The most intense experience of my life was the eighteen months I spent in Pleiku in 1967-1968 when the U.S. military involvement in Vietnam was at its peak, and I was working under the auspices of the United States Agency for International Development (USAID) as a nurse advisor at the Pleiku Provincial Hospital. I went as a young and idealistic nurse devoted to the care of the civilian population and learned from experience what it's like to be up close to this organized violence we call war.

One memorable patient was a 6-year-old Vietnamese boy who was very thin and pale, perhaps anemic. Third-degree burns covered the whole of his back, which looked very red and raw. He was burned while fleeing from an exploding napalm bomb, which was part of the arsenal used by the U.S. Army. We treated Vietnamese and Montagnard civilians who were injured or caught in the cross-fire in the villages and fields. They were sometimes given initial treatment and stabilized in U.S. Army Hospitals before being transferred to the provincial hospital. Others were simply left in the field untreated. There is no way of knowing how many civilians were injured or killed by soldiers during the war-many hundreds of thousands, including infants and children.

Every morning, I removed the gauze dressings from his burns and saw countless maggots, with their bodies writhing and swollen from feeding on dead or infected tissue over the past 24 hours, but his wound was successfully cleaned. With some squeamishness, I removed all of the creepy, crawly little grubs. The next day, there was a new bunch of well-fed larvae, which had done another great job of removing necrotic tissue. (It is true now, as it was then: Maggots are the most effective means of wound debridement and are still applied in modern medicine. See accompanying article by Juanillo in this issue of Pediatric Surgical Nursing 10:4.) We did not have to place an order for these maggots. They appeared, like magic!

This little guy was adorable and so cooperative and patient during the dressing changes, which must have been painful. He showed amazing courage; soon, I became very fond of him. When it came time for extensive skin grafts, I took this boy to Nha Trang, where the U.S. Army Hospital had excellent plastic surgeons on staff. When we left the hospital for the airstrip and an Air America flight to Nha Trang, there was no crying or resistance. He trusted me to take care of him, and I trusted his ability to deal with the procedures, treatments, and absence from home. No family or relatives ever came to visit him so he was presumed to be an orphan. We had a special bond.

When I presented the boy to the U.S. Army hospital ward where he would stay while under treatment, the GIs were immediately all around him, greeting him, patting him on the head, shaking his hand, and engaging him in dialogue with whatever Vietnamese words they had learned. This little guy would be the center of their attention in the next few weeks and would not want for affection, or anything the GIs could buy, cheat, or steal for him. I was thrilled for this kid! Although I had felt quite comfortable with the idea of leaving this boy with the GIs, I was overwhelmed with their welcoming embrace. Upon leaving, I said to the GIs, "Take good care of him," knowing full well that they would do nothing less than adore this child for every minute he was with them. When I picked him up some weeks later, he looked like a different boy with pink cheeks, big smile, and a healthy weight gain. He had been at a great risk of a life-threatening infection from the burns; now, he was healed.

I do not know what happened to this young child. His severe injury was limited to his back, and chances are that he was adopted or went to an orphanage-until he was of military draft age. All young boys could anticipate being drafted into the Vietnamese Army. Girls became single mothers and widows and also joined the work force. Some became prostitutes to support their families. Educational opportunities were limited.

Although I am older now as I write this in 2021, I remember the thrill of being a young nurse during wartime, even now. Thrills and heartache. Sadly, the loss and disruption of lives in war goes on and on.