Broken Bodies, Shattered Minds: A Medical Odyssey From Vietnam to Afghanistan

by Ronald Glasser M. D.

  All of this was, of course, not so much a way to win as it was a way not to lose. That was no small thing when the only other alternative was simply to take the pounding and die in place. But for the Vietnamese, the war was not to be a sprint, but a marathon.

  It was a desperate policy, but in the give-and-take of war, it worked. Quick attacks, close-in ambushes, the breaking off of contact before the gunships and fighter bombers arrived, became the North Vietnamese way of neutralizing both American technology and American firepower. And of course, the other part of the strategy was the willingness to accept both civilian and military casualties. We would lose some 58,000 soldiers and marines over the next ten years while the North Vietnamese would lose close to 2 million.

  But what was of real interest to military historians were the different conclusions drawn by the North Vietnamese Government and military compared to our own Government and Pentagon about that first battle in the Ia Drang Valley. The Johnson Administration, backed by the hawks in Congress as well as the Pentagon itself, viewed what had happened on the ground as a positive; that a death rate of ten to one meant that a war of attrition would surely prove successful. The Vietnamese took a totally different view.

  In Hanoi, President Ho Chi Minh and his military commanders came to the conclusion that they could eventually win the war. Senior General Vo Nguyen Giap—a school teacher who had turned military genius, defeating both the Japanese and then the French in the years following World War II—correctly understood that the helicopter was the newest and most important innovation in the war. But he also had grasped that for all their virtuosity, the use of the helicopter was not a strategy but merely a tactic—a powerful tactic to be sure—but still no more than a tactic. “We thought the Americans must have a strategy. We did. We had a strategy of people’s war. You (the Americans) had only new tactics … your helicopters … you need decisive tactics to win a strategic victory … if we could defeat your helicopters then we defeat your (lack of) strategy. Our goal was to win the war.” In short, the Vietnamese saw nothing different in our strategy from the French. Basically, despite all our power and technological advances, we were relying only on tactics. General Giap knew that in the long term the helicopter, as well as the new technologies, would not be enough. And of course, the North Vietnamese were willing to take whatever casualties it took in order to win. Despite what the experts and even the pundits might offer, in any war the enemy does have a say in how things turn out.

  General Giap wrote with uncanny insight about what would be the future course of the war:

  The enemy will pass slowly from the offensive to the defensive. The blitzkrieg will transform itself into a war of long duration. Thus, the enemy will be caught in a dilemma: He has to drag out the war in order to win it but does not possess, on the other hand, the psychological and political means to fight a long-drawn-out war.

  At the beginning of the Iraq and Afghanistan wars, the numbers of patients suffering flashbacks who were being admitted to the PTSD clinics of the VA hospitals quadrupled. What surprised the physicians and psychologists running the clinics was that these patients were not those who had recently been deployed to Iraq and Afghanistan; they were the Vietnam veterans whose remembrances of the war had been reactivated by the deployment of a new generation of young soldiers and marines sent into what appeared to be another hopeless war set out once again at the very borders of things. But that kind of reactivated PTSD would eventually affect the whole country, if in no other way, through the personal desire not to remember and then the collective effort to simply forget.

  James Kitfield, in his 1995 book, Prodigal Soldiers: How the Generation of Officers Born of Vietnam Revolutionized the American Style of War, deals with the years from the end of the Vietnam war to the First Gulf War in 1991. He documents the lives, ideas, and struggles of those few officers who, at great personal sacrifice and facing enormous professional and public ridicule, stayed in the military after Vietnam to reinvent and reconstitute an army and a military culture no longer crippled by the effects of that war, nor abused by those it was pledged to protect.

  Those officers focused on re-establishing morale within the military, the confidence of the country in its armed forces, and a new professionalism among the officers and enlisted ranks. The “Be All You Can Be” motto came out of that era of rebuilding, as did a more defined role for committing the U.S. Army, Air Force, and Marines.

