Part 5: The Life of Gus Kappler MD, Vietnam Trauma Surgeon

Fully integrated in this equation is the soldier’s comrades, the “band of brothers” he entrusts to make certain he does not flee under fire, to ensure he kills when they kill, the buddies who help him choke down the fear, anxiety, and self-doubt and help him justify whatever has to be done during the patrol.  They are the ever-present support system.  They become his wartime moral conscience.  All for one and one for all.  And he is their support system.  If the unit is doing it, it must be justified.  They can’t all be wrong.  Without belief in the unit or platoon, there would be no cohesiveness, and no goals achieved as a whole.  Once the soldier leaves Vietnam, he no longer has a unit around him to reassure him that what he did was good or just or needed under the circumstances.  With time, he may not be able to keep the fear, or anxiety or doubt from cropping up.  When his subconscious memories seep into the mind, there is no longer a support system to help reassure him or suppress it.  Pulse may race, breathing may get rapid, the flight or fight response, long suppressed and ruled by the band of brothers, may materialize for conscious or unconscious reasons.  A bathroom door being slammed loudly in a pizza parlor may cause the soldier to want to duck for cover.  Even if he can control himself, his heart may race, or he may break into a sweat.  After all, not reacting rapidly to sensory stimulus in Vietnam may cost you your life.  On Main Street, these reactions may make you appear bizarre or feel like you no longer fit in with the normal society around you.  If his platoon buddies were still around, he would know exactly how to react or what to feel.  Now he is alone.  Naked.  His sympathetic nervous system, which controls the flight or fight response, stays finely tuned as if he were still in the jungle, but he’s not.  It wants to sound the alarm but its higher levels are trying to suppress the signals.  His mind is still at war but with itself.  The trauma and the response have been hardwired into the brain.  It becomes a challenge to be and seem normal.   

After TET, the mood darkened in Vietnam.  Dope, disillusionment, poor leadership, disgraceful decision-making, and an increasing number of casualties were the main ingredients boiling in the cauldron. The broth, being portioned out daily, began to poison the minds of the American soldiers.  The American public was not used to hearing about American war atrocities.  That was what made the My Lai massacre so surreal.  The moral code of war was not only breached, it was abandoned in My Lai.  Those type of atrocities were expected from Nazi’s, not American soldiers, who were surely above that level of barbarism.  What happened at My Lai and what does it reveal about the nature of man, society, or the cosmos? 

On March 16th, 1968, American troops engaged in what is known as Total War.  The indiscriminate killing of men, women, and children.  Total War blurs the boundaries between soldiers and civilians.  It makes no distinction between the two.  One could argue that Total War has been around since Adam took that first bite of the apple. Hominids, our pre-human ancestors, have been around for around 4 million years; homo sapiens, or modern humans, for about 50,000 years.   It’s hard to imagine a band of cavemen, raiding another groups cave in a dawn raid, would have bludgeoned the men to death but spared the women or children because they shunned moral turpitude.  If they were spared, it would have been for a calculated reason, enslavement, rape, to repopulate the tribe after pestilence or war.  Man is a complex being.  He is capable of self-sacrifice and charity, but he is also capable of ruthlessness and cruelty.  Sometimes, he is capable of both on the same day, or in the same act.  Man is the only animal that will kill for sport and torture is a uniquely human quality.  

Total War as a philosophy was used in the Crusades.  People were slain or not slain based on their religion, nothing more.  This included women and children.  Same for the ravages of Genghis Khan, as his band of savages swept West over the steppes, killing everything in their path and inadvertently unleashing the plague, or the Black

Death, into medieval Europe. The firebombing of Dresden was also an act of Total War, committed by the US and the British, as was the Holocaust.  Total War is achieving a goal without regard for how you do it.   

In Vietnam, the moral code of war was still operative.  Total War was not an American philosophy in Vietnam, according to Kappler.  My Lai, though, was a case in point of an individual act of Total War.  To the victims, however, philosophy or individual act, it mattered not.  What happened was due to a combination of factors, which trickled down to the soldier level.  The soldiers committed these horrendous acts based on a number of factors, including cumulative mental trauma during their military tour.  One could not imagine My Lai happening on the first day of everyone’s first tour.  

