Field psychiatry for the medical officer (1944)

[Music] h [Music] of course actually the trouble is that the whole thing depends entirely on the personality of the examiner I mean what I mean is some of them think that if you if you belch back what they've said then you've learned something but the other type loves to have his own word shot back in him but thinks that if you paraphrase what he said they using their own intelligence wouldn't be so bad you know if one knew what type one was up against of course one never does as well actually I think they all to tell you who's going to Mark the papers oh shut up Wilson damn it you're always talking well really 38 please what's he like GL awful I M what did he give you branches of the tri ginal oh God same as four years ago gal a dry ginal lingual nerve took a swerve over the higher glosses said won's duck number 39 please lingual Nerf took a swerve over the higher glosses said warton's duck well best of luck okay Dad it's all blacked out don't M the glass few yards nearer and we'd have been well it wasn't so don't worry dead look I know I'll make a cup of tea yes it'll do you good would you like it now or after your bath excuse me sir what is it drag bit of private medical advice sir if you don't mind giving it yes can you tell me what a lipoma is please sir lipoma you mean that'll be it is it a growth doctor no it's a sort of fatty lump why is it is it dangerous no not at all think you've got one oh no it's not me it's a wife got one on her arm in her last letter she said she'd have to go into Hospital have it taken away well I wouldn't worry about about that is not at all dangerous can be inconvenient she'd be better to have it removed yes doctor but uh the operation well it's very simple they won't even have to put her under guess well no honestly there's nothing to worry about this was 6 weeks ago doctor haven't had a letter from since well probably something's gone wrong with the Maes up with your wife there's nothing in the operation to stop her writing for 6 weeks really rag I wouldn't worry thank you doctor sir wish I was dead all the same keep an eye on that Gap will you that go [Music] problem nice work rag you're all right all right these bloody mortars pasting us of five solid days not food since Sun well we're all in the same boat don't expect a lion's Corner House up here do you no but I don't expect a bit of sleep sleep what do you think this is the W office [Music] bloody clo few more like like that for it you know off the rest of the section the rest of the section there for it too oh don't be doubt thousands of men have come through worse than this without a scratch the last war the last war passionale s plenty millions of casualties oh for God's sake take a grip of yourself happed a chance how you why haven't we got any more a chance you've got a very good chance 10 to one you won't even any 10 to one that's what Fred Blair said just before he got it what they want to leave you there for stti buty face blown off why don't they take him awayy stretch be can't get through oh shut up go like got your go crackers seven men in the section aren't there only one killed in five days of sh [Music] rag rag cor R how many rounds have you got left 14 C there you are find Soldier you are used to be the smartest man in the section didn't you and now you can't even count a few rounds without dropping one pull yourself together for God's sake you've got a rifle haven't you and you're have good shot aren't you and those JS are nice in range aren't they well had a chance n of a chance you blood is [Music] ra like what the hell do you think you're doing man I thought I told you to get up the rest of the section right get through re step out of it man what the hell's the matter you realize I can put you in charge for this we just have made an order God's sake man don't you recognize the hire when you see one come back they always do it he listen rag if you don't go back and Jo any others I'm going to send you down to the co I can't afford have anybody yellow in my section now get going now get going all right you had your chance they under arrest now get back to Mr sandord suppose you know where HQ is now get back Mr Sandford and tell him I send you want to send you on escort I suppose but I can't spare a good man now get cracking for Dr sir looks B happy to me God rag what on Earth are you doing here damn it man I asked you a question come on come on put us up together egg can't go on like this go on put this out together come on get back to your section at once I wonder if that's genu hell I believe it is can't go back to a section like that he's completely useless useless he's a bloody Menace the other chap see him like this they'll start going the same way themselves better send him down to Theo I suppose rag can't spare an escort though God knows where he'll go if we turn him loose by himself rag come back is there anyone we can send down with him yes what about our grief sir you know that arm of his well should have thought it was that bad it is still no reason why he shouldn't go down probably won't do him any harm to have the doctor look at it no will we fix that Sergeant yes sir hrees yes sir you're going down to the ammo after all and there' be another blow going along