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ix
The Authors
Graham A. Cosmas was born in Weehawken, New Jersey, and re-
ceived his education from the schools of Leonia, New Jersey, and from
Columbia University, Oberlin College, and the University of Wisconsin.
After teaching at the Universities of Texas (Austin) and of Guam he
joined the staff of the U.S. Marine Corps' History and Museums Divi-
sion and, since 1979, that of the U.S. Army Center of Military History,
serving in 1984-85 as the Harold Keith Johnson Visiting Professor of
Military History at the U.S. Army Military History Institute, Carlisle
Barracks, Pennsylvania. Dr. Cosmas is the author of An Army for Empire:
The U.S. Army in the Spanish-American War, 1898-1899, and coauthor of
U.S. Marines in Vietnam: Vietnamization and Redeployment, 1970-71. He also
has published numerous journal articles and book reviews.
x
Preface
The Medical Department: Medical Service in the European Theater of Oper-
ations is the second of three volumes recounting the overseas activities
of the U.S. Army Medical Department in World War II. Charles M.
Wiltse's volume on the Mediterranean and minor theaters was pub-
lished in 1963, and a completed manuscript dealing with the war
against Japan now exists in the Center of Military History. These vol-
umes deal primarily with the operational and organizational history of
Army medicine in the theaters, as distinguished from the clinical vol-
umes published by the Office of the Surgeon General. In each case the
combat narrative has been drawn from relevant volumes in the United
States Army in World War II series, as well as from the large body of
subsequent scholarship. Our aim has been to show how the military
medical system organized itself in a combat theater; how medical plan-
ning was integrated with logistical and tactical planning; how medical
troops were organized, trained and deployed; how hospitals were built
and supplies assembled and moved forward; and how casualties were
treated and evacuated from the field of battle. The volume deals only
peripherally with medical support for the Army Air Forces, in view of
the fact that a lengthy published official history already exists.
Army medicine has long possessed a consciousness of its own histo-
ry. ETO medics were especially concerned with recording their
achievements in the largest and most complex American land campaign
of World War II. Well before D-Day the theater chief surgeon estab-
lished a historical section in his office under Col. Sanford V. Larkey.
The manuscript history that Colonel Larkey's office produced during
and immediately after the war formed the starting point for an ex-
tended effort by the Office of the Surgeon General to publish a history
of the campaign. Among the various manuscripts written during the
subsequent three decades, a study by George Garand, Hubert E.
Potter, and Pauline Vivette stands out for its length and detail. Never-
theless, the present volume in many ways represents a new start; a
fresh conception of the theme and organization led us into much addi-
tional research in manuscripts, recent secondary works, and interviews
with participants.
xi
Yet we gladly acknowledge our debts to the many people who con-
tributed their efforts and expertise to this volume. Members of the
review panel included Col. Richard O. Perry, David F. Trask, Tom F.
Whayne, MD, Charles B. MacDonald, Col. Roger H. Wichelt, MC, and
Arnold G. Fisch, Jr. Their comments and suggestions contributed much
to the final form of this volume. We are especially grateful to the fol-
lowing veterans of the campaign interviewed by us and other members
of the Medical History Branch: Honorable Elliot Richardson, Maj. Gen.
Thomas J. Hartford, Maj. Gen. Collin F. Vorder Bruegge, Brig. Gen.
Sam F. Seeley, Brig. Gen. Crawford F. Sams, Col. Virginia Brown, Col.
Tom F. Whayne, Joseph A. Gosman, M.D., Lester Wallman, M.D., Her-
bert G. Wing, and Jane A. Lee. Their reminiscences added color and
human detail to the documentary record. We are grateful to Dr.
Gosman for allowing us to consult his manuscript "War Without
Blood" and to Mrs. Lee for providing us with personal snapshots of
nurses and hospitals in Great Britain. Robert J. T. Joy, M.D., and Col.
Charles J. Simpson contributed expert knowledge, encouragement, and
counsel.
Archivists in the Washington, D.C., area and at Carlisle Barracks,
Pennsylvania, provided unstinting help during our research. Among the
many to whom we owe our gratitude, Fred W. Pernell, Richard L.
Boylan and Victoria Washington of the National Archives, and Richard
Sommers of the Military History Institute, were particularly generous
with their time and expertise. Among our present and former col-
leagues at the Center of Military History, Hannah M. Zeidlik, Charles
Ellsworth, Geraldine K. Harcarik, Carol I. Anderson, James B. Knight,
and Mary J. Sawyer helped us obtain needed materials. Arthur S. Har-
dyman and Linda M. Cajka oversaw the preparation of maps and
charts, and Howell C. Brewer searched out photographs. Mr. Hardy-
man was in overall charge of the visual aspects of the volume. Terrence
L. Offer was our rapid and helpful manuscript typist.
Our greatest debt, of course, is owed to our meticulous and hard-
working editor, Joanne M. Brignolo, whose technical proficiency and
attention to detail contributed immeasurably to the smooth flow of the
manuscript and the accuracy of its citations. Any errors of fact or inter-
pretation remaining in the book, however, are ours alone.
xii
Contents
Page
PROLOGUE: THE ONSET OF WAR......................................................... 3
Chapter
I. BEGINNINGS.................................................................................. 5
Early Activities in Britain................................................................. 6
Chief Surgeon, USAFBI................................................................... 12
Medical Plans and Programs ............................................................ 14
xiii
Chapter Page
xiv
Chapter Page
xv
Page
EPILOGUE: THE THEATER IN RETROSPECT ..................................... 614
BIBLIOGRAPHICAL NOTE ...................................................................... 621
LIST OF ABBREVIATIONS....................................................................... 625
BASIC MILITARY MAP SYMBOLS........................................................... 629
INDEX.......................................................................................................... 631
Tables
No.
1. Hospital Bed Requirements and Provisions, Second Key Plan,
July 1942............................................................................................ 41
2. Chief Surgeon's Recommended Troop Basis, January 1944 ............... 113
3. Planned Landing of Medical Units, 6-14 June 1944............................ 170
4. Key Depot System, United Kingdom, 1944.......................................... 188
5. Personnel and Patient Capacity of Hospital Carriers........................... 245
6. Casualty Reception at Ports, June 1944 ............................................... 247
7. Cross-Channel Evacuation, June-July 1944.......................................... 257
8. Trends in Evacuation From the Armies and Advance Section............ 331
9. Medical Personnel Strength, ETOUSA, Late 1944.............................. 441
Charts
1. Organization of the Office of the Chief Surgeon, USAFBI,
May 1942............................................................................................ 15
2. Organization of the Office of the Chief Surgeon, ETOUSA-SOS,
September 1942................................................................................. 35
3. Organization of the Office of the Chief Surgeon, ETOUSA,
June 1944........................................................................................... 75
4. Organization of the Consultant System, ETOUSA, 1944 ......... Facing 78
5. Planned Command Arrangements for OVERLORD................................ 158
6. Organization of the Office of the Surgeon, ADSEC, COMZ,
ETOUSA, May 1944.......................................................................... 162
7. Organization of the Office of the Surgeon, FECOMZ, ETOUSA,
June 1944........................................................................................... 163
8. Causes and Locations of Wounds, Battle of Normandy,
June-July 1944................................................................................... 225
9. Organization of the Medical Section, Third Army, 1944..................... 285
10. Organization of the Office of the Chief Surgeon, ETOUSA,
February 1945........................................................................ Facing 432
11. Evacuation to the Zone of Interior, October 1944-July 1945 ............. 505
12. Organization of the Office of the Chief Surgeon, TSFET,
October 1945..................................................................................... 609
xvi
Diagrams
No. Page
1. Infantry Division Landing Phase Evacuation Plan................................ 169
2. Casualty Reception System in Great Britain, June 1944...................... 196
3. ETO Evacuation System, Late 1944..................................................... 335
4. Field Armies and COMZ Evacuation Responsibility............................ 376
5. Typical Divisional Evacuation and Medical Supply Plan for
Rhine Crossing .................................................................................. 517
6. DDT Dusting Procedure ....................................................................... 556
Maps
1. British Isles, 1942.................................................................................. 20
2. Hospital Locations, United Kingdom, 31 December 1942 .................. 45
3. Hospital Centers, Great Britain, 1944.................................................. 93
4. Operation OVERLORD Plan, 1944.......................................................... 154
5. Medical Depots, United Kingdom, December 1943............................. 180
6. Casualty Reception Facilities, June 1944.............................................. 197
7. Clearing Stations at UTAH Beach, 6 June 1944 .................................... 207
8. Clearing Stations at OMAHA Beach, 7 June 1944 ................................. 217
9. Battle for Normandy, 6 June-24 July 1944 .......................................... 220
10. Advance Section Medical Units, Late July 1944................................... 262
11. Allied Advance, 24 July-16 September 1944 ....................................... 276
12. Operation MARKET Medical Support, 17-26 September 1944............. 307
13. COMZ Base Sections, August-October 1944....................................... 314
14. General Hospitals and Depots, November 1944.................................. 326
15. Blood Route, 1944 ................................................................................ 351
16. Army Holding and Supply Units, 16 September-15 December
1944................................................................................................... 378
17. First Army Medical Units in the Ardennes, 16 December 1944.......... 403
18. Bastogne, 19-27 December 1944 ......................................................... 416
19. COMZ Base Sections, January 1945 ..................................................... 435
20. Continental Medical Depots, November 1944-April 1945 .................. 460
21. Evacuation System, Late 1944-Early 1945........................................... 469
22. Crossing the Rhine, March-April 1945 ................................................ 510
23. Invasion of Germany, 7 March-7 May 1945......................................... 526
24. POW Transient Enclosures, Spring 1945............................................. 564
25. Major Concentration Camps, Spring 1945........................................... 573
26. Occupation Boundaries, August 1945.................................................. 580
27. Hospital Distribution in the American Zone, Late 1945...................... 604
xvii
Illustrations
Page
The Man Without a Gun ................................................................... Frontispiece
Lt. Gen. Sir Alexander Hood...................................................................... 7
Col. Arthur B. Welsh................................................................................... 9
Maj. Gen. Paul R. Hawley ........................................................................... 11
Lt. Gen. John C. H. Lee.............................................................................. 27
Col. James C. Kimbrough............................................................................ 32
Col. Charles B. Spruit ................................................................................. 33
Lt. Col. James B. Mason.............................................................................. 34
EMS Hospital at Bristol............................................................................... 38
Theater Chief Surgeon and Staff, Cheltenham, November 1942 .............. 47
Maj. Gen. Albert W. Kenner ....................................................................... 64
Col. Alvin L. Gorby ..................................................................................... 66
Brig. Gen. Thomas D. Hurley..................................................................... 67
Brig. Gen. Malcolm C. Grow....................................................................... 69
Col. Joseph R. Darnall................................................................................. 83
Fourth Key Plan Medical Facilities.............................................................. 84
Nissen-Hut 834-Bed Station Hospital......................................................... 89
Tented Expansion Wards............................................................................ 91
British-Supplied Ambulance Bus................................................................. 101
Medical Personnel Enjoying the Amenities of British Life......................... 115
Lt. Col. Ida W. Danielson............................................................................ 120
Nurses of the 250th Station Hospital.......................................................... 121
Black Medics Prepare for Evacuating Casualties ........................................ 123
London Central Dental Laboratory and Mobile Clinic .............................. 129
U.S. Army Medical Officer on Temporary Duty at a British
Civilian Hospital....................................................................................... 133
Col. John E. Gordon.................................................................................... 138
Prophylactic Station and Procedure............................................................ 145
British Hospital Carrier Naushon ................................................................. 151
Col. Thomas J. Hartford ............................................................................. 156
LSTs Readying for the Invasion.................................................................. 166
Gas Decontamination Equipment................................................................ 174
Expeditionary Hospital at Carmarthen ....................................................... 178
Col. Tracy S. Voorhees ............................................................................... 185
Col. Silas B. Hays ........................................................................................ 187
Col. Byron C. T. Fenton ............................................................................. 187
Medics Administering First Aid to Invasion Casualties on UTAH
and OMAHA............................................................................................... 209
Men and Equipment in Support of the Normandy Buildup....................... 215
Nurses of the 13th Field Hospital............................................................... 222
xviii
Page
Infantrymen in Action in the Hedgerows ................................................... 227
Medics With Improvised Red Cross Insignia.............................................. 230
Removing a Casualty From an LST............................................................ 244
Transferring Casualties From a DUKW to a Water Ambulance................ 246
Casualty Reception in Britain...................................................................... 249
Col. Fred H. Mowrey................................................................................... 254
Detraining a Casualty in Britain for Transport to a General Hospital...... 255
Col. Charles A. Beasley ............................................................................... 260
Constructing the 5th General Hospital Tented Plant at Carentan ............ 269
Awaiting Evacuation From the Third Army's Air Holding Unit at Toul... 289
Col. Myron P. Rudolph ............................................................................... 290
Brig. Gen. William E. Shambora................................................................. 291
Medic Aiding a Casualty of the Moselle Fighting....................................... 295
Typical Half-Track....................................................................................... 297
Medics Treating Wounded German Soldiers ............................................. 304
Installation of Air Holding Unit at Toul..................................................... 321
French Civilian Litterbearers Preparing To Unload a Hospital Train
at Gare St.-Lazare .................................................................................... 324
UC-64 of the "Grow Escadrille"................................................................. 333
Civilian Hospital in Paris Vacated by Retreating Germans........................ 339
Maneuvering a Captured German Tractor Through the Mud at
Medical Depot M-402.............................................................................. 344
Flight Nurse Lifting Marmite Can of ETO Blood Onto a
Continent-Bound C-47............................................................................ 349
Medics on the Line...................................................................................... 360
Preparing an Emergency Medical Tag........................................................ 362
Litterbearers Meeting the Challenge of the Huertgen Fighting ................ 365
Battalion Aid Station Personnel Readying Casualties ................................ 367
Workhorses of Battlefield Evacuation......................................................... 371
Evacuation Hospital Receiving Ward.......................................................... 381
Packing Medical Supplies in a 155-mm. Howitzer Shell ............................ 383
American Victims of the Malmedy Massacre .............................................. 394
Bullet-Riddled Army Ambulance ................................................................ 398
Caring for an Infantryman Injured in the Ardennes Fighting ................... 401
Brig. Gen. John A. Rogers .......................................................................... 402
Former School Facility Housing the 130th General Hospital at Ciney ..... 413
Bundles of Medical Supplies ....................................................................... 421
Army Ambulance in Bastogne..................................................................... 423
General Kenner on One of His Many Inspection Trips............................. 433
Col. Charles F. Shook.................................................................................. 439
Troops Undergoing a Physical Examination .............................................. 449
German POWs Unloading Casualties From a Hospital Train at Reims .... 452
xix
Page
American Red Cross Workers Supplying Doughnuts for Casualties ......... 455
Station Hospital Dayroom........................................................................... 456
Medical Supplies at Medical Depot M-407................................................. 461
Gare St.-Lazare, Paris .................................................................................. 473
Tents of the 76th General Hospital............................................................ 475
Cross-Channel Evacuation on Hospital Carrier Prague............................... 478
Sea Evacuation on U.S. Army Hospital Ship St. Olaf.................................. 485
Care of the Feet........................................................................................... 491
Sentry Wearing Improvised Boots of Straw-Filled Blankets ...................... 493
Wreckage of Hospital Train After Gare St.-Lazare Bombing .................... 499
Hospital Emergency Beds ........................................................................... 501
Air Evacuation of Wounded in a C-47 ....................................................... 513
Airborne Medics Loading Medical Equipment for Assault Drop............... 518
Litterbearers Carrying a Casualty Back Through a Minefield.................... 519
Medics Pulling an Assault Boat Filled With Medical Supplies................... 523
Jeep Ambulance Evacuation ........................................................................ 532
A Job for Civil Affairs: St.-Lo...................................................................... 547
Malnourished American RAMP................................................................... 560
Prisoner-of-War Transient Enclosure at Remagen..................................... 563
German Medics Treating a German POW.................................................. 567
Last Shipment to Dachau ............................................................................ 575
German Civilians Awaiting Their Food Rations......................................... 587
Food Assistance for German Refugees ....................................................... 589
POW Laborers at Delta Base Section Staging Area ................................... 598
German Hospital Taken Over by Occupation Forces ................................ 607
xx
MEDICAL SERVICE IN THE
EUROPEAN THEATER OF OPERATIONS
PROLOGUE
Beginnings
The European Theater of Oper- war. Under ABC-1 and the subse-
ations, which was to conduct the quent War Department RAINBOW-5
United States Army's largest and plan of April 1941, the U.S. Army ini-
most complex land campaign of the tially would play a limited role in the
Second World War and complete the North Atlantic and Western Europe.
destruction of Nazi Germany, had Army troops were to replace the Brit-
modest beginnings. Its initial objec- ish garrison in Iceland. An Army air
tives were to establish Army forces in force would deploy to Great Britain
the British Isles in order to protect to join the Royal Air Force in bomb-
them from invasion; to relieve British ing Germany, while ground elements
troops for operations in the Mediter- protected U.S. Navy bases in Scotland
ranean; and to reinforce the Royal Air and Northern Ireland and a rein-
Force (RAF) Bomber Command in its
forced regiment took station to help
strategic air offensive against the
Third Reich. defend southern England. Altogether,
Preparation for establishment of the contingents in the United King-
the theater began early in 1941. At dom were to include about 87,000 of-
that time, almost a year before Pearl ficers and men, almost half of them in
Harbor, the United States, which had the bomber command.1
undertaken limited mobilization soon 1
Maurice Matloff and Edwin M. Snell, Strategic
after the outbreak of war in Septem- Planning for Coalition Warfare, 1941-1942, United
ber 1939, advanced its support of States Army in World War II (Washington, D.C.:
Great Britain to the stage of direct Office of the Chief of Military History, Department
of the Army, 1953), pp. 43-46; Roland G. Rup-
matériel aid and combined contingen- penthal, Logistical Support of the Armies, United States
cy planning. While Congress debated Army in World War II, 2 vols. (Washington, D.C.:
and passed the Lend-Lease Act, au- Office of the Chief of Military History, Department
of the Army, 1953-59), vol. 1, May 1941-September
thorizing direct government transfers 1944 (1953), pp. 2 and 19-20; An. 2, ABC-1 (Amer-
of American military equipment to ican-British Conversations), 27 Mar 41, quoted in
anti-Axis nations, American and Brit- Historical Section, ETO, "The Special Observer
Group Prior to the Activation of the European The-
ish staff officers met secretly in Wash- ater of Operations" (hereafter cited as "SPOBS
ington. They drew up an agreement, Hist"), October 1944, p. 13. Depository codes used
known as ABC-1, outlining Anglo- in citations in this volume are as follows: CMH (U.S.
Army Center of Military History, Washington, D.C.);
American worldwide strategy in the MHI (U.S. Army Military History Institute, Carlisle
event the United States entered the Continued
6 EUROPEAN THEATER OF OPERATIONS
York City doctors and laymen and fi- injured when bombs demolished his
nanced by the British War Relief So- London apartment, but he soon re-
ciety in America, went into operation turned to work. In September the
late in 1940. Its British-American-Ca- unit opened its 22-building complex
nadian staff occupied a 300-bed wing near Salisbury in southern England.
of an EMS hospital at Basingstoke Its field teams and laboratory helped
and specialized in orthopedics and the British suppress outbreaks of
plastic surgery. In January 1942 the paratyphoid and scabies, among other
unit, renamed the Churchill Hospital, diseases. Dr. Gordon, besides over-
moved to a larger facility, taking over seeing the unit, advised the minister
an entire new 600-bed EMS hospital of health on epidemiology, served on
near Oxford.5 Ministry of Health committees, and
At the time the American Hospital
transmitted information between Brit-
was taking shape, the Harvard Medi-
ish and American public health agen-
cal School and the American Red
Cross, in cooperation with the Minis- cies. After the unit had been in oper-
try of Health, established a conta- ation for a year, Sir Wilson Jameson,
gious disease treatment and control chief medical officer of the Ministry
unit. Named the American Red of Health, declared that Gordon and
Cross-Harvard Field Hospital Unit, his colleagues "have come to be re-
this facility included a laboratory, garded not as a group of workers
mobile investigating teams, and a from America but more as a part of
125-bed hospital, staffed except for the general public health staff of this
nurses by Harvard and equipped country" and that the volunteer unit
largely by the Red Cross, which also would be "a model for the post-war
recruited the nurses. The unit's direc- development of epidemiological stud-
tor, Dr. John E. Gordon, professor of ies" in Britain.6
Epidemiology at Harvard, and many Medical Department activity in Brit-
of the professional staff began work ain expanded and became more sys-
in Britain in mid-1940. They assisted tematic after the signing of ABC-1.
the Ministry of Health in combating To execute and maintain that agree-
disease outbreaks, which were a con- ment, the United States and Great
stant threat in the crowded and Britain exchanged military missions.
bomb-damaged cities; they also com- The members of these missions col-
pleted plans for the hospital. The rest lectively represented their country's
of the unit arrived in Britain during chiefs of staff. Individually, each mis-
early 1941. Five of the staffs Red sion member exchanged information
Cross nurses and their chaperone and developed contacts with counter-
died at sea when a U-boat torpedoed
parts in his own branch of service.
their ship in the North Atlantic. Dr.
Gordon also became a war casualty, 6
Ltr, Sir Wilson Jameson to Dean Burwell, Har-
vard Medical School, 16 Sep 42, in The American Red
5
Larkey "Hist," ch. 1, pp. 3-7; Sheila M. Dwyer, Cross-Harvard Field Hospital Unit (Cambridge, Mass.:
"A Base Hospital in England," The American Journal Harvard University, 1943), pp. 38-40. This publica-
of Nursing 41 (August 1941): 877-79; Bliss Rpts, file tion sketches the history of the unit. On Gordon's
ETO 7/1. injury, see New York Times, 7 May 41, p. 6.
BEGINNINGS 9
and Royal Air Force, and the Colonial ing less than 72 hours of care in their
Medical Service; accumulated material own dispensaries, more serious cases
on medical and sanitary conditions would go to station hospitals, and
and hospitals in the United Kingdom, those needing over 120 days of hospi-
Iceland, and Africa; became familiar talization would be evacuated to the
with British Army and RAF medical United States by air or hospital ship.
organization; and compiled reports In addition to these hospitalization
on such subjects as the proper goggle and evacuation programs Welsh sub-
lense colors for the desert and Arctic, mitted lists of medical units for the
the most common types of bombing ABC-1 and RAINBOW-5 forces, as well
injuries, and the special problems of as a proposed table of organization
evacuating wounded men from tanks. for a small theater chief surgeon's
During July and August 1941 Welsh office; recommended the use of
completed his medical plans for the
American rations to feed U.S. troops
U.S. Army forces to be stationed in
stationed in Great Britain and the
Iceland, Northern Ireland, Scotland,
and England. These plans, in accord need for various preventive medicine
with ABC-1 and RAINBOW-5, provid- measures, such as venereal disease
ed for static garrison and antiaircraft suppression; and warned that all hos-
defense units and for air commands pital equipment and medical supplies
operating from fixed bases. Because would have to come from the United
of their limited scale, they soon States, an assumption which turned
9
became obsolete by the rush of out to be wrong.
events. In mid-September illness forced the
Welsh's medical plans, despite their relief of Major Welsh.10 To replace
quick demise, contained hospitaliza- him, the War Department, on Welsh's
tion and evacuation principles that recommendation, selected Col. Paul
were to reappear in subsequent more R. Hawley, MC, at that time assistant
elaborate programs. For example, commandant of the Medical Field Ser-
Welsh emphasized that the Army in vice School at Carlisle Barracks,
the British Isles should establish "its Pennsylvania. Fifty years old in 1941,
own complete medical service with Hawley had served in France in
10% fixed beds and sufficient medical World War I as a regimental surgeon
units and transport to collect and
evacuate sick and wounded. . . . "
While he arranged for the initial care "Larkey "Hist," ch. 1, pp. 11-15, 19-26, 30-31.
of American casualties in British hos- Ch. 1, app. 1, reproduces Welsh's major plans. See
also ETO, "SPOBS Hist," pp. 30-31 and 34-35.
pitals, his plans called for early con- Army medical service in the Iceland occupation,
struction of U.S. Army hospitals for which began in late 1941, is covered in an earlier
the entire command. Welsh outlined volume of this series. See Charles M. Wiltse, The
Medical Department: Medical Service in the Mediterranean
a hospitalization scheme based on and Minor Theaters (hereafter cited as Mediterranean),
unit dispensaries, station hospitals United States Army in World War II (Washington,
with 250 to 750 beds, and general D.C.: Office of the Chief of Military History, Depart-
hospitals with 1,000 beds. Under his ment of the Army, 1965), pp. 10-18.
10
Welsh spent the rest of the war in the Office of
proposed evacuation policy units the Surgeon General in high-level planning and su-
would treat sick and wounded need- pervisory assignments.
BEGINNINGS 11
tenant Fleming and two other Medical Additional officers gradually strag-
Corps officers, Capt. John T. Martin gled in. By mid-May Hawley's com-
and 1st Lt. Barron D. Knox, both missioned staff had grown to nine, in-
fresh from the United States. Knox cluding an executive officer of field
initially assumed the tasks of execu- rank, a dentist, a veterinarian, and a
tive officer, liaison officer, and supply supply officer, the latter transferred
officer. Fleming, an epidemiologist, from duty with the Canadian Army.
took charge of preventive medicine, With these reinforcements Hawley
personnel, physical standards, and was able to place at least one man in
medical reports and returns; and seven of the planned nine divisions of
Martin, a recent Medical Field Service his office (Chart 1). Many of his new
School graduate, became flight sur- assistants, nevertheless, lacked experi-
20
geon. ence in their jobs, and the staff short-
With the exception of Fleming, age would continue to grow worse as
whom Hawley considered a "very the chief surgeon's responsibilities ex-
good young epidemiologist," Haw- panded.22
ley's first assistants were of only limit-
ed use. Martin and Knox, Hawley re-
ported, "are both good youngsters Medical Plans and Programs
and will make someone a good assist- During early 1942 Hawley revised
ant; but they are quite incapable of his Air Force medical support plans
taking over any section of this office to conform to the evolving require-
and operating it, and there simply ments of General Eaker's projected
isn't time to devote long hours to bomber command. Hawley reiterated
training them from the ground up." his recommendation that each air sta-
Repeated pleas to the surgeon gener- tion have an infirmary with enough
al's office for experienced executive beds for 1 percent of the troops locat-
and supply officers elicited little but ed there, while a base command serv-
promises, as the Medical Department
ing all ground and air forces fur-
as a whole was short of qualified men
nished station and general hospitals
in these fields. As a result, until late
and supply depots. By 13 March
April, Colonel Hawley had to do most
Hawley had selected locations for
of his planning and administration
three station hospitals to support the
himself. He lamented: "I can do the
first bombardment groups scheduled
administration, the preventive medi-
for deployment. Additional site selec-
cine, the medical planning. But I can't
tions had to await completion of
keep on doing all of them.
Eighth Air Force plans and the arrival
And ... I am not qualified to do the
21
detailed supply planning." with the rest of USAFBI, which included a total of
twenty-four officers and thirteen enlisted men in
20
Office Order No. 2, OofCSurg, USAFBI, 10 January 1942 and received no significant augmenta-
Mar 42. tion until April. See Ruppenthal, Logistical Support,
21
Quoted words from Ltr, Hawley to TSG, 4 Apr 1:31-32, and Msg, Chaney to TAG, WD, 17 Jan 42,
42. See also Ltrs, Hawley to TSG, 12 Feb and 29 file ETO Admin 388.
22
Apr 42; Ltr, Col F. A. Blesse, MC, to Hawley, 21 Office Orders Nos. 5, 7, 12, OofCSurg,
Mar 42. All in file HD 024 ETO O/CS (Hawley- USAFBI, 29 Apr, 11 May, and 19 May 42, respec-
SGO Corresp). Hawley shared his staff shortage tively; Larkey "Hist," ch. 3, pp. 3-5.
16 EUROPEAN THEATER OF OPERATIONS
of troops. The latter were slow in The Air Force would need thirty-
coming, due to shipping shortages seven battalion-size infirmaries and
and the diversion of men and aircraft five station hospitals, each with 125 to
to meet urgent needs in the Pacific. 500 beds. The base command, for lo-
The first contingent of 1,800 Air gistics and support troops, would re-
Force soldiers did not reach England quire twenty-five battalion infirmaries;
until 11 May, and major movements two station hospitals; two general
of men, equipment, and aircraft were hospitals, each with 1,000 beds; and
23
delayed until June. one convalescent hospital, with 2,000
Besides reworking his Air Force beds. The general and convalescent
medical plans, Hawley expanded hospitals were to serve both the base
upon his overall hospital program for and the bomber commands.24
the United Kingdom. On 16 January Throughout the short organization-
he recommended provision of hospi- al life of USAFBI, reception and ac-
tals for the entire command on the commodation of the MAGNET force
formula earlier established for the Air absorbed much of the effort of all
Force: infirmary beds for 1 percent of staff sections. Plans called for the ini-
strength, station hospital beds for 4 tial MAGNET troop contingent—the
percent, general hospital beds for 3 first significant American force to
percent, and convalescent beds for reach the United Kingdom—to arrive
1.3 percent. He declared that few late in January. More troops were to
British hospitals would be available follow as rapidly as the limited
for transfer to the American Army amount of shipping and the demands
and ruled out conversion of other of global war permitted.
buildings as expensive and unlikely to Colonel Hawley quickly revised his
produce satisfactory results. Hawley and Major Welsh's Northern Ireland
favored instead constructing new medical plans. Between 6 and 15 Jan-
semipermanent hospitals from the uary Hawley surveyed British medical
ground up. He advocated use of the facilities in Northern Ireland. He ar-
British 20-by-40-foot wood and metal ranged with the commander of British
Nissen hut as the basic unit for such troops in Northern Ireland for
hospitals, as the hut could be adapted MAGNET to take over the hospitals
for wards, operating rooms, mess and medical supplies of redeploying
halls, or any other purpose and af- British units and also secured an
forded some protection against agreement that this force would treat
bombing. By late February Hawley MAGNET casualties in its hospitals
had established definite hospital re- until the Americans established their
quirements for the forces in England.
own. Hawley set the MAGNET hospital
23
Larkey "Hist," ch. 2, pp. 12-16. For the begin-
requirements on the same 1-4-3-per-
ning of the Air Force buildup, see Ruppenthal, Lo-
24
gistical Support, 1:26-31, and Wesley F. Craven and Memo, Hawley to CEngr, HQ, USAFBI,
James Lea Cate, eds., The Army Air Forces in World via G-4, 16 Jan 42, in Larkey "Hist," ch. 2. app. 1;
War II (hereafter cited as AAF), 7 vols. (Chicago: Uni- Ltr, Hawley to CSurg, GHQ, WD, 12 Feb 42, file
versity of Chicago Press, 1948-58), vol. 1, Plans and HD 024 ETO O/CS (Hawley-SGO Corresp); Msg,
Early Operations, January 1939 to August 1942 (1948), USAFBI to AGWAR, 28 Feb 42, file ETO Admin
pp. 618-42. 388.
BEGINNINGS 17
On 24 January Hawley and Brenn men, including the 7th General Dis-
left London for Belfast to meet the pensary and elements of the 109th
first MAGNET troop contingent. That Medical Battalion, arrived on 2 March
same day General Chancy issued no better supplied, although "drib-
orders creating the U.S. Army North- lets" of medical equipment addressed
ern Ireland Force (USANIF) to con- to units in the Caribbean and Iceland
trol all MAGNET troops under came in on various transports.28
USAFBI. Two days later about 4,000 With extensive British assistance
United States soldiers, most of them the first MAGNET contingents settled
members of the 34th Infantry Divi- in. The troops crowded into Nissen
sion, became the first American fight- huts in camps turned over by the
ing men of World War II to disem- British. Initially, the Americans ate
bark in the United Kingdom. The di- British Army rations, received their
vision commander, Maj. Gen. Russell mail from the British postal service,
P. Hartle, who accompanied the
and had their clothes cleaned and
troops, assumed command of both
shoes repaired in local establish-
USANIF and V Corps.27
This initial MAGNET contingent ments. Field artillerymen, sent over
brought with it the first Army medical without their 105-mm. howitzers,
troops to enter the European Theater learned to fire and maintain the Brit-
of Operations. They included the ish 25-pounder. Gradually, as supply
10th Station Hospital; an element of ships arrived, USANIF established its
the 136th Medical Regiment; and own mail, laundry, and post exchange
medical detachments of the 133d In- services. By late March the mess halls
fantry, the 151st Field Artillery, the were beginning to serve American ra-
109th Quartermaster Regiment, the tions instead of the unfamiliar and
112th Engineer Battalion, and the nutritionally less satisfactory British
29
63d Signal Battalion—in all 41 offi- menu.
cers, 42 nurses, and 322 enlisted As rapidly as possible, USANIF set
men. As a result of mismanagement up its own hospitals. On 9 March the
at the New York Port of Embarkation 10th Station Hospital took over a
and a shortage of shipping, these British military hospital at Ebrington
units landed at Belfast without most Barracks, Londonderry, complete with
of their equipment. Hence, the first its existing equipment and patients.
MAGNET troops had to depend on the By rearranging the wards and acquir-
British for all medical services. While ing additional buildings the American
the Allies provided generously, the staff increased the capacity of this
Americans' total dependency, accord- plant from 150 to 350 beds. To fur-
ing to Hawley, "made a very bad im- nish additional fixed hospitals,
pression upon the British." A second USANIF pressed mobile medical units
MAGNET contingent of about 7,000
28
An. 6 (Medical Plan) MAGNET, 19 Jan 42, in
CSurg, GHQ, WD, 12 Feb 42 (see also Ltr, Blesse Larkey "Hist," ch. 2, app. 2; Ltrs, Hawley to CSurg,
to Hawley, 21 Mar 42), all in file HD 024 ETO GHQ, WD, 12 Feb 42, Blesse to Hawley, 21 Mar 42,
O/CS (Hawley-SGO Corresp); Larkey "Hist," ch. 2, and Hawley to TSG, 4 Apr 42, all in file HD 024
p. 9. ETO O/CS (Hawley-SGO Corresp).
29
"Ruppenthal, Logistical Support, 1:22-26. Ruppenthal, Logistical Support, 1:23-26.
BEGINNINGS 19
upon refused to join the Army. The Oxford plant, to Belfast to reinforce
2d General Hospital finally estab- the 5th General Hospital. The 2d
lished itself in the Oxford plant, General Hospital personnel helped
which the British enlarged to accom- operate the 5th's convalescent facility
modate the unit.37 at Waringfield. With this augmenta-
The 2d General Hospital arrived in tion and with continued British help,
time to help USAFBI and USANIF the Northern Ireland hospitals satis-
cope with their first major medical factorily met the emergency. At
crisis, an epidemic of serum hepatitis. USAFBI direction, the Red Cross-
This epidemic had begun in February Harvard Unit and the 5th General
and quickly incapacitated large num- Hospital conducted their own search
bers of troops in the United States for the source of the epidemic. They
and overseas. By late April the Pre- independently reached the same con-
ventive Medicine Service, Office of clusion as investigators in the United
the Surgeon General, had traced the States, that it was a post-vaccinal in-
source of the epidemic to several lots fection. This finding reassured British
of contaminated yellow fever vaccine health authorities, who feared the
made with human serum. The Army spread of a possible infectious hepati-
at once stopped using vaccine from tis epidemic to the civilian popula-
that particular manufacturer, but by tion.
39
that time men who had received the While the epidemic ran its course,
vaccine earlier in the year were more ambitious deployment plans su-
coming down with hepatitis,38 includ- perseded RAINBOW-5 and MAGNET,
ing many who arrived in Northern and USAFBI gave way to a new thea-
Ireland in the May troop shipments.
ter command. These changes nullified
Before the epidemic passed its peak
most of the plans and many of the
in late July 1,950 soldiers in the Euro-
preparations of Colonel Hawley and
pean Theater were stricken, 2 of
his slowly expanding medical estab-
whom died. About 100 suffered per-
lishment. The chief surgeon and his
manent liver damage, which rendered
them unfit for further military service, staff would have to do most of their
and those who recovered required work over again on a grander scale.
long periods of recuperation. To help
care for the sudden influx of sick, 39
The course of the epidemic, which caused over
Colonel Hawley in July sent part of 49,000 cases in the Army throughout the world, is
the 2d General Hospital staff, who recounted in Ebbe Curtis Hoff, ed., Communicable
were awaiting expansion of their Diseases Transmitted Through Contact or by Unknown
Means, Medical Department, United States Army in
World War II (Washington, D.C.: Office of the Sur-
37
Larkey "Hist," ch. 1, pp. 3-8; ETO, "SPOBS geon General, Department of the Army, 1960), ch.
Hist," p. 170; Ltrs, Hawley to TSG, 29 Apr and 17 XVII. See also "Med Svc Hist, 1942-43," p. 37, file
Jul 42, and TSG to Hawley, 25 May 42, file HD 024 HD 314.7-2 ETO; Interv, Harlan B. Phillips with
ETO O/CS (Hawley-SGO Corresp); Ltr, Maj Gen J. Dr. Stanhope Bayne-Jones, 21 Mar-28 Jul 66 (here-
C. H. Lee to CG, SOS, WD, 21 Sep 42, file HD 024 after cited as Bayne-Jones Interv, 1966), vol, 3, p.
ETO CS (Hawley Chron); file 322.15 (Churchill 692, NLM; Keeler Interv, 17 Jul 45, box 223, RG
Hospital, Misc. Papers) on Churchill transfer. 112, NARA; Ltrs, Hawley to TSG, 9 Jun, 1 and 17
38
Serum hepatitis has an incubation period of 60- Jul, and 7 Aug 42, file HD 024 ETO O/CS (Hawley-
154 days. SGO Corresp).
24 EUROPEAN THEATER OF OPERATIONS
Yet they had gained valuable experi- important, they had established a
ence in these first months of war, es- close cooperative relationship, based
pecially in supporting the MAGNET on mutual professional respect and,
force. They had worked out the gen- in many cases, personal friendship,
eral principles for organizing an Army with British military and civilian medi-
medical service in Great Britain. Most cal officials.
CHAPTER II
Allied Force Headquarters and even- be able to supervise medical unit op-
tually went to North Africa.6 erations and training in all echelons
to ensure adequate, uniform treat-
Chain-of-Command Problems ment of casualties throughout the
chain of evacuation. Second, he
Less easily resolved were the ques- should have authority to coordinate
tions of authority and jurisdiction evacuation between the several eche-
arising from the interposition of an- lons of command. Casualties, Hawley
other headquarters—the Services of pointed out, "are perishable. . . .
Supply—between special staff section They require continuous care and
heads, such as the chief surgeon, and treatment during the entire journey
the theater commander. The chiefs of from front to rear; and this can only
the technical services now were in a be accomplished if one agency co-
different echelon from the command- ordinates the entire operation."
er they were supposed to advise. Fur- Third, the theater surgeon also
ther, being incorporated within one should supervise preventive medicine,
of several coordinate commands
because "communicable diseases rec-
under the theater, the service chiefs
ognize no echelon of command" and
lacked the authority to give technical
direction to subordinate elements op- because it was not practicable to es-
erating outside the Services of tablish the necessary expert staff at
Supply, for example, medical units at- every headquarters. Finally, he should
tached to the Eighth Air Force or the collect medical reports and statistics,
ground armies. to avoid burdening nonmedical chan-
This latter problem especially con- nels with this information. Comment-
cerned Colonel Hawley. Even before ing early in June on a draft general
formation of the Services of Supply, order defining SOS functions, Hawley
Hawley had maintained that the ETO warned that subordination of the
chief surgeon required theater-wide ETO chief surgeon to the SOS com-
technical control in at least four mander effectively would prevent him
areas. First, the theater surgeon must from performing any of the afore-
mentioned tasks, unless the com-
6
Memo, TSG to Maj Gen J. C. H. Lee, 7 May 42, mander himself were empowered to
file SPMC 322.051-1; Hawley Interv, 1962, pp. 12- issue theater-wide directives on some
14, CMH; MFR, Col Joseph T. McNinch and Dr. matters. Privately, he expressed him-
Nora V. Lewison, 24 May 49, sub: Interview With
Col James B. Mason, MC (Ret.), file HD 000.71, self bluntly: "From where I set [sic],
CMH; Ltrs, Hawley to TSG, 10 and 15 Jun 42, HD everybody seems to have gone com-
024 ETO O/CS (Hawley-SGO Corresp). Hawley pletely nuts in the field of staff orga-
was a close friend of Dr. Frederick W. O'Donnell,
with whom Lee had served in the 89th Division in nization." 7
World War I, and the sentimental tie weighed heavi-
7
ly with Lee. See Lt Gen J. C. H. Lee, "Service Re- Chief surgeon's views on his authority, including
miniscences," pp. 82, 97, P-1, box 1, Hawley quotations in body of paragraph, from: Memo,
Papers, MHI. Corby, who lacked staff experience Hawley to Gen Larkin, 29 May 42, sub: Definition of
and suffered from emotional problems, was relieved Medical Responsibility, Hawley Big Picture file,
from the Allied Force Headquarters in early Febru- SGO HistDivFiles; and Memos, Hawley to G-1,
ary 1943. See Interv, OSG with Maj Gen Albert W. USAFBI, 17 Apr 42, Hawley to AG, USAFBI, 1 Jun
Kenner, MC (Ret.), 9 Jan 52 (hereafter cited as 42, sub: Comments on Draft of General Order Es-
Kenner Interv, 1952), file HD 000.71, CMH. Continued
FROM BOLERO TO TORCH 29
officer in London only partially over- medical records. Several ETO staff
came the separation of theater and section heads, who themselves found
SOS staffs, for the ETO chief sur- the service chiefs' exile to Chelten-
geon's representative was out of ham an obstacle to business, en-
touch with day-to-day activities and dorsed Hawley's proposal. General
decisions at Cheltenham and lacked Lee, however, vetoed it, arguing that
independent authority of his own. In the theater surgeon "can best per-
addition, Hawley found it difficult to form his primary mission of coordina-
deal from Cheltenham with the Brit- tion, supply and evacuation from HQ,
ish medical services in London. SOS," while maintaining a London
"Many time-consuming trips," he re- deputy of the "highest obtainable
ported, "have not effected proper liai- quality" for ETO planning and liai-
son." More fundamentally, Hawley son. Lee on 30 November presented
continued to complain of "the diffi- a reorganization plan of his own with
culty, if not complete inability, of con- the opposite objective to Hawley's.
trolling the technical operations of The SOS commander wanted to con-
medical units in echelons of ETOUSA centrate all but a few theater staff sec-
other than SOS." Other commands, tions and all supply and administra-
and even the theater staff, persistently tive responsibilities in the Services of
misunderstood Hawley's position. Supply. The theater staff, in turn, re-
"Regardless of published directives," jected this plan, insisting that theater
he declared in mid-November, "the headquarters had to retain certain ad-
Chief Surgeon is rather generally re- ministrative and logistics functions,
garded as solely a staff officer of the especially in Great Britain, where
S.O.S commander." At the ETO clearly defined geographical combat
headquarters it was "common prac- and communications zones did not
tice ... to refer direct recommenda- exist. With this stalemate General
tions of the Chief Surgeon to his rep- Order No. 19 remained in effect, and
resentative at ETO 'for remark and Hawley stayed at Cheltenham.11
10
recommendation.' " Within the Services of Supply Gen-
On 14 November, therefore, eral Lee delegated operational re-
Hawley proposed that he, as ETO sponsibility to geographical base sec-
chief surgeon, be moved to London tions. On 20 July he designated the
and given his own staff to oversee Northern Ireland Base Command
medical operations, training, and pre- (Provisional) as the Northern Ireland
ventive medicine. A separate SOS Base Section and ordered establish-
chief surgeon, with his own staff, ment of Eastern, Western, and South-
Hawley suggested, should take charge ern Base Sections. Each of these
of such theater-wide functions as hos-
11
pital construction and administration, Quotations from Memo, Lee to CG, ETOUSA,
supply, personnel procurement, and also 10 Dec 42, file HD 320 ETO (Reorganization). See
Ruppenthal, Logistical Support, 1:159; Memo,
Hawley to Barker, 14 Nov 42, box 1, Hawley
10
Memo, Hawley to Brig Gen Ray W. Barker, 14 Papers, MHI; Memos, Barker to CofS, ETO, 30 Nov
Nov 42, box 1, Hawley Papers, MHI; Memo, Hawley 42, sub: Reorganization, Medical Services, and Col
to CEngr, CCWOff, CSigOff, COrdOff, and CQM, Ralph Pulsifer to CG, SOS, 22 Dec 42, file HD 320
10 Nov 42, file HD 024 ETO CS (Hawley Chron). ETO (Reorganization).
FROM BOLERO TO TORCH 31
territorial divisions encompassed that accord with Army regulations that
portion of the United Kingdom im- vested authority over general hospi-
plied by its name, and the boundaries tals outside the United States in the
of each roughly coincided with those geographical department or tactical
of the British regional administrative commander. Instead, Lee urged
and defense commands. Each base Hawley and the other service chiefs to
section commander, directly under establish informal cooperation with
General Lee, controlled all SOS the base sections. The conflict of au-
troops, installations, and activities thority remained unsettled in princi-
within his area; served as SOS point ple, with each new problem requiring
of contact for U.S. ground and air another ad hoc compromise.12
forces; and maintained liaison with The theater command structure es-
British authorities. tablished in mid-1942, especially that
Lee gave his base section com- part of it affecting the medical and
manders operational control over all other technical services, thus had con-
general and station hospitals, medical flict of authority built into it. In spite
supply depots, and SOS medical units of this fact the commanders involved
and personnel within their bound-
made it work, more by informal coop-
aries. This authority brought the sec-
eration than by following the organi-
tion commanders into conflict with
Colonel Hawley, who was supposed zation chart. Colonel Hawley excelled
to direct technical activities of SOS at this kind of personal give-and-take.
medical units through the base sec- He collaborated effectively, if not cor-
tion staff surgeons. In practice, dially, with General Lee, although
Hawley declared, "every instruction they had occasional disagreements.
of a base section commander inter- He later said of Lee, whom many in
feres with technical operations. No the European Theater regarded as ar-
person can serve two masters; and rogant and difficult to deal with,
with technical instructions requiring "He's nobody I'd ever want to go
time and effort to follow coming from fishing with for a week. . . . But . . .
one source and other instruction from I never went to ... Lee with a prob-
another . . . , confusion is inevita- lem that I didn't get complete sup-
ble." As American forces increased in port." Hawley established cordial re-
size during the second half of 1942, lations with the other SOS special
Hawley complained that base section staff sections. "Whatever success we
commanders were imposing inappro- 12
priate training and detrimental extra Quotations from Note, Hawley, 10 Oct 42, and
Ltr, Hawley to AG, SOS, 15 Oct 42, both in file HD
duties on his hospitals. He agitated 024 ETO CS (Hawley Chron). See also Ruppenthal,
continuously for centralized control Logistical Support, 1:84-87; Armfield, Organization and
by his office of all general hospitals, Administration, pp. 317-18. Authority over general
hospitals is established in AR No. 40-600, 6 Oct 42,
insisting that "when battle casualties Medical Department: General Hospitals. Hawley had
begin to arrive, complete control . . . ailed early for central control of general hospitals.
is imperative" to ensure rapid distri- See Larkey "Hist," ch. 2, p. 6. Base section com-
bution of patients and efficient em- manders in their turn complained of interference by
service chiefs. See Interv, ETO with Brig Gen Leroy
ployment of staffs. General Lee re- P. Collins, CG, Northern Ireland Base Section
jected Hawley's pleas on this point, in (hereafter cited as Collins Interv), 8 Apr 44, CMH.
32 EUROPEAN THEATER OF OPERATIONS
sion lines, "submitting to the Chief First, the army required a garrison
Surgeon for decision . . . cases in medical establishment to care for its
which the Chiefs concerned are sick and injured during the buildup
unable to agree." He especially and waiting period before the inva-
stressed the need for cooperation, sion, as well as additional hospitals
declaring: for Air Force battle casualties.
It is ... fatal to attempt a military op- Second, when the cross-Channel as-
eration without complete cooperation sault began, it would need almost as
between responsible officers. Although a many hospitals again to accommodate
cooperate and friendly spirit will not the expected flood of wounded from
compensate for want or ability in an offi-
cer, inability to play in a team renders an the decisive—and hence undoubtedly
officer useless, regardless of his other the bloodiest—campaign of the war.
Qualification. Each officer must study the All of these hospitals would have to
individual characteristics of the other offi- be fitted into overcrowded Britain
cers with whom he deals and adjust his
approach accordingly. . . . Each officer and, if possible, combined with the
must study his own peculiarities and curb additional housing required for the
such traits that interfere with his relations American troops.
with his fellows. . . .19 The exact number, size, and loca-
The organization established in tion of hospitals depended on the
Hawley's 26 August memorandum re- overall plans developed by the Wash-
mained stable in structure for the rest ington and London BOLERO Com-
of the year, although some divisions bined Committees. The Washington
underwent one or more changes of committee, in consultation with ETO
chief and all received driblets of addi- headquarters, determined the force
tional personnel. Hawley himself re- structure and set movement schedules
ceived a brigadier general's star on 10 and shipping priorities. The London
September. He needed both the addi- committee, consisting of representa-
tional staff and the rank, first to nego- tives of ETOUSA and the British
tiate with the British on medical plans armed forces and civilian ministries,
for BOLERO and then to cope with the decided on ports of entry and troop
demands of TORCH upon an inexperi- billeting areas and arranged for hous-
enced, undermanned, undersupplied ing, transportation, storage facilities,
medical service. and hospitals. This committee report-
ed to the administrative heads of the
The Hospital Program British armed forces and relied on the
War Office and other ministries to
As BOLERO planning began, provi- implement its recommendations.
sion of hospitals for the million-man Working with the strength esti-
ETOUSA force claimed much of the mates and shipping schedules from
chief surgeon's time and attention. the Washington committee, and on
This medical challenge had two parts. what little had been decided thus far
about the tactics of ROUNDUP, the
19 London Combined Committee be-
Memo No. 7, OofCS, HQ, SOS, 26 Aug 42,
filed 519 Admin Med Hist (ETO), in Larkey "Hist," tween May and July 1942 developed
ch. 3, app. 19. the First and Second Key Plans for
FROM BOLERO TO TORCH 37
BOLERO. These plans were compre- Medical Services, surveyed existing
hensive programs, embodied in direc- hospital facilities. The survey reaf-
tives to British civilian and military firmed his earlier conclusion that U.S.
agencies, for the reception of Ameri- forces in Great Britain would have to
can troops and supplies and for the rely for hospitals primarily on new
building of the British invasion base. construction. He also evaluated a
The First Key Plan, issued on 31 May, flood of offers of English country
and the Second Key Plan, issued on houses, whose owners wanted to turn
25 July, differed in the troop numbers them over to the Army for hospitals,
used as the basis for planning either out of patriotism or to escape
(1,049,000 versus 1,147,000) but real estate taxes. Hawley disappointed
were similar in assumptions and prin- most of these gentry. He rejected
ciples. Both plans assumed that in the their mansions as too small or requir-
cross-Channel invasion U.S. troops ing too much alteration for efficient
21
would constitute the Allied right wing use.
and the British the left. Hence, the During May Hawley and his British
Americans, entering England through colleagues reached a number of sig-
the west coast ports, would concen- nificant understandings. The British
trate the bulk of their ground forces already had turned over two hospi-
in southwestern England and eventu- tals—those at Musgrave Park and
ally embark for the assault from ports Ebrington Barracks in Northern Ire-
in that region. Under the Key Plans, land—to the U.S. Army and had
accordingly, the British Army was to agreed to turn over three more—the
turn over its Southern Command to American Red Cross-Harvard Unit
the Americans, complete with all and the EMS plants at Oxford (the
camps, hospitals, and supply depots. Churchill Hospital) and Mansfield.
To accommodate the American These facilities contained in all about
ground troops in southern England, 2,200 beds. On the eleventh the Brit-
as well as the Air Force in the north- ish Army promised to transfer all its
east, the British would construct addi- Southern Command hospitals to the
tional facilities as required, using Americans—another 4,500 beds in
their own labor and both their own units of 50 to 1,000. The Emergency
and American materials. Hospitals Medical Services at the same time of-
were to be a major element of this fered three more 600-bed hospitals,
20
new construction. then under construction, at Odstock,
Colonel Hawley began his hospital Taunton, and Bristol. Hawley accept-
planning before the formal establish- ed all these facilities.
ment of the BOLERO committees. In a conference on 21 May Hawley,
During late April Hawley, in consulta- the USAFBI chief engineer, and rep-
tion with the medical chiefs of the resentatives of the British Ministry of
British Army, the Canadian Expedi-
tionary Force, and the Emergency 21
Ltr, Hawley to TSG, 29 Apr 42, file HD 024
ETO O/CS (Hawley-SGO Corresp); Hawley Interv,
1962, p. 25, CMH; Ltr, Hawley to Surg, HQ, Eighth
20
Ruppenthal, Logistical Support, 1:53-74, describes Air Force, 28 Sep 42, file HD 024 ETO CS (Hawley
the general course of BOLERO planning. Chron).
38 EUROPEAN THEATER OF OPERATIONS
Works decided to enlarge the five Works, would erect the plants using
EMS hospitals earmarked for the British designs and specifications
Americans to 1,000 beds each. At the modified to meet American require-
same time Hawley secured British ments.22
concurrence on the nine proposed lo- On 27 May the London Combined
cations for new station hospitals, and Committee established the Provision
he and the British established proce- of Medical Services Subcommittee to
dures for selecting additional sites. take charge of hospital planning. This
The Allies also agreed on the agen- action merely gave formal status to
cies and methods of BOLERO hospital the consultations already under way
construction. Hawley initially had between Hawley, the British military
wanted American hospitals built by medical chiefs, and the EMS direc-
U.S. Army Engineers following stand- tor—all members of the subcommit-
ard plans made by the surgeon gener- tee. Later, representatives of the Ca-
al's office. In the face of limited
nadian Army medical service and the
transatlantic shipping for men and
matériel, however, he accepted a plan
under which British civilian contrac- 22
Larkey "Hist," ch. 2, pp. 22-30, and ch. 7, pp.
tors, employed by the Ministry of 2-3 and app. 1; Hawley Interv, 1962, p. 24, CMH.
FROM BOLERO TO TORCH 39
Department of Health for Scotland numbers. For ROUNDUP and the ensu-
joined the group.23 ing continental operations Hawley
During the drafting of the First and wanted beds for 10 percent of the
Second Key Plans Hawley worked out number of men actually committed to
the total number of hospital beds that combat. In all, he requested about
would be needed to support both 90,000 station and general hospital
BOLERO and ROUNDUP. He based his beds, about half of which—mostly in
estimate on U.S. Army experience in station hospitals—would be needed
World War I and on British Army before the invasion.24
casualty rates in the interwar years The Medical Services Subcommit-
and in the French, Norwegian, and tee, after what Hawley described as "a
North African fighting. Hawley as-
lot of diplomacy," accepted his state-
sumed that before the invasion, the
Army would have 2.25 sick and non- ment of requirements as the basis for
battle injured per day for each 1,000 planning. Disagreements developed,
troops. Active operations would result however, about ways and means.
in at least another 2.5 combat casual- Hawley insisted, correctly, that the
ties per 1,000 men per day. Hawley British were overestimating the bed
then calculated the probable patient capacity of the hospitals they were
accumulation in hospitals under a turning over and hence underestimat-
180-day theater evacuation policy and ing the amount of new building
established his bed requirement as a needed. The extent of new construc-
percentage of total troop strength. tion worried the British quartermaster
For the static preinvasion period general, who not only expressed con-
Hawley asked for dispensary beds suf- cern at the cost in scarce funds, mate-
ficient for 1 percent of the entire rials and labor but also urged more
force and station hospital beds for 3 use of converted camps, requisitioned
percent. On top of this, the Air Force buildings, and tent hospitals. Hawley
should have beds for an additional firmly rejected the latter two alterna-
1.5 percent of its strength for its tives, but he decided that some troop
battle casualties. Black troops, whom housing, existing and to be built,
Hawley expected to have a higher sick could be adapted for hospitals after
rate than whites, would need beds for the units left for France.25
an extra 2.5 percent of their total The medical annex of the Second
23
Key Plan incorporated the agreement
Larkey "Hist," ch. 2, p. 25. Initial members of
the subcommittee were: Maj. Gen. H. M. Gale,
reached by Hawley and the British on
MGA Home Forces, Chairman (replaced in Septem-
24
ber by Maj. Gen. R. H. Lorie, MGA Home Forces); Memos, Hawley, 1 Jun 42, sub: Hospitalization
Surgeon Vice Admiral S. F. Dudley, MDG, Admiral- Required by USAFBI, and Hawley to Provision of
ty; Lt. Gen. A. Hood, DGAMS, War Office; Air Mar- Medical Services Subcommittee, 14 Jun 42, sub: Re-
shal Sir H. W. Whittingham, DGMS, Air Ministry; statement of U.S. Requirements, in Larkey "Hist,"
Brigadier W. Hartgill, DDG Operations, War Office; ch. 2, apps. 3-4; Ltr, Hawley to TSG, 9 Jun 42, file
Prof. F. R. Fraser, DGEMS, Ministry of Health; and HD 024 ETO O/CS (Hawley-SGO Corresp).
25
Col. P. R. Hawley, Chief Surgeon, HQ, USAFBI. At Quotation from Ltr, Hawley to TSG, 9 Jun 42,
this time separate planning committees began work file HD 024 ETO O/CS (Hawley-SGO Corresp).
on medical aspects of SLEDGEHAMMER and ROUNDUP. See also Larkey "Hist," ch. 2, pp. 26-36 and app. 4,
This planning, in which Colonel Spruit was heavily and Memo, Hawley to CG, SOS, 20 Jan 43, in ibid.,
involved, is covered in Chapter VI of this volume. ch. 7, app. 1.
40 EUROPEAN THEATER OF OPERATIONS
the number of hospital beds needed Selection of sites for station and
and the means of providing them general hospitals had begun before
(Table 1). Following Hawley's percent- publication of the Second Key Plan in
age-of-strength requirements, the July and accelerated during the fol-
Second Key Plan called for provision lowing month. For station hospitals
of 40,240 beds during the buildup to Hawley, after obtaining troop loca-
accommodate sick, nonbattle injured, tions from the ETO G-3, asked the
and Air Force combat casualties. British War Office for a site within 5
Roughly 12,000 of these beds were to miles of each center of concentration.
be in enlarged former British Army The War Office and the Ministry of
and EMS hospitals; newly constructed Agriculture then chose the ground,
beds in thirty-five 750-bed station usually in a park or estate to avoid
hospitals and two 1,000-bed general building over farmland. By mid-
hospitals would account for the rest. August Hawley and the British had
To support ROUNDUP, the Allies agreed on sites for thirty-three of the
agreed to furnish 50,750 additional projected thirty-five station hospitals,
beds—18,000 of them in new general most of them in southern England
hospitals to be built before D-Day and East Anglia. Hawley wanted to
and the remainder after D-Day in group his general hospitals in centers
vacated British militia camps and of four or five units for greater effi-
American hut cantonments. These in- ciency. He allowed the British to de-
stallations would have structures for termine locations for these centers so
as to ensure adequate rail connections
operating rooms, clinics, and labora-
for hospital trains without disrupting
tories added to them before the inva-
overall traffic patterns. After consult-
sion so that they could be converted
ing the railway authorities, the War
quickly into 750-bed station or 1,000-
26 Office placed the first three centers in
bed general hospitals. the west of England—at Cirencester,
Separately from the BOLERO discus- Great Malvern, and Whitchurch.
sions, Hawley and Surgeon General Construction also got under way.
Magee decided to use, as far as possi- By the end of July the War Office had
ble, only 750-bed station and 1,000- given orders for all the required ex-
bed general hospitals in the United pansions of military and EMS plants
Kingdom. Hawley asked for inclusion and for one 750-bed and two 1,000-
of a few 250- and 500-bed station bed Nissen-hut installations. In addi-
hospitals in the early troop ship- tion, the British began building ten
ments, to occupy small facilities taken 1,250-man troop camps in Southern
over from the British or designed Command, designed for conversion
before BOLERO to serve the Air Force, into hospitals, and they made plans
but for the new plants he desired only and preparations for altering a
the larger units.27 number of existing camps. During
26
August the British promised to have
Larkey "Hist," ch. 2, pp. 36-40, and ch. 7, the five EMS hospitals, each enlarged
app. 1.
27
Ltr, Hawley to TSG, 6 Jul 42, file HD 024 ETO to 1,000 beds, ready for American oc-
O/CS (Hawley-SGO Corresp). cupancy between 1 October and 31
FROM BOLERO TO TORCH 41
TABLE 1—HOSPITAL BED REQUIREMENTS AND PROVISIONS, SECOND KEY PLAN, JULY 1942
a
b
For battle casualties of forces on the Continent.
For nonbattle casualties of forces in the United Kingdom.
Source: Adapted by authors from Larkey "Hist," ch. 2, pp. 36-40.
