Operation Vietnam: A New Zealand Surgical First

2004

1: The Start

Would you be interested in going to Vietnam as surgeon and leader of a medical team for a year?' With these words, the Dean of the Otago Medical School raised both my interest and my pulse rate. We were standing in the Students Union Building at the University of Otago in Dunedin, amongst the busy preparations for the trade exhibition at the 1963 Biennial Conference of the New Zealand Branch of the British Medical Association. The drug and instrument companies were busy laying out their wares, with cables, stands, advertising placards and drug samples in profusion. It was all brightly lit by the slanting sunlight of a clear February day. These were the days when the BMA Conference was a major opportunity for clinical discussion and case presentation across the whole spectrum of medical practice. The meetings were always well attended by both GPs and specialists – a far cry from the sectionalised meetings characteristic of today's gatherings.

Having given the Dean, Dr E. G. (later Sir Edward) Sayers, a guarded expression of interest in a project that sounded very vague indeed, I was given the telephone number of the Foreign Affairs Department in Wellington and told to ask for a Mr Brian Lendrum. As Press Liaison Officer for the BMA meeting, I had responsibility for arranging interviews with key speakers by newspaper and radio reporters. It happened that just after I had spoken with Dr Sayers, Jean Heal of the BBC appeared unannounced, looking for information to include in her travel talks and a book. In a rather preoccupied way I gave her some background information on the Otago University Medical School and the New Zealand Branch of the British Medical Association, all of which left her convinced that we were still quaintly and traditionally British. I recall going home to lunch that day and saying to my wife Annabel, 'How would you like to go to Vietnam for a year?' Her response was immediate and emphatic: 'Why not, when do we start?'

Neither of us had any knowledge of Vietnam and we were only recently back from five years in the UK. Perhaps our optimism was partly due to the fact that my career path was anything but clear. I had come back to Dunedin on spec and with no proper surgical appointment. In desperation I had taken the post as Resident Surgical Officer in the Dunedin Hospital the year before. That was followed by an attempt to set up in private practice. I had a small income from a post as surgeon demonstrator in the Anatomy Department, but with five young children the financial prospects for 1963 looked bleak indeed.

It was, therefore, with a sense of heightened anticipation that I telephoned Brian Lendrum later in the day. His dulcet tones became almost excited as he took on board my evident interest and immediately asked me to fly to Wellington to discuss the project in detail. He met me at the airport and his urbanity and ease of manner instantly appealed. He whisked me off to one of Wellington's better known restaurants, The Copper Kettle on Oriental Parade, where he introduced me to avocado with herbs and a french dressing. A glass of very passable Hawke's Bay dry white wine further contributed to the comfort of this first briefing. Over the next few weeks, Brian was to become a familiar figure to us.

In broad outline he told me that the Americans had built a series of surgical suites in most of South Vietnam's main provincial towns. The Vietnamese were asking other Western countries to help them staff these units so that civilian victims of Viet Cong guerilla operations could be properly cared for. New Zealand's close political and military relationship with the USA meant it had been very much to the fore in agreeing to contribute. It transpired that a team had already been recruited but the surgeon originally selected to act as leader had been forced to withdraw. Brian Lendrum was therefore desperately trying to find a substitute. Dr Aldwell, a general practitioner, and Ron Mackenzie, a medical laboratory technologist, were already overseas with their families and the two nurses recently appointed were about to leave for Vietnam. They were Mary Mackay from Wellington and Betty Forgesson from Auckland. None of these people were known to me at the time.

It was thus not just a pioneering exercise in establishing a working surgical unit in a foreign country that I was required to do, but also an administrative role dealing with an unknown group of individuals who had already been appointed to their positions. I learnt, for example, that Basil Aldwell was to act as a roving GP gathering patients for the Unit from the surrounding countryside, and that Ron Mackenzie would double as a radiographer and run a laboratory service with a blood bank. I was given no information about the nurses except that they had some theatre experience. My anaesthetist, also just appointed, was to be Dr Trevor Jacquiery, at the time an anaesthetic registrar at Wellington Public Hospital. The continuation of the project depended totally, therefore, on my acceptance of the task.