with you rag he's bumb happy tell that to Theo when you see him right time and there'll be a chit for Mr Sanderford give that to Theo too will you bload do bring right back oh well that's out of Theo these bloody mortars chew anybody up hello hares what's the matter it's rankon he's bump all right set him down there it'll be all right what's the matter with you H Graves wound in the arms on right hog Graves sir wound in the arm what did it splend okay lad take it easy a cigarette yeah that'll be all right this is Mr sand it's about right it's okay charm it's all right come and sit down sit down go and look after harrie sergeant I've put a dressing on and give it some tea good what's wrong with you rag let's have a look at you nothing wrong with your legs more sorry I know we've all heard them not very pleasant are they you've had a bit of a shaking all right R all right we soon fix you up well there's nothing wrong here I think it's just a shaking Sergeant sir going that's stew yes there is some left well give this chap a meal and barbitone 10 grains that's the two tablets very good sir you're going to be all right rag s's going to give you a couple of pills and then some grub let's see what it looks like after that okay L take these that's right wash them down with the tea okay now come around the back and we'll get some grub be com there you go might take around the back Sergeant he probably get some sleep there yes sir I've done that just wondered if you're like a mug of Tears things seem to be quietening down a bit thanks very interesting case then rag I mean yes sir he was what exactly was the matter with he was a typical acute anxiety Neurosis you couldn't have seen a better example he was acute and all he needed was a sedative no we need more than that soon as transport's available we whip him off to the core exhaustion Center only to be a handicap the way he is now will core evacuate him sir well I shouldn't think so for a minute they keep him there for a week or two until this thing's cleared up and then send him back perfectly fit again that's the draw for these anxiety cases is it sir send them to core exhaustion Center no not always some cases are quite mild take a young soldier in his first battle for instance well we don't send them back give them a good dose of Medal and several hours sleep the main thing is to get them early I see uh I've often wondered how you tell when a man has one of these uh new um Neurosis yes Neurosis well it's pretty difficult at times you see there's so many factors involved in the production of anxiety physical things exhaustion and infection for instance and the man's mental makeup everyone gets [ __ ] out in time of course but if you're anxious as well then you get exhausted much quicker than you normally would sleep's the best antidote it acts as a sort of shock absorber it helps a blo to keep his balance yes sir but it's not quite so easy to just drop off to sleep in these parts you're telling me it's even worse if you have too much anxiety Then a fellow doesn't sleep properly no matter how physically exhausted he may be anxiety is his trouble that's what keeps him awake so the first thing to do is to give him a set not a textbook dose but a a whacking bait big dose to wipe out his anxieties and let him get a deep proper sleep with no nightmares have you had many cases of anxiety sir no more than you'd think a lot of people get anxious very easily but they're decent fellows and they try and hide it like our driver sir barl yes yes you see that sort of chat gets tired more quickly anxiety is more exhausting than pure physical labor that's why the imaginative bloke gets tired more quickly than the thick skinned one I remember a case in North Africa a fellow came in completely worn out he looked as if he'd walk a couple of hundred miles did you see your Pon Commander yes doctor and did he give you a note for me yes doctor have you got it yes got a pretty tiring time haven't you yes TI kind God can't f is it you've been under Fire for 6 days haven't you 6 days no food BS Morts now is gone you stay there here I take these wash them down with the tea ply yes sir put him on a stretch and take his boots off well that's exhaustion caused through anxiety that's too much anxiety and not enough sleep another common result is depression that can be anything from the sort of sadness some soldiers get after a battle right up to Suicide remember this serious case in Italy a fellow came in absolutely gone to Pieces a te trap come on drink it up come on [Applause] what's the matter section wiped out my fault oh lot gone who sent you back here Tom Commander they all know I I I let them down all right I take these poison don't be silly old man doctor all I'm fit for put me out that sort of a thing can be pretty Grim sometimes of course it's just another result of anxiety Then you get the case of a man who can't think clearly well that's confusion what case of that I ever had not so long ago fellow came into the RP and was completely lost and dazed who sent you here what company are you from who's your Pon Commander what's the matter with you don't know I'll take these no take them go on orderly yes sir you're hypodermic an ample of luminal yes sir of course they're not always as bad as that the simple