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A Different Face of War: Memories of a Medical Service Corps Officer in Vietnam

A Different Face of War: Memories of a Medical Service Corps Officer in Vietnam

by James G Van Straten

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Selected by Major General Pat Sargent, Chief of the U.S. Army Medical Service Corps, for the Corps Chief’s Reading List, May 2016.

A Different Face of War is a riveting account of one American officer in the Medical Service Corps during the early years of the Vietnam War.

Assigned as the senior medical advisor to the Army of the Republic of


Selected by Major General Pat Sargent, Chief of the U.S. Army Medical Service Corps, for the Corps Chief’s Reading List, May 2016.

A Different Face of War is a riveting account of one American officer in the Medical Service Corps during the early years of the Vietnam War.

Assigned as the senior medical advisor to the Army of the Republic of Vietnam in I Corps, an area close to the DMZ, James G. Van Straten traveled extensively and interacted with military officers and non-commissioned officers, peasant-class farmers, Buddhist bonzes, shopkeepers, scribes, physicians, nurses, the mentally ill, and even political operatives. He sent his wife daily letters from July 1966 through June 1967, describing in impressive detail his experiences, and those letters became the primary source for his memoir.

The author describes with great clarity and poignancy the anguish among the survivors when an American cargo plane in bad weather lands short of the Da Nang Air Base runway on Christmas Eve and crashes into a Vietnamese coastal village, killing more than 100 people and destroying their village; the heart-wrenching pleadings of a teenage girl that her shrapnel-ravaged leg not be amputated; and the anger of an American helicopter pilot who made repeated trips into a hot landing zone to evacuate the wounded, only to have the Vietnamese insist that the dead be given a higher priority.

Editorial Reviews

From the Publisher

"Daily letters home are the basis of this important memoir. The author’s insight into all that was swirling around him was outstanding. He was on the move all the time, in the air and on the ground, in hostile territory and in the relative sanctuary of the cities. He witnessed what is recorded. If you have any interest in the history of the Vietnam War, the age-old culture, values, and religions of the Vietnamese people, the terrible effects of the war on the civilian population and the challenges of providing medical advisory support—this book is for you. I had one problem with it. I could not lay it down."—LTG Quinn H. Becker, U.S. Army Retired, Former U.S. Army Surgeon General
"This is a fine memoir that will add significantly to the historiography of the Vietnam War. Van Straten witnessed more death and destruction than most combat soldiers, and his memories of those moments are riveting. No one can tell the story of the devastating effect of war on civilians better than a medical department officer."—Ron Milam, Texas Tech University, and author of Not a Gentleman's War: An Inside View of Junior Officers in the Vietnam War
“In this sensitive and compassionate account of his year as an advisor, Colonel Van Straten provides valuable insights into the lives and culture of ordinary South Vietnamese struggling to survive a hellish war. An important addition to the literature of the conflict. Highly recommended.”—Lewis Sorley, author of A Better War: The Unexamined Victories and Final Tragedy of America’s Last Years in Vietnam
"The outcome of the Vietnam War might have been different if President Johnson had had the insights and information of then-Major Jim Van Straten, so thoughtfully shared in A Different Face of War. His stories of little Ho Thien, the gifted Dr. John Henry Giles and the German hospital ship, the Helgoland, presage what we know today as ‘medical diplomacy.’ He is inspired—and inspiring—as he describes ‘winning the hearts and minds of the Vietnamese people’ through the best of medicine and education."—John P. Howe III, M.D., Former president and CEO of Project HOPE
"Van Straten was a very attentive observer and has thoughtful and detailed observations of numerous aspects of Vietnamese culture. The book is full of great snapshots of Vietnamese life during the war, and of many aspects Western accounts rarely discuss.”—James E. Westheider, University of Cincinnati-Clermont, and author of Fighting in Vietnam: The Experiences of the U.S. Soldier
“In stark, yet humane language, Jim Van Straten has rendered a great service for those who still seek  to understand America’s failure to win the ‘hearts and minds’ of the Vietnamese people. In graphic detail he describes tragedies witnessed by few Americans, and provides clues for today’s leaders of America’s wars on behalf of, and against, indigenous peoples. He was true to the principle that a soldier is charged with protection of the weak and unarmed.”—Thomas M. Hatfield, Director, Military History Institute, Dolph Briscoe Center for American History, University of Texas at Austin

