WASHINGTON — WASHINGTON - John Ripley's worthless liver had left his skin a sickly yellow. Toxic fluids were collecting in his system, causing his lean frame to bloat: Once 175 pounds, he now weighed 425. His kidneys were failing. An incision glared from his abdomen, closed with staples in case surgeons had to rip it open fast. Eighteen IV lines fed into his unconscious body.
One of the Marine Corps' greatest living heroes was dying.
In the intensive care unit at Georgetown University Medical Center, a son of the retired colonel, Tom Ripley, sat vigil. It was 7 a.m. when the phone rang: A donor liver had been found, but his father might not live long enough to get it.
That's when the Ripleys understood that the delivery of the liver, from a 16-year-old gunshot victim in Philadelphia to the dying veteran in Washington, would take too long if left in the hospital's hands. Their only thought: Call in the Marines.
Over the next hours on that day last month, saving John Ripley's life became a military mission. It would involve the leader of the Marine Corps and helicopters from the president's fleet. Support teams would come from police in two cities, a platoon of current and former Marines, the president of Georgetown University and even a crew of construction workers.
"Sir, this is my dad's last chance," Tom Ripley said in a call to the Marine commandant's office. "I'm measuring my father's life in hours, not days."
The extraordinary efforts to save the 63-year-old Ripley, recovering from transplant surgery at Walter Reed Army Medical Center in Washington, shows how far the Corps will go to protect one of its own.
Marines will say they'd do this for any fallen comrade. But Ripley is no ordinary Marine. In a messy war with few widely recognized heroes, he is a legend. And at his moment of need, the Corps treated him like one.
"Colonel Ripley's story is part of our folklore - everybody is moved by it," said Lt. Col. Ward Scott, who helped organize the organ delivery from his post at the Marine Corps Historical Center in Washington, which Ripley has directed for the past three years. "It mattered that it was Colonel Ripley who was in trouble."
A heroic effort
On Easter Sunday 1972, Col. John Walter Ripley - swinging arm over arm to attach explosives to the span while dangling beneath it - almost single-handedly destroyed a bridge near the South Vietnamese city of Dong Ha. The action, which took place under heavy fire over several hours as he ran back and forth to shore for materials, is thought to have thwarted the onslaught of 20,000 enemy troops.
His tale is required reading for every Naval Academy plebe. In Memorial Hall, Ripley, a 1962 academy graduate, is the only Marine featured from the Vietnam War: A diorama shows him clinging to the grid work of the bridge at Dong Ha.
Ripley received the Navy Cross, the second-highest award a Marine can receive for combat. That decoration is surpassed only by the Congressional Medal of Honor, which, many in the Marine Corps vigorously argue, Ripley deserves.
But on this July morning, three decades after surviving combat wounds, Ripley was facing death from a transportation problem. His doctors tried four civilian organ transportation agencies and could not immediately be guaranteed a helicopter by any of them.
The Ripleys say they were told that a civilian helicopter would not be available for at least six hours. Driving to Philadelphia was not an option because doctors worried that any traffic delays would ruin the organ.
Tom Ripley saw only one solution. From his father's hospital room, he called the office of the Marine Corps commandant, James L. Jones, and secured the use of a CH-46 helicopter, which is part of the presidential Marine One fleet.
The plan: The chopper would ferry the transplant team to the University of Pennsylvania hospital to remove the donor liver and then transport the doctors back to Washington.
Marine lawyers instantly approved the use of military materiel for Ripley, including nearly three hours on a helicopter that costs up to $6,000 an hour to operate. The commandant considered this an official lifesaving mission for a retired Marine still valuable to the Corps as a living symbol of pride.
Action was swift. The doctors rushed to Anacostia Naval Air Station, where the helicopter was waiting, rotors spinning. The chopper took off before the surgeons were even strapped in. By about 10 a.m., just three hours after learning that a new liver would be available in Philadelphia, the transplant team was swooping into that city. On the landing pad, an ambulance and a Philadelphia Highway Patrol car, both summoned by the Marines, were waiting. The motorcade took off, sirens blaring.
"When you're in a situation like this, and an organ becomes available, you use the fastest resource to get it," said Dr. Cal Matsumodo, a transplant surgeon from Walter Reed who flew on the helicopter to retrieve the new liver. "This turned out to be the swiftest and best-organized effort that I've ever seen."
Years of problems
Ripley's original liver had been ruined by a rare genetic disease as well as by a case of Hepatitis B that he believes he contracted in Vietnam. After a year-and-a-half of hospitalizations and infections, Ripley had received a new liver from a D.C. area donor July 22. But within hours of the surgery, that donor liver began to fail.
Medical professionals say the organ donation process is safeguarded to keep powerful people from skipping to the top of the waiting list. It was Ripley's critical condition - caused by the failure of the first donor liver, his doctors say - not his personal story, that put him first in line for another liver July 24.
