Combat Nurses in Vietnam: What’s an angel doin’ here in hell?

1. Combat Nurses in Vietnam:What’s an angel doin’ here in hell? Sheon Montgomery Assistant Archivist, The Vietnam Archive November 7, 2012

2. The Vietnam Center and Archive • Female Military Personnel in Vietnam • 8,000-10,000 military women served In Country • Support positions – 10%, 1962-1973 • Military Nurses – 1956-1973 • 90% of women who served in Vietnam • 5,000+ Army nurses served • 3,000+ nurses, other branches • 1960’s – nursing still traditional woman’s role In US only 1% male nurses / in VN <30%

3. The Vietnam Center and Archive Operation Nightingale: Recruiting US Army Nurses

4. The Vietnam Center and Archive • Female Nursing Personnel in Vietnam • Vast majority were Combat Nurses • Physical Therapists (43 total / 33 women) • Dieticians (26 total / 20 women)

5. The Vietnam Center and Archive Typical Female U.S. Army Combat Nurse Average age 23.6 Volunteer Higher education Straight from nursing school Little professional experience Learned “on the job” Officer Basic Training for Medical Field Services No combat training / No weapons Officer – entered as Lieutenant

6. The Vietnam Center and Archive Military Nursing Environment Fixed Medical Installations (in 1968, 5,283 hospital beds in country) Surgical Hospitals Field Hospitals Evacuation Hospitals Convalescent Center (3,000 beds) Hospital Ships (USS Repose & USS Sanctuary) Medical Support Network Centralized blood bank Medical logistical support Medical laboratories Air ambulance units

7. The Vietnam Center and Archive • System of • Phased Treatment • Medic – in the field • 2. Medevac to nearest hospital • triage & emergency treatment • died / expectant • stabilized • 3. Evacuate to • Rear Hospital • Medical Ship • (USS Sanctuary or Repose) • Japan or Philippines • United States United States And Free World Military Hospitals Vietnam, 1968

8. The Vietnam Center and Archive Dustoff / Medevac Created New Situation For Nurses Quick response saved more lives Brought trauma and burns straight from the field . . . Including those who would have died in the field – “Expectant” “After awhile in Vietnam, I guess I wasn’t so young anymore. I was seeing things, doing things that I never imagined could happen to anyone. I had to do a lot of things on my own, making snap decisions that could end up saving someone or costing him his life.” -- Jacqueline Navarra Rhoads, 1970-71

9. The Vietnam Center and Archive New Kind of War . . . New Kinds of Trauma • Even nurses with trauma experience were unprepared (most nurses had less than 6 months of experience) • Small arms fire and anti-personnel mines • massive, multiple injuries • traumatic and multiple amputations • huge and multiple blast wounds • Napalm & white phosphorus burns • burn flesh down to the bones • burn wards particularly gruesome “… nurses were essentially doctors’ handmaidens. We were the most inexperienced group of medical personnel ever to serve in war time.” -- Jeanne Diebolt Former USAF Nurse, Vietnam

10. The Vietnam Center and Archive “You have to remember these were healthy guys . . . I knew he was expectant . . . My feeling was that one of the worst things that can happen to anybody is dying alone . . . . . . he shouldn’t die alone. -- Lorraine Boudreau 1965-66, 1969-70 • Combat Nurses were expected to be all things . . . . 24/7 • Nurse • Doctor • Girlfriend • Mother • Counselor So put on some perfume, lipstick and a smile --Helen White

11. The Vietnam Center and Archive Combat Nurses • worked 12+ hour shifts / 6 days a week • on call 24 / 7 for times of high casualties • often went back after hours to help out • often rudimentary “hootches” and latrines • often under rocket or sapper attack at night • saw friends among the wounded • constant stress – numb to situation to do jobs • 12-month rotation – always knew their last day

12. The Vietnam Center and Archive • MEDCAP – Medical Services for Civilians

13. The Vietnam Center and Archive • Conflicts Within Themselves • Conflicts between vision of themselves and what they did • sheer enormity of nursing war casualties • making decisions about life/death, priorities • paperwork for dead • using weapons to defend self and wounded in care • Conflicts between nursing mission and having to provide medical services for enemy prisoners • sometimes came in with the Americans they wounded/killed

14. The Vietnam Center and Archive • 8 Female Military Casualties – All Nurses • 2LT Carol Ann Drazba, 22 – helicopter crash (1966) • 2LT Elizabeth Ann Jones, 22 – helicopter crash (1966) • CPT Eleanor Grace Alexander, 27 – a/c crash (1967) • 1LT Hedwig Diane Orlowski, 23 – a/c crash (1967) • 2LT Pamela Donovan, 26 – illness (1968) • Lt Col Annie Ruth Graham, 52 – stroke (1968) • 1LT Sharon Ann Lane, 25 –shrapnel wounds,KIA (1969) • CPT Mary Therese Klinker – OpnBabylift a/c crash (1975)

15. The Vietnam Center and Archive

16. The Vietnam Center and Archive • Stages of Returning Home • Isolation / Denial • Struggle for Recognition • Results

17. The Vietnam Center and Archive Returning Home Stage 1: Isolation / Silence

18. The Vietnam Center and Archive • Multiple Difficulties Returning Home • post-war adjustment problems • insensitivity / lack of interest • sense that women were not “true” veterans • professional / occupational challenges • VA services inadequate for women

19. The Vietnam Center and Archive • Post-War Adjustment Problems • expected to forget and go on as before • symptoms of PTSD Anger / Guilt / Depression / Withdrawal / Drug & Alcohol Dependency • “mysterious” physical ailments • trouble maintaining relationships • occupation / professional difficulties • disillusioned “I learned fast not to mention it.” Even more than the men, the women retreated deep into silence. --Penny Burwell

20. The Vietnam Center and Archive • Occupation / Professional Difficulties • In Vietnam they had performed as a team beyond accepted duties of nurses in the U.S. • - making decisions • - performing procedures • Not allowed in the U.S. hospitals, many either . . . • - quit nursing • - additional medical-related education • - went back into the military

21. The Vietnam Center and Archive • Lack of VA Services for Women • No private areas for women patients • VA Medical staff not trained in women’s health issues • Lack of recognition that Combat Nurses had seen their own type of combat • Myth: women not exposed to Agent Orange • - symptoms all in their heads • - why so many miscarriages & birth defects?

