relieve them of their own personal knowledge that they ran. It is certain that years later some of these men will still feel shame at their behaviour and all for what?1023
Psychologists were in an impossible position. Defence research on combat stress reactions required ethical compromises. Those concerned were not willing to make such concessions. Until the end of the Cold War, Canadian knowledge was largely based on experiences of World War II and Korea.1024
1021 Roland, ‘Note,’ 53. 1022 WF Cockburn to Mr Watson, 7 Aug. 1964, LAC: RG 24, Acc 1983-1984/167, Box 7559, 9400- 1. 1023 Chief Superintendent of Defence Research Medical Laboratories to Chair of Defence Research Board, 20 Jan. 1965, LAC: RG 24, Acc 1983-1984/167 GAD, Box 7559, 9400-1. 1024 Ibid. Rawling, The Myriad Challenges of Peace, 216-217.
252 The Royal Army Medical Corps (1953-1990s) From its earliest beginnings, manpower has always been a problem for the Royal Army Medical Corps. They have struggled mightily to attract the best and brightest doctors to their ranks but have often failed in their task.1025 There are several reasons why this is the case. Throughout the twentieth century, medical officers have been paid less for their services than civilians. Moreover, a life in service generally presents fewer opportunities for clinical innovation and personal advancement. As an organisation, the RAMC has been forged by adversity and shaped by its recruitment difficulties. WWI and WWII temporarily alleviated the shortages in question. Demobilisation in 1945 and the advent of National Service also served to obscure the severity of the situation.1026 However, they proved to be temporary solutions to a long-term problem. Like their Canadian counterparts, the British would face many trials and tribulations in the decades following the Korean War. Funding cuts and recruitment were a constant worry for those in command. The Cold War was a period of slow transformation and ceaseless reinvention for the RAMC. Army medical and psychiatric practice was moulded by the stark economic and political realities of post-war Britain.
During the Korean War, the vast majority of MOs were National Servicemen rather than career officers because regulars were largely deployed to Germany and other bases
1025 JR to Minister of Defence, Memorandum in Response to Minute, 1961, TNA: Ministry of Defence (DEFE) 7/1443. War Office, Report on the Health of the Army 1949-1950, 27 Mar. 1953, TNA: WO 279/610. Army Medical Advisory Board, Meetings 1 July 1949-1954: Deficiency of Medical Officers in the RAMC, 1 July 1952, TNA: WO 32/13465. Committee on the Shortage of Medical Officers in the Forces, Report, 31 Dec. 1952, TNA: WO 32/14683. 1026 Adjutant General, Manpower—Medical Services 1962-1963: Paper for consideration at a future meeting of the Army Council Secretariat, 11 Dec. 1961, TNA: WO 32/19523. War Office, The Present Organisation of the Medical and Dental Services of the Army, 22 Jan. 1954, TNA: DEFE 10/58. Adjutant General, Deficiency of Medical Officers in the Royal Army Medical Corps: Paper for Consideration by the Army Council at a Future Meeting, 17 Apr. 1953, TNA: WO 32/13465.
253 overseas. 1027 Beginning in 1949, young men between the ages of 17 and 21 were conscripted into the armed forces for a period of up to two years.1028 Medical students often delayed being called up in order to complete their training. Once they finished their education, they were required to report to Keogh barracks as new RAMC officers.1029 For over a decade, these fresh and inexperienced graduates were valued members of the corps and vital to its survival.1030 However, compulsory military service was set to end and the last group of conscripts was slated to enrol in November 1960.1031 After this time, the government would no longer be able to compel doctors to serve and the Army would lose an important source of medical manpower. Since the advent of the National Health Service (NHS), a great deal had changed. The NHS had grown substantially, civilian medical pay had increased and working conditions for doctors had gradually improved. Physicians employed by the NHS could expect opportunities for steady advancement and reasonable compensation. Meanwhile, doctors in the Army were not paid as well nor could they expect the same level of clinical variety as their civilian colleagues.1032 The RAMC had reached a decisive turning point in its history.
1027 Army Medical Advisory Board, Meetings 1 July 1949-Sept. 1954, 8 Dec. 1950, p. 4, TNA: WO 32/13465. 1028 The length of National Service was changed several times and varied between one to two years of active service. War Office, Report on the Health of the Army 1949-1950, 27 Mar. 1953, TNA: WO 279/610. Roger Broad, Conscription in Britain 1939-1964: The Militarisation of a Generation, British Politics and Society (New York: Taylor & Francis, 2006), 117. SJ Ball, ‘A Rejected Strategy: The Army and National Service 1946-60,’ in eds. Hew Stratchan, The British Army, Manpower and Society into the Twenty-First Century (London: Frank Cass, 2000), 39. 1029 ‘Future Conscription,’ supplement, British Medical Journal 1, No. 2207 (26 Apr. 1947): 84. 1030 Adjutant General, Manpower—Medical Services 1962-1963: Paper for consideration at a future meeting of the Army Council Secretariat, 11 Dec. 1961, TNA: WO 32/19523. 1031 Ball, ‘A Rejected Strategy,’ 47-48. 1032 ‘The Defence Services: Students’ Guide 1958-1959,’ Lancet (30 Aug. 1958), pp. 474-476. Adjutant General, Manpower—Medical Services 1962-1963: Paper for consideration at a future meeting of the Army Council Secretariat, 11 Dec. 1961, TNA: WO 32/19523.
254 The War Office (WO) had long sensed the gathering storm. On 19 September 1953, the War Office announced the appointment of a committee, ‘to review the arrangements for providing medical and dental services for the Armed Forces at home and abroad in peace and war.’1033 The Waverley Committee included prominent figures from the worlds of medicine and defence like Sir Arthur Porritt and General Sir James Steele.1034 They met to discuss the RAMC’s bleak future. How could they solve the problems surrounding manning, pay and working conditions? What could they do to ensure the RAMC’s survival after the end of national service? Over many months, they took expert testimony and debated the matter amongst themselves. In the Waverley Committee’s final report, they recommended a much greater degree of cooperation between the medical services of the Army, Air Force and Navy. They even suggested amalgamation. Such a union would ensure considerable savings and the elimination of redundant positions.1035 The RAMC had flirted with the idea of amalgamation on many previous occasions but had retreated in each instance. The Weir Committee of 1923, the Warren Fisher Committee of 1933 and the
Colonel RH Robinson, ‘Future Medical Officers for the Army,’ Journal of the Royal Army Medical Corps 96, No. 2 (Feb. 1951): 130-135. Forces Medical and Dental Services Committee, Pay of Doctors and Dentists Employed In the National Health Service and by Local Authorities in Great Britain, 5 Jan. 1954, TNA: DEFE 10/58. War Office, The Rates of Pay and Allowances and Promotion: Prospects of Regular Medical and Dental Officers, 19 Jan. 1954, TNA: DEFE 10/58. 1033 ‘Career in the Services,’ British Medical Journal 1, No. 4969 (31 Mar. 1956): 732. 1034 Arthur Porritt was a distinguished surgeon and figure within the British medical community. Throughout his career, he held the position of the president of the Royal College of Surgeons of England and was a member of the British Medical Association council. He eventually served as New Zealand’s governor general from 1967-1971. General Sir James Steele was a Regular Army officer. He had risen to position of Adjutant General by the end of his career. After retirement, he continued to be involved with the Armed Forces and related charitable organisations. ‘Obituary: Lord Porritt, GCMG, GCVO, CBE, MCH, FRCS,’ British Medical Journal 308, No. 6922 (15 Jan. 1994), 197. RH Hewetson, ‘Steele, Sir James Stuart (1894-1975),’ Oxford Dictionary of National Biography, last modified Jan 2011, http://dx.doi.org/10.1093/ref:odnb/31716 ‘Nurses and Ancillaries in the Services,’ Lancet 268, No. 6934 (July 1956): 153-154. Forces Medical and Dental Services Committee, Conclusions of Meeting, 10 Feb. 1954, TNA: DEFE 10/291. 1035 James Baird, Paper by Director General of Army Medical Services on the Role and Organisation of the Army Medical Services, 31 Jan. 1977, TNA: DEFE 24/1007.
255 Nathan Committee of 1946 had all advised the Army to join forces with the Navy and Air Force.1036 Despite the sense of their counsel, senior officers had always refused to move forward with the amalgamation of military medicine. They contended that the cultures of the three services were far too different. Each had a distinct identity associated with the force that it served and cultivated service-specific medical skills.1037 While the Royal Canadian Army Medical Corps became the Canadian Forces Medical Service, the RAMC remained a single service organisation. Ultimately, they would have to face the consequences of that decision.
In the closing months of 1961, the War Office called its professional medical advisors Sir Cecil Wakeley, Sir Stanford Cade and Dr ER Boland together for advice on the RAMC’s manpower problems. The year following the end of national service had proved devastating for the Army medical corps. Recruitment figures were at all time low and there was no suggestion of improvement on the horizon.1038 Predictions strongly suggested that by December 1963, the RAMC would have a 50% deficit of medical officers. Shortages would be worst amongst general duty officers (GDOs) and those between the ages of 25 and 39.1039 These middling rank officers were considered to be the backbone of the RAMC and
1036 Ibid. Committee on the Organisation of the Common Services, War Office, Report on the Amalgamation of the Medical Services of the Armed Forces, Aug. 1946, LAC: RG 24, Acc 1983-84/167 GAD, Box 6582, Volume I, File C-2-70-63. 1037 James Baird, Paper by Director General of Army Medical Services on the Role and Organisation of the Army Medical Services, 31 Jan. 1977, TNA: DEFE 24/1007. 1038 Deputy Director General of Army Medical Services to Adjutant General Secretariat, Recruitment of Doctors, 23 Feb. 1971, TNA: WO 32/15735. Cecil Wakeley, Stanford Cade and ER Boland, Report by the Professional Medical Advisors to the Three Services on the Recruitment of Medical Officers, 16 Sept. 1961, TNA: DEFE 7/1443. 1039 Deputy Director General of Army Medical Services to Adjutant General Secretariat, Recruitment of Doctors, 23 February 1971, TNA: WO 32/15735. JR to Minister of Defence, Memorandum in Response to Minute, 1961, TNA: DEFE 7/1443. AD Young to Sir Arthur E. Porritt, 4 Aug. 1967, TNA: WO 32/21018.
256 were responsible for most everyday clinical care.1040 Wakeley, Cade and Boland were under no illusion as to the gravity of the Army’s situation when they stated, ‘It is clear that recruitment figures are very bad and unless there is a radical change of policy resulting in improved professional prospects and pay readjustment, the extinction of the Medical Services of the Armed Forces will inevitably result from lack of personnel.’1041 A plan of action was drawn up in discussions between the three men, the British Medical Association (BMA) and the Army Medical Advisory Board.1042 As a matter of urgency, the War Office had no choice but to implement their recommendations immediately. Pay was increased to equate with that of general practitioners (GPs) in the National Health Service. A War Office official later explained that, ‘This was done by taking the average earnings of the GP in the NHS and adding to that by an inducement factor amounting to 15.8%.’1043 Married and single living quarters were renovated and improved in the UK and overseas.1044 Age of retirement was extended from 57 to 65, which was in line with civilian practice. The early timing of retirement had long been a grievance of both recruits and active servicemen.1045 In a 1951 article entitled, ‘Future Medical Officers for the Army Part III: Some Suggestions,’ Colonel RH Robinson had complained that MOs had to retire at the same age that their civilian colleagues were earning the most money for their skills.1046 Where promotions had been somewhat arbitrary and informal before, they would now take place at
1040 JR to Minister of Defence, Memorandum in Response to Minute, 1961, TNA: DEFE 7/1443. AD Young to Sir Arthur E. Porritt, 4 Aug. 1967, TNA: WO 32/21018. 1041 Cecil Wakeley, Stanford Cade and ER Boland, Report by the Professional Medical Advisors to the Three Services on the Recruitment of Medical Officers, 16 Sept. 1961, TNA: DEFE 7/1443. 1042 Deputy Director General of Army Medical Services to Adjutant General Secretariat, Recruitment of Doctors 1960s, 23 Feb. 1971, TNA: WO 32/15735. 1043 AD Young to Sir Arthur E. Porritt, 4 Aug. 1967, TNA: WO 32/21018. 1044 Deputy Director General of Army Medical Services to Adjutant General Secretariat, Recruitment of Doctors, 23 Feb. 1971, TNA: WO 32/15735. 1045 Ibid. 1046 Colonel RH Robinson, ‘Future Medical Officers for the Army Part III: Some Suggestions,’ Journal of the Royal Army Medical Corps 96, No. 3 (Mar. 1951): 182.
257 set times and be based upon, ‘qualification, recommendation and selection.’1047 Finally, the War Office agreed to further nurture the medical cadet scheme. Scholarship recipients were commissioned members of the corps and received a lieutenant’s pay while attending medical school. In return, they would be required to spend five years on active duty.1048 Throughout 1962, the War Office went to great lengths to improve its reputation as a competitive employer. An advertising campaign called, ‘The New Deal for Doctors,’ was launched in professional publications like the Lancet and the British Medical Journal. The publicity blitz was initially successful in attracting physicians from around Britain and the Commonwealth.1049 New recruits were suitably impressed by the rapid improvements to pay, promotion and working conditions. Many short service officers were also convinced to extend their existing commissions in exchange for large inducement payments of up to £3,000. 1050 In spite of such early success, recruitment figures soon began to slump again.1051 Subsequent events within the National Health Service helped to destroy any feasible chance of recovery.
Over the course of the 1950s, NHS general practitioners had become increasingly frustrated with the government and the manner in which they were treated. A large proportion felt overburdened by the number of patients they were expected to treat and underpaid for their services. A scathing indictment of the current system appeared in the supplement to the British Medical Journal on 16 June 1956.1052 General practitioner, Dr JRF Jenkins wrote on
1047 Deputy Director General of Army Medical Services to Adjutant General Secretariat, Recruitment of Doctors, 23 Feb. 1971, TNA: WO 32/15735. Colonel AB Dick, ‘Soldiers’ Careers in the Royal Army Medical Corps and the Royal Army Dental Corps,’ Journal of the Royal Army Medical Corps 116, 2 (1970): 66. 1048 Ibid. 1049 Anon, Royal Army Medical Corps Officers—Advertising Policy, 1962, TNA: WO 32/20444. Director General of Army Medical Services to Parliamentary Under Secretary of State, 4 Oct. 1962, TNA: WO 32/20444. 1050 Deputy Undersecretary to Undersecretary of State, 17 Oct. 1962, TNA: WO 32/20444. 1051 Anon, Royal Army Medical Corps Officers—Advertising Policy, 1962, TNA: WO 32/20444. 1052 JRF Jenkins, ‘Improving General Practice,’ British Medical Journal 1, No. 4980 (16 June 1956): 351-352.
258 behalf of his colleagues and gave voice to their anxieties in an article entitled, ‘Improving General Practice.’ He observed that there was a, ‘complete absence…of any incentive to good work,’ and a, ‘failure to recognise or offer scope for the exercise of any special knowledge and training within general practice.’ 1053 Jenkins and countless other correspondents and writers urged the government to take immediate action to remedy the situation but change was not forthcoming.1054 By the early 1960s, GPs were overworked and fed up with the existing order. The dispute took on an increasingly vitriolic tone and negotiations between the Ministry of Health and British Medical Association floundered.1055 In 1965, discussions between the two warring factions finally moved forward and became reasonably constructive. The Family Doctors Charter was the result of their efforts.1056 Around 18,000 or 75% of general practitioners threatened to resign from the NHS if parliament failed to pass the charter.1057 It was promptly approved and came
1053 Ibid., 351. 1054 A selection of articles and letters that deal with the problems surrounding British general practice include: John Fry and JB Dillane, ‘Towards Better General Practice: A Preliminary Survey and Some Suggestions,’ British Medical Journal 2, No. 5315 (17 Nov. 1962), 1311-1315. JDH Mahoney, ‘Better General Practice,’ British Medical Journal 1, No. 5332 (16 Mar. 1963), 753. Martin Parry, ‘Future of General Practice,’ British Medical Journal 1, No. 5339 (4 May 1963): 1227. DG Barrowcliffe, ‘Future of General Practice,’ British Medical Journal 2, No. 5350 (20 July 1963): 192. ‘Crisis in General Practice,’ British Medical Journal 1, No. 5387 (4 Apr. 1964): 851-852. D John Davies, ‘Malaise of General Practice,’ British Medical Journal 2, No. 5414 (10 Oct. 1964): 948. John Stephen, ‘Improving General Practice,’ British Medical Journal 1, No. 5440 (10 Apr. 1965): 1002. 1055 Davies, ‘Malaise of General Practice,’ 948. David Morrell, ‘As I Recall,’ British Medical Journal 317, No. 7150 (4 July 1998): 42-43. ‘Charter for General Practice,’ British Medical Journal 1, No. 5436 (13 Mar. 1965): 669-670. Nuffield Trust, ‘National Health Service Timeline,’ last modified 2011, http://nhstimeline.nuffieldtrust.org.uk/1960s.html 1056 Morrell, ‘As I Recall,’ 42-43. ‘Charter for General Practice,’ British Medical Journal 1, No. 5436 (13 Mar. 1965): 669-670. Margot Jeffreys, ‘General Practitioners and the Other Caring Professions,’ in General Practice under the National Health Service 1948-1997, eds. Irvine Loudon, John Horder and Charles Webster (New York: Oxford University Press, 1998): 142-143. 1057 Allyson M Pollock, Colin Leys and David Price, National Health Service plc: The Privatisation of Our Health Care (London: New Left Books, 2005), 138-139.
