Thursday, March 04, 2021

The Sound of a Sucking Chest Wound



     “Laypersons can treat penetrating chest injuries (sucking chest wounds) by the application of an occlusive dressing. These chest seals may slow the development of tension pneumothorax and allow for better breathing. All penetrating chest wounds need to be treated. They are used on any penetrating injuries from collarbone to naval (belly button) on all four sides of the thorax.”

     Did you get that? It’s the technical procedure soldiers follow when treating a “sucking” chest wound. It’s an ugly injury, usually caused by a bullet or piece of shrapnel, and it causes a nasty sucking sound, as air enters the chest cavity and a lung begins to collapse, not unlike the sound you might hear from a covid-19 victim in need of a ventilator.

     Often, the wounded soldier is too weak or disoriented to apply the bandage himself, so the first soldier on scene must act quickly by taking the bandage from the injured soldier’s pouch and placing it over the gaping wound, tie the attached laces tightly, and continue on with the mission. When a medic arrives, he will probably have to cut a hole somewhere in the throat, so the soldier won’t choke to death, then get the fallen warrior to an infirmary.

     Anyway, that’s how the drill instructor taught us in the first-aide class in Basic Training. The D.I. even had us partner-up, take our buddy’s bandage from his pouch, and place it on him, as if he were wounded. When one guy finished, we switched places and repeated the mock procedure.

     I use the masculine, guy, because when I was in the military there were no women, unlike today. I think it would be difficult to confront a real combat situation and see a woman, her chest exposed, an open gash on her flesh, and blood spouting everywhere. Oh, it has nothing to do with sex, as some might quickly assume. It’s more sentimental, maybe even sexist. For me, even imagining a woman with a sucking chest wound, might bring up thoughts of my mother, aunts, or sisters, and the idea of seeing them suffering, surrounded by dirt, smoke, cries for help, and stink, would be traumatic in itself. Our society has conditioned us to see men suffer in combat, yet, now we know, women are also suffering.

     Anyway, back to Basic Training. What really has stayed with me all of these years about that one first-aide class was when the D.I. said, “And if the guy with a sucking chest wound, for any reason, doesn’t have his bandage, DO NOT! I repeat, DO NOT! under any circumstances, use your bandage on him.”

     Of course, that left a lot of us bewildered. After weeks of training, we’d been taught about brotherhood, self-sacrifice, teamwork, and “leave no man behind,” all that stuff. I can’t remember one-hundred percent, but I’m sure, someone must have asked, “What do we do?”

     The probable answer, “Call for a medic and move on.”

     The D.I. let it sink in. These highly-trained cadre, the finest of actors, and with perfect timing, would eventually explain how each soldier is responsible for the maintenance and accountability of his own equipment. You don’t share water from your canteen with anyone, your C-rations or mosquito repellent, and you don’t use your only bandage for a sucking chest wound on anybody else. The lesson: if you give yours away don’t expect the guy who finds you with a hole in your chest to give up his. In fact, he is under strict orders to keep his for himself.


     This tough lesson has stayed with me all these years, and it made me aware of people who were unprepared for life's precarious situations, or they just didn’t care, and when they’d exhausted whatever rations they possessed, they, casually, borrowed from others, a sense of self-entitlement. 

     Even forgetfulness, in the military, can be a sign of weakness. I remember in the '70s, a few years after returning from Vietnam, I saw the movie the Deer Hunter. In one scene, the main characters, friends since childhood, arrived in the mountains to begin their day of hunting. One guy showed up without his boots. After razzing him, the others told the main character, Michael (Robert De Niro), to let the guy borrow his extra pair of boots. Michael refused, accused the guy of always forgetting something or coming unprepared, then flat-out said, “No, no way, not this time.”

     Michael's refusal upset the friends, as if a code of brotherhood had been violated. How could he not let his friend borrow his boots? But it was Michael's last days as a civilian. He was preparing to enter the military, maybe his mindset had changed, and he realized life wasn't a game. 