December. The War Office ordered which might be increased later. The
construction of fifteen general hospi- authorities in Great Britain, neverthe-
tals in groups of five at the three pre- less, at first tried to keep the full
viously chosen locations. By the end BOLERO construction program going.
of the month the British Army had Around midmonth, in the face of the
evacuated twelve of its hospitals for cutback in American deployment
turnover to the Americans.28 goals, General Lee and the British
After the decision to attack North- deputy quartermaster general (liai-
west Africa, the United States gradu- son), who represented the War
ally scaled down its short-range Office, agreed to continue construc-
BOLERO deployment objectives. In
tion at the levels established in the
October, with TORCH preparations
under way on both sides of the Atlan- First and Second Key Plans. This con-
tic, the War Department decided to struction was primarily a British task
base troop and supply shipments to in any event, and both sides assumed
Britain on a post-TORCH maximum that the million-man buildup event-
strength there of only 427,000 men, ually would resume.
General Hawley, in accord with this
28
Hospitalization Division, OofCSurg, HQ, approach, continued to press for his
ETOUSA, Annual Rpt, 1942; Larkey "Hist," ch. 2, full requirement of over 40,000 pre-
pp. 38-44, and ch. 7, pp. 7-13; Hawley Interv,
1962, pp. 45-46, CMH; Ltr, Hawley to TSG, 15 Jun ROUNDUP and of nearly 51,000 post-
42, file HD 024 ETO O/CS (Hawley-SGO Corresp). ROUNDUP hospital beds. He increased
42 EUROPEAN THEATER OF OPERATIONS
his station hospital capacity request plans Hawley, at British insistence, in-
from 3 percent of strength to 4 per- cluded in his calculations the fact
cent, citing as justification the ab- that, as built to British specifications,
sence of convalescent facilities, troop a 750-bed station hospital actually
overcrowding in camps and the con- had a capacity of 834 beds while a
comitant higher sick rate, and the lack 1,000-bed general hospital had room
of hospital ships to carry out a 180- for 1,084. Hawley previously had
day theater evacuation policy. The rated the capacity of these plants
London Combined Committee, in its strictly by the table-of-organization
initial revision of the Key Plans to bed strength of the units slated to
take into account the slower U.S. occupy them. Now he gave way to the
buildup, reaffirmed Hawley's 90,000- British in order to obtain more beds
bed hospital request.29 for the same amount of construction
The demands of the North African and planned to reinforce units to op-
expedition for shipping and supplies erate the odd-size hospitals.
30
THEATER CHIEF SURGEON AND STAFF, CHELTENHAM, NOVEMBER 1942. To oversee the
medical requirements of BOLERO, General Hawley (1) relied on such able administrators as
Col. Eli E. Brown (2), chief of the Hospitalization Division; Col. William S. Middleton (3),
chief consultant in medicine; Colonel Mason (4), chief of the Operations Division; Lt. Col.
John E. Gordon (5), chief of the Preventive Medicine Division; Capt. Margaret E. Aaron
(6), chief of the Nursing Division; Lt. Col. Rex L. Diveley (7), senior consultant in orthopedic
surgery; Col. Kimbrough (8), chief of the Professional Services Division; Col. Elliott C. Cutler
(9), chief consultant in surgery; Lt. Col. Paul Padget (10), senior consultant in venereal
disease; and Lt. Col. Joseph H. McNinch (11), chief of the Medical Records Division.
should have at least ten medical offi- ern Base Section, which supported
cers. Until late in the year each actu- the Eighth Air Force, had only four.
ally had received no more than one To furnish even this slim comple-
or two—often borrowed from units— ment, Hawley perforce employed men
and a handful of enlisted men. Only of inferior ability, a number of whom
the Southern Base Section reached had failed in other assignments. The
the desired strength, with eleven Western Base Section surgeon, ac-
medical officers and forty-one enlist- cording to Hawley, "was recommend-
ed men at the end of 1942. The ed by his first C.O. for reclassifica-
Western Base Section, responsible for tion. I had to give him another job
the American ports of entry into the and Surgeon, Western Base Section,
United Kingdom, finished the year was the only place I could put him
with eight medical officers. The East- with his rank. . . . You can gauge the
48 EUROPEAN THEATER OF OPERATIONS
immediately needed units and troops. ture of some hospitals for North
By early October the medical service Africa. Besides the one evacuation,
"was relatively so weak that not only four general, and four station hospi-
could it not furnish adequate support tals in operation, SOS medical units
in any operation but it was unable to in the United Kingdom at the end of
care for the routine sick and nonbat- 1942 included one general and five
tle injured in a static situation." In re- station hospitals, changing location or
sponse to urgent pleas from General waiting for buildings; a medical
Hawley, who now faced the loss of supply depot company; two general
some of his hospitals to TORCH, the dispensaries; and an auxiliary surgical
ETO chief of staff on the twentieth group. The SOS medical buildup,
called a special conference on medical nevertheless, still was proceeding
personnel. The conferees, who in- more slowly than that of the organiza-
cluded Hawley and the ETO deputy tion as a whole. General Hawley esti-
chief of staff and G-4, agreed that the mated early in December that when
medical manpower shortage was criti- the Services of Supply reached 59
cal. As a result of the conference percent of its projected strength, the
Hawley and the theater G-4, at the medical service would have expanded
direction of the chief of staff, drew up to only 43 percent. "In the troops
plans for bringing the medical service priorities now set up," he concluded,
to its proper relative strength by "the medical service becomes propor-
adding about 4,500 hospital beds and tionately weaker and weaker until
3,500 people per month during No- near the very end of the buildup,
vember and December and 3,500 when it is suddenly built up to
beds and 2,900 personnel a month strength."
41
40
during early 1943. From the start of the BOLERO build-
This plan, while it also fell victim to up shortages and administrative defi-
the worldwide shortage of shipping, ciencies hampered medical supply ef-
did result in deployment of more forts. Many of the administrative
medical troops. By the end of Novem- shortcomings originated in the Supply
ber SOS medical strength had in- Division of General Hawley's office.
creased to over 7,000; enough Hawley, by his own admission, was
additional reinforcements arrived in "less familiar with the technique of
December to keep the service at medical supply than with other as-
6,500 people, even after the depar-
pects of medical service" and "there-
40
As of 1 September, the Engineers were 86 per-
fore, more dependent upon the
cent of planned strength; the Signal Corps had
41
reached 22 percent and Chemical Warfare 8.5 per- Quotation from Memo, Hawley to G-1, SOS, 2
cent. Memos, Hawley to CG, SOS, 6 Oct 42 (source Dec 42, sub: Troop Unit Priorities for SOS, file HD
of quotation), and Hawley to G-4, ETO, 21 Oct 42, 024 ETO CS (Hawley Chron). In December another
in Larkey "Hist," ch. 4, apps. 6 and 15 (see also pp. 3,400 medical personnel were in non-SOS units and
10-11); Memos, Hawley to G-4, SOS, 10 Sep 42, detachments in Great Britain. See John H. McMinn
and Hawley to Col Charles B. Spruit, MC, 11 Sep and Max Levin, Personnel in World War II, Medical
42, file 370 (Bible File of Troop Requirements, Department, United States Army in World War II
Early Planning); Memos, Hawley to Gen Littlejohn, (Washington, D.C.: Office of the Surgeon General,
21 Oct 42, and Hawley to G-4, ETO, 23 Oct 42, file Department of the Army, 1963), pp. 308-09; "Med
HD 024 ETO CS (Hawley Chron). Svc Hist, 1942-43," p. 15, file HD 314.7-2 ETO.
50 EUROPEAN THEATER OF OPERATIONS
their Allies' needs, requested large- exceeding the 28,000 tons received
scale orders far in advance of the de- from the United States. At the begin-
sired delivery dates, to give their ning of 1943 Hawley expressed confi-
plants time to plan production and dence that he could obtain almost 90
tool up. Colonel Perkins had difficulty percent of his hospital equipment and
formulating such orders, as he could general medical supplies from his
not obtain reliable early information Allies—nearly everything, in fact,
on requirements from Standlee and except field chests and other articles
Higbee. Changes in buildup plans for mobile units. Nevertheless, due to
forced frequent revision of what esti- the slow start and uncertain reliability
mates he did receive. Perkins also dis- of local procurement, the chief sur-
covered that the Americans and Brit- geon's Supply Division customarily
ish used different names for many of sent duplicate requisitions to the
the same items; the resulting break- United States for everything it or-
down of communication made it diffi- dered from the British, intending to
cult to determine exactly what Ameri- cancel these requisitions if the British
can requirements the British could delivered. This practice only com-
fill. In an effort to resolve this prob- pounded the resupply misunderstand-
lem, General Hawley put his profes-
ings between Hawley's office and that
sional consultants to work on a 49
catalog of equivalent British and of the surgeon general.
American medicines and equipment, Whether American or British in
but this catalog was not available origin, medical supplies, once pro-
during most of 1942. cured, had to run a gauntlet of obsta-
In spite of these difficulties, the cles before reaching the troops who
SOS Procurement Division between needed them. During the summer and
June and October placed several large early autumn the flood of BOLERO
orders for British medical supplies, and TORCH cargo swamped the al-
including complete hospital assem- ready heavily taxed western British
blies. Colonel Perkins, whom Hawley ports through which most American
considered "a fine gentleman and goods arrived. Shipments were split
. . . unusually capable," combined up during unloading and some items
tact with firmness in moving the Brit- smashed by unskilled stevedores.
ish from general promises to particu- Much matériel from the United States
lar commitments. He also ferreted came without bills of lading and in
out untapped commercial reserves of containers wrongly labeled, if labeled
operating room furniture, surgical in- at all, and never reached the depots
struments, and other needed matériel. for which it was intended. As a result,
During the last months of 1942 a
49
growing amount of British supplies "Med Svc Hist, 1942-43," pp. 56-58, file HD
flowed into American depots, in time 314.7-2 ETO; Wiltse, ed., Medical Supply, pp. 268-
70; Larkey "Hist," ch. 5, pp. 6-11. See also Ltrs,
to be of indispensable help in outfit- Hawley to TSG, 9 Jun 42, 6 Jul 42, and 3 Mar 43;
ting the TORCH forces. Even with the Ltr, Hawley to Tyng, 7 Nov 42; Memo, Col Elliott
initial delays British medical supply C. Cutler, MC, to TSG, 26 Nov 42; Ltr, Hawley to
General Purchasing Agent, ETOUSA, 15 Oct 42;
deliveries during the last half of 1942 Note, Hawley, 6 Nov 42. All in file HD 024 ETO CS
amounted to 84,000 ships' tons, far (Hawley Chron).
54 EUROPEAN THEATER OF OPERATIONS
Firth of Clyde and, after a final land- and extent of ETO responsibility for
ing rehearsal off the Scottish coast, care of North African casualties.
departed for the Mediterranean on 22 Hawley eventually lost patience with
and 26 October. On 8 November the the chaotic procedures, as revealed in
landings took place on schedule. his 11 December letter to the surgeon
Follow-up convoys left England on general:
the eighth, eleventh, and twenty-
first.
53 I watched the muddled medical planning
until I could stand it no longer and then
This simply described sequence of went to the Chief of Staff, ETO and told
plans and preparations was a trying him that the stage was all set for the big-
time for the ETO medical service. gest medical scandal since the Spanish-
General Hawley, although responsible American War. That jolted them a little,
for furnishing troops and supplies, and General Eisenhower told me to step
had no direct role in medical plan- in and straighten things out. I did, but
within a week things were right back to
ning for the 40,800-man Center Task where they were—each separate task
Force, the logistical support of which force doing its own planning without the
54
was the primary task of ETOUSA. least coordination. . . ,55
Instead, the Allied Force Headquar-
ters, with Colonel Corby acting as The theater Services of Supply had
deputy to a British chief surgeon, and to provide hospitals and other medi-
the U.S. II Corps, of which Col. Rich- cal units, primarily for the Center
ard T. Arnest, MC, was surgeon, pre- Task Force, as directed by the Allied
pared the plans with little coordina- Force Headquarters. While meeting
tion with ETOUSA and even less with these requirements, Hawley struggled
the other task forces. Delay in com- successfully to retain his important
pleting the overall Allied operation operating units. An early AFHQ
plan further confused matters, be- troop list, for instance, included the
cause the task force had to start plan- 3d and 10th Station Hospitals, both
ning without a final directive, a full of patients, and a detachment of
procedure which led to repeated last- the overextended 1st Medical Depot
minute changes. The Allied Force Company. The chief surgeon secured
Headquarters did not issue its logis- deletion of these organizations and
tics plan for the whole operation until their replacement with others due in
December. Until then Hawley had to from the United States. By the end of
proceed without definite answers to the year the Services of Supply had
such vital questions as the duration given up to TORCH five station and
two general hospitals and a medical
53
TORCH plans and preparations are described in supply depot company. In addition, a
Matloff and Snell, Strategic Planning, pp. 286-93 and medical regiment, a medical battalion,
315-516; George F. Howe, Northwest Africa: Seizing
the Initiative in the West, United States Army in World
55
War II (Washington, D.C.: Office of the Chief of Quotation from Ltr, Hawley to Hillman, 11 Dec
Military History, Department of the Army, 1957), 42, file HD 024 ETO O/CS (Hawley-SGO Corresp).
pp. 46-47, 70-72, app. A. Wiltse, Mediterranean, pp. 105-08, summarizes
54
The Eastern Task Force, British in composition TORCH medical planning. See also Howe, Northwest
except for two American regimental combat teams, Africa, pp. 32-33 and 63-67; MFR, McNinch and
received medical and other logistical support almost Lewison, 24 May 49, sub: Interview With Col James
entirely from the British Army. B. Mason, MC (Ret.) file HD 000.71, CMH.
FROM BOLERO TO TORCH 57
and one surgical and three evacuation ceiving requisitions, many of them
hospitals passed through the United duplicates, from three separate
Kingdom on their way to North TORCH headquarters—AFHQ the II
Africa. The II Corps, the 1st Armored Corps, and the Twelfth Air Force
Division, and the 1st and 34th Infan- (which was being formed out of the
try Divisions took away their own or- Eighth for North African service).
ganic medical units and detachments. Hawley, lacking authority to coordi-
From his own office Hawley lost nate TORCH supply, could do no
seven officers and eighteen enlisted more than suggest that all commands
men; SOS and non-SOS medical units channel their requisitions through
that stayed in Great Britain also sur- Colonel Corby at the Allied Force
rendered personnel to fill up TORCH Headquarters "so that he may detect
organizations. In spite of these losses these duplications and establish ap-
increased arrivals from the United propriate priorities." Units at times
States kept total SOS medical
made almost impossible demands.
strength at between 6,000 and 6,500
through early 1943; nevertheless, the The 16th Medical Regiment, alerted
departure of experienced key people on 7 October for embarkation in a
and temporary personnel shortages November convoy, failed to requisi-
hindered the work of hospitals and tion needed equipment until 1 No-
other units.56 vember and then complained of
57
The supply demands of TORCH on delays in delivery.
the ETO medical service were more In an attempt to coordinate TORCH
extensive and crippling than those for supply, the theater G-4 set up a com-
personnel. The Services of Supply mittee of representatives from each of
was required to equip all North the technical services. Maj. Clark B.
Africa-bound ETO units and medical Meador, MC, the most active ETO
detachments, as well as furnish a medical service member of this com-
sixty-day reserve of supplies. Difficul- mittee, "practically unaided, under-
ties abounded. Many hospital and took the whole calculation of medical
other units designated for TORCH ar- requirements, of shipping require-
rived in Great Britain with 25 percent ments, of phasing of supply and the
or less of their basic allowances, a fact checking of unit shortages against
of which Hawley received no advance T/E allowances." Meador formed
warning. As each command tried to special teams to inspect all medical
remedy its own shortages, requisi- units designated for TORCH and de-
tions poured into the chief surgeon's termine exactly what they had and
office from a variety of sources. At what they needed. Because much matériel
one point the Supply Division was re-
56 57
Memo, Hawley to Larkin, 7 Sep 42, in Larkey Ltrs, Hawley to Col A. L. Hamblen, 26 Sep 42,
"Hist," ch. 4, app. 5 (see also ch. 4, pp. 4, 8, 11, and Hawley to TSG, 3 Nov 42, sub: Medical Supply;
and app. 7; and ch. 5, p. 35); Ltr. Hawley to Col J. Memo, Hawley to CO, 16th Medical Regt, 4 Nov 42,
F. Corby, MC, 6 Oct 42, box 2, Hawley Papers, sub: Requisition No. MR-114-3(F); and Ltr, Hawley
MHI; "Med Svc Hist, 1942-43," p. 53, HD 314.7-2 to Corby, 5 Nov 42. All in file 024 ETO CS (Hawley
ETO; Administration Division, OofCSurg, HQ Chron). See also Wiltse, ed., Medical Supply, pp.
ETOUSA, Annual Rpt, 1942, p. 6 204-05.
58 EUROPEAN THEATER OF OPERATIONS
from the British and no catalog of sembling a hospital, and no one even
Anglo-American equivalents and sub- knew what an assembled hospital
59
stitutes yet was available, Meador im- looked like."
provised his own. Through his efforts In the course of mounting TORCH
and those of others, the medical ser- the ETO medical service assembled
vice managed to outfit the units em- and shipped five station, three evacu-
barking for TORCH. Equipment for ation, one surgical, and two general
some organizations arrived in time hospitals. It completed the equipment
from the United States. For others, of all embarking organizations and
the medical service transferred arti- sent out twenty-two medical mainte-
cles from non-Torch units or used nance units. Hawley reported:
British supplies.58 "We . . . got the North Africa units
To assemble equipment for the out fully equipped and, in that show,
eleven hospitals dispatched from Brit- were probably the best of the ser-
ain to North Africa, the depot medical vices." The cost to the European
sections broke up most of the thirty- Theater, however, was substantial.
odd partial outfits that had arrived TORCH stripped the depots of sup-
from the United States and, where plies and left many medical units
necessary, added British matériel. short of equipment. Replenishment
Until TORCH preparations began, only was slow in coming, as the North Af-
the medical section of Depot G-45 at rican campaign received priority in
Thatcham had assembled hospitals. shipping. Viewing the aftermath,
As demands increased and time ran Hawley declared: "The mess that is
short, the Supply Division shifted left will take months to straighten
some assembly work to the other four out." His chief of Preventive Medi-
depot medical sections, which until cine, Colonel Gordon, observed that
then had only stored and issued sup- the theater "had much the appear-
plies. The short-handed, inexperi- ance of a plucked fowl. . . ." 60
enced staffs learned rapidly on the The shift of forces and attention to
job. A warrant officer at Depot G-35 North Africa reduced the European
in Bristol, tasked with putting togeth- Theater of Operations temporarily to
er a 1,000-bed general, a 750-bed a backwater and made uncertain the
evacuation, and a 250-bed station
hospital, recalled: "The only things I 59
WO(jg) Lewis H. Williams is quoted in Wiltse,
had to help me was one Basic Equip- ed., Medical Supply, p. 274. See Larkey "Hist," ch. 5,
ment List and a prayer. ... I pp. 35-37; Memo, Hawley to Lt Col C. E. Higbee,
SC, 9 Oct 42, file HD 024 ETO CS (Hawley Chron);
needed both of them, as no one in Ltr, Hawley to Tyng, 7 Nov 42, file HD 024 ETO
the Medical Section at that time had O/CS (Hawley-SGO Corresp).
60
any idea of the procedure used in as- First and second quotation from Ltrs, Hawley to
Tyng, 7 Nov 42, and Hawley to Hillman, 5 Feb 43,
file HD 024 ETO O/CS (Hawley-SGO Corresp).
58
Quotation from Memo, Hawley to CG, Third quotation from John E. Gordon, "History of
ETOUSA, 11 May 44, sub: Recommendation for the Preventive Medicine in the European Theater of
Award of the Legion of Merit, file HD 024 ETO CS Operations, USA, 1941-1945" (hereafter cited as
(Hawley Chron). See also Memos, Hawley to CofS, Gordon "Hist"), vol. 1, pt. 10, p. 10, CMH. See also
SOS, 14 Sep 42, and Hawley to Lee, 19 Sep 42, in "Med Svc Hist, 1942-43," pp. 57-58, file HD 314.
same file, and Wiltse, ed., Medical Supply, pp. 266- 7-2 ETO. For the general difficulties of TORCH
67. supply, see Ruppenthal, Logistical Support, 1:96-99.
FROM BOLERO TO TORCH 59
future of BOLERO. TORCH took out of improvisation that left the theater im-
England all but one combat unit, the poverished and temporarily outside
29th Division. The Eighth Air Force the mainstream of wartime events.
lost four fighter and two bombard- Yet in spite of these vicissitudes, the
ment groups, much equipment, and theater medical service succeeded in
25,000 officers and men. In all, over completing its basic organization and
150,000 troops left England for North implementing medical programs,
Africa. Total ETO strength, even with some with systemic problems. The
reinforcements from the United chief surgeon, with the cooperation of
States, dropped to 105,000 and would the British, organized a comprehen-
remain at that level until well into sive American hospital system and
1943. Monthly cargo deliveries de- saw construction begin, however halt-
clined from 240,000 long tons in Sep- ingly. U.S. Army hospitals, once in
tember 1942 to only 20,000 in Febru- operation, furnished medical care that
ary 1943. ETO headquarters and the the surgeon general described as
BOLERO Combined Committee sus- "adequate and in some instances su-
pended most of their buildup and perior." 62 The supply system still
cross-Channel assault planning. After needed to be overhauled. Supply
a year-end visit to medical installa- shortages remained severe, causing
tions in Great Britain, Surgeon Gen- the Allies to meet most medical
eral Magee observed: "One could not supply requirements from sources
escape the feeling that service there within the United Kingdom. In
represented a back-eddy since the mounting TORCH the ETO medical
61
opening of activities in Africa." service gained valuable, if often pain-
For the medical service, as for the ful, administrative and logistics expe-
rest of ETOUSA, 1942 proved to be a rience, readying it for continued
year of large plans and false starts, growth with the European Theater
culminating in a convulsive flurry of when the latter resumed its place as
61
the focal point of the American war
Memo, Magee to CG, SOS, 12 Jan 43, file HU: effort in the new year.
Experience in Medical Matters F/Overseas Force.
For the impact of TORCH on the European Theater,
see Harrison, Cross-Channel, pp. 46-47; Ruppenthal,
62
Logistical Support, 1:99-104, 110; and Craven and Memo, Magee to CG, SOS, 12 Jan 43, file HU:
Cate, eds., AAF, 2:50-52, 231-32, 235. Experience in Medical Matters F/Overseas Force.
CHAPTER III
Kenner, MC, SHAEF's chief medical installations and units and to investi-
officer, who took up his duties in gate and report on any aspect of the
London in February. Kenner, a Regu- medical service that he chose. The
lar Army medical officer and close ac- exact boundary between Kenner's
quaintance of Marshall, Eisenhower, sphere of interest and that of General
and Lt. Gen. George S. Patton, Jr., Hawley—and indeed the overall de-
had accompanied the latter to North marcation line between the activities
Africa in November 1942 as surgeon of the American staff of SHAEF and
of the Western Task Force. As the Af- the ETO staff—never was very clear.
11
000.71, CMH. For views of the Kenner-Hawley rela- in the U.S. Army before," he recalled,
tionship, see Spruit Interv, 1949, and Interv, OSG
with Col Alvin L. Gorby, MC, 10 Nov 49 (hereafter "and the concept of what the Group
cited as Gorby Interv, 1949), both in file HD Surgeon's office would do, and what
000.71, CMH; Interv, OSG with Col John K. Davis, its organization should be, we just
MC (hereafter cited as Davis Interv), 19 Jun 45, box
222, RG 112, NARA; and Interv, NLM with William had to pull it out of the air and set it
S. Middleton, July and November 1968, February in." Gorby decided early that his role
1969 (hereafter cited as Middleton Interv, 1968-69), would be analogous to that of a corps
vol. 1, p. 261, NLM. Ruppenthal, Logistical Support,
1:200-201, outlines the continuing SHAEF-ETO or division surgeon, "a tactical setup,
problem of staff jurisdiction. rather than administrative, and that
THEATER CHIEF SURGEON 67
tinct from command control through similar hospitals in the overseas thea-
15
command channels." 14 ters.
The most significant challenge to In the European Theater the Air
unified medical service in the Europe- Force expanded rapidly under the
an Theater was a theater-level mani- impact of the Casablanca decision to
festation of the worldwide Air Force intensify the bombing offensive
struggle for autonomy. In 1941 the against Germany. By mid-1944 AAF
newly formed Army Air Forces (AAF) strength in the United Kingdom had
headquarters had secured its own reached almost 427,000 officers and
medical division under Air Surgeon men of the Eighth (strategic) and
Lt. Col. David N. W. Grant, MC. Ninth (tactical) Air Forces and various
Grant was nominally subordinate to support and service commands, under
the surgeon general, but he waged a the overall control of Headquarters,
series of increasingly bitter bureau- United States Strategic Air Forces
cratic conflicts and gradually won ef- (USSTAF). Of these troops almost
13,000 were members of the Army
fective independence. To justify this Medical Department, headed by
drive for autonomy, Grant and his USSTAF surgeon, Brig. Gen. Mal-
colleagues argued that the unique colm C. Grow, MC.16
clinical and technical problems of From the early days of the buildup,
air warfare could be dealt with only when the Eighth Air Force, with Colo-
by a specialized aviation medical ser- nel Grow as surgeon, was the senior
vice. In 1943 the surgeon general dis- air headquarters in the theater, the air
agreed, insisting that treatment of air service waged a running battle with
crew casualties in most respects in-
15
volved the same medical and surgical For the general development of the AAF medi-
cal service, see Armfield, Organization and Administra-
practice as treatment of any other cas- tion, pp. 47-48 and 79-82, and Link and Coleman,
ualties. Step by step the air surgeon AAF Medical Support, passim. See also Ltr, TSG to
gained ground. By the end of the year Hawley, 7 Aug 43, file HD 024 ETO O/CS
(Hawley-SGO Corresp).
Grant, now a major general, con- 16
Air command arrangements were complicated
trolled what amounted to an inde- by the fact that the Combined Chiefs of Staff re-
tained direct control over the strategic bombing of-
pendent personnel procurement fensive until the final months before OVERLORD,
system and a separate supply service. while General Eisenhower, through SHAEF, con-
In the United States the Air Force trolled British and American tactical air. Hence,
USSTAF had both operational and administrative
had its own convalescent centers and control of the Eighth Air Force in England, oper-
station and general hospitals, and the ational control of the Fifteenth in the Mediterra-
nean, and administrative control of the Ninth,
air surgeon had begun pushing for formed in Britain early in 1944 to furnish tactical air
support to the American armies. Eisenhower had
operational control of the Ninth through the Allied
14
Quotation from Ltr, Hawley to TSG, 4 Dec 43, Expeditionary Air Forces, a division of SHAEF. For
file HD 024 ETO O/CS (Hawley-SGO Corresp). the air buildup and command relations, see Rup-
See also First U.S. Army Report of Operations, 20 penthal, Logistical Support, 1:192-93 and 202-03;
Oct 43-1 Aug 44, bk. I, pp. 13-15, and bk. VIII, an. Craven and Gates, eds., AAF, 2:639; and ibid., vol.
16 (Medical Section); Surg, Third U.S. Army, 3, Europe: ARGUMENT to V-E Day, January 1944 to May
Annual Rpt, 1944; Editorial Advisory Board, 1962, 1945 (1951), pp. 107-19. See also Link and Cole-
pp. 85-86. man, AAF Medical Support, pp. 558-59 and 580.
THEATER CHIEF SURGEON 69
SOS station and general hospitals conflict, see Ruppenthal, Logistical Support, 1:170-71;
were to treat all Air Force sick and Craven and Cates, eds., AAF, 1:648-49; Armfield,
Organization and Administration, pp. 331-32; and Link
wounded who required more than and Coleman, AAF Medical Support, pp. 555-71. On
short-term care. The Air Force was to rest homes and schools, see Ltrs, Hawley to Brig
have no hospitals of its own except Gen David N. W. Grant, 30 Mar 43, and Hawley to
TSG, 8 Jul 43, both in file HD 024 ETO O/CS
25-bed unit dispensaries. The Ser- (Hawley-SGO Corresp); Items 47 and 55, file HU
vices of Supply was to furnish all 312.3 (Corresp File, ETO Chief Surgeon). On the
medical supplies except items used dispensary fight, see file 320.2 ETO (T/O Medical
Dispensary). On supply, see Ltrs, Hawley to Tyng, 7
exclusively by air surgeons, which Oct 42, Hawley to G-4, SOS, 14 Oct 42, and 1st
would come from the United States End, Hawley to CG, SOS, 9 Nov 42, file HD 024
through Air Force channels. Grow ETO CS (Hawley Chron); see also Ltrs, Tyng to
Hawley, 18 Oct 42, Hawley to Tyng, 7 Nov 42, and
and his staff steadily undermined Hawley to TSG, 19 Aug, 9 Sep, and 14 Oct 43, file
these arrangements, taking advantage HD 024 ETO O/CS (Hawley-SGO Corresp). The
AAF in the United States had secured a supply of
of early SOS delays in hospital con- common medical items, held in its own depots, from
struction and slow supply deliveries which it filled Grow's requisitions.
70 EUROPEAN THEATER OF OPERATIONS
pp. 38-40. For an example of his pressure on a base ning" and for "administration and
section commander, see Ltr, Hawley to Brig Gen C. technical supervision of the medical
O. Thrasher, CG, Southern Base Section, 16 May
44, and Memo, Hawley to Lee, 16 May 44, both in
25
file HD 024 ETO CS (Hawley Chron). See also Personnel Division, OofCSurg, HQ ETOUSA,
MFR, OofCSurg, ETOUSA, 26 Jul 43, sub: Notes Annual Rpts, 1943 and 1944. For the gradual reso-
From the Chief Surgeon, file HD 024 ETO O/CS lution of the administrative personnel shortage, see
(Spruit Policy Notebook); Mins, 1st Meeting of Base January-December 1943 correspondence in file HD
Section Surgeons, 2 Aug 43, file HD 337; Ltr, Col 024 ETO O/CS (Hawley-SGO Corresp). The prob-
Liston to Col Abner Zehm, General Board, USFET, lems of the Supply Division are covered in Chapter
14 Aug 45. VI of this volume.
74 EUROPEAN THEATER OF OPERATIONS
ing of seventeen officers, six enlisted managing his "prima donnas." In mo-
men, and ten civilian employees.28 ments of crisis "he would first cajole
Kimbrough's immediate subordi- them. Then he would quote Shake-
nates were Chief Consultant in Sur- speare and then the Scripture. Finally
gery Col. Elliott C. Cutler and Chief he'd burst out into the vilest profanity
29
Consultant in Medicine Col. William you have ever heard."
S. Middleton. Arriving in the Europe- The consultants' primary task was
an Theater in mid-1942, both had to ensure uniformity and high quality
served in the Army Medical Depart- in theater surgical and medical prac-
ment in the previous war before at- tice, but General Hawley used them
taining civilian professional emi- for much more than that. He made
nence—Cutler as Moseley professor them his personal advisers, agents,
of surgery at Harvard and Middleton and inspectors and involved them in
as dean of the University of Wiscon- most aspects of ETO medical policy
sin Medical School. Each chief con- and administration. The Professional
sultant had under him a number of Services Division, Hawley declared,
senior consultants in particular surgi- "was an operating division. And prob-
cal or medical specialties. Cutler kept ably, except for the Operations and
most of his senior consultants on duty Training Division, was the really con-
in his own office, using them as a per- trolling division in the office." At the
sonal staff. Middleton, who thought consultants' first general meeting, in
October 1942, Hawley told them:
that consulting in most fields did not
require the full time of scarce experts, I expect advice from this group, not only
maintained only his dermatology and when I ask for it, but when any member
of this group thinks that I need it. ...
neuropsychiatry consultants at Chel- You people, within your specialties, are to
tenham. For other specialties he represent me and act with my complete
relied on general hospital chiefs of authority. . . . You have technical control
service assigned to additional duty. of the practice of your specialties in this
Regardless of how organized, the Theater. ... I do want you to correct
things I spot. . . . You have my complete
senior consultants, authorities in the authority to make corrections in technical
30
civilian profession and mostly new to procedures right on the spot. . . .
the Army, required careful handling.
29
Kimbrough, according to Middleton, Quotations from Middleton Interv, 1968-69,
had to employ "unusual talents" in vol. 1, pp. 195-96, NLM. See also ibid., pp. 197-98
and 228-30; Havens, ed., Medical Consultants, pp.
232-34; Carter, ed., Surgical Consultants, 2:5-9, 19-
28
Professional Services Division, OofCSurg, HQ 21, 28; Larkey "Hist," ch. 3, pp. 54-59.
30
ETOUSA, Annual Rpt, 1944. For the origins and First quotation from Hawley Interv, 1962, pp.
World War I background of the consultant system, 24-26, CMH. Second quotation from Verbatim
see W. Paul Havens, Jr., ed., Activities of Medical Con- Report of First Meeting of the Chief Surgeon's Con-
sultants, Medical Department, United States Army in sultants Committee, 16 Oct 42, in Professional Ser-
World War II (Washington, D.C.: Office of the Sur- vices Division, OofCSurg, HQ ETOUSA, Annual
geon General, Department of the Army, 1961), pp. Rpt. 1942. See also Carter, ed., Surgical Consultants,
1-4 and 231-32, and B. Noland Carter, ed., Activities 2:6-8, 13-14, 22; Ltrs, Hawley to Hillman, 5 Feb
of Surgical Consultants, Medical Department, United 43, and Hawley to TSG, 28 Sep and 14 Oct 43, file
States Army in World War II, 2 vols. (Washington, HD 024 ETO O/CS (Hawley-SGO Corresp). The
D.C.: Office of the Surgeon General, Department of position of the consultants in the European Theater
the Army, 1962-64), 2:1-5. For British consultants, contrasted sharply with that in the Pacific. See Arm-
see Crew, AMS, Administration, 1:136-45. field, Organization and Administration, pp. 421-23.
THEATER CHIEF SURGEON 77
The theater consultants involved the coordination and consolidation of
themselves in most aspects of the medical practice." 31
medical service. Colonel Cutler's sur- As the ETO medical service ex-
gical consultants, free of other duty, panded and the Services of Supply
were especially active. They visited delegated operating responsibility to
each arriving medical unit; evaluated the base sections, General Hawley es-
the professional qualifications of the tablished a system of base section
staff; and recommended to the Per- consultants in general surgery and
sonnel Division assignments and medicine. He also arranged for the
transfers, to make the best use of tal- appointment of regional and later
ents and to assure balanced strength hospital center or group consultants
in each hospital. Cutler and his staff in various special fields. Many of the
reviewed the medical supply tables, base section consultants were theater
eliminating superfluous or obsolete senior consultants on additional duty;
drugs and instruments, and put to- regional and center consultants usual-
gether a catalog of British and Ameri- ly were general hospital chiefs of ser-
can supply equivalents. Late in 1942 vice. These consultants, who worked
Cutler discovered severe deficiencies under the base section surgeons but
in division surgical equipment and sent copies of all reports to the Pro-
recommended supplementary issues, fessional Services Division, took on
all of which could be made with items much of the task of supervising clini-
obtainable in England. The consul- cal practice in their areas of responsi-
tants performed research on surgical bility. The base section consultants
problems and oversaw the develop- also evaluated unit personnel and
ment of specialized treatment facili- oversaw hospital operations and evau-
ties and convalescent rehabilitation cation. In addition to these SOS con-
programs. They supervised profes- sultants each field army headquarters
sional training in the hospitals and had consultants in surgery, medicine,
advised and assisted in general medi- and neuropsychiatry, often personally
cal unit training. They helped orga- selected by the army commander.
nize a theater blood collection and The higher AAF headquarters also
transfusion system, directed the intro- maintained its own group of consul-
duction of penicillin into ETO medi- tants.
32
The Professional Services Division In the two and a half years before
bound all these experts into a unified D-Day General Hawley established ef-
network (Chart 4). The division con- fective central control over the poten-
ducted weekly meetings for theater, tially fragmented ETO medical ser-
base section, army, and air force con- vice. His ascendency resulted in part
sultants, at which the participants ex- from the success of General Lee's ef-
changed information and reached forts to secure theater-wide logistics
consensus on professional matters. authority for the Services of Supply,
General Hawley held similar monthly but it also depended heavily on intan-
conferences with consultants from all gible personal elements. Longevity
commands. The chief surgeon en- worked in Hawley's favor. Having
couraged consultants at every level to been in England since late 1941,
deal directly with each other on Hawley knew the country and its
"purely professional" subjects, out- medical facilities better than any
side regular command and technical other senior American medical officer
except possibly Grow; he had un-
channels. Because "professional"
matched British official and profes-
matters were broadly defined in the sional contacts. Hawley worked hard
ETO medical service, and because ci- at his job. He kept thoroughly in-
vilian reputation lent great weight formed about even minor details of
among doctors to even informal sug- his service's operations, and he spent
gestions from the senior consultants, as much time as he could visiting
these experts constituted, in effect, a medical units and installations, espe-
separate medical line of communica- cially favoring unannounced descents
tions into every major headquarters. on hospitals. At the same time
According to Colonel Middleton, Hawley readily delegated responsibil-
"You could, in a period of minutes by ity to subordinates and won their firm
telephone . . . carry out any profes- personal loyalty even as he drove
sional policy. One did not have to them hard. His consultants, and
communicate through chains of mili- former members of his staff at other
tary command. . . . " The effect, Mid- headquarters, provided him with an
dleton noted, "was centripetal . . . informal communication network cov-
since General Hawley's office, ering most of the theater.34
through this medium, was constantly
in touch with all medical echelons of Professional Services Division, OofCSurg, HQ
the theater." 33 ETOUSA, Annual Rpts, 1943 and 1944.
34
On Hawley's grasp of detail, see file Hawley
Planning Directives, box 2, Hawley Papers, MHI,
ETOUSA, Annual Rpt, 1944, especially Chief Con- and Ltr, Hawley to Col Mack M. Green, MC, 11 May
sultant in Surgery and Medical Consultation Service 44, file HD 024 ETO CS (Hawley Chron). For an
sees.; Carter, ed., Surgical Consultants, 2:118-21; example of an officer who went from Hawley's staff
Havens, ed., Medical Consultants, pp. 238-39. Col. J. to SHAEF, see Davis Interv, 19 Jun 45, box 222, RG
B. Coates, in Editorial Advisory Board, 1962, pp. 112, NARA. For Hawley's effect on subordinates,
85-90, describes the personality problems attending see Middleton Interv, 1968-69, vol. 1, pp. 193-95,
General Patton's choice of a Third Army surgical NLM, and Interv, Medical History Branch, CMH,
consultant. with Brig Gen Sam F. Seeley, MC, 14 Aug 79 (here-
33
First quotation from Middleton Interv, 1968- after cited as Seeley Interv, 1979), sess. 2, cassette
69, vol. 1, pp. 197-98, NLM. Second quotation from 4, p. 2, HSF (Seeley-1979), Medics' War Ms, Acces-
Havens, ed., Medical Consultants, pp. 239-40. See also sion no. 319-88-055, RG 319, NARA.
THEATER CHIEF SURGEON 79
Always skilled in political maneu- more forceful administrator than his
ver, Hawley maintained profitable predecessor, Kirk gave Hawley all the
contacts with those above him in the support he could, although he noted:
chain of command. He kept on good "This office doesn't have much to say
terms with his imperious immediate about what happens in these theaters.
superior, General Lee. "We gave on We are told." Effective medical plan-
small things," he recalled, including ning and control depended in the end
agreement to Lee's pet project of on the theater chief surgeon. Hawley
using osteopaths in patient rehabilita- was equal to the task.35
tion, "and always won our point on 35
First and second quotations from copy of Ltr,
the large issues." Through corre- Hawley to Col E. C. Cutler, 5 Jun 46, Misc Notes-
spondence and a brief Washington ETO file, CMH. Third quotation from Ltr, TSG to
Hawley, 3 Dec 43, file HD 024 ETO O/CS (Hawley-
visit early in 1944, Hawley maintained SGO Corresp); in same file, see Ltrs, Hawley to
close ties to Surgeon General Kirk. A TSG, 4 Dec 43 and 20 Apr 44.
CHAPTER IV
tuted general hospital units for a change almost until D-Day, in re-
number of station hospitals requisi- sponse to alterations in troop deploy-
tioned for the theater. This change ment and to delays and difficulties in
entailed no major alteration in con- construction. As the head of the Hos-
struction because a British-built 834- pitalization Division, Col. Joseph R.
bed plant, with minor additions to Darnall, MC, put it, "The constant
wards and staff quarters, could ac- shuffling of work priorities, and of
commodate a 1,000-bed general hos- plans, made it necessary to build and
pital. To reduce his demands on rebuild our . . . program in a recur-
scarce British construction labor and ring administrative fog and on the
material, Hawley tried to secure exist- shifting sands of uncertainty." Never-
ing EMS buildings, but to no avail. theless, the broad outlines established
The Emergency Medical Services, in mid-1942 and reaffirmed in the
hard-pressed to support British inva- Fourth5 Key Plan remained generally
sion forces, insisted on retaining intact.
thousands of empty beds for possible Most of the over 100 plants eventu-
air raid casualties and offered only a ally built or acquired under this pro-
few hospitals large enough or well- gram represented a few standard
enough equipped for American use. It types. Commonest were the new 834-
also tendered blocks of beds in hospi- bed station and 1,084-bed general
tals it would continue to operate, but hospitals. Almost invariably consisting
these Hawley summarily rejected. of semicylindrical metal Nissen huts
Except in the direst emergencies, he on concrete foundations, each such
wanted only beds in plants entirely installation sprawled over up to fifty
under U.S. control.4 acres of ground, often in the park of
Reflecting these negotiations and a country estate where the bleak mili-
rearrangements, the Fourth Key Plan tary construction incongruously ad-
provided for 94,108 beds—14,896 of joined a medieval manor house or
them in former British and EMS hos- Georgian mansion. Convertible troop
pitals; 51,220 in newly constructed cantonments included British militia
plants, mostly 834- and 1,084-bed; camps and dual-purpose camps. The
and 27,992 in convertible troop militia camps consisted of hut bar-
camps. The exact number, location, racks arranged in spider-like clusters
and types of hospitals continued to radiating from a central core, as well
as operating rooms, laboratories, and
Ltrs, Hawley to Brig Gen H. McC. Snyder, 21 administration buildings constructed
4
Jul 43, and Hawley to TSG, 21 Jul 43, file HD 024 by the Ministry of Works on the
ETO O/CS (Hawley-SGO Corresp); correspondence parade grounds; the dual-purpose
in HospDivConstCorresp, 1942-43, file HD 600.1
ETO (Construction); Memos, Hospitalization Divi-
5
sion to Chief, Installations Branch, G-4, SOS, 24 Quotation from Joseph R. Darnall, "Hospitaliza-
May 43, and Hospitalization Division to DepCSurg, tion in the European Theater of Operations, U.S.
14 Oct 43, Hospitalization Division O/CS General Army, World War II," The Military Surgeon 103 (De-
Correspondence file, 1943 (hereafter cited as Hosp- cember 1948): 427-28. Colonel Darnall, a Regular
DivGenCorresp, 1943), file HD 312 ETO; Hospitali- Army medical officer since 1919, relieved Col. Eli E.
zation Division, OofCSurg, HQ ETOUSA, Annual Brown as head of the Hospitalization Division on 1
Rpt, 1943, p. 3; Larkey "Hist," ch. 2, pp. 50-51, July 1943. The Fourth Key Plan is reproduced in
and ch. 7, p. 20. Larkey "Hist," ch. 2, pp. 49-50.
HOSPITALIZATION AND EVACUATION 83
tals, complete with patients and however, leaving many new plants
equipment, by gradual infiltration. with bare floors of poor-quality con-
U.S. doctors and nurses, a few at a crete, which the British contractors
time, relieved British counterparts; had put in in anticipation of another
the soldiers being treated remained, covering being laid on top of it.
under American care, until recovery Often rough and not level, these
and discharge. New EMS plants, al- floors crumbled under foot, creating
though usually empty of staff and pa- large amounts of dust. They were im-
tients, required complicated turnover possible to keep clean, and the irreg-
transactions, because the Emergency ular surfaces damaged delicate equip-
Medical Services legally handed the ment that was wheeled over them.
facilities over, not to the Americans, Hawley pressed the British hard for
but to the War Office. The latter, as suitable floor coverings. After unsuc-
an EMS tenant, then in effect sublet cessful experiments with various coat-
the plants to the U.S. Army. Three ings, the Ministry of Works settled on
ministries—Health, Works, and the pitch mastic, a synthetic black materi-
War Office—provided portions of the al, spread in liquid form, which con-
furnishings and equipment, creating gealed into a hard, smooth, waxable
bewildering accountability require- surface. While adequate, floors of this
ments.11 substance showed every scratch and
In spite of these elaborate turnover dust particle, softened around hot
procedures, defects in design and stoves, and would not support heavy
workmanship in many of the hastily furniture unless it had wide pads
built hospitals annoyed staffs; hin- under each leg. American doctors and
dered operations; and required ex- nurses learned to live with pitch
pensive, time-consuming corrections. mastic floors but not to like them.12
Many hospital units had to repaint Still other defects appeared. The
poorly painted buildings. Most had to new EMS hospital at Odstock, near
use their own personnel to complete Salisbury, one of the first turned
roofs over outside walkways. Floors over, had "tremendous difficulties"
were a perpetual source of irritation. with roof leaks and water seepage.
The Allies initially had planned to The 5th General Hospital, which
cover all hospital floors with linoleum moved from Belfast to Odstock in late
to ensure a hard, smooth, easily 1942, found that the facility had nei-
cleaned surface—required both for ther heat nor running electricity and
good appearance and proper sanita- 12
Hawley Operational Directives No. 16, 29 Jun
tion. Linoleum was in short supply, 43, and No. 32, 6 Aug 43, box 2; Ltr, Hawley to
Surg, Southern Base Section, 20 Sep 42, and Memo,
11
Memo, Brown to CSurg, SOS, 22 May 43, sub: Hawley to CEngr, SOS, 24 Jul 43, sub: Effects of
Current Policies and Procedures of the Hospitaliza- Poor Walks in New Hospital Construction, box 3.
tion Division, in Hospitalization Division, OofCSurg, All in Hawley Papers, MHI. HospDivGenCorresp,
HQ ETOUSA, Annual Rpt, 1943. For an example 1943, file HD 312 ETO, contains exhaustive cover-
of takeover arrangements, see Memo, Brown to Op- age of floor and other problems. See also Darnall,
erations and Training Division, OofCSurg, 12 Feb "Sidelights," p. 22; Hawley Interv, 1962, p. 31,
43, HospDivGenCorresp, 1943, file HD 312 ETO. CMH; Col Lee D. Cady, MC, USAR, "Notes on the
Crew, AMS, Administration, 1:406-07, gives the Brit- 21st General Hospital (AUS)," p. 570, Lee D. Cady
ish view of hospital turnovers. Papers, MHI.
88 EUROPEAN THEATER OF OPERATIONS
Abandoning his earlier opposition units) made room for up to 1,300 pa-
17
to fixed hospitals under canvas, tients.
Hawley directed the addition of On 6 June 1944, as a result of this
tented expansion wards to most sta- accelerated effort, the European The-
tion and general hospitals. The chief ater of Operations had over 84,000
surgeon had begun planning for this fixed hospital beds ready to receive
measure as early as July 1943, survey- patients, only 26,000 of them in use.
ing each hospital to find out how These beds included about 59,000 in
many beds over its table-of-organiza- regular BOLERO installations plus the
tion (T/O) capacity it could add with- 25,000 in tented expansions. The first
out overtaxing its operating rooms, militia, conversion, and dual-purpose
messes, and lavatories. The tents, camps became available for occupan-
preferably erected at the rear of each cy in mid-May, with the rest following
hut ward, were to have concrete in June and July. With these, and the
floors, stoves, and insulation against gradual completion of other planned
winter cold. To protect the overall installations, Generals Kenner and
BOLERO program, Hawley secured Hawley could count on having
British concurrence that such enlarge- enough hospital space for the casual-
ments were a supplement to—not a ties of each stage of the projected
replacement for—the planned beds in campaign. Although by a narrow
semipermanent buildings. Construc- margin, the BOLERO hospital con-
tion of the tented additions began in struction program had reached its
December and continued through the goal.18
eve of the invasion, with the British
War Office and the U.S. Army Engi-
neers furnishing material and the hos- 17
Larkey "Hist," ch. 7, pp. 25 and 27-29; Hospi-
pitals providing labor. Despite delays talization Division, OofCSurg, HQ ETOUSA,
Annual Rpt, 1944, pp. 5-6; Ltr, Hawley to TSG, 13
in securing British consent for the Dec 43, HD 024 ETO O/CS (Hawley-SGO Cor-
necessary grading at the sites and the resp); Ltrs, Hawley to Base Section Surgs, 5 Jan 44,
sub: Preparation for Expansion of Hospitals, and
slow arrival of supplies, hospital units Hawley to CO, Eastern Base Section, 23 Feb 44,
put almost 25,000 expansion beds HD 024 ETO CS (Hawley Chron); Memo, McNinch
into operation before D-Day, in an- to Base Section Cdrs, 6 Jul 43, sub: Expansion of
Existing Hospitals, and Ltr, McNinch to Surgs, East-
nexes to hutted wards and in three ern, Western, and Southern Base Sections, 2 Dec
complete tented 750-bed station hos- 43. sub: Preparation for Tented Expansion, both in
HospDivGenCorresp, 1943, file HD 312 ETO; Mins,
pitals. By this means, most 1,084-bed 16th, 17th, 18th, 20th, and 22d Meetings of Base
general hospitals in the United King- Section Surgeons, respectively 28 Feb, 13 Mar, 27
dom increased their capacity to be- Mar, 24 Apr, and 22 May 44, file HD 337.
18
Larkey "Hist," ch. 7, pp. 27-29; Memo, Kenner
tween 1,100 and 1,500 beds; many to ACofS, G-4, SHAEF, 5 Jun 44, in Medical Divi-
834-bed station hospitals (often occu- sion, COSSAC/SHAEF, War Diary, June 1944;
Mins, 23d Meeting of Base Section Surgeons, 5 Jun
pied by 1,000-bed general hospital 44. pp. 1-2 and 4, file HD 337. In addition to these
fixed beds, large numbers of beds in tactical units
and 19th Meeting of Base Section Surgeons, 10 Apr were available as transit, holding, and other special-
44, p. 1, file HD 337; Surg, Western Base Section, purpose hospitals. See Chapter VI of this volume
Rpt, 1 Jan-31 Aug 44, p. 10. for details of their activities.
HOSPITALIZATION AND EVACUATION 91
TENTED EXPANSION WARDS. Note the adjoining Nissen hut (far left).
phasized the minutia of military cour- a real surgeon at the bedside of the
tesy and appearance. To hospital patient." Cutler's medical counter-
staffs, especially veteran ones from part, Colonel Middleton, declared
the Mediterranean Theater, the fre- that he "made medical rounds each
quent inspections and many spit-and- time I went into a hospital and that
polish requirements seemed like was with my stethoscope and not with
"unnecessary show and 'play-war' the white gloves and towel. So that I
procedures." Medical people search- knew what medicine was doing." Sup-
ing in haste for shined shoes, with an plementing the efforts of his con-
inspector at the gate, coined a new sultants, General Hawley kept in close
name for the ETO: "European Thea- touch with hospital operations
19
ter of Inspections." through informal contacts, as well as
To regulate medical and surgical his own often unannounced visits,
practice, the Professional Services Di- and through reports. He exhorted,
vision drafted and enforced directives and occasionally threatened, his base
on treatment procedures and on the
section surgeons and individual hos-
use of drugs and surgical techniques.
Its network of senior, base section,
pital commanders in an effort to en-
and regional consultants, besides ad- force his principle that "there is noth-
vising hospital staffs on particular ing satisfactory in a hospital here
20
cases, also supervised the general except 'superior.'"
conduct of their specialties and saw to To simplify control of the largest
it that deficiencies were corrected. geographical clusters of general hos-
Colonel Cutler, the chief surgical con- pitals, the chief surgeon in 1944 ac-
sultant, enjoined his base section sur- tivated three hospital centers (Map 3).
gical consultants to "keep familiar These were regular T/O medical
with the level of professional work units, 21 each designed to coordinate
... at all hospitals in your base sec- and assist the work of a variable
tion. This means constant personal number of general hospitals. Two of
visits. Written directions . . . can these units, the 12th and 15th Hospi-
never take the part of the influence of tal Centers, arrived in Britain during
March. General Hawley in early June
19
The base section surgeons actually did the in-
20
specting, using men trained by the Hospitalization Cutler quotation from Professional Services Di-
Division and working under its guidelines. See Dar- vision, OofCSurg, HQ ETOUSA, Annual Rpt,
nall, "Hospitalization," p. 431; Hospitalization Divi- 1944, Chief Consultant in Surgery sec., pp. 1-2.
sion, OofCSurg, HQ ETOUSA, Annual Rpts, 1943, Middleton quotation from Middleton Interv, 1968-
pp. 1 and 14-17, and 1944, pp. 1-2; Cir Ltr No. 80, 69, vol. 2, p. 209, NLM. Hawley's remark from
OofCSurg, HQ ETOUSA, 10 Jun 44, sub: Policies Mins, 21st Meeting of Base Section Surgeons, 8 May
and Procedures Governing Care of Patients in ETO, 44, p. 10, file HD 337. See also Professional Ser-
ex. M, which digests earlier policy directives; Ltrs, vices Division, OofCSurg, ETOUSA, Annual
McNinch to Surgs, Eastern, Western, and Southern Rpt, 1943. General Hawley's relationship to his hos-
Base Sections, 6 Sep 43, sub: Inspection Reports of pitals can be followed in file HD 024 ETO CS
Fixed Hospitals and General Dispensaries, and (Hawley Chron), file HD 024 ETO O/CS (Hawley-
McNinch to Surg, Western Base Section, 22 Sep 43, SGO Corresp), file HD 024 ETHQ O/CS (Spruit
same sub, HospDivGenCorresp, 1943, file HD 312 Policy Notebook), and Hawley Operational and
ETO. For complaints about spit-and-polish, see Max Planning Directives, box 2, Hawley Papers, MHI.
21
S. Alien, ed., Medicine Under Canvas: A War Journal of Each included some 30 medical officers and 230
the 77th Evacuation Hospital (Kansas City, Mo., 1949), enlisted men in a headquarters and service compa-
pp. 96-97. Quotation from latter source. ny, a convalescent camp, and a laboratory.
94 EUROPEAN THEATER OF OPERATIONS
activated a third, the 6810th Hospital could draw, thereby eliminating the
Center (Provisional), from personnel need for the individual hospital to
in the theater. The 12th and 15th deal with base sections and SOS
Hospital Centers established them- depots. Center receiving and evacu-
selves respectively at Great Malvern ation officers would oversee all move-
and Cirencester in the Western Base ment of patients into and out of the
Section, to control the hospitals, clus- attached hospitals, as well as select
tered around those two places. The patients for evacuation to the United
6810th set up at Whitchurch, also in States. Center commanders would
western Britain, the center of a third monitor professional activities in their
group of general hospitals. hospitals, and they could designate
At the outset the exact functions of hospitals to specialize in particular
these centers were uncertain. Hospital types of cases. Beyond these pre-
centers had existed in the American scribed functions, Hawley's directive
Expeditionary Forces in World War I, encouraged center commanders to
but few ETO medical officers had had adopt any expedient for pooling hos-
any experience with their operations. pital resources and for freeing the op-
The table of organization provided erating units from administrative
only that each center was to coordi- chores. Hospital centers constituted
nate hospital administration and to an intermediate headquarters between
establish a supply depot and convales- the base section and the individual
cent camp. When the 12th and 15th hospital. Hawley told base section
Hospital Centers began setting up in surgeons: "You can use these center
May, after a period of orientation, commanders and it will cut down
they found no plans or standard oper- your work." 22
ating procedures (SOP) to guide By mid-June the 12th and 15th
them. Col. Asa M. Lehman, MC, the Hospital Centers each had seven gen-
12th Hospital Center commander, eral hospitals attached, and each
drafted an SOP of his own, which center controlled (with tented expan-
General Hawley adopted and pub- sion of many plants) about 9,500
lished on 5 May as an SOS directive. beds. For the most part, the centers
Under this directive a hospital center performed the administration, supply,
would "act as Headquarters for a and evacuation functions specified in
group of general hospitals; to corre- the 5 May directive. Center com-
late and coordinate their activities, to manders tried to keep out of the in-
relieve them insofar as possible from ternal administration and practices of
administrative details and supply their hospitals, playing the role of
problems; to supervise evacuation and helpers rather than inspectors, but
reception of patients[;] and by fre- 22
quent inspections, [to] aid and assist First quotation from Admin Memo No. 63,
OofCSurg, HQ ETOUSA, 5 May 44, sub: Oper-
them in maintaining the highest pos- ation of Hospital Centers, ETO, in Hospitalization
sible degree of professional, adminis- Division, OofCSurg, HQ ETOUSA, Annual Rpt,
trative and training excellence." Each 1944. Second quotation from Mins, 21st Meeting of
Base Section Surgeons, 8 May 44, pp. 3-4, file HD
center would maintain a central 337. See also 12th and 15th Hospital Centers
supply depot upon which its hospitals Annual Rpts, 1944.
HOSPITALIZATION AND EVACUATION 95
they gradually established many uni- cases of particular types from other
form procedures. They also became hospitals. The 36th Station Hospital
involved in efforts to balance profes- at Exeter, for example, became the
sional staffs. According to Colonel theater's treatment center of psychot-
Lehman of the 12th, most of his gen- ics and men with other noncombat-
eral hospitals displayed a "tendency related mental disorders; the 5th
toward internal specialization." One General Hospital, in addition to its
hospital "might have a surplus of ca-
pable surgeons, but be entirely want- normal functions, established special
ing of an officer . . . competent . . . facilities for care of soldiers suffering
as chief of medical service. In con- from combat fatigue. Other general
trast, another hospital would be over- hospitals set up facilities for burns
staffed with exceptional medical and cold injury. Under an arrange-
service personnel, the surplus being ment with the ETO medical service, a
used in positions for which they had British facility, Saint Dunstan's Insti-
no special qualifications." To build tute for the Blind, began the retrain-
up weak services, Lehman transferred ing and rehabilitation process for
doctors temporarily between hospi- American servicemen who had lost
tals; he arranged with the base sec- their sight prior to evacuation to the
tions and the chief surgeon's office United States. In 1944 each hospital
for permanent reassignments if the center arranged to concentrate burn
changes proved beneficial. The center
treatment, neurosurgery, and thorac-
headquarters soon found that they
needed less than one-third of their as- ic, urological, plastic, and maxillofa-
signed personnel for administration; cial surgery at one or two of its at-
they used their extra medical and tached hospitals. At the same time
dental officers to reinforce hospital General Hawley, on the advice of his
staffs and their extra enlisted men to senior consultants, designated nine
aid in patient rehabilitation. Even hospitals not attached to centers as
before the invasion, hospital centers specialized neurosurgical facilities and
were proving effective in simplifying seven hospitals for plastic and maxil-
control over the many plants. Their lofacial surgery and burns. Station
value in coordinating evacuation and general hospitals were to transfer
would become apparent as soon as to these installations any patient
trainloads of wounded from France whose condition, in the hospital com-
began moving inland from the Chan- mander's judgment, required unusu-
23
nel ports. ally complicated or lengthy treatment.
A network of specialized hospitals
took shape. During 1943 General Specialized-care hospitals made effi-
Hawley designated certain general cient use of scarce medical and sur-
and station hospitals to receive severe gical talent and eased the burden of
difficult cases upon general-care hos-
Quotations from 12th Hospital Center Annual pitals. The consultants, however, con-
23
Rpt, 1944, p. 29 (see pp. 1, 27-32, 40). See also stantly had to combat the tendency of
15th Hospital Center Annual Rpt, 1944; Interv,
OSG with Maj Oliver J. Irish, SC, 13 Oct 44, box hospital commanders to treat those
220, RG 112, NARA. patients who would fare better if dis-
96 EUROPEAN THEATER OF OPERATIONS
reinforced and equipped station hos- The 700-square mile London met-
pitals, which treated Eighth Air Force ropolitan area, organized in April
sick and wounded, to retain men for 1943 as the Central Base Section,
180 days—in effect to function as posed special hospitalization and
29
general hospitals. evacuation problems with its numer-
During 1942, with few U.S. hospi- ous headquarters and service units,
tals in operation, ETO units often many of which lacked organic medical
evacuated sick and injured troops to personnel, and with its constantly
nearby British Army, Royal Navy, large transient population of soldiers
Royal Air Force, or EMS institutions, on leave or temporary assignment.
in that order of preference. These During 1943 and 1944 two general
British hospitals treated Americans dispensaries—the 7th and 10th—pro-
under agreements made early in 1942 vided outpatient care for casuals and
by Major Welsh and reconfirmed by people from units lacking medical de-
Hawley. The sending of American pa- tachments and dispensaries. The gen-
tients to Allied hospitals gradually eral and unit dispensaries evacuated
ceased during 1943, as more U.S. all enlisted men who needed hospital
treatment directly to the 1st General
Army facilities opened. Periodically,
Hospital at North Minims, an hour
the Office of the Chief Surgeon in-
away from London by ambulance. Of-
formed base section surgeons how ficer patients went from the dispen-
many Americans were in British hos- saries to the 16th Station Hospital, a
pitals in their areas and directed 150-bed unit installed in a former
transfer of these men, as soon as their British civilian plant and reinforced
condition allowed, to U.S. Army in- with extra staff and equipment to
30
stallations. make it a "show-place" for its pa-
29
tients, many of whom were of high
Admin Order No. 1, HQ SOS, August 1942,
an. E, file ETO 700.1 (MiscMedSvc); Memo, Lt Col rank. The 16th evacuated officers
G. D. Newton to CSurg, SOS, ETO, 9 Dec 42, sub: needing long-term or specialized care
Policies Affecting Hospitalization, file HD 312 to the 91st General Hospital at
(HospDivChronCorresp, 1942); Ltr, Hawley to TSG,
29 Apr 42, file HD 024 ETO O/CS (Hawley-SGO Oxford, a three-hour ambulance ride
Corresp); Cir Ltr No. 70, OofCSurg, HQ ETOUSA, from the capital.31
15 May 44. For examples of overlapping hospital During late 1942 and early 1943
functions, see 5th General Hospital Annual Rpt,
1944, p. 2; 168th Station Hospital Annual Rpt, the ETO medical service temporarily
1944, p. 4; Interv, OSG with Maj Ralph Soto-Hall, formed part of the evacuation chain
MC, 30th General Hospital, 24 Apr 44, box 219, from North Africa. Under the TORCH
RG 112, NARA.
