“Yeah, that needs reinforcing okay. Let’s wrap it with another couple layers of gauze. We’re just going to reinforce most of the dressings on these guys. We don’t usually change them when they come straight from the field and are medevaced the next day. Too much danger of infection. Open up a wound here and it sucks germs out of the air. Pseudomonas, staph, you name it, Vietnam’s got it.”
“I didn’t see much of that on neuro, but then, a lot of times we didn’t get open wounds,” I told her. “And I suppose the Vietnamese have a certain tolerance built up.”
“Probably, or anyway those that don’t are dead before they get here. But we get a lot of infection on the Vietnamese side of the ward, too. You’ll see that later.”
Another soldier, this one with frag wounds of his upper torso and compound fractures of the right clavicle and humerus, couldn’t wait for us to reach him. He had been using his good arm to scratch frantically at his cast and dressings. “Ma’am, ma’am, you can change my dressings, can’t you? I mean, since I’m asking. You’ve just got to. They itch like hell.”
Marge said something soothing and regretful and examined his bandages, then pointed to a fly that had lighted on the dirty part of the dressing. “Probably maggots.”
The soldier, who looked about fourteen, turned a green only a shade or two lighter than my fatigues. “Yuck. Get them the fuck off me,” he said, trying harder than ever to scratch.
Marge gently restrained his left hand. “Leave them alone, soldier. They’re saving you from gangrene. Maggots only ea—maggots clean up dead tissue, sort of nature’s way of debriding wounds. They won’t hurt you. They just itch a little. They keep wounds like yours from putrefying.”
The boy, red-faced and almost in tears, lay back with a whimper. Not knowing what else to do, I handed him an emesis basin. He appeared neither convinced by the major’s explanation nor willing to revise his no doubt long-standing prejudice against maggots. He was in for a long trip to Japan. I could only hope he’d get accustomed to the idea of bodily dinner guests.
There was also a marine with a self-inflicted gunshot wound to his right foot, and two other patients with less serious multiple frag wounds, overflows from the general surgery ward.
Voorhees and Meyers were already at work with razors and basins of water. Sergeant Baker brought the dressing cart, and Marge and I put fresh layers of bandage around the filthy, seeping dressings. It felt like sweeping dirt under the rug.
The boy with the maggots groaned when we raised him to reinforce his dressings and cursed us as we manhandled him, but when we were done, lay back and said, “Thank you, ma’am,” as sweetly as if he were talking to his Sunday school teacher.
We were headed for the Vietnamese side when recovery room called to tell us that the first of our new admissions was being transferred to us.
After that, three more arrived in fairly rapid succession. The corpsmen were still busy escorting the GIs to the helicopter, so Marge, Mai, and I did routine vitals. I wondered where the charts were, but every time I asked about pain or nausea medication or whether to touch a bandage, Marge referred me to a little recipe box containing standing orders. These orders authorized nursing staff to administer medication for pain, nausea, or fever, to reinforce dressings, and to perform other routine care without doctors’ orders written specifically for each patient. I was finishing the vital signs on the second patient when the third was wheeled onto the ward.
Joe Giangelo, red-eyed and barely able to lift the soles of his paper scrub shoes, pushed the last gurney in front of him and stopped at the desk to hand the major a stack of charts.
His scrub suit was dotted with a fine spray of red droplets up one side, blood that had soaked through his scrub gown while he worked. His hair was matted from being tucked under a scrub cap all night. He opened the refrigerator door and gulped down a canned Coke as if he’d been dying of thirst. He looked a lot different from the twinkly-eyed benefactor who whistled while he built cabinet shelves. I thought he was about to drop. But when I reached for some of the charts, he said, “Why don’t you grab a clipboard instead, Kitty, and make rounds with me. I’ll tell you what I know about some of these folks and what we’re going to try to do with them.”
The Vietnamese side of the ward was more vigorously noisy than neuro had been. A bedlam of troi ois, dau quadis, and less articulate moans and whimpers greeted us, along with a cheerful wave from the end of the ward from a girl who squealed, “Bac si Joe! Bac si Joe!”
