Welcome Home From Vietnam, Finally: A Vietnam Trauma Surgeon's Memoir

LEAVING ON A JET PLANE

Robin’s eyes were injected red and full of tears. Her pitiful expression on that sweltering Dallas morning at Ben and Helen’s in early September 1970 is forever burned into my memory. It conveyed panic, my desertion, loss, fear, and disbelief. Her eyes asked, How could you do this to me?

I had no choice. The US Army was sending me to Vietnam as a trauma surgeon for a year. The good-bye was as sad as attending the wake of a loved one.

Not to say we did not know this day would eventually challenge us. We had prepared, but there is nothing as devastating as having to experience that onset of separation.

ROBIN AND EDDIE

Robin Viverito and I, Eddie Kappler, first dated at Port Jefferson High School in 1957. She knew she would marry me. I had no idea seventeen-year-old girls (women) thought that far ahead. We committed before I departed for Cornell University in Ithaca, New York, to begin my pre-med studies.

I studied incessantly, majored in chemistry, joined the Theta Xi fraternity, played some basketball, did some partying, did honors research in chemistry, was president of the house my senior year, and was accepted to Cornell Medical College in New York City.

Dr. J. Johnson was my faculty advisor. The best advice he gave me was to take the rigorous German language course, a requirement for chemistry majors, in my junior year. I could not process the spoken portion and did so dismally that I had to take a makeup course the next year to graduate. Thank goodness I did have the senior year. There were three of us in that class who had been accepted to medical school. I felt a little better.

Robin visited Cornell frequently; took her SATs during a fraternity homecoming weekend milk punch party; studied elementary education at Notre Dame of Maryland in Baltimore; partnered with me in the summers in the Hamptons; taught in Middle Island, New York, after her graduation from college; planned our wedding; and with her mom began sewing her wedding dress and the bridesmaids’ dresses.

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After I was born, my mother negotiated with my dad and his parents that yes, I would be named Gustav Edward Kappler III, but I would be addressed as Eddie. She disliked the name Gus and referred to my dad as Kappy. Once I left home for college, I became Gus. Robin causes great confusion in the faces of new friends when she discusses her husband, Gus, in their conversation and then asks me, Eddie, to pour more wine.

OUR NEW LIFE

On June 29, 1963, after my second year at the Cornell Medical College, we were married in St. John the Baptist Roman Catholic Church in Wading River, New York, followed by the reception at Felice’s in Patchogue, New York. This event was their first such function, just having opened for business, and in spite of that, we all had a great time. Back then on Long Island, the centerpieces were practical, a cluster of various liquors with mixers in a bucket. As we entered for the event, the substitute band leader asked the name, and Robin replied Viverito. When presented to the gathering, we were referred to as Mr. and Mrs. Viverito. Everyone exploded in laughter. My mom was not too happy, for her German son was marrying an Italian.

In a way that introduction was a premonition, for during all our fifty-plus years of marriage, she mastered the sometimes-daunting task of defining our family as I concentrated on my study of and the practice of surgery.

We experienced an abbreviated honeymoon at Mt. Airy Lodge in the Poconos. Loving to camp, I wanted to stay in a cabin not knowing we would share accommodations with a skunk. Thus, the early departure to return to our newly painted one-half tenement at 425 East, Sixty-Ninth Street, just up the block from Cornell Medical College in New York City.

Ed, Jack, Ron, George, and I became fast friends. Robin would fix them up with dates from Notre Dame.

I generated income by donating blood and performing EKGs on hospital patients. During exam time, a professor would pay a male student for his semen to study sperm mobility under stressful conditions. He was referred to as the professor of manual arts. I skipped that one.

Our windows bordered on Sixty-Ninth Street, and the pedestrians passing below ran the risk of being bombarded with water balloons.

The drug companies gave free formula to new mothers, a lot of it. We used formula as a cream substitute in Grasshoppers, Black Russians, and our coffee.

MOVING ON

The third and fourth years of medical school were more clinical, hands on, and a time to decide on one’s specialty. I administered anesthesia, did research in colon surgery, rotated through the notorious Bellevue Hospital, and reaffirmed my passion for surgery. I sought out a hospital where I would operate from day one and chose to apply for a surgical residency headed by Dr. David Hume at the Medical College of Virginia (MCV) in Richmond, Virginia. Dr. Hume had participated in the world’s earliest kidney transplants, directed a universally renowned kidney transplant department, and as chief of surgery was the ultimate teacher. He was also instrumental in redefining death.

Traditionally, death was defined as the stoppage of the heart. The concept of brain death in a patient with a beating heart was essential to move the field of transplant surgery forward. The courts became involved and accepted the change. With this new definition, even though the patient’s brain was dead, his organs were being kept viable and available for transplant.

My first rotation at MCV as an intern was neurosurgery, and I covered the emergency departments (ED). In the sixties, there were two EDs, for segregation was alive and well in Richmond. My first surgery was to drill holes in the skull of a gentleman with a subdural hematoma to relieve the pressure. This was done in the ED as an emergency for the patient was crashing. He did well.

During my third and fourth years in medical school, Robin taught elementary school on 117th Street in Spanish Harlem. She’d often ask me what the new expressions meant that she heard the children utter. Back then it would be perfectly acceptable to have students visit our apartment and even travel to Long Island to visit Robin’s family. She almost blew an FBI investigation across the street from the school by pointing out and complaining of strange men in the boy’s bathroom and interference on the TV monitor. Kimberly Ann Kappler was born on May 15, 1965, just before my graduation. I felt sorry for Robin’s OB GYN for he was favored by most of the pregnant noninsured medical-student wives. God bless Dr. Davis. We did gift him a small Steuben-cut glass piece.

