NamNews, 1-02, Pages 13-15, 5 Dec 1987
By: Lynda M. Van Devanter
When I read about President Carter's call to renew registration of the draft, this is what I see: It is 3 a.m. in Pleiku, South Vietnam. The fighting in the central highlands is heavy, and I am called out of my sleep to the operating room. I have been sleeping on the floor under my cot, having been awakened an hour earlier by a rocket attack, as on most other nights. Even in my groggy state, the gruff words on the phone, "Casualties! Get down here, on the double!," are enough to send my adrenaline flowing, and I'm alert by the time I get to the OR. I change quickly to scrub cloths, and report to the head nurse for my assignment.
"There's a bad one in the neuro," she says, "and I need you to pump blood in there." The neuro room is one that I don't particularly like to work in, since head wounds are usually so messy, but, even knowing that I am unprepared for the sight that awaits me.
It's the largest trail of blood leading to the table that I have ever seen. I slip on it because my eyes are drawn to the gurney where several people are transferring the soldier to the operating table. I watch in horror as the lower portion of his jaw, teeth exposed, dangles from what is left of his face. It swings in the air as he is moved from the gurney to the table, and I hold my breath to keep from getting sick. For a moment I am glued to the spot. I thought I had gotten used to it but it keeps getting worse.
The shout of the anesthetist brings me up sharply, and I rush to his side to assist him in a tracheotomy. "We've got to get an airway into him fast - he's drowning in blood." he yells, and my training moves me into action. I grab a tray of instruments and open it. For the sake of speed, we perform the trach without donning gloves. Once the opening into the boy's windpipe is completed, and he is being ventilated, I move to help the surgeon. He grabs instruments from the tray to clamp off the largest bleeders in the face and jaw.
Meanwhile, the scrub technician is setting up the sterile field of linens and instruments, and, once the largest bleeders are tied off, the surgeon puts on his gown and gloves and they begin to work in earnest to try and repair the damage. Now I know what the head nurse meant when she told me that I was needed to pump blood. The young soldier is bleeding so fast that it is necessary to start four large needles in his leg, neck and both arms, and pump blood into all of them simultaneously. I do only this for several hours.
I invent a routine. Start at the neck, take down the empty bag of blood, slip a new one into the pressure cuff, pump up the pressure in the cuff and rehang it. Then go to the left arm and repeat the process. Next the left leg, then finally the right arm. Then start back at the neck line and repeat the entire sequence. It takes about five minutes to complete the steps at each site, about twenty minutes to make a round of him. It becomes rote after a while and I lapse into thinking about the patient.
During one of my circuits around the table, I move his clothes to one side, and a snapshot falls out of the pocket of his fatigues, it is of a young couple - him and his girl, I guess - dressed for a prom. Tears come to my eyes. He is gazing sweetly at the girl. Straight, blond and tall, he looks good in a tuxedo. She, too, is tall, with shining dark hair. She is wearing a long pastel gown. Love for him shining in her eyes.
The scene is stark contrast to what I see in this room. The lovely young man is now a mass of blood vessels and skin, so macerated that nothing could hold them together. The more the surgeon works, the more the boy bleeds. I've always held onto the notion that, given enough time, anything can be stopped from bleeding. Just keep at it, and eventually you'll get every last vessel. I am about to learn a hard lesson.
I pump 120 units of blood i to that young man. But as fast as I pump it in he pumps it out. After hours of work, the surgeon finally realizes that it is futile. He wraps the boys head in layers of pressure bandages and sends him to the post op/intensive- care unit to die. As I clean up the room, I keep telling myself that a miracle could happen. He could stop bleeding. He'll be alright. I moved about the mess, picking up blood-soaked linen and putting them into the hamper. I come across the photograph again, pick it up and stare. He had been real. He was a person who could love and think and plan and dream - and now he is lost to himself, to her and to their future. I sit on the floor, my head in my hands, and sob.
After making the room ready for the next head injury - the next person - I walk over to the post-op/ICU to see him. His bandages have become saturated with blood several time over, and the nurses have reinforced it with more rolls of bandage, mostly to cover it up, so now his head is grotesquely large under the swath of white. I hold his hand for a few moments and ask him if he is in pain. He squeezes my hand weekly and I tell him I'll request some pain medication. He squeezes my hand again in answer. I stand holding hands with him for another few moments, the last of his life. My hands shake now as I write this, as they did then, and the tears return.
I think of this incident again now, and of many others like it during that year in Vietnam. I am reminded of tiny children with their arms and legs blown off. I remember a pregnant woman with a belly wound, and the delivery of her child by Caesarean section - the child who entered this life with a gunshot wound in his belly, the perfect circle of life in war.
A decade later, we have even more advanced weapons of war, and my heart aches with the thought that we may decide to use them.
When will we learn the lessons of past wars? When will we stop taking the seed of our lives, our children, and sending them to destruction? When will we realize that war does nothing but perpetuate war - that violence begets only violence? I ask our President and the leaders of the world community, can we not find some way of living together in peace and harmony? Can we not stop what seems to be carrying us inexorably toward another war - and possible nuclear destruction?
I don't know the answer, I can only pray for peace.
Linda M. Van Devanter, a registered nurse, was a Lieutenant in the Army, stationed at Pleiku, and Qui Nhan, South Vietnam from 1969 to 1970. She is the women's director of Vietnam Veterans of America and a published author of the best seller, "Home Before Morning"; THE story about nurses in Vietnam.