The Vietnam War

Supplies from Vietcong Underground Hospital

The following is a chapter from a book I'm writing about my experiences as a medical officer in Vietnam during the war. That's why it's a little longer than my usual post. It's painful to think about Vietnam and it's hard to understand if you weren't there, so I haven't written or talked much about it during the almost 55 years since I was there. But as I see wars continue, and listen to the same war psychology of thinking of strategy rather than suffering and loss of life, I think maybe those of us who've experienced war have an obligation to at least try to warn the next generation about its costs. The victims of war can't speak for themselves.  

The Vietnam War

We have met the enemy and they are us. Pogo. 1970.

When I was 8 or 9 years old my parents took me on a vacation into the “Cookson Hills,” a mountainous area in northeastern Oklahoma where my mother had worked as a social worker during the Depression. It’s a heavily wooded area with lots of hills and streams, and no highways, at least back then. As my dad was driving down a winding road, I asked, “When are we going to get to the mountains?”

He replied, “We’re already in the mountains.” It became a family joke.

While I was in Vietnam, I could have asked a similar question, “When are we going to get to the war?” 

I knew there was fighting all around me. I heard the body counts in the general’s briefings. I visited the hospitals where the casualties were brought in. Although 11780 American troops lost their lives in Vietnam in 1969, second only to 1968, the year of the Tet offensive, I had very little personal experience with the war. I lived in a comfortable hooch. I made trips to Saigon every month, and I made frequent visits to the nearby towns on MEDCAP missions, and to units in the field for my urine tests, but I didn’t get shot at. Even my visits to the hospital were mainly academic, investigating outbreaks of food poisoning, malaria or hepatitis.

I travelled mainly by jeep along Highway 1. There were a few attacks along the road, usually by mines set off by a hidden Vietcong or by a buried trigger. Once a mine exploded on the road to Tam Ky, which I had visited the day before, but I didn’t see the damage. Then there was the time when the fuselage of a fighter plane crashed through the bath house where I had just taken a shower, but at the time I just laughed it off.

In Chu Lai I was relatively isolated. It was a huge base several miles in diameter. There were only occasional breaches of the perimeter while I was there, usually by a single sapper, able to crawl through the barbed concertina wire barricades because the guys on guard duty were high on pot. I only found out because the sirens would go off, and I would have to don my helmet and flack jacket, strap on my pistol, and walk over to the clinic to wait for the “all clear.”

I think my friend Jim experienced the war more than I. He was shot at several times. He told me that he had nightmares for years afterward. Frankly I don’t know how he got through his residency. I couldn’t have functioned if I had to deal with PTSD.

The serious attacks were on troops on patrol, and on Battalion fire bases, sitting ducks for mortar fire. This is how my classmate, Norman Singer, was killed. A mortar round struck his aide station in May of ’69, just a couple of months before I went to San Antonio for basic training.

Of course the most dangerous assignment was to be on patrol in the “boonies.” Every company in a battalion had at least one platoon on patrol at any one time. The strategy was to go into an area known to contain VC or NVA troops, to “establish contact.” In other words, they were to wander through the area until they were fired on. This gave the enemy a tremendous advantage. They knew the area, and they had civilians working as sentinels to warn them of the presence of American troops. They could bide their time, waiting for an opportunity, strike a platoon, killing 2 or 3 guys, and then disappear back into the bush. Of course, they also booby trapped the trails with mines and pungi stakes.

Since I attended the general’s briefings, I heard the mortality statistics every week. It was usually 2 or 3 of our guys to 10 to 20 VC and NVA. “VC” referred to any Vietnamese who wasn’t wearing a uniform. According to our statistics there were no civilian casualties. I can’t find it in my notes, but I remember calculating the risk of an infantryman being killed during a year in the field. It was something like 30 or 40%. I probably tossed those notes because they were classified. 

This is why the guys were so desperate to get out. They would put peanut butter on their toes to get rat bites, or skip their malaria pills to get malaria, just so they could get sent back to the rear. Actually there was no “rear” since battalion fire bases were scattered throughout the country, providing maximum exposure to enemy attack.

The danger of being in the field put the men in a state of constant fear, which led to hostility toward the enemy, and toward all Vietnamese, who were blamed for the war.  This is why Vietnamese civilians were sometimes killed indiscriminately as they were in the hamlet of My Lai.

The men also blamed the danger they faced on their leaders, and that’s why the practice of “fragging” became common. Fragging was the slang term used to describe the murder of an officer who the men felt put them in unnecessary danger. This was usually done by a grenade tossed in the officer’s direction, or by misdirected fire during a fire fight. I heard of one officer killed by a grenade thrown into a latrine. Fragging became more common as the war dragged on. There were 600 such incidents between 1969 and 1971. [i]

Not every officer was unpopular though. One of my hooch mates, Tyson, had been a company commander. Here’s what I wrote about him in my notes:

Tyson was a company commander, tough as a cob. John, another of my hooch mates who worked in G-1, personnel and public affairs, condemned him for refusing to write a letter to the family of a soldier who died. John said that’s why he hates the army. It’s so cold and hard.

Actually Tyson is one of the nicest guys I’ve met here. He’s clever, the life of the party among his colleagues. When he was a company commander he says he rode his men all the time; allowed only seven men to stay in the rear while most companies leave 20%. He held back leaves for the good of his unit. He even refused to allow med-evacs unless he was satisfied the man couldn’t function in his job.  

In return he gave the men his support, always accompanying them into the field. He was injured once while standing up so he could see better to direct the battle. As a result, his unit had fewer killed than any other company. His men respected him. When he left, they all chipped in and bought him a fancy camera. 

When Tyson refused to write the letter, he said, “What the Hell. He’s dead. What more can you say.” In retrospect, I think he felt guilty that the man was killed on his watch.

Barney Neal was my other med school classmate killed in Vietnam. I’ll bet he was a popular officer as well, but not for being a hard ass. But who knows? Maybe he was different as a commander. The Barney Neal that I knew was a really nice guy. He was a little older than most of us, but he fit right in. To us he was just one of the guys. (There were only three women in my class.)

