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 30° 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.