42 The respondent next contends that there was no evidence as to the content of the recurrent nightmares and points to the fact that the deceased gave evidence de bene esse that he did not recollect the dreams and that when undergoing structured testing had answered no to the questions: "Have you experienced painful images of memories of your experiences which you couldn't get out of your mind even though you may have wanted to?"; and "Have you had repeated dreams of violence, death or other themes related to your experience?"
43 That contention, however, overlooks the evidence of Mrs Stafford, the deceased's widow, that before the collision the deceased had been a good sleeper who had gone straight to sleep and that after the collision he had been a very poor sleeper who had nightmares sometimes twice a week, sometimes not, other times two to three times per week, and that he would moan and groan and say "Watch out. Mind the water". Professor McFarlane was of the opinion that the fact that the deceased had slept well before the collision and that after it he would wake up in a sweat and sleep walk was strongly suggestive that the dream content was likely to be related to the trauma.
44 There was also evidence given by Dr Fellows-Smith and Dr Stain that the deceased's failure or refusal to disclose the contents of his dreams was part of an avoidance or denial process which was a consequence of the disorder. Dr Fellows-Smith observed that there were particular indications that the deceased avoided talking about the trauma, of which one example was that the deceased had not spoken to his brother, Terry, about the incident since the collision, even though for a while after the accident the deceased had believed that Terry was on the Voyager. In turn that evidence was backed by the opinions of Professor McFarlane and Dr Stain and Professor Hopwood. Professor McFarlane said that the most common form of avoidance is avoidance of any thoughts and feelings. Dr Stain explained that while the deceased did not want to talk about the collision and wanted to block it out, he admitted to a disturbed sleep pattern and displayed strong cognitive avoidance which met the criteria for PTSD. In Dr Stains' opinion, therefore, the denial of dreams or recurring memories was an indicator of avoided reminders. Professor Hopwood gave evidence that while a majority of PTSD sufferers are aware of the troubling nature of reliving the events some of them are not. Some deny psychological symptoms for fear of being asked to describe events that they find overwhelmingly arousing to discuss.
45 The significance of the de bene esse examination also needs to be seen in context. Dr Fellows-Smith viewed the video tape of the examination and noted that the deceased had an avoidant style and a consequent tendency when giving evidence to deny symptoms. He observed that the deceased had difficulty verbalising his traumatic memories and became distracted and distressed when pressed by counsel. Dr Fellows-Smith explained that those recollections needed to be drawn out and that by bringing the deceased to a more comfortable state of mind he was indeed able to obtain a history of recurring memories and indicia of persistently re-experienced "second-hand traumas". Dr Fellows-Smith set out those recurrent memories and experiences in some detail and it is of particular significance that the deceased's intrusive thoughts included the concern that if a party of shipwrights were unsuccessful the bulkhead would collapse and the ship sink. In Dr Fellows-Smith's opinion those recurring memories plainly satisfied criterion B.
46 The respondent next contends that it was not open to conclude that the deceased had satisfied criterion B because of the competing possible inference of alcohol abuse. We do not accept that contention either. Experts called on each side, Professor McFarlane and Professor Shalev, were both of the opinion that chronic PTSD is linked to alcohol abuse and that, while PTSD and alcohol abuse are separate disorders, PTSD sufferers may use alcohol to sleep better and to reduce invasive recollections of the trauma. In any event, the evidence before the trial judge was that the diagnosis of PTSD involves skilled clinical assessment. That is to say, there is no foolproof objective method of determining PTSD. Diagnosis is entirely clinical, based on the presence of specific symptoms as recognised by skilled clinicians. Given the other evidence to which we have referred it was in our opinion plainly open to the judge to accept Dr Stain's diagnosis that the deceased did in fact have recurring memories which satisfied criterion B.
