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Combat Medicine

The Spirit of Good Medicine

Chuck Fenwick, Navy Corpsman,
Combat Medicine Instructor

by Chuck Fenwick,
Navy Corpsman

Reprinted with permisison from: Semper Fi Magazine , and
The Journal of the American Civil Defense Associaiton

It was midnight and I was the only Corpsman on duty. The ward was quiet and I had just finished charting for the 25 or so patients. The ward was the dirty-ortho ward at Great Lakes Naval Hospital.

It being a "dirty-ortho" ward meant that every patient had difficult-to-treat infections and bone involvement---usually several severe fractures and/or missing limbs.

The welfare and recovery of the patient dictated ward duties which consisted of: Changing bandages every 4 to 6 hours, starting and hanging IVs, pouring and passing medications, bedpans, bed baths, changing linen, hanging and adjusting traction, casts, shots, x-ray, transporting, meals, minor surgery, vital signs, nursing rounds, and of course, that dreaded charting.

At night though, things would settle down and at most, only two Corpsmen were needed, but in a pinch, one would suffice.

I decided that since things were quiet and considering these were Marines, I should make rounds and check on the patients.

Since all of the patients were confined to bed there is always something that needs to be done---quiet or not.

"Hey, Doc, my urinal is full." "Say...uh... Doc, my pillow fell on the floor. Can you hand it to me?"

No complaints or bed lights coming on, just, "Hey, Doc," when the chance presented itself and as a Corpsman I wanted them to have that chance.

I quietly started walking down the long row of beds with their sleeping occupants. I checked the drip-chamber of an IV here and the weight on some traction there, making my way toward the end of the first row.

About halfway down the ward a sudden noise distracted me and I turned to my left. No sooner had I turned to look than from behind me a Marine swung out from the bed and wrapped what was left of his two legs around my neck and pulled me up against the frame.

He laughed and said, "Gotcha, Doc! Nice ambush, huh?" Then his partner in distraction laughed too. Funny man, that Marine.

He was notorious for asking visitors to scratch his foot for him. We finally had to make a rule, "Mustn't Scare The Womenfolk!" Now he just picked on Chaplains and Corpsmen.

I continued on with my rounds until my last patient. He was in traction for a fractured femur.

In the daytime he was a good natured, extremely large Marine who reminded everyone of a pirate.

Tonight, though, he was making a little bunny rabbit out of his sheet and cooing to said bunny rabbit. I got up close to him and asked, "What's the matter with you, man?" No answer except for that baby talk to his little white rabbit. I looked in his eyes and, yep, nobody home.

I went back to the nursing station and started checking his records. He was on Ampicillin, some vitamins, something for itching, Surfak, codeine--PRN for pain and Seconal for sleep.

Nothing odd there so I checked his history. A gunshot wound, fractured femur, pseudomonas infection and that was it. I checked a little deeper. Ah ha!

He had been in the hospital on another occasion with a head wound, from a previous tour in Vietnam. Head wounds and barbiturates don't go together. We would have to figure out something else to help him sleep.

Thus it went, day after day, night after night on that ward. The patients were some of the war's worst wounded. We never lost a patient though.

The Corpsmen, Doctors and Nurses worked hard to make sure of that. Yet, it's not just the medical that carried the patients through to recovery, it was a certain spirit that the Marines had.

The ward was a place of laughter and smiles and high spirits. The Marines didn't complain or lose their tempers. They were polite and always said, "Thanks, Doc", but in an odd, almost complimentary way they seemed indifferent to their medical treatment.

It's as if they knew they would get the very best that the Corpsmen, Nurses and Doctors could offer. There was something different about the Marines on our ward.

Over the years I have worked on Dependent wards and in civilian hospitals and they are not like the Marine patients, but at the time I couldn't quite put my finger on that difference.

Truly, I did not understand because I could not understand--I was an outsider.