Barney was called up in 1965, after we started sending troops over to Vietnam. We were just finishing our second year in med school. He sailed to Vietnam on the USNS General Walker as executive officer for a Battalion in the 4^th Infantry Division, landing at Qui Nhon on August 6, 1966.

By 1970, Barney was on his 2^nd or 3^rd tour in Vietnam, and had been promoted from major to Lieutenant Colonel, commanding a battalion of about 1000 men at An Khe, near Pleiku in the Central Highlands. On Sept. 11, 1970, he was on his way to inspect an NVA bunker complex discovered by one of his companies on a search and destroy mission, but he never made it. His helicopter crashed, apparently due to mechanical failure. The pilot tried to autorotate, a maneuver designed to slow the descent by taking the motor out of gear and changing the pitch of the rotor blades. The gears were locked though, and the helicopter crashed, bursting into flames, killing Barney and his artillery liaison officer, Lt James Nobles. 

The rest of our class had graduated by that time. I was already back from my year’s service in Vietnam. It wasn’t long before we found out about Barney though, and also about Norman. It was before the days of the internet, but our class kept in touch through newsletters. Word of their deaths cast a cloud over my Army service. Norman was killed just before I went to San Antonio for training, and Barney was killed just after I got back from Vietnam. I had been incensed by the needless loss of life in Vietnam from the start of the war, but learning about the death of Norman and Barney somehow made it more real. As a doctor, I had felt removed from the war. Doctors don’t take lives, we save them, and we’re not supposed to get killed.

Actually the career military officers, “lifers” as we draftees liked to call them, looked at Vietnam as an opportunity. There, commanding troops in a real war, they had more opportunity for advancement than in peacetime, but like with Barney, there were risks.

About half way through my tour we heard that our commanding general, Lloyd Ramsey, had crashed in a helicopter and was lost in the jungle. The only details I heard were that he had a broken leg and one of the orthopedic docs had flown out in the rescue helicopter to splint it so he could be flown out. He’s the only doctor I know of who got a silver star, the third highest medal awarded by the Army.

I never knew exactly what happened. There was a brief article in the Americal Magazine about it:

On March 19, Major General Lloyd Ramsey, commanding general of the Americal Division, was hoisted from the thick jungle where he had been stranded overnight following the crash of his command and control UH1 (Huey) helicopter in which two men were killed and six injured.

Army and Air Force rescue units flew to the area and an infantry element of the 1^st Battalion, 6^th Infantry was airborne to within two miles of the crash site.

Radio contact was lost at 4 PM Wednesday, March 19, and was not regained until 8 AM when Major Tommy P. James (Bixby, Okla.) arrived in the area in a helicopter. Major James was awarded the Distinguished Flying Cross (the Army’s second highest medal, just below the Medal of Honor) for his outstanding actions in the successful rescuing of downed personnel. 

On March 22, following the injury of General Ramsey, Major General A.E. Milloy assumed command of the Americal Division.

The article doesn’t mention the poor doc who flew out with the rescue team, but the incident sticks in my mind since the awarding of Silver Stars is so rare.    

Vietnam was the only war I have been in, but in reading more about war, especially the war in Vietnam, I think it deserves special recognition for cruelty and senseless slaughter. I’m no expert, but it seems to me that this arose out of our strategy of attrition, the targeting of civilians, their homes, villages, and crops, to deprive the Vietcong and NVA of their means of support. This strategy led the men to rationalize their contempt and hatred of the Vietnamese, and to justify in their minds their inhumane treatment of them. I wrote in my notes:

Combat orientation: Men told that although it was understood they would torture and kill prisoners, they should make sure no one found out. August 4, 1969.

It was common knowledge that torture was practiced by American troops. One method was to dangle the prisoner out of a helicopter at 10,000 ft., holding him by an ankle, just to make him scream. Then they would often just let go, watching him drop to his death.  The Vietnamese prisoners not killed were turned over to the ARVNs who might also torture them, or enlist them in the South Vietnamese army.

Torture was practiced by both sides. Jim told me of a couple of examples he witnessed. Once, while visiting a village on a medcap mission, he saw the heads of the village chief and his wife impaled on stakes. On another occasion he saw the body of a man who had been tortured by driving nails into both sides of his head and then shocking him into convulsions by attaching wires and a generator to the nails.

In looking for accounts of the war from the Vietnamese’ perspective, I ran across a memoir by a woman, Le Ly Hayslip, who was born a peasant under French rule, and survived the Vietnam war to eventually marry an American Soldier and escape to the  US. Her book, “When Heaven and Earth Changed Places,” was later made into a major motion picture by Oliver Stone. The book describes how Le Ly, as a young girl, was recruited to work as a sentry for the Vietcong. She describes being captured by government troops and being tortured by tying her to a post on an ant hill and then rubbing honey on her legs.

The ambivalent relationship between Vietnamese civilians and the Vietcong was illustrated by Le Ly’s experience. When she was released by the government troops, the Vietcong, assuming she had betrayed them, raped her, and during the assault, one of her attackers actually apologized, saying he was only doing what he was told.[ii]

Vietnamese civilians were in a bind. Many sided with the Vietcong because they also opposed the corrupt South Vietnamese government, and they knew them. Most were local boys usually led by Vietnamese who had infiltrated from the North. A few civilians participated in the government pacification program intended to separate and arm loyal citizens to defend themselves against the Vietcong. The Americans participated in these projects, and befriended many Vietnamese, but as soon as the US troops left, it was up to the Vietnamese government troops to equip and support them, which didn’t happen. These groups soon became infiltrated by Vietcong, and the leaders were assassinated. The common saying was that “the villages belong to the Vietcong after dark.” Not even the village chiefs would spend the night in a village.[iii]      

There was a Korean military unit just south of us, and they were notorious for their brutality. According to Colonel Wilson their solution to the problem of prostitution was to wrap a prostitute in barbed wire and hang her over the entrance to the base. I expect that was more effective than Jim’s program of weekly exams and ID cards. The Colonel told us the Koreans didn’t see much action in Vietnam because the Vietcong and NVA troops were afraid of them.

