"But the War Ended 25 Years Ago": Vietnam Veterans Talk To A Civilian Nurse
By Jehnana Balzer
Working as a registered nurse for 30 years in a large urban teaching hospital, I listened to countless fascinating patient histories. Our night shift crew never knew who we would tug off the gurney next: poor people and rich, sane people and psychotics, prisoners, cops, undocumented immigrants. Many of their tales still linger in my mind, but Vietnam veterans told the most unforgettable stories of all.
For them that horrifying war had never really ended. We nurses cleaned and bandaged physical injuries that were freshly layered onto old unhealed psychological wounds. In the 1980s and 1990s, I was reading memoirs and fiction by American and Vietnamese soldiers who describe how persistently the war still haunted them. Philip Caputo, Bao Ninh, Tim O'Brien, Tobias Wolff, James Webb, Stephen Wright. Their words carried my imagination backward in time to distant battles in the jungles of Southeast Asia.
But then I would clock in for work, meet my new patient, discover that he was a Vietnam vet, and suddenly the war became real, immediate, palpable. Sometimes I recorded their conversations in my nursing journals. Those impressions are edited here for length, clarity and HIPAA compliance.
By 1993, I had reached my own conclusions about why so many vets landed on our trauma/surgical floor. One night I confided this theory to a kidney transplant patient from the Lakota tribe:
He remembers the battles between the FBI and the American Indian Movement at Wounded Knee in the 1970s and argues that young hoodlums should all be drafted. "They must learn that people have fought and died for American values!" Though I did not ask about his time in Vietnam, he used his experiences there as an excuse for laying about in bed, "I know how much I can take. I have been to the wars. I have been to the rodeos." "Were you happy when YOU got drafted?" I asked. "NO!" He did not reply when I insisted that Vietnam had permanently damaged a generation of American males. If we take care of a guy aged 40 to 50 who is in the hospital because of ETOH abuse or suicide attempts or violence, there is a 50/50 chance he is a Vietnam vet.
During that war, young males from poor and minority communities were disproportionately more likely to enlist or be drafted than were middle class whites. My own patients demonstrate the accuracy of these statistics:
Last night when I admitted a stab wound to the neck patient from the emergency room I took one look at him and asked: "Which tribe do you belong to?" "Hualapi! From the Grand Canyon!" Pointing to old scars he mumbled an alcoholic boast, "I am a MARINE! I been to VIETNAM! I am a WARRIOR! I want to kill that guy!" He couldn't or wouldn't tell me more about his assailant and did not answer when I asked, "What were you guys fighting about?" Like the ghost dancers Bill Miller sings about, this Native American has been destroyed by homelessness and unemployment. "My wife don't want me no more. My mother told me to join the military, she is dead now. I can't quit drinking. I don't take my insulin because I am too drunk. I am going blind ... I just get mad at myself."
This evening his niece came to visit my Black gun shot wound patient. She told me: "He won scholarships in high school and we were all so proud of him. Then he signed on for 7 years in the Army and came home a completely different person," withdrawn, paranoid, drinking port wine alone in his room. According to the psychiatric nurse practitioner, my patient has "the bizarre notion that his parents are not really his parents. He thinks they are doppelgangers."
What happened to this man during his time in the military? The trauma doc and the social worker and the nurse practitioner and I all try to answer that riddle so that we can get him the VA benefits that he clearly needs. But he speaks only if we question him directly. And he asks us for nothing. I took care of many soldiers who felt neglected and wronged by the Veterans Administration. But they did not always get real help at the hospital where I worked either, and my colleagues occasionally expressed callow attitudes toward the vets.
Yesterday I listened to a medical student denounce the Veterans Hospital. "You draw your own labs because if you don't they never get done." "Yah!" I agreed. "The Reaganites go on and on about honoring veterans yet they cut back on funding until the veterans hospital is almost nonfunctional!" Suddenly a gulf opened between this aspiring young professional and myself, an old 1960's anti-war demonstrator. Rather than utter a word against Reagan or Bush, the doc blamed the veterans instead. "Some of those old guys just want 3 squares a day and a warm bed. If you check back through their history you find that they have had themselves admitted 30 times in the past year for the same complaints."