"Beyond describing his everyday activities, Van Straten tells stories about revelatory encounters with a long list of people, from the famous to the unknown. He explores nuances of Vietnamese culture overlooked in many other Vietnam War memoirs. He provides memorable word pictures of scenes such as the difference between American and Vietnamese casualty wards. He editorializes against the tactic of search-and-destroy."--The VVA Veteran

"[Van Straten] has written about the Vietnamese people and soldiers in a way that is honest, yet compassionate and personal. As a result, he enables us to see the war through the eyes of an American Advisor, immersed in a difficult, dangerous and often baffling environment. . . . A Different Face of War offers a valuable look into the developing confidence, tempered with a growing sense of frustration that characterized the journey of most Advisors, regardless of their assignment, rank, or duties."--Counterparts

"A Different Face of War presents a soldier and practitioner of medical diplomacy discharging his duty to conserve fighting strength while fully meeting the requirement to protect the weak and the unarmed. One hopes Van Straten's legacy will inspire serving and future MSC officers."--On Point, the Journal of Army History

"[A] captivating account of Americans serving in Vietnam during the early days of a tumultuous time in our nation's history. While written as a memoir, it also serves as a heartfelt tribute to military service members and the South Vietnamese who battled communism a half century ago in the hopes of a better tomorrow."--San Antonio Express-News

"These stories are poignant and range from heartwarming to soul-crushing and everything in between. . . . Van Straten does a great job of illuminating the impact an effective medical program can have when it operates within the cultural norms of a society. His work brings out a very human, redeeming side to the conflict, which I believe readers will embrace."--H-WAR

Product Details

University of North Texas Press
Publication date:
North Texas Military Biography and Memoir Series , #8
Sales rank:
Product dimensions:
6.30(w) x 9.10(h) x 1.60(d)

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A Different Face of War

Memories of a Medical Service Corps Officer in Vietnam

By James G. Van Straten

University of North Texas Press

Copyright © 2015 James G. Van Straten
All rights reserved.
ISBN: 978-1-57441-617-6


July 1966

Very early on Sunday morning, 3 July 1966, while the rest of the country was celebrating a long Independence Day weekend, I had the sad task of saying goodbye to my wife and children.

After hugging each of our six little ones and telling them how much I loved them, I kissed my wife goodbye and held her tightly. I then threw my military duffel bag and one small suitcase into the trunk of the waiting taxi and got in for the short ride to San Antonio International Airport. I had hired the cab, despite our tight budget, not wanting to subject my wife to saying goodbye at the airport and then having to drive home with all the children.

As the cab pulled away from our home I waved a final goodbye. There stood my wife on the front steps with tears in her eyes holding our fragile, one-year-old baby, Michael. Clinging to one of her legs was our two-and-a-half-year-old son, Steven, while five-year-old Laurie clung to the other. And clustered around their mother and younger siblings were six-year-old Kathy, nine-year-old Susan, and ten-year-old Leslie.

I remember thinking at the time that my wife's responsibilities while I was away would be, in many respects, far more daunting and challenging than mine in Vietnam. I also thought of the countless military wives around the country who saw their husbands off to war under similar or far more difficult circumstances.

It was a sad ride to the airport.

After several lengthy delays in California, another in the Philippines because of concerns that Mount Pinatubo was about to experience a volcanic eruption, and losing essentially a day because of time zone changes, we finally approached Vietnam on the afternoon of 6 July. It looked so peaceful from the air, with long sandy beaches punctuated by hundreds of little inlets and coves off the South China Sea, then high hills and mountains rising rather sharply beyond the coastal lowlands.

As we started our descent, evidence of war became visible. Air activity was great. Helicopters, fighter jets, and reconnaissance planes were below us and to our sides. When we neared Saigon, on a crystal clear day, we saw puffs of smoke on the ground. An older non-commissioned officer seated across the aisle from me peered out the window and told me artillery fire was causing the puffs of smoke. We were too high to see the actual artillery pieces.

Upon reaching the Saigon area, we were forced to circle for about 55 minutes before being cleared by air traffic control to land. We circled deep into the Mekong River Delta. It seemed to me as if much of the delta landmass was covered with a shallow sheet of water.

From the air, Saigon was beautiful. It looked like a big, lazily sprawling city with a river running through it. The captain warned us that the landing would be unlike any we had ever experienced. He was right.

Because of the danger of anti-aircraft fire from the ground, there was no lengthy, slow descent. When the word to land came, the captain put the plane in a fairly steep dive and descended very rapidly. The object was to get the plane on the ground as quickly as possible.

