The Battle of Bunker Hill
as seen from Easy Medical Company (part two of three)

Lt. Birney Dibble, M.D. (s.g., MC, USNR, 1st MarDiv, Korea), Eau Clarie, WI

About 1000 hours I decided Iíd had enough of the triage ward. Iíd been in there for almost 16 hours straight with only short breaks for gulps of coffee. I hadnít slept; no one had. I knew from my experience at Cook County Hospital that Iíd be okay until about four or five in the afternoon, then it would hit me, hard. At County that was fine; I was never on call two nights in a row and could usually get away from the wards by late afternoon. I would have supper, a beer or a glass of wine, watch some dumb TV show till seven or eight, and collapse.

Now, with no one coming on duty to relieve me, I didnít know what I was going to do if I couldnít get some sleep some time during the day.

I found out.

Iíd sent Lee Yung-kak and Lou Shirley back to the minor surgery tent hours ago and went back there myself. I asked if theyíd like to work triage for a while and both agreed. I changed my mind and asked Lee if he would like to stay in minor surgery for a while and he readily agreed to that, too.

As their CO I could have ordered them, but there was little of that kind of baloney in the medical corps. Not at our level, anyway, and not with most reserve officers. There was an occasional Regular Navy captain-type jerk who was so insecure or gungho that he had to order people around, but usually those guys could also make sure that they didnít end up in Korea, and back in the States you knew you had to put up with a certain amount of military garbage.

Minor surgery

While Shirley finished the case he was working on, I walked into the small tent containing the scrub basin and brushes. I soaped my hands and arms and scrubbed off the dirt and blood and vomitus that had accumulated in my knuckles and under my fingernails. Iíd washed frequently during the past 16 hours but hadnít had a chance to really scrub.

I stood with my eyes closed, half asleep, hands mechanically working with brush and soap, mind jumping from thought to random thought.

Wonder when this will let up. No end in sight.

Getting pretty tired.

Poor Jesse. That was my fault. He said I must be a good doctor if I trained at Cook County. Sure.

Drop of sweat running down my eyebrow.

Hope my mail finds me down here. Should hear from Edna soon, see how she likes her new job. (Sheíd moved back to Springfield, IL, where her parents lived. She was making over $200 a month, most of which she could save. The Navy was sending most of my pay [about $400] home so we figured weíd build up quite a nest egg during my year in Korea.)

Shouldíve had Lee go into triage. He works hard in minor surgery but canít turn out the cases as fast as Lou Shirley.

That Lee! Hardest working guy I ever saw. Almost always the first man down when the choppers come in. Always the last one to leave. Funny how little anyone knows about Lee Yung-kak. The inscrutable Oriental. Good man. Has a wife somewhere, Seoul I think, but never asks for special leave. Apparently doesnít go see any of these little sheba-shebas, either, who keep working their way up to the lines.

Shirley woke me from my reverie. ìOK, Skipper, take over. Theyíll have the next guy up for you in a second. Whatís the matter, you sick or something?î

I opened my eyes and grinned. ìNo, just resting. Just like the old internship, nicht wahr?î

ìYeah.î We both knew that even if the wounded stopped coming right then we had another long night ahead of us.

I wiped my hands on the green towel hanging from the wooden rack next to the basin and walked back into the minor tent. Two corpsmen were lifting a Marine up onto the sawhorses. He lay on his belly with a large dressing over his left buttocks. I put on my gloves and started drawing up procaine from a bottle held by the corpsman. The corpsman pulled off the dressing. I glanced at the wound and was surprised to see a large piece of wood sticking out of it.

ìMy God, man, you still here?î I exclaimed, recognizing the potato-masher handle. ìThought you wouldíve been done hours ago.î

ìGuess they thought I could wait, Doc.î

The corpsman scrubbed around the wound with liquid green soap. I placed my sterile towels and anesthetized the skin and muscles as well as I could. Several times I hit the wood with the needle as I probed deeper and deeper. Thatís great for sterile technique, I thought. Finally I felt Iíd numbed it as much as I could.

I made an elliptical skin incision around the protruding wood and controlled the bleeding. Then I grasped the grenade handle with a heavy Kocher hemostat and pulled. I pulled harder. It started to move slowly, then faster and faster like a champagne cork, and finally slurped out with a gush of blood. The fragment was nearly four inches long, 1 inches in diameter and fragmented on the distal end. The flow of blood was profuse and I placed a gauze sponge deep into the wound and held it there firmly with my fingers.

The grenade handle had severed the gluteal artery but with a figure-of-eight stitch I controlled it. Then I debrided the wound of splinters and other debris and packed it open with vaseline gauze and fluffed gauze.

ìAll done, Mac,î I said.

ìGot it sewed up already?î

ìOh, no. We never do that here. We leave it wide open to drain for five to 10 days. Then any dirt or other junk we mightíve missed will work its way out. Prevents infection. Somebody back at Able or maybe the hospital ship will close this up when itís ready. Sorry if I hurt you. That thing was really deep. You want it as a souvenir?î

He grinned. ìHell, no!î Then he grinned wider. ìThat holeíll be kinda hard to explain to the boys in the locker room, wonít it, Doc?î

ìYou can always tell íem an old witch stuck her broom up your ass.î

With a mischievous smile, incongruous under the circumstances, he said, ìWish there was a couplía young witches around here about now.î

I chuckled and went into the scrub tent to wash up. I was dripping with perspiration and when I stripped off my rubber gloves water splattered from them. I poured myself a drink from the 5-gallon water can on the ground and gulped it. I remembered then that I hadnít eaten and realized I was voraciously hungry. None of the others had eaten either. I walked back into the minor OR.

