Gus Kappler MD FACS

Mystery, Thriller & Suspense, Biographies & Memoirs

Author Profile

Gus  Kappler MD FACS

Dr. Gus Kappler served as a trauma surgeon during the Vietnam War at the 85th Evacuation Hospital ’70-‘71. His well-received 2015 memoir, Welcome Home From Vietnam, Finally, describes his surgical experiences and personal transformation. After his military service, Gus enjoyed a successful solo surgical practice in the small city of Amsterdam located in the majestic Mohawk River Valley in upstate New York. He and his family enjoyed hiking, camping, snowshoeing, hunting, kayaking, and photographing in the valley and the nearby Adirondack Mountains. Gus’s current historical medical mystery, One Degree, reflects his real-life knowledge gained in Vietnam, during solo surgical practice, living and recreating in the Mohawk Valley, teaching at Weill Cornell Medicine, and in understanding global politics. Through reading One Degree, he wishes to remind us of how morality, personal goals, and life choices may be complicated by the unique influences introduced by an unfamiliar environment. The reader is introduced to the development of PTSD, the condoning of corrupt practices, and the virulent pursuit of wealth and power.

Books

ONE DEGREE

Mystery, Thriller & Suspense

ONE DEGREE is an historical medical mystery thriller involving a fatal infectious illness that begins in the 1971 Vietnam wartime jungle. Five Vietnam Veterans who observed the illness first hand and others touched by it are followed in their stateside journey to define and irradicate this fatal gruesome disease. The veterans feel helpless to treat this disease first encountered in soldiers during the early 1970s, peaking globally in the mid-1970s, and essentially disappearing by 1975. A talented plastic surgeon, Claire Ferrier, tragically succumbs to this dormant illness after returning to the US from Cameroon in 1986. With great effort, dedication and original thinking the brotherhood of Vietnam Veterans spearheads the discovery of the disease's causation and eliminates this vile occurrence. Corrupt activities of Big Pharma in collusion with an influential US Senator are at the root of the causation of the disease.

Book Bubbles from ONE DEGREE

#11) High-Velocity Wounding

"Phu Bai "Fred administered twenty-eight units of blood during Richard's procedure. An initial thought could be that Declan was a sloppy surgeon, losing an excessive amount of Private Burrows' blood. Military missiles, bullets and fragments from exploding ordinance, travel at 2,600 feet per second or more. As they speed along, air molecules cannot get out of the way, becoming compressed into a ballistic shock wave. Just like a jet, "going through the sound barrier." This energized wave scrambles molecular structure as it passes through tissue. Immediately following, the kinetic energy associated with the speeding missile striking the body imparts an extraordinary amount of power, creating a hydrostatic shock wave that destroys tissue and, passing nearby, fractures bones. It is called hydrostatic for the body's density is essentially that of water, its major component. Skin and fatty tissue are somewhat resistant to damage. The surgeon must debride all dead (devitalized) muscle, for it becomes gangrenous and infected, threatening the patient's life. Often referred to as "meatball surgery," meticulous dissection is required to define and enter the viable muscle, thus releasing excessive blood loss that requires replacement. Coagulation issues occur due to decreased platelets, fibrinogen, and clotting factors (molecules that create the clot). The surgeon must order these components restored. Fresh warm "walking donor" unprocessed blood solves that problem.

#10) Meet a Few People

During the Vietnam War, the great majority of military physicians, following graduation from medical school, were drafted the moment they began their internship. The military's Berry Plan deferred a lucky few to complete their training. The others, as General Medical officers, GMOs, often lived and patrolled the jungle with the grunts. I proudly served with Duane Wall, Bob Hooper, MD, Mike Clark, Patti Hendrix, RN, Fred Brockschmidt, RN, and Roger King, MD. I see them, except for Hooper, at our therapeutic 85th Evacuation Hospital '70-'71 biannual reunions. After fifty years, we still harbor our Vietnam demons. Duane (a grape grower Napa Valley) and Mike (a cardiac OR tech) were exceptionally talented ED and OR corpsmen. Patti (retired Army Lt. Colonel) efficiently supervised the young OR staff. Fred (retired Army Colonel) saved my butt, actually the patient's, more than once with his skill. Roger King (practiced in Morgantown, WV) and I trained together at the Medical College of Virginia in Richmond, and we shared time at the 85th Evac. We often operated together like a well-oiled machine. Mike's severely diabetic wife, Connie, died following a heart transplant as I was writing ONE DEGREE. We wished to preserve Connie's memory. These individuals and others you will meet are part of my being and are indeed considered a brotherhood.

