Tag: Clinical-Nursing

  • Practice Immersion Clinical Evaluation Tool – Agency/Site

    Practice Immersion Clinical Evaluation Tool – Agency/Site

    Agency/Site Criteria

    Student Evaluation

     

    Faculty Evaluation

    Comments

    Does Not Meet

    Meets

    Excels*

    Does Not Meet

    Meets

    Excels*

    1.       Agency/site was able to provide the opportunities for the student to meet practice immersion clinical objectives.

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    ☐

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    2.       Agency/site was able to establish a comfortable, yet stimulating, practice environment.

    ☐

    ☐

    ☐

    ☐

    ☐

    ☐

    Criteria:

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    Does Not Meet:
      Elements are missing.

    Meets: 
    Agency/site meets this criterion.

    Excels: 
    Agency/site meets this criterion and further a teaching point opportunity or expanded information, guidance, or other element to further enhance student learning.

    Agency/site – strengths:

    Student Evaluation

    Faculty Evaluation

    Agency/site – areas of improvement needed:

    Student Evaluation

    Faculty Evaluation

     

    Agency/site – Suggestions to incorporate more responsiveness to student learning needs:

    Student Evaluation

    Faculty Evaluation

     

    Practice Immersion Clinical Evaluation Tool – Mentor

    Clinical Criteria

    Student Feedback of Mentor Experience

    Comments

    Does Not Meet

    Meets

    Excels*

    3.       Exemplify professionalism in diverse health care settings.

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    4.       Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents.

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    5.       Implement patient care decisions based on evidence-based practice.

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    6.       Utilize patient care technology and information management systems.

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    7.       Communicate therapeutically with patients.

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    8.       Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.

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    9.       Understand the human experience across the health-illness continuum.

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    10.    Provide culturally sensitive care.

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    11.    Preserve the integrity and human dignity in the care of all patients.

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    Criteria:

    Does Not Meet:
      Elements are missing; mentor did not achieve.

    Meets: 
    Mentor meets this criterion.

    Excels: 
    Mentor meets this criterion and further incorporates a teaching point scenario or expanded information, guidance, or other element to further enhance student learning.

    Practice Immersion Clinical Evaluation Tool – Student

    Clinical Criteria

    Mentor

    Sign Off

    Faculty Sign Off

    Comments

    Does Not Meet

    Meets

    Excels*

    12.    Exemplify professionalism in diverse health care settings.

    ☐

    ☐

    ☐

    ☐

    13.    Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents.

    ☐

    ☐

    ☐

    ☐

    14.    Implement patient care decisions based on evidence-based practice.

    ☐

    ☐

    ☐

    ☐

    15.    Utilize patient care technology and information management systems.

    ☐

    ☐

    ☐

    ☐

    16.    Communicate therapeutically with patients.

    ☐

    ☐

    ☐

    ☐

    17.    Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.

    ☐

    ☐

    ☐

    ☐

    18.    Understand the human experience across the health-illness continuum.

    ☐

    ☐

    ☐

    ☐

    19.    Provide culturally sensitive care.

    ☐

    ☐

    ☐

    ☐

    20.    Preserve the integrity and human dignity in the care of all patients.

    ☐

    ☒

    ☐

    ☐

    Criteria:

    Does Not Meet:
      Elements are missing; student is required to remediate this element to pass the course

    Meets: 
    Student meets this criterion.

    Excels: 
    Student meets this criterion and further incorporates a teaching point scenario

  • Health Belief Model Essay

    Define health belief model?

    Using the health belief model, how can nurses encourage patients to make immediate and permanent behavior changes; particularly as they relate to lifestyle choices?

  • LVN/LPN Medication (27 minutes) Comprehensive Core Competency- Nursing (58 minutes) 80% or above to PASS Will give log in details after agreement

    LVN/LPN Medication (27 minutes) Comprehensive Core Competency- Nursing (58 minutes) 80% or above to PASS Will give log in details after agreement

  • Major healthcare historical events that changed the landscape of healthcare today

    Major healthcare historical events that changed the landscape of healthcare today

    Thoroughly describe major healthcare historical events that changed the landscape of healthcare today.

    Discussions are required a key part of your grade for this course and supplant the in-class environment, therefore discussions should thoroughly demonstrate the students’ knowledge of the learning objectives for the course and required readings. A minimum of two other sources beside the video and the textbook.

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    Proper use of APA format in-text citations and bibliography.

    Apply key concepts from the text

    Demonstrate professionalism, critical analysis and scholarly writing.

    For this discussion, students do not need to respond/thread to another student post.

    Grading is based upon the students’ depth and breadth of the topics assigned for that session

    A minimum of three paragraphs with each paragraph having a minimum of five sentences

    Correct spelling, grammar, and sentence structure is expected

  • Group G Table of Evidence (TOE) Toni Banks, ObeFangbemi, Yessenia Miranda, Claudia Rodriguez

    Group G Table of Evidence (TOE) Toni Banks, ObeFangbemi, Yessenia Miranda, Claudia Rodriguez

    Table 1: Group G Table of Evidence (TOE)

    Toni Banks, ObeFangbemi, Yessenia Miranda, Claudia Rodriguez

    Citation

    (Write citation using APA format, just as you would in a reference list. Put articles in alphabetical order by the first author’s last name)

    Purpose Statement (quote directly from the study), Sample, and Setting

    Research Question or Hypothesis

    (If the study doesn’t list one, write what the implied RQ or Hypothesis is and label as “implied.”)

    Variables

    (State independent and dependent variables using bullet points.
    Note: Participants are not variables)

    Design

    (Include study design (i.e. meta-analysis, RCT), level of evidence (See the Evidence Hierarchy in Polit & Beck (2014)), other key design features such as use of placebo, blinding, etc.

    Outcomes (meaning what the researchers were trying to measure) with Measures and Time Administered (meaning how the data was collected/recorded)

    (Do not put the actual data here. That belongs in the Findings column.)

    Findings

    (Include quantitative data. What are the researchers’ final conclusions based on the outcomes?)

    Asao, T., Kuwano, H., Nakamura, J., Morinaga, N., Hirayama, I., & Ide, M. (2002). Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. Journal of American College of Surgeons, 195, 30-32.

    Purpose:

    To examine the likelihood of enhancing early recovery after gum chewing after Laparoscopic Colectomy from postoperative ileus.

     

     

    Sample:

    19 patients suffering from colorectal cancer took part in the study after undergoing elective laparoscopic colectomy.

    Setting:

    Incheon St. Mary’s Hospital, The Catholic University of Korea School of Medicine

     

     

     

     

     

     

     

     

     

     

     

     

     

    Research Question/Hypothesis:

    Chewing gum can be used to enhance the recovery period after cancer surgery from postoperative ileus.

    Independent variable(s):

    Chewing gum is the independent variable because it was controlled as 10 patients randomly selected were given gum while 9 were in a controlled group

     

    Operational definition:

    Patients randomly chosen to chew gum were given sugarless gum thrice a day after first postoperative AM up to the initiation of oral intake.

    Conceptual definition:

    Chewing gum is a repetitive action of biting or working gum with teeth in the mouth over a period of time.

    Dependent variable(s):

    Postoperative ileus is the dependent variable because the effects resulting from patients chewing and not chewing gum was noted, recorded and observed to be directly related in terms of first flatus, occurrence of first bowel movement and hospital stay duration.

     

     

     

     

    Study design:

    Two-group controlled trial that was randomized

    Level of evidence:

    Level 1 – meta-analysis of randomized trials

    Key design features:

    Placebo controlled

    Outcomes:

    Interest was in first flatus passage time, first defecation time and hospital stays after operation were recorded.

