SOME EXPERIENCES AS A MEDICAL OFFICER WITH THE ROYAL ARMY MEDICAL CORPS
AN ADDRESS BY DR. JACOB MARKOWITZ, M.B.E., M.B., Ph.D., M.S.
Chairman: The President, Major F. L. Clouse
Thursday, October 17, 1946
MAJOR CLOUSE: Gentlemen of the Empire Club of Canada and our audience of the air: Our guest of honor and speaker today is a hometown boy who has acquitted himself with distinction in many fields in his few years since graduation. My first reference is one of congratulation in his having been awarded the M.B.E. for his unselfish and most conspicuous devotion to duty while a prisoner of war of the Japanese, having been captured at Singapore in February, 1942.
Prof. Markowitz was born in Toronto, educated at Jarvis St. Collegiate Institute and the University of Toronto. He received his M.B. at the age of 22 and his Ph.D when only 25. He was appointed Assistant Professor in Physiology Glasgow University 1926-27, and later Professor of Physiology, Georgetown University, Washington. The Doctor is the author of nearly one hundred scientific papers on Metabolism and Surgery, some of them having been written when serving at the Mayo Foundation. He is also National Secretary of the Canadian Authors' Association.
It is my privilege to introduce to you Professor and Dr. Jacob Markowitz, M.B.E., M.B, Ph.D., M.S., who will tell us
"SOME EXPERIENCES AS A MEDICAL OFFICER WITH THE ROYAL ARMY MEDICAL CORPS WHILE A PRISONER OF WAR WITH THE JAPANESE."
DR. JACOB MARKOWITZ: Mr. Chairman and Gentlemen: You will forgive me if I point out that this war represents the termination of the greatest and most terrible religious war in all history. The only one I can compare it with is the Thirty Years War m Germany about the year 1600. It is significant that that religious war also occurred in Germany. When it was finished half of the people in that country were dead. However, the religious points involved in this war can not in all fairness be stated to belong in their entirety to the Christian, or for that matter, to any other religion. These tenets are three in number.
First, we fought this war to establish the sanctity of the human personality. Every human being, no matter how humble, has an inalienable right to his life, to his dignity, and to his right of appearing equal before the law, as we believe he is equal before God, to the richest man in the country. We do not believe that any human being can be sterilized against his will. We do not believe that the privacy of his home can be violated without due process of law, which at all times must be regarded as a grave matter. This principle is a Christian principle.
The second point for which we fought this war is our right of free speech. This is not a Christian principle and indeed has often been combated by the various branches of the Church. The right of a man to have his say openly, subject to the laws of libel, subject to the law against creating a public disturbance, is a peculiarly British institution. How it came about that this wonderful thing should have originated from a funny cold little island I do not know. John Stuart Mill made the statement in his essay on Liberty, that if 999 men believed one thing, and one man disagreed with them, they had no more moral right to restrict his utterance on the subject than he had to prevent them having their say. This principle of free speech in Canada is far more important than the fact that there are a few scatter-brained Communists in the country: let them have their say.
The third point over which this war was fought is our right to govern ourselves. We British maintain that this business of government is no more complicated than the management of a club, a church or a village. Stripped of its verbiage, running the country is similar to running any other institution which involves a number of people, and we insist on doing it ourselves or delegating someone who is responsible to us to do it for us.
These principles are peculiarly British and they stem from no other part of the world. When the American Colonists revolted against the British Crown they behaved in the best' British tradition, and I should like to point this out to our American listeners of the air. The Americans had no greater defendants in their own country than William Pitt and Edmund Burke, who fulminated in the British House of Commons against our iniquity in shooting down fellow-Englishmen. The tradition of liberty in America is still a British tradition.
It is appropriate to mention with pride before the Empire Club of Canada that in the last three hundred years we British have done more for the human race than the rest of the world put together. I don't know why. I am a physiologist and not a philosopher. It is part of any creed to maintain that human beings and dogs have much in common; consequently I am not able to explain why a person living in Britain should be so different from one living in Romania or Turkey. Perhaps we British have become great because we were spared the horrors of invasion for a thousand years, so that the human personality has been able to flourish there. Some of my friends believe in the British Israelite movement; and if I- were sufficiently in sympathy with them, I would say that their claims fit the story perfectly because the British people are so utterly different from any other people in the world. If it hadn't been for them, just think what a sorry mess the world would be in today! It is an extraordinary thing to contemplate that if it had not been for four or five European countries, namely the United Kingdom, France, Germany, Italy, there would be no such thing as modern civilization and we would be living in the culture implanted by Egypt three thousand years ago, the culture of ancient China and Peru; and of these four countries that I have mentioned by far the sublimest has been the British contribution.