When we disembarked onto the sweltering tarmac of Tan Son Nhut Airport, temperatures were beyond 110 degrees. Once inside the terminal, the sorting process began. Those being assigned to U.S. Army, Vietnam over here; those going to Military Assistance Command, Vietnam over there; Air Force over here; Navy over there. After what seemed an interminably long time, the sorting and personnel accounting processes were over. The MACV contingent, of which I was a part, was about to board a bus for the trip to a downtown Saigon hotel when, unexpectedly, an old friend, Major John Bullard, slapped me on the back and said, "Jim, welcome to Vietnam. You're about to get your first glimpse of Saigon, the Paris of the Orient." He then told me that he'd pick me up at the hotel MACV used for in-processing at 1830 hours and we'd go out to dinner. He also told me that in all likelihood I'd be going "up country" to Da Nang. This was my very first indication of where I was being assigned.

The bus had no air conditioning. All the functioning windows in the bus were wide open and covered with heavy-gage mesh wire welded to the side of the bus. A Military Policeman, armed with a rifle, stood in the entrance well of the bus. He explained that the mesh wire over the windows was precautionary. On several recent occasions, terrorists riding on motorized bicycles had thrown grenades into the open windows of buses carrying troops, taking a number of lives and severely injuring many.

As our bus passed through the city, I couldn't help but notice the mounds of rotting garbage coupled with the overwhelming smell of diesel fuel. The garbage piles were twenty to thirty feet high, and rats scavenged n abundance, scurrying all over the mounds. There seemed to be one mound on each downtown city block. The guard aboard the bus explained that there was an ongoing strike by the garbage collectors' union. My weariness from the long journey and the stifling heat and humidity, combined with the stench of downtown, exceedingly odiferous and nauseating, made for an uncomfortable ride into the heart of Saigon.

Surprisingly, some sections of the city seemed unaffected by the garbage collectors' strike. They were clean and attractive. Outdoor dining seemed popular, not only on the sidewalks in front of fine restaurants but also alongside the plethora of eateries mounted on pull carts.

I quickly noted a major difference in the way commercially available products were displayed and marketed. There were two or three city blocks where nothing but plumbing fixtures were displayed and sold. Head-to-head competition was the norm. If you wanted a new toilet or a sink or a bath tub, you knew precisely where to go. Another section of the city was reserved for flowers and growing plants, while another concentrated on clothing and shoes. Birds and birdcages even had their own section of the city.

Bicycle repair shops seemed not to have adopted this marketing plan. They were everywhere. Men and boys dressed in shorts, tank tops, and sandals made from old tires, squatting with their knees to their chests next to a bicycle with a flat tire or a broken chain, were everywhere. It was so different from anything I had experienced in the United States or Europe.

Another thing that caught my attention was the absolute absence of obesity among the Vietnamese people. I made a point of looking for an obese person, and had great difficulty finding even one.

And then there were the gorgeous young Vietnamese women wearing ao dais, the traditional dress for the affluent woman of Vietnam. The absolute elegance of the garment was stunning. The ao dai is a very tight-fitting, long tunic, which is split up the sides to the waist and worn over pantaloons.

When we arrived at our hotel at about 1400 hours, the first step in the in-country processing was to draw our equipment and weapons. After that, we had a series of briefings and watched films to orient us to the country, its people, and some of their customs, traditions, and taboos. At about 1745 hours, we knocked off for the day, and I headed to my assigned room, which I shared with eight others. I was ready for a shower and a shave, followed by dinner with my friend, John Bullard. Although I was dead tired, I knew that it was best to "tough it out" until about 2200 hours and then try to get a good night's sleep to minimize the inevitably negative and sometimes prolonged effects of jet lag.

Still in duty uniform, John picked me up promptly at 1800 hours, and we rode to his downtown Saigon hotel in his assigned jeep. He grabbed a quick shower and changed into civilian clothes while I enjoyed a cold bottle of Ba Moui Ba, the local beer.

When John was finished showering and changing clothes, we enjoyed another Ba Moui Ba while he told me what he knew about my upcoming assignment to Da Nang. He then said that he wanted to treat me to the best French onion soup "in the whole wide world" and that the fastest way to get to the French restaurant that served it was by pedicab. A pedicab has a single seat mounted on the front of a tricycle that has two wheels in front and one in the back. It required two pedicabs to transport us to the restaurant.