Much emphasis in the early briefing that weekend was put on the upside of life in a former French colony. Vietnam was portrayed as an attractive country with beautiful beaches and reasonably sophisticated living conditions. The people were intelligent, industrious, and French speaking; servants would be reliable; and almost certainly the children could attend French-speaking schools. A magic carpet of first-class airfares, accommodation, and ambassadorial assistance with no expense spared was spread before me. My pay was to be that of a specialist surgeon about mid-point on the automatic scale and paid in US dollars on site. Various allowances for clothing and leave were added to the glittering array of rewards on offer. The chief temptations, apart from the apparently well-paid employment, were the prospect of adventure, the appeal of a unique pioneering enterprise, and the feeling that one could do some good for the unfortunate local people in South Vietnam. I had no idea what part the Colombo Plan had in all this.

While in Wellington I was kindly entertained by Rodger Perrin and his wife. Rodger was a former fellow student and now a diplomat. He and his wife had recently returned from Bangkok, but what they told me about South-East Asia simply went in one ear and out the other, including their warnings about 'culture shock', which to me at that time meant the bite of a vindaloo curry or eating Japanese raw fish dishes. I returned home to Annabel and poured out all the tempting information I'd gleaned, with just a little exaggeration to convince her still further.

Our parents took the news of our proposed venture firmly on the chin. My wife's father, Stanley Wilson, had earned the DSO in the Western Desert as a surgeon with the Mobile Surgical Unit, which had operated as near to the fighting as it was possible to get. He had also just retired as President of the Royal Australasian College of Surgeons. My own father was a fully qualified surgeon who had given remarkable service to South Canterbury and Waimate, not only as a surgeon but also as an obstetrician and a GP. Both sets of parents accepted our decision without attempting to interfere or remonstrate in any way, which of course made our decision to proceed just that much easier.

In the end I simply rang Brian Lendrum and agreed to take on the assignment. No contracts were signed on either side. That agreement, however, meant we had to move at break-neck speed. From 18 February 1963 we were swept up in a chaotic round of business, travel arrangements, and social activities that seemed quite unreal. My most enduring memory from that time was the assembly-line procedure adopted for the vaccination of the children. They needed paratyphoid A and B, smallpox, cholera, scrub typhus, and ultimately plague – all regarded as essential. As well they had the usual tetanus jab. It became a nightmare for the younger children and just another stress for us. The whole process was accomplished in ten days, so heaven knows what we did to their immune systems.

My urgent search for advice on tropical diseases virtually drew a blank, apart for one valuable comment: 'wait until you get there and see what turns up'. Then, anxious to shore up my future prospects after the proposed year of absence, I went to see Dr Sayers as well as the Professor of Anatomy, W. E. Adams; the Registrar of the University, Jock Hayward; and the Professor of Surgery, G. J. Fraenkel. I also saw the Chairman of the Hospital Board, John Fulton. Finally I had several sessions with my somewhat bemused accountant, Jim Valentine, who was only too well aware of how low our finances were. My lawyer, Iain Gallaway, undertook to keep an eye on our affairs at home, and lease the house while we were away: a task which he managed very satisfactorily. We simply fired all our possessions into a spare bedroom and locked the door. Numerous friends invited us to farewell dinners, and all expressed concern that we, with somewhat gay abandon, seemed to be throwing ourselves into an abyss of uncertainty. There is nothing quite so exciting and euphoria-inducing as the promise of expensive travel and employment paid for and underwritten by a government department such as External Affairs. It was that, as much as the fact that we were already used to travelling with the children, although mainly by sea, which gave us our confidence. My training in general surgery seemed to me to be broad enough to cover most problems I might have to face. In that sense, therefore, I did not feel unprepared and perhaps this enabled me to view the prospect of team management and family care with some degree of equanimity. Nevertheless, by taking the most optimistic view instead of being fully prepared to assess the challenges in a more pragmatic way, I did not make my future task any easier.