It was my great privilege to be associated with the British Army in the capacity of a Medical Officer when I was finally captured in Singapore. Prior to that I had been Surgical Officer with No. 5 C.C.S. just behind the front lines all during the Japanese invasion of Malaya. We would do our stuff for three days or so during which we were bombed, not directly, but because we were always close to the post office and the railway station we were continuously under fire. When it got so bad that we could not work we would be ordered back fifty miles or so. For the benefit of Dr. Gallie, I might state that an Indian C.C.S. has a heavy section and a light section. The heavy section is equipped somewhat like a general hospital; the light section resembles in equipment a field ambulance. Since it takes about three days to set up a heavy section, we used our light equipment. We operated on stretchers, for example, and didn't do too badly.
The British Army is of course the greatest retreating army in the world. We have done far more retreating than advancing. I need only mention the retreat of Sir John Moore at Corunna; then there is the campaign of Arthur Wellesley in Portugal, and of course our magnificent evacuation from Dunkirk. So as we retreated through Malaya, we didn't feel too down-hearted; we knew that we were overwhelmed in point of numbers, preparedness, strategy and aircraft.
However, there came a time when the incredible happened. The British Army suffered the biggest military reverse in its history: as one Tommy put it, we finally ran out of earth and had to surrender. It looked as if the end of the world had arrived. How could we then know that this was inevitable, that all this talk about Singapore being impregnable was so much talk to deter the Japanese from doing the suicidal thing that they finally did.
On the Sunday following our surrender we all went to church, as if an Order had been published to that effect. We British are like that. The Padre looked very melancholy, and in his sermon asked the question how Divine Providence could permit us to fall into the hands of the Japanese? Divine Providence knew more about it than we did. I don't recall that, he answered the question very successfully.
We were abominably treated. For the first ten days after our capture we received no food from the Japanese whatever. Meanwhile they commandeered all supplies of tinned food. We got very hungry. Most of us had a tin or two of bully beef, in addition to our iron rations. After about ten days we asked the Japanese guards if it was their intention to starve us to death, but they gave no answer; perhaps they didn't know. Then rations of rice appeared, ten ounces of rice a day, about a thousand calories. This continued for roughly six months. The men developed beri-beri and other nutritional disturbances in droves. We were given the explanation that because we dared to take up arms against the divine emperor we would be punished by partial starvation for six months. You know it was a great spiritual experience. Now that it is all over I would not have missed it for worlds. Here we were precipitated back at least three thousand years into a civilization described in the Old Testament. We didn't even have a light. We had to do everything by hand, and we were desperately poor. Would you be amused-if I told you that we grew cotton and spun it? We had to keep a perpetual fire going, as otherwise there would be no means of cooking our miserable ration of rice. We suddenly understood how important were the Vestal Virgins in Rome whose job of course it was to keep the sacred fire going all the time. Our fire did go out once I think and we did without cooked food until somebody mysteriously produced a match.
Six months after the surrender the Japanese affably told us that our period of punishment was over and that we would now be transferred to Siam, a primary food producing country where our lot would be better. That was always the Japanese technique. Whenever they wished to punish us they promised us an amelioration of our lot that made the subsequent disillusionment much harder to bear. Our destination was about twelve hundred miles from Singapore. We were bundled into tiny box cars, which were somewhat smaller than the French cars for forty men or eight horses. We could not lie down, we got tired of standing up, and this nightmare journey lasted for five days and four nights.
We arrived at our destination bruised physically and numb mentally. We arrived into a flooded country at the height of the Monsoon season, with no shelter. We were drenched by rain during the night, we were scorched by the sun in the daytime. And this was our new home. This was the improvement that had been promised us.
We were told that it was our duty to build a railway from Bangkok to Rangoon. It was of course in defiance of the Geneva Convention, but our captors had never heard of this. It was an impossible, a mad undertaking, one that had been refused by a British construction company as an impossible venture years ago. The soldiers developed malaria and dysentery by the thousand, and it soon appeared that there would be no soldiers left. In the meantime coolies from Malaya had been seduced up country by the promise of good wages. Bad as we thought was our neglect, theirs was even more pitiable. When the railway was finally constructed-for the Japanese, like ourselves, are a determined race-we computed that for every rail laid a British Tommy gave his life, and for every wooden tie, or sleeper as the English call it, a coolie died. When the Medical Officers protested, they were' of course smacked about vigorously and were told that if a British soldier broke one stone before he died, it would be in the service of the emperor; and it would be counted to him as virtue.
