Tuesday, June 19, 2018

Book Review

Book Review: THE MOUNTAIN BETWEEN US by Charles Martin A Survival Novel

I'm not sure what time it is. It's still dark. I don't know how long I was out. Snow is spilling in through the broken windshield. Can't catch my breath. Maybe broke two or three ribs.
He was dead before we hit the treetops. I'll never understand how he landed this thing without killing me, too. There's a dog here and . . . a woman. Trying to get home to her fiancé and a rehearsal dinner. I'll look . . . .

Chapter one then flashes back to twelve hours before, at the Salt Lake City Airport. The weather is closing in; his flight is delayed, passengers crowding everywhere, and Dr. Ben Payne, an orthopedic surgeon is catching up on his medical records dictation, sitting on the floor by an electric outlet. A woman perhaps age thirty asks if she can share the wall outlet. He agrees, and she begins dictation of a magazine story. Ben learns that Ashley Knox, a writer, hopes to reach Atlanta in time for her wedding two days hence.

Their flight is finally cancelled. Ben rides a shuttle to the private plane area and finds he can charter a flight to Denver. Thinking about the girl who will be late for her wedding, he finds her in the long waiting line for taxis, and offers her the chance to get ahead of the storm; she accepts. Grover, private pilot, has had thousands of hours flying over the Rocky Mountains and gets prompt clearance from flight control. Despite the turbulent flying conditions, he handles his plane easily, while talking with Ashley about his own more than forty years of happy marriage. Grover introduces them both to his dog who is “flying copilot”.

As the plane rises higher to cross the Uinta Mountain Wilderness, Grover begins coughing occasionally. He draws a roll of Tums from his pocket, takes two. Physician sense alerted, Ben taps him on the shoulder. “Tell me about your bum ticker – how long you been coughing and popping antacids?” The plane continues to rise as they approaches the peaks; Grover changes the subject and answers a question from Ashley. A few minutes later he coughs, grunts, grabs his chest. Our speed slowed. Then, as if he'd done it a thousand times, he pancaked the plane against the mountain snow. That's about the last thing I remember.

Ben slowly recovers consciousness, confusing the recent conversation with memories of his own wife. He's gradually aware of chest pain and shivering. The plane's tail has broken off, leaving them exposed to the air, but the rest of the plane is in deep snow, giving a cocoon-like shelter. Ashley lies comatose but the pulse in her neck is even. She has a dislocated shoulder and a bad angle to her left thigh, though the bone hadn't broken through the skin. Her shoulder goes back into place easily, but the break in her left thigh bone is a problem. He is finally able to reduce the fracture and fashion two splints from broken pieces of the plane, tying them with wadded T-shirts from his luggage. Her thigh has swollen twice its size and he packs snow around it. He slowly realizes Grover had not been required to file a flight plan, and that no one knew he even had passengers. They are in a National Wilderness Area, seventy miles from anywhere, invisible to the occasional airplane high overhead. Grover's plane has a few emergency supplies, but they both need medical attention, especially Ashley.

Rummaging around, Ben discovers two sleeping bags, a couple small packs of trail mix, and a small gas heater for water. No one knows their situation; it's urgent to get to a lower elevation and find food. They are on their own. With daylight, and after Ashley has regained consciousness, Ben climbs a small ridge and sees that the only way showing any hope is to head southeast. He can fashion something like a stretcher for Ashley from part of the exposed wing, and a shovel of sorts from a rudder flap with which to dig in the snow and bury Grover's body.

On day six, Ben gently lifts Ashley in her sleeping bag onto the sled, puts the dog beside her and adds Grover's bow, arrows and fly rod. Ashley grabs his arm. “One question, and I want an honest answer. Can you get us out of here?”

Seriously? No idea.”

Her eyes narrow. “We've got to work on our communication. I'm not asking you because I want honest answers. I want you to lie your butt off. Tell me we've got only a mile to go when there might be a hundred ahead of us.”
I laughed. “Okay. Listen. There's a helicopter waiting just beyond that first ridge. They've got sausage, muffins, and a dozen glazed donuts. And Starbucks.”