We exited the front door of John's hotel, walked about a block along an incredibly boisterous and busy street, and there were the pedicabs--dozens of them--each with an entrepreneur owner hoping for a fare. John immediately got into one of them, and I started to do likewise when I thought I heard John say something to me. I walked over to him as he sat in his pedicab, and he told me that what he wanted to tell me could wait until we got to the restaurant. I then apparently got into a different pedicab than the one I had originally started to get into. The first driver became very agitated and angry, yelling at the driver of the second pedicab. Then the two drivers started shouting and shaking their fists at each other.

The cyclist powering my pedicab was exerting maximum energy trying to get away from the scene of the altercation. He kept looking back over his shoulder as he pedaled down the busy Saigon street. Suddenly, I sensed the other pedicab about to overtake us. I turned around, and there was driver number one brandishing a tire iron and looking furious. He jumped off his pedicab and smashed the driver of my pedicab in the head with the tire iron. Bleeding profusely from a deep scalp wound, the driver lost consciousness in the street. Almost immediately, a Saigon policeman was on the scene signaling for me to get the hell out of there, perhaps fearing that the growing crowd surrounding the injured driver was about to get out of control. John jumped out of his pedicab and quickly paid his driver. I threw some money onto the seat of my pedicab, and John and I sprinted down the street toward the French restaurant.

When we got inside the restaurant, soaking wet from perspiration, John smiled at me and said, "Jim, again, welcome to Vietnam."

* * *

Despite my best efforts to avoid it, jet lag plagued me upon arrival. The morning after the pedicab incident, I woke at 0230 hours and couldn't get back to sleep, so I got up and, after showering, shaving and getting into a fresh uniform, went down to the hotel restaurant and had an early breakfast. There were several other officers in there, so I can only assume that they, too, were afflicted with jet lag. After finishing my breakfast, it was still only 0400, and the first briefing of the day was not scheduled until 0800 hours. I had four hours to kill, so I boarded one of the Navy buses that operated around the clock, shuttling troops throughout the city on a prescribed route. The bus was due to return to our hotel at 0735 hours, which accommodated my schedule very nicely.

The activity level in the city, even at that early hour, can best be described as frenetic. Saigon showed only fleeting evidence of the once beautiful city that, by most accounts, it once was. Once again I encountered the mounds of decaying garbage populated by huge hungry rats with voracious appetites and bold dispositions. I concluded that rats must be nocturnal animals, for there were far more of them at night than there had been the previous day.

Never before had I seen such masses of people use such diverse means of transportation. At about 0630 the sidewalks and streets were full. Bicycles, cyclos, motorized bicycles, pedicabs, motor scooters, pushcarts, diesel fuel-spewing buses and trucks, taxis, military vehicles, armored personnel carriers, several tanks, a few privately owned passenger vehicles — the city was teaming with people and vehicles of all types. Refugees from the countryside had swelled Saigon's population to almost two million, over twice the population of the pre-war days. Children were everywhere. Many of the younger ones wore only shirts or tee shirts and flip-flops. Some of the street urchins were totally naked. I saw countless numbers of people sleeping on the street. Many homeless refugee families spent the night huddled in the entryways of stores.

Craftsmen, mechanics, and artisans were everywhere, all looking for a way to earn a few piastres, the South Vietnamese currency.

All military buildings were fortified and guarded. Sandbagged defensive positions had been erected at all strategic locations: key intersections, important bridges, government buildings, train stations, etc. Saigon stood in stark contrast to cities I had seen throughout the United States and Europe. The early morning bus ride boggled my senses.

* * *

During my in-country processing and orientation, I lived in the Koepler Hotel, a facility in great need of maintenance. There were major plumbing problems that made occupancy interesting, to say the least. There was one small bathroom consisting of one small sink, one toilet, and one shower stall for each eight-to-ten-person room. Shaving and showering in the morning was a challenge. I was one of nine officers in the dormitory-style room to which I was assigned.

There was no potable water in the entire hotel except for bottled water that could be purchased in the hotel restaurant. To accommodate the absence of potable running water, two whiskey bottles, still with the Jim Beam and Seagram's labels attached, were placed in each bathroom. These bottles had been filled with potable water to be used exclusively for tooth brushing. Taped to the wall over the sink were instructions for brushing our teeth. We were instructed to take a small sip of water from one of the whiskey bottles, swish it around in our mouth, then spit it out and brush our teeth. After finishing the brushing process we were to take another small sip of water, swish it around in our mouth, and spit it out in order to rinse the toothpaste residue from our teeth and mouths. All nine occupants of our room used the same two bottles of water for this process. The bottles were re-filled once a day.

