12, 20 & 5: A Doctor's Year in Vietnam - John A. Parrish

I suspect just about everyone reading this will have seen one or more episodes of MASH. Add much blood, gore, and horror and you'll have a fair idea of this book. Parrish was drafted, as were most physicians his age, during Vietnam as their skills, such as they were, were in high demand. ("The alternatives were clear—jail for three years, Canada for life, or Vietnam for one year. ") I say, such as they were, because nothing in their training prepared them for Vietnam. 

Parrish was first assigned to a rear hospital located on an airbase (closer to the incoming medevac flights) where there were two scheduled fixed-wing arriving flights although others could come in at any time day or night depending on the level of fighting. They received a set of numbers by radio giving them some warning. The numbers in the title are a reference to that set: "The first represented the number of litter-borne wounded, the second the number of ambulatory wounded, and the third represented the dead. 

He learns quickly the principles of triage: ignore the dying for whom there is no hope and work on those for whom there is. 
He grabbed a handful of scalp hair and raised the marine’s head up off the litter at which time a large part of his mashed brain tissue slid like jelly out of his broken skull and onto the litter. “No other evidence of injury,” I continued. “His—” He let the head flop back down. 
“Are you shitting me?” he said. He gave me a brief look as if I were crazy and then hurried off to help the other doctors as I talked on. “His corneal reflex is absent and—” 
“We usually just leave these, Sir. Not much we can do.” A corpsman had been watching the whole sequence of events. There followed a silence that made me feel empty and helpless 
. “I know. I know,” I said finally. “I guess I’m used to a little different approach. I just—” 
“We don’t always have time to be nice, Sir. You’ll get used to it. Do you want me to put him over in the corner, Sir?” 
“Corner? To wait to die?” 
“Yes, Sir.” 

To help himself deal with the ennui and boredom in the hours between the last patients and night, Parrish decides to learn Vietnamese, a difficult language in that much of the meaning is conveyed through tone and intonation rather than word content. That decision was to have a major influence on his tour. As the word gets out, he's picked to do visits to local villages to offer medical advice and treatment. Of course, since these are our "friends" whom we are trying to influence and show we care, the marines have to go in first to make sure the village is secure and there is constant worry about booby-traps. Parrish remarks that the patrol's sergeant had things well in hand, there were no rapes (they had one hooch doing a brisk "trick" business) or beatings. “These people don’t give their minds and hearts because we come in under guard and pass out pills, candy, and soap. We just provide a little entertainment.” “And support our superiority complex,” I added. “And increase the income of some of the women,” Roland gave an evil smile. “They were getting five hundred piasters a trick from the marines.” “I didn’t see that.” 

His colleague replies: “You put those same kids in the jungle for awhile, get them real scared, deprive them of sleep, and let a few incidents change some of their fear to hate. Give them a sergeant who has seen too many of his men killed by booby traps and by lack of distrust, and who feels that Vietnamese are dumb, dirty, and weak, because they are not like him. Add a little mob pressure, and those nice kids who accompanied us today would rape like champions. Kill, rape, and steal is the name of the game.”>/i> 

The contrasts are particularly horrifying. Graves registration calls excitedly to report one of the "corpses" moaned. They rush him to triage. He is missing two legs and an arm and his belly is all shot up. Hours of surgery later, he has tubes coming out of everything and one of the orthopods wonders whether they should have bothered given he might only be useful as "third base." Yet the humor masks heroic efforts to save lives and avoid "playing God." They were there to restore life, not decide whether to take it or not. Parrish and the other surgeons worked on the man and sent him to the major hospital in Saigon where the contrast between Parrish, dirty, bloody, smelly is so different from the doctors in Saigon, decked out in white, clean, superior and arrogant. They do all they can. In the end he died. He might as well have stayed in Graves.

" The war took its toll psychologically and tragic stories abound. "One of war’s dirtiest tricks is to leave you physically intact and systematically take away little pieces of your very self." A soldier is brought in who hopped aboard a medevac chopper. Parrish talks to him at triage. 
“Fucking gunny thinks I’m crazy.” The boy was fighting tears. “Fucking gunny took me off my watch. I can stand my own fucking watch, I just need some nerve pills or something. I can stand two watches for every one the fucking gunny wants me to.” 
“I think you could use some rest. We’ll talk again later.” 
“Fucking gunny. I could kill that son-of-a-bitch. Toughest gunny in the corps. I love the bastard. If he wants me to stand watch, I’ll stand watch all night every night.” 
“I know, buddy.” 
“It gets so fucking black at night. Everything moves. My eyes play tricks. I get so worked up that my breathing is louder than the crickets and I hear voices. I shot at the fucking voices. That’s why the gunny sent me here. If they’d been VC I’d be a fucking hero. Now, I’m crazy. It’s not fair.” 
“We’ll talk again.” Prince [the psychiatrist] called for a corpsman who stood by the desk while Prince wrote something on the chart. Prince handed the chart to the corpsman, “Snow him. The usual. Thorazine. Phenobarb later. I want to talk to him tomorrow.” 
“Is he crazy?” I asked. “Don’t know, John. We’ll find out tomorrow when he’s rested. They’re all crazy when they first come in.” 
“I guess his gunny realized he needed some rest.” 
“He shot his gunny in the head.” 

I could go on and on. One of the best Vietnam memoirs I have read. And from an unusual perspective. My thanks to the publisher for this preview in exchange for my always honest review.