My two years in surgery at Clark AFB during the Vietnam War.
CLARK AFB, PHILIPPINES
We (wife, daughter, and I) arrived at Clark after a fuel stop on Wake Island, a tiny dot in the middle of the Pacific Ocean. The island is so small that it consists of a runway and a few buildings. After gassing up, the plane taxied out. Upon turning onto the active runway, I noticed several feet of the wingtip was out over the water, which seemed only about five feet below us. On takeoff, the fully loaded 707 lifted and ran out of ground at the same time.
During the break at the terminal, we went into the cafeteria for a snack. I noticed a large map of the island on the wall behind the main passenger desk. Noting how small the island was, I asked a Sgt about the short runway and was told, "Yes, it is. A couple years ago, a KC-97 tanker did not get off and hit the water, skipping almost a mile like a flat stone thrown across a still pond. No one was hurt, and the aircraft floated out there for two days until the AF called in a Navy gunboat that blew it to hell as it was considered a navigation hazard."
Arriving at Clark, we were put into temporary quarters for a few days until I cleared in and found a house to rent off base. It was a nice one-story, 3bdrm, and had concrete floors! The walls were also concrete. The reason was termites! The house was surrounded by a six foot rock fence with two rows of barbed wire across the top plus broken glass embedded into the concrete to discourage robbers and a steel gate that secured the car. Once moved in, I hired a house-girl to help with the cleaning. She cost $25/month and lived in one of the bedrooms. Her name was Ester, and she spoke better English than I and cooked great. She had graduated from beauty school and specialized in painting fingernails with scenes or faces! Ester was very good with Sharon, our two-year old.
My car had not yet arrived down at the Navy port of Subic, sixty miles south, so I took a cab, a Jeepney, to work, which was cheaper than renting a vehicle.
Once reported in at the base hospital, I got a "Rent-a-Wreck" from a base Sgt for the month that it took for our VW bug to arrive.
It was great to be back in the operating room! I had learned so, very much at Hickam working at the dispensary. From sewing up cuts, doing ambulance calls, crash calls, x-ray, lab, pharmacy, and a hundred other things one would just not be exposed to as an OR tech. I was a busy medic!
The surgery suite had six operating rooms with a central core between them that contained supplies, sterilizers, and worktables. At Clark, because we were the closest full-service medical facility to Vietnam, our rooms were called the 'dirty side' and the 'clean' side. The nurses/techs and anesthesia personnel assigned to one side did NOT move to the other side during their shift as the patients coming out of Vietnam were usually infected with some pathogens not even classified by science yet! Cross-contamination from that side to the other could be a disaster! The clean side was reserved for local cases such as C-sections, tonsils, hysterectomies, hernias, Honda accidents, etc.
During a surgical procedure, there are, commonly, two non-doctor positions: the instrument tech/nurse who wears a sterile gown and gloves and stands next to the surgeon(s) maintaining a small table (Mayo Stand) that is moved over the patient. It is used for instruments needed close at hand during stages of an operation such as opening and closing with constant instrument and supply needs moving on and off the Mayo. A large 'back-table' stayed at the foot of the draped patient within reach of the 'scrub' and loaded with items needed during different stages such as larger sponges, retractors, specialized instruments, etc.
Most often, cases on the 'dirty' side were soldiers who had been stabilized at a facility 'in-country' then air-evacuated to Clark. We would bring them back to our OR every other or every three days for further work such as debridement and irrigation (D&I). There were usually two doctors on the D&Is with one scrub passing instruments. Bad tissue was removed, and wounds irrigated, then redressed/casts applied only to return in 2-3 days and do it all again.
Almost every patient was toxic, running a high fever due to all the infection, making him a real challenge for anesthesia. On large cases such as abdominal or chest, there were many more instruments at hand with blood transfusions common during the case. The record for transfusions while I was there was TWENTY-FOUR quarts (units) on the table!
The largest group of injuries we worked on was called MFWs (multiple fragment wounds) caused by trip-wire mines, mortars, artillery, and grenades. These caused many small to large wounds, each needing surgical care and often led to amputations. Sometimes for a simple D&I, there might be three techs and three surgeons working on different areas of the body at once. This saved time for us and shortened anesthesia time for the patient. It was not unusual for 2-3 senior techs to have their own D&I instrument set and take an extremity doing the cutting/ cleaning, and closing. Once a patient was out of danger and on the road to recovery, they would be flown to the nearest stateside military hospital to their home.