Memo, Brown to Surgs of All Units . . . , 26 plan patients from the Western Task
30
Jul 42, sub: Tentative Instructions Regarding Hospi- Force in Morocco went directly back
talization of U.S. Forces in Great Britain, in Hospi- to the United States on returning
talization Division, OofCSurg, HQ ETOUSA,
Annual Rpt, 1942. For examples of transfer direc- transports. The Central and Eastern
tives, see Ltrs, Brown to Surg, Southern Base Sec- Task Forces, in the first stages of the
tion, copy to Surg, Eastern Base Section, 25 Jan 43,
and Brown to Surgs, Eastern and Southern Base
campaign, evacuated their sick and
Sections, 10 Mar 43, sub: Hospitalization in Other
31
Than U.S. Hospitals, in HospDivGenCorresp, 1943, Surg, Central Base Section, History of Medical
file HD 312 ETO. Section, January-July 1944.
100 EUROPEAN THEATER OF OPERATIONS
wounded, American and British alike, the American Army with many of its
to the United Kingdom in British hos- ambulances. In June 1942 they turned
pital ships. Under an agreement be- over to the chief surgeon 600 four-
tween General Hawley and the War litter Austins for issue to his units and
Office to divide the labor of unload- hospitals. These two-wheel-drive vehi-
ing these vessels, American Army cles were well suited to the road
medical units handled casualties of travel involved in most evacuation
both nations at the Bristol Channel within the United Kingdom. Their
ports. Between 17 December 1942 availability permitted Hawley to rede-
and 8 April 1943 Company C, 53d ploy his relatively scarce four-wheel-
Medical Battalion, working under the drive U.S. Dodge ambulances, de-
supervision of the Bristol port sur- signed for cross-country work, at
geon, discharged seven hospital ships hospitals and depots to equip units
from North Africa at Avonmouth. going into the field and also at air
The company moved over 2,100 casu- stations for removing wounded from
alties, about 660 of them Americans, aircraft that crashed in the vicinity of
to the nearby 298th General Hospital the airfields. The supply of American-
for triage and initial treatment. The built ambulances expanded rapidly, as
British Army then collected its troops organizations brought their allow-
from the 298th for evacuation to its ances with them and the War Depart-
own as well as EMS hospitals. Ameri- ment shipped extra ambulances, as
can casualties ceased arriving from well as other vehicles, to outfit later-
the Mediterranean in early April, as arriving units and to replace combat
NATOUSA fixed hospitals went into losses. With this inflow from the
operation. American medical units United States and the Austins sup-
continued to unload British hospital plied by the British, the theater
ships at Bristol, however, and the maintained a comfortable ambulance
298th treated those few disembarked surplus at all times and by D-Day had
patients who could not be moved im- accumulated a reserve of over
32
mediately to Allied facilities. 1,200.
33
General Hawley's office had re- Besides the small Austin ambu-
sponsibility for securing the means of lances, the British supplied the Amer-
evacuation by road and rail. In this, as icans with passenger buses converted
in so many other areas of BOLERO for carrying patients. The Emergency
preparations, the Americans initially Medical Services, anticipating a need
had to depend heavily on the British. to move many casualties quickly
The British, for example, provided during air raids, had refitted 300
32
The British Army similarly unloaded patients at
London Green Line commuter buses
Clyde and Merseyside ports. See Operations and
33
Training Division, OofCSurg, HQ ETOUSA, Troop Movements and Training Branch, Oper-
Annual Rpt, 1942; Evacuation Division, Oof C Surg, ations Division, OofCSurg, HQ ETOUSA, Annual
HQ ETOUSA, Annual Rpt, 1943; "Med Svc Hist, Rpt, 1944, p. 43; Memo, Hawley to AG, SOS, via
1942-43," pp. 19-20 and 107, file HD 314.7-2 G-4, 7 Nov 42, sub: Exchange of Field Ambulances
ETO. For termination of U.S. evacuation to Great for British-Made Ambulances, file HD ETO 451.8
Britain, see messages in Evacuation From Europe (Amb), 1942-44. See also other correspondence in
and North Africa file, CMH. same file.
HOSPITALIZATION AND EVACUATION 101
Until well after D-Day, the European Those hospital ships, however, did
Theater and the War Department dis- not exist in mid-1942 and were still
agreed on whether mentally ill pa- lacking two years later, due to vacil-
tients requiring restraint and nonam- lating War Department policy. In
bulatory cases should be evacuated on June 1942, after an Army-Navy dis-
39
returning troopships. In contrast to pute over how many hospital ships
specially designed hospital ships, should be obtained and which service
which were protected by the Geneva should build and operate them, the
and Hague Conventions, troop trans- Joint Chiefs of Staff decided to pro-
ports were legitimate targets for cure only three Army hospital ships,
U-boats. For this reason, General none for the European Theater. At
Hawley insisted from the start of the same time the Joint Chiefs,
BOLERO planning that "no officer or
through General Somervell, instruct-
soldier who is unable to care for him-
self in the event of enemy attack upon ed ETOUSA and the other theaters to
the vessel in which he is a passenger, evacuate their sick and wounded
be evacuated on any but a plainly whenever possible on returning trans-
marked and regularly operated hospi- ports. The transports would be
tal ship." The theater adopted this equipped with beds for mental and
principle as official policy in June nonambulatory patients up to 5 per-
1942. At the same time the London cent of their passenger capacity and
Combined Committee endorsed Haw- for ambulatory patients up to 20 per-
ley's request for ten U.S. hospital cent, as well as with surgical, labora-
ships for the European Theater.
40
tory, pharmacy, and other supporting
facilities, and the ports of embarka-
file HD 312 ETO. At this time, in its first effort to tion would furnish hospital ship pla-
set an official evacuation policy for each theater, the toons to reinforce the transports' own
War Department, with the surgeon general's assent,
authorized 120 days for all theaters but the ETO medical complements. This policy
and the Pacific, both of which were allowed 180 prevailed for less than a year. As the
days. See Smith, Hospitalization and Evacuation, pp. general shipping shortage eased, and
215-16. The ETO rationale is summarized in
Memo, Lt Col R. P. Fisk, to CG, ASF, 5 Jul 43, sub: in response to pleas from the surgeon
Evacuation Policy for Overseas Commands, file 008 general and the theaters, the Joint
(Policy re Evac for Overseas Cmds).
39
The Army Service Forces in August 1942 estab-
Chiefs on 11 June 1943 reversed
lished four patient classes for evacuation: Class I themselves and ordered evacuation of
(mental patients requiring locked wards or other re- nonambulatory men on hospital ships.
straints); Class II (bed patients who could not move
about or care for themselves); Class III (ambulatory The Chiefs now authorized the Army
but requiring much medical and nursing care, e.g. to develop its own fleet of twenty-
the blind, amputees, men with heavy casts, and pa- four such craft, most of them convert-
tients needing special diets); and Class IV (ambula-
tory patients needing minimal medical attention and ed from other passenger and cargo
able to travel in ordinary troop accommodations). types. Refitting of the vessels went
See Smith, Hospitalization and Evacuation, pp. 331-32. slowly so that the first U.S. Army hos-
40
Quotation from Larkey "Hist," ch. 2, pp. 52-
54. See also Ltr, Hawley to TSG, 25 Apr 42, sub:
Hospital Ships, file HD 024 ETO O/CS (Hawley- thorities emphasized that hospital ships also could
SGO Corresp); Msgs, Lee to AGWAR, 11 Aug 42, carry medical supplies and personnel outbound
and ETO to AGWAR, 16 Aug 42, Evacuation From from the U.S. without violating international con-
Europe and North Africa file, CMH. The ETO au- ventions.
HOSPITALIZATION AND EVACUATION 105
arriving in the theater and took over more planes and aviation medical
this task. Ten of these units had people available. It also had improved
45
reached Britain by D-Day. its equipment; a new stretcher bracket
During the first year and a half of for cargo aircraft, for example, in-
the buildup very few sick and wound- creased the carrying capacity of the
ed were evacuated by plane. The War C-54 from 10 litter patients to 18. In
Department, in its air evacuation in- March 1944, as part of the final inva-
structions of September 1942, en- sion preparations, the command
joined that requests be kept to a mini- began enlarging medical facilities at
mum, and the ETO medical service intermediate stations on its transat-
complied. Furthermore, the Air lantic routes, a necessary preliminary
Transport Command, primarily con- to mass patient movements. The fol-
cerned with carrying troops and sup- lowing month gave the theaters more
plies, gave medical evacuees a low latitude in establishing priorities for
priority, and the European Theater loading U.S.-bound flights. In May
had a constant backlog of higher-pri-
the European Wing, Air Transport
ority westbound passengers. Up to
the end of 1943 only 116 patients, Command, began making long-term
many of them ambulatory convales- commitments to the ETO medical
cents, left the United Kingdom by service of space for air evacuation, al-
air.46 lowing more ambitious planning by
Air evacuation expanded in scale the chief surgeon. About 1,600 pa-
and increased in tempo in early 1944. tients left England by plane between
By this time aircraft had proved their 1 January and 31 May. The Evacu-
worth in carrying patients in the Med- ation Branch looked forward to flying
iterranean and Pacific, both for bring- out 6,000 to 10,000 casualties each
ing casualties the benefits of early month after the campaign began.47
care and for reducing the number of As air evacuation expanded, the
medical personnel needed to attend geographical defects of Prestwick, for
them in transit. In the European The- medical purposes, became apparent.
ater the Air Transport Command had The ATC terminal was located far
from most general and station hospi-
45
For the general development of air evacuation, tals and had no facilities to house and
see Smith, Hospitalization and Evacuation, pp. 337-40; care for patients awaiting planes. In
Link and Coleman, AAF Medical Support, pp. 384-90.
See also Msg, AGWAR to USSOS, ETO, 26 Sep 42; mid-1943 the medical service ac-
Air Priorities Instruction No. 4 (source of quota- quired the 750-bed Cowglen Hospi-
tion), Air Priorities Division, HQ, Air Transport tal, an EMS facility in Glasgow, and
Command, AAF, 26 Feb 43; Memo, 1st Lt D. J.
Twohig, MC, to Medical Field Service School, installed there the 2d Evacuation
American School Center, 21 Apr 43, sub: Air Evacu- Hospital, later replaced by the 50th
ation; Memo, Fisk to CG, SOS, ETOUSA, 13 Sep General Hospital, to operate an air
43, sub: Delegation of Authority To Authorize Pa-
tients To Travel by Air. All in Evacuation Branch,
Operations Division, O/CS file on Air Evacuation Link and Coleman, AAF Medical Support, pp.
47
(hereafter cited as AirEvacCorresp), file HD 580 391-95; Evacuation Branch, Operations Division,
ETO. OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, pp.
46
Operations and Training Division, OofCSurg, 14-15 and encl. 11; Evacuation Branch, Operations
HQ, ETOUSA, Annual Rpt, 1942; "Med Svc Hist, Division, OofCSurg, HQ, ETOUSA, Daily Diary, 16
1942-43," pp. 19-20, file HD 314.7-2 ETO. May 44, file HD 024 ETO.
108 EUROPEAN THEATER OF OPERATIONS
Medics in Britain
During the BOLERO buildup U.S. ditions. Still, they resided among hos-
Army medics in the United Kingdom pitable people who spoke more or
lived and worked on the margin be- less the same language; they could
1
tween war and peace. Food ration- enjoy the society of British profes-
ing, blackouts, occasional air raids, sional counterparts; and they had
and the arrival of wounded men from access to a wide range of amuse-
Eighth Air Force fields reminded ments, wholesome and otherwise. 2
them that they were at war, as did the ETO medics also had work to do.
constantly expanding number of Besides completing their hospitaliza-
American troops, the invasion prep- tion and evacuation system, they con-
arations, and the growing tension as ducted their own portion of the
D-Day approached. Yet embattled BOLERO personnel buildup. They fur-
Great Britain still offered many of the nished day-to-day medical service to
amenities of urban-industrial civiliza- the growing American Army in the
tion, and in areas outside the blitzed United Kingdom. They conducted
cities war at times could seem far militarily and scientifically significant
away. Colonel Middleton, the theater research, exchanged information and
chief medical consultant, lived in a ideas with British colleagues, trained
room in a small Cheltenham hotel for their wartime missions, and
that overlooked a garden, "always sought to preserve the health of the
well kept up even during war ... as fighting forces.
a British garden would be." He and
his colleagues, in their infrequent
spare time, attended concerts in the 2
Quotation from Middleton Interv, 1968-69, vol.
nearby town hall and took weekend 1, pp. 201-04, NLM. For recollections of the experi-
walks in the Cotswolds. Lower-rank- ence of other medics, see Interv, Medical History
ing officers and enlisted medics Branch, CMH, with Col Virginia Brown, ANC, 5 and
13 Jul 79 (hereafter cited as Brown Interv, 1979),
subsisted under less comfortable con- CMH; Interv, Medical History Branch, CMH, with
Maj Gen Collin F. Vorder Bruegge, MC (Ret.)
(hereafter cited as Vorder Bruegge Interv), 29 Jan
80, tape 1, side 1, pp. 7-8, CMH. See also reminis-
1
The term medics is used in this volume as short- cences of Mrs. Jane A. Lee, a former nurse, in
hand for "the men and women of the U.S. Army Interv, Medical History Branch, CMH, with Lee,
Medical Department." Enlisted medics are identified June 1981 (hereafter cited as Lee Interv, 1981),
either by this term or as aidmen, litterbearers, etc. CMH.
110 EUROPEAN THEATER OF OPERATIONS
zations in proportion to overall ETO for the then projected ground force
troop numbers. In all, the chief sur- of 591,000 men in two field armies
geon called for fifty-three general, and eight corps. Assuming that divi-
sixty-one station (mostly 750 beds), sions and smaller formations would
three convalescent, and ten field hos- deploy with their organic medical
pitals; eleven medical sanitary, six units and detachments, Spruit called
depot, and two ambulance companies; for an additional 33,000 corps and
twenty-eight hospital train crews; two army medical troops. This initial list,
medical gas treatment battalions; and which included such soon to be abol-
four general dispensaries, as well as ished units as medical regiments and
hospital centers, an auxiliary surgical surgical hospitals, would require ex-
group, and a medical general labora- tensive revision to take into account
tory. the general 1943 reorganization of
Defending this troop basis to Gen- Army Ground Forces units, including
eral Lee and the ETO staff, Hawley medical ones.6
emphasized that it was the result of As the TRIDENT and QUADRANT con-
careful study of American Expedition- ferences set firm invasion dates and
ary Forces (AEF) medical operations COSSAC developed an outline oper-
in World War I and of British practice ational plan, ETO troop basis discus-
in the current war. He noted that the sions became more detailed and defi-
number of medical troops asked for nite. In early July the theater's air,
was a smaller percentage of the ground, and service components
strength of both the total theater and began working out a definitive two-
the Services of Supply than the AEF phase list of manpower and unit re-
medical service had required in 1917-
quirements. Phase One of this new
18. Hawley asked that shipping priori-
troop basis set preinvasion buildup
ty during 1943 be given to the station
goals; Phase Two specified the forces
and general hospitals needed to care
for sick and nonbattle injured. Other needed to break out of the beachhead
units should be sent as space permit- and advance across the continent.
ted, preferably in proportion to the This planning process was lengthy
troop buildup.5 and complex, as the theater tried to
On 19 February Colonel Spruit, adapt to changing invasion plans and
then Hawley's representative in varying War Department estimates of
London, issued a medical troop basis what forces would be available. At the
same time, the theater had to achieve
5
Operations Division, OofCSurg, HQ, ETOUSA, a balance between the often exhorbi-
Annual Rpt, 1944, pp. 5-6; Larkey "Hist," ch. 4, pp. tant demands of each of its compo-
11-13 and apps. 8-9; Memo, Lt Col J. B. Mason, nents.
MC, to ACofS, G-1, SOS, 22 Jan 43, sub: Medical
Troops for "B" Plan (Revised), file ETO 320.2 General Hawley, like the other
(Strength); Memo, Lt Col J. B. Mason, MC, to technical service chiefs, repeatedly re-
ACofS, G-1, SOS, 6 Feb 43, file HD 024 ETO O/ vised his troop lists. Besides respond-
CS (Planning, Hawley) 1943; Memo, Hawley to CG,
SOS, 8 Feb 43, sub: Medical Troop Basis, SOS, file
6
370 (Bible File of Troop Requirements, Early Plan- Memo, Col C. B. Spruit, MC, to ACofS, G-3,
ning). For overall SOS troop planning, see Rup- ETO, 19 Feb 43, sub: Tentative Troop Basis,
penthal, Logistical Support, 1:117-20. Ground Forces, file ETO 024 (Spruit File re Policy).
112 EUROPEAN THEATER OF OPERATIONS
ing to ETO and War Department di- Supply. About half of these troops
rectives, usually to cut service forces, were scheduled to reach Great Britain
the chief surgeon followed General before the invasion. By mid-Decem-
Kirk's instructions to use more gener- ber Hawley's Operations Division had
al and fewer station hospitals. He and made up detailed lists of the number
his staff also adapted ground force and types of units in the ground force
and SOS troop bases to changes in and SOS medical complements (Table
medical unit tables of organization, 2) and had established a monthly
replacing fixed-T/O medical regi- schedule of arrivals. Among ground
ments and battalions with the new force units 400-bed evacuation hospi-
flexible group and battalion head- tals, field hospitals, and collecting,
quarters detachments and separate clearing and ambulance companies
collecting, clearing, and ambulance accounted for most of the manpower.
companies. Profiting from experience In the SOS troop list 1,000-bed gen-
in North Africa and Italy, Hawley in-
eral hospitals—141 of them—made
creased the number of field hospitals
with the ground forces, to provide up the largest single block of person-
forward surgical support for division nel. Only 45 station hospitals re-
clearing stations.7 mained on the list, reflecting the sur-
By late November the European geon general's directive to minimize
Theater and the War Department had use of that type of unit. In response
settled on a total force of nearly 2.8 to pleas from General Hawley, 22 of
million troops and had developed a the 46 field hospitals called for, which
month-by-month unit deployment were intended for service with the
schedule for reaching this strength by armies, were counted against ground
1 February 1945. Of these forces force strength rather than that of the
about 1.42 million men—417,000 Air Services of Supply, even though field
Force, 626,000 ground forces, and hospitals were not Army Ground
375,000 SOS—were to be in the Forces units. In the months remaining
United Kingdom before D-Day. The until the assault the exact mixture of
medical service, which would amount units altered repeatedly, in response
to 7.5 percent of theater strength, was to changing availability in the United
to include about 43,600 officers and States and to new requirements of the
men in units attached to the armies armies and Services of Supply. Never-
and 127,500 in the Services of
theless, the basic list of unit types,
7
For the overall establishment of the troop basis,
and the general proportion of medical
see Ruppenthal, Logistical Support, 1:123-29; Smith, manpower absorbed by each, stayed
Hospitalization and Evacuation, pp. 218-19 and 451- more or less stable throughout the
52; Operations Division, OofCSurg, HQ, ETOUSA,
Annual Rpt, 1944, pp. 6-7; Larkey "Hist," ch. 4, pp. buildup and the invasion.8
16-17 and app. 17; Hawley Planning Directive No.
8
9, 13 Jul 43, box 2, Hawley Papers, MHI. For an ex- Ground Forces and SOS Medical Troop Bases,
ample of adjustment to new T/Os, see Memo, 13 Dec 43; MFR, Brig Gen James B. Mason, MC, 4
CSurg to CofOpns, SOS, 21 Oct 43, file ETO 320.0 Aug 67. Both in box 1, James B. Mason Papers,
(Strength). File HD 024 ETO O/CS (Hawley-SGO MHI. See also Troop Movements and Training
Corresp), July-November 1943, includes his negoti- Branch, Operations Division, OofCSurg, HQ,
ations with the surgeon general. Continued
MEDICS IN BRITAIN 113
Source: Adapted by authors from Troop Movements and Training Branch, Operations Division,
OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, chart A.
By the time ETOUSA completed its flow; later in the year SOS organiza-
final troop lists, the buildup already tions received precedence. The
was under way, guided by the earlier ground forces, which would be
tentative statements of requirements. needed last, built up more slowly,
The number of American soldiers in with only five divisions arriving in
Great Britain increased from 122,000 1943. Medical troop strength in-
in January 1943 to 773,000 at the end creased at about the same rate as that
of the year. Initially Air Force units of the theater as a whole, from 10,000
predominated in the transatlantic officers and men (6,700 of them in
the SOS) in January to over 65,000
(31,000 in the SOS) in December.
ETOUSA, Annual Rpt, 1944, pp. 6-9 and charts A, Medical forces continued to build up
B, C; Larkey "Hist," ch. 4, pp. 18-20. For the ques-
tions of field hospitals, see file HD 024 ETO O/CS rapidly during the first half of 1944,
(Hawley-SGO Corresp), November-December 1943. with the arrival of large numbers of
114 EUROPEAN THEATER OF OPERATIONS
field units paralleling the now rapid of their plants or instructions to take
influx of ground combat troops.9 over an already operating hospital.
Medical units arriving from the The Western Base Section, which re-
United States came under the over- ceived most newly arrived hospitals,
sight of the Troop Movements and quartered them in towns and canton-
Training Branch of Hawley's Oper- ments around Llandudno, Wales.
ations Division. This branch request- Here, the units underwent orientation
ed orders from the theater G-3 as- to the theater and preliminary profes-
signing each new unit to a major sional evaluation of their staffs, under
command, and, in the case of SOS supervision of the Western Base Sec-
units, to a base section. Non-SOS tion surgeon. While awaiting perma-
medical units received their final duty nent assignments, medical officers,
assignments from Air Force or 1st nurses, and enlisted men lived in
Army Group headquarters. The hutted camps or were billeted with
Troop Movements and Training British families. A nurse who entered
Branch also proposed changes in the Britain early in 1944 with the 48th
unit shipment schedule when neces- General Hospital recalled: "The po-
sary, for example, to advance the ar- liceman took a group of you and
rival of urgently needed depot com- walked down the street and said, 'One
panies for the Supply Division; and it goes here and two goes there,' and
kept the base sections, which were re- you walked into a stranger's house
sponsible for moving and housing de- and that's where you stayed for about
barking units, informed of the organi- a month."11
10
zations they could expect to receive. Since the beginning of mobilization
Typically, European Theater medi- in 1940, the Office of the Surgeon
cal units disembarked at Scottish, General had fought, in the main suc-
western English, or Welsh ports and cessfully, for the activation of enough
then moved by train to their assigned medical units of all types for the ex-
locations. Until the final inrush of panding Army. As a result of these ef-
units before D-Day most general and forts, the units required for the ETO
station hospitals spent time in tempo- medical troop basis became available
rary billets awaiting either completion in the United States at about the
9 same rate as the forces they were to
For strength, see McMinn and Levin, Personnel,
pp. 308-11; slightly different figures are given in support.12 Nevertheless, as the build-
Personnel Division, OofCSurg, HQ, ETOUSA, up proceeded, General Hawley had to
Annual Rpt, 1943, p. 11. For general progress of cope with several persistent manpow-
the buildup, see Ruppenthal, Logistical Support,
1:130-32 and 231-40, and Matloff, Strategic Planning, er problems. By D-Day, shortages of
pp. 551-52. Encl. 8 of Troop Movements and key personnel had begun to develop,
Training Branch, Operations Division, OofCSurg, most resulting from Army-wide—even
HQ, ETOUSA, Annual Rpt, 1944, details the unit
types arriving in 1944.
10 11
Troop Movements and Training Branch, Oper- Quotation from Brown Interv, 1979, CMH. See
ations Division, OofCSurg, HQ, ETOUSA, Annual also Surg, Western Base Section, Rpt, 1 Jan-31 Aug
Rpt, 1944, pp. 9, 11, 13. Memos, Lt Col J. B. 44, pp. 2-3.
12
Mason, MC, to Surgs, Western and Southern Base For development of the overall Army medical
Sections, 10 Aug 43, file 320.2 (Strength), are ex- troop basis, see Smith, Hospitalization and Evacuation,
amples of advance information to base sections. pp. 38-39 and 149-51.
MEDICAL PERSONNEL ENJOYING THE AMENITIES OF BRITISH LIFE.
A soldier bicycles through the countryside and nurses take tea in a garden.
116 EUROPEAN THEATER OF OPERATIONS
replace one surgeon in each battalion theater and earmarked for early
and fill as many other former MC movement to France bitterly resented
slots as did not absolutely require these transfers, but the process went
doctors. General Hawley welcomed inexorably forward. The 10,500
this policy and hoped to use the MC nurses on hand at D-Day were
officers thereby released as a general enough to meet immediate require-
theater reserve and replacement pool. ments, but General Hawley had to an-
The number of MAC officers in the ticipate strains on a limited force and
European Theater grew from under further T/O reductions as the cam-
900 in November 1943—when the paign developed.17
substitution policy went into effect— As the troop buildup accelerated,
to over 2,400 by D-Day, but most of one category of theater medical man-
them arrived too late to be integrated
power diminished in relative impor-
into units before the invasion. When
they finally entered service, the MC tance if not in absolute numbers.
officers they relieved barely sufficed During the TORCH preparations Gen-
to replace current combat losses.16 eral Hawley had encouraged Army
As D-Day approached, a nurse hospitals to employ British civilians to
shortage was in prospect, the result, replace military personnel detached
like the doctor shortage, of recruiting for North African service. By mid-
difficulties in the United States. The 1943 over 500 British laborers, secre-
Army Medical Department, anticipat- taries, and telephone operators were
ing a worldwide lack of nurses, re- working in American hospitals, as
duced the T/O complements of its were a few medical professionals, in-
fixed hospitals and announced plans cluding 4 women contract doctors.
to send units overseas without nurses While useful as a temporary expedi-
to absorb the paper surpluses thereby ent, this policy was military undesir-
created in the theaters. Accordingly, able, because a hospital heavily
under instructions from theater head- staffed with local employees would
quarters, General Hawley in May lose much of its labor force whenever
1944 began cutting the nursing force it moved. The British, at the same
of each of his general hospitals from time, objected to the Americans' re-
100 to 83 in order to staff twelve gen- moval from their economy of scarce,
eral hospitals coming over with no vitally needed workers. With military
nurses. Base section chief nurses pre- personnel now available to replace
pared lists of women for transfer to many of the civilians, Hawley's Per-
the new units, except for key special- sonnel Division, in conjunction with
ties selecting them by lot to prevent the British Ministry of Labor and War
hospitals from dumping their undesir- Office, issued on 11 September 1943
ables. Nurses from units long in the
17
Ltr, Lt Gen Eisenhower to CGs and Base Sec-
16
Ltrs, TSG to Hawley, 3 Nov and 3 Dec 43, and tion Cdrs, 19 May 44, sub: Release of Nurses From
Hawley to TSG, 13 Dec 43, file HD 024 ETO O/CS General Hospitals, file HD 024 ETO CS (Hawley
(Hawley-SGO Corresp); Personnel Division, Chron); Mins, 23d Meeting of Base Section Sur-
OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, pp. geons, 5 Jun 44, p. 3, file HD 337; Hawley Speech
8-9; War Department, Strength of the Army, 30 Nov on Nurse Shortage, 4 Jan 45, file HD 024 ETO
43, 30 Jun 44. O/CS (Medical Organization in ETO).
MEDICS IN BRITAIN 119
new guidelines that sharply restricted while the Veterinary Corps, Sanitary
the number of local workers in each Corps, and Medical Administrative
type of American Army hospitals. A Corps were over strength, as was the
1,000-bed general hospital, for exam- Army Nurse Corps (by virtue of the
ple, could hire no more than 32 Eng- reduction in general hospital staffs).19
lishmen. In all hospitals civilians
could perform only nonmedical tasks, The Status of Nurses
such as manning telephone switch-
boards and operating sewage treat- The morale and welfare of ETO
ment and boiler plants. In response nurses received considerable com-
to this directive Army hospitals rapid- mand attention during the BOLERO
ly reduced their civilian labor compo- personnel buildup. According to Lt.
nents. In May 1943 the theater medi- Col. Margaret E. Aaron, the Army
cal service included 1 hired civilian Nurse Corps (ANC) representative in
for every 7.5 enlisted men; by Decem- General Hawley's office, ANC officers
ber, although the total number of "were not a very happy group" at the
British employees had risen to 986, outset of theater operations. Mostly
their share of the work force had de- young and new to the Army, the
18
clined to 1 per 22 medical soldiers. women found themselves bewildered
By 31 May 1944, in spite of immi- and homesick in a strange country.
nent shortages of doctors and nurses, Wearing uniforms and work dresses
nagging demands for casuals, and the ill-adapted to the cold, damp climate,
unsatisfactory replacement flow, the and minimally heated buildings, they
medical service, like the rest of suffered a high rate of colds, flu, and
ETOUSA, substantially had met its pneumonia. Many nurses, lacking
first-phase buildup goals. About enough work to keep them occupied
133,000 medical officers, nurses, and in the partially filled hospitals, ap-
enlisted men were in Great Britain, plied for transfer to Mediterranean
preparing for their multifarious D-Day bound units in search of more inter-
tasks. Of these personnel some esting and professionally useful activi-
71,000 belonged to SOS units, an- ty.20
other 49,000 were with the ground Lieutenant Colonel Aaron and her
armies, and the remainder supported successor as chief of the Nursing Divi-
the air forces. The theater still fell sion, Lt. Col. Ida W. Danielson, la-
short (by 35) of its authorized Medi- bored to improve nurses' morale and
cal Corps officer strength. The Dental professional performance, assisted by
Corps also lacked its full complement, a gradually expanding number of
18
base section, army, and hospital
Personnel Division, OofCSurg, HQ, ETOUSA,
Annual Rpt, 1943, p. 4 and app. E. The 11 Septem-
center chiefs of nursing. Training, in
ber 1943 directive emphasized use of British work-
19
ers in maintenance and plant operation because Personnel Division, OofCSurg, HQ, ETOUSA,
they were familiar with the intricacies and idiosyn- Annual Rpt, 1944, app. D, pp. 1-2; Larkey "Hist,"
cracies of the largely British-built hospitals. In the ch. 8, pp. 27-28; McMinn and Levin, Personnel, pp.
same manner, it was thought British telephone op- 105-07.
20
erators had a better chance of placing calls success- "Med Svc Hist, 1942-43," p. 60, file HD 314.7-
fully in their own country's telephone system. 2 ETO.
120 EUROPEAN THEATER OF OPERATIONS
detachments of segregated combat rience was far from happy. The offi-
and support units or in the ten black cers complained that the women were
ambulance and seventeen sanitary less efficient and required more su-
companies. pervision than a comparable number
The one major exception to this of white nurses. Conducting an offi-
rule was a group of 63 black nurses. cial inspection, a black officer found
General Hawley accepted these that the black nurses "feel that they
women in May 1944, at the personal are a separate group, set apart for a
request of General Kirk who was particular type of service, and have
under political pressure to send more little hope for advancement or any
blacks overseas. The nurses reached variation in the type of service they
Great Britain in July. After training at are performing." Sadly, that was in
the theater ANC school, they began
fact the case, not only for the nurses
work in September at the 168th Sta-
of the 168th but for the theater's
tion Hospital, a 1,700-bed facility
other black medics as well.27
near Manchester, then caring for
wounded German prisoners. The
27
nurses performed satisfactorily in the Quotation from Memo, Brig Gen B. O. Davis to
Maj Gen C. H. Bonesteel, 21 Feb 45, sub: Special
white-officered 168th, but their expe- Continued
124 EUROPEAN THEATER OF OPERATIONS
surgery would prevent or reduce in- plinary action against any doctor who
fection. Besides supervising these diverted the antibiotic to unauthor-
clinical trials, the board trained offi- ized treatments or experiments, de-
cers form Army general hospitals in claring that "even as we widen its use,
what was then known about the use we must control its use. Otherwise,
and storage of penicillin, so as to some damn fools are going to waste it
have in each installation at least one trying it on ingrowing toenails so that
doctor acquainted with the new anti- they can write a paper on it." Colonel
31
biotic. Cutler in April 1944 completed plans
In late 1943 Surgeon General Kirk for using penicillin as a prophylactic
was able to promise the European in forward surgery, although he ex-
Theater regular penicillin shipments pressed his "firm conviction . . . that
of 100 million or more units per surgery will be responsible for 95 per
month from the expanding American cent of the success or failure in battle
production. With a steady supply thus casualties." 32
assured, General Hawley on 7 Decem- Professional societies and meetings,
ber authorized the issue of penicillin strongly encouraged by the chief sur-
to all general and two station hospi-
geon as a means of keeping up
tals. General hospitals, the staffs of
which had been trained in penicillin
morale and disseminating useful
therapy at the 2d General Hospital, knowledge, proliferated among ETO
now were to instruct the surgical, doctors during the months of the
medical, and laboratory chiefs of buildup. Much of this activity was
neighboring hospitals in preservation international in character. For exam-
and administration of the drug. While ple, in mid-1942, Colonel Cutler
he distributed penicillin widely, the helped start the Inter-Allied Confer-
chief surgeon restricted its use to pa- ence on War Medicine and Surgery,
tients with life-threatening or persist- 32
ent infections and to those with sulfa- FredFirst quotation from Ltr, Hawley to Brig Gen
W. Rankin, 16 Feb 44. Second quotation from
resistant venereal diseases—priorities Ltr, Cutler to Rankin, 25 Apr 44. Both in file HD
suggested by the surgeon general for 024 ETO O/CS (Hawley-SGO Corresp). See this
source, September-December 1943, for a running
all theaters. Hawley threatened disci- account of the development of penicillin supplies
and policy. See also Memo, Col Kimbrough to
31
U.S. penicillin research and mass production DepCSurg (Cheltenham), 13 Nov 43, file HD 024
began after a 1941 visit of Professor Florey to ETO O/CS (Spruit Policy Notebook); Professional
America. See Wesley W. Spink, Infectious Diseases: Services Division, OofCSurg, HQ, ETOUSA, Annual
Prevention and Treatment in the Nineteenth and Twentieth Rpts, 1943, p. 7, and 1944, pp. 6 and 8; Carter, ed.,
Centuries (Minneapolis, Minn.: University of Minne- Surgical Consultants, 2:142-45; Mins, 13th, 14th, and
sota Press, 1978), pp 89-100; Carter, ed., Surgical 15th Meetings of Base Section Surgeons, respective-
Consultants, 2:68-69 and 133-46; Havens, ed., Medi- ly, 17 Jan, 31 Jan, and 14 Feb 44, file HD 337.
cal Consultants, 1:265-66; Professional Services Divi- Before the advent of sulfa drugs, treatment of gon-
sion, OofCSurg, HQ, ETOUSA, Annual Rpt, 1943, orrhea and other venereal diseases had been
p. 7; Col E. C. Cutler, Lt Col P. C. Morton, and Maj lengthy and painful for the patient, keeping men
J. W. Sandusky, "Observations on the Prophylactic away from duty for long periods and requiring
Use of Penicillin in the Wounds of Aerial Warfare," much hospital space, staff, and equipment. The use
ex. H, Chief Consultant in Surgery sec., Professional of sulfa and penicillin for a faster, simpler cure
Services Division, OofCSurg, HQ, ETOUSA, Annual greatly reduced both the logistics burden on the
Rpt, 1944; Middleton Interv, 1968-69, vol. 1, pp. theater medical service and the Army's noneffective
218-20, NLM. rate. See Haven, ed., Medical Consultants, 1:24-25;
MEDICS IN BRITAIN 127
which brought American doctors to- ing hospitals and units. The contribu-
gether with British colleagues and tion to the war effort of this constant
with the exiled medical elite of occu- round of professional conferences
pied Europe. At least 100 American and socializing was difficult to meas-
medical officers attended each of the ure, but it promoted the sharing of
society's conferences, held in London knowledge and experiences and fos-
under sponsorship of the Royal Socie- tered acquaintanceships that eased
ty of Medicine, to hear papers and working relationships among Army
enjoy cocktail hours and dinners. medical officers and between the
British medical associations accepted latter and their British colleagues.34
Americans into membership. They ETO hospitals made the most of
opened their meetings and their li- the time and relative leisure afforded
braries to their American colleagues. them by the long wait for the begin-
Hawley's senior consultants met regu- ning of full-scale combat. In March
larly with their British counterparts, 1944 Surgeon General Kirk, after
and the chief surgeon hosted occa- touring theater hospitals in the course
sional dinners at which American offi- of the presidentially directed review of
cers mingled with distinguished Brit- Air Force patient care, expressed high
33
ish medical men. praise for what he had seen. Patients
In July 1943, at General Hawley's in the European Theater, he told
suggestion, U.S. Army doctors Hawley,
formed their own European Theater
of Operations Medical Society, of are receiving superb treatment as a result
of professional efficiency and individual
which all Army MC officers were auto- care. . . . Surgical pavilions are well
matically members. At first, the entire planned, the wards bright, cheerful and
membership met once a month at a immaculate in cleanliness. Your General
particular general hospital for papers, Medical Laboratory, dental clinic and lab-
ward rounds, and lunch. As the thea- oratories, both fixed and mobile, are
ter expanded in late 1943, the organi- ideal. The research work that is being
carried on is outstanding. . . . We are as-
zation perforce broke down into base sured that the Medical Department will
section branches, each of which car- be ready to do its job on D-Day.35
ried on its own social and profession-
al program. Dentists and veterinarians
Organizing the Dental Service
established similar theater and base
section associations. Local activities In hospitals and unit medical de-
abounded. Station and general hospi- tachments the ETO dental service
tals, for example, organized frequent conducted its own buildup, coped
clinical and pathological conferences with its own problems, and contribut-
open to medical officers of neighbor-
34
American Medical Society, ETO, memoranda
33
and meeting programs, various dates, box 3, Hawley
Maj Gen Sir H. L. Tidy, ed., Inter-Allied Confer-
Papers, MHI; Hawley Interv, 1962, p. 49, CMH;
ence on War Medicine, 1942-1945 (London: Staples
Press, 1947), pp. 12-15 and passim; Middleton Surg, Northern Ireland Base Section, Annual Rpt,
1944, p. 4; Surg, XIX Corps, Annual Rpt, 1944,
Interv, 1968-69, vol. 1, pp. 199-201, 225-27, 231,
NLM; Professional Services Division, OofCSurg, p. 2.
35
HQ, ETOUSA, Annual Rpt, 1943, pp. 12-13; Ltr, TSG to Hawley, 19 Mar 44, file HD 024
Hawley Papers, MHI, passim. ETO O/CS (Hawley-SGO Corresp).
128 EUROPEAN THEATER OF OPERATIONS
The laboratories were to serve a simi- Late in 1943, after reviewing Erpf's
lar purpose on the Continent for initial reports and results, the chief
combat units resting behind the surgeon, on the advice of the Dental
37
front. Division and of his senior opthalmo-
As a result of the initiative of one logy consultant, adopted the acrylic
Dental Corps officer, Capt. Stanley F. eye for theater-wide use. In January
Erpf of the 30th General Hospital, 1944 the medical service set up a two-
the European Theater developed a week course at the 30th General Hos-
new type of artificial eye, thereby pital, taught by Erpf, to train both
helping to solve an Army-wide prob- U.S. Army and British Army dental
lem of supply and patient welfare. officers in fabricating and fitting the
The Army by 1943 faced a growing eyes. By the time the course closed
demand for glass eyes, both for men down for the invasion in late May
with empty sockets resulting from ac- thirty-three dentists had graduated
cidental and combat injuries and for from it. The acrylic eye school later
one-eyed recruits being inducted reopened at the two central dental
under lowered physical standards. laboratories. On the strength of re-
However, material for glass eyes, pre- ports from the European Theater, the
viously imported from Europe, was in War Department adopted the acrylic
short supply. The eyes themselves eye as a substitute for glass through-
took up to two months to make and out the Army and brought Erpf back
fit to the individual and also broke to the United States in June to help
easily. In September 1943, at the re- organize production and employment
quest of a staff opthalmologist whose of his invention.
38
them captains and first lieutenants, through the school before it closed in
graduated from this course before the October 1944. They went back to
Medical Field Service School ceased their units to help train other nurses
operations in October 1944.42 and to set a more military tone
In May 1943, an Army Nurse Corps among their colleagues.
43
During the prolonged buildup ETO Besides the staff at Cheltenham, the
medics guarded the health of the ex- Preventive Medicine Division included
panding American force. To carry out the ETO's central medical laboratory
this mission, the chief surgeon estab- at Salisbury. The theater, in July
lished the Preventive Medicine Divi- 1942, acquired a central laboratory by
sion and in June 1942 selected the the simple expedient of taking over
newly commissioned Lt. Col. John E. Gordon's Red Cross-Harvard Unit,
Gordon as division chief. Gordon, an complete with facilities and staff, as
epidemiologist, had been working in the provisional Medical General Lab-
public health in the United Kingdom oratory A. During late 1942 and early
since 1940, when he arrived with the 1943 the medical service enlarged the
Red Cross-Harvard Field Hospital Salisbury plant to accommodate a
Unit, and had become a respected T/O central laboratory unit. This
member of the British medical estab- unit, the 1st Medical General Labora-
lishment. A U.S. Army colleague con- tory, arrived from the United States
sidered him "the most efficient civil- in June 1943. Medical General Lab-
ian turned military I've ever seen." oratory A then disbanded, part of its
staff remaining with the new organi-
Movements and Training Branch, Operations Divi- zation and the rest going to other
sions, OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, ETO assignments. From then until
pp. 24, 27-28, 32-35.
49
Troop Movements and Training Branch, Oper-
50
ations Division, OofCSurg, HQ, ETOUSA, Annual Quotation from Editorial Advisory Board, 1962,
Rpt, 1944, pp. 23-24 and 28, evaluates the effec- p. 47. See also Gordon "Hist," vol. 1, pt. 1, pp. 7-8,
tiveness and deficiencies of the training effort. and pt. 2, pp. 3-4 and 6, CMH.
138 EUROPEAN THEATER OF OPERATIONS
age tanks in many buildings used for period. Medical officers considered
quarters, and required all commands Otway pits more practical and less of-
to send water samples to station or fensive than other disposal means,
general hospital laboratories each but they were at best the least of
53 54
month for bacteriological analysis. evils.
At all levels of command preventive General Hawley, in setting up his
medicine officers closely supervised office, placed nutrition under Preven-
garbage and sewage disposal. Gar- tive Medicine in order to emphasize
bage removal entailed few difficulties. the importance of diet in maintaining
Following British law and practice, troop health. Officers of the Nutrition
American units sold their edible Branch cooperated with those of the
refuse to local contractors for animal Subsistence Branch of the chief quar-
food; they separately salvaged grease termaster's office in planning menus
and bones for turnover to their Allies. and overseeing food procurement and
Sewage disposal proved to be more preparation. During the buildup most
difficult. At hospitals and other large units in Great Britain lived on a garri-
installations British-built waste treat- son ("A") ration, modified to take ac-
ment plants lacked adequate provi- count of shipping limitations and
sion for drying out and disposing of make use of locally procured food-
sludge. Engineers and medical offi- stuffs. The first troops to arrive in
cers had to engage in much rebuild- early 1942 ate the standard British
ing and improvisation to keep them Army ration. Neither they nor their
sanitary. Units in smaller camps, for-
medical officers liked it, because it
bidden to dig pit latrines because of
contained too little meat, milk prod-
British fears of ground water contami-
ucts, tomatoes, fruit, and coffee; fur-
nation, learned the unsavory details
of using and emptying latrine buckets, nished too few calories; and did not
the latter a noisome task seldom satis- include the amounts of calcium, ribo-
factorily performed by either troop flavin, and ascorbic acid considered
details or civilian contractors. Some necessary by American nutritionists.
units tried burning their feces in in- During late 1942, as American supply
cinerators, in the process subjecting depots went into operation, most
themselves to foul odors. Where pos- commands shifted to a ration jointly
sible, the Americans copied a British planned by representatives of Preven-
expedient called the Otway pit—a tive Medicine and the chief quarter-
hole in the ground, 10 feet on each master. This ration met American vi-
side and 10 feet deep, lined with tamin and calorie requirements, al-
canvas or sheet metal and with a fly- though it included canned milk and
proof timber cover. A single such pit, powdered eggs; incorporated British
properly maintained, could accommo- 54
Gordon "Hist," vol. 2, pt 9, pp. 16-18, CMH.
date the waste of 100 men for a long For technical deficiencies of sewage treatment
plants, see Ralph S. Cleland, "Sanitary Engineering
53
Gordon "Hist," vol. 2, pt. 9, pp. 4-8, and pt. in the European Theater of Operations," The Mili-
10, pp. 2-6, CMH. Mins, 22d Meeting of Base Sec- tary Surgeon 101 (July 1947): 36-40, and 168th Sta-
tion Surgeons, 22 May 44, p. 5, file HD 337, is an tion Hospital Annual Rpt, 1944, p. 14. Crew, AMS,
example of many exhortations to conserve water. Administration, 2:100-101, describes the Otway pit.
140 EUROPEAN THEATER OF OPERATIONS
flour, bread, cereals, condiments, and ETO veterinarians assisted the Pre-
vegetables; and was short of fresh ventive Medicine Division in ensuring
fruits and salad ingredients. Hospital food quality. The personnel of the
patients received the standard ration, Veterinary Division, who numbered
supplemented with extra chicken, 118 officers and 282 enlisted men by
fruit, and eggs and with British-pro- D-Day, were parceled out among base
duced fresh milk, which General sections, general and Quartermaster
Hawley refused to have issued to all depots, ports of embarkation, the 1st
troops in order not to aggravate local Medical General Laboratory, and
shortages and because most British ground and air forces headquarters.
processing plants did not conform to With no animals for which to care
American hygenic standards. except a few pigeons and sentry dogs,
The resulting diet more than suf- veterinarians concentrated on their
ficed to nourish the troops, provided other primary task of inspecting food
that they ate all the prescribed items. and supervising its storage and trans-
To ensure that they did so, the Nutri- portation. Although their mission
tion Branch, and nutrition officers in normally encompassed only foods of
the base sections, worked closely with animal origin, veterinarians in July
commands to educate men in proper 1943, under an agreement with the
eating habits and to train cooks to theater chief quartermaster, also
make nourishing foods appealing. Of- began examining fresh fruit and vege-
ficers from the Preventive Medicine tables and canned and packaged
Division attended Quartermaster products. Veterinarians in the ports
mess management conferences, made functioned as perishable freight offi-
nutritional inspections and surveys of cers, supervising the unloading of re-
units, and furnished educational post- frigerator ships. The inspecting offi-
ers and material to messes and to the cers found few deficiencies in Army
soldiers newspaper, Stars and Stripes. foodstuffs, but the equipment and
In the Western Base Section the sur- sanitary practices of British commer-
geon, trying to increase consumption cial carriers fell short of American
of canned milk and powdered eggs, standards and caused much spoilage.
distributed recipes for using these At the suggestion of the Veterinary
Division, the theater transportation
items in scrambled eggs, lemon cream
chief ordered 800 refrigerator cars
pie filling, baked custard, and other
from the United States and by the
delicacies he hoped would be entic-
55 end of 1943 had 45 of them running
ing. on British railways moving highly per-
55
Gordon "Hist," vol. 1, pt. 2, p. 5, and pt. 4,
ishable items.56
passim, CMH; Preventive Medicine Division,
56
OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, p. 26; Veterinary Division, OofCSurg, HQ, ETOUSA,
Surg, Western Base Section, Annual Rpt, 1943. For Annual Rpts, 1943 and 1944; "Med Svc Hist, 1942-
the evolution of the ETO ration, see William F. 43," pp. 6 and 68-69, file HD 314.7-2 ETO; Ever-
Ross and Charles F. Romanus, The Quartermaster ett B. Miller, United States Army Veterinary Service in
Corps: Operations in the War Against Germany, United World War II, Medical Department, United States
States Army in World War II (Washington, D.C.: Army in World War II (Washington, D.C.: Office of
Office of the Chief of Military History, Department the Surgeon General, Department of the Army,
of the Army, 1965), pp. 290-92. 1961), pp. 271-72.
MEDICS IN BRITAIN 141
Suppression of disease outbreaks never had had, or long ago had eradi-
involved every level of command. cated, most of the deadliest communi-
Unit surgeons, assisted by base sec- cable diseases. Insects and vermin
tion, army, and air force staff epide- were limited in numbers and consti-
miologists, had primary responsibility tuted no major threat to the health of
for spotting health problems early the Army. Not only was the environ-
and taking corrective action. In the ment relatively favorable, most sol-
chief surgeon's office the Epidemiolo- diers arrived in Great Britain with
gy Branch of the Preventive Medicine their required immunizations against
Division established general policies smallpox, typhoid, paratyphoid,
for controlling particular diseases, typhus, and tetanus. The Preventive
distributed information, and sent doc- Medicine Division supervised a con-
tors to help meet particularly severe tinuing program of reimmunization
emergencies. Colonel Gordon re- and was prepared to provide addi-
ceived periodical formal reports on tional immunization, as required for
the health of the Army from the Med- military missions, against a variety of
ical Records Division and the base other disease threats.58
sections, and he maintained informal Epidemics did occur, the first being
contact with other divisions of the the serum hepatitis outbreak of mid-
chief surgeon's office that were con-
1942.59 The climate, and the often
cerned with treatment and prevention
poorly heated and ventilated living
of disease. Colonel Middleton, the
quarters, produced a high continuing
chief consultant in medicine, recalled:
"Virtually daily interchanges occurred incidence, especially in winter, of in-
between [Gordon] and me or some fluenza and other respiratory infec-
members of our staff, so that there tions, which accounted regularly for
was a ready communication from the about 30 percent of all disease among
clinical standpoint to preventive med- ETO troops. To control these infec-
icine." As a result of Gordon's rap- tions, medical officers and unit
port with the British, Preventive Med- commanders emphasized personal
icine obtained weekly reports from cleanliness among their men, tried to
the Ministry of Health and the War improve barracks heat and ventilation,
Office on outbreaks of infectious dis- and provided extra facilities for
ease in the British civilian population drying clothing. Scattered outbreaks
and armed forces.57 of diarrhea—sixty between January
For U.S. Army forces in the United and October 1943—and less fre-
Kingdom sickness was more a nui- quently of dysentery and food poison-
sance than a menace. The troops ing plagued the Army. The medical
lived and worked in a temperate—if service traced most of these to unsan-
damp and chilly—climate and in a de- itary mess practices, typically efforts
veloped industrial country which un- 58
derstood basic sanitation and either Medical Bulletin No. 6, OofCSurg, HQ,
ETOUSA, 15 Jun 43, pp. 7-9; Mins, 15th and 19th
Meetings of Base Section Surgeons, 14 Feb and 10
57
Quotation from Middleton Interv, 1968-69, vol. Apr 44, file HD 337; Gordon "Hist," vol. 2, pt. 3,
1, pp. 206-07, NLM. See also Gordon "Hist," vol. sec. 7, pp. 4-5, CMH.
59
1, pt. 2, pp. 2-3, and pt. 3, sec. 1, pp. 5-6, CMH. For details, see Chapter I of this volume.
142 EUROPEAN THEATER OF OPERATIONS
to store food too long without ade- medical officers, resulted from infec-
quate refrigeration. Epidemics of a tion outside the United Kingdom.
mild form of hepatitis constantly re- To check the spread of the disease
curred, especially during the winter of to the rest of the Army and the Brit-
1943-44, when divisions redeploying ish people, hospitals kept malaria pa-
from the Mediterranean for OVER- tients isolated under mosquito netting
LORD brought the disease with them. or in screened rooms until treatment
Medical officers never determined cleared their bloodstreams of the
definitely the mode of transmission of parasite. Preventive medicine officers
this infection, and the Army would in the base sections started or intensi-
suffer from occasional hepatitis epide- fied mosquito eradication efforts
mics until V-E Day.
60 around hospitals and camps. Unit
The four divisions and an engineer medical officers tested the blood of
special brigade that entered the all men who had served in malarial
United Kingdom from the Mediterra- regions to detect carriers of the para-
nean in November 1943 carried with site. To prepare for the invasion, af-
them a clinically more severe, and fected units transferred out the men
militarily a more potentially disrup- most debilitated by malaria, and two
tive, disease than hepatitis: They weeks before D-Day they put all sol-
brought malaria. By the beginning of diers who had had malaria within the
the twentieth century indigenous ma- past twelve months back on daily
doses of Atabrine. These measures
laria very nearly had disappeared
prevented the occurrence of new
from the British Isles. However, at
cases among troops and civilians, but
least one species of mosquitoes— already infected men in the veteran
Anopheles—lived there, and the units would continue to be incapaci-
troops from the Mediterranean, as tated by the disease during the assault
well as aircraft crews who picked up on continental Europe.61
the infection at African stopovers on Venereal disease, in spite of rapid
transatlantic flights, provided a new and effective treatment with sulfa
reservoir of the parasite, creating con- drugs and penicillin, cost the Army
ditions for further spread of the dis- heavily in lost time from duty and di-
ease. As men in the newly arrived version of medical resources, as well
units stopped taking suppressive Ata- as being a source of political and
brine, the European Theater's rate of social tension between the Americans
hospital admissions for malaria began and their British hosts. Recognizing
rising. All cases, of the vivax variety, the importance of this health prob-
were benign and all, as judged by
61
The affected units were the 1st and 9th Infan-
60
Gordon "Hist," vol. 1, pt. 3, sec. 2, no. 1, pp. try, the 2d Armored, and the 82d Airborne Divi-
8-9, and sec. 3, no. 1, pp. 1-2, 12-15, and vol. 2, sions and the 1st Engineer Special Brigade. See also
pt. 3, sec. 6, pp. 9-16, 22-25, CMH; Essential Tech- Gordon "Hist," vol. 1, pt. 3, sec. 5, no. 2, pp. 1-11,
nical Medical Data Rpt, HQ, ETOUSA, October CMH. On malaria in the Mediterranean, see Ebbe
1943, p. 2. HQ, Eastern Base Section, Directive, 19 C. Hoff, ed., Communicable Diseases: Malaria, Medical
Dec 42, sub: Common Respiratory Diseases, in Department, United States Army in World War II
Surg, Eastern Base Section, Annual Rpt, 1942, is (Washington, D.C.: Office of the Surgeon General,
typical of measures against respiratory diseases. Department of the Army, 1963), pp. 262-64.
MEDICS IN BRITAIN 143
the Venereal Disease Control Act of ners from infected soldiers and then
1916, which permitted libel action visit the women, warn them they
against a person who implied that might be infected, and suggest they
someone else was infected, effectively go to a British clinic for treatment.
barred British social agencies from Because the entire action was confi-
helping the Americans trace them. dential and informal and the contacts'
The Privy Council, in Defense Regu- responses were voluntary, the Ameri-
lation 33B, issued in December 1942, cans by this means could get around
permitted a venereal disease patient the rigid rules of Regulation 33B.
privately to name his or her partner Colonel Padget launched the program
to a physician, who then could pass in February 1943 in six counties in
on the information to the appropriate East Anglia, employing four Army
local public health officer. After two nurses experienced in public health
separate identifications of the same work. Much to the surprise of the
person as the "source of infection," sceptical British, the program pro-
the public health officer could compel
voked almost no civilian resentment
the individual to report for examina-
and had substantial results. Of the
tion and treatment. This regulation
was of little direct use to the theater first 500 women approached, only
medical service, because two soldiers one—a professional prostitute—took
rarely identified the same woman de- offense, and over 75 percent eventu-
finitively enough to meet the eviden- ally sought medical assistance. The
tiary requirements.66 Preventive Medicine Division expand-
The medical service could do little ed the effort throughout the United
to check prostitution, except make oc- Kingdom, doubling the number of
casional informal arrangements with nurses assigned, and in February
local police. In London, for example, 1944 transferred administration of it
American MPs and officers of the to the base sections. British county
Metropolitan force rigorously restrict- health officers, impressed with the
ed loitering by soldiers and civilians U.S. Army's success, organized similar
in Piccadilly Circus and Leicester contact teams and gradually began
Square, making pickups at least exchanging information with their
harder to arrange. The Americans Allies.67
had more success with contact trac- In reciprocity for British acquies-
ing, using Regulation 33B as their cence in this benign invasion of their
opening wedge. Exploiting to the full cherished privacy, General Hawley
his cordial relations with the Ministry tried to respond to Ministry of Health
of Health, Colonel Gordon prevailed and Army Medical Services protests
on the reluctant British to allow U.S. against the introduction into the
Army nurses to take names of part- United Kingdom of American soldiers
66 67
Gordon "Hist," vol. 2, pt. 5, pp. 5-7 and 12- Gordon "Hist," vol. 2, pt. 5, pp. 6, 13-14, 16,
13, CMH; Padget Interv, 1 Aug 45, box 223, RG CMH; Padget Interv, 1 Aug 45, box 223, RG 112,
112, NARA. For an account of antiprostitution NARA; Medical Bulletin No. 7, OofCSurg, HQ,
measures and contract-tracing in the United States, ETOUSA, 1 Jul 43, pp. 6-9; Mins, 14th and 15th
see Hoff, ed., Diseases Transmitted Through Contact, pp. Meetings of Base Section Surgeons, 31 Jan and 14
179-81. Feb 44, file HD 337.
MEDICS IN BRITAIN 147
already infected with venereal disease. cases per 1,000 troops per year,
He repeatedly called to Surgeon Gen- which stood at 58 at the end of 1942,
eral Kirk's attention the fact that dropped to 21 by late 1943 and to
transports from the United States reg- about 20 in mid-1944. Colonel
ularly made port with scores of new Padget attributed part of this decline
syphilis and gonorrhea cases on to what he called a "dilution factor"
board, and he warned that apparent resulting from the rapid influx of new
American nonchalance on this ques- troops who had not yet had time to
tion jeopardized hard-won British co- find female company. Nevertheless,
operation with his control measures. he was "reasonably certain that the
The chief surgeon arranged to detect lowering of the rate . . . was an actu-
and hold for treatment all infected ality and not just an artifact brought
soldiers on arriving vessels. On the about by troop movements." As was
other side of the Atlantic the New true throughout the Army, black sol-
York Port of Embarkation inspected diers in the European Theater had a
troops carefully before embarkation venereal disease rate about four and
and either kept infected men back for one-half times that of white troops,
treatment or provided treatment on the result of complex causes largely
shipboard. Surgeon General Kirk, not correctable by the theater medical
however, was reluctant to stop alto- service. The black rate did respond,
gether shipment of men with venereal however, to education and prevention
disease, lest he create a new medical efforts, falling from 127 cases per
way for malingerers to avoid overseas 1,000 troops per year in February
duty. Further, many troops became 1944 to 83 in June. Its general rise
infected during their last preembarka- and decline paralleled those for other
tion leaves, twenty-four to forty-eight troops, only at a higher level. Among
hours before sailing, and their symp- overseas theaters, which normally had
toms did not appear in time to be higher venereal disease rates than the
noted in boarding inspections or to continental United States, the Euro-
be treated and cured on the voyage. pean Theater during 1942-44 ranked
The Army, as a result, continued to lower than all other theaters but the
import venereal disease into the Brit- Southwest Pacific and Pacific Ocean.69
ish Isles, and its doing so remained Between the start of BOLERO in
an unresolved irritant in Anglo-Amer- mid-1942 and the end of May 1944
ican medical relations.68 the European Theater of Operations
The medical service's broad-fronted recorded about 433,000 cases of dis-
attack on venereal disease produced ease admitted to hospitals and quar-
encouraging results. The rate of new ters, about 64,000 cases of nonbattle
68 69
Ltrs, Hawley to TSG, 19 Aug and 14 Oct 43, Quotation from Padget Interv, 1 Aug 45, box
and TSG to Hawley, 25 Aug and 2 Oct 43, file HD 223, RG 112, NARA. See also Hoff, ed., Diseases
024 ETO O/CS (Hawley-SGO Corresp); Ltrs, Transmitted Through Contact, p. 266; Mins, 23d Meet-
Hawley to CG, New York Port of Embarkation, 3 ing of Base Section Surgeons, 5 Jun 44, p. 4, file
Feb 44, and to DepCdr, ETO, 27 Mar 44, file HD HD 337; Gordon "Hist," vol. 2, pt. 5, pp. 28-33,
024 ETO C/S (Hawley Chron). For the U.S. end of fig. 18, table 7, CMH. For the venereal disease
the problem, see Hoff, ed., Diseases Transmitted problem among black soldiers and its causes, see
Through Contact, pp. 148 and 155. Lee, Employment of Negro Troops, pp. 277-78.
148 EUROPEAN THEATER OF OPERATIONS
injury, and 4,300 of combat wounds. and Pacific areas of operations, with
Throughout the buildup, the theater their greater incidence of deadly sick-
had fewer sick per 1,000 troops per ness. The ETO's daily average nonef-
year than any other overseas theater fective rate for all causes remained
but the North American and Latin below that in the United States until
American. The ETO sick rate de- the invasion. Clearly, as it awaited the
clined month by month, except for invasion of Europe, the medical ser-
temporary winter upsurges reflecting vice was carrying out its mandate to
the prevalence of respiratory infec-
conserve the fighting strength of the
tions, from 1,087 admissions per
1,000 in February 1942 to 245 in Army.70
June 1944. Deaths from disease per 70
These figures are drawn from Frank A. Reister,
1,000 men remained consistently ed., Medical Statistics in World War II, Medical Depart-
below 0.500 during the preinvasion ment, United States Army in World War II (Wash-
period, a rate lower even than that in ington, D.C.: Office of the Surgeon General, De-
partment of the Army, 1975), pp. 72-79, 608-09,
the United States and half what the 630-31. See also tables in Gordon "Hist," vol. 2, pt.
Army suffered in the tropical Asian 12, CMH.
CHAPTER VI
The ground forces and Services of ment, with the qualification that he
Supply were to collect evacuees at would be able to support the landing
French airstrips for pickup by trans- if he could borrow field medical units,
port planes returning to England. Air hospitals, and equipment from the
Force medical personnel were to care British, who, of course, had none to
for the patients in flight, and the Ser- spare. Reports such as this helped
vices of Supply would deplane them scuttle SLEDGEHAMMER and ROUNDUP
in Britain and transfer them to hospi- and paved the way for the commit-
5
tals. For their own forces the Ameri- ment to TORCH.
can planners began outlining the Cross-Channel assault planning of
complicated sequence in which field all sorts came to a stop in late 1942,
army and then SOS medical units as TORCH plans and preparations mo-
would land in France. They also nopolized the attention of British and
roughed out a system for receiving American staffs. Yet the ROUNDUP
water-evacuated casualties in England, studies and conclusions—preserved in
using field hospitals and clearing sta- memoranda, data books, and individ-
tions at the ports for triage and emer- ual memories—would constitute a
gency surgery and distributing trans- starting point for the next round of
portable patients at once to selected invasion planning. Many of the princi-
hospitals inland.4 ples and concepts of operation first
Medical invasion planning, in this sketchily outlined in ROUNDUP would
period of limited theater resources, at be the foundation of the much more
6
times took on an air of unreality. elaborate plans to follow.
During July, for example, in a last
effort to avoid the diversion to North OVERLORD: The Planning Process
Africa, General Marshall ordered the The decision of the Allied leaders
European Theater and Services of at Casablanca, in January 1943, to
Supply to report on the feasibility of revive the cross-Channel attack
launching a small-scale cross-Channel project for execution sometime in
attack, code-named SLEDGEHAMMER, 1944 set in motion a lengthy, com-
on 15 September. Hawley, in re- plex planning process. It began with a
sponse, informed General Lee that, if small Anglo-American staff, eventual-
the buildup continued at its present ly drew in most British and American
pace, the medical service would be headquarters, and ended in the final
short 8,900 beds and 8,616 officers test of strength in the west with Nazi
and men on the projected attack date Germany.
and would have no hospital train In March 1943, to give organiza-
units, ambulance battalions, or boats tional substance to the Casablanca de-
for water evacuation. Pressed by Lee
to report positively on how he could
5
support the operation, the chief sur- An account of this incident, with documents, is
in Larkey "Hist," ch. 4, pp. 2-6 and apps. 2 and 3.
geon reiterated his previous assess- 6
Harrison, Cross-Channel, pp. 31-32; Larkey
"Hist," ch. 2, p. 73; Memo, CG, SOS, to ACofS,
G-4, and CsofSupSvcs, SOS, 1 Apr 43, sub: Admin-
4
Larkey "Hist," ch. 2, pp. 68-72; Miscellaneous istrative Planning, file HD 024 ETO O/CS (Spruit
SPOBS/ROUNDUP Papers file, CMH. File re Policy).
PREPARATIONS FOR INVASION 153
continental logistics system, General nate with it was never entirely set-
Eisenhower, as ETO commander, tled). ADSEC at this point was to
early in February activated two new revert to the status of a movable base
headquarters: Advance Section, Com- section under FECOMZ. The section
munications Zone (ADSEC), and For- would follow close behind the armies
ward Echelon, Communications Zone and link them to the Services of
(FECOMZ). Supply, relinquishing supply activities
Each of these new headquarters nearer the shore to other base sec-
possessed immediate planning and tions that would be formed as the
future operational functions. The Ad- campaign progressed. Around D + 90
vance Section was attached to the SHAEF and ETOUSA were expected
First Army, which had charge of all to move to France, whereupon
tactical planning for the American FECOMZ would merge back into the
part of the amphibious assault and ETO-SOS headquarters and General
also did logistics planning for the first Lee, as Eisenhower's deputy for logis-
fifteen day on shore. Besides assisting tics, would assume direct control of
with army planning, ADSEC worked all elements of the Services of
out the details of SOS operations for Supply—to be redesignated the Com-
9
the period from the sixteenth through munications Zone (COMZ).
the fortieth day after D-Day (D+16 Under this administrative arrange-
through D+40). The Forward Eche- ment the First Army surgeon, Colonel
lon, at the outset an element of 21 Rogers, and his staff, working closely
Army Group headquarters, supervised with the surgeons of the two assault
ADSEC planning and itself made SOS corps, the V and VII, drew up medi-
plans for D+41 through D+90. cal support plans for the initial land-
Operationally, ADSEC was to act as ing and the first two weeks of combat.
the supply element of the First Army The ADSEC surgeon, Col. Charles H.
until D+15, organizing the beach
behind the advancing troops. From Beasley, MC, and the FECOMZ sur-
D+15 through D+40, after the army geon, Colonel Spruit, prepared plans
established its rear boundary, ADSEC for establishing the medical portion
would constitute the communications of the continental Communications
zone under the supervision of 21
Army Group, exercised through the 9
The SOS underwent formal redesignation as
Forward Echelon. FECOMZ itself was Communications Zone, ETOUSA, in GO No. 60,
HQ, ETOUSA, 7 Jun 44, but the term came into in-
to become active on D+41, when a creasing use from the end of February, even on
second U.S. army went into operation SOS letterheads. COMZ will be used in this chapter
and the 1st Army Group, hitherto in discussing logistical and medical planning, but
SOS will be used in reference to operations until
subordinate to 21 Army Group, the narrative reaches the actual activation of COMZ.
became a separate command directly For a description of the convoluted logistics com-
under SHAEF (see Chart 5). The For- mand system, see Ruppenthal, Logistical Support,
1:203-15 and 219-27. See also First U.S. Army
ward Echelon then would take com- Report of Operations, 20 Oct 43-1 Aug 44, bk. I,
mand of the entire American support pp. 25-27; HQ, Forward Echelon, COMZ,
area behind the armies (whether ETOUSA, Communications Zone Plan (hereafter
cited as FECOMZ Plan), 14 May 44, pp. 2-5, file
under the U.S. army group or coordi- HD 370 ETO.
160 EUROPEAN THEATER OF OPERATIONS
Zone. Roger's First Army medical sec- portions of their plans, including, for
tion had come over from the United instance, the basic army-navy agree-
States with its parent headquarters ment on division of cross-Channel
and had been in operation in London evacuation responsibility. Hawley's
and Bristol since October 1943, but office published its own standard op-
the ADSEC and FECOMZ surgeons' erating procedure for medical service
staffs had to be improvised in haste on the Continent and oversaw base
(see Charts 6 and 7). Of substantial section planning for support of the
size—the ADSEC surgeon's office embarking invasion forces and for re-
eventually included forty-three offi- ceiving casualties from the far shore.
cers and fifty-six enlisted men—these At SHAEF General Kenner kept in
organizations drew manpower from close touch with ETO medical plan-
casuals, base section headquarters, ning and intervened in selected as-
and General Hawley's office. Colonel pects of it. Of the higher-level ETO
Beasley, for example, had been sur- surgeons, Colonel Gorby of the 1st
geon of the Eastern Base Section; his Army Group, in accord with the
deputy, Col. James B. Mason, MC, group's inactive role at this stage, had
had served as Hawley's chief of oper- the least to do with NEPTUNE plan-
ations; and Colonel Spruit had come ning. He confined himself to keeping
over to FECOMZ from running the informed of First Army activities, as-
Cheltenham branch of the chief sur- sembling the medical portion of the
geon's establishment. Each of the troop buildup schedule, and partici-
COMZ surgeons organized his office pating in SHAEF medical policy dis-
11
into divisions paralleling those under cussions.
the chief surgeon. Spruit's office, The NEPTUNE medical planners
indeed, was for practical purposes an made use of the data collected by
10
advance echelon of Hawley's. their ROUNDUP predecessors and
While the First Army, ADSEC, and adopted many principles worked out
FECOMZ surgeons drafted the NEP- for the projected earlier invasion.
TUNE plans, many of the decisions in- They also availed themselves of the
corporated in them came from other medical lessons learned in amphibi-
headquarters. General Hawley, ous operations in North Africa, Sicily,
charged with supervising all theater and Italy. The Fifth Army late in 1943
medical planning, took part in estab- assembled many of these lessons into
lishing most major policies. His staff
11
furnished information to the army OofCSurg, HQ, ETOUSA, Standard Operating
Procedure for Medical Service in Continental Oper-
and COMZ surgeons and wrote key ations (hereafter cited as O/CS Continental SOP), 4
Apr 44, file 370.02. For activities of Hawley's office,
10
An. 9, COMZ Medical Plan (hereafter cited as see annual reports of the Operations Division—es-
An. 9—Medical), p. 1, to FECOMZ Plan, 14 May 44, pecially Planning Branch, Evacuation Branch, Medi-
file HD 370 ETO; An. 8—Medical, p. 4, to HQ, cal Intelligence Branch, Statistics and Requirements
ADSEC, COMZ, NEPTUNE Operation Plan D to Branch—and of the Hospitalization Division for
D + 4 1 (hereafter cited as ADSEC Plan), 30 Apr 44, 1944, as well as Middleton Interv, 1968-69, vol. 1,
file HD 370 ETO; Surg, ADSEC, COMZ, Annual p. 218, NLM. On Kenner's activities, see Medical
Rpt, 1944, pp. 1-5; Larkey "Hist," ch. 8, pp. 5-9; Division, COSSAC/SHAEF, War Diary, February-
Personnel Division, OofCSurg, HQ, ETOUSA, May 1944. On Gorby, see 12th Army Group Report
Annual Rpt, 1944, p. 12. of Operations, vol. XIII (Medical Section), p. 7.
PREPARATIONS FOR INVASION 161
treacherous body of water, with limit- supply dumps. Their medical battal-
14
ed shipping and port facilities. ions would set up the first nondivi-
Support for the initial attack from sional medical facilities on the far
15
the sea required the most complex ar- shore.
rangements and caused the planners For medical support planners the
the most controversy and soul-search- number of casualties to be expected
ing. The First Army tactical plan was on and immediately after D-Day was
straightforward. On D-Day the V the first crucial consideration. On this
Corps, with elements of the 1st and point COSSAC and SHAEF for a long
29th Infantry Divisions, was to go time could not obtain agreement
ashore on the army's left on OMAHA among the concerned staffs, although
beach, a stretch of Normandy coast all expected losses to be very heavy.
backed by low bluffs northwest of Different headquarters held to various
Bayeaux. The VII Corps, with the 4th estimates until February 1944, when
Infantry Division, was to land on the General Kenner assembled the chief
right on UTAH beach, near the base of medical officers of the major invasion
the eastern side of the Cotentin Pe- commands to reach a common figure
ninsula. The 82d and 101st Airborne "to establish our position for General
Divisions, also under VII Corps, were Eisenhower." The conferees, after
to drop before the main attack, to much debate, decided to assume for
secure crossings over the flooded planning purposes that the assault
areas immediately behind UTAH. Lo- force would suffer 12 percent wound-
gistical support for the seaborne ed on D-Day and 6.5 percent on D+1
forces was to come from engineer and D+2, with a declining proportion
special brigades—two, forming a pro- thereafter. Using this ratio, First
visional brigade group, for OMAHA Army surgeons had to think in terms
and one for UTAH. These brigades of treating or evacuating over 7,200
were to begin landing soon after the wounded on D-Day and another
first infantry elements. Assisted by 7,800 in the next forty-eight hours, of
shore party battalions of Rear Adm. whom about 3 percent—at least
Alan G. Kirk's Western Naval Task 450—would be too severely injured to
Force, which was responsible for
transporting, landing, and supporting 15
For the assault plan, see First U.S. Army Report
the American invasion troops, the of Operations, 20 Oct 43-1 Aug 44, bk. 1, p. 26;
Harrison, Cross-Channel, pp. 174-97; and Rup-
special brigades would clear the penthal, Logistical Support, 1:178, 269-70, 282-85,
beaches of wreckage, mines, and ob- 324-44. Each engineer special brigade employed in
NEPTUNE consisted of 1 medical and 3 engineer bat-
stacles; open roads; and establish talions, a DUKW battalion, and various small signal,
military police, and quartermaster elements. The
14
Unless otherwise noted, the following discus- brigade group on OMAHA also included the 11th
sion is based on An. 6, Medical Plan (hereafter cited Port, to operate the MULBERRY artificial harbor. Spe-
as An. 6—Medical), to First U.S. Army Operations cial brigades could break down into battalion- or
Plan, Operation NEPTUNE (hereafter cited as company-size composite beach groups to support
FUSA Plan), 25 Feb 44; An. 8—Medical to ADSEC regimental or battalion combat teams. The Western
Plan, 30 Apr 44; and An. 9—Medical to FECOMZ Naval Task Force, also designated by the U.S. Navy
Plan, 14 May 44. All in file HD 370 ETO. See also as Task Force 122, was the U.S. component of the
O/CS Continental SOP, 4 Apr 44, file 370.02. Addi- Allied Naval Expeditionary Force, the overall naval
tional sources are cited where appropriate. command under SHAEF.
PREPARATIONS FOR INVASION 165
evacuation and a serious medical break- all movable casualties on LSTs and
down must inevitably occur.20 other landing craft (Diagram 1). The
Colonel Rogers and his staff built beach medical elements also were to
their First Army medical support evacuate and support the airborne di-
plans around the basic COSSAC- visions, as soon as the seaborne
SHAEF evacuation decisions and at- forces made contact with them. Until
tempted to provide against a break- then the airborne medical companies,
down of seaward evacuation. To this landing by parachute or glider with
end Colonel Rogers arranged to rein- attached surgical teams soon after the
force each assault division medical infantry touched down, would collect
battalion with an additional collecting and treat all paratrooper wounded.
21
first, between D-Day and D+15, with and go into operation in Cherbourg.
field hospitals, auxiliary surgical By D+90 both the Advance Section
teams, and the corps medical battal- and Forward Echelon expected to
ions leading. Evacuation hospitals have twenty-five general hospitals on
were to follow, beginning on D + 5 , the Continent, at preassigned loca-
along with army medical battalions tions in Normandy and Brittany, be-
(separate) and groups, a supply depot
sides a full complement of supply
company, a convalescent hospital, a
laboratory unit, and a gas treatment depots and other COMZ medical
battalion. A few ADSEC units were to units.22
be interspersed with those of the First Medical supplies in large quantities
Army, but most would arrive after were to start arriving on the beaches
D+12. The first scheduled to come as soon as the troops did. All First
were additional ambulance companies Army combat and support units land-
and evacuation and field hospitals, in-
tended to function as station hospitals 22
In addition to the basic plans previously cited,
and holding units. On or about see Surg, VII Corps, Annual Rpt, 1944, pp. 3-4 and
6-7. Memo, Surg, FECOMZ, to G-4, FECOMZ, 6
D+15 the first general hospital in Apr 44, file HD 370 (HQ. ADSEC Plans and Cor-
France, the 298th, was to disembark resp, 1944); Larkey "Hist," ch. 8, app. 4.
170 EUROPEAN THEATER OF OPERATIONS
TABLE 3—PLANNED LANDING OF MEDICAL UNITS, 6-14 JUNE 1944
a
Small portion of troop buildup schedule, exclusive of brigade and corps units.
Source: First U.S. Army Report of Operations, 20 Oct 43-1 Aug 44, bk. II, an. 2, pp. 60-61.
ing on D-Day and the following 3 D-Day the First Army, Advance Sec-
days were to carry reserves of rapidly tion, and Forward Echelon submitted
consumable items, in the hands and requisitions to the chief surgeon's
on the backs of soldiers and loaded Supply Division for their periods of
into vehicles. Each infantry, artillery, primary logistical responsibility, with
chemical warfare, engineer, and allowances calculated to replace lost
ranger battalion; each divisional col- and consumed matériel and to estab-
lecting and clearing company; and lish 14- or 21-day reserves (depend-
each engineer special brigade medical ing on the echelon and the class of
battalion was to receive a special al- supplies) in army and COMZ depots
lowance of dressings, small imple- by D+90. The supplies so requested
ments, drugs, morphine, and dried
were to be packed before the assault
plasma packed in waterproof contain-
ers portable by a single man. Each or- and loaded on ships on a daily sched-
ganization also would bring ashore ule as the buildup proceeded.
extra litters, field medical chests, From D-Day until about D+40
splints, and blankets. In the Advance most maintenance supplies would
Section mobile hospitals were to consist of special division assault sur-
embark with reserves of expendable gical and medical units, designed by
supplies sufficient for 10 days of op- the First Army and assembled by the
erations; other medical units were to Supply Division. Each of these units
carry 3-day reserves. included dressings, drugs, and equip-
Medical maintenance supplies were ment for treating 500 casualties and
to be shipped automatically from the was divided into 100-pound water-
United Kingdom during the first 90 proof packages for easy, safe move-
days of continental operations. Before ment and storage. To ensure arrival
PREPARATIONS FOR INVASION 171
rolling off ships at ports and beach- tial danger. Commanders and sur-
es.24 geons also would have to guard
The NEPTUNE planners concerned against typhoid, but such familiar dis-
themselves with keeping the troops eases of troops in the field as dysen-
on the Continent healthy, as well as tery, diarrhea, influenza, venereal dis-
with treating them when sick and in- eases, and infectious hepatitis, as well
jured. Army and COMZ preventive as a variety of skin ailments and
medicine plans, based on information vermin infestations, were likely to
collected and collated by the chief constitute the campaign's principal
surgeon's Medical Intelligence medical problems. Even though
Branch, assessed the state of public American troops had already been
health in occupied France and listed immunized against typhus, the field
the likely major disease threats on the armies and the Communications Zone
Continent. Troop commanders in planned to issue insecticide powder
France, the plans warned, could to their troops and prepared for mass
expect to find an ill-nourished, dirty inspection and delousing of soldiers,
civilian population whose hospitals civilians, and prisoners of war. NEP-
and public health agencies were oper- TUNE plans for combating other dis-
ating inefficiently because the occupy- eases depended on the standard im-
ing Germans had stripped them of munizations, personal hygiene, mass
much equipment and personnel. sanitation, water treatment, sewage
French water purification and sewage disposal, and pest eradication proce-
disposal facilities, never the best, dures, as well as on special supervi-
could be assumed to have broken sion of soldier eating habits to pre-
down under administrative neglect vent vitamin deficiencies among men
and combat damage. subsisting for long periods on C- and
25
Compared to what the Army faced K-rations.
in the Mediterranean, the Southwest Preventive medicine planners ex-
Pacific, and other non-European trop- pected venereal diseases, the inci-
ical theaters, disease in northwestern dence of which reportedly had in-
Europe posed hardly any threat to the creased threefold in France since
conduct of operations. Epidemic 1941, to constitute "one of the most
louse-borne typhus, which the plan- difficult control problems to be en-
ners considered likely to be intro- countered." First Army and COMZ
duced from eastern Europe by plans, backed up by a theater circular
German troops and slave laborers, drafted by Colonel Gordon's Preven-
loomed as the disease of most poten- tive Medicine Division in cooperation
with the senior medical consultants
24
Memo, Kenner to ACofS, G-4, SHAEF, 13 Apr
25
44; see also Mins, Conference of Gen Kenner with For medical intelligence, see Medical Intelli-
Brig Gen Grow, 11 Apr 44. Both in Medical Divi- gence Branch, Operations Division, OofCSurg, HQ,
sion, COSSAC/SHAEF, War Diary, April 1944. For ETOUSA, Annual Rpt, 1944, pp. 2-3, and Ltr,
a definition of nontransportables, see Ltr, Col E. C. Hawley to TSG, 29 May 44, file HD 024 ETO O/CS
Cutler to Lt Col Crisler, 16 Apr 44, box 3, Hawley (Hawley-SGO Corresp). See also Cir Ltr No. 53,
Papers, MHI. See also Memo, Col F. H. Mowrey to OofCSurg, HQ, ETOUSA, 8 Apr 44, sub: Improve-
Movements Division, Office of CofTrans, ETO, 29 ment of Nutrition of Combat Troops, in Larkey
May 44, EvacCorresp, 1942-45, file HD 024 ETO. "Hist," ch. 8, app. 17.
PREPARATIONS FOR INVASION 173
that plasma alone could not. In re- ished organizing and training the 11
sponse to this growing weight of evi- officers and 143 enlisted men of its
dence General Hawley in July 1943 base, COMZ, and army depots. Gen-
decided to establish an ETO whole eral Hawley meanwhile secured from
blood service, modeled on the highly the theater top priority for shipments
successful British Army Transfusion of blood to France and from the
Service. Ninth Air Force a guarantee of daily
The American blood bank took
space on aircraft.28
shape during late 1943 and early
1944, planned and supervised by an As the invasion approached, the
ad hoc committee headed by Colonel ETO blood service faced a prospec-
Mason, then chief of the Operations tive supply shortage. Since whole
Division, and including Colonels blood could be stored for a maximum
Cutler and Middleton, the command- of fourteen days, the theater required
er of the 1st Medical General Labora- a reliable flow of new blood about
tory, and the chief of the Supply Divi- equal to the expected usage rate in
sion. No T/O blood bank unit exist- the field, a rate which Colonel
ed, so General Hawley improvised Mason's committee, applying the Brit-
one. He reorganized the 250-bed ish planning ratio of 1 pint of blood
152d Station Hospital into a base for each 8-10 wounded, estimated as
depot, located at the 1st Medical Gen- averaging about 200 pints per day
eral Laboratory at Salisbury, and during the first three months of
mobile advance depots—two for the combat. This amount was safely
Communications Zone and two for within the ETO blood bank's 600-
the armies. The base depot was to
pints-per-day collection and process-
collect type O blood (the only kind
used) from volunteer SOS donors, ing capacity. Even as the bank pre-
process it, and prepare it for daily pared for operations, however, the
shipment to France, where the ad- medical service, on the basis of re-
vance depots, using truck-mounted ports from the Fifth Army in Italy, in-
refrigerators, would distribute it as far creased its estimate of requirements
forward as the field hospital platoons to 1 pint for every 2.2 casualties.
attached to division clearing stations. 28
Equipment for the units came from For development of the concepts of shock and
transfusion, see Douglas B. Kendrick, Blood Program
the United States, under a special in World War II, Medical Department, United States
project for continental operations Army in World War II (Washington, D.C.: Office of
(PROCO), and from the British, who the Surgeon General, Department of the Army,
1964), pp. ix, 15-17, 30-60, 459, 469-500, 508-12.
furnished indispensable refrigerators, For development of the ETO blood bank, see file
as well as bottles, tubing, and needles 742 ETO General File (Blood Program). See also
for bleeding and transfusion. By mid- Professional Services Division, OofCSurg, HQ,
ETOUSA, Annual Rpt, 1943, p. 8; James B. Mason,
April 1944 the blood bank, under the "Planning for the ETO Blood Bank," The Military
overall command of the 1st Medical Surgeon 102 (June 1948): 460-68; O/CS Continental
General Laboratory and with Maj. SOP, 4 Apr 44, pp. 29-32, file HD 370.02. PROCO
Robert C. Hardin, MC, in immediate was an Army Service Forces system for tailoring
equipment for particular tasks not covered by ordi-
charge as executive officer, had se- nary unit allowances or T/E. See Ruppenthal, Logis-
cured most of its equipment and fin- tical Support, 1:260-61.
176 EUROPEAN THEATER OF OPERATIONS
buildup persistent shortages and ad- The Supply Division during 1942
ministrative deficiencies had made it had been the weakest element in
difficult for the supply service even to ETO medical administration; it im-
support the troops in Britain. The proved only marginally in 1943. In
Supply Division of the chief surgeon's March Col. Walter L. Perry, MC, ar-
office lacked qualified manpower and rived to take over the division, replac-
leadership to meet its expanding re- ing the third in a series of unsatisfac-
sponsibilities, and the flow of matériel tory chiefs. General Hawley welcomed
from American and British sources Perry, whom the surgeon general had
encountered diversions and dams at picked for the position and who was
many points. By early 1944 both Gen- experienced in depot operations, and
gave him a free hand in reorganizing
eral Hawley and Surgeon General
the supply system. Perry, however,
Kirk had been forced to realize that, like his predecessors, found the job
unless drastically reorganized and re- too much for him. Most of his diffi-
inforced, the medical supply service culties stemmed from a lack of
would fail in its effort to support the trained men. Although his Chelten-
coming offensive. ham staff doubled during the year,
PREPARATIONS FOR INVASION 179
own stock control procedure. In most During 1943, as American war pro-
depots, record-keeping fell behind duction reached full momentum and
issues, leaving both local commanders the shipping shortage eased, the Eu-
and the Supply Division unaware of ropean Theater drew an increasing
developing shortages until the shelves proportion of medical items, as well
were empty. The Supply Division re- as other types of supply, from the
quired periodic reports from the United States. Small at the beginning
depots of stores on hand; but the of the year, the flow of matériel grew
depots' poor record-keeping rendered with the accelerating BOLERO buildup,
this information suspect, and the but it by no means went smoothly.
Cheltenham office lacked the staff General Hawley complained through-
and tabulating equipment to prepare out the year about delayed or only
up-to-date theater-wide reports on partly filled requisitions, while the
stock levels and distribution. With in- surgeon general's office and the Port
complete and outdated information, of New York insisted that they were
the Supply Division could not shift meeting all ETO requirements. The
matériel between depots to even out stock control deficiencies in Hawley's
local shortages and surpluses. The depots contributed much to these dis-
more enterprising depot commanders agreements, both by preventing
developed their own contacts for this timely dispatch of requisitions to the
purpose. Medical units and hospitals, United States and by making it diffi-
in spite of instructions to the con- cult to ascertain exactly what supplies
trary, went from one depot to another actually had arrived.35
until they secured not only the items Shipment of preassembled and
they needed but also reserves consid- packed table-of-equipment (T/E) out-
erably over authorized allowances. fits for hospitals and field medical
These field improvisations enabled units continued to be trouble-
the medical service to get along from plagued, in spite of War Department
day to day, but the resulting lack of and ETO efforts to improve the
accurate information disrupted thea- system and in spite of the abandon-
ter-wide supply planning and hin- ment by the New York Port of Embar-
dered General Hawley in dealing with kation of the practice of earmarking
his sources of medical supply in Brit- particular outfits for individual orga-
ain and the United States.34 nizations. Delivery of assemblies, in-
stead of keeping pace with unit arriv-
As quoted in Wiltse, ed., Medical Supply, p. 274.
34 als in Britain, fell behind. ETO
See also Progress Report, 16 Feb 44, in ETO depots then had to deplete their
Supply Survey, January-March 1944, file HD 333 stocks to outfit disembarking units,
ETO; Kelley Interv, 27 Jan 45, box 221, RG 112,
NARA; Memo, Hawley to DepCSurg (Cheltenham),
22 Sep 43, file HD 024 ETO O/CS (Spruit Policy many difficulties in common with the other supply
Notebook). In latter file Cir Ltr No. 54 (Supply No. services.
35
6), OofCSurg, HQ, ETOUSA, 9 Apr 43, sub: Supply "Med Svc Hist, 1942-43," pp. 58-59, file HD
Policies and Procedures, ETO, outlines the pre- 314.7-2 ETO. For typical complaints, see Ltrs,
scribed—but often not followed—procedures. Rup- Hawley to TSG, 7 Dec 43; Hawley to Col S. B.
penthal, Logistical Support, 1:152-59, describes the Hays, MC, 7 Feb 44; and Hawley to Rankin, 16 Feb
organization, procedures, and problems of U.S. 44. All in file HD 024 ETO O/CS (Hawley-SGO
depots in Great Britain. The medical service had Corresp).
182 EUROPEAN THEATER OF OPERATIONS
with no assurance of early replenish- over 900 other items, among them
ment. Furthermore, most medical unit surgical instruments and many drugs.
assemblies—especially those for hos- British procurement had been in-
pitals—reached British depots short valuable in meeting TORCH require-
15-30 percent of their components, in ments and in tiding the medical ser-
spite of strenuous efforts by the New vice over its period of low priorities
York port to have them carefully and limited support from the United
marked and loaded on one ship. After States, but it possessed many unsatis-
much mutual recrimination between factory aspects. The British insisted
Hawley and the surgeon general's that the Americans place very large
office, an investigation early in 1944 long-term orders far in advance of de-
disclosed that most assemblies were liveries, a procedure that made it all
entering English ports intact but that but impossible to adjust procurement
the Supply Division had made no spe- to changing requirements. At the
cial arrangements for keeping them same time British deliveries on these
together as they were unloaded. As a contracts were irregular in both
result, portions of hospitals and unit timing and quantity. Few quality con-
outfits turned up in different depots. trols existed. In the emergency of
These depots, uninstructed in han- 1942 General Hawley had disregard-
dling this matériel, simply added it to ed American specifications in accept-
their general stock without informing ing British supplies. He used what-
36
the Supply Division. ever his consultants, after examining
Although shipments from the samples, declared would serve the
United States increased, the medical purpose. These items underwent no
service during 1943 procured more inspection as they came off the pro-
than half of its supplies, by tonnage, duction lines; shipments reaching
from Great Britain. British matériel, American units frequently were
in fact, comprised 49 percent of all poorly packed, substandard in quality,
the goods received by the medical or in unusable condition. Even when
service between mid-1942 and mid- British matériel arrived in good con-
1944. These supplies included most dition, U.S. Army medical people
hospital furniture and housekeeping were unaccustomed to its differences
equipment, as well as quantities of from their own and considered many
items inferior to their American
36
Memo, Col T. S. Voorhees to TSG, 17 Mar 44, equivalents. Seemingly small differ-
sub: Report as to Splitting Up of Hospital Assem- ences in design and markings took
blies in Shipment From the U.S. to the ETO, in getting used to, and at least one cost
ETO Supply Survey, January-March 1944, file HD
333 ETO; "Med Svc Hist, 1942-43," p. 58, file HD lives. British-supplied carbon dioxide,
314.7-2 ETO; Supply Division, OofCSurg, HQ, used in anesthesia, came in tanks
ETOUSA, Annual Rpt, 1944, sec. IV, pp. 1-4, sec.
V, p. 1, and sec. VI, p. 2; Ltr, Tyng to Hawley, 21 painted green, the color used in the
Jan 43, and other 1943 letters, file HD 024 ETO United States to denote oxygen. The
O/CS (Hawley-SGO Corresp). Ruppenthal, Logistical resulting mixups caused at least eight
Support, 1:132-46, describes the complex problems
of shipping and marking ETO-bound supplies of all deaths on operating tables before the
kinds. Professional Services Division issued
PREPARATIONS FOR INVASION 183
warnings and arranged for relabeling large orders for British goods to be
of tanks.37 delivered in the first half of 1944.38
In August 1943 General Hawley During the last few months of
began trying to reduce his dependen- 1943, as more and more troops
cy on the British. Aware of deficien- poured into the British Isles and inva-
cies in quality and slow deliveries, he sion preparations got under way, the
also had discovered that his allies, Supply Division obviously began to
while furnishing inferior goods to the buckle under its steadily increasing
European Theater, simultaneously work load. Disembarking units and
were obtaining large quantities of newly opened hospitals waited for
standard American medical supplies weeks for their basic equipment. The
and equipment from the United Air Force, to Hawley's embarrassment
States under Lend-Lease. At Hawley's in his fight against an autonomous air
medical service, continued to com-
urging, Surgeon General Kirk author-
plain of shortages of field chests and
ized the theater chief surgeon to other vital articles; the flight surgeons
cancel contracts with the British for continued to resort, successfully, to
items duplicating lend-lease ship- their own channels to remedy these
ments and to requisition them direct- deficiencies. Early in 1944 the fixed
ly from the New York Port of Embar- hospitals in the Southern Base Sec-
kation. The War Department, at the tion, where most American troops
same time, instructed the medical and were concentrated, had only 75 per-
other supply services to stop buying cent of their authorized equipment.
from the British a long list of items In response to complaints from all
now overstocked in the United States. quarters, Hawley pressed the Supply
In spite of orders from Hawley, how- Division for information but received
ever, the Supply Division and its only incomplete, inconsistent, or inac-
London procurement office, through curate replies. At the same time the
poor coordination, made no real at- tone of his correspondence with the
tempt to reduce local purchases. In- surgeon general's office grew increas-
stead, the procurement office placed ingly testy, as each side blamed the
other for shortages and delays. On 7
37
Memo, Col T. S. Voorhees to TSG, 14 Mar 44, December Hawley told General Kirk:
sub: British Procurement, in ETO Supply Survey, "I have had a Hell of a lot of trouble
January-March 1944, file HD 333 ETO; Ltr, Hawley
to TSG, 14 Oct 43, file HD 024 ETO O/CS
with supply and am still having
(Hawley-SGO Corresp). For statistics on British pro-
38
curement, see Wiltse, ed., Medical Supply, p. 270, Ltrs, Hawley to TSG, 10 Aug and 17 Sep 43;
and Ruppenthal, Logistical Support, 1:256-57. See Memo, Edward Reynolds to TSG, 24 Aug 43, sub:
also Carter, ed., Surgical Consultants, 2:36-37. For the Letter From Gen Hawley . . . ; Ltr, TSG to
tank problem, see Senior Consultant in Anesthesiol- Hawley, 24 Aug 43; Memo, Reynolds to TSG, 18
ogy sec., Professional Services Division, OofCSurg, Nov 43, sub: Data for Reply to General Hawley's
HQ, ETOUSA, Annual Rpt, 1943; Mins, 18th Meet- Letter. ... All in file HD 024 ETO O/CS (Hawley-
ing of Base Section Surgeons, 27 Mar 44, p. 10, file SGO Corresp). See also Voorhees, "Resume," 12
HD 337; Editorial Advisory Board, 1962, p. 48; and Apr 44, pp. 4-5, and Memo, Col T. S. Voorhees to
Col T. S. Voorhees, "A Lawyer Among Army Doc- CSurg, ETO, 18 Mar 44, sub: Report as to British
tors" (Fort Detrick, Md.: Historical Unit, U.S. Army Procurement, both in ETO Supply Survey, January-
Medical Department, n.d.), pp. 92-94. March 1944, file HD 333 ETO.
184 EUROPEAN THEATER OF OPERATIONS
lowed the chief surgeon to retain activated in Great Britain or called for
Fenton as deputy Supply Division from the United States eight addition-
chief. Hawley held onto Fenton partly al field medical depot companies and
as a possible replacement for Hays, assigned all depot personnel to them.
who suffered a severe gastric attack While these field companies rarely
early in May; but, to the chief sur- matched in size and composition the
geon's immense relief, his supply requirements of any particular depot,
chief recovered and was able to and hence usually had to be divided
resume duty before D-Day.46 among several installations, their es-
Depot reorganization went forward tablishment did end the transiency of
(Table 4). On 2 February Colonel depot personnel. They also provided
Voorhees and the chief surgeon pre- an organization in which deserving
vailed upon the ETO G-1 to halt all soldiers could receive promotions.47
transfers of soldiers then working in Hangen and Beers revamped depot
medical supply depots. This action operations and stock record-keeping.
temporarily stabilized the depot force. To better control supply issues, they
After much negotiation between reduced the number of depots distrib-
Hawley, Voorhees, and the theater
G-1 and G-4, the ETO headquarters 47
The chief surgeon tried unsuccessfully to per-
suade the theater to authorize permanent non-T/O
organizations adapted to the various depots, but the
46
Ltrs. Hawley to TSG, 20 Apr and 6 May 44; Ltr, theater insisted on standard T/O units, leaving the
TSG to Hawley, 26 Apr 44; Ltrs, Col E. Reynolds to field companies the only alternative. Each such com-
Hawley, 16 May and 8 Jun 44; Ltr, Hawley to Reyn- pany included 8 officers and 167 men. Of the four-
olds, 15 Jun 44. All in file HD 024 ETO teen such companies in the ETO by D-Day, eight
O/CS (Hawley-SGO Corresp). See also Supply Divi- were used in fixed depots; the rest were assigned to
sion, OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, field armies or the SOS for mobile operations. See
sec. I, p. 1, ex. III; Kelley Interv, 27 Jan 45, box Supply Division, OofCSurg, HQ, ETOUSA, Annual
221. RG 112, NARA; Fenton Interv, 7 Jun 45, box Rpt, 1944, sec. II, pp. 1-2; Voorhees, "Resume," 12
222. RG 112, NARA; Memo, Voorhees to Hawley, Apr 44, and Ltr, Voorhees to TSG, 21 Feb 44, in
25 Mar 44, sub: Review of Situation as to Medical ETO Supply Survey, January-March 1944, file HD
Supply, in ETO Supply Survey, January-March 333 ETO; Kelley Interv, 27 Jan 45, box 221, RG
1944, file HD 333 ETO. 112, NARA.
PREPARATIONS FOR INVASION 189
uting to units from eight to five. They supply table. By mid-May the ETO
designated five key depots, each of depots were well stocked, and the
which held the bulk of theater stocks Supply Division knew what and how
of certain scarce items and filled req- much was in them.48
uisitions for them passed on from is- While his associates reorganized
suing depots. A sixth key depot as- the depots, Colonel Voorhees sur-
sembled and issued all tactical unit veyed the record of British medical
equipment. Other nonissuing depots supply. Reviewing the orders placed
performed maintenance and repair, late the previous year for 1944 deliv-
received matériel from the ports, and ery, he and his assistants discovered
stored reserve stocks. Hangen and that, of over 800 items involved, all
Beers published a depot operations but several varieties of dental burs
manual, establishing uniform issuing either were in oversupply in the
and inventory procedures that the United States or were being shipped
Supply Division's Depot Technical from America under Lend-Lease for
Control Branch saw were carried out. British use. After much negotiation
They also set stock levels for each is- with the Ministry of Supply and the
suing depot, based on the number of War Department, Hawley and Voor-
troops it served, and redistributed on- hees canceled most supply requests
hand matériel among installations to with the British except those for
give each its proper allowance. To dental burs and a few nonstandard ar-
collect theater-wide supply informa- ticles; they also retained arrange-
tion, Hangen and Beers replaced the ments for small local emergency pur-
three existing separate depot stock re- chases. The British either stopped
ports with a single comprehensive bi- production of the no longer wanted
weekly one. From this, the Supply Di- items or diverted them to their own
vision, employing electric tabulating forces. To assure more effective con-
machines, compiled statistics on total trol of any additional buying within
supplies on hand and required. At the the theater, the chief surgeon, at
same time Hangen and Beers set a Voorhees' suggestion, placed the
theater stock level of 75 days' supply London procurement office within the
of each item and provided for auto- Supply Division's new Stock Control
matic reorder when quantities fell
below that point plus an additional 48
Supply Division, OofCSurg, HQ, ETOUSA,
margin to allow for time taken in or- Annual Rpt, 1944, sec. II, pp 2-4, and sec. VI, pp.
dering and shipment. To bring all 6-7; Ltr, Voorhees to Reynolds, 7 Mar 44, in ETO
stocks to the 75-day level, the Supply Supply Survey, January-March 1944, file HD 333
ETO; Memo, Medical Division, SHAEF, to ACofS,
Division placed large emergency req- G-4, SHAEF, 7 Apr 44, in Medical Division,
uisitions on the New York port; it also COSSAC/SHAEF, War Diary, April 1944; Kelley
sent initial orders for over 800 items Interv, 27 Jan 45, box 221, RG 112, NARA; Memo,
OofCSurg, HQ, ETOUSA, to Maj Gen LeRoy Lutes,
in the surgeon general's catalog hith- 1 May 44, file HD 024 ETO CS (Hawley Chron);
erto not used in the theater to reduce Wiltse, ed., Medical Supply, pp. 285-87. These addi-
shipping requirements. With vessels tional medical supply shipments were only a small
part of the massive last-minute flow of OVERLORD
and supplies now available, the Euro- and BOLERO cargo into Britain. See Ruppenthal, Lo-
pean Theater thus expanded its gistical Support, 1:234-40 and 258-60.
190 EUROPEAN THEATER OF OPERATIONS
Britain had received their full equip- Third Armies, Advance Section, and
ment and held at least sixty days of Forward Echelon, in consultation with
reserve supplies. Even the Air Force General Hawley, developed medical
now relied for medical supply more troop lists for their respective com-
upon SOS channels than upon its mands. The ETO headquarters then
own. Three days before the invasion, assigned the requested units from the
a still-cautious Hawley declared: "We huge pool accumulating in the United
have just barely squeaked through on Kingdom. The First Army's preinva-
our supply. ... I shall not, however, sion allocation included one 750-bed
breathe really easily about it for an- and ten 400-bed evacuation hospitals,
other month." He had no further five field hospitals, a convalescent
cause for worry. ETO medical supply, hospital, headquarters of three medi-
as reorganized by the Voorhees mis- cal groups and eight medical battal-
51
sion, was ready for war. ions (separate), a medical gas treat-
ment battalion, an auxiliary surgical
Mounting the Attack group, a medical laboratory, a medi-
cal depot company, and eleven
Preparations for mounting NEP- collecting, six clearing, and seven am-
TUNE—equipping, organizing, and bulance companies (separate). These
embarking the assault troops and re- units underwent personnel augmenta-
inforcements so as to ensure their ar- tions and rearrangements. To provide
rival on the far shore in the right ready replacements for invasion casu-
order with the right matériel— alties, medical elements of the engi-
merged with the final stages of inva- neer special brigades and of the
sion planning. For its part in this assault and early buildup divisions re-
process the medical service selected, ceived extra officers and men above
assigned, and completed the training T/O strength. Army mobile hospitals
of army and COMZ units, equipped transferred doctors to balance their
them, and packed their supplies. It professional staffs. First Army field
furnished treatment and evacuation to and evacuation hospitals had the
troops assembling for embarkation, painful task of replacing 95 veteran
and it prepared to receive and care nurses who were considered too old
for wounded from the opening battle or physically unfit for active cam-
in Normandy. paigning.
During the final months before D- The Advance Section and Forward
Day the surgeons of the First and Echelon also received their full allot-
51
Quotation from Ltr, Hawley to TSG, 3 Jun 44,
ments of units before D-Day. ADSEC
file HD 024 ETO O/CS (Hawley-SGO Corresp). included over 1,800 medical officers,
See also Memo, Col T. S. Voorhees and H. C. 2,300 nurses, and 16,000 enlisted
Hangen to TSG, 5 Apr 44, sub: Final Report as to men when the campaign began.
Survey of Medical Supplies in E.T.O., in ETO
Supply Survey, January-March 1944, file HD 333
52
ETO; Memo, OofCSurg, HQ, ETOUSA, to Lutes, 1 First U.S. Army Report of Operations, 20 Oct
May 44, file HD 024 ETO CS (Hawley Chron). The 43-1 Aug 44, bk. VII, p. 61. For personnel arrange-
medical supply situation more or less paralleled that ments, see Surg, Third U.S. Army, Annual Rpt,
in other technical services and the theater as a 1944, pp. 16, 102, 105, and Nursing Division,
whole. See Ruppenthal, Logistical Support, 1:261-66. OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, p. 9.
192 EUROPEAN THEATER OF OPERATIONS
Equipment and supply of the as- for later retrieval. Eight such cases
sault and early buildup units required constituted a single unit of these sup-
cooperation between the First Army plies, and every battalion or company
and the chief surgeon's Supply Divi- received an allowance of units. The
sion. On the basis of a First Army 4th Infantry Division landed with 285
study of assault requirements, the of these cases, containing over 3,500
Supply Division issued supplemental pounds of supplies.55
equipment, above T/E allowances, to Following theater policy, the
army medical units of all types. In Supply Division loaded all scheduled
spite of duplicated and misdirected maintenance supplies for the first
shipments, the result of frequent unit sixty days on standard wooden skids,
movements during marshaling, most each a sled-like device weighing about
First Army organizations had received 1,700 pounds with cargo, designed to
their extra allotments, as well as be dragged across beaches and stored
nearly 100 percent of their authorized in open-air depots. By 8 May medical
equipment, before they embarked, a
tribute to the effectiveness of the depots had finished loading these
newly reorganized depots. Amphibi- supplies for D-Day through D+15.
ous packing received careful attention Piled onto 955 skids, this matériel in-
from all echelons. The Supply Divi- cluded ninety-two surgical and
sion distributed standard watertight twenty-two medical division assault
shipping boxes to First Army field units and twenty regular maintenance
and evacuation hospitals and sent an units, as well as other freight. General
officer to advise units on how best to Hawley, meanwhile, secured from the
protect their matériel against the haz- Ninth Air Force a guarantee to airlift
ards of sea, weather, and battle. Army daily across the Channel 4,000
units prepared thousands of hand- pounds of blood, penicillin, and other
portable assault supply containers, perishable items, which Depot G-45
each a waterproof cylinder 21 inches at Thatcham was to pack for emplan-
long and 9.5 inches in diameter, ing at a nearby Army airfield. Late in
originally used to ship 60-mm. mortar May the theater blood bank began
shells. Each case, with a carrying strap collecting and processing; its detach-
attached and painted with a Red ments made their first deliveries, over
Cross in a white circle, weighed about 1,100 pints, to LSTs and hospital car-
14 pounds when filled with first aid riers. The latter vessels, fitting out at
dressings, sulfa crystals, dried plasma, English, Scottish, and Welsh ports,
and other small items. Each container took on blood and biologicals, both
would float, serving the medical sol-
dier hauling it as a life preserver that 55
First U.S. Army Operations Report, 20 Oct 43-
he could take inland with him as he 1 Aug 44, bk. VII, pp. 73-74 and 114-16; Supply
Division, OofCSurg, HQ, ETOUSA, Annual Rpt,
advanced or could drop on the beach 1944, secs. II, IV, and VI; Kelley Interv, 27 Jan 45,
box 221, RG 112, NARA; Surg, United Kingdom
is taken, is in OofSurg, United Kingdom Base, His- Base, Annual Rpt, 1944, p. 35; Mins, 18th Meeting
torical Resume of the Planning for and Staging of of Base Section Surgeons, 27 Mar 44, pp. 2-3, file
Operation OVERLORD and the Preceding Exercises HD 337. Surg, VII Corps, Annual Rpt, 1944, pp. 6-
(hereafter cited as Surg, UKB, OVERLORD 8, contains a detailed description of the hand-car-
Resume), n.d., pp. 1-8, file HD 370. ried container.
194 EUROPEAN THEATER OF OPERATIONS
for their own use and to supply the mounting, accordingly, rested princi-
56
beachheads. pally with Col. Robert E. Thomas,
To embark the 130,000 troops and MC, the Southern Base Section sur-
17,000 vehicles of the assault and ini- geon, and Col. Mack M. Green, MC,
tial buildup forces, the U.S. Army the Western Base Section surgeon.57
used a system worked out by the Brit- Medical support provisions for the
ish early in the ROUNDUP planning. embarkation were limited and
Under it each organization, in prear- straightforward. In the marshaling
ranged sequence, went from its per- camps the base sections established
manent station through a concentra- medical supply points to make emer-
tion area to a dockside marshaling gency preembarkation issues and over
camp. In the course of this movement 150 camp dispensaries, each staffed
the unit dropped off men and matériel with 1 officernotand
needed for the
4 enlisted attack,
men, to water
serve units that had dropped off or
proofed its vehicles, and picked up packed up their own medical detach-
assault equipment. Finally, in a mar- ments. Most of the officers and men
shaling camp sealed off by barbed for these dispensaries, and for 24
wire and security patrols, the unit re- mess teams that helped feed the tran-
ceived its mission briefing and orga- sient soldiers, came on temporary as-
nized into ship and landing craft signment from station and general
loads. The First Army directed these hospitals throughout Great Britain.
troop movements and the embarka-
From the same sources the Dental Di-
tion, while the Services of Supply vision of the chief surgeon's office as-
built and manned the concentration
signed a dentist and an assistant to
and marshaling camps and provided
the marshaling camps for each 3,000
messing, medical, and other adminis-
troops, to do last-minute fillings, ex-
trative support for the combat units
tractions, and prosthesis repairs.
passing through them. The SOS
headquarters, in turn, delegated most Taken as they were from fixed hospi-
mounting tasks to the Southern Base tals, many of these temporary camp
Section, which embarked the OMAHA doctors had little experience and only
and UTAH seaborne attack forces and brief predeployment training 58
in field
the glider elements of the airborne medicine and sanitation.
divisions, and to the Western Base 57
For the mounting system, see Ruppenthal, Lo-
Section, which loaded the first build- gistical Support, 1:218 and 357-62, and Southern
up divisions and the airborne para- Base Section History, August 1943-August 1944,
troopers. Medical support for the pp. 6-7. See also Surg, UKB, OVERLORD Resume,
pp. 1-4, file HD 370; SOS Mounting Plan, 20 Mar
56
44, in Larkey "Hist," ch. 8, app. 3; Planning Branch,
Supply Division, OofCSurg, HQ, ETOUSA, Operations Division, OofCSurg, HQ, ETOUSA,
Annual Rpt, 1944, secs. II and VI; Surg, ADSEC, Annual Rpt, 1944, p. 6.
58
COMZ, Annual Rpt, 1944, p. 25; HQ, SOS, Each mess team included 1 officer, 4 cooks, and
ETOUSA, Mounting Plan, an. 8, Medical Corps 11 men. The latter medical troops were only a few
(hereafter cited as SOS Mounting Plan), 20 Mar 44, of the 4,500 new cooks hastily assembled for the
in Larkey "Hist," ch. 8, app. 3; Evacuation Branch, camps. See Ruppenthal, Logistical Support, 1:361. See
Operations Division, OofCSurg, HQ, ETOUSA, also Larkey "Hist," ch. 8, pp. 28-31; SOS Mounting
Daily Diary, 19 May 44, file HD 024 ETO; Kendrick, Plan, 20 Mar 44, in ibid., app. 3; Surg, UKB, OVER-
Blood Program, p. 512; Kelley Interv, 27 Jan 45, box LORD Resume, pp. 11-12, file HD 370; Surg, West-
221, RG 112, NARA. Continued
PREPARATIONS FOR INVASION 195
The abilities of the camp surgeons, psychiatrists spent their time giving
fortunately, were not sorely taxed. impromptu short courses in battle-
Marshaling and embarkation began field neuropsychiatry to unit medics.59
early in May, after General Eisenhow- As the Army embarked, the medical
er set D-Day for 5 June, and went for- service completed its preparations for
ward with no major enemy harass- receiving invasion casualties (see Dia-
ment and, from a medical standpoint, gram 2). The chief surgeon's office
few problems. As planned, the em- and Southern Base Section, working
barking troops enjoyed hot meals of closely with the British Southern
fresh, tasty food. They donned uni- Command, drafted plans for this op-
forms treated to resist gas and picked eration, which was a complicated task
up seasickness preventives, insecticide in itself. Under the final plan, pub-
powder, and water purification tab- lished in mid-March, evacuation LSTs
lets. They heard a final one-hour pre- and hospital carriers were to unload
ventive medicine lecture that empha- American wounded at three Channel
sized proper eating habits, personal coast ports: Brixham, Portland-Wey-
cleanliness in the field, and precau- mouth, and Southampton. The arriv-
tions against venereal disease. In ing patients were to undergo two
many marshaling camps, sanitation stages of triage and emergency treat-
left much to be desired—the result of ment. Holding units at the docks and
inevitable carelessness among tran- hards (concrete ramps at which LSTs
sient soldiers and of mistakes by the could load and unload through their
hastily assembled, sketchily trained bow doors) were to give surgical
camp and mess hall staffs. Base sec- treatment to men tagged by LST doc-
tion preventive medicine officers, tors as requiring immediate attention
aided much of the time by Colonel before further transportation. The
Gordon and members of his division, rest of the patients were to go by am-
quickly corrected these deficiencies, bulance directly from the ships to
although lapses in mess hall cleanli- transit hospitals, designated station
ness caused a few battalion-wide out- and general hospitals 15-30 miles
breaks of diarrhea. Filing a gap in the inland. These hospitals again were to
planning, Gordon's officers devised a separate out wounded who were
system for feeding hot meals to unable to travel further and prepare
troops held for hours on the docks by the transportables for rail movement
embarkation delays. One anticipated to general hospitals for definitive
problem did not develop. The base
section surgeons, expecting a rash of 59
For the course of the embarkation, see Harri-
preinvasion emotional disorders, as- son, Cross-Channel, pp. 188-90 and 269-74; Rup-
signed psychiatrists to the marshaling penthal, Logistical Support, 1:363-73; and Southern
camps. Few cases appeared, and the Base Section History, August 1943-August 1944,
pp. 42-52. See also Surg, UKB, OVERLORD
Resume, pp. 14-15, file HD 370; Surg, Infantry Di-
ern Base Section, Rpt, 1 Jan-31 Aug 44, pp. 5-6; vision, Annual Rpt, 1944, pp. 2 and 5; ADSEC Hist,
Mins, 13th and 15th Meetings of Base Section Sur- p. 8; Surg, United Kingdom Base, Annual Rpt,
geons, 17 Jan and 14 Feb 44, file HD 337; Surg, 1944, pp. 79-81; Surg, Western Base Section, Rpt,
United Kingdom Base, Annual Rpt, 1944, p. 22; 1 Jan-31 Aug 44, pp. 5-6; Gordon "Hist," vol. 2,
Dental Division, OofCSurg, HQ, ETOUSA, pt. 4, pp. 38-39, CMH. For the preventive medicine
Annual Rpt, 1944, pp. 4-5. briefing, see Larkey "Hist," ch. 8, app. 15.
196 EUROPEAN THEATER OF OPERATIONS
60
SOS Mounting Plan, 20 Mar 44, in Larkey vice at Hards; Memo, Col J. H. McNinch, MC, to
"Hist," ch. 8, app. 3; Carter, ed., Surgical Consultants, OofCSurg, HQ, ETOUSA, 15 Feb 44; Memo, Chief,
2:173-75. See also MFR, 5 Jan 44, sub: Decisions Passenger Branch, Office of CofTrans, ETO, to
Made by Gen Hawley at Informal Conference With ACofTrans, Movements, 2 Mar 44, sub: Evacuation
Cols Hartford and Peyton; Memo, Lt Col F. H. of Sick and Wounded From the Continent. ... All
Mowrey, MC, n.d. sub: Evacuation and Medical Ser- in EvacCorresp, 1942-44, file HD 024 ETO.
PREPARATIONS FOR INVASION 197
MAP 6
Introduction to Battle
On 6 June 1944 U.S. and British obstacles that studded both UTAH and
forces went ashore along a 40-mile OMAHA between high and low water
stretch of the Normandy coast. Fol- lines. As the troops transferred from
lowing the NEPTUNE plan, 13,000 transports to landing craft, a gusty
parachute and glider troops of the northwest wind kicked up a choppy
82d and 101st Airborne Divisions, sea, tossing about the smaller craft
who landed just after midnight in the and quickly overcoming antiseasick-
Cotentin countryside behind UTAH ness efforts. At about 0530 the Ger-
beach, opened the American part of mans, hitherto passive, opened artil-
the attack. Widely scattered and badly lery fire; fifteen minutes later the final
disorganized in the drop due to navi- Allied naval bombardment began, as
gation errors, high winds, and enemy the assault waves headed for the
antiaircraft fire, each division man- beaches. About on schedule, the first
aged to assemble enough men and bow ramps went down.
equipment to accomplish at least part At UTAH Maj. Gen. J. Lawton Col-
of its D-Day mission. In confused vi- lins' VII Corps, the 4th Infantry Divi-
cious fighting against initially uncoor- sion leading, went ashore almost un-
dinated but increasingly stubborn and opposed. Quickly overcoming beach
aggressive German opponents, the defenders, who were few in numbers
airborne troops by the end of D-Day and were distracted by the airborne
had opened the way inland for the attack behind them, the infantry
seaborne forces across the flooded pushed inland over causeways cross-
areas behind UTAH beach, and they ing the inundated areas. Elements of
were well on the way to securing the the 1st Engineer Special Brigade, sup-
lodgement's western and southern porting this assault, cleared away
flanks. mines and obstacles; opened vehicle
The amphibious assault task forces, routes across the beach; readied the
Force U for UTAH and Force O for causeways for heavy traffic; and set up
OMAHA, dropped anchor in their as- supply dumps, harassed only by a few
sembly areas 12 miles off the coast at snipers and by sporadic German
about 0230. H-hour for the first land- shelling. By the end of the day 23,000
ings was 0630, when low tide would of the 32,000 troops of the initial
uncover for demolition the German UTAH assault force were ashore. The
202 EUROPEAN THEATER OF OPERATIONS
blankets above its regular allowance, an. Surg, 82d Airborne Division, Annual Rpt, 1944,
I, p. 1; Surg, 101st Airborne Division, Annual
Rpt, 1944, pp. 1-2; Interv, OSG with Capt Ernest
3
Col. Hayes was replaced as VII Corps surgeon Gruenberg (hereafter cited as Gruenberg Interv), 13
on 4 July 1944 by Lt. Col. Robert H. Barr. Jun 45, box 222, RG 112, NARA.
204 EUROPEAN THEATER OF OPERATIONS
hours, when the surgeons did not yet battalion commander, Lt. Col. Patrick
need it and darkness made it almost J. Cassidy, and his surgeon, Capt.
impossible to find. Frank Choy, MC, secured a small cart
During the first hours on the and a horse to pull it and drafted a
ground, medical officers and aidmen dental technician to drive it. "All day
collected what supplies they could long," according to a battalion report,
locate. They made contact with other "this boy drove up and down the
paratroopers, gave first aid to men in- roads, exposing himself to sniper fire,
jured in the jump or in glider crashes working like a Trojan, to bring in the
and in the first firefights, and worked wounded and the parachutists who
their way toward battalion assembly had been hurt on the jump; his
areas. Especially in the 82d Division, energy saved countless lives." During
elements of which landed farthest much of the day Colonel Cassidy,
inland, small groups of paratroopers who had to send his surgeon to treat
were cut off from their units for days. an untransportable casualty at an out-
Injured and wounded soldiers with lying position, acted as his own medi-
these groups received at best impro- cal officer. Cassidy, and the medical
vised care, even if their chance-met sergeant who remained with him, de-
companions included medical officers cided which badly wounded men
and aidmen. Some groups, forced to should receive their limited supply of
maneuver to avoid Germans or driven plasma, and the battalion commander
from their positions by counterat- personally helped retrieve medical
tacks, had to leave their wounded supply bundles from the surrounding
behind to be captured, frequently fields. Because his drop zone was just
along with medical personnel who inland from UTAH, Cassidy was able
voluntarily stayed with their patients.
to evacuate many of his casualties to
At isolated positions, wounded men
died for lack of plasma. Other cut-off
the beach late in the afternoon, after
groups were more fortunate. Medical making contact with the 4th Division.5
officers with them managed to salvage Although a few units, such as Cas-
equipment for adequate first aid and sidy's, sent casualties directly to the
in at least one case secured milk and beach, most airborne wounded went
food for the wounded from French from battalion aid stations, and often
farmers. from where they fell, to the clearing
Medical officers and men who stations set up by their division medi-
reached their battalion assembly areas cal companies. These companies,
set up rough-and-ready aid stations, each of which included an attached
usually near their unit command team from the 3d Auxiliary Surgical
posts. At these stations improvisation Group, deployed in Normandy on D-
was the common practice, as surgeons 5
This account of unit medical support is based on
scavenged for supplies and comman- Surg, 82d Airborne Division, Annual Rpt, 1944, an.
deered farm wagons and captured I, pp. 1-2; Surg, 101st Airborne Division, Annual
enemy vehicles to collect wounded Rpt, 1944, pp. 2-6; Gruenberg Interv, 13 Jun 45,
from widespread company positions. box 222, RG 112, NARA, and in RG 407, NARA,
82d Airborne Division Combat Intervs, box 24057,
In the 1st Battalion, 502d Parachute and 101st Airborne Division Combat Intervs (source
Infantry, a 101st Division unit, the of quotation), box 24072.
INTRODUCTION TO BATTLE 205
Day in several echelons. An advance By early afternoon the members of
element of each company, with the di- the original party, reinforced by other
vision surgeon and the auxiliary sur- medical officers and men who strag-
gical team, went in by glider around gled in, had a rudimentary surgical
dawn with enough hand-carried and hospital and clearing station in oper-
air-dropped instruments and equip- ation. Surgeons worked at three
ment for a small emergency surgical tables, as the chateau courtyard filled
station. The rest of the personnel, with casualties brought in on impro-
with the company vehicles and the vised litters, horses, and captured
balance of the clearing station outfit, trucks. Living on D-bars and Benze-
arrived during the late afternoon by drine, the surgeons treated about 300
glider and, in the case of the 101st patients during the day. In the
Division, partly by sea. evening another glider lift of the
An advance element of the 101st's company and the seaborne element,
326th Airborne Medical Company which had landed on UTAH, reached
parachuted in with the infantry at
0100. As many of the four officers the chateau. But even with this rein-
and forty-five men of this detachment forcement, which included Lt. Col.
as could reach their rendezvous im- David Gold, MC, the 101st Division
provised a small hospital in a French surgeon, the number of wounded ar-
farmhouse near Hiesville, the division riving all but overwhelmed the staff.
command post site about 5 miles The surgical team leader, Maj. Albert
from UTAH beach. The group per- J. Crandall, MC, recalled: "We had to
formed first aid and emergency sur- maintain a careful priority system, op-
gery here until well into D+1 (7 erating on those who were most in
June), when it joined the rest of the need of surgery and giving the others
company. About two hours behind emergency treatment." In surgery,
this advance group two gliders ar- "first we did the heads and chest and
6
rived carrying the 326th Company next the abdomens and extremities."
commander, Maj. William E. Barfield, An advance group of the 82d Divi-
MC, and seven officers and twenty- sion's 307th Airborne Medical Com-
one men, including the auxiliary sur- pany, with the division surgeon, Col.
gical team, with four jeeps and trail- Wolcott L. Etienne, MC, and a surgi-
ers. Although both gliders crash- cal team, also went in by glider before
landed, painfully injuring every dawn. Shrapnel from German antiair-
member of the surgical team, the men craft fire wounded Colonel Etienne
retrieved most of their gear and ma- before he even touched ground; the
neuvered around German positions same fire caused the gliders to over-
toward the Chateau Colombierre, just shoot their planned landing zone at
north of Hiesville, selected on the Blosville near Ste.-Mere-Eglise, a
basis of preinvasion aerial reconnais-
sance as the site for the division clear- 6
Surg, 101st Airborne Division, Annual Rpt,
ing station. They arrived at about 1944, pp. 2-3; 3d Auxiliary Surgical Group Annual
0700, just as paratroopers were driv- Rpt, 1944, pp. 17-19; Capt W. P. McKee Recorded
Rpt, pp. 2-4. Quotation from Interv, OSG with Maj
ing German defenders out of the A. J. Crandall (hereafter cited as Crandall Interv), 8
buildings. Jun 45, box 222, RG 112, NARA.
206 EUROPEAN THEATER OF OPERATIONS
major division objective, and crash Corps, the company resumed work
land at Hiesville. Medics were scat- the next day at a new site near Hies-
tered in the landing and lost much ville. On D-Day the 326th Company
equipment. Some of them, including evacuated a few wounded to the 261st
the surgical team leader, Maj. James J. Medical Battalion of the 1st Engineer
Whitsitt, MC, found their way to Cha- Special Brigade at UTAH beach and
teau Colombierre, where they assisted then kept up a steady seaward flow of
326th Company doctors for the rest patients, mostly carried in Quarter-
of the day. The bulk of the 307th master Corps trucks (Map 7). Ambu-
Company arrived in gliders near Ste.- lances of the VII Corps medical bat-
Mere-Eglise in the late afternoon and talion began evacuating the company
also ran into hard luck. Many gliders on the ninth. The 82d Division's
plunged into flooded areas, and the clearing station had accumulated 300
landing zone came under shelling that patients before starting evacuation to
killed the company commander. In the beach on the seventh, using bor-
spite of these setbacks, the company rowed trucks and ambulances, many
pulled itself together and had its of them from the 4th Division's 4th
clearing station in operation at Blos- Medical Battalion. The clearing com-
7
ville by morning of the seventh. pany of the latter unit received, treat-
During the first few days after D- ed, and evacuated many airborne sol-
Day the airborne division medical ser- diers during its first days on shore; at
vice lost its improvised, irregular times half the wounded passing
character and gradually came to re- through the infantry division clearing
semble that of a conventional infantry station were parachute and glider
division. Both the 82d and the 101st troops.8
Divisions remained fully committed to On UTAH beach, the landing of
hard offensive combat, and the flow medical units and the establishment
of wounded through their aid stations of the initial chain of evacuation went
and clearing companies was steady about as smoothly as an operation
and substantial. On 8 June alone the could go under combat conditions.
326th Company treated and evacuat- Company aidmen and battalion medi-
ed over 400 casualties. On the ninth cal sections of the 4th Division landed
the 326th was bombed out of its cha- first, followed closely by the nine offi-
teau, fortunately just after evacuating cers and seventy-two hospital corps-
most of its patients. The company, men of the 2d Naval Beach Battalion.
however, lost 5 officers and 9 enlisted Collecting companies of the 4th Med-
men wounded and 8 enlisted men ical Battalion came in with the regi-
killed, as well as much of its equip-
ments they supported, bringing most
ment. Obtaining new equipment and
personnel replacements from VII 8
First U.S. Army Report of Operations, 20 Oct
43-1 Aug 44, bk. VII, pp. 65-66; VII Corps Medical
7
VII Corps Medical Plan, pp. 14-15, encl. 1 to Plan, p. 15, encl. 1 to Surg, VII Corps, Annual Rpt,
Surg, VII Corps, Annual Rpt, 1944; Surg, 82d Air- 1944; Surg, 82d Airborne Division, Annual Rpt,
borne Division, Annual Rpt, 1944, pp. 3-4 and an. 1944, an. I; Surg, 101st Airborne Division, Annual
I, p. 1; 3d Auxiliary Surgical Group Annual Rpt, Rpt, 1944, p. 2; Medical Service, 101st Airborne Di-
1944, pp. 16-17; 307th Airborne Medical Company vision, After-Action Rpt, 6-25 Jun 44; Crandall
Annual Rpt, 1944. Interv, 8 Jun 45, box 222, RG 112, NARA.
INTRODUCTION TO BATTLE 207
MAP 7
of their thirty ambulances. In spite of first engineer special brigade unit,
day-long sporadic artillery fire, which Company C, 261st Medical Battalion,
killed a medical officer and several arrived on the beach, followed two
enlisted men on the beach, wounded hours later by Company A. These
the regimental surgeon of the 12th two "collecto-clearing" companies,
Infantry, and peppered the 4th Medi- formed by combining the litter and
cal Battalion's ambulances with shrap- ambulance elements of a collecting
nel, the division medical elements company with a platoon from the bat-
rapidly moved inland. The Navy talion's clearing company, set up sta-
corpsmen organized two beach aid tions at a crossroads just behind the
stations, collected the few casualties flooded area. Their attached surgical
of the assault, and loaded on DUKWs teams began performing operations at
and landing craft for movement to around 1800, carrying out their mis-
LSTs offshore. At about 1000 the sion of providing emergency surgery
208 EUROPEAN THEATER OF OPERATIONS
for nontransportable patients. These the 261st and helped move patients
clearing stations evacuated few from that unit to the Navy beach sta-
wounded to the beach during the first tions. On the ninth the Lady Con-
hours, as casualties from the airborne naught, first of what was to be a regu-
divisions and the 4th Medical Battal- lar series of hospital carriers,
ion did not start flowing back in sig- anchored off UTAH. She discharged
nificant numbers until the following supplies and six additional surgical
day. Between 2100 and 2130 the VII teams for the 261st Medical Battalion,
Corps surgeon, Colonel Hayes, and allowing relief to the battalion's origi-
the 4th Division surgeon, Lt. Col. nal teams that had worked for 36
Robert H. Barr, MC, landed with hours with little rest. The carrier took
members of their staff sections. on board 400 wounded for the return
During the next three days VII voyage to England. As the first army
Corps medical support expanded, as field and evacuation hospitals opened
did the corps and its beachead. The on 10 and 11 June, the VII Corps
4th Division's clearing company,
medical service was well into the tran-
scheduled to land late on D-Day but
held back in favor of additional sition from an amphibious to a con-
combat units, came ashore on 7 June ventional land organization and
and went into operation at Hebert, a system of support.9
crossroads village just beyond the in- On OMAHA the story was different.
undated area. Later the company fol- This beach, about 5 miles from end
lowed the 4th northward. By the to end, consisted of a tidal flat bor-
ninth two more infantry divisions— dered at the high water mark by an
the 9th and 90th—had disembarked, embankment of loose stones, called
each with its full medical comple- shingle, backed on the eastern por-
ment. Clearing stations of these divi- tion by sand dunes and on the west-
sions opened in the general vicinity of ern by a wooden seawall 4-5 feet
Ste.-Mere-Eglise. The rest of the high. At varying distances from the
261st Medical Battalion, meanwhile, shingle, usually 200-300 yards, rose
landed on the seventh. The battalion low bluffs, too steep to be negotiated
established a medical supply depot. by vehicles except through five draws
Its surgical teams worked around the that the Germans had mined and
clock to handle an increasing flow of blocked with obstacles. The defend-
casualties, as the divisions attacking ers, entrenched on and in front of the
northward and westward from UTAH bluffs in pillboxes and machine-gun
met strong German opposition. Be- nests, met the first assault waves with
tween 8 and 12 June the VII Corps'
50th Medical Battalion disembarked. 9
First U.S. Army Report of Operations, 20 Oct
The battalion's clearing company, be- 43-1 Aug 44, bk. VII, pp. 65-67 and 96; Surg, First
U.S. Army, Annual Rpt, 1944, p. 33; VII Corps
sides supporting corps troops, its Medical Plan, pp. 13-17, encl. 1 to Surg. VII Corps,
normal role, took part of the burden Annual Rpt, 1944; Dowling, Normandy Rpt, 11 Jan
of general medical and surgical care 45, pp. 17-18; 3d Auxiliary Surgical Group Annual
from the 261st's companies, and its Rpt, 1944, pp. 13 and 20; 4th Medical Battalion
Report of Operations, 6-30 Jun 44, box 6727, RG
collecting and ambulance companies 407, NARA; 50th Medical Battalion Annual Rpt,
evacuated division clearing stations to 1944, pp. 2-3.
MEDICS ADMINISTERING FIRST AID TO INVASION CASUALTIES ON UTAH (top) AND
OMAHA (bottom)
210 EUROPEAN THEATER OF OPERATIONS
heavy fire. As the landing craft nosed ness fell, the infantry had partially se-
into shore, German machine-gun cured the objective towns of Vierville
nests cut down many Americans on the western end of the beach, St.-
before they even left the bow ramps Laurent in the center, and Colleville
and others as they struggled across on the east. The engineers, using
the tidal flat. Artillery shells sank, set what equipment they could salvage,
on fire, or blew up one landing craft cleared mines, bulldozed openings for
after another. Wading and crawling vehicles through the shingle opposite
across the sand, pushed by the now several of the beach exit draws, and
rising tide, dragging their wounded, began developing roads through the
and losing or abandoning weapons, draws themselves.10
radios, and equipment, the assault The near-catastrophe of D-Day
troops sought cover from the search-
morning and the resulting delay of
ing fire behind the seawall and shin-
gle pile. The American units took the advance inland telescoped the
their heaviest losses of the day in this elaborately sequenced arrival of medi-
movement up to the high water line; cal units. Organizations landed off
one 16th Infantry company suffered schedule and on the wrong beach sec-
most of its 105 D-Day casualties here. tors, often losing much of their
Exhausted from seasickness and the equipment. Regardless of type or in-
struggle ashore, the survivors tried to tended function, each unit and de-
clear sand-clogged weapons, to rescue tachment, as it plunged into the
and tend wounded, to demolish beach welter between the low tide line and
obstacles, and to cut the barbed wire the bluffs, dissolved into scattered
the Germans had laid along the shin- groups of men, working desperately
gle pile. under fire to drag wounded to places
Troops and vehicles of the first and of relative safety, to give first aid, and
subsequent landing waves remained to salvage supplies.
bunched along the high water line for The battalion and regimental medi-
much of the day. Around 0800 small cal sections and attached divisional
intrepid groups began pushing across collecting companies of the 16th and
the beach to the foot of the bluffs and 116th Regimental Combat Teams,
then working their way up the hills. closely followed by the officers and
One by one, they eliminated German hospital corpsmen of the 6th and 7th
strongpoints, aided after about 1030 Naval Beach Battalions, came ashore
by point-blank naval gunfire. Landing early in the morning, just after the
of reinforcements, temporarily halted first assault companies had been shot
when high tide covered the beach ob- to pieces. The medical soldiers took
stacles, resumed when landing craft their share of casualties. The 2d Bat-
commanders discovered that they talion, 116th Infantry, lost five
could ram through safely. During the aidmen, killed leaving their landing
afternoon the trickle of men across
craft, and its surgeon, wounded on
the beach and over the bluff became a
flood. The arrival of two additional 10
This account is based on 1st Infantry Division
infantry regiments gave still more mo- Combat Intervs, box 24011, and 29th Infantry Divi-
mentum to the inland drive. As dark- sion Combat Intervs, box 24034, RG 407, NARA.
INTRODUCTION TO BATTLE 211
the beach by shrapnel. Other medics face downward with arched backs were in-
quickly fell as they tried to drag casu- numerable human forms eddying to and
alties out of the rising water. As fro with each incoming wave, the water
above them a muddy pink in color. Float-
German artillery blasted the landing ing equipment of all types like flotsam
craft, medical supplies went up in and jetsam rolled in the surf mingled with
flames or disappeared under the the bodies. . . . Everywhere, the frantic
waves; the 116th Infantry lost its cry, 'Medics, hey, Medics,' could be heard
entire regimental supply of plasma in above the horrible din.12
two LCIs (landing craft, infantry) Among the company aidmen on
sunk off the beach.11
OMAHA, heroism was the only stand-
Maj. Charles E. Tegtmeyer, MC,
regimental surgeon of the 16th Infan- ard procedure. Under the punishing
try, who landed at about 0815, de- fire, often themselves wounded, these
scribed what faced those medical soldiers worked up and down the
troops who survived the wade and shingle pile, bandaging, splinting,
crawl through the obstacles to the giving morphine and plasma if they
shingle pile: had any. Many ventured repeatedly
back into the water to pull in the dis-
The shelf on which I rested was about ten abled and drowning or to retrieve
yards in width sloping upward from the
water's edge to a height of from two to medical supplies. Others went into
ten feet at an angle of roughly 35 de- minefields to carry out injured men.
grees. Face downward, as far as eyes A 29th Division staff officer with
could see in either direction were the 116th Infantry recalled: "First-aid
huddled bodies of men living, wounded
and dead, as tightly packed together as a men of all units were the most active
layer of cigars in a box. Some were franti- members of the group that huddled
cally but ineffectually attempting to dig against the seawall. With the limited
into the shale shelf, a few were raising . . . facilities available to them, they
themselves above the parapet-like edge
and firing toward the concrete protected did not hesitate to treat the most
enemy and those on the cliff above but severe casualties. Gaping head and
the majority merely huddled together belly wounds were bandaged with the
face downward. Artillery . . . and mortar same rapid efficiency that was dealt to
shells exploded on the beach and in the
water . . . and threw fragments in all di- the more minor wounds." As the in-
rections. Uncomfortably close, overhead, fantry filtered in to the base of the
machine gun and rifle bullets grazed the bluff, the medics took additional risks
top of the ledge . . . and plunged into to drag wounded to the shelter of the
the water behind us with innumerable
sharp hisses or whined away in to the dis- hill. Paradoxically, most evacuation
tance as they richocheted off the stones on OMAHA in these first hours 13
was
of the beach. At the water's edge floating forward, toward the enemy.
11 12
For overviews of D-Day medical operations on Col Charles E. Tegtmeyer, MC, "Personal Mili-
OMAHA, see First U.S. Army Report of Operations, tary Diary" (hereafter cited as Tegtmeyer "Diary"),
20 Oct 43-1 Aug 44, bk. VII, pp. 62-63; Surg, V pt. 1, ch. 20, pp. 1-5.
13
Corps, Annual Rpt, 1944, pp. 2-3; Surg, 1st Infan- Quotation from Lt. Jack Shea, D-Day Narrative,
try Division, Annual Rpt, 1944, p. 9. For medical in 29th Infantry Division Combat Intervs, box
losses in the initial assault, see 1st Infantry Division 24034. See also other company narratives in this
Combat Intervs, box 24011, and 29th Infantry Divi- collection and in the 1st Infantry Division Combat
sion Combat Intervs, box 24034, RG 407, NARA. Intervs, box 24011. All in RG 407, NARA.
212 EUROPEAN THEATER OF OPERATIONS
The work of Major Tegtmeyer and and along the bluff to collect casual-
his 16th Infantry medical section typi- ties and by nightfall had over eighty
fied the character of regimental medi- wounded at his station. Running low
cal support on OMAHA.14 Landing with on blankets and plasma, he secured
the regimental commander, Col.more from a passing battalion of the
George A. Taylor, and his staff on newly landed 26th Infantry, the com-
Easy Red sector, the left center of the mander of which he knew. Even with
beach, Tegtmeyer and his aidmen fol- these supplies, men came in that
lowed the command group back and emergency care could not save, such
forth along the shingle pile as Taylor as the infantryman with one leg trau-
tried to organize an advance toward matically amputated and multiple
the bluffs. The medical soldiers, now compound fractures of the other. "He
wading, now stumbling over prone was conscious and cheerful," Tegt-
men, bandaged and splinted wounded meyer reports, "but his only hope was
as they came upon them, then left rapid evacuation, and at this time
them in the shelter of the embank- evacuation did not exist. An hour
ment with instructions to call for help later he was dead."
and evacuation to incoming landing Around 2200 an auxiliary surgical
craft. "I examined scores as I went," team, which had become separated
Tegtmeyer declared, "telling the men from its engineer special brigade,
who to dress and who not to bother reached Tegtmeyer's position, but the
with." surgeons lacked equipment and did
At around 1040 the medical section little but dig foxholes for shelter
followed the rifle companies off the against the continuing artillery bom-
beach and set up an aid station near bardment. More useful were the
the regimental command post, dug twelve litterbearers of Company A,
into the seaward slope of the bluff, 1st Medical Battalion, the 16th Infan-
which sheltered them from direct try's attached collecting company,
enemy fire. The group used what sup- who appeared with their commander,
plies they had carried ashore, plus Captain Ralston, shortly after the sur-
two litters and some other matériel gical team. This company was sched-
they picked up on the beach. Troops uled to land with the regiment in the
from the first waves were still thick on morning, but enemy guns had set
the shore below Tegtmeyer's posi- their landing craft on fire during two
tion, and landing craft kept bringing unsuccessful attempts to beach. Ral-
in more under shelling that steadily ston and his men had worked hero-
added to the number of dead and ically, rescuing soldiers and sailors
wounded littering the sand. Tegt- from burning holds and compart-
meyer sent aidmen down to the beach ments and treating the injured who
14 encumbered the decks. After the craft
This account is based on Tegtmeyer "Diary,"
pt. 1, ch. 20, pp. 5-15, from which the quotations limped seaward to a transport and
come; Rpt, Maj Charles E. Tegtmeyer, sub: Activi- unloaded its casualties, Ralston rallied
ties of Medical Detachment, 16th Infantry, and his tired, shocked company; got them
Company A, 1st Medical Battalion, After-Action
Rpt, both in 1st Infantry Division Combat Intervs, onto another craft; and disembarked
box 24011, RG 407, NARA. them on OMAHA at about 1700. Then
INTRODUCTION TO BATTLE 213
he and part of his command found company had attached teams of the
their way to Tegtmeyer. 3d Auxiliary Surgical Group. Besides
With the help of Ralston's litter- the clearing station and operating
bearers Tegtmeyer began moving his room equipment packed into their
patients down to the beach, the am- trucks, each company went in heavily
bulatory cases walking and the rest la- laden with hand-carried supplies. Men
boriously carried on litters. All but of the 61st's 393d Collecto-Clearing
about ten of the most severely injured Company, for example, landed with
arrived at the beach station the Navy mortar shell casing containers and
now had in operation before renewed waterproofed dufflebags filled with
shelling halted the evacuation. Be- dressings, bandages, tourniquets,
cause no more landing craft were sulfa powder, and plasma. Every lit-
coming in, the wounded on the beach terbearer took along an extra litter
stayed there all night, tended by Navy with a life belt attached, to float the
corpsmen. Tegtmeyer's group and litter ashore if he lost hold of it.15
the remaining patients spent a cold,
During D-Day these medical battal-
damp night in foxholes, during which
time four more of the injured died. ions were only partially able to per-
During the early afternoon the form their evacuation tasks, and they
engineer special brigade medical bat- could not undertake emergency sur-
talions began landing. Both special gery at all. For the most part, their
brigades—the 6th, responsible for or- officers and men simply joined in the
ganizing the western half of OMAHA general effort at casualty collection,
behind the 116th Infantry; and the first aid, and supply salvage. Such was
5th, in charge of the eastern half the fate of the small advance party of
behind the 16th Infantry—were the 60th Medical Battalion, which
formed into battalion beach groups landed at 0855 on Easy Green sector
for the assault, with a group attached below St.-Laurent, to reconnoiter a
to each regimental combat team. Each previously selected clearing station
beach group included one or more site. German troops still controlled
companies from the brigade medical the site, and the officer and enlisted
battalion. The 6th Brigade's 60th men of the advance party worked all
Medical Battalion was organized con- day with regimental and Navy medics
ventionally in one clearing and three along the beach. Between 1400 and
collecting companies; its 500th Col- 1500 the bulk of the 500th Collecting
lecting Company and a platoon of the Company and part of the 634th
634th Clearing Company came ashore Clearing Company came ashore on
with the battalion beach group sup-
porting the 116th Infantry. The 5th 15
For the assault, the 5th Brigade had operational
Brigade's 61st Medical Battalion, like control of all 6th Brigade elements, even as the 1st
its UTAH beach counterpart, had Division controlled the first 29th Division elements
on shore. When the brigade group headquarters
formed three provisional collecto- landed, which occurred late on D-Day, 6th Brigade
clearing companies. Of these, the units reverted to control of their parent brigade.
391st Collecto-Clearing Company See Rpt, ProvESBGp, 30 Sep 44, sub: Operation
NEPTUNE, pp. 36-38 and 327-28; 61st Medical
landed first, behind the 16th Infantry. Battalion Annual Rpt, 1944, pp. 1-6; 393d Collecto-
Each clearing and collecto-clearing Clearing Company Annual Rpt, 1944, p. 8.
214 EUROPEAN THEATER OF OPERATIONS
Easy Green. The units lost men and 18th Infantry, far to the right of the
equipment on the way in. Casualties 391st and almost in the 6th Brigade
included Lt. Col. Bernard E. Bullock, sector. This company set up a collect-
MC, the battalion commander, who ing station in an antitank ditch under
landed with the 500th Company, only the bluff northeast of St.-Laurent.
to be mortally wounded within min- These companies, and the 61st Battal-
utes. Men of these two companies ion headquarters, suffered five enlist-
spread out along most of the western ed men killed and five officers and
half of OMAHA, setting up casualty twenty men wounded on D-Day.
17
crews to stay exposed near shore long could not begin work until 12 June.
enough to load, limited seaward evac- Most of the 60th Medical Battalion
uation and in many places prevented came ashore on the seventh. Its col-
it entirely. By the end of the day lecting companies helped Navy ele-
medics had cleared about 830 casual- ments remove dead and evacuate cas-
ties off the beach. Hundreds more re- ualties from the western half of
mained, huddled under blankets at OMAHA. In the afternoon the 634th
collecting points or still lying where Clearing Company opened a station
they fell. Long after sunset, carrying just northwest of St.-Laurent, where
parties and a few ambulances contin- its attached surgical teams began op-
ued to seek and pick up wounded.19 erating at about 2000 under genera-
During D+1 (7 June) the organiza- tor-powered lights. The 61st Battal-
tions that had landed on D-Day ion's two companies on the eastern
gradually assembled or finished half of OMAHA, still unable to bring
bringing ashore their men and equip- most of their equipment ashore, con-
ment and began performing more or tinued to function as aid and collect-
less their intended functions (Map 8). ing stations.
Regimental and battalion aid stations Colonel Brenn, the V Corps sur-
and collecting companies of the 1st geon, had landed on D-Day with part
and 29th Divisions evacuated their ac- of his section, losing most of his per-
cumulated casualties to the beach and sonal equipment and office records in
headed inland with their units. Early the process. On the seventh he
in the morning the 1st Medical Battal- toured his units on foot, finding most
ion's clearing company, which had of them short of men and matériel
landed late on D-Day, opened its sta- but doing their best with what they
tion on the bluffs northeast of St.- had. Evacuation to the beach and sea-
Laurent. Reinforced with two auxilia- ward, Brenn reported, was proceed-
ry surgical teams sent up by the 61st ing "in dribbles," but with "no stag-
Medical Battalion, this station was nation." Part of the 1st Medical
one of the first facilities on OMAHA Depot Company arrived with sup-
able to operate on nontransportable plies, which it and the special brigade
cases. The 29th Division, on the other units began organizing into rudimen-
hand, had to rely for clearing for sev- tary dumps. At 1900 the hospital car-
eral days on the 60th Medical Battal- rier Naushon, anchored off the beach,
ion, as the clearing company of the unloaded a stock of whole blood for
division's 104th Medical Battalion was the clearing stations and took wound-
slow to disembark its equipment and ed on board. The vessel remained
overnight, its surgeons operating on
19
First U.S. Army Report of Operations, 20 Oct emergency cases, and sailed for Eng-
43-1 Aug 44, bk. VII, pp. 62-63, estimates the
number evacuated. See also Dowling, Normandy
land on the eighth.20
Rpt, 11 Jan 45, p. 16, and Rpt, ProvESBGp, 30 Sep
20
44, sub: Operation NEPTUNE, pp. 88 and 331. For Quotation from Surg, V Corps, Annual Rpt,
firsthand views, see Maj Gen C. H. Gerhardt, 1944, pp. 2-3. See First U.S. Army Report of Oper-
"Battle Lessons and Conclusions"; and Lt. Jack ations, 20 Oct 43-1 Aug 44, bk. VII, p. 63; Surg,
Shea, Narrative, both in 29th Infantry Division 1st Infantry Division, Annual Rpt, 1944, p. 9; Rpt,
Combat Intervs, box 24034, RG 407, NARA. Continued
INTRODUCTION TO BATTLE 217
MAP 8
During the period 8-11 June, as the the ninth, transported wounded over
advance gathered momentum, the V the increasing distance separating the
Corps medical service fully assumed divisions and beach clearing stations.
its planned shape, and its operations On the eleventh, as the evacuation
displayed increasing regularity. Divi- network expanded, Colonel Brenn
sion clearing stations moved inland. and the medical section moved with
The ambulance platoons of the engi- the corps command post from St.-
neer special brigades and of the V Laurent to La Poterie, about 5 miles
Corps, 53d Medical Battalion, which deeper in the Norman countryside.
disembarked between the seventh and Back at the beach the 60th and 61st
Medical Battalions, no longer under
ProvESBGp, 30 Sep 44, sub: Operation NEPTUNE,
p. 333; Tegtmeyer "Diary," pt. 2, ch. 1, pp. 1-6; enemy harassment except for ineffec-
60th Medical Battalion Annual Rpt, 1944, pp. 6-9, tual night air raids, brought their re-
12, 15-16; 104th Medical Battalion After-Action
Rpt, June 1944; 1st Medical Battalion After-Action maining men and equipment ashore
Rpt, May-June 1944, box 5966, RG 407, NARA. and developed into full-fledged clear-
218 EUROPEAN THEATER OF OPERATIONS
ing and emergency surgical facilities. Further, the ability of Medical Depart-
The 60th Battalion clearing station ment officers and men to take individ-
stayed near St.-Laurent, and the three ual initiative and improvise in carry-
61st Battalion companies one by one ing out their missions amid great
moved up from the beach onto the danger and confusion testified to the
bluffs east of that town. These move- effectiveness of the months of pre-
ments, and a consolidation of naval attack training and indoctrination,
shore medical activities, established a both military and medical.
single line of seaward evacuation On the other hand, especially on
across roughly the center of OMAHA heavily contested OMAHA, evacuation
beach. By 11 June over 3,160 patients and forward surgery arrangements
had passed through this chain of
came near collapse. The tactical situa-
evacuation.21
The NEPTUNE medical planners tion restricted early loading of
concentrated on two objectives in wounded on landing craft and pre-
their arrangements for supporting the vented the auxiliary surgical teams
initial assault: the provision of emer- from doing any more than could have
gency surgery on the far shore during been done by battalion medical offi-
the first hours of combat, and the cers and company aidmen. The com-
early and complete seaward evacu- manders of the engineer special
ation of the wounded. Measured by brigade group and the 61st Medical
these objectives, medical results on Battalion later criticized the rigidly
D-Day were mixed. The First Army's scheduled landing of surgical teams
decision to place as much consumable and clearing companies, arguing that
medical matériel—splints, litters, it had resulted in the unproductive
blankets, plasma, morphine, and exposure to danger of valuable spe-
other such items—as possible on cialists and equipment. Instead, they
shore with the first troops in a wide suggested, the clearing companies
variety of packaging and means of and attached teams should have been
transportation proved to be a lifesav- held on vessels offshore, to be called
er, in the most literal sense of the in when beach conditions permitted
term. Even medics who reached dry orderly disembarkation and the im-
land with little more than the clothes mediate performance of their intend-
they stood up in seem to have been ed functions. In the meantime a few
able to pick up on the beach or, in companies and teams could have
the airborne, scattered in the fields, staffed shipboard surgical facilities for
enough supplies to do their jobs. care of wounded brought out to them
21
in landing craft.22
First U.S. Army Report of Operations, 20 Oct Whatever the merits of these sug-
43-1 Aug 44, bk. VII, pp. 63-65 and 69; Dowling,
Normandy Rpt, 11 Jan 45, p. 4; Surg, V Corps, gestions, experience on OMAHA—
Annual Rpt, 1944, pp. 3-7; 53d Medical Battalion where casualties, though heavy, still
Annual Rpt, 1944, pp. 4-5; Rpt, ProvESBGp, 30 were fewer than planners had antici-
Sep 44, sub: Operation NEPTUNE, pp. 333-34;
60th Medical Battalion Annual Rpt, 1944, pp. 6-7,
22
9-10, 12-14; 61st Medical Battalion Annual Rpt, Rpt, ProvESBGp, 30 Sep 44, sub: Operation
1944, p. 5; 104th Medical Battalion After-Action NEPTUNE, pp. 334 and 337-38; 61st Medical Bat-
Rpt, June 1944. talion Annual Rpt, 1944, pp. 5-6.
INTRODUCTION TO BATTLE 219
pated, and where, after the coastal as- and the wharves damaged, full use of
sault, the rapid collapse of German the port by the Allies was delayed for
resistance allowed early organization many weeks.
of the beach—did much to substanti- After the capture of Cherbourg, the
ate the fears of General Kenner and First Army redeployed its Cotentin
other officers that untreated, uneva- forces southward. On 3 July most of
cuated wounded would pile up on the the army attacked into the swamp and
far shore. In summary, the medical hedgerow country at the base of the
service on D-Day benefited from care- peninsula, with the objective of gain-
ful planning and meticulous prepara- ing roads and open ground for an ar-
tion, but the success achieved also mored breakout. This offensive led to
owed much to individual courage and bitter, apparently inconclusive fight-
competence, and to good fortune. ing. The Germans, prevented by
Allied air power and French partisans
First Army Medical Buildup from massing for a major early coun-
terattack on the beaches, nevertheless
Between the linkup of the beach-
stiffened their line with a steady
heads on 10-11 June and the end of
stream of infantry and armor. Taking
July, reinforcements enlarged the
First Army to over 437,000 officers advantage of very favorable defensive
and men in eighteen divisions and terrain and of rainy and cloudy weath-
four corps. So augmented, the army er, which limited Allied air support,
fought a hard, costly battle to take the Germans fought to confine their
Cherbourg, to expand its continental more mobile foes within a narrow pe-
lodgement, and to break out toward rimeter. When the so-called Battle of
Brittany and the interior of France. In the Hedgerows ended on the nine-
this same period the army medical teenth, with the American capture of
service brought all of its elements the key road center of St.-Lo, it
into Normandy, completed its organi- seemed as though the Nazis had suc-
zation, and treated and evacuated a ceeded. They had restricted the First
constant flow of casualties (see Map 9). Army to a maximum advance of 7
Tactically, the First Army shifted its miles, at the cost of about 40,000 cas-
strength and most of its offensive ualties. In this offensive, and indeed
effort to its right wing while holding in the entire campaign thus far, the
its ground on the left. Inland from Americans, and the British (who were
OMAHA, the V Corps, reinforced after stalled around Caen), fell far short of
13 June by the XIX, pushed forward their planned objectives. Their conti-
about 20 miles and then stood fast. nental lodgement at the end of July
Meanwhile, in the Cotentin, the heavi- included only a fraction of the terri-
ly reinforced VII Corps drove on tory that NEPTUNE planners had ex-
Cherbourg, the Americans' most im- pected to hold by that time. The Ger-
portant early objective of the cam- mans, however, also lost heavily in
paign. That major port fell on the the Cotentin and the hedgerows; their
twenty-sixth, after a stubborn German defensive crust had worn very thin
defense. With the harbor obstructed and was ready to crack, if the Allies
220 EUROPEAN THEATER OF OPERATIONS
MAP 9
NURSES OF THE 13TH FIELD HOSPITAL, first to land in Normandy to tend the wounded,
take time outfor a meal
the Advance Section and the Third Well before all these units were in
Army, landed at OMAHA and UTAH. place, Colonel Rogers established
They issued supplies from improvised centralized control of First Army hos-
beach dumps near the engineer spe- pitalization, evacuation, and medical
cial brigade clearing stations and then supply. Between 12 and 19 June, after
set up depots in open fields a short the headquarters and sufficient com-
distance inland, at St.-Laurent, Colle- panies of his medical groups had
ville, and later Le Molay behind landed for immediate operations,
OMAHA and at Le Grand Chemin Rogers relieved the V and VII Corps
behind UTAH. Initially, the companies surgeons of responsibility for all med-
stocked their dumps with salvage
from the invasion flotsam on the 28
For a general view of the supply situation, see
beaches. The first scheduled medical Ruppenthal, Logistical Support, 1:391-422, 439, 464-
74; Harrison Cross-Channel, pp. 422-23; Supply Divi-
maintenance units arrived on OMAHA sion, OofCSurg, HQ, ETOUSA, Annual Rpt, sec. II,
on 7 and 8 June, but were lost when pp. 7-8; Surg, First U.S. Army, Annual Rpt, 1944,
the tide came in and engulfed them p. 14; First U.S. Army Report of Operations, 20 Oct
43-1 Aug 44, bk. VII, p. 76; Surg, V Corps, Annual
before they could be dragged to the Rpt, 1944, pp. 4 and 8; VII Corps Medical Plan, pp.
18-19, encl. 1 to Surg, VII Corps, Annual Rpt,
27
VII Corps Medical Plan, p. 22, encl. 1 to Surg, 1944; 1st and 32d Medical Depot Companies
VII Corps, Annual Rpt, 1944; 31st, 68th, and 134th Annual Rpts, 1944; Wiltse, ed., Medical Supply, pp.
Medical Groups Annual Rpts, 1944. 307-13.
224 EUROPEAN THEATER OF OPERATIONS
ical support to the rear of the divi- 27 percent of these admissions, sol-
sions. Evacuation, field, and convales- diers with nonbattle injuries for 8
cent hospitals and supply depots now percent, and combat wounded for the
reported directly to the army sur- rest. Of the 60,279 battle casualties,
geon. His office, through the 31st and the majority received their injuries
68th Medical Groups, directed the from shell and bomb fragments, most
flow of patients from division clearing often in the arms and legs—a pattern
stations to the beaches. On the of causative agents and anatomical lo-
twenty-first, deviating slightly from cations similar to that in other thea-
the NEPTUNE plan, Rogers put into ters—and over one-third suffered
effect a ten-day evacuation policy, al- multiple wounds (Chart 8).30
lowing retention in France of many Throughout the drive to Cherbourg
sick and lightly wounded men hither- and the struggle among the hedge-
to sent back across the Channel.29 rows, about 90 percent of all battle
During the first two months of the casualties occurred in the infantry
campaign, the buildup of the First rifle companies. For the company
Army medical service went essentially aidmen and battalion and regimental
according to the NEPTUNE plan. By surgeons who first cared for these in-
the end of the period over 35,000 jured, as for the riflemen they accom-
army medical people were on shore. panied, the Normandy hedgerows
For them, and for the organization to became the dominant fact of life, and
which they belonged, these early too often of death. These earthen
summer weeks of activity—the first banks, overgrown with trees and
combat experience for the majority of brush, crisscrossed most of the coun-
personnel and units—provided a test tryside outside the marshes, trans-
of doctrine and training, taught prac- forming roads into sunken lanes ideal
tical lessons, brought forth field im- for ambush and breaking up the land-
provisations, and revealed certain an- scape into easily defended terrain
ticipated and unanticipated problems. compartments that had to be cleared
one at a time by teams of tanks and
Cherbourg and the Hedgerows riflemen. Each 100- or 200-yard-long
During the fighting for Cherbourg rectangle of plowed ground, pasture,
and St.-Lo, First Army medical units or orchard had its price in American
admitted 95,172 Army personnel; dead and wounded. In five days of
they returned 22,639 of these patients fighting during the July offensive one
to duty, evacuated 60,317 to the 4th Division regiment, the 22d Infan-
United Kingdom, and lost 2,027 to try, suffered 729 casualties, including
death. Sick men, including neuropsy- 30
In addition to U.S. soldiers, the army hospitals
chiatric patients, accounted for almost admitted 337 U.S. Navy men, 486 Allied personnel,
6,207 enemy POWs, and 812 civilians. For statistics,
29
First U.S. Army Report of Operations, 20 Oct see: First U.S. Army Report of Operations, 20 Oct
43-1 Aug 44, bk. VII, pp. 70-71 and 87-91; VII 43-1 Aug 44, bk. VII, apps. 11, 17, 26, and 29; VII
Corps Medical Plan, pp. 18-19, 22-23, 25, encl. 1 to Corps Medical Plan, p. 29, encl. 1 to Surg, VII
Surg, VII Corps, Annual Rpt, 1944; Surg, V Corps, Corps, Annual Rpt, 1944; Medical Bulletins, 2d In-
Annual Rpt, 1944; 31st Medical Group Annual Rpt, fantry Division, June and July 1944, box 388, RG
1944, p. 8. 112, NARA.
226 EUROPEAN THEATER OF OPERATIONS
mands, had to split up their tank and and transferred men needing immedi-
armored infantry battalions into pla- ate emergency surgery to adjacent
toons to help the infantry clear field hospital platoons. Moving fre-
ground, hedgerow by hedgerow. The quently to keep up with their divi-
divisions then had to attach aidmen sions, clearing companies handled a
and litterbearers to each separate large volume of casualties. The 4th
platoon, in violation of their doctrine, Division clearing station, for example,
under which tank battalions, especial- received, treated, and evacuated over
ly, kept all their enlisted medical per- 6,100 patients—an average of about
sonnel at their aid stations. Because 245 per day—during its first twenty-
tank and mechanized infantry battal- five days in operation. During the
ions included only half as many battle for St.-Lo in July, the 83d In-
enlisted medical people as standard fantry Division clearing station proc-
infantry battalions, the armored divi- essed 1,600 wounded in three days.
sions had to strip their medical battal- To relieve the exhausted staff of this
ions to build up their unit detach- company, the VII Corps surgeon rein-
ments. After the initial weeks of forced it temporarily with elements of
hedgerow combat, the 3d Armored the corps medical battalion and with
Division surgeon, Col. James L. an entire clearing company borrowed
Salmon, MC, requested an additional from the 134th Medical Group. As it
eighty-four medical enlisted men for had in other theaters, the combina-
his division so that tank and mecha- tion of clearing station and field
nized infantry battalions could main- hospital platoon worked smoothly,
tain what was, in effect, a convention- freeing the clearing company of non-
al infantry system of evacuation. In transportable patients and saving the
the absence of such permanent rein- lives of severely injured men. General
forcements the XIX Corps surgeon Kenner reported after a mid-July in-
temporarily attached men from his spection tour: "Many men, wounded
corps medical battalion to the ar- within the hour, were receiving emer-
mored units.34 gency major surgical treatment in
Collecting and clearing station op- these installations. The forward dis-
erations conformed closely to doc- position of these elements is responsi-
trine. Collecting stations, usually lo-
ble in large measure for the . . . low
cated near the command posts of the
mortality rate amongst our casual-
regiments they supported, changed 35
ties."
bandages on incoming wounded, ad-
justed splints, administered plasma, 35
Quotation from Memo, Kenner, 13 Jul 44, sub:
and combated shock while preparing Report of Inspection of Medical Service in Liberat-
patients for further evacuation. Clear- ed Areas, in Medical Division, COSSAC/SHAEF,
ing stations, 4-6 miles behind the col- War Diary, July 1944. For 4th Medical Battalion sta-
tistics, see 4th Medical Battalion Report of Oper-
lecting companies, performed triage, ations, 6-30 Jun 44, box 6727, RG 407, NARA. On
maintained wards for care of shock the 83d Division, see VII Corps Medical Plan, pp.
and of minor sickness and injuries, 33 and 35, encl. 1 to Surg, VII Corps, Annual Rpt,
1944, and 134th Medical Group Annual Rpt, 1944,
p. 8. For other examples of collecting and clearing
34
Surg, XIX Corps, Annual Rpt, 1994, ends. 15- station activities, see Medical Bulletin, 2d Infantry
16. Continued
INTRODUCTION TO BATTLE 229
Division medical elements, especial- unit commanders concluded that,
ly the infantry regimental detach- except for isolated cases, the Ger-
ments and the collecting company mans were following the rules. The
litter platoons, suffered substantial commander of the 4th Medical Battal-
casualties. Colonel Hayes, the VII ion, which had had men killed and
Corps surgeon, reported as early as wounded and ambulances damaged
14 June: "All divisions in the line by artillery and machine-gun fire,
have lost from one to eight medical summed up the prevailing opinion:
officers and from five to forty enlisted "It is the consensus . . . that little of
men." Between 10 and 24 July, in the this damage was deliberate and that
already understrength regimental de- for the most part the enemy respects
tachments of the 9th Division, 1 med- the Rules of Land Warfare. . . . " Ac-
ical officer and 20 enlisted men were cording to German prisoners, sniper
killed, 4 officers and 155 men wound- incidents often resulted from difficul-
ed, and 2 officers and 19 men cap- ty in seeing Red Cross arm brassards
tured. The 83d Division, in the July on men moving along the hedgerows;
offensive, had two entire battalion aid medics in some divisions noted that a
stations overrun and taken prisoner high proportion of their small-arms
during a local German counterat- casualties were shot from the unbras-
36
tack. sarded right side. Aidmen and litter-
Random artillery and mortar fire bearers accordingly began wearing
accounted for most medical troop cas- brassards on both arms and painted
ualties, as well as for frequent damage nonregulation red crosses in white
to medical service vehicles and instal- squares on their helmets. The XIX
lations. However, the killing and Corps surgeon late in July officially
wounding of aidmen, litterbearers, authorized these and other measures
and aid station personnel by aimed to make Geneva Convention markings
rifle fire, usually from snipers, raised on men and vehicles more conspic-
the question whether the enemy, as uous.37
general policy, was respecting the
Geneva Convention rights of un- 37
Quotation from 4th Medical Battalion Report of
armed Red Cross-marked medical Operations, 6-30 Jun 44, box 6727, RG 407, NARA.
personnel. After two months of For other expressions of this view, see Memo,
Kenner to CofS, SHAEF, 20 Jun 44, sub: Report of
combat and careful analysis of many Inspection ETO, and Memo, Kenner, 13 Jul 44, sub:
incidents, most corps, division, and Report of Inspection of Medical Service in Liberat-
lower-echelon surgeons and medical ed Areas, both in Medical Division, COSSAC/
SHAEF, War Diary, June and July 1944; and Medi-
cal Bulletin, 2d Infantry Division, box 388, RG 112,
Division, June 1944, box 388, RG 112, NARA; Rpt, NARA. Less favorable views of the Germans are in
Surg, 9th Infantry Division, 1944, sub: Medical Ac- VII Corps Medical Plan, p. 20, encl. 1 to Surg, VII
tivities—Marigny Sector, box 388, RG 112, NARA; Corps, Annual Rpt, 1944; Tegtmeyer "Diary," bk.
1st Medical Battalion After-Action Rpts, May, June, II, p. 15; Richardson Interv, tape 1, side 2, CMH;
and July 1944, box 5966, RG 407, NARA; Richard- and Bradley, Aid Man, p. 49. On Red Cross mark-
son Interv, tape 2, side 1, CMH. ings, see Surg, XIX Corps, Annual Rpt, 1944; Surg,
36
VII Corps Medical Plan, p. 20, encl. 1 to Surg, 29th Infantry Division, Annual Rpt, 1944, p. 13;
VII Corps, Annual Rpt, 1944; Rpt, Surg, 9th Infan- Surg, 35th Infantry Division, Annual Rpt, 1944, pp.
try Division, 1944, sub: Medical Activities—Marigny 4-5; and Rpt, Lt Col C. L. Milburn, Jr., 28 Jun 44,
Sector, box 388, RG 112, NARA; Surg, 83d Infantry sub: Report of Medical Officer Observer in France,
Division, Annual Rpt, 1944, p. 3. 19-26 Jun 1944, in Shambora Papers, MHI.
230 EUROPEAN THEATER OF OPERATIONS
bulance convoys from the divisions to weather much of the time and plenty
hospitals in their sectors and from the of returning cargo planes, the 60th
hospitals to UTAH and OMAHA beach- and 61st Medical Battalions on some
es. Each group transported as many days flew out as many as 600 patients,
as 2,500 patients a day, keeping its while the number leaving OMAHA
ambulances rolling steadily in the daily by ship dwindled to less than
constant bumper-to-bumper traffic of 20. On UTAH beach, by contrast, sea
the congested beachhead. Occasional- evacuation continued to predominate.
ly, they massed forces to meet sudden A company of the 134th Medical
emergencies. Between 28 June and 1 Group opened an air evacuation hold-
July, for instance, the 68th Group, ing unit at Ste.-Mere-Eglise on the
which normally worked in the OMAHA eighteenth, but it closed after eleven
area, sent men, trucks, and ambu- days of limited operation because
lances to Cherbourg to evacuate to transport flights there interfered with
UTAH beach over 1,300 wounded combat air activities. Not until 20 July
German prisoners. During July, as the did the medical service secure more
intensity of combat and the number or less regular evacuation use of an
of divisions in Normandy increased,
airfield in the Cotentin. Air evacu-
Colonel Rogers reinforced the medi-
cal groups with additional ambulance ation at once proved its worth. With
and collecting companies temporarily the flight itself taking no longer than
detached from the Third Army and ninety minutes, General Kenner re-
with ambulance companies taken ported, "men wounded in the morn-
from the corps medical battalions.39 ing are often on the operating table
At OMAHA and UTAH the engineer of a general hospital in the UK within
special brigade medical battalions, 10 hours." With such rapid evacu-
rearmost evacuation elements of the ation available, surgeons could send
First Army, received patients from the to Britain many severely wounded
medical groups and prepared them men hitherto classified nontransporta-
for cross-Channel movement, by ship ble, reducing the surgical burden on
and, for an increasing proportion, by hard-pressed field and evacuation
40
airplane. The NEPTUNE plans called hospitals.
for the beginning of mass air evacu- 40
ation from France around D+14 (20 Quotation from Memo, Kenner to CofS,
SHAEF, 20 Jun 44, sub: Report of Inspection ETO,
June), but the engineer special bri- in Medical Division, COSSAC/SHAEF, War Diary,
gades managed to complete a tempo- July 1944. In same file, see Memo, Kenner to
rary airstrip near St.-Laurent on the CAdminOff, 26 Jul 44, sub: Evacuation of Casualties
by Air. See also Professional Services Division,
eighth. A IX Troop Carrier Com- OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, Chief
mand C-47 lifted out the first 13 pa- Consultant in Surgery sec., pp. 12-13; First U.S.
tients, including 7 wounded POWs, Army Report of Operations, 20 Oct 43-1 Aug 44,
bk. VII, pp. 69-70; John W. Pace, "Air Evacuation
two days later. With passable flying in the European Theater of Operations," Air Sur-
geon's Bulletin 2 (October 1945): 324; Dowling, Nor-
39
First U.S. Army Report of Operations, 20 Oct mandy Rpt, 11 Jan 45, p. 17; Rpt, ProvESBGp, 30
43-1 Aug 44, bk. VII, p. 71; 31st and 68th Medical Sep 44, sub: Operation NEPTUNE, pp. 115, 335,
Groups Annual Rpts, 1944; Surg, V Corps, Annual 339; VII Corps Medical Plan, pp. 21-22, encl. 1 to
Rpt, 1944, p. 9; Surg, VII Corps, Annual Rpt, 1944, Surg, VII Corps, Annual Rpt, 1944; 134th Medical
p. 10; Surg, XIX Corps, Annual Rpt, p. 5. Group Annual Rpt, 1944, p. 8.
232 EUROPEAN THEATER OF OPERATIONS
rary accommodations for 250 walking Most wounded men who passed
wounded, and the 499th Collecting through the army evacuation chain
Company sorted incoming patients underwent surgery in field or evacu-
and furnished litterbearers and ambu- ation hospitals. Field hospital pla-
lances. Working with attached Air toons, located close to division clear-
Force liaison personnel and in direct ing stations, received the most urgent
telephone contact with the airstrip nontransportable cases, primarily,
and the naval beach station, the cen- General Hawley observed, "perforat-
ter's evacuation control officer, bor- ing wounds of the belly and sucking
rowed from the 11th Port, dispatched wounds of the chest." Each platoon
patients as LSTs, hospital carriers, had auxiliary surgical teams attached
and aircraft became available. The as operating staff, and between them
center normally gave stretcher cases the three platoons of a field hospital,
priority for cross-Channel flights and if all were active, could perform about
sent the walking wounded by ship. As thirty major and usually complex pro-
Captain Dowling, the Western Naval cedures a day. Death rates in these in-
Task Force surgeon, later reported, stallations ranged from 11 to 14 per-
"This system was easily regulated and cent of surgical admissions, about
maintained, and greatly facilitated three times the rate for evacuation
speed and ease in handling casual-
41 hospitals, which reflected the desper-
ties. . . ."
ate nature of the cases the field units
41
Dowling, Normandy Rpt, 11 Jan 45, p. 17; Rpt,
received. As the commander of the
ProvESBGp, 30 Sep 44, sub: Operation NEPTUNE,
42
pp. 335-36; 60th Medical Battalion Annual Rpt, First U.S. Army Report of Operations, 20 Oct
1944, pp. 11-13; 61st Medical Battalion Annual Rpt, 43-1 Aug 44, bk. VII, pp. 69-70; Dowling, Norman-
1944, pp. 6-7 and 10; 393d Collecto-Clearing Com- dy Rpt, 11 Jan 45, pp. 17-18 and app. N; 261st
pany Annual Rpt, 1944, pp. 11-12. Medical Battalion Annual Rpt, 1944, p. 3.
INTRODUCTION TO BATTLE 233
51st Field Hospital put it, "Exsan- up," the 41st Evacuation Hospital
guination, eviscerations, cardio-respi- commander complained, "there
ratory difficulties, and deep shock" would always be a big influx of pa-
were the normal fare of his doctors. tients, which continued until every
For the attached teams, who had com- bed was filled and this hospital
plete authority over the surgical ser- bogged down. Then the hospital
vice, field hospital work, while hard would be closed and left to work itself
and demanding, offered a high level out of the mess." 44
of professional challenge and satisfac- With the arrival of more evacuation
tion. With perhaps some exaggera- hospitals the flow of patients evened
tion, a 3d Auxiliary Surgical Group out, but in more units a chronic sur-
report referred to this duty as "the gical backlog persisted. The majority
surgeon's paradise." The first weeks of the casualties reaching these hospi-
of operation revealed only a few defi- tals were injured men who needed
ciencies in platoon organization and surgery—for example, 894 patients
equipment: a shortage of litter- out of 1,302 admitted by the 5th
bearers; a need for extra officers and Evacuation Hospital during its first
nurses to stay behind with patients two weeks in Normandy and all but
when the unit moved; and require- 360 out of 3,200 treated at the 128th
ments for larger generators and addi- Evacuation Hospital in a similar space
tional suction, anesthesia, and oxygen of time. The T/O surgical staff of this
43
apparatus. type installation, working twelve-hour
While the field hospitals proved shifts and reinforced by as many aux-
more than equal to their task, the iliary surgical teams as the hospital's
400-bed army evacuation hospitals 40 nurses and 217 enlisted men could
found themselves consistently over- support, could perform about 100
burdened. Processing all patients who major operations every twenty-four
were transportable and needed more hours; the patient influx during heavy
than the most elementary treatment, combat occurred at about double that
these hospitals worked in rotation, rate. Inevitably, the less urgent cases
some receiving casualties while had to wait their turn on the operat-
others, cleared of patients, rested or ing tables, often developing infections
moved forward behind the divisions. in undebrided wounds or suffering
During the first weeks evacuation hos- other complications. To help its hos-
pitals lived from crisis to crisis. pitals overcome this backlog, the First
"When a hospital moved in and set Army deployed surgical teams and
43
mobile truck-mounted surgical and X-
First quotation from Ltr, Hawley to TSG, 26ray units of the 3d Auxiliary Surgical
Jun 44, file HD 024 ETO O/CS (Hawley-SGO Cor-
resp). Second quotation from 51st Field Hospital Group and, when these proved insuf-
Annual Rpt, 1944, pp. 24-25; see also pp. 8-11. ficient, added provisional teams from
Third quotation from 3d Auxiliary Surgical Group COMZ hospitals landed but not yet
Annual Rpt, 1944, p. 33; see also pp. 3-4, 32, 34-
35, 44-46. See First U.S. Army Report of Oper-
44
ations, 20 Oct 43-1 Aug 44, bk. VII, pp. 72-73 and Quotation from 41st Evacuation Hospital
96-97; Rpt, Milburn, 28 Jun 44, sub: Report ofAnnual Rpt, 1944, p. 60. See also First U.S. Army
Medical Officer Observer in France, 19-26 June Report of Operations, 20 Oct 43-1 Aug 44, bk. VII,
1944, Shambora Papers, MHI. p. 72.
234 EUROPEAN THEATER OF OPERATIONS
functioning. The medical groups as- Clinically, surgery during the first
signed a collecting company to each two months of combat produced few
evacuation hospital, to provide reliefs surprises. Surgeons were impressed
for ward officers, additional litter- by the frequency and severity of the
bearers, and ambulances to help in multiple wounds from artillery fire.
moving out patients. Clearing compa- On his July inspection trip General
nies, from the 134th Medical Group Kenner saw patients "with a penetrat-
or the corps medical battalions, set up ing wound of the skull, sucking
near evacuation hospitals to relieve wound of the chest, partial eviscera-
them of the sick and minor surgical tion and a compound fracture. This
patients. For unskilled labor, the hos-
means that one surgical team, on that
pitals obtained German prisoners
from the First Army provost marshal. one individual, must perform four
The First Army tried to manage major operations." The rate of use of
evacuation so as to reduce the surgi- whole blood about matched the high-
cal log jam. The 31st and 68th Medi- est pre-D-Day projections, running
cal Groups directed ambulances from about one pint for each pint of
clearing stations to the evacuation plasma. According to Colonel Rogers,
hospitals on the basis of surgical the Manual of Therapy "met all expec-
backlog, rather than proximity or tations" as a practical guide to for-
number of empty beds. As a final ex- ward surgery. Rogers' staff, working
pedient, on 28 June, Colonel Rogers, closely with the theater consultants,
at the urging of General Hawley and issued a steady stream of directives to
Colonel Cutler, authorized hospital clarify certain points in the Manual
commanders to send transportable and to correct surgeons' minor devi-
minor surgery patients directly to the ations from it. Early debridement and
beach holding units for air evacu- liberal use of penicillin and sulfa
ation, whenever, in their judgment, drugs kept the incidence of serious
that course of action would bring the wound infection low, in spite of surgi-
patient earlier treatment. Under this cal backlog, and in spite of the fact
policy, evacuation hospitals could re- that many casualties occurred on pas-
lieve themselves of between 15 and tures and farmland contaminated with
25 percent of their surgical patients; animal and human feces. Of the
but, even with this assistance, it was wounded men treated in First Army
clear that this type of unit needed installations and then evacuated
constant augmentation to carry out its across the Channel less than 1 per-
mission.45 cent died after reaching England, a
45 result which Kenner attributed to
First U.S. Army Report of Operations, 20 Oct
43-1 Aug 44, bk. VII, pp. 73, 81-82, 98-99; First"the echeloning of skilled surgical
U.S. Army Command Journal, 27 Jun 44; Mins, Firstcare throughout the evacuation
U.S. Army Surgeons Conference, 25 Jun 44, in First
chain." Colonel Cutler, after a visit to
U.S. Army Log, D-Day through D+56; Medical
News No. 10, First U.S. Army, 28 Jun 44; 3d Auxil-
iary Surgical Group Annual Rpt, 1944, pp. 32-35 2:220-22 and 227. For examples of the problem
and 44-46; 31st Medical Group Annual Rpt, 1944, and its solutions in various units, see 24th, 32d,
pp. 10-11 and 13; Surg, XIX Corps, Annual Rpt, 41st, 91st, and 128th Evacuation Hospitals Annual
1944, p. 5 and an. B; Carter, ed., Surgical Consultants, Rpts, 1944.
INTRODUCTION TO BATTLE 235
with the flexibility and adaptability of rear boundary, no such boundary yet
his medical groups. Nevertheless, un- existed. The Advance Section barely
resolved questions existed as the First had shouldered its way ashore and
Army paused after the capture of St.- was in only limited operation. The
Lo and prepared for new attacks. slow advance of the front in June and
Thus far, the army medical service July had disrupted COMZ plans for
had supported a static or slow-moving movement across the Channel, even
force; how well prepared was it to as the base sections in England re-
perform if the army broke out of the ceived and cared for the First Army's
beachhead into truly mobile warfare? wounded as well as supported its op-
Further, if the army did start moving erations.52
rapidly away from the beaches, its
medical service would need a conti- 52
First U.S. Army Report of Operations, 20 Oct
nental Communications Zone to fill in 43-1 Aug 44, bk. VII, pp. 108-09; Rpt, Milburn, 28
behind it and relieve it of its rearmost Jun 44, sub: Report of Medical Officer Observer in
France, 19-26 June 1944, Shambora Papers, MHI;
hospitalization, evacuation, and sup- Memo, Kenner to ACofS, G-4, SHAEF, 21 Jul 44,
ply tasks. However, as the campaign sub: Present Status of Fixed US Hospital Beds, UK
approached D+50, a point well and Continent, in Medical Division, COSSAC/
SHAEF, War Diary, July 1944, which reflects the
beyond the date the NEPTUNE plan- concern at the delay in organizing the Normandy
ners had set for drawing the army COMZ.
CHAPTER VIII
mand under the army, a narrow strip principal tasks. In the United King-
of territory along OMAHA beach, later dom the medical service put into exe-
enlarged to include UTAH beach and cution preinvasion plans for receiving
the upper Cotentin around Cher- and caring for battle casualties from
bourg. SHAEF, increasingly impatient the Continent. In France it revised
at the army's delay in relinquishing and then tried to implement plans for
logistical responsibilities, on 14 July evacuating patients from the field
nominally detached ADSEC from the forces, setting up supply depots, and
First Army and placed it under Gen- establishing general hospitals.
eral Lee, the COMZ commander, but
under provisions that, for practical
Cross-Channel Evacuation
purposes, left the section under field
army control. During the invasion COMZ respon-
The Advance Section at least per- sibility for battle casualties began at
formed its intended functions, the water's edge in Normandy, where
although under different command Navy shore parties loaded the wound-
arrangements than initially contem- ed onto LSTs and other vessels for
plated. Forward Echelon, organized the voyage back to England. Under
to direct all continental COMZ activi- the NEPTUNE plans the Army and
ties from roughly D+41 (17 July) to Navy shared the task of cross-Channel
D+90, never really went into oper- evacuation, and medical relations be-
ation at all. A FECOMZ advance party tween the two services were close and
occupied a chateau in Valognes, at cordial throughout the operation.
the hub of the Cotentin road network, General Hawley characterized his
on 18 June, and the headquarters for- naval counterpart, Captain Dowling of
mally opened a month later. Howev-
the Western Naval Task Force, as "a
er, it had nothing to command, be-
cause the Advance Section remained man whose middle name is coopera-
under the First Army. General Lee, in tion." Dowling, on his part, praised
mid-July, decided to move the main the Army Medical Department for
COMZ headquarters to France ahead "one of the finest examples of un-
of schedule and to take direct charge stinted cooperation I have ever expe-
3
of the developing rear area. rienced."