Finally, after several urgent appointments with our incredibly accommodating dentist, Don Green, and an extensive photographic session with Franz Barta, we departed for Wellington on 4 March. An overnight stay at the Grand Hotel, Willis Street, included a brief audience with the Prime Minister, Keith Holyoake: my first encounter with someone of real importance in the political world. The PM had vaguely impinged on our lives when were in England in 1956-61. Our most enduring image of him was a televised state dinner which he attended alongside other political dignitaries and the Queen. He was caught on camera lighting a cigarette before the Royal Toast was given and hastily putting it behind his back. An amusing moment that stuck in the memory – indicative of the socially ignorant colonials we were still regarded as then, but hardly damaging behaviour on his part.

He was, face to face, very affable and apart from the faintly pontifical accent, which seemed to be very much part of his image, he spoke warmly enough though I recall little of the conversation, probably because I was a bit overwhelmed by the occasion. I had after all been ushered into the PM's presence by Alister Mcintosh, then Secretary of the Department of External Affairs, who indicated that here was a young surgeon about to put New Zealand on the political map in Vietnam. The few words I'd had with Mcintosh beforehand had, however, indicated his rather lukewarm approach to the whole exercise. He was clearly unconvinced much good would come of it, but to me he was kindness itself, and I would have welcomed an opportunity to talk further with him. Holyoake told me he had visited Vietnam a year or so ago and had been captivated by the attractive Vietnamese women in their flowing, rather sensual costume, the ao dai. About the only thing I recall of that meeting was his rather jovial, slightly conspiratorial comment that he longed to pat them (the Vietnamese women) on the bottom. Having laughed dutifully at this little aside, I noticed a photographer was being ushered in and the PM produced his Visitors' Book for me to sign. Holyoake carefully stage-managed the moment by seating me at his desk and standing over me while I made my rather shaky signature beneath that of the latest American Ambassador. He was careful to push the cigarettes and matches out of range of the camera, and it was this photograph that Mcintosh later sent to me in Vietnam as a momento of my elevation to brief prominence.

In hindsight it was hardly surprising that I remember little of Holyoake's monologue. The whole programme was so fragmented and thinly prepared that only the broadest and most simplistic comments were possible. We were going to relieve the suffering of a civilian population in Vietnam ravaged by the guerilla tactics of the Viet Cong insurgents in a countryside almost devoid of sophisticated medical care. We were told that the Vietnamese army looked after its wounded and had absorbed most of the local expertise available. The Americans were prepared to offer equipment and buildings in which teams of surgeons could work, at the request of the Vietnamese government. The fact that their request had not preceded the American offer was lost on us until much later. To an innocent young man not averse to an adventure, it all sounded remarkably plausible. It was also highly significant (and doubtless earned the government many brownie points) that New Zealand was to be first in the field alongside the Americans. Our publicity machine had started to roll. On 6 March we were duly taken to Wellington Airport armed with official British passports loaded with the children's names, and our hastily compiled travel tickets. Farewelled by Brian Lendrum, we boarded the afternoon Lockheed Electra flight to Sydney.

It became obvious as we boarded the plane that, first, it was full to capacity and second, we had been allocated a carrycot for our nine-month-old Sarah and three seats for ourselves and four children whose ages ranged from six to two. It was an impossible to compress ourselves into this space even with lap-sitting, and by now the children were getting anxious. Annabel and I ended up standing in the aisle for the entire four-hour journey, to the embarrassment of the cabin crew, who largely ignored our plight. It was not an auspicious start to our supposed first-class trip to Vietnam. In fact it was a portent of all that was to follow.

