Doctors notching wins in a war that can't be won

It is incumbent upon us to promote the desirability of alternative solutions to conflict

At the recent Armistice Day centenary commemorations, I had the privilege of attending a splendid rendition of the concert An Australian War Requiem in Sydney’s Town Hall.

The requiem to the nation’s fallen soldiers in World War I is in three tableaux; the first concerns the horror of war, the second focuses on sons and mothers, and the third — and most dramatic — is a reflection on loss.

The event led me to reflect on the far-reaching role ­doctors have played throughout history in times of war, and continue to play when it comes to human horrors.

Our role is multifaceted and spans the breadth of war.

Our first contribution, of course, is to do our best to heal those who are physically and mentally injured by war, and to understand, as best we can, the awful circumstances they have endured.

One such doctor was New Zealand ENT surgeon Sir Harold Gillies. Working on the Great War’s Western Front, he witnessed attempts to repair the ravages of facial injuries and, as a result, became a pioneer in plastic surgery.¹

A plaque honours Sir Harold Gillies. Photo: Simon Harriyott/Wikimedia Commons. https://bit.ly/2TBAgLu

He opened a hospital in the UK after the Battle of the Somme in 1916, where he treated thousands of cases of jaw and facial mutilation.

In World War II, Australian surgeon Sir Ernest Edward ‘Weary’ Dunlop was renowned for his leadership while being held prisoner by the Japanese.

He was hailed by other POWs in the prison camps and jungle hospitals on the Burma-Thailand railway for being “a lighthouse of sanity in a universe of madness and suffering”.²

Kanchanaburi war cemetery, where thousands of Allied POWs who died on the notorious Thailand to Burma death railway are buried.

Our second contribution comes in the aftermath of war when we look at the reasons for negative behaviour in affected servicemen and women and try to assist them if they emerge shell-shocked or, in modern parlance, with PTSD.

Research suggests that even medieval soldiers suffered from the psychological impact of war despite their training from a young age and being surrounded by death.

In 15th-century France, people believed that warfare caused a kind of madness and soldiers who went “berserk” were celebrated. However, non-combatants who were traumatised by war were pitied or ridiculed.³

Today PTSD remains a major therapeutic challenge, and not only for war veterans. A Google search of the phrase ‘Australian doctors treating PTSD’ yields a vast number of entries concerning psychiatric treatment, medication, lifestyle and other treatments.

Finally, we are bound to share our medical insight into the real cost of war with our communities.

Doctors in the US recently engaged in the modern-day version of this duty of care when, just a few days before the Armistice Day centenary, they took to Twitter to reveal the day-to-day horror of the country’s gun crime.⁴

Fuelled by the US gun lobby’s call for doctors to “stay in their lane” on the country’s gun control debate, dozens of emergency care medics posted photos of themselves working while covered in patients’ blood as a visual reminder of the human cost of America’s shooting epidemic.

Away from the front-line, numerous doctors have also been honoured for championing a reduction in the engines of war.

SA palliative care physician Professor Ian Maddocks was president of the Medical Association for Prevention of War when it received an Australian Peace Medal, and vice-president of the International Physicians for the Prevention of Nuclear War when it received the Nobel Peace Prize in 1985.⁵

And, more recently, Professor Tilman Ruff, an infectious disease and public health doctor from the University of Melbourne, was chair of the International Campaign to Abolish Nuclear Weapons — the recipient of the 2017 Nobel Peace Prize.⁶

It is important for doctors, who see the damage, to make clear to our communities and their political representatives the absolute desirability of finding alternative solutions to conflict.

But the reality is that in a world of scarce resources, war will likely remain part of the human condition, and will not, unfortunately, be going away. We must therefore remain ready to meet its challenges.

Requiescat in pace.

Professor Leeder is an emeritus professor of public health and community medicine at the Menzies Centre for Health Policy and School of Public Health, University of Sydney. 

Published in Medical Observer 26 November 2018

https://www.medicalobserver.com.au/views/doctors-notching-wins-war-cant-be-won