Saturday, June 26, 2021

"The First 100 Yards"


You are 19 years old standing in the muck and mud that are the trenches of World War I. You are cold, hungry, filthy, emotionally, mentally, and physically exhausted; you stare straight ahead, eyes vacant not revealing deep inside you a visceral fear that defies description; a fear that only those who have faced the horror of combat know. You are an American soldier and this is your reality. You know what awaits when the order is given to “go over the top” – the withering rifle, machine gun, and artillery fire, a rain of deadly hot steel indiscriminately finding flesh and bone, mutilating and killing those around you and quite possibly you. Any sense of youthful immortality long erased by the nightmares you have already experienced.


The first 100 yards, survive the first 100 yards you keep telling yourself. If you can just make those 100 yards you know your chances of surviving the day increase significantly. Importantly, as well, gaining victory. A mere 100 yards…but it might as well be 1000. Knowing that many among your “band of brothers” will die, that you may die within the next few moments, you still do it. The order is given and you immediately go over the top, the fear replaced by a single thought, survive those 100 yards. How do you do it? Why do you do it? You cannot do otherwise. You cannot, you will not, let your buddies down, those with whom you have shared hardships and terrifying moments; those with whom you have a special bond that no one else can understand. You have to be there for them; you will be there for them no matter the cost.


The first 100 yards speaks directly to facing one’s fears, struggles, challenges; of persevering, of doing what has to be done despite the fear, however that may look. The war with COVID-19 has been, for those in the front - line trenches, so to speak, their own first 100 yards. Yet, despite the heartbreak – death, suffering, isolation, loneliness– and their own personal fears, they daily went “over the top” to cross those 100 yards and lovingly, compassionately care for those at their most terrifying and vulnerable time.  


History is replete with those willing to “go over the top” and dare to cross the “first 100 yards” to confront whatever the “enemy” was – the “Black Plague”, TB, Spanish Flu, Ebola, and now COVID-19. The risks were real; death was possible just as it was with the soldier in the trenches. Yet, time and again, they stepped up and said, “I will go. I will do it. Send me.” As a nation, we owe thanks to those who did just that. I for one am most thankful!


Andy Lamb, MD



Monday, June 21, 2021


They were migrant workers in the Central Valley of California. She was expecting her first child when  she first crossed the border with her husband illegally only a few weeks before. Most everyone working beside them had done the same, the majority from Mexico, as they were, but some from Central America. The “Coyotes” were always busy in their mercenary work. They were all desperate for a “better life”, the “American Dream”, especially when a baby was soon to arrive.

 The work was hard, soul-breaking, endless; the foreman, merciless. They endured, they had to, their baby’s life depended upon it. A missed day of work meant the difference between work or no work; food or no food…. After he was born, she was back in the fields within days, the foreman was waiting. She brought the baby with her, enshrouded in a traditional cloth wrap slung across the front of her body so she could more easily nurse while she worked. What else could she do?  The foreman made no exceptions. The baby cried, often, too often. The foreman quickly became angry at the incessant crying. He threatened to fire them both if she did not keep the baby quiet. She tried, she tried hard, very hard but nothing worked, and she became desperate. Another worker suggested she do what others did, give the baby “a little alcohol” in his bottle. It would make the baby sleepy and the crying would stop. She did, the crying stopped, and they continued to work. They did so day after day, month after month, and the work continued, endless….

 “He’s a 21year-old Hispanic male who presented last night for a significant upper GI bleed secondary to esophageal varices from end-stage alcoholic liver disease”, the ED physician said. “What!”, I said. “He’s way too young to have this!”.  I was in disbelief. How could this happen? There must be extenuating circumstances The interpreter provided further history on the patient.  His parents had for many years been migrant-workers in California….

 He died a few days later but his memory remains hauntedly with me.


Andy Lamb, MD