259 into effect in the closing months of 1966.1058 Amongst its provisions, the charter set limits on the number of patients a doctor could accept and granted allowances for the employment of secretaries and non-medical support staff.1059 Most importantly, it provided for a pay increase of nearly 33%.1060 This was not good news for the Royal Army Medical Corps. The dramatic rise in NHS pay immediately, ‘eroded…the inducement factor,’ granted to medical officers during the previous year.1061 Once again, they were earning less than their civilian colleagues.1062
Actions taken by the War Office served to further weaken the RAMC’s position. First issued in July 1958, the Grigg Committee’s, ‘Report on the Future of Manpower in the Armed Forces of the Crown,’ harshly criticised the state of the British military.1063 Similarly to the RAMC, the Army had great difficulty in enlisting and retaining career officers. Members of the committee strongly recommended that soldiers be more fairly remunerated for their services. For nearly a decade, the War Office had neither the means nor the inclination to put the Grigg Committee’s suggestions into effect. In April 1966, they finally took action. That month, all Army officers were granted a substantial pay increase of 18%.1064 However, the budget could not accommodate for an equivalent rise in the pay of RAMC medical officers and technical personnel. They were awarded a comparatively modest 10%. Coming at the same time as the Family Doctors Charter, the Grigg Awards
1058 Morrell, ‘As I Recall,’ 42-43. ‘Charter for General Practice,’ British Medical Journal 1, No. 5436 (13 Mar. 1965): 669-670. Jeffreys, ‘General Practitioners,’ 142-143. 1059 Ibid. Ibid. Ibid. 1060 AD Young to Sir Arthur E. Porritt, 4 Aug. 1967, TNA: WO 32/21018. 1061 Ibid. 1062 Ibid. 1063 United Kingdom, House of Commons, Debates, 24 Nov. 1958, Series 5, Volume 596, cc. 53- 159. 1064 Anon, Minutes of a Meeting of the Army Medical Advisory Board, 27 June 1968, TNA: WO 32/21018.
260 were a huge disappointment to service doctors.1065 They also brought the WO into direct conflict with the British Medical Association. The WO and the BMA had long had an antagonistic relationship and pursued opposing aims.1066 Members of the association were determined to protect the interests of their professional colleagues and the formation of the Ministry of Defence (MoD) in 1964 did nothing to address their concerns.1067 They had continually pressed for better pay and been disappointed by the results on most occasions. On 15 March 1967, the British Medical Association council, ‘informed the Secretary of State for Defence that the Association could no longer assist in recruitment of [medical officers].’ For the next two years, the RAMC was banned from advertising in the British Medical Journal.1068 Events had reached an impasse.
The late 1960s represents a significant low point in the history of the Royal Army Medical Corps. In the wake of further funding cuts, the MoD was forced to freeze pay between 1966 and 1969. Several key defence reviews had, ‘reduced both the commitments and the size of the Services.’1069 The Army could not afford to pay doctors high salaries or match the NHS in terms of what it could offer. To many within the RAMC, the BMA’s decision to withdraw its support seemed like the final nail in the coffin. As the main representative body of British doctors, the BMA held a great deal of power in the medical community.
1065 Ibid. 1066 AD Young to Sir Arthur E. Porritt, 4 Aug. 1967, TNA: WO 32/21018. Army Medical Advisory Board, Minutes of Meeting, 27 June 1968, TNA: WO 32/21018. Anon, Medical Officer Manning, 1 Sept. 1971, TNA: WO 32/15735. Deputy Director General of Army Medical Services to Adjutant General Secretariat, Recruitment of Doctors, 23 Feb. 1971, TNA: WO 32/15735. 1067 The present Ministry of Defence (MoD) is a, ‘fusion of old ministries: from 1946-1964 there were five departments doing what the MoD does now: the Admiralty, the War Office, the Air Ministry, the Ministry of Aviation and the Ministry of Defence itself. In 1964 the first three and the MoD were amalgamated, and the defence functions of the Ministry of Aviation Supply (as it had by then become) were absorbed in 1971.’ Ministry of Defence, ‘History of the Ministry of Defence,’ last modified 10 Dec. 2012, https://www.gov.uk/government/publications/history-of-the-ministry-of-defence 1068 Anon, Minutes of a Meeting of the Army Medical Advisory Board, 27 June 1968, TNA: WO 32/21018. 1069 Anon, Medical Officer Manning, 1 Sept. 1971, TNA: WO 32/15735.
261 When they decided to ban the RAMC from advertising posts, they isolated service doctors from the rest of their profession. The impact was deeply felt. On 26 June 1968, the Director General of Army Medical Services Lieutenant General Sir Robert Drew wrote to Adjutant General Sir Geoffrey Musson. He lamented that, ‘The morale of medical officers is lower by far than I have known it in some 38 years of service. They are disgruntled and disillusioned at what they regard as unjust treatment.’1070 With ever diminishing career prospects, many older officers chose to take early retirement and make the most of their final working years.1071 The RAMC was only able to meet its obligations through the employment of medical cadets, who had been recruited in the early 1960s. After completing their education and ‘pre-registration appointments,’ they were required to join the active list for five years.1072 Thankfully, 1969 was a fortuitous year for the RAMC and events finally began to turn in their favour. With the endorsement of the National Board for Prices and Incomes (NBPI), the government agreed to another salary increase. Once more, MOs could expect to earn the same as NHS general practitioners.1073 On account of this decision, relations between the BMA and the MoD began to thaw and the lines of communication were opened. The association decided to lift its ban on advertisements.
Several years later, there were encouraging signs that the RAMC was recovering, adapting and evolving to the circumstances at hand. On 1 September 1971, an internal report indicated that there had been a ‘dramatic drop’ in the number of premature retirements.1074 There had been a, ‘reduction in the region of 50% on the previous year’s figures.’1075
1070 Director General of Army Medical Services to Adjutant General, 26 June 1968, TNA: WO 32/20194. 1071 Anon, Recruitment of Medical Officers: Loose Minutes, 2 July 1970, TNA: WO 32/20194. 1072 Anon, Medical Officer Manning, 1 Sept. 1971, TNA: WO 32/15735. 1073 Anon, Minutes of a Meeting of the Army Medical Advisory Board, 27 June 1968, TNA: WO 32/21018. Denis Healy to Barbara Castle, 17 Feb. 1969, TNA: WO 32/20194. Defence Medical Services Inquiry, Pay, 1970s, TNA: DEFE 47/9. 1074 Anon, Medical Officer Manning, 1 Sept. 1971, TNA: WO 32/15735. 1075 Ibid.
262 Recruitment numbers had also noticeably improved in terms of both cadet and direct entry applications. These developments were widely attributed to a general, ‘return in confidence.’1076 Since 1969, Army wages were once again on par with those in the civilian sector. Moreover, the British economy had begun to experience a decline in fortunes and inflation was on the rise.1077 In discussions with UK universities, recruiters discovered that medical students were appreciably more optimistic about choosing a career in the military. The RAMC was no longer an outcast. Students were now reasonably positive that they could satisfy their clinical ambitions as Medical Officers.1078
The British Army and the RAMC were in a process of streamlining and modernising throughout the 1970s and 1980s.1079 Career structures were patterned more closely on civilian trades and promotion based more firmly upon merit.1080 The RAMC continued to experience funding cuts and many military hospitals were closed or converted to civilian institutions.1081 However, the 1970s and 1980s represented a period of much greater stability than the previous four decades of RAMC history. As the British Army shrank in size, the RAMC was better able to meet its needs at home and overseas. Like the CFMS, the RAMC had become a smaller, more agile and responsive organisation by the end of the Cold War.
1076 Ibid. 1077 The 1970s was a very unstable decade in terms of British economic performance. Inflation and unemployment rose significantly and industrial unrest became common. R Coopey and N Woodward, eds., Britain in the 1970s: The Troubled Economy (London: University College London Press, 1995), 1-27. 1078 Ibid. 1079 Dick, ‘Soldiers’ Careers,’ 73. 1080 Ibid. 1081 Defence Medical Services Inquiry, Position Paper No. 2: Statement of the Organisation of Service Hospitals and Breakdown of Hospital Costs, 2 Sept. 1971, TNA: DEFE 10/784. Dr NRH Burgess, ‘Millbank From Medieval Times to the Present,’ Journal of the Royal Army Medical Corps 124, No. 2 (1978): 104.
263 The British Army and Psychiatry Throughout the Cold War, the Directorate of Army Psychiatry was subject to the same pressures as the rest of the RAMC. They were strained financially and always short of the necessary personnel. As a specialist service, they were particularly exposed to the vicissitudes of the economy and politics. In January 1954, the RAMC employed a mere 23 psychiatrists. This small band included consultants, senior specialists, junior specialists and trainees at various stages in their education. They were responsible for providing clinical care to over 800,000 British soldiers and their families. There was no shortage of work to be done as psychiatric conditions constituted the chief cause of invaliding from the armed forces during this period.1082 However, by 1965 their numbers had dwindled to 18.1083 As a group they often had to contend with the mistrust and suspicion of their fellow officers. There was still a strong social stigma towards the mentally ill and those who treated them. During both world wars, psychiatrists had struggled to prove themselves useful and to gain the respect of their colleagues. In the 1950s and 1960s, they continued to fight for a place at the table. An anonymous article published in the Journal of the Royal Army Medical Corps (JRAMC) provides a revealing glimpse into how psychiatrists were perceived in the military. Appearing in November 1951, the author of, ‘At Random,’ severely criticised the performance of British psychiatrists in WWII. Although he acknowledged psychiatrists could be useful in the field, he generally saw them as impractical.1084 They indulged too often in, ‘soft-hearted pandering to possibilities.’1085 Lieutenant Colonel Harry Pozner was disappointed that the JRAMC had chosen to publish such an article and afraid it reflected official opinion. While the journal’s editors denied this, there is no doubt that, ‘At
1082 War Office, Report on the Health of the Army 1951-1952, TNA: WO 279/615. AH Gould, ‘Report on the Health of the Army 1965,’ Journal of the Royal Army Medical Corps 114, No. 1 (1968): 5-10. 1083 War Office, The Numbers of Medical and Dental Officers Arranged in Categories Employed in the Army Medical and Dental Services showing present numbers and trends as regards intake and outflow, 19 Jan. 1954, TNA: DEFE 10/58. Anon, Minutes of a Meeting of the Army Medical Advisory Board, 26 July 1965, TNA: WO 32/21018. 1084 ‘At Random: Psychiatric Wastages,’ Journal of the Royal Army Medical Corps 97, No. 5 (Nov. 1951): 389-391. 1085 Ibid., 391.
264 Random,’ was indicative of wider feeling.1086 Pozner noted that, ‘Military psychiatry is the newest of the service specialities,’1087 and that, ‘The small group of Regular officers who practice full time psychiatry do so under conditions in which prejudice and unnecessary criticism play no small part.’1088
The heart of the Army psychiatric community was the Royal Victoria Hospital Netley. It had housed and treated soldiers suffering from psychotic and psychoneurotic conditions since the late nineteenth century.1089 Due to the closure of several naval hospitals, Netley was under increasing strain by the late 1950s. When Great Yarmouth Hospital was shut in 1958, the Navy lost 236 dedicated psychiatric beds. 1090 Rather than invest in the construction of new facilities, they chose to send their patients to the Royal Victoria.1091
1086 Lieutenant Colonel Harry Pozner, ‘Letter to the Editor,’ Journal of the Royal Army Medical Corps 98, No. 1 (Jan. 1952): 79-82. 1087 Ibid., 82. 1088 Ibid. 1089 Anon, Long Term Hospital Requirements in the United Kingdom for the Army: Minutes of a Meeting Held in the Vice Adjutant General’s Office, 12 Nov. 1957, TNA: DEFE 7/411. Anon, A Career for Doctors in the Royal Army Medical Corps, c. 1962, TNA: WO 32/20444. Anon, Report by the Working Party on Service Hospitals in the United Kingdom, 1963, TNA: DEFE 7/411. Anon, Review of Service Hospital Requirements in the United Kingdom, 1963, TNA: DEFE 7/411. Anon, Working Party on Hospital Requirements: First Report (in Draft form), 3 Nov. 1965, TNA: DEFE 10/609. Major GW Thompson, ‘The Presentation and Recognition of Schizophrenia in a Service Setting,’ Journal of the Royal Army Medical Corps 113, 2 (1967): 75-81. Defence Medical Services Inquiry, Position Paper No. 2: Statement of the Organisation of Service Hospitals and Breakdown of Hospital Costs, 2 Sept. 1971, TNA: DEFE 10/784. 1090 Anon, Review of Service Hospital Requirements in the United Kingdom, 1963, TNA: DEFE 7/411. 1091 Anon, Review of Service Hospital Requirements in the United Kingdom, 1963, TNA: DEFE 7/411. Anon, Report by the Working Party on Service Hospitals in the United Kingdom, 1963, TNA: DEFE 7/411. Lieutenant Colonel RJ Wawman, ‘Psychiatry and the Serviceman’s Family,’ Journal of the Royal Army Medical Corps 119, 1 (1973): 17-20. Anon, Working Party on Hospital Requirements: First Report (in Draft form), 3 Nov. 1965, TNA: DEFE 10/609. Thompson, ‘The Presentation and Recognition of Schizophrenia,’ 75-81.
265 The unit at Netley eventually came to be known as the Joint Armed Services Psychiatric Unit. Over the following decade, it admitted and cared for servicemen from both the Army and the navy. When facilities at Netley fell into disrepair, they were forced to relocate to the Queen Elizabeth Military Hospital, Woolwich in 1978.1092
In order to contend with continuing recruitment problems, the directorate focused on training existing general duty officers as specialists. The initial RAMC Junior Officers Course was held at the Royal Army Medical College at Millbank three times a year. Over the course of ten weeks, students were lectured in Army psychiatry, tropical medicine, military surgery, applied pathology and a number of other subjects. Medical officers scoring 70% or higher on the final exam were selected to receive further training as specialists. Young psychiatrists were placed under the direct supervision of a senior colleague and put on probation for the first six months.1093 Over the following years, candidates spent several years in clinical training at military and civilian hospitals around the United Kingdom. After advancement to the rank of junior specialist, officers were, ‘encouraged to obtain the Diploma of Psychological Medicine (DPM).’1094 As they rose through the ranks, they were expected to attend refresher courses and the Senior Officers Course at Millbank. The most talented and qualified men were granted time to study for higher qualifications such as the Membership of the Royal College of Physicians (MRCP)
1092 Wawman, ‘Psychiatry and Serviceman’s Family,’ 17-20. Sylvia M Blunden, ‘Drugs and the Soldier,’ Journal of the Royal Army Medical Corps 127, No. 2 (1981): 72-77. 1093 Anon, Interim: Training of Regular Medical Officers of the Royal Army Medical Corps, June 1957, TNA: WO 32/16498. Medical Services Coordinating Committee Broadening of Experience of Service Medical Officers—Facilities Made Available by the Service Departments, 24 July 1961, TNA: WO 32/16498. 1094 Medical Services Coordinating Committee Broadening of Experience of Service Medical Officers—Facilities Made Available by the Service Departments, 24 July 1961, TNA: WO 32/16498.