I don’t want to dwell too much on the subject of torture, or on the cruelty practiced during the war, only to say that neither side was innocent. It was just an example of war’s evil psychology of dehumanizing the enemy. It’s okay to kill or torture them because they’re trying to kill us, and their lives are worthless because we’re trying to kill them.

Several especially cruel but effective weapons were developed for use in Vietnam.

I already mentioned our “Dragon Ships,” large cargo planes outfitted with machine guns able to pulverize an area with thousands of rounds of high caliber bullets, and the bomb craters from our B-52 strikes, 50 feet wide and just as deep, which dotted the countryside.

While the Vietcong had their pungi stakes, we had our Claymore mines. The Claymores were antipersonnel mines aimed in the direction of expected enemy approach. They were detonated remotely by a trigger device set off by a soldier, or by a trip wire, exploding the C-4 inside and firing 700 pellets out about 100 yards in a 60⁰ radius. They were meant to be used against advancing troops and were nicknamed “toe poppers” because they frequenty injured the victim’s legs, disabling him and requiring the help of several others to rescue him. Of course Claymores also killed children going to school or random civilians walking down a trail. It is now illegal to set one up with a trip wire.

Our most famous weapon from the Vietnam era was probably Agent Orange, which wasn’t technically a weapon. It was a defoliant, meant to clear vegetation from around a fire base or landing zone to prevent surprise attack, and it was also used to just destroy crops, the food supply for the enemy, but also for the civilians. Its effectiveness is illustrated by the fact that during the war Vietnam changed from being a major exporter of rice, to being an importer. 

Agent orange was toxic, causing birth defects, certain kinds of cancer, and a skin condition called Chloracne. I know a little bit about it because when I worked at the VA all the Agent Orange claims were sent to me because I was a Vietnam vet myself. There were so many outrageous claims, from impotence to marital problems, that it got to be kind of a joke, but the government did take the claims seriously. There were maps charting different levels of exposure, and each claimant was rated by where he had served. Large studies were done to determine the long term effects. As I remember, the highest level of exposure was up near the DMZ.

Of course, the Vietnamese, civilian and military, were the most highly exposed to Agent Orange, and I don’t have any idea how many of them were affected. They were aware of the potential danger though, so the South Vietnamese government launched a publicity campaign to quiet their fears. What I remember about it was a TV ad picturing a Vietnamese family putting Agent Orange on their breakfast cereal, to show how harmless it was.

The most famous picture from the war might be that of a little Vietnamese girl, nine years old, completely naked, running away from her village with a group of children, screaming from the pain of napalm burning her back. She had taken off her clothes to try to stop the burning. Running behind her was her grandmother, carrying her infant cousin, who later died of his injuries.

Napalm was developed as an incendiary agent during WWII. It is a mixture of gasoline, kerosine and diesel fuel, mixed with a gelling agent. It burns at a high temperature and much more slowly than gasoline alone, sticking tenaciously to its targets, making it extremely effective against structures and personnel. It causes severe burns even on slight contact, and kills anyone near the blast by burning up all the available oxygen.

It is dispersed by flame throwers or in cannisters dropped by aircraft which explode on contact, igniting the mixture.

Reportedly about 388,000 tons of U.S. napalm bombs were dropped in Vietnam between 1963 and 1973, compared to 32,357 tons used over three years in the Korean War, and 16,500 tons dropped on Japan in 1945. The UN banned the use of napalm against civilian populations in 1980, but it was not eliminated from the US arsenal until 1995, and the UN resolution was not signed by a US president until Obama signed it in 2009. [iv]

Kim Phuc, or “Napalm girl,” as she is also known, survived the severe burns to her back and arms, and after ten years and 17 surgeries, was finally able to move properly. She is now married with two children and is a Canadian citizen. In 1997 she established the first Kim Phúc Foundation in the U.S., with the aim of providing medical and psychological assistance to child victims of war.

The following is a quote from an NPR interview with Phuc in 2008:

Forgiveness made me free from hatred. I still have many scars on my body and severe pain most days but my heart is cleansed. Napalm is very powerful, but faith, forgiveness, and love are much more powerful. We would not have war at all if everyone could learn how to live with true love, hope, and forgiveness. If that little girl in the picture can do it, ask yourself: Can you?[v]

Underground bunkers were everywhere in Vietnam, like storm cellars in Oklahoma. The most notorious ones were built by the Vietcong, tunnels several hundred yards long and several levels deep, fortified with large beams; but actually every family built their own, because everyone was in danger from aerial bombing.

Every search and destroy mission was accompanied by a search for underground bunkers. Volunteers were specially trained as “tunnel rats” to descend into these structures to look for hidden Vietcong, valuable intelligence and supplies. During Operation Cedar Falls, US troops discovered almost 500 tunnels stretching over 12 miles. Hundreds of weapons and thousands of rounds of ammunition were captured along with enough rice to feed 13000 troops for a year. 500,000 documents were found including diagrams of US billets in Saigon and plans for terrorist attacks.[vi]

Tunnel rats took a huge risk going into these bunkers. The tunnels had booby traps, and there were many branches to facilitate escape or ambush. Sometimes Vietnamese translators volunteered for these missions, especially in small tunnels dug by civilians. They could call out warnings to those hiding within, and perhaps save some people just hiding for safety.

Pepper spray was used to flush out people not responding to warnings, and also “white phosphorus,” an incendiary device used in grenades, tracer bullets, and bombs. White phosphorus ignites on contact with air and leaves a trail of white smoke. A white phosphorus grenade thrown into a tunnel would immediately burn up all the available oxygen, suffocating those inside.

White phosphorus was also used by tactical units to create a smoke screen to hide them from enemy fire, and by Forward Air Control (FAC) planes to mark targets for fighter-bomber fire during “pacification” operations. [vii] 

After clearing tunnels of enemy troops and supplies, and exploring them for intelligence, the tunnels were destroyed, either by explosives or by bulldozing. In my notes I illustrate the risk involved in these operations.

