Cutthroat (May, 2013)

They sat on a hallway bench, waiting while the operating rooms were cleaned. Both surgeons had been operating the entire night in hospital tents pitched between Vietnamese fishing villages on a beach of the South China Sea.

Orderlies scooped blood from the floors with snow shovels, pushing the jiggling clots into large plastic bags for incineration. Craig walked over to the scrub sink to wash sweat and sand off his face, his arm brushing against streaks of blood on his shirt. He looked at Graham, the wet blood on his tank top and shorts, dried clots on his feet and sandals. Craig spit sand from his mouth into the sink and breathed the air, smelling of humid decay and antiseptics.

“I never imagined it would be like this,” he said.

Craig recalled how it had been those first days when he came to Vietnam, well-trained, eager, inexperienced. How he had dressed in fatigues and boots instead of scrubs and sandals. How he had saluted and carefully followed protocol, even gone to church every Sunday, with the comforting belief that God’s providence would give him guidance.

A few minutes later, two large Chinook helicopters landed on the helipad and the surgeons covered their eyes as chunks of dirt and dust blew through the flimsy hospital tents. Twenty casualties were unloaded and carried on stretchers into Admissions, a drab, open-ended tent, painted with red crosses. Craig ground his cigarette into the sand; they both stood up to make room as patients were rushed along the narrow corridor into the operating rooms. A curly-haired kid from Iowa with a belly wound went into Operating Room #1 and was quickly anesthetized. Craig began the surgery; blood spilled out of the abdomen through the incision, splashing everyone before pooling on the floor. Somehow the bullet had missed the aorta and the vena cava by millimeters. Talk about luck, he thought.

When the bleeding was controlled, Craig went into Operating Room #2. Another near miss. A piece of shrapnel skimmed past the heart of this soldier and tore into his lung. A few sutures stopped the bleeding. A bullet had just missed the largest artery in his leg. Neurosurgeons operated on the soldier’s head, while orthopedic surgeons stabilized his fractured leg. Crowded between the other surgeons, arms pushed against his sides, Craig looked up.

“You guys have to move the hell over so I can get this chest closed.” He managed to finish the surgery, stripped off his gloves and gown and left the operating room. Craig leaned over the sink just outside Surgery. He looked at his face in the mirror above the sink: unshaven, sand streaked, baggy-eyed, a few grays in his matted hair. He washed off his glasses and pulled off the soaked gauze taped to his face, an ineffective effort to prevent sweat from dripping into wounds. Months ago, he had worried about the contamination, but he hadn’t seen any complications. It would have been a major breach of sterility at home, but here it was routine.

He changed into dry scrubs and walked over to Admissions where Graham was examining a soldier sitting on the edge of a stretcher: Some scalp was missing, some just hung loosely from the back of his head. A strip of white skull shone from the depths of the wound. While someone cleaned off caked blood from his face and hair, the soldier talked about an ambush and thanked God for his life.

“Frenchie and I were sitting in a small jungle clearing, opening rations for dinner. I bent forward to open one of the cans on the ground just as the bullet grazed the back of my head and then hit poor Frenchie in the chest. I know he’s dead. I saw you guys cover him up after we got out of the medivac. He was bad in the air, could hardly talk, but kept asking if I was OK.” He leaned forward, holding his head with bloody hands. “I tried to stop the bleeding. I held my hands against his chest, stuffed some of his shirt into where he was shot. But the blood kept running along the helicopter deck and out the open door.” He paused. “Oh my God. What will I tell his parents?”

Graham looked carefully at the skull which was fortunately still intact, but there wasn’t enough scalp to cover the bone. “Son,” he said, gently grasping the soldier’s arm, “we’ll have to move the scalp over and use skin grafts behind your ears.” Perhaps confused, the soldier silently looked up at Graham. But there was no time to explain the procedure in more detail.

“Let’s take him to surgery next.”

Father Perez, the Catholic priest, knelt briefly beside the wounded man, holding his hand, offering prayers before the soldier was carried into surgery. Perez followed for a short distance, still talking with the soldier. “I’ll help you with the letter,” he said. “We’ll write it together.” Then Father resumed giving last rights to dying soldiers and blessing the dead. Supplies of fluids and bandages were replenished in Admissions and medivac helicopters were informed by radio that the hospital was ready for more casualties.

Late in the afternoon, on the way back to the room they shared, the two surgeons walked past the morgue. Frenchie was lying there with all the other bodies. A moment too soon or too late, an inch this way or that; it seemed only chance to the surgeons, whether you did or didn’t end up toe-tagged, staring at the ceiling like Frenchie. Months before, Craig had thought God was watching over them and was protecting the just side, but now he realized there wasn’t any just side.

