Too much danger of infection.
Open up a wound here and it sucks germs out of the air. Pseudomonas, staph, you name it, Vietnam's got it."
"I didn't see much of that on neuro, but then, a lot of times we didn't get open wounds," I told her. "And I suppose the Vietnamese have a certain tolerance built up."
"Probably, or anyway those that don't are dead before they get here. But we get a lot of infection on the Vietnamese side of the ward, '%u'll see that later."
too.
Another soldier, this one with frag wounds of his upper torso and compound fractures of the right clavicle and humerus, couldn't wait for us to reach him. He had been using his good arm to scratch frantically at his cast and dressings. "Ma'am, ma'am, you can change my dressings, can't you? I mean, since I'm asking. You've just got to. They itch like hell."
Marge said something soothing and regretful and examined his bandages, then pointed to a fly that had lighted on the dirty part of the dressing. "Probably maggots."
The soldier, who looked about fourteen, turned a green only a shade or two lighter than my fatigues. "Yuck. Get them the fuck off me," he said, trying harder than ever to scratch.
Marge gently restrained his left hand. "Leave them alone, soldier.
They're saving you from gangrene. Maggots only ea-maggots clean up dead tissue, sort of nature's way of debriding wounds. They won't hurt you.
They just itch a little. They keep wounds like yours from putrefying."
The boy, red-faced and almost in tears, lay back with a whimper. Not knowing what else to do, I handed him an emesis basin. He appeared neither convinced by the major's explanation nor willing to revise his no doubt long-standing prejudice against maggots. He was in for a long trip to Japan. I could only hope he'd get accustomed to the idea of bodily dinner guests.
There was also a marine with a self-inflicted gunshot wound to his right foot, and two other patients with less serious multiple frag wounds, overflows from the general surgery ward.
Voorhees and Meyers were already at work with razors and basins of water. Sergeant Baker brought the dressing cart, and Marge and I put fresh layers of bandage around the filthy, seeping dressings. It felt like sweeping dirt under the rug The boy with the maggots groaned when we raised him to reinforce his dressings and cursed us as we manhandled him, but when we were done, lay back and said, "Thank you, ma'am," as sweetly as if he were talking to his Sunday school teacher.
We were headed for the Vietnamese side when recovery room called to tell us that the first of our new admissions was being transferred to us.
After that, three more arrived in fairly rapid succession. The corpsmen were still busy escorting the GIs to the helicopter, so Marge, Mai, and I did routine vitals. I wondered where the charts were, but every time I asked about pain or nausea medication or whether to touch a bandage, Marge referred me to a little recipe box containing standing orders.
These orders authorized nursing staff to administer medication for pain, nausea, or fever, to reinforce dressings, and to perform other routine care without doctors' orders written specifically for each patient. I was finishing the vital signs on the second patient when the third was wheeled onto the ward.
Joe Giangelo, red-eyed and barely able to lift the soles of his paper scrub shoes, pushed the last gurney in front of him and stopped at the desk to hand the major a stack of charts.
His scrub suit was dotted with a fine spray of red droplcts up one side, blood that had soaked through his scrub gown while he worked. His hair was matted from being tucked under a scrub cap all night. He opened the refrigerator door and gulped down a canned Coke as if he'd been dying of thirst. He looked a lot different from the twinkly-eyed benefactor who whistled while he built cabinet shelves. I thought he was about to drop. But when I reached for some of the charts, he said, "Why don't
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