Fourteen guys killed protecting bulldozers clearing area after removing 1200 civilians. Nov 2, 1969

During the last month of my tour, a large collection of Vietcong medical supplies was found in an underground hospital in the mountains west of Chu Lai, and was brought into our office. Included were surgical instruments, bandages, pills and bottles labeled in Vietnamese, and small packets of morphine, anesthetic or antibiotics, each attached to a short IV tubing and a needle. There were also papers, apparently certificates or documents of identification, and pictures of family members or girlfriends, and letters. I was fascinated by this. I knew the Vietcong and NVA had underground hospitals, but this was the first example I had seen.

In developing information for this book I ran across a memoir written by a Vietnamese doctor,  Dang Thuy Tram, who volunteered to halt her post graduate training in ophthalmology, and make the three month trek down the Ho Chi Minh Trail to treat Vietcong and NVA troops in South Vietnam. She worked at a hospital near Duc Pho, which was just south of Chu Lai where I was stationed, and at various locations to the west of us in the mountains. After working there for over three years, Thuy was shot and killed.

Two volumes of Thuy’s diary were saved by a US military officer, Fred Whitehurst, who kept them for thirty years before he decided to have them translated. They were then published under the title “Last Night I Dreamed of Peace,” a quotation from the diary. Since then, Whitehurst, an attorney, has become acquainted with Thuy’s family; the memoir has become a best seller in Vietnam, and a hospital has been built in Duc Pho in her memory.[viii]

Thuy’s diary is eloquently written, at times poetic. She quotes from memory sayings and poems from literature. She is a devoted but somewhat naïve communist, but she doesn’t talk in the diaries about communist dogma, but rather her love and concern for her patients, and the suffering of her people.

In her diary, Thuy describes the fear of discovery, as enemy (American) troops pass near the opening of her bunker, left open because of the heat; her fear that a young man with an injured leg will start bleeding after his leg is crushed by a fallen beam, dislodged by a bomb blast. She describes shivering with cold as she works to bail water out of her bunker during the rainy season, and struggling to move patients from one location to another when enemy troops move into her area.

Thuy treated both civilian and military patients. She grew to know and care about her patients and their families, who often lived nearby. She trained medics to go out and serve with the troops. She keeps up a correspondence not only with her family in Hanoi, but with former patients and medics she has trained. The Vietcong communication network was apparently more efficient than the US mail, because Thuy describes receiving letters several times a week, much more often than I did.

What the Vietcong feared most, even more than being killed, was capture, because they knew they would be tortured. But sometimes instead, they were inducted into the ARVN army. Thuy describes a letter she received from a former patient then an ARVN soldier, in which he states his intention to escape and return to the Vietcong.

The Ho Chi Minh trail wasn’t the only source of supply for the Vietcong and NVA troops in the south. Equipment and men were also shipped across the South China Sea, and Duc Pho was apparently one of the delivery points. Thuy’s diary mentions a group of NVA soldiers injured while disembarking from a boat from Hanoi. In my notes I mention the sighting of a similar craft.

Boat off coast with about 20 people. Helicopter strike called in. Didn’t show. Someone set off a flare in their direction and they left. October 2, 1969.

In addition to keeping her personal diary, Thuy kept detailed records of her surgical procedures. These were also discovered after her death, but she also refers to numerous cases in her diary: an appendectomy she performed without anesthesia, amputations, repair of ruptured kidney. Here’s her description of a man burned by a phosphorus bomb:

This morning they bring me a wounded soldier. A phosphorus bomb has burned his entire body. An hour after being hit, he is still burning, smoke rising from his body. This is Khanh, a twenty year old man, the son of a sister cadre in the hamlet where I’m staying….Nobody recognizes him as the cheerful handsome man he once was. Today his smiling joyful black eyes have been reduced to two little holes- the yellowish eyelids are cooked. The reeking burn of phosphorus smoke still rises from his body.

I stand frozen before this heartbreaking tableau.

His mother weeps. Her trembling hands touch her son’s body; pieces of his skin fall off, curled up like crumbling sheets of rice cracker. His younger and older sisters are attending him, their eyes full of tears.[ix]

I can’t do justice to Thuy’s journal with a few quotations, but listening to her experiences in her own words gives me a feeling of empathy, of kinship with her and the many like her, more than any statistics, or description of the hardship and carnage.

I’ll just include one more set of quotations, from the last days before Thuy was killed. Her hospital in the mountains near Pho Cuong was bombed twice in a week’s time - apparently a traitor had revealed its location - the consensus was that a new location for the hospital must be found. The following are excerpts from her diary during the days that followed:

June 14, 1970: Sunday, it is clear and cool after the rain. The trees are brilliantly green. In the house, a vase of fresh flowers just cut from the garden this morning … The turntable is playing a familiar song. “The Blue Danube” … Voices and laughter of visiting friends…

Oh, that was but a dream- a daydream!

This morning is also a Sunday, fresh after the rain. The air is calm. If not for the sky tearing roar of aircraft, this morning would be no different from my daydream. My place has just suffered another bombardment. The afternoon before yesterday, two observation planes circled for a long time and then launched rockets… after four waves of bombardments, we were surprised to find that the bombs had struck not 20 meters from us. The entire area was denuded of trees. Plastic sheets covering the houses were shredded and scattered … Shrapnel had cut beams and columns. Dirt filled the shelter! Fortunately no one was injured … Yesterday it was pouring rain. We covered the floor with plastic sheets, but the water still came in and flooded the building. Everyone was thoroughly soaked…

Yesterday, in the ravaged scene after the bombardment, people departed, loaded with their belongings…

Thuy and two nurses were then left alone to care for five patients, too sick to be moved. She reflects on her decision to stay:

June 16, 1970.

The clinic is being attacked, and the enemy is continuing to put tremendous pressure on us with all types of aircraft. The roar of the aircraft is enough to make me as tense as a taut guitar string.  

There is no other solution than to stay with the wounded soldiers. It is laughable that the commissioner for the clinic dare not stay with us. He refuses to stay with me. … I have resigned myself to bear this situation. What else is there to say?

June 17, 1970.