Even the moral code of war went over the falls in a barrel with what became known as the My Lai massacre, or in Vietnam, the Song My massacre.  Following the Tet offensive in January 1968, military leaders were both angry and embarrassed.  The 48th battalion of NVA were supposedly responsibly for the Tet activities specifically in Quang Ngai province.  Military leaders wanted the 48th battalion hunted down and eliminated.  As a result, elements of Charlie Company were dispatched to the area.  They expected to find the villagers gone to market and the remnants to be part of the 48th battalion.  What they found instead were the villagers themselves, and no elements of the 48th.  The villagers were preparing for the market but had not yet left.

11th Brigade commander Oran Henderson ordered his troops to “go in there aggressively, close with the enemy and wipe them out for good.” (Time magazine Trials: My Lai. 25 January 1971).

Captain Medina, an officer from Charlie Company who detailed the troops, was asked if that included women and children.  His response was lathered in controversy but was reported by some to say the following:  …to kill all VC and North Vietnamese combatants and suspects (including women and children, as well as all animals), to burn the village and pollute the wells.” (American soldiers testify in My Lai court martial, Amarillo Globe-News archived 29 sept 2007) Additionally, he stated, “They’re all VC, now go and get them.” A soldier asked, who was the enemy?   “Anybody that was running from us, hiding from us or who appeared to be the enemy.” (Walzer, Michael, Just and Unjust Wars, New York, Basic Books1977, page 310).  Medina reportedly added (to destroy everything in the village that was) “walking, crawling, or growling.” (Calley’s trial puts emphasis on CO. Bangor Daily News 21 dec, 1970).   The soldiers were repeatedly told that the villagers should be at the market, and anyone left should be considered VC.  Unfortunately, the villagers were not yet at the market and things quickly got out of hand. 

1st platoon was led by Lieutenant Calley, the only man convicted in the massacre, though many were charged.  Captain Medina remained outside the hamlet during the attack.  On entering the village, they found mostly women, children, and old men cooking over campfires.  A 1st platoon soldier drew first blood by bayonetting a Vietnamese man and then hauled another down a well followed by a grenade.  Others followed suit by executing about 20 women and children kneeling, terrified, in front of a temple.  80 villagers were then herded into a large irrigation ditch and were mowed down by a wild barrage of bullets under orders from Calley. Women were reportedly shielding their children and saying, “No VC, No VC.”  (Hirsch, Seymour, My Lai, soldiers' bullets silenced plea’s, prayers of victims, The Milwaukee Journal, 27 May 1970)

From private first-class Michael Bernhardt:  “I walked up and saw these guys doing strange things....Setting fire to hooches and huts and waiting for people to come out and then shooting them...going into the hootches and shooting them up...gathering people in groups and shooting them...As I walked in you could see piles of people all through the village...all over.  I saw them shoot an M79 grenade launcher into a group of people who were still alive.  But it was mostly done with a machine gun.  They were shooting women and children just like anybody else.  We met no resistance, and i only saw three captured weapons.  We had no casualties.  It was just like any other Vietnamese village-old papa-sans, women and kids.  As a matter of fact, I don’t remember seeing one military-age male in the entire place, dead or alive.  (Hersh, Seymour, Eyewitness account of the My Lai massacre, The Plain Dealer, 20 Nov. 1969).  

2nd platoon soon followed suit north of the village and 3rd platoon was later called on to “mop up” the action.  As many as 20 rapes were reported, including 9 rapes in girls under 18 years old, along with a multitude of gang rapes.  A helicopter pilot who happened to fly over the scene was astounded by the destruction and made repeated offers to help airlift the remaining casualties to the hospital.  His offers were rejected outright.  On landing, he found 2nd platoon Lieutenant Stephen Brooks about to hurl a hand grenade into a bunker of women and children who were too terrified to come out.  Thompson firmly volunteered to get them out and demanded Brooks holster the grenade.  He was able to coax out between 12 to 16 women and kids and stood over them, protecting them as a group, until they could be flown out in two batches.  He later received a medal for his actions.  

