BCMS Medical Record Fall 2020 - 48

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Reflections on the War

Then and Now
This piece originally appeared
in the Summer 2020 edition of
Connections, a publication of the
Foundation of the Pennsylvania
Medical Society"

by Raymond C. Truex, Jr. MD
Kristen Sandel, MD

THEN
We commonly see reference to our current battles as "being
at war" with the Corona Virus. That, of course, is a metaphorical
reference to actual military conflict. Upon consideration, there
seem to be many parallels between our current medical struggles
with the virus to what I experienced as a military physician in Viet
Nam some fifty years ago. While I can clearly remember my war
memories, as a semi-retired physician, I am not on the front lines
of the current fight to save lives from the Corona Virus, so I have
enlisted the experience of Kristen Sandel, MD, an ER physician
and current Chair of the Berks County Medical Society Executive
Council, to compare and contrast what she sees today with my
recollections of the past.
In 1969, after completing a Rotating Internship and a year
of General Surgery residency, my deferment ran out, and under
the Berry Plan, at 27 years of age, I was sworn in as a Lieutenant
in the US Navy Medical Corps. I quickly learned that the US
Marine Corps is a branch of the US Navy, and that the medical
support for the Marines comes from the Navy. By virtue of my
surgical training, I was qualified to serve with the Fleet Marine
Force. After six weeks of basic training at Camp Pendleton in
California, I shipped out to the Far East. When I arrived in Viet
Nam, I was assigned to
3rd Medical Battalion,
3rd Marine Division
in Quang Tri, in the
northernmost province
of Viet Nam. This was
what we now refer to
as a MASH unit. It
served as the emergency
referral hospital for
Marines fighting the
North Vietnamese
Army regulars in remote
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outposts along the DMZ which are legendary in Marine Corps lore,
such as Khe Sanh, The Rockpile, and Con Thien.

I was assigned to several duties, on a rotating basis. These duties
included working in the triage unit, as a first assistant in one of the
four ORs, or being helicoptered into a rural Vietnamese village to
provide medical care to the impoverished and poorly served local
populace. These forays were called MedCAPS (Medical Civilian
Action Program).
Viewing the current viral crisis, as I understand it from
the remote vantage point of my home, there are some striking
similarities or contrasts between my wartime experiences and what
physicians on the front line are facing today:

Triage
In medical school, I was introduced to the concept of triage,
but had no practical experience with it. That changed immediately
upon my arrival at 3rd Med. Triage is the process of rapidly
determining during a mass casualty which of three categories an
injured patient falls into:
a. Those who will probably live with minimal medical
intervention
b. Those who will probably die even with aggressive medical
intervention
c. Those who will possibly live only with aggressive medical
intervention
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BCMS Medical Record Fall 2020

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