Today there are no scout planes circling over us. The air is calm. Once in a while, waves of HU-1A’s rise to hover above the hills. The enemy is certainly nearby. There are only three women here, with five non-ambulatory wounded soldiers. If the enemy comes, there is nothing we can do but run! Is that acceptable? Everyone agrees that under such circumstances, there is no other way. But will I have the heart to do it? … Nien, an injured young soldier, tells us sincerely; “Be calm, sisters. Run if the enemy comes. We will stay and fight them to the death!”

Nien is only nineteen years old. He is a commando, a very handsome boy with a full face, a high nose, and big eyes with thick lashes. When he is in pain, he turns to me with tears in his eyes.

Nien was injured in action. The wound caused secondary bleeding in the tibia. I had just operated on his leg three or four days ago, then the bombs fell on the clinic. A broken beam in the shelter crushed Nien’s leg right at the old wound. For the past twelve days, I worried that his leg would bleed again. … Today that danger is past, but if the enemy comes….

June 20, 1970. 

Still no one comes. It has been almost ten days since the second bombardment. People left with a promise to come back quickly and get us out of this dangerous area. …Questions whirl around in our minds. Why? Why haven’t they come back? Is something wrong? Is it impossible that they have the heartlessness to leave us in this situation…?

Today there is only enough rice left for an evening meal. We cannot sit and watch the wounded soldiers go hungry. But if one of us goes out, there is no guarantee that she will be safe or that she can come back…. And if two of us go, leaving one behind, what can she do alone if something happens? …This rain in front of us is difficult enough. If it starts pouring in earnest, how can one person manage? She can’t cover the shelter in advance because of the danger of being spotted by airplanes. Still in the end, two of us must go.

Sister Lanh and Xang leave, and I stand there looking at them, pants rolled up to their thighs, wading through the stream, my eyes blurry with tears. …at this moment, I yearn deeply for Mom’s caring hand. Even the hand of a dear one or that of an acquaintance would be enough.

Come to me, squeeze my hand, know my loneliness, and give me the love, the strength to prevail on the perilous road before me.

That is the end of the diary. Two days later Thuy was shot and killed while walking across a field by soldiers from the Americal Division. It must have been her turn to go for food and supplies. US intelligence records from June 14 reveal knowledge of a medical clinic  with 30 medics and one doctor, so we knew Thuy’s shelter was a hospital and bombed it anyway. The Vietcong didn’t abandon Thuy’s clinic. By the time she was killed, the clinic had been resupplied and the patients evacuated. [x]

Thuy was born in 1942, the same year as I. We were doctors in the same location and at the same time, only on different sides of the conflict. I received the medical supplies captured from the underground Vietcong hospital the month after Thuy was killed. I’m sure they were hers.

 

 

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[i] Eyewitness History of the Vietnam War, 1961 - 1975: George Esper and Associated Press, 1983, Ballantine Press. P 138.

[ii] When Heaven and Earth Changed Places; a Vietnamese Woman’s Journey from War to Peace, Le Ly Hayslip with Jay Wurts, New York, NY, 2003. Penguin East meets West foundation.

[iii] The Military Half, An Account of Destruction in Quang Ngai and Quang Tin, Jonathan Schell, Alfred A Knopf, New York, 1968. P 202.

[iv] Wikipedia: Napalm

[v] Wikipedia: Phan Thi Kim Phuc

[vi] Eyewitness History of the Vietnam War, 1961 - 1975: George Esper and Associated Press, 1983, Ballantine Press, P 92.  Tunnel Rats.

[vii]  The Military Half, An Account of Destruction in Quang Ngai and Quang Tin, Jonathan Schell, Alfred A Knopf, New York, 1968. P 22.

 

[viii] Last Night I Dreamed of Peace. Dang Thuy Tram. 9/11/2007, Crown Publishing.

 

[ix] Last Night I Dreamed of Peace. Dang Thuy Tram. 9/11/2007, Crown Publishing. July 29, 1969.

 

[x] Last Night I Dreamed of Peace. Dang Thuy Tram. 9/11/2007, Crown Publishing. P xv.

 

Jim Walraven

 

                                               Jim and Julie

I just discovered something today that really makes me sad. Jim Walraven, one of my best friends, has died. I know it makes no sense, but emotionally I believed he would always be there.

We used to exchange e-mails at least once a week since we couldn’t get together in person. He didn’t answer one of my messages and I thought he was just getting tired of our frequent e-mails. He didn’t answer my Christmas card so I just Googled him.  All I found was his obituary. There was a picture of him and his little dog, Julie. He told me once that Julie had saved his life. He was depressed and getting ready to commit suicide. She jumped up on the bed next to him, licking his face and wagging her tail, and he couldn’t do it. He couldn’t leave her alone. 

Jim and I were old friends. We had gone to the same medical school, but we didn’t really know each other until later. It was after Vietnam, after we had both gone into private practice that we got to be friends. We were sitting together in the doctors’ lounge one day after making rounds and discovered that we had both been in Vietnam. Not only in Vietnam, but in the same Division, and with the same position. Preventive Medicine Officer. I was actually his replacement! 

After that, we started trading weekends covering for each other, and on Sunday nights when we called to report on any changes in each other’s patients, we would talk, not only about medicine, but about our interests, our personal lives, our philosophy of life. Jim was a Buddhist. I don’t think he went to a Buddhist church, if there is such a thing, but he admired their philosophy. I had gotten interested in the Eastern religions too, during my tour in Vietnam. Our conversations renewed my interest, and I read a couple of books by the Dalai Lama, and by Thich Nhat Hanh, a Vietnamese Buddhist. He gave me a copy of the Tao Te Ching, the foundation of Taoism. I sometimes meditate. It gives me peace. 

I admired Walraven so much. He was a good doctor, and dedicated. I don’t think he took a vacation during the eight or ten years we worked together.  His patients loved him. No problem was too big or too small. He had ointments for this, balms for that. He had the pharmacist compound special mixtures for him. 

And he was always interested in something. He got an Apple computer for the graphics feature, which he used to plan renovations to his house. He was a pilot, and a sailor. He built a sailboat in his back yard. It was large enough to sleep a couple of people in the cabin. It had beautiful mahogany paneling. For a while he was into Bingo. He’d go one night each week. He proudly announced during one of our Sunday conversations that he had won a $500 Jackpot. He bought a metal detector and for a while he was into treasure hunting. Treasure hunters share information. They have periodicals that describe potential finds. Jim was particularly interested in an army payroll that had disappeared back in the 1800’s down in Southeastern Indian Territory, now Oklahoma. For a while he’d spend his free weekends down there, with his metal detector, scouring the countryside for treasure. 