  The history of our military during the late 1970s, through the 80s and 1990s was also one of refinement of tactics and force structure as much as it was strategy. The change in strategy was simple enough. The new post-Vietnam doctrine—put into place by Secretary of Defense Casper Weinberger and Secretary of State Colin Powell—insisted on no war without first putting into place overwhelming force. No war without the commitment of the whole country. No war without well-defined goals and no war without an appropriate and attainable exit strategy.

  But unfortunately the operational emphasis of this transformation was again on “things.” Much of the effort and focus was on increasing the lethality of weapon systems, with the blueprint for it all being a military able to defeat any army anywhere in the world. Apparently no one asked if our new enemies would actually be armies. But whoever the enemy might be, technology became the default mode for the transformation.

  The Army, Air Force, Marines, and Navy developed computerized technologies to re-task combat assets in real time, and found ways to increase their strike capabilities by bringing more modern and lethal firepower to bear at those points where their new computerized programs indicated that maximum force would not only work but was an absolute requirement for success.

  Colonel Douglas A. Macgregor, in his monograph Breaking the Phalanx, recommended a reconfiguration of combat units to ensure more mobility and flexibility, while giving those units the ability to concentrate overwhelming force at the precise time and, at what were calculated to be, the exact and necessary points of engagement. Macgregor clearly understood that as a technologically advanced and innovative nation we should use those very talents to bear on the problem of military efficiency and effectiveness.

  The adaptations to what the military theorist had begun to call the new realities of both symmetrical and asymmetrical warfare were greeted with enthusiasm by the military-industrial complex only too pleased to develop the hardware to “extend the battlefield in both time and place” while giving both “increased informational awareness as well as immediate situational dominance” in the battlefields of the future. Change the vocabulary and you change the discussion.

  Those officers who stayed on to implement the new strategy with the new technical advances formed the nucleus of a military that would take on and defeat Saddam Hussein’s Republican Guards in less than 100 hours during the first Persian Gulf War.

  Smart bombs, in the form of satellite-guided munitions, were developed that could be sent through a second floor window in a four-story building, or take out a single truck on a bridge tracked by an unmanned predator drone flown by a technician using a real-time computer and joy stick seated in a tiny air-conditioned room at Nellis Airforce Base, Nevada—some 16,000 miles away from the bridge.

  There were the advanced combat optical gunsights and night-vision goggles to be used in both fog and mist, all of which were to allow smaller and faster units carrying lighter equipment and moving quickly to overcome larger and less nimble forces. There were even new computer-generated war games that clearly showed the inevitability of these newer lighter forces to win any battle, whatever the odds, by simply adding more modern and more effective technology into the mix.

  Mogadishu in early 1993, with two choppers shot down by simple rocket-propelled grenades and three more damaged by small-arms fire with eighteen American soldiers killed and over a hundred wounded, was a shock to the newly transformed military. What became clear in Mogadishu was that without old-fashioned armor, and with the vulnerability of helicopters to the close-in fighting of urb
an warfare, a firefight was really what it had always been. It was a group of gunmen against other gunmen, fighting not only to win, but to stay alive. And in those real life gunfights, the side with the most gunmen usually wins.

  And that was what happened in the streets of Mogadishu and would eventually happen in the streets of the cities and towns of Iraq and along the roads of Afghanistan. Even with half a million troops in Vietnam, we never had enough troops on the ground. The narrow streets, along with militias and the gangs of Mogadishu, should have told the military and our policy makers something new, but it didn’t, since all the Pentagon did was double-down on technology.

  Flushed with the increasing sophistication and lethality of our things, the concentration of enemy formations—whatever their size, configuration, or force structure—was no longer viewed as an issue. And in a way it worked, at least in 2001 and at least for a short time.

