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First copter stop may be either a MASH (mobile army surgical hospital) or the division unit. These are fairly close to the scene of action, and are used mainly for grave emergencies in which a ten-minute delay in starting treatment might mean death. Division hospitals average only about ten beds each, with four doctors. Each MASH has 60 beds, along with 80 medical personnel, including ten doctors. Behind these, in turn, are field hospitals and evacuation hospitals—all misnamed, judged by their current functions.* In South Viet Nam, there are now two U.S. MASH units and one Korean, three field and two evacuation hospitals, and the Navy's 3rd Medical Battalion.
Front & Back Surgery. One recent patient at the 85th Evacuation Hospital in Qui Nhon in the Central Highlands was a first lieutenant whose family does not yet know he has been wounded. Shot and partly paralyzed during a night action near Plei Me, the lieutenant propped himself against a tree and went on directing his platoon for half an hour before he felt himself blacking out. Then he turned over command to a sergeant. He lay in the field for an estimated seven hours. Then corpsmen and doctors got to him and gave blood, other intravenous fluids, a tetanus booster shot and antibiotics. A MedEvac helicopter (TIME, July 2) set down gently on the dangerous terrain, took the lieutenant aboard and deposited him only minutes later at the 85th Evac Hospital.
Entrance & Exit. The lieutenant needed all kinds of doctors, and the 85th had them all. Besides a platoon of general practitioners, it has six general surgeons, two neurosurgeons, two orthopedists, one thoracic and one urologic surgeon, two anesthesiologists, two internal-medicine specialists, two dentists and one psychiatrist; also 39 U.S. Army women nurses and 16 male nurses.
"We could see the entrance and exit of the bullet," says Captain Albert Dibbins of Melrose, Mass., "and the paralysis in the legs made it obvious that there was a spine injury."
Dr. Dibbins opened the patient's abdomen. The bullet had gone through the right kidney, but the wound was clean and would heal itself. The pancreas and duodenum were undamaged. A wound in the diaphragm was too far back to be treated; it would heal itself. So would the punctured lung: "It's so spongy that it acts like a self-sealing gas tank," explains Dr. Dibbins. He put a drainage tube in the lieutenant's chest, closed the abdominal incision and helped turn the patient over on his belly.
Next, Neurosurgeon Benjamin Blackett took over. He made an incision down the spine, found two fractured vertebrae, with bone chips up to a ½in. long broken from their tops and sides. Dr. Blackett removed the chips. But they did not explain the paralysis; so the doctor moved on to the exquisitely delicate job of "unroofing" three vertebrae, to expose the sensitive spinal cord. There, Blackett found what he was looking for: another bone chip, hardly bigger than a broken pencil point, was pressing against the cord. Insignificant as it seemed, it was enough to have caused the paralysis. Dr. Blackett left the vertebrae unroofed—the heavy back muscles would unite to give the spinal cord enough protection. Within a few days, the lieutenant regained partial feeling in his legs and was started on his way to the Z.I.