Remembering Vietnam—Donna Barbisch

The National Library of Medicine (NLM) is pleased to collaborate with the National Archives and Records Administration (NARA) to present the panel discussion “Remembering Vietnam: Medics, Corpsmen, and Nurses” on April 26, 2018 at the McGowan Theater in Washington, DC, livestreamed and archived on YouTube, in association with the National Archives exhibition Remembering Vietnam. Panel members include Major General (Retired) Donna Barbisch, Colonel (Retired) Merle Snyder, Colonel (Retired) Don Hall, and Tom Berger, PhD. The discussion will be moderated by Dale Smith, PhD, Professor of History at the Uniformed Services University of the Health Sciences and a member of NLM Board of Regents. Today we hear from Major General Donna Barbisch, a nurse who served with the 91st Evacuation Hospital in Chu Lai, Vietnam, from 1969-1970.

Circulating Now: Please tell us a little about yourself, your decision to volunteer, and your experiences in Vietnam.

Donna Barbisch: In the late 60s, Walter Cronkite brought the Vietnam War and the casualties into our living rooms. I was in nursing school. I just knew that the Army, our guys, needed me. Nursing is an honorable profession, but there is no “higher calling” than taking care of the patriots who serve our country. I volunteered and was sent to Vietnam September 4, 1969, returning a year later with vivid experiences ranging from the rewarding feeling of saving lives to emotionally draining and clinically overwhelming challenges. At 21 years old, we were young and naïve. We taught each other and learned from everyone. It was intense and demanding and we all gave it our all!

Most of us had little experience in emergency nursing, let alone mass casualties. Sometimes up to 50 casualties arrived at one time. We had to triage casualties to identify how many we could save. We did not always have enough resources or time to save all of them, even if they could have been saved under different circumstances. It was hard to realize that if we had more time or fewer casualties to care for, more of these guys could live. We had to put some of the worst injured off to the side into the “expectant” category when taking care of them might mean losing several others. If they were still alive after we stabilized the others, we would work on them. Most of the time they died. It was horrific to have to go back and process their remains. As I emptied their pockets, I often connected with the pictures of their family or the notes they carried. Those things spoke volumes about their lives. I spent years saying the experience did not affect me. Today as I look back, I know it did!

91st Evac, receiving casualties, 1970

On the Ward, 1970

Working in the hospital, 1970

91st Evac, with Friends, 1970

Emergency Room, 1969

CN: What training did you receive before deploying to Vietnam? Did you feel adequately prepared?

DB: The training we received barely touched the surface, but it is hard to imagine anything that could prepare you for the work we did. At the time I went (remember I was 21 years old), I thought, sure I can do this! I joined the Army while still in nursing school. After graduating, I was commissioned as a 2nd Lieutenant and sent to San Antonio to attend the Officer Basic Course. They taught us how the Army was organized, how to march, salute, and follow orders. We learned about military weapons and the tremendous tissue damage they cause. We learned about injuries caused by shrapnel and booby traps. We spent two weeks in the field for jungle training where we learned the tactics and techniques used by the North Vietnamese and Viet Cong forces, along with learning to read a map and survive in the jungle.

CN: Your career evolved over the years from a nurse in Vietnam to a senior officer focused on terrorism and disaster management policy. What inspired the course of your career?

DB: I went to Vietnam to make a difference for the soldiers that needed nursing care. As I mentioned earlier, it was and I believe still is, the highest calling for a nurse. Working with our service members and the Vietnamese solidified my life’s goal of making a difference. During the ensuing years, I worked on defining my path in life. That path has been to go to school, practice a while and build on what I learned, then go back to school. After Vietnam, I became a nurse anesthetist, then went back to attain my bachelor’s degree, then a master’s degree, and finally a doctorate, all the while growing as an individual and searching for ways to improve outcomes in war. I discovered that we planned and trained at the tactical and operational level, but there was a gap in education and training at the senior leader level. We were putting our troops in harm’s way, ending their precious lives with little regard to the underlying issues that, if addressed appropriately, could improve outcomes.

After Vietnam, I moved from active duty to the Army Reserve. Within my military role, I became the commander of a Mobile Army Surgical Hospital (MASH). At the same time, I was the manager of an anesthesia department at a small community hospital and was working on my master’s degree in Public Health. It was 1992. The cold war was over. With the fall of the Soviet Union, few in the US wanted to consider the “what next” scenario. I became immersed in the planning factors I was first introduced to back in Vietnam. I took the lead in the Army for “Domestic Preparedness.” I worked with the Biological Warfare Improved Response Program (BW-IRP) where, as a senior subject matter expert, I built on my Vietnam experience. With what started in Vietnam and developed over a long Army career, I engaged in a doctoral program. My dissertation was “Identification of Barriers to the Use of Department of Defense Medical Assets in Support of Federal, State, and Local Authorities to Mitigate the Consequences of Domestic Bioterrorism.” It was published in early 2000. All my colleagues thought I was crazy. They told me the military would never use military assets domestically. My question to all who challenged me was, but if…then what? Planning is inexpensive compared to response! I presented to the Army War College in August 2001, just before 9/11, on the need for “surge capacity,” something I had to define at the time as no one seemed to be able to fathom what or how to manage mass casualties in the hundreds or thousands. The concept grew from my experience in Vietnam.

Vietnamese Ward, 1970

91st Evac Crest, 1970

91st Evac, 1970

Volleyball, 1969

Finally, as I’ve dedicated my life to synchronizing all the moving parts of a strategic or operational plan, it comes down to the leader to make it happen. To me, the leader’s job today, just as it was in Vietnam, is to have the supplies (stuff), personnel (staff), and facilities (structure) as well as the big “S,” the system, in place where and when they are needed. In 2006 I published an article about this in the journal Academic Emergency Medicine.

CN: Please share any closing thoughts about the National Archives event and the importance of remembering Vietnam as we commemorate the 50th anniversary of the U.S. involvement in that war.

DB: As those of us who were part of the Vietnam War came home, most of us put our experience behind us. I would only talk about it to other Vietnam vets. Today, we are a community of people moving into our retirement years when we have time to reflect. I am glad to see some of what we experienced being shared with the rest of the world. There were rewarding experiences and tragedy. I am amazed by how much I learned while there, and how much it influenced my life.

All images are used with permission from the personal collection of Donna Barbisch unless otherwise attributed.

Watch the panel discussion “Remembering Vietnam: Medics, Corpsmen, and Nurses” on April 26, 2018 live on YouTube.