“Jesus, Graham, all of them probably had thought they would survive the fighting with God’s help.”

“Only fucking chance determines survival,” Graham answered. He tried to remember some of the names or the injuries of the soldiers he had operated on in the past twenty-four hours, but it was just a bloody haze, a tragic game of hit or miss. But the Chaplain went from soldier to wounded soldier, comforting, taking down names, giving rites. Perez was playing an illusionary game, they both thought. It was almost witchcraft, a laying on of hands.

* * *

That evening, a monsoon swept over Da Nang, white crested waves crashed onto the beach sending blasts of water and sand into the surgeons’ sleeping quarters; three sides of plywood, the fourth, canvas, flapped in the wind. They both lay on their cots and tried to rest. The most intense fighting and serious wounding occurred in darkness. Graham stood up and tilted his narrow canvas cot, showering the floor with sand before flicking the ash tipped cigarette away to the dirt floor and lying down again on his side of the room.

“Maybe the rain will keep everyone under cover and tonight we’ll be able to get up a game of poker,” he said. Dried blood clots clung to the bottom of his sandals.

“We’ve got to get Perez in the game with us,” Craig said. “That stone face of his. He hides his weak cards. Hell, I’m down a month’s pay to him. I try to bluff the bastard, try to look uncertain and fidget when I’ve got a strong hand, sit still with a weak one, mix up the signals, but that guy can somehow read me. Must be something they learn in a seminary.”

“Well, He’s got God on his side,” Graham smirked.

Craig had tried to push thoughts about the dead and wounded out of his mind. Repair what you can and go on to the next patient, he thought. When he was a resident in cardiac surgery the surgical team had operated on high-risk infants. His professor had visited the families only briefly the night before the surgery. If one of the kids died during the operation, the professor would have someone else talk to the family. He’d lock himself in his office until the next morning. Now Craig could understand why he did it.

He thought again about Father Perez , always there in the hospital, round-faced, sweaty like everyone else, the usual fatigues, a bottle of Irish Mist in one pocket and Holy Water in another. His only vestment, a long, narrow silk stole around his neck and draped over his wet shirt, doubled back over his shoulder when he knelt at a patient’s side. Perez, who seemed to have concerns other than just life. Perhaps he actually believed in the spirit, life after death. Well, goddamn it, he can have that belief, Craig thought. The dead look dead to me.

Graham sat up, again flicked ash from his cigarette, and brushed sand off his cot. He had to shout above the wind and the crashing waves. “I dream of silence, fucking silence. The rockets, shrapnel flying through the hospital, sappers cutting through our concertina wire—the wind and ocean make so much noise I never realize we’re in danger.” Craig remembered running to their hootch when he finally heard the gunfire during the sapper attack a few weeks ago. He had raced for the .45 under his cot, stuffed in the clip and waited, safety off, hammer cocked. I may end up dead, he had thought, but I’ll take some Viet Cong with me, the sons of bitches.

* * *

A helicopter flew low over the ocean from Monkey Mountain toward the hospital, its turbine blades whomping at full throttle, the landing light reflecting off the water. The surgeons finally heard the noise and ran through the rain, across the sand to the Admission Ward. Father Perez was already there, sitting beside an unconscious Vietnamese boy with a deep head wound, holding the mother’s hand. Colonel Thompson, the hospital chief, was standing by the communications radio.

He looked at Craig. “A medivac helicopter radioed they just picked up a soldier with an unexploded rocket grenade in his chest. They’re bringing him here in about five minutes.”

“We can’t put him in the operating rooms,” the Colonel added. “If the grenade blows, the whole damn surgical unit will go up in smoke. Put the soldier in the morgue. You two can operate on him in the morgue. We’ll surround you both with sandbags so that only your arms and head will be exposed.”

“Great, Colonel,” Graham frowned. “Thanks for thinking of our safety. Maybe we should operate on the beach with flash lights.”

“Well, hell, Major, what else can we do? And don’t bring him into the goddamn x-ray department. Take the x-ray with the portable machine out on the helicopter pad. I’ve called an ordinance expert who’s supposed to show up soon. Good luck.” The Colonel returned to his air-conditioned trailer.

All the bodies had been moved to the hallway, but the morgue’s humid air still held a nauseating odor of decay. A cot, closely rimmed with sandbags, had been placed under a dim ceiling lamp. A nurse quietly sorted surgical instruments on the metal autopsy table and then left the room. The helicopter approached the hospital, slowed, turned into the wind, and lowered gradually into the blowing sheets of sand for a gentle landing. The wounded soldier was the only passenger, buried under flack vests except for his wide-eyed face. After the vests were removed, he was carefully placed on a stretcher, floodlights revealing a deep, bloody chest wound which bubbled when the soldier tried to speak. The helicopter quickly took off, leaving just an orderly, Craig, and the patient on a stretcher outside the hospital. Two nurses, standing at the entrance of Admissions, wearing helmets and flack vests, shielded their eyes from the wind and stared at the helicopter disappearing into the night.

