Within the general evolution of the art of war, the conflict in Vietnam was notable for several novel and important features that were destined to become irreversible. Among these were such things as the helicopter gunship, the electronic battlefield and even the hush-hush array of satellite-based surveillance assets. All of these are powerful tactical factors that we today seem to take pretty much for granted, to the extent that from our present perspective, a generation later, we may overlook the significance of their original development. We tend to forget that a large number of the key elements of modern warfare were totally new in 1965, and that it was the Vietnam War that first allowed them to be explored and deployed under the stresses of real and mortal combat.

From the viewpoint of troops on the ground in Vietnam, the innovation that made by far the greatest impact was not directly tactical at all, but actually medical in nature. This was the casualty evacuation helicopter, or "dustoff," which could whisk a wounded man to a well-equipped aid station within minutes, and from there to a base hospital within a few hours. One Vietnam infantry veteran told me: "The troops in my own unit always felt that if we were not killed outright if we were hit, the odds of surviving were in our favor. This added greatly to the confidence factor in any situation."

In historical terms, it represented still another advance in the speed of casualty evacuation and in the treatment of shock, which had significantly improved since the Napoleonic Wars. Until then, unless one was a high-ranking officer, wounded soldiers were not removed from the field until after the battle was over. In 1792, however, French surgeon Dominique Jean Larrey began to develop horse-drawn, two-wheeled "flying ambulances" for the swift removal of casualties–primarily to prevent their being slaughtered by the enemy–and he soon discovered that the earlier they were treated, the better their chances of recovery. Even after that fundamentally critical innovation, some 44 percent of the soldiers wounded during the American Civil War failed to survive, but by 1918 the British died-of-wounds figure was down to around 8 percent. In World War II it was 4.5 percent for U.S. troops, and in Vietnam it was as low as 2.6 percent.

Each successive improvement in medevac procedures brought a concrete tactical advantage in terms of troop morale, and in Vietnam the process was brought to practically the highest level it could possibly attain. There was also a political advantage for the U.S. government to take unprecedented care of its conscripted soldiers and lavish upon them a degree of medical succor that had been unknown in any previous war. Fewer losses meant more support back home.

The dustoff, however, did not come cheap. First, it involved a heavy cost in rear-echelon personnel, as well as some long-term cash payouts. More convalescents in the hospital, surviving for longer, meant that more doctors and nurses were needed to look after them, after which more veterans’ pensions had to be found. It is a sad fact that the average wounded soldier costs the taxpayer many more dollars than a soldier killed in action, however differently we may rate the psychic or moral costs. Second, the helicopters themselves represented a particularly significant drain on a precious tactical resource.

We must recall that 1965 came only 11 years after the entire French empire had been able to deploy a grand total of only seven helicopters in the Southeast Asia theater. The United States would eventually deploy something like 4,000. But even then the average time available for flying might be only about 10 percent, since as much as 90 percent of any chopper’s time had to be devoted to maintenance tasks. Hence, on average, only something like 400 helicopters were reliably available at any moment to cover all the requirements of the U.S. forces in-country, as well as of the ARVN and of the many political and civilian agencies.

If we break this down still further, it is not difficult to understand that only some 70 to 80 helicopters might be available for military use within each corps area. This might translate into only one or two dozen per division. Lifting a single infantry company might normally require some 16 to 20 helicopters, depending on fuel load. Those choppers were supplemented by the necessary accompaniment of gunships, command ships and associated heavy-lift support–or indeed the continuing routine requirement for logistic backup throughout the Army. So by definition, there can rarely have been very many surplus helicopters available for medevac purposes. As Lt. Gen. Harold G. Moore (then the lieutenant colonel commanding the lead battalion) later reported on the start of the November 1965 Ia Drang battle, "my main concern focused on the fact that we would have only sixteen Huey slicks to ferry the battalion into the assault area….What that meant was that fewer than eighty men–not even one full company–would hit the landing zone in the first wave…." (In the face of three whole enemy battalions!)

Then again, in December 1969, Lieutenant Michael Lee Lanning experienced a nerve-wracking wait when only three helicopters could be made available to lift his company out of the scene of a bloody battle. "We would have to be extracted in three separate lifts," he recalled. "Turnaround time between each sortie would be about thirty minutes. That meant that before the last group could be picked up, any lingering dinks would have an hour to plan an attack on the remaining eighteen men." All in all, we must conclude that despite the apparently plentiful supply of helicopters available to the U.S. forces in Vietnam, they were still always a relatively rare resource that needed to be managed and husbanded very carefully.

The dustoff suffered from a particular difficulty that has been common to all front-line ambulances throughout history. It was designed to rescue wounded soldiers from as near as possible to the time and place they were wounded–which by definition would add up to an especially dangerous situation. The dustoff had to fly right into the heart of the battle zone and pluck out shocked, suffering, bleeding and badly damaged combatants who might still be under heavy fire. Yet the medical crew also had to make sure that they themselves managed to survive such fire, so that their rescued casualty could be removed safely to an aid station in the rear.

That made for some urgent personal dilemmas. As one crewman recalled in Moore and Joseph C. Galloway’s We Were Soldiers Once…and Young: "The NVA were in the wood line shooting at the helicopter. The medevac pilot kind of froze up on us and was having trouble setting the ship down. We never did come to a complete hover. All aboard had to dive out on the ground from about six feet up in the air. We ran in a crouch."

On some occasions the infantry had particularly bad experiences with dustoff crews. William Shucart reported of the Ia Drang battle: "We were trying to get the medevac ships to come in but they would not. A couple of Huey slicks came down but we were taking fire and the medevacs wouldn’t come. When you are taking fire is precisely when you need medevac. I don’t know where those guys got their great reputations. I was totally dismayed with the medevac guys. The Huey slick crews were terrific."

Obviously, there was always a serious conflict of interest inherent in the whole business of medevac. On one side, the dustoff crews had to ignore the tactical dangers and go in regardless, and in fact many of them were often among the bravest men to be found anywhere in the military. Yet, on the other hand, they had to carefully calculate their risks and make sure that conditions were relatively safe, or at least safe enough. Otherwise, they would be certain to lose the wounded men they were evacuating as well as their own lives.

Pages: 1 2 3