266 exam.1095The RAMC expected its medical officers to have the same qualifications and perform at the same level as civilians.1096
British military psychiatry evolved along the same lines as its civil counterpart. During the 1960s, there was great excitement about drug treatment, out-patient care and other emerging trends. By the early 1970s, it had also become something of a team effort. Consultants regularly liaised with welfare officers, child guidance teams, social workers, nursing sisters from the Soldiers, Sailors and Air Force Association (SSAFA) and padres in determining the proper course of treatment. 1097 This increasingly multidisciplinary approach was reflective of outside developments. Due to the limited number of trained RAMC psychiatrists, it was also a necessity. Teams of mental health workers were especially vital in isolated or distant Army postings. 1098 In a 1973 JRAMC article, Lieutenant Colonel RJ Wawman described activities in the Far East. He noted that, ‘comprehensive and community based services have slowly evolved,’ 1099 and that ‘psychiatrists have found themselves increasingly involved in an advisory and co- ordinating role with the various social agencies.’1100 By drawing upon the strengths of both medical and non-medical personnel, RAMC psychiatrists sought to make the most of their limited resources.
1095 Ibid. 1096 Ibid. ‘Editorial: Postgraduate Medical Education,’ Journal of the Royal Army Medical Corps 127, No. 3 (1981): 113-114. 1097 ‘Editorial,’ Journal of the Royal Army Medical Corps (1978): 56-57. Major JR Bird, ‘Marital Stress—Disease and Dilemma,’ Journal of the Royal Army Medical Corps 124, No. 2 (1978): 67-74. Major JR Bird, ‘Conjoint Marital Therapy in the Services,’ Journal of the Royal Army Medical Corps 124, No. 2 (1978): 60-66. Wawman, ‘Psychiatry and the Serviceman’s Family,’ 14-21. 1098 Ibid. Ibid. Ibid. Ibid. 1099 Wawman, ‘Psychiatry and the Serviceman’s Family, 18. 1100 Ibid.
267 The Korean War featured very little in the formation of British Army psychiatric policy. While an RAMC conference was held at the Royal Society of Medicine shortly after the war, there was little mention of psychiatry and there are no explicit references to the subject in later documents.1101 Be that as it may, Korea did have a significant effect on the direction of defence research. Officials from the War Office were as interested in the value of psychiatric and psychological research as their colleagues overseas. First established in 1946, the Army Operational Research Group (AORG) was the British equivalent of the Canadian Defence Research Board.1102 Headquartered in a country house in Surrey, the AORG was designed to, ‘advise the rest of the Army [on] how to deal with those of its problems, of which the proper solution needs either a knowledge of science or a scientific approach.’1103 Its civil and military experts studied a wide range of subjects like, ‘strategy, tactics, weapons [and] logistics.’1104 The Psychological or Human Resources branch was added in July 1951 to conduct, ‘research into methods of personnel selection for both officers and other ranks…training methods, job analysis and psychological warfare.’1105 They maintained close contact, ‘with the Medical Research Council through the Army Personnel Research Committee and with the psychological profession through the War Office Advisory Committee of Psychologists.’1106 Similarly to the DRB, the AORG was
1101 ‘Discussion on Military Medical Problems in Korea,’ Proceedings of the Royal Society of Medicine 46 (10 June 1953): 1037-1046. 1102 Anon, Army Operational Research Group Visitor’s Brief: Historical Background, 1960, TNA: WO 291/2669. AW Ross, Army Operational Research Group Memorandum No. F10: An Introduction to the Army Operational Research Group, 1955, TNA: WO 291/1437. 1103 AW Ross, Army Operational Research Group Memorandum No. F10: An Introduction to the Army Operational Research Group, 1955, TNA: WO 291/1437. 1104 Ibid. Army Operational Research Establishment, Reports and Memoranda Released to United States and Canada: Jan. 1949-Dec. 1961, 7 Feb. 1962, TNA: WO 291/2533. 1105 Anon, Army Operational Research Group Visitor’s Brief: Historical Background, 1960, TNA: WO 291/2669. Army Operational Research Establishment, Reports and Memoranda Released to United States and Canada: Jan. 1949-Dec. 1961, 7 Feb. 1962, TNA: WO 291/2533. RW Shephard, Army Operational Research Establishment: A Short Survey of Army Operational Research, 1965, TNA: WO 291/2408. 1106 AW Ross, Army Operational Research Group Memorandum No. F10: An Introduction to the Army Operational Research Group, 1955, TNA: WO 291/1437.
268 primarily interested in research on topics such as recruit screening and selection, brainwashing, and mind control.
The majority of AORG psychological research was focused on refining troop selection methods. Neither the Canadians nor the British could abandon the idea that screening had transformative potential for the military.1107 During the Korean War, between 10% and 17% of the Commonwealth Division’s psychiatric casualties had been diagnosed with character disorders or behaviour problems.1108 Senior officers were often disappointed with the quality of new recruits.1109 The 1953 Report on the Health of the Army indicated that many were, ‘immature and over-dependent,’ individuals.1110 They displayed a, ‘passive attitude to life and lack of incentive,’ as well as a, ‘lack of identification with the aims and loyalties of the Army.’1111 Despite its flaws, screening seemed to offer a solution. In a 1953 AORG memorandum, Dr JC Penton and Dr IR Haldane admitted that, ‘The definition of signs of maladjustment and the establishment of their existence in individual cases has not proved an easy matter and they are still not satisfactorily standardised as scientific
1107 JC Penton and IR Haldane, Army Operational Research Group Memorandum No. D20: A study of the evidence upon which the psychiatric element in the selection of other ranks is based, Jan.- Dec. 1953, TNA: WO 291/1401. IR Haldane, Army Operational Research Group Memorandum No. E14: A Follow-Up of Psychiatric Screening of Recruits, Jan.-Dec. 1954, TNA: WO 291/1417. 1108 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. 1109 Brigadier AE Richmond, ‘Positive Health--Its Attainment in the Soldier and the Army’s Contribution to it in the Civilian,’ Journal of the Royal Army Medical Corps 89, No. 6 (December 1947): 277-287. Major Martin M Lewis, ‘The Promotion and Maintenance of Mental Health in the Military Community,’ Journal of the Royal Army Medical Corps 96, No. 1 (January 1951): 17-18, 23, 31-35, 39. Major Martin M Lewis, ‘The Promotion and Maintenance of Mental Health in the Military Community: Part II,’ Journal of the Royal Army Medical Corps 96, No. 2 (Feb. 1951): 112. Captain HJ Groves, ‘Medical Aspects of Selection Procedure,’ Journal of the Royal Army Medical Corps 96, No. 2 (Feb. 1951): 115-121. Anon, Assistant Director of Medical Services War Diary, 1953, TNA: WO 281/888. Anon, 25 Canadian Field Dressing Station War Diary, 1953, LAC: RG24-C-3, Volume 18397. 1110 War Office, Report on the Health of the Army 1953, TNA: WO 279/614. 1111 Ibid.
269 concepts.’1112 However, both men insisted that reliable screening was possible. They observed that, ‘the basic assumption of psychiatric selection…[was] based firmly on practical and clinical experience that those who break down under stress once are likely to do so again.’1113 With this premise in mind, numerous trials were conducted on the effectiveness of questionnaires and standardised testing. The AORG published studies on the Cornell Selection Index and the Minnesota Multiphasic Personality Inventory and experimented with the use of personality and temperament tests like the Rorschach ink blot.1114
While the AORG never produced original research on brainwashing, they were well aware of Canadian work on the subject. Clinical psychologists in the Human Resources branch replicated Hebb’s sensory deprivation experiment on several occasions. They were also very interested in the related subjects of mind-control and interrogation.1115 Korea was the first time that British troops had been, ‘held captive by a Communist country.’1116 The authors of a government report on the subject concluded that servicemen had been largely ‘unprepared for this ordeal,’1117 and that their ‘experiences were of great importance.’1118 Shortly thereafter, a committee was appointed to look into the matter of preparing soldiers
1112 JC Penton and IR Haldane, Army Operational Research Group Memorandum No. D20: A study of the evidence upon which the psychiatric element in the selection of other ranks is based, Jan.- Dec. 1953, TNA: WO 291/1401. 1113 Ibid. 1114 In a study of selection, Dr JC Penton and Dr IR Haldane noted that the Cornell Selection Index and Minnesota Multiphasic Personality Inventory had been tested frequently. They considered both to be useful in combination with interviews. They dismissed personality and temperament tests like the Rorschach ink blot as unhelpful. JC Penton and IR Haldane, Army Operational Research Group Memorandum No. D20: A study of the evidence upon which the psychiatric element in the selection of other ranks is based, Jan.-Dec. 1953, TNA: WO 291/1401. 1115 JC Penton to Patrick Johnson, Scientific Advisor to the Army Council, 23 Jan. 1957, TNA: WO 342/2. 1116 Ministry of Defence, Treatment of British Prisoners of War in Korea, 1955, TNA: Admiralty, Navy, Royal Marines and Coastguard (ADM) 1/25760. 1117 Ibid. 1118 Ibid.
270 for potential future imprisonment.1119 In addition, the AORG ran a series of exercises designed to test how British troops would react to interrogation. First conceived and developed by the US Army, escape and evasion exercises pit one group of soldiers against another. Dropped into an unfamiliar environment, units are either tasked with evading capture or pursuing their fellow soldiers. If caught, troops are detained and treated like prisoners of war.1120 Exercise Long Man was held from 14-16 March 1958 in the area of Maresfield in East Sussex and involved 40 members of the Reserve Reconnaissance Unit (RRU) and 80 soldiers from the Special Air Service (SAS).1121 From 6-8 February 1959, the AORG ran Exercise White Knight at Plasterdown Camp in the Dartmoor area with Territorial Army units from 21 SAS Regiment, Special Boat Section Royal Marines (RM), 44 Independent Parachute Brigade and 161 Infantry Brigade.1122 In each case, a small number of men were captured and subjected to hours of questioning by the Joint Service Interrogation Unit (JSIU). Interrogators were not allowed to beat prisoners but tactics were far from gentle.1123 Men were subjected to:
(a) Confinement in steel lockers, (b) Confinement in steel ‘Coffins’--actually steel cupboards laid flat with the door uppermost. (c) Confinement in a cell lighted only by a red lamp, into which a loudspeaker emitted unpleasant high frequency sounds; in this cell the prisoner was handcuffed to two steel bars, in order to prevent him protecting his ears from the noise. (d) Plying prisoners with whisky to the point of drunkenness. (e) Handcuffing the prisoner to a post. (f) Ridicule, abuse, threats, confidence tricks, accusations and other non-physical attacks. (g) Stripping to the underpants, possibly combined with standing outside, or with confinement…
1119 JC Penton to Patrick Johnson, Scientific Advisor to the Army Council, 23 Jan. 1957, TNA: WO 342/2. 1120 Anon, Research into the Relationship between Personality and Behaviour during Interrogation, 23 Jan. 1958, TNA: WO 342/2. Anon to JC Penton, Intelligence Problems (New Study), 24 Sept. 1957, TNA: WO 342/2. 1121 Anon to JC Penton, Exercise LONG MAN, 1958, TNA: WO 342/2. 1122 FH Lakin to JC Penton, Exercise WHITE KNIGHT, 11 July 1959, TNA: WO 342/2. 1123 Ibid.
271 (h) Physical jerks and stress positions.1124
The Chinese had used similar methods on Commonwealth and American POWs confined to prison camps from 1950-1953.1125 While a great deal of time and effort had been invested, AORG researchers were largely disappointed with the results of both exercises. They concluded that it was impossible to artificially reproduce the levels of stress that POWs experience.1126 Dr FH Lakin remarked that, ‘The difficulty in devising a sound experimental approach…is almost insuperable.’1127 Troops would be no better prepared after taking part in an escape and evasion exercise. Studies of this nature could even be harmful to interrogator and prisoner alike. The researchers believed that interrogators were in ‘danger of forming bad habits,’ and encouraged to act out ‘sadistic fantasies.’1128 Meanwhile, the prisoner could develop, ‘strong negative feelings towards…members of his own side.’1129 Despite this failure, the AORG did not completely abandon research into mind control during the 1960s. Clinical psychologists were intimately involved in training British interrogators and were routinely attached to teams from the JSIU.1130 Psychiatrist Lieutenant Colonel Warnands (RAMC) also observed and wrote lengthy reports about Army interrogation methods in Cyprus.1131
Finally, Korea served to revive the British Army’s interest in psychological warfare. In a confidential memorandum, the term is defined as, ‘the planned use of propaganda and other
1124 Ibid. 1125 Ministry of Defence, Treatment of British Prisoners of War in Korea, 1955, TNA: ADM 1/25760. 1126 FH Lakin to JC Penton, Exercise WHITE KNIGHT, 11 July 1959, TNA: WO 342/2. 1127 FH Lakin to JC Penton, Intelligence Problems (New Study), 24 Sept. 1957, TNA: WO 342/2. 1128 Ibid. 1129 FH Lakin to JC Penton, Exercise WHITE KNIGHT, 11 July 1959, TNA: WO 342/2. 1130 JB Parry, Air Ministry Science 4 to JC Penton, Army Operational Research Group, 17 Jan. 1957, TNA: WO 342/2. JC Penton to Patrick Johnson, Scientific Advisor to the Army Council, 23 Jan. 1957, TNA: WO 342/2. War Office, Policy Statement (First Draft): Psychological Warfare, 10 Oct. 1955, TNA: WO 342/2. 1131 Anon to JC Penton, Intelligence Problems (New Study), 24 Sept. 1957, TNA: WO 342/2.
272 psychological actions designed to support current policy by influencing the opinions, emotions, attitudes and behaviour of enemy, neutral or friendly groups.’1132 During World War II, the Army, Navy and Air Force had all actively encouraged scientific research into the matter.1133 After the Korean War, the Chiefs-of-Staff revived discussion.1134 A new tri- service Psychological Operations Centre (POC) was opened in the summer of 1959 and was, ‘responsible for conducting courses for officers of the three Services and representatives from other Government Ministries…to teach them the principles of psychological support for military operations.’1135 The majority of teaching took place at the Joint Concealment Centre (JCC) in Netheravon, Wiltshire. 1136 Outside of their pedagogical duties, psychologists were expected to deploy to active theatres.1137 For nearly two and a half years, an operational research section was stationed in Malaya to study the enemy and devise means of undermining morale.1138 When reviewing the lessons of Malaya, Dr Lakin concluded that the team had played, ‘an important part in inducing disaffection and surrender.’1139 The unit had spread word of British victories by dropping
1132 CM Fife, Charter for the Psychological Operations Centre, 7 Nov. 1960, TNA: WO 342/2. 1133 War Office, Third and Final Draft of Policy Statement on Psychological Warfare Equipment, Part I: Military Need, Jan. 1960, TNA: WO 342/2. 1134 Chiefs of Staff Committee--Interdepartmental Working Party on Psychological Warfare Report on First United Kingdom Psychological Warfare Course, Note by Chairman, 18 Oct. 1956, TNA: WO 342/2. Chiefs of Staff Committee--Interdepartmental Working Party on Psychological Warfare, Fostering Research within North Atlantic Treaty Organisation, Note by Chairman, 13 Feb. 1956, TNA: WO 342/2. 1135 CM Fife, Charter for the Psychological Operations Centre, 7 Nov. 1960, TNA: WO 342/2. 1136 Chiefs of Staff Committee--Interdepartmental Working Party on Psychological Warfare Report on First United Kingdom Psychological Warfare Course, Note by Chairman, 18 Oct. 1956, TNA: WO 342/2. 1137 AW Ross, Army Operational Research Group Memorandum No. F10: An Introduction to the Army Operational Research Group, 1955, TNA: WO 291/1437. 1138 Ibid. FH Lakin, Army Operational Research Group Report No. 5/56: Psychological Warfare Research: Its Role in the Cold War, 1956, TNA: WO 291/1509. 1139 FH Lakin, Army Operational Research Group Report No. 5/56: Psychological Warfare Research: Its Role in the Cold War, 1956, TNA: WO 291/1509.