Showering was even more adventurous. Water seemed to be in very short supply. During my stay in the hotel, I never had the luxury of hot water. Frequently, the water simply stopped running right in the middle of a shower. Consequently, there was yet another sign taped to the wall near the shower, instructing us how to take a shower: Fill the nearby sink with water, get under the shower, wet down one's body, turn off the shower to conserve water, and then soap up and scrub one's entire body. We were then to turn on the shower once again. If there was water, we were able to rinse the soap off under the shower. If not, we had a sink full of water and a washcloth to complete the process.

The first morning I was a guest in the Koepler Hotel, I arose at 0230 because of jet lag. I tried to do everything according to the rules. I brushed my teeth without incident, and then got into the cold shower, wetted myself down, turned off the water, soaped and scrubbed my entire body, and then turned on the shower to rinse off. You guessed it: not only was there no running water, but I had forgotten to fill the sink. I rinsed off using a washcloth and a whiskey bottle full of potable water, thereby probably depriving others of the opportunity to brush their teeth.

I remember thinking as Spartan as this room in the Koepler Hotel was, it would probably be considered luxurious by the soldiers, marines, and navy corpsmen slogging around in the rice paddies and jungles.

* * *

The briefings presented during the two and a half days of in-country processing and orientation were excellent. I was surprised to learn that the U.S. troop strength had risen to 285,000 and even more surprised to learn that an anticipated 100,000 would be added during the coming year. Clearly a rapid buildup of U.S. forces was underway. President Lyndon Johnson had made a clear and seemingly unequivocal commitment to take the war to the enemy.


Excerpted from A Different Face of War by James G. Van Straten. Copyright © 2015 James G. Van Straten. Excerpted by permission of University of North Texas Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

What People are Saying About This

A. R. Lamb
Up to that time the war in Viet Nam was unlike any war in which the United States Military had been involved. This was largely due to making adjustments for unusual policy, cultural and geographic factors. Initially our government's policy was that U.S. Military Forces arriving in Viet Nam would be acting in an advisory capacity. Over time this morphed into a joint advisory/combat role. Adding to the complexity of the war was the involvement of civilian agencies such as the United States Agency for International Development (USAID).
Viet Nam served as a transition in warfare. There were no clearly defined lines separating opposing forces. Civilian and combatant were in many cases indistinguishable, inseparable and actively engaged in hostile action. In many cases enemy combatant and civilian were dressed identically. Casualties were comingled stressing to the breaking point critical medical support.
James G. Van Straten, a young Field Grade Officer in the U.S. Army Medical Service Corps, was thrown into this milieu with little preparation for the realities of this kind of war. Never before had the U.S. Army Medical Service Corps been involved as broadly with allied military and civilian medical support systems. He has now written a book which accurately and graphically details his experience.
A Different Face of War is a book which demands reading by any serious student of Military Art and military history, and should be required reading in all upper level professional military schools. George Santayana, philosopher, essayist and novelist has said, “Those who cannot remember the past are condemned to repeat it.” and this reviewer believes, suffer the consequences of such dereliction. This book clearly identifies policies which if repeated in future conflicts could result in the same unsatisfactory results as in Viet Nam.
The book does not require the reader to have memory of the events described therein. Thanks to the prescience of the author's wife, who saved over 350 letters written to her during Van Straten's year (1966-67) of service in Viet Nam, the book contains virtual real time reporting of the events narrated. Many of the letters containing information concurrently observed while the events were taking place.

A central theme of Van Straten's book is his answer to the question; to what extent is the United States Military committed to the medical support of the indigenous civilian population in a combat zone as well as to combat units when its role is both advisory and combat?
The author does not engage in “second guessing” but his observations are worthy of future consideration. Although no one knows precisely what form future conflicts will take, being prepared for conditions similar to those in Viet Nam is only a wise course. --A.R. Lamb
LtCol USAF Retired

Meet the Author

After his thirty-year military career ended in 1986, JAMES G. VAN STRATEN moved into academia. In 1990 he was appointed dean of the School of Allied Health Sciences at the University of Texas Health Science Center at San Antonio. He and his spouse now reside in Windcrest, Texas.

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