It became evident that our job as Medical Officers was to patch up these broken wrecks so that they could do their work more efficiently in the construction of this railway. We quickly learned that a prisoner-of-war of the Japanese becomes a Japanese national, subject to Japanese military and civil law. He is expected to do his duty by the Emperor and any dereliction in this is most reprehensible. If he attempts, to escape he is regarded as a deserter and, like a Japanese, is shot. I was able to secrete, the following document which was read out to us at our camp. It is an example of English as she is Japped by a second-rate interpreter.
INSTRUCTIONS GIVEN TO P. O. W. ON MY ASSUMING THE COMMAND
I have the pleasure to lead you on the charge of last stretch of Railway Construction Wardom with the appointment of present post.
In examination of various reports, as well as to the result of my partial Camp inspection of the present conditions, am pleased to find that you are, in general, keeping discipline and working diligently. At the same time, regret to find seriousness in health matter.
It is evident that there are various causes inevitable for this end, but to my- opinion, due mainly to the fact for absence of firm belief of Japanese. "Health follows will" and "Ceases only when enemy is completely annihilated."
Whose who fail to reach objective in charge, by lack of health or spirit, is considered in Japanese Army as most shameful deed: "Devotion till death" is good, yet still we have the spirit, "Devotion to Imperial cause even to the 7th turn of life in incarnation," the spirit which, cannot become void by death.
You are in the act of charge in colleague with charge to the last stage of this work with good spirit by, taking good care of your own health. Besides, you are to remember that your welfare is guaranteed only by obedience to the order of. the Imperial Japanese Army.
Imperial Japanese Army, will lot be unfair to those who are honest and obey them, but protect them. You are to understand this fundamental Japanese spirit, and carry out the task given you, with perfect ease of mind, under protection of I. J. A.
Given in Kanchanburi, June 26, 43. Col. Sijuo Nakamura. Commander of P. O. W. Camp in Thailand.
DR. MARKOWITZ continued: This is a fantastic document. Here was a camp of seven thousand sick, most of whom were bedridden. About twenty deaths a day occurred, and we were told that "health follows will", and that it was a most shameful thing to be sick.
I do not wish to expatiate on the cruelties practised on us. They were real enough, and in fact were exactly like the atrocity stories so generally believed to be fictitious and offered to a gullible public to incite them to hate their foes. It is the British way to be generous to a beaten foe; and at this period I can not help expressing my admiration of these Japanese--their devotion to duty, their superb bravery, their cleanliness, their ability to work harmoniously, and their industry. It is somehow alien to the Eastern mind to practice this totally European thing called chivalry, and in spite of all their twaddle about "Bushido" they do not understand that a prisoner-of-war who is helpless must not be kicked around, must not be outraged, and must be treated generously in consequence.
One of the most trying things of our captivity was the almost complete absence of reliable news, except here and there where a radio could be secretly made and kept operating. A certain Major Smith, an engineer, walked into the Medical Officers' Mess one day and he said, "You know we have got a canary but it can't whistle without food. I have been trying to get bird seed for this canary for a long time, but without success." So I waved five local dollars in the air (equivalent to twenty cents in Canadian money, and I say, "If you offer this to one of your thugs, I am sure that some bird seed will be stolen." That afternoon an enterprising Tommy stole a battery from a parked lorry, and the canary began to chirp.
This was about the time when Admiral Darland came over to our side, and we received the news joyfully. In spite of all the promises of decoration that Major Smith could make, it was not until he offered five dollars that a battery was produced. This is something for Socialists to ponder over: to me that has demonstrated forever the superiority of capitalism over socialism. By the way, the radio was discovered and Major Smith and his associates were taken into captivity and were brutally tortured in an effort to make them confess that this was a broadcasting unit.