Whether damages excessive
47 The respondent further contends that the judge's assessment of damages for pain and suffering in the sum of $180,000 was manifestly excessive, and the respondent points to the fact the deceased gave evidence that while for a time after the accident he became disillusioned with the Navy he was able to overcome that and continued to be superior in efficiency and was proud of his Naval record. The respondent did not otherwise, that is save for the pain and suffering component, challenge the assessment of damages. It is submitted that upon the evidence the deceased did not seem to have much insight into his condition, and it is noted in particular that when medically examined at the time of re-engagement in 1965 and again at the time of his discharge in 1970 he made no complaints about emotional instability or mental incapacity. Further when his wife complained to him about the excessive drinking habits which he developed following the accident he would say that there was nothing wrong with him. The respondent points to the fact that the deceased did not leave the Navy because he was affected by his condition but because of personal reasons, to assist his wife with his son, and that after some temporary employment he settled to a position with MacRobertson Miller Airlines which he enjoyed and in which he worked well and had planned to remain until he reached 65 years of age. He enjoyed boating and playing golf and he was a member of the Raffa Club. It was only because he suffered a very significant injury to his left foot and ankle during the course of his employment in 1989 that he was compulsorily retired in 1990 at the age of 61 years and he did not seek any work thereafter.
48 Further reliance is placed on the fact that the deceased suffered serious health problems during the 1990's. In 1990, following compulsory retirement, he was diagnosed with chronic lymphocyte leukaemia and, in February 1995, when he was 65 years of age, he was found to have colon cancer which had spread and he underwent surgery for bowel cancer. In March 1995, he was found to have tumours in his bladder and he underwent intensive radiotherapy which caused him to suffer chronic diarrhoea. Following the radiotherapy he suffered recurring episodes of small bowel obstruction leading to 40 to 45 hospital admissions over a space of a few years. In time he came also to suffer from multiple skin cancers and breathlessness on exertion. He underwent open heart surgery for the replacement of an aortic valve and had a pacemaker fitted to control atrial fibrillation. Then in mid 2002 he was found to have further cancer in the bladder and underwent chemotherapy before unsuccessful bladder salvage surgery was attempted in 2004. Finally, while he made six applications to the Department of Veterans Affairs for pension in respect of bowel cancer, bladder cancer, colon cancer, impotence, loss of hearing and skin disorder, he never mentioned any symptoms of PTSD. In a statutory declaration dated 28 January 1998, he deposed to the extent to which his physiological ailments affected his life in a way which it is said leaves little room for such of the effects of PTSD as he may have experienced. In short, it is contended that the deceased's condition was so wretched as the result of his physical maladies, and consequently that his enjoyment of life was so reduced, that there could have been very little room for further reduction in the quality of life as a result of the effects of the PTSD.
49 In the respondent's contention, when one has regard to all of that evidence, and bears in mind that the two largest amounts of general damages for pain and suffering yet awarded in this State are $450,000 (where an outstanding athlete at the height of his powers was rendered quadriplegic)[29] and $500,000 (which went to a plaintiff who was so incapacitated as a result of his injuries as to be completely paralysed in every respect except for his head)[30], a sum of $180,000 was plainly manifestly excessive. In the respondent's submission, the very top of the range would have been in the order of $80,000 to $90,000.
50 The appellant resists that contention. He submits that the judge's assessment was if anything conservative, and in any event well within the range of damages commonly awarded for PTSD injuries. Further, and while recognising that it is not always helpful to attempt comparisons with other cases, the appellant points by way of example to a number of recent matters in which comparable verdicts have been awarded. They include: Commonwealth v Stankowski[31] (13 April 2005): $150,000 (Melbourne-Voyager case); Naidu v Group 4 Securitas[32] (24 June 2005) (injury at work): $150,000 (would have awarded $200,000 but for statutory restraint); Russell v Commonwealth[33] (12 November 1999) (Melbourne-Voyager): $150,000; and SB v New South Wales[34] (14 December 2004) (failure to properly care for ward of state): $195,000. Finally, the appellant invokes the settled rule "that an appellate court will not disturb a primary judge's award of damages for personal injury unless it is convinced that he has acted on a wrong principle of law or that he has misapprehended the facts or that the amount of damages awarded is so inordinately low or so inordinately high as to be a wholly erroneous estimate of the damage suffered"[35]. In the appellant's submission the respondent has not demonstrated that the trial judge fell into any such error.
