Winning the Hearts and Minds

Winning the Hearts and Minds

"Dinky Dau," Kate replied. "It's Vietnamese for 'crazy'." The lieutenant was in her mid thirties, an army nurse with a voice like a wood rasp. She had a few miles on her after eight months in country, but she was still attractive.
"They call the C.O. Colonel Dinky Dau?" asked Ellen. She was just off the plane and still had that fresh look the cherries always have. She had bright red hair, freckles, an engaging smile, and some nice curves.
"He distinguished himself again today," Doug Warren began. Doug was our court jester. He carried an extra twenty pounds and had an easy laugh. He was the internist, assigned to volunteer for this week’s medcap mission.
"Our mission is to win the hearts and minds in Hoa Loc Village. Right?" At lunch, Doug began his irreverent imitation with this description. "Colonel Crazy, chief of Neurosurgery, steps out of his air conditioned headquarters. He is a bad ass in his Special Forces camouflage with subdued insignias, a jungle hat with a plastic bottle of insect repellent in the hatband and camouflage netting securing branches and leaves. He looks like Dicky Smothers in a special forces uniform—with a web belt and canteen on the left, a forty five holster on the right, and an extra clip at each side of his chest for the M-16 in his left hand. He takes command. With a snappy salute to our protection, the platoon of grunts in the first three jeeps, he jumps in the lead jeep of our little convoy, and we're eating his dust down to the river.”
The mess hall was a dangerous place for this performance, but that’s where Doug performed and he would risk anything for the laugh.
Mike McManus, our soft spoken, thin, balding trauma surgeon from St. Louis had laughter in his pale blue eyes. "Not one of those grunts laughs at Dinky Dau. Right away, I feel safe—those are some disciplined troops." We laughed again.
"We all know Col. Dinky Dau. But what about this "winning the hearts and minds" deal. You want crazy? We pass out a few pills to the women and children. When the men come back to the village tonight, are they going to be impressed with our humanitarian effort? What do we expect? That they--what? Call in V.C. positions? Hell, maybe they are V.C. themselves. We are expecting them to change sides to the ARVN’s? "
"So. How's ‘winning the hearts and minds’ any different from this whole damned war?" Kate asked.
Nobody had the answer.
We were two docs, two nurses, the dentist, two dental assistants and the pharmacist back from our jungle medcap mission late for the usual Saturday lunch of fried rice. We were chasing it with Kool Aid, the only substance that could partially disguise the heavily chlorinated water.
"Well. Look who's coming. It's our mover and shaker, Dr. J.D. White," Mike said almost under his breath.
"This one's not crazy. He's just a jerk—also the chief of surgery," Kate murmured to Ellen, still looking after her newcomer.
"Did we get some good numbers?" J.D. asked Mike as he pulled up a chair.
"Step right up, folks. It's the Great American Medicine Show." Mike pulled some folded sheets from a pocket. He smoothed them out on the table with both hands, and read aloud. "We saw 32 patients for medical diagnoses 6 for infectious disease, 14 for surgical diagnoses, 3 minor surgeries if we count iatrogenic disease. Pharmacy dispensed 44 bottles of liniment, 240 tabs of Pen VK, 220 tabs of lomotil, two million units of IM penicillin. Jim did 5 extractions and 7 fillings, and stole the show with his shiny instruments, mirrors, and dental chair.
"I sure am glad to have the support of some numbers, J.D. Aren't you?" Doug asked irreverently. He loved to needle J.D. "It’s important that we go about this scientifically."
J.D. just shook his head. He knew what was coming. He would chuckle at the jokes, even enjoy them. But he had one main interest. That was command.
"Let's see," Doug continued. "What equals one 'heart and mind'? An extracted tooth? A lomotil tablet? Tell me. And I’m sure that we have a control group…you know, a village that has had no madcap mission. Do the generals compare these stats with body counts of the field units? You know, see how we did on the hearts and minds, see if we decreased the number of our casualties."
"If you want to find out what goes on in the field units, I can arrange that. I just hope that you saw more patients than the docs from 93rd Evac, smartass. That’s what the brass wants. It’s what I’m going to give them. They want us to count, we’re going to count." J.D. bored in.