273 leaflets and making announcements over an aircraft loudspeaker.1140 These early triumphs helped to cement a more permanent place for the Psychological Operations Centre.1141
Post Cold War Developments Since the fall of the Soviet Union, British and Canadian troops have deployed to war zones on many occasions. For the first time in years, service psychiatrists have had direct experience of combat and the effects of trauma on regular soldiers. This has contributed to a growing awareness of mental health issues and encouraged greater innovation in care. It has also made servicemen better aware of and prepared to deal with the psychological consequences of war.
CFHS mental health services have expanded substantially over the past decade. 1142 Between 2005 and 2010 alone, the defence budget for psychiatry was doubled and the number of staff employed rose from 212 to 400. The Canadian government has invested heavily in the creation of educational programmes and the extension of clinical services.1143 The Road to Mental Readiness Programme (R2MR) is designed to make servicemen more psychologically, ‘resilient,’ and informed about issues like stress and leadership.1144 Before and after deployment, soldiers and their families are briefed about what challenges and obstacles they can expect. 1145 Operational Trauma Stress Support Centres (OTSSCs) operate at military bases nationwide and provide counselling, treatment for addiction and
1140 Ibid. 1141 Ibid. 1142 The Canadian Forces Medical Service is now referred to as the Canadian Forces Health Service. 1143 Lieutenant Colonel Jim Jamieson, ‘Department of Veterans Affairs Operational Stress Injury Social Support,’ in Canada, House of Commons Standing Committee on Veterans Affairs, 39th Parliament, 1st Session, Number 030 (20 Mar. 2007). 1144 Canadian Forces Health Services, ‘Road to Mental Readiness (R2MR),’ National Defence and Canadian Forces, last modified 2 Sept. 2011, http://www.forces.gc.ca/health-sante/ps/mh-sm/r2mr-rvpm/default-eng.asp. 1145 Ibid.
274 crisis intervention.1146 A mental health team composed of a psychiatrist, nurses and social workers always accompanies deploying Canadian troops.1147
Similar developments have been made in the United Kingdom. Pre and post-deployment briefings commonly take place when soldiers are sent on tour.1148 Uniformed mental health nurses travel with the troops and are responsible for providing care while they are in theatre. On average, consultant psychiatrists visit every three months and can be sent in case of an emergency.1149 In an attempt to identify those at risk for mental health problems, the military has also developed peer support schemes like the Trauma Risk Management programme (TRiM). Initially developed with the Royal Marines, TRiM, ‘practitioners are
1146 Canada, Department of National Defence, CANFORGEN 003/02, 25 Jan. 2002. Canadian Forces Health Services, ‘Mental Health Programs,’ National Defence and the Canadian Forces, last modified 21 July 2008, http://www.forces.gc.ca/health-sante/ps/mh-sm/pg-eng.asp. 1147 Canada, House of Commons Standing Committee on Veterans Affairs, Minutes of Proceedings, 1st session, 39th Parliament, Meeting No. 30 (Lieutenant Colonel Jim Jamieson), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=jim+jamieson&arpidf=2006%2f04%2f03&arpidt=2008%2f09%2f07&arpid=False&arpij=False &arpice=True&arpicl=13177&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&La nguage=E&Mode=1&Parl=41&Ses=1&arpicpd=2778516#Para519641 1148 The utility and efficacy of post-deployment briefings, also known as decompression, has been disputed. Recent articles and chapters that discuss the value of decompression include: Jamie Hacker Hughes, Mark Earnshaw, Neil Greenberg, Rod Eldridge, Nicola T Fear, Claire French, Martin P Deahl and Simon Wessely, ‘The Use of Psychological Decompression in Military Operational Environments,’ Military Medicine 173, No. 6 (June 2008): 534-538 M Fertout, N Jones and N Greenberg, ‘Third location decompression for individual augmentees after a military deployment,’ Occupational Medicine 62, No. 3 (Apr. 2012): 188-195. N Burdett, H Burdett, S Wessely and N Greenberg, ‘The subjective utility of early psychosocial interventions following combat deployment,’ Occupational Medicine 61, No. 2 (2011): 102-107. Martin P Deahl, Adrian B Gillham, Janice Thomas, Margaret M Searle and Michael Srinivasan, ‘Psychological Sequelae Following the Gulf War: Factors Associated with Subsequent Morbidity and the Effectiveness of Psychological Debriefing,’ British Journal of Psychiatry 165 (1994): 60- 65. Jonathan I Bisson, Alexander C McFarlane, Suzanna Rose, Josef I Ruzek and Patricia J Watson, ‘Psychological Debriefing for Adults,’ in Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies, eds. Edna B Foa, Terence M Keane, Matthew J Friedman and Judith A Cohen (New York: The Guildford Press, 2009), 83-105. 1149 British Army, ‘Delivery of Care,’ last modified 2012, http://www.army.mod.uk/welfare- support/23246.aspx
275 embedded within…units and after traumatic events they ensure that the psychological needs of personnel involved in the event are assessed and managed.’1150 As soldiers are often reluctant to speak to a doctor when experiencing mental health problems, ‘TRiM practitioners are non-medical personnel in junior management positions.’1151 According to the King’s College Centre for Defence Mental Health, ‘The TRiM system aims to provide an early indication of who may go on to develop formal illnesses and to empower unit leaders to implement management plans which may help create the best possible conditions for psychological recovery to occur.’1152 In addition to the Royal Marines, the Army has also trained personnel for regiments like the Grenadier Guards. Across the armed forces, TRiM is generally viewed as a positive development though there is no clinical evidence to support its use; the sole study into TRiM showed that it did no harm.1153 When stationed within the United Kingdom, service personnel are expected to access psychiatric care through one of fifteen military departments of community mental health. Treatment is no longer delivered by dedicated military mental hospitals but by an NHS consortium.1154
A great deal has changed since the guns fell silent in Korea. Be that as it may, modern military psychiatry bears a striking resemblance to psychiatry as practiced from 1950-1953. While new drugs and techniques are available, military psychiatry is still based on the same central tenets and doctors still adhere firmly to the principles of PIE (proximity,
1150 British Army, ‘Trauma Risk Management (TRiM),’ last modified 2012, http://www.army.mod.uk/welfare-support/23245.aspx 1151 N Greenberg, V Langston and N Jones, ‘Trauma Risk Management (TRiM) in the UK Armed Forces,’ Journal of the Royal Army Medical Corps 154, No. 2 (2008): 125. N Jones, P Roberts and N Greenberg, ‘Peer-group risk assessment: a post-traumatic management strategy for hierarchal organisations,’ Occupational Medicine 53 (2003): 470. 1152 Greenberg, Langston and Jones, ‘Trauma Risk Management,’ 125. 1153 Ibid., 125-127. 1154 The last dedicated military mental hospital was the Duchess of Kent Psychiatric Hospital in Yorkshire. Originally opened in 1976, the hospital finally closed in 2001. British Army, ‘Delivery of Care,’ last modified 2012, http://www.army.mod.uk/welfare-support/23246.aspx
276 immediacy, expectancy).1155 The authors of the US Army’s textbook on the subject note that: After a soldier has become a psychiatric casualty, it is important to restore as many positive factors as possible: rest, sleep, and nutrition. Bonds to the unit are kept intact with expectation of return to the unit, hence the importance of treating as far forward and as quickly as possible. Treatment must be kept simple to emphasize the normality of the soldier’s experience rather than give an imputation of mental illness.1156
When reviewing recent operations in Afghanistan, Colonel Rakesh Jetley of the CFHS describes a similar process. In a 2006 article in the Canadian Journal of Surgery, he observed that, ‘Most soldiers who have difficulties will respond positively to brief interventions, such as rest, replenishment, brief use of hypnotics and rapid return to duty.’1157 Military psychiatry remains an inherently practical speciality. As Lieutenant Colonel PD McAllister of the RAMC explains, the focus remains firmly on the, ‘maintenance of fighting capability.’1158
Attitudes towards mental illness are significantly more liberal than they were at the time of the Korean War. However, old habits die hard and there is more than enough evidence to suggest that some of the old mind-sets have persisted into the twenty first century. At a 2007 hearing of the Canadian Senate Standing Committee on Veterans Affairs, senators were shocked to hear that soldiers at the Valcartier base popularly referred to the stairs
1155 Hans Binneveld, From Shell Shock to Combat Stress: A Comparative History of Military Psychology. (Amsterdam: Amsterdam University Press, 1998), 137. Captain JJ Flood, ‘Psychiatric Casualties in United Kingdom Elements of Korean Force: Dec. 1950—Nov. 1951,’ Journal of the Royal Army Medical Corps 100, 1 (Jan. 1954): 41. 1156 This is the current edition of the textbook available on the US Army Medical Department Center and School website. http://www.cs.amedd.army.mil/borden/Portlet.aspx?ID=32eabeff-48ce-42ec-b902-a52be47a051a Franklin D Jones, ‘Psychiatric Lessons of War,’ in War Psychiatry: Textbook of Military Medicine, eds. Franklin D Jones, Linette R Sparacino, Victoria L Wilcox, Joseph M Rothberg and James W Stokes (USA: Office of the Surgeon General, 1995), p. 29. 1157 Colonel Rakesh Jetly, ‘Psychiatric lessons learned in Kandahar,’ Canadian Journal of Surgery/Journal canadien de chirurgie 54, 6S (Dec. 2011): 143. 1158 PD McAllister, ‘Career Focus: Military Psychiatry,’ Journal of the Royal Army Medical Corps 152, No. 2 (2006): 105.
277 leading to the psychology clinic as the ‘stairs of shame.’ 1159 Until 2008, Canadian servicemen and women who developed mental health problems while on deployment were not allowed to wear a wound stripe on their uniforms. This was a privilege reserved for the physically injured.1160 In a recent study of stigma in the UK armed forces, the authors contend that, ‘Less than half of those who return from combat with mental health problems…seek help for their disorder.’1161 Many choose to remain silent for fear of how they will be, ‘treated and perceived,’ by their colleagues.1162 While policy has changed, military culture has emerged less altered. By necessity, the armed forces value, ‘physical and psychological resilience in the face of adversity.’1163 Personnel are selected for their self-sufficiency and expected to perform efficiently in a stressful and dangerous environment. By embodying these characteristics, servicemen and women find acceptance from their peers and their superiors. Mental illness can still appear taboo in such a milieu.
1159 Canada, House of Commons Standing Committee on Veterans Affairs, Minutes of Proceedings, 1st session, 39th Parliament, Meeting No. 29, 1 Mar. 2007 (Mr Gilles A Perron), http://www.parl.gc.ca/HouseChamberBusiness/ChamberPublicationIndexSearch.aspx?arpist=s&arp it=gilles+a+perron&arpidf=2007%2f3%2f1&arpidt=2007%2f3%2f2&arpid=False&arpij=False&ar pice=True&arpicl=13177&ps=Parl39Ses0&arpisb=Publication&arpirpp=10&arpibs=False&Langu age=E&Mode=1&Parl=41&Ses=1&arpicpd=2761911#Para489711 1160 On 29 August 2008, the government of Canada announced the creation of the new Sacrifice Medal. The medal replaced the Wound Stripe and is awarded to those soldiers who have, ‘died or been wounded under honourable circumstances as a direct result of hostile action on the condition that the wounds that were sustained required treatment by a physician and the treatment has been documented.’ Mentally ill servicemen are eligible as long as their disorder has been, ‘diagnosed by a qualified mental health practitioner and [judged to be] directly attributable to hostile action.’ Department of National Defence, ‘Canadian Honours Chart: Sacrifice Medal,’ last modified 5 Jan. 2012, http://www.cmp-cpm.forces.gc.ca/dhr-ddhr/chc-tdh/chart-tableau-eng.asp?ref=SM&submit1=Go. Department of National Defence, ‘Examples for the Sacrifice Medal--Eligible Cases,’ last modified 27 Jan. 2012, http://www.cmp-cpm.forces.gc.ca/dhr-ddhr/chc-tdh/smec-msce-eng.asp Rawling, The Myriad Challenges of Peace, 352. 1161 Amy C Iverson, Lauren van Staden, Jamie Hacker Hughes, Neil Greenberg, Matthew Hotopf, Roberto J Rona, Graham Thornicroft, Simon Wessely, and Nicola T Fear, ‘The stigma of mental health problems and other barriers to care in the UK Armed Forces,’ BioMed Central Health Services Research 11 (2011): 1. 1162 Victoria Langston, Neil Greenberg, Nicola Fear, Amy Iversen, Claire French, and Simon Wessely, ‘Stigma and mental health in the Royal Navy: A mixed methods paper,’ Journal of Mental Health 19, 1 (Feb. 2010): 14. 1163 Ibid., 8.
278 Conclusions In the tense atmosphere of the Cold War, Canadian and British forces each prepared for the possibility of global conflict. They had good reason to believe that the standoff between the USA and the USSR would eventually erupt into active hostilities. Despite the increasing importance of security and defence, money was scarce throughout this period. Both the CFMS and the RAMC had to make do with limited resources and exceptionally restricted funding. On a regular basis, commanders were required to make painful decisions. Plans for the expansion of services often came to nought and military hospitals were systematically closed and converted into public institutions. Frugality was central to the formulation of policy. Manpower shortages remained the most persistent and alarming challenge. As medicine became an increasingly specialised discipline, doctors expected to be compensated well for their services. Within the public health system, they successfully fought for better salaries and working conditions. The military could not offer anything comparable. Consequently, recruitment dropped periodically and the CFMS and RAMC were often on the verge of breakdown. Over the past twenty years, they have continued to respond to change. Both have undergone major reorganisation in order to meet the challenges of an increasingly complex operating environment.
The Korean War did not have a significant impact on the formulation of Canadian or British psychiatric policy or everyday clinical care during the Cold War. Experiences in the Far East simply served to reaffirm old lessons that would prove useful in subsequent decades. From the 1950s-1990s, change came from outside the military. Mentally ill patients benefited from the liberalisation of public attitudes and the development of new treatments. Korea’s lasting legacy was an important body of defence medical research. Clinical studies on the psychological effects of cold, troop selection, brainwashing and interrogation were all undertaken to meet problems encountered by the Commonwealth Division. Korea revitalised research of this nature by underlining the relationship between defence, science and the value of understanding human psychology.
279
Conclusion
280 ‘One woman asked my Mum, ‘Where’s John?’ ‘In Korea,’ she answered. The woman replied, ‘Oh, on holidays.’ I’ll say no more.’1164 Australian veteran John Bushy Burke
Fighting on behalf of four different nations, the troops of the 1st British Commonwealth Division lived and worked side by side during the Korean War (1950-1953). They were a unique and closely-knit group. While arguments could arise out of national differences, they succeeded in their goals and were much admired by their allies. The medical team was equally multinational in composition and included British, Canadians, Australians and Indians. However, the officers of the Royal Canadian Army Medical Corps and the Royal Army Medical Corps were principally responsible for the physical and mental health of the division. When I started my doctorate in the autumn of 2009, I set out to provide a comprehensive account of Commonwealth psychiatric practices during the Korean War. Very few scholars have chosen to study the history of the division, let alone the medical and psychiatric aspects of the subject. This represents a significant hole in the literature on the Korean conflict and on the development of military psychiatry in the twentieth century. Due to the multinational scope of the project, it has been challenging to gather source materials over the past several years. Nevertheless, perseverance has prevailed and ‘Invisible Scars’ is the result.
At the beginning of this project, I put forward several key research questions. Firstly, how were soldiers treated for psychiatric disorders in the field and at hospital? Secondly, how successful were doctors in treating the mentally ill in both the short term and the long term? Finally, what effect, if any, did the Korean War have on the evolution and further development of military psychiatry? Throughout the past seven chapters, I have answered each of these questions in turn. In this final chapter, I will review my findings and discuss the larger implications of my conclusions.
1164 John Bushy Burke, quoted in Richard Trembeth, A Different Sort of War: Australians in Korea 1950-53 (Melbourne: Australian Scholarly Publishing, 2005), 150.