#9) I Served Honorably. Now, I'm Punished!

Our military sprayed fifty-four thousand three hundred gallons of Agent Orange (AO) over Phu Bai, Vietnam. It was the home of the 85th Evacuation Hospital. I served there as a trauma surgeon in '70-'71. Dioxin is a predictable by-product in Agent Orange production. It is a potent carcinogenic and mutagenetic compound. This poison was in the dust we breathed and water we drank. It's now fifty years later, and I'm eighty years old but feel like I'm fifty. Six months ago, I was diagnosed with Chronic B-Cell Lymphocytic Leukemia (CLL). I just learned that the Veterans Administration recognizes Dioxin as the cause of my blood disease. Now I'm a statistic! It's not just the other guy anymore. I served my country honorably, and now I'm being punished for dedicated service to my wounded patients. It's remarkably ironic that my historical medical mystery, One Degree tells a similar story. Go to www.guskappler.com and visit essays to read my thorough analysis of the Agent Orange tragedy.

#8) Bob Nevins

Bob Nevins is a real-life character in my medical mystery thriller, ONE DEGREE. This 326th Medical Battalion medivac pilot flew the wounded to me, a trauma surgeon at the 85th Evacuation Hospital, Phu Bai, Vietnam, '70-'71. He was shot down and crashed several times. He rescued the surviving crew members and waited for extraction. This transmission is genuine: "We can't land. Do you think he'll make it to first light?" asked the pilot. A long destining pause came over the radio as the sound of rain pelted the helicopter. "He's not going to make it 30 minutes," the voice on the ground radio replied hopelessly. The crew onboard looked at each other intensely as the monsoon swirled around them, making it difficult for the copter to stay in the air. "Ok," the pilot replied. Hang in there, "We're turning around to get you." Bob and I have collaborated in researching which neural pathways align to allow a veteran with PTSD to switch off his demons and begin to reintegrate into a peaceful society when introduced to equine intervention. Now, in Saratoga Springs, NY, he rescues those with PTSD with the program he created - Alliance 180. Visit: https://www.alliance180.org/your-fight-is-our-fight

#7) Agent Orange

54,300 gallons of Agent Orange were sprayed from fixed-wing aircraft over a small area in northern South Vietnam identified as Phu Bai. That was where the 85th Evacuation Hospital was located when I served as a trauma surgeon. Dioxin, one of the most carcinogenic and mutagenic compounds known to science and a predictable contaminant in Agent Orange production, was in the dust we breathed and water we drank. Nine men I served with have either died from or have been treated for cancers caused by the Agent Orange (AO) contaminant. Its presence and consequences were totally understood by the government officials who ordered the continued spraying. Our service in Vietnam is still, after half a century, killing Vietnam Veterans. My experiences with and study of Agent Orange profoundly influenced the plot of "One Degree.” My AO challenge: https://www.youtube.com/watch?v=g8BUnLPQDkw

#6) Golden Hour

When wounded in the Civil War, the soldier's first thought was to determine if he were "gut shot." If so, he would die a prolonged, agonizing death. In Vietnam, the booby trap fragments angled upward, threatening one's manhood. These shards of metal, screws, glass, and feces impacted with massive energy, destroying excessive amounts of muscle, tendons, blood vessels, and bone. My friend, Sergeant Ken Israel, directed the enlisted men in the 85th ED, '70-'71. Untreated blood loss of 3 pints or more results in less cardiac output, and hemorrhagic shock develops due to insufficient oxygen delivery. The body becomes acid, and death follows. The term Golden Hour is a metaphor; begin shock therapy in less than sixty minutes, for the shock state is still REVERSIBLE, and the patient has a better chance of survival. The placement of multiple IV sites is required—excellent IV access results from using IV tubing in arm and leg veins placed through small incisions. Replacing blood alone DOES NOT achieve resuscitation. In shock, the body's saltwater becomes depleted. For replacement, we at the 85th Evac used Ringers Lactate (a unique table salt solution). If, as early in the war, excess RL is administered, life-threatening "shock lung" developed. Go to https://youtu.be/yZ7AXi_pkOg for an in-depth shock review. Watch 0 to 1:40 and 6:13 to 6:50 minutes.

