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Sunday Journal: Maybe time heals the instant war hero

Using the forceps with the finely serrated beaks, I found the bandage's edge, gritty adhesive seeping onto the adjacent skin and into matted hair. I teased the edge of the material and started to lift it. For a moment I felt as if I were Howard Carter, laboring over King Tut.

Underneath, densely woven gauze was stained brownish green with an irregular edge of blueish red and still held the dank odor of the jungle, which hung like a dark valley mist.

Sgt. Caldwell had been the platoon sergeant of an infantry unit in Vietnam's Mekong Delta when they came under small arms and mortar fire, as was later related in detail.

The platoon sergeant screamed, "Dig in!" while the lieutenant shouted to call on the radio for air support. Immediately Caldwell went to work with his small shovel but it was like digging in a pile of stale straw. He removed his entrenching grenade from his belt, pulled the clip, and tossed the grenade 10 feet away. The explosion blew dirt and stones into the air as it excavated the ground. He then threw a second grenade in to ensure it was sufficiently deep to shield his entire body. This time there was no explosion. He waited; still no explosion. The clamor and din of the firefight around and above him was terrifying. Keeping low, Caldwell crawled toward the hole. He leaned his head over the edge to see what was what. It was at that moment that the second grenade exploded.

As Cobra gunships hovered, spitting suppressive fire on the enemy positions, a Huey Medevac landed about 100 yards behind the firefight. Caldwell was placed in a poncho and was dragged to the helicopter. Once inside, an IV was started and with rotors whirring, he was lifted away.

Before long, inside a massive C-5A Galaxy transport, Caldwell was one of 100 casualties being airlifted stateside with a crew that included six trauma nurses. They stopped in Guam to stabilize some of the more fragile patients, but in a haze of morphine and trauma, Caldwell was oblivious to all of this. Upon landing in Denver, boxy ambulance buses quickly accessed the aircraft's huge cargo doors. Caldwell was gingerly handed down to the hospital medics and transported the last 2 miles.

Just a few short days ago, this healthy kid, who should have been in a college classroom, was bleeding in a far-off war. Now he was in the emergency triage area of Fitzsimons Army Hospital in Denver. In any prior conflict he might not have survived the day of injury. But time mattered. Rapid evacuation from the war zone was crucial for the specialized care he required. Now there was hope. Somewhat.

With each layer of gauze removed, clots of dirt and blood clung fast. The scrub nurse saturated the gauze with warm saline from a large syringe, easing its removal and exposing the wound that would be forever. She glanced up at me for a moment over her mask.

We were finally able to see the effects of a grenade exploding into his face, or what was left of it. By pure luck, he was spared the sight in his right eye. Beyond an irregular opening suggestive of a mouth, all facial features were absent. The remaining tissues were speckled with dirt and debris. The pattern of dark splotches and clots was, in a bizarre manner, suggestive of a Jackson Pollock painting.

Caldwell blinked. He was conscious. "How's it look, Doc?" he asked.

I offered a guarded smile. "It's really too early to tell," I said.

How could I explain to this young soldier that his life had forever changed?

"You'll need a number of surgeries and be with us for many months," I said.

"Doc, I don't feel nothin', no pain, nothin'. That's good, ain't it?" he asked.

How to explain that we were very limited in our ability to rebuild a normal face? How to explain that his life will never, ever be the same? My God, I thought, he is only 19 years old.

He would turn 20 before he would be discharged. In that time he was a hero living among heroes in this protective cocoon where men bonded, protected from the reality beyond these walls. The entire staff tried to potentiate this false reality; time was needed for the soldiers to rebuild their self-esteem while we rebuilt, as best we could, their bodies.

The day came when Caldwell was allowed to see himself in the mirror without bandaging or dressings. He was calmer than both I and the nursing staff. Before the big day he'd had a few sessions with the hospital psychiatrist concerning mind/body image. I really don't think he understood that message.

After more than a year the day came when Billy Caldwell was discharged. We had expended all our skill and a great deal of the government's money to put the pieces back together. He no longer looked horrible, but he never would look normal again either. His reconstructed facial features were frozen in place. His rebuilt nose and mouth resembled normal structures but were obviously wrong. A patch covered the left eye socket, reminiscent of the Hathaway Man. His silicone prosthetic ears were held in place by a medical grade adhesive.

I have often thought about Sgt. Caldwell and his young buddies — if survivors, now in their 60s. Perhaps, despite having confronted a terrible reality, they would persevere and enjoy a loving and successful life.

But it was more likely that, gone from this transitory sanctuary, some would fall into alcoholism and drug addiction, wake with screaming nightmares, be deserted by wives and lovers. They bore the scars of heroes but would live the lives of men.

Dr. Charles Walowitz was for a decade an officer in the Regular Army Dental Corps. He is a retired maxillofacial prosthodontist who for many years was head of the Division of Dentistry, Department of Otolaryngology/Head and Neck Surgery at the Greater Baltimore Medical Center. He lives in St. Petersburg.

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Sunday Journal: Maybe time heals the instant war hero 04/23/11 [Last modified: Saturday, April 23, 2011 5:30am]

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