Last week the nation celebrated National Vietnam War Veterans Day—though you’d be forgiven for not knowing that there is such a U.S. holiday. Legislation to mark the day—March 29th—was only signed into law by President Donald Trump in 2017, though the idea had earlier origins in the 110th Congress when legislation authorizing the secretary of defense to conduct a program commemorating the 50th anniversary of the Vietnam War was signed into law as the National Defense Authorization Act (NDAA) for Fiscal Year 2008. When U.S. Senators Pat Toomey (R-PA) and Joe Donnelly (D-IND) introduced the proposed legislation, they chose the anniversary date of the withdrawal of military units from South Vietnam to be the designated date of the holiday. The idea was inspired by the felt need to offer official respect to all those who had served during the Vietnam War—especially those conscripted to fight in it—who were not given respect or support afterward due to the social upheavals of the 1960s and ‘70s surrounding anything at all connected with war.
The United States has six other military-centric annual observances codified into law—Armed Forces Day, Memorial Day, Independence Day, National Korean War Veterans Armistice Day, Navy Day, and Veterans Day—but National Vietnam War Veterans Day has four additional objectives alongside thanking and honoring Vietnam veterans and their families for their service and their sacrifice. These remaining objectives highlight: “the service of our Armed Forces and support organizations during the war; pay tribute to wartime contributions at home by American citizens; highlight technology, science and medical advances made during the war; and recognize contributions by our Allies.”
It’s not often that we stop to think about the medical advances made during war. As a society, we don’t ever really highlight the civilian lives saved down the line because of war—indeed, the very phrasing sounds suspect, if not distasteful. But there is a deeper reason for the Nurses Memorial and Section 21 within Arlington National Cemetery than the mere affiliation with the U.S. Armed Forces of the departed nurses buried there. They are uniquely honored because their service during war directly translated into new and better life-saving practices in civilian, as well as military, medicine.
For the Vietnam War—and the Korean War just prior to it—it was lessons learned there that sparked the development of civilian paramedics, modern trauma centers, helipads at hospitals, civilian air ambulance services, and MEDEVAC. In battles in Vietnam, the UH-1 Iroquois helicopter, commonly known as the “Huey,” transported the wounded to treatment faster than in any previous war, enabling doctors to discover that they could use flight crews and surgical teams in the field to stabilize the wounded during air evacuations, treating patients for hemorrhagic and traumatic shock, which drastically reduced the rate of death from battlefield injuries. To this day, triaging and “the golden hour” remain the benchmark of civilian emergency care.
It’s to Vietnam veterans that we owe the field and practice of “Physician Assistant.” As corpsmen and medics were returning from the Vietnam War and in possession of a plethora of trauma skills, Duke University sought a way to ease the shortage of family practice doctors, especially in rural regions of America. Duke’s Medical Center in Durham, North Carolina, began a two-year Physician Assistant training program, and its original class was comprised of four veteran Navy corpsmen. Today, PAs are an integral part of the medical system, working in sixty-five distinct areas of medicine and surgery and growing. Notably, for those who keep track of such things, today the majority of PAs (76 percent) are female.
Considering the origins and connections between military-connected medics and the concept of civilian medics, EMTs, and other occupations short of doctors in the medical field, it’s rather ironic that today most veterans with medical skills are prevented by reams of red tape from qualifying for similar medical jobs as civilians. Nationwide, and despite a severe shortage of paramedics, EMTs, and other medical staff in the United States, currently only six states (Arizona, Arkansas, Florida, Kentucky, Missouri, and North Carolina) provide a clear pathway for EMT licensure with straightforward requirements for veterans, according to a recent study by the Call of Duty Endowment. Ten states—including California, the state with the highest percentage of veterans—and territories outright discount military-connected medical experience, requiring veteran medics and hospital corpsmen to start their training completely over and from the ground up. Meanwhile, around 50 percent of former medics and hospital corpsmen who want to work in the civilian medical profession report that they cannot find jobs in the industry—what amounts to a ready and willing workforce of approximately 30,000 to 50,000 individuals.
Remembering and honoring the positive medical advances made during war does not mean that to honor those veterans involved, we must glorify war, far from it. But acknowledging the debt can help us today find positive ways of honoring veterans’ service by allowing them to continue to serve society through their chosen fields of industry, especially when those fields directly contribute to the health and safety of all Americans, through the health industry.