Authors: Peter Glassman
There it was, a “good luck Adams” with a date that preceded the Subic Bay arrival. Sergeant Adams’ cast was in fact a Vietnam applied plaster which now presented as an opportunity Corpsman Perkins couldn’t resist. Perkins logged the cast as a Subic Bay application and put it in a laundry bag which he placed in his locker.
Perkins closed the door and took out his small notebook. He entered the long leg cast with the day’s date as going to regular trash disposal as if it was not a Vietnam applied dressing. He’d make the call to his outside connection as soon as his shift was over. All casts validated as being put on in Vietnam had special disposal rules.
Chapter 4
Admission and Triage
Regardless of how the air-evacs to Queens Naval were pre-sorted and dispatched from Fort Dix the train patients and the bus patients had to undergo further scrutiny and assessment. Some physical status categories may have changed from stable to critical. Post-surgical patients with medical problems might be properly assigned to medical wards to take care of fluid and electrolyte imbalances and a surgical consultation obtained. Medical patients may have to be further separated into gastrointestinal, cardiovascular, pulmonary or infectious diseases and then dispatched to the appropriate hospital wards.
The JMOOD and JNOOD generally met the train and checked the patients before they were allowed into ambulances to the ER for admission. The timing was critical because they were always short staffed and couldn’t manage the huge bus loads and the train at the same time. It never seemed to be a problem. The JMOOD’s paging light blinked off-and-on–580, 580, 580. Queens Naval had a light paging system instead of a beeper or PA system. When the light number 580 flashed Dr. Paul Norman called the operator and got his message.
“Dr. Norman here.”
It was Zettler. “The two train patients are here sir. We’re at the ER.”
Norman approached the JNOOD. LT (JG) Minnie Zettler and Norman had served many watches together and had attended many train air-evac arrivals. “You said you had something else with the train patients LT Zettler?”
“Only one queer situation with the ortho patient in the total body cast. He has no IVs or indwelling Foley. He also came with his own corpsman according to this roster Dr. Norman.” Zettler and Norman used appropriate military and professional decorum in front of the hospital staff. Otherwise they would naturally lapse into first name address.
“Corpsman? He has his own corpsman?” Norman never heard of this scenario before but the Navy was full of surprises.
The gray Navy Pontiac ambulance with the plaster-clad patient was backed into the ER with its red dome lights flashing. Two ER corpsmen and the ambulance driver quickly maneuvered the bulky white Vietnam returnee onto a hospital gurney and placed two straps at chest and thigh level to secure him in place. Kaplan came up to Norman as the patient labeled Sergeant William Stiles was wheeled into an ER examination stall.
“Senior Corpsman Isaac Kaplan sir.” Kaplan explained his presence and assignment to the staff at the Queens Naval train depot and he would do it again in the ER triage area. “As you can see my orders are specific to whatever ward Boomer Stiles goes to.”
“Boomer?”
“He’s an artillery crew chief, sir. He prefers Boomer to William or Bill.”
“Okay Kaplan we’re glad to have you on board. We’re always in need of help.” Norman checked on Boomer Stiles on the ER gurney under Kaplan’s watchful eye and looked at the sleepy-eyed Boomer. “I’ll look at your X-rays in the ER before I send you to your ward.”
‡
Norman addressed the head ER nurse. “Let’s take care of these two train patients quickly. The air-evac bus is less than twenty minutes away.” He motioned Kaplan over to him.
Boomer’s X-ray jacket was almost an inch thick and was heavy. Norman had Kaplan select and place one X-ray film each of Boomer’s head, neck, torso, pelvis, arms and legs. “Wow. He’s lucky these fractures are all non-displaced. Not a one of them required surgery.” Norman couldn’t believe it. Most total body cast patients have a few long bones with plates, screws and nails or at least K-wires to fix the fracture in proper alignment. They also usually have showers of metal shrapnel fragments looking like a snowstorm on each X-ray. Boomer had none suggesting his injuries were concussion and shock wave related. Norman looked down at Boomer on the wheeled gurney. “You’re a lucky man. I’ll have the orthopedic resident see you on the ward.” He turned back to Kaplan. “I’m the GMO assigned to orthopedics for the next few months until I get my next assignment but I can get you placed on my G-1 staff. I’m short one corpsman. We’re always short of corpsmen.”