51 There is force in the appellant's submission. Some of the evidence showed that injuries suffered by the deceased as a result of the PTSD had a profound adverse impact on the deceased's relationships with his wife, children, workmates and friends. It led the deceased to give up the sort of leadership role to which by temperament and training he had once naturally been suited and to withdraw to a socially isolated job devoid of prospects for advancement. In the result, he went from being a young and happily married man and father, with an excellent employment future and a very satisfactory marriage, to a man whose prospects for advancement were over and whose marriage and relationships with his children were irreparably damaged. On that view of the evidence, the plaintiff was 35 years old at the time that he suffered the injury and at that point he should have had the best years of his life ahead of him. He was getting on well in the Navy, and he had a young family with children of five and seven years. His family life was happy and stable, his wife was supportive of his naval career, and he enjoyed a good and rewarding relationship with his young children. He had a good social and recreational life. He advanced rapidly in the Navy and had pride in his job, and he commanded the admiration of his superiors and colleagues. He was a born leader; in charge of 100 apprentices over a 2 year period. After the collision, he was a changed man. He became disillusioned with the Navy, he became very hard with his men, he became short tempered and he became very intolerant of other people. He could not get any enjoyment from his home life, and he became a real problem at home to the point where his wife and children felt more comfortable with him away than at home. He went from being a caring father to becoming violent towards his children. He was unable to talk to his wife or indeed anyone else about his problems. His relationship with his wife and the children became destructive. He suffered nightmares and developed a dependence on alcohol. These are the considerations which go to the essence of the enjoyment of life and thus the loss of that enjoyment which the deceased incurred.
52 So to say is not to suggest that the evidence was all one way. There was direct evidence both ways and, as we view the totality of the evidence, it was open to draw inferences either way on approximately half a dozen critical issues. Accordingly, we would allow that the trial judge's conclusion as to the effect of the PTSD upon the deceased's enjoyment of life was not the only conclusion that was reasonably open. But, as we view the matter, one need only state the evidence, as we have done, to be convinced that the judge's conclusion was one view of the evidence that was reasonably open. And, for present purposes, that is enough to dispose of the respondent's contention. An appellate court cannot make its own assessment "upon its own view of the evidence, or upon inferences drawn from the accepted facts in a sense other than a sense open to the trial judge, which favoured the judgment, and use that assessment as the basis of a decision as to the adequacy of the judge's assessment."[36] As we have said, in a case like this we can only interfere if we are convinced that the trial judge has acted on a wrong principle of law or misapprehended the facts or that the amount of damages awarded is so inordinately low or so inordinately high as to be a wholly erroneous estimate of the damage suffered. In the end we are far from convinced that the trial judge committed any error of that kind.
53 In the respondent's written submissions it was further contended that the trial judge erred in the assessment of damages for loss of earnings by adopting as a comparator the earnings of one Leslie Passmore, who was for some time a clerk, credit manager and inspector of traffic services at MacRobertson Miller Airlines. The argument as thus formulated was that the deceased lacked the management skills of Passmore and was thereby limited to what was characterised as the lesser and presumably therefore less well paid skills of a maintenance supervisor. It was said to follow that it was not open to the judge to conclude that but for the PTSD the deceased would have been capable of earning more money than Passmore.
54 The essence of that argument was, however, abandoned in the course of oral submissions - it was conceded that Passmore was an appropriate comparator - and replaced with a contention that although it was open to the judge to assess loss of income on the basis of what Passmore earned, there was no evidence to support the judge's addition of 10% to that amount. We do not accept that contention.
55 In order to explain why, it assists to record the relevant part of the judge's reasons. On this aspect of the matter his Honour said that: