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Doctor Jimmy Capri leaned forward in his seat, looked out the window, and watched the flooded green rice-paddies streak by below the wing. He was inbound on China Airlines 683 to Hanoi Noibai International Airport. He hadn't seen Vietnam for over thirty-five years. In fact, he hadn't thought about it, read about it or been to a movie about Vietnam, since leaving Da Nang in 1970. Doctor's orders. The therapy had worked. No more nightmares and no more Post Traumatic Stress Disorder of sleepless nights followed by depression for a week or more.
Jimmy was anxious to see his colleague, Doctor Maureen Lally. The events of the past five months flipped through his memory bank. "Mo" Lally was an attractive thirty-six year old anesthesiologist with a Master of Public Health from The Johns Hopkins University. In January, she had asked Jimmy about presenting a paper with her at the Fifteenth Annual Asian-Pacific Military Medical Conference in Hanoi, Vietnam in May.
"About what?" Jimmy had asked.
"About the civilian-military medical partnership that you have been working on for the last couple years," Mo replied. "A presentation to a military medical conference should highlight and improve your efforts at our own institution as well as showcase your work, worldwide."
Jimmy thought for a moment. "You bet. I'll do it."
"It means another presentation before an international audience and an automatic publication in Military Medicine," she said excitedly. Mo had written the initial abstract on the partnership that Jimmy was working on with the Air National Guard and the Air Force and the abstract had been accepted for presentation. Even more surprising, Mo had submitted a request for funding to their hospital corporation for each of them and the institution had agreed to pay for the airline ticket, hotel and any other incidentals for both Jimmy and her. Jimmy was grateful. Mo's enthusiasm and energy were infectious.
"I'm really excited about presenting this work to a military audience in Vietnam," Jimmy had told Mo. Yet, in some ways, he also felt trapped. He had said, "Yes." Until now, he had never reneged on his word on a professional commitment. So he couldn't back out of returning to Vietnam, although he had to admit, he was really worried.
He thought it would be interesting seeing Hanoi from the ground. He had only seen Hanoi before, from altitude, in the right seat of an A-6 Intruder bomber, flying off the aircraft carrier, USS Constellation. As a Naval Flight Surgeon it was his duty to check a pilot's medical adaptation to flight after having been off flying status. "Up chit," the aviators called it. Jimmy would substitute for the regular Naval Flight Officer who usually sat in the right seat. It meant that Jimmy had to know the NFO's routine, including setting the coordinates for the targets for the bombs. Jimmy's intent during the early part of the "Vietnam Conflict" was to poke holes in the Vietnamese landscape with five hundred-pound bombs. Fortunately, he only had to set the coordinates. The pilot pulled the trigger that released the bombs. Jimmy felt he hadn't actually killed anybody, himself, but setting coordinates troubled him.
Doctor Capri's return to Hanoi was far different this time. The United States was helping Vietnam with many of their medical problems, such as malaria and HIV which is how Doctor Lally had become involved. In addition to anesthesiology, she was an international expert in infectious diseases, epidemiology, and the public health aspects of worldwide infection problems. Her network of friends in the military and public health that she had nurtured while working on her United States Navy post-doctoral fellowship had encouraged her to attend this meeting. Jimmy's work provided the impetus and vehicle for her to do so. Jimmy yawned a couple times and shortly thereafter fell into a deep sleep.
He didn't hear or feel the wheels of the aircraft hit the runway. The rain had stopped, but the grass alongside the runway was bright green and wet. The plane quickly pulled onto a taxiway and after a short time slid to a stop.
"We aren't at the gate, yet," the pilot announced. "We're holding while the gate clears," he said in accented English as well as Vietnamese.
Jimmy didn't hear the pilot's message and wasn't even aware when the plane reached the gate. And he didn't notice the luggage hitting the conveyor belt below him nor the noise as the bags were tossed onto the baggage cart. He hadn't heard the flight attendant's messages, either. He was already dreaming of his tour in Vietnam with First Marines, First Medical Battalion in 1969.
It was hot and muggy. Sweat was running down Jimmy's back in torrents. He had soaked his dull olive drab (OD) T-shirt and fatigues, already. Even his socks were wet. He had been in-country in Vietnam for less than six hours. His Military Airlift Command (MAC) flight from the States was long and eventful. He had spent forty-five minutes in Hawaii, then an hour at Wake Island to refuel, and finally landed and remained over night at Clark Air Base in the Philippines.
He recounted the dinner in the Air Force Officers' Club at Clark Air Force Base less than twenty-four hours ago. He and some of the other officers he had met on the MAC flight had agreed to get together in the officers club for dinner and take the four stewardesses from their flight as guests. An uninvited burly linebacker from a pro-football team, on his way to Vietnam to entertain the troops before the season started, had joined them. Jimmy guessed that, "where the stewardesses are, that's where the professional football players are." They know the game, and it's not just football! The linebacker left early with the youngest, prettiest stewardess in tow. His routine for gettin' in shape, Jimmy though! He also didn't pay his share of the bill. Jimmy was still pissed off. The richest guy at the table had skipped out on paying his fair share of the bill. A big name star, but a social dwarf, Jimmy reflected.