Still, most new organs are never granted military escorts.
"It was clearly extraordinary, what they did," said Roger Brown, manager of the Organ Center at the United Network for Organ Sharing, a clearinghouse for organ procurement and allocation. Sometimes, Brown said, patients will die because available organs cannot be transported to them in time.
"There's a lot of work that goes into matching a donor with a patient," he said. "If you can't find that one piece of the puzzle, it's just devastating."
In Ripley's mind, the mission that day reflects the strength of the Marine Corps fraternity. As he convalesces at Walter Reed, where he went after his operation and is listed in stable condition, he summons his booming voice long enough to insist that Marines would do the same for even an unknown grunt.
"Does it surprise me that the Marine Corps would do this?" Ripley said from his hospital bed, his dog tags still hanging around his neck. "The answer is absolutely flat no! If any Marine is out there, no matter who he is, and he's in trouble, then the Marines will say, 'We've got to do what it takes to help him.'"
A battle plan
In Philadelphia, though, the Marine pilots knew exactly whom they were helping, and they called it an honor. On the helipad, the flight crew stood ready as the transplant team rushed back with a box marked "HUMAN ORGAN: FRAGILE."
Moments later, Tom Ripley, traveling with the doctors, got an update from his oldest brother, Stephen, at his father's bedside. Their dad's condition was worsening. The organ had to get to Washington, fast.
Tom and Stephen, both former Marine captains, debated the quickest "rtb" - return to base, which in this case meant the Georgetown hospital. In pager messages fired off like battlefield dispatches, the chopper became "the bird" and the doctors the "pax," slang for passengers. As the day wore on, the brothers drew from their military roots, comforting each other with the Marine motto, Semper Fidelis.
Their father, meanwhile, lay still. His dog tags, fastened with the same tape he'd used to keep them from clanking on secret missions in Vietnam, had been removed. Twice, the family had summoned a Catholic priest to deliver last rites. Now, the Ripleys wondered whether a third might be needed.
The hours ticked away, and the family learned that the Marine helicopter was too big to land on the Georgetown hospital helipad. But the doctors feared getting stuck in traffic on the drive from the Anacostia helipad to the hospital.
A well-connected Marine buddy of Ripley's called the president of Georgetown University and got permission to land on the school's football field. A construction crew standing nearby was soon ripping down fencing to make room.
But the Marines rejected that makeshift helipad after sending another helicopter to survey it. The area was deemed too crowded for a landing. At one point, the Ripleys suggested landing at the Marine Corps War Memorial, across the river from Georgetown, by the statue that depicts Marines raising the flag at Iwo Jima. But that fanciful notion went nowhere.
The answer finally came in the form of a D.C. police helicopter pilot - Sgt. Thomas Hardy, a former Marine. A Corps official found him and asked whether he would take the team from Anacostia to Georgetown on his smaller chopper.
"This was a Marine Corps mission," said Hardy, a Vietnam veteran who agreed to fly without hesitation. "Once a Marine," he explained, "always a Marine."
The organ delivered, the surgery could finally start. The next day, Ripley's recovery began.
Slowly, he is gaining strength and returning to a normal weight. Despite the surgery's success, risks of infection or other problems remain. His family expects him to be in the hospital for up to three more weeks.
Ripley rests quietly, unable to accept visitors. His wife of 37 years, Moline, sits with him amid pictures of their four children and their grandkids.
Repaying an old debt
The sons who orchestrated this rescue operation call it a culminating moment in their father's military life. John Ripley was shot in the side by a North Vietnamese soldier and during two tours of duty was pierced with so much shrapnel that doctors found metal fragments in his body as recently as last year. After Vietnam, Ripley continued to serve, losing most of the pigment in his face from severe sunburns while stationed above the Arctic Circle.
The Marines, his family believes, repaid a longtime debt.
"Dad gave 32 years of his life to the Marine Corps," said Stephen Ripley. "When he really, really needed the Marine Corps, they were there for him."
Even from the quiet of his hospital room, the Marine Corps still defines Ripley. His family has packed a cabinet by his bed with copies of a book that John Grider Miller wrote about Ripley's heroics; Ripley says he will give complimentary copies of The Bridge at Dong Ha to the medical staff.
Not long ago, a military color guard held a bedside ceremony for him, placing in the room the Marine Corps colors that normally hang in Commandant Jones' office. Ripley was urged to keep the flags in his room until he leaves the hospital.
On a recent afternoon, Ripley looked past his IV machine, past the uneaten hospital lunch, past the plastic cup of pills, to the flags. He was, at that moment, John Ripley, grateful warrior, awed by what his sons, and the Marines, had done.
"They reached over the side," he said, "and they pulled me back in the boat."