anxiety state is the common one but you may see one or two odd variations now and then hysterical conversions for instance what exactly is that sir well it's when a man develops a hysterical condition to blot out his anxiety I don't mean that he does it deliberately but the body takes charge and organizes its own defense of course the story behind it wouldn't be obvious here but it would become obvious farther down the line during treatment you can get all kinds of symptoms of that sort blindness deafness stammering almost any damn thing you mean to say all these are symptoms of anxiety sir not necessarily but they may be sometimes you get what called a dissociation chap May develop Amnesia or Fugue that's where the memory goes and sometimes you get an extreme dissociation the chap shuts himself off from his surroundings and gets stuper just like a coma there's so much anxiety in these cases that the mind can only deal with it by shutting out everything you realize that when you see one of these chaps under treatment at a psychiatric hospital under Narcosis they get it all out like P from an Epis well now tell me what happened when you were at sine they're trying to get me they're trying to get me there it is go was the near one they pting in this place bastard where the hell don't we get him bloody bastard there it is it's coming straight follow me God hel they get me they get me soon I know they will bastard in some of these cases the result of treatment is pretty dramatic but it does the bloke's good to get it off their mind incidentally that goes for everybody including people that you wouldn't look upon as cases at all how do you mean sir well there are lots of people that have got painful experiences that they'd like to get off their mind and the early they do so the better so you must always be prepared to listen to a man who wants to talk to you about something that's worrying him if more people realize this we've have far less men breaking down you see it's more or less true that it doesn't matter what a psychiatric casualty looks like there's always anxiety there and how are we supposed to deal with it sir I mean they seem to turn up in so many different forms yes they do but the first aid treatment is always the same hot sweet tea or soup or food then a sedative luminol three grains for a walking case or medal 10 grains that's two tablets for the mild or walking case 15 or even 20 grains sometimes for the severe cases these two are provided especially for psychiatric cases but of course any sedative will do morphia a quar of a grain bromide 30 grains or a good strong tot of whiskey or brandy and finally unless the case is very mild indeed we evacuate it to the core exhaustion Center in other words we pass the back to the psychiatrist that's what they paid for it looks like the ambulance's coming yes sir shall I get them ready for a move yes please meantime I'll fill in rags 3118 for there's five you this time two stretcher cases this one here and one around the back and three walking well there he goes unless I miss my bet he'll be back here in under a week what exactly will they do with him up there sir a core exhaustion Center they have a pretty simple routine it's simple but effective they break the treatment up into three stages of 48 hours each and in the first 48 hours they treat the lads all more or less like babies they get plenty of good hot food and sound sedated sleep during the second two days they're treated like kids they relaxed do bits of making and mending and play games and so on and have plenty of time to get clean and get back their self-respect during this stage psychiatrist interviews each of the fellows personally well your sleep seems to have done you good you look a different man how' you feel not at all bad thank you sir I suppose I I suppose I just need a bit of a rest like that you did your company had a pretty rough time from all accounts do you remember what happened well not very well sir I know I was out there six days it must have been and and then he said I remember he said I remember it now what about the others sir do you know what happened to the rest of be company Sir with Dawn the day after you left did very well indeed incidentally we've got one of your sergeants back here sergeants well I don't know well this sort of thing even happens to generals you know have you um have you ever had a general here sir no but I'm still hoping oh what exactly you did do with them all sir exactly what I'm doing with you getting you cleaned and rested and sending you back when sir in a day or so I got to get you right back on form first in the next few days my lad you're going to be reminded that you're a soldier I see you've got your button sewn on yes sir well get your boots clean too yes sir got any cleaning materials yes sir the sergeant see this man has a loan with some cleaning deer don't forget you're a fuselier Penton tomorrow morning I want to see you looking like one yes sir may I have your permission to dismiss the parade so please turn it right and salute Miss Sergeant yes may I have permission to speak to the officer Sergeant what no yes right hang on here a minute that's how it's done right Sergeant well well sir I'm feeling pretty champing again now sir that's good well well sir sir