Neurosurgery Up Forward

At 11 o'clock one morning last week, the heavy tread of a Chinese artillery barrage marched across a Korean hillside near the 38th parallel. Sitting in a slit trench, a U.S. private caught the blast of a shell exploding in front of him. A tiny, singing splinter drove through his skull and lodged in his brain. In the foggy depths of consciousness, the private heard his buddy screaming, "Medics, damn it! Medics!"

Eleven hours later, the private was resting comfortably between the clean sheets of a U.S. Army evacuation hospital near Seoul. The faithful medics had brought him down from his bloody hill by litter jeep, taken him to a mobile field hospital where a helicopter whirled him off for neurosurgery at the evacuation hospital. The surgeons deftly chipped away some of the skull, carefully picked and washed the dirt, bone splinters and hair from the missile track in his brain, and sewed him up again. The splinter itself, about five milimeters square, was left untouched; to remove it would have meant damaging unharmed tissue, and experience has shown that it will soon be covered with scar tissue and cause no trouble. At week's end, the private was completely lucid and feeling fine.

The Early Days. The men he owes his life to are the medics and surgeons of the Army's ist Provisional Neurosurgical Detachment and its trim, brown-haired commander, Lieut. Colonel Arnold M. Meirowsky. In the early days in Korea, it often took a week or more be fore a man with a delicate head wound could be gotten to a neurosurgeon back in Tokyo. The chances of infection are great in head and spinal wounds; too many of the first cases died or suffered crippling paralysis. Nowadays, thanks to forward-area teams, wounded men are being treated in a matter of hours.

When Colonel Meirowsky first proposed such teams last year, higher echelons frowned on the idea. It was felt that skilled nerve men are too hard to come by to risk exposing them in combat areas, that intricate operations cannot be per formed in field hospitals. Meirowsky, 41, a German-born neurosurgeon who volunteered for active duty, refused even to consider the first objection. He argued until the Army agreed to let him "study" the possibilities.

At the height of the retreat from the Chosin Reservoir last winter, Meirowsky arrived at Hamhung with a duffel bag full of instruments. He elbowed some space in a field hospital, persuaded a peacetime obstetrician to team up with him, and got to work. By the time the evacuation was over, he had proved his point that brain operations could be performed under com bat conditions.

The Three-Man Team. The Army let him set up a three-man team in Taegu. Operating under primitive conditions, with the aid of one enlisted man instead of the two trained surgeons civilian doctors are used to, his surgeons performed 108 operations in the first three weeks of the spring offensive.

Meirowsky shuttled between Japan and Taegu, performing operations at both bases. During lulls, he dashed off by jeep or helicopter to the front to tell medics how to handle brain cases, teaching them to go easy on morphine, so that any complications could be spotted easily. He devised a system of sandwiching paraplegics between two padded litters so that their position could be safely changed by a single quick flip, thus avoiding blood poisoning from bed sores.

By last week, Meirowsky's team had been in Korea for seven months. In that time, the percentage of soldiers arriving back in Japan with infected head and spinal wounds has dropped from 42% to 2%. Says Neurosurgeon Meirowsky: "There's nothing spectacular in any of this. It's just plain hard work."

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