4.4.6 Parasitology

Parasitology

            Nevertheless, I'm grateful for their breakdown in field sanitation.  It got me out of the Telephone Business and into the Disease Business, where I've happily spent most of the rest of my life.  When I joined the laboratory staff, I learned to diagnose malaria before we got into the stool survey.  All the lab personnel liked the malaria work, but they were glad to have me there to do the dirty work on the stool survey: blood smears are more esthetically pleasant to work with than fecal samples.        

              

I routinely processed up to 300 stool samples a day.  They were delivered shortly after 8:00 AM by a driver from the 81st., each in its neat little white ice cream carton container with name, rank and serial number attached.  We stipulated a few grams of sample, but some jokers apparently delighted in filling the container. 

            I would line up the samples in rows, set up small centrifuge tubes containing distilled water in a series of carriers that each held ten tubes, emulsify a small sub sample from each sample in the tube and spin them down in the centrifuge (My recollection is that the centrifuge would hold 32 carriers- so I could process 320 samples at one time).  I would then pour off the liquid, add Zinc Sulfate solution, re-emulsify and spin down again.  The carriers were then removed from the centrifuge, the samples stirred, additional Zinc Sulfate  added to form a slight crown at the top of the tube and a microscope cover slip placed on the top of each tube.  

This was the Zinc Sulfate Flotation Technique for recovering intestinal parasites.  The cysts of E. hisolytica, other intestinal protozoans, hookworms, ascarids, whipworms and most tapeworms and trematodes float to the surface and adhere to the underside of the cover slip.  Meanwhile, a slide, labeled with the appropriate number for each specimen, was laid out and received a drop of an Iodine solution.  The appropriate cover slip was, after sufficient floatation time, removed and placed on the Iodine.  Then the real fun began; each slide was scanned under the microscope.  Major Larson initially did all the diagnosing; but he loved teaching and kept showing me various parasites.    

    

Soon I was screening most, then all, cases.  The Iodine stains the protozoan cysts brown, with the nuclei and nucleoli black.  E. histolytica cysts have one to four nuclei, each with a regular, centrally located nucleolus; E.coli has up to eight nuclei, with eccentrically located, irregular nucleoli.  Major Larson had several Parasitology Textbooks and I virtually memorized all of them.  I would place all the slides with parasites, along with my diagnosis, on Major Larson's desk for confirmation. 

We saved all the stool specimens until the slides had been read because we did Iron Hematoxylin stains of fecal smears of all cases diagnosed positive for E. ”histolytica by the Zinc Sulfate flotation-Iodine staining technique.  That meant I spent all day working with two or three hundred fecal samples (carefully closed but still odiferous in the tropical climate) at my elbow.  Uncounted hundreds of soldiers, on entering the Laboratory said, with what each thought to be clever, but also completely original, "SPARKS, YOU'VE GOT THE SHITIEST JOB IN THE WHOLE FUCKING ARMY".  I didn't argue with them, but I thought I had the best job in the whole army.  I was doing something worthwhile, learning a lot and had my first mentor; who could ask for anything more.  Besides, my nose had been broken so many times and the nasal passages so clogged by bone and cartilage, my olfactory epithelium was not fully functional.

The Iron Hematoxylin stains of the fecal smears did create a problem; they took a long time and didn't begin until near the end of the normal work day.  I was usually in the Lab at least 10 and often 12 hours before I finished staining and cover slipping the fecal smears so Major Larson could read them the next morning.  I still have some of those slides, more than 60 years later, still clearly demonstrating the parasites, I was working my butt off and enjoying every minute of it.  Added to the problem was the fact that I was "On Call" approximately one night a week, the Lab representative for emergency cases usually appendectomies, but sometimes trauma cases (vehicle wrecks, stabbings, shootings, etc.).  The former called for a white blood count and differential smear; the latter for blood typing and cross matching while the MOD (Medical Officer of the Day) and surgeon, if called for, waited for your results--usually at 1:30 in the morning. 

I learned that E.histolitica did not respect rank; the Commanding General was loaded. Most people with the bug did not exhibit symptoms, but we had some acute cases in the hospital that lost twenty or thirty pounds during the episodes of constant, bloody dysentery.  To the best of my memory, the prevalence was over 30 per cent for the entire division.       

While I was working in the Malaria and Epidemic Control Unit, some Aedes aegypti inoculated me with a flaming case of Dengue Fever. I spent a couple of weeks in the hospital during which (after I realized I was not going to die) I won several hundred dollars in the running poker game.  That convinced me that when working with infectious diseases one should be EXTRA careful.  I did not pick up E. histo. or any other intestinal parasites while working on the survey, but several people in the Lab.did. 

As a Private, I had KP Duty often; with the Officer's Mess, the Enlisted Mess combined with the Patient's Mess (those that were ambulatory), there were a lot of bodies to cook for and clean up after and, therefore, a lot of mule labor needed.  The demand was so great that even Corporals had to pull KP-unheard of in the fighting army.  Jobs were assigned as requested in the order of reporting; table waiter was the easiest and pots and pans the hardest.  Some guys would get up at 4:00 AM to get table waiter; I soon learned to sleep until 8:00, saunter down for a leisurely breakfast and accept pots and pans. 

