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A Surgeon’s War; My Year in Vietnam By Henry Ward Trueblood, MD TWO DIFFERENT PATHS ONLY FIVE YEARS APART: In 1968, the Tet Offensive failed to overthrow the South Vietnamese government but marked a turning point in the war with disillusionment and public support at home diminishing. A large antiVietnam War movement had developed as part of a larger counter culture. In 1970, the Vietnam War was still raging when I graduated from high school and first registered for the draft as an 18-year-old. Membership at the Berkeley (Quaker) Friends Church, and letters from family supported my opposition to becoming a combatant. I was fortunate to receive a 1-O or conscientious objector classification. Five years earlier, the Vietnam War was our undisputed national priority. Dr. Ward Trueblood received his draft notice immediately after internship at the University of Pennsylvania. As did his father who served as a physician during WWII, Ward made the decision to serve in the U.S. Navy as a surgeon, and was sent directly to Vietnam to treat the wounded. In 1989, I first met Ward Trueblood when entering private practice as an anesthesiologist. We worked together over the next 17 years at El Camino Hospital. He was well respected and a skilled surgeon who kept up on current affairs and the bigger picture of world events. As a member of Physicians for Social Responsibility, Ward had deep convictions and a strong moral compass. Twenty-six years later, I have in my hands, “A Surgeon’s War; My Year in Vietnam”, a personal account of Dr. Trueblood’s year of service in Vietnam. As another Memorial Day passes us, the significance of Dr. Trueblood’s observations of war cannot be ignored.

HORRORS THAT NEVER LEAVE YOU: “October 30, 1965: Bad night. Sixteen dead and thirty-three wounded. Very close to us. Had to keep helmets and flak jackets close by while in triage.” With limited supplies, 18-hour days working to exhaustion and heroics beyond belief, the inevitable would happen. A sutured wound would stop bleeding. The EKG suddenly became flat and realization that an 18 year-old precious son had just lost his life.

One of the hardest duties was the unzipping of body bags to fill out the official death report for each dead Marine. For Dr. Trueblood, each body bag was a reminder that he had to make his life add up to something; “to alleviate the suffering that surrounded us.” “Nearly every day we cared for people on the verge of death. At times it was overwhelming, and I would close my eyes for a few seconds, hoping to make the right decisions for the Marine in front of me. I was painfully aware of my limits. No doubt colleagues were going through a similar kind of agony, although we never talked about it. Our patients simply died or lived. None of us kept a tally.” A colonel was brought into the triage area with nothing recognizable below his navel. The wish to die, surrounded by family in a dignified fashion, was not possible. Given morphine, he died quietly. It is a horror that awoke Dr. Trueblood many, many nights and a memory that has never left him.

PERSONAL LESSONS AND INTROSPECTION: Yet in this sea of human destruction, somehow the tightly knit comradery of the healers tried to make light of their limitations. Many times, short of supplies, when a needed instrument wasn’t there, a corpsman would respond, “It’s on back order, Doc”. “Three joys: letters, showers, cold beer.” “Never take your eyes off the field. Never. Never”, yelled the senior surgeon. “To this day, I judge a surgeon by the same standard.” Recognition of extraordinary qualities in others: Walderon’s dry wit and talents as an anesthesiologist, Dr. Escajeda’s guidance in performing Dr. Trueblood’s first splenectomy. The prayer of St. Francis: “Make me an instrument of thy peace.” “I couldn’t save every Marine. I could only do my best. That’s all I could do.” Thirty-five years later, recognition of the stoicism and sadness, like his father before him, that resulted in a groundswell of unprocessed emotion.

SILVER LINING? If there is any silver lining in wartime medicine, it must be the accumulated knowledge learned. Frozen blood storage, early hydration

saline replacement to protect the kidneys and lungs, and more sophisticated measurements and understanding of acid-base balance, cardiac output and vascular resistance all came about during this time. A generation of more skilled surgeons in trauma medicine returned to civilian life but at a tremendous price in blood and treasure.

A FULL AND DISTINGUISHED CAREER: Dr. Trueblood finished his tour of duty, came home, married Nancy, the love of his life and completed his surgical training at Stanford University. Continuing a full and distinguished career, he currently serves as Trauma Attending at Santa Clara Valley Medical Center and teaches medical students bedside skills. This is in addition to being the recipient of many awards including Kaiser Family Foundation Award for Excellence in Clinical Teaching, Stanford University School of Medicine, 2010 Alumnus of the Year for Earlham College among others. “Long after war, whether in private practice, engaged in university teaching or operating on strangers or friends, I continue to follow the spiritual path that I discovered in Vietnam and that I remained determined to follow.” - Ward Trueblood, MD On this Memorial Day, let us remember and honor those who have served and continue to serve. And through Dr. Trueblood’s writings, never forget the heavy price and burden that those who witness war carry forward which ultimately touches all of our lives. Respectfully Submitted, Joseph Andresen, MD MAY / JUNE 2016 | THE BULLETIN | 7

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