"Is it always this hot?" Jimmy asked.
"No. Sometimes it's worse in August," the duty corpsman replied. "This is typical for late July."
"Oh, Wow," Jimmy commented. "Can you give me a brief tour, before the incoming starts?"
"Hey, don't jinx us," the duty corpsman said. "My name is Jim Spettle. The nights are usually quieter than the days"
"My name is Jimmy Capri."
"Good first name," Spettle said with a laugh. "So they put you on first call on your first night in-country, eh?"
"Baptism of fire," Jimmy replied. "But they said there was plenty of help if I needed it."
"That's true. You don't venture off this compound at night unless you have to," Spettle said. "They bring entertainment to the enlisted club every night. Some of the officers usually slip in the back for a drink and to enjoy the entertainment, too. So all the surgeons are on the compound and ready to help you. Great group of guys."
"That's good to know," Jimmy said. "So the schedule is first call tonight, second call tomorrow night, third call the next night, all the way to eighth call, then a day off?"
"You've got it," Spettle said. "Second call usually assists you if you need it, unless they have a case at the same time, then third or fourth call can help you. Most of the time the corpsman is your first assistant, unless it's complicated or you're 'two teaming' a case. But anytime you get overwhelmed one of the other surgeons will step in. That's what I mean; a great bunch of docs."
"Who's the boss?" Jimmy asked.
"The CO or the top surgeon?"
"The top surgeon," Jimmy said.
"That's Doc Centrino. Anthony Centrino. He's a really good guy to work with. I think that's why the whole group acts the way they do. He's on second call, tonight, backing you up."
"Did he do his surgical training at UCSF?"
"I donno. We don't pay much attention to where you trained. That don't matter. It's how fast ya cut and how good ya are. All the Hotel Sierras right out of training come out here in July and August and after a couple of weeks, they all get much better. They call us the year long postgraduate training course in trauma surgery. Don't worry; you'll fit in, if I know ya."
"Thanks, Spettle." Jimmy looked at the sign in the triage area. It read, "It is the duty of a hospital corpsman to waitin ..." Jimmy heard distant rotors chopping through the air. They were coming toward him. His heart raced a little in anticipa- tion. "Didn't take long," he said.
"I told ya, ya jinxed us." Two other corpsmen came out of no- where and ran out to the helipad. Jimmy watched from the open tri- age door. The helipad was about one hundred feet away. "There are two- foot thick reinforced walls on the sides of the helipad facing the triage and operating rooms with a small opening between them to get to the patients." A little concrete ramp led up to the opening where the two corpsmen stood, ducked just behind the wall where countless stretchers racked in a covered holder in anticipation of the next combat casualties.
"The Sea Bees built the concrete pad and the walls," Spettle explained. "The walls are in case someone lobs a bomb or explosive device onto the pad or live ammunition goes off on one of the Marine combat helicopters while they are offloading casualties, it won't blow our house down! Our house is triage, the operating rooms and the wards, plus the dining hall, the clinic and some other buildings ... Headquarters."
Dust kicked up as the rotor wash hit the helipad and the dirt around it. The rotors kept turning as the corpsmen off-loaded the casualty on a stretcher and hurried down the ramp, across the gravel road and up the little grade toward triage.
"Oh, Oh. 'Hot offload.' That's not good," said Spettle.
The hurrying corpsmen plopped the stretcher on the waiting sawhorses in triage. The casualty was a Marine. He was pasty white. The left leg of his camouflaged pants had been cut away, all the way up to his belt. There was a tourniquet clamped down over a bloody dressing on his left thigh. The end of his penis had a chunk out of it, ragged, shot away. There were no IV's. Jimmy felt the casualty's right groin through his pants for the femoral pulse.
"No pulse," Jimmy blurted out. He put his hand on the Marine's abdomen under his shirt. "He's still warm. We need to get some fluids into him, pronto." Two corpsmen cut away the sleeves of the dead Marine's camouflaged jacket. Jimmy slipped on some sterile gloves and reached for some prep solution. "What's this brown stuff?"
"That's our new prep solution," the corpsman said. "We just got it a few days ago."
"What's it called?"
"Betadine," I think.
Jimmy spread some Betadine over the right upper arm, just above the elbow. He grabbed a scalpel from the opened sterile "cutdown pack" and cut the skin and fat over the vein on the outside of the upper arm, two inches above the elbow crease. One of the corpsman nonchalantly placed the fingers of both his hands around the Marine's well-formed arm above were Jimmy was working and squeezed down as a human tourniquet to make the vein stand out. It didn't fill. Jimmy slipped a curved clamp under the flat vein, grasped the ends of two silk sutures and pulled them through. He pulled the suture closest to the elbow down, and tied it, choking off the distal end of the vein. He grabbed the sterile IV tubing from the pack and cut off the distal end at a slight angle. He handed the other pointed end of the line that went into the rubber cover of the bottle, to the corpsman.
