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CAHILL
FRANCIS JOSEPH Captain |
VX39702 2/9 Field Ambulance |
Frank Cahill was born in Melbourne on 1 July 1914. His
primary school education took place at St. Brendan's Catholic primary
school in Wellington Street Flemington and his secondary education took
place at St.Patrick's in East Melbourne. He undertook medical
studies at the Melbourne University Medical School entering university
at 15 years of age and graduating in 1935 at the age of 21.
Frank still holds the record of the youngest doctor to have graduated
from an Australian University. He graduated along with Colin
Juttner (later to become a fellow Medical Officer in 2/9 Field
Ambulance, a Prisoner of War and later a member of "F" Force on the
infamous Burma Thailand Railway).
Frank completed his residency at St. Vincent's hospital in East
Melbourne. In 1935 he was awarded the Michael Ryan
scholarship in surgery, which was an award of £100 presented
through the St. Vincent's clinical school of medicine and
surgery. The rules at that time prevented doctors under the
age of 25 from practising surgery unless they had an overseas
qualification. Keen to study surgery, he travelled to London
to complete his FRCS at Guy Hospital. He was one of the
youngest to have been granted the fellowship.
(Co-incidentally, his colleague Captain Colin Juttner was in the United
Kingdom around the same time- See Juttner story elsewhere).
Frank returned to Melbourne and was appointed a surgical clinical
assistant (out patients) at St.Vincent's on the 31st March 1939.
On the outbreak of war, Frank enlisted in the Australian Imperial
Forces on 13th February 1941 and was appointed Captain (Medical
Officer) in the 2/9 Field Ambulance. (The writer is surprised
that as a specialist he was not appointed with the rank of Major and on
the staff of an Australian General Hospital).
On the 25th February 1941 he married Marjorie Mary Atchison, a nurse
whom he had met while working at St. Vincent's Hospital.
After 1 day's honey moon in Lorne Victoria, he was called up and went
to Sydney staying briefly at Manly with his mother and his new bride
who had travelled with him.
The members of the 2/9 Field Ambulance boarded the Queen Mary and
sailed from Sydney early in February 1941. The ship proceeded
to Fremantle without a stop at Melbourne or Adelaide. On 16
February, the Queen Mary left a convoy in the Indian Ocean and
proceeded to Singapore. The remainder of the convoy proceeded
to the Middle East. Captain Frank Cahill left for Singapore
on the troopship Zealandia arriving on the 9th June 1941. It
seems that Captain Cahill may have been a reinforcement.
The 2/9 Field Ambulance was deployed on the East Coast of Malaya and it
is recorded in the book "Men of the Ninth" by, then, Lieutenant Colonel
Robert Likeman p 129 that Captain Frank Cahill on around 14 January
1942 was with Head Quarters Company. On 15 February he, with
many others, became Prisoners of War and was incarcerated on Singapore
Island..
In April 1943 Captain Frank Cahill was one of ten Australian Medical
Officers who were sent to Thailand as part of a group known as "F"
Force. "F" Force was a party of 7,000 POWs comprising 3,400
British and 3,600 Australians.
This Force, endured a 4 night/5 day train trip from Singapore to a
location called Banpong in Thailand. On this train trip about
30 men were crammed into steel railway trucks about 18 feet by 7
feet. The only ventilation was a sliding door in one
side. Meals (usually about a cup of rice, supplemented with a
small amount of meat or seaweed) and toilet stops were
spasmodic. The force moved to Thailand in train loads of
about 650 men at a time. The Australians were first, followed
by the British.
On arrival they were forced to march north about 270 kilometres, mainly
on jungle tracks, towards the Burma border. The march was at
night, as the daytime temperatures were around 45 degrees Celsius and
the monsoon rains were just starting. By day they tried to
find some shade and sleep. However, for the Medical personnel
there was little rest, as they attended to the sick, sore and
lame. The march lasted about 18 nights.
It is fortunate that Captain Roy Mills published extracts of his diary
in a book titled "Doctor's Diary and Memoirs" ISBN0 646 19473 9 in
1994. From this record it is possible to plot where Captain
Frank Cahill was from time to time.