She patted me on the back. “Now you're getting the hang of it.”

But the going was slow. Leaning into the harness I had devised, I would take three steps and stop to breathe. By noon, we had gone maybe a mile. By dusk, perhaps two. It wasn't just my busted ribs. The air at 11,000 feet elevation is thin. And our food about gone. A few finger-sized fish. And one day, a rabbit.

Day eleven.After an hour we'd come maybe a quarter mile, dropping maybe a hundred feet in elevation. She was not impressed. “How long do think you can do this?”

Don't know.”

We can't do this. You can't. We're in the middle of nowhere.”

I stopped, sweat dripping off me, breathing deeply. “We can't stay up here. If we do we'll die. And I can't leave you. If I do, you'll die. So we're walking out.”

Her frustration at being helpless bubbled over. She screamed, “It's been eleven damn days and not a soul has come looking. What's your plan?”

One step at a time.”

And how long do you think you can keep that up?”

As long as it takes.”

We didn't speak again for several hours.

Day fifteen. Overlooking a wide valley in the distance, I could see some kind of horizontal line half-hidden.

Day seventeen, we see it closer, a building across a frozen lake. A large A-frame, empty; evidently a summer campground. No sign of car tracks, or people. But warm shelter! firewood, water. And big game nearby. A map on the wall with a “You are here” mark tells us we are in the Ashley National Forest. But it nearly becomes her memorial park before anyone finds us.

It will be another ten days before we will reach civilization. And, despite all the complications we have encountered so far, the end will be stranger yet.

Wednesday, June 6, 2018

Book Review: CODE GIRLS by Liza Mundy (non-fiction history 2017 )
The Untold Story of the American Women Code Breakers of World War II

More than ten thousand American women served as code breakers during World War II. The army and navy competed for them, recruiting from top university graduating classes and from high school teachers. Told only that they would be doing important office work in the Nation's Capital, they were given a letter telling them where to report, and cautioning them to never talk to anyone about their work, not even family or fellow workers.

Armies have used codes for centuries. But when radio communication enabled real-time contact with ships at sea, airplanes, commanders on front battle lines, or diplomats in far countries, anyone with radio savvy could listen in. Secrecy demanded cryptic speech that an enemy would not understand. Anyone who could figure out the meaning could anticipate enemy action before it happened. With war approaching in 1939, Army and Navy geared up to detect enemy plans. Recruits were tested to detect high intelligence, especially ability in math and foreign languages.

The influx of hundreds of young women overwhelmed Arlington County, across the Potomac River from Washington. The government hastily built new apartment buildings and dormitories; officials went door to door asking residents if they had an extra room, or a basement apartment two or three girls might occupy. Ms. Mundy entitles one chapter “Twenty-Eight Acres of Girls.”
Many were from small rural towns; their ability to de-code developed as they worked. Washington was keeping track of nations all over the world, but the main focus was on Hitler's Nazi Germany, already at war with Britain and France, and Japan in its expansion through China and beyond. Both countries had complicated code systems which were changed every few days or weeks. Germany had developed a portable machine, “Enigma”, which automaticaly encoded German. It had three wheels, each with twenty-six positions. Varying their relative positions could create thousands of different ways of scrambling the letters of a message.

Japan had a similar device, the “purple machine” which would take phonetic Japanese (using the English alphabet to change Japanese writing and then scrambling the letters.) The British had already decoded Enigma's output, but the teams of both British and American decoders were stymied by the Japanese “Purple Code” for months. They had solved six of the letters, but could not crack the other twenty.

September 20, 1940, several team members were talking together, when a shy young recruit, Genevieve Grotjan, approached. “Excuse me,” she said, “I have something to show you.” She laid down a very long message in Japanese purple code, where she had encircled the position of the same two symbols appearing together four times in different spots. From her discovery, the team was able to deduce the rest of the code.