     

    Findings:

    First flatus passage was observed on day 2.1 after the surgery in the group chewing gum, while the control group was observed to be day 3.2 (P < 0.01). In the group that chewed gum, first defecation occurred 2.7 days earlier that is on postoperative day 3.1 as compared to 5.8 days for the control group (P < 0.01). For the gum-chewing group, postoperative hospital stays was 13.5+/-3.0 days while for the control group was 14.5+/-6.1 days. Conclusions: Chewing gum promotes postoperative ileus early recovery and can be used as a physiologic and inexpensive way to stimulate bowel motility. Harma, M., Barut, A., Arikan, I., & Harm. M. (2009). Gum-chewing speeds return of first bowel sounds but not first defecation after cesarean section. Anatolian Journal of Obstetrics & Gynecology, 1, 1-3. Purpose: To examine the gum-chewing effects on ileus duration following cesarean section and the effects differences when sugar-substituted and sugar-free gum is used. Sample: 76 women were studied after elective cesarean section, with no history of cesarean or abdominal surgery. Setting: ZonguldakKaraelmas University School of Medicine, in Turkey Research Question/Hypothesis: Postoperative ileus resulting in discomfort in patients leads to higher hospital days after abdominal surgery. Gum chewing has been shown to enhance recovery after surgery. The study seeks to determine the effects of sugar-substituted and sugar free gum on postoperative ileus. Independent variable(s): Chewing gum is the independent variable because it was controlled as 28 women randomly selected were given sugar-free gum, 25 were given sugar-substituted gum, and 23 patients were in a controlled group Dependent variable(s): First bowel sounds and first flatus are the dependent variables as results of these were recorded when patients were given sugar-substituted gum, sugar-free gum and no gum at all after cesarean section. Study design: Randomized controlled trial (RCT) Level of evidence: Level 1 – RCT Key design features: Placebo-controlled study Outcomes: Interest was infirst bowel sound and first flatus or defecation after surgery.   Findings: For the group given sugar-substituted gum, first bowel sounds time decreased significantly at 6.3+/-2.0 h comparing to the group given sugar-free gum that was at 8.8+/-1.9 h (P<0.05). First bowel sounds for the sugar-substituted group recorded an equally lower time at 11.2+/-1.0 h (P<0.05) than the control group. First defecation or flatus did not record any major difference. Conclusions: First defecation or flatus had no difference for patients in the gum-chewing study bearing in mind that the women had no previous history of abdominal operation. This patient went through cesarean surgery after being injected with general anesthesia. It was shown to reduce postoperative ileus and improve gastrointestinal motility recovery following cesarean section. Matros, E. Rocha, F., Zinner, M., Wang, J., Ashley, S. Breen, S. et al. (2006). Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial. Journal of the American College of Surgeons, Volume 202, Issue 5, pp. 773-778. Purpose: To determine if gum chewing improves postoperative ileus following open appendectomy Sample: 66 randomized patients took part in the study after undergoing open colectomy Setting: Brigham and Women’s Hospital, Harvard Medical School, Boston.     Research Question/Hypothesis: Is chewing gum able to reduce post colectomy ileus? Hypothesis: Implied Chewing gum is suggested to minimize post colectomy ileus duration.     Independent variable(s): Chewing gum is the independent variable in this case because it was controlled as 66 patients would randomly receive on postoperative day 1, 1 of 3 postoperative regimens. Dependent variable(s): Postoperative ileus is the dependent Study design: Meta-analysis of randomized trials Level of evidence: Level 1 – meta-analysis of randomized trials Key design features: placebo-controlled study Outcomes: Interest was in first postoperative flatus passage and postoperative complications   Findings: First postoperative flatus passage median times recorded were: 60 hours for gum and sips, 67 hours for sips, and 72 hours for bracelet and sips (p=0.384). Differences in first bowel movement passage time, actual discharge time, and patient discharge time were insignificant. 30-day and inpatient follow up indicated no distribution or frequency difference of postoperative complications. Conclusions: Contrary to preliminary study findings, clinical trial results demonstrated that even though chewing of gum was safe, it does not minimize post colectomy ileus duration. Ngowe, M., Eyenga, V., Kengn, B., Bahebeck, J. &Sosso, A. (2010). Chewing gum reduces postoperative ileus after open appendectomy. Acta ChirBelg, 110(2), 195-199. Purpose: To examine the possibility of gum chewing in reduction of postoperative ileus whenever open appendectomy is conducted on a patient. Sample: 46 randomized patients that underwent open appendectomy as a result of appendicular generalized peritonitis, appendicular abscess and acute catarrhal appendicitiswere studied. Setting: University teaching hospital in Cameroon   Research Question/Hypothesis: What effect does chewing gum provide after open appendectomy on postoperative ileus? Hypothesis: Chewing gum will speed up recovery after open appendectomy. This is based upon successful recovery acceleration in postoperative intestinal transit. Independent variable(s): Chewing gum is the independent variable because it was controlled as half the number of patients was asked to chew gum after surgery while half was not given gum. Operational definition: Patients randomly chosen to chew gum were given sugarless gum every evening, morning and afternoon for 30 minutes. Conceptual definition: Chewing gum is a repetitive action of biting or working gum with teeth in the mouth over a period of time. Dependent variable(s): -First bowel movement -First flatus -Complications resulting from appendectomy -Hospital duration Postoperative ileus represented by the measurable outcomes noted above is the dependent variable because the effects resulting from patients chewing and not chewing gum was noted, recorded and observed to be directly related. Patients that were given gum to chew showed improvement in recovery after surgery. For example, hospital duration mean time for the group that chewed gum was 4.9 days, while for the controlled group it was 6.7 days. Also, the first bowel movement for the group that chewed gum was at postoperative day 2.3, while for the controlled group it was at postoperative day 3.3. Operational definition: Postoperative ileus is the oral intake intolerance and obstipation affecting gastrointestinal tract activity after open appendectomy. Conceptual definition: Postoperative ileus is the oral intake intolerance and obstipation resulting from non-mechanical factors that result in a disruption of the gastrointestinal tract motor activity after surgery either abdominal or non-abdominal. Study design: Two-group controlled trial that was randomized Level of evidence: Level 1 – meta-analysis of randomized trials   Key design features: Placebo controlled Outcomes:            Interest was in hospital duration, first bowel movement occurrence, first flatus occurrence and arising complications   Findings: First flatus passage happened on day 2.2 postoperative for the group that chewed sugarless gum and on day 3.0 for the group that was controlled (P < 0.0001). 4.9 days was the hospital stay period for the group that chewed gum and 6.7 days for the group controlled (p < 0.00001). Conclusions: The research was conducted on 46 patients in Yaoundé, Cameroon where half of the patients were in a control group and the other half in a chewing gum group. It was concluded that the group that chewed gum after open appendectomy had a reduction in postoperative ileus. This treatment was recommended for use in other African nations due to its cheapness and effectiveness.

  • Advanced Coding: Integumentary/Cardiovascular/Sensory

    Advanced Coding: Integumentary/Cardiovascular/Sensory

    Please answer all questions CORRECTLY, and return back to me.

    1.   A 38-year-old patient is admitted to the hospital due to a lesion in her right breast, and a painful lump and nipple discharge from the left breast. The physician places a percutaneous needle localization device in the right breast under ultrasound guidance, excises the right breast lesion, and then excises the lactiferous duct fistula in the left breast. What CPT codes should be assigned?

    A.
    19129-RT, 19284-RT, 19122-LT   
    B.
    19125-RT, 19285-RT, 19112-LT   
    C.
    19127-RT, 19283-RT, 19132-LT   
    D.
    19122-RT, 19275-RT, 19142-LT

    2.   A 92-year-old female patient experiences difficulty hearing in her left ear. She is prescribed a BICROS hearing aid that she can wear behind the ear. What HCPCS code is assigned?

    A.
    V5250   
    B.
    V5320   
    C.
    V5220   
    D.
    V5240

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    3.   A 57-year-old patient is admitted to the hospital for a hip arthroscopy procedure. The patient is a normal healthy patient with no systemic disease. What CPT code should be assigned?

    A.
    01612-P1   
    B.
    01402-P1   
    C.
    01202-P1   
    D.
    01312-P1

     

    4.   An 80-year-old patient is admitted to the hospital with congestive heart failure. What ICD-10-CM code should be assigned?

    A.
    K15.0   
    B.
    L50.5   
    C.
    K52.9   
    D.
    I50.9

     

    5.   A 44-year-old female patient comes to the hospital for removal of a 4 cm malignant lesion from the arm. During the course of the procedure, the patient undergoes a 14 sq. cm adjacent tissue transfer from the right leg, as well as a 20 sq. cm split-thickness skin graft from the left arm. What CPT codes are assigned?

    A.
    14021, 15100-51   
    B.
    14045, 15400   
    C.
    14032, 15207   
    D.
    14044, 15350

     

    6.   A patient has a breast localization device placed through the skin using stereotactic guidance in order to treat two lesions. What codes would be assigned?

