Vietnam Veteran Myths

I’m leaving for Albury tomorrow for a reunion of the army unit (85 Transport Platoon) with whom i served in Vietnam. We expect 150 – 160m people to attend.
The unit was formed in Brisbane in 1966 especially to serve in Vietnam and it returned to Australia in 1972. My service was from April 1969 to April 1970. Men were posted to the unit for a typical tour of duty for one year. A total of around  600 men served in the unit over its time in Vietnam. Many of these  men were regular soldiers (‘Regs’) and a good number were conscripted National Servicemen (‘Nashos’) of which I was one. Both types of soldiers performed exactly the same tasks without discrimination.

There has been a lot of controversy about the experience of Nashos during and after the Vietnam conflict. The Vietnam Veterans Association recently distributed a paper by Dr Brian O’Toole, an epidemiologist with the ANZAC Institute, who has a long term interest in the health consequences of service in Vietnam by National Servicemen. Here is a synopsis of his research findings into a number of common myths and legends held about Vietnam Veterans. Very interesting!

1. “It was safer in Vietnam than in Australia for the Nashos”

Only 1-in-16 young men who were called up actually got enlisted in the Army. From the 63,745 NSM who were enlisted in the eligible time period, 19,450 were sent to Vietnam. That’s 30.5%, less than a third. So even if you were called up, there was actually only a 1.9% chance that you would be sent to Vietnam. The mortality rate of NSM veterans in Vietnam was about 1.1%, very similar to the Regular mortality rate and very similar to the overall American mortality rate. Australia’s contribution was exactly proportional. But during the war years there were 188 deaths of NSM in Australia (mostly occurring as road deaths). This is a mortality rate of les than 0.3%. So the relative risk of death, if you were a Nasho and were sent to Vietnam, was 4 times higher than the risk if you were a Nasho who stayed at home.

2. “Only the ones dumb enough not to get out of it were sent”

The Army had a screening Psych test administered on enlistment called the AGC that basically measured intelligence. It was scaled, or “normed” on a general Regular population to have an average of 10.5 on a scale of 1-20. The average AGC score of the Nasho veterans was 13.5, much higher than the background Regular Army population of 10.5. But, when compared with the Nasho veterans, the Regulars were not different; this means that the Regs who went to Vietnam were significantly brighter than the ones who stayed at home. Australia sent its best, fittest and brightest of both Regulars and Nasho’s to Vietnam and it’s more likely that the dumb ones stayed home.

3. “The Nasho had it easier than the Regs”

When you look at the rate of Post Traumatic Stress Disorder (PTSD) and other mental disorders in Regs and Nasho’s, there is absolutely no difference. This means that you don’t need lots of direct combat or be a Regular enlistee to be vulnerable to PTSD and depression. Dr O’Toole states that eight months in a war zone alone will do it for you, whether you were a Nasho or a Reg. Sometimes, it can only take one day.

4. “The blokes who came home by sea have less PTSD”.

This was a common myth heard around government circles and military senior ranks for some time; that a nice sea voyage home, fuelled by lots of beer, would leave PTSD behind, much like the line of cans that floated behind the troop ship known as the Vung Tau Ferry on the return trip. Controversy raged and was fed by the image of men fighting in the jungle one day, and the next finding themselves discharged at the airport and alone late at night on the way home. But when Dr O’Toole looked at the different rates of PTSD for those who came home by sea and by air, there was absolutely no difference.

5. “Just get over it, son; it’ll get easier as you get older”.

Population evidence shows that the prevalence of most mental disorders actually reduces as people age – older people have better overall mental health, except for the dementing disorders, of course. The ages of 15-25 are dangerous for schizophrenia and the psychotic disorders, and the ages of 35-55 are dangerous for anxiety and depression, with the peak age of suicide in men occurring in their mid-50s.  Post Vietnam studies showed that veterans had many times higher rates of depression and anxiety than expected based on population figures. Although it is a rare condition, imagine rates of recurrent, severe, chronic depression at literally 40 times higher, not just 40% higher, than for the same age groups in the Australian population. And this study took place 3 decades after the war.