We got together with our wives too. Jim’s wife Gracie was working in marketing for a department store. She got to be friends with my wife at the time. They had no children, but lots of friends. They had an active social life. 

Jim and I lost track of each other for a few years. I took the geriatric boards and became a geriatrician. Kaiser Permanente advertised for a geriatrician in Dallas, so I moved down there, and later transferred to Denver, where I retired.

Years later I ran into Jim during a trip to Oklahoma City and we started corresponding. He and Gracie were living in a retirement center where they had planned to retire. Jim was the same dynamic person as he had always been. He had only recently retired, working five or ten years longer than me. He was studying Spanish, writing book reviews of Spanish books. He had joined a group who met weekly to practice their Spanish. He was making jewelry – pendants and bracelets - out of charms he found at Michael’s, as presents for the ladies at the center. I was compiling stories about my experiences in Vietnam, so he wrote down some of his experiences, much more exciting than mine, and gave them to me to include in my book. 

At the same time, Jim’s wife Gracie was suffering from dementia, and he had become an almost full time caregiver. They still went out together, but he had to help her with everything, dressing, bathing, eating. She still appeared normal superficially, but more and more she had episodes of agitation. After a particularly scary incident where she wandered off toward a busy street, Jim had to put her in an assisted living facility for dementia patients. Then he would go there every day to make sure she ate, to watch her medication to make sure she wasn’t oversedated. The cost of maintaining her at the dementia facility and living at the retirement center became too expensive, so he had to move. He bought himself a small house with a GI loan where he lived until he passed away. 

Jim Walraven meant a lot to many people. He was a fascinating, interesting person who saved lives, relieved suffering, and brought joy to all of us who were fortunate enough to know him. 

Getting old is different than I thought it would be. I used to tell my patients to cultivate friendships with younger people so you won’t be left alone when you’re old, but I no longer feel that way. I would never be able to replace my memories with new friendships. Take my memories of Jim. He was such a dynamic person. He led such a rich, meaningful life. The times we shared, the conversations we had over the years are priceless. I could never build such a relationship again. I’ve known several remarkable people, my wise cousin that I’ve mentioned in previous posts, my lifetime friend Harlan, who died just a couple of years ago. They were part of my life, part of the times I’ve lived in, but now mostly in the past. 

As I grow older, I feel more and more out of place. Most of the people I’ve admired, people I have known are gone. All that’s left of them are brief summaries of their accomplishments, like Jim’s three paragraph obituary. What it was like to know them, to experience their spirit, their enthusiasm lives on only in the memories of those of us who were touched by their lives. When we are gone, so will be our memories of them. I’m happy though.  I’m fortunate to have known some remarkable people, and I’ll continue to try and communicate some of those memories in words, but they are a pale imitation of reality. The future is for others.

 

Talent

 

                                                           Buddha

 

This afternoon I was looking at the stuff stuck to the refrigerator by my wife, Sarah. We both like to post wise sayings. The frig is her domain. “Dust Bunnies Killed My Cleaning Fairy” is a favorite of mine, but the one that really started me thinking was, “He is able who thinks he is able,” by the Buddha. It has been up there as long as I can remember, and I never thought much about it. I suppose it’s authentic, or at least as authentic as a 2500 year old saying can be, but it doesn’t sound like the kind of thing Buddha would say. He sounds almost like a capitalist. I would imagine a more Buddha like saying would be, ‘Don’t worry about losing your cleaning fairy. Just go with the flow.’ It makes me think that a capitalist took Buddha’s words and altered them to go along with more ‘modern’ thinking. 

The idea that anyone can become successful, rich, or famous, that anyone can make a significant contribution to society, is baked into our culture. I remember believing that since childhood. It inspired me to study harder, to practice long hours on my violin. When I didn’t get an A or wasn’t the best at something, I just attributed it to lack of effort. 

This attitude worked pretty well through college. I didn’t get straight A’s but I was always in the top 15 or 20% of the class, and I managed to win first chair in the All-state Orchestra in high school, and in the University of Oklahoma orchestra too. On top of that, I read books by really smart authors like Asimov, even Camus, and I cultivated friendships with really smart people, thinking that if I could understand them and if they accepted me, that would put me on their level. The fact that I couldn’t understand integral calculus, or learn to speak German didn’t put me off. I just needed to find my niche. 

I think my first suspicion that I couldn’t be the best just by thinking I was, like Buddha supposedly said, or by working hard, came after my first year in medical school. I went there intending to be among the best in my class. I thought, ‘this is going to be my profession, my life’s work, so I’m going to work hard and be successful.' I studied the material for long hours. I even started smoking a pipe because someone told me it would help me to stay alert when I was tired, but I found that wasn’t enough. In med school everyone was smart. Everyone was working hard. I couldn’t be the best no matter how hard I tried. I was making C’s. I had never been a C student, never in my life. 

So I made a decision. I marched into the dean’s office and told him that I hadn’t learned the material well enough, and that I needed to repeat the first year. He didn’t seem upset. He didn’t kick me out of school like I half expected he would. He just reassured me. He said that nobody remembers all that stuff, that all you have to do is get familiar with the subject. If you need to refresh your mind about the details, you know where to look it up. He said that what it takes to be a good doctor is the humility to realize your limitations and the interest to keep learning.  So I  stayed in school, and tried to accept the fact that I wasn’t going to be at the top of my class. 