    A.
    19285, 19286   
    B.
    19287, 19288   
    C.
    19283, 19284   
    D.
    19296, 19297

     

    7.   A 19-year-old patient is diagnosed with acne vulgaris. The physician performs laser dermabrasion of the facial skin. What codes are assigned?

    A.
    L50.5, 0HB1XZZ   
    B.
    L70.0, 0HD1XZZ   
    C.
    L70.5, 0HA1XZZ   
    D.
    L70.6, 0HQ1XZZ

     

    8.   Implantation of a patient-activated cardiac event recorder is assigned to code

    A.
    33286.   
    B.
    33282.   
    C.
    33285.   
    D.
    33284.

     

    9.   A 27-year-old patient is diagnosed with a chalazion on the upper left eyelid, which is excised using an external approach. What ICD-10 diagnosis and procedure codes are assigned?

    A.
    H04.16, 08BQXZZ   
    B.
    H02.14, 08BTXZZ   
    C.
    H00.14, 08BPXZZ   
    D.
    H07.19, 08BRXZZ

     

    10.   A 77-year-old patient is diagnosed with an ear infection. She receives an injection of 40 mg of gentamicin sulfate. What HCPCS code should be assigned?

    A.
    J1452   
    B.
    J1472   
    C.
    J1675   
    D.
    J1580

     

    11.   A patient undergoes a transcanal labyrinthectomy. What code would be assigned?

    A.
    69930   
    B.
    69915   
    C.
    69955   
    D.
    69905

     

    12.   A 92-year-old patient is diagnosed with senile cataracts and bilateral sensorineural hearing loss. The physician performs a bilateral cataract extraction. What ICD-10 codes are reported?

    A.
    H27.9, H90.3, 08KJ3ZZ, 08MK3ZZ   
    B.
    H26.9, H90.3, 08EJ3ZZ, 08LK3ZZ   
    C.
    H25.9, H90.3, 08DJ3ZZ, 08DK3ZZ   
    D.
    H21.9, H90.3, 08PJ3ZZ, 08NK3ZZ

     

    13.   Mr. Oliver is an elderly gentleman who has been having problems with his vision for the previous three weeks. He is diagnosed with keratoconus, as well as hypertension with stage III chronic kidney disease, and diabetes mellitus, for which he takes long-term insulin. The anesthesiologist provided general anesthesia for this patient with severe systemic disease. After the administration of anesthesia, the surgeon performs an endothelial keratoplasty. Prior to performing the endothelial keratoplasty, the surgeon performs backbench preparation of the allograft. Code this scenario (including the anesthesiology service).

    A.
    65756, 65757, 00144-P3; H18.609, E11.65, R46.89, Z79.4   
    B.
    65754, 65727, 00134-P1; H18.609, E11.40, I12.9, N18.4, Z79.899   
    C.
    65756, 65757, 00144-P3; H18.609, E11.9, I12.9, N18.3, Z79.4   
    D.
    65757, 65787, 00142-P2; H18.229, E11.51, I12.0, N18.9

     

    14.   A 47-year-old female patient is seen for a worrisome lesion on the back of her hand. What ICD-10-CM code should be assigned?

    A.
    L94.9   
    B.
    L98.9   
    C.
    L91.5   
    D.
    L97.4

     

    15.   Breast reconstruction with transverse rectus with a TRAM flap would be assigned to code

    A.
    19370.   
    B.
    19342.   
    C.
    19369.   
    D.
    19316.

     

    16.   Ms. Nelson comes to the emergency room due to sustaining multiple lacerations after being pushed into a glass door during a physical altercation with her husband at a hotel. She sustained a 5 cm laceration on her right hand and a 7 cm cut on her neck. She also has a 5.0 benign lesion removed from her left arm. The physician performs a simple repair on the lacerations on her hand and neck. Code this scenario.

    A.
    11443, 12008-59; S61.209A, S31.652A, Y04.0XXA, W45.8XXA, V97.29XA   
    B.
    11422, 12007-59; S51.809A, S61.351A, W86.8XXA, Y04.0XXA   
    C.
    11409, 12005-59; S58.119A, S11.22XA, X19.XXXA, V95.13XA   
    D.
    11406, 12004-59; S61.401A, S11.90XA, Y04.0XXA, W45.8XXA, Y92.29

     

    17.   Biopsy of the lacrimal gland is assigned to code

    A.
    68520.   
    B.
    68811.   
    C.
    68815.   
    D.
    68510.

     

    18.   A patient comes to the emergency room complaining of lightheadedness and difficulty hearing. The physician examines her and determines that she has Ménière’s disease. The physician performs an endolymphatic sac decompression (excision of the right inner ear using an open approach). What ICD-10 diagnosis and procedure codes are assigned?

    A.
    H81.03, 09BF0ZZ   
    B.
    H83.03, 09BK0ZZ   
    C.
    H81.03, 09BD0ZZ   
    D.
    H82.03, 09BG0ZZ

     

    19.   A physician performs a biopsy of the cornea. What code should be assigned?

    A.
    65420   
    B.
    65410   
    C.
    65419   
    D.
    65415

     

    20.   Injection of contrast medium for dacryocystography is assigned to code

    A.
    68853.   
    B.
    68854.   
    C.
    68850.   
    D.
    68851.

    Advanced Coding: Integumentary/Cardiovascular/Sensory

  • Advanced Pathophysiology and Pharmacology for Nurse Educators

    Advanced Pathophysiology and Pharmacology for Nurse Educators

    Document a focused history, physical exam, nursing diagnoses, and nursing process of a case study from NUR-641E: Advanced Pathophysiology and Pharmacology for Nurse Educators and compare the differences with a complete assessment. At least 3-4 references

    Case Study

    A 22-year-old woman reports being “sick with the flu” for the past 8 days. She is vomiting several times every day, having difficulty keeping liquids or food down, and has been using more than the recommended dose of antacids in an attempt to calm the nausea. She has become severely dehydrated. After fainting at home, she was taken to a local hospital. An arterial blood gas sample was drawn and then an IV was placed to help rehydrate her. The arterial blood gas revealed the following:

    Test​ Result​           Normal levels

    pH​​7.5​​7.35 – 7.45

    PaCO2​40 mm Hg​35-45 mm Hg

    PaO2​95 mm Hg​80-100 mm Hg

    SaO2​                        97%​95-100%

    HCO3-​      32 meq/liter​22-26 meq/liter

  • nursing associations and the numerous current issues

    Reflect on the purpose of nursing associations and the numerous current issues with which they are faced. How do nursing associations work to promote policies that are patient-centered and lead the profession forward? Provide at least 2 specific examples of policies from one specific association.

    Discussion Board Rubric.docx

    **As a reminder,
     all questions must be answered to receive
     
    full credit for this discussion
    .
     please include your name in the title of the discussion. Also, make sure to use scholarly sources to support your discussion. Original posts must be  a minimum of 250 words and reply posts 100 words.**

  • First Lieutenant Jimmy Cross carried letters from a girl named Martha, a junior at Mount Sebastian College in New Jersey. They were not love letters, but Lieutenant Cross was hoping, so he kept them folded in plastic at the bottom of his rucksack. In the late afternoon, after a day’s march, he would dig his foxhole, wash his hands under a canteen, unwrap the letters, hold them with the tips of his fingers, and spend the last hour of light pretending. He would imagine romantic camping trips into the White Mountains in New Hampshire. He would sometimes taste the envelope flaps, knowing her tongue had been there. More than anything, he wanted Martha to love him as he loved her, but the letters were mostly chatty, elusive on the matter of love. She was a virgin, he was almost sure. She was an English major at Mount Sebastian, and she wrote beautifully about her professors and roommates and midterm exams, about her respect for Chaucer and her great affection for Virginia Woolf. She often quoted lines of poetry; she never mentioned the war, except to say, Jimmy, take care of yourself. The letters weighed 10 ounces. They were signed Love, Martha, but Lieutenant Cross understood that Love was only a way of signing and did not mean what he sometimes pretended it meant. At dusk, he would carefully return the letters to his rucksack. Slowly, a bit distracted, he would get up and move among his men, checking the perimeter; then at full dark he would return to his hole and watch the night and wonder if Martha was a virgin.

