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Flight Quarters

Brent is one of the speakers in our Vietnam War 360 panel series.
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The hospital ship USS Repose glides though the waters off the coast of Vietnam, three miles out. The floating hospital is protected from enemy fire by the Geneva Convention because it does not carry any armament. Do the Viet Cong honor the Statutes? History says not. Ask any P.O.W. 

Large white ship with a red cross on its side.

The U.S. Navy hospital ship USS Repose (AH-16). Photo courtesy of U.S. National Archives.

Patients are transported from the battle sites in Vietnam to the helicopter deck by Huey helicopters. At least Bell Helicopter in Texas is profiting from this senseless war, I think. 

"Flight Quarters" is announced around the clock, signaling a patient load is imminent. The sorting Triage is staffed with doctors, nurses, navy corpsman, and a chaplain. We corpsmen are assigned Triage duty every fourth day and night in addition to our regular duties. Other non-medical personnel serve as litter bearers for transfer of patients from the fantail up a slight ramp to the Triage area.

After being on assigned duty for only two days the sound of Flight Quarters has already become routine, if you could call it that. Everyone knows his role by now. The thousand beds are filling up fast. We anxiously wait for the huge green camouflaged copter to unload. Are the patients psych, medical, surgical, or all three? One learns to simply sort by sight. 

A chopper approaching the landing pad of a large ship.

A Sikorsky UH-34D Seahorse of Maine Medium Helicopter Transport Squadron 263 (HMM-263) prepares to land wounded on the U.S. Navy USS Repose (AH-16) off the coast of Vietnam, in 1966. Photo courtesy of U.S. Navy.

From the observation post outside the Triage, I spot him--the first one off the copter. 

He appears about three feet long. As the liter approaches on the run, I get a better mental picture. His legs are missing, replaced by mutilated, blood tinged hamburger with large tourniquets around both upper thighs, or what is left of them. Some corpsman on the beach really did his job or this Marine would not have survived this long, I think. Kudos to the fellow corpsman. 

The patient appears barely eighteen years old. His life is changed forever. At least the war is over for him. What a price to pay! 

The litter carrying the squat physique is quickly placed on the wheeled gurney in Triage as skillful hands start their work. An I.V. placed on site soon carries another bottle of a blood volume expander (Ringers Lactate) to help maintain a probable struggling blood pressure. A large "M" is present on his forehead with now dried blood, signifying morphine is on board. His fixed pupils confirm this. 

Ironically, the Catholic Chaplain administers last rites with the sign of the cross directly over the bloody "M," while he stands at the head of the gurney. Is the wounded patient catholic? What difference does it make now? He needs all the help he can get, I think. 

The vital signs are quickly taken. Miraculously, he has a blood pressure of 90 over 50, but the pulse is weak and waning. He is obviously in severe shock. 

The flight surgeon does a quick assessment then says, "We need to get him to the O.R. Stat! Type and cross match five units of type "O" blood. Hang one and send the rest down with him. 

On the transport to O.R I realize we don't even know his name. Maybe this is better as "Attachment Syndrome" can hinder good care.

He is a freckle-faced American Marine, a former physical specimen with linebacker arms.

A young boy only a few short ears ago, now his life balances precariously in our hands. 

In the O.R., the surgeon removes foreign debris from the stumps with a forceps, then flushes them with copious liters of normal saline to remove any contaminants imbedded from the blast. 

On the third day post-op he regains limited consciousness but signs of impending infection are already present. The puffy stumps smell like rotting flesh, even though massive does of newly acquired penicillin are administered.

Obviously, he had stepped on a land mine with traumatic amputation occurring in a split second. It happened so fast he probably never felt it.

There is not enough tissue left to form a pedicle skin graft over the stumps. The blood vessels are cauterized to prevent further bleeding as the tourniquets are removed one at a time. Any remaining exposed tissue is wrapped with sterile gauze. The tissue is left to heal on its own. A bilateral penrose, rubber drain is left in place to hopefully wick any impending pus or infection away from any healthy tissue left behind.

