by Jim Chaffee
[ fiction - august 09 ]
I remember the poor bastard's blood. Not gobs of it clotting in great liver-like chunks, like you'd expect in war, but rather a single drop viewed at a focal point projected with convex lenses in a pair of tubes; image resolved to enlarge and discriminate between corpuscles burst and whole swimming in the azure-dyed pin-prick's ooze squeezed between glass slides; corpuscles intermingled like the lucky and not so lucky adrift in a battlefield of some purple swamp. Infested with fauna from hell: plasmodium falciparum scattered within and between the dead and dying cells, platelets, schistocytes, the stuff of disseminated intracellular coagulation halting capillary flow, strangling brain, kidneys, everything.
He'd come from somewhere up north via Charley Med at Dong Ha, a day there and on to us pale and delirious, sweating like a bitch. Not yet twenty years and experiencing a stroke of malevolence well beyond the expected violence of combat so comforting to loved ones.
We got him off the stretcher and into a bed and I felt his forehead, declaring him at least a hundred and three. The thermometer had me low by a degree.
I pulled the leaking butterfly IV from the back of his hand and inserted a 16-gauge jelko catheter into his left forearm, just above the wrist. We slid the alcohol mattress beneath him and plugged it in, and he bolted upright and stared at me. I asked if he could take some aspirin, he nodded and I gave him five in a paper cup with water to chase them, watching to be sure he swallowed. I pricked his finger and squeezed a drop of blood onto the glass slide.
His chart read malaria but didn't specify the genre. They'd started the standard chloroquine regimen, evidently not finding it serious enough for quinine.
Complicating matters, Lt Wong's tour neared its end, our ward physician preparing to rotate back to the world, eager to return to Hawaii and chase money and women. The new guy they'd sent not easy to swallow, a patronizing worm peering out of tiny round lenses perched flat against his eyes, intentionally studious among us louts of war. Someone had pegged him behind his back with The Dweeb and it stuck. Wong hated the little shit from the start; I sensed it over Wong's cool, which levitated him above the fray without any hint of personal feeling. Like when a Marine begged for medevac out of Nam, Wong telling me to discharge him to duty that day, looking the corporal in the eye and saying quietly, "You chose to join the Marines."
Peering into the microscope I retraced my training, the lab tech now returned to duty at Great Lakes smiling, friendly, explaining the significance of the parasitemia, counting the prevalence of cellular invaders, excited when first happening upon an equivalent vision provided by a hapless Kit Carson scout, former Viet Cong who succumbed to this native parasite at the advanced age of thirty. The tech gleeful in his passion for the dubious honor the victim's blood presented. "See how many cells destroyed and invaded, some of them more than one parasite," he explaining, a teacher with this example of so rare an occurrence: blood invaded with over eighty percent parasitemia, a notch for his mental collection, specimen for my edification. "Never seen so many before. He's dying isn't he," not a question but statement of fact, the wiry Asian in fact remaining cloaked within the coma he'd arrived wearing until death.
I looked at this one. Marine grunt from 3/26, unshaven face downed with blonde peach fuzz red with dust, probably from Khe Sanh. The medical battalion hadn't bothered to clean him up, sending on this rarity for the medical collectors, gift for this new asshole physician on the ward.
I told The Dweeb the new patient had a very high parasitemia. "Can I see?" as if not believing me. Musing, "Now what am I looking at here," "Stained drop of blood," asswipe swallowed off the tail of my reply, "Better have the lab check it to be sure," he said and "You'll wait a day for the reply," I told him, the lab so overloaded they'd long ago asked me to handle these. Another vial of blood off to the lab but I told Wong anyway, calling it a CM and Wong asking what the fuck that meant, and when I said cerebral malaria he said how could I tell and I said the guy's got a ninety per cent parasitemia. Wong stared long enough to let me know it wasn't appreciated, like the time I asked him to sign a prescription for a female collie. Turning on his heels, without a word off to make rounds.
The CM meandered in and out of consciousness, seeming coherent and sitting up gibbering only to slip away, though for a time we could rouse him with needle pricks on his fingers and toes. In a matter of two days he disappeared inside some dream at the end of a dark hole to which we were not privy, body stretched out on the bed racked with huge fever, teeth clenched. More IVs running, then an indwelling catheter collecting urine turning dark. Wong interceded with quinine over the milder treatment started by The Dweeb, an uncharacteristic breech of etiquette.
