Dr. Ron Smith served in the United States Army from 1966 to 1968. He is a Wyoming native and practiced internal medicine and infectious disease at the Billings Clinic. This is part of his Vietnam story. For the complete interview, go to www.billingsgazette.com/Vietnam.
Gazette: What was life like for you before the Army?
Smith: "Well, I was finishing my residency at the University of Washington, and I had been the chief resident at the VA hospital. Being a procrastinator, I had not joined the Berry Plan, where you are given so many years and then you go into the military. Being a procrastinator, I thought, 'Gee, maybe I ought to see what my doctor's draft status is down in Wyoming,' so I called and they said, 'We're drafting three, and you're No.3.'
"I had interviewed down in Wyoming and here at Billings Clinic and at Missoula. So, I called them and said, 'I'm going into the Army.' As time went on, I heard that I would not go in until October. The residency ended the 30th of June. I was wondering what we were going to do and how we were going to feed the family, if you will. So, the people at the university said they'd find a spot for me for a few months, which was very nice.
"But, Allan Goulding an internist at the Billings Clinic, who was sort of the recruiter and said that we were losing one their internists and could I come for three months because that's vacation time and everyone wants to be out in the mountains? We said sure, and they found a house for us to rent, mostly furnished. So we were here until early July until the end of September, and it was a great experience."
Gazette: I don't think a lot of people realize that you weren't necessarily given a special exemption because you were a doctor.
Smith: "You are, and you aren't. It was a special draft called 'the doctors draft' — totally different from the other one. For one thing, we were much older. But the big thing: You should go to Butte or Cheyenne for a physical exam or you may volunteer — obligated volunteer for two years, but you can come in as a captain. I said, 'What happens if I just want to be drafted?' And they said, 'Well, you won't be practicing medicine.' That did not seem like a good deal. And that's one of the big differences. One of the peculiar things is that you suddenly go from being a civilian to being a captain."
Gazette: Did you have any military background?
Smith: "I had two years of (Reserve Officers' Training Corps) at the University of Wyoming."
Gazette: Do they put doctors through boot camp?
Smith: "It's called 'military service school' down in San Antonio. It's six weeks. That's the first thing you do and they teach you how to wear the uniform, where to put the insignia, how to march, which is hilarious because you have all these men with many years of education and we all had two left feet.
"Then you got to do some interesting fun things — a night compass course. You have to go through an infiltration course where you crawl underneath a barbed wire and there's live machine gun fire on top of you. It's like playing guns when you were a kid in a way. You also didn't want to get scared and stand up. They watched you very well.
"One sort of funny thing happened: There was a very large orthopedic surgeon there and they had dug this special trench for him because he did not fit under the wire. It was obvious where he was going."
Gazette: On one hand, you're a doctor completing a residency and then you go to the Army, and that doesn't necessarily translate.
Smith: "It does and it doesn't. It's one of the differences about being a physician in the military as opposed to a draftee. Your job is to take sick or wounded people. There was always some tension the Army way and what we thought was the proper way. Of course, we were young cocky guys who just had lots of training, so there is some tension there. If you have any sense at all, there's a line as to where you can go and where you can't. The military knows their business well. It is sort of an interesting relationship.
Gazette: I imagine practicing medicine is a lot different in a combat zone than if you'd just stayed here, right?
Smith: "Everybody was young in Vietnam. Everybody's not young in a general internal medicine practice."
Smith went to the 93rd Evacuation Hospital, which was in Long Binh.
Gazette: How does practicing medicine differ and what's it like? Are you seeing the same types of cases?
Smith: "As an internist, you did not care a lot for injured people, just like if you get hurt in the Billings hospital, you'd see a surgeon or an orthopedist or an (emergency room) doc. You had an assorted day. You had clinics that you'd go to. You were on call. You got all of the admissions from 4 p.m. until 7 the next morning and we admitted the patients during the day that came, internal medicine patients that were screened in the ER.
"... The days that you were on call you could get many, many admissions and other times — there was lots of boredom in between. There was this scheme that we forwarded the 1st Infantry a lot. They'd go out on an operation and the surgeons would be very busy for several days and everybody was flown in on helicopter. They'd be very busy and then about three days later, people with fevers would start coming in, and we'd get very busy. In between, it was often very boring, and we all wanted to be busy. It was easier spending your year being busy other than sitting around griping. We played volleyball and softball at times."
Gazette: What were the conditions like in a hospital in Long Binh and how did it differ from what you were used to? What was Vietnam like?
Smith: "Everybody says that when they opened the door of the plane, it was like a blast furnace and that's just absolutely true. It's unbelievable. At Tan Son Nhut, you could hear 'harassment and interdiction fire,' which wasn't aimed at anyone, but in case someone was trying to sneak in. Hearing that at night was a bit unnerving. It was hot and humid and people mentioned the smells. It was a different place and pretty interesting.