Bac si Joe drew himself up to his full five feet four inches and summoned Voorhees, who was counting vitals on one of the new patients. “Specialist Voorhees.”
“Sir?” Voorhees asked, his head snapping up as if he expected to be called to attention.
“What’s the matter with you, Voorhees? Why haven’t you informed these patients that they, as Orientals, are stoic and inscrutable? Look at them! Listen to them! Scrutable as hell!”
Voorhees gave him a “Give me a break” sigh and started counting the pulse again.
Joe’s face turned serious as he bent over the middle-aged woman in the first bed, however. She was curled on her side, biting her knuckles, her face and pillow wet with tears, and she cried a little harder for a moment when he stooped down to say something soothing to her. Her patient gown was rucked up over a saturated pressure dressing covering her from waist to knee.
“This is one of our new admissions from last night, Kitty, Dang Thi Thai. Mrs. Dang’s husband was murdered in the assault that brought us most of these people. He was the village chief. After they killed her husband, the VC shot her too.”
“At least they didn’t kill her,” I said.
“No, but this way she makes a good example to anybody who wants to cooperate with us. And it will take time and money to take care of her. You’ll see what I mean when we get to another patient, a couple of beds down. Now then, Mrs. Dang, let me show the nurse where you’re hurt. That’s right.” Dang Thi Thai gasped a little as he pulled the dressing off her wound and showed me a smallish entry hole. She cried out once as he gently turned her to show the gaping crater of medicated bloody gauze where her left hip had been. “You see here the tumbling effect of the bullet. Little hole here”—he pointed to the front—“totally blasts away or pulverizes the entire structure back here. We did a preliminary debridement in O.R. to clean out the worst of the necrosed tissue and dirt and tie off the bleeders, but of course we’ll have to delay closure until infection is no longer a problem, and we can maybe get some skin to graft onto the area. It’s going to be a long haul for her, but there’s nothing else to do except maybe sew a volleyball in there.”
“Dau quadi, co,” the woman said and stretched her tear-slicked hand toward me, then dropped it again, as if the effort of holding it up was too much for her.
“She’s been medicated within the hour,” Joe said. “I don’t think we could give her much else right now.” He adjusted the flow of one of her two I.V.s and moved to the next bed, where an ARVN soldier with bilateral below-the-knee amputations lay.
The man ignored Joe’s greeting and held out his hand for a cigarette. Joe shrugged. “No can do. They’re in my other pants. You bic? Other pants?” The man just looked disgusted and turned away, ignoring us while Joe told me about his unsuccessful attempts to save at least one of the legs. “He’s been here about three weeks. You know how to do the figure-eight wrap to mold a stump for prosthesis?” I said I did.
I had to say it loudly because about half the noise on the ward was coming from the next bed, a small boy with a big mouth.
The stump of one of his legs was tightly bandaged, but draining. His right arm was in a plastic splint.
“This little devil is Nguyen Tran Ahn, a ten-year-old orphan, parents killed by the VC before this last raid. He keeps saying he wants to go home, but nobody’s claimed him. He was apparently up in a tree when a shell took his right leg. He fractured his right radius and ulna when he fell out of the tree. I—Jesus—” He l
ooked down into the screwed-up little face, which reminded me of a monkey face carved out of a coconut, only smoother, of course.
The volume of the kid’s howling and sobbing increased as Joe started to unwrap his stump dressing. I tried to shush him, but that made him howl even more loudly. Joe cut his examination short and sprinted two beds down. “I would have debrided him this morning, but the little devil got ahold of a candy bar somewhere and I couldn’t operate.”
Sergeant Baker, a towel draped over one shoulder, paused to catch what the doctor was saying. “Yeah, well, bac si, you can do somethin’ for me when you take him in to surgery. Sew his mouth shut, will you? Whoo, that child sure can holler.” He tugged his ear, shook his head, and ambled toward the back door.
The next patient sat stone-still in bed, disregarding the slings around her shoulders and arms, staring at the far side of the ward.
“What’s the matter with her?” I asked, dropping my voice.
