Dartmouth Veterans: Vietnam Perspectives

Nobody Knows and Nothing Changes

Nobody Knows and Nothing Changes ---------------------------------------------------------lynn mccanse : u.s. army S everal years ago a surgeon friend of mine gave a presentation at a trauma conference regarding his deployment to Iraq, which occurred in the middle part of that war. At that time, it was still the U.S. policy not to acknowledge returning fatalities, and while the war was well publicized, the injuries occurring there were not. The Iraq War was the first to have an improved mortality rate since World War II, meaning soldiers were surviving more serious wounds than ever before. After watching thirty minutes of the most horrendous injuries I had ever seen, I remember leaving the meeting thinking, if pictures like those were publicized, the war would be over tomorrow. By the time I arrived in Japan in the summer of 1969, if a soldier was injured seriously enough in Vietnam to be sent elsewhere for care, his tour was over and he was eventually headed home, although not necessarily whole. My yearlong war experience was providing this intermediate care at a time when, fortunately, the number of casualties was decreasing. The Tet offensive had occurred more than a year before, but an operative schedule from that time was still taped to the door to surgery. It went from the ceiling to the floor. I was one year out of medical school, with no specialty training. There was a need for orthopedic surgeons, and I was placed in that job category, although as a class D (no previous training). I was given on-­ the-­ job training , which consisted of spending a day with someone with experience and then being given an operating room of my own. I spent the next year closing open wounds of soldiers with associated broken bones. If there were no broken bones, then the general surgeons closed the wound. These DPCs (delayed primary closures) were necessary to prevent infection, as almost all “in-­ country” wounds were “dirty” and if closed at the time of Lynn McCanse : 317 injury would become infected, but if left open for one to two weeks could be closed safely with good results. Basically I was a glorified seamstress who coated his finished work in plaster. Life was good in Japan, the war was a long way away, and I was too young and immature to appreciate the horrors of what had happened to the young men I was caring for, soldiers with multiple open wounds and fractures and frequently with one or two limbs missing, and occasionally three or four. They would usually stay with us for one to three weeks, depending on the bed status in the “States” and the availability of flights. Being young and healthy to start with, they usually did well with our surgery, and were surprisingly upbeat. I still have a film of a smiling young man demonstrating, with his only remaining limb, the trigger mechanism to the Claymore mine booby trap he had triggered. They were probably happy because they knew they were going home, and unlike today, single tours of duty were more the norm. This equanimity , among other things, allowed me to be fooled and minimally affected by what was going on around me. The significance of mini-­ concussions from exploding ordinance was only first noted and diagnosed during the Iraq War. Harmful effects from Agent Orange were suspected then, and, as now, the whole subject was controversial. “PTSD” was not the buzz term it is now, but I cannot imagine that the incidence was not as high, if not higher than it is now. Forty years after being intimately involved with these men, I read Matterhorn, a novel of the Vietnam War based on true experiences, and I was overwhelmed to think of how clueless I had been about the experiences of the soldiers I had treated. Helicopters landed in the parking lot all day, transferring casualties from the nearby Air Force base to our hospital, where they would be evaluated one day and usually operated on the next. Sometimes when inside one of the surrounding buildings, it was hard to differentiate the vibrations from the helicopters from one of the frequent earthquakes. Our Lynn McCanse 318 : dartmouth veterans work was so routine that we were able to live fairly normal lives outside the hospital, and most of us were accompanied by our families, enjoyed exploring the country, and had very little hardship. The movie...