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War Surgery and Medicine

Psychological Efficiency

Psychological Efficiency

The psychoneurotics undoubtedly formed the majority of those who complained of foot disability. This may have been due in some measure to the possibly lower physical standard of this type. The main reason, however, was that the foot was used as the means page 401 of escape, and the normal symptoms of fatigue were exaggerated into a disability which the individual gave in to. If there was some anatomical abnormality, then it was easier for the man to plead disability and more difficult for the medical officer to deny it.

It was realised very early in the war that the large majority of the men complaining of foot disability were the psychoneurotics and the poorer types in the force, and that as often as not there was no demonstrable abnormality in the feet. The flat foot was not an anatomical defect but could produce an abnormal personality. The undue stress laid on the anatomical factor naturally made the management of these cases at times very difficult. Colonel Spencer, OC 2 NZ General Hospital, stressed this aspect very strongly in a valuable report he submitted on the psychological aspect of hospital treatment early in the war.

Brigadier Ogilvie, Consultant Surgeon MEF, stressed the importance of sizing the man up as a whole, and of referring men without demonstrable signs of disability to the psychiatrist for his opinion. He emphasized that flat foot was merely an abnormality of posture and that in the absence of stiffness was not a sign of disability.