FECOMZ, as a result, spent its brief The Army and Navy medical ser-
time in operation preparing facilities vices worked together to make the
at Valognes for its parent headquar- LST, upon which the NEPTUNE plan-
ters.
2 ners based their arrangements for
As the Communications Zone early casualty clearance from the
struggled to adapt to the changing beaches, into an effective carrier of
circumstances of the campaign, its sick and wounded. The Western
medical service concentrated on two Naval Task Force, which anticipated
transporting 5,000 patients per day
2
Ruppenthal, Logistical Support, 1:430, 433-37,
3
449-58; ADSEC Hist, pp. 26-28 and 40; Memo, First quotation from Ltr, Hawley to TSG, n.d.
Brig Gen R. G. Moses to Gen Bradley, 9 Oct 44, [1944]. Second quotation from Ltr, Capt G. B.
sub: Responsibility for COMZ, Raymond G. Moses Dowling to Hawley, 12 Jul 44. Both in file HD 024
Papers, MHI. ETO O/CS (Hawley-SGO Corresp).
COMZ REACHES THE CONTINENT 241
across the Channel during the first Hawley and Dowling anticipated, as
ten days of the campaign, structurally did the NEPTUNE planners, that
converted 54 of its 103 LSTs to ac- during the first days of the assault
commodate casualties. The task force many wounded would reach the LSTs
installed tiers of removable bulkhead having received only minimal first aid
litter brackets and a platform, lights, and requiring emergency surgery to
and plumbing for a surgical station keep them alive. The Western Naval
on the tank deck of each vessel. So Task Force, accordingly, reinforced
equipped, an LST could hold 144 the medical complement of each LST,
stretcher patients suspended from the both converted and unconverted, with
bulkheads and 150 more lashed to the 2 additional medical officers and 20
deck surface. Another 150 walking hospital corpsmen. These Navy doc-
wounded could ride in the troop com- tors, although given a short course in
partments, making a maximum capac- amphibious warfare medical support
ity several times the conservative av- at the Navy's training center in Corn-
erage load of 75 litter and 75 ambula- wall, were not experienced surgeons.
tory patients used in planning. Con- To ensure adequate shipboard emer-
verted LSTs, and the 49 that were not gency care, Hawley, at Dowling's re-
converted but were able to take on quest, placed 1 Army medical officer
casualties if necessary, all received al- and 2 enlisted surgical technicians on
lowances of dressings, morphine, each LST. Colonel Cutler, the theater
sulfa, splints, whole blood, plasma, chief surgical consultant, handpicked
and penicillin. These supplies came the 100-odd officers, mostly captains
partly from Army and partly from and majors, from the Third Army, the
Navy stocks, and Southern Base Sec- Communications Zone, and the air
tion medical facilities at the ports and forces on the basis of their surgical
hards issued and replenished them. training and qualifications. In mid-
On its first outbound voyage each May, before joining their ships, the
LST carried an exchange unit of blan- officers and their supporting techni-
kets, litters, splints, surgical dressings, cians assembled at three station hos-
and plasma, to be deposited on the pitals for orientation to their mission
beach to replace matériel taken off and for a refresher course, taught by
with the wounded. Each vessel em- the ETO senior consultants, in shock,
barked another such package on sub- anesthesia, transfusion, and surgical
sequent trips until 300 exchange management of trauma.
units, containing in all 30,000 litters Hawley and Dowling, concerned
and 96,000 blankets, had been landed lest the LST doctors attempt too
4
in France. much surgery, issued a directive care-
4
Dowling, Normandy Rpt, 11 Jan 45, p. 19, app.
fully defining the shipboard officers'
A, pp. 6-7, app. M, p. 3, app. N, pp. 3-4; Essential task. In general, they declared, "treat-
Technical Medical Data Rpt, HQ, ETOUSA, June ment on board LSTs should be simi-
1944, encl. 2; Supply Division, OofCSurg, HQ, lar to that of a Division Clearing Sta-
ETOUSA, Annual Rpt, 1944, sec. VI, p. 6; Direc-
tive, HQ, ETOUSA, to CG, FUSAG, and Cdr, US
Fleet, TF 122, 19 May 44, sub: Initial Evacuation of "Hist," ch. 8, app. 5; First U.S. Army Report of Op-
Casualties From Far to Near Shore . . . . in Larkey erations, 20 Oct 43-1 Aug 44, bk. VII, p. 75.
242 EUROPEAN THEATER OF OPERATIONS
a
On loan to U.S. Navy from Great Britain.
Source: Encl 2, Report of Evacuation Operations, 10 Jul 44, p. 2, of Essential Technical Medical Data
Rpt, HQ, ETOUSA, July 1944.
Hawley withdrew his Army surgeons SHAEF. Beginning soon after D-Day,
and technicians from the vessels and the carriers shuttled between South-
sent them back to their units. By the ampton and Normandy, on a schedule
time he did so, it was clear to senior that placed one off each invasion
consultants and shipboard surgeons beach every day. For their size (pa-
alike that preinvasion forebodings tient capacities ranged from 62 litter
about the use of the LST had been and 146 ambulatory on the smallest,
exaggerated. The tank landing ship, the Dinard, to 194 stretcher and 228
although cold, damp and vulnerable ambulatory on the largest, the Prague)
to attack, had demonstrated its effec- they moved a substantial number of
10
tiveness for moving casualties. casualties. The Prague alone, in her
Except for 560 men taken out on first eleven trips, transported 3,280
assault transports, those sea-evacuat- patients.
ed casualties who did not travel on Hospital carriers, which had
LSTs crossed the Channel on hospital Geneva Convention protective mark-
carriers (Table 5). Four of these white- ings, were safer from attack than
painted, Red Cross-marked converted LSTs. Heated inside and equipped
ferries and coastal steamers support- with bunk beds, they were more com-
ed the American Army: the Dinard, fortable for patients than the landing
Naushon, Lady Connaught, and Prague. vessels and, with fully outfitted oper-
With British crews and, in three, U.S. ating rooms, could provide more
Army medical complements, these
complete medical and surgical care.
vessels operated under the British
Nevertheless, the carriers had major
Ministry of Transportation, which dis-
patched them at the request of the deficiencies beyond their limited pa-
First Army, transmitted through the tient capacity. Outside a regular port
Western Naval Task Force and where they could tie up to wharves,
10
they were difficult to load. The carri-
Correspondence in file Evacuation on LSTs, ers, unlike the LSTs, could not take
June 1944; Ltr, Hawley to TSG, 26 Jun 44, file HD
024 ETO O/CS (Hawley-SGO Corresp); Dowling, casualties on board directly from
Normandy Rpt, 11 Jan 45, pp. 23-26. DUKWs and other landing craft, forc-
246 EUROPEAN THEATER OF OPERATIONS
protected transport to its fullest capacity, After D-Day the seaborne move-
we are laying ourselves wide open to ter- ment of wounded back across the
rific criticism. ... I want protected hos- Channel began slowly. A few casual-
pital carriers used to their fullest capac-
ity.11 ties, mostly soldiers and sailors hurt
on board ships and landing craft,
11
First quotation from Evacuation Branch, Oper- reached England during the first
ations Division, OofCSurg, HQ, ETOUSA, Daily forty-eight hours. On 9 June (D+3)
Diary, 11 Jun 44, file HD 024 ETO. See also 9-10
Jun 44 and 1, 4, and 31 Jul 44. Second quotation returning convoys of LSTs made
from Ltr, Hawley to Col C. H. Beasley, 4 Jul 44, file port, carrying casualties from the ini-
HD 024 ETO CS (Hawley Chron). See also Ltr,
Hawley to TSG, 26 Jun 44, file HD 024 ETO O/CS
tial assaults. Thereafter daily patient
(Hawley-SGO Corresp); Dowling, Normandy Rpt, arrivals numbered in the hundreds
11 Jan 45, pp. 19, 26, app. N. pp. 5 and 10; Surg, and, on some days, in the thousands
United Kingdom Base, Annual Rpt, 1944, p. 27;
Professional Services Division, OofCSurg, HQ, (Table 6). Most Americans evacuated
ETOUSA, Annual Rpt, 1944, Chief Consultant in from Normandy landed at Southamp-
Surgery sec., p. 12; Essential Technical Medical ton and Portland-Weymouth, al-
Data Rpt, HQ, ETOUSA, June 1944; Memo, Col J.
K. Davis to CMedOff, SHAEF, 7 Aug 44, sub: Visit though the medical service also had
to Medical Facilities, Southampton, in Medical Divi- made major reception preparations at
sion, COSSAC/SHAEF, War Diary, August 1944;
Memo, Col F. H. Mowrey to Hawley, 27 Jul 44, sub: Brixham and more limited provisions
Report on Trip to Continent, file 370.05. at other Channel ports. Between 6
248 EUROPEAN THEATER OF OPERATIONS
vern and Cirencester. The centers work long hours and hard on receipt
now proved their value in organizing of the casualties." Indicating the qual-
and directing the rapid transfer of ity of work done at holding and tran-
wounded and sick soldiers from rail- sit units, most patients arrived at the
road cars to hutted wards. After early general hospitals with fractures prop-
difficulties with late-arriving and un- erly immobilized, wounds debrided
announced trains and with confusion and ready for secondary closure, and
in unloading, the centers rapidly re- relatively little infection or gas gan-
duced mass admissions to routine. grene. Patient deaths on the way to
The 15th Hospital Center, for in- general hospitals, and after arrival
stance, designated one of its attached there, were very few.24
general hospitals to receive each
trainload of patients and pooled am-
bulances and litterbearers from the 24
Quotation from Surg, Ninth U.S. Army, Daily
Journal, 9 Jul 44, Shambora Papers, MHI. See also
others to empty the railcars. By such Professional Services Division, OofCSurg, HQ,
means the hospital center could have ETOUSA, Annual Rpt, 1944, Chief Consultant in
a wounded man in bed in a ward Surgery sec., pp. 9 and 13-14; Rpt, Kenner, 17 Jun
44, sub: Visit of CMO to 91st and 97th General
thirty-five minutes after the train car- Hospitals, Oxford, in Medical Division, COSSAC/
rying him pulled into the station. SHAEF, War Diary, June 1944; Evacuation Branch,
Hospital personnel, an observer Operations Division, OofCSurg, HQ, ETOUSA,
Daily Diary, 10 Jun 44, file HD 024 ETO; 12th Hos-
noted, "consider this time as their pital Center Annual Rpt, 1944, pp. 31-32; 15th
actual 'battle participation' and all Hospital Center Hist, 1944, pp. 21-22.
256 EUROPEAN THEATER OF OPERATIONS
Source: Evacuation Branch, Operations Division, OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, encl. 10.
craft and dispatched them to hospi- the same as that for seaborne pa-
26
tals. tients. The airstrip holding units,
Most air-evacuated casualties which could remove a C-47's cargo of
landed at the Ramsbury and Mem- 24 litter cases in no more than eight
bury airfields in the Southern Base minutes, between them could process
Section, which the Ninth Air Force 1,000 wounded a day, although actual
had designated for this purpose daily flow averaged about half that
before D-Day. At each base a field number. Patients generally showed no
hospital platoon (the 3d of the 6th at ill effects from their flight, except for
Ramsbury and the 2d of the 28th at a few with chest and abdominal inju-
Membury), reinforced by an auxiliary ries who were evacuated too early
surgical team, acted as a holding unit. after surgery in France.27
Set up in tents close to the runways, As the logistical efficiency and med-
these hospitals retained nontranspor- ical advantages of air evacuation
tables selected by plane-side triage of- became apparent, the medical service
ficers for emergency surgery and re- and the Air Force opened additional
suscitation. Ambulances, from the receiving facilities at Merryfield, Red-
field hospitals and an attached ambu- nail, and Tarrant Rushton airfields.
lance company, took evacuees able to Located close to general hospitals,
travel to two station and two general these fields required no elaborate
hospitals within a 30-mile radius, holding and transit arrangements.
which served as transit facilities. From The medical service, accordingly, sta-
then on, the evacuation pattern was tioned only a small holding element
26
at Merryfield and placed detachments
Link and Coleman AAF Medical Support, pp. of litterbearers and ambulances at the
598-600; Surg, Ninth Air Force, Annual Rpt, 1944,
pp. 16 and 21-22; Surg, IX Troop Carrier Com-
27
mand, Annual Rpt, 1944, p. 9. On the NEPTUNE Surg, United Kingdom Base, Annual Rpt, 1944,
plans, see An. 6—Medical, pp. 13-14, to FUSA Plan, p. 24; 6th Field Hospital Annual Rpt, 1944, pp. 3-4;
25 Feb 44; An. 8—Medical, p. 8, to ADSEC Plan, 30 28th Field Hospital Hist, 1944, pp. 5-6 and 30, box
Apr 44; and An. 9—Medical, pp. 13-14, to 412, RG 112, NARA; Evacuation Branch, Oper-
FECOMZ Plan, 14 May 44. All in file HD 370 ETO. ations Division, OofCSurg, HQ, ETOUSA, Daily
See also O/CS Continental SOP, 4 Apr 44, pp. 12- Diary, June-July 1944, file HD 024 ETO; 98th Gen-
13, file 370.02. On statistics, see Evacuation Branch, eral Hospital Annual Rpt, 1944, pp. 2 and 38-39;
Operations Division, OofCSurg, HQ, ETOUSA, 598th Ambulance Company Annual Rpt, 1944, p. 3;
Annual Rpt, 1944, p. 13 and encl. 10; Memo, correspondence in Medical Division, COSSAC/
Kenner, 26 Jul 44, sub: Evacuation of Casualties by SHAEF, War Diary, June-August 1944; Ltr, Hawley
Air, in Medical Division, COSSAC/SHAEF, War to Col Thomas, 28 Jul 44, file HD 024 ETO CS
Diary, July 1944. (Hawley Chron).
258 EUROPEAN THEATER OF OPERATIONS
other two fields. Meanwhile, the two redeployed two of the four field hos-
original evacuation air bases, Rams- pitals, the 12th and 28th, from Port-
bury and Membury, continued in op- land-Weymouth and Southampton
eration, with the 6th Field Hospital and gradually detached ambulance
during July taking over the entire and collecting companies from the
holding mission at both places. The 33d Medical and 93d Medical Gas
number of nontransportable wounded Treatment Battalions. All the medical
arriving at these fields dwindled receiving units left the smaller Chan-
steadily, reducing the hospital to the nel ports. In late June General Haw-
tasks of triage and ambulance-load- ley's office returned all but five of the
ing, much to the discontent of the Southern Base Section transit hospi-
unit's professional staff. With all these tals to regular duty. Nevertheless, sea
bases available, the medical service by evacuation by LSTs was to continue.
late July had the capacity to handle On 18 July the theater commander
6,000 air-evacuated casualties per day. and the commander of the United
General Kenner and Colonel Cutler States Naval Forces in Europe agreed
hoped that air transportation on this that the Navy would furnish landing
scale would permit the service to
ships, in diminishing numbers, for
abandon the LST as a means of carry-
ing wounded, especially as the open- transport of wounded through 1 Oc-
ing of continental ports facilitated use tober, by which date French ports
of the hospital carriers. Air evacu- should be open for hospital ships and
ation, however, was subject to other carriers and the autumn storms would
limitations than the capacity of receiv- cause all logistical activity on the
ing fields in England, and Kenner's beaches to cease.29
and Cutler's hopes were not to be re- During the first two months of the
alized.
28 campaign over 65,000 casualties
The expansion of air evacuation, 29
combined with the lighter-than-ex- The remaining transit hospitals, all station hos-
pitals, were: 38th (Winchester), 110th (Netley),
pected invasion casualties and the 228th (Sherbourne Park), 305th (Warden Hill), and
opening of First Army hospitals, ren- 315th (Axminster), with a total of 5,093 beds. This
list does not include the hospitals doing air evacu-
dered superfluous much of the elabo- ation transit duty, usually in addition to regular
rate network of port holding units functions. See Essential Technical Medical Data Rpt,
and transit hospitals. Accordingly, the HQ, ETOUSA, June 1944, encl. 2; 33d Medical and
93d Medical Gas Treatment Battalions Annual Rpts,
Communications Zone during June 1944; 7th and 12th Field Hospitals Annual Rpts,
1944; 28th Field Hospital Hist, 1944, box 412, RG
28
Surg, United Kingdom Base, Annual Rpt, 1944, 112, NARA; 48th General Hospital Annual Rpt,
pp. 24-25; Evacuation Branch, Operations Division, 1944, p. 5; Evacuation Branch, Operations Division,
OofCSurg, HQ, ETOUSA, Daily Diary, June-July OofCSurg, HQ, ETOUSA, Daily Diary, 22 Jun 44,
1944, file HD 024 ETO; Surg, Western Base Sec- file HD 024 ETO; Memo, Col D. E. Liston to G-4,
tion, Rpt, 1 Jan-31 Aug 44, pp. 9-10; 6th Field ETO, 10 Jun 44, EvacCorresp, 1942-44, file HD
Hospital Annual Rpt, pp. 3-4 and 6; Memo, Kenner, 024 ETO. See also in EvacCorresp, 1944-45, file
26 Jul 44, sub: Evacuation of Casualties by Air, in HD 370.05 ETO, the following: Memo, Liston to
Medical Division, COSSAC/SHAEF, War Diary, July Capt J. H. Chambers, MC, USN, 13 Jul 44, sub: LST
1944; Memo, Cutler to Hawley, 30 Jun 44, in Pro- Requirements for Evacuation of Patients; Ltr, Cdr,
fessional Services Division, OofCSurg, HQ, NAVFOREU, to CG, ETO, 18 Jul 44, sub: Intra-
ETOUSA, Annual Rpt, 1944, Chief Consultant in Theater Evacuation of Casualties; Ltr, Liston to G-
Surgery sec., p. 12. 4, ETO, 30 Jul 44.
COMZ REACHES THE CONTINENT 259
passed across the Channel into the shaken constantly by the blast of
hospitals so laboriously constructed nearby American artillery and in
under the BOLERO program. Except danger from German shelling and air
31
for the fact that the casualty receivingraids aimed at a nearby bridge.
system turned out to have been over- During their first month in Nor-
built for the number of patients it mandy, Beasley and his growing staff,
handled, this portion of COMZ medi- in keeping with the subordinate status
cal support went essentially according of ADSEC, worked under Colonel
to plan. The same could not be said Rogers, the First Army surgeon. Beas-
for the effort to establish COMZ med- ley, who initially had little to do but
ical support in Normandy. On the keep up with army activities, attended
Continent the medical service, like Rogers' daily conferences. The heads
the other technical services, ran afoul of the various divisions of Beasley's
of the slow progress of the attack. By office established close liaison with
late July the resulting delays in open- their First Army counterparts, and
ing facilities, especially general hospi-
with the medical staffs of 21 Army
tals, had compelled major revisions in Group and the Ninth Air Force.
the COMZ medical plan.30 Gradually, they found employment in
overseeing the disembarkation and
ADSEC Medics in Normandy positioning of ADSEC medical units,
and they prepared to take over par-
Shortly before D-Day the ADSEC
ticular support functions as Rogers
surgeon, Colonel Beasley, and his
staff were alerted and began staging directed. The latter process began on
for movement to France. Officers of 19 July, when Rogers transferred to
Beasley's section landed at OMAHA Beasley responsibility for the receipt,
and UTAH beaches on 12 June, and storage, and issue of medical supplies
Beasley himself came ashore on the arriving on the beaches and at Cher-
32
sixteenth. Two days later Beasley and bourg.
the advance elements of his office es- In the crucial matter of evacuation
tablished themselves at Auville-sur-le- the ADSEC surgeon's role was still
Vey near Carentan, close by the main evolving when the Battle of the
ADSEC headquarters at Catz. During Hedgerows ended. In accordance with
the next month the rest of the 100- NEPTUNE plans the Advance Section
man section, in prearranged incre- was to assume command of the engi-
ments, disembarked at UTAH; neer special brigades around D+25
marched to concentration areas; and (1 July) and was to be directing most
then rode in trucks to Auville. 31
Housed in battle-damaged dwellings 7 andSurg, ADSEC, COMZ, Annual Rpt, 1944, pp. 6-
14-15; Joseph R. Darnall, "Scouting for Hos-
and in tents in an apple orchard, the pital Sites in Normandy," The Military Surgeon 101
medical section until late in July was (September 1947): 192-93 and 196.
32
only a few miles behind the front, and Surg, ADSEC, COMZ, Annual Rpt, 1944, pp. 7
26. See also in Charles H. Beasley Papers, MHI,
the following: Surg, ADSEC, Daily Activities Rpts,
30
Evacuation Branch, Operations Division, June-July 1944; Supply Division, OofSurg, ADSEC,
OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, encl. Weekly Activities Rpts, weeks ending 8 and 22 Jul
10. 44.
260 EUROPEAN THEATER OF OPERATIONS
COL. CHARLES A. BEASLEY, the ADSEC surgeon, receiving a decoration from the French in
April 1945
had had no running water for the last tals, in caring for their wounded
week of the siege; discipline had countrymen until the last POWs were
broken down; and French civilian evacuated early in July. Supplement-
doctors, who had used part of the ing their equipment and medical sup-
building under the occupation, now plies with confiscated German arti-
were looting the supplies of their cles, the Americans opened 400 beds
former conquerors. According to the for their own patients on 30 June.
12th's commander, The 12th functioned as a small gener-
the sanitary facilities were virtually non- al hospital, receiving sick and injured
existent—bed pans and urinals were used from the Cherbourg area, including
again and again without being cleaned many mine and booby-trap casualties
and . . . were at the bedside of the pa- from the port clearing operations.
tients; no attempt has been made to pro- Under the First Army evacuation
vide for any form of laundry facilities and
thus filth was evident on the bedding and policy the hospital retained men re-
on the patients themselves. The stench turnable to duty within ten days; it
which emanated from these wards is one sent other patients by ambulance to
that can never be dismissed from the UTAH beach for transportation to
minds of those who worked therein. Per- England. In addition to its other
haps the operating theater, an under-
ground set-up, presented the most ghast- tasks, the 12th housed and fed medi-
ly scene. Surgeons of the German staff cal organizations awaiting deployment
36
had been operating for ... 72 hours in the upper Cotentin.
non-stop and with water unavailable, no Other ADSEC medical units went
attempt had been made to clean up the into operation throughout the Coten-
place. Debris from amputations lay in var-
ious receptacles about the operating . . . tin and in the crowded space inland
tables and blood and filth was evident of OMAHA beach. Typically, these or-
throughout the rooms. On the grounds in ganizations moved to their assigned
back of the hospital, as well as in the locations in their own vehicles, or in
morgue, still remained the unburied transport borrowed from other units,
bodies of soldiers and civilians; and
dumped on the ground near the mess over roads marked "Mines Cleared to
hall, amputated extremities were in abun- Hedges Only." Usually setting up in
dance,35brought there from the operating hedged fields, the medical people had
room. to clear away battle debris—discarded
Medics of the 12th Field Hospital equipment, glider wreckage, and oc-
fell to work, cleaning up and repair- casionally bodies or parts of bodies—
ing wards, operating rooms, kitchen, before they could erect their facilities.
and mess hall. They restored the The more enterprising organizations
water supply. They supervised cap- found uses for some of the litter. Sal-
tured German medical personnel, as- vaged wood from glider frames, for
sembled from all three overrun hospi- example, went into floors and furni-
ture for living quarters and work
37
35
Quotation from 12th Field Hospital Annual
spaces.
Rpt, 1944, p. 5. See also Surg, ADSEC, COMZ,
36
Annual Rpt, 1944, p. 7; Darnall, "Hospital Sites in 12th Field Hospital Annual Rpt, 1944, pp. 5-6.
37
Normandy," p. 194. On clearing captured hospitals, For typical descriptions of countryside, cleanup,
see VII Corps Medical Plan, pp. 27-28, encl. 1 to and salvage, see 8th Field Hospital Annual Rpt,
Surg, VII Corps, Annual Rpt, 1944; 68th Medical 1944, p. 5, and Alien, ed., Medicine Under Canvas, pp.
Group Annual Rpt, 1944. 108-11.
264 EUROPEAN THEATER OF OPERATIONS
The 428th Medical Battalion, with Under an agreement with the First
four attached ambulance companies, Army, made on 17 July, the Advance
disembarked between 28 June and 8 Section opened an air evacuation
July. With its headquarters at Cher- holding unit at Biniville, about 15
bourg and its companies spread miles south of Cherbourg, to support
throughout the Cotentin, the battal- the army's right wing. For this pur-
ion evacuated First Army and ADSEC pose Colonel Beasley employed the
units and hospitals. The 7th Field 93d Medical Gas Treatment Battalion,
Hospital opened at Osmanville, in the which had landed on the fifteenth, re-
OMAHA area, early in July; it treated inforced for emergency surgery by a
patients from the Advance Section, platoon of the 8th Field Hospital.
received some battle casualties, and The units opened their installations
administered one of the medical tran-
on the twentieth, in a tented camp
sit camps. Another field hospital, the
8th, set up one of its platoons at spread over several hedgerow-lined
Montebourg in the Cotentin to per- fields. Later augmented by the rest of
form similar functions. On 12 July the 8th, the Biniville holding unit
still another field hospital, the 9th, could accommodate almost 900 pa-
occupied a site at Tourlaville, on the tients. It received casualties from
outskirts of Cherbourg, but it could army hospitals, and at times from bat-
not go into operation until the thirti- talion aid stations; held them for
eth, when its equipment, lost in dis- treatment when required; and, when
embarkation, at last was delivered. they were ready to travel, loaded
The 77th Evacuation Hospital, a 750- them on aircraft at a nearby airstrip
bed unit, again after a frustrating wait used exclusively for evacuation. The
for a misdirected equipment assem- unit assembled planeloads and moved
bly, opened near Ste.-Mere-Eglise on them out on short notice, to minimize
the fifteenth. This unit admitted casu- waits by the C-47s on a runway still
alties from First Army evacuation hos- subject to Luftwaffe attacks. This
pitals so that the latter could clear ADSEC holding unit supplemented
their wards and move forward; it also the OMAHA beach facility operated by
received wounded directly from divi- the 60th and 61st Medical Battalions.
sion clearing stations.38 The latter installation, which had
38
moved on the sixteenth from its St.-
First U.S. Army Report of Operations, 20 Oct Laurent site to an airfield 2 miles
43-1 Aug 44, bk. VII, p. 72; ADSEC Hist, p. 19;
Surg, ADSEC, COMZ, Annual Rpt, 1944, pp. 14, south of Colleville, came under
16, ex. J; 7th Field Hospital Annual Rpt, 1944, pp. ADSEC command on the twenty-
1-2; 8th Field Hospital Annual Rpt, 1944, pp. 3-7; fourth.39
9th Field Hospital Annual Rpt, 1944, pp. 3-6; 77th
Evacuation Hospital Annual Rpt, 1944, pp. 1-7;
39
Alien, ed., Medicine Under Canvas, pp. 108-11; Dar- Surg, ADSEC, Daily Activities Rpts, 16-17 and
nall, "Hospital Sites in Normandy," p. 198. See also 20 Jul 44, and Evacuation Division, OofSurg,
in Beasley Papers, MHI, the following: Surg, ADSEC, Weekly Activities Rpt, week ending 22 Jul
ADSEC, Daily Activities Rpts, 8 and 12 Jul 44; Evac- 44, in Beasley Papers, MHI; 93d Medical Gas Treat-
uation Division, OofSurg, ADSEC, Weekly Activities ment Battalion Annual Rpt, 1944, pp. 6-9; 8th Field
Rpts, weeks ending 10 and 22 Jul 44; Hospitaliza- Hospital Annual Rpt, 1944, pp. 6-7; Memo, Mowrey
tion Division, OofSurg, ADSEC, Weekly Activities to Hawley, 27 Jul 44, sub: Report on Trip to Conti-
Rpt, week ending 9 Jul 44. nent, file 370.05.
COMZ REACHES THE CONTINENT 265
In connection with its assumption For the most part, the establish-
of responsibility for medical supply to ment of ADSEC supply facilities and
the rear of First Army, the Advance field and evacuation hospitals in Nor-
Section during July reclaimed from mandy followed preinvasion NEPTUNE
the army command of its 30th and plans, with modifications due to de-
31st Medical Depot Companies and layed movement and the occasional
brought in another, the 13th, to rein- need to find alternate locations. The
force them. Colonel Beasley's Supply same could not be said of the sec-
Division set up three new depots. On tion's effort to set up 1,000-bed
the tenth a platoon of the 30th Com- general hospitals on the Continent.
pany established Depot M-1 (later re- Execution of this part of the medical
designated M-401T) in a taken-over program became snarled in confusion
building in Cherbourg, to distribute and delay, resulting largely from the
medical supplies to units in the north- First Army's failure to attain its
ern Cotentin and to receive and store planned tactical objectives.
matériel landed at the port once it Before D-Day the Advance Section
opened. Ten days later, the 32d Med- and the Forward Echelon had made
ical Depot Company, a Third Army detailed plans for moving twenty-five
unit soon replaced by the 13th Com- general hospitals, selected by General
pany, organized Depot M-2 (M- Hawley on the basis of performance
402T) at Chef-du-Pont, to receive, in Great Britain, into various French
store, and issue supplies brought in cities during the first ninety days of
over UTAH beach. This depot drew its the campaign. Early in May, following
initial stock from the First Army a schedule contained in the plans, the
dump at Le Grand Chemin, which first of these general hospitals began
then closed. To handle supplies turning over their British plants, com-
coming in at OMAHA, the 31st Compa- plete with furnishings and supplies, to
ny set up Depot M-3 (M-403T) at units newly arrived from the United
L'Etard on the nineteenth. This depot States. Relieved about a month before
also replaced the rearmost First Army their sailing dates, the deploying hos-
dumps and took over their stocks. pitals went into temporary billets,
Both the Chef-du-Pont and L'Etard usually in the Western Base Section.
depots, part of larger ADSEC storage There, they conducted training and
areas, consisted simply of open fields prepared vehicles and personal equip-
in which crated supplies were stacked, ment for the cross-Channel voyage.
with a few ward tents sheltering loose For each hospital Hawley's Supply Di-
40
items and administration offices. vision set up a complete equipment
assembly—a block of matériel filling
40
Supply Division, OofCSurg, HQ, ETOUSA, almost sixty small British freight
Annual Rpt, 1944, sec. II, pp. 1-2 and 7-8; Surg, cars—at one of its depots, where the
ADSEC, COMZ, Annual Rpt, 1944, pp. 25-26 and
ex. K; Supply Division, OofSurg, ADSEC, Weekly unit medical supply officer checked it
Activities Rpts, weeks ending 15 and 22 Jul 44, and for completeness and oversaw its crat-
ADSEC Stock Control Team Progress Rpts, 25 Jul ing for shipment. While hospitals
and 1 Aug 44, in Beasley Papers, MHI. Ruppenthal,
Logistical Support, 1:431-33, covers overall develop- waited to be called forward for em-
ment of ADSEC depots. barkation, they furnished surgical
266 EUROPEAN THEATER OF OPERATIONS
teams, nurses, and enlisted men for 7th Field Hospital at Osmanville,
mounting and casualty reception as- waiting for engineers to complete
signments; and they provided custodi- construction of its facility. In the
al details for newly completed but not meantime it detached surgical and
41
yet occupied hospital plants. shock teams to First Army evacuation
The first two general hospitals to hospitals and sent most of its remain-
reach Normandy, the 5th and 298th, ing medical officers, all its nurses,
stood down from operations in Brit- and 100 enlisted men to help the
ain respectively on 7 and 10 May. 12th Field Hospital with cleaning and
Col. Maxwell G. Keeler's 5th General repairs at Cherbourg.42
Hospital, the initial unit of its type to The second general hospital to land
enter the European Theater back in
in Normandy, the 298th, a University
1942, staged at Tidworth until its em-
of Michigan-affiliated unit under Lt.
barkation on 3 July. Three days later
the unit's 58 officers, 102 nurses, and Col. Walter G. Maddock, MC, was as-
500 enlisted men, with their vehicles, signed to occupy the Cherbourg
came ashore at OMAHA beach; howev- Naval Hospital that the 12th Field
er, its hospital assembly, sent from Hospital was rehabilitating. A victim
England on a different vessel, did not. of shipping schedule changes, the
Keeler's supply officer searched 298th spent two months shuttling be-
beachhead dumps to no avail, only to tween camps in Wales and England,
discover eventually that the assembly, ending up only a few miles from its
scheduled to be landed at still unus- former site at Frenchay Park, near
able Cherbourg, had been held on Bristol. The unit personnel at last
shipboard awaiting discharge at one embarked at Plymouth on 15 July and
of the beaches. Even if the equipment waded ashore on UTAH beach the
had been immediately available, the next day, again separated from their
5th would have had no place to set it equipment assembly. They moved
up; the hospital's assigned location at into billets in houses and barracks in
St.-Lo still was German-held. Fortu- Cherbourg on the seventeenth. The
nately, the unit was prepared to oper- 298th at least had a plant to occupy.
ate in an expeditionary tented plant. It prepared to relieve the 12th in the
On the tenth Colonel Keeler and Naval Hospital and continued the
Colonel Beasley decided to place it smaller unit's work of cleaning and
on a new site, a low-lying field near refurbishing, while engineers began
Carentan. The 5th spent the next the extensive alternations needed to
twenty-one days bivouacked with the fit the old plant for a 1,000-bed gen-
41
Troop Movements and Training Branch, Oper-
eral hospital.43
ations Division, OofCSurg, HQ, ETOUSA, Annual
42
Rpt, 1944, pp. 13-14 and encl. 15; Surg, ADSEC, Darnall, "Hospital Sites in Normandy," pp.
COMZ, Annual Rpt, 1944, p. 14; Technical Direc- 191-92; 5th General Hospital Annual Rpt, 1944, pp.
tive No. 1, OofCSurg, HQ, ETOUSA, 17 May 44, 4-7; Keeler Interv, 11 Jul 45, box 223, RG 112,
sub: Procedure for Equipping General Hospitals To NARA; Surg, ADSEC, Daily Activities Rpts, 9-11 Jul
Be Utilized in Continental Operations, in Supply Di- 44, Beasley Papers, MHI.
43
vision, OofCSurg, HQ, ETOUSA, Annual Rpt, sec. 298th General Hospital Annual Rpt, 1944, pp.
V, ex. 1 (see also sec. II, p. 6). 1, 61-65, 72-74, 78, 233-34, 299-300.
COMZ REACHES THE CONTINENT 267
Even as the 298th was settling adopted the only feasible solution to
down in Cherbourg, the Advance Sec- the problem: He scrapped the origi-
tion and the chief surgeon's office un- nally planned sites and ordered Colo-
dertook a major revision of fixed hos- nel Beasley immediately to set up as
pital plans. Those plans had called for many general hospitals as possible
twelve of the continental general hos- wherever they would fit in the exist-
pitals, including the two already ing beachhead. "We simply must get
landed, to be functioning in France beds operating over there," he told
by mid-July; but at that time the 5th Beasley, "regardless of changes in lo-
and 298th still were not open. The cations." 44
ground forces had yet to capture the The chief surgeon and his staff in-
sites of the other ten hospitals. Gen- tervened directly to get the revised
eral Hawley now confronted a sudden hospitalization program moving. Be-
fixed bed shortage. His plans for pro-
tween 15 and 19 July Hawley's Hospi-
viding beds to care for the still ex-
panding American force in the theater talization Division chief, Colonel Dar-
depended on the prompt establish- nall, conferred at Auville with Beasley
ment of hospitals in France, since and his staff. In these discussions
completion of the pre-D-Day program Darnall emphasized the need for
would use up the supply of available rapid action, and in company with
United Kingdom locations. Twenty- ADSEC and First Army officers he
five of Hawley's best general hospi- did preliminary reconnaissance
tals, those staging for movement, throughout the beachhead for general
were out of action. At the same time, hospital sites. Hawley himself visited
with no fixed COMZ beds in France, the Advance Section on the seven-
the field forces had to evacuate even teenth, escorting Secretary of War
their lightly wounded back across the Henry L. Stimson, Surgeon General
Channel, threatening to overload the Kirk, and General Lee. Shortly there-
nearshore hospitals. Colonel Mowrey, after, the chief surgeon by letter ex-
the Evacuation Branch chief, warned horted Beasley, whom he considered
Hawley on 21 July that the general overly influenced by geographical
hospitals had room for only about phase lines, to move rapidly and flexi-
6,900 more patients. "The patient bly. On 22 July Colonel Mowrey flew
census has increased 14,533 in the over to coordinate plans with the
past two weeks," he reported, "or an
average increase of 1,032 per day; 44
First quotation from Ltr, Mowrey to DepCSurg,
hence, it is anticipated that general HQ, ETOUSA, 21 Jul 44, sub: Evacuation Policy to
hospitals will be filled within approxi- ZI, EvacCorresp, 1944-45, file HD 370.05 ETO.
Mowrey's calculations included only fixed beds for
mately eight days." At SHAEF Gener- definitive long-term care, excluding transit and
al Kenner, whose calculations of the holding beds. Second quotation from Ltr, Hawley to
impending bed shortage reached Beasley, 19 Jul 44, file HD 024 ETO CS (Hawley
Chron). See also Memo, Kenner to ACofS, G-4,
about the same conclusion as Mow- SHAEF, 21 Jul 44, sub: Present Status of Fixed US
rey's, pressed for speed in setting up Hospital Beds, UK and Continent, in Medical Divi-
fixed hospitals in Normandy. Even nall, sion, COSSAC/SHAEF, War Diary, July 1944; Dar-
"Hospital Sites in Normandy," p. 191; Hospi-
before receiving Kenner's and Mow- talization Division, OofCSurg, HQ, ETOUSA,
rey's pessimistic forecasts, Hawley Annual Rpt, 1944, p. 8.
268 EUROPEAN THEATER OF OPERATIONS
ADSEC and First Army medical and later. Both units initially had less than
engineer authorities and again to half their beds in operation. The
press for swift action. Working under 298th began work amid the noise and
this high-level pressure, Beasley's debris of construction, as engineers
staff, between the twenty-third and struggled to renovate "a building for
twenty-ninth, secured from the First which they had no ... plans, whose
Army ten sites for expeditionary-type wiring and plumbing was a composite
tented general hospitals. In the of 80 years' development, a continen-
OMAHA area the Advance Section ob- tal hodgepodge that often defied
tained five locations: three at Lison analysis." Major alterations continued
Junction, on a rail line to Cherbourg; until shortly before the 298th left in
and two at Carentan, including the October. In the meantime the staff,
one previously selected for the 5th besides caring for patients in tempo-
General Hospital. The remaining five rary facilities, kept busy with a host of
sites were in the Cotentin: three at La minor repairs and tried to make do
Haye-du-Puits, at the base of the pe- with barely adequate, always unreli-
ninsula, and two at Tourlaville, just able, water and power supplies. At
outside Cherbourg.45 Carentan the 5th also began oper-
The ADSEC surgeon, under per- ations while still under construction,
emptory direction from Hawley, expe- receiving patients before it had either
dited the opening of the two general electric lights or running water. Its
hospitals already in Normandy, the hastily chosen, poorly drained site
5th and 298th. Construction of the was mosquito infested and turned
5th's tented plant at Carentan had into a quagmire with every rain-
begun on 14 July, but neither that storm.46
unit nor the 298th had received its Both general hospitals eventually
equipment assembly. On the twenty- expanded beyond their rated capac-
second Colonel Beasley's Supply Divi- ities, each attaining a size of about
sion finally released to these units two 1,500 beds. Under a First Army-
hospital assemblies that had arrived ADSEC agreement on 1 August the
for other organizations not yet 5th and 298th, besides acting as area
landed. This action resulted in the station hospitals, admitted lightly
opening of the 298th on the twenty-
wounded men returnable to duty
ninth and that of the 5th two days
within ten days. They thereby relieved
45
Darnall, "Hospital Sites in Normandy," pp.
army installations of these patients
191-201; Ltr, Hawley to Beasley, 19 Jul 44, and
46
Memo, Hawley to G-4, ETO, 5 Aug 44, sub: Hospi- Quotation from 298th General Hospital Annual
talization and Evacuation—Cherbourg Peninsula, Rpt, pp. 78-81. See also 5th General Hospital
file HD 024 ETO CS (Hawley Chron); Memo, Annual Rpt, 1944, pp. 7-8, 10-11, 13-15; Hospitali-
Mowrey to Hawley, 27 Jul 44, sub: Report on Trip zation Division, OofSurg, ADSEC, Weekly Activities
to Continent, file 370.05; Surg, ADSEC, COMZ, Rpt, week ending 29 Jul 44, and Supply Division,
Annual Rpt, 1944, pp. 8 and 21-22; Hospitalization OofSurg, ADSEC, Weekly Activities Rpt, week
Division, OofCSurg, HQ, ETOUSA, Annual Rpt, ending 30 Jul 44, Beasley Papers, MHI; Lt Col J. E.
1944, pp. 8-9; Surg, ADSEC, Daily Activities Rpts, Dunphy and Maj. S. O. Hoerr, "A General Hospital
23 and 25 Jul 44, and Hospitalization Division, in the Normandy Campaign," The Bulletin of the U.S.
OofSurg, ADSEC, Weekly Activities Rpt, week Army Medical Department 6 (November 1946): 594-
ending 29 Jul 44, Beasley Papers, MHI. 602.
CONSTRUCTING THE 5TH GENERAL HOSPITAL TENTED PLANT AT CARENTAN.
Engineers prepare concretefor the ward platforms, and a completed ward tent with beds.
270 EUROPEAN THEATER OF OPERATIONS
while ensuring their retention on the sent them to bivouac at their assigned
Continent, a manpower conserving operating sites. Most were in position
measure strongly desired by General by 5 August. While they awaited com-
Bradley. The 5th, located close to the pletion of their facilities and delivery
fighting line, also became a collecting
point for combat exhaustion patients of their equipment, these general hos-
and for soldiers with suspected self- pitals furnished surgical teams to field
inflicted wounds, a circumstance that force installations and enlisted details
led General Kenner to complain that to aid the engineers preparing their
the unit's surgical capabilities were plants.
being wasted on the mission of a con- ADSEC engineers began construc-
valescent hospital. By contrast, the tion at the sites between 21 July and
298th had no lack of emergency sur- 2 August. At each installation the en-
gical patients, mostly mine casualties gineer officer in charge and the hos-
from the Cherbourg port. For its
short-term patients the 298th, without pital commander cooperated in adapt-
guidance on the point from higher ing standard plans, developed and
headquarters, during the first weeks tested in Britain before D-Day, to
followed an informal evacuation pro- ground conditions and to unit prefer-
cedure. The hospital used its own am- ences. Enlisted medics and engineers
bulances to return recovered men di- labored side by side, pouring con-
rectly to their units, or, if the organi- crete tent bases, grading roads and
zation were nearby, simply discharged paths, and installing wiring and
patients and let them find their own plumbing. They worked under handi-
way back. Casualties requiring ex- caps. Engineers, few in numbers and
tended care went by ambulance to the in heavy demand, frequently were
Biniville holding unit for evacuation
to England.
47 abruptly transferred to other jobs.
Establishment of the other nine Building supplies arrived irregularly,
general hospitals, meanwhile, got forcing periodic work stoppages at
under way. General Hawley worked most plants. Short of American mate-
with SHAEF and ETOUSA to hasten rials, the engineers substituted
the dispatch of more 1,000-bed units German and French cement and pipe,
to Normandy; and, as these organiza- among other items. The cement often
tions arrived, the Advance Section failed to set properly, requiring time-
47
consuming tearing up and repouring
Surg, ADSEC, Daily Activities Rpt, 1 Aug 44,
Beasley Papers, MHI; Memo, Hawley to G-4, ETO, of foundations. The mixture of ill-fit-
5 Aug 44, sub: Hospitalization and Evacuation— ting pipe that made up water and
Cherbourg Peninsula, file HD 024 ETO CS (Hawley
Chron); Rpt, Kenner, sub: Inspection of Medical sewage systems had to be welded at
Troops and Installations—12th AG, ADSEC, CZ, every joint. Engineers and enlisted
and 21 AG, 2-13 August 1944, in Medical Division,
COSSAC/SHAEF, War Diary, August 1944; 5th
medics overcame these obstacles, but
General Hospital Annual Rpt, 1944, p. 8; 298th slowly. By the third week of August
General Hospital Annual Rpt, 1944, pp. 101-03 and the engineers had managed to finish
107; Keeler Interv, 11 Jul 45, box 223, RG 112,
NARA. one plant and had completed 65 to
COMZ REACHES THE CONTINENT 271
75 percent of the work on most of the equipment. His staff continued the
48
others. practice, begun with the 5th and
Besides construction delays, miss- 298th, of assigning whatever general
ing unit assemblies plagued the hos- hospital assembly was available to any
pital program. The transportation unit otherwise ready to open. This
system simply could not deliver the expedient delivered equipment to
personnel of a general hospital and hospitals that could use it, but it re-
their assigned equipment to the same quired much exchanging later be-
place at the same time. Changes in
tween organizations that had packed
unit movement dates, timely notice of
which often failed to reach the send- personal property with their assem-
49
ing depots, helped to desynchronize blies.
shipments. Even when a unit and its The new general hospitals gradual-
assembly left England together, they ly went into operation, most of them
rarely traveled on the same vessel; initially at less than their rated 1,000
frequently, the assembly would be beds. Two Lison units, one at La
split among several ships that dis- Haye-du-Puits, and the second Caren-
charged cargo on different beaches. tan hospital opened on 15 August;
The theater chief of transportation another hospital at La Haye became
never permitted hospital detachments active on the twenty-fourth. The re-
to accompany their assemblies; hence, maining four units, however, did not
equipment arrived on the beaches open until September and October.
unescorted and disappeared into vari- Long before they did, it had become
ous dumps unless a unit representa- apparent that the continental Com-
tive was there to claim it immediately. munications Zone would not meet its
Colonel Beasley and his supply offi-
NEPTUNE goal of having 25,500 fixed
cer, Maj. Thomas A. Carilia, MAC, re-
peatedly remonstrated with the hospital beds in operation by
50
ADSEC G-4 and the Transportation D+90.
Corps about the assembly problem,
49
but to little avail. Beasley finally re- Supply Division, OofCSurg, HQ, ETOUSA,
sorted to sending one of his officers Annual Rpt, 1944, sec. V, pp. 2-3; Supply Division,
OofSurg, ADSEC, Weekly Activities Rpts, weeks
to visit the OMAHA and UTAH dumps ending 15 and 22 Jul 44, and Hospitalization Divi-
on alternate days, for the sole pur- sion, OofSurg, ADSEC, Weekly Activities Rpt, week
ending 19 Aug 44, Beasley Papers, MHI; Surg,
pose of finding and redirecting lost ADSEC, COMZ, Annual Rpt, 1944, pp. 26-27; Ltr,
Hawley to Beasley, 19 Jul 44, file HD 024 ETO CS
48
Hospitalization Division, OofCSurg, HQ, (Hawley Chron). For the exchange problem, see
ETOUSA, Annual Rpt, 1944, pp. 9-10; Surg, 298th General Hospital Annual Rpt, 1944, pp. 233-
ADSEC, COMZ, Annual Rpt, 1944, pp. 22 and 63; 34.
50
Surg, ADSEC, Daily Activities Rpts, 11-12, 26 and Hospitalization Division, OofCSurg, HQ,
28 Jul 44, and Hospitalization Division, OofSurg, ETOUSA, Annual Rpt, 1944, p. 9; Surg, ADSEC,
ADSEC, Weekly Activities Rpts, weeks ending 5 and Daily Activities Rpts, 14-15 Aug 44, and Hospitali-
19 Aug 44, Beasley Papers, MHI; Keeler Interv, 11 zation Division, OofSurg, ADSEC, Weekly Activities
Jul 45, box 223, RG 112, NARA; Memo, Mowrey to Rpts, weeks ending 5 and 19 Aug 44, Beasley
Hawley, 27 Jul 44, sub: Report on Trip to Conti- Papers, MHI; Rpt, Kenner, sub: Inspection of Medi-
nent, file 370.05; Memo, Maj S. Blumenthal to Lt cal Troops and Installations—12th AG, ADSEC, CZ,
Col Meador, 1 Aug 44, EvacCorresp, 1942-44, file and 21 AG, 2-13 August 1944, in Medical Division,
HD 024 ETO. COSSAC/SHAEF, War Diary, August 1944.
272 EUROPEAN THEATER OF OPERATIONS
At the end of July the Advance Sec- tablishment of general hospitals, de-
tion medical service gradually was layed by slow adaptation of preinva-
carving out its sphere of influence in sion plans to the tactical situation, at
the Normandy beachhead. Colonel last was under way. Ironically, even as
Beasley and his staff were acquiring the Advance Section thus adjusted to
an increasing amount of control over operations in a constricted lodge-
supply, evacuation, and hospitaliza- ment, the battlefront broke wide
tion. ADSEC depots and field and open, initiating a period of mobile
evacuation hospitals were in oper- warfare that again would force radical
ation, beginning to relieve First Army change in COMZ medical plans and
units of part of the support task. Es- hasty improvisation in operations.
CHAPTER IX
Army control of the already commit- planned lodgement area between the
ted VIII Corps and of the newly ar- Seine and the Loire and in the proc-
rived XV and XX Corps. Most divi- ess destroyed much of the German
sions and supporting elements of the army opposing them (see Map 11). On
new army had been in France for the American right, the Third Army
some time, attached to the First rolled ahead almost unimpeded; its
Army; they now reverted to their XV Corps took Le Mans on 8 August
original command. Also on the first after driving 75 miles in three days.
Bradley activated the 12th Army On the Third Army's left, the First
Group (actually the 1st Army Group Army pushed forward slowly against a
headquarters, redesignated as part of still solid German line. The Germans
the Allied effort to convince the Ger- now compounded their own difficul-
mans that another invasion still was ties. On the seventh they had attacked
coming in the Pas-de-Calais). Bradley westward toward Avranches with most
took command of this army group, of their remaining armor, trying to
while Lt. Gen. Courtney Hodges re- cut the Third Army's line of commu-
placed him at the First Army. General nications at its narrowest point, but
Montgomery remained in overall after five days of bitter fighting
Allied ground command for another around Mortain the 30th Infantry Di-
month, until SHAEF opened its conti- vision and other First Army units
nental headquarters on 1 September. blocked the German thrust. Eisen-
The reorganized Allied ground hower, Montgomery, and Bradley,
forces rapidly exploited the success of meanwhile, set in motion a large-scale
COBRA. Departing from the original envelopment of the attackers, turning
plan so as to take advantage of Third Army elements north from Le
German disintegration in the western Mans while the British and Canadians
Cotentin, the Third Army used only pushed southward from Caen. The
one of its corps, the VIII, to secure ensuing battle of the Falaise pocket
Brittany. This corps, which met only between 16 and 20 August, eliminat-
disorganized resistance, quickly over- ed the German army in Normandy as
run the entire peninsula, captured an effective fighting force, the First
Nantes without a fight, and took St.- and Third Armies, quickly following
Malo after a stubbornly contested up success, reached and bridged the
siege. By the end of August it had Seine, respectively east and west of
penned up the remaining major Paris, by the twenty-fifth. The French
German forces in Lorient and Brest. capital itself fell to the Allies on the
However, the Brittany ports, consid- twenty-ninth.
ered essential as entry points for sup- The OVERLORD and NEPTUNE plan-
plies and reinforcements, were either ners had assumed that the Germans
too badly damaged for early use or, would form a strong defense line
as in the case of Brest, were occupied along the Seine and that the Allies
by garrisons determined to hold them would halt at that river for a month
as long as militarily possible. or so, to reorganize and bring for-
To the eastward of Brittany, the ward supplies. However, the com-
Allies fanned out to seize their pleteness of the German collapse
BREAKOUT AND PURSUIT 275
units were moving into and reinforc- the twenty-fifth, as the survivors of
ing the line. the shattered 1st withdrew to the
Renewed First and Third Army of- south bank of the lower Rhine, it was
fensives, accordingly, produced heav- clear that MARKET-GARDEN, too, had
ier casualties and disappointing re- failed to break the solidifying German
sults. Between 10 and 22 September defense.
the First Army penetrated the West These final setbacks notwithstand-
Wall in the Ardennes and partially en- ing, the Battle of France was a sub-
circled Aachen, the first major stantial Allied victory. In four months
German city to come under attack, of campaigning, the British and
but supply shortages and enemy rein- Americans killed, captured, or penned
forcements stalled the offensive short up in coastal fortresses about 500,000
of a breakthrough. South of the Ar- German soldiers, at a cost to them-
dennes the Third Army forced its way selves of about 40,000 dead, 164,000
across the Moselle against desperate wounded, and 20,000 missing. The
resistance and fierce counterattacks. German debacle in Normandy permit-
Patton's troops captured Nancy, but ted the Allied advance to surge far
they failed to take the fortress of Metz ahead of schedule. By 11 September
and from 19-30 September had to (D+97) the Anglo-Americans already
fight off a major armored assault on
had reached a line that the OVERLORD
their southern flank. Then the Third
planners had not expected them to
Army, too, had to halt for rest and re-
attain until D+330 (2 May 1945).
plenishment.
On the British front, General Mont- This sharp acceleration of Allied
gomery persuaded SHAEF to try a progress, while a tactical triumph,
final audacious effort to maintain the forced upon the theater medical ser-
momentum of the pursuit. On 17 vice, as upon all the technical ser-
September, in Operation MARKET- vices, a period of often frantic adjust-
GARDEN, one British and two Ameri- ment and improvisation.
can airborne divisions dropped into
Holland, to seize bridges over the First Army Medical Support
rivers between the Belgian border
and the lower Rhine and to open a Since D-Day the First Army medical
corridor through which the British service had supported a slow-moving
XXX Corps could drive to secure a advance with high casualty rates and
bridgehead in Germany and flank the short lines of evacuation. The army's
West Wall. The airborne assault larger medical units had changed po-
achieved most of its objectives. How- sition only a few at a time and at long
ever, the British 1st Airborne Divi- intervals. In the breakout and pursuit
sion, which had landed farthest north, the medical service had to adapt itself
could not hold its Rhine bridgehead to just the opposite conditions: a rap-
at Arnhem against armored counter- idly moving front, low casualty rates,
attack, and the tanks and mechanized long lines of evacuation, and frequent
infantry of the XXX Corps could not repositioning of even the least mobile
get through the corridor before the medical units. Colonel Rogers, the
paratroopers' perimeter collapsed. By army surgeon, assembled his forces to
BREAKOUT AND PURSUIT 279
support the breakthrough attack, re- congestion temporarily blocked evac-
organized them to keep up with the uation. The evacuation vehicles, be-
accelerating pursuit, and finally re- sides carrying casualties back, were to
grouped them behind another solid, haul medical supplies forward to the
slow-moving front. divisions from an advance dump set
Operation COBRA confronted the up close to the breakthrough point.
army medical service with a support As the hedgerow fields of the VII
problem hitherto not encountered in Corps sector filled with infantry,
the campaign. In the First Army's armor, and artillery massing for the
previous broad frontal attacks, each attack, the army reequipped the as-
division could receive medical sup- sault division medical elements and
port along a separate axis of commu- brought them up to strength with re-
nications. In COBRA, by contrast, placements. It assembled numerous
medical units and supplies for seven evacuation hospitals in rear of the
divisions would have to go forward, corps, ready either to receive casual-
and casualties come back, along a few ties or to follow the pursuit. Colonel
roads through a corridor no more Barr at the same time established
than 5 miles wide. If the attack went communications and coordinated
as planned, the distance to be cov- plans with the commanders of the
ered in this corridor between front
31st and 68th Medical Groups, which
and rear medical installations steadily
were to evacuate respectively the left
would increase, as would the flow of
traffic through the constricted com- and right wings of the VII Corps. He
munications arteries. visited each division surgeon to ex-
The task of finding a solution to plain the corps medical plan and to
this problem fell primarily to the VII ensure that all preparations were
Corps surgeon, Colonel Barr. Under complete. In the divisions the regi-
a plan developed by him, the First mental surgeons, briefed at the last
Army made preparations on the as- moment, hurriedly made their own
sumption that the assault divisions, plans and preparations, usually in in-
once they broke through, would formal coordination with the com-
suffer relatively low casualties—a manders of their 3
supporting collect-
maximum of 300 severely wounded ing companies.
and the same number of lightly In the light of these elaborate pre-
wounded per day for each division. liminaries, the execution of COBRA,
To move these casualties up the cor- from the standpoint of the theater
ridor, the army attached 15 extra am- medical service, was anticlimactic.
bulances and 15 trucks (for ambulato- The preparatory bombing killed, in-
ry patients) to each assault division jured, or stunned dozens of infantry-
clearing station. It worked into its men in a few battalions, and the
complex traffic control plan provision breakthrough area presented an ap-
for rearward movement of as many as
3
1,300 ambulances a day and also VII Corps Medical Plan, pp. 36-43 and 52, encl.
planned for holding patients up to cal 1 to Surg, VII Corps, Annual Rpt, 1944; 68th Medi-
Group Annual Rpt, 1944, p. 7. Tegtmeyer
twenty-four hours in clearing stations "Diary," bk. II, pp. 34 and 38-40, illustrates regi-
and field hospital platoons if traffic mental preparations.
280 EUROPEAN THEATER OF OPERATIONS
Medical Department." The group suit, some 300-600 a day for the
oversaw most medical support oper- entire army.10
ations north of the Seine as the pur- As the forces north of the Seine
suit accelerated. It maintained contact rolled forward almost 200 miles in fif-
with the fast-moving combat forces; it teen days, First Army medical units
coordinated hospitalization, evacu- other than those of the 68th Medical
ation, and medical supply; and it rec- Group fell steadily farther behind.
onnoitered hospital and depot sites The speed of the pursuit outran army
for the heavier units struggling up medical planning. Early in September
from the rear.
9
Colonel Rogers began shifting evacu-
The group's field hospitals, operat- ation hospitals northward from Sen-
ing under control of the 177th Medi- onches to a new concentration point
cal Battalion, leapfrogged platoons at La Capelle on the Franco-Belgian
forward across northern France and border. However, by the time the first
into Belgium, using trucks borrowed units, delayed in movement by short-
from other medical and nonmedical ages of trucks and gasoline and by
units. Ordinarily, only one of a hospi- heavy traffic, reached La Capelle, the
tal's three platoons (often called area already was too far behind the
"hospitalization units") set up at a line for convenient use and the
time, reinforced by the personnel of a medics had to pack up and move
again to another site further on. At
second. The third platoon held itself
the end of the first week of Septem-
ready for the next advance. When an
ber army medical units were strung
active platoon closed, it turned over out along the entire path of the pur-
its remaining nontransportable pa- suit. A few evacuation hospitals—too
tients to a clearing platoon from the few for the peace of mind of corps
134th Medical Group. Each field hos- surgeons anticipating heavier casual-
pital, augmented with half a dozen ties from the intensified German re-
auxiliary surgical teams, could keep sistance—were in the process of
six operating tables, and in emergen- opening in Belgium. The least mova-
cies nine, working around the clock. ble installations, such as the 4th Con-
A collecting company traveled with valescent Hospital, still were trying to
each hospital to provide clerks, litter- assemble at Senonches.
bearers, and general labor for mass The abrupt slowing of the advance
triage, treatment, feeding, and evacu- in mid-September (see Map 11), while
ation of transportable wounded and it caused tactical frustration, paradox-
sick. Employed in this fashion until 19 ically improved the position of the
September, the field hospitals main- theater medical service by allowing
tained treatment and evacuation fa- the slower units to close up behind
cilities within 20 miles of the forward
10
clearing stations. They efficiently han- Ibid., p. 11; Surg, First U.S. Army, Annual Rpt,
1944, pp. 44 and 60; 177 Medical Battalion Annual
dled the light casualties of the pur- Rpt, 1944, pp. 17-20; 13th, 42d, 45th, 47th, and
51st Field Hospitals Annual Rpts, 1944; 57th,
9
68th Medical Group Annual Rpt, 1944, pp. 15- 175th, and 176th Medical Battalions Annual Rpts,
16. 1944.