My patient last night was admitted with seizures after a two-week-long vodka and beer binge during which he vomited any food he tried to eat. "He has a strange affect," said Jane during her report but there is nothing strange about this patient at all. He is simply a victim of USA policies in SE Asia. "I have had seizures ever since I got injured in Vietnam. I was a fool. I just wondered if I could try alcohol again after no drinking for 3 years but it only makes things worse." I plugged AA and warned about cirrhosis and pancreatitis but mostly we discussed his depression and his antagonism against the Veterans Administration. "I will go to court and ask for reparations. I was exposed to Agent Orange, you know. And now they are doing the same thing to these guys ..." In the darkened room his voice was more hopeless than angry. "Spending hundreds of billions of dollars a day to keep those troops in Saudi Arabia but when the guys come home they will say, we can't afford to help you, we need to cut back expenses!"
If Bush institutes the draft again my patient's two sons will be eligible. "It may not be patriotic but I told them: Don't go!" Were you melancholy before you got sent to Vietnam? I asked. "No! I was the life of the party!"
He thanked me for talking to him. "Hell!" I replied. "I am from your generation too and what happened in Vietnam was not your fault. You guys did what you thought was right, what you were told to do. Don't let the bastards get you down." Sadly he answered, "But the war ended 25 years ago." He is disabled by despondency so deep that he had to quit selling the Encyclopedia Britannica though the work is gratifying and earned him $80,000/year.
When I described the bureaucratic hassles of getting an appointment for my mother-in-law at the VA hospital he said, "I don't let them tell me there is no record of my appointment. I stay until they see me!" Never once did he blame war resisters nor even the country at large for his predicament. He holds the USA government itself responsible.
Another vet was a pulmonary fibrosis patient so near death that he conferred with lawyers about his DO NOT RESUSCITATE orders while I cared for him. "If the government finally acknowledges that Agent Orange scarred my lungs do you think I will still be alive when they pay compensation?" as he challenged me when I suggested that he seemed depressed about his deteriorating respiratory condition. The man could not even pull up his sheet without getting winded. "How long did it take them to compensate the Japanese who were incarcerated during WWII? Forty years? The VA gives me medical care but won't admit that Agent Orange caused my disease. So I won't get disability payments and anyway I do not want to lie in bed for years and years."
This is a story about the irrationality of the US medical system. Last week we saved the life of an alcoholic Vietnam vet found comatose on a sidewalk, dying of heat prostration and seizures. While still groggy with fever, ETOH, and post-ictal lethargy, he had called me a bitch and a cunt. Then he woke up and explained that he had been "living on beer and cigarettes for the past week." Though the medical resident and I both questioned this patient's capacity for change, we agreed that we should give him the benefit of the doubt. But we could not find him the medications he needed to weather his withdrawal from alcohol. He was discharged on Saturday afternoon and could not cash his check until Monday, so how was he supposed to pay for the Librium that would prevent delirium tremens during those 36 hours? The resident tried and failed to procure Librium pills for him, calling Mercy Clinic and the emergency room in vain. I violated hospital policy by handing him a sack containing the four 25 milligram tablets of Librium that I found in his medication drawer, but he needed 6 or 8 doses of Librium 50 milligrams.
"Your social worker's notes say you can get seizure medications at the VA hospital," I told him. "Yah, but he does not know the VA like I know the VA!" replied this lost soul, bruised and unwashed, who hadn't even one friend to visit him in hospital. I did not pretend that his cynicism was unjustified.
I did not always see eye-to-eye with the veterans I met in the hospital. Vietnam opened fissures in this nation that never really closed again.
In the past fortnight I have cared for two different guys who went to Vietnam. The chronic kidney stone patient warned us nurses that "I can get violent if you wake me up without warning!" When I muttered, "Oh shit!" while fixing his IV he assured me that he believes in freedom of speech. "The only thing I do not believe in is freedom of choice! If you kill a pregnant female in a highway accident you are charged with 2 counts of manslaughter but they say abortion is not murder?" I wondered why he went to Vietnam if he is such a pacifist? But our incipient argument was defused when he agreed with my reply, "Letting males decide whether or not women must bear children is like letting women decide whether men should be sent into battle!"
