A Different Face of War by James G. Van Straten

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James G. Van Straten served as a U.S. Army senior medical advisor with the South Vietnamese Army throughout I Corps in 1966-67. During that period, he wrote three hundred fifty-two letters to his wife and six children in Texas. Forty-five years later, he has assembled the letters into A Different Face of War: Memories of a Medical Service Corps Officer in Vietnam (University of North Texas Press, 497 pp.; $34.95 hardcover; $15.99 Kindle). The book takes the reader through Van Straten’s year, nearly day by day.

American advisors had no power of command within the Vietnamese military hierarchy; their leadership depended solely on persuasive talent. Advisors worked under the authority of Vietnamese commanders who made the final decisions on policies and actions. Nevertheless, advisors were accountable to their American regional commanders for overall results.

Recently, I read Bob Andretta’s Brown Water Runs Red: My Year as an Advisor to the Vietnamese Navy Junk Force, which describes how an American lieutenant immersed himself in the Vietnamese culture to influence the Vietnamese regional commander’s thinking. Maj. Van Straten employed a similar strategy. Both men, despite working long hours, including occasional around-the-clock days, attended countless Vietnamese town meetings and social functions to build relationships. Open hostility between Buddhists and Catholics complicated Van Straten’s task of remaining politically neutral.

Andretta’s experience centered on Navy combat actions. Van Straten performed Army medical service tasks. Their introspection about how to deal with cross-cultural differences makes these books valuable.

Under the supervision of Maj. Pham Viet Tu, the head doctor of Da Nang’s Duy Tan hospital, Van Straten constantly traveled across I Corps. The United States provided much of the material medical support, and Van Straten performed many minor miracles to ensure that its delivery was timely and in adequate quantity for Vietnamese soldiers and civilians. He faced the endless task of suppressing rampant outbreaks of tuberculosis, bubonic plague, malaria, cholera, rubella (measles), lice, dysentery, and diarrhea.

He also supervised movements of the wounded. Sometimes hospitals had to handle double the number of patients they could handle. During his time in Vietnam, I Corps suffered more casualties than the rest of the country combined. He helped to sort the wounded from the dead and the Americans from the Vietnamese.

In his ten-year Army career before the war, Van Straten had never been assigned to a hospital of any type. “The number of civilian casualties produced by the war was appallingly high,” he writes. “As a younger man, I had so wanted to become a physician, but exposure to trauma of that magnitude convinced me that I was not equipped to handle it. Sometimes I got mildly depressed. I was encountering heart-rending trauma almost on a daily basis.”

From this experience, Van Straten developed an overwhelming compassion for the Vietnamese people. In 1967, to counter the high civilian casualty rate, he helped relocate eighteen thousand civilians away from the DMZ to safer homes southward.

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A civilian hospital in South Vietnam during the war

In their occasional free time, he and American surgeons corrected deformities, such as cleft palates and clubfeet among civilians, mainly children.  Dr. John Henry Giles was the prime motivator for this program.

Beyond describing his everyday activities, Van Straten tells stories about revelatory encounters with a  long list of people, from the famous to the unknown. He explains nuances of Vietnamese culture overlooked in many other Vietnam War memoirs. He provides memorable word pictures of scenes such as the differences between American and Vietnamese casualty wards. He editorializes against the tactic of search-and-destroy.

He also subtly argues that the NVA won the war in I Corps while he was there and that an NVA final victory was inevitable. Many photographs, mostly taken by the author, supplement the text.

For James Van Straten, remorse for events that ended unsatisfactorily transcends the long interval since they occurred. He repeatedly apologizes for his mistakes—mainly minor and unavoidable—and wishes that any outcomes he left unresolved have had no negative repercussions on the people involved.

His conscience and wartime experience have locked the Vietnamese people in his mind forever.

—Henry Zeybel

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