Many times, it was necessary to do multiple amputations. Both legs at the hip or both at the knees, a leg and an arm were not rare. The most dramatic case was a very large AF electrician. He was up on a pole, and his partner on the ground got their signals mixed up, causing a 10,000-volt discharge across his back when he thought the power was off! His injuries from this were so severe we had to amputate both legs at the hip, one arm at the shoulder, and the other at the elbow! He required those TWENTY-FOUR units of blood while on the table!
The demand for fresh whole blood was enormous, and the local supply wasn't near enough. There was set up a 'Pony-Express' style delivery system that shuttled blood from Travis AFB, CA to Clark. At Travis, two to three pallets were loaded onto a C-141, which flew to Hickam AFB, HI.
At Hickam, the Starlifter stopped on the apron next to another 141. Immediately, a fork-lift would unload the blood and transfer it to a fueled aircraft that had started its engines when the Travis bird was on final approach to the field. This was faster than going through a complete refueling and ground inspection of the first plane. The second was in the air, at maximum speed within thirty minutes. Another jump happened at Wake island, then on to Clark. Upon arrival, the 141 would be met by two ambulance buses to transport the blood to the hospital.
When I arrived, the daily average number of surgeries was twenty in the three dirty rooms. During the '68 TET offensive, that number doubled! We got so busy that for one two-week period, we operated 16hrs/day. One would work until so tired he/she had blurred vision. The circulator nurse would go into the lounge and wake up another tech who had maybe had an hour break to replace the one who was just completely drained.
Being a Staff Sgt, I was made a shift leader with eight techs to supervise. My shift was 'on-call' one week at a time, so every 3rd weekend, we worked normal operating duties and were available for emergency cases all through the night. I took my share of call. It was a terrible time of exhaustion, infection, massive surgeries, amputations, and every disease known to science.
It was while working a middle of the night emergency case that we experienced a severe earthquake! This was the 1968 Casiguran quake measuring 7.6 magnitude. We had a Korean Army patient who had developed abdominal bleeding. He was opened from lower chest to upper pubic bone when the hospital began to shake! I had traded jobs that night with my circulating nurse, Major Hancock, who wanted to scrub for a change. As items in the supply cabinet began moving around, some crashing to the floor, the big operating light above the patient was swaying, and plaster dust began falling. A quart bottle of methyl salicylate (oil of wintergreen) fell and shattered. We used this to saturate our masks so as to be able to tolerate the powerful odor of gas gangrene, staph, strep, and a dozen other noxious aromas the patients carried. In moments, the whole room smelled very strongly of wintergreen!
Major Hancock, being the finest surgery nurse with whom I ever worked, saw the situation and grabbed a sterile towel to cover the wide-open belly of the patient. The two surgeons held on to the heavy table, and the anesthetist was frozen in shock but never missed a squeeze on the breathing bag, which kept the patient alive.
I went to the OR door and looked down the long, dark hall. The first floor was much wider than the others. We were on the second, and at each end, there was an emergency exit marked by lighted green letters. Our power had surged once then, thanks to the emergency generator, was restored. The exit sign at the door opening onto the first floor roof looked like a snake moving back and forth. I thought it possible that we might have to evacuate our patients and ourselves quickly at any moment.
After what seemed hours but was actually only 45 seconds, the sounds of TVs, glass, etc. falling to the floor above us for 3 floors stopped. The hospital was new and had been constructed to withstand earthquakes to some extent, but the loose joints made a sound like 4-5 freight trains all going by at once!
We had no phone at our house. None of those living off-base did. We carried a walki-talki when on call. It was not until 5hr later that I got to the house to check on the family. Everyone was OK but still shook up, of course. There was a 4ft long, 5in deep crack in the concrete wall out front and a narrow, 7ft one in the wall between the dining room and kitchen. Ester woke up my wife and daughter, telling them to dress and get out into the street NOW as the roof might cave in!
Manila was much closer to the epi-center than were we. A multi-story, luxury apartment building collapsed during the quake. It was full of Chinese businessmen and their families. The quack killed 300 men, women, and children.