Rumored the son of a Navy Captain senior medical officer and researcher, here with Daddy's help in this favored place of the damned, The Dweeb seemed drawn to the Brueghelian vision and tableau-too-vivant from Bosch's worst nightmare. Young Marine of pasty flesh crying out "Doc I have to take a shit I can't help myself" brown, flattened worm slithering from his rectum, ascaris so plentiful his abdomen distended like an air pillow. Wong medevaced the kid. "How do you treat that?" I'd asked. "Not my problem now," Wong had answered, "enough poison to kill all those worms would kill him too. Let them handle it in Yokosuka." Quonset hut full of feverish dreams, malaria wall to wall with the odd parasitic infestation of intestines, the glow of hepatitis, an encephalitis in the sole private room tied to the bed to prevent banging of head upon wall. Take temps at midnight and o four hundred in the morning, fevers one hundred four: five aspirin and a liter of water by mouth from an expended dextrose IV bottle. Hang the live IV on the stand beside the metal chair in the shower where he sits, hope he doesn't pass out and don't forget to check, lone night corpsman the captain and first mate and all hands on this eighty-man ward, a ship of delirious fools plowing unstable seas overnight amidst the odd mortar bombardment and singing of rockets overhead meant for the chopper base, always fearing the ones that fall short.
Wong another story, rich man's son fresh out of medical school just doing his time, ladies' man with plenty of lookers for girlfriends, one a Playmate of the Month; slick; not one to ruffle feathers, so changing The Dweeb's treatment of the CM a big deal.
The kid descends at an alarming rate into some gone world. The Dweeb's got an itch to experiment, to see the black water fever run its course. Wants to be like daddy. Wong not amused, not something you medevac so unable to wash his hands of this one and The Dweeb moving the kid next to the nursing station for close observation, unable to get Wong to release the private room without sufficient corpsmen to keep vigil and unwilling to send his victim to ICU even were they to accept him. The kid a spectacle sleeping on the rubber temperature blanket to cool his fever-racked body, two IVs, nasal gastric tube, indwelling catheter and the onset of intermittent breathing. Marines muttering as they warily pass their prone comrade, fallen by something none of them can see. Wong roughly thumbs the soles of his feet to no effect, shining a flashlight into his heavenly blues staring at nothing, pupils dead to the light, pin pricks to no avail. When he begins Cheyne-Stoking Wong takes The Dweeb aside and whispers. The Dweeb shakes his head no.
There is no private place to take the argument except off the ward and it's too fresh, Wong freaking out like I've never seen, actually angry, but his words unheard except by The Dweeb who looks down for a bit, then levels his gaze with Wong's and smiles, eyes hiding behind those fucking tiny round lenses, and says loud enough for everyone, "He's alive, it's our duty to keep him alive."
Wong backs down.
The stubborn kid refuses to breathe with any consistency; toes turn back; black piss like coke trickles into the urine bag; defiant constant grimace stamped on once-boyish visage; fingers curled like claws clutch at nothing. A respirator, never before seen on the ward, brought on The Dweeb's order straight from ICU. The Dweeb tries to intubate the kid but can't seem to get the damned stiff plastic tube to go down the right place, trying to lift the glottis and instead knocking out some teeth with the metal guide. We call for some help from triage and they send a corpsman who waits for the kid to take one of those drawn-out breaths and then shoves the tube in his nose. The respirator pumps air into the lungs via the newly inserted stiff plastic protruding from the kid's unshaven face, Saint Sebastian of NSA Danang, the plethora of tubules like plastic arrows from veins, penis, face, long-suffering martyr to The Dweeb's interest in seeing the disease run its course. Or maybe he believes in the sanctity of some primitive atavistic response only he can see, some spark of sanctified life or whatever you call it dwelling within this rapidly rotting breathing carcass.
The next day finds the kid fighting the respirator, blocking the mechanism to the chagrin of Wong. Unflappable, the Dweeb injects curare to defeat the hopeless young Marine, now a shell, still not responding to light in the eyes, pin pricks and rough metal runs along the bottoms of bare feet, toes curled back, fingers gripping tighter, nails turning black, color draining away, the whiff of ammonia hovering, and Wong furious. Two days continually curarizing and the corpse blackens more, stinks more, and Wong with an order from his superiors to pull the tubes. The bed space is needed, not to mention the restlessness of the native Marines, up and about warily avoiding their captive comrade, revenge in their eyes.
We unhooked him from the respirator, pulled all the plugs and let him stop breathing before sending him to Graves Registration, to his parents who doubtless considered him a hero. No one told them he suffered long and alone for the sake of the curiosity of this Navy doctor who suddenly vanished from the hospital with some new orders, never again mentioned by Wong, whose replacement soon arrived, a Lieutenant Commander proctologist with a sense of humor.