Captain Medina was given a commendation for the attack for reportedly “128 communists killed.”  General William Westmoreland, head of the Military Assistance Command Vietnam (MACV), commended Charlie Company for "outstanding action; "they had "dealt [the] enemy [a] heavy blow.” (Bourke, Joanna, An intimate history of killing, New York, Basic Books, 1999).   Afterwards, the massacre was covered up for one and half years until Seymour Hersh broke the story after receiving a secondhand tip from a soldier.  It became a major news story for years to come and came to define the war in Vietnam.  Calley was the only officer or soldier convicted.  He was sentenced to life imprisonment which was quietly reduced to three and a half years home confinement by the Nixon administration.  

What were the factors that brought about the massacre?  What could have caused these soldiers to exceed the boundless Moral Code of War?  Is it possible that Charlie Company’s first, second, and third platoons randomly attracted a majority of criminally insane soldiers and set them adrift in Brownian motion to wreak havoc on the Vietnamese people, or is there a simpler explanation, like Occam’s razor would suggest?  Certainly, the success of the Vietnamese TET Offensive was intimately involved.  Up until then, the American people relied on positive news reports from the media with typical Washington DC spin supplied by smooth administration and pentagon officials with slicked back hair, who artificially inflated kill counts and hyped overly enthusiastic progress reports of American success beating back the devil-like communists. When TET occurred, the military and government propaganda machine’s purposely distorted view that the US was winning the war was exposed as a lie.  The soldiers knew the truth.  Not only were they not winning, but they knew it was unwinnable, just as the French found out a decade before.  The US had learned nothing from their defeat. The military now needed a way to pull out, but to save face as it did so.  Unfortunately, that too years.  

Military command desperately needed a victory to turn the news cycle away from TET.  They were embarrassed and angry by the TET defeat.  Pressure trickled from the top down to produce victories at all costs.  The soldiers, their nerves already wound tight, were pressured to complete the task.  They were expecting a fierce battle for the hamlet, but when they arrived there were no VC in sight.  Instead, they found a village of women, children, and the elderly cowering in fear.  The soldier’s sympathetic nervous systems were fully activated, primed, ready for a fight. The stage was set for a modern-day calamity straight out of Dante’s Inferno.  

Arrector pili muscles embedded in the skin of the soldiers began contracting as they walked into the village, causing fine villous hairs on their sun-tanned arms and neck to stand erect.  Their skin was clammy, pupils dilated, pulse rapid, sugar levels climbing in the bloodstream for the energy necessary for the coming battle.   Blood shunted away from the digestive tract, hunger dissipated. The soldiers' minds were anticipating a fight.  Fingers felt for the comfort of the gun’s trigger.  They had already been told many times, anybody in the village at this time was likely VC and should be dealt with harshly. Even though they didn’t see any soldiers, their guard was still high, their nerves on edge for booby traps.  After TET, no one wanted to be the last to die in Vietnam.  They were taking no chances.  It was us vs them.   The soldiers were dirty, tired of living and sleeping in the jungle, their minds fried from the constant stress and danger.  They were on edge.  They were 20 years old, with poor impulse control, some worse than others.  All of them had seen horrific things up.  Some of them had done horrific things.  They are tired of swatting flies, killing mosquito’s and dealing with ants, centipedes, spiders and scorpions, not to mention bush rats.  Many are sleep deprived and battle weary, some are probably high on heroin or marijuana, purchased from the Mama Sans.  They know the villagers may be harboring grenades, knives, guns and know where the booby traps are. The villagers are a danger.  The soldiers are aware of every sound, every movement.  They are coiled like snakes.  They are waiting for the slightest provocation to unleash destruction.  They hate the Vietnamese, and they hate Vietnam, especially today, especially at this moment. 

The villagers stare in fear.  They were expecting to go to the market and now this unwelcome intrusion.  They know something bad will come out of this encounter and their worry starts to show.  The more panicked they get, the jumpier they see the soldiers get, and the soldiers seem plenty jumpy.  An unbridgeable barrier looms before them: language.  They cannot communicate with the soldiers.  Any attempt brings hostility and threats.  That much is obvious.  It is clear there are no NVA here.  The soldiers should know they have nothing to fear from them.  They are many, yes, but clearly all women, children and old men who cannot possibly hurt them.  Yet they remain belligerent.  The soldiers are trying to start a fight.  The villagers have been fighting for 15 years now and they are tired of it. They hated the French, and now they hate the Americans.  They are worried.  There are no NVA here, but they know the soldiers are determined to find some.  

