"Spare Time" in Viet Nam

In the operating room at Danang East, two green-gowned Navy surgeons wielded their scalpels as Medical Corps technicians hovered around the table. But the patient was not one of the U.S. Marines for whose after-battle care the big Navy hospital was primarily in tended. She was Hoi Pham Tri, a tiny, frail Vietnamese girl of 13.

For four hours Neurosurgeon Paul Pitlyk and Orthopedist Kenneth Spence worked on the prone patient's cervical spine. They cut under the spinal cord, removed the tooth-shaped projection that hooks the second vertebra into the first just below the skull, and then deliberately fractured the two vertebrae.

The white spinal cord continued to pulsate regularly, but there was no assurance that Hoi Pham would ever move her limbs again -- until the surgeons gave a sharp tweak to her left leg. It kicked up smartly.

Mixed Motives. For the surgeons, no less than for Hoi Pham, that reaction was a near miracle. For two months the child had stoically borne a pain in her neck that gradually forced her head toward her shoulder at a grotesque 30DEG angle. With paralysis from strangulation of her spinal column, she could no longer walk, could barely move her arms. A corpsman took Hoi Pham to Project Viet Nam civilian doctors, who have volunteered to care for civilians (TIME, May 20). With no neurosurgeon among them, they referred her to the Navy. Dr. Pitlyk found that Hoi Pham had been walking around with a broken neck.

The case of Hoi Pham Tri illustrates the growing, voluntary response of U.S. military doctors and corpsmen to the medical problems of civilians. In the slack times between treating service men's wounds and illnesses, many doctors in the three medical corps have turned to treating the Vietnamese. Their motives are admittedly mixed. One is concern for the helpless, neglected sick; another is the challenge of severe cases. "Imagine!" says Dr. Pitlyk, "I wouldn't have seen a case like Hoi Pham's in five years at any emergency ward in the U.S., where people just don't walk around with broken necks." Surgeons also enjoy a respite from the depressing monotony of treating the destructive effects of war.

Operation Harelip. The Army, which operates most of the U.S. military hospitals in Viet Nam, is hesitant about letting its medics take on civilian care, insisting that "our mission is to support our own troops." After a rash of plastic surgery for cleft-palate victims won the nickname "Operation Harelip" for all U.S. compassionate services, the Army officially put aid to civilians on an "emergency only" basis, partly on the ground that noisy children were disturbing sick servicemen.

But at the Army's biggest facility, the 85th Evacuation Hospital at Qui Nhon in the Central Highlands, the restrictions are being quietly ignored. Colonel Harold C. Murphree, a neurosurgeon who commands the 85th, smiles and says: "Everyone else is taking chances over here, so I don't know why we shouldn't." Though casualties are increasing at the 85th, there are still some widely spaced beds available for children; for women patients, a simple isolating screen is sufficient. Last week Orthopedist William E. Burkhalter had almost completed a long series of operations, including tendon transplants, to give the use of fingers to a boy whose hand had been fused into a shapeless mass in a fire. Even among infants there are battle casualties: Dr. Murphree has removed a mortar fragment from deep in the brain of a three-day-old child. Dr. Robert Filler has taken a Chinese .25-cal. bullet from inside the heart of a three-year-old montagnard girl.

Friend or Foe? When the hospitals are flooded with military casualties, even the most humanitarian commanders must turn civilians away. And some doctors and corpsmen dislike giving any aid to a population that they distrust. Even at Danang East, after a recent mortar attack, corpsmen grumbled at admitting patients from a local aid hospital. "How do we know," one asked, "that these aren't the people who were shooting at us last night?"

But the majority are determined to give what help they can. Two Navy doctors have opened a 32-crib children's hospital near Danang, tackled such cases as that of a three-year-old girl so malnourished that she weighed in at only 12 lbs. After six weeks of treatment, she was up to 21 lbs. Marine Corps commanders now encourage other battalion medics to open similar facilities. Doctors in the Danang area have formed the I Corps Medical Society to promote and coordinate civic action. Its first meeting this month was such a success that one doctor declared: "Pretty soon we'll be having A.M.A. conventions."

Meanwhile, across the Danang compound, Hoi Pham Tri still lay in a frame brace with her head in tongs. She would be immobilized that way for weeks to come. But for the first time in months, her neck was straight, and she could move her frail limbs freely, and she smiled her gratitude to the medics.

This file is automatically generated by a robot program, so reader's discretion is required.