I think that most Corpsmen notice this difference and that is what draws the men and women of the Hospital Corps to the FMF. My father had been an FMF Corpsman in WWII, Korea and Vietnam. I had been through all the schools, but as yet had not been given a duty station with a combat unit.

Treating the wounded in a hospital is one thing, but applying your skills in the field and following in the footsteps of Corpsmen like your own father or Doc Bradley, Lipes, Ingram, Ray and a whole host of others, well, that is a different dance altogether.

The third time I volunteered for Vietnam, I got it! My turn at the wheel had come.

Combat Medicine and the Fleet Marine Force

The Honorable James Forrestal, Secretary of the Navy during World War II, had these words to say about the men and women of the Naval Hospital Corps for their singular attainments during that deadly conflict. This was the first time in military history any single corps had been commended by that office.

"Out of every 100 men of the United States Navy and Marine Corps who were wounded in World War II, 97 recovered.

That is a record not equaled anywhere, anytime... So, to the 200,000 men and women of the Hospital Corps, I say, Well done. Well done, indeed!"

Secretary Forrestal described the horrific conditions under which the Corpsmen tended the wounded.

" ... while shell fragments ripped clothing from their bodies and shattered plasma bottles in their hands..."

From World War II until this day, of all the Medals of Honor presented to Naval enlisted personnel, Corpsmen own the lion's share with well over half the number awarded.

Other personal medals such as the Navy Cross, Silver Star, Bronze Star and Purple Hearts won by Combat Corpsmen number in the multiple thousands and are almost too numerous to count. During WWII, the cost was high with 1,170 hospital corpsmen killed in action with thousands more wounded.

Korea was no different. During the Inchon-Seoul operation of 1950 in the period between 15 Sept and 7 Oct, Corpsmen attached to the lst Marine Division treated over 2,800 casualties.

Of the seven Medals of Honor awarded to Naval personnel during Korea, a total of five were conferred upon Corpsmen for their heroic service.

The Corpsmen, Doctors, and Nurses manning the hospital ships in the Korean waters off those beaches found themselves in no better conditions handling 20,000 combat casualties, 30,000 non-combatant casualties and 80,000 outpatients.

In Vietnam, Navy Corpsmen were awarded 4 Medals of Honor, 30 Navy Crosses, 127 Silver Stars, 290 Bronze Stars and 4,563 purple hearts. Records show that we treated 70,292 Marine and Navy casualties and multiple tens-of-thousands of civilians. Our own death toll was not light at well over 600 killed in action.

Esprit de Corps

The men and women of the Hospital Corps did not suffer and die for themselves, but presented their minds and bodies to their units for a greater purpose. This willingness to serve is the esprit de corps to which they were drawn.

HM2 Chris Pyle wrote the following letter home just before being assigned to the first 1st Marine Division in Vietnam.

Many people have died to save another. The Navy Corpsman has had more honors bestowed on him than any other group. My life has but one meaning, to save or help someone.

Soon I will be going over to Vietnam. I have my fears and beliefs, but they lay hidden under my emotions. That's why God has made me so.

Someday I will see before me a wounded marine. I will think of all kinds of things, but my training has prepared me for this moment.

I really doubt if I will be a hero, but to that Marine I will be God. I am hoping that no one will die while I am helping him; if so, some of myself will die with him.

Love for fellow man is great in my book. It's true they make me mad at times but no matter who it is, if he's wounded in the middle of a rice paddy, you can bet your bottom dollar that whatever God gave me for power, I will try until my life is taken to help save him, and any other.

Five months later, on 28 May 1969, HM2 Pyle was killed in action.

As Americans we would do well to learn from their struggles and the men they loved. From faceless heroes came priceless information which revolutionized the world of medicine and surgery. To this day there is no medical practice or attendant service which has not been touched and enhanced by Combat Medicine.

Medical Excellence

Yet, what is so unique about Combat Medicine that it eclipses all other forms of Emergency Medical Technique? Probably the best way to answer this is to tell what the field is not.