A soldier bayonets a villager…the fuse is lit.  The Devil looks on keenly from his perch. The stage is set for man as beast.  It’s an act he knows all too well.

A total of 504 villagers were executed that day.  A memorial statue now stands in the village with the names inscribed of those killed.  

In 2013, something significant happed in Gus Kappler’s life that, like the title of his book suggests, allowed him to finally come “home” from Vietnam.  “I was beginning the first group of problem-based learning (with Cornell medical students).  I would memorize their names, so as they walked in, I’d greet them with their name.  And this Asian girl walked in, and I said, Hi, Mytrang.  A young man named Anfei was right behind her.  She walked past me and I’m talking to someone else and all a sudden I hear English spoken with a Vietnamese accent.  I hadn’t heard it in 50 years.  Oh, my God.  In Vietnam, I hated every Vietnamese.  It’s unreasonable.  But when our interpreter in the ER turns out to be VC, you just don’t trust anybody.  So, I just didn’t like any of them.  In fact, sometimes I called them subhuman.  In fact, we operated on the Americans first.  We let the partially trained surgeons operate on them (the Vietnamese).  We would send them to their hospital where they didn’t know what they were doing (Vietnamese surgeons).  

“By the end of that first class, I noticed her squatting on the chair.  Wow, I was back in Vietnam.” (Welcome home from Vietnam, page 165).   Kappler states Vietnamese women never sat, they preferred to squat.

“I treated her with respect.  And we’d talk.  I said, did you learn about the War ofAmerican Aggression?  She said, “yes.  But in Louisiana, when I got there, when I was 13, I learned about the Vietnam War.”  So, Mytrang and I just kept on getting closer.  Because Vietnamese culture is very forgiving and very supportive.  And their incidence of post-traumatic stress is minimal, because they come back to a community that supports them.  Our community didn’t support us.  She was probably one of the most brilliant students I ever had.”

She eventually married Anfei, who was from China.  “The three of us developed a love for each other, basically, and we were invited to their wedding in New Orleans.  They treated us like gold down there.  I was a little afraid, it was going to be the first time I was going to be surrounded by Vietnamese.  But they treated us absolutely beautifully.  They both got their MD/ PhD’s.  We (still) see them in New York.  She’s in the last year of dermatology.  He finished ophthalmology at New York Hospital.  They have a boy, and we’re their American grandparents.  She’s the “Finally,” in my book, Welcome Home from Vietnam, Finally.   It wasn’t the government, it wasn’t my wife, it wasn’t my kids.  Mia (Mytrang) was the Finally.  She allowed me to heal.  It wasn’t writing my book that was a catharsis.  The catharsis was letting my guard down.  The trust of the Vietnamese.  I’ve never said that before, but probably that was it.  Then feeling ashamed about how I felt all those years.”  

There was a more subtle killer in Vietnam called Agent Orange, and its use was pervasive.  Unfortunately for Kappler and the rest of our soldiers, contact with it was unavoidable and in the end it may have harmed more US soldiers than the Viet Cong.  Between 1961 and 1971, 20 million gallons of that herbicide was sprinkled over South Vietnam.  The chemical was sprayed from American UC 123K aircraft in what was known as Operation Ranch Hand in an effort to defoliate the jungle so the enemy was deprived of camouflage and cover and to damage the food supply that the military suspected was feeding the NVA army and the Viet Cong militia.  It is estimated that 20% of the rich, lush jungle of Vietnam was destroyed, some of it never to regrow, and approximately 25% of mangrove swamps, which are important for the ecosystem.  Even worse, some of the spray dropped from the sky sprinkled Vietnamese men, women and children, causing skin and eye irritation, and sinking into soil, which the rains washed into the rivers, thus contaminating fish, which the villagers would eat. It also contaminated fresh ground water resources.  The US army’s Chemical Warfare Service first developed chemical weapons at the end of World War 1.  Agent Orange was developed by Dow Chemical and Monsanto and consisted of 2,4-dichlorophenoxyacetic acid(2,4-D) and 2,4,5,trichlorophenoyacetic acid (2,4,5-T).  As a byproduct of making 2,4,5-T, another molecule called 2,3,7,8-Tetrachlorodibenzo-pdioxin is produced.  This molecule, also called Dioxin for short, is one of the most lethal chemicals ever produced by man.  It has been implicated in miscarriages, congenital malformations (birth defects), and innumerable cancers.  It is estimated that 400,000 Vietnamese have died as a direct result of dioxin exposure.  The number of American servicemen exposed is probably close to everyone who ever fought in the Vietnam War.  The chemical persists in the Vietnam ecosystem even today.  There is a direct correlation between spinal bifida and Agent Orange exposure based on three separate studies.  (Ngo, Anh, Taylor, Roberts, Paternal exposure to Agent Orange and Spina Bifida, European Journal of Epidemiology, jan 2010).  Dioxin levels have been found in human milk, adipose, and blood samples (Schecter, Agent Orange and the