John Day had the best solution; he was the bartender at the Officer's Club and the best poker player I ever knew (He told me he had never in his life done anything but gamble and tend bar and never intended to do anything else).  He simply paid someone else $10.00 to take his KP; that was a fifth of a month's pay for a buck private, but no problem for Corporal Day.

           

The worst thing about my being on KP was that the stool samples stacked up when I was not at the Lab.  Major Larson tried to get me excused from KP because I was so badly needed for the important survey, but nobody bought that real truth.  However, when he subsequently pointed out (at my suggestion) that I, working with all those parasites and feces, was not someone they wanted handling their silverware and was possibly a WW II Typhoid Mary, I was relieved of KP duty. 

            The 31st Station Hospital was a real education for me.  I had grown up in Texas, incredibly parochial in the 1920's, 1930'sand early 1940's.  EVERYONE I knew was growing up in Texas, children of parents who had grown up in Texas, most of whom had never been out of Texas except possibly for quick incursions into Oklahoma or Arkansas.  My eyes had been somewhat opened by the Boy Scout Jamboree; but I spent most of the time with other kids from North Texas, agreeing with them about how "funny" Yankees and other Foreigners talked.  Even in college, most people I knew were from Texas or nearby states; basic training was so intense we didn't have much time for cross cultural exchanges and, besides, everyone was young, well educated, and extremely bright.

Almost all the enlisted men in the 31st Station Hospital, on the other hand,  had been drafted, most from New York City.  It was an incredible racial and ethnic polyglot; probably a third were naturalized American citizens and they ”ALL” spoke with strange accents, racial or Bronx or Brooklyn. Most were Irish, but we also had Germans, Jews from all over Europe, several from various Middle European Countries, and even a Russian or two.  Most were in their late twenties or early thirties, and many didn't speak or read English fluently.  Stirred into that stew were some new ingredients: a Mexican Pachinko and professed professional boxer from Los Angeles, a Chinese from San Francisco, a High School teacher with a Master's Degree and a bunch of kids under 22 -- from all over the US.

Sgt. Patrick McNelis was the senior enlisted man in the Lab. He told me several times in his low, confidential voice of getting off the boat from Ireland in New York at 16 with $17.00 "in me pocket".  He became a Lab Technician for DuPont in Delaware, married and had a couple of children before being drafted.  Apparently he couldn’t handle the stress of being separated from his family; he was the first full blown alcoholic I met.  Many Texans are heavy or "hard" drinkers, but Pat was a new experience for me. 

He would stay off the sauce for a couple of weeks, then find some excuse, almost always related to his family: bad news, no news, or despondency at not being with them.  He would drink all the beer and liquor he had, beg all he could from his friends, going all out until he ran out.  He usually ended the binge by provoking a fight that he never won.  I remember one night with him stark naked in our tent (we had taken him to his tent and stripped him before putting him to bed in the hope the lack of clothes would ground him) saying "I'm going to hide in the shadows and when that Goddamn Mexican comes by, I'm going to pounce on him like a tiger".  We took him back to his tent, put him back to bed with the admonition that pouncing on the Mexican was not a good idea. The next thing we heard was a scream, a sodden thud, then silence.  

The Mexican was apologetic; "I was just going to the latrine and "something" jumped on my back in the dark; I hit him before I knew what it was".  The fight was over, the binge was over and we didn't see Pat for a couple of days after putting him to bed one last time.  When he finally appeared at the Lab, he was all contrition and with a black eye. 

We later discovered how he could keep going after all his friends cut him off. I spilled some of the Lab 95% Ethyl Alcohol over a small cut while setting up a Staining Procedure and it didn't sting.  It turned out to be less than 10% alcohol; Pat had a key to the Lab and one of the few keys to the cabinet containing the Lab alcohol.  When all his other sources dried up, he'd go to the Lab with an empty bottle, pour off some alcohol and replace it with distilled water.  He would have soon been drinking distilled water. Major Larson reluctantly took Pat's key to the Alcohol Cabinet and the quality of our microtechnique improved dramatically.       

Although McNelis was the EM Chief of the Lab, Louden Stanford was the glue that kept it together.  He had a Master's Degree in Botany and was a High School Biology teacher prior to the war; he taught all the new replacements, Nick, Jackson, Montgomery and me all the laboratory procedures.  He also counseled us on a wide range of subjects.  Joseph Yakaloff was another of the older enlisted technicians, but I didn't ever really know him because he never talked to anyone in the Lab except Major Larson and then only to answer a direct question.  I was told that he had been a proofreader for a major New York newspaper, but, because of his apparent "vow of silence", I never learned which one.

One of the major members of the Lab Staff was Shit Heel, the Laboratory Cat.  He had been given that name because Major Larson had retrieved him, when he was a tiny kitten, from the bowels of the Officer's Latrine.  He would leap up on counters and walk among the various samples and equipment without ever knocking anything over.  He lived in the Lab and lived well, because everyone brought him goodies from the Mess Hall.