Dr. POW (book excerpt: Conduct Under Fire)

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The doctors at Bilibid had their individual specialties, but they quickly gained familiarity with a range of diseases that were almost numbing in their consistency.

There was one case, however, that Fred would never forget. Corporal Lloyd D. Adams had been bitten on the face and leg by a rabid dog when he was on a work party at Balanga. He was placed in Bilibid's isolation ward and given a course of rabies vaccine provided by the Japanese, but it did little to stop the virus from multiplying in the brain and surging through the efferent nerves to the salivary glands. Adams went insane. He salivated uncontrollably and developed hydrophobia. His spasms -- triggered by the most innocuous stimuli -- became so violent that the disease seemed to have seized his body, to speak and act for it in a bizarre parody of human behavior. Ted Williams could barely see from xerophthalmia, but at night and at bango [count-off] he could hear the most horrible screaming. The spectacle induced in Fred a sense of awe in the face of the incurable.

Doctors quickly learn to separate the personal from the professional, but some relationships at Bilibid blossomed into friendships. Corporal Donald E. Meyer, who had been stationed at Nichols Field with the 693rd Aviation Ordnance, suffered a depressed skull fracture and a dislocated hip on Corregidor. When he arrived at Bilibid in October 1942, Carey Smith and Lieutenant E. R. Nelson tended his hip fracture first. Later Nelson and George Ferguson operated successfully on his skull. Meyer recovered beautifully. "I knew he would be a friend to me always," he said of George.

Some cases, however, were medical mysteries. Murray was intrigued by patients complaining of "painful feet." Their extremities felt as if they were on fire, they said. Their fingers tingled, and the discomfort in their toes was so intense that some of them couldn't walk. Was it neurological in origin, psychological, or nutritional? he wondered. Was it dry beriberi? Murray began to experiment by administering 20 milligrams of thiamin each day. Nogi was so concerned about the "sore foot syndrome" that he appointed Hayes the head of a "commission" to study the disease, and together they visited Philippine General Hospital and the Institute of Hygiene in Manila. The incidence of "painful feet" decreased as the daily diet was supplemented with meat, mongo beans, and black-eyed peas from the Indigent Sick Fund. But what exactly caused it?

~~~

This next excerpt is about how one physician treated a blind POW.

As mysterious as ancient Chinese medical techniques were to the Allied POW doctors and their patients, one American therapy left the Japanese medical staff at Kobe awestruck. The case involved a young American POW from Tennessee who was blind, and a British POW whose toes had been amputated as a result of "painful feet." The blind man managed to get around the hospital at Kobe by towing on a little cart his buddy who served as the eyes behind him.

"Turn left," his friend would call out like a carriage driver. "Turn right." And the American would obey like a well-trained pony.

It was a pathetic sight, and a touching one, Murray thought. The men teamed up out of necessity to compensate for their respective infirmities. One had to get food for the other; the other had to show him where the food was before he could even get it. They were best friends out of need, two halves of one man.

Intrigued, Murray decided to examine the blind man's eyes. His patient had no corneal opacities, so he asked for an ophthalmoscope to examine the retina. The Japanese provided him with a reflecting ophthalmoscope of the kind that came into use in Europe and America a generation after Dr. Richard Libreich's invention in 1855. An antique, but serviceable -- if you stood about three feet away from your subject. And what Murray saw took him by surprise. The retina was intact. The optic nerve appeared to be perfectly healthy, and the optic reflexes were normal. There were no signs of xerophthalmia. In fact, he could find no neurological or ophthalmological basis for the man's blindness. Then why couldn't he see?

In World War I German soldiers suffering from war neuroses in the field were typically treated with electric shock. Neurotics were considered malingerers whose symptoms were a result of the conflict between the instinct for self-preservation and a sense of duty. The doses were so high that men actually died during treatment; others committed suicide afterward. Given the choice, some soldiers decided the front didn't look so bad after all. In his "Memorandum on the Electrical Treatment of War Neurotics," written in 1920 for a special commission of the Austrian military, Freud suggested that psychoanalysis might be a more effective remedy for war neuroses than electric shock therapy.

A neurologist and also a bit of a dreamer, Murray was naturally drawn to psychoanalysis. He had read Charcot, the nineteenth-century French neurologist whose pioneering work on hysteria Freud had translated into German. And he had read the cornerstone of psychoanalytic theory, Studies on Hysteria, in which Freud and his co-author Josef Breuer argued that "hysterics suffer mainly from reminiscences."

By hypnotizing their patients, Freud and Breuer were able to bring the memory of a traumatic event to light, at which point "each individual symptom immediately and permanently disappeared." Murray decided to try their technique on the blind American POW.

Slowly, calmly, he coaxed his subject into a trance. He asked him to describe in his own words the traumatic event, then firmly suggested that he would be able to see when he woke up. The result was not instantaneous, as Freud and Breuer had reported in their case histories. But after several sessions, Murray achieved his goal. On awakening to consciousness, his patient reclaimed his sight.

The Japanese were dumbfounded. The corpsmen were amazed. He'd been as blind as a bat, had had that faraway gaze that blind men have, could not even light a cigarette by himself -- and now he could see?

It seemed nothing short of a miracle, but it was not without its consequences. The Tennesseean quickly abandoned his British buddy, who would now have to fend for himself on the chow line, having been discarded like an old appliance that has outgrown its usefulness.

Hysterical paralysis was a more common condition at Kobe. One evening in the fall of 1944 a truckload of twelve to sixteen men arrived at the gate. Some of the POWs had been working on the Siam-Burma Railway. They had been removed to Saigon, and then transported from Singapore to Japan by freighter. For days on end they were kept down in the hold until their convoy, which included the Kachidoki Maru and the Rakuyo Maru, came under Allied submarine attack. Six hundred and fifty-six of the POWs who survived were taken to Japan aboard the 20,000-ton "whale factory" vessel Kibibi Maru.

Dixie Dean watched as Murray separated the healthy arrivals from the infirm. But it was obvious to Dean who was ill -- they all were. They stank to high heaven, were filthy dirty, and could not lift one foot in front of the other. And there was the doc, saying, "He can walk." To which John Quinn replied: "And he can kiss my arse." Quinn proceeded to carry the prisoners to the hospital. The corpsmen bathed the men, fed them, and put them to bed. They were exhausted and malnourished, but Murray saw by their gait, by the paralysis they affected, that in some of the cases their physical symptoms merely mimicked illness; they were not caused by it. One by one he hypnotized them, and soon enough, like the blind marine from Tennessee, they were able to see and walk normally out of the hospital.

The question remained: what was the trauma that triggered their visual and motor hysteria? A beating, a torpedo attack, watching men die on land and at sea. Sometimes there was no sole causative factor except the general predicament of being a prisoner of war. Blindness or paralysis was an unconscious defense against the rigors of reality -- and the prospect of more work details.