The Vietnam War: Defeating the US

The Vietnam War: Defeating the US Why did the Vietnam war happen? Why didnt we just back down?. I think that he United States could have won this war, with a mixture of better weapons usage, better moves, and better support from their home country, this could also have even been prevented. Before the war, Vietnam was a disputed territory. Many countries countrys in the past had taken Vietnam over, and after World War II, Vietnam was in the hands of France. Clearly, the Vietnamese wanted their own country, and their long history of being a colony prompted the oppressed people to fight for their independence in the French Indochina war. Ho Chi Minh, the leader of the Communist party, organized the Vietnamese independence movement, Viet Minh. Asked for support from America first, since that leader didnt want to use communism to free his people. The United States looked helping Ho Chi Minh gain his independence from France as a move against their own allies, they declined. It was only after Russia and China offered to help that Ho Chi Minh adopted communist ideals and wanted to make all of Vietnam communist. The Vietnam war started because communism was going to expand into Korea and eventually into other countrys. America didnt want that. If the United States had looked past its alliances and not helped another country gain its independence like we had gained ours so many years ago, this war would have been completely avoided. Unfortunately for the families of over 58, 000 soldiers, it wasnt. this began as early as 1954, the United States started sending financial and military aid to South Vietnam, hoping to stop the spread of communism. The flow of military advisors from 700 to over 14,000 built up steadily through John F Kennedys presidency, and after he was assassinated, Johnson escalated the war to the point of no return. American people were so scared of communism that they were willing to do anything to stop communism where it started. The people of the United States let Johnson build up a huge force in Vietnam, and he was also almost unanimously backed by congress. By the end of the war, Johnson was so ashamed that he didnt even try to run for reelection. If the Americans would have stopped and thought about wh at they were getting themselves into and not jumping right into it, we would be ok. In 1964, the event that all war hawks wanted happened. In the Gulf of Ton kin, several Viet Cong torpedo boats reportedly fired on a U.S. vessel. Even though the American ship sustained no damages, Johnson drafted the Gulf of Ton kin Resolution, which authorized him to use any force necessary to beat back the North Vietnamese. Congress never declared war or even directly authorized troops, but Johnson somehow got to declare it. Early in the War At first, Johnson didnt let the problem go into the air, because he was hoping to destroy Viet Cong. He used planes such as the B-52 bomber and the F-4 Phantom to try to win the war as quickly as possible. Unfortunately, the United States air power had many shortcomings. The F-4 Phantom was the latest and best technology out there during Vietnam War. Manufactured by McDonnell-Douglas, this plane was capable of multiple roles, as a dogfighter, bomber, recon, and support aircraft. But, the F-4 had its some problems. First, the engineers who desi gned it did not mount any type of gun on the F-4A through the F-4D, thinking that the Phantoms frightening compliment of missiles could take out any enemy threat. This wasnt the smarted move. Not having a gun made the dog-fighting role of the Phantom extremely hard, because the AIM-9 and AIM-7 missiles were not as effective at closer ranges against the enemy MIGs. Only after almost 2 years was the F-4E Phantom fitted with a 6-barrell gatling gun. Also, many pilots were not trained very well, only having 6 weeks of training as opposed to the normal 1-year. The B-52 Stratofortress was the largest bomber ever made at that time. We should have used it wisely There were also negative sides to the use of the B-52. During World War II, the allies could depend on destroying the industry of their enemy, eventually destroying its fighting power. The VC did not count on industry and big guns, but guerrilla tactics and small arms weapons. The U.S. also thought by using a lot of bombs and by using napalm, the enemy would be scared and finally give up. Both of tactics proved to be wrong. The bombings got the enemy angry and brought the North Vietnamese closer together, instead of its actual goal. Napalm was also bad mistake. By using a flammable jelly which consisted of gasoline and some other chemical to make it think, they burned up all of North Vietnam, the United States not only killed more people than enemies, but also made people think was this the right thing to do? Anything that Napalm touched burned for up to a week. Another type of bomb was dropped by the B-52s, this one containing a large amount of the deadly gas, Agent Orange. Millions of acres of jungle were destroyed and even more fields and paddies were poisoned. South Vietnamese farmers complained about the effect Agent Orange had on their rice paddies. Agent Orange was supposed to eliminate the Viet Cong s advantages of there hiding places, but it only turned the people we were fighting for against us even more. Agent Orange also hurt us to, many of the Veterans ended up getting sick, like cancer and other deadly sicknesses. The use of Agent Orange was perhaps one of the worst mistakes made in Vietnam. If we just thought ahead, and figuring out the consequences of using weapons such as napalm and Agent Orange, the U.S. could have won the Vietnam War, mostly through the use of air