"Oh," said Doug in mock disappointment. "You mean it's not really an experiment?" Doug couldn’t quit.
“You just volunteer and count and things will be fine, Doug,” J.D. turned to Mike, "If iatrogenic disease counts? What's that supposed to mean, Mike?"
"Physician caused disease, J.D."
"I know what the word means, smartass. What did you guys do out there this morning?
"We did you proud J.D.," Mike said, deadpan serious. "We're the only medical team to come back with a body count. We had down three when the smoke cleared. It took two cases of oranges, but it worked like a charm."
Doug laughed. Ellen burst out crying.
"You insensitive clod," Kate hissed at Mike. "She thinks it's her fault."
"I wanted to give the children a treat...some candy or...something." Ellen sobbed.
"Oh no you don't," Doug said earnestly. I want the credit. I’m in line for a bronze star. Those oranges were my idea. While you nurses were dreaming about candy; I scrounged two cases of oranges."
"I guess you got the three notches for orange crates." Mike saluted Doug with his left hand.
"You're not funny." Kate was furious.
"We wanted to give the kids something," Ellen whispered.
"Goodwill miscarried once again. It's the American way." Mike said.
“As American as apple pie and Viet Nam,” said Doug.
J.D. gave them a wry smile.
"It's all a joke to you two. You make fun of everything don’t you?" Ellen was bright red in the face angry.
"We try," Doug replied
"This is funny," Mike said softly to Ellen. "Enjoy this. Serious will come in on the choppers tonight."
"Now, children." J.D. held both hands up, palms out. Then he got serious."Stop talking in innuendo, Doug. Tell me what happened, the details."
Here's how Doug reported our mission:
They loaded us into three gun boats. The river was a half mile wide and bordered by a lush tropical jungle. Two hundred foot trees, triple canopy, with growth between the trees so dense that it was almost dark on the ground. There was all kinds of sampan traffic. Several boats passed us very close. They were filled to the gunwhales with people taking goods to market...fish, wicker cages full of ducklings, bags of fruit, and baskets of eggs. The river people were doing their activities of daily living. The war seemed remote.
We tied up at Hua Loc just upriver from the outhouse, the four holer on stilts over the river. The water beneath was boiling with jumping fish -- number one Vietnamese fish flush toilets. Some women were washing clothes on rocks 200 feet—down stream.
Our platoon did a sweep through the village and sent their interpreter to fetch us.
"Alpha Charlie Echo," he said.
I didn't get it. Then I realized it was the name that the grunts had given him.
"Ace?" I asked.
"Yes," he said with a broad smile. He was enthusiastic.
Ace was about 17 years old, with skin as smooth as a nectarine. He was dressed in the smallest possible size of camouflage fatigues. He wore the same U.S. jungle boots that I had and a canvas military style belt with a brass buckle. He spoke quickly but exactly. His English was good, and he was comfortable with us round eyes. As I talked with him, the boisterous conversation in the platoon quieted, and every soldier concentrated on Ace. When he talked, they listened. The platoon had chosen his name carefully.
"Number one platoon?" I asked.
"Yes, number one," he said.
"Are you always with them?"
He nodded once, "Yes, always."
"At night?"
"Many missions in night," he replied seriously.
I nodded.
"Hua Loc. V.C.?"
"No V.C.," he said with confidence.
"Do you live here?" I asked.
"My village …Mekong...south."
"Long way," I said.
"Gone," he said flatly.
"Gone?" I asked crossing my throat with my index finger.
He nodded yes.
"Your family?" I asked.
"Dead," he said. He maintained his control, only his eyes showed the loss.
"I'm sorry," I almost whispered.
He just looked at me, alert, waiting for my next question. God, my “sorry” was so inadequate.
"Have you translated for clinic before? You know. Words for talking to sick people?"
"Yes, many."