Doc Lee

ìDr. Lee, why donít you and Don Flowe go get some chow. When you get back, Lou and Iíll go over.î

I watched Lee for a moment, the small, brown hands working carefully in the debridement of a nasty shrapnel wound of the face. The Marine he was working on lay with his eyes closed, but opened them as I came up to the stretcher. He asked, ìHe doiní a good job, Doc?î

ìThe best, Mac, the best,î I said. The Marine closed his eyes again. Yung shot me a grateful glance. His hands had a very faint tremor now as they laid the vaseline gauze into the wound. Iíd touched a sensitiveness in Lee I hadnít been aware of. After theyíd carried off the patient, I queried, ìThings going OK Dr. Lee?î

ìVery fine, Captain. Taksan number one.î He paused for a split second. Then without looking at me he said, ìYou did a very good thing to me now.î

ìWell, I meant it.î And I was glad Iíd sent Shirley into triage instead of Lee.

I turned to my next case. The corpsman was scrubbing a Marineís leg, which had a dozen or more jagged puncture wounds.

ìThese donít look too bad, Mac. Probably keep you out of action a month is all.î I talked almost continuously with the Marine as I injected each wound with an ellipse of procaine.

Most of the boys liked to talk. There was a release in talking. Whether theyíd been on line a few days or a year, theyíd been under constant discipline. Furthermore, the mere fact that they were wounded indicated that theyíd just recently been under tension in a life-and-death situation over which they had practically no control.

Theyíd sat in their bunkers waiting for the rounds to fall, or theyíd crouched in their foxholes hoping they were concealed from sniper fire, or they were climbing a hill or running a valley, all the time listening for the flutter of a mortar round coming in.

Then they felt the blast as it blew them to the ground. They took stock of themselves and tried to determine the extent of their injuries. If they could, they crawled or walked back to the battalion forward aid station. If they couldnít, they called for a corpsman and were carried out on a stretcher.

I cut ellipses of skin from around the shrapnel wounds, then cut similar ellipses of fat and muscle from around the tracts which led to the metal fragments embedded deeper in the leg. Most of the shrapnel I removed easily, along with bits of cloth, dirt, leaves and other debris blown in by the blast or carried into the wound with the metal.

There were smaller fragments of metal that I couldnít remove easily and I left them in place. I knew that a few of these would have to be removed at a later date, but most would cause no trouble and it was never worth the time and effort to try to get them all. Debride the wound, stop the bleeding, pack it open, cover it up and ship the patient out. Next man.

More wounded

Morning eased into afternoon. Saturday night came and weíd been up for 36 hours without sleep. Night passed. Sunday morning the 17th came and weíd been up for 48 hours without sleep. The wounded kept coming ó in trucks, jeep ambulances and helicopters. There was no sign of a letup. Periodically I called Commander Ayres and a flight of Sikorskys would come in and take off with the backlog of serious unoperated cases and stable post-op belly and chest cases.

We now had men lying in more or less orderly rows on the hillsides all around the hospital, some on stretchers, most on the ground. Ward corpsmen making their rounds walked along the rows, checking dressings, marking the wounded for evacuation by truck, jeep, helicopter, or for holding for a doctor to recheck them before evacuation. It was hot, lying there in the sun, and we had to be sure the wounded werenít getting dehydrated. I asked WOHC George dePreaux to send a couple of our security Marines around with jerry cans of water.

Commander Ayres sent up a crew of Marines from Able Med to put up five 16x32 squad tents to use as post-op recovery wards. I could hear them laughing and talking and had the urge to run out there and ask them what was so damn funny, didnít they know there was a war on and would they kindly knock off the noise. Fortunately I recognized that I was getting irrational in my fatigue and that those gyrenes had every right to be happy. I closed my eyes and clenched my jaws and kept on cutting. I was mighty glad Iíd controlled my temper when a couple of hours later one of those Marines came to the flap of the minor OR tent and said, ìSir, we got the tents up and we rolled up the sides and laid out the stretcher racks. Is there anything else we can do while weíre up here?î

We emptied out our old wards to take the newly operated cases. And Ayres, God bless him, sent two six-by trucks up from Able and took 25 walking wounded back to have their debridements done there. I wished I couldíve seen the looks of horror on the faces of the internists and pediatricians when they were called out of their snug bunks to do surgery!

We were all beginning to show heavy dark circles under our bloodshot eyes. Small drops of tears trickled from the inner corners. The supply of surgical caps ran out so we tied masks onto our foreheads to keep loose hairs and sweat from dripping into the open wounds. Some of the corpsmen wore their green fatigue hats backward like a baseball catcherís cap.

It was steamy hot in those tents and most of us had taken off our fatigue blouses. One of the guys who was just moving patients around had taken off his pants, too. I stopped him dead with, ìThree demerits for being out of uniform, Mac!î Startled, he almost came to attention and then saw the laughter on my face.

A visitor would have thought it a ludicrous sight to see doctors and corpsmen running around the tents in combat boots, white scivvy shirts, green fatigue pants, and two masks tied to the front of their heads.

Nobody was laughing.

Those laughing the least were the doctors and corpsmen in the main operating tent. Their job was the toughest of all. It was here that life or death operations were performed. It was here that legs were saved or lost, bellies were opened to stem the flow of blood and liquid feces. Shattered kidneys and spleens were removed. Livers were sutured. Chest drainage tubes were inserted ó and through it all the principles of good surgery had to be observed.

Even when sweat poured down your face and stung your eyes; even when your hands trembled from fatigue; even when your brain was numb from sleeplessness.

(to be concluded next month)