6. “You didn’t fight in a real war”.

How many Vietnam veterans heard this, just before they were chucked out of an Returned Services League Club? It comes from the old view of what types of activity occur in a war that sees army set upon army, as occurred in previous conflicts. Vietnam was a war without fronts, where non-combatants could easily become targets, where the friendly local by day could become a most unfriendly cat in black pyjamas by night, where you could get into trouble walking down the wrong alley in town. It was a conflict of counter insurgency, fought among a civilian population, all the time on TV. Where the military historian (Major) McNeill wrote that Vietnam placed Australian men into longer periods of risk of contact with the enemy than at any time in Australia’s history since Gallipoli. Scientists are beginning to untangle the causes of PTSD and other war-related disorders by looking at the environmental assaults experienced by combatants. It is probably impossible, or at least unsatisfactory, to try and compare wars – but you can extrapolate. From what we know about Vietnam and subsequent conflicts, the veterans of World War I, World War II, Korea, and other conflicts will have had similar rates of psychological problems as a result of their war service. We can extrapolate that the peacekeepers in nasty places like Rwanda would have similar rates of reactions to their experiences and require the same levels of support. All wars and conflicts are traumatic and nobody’s war is more traumatic or less traumatic than anyone else’s war; the same level of human suffering can be expected after any military conflict.

7. “Veterans have multiple unstable marriages”

This common myth is definitely not supported by Dr O’Toole’s data: 79% of veterans had been married once only – compare this with up to 40% of Australian marriages ending up on the rocks. At the time of interviews, 3% had never married, 4% were separated, 3% were widowers, and 10.5% were divorced. When these are compared with Australian population (Bureau of Statistics) data, it shows that there is no essential difference between the marital status of veterans and the marital status of the general population. Moreover, the level of domestic violence is exactly the same among veterans as in the general Australian population.

8. “They would have been like that anyway”.

This is one of the most insidious, arrogant and destructive myths that Dr O’Toole says that he has heard expressed around DVA (Dept of Veterans Affairs) and Department of Defence. From his paper that examined the risk factors for PTSD (that was published in 1998), he took information from different time periods – at school, between school and the Army, in the Army before going to Vietnam, and in Vietnam. He tested 100’s of items. He asked veterans if their father was in the military in World War II, in combat, and whether he was affected by his service. Interestingly, a father being affected by his WWII service came up as a predictor of PTSD, so much so that he had a long exchange with a journal editor and an anonymous journal referee who wanted to emphasise the possible genetic influences on PTSD. His psychiatric assessments showed that a few veterans had symptoms of depression and agoraphobia before going to Vietnam. And there was some association between having depression and agoraphobia before going overseas and later development of PTSD. So it seems the myth may be correct. But we are talking very small amounts, although statistically significant.

9. “Veterans biggest problem is PTSD”.

No, the veterans’ biggest problem is not PTSD. In an early post Vietnam study, he found PTSD to have occurred in 20% of veterans and it was current (i.e. symptoms in the past month) to the level of 10%. But alcohol abuse and dependence were much more prevalent – approximately 47% of veterans with alcohol disorders, more than double the PTSD rate. In a letter study, 30 years after the war, he found PTSD had increased to about 25%, while alcohol disorders had come down to about 28%, but they were still the highest prevalence of the psychological disorders and were many times more prevalent than the background Australian population. High cholesterol, hypertension, deafness, haemorrhoids, osteoarthritis, gout and back pain were all at much higher prevalence’s than PTSD, as was general anxiety disorder.

10. “We don’t have to worry about the wives until they become widows”.

This has been the traditional view of the government and military support organisations such as Legacy. In his study of veterans’ wives and partners, Dr O’Toole found that the partners of veterans are not just struggling with their impaired partner but are themselves suffering elevated rates of serious psychiatric illness, especially severe, recurrent depression, even 3 decades after the war.