An old man with a wispy goatee greeted us. He was the village chief. Slowly, Ace and Chief led the procession. Mutual curiosity was silent at first. Ace broke the ice and started a few conversations for us. We broke out our Nikons, and the villagers had a good look at us…at all the stuff we hauled out there. Their houses were open, thatched roof structures. They had no windows and no doors. During the day the ducks, chickens, dogs, and pigs had free run of the village including the houses. The only villagers around were women, children, and a few frail old men. The men were hiding. If the Americans get your “hearts and minds” in the morning, the V.C. come at night and get you “by the nuts”.
The old women were in the streets. They had taken positions in front of their houses and were squatting flatfooted with their butts effortlessly suspended above the ground between their ankles. Most were grinding what looked like rice using mortar and pestle. They looked at us with a mixture of curiosity and the resolute acceptance. About half were chewing beetelnut. They smiled broadly and showed us their red stained teeth. Chewing is an old woman's sport. They are tough. No spitting—they swallow most of it.
A group of about twenty children brought up the rear following the nurses and medics who were toting the boxes of medicines, instruments, and oranges.
"The chief says after clinic...big party," Ace told me as we arrived at the community center. There were about 30 patients waiting in line.
"What do they eat?" I was worried about this party.
"Fish," Ace said. My stomach flipped as I remembered where the fishing would probably be best. And what about drinking water. I was worried about this party.
We set up clinic. Mike with Kate and Ellen with me, we kept Ace between us so that we could alternate patients. We started working on the line hawking our medical magic.
We started with a middle aged lady with deep set eyes.
"What kind of trouble is she having?"
Ace exchanged several sentences with her. "Pain. Arms and legs" he summarized.
"Have her point."
More chatter. She points to her left elbow, then right knee.
"How long?"
This question stimulated a long conversation.
“Some pains a long time from child but not bad. Very bad one month.”
"Both the knee and the elbow?"
Another long conversation. "Mostly elbow," Ace replied.
Did she ever hurt it? Has it been red or warm? Other joints involved? Each question had its conversation. I gave up sorting out degenerative joint disease, rheumatic fever, and rheumatoid arthritis using Ace's condensed history and a thermometer.
"Are we taking any samples back to the laboratory?" I asked looking over at our supervising CO.
He shook his head "No lab work."
"Follow up visits?"
The Dinky Dau shook his head, "No" again. "No hospitilization. No surgery," he said.
"Not much to do. We can only treat her symptoms. Have we got some kind of Tiger Balm--something topical? "I asked our pharmacist.
"Sure. Liniment in 8 ounce bottles." He held it up. It was a pretty blue liquid. Our patient smiled. She liked the looks of it.
"Tell her to rub it in. Right where it hurts. It will feel very warm. She should exercise the elbow, keep it moving," I told Ace and he passed it on.
She opened the bottle and rubbed a few drops on her elbow. We could all smell the oil of wintergreen. Her eyes widened with surprise of the warm skin sensation. She looked at me and bowed slightly.
My second patient was a middle aged woman who presented her arm to me and pointed to her elbow.
"How long it has been hurting?" I asked Ace. They traded several sentences of Vietnamese.
"Long time," Ace replied.
"Give her some liniment," I told Ellen.
Mike and Ace took the next patient in line who pointed to his knee. The history was briefer this time, and the end result was a bottle of the blue medicine.
Ellen had been down the line.
"The patients in the front of this line aren't sick. There are two draining abscesses at the back, and two patients that had to be carried," she said.
Our next patient was pointing to her wrist. A short sentence of translation, Vietnamese then English.
"Pain," said Ace.
I reached into the box and retrieved a blue bottle, and gave it to our patient who nodded her head with great satisfaction. Once they caught on, every patient stepped up and said “Pain”, Ace told us. “Same, Same last man”
“Do they all want colored liniment to rub on?” I asked Ace. He nodded.
"Tell him to get rid of these people who crowded into line. Let's get to the sick ones," hissed Kate.
Ace shook his head. I looked at him inquisitively.
"These first," he said, pointing to the front of the line. "Number one big shots."
"Bullshit," said Ellen with disgust.
"No bullshit," Ace stood his ground. He knew how to buy influence. The generals should put Ace in charge of the Hearts and Minds program.