In another camp the Royal Corps of Signals, a most efficient body, constructed a workable radio set from one tube, some bits of paper, and a pair of ear phones. This was powered by a flashlight battery. It was concealed in the false bottom of an Army water bottle. The Japanese never did find it, but they looked awfully hard. Most units, however, did not have a wireless and we found the lack of news exasperating. It resulted in an incredible crop of rumours which masqueraded as authentic news. A psychologist would have had an interesting time studying these. The statement that the war was over in Europe and that Germany had capitulated cropped up every two months, and would be believed until a slip of paper with some authentic news would be secreted into the camp. We concluded that the news of Germany's capitulation always originated in the following way: a friendly native would shout over the fence that Germany was being badly bombed. A Tommy would repeat this and add that he didn't see how she could stand it much longer. This would be repeated as the statement that the Germans were not able to stand the bombing much longer. The story then would progress serially as, that Germany was tottering; that her collapse was y imminent. A Tommy would -say that the last news he had heard was that Germany was collapsing and that by this time she had probably capitulated; and so on. Those of us who heard about the Russian advance had the Russians in Berlin a year before they reached Berlin.
It became evident to us that without the corrective feature of the written word, it was impossible for a human being to repeat accurately what he had heard: he always colored it with an inference which generally took the direction of what might be called "wishful thinking." After all, this conclusion is not remarkable. It explains how it is that legends develop an accretion of myth and supernatural detail, even when the original story is probably quite true. This incidentally explains much of the Biblical narrative, which I am sure is fundamentally accurate but which a succession of pious narrators have unconsciously altered.
As I said, we doctors were there to patch up the broken wrecks of humanity. Of course we had no equipment. It had all been taken by the Japanese Army. However, we were able, by sending out a petition among the troops to procure a dozen well worn forceps, a few hypodermic needles and some stethoscope tubing. There was always plenty of chloride of lime for a disinfectant. It became a surprisingly simple thing to improvise an operating room and to do transfusions. I am sure that by means of transfusions we saved thousands of lives. Ever physician knows that if you take a stick and stir blood as it is being collected from a vein, the material that makes it clot collects on the stick and the blood stays fluid indefinitely. So, instead of using sodium citrate, the chemical normally used in transfusion work to prevent clotting, we did nearly four thousand transfusions using this "defibrinated" blood. There were no deaths and very few reactions. We would take a big husky Australian and give his blood to some poor fellow whose life has ebbing away because of dysentery or malaria, and later when he got better, we would give his blood perhaps to the big fellow who by this time might be down.
In addition we had a large number of men who had to have their legs amputated because they were, going crazy with pain from tropical ulcers, or were suffering from severe infections of their shin bone. Their illness was of, course entirely due to neglect and normally would not occur. By means of novocaine, which we were able to purchase in the 'black market, our doctors in one camp alone did a most charitable work removing legs from ' 115 people, of whom over half were alive at the end of the war. I recently received a photograph of the Chungkai Amputation Group, as they called themselves, in Rangoon, where they were flown on our release. One of these fellows was an Australian who, following his spinal anaesthetic, stopped breathing. This is a very distressing episode for the doctor in charge. The doctor of course is a magician. He puts people to sleep and he wakes them up at will. He looks at funny things through a microscope. When he claps his stethoscope over his ears, he looks as mysterious as any savage medicine man with horns on his head. Well, here was a fellow who stopped breathing and appeared to be dying, and the orderlies in the operating room demanded magic. You should know that artificial respiration, according to the usual technique, does not work in spinal anaesthesia, because the chest is collapsed, so there is no use compressing it to get air in and out of the chest; it just doesn't work. So in a moment of desperation a rubber tube was put into the man's mouth and we blew air into it, very, much like Elijah the Prophet. You remember how the widow came to Elijah and asked for help for her son. Elijah breathed into him face to face, and the child recovered. I have often done this very thing during the Malayan campaign. That story of Elijah is too. circumstantial just to be a yarn. At any rate, when we blew air into this man's lungs, we could see the color return to his face. After about 'twenty minutes, he spat the tube out of his mouth, and said, "I am glad you guys don't eat onions; I don't like onions." These Australians are a hardy race.
I want to tell you a story about the intrepid spirit of an Englishman. You know in all the three-and-a-half years of my captivity I laughed more heartily than in any three-and-a-half years of my life. It was our sense of humour that kept us alive. The Japanese told us that a pig was dying outside the compound and they would be glad to sell it to us, because we always had money, for some mysterious reason. Well, pig is pig even if it's dying. We bought it, and in order to tell the troops that there was pork available, the head was disarticulated and put on the table of our improvised canteen, so anyone who went by would see it and say, "Well, there must be pork."