281 The Commonwealth Division had a low rate of psychiatric illness and casualties of this kind accounted for only around 1 in 20 wounded or sick.1165 Despite having to endure many privations, the division was well known for its combat efficiency and high levels of morale.1166 In the field and at hospital, psychiatric treatment was practical and in line with methods developed during World War I and World War II. There was a focus on rest, reassurance and brief psychotherapy. Medical officers did not administer drugs extensively and there is no evidence to suggest that physical treatment methods like electroconvulsive therapy were ever employed.1167 Commonwealth doctors were generally successful in returning men to active duty following treatment. Only 5% to 7% of patients were evacuated for hospitalisation in Japan and even fewer were repatriated for long term care.1168 Throughout the Korean War, medics and officers alike were eager to re-employ
1165 Captain JJ Flood, ‘Psychiatric Casualties in United Kingdom Elements of Korean Force: December 1950—November 1951,’ Journal of the Royal Army Medical Corps 100, 1 (Jan. 1954): 46. Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. 1166 General Bruce C Clarke, interview by Jerry N Hess, 14 January 1970, Harry S Truman Library and Museum, date accessed 20 Apr. 2013, http://www.trumanlibrary.org/oralhist/clarkeb.htm David French, Army, Empire and the Cold War: The British Army and Military Policy, 1945-1971 (Oxford: Oxford University Press, 2012), 141. Max Hastings, The Korean War. Pan Grand Strategy Series (UK: Pan Macmillan Books, 2000), 286-287. 1167 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. Anon, Psychiatric Classifications and Criteria, 1958-1967, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1. Captain HCJ L’Etang, ‘A Criticism of Military Psychiatry in the Second World War: Part III Historical Survey,’ Journal of the Royal Army Medical Corps 97, No. 5 (Nov. 1951): 326. Hyam Bolocan, ‘Functions of a Psychiatric Consultant to a Division, and to an Army,’ in Recent Advances in Medicine and Surgery: Based on Professional Medical Experiences in Japan and Korea 1950-1953, Medical Science Publication No. 4 (Washington, DC: US Army Medical Service Graduate School, Apr. 1954). 1168 Anon, 25 Canadian Field Dressing Station War Diary, 1951, LAC: RG24-C-3, Volume 18395. Anon, 25 Canadian Field Dressing Station War Diary, 1952, LAC: RG24-C-3, Volume 18396. Anon, Weekly Returns of UK Patients transferred to BCOF General Hospital from Korea via US Medical Units, 1951, TNA: WO 281/892, 1275-1278. War Office, Report on the Health of the Army 1951-1952, TNA: WO 279/610.
282 men either in their original units or along the division’s line of communications. Commonwealth psychiatric treatment policy was driven by manpower considerations.1169
Like Vietnam, Korea was initially a success story with regards psychiatric medicine. Medical officers excelled in returning men to active duty and return to unit (RTU) rates soared. RTU rates ranged between 50% to 83% from July 1951 to July 1953.1170 Be that as it may, both Korea and Vietnam were problematic in the long term. Commonwealth officials failed to put support systems in place and have only recently encouraged veterans to seek compensation or psychological counselling. This failure was not the result of any deliberate mistreatment or abuse on the part of government or pensions’ officials. Rather, it reflected the medical, cultural and social realities of the period in question. The Korean War took place at a time when psychiatry was still developing and effective psychopharmaceuticals were just beginning to arrive on the market.1171 There was also a strong cultural and social stigma surrounding the mentally ill and seeking treatment for a psychiatric condition. Across the Commonwealth, it was widely believed that problems of this nature should be dealt with privately. The best medicine was active employment. The pensions and care system was a product of the era and of a conservative society. Rehabilitation and treatment programmes were centred on returning veterans to work and fostering economic independence. Compensation was believed to have a detrimental rather than a salutary effect upon the mentally ill. It would only serve to worsen or prolong
1169 Anon, Psychiatric Classifications and Criteria, 1958-1967, LAC: RG24, 1983-84/167 GAD, Box 7985, File No. C-2-6720-1. Bill Rawling, Death Their Enemy: Canadian Medical Practitioners and War (Quebec: AGMV Marquis, 2001), 252. 1170 Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volume 18395-18397. War Office, Report on the Health of the Army 1951-1952, TNA: WO 279/610. 1171 Canadian Mental Health Association, ‘History of the Canadian Mental Health Association,’ last modified 2013, http://www.ontario.cmha.ca/inside_cmha.asp?cID=7620. Liam Clarke, ‘The opening of doors in British mental hospitals in the 1950s,’ History of Psychiatry 4 (1993): 527-551. Ivan Patrick Ryan, Korea Veterans Association of Australia, email message to author, 24 May 2012. Les Peate, Korean Veterans Association of Canada, email message to author, 16 June 2012.
283 symptoms that would diminish over time.1172 While the modern observer might perceive this approach as unfeeling, it was seen as benevolent and generous at the time.
Korean War veterans were also denied other forms of support that had proved valuable in the past. Unlike their predecessors, they were not greeted with parades and acclaim nor were they universally welcomed by veterans’ organisations like the Royal Legion and the Returned & Services League. Responding to enquiries by the author, Ivan Patrick Ryan of the Korea Veterans Association of Australia expressed disappointment in how veterans were received by these groups.1173 Les Peate of the Korea Veterans Association of Canada had a similar response and many veterans from Britain and New Zealand faced rejection as well.1174 Korean War memorials were also not erected until the late 1990s and there were no significant events to highlight the service of those who had fought in the Far East. When the Australian government attempted to secure, ‘royal messages of condolence to the relatives of service personnel killed in Korea,’ they were told that such letters were not issued, ‘in operations of lesser magnitude than a World War.’1175 As Australian historian Richard Trembeth has underlined, ‘It appeared that grief, like bravery, was measured in degrees, and some wars, like some acts of courage, only deserve lesser awards.’1176 Neither the Commonwealth governments nor the public at large acknowledged the sacrifices that the veterans had made or gave them a public forum in which to grieve. There are a number of reasons why this was the case. The war did not involve the same level of public
1172 Alice Aiken and Amy Buitenhuis, Supporting Canadian Veterans with Disabilities (Kingston, ON: Defence Management Studies Program, School of Public Policy, Queen’s University, 2011), 6. Travis E Dancey, ‘The Interaction of the Welfare State and the Disabled,’ Canadian Medical Association Journal 103 (1 Aug. 1970): 274-277. , ‘Treatment in the Absence of Pensioning for Psychoneurotic Veterans,’ The American Psychiatric Journal 107 (1950): 347. 1173 Ivan Patrick Ryan, Korea Veterans Association of Australia, email message to author, 24 May 2012. 1174 Les Peate, Korean Veterans Association of Canada, email message to author, 16 June 2012. Department of Health and Social Security—Central Advisory Committee on War Pensions, Minutes of the 97th Meeting, 18 Nov. 1981, TNA: PIN 88/90. 1175 Trembeth, A Different Sort of War, 48. 1176 Ibid.
284 involvement as WWII and a far smaller group of men were sent to Korea. Over 6,000,000 soldiers from Canada, the United Kingdom, Australia and New Zealand were enlisted or conscripted into the armed forces between 1939 and 1945. In contrast, only 145,000 were deployed from 1950-1953. 1177 Moreover, they had largely volunteered for the task. Presidents Harry S Truman, Dwight D Eisenhower and the Commonwealth Prime Ministers universally referred to Korea as a ‘police action.’1178 Afraid that the use of provocative terminology would only serve to further escalate hostilities, they refused to label Korea as a war.1179 By downplaying the ferocity of the fighting, they contributed to a widespread misunderstanding of events. Finally, UN forces neither won nor lost the Korean War. Unlike WWII, there was no great victory to celebrate or help focus commemorative events.
The Korean War brings up important questions as to why we choose to commemorate one conflict over another. No matter how advanced or attentive military medicine may become, how society responds to returning servicemen is pivotal in how veterans process their experiences and reconcile themselves to loss. WWII veterans were feted as heroes and celebrated for their accomplishments. Vietnam veterans were initially abused and eventually became symbols of an unjust war. Korean War veterans were simply ignored.
1177 British Broadcasting Corporation, ‘WW2 People’s War: Commonwealth and Allied Forces,’ last modified Mar. 2012, http://www.bbc.co.uk/history/ww2peopleswar/timeline/factfiles/nonflash/a6651218.shtml Lieutenant Colonel Herbert Fairlie Wood, Strange Battleground: The Operations in Korea and their Effects on the Defence Policy of Canada (Ottawa: Queen’s Printer and Controller of Stationary, 1966), 257 Anthony Farrar-Hockley, The British Part in Korean War, Vol II: An Honourable Discharge (London: HMSO, 1995), ix. Ian McGibbon, New Zealand and the Korean War, Vol II: Combat Operations (Auckland: Oxford University Press, 1996), vii. Trembeth, A Different Sort of War, 1. 1178 Lieutenant Colonel DK Palit. “Military Lessons of the Korean War.” United Services Institute of India Journal 82, Nos. 348, 349(July-October 1952): 168. Wood, Strange Battleground, 13. 1179 Ibid. Ibid.
285 There is no quantitative way of measuring the impact of this exclusion. Nevertheless, there is more than enough anecdotal evidence to suggest that veterans were negatively affected. There are countless examples. For instance, Jean Rayner’s husband Louis was a driver with the Australian Army during the war. In an interview with author Joy Damousi, Jean later recalled that: One thing that did annoy Lou…was that people called it a pointless action, not a war. Even when I became a war widow, I was asked point blank, ‘How come you’re a war widow?’…And they said, ‘You’re not old enough for the Second World War and you are too old for Vietnam. Now I was asked that point blank. And I said there was such a thing as Korea. And anyway [they said] ‘was that a war?’…. If they hadn’t kicked up a stink about Vietnam, would have been the same thing. Put it out of your mind and forget it, it didn’t happen.1180
Jessie Morland, the wife of another Australian veteran, noted that, ‘it was like they tried to wipe it [Korean War] off the earth…no one ever want[ed] to talk about it.’1181 When former Canadian medic Don Leier applied for a home loan in the early 1960s, the veterans’ loan officer refused him, pointing out, ‘Korea was no war, just a police action. Here’s fifty cents. That’s all you’re getting.’1182
The widespread lack of public acknowledgement is the major contributing factor as to why the Korean War has been neglected as a subject of scholarly debate and interest over the past six decades. Chronologically, Korea is also positioned between two other major wars. As a topic of study, it lacks the scope and scale of WWII or the political controversy of Vietnam. These conflicts have overshadowed and distorted how both academic and popular writers understand Korea. However, the Korean War is historically important for a variety of reasons, many of which have become clear in the course of this dissertation. In terms of military psychiatry, it represents the last major deployment of Commonwealth forces before
1180 Jean Rayner, quoted in Joy Damousi Living with the Aftermath: Trauma, nostalgia and grief in post-war Australia (Cambridge, UK: Cambridge University Press, 2001), 44. 1181 Jessie Morland, quoted in Joy Damousi Living with the Aftermath: Trauma, nostalgia and grief in post-war Australia (Cambridge, UK: Cambridge University Press, 2001), 46. 1182 Don Leier, quoted in Ted Barris, Deadlock in Korea: Canadians at War 1950-1953 (Toronto: Macmillan Canada, 1999), 304-305.
286 a revolution in psychiatric medicine and an example of what practical treatment methods can achieve. It was also the first time that limited tours of duty were uniformly enforced for the purposes of boosting morale. Commonwealth and UN operational goals were constantly evolving and changing between 1950 and 1953. Nevertheless, the Commonwealth Division remained combat effective and morale was high in both periods of rest and intense fighting.1183 As a campaign, Korea shares many similarities with modern operations in Afghanistan and around the world. Working out of static bases, soldiers are called upon to patrol and infiltrate enemy territory on a daily basis. Political necessity dictates the direction of events on the ground and destroying the enemy is not necessarily the end goal. Soldiers, scholars and commentators could all learn a great deal about operations of this nature by studying Korea more closely. ‘Invisible Scars,’ also illustrates that the establishment of long term care and support systems is of equal importance to the development of forward and front line psychiatric treatment. Since 2001, roughly 145 New Zealand, several thousand Australian, 40,000 Canadian and 134, 780 British troops have been deployed to Afghanistan alone.1184 Over 2 million Americans have served in either Afghanistan or Iraq.1185 In a March 2013 article for The Atlantic, journalist and historian James Wright argued that Americans have already begun to forget the war in Afghanistan. Preoccupied by other international commitments and domestic problems, he contends that
1183 General Bruce C Clarke, interview by Jerry N Hess, 14 January 1970, Harry S Truman Library and Museum, date accessed 20 Apr. 2013, http://www.trumanlibrary.org/oralhist/clarkeb.htm French, Army, Empire and the Cold War, 141. Hastings, The Korean War, 286-287. 1184 Associated Press, ‘New Zealand pulls troops out of Afghanistan,’ Fox News, last modified 4 April 2013, http://www.foxnews.com/world/2013/04/04/new-zealand-pulls-troops-out-afghanistan/ Postmedia News, ‘End of Afghan mission leaves vets grappling with their return to Canada,’ National Post, last modified 27 Feb. 2012, http://news.nationalpost.com/2012/02/27/end-of-afghan-mission-leaves-vets-grappling-with-their- return-to-canada/ ‘A Review of the 12 Years of British Troops in Afghanistan,’ Pakistan Kakhuda Hafiz: Leading Alternative Policy Institute, last modified 24 July 2013, http://www.pakistankakhudahafiz.com/opinion/a-review-of-the-12-years-of-british-troops-in- afghanistan/ 1185 Luis Martinez, ‘US Veterans: By the Numbers,’ ABC News, last modified 11 Nov. 2011, http://abcnews.go.com/Politics/us-veterans-numbers/story?id=14928136#1
287 Americans are war weary.1186 Blogging for the London Review of Books on 10 July 2013, retired British ambassador Oliver Miles has made similar claims about his own country.1187 How the public receives these veterans will have a lasting impact on their lives. Korea underlines important lessons about commemoration and acknowledgement that present day policy makers ignore at their peril.
Korea is also an example of successful inter-allied cooperation. Over the past several decades, multinational operations have become increasingly common and a hallmark of the new operating environment. Countries commonly work in tandem with one another for reasons of economy, manpower or politics. For example, the International Security Assistance Force (ISAF) in Afghanistan and the North Atlantic Treaty Organisation (NATO) are multinational groups and recent United Nations (UN) peacekeeping missions to Mali and South Sudan have involved soldiers from all corners of the globe. The Commonwealth Division included four countries with competing agendas and objectives. Canada, Australia and New Zealand were beginning to distance themselves from the United Kingdom and assert their independence. Be that as it may, they were able to compromise for the common good and the benefit of the troops. Besides the Commonwealth countries: Columbia, Belgium, France, Greece, Ethiopia, the Netherlands, Luxembourg, the Philippines, Turkey and Thailand all contributed ground troops to the United Nations Command. There is still much left to be discovered as to how these units worked together and in concert with the Americans. These lessons could be of benefit to those interested in the inner workings of an inter-allied coalition.
1186 James Wright, ‘Have Americans Forgotten Afghanistan?’ Atlantic, 25 Mar. 2013, http://www.theatlantic.com/international/archive/2013/03/have-americans-forgotten- afghanistan/274331/ 1187 Oliver Miles, ‘Why are we still in Afghanistan?’ London Review of Books Blog, last modified 10 July 2013, http://www.lrb.co.uk/blog/2013/07/10/oliver-miles/why-are-we-still-in-afghanistan/
288 There are many other stories waiting to be uncovered. As there are few books and articles on US medical and psychiatric practices, this area of research could prove exceptionally fruitful. American servicemen endured similar privations and suffered from many of the same psychiatric problems as Commonwealth troops. The original source materials for such a project are readily available. The US Army Office of Medical History has digitised numerous articles, reports and statistical charts. The Stimson Library at the US Army Academy of Health Sciences also has a wide selection of online collections that include the Medical Bulletins for the US Army Far East and internal Army medical department (AMD) newsletters from the 1950s-1970s. The remaining documents are all centrally housed at the US National Archives at College Park, Maryland. The necessary war diaries, unit histories and manuscripts on military psychiatry are stored here and are a matter of public record. There also needs to be more research conducted on how both American and Commonwealth veterans have coped with their experiences over the past decades. While small groups have been included in clinical studies of Post Traumatic Stress Disorder (PTSD), the literature remains patchy. Largely ignored by the society on whose behalf they fought, Korean War veterans are unique. They also serve as a valuable comparison to World War II and Vietnam veterans. Interviews will help us to better understand the war and its aftermath. As these men are largely in their eighties and nineties, time is of the essence.