A number of factors conspired to affect the lack of preparedness at Pearl Harbor that brought America into the World War, but the code breakers had advanced far enough in the following year to achieve three major victories. Japan's progress toward Australia in 1942 was halted by the battle of the Coral Sea. Japanese aircraft carriers were astonished when, approaching Port Moresby, New Guinea, they met American planes from the carriers Yorktown and Lexington, who destroyed some of Japan's best pilots. No ships on either side saw the ships of the other, but the American decoders monitoring Japan's radio traffic directed the Navy to the spot where they could stop the Japanese.

A month later, the Navy was uncertain whether the Japanese designation “AF” stood for Alaska Force or for Midway Island, north of Hawaii. The coders sent a fake notice (in plain English) that Midway's water supply had broken down and soon detected Japanese messages that AF's water supply was short. Japan sent one force northward toward Alaska to draw off the American Navy but the Americans didn't take the bait. Four Japanese carriers at Midway were unaware that the Yorktown, Enterprise, and Hornet were lying in wait off Midway. The score: US lost 2 ships, 145 aircraft and 707 men, Japan lost all 4 aircraft carriers, nearly 300 planes, (they had no place to land) and over 2,400 men. US Admiral Nimitz declared that code breaking had provided a “priceless advantage” at Midway. The Japanese advance never regained its momentum.

The code breakers' third dramatic moment came when they decoded the detailed itinerary of Admiral Yamamoto's inspection trip of Japan's conquests. They learned the precise time his planes – two bombers and six escorting fighters – would leave the Japanese base at Rabaul. Sixteen US P-38s intercepted the Japanese over Bougainville and shot down both bombers. Admiral Yamamoto, commander of the attack on Pearl Harbor was later found dead in the jungle, “his white-gloved hand clutching his sword.” The girls in Washington had solved the code.

The war ended without Japan ever becoming aware that their “purple code” and several other military and diplomatic codes had been broken. Their ambassador to Hitler's Germany was a gold mine of information about German defenses on Europe's seacoast as D-Day approached.

It's not appropriate to exult now over enemy ships sunk, nor enemy soldiers killed; they had families who grieved, just as ours did. But for the millions of lives saved on both sides of the war because it ended when it did, we can honor the Code Girls.

Liza Mundy's book is a fascinating and detailed account of women who never spoke of their accomplishments until long after the war ended.

Reviewer's note: At one point 8,000 women were at work in US military cryptography, counting civilians, army (WACS), and navy (WAVES). I had a cousin, born about 1917 who spent part of her childhood in Japan ( her Dad worked for the YMCA there.) It never occurred to me to ask what she did in the WAVES, but with her experience of Japanese language, I now suspect she was one of those thousands.

Tuesday, June 5, 2018

Book Review

Book Review: THE MOUNTAIN BETWEEN US by Charles Martin A Survival Novel

I'm not sure what time it is. It's still dark. I don't know how long I was out. Snow is spilling in through the broken windshield. Can't catch my breath. Maybe broke two or three ribs.
He was dead before we hit the treetops. I'll never understand how he landed this thing without killing me, too. There's a dog here and . . . a woman. Trying to get home to her fiancé and a rehearsal dinner. I'll look . . . .

Chapter one then flashes back to twelve hours before, at the Salt Lake City Airport. The weather is closing in; his flight is delayed, passengers crowding everywhere, and Dr. Ben Payne, an orthopedic surgeon is catching up on his medical records dictation, sitting on the floor by an electric outlet. A woman perhaps age thirty asks if she can share the wall outlet. He agrees, and she begins dictation of a magazine story. Ben learns that Ashley Knox, a writer, hopes to reach Atlanta in time for her wedding two days hence.

Their flight is finally cancelled. Ben rides a shuttle to the private plane area and finds he can charter a flight to Denver. Thinking about the girl who will be late for her wedding, he finds her in the long waiting line for taxis, and offers her the chance to get ahead of the storm; she accepts. Grover, private pilot, has had thousands of hours flying over the Rocky Mountains and gets prompt clearance from flight control. Despite the turbulent flying conditions, he handles his plane easily, while talking with Ashley about his own more than forty years of happy marriage. Grover introduces them both to his dog who is “flying copilot”.