BREAKOUT AND PURSUIT 283
the front line. Colonel Rogers desig- ing units at Le Mans and Chartres,
nated Eupen, Belgium, behind the and to general hospitals and an air-
army's center, as a medical concentra- field at Paris. In Belgium, with
tion area and directed the assemblage ADSEC facilities temporarily left far
there of his supply depot, exhaustion behind, the army turned some of its
centers, convalescent hospital, gas field and evacuation hospitals, and for
treatment battalion, and medical a brief period an exhaustion center,
group headquarters. He also concen- into improvised holding units. These
trated around Eupen most of his units received patients from mobile
evacuation hospitals, except for one hospitals nearer the front and re-
or two supporting each wing of the tained them until ADSEC ambulances
army. Moving by truck, and in a few could transfer them to airstrips and
instances by rail over recently rebuilt railheads near or below the French
12
lines, all the army medical units had border.
arrived within convenient supporting On 19 September Colonel Rogers
distance of the front by early Octo- again reorganized his medical groups
11
ber. and redefined their missions. Depart-
As the First Army advanced, the ing from the earlier pattern of spe-
point at which it turned casualties cialized functions, Rogers placed each
over to the Communications Zone of his three groups in charge of evac-
shifted eastward, then northward. In uation for a particular corps, from
the initial stage of the offensive, pa- clearing stations to the forwardmost
tients went by ambulance from army ADSEC element. He reassigned units
hospitals to the OMAHA beach holding so as to give each group an identical
unit, now under the Advance Sec- composition—two battalion headquar-
tion's control, or to the ADSEC 77th ters and one clearing, three collect-
Evacuation Hospital, which opened at ing, and four ambulance companies.
St.-Lo on 9 August. The latter unit Rogers delegated to the groups re-
relieved army installations of an im- sponsibility for deploying field and
mobilizing burden of lightly wound- evacuation hospitals in their sectors,
ed, and it sorted casualties of all types tasks hitherto performed largely by
for air and sea evacuation. As the the army surgeon's office. Directly
army moved farther from the beaches, under Rogers' control, two separate
it sent evacuees successively to an air- medical battalions evacuated the con-
strip near Avranches, to ADSEC hold- valescent hospital and the specialized
11 12
Surg, First U.S. Army, Annual Rpt, 1944, pp. 31st Medical Group Annual Rpt, 1944, p. 16
17-19, 42-46, 60, 161-65; Surg, V Corps, Annual and an. C; 134th Medical Group Annual Rpt, 1944,
Rpt, 1944, pp. 16-18; VII Corps Medical Plan, pp. p. 9; Kenner, 12 (sic) Aug 44, sub: Report of Inspec-
69-71, 77-83, 88, encl. 1 to Surg, VII Corps, tion of Medical Troops and Installations . . . , 2-
Annual Rpt, 1944; Surg, XIX Corps, Annual Rpt, 13 Aug 44, and Memo, Kenner to CofS, SHAEF, 20
1944, pp. 5-6; 4th Convalescent Hospital Annual Sep 44, sub: Report of Inspection of FUSA Medical
Rpt, 1944, pp. 1-2; 1st Medical Depot Company Service . . . , both in Medical Division, COSSAC/
Annual Rpt, 1944, pp. 5-6; Editorial Advisory SHAEF, War Diary, August and September 1944;
Board, 1962, p. 142; Memo, Kenner to CofS, Surg, ADSEC, Daily Activities Rpt, 12 Aug 44, and
SHAEF, 20 Sep 44, sub: Report of Inspection of Operations Division, OofSurg, ADSEC, Weekly Ac-
FUSA Medical Service . . . , in Medical Division, tivities Rpt, week ending 19 Aug 44, both in Beasley
COSSAC/SHAEF, War Diary, September 1944. Papers, MHI.
284 EUROPEAN THEATER OF OPERATIONS
and his staff also paid attention to nized his forces to support simultane-
supply. Third Army units, like those ous offensives in Brittany and in the
of other commands, often crossed the interior of France. He had ample re-
Channel separately from their equip- sources with which to work. Com-
ment. To reduce loss and misdirec- pared to the First Army, the Third
tion, Hurley's medical supply officer, was lavishly endowed with nondivi-
in cooperation with his ADSEC coun- sional medical support, especially for
terpart, stationed men on the beaches evacuation. Its initial medical troop
to watch for incoming Third Army allocation, more than double that of
medical gear and to ensure its prompt the First Army for about the same
unloading and delivery. Elements of number of divisions, included five
the two army medical depot compa- groups, seventeen battalions, and
nies, the 32d and 33d, had been in twenty-one ambulance, eighteen col-
Normandy since D-Day, attached to lecting, and ten clearing companies.16
the First Army and ADSEC. Late in The Third Army kept the same
July these companies reassembled medical organization throughout the
under the Third Army's control. The pursuit and the transition to static
32d, at Bricquebec in the concentra- warfare on the Moselle. Its medical
tion area, replenished supplies and system, like its general method of ad-
replaced equipment for army medical ministration and command, empha-
units. The 33d, at Besneville close sized simplicity, informality, and the
behind the VIII Corps, received and assumption of responsibility by lower
stored for the beginning of oper- echelons. The army employed its
ations ten medical maintenance units
medical groups solely to control evac-
made up by the Advance Section,
uation, assigning to them all of its
which contained fifteen days of sup-
plies for 200,000 men.
15 ambulance companies and also the
On 1 August the Third Army went ambulance platoons of its collecting
into operation and resumed control companies. A different group evacuat-
of its medical units and surgical teams ed the clearing stations of each of the
that had been attached to the First army's varying number of corps—nor-
Army. Colonel Hurley at once orga- mally two or three in the eastward ad-
vance plus the VIII Corps in Brittany.
Surg, First U.S. Army, Annual Rpt, 1944, p. 15; A single group, the 69th, transferred
15
Surg, Third U.S. Army, Rpt, 1944, pp. 12-25, 99, patients between evacuation and con-
103-06, 153-59, ex. III; Third U.S. Army Outline valescent hospitals and holding units.
Plan, Operation NEPTUNE, Annex 16: Medical
Plan, in CMH; Editorial Advisory Board, 1962, pp. When necessary, it also evacuated
85-86; Memo, Lt Col H. Reinstein to Surg, Ninth casualties from these installations to
U.S. Army, 9 Sep 44, sub: Observation of Medical the Communications Zone. The
Service in Operation, TUSA, Shambora Papers,
MHI (in same collection, see Third US Army fldr);
16
Surg, ADSEC, COMZ, Annual Rpt, 1944, p. 26; Surg, Third U.S. Army, Annual Rpt, 1944, pp.
Surg, XII Corps, Annual Rpt, 1944, p. 3; 67th Medi- 15-16. For First Army figures, see Chapter VI of
cal Group Annual Rpt, 1944, p. 6; Supply Division, this volume. Even as reorganized in September
OofSurg, ADSEC, Weekly Activities Rpts, weeks 1944, the First Army included only three groups,
ending 30 Jul and 5 Aug 44, Beasley Papers, MHI; eight battalions, and fourteen ambulance, eleven
32d Medical Depot Company Annual Rpt, 1944, pp. collecting, and six clearing companies. See Surg,
4 and 6. First U.S. Army, Annual Rpt, 1944, pp. 45-46.
BREAKOUT AND PURSUIT 287
lescent hospitals, and they provided Medical units supporting the main
trucks to move other organizations.17 Third Army drive to the Moselle, like
In Brittany the VIII Corps surgeon, their First Army counterparts, had
Col. Richard H. Eckhardt, MC, man- difficulty keeping up. Field hospitals,
aged an independent medical service by borrowing trucks from divisions
for a force separated by a rapidly wid- and corps, managed to push at least
ening distance from the main body of some of their platoons well forward,
the army. To support three infantry but in spite of their best efforts dis-
17
tances of as much as 100 miles
Quotation from Memo, Reinstein to Surg, opened between their leading and
Ninth U.S. Army, 9 Sep 44, sub: Observation of
Medical Service in Operation, TUSA, Shambora rearmost elements. Third Army evac-
Papers, MHI. See also Surg, Third U.S. Army, uation hospitals, each of which moved
Annual Rpt, 1944, pp. 25, 27, 31, 39, 73-78, 87-93; an average of four times during
4th Auxiliary Surgical Group Annual Rpt, 1944, pp.
9-12; Surg, XX Corps, Annual Rpt, 1944, pp. 24-
18
25; 66th Medical Group Annual Rpt, 1944, pp. 4-5 Surg, Third U.S. Army, Annual Rpt, 1944, pp.
and 9; 67th Medical Group Annual Rpt, 1944, pp. 27-28 and 160; Surg, VII Corps, Annual Rpt, 1944,
9-10; 95th Medical Gas Treatment Battalion Annual pp. 4-7; 64th Medical Group Annual Rpt, 1944, p.
Rpt, 1944, pp. 3-5. For a well-known summary of 5; 33d Medical Depot Company Annual Rpt, 1944,
Patton's view of command and organization, see an. 1; Memo, Kenner to CofS, SHAEF, 4 Sep 44,
George S. Patton, Jr., War as I Knew It, an. by Colo- sub: Inspection Report, Brittany Sector, 3 Septem-
nel Paul D. Harkins (Boston: Houghton Mifflin Co., ber 1944, in Medical Division, COSSAC/SHAEF,
1947), pp. 399-400. War Diary, September 1944.
288 EUROPEAN THEATER OF OPERATIONS
AWAITING EVACUATION FROM THE THIRD ARMY'S AIR HOLDING UNIT AT TOUL
Seventh and Ninth Annies corporation into a more or less uni-
Medical Support form system of support.
On 15 August elements of Maj.
The Seventh and Ninth Army medi- Gen. Alexander M. Patch's U.S. Sev-
cal departments initially had different enth Army and General Jean de
tasks. Seventh Army medics partici- Lattre de Tassigny's French Army B
pated in an amphibious assault and (later redesignated the French First
wide-ranging exploitation. The Ninth
Army medical service, in contrast, Army) assaulted the Riviera beaches
began its existence supporting a siege in Operation DRAGOON, beginning the
and preparing forces for later move- long-delayed campaign for southern
ment into the front line. By the end France. These armies went into action
of September, as their parent armies under the Supreme Allied Command-
joined, or got ready to join, the array er in the Mediterranean and drew
facing the West Wall, both army med- their logistical support from NA-
ical services were on the verge of in- TOUSA headquarters. Overwhelming
weak opposition on the beaches, the
SHAEF, 16 Oct 44, sub: Report of Inspection of American VI Corps, the only one
TUSA Medical Service, in Medical Division, under the Seventh Army, pursued the
COSSAC/SHAEF, War Diary, October 1944; 94th
Medical Gas Treatment Battalion Annual Rpt, 1944, withdrawing German Army Group G up
pp. 2-6. the Rhone valley; after securing the
290 EUROPEAN THEATER OF OPERATIONS
COL. MYRON P. RUDOLPH (seated), with his evacuation and operation officers
evacuating litter patients. One time In the breakout and pursuit ar-
he carried a wounded man 300 yards, mored division medical units, for the
unaided, walking erect through small first time in the campaign, performed
arms fire, after having crawled 300 the function for which they had been
yards to reach the man." Other designed: treatment and evacuation of
medics at Dornot were as heroic, but casualties in fast-moving independent
less fortunate. Four men of the 5th combat commands. The armored divi-
Medical Battalion appropriated an sion medical service, completely mo-
abandoned engineer assault boat and torized and lavishly equipped with
crossed the fire-swept Moselle to radios, worked on the same general
bring back a couple of casualties, only principles as that of the infantry, but
to be blown out of the water by a with variations in organization and
tank shell as they began a second procedures. Combat units—except for
trip.29
24023, RG 407, NARA. See also Surg, 5th Infantry
29
First quotation from Narrative by Lt Harry A. Division, Annual Rpt, 1944, pp. 17-21. Surg, 80th
Morris. Second quotation from Narrative ("Crossing Infantry Division, Annual Rpt, 1944, pp. 6-8, de-
of the Moselle") by 2d Battalion, 11th Infantry. scribes medical support of a more successful Mo-
Both in 5th Infantry Division Combat Intervs, box selle crossing.
296 EUROPEAN THEATER OF OPERATIONS
combat exhaustion patients. The gers, all of these things come into
medical battalion headquarters com- play in controlling an army that's
panies acted as rolling supply depots; moving rapidly." During September,
they issued expendable items to active to ensure prompt response to the
companies, which in turn replenished constantly changing situation, Colonel
battalion aid stations. Such was the Rogers of the First Army sent his ex-
system that proved itself in action ecutive officer with a small advance
during the breakout from Normandy. medical party into Belgium ahead
Using it, the 6th Armored Division, even of the army's forward echelon.
for example, during its six day 200- These officers, who accompanied the
mile drive through Brittany, managed 1st Division much of the time, made
to get most of its wounded back to on-the-spot decisions on such matters
army hospitals, even though the as selection of Eupen for a medical
country beyond its immediate lines of concentration area.33
march remained in German hands.32 Securing transportation to move
During the advance the First and evacuation hospitals and larger medi-
Third Army surgeons, with their exec- cal units constantly taxed the ingenui-
utive officers and those in charge of ty of army surgeons. These organiza-
hospitalization, evacuation, and tions, unlike divisional and corps
supply, usually accompanied the for- elements and army medical groups
ward echelon of army headquarters, and their subunits, had to obtain
which kept as close as possible to the extra vehicles to lift all their people
front. The rest of the medical section and equipment at once. A 400-bed
followed, as much as 100 miles evacuation hospital, for instance, re-
behind, with the rear headquarters quired 30 more trucks than its stand-
echelon. Corps and division surgeons ard allowance if it were to move in a
similarly divided their staffs. Wherev- single convoy. Such units could, and
er located, it required constant effort often did, shift position by shuttling
and much improvisation for surgeons in their organic vehicles, but this
to maintain contact with and control process was time-consuming and
over their widespread units. As the wearing on drivers and machines
pursuit outran the construction of alike.
telephone lines and even the range of Because all other parts of the field
radios, surgeons had to rely largely armies also were moving and had no
on couriers to transmit orders and
collect information. In the Third 33
Quotation from Editorial Advisory Board, 1962,
Army the surgeon's executive officer pp. 148-49. See also ibid., pp. 143-47 and 150;
recalled that "individual officers . First. U.S. Army Report of Operations, 1 Aug 44-22
.
Feb 45, bk. IV, pp. 133-34; Surg, Third U.S. Army,
had to go out [and] contact units and Annual Rpt, 1944, pp. 26, 32-33, 69, 74; VII Corps
find out where they were. The use of Medical Plan, pp. 54-55, encl. 1 to Surg, VII Corps,
ambulances, the use of jeep messen- Annual Rpt, 1944; Surg, VIII Corps, Annual Rpt,
1944, p. 6; Surg, 5th Infantry Division, Annual Rpt,
1944, pp. 16-17; Briefing (untitled and n.d.), ca.
32
Surgs, 2d, 4th, 5th, and 6th Armored Divisions, August 1944, and Memo, Reinstein to Surg, Ninth
Annual Rpts, 1944; Asherman Interv, 3 Feb 45, box U.S. Army, 9 Sep 44, sub: Observation of Medical
221, RG 112, NARA; Surg, XX Corps, Annual Rpt, Service in Operation, TUSA, both in Shambora
1944, p. 21. Papers, MHI.
BREAKOUT AND PURSUIT 299
vehicles to spare, army medics had to In both field armies the evacuation
rely on their own transportation. The hospitals, the large units that moved
First Army surgeon, after concentrat- most frequently, became expert at the
ing his forces at Senonches, formed a process. Typically, once the army di-
Provisional Medical Department rected a hospital to a new general
Truck Company, composed of over area, the unit sent an advance party
200 vehicles detached from evacu- to locate and begin preparing a spe-
ation hospitals and gas treatment bat- cific site, usually after securing ap-
talions. (The 96 trucks of the latter proval for it from the nearest corps
were an invaluable asset that army headquarters. Veteran location scouts
surgeons occasionally had to defend learned to pick high ground, prefer-
against diversion to other uses.) This ably a pasture, because cultivated
unit provided a pool of trucks for fields were dusty when dry and a
rapid concentration where needed, morass of mud when wet. The pre-
but hospital commanders objected to paratory parties often worked under
what amounted to the permanent re- fire, as the armies tried to push evac-
moval of most of their vehicles. The uation hospitals as far forward as pos-
Third Army formed a similar truck sible in anticipation of further ad-
pool, also taken from evacuation hos- vances by the combat elements. The
pitals and gas treatment battalions, main body, meanwhile, usually
but, in keeping with its more informal stopped receiving patients several
organization, left the vehicles with days before a movement; turned
their parent units except when re- those left in its wards over to another
quired for army missions. In ordinary hospital or a holding unit; and then
movements Third Army evacuation took down its tents and packed per-
hospitals often simply borrowed sonal and unit equipment. When
trucks from one another, rather than transportation arrived, often after a
going through army channels. Howev- frustrating wait, the unit loaded up
er they obtained vehicles, medical and set off, the personnel riding in
units of both armies had to compete ambulances and jeeps and, occasion-
with everyone else for gasoline, espe- ally, in the open backs of trucks.
cially when forward-area supplies ran Movement, over crowded roads,
short in early September. The army often at night under blackout or air
surgeons, by vigorous wheeling and attack, produced its share of accidents
dealing, secured enough fuel for es- and lost vehicles and property. De-
sential transportation and evacuation. pending on circumstances, army
Individual units used ingenuity, such traffic control directions, and the
as salvaging the residue in discarded
commander's preference, hospitals
jerry cans, to keep their own tanks
34
from running dry. Annual Rpt, 1944, p. 17; VII Corps Medical Plan, p.
79, encl. 1 to Surg, VII Corps, Annual Rpt, 1944;
34
For unit truck requirements, see Memo, Rein- 31st Medical Group Annual Rpt, 1944, p. 16; 68th
stein to Surg, Ninth U.S. Army, 9 Sep 44, sub: Ob- Medical Group Annual Rpt, pp. 11-12; 12th, 41st,
servation of Medical Service in Operation, TUSA, 91st, 106th, and 109th Evacuation Hospitals Annual
Shambora Papers, MHI; Surg, First U.S. Army, Rpts, 1944; 57th Medical Battalion Annual Rpt,
Annual Rpt, 1944, pp. 59-60; Surg, Third U.S. 1944, pp. 17 and 19-20; Editorial Advisory Board,
Army, Annual Rpt, 1944, pp. 34-91; Surg, V Corps, 1962, pp. 119, 138, 142-43.
300 EUROPEAN THEATER OF OPERATIONS
traveled either in large convoys or by had to borrow trucks from other units
infiltration, which meant: "Load the to transport themselves and their sup-
vehicles and start them forward plies—a two- to three-week reserve,
toward their destination as single including over 2,000 inventory items
units. Supply each driver with a strip and weighing between 500 and 1,200
map and leave him to his own skill tons. In both field armies the advance
and determination." At least some sections of the depot companies, nor-
hospitals preferred the latter method, mally carrying 50-100 tons of the
as it avoided the difficulties of keep- most frequently issued supplies, leap-
ing many trucks together amid the frogged ahead close behind the divi-
general stream of traffic. Hospitals sions. The base depots moved less
usually tried to arrive at their new often and more laboriously. The First
sites around noon, and an experi- Army's 1st Medical Depot Company
enced unit could unpack, pitch tents, had special difficulty, for it had accu-
set up equipment, and be ready to re- mulated large stocks during the
ceive patients in three-five hours. As hedgerow battles. After its first move
did other units, hospitals on the move to St.-Lo early in August, which re-
through liberated France and Belgium quired three days and 180 trucks to
encountered an enthusiastic popular move over 1,300 tons of matériel, the
welcome. In Belgium, civilians gath- company began stripping down for
ered to watch hospitals being put up, the pursuit. It issued to units or
brought gifts and food and wine, and turned back to the Advance Section
at times volunteered to help as work- hundreds of tons of supplies, includ-
35
ers and guards. ing refrigerators and other bulky
Army medical supply in the pursuit items. Even with these reductions in
was concerned not only with trying to load, the company still required large
keep depot companies within practi- vehicle reinforcements for each ad-
cable distance of the forward hospi- vance, as well as additional manpow-
tals and clearing stations but also with er, borrowed from the medical
replenishing the depots from COMZ groups. As supply lines lengthened in
installations that fell steadily farther spite of such expedients, several
behind. The army depot companies corps formed small subdepots in their
35
medical battalions, from which they
Quotation from 106th Evacuation Hospital issued to subordinate units.
Annual Rpt, 1944, p. 11. See also 12th, 41st, and
91st Evacuations Hospitals Annual Rpts, 1944; The theater medical service was
Abraham Katz, ed., Fifth Evac (Fulda, FRG, 1945), more successful than the other techni-
pp. 37-38; A. W. Kuhlmann et al., A Narrative Style cal services in replenishing its depots
Report of the Activities of the 41st Evacuation Hospital,
Semimobile (Bad Neuheim, FRG, 1945), pp. 89-90 in the field armies. Medical supplies
and 94-95; Surg, First U.S. Army, Annual Rpt,were small in tonnage compared to
1944, pp. 59-60; Briefing (untitled and n.d.), ca. fuel and ammunition, and, with the
August 1944, and Memo, Reinstein to Surg, Ninth
U.S. Army, 9 Sep 44, sub: Observation of Medical low casualty rate, issues were limited.
Service in Operation, TUSA, both in Shambora In the Third Army, for example, a
Papers, MHI; 68th Medical Group Annual Rpt, ten-day reserve, calculated on normal
1944, p. 14; Interv, Medical History Branch, CMH,
with Dr. J. A. Gosman, MD (hereafter cited as usage, sufficed in the pursuit for
Gosman Interv), 24 Mar 82, CMH. twenty or thirty days. Delays and diffi-
BREAKOUT AND PURSUIT 301
culties did occur. Army surgeons had supplied itself by capture with, among
to send their own trucks back to the other things, dental instruments, ban-
Communications Zone to pick up re- dages, gauze, adhesive tape, tetanus
quisitioned supplies. Other matériel antitoxin, bottles, corks, paper bags,
came forward on replacement vehicles cognac, and brandy. The division's at-
bound for the combat units. In both tached field hospital picked up rubber
the First and Third Armies the sur- sheeting, instrument trays, and plaster
geons arranged special airlifts, direct- of Paris.36
ly from the United Kingdom, of such The circumstances of mobile war-
urgently needed items as penicillin, fare that complicated forward move-
sutures, intravenous solution, and ment of medical units and supplies
plasma. Early in September both created, if anything, greater difficul-
armies suffered from an acute short-
ties in evacuation, both within and
age of blankets and litters, as evacu-
ation drained hospitals and clearing from the field armies. According to
stations of these mundane but vital General Hawley, in a rapid advance
commodities. Emergency shipments "we may get only one-fifth as many
from COMZ remedied the deficiency casualties, but it takes five times the
by the end of the month, but at one effort to get each casualty out." 37
point the First Army had in reserve Within their areas the field armies
only 800 litters and 10,000 blankets, had to move substantial numbers of
all captured from the Germans. helpless men over growing distances.
The armies in fact made up many During September alone ambulances
deficiencies from enemy stocks. As of the 68th Medical Group in the
troops overran what had been First Army made over 20,000 patient-
German logistical support areas, they carrying trips, in the course of which
seized medicines, hospital equipment, the vehicles traveled over 311,000
and surgical supplies. During August miles. Evacuation of the wide-ranging
the Third Army alone captured over armored divisions accounted for a
100 tons of this matériel. Whenever good part of this mileage in both
possible, the armies turned captured armies. The 6th Armored Division,
supplies over to their depots. There,
soldiers translated labels and tried to 36
Surg, First U.S. Army, Annual Rpt, 1944, pp.
determine which German items had 16-19 and 59; First U.S. Army Report of Oper-
ations, 1 Aug 44-22 Feb 45, bk. IV, pp. 152-54;
equivalents in the U.S. supply table; Surg, Third U.S. Army, Annual Rpt. pp. 159-65;
these they added to stock for issue. 31st Medical Group Annual Rpt, 1944, pp. 16-17;
The residue went to civil affairs units, 68th Medical Group Annual Rpt, 1944, pp. 10 and
14; 32d and 33d Medical Depot Companies Annual
to meet local civilian needs, or to Rpts, 1944; Surgs, V, XII, and XIX Corps, Annual
POW enclosure dispensaries. At times Rpts, 1944; Surgs, 1st and 5th Infantry Divisions
the armies, unable to move captured Annual Rpts, 1944; Medical Division, COSSAC/
supplies, simply turned them over to SHAEF, War Diary, August-September 1944; Edito-
rial Advisory Board, 1962, pp. 151-52; Ruppenthal,
units on a first-come-first-served Logistical Support, 1:519. Supply problems in the Sev-
basis, and divisions also helped them- enth Army were similar. See Wiltse, Mediterranean,
selves to much that their own troops pp. 405-06.
37
Notes Taken at Press Conference, Paris, 4 Oc-
found. In the Third Army rush across tober 1944, ... by the Chief Surgeon, ETOUSA,
France, for instance, the 5th Division in Hawley Papers, MHI.
302 EUROPEAN THEATER OF OPERATIONS
for example, during its dash across empty to the front. During the Third
Brittany, within days opened a 100- Army tank battle at Arracourt in Sep-
mile distance between its clearing sta- tember, the 4th Armored Division lost
tion and the nearest Third Army hos- fourteen drivers, twenty-one patients,
pitals. With no field hospital platoon and seven ambulances and trucks in a
able to keep up with it and receive single German ambush on a road er-
nontransportable casualties from 38
small engagements, the division sta- roneously reported safe.
tioned part of an armored medical With both clearing stations and
company at roughly the midpoint of evacuation hospitals widely separated
its evacuation route to immobilize and moving frequently, the medical
emergency cases. Even with this expe- groups perforce adopted new expedi-
dient a few men died who might have ents for controlling the flow of pa-
been saved by earlier surgery; others tients. They found that the standard
reached evacuation hospitals in poor fixed ambulance control points were
condition. Elsewhere, especially in inefficient, because ambulances had
early September, when lines of evacu- to make lengthy detours on already
ation were stretched to the utmost, long runs to check in with them. To
both infantry and armored divisions prevent this waste of time and gaso-
occasionally left wounded in civilian
line, the Third Army's 66th Medical
hospitals rather than risk the patients'
lives in long ambulance rides. Group sent jeep-mounted liaison
Evacuation over long distances tied teams to reconnoiter every evacuation
up army ambulances in numbers out hospital in its sector twice daily and
of proportion to the casualties car- then distributed instructions for am-
ried. In the 2d Armored Division, ac- bulance drivers to each medical bat-
cording to one surgeon, "the maxi- talion and division clearing station.
mum run from our station to the Other medical groups placed traffic
nearest hospital . . . was one officers
control hun- at clearing stations or
dred forty miles. Travelling those dis- formed mobile regulating teams able
tances over unknown roads, to set up and move control points on
the . . . drivers were able shortto take39
notice.
their patients to the hospital but were
unable to get back to us as they had 38
Quotation from Asherman Interv, 3 Feb 45, box
to find our new location. . .221, RG.112,We NARA. See also VII Corps Medical
considered an ambulance sent to the Plan, pp. 74-75 and 78-79, encl. 1 to Surg, VII
rear lost to use for one day." Some Corps, Annual Rpt, 1944; Surg, 4th Armored Divi-
sion, Annual Rpt, 1944, p. 9 and encl. 6; Surg, 6th
ambulances were more permanently Armored Division, Annual Rpt, 1944, encl. 7; 64th
lost on these runs, which often passed Medical Group Annual Rpt, 1944, p. 2; 66th Medi-
through unsecured areas infested with cal Group Annual Rpt, 1944, p. 11; 57th Medical
armed Germans. Ambulances came Battalion Annual Rpt, 1944, pp. 12 and 16; 4th Ar-
mored Division Combat Intervs, box 24092, RG
under fire; others were captured with 407, NARA; 104th Evacuation Hospital Annual Rpt,
drivers, attendants, and wounded. 1944, pp. 7-8. 39
Sometimes the Germans left rear- 12 and 66th Medical Group Annual Rpt, 1944, pp. 11-
encl. 6; 67th Medical Group Annual Rpt,
ward-moving ambulances alone but 1944, p. 9; 57th Medical Battalion Annual Rpt,
attacked or detained those returning 1944, pp. 13-14.
BREAKOUT AND PURSUIT 303
In spite of the lengthening dis- example, the 68th and the VII Corps
tances to be covered and the limited relieved the 1st Infantry and 3d Ar-
supply of vehicles and fuel, the field mored Divisions of about 1,500 Ger-
armies, thanks to low casualty rates, mans in three days, although not
encountered no major internal evacu- before the division surgeons had de-
ation bottlenecks. The only evacu- veloped a desperation plan for put-
ation emergencies of the pursuit in- ting the enemy wounded in a French
volved disposition of large numbers Resistance-run civilian hospital.
40
of wounded German prisoners taken The other field armies also had to
in the Falaise and Mons encircle- handle German wounded. The Third
ments. Some of these wounded hob- Army, while it evacuated no big pock-
bled into the American lines under ets, hospitalized over 5,400 Germans
white flags carried by their own during August and September and
aidmen. U.S. troops overran others in also cared for almost 600 sick and
German aid stations and hospitals or wounded Allied soldiers found in a
found them lying on the battlefield, captured hospital in Rennes. The
often suffering from exposure and in- Ninth Army's VIII Corps evacuated
fection. This sudden flood of enemy over 4,700 POW casualties and
casualties (the 90th Infantry Division almost 1,000 enemy medical person-
clearing station at Falaise admitted nel from Brest after the fortress capi-
1,500 in one week) temporarily over- tulated, and its 83d Infantry Division
whelmed and immobilized divisional sent ambulances over 90 miles south
medical units and the few hospitals of the Loire to bring out the casual-
not left far to the rear. At the 103d ties among the 20,000 Germans who,
Evacuation Hospital German litter pa-
cut off from the rest of their forces in
tients from Falaise covered the France, had agreed to surrender.
41
The First and Third Armies both General Kenner, who closely followed
had difficulty clearing their evacu- this situation—were not easy in their
ation hospitals of patients destined minds about evacuation until well into
for the Communications Zone. The the autumn. In the south the Seventh
problem stemmed from largely un- Army had similar difficulty, also as a
avoidable ADSEC delays in moving consequence of slow development of
up its own medical units and hospi- its communications zone. By late Sep-
tals. Of the two field armies, the tember its hospitals contained over
Third was the more fortunate in evac- 1,400 patients awaiting transporta-
uation. Throughout the pursuit it was tion.
42
life-saving surgery on them until air had little time for training before
evacuation became possible or until MARKET began and flew in gliders for45
the ground force, the XXX Corps, the first time on the way to Holland.
reached them in its drive up the corri- Tactically, the American part of
dor that the parachute and glider MARKET went generally according to
troops were to open. The XXX Corps plan (Map 12). On D-day, 17 Septem-
was to move medical installations for- ber, the daylight parachute and glider
ward and evacuate its own wounded landings were models of precision
and those of the British 1st Airborne compared to those in Normandy, with
Division. Attached to the British few losses in men and aircraft. The
corps, U.S. First Army ambulance, 101st Division, committed farthest
collecting, and clearing companies, south, secured its lodgement area and
and an evacuation hospital,44 were to the bridges around Eindhoven and
handle American casualties. Veghel. Just north of it, the 82d Divi-
The U.S. XVIII Airborne Corps sion, after a hard fight and a daring
and the 82d and 101st Divisions cross-river assault, captured intact the
based their medical plans on lessons vital span over the Waal at Nijmegen.
learned in the D-Day drop. They re- Holding the ground taken was more
vamped the equipment and supply al- difficult, and more costly in casualties,
lowances of regimental and battalion as the Germans counterattacked re-
medical detachments and aid stations, peatedly and in force to cut the XXX
removing items that had proved use- Corps line of communications. By the
less and adding others, such as glider- twenty-fifth the two American divi-
carried jeeps and trailers, that experi- sions had lost a total of 530 dead,
ence indicated would be of value. 2,038 wounded, and 974 missing—
Corps and division surgeons paid spe- significant casualties but hardly com-
cial attention to increasing the air- parable to the more then 6,00046 suf-
borne medical companies' capacity for fered by the British 1st Division.
emergency surgery, which had been The airborne division medical ele-
barely adequate in Normandy. Be- ments shared in the general good for-
sides reinforcing each company with tune of the drop, arriving on the
an auxiliary surgical team, as had ground with almost all their men and
been done in the earlier operation, with their equipment substantially
the airborne corps attached for intact. Unit first aid and evacuation
MARKET a field hospital platoon, to go proceeded about as smoothly as such
in by glider with the rest of the com-
pany. These platoons came from the 45
The airborne divisions had been pulled out of
50th Field Hospital, which had been Normandy in July and returned to England, where
receiving water-evacuated casualties at they refitted and planned for operations rendered
Weymouth. Attached in August, they unnecessary by the speed of the pursuit. See Surg,
XVIII Airborne Corps, Annual Rpt, 1944, p. 2;
Surg, 82d Airborne Division, Annual Rpt, 1944, an.
44
For British planning and arrangements, see III; Surg, 101st Airborne Division, Annual Rpt,
Crew, AMS, Campaigns: North-West Europe, 4:294 and 1944, p. 8; 50th Field Hospital Annual Rpt, 1944,
299-306; Col Renfro Interv, 10 Oct 44, in 101st pp. 1-2; Crandall Interv, 8 Jun 45, box 222, RG
Airborne Division Combat Intervs, box 24073, RG 112, NARA.
46
407, NARA; 31st Medical Group Annual Rpt, 1944, MacDonald, Siegfried Line, chs. VI-VIII. Casual-
p. 18; 134th Medical Group Annual Rpt, 1944, p. 9. ties are tabulated on p. 199.
308 EUROPEAN THEATER OF OPERATIONS
activities could in actual combat. Nev- elements moved out to contact the
ertheless, in Holland as in Normandy, regiments, while the rest of each com-
improvisation and courage came near pany, helped by Dutch civilians, set
to being standard procedure for the up its clearing and surgical station.
airborne medics. On 22 September, The 101st Division's 326th Airborne
for example, during one of the major Medical Company worked at two loca-
German attempts to cut the corridor tions: a commandeered tuberculosis
in the 101st Division sector, elements
sanitarium in Zon, occupied by the
of the 3d Battalion, 327th Glider In-
fantry, made a successful local coun- company itself, at the southern end of
terattack and then received orders to the division area of responsibility; and
fall back and regroup. Before doing a tented facility near Veghel at the
so, the battalion had to retrieve its northern end, composed of the field
wounded, scattered in buildings and hospital platoon and a surgical team.
open ground. The battalion com- In the 82d Division zone the 307th
mander, Lt. Col. Ray C. Allen, re- Airborne Medical Company and its at-
called: tached forces established a single sta-
We just couldn't walk off and leave our tion south of Nijmegen, in a school
wounded. That was when our medical de- that the Germans had converted into
tachment under . . . Maj Martin Wisley
an obstetrical hospital for "Hitler
did its stuff. . . . They had toMothers."advance all
the way under fire, crawling most of the
time in ditches. Not having enough litters The clearing stations treated a
to carry out all the wounded at one time, steady stream of casualties, mostly
they had to dart from house to house, American troops and also a few Brit-
dodging fire from artillery and mortars ish dropped off by XXX Corps units
and small arms, procuring ladders and
tearing doors from houses to use as lit- hurrying toward Arnhem. The 101st
ters. . . . Several men were Division's
evacuatedmedical company accumu-
from houses through the windows, be- lated over 400 patients and that of
cause fire on the doorways was too in- the 82d Division about 300 before
tense. The medics then had to drag each
improvised litter down ditches47 for two or ambulances reached them, respective-
three hundred yards to safety. ly on 19 and 20 September. Especially
As they had in Normandy, the divi- when German attacks temporarily
sion medical companies landed small stopped road evacuation, the airborne
advance parties on D-day, to scout doctors operated on all types of pa-
clearing station sites and to begin col- tients, including men with severe
lecting and treating wounded. The chest and abdominal injuries. Work-
main body of the companies, with ing under roofs in relatively favorable
their attached field hospital platoons, conditions, the surgeons obtained sat-
came in by glider during the after- isfactory results. One of them com-
noon of 18 September. Collecting mented: "Only two or three . . .
racic cases that reached surgery [in
47
Allen quoted in Leonard Rapport and Arthur the 101st Division] didn't survive.
Norwood, Jr., Rendezvous with Destiny: A History of the
101st Airborne Division (Greenville, Tex., 1948), pp. The ones that did not survive were
356-57. very severe injuries, of the type that
BREAKOUT AND PURSUIT 309
couldn't have been saved any- Ambulances of the 384th and 493d
where." 48 Companies closely followed the XXX
Throughout the campaign the divi- Corps' advance. On 19-20 September
sions received at least adequate medi- platoons made contact with the two
cal resupply, initially through air airborne division clearing stations and
drops and later by road. When Amer- relieved them of about 600 casualties.
ican supply deliveries did fall short, Ambulance evacuation during the fol-
the British more than made up the lowing week entailed running the
deficiencies. According to the 82d Di- gauntlet on what was aptly called
vision surgeon, Lt. Col. William C. "Hell's Highway," the single two-lane
Lindstrom, MC, British "generosity road that was the artery of the ad-
and whole hearted cooperation" vance. Southbound ambulances bat-
during the offensive "left nothing to tled a constant northward flow of
be desired." Overall, the airborne di- British troop and supply trucks; often,
vision medical service, as revised after they had to take to sidewalks, shoul-
Normandy, proved effective during ders, and the fields to get around
MARKET, although Colonel Lindstrom huge traffic jams. Periodically,
recommended at the end of the cam- German attacks blocked sections of
paign that the division medical com- the highway, and the enemy artillery
pany be enlarged into a small battal- fire posed a never-ending hazard. A
49
ion. 384th Company driver received the
As the airborne assault began, the Silver Star for pulling an injured Brit-
American medical contingent with the ish soldier out of an ammunition
British XXX Corps moved into posi- truck set afire by a shell. The ambu-
tion close behind the line of depar- lance platoons evacuated over 1,600
ture. The 384th Collecting Company patients from the 101st Division to
(actually an ambulance unit in spite of Bourg-Leopold during the first nine
its designation) established its head- days of MARKET-GARDEN; but evacu-
quarters at Hechtel and attached pla- ation over the 75-mile run from the
toons to the British evacuation ele- 82d stopped altogether for four days
ments scheduled to advance up the and was sporadic thereafter until
corridor. Nearby, at Bourg-Leopold, SHAEF and the British Second Army
the 24th Evacuation Hospital opened, arranged late in September for airlifts
50
reinforced by elements of the 662d from Eindhoven and Nijmegen.
Clearing and 493d Collecting Compa- Almost all the wounded Americans
nies. who traveled "Hell's Highway"
48 50
Crandall Interv, 8 Jun 45, box 222, RG 112, Crew, AMS, Campaigns: North-West Europe, 4:294-
NARA. 97; Surg, 82d Airborne Division, 1944, an. III;
49
Quotation from Surg, 82d Airborne Division, Davis, MARKET-GARDEN Rpt, 28 Sep 44, in Medical
Annual Rpt, 1944, an. III; Surg, 101st Airborne Di- Division, COSSAC/SHAEF, War Diary, September
vision, Annual Rpt, 1944, pp. 5-6, 9, 18; Crew, 1944; 493d Collecting Company Annual Rpt, 1944;
AMS, Campaigns: North-West Europe, 4:233; Memo, 384th Collecting Company (956th Ambulance Com-
Col. J. K. Davis to CMedOff, SHAEF, 28 Sep 44, pany) Annual Rpt, 1944, in 57th Medical Battalion
sub: Visit to British Second Army (hereafter cited as Annual Rpt, 1944. Reorganized under the 956th's
MARKET-GARDEN Rpt), in Medical Division, T/O&E in November 1943, the 384th was not re-
COSSAC/SHAEF, War Diary, September 1944. designated until after MARKET-GARDEN.
310 EUROPEAN THEATER OF OPERATIONS
before D-Day; the Northern Ireland Section surgeon, Lt. Col. Thair B.
Base Section did likewise nine days Rich, MC, left the Central Base Sec-
after the invasion. On 10 September tion in London expecting to oversee
the United Kingdom Base went into in Paris only a few hospitals and dis-
operation, with the remaining three pensaries serving headquarters and
original base sections—Southern, troops on leave. When he reached
Central, and Western—reorganized as France, he found himself in charge of
subordinate districts (see Map 13).1 several thousand general hospital
Most of the continental base sec- beds, a major depot, and rail and air
tion surgeons had served in the same holding units at what rapidly became
capacity in their sections' parent the medical supply and evacuation
headquarters in Great Britain. As in center of the entire continental Com-
their previous posts they supervised munications Zone. Rich's staff from
hospitals, depots, and other medical the Central Base Section perforce re-
service units and installations in their ceived hasty augmentation from Gen-
areas; they provided hospitalization, eral Hawley's office, 12th Army
evacuation, and medical supplies for Group, Advance Section, and a gener-
troops stationed there; and they ad- al hospital. In the Channel Base
vised section commanders on preven- Section Col. Mack M. Green, MC,
tive medicine and sanitation. On the managed the medical affairs of Ameri-
Continent several base section sur- can enclaves in a British zone, includ-
geons had additional responsibilities ing eventually the great port of Ant-
at crucial points in the theater chain werp. Besides caring for the sick and
of evacuation. Lt. Col. Raymond E. injured of local service units, Green
Duke, MC, in the Normandy Base and his assistants set up hospitals and
Section, had charge of sea evacuation dispensaries for the large RED HORSE
to England, of the disembarkation troop staging area 2that COMZ estab-
and storage of most medical supplies lished at Le Havre.
reaching the Continent, and of a large
group of general hospitals. Because Hawley Moves to Paris
of the importance of this position,
General Hawley prevailed on the sec- The Office of the Chief Surgeon
tion commander to appoint Duke, had begun its move to France in mid-
who had been theater hospital inspec- June. At that time an advance element
tor on the chief surgeon's staff, to re- under Colonel Spruit, formerly Haw-
place a less experienced base surgeon ley's deputy at Cheltenham, crossed
brought from England. the Channel with the headquarters of
In the Brittany Base Section Col. the abortive Forward Echelon of
Robert B. Hill, MC, provided evacu- COMZ and established itself at Va-
ation and medical supply for the 2
forces besieging Brest. The Seine tany,Surg, Seine Section, and Surgs, Normandy, Brit-
Channel, Loire, and Oise Base Sections,
Annual Rpts, 1944. For Duke's appointment, see
1
Ruppenthal, Logistical Support, 1:216-18; ibid., Ltr, Hawley to Col Theodore Wyman, Jr., 1 Aug 44,
vol. 2, September 1944-May 1945 (1959), pp. 24 and file HD 024 ETO CS (Hawley Chron). Rich recalls
32-38; Surg, United Kingdom Base, Annual Rpt, the expansion of his mission in Editorial Advisory
1944, p. 59. Board, 1962, pp. 123-24.
THE EXPANDING COMZ 315
lognes in the central Cotentin, the Hardly had the office settled in at
planned COMZ headquarters site. Valognes when it moved again, this
Awaiting the activation of FECOMZ, time to Paris. As soon as the Allies
Spruit and his group observed medi- liberated the French capital, General
cal operations and assisted (and Lee, without prior SHAEF authoriza-
sometimes, at Hawley's behest, pres- tion, and to General Eisenhower's an-
sured) the Advance Section on such noyance, precipitately rushed COMZ
matters as setting up general hospi- headquarters into the city. SHAEF re-
tals. FECOMZ never went into oper- luctantly accepted Lee's fait accompli.
ation. Instead, in mid-August, the Lee acted in order to place his head-
main COMZ headquarters moved to quarters at what he expected to be
Valognes so that General Lee could the center of continental logistics and,
take personal charge of his expanding his detractors claimed, in order to
continental establishment. As part of
secure the most comfortable accom-
this movement, General Hawley and
his London and Cheltenham staffs— modations available. Hawley was only
less about 50 officers and 150 enlist- a few steps behind his commander. A
ed people left behind for the United day or two after the liberation, he
Kingdom Base—transferred to Va- sent his executive officer and his
lognes in a series of echelons. Spruit chiefs of hospitalization and supply
and several of his men, much to their into Paris by jeep to secure locations
disappointment, now went back to for, respectively, offices, general hos-
England to join the new base head- pitals, and a major medical depot. All
quarters. Housed in a spacious tent three men accomplished their mis-
and hut camp, in woodlands almost sions with dispatch and some disre-
untouched by combat, Hawley and his gard for formal procedure. Swift
assistants worked in pleasant sur- action had side benefits: The depot
roundings. However, the disruption building turned out to be a ware-
attendant on uprooting personnel, house for the German officers club's
furniture, and records, and a lack of liquor, all of which for medicinal pur-
communications, put the chief sur- poses, became U.S. Army property.
geon's staff almost completely out of The main body of the chief surgeon's
action during the weeks when Paris staff transferred to Paris by truck and
fell and the armies crossed the Seine.3 hospital train and opened in a requisi-
tioned hotel on the Avenue Kleber on
3
Administration Division, OofCSurg, HQ, 14 September. By the end of 1944 all
ETOUSA, Annual Rpt, 1944, pp. 8-14 and ends.
5-6; Evacuation Branch, Operations Branch,
divisions of Hawley's establishment
OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, pp. were in Paris except Rehabilitation,
6-7; Planning Branch, Operations Division, which remained in London to super-
OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, pp.
12-13; Hospitalization Division, OofCSurg, HQ,
vise its extensive facilities in Britain.4
ETOUSA, Annual Rpt, 1944, p. 8; Supply Division,
OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, sec. I, Middleton Interv, 1968-69, vol. 1, p. 228, NLM, de-
p. 1. For descriptions of the site at Valognes, see scribes Spruit's disappointment.
4
Ltr, Hawley to TSG, 24 Aug 44, file HD 024 ETO Ruppenthal, Logistical Support, 2:31-32; Adminis-
O/CS (Hawley-SGO Corresp); Joseph R. Darnall, tration Division, OofCSurg, HQ ETOUSA, Annual
"Fixed Hospitals Follow the Breakthrough to Paris," Rpt, 1944, pp. 8-14; Evacuation Branch, Operations
The Military Surgeon 101 (October 1947): 276-77. Continued
316 EUROPEAN THEATER OF OPERATIONS
In England the residue of the chief rapid advance. On the one hand,
surgeon's staff, reinforced by medical COMZ had to furnish to the combat
people from the Southern Base Sec- forces enough ammunition, food, and
tion, formed the United Kingdom gasoline to enable them to continue
Base surgeon's office. Initially, the their victorious drive as long as possi-
staff was located at Cheltenham, but ble. Yet at the same time, to sustain
it soon took over General Hawley's the full-scale offensive to the Rhine
old London quarters at 9 North and beyond, COMZ had to advance
Audley Street. The United Kingdom its own troops and matériel so as to
Base medical department, which in- build a network of intermediate facili-
cluded over 100 general and station ties between the armies and, by now,
hospitals and scores of other facilities, the well-developed Normandy ports
possessed higher status and more in- and supply dumps. With limited
dependence of action than those of transportation and steadily lengthen-
ordinary base sections. Colonel ing distances to overcome, the Com-
Spruit, the base surgeon, also served munications Zone could not do both
as a deputy chief surgeon, ETO. He jobs at once. Necessarily, it put sup-
exercised within the British Isles most port of the armies—at a minimal
of the chief surgeon's authority over level—first and used what resources
the medical service, including the were left over to develop its logistical
right, in consultation with base and base in northern France and Belgium.
district authorities, to remove or The end result was less than satisfac-
transfer hospital commanders. Spruit tory, tactically and logistically. The
also directed the reception and treat- armies had to halt for a month at the
ment of casualties from the Conti- West Wall, for lack of supplies,
nent, as well as air and sea evacuation affording the Germans invaluable
from the theater to the United recovery time, while the Communica-
States.5 tions Zone established at least rudi-
Hawley, Spruit, and the base sec- mentary advance facilities. Even then,
tion surgeons, even as they tried to an underdeveloped structure ham-
move and reorganize their own staffs, pered operations throughout most of
grappled with the conflicting tasks the fall and winter. The COMZ medi-
that all elements of the Communica- cal service shared this dilemma with
tions Zone confronted during the the rest of COMZ, and it faced the
added problem of moving masses of
Division, OofCSurg, HQ, ETOUSA, Annual Rpt, casualties to the rear as well as sup-
1944, p. 9. Hawley and several other officers re- 6
count their entry into Paris in Hawley Interv, 1962, port units and supplies to the front.
pp. 74-76, CMH, and Editorial Advisory Board,
1962, pp. 120 and 123. See also Carter, ed., Surgical
Consultants, 2:251, and Middleton Interv, 1968-69, Forging the Evacuation Chain
vol. 2, p. 560, NLM.
5
Surg, United Kingdom Base, Annual Rpt, 1944; Until the breakout from Normandy,
Memo, Hawley to Surg, United Kingdom Base, 16 evacuation from the armies to the
Sep 44, sub: Scope of ETO Medical Operations in
UK Base, file HD 024 ETO CS (Hawley Chron); Ad-
6
ministration Division, OofCSurg, HQ, ETOUSA, Ruppenthal, Logistical Support, 1:481-89, summa-
Annual Rpt, 1944, pp. 4 and 14. rizes the logistics dilemma.
THE EXPANDING COMZ 317
Mans, Etampes, Reims, and finally listed men of each evacuation section
Namur, which it reached on 22 Octo- began work with the sketchiest of
ber. To oversee medical activities training, no experience, and only
throughout the extensive Advance World War I precedents to guide
Section, Beasley set up suboffices in them. They learned on the job and by
Liege and Bar-le-Duc as the armies mid-September had established effec-
paused at the West Wall. The ADSEC tive working relations with the armies
surgeon maintained direct personal and ADSEC. This was especially the
contact with the field army command- case after Colonel Beasley obtained
ers and their surgeons. He also at- field-grade MC officers from COMZ
tached medical liaison officers, select- headquarters to command the sec-
ed before D-Day for the First and tions, Lt. Col. Maurice E. Glock for
Third Armies, to the army headquar- the 25th Regulating Station and Maj.
ters. These officers transmitted medi- Sidney Blumenthal for the 24th.
cal support and supply requests and Glock and Blumenthal and their as-
complaints to Beasley; they also re- sistants allocated ADSEC hospital and
ported daily to him the positions of holding unit beds to the armies and
the army medical units and the dispatched ambulances to collect pa-
number of casualties in them awaiting
tients from army facilities. They also
evacuation.9
helped select locations for air and rail
Under Beasley's technical supervi-
sion, the medical evacuation sections holding units. They supervised the
of the 24th and 25th Regulating Sta- loading of hospital trains, once these
tions controlled the day-to-day move- came into use, although dispatch of
ment of sick and wounded across the the trains, contrary to original plans,
army rear boundaries. With their remained the responsibility of the
parent regulating stations, which Evacuation Branch in General Haw-
managed the flow of traffic into and ley's office. Supplementing the efforts
out of the army areas, the medical of the ADSEC liaison officers, the
sections went into operation late in medical regulators formed another
July, that of the 24th supporting the channel of communications between
10
Third Army and that of the 25th the COMZ and army surgeons.
First. Like the rest of the station per- ADSEC holding units constituted
sonnel, the four officers and four en- the indispensable link between mobile
army evacuation hospitals and the
9
Quotation from Ltr, Hawley to Beasley, 22 Aug usually distant railheads and airfields.
44, file HD 024 ETO CS (Hawley Chron). See also They received sick and wounded by
Ltrs, Hawley to TSG, 24 Aug 44, and TSG to ambulance from the army units, per-
Hawley, 1 Sep 44, file HD 024 ETO O/CS (Hawley-
SGO Corresp); Surg, ADSEC, COMZ, Annual Rpt, 10
1944, pp. 5, 8-9, 11; Ltr, Beasley to Col W. E. For general development of regulating stations,
Shambora, 14 Oct 44, Shambora Papers, MHI; see Ruppenthal, Logistical Support, 1:497-99; Evacu-
Surg, ADSEC, Daily Activities Rpts, August-October ation Branch, Operations Division, OofCSurg, HQ,
1944, and Rpts, Liaison Offs, First, Third, and ETOUSA, Annual Rpt, 1944, pp. 8-9, and, in file
Ninth Armies, August-December 1944, all in Beas- HD 024 ETO, ibid., Daily Diary, 31 Aug 44; Surg,
ley Papers, MHI; Editorial Advisory Board, 1962, ADSEC, COMZ, Annual Rpt, 1944, pp. 17 and 60;
pp. 129-30; Interv, OSG with Maj Gen Paul R. Ltr, Lt Col M. E. Glock to Col F. E. Mowrey, 12 Sep
Hawley, 18 Apr 50 (hereafter cited as Hawley 44, file HD:ETO:370:Evacuation, September-De-
Interv, 1950), file HD 000.71, CMH. cember 1944.
THE EXPANDING COMZ 319
mitting the latter to clear out patients For holding units behind the
promptly and move forward. The armies, the Advance Section used the
holding units provided shelter, food, 7th, 9th, 12th, and 28th Field Hospi-
and minimal supportive and emergen- tals; the 77th Evacuation Hospital, its
cy care for a large, rapid turnover of only 750-bed unit; and the 93d Medi-
casualties, whom they retained only cal Gas Treatment Battalion. The first
long enough to accumulate efficient real holding units, aside from those
loads for air and railtransportation. established earlier on the beaches,
These organizations had to be put to- went into operation in mid-August.
gether in the field; no T/O unit for The 77th, succeeded by the 7th, set
this purpose existed, and the NEP- up near St.-Lo for reception and
TUNE planners had not anticipated the triage of First Army casualties. At
size and importance such facilities roughly the same time, elements of
would assume in a fast-moving the 12th and the 93d opened an air
mechanized advance. At the outset evacuation facility for the Third Army
the theater made the Communications at an airstrip near Avranches. From
Zone solely responsible for setting up then on, as the Allies overran France
holding units close to the army rear and the Low Countries, holding units
boundaries. However, as COMZ fell opened and closed with bewildering
frequency. They advanced successive-
behind the pursuit, the armies per-
ly to Le Mans, Chartres, Orleans, and
force improvised their own units to
Reims, always trying to stay within
function until replaced by those of something resembling a practicable
the Advance Section. The theater in ambulance haul of the rearmost army
late September formally directed this hospitals. By late September the hold-
sharing of the task. In practice, when ing units serving the First Army were
lines of evacuation were longest, the well up into Belgium; those support-
armies and ADSEC both had holding ing the Third Army had reached
units in operation, relaying casualties Etain and Toul. ADSEC medical bat-
toward the rear.11 talions, the 428th in support of the
11
First Army and the 425th following
Operations Division, OofCSurg, HQ, ETOUSA,
Annual Rpt, 1944, pp. 3-4; Evacuation Branch, Op- the Third, traveled with the holding
erations Division, OofCSurg, HQ, ETOUSA, Annual units. Their attached ambulance com-
Rpt, 1944, p. 8 and encl. 6; Surg, ADSEC, COMZ, panies, under control of the regulat-
Annual Rpt, 1944, pp. 15 and 56-57; Memo, HQ,
12th Army Group, to Surgs, First and Third Armies, ing stations, collected patients from
ADSEC, and COMZ, 8 Aug 44, AirEvacCorresp, file the armies and furnished transporta-
HD 580 ETO; Memo, HQ, ETOUSA, to CGs of Air, tion between holding units and air-
Ground, and Service Forces, 24 Sep 44, sub: Evacu-
ation of Army Medical Installations, in Planning fields. Far to the southwest of the
Branch, Operations Division, OofCSurg, HQ, main battlefront, the 29th Field Hos-
ETOUSA, Annual Rpt, 1944. In proportion to their
strength, the World War II field armies contained pital and 666th Clearing Company,
fewer hospital beds than did their World War I under the Brittany Base Section, evac-
counterparts; hence, they had almost no long-term uated the VIII Corps. With detach-
patient-holding capacity. See Hospitalization Divi-
sion, OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, ments at an airfield and on the beach
pp. 23-24. near Morlaix, these units shipped cas-
320 EUROPEAN THEATER OF OPERATIONS
Wherever they were set up, holding The forward holding units sent off
units built around field hospitals most of their patients by air, long-
struggled with similar problems. The term cases directly to Great Britain
field hospitals, like their counterparts and those falling within the continen-
in the armies, had to scour the coun- tal time limit to a field near La Haye-
tryside for trucks for every movement. du-Puits for transfer to the Normandy
Usually expanded to 600 or more general hospitals. For the medical ser-
beds in the holding role, they found vice, during the height of the pursuit,
themselves with a surplus of profes- air transport was the only means
sional staff and shortages of cooks, available for spanning the steadily
admission and evacuation clerks, ward widening gap between the combat
attendants, and litterbearers. To forces and the COMZ treatment and
remedy this deficiency, ADSEC at- evacuation facilities still clustered
tached gas treatment and sanitary near the beaches and in England.
companies, and occasionally groups During August and September C-47s
of combat exhaustion convalescents, flying from British bases carried
to the field hospitals. Lacking enough about 54,000 patients across the
mess equipment, tentage, cots, and Channel and another 6,300 to desti-
bedding for their expanded capacity, nations in France. The Advance Sec-
field hospitals borrowed matériel tion, after it moved out of Normandy,
from other medical units or appropri- for practical purposes did all its evac-
ated captured German supplies. uation by air until late September.14
While it accomplished the mission, While extremely efficient, and ben-
the field hospital, in the words of the eficial to the patients, air evacuation
7th's commander, was "not an ideal in the European Theater rested ad-
unit for holding and mass evacuation ministratively on foundations of sand.
of patients. It is necessary to supple- Under SHAEF policy, transportation
of casualties had no status as a sepa-
ment it with personnel from various
rate mission; instead it was consid-
organizations and the result is a
hybrid affair with many complications, 13
Quotation from 7th Field Hospital Annual Rpt,
1944, p. 3. See also Surg, ADSEC, COMZ, Annual
12
7th, 9th, 12th, and 28th Field Hospitals, 77th Rpt, 1944, p. 65; 8th Field Hospital Annual Rpt,
Evacuation Hospital, 93d Medical Gas Treatment 1944, p. 7; 9th Field Hospital Annual Rpt, 1944, pp.
Battalion, and 425th and 428th Medical Battalions 9-14 and 19-20.
14
Annual Rpts, 1944; Surg, ADSEC, Daily Activities Msgs, HQ, COMZ (FWD), to 24th and 25th
Rpts, August-September 1944, and Operations and Regulating Stations, 29 Aug 44, EvacCorresp, 1942-
Evacuation Divisions, OofSurg, ADSEC, Weekly Ac- 44, file HD 024 ETO; Memo, Hawley to G-4,
tivities Rpts, August-September 1944, all in Beasley COMZ, 1 Sep 44, sub: Distribution of Patients
Papers, MHI; Memo, Evacuation Division, OofSurg, Among Hospitals in France, file HD:ETO:370:
ADSEC, to Surg, ADSEC, 17 Sep 44, sub: Daily Sit- Evacuation, September-December 1944; Essential
uation and Activities Rpts, file HD:ETO:370: Evacu- Technical Medical Data Rpt, HQ, ETOUSA, Sep-
ation, September-December 1944; Evacuation tember 1944, p. 2; Evacuation Branch, Operations
Branch, Operations Division, OofCSurg, HQ, Division, OofCSurg, HQ, ETOUSA, Annual Rpt,
ETOUSA, Annual Rpt, 1944, p. 9; Surg, Brittany 1944, pp. 7-8; Link and Coleman, AAF Medical Sup-
Base Section, Annual Rpt, 1944, pp. 2-3; 29th Field port, p. 609; Surg, ADSEC, COMZ, Annual Rpt,
Hospital Annual Rpt, 1944, pp. 13-16. 1944, ex. H.
THE EXPANDING COMZ 321
ered strictly a side benefit of emer- transport planes. Under the Ninth Air
gency resupply. If transport planes Force the IX Troop Carrier Com-
carried cargo for the armies to for- mand, with over 1,400 aircraft, flew
ward airstrips, they could take out supply missions and also was formally
wounded and sick on their empty in charge of air evacuation. However,
return flights. But as Hawley succinct- its principal task was transporting air-
ly summarized, "Where there is no borne troops; SHAEF withdrew its
supply by air, there is no evacuation planes from supply and evacuation
15
by air." whenever a major air drop was in
Air resupply itself possessed uncer- prospect. The other command, the
tain priority, and responsibility for it 302d Air Transport Wing, directly
was divided. Two separate air head- under USSTAF, had about 180 air-
quarters, each with other primary craft and did a disproportionately
missions than logistical supply of the large share of both supply and evacu-
ground forces, controlled most ETO ation, even though its main mission
was logistical support of the air
15
forces. SHAEF assigned tasks to both
Memo, Hawley to Kenner, 30 Aug 44, sub:
Evacuation by Air, file HD:ETO:370:Evacuation, these commands through the Com-
September-December 1944. bined Air Transport Operations
322 EUROPEAN THEATER OF OPERATIONS
scouting for additional sites around able, by rail to the Normandy Base
23
Paris and in northern France and Bel- Section.