‘Invisible Scars,’ is only the beginning and represents a modest contribution to the literature on the development of military psychiatry and on the Korean War. In future, I hope it will act as a starting point for others who wish to understand the psychological consequences of what happened sixty years ago. Although Korea is popularly referred to as the ‘forgotten war,’ it still haunts many of the men who fought there. Former operating theatre technician Dr David Oates reminisced about his experiences many decades later. He noted, ‘Looking back on those days it is the comradeship I think about and as the years have gone on I have often thought and wondered how those soldiers who passed through our hands are getting
289 on. The broken bones and scarred tissue will have healed, but what of the emotional trauma that these young men suffered?’1188
1188 Dr David Oates, quoted in Eric Taylor, Wartime Nurse: One Hundred Years from the Crimea to Korea, 1854-1954 (London: Robert Hale, 2001), 207.
290 Illustrations
Ill. 1: Depiction of the Canadian demobilisation and reestablishment process. Canadian Rehabilitation Committee, Wartime Information Board, The Whole Picture in Historical Section, Army Headquarters, ‘A Study on Demobilisation and Rehabilitation of the Canadian Armed Forces in the Second World War, c 1939-1945, From Library and Archives of Canada (LAC): COP.CA.V.13
Ill. 2: ‘Arrival of a national service recruit at the Scots Guard depot.’ British official photographer, Untitled, Photograph, From Imperial War Museum (IWM): Central Office of Information Post 1945 Official Collection, D 70137, http://www.iwm.org.uk/collections/item/object/205196736 (accessed 10 June 2013)
291
Ill. 3: Captain AJM Davis of the RCAMC lecturing a service audience on mental health. Anon, photographer, ‘Captain AJM Davis,’ Photograph, March 1945, From LAC: R1196-14-7-E, Item No. 10935, http://collectionscanada.gc.ca/pam_archives/index.php?fuseaction=genitem.displayItem&lang=&rec_nbr=429 5564&rec_nbr_list=4295565,4295564 (accessed 10 September 2012)
Ill. 4: A Cold War era RAMC recruiting poster. Anon, 5 Years in the RAMC, Lithograph, c 1945-1975, From IWM: Art.IWM PST 14607, http://www.iwm.org.uk/collections/item/object/32167, (accessed 10 June 2013).
292
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Ill. 5: Members of Task Force Smith in Korea. United States Army, photographer, Untitled, Photograph, 1950, From United States National Archives and Records Administration (NARA): File No. 111-SC-342731.
Ill. 6: Her Majesty’s Australian Ship (HMAS) Bataan at Inchon on 1 August 1952 Anon, photographer, HMAS Bataan, Photograph, 1 August 1950, From Australian War Memorial (AWM): ID number 300373, https://www.awm.gov.au/collection/300373/ (accessed 14 July 2013).
293
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Ill. 7: ‘(left to right) Ray Morgan, Red Butler, Ken McOrmond, Vern Roy and Roland pose for a photo in Sudbury, Ontario before heading to Chorley Park in Toronto to enlist for the Canadian Army Special Force.’ Anon, photographer, Untitled, Photograph, August 1950, in Ted Barris, Deadlock in Korea: Canadians at War 1950-1953 (Toronto, Canada: Macmillan Canada, 1999).
Ill. 8: ‘A recruitment depot, Merrickville, Australia. The sign details conditions and qualifications for enlistment for service in Korea.’ DH Wilson, photographer, Untitled, Photograph, From AWM: Photograph Collection, ID No. 134322, https://www.awm.gov.au/collection/134322/ (accessed 16 July 2013).
294
Ill. 9: ‘Troops from 3rd Battalion, Royal Australian Regiment (3RAR).’ Claude Rudolph Holzheimer, photographer, Untitled, Photograph, 26 April 1951, From AWM: Photograph Collection, ID No. 147350, https://www.awm.gov.au/collection/147351/ (accessed 12 July 2013).
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Ill. 10: Members of Princess Patricia’s Canadian Light Infantry exercise aboard United States Naval Ship (USNS) Private Joe P Martinez. Anon, photographer, Untitled, Photograph, November 1950, in John Melady, Korea, Canada’s Forgotten War (Toronto, Canada: Macmillan, 1983).
295
Ill. 11: ‘Members of the 16th New Zealand Field Artillery Regiment prepare to fire their 25 pounder gun during a visit of editors and war correspondents from Australian newspapers.’ Douglas Herbert Lee, photographer, Untitled, Photograph, c January 1952, From AWM: ID No. LEEJ0166, https://www.awm.gov.au/collection/LEEJ0166/ (accessed 20 July 2013).
Ill. 12: Lieutenant General Sir Horace Robertson flanked by officers of the Royal Australian Air Force in Pusan, South Korea. Anon, photographer, Untitled, Photograph, December 1950, From AWM: Photograph Collection, ID No. P01254.127, https://www.awm.gov.au/collection/P01254.127 (accessed 23 July 2013).
296
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Ill. 13: Canadian troops practice at Camp Borden, Ontario. Anon, photographer, Untitled, Photograph, c 1950s, From LAC: R112-942-X-E.
Ill. 14: ‘Driver Nathu Singh, a Sikh member of the 60th Indian Field Ambulance Unit standing in front of the Indian and the Red Cross flags in Korea.’ Anon, photographer, Untitled, Photograph, c. 1950-1953, From IWM: Central Office of Information Korean War Official Collection, Cat No. MH 32046, http://www.iwm.org.uk/collections/item/object/205190017 (accessed 24 July 2013).
297
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Ill. 15: British Commonwealth General Hospital in Kure, Japan. David Oates, photographer, Untitled, Photograph, c 1950-1953, From Memories of Kure, http://www.kurememories.com/ (accessed 10 June 2010).
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Ill. 16: 1st British Commonwealth Division Headquarters at Tokchong. 2nd Lieutenant CE Goodman, photographer, Untitled, Photograph, c November 1951-December 1952, From Canadian War Museum/ Musée canadien de la guerre (CWM): Photo Archives, File No. 52E 8.2.
298
Ill. 17: ‘The British Minister of Defence, Field Marshal Sir Harold Alexander with Major General AJH Cassels, Commander 1st Commonwealth Division, in “Gloucester Valley.”’ Anon, photographer, Untitled, Photograph, c 1951-1952, From IWM: Ministry of Defence Post 1945 Official Collection, Cat No. BF 10734, http://www.iwm.org.uk/collections/item/object/205190875 (accessed 1 July 2013).
Ill. 18: ‘Australian Director General of Medical Services Major General Frank Kingsley Norris (centre) meets with (left to right) Deputy Director of Medical Services Colonel Nye, British Director General of Medical Services Brigadier Taylor, an unnamed Australian Major and Assistant Director of Medical Services of the 1st Commonwealth Division, Colonel Anderton.’ Philip Oliver Hobson, photographer, Untitled, Photograph, 1951, From AWM: ID No. HOBJ2220, https://www.awm.gov.au/collection/HOBJ2220/ (accessed 1 June 2013).
299
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Ill. 19: 25 Canadian Field Ambulance at the US Army base in Washington before departure for Korea. Anon, photographer, Untitled, Photograph, c 1951, CWM: Photo Archives, File No. 52A 6 16.
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Ill. 20: 25 Canadian Field Dressing Station at Camp Borden, Ontario before embarking for Korea. Anon, photographer, Untitled, Photograph, c 1951, From LAC: RG24-C-3, Volume 18395.
300
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Ill. 21: 25 Canadian Field Dressing Station in Seoul. Anon, photographer, Untitled, Photograph, c 1950-1953, From the National Archives at Kew (TNA): WO 281/899.
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Ill. 22: Nursing Sister Marie Guimond of the RCAMC attends to a patient at the British Commonwealth Communications Zone Hospital. Anon, photographer, Untitled, Photograph, c 1952-1953 in GWL Nicholson, Canada’s Nursing Sisters, Historical Publications 13, ed. John Swettenham, Canadian War Museum (Toronto, Canada: Samuel Stevens, 1975)
301
Ill. 23: ‘Private Vic Arsenault takes Private Russ Sutherland for a tour around the grounds at the Commonwealth Hospital in Kure. Both men are Canadian soldiers.’ Sergeant William Olsen (Canadian Army), photographer, Untitled, Photograph, c 1950-1953, From IWM: Central Office of Information, Korean War Official Collection, MH 33019A, http://www.iwm.org.uk/collections/item/object/205191643 (accessed 10 April 2013).
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Ill. 24: ‘A grief stricken American infantryman whose buddy has been killed in action is comforted by another soldier. In the background a corpsman methodically fills out casualty tags, Haktong-ni area, Korea.’ Sargent First Class Al Chang, photographer, Untitled, Photograph, 28 August 1950, From NARA: Records of the Office of the Chief Signal Officer (111-SC-347803) [VENDOR #122].
302
Ill. 25: ‘A wounded British lieutenant receives aid from 3rd US Division medics near Uijongbu, Korea.’ Corporal E Welter, photographer, Untitled, Black & White, Photograph, c 1950-1953, From IWM: Central Office of Information, Korean War Official Collection, Cat No. KOR 659, http://www.iwm.org.uk/collections/item/object/205191640 (accessed 21 April 2013).
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Ill. 26: Aerial view of the forward section of 25 Canadian Field Dressing Station in August 1952. Number 3 at the bottom left hand side of the picture indicates where the hospital tents were located. Anon, photographer, Untitled, Photograph, August 1952, From LAC : RG24-C-3, Volume 18396.
303
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Ill. 27: ‘(left to right) Former prisoners of war Paul Dufour, George St Germain, Joseph Binette, Ernie Taylor, Len Badowich, Jim Gunn, Barry Gushue, Victor Percy and Red Cross worker Ina McGregor travel to 25 Canadian Field Dressing Station.’ Jim Lynch, photographer, Untitled, Photograph, 1953, in Ted Barris, Deadlock in Korea: Canadians at War 1950-1953 (Toronto, Canada: Macmillan Canada, 1999).
Ill. 28: 3rd Battalion Royal Australian Regiment Regimental Aid Post Claude Rudolph Holzheimer, photographer, Untitled, Photograph, From AWM: ID No. 147776, https://www.awm.gov.au/collection/147776/ (accessed 25 April 2013).
304
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Ill. 29: Private Heath Matthews of the Royal Canadian Regiment waits to be seen by a medical officer at a regimental aid post. Paul Tomelin, photographer, Untitled, Photograph, June 1952, From LAC: PA 128850.
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Ill. 30: An example of a field ambulance in Korea (37 Canadian Field Ambulance) Anon, photographer, 37 Canadian Field Ambulance, Photograph, July 1952, From LAC: RG24-C-3, Volume 18384.
305
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Ill. 31: ‘(left to right) Lance Corporal Wally Jones, Private Alan Markus and Private Doug McCallum from B Company, 1st Battalion Royal Canadian Regiment rest after an attack by Chinese troops.’ Anon, photographer, Untitled, Photograph, October 1952 in John Melady, Korea, Canada’s Forgotten War (Toronto, Canada: Macmillan, 1983).
Ill. 32: Her Majesty’s Hospital Ship Maine. Lieutenant EE Allen, Royal Navy Official Photographer, Untitled, Photograph, c 1939-1945, From IWM: Admiralty Official Collection, Cat No. A 20352, http://www.iwm.org.uk/collections/item/object/205119751 (accessed 25 April 2013).
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Ill. 33: Soldiers exercising at No. 6 Convalescent Training Depot in Kure. Philip Oliver Hobson, photographer, Untitled, Photograph, c 1951-1953, From IWM: Central Office of Information Korean War Official Collection, Cat No. MH 32739, http://www.iwm.org.uk/collections/item/object/205190712 (accessed 24 April 2013).
Ill. 34: Patients from the British Commonwealth General Hospital on a trip to an animal park on the island of Miyajima. Harold Vaughan Dunkley, photographer, Untitled, Photograph, c February 1951, From AWM: ID No. DUKJ3882, https://www.awm.gov.au/collection/DUKJ3882/ (accessed 20 April 2013).
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Ill. 35: A Commonwealth patient being loaded onto a plane for evacuation. Anon, photographer, Untitled, Photograph, From TNA: AIR 20/7782.
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Ill. 36: Royal Victoria Hospital Netley Anon, photographer, Untitled, Photograph, No Date, From Netley Military Cemetery, http://www.netley-military-cemetery.co.uk/royal-victoria-hospital/ (accessed 19 April 2013).
308
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Ill. 37: Ste-Anne-de-Bellevue Hospital Anon, photographer, Military Hospital, Ste-Anne-de-Bellevue, PQ--13, Photograph, No Date, From Acadian Family, http://acanadianfamily.wordpress.com/2009/04/29/my-paternal-grandfathers-military-career/ (accessed 19 April 2013).
Ill. 38: Republic of Korea Service Corps unloading American C-4 and C-6 rations for the Royal Australian Regiment. Ian Robertson, photographer, Untitled, Photograph, 1950, From AWM: ID No. P02201.081, https://www.awm.gov.au/collection/P02201.081 (accessed 11 May 2013).
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Ill. 39: Australian soldiers Private Bob Parker and Private Vin O’Brien read mail that they have collected from the Post Office. Philip Oliver Hobson, photographer, Untitled, Photograph, 6 August 1953, From AWM: ID No. HOBJ4562, https://www.awm.gov.au/collection/HOBJ4562/ (accessed 11 May 2013).
Ill. 40: Navy, Army and Air Force Institutes Mobile Canteen serving a group of Commonwealth soldiers. Ian Robertson, photographer, Untitled, Photograph, 1951, From AWM: ID No. P01813.741, https://www.awm.gov.au/collection/P01813.741 (accessed 24 May 2013).
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Ill. 41: The snack bar at the Empire Club in Hiro, Japan. Claude Rudolph Holzheimer, photographer, Untitled, Photograph, 1953, From AWM: ID No. 148707, https://www.awm.gov.au/collection/148707/ (accessed 24 May 2013).
Ill. 42: British soldiers pose with a sailor in front of the Kookaburra Club. Harold Vaughan Dunkley, photographer, Untitled, Photograph, June 1951, From AWM: ID No. DUKJ4425, https://www.awm.gov.au/collection/DUKJ4425/ (accessed 23 May 2013).
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Ill. 43: Soldiers from 38 Canadian Field Ambulance compete in a tug of war. Anon, photographer, Untitled, Photograph, c 1952-1953, From LAC: RG 24, 1983-1984/167, File R112-135- 3-E, Volume 18393.
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Ill. 44: Canadian troops play hockey on the Imjin River. Anon, photographer, Untitled, c 1951-1953, Photograph, From LAC: PA-128850.
312
Ill. 45: Commonwealth soldiers work on an iceboat. Vince J Sweeney, photographer, Untitled, 2 February 1956, Photograph, From AWM: ID No. SWEJ0208, https://www.awm.gov.au/collection/SWEJ0208/ (accessed 4 May 2013).
Ill. 46: ‘Warrant Officer Class 1 (WO1) Trevor Williams of South Grafton, New South Wales (left), Chief Announcer of the Crown Radio, the British Commonwealth Radio Station in Korea, was kept busy before Christmas recording troops Christmas greetings. He is seen here holding the microphone for Staff Sergeant TE (Sandy) Powell of Oatlands, Tasmania. WO1 Williams was an announcer…for four years before joining the Army.’ Philip Oliver Hobson, photographer, Untitled, Photograph, 3 December 1954, AWM: ID No. HOBJ5567, https://www.awm.gov.au/collection/HOBJ5567/ (accessed 4 May 2013).
313
Ill. 47: Private William Alfred Smith of the Royal Australian Regiment at work in the camp cinema. Claude Rudolph Holzheimer, photographer, Untitled, November 1955, Photograph, From AWM: ID No. HOLJ0138, https://www.awm.gov.au/collection/HOLJ0138/ (accessed 4 May 2013).
Image removed for copyright purposes
Ill. 48: ‘French-speaking singer Lorraine McAllister and accordionist Karl Karleen perform for Royal 22e Régiment in Korea.’ Dal Richards, photographer, Untitled, Photograph, in Ted Barris, Deadlock in Korea: Canadians at War 1950-1953 (Toronto, Canada: Macmillan Canada, 1999).