It was the same with my violin playing. I love to play and I’ve continued to play in my spare time all my life. Sometimes I have played in amateur orchestras and chamber groups, and occasionally for small groups as a soloist. But mainly, I just play for myself. It’s a time when I can relax and reflect. During my last years in medical practice I started playing at nursing homes, and I started transcribing and arranging popular pieces. The classical solo pieces for the violin were flashy but difficult to play and so I tried to play tunes that were easier and more familiar to the patients, popular tunes from the 30’s and 40’s. Gradually I’ve come to realize that I’m just a mediocre violinist. The reason I used to think I was exceptional was because there wasn’t much competition. I was only competing against people my age, mainly in just my home town, and when I won first chair in the state orchestra it was in Oklahoma, a small state. Recently I auditioned for a seat in our community orchestra, one of several in the city of Denver. I made the cut but when I started playing with them I was surprised to find that they were all as good or better than I. I still play, but it’s only because I enjoy it. I get better with practice, but no matter how hard I try I’ll never  be exceptional. 

I have had to fight this misconception all my life, that I’m just as smart or capable as anyone. The media reinforces this idea. They interview successful people and almost without exception the story they tell is one of hard work, determination, overcoming obstacles. The truth, in my opinion, is that they just have exceptional abilities. If you interview people who are average, I think you would get similar stories. Some people are just smarter or more talented than others. 

I think it is a dangerous delusion to accept the notion that we are all equal, that anyone can be successful with hard work and determination. It makes us take on tasks or responsibilities that are beyond us. It makes us discount the opinions of experts, and credit the opinions of those with little knowledge or background. It makes people disbelieve well established scientific facts, like human induced climate change, or evolution. It enables charlatans to create followings on the strength of their personalities without any facts to support them. 

So what’s a conscientious person to do? No matter how smart you are there are millions smarter, more educated, more talented than you. Should you just give up and let others make the decisions? That obviously doesn’t work. Smart people don’t all agree. They make decisions based on ambition, prejudice, status, expectations, and the smarter they are, the better they are at rationalizing their decisions. On a societal level decisions are made by the most vocal, usually a minority - think Nazis in Germany, the Taliban in Afghanistan, Communists in Russia and China. 

What would my wise cousin Steve say? (I’ll find out as soon as I publish this post) First he’d say, “earn your oxygen.” Do things that benefit your family, friends and society. Then he’d say, “be open minded.” Listen to people on both sides of every issue, and try to understand their point of view. Most of them are just as smart as you, and they have reasons for their viewpoints, no matter how foolish they may seem, and then share your opinions. 

Wisdom

 

                                         Rodin's The Thinker

Wisdom is not what it’s cracked up to be, especially in times of change. According to my hero, Eric Hoffer (see my post of Aug. 27, 2024), “In a time of drastic change it is the learners who inherit the future. The learned usually find themselves equipped to live in a world that no longer exists.”

It’s not that wisdom isn’t important. It is the way we understand the world around us, but you have to be careful whom to believe. There are a lot of smart, educated, ‘wise’ people in the world, and whatever your opinion, you can find some of them who agree with you, and can make your case much better than you. Groups of people with similar views banding together and getting their “news” from the same sources is especially common in this age of polarization.

 I’m just as guilty as the next person. I have my favorites: Rachel Maddow, Larry Summers, Josh Brown, and my wise cousin Steve.  It makes me feel smart when I can find a really smart person that agrees with me. Occasionally I accidentally hear or read something by a smart person that totally disagrees with me. My immediate response is to try and pick holes in his/her argument, or assume that he’s making stuff up, but that doesn’t always work. What’s an arrogant egotist to do?

I think too often we come to conclusions first and later think of reasons to justify them.  Finding a smart person who agrees with you is just icing on the cake. It should be the other way around. Gathering information should come first, and then the conclusion.

It starts early in life. We start out with a set of beliefs given to us by our parents, by our culture, and then, as we grow older we learn to rationalize those beliefs, and we find smart people who support them. This process explains most of our traditions. It explains why most Americans are Christian, and most Arabs are Muslim. It explains why most Americans are capitalists and most Europeans are socialists.

It seems to me that there is a lot of criticism of capitalism these days. We’re taught in school that capitalism rewards those who work hard, and it enables us to find the most efficient way to do things. It’s supposed to go together with democracy: life, liberty and “The pursuit of happiness,” but just during my lifetime, communist China – Russia, not so much – has gotten about as good at capitalism as we are, without granting the other two rights stated in our Declaration of Independence.

The trouble with capitalism is that it fosters competition and a “winner takes all” culture. What’s wrong with competition, you say? Well, it leads to resentment and hostility, preventing cooperation between the people who work together. It rewards greed and punishes altruism. When there’s competition, there has to be a winner, and in a corporation the winners rise to the top, make all the decisions and more money, whereas studies have shown that a team approach leads to more innovation and diversity.

On a society level you end up with a small group of people who control the country, and become immensely wealthy, while the needs of the rest are disregarded. That is why in America, medical science is arguably the most advanced in the world, while the level of health care overall is among the worst.

In America we glorify capitalism and attribute to it our success as a country. Why? Because that’s what we were taught. It’s part of our culture. We accept it without question.     

Back to wisdom.

This way of backward thinking, where we make conclusions and then rationalize them, works on a personal level too. A sad but true expression is “The road to Hell is paved with good intentions.” I have made some terrible decisions in my life which seemed to make sense at the time, but in looking back, I performed the same kind of backward logic of making a decision and then justifying it. Rationalization is a dangerous mistake.

The other problem with backward thinking is the future. As Yogi Berra once said: “making predictions is hard, especially about the future.” No one, no matter how smart, can predict the future, but we have to try. We have to make plans, decisions. Knowledge helps. As one of my professors said, “You can either learn from the mistakes of others or you can make them all yourselves,” but unexpected events, and new discoveries can change the course of events. Think of artificial intelligence. Changes need to be integrated into our view of the world, our expectations for the future.

I’ve been lucky in life to know some truly wise people who have questioned some of my poorly thought out conclusions. First was my dad. I talked with him a lot, and he always patiently listened to my ideas. Once I decided that all behavior was selfish. Whether you decide to help someone or steal something, you do it because you think it will make you feel better. Helping will give you satisfaction, and hocking stolen goods will make you richer. His response was, “If you’re playing basketball (he was an outstanding athlete in high school and college) and you steal the ball, then run down the court and pass the ball to one of your teammates to make the score, you can’t convince me that’s selfish.” From that I learned not to make conclusions by manipulating semantics. And he taught me much more.