  There was an incident at the beginning of what can be considered The First American/Afghan War where a single Special Forces unit, using handheld GPS locators, called in air strikes on the hundreds of Taliban fighters blocking the passes out of the northern mountains leading to the wide southern planes of Afghanistan. The tribes of the Northern Alliance that had been fighting the Taliban for almost a decade and were all too familiar with the decade-long ineffectual Russian carpet-bombing, watched as U.S. F-16s dropped satellite-guided, 500-pound bombs to within twenty-five meters of their own positions. More than one uncommitted Afghan tribal chief, having watched the precision bombing that allowed the breakout onto the plains of Afghanistan, decided on the spot that they wanted to be on the side of these new guys. It was indeed a true example of real “shock and awe.”

  In a way, all this has made us look too good—if not to others then certainly to ourselves—at fighting the kinds of wars we want to fight, even if they are not the wars we are given. Our weapons have become too deadly, our tanks too powerful, our bombs much more precise, and our modern personal body armor too protective. But what technology gives, technology can also hide or eventually even give away.

  The last Administration did indeed take the country into Iraq in April 2003 with the world’s most powerful military. It had pushed for “faster, quicker, lighter” and by extension, a cheaper force structure supported by ever more lethal “on demand” fire power. And that is precisely what it had built. The past experiences of Korea, Vietnam, and Mogadishu were clearly ignored. It was not what usually happens when governments and their military go to war—starting out by fighting the last war rather than the current one—so much as simply fighting the wars we wished to fight and were convinced we would be allowed to fight.

  There were those in charge who cavalierly or foolishly felt that the most powerful nation on earth should be able to do as it chose. It has been reported that in a private conversation a Bush policymaker was heard to say that “it never hurts a great nation to throw a small nation up against the wall to let everyone else know that the great nation means business.” Who said that had ignored or simply forgotten the past. The American historian Arthur Schlesinger stated as the Vietnam War began to spiral out of control that the four most dangerous words in the English language are, “This time it’s different.”

  Colonel Macgregor acknowledged, in his latest book, Transformation Under Fire: Revolutionizing How America Fights, that whatever the new technical advances, there is always the need for survivability once an army is set loose on an enemy force. You cannot ever discount the unexpected and fight a war on the cheap or at a distance.

  When American light infantry is armed with automatic weapons and the enemy has automatic weapons, any resistance encountered is stiff because conditions of symmetry prevail.

  What Macgregor is saying is that without the availability of sufficient quantities of armored equipment to use as stable and protected weapons platforms—and even with the ability to call in air assets—lightly-armed units moving through enemy territory are always in danger.

  Macgregor goes on to make the statement that whatever the situation, “When significant armor arrives on the scene, the battle ends quickly.” Yet, this ability to endure as well as survive was not only ignored but dismissed as unimportant by those who took us into Iraq and have now taken us back into Afghanistan.

  For well over a decade now, our light infantry has been sent out in under-armored transport vehicles to fight light infantry. And the increasing deaths and increasing casualties have documented the obvious. We now have Poly-trauma Units in our VA hospitals for a reason.

  In any war, weaknesses soon become apparent and those weaknesses are exploited, whether it is in Vietnam, Mogadishu, Iraq, or Afghanistan. We have a military that could level any city in the world in a few days and cripple or destroy any division of enemy troops caught out in the open within hours. Yet, our latest two wars have taken both our soldiers and our marines to the edge of the abyss. Unfortunately, while no one was looking, these are no longer the wars we wish to fight. In villages and cities and along highways and roads where quick and painless success was assured, our troops, inadequately protected, spread too thin, only partially armored, overworked and worn down, are paying the price.

  General Weyand ends his 1976 analysis on Military Tactics and Strategies by offering the following advice:

  As military professionals, we must speak out, we must counsel our political leaders and alert the American people that there is no such thing as a “splendid little war.” There is no such thing as a war fought on the cheap.