As the plane rises higher to cross the Uinta Mountain Wilderness, Grover begins coughing occasionally. He draws a roll of Tums from his pocket, takes two. Physician sense alerted, Ben taps him on the shoulder. “Tell me about your bum ticker – how long you been coughing and popping antacids?” The plane continues to rise as they approaches the peaks; Grover changes the subject and answers a question from Ashley. A few minutes later he coughs, grunts, grabs his chest. Our speed slowed. Then, as if he'd done it a thousand times, he pancaked the plane against the mountain snow. That's about the last thing I remember.

Ben slowly recovers consciousnes, confusing the recent conversation with memories of his own wife. He's gradually aware of chest pain and shivering. The plane's tail has broken off, leaving them exposed to the air, but the rest of the plane is in deep snow, giving a cocoon-like shelter. Ashley lies comatose but the pulse in her neck is even. She has a dislocated shoulder and a bad angle to her left thigh, though the bone hadn't broken through the skin. Her shoulder goes back into place easily, but the break in her left thigh bone is a problem. He is finally able to reduce the fracture and fashion two splints from broken pieces of the plane, tying them with wadded T-shirts from his luggage. Her thigh has swollen twice its size and he packs snow around it. He slowly realizes Grover had not been required to file a flight plan, and that no one knew he even had passengers. They are in a National Wilderness Area, seventy miles from anywhere, invisible to the occasional airplane high overhead. Grover's plane has a few emergency supplies, but they both need medical attention, especially Ashley.

Rummaging around, Ben discovers two sleeping bags, a couple small packs of trail mix, and a small gas heater for water. No one knows their situation; it's urgent to get to a lower elevation and find food. They are on their own. With daylight, and after Ashley has regained consciousness, Ben climbs a small ridge and sees that the only way showing any hope is to head southeast. He can fashion something like a stretcher for Ashley from part of the exposed wing, and a shovel of sorts from a rudder flap with which to dig in the snow and bury Grover's body.

On day six, Ben gently lifts Ashley in her sleeping bag onto the sled, puts the dog beside her and adds Grover's bow, arrows and fly rod. Ashley grabs his arm. “One question, and I want an honest answer. Can you get us out of here?”

Seriously? No idea.”

Her eyes narrow. “We've got to work on our communication. I'm not asking you because I want honest answers. I want you to lie your butt off. Tell me we've got only a mile to go when there might be a hundred ahead of us.”
I laughed. “Okay. Listen. There's a helicopter waiting just beyond that first ridge. They've got sausage, muffins, and a dozen glazed donuts. And Starbucks.”

She patted me on the back. “Now you're getting the hang of it.”

But the going was slow. Leaning into the harness I had devised, I would take three steps and stop to breathe. By noon, we had gone maybe a mile. By dusk, perhaps two. It wasn't just my busted ribs. The air at 11,000 feet elevation is thin. And our food about gone. A few finger-sized fish. And one day, a rabbit.

Day eleven.After an hour we'd come maybe a quarter mile, dropping maybe a hundred feet in elevation. She was not impressed. “How long do think you can do this?”

Don't know.”

We can't do this. You can't. We're in the middle of nowhere.”

I stopped, sweat dripping off me, breathing deeply. “We can't stay up here. If we do we'll die. And I can't leave you. If I do, you'll die. So we're walking out.”

Her frustration at being helpless bubbled over. She screamed, “It's been eleven damn days and not a soul has come looking.. What's your plan?”

One step at a time.”

And how long do you think you can keep that up?”

As long as it takes.”

We didn't speak again for several hours.

Day fifteen. Overlooking a wide valley in the distance, I could see some kind of horizontal line half-hidden.

Day seventeen, we see it closer, a building across a frozen lake. A large A-frame, empty; evidently a summer campground. No sign of car tracks, or people. But warm shelter! firewood, water. And big game nearby. A map on the wall with a “You are here” mark tells us we are in the Ashley National Forest. But it nearly becomes her memorial park before anyone finds us.