UNCHARTED WATERS

I was accepted at MCV, and we embarked on an adventure, which tested our reserve and humanity. We packed all our possessions into a small U-Haul trailer that I attached to the back bumper of our car. We then departed for Richmond. After a month of easy living at the Westover Hills condominiums and pool, I began my surgical internship and residency, which my dear friend Deming Payne now refers to as child abuse for adults. Robin had no idea I had to stay at the hospital when I was on call. She would be alone for the first time in her life and responsible for an infant’s welfare.

Robin cared for Kim and eventually began teaching English in Richmond’s Welfare Incentive Program to women wishing to improve their lives. When Chris, our son, was born in 1970, the LPN (licensed practical nurse) who brought him to her had been one of her students. The ladies loved her so much they referred to me through her. One afternoon when I was almost a chief resident, a group of us were making rounds in the surgical ward. A junior resident had presented a female patient’s case and I was critiquing her care. I bent over to palpate her incision when she exclaimed, You’s Mrs. Kappler’s husband, I’s got your picture right here.

The group erupted in laughter, and from that point on, I was referred to as Mrs. Kappler’s husband. I remember two stories about her students who lived in Richmond’s sixties black culture. Their beliefs were new to her.

First of all, if they wished to have their husbands become more attentive, they added a portion of their urine to his Kool Aid. They also believed that the cadavers dissected in the medical school were still obtained by nefarious men pithing the unsuspecting citizen and selling the body to MCV. Her income far exceeded mine, which was $250 a month.

The hours were long, the challenges were at times overwhelming, sleep deprivation was the standard, and the learning curve required superhuman attention and effort. In the sixties, there were no defined working hours; one stayed at the hospital until all work was completed and the chief resident dismissed you. I remained at MCV every other night and weekend. The weekend was from Saturday morning to Monday evening. Almost nothing was left in reserve to be a suitable husband and father. After our five-year MCV sojourn, only two of the original twelve married couples were still together. However, we surgical residents did become damn good clinicians and surgeons, but with naiveté of youth that convinced us we could accomplish anything in the surgical arena. That misconception was certainly challenged and redefined as over time I discovered reality.

There was no draft lottery in 1965, and regardless of age, marital status, number of children, and even disabilities, all surgeons were drafted at the onset of the internship. Even non-US citizens with green cards, who were participating in a US residency, were drafted. I was lucky to be granted a deferment to complete my training: the Berry Plan. That was great ‘cause Vietnam would surely be over by 1970. Wrong!

Now, if I were not deferred, I would have been activated after my internship as a GMO (general medical officer). That designation would have possibly assigned me in 1966 into the field with the fighting troops. Not a safe place. The fact was that with the minimal medical resources in the field, an experienced corpsman could accomplish the same level of treatment as a newly minted doc. Eventually, the army abandoned the practice of sending physicians afield.

One of my fellow interns was activated, arrived in Vietnam as a GMO, was assigned to a firebase, and proceeded, in addition to his other responsibilities to practice preventive medicine. The troops for which he was responsible were experiencing a high rate of clinically significant VD (venereal disease):gonorrhea. This clap was at times disabling enough to reduce the number of troops fit for the field. So Jack, a Harvard man, visited the local Vietnamese villages, identified the working girls, treated their disease, created ID cards, and regularly re-examined and retreated the ladies. The VD rate plummeted, the troops were happy, and command had their fighting men back. One trooper was so overwhelmed with gratitude he wrote home reporting the successful safety measures. His mother notified the appropriate state senator, and soon, a directive arrived in the Vietnam jungle to cease and desist Jack’s preventive measures. Gonorrhea would be king again.

LIFE-ALTERING PLANS

My son, Christopher Jon Kappler, was born on February 4, 1970, in an MCV delivery room. He weighed nine and one-half pounds when he was delivered around 8:00 a.m. after a prolonged labor due to an abnormal presentation. I was a chief resident at the Veterans Administration Hospital (VA) and had a Whipple operation for cancer of the pancreas scheduled for that hour. The VA was a twenty-minute drive from MCV. Dr. Ware, who also would not be compensated by medical insurance, saved me from having to decide to forego a rare surgical opportunity or desert my wife when he used Keelan forceps to bring Chris into the world and give me time to make it to the VA for the surgery.

We knew I was going to Vietnam that year. The planning had begun years before.

Robin was instrumental in organizing at MCV the Sally Tompkins Chapter of WASAMA, the Women’s Auxiliary to the Student American Medical Association. Sally, a nurse, was a commissioned officer in the confederate army. We visited her home and gravesite in Manasses, Virginia.

The auxiliary, as a group, aided the wives of medical students, interns, and residents in the trials and tribulations of their everyday lives being married to medical students and house staff physicians: residents in training. Robin campaigned for and was elected the national president of WASAMA to occupy her for the year I was away in Vietnam. She would travel to any and all chapters in the United States at their invitation and expense. Both children usually traveled with her. Controlling the entourage could be a daunting challenge at airports. Robin’s solution was to place Kim, five, in a wheelchair and Chris, one, on her lap qualifying for early boarding.

One highlight of her travels was the embarrassment of calling in the hogs as she stood on the steps of the state capitol in Little Rock, Arkansas. There she was being honored and encouraged to emit animal noises by her hosts. How could she refuse; Sooey, Sooey, Sooey …

We would sell the cottage in Richmond, also the sporty Sprite, rent a home near her father, Frank, and his wife, Alice, in Lake Panamoka, New York, and secure her a teaching position in Middle Island, New York. While Robin was teaching, Kim was in school, and Robin’s sister Muffin watched Chris. Both towns were on eastern Long Island, New York.

One day, she substituted