Entry for 23 May
1943 says -
"171 men off duty
with dysentery or diarrhoea or convalescing-
………..
Fit men working on
roads or bridges.
Have been very
busy- No figures but cholera position reported under control from
higher up. Believe Major Hunt, Lloyd Cahill and John Taylor went to No
1 Aust Camp whereas Major Stevens, Pete Hendry and Frank Cahill
remained at no 4 Camp about 16 km N of here." This
would place Frank Cahill at Koncoita.
Entry for 16 June
1943 says -
"…………
Capt Pete Hendry and Frank Cahill having gone to Nike
……."
Entry for 13
September 1943 -
"Major Hunt went
to Burma with one other R.M.O. Capt F Cahill"
Entry for 26
November 1043 says -
"…..
Tanbaya train arrived around 1130. Major Bruce Hunt looking
well - still had extrasystoles following cardiac beri beri. Capt Fred
Stahl, Norm Couch, Geo Gwyne all looking well. 320 left behind
including 107 fit men. Captain Frank Cahill & Assistant Surgeon
Wolfe remained (at Tanbaya)."
The above mention of Tanbaya, signals an important part of the Frank
Cahill story and his close association with Major Bruce Hunt.
Briefly, 'F" Force had such a high sickness and death rate that even
the Japs finally conceded that something must be done. It was
agreed that around 2,000 of the sickest would be moved to a special
hospital where they could recover. However, defying logic,
this hospital camp was located in Burma, just 50 km from where the
railway started from the north.
To care for the nearly 2,000 there were only five Medical Officers -
Major Bruce Hunt (AAMC), Captain Frank Cahill (AAMC), Major Bill
Phillips (RAMC), Captain Emery (RAMC) and Warrant Officer (Assistant
Surgeon) Patrick Wolfe (Indian Medical Service). Frank Cahill
was the sole surgeon. There was also a group of men who
worked hard to keep their fellow POWs alive. This included
Officers who became Wardmasters, Medical Orderlies and the volunteers,
who were often convalescents. One should not forget the sole
Chaplain, who was a British officer Noel Duckworth.
Notwithstanding their efforts 671 died over a matter of 3 to 4 months.
Detail about this hospital camp is shown on the World Wide Web www.2-26bn.org/tanbaya_hospital.htm
. Fortunately the report of Major Bruce Hunt is published in
detail on this website. The report was written on 23 December
1943. Unfortunately, Hunt mentions a report by Capt F.J.Cahill
concerning Tropical Ulcers. This I have not been able to
locate. Below are extracts from the book "Clinical Problems
of War" by Allan S Walker. The extracts may have been based
on Cahill's report (apologies for the medical terms). -
Page 509 "Captain
F.J. Cahill, A.A.M.C., in reporting a series of 420 men suffering from
tropical ulcers in Tanbaya camp hospital, described the almost
incredibly unfavourable circumstances under which amputation became
necessary for the rapid spreading of these ulcers. The tibia
was often exposed and wide-spread sepsis was very common.
Amputation was done on 40 men, at first as low a site as seemed
advisable being chosen, but the site of election too often ran through
an ulcerated area, and sloughing of flaps was frequent, often with
secondary haemorrhage. Cahill found the association of
oedematous beriberi with acute ulcer was very often fatal, and in this
condition amputation was abandoned. The level of amputation
was at mid-thigh in twenty-five cases and the upper third of the thigh
in fourteen. Though these men survived immediate operation,
only four patients were still alive three months after the last
operation. Under more favourable conditions the hazard of
spreading sepsis and chronic osteomyelitis in the lower limb could be
reduced by an earlier and bolder policy of amputation at a reasonably
high level before ulceration spread in the limb."
Page 600 "Captain
F.J. Cahill, A.A.M.C., wrote a special report in March 1944 which
describes well "tropical ulcers" as seen by only too many medical
officers. He emphasised the speed with which a small abrasion
of the skin became infected and within 48 hours would appear as a
sloughing ulcer involving fascial and muscular structures.