It will be another ten days before we will reach civilization. And, despite all the complications we have encountered so far, the end will be stranger yet.

Tuesday, May 29, 2018

Pres. Trump's pharmacy ideas

President Trump has it backwards when he declares that USA will no longer subsidize foreign countries' low prices of American medicines.
American pharmaceutical companies price their medicines lower in foreign countries in order to compete with similar medicines manufactured in those countries. Their huge profits on American sales allow this.
I am an American-trained physician (now retired) who spent five years in Myanmar, and another ten years in Thailand, licensed by both governments to practice medicine and surgery. I worked in hospitals and was in charge of ordering the medical supplies. That was in the days when most companies published prices in their catalogs.
I ordered many generic medicines from the Rangoon-based Burma Phramaceutical Industry. Their manufacturing standards followed the British Pharmacopia. Local labor, and lower shipping costs allowed them to sell at prices most Burmese could afford.
For medicines not sold by BPI, I shopped around from Australian, Japanese, or European catalogs, all of them eager to expand into Southeast Asia. I needed very few medicines from USA.
What the US Government is doing is subsidizing exorbitant profits for American corporations by preventing US agencies (Medicare, etc.) to negotiate costs.
This is counter-productive for the American public. Congress could easily remedy this:
(1) Require pharmaceutical and medical equipment companies to publish their up-to-date wholesale prices in annually published, freely available catalogues. I have found most physicians clueless about the cost of medicines they prescribe.
(2) Eliminate the ban on negotiation of prices by public agencies.

Keith Dahlberg, MD keithdahlberg03@gmail.com

Wednesday, March 21, 2018

DOCTORS WITHOUT BORDERS

Doctors Without Borders
I first met this French medical group near Sangklaburi, Thailand when I was working at the Kwai River Christian Hospital on the Thai/Myanmar border in 1994. A dusty pickup truck would occasionally arrive bearing a patient in need of surgery or some other crisis they could not treat in their rural clinic across the border.
The paved two-lane highway that went past Sangklaburi was probably the shortest road between Thailand and Burma (now called Myanmar), following the old “death railroad” of World War II notoriety, crossing the border at Three Pagoda Pass. It was a convenient way for smugglers to sneak illegal imports into Burma, a caravan of eight luxury sedans, for example, that we met on the road one day.
But the road was unique in other ways, too: it had a branch going due westward passing right by the Hospital (20 km west of town) and proceeding another 10 km to a point on the national border that Mon tribal rebels controlled, at the village of Holokani.
Many Burmese enter Thailand looking for jobs. Thai Immigration police jail those lacking proper documents and ship them back to Myanmar, but not where the Myanmar police can arrest them. In Mon territory they have a long border over which they can infiltrate without much risk. Every Wednesday two or three truckloads of deportees, a hundred per truck, would pass the hospital en route to Holokani. Often there would be several who were too sick or too malnourished to walk across the border, and they would be dropped at the hospital. Immigration had a standing agreement that they wouldn't hassle them while under treatment, and we would send them on their way when they were strong enough. We had a safe house with exercise equipment where they could stay in the meantime.
Lois and I went to visit Holokani one day, accompanied by a couple of locals. The pavement ended 3 or 4 km beyond the hospital, and the road got progressively worse over the rest of the way. Holokani turned out to be a population of some 5,000 people, living in bamboo thatch-roofed houses, crowded on both sides of the road for 2 or3 km. The town had no electricity, no running water or farmland; everything was provided by the Thai Border Consortium, a volunteer group. The Doctors Without Borders had a larger bamboo building with room for about 20 patients lying on the floor. They had a microscope using sunlight-and-mirror, were able to give IV fluids and blood. By contrast, our little mission looked like a city hospital. with its lab, X-ray and operating room.
I never again gave a hard time to the people in the dusty pickup, and I still make contributions to the Doctors Without Borders, God Bless them!