Kaplan addressed Norman while still keeping his eyes on Boomer. “Thanks Dr. Norman. “I’m part of a study by the Navy to evaluate the effects of continuity of patient care on decreasing the incidence of battle fatigue syndrome and depression. Keeping me on G-1 with Boomer will maintain my compliance with the protocol.”
“As I said I’m glad to have you on board.” He wrote the admission orders for Boomer Stiles for his assigned orthopedic ward–G-1. Norman found this most unusual for a corpsman’s request but hell; this Kaplan knew the patient and it would make his job easier.
“Okay and thank you sir.” Kaplan grabbed Boomer’s chart and wheeled his gurney out of the ER area with another corpsman at the foot end to help prevent Boomer’s protruding plaster clad legs from bumping into things.
‡
Brooklyn College had started out as a junior college granting a two-year Associates Degree. It was a stepping stone and guaranteed admission ticket to other full degree colleges and universities if a student’s grade index was good. Within five years Brooklyn College had expanded its advanced degrees teaching staff and was granted recognition to offer four year Bachelor’s Degrees. And today it had progressed with Masters of Arts or Science programs with future aspirations to offer advanced degrees with PhD awards in sciences first and other academic categories to follow.
Abraham Linsky was holder of a Brooklyn College Bachelor of Science in chemistry. He worked for an upstate New York chemical company for a while and became one of the first Masters candidates in toxicology and advanced organic chemistry. Linsky’s undergraduate income was supplemented in his senior year of undergraduate study by becoming an assistant to Boris Mindel, a middle-aged chemist who synthesized methamphetamine from pseudoephedrine cough syrup. Mindel also had a bachelor’s in chemistry plus many years with the drug cartel. He was a master cook converting pure crystalline cocaine to free-base crack “rock”cocaine. Since US involvement in Vietnam Mindel’s fulltime illegal employment included participation in various schemes to import heroin.
“Hey Boris I’ve been working for your group goin’ on two years now at the same salary. I’m in grad school now and I really could use more money.” Linsky saw the daily cash flow increase and he was frustrated at his stagnant pay rate. Linsky also wanted to have some of the material advantages of the lesser educated street dealers in his current work domain.
“I’ve developed an extraction process to remove heroin from calcium sulfate-plaster of Paris also known as gypsum. I need help and I might be able to get you more money once you get some expertise in this operation.” Mindel was cautious. Greed spawned an attitude of skimming and sloppiness. Sloppiness could get the person nabbed by the cops. The next natural sequence was to blab to the authorities to cut a deal for less or no prison time. On the other hand Linsky had never complained about the long work hours and this was the first and only time in over a year that he asked for a pay raise. Mindel made the decision to bring Linsky into the plaster cast operation.
“Once I have my Masters Degree Boris, I hope to get more financial incentive here than in a legitimate corporate setting.” Linsky had never evoked any complaints from the cartel and never voiced any himself.
“I’ll see what I can do. The work load is increased. You should get more for that and with a Master’s degree coming you should be moved up in the organization.”
Linsky did indeed want more money–more than a raise in pay from Mindel could satisfy. The phone rang at Linsky’s modest one bedroom Brooklyn apartment.
“Abe it’s Amstel–Amstel Perkins.”
“Yeah Perk. What’s happening?”
“I got a long leg cast from a six-footer.” Perkins explained how it would not be logged into the regular Viet Nam cast depot. “How much heroin do you get from that?”
Linsky’s pulse quickened. “The guy’s six-foot and has a full long leg cast.” Linsky did some quick calculations. “That would net about $50,000 of pure heroin and worth ten times that on the street after its cut.”
Chapter 5
Brownsville, Brooklyn
The old Dodge van backed into the opened doors of the sooty brick one-level warehouse. The large corrugated aluminum doors were closed and the two rear doors of the van opened.
