Australasian Society for HIV Medicine

Reviewed by Levinia Crooks, CEO, ASHM

This book is a collection of letters, almost complete, spanning a year spent predominantly in Nui Dat, during the Vietnam war. The author of the letters and the book is David Bradford. Many ASHM members will be well acquainted with David, and may have worked with him, shared patients, friendships, hardships and experiences. David had recently "found" the letters, returned to him by his mother. When he told me he was writing the book, I was intrigued - what was this man like as an army doctor, how did he experience Vietnam, how did he relate to his family and how would he reflect on this now?

David was a prolific letter writer while in Vietnam. The book combines the letters, published we are told "intact", and his commentary written at the end of each month of mail. It is an interesting format, as you have only one side of the correspondence. The commentaries are self-exploring and have not been sanitised for today's reader, though it is clear that many of the letters were sanitised for the readers and family back home.

When I was told by a colleague that the book was being released, I contacted David and told him I wanted to review it for ASHM News. He told me he had not thought of ASHM as a place for a review, and did not think the ASHM membership would be interested, but I'm sure that assessment is incorrect. ASHM members do not only curl up with a recently released issue of MBJ or MMWR. Many members are David's contemporaries and I am sure they will find the book a great read. There are all the elements that make such a book additionally readable, such as references to people we know and places with which we are familiar.

For me there was also the desire to see whether there would be an analogy between war and HIV. This is not a strong theme in the book, and in that sense the book is not over written, nor over analysed with hindsight. The young Baptist doctor appears to have led quite a sheltered life before the war. His war correspondence is not reflective of adventure, but he was startlingly honest about some of the activities he observed. He seems surprised now that he was as frank as he was in some of his letters. There is a level of naivety in his correspondence, for example telling his mother about girlie magazines and his absolutely banal reaction to them. It is as if he could write about anything, because he was just telling the truth about what was going on around him.

It is only in his present day commentary that we understand David is gay and was coming to terms with this realisation throughout his time in Vietnam. He wrote to his father: "I have been thinking about my situation up here a lot, with regard to being a doctor and a Christian and living in an essentially non-medical (as opposed to hospital medicine), non-Christian environment all the time. It needs a lot of wisdom, which I often feel I lack. It is good to be able to share this with you". In his commentary at the end of the month of June he wrote: "I was enjoying what I was doing and was probably becoming a more effective army doctor. And slowly I was becoming aware and testing the limits of the independence I now had as a free agent beyond the reach of church and family."

What struck me was the level of compassion which David showed to "his gunners" and his colleagues. He recognises that there is much talking to be done in doctoring. While he left the army, ostensibly to take up surgery, I was surprised he did not take up psychiatry.

His letters also reflect a subtle change in his feeling toward the war. In joining the army he was pursuing a career of practicing his religion and his medicine. You get the feeling he had to do this duty. As the letters progress it seems that he was questioning the rationale for the war. Yet he did not question his duty to his gunners. While you get an inkling of this from the letters, it is reinforced by his current day commentary.

Is the war-AIDS analogy there? I think not. What is there, though, gives us a good understanding as to why David became a sexual health physician. Even as a young practicing Baptist he was not critical of the young men who contracted STIs. He took a pragmatic approach and even discussed this in his letters home.

I enjoyed reading this book very much. I could see and hear David as I read. I think you will agree that it is a valuable insight into the development of this doctor, a complex and compassionate man and a very dear friend.