Thursday, February 15, 2018

ONE HUNDRED MILLION IN THE AUDIENCE

ONE HUNDRED MILLION IN THE AUDIENCE 2,380 wds

In 1979, Communist Viet Nam invaded Communist Cambodia, where Pol Pot had set up his Khmer Rouge government. The Khmer Rouge are said to have executed between one and two million of their own citizens during Pol Pot’s doctrinaire rule. During rainy season, the mud kept the two armies apart. But in late October, the Vietnamese tanks could move across the land again, pinning the Khmer Rouge army against the Thai border.
Each army had tried to deny food to the other, and so each side had destroyed crops wherever they found them. Hundreds of thousands of Cambodian refugees, mixed with fleeing Khmer Rouge soldiers, were caught in the hill forests of southwestern Cambodia. They had no food except leaves on the trees, and no protection from malaria and other forest diseases. As the Vietnamese army drew closer, a half-million or more sick and starving human beings fled across the border into Thailand.
There was nowhere to put them. The daily newspapers carried pictures of dying children and mass burials. Thirty-thousand refugees flooded across the border in a single day, near the border town of Aranya Prathet, and were vulnerable to the mortar shells of the pursuing Vietnamese. The Thai army assembled dozens of buses to move the refugees away from the border, and set up the first of many camps by clearing a field near the town of Sa Kaew.
Up in Mae Sariang. 500 miles to the northwest, I wrote to our former neighbors Bob and Pat Coats who now worked at mission headquarters in Bangkok:
"We understand that some 91,000 have come across the border from
Cambodia this month, that a great many need medical help, and medical workers are swamped. We try to look at this realistically and not let our emotions run away with us. But the thought persists that here we are, in our slack season, [in rice harvest time]
seeing patients for only 3 to 5 hours a day, when there is this shortage of
medical help down on the border. We could spare a doctor for a month
or so if you can use us. We don’t know if this is God’s will or not, but thought
we would make the offer and see what he does with it."