“Wow, a full load. This’ll keep us busy for a few days.” The bearded, long-haired Mindel stared at the numerous plastic bags from floor-to-ceiling in the cargo space and filling the passenger seat.
“I’m gonna need some help–real soon.” Boris Mindel logged-in each labeled plastic bag with date and source and locked the storage room door.
Crosley Bizetes followed Boris Mindel into the corridor. The one story warehouse was partitioned into three storage rooms for the plastic bags and their pre-processing drug contents. In addition, there was one large adjoining laboratory-like area containing two benches with steam pipes, soapstone counters with a sink at each end, and a huge hooded area for grinding the incoming raw drug material. Bizetes closed the lab door and blew his nose on a well-used handkerchief. “This place has three smells to it. Those storage closets smell like sour laundry, the corridor stinks like sewage and in here all I can smell is a cross between Lysol and acetone.”
“Yeah, Cros, we make our living on toxic waste so it’s fitting the place should waft the air with its unique smells.” Mindel smiled. “You know heroin is water soluble and it’s amazing no one figured out you could add heroin to the gypsum gauze used in making plaster casts for smuggling purposes.”
The haggard scientist Mindel continued his thoughts. “The only thing with these casts is they contain bacteria, dirt, sweat and ink from people signing them. The Lysol does a good job as a disinfectant and the acetone gets rid of the ink and other organic contaminants.”
Bizetes yawned, “Well most people don’t use science for illegal purposes. It takes a devious mind like yours to come up with putting the dope in plaster.” Bizetes opened a new box of surgical masks for them to wear when they start homogenizing the old casts in the giant blenders. “It’s a good thing there was a war in an area of the world that makes dope and produces a good number of broken bones needing plaster casts.”
Mindel sat on a wooden folding bridge chair at an old scarred oak desk. He opened a school-type lined notebook and entered the day’s shipment codes.
Bizetes remained standing and consulted his leather-covered pocket note pad. “Boris, we expect an increase in inventory of pre-processed goods over the next four months.” He pointed with his pen to the lab benches and the huge hood covering the end bench at the far end of the lab. “Which means we have to have final product production doubled what we’re doing now.”
Mindel finished his entries. “So your boss tells you to pass the word, and workload, down to me.” He pushed himself away from the desk to face Bizetes. “I have no problem with that if you get me two more people. Linsky and I are maxed out and the Navy guy is only here every other weekend.”
“You have two now and want two more? That’s what you want me to tell my upper management?”
“You want more heroin comin’ out of here you get me more help.” Mindel stood up. His sloppy appearance belied his four-year college education and training in chemistry. His speech was that of an educated street person. He stood taller and was built bigger than Bizetes. “And it means more money for your organization and therefore more money for me and my end of the operation.”
Bizetes wiped his sweating face with his soiled handkerchief. “Don’t worry about it. I’ll get the two women for you. Jesus Christ I hate this lab. Why is it so hot in here?”
“I need the ambient temperature at least 80-degrees for precipitating the heroin in pure form and of course there’s the ladies.” Mindel pointed to two naked women working a small steam press which was sealing one-kilogram bags of final processed heroin. They were under thirty-years old with slightly plump figures.
“Oh yeah, the women have to be naked so they can’t steal any of the goods. How do you know they don’t stuff a plastic tube of the stuff up their snatch and walk outta here with a percent of the profits?”
“They get urine-tested weekly to make sure they’re not using the stuff and once a week I get a nurse to examine them at random. The nurse speaks Spanish like them. She looks in their vagina and probes their rectum. So far the girls have been good.”
“Where do you get people like them?” Bizetes stared at the two nudes who ignored their male presence.
“They’re illegals from Puerto Rico.”
“Okay. Get two more.” Bizetes watched as they put on transparent plastic coveralls. “I’m leavin’. I can’t stand this part of the business.”
