"Triage"
by Bill Tom
Like a chaplain, a medic was non-denominational when it came to caring for the well-being of our troops. Both were obligated to provide care for every wounded or injured soldier, regardless of unit, rank, friend or foe. They worked well together in a common goal in WW II to heal so large a percentage of our casualties, spiritually and physically. However, there were circumstances when the medic had to make a moral choice that differentiated him from a chaplain because of a medical term called "triage". A chaplain will never give up hope on a man's soul, but a medic was sometimes forced to give up hope on a man's life.
During the First World War, the French army, swamped by the large numbers of casualties, had to devise a priority procedure, known as "triage", to guide their medics. A medic was to determine the severity of the wounds and treat them in an orderly priority. As far as the individual soldier was concerned, his own wound, no matter how comparatively slight, was always the most serious one. Therefore, a triage policy had to be instituted for a medic to summarily segregate those who needed to be treated first, since there had to be a wound that was far more serious than another with regards to survival. Yet, there could be a wound so serious that we cannot devote the time or effort to care for, as brutal as it may sound. That was what triage was all about and how it was to ease the battered conscience of the medic who had to make that drastic decision.
I was initially trained as a rifleman, but, at the last moment, I was converted to a medic. I was fortunate to have had some Red Cross training in emergency first aid and minor wounds while in high school. But, in the rush of war, the army gave me a minimal of exposure to actual wounds, with some hands-on experience in giving injections and sterile technique. There were a few black and white documentary films on treating gunshot wounds and how to pitch a hospital ward tent. The rest was strictly on the job training under fire, but I became a very dependable and dedicated medic. Initially, I comforted myself into thinking that a medic had a greater chance of survival in combat. It was not until many years after the war that I learned that 20,000 of our medics were killed in World War II, including many women nurses.
My first day in combat was a horror beyond all description or expectation. Not every wound turned out to be a simple gunshot penetration as demonstrated in the films. Furthermore, the wounds were no longer black and white images, they were gory gooey bloody red, and was terrifying and gruesome with torn off limbs and detached body parts. Life was in full vivid color of spurting blood, the sickening smell of warm blood; and the squishy feel of flesh and clots as we try to stem the loss of blood. Each new casualty meant another nice handsome young soldier cut down so early to become disabled or dead, but, yet, most of them were seemingly able to walk away with their wounds with little after-effect, thanks to the diligence of our medical service.
I will never forget the very first seriously wounded soldier I had encountered and whose life had to be triaged out of his favor. He was so grossly wounded that he was immediately beyond hope. He was a young infantryman who was found with an entry wound in the back with a gaping hole from the back through his chest cavity, with most of his right rib cage and his right lungs torn away. His heart was exposed and weakly pumping, but he was alive. We had no facility or replacement parts to keep him alive, and our entire supply of whole blood and blood plasma would have been insufficient to replace what he had already lost.
According to witnesses, that young soldier was dug in at a protected position during the battle. When a P-47 flew over, he got up out of his position to wave at that fighter which was brand new to that area at the time. The P-47 turned a loop and came back with his guns blazing. A ricochet 50-caliber round, perhaps, hit the soldier squarely in the back on the right side, exiting through the front. When viewed from his front, all I saw of him was his back bone, his heart in this gaping hole next to his bloody left chest. His main aorta was still intact and the blood loss was reduced to an ooze by his diminished blood pressure and a massive blood clot that had filled his body cavity. His heart was still pulsing weakly and his left chest did not appear to be moving, but he did not die. There had to be a reason why his heart did not stop.
He was brought to the 113th Evacuation Hospital where several doctors had a good look at the situation and they each shook their head to signify that the hopeless stage of triage was in effect. There was nothing that can be done out in the field, for certain, and there was nothing to be done even in a major hospital of that time, or at any other time.
That unconscious wounded soldier was simply left on the blood-filled stretcher to die. But he would not die. His heart continued to pulse. I stayed up with him through most of the night, absolutely helpless and hopeless, and wondering why God had not interceded. I had wanted his mother to know that someone was with him at his most desperate hours. A chaplain came by to say a prayer for him. In the wee hours, I lapsed into a snore, being all wiped out from the day's terror. When I was awakened at dawn, the wounded soldier's body was being carted away. He had finally met his Lord, with half of his torso torn off. How sad it was, how helpless, how sorry I was. I pondered how his company commander was going to explain that to the boy's parents, or about his valiant cling to life. I deplored the pilot who may have boasted how he had shot a German soldier that day.
Today, over fifty years later, that young man would now be about my age had he survived, but I still think of him as that young man. I wish I could talk to him to tell him how sorry I was for him. I will think about that young man for the rest of my days, and I will feel great sorrow for him for the rest of my life. My only consolation was that while we were unable to save his life, a chaplain was there to save his soul.