We arrived at Sydney Airport, neither rested nor happy, but the children remained remarkably well behaved as we queued up in the customs area. Our first use of our official passports was not encouraging. The large and aggressive Australian customs official we finally reached made no concessions whatever. It seemed he was being deliberately slow and officious, as he checked all our credentials, ignoring the needs of the family, all of whom instantly asked to go to the toilet. These, we found, were on the other side of the customs barrier.

We had been booked in overnight at the Hotel Australia in Sydney, a large, busy, impersonal place, and again our arrangements were less than satisfactory. To our dismay we had been given three rooms on different floors, the family being effectively separated. Why? Because no one had given the hotel the ages of our children. It was a traumatic night and we had to forego the farewell dinner planned with Annabel's parents, who were in Sydney for a meeting of the Royal Australasian College of Surgeons.

Quite early next day we were at Kingsford Smith Airport to join the BOAC Constellation flight to Singapore – and here at last was our taste of luxury. The entire first-class area was given to us, complete with our own butler and air hostess. Champagne never tasted so good as we taxied out for take-off and a comfort-filled flight to Singapore. Before we left Sydney I'd taken the precaution of cabling the New Zealand High Commissioner's office in Singapore, not just to confirm our arrival, of which it seems they were unaware, but to give them our accommodation needs. I had also rung Brian Lendrum in Wellington who was soothingly apologetic and hoped things would improve.

Singapore then was a far cry from the worldly metropolis it is today. The arrival area was basically a corrugated iron shed with the most spartan arrangements. At least there was little delay in getting through the formalities and we were met by Bart Finney, a most genial and helpful first secretary at the New Zealand High Commission. Although the best places were full, the Hotel Cathay proved reasonable and at least our rooms were adjacent.

It was our first experience of tropical heat and the sounds of the night: the cicadas, the street calls, the subdued traffic noises seemingly blanketed by a sticky warmth and stillness. In those days Singapore was distinctly Malaysian with a minority of Chinese. Things seemed to move slowly – rickshaws were common, and cars less evident, but Robinsons was a busy department store while bargaining at Change Alley market was in full swing. We had been told not to take a lot of clothing with us and therefore arrived with little more than what we stood up in. It seemed a good time to put our clothing allowance to immediate use in light cotton clothes for the children and tropical outfits for Annabel and me. I even had a couple of suits made to measure within thirty-six hours, together with extra trousers as I'd been warned that no professional person in Vietnam wore shorts. All our outfits were washable and lasted the distance very well.

I met Hunter Wade, the High Commissioner, next day. He was austere and slightly distant, but offered some very sensible views on South-East Asia and the threat of communism. For all that, he did not enthuse about our proposed venture and couldn't throw any light on where the other team members were or what was going on in Qui Nhon. By this time I was feeling pretty desperate about our future. Qui Nhon might as well not have existed and any accommodation for us as a family remained a complete mystery. By a fortunate chance, however, my cousin Ruth Mary and her husband, Neville Beach, were resident across the causeway in Johore Bahru. Neville, a civil engineer, was working on site. After much soul-searching we decided, through Hunter Wade, that I would proceed alone to Bangkok and Vietnam to try and expedite the accommodation plans. Annabel meantime would move the family to a hotel in Johore Bahru where she'd be closer to our relatives.

On 10 March I flew Cathay Pacific to Bangkok. Again I'd cabled ahead, and was met by Peter Gordon, the second secretary at the embassy. A cheerful extrovert, Peter had a passion for Thai and Chinese pottery. He gave me the only first-hand account I had had of Qui Nhon. The previous year he had flown over it at 5, 000 feet, and saw a sandy peninsula with a small fishing village at one end.

It transpired that just as I arrived in Bangkok, Sir Stephen Weir, the Ambassador, had taken off for Saigon with his third secretary and an administrative assistant. For some unexplained reason I was not allowed to proceed. This made me more anxious than ever. I suspected they were trying desperately to make