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Vital Sorting. Though the Marine Corps has no separate medical service, and depends on the Navy's, it has the 3rd Medical Battalion, comprising four companies. At Danang is Company C, or "Charlie Med" to the gyrenes. "Back last summer," says Lieut. Commander Richard M. Escajeda, 36, chief surgeon and commander of Charlie Med, "we used to classify eight casualties as a mass casualty event. Then we rang a big metal ring—like a country fire alarm—and everybody reported to his station. Now things have changed so, we have to get 20 patients at once before we consider it a mass casualty."
In recent weeks as many as 160 wounded and ill marines have swamped Charlie Med's 13 physicians, five dentists and one oral surgeon in a single 48-hour period. "Then," says Dr. Escajeda, "when they come in with everything wrong with them, from missing limbs to multiple wounds, the most important person here is the triage officer."
Tough Decisions: Triage (pronounced tree-ahj) is French for "sorting," and because of the word's emotional overtones, most military medics prefer not to talk about it. But it is a process of sorting that works for the greatest good of the greatest number. The triage officer looks over the wounded and makes the vital, split-second decision as to which require immediate surgery, which can wait a few hours, and which need only more first aid. Sometimes he must also make the conscience-racking decision that a man is beyond help or hope, that it would be a waste of doctors' time, and therefore endanger others' lives, to work on him. Such cases have been rare in Viet Nam.
"The triage officer's pitfall," says Dr. Escajeda, "is to start helping in emergency cases. The good triage officer doesn't do that. Spending time doing the humanitarian thing for one patient who obviously needs help right now is fatal. Mass confusion results. Patients pile up, half the emergency cases don't get cared for, and the whole system breaks down."
At mass casualty times, all Charlie Med personnel work round the clock; they have done so for as long as 48 hours. Then, even the dentists quit their cavities and turn to as assistant surgeons, working not only in the mouth, but debriding (cleaning, by removing dead tissue) wounds in any part of the body. Enlisted marines inevitably have made this the basis for a wisecrack: "If you're gonna get wounded, be sure you get hurt real bad or you'll draw a dentist for your doctor."
Elapsed Time: 35 Minutes. There was no triage problem in the case of Marine Colonel Michael R. Yunck, 47. As operations officer of the First Marine Air Wing, Yunck had helped to plan Operation Harvest Moon; later he went out in a four-man armed "Huey" helicopter, directing fighter-bomber attacks south of Danang. He was about to call in a strike on a tiny, nameless hamlet when he looked down. His chopper was low enough for him to see women and children. It was also low enough for a Viet Cong machine gunner to sight in on the Huey. "I knew I couldn't call in a strike," said Yunck soon afterward. "And that was when I got the fifty caliber." Commented a surgeon: "He's going to lose his leg because he was too compassionate."