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The previous column has described Dr. Lawrence Jelsma’s medical education, including MD from The Johns Hopkins University School of Medicine in 1962, followed by internship at the University of Kentucky Medical Center in 1962-63.
In 1966, in the midst of a 5.5-year residency in neurosurgery, he was drafted into the U. S Army Reserve with the rank of captain in the Medical Corps. In June 1967, he was ordered for duty in South Vietnam, leaving his wife and two children at home.
Here, he served as a neurosurgeon with the 24th Evacuation Hospital (24th Evac) at Long Binh for a year until June 1968.
This is where we pick up the story of Dr. Jelsma, with the incredibly difficult conditions under which he not only had to live but also treat those who were injured severely.
For instance, in South Vietnam the Army had its own potable water supply, because local water was not safe to drink. Toilets were burned out daily. The smell of deteriorating fish, put on tin roofs of civilian huts to cure, was overwhelming and constant. It permeated the encampment.
“The six-month-long monsoon season worsened the living conditions in our semipermeable tents,” he said. “We finally received permission to build our own Adams hut and thereafter did not have rain- soaked cots and deep mud in the sleeping area.”
Jelsma said he performed more than 376 neurosurgical procedures during his year in Vietnam. Of these 330 involved the head and 46 the spine.
After a battle, when casualties increased, the capabilities of the 24th Evac and its surgeons were put to the test, requiring application of triage, which is a process of determining the priority of patients' treatments based on the severity of their condition, allowing more efficient treatment when resources are insufficient to treat all patients immediately.
GI’s were given first priority. A clinical protocol was developed in the handling of those patients that available resources could not save.
In the operating rooms, uniforms were not required. The focus was on the patient, rather than on military dress. The 24th Evac handled all U. S. Army neurosurgery cases, as well as those of the Army of the Republic of Vietnam, Viet Cong and North Vietnamese Army and civilians casualties.
About 75 percent of wounds were from explosives – artillery, mortars, improvised explosive devices (IED’s), etc. Up to 20 percent of all wounds were head wounds, resulting in part from failure to wear helmets in the hot and humid jungle. In the Korean War, only 12 percent of wounds were head wounds; it was easier to wear helmets in the temperate climate of Korea.
The 24th Evac had up to 25 surgeons, three of whom were neurosurgeons. They were supported by nurses, both male and female, and Army corpsmen.
Neurosurgery patients were kept an average of six days in the ICU at the 24th Evac before being airlifted to the Naval Base in Yokosuka, Japan.
Ammunition dumps were located not far from the 24th, and sometimes they were infiltrated and blown up. After a blast, the surgical hut would move and glass would shatter as IV bottles hit the ground.
Finally, dust would rise, creating a fog that permeated the operating theaters. This often resulted in electrical outages, requiring ingenious “jury-rigged” substitutes for lighting in the midst of an operation.
Electricity was supplied by generators, which often shut down during attacks and explosions. During these interruptions, it was possible to continue operating by use of a Jeep seal-beam light, connected to a storage battery and held by an orderly.
The Tet Offensive
During the Tet Offensive (January-February, 1968), launched by the Viet Cong and the North Vietnamese Army, Long Binh Post was attacked, and the ammunition dump was blown up.
The Viet Cong came out of hiding to attack the ammunition dump on Feb. 4, 1968, destroying at least 15,000 high-explosive, 155-mm artillery projectiles.
Jelsma was one of only two neurosurgeons at the 24th Evac at this time. They worked in 12-hour shifts for two weeks before the regular schedule could be resumed. He described the challenges faced.
“I will never forget the sound of an incoming helicopter,” he said. “Each time the choppers came in, they were loaded with desperately wounded men. We ran to the operating room to get ready.
“The Army Huey, converted for medical evacuation, was ideally suited for this mission. The pilot was usually a twenty-year-old warrant officer on a second or third tour of duty. These intrepid young men could fly under fire and land anywhere.
“Without the esprit de corps of the support team, we could not have done our job.
“Keeping the surgeries going was difficult, with surgeons, nurses, and corpsmen working twelve hours on and twelve off. The twelve hours off was often consumed by the demands of post-operative care.”
The 24th Evac received its first Meritorious Unit Citation in recognition of its performance from Jan. 9, 1967, to Feb. 25, 1968, which included its response to the Tet Offensive.
Although the Tet Offensive was a military defeat for the Communists, it had a profound effect on the U.S. government and shocked the U.S. public, which had been led by its political and military leaders to believe that the enemy was incapable of launching such a massive effort.
Jelsma said he recalls hearing, not long after Tet, that President Lyndon Johnson had decided not to seek reelection. This decision by the president, announced on March 31, 1968, had startled the nation, as well as those fighting the war in Vietnam.
After the war
Upon coming home from Vietnam, Captain Jelsma returned to Johns Hopkins Hospital from 1968 through 1970 to complete his residency, serving as chief resident in Neurosurgery in 1970. His brother, Richard,, also a neurosurgeon, served at the 24th Evac Hospital during 1970-71.
In 1971 Jelsma joined his father, Franklin, and Richard in the private practice of neurosurgery in Louisville. He found that the ease of sharing opinions in their specialty among family members was very helpful.
The Jelsmas of Shelby County
In 1984, the Jelsmas purchased and renovated Stockdale, a Federal house on the Eminence Pike, adjoining their farm. It was built between 1830 and 1832 by Charles Stuart Todd and his wife, Letitia, on land left in trust to Letitia by her father, Kentucky Governor Isaac Shelby.
Todd, (1791-1871), son of U.S. Supreme Court Justice Thomas Todd, in 1816 was appointed Secretary of State by Kentucky Governor George Madison. He later served as the 15th U. S. Ambassador to Russia, from 1842 to1846.
Stockdale is described by John David Miles in The New History of Shelby County Kentucky as being "by far the most sophisticated early dwelling to survive in Shelby County.”
Sherry Jelsma, a former chair of the Jefferson County Board of Education, served as Secretary of the Arts and Humanities Cabinet during the administration of Governor Brereton C. Jones. She is the immediate past president of the Shelby County Historical Society.
In my discussions with Dr. Jelsma, I was impressed with his low-key, objective manner in discussing his experiences and, in particular, by his emphasis upon the vital roles played by his assistants, such as corpsmen and nurses.
Ron Van Stockum can be reached at firstname.lastname@example.org. His latest book, Coming to Kentucky: Heaven is a Kentucky of a Place, just off the press, as well as his others, Kentucky and the Bourbons: the Story of Allen Dale Farm, Squire Boone and Nicholas Meriwether: Kentucky Pioneers,and Remembrances of World Wars, may be purchased at Terhune’s Style Shop in Village Plaza Shopping Center in Shelbyville or from Amazon.com.