The two women swallowed a twelve-ounce glass of water each and put on surgical face masks. They opened a large plastic bag which released a locker-room laundry odor to the organic atmosphere. The two men watched them put the contents of the bag into the hooded grinder and throw the switch. Immediately a fan was set in motion sending gray-white dust to a filter at the mouth of the hood while the irregular solid material was rendered into pumice-fine powder. The noise was deafening.
Bizetes motioned Mindel to go outside the lab door.
“Get the additional girls by the end of the week. I’ll be back with the cash you need tomorrow.” Bizetes shook Mindel’s hand and left.
‡
“It’s okay with me if you want to stay with Sergeant Stiles while he gets admitted. You won’t be officially on our staff until you check in your orders with the MSC officer.” Norman wrote orders on SGT “Boomer” Stiles medical admissions chart. “The MSC Officer today is head of security–LCDR Curly Norton.”
“Security Officer? Okay by me. I’ll get Stiles settled into his ward after his admission X-rays and check in with LCDR Norton.” Kaplan took the head end of the gurney with the Queens Naval corpsman at the foot leading the way to X-ray.
“Thanks for the help Kaplan. I usually have to fend for myself. We usually don’t get new personnel arriving by air-evac.” Kaplan and another corpsman steered the gurney.
It was going to take two corpsmen and two X-ray technicians to maneuver with Boomer’s total body cast. In the meantime over twenty other patients from the air-evac were lined up for X-rays. Most needed to be admitted right away to maintain their continuum of care. The duty radiologist looked at the backup.
“Stiles had X-rays just prior to his disembarking from Subic Bay. There’s no hurry with this guy and it’ll take all my man-power to maneuver him to get the correct films. We’ll get repeat films another time when we have full compliment on board to help. In the meantime I’ll give his Subic Bay films a quick reading and send them on to G-1.” The radiology resident looked at Kaplan. “You can tell Dr. Norman to reschedule.”
“Okay by me. I was there in Subic when they did his last X-rays. It took two hours and we had to repeat several films because of bad positioning.” Kaplan documented the plan in the admission progress notes for Norman to see. Kaplan and the ward corpsman headed out with their white mummified Boomer to G-1, the uncomplicated orthopedic patient ward.
The X-ray tech was arranging Boomer’s films when the staff radiology Medical Officer entered. “Are these the films of the total-body plaster case I just passed in the hall?”
“Yes sir.” The corpsman put the films up on the illuminated view boxes.
The radiologist looked at the long-leg films first and then went to the hips, torso, chest, neck, arms, and skull films. “These are most unusual. His diagnoses from his X-rays from Nam read ‘no change from prior films’. The prior films were his acute films taken just back from the tactical zone where he got injured and they didn’t even show shrapnel fragments. What the hell is going on?”
‡
“Why am I in this single room? Why ain’t I in the ward with the rest of the guys?” Army Corporal Sebastian Remo looked around the sterile surroundings. “Why are you wearing a mask and gown? They didn’t do this in Nam or the Philippines.”
“You’re on F-2, the dirty surgery ward and you have a draining chest wall abscess Remo.” The young corpsman wore a surgical cap, surgical mask, latex gloves and a sterile gown. “You’ll go to F-1 with other colostomy patients after we get the cultures back and your doctor declares you non-infectious. Relax, you’re home now soldier.”
Remo looked around the lonely room. He wanted a crowd. He wanted other patients around him and especially he wanted tons of visitors swarming around the ward during visiting hours. He didn’t want his visitors to be memorable and his being in isolation would make his people stand out.
Dr. Paul Norman came into the isolation room donned in his sterility precaution regalia. “Hello again Corporal Remo. While you’re a patient we drop all rank protocol. You can call me Dr. Norman, doctor or just doc. What do you prefer–Sebastian or Remo? Most of the patients call each other by their last names?”
The emaciated patient looked at Norman, “Remo will be fine Doc.”