power. During the Vietnam War we dropped more bombs than in any other war, this would make you think that we should win because its easy. Sadly, ethical problems and lack of planning made it impossible to settle the war in the air, making the U.S. invade with ground forces. President Johnson chose General William C. Westmoreland to command the land forces. Westmoreland commanded over 500,300 troops at the high point of the war, and was still unable to defeat the Viet Cong. But there were many factors that contributed to our shocking defeat on the ground in Vietnam. The first and foremost was the difference in tactics. The Viet Cong was ruthless soldiers, who, even though sometimes poorly trained, fought with a lot of drive and pride. The Viet Cong used something called guerrilla tactics. They would get children, to join use babys as bait for booby traps, and other unethical things. These were a few deaths that the U.S. soldiers had. Also on the tactics side, the entire U.S. consisted of sea rch and destroy missions. Search and destroy missions involved a group patrol, (usually 15-30 soldiers), going out of the home territory and finding and killing the enemy. Unfortunately, the booby traps placed by the Viet Cong and the fact that they knew the land meant that they could hide well. They took advantage of that and so U.S. soldiers died a lot from that. If the United States only thought about what they were getting them selves into and realized the consequences then they would have probably not gotten involved. Either way I do believe that if we didnt help out the other country that, they would try to get back at us in a some way. But the amount of people that died, and the amount that got sick was really just unnecessary. But since we did get involved we should have just stuck with fighting in the air. That was our strength at the time and we should have taken advantage of it. Compassion in Medicine | Reflective Essay Compassion in Medicine | Reflective Essay Advancements in medical technology have given rise to medicalization, a process where ‘non-medical’ problems have become understood and treated as ‘medical’ issues.1 This potentially objectifies humans, leading to â€Å"deindividuation†2, where doctors identify patients by their disease or procedure. The distancing of doctor-patient relationships have been worsened by limited doctor-patient interactions.3 Humanization of medicine is critical to ensure patients receive adequate care because they are reliant on the doctors competence and good will.4 This is where the BH1002 module contributes to my development as a good doctor. It increases my awareness of patients’ needs and the complexities of the healthcare system. The essence of this module is encapsulated in three learning points: a) Professionalism; b) Communication in Doctor-patient relationships; and c) Patient safety. My role as a future doctor is to heal. Professionalism exemplifies the contract between society and medicine as it is the foundation of doctor-patient trust.5 In the BH1002 tutorials, I was exposed to three fundamental principles of professionalism, namely, the primacy of patient welfare, patient autonomy and social justice. Professionalism requires honesty with patients, empowering them to make informed medical decisions; it requires trust and having patients’ interests at heart; it involves equal distribution of healthcare resources to all patients.5 In my opinion, medical professionalism involves demonstrating humility and compassion. Modern medicine has established a culture defined by entitlement and conceit, and humility indicates weakness or false modesty.6 Having the confidence to tackle my insecurities is paramount to my development as a doctor. However, I am aware that self-confidence can develop into overconfidence as my level of clinical knowledge and skills increases. It can cause me to overestimate my capabilities, breeding incompetency and arrogance. As a future doctor, I strive to remain grounded and be accountable for my blunders. I will avoid finger-pointing when mistakes occur. Being humble makes me mindful of the limits of my knowledge, allowing me to recognize opportunities for improvement. I will consider things from my patient’s perspective, prioritizing the well-being of my patients. Humility and confidence are not mutually exclusive.7 To strike a balance, I will constantly evaluate myself in clinical encounters. Through introspection, I can work towards being a more gracious person. I understand that when I am tired, I may have a temporary lapse in humility and be rude to someone. In response, I will take time to apologize sincerely, fostering better work dynamics in the medical setting. Compassion is an important aspect of medical professionalism. It involves both empathy and the desire to improve the current situation. The Society for General Internal Medicine describes empathy as â€Å"the act of correctly acknowledging the emotional state of another without experiencing that state oneself.