In Mekong Medicine: A U.S. Doctor’s Year Treating Vietnam’s Forgotten Victims (McFarland, 222 pp. $35, paper; $16.49, Kindle), Richard Carlson offers an extremely sobering account of his efforts to provide the best possible medical care under Spartan conditions at a civilian hospital in South Vietnam during the war.
In 1966, two years after completing medical school at the University of Southern California, Carlson was drafted into the Army. After basic training at Fort Sam Houston, he received orders for Vietnam. Posted in Bac Lieu Province, sixty miles southwest of Saigon in the Mekong Delta, he spent a year at the provincial hospital where he led the American team of military and civilian personnel in the Military Provincial Health Assistance Program.
The contrast between American hospitals and a rural Vietnamese facility was shocking. Set in one of the world’s poorest countries, and one at war for years in a relentlessly hot and humid climate, the hospital resembled a farm in many ways, with animals wandering across the grounds–and often into the buildings.
Supplies of medications, equipment, clean water, and electricity—the hallmark of any modern hospital—were inconsistent at best. This was especially problematic as the staff dealt with endless numbers of patients that increased as the war dragged on. Despite the shortages, and because he had to view medical problems as objectively as possible, Carlson’s voice remains that of a doctor throughout his book, no matter how dire the condition of his patients.
He and his team brought heartfelt compassion to their work in caring for patients struggling with illnesses or grievously wounded. Their compassion, though, was too often tempered by the grim knowledge that there was only so much they could do. Some patients succumbed to their injuries or illnesses, while others deemed themselves well enough to leave on their own. Many children died, and their grieving parents simply took their bodies away and disappeared into their private darkness in ways completely unheard of in an American hospital.
Throughout the book Carlson repeatedly praises the dedication of his co-workers, Vietnamese and American, as they tried to accomplish the most while working with so little. He gives the highest praise of all to the hospital’s director, Dr. Vinh.
Initially appearing reserved, even solemn, Vinh displayed extraordinary depth of feeling and candor when he mused about his country’s future, as well as dismay when he witnessed the results of the Viet Cong’s treatment of the people they claimed to love.
Dr. Vinh also provided insights that were slow to come to many American newcomers, particularly why change occurred so slowly in Vietnam. After centuries of foreign occupation and countless years of war, the country’s capacity to improve itself, especially in the rural interior, was strained to breaking point.
Despite the bleak conditions in which he was compelled to work, Richard Carlson finished his tour—and he ends his memoir—with a note of hard-earned optimism.
“Despite the horror,” he writes, “confusion, and the war’s conclusion, my odyssey reaffirms individuals will aid those in need despite overwhelming odds. And that is a reason for hope.”