I suppose we'll be going back again soon yes you will perhaps tomorrow if I can get transport to our own M sir certainly why not well sir you know how it is Sir sometimes when you've been sick for a while they post you somewhere else and well I to get back to me own B and that's what you're going to do you're all going back to your own units and with a strong recommendation from me that you go back again immediately to the duties you were doing before you came here in other words you're perfectly fit and ready for anything does that satisfy you yes sir thank you sir good a good lad ah just what I wanted three volunteers for SP bashing come [Music] on [Music] pity you've never learned to play in any key but see yes doc Sandy that fellow rag of yours will be back in a day or two oh he's a pretty good soldier wasn't he until he cracked up yes till he cracked up but when a good soldier Goes To Pieces like that well there must have been a yellow streak in him somewhere Sandy you're probably a very good soldier yourself but uh bloody Bad Doctor under certain circumstances any man will crack up particularly if he's got some some private worry well had he any private worry well you should know you're his patoon commander of course he hadn't heard from his wife for some time surely a thing like that wouldn't turn a good soldier into a gibbering maniac he wasn't a gibbering maniac look he was worried about his wife he probably had a dozen other things on his mind as well and he had taken a hell of a pasting and you understand yes well that's why I'd like to make sure that when he comes back you and the rest of your Pon don't make him feel an outsider don't make him feel that he's not wanted I see what you mean okay dark I'll do that and there's another thing when he does come back I'd like you to keep an eye on him yourself and let me know what you think about him all right oh and uh while we're on the subject that Corporal of yours um what's his name the fellow that's in charge of rag section Corporal M do you mean yes that's right well he's tired too I'd like you to let me have him down the RP for a couple of days man didn't know he was a scrim Shanker what's he say is wrong with him he doesn't say anything's wrong with him and he's not a scrim shank you should know that but he'll wind up the same way as rag if we don't get him in time nuts remains as sound as any man in the company trouble with you Doc is you've got this Psychiatry business on the brain Psychiatry business I'm no bloody psychiatrist it's just common sense quick get this fellow Main in time he won't need a psychiatrist what's wrong with him he looks all right to me would you saw him yourself last night in the corporal's mess for a fellow that used him to drink he's shifting a hell of a lot of beer well you're shifting a hell of a lot of beer yourself if it comes to that well who wouldn't after the time we've had well it's good beer anyway that's not M's only symptom had to talk to him this morning he doesn't seem to be sleeping well nightmares he's pretty depressed I took the liberty of having a chat with the opportune Sergeant he says that M's very quiet lately you know how that chap used to chatter so if I can have him now for a couple of days in the RP he'll probably save a week at the core exhaustion Center later on that would be a waste do I get him okay doct you're probably right Captain Booth is Colonel's compliments sir and he'd like to see you in his office suits convenient all right thank you see you later Sandy okay do you sent me sir do yes um have a chair cigarette thank you just wanted to congratulate you thank you very much sir what am I supposed to have done I'm not quite sure but whatever it was it seems to have been remarkably effective we had very few PC cases psychiatric oh yes psychiatric cases in this last show something like a third of the number we had in the party before when Copeland was M Mo and this show is just as bad as that one so I can only imagine that all this unasked for advice of yours is has proved pretty sound I'm very glad you think so sir cuz I'd rather like to suggest yes yes you've certainly done a good job of work doc fixing up showers staring them up in the Cook House seeing the chaps get a good night's rest and all that sort of thing you're more like a nurse doctor well the point is Sir the prevention is better to inure and that's why I'd like to suggest yes yes that's what they say in the pamphlet or L the pamphlet yes this thing just been reading it damn interesting that's where it got to I've been expecting that for some time well you better hang on to it yes I must say I find it very interesting all these symptoms very interesting indeed this R doc well that's all I wanted to say all right thank you sir oh do yes that practically confirms it startle reactions nervous chatter excessive smoking and isn't there something about erratic eating and drinking too well yes there are symptoms but you can't diagnose it have any lunch today no sir pretty busy I wasn't hungry Qui sleeping well damn it so with all due respect ability that caps it Captain Booth this is an order you'll take things quietly for the next few days leave an orderly in charge for night and give yourself a nice sedative medal full dose 15 grains I don't know the