Sometimes a line of demarcation would be formed, with an associated
zone of tissue reaction. In debilitated patients no such
reaction occurred, and death from toxaemia was frequent. The
pain was considerable, and sometimes intolerable, of a constant burning
type, preventing sleep. Muscular spasm was an important
associated feature, leading not infrequently to contractures
perpetuating flexion of the knee or dropped foot. Where bone
was near the surface, as in the front of the leg, the periosteum soon
became necrotic, and the exposed bone eroded. Sequestration
of flakes of bone or even large parts of a diaphysis was not
uncommon. Favourable progress sometimes took place with
granuation of the deeper tissues, but, even if bony sequestra
separated, healing was very slow. The growth of skin was
exceedingly slow: an ulcer not much larger than an inch in diameter
would take many weeks to close. Pus formation did not occur
in the most virulent ulcers, but in others it tracked along tissue
planes for considerable distances, calling for incision and
drainage. Cahill remarked particularly on the rapid spread of
tropical ulcers if the patient fell ill with malaria, or dysentery,
when physical deterioration and death were not infrequent.
Beriberi was a frequent complicating factor also, and oedema whether
due to protein or vitamin deficiency hastened the extension of
ulcers. One common and very serious combination was the
infection of a subcutaneous bleb on the dorsum of an oedematous
foot. The skin and deeper tissues disappeared, leaving a foul
ulcer, and the patient rapidly died from toxic absorption.
Secondary haemorrhage was fortunately rare, but very dangerous.
There was no
question of the importance of the nutritional factor in the production
and extension of these ulcers, but unfortunately it was largely outside
the control of the medical services. Treatment was therefore
limited to local measures; it was never certain if the unfortunate
patient would be allowed to rest, or be forced out to work.
It was in those camps where tropical ulcers appeared in their most
severe form, that drugs and dressings were exceedingly
scanty. For example, four hundred men in all needed treatment
in Tanbaya, and the quantities of antiseptics, sulphanilamide or even
salt were totally inadequate. Water sterilisation powder in
solution was used as a dressing, but water too was limited in
supply. Sulphanilamide could be given only a restricted
trial, but Cahill obtained excellent results, and thought that further
supplies would have lowered the death rate substantially."
Page 602 "At
Tanbaya 420 patients were treated for "tropical ulcer"; of these 250
died (60 per cent). Two-thirds of the deaths were associated
with the onset of intercurrent disease, in particular dysentery,
beriberi, and malaria. Amputation was performed on 40
patients with no immediate deaths. Three months later,
however, only four of these patients were still alive. Cahill
comments on "the amazing cheerfulness and fortitude of the patients in
the ulcer wards - and the steadfast devotion to duty of so many of the
workers" in these wards."
The book "Heroes of F Force" ISBN0 646 16047 8 published by the late
Don Wall has a number of references to Captain Frank Cahill.
Page 5 - April 43
- Lt Bob Kelsey - "The first time I saw Captain Frank Cahill, AAMC, was
on the short and very hot walk from the train to the huts waiting us at
Banpong. I noticed a man dumping a portable typewriter beside the
track, and asking him why he did so. It was Frank Cahill - he said he
could carry it no further, so I picked it up for him, carried it on and
handed it back to him when we reached our
accommodation………..". " I
meant to illustrate his courage on the exhausting walk up the line,
when we all were soon at the point of collapse. It was while I was
lying on the track during one of our inexplicable breaks that
saw Frank Cahill, still plump and flabby as a result of never having
indulged in physical exercise - certainly never on a route march
wavering down the line of panting men asking if anyone needed help and
asking "Any Complaints?" I thought, "Here is a better man than I am."
Page 91 -
September 43 - "Stricken men were found with gaping ulcers on legs,
arms and backsides. Almost every man in the ward of thirty had ulcers,
malaria and dysentery - their only relief was a merciful death. Firstly
began the clean up - blankets filled with lice - bed bugs ran unchecked
through the bamboo slats - excreta ran underneath the hut.