†8 In this module, I was taught to strive for detachment with my patients to ensure that my feelings do not hinder the quality of care I provide.8 Nonetheless, it is essential to be sufficiently vulnerable to my patient’s suffering. When my attention is focused on my patients, they will be able to feel that I care. In contrast, being emotionally-detached could be interpreted as being indifferent, increasing their suffering due to the lack of understanding. A study on the effect of forty seconds of compassion on patient anxiety noted, â€Å"The enhanced compassion segment was †¦ effective in decreasing viewers anxiety†9. Compassion builds trust between the doctor and patients, encouraging them to recall and disclose significant details about their conditions.8 Increased awareness of the patient’s situation allows for more accurate diagnosis and effective personalization of treatments, improving the quality of care.8 Patient satisfaction is increased, enhancing the doctor-patient relationship. I strive to exhibit medical professionalism by being compassionate. As a future doctor, I am responsible for the welfare of my patients. Having compassion will make me attentive to their needs. I can understand the situation from their perspective, and think about how I can ease their suffering. Consequently, my patients will not have to face their difficulties alone. The doctor-patient relationship is a keystone of care. Built on trust and compliance, it exists when a doctor serves a patient’s medical needs, providing support and healing.10 There were two key reasons taught on why effective communication is crucial: a) provision of quality care; and b) medicine adherence. I believe patients benefit most when there is mutual trust and respect – doctors set aside time to listen to their patients; patients provide information about their medical condition to the best of their ability and comply with prescriptions. This can only be achieved with effective communication. In the provision of better healthcare, it is important to focus on the medical interview between the doctor and patient. This is the main medium through which doctors gather information about the patient, make diagnoses and develop the doctor-patient relationship.3 During the tutorials, I was introduced to a famous painting, The Doctor by Fildes. The painting exemplifies the qualities of an ideal doctor. Despite the inadequacy of medical technology, and thus inability to save the patient, he remains by the patient’s bedside, providing reassurance through his presence. This is a huge contrast with the modern physician, who, because of the large number of patients to see every day11, is often unable to set aside time to stay by the patient’s side. In his book, Being Mortal: Medicine and What Matters in the End, Gawande laments the deterioration of care in the medical setting. He attributes it to the shift in focus to curing diseases quickly using modern technology, highlighting that â€Å"fast, solution-oriented care accounts for approximately one-quarter of Medicare expenditures†11. Moreover, the time spent on write-ups is threefold the time spent in direct contact with the patient12. This means that little time is spent on communication with the patient. For this reason, patients feel neglected and even more miserable when doctors are unable to listen to their emotional needs and address their concerns. What I wanted †¦ was a doctor †¦ who understood that a conversation was as important as a prescription; a doctor to whom healing mattered as much as state-of-the-art surgery did. What I was looking for †¦ was a doctor who is able to slow down, aware of the dividends not just for patients but for herself and for the system.11 In the introduction to the course, I was taught that doctors have an ethical obligation to prioritize the best interests of the patient. This means alleviating their suffering and minimizing patient dissatisfaction. When doctors take the time to listen carefully, the quality of information obtained increases, enabling a more accurate diagnosis to be made.3 In mastering communication skills, I can clearly explain my patient’s situation, preventing misunderstandings that may occur due to the lack of understanding of â€Å"basic health ideas, medical terms or medical information†13. I can provide emotional reassurance to those involved, facilitating the process of healing and enhancing the doctor-patient relationship. Medicine adherence refers to whether patients follow the agreed recommendations and whether they take their medication for the entire duration.14 Effective communication is the major determinant of compliance.15 Doctors struggle with communicating information effectively, as seen in a study that reported, â€Å"40-80 percent of the medical information patients receive is forgotten immediately and nearly half of the information retained is incorrect†15. In this module, I was taught the teach-back method to improve medicine adherence, which relies heavily on communicating information to patients in a way that is easily understood. In teach-back, patients are asked to describe the information taught. This involves them in prescription decisions and serves as confirmation that they understand what has been explained, such as the prescribed dosage of their medication. Patients can then make informed decisions regarding their use of medicines. By engaging patients in their care, they are more likely to comply with the prescriptions, leading to a higher quality of life and higher satisfaction.14 As a future doctor, I strongly believe that patients have a right to make decisions in regard to their health. This means that if patients refuse to take the prescribed treatment, that choice must be an informed one; if they accept the recommendation, I am responsible for facilitating the appropriate adherence to optimize the efficacy of treatment and reduce risk of side effects. Using what I learnt, as well as the â€Å"SPIKES† model detailed in WHO Multi-professional Patient Safety Curriculum Guide16, I will provide uninterrupted time for patients to share their concerns and ask questions about their conditions. This will help me understand my patients’ beliefs and assure them that I am listening. After which, I will provide the necessary information, in a comprehensive manner, using the teach-back method to check their understanding. This will facilitate shared-decision making, where patients