314
Ill. 49: Chaplain Clout delivers a service to the 1st Battalion Royal Australian Regiment. Douglas Herbert Lee, photographer, Untitled, Photograph, 1952, From AWM: ID No. LEEJ0696, https://www.awm.gov.au/collection/LEEJ0696/ (accessed 4 May 2013).
Image removed for copyright purposes
Ill. 50: (left to right) Allan Minette, Gerald Patenaud, Roy Temple and Henry Graveling of Lord Strathcona’s Horse celebrate the end of the Korean War. Jim Lynch, photographer, Untitled, Photograph, July 1953, in Ted Barris, Deadlock in Korea: Canadians at War 1950-1953 (Toronto, Canada: Macmillan Canada, 1999).
315
Image removed for copyright purposes
Ill. 51: Trooper Richardson greets his family at Southampton. Hulton, photographer, Untitled, Photograph, September 1953, in General Sir Anthony Farrar-Hockley, The British Part in Korean War, Volume II: An Honourable Discharge (London, UK: HMSO, 1995).
Ill. 52: ‘Australian soldiers waiting to return to base after the Battle of Long Tan in Vietnam.’ Anon, photographer, Untitled, Photograph, 18 August 1966, From AWM: Negative ID No. CUN/66/704/VN, http://www.anzacsite.gov.au/5environment/timelines/australia-at-war-1901-2000/1967-1970.html (accessed 4 May 2013).
316
Image removed for copyright purposes
Ill. 53: ‘An anti-Vietnam War demonstration in Victoria Square, Adelaide.’ Anon, photographer, Untitled, Photograph, 1971, National Library of Australia (NLA): pic-vn4268191, http://vietnam-war.commemoration.gov.au/conscription/moratoriums-and-opposition.php (accessed 4 May 2013).
Image removed for copyright purposes
Ill. 54: Lieutenant General Roméo Dallaire. Anon, photographer, Roméo Dallaire, Photograph, c 1990s, http://legionmagazine.com/en/index.php/2011/05/romeo-dallaire/ (accessed 1 June 2013).
317
Image removed for copyright purposes
Ill. 55: National Defence Medical Centre Anon, photographer, NDMC, Photograph, c 1960s, in Anon, ‘Defence Construction Projects Through the Decades,’ Defence Construction Canada/Construction de Défense Canada, http://www.dcc-cdc.gc.ca/english/history_1960_projects.html (accessed 1 May 2013).
Image removed for copyright purposes
Ill. 56: Dr Donald Olding Hebb Anon, photographer, Untitled, Photograph, No date, From the Canadian Medical Hall of Fame, http://www.cmaj.ca/site/100/medleaders.xhtml (accessed 1 June 2013).
318
Image removed for copyright purposes
Ill. 57: An image comparing pre and post deployment Road to Mental Readiness (R2MR) briefings to the stops needed during a road trip. Anon, The Deployment Highway, Chart, 2013, From Directorate of Mental Health, Department of National Defence, Canadian Armed Forces, http://www.forces.gc.ca/en/caf-community-health-services-r2mr- family/index.page (accessed 1 May 2013).
Image removed for copyright purposes
Ill. 58: British mental health nurse attends to a patient. Anon, photographer, Untitled, Photograph, No date, From British Army Role Finder, http://www.army.mod.uk/rolefinder/role/147/mental-health-nursing-officer/ (accessed 7 June 2013).
319
Appendices
320 Appendix A Chronology of Important Events June 1950-December 1953
1950
25 June North Korean People’s Army (NKPA) attacks the Republic of Korea
27 June United Nations calls upon member states to, ‘furnish such assistance to the Republic of Korea as may be necessary to repel armed attack and to restore international peace and security in the area.’1189
28 June North Korean forces capture Seoul.
29 June United Kingdom, Australia and New Zealand announce that they will send naval forces to Korea.
1 July American ground troops arrive in Korea as part of Task Force Smith.
7 July American officer, General Douglas MacArthur is appointed as Commander-in-Chief of UN forces in Korea
12 July Canadian naval forces despatched for service in Korea.
26 July Australia, Britain and New Zealand announce that ground troops will be sent to Korea.
August UN forces retreat to a perimeter around Pusan on the south coast of Korea.
7 August Canadian Government announces the recruitment of a Canadian Army Special Force (CASF) for Korea
28 August 27th British Infantry Brigade lands at Pusan. They are put under the command of I Corps, US Eighth Army.
1189 83 (1950). Resolution of 27 June 1950 [S/1511], as quoted in, Evan Luard, A History of the United Nations, Vol. 2: The Years of Western Domination 1945-55 (London and Basingstoke, UK: The Macmillan Press Ltd., 1982), 241-242.
321 5 September 27 Brigade becomes operational.
15 September US X Corps lands at Inchon on the northwest coast of Korea in order to outflank the NKPA.
22 September US Eighth Army manages to break out of the Pusan Perimeter.
26 September UN forces recapture Seoul.
28 September 3rd Battalion Royal Australian Regiment arrives in Korea and joins 27 Brigade.
30 September Republic of Korea (ROK)/South Korean troops advance across the 38th parallel.
September-October UN forces capture the North Korean capital of Pyongyang and advance towards the Yalu River.
14 October Chinese forces cross the Yalu River
25 October Chinese forces launch first phase offensive.
November Chinese launch second phase offensive and UN forces retreat. 29 British Independent Infantry Brigade arrives in theatre. They are supported by 26 British Field Ambulance, 22 Field Surgical Team, 9 Field Transfusion Team, 223 and 224 Mobile Dental Teams. 29 British General Hospital (29 BGH) opens in Kure, Japan with 400 beds available. A 30-bed psychiatric unit is opened under the command of Captain JJ Flood (RAMC).
December 60th Indian Parachute Field Ambulance arrives in theatre to support 27 Brigade.
18 December 2nd Battalion Princess Patricia’s Canadian Light Infantry (PPCLI) land in Pusan.
December-January Chinese launch third phase offensive.
1951
4 January Seoul falls to North Korean and Chinese forces. 27 Brigade acts as rear guard for the withdrawal of UN forces.
322
14 January UN front line stabilises.
22 January 16 New Zealand Field Artillery Regiment arrives in Korea to support 27 Brigade.
February 2nd Battalion PPCLI joins 27 Brigade
14-17 February Chinese launch fourth phase offensive.
February-March UN forces launch Operation Killer in response to Chinese fourth phase offensive.
March UN forces advance across the Han River as part of Operation Ripper.
3-15 March 27 Brigade advances to Kapyong as part of Operation Rugged.
18 March UN forces recapture Seoul.
Spring The number of beds available at 29 BGH is raised from 400 to 600.
April On orders from President Harry S Truman, General Matthew Ridgway takes over command of UN forces from General MacArthur. 28 British Commonwealth Infantry Brigade relieves 27 Brigade. Canadian medical reconnaissance teams tour Korea and Japan in preparation for the arrival of the 25th Canadian Infantry Brigade.
22 April Chinese launch fifth phase offensive and push towards Seoul.
22-25 April Battle of Imjin River
24-25 April Battle of Kapyong
May Chinese launch offensive. Remaining forces of 25 Canadian Infantry Brigade arrive in theatre and the 2nd Battalion PPCLI is integrated into the unit. 25 Canadian Field Ambulance accompanies the troops.
20 May Chinese offensive halted by UN forces
May-June UN forces advance north.
323 Summer An 80-bed Canadian section of 29 British General Hospital is opened.
June-July Negotiations for a cease-fire begin. UN forces establish a defensive line.
July Rotation of Australian troops.
2 July No. 6 Convalescent Depot opens in Kure with 200 beds available.
21 July 25 Canadian Field Dressing Station arrives in theatre Major RJA Robitaille (RCAMC) is attached to the field dressing station as a psychiatrist.
28 July 1 Commonwealth Division is officially formed. Major General AJH Cassels is appointed as the General Officer Commanding of the Division. Colonel G Anderton (RAMC) assumes his appointment as the division’s first Assistant Director of Medical Services (ADMS). Major Robitaille (RCAMC) becomes divisional psychiatrist.
9 August 25 Canadian Field Dressing Station moves to Seoul. The unit can accommodate 200 patients. The psychiatric wing has room for 44 patients.
2-15 October Operation Commando
October-November Rotation of Canadian troops.
October-December Rotation of British troops.
December 29 British General Hospital becomes the British Commonwealth General Hospital (BCGH). The hospital expands to a 1,000 bed facility. Brigadier JE Snow (RAMC) serves as the hospital’s first commandant and Director of Medical Services.
1952
February British Director General of Army Medical Services (DGAMS) Lieutenant General Sir Cantlie and divisional Deputy Director of Medical Services (DDMS) Brigadier CW Nye (RAAMC) tour medical units in Korea and Japan.
324 18 March Psychiatrist Major Franklin Cyril Rhodes Chalke (RCAMC) replaces Major Robitaille as divisional psychiatrist.
April-May Rotation of Canadian troops Rotation of Australian troops. No. 37 Canadian Field Ambulance relieves 25 Canadian Field Ambulance.
May Colonel GL Morgan Smith (RCAMC) replaces Colonel Anderton as the Assistant Director of Medical Services. Colonel ANT Meneces (RAMC) arrives in Japan to assume appointment as the officer commanding the British Commonwealth General Hospital.
June-September Rotation of British troops.
18 June An 80-bed forward section of 25 Canadian Field Dressing Station opens. A third of the beds are allocated for psychiatric patients. A rear-section of the field dressing station continues to operate in Seoul.
August Colonel ANT Meneces (RAMC) and a party of officers visit Commonwealth medical units in the field to assess the feasibility of opening a new composite medical unit in Seoul.
September The rear section of 25 Canadian Field Dressing Station moves forward to the Tokchong-Uijongbu area.
7 September Major General Michael Montgomerie Alston-Roberts-West replaces Major General Cassels as commanding officer of 1 Commonwealth Division.
16 September The British Commonwealth Communications Zone Medical Unit (BCCZMU) opens in Seoul.
3 October Major JL Johnston (RCAMC) arrives in theatre to replace Major FCR Chalke (RCAMC) as divisional psychiatrist.
15 December Lieutenant NG Fraser (RAMC) is attached to 25 FDS. He serves as a clinical assistant in psychiatry to divisional psychiatrist Major Johnston (RCAMC).
325 1953
February Lieutenant NG Fraser (RAMC) promoted to rank of Captain.
Spring Rotation of Canadian troops.
March Brigadier RV Franklin (RAMC) arrives in Japan to replace Brigadier O’Meara as DDMS. Rotation of Australian troops.
April Major JS McCannel (RCAMC) replaces Major GL Morgan Smith (RCAMC) as ADMS.
20 April-3 May Operation Little Switch (exchange of sick and wounded prisoners of war)
May Captain NG Fraser (RAMC) replaces Major JL Johnston (RCAMC) as divisional psychiatrist when the latter has to return home unexpectedly.
1 May No. 38 Canadian Field Ambulance relieves No. 37 Canadian Field Ambulance
July Rotation of British troops.
27 July Armistice signed
5 August- 6 September Operation Big Switch (exchange of remaining prisoners of war)
29 August 60 Indian Field Ambulance is re-assigned to the United Nations Custodian Force.
September Psychiatrist Major Magrath (RAMC) visits Korea.
October Psychiatric unit moves to 26 British Field Ambulance.
16 December No. 38 Canadian Field Ambulance is redesignated No. 4 Canadian Field Ambulance
Archival Sources: Anon, 25 Canadian Field Dressing Station War Diaries, 1951-1953, LAC: RG24-C-3, Volumes 18395-18397.
326 Anon, British Commonwealth Communications Zone Medical Unit War Diary 1952, TNA: WO 281/898. Anon, Historical Notes: Medical Services, British Commonwealth Forces Korea, TNA: WO 308/21.
327 Appendix B Organisation of the 27th British Commonwealth Brigade and 29th British Independent Infantry Brigade Group January/February 1951
Reproduced from: General Sir Anthony Farrar-Hockley, The British Part in Korean War, Vol II: An Honourable Discharge (London, UK: HMSO, 1995), Appendix B.
27 Brigade 29 Brigade
Commander Commander Brigadier AB Coad Brigadier T Brodie
Headquarters Staff Headquarters Staff
Brigade Major Brigade Major (Major JD Stewart) (Major KRS Trevor)
GSO3 GSO 3 (Operations) Intelligence Officer GSO 3 (Staff Duties) GSO 3 (Liaison) GSO 3 (Intelligence) Intelligence Officer & specialist sections
DAA& QMG DAA&QMG (Major A Hunter) (Major BJ Eastwood) Staff Captain ‘A’ Staff Captain ‘A’ Staff Captain ‘Q’ Staff Captain ‘Q’ Transport Officer Brigade RASC Officer Brigade Ordnance Officer Brigade Ordnance Officer Brigade Electrical & Brigade Electrical & Mechanical Engineer Mechanical Engineer Pay, Chaplains, Postal services etc.
Provost Provost Brigade Section Brigade (GHQ) Company (f)
Camp staff including Camp staff including Defence & Employment Transport Officer and Platoon Defence & Employment Platoon
328 Brigade Signals Brigade Signals Signal Troops, Signal Squadron, Royal Signals Royal Signals
ARMOUR ARMOUR 8th The King’s Royal Hussars (8H)
Commanding Officer Lt Col Sir WM Lowther bt
Regimental Headquarters including: Reconnaissance and Signals Troops
Three sabre squadrons, each 20 Centurion tanks
Troop, Royal Signals LAD REME
C Squadron, 7th Royal Tank Regiment (C Sqn, 7 RTR) Officer Commanding Major AJD Pettingell
Four troops, each 4 Centurion tanks (c)
INFANTRY INFANTRY (b) 1st Battalions: 1st Battalions: The Middlesex Regiment The Royal Northumberland (1 MX) Fusiliers (1 NF)
Commanding Officer Commanding Officer Lt Col AN Man Lt Col KON Foster
The Argyll & Sutherland The Gloucestershire Highlanders (1 A&SH) Regiment (1 GLOSTERS) Lt Col GL Neilson Lt Col JP Carne
3rd Battalion, The Royal Royal Ulster Rifles Australian Regiment (1 RUR) (3RAR) Lt Col RJH Carson Lt Col IB Ferguson
329 each, with Headquarters Company, Support [Weapons] Company and four rifle companies (periodically reduced to three in 27 Brigade)
ARTILLERY ARTILLERY 16th Field Regiment, 45th Field Regiment, Royal New Zealand Royal Artillery Artillery (16 Fd Regt) (45 Fd Regt)
Commanding Officer Commanding Officer Lt Col JW Moodie Lt Col MT Young each with three batteries of 8 x 25-pounder field guns, total 24 guns, and a light aid detachment, REME and RNZEME
Troop, Royal Signals
11th (Sphinx) Light Anti- Aircraft Battery (11 LAA Bty) Officer Commanding Major LVF Fawkes
170 Mortar Battery (170 Mor Bty) Officer Commanding Captain CSR Dain
ENGINEERS 55 Independent Field Squadron, RE (55 Indep Fd Sqn) Officer Commanding Major AE Younger
SUPPLY AND TRANSPORT SUPPLY AND TRANSPORT Artillery Ammunition 57 Company, Royal Army Platoon, RNZASC Service Corps, (57 Coy) (d) and Workshop Platoon, REME Officer Commanding Major MGM Crosby
MEDICAL MEDICAL 60th Parachute Field 26th Field Ambulance Ambulance, IAMS RAMC (26 Fd Amb) (60 Para Fd Amb)
330 Commanding Officer Commanding Officer Lt Col AG Rangaraja Lt Col A McLennan with: 22 Field Surgical and 9 Field Transfusion Teams, 223 and 224 Mobile Dental Teams
ORDNANCE (e) ORDNANCE (e) 27 Brigade Ordnance 29 Brigade Ordnance Field Park (OFP) Field Park (OFP) Royal Army Ordnance Corps Officer Commanding Officer Commanding Major J Mockford Captain HWB Hatcher
ELECTRICAL & ELECTRICAL & MECHANICAL ENG. MECHNICAL ENG. 11 Infantry Workshops 10 Infantry Workshops (11 Inf Wksps) (10 Inf Wksps) Royal Electrical and Mechanical Engineers Officer Commanding Officer Commanding Major JR Matthews Major JC Smith
29 Brigade and Support Troops Light Aid Detachment (LAD)
PAY PAY 27 Brigade Field Cash 208 Field Cash Office, (FCO) Office, (FCO) Royal Army Pay Corps
Notes--see variously in text, (b) to (f).
a.) As will be apparent, 29 Brigade was more than twice the strength of 27 Brigade and backed by a Field Maintenance Area and supporting organisation of the British Commonwealth Korean Base. Fortunately, this was of sufficient magnitude to support 27 Brigade progressively from December 1950, when its withdrawal to Hong Kong was suspended without extra resources. b.) Infantry--The British battalions in 27 Brigade were manned nominally at 650 ranks, effectively about 560 present in operations. Those in 29 Brigade were established at 983 to which were added first reinforcements of 185, maintaining 880 in operations. c.) Armour--The Churchills were originally disposed as ‘Crocodiles’-flamethrowing tanks towing a trailer with flame fuel--but were more frequently employed solely with their 75mm gun as the main armament d.) Transport--57 Company RASC had 90 x 3 ton trucks for supply and transport of brigade units, in addition to those employed for its own domestic purposes. These were periodically shared with 27 and, later, 28 Brigades, but the distance between the operational areas often
331 meant that the latter were obliged to rely on the United States resources to lift troops. As difficulties in obtaining American trucks persisted, the New Zealand transport platoon, deployed to supply 16 Field Regiment with gun ammunition became a maid of all work, while giving first call on its services to artillery ammunition requirements. e.) Ordnance--Each REME workshop was supported by a stores section, RAOC additional to the units shown. f.) Provost--To provide 29 Brigade with a military police unit of sufficient strength, 249 General Headquarters Provost Company, Royal Military Police, had been deployed to it numbering 4 officers and 86 other ranks--disposing four strong operating sections. The 27 Brigade section numbered 16 all ranks.