Well, a Japanese Sergeant-Major strutting through the camp and waiting to be saluted, noticed out of the corner of his eyes that a British captain was in the vicinity, and that he did not salute him perhaps because he hoped he was not seen. So he came up to the British captain, who saluted him somewhat lamely. The following performance took place
"You English officer-ka ?"
"Yes", was the answer. (smack )
"You proud-ka?" (no answer)
"Answer, you proud-ka ?"
"Not proud." (smack)
"Yes, I proud."
"Oh, you proud!" (smack, smack)
Then he walked away in accordance with the Geneva Convention.
How did an Englishman handle a thing like that? I think like an American would handle it. He saw the disarticulated head of the pig and walked up to it, and said,
"You English officer, eh?" (smack)
"You proud, eh?" (smack)
"Oh, you not proud, eh?" (smack)
"English shoko (officer) no goodena." (smack, smack)
A Korean sentry had stalked up behind the officer's back to see what all the excitement was about, and do you know what he did? He walked away very much ashamed. That was the most marvellous thing I saw. That is the way an Englishman behaves when he is in trouble.
I don't know how much time we have got, but you should know that we had quite an epidemic of cholera. This is a ghastly disease. Whole villages in India have lost fifty percent of their population in a week through cholera. In this disease the patient loses a great deal of fluid because of painless diarrhoea. He shrivels up like a mummy; his pulse becomes feeble; his voice becomes a whisper. Sometimes he gets painful muscular cramps, and he passes away in a coma. All this is due entirely to the fact that he has become dried out from the loss of fluid, like a frog that loses its way and becomes locked in one of our rooms. Now the proper treatment is to replace this fluid, which must be a weak solution of salt water-pure water of course, otherwise it is a bad business. You will be interested to hear how the Medical Officers encountered this disease in most camps. One Medical Officer made an intravenous needle by drilling a bamboo thorn, by means of which he infused a salt solution that he made by adding table salt to filtered well water. This caused reactions but it saved lives. In areas where it rained a lot, rain water was regarded as perfectly good distilled water, and when salt was added to it, it was just as good as water obtained in a hospital.
In my particular camp we heard about cholera before it actually struck us, so we got two discarded four-gallon petrol drums, and out of these we managed to make a still. Thus we were prepared to make a supply of salt water when cholera finally appeared among us. When the cholera left us the still came in most handy for the making of gin, which gladdeneth the heart of man. But that is another story.
One of the saddest features of our captivity was the premature aging of thousands of men. Let no one tell you that old age does not involve a nutritional factor. I know that it does. A young man of twenty-five would look forty-five by the time three years had elapsed. A dashing Colonel of fifty-two after three years would be a broken, decrepit old soldier, one who obviously would be unable to continue his career in the Army. I remember the classical scolars quoting:
"Eheu fugaces, Postume, Postume, labuntur anni, nec pietas moram rugis et instanti senectae adferet, indomitaeque morti . . ."
"The moving finger writes, and having writ, moves on" . . . Horace said it much better.
You will be interested to hear that there were some Americans in our group towards the end. They were Regulars in the American Navy, and . we kidded them a great deal, of course. They used to say to us: "Yours is a decadent and effete civilization." I wish we had known then about radar and penicillin. It might have been quite a good talking point. Instead one British Tommy said, "Now look here, old fellow, you know the story of Noah, you know, the Bible chappie. He was a farmer you know; remember the vineyard? Well, you know Noah carried a lot of animals with him in the Ark, and, it rained interminably. He did not want to lose the manure that accumulated, so he kept it on deck. But there came a time when he could not stand it any more, and he threw it overboard, and you know that stuff was not discovered until 1942." We heard nothing more about our decadent and effete civilization after that.
Now I think I am getting near the end of my titre. It has been my privilege to address the Empire Club of Canada. I have come home again. I think the people of the United Kingdom are the very salt of the very earth, and I think we in Canada would be very wise to follow their lead. Just think what is happening to the meat situation across the line! Can, you imagine that in the United Kingdom? There, the worst possible thing has already happened--they have a Labor Government!!! There is no shooting, and if it happens to be a mistake, it can be rectified. It is true the, new government is making a hash of the Palestinian siuation. Nevertheless we in this country would be well advised to hitch our wagon to their star, because I think that star will ascend again and it will be brighter than ever.
We have won this war handsomely, and I don't think we are going to fritter it away.
I want to close with a quotation from Rupert Brooke
"Honour has come like a king to the earth, And' paid his subjects with a royal wage, And nobleness walks in our ways again, And we have come into our heritage."