    The things they carried were largely determined by necessity. Among the necessities or near-necessities were P-38 can openers, pocket knives, heat tabs, wristwatches, dog tags, mosquito repellent, chewing gum, candy, cigarettes, salt tablets, packets of Kool-Aid, lighters, matches, sewing kits, Military Payment Certificates, C rations, and two or three canteens of water. Together, these items weighed between 15 and 20 pounds, depending upon a man’s habits or rate of metabolism. Henry Dobbins, who was a big man, carried extra rations; he was especially fond of canned peaches in heavy syrup over pound cake. Dave Jensen, who practiced field hygiene, carried a toothbrush, dental floss, and several hotel-sized bars of soap he’d stolen on R&R° in Sydney, Australia. Ted Lavender, who was scared, carried tranquilizers until he was shot in the head outside the village of Than Khe in mid-April. By necessity, and because it was SOP,° they all carried steel helmets that weighed 5 pounds including the liner and camouflage cover. They carried the standard fatigue jackets and trousers. Very few carried underwear. On their feet they carried jungle boots—2.1 pounds—and Dave Jensen carried three pairs of socks and a can of Dr. Scholl’s foot powder as a precaution against trench foot. Until he was shot, Ted Lavender carried six or seven ounces of premium dope, which for him was a necessity. Mitchell Sanders, the RTO,° carried condoms. Norman Bowker carried a diary. Rat Kiley carried comic books. Kiowa, a devout Baptist, carried an illustrated New Testament that had been presented to him by his father, who taught Sunday school in Oklahoma City, Oklahoma. As a hedge against bad times, however, Kiowa also carried his grandmother’s distrust of the white man, his grandfather’s old hunting hatchet. Necessity dictated. Because the land was mined and booby-trapped, it was SOP for each man to carry a steel-centered, nylon-covered flak jacket, which weighed 6.7 pounds, but which on hot days seemed much heavier. Because you could die so quickly, each man carried at least one large compress bandage, usually in the helmet band for easy access. Because the nights were cold, and because the monsoons were wet, each carried a green plastic poncho that could be used as a raincoat or groundsheet or makeshift tent. With its quilted liner, the poncho weighed almost two pounds, but it was worth every ounce. In April, for instance, when Ted Lavender was shot, they used his poncho to wrap him up, then to carry him across the paddy, then to lift him into the chopper that took him away.

    They were called legs or grunts.

    To carry something was to hump it, as when Lieutenant Jimmy Cross humped his love for Martha up the hills and through the swamps. In its intransitive form, to hump meant to walk, or to march, but it implied burdens far beyond the intransitive.

    Almost everyone humped photographs. In his wallet, Lieutenant Cross carried two photographs of Martha. The first was a Kodacolor snapshot signed Love, though he knew better. She stood against a brick wall. Her eyes were gray and neutral, her lips slightly open as she stared straight-on at the camera. At night, sometimes, Lieutenant Cross wondered who had taken the picture, because he knew she had boyfriends, because he loved her so much, and because he could see the shadow of the picture-taker spreading out against the brick wall. The second photograph had been clipped from the 1968 Mount Sebastian yearbook. It was an action shot—women’s volleyball—and Martha was bent horizontal to the floor, reaching, the palms of her hands in sharp focus, the tongue taut, the expression frank and competitive. There was no visible sweat. She wore white gym shorts. Her legs, he thought, were almost certainly the legs of a virgin, dry and without hair, the left knee cocked and carrying her entire weight, which was just over one hundred pounds. Lieutenant Cross remembered touching that left knee. A dark theater, he remembered, and the movie was 
    Bonnie and Clyde,
     and Martha wore a tweed skirt, and during the final scene, when he touched her knee, she turned and looked at him in a sad, sober way that made him pull his hand back, but he would always remember the feel of the tweed skirt and the knee beneath it and the sound of the gunfire that killed Bonnie and Clyde, how embarrassing it was, how slow and oppressive. He remembered kissing her good night at the dorm door. Right then, he thought, he should’ve done something brave. He should’ve carried her up the stairs to her room and tied her to the bed and touched that left knee all night long. He should’ve risked it. Whenever he looked at the photographs, he thought of new things he should’ve done.          5

    What they carried was partly a function of rank, partly of field specialty.

    As a first lieutenant and platoon leader, Jimmy Cross carried a compass, maps, code books, binoculars, and a .45-caliber pistol that weighed 2.9 pounds fully loaded. He carried a strobe light and the responsibility for the lives of his men.

    As an RTO, Mitchell Sanders carried the PRC-25 radio, a killer, 26 pounds with its battery.

    As a medic, Rat Kiley carried a canvas satchel filled with morphine and plasma and malaria tablets and surgical tape and comic books and all the things a medic must carry, including M&M’s for especially bad wounds, for a total weight of nearly 20 pounds.

    As a big man, therefore a machine gunner, Henry Dobbins carried the M-60, which weighed 23 pounds unloaded, but which was almost always loaded. In addition, Dobbins carried between 10 and 15 pounds of ammunition draped in belts across his chest and shoulders.          10

    As PFCs or Spec 4s, most of them were common grunts and carried the standard M-16 gas-operated assault rifle. The weapon weighed 7.5 pounds unloaded, 8.2 pounds with its full 20-round magazine. Depending on numerous factors, such as topography and psychology, the riflemen carried anywhere from 12 to 20 magazines, usually in cloth bandoliers, adding on another 8.4 pounds at minimum, 14 pounds at maximum. When it was available, they also carried M-16 maintenance gear—rods and steel brushes and swabs and tubes of LSA oil—all of which weighed about a pound. Among the grunts, some carried the M-79 grenade launcher, 5.9 pounds unloaded, a reasonably light weapon except for the ammunition, which was heavy. A single round weighed 10 ounces. The typical load was 25 rounds. But Ted Lavender, who was scared, carried 34 rounds when he was shot and killed outside Than Khe, and he went down under an exceptional burden, more than 20 pounds of ammunition, plus the flak jacket and helmet and rations and water and toilet paper and tranquilizers and all the rest, plus the unweighed fear. He was dead weight. There was no twitching or flopping. Kiowa, who saw it happen, said it was like watching a rock fall, or a big sandbag or something—just boom, then down—not like the movies where the dead guy rolls around and does fancy spins and goes ass over teakettle—not like that, Kiowa said, the poor bastard just flat-fuck fell. Boom. Down. Nothing else. It was a bright morning in mid-April. Lieutenant Cross felt the pain. He blamed himself. They stripped off Lavender’s canteens and ammo, all the heavy things, and Rat Kiley said the obvious, the guy’s dead, and Mitchell Sanders used his radio to report one U.S. KIA° and to request a chopper. Then they wrapped Lavender in his poncho. They carried him out to a dry paddy, established security, and sat smoking the dead man’s dope until the chopper came. Lieutenant Cross kept to himself. He pictured Martha’s smooth young face, thinking he loved her more than anything, more than his men, and now Ted Lavender was dead because he loved her so much and could not stop thinking about her. When the dustoff arrived, they carried Lavender aboard. Afterward they burned Than Khe. They marched until dusk, then dug their holes, and that night Kiowa kept explaining how you had to be there, how fast it was, how the poor guy just dropped like so much concrete. Boom-down, he said. Like cement.

    In addition to the three standard weapons—the M-60, M-16, and M-79—they carried whatever presented itself, or whatever seemed appropriate as a means of killing or staying alive. They carried catch-as-catch-can. At various times, in various situations, they carried M-14s and CAR-15s and Swedish Ks and grease guns and captured AK-47s and Chi-Coms and RPGs and Simonov carbines and black market Uzis and .38-caliber Smith & Wesson handguns and 66 mm LAWs and shotguns and silencers and blackjacks and bayonets and C-4 plastic explosives. Lee Strunk carried a slingshot; a weapon of last resort, he called it. Mitchell Sanders carried brass knuckles. Kiowa carried his grandfather’s feathered hatchet. Every third or fourth man carried a Claymore antipersonnel mine—3.5 pounds with its firing device. They all carried fragmentation grenades—14 ounces each. They all carried at least one M-18 colored smoke grenade—24 ounces. Some carried CS or tear gas grenades. Some carried white phosphorus grenades. They carried all they could bear, and then some, including a silent awe for the terrible power of the things they carried.