22. The Vietnam Center and Archive Early 1980’s-mid 1990’s Stage 2: Struggle for Recognition

23. The Vietnam Center and Archive • Vietnam Male Veterans Getting Recognition • Women excluded from veteran surveys & studies • 1980 - PTSD diagnosis re-instated • 1981 – Congress granted federally funded medical care for veterans who can prove direct exposure to Agent Orange • 1982 - Vietnam Memorial (The Wall) dedicated

24. The Vietnam Center and Archive • Vietnam Memorial – A Touchstone • Includes the names of 8 women nurses • Women veterans drawn to it, too – Service acknowledged by male veterans • Finding comfort • Society’s recognition • Opened up barriers • within the women

25. The Vietnam Center and Archive • Women’s Veteran Advocacy Begins • Reaching out; Acknowledging their experiences • Women’s Veteran Associations • Newsletters and Support Groups • Health Research • VA to provide improved services to women veterans facilities / treatment / attitude

26. The Vietnam Center and Archive Stage 3: Results

27. The Vietnam Center and Archive • 1988 – National Vietnam Veterans Readjustment Study • Concluded women veterans had PTSD • Particularly high for those in combat theaters • High incidence of associated disorders •  generalized anxiety disorder •  depression  occupational instability •  substance abuse  non-specific distress •  flashbacks and panic disorder •  marital and relationship problems

28. The Vietnam Center and Archive • Agent Orange • Women Veterans included in AO Lawsuit • Survey of women veterans – found Vietnam veterans: • Higher percentage of gynecological problems • Twice the percentage of cancers • Three times the percentage of birth defects • Twice the percentage of a child dying in 1st year • 1991 – Permanent disability benefits allowed to Vietnam Veterans exposed to Agent Orange

29. The Vietnam Center and Archive • Vietnam Women’s Memorial Project • Incorporated in 1984 • Promote recognition and healing of Vietnam women veterans, particularly the Combat Nurses • Placement of memorial on the grounds of the Vietnam Veterans Memorial in Washington, D.C. near The Three Servicemen Statue (dedicated 1984)

30. The Vietnam Center and Archive • Vietnam Women’s Memorial Project • Commission of Fine Arts rejected addition • Diminish overall impact • Unnecessary “none bore the brunt of battle more than the infantrymen who fought in the jungle; thus they were chosen to represent all” --Letter on Decision from The Commission of Fine Arts I asked the students what they thought was the toughest job in Vietnam . . . . . . I told them I thought it was being a nurse. \ --Letter from Vietnam Veteran Joe Muharsky

31. The Vietnam Center and Archive • Vietnam Women’s Memorial - 1993

32. The Vietnam Center and Archive Women Vietnam Veterans Have Made a Difference

33. The Vietnam Center and Archive • Women Military • Veterans Today • 1.8 million in the U.S. today (8%) • Women Veterans Health Program, est. 1988 • VA Center for Women Veterans website • Women Veterans Program Manager in each VA Medical Center

34. The Vietnam Center and Archive American Women Veterans Foundation http://americanwomenveterans.org/home/ • Current Programs • awareness • advocacy • resources • childcare • employment • education • business • housing • Future Programs • outdoor retreats • education • transitional housing

35. The Vietnam Center and Archive • Since 2000, Legislation passed specifically to benefit Women Veterans • Service connected mastectomy • Broader benefits for children with birth defects born to Vietnam Veteran mothers • Military Sexual Trauma counseling and treatment (20%) • Women Veterans Business Training Resource Program • Contract for study on barriers to health care • Pilot program for Readjustment Counseling in retreats • Pilot program on feasibility for offering child care

36. Selected Sources • Jacobs, Marianne Scherer. The Best of Times, The Worst of Times: The Vietnam Experiences of and Post-Traumatic Stress Disorder Among Female Nurse Veterans. Dissertation: University of Washington. 1990. • Lintecum, Sarge. Lyrics of Sister Soldier. • Vuic, Kara Dixon. Officer, Nurse, Woman: The Army Nurse Corps in the Vietnam War. The Johns Hopkins University Press: Baltimore, Maryland. 2010. • Walker, Keith. A Piece of My Heart: The Stories of Twenty-Six American Women Who Served in Vietnam. Presidio Press: Novato, California. 1985. • http://www.vietnam.ttu.edu/virtualarchive/ - Virtual Vietnam Archive • http://www.va.gov/womenvet/ - US Dept of Veterans Affairs, Women Veterans • http://www.whitman.edu/content/news/WomenWarVeterans - Forgotten Veterans: U.S. Women in Vietnam • http://www.war-veterans.org/Angels.htm - Touched By An Angel • http://www.vietnamwomensmemorial.org/ - Vietnam Women’s Memorial Foundation

37. Q & A Sister Soldier, Sister Soldier