Lessons from the Field
What being in Vietnam taught me about organized medicine

It was a dark, moonless night when I first heard that wailing siren. I had been in Vietnam only days when I was sent to the First Medical Battalion just outside Da Nang. I was one of six physicians housed in a tent with a wooden floor. When the siren sounded, I sat up inside my mosquito-net canopy and called out in the blackness to my tentmates, “What does that mean?”

“Incoming — hit the deck,” came the reply. I hurriedly fell on the floor, kicked my duffle bag over, and took its place under my bed, waiting for the rockets to land around me. I hoped that I had sent enough letters home to my new bride and family that they would know I loved them when I was killed in action—a fate I fully expected at any moment. After about 30 minutes of silence, a second siren sounded the “all clear,” and I crawled back into my sleeping bag. I now figured I probably would live at least one more day. This ritual was repeated about twice a week.

Soon I was reassigned as battalion surgeon of the Third Battalion, Seventh Marines, which occupied Landing Zone (LZ) Ross. Despite the nice job title, that really meant I was going to “the bush” with the infantry! LZ Ross occupied a hill on real estate about the size of Medical City Dallas Hospital. From this base, the battalion sent patrols out in the rice paddies, roads, villages, and mountains around us. At LZ Ross, one of the medical corpsmen gave me an M-16 automatic rifle. (Physicians were expected to defend themselves with a .45 caliber pistol.) Two weeks after my battalion rotated to the larger regiment headquarters base at LZ Baldy, LZ Ross was overrun at night by a unit of Viet Cong that included the “civilian” barber who cut our hair! Eight Marines were killed and many others in the unit that replaced us were injured. The potential usefulness of having an M-16 was amply demonstrated when the VC shot up the battalion aid station.

After six months in the bush, I was transferred back to the First Medical Battalion, taking my M-16 with me. After my experience in the bush, I built a sandbag bunker at the end of our tent. Now we would be protected from shrapnel that would have gone right through the walls of our tent (and us). When the sirens sounded, I took my M-16 with me as my tentmates and I jumped into our bunker. Soon after, I discovered I was not the only physician who had acquired an M-16. I heard the unmistakable sound of live rounds being chambered into M-16s all up and down the row of tents where the physicians lived.

It didn’t take long for me to realize that there was a much greater risk that I would be shot by accident by another doctor than by the Viet Cong on purpose.

The Medical Battalion was believed to be at low risk for attack, so the Marines who stood watch over our barbed-wire perimeter at night were sometimes the pot-smoking asleep-at-the-switch guys who had been kicked out of their own units for inattention to duty. It became obvious to me that if the Viet Cong sent a handful of men through the barbed wire at night, they wouldn’t need any weapons to kill the doctors. All they would have to do would be to run around the camp yelling and making noise. Unquestionably, all the physicians would grab their M-16s and shoot at everything that moved, rapidly killing each other. For the remainder of my time at the Medical Battalion, I stayed in my bunker for awhile after the all-clear sounded, just to make sure everyone else had time to unload their M-16s and put them away before I ventured from my cocoon.

This Vietnam experience has a great deal to do with organized medicine. Wonderful advances in technology and pharmacology have enabled us to successfully treat many diseases that were death sentences in the past. The cost of delivering medical care has risen astronomically, mostly because of these advances. Physicians have been made the scapegoat of politicians, insurance companies, the government (Medicare), and the business community. As the federal government has gradually taken over a larger share of the funding of medical care, the battlefield for physicians has moved from the lush jungles of Vietnam to the jungles of concrete and steel that house our federal and state legislatures. It is too easy for our adversaries to run around making noise among different factions of organized medicine, particularly groups representing surgeons or primary care physicians, resulting in physicians shooting each other with political bullets. As the AMA continues its process to determine the best model for concerted action by county and state medical societies and specialty societies, we need to seek a model that will allow us to debate our differences among ourselves and come to a position we all can support when we go to Austin or Washington seeking changes in the system. We will help neither our patients nor ourselves by shooting each other.

Copyright 1997-2002, Dallas County Medical Society.
Information contained in this site does not constitute legal or medical advice. Links are provided within this site as an added benefit to our visitors. The content of other sites is not monitored by DCMS.