A telegram asked us to come as soon as possible. Lois and I were in the first group to go, along with Rosa Crespo-Harris, Mala (a Karen nurse) and Weena, a Karen nurse-aide. We drove to Chiangmai next day and took the overnight train to Bangkok, where Bob and Pat Coats met us. They explained that we would be on loan to CAMA Services, the relief arm of the Christian and Missionary Alliance Church. We would work at the Sa Kaew camp, three hours drive east of Bangkok, where Red Cross was setting up a tent hospital. CAMA had a permanent medical team coming from Holland, but they wouldn’t arrive for two weeks. Rescue workers said thousands more refugees were scattered about the border area, many of them too weak to walk. The camp had existed for four days when we arrived, and of the 30,000 refugees, 1,200 of them were in the make-shift camp hospital. Some ill Communist soldiers were among them, but those strong enough to fight were still across the border in Cambodia. Sa Kaew was far enough back from the border to make hot pursuit by the Vietnamese unlikely.
Our driver turned off the highway and stopped at a Thai Army checkpoint, where a Red Cross worker gave us ID cards. My first impressions were of a sea of mud, surrounded by barbed wire. Thousands of make-shift lean-tos― blue plastic sheets supported by a few sticks― crowded the fields. Our first problem was to navigate the deep mud. We picked our way from rock to tree root; at one point, Lois had to reach elbow-deep into the mud to retrieve a shoe. The hospital area was on slightly higher, more solid ground.
The refugees were deathly afraid of the Khmer Rouge among them, and we had no way of telling who was who. We just treated them all as the severely ill humans they were. We didn’t even have a translator for the first two or three days.
That first day was chaos. We were put to work immediately on arrival, I with another new doctor, Lois over in a large tent full of orphan children, and we lost track of the other team members. None of us knew where things were, or even what was available. Each of us scrounged through the supply tents to find whatever might be useful. At dusk, another convoy of army trucks arrived, bearing yet more starved, feverish, even unconscious people, with meager bundles of cook pots or other small possessions. Some made no move to get down from the truck, and workers clambered up to pass them down to those of us waiting on the ground. Another worker and I struggled to carry a comatose man on a piece of box-cardboard over to the perimeter fence and pass him through the barbwire to others inside.
Severe starvation resembles being isolated in a blizzard. First you burn the firewood to keep warm. When the firewood is gone, you break up the furniture, and finally the walls of the house itself, to ward off death. Many of these people had lived off nothing but their own body tissues for weeks, and had arms and legs scarcely bigger around than their skin-covered bones. They had lost all fat and most of their muscle, to fuel the remaining small spark of life. Even the proteins to make digestive juices were gone.
We had to be very careful not to overload their digestive tracts those first few days. We started with clear broth, with a little rice and vegetables added. Some couldn’t even handle that, and quietly died after reaching the camp. After a day or two, we added protein gruel, “Kaset food” made by Kasetsart University in Bangkok. Weena carried a pail of it back and forth, ladling out a cup twice a day to each of our ward’s hundred and fifty patients. Later still, rice and curry came from a central kitchen for all 30,000 in the camp. Different volunteer groups managed each of the dozen or so tent-wards; we cooperated with each other, but we were too fatigued to socialize much.
We treated malaria, diarrhea, pneumonia, parasitic worms, anemia, and nutritional deficiencies. The chief deficiencies were iron (malaria destroys red blood cells) and beri-beri (lack of thiamine, one of the B vitamins, causing nerve weakness and heart disease.) That first day, we had nothing to clean patients with, nor any change of clothing for those who had soiled themselves. Each morning when we came to work, those who had died in the night had been left outside the tent, rolled up in their bamboo mats. We took the dead to the penetrating stench of the morgue tent at the far edge of the hospital area, to await burial in mass graves by Buddhist monks who volunteered their service.
Those first few days, silence reigned in the hospital tents except for coughing. Not even a baby crying. Everyone lay there on mats, too weak to move. I remember how, during the first week, they gradually began to talk and even smile and walk around as they grew stronger. In particular I remember two men, an amputee and a blind man, who often walked together, the cripple on his crutches, holding a guide-stick for his blind friend to grasp and follow.
Daily bus-loads of volunteers swarmed out from Bangkok to respond to the need. Leaders of Bangkok society mingled with students, digging ditches, feeding patients, acting as go-fers. Our daughter Nancy and some of her schoolmates from International High School used their "Senior Sneak" holiday to come help. One elderly European man, with whom I could only converse in Thai, adopted an old Cambodian who was too weak to lift a spoon by himself, and stayed with him night and day until the old man died.
Bob Jono, a CAMA supervisor about half my age, saw to the medical team’s needs. He found us a Khmer man who spoke Thai, and a Khmer girl who had returned from her home in New Zealand to help her fellow Cambodians, despite her terror that the Khmer Rouge would murder her. That made our job much easier. Through an interpreter, we could hear the patient's symptoms; we no longer had to practice "veterinary medicine."
Jono and his crew also made sure that a hot meal awaited us back at our house in town each night. The camp had a security curfew, not even medics were allowed to stay after dark, except for a single team to keep watch over the whole thousand-bed hospital from six pm until eight a m. Jono and I had to stay after the rest of the team left, for staff meeting at the Red Cross tent, where the day’s problems were worked out. I got back to town each night about 7:30 p.m. after a thirteen-hour day, ate supper, and fell into bed.