    In the first week of April, before Lavender died, Lieutenant Jimmy Cross received a good-luck charm from Martha. It was a simple pebble, an ounce at most. Smooth to the touch, it was a milky white color with flecks of orange and violet, oval-shaped, like a miniature egg. In the accompanying letter, Martha wrote that she had found the pebble on the Jersey shoreline, precisely where the land touched water at high tide, where things came together but also separated. It was this separate-but-together quality, she wrote, that had inspired her to pick up the pebble and to carry it in her breast pocket for several days, where it seemed weightless, and then to send it through the mail, by air, as a token of her truest feelings for him. Lieutenant Cross found this romantic. But he wondered what her truest feelings were, exactly, and what she meant by separate-but-together. He wondered how the tides and waves had come into play on that afternoon along the Jersey shoreline when Martha saw the pebble and bent down to rescue it from geology. He imagined bare feet. Martha was a poet, with the poet’s sensibilities, and her feet would be brown and bare, the toenails unpainted, the eyes chilly and somber like the ocean in March, and though it was painful, he wondered who had been with her that afternoon. He imagined a pair of shadows moving along the strip of sand where things came together but also separated. It was phantom jealousy, he knew, but he couldn’t help himself. He loved her so much. On the march, through the hot days of early April, he carried the pebble in his mouth, turning it with his tongue, tasting sea salt and moisture. His mind wandered. He had difficulty keeping his attention on the war. On occasion he would yell at his men to spread out the column, to keep their eyes open, but then he would slip away into daydreams, just pretending, walking barefoot along the Jersey shore, with Martha, carrying nothing. He would feel himself rising. Sun and waves and gentle winds, all love and lightness.

    What they carried varied by mission.

    When a mission took them to the mountains, they carried mosquito netting, machetes, canvas tarps, and extra bug juice.          15

    If a mission seemed especially hazardous, or if it involved a place they knew to be bad, they carried everything they could. In certain heavily mined AOs,° where the land was dense with Toe Poppers and Bouncing Betties, they took turns humping a 28-pound mine detector. With its headphones and big sensing plate, the equipment was a stress on the lower back and shoulders, awkward to handle, often useless because of the shrapnel in the earth, but they carried it anyway, partly for safety, partly for the illusion of safety.

    On ambush, or other night missions, they carried peculiar little odds and ends. Kiowa always took along his New Testament and a pair of moccasins for silence. Dave Jensen carried night-sight vitamins high in carotene. Lee Strunk carried his slingshot; ammo, he claimed, would never be a problem. Rat Kiley carried brandy and M&M’s candy. Until he was shot, Ted Lavender carried the starlight scope, which weighed 6.3 pounds with its aluminum carrying case. Henry Dobbins carried his girlfriend’s pantyhose wrapped around his neck as a comforter. They all carried ghosts. When dark came, they would move out single file across the meadows and paddies to their ambush coordinates, where they would quietly set up the Claymores and lie down and spend the night waiting.

    Other missions were more complicated and required special equipment. In mid-April, it was their mission to search out and destroy the elaborate tunnel complexes in the Than Khe area south of Chu Lai. To blow the tunnels, they carried one-pound blocks of pentrite high explosives, four blocks to a man, 68 pounds in all. They carried wiring, detonators, and battery-powered clackers. Dave Jensen carried earplugs. Most often, before blowing the tunnels, they were ordered by higher command to search them, which was considered bad news, but by and large they just shrugged and carried out orders. Because he was a big man, Henry Dobbins was excused from tunnel duty. The others would draw numbers. Before Lavender died there were 17 men in the platoon, and whoever drew the number 17 would strip off his gear and crawl in headfirst with a flashlight and Lieutenant Cross’s .45-caliber pistol. The rest of them would fan out as security. They would sit down or kneel, not facing the hole, listening to the ground beneath them, imagining cobwebs and ghosts, whatever was down there—the tunnel walls squeezing in—how the flashlight seemed impossibly heavy in the hand and how it was tunnel vision in the very strictest sense, compression in all ways, even time, and how you had to wiggle in—ass and elbows—a swallowed-up feeling—and how you found yourself worrying about odd things: Will your flashlight go dead? Do rats carry rabies? If you screamed, how far would the sound carry? Would your buddies hear it? Would they have the courage to drag you out? In some respects, though not many, the waiting was worse than the tunnel itself. Imagination was a killer.

    On April 16, when Lee Strunk drew the number 17, he laughed and muttered something and went down quickly. The morning was hot and very still. Not good, Kiowa said. He looked at the tunnel opening, then out across a dry paddy toward the village of Than Khe. Nothing moved. No clouds or birds or people. As they waited, the men smoked and drank Kool-Aid, not talking much, feeling sympathy for Lee Strunk but also feeling the luck of the draw. You win some, you lose some, said Mitchell Sanders, and sometimes you settle for a rain check. It was a tired line and no one laughed.

    Henry Dobbins ate a tropical chocolate bar. Ted Lavender popped a tranquilizer and went off to pee.          20

    After five minutes, Lieutenant Jimmy Cross moved to the tunnel, leaned down, and examined the darkness. Trouble, he thought—a cave-in maybe. And then suddenly, without willing it, he was thinking about Martha. The stresses and fractures, the quick collapse, the two of them buried alive under all that weight. Dense, crushing love. Kneeling, watching the hole, he tried to concentrate on Lee Strunk and the war, all the dangers, but his love was too much for him, he felt paralyzed, he wanted to sleep inside her lungs and breathe her blood and be smothered. He wanted her to be a virgin and not a virgin, all at once. He wanted to know her. Intimate secrets: Why poetry? Why so sad? Why that grayness in her eyes? Why so alone? Not lonely, just alone—riding her bike across campus or sitting off by herself in the cafeteria—even dancing, she danced alone—and it was the aloneness that filled him with love. He remembered telling her that one evening. How she nodded and looked away. And how, later, when he kissed her, she received the kiss without returning it, her eyes wide open, not afraid, not a virgin’s eyes, just flat and uninvolved.

    Lieutenant Cross gazed at the tunnel. But he was not there. He was buried with Martha under the white sand at the Jersey shore. They were pressed together, and the pebble in his mouth was her tongue. He was smiling. Vaguely, he was aware of how quiet the day was, the sullen paddies, yet he could not bring himself to worry about matters of security. He was beyond that. He was just a kid at war, in love. He was twenty-four years old. He couldn’t help it.

    A few moments later Lee Strunk crawled out of the tunnel. He came up grinning, filthy but alive. Lieutenant Cross nodded and closed his eyes while the others clapped Strunk on the back and made jokes about rising from the dead.

    Worms, Rat Kiley said. Right out of the grave. Fuckin’ zombie.

    The men laughed. They all felt great relief.          25

    Spook city, said Mitchell Sanders.

    Lee Strunk made a funny ghost sound, a kind of moaning, yet very happy, and right then, when Strunk made that high happy moaning sound, when he went 
    Ahhooooo,
     right then Ted Lavender was shot in the head on his way back from peeing. He lay with his mouth open. The teeth were broken. There was a swollen black bruise under his left eye. The cheekbone was gone. Oh shit, Rat Kiley said, the guy’s dead. The guy’s dead, he kept saying, which seemed profound—the guy’s dead. I mean really.

    The things they carried were determined to some extent by superstition. Lieutenant Cross carried his good-luck pebble. Dave Jensen carried a rabbit’s foot. Norman Bowker, otherwise a very gentle person, carried a thumb that had been presented to him as a gift by Mitchell Sanders. The thumb was dark brown, rubbery to the touch, and weighed four ounces at most. It had been cut from a VC corpse, a boy of fifteen or sixteen. They’d found him at the bottom of an irrigation ditch, badly burned, flies in his mouth and eyes. The boy wore black shorts and sandals. At the time of his death he had been carrying a pouch of rice, a rifle, and three magazines of ammunition.

    You want my opinion, Mitchell Sanders said, there’s a definite moral here.

    He put his hand on the dead boy’s wrist. He was quiet for a time, as if counting a pulse, then he patted the stomach, almost affectionately, and used Kiowa’s hunting hatchet to remove the thumb.          30

    Henry Dobbins asked what the moral was.

    Moral?

    You know. 
    Moral.

    Sanders wrapped the thumb in toilet paper and handed it across to Norman Bowker. There was no blood. Smiling, he kicked the boy’s head, watched the flies scatter, and said, It’s like with that old TV show—Paladin. Have gun, will travel.

