Medical Lessons From the Vietnam War

‘If I can lead in a crisis, I can do anything…’

Doctor touching a child

By: Toby Cosgrove, MD

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Six months after finishing medical school, I was made a captain in the Air Force and sent off to Vietnam. It was 1968 and the war was in full force. Everyone had to do their part.

I was sent to Da Nang and put in charge of the 22 Casualty Staging Flight at Da Nang Air Base. Our duty was to evacuate all casualties from the I Corps sector of Vietnam. Sick, wounded and injured, there were 50 to100 new patients a day. Their bleeding was stopped on the field, and they were sent on to us to be stabilized and shipped out to advanced facilities overseas.

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Personnel and supplies were scarce. Conditions were comparatively primitive. The volume and severity of cases were beyond anything we would have seen at a civilian hospital. We were shelled by artillery. Firefights broke out nearby. Some people crumbled under the stress, but I remember thinking, “If I can do this: If I can lead in crisis, then I can do anything when I get home.”

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Excellence under all conditions

It was a lot of responsibility at an early age. In just five and a half months, we shipped more than 22,000 wounded personnel back to the United States. In the process, I learned that it is possible to achieve excellence under difficult conditions.

Today, as CEO and president of Cleveland Clinic, I’m still applying the lessons of Vietnam to our organization.

In Da Nang, we were continually inundated with patients. There weren’t nearly enough doctors and nurses. So we gave medical corpsmen major responsibilities. Everyone practiced at their level of ability and it worked very well.

This is how it will be at medical centers across the United States in coming years. There aren’t enough doctors to see all the patients coming on board. Advanced practice nurses and physician assistants will perform more routine care, and doctors will be free to focus on the patients who need them the most.

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Vietnam demonstrated the value of getting patients the right care, at the right time, at the right place. At Cleveland Clinic, we have a Critical Care Transport team that can go anywhere on earth to pick up patients and take them to the facility that is most appropriate for their treatment.

The importance of touch

There were also emotional lessons to be learned. Part of my job was to go from bed to bed and assess each patient to see if they were at least well enough to get on an airplane.

We had 100 beds. I didn’t have hours to spend with each patient, but I discovered the importance of touch. It didn’t take much. Sometimes I’d just shake their hand or touch their toe, but that small personal connection made a big difference.

Today at Cleveland Clinic, we build that connection through our Office of Patient Experience. We understand that patient care is a medical, emotional and physical process. Every patient deserves to be acknowledged and respected as an individual.

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