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Lt. William B. Walsh, then serving on a U.S. destroyer-minesweeper in the Pacific Theater as a ship's doctor, was the first U.S. physician on the ground in Hiroshima, Japan, after the atomic bomb was dropped. This is his story, gleaned from interviews and his own letters to his wife written while he was serving on the USS Ellyson. His thoughts on the war, the enemy, and the bomb and the fears of the probable invasion of the Japanese mainland are a reflection of the thoughts of many in his position in the Pacific Theater at that time. The article is accompanied by previously unpublished photographs Dr. Walsh took when he was able to go to Hiroshima after the surrender ceremony. [ABSTRACT FROM AUTHOR]

Medical services have long been an integral part of the military and warfare. Civilians, however, are also caught up in wars. This article discusses the care of the indigenous civilians by U.S. military medical personnel during the Vietnam War. Civilian medical care is rendered both for altruistic purposes and to satisfy the policy aims of the U.S. government. Evaluation of these two aspects of the programs does not lead to the same conclusions. Doctors doubted the value of the programs, whereas the command structure was enthusiastic. For a program to be of sustained value to the people, it must persist over time and train those who will remain after U.S. forces are withdrawn. This did not occur in Vietnam. Furthermore, I doubt that medical care rendered by U.S. troops in uniform can serve to build up loyalty to another organization, such as the host government.

A child born without scalp, or dura to cover the brain (aplasia cutis congenita) was successfully treated by a multidiscipline team. A coexisting rupture omphalocele forced a change in treatment from the currently recommended regimen of mandatory early scalp closure. Homograft skin was used to protect the brain during the time the omphalocele was treated and skin flaps were delayed. Fluoroscein dye was utilized to determine flap viability and predicted ischemia until after a third delaying procedure was performed. The successful outcome suggests that the present philosophy of early surgical closure being essential for survival in infants with large cranial defects can be altered and, in fact, permanent full-thickness flaps may be designed, tested for viability, and delayed while homograft skin protects the infant's brain from infection and thrombosis.