The second week was a little better. Fewer died, and many were obviously recovering. A lab technician appeared from somewhere, and set up a blood transfusion service. He split every pint in two; even a half pint is enough to help someone with a hematocrit of only two. By mutual consent, the medical teams refused interviews unless the reporter could show his receipt for donating blood.
An orphan girl in our tent, eight or ten years old, pointed excitedly one morning at the passing people. Her father and sister had just passed by; she had been separated from them a year ago! And a little girl who had been bed-ridden with beriberi heart disease squealed in mock alarm as her sister told her I was going to give her a shot. (I wasn't.)
Lois and I had even taken our turn on the all-night hospital crew. There isn't much you can do for a thousand patients, most of whom you've never seen before. The four of us (another nurse, Ruth Jones, and Tan, the translator) tried to visit every ward at least every three hours and be sure the IVs were running properly. We removed two patients who had died; checked one teenager with severe diarrhea, and a couple of women in labor.
About three o'clock in the morning, I took a few minutes on a break to gossip with the Israeli military doctor from the triage tent, the one other medic who was allowed to stay all night. We watched a team of workers adjust the new lighting on a scaffold outside, where a drilling crew was sinking a well. As we looked up at the scaffold, I said meditatively, "Haman built a gallows, fifty cubits high . . ."
Startled, the Israeli demanded, "How did you know what I was thinking! Where did you hear that story?"
"Hey, the book of Esther is in our scriptures too, just like yours."
News media were everywhere, every day. A man squatted beside me with a hand microphone as I treated a boy with pneumonia, and asked me to describe the case. I am told I was on Voice of America Radio the next night. A few days later, a television crew from NBC taped the hospital. I happened to be the only doctor available who had an American accent. Letters from back home later told me I had appeared in all the bars in Kellogg, to shouts of “Hey! There’s Doc Dahlberg on TV!” The broadcast was repeated several times all over USA and Europe, probably the only time in my life I will ever speak to over a hundred million people. At the time, I was more concerned with tucking my feet under me so the camera wouldn’t show how swollen my legs had become from long hours without rest.
Rosalynn Carter talked with Lois when the First Lady toured our tent. (I missed that because I was at a meeting back in town that day, orienting a group of newly arrived doctors.) Mrs. Carter asked her several questions, but Lois says her own finest moment was in response to all the newsmen, who nearly trampled our patients as they shouted at her, “Get down! Get down!” so they could get a clear photo of the President’s wife. Lois said, “If the reporters would move back a few feet, they wouldn’t be standing in the patients’ latrine ditch.” A lady in the group said, “Oh dear! I wish I’d known that a little sooner.” And one of Mrs. Carter’s Secret Service men grinned to Lois, “Say it louder. We’re being recorded.”
We were more tired every day than I can ever remember being. And I felt a dull anger as I watched some of my patients die, anonymous and alone, an anger at those who start wars and let others pay the consequences. But you suppress your emotions after the first day or two, because you have to choose between emoting about the tragedy, or doing something to fix it. I found I don't have enough personal resources to do both.
But the feeling I remember most, and am most grateful for, came to me one evening after the nightly staff meeting, as I drove back to town alone in the warm night air. Through the open car window I inhaled the pungent, vinegar smell of the tapioca crop drying in the farmyards I passed. I felt at peace, tired but no longer drooping with fatigue.
We had taken everything that Sa Kaew camp had thrown at us, and most of our patients were getting well. And I thought, I can do this! I can practice medicine under the worst conditions, and still look anyone in the eye and know without any doubting: I am a doctor! No one can ever take that away from me.
And I shall always remember the effect a single letter or action can have on one's life when mailed at the right moment, not only on other people's lives, but on my own as well.

THE SECOND AMENDMENT

The United States Constitution addresses the right to bear arms. I don't have much problem with that. Guns are useful to hunt food or protect one's family from danger. But when the writers of the Constitution were alive, there were no automatic rifles, no machine guns. They did not even exist on a drawing board.

No one who lived then could conceive of a young man buying multiple guns, and tens of thousands of rounds of ammunition. Nor would they have waited to hold such a person accountable to civil authority until after he has already committed mass murder. Am I the only one to imagine that fifty men could conspire to each buy that much, to start a civil war or terrorist plot?

Police, military, and publicly organized disciplined militia conceivably might have reason to own such weapons. But common sense and the daily news media show that free market sale and ownership of semi-automatic weapons are not controlled by licensing alone, no matter what the NRA claims.  Private ownership of bombs, antiaircraft guns, howitzers, armed tanks, are all forbidden. Even the cannon in my home town's veterans park had to be neutered before the army released it.

Weapons similar to the AR-15 have no use other than to kill multiple human beings rapidly. Individual trade, sale, or possession should be a felony. How many more school children have to die to get this idea across ?