Thump, thump, thump, thump! The sound of military boots running down the hospital corridors could not be missed.
The year was 1969 and the United States was deeply involved in the Vietnam War. The U.S. Army had four hospitals — about 3,500 hospital beds — in Japan, dedicated to treating troops flown in from Vietnam.
I was a pharmacist stationed at the 106th General Hospital, a 1,000-bed Army hospital in Yokohama. My primary responsibility was overseeing a staff of Army-trained pharmacy technicians. Our hospital provided both medical and surgical services and was the designated burn treatment center for all U.S. and allied military service members.
One day, one of the burn treatment surgeons came to the pharmacy and showed me a surgical-journal article. The article said intravenous fluids with high concentrations of vitamins would greatly benefit the treatment of burned patients. The surgeon asked me if the pharmacy could help implement this.
This was quite a personal challenge. The burn unit was always full. Where would the IVs be compounded? Who would be the most effective staff to compound the fluids? How would they be trained? How would the IVs be delivered? Who had the authority to make these changes?
All these questions had to be addressed in a system with the attitude, “We have always done it this way, why change?”
My first challenge was to do some research. Previously, IV fluids were compounded by the nursing staff under less-than-ideal conditions. I found that several hospital pharmacies in the U.S. were starting to compound these IV admixtures (that’s what you call it when medications are added to a sterilized fluid) in clean rooms.
To implement this program, I obtained a dedicated work room that was aseptically cleaned by surgical technicians on a regular basis. We set up pharmacy technicians who compounded the drugs into the IV fluids in back-to-back workstations. Once the compounds were measured, the techs would switch seats to check each other’s work.
This was the “tech-tech check.” If a tech made an error, they would never hear the end of it. Once an IV admixture was finished, it had to be delivered across the hospital compound to the burn unit. That’s when I turned to a group of gung-ho U.S. Marines who’d been assigned support duties for the hospital. They’d been patients and were waiting to be sent back to Vietnam.
When a patient needed a speedy delivery of IV drugs, I would call the sergeant in charge and ask if he had Marines available. The Marines knew these IVs were critical to their fellow wounded. They would run with the IV full of compounded fluids (it was like a glass football filled with liquid) across the helicopter pad and up to the burn unit.
The only problem I encountered was staff complaining about Marines running down the halls. I was not sympathetic to complaints because speed was necessary.
“If you hear the Marines coming, just step out of their way,” I would tell people.
Years later I ran into Michael, a combat infantryman in Vietnam whose uniform had been engulfed in fire.
“The 106th isn’t a number. It was a new beginning at a very young age,” he told me. “We were very far from home, very lonely and very injured. The staff at the 106th did an outstanding job giving us medical treatment, which they probably received little credit for.”
Working at the 106th was a unique and valued experience. I learned that I had the skills to work with others, to set big goals and to take initiative in the best interests of our patients. The professionalism and enthusiasm for healing at this hospital was top-notch.
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