  The General wasn’t speaking to those who had been in Vietnam, nor was he speaking to the families of those repeatedly being deployed to the Middle East, nor to those who have already made the fight in Iraq or are currently on patrol up in the mountains or on the plains of Afghanistan. He was talking to all of us.

  6.

  MED-EVACS AND GUNSHIPS/A SHORT AND DEADLY TECHNICAL HISTORY

  It was true that unlike the French, who lost a whole army in Vietnam, we might have lost a platoon and even a company in an afternoon, and maybe a battalion by nightfall, but never a regiment and definitely not a division, and certainly, we would never have lost a whole army. You cannot mass against gunships or charge through mini-guns. Our slicks and gunships, loaches and Chinooks always kept us in the war and may well have kept us in Vietnam forever. But for all their versatility—the ability to overfly areas open to ambushes, to be able to get the wounded to hospitals in a timely fashion, to level areas the size of football fields with rockets and automatic fire, to deliver more troops to the battlefield while at the same time being able to bring in supplies and ammunition to units running low on both—they were very complicated machines with all kinds of mechanical problems that made them easy to shoot down. Whatever else can be said about helicopters, they are strangely fragile affairs.

  Even the tiny, glass-domed loaches that could hover motionless fifteen feet off the ground and pour machine-gun fire through the six-inch slit of a pill box, or slowly and maliciously track a man down a narrow jungle path, looked out of place in the air. Helicopters have none of the grace of an airplane and even less of the style. They seem to have to tug themselves off the ground. And once in the air they stay there, churning on through the sheer power of their engines. If anything happens to that power, and it didn’t take much in Vietnam and in Mogadishu, it doesn’t take much in Iraq and even less in Afghanistan …

  In a very real way, we paid a deadly price for this new technology. By late 1972, more than 4,000 helicopters had been shot down. A third of all the chopper pilots who had ever been to Vietnam would be killed, wounded, or medically boarded out of the Army. The average life span of any loach pilot, whether in ’Nam, Laos, or Cambodia, was somewhere around three months. Living any longer than that was no more than sheer luck. If you weren’t killed when you were shot down, you died when you crashed. The nasty little secret about choppers is that they have to be light-weight and so they’re made mostly out of aluminum and with their large gas tanks filled w
ith jet fuel they burn when they crash. Most of the burns in Vietnam, and there were a lot of them, were the result of downed helicopters. But the warrant officers who flew those choppers continued to volunteer and they still do.

  Those who chose to become warrant officers and fly choppers then, or now, are of a type—lean and tough, mechanically-oriented, obsessed with speed and daring, and incredibly brave. That too, like the medics, hasn’t changed. In case we forget, this was then:

  My God! One moment the chopper was there, charging in protectively across the perimeter, tail up, and the next it was gone, torn apart in a monstrous ball of flame. For a moment, the sheer unexpected violence of it all held them. Stunned, the troopers looking up from the mud, watched what was left of the chopper come hurtling headless out of the flames, a great torn piece of steel plunging blindly on across the paddy.

  And it doesn’t take much. A single AK round is effective up to 1,200 feet; a Russian-made 51-caliber machine gun can reach out to over 5,000. A 37-mm anti-aircraft shell is effective up to almost any height. A rocket-propelled grenade or a Stinger Missile will most likely bring down a chopper hit at any height. In the mountains of Afghanistan, the Taliban actually shot down at the choppers.

  In Vietnam though, most choppers were destroyed in the thirty feet above ground when landing or taking off. At Hunter Air Force Base and Fort Rucker, the main bases for training chopper pilots, they called it the area of translational flight, the space between hover and forward flight when the lift from the rotors is decaying and the lift from the forward flight has yet to build up. The stresses on the gear train and the rotor system are simply fantastic. If anything happens then, if a rotor went, or a round ground up the gearbox, if the hub froze, or the hydraulics fouled, there was no time to change the pitch of the blades and not enough height to allow for auto rotation. It was then and still is straight down.