"Then, when I finally got assigned, we drove to Long Binh, 23 miles away, and was interesting to see the tropics. I'd never been to the tropics before — a totally different lifestyle, a small community, look like very frail buildings that would blow away but don't seem to. Long Binh was a huge logistical base. Our hospital was sort of toward the north end of it. It's pretty barren. A lot of things were paved. There was hardly any vegetation in this logistical center.
"Our hospital was interesting in that the wards were made up of four quonset like buildings which were hooked together in a cross. It was very efficient. The center part was the nursing station where the charts were kept. Each branch where were the beds were on each side. It was very efficient. In terms of work, it was not unlike being in a regular hospital. It wasn't like being at Deaconess or St. V's like I was the previous summer. Those were pretty plush. This was basic. But it was quite efficient."
Gazette: Was it primitive as far as the technology and the care? Was it basic but adequate?
Smith: "We didn't have as many lab tests or quick as you could get it here. Looking back that many years ago, the number of lab tests now are just huge compared to what we had. We could get the basic stuff done and the equipment was fine. We had X-rays, and it was long before the days of CT scans and MRIs. People were experts at reading malaria smears."
Gazette: When you got there, what was your first impression of the hospital and Long Binh?
Smith: "It was very strange. As I think about it, there was a tropical lethargy, especially when you get there, and it's hot and humid, and you're wearing these fatigues and you're sweating and miserable. I thought when I got to the hospital there'd be people greeting you and helping you out, but everybody just didn't seem to care. They had the blahs, and I had the depression and blahs. But that gradually changes as you get to know people.
"Someone took me on a tour, and I stayed in a GP medium tent for several months, which turns out was pretty good living. We could roll the sides of it up to get a little cool, semi-cool breeze. The roads were dirty roads and they gradually paved them. We used to laugh and say, 'We think we're going to win the war because we're going to pave all of Vietnam.' There were some other docs in the tent, some from Mayo Clinic, who were assigned to the 36th Evac Hospital on the other side of Long Binh."
Gazette: You're not seeing the guys coming in right off combat, right? Those guys, I imagine, need surgeons or trauma specialists.
Smith: "Usually not, but we had a couple of mass casualties where everybody chipped in. Guys would come in by helicopter who had high fevers, diarrhea and a wide variety of illness, and we would be the medical officer of the day would decide whether they would be admitted or whether they could go back. Your colleagues in your specialty would be on call during the day, taking turns admitting patients."
Gazette: You were married at the time. Did you have a family?
Smith: "I had two kids."
Gazette: We haven't heard much of that. Most of the vets we've spoken with may have had a wife, but how was that for a family?
Smith: "It was very difficult. ... I had a son who was about 2½, and our daughter was 9 months old. Communication was difficult. I actually found some old letters that my wife and I have been reading. I'd be talking about one thing and she'd be writing about another. Sometimes, you'd get three at a time, sometimes none for 10 days. It was very frustrating. ... You didn't know what was going on at home."
Gazette: What were the most common things that you treated — that came to you?
Smith: "You get colds and flus, and diarrhea was very common. You could get high blood pressure in some people. Asthma in some. They'd tried to screen individuals who had asthma out of Vietnam, not coming there because many people had asthma reactions when they got there. That was fairly common. Chronic diseases that you see so prominently here, diabetes, hypertension, coronary artery disease, things like that — that was almost unheard of. We did have one heart attack while I was there."
Gazette: Because those are diseases associated with older, sedentary populations, and that was not Vietnam?
Smith: "Most everybody was young, in their 20s and 30s."
Gazette: So you saw malaria, and we've heard a lot about malaria. That was a concern?
Smith: "People with malaria are very ill, fevers of 105, 106. They're shaking and their temperature goes way up, and then they start to sweat and then they're shaking because they feel cold. They're very, very ill. There's a significant mortality rate to malaria."
Gazette: Could you cure them and would they go back?
Smith: "We'd cure them, and they'd go back in the field. There's all kinds of malaria.
"I have to tell you a story: Gen. (William) Westmoreland was coming to visit our hospital and he hadn't been there as far as I knew and that's a big deal. This was supposed to be a secret, surprise visit. That wasn't true at all.
"Some of his adjutants came and talked to us and they said, 'Doctor, Gen. Westmoreland will be visiting most of the wards, but not the medical wards.' Of course I said, 'What?' He said, 'No, they're there with malaria because they did not take their anti-malaria pills. ... I said, 'That doesn't work for falciparum malaria, which is the kind we have. That's totally resistant.' He said, 'The general will not be visiting the ward because they're sick because they didn't take their pills.' I said, 'Colonel, that's not true.' ... He very sternly looked at me and said, 'The general will not be coming.'
"I was smart enough that I shut my mouth, but I was very angry about that. And, (Westmoreland) didn't (visit). But he visited the genitourinary ward — 'the GU' ward — which was filled with soldiers with complications of venereal disease, which we laughed at because that was in the line of duty?!?"