    Henry Dobbins thought about it.          35

    Yeah, well, he finally said. I don’t see no moral.

    There it is, man.

    Fuck off.

    They carried USO stationery and pencils and pens. They carried Sterno, safety pins, trip flares, signal flares, spools of wire, razor blades, chewing tobacco, liberated joss sticks and statuettes of the smiling Buddha, candles, grease pencils, 
    The Stars and Stripes,
     fingernail clippers, Psy Ops leaflets, bush hats, bolos, and much more. Twice a week, when the resupply choppers came in, they carried hot chow in green mermite cans and large canvas bags filled with iced beer and soda pop. They carried plastic water containers, each with a two-gallon capacity. Mitchell Sanders carried a set of starched tiger fatigues for special occasions. Henry Dobbins carried Black Flag insecticide. Dave Jensen carried empty sandbags that could be filled at night for added protection. Lee Strunk carried tanning lotion. Some things they carried in common. Taking turns, they carried the big PRC-77 scrambler radio, which weighed 30 pounds with its battery. They shared the weight of memory. They took up what others could no longer bear. Often, they carried each other, the wounded or weak. They carried infections. They carried chess sets, basketballs, Vietnamese-English dictionaries, insignia of rank, Bronze Stars and Purple Hearts, plastic cards imprinted with the Code of Conduct. They carried diseases, among them malaria and dysentery. They carried lice and ringworm and leeches and paddy algae and various rots and molds. They carried the land itself—Vietnam, the place, the soil—a powdery orange-red dust that covered their boots and fatigues and faces. They carried the sky. The whole atmosphere, they carried it, the humidity, the monsoons, the stink of fungus and decay, all of it, they carried gravity. They moved like mules. By daylight they took sniper fire, at night they were mortared, but it was not battle, it was just the endless march, village to village, without purpose, nothing won or lost. They marched for the sake of the march. They plodded along slowly, dumbly, leaning forward against the heat, unthinking, all blood and bone, simple grunts, soldiering with their legs, toiling up the hills and down into the paddies and across the rivers and up again and down, just humping, one step and then the next and then another, but no volition, no will, because it was automatic, it was anatomy, and the war was entirely a matter of posture and carriage, the hump was everything, a kind of inertia, a kind of emptiness, a dullness of desire and intellect and conscience and hope and human sensibility. Their principles were in their feet. Their calculations were biological. They had no sense of strategy or mission. They searched the villages without knowing what to look for, not caring, kicking over jars of rice, frisking children and old men, blowing tunnels, sometimes setting fires and sometimes not, then forming up and moving on to the next village, then other villages, where it would always be the same. They carried their own lives. The pressures were enormous. In the heat of early afternoon, they would remove their helmets and flak jackets, walking bare, which was dangerous but which helped ease the strain. They would often discard things along the route of march. Purely for comfort, they would throw away rations, blow their Claymores and grenades, no matter, because by nightfall the resupply choppers would arrive with more of the same, then a day or two later still more, fresh watermelons and crates of ammunition and sunglasses and woolen sweaters—the resources were stunning—sparklers for the Fourth of July, colored eggs for Easter—it was the great American war chest—the fruits of science, the smokestacks, the canneries, the arsenals at Hartford, the Minnesota forests, the machine shops, the vast fields of corn and wheat—they carried like freight trains; they carried it on their backs and shoulders—and for all the ambiguities of Vietnam, all the mysteries and unknowns, there was at least the single abiding certainty that they would never be at a loss for things to carry.

  • necessity

    First Lieutenant Jimmy Cross carried letters from a girl named Martha, a junior at Mount Sebastian College in New Jersey. They were not love letters, but Lieutenant Cross was hoping, so he kept them folded in plastic at the bottom of his rucksack. In the late afternoon, after a day’s march, he would dig his foxhole, wash his hands under a canteen, unwrap the letters, hold them with the tips of his fingers, and spend the last hour of light pretending. He would imagine romantic camping trips into the White Mountains in New Hampshire. He would sometimes taste the envelope flaps, knowing her tongue had been there. More than anything, he wanted Martha to love him as he loved her, but the letters were mostly chatty, elusive on the matter of love. She was a virgin, he was almost sure. She was an English major at Mount Sebastian, and she wrote beautifully about her professors and roommates and midterm exams, about her respect for Chaucer and her great affection for Virginia Woolf. She often quoted lines of poetry; she never mentioned the war, except to say, Jimmy, take care of yourself. The letters weighed 10 ounces. They were signed Love, Martha, but Lieutenant Cross understood that Love was only a way of signing and did not mean what he sometimes pretended it meant. At dusk, he would carefully return the letters to his rucksack. Slowly, a bit distracted, he would get up and move among his men, checking the perimeter; then at full dark he would return to his hole and watch the night and wonder if Martha was a virgin.

    The things they carried were largely determined by necessity. Among the necessities or near-necessities were P-38 can openers, pocket knives, heat tabs, wristwatches, dog tags, mosquito repellent, chewing gum, candy, cigarettes, salt tablets, packets of Kool-Aid, lighters, matches, sewing kits, Military Payment Certificates, C rations, and two or three canteens of water. Together, these items weighed between 15 and 20 pounds, depending upon a man’s habits or rate of metabolism. Henry Dobbins, who was a big man, carried extra rations; he was especially fond of canned peaches in heavy syrup over pound cake. Dave Jensen, who practiced field hygiene, carried a toothbrush, dental floss, and several hotel-sized bars of soap he’d stolen on R&R° in Sydney, Australia. Ted Lavender, who was scared, carried tranquilizers until he was shot in the head outside the village of Than Khe in mid-April. By necessity, and because it was SOP,° they all carried steel helmets that weighed 5 pounds including the liner and camouflage cover. They carried the standard fatigue jackets and trousers. Very few carried underwear. On their feet they carried jungle boots—2.1 pounds—and Dave Jensen carried three pairs of socks and a can of Dr. Scholl’s foot powder as a precaution against trench foot. Until he was shot, Ted Lavender carried six or seven ounces of premium dope, which for him was a necessity. Mitchell Sanders, the RTO,° carried condoms. Norman Bowker carried a diary. Rat Kiley carried comic books. Kiowa, a devout Baptist, carried an illustrated New Testament that had been presented to him by his father, who taught Sunday school in Oklahoma City, Oklahoma. As a hedge against bad times, however, Kiowa also carried his grandmother’s distrust of the white man, his grandfather’s old hunting hatchet. Necessity dictated. Because the land was mined and booby-trapped, it was SOP for each man to carry a steel-centered, nylon-covered flak jacket, which weighed 6.7 pounds, but which on hot days seemed much heavier. Because you could die so quickly, each man carried at least one large compress bandage, usually in the helmet band for easy access. Because the nights were cold, and because the monsoons were wet, each carried a green plastic poncho that could be used as a raincoat or groundsheet or makeshift tent. With its quilted liner, the poncho weighed almost two pounds, but it was worth every ounce. In April, for instance, when Ted Lavender was shot, they used his poncho to wrap him up, then to carry him across the paddy, then to lift him into the chopper that took him away.

    They were called legs or grunts.

    To carry something was to hump it, as when Lieutenant Jimmy Cross humped his love for Martha up the hills and through the swamps. In its intransitive form, to hump meant to walk, or to march, but it implied burdens far beyond the intransitive.

    Almost everyone humped photographs. In his wallet, Lieutenant Cross carried two photographs of Martha. The first was a Kodacolor snapshot signed Love, though he knew better. She stood against a brick wall. Her eyes were gray and neutral, her lips slightly open as she stared straight-on at the camera. At night, sometimes, Lieutenant Cross wondered who had taken the picture, because he knew she had boyfriends, because he loved her so much, and because he could see the shadow of the picture-taker spreading out against the brick wall. The second photograph had been clipped from the 1968 Mount Sebastian yearbook. It was an action shot—women’s volleyball—and Martha was bent horizontal to the floor, reaching, the palms of her hands in sharp focus, the tongue taut, the expression frank and competitive. There was no visible sweat. She wore white gym shorts. Her legs, he thought, were almost certainly the legs of a virgin, dry and without hair, the left knee cocked and carrying her entire weight, which was just over one hundred pounds. Lieutenant Cross remembered touching that left knee. A dark theater, he remembered, and the movie was 
    Bonnie and Clyde,
     and Martha wore a tweed skirt, and during the final scene, when he touched her knee, she turned and looked at him in a sad, sober way that made him pull his hand back, but he would always remember the feel of the tweed skirt and the knee beneath it and the sound of the gunfire that killed Bonnie and Clyde, how embarrassing it was, how slow and oppressive. He remembered kissing her good night at the dorm door. Right then, he thought, he should’ve done something brave. He should’ve carried her up the stairs to her room and tied her to the bed and touched that left knee all night long. He should’ve risked it. Whenever he looked at the photographs, he thought of new things he should’ve done.          5

    What they carried was partly a function of rank, partly of field specialty.