can effectively voice concerns about aspects of the treatment they disagree with. This allows me to tackle the issue of limited health literacy of patients and negotiate a treatment they are agreeable with. A large proportion of the BH1002 module was spent discussing patient safety. I was exposed to the idea of human limits and reasons why healthcare systems fail. My greatest takeaway was being constantly reminded that doctors are not infallible. In fact, great doctors are people who expect errors to occur and take measures to prevent them before these errors can happen. Humans have limitations that can predispose them to error. Through the lectures, I learnt about memory constraints, confirmation bias in perception and selective vision. The recalled memory is reconstructed, changing according to what we perceive; we tend to seek evidence to support our decisions, even if the decision may not be correct; we do not notice when something unexpected enters our field of vision, especially when we are focused on something else. These cause difficulty multi-tasking and recalling detailed information quickly15, creating room for error. Now that I am aware of these limits, I will put in greater effort to reduce the impact human limits have on my patients’ health. I will use writing aids, noting important information immediately, reducing the reliance on human memory. This also removes the uncertainty that I could have remembered the wrong details. I believe this habit needs to be cultivated while I am a medical student. Therefore, I have begun with the lectures I attend, jotting down points raised by lecturers and reviewing them for greater understanding of the content taught. To reduce the risk of confirmation bias, I will make sure to gather information from reliable sources, analyze the data carefully before reaching a conclusion, instead of drawing a conclusion before finding evidence that tally with my opinion. In a medical practice study conducted in 2000, To Err Is Human: Building a Safer Health System, it is emphasized that to assure patients that they are safe from accidental injury, concerted effort by all professionals is required to â€Å"break down traditional clinical boundaries, the culture of blame, and systematically design safety into processes of care†.17 There are several reasons why healthcare systems fail. First would be the traditional intolerance for error in the medical setting. Doctors are held personally accountable even if the error was systems-based and beyond their control. The medical culture of blaming encourages doctors to underreport errors out of fear of disciplinary measures.18 The BH1002 module taught the importance of sharing the burden of guilt. If a doctor makes a mistake, sharing creates opportunities for everyone to review the problem objectively. Improvements can then be made to existing systems to prevent a repeat of the same mistake. I learnt about the â€Å"Swiss cheese model of system accidents†. This model compares the different levels on which mistakes occur with slices of cheese. Each slice represents a layer of defense against potential errors. In the real world, each slice has holes in different places, each representing a loophole. A catastrophe will occur when the holes align to permit an opportunity for accidents, directly bringing patients in contact with hazards.19 These lapses in defense arise from two types of errors. Active errors are unsafe behaviors committed by people that lead directly to a given error. Latent errors are errors that remain dormant in the system until ‘triggered’ by other events. These occur further away from the action itself, such as flaws in the healthcare organization or faults in the equipment used. Active errors are often unpredictable whereas latent errors can be prevented. The persons-approach, which focuses solely on active errors and individual blame, is therefore of limited benefit because it deals with errors only after they occur. In contrast, the systems-approach revolves around the idea that errors are to be expected and designs a resilient system to reduce the risk of incidence of error before it happens. The systems-approach is important to my development as a good doctor. It reminds me of the need to adhere to standard operating procedures in the medical setting. Simple practices such as hand hygiene can reduce the risk of spreading infections among patients. I understand that patient handovers are an integral part of the healthcare system. There are an average of 50-100 steps between the doctor’s decision to order a medicine and the delivery of the medicine to the patient, causing an overall 39% chance of error.20 I will do my part by making my case notes comprehensible and legible to prevent miscommunication between doctors. I will clarify expectations before undertaking any tasks and consult my superiors should I be unsure of any issues. When reporting critical laboratory results, I will use the read-back method, noting and correcting any discrepancies to ensure the relayed information is accurate. This will reduce the risk of harm brought to the patient. The healthcare environment is a very complicated one. In the beginning, I was fearful of the rigid and complicated hierarchies that exist. The BH1002 module has equipped me with the necessary knowledge of what it takes to be a good doctor, as well as how I can understand my patients better and ensure their safety. I believe being accountable for my actions is the best way to exhibit professionalism and help people. I look forward to overcoming the trials I will face as a doctor. I hope to become a doctor who can serve my patients and peers well, by providing quality care and becoming a pillar of support.