Combat Medicine is not just First Aid, First Response, or any of the other euphemistic terms for, "keep 'em alive until the doctor arrives." Neither is it Alternative Medicine which is suddenly being "rediscovered" by the masses.

It is definitely not crude or improvised, unless the saving of lives can be considered crude. Combat Medicine is the very best of all of the above, and without question, it is much, much more.

Field Corpsmen are trained to not only respond, but to be the only response in obstetrics, mass casualties, surgery, pharmacy, orthopedics, nutrition, and sanitation - even pest control.

When there's no 911 to call, ambulance, medevac, aid station or emergency room, whether on a hunting trip or atop Mt. Suribachi, the basic principles of Combat Medicine cannot be equaled when it comes to the survival of the patient.

What is accomplished in the field is often done without the aid of the marvelous life-saving machinery found in sickbays, emergency rooms and ORs.

Combat Medicine is a technique borne by the heart, mind and hands of the individual responder which insures the survival of the sick and injured.

In its simplest, the Navy takes a man or woman, gives them a few weeks medical training, a medical bag and puts them in the field with the Marines.

The Navy and Marines will expect the Corpsmen to perform their duties by caring for the sick and injured in a manner which exceeds the success rate of any civilian hospital or trauma center.

They will accomplish this in all weather, terrain and, if called upon, while under fire.

My Pleasure and Honor

I had the pleasure and honor of serving as a Combat Corpsman with the 1st Marine Division, 1st Reconnaissance Battalion--RVN, 69-70.

I served on other bases in hospitals and dispensaries around the world, but it was as a Recon Corpsman that I came to realize what we did affected the future in ways we might never understand or suspect.

I had been medevaced to Guam to recover from a concussion and hearing loss. While awaiting orders back to my Recon unit, I was working in a dispensary. As is par for the Navy, my Chief "suggested" that I, without delay, go get my hair cut.

So I, without delay, went to a small PX where Marines and Corpsmen took their turn being shorn. My barber, who looked to be from Guam or Okinawa, began snip-snipping away with his long scissors.

He was one of ours, a U.S. Navy “Steward” with the rank of 1st Class (E-6). I had a name tag that said “Fenwick” and was wearing my insignia and rank. Suddenly the man stopped cutting my hair and pointed his scissors at me.

I swear they were pointing at my throat and he wasn't smiling. In a strong voice he asked, "You Ralph Fenwick's boy?" My mind was racing as I tried to figure out what my Dad could have possibly done to make some guy point scissors at me.

I finally said, "Yes, I am."

The Navy Steward said, "Tell your Daddy I said, 'Thank you.' " He then went back to cutting my hair. I mumbled that I certainly would. I could breathe again and was happy just to be alive.

After a few moments, I asked, "Do you mind telling me what I'm thanking him for?"

He paused, pointed those scissors again and said, "Your daddy liberated me from a Japanese POW camp!"

When I went back to the dispensary I called my father in Oklahoma and told him what had happened and asked if he remembered the man's name. He didn't remember and as he put it, "Oh hell son, we did a lot of things and I don't remember the names."

It made me think about who I might be working on. It might be Marine, or child or an old woman who needs a bandage on her hand. It might also be a future George Washington or someone's grandmother who was thought to be lost.

And to "Ralph Fenwick's boy" they are just a swirl of faces or some injury that needs tending.

Passing on the Spirit

I teach now. I founded Medical Corps in 1995. The "Corps" in Medical Corps is named after the Marines--just because I could do it. We teach Combat Medicine to the public, the military and our private contractors. We are the only people in the world who do this.

I always ask if there are any Marines in class and there always are. There are also Air Force, Army, Navy and Coast Guard. Doctors and nurses, mothers and fathers, missionaries and policemen will be there too.

I look at the class. They are a sea of bright smiling faces and they expect something from me because I am a U.S. Navy Combat Corpsman.

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