    As a first lieutenant and platoon leader, Jimmy Cross carried a compass, maps, code books, binoculars, and a .45-caliber pistol that weighed 2.9 pounds fully loaded. He carried a strobe light and the responsibility for the lives of his men.

    As an RTO, Mitchell Sanders carried the PRC-25 radio, a killer, 26 pounds with its battery.

    As a medic, Rat Kiley carried a canvas satchel filled with morphine and plasma and malaria tablets and surgical tape and comic books and all the things a medic must carry, including M&M’s for especially bad wounds, for a total weight of nearly 20 pounds.

    As a big man, therefore a machine gunner, Henry Dobbins carried the M-60, which weighed 23 pounds unloaded, but which was almost always loaded. In addition, Dobbins carried between 10 and 15 pounds of ammunition draped in belts across his chest and shoulders.          10

    As PFCs or Spec 4s, most of them were common grunts and carried the standard M-16 gas-operated assault rifle. The weapon weighed 7.5 pounds unloaded, 8.2 pounds with its full 20-round magazine. Depending on numerous factors, such as topography and psychology, the riflemen carried anywhere from 12 to 20 magazines, usually in cloth bandoliers, adding on another 8.4 pounds at minimum, 14 pounds at maximum. When it was available, they also carried M-16 maintenance gear—rods and steel brushes and swabs and tubes of LSA oil—all of which weighed about a pound. Among the grunts, some carried the M-79 grenade launcher, 5.9 pounds unloaded, a reasonably light weapon except for the ammunition, which was heavy. A single round weighed 10 ounces. The typical load was 25 rounds. But Ted Lavender, who was scared, carried 34 rounds when he was shot and killed outside Than Khe, and he went down under an exceptional burden, more than 20 pounds of ammunition, plus the flak jacket and helmet and rations and water and toilet paper and tranquilizers and all the rest, plus the unweighed fear. He was dead weight. There was no twitching or flopping. Kiowa, who saw it happen, said it was like watching a rock fall, or a big sandbag or something—just boom, then down—not like the movies where the dead guy rolls around and does fancy spins and goes ass over teakettle—not like that, Kiowa said, the poor bastard just flat-fuck fell. Boom. Down. Nothing else. It was a bright morning in mid-April. Lieutenant Cross felt the pain. He blamed himself. They stripped off Lavender’s canteens and ammo, all the heavy things, and Rat Kiley said the obvious, the guy’s dead, and Mitchell Sanders used his radio to report one U.S. KIA° and to request a chopper. Then they wrapped Lavender in his poncho. They carried him out to a dry paddy, established security, and sat smoking the dead man’s dope until the chopper came. Lieutenant Cross kept to himself. He pictured Martha’s smooth young face, thinking he loved her more than anything, more than his men, and now Ted Lavender was dead because he loved her so much and could not stop thinking about her. When the dustoff arrived, they carried Lavender aboard. Afterward they burned Than Khe. They marched until dusk, then dug their holes, and that night Kiowa kept explaining how you had to be there, how fast it was, how the poor guy just dropped like so much concrete. Boom-down, he said. Like cement.

    In addition to the three standard weapons—the M-60, M-16, and M-79—they carried whatever presented itself, or whatever seemed appropriate as a means of killing or staying alive. They carried catch-as-catch-can. At various times, in various situations, they carried M-14s and CAR-15s and Swedish Ks and grease guns and captured AK-47s and Chi-Coms and RPGs and Simonov carbines and black market Uzis and .38-caliber Smith & Wesson handguns and 66 mm LAWs and shotguns and silencers and blackjacks and bayonets and C-4 plastic explosives. Lee Strunk carried a slingshot; a weapon of last resort, he called it. Mitchell Sanders carried brass knuckles. Kiowa carried his grandfather’s feathered hatchet. Every third or fourth man carried a Claymore antipersonnel mine—3.5 pounds with its firing device. They all carried fragmentation grenades—14 ounces each. They all carried at least one M-18 colored smoke grenade—24 ounces. Some carried CS or tear gas grenades. Some carried white phosphorus grenades. They carried all they could bear, and then some, including a silent awe for the terrible power of the things they carried.

    In the first week of April, before Lavender died, Lieutenant Jimmy Cross received a good-luck charm from Martha. It was a simple pebble, an ounce at most. Smooth to the touch, it was a milky white color with flecks of orange and violet, oval-shaped, like a miniature egg. In the accompanying letter, Martha wrote that she had found the pebble on the Jersey shoreline, precisely where the land touched water at high tide, where things came together but also separated. It was this separate-but-together quality, she wrote, that had inspired her to pick up the pebble and to carry it in her breast pocket for several days, where it seemed weightless, and then to send it through the mail, by air, as a token of her truest feelings for him. Lieutenant Cross found this romantic. But he wondered what her truest feelings were, exactly, and what she meant by separate-but-together. He wondered how the tides and waves had come into play on that afternoon along the Jersey shoreline when Martha saw the pebble and bent down to rescue it from geology. He imagined bare feet. Martha was a poet, with the poet’s sensibilities, and her feet would be brown and bare, the toenails unpainted, the eyes chilly and somber like the ocean in March, and though it was painful, he wondered who had been with her that afternoon. He imagined a pair of shadows moving along the strip of sand where things came together but also separated. It was phantom jealousy, he knew, but he couldn’t help himself. He loved her so much. On the march, through the hot days of early April, he carried the pebble in his mouth, turning it with his tongue, tasting sea salt and moisture. His mind wandered. He had difficulty keeping his attention on the war. On occasion he would yell at his men to spread out the column, to keep their eyes open, but then he would slip away into daydreams, just pretending, walking barefoot along the Jersey shore, with Martha, carrying nothing. He would feel himself rising. Sun and waves and gentle winds, all love and lightness.

    What they carried varied by mission.

    When a mission took them to the mountains, they carried mosquito netting, machetes, canvas tarps, and extra bug juice.          15

    If a mission seemed especially hazardous, or if it involved a place they knew to be bad, they carried everything they could. In certain heavily mined AOs,° where the land was dense with Toe Poppers and Bouncing Betties, they took turns humping a 28-pound mine detector. With its headphones and big sensing plate, the equipment was a stress on the lower back and shoulders, awkward to handle, often useless because of the shrapnel in the earth, but they carried it anyway, partly for safety, partly for the illusion of safety.

    On ambush, or other night missions, they carried peculiar little odds and ends. Kiowa always took along his New Testament and a pair of moccasins for silence. Dave Jensen carried night-sight vitamins high in carotene. Lee Strunk carried his slingshot; ammo, he claimed, would never be a problem. Rat Kiley carried brandy and M&M’s candy. Until he was shot, Ted Lavender carried the starlight scope, which weighed 6.3 pounds with its aluminum carrying case. Henry Dobbins carried his girlfriend’s pantyhose wrapped around his neck as a comforter. They all carried ghosts. When dark came, they would move out single file across the meadows and paddies to their ambush coordinates, where they would quietly set up the Claymores and lie down and spend the night waiting.