“Bilateral fractured clavicles and shock. Remember what I told you about the VC?”
I nodded.
The question was rhetorical. He used the pause to swallow. He’d been doing a fairly good job of putting on the Jolly Joe Giangelo Show for my benefit and that of the patients, but the jolliness vanished suddenly and it was easy to see that the man had been working all night.
“They, uh—the VC—shot—she was walking down the street, see, coming back from taking dinner to her husband, who’s one of the CIDG civilian guards. She had her one-and-a-half-year-old on one hip and her three-month-old on the other. The sniper shot both babies out of her arms. They were small. The impact fractured her clavicles.” He continued talking in a flat, chart-dictating voice about what he was going to do for her. He had two daughters, a toddler and an infant, back home.
The next two beds were empty, but in the last a pretty young Vietnamese girl ostentatiously pouted until we turned toward her, then bounced up and down like a puppy while she waited for us to reach her bedside. Bouncing up and down when your leg is in traction is not all that easy to do, so we hurried, while she beckoned urgently with her hand and called, “Bac si Joe, Bac si Joe, I no see you long time.”
“This is Tran Thi Xinh,” Joe told me. “Xinh, this is—”
“This your girlfrien’, huh?” she asked.
“Nah. You know you’re my best girl. This is Kitty. Lieutenant McCulley. She’s going to be working with us now, so I want to show her your leg, okay?”
“Okay, Joe. Kitty, how old you? You marry? Have children?”
We straightened the sheets under her while she pulled herself up in bed with the help of the metal trapeze suspended from her overhead bed frame. I told her I was twenty-one, not married, no children, and she said, “Ah, same-same me,” though she looked no more than seventeen.
“Xinh here is going to put me in the textbooks, Kitty. She has an unusual spiral fracture of the distal femur. We don’t really have the equipment here to work with. I’d send her back to the States except that her family doesn’t want her to go. So I ordered the equipment through channels. Needless to say, Xinh is going to be one of our long-term patients.”
Xinh flashed a cover-girl smile, followed by a torrent of Vietnamese. Mai, also speaking rapidly in Vietnamese, rushed over, half hugging Xinh every time she winced as Joe examined her. The two of them were almost as noisy as the little boy, Ahn, who was still alternately caterwauling and whining.
Both were drowned out by the sudden boom of Sergeant Baker’s bass voice. “Wait just a goddamn minute, soldier. What you think you’re doin’?”
“Bringin’ you a new patient, Sarge. Ain’t that nice of me?” The response was from an equally forceful voice with a thick overlay of Southern drawl—which didn’t necessarily mean the guy came from the South, not in Vietnam. For some reason, even guys from Boston started talking like Georgia crackers by the time they’d been in country a week.
“Not without no authorization you ain’t,” Baker replied, pulling his towel off his shoulder as if he would flip the tall redhead with it if he made a false move.
Joe flipped the sheet back over Xinh and headed toward the two men fighting over the gurney.
“Hi, Joe. You want to tell the sergeant here that you authorized this transfer?” the redhead said. His uniform was funny-looking: a regular camouflage shirt mixed with green tiger-stripe trousers, his only insignia a Woody Woodpecker pin he’d probably picked up at the PX. From his manner, I thought he might be one of the doctors in from the boonies. They all spurned Army dress codes.
Joe temporized, “Now, Doc, I didn’t…”
Marge popped her head through the door. “Something the matter, Sergeant Baker?” she asked cheerfully.
“This man bringin’ us this patient got no authorization, ma’am. Unless, that is, Captain Giangelo, you authorize it, sir?”
“If Chalmers is all finished with his head, I—”
“Nothing wrong with his head,” the redhead said.
“There was a depressed skull fracture,” Joe said, not arguing, just informing.
“That was a mistake, Captain. If you X-ray him now you’ll see there’s nothing wrong with his head. He needs to get somethin’ done about replacin’ his legs so he can go back to the villages, though. They need him out there.”
“Wait a minute, wait just a minute here,” Baker said. “You a doctor? You don’t look like no doctor.”