The blankets were placed on the ant hills of the red ants who feasted
on the lice and bugs; suppurating ulcers were scraped with spoons and
those whose limbs were beyond repair were amputated by Capt
Frank Cahill with a carpenter's saw and the very little morphine to
deaden the pain….."
Page 98 -November
43 - Lt Bob Kelsey says - "I was searching in the rain forest
for wild mushrooms to make soup for one of my men who could not eat
rice, or would not, when I came into a small clearing. There I saw the
camp surgeon Capt Frank Cahill on his knees praying. I backed away
quietly. His was a terrible job. Forced to decide whether to operate,
or rather amputate while there was still a chance of recovery, or wait
until there was no alternative to
amputating…………"
I will now quote from the unpublished Autobiography of Captain Fred
Stahl - 8th Division Signals. I would also mention that I
feel this has a direct link to Lt Bob Kelsey quote of November 1943
(see above).-
The five
amputations referred to in the diary entries were a part of a total of
40 resulting from tropical ulcers. These occurred very
frequently and followed upon small scratches or cuts, the skin of many
of the POW appearing to possess little or no resistance to infecting
organisms. Quite a large proportion of the ulcers were
horrifying severity - huge areas of skin, flesh and, in some cases,
bone were eaten away. Although Tanbaya was supposed to be a
hospital camp no drug supplies of any kind were received from the
Japanese until 5 November - three months after the hospital was
established and only 19 days before the main body of surviving patients
were evacuated. The only dressings available were those made
from the clothes of dead men, and in most cases the ulcers were
bandaged with banana leaves. It was not uncommon for
blowflies to lay their maggots on the ulcer wounds a happening which
was usually welcomed by the sick for the maggots ate only the purulent
flesh and disposed of it in a much less painful way than the scaping
with a spoon.
In these
conditions it is not surprising that the only hope of saving lives of a
large proportion of the ulcer patients lay in amputation.
Most ulcers occurred in the lower leg and particularly in the region of
the ankle to knee. In these cases amputation above the knee
was imperative. We had a first-class surgeon in the person of
Frank Cahill, but he had no operating instruments. The Japs were unable
to supply any, but agreed that Frank could visit an "A" Force camp at
the 45 kilo mark to endeavour to obtain some. He was
successful in obtaining most of the essentials, but could not get a
surgical saw. A further appeal to our own Jap guard failed,
but again the Nip engineers at the camp across the railway came to our
aid, agreeing to make a carpenter's panel saw available from three to
four p.m. each day.
There was an acute
shortage of trained medical orderlies. Frank Cahill's only qualified
assistant being a sergeant from the Australian Army Medical
Corps………in the conditions existing at
Tanbaya Frank readily accepted my offer to help in any way I could and,
in fact, I became one of his assistants at every operation,
and also at several post mortems he performed.
The "Operating
Theatre" was a small hut, about ten feet square, with bamboo sides and
a floor of bamboo slats. The roof was of Attap. The
operating table was made from bamboo, with the top also of bamboo
slats. Outside the door we built a fire to boil the water in
which we sterilised the instruments, including the Japanese
saw. Fortunately, included in the medical supples laboriously
carried from Changi and husbanded so carefully there was some Pentothal
and Chloroform. The former was used by the anaesthetist
Captain E.J .Emery R.A.M.C. to induce unconsciousness, the patients
then being kept under by ether. Even in those daunting
circumstances the skill of Capt Emery in anaesthesia was so great the
no amputation patient- and many of these were appalling anaesthetic
risks, died during an operation.
No praise can be
too high for the work done by Frank Cahill in those primitive
conditions. Looking back on the circumstances under which he
worked (he actually fell through the bamboo-slat floor in the middle of
one operation) one wonders that he had any success at all.
Altogether he carried out 40 amputations- 39 legs and one
arm. But he operated against almost hopeless odds.
His patients were grossly undernourished, being long deprived of
adequate protein and vitamins. They had been forced to labour
outrageously long hours in mud and filth, they were constantly exposed
to trauma and infection, but, deprived of adequate drugs and
dressings. It is little wonder that ulceration and gangrene
spread like wildfire and that by the time they reached the operating
table their resistance to infection had already been reduced to a very
low level.