    Other missions were more complicated and required special equipment. In mid-April, it was their mission to search out and destroy the elaborate tunnel complexes in the Than Khe area south of Chu Lai. To blow the tunnels, they carried one-pound blocks of pentrite high explosives, four blocks to a man, 68 pounds in all. They carried wiring, detonators, and battery-powered clackers. Dave Jensen carried earplugs. Most often, before blowing the tunnels, they were ordered by higher command to search them, which was considered bad news, but by and large they just shrugged and carried out orders. Because he was a big man, Henry Dobbins was excused from tunnel duty. The others would draw numbers. Before Lavender died there were 17 men in the platoon, and whoever drew the number 17 would strip off his gear and crawl in headfirst with a flashlight and Lieutenant Cross’s .45-caliber pistol. The rest of them would fan out as security. They would sit down or kneel, not facing the hole, listening to the ground beneath them, imagining cobwebs and ghosts, whatever was down there—the tunnel walls squeezing in—how the flashlight seemed impossibly heavy in the hand and how it was tunnel vision in the very strictest sense, compression in all ways, even time, and how you had to wiggle in—ass and elbows—a swallowed-up feeling—and how you found yourself worrying about odd things: Will your flashlight go dead? Do rats carry rabies? If you screamed, how far would the sound carry? Would your buddies hear it? Would they have the courage to drag you out? In some respects, though not many, the waiting was worse than the tunnel itself. Imagination was a killer.

    On April 16, when Lee Strunk drew the number 17, he laughed and muttered something and went down quickly. The morning was hot and very still. Not good, Kiowa said. He looked at the tunnel opening, then out across a dry paddy toward the village of Than Khe. Nothing moved. No clouds or birds or people. As they waited, the men smoked and drank Kool-Aid, not talking much, feeling sympathy for Lee Strunk but also feeling the luck of the draw. You win some, you lose some, said Mitchell Sanders, and sometimes you settle for a rain check. It was a tired line and no one laughed.

    Henry Dobbins ate a tropical chocolate bar. Ted Lavender popped a tranquilizer and went off to pee.          20

    After five minutes, Lieutenant Jimmy Cross moved to the tunnel, leaned down, and examined the darkness. Trouble, he thought—a cave-in maybe. And then suddenly, without willing it, he was thinking about Martha. The stresses and fractures, the quick collapse, the two of them buried alive under all that weight. Dense, crushing love. Kneeling, watching the hole, he tried to concentrate on Lee Strunk and the war, all the dangers, but his love was too much for him, he felt paralyzed, he wanted to sleep inside her lungs and breathe her blood and be smothered. He wanted her to be a virgin and not a virgin, all at once. He wanted to know her. Intimate secrets: Why poetry? Why so sad? Why that grayness in her eyes? Why so alone? Not lonely, just alone—riding her bike across campus or sitting off by herself in the cafeteria—even dancing, she danced alone—and it was the aloneness that filled him with love. He remembered telling her that one evening. How she nodded and looked away. And how, later, when he kissed her, she received the kiss without returning it, her eyes wide open, not afraid, not a virgin’s eyes, just flat and uninvolved.

    Lieutenant Cross gazed at the tunnel. But he was not there. He was buried with Martha under the white sand at the Jersey shore. They were pressed together, and the pebble in his mouth was her tongue. He was smiling. Vaguely, he was aware of how quiet the day was, the sullen paddies, yet he could not bring himself to worry about matters of security. He was beyond that. He was just a kid at war, in love. He was twenty-four years old. He couldn’t help it.

    A few moments later Lee Strunk crawled out of the tunnel. He came up grinning, filthy but alive. Lieutenant Cross nodded and closed his eyes while the others clapped Strunk on the back and made jokes about rising from the dead.

    Worms, Rat Kiley said. Right out of the grave. Fuckin’ zombie.

    The men laughed. They all felt great relief.          25

    Spook city, said Mitchell Sanders.

    Lee Strunk made a funny ghost sound, a kind of moaning, yet very happy, and right then, when Strunk made that high happy moaning sound, when he went 
    Ahhooooo,
     right then Ted Lavender was shot in the head on his way back from peeing. He lay with his mouth open. The teeth were broken. There was a swollen black bruise under his left eye. The cheekbone was gone. Oh shit, Rat Kiley said, the guy’s dead. The guy’s dead, he kept saying, which seemed profound—the guy’s dead. I mean really.

    The things they carried were determined to some extent by superstition. Lieutenant Cross carried his good-luck pebble. Dave Jensen carried a rabbit’s foot. Norman Bowker, otherwise a very gentle person, carried a thumb that had been presented to him as a gift by Mitchell Sanders. The thumb was dark brown, rubbery to the touch, and weighed four ounces at most. It had been cut from a VC corpse, a boy of fifteen or sixteen. They’d found him at the bottom of an irrigation ditch, badly burned, flies in his mouth and eyes. The boy wore black shorts and sandals. At the time of his death he had been carrying a pouch of rice, a rifle, and three magazines of ammunition.

    You want my opinion, Mitchell Sanders said, there’s a definite moral here.

    He put his hand on the dead boy’s wrist. He was quiet for a time, as if counting a pulse, then he patted the stomach, almost affectionately, and used Kiowa’s hunting hatchet to remove the thumb.          30

    Henry Dobbins asked what the moral was.

    Moral?

    You know. 
    Moral.

    Sanders wrapped the thumb in toilet paper and handed it across to Norman Bowker. There was no blood. Smiling, he kicked the boy’s head, watched the flies scatter, and said, It’s like with that old TV show—Paladin. Have gun, will travel.

    Henry Dobbins thought about it.          35

    Yeah, well, he finally said. I don’t see no moral.

    There it is, man.

    Fuck off.

    They carried USO stationery and pencils and pens. They carried Sterno, safety pins, trip flares, signal flares, spools of wire, razor blades, chewing tobacco, liberated joss sticks and statuettes of the smiling Buddha, candles, grease pencils, 
    The Stars and Stripes,
     fingernail clippers, Psy Ops leaflets, bush hats, bolos, and much more. Twice a week, when the resupply choppers came in, they carried hot chow in green mermite cans and large canvas bags filled with iced beer and soda pop. They carried plastic water containers, each with a two-gallon capacity. Mitchell Sanders carried a set of starched tiger fatigues for special occasions. Henry Dobbins carried Black Flag insecticide. Dave Jensen carried empty sandbags that could be filled at night for added protection. Lee Strunk carried tanning lotion. Some things they carried in common. Taking turns, they carried the big PRC-77 scrambler radio, which weighed 30 pounds with its battery. They shared the weight of memory. They took up what others could no longer bear. Often, they carried each other, the wounded or weak. They carried infections. They carried chess sets, basketballs, Vietnamese-English dictionaries, insignia of rank, Bronze Stars and Purple Hearts, plastic cards imprinted with the Code of Conduct. They carried diseases, among them malaria and dysentery. They carried lice and ringworm and leeches and paddy algae and various rots and molds. They carried the land itself—Vietnam, the place, the soil—a powdery orange-red dust that covered their boots and fatigues and faces. They carried the sky. The whole atmosphere, they carried it, the humidity, the monsoons, the stink of fungus and decay, all of it, they carried gravity. They moved like mules. By daylight they took sniper fire, at night they were mortared, but it was not battle, it was just the endless march, village to village, without purpose, nothing won or lost. They marched for the sake of the march. They plodded along slowly, dumbly, leaning forward against the heat, unthinking, all blood and bone, simple grunts, soldiering with their legs, toiling up the hills and down into the paddies and across the rivers and up again and down, just humping, one step and then the next and then another, but no volition, no will, because it was automatic, it was anatomy, and the war was entirely a matter of posture and carriage, the hump was everything, a kind of inertia, a kind of emptiness, a dullness of desire and intellect and conscience and hope and human sensibility. Their principles were in their feet. Their calculations were biological. They had no sense of strategy or mission. They searched the villages without knowing what to look for, not caring, kicking over jars of rice, frisking children and old men, blowing tunnels, sometimes setting fires and sometimes not, then forming up and moving on to the next village, then other villages, where it would always be the same. They carried their own lives. The pressures were enormous. In the heat of early afternoon, they would remove their helmets and flak jackets, walking bare, which was dangerous but which helped ease the strain. They would often discard things along the route of march. Purely for comfort, they would throw away rations, blow their Claymores and grenades, no matter, because by nightfall the resupply choppers would arrive with more of the same, then a day or two later still more, fresh watermelons and crates of ammunition and sunglasses and woolen sweaters—the resources were stunning—sparklers for the Fourth of July, colored eggs for Easter—it was the great American war chest—the fruits of science, the smokestacks, the canneries, the arsenals at Hartford, the Minnesota forests, the machine shops, the vast fields of corn and wheat—they carried like freight trains; they carried it on their backs and shoulders—and for all the ambiguities of Vietnam, all the mysteries and unknowns, there was at least the single abiding certainty that they would never be at a loss for things to carry.