     I suppose part of Michael’s anger was his friend’s lack of personal responsibility, and shifting that responsibility onto the others, who now had to make up for the friend's lack of preparedness. Also, maybe Michael’s boots weren’t an extra pair. After trekking in the snow all day hunting deer, clothes and boots get wet. Perhaps he wanted to use those boots when his first pair got soaked and were unusable. Now, by letting his friend use his extra pair, he’d have to stay in wet boots all day.

     This reminded me of a Study Abroad trip another teacher and I took to Belize with about 30 college students. We had an all day trip planned to visit a pyramid complex in the jungle. We told the students how to prepare and what to take. Some students felt no need to carry water, claiming the extra weight was an inconvenience and there had to be some place they could buy bottled water along the way. There wasn’t.

     Inevitably, when the rest of us stopped to sip from our water bottles or canteens, those without water asked others to share theirs with them, which left many of students dying of thirst by the end of the trip. I remember the look the students gave me when they saw I wasn't offering to share my water. Finally, when one student asked for a drink, I refused. I could hear my D.I.'s voice telling me to keep my bandage in my pouch and let no one use it. 

     I'm glad I remained firm. The day had been much hotter and the hike much longer than expected. I barely had enough water for myself. Oh, I knew the students would survive a few hours without water. A human can go, what, five to seven days without liquid? I was hoping to teach them a lesson, reminding them they'd been instructed what to carry . When we returned from the excursion, those who had taken no water, or who had run out, were useless. Those who had prepared were still strong.

     My military training is so much a part of me, on the same trip to Belize, I saw the students walking casually, clogging up a muddy trail, the jungle surrounding us, I called, “Put some space between you and the person in front of you.”

     Of course, one of the kids returned my warning with, “Why?”

     How could I tell them that one grenade would take out the lot of them? Instead, I offered, lamely, as if they were dominoes, “Well, if one of you falls, you’ll knock down everybody behind you.” That got a laugh.

      During the pandemic, I watch human behavior unfold around me. As difficult as it has been, those who self-quarantine, wear masks, social distance, wash their hands, take the vaccination, stay informed, and, generally, act responsibly in the face of a possible deadly virus, bear the burden for those who don’t.

     This month, it's been a year since my wife and I have stepped into anyone else's house or anyone has stepped into ours, except for brief home repairs. Fortunately, my adult children understand. They also have remained quarantined, as much as possible. If we see each other, we stay outside, masked, and at least six-feet between us.

     I can hear some say this is taking it all too far, especially in Latino and ethnic families, where it’s difficult for the elders to tell their children and grandchildren they can’t visit, or come into the house. I have friends whose children and grandchildren continue to visit. My friends babysit and entertain, even when they tell me they feel it’s unsafe. They say things like, "But it's our kids." Their adult children expect the grandparents to continue as if all is normal.        

     Then I hear of grandparents who have caught the virus, ended up on ventilators, and passed away, no one at their sides. Their children cry on social media about what great-grandparents they were, always playing with the kids, cooking great meals, and telling wonderful stories, which tells me, the pressure to quarantine was just too much for them, so they gave in. They found it impossible to keep their bandage for a sucking chest wound where they could use it if they needed it. Instead, they gave it away, so when they needed it, the pouch was empty.

     I remember the message that wise D.I. was delivering in Basic Training. “If you don’t take care of yourself first, you can’t take care for anyone else.”

     If the “bug” gets me because I wasn’t strong enough to do what I know was correct, I have no one to blame but myself. If I listen to some powerful politician say it’s all a hoax, and I refuse to take precautions and get sick, I have only myself to blame for my gullibility, especially, when privately, the politician is making sure he and his family get vaccinated, out of the public’s eye.  

     Sure, any of us can get sick or catch the virus anywhere, at any time. That’s fate, an enigma, a mystery, but we all must play the odds as best we can, like the time I was sitting just inside my hootch and a sniper’s bullet whizzed past my ear, missing me, it seemed, by inches, but because I chose to listen to my team leader and stay in a safe place, just outside of the sniper’s line of fire, I survived, even if only by inches.  

      If I use my bandage on someone else during this pandemic, and it isn’t there for me when I need it, I shouldn’t expect anyone to use his bandage on me if I should hear a sucking sound through a ventilator.

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