MASH Crew’s Descendants Curing Snake Bites : Medicine: Heat exhaustion and broken bones also get treated at forward U.S. hospitals in Saudi Arabia. But the doctors and nurses are ready for war if it comes.

They are the linear descendants of Hawkeye Pierce, Major Houlihan and Trapper John McIntyre, the doctors and nurses of a modern-day MASH unit living and working on a barren plain under the bulbous dome of an inflatable tent.

Plucked out of pediatric wards and X-ray labs back home, they are here to provide what the Army calls “the first level of definitive care” for American troops if war comes to the Arabian desert. Surgery and decontamination of soldiers exposed to chemical weapons are their combat specialties.

But for the moment there is no war. Only snake bites.

Snake bites and heat exhaustion, kidney stones induced by dehydration, the monotonous aggravation of sand eating up the air conditioning and the broken leg of a soldier who tried to play Frisbee football in the dark.

The snake bites seem the most threatening.

At the Walter Reed Medical Center, Maj. Lenardo Thompson is the 34-year-old chief of pediatric heart surgery. Here, he is fast becoming the resident expert on the neurological effects of reptile venom.

Saudi Arabia, he now knows, has a great many snakes--all of them poisonous.

There are Egyptian cobras, Asiatic cobras and puff adders. Also saw-scaled vipers, sometimes known as carpet vipers, plus Persian horned vipers, Levantine vipers and the African desert horned viper.

The snakes have become a serious problem, especially for inexperienced American troops who tend to do things like stroll about camp in open-toed sandals. Already, the 28th Combat Support Hospital, which serves the 18th Airborne Corps, has treated two cases of snake bite. Other forward medical units are encountering cases, too, and more are likely as the advance of autumn brings cooler temperatures to this barren plain.

“As it gets cooler, more and more snakes are going to come out at night,” Maj. Thompson said in an interview. “Pretty soon, those sand vipers are going to be snuggling up to someone for warmth.”

Venom from the snakes can cause severe neurological damage, and doctors in both cases here administered large doses of anti-venin. The first victim still had to be airlifted to a hospital in Germany, while the second continues to suffer from venom-induced problems, Thompson said.

The more serious of the two cases involved a soldier who was walking in rubber sandals between tents late at night last weekend. He was bitten twice in the toe by a sand viper. A second victim was bitten in the hand two days later.

In anticipation of further bites as the desert snakes emerge from their summertime hiding places, Thompson said that the hospital had requested a new shipment of antivenin from the Saudi government. But in a country where there are no nonpoisonous snakes, he said, the only truly effective treatment is prevention.

Less seriously hurt but more chagrined than the snake-bite victims is Spec. John Miller, a member of the 3rd Battalion of the 24th Artillery Division, who spent five hours in an ambulance between his unit and the hospital after suffering a broken leg on a “recreation night” in the desert.

“We were playing Frisbee football,” Miller said, “and I kind of tripped over a bush.”

Lt. Col. Robert Ball, as commander of the hospital, worries about the broken legs and the snakes and the other medical problems but, in the two weeks since his unit became operational, he has also waged an endless struggle with more prosaic challenges--especially the generators.

The electrical generators, which consume 8,000 gallons of jet fuel a day, run an air conditioning system for the 200-bed hospital. The generators turn out to be highly vulnerable to blowing sand.

“The sand basically eats the turbines up,” said Ball, who confirmed that temperatures in part of the hospital once reached such a high point that all patients who could walk were asked to evacuate.

A few days ago, when things got especially bad, two wards had to be temporarily emptied.

“You get that sand kicking up,” the commander said, “and you just have to shut that unit down.” Fortunately, the hospital is operating at only one-quarter capacity.

Ball said that maintenance workers assigned to the hospital are spending as many as 16 hours a day repairing the generators.

Reporters found that 98-degree heat baking into the inner-tube-like material of the massive inflatable tents had rendered the operating room a veritable oven.

“It’s not the most comfortable situation in the world,” agreed its supervisor, Lt. Col. Lola Smeltzer.

Lt. Col. Ball, surveying the tent compound and the clear patch of scorching sand that makes up his command, acknowledged its primitive aspects. “It would be very difficult to bring the Walter Reed Medical Center and put it out here in the desert,” he told visiting reporters.

For his part, Maj. Bill Prominski has one eye on the calendar. A 35-year-old radiologist, he committed himself to a four-year hitch in the Army in exchange for an Army-funded education at Georgetown University Medical School.

Prominski’s tour is nearing its end, but the Persian Gulf crisis could disrupt his plans.

“The 12th of January is my exit date,” Prominski said in an interview in the hospital’s cramped X-ray room, “but that may not happen.”

For women on the staff, including Maj. Gail Thompson, a 37-year-old supervising nurse, one of the troubling problems at the rugged facility is the lack of privacy.

In that, at least, the 28th Combat Support Hospital resembles the Korean War-vintage mobile unit immortalized by film and television.

The 28th is a hierarchical step above and decades more advanced than the theatrical MASH, yet even Ball acknowledges that the comparison is inescapable.

“I guess you’re seeing the real MASH now,” said the colonel, whose ceremony of inauguration when he joined the unit last July included a rendition by the 82nd Airborne Band of the movie’s musical theme.

“You won’t see any male soldiers walking around in dresses or anything like that,” he added. “This is the real Army.”

THE HORNED VIPER

Several species of vipers are found in desert regions of the Persian Gulf, including two families of the horned viper (right), the carpet viper and the puff adder. They are often locally called “sand vipers,” although the true Asian sand viper is native to areas farther east, such as southeastern Iran, Afghanistan and Pakistan.

Like members of the separate family of pit vipers, such as the rattlesnake and the copperhead in the United States, gulf vipers have hypodermic fangs folded back against the roofs of their mouths except when the snakes strike.

Among the gulf vipers, the puff adder is considered the deadliest.