Then there was my lifelong friend, Harlan. Once I got interested in Albert Schweitzer. He was a doctor, philosopher, musician and a missionary in Africa. He was also recognized as a biblical scholar, and a psychologist. I was telling Harlan how much I admired Schweitzer, when he reminded me that he had a patronizing attitude toward the Africans. Harlan knew a little bit about everything. He was gentle but ruthless in his logic. He taught me to look at things from a broader perspective.

Then there is my wise cousin Steve. We’ve been discussing things since childhood. Now we’re getting older, declining mentally and physically. We deal with it each in our own way. He organizes genealogy and photos for his kids and grandkids on Excel. He must be one of the world’s authorities on Excel. I manage our investments and play the violin. I’ve learned many things from Steve, whether it’s earning your oxygen (see blog post of 11/23/23),  or being ambivalent (see post of 11/8/23), or the scientific method (see post of 6/10/24), to which he attributes most advances in science. We can’t get together anymore, but we talk by phone for about two hours every other week. Last week I was telling him how disappointed I was that my wife Sarah and I couldn’t travel anymore. He seemed concerned that I was getting depressed, and started reeling off all the things that we can still do. He finished by telling me to remember Pollyanna, who always found something good in everything and everyone. Steve watches the movie “Pollyanna” over and over. What can be more useful than always looking on the bright side?

I’ve been truly blessed.   

 

 

 

 

Where Have All the Democrats Gone?

 

From "Trumpty Dumpty Wanted a Crown" by John Lithgow

Last week I watched an interview with Ruy Teixeira, one of the authors of the book, “Where Have all the Democrats Gone?” on the Daily Show, with Jon Stewart. His main point was that the Democratic Party has gone from a party of the working class under FDR, to a party of intellectuals championing liberal causes and minorities, a party that doesn’t get much done. In the meantime, the unions have lost power due to globalization and immigration, and it’s the Republicans who have become the populist party, favoring nationalism, isolation, law and order, and religious fundamentalism, at least they say they do. 

Jon Stewart made the point that the Democrats were thought of as weak, because of their adherence to the rules of the system, which is making it hard for them to get anything done. He made fun of Obama for not pushing through Merrick Garland’s nomination as a Supreme Court justice, and Joe Biden’s dropping of immigration reform from his economics’ bill because of a parliamentarian’s ruling, while the Trump Republicans don’t have any qualms about pushing through their justices, and blocking said immigration bill just so they could use it as a campaign issue. 

While president, Trump trashed the nuclear deal with Iran, and threatened to leave NATO. He intends to conduct unprecedented deportation, using the military against not only illegal immigrants, but also against demonstrators who oppose him. While president, Trump used the Department of Justice as his own personal legal defense team. He disregarded the advice of experts on climate change, and on the effects and management of the COVID pandemic. He plans to eliminate regulations on industry and even eliminate large departments within the government. He’s even threatened to take away licensing from news outlets that oppose him. 

The interview seemed to conclude that the Democrats’ failure is due to their adherence to laws and tradition. Trump and the Republicans, on the other hand, are intent on getting their policies through, regardless of law and even Constitutional barriers. They now control the Supreme Court, and Trump seems well on the way to controlling both houses of Congress. Many seem to favor Trump, in spite of his scandals and frankly illegal behavior, just because he gets things done, and doesn't let laws, regulations, or science get in his way.  

Jon and the author, Mr. Tiexiera, seemed to think that the Democrats should “fight fire with fire,” to be more like the Republicans, and to fight for their policies, but I think the problem goes far beyond leadership or strategy. People are actually losing faith in our system of government. The Democrats are following the rules and the Republicans aren’t, and that couldn’t happen if people believed in the system. 

I’ve always assumed that our Constitution, our complex system of laws and regulations, and the bureaucracy that’s been built to enforce them, are what keeps our country strong, and guarantees the survival of our form of government, but that’s not it at all. It’s our belief in the system that keeps it going. Without that, the whole edifice will crumble to the ground. 

This discussion is akin to something my wise cousin Steve and I have talked about. He believes in gradual change, allowing society time to adapt. I’ve not been so patient. I’d like to see changes happen quicker, so that those who are suffering, or exploited can live long enough to see their lives improve. 

Right now there are a lot of people clamoring for change, rapid radical change. I'm not sure whether we need a change in government or just a change in attitude, but here's what Alex Hoffer (see post of August 27) said about change: “-the people who clamor for change are, on the whole, usually hostile to authority, --- Actually, in all the outstanding instances of rapid, drastic change we know of – successful rapid changes, drastic changes – occurred in an authoritarian atmosphere.” This is what scares me. Now that we’re losing patience with our system of government , we are looking for a leader. maybe it will be Trump, maybe somebody else, who will trash our republic and replace it with something else, who knows what. 

We have a choice to make, if it’s not too late: radical vs. gradual change, possibly even autocracy vs democracy. I side with cousin Steve this time, and chose the latter.

 

 

Donald and Fidel

 

                     Castro and Putin, another Trump Supporter

Fidel Castro led a popular revolution which took over Cuba in 1959. I was in high school at the time. When it became clear that Castro was a communist, many of the more affluent Cubans migrated to America. One of these was a friend of my mother’s. When she got back to the States she told my mother about how Cuba had changed under Castro. 

What struck me was what she said about the people he put into leadership positions. She said that they were the least competent, the least qualified people he could have picked. 

As Donald Trump makes his cabinet and other appointments known, I think you could describe them in the same way. From Mike Huckabee, the new Ambassador to Israel, a fundamentalist Christian who believes the Bible gives Israel the right to occupy the West Bank and Gaza, to Tom Homan, new Director of Immigration Enforcement, and author of the cruel family separation policy of Trump’s first term. From Matt Gaetz, Trump’s new Attorney General, under investigation for sexual misconduct by the House of Representatives, to Pete Hegseth, a political commentator on Fox News, now appointed Secretary of Defense, to Dan Scavino, Trump’s former golf caddie, now deputy White House Chief of Staff.    

What do these misfits have in common? They are loyal to Trump and dependent on him for their prominent positions. I suspect Castro’s appointees had the same qualifications.