After three days of looting the building rubble, the city requested assistance from Clark AB. Heavy equipment was needed to clear the debris. The Air Force sent both machines and personnel to help. On day four after the quake, two little girls, sisters, were found alive! They had survived by licking the partial walls of their concrete prison by licking water that dripped down it. I took a full day for them to be heard screaming.
Things settled down after a while and it was work as usual. Ester and my yard man, Enrico, waxed the house's dark red concrete floors once a month. He would move all the furniture into the yard one room at a time. Ester put down dark red paste wax then, using the husk of a coconut cut in half, would put a foot on the top and 'do the twist' all over the floor, bringing the wax to a high shine.
We had an Armed Forces TV station on base. Also, the 2 stations from Manila could be watched using the large bamboo antenna pole outside with a yagee at the top bringing in stations. The Manila station was mostly broadcast in English and ran US shows such as Leave it to Beaver!
One night, I was awakened by sounds coming from the kitchen. Thinking it was an intruder, I grabbed a two-pipe vacuum cleaner attachment that I kept beside the bed and investigated. I heard dishes and glasses rattling in a cupboard. Flipping on the light, I opened the cabinet door and found a beheaded roach/water bug of about 3in in length laying on its back in a saucer. A gecko ran off. A gecko is a small, green lizard. The PI is tropical. HUGE roaches called water bugs lived outside, mostly, but came into the house also. We were encouraged by friends to NEVER harm an inside gecko! They could be heard chirping during the night and were often seen on a wall. And that is why they were NOT harmed!
We had a dog. Smooch was the color of an Irish setter and looked like a German Sheppard. We were her third American family. It was way too much stress on the dogs to take them back to the states, what with having to quarantine for two weeks down at Subic Navy base then across the Pacific, then quarantine ANOTHER two weeks at a US Port before joining the family again. So, she went from family to family. Smooch was a gem. Filipinos love kids. Sharon, our daughter, would go over to the driveway gate where locals would talk to her. But that was not a good idea as once in a while, an American kid would be stolen and ransomed! Somehow Smooch knew Sharon should not go within six feet of the gate and would put herself between it, and she then moved sideways, forcing Sharon to get back. This would infuriate her, and she would yell and hit the dog.
During the monsoon season, it rained every day, all day! The local river would rise and flow faster. This was a good thing as all the city's sewage was dumped into it, raw! However, the river flooded the rice patties causing the rice rats to come up into town. Twice, as I left for work in the morning, I would find Smooch sitting at the front door with a large smile on her face and a rice rat in her mouth. She hated the things and never ate them but wanted to present her catch to me, proudly. The rat would be dead, and I would take it from her and dispose of the thing. As soon as it was out of her mouth, she would paw at it as to remove the terrible taste and smell.
The country is Catholic. On Easter Sunday, a group of men would stage a ritual. Half were tied to a cross of railroad ties and, with great effort, would carry it a mile or so to the local church. The other half were called flagellates. They were barebacked and used a length of leather braided into a whip with one end cut to form many threads. Holding this in their hands in front, they would swing the whip so as to strike their bare backs, back and forth, back and forth. After a while, the skin would become raw and bleed. They did this hundreds of times as they walked with the cross carriers to the church. The priest would come out and bless them, then the cross carriers were raised, and their crosses planted into holes dug into the ground. The result was a depiction of Jesus at his crucifixion. At the end of the day, they would all go down to the river to 'cleanse' themselves!
We all received ration books as coffee, cigarettes, gasoline, and some grocery items were limited in order to cut down on black market selling. Guys who did not smoke could sell their ration and make a little extra money. A pack cost us TEN CENTS! A gallon of gas was also ten cents. All this was government subsidy and made for a bustling black market anyway. Every six months or so, we had to turn in all our 'script' and exchange it for new. American greenbacks were not used. A dime was a piece of paper half the size of a US bill. So, dimes, nickels, quarters were all paper. Other bills went from one to twenty dollars, no larger.