A Jeep with Ordinance painted on its bumper drove rapidly up to the hospital. The driver, armor and helmet clad, ambled like a heavyweight wrestler into Admissions, pulling a large metal box on wheels. Stopping and dropping the cart handle, he said, “Who’s the cutter?” Craig shook his huge hand.

Both surgeons watched the ordinance officer closely as he drew a large egg with a rear propeller. “Now this thing in his chest is about this shape,” he said, “and this propeller is how the grenade is armed. The propeller turns and arms the rocket as it flies through the air. This one didn’t explode—maybe it hit the marine before the propeller had time to turn enough. Maybe it has to turn just a little more before it explodes. Or maybe it’s just a dud.”

“Have you handled one of these before or are you just talking from some fucking army ordinance book?” Graham asked, staring at the sandy floor.

Looking up from the drawing: “Major, I want you to be very careful when you remove this. Don’t turn the propeller, even slightly. Don’t pull or push the grenade and you sure as hell don’t want to drop it. Just gently remove it and hand it to me. I’ll be right behind you in this armor suit and I’ll put the grenade in the box and take it away. Got it?”

The x-ray showed the grenade.

Craig looked at the morgue, the sandbags arranged so the surgeons could look over the top and put their arms through small openings to operate on the soldier. How could that work? he thought. How can we operate so far from the patient ? If it blows up we’ll be dead like the soldier, anyway.

“It’s a coin flip again,” Graham added, “heads or tails,” as he thought about their chances of success.

“Move the sandbags away from the autopsy table so they will be behind us instead of in front of us,” Craig said, thinking the hospital would still be protected and he could operate with greater precision. Someone brought flack vests and helmets for the surgical team. He thought about what he and Graham had been saying about chance and whether God was watching over them. As his vest was zipped closed, he thought about his wife and kids—what would they do if he didn’t come home? He couldn’t remember their voices or even what they looked like—it had been so long. But for a moment he saw his own coffin in the Methodist sanctuary, Reverend Coleman in the pulpit, arms and scarlet shawl reaching out in intercession above the flag-draped box. His favorite hymns echoed from the sanctuary’s stained glass. He silently spoke remembered parts of the Apostles’ Creed:


I believe in God, the Father Almighty,

Creator of heaven and earth.

I believe in Jesus Christ, his only Son, our Lord,

On the third day he rose again and ascended into Heaven and life everlasting.

* * *

Just as the surgery was about to begin, Father Perez appeared and gave Graham and Craig bottle caps full of Irish Mist. “Have a sip of this,” he said, looking at them solemnly, like a communion offering. “We’ll have a little more when you’re finished.” Then that damn smile of his. “And maybe even some poker.”

The surgical team was ready. Craig picked up the scalpel and cut into the soldier’s chest. He didn’t see or feel the grenade. Cutting deeper, he entered the chest cavity and pushed the lung gently aside. There was a soft, metallic scrape when a retractor was repositioned. The fins and propeller were resting against the lung, the egg-shaped grenade lay on the diaphragm. He turned around to the ordinance expert who was standing outside the ring of sandbags, his face covered with a Plexiglas mask.

“It’s right against the diaphragm,” Craig said.

“Go get it,” the ordinance expert answered. As Craig turned back to the patient, he saw Father Perez standing on the other side of the table behind Graham, inside the sandbag ring, hands together, no flack vest or helmet, his fatigues soaked with sweat. Their eyes met. Father nodded. Craig cut away the bleeding red muscle with tremulous hands until the grenade could be brought out of the soldier’s chest as easily as taking an egg from a carton. Sweat dripped into the wound and onto to the bomb’s dull casing. Protecting the propeller with one gloved, bloody hand, Craig handed it over the sandbags to the ordinance expert who placed the grenade carefully into the armored box, closed the heavy lid, and wheeled it away. Someone mopped Craig’s face and cleaned his glasses. During those few seconds, he recalled Hemingway’s story about a terrified soldier huddled in a trench, continuously praying to Jesus as bombs exploded, saying he loves Him and will forever be a disciple if God spares his life. The next night he is with a girl at the Villa Rossa and does not tell her or anyone else about Jesus.

Craig looked around the morgue as orderlies brought back the bodybags from the hallway. He looked over at Graham standing at the other side of the cot. The surgeons grasped hands in sweaty relief.

They looked for Father who, a few moments ago, had given a thumbs up and pointed to the Irish whiskey in one of his pockets.

But he had returned to the Vietnamese mother with the brain-injured child.