Despite this not
one patient died during an operation. Sepsis in the stump
was, however, extremely common, and one patient died within 24 hours of
the operation. Four more died during the next six days and
thereafter the death rate steadily rose. Intercurrent disease
was particularly lethal amongst the amputees and finally only four of
the forty survived. Small though this proportion might
appear, it is nevertheless a major triumph for the surgeon, for had the
operations not been performed not one of the forty could have survived.
In Fred Stahl's autobiography there is mention of Frank having to use
the Engineer's saw for the amputations. It is not necessary
to corroborate that story.
However, when I was in Adelaide June 07, Max Venables (one of only 3
people who I know was in Tanbaya Camp) informed me that he made mention
of Captain (Dr) Frank Cahill and a saw in his book "From Wayville to
Changi" ISBN 0 9579688-0-9. The following is the appropriate
extract from p154 of that book.
" Thursday 16
September 1943 - The saw that is being used for the amputations is just
an ordinary hand saw, and is used for cutting bamboo, as well as
cutting off limbs. Feel a little silly in the head
today. Health fair.
On this day I was
cutting two and three inch bamboos used to repair the attup huts, when
at about 10am, Dr Cahill sent a message out that he wanted to use the
saw.
I was using it so
was detailed to return it to camp. I took it to the "Operating Theatre"
which was a small lean-to in the open. The doctor took the
handsaw from me and dipped it into boiling water for a while.
Several orderlies held the man down by his head, arms and body as the
doctor cut off his leg just below the knee. He returned the
saw into the bucket, gave it to me and I returned to the working
party. I don't know whether any anaesthetic was used but to
my knowledge we had none. The doctors did marvellous things
with practically nothing, up there in that hell-hole."
It is known that Captain Frank Cahill remained at Tanbaya to care for
the sick and dying after the Railway line became operational.
He followed into Thailand, probably early 1944 and subsequently moved
back to Singapore along with all the survivors of "F" and "H" Force.
Captain Peter Hendry has told me that the Medical Officers who remained
in Singapore relieved the "F" & "H" Force doctors of their
duties on their return to Singapore. This gave them the best
chance of making a recovery. See below a picture of three"F" Force
Medical Officers (left to right) Captains Frank Cahill, Victor Brand
and Peter Hendry (there are separate articles about Victor Brand and
Peter Hendry). This photograph was probably taken around September
1945, after the Japanese surrender. Note - it was in front of
the "AIF Embarkation Office". I am indebted to Peter Hendry
for supplying the photograph in July 2007.
Frank Cahill was liberated from Changi camp on the 14th September 1945
and repatriated to Australia on the troop ship Largs Bay. On
the 15th of November 1945 he assumed his role as clinical assistant to
Dr. Robert Hadley, who on hearing that Frank had re-applied for his
previous surgical position at St.Vincent's said 'He will be welcome as
flowers in May'. In December 1945 he was awarded the
FRACS. On the 15th April 1946 Frank was appointed surgeon to
out patients at St.Vincent's and worked in an honorary capacity until
1956 when he assumed the role of surgeon for in-patients until his
resignation on the 20th August 1961. From 1946 to 1960 Frank
also operated a private surgery practice in Collins Street Melbourne.
In 1962 he went into general practice in Hughesdale. In the
final years of his working life he undertook the role of Medical
Officer for the Victorian Railways retiring in 1978.
In 1979 he moved to San Remo, Victoria with his wife where he died on
the 2nd of September 1989. Frank and Marjorie had six
children; Peter, Mary, Anna, Eileen, Frank and Stephen.
Frank Cahill will always be remembered by his colleagues, family and
friends as a gentle man, who with courage, quietly went about his job
of saving lives.
Article prepared by Lt Col
Peter Winstanley with the assistance of Frank Cahill Junior, who
accessed records at St Vincent's Hospital. When at St
Vincent's Frank Junior met a nun who had assisted Frank in theatre and
was able to provide her observations.
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