#5) Booby Trap

Gary Stoller will be seventy-three during September. He lives in Meco, NY, not far from Mayfield, NY where he graduated high school and soon found himself, as an eighteen-year-old, with the First Calvary in the Quang Tri region of Vietnam's I Corps. In April 1968, now nineteen and a Buck Sergeant, he was severely injured by a VC booby trap. We have been close friends for almost forty years. During that time I've remembered snippets of his guarded Vietnam War disclosures. I used them to describe Private Richard Burrows' traumatic experience. The booby trap explosions delivered between 4 to 6000 horsepower of energy to create devastating wounds; decimated flesh and multiple bone fractures. The Soviet-designed AK 47 imparted similar energies when wounding. Long bones, as the femur, were fractured by only the shock wave associated with this weapon's high-velocity missile. Bubba Smith, also a hunter, lives in Meco, NY. Bill Papas is an outdoor buddy from Breakabeen, NY. Donn Gates was a corpsman at the 85th Evac in its ED. Sgt. Ken Israel was in charge of the 85th's ED corpsmen. The distinctive sound of the Medivac chopper's swirling blades was uplifting to the wounded for they knew that definitive care and therefor survival was not far away.

#4) The Dehumanizing Vietnam Jungle

Only one out of every eight ground troops actually saw combat. The other seven were in support rolls. The "grunts" served in combat. The majority of them were 18 to 20 years of age. A patrol could last from a day to a month or more. The monsoon season permanently drenched them. The heat of the remainder of the year was intense and dehyrdrating. Negotiating the dense jungle vegetation was exhausting. They were on constant alert, for their dedicated, experienced, and adaptable enemy could ambush and attack at will from massive tunnel systems and spider holes. The Viet Cong and North Vietnamese Army accepted excessive casualties. The US military leadership inappropriately considered "body counts" in our favor as a sign of American success. At the Paris Peace Talks, a proud US diplomat chided a North Vietnamese negotiator that "the US never lost a battle." "Yes," was the response, "but we won the war." This YouTube video will show you more about patrols. https://youtu.be/Bk58cRKI5xQ

#3) I Propose Prevention

Matt's mental state improved by sharing his demons with a group of men who suffered similar wartime experiences. Modern medicine controls the occurrence of a myriad of potentially lethal diseases through applying PREVENTIVE measures; vaccinations (Smallpox), pills (Malaria), medications (High blood pressure). The warrior must be rescued from the onslaught of adrenalin and cortisol; the Limbic System must be calmed PRIOR to discharge or reassignment. I propose a THERAPEUTIC TIME OUT where in the soldier's UNIT (a brotherhood) is isolated in a safe place without record keeping and threat of stigmatization to defuse their experiences by "opening up" and realizing they are Not crazy. ALL are reacting predictably to military stresses. The US Air Force is successfully applying this approach! Watch https://youtu.be/Q-FDupMy8J8 for details.

#2) Why did Matt develop PTSD?

The average age of the Vietnam warrior was twenty-two. The majority of Vietnam KIAs were twenty-two or younger. The portion of their brain that makes sense of their challenging environment is physiologically less potent than that portion that is explosively reacting to their stresses. Adrenaline and cortisol flood their bodies and result in hyper-vigilance, increased heart rate and respiration, tunnel vision, increased hearing acuity, sweating and a readiness to fight. They were conditioned to react in that fashion. When Matt's discovery of the abnormal white blood cell was dismissed by those he would not dare question and similar deaths became global, he was consumed with guilt and depression. His peers, just before discharge, were helpful but once back in the US there initially was no support system and he self medicated with alcohol to still his demons. His new peer group understood and supported him. He became functional. Next week I'll discuss the preventive approach to PTSD and not accepting its occurrence as the "cost of doing business."

Gus went to Vietnam. A changed Gus came home.

