Surgery just isn’t what it used to be

Once upon a time, in pop culture if not in real operating rooms, “surgical” meant bloody, messy work with metal tools cutting through skin and bone. The television show “M*A*S*H” depicted that kind of surgery. Hawkeye, B.J. and the other doctors worked like factory workers against time and wounds and sickness to put war-torn bodies back together.
Now, though, to be surgical is to be sterile, precise and painless. Lasers are surgical now, not scalpels; a smart bomb results in a surgical strike. Businesses make surgical cuts, firing lots of individual employees instead of whole departments. Surgical is sleek, it’s George Clooney’s bedside manner or George Bush’s videotape of homing missiles.
Even real surgeons are becoming more surgical. In the Army, the real mobile army surgical hospitals that were the inspiration for “M*A*S*H” are being phased out. Just last week, the 43rd MASH unit in Korea was deactivated.
The real-life 43rd became the 4077th on MASH. But Army veterans and the outgoing staff of the 43rd praised the show’s accurate depiction of the messy and grim realities of wartime doctoring. The mobile part of the unit’s name meant that the hospital followed the front, never far from the fighting.
In the brief weeks after the Inchon Landing that turned the tide of the Korean War in 1950, the U.S. Army advanced up the Korean peninsula to the Yalu River. The 43rd followed, even setting up camp in Pyongyang, now the capital city of North Korea.
In the mountains of Korea, the carnage never ceased. When the U.S. Army reached the Chinese border, the Chinese army joined the fray and chased the American forces back down the peninsula. Soldiers poured into the mobile hospitals with all manner of horrible wounds, many to die and many more to be rebuilt but never again whole.
As on TV, the doctors in the real war worked to save the lives of young men who, if the surgeons succeeded, would be thrown back into harm’s way.
The MASH units’ handful of doctors were supported by about 100 nurses, recruits and officers. They camped with several large tents and many smaller ones in clearings or valleys; the operation was large and had to be fed, supplied and guarded by even more troops.
After a wave of new patients, the TV doctors always looked sweaty and tired, with bloodied shirts and bloodshot eyes. Surgery was a trauma, an affair to be gotten through like work and forgotten over drinks or parties. The enormity of war and the scars it leaves on the young people sent to fight were most clear to these doctors in their dusty operating rooms.
But no more. The army deactivated the 43rd last week; only three other MASH units exist. Two in the United States will stand down this year while a third in Bosnia — another mountainous peninsula with a brutal war, no real resolution and U.S. troops committed under a United Nations mandate — will remain open.
The old MASH units will be replaced by DEPMEDS — Deployable Medical Systems. The new Army doctors will be surgical in the modern sense: The units will be faster, smaller and more efficient. Informally, they’re called forward surgical teams, strike forces of doctors they could have called commando medicos.
These new surgical teams will descend upon the wounded like a stealth smart bomb or the trauma team on “ER.” Presumably, injured GIs won’t even know what hit them after they wake up with their arms put back on or their guts squeezed back in.
It seems the military is catching up with the rest of America on this one. But then again, it was the military that came up with the new definition of “surgical” in the first place.
Before Korea, there was World War II. Recruiting posters and newsreels in the 1940s celebrated the sweaty soldier with a bandaged arm and a howitzer. That war was American grit and know-how vs. fascism, the last good war and the boys were in it “for the duration.” War was supposed to be messy, and so were the doctors on the front line. It was a radio war anyway; you couldn’t see the gore.
Korea followed, still pre-TV. It was OK to machine-gun the Reds or carpet-bomb villages, because on radio all you hear is a roar of gunpowder and steel and a reporter’s voice.
And then, of course, came Vietnam. Suddenly, the blood and guts of the MASH unit and the war in general were live on TV instead of motionless on a Norman Rockwell canvas. Between the television cameras and roving photographers, the military lost control of what America thought about war.
The Pentagon wouldn’t make that mistake again. War is certainly no cleaner or more precise — we still bulldoze enemy trenches when we have to — but the military no longer allows us to see that side of things. For almost 10 years after Vietnam, there were no real wars. In that time, the armed forces became “all-volunteer,” a faster, smaller and more efficient force. Technology improved, too.
Fighter jets became sleeker, smoother, more stealth. Lasers were deployed, and rapid-response became the buzz. No more sending the troops to sit around or wade through enemy rice paddies. Remember Grenada? In and out so fast few people had time to wonder whether the United States ought to be invading small islands for the sake of a handful of American students attending quack medical schools.
It was a fast strike, so swift that Grenadians themselves hardly noticed that they’d been invaded. Just like on “ER” — in and out of the operating room faster than you can spell “anesthesiologist” and we’ll send you the bill later.
Americans swallowed the new, more sexy Army like it was the latest model of ultra-streamlined Ford Taurus. Remember the ’85 Taurus? Probably not. And that’s the point. You probably don’t really remember Grenada, either.
Or Panama, where the invasion was so high-tech on TV that nobody much minded George Bush’s boasting about taking Noriega and his CIA drug-running buddies down. The macho bravado matched the sleek images of stealth fighters dropping laser-guided missiles through the windows of empty buildings.
We didn’t get to see — nor did we want to see — the Marines clearing the slums of Panama City with Napalm. And when we saw the soldiers the medics couldn’t save, they were already draped in flags, ready for burial. It was all a little like Super Mario Land.
Panama was so super that we got a sequel in the Persian Gulf with even more cool toys and video games and laser-like surgical precision. That so-called war was more an episode of “Mission Impossible” or a Tom Clancy book on steroids. It was cool. Sure, we carpet-bombed Iraq, but who cares when we’ve got footage of the smart bombs and cruise missiles pinpointing the bathroom window of a bunker or an empty bridge?
And now the doctors who clean up after our sanitary wars also work with the illusion of laser-like precision. They don’t operate in mobile hospitals; they’re forward teams. Even surgeons, now, are surgical.

R. Scott Rogers is the Editor in Chief of The Minnesota Daily. He is a junior in University College.