There were moments when my patient was gone, just....gone.
At first I couldn't figure out why this 60-year-old man, apparently in terrific health, who bragged that he still pounded out the mileage every day, would from time to time squeeze his eyes tight, begin sweating profusely and whimper.
There was no connecting with him in that state.
It was as if his body was here but his spirit had traveled elsewhere.
And as fast as he left, he returned, opening his eyes as if seeing his surroundings for the first time.
I was baffled.
And then I noticed a familiar tattoo on his left biceps.
"Were you in the Marines?" I asked.
"I was."
"Me, too. Semper Fi."
We shook hands.
"I was with 2/5, in 1968," he said.
And suddenly it all made sense.
2nd Battalion, 5th Marine Regiment.
A storied unit that has done three deployments to Iraq in this latest war, 2/5 had its origins in the early days of World War I, the unit's motto -- "Retreat, Hell!" -- derived from a perhaps apocryphal quote by a Marine 2/5 officer who, when ordered to retreat during a battle in The Great War, is said to have exclaimed "Retreat? Hell, we just got here!"
Forty-one years ago, my patient's regiment greeted the new year by undergoing the onslaught of the Tet Offensive in the Vietnam War, followed in February by the door-to-door carnage of some of the war's most violent combat, the battle to take the Imperial City of Hue, fighting immortalized in the movie "Full Metal Jacket."
It was clear that when my patient's spirit left our ambulance he was returning to those bloodied streets, where he was a rifleman in one of three battalions of Marines who fought 10,000 enemy soldiers in some of the most brutal close quarter fighting of the war.
A little math gave me my patient's age at the time of the battle -- 18-years-old.
My patient wasn't particularly sick, at least not in a physical sense.
I started an IV anyway, drew some labs for the ED, placed the man on our heart monitor.
Mostly I just rested a hand on his shoulder during the worst moments, letting him know that even though I was in the Corps 20 years later and on the opposite coast, that he wasn't alone, that he had a buddy with him nonetheless.
It was one of those calls where afterwards you thank God for what you do for a living, for the rare and brief chances we get to touch, even for a moment, the sublime.
I can't imagine what it would be like to be chased by nightmares for 40 years.
I wish I had the power to bring him some peace.