Integrated circuitry had just been introduced. We all wanted a solid -state stereo receiver, big speakers, a reel-to-reel tape recorder/player, and a turntable. We were rationed on all this also. The Clark exchange did not have a good selection, so I rented a car and driver to take me down to Subic Naval station sixty miles south. It was not safe for Americans to travel the highways as 'Hucks' who were communist rebels, would set up roadblocks and demand cash. This threat was lessened if one had a Filipino driver. At Subic, I purchased, without a ration book, a Pioneer receiver/amplifier, a Teac auto-reverse tape recorder, one pair of big Sansui solid walnut speakers, and a small pair of Coral additional speakers plus a Dual turntable. It all sure looked and sounded nice once set up at home. I checked out American Airline's tapes from the base library. These were three-hour reels of uninterrupted music as used on flights. I bought a 'slave' deck. It would not record but played back tapes. I could dub a tape from it to my Teac, thus making my own three-hour one.
I certainly never got shot at nor even stepped foot in Vietnam proper. My two years at Clark AFB (68-69) as a surgery tech went reasonably fast. We were doing twenty surgeries/day in only three rooms with the 'clean' cases in two rooms on the other side of the complex. The '68 TET Offensive was massive as we spent a month leaving surgery ONLY for meals downstairs or having them brought up to us on carts. We worked 24-7 that month, sleeping in the lounge for 2-3hr at a time. One Sgt a day was detailed to go to the houses of our dependents, get lists, and make runs to the BX and commissary for those who could not do it themselves. My wife could not as she did not yet drive. Our daughter was 3yo then, and we lived off-base.
It was a terrible time of exhaustion, infection, massive surgeries/amputations, and every disease known to science. We saturated our masks with oil of wintergreen in order to be able to breathe through the odor of gas gangrene, strep, staph, and some Asian bugs not yet classified. We stripped down to nothing before donning our OR greens, then took a shower before getting dressed to go home after work, whenever 'after-work' turned out to be. Greeting me at the door at home, my wife could tell which side of surgery I had worked that day from the slight odor coming off my skin even though I had showered only minutes before. "Worked the dirty side today, eh?
Before TET, we received an average of two C-141 air-evac flights from Saigon each day. During TET, for 3 months, that number went to SIX flights/day! The old, wood, single-story hospital was used for patients again, having evicted the Boy and Girl Scouts, plus several other activities so as to expand our bed capacity. That STILL wasn't enough, and a 250-bed TAC (Tactical Air Command) Hospital was flown in and set up at the end of the runway to absorb even more overflow from in-country casualties.
This was a terrible time but, once back in 'The World', I have never regretted the experience. I can happen on a multi-car pile-up on the highway now and "take charge" until the pros arrive. I DO NOT PANIC!! I have probably had eight people die either in my arms or while working to save them in surgery, X-Ray, on the wards, or, once inside a Pontiac ambulance racing from Hickam AFB to the Army hospital, Trippler.
All this made me a better technician for working seven years at Seattle Children's Medical Center and Seattle's Swedish Hospital, and Providence Hospital Department of Radiology (also 7yr). Those two years of Vietnam wounded allowed my father to finally talk to me of his experiences as a combat medic in France/Germany in WW II and a M.A.S.H. facility 1st SGT during the Korean war. Until I came back from the Philippines in 1969, he had never told me anything he had seen/done during those conflicts. Guess I had to 'make my bones' eh?
It was time to rotate back to the world.
My next duty site was going to be Sheppard AFB, Texas, at the top of the state close to the Oklahoma border.
Sheppard AFB Hosp is the Air Force's Psychiatric center as well as a general hospital. Many of us who worked in surgery there would change back into our whites and go to the dining room for lunch. Trusted psych patients were allowed off their wards to also eat there.
One day, as I stood in line to approach the food trays, a young guy behind me said, "I see you have to bring your toothbrush also." I had no idea what he was getting at as the only thing in my shirt pocket was a pen. He pointed to his hospital patient shirt and, sure enough, there was a toothbrush in the pocket. He said, "You are supposed to brush after every meal! I kept an eye on him at his table, and, sure enough, when he finished eating, out came the brush, and he cleaned his teeth right there at his table!
One of the psych techs came through checking on any of his patients there, and I stopped him relating the story. He went over to the guy saying, "Frank, you seem a bit confused today. Did you take your meds this morning?"
"Oh yes, SGT. then I brushed my teeth!"