Hours later, he is finally transferred to the surgical ward in critical but stable condition. His young, otherwise healthy status may save him. 

This is my normal assigned workstation so I feel fortunate to monitor his progress in the upcoming days, IF he does survive.

On the third day post-op he regains limited consciousness but signs of impending infection are already present. A persistent fever waxes and wanes. The pulse rate has increased to above one hundred beats per minute. The puffy stumps smell like rotting flesh, even though massive does of newly acquired penicillin are administered.

Hyperbaric therapy is the last alternative. 

Nurse in naval uniform checking in on a patient.

Lieutenant Commander Dorothy Ryan checks the medical chart of Marine Corporal Roy Hadaway aboard the hospital ship USS repose off South Vietnam. Photo courtesy of Department of Defense. Department of the Navy. U.S. Marine Corps. 09/18/1947.

The surgeon orders immediate treatment as he cannot debride any higher on the stumps. The hyperbaric chamber is mounted under the fantail of the ship. Due to the claustrophobic nature of the chamber, I am one of four corpsman that has earned the psychological clearance to go down with the patient. I volunteer but immediately regret the decision.  

The chamber is roughly four feet wide and eight feet long, barely enough room for the patient, stretcher, plus an attendant. It smells like a musty cave or pending grave. Take your pick, I think, as the hatch is ratcheted down. 

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The surgeon orders immediate treatment as he cannot debride any higher on the stumps. The hyperbaric chamber is mounted under the fantail of the ship. Due to the claustrophobic nature of the chamber, I am one of four corpsman that has earned the psychological clearance to go down with the patient. I volunteer but immediately regret the decision. 

The chamber is roughly four feet wide and eight feet long, barely enough room for the patient, stretcher, plus an attendant. It smells like a musty cave or pending grave. Take your pick, I think, as the hatch is ratcheted down. 

The amassed heat is already stifling. What does this do to his fever? The soil bacteria growing in his leg is gas gangrene. It oozes and reeks like dead meat, especially in close quarters. The bacteria is an anaerobe, which cannot live in the presence of oxygen. The chamber is designed to force healing, pressurized oxygen into the dead tissue and kill the persistent bug.

I feel the mounting pressure of the chamber in my ears and swallow to stabilize it. Chewing gum temporarily helps the ear pressure but not the ear ringing, nor claustrophobia. I hope I'm not in over my head manned only with a blood pressure cuff plus an ampule of morphine. It can be administered to the patient only as a last resort as it has a tendency to lower the persistent unstable blood pressure. I encourage him to swallow. 

Fortunately, Tim follows a few commands (I know his name now) but he starts to scream in agony from the pain of oxygen being driven into the stumps. I hold his arm like we are arm wrestling, both with an adrenaline rush. I certainly hope the I.V. does not blow. Please not now!

The oxygen pressure treatment will last thirty minutes, but it feels like an eternity. My ears are popping and painful. I swallow more frequently and chomp faster on the gum to equalize the pressure. 

He screams again, only louder. I'm not sure if it's his legs or ears. I relent and inject the morphine. What will happen to this young man? Will he sit on a corner in some American city and sell pencils. Will he overcome mental trauma? Can he father a child? I say a silent prayer for us both. 

He will require several more hyperbaric treatments. The gas gangrene is relentless and he succumbs peacefully the next week. Part of me dies also that day. I am more determined than ever to do what is necessary for those poor anonymous souls that rely on us for medical help in a strange, hostile foreign land. Flight Quarters, Flight Quarters.

Brent Hanson

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Biographical Details

Primary Location During Vietnam: Da Nang, Vietnam Vietnam location marker

Story Subject: Military Service

Military Branch: U.S. Navy

Specialty: Corpsman

Story Themes: Brent Hanson, Corpsman, Da Nang, Death and Loss, Medical Personnel, Minneapolis, Navy, Physical Wounds, Read, Reflection, Religion, USS Repose

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