"Lactated Ringers," Jimmy shouted.
"Will this do?" said another corpsman who was standing near Jimmy with three bottles of O-negative blood in his arms.
"It will," Jimmy said. "You're right, this Marine's in class four shock." The corpsman put two of the bottles on the floor and plugged the IV tubing set into the bottle of blood he was holding and filled the drip-chamber, plastic-bulb pump and the tubing with blood all the way down to Jimmy's end. Jimmy made a little hole in the vein, slipped in the tubing and tied it in place with the other suture near the top of the incision. He looked across at Spettle. Spettle's cutdown was already in and blood was running. In fact about one third of the bottle was already in and Spettle had closed his incision, loosely. Jimmy opened the valve and blood began to run through his cutdown. Spettle had beaten him, badly. Welcome to Vietnam, rookie; welcome to combat casualty care, he thought. These corpsmen are really good. Now he understood, "how fast ya are."
As soon as the first two bottles of blood ran in, two more bottles of blood were hung. The corpsmen continued to pump the little bulbs on the IV tubing to force the blood in faster. Jimmy threw in a stitch to close his wound and a corpsman put a "Betadine" dressing on the cutdown site. He hadn't noticed, but Lieutenant. Joe Carroll was standing behind him.
"Is he going to make it?" Father Joe asked.
"Looks like it," Spettle assured the new Catholic chaplain.
"'Wiggers prep' shock model," Jimmy mumbled to no one in particular. Jimmy had met the priest at the Da Nang airport early that morning having flown in from Clark Air Force base on a military transport plane. They had ridden in the same "cracker-box" ambulance from the airport to First Marines, First Medical Battalion, just a few hours ago. They were both brand-new and inexperienced with war casualties. The Marine on the stretcher began to stir. The corpsmen had pumped seven pints of blood into him.
"Can I talk to him?" Father Joe asked. "I noticed that he has a cross on the chain around his neck."
"Sure, Father," Jimmy said. Jimmy hadn't noticed the cross nestled in the Marine's thick black chest hair. He backed away from the patient's right side and Father Joe slipped in and bent over, near the Marine's right ear. The Marine lifted his head and began to look around.
"Do you have any questions, son?" Father Joe asked in a soft, almost shy voice. The Marine looked down at his bloody penis.
"Yeah, Father, will it fuck?"
The priest reeled back into Jimmy and looked up at him. Jimmy caught him and shook his head, yes. Father Joe regained his composure and moved back alongside the Marine.
"The doctor says it will. What's your name, son?" Father Joe asked.
"Where are you from?"
"Brooklyn ... Are you sure, Father?"
"Doc says he can make it as good as new."
"Yes. And I'll pray for you." Father Joe got out his little metal case and administered the sacrament of the sick and blessed the Marine. When he turned around Jimmy saw that Father Joe was almost as pale as the Marine had been when he came in.
"Yeah. My first day, too, Father," Jimmy said. They shot an X-ray of the left hip and thigh, moved Marciano over to a gurney and wheeled him toward the operating room. Jimmy looked up and saw Tony Centrino standing in the OR.
"Do you need a hand?" Tony asked.
"Sure do," Jimmy replied. "I haven't taken the tourniquet off yet. He must've shot the femoral vessels in two, since he bled out from the injury. No exit wound, either. X-ray shows the bullet under the skin behind and on the outside. You can feel it, too."
"Did you get the story?" Dr. Centrino asked.
"Guess it doesn't matter," Tony said.
"The fuckin' PF shot me," Marciano groaned.
"Glad to see your doing better, Marciano," Jimmy said.
"I ain't doing for shit, doc. That bastard tried to kill me. He shot my dick off."
"The dick I can fix. It's the blood vessels in your thigh that worry me," Jimmy said.
"Ya can cut my leg off, but ya gotta fix my dick."
"We'll try to fix 'em both, Marciano."
"You gave me two big lines for fluids," Doctor Greg Suiter said. "Should be able to get 'em the drugs to put him to sleep. Who's your new side kick, Tony?"
"Sorry Greg. This is Jimmy Capri. He just started today. Got himself a real nice case right off the bat! Jimmy, this is Greg Suiter. Best damn anesthesiologist in the Navy," Tony said.
"Tony says that about every anesthesiologist we have here," Greg said.
"Glad to meet you," Jimmy said. "Just didn't expect to do it so soon."
Excerpted from Vietnam, I Love You by Tom Lee Copyright © 2011 by Tom Lee. Excerpted by permission of AuthorHouse. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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