“Okay, as the nurse said, this is going to be only temporary quarters for you until we move you out to the regular ward probably tomorrow when we get the cultures back.” Norman approached his patient and lifted the Johnny to examine his right chest wall where the chest tube was exiting. Norman milked it a couple of times to get exudate flowing down to the collection bag. Nothing happened. “Remo a chest X-ray showed this chest tube is only subcutaneous. It doesn’t even go beneath the chest wall’s outer muscle layer. So tomorrow I’m suggesting the F-2 GMO to pull it and insert a small Penrose drain and we'll go from there.”
“What about my shit bag, Doc.” Remo held his gown up exposing his double barrel colostomy.
“You know, one other thing we clean up here is language. You’re no longer in the bush. And that is no longer a shit bag. It’s a colostomy bag understand?”
“Yes sir.”
Norman knew it would be a losing battle. Among each other all patient soldiers used their second language–profanity. “Your vital signs are normal and there’s no temperature so you can begin to receive visitors tonight–two at-a-time.”
“My visitors will be dressed like you?” Remo adjusted his Australian hat.
“Just until you get moved outside this room.” Norman looked at his watch. He then looked at the colostomy bag. “Your bowels seem to functioning normally so you can get a regular diet.”
A wave of relief swept over Remo.
With the masks and the other stuff no one can identify or remember my visitors.
He watched Norman at the doorway depositing his gloves and sterile gown into the hamper and which would later be taken to the dirty surgery laundry. “Thanks Doc.” Remo watched him disappear and fell asleep.
‡
Norman's next stop was orthopedics–G-1. SGT William Boomer Stiles was easy to spot in his total body cast with placement of his bed right next to the Nurses Station. Cast technician Corpsman Kenneth Gantz was writing in Stiles medical chart. “Gantz, can I have the patient's chart please.”
“Yes sir. I'm just noting that there are no soft spots or bloodstains on the cast material sir.” Gantz matched Norman’s six-foot height and smiled as he handed Norman the X-ray folder.
Norman held the folder while he began speaking to the ward corpsman. “What’s this? Didn’t we get new X-rays on admission?”
“The new corpsman–Kaplan–wrote a note about that. Radiology was backed up so they ask you get his new films during the normal work day when they’re fully staffed.”
Norman nodded and went over the normal hospital etiquette with Stiles as he had with Remo. “Boomer? How'd you get that handle?”
“It was a natural ever since training in artillery sir.”A smile formed on the plaster window outlining Boomer’s mouth and nose. “I hung around with mostly other infantry guys from my basic training. They hung the name ‘Boomer’ because I fire the biggest field pieces.”
“You don't seem to be in any pain Boomer.” Norman pulled down the sheet from the abdomen down to the knees, exposing the rectangular cutout at his crotch. “No Foley catheter or rectal tube. How do you manager bladder and bowels Boomer?”
“Actually I don’t have too much of a problem. I have my own personal corpsman sir.”
“Yes that's right. I met him already–guy named Kaplan?”
“Right here sir.” Kaplan appeared at Norman's side almost magically. Kaplan looked at Norman and stared at Gantz. “You’re done here Gantz.”
“I’m the chief cast tech Kaplan.” Gantz gave Kaplan an icy stare.
Kaplan looked from Norman to Gantz and grabbed Boomer’s chart. “Dr. Norman you saw my orders assigning me to this ward and Boomer’s care and agreed back there to continue this capacity at the ER triage.”
“Correct, Kaplan.” Norman looked at Gantz. “Gantz you can go. I have to determine when the next cast change for Stiles will be.”
Gantz left G-1 looking over his shoulder at both Kaplan and Norton. He bumped into Zettler on his way out.
“Gantz look straight ahead when you're walking or you’ll end up wearing plaster like all your other patients.” Zettler’s smile was not returned from Gantz. She went directly to Norman and Boomer.
“Okay it’s X-ray viewing time.” Norman led Zettler and Kaplan into the X-ray view box room. He posted all the X-rays, remaining silent as he looked from the skull films all the way down to the long leg films. He turned to Zettler then to Kaplan. “I'll be damned if I can find anything serious here or evidence of any surgery. There are no plates, wires, screws or any orthopedic devices on any bones. The neck and skull are completely intact.”