Mike's next patient was pointing to her wrist.
"Blue medicine?" he asked Ace. He nodded.
Ace nodded and Kate gave her a bottle as the next patient stepped up for Ellen and me.
"Line up for blue medicine," I announced.
Ace translated. Things moved right along. I passed out a bottle of blue medicine to 26 patients, exuded good will, and examined any offered body part. There was a slight hitch when we ran out of blue medicine and had to switch to red liniment with a cinnamon scent. Red sold even better. We passed out another 18 bottles, and the cupboard was bare. It added to the prestige of those who had received liniment when some of their later and lesser neighbors came up short. Oil of wintergreen – now there is some kind of propaganda juice.
We were down to the patients who were sick. A twelve year old boy had a bamboo splinter in his elbow for about 3 weeks, an untreated joint space infection that had destroyed the radial head. We incised the joint and left a drain in, with instructions for irrigation and oral antibiotics.
We had about five of these spectacular complications from untreated infections. There were four of five patients with untreated fractures that had healed with debilitating deformities. But we couldn’t do any surgery, so the patients had to get by on liniment.
As the finale, we saw a woman with a huge ulcerating breast cancer. No magic. No one had the fortitude to offer her liniment.
The villagers took us to a clearing where they had cooked a pig on a spit. They had put it on a table surrounded with bowls of rice and fruit. The chief made a long speech. I feigned interest in the cook's carving skill to get in for a close look at the meat. It was well done.
We ate with a feeling of ceremony. The meal was delicious. The locals came out in force...to eat and to inspect us. They gave us the same curious awe that Mike had for their water buffaloes.
As things were winding down, the time seemed right for an American innovation--dessert. Ellen and Kate were giddy. They could give their gifts to the children. The corpsmen brought the two cases of oranges to the tables and opened them.
"Have the children form a single line. We will give each child an orange," Ellen told Ace.
I made a rough check. No problem. Plenty of oranges. Ace was making the public announcement and the line was forming in front of Ellen. The smaller children were eager. They were the first in line, a horde of eager cherubic faces. As Ellen began to pass out the oranges, the older children began to come forward. They were trying to say something to each kid, to present each orange. It was too slow. The older kids pressed from behind.
"Tell them to stop pushing," Ellen said to Ace.
Ace tried. Despite his efforts, excitement in the lines mounted. The small ones in front had their faces smashed up against the edge of the table. They were wedged, unable to move.
"Let's get rid of the damn things," urged one of the corpsmen as he took oranges from the box behind the table and started passing them out to the left side of the table. Another corpsman took a position on the other end of the table. The lines disintegrated. The larger children were breaking for the ends of the table. They knocked the smaller children down, ran over them, on them. Small bodies hit the ground. They made dull thuds. Sounded like a close up mike on a goal line stand at a Rose Bowl game. Heads were bouncing like melons. Sickening sounds. Mike and I started throwing oranges toward the rear of the crowd to take the pressure off of the front rows, and the larger children still overran several of the small ones in the open field.
"Dear God! Stop this!" Ellen was screaming.
Where were the parents? Standing at the periphery gathering the booty, five or six oranges cradled in folded arms. None of us had thought to ask the street value of an orange. A child would deposit an orange with a parent, and fly back into the melee undaunted by a bloody nose or a knot on the head.
I looked to one of the mothers hoping for help. She turned away in fear. She looked back over her shoulder like a raccoon stealing groceries, ready to bolt...with her arm load oranges. We began throwing the oranges near the parents to reduce the collisions. The corpsmen followed suit.
It was as fast as a prairie grass fire. Whoosh. Then it was over.
As families left, almost in flight, we surveyed the damage. Three kids were still down, semi-conscious. There were no fractures. We got off with a bloody nose and three scalp lacerations and three concussions. We did a thirty minute suture clinic. Then we packed up to leave.
Doug ended his report with: “So, J.D. They stood in line all morning for thirty eight bottles of liniment. They almost gave the lives of several children for 2 boxes of our oranges. So, the jury’s out with regard to the hearts and minds?