“Yeah? Say the same thing to me when you’ve got your ass shot off or are burnin’ up with fever and I’m the only dude in sight with a first-aid kit and some kind of training.”
“I’m real impressed. Been a field medic myself in two wars. That don’t mean I haul patients around makin’ unauthorized transfers or sassin’ the real doctors. What’s your name and your outfit, soldier?”
“Spec-6 Charles W. Heron, Special Forces medical supervisor assigned to C-1 operations detachment attached from B-53 Special Missions Advisory Force.”
“Uh huh,” Baker said. “And who might this man be? Your C.O.?”
“Sergeant Baker, Specialist—uh—” Major Canon said. “Whoever this patient is, don’t you think we’d better make up our minds where he’s going and get him back to bed?”
“I’m tellin’ you, Joe, there’s no head injury,” the redhead said.
“I’ll have to clear that with Major Chalmers, Doc.”
“Chalmers! That asshole has his head so far up his—”
The man seemed to be a good judge of character anyway.
I remembered belatedly to try to reassure the patient, the object of all of the argument. It took me a moment to recognize old Xe. His color was much improved, his head unbandaged, and his face less sunken. His eyes were open and alert, seemingly staring at the ceiling, though as I watched I saw that he shifted them from the redhead to Joe to Baker like someone watching a three-way Ping-Pong match. I probably wouldn’t have recognized him at all in a couple of days—legless, bald elderly Vietnamese men weren’t uncommon at the 83rd. But his hands were crossed at his chest, over the medal, in the gesture I remembered well from the night before last.
“Way to go, papasan,” I said, patting his shoulder. “You sure healed in a hurry.”
“You should watch how you touch him,” Heron told me. “It’s disrespectful to touch a holy man casually.”
“You’re the one who’s disrespectful—” Baker began, but Heron wasn’t paying any attention. The old man was speaking to him in a soft, hoarse voice.
When Heron looked back up, his face wore an odd expression, as if he was trying to assess me, and at the same time resented me.
Marge, who had been on the phone, reappeared. “Neuro got swamped last night with ICU overflow, apparently. When I told Captain Simpson that we had one of her patients over here, she spoke to Major Chalmers. He said he didn’t know why we didn’t take the old man in the first place, and if you need help with the mild concussion the admitting physician misdiagnosed as a depressed skull fracture, Chalmers will be happy
to consult with you, Joe.”
Mai helped Heron put Xe to bed. I transcribed the orders, trying to hurry so I could talk to Heron before he left. It occurred to me that he was the mystery man who had called in the air evac on old Xe’s behalf. But when I looked up from my chart, the old man was sleeping fitfully in the bed between the woman who had lost her children and the whiny little boy. I thought it might have been the light, but he looked sicker and wearier than he had a few moments before.
Joe Giangelo, when he returned to the ward, evidently agreed with me, because he ordered a new antibiotic, an extra I.V., and two units of blood for the old guy and scheduled him for surgery as soon as he was judged strong enough to withstand anesthesia.
We were moderately busy those first few days I worked ortho. One morning the husband of the woman with the fractured clavicles simply appeared and packed her off. Marge called Joe, and Joe, with help from Mai, tried to talk the man out of it, but the husband just gave a tight bow and a tight thanks. Mai said the woman would feel better with her own people and would want to be present at the funeral of her children. Personally, I thought the woman looked as if she would die of grief very soon and the man looked as if he blamed us for the tragedy and himself for ever becoming involved with “our” side. Which irritated me. “Our” side was supposed to be the side of most of the South Vietnamese, wasn’t it? We were helping them, not the other way around. And he wouldn’t even let us try to repair some of the damage.
Nor was he the only one who didn’t want our help. The day Ahn was scheduled for surgery, the O.R. tech wheeled him away and then, a short time later, came back scratching his head, wondering if we’d seen the boy.
Voorhees and Sergeant Baker divided up the hospital and started searching, but a few minutes later a sergeant I vaguely recognized carried a wailing Ahn back onto the ward. “I understand this might belong to you ladies,” the sergeant said. I showed him where to deposit the boy while Marge tried to call Joe in O.R.
The Healer’s War Page 6