I am caring for a guy of my generation who is long since destroyed by the Vietnam war and his subsequent drug abuse, bad temper, political ignorance. He enlisted for that evil war, which he tells me he is unwilling to discuss. Then he signed on with Soldier of Fortune magazine to fight in Zimbabwe against the Africans and Mugabe, a scheme he never actually carried through on. When he pulled a gun on the police twice they shot him in each shoulder after a chase. His wife had called the cops because he was trying to assassinate her and now he will probably go to to prison. Because of the damage to nerves and muscles in his upper extremities the poor bastard won't be able to defend himself against other jailbirds.
I feel pity for him and do not question this society's obligation to heal his wounds, pay for his occupational therapy and drug rehab and give him a fair trial. Still, I balk at feeding him and brushing his teeth, placing and emptying his urinal, washing his hair and his ass. I wonder why I should minister so intimately to a guy who killed Vietnamese peasants and volunteered to murder African freedom fighters?
Sometimes a survivor of the Vietnam war reminded me of characters I had met before in literature. I once took care of a self-described "burnt-out nurse" who could have stepped from the pages of the Sigrid Nunez novel "For Rovenna," about a military field hospital nurse who kills herself after returning from Vietnam to the USA.
My patient's numerous medical issues include 5 years of heroin addiction which she did not mention to me. But she did tell me that her two brothers, both of them Vietnam vets, are dead of ETOH abuse. Never graduating from any nursing school, she learned on the job in country how to care for soldiers burned by napalm, legless, armless, guys who died in her arms with blood seeping from their ears and noses.
This patient sees herself as a comforting mama-style nurse. "One boy said to me: hold me as if I were your son ... and then he died." But she resents male Vietnam vets who do not understand how that war affected the women who took care of them. "Nurses were their lifeline to the states, blond hair and blue eyes, brown hair and green eyes. But when we complain that Vietnam was hard for us too they say, you were never in combat! They expect us to be mothers and girlfriends, nurturing the one lone feeling they still have left."
For a while this patient worked with a nurse who seemed born for her military career, working shift after shift without a break, never flinching when burn victims screamed at her during debridement. I would wonder, how does she DO that? And then one day without saying a word to anyone she went home, drank a fifth of whiskey, and blew her brains out. She had gotten a letter from her husband, a photo of himself standing beside his new love. :Guess what? I can't wait a whole year for you to come home! I want to get laid now!"
How I wish I could write eloquently enough to transform my black and white and Apache Vietnam veteran into the hero of his very own absurd and comic tragedy!
Big hullabaloo last night when my patient threatened suicide. I had gotten fond of this guy though I also understand why his ex-wife distrusts his drug addiction, his gun collecting, his Harley-Davidsons and his frequent suicide attempts. "One day I put a straw hat on her and opened fire." "What do you mean, a straw hat?" I asked. "And black pajamas, man, I thought I was back in NAM!" Though he does not blame this woman for leaving him, she was the immediate cause of his talk about jumping from the 7th floor.
"I do not see any other way out. My old lady cleaned out the $2,000 from our bank account. I got no way to pay the rent and my daughter is out on the street ... If I jump my girl will get my life insurance money from the Veterans Administration." The night shift supervisor was not sympathetic, "Tell him that when you commit suicide in a Catholic hospital all your money goes to the pope!"
My patient expresses no qualms about his participation in the war. "I have a machete I took off an NVA soldier I killed. Hell, he was a communist! And he did not need it anymore." He had conned the Army into letting him enlist, "I could not pass the test cause I did not finish school so another guy wrote the exam for me."
He wanted to go to Vietnam to avenge the death of "my brother." Abandoned by his white biological parents, he had been adopted by a black family and raised on the San Carlos Apache rez. "I don't belong to any race!" He lost most of his intestine to a gun-shot wound when he taunted a stranger in a tavern. "You're just a pussy! You ain't got the balls to shoot me!" For 6 years he has been kept alive intravenously by total parenteral nutrition but his prognosis is not good. "I got no more veins man! This is my last portacath and now I got this abscess in my brain because the cath is infected. I'm a mess!" When I offered to cut the long hair that he is too weak to brush anymore he protested, "No! That is all I got left! Apaches never let their hair be cut!"
Jehnana Balzer was a Registered Nurse from 1984 to 2013.