332 Appendix C 1st Commonwealth Division Order of Battle, 1st August 1951
Reproduced from: General Sir Anthony Farrar-Hockley, The British Part in Korean War, Vol. II: An Honourable Discharge (London, UK: HMSO, 1995), Appendix E.
Commander Major General Archibald Halkett Cassels (UK)
Headquarters and Principal Staff Officers
GSO 1 Lt Col ED Danby (CAN) AA & QMG Lt Col AWNL Vickers (UK)
ARTILLERY INFANTRY BRIGADES
Commander Brigadier WGH Pike (UK) Brigade Major Major PM Victory (UK)
2nd Regiment, Royal Canadian Horse Artillery Commanding Officer Lt Col AJB Bailey (CAN)
16th Field Regiment, Royal New Zealand Artillery Commanding Officer Lt Col JW Moodie (NZ)
45th Field Regiment, Royal Artillery Commanding Officer Lt Col MT Young (UK)
11th (Sphinx) Battery, Royal Artillery Officer Commanding Major LVF Fawkes (UK)
333
170th Light Battery, Royal Brigade Officer Commanding Major TV Fischer-Hoch (UK)
ENGINEERS
Commander Colonel ECW Myers (UK)
28th Field Engineer Regiment, Royal Engineers Commanding Officer Lt Col PWM Moore (UK)
57th Independent Field Squadron, Royal Canadian Engineers Commanding Officer Major DH Rochester (CAN)
64th Field Park Squadron, Royal Engineers Officer Commanding Major JA Keer (UK)
SIGNALS
Commander, Divisional Royal Signals and Signal Regiment Lt Col AL Atkinson (UK)
SUPPLY & TRANSPORT
Commander, Royal Army Service Corps Lt Col MGM Crosby (UK)
10 Company RNZASC 54 Company RCASC 57 Company RASC
MEDICAL
Assistant Director of Medical Services Colonel G Anderton (UK)
334 25th Canadian Field Dressing Station, Royal Canadian Army Medical Corps Commanding Officer Major WR Dalziel (CAN)
25th Canadian Field Ambulance, Royal Army Medical Corps Commanding Officer Lt Col BLP Brosseau (CAN)
26th Field Ambulance, Royal Army Medical Corps Commanding Officer Lt Col A McLennan (UK)
60th Indian Parachute Field Ambulance Commanding Officer Lt Col AG Rangaraja (IN)
ORDNANCE
Commander, Royal Army Ordnance Corps Lt Col MF Maclean 1st Commonwealth Division Ordnance Field Park 1st Commonwealth Division Stores Distribution Unit
ELECTRICAL & MECHANICAL ENGINEERS
Commander, Royal Electrical & Mechanical Engineers Lt Col HG Good (UK)
10 Infantry Workshops, REME 16 Infantry Workshops, REME 191 Canadian Infantry Workshops, RCEME
ARMOUR
8th Hussars Commanding Officer Lt Col Sir WM Lowther bt (UK) C Sqn, Lord Strathcona’s Horse Officer Commanding Major JW Quinn (UK)
335
INFANTRY BRIGADES
25th Canadian Infantry Brigade Commander Brigadier JM Rockingham (CAN)
2nd Battalion, the Royal Canadian Regiment Commanding Officer Lt Col RA Keane (CAN)
2nd Battalion, Princess Patricia’s Canadian Light Infantry Commanding Officer Lt Col JR Stone (CAN)
2nd Battalion, Royal 22e Regiment Commanding Officer Lt Col JA Dextraze (CAN)
28th British Commonwealth Brigade Commander Brigadier G Taylor (UK)
1st Battalion, The King’s Own Scottish Borderers Commanding Officer Lt Col JFM MacDonald (UK)
1st Battalion, The King’s Own Shropshire Light Infantry Commanding Officer Lt Col VW Barlow (UK)
3rd Battalion, The Royal Australian Regiment Commanding Officer Lt Col FG Hassett (AUS)
29th British Infantry Brigade Brigadier T Brodie (UK)
1st Battalion, The Royal Northumberland Fusiliers Divisional Royal Commanding Officer Lt Col MC Speer (UK)
1st Battalion, The Gloucestershire Regiment Commanding Officer
336 Lt Col DBA Grist (UK)
1st Battalion, The Royal Ulster Rifles Commanding Officer Lt Col RJH Carson (UK)
AVIATION
1903 Independent Air Observation Post Flight, Royal Artillery Officer Commanding Major RNL Gower (UK)
1913 Light Liaison Flight Officer Commanding Captain P Downward (UK)
Notes
a.) As will be apparent from several unit titles, the divisional troops formed from the Arms and Services, other than infantry, with the three originally independent brigades. Some integrated--not least the Divisional Provost Unit--with considerable success. b.) Some minor units are omitted due to size, which were nonetheless of considerable importance, such as the Royal Engineers Postal elements, and the Intelligence Corps units. The Pay and Dental units were ‘blistered’ on to larger units for economy of domestic manpower. The REME organisation subsumes the vital Recovery detachments. Chaplains, though established principally at brigade headquarters, were for the most part permanently attached to major units, from which they also toured allotted minor units. c.) The Air OP Flight was under command of the Commander, Royal Artillery, though it was located at and shared the airstrip facilities with the Light Liaison Flight, the Field Security organisation.
337 Appendix D 1 Commonwealth Division Pertinent Medical Staff
Deputy Director of Medical Services
Brigadier CW Nye, RAAMC, July 1951-May 1952 Colonel JE Snow, RAMC, September 1951-December 1951 Brigadier FJ O’Meara, RAMC, May 1952-March 1953 Brigadier Franklin, RAMC, March 1953-
Assistant Director of Medical Services
Colonel G Anderton, RAMC, June 1951-May 1952 Colonel GL Morgan Smith, RCAMC, May 1952-April 1953 Colonel JS McCannel, RCAMC, April 1953-April 1954 Colonel EJ Young, RCAMC, April 1954-November 1954
Commanding Officer, No. 25 Canadian Field Dressing Station
Major WR Dalziel, RCAMC, May 1951-January 1952 Major AC Hardman, RCAMC, January 1952-May 1952 Major JS Hitsman, RCAMC, May 1952-October 1952 Major JR Arsenault, RCAMC, October 1952-July 1953 Major LS Glass, RCAMC, July 1953-January 1954 Major LH Edwards, RCAMC, January 1954-June 1954 Major GL Stoker, RCAMC, June 1954-November 1954
Divisional Psychiatrist (Based at 25 Canadian Field Dressing Station)
Major RJA Robitaille, RCAMC, July 1951-March 1952 Major FCR Chalke, RCAMC, March 1952-October 1952 Major JL Johnston, RCAMC, October 1952-May 1953 Lieutenant/Captain NG Fraser, RAMC, May 1953-November 1953 Major RG Davies, RAMC, April 1953-May 1953 Lieutenant Leslie Bartlet, RAMC, November 1953-November 1954
Clinical Officer in Psychiatry (Based at 25 Canadian Field Dressing Station)
Captain RG Godfrey, RAMC, August 1951-December 1952 Lieutenant/Captain NG Fraser, RAMC, December 1952-May 1953
338 Psychiatrist, 29 British General Hospital
Captain JJ Flood, RAMC, c November 1950-November 1951
Officer Commanding, British Commonwealth General Hospital Colonel JE Snow, RAMC, December 1951-May 1952 Colonel ANT Meneces, RAMC, May 1952-
Psychiatrist, British Commonwealth General Hospital Captain JJ Flood, RAMC, December 1951-January 1952 Major RG Davies, RAMC, 1952 Major JL Johnston, RCAMC, 1952 Major Magrath, RAMC, 1953 Lieutenant/Captain NG Fraser, RAMC, 1953 Lieutenant Leslie Bartlet, RAMC, 1953
339 Bibliography
Primary Material
A. Unpublished
(i) Official documents, correspondence, and other government publications
Australia
Australian War Memorial Digital Collections AWM 85, Class 1 Headquarters, 28 British Commonwealth Infantry Brigade Class 2 1 Battalion, The Royal Australian Regiment Class 3 2 Battalion, The Royal Australian Regiment Class 4 3 Battalion, The Royal Australian Regiment Class 5 Headquarters British Commonwealth Forces in Korea
National Archives of Australia Digital Collections A462 Department of Prime Minister and Cabinet/Department of Foreign Affairs and Trade, Central Office--Australian High Commission Correspondence Files A5954 Sir Frederick Shedden Collection
National Library of Australia Trove Collections
Canada
Canadian War Museum Textual Records Papers of Major David Spencer Whittingham (1923-1994)
Directorate of History and Heritage, Department of National Defence File Nos. 000.8 (D96) 112.3H1.009 (D113) 1326-2676 361.003 (D1) 681.013 (D48)
340 Library and Archives of Canada MG 31 Sneath Papers RG 24 National Defence files from commands, schools, units, ships, bases and formations
United Kingdom
Legasee: The Veteran Video Archive Korean War Collection
Liddell Hart Centre for Military Archives Reference Material: postwar, 1945-1970, Papers, 1927-1972.
Imperial War Museum The Sound Archive
Private papers of Dr NG Fraser
The National Archives at Kew ADM 1 Admiralty and Ministry of Defence, Navy Department: Correspondence and Papers DEFE 3 Admiralty: Operational Intelligence Centre DEFE 7 Ministry of Defence prior to 1964: Registered Files (General Series) DEFE 10 Ministry of Defence: Major Committees and Working Parties: Minutes and Papers DEFE 11 Ministry of Defence: Chiefs of Staff Committee: Registered Files DEFE 24 Ministry of Defence: Defence Secretariat Branches and their Predecessors: Registered Files FO 371 Foreign Office: Political Departments: General Correspondence from 1906-1966 MH 79 Ministry of Health: Confidential Registered Files MH 95 Board of Control: Entries Files PIN 14 Ministry of Pensions and successors: Codes and Instructions PIN 15 Ministry of Pensions and successors: War Pensions, Registered Files (GEN Series) and other records PIN 18 Ministry of National Insurance and successors: Registered Files (F Series) PIN 19 Ministry of National Insurance and successors: Registered Files (NI Series) PIN 47 Ministry of National Insurance and successors: Registered Files (STA Series) PIN 59 Ministry of Pensions and successors: War Pensions Policy, Registered Files (WPP Series) WO 32 War Office and successors: Registered Files WO 163 War Office and Ministry of Defence and predecessors: War Office
341 Council, later War Office Consultative Council, Army Board and their various committees: Minutes and Papers WO 216 Office of the Chief of the Imperial General Staff: Papers WO 231 War Office: Directorate of Military Training, later Directorate of Army Training: Papers WO 279 War Office and Ministry of Defence: Confidential Print WO 281 War Office: British Commonwealth Division of United Nations Force: War Diaries, Korean War WO 308 British and Commonwealth Forces: Historical Records and Reports, Korean War WO 342 War Office: Army Operational Research Group later Army Operational Research Establishment: Registered Files WO 348 Military Personnel Research Committee and Sub-committees, later Army Personnel Research Committee: Minutes and Papers WO 279 War Office and Ministry of Defence: Confidential Print WO 281 British Commonwealth Division of United Nations Force: War Diaries, Korean War WO 291 Ministry of Supply and War Office: Military Operational Research Unit, successors and related bodies: Reports and Papers
The Wellcome Library and Archives Royal Army Medical Corps Muniments Collection
United States of America
Harry S Truman Library Audiovisual Materials Collection
National Archives and Records Administration RG 112 Records of the United States Army Surgeon General
United States Army Academy of Health Sciences, Stimson Library Digital Collections
(ii) Interviews
Davison, Kenneth. Interview by author; Newcastle-upon-Tyne, UK, February 2010.
Milsted, Allan. Interview by author; Trowbridge, Wiltshire, UK, November 2010.
Trevett, Bill. Interview by author; Trowbridge, Wiltshire, UK, November 2010.
342 B. Published
(i) Proceedings of Parliament
Australia
Hansard Parliamentary Debates, House of Representatives, 19th Parliament (1949-1951) 22nd Parliament (1955-1958) 23rd Parliament (1959-1961)
Hansard Parliamentary Debates, Senate, 22nd Parliament (1955-1958)
Canada
House of Commons, Committee on Veterans Affairs, 39th Parliament (2006-2008) Committee on National Defence, 39th Parliament (2006-2008)
United Kingdom
Hansard Parliamentary Debates, House of Commons, 41st Parliament (1955-1959) 42nd Parliament (1959-1964)
Secondary Material
A. Unpublished
(i) Dissertations
Burlotte, Bryan. ‘Visions of Grandeur: Planning for the Canadian Post-War Army 1944- 1947.’ MA Dissertation, Carleton University, 1991.
Fensome, Jason Timothy. ‘The Administrative History of National Service in Britain, 1950-1963.’ PhD Dissertation, University of Cambridge, 2001.
Gobindpuri, Avinder, ‘The Forgotten War: Medicine in Korea,’ BSc Dissertation. University College London. Wellcome Trust, 2005.
Rivard, Jeffrey R. ‘Bringing the Boys Home: A Study of the Canadian Demobilisation Policy After the First and Second World Wars.’ MA Dissertation. University of New Brunswick, 1999.
343 (ii) Speeches
Wessely, Simon. ‘War and Psychiatry: A Story in Three Acts.’ Lecture, Global History Seminar, The London Centre of the University of Notre Dame, 27 March 2013.
B. Published
(i) Articles
Agnew, GH. ‘The Shortage of Hospital Beds.’ Canadian Medical Association Journal/Journal de l’Association médicale canadienne 46, No. 4 (April 1942): 373- 374.
Alamo, C, Clervoy, P, Cuenca, E, López Muñoz, F and G Rubio. ‘History of the discovery and clinical introduction of Chlorpromazine.’ Annals of Clinical Psychiatry 17, No. 3 (2005): 113-135.
Allison, William. Review of War of Patrols: Canada’s Army Operations in Korea by William Cameron Johnston. Canadian Historical Review 85, No. 4 (2004): 805.
American Medical Association. ‘Our History: 1940-1960.’ Last Modified 2013. http://www.ama-assn.org/ama/pub/about-ama/our-history/illustrated- highlights/1940-1960.page
Anderson, Donald. ‘Navy, Army, and Air Force Institutes in War and Peace.’ Royal United Services Institute Journal 85, No. 537 (1940): 64-72.
Anderton, Geoffrey. ‘The Birth of the British Commonwealth Division Korea.’ Journal of the Royal Army Medical Corps 99, No. 2 (January 1953): 43-54.
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377
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(v) Maps
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