This is my first bubble attempt. In the fifty years since I arrived in Vietnam as a trauma surgeon I have researched and dealt with PTS(D). I never reached the (D) designation for I chose Vietnam War storytelling to defuse my demons. It was like the little teapot. In 2015 I published a compilation of the stories in Welcome Home From Vietnam, Finally, A Vietnam Trauma Surgeon's Memoir. It is loving, brutal, funny, vile and truthfully real-life. For more information, go to www.guskappler.com. I have studied PTS(D) on the psychological, chemical, cellular and molecular levels. I consider myself an expert. Early in One Degree I introduce the reader to one PTS effector. Next week I will expand on today's excerpt. Each week I'll relate the book's text to real-life.

Welcome Home From Vietnam, Finally

Biographies & Memoirs

I served as an Army trauma surgeon at the 85th Evacuation Hospital, Phu Bai, Vietnam, '70-'71. Into our emergency room were intermittently deposited the wounded, some grievous others not, by the daredevil Dust Off medieval pilots who risked imminent death with each mission. We routinely witnessed the devastation of war on the body, mind, and soul. The corpsmen, technicians, nurses, anesthesiologists, and surgeons explored every known and out-of-the-box technique to salvage life and limb. If the wounded arrived alive at the 85th, he had a 95% chance of survival. It was and still is that 5% whose injuries were so severe or whose blood loss could not be stemmed that haunt us today. That's PTS. By storytelling for fifty years since returning to the US in late August 1971, I have avoided the (D) and mollified my demons. The intense emotions during my traumatic experience have softened greatly but, I am back in Vietnam on a daily basis. In 2015 I compiled my stories into Welcome Home From Vietnam, Finally, A Vietnam Trauma Surgeon's Memoir. It is gripping, honest, real-life, and disturbing. Then we realize that the 58,000+ lives lost did not change a thing. No dominos fell and Vietnam is now our close trading partner. They have been gracious victors.

Book Bubbles from Welcome Home From Vietnam, Finally

Leaving On a Jet Plane

It was September 1970. High school dating in 1957, Theta Xi fraternity parties at Cornell, our June 1963 wedding, receiving my MD degree from Cornell University Medical College in 1965, the birth of two children, and in 1970 completing an arduous five-year surgical residency at the Medical College of Virginia in Richmond were history. I was drafted as an intern in 1965 and received a deferment to complete my surgical training. We were sure by 1970; the Vietnam War would also be history. No way! So in July 1970, Robin and I went back to Wading River, Long Island, NY, to prepare for a drive across the country to San Antonio, Texas, to complete basic training at Fort Sam Houston. The clock was ticking. Two weeks ahead of me at Fort Sam, Ed Kayser, my first roommate in medical school, who had trained as an orthopedic surgeon, said good to his family and left for Vietnam. Robin and I did our best to make the most of our remaining time as a family. My orders eventually arrived. I was to board my plane in Dallas, Texas, in early September 1970. The count down to separation was getting closer. We drove to Dallas and stayed with friends. Ben took me to the airport. Helen consoled Robin. My most devastating day! Ever!

Welcome Home From Vietnam, Finally

Biographies & Memoirs

I served as an Army trauma surgeon at the 85th Evacuation Hospital, Phu Bai, Vietnam, '70-'71. Into our emergency room were intermittently deposited the wounded, some grievous others not, by the daredevil Dust Off medieval pilots who risked imminent death with each mission. We routinely witnessed the devastation of war on the body, mind, and soul. The corpsmen, technicians, nurses, anesthesiologists, and surgeons explored every known and out-of-the-box technique to salvage life and limb. If the wounded arrived alive at the 85th, he had a 95% chance of survival. It was and still is that 5% whose injuries were so severe or whose blood loss could not be stemmed that haunt us today. That's PTS. By storytelling for fifty years since returning to the US in late August 1971, I have avoided the (D) and mollified my demons. The intense emotions during my traumatic experience have softened greatly but, I am back in Vietnam on a daily basis. In 2015 I compiled my stories into Welcome Home From Vietnam, Finally, A Vietnam Trauma Surgeon's Memoir. It is gripping, honest, real-life, and disturbing. Then we realize that the 58,000+ lives lost did not change a thing. No dominos fell and Vietnam is now our close trading partner. They have been gracious victors.

Book Bubbles from Welcome Home From Vietnam, Finally

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