Vietnamese, American Journal of Public Health, 1995).  Based on studies conducted in and around Bien Hoa, a south Vietnamese city, blood samples were positive for Dioxin 20 years after the Vietnam War, and present in the blood of emigrants to the city and children born after the war officially ended, indicated its continued presence in the environment. (Schecter, recent Dioxin Contamination from Agent Orange in Residents of a Southern Vietnamese City, Journal of Occupational and Environmental Medicine, Lippincott, Williams, and Wilkins, May 2001.)

“Dioxin is probably the most vicious chemical known to man and they doubled the concentration for Vietnam.  Vietnam is jungle.  Get rid of the jungle, and you can see the enemy.  Great idea.  Destroy all the rice in the south, so the North Vietnamese don’t have food to support them.  Force all the population to go to the cities.  Get them out of the periphery.  (The only problem is) Dioxin is harmful to human beings.  Military scientists responsible for supporting the use of Agent Orange assumed it would only be dropped on the enemy.  Idiots!  A total of 20 million gallons gets dropped.  On my hospital compound, to clear the area for the 85th Evac and the airport, a total of 54,000 gallons of Agent Orange was dropped.  The C-123 planes were designed to spray from the wings, but there is no accounting of what was dropped from helicopters and from handheld units.  We have a video, and pictures, of kids (soldiers) standing there, with no shirt, and holding a hose spraying Agent Orange.  It’s gone (the vegetation) in a couple of weeks, then you take a bulldozer and clear the area.  It’s in the water, it’s in the dust, it’s in the clothes.  It’s on your skin and you’re inhaling it.  And the VA denied the problem for 20 years.  Now, there are probably 20 different diseases that are compensable from the VA because there is evidence they are related to Agent Orange exposure.  

My first one (cancer) was basal cell carcinoma of the skin.  I had the first one removed in the Army.  Now I’ve had 65 of them.  My second cancer was cancer of the colon.  Now, they don’t consider that compensable, but I think they are lying through their teeth.  Because if you can get cancer of the rectum (compensable), you can get cancer of the colon.  And (I had) melanoma.  About three years ago, I was diagnosed with Chronic Lymphocytic Leukemia.  Blood dyscrasia’s, neurologic diseases, they’ve all been traced to Agent Orange.  Most recently I have atrial fibrillation and congestive heart failure, both of which the VA is now agreeing is service-related due to Agent Orange.”  

The population of Vietnam was estimated at 37 million in 1965, just prior to the escalation.  It is estimated that 2 million civilians died in the war, and 1.1 million North Vietnamese and Vietcong soldiers.  America suffered 59,000 losses, South Korea 4,000, Australia 500, Thailand 350, and New Zealand 36.  (Britannica, The Vietnam War.).   In addition, Vietnam itself was partly defoliated and the land and water poisoned for generations to come.  All in the name of protecting the world from Communism.  Furthermore, many of the soldiers who fought so gallantly in Vietnam returned home with heroin addictions, hepatitis B or C from blood transfusions, war injuries, some of them horrific, PTSD, and Agent Orange exposure.  They were never thanked or welcomed home by most of the populace.  Despite the horror and hardship, Dr. Kappler doesn’t resent his time in Vietnam.  He states it solidified his surgical skills, and he was able to avoid PTSD.  And finally, thanks to a young Vietnamese woman named Mytrang, Dr. Gus Kappler, after 45 years, was able to come to terms with his feelings for the Vietnamese people. For that he feels lucky and grateful.