22
gium. Two companies of Advance Sec-
Paris, as the stabling of hospital tion's 93d Medical Gas Treatment
trains and the concentration of gener- Battalion opened the Le Bourget
al hospitals there indicated, rapidly holding unit on 5 September; ten
became the hub of the continental days later, they turned it over to the
evacuation system. The principal rail 8th Field Hospital, which the gas
lines from Belgium and eastern treatment battalion's trucks had
France converged at the capital, and hauled up from Normandy. As the
it possessed two major airports. On 5 Paris evacuation system went into full
September representatives of the operation, the hospital soon found
chief surgeon and the surgeons of itself running one of the busiest hold-
ADSEC, Seine Section, and the ing units on the Continent. Housed in
armies initialed an evacuation plan tents near the runways and later in a
under which most casualties not flown converted school building, the 8th,
directly from the Advance Section to with the 426th Medical Ambulance
Britain and Normandy would pass and 706th Medical Sanitary Compa-
through Paris. An air holding unit nies attached, routinely handled over
and ambulance directing point at Le 1,000 patients a day—incoming casu-
Bourget field in the northern out- alties from the First and Third Armies
and outgoing evacuees from the Paris
skirts was to receive and sort patients
general hospitals.24
from ADSEC and the armies—then The Paris hospitals and holding
only a short distance away. The unit unit were barely in place when the
was to send over-30-day patients di- need for them became urgent.
rectly to England by air and those Throughout the first couple of weeks
destined for COMZ either by plane to after the armies crossed the Seine,
Normandy or by ambulance to the SHAEF had committed most of its
Paris general hospitals. Those hospi- transport planes to their resupply;
tals, in turn, were to evacuate by air hence, the medical service had been
to the United Kingdom through Le able to rely almost entirely on air
Bourget and, as trains became avail- evacuation. On 15 September this sit-
22
uation abruptly changed. Supreme
The five general hospitals were the 108th Allied Headquarters, without advance
(Beaujon), 217th (La Pitie), 203d (Garches), 40th
(Le Vesinet), and 62d (Eaubonne); the station hos- warning to the medical service, with-
pital was the 365th (American Hospital of Paris). drew the IX Troop Carrier Command
See Hospitalization Division, OofCSurg, HQ, from logistical missions to prepare for
ETOUSA, Annual Rpt, 1944, pp. 10-11. See also
Essential Technical Medical Data Rpt, HQ,
23
ETOUSA, August 1944, encl. 1; Surg, ADSEC, Memo, Maj D. J. Twohig to DepCSurg, HQ,
Daily Activities Rpts, August-September 1944, Beas- COMZ (Fwd), 5 Sep 44, sub: Plan for Evacuation
ley Papers, MHI; Surg, Seine Section, Annual Rpt, Through Paris Area, file HD:ETO:370:Evacuation,
1944, p. 27; 108th General Hospital Annual Rpt, September-December 1944; Surg, Seine Section,
1944, p. 14; 127th General Hospital Annual Rpt, Annual Rpt, 1944, p. 26.
24
1944, p. 3; Ltrs, Hawley to TSG, 24 Aug and 14 8th Field Hospital Hist, 1943-44, pp. 7-8; 93d
Sep 44, file HD 024 ETO O/CS (Hawley-SGO Cor- Medical Gas Treatment Battalion Hist, 1943-44, pp.
resp); Darnall, "Breakthrough to Paris," pp. 280-81. 10-11.
THE EXPANDING COMZ 329
MARKET-GARDEN, just as the first at- Hawley took the evacuation crisis as
tacks on the West Wall increased an occasion to bring to a head his
combat casualties. For the next campaign for more reliable, respon-
couple of weeks the airborne oper- sive air support. Through General
ation tied up most Allied transport Lee, he asked SHAEF immediately to
planes when bad weather did not assign 200 C-47s daily to evacuation
ground them. Patients, many needing until the patient backlog was cleared
early definitive treatment, filled army up, which should take about three
and ADSEC holding units and then days. Thereafter, Hawley wanted 50
backed up into the evacuation hospi- planes a day, which would give him a
tals. By the twentieth at least 5,000
daily capacity of about 2,000 casual-
sick and wounded were awaiting evac-
uation in and just to the rear of the ties. SHAEF rejected this proposal.
armies, and the Advance Section was On 21 September Lt. Gen. Walter
removing them at a rate of only 1,500 Bedell Smith, Eisenhower's chief of
a day. staff, informed General Lee that air-
COMZ evacuation officers impro- borne operations then in progress
vised frantically to compensate for the ruled out the proposed medical airlift
near-total loss of air transport. What and that "in any event, your medical
hospital trains were available shuttled evacuation plans must not be predi-
continuously between the forward cated on any fixed air evacuation.
areas and Paris. The ADSEC holding Rather, air evacuation must be con-
units behind the First Army sent casu- sidered as a bonus to be available
alties all the way from Belgium to the from time to time as conditions
French capital by ambulance. These permit." Smith held firm even in the
expedients, however, quickly filled the face of an appeal from General Brad-
Paris general hospitals, which them- ley. He explained to the army group
selves had few means of sending off commander that C-47s for the medi-
patients. From the 302d Transport cal service would have to come from
Wing, General Hawley obtained some
air commands "created to meet spe-
evacuation planes, no more than a
quarter of those he needed. He finally cific operational needs, and their per-
resolved the immediate crisis by ar- manent diversion to another mission
ranging informally, through General could only be accomplished at the ex-
Grow, for an indeterminate but sub- pense of their original purpose." In
stantial number of off-the-record IX place of improved air evacuation
Troop Carrier Command evacuation Smith, after consulting with Kenner
25
flights. and Hawley, gave the medical service
high priority for transportation and
25
Memo, Evacuation Division, OofSurg, ADSEC, other support so that it could set up
to Surg, ADSEC, 17 Sep 44, sub: Daily Situation
and Activities Report, file HD:ETO:370:Evacuation,
more general hospitals north and east
September-December 1944; various memos, Sep-
tember 1944, in file HD 024 ETO CS (Hawley ion Annual Rpt, 1944, p. 4; Gorby Interv, 1962, pp.
Chron); Evacuation Branch, Operations Divsiion, 90-93, CMH; Ltr, Hawley to Col E. L. Bergquist, 28
OofCSurg, HQ, ETOUSA, Daily Diary, 3, 16, and Sep 44, box 2, Hawley Papers, MHI; Surg, ADSEC,
22 Sep 44, file HD 024 ETO; 428th Medical Battal- COMZ, Annual Rpt, 1944, p. 18.
330 EUROPEAN THEATER OF OPERATIONS
of Paris and put additional ambulance had those cities within its area and re-
26
trains in operation. fused to turn over hospitals and other
Taking advantage of SHAEF inter- structures occupied by its own medi-
est and support, Hawley lost no time cal units. The Advance Section finally
in strengthening his ground evacu- opened three general hospitals (the
ation system. He quickly pushed gen- 90th, 95th, and 100th) in Bar-le-Duc,
eral hospitals across the Seine. By considerably to the west of Nancy, be-
mid-September he already had two of tween 18 and 28 October. Wherever
these units bivouacked at Reims and located, these and the previously es-
three more at Paris, ready for assign- tablished continental general hospi-
ment. Five more general hospitals in tals functioned essentially as large
Normandy awaited disembarkation of professionally well-endowed holding
their equipment. Hawley obtained a and transit facilities. The hospitals in
speedup in landing the latter units' and to the north of Paris gave defini-
assemblies at Cherbourg. He de- tive treatment only to very short-term
ployed the hospitals already in north- patients; they evacuated all others as
ern France, and others as soon as soon as transportable. The Normandy
they came up, in positions close general hospitals retained casualties
behind the First and Third Armies. returnable to duty within thirty days.
To provide more beds for the First This was an inefficient use of general
Army, the 15th General Hospital hospitals. But a shortage of evacu-
opened in Liege on the twenty-first in ation hospitals in the COMZ troop
a former Belgian military hospital and basis, and the seemingly limitless
the 28th General Hospital went into demand for holding beds, made it
operation in the same city about two necessary (see Map 14).27
weeks later. In Paris, meanwhile, a
The medical service and the Trans-
sixth general hospital, the 48th, portation Corps cooperated to put
began admitting patients on the
more hospital trains in service. Maj.
twenty-third and the 99th General
Gen. Frank S. Ross, the theater chief
Hospital opened in Reims on the
twenty-ninth. However, an effort to 27
Ltrs, Hawley to TSG, 14 Sep 44, and Hawley to
move three general hospitals into Inspector General, WD, 10 Oct 44, file HD 024
Nancy and another into Verdun ran ETO O/CS (Hawley-SGO Corresp); September-Oc-
tober 1944 correspondence in file HD 024 ETO CS
afoul of the Third Army, which still (Hawley Chron); Surg, ADSEC, Daily Activities
Rpts, September-October 1944, Beasley Papers,
26
First quotation from Memo, Smith to Lee, 21 MHI; Memo, Hawley to G-4, ETO, 21 Sep 44,
Sep 44, sub: Medical Evacuation, file HD: AirEvacCorresp, file HD 580 ETO; Ltr, Brig Gen H.
370.05:Evacuation and Movement of Troops. R. Gay to Hawley, 1 Oct 44, box 2 Hawley Papers,
Second quotation from Ltr, Smith to CG, 12th MHI; Essential Technical Medical Data Rpt, HQ,
Army Group, 30 Sep 44, sub: Evacuation of Casual- ETOUSA, September 1944, pp. 7-8 and encl. 1;
ties, file HD:ETO:370:Evacuation, September-De- Operations Division, OofCSurg, HQ, ETOUSA,
cember 1944. See also September 1944 correspond- Annual Rpt, 1944, p. 4; Hospitalization Division,
ence in file HD 024 ETO CS (Hawley Chron); OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, p. 12;
Memo, Col V. A. Rapport to Lee, 20 Sep 44, sub: Surg, ADSEC, COMZ, Annual Rpt, 1944, p. 68;
Air Evacuation of Casualties, AirEvacCorresp, file Surg, Normandy Base Section, Annual Rpt, 1944,
HD 580 ETO; Medical Division, COSSAC/SHAEF, pp. 8-9; 15th General Hospital Annual Rpt, 1944,
War Diary, September 1944; Link and Coleman, pp. 3-4 and 16-17; 76th General Hospital Annual
AAF Medical Support, p. 606. Rpt, 1944, p. 34.
THE EXPANDING COMZ 331
TABLE 8—TRENDS IN EVACUATION FROM THE ARMIES AND ADVANCE SECTION
Wing often evaded this restriction, to the Paris hospitals had 2,000 empty
the benefit of the medical service. beds.32
When the medics desperately needed By late October, as the armies pre-
planes, their aviation colleagues, with pared for a new assault on the West
a little ingenuity, usually could dis- Wall, the continental evacuation
cover an urgent requirement for system was complete in outline (Dia-
cargo somewhere, or they could send gram 3), although elaboration and ex-
a replacement aircraft just arrived in pansion would continue. Army and
the theater on an extra mission ADSEC holding units sent very short-
before it reported to its assigned term patients to the general hospitals
squadron. By such formal and infor- at Liege, Reims, and Bar-le-Duc, for
mal means the Army Air Forces, definitive treatment close to the front
within the confines of SHAEF policy,
always made at least some evacuation and early return to duty. Whenever
aircraft available to the medical ser- possible, they dispatched severe cases
vice.
31 directly to the United Kingdom by
The medical service rapidly elimi- air. Now, however, the majority of
nated its late September evacuation long-term patients left the forward
backlog, assisted by the almost daily area by hospital train, bound for
arrival of additional hospital trains; by Paris. At the capital the Seine Section
the resumption of large-scale air re- detrained all incoming casualties for
supply after MARKET-GARDEN; and, sorting and rest. The Paris general
above all, by a lull in combat and its hospitals retained a few patients for
attendant reduction in casualties. At treatment, but they evacuated most as
the end of September no more than soon as they were able to travel in
800 patients were awaiting evacuation order to maintain large reserves of
in the armies and ADSEC, and the empty beds for sudden surges of cas-
Paris hospitals were clearing out their ualties from the front. Evacuees from
own accumulations by air and rail. Paris might go by ambulance to Le
Evacuation continued to improve Bourget, for loading on United King-
during October. On the nineteenth dom-bound aircraft. More likely, they
the Evacuation Branch of Hawley's would be taken to the Gare St.-Lazare
office reported that the situation was and placed on trains again, for the up
"excellent in forward areas" and that to three-day run to the Normandy
31
Base Section general hospitals or to
Ltr, Smith to CG, 12th Army Group, 30 Sep 44, Cherbourg and embarkation on hos-
sub: Evacuation of Casualties, file
HD:ETO:370:Evacuation, September-December pital carriers for the voyage to South-
1944; Evacuation Branch, Operations Division, ampton. While surgeons continued to
OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, pp. prefer air evacuation whenever they
13-14, and, in file HD 024 ETO, ibid., Daily Diary,
18 Sep and 1, 2, 4, 6 Oct 44; Link and Coleman,
32
AAF Medical Support, pp. 606-07 and 616. See also Quoted words from Evacuation Branch, Oper-
Memo, Col F. H. Mowrey to G-4, ETO, 4 Oct 44, ations Division, OofCSurg, HQ, ETOUSA, Daily
sub: Communications for Air Evacuation; SOP, IX Dairy, 19 Oct 44, file HD 024 ETO. See also ibid.,
Troop Carrier Command, 18 Oct 44, sub: Medical entries for 29 Sep-31 Oct 44, same file; Memos,
Air Evacuation of Casualties; Ltr, Col F. H. Mowrey Hawley to Kenner, 26 and 29 Sep 44, file HD 024
to CSurg, ETO, 22 Nov 44, sub: Air Evacuation. All ETO CS (Hawley Chron); Essential Technical Medi-
in AirEvacCorresp, file HD 580 ETO. cal Data Rpt, HQ, ETOUSA, October 1944, p. 1.
336 EUROPEAN THEATER OF OPERATIONS
could obtain it, the medical service on setting up of units. The Supply Divi-
the Continent now appeared to pos- sion put together and shipped the
sess the resources and flexibility to bulky unit equipment assemblies,
33
get along without it. trying, not altogether successfully, to
bring them together in France with
General Hospitals to the Front the people who were to use them.35
Colonel Darnall did much of the
Between the St.-Lo breakout and site reconnaissance in person, assisted
the end of October the medical ser- by Lt. Col. Irving A. Marshall, the
vice placed 18,000 general hospital head of his Construction Branch, and
beds in operation on the Continent. by officers from the Advance Section
The majority of these were in units and the newly formed Allied govern-
hastily moved forward and established ments. During August Darnall select-
in northern France and Belgium, to ed hospital locations around Rennes
help relieve army facilities and hold and then entered Paris in the first
patients for air and rail evacuation. days of liberation to stake medical
Deploying these large, cumbersome service claims there. Early in Septem-
hospitals was a complicated task, in- ber he traveled eastward from the
volving inter-Allied politics as well as capital over the old American World
American logistics. The hospitals War I battlefields, where he himself
themselves, besides overcoming the had worked in an evacuation hospital,
problems of movement, had to adapt to choose sites close behind the Third
to new, often unsuitable quarters and Army. As the pursuit ended at the
to take on functions different from West Wall, he made a four-day 800-
those usually performed by general mile swing through Belgium and Lux-
hospitals.34 emburg. Riding in jeeps and
Several divisions of the chief sur- equipped, Darnall recalled, "with
geon's office had a hand in setting up maps, K-rations, full canteens, and
general hospitals. The Operations Di- jerricans of gasoline," the hospital re-
vision selected the areas in which they connaissance parties kept up with the
were to be established and oversaw forward combat troops and occasion-
the entire deployment procedure to ally, in the confusion, entered towns
ensure that hospitals opened where ahead of them. Darnall and his assist-
they were supposed to more or less ants inspected dozens of buildings
on time. The Hospitalization Division and tramped over acres of pasture
located, and secured permission to and cultivated land, marking usable
use, particular buildings or pieces of locations on maps to guide subse-
land and directed the movement and quent planning. Whenever possible,
33
they selected sites grouped together
Memo, Col. F. H. Mowrey to DepCSurg, ETO, on roads and railways, for organiza-
8 Nov 44, AirEvacCorresp, file HD 580 ETO; Evac- 36
uation Branch, Operations Division, OofCSurg, HQ, tion later into hospital centers.
ETOUSA, Annual Rpt, 1944, pp. 9-11; Essential
35
Technical Medical Data Rpt, HQ, ETOUSA, Octo- Operations Division, OofCSurg, HQ, ETOUSA,
ber 1944, p. 2. Annual Rpt, 1944, p. 4.
34 36
The number of beds is from Ltr, Hawley to In- Quotation from Joseph R. Darnall, "Hunting
spector General, WD, 10 Oct 44, file HD 024 ETO Hospital Sites beyond Paris, September 1944," The
O/CS (Hawley-SGO Corresp). Continued
THE EXPANDING COMZ 337
Once Darnall and his associates the Americans with many of the best
found suitable locations, they negoti- hospitals, because those were precise-
ated with COMZ and army headquar- ly the buildings the Germans had
37
ters, and with Allied civil authorities, seized.
for permission to occupy them. Under When Darnall and Marshall entered
theater policy, hospitals had first Paris in the last days of August seek-
claim on existing buildings, which the ing hospital buildings, they made im-
medical service, for obvious reasons mediate, beneficial contact with the
of patient comfort and operating con- newly installed acting French minister
venience, preferred to use whenever of health, Dr. Pasteur Vallery Radot.
available. Nevertheless, in the army According to Darnall, Radot, a Resist-
areas COMZ general hospitals at ance member and grandson of the
times took second place to medical
famous scientist Louis Pasteur, "real-
units of the organization in control of
the ground, as in the case of the ized that the salvation of France lay
Third Army's exclusion of general not in quickly grabbing back the
hospitals from Verdun and Nancy. In properties vacated by the retreating
liberated towns and cities the medics Germans, but in helping the Ameri-
had to deal, through SHAEF, with re- cans to acquire and utilize these facil-
established French or Belgian civil ad- ities until the war was won." The
ministrations. These governments, Americans, with Radot's help, within
understandably, often put their own days secured five of the largest and
peoples' health and social needs best-equipped civilian hospitals, all of
ahead of U.S. Army requirements, which had been occupied by the Ger-
and SHAEF frequently deferred to mans until the liberation. During the
their wishes. Fortunately for the med- late September evacuation crisis
ical service, the overrunning of much Radot's successor unhesitatingly evict-
of France and the Low Countries ed a recently installed French staff
without heavy fighting left a larger from a sixth facility, Lariboisiere, to
than anticipated stock of intact struc- make room for the 48th General Hos-
tures. In most places the Hospitaliza- pital. The Count de Chambrun, the
tion Division simply took over facili- German-appointed French administra-
ties formerly appropriated by the tor of the American Hospital of Paris,
Germans. The division thereby avoid- an American-financed private institu-
ed any new displacement of civilians tion, was less accommodating. A sus-
and at the same time made it politi- pected collaborator, as were many of
cally awkward for local officials to
deny to the Allies what they previous- 37
For hospital priority, see An. 8-Medical, pp. 5-
ly had yielded to the enemy. As an 6, to ADSEC Plan, 30 Apr 44, and An. 9-Medical,
pp. 39-40, to FECOMZ Plan, 14 May 44, file HD
added benefit, this policy provided 370 ETO; Operations Division, OofCSurg, HQ,
ETOUSA, Annual Rpt, 1944, p. 5; ADSEC Hist, pp.
Military Surgeon 103 (August 1948): 85-93. See also 73-74; Darnall, "Breakthrough to Paris," pp. 273-
ibid., "Breakthrough to Paris," pp. 271-81; Hospi- 74; Hospitalization Division, OofCSurg, HQ
talization Division, OofCSurg, HQ, ETOUSA, ETOUSA, Semiannual Rpt. January-June 1945. Ltr,
Annual Rpt, 1944, pp. 3 and 10-12; Surg, ADSEC, Hawley to Kenner, 3 Nov 44, file HD 024 ETO CS
Daily Activities Rpts, August-September 1944, Beas- (Hawley Chron), illustrates difficulties with civilian
ley Papers, MHI. authorities.
338 EUROPEAN THEATER OF OPERATIONS
his staff, Chambrun first appealed to ing hospitals sent doctors and nurses
General Hawley not to take over his off on detached service, usually with
well-appointed 150-bed facility. That auxiliary surgical teams. The rest of
failing, Chambrun asked Hawley to let their people whiled away the time in
the existing international staff stay on
training, physical conditioning, and
as U.S. Army employees. Hawley re- bargaining with neighboring civilians
fused both requests and took the hos- for Calvados and souvenirs.39 Two of
pital, less because he absolutely the first hospitals into Paris, the
needed it than as a symbolic compen- 108th and 203d, were preparing to
sation to the French for the expro- open tented plants near Cherbourg
priation of so many of their facilities. when they received orders to stop
The chief surgeon installed the 350th work and pack again for movement.
Station Hospital in the plant, where it The personnel of hospitals bound
cared for officer and female patients for Paris and points north and east of
from the U.S. headquarters in the it usually traveled on empty hospital
capital.38 trains, except for detachments driving
As it secured buildings and open- the unit vehicles. For the nearly 1,000
field sites, the Hospitalization Divi- men and women of a general hospi-
sion moved units forward to occupy tal, crowded into a single train along
them. To achieve this, the division with the on-board medical unit, it was
first coordinated with medical service an uncomfortable trip, memorable for
channels and then forwarded a re- the shortage of seats, berths, toilets,
quest to the COMZ G-4 to issue di- and cooking facilities and for the in-
rectives to the appropriate base sec- terminable delays. Inevitably, units
tions, which actually conducted the became separated from their equip-
movement. Most general hospitals ment assemblies; the 48th General
that went into operation during the Hospital, for example, went to Paris
pursuit came to the Continent from while its outfit went to Liege. Hospi-
the United Kingdom, although late in tals arriving early in newly captured
September units began arriving di- cities underwent a variety of adven-
rectly from the United States. All the tures. The 62d General Hospital,
hospitals spent varying lengths of which entered Paris on 30 August,
time encamped in Normandy, in spent three days trying to find a head-
hedgerow fields that still bore the quarters to assign it a location and
scars and debris of battle. Most stag- then—without maps—the locations
38 itself. Bivouacked at a chateau south
Hospitalization Division, OofCSurg, HQ,
ETOUSA, Annual Rpt, 1944, p. 11; Darnall, "Break- of the capital, unit personnel heard
through to Paris," pp. 277-81 (quotation on p. nightly rifle shots as Free Frenchmen
281); ibid., "Sidelights," p. 26; Surg, Seine Section,
rounded up German stragglers in the
Annual Rpt, 1944, pp. 16-17; Ltr, Hawley to Gener-
al Purchasing Agent, ETO, 24 Sep 44, file HD 024 nearby woods. They also found sever-
ETO CS (Hawley Chron); Editorial Advisory Board, al Germans living in their own attic
1962, pp. 123-124 and 192-93; Hawley Interv, on stolen American rations. With no
1962, pp. 77-79; CMH. The 350th Station Hospital
in fact employed many of the nurses, clerical
39
people, and general laborers of the American Hos- Calvados was a French brandy from the Depart-
pital. See 350th Station Hospital Annual Rpt, 1944. ment of Calvados.
THE EXPANDING COMZ 339
supply depots yet in operation, the vandalism. In many of the large Paris
hospital sent its own trucks back to hospitals the departing enemy ripped
the beaches for food and gasoline, out wiring, plugged toilets, sabotaged
only to have several cargoes hijacked plumbing, carried off or smashed fur-
on the return trip, reportedly by nishings and equipment, and created
Third Army troops.40 a revolting welter of rotten garbage,
Whether in buildings or tented soiled dressings, and overflowing uri-
camps, general hospitals labored to nals and bedpans. Yet the Germans
place their facilities in operation in left other plants almost undamaged,
the shortest possible time. Units occu- with furniture, instruments, and X-ray
pying existing hospitals often had to and other machines in good order,
contend with the results of German ready for use. In a few instances the
Americans found well-stocked phar-
40
Troop Movements and Training Branch, Oper- macies. Even in the more severely
ations Division, OofCSurg, HQ, ETOUSA, Annual vandalized premises, general hospitals
Rpt, 1944, pp. 14-15; Surg. Normandy Base Sec-
tion, Annual Rpt, 1944, pp. 2-4 and 16-17; Surg, could begin receiving patients within
ADSEC, Daily Activities Rpt, 17 Aug 44, Beasley days of moving in, after a thorough
Papers, MHI; 15th, 40th, 48th, 62d, 95th, 99th, cleanup and limited repairs.
108th, and 203d General Hospitals Annual Rpts,
1944; 15th General Hospital Unofficial Hist, 1943- Units that had to remodel barracks
44; Brown Interv, 1979, CMH. and schools or construct expedition-
340 EUROPEAN THEATER OF OPERATIONS
ary tented plants took much longer to had received little more than first
go into full operation. Even though aid—during its initial forty-eight
the theater gave hospital construction hours of operation. The hospital re-
high priority, units had difficulty ob- sponded to the crisis with rapid im-
taining engineer support and building provisation. According to the unit's
materials, especially when hard- report:
pressed base section commanders
chose to put other projects ahead of Our own U.S.A. supplies had not come
those for the medical service. Torren- up from Le Mans, many of our surgeons
tial rains, which began in mid-Octo- and shock teams . . . were still away
ber, turned open-field sites into seas detached service, no penicillin was avail-
of mud, further slowing the work. able, the hospital communications sys-
tems had been destroyed by the retreat-
General hospitals facing long con- ing Germans, and we had no practical
struction delays concentrated on get- experience as a group in handling large
ting their people and equipment numbers of casualties as an evacuation
under shelter and opening wards for hospital. We used German paper dress-
emergency care and holding pur- ings and other material they had left
poses. To speed the opening of the behind. . . . We put dentists, ch
general hospitals at Bar-le-Duc, the and bacteriologists to work in the wards
Advance Section temporarily attached with the medical men who were not
field hospital platoons to them. These giving anesthetics or assisting in surgery.
We worked 36 hours straight, hoping to
platoons set up tented operating fa- catch up, but were still 500 cases, need-
cilities for the larger hospitals, which ing operation, behind schedule. We then
otherwise could not have performed organized 12-hour day and night shifts
surgery until the engineers finished and operated only upon the most severely
41
extensive renovation of their plants. wounded. . . .
The forward general hospitals, ac-
customed to providing comparatively For the 108th, and the other hospitals
leisurely long-term treatment, had to that followed it into operation, the
reorganize on the job for mass casual- flow of casualties directly from aid
ty reception, emergency care, and and clearing stations soon ended.
evacuation. The first hospitals to Nevertheless, most general hospitals
open were inundated with wounded, on the Continent continued to give
many fresh from division clearing sta- only the simplest of care to a rapid
tions. In Paris the 108th General Hos- turnover of patients. Only those far-
pital admitted about 1,000 patients— thest to the rear, in the Normandy,
the majority German prisoners who Brittany, and Loire Base Sections,
41
performed anything like their text-
Surg, ADSEC, COMZ, Annual Rpt. 1944, pp. 42
49-50; Surg, Brittany Base Section, Annual Rpt, book functions.
1944, p. 2; 15th, 40th, 62d, 76th, 99th, 100th, 203d,
and 217th General Hospitals Annual Rpts, 1944;
42
Darnall, "Breakthrough to Paris," pp. 279-80; 108th General Hospital Annual Rpt, 1944, pp.
Hawley Interv, 1962, pp. 76-77, CMH; Memo, 19-20 and 24-25; 127th General Hospital Annual
Hawley to G-4, ETO, 5 Oct 44, sub: Hospital Con- Rpt, 1944, p. 4. These units also acted as station
struction—Le Mans, file HD 024 ETO CS (Hawley hospitals for neighboring COMZ troops. See Surg,
Chron); 58th Field Hospital Annual Rpt, 1944, pp. Oise Base Section, Annual Rpt, 1944, pp. 4-5 and
11-18. 8-9.
THE EXPANDING COMZ 341
er, required depot company men to November the depot shifted oper-
guard them), with enlisted men de- ations to Carentan, where it obtained
tailed from staging medical units, and buildings and hard-surfaced open
with French civilians. At M-407 the storage on an abandoned airstrip.46
31st Company eventually employed Control of depot operations and
over 200 Parisians. The depot compa- supply issues changed as the lines of
nies needed all the manpower they communications lengthened. At the
could obtain because, except for start of the pursuit the ADSEC and
M-407, they were short of cranes, FECOMZ surgeons supervised all
forklifts, and other machinery for medical supply functions, including
moving heavy weights. Much of their reception of incoming goods and
initial stock arrived on the massive issues to the Communications Zone
sled-like skids intended for beach dis- and the armies. The ADSEC medical
embarkation and open-air storage. supply division processed all requisi-
Lacking equipment for lifting these
tions from the armies, either filling
skids, depot troops often had to
them from its own dumps or calling
unpack them on the trucks that
for emergency shipments from Great
brought them, thereby delaying the
release of scarce vehicles. At Le Mans Britain. As it moved away from the
and Chartres they hit upon the expe- coast, the Advance Section turned
dient of digging pits into which trucks over its beach installations to the
could back, bringing the decks of Normandy Base Section, the surgeon
their cargo compartments level with of which thereafter oversaw reception
the ground and permitting other vehi- and forwarding of medical supplies
cles, or men with ropes, to drag off that arrived by sea. The Advance Sec-
the skids. Open-field depots dissolved tion set up the depots at Rennes, Le
into quagmires, as heavy traffic de- Mans, Chartres, and Reims, and then
stroyed the surfaces of dirt roads and left them to other base sections as it
as the fall rains soaked the country- continued to follow the armies. From
side. The mud became so deep at mid-August on, the Supply Division
M-406T that Red Ball trucks at times of the chief surgeon's office assumed
simply unloaded where they bogged direct technical supervision of receiv-
down. After much effort, the 30th ing, storage, stock control, and issu-
Company, which operated this depot, ing by all COMZ depots. The armies
managed to pave two roads with then requisitioned directly from the
gravel and obtained a portable con- depots through the regulating sta-
veyor to move freight from trucks to tions, entirely bypassing the ADSEC
the fields, where it rested on dunnage surgeon.47
made of brush and timber from the
nearby woods. At busy M-402, deep- 46
Surg, ADSEC, COMZ, Annual Rpt, 1944, p. 29;
ening mud finally defeated the efforts Surg, Normandy Base Section, Annual Rpt, 1944, p.
19; Surg, Seine Section, Annual Rpt, 1944, pp. 40-
of the 11th Medical Depot Company 41; 11th, 13th, and 30th Medical Depot Companies
to keep supplies moving, even though Annual Rpts, 1944.
47
the company reconditioned several Surg, ADSEC, COMZ, Annual Rpt, 1944, p. 27
and ex. K; Supply Division, OofSurg, ADSEC,
abandoned French and German trac- Weekly Activities Rpt, week ending 19 Aug 44,
tors to free mired vehicles. During Continued
344 EUROPEAN THEATER OF OPERATIONS
Beginning in September the 12th ADSEC requisitions with the Red Ball
Army Group-SHAEF tonnage alloca- space assigned to the medical service
tion systems dominated medical for that day. The Normandy Base
supply of the armies and ADSEC. Section loaded the supplies and start-
Under these systems each army and ed them forward, initially to the
the Advance Section received a daily Chartres terminal area and later to
allowance of supplies, which they di- Soissons and Sommesous. At the
vided among their own technical ser- latter two places ADSEC medical in-
vices as the basis for their requisi- transit storage points (MISPs),
tions. For the medical service First manned by detachments from the
Army, Third Army, and ADSEC allot- regulating stations, checked incoming
ments together varied from 20 to 90 Red Ball trucks for medical service
tons a day, depending on the period freight and either directed the drivers
of the pursuit. At COMZ headquar- to final destinations or unloaded the
ters medical supply officers, working cargo and held it for pickup by the
with the G-4, reconciled army and armies.
Through tonnage allocation and
Beasley Papers, MHI; Surg, Normandy Base Section,
Annual Rpt, 1944, pp. 18-19; Fenton Interv, 7 Jun the Red Ball Express, the medical ser-
45, box 222, RG 112, NARA. vice was guaranteed transportation
THE EXPANDING COMZ 345
and drugs. In Paris alone the Seine During the pursuit the Communica-
Section discovered 127 separate tions Zone kept supplies flowing to
caches of enemy medical matériel—in the armies at a rate sufficient to meet
warehouses, office buildings, tunnels, the fortunately reduced requirements
barracks, barges, railroad cars, and of a period of mobile warfare with
hospitals. The American collected light casualties. It also filled the day-
these supplies, made inventories, to-day needs of its own holding units,
checked medicines for safety and cor- general hospitals, and other installa-
rect labeling, and separated out items tions. Only COMZ medical units in
already in the medical service catalog army areas reported difficulty in se-
or which could substitute for standard curing supplies; not permitted to
Army goods. They issued the rest of draw for expendables on scanty army
the matériel to civil affairs units, local stocks, these organizations had to
health authorities, and POW camp send their own trucks long distances
dispensaries. In September, elements back to ADSEC or the beaches, or to
of the 13th Medical Depot Company call for emergency air shipments.
set up in Reims a central collecting Medical supply officers, by loading
point for captured supplies in what stores on anything they could find
had been a major German medical that was moving forward, made at
51
Supply Division, OofCSurg, HQ, ETOUSA,
least a start on building reserves close
Annual Rpt, 1944, sec. II, ex. III, pp. 1-2 and 14-
52
15; Fenton Interv, 7 Jun 45, box 222, RG 112, Surg, ADSEC, COMZ, Annual Rpt, 1944, p. 28
NARA; Surg, Normandy Base Section, Annual Rpt, and ex. K; Supply Division, OofCSurg, HQ,
1944, pp. 20-21; Surg. Seine Section, Annual Rpt, ETOUSA, Annual Rpt, 1944, sec. II, pp. 16-17;
1944, pp. 39-40; Surg, ADSEC, COMZ, Annual Rpt, Surg, Seine Section, Annual Rpt, 1944, pp. 38-39;
1944, p. 29; Surg, ADSEC, Daily Activities Rpt, 31 Surg, Oise Base Section, Annual Rpt, 1944, pp. 3-4;
Aug 44, Beasley Papers, MHI; 30th and 66th Medi- 13th Medical Depot Company Annual Rpt, 1944,
cal Depot Companies Annual Rpts, 1944. pp. 15-16.
348 EUROPEAN THEATER OF OPERATIONS
to the front. As was true for evacu- the main advance to supply the VIII
54
ation, the framework of a continental Corps in Brittany.
medical supply system was in place by For General Hawley and his assist-
53
the end of October. ants, the question late in July was
whether the detachments would have
Supplying Whole Blood enough blood to distribute. The first
two months of combat surgery in
The European Theater whole blood evacuation and field hospitals con-
distribution system, carefully planned firmed what medical officers had an-
and organized before D-Day, was in ticipated before D-Day: that the rate
full operation by the time of the St.- of blood usage would be high and
Lo breakout. Behind each of the that the theater, from its own sources,
armies, an ADSEC blood bank de- would not be able to meet the
tachment, located at a resupply air- demand. Whereas the writers of the
field, received daily planeloads of Manual of Therapy envisioned surgeons
blood from the Salisbury bank, which administering approximately 1 pint of
sent it across the Channel packed in whole blood to every 2 of plasma, the
ice in insulated Marmite cans de- actual ratio was nearer 1 to 1. Sur-
signed originally as Quartermaster geons in Normandy used an average
of 1 pint of whole blood for every 4
food containers. Refrigerator trucks
casualties. On visits to the forward
of the ADSEC detachments delivered hospitals Hawley and his consultants,
the blood to counterpart units with after careful observation, concluded
the First and Third Armies; the army not only that such lavish (as they
detachments in turn distributed the thought) transfusion of whole blood
precious fluid to evacuation hospitals was clinically justified, especially in
and clearing stations. Colonel Beas- combating shock, but that patients
ley's deputy surgeon, Colonel Mason, probably would benefit from even
who had helped set up the system, more blood than surgeons were ad-
now directed its operation, working ministering. At first sceptical, Hawley
closely with the army group and army was later to recall that doctors in the
surgeons. The blood supply service Normandy evacuation hospitals
encountered typical difficulties of the
pursuit, such as diversion of its vehi- 54
Assignments were: First Army - Detachment A,
cles to other missions and inability of with Detachment B in COMZ; Third Army - Detach-
ment C, with Detachment D in COMZ. See Ken-
truck drivers to find rapidly moving drick, Blood Program, pp. 518-21, 532-35, 549-51;
evacuation and field hospitals. In gen- Supply Division, OofCSurg, HQ, ETOUSA, Annual
eral, though, the whole blood system Rpt, 1944, sec. II, p. 20; Surg, ADSEC, COMZ,
Annual Rpt, 1944, pp. 55-56; Surg, ADSEC, Daily
worked smoothly, even as supply lines Activities Rpts, 22 Jul and 16 Aug 44, Beasley
lengthened and one ADSEC detach- Papers, MHI; Surg, Brittany Base Section, Annual
Rpt, 1944, p. 5. On operating difficulties, see Ltr,
ment was taken away from support of Hawley to Col J. A. Rogers, 19 Jul 44, file HD 024
ETO CS (Hawley Chron); Surg, XII Corps, Annual
53
For COMZ unit supply problems, see 9th Field Rpt, 1944, p. 6; Surg, XX Corps, Annual Rpt, 1944,
Hospital Annual Rpt, 1944, p. 13; 15th General p. 24; Joseph B. Mason, "The Role of ADSEC in
Hospital Annual Rpt, 1944, p. 8; and 127th General the Supply of Whole Blood to the Twelfth Army
Hospital Annual Rpt, 1944, p. 7. Group," The Military Surgeon 103 (July 1948): 9-14.
FLIGHT NURSE LIFTING MARMITE CAN OF ETO BLOOD ONTO A CONTINENT-BOUND C-47
350 EUROPEAN THEATER OF OPERATIONS
"made a Christian out of me. They it, even though he himself feared that,
convinced me." Accordingly, army given the time required for shipment,
blood requirements increased. By the blood from the United States would
end of June the First Army was con- have only a short usable life in the
suming about 500 pints a day, in European Theater. After a final con-
effect the entire production capacity ference with his consultants on 28
of the Salisbury bank. The Third July, Hawley four days later radioed
Army, as it prepared to go into to General Kirk a request for a daily
action, requested 300 pints a day ini- transatlantic blood airlift of up to
tially, to be increased to 550 as its 1,000 pints. In a follow-up letter he
front expanded, an amount that the informed the surgeon general that the
theater blood bank, with its donor Air Transport Command had agreed
pool of COMZ troops shrinking as to provide long-range C-54s for the
units moved to France, could not pos- mission, and insisted that blood was
sibly furnish. With a shortage immi- being used economically and that it
nent, the 12th Army Group surgeon was "saving lives and hastening re-
early in August began daily allocation covery of patients." 56 Hawley also ar-
of the available blood to the armies to ranged to fly Colonel Cutler, his chief
ensure its most efficient use. Evacu- surgical consultant, Major Hardin, of-
ation and general hospitals set up
ficer in charge of the ETO blood
their own blood banks, drawing from
bank, and Col. William F. MacFee,
their personnel and the lightly
MC, a veteran evacuation hospital
wounded. They used German POWs
as donors for their injured country- commander, to Washington to plead
men.55 the theater case in person. The three
These expedients, however, were men left Prestwick on 12 August.
but stopgaps. Hawley and his assist- Even as the delegation was air-
ants realized that the theater needed borne, the issue was all but settled. In
an additional source of whole blood early August General Kirk, on the
and that the only possible one was basis of additional study and of first-
the United States. Surgeon General hand observation on a trip to the
Kirk, before the invasion, had reject- Mediterranean Theater in July 1944,
ed as unnecessary and impractical a reversed his earlier decision against
theater proposal to fly blood across shipping blood overseas and put his
the Atlantic. Nevertheless, under Surgery Division to work on tentative
pressure of necessity, Hawley revived plans for a blood airlift to Europe. By
the time Cutler and his colleagues
55
Quotation from Editorial Advisory Board, 1962, landed in Washington, Kirk's consul-
pp. 107-08. See also Kendrick, Blood Program, pp. tants already had worked out a
484-87 and 556-65; Surg, ADSEC, COMZ, Annual method for shipping blood and had
Rpt, 1944, pp. 53-54; Admin Memo No. 2, Surg,
ADSEC, 5 Aug 44, in Essential Technical Medical tested it by flying sample lots to
Data Rpt, HQ, ETOUSA, August 1944; Medical Di- Prestwick, Bermuda, Los Angeles, and
vision, COSSAC/SHAEF, War Diary, August 1944; Hawaii. All that remained for the
Ltr, Hawley to Rogers, 19 Jul 44, file HD 024 ETO
CS (Hawley Chron). For a dissenting view of blood
56
use, see Keeler Interv, 17 Jul 45, box 223, RG 112, Ltr, Hawley to TSG, 5 Aug 44, file HD 024
NARA. ETO O/CS (Hawley-SGO Corresp).
THE EXPANDING COMZ 351
MAP 15
ETO representatives to do was to 54s unloaded the blood at Prestwick,
help work out detailed arrangements, for movement by truck to Salisbury
which they promptly did.57 and transfer to C-47s for the cross-
Blood flights began on 21 August, Channel flight. Late in October trans-
with a shipment of 258 pints from atlantic planes carrying blood began
New York, via Newfoundland, to landing at Orly Field, near Paris,
Prestwick (Map 15). Under the formu- eliminating the time-consuming extra
la worked out by Cutler in Washing- handling in Great Britain. Kept refrig-
ton, the daily amounts were to in- erated except while actually on the
crease to 500 pints on 28 August and airplane, the preserved American
1,000 by 11 September. Actual deliv- blood could be used safely for at least
eries reached a little over 500 pints eight or nine days after it reached the
per day in late October, the reduction theater. Blood from the United States
from the scheduled goal resulting soon predominated in ETO stocks.
from a decrease in demand. The Red During September, for example, the
Cross collected the fresh blood at armies received about 11,000 pints
centers on the East Coast and in the from America and only 5,600 from
Midwest, processed it, and put it up within the theater. Ironically, the be-
for shipment in 1,000 cc. bottles con- ginning of shipments from the United
taining equal amounts of blood and States coincided with a decline in cas-
Alsever's solution, a preservative. So ualty rates. In late September the
prepared, the blood could be flown medical service possessed a surplus of
without refrigeration, which saved about 6,000 pints and made special
weight. Air Transport Command C- efforts to use up the oldest blood
57
before it had to be discarded.58
Kendrick, Blood Program, pp. 487-93; Ltrs, TSG
58
to Hawley, 11 Aug and 1 Sep 44, file HD 024 ETO Unlike ETO blood, which contained no preser-
O/CS (Hawley-SGO Corresp); Hawley Interv, 1962, vative and was shipped in food cans packed with ice,
p. 62, CMH. Continued
352 EUROPEAN THEATER OF OPERATIONS
The theater blood bank reorga- the high side. Clearly, the whole
nized and expanded for continental blood service, with its supplies now
operations. Under plans made back in assured, had proved to be one of the
April, the medical service converted ETO medical service's major logistical
59
the newly arrived 127th Station Hos- successes.
pital into a second blood bank unit.
On 26 August the 127th took over On the Eve of New Battles
the Salisbury collection and process-
ing plant. The veteran 152d Station During the three months following
Hospital then moved to Paris, first to the breakout from Normandy, the
temporary quarters at the 203d Gen- medical service, like the other techni-
eral Hospital and then to a perma- cal services, saw its preinvasion plans
nent facility at Vitry. This unit, begin- for orderly development of the Com-
ning early in November, received all munications Zone swept aside by
blood sent to the Continent from events. The chief surgeon and his as-
Britain and the United States and dis- sistants constructed evacuation, hospi-
tributed it to ADSEC detachments. It talization, and medical supply systems
also collected blood locally from on the run, while trying to meet the
COMZ troops. At the front the four daily needs of the armies and to push
detachments serving the First and people and equipment forward along
Third Armies were augmented on the axes of advance. By late October
1 November by Detachments A and B they had completed the framework of
of the 127th Station Hospital, which a medical Communications Zone
supported the recently deployed stretching from the beaches to the
Ninth Army. Refrigerator trucks of army rear boundaries. General hospi-
these units regularly distributed as tals were in operation at key points in
many as 20,000 pints of blood a France and Belgium, supply depots
month, with losses of less than 10 were being stocked, and rail and air
percent from breakage, refrigerator evacuation channels were increasing
failure, and deterioration from lack of in variety and efficiency.
use. The latter wastage was unavoid- Nevertheless, the medical support
able, for army medical units requisi- system gave evidence of its hurried,
tioned daily on the basis of casualty disorderly origins. It incorporated
estimates and thus preferred to err on major inefficiencies, such as employ-
ment of many of the theater's best
American blood traveled all the way to the front in staffed general hospitals as holding
cardboard containers, each holding six bottles. See and transit units. Air evacuation, the
Kendrick, Blood Program, pp. 208-10, 493-96, 538- most rapid and clinically beneficial
41, 554-55; Essential Technical Medical Data Rpts,
HQ, ETOUSA, August 1944, pp. 13-14, September means of moving patients, remained
1944, p. 13, and October 1944, p. 4; Supply Divi- at the mercy of weather and adminis-
sion, OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, trative uncertainties. There existed
sec. II, p. 22; Medical Bulletin No. 25, OofCSurg,
HQ, ETOUSA, 1 Nov 44, sub: The Supply of Pre-
59
served Blood From the Zone of Interior to the Eu- Kendrick, Blood Program, pp. 513-17 and 566-
ropean Theater of Operations; Ltr, Hawley to TSG, 67; Surg, ADSEC, COMZ, Annual Rpt, 1944, pp.
14 Sep 44, file HD 024 ETO O/CS (Hawley-SGO 54-56; Essential Technical Medical Data Rpt, HQ,
Corresp). ETOUSA, October 1944, p. 4.
THE EXPANDING COMZ 353
within the medical service, also, other these deficiencies would become ap-
organizational weaknesses and per- parent, and provoke vigorous efforts
sonnel and matériel shortages largely to overcome them, during the winter
overlooked in the triumphant forward of hard, costly fighting that lay ahead
rush of the summer. The effects of all at the West Wall.
CHAPTER XI
tifications, and introduce new weap- On the southern flank of this attack
ons. The Germans, however, had the First Army fought possibly the
used all too well what breathing space bitterest battle of the campaign for
the September and October pause in the Huertgen Forest, a gloomy road-
Allied attacks had given them. By the less tangle of fir trees, hills, and ra-
time the new offensive started, their vines. Although the Americans
desperate late-summer mobilization cleared the woodlands in the end,
had produced enough troops to con- combat for the infantrymen of five di-
tain the Allied advance while accumu- visions who battled there was a night-
lating a 25-division reserve for Hit- mare of endless minefields, treetop
ler's projected grand counterattack. shellbursts, hidden pillboxes and ma-
Gone were the days of swift break- chine-gun nests, and fierce German
throughs and hell-for-leather armor counterattacks. A rifle company in the
exploitation. The battle became one Huertgen Forest could lose 100-200
of attrition, as British, French, and percent of its original strength in a
American divisions crawled forward week's fighting; battalion and compa-
against tenacious resistance. The Ger- ny officers and NCOs were killed and
mans drew upon the hard-learned de- wounded or broke down in near-dis-
fensive experience of five years of war astrous proportions. A 4th Infantry
and made lavish, effective use of Division soldier summed it up:
mines and artillery; they exacted a
fearful price in men and time for You can't get all of the dead because you
can't find them, and they stay there to
every town, village, ridgeline, river remind the guys advancing as to what
crossing, and pillbox. The rain, snow, might hit them. You can't get protection.
and freezing temperatures of one of You can't see. You can't get fields of fire.
the earliest and severest winters on The trees are slashed like a scythe by ar-
record in that part of Europe reduced tillery. Everything is tangled. You can
scarcely walk. Everybody is cold and wet,
Allied mobility and air support and and the mixture of cold rain and sleet
added to the misery of the combat- keeps falling. Then they jump off again
ants on both sides. and soon there is only a handful of the
2
Nevertheless, through hard pound- old men left.
ing and steady pressure the Allies South of the Ardennes the enemy
made limited territorial gains. On defended with similar tenacity, but
their left wing the British Second and American troops gained more
Canadian First Armies conquered the
ground. Patton's Third Army crossed
German forces blocking the seaward
the rain-swollen Moselle in force;
approaches to Antwerp, thus opening
took Metz on 22 November; and a
that great port to shorten Allied
month later, after liberating 5,000
supply lines; then they liberated most
of southern Holland. The U.S. Ninth square miles of Lorraine, reached the
and First Armies, attacking side by German border at the Saar River. On
side, forced their way well inside the the right of the Third Army the 6th
German frontier and drove almost to 2
Interv, T5g George Morgan, 1st Battalion, 22d
the Roer River, the last major water Infantry, in 4th Infantry Division Combat Intervs,
barrier between them and the Rhine. box 24021, RG 407, NARA.
356 EUROPEAN THEATER OF OPERATIONS
Army Group cleared the west bank of crippled soldiers, many permanently
the Rhine from the Swiss border to incapacitated for combat duty, and
Strasbourg, except for a German-held further diminished the already casual-
bridgehead around Colmar. While the ty-thinned ranks of the infantry.4
French First Army battered at this
pocket, the U.S. Seventh Army in Organizing for the Offensive
early December pushed northeast-
ward though the old Maginot Line Redeployments and exchange of
fortifications and prepared to assault medical units accompanied the reor-
the West Wall. The American armies ganization of the American armies for
thus captured significant territory, the November offensive. New ground
though less than their commanders force medical formations continued to
had hoped to secure. In addition, arrive in the theater, increasing the
they inflicted tens of thousands of number of medical personnel in the
German casualties, destroyed large armies to over 65,000 by mid-Decem-
quantities of equipment, and took ber. The 12th and 6th Army Group
3
almost 200,000 prisoners. surgeons, in consultation with those
The four American armies paid a of the armies and with Generals
high price for this ground and the Kenner and Hawley, distributed the
wearing down of German forces. Be- new arrivals and reshuffled the forces
tween them, they suffered over already on the ground to give each
140,000 battle casualties, more than army a medical complement propor-
85 percent of them in the infantry tional to its strength.5
rifle companies. Among the approxi- The Ninth Army, for example, ini-
mately 100,000 wounded, the pattern tially entered the line in the Ardennes
of cause and location of injury resem- with the 64th Medical Group, sup-
bled that in earlier phases of the cam-
paign. About 65 percent fell victim to 4
MacDonald, Siegfried Line, p. 617; Cole, Lorraine
shell, bomb, and grenade fragments, Campaign, pp. 592-93; Surg, First U.S. Army,
and a similar proportion were hit in Annual Rpt, 1944, pp. 5-6; First U.S. Army Report
of Operations, 1 Aug 44-22 Feb 45, bk. IV, pp. 139,
the arms and legs. Besides combat 179, 201, 205; Surg, Third U.S. Army, Annual Rpt,
casualties, army hospitals during No- 1944, pp. 43-44, 104, 108, ex XXVII; Surg, Seventh
U.S. Army, Annual Rpt, 1944, pp. 29-32 and 37d-
vember and December admitted an- 37f; Seventh U.S. Army Report of Operations,
other 150,000 cases of injury, sick- 1944-1945, vol. III, p. 1,029; Surg, Ninth U.S.
ness, and combat fatigue. The cold Army, Annual Report, 1944, pp. 20-22; Surg, Ninth
U.S. Army, Combat Experience Tables of Casual-
damp weather increased the incidence ties, Ninth U.S. Army, October-December 1944
of respiratory ailments. An epidemic (hereafter cited as Combat Experience Rpt, with
of trenchfoot crowded clearing sta- month), file HD 319.1-2. For typical casualty distri-
tions and evacuation hospitals with bution among arms, see Surg, XIX Corps, Annual
Rpt, 1944, encl. 20.
5
Ground forces medical personnel amounted to
3
This account is based on MacDonald, Siegfried about 32-38 percent of the total theater medical
Line, passim; Cole, Lorraine Campaign, passim; Robert strength of over 212,000 in late December. See Per-
R. Smith and Jeffrey J. Clarke, The Riviera to the sonnel Division, OofCSurg, HQ, ETOUSA, Annual
Rhine (Washington, D.C.: U.S. Army Center of Mili- Rpt, 1944, app. D. MFR, Col B. A. Holtzworth, 8
tary History, forthcoming), chs. XVI-XXVI; Seventh Jan 45, sub: Notes on Service Troops, Moses
U.S. Army Report of Operations, France and Ger- Papers, MHI, gives 12th Army Group standards for
many, 1944-1945, vol. II, pp. 456-94, 505-13, 529. field army medical troop strength.
HARD FIGHTING AT THE WEST WALL 357
porting the VIII Corps, as well as sev- Third Army an additional medical
eral former Third Army field and battalion headquarters, three collect-
evacuation hospitals and other units ing companies, a clearing company,
taken over in Brittany. When it and a field hospital, as well as the
moved to Holland and joined the Third's XV Corps. SHAEF at the
12th Army Group's left wing, the same time directed the European
army relinquished these organiza- Theater and 12th Army Group to
tions, except for two field hospitals, provide the southern army with three
to the First Army and assumed com- additional ambulance companies,
mand in turn of the 31st Medical three evacuation hospitals, a depot
Group, which supported the XIX company, and part of an auxiliary sur-
Corps (taken over from the First gical group. Both headquarters com-
Army) and three evacuation hospitals. plied, in part by transferring units al-
The new army also inherited several ready in France to the 6th Army
evacuation hospitals and field hospital Group and in part by diverting new
platoons serving American divisions, units then still in the continuing flow
including the 82d and 101st, which of troops across the Atlantic. Late in
were fighting in Holland under 21 November, with planning under way
Army Group in the aftermath of to expand Seventh Army to three
MARKET-GARDEN. Other Ninth Army corps and nine divisions, SHAEF
medical units, arriving from the called on the northern forces for still
United States and Great Britain, as- more field medical units, and they
sembled at concentration areas in again responded with redeployments,
France and Belgium and then moved to include, whenever possible, redir-
into Holland to support the army's ecting reinforcements already at sea
second corps, the XIII, when it began to the French Mediterranean ports.
6
operations late in November. Augmentation of the Seventh Army
The Seventh Army came ashore on medical service did not go altogether
the Riviera with a complement of smoothly. Colonel Gorby, the 12th's
medical battalions, of ambulance, surgeon, resisted turning over an aux-
clearing, and collecting companies, iliary surgical group, insisting he
and of field and evacuation hospitals needed it for his own still expanding
sufficient only for a single corps. As army group, but in the end he com-
SHAEF added to that army's combat plied with SHAEF directions. The 6th
strength, it also reinforced the medi- Army Group surgeon, Col. Oscar S.
cal service—a process involving multi- Reeder, MC, and the Seventh Army
lateral consultations among the sur- surgeon, Colonel Rudolph, at times
geons of the two army groups, four disagreed in estimating their require-
field armies, and two separate com- ments. Reeder, for example, accepted
munications zones. During September a medical group headquarters, taken
the Seventh Army acquired from the from the Third Army, for which the
6
Seventh Army surgeon had no use,
Surg, Ninth U.S. Army, Annual Rpt, 1944, pp. but withdrew a request for a gas
8-9 and 11-13; Surg, First U.S. Army, Annual Rpt,
1944, p. 48; First U.S. Army Report of Operations, treatment battalion that Rudolph
1 Aug 44-22 Feb 45, bk. IV, p. 136. wanted. The medical units assigned
358 EUROPEAN THEATER OF OPERATIONS
one American army to oversee and, For the army surgeons, and for
until May 1945, was submerged those at corps and division levels,
within the group G-4 office instead of planning and coordinating medical
constituting a separate special staff support for the November-December
9
section. offensive was a comparatively
Day-to-day direction of activities, straightforward task. The surgeons
both administrative and clinical, confronted a problem similar to that
rested primarily with the army sur- in the hedgerow battles: evacuation of
geons and their fifty- to sixty-person a large but steady volume of casual-
staffs. The surgeons of all four armies ties over relatively short distances
had satisfactory working relationships from slowly advancing combat units.
with their army commanders, who Until the German Ardennes counter-
generally paid little attention to the stroke, the Allies held the tactical ini-
medical service except on the exceed- tiative; hence, surgeons generally
ingly rare occasions when something could forecast accurately the rates
went drastically wrong. Usually locat- and locations of casualties and the
ed with the forward, or tactical, eche- supply and evacuation requirements
lon of army headquarters, the sur- of each stage of the attack. The ab-
geons participated in all stages of sence of major breakthroughs, al-
operational planning. For practical though disappointing to tactical com-
purposes, they had operational con-
trol of nondivisional medical units, al- 10
First U.S. Army Report of Operations, 20 Oct
though the formal definition of this 43-1 Aug 44, bk. 1, pp. 16-17; Surg, Third U.S.
Army, Annual Rpt, 1944, pp. 37-38 and 68-70;
authority varied from army to army. Surg, Ninth U.S. Army, Annual Rpt, 1944, pp. 3 and
Their medical and surgical consult- 6; Surg, Seventh U.S. Army, Annual Rpt, 1944, pp.
ants supervised patient care and en- 116 and 129; Hartford Interv, 7-8 Oct 80, tape 1,
side 2, CMH; Editorial Advisory Board, 1962, pp.
forced the principles of the ETO 97-98. In Shambora Papers, MHI, see Surg, Ninth
Manual of Therapy, as well as appor- U.S. Army, Daily Journal, 1 Nov 44; Memo, Col W.
tioning auxiliary surgical teams E. Shambora to ACofS, G-4, Ninth U.S. Army, 12
Jun 45, sub: Organization of the Medical Section,
among army hospitals. Army surgeons HQ, NUSA; Memo. Reinstein to Surg, Ninth U.S.
Army, 9 Sep 44, sub: Observation of Medical Ser-
9
Gorby Interv, 1962, p. 5, CMH; Hartford Interv, vice in Operation, TUSA; and Memo, HQ, ADSEC,
7-8 Oct 80, tape 1, side 2, CMH; Surg, 6th Army COMZ, to Surg, Ninth U.S. Army, 28 Sep 44, sub:
Group, Annual Rpt, 1944-1945, pp. 1-3. Liaison Officer.
360 EUROPEAN THEATER OF OPERATIONS
vidual first aid packet, containing field lives. He13just held it there and didn't get
dressings and sulfa powder and tab- excited.
lets, and was supposed to know how Fortunately, comparatively few
to improvise and apply splints and wounded men—only one in five, ac-
tourniquets. First aid procedures cording to one hospital survey—had
called for a wounded man, if able, to to give themselves first aid. Most
seek protection from fire, examine his found a company aidman at their
injury and assess its severity, sprinkle sides within less than half an hour of
it with sulfa powder, apply a dressing, being hit. Besides bandaging, splint-
and swallow his sulfa tablets. Then he ing, applying tourniquets, administer-
was to get back to the aid station on ing sulfa powder and tablets, and
his own or call for the aidman. injecting morphine, aidmen were
In practice, a large proportion of supposed to fill out an emergency
the wounded forgot to do, or could medical tag (EMT) for each casualty,
not do, any number of these things. providing the basic record of his
Of casualties polled in COMZ general identity and initial treatment. Many
hospitals, for example, about one- divisions in practice transferred this
third did not take their sulfa pills chore to the battalion aid stations, for
before they reached the aid station, the company medics, amid the urgen-
claiming that they lacked water to cy and danger of combat, were hardly
wash them down; doubted the tablets' in an ideal position to do paper work.
usefulness; or were incapacitated by Company aidmen had a deserved rep-
their injuries. Soldiers often did not utation for bravery but they com-
have their belt first aid packets on plained that some of their heroics
their persons when hit. "They'd take were unnecessary, the result of panic
them off," an aidman reported, "for calls for help by the slightly injured
example to be more comfortable in a or of poor judgment by line officers
fox hole, and we'll usually find the in sending out their medics under
belts [and packets] lying close by." fire. One medic commented: "If a
Hurt, frightened soldiers yelled franti- man is hit, he's hit, and it may be
cally for the aidman even when only better to leave him there for a while
slightly wounded and capable of leav- than to send the aid man to him on a
ing the field under their own power. suicide job—for example, I've seen it
Many, in panic, further injured them- done when mortars were pounding
selves, at times fatally. A company the area and every foot was covered
aidman recalled the actions of with [machine-gun] fire." 14
a lieutenant. He got hit and just had a
little bit of gut hanging out and he sits up 13
Rpt No. E-81, Research Branch, Special Ser-
and lies down and hollers and thinks he is vices Division, ETO, September 1944, sub: Opin-
going to die and we fix him up but he's ions of Wounded Combat Veterans on Battlefield
still excited and pretty soon air gets in First Aid Treatment (hereafter cited as ETO, Battle-
and he dies. That same day there's a field First Aid Rpt, 1944), pp. 2-5, file HD:ETO:
350.07:Battle Experiences. Quotations from app.,
Jerry with all his guts hanging out. He pp. ii and iii.
puts his hand down there and holds it in. 14
Quotation from ETO, Battlefield First Aid Rpt,
We get him to the aid station and we 1944, app., p. ii, file HD:ETO:350.07:Battle Experi-
hear later that the son-of-a-bitch still Continued
362 EUROPEAN THEATER OF OPERATIONS
Most demands for courage on the from one casualty to the next. Finally
par of aidmen, however, were legiti- too weak to move, he instructed other
mate and essential to their mission, soldiers in giving first aid until un-
and the medics responded with dedi- consciousness overcame him. His unit
cation and self-sacrifice. During the credited Wilson, who received a post-
Third Army fighting along the Mo- humous Medal of Honor, with help-
selle, for example, Technician 5th ing to save the lives of at least ten
Class Alfred L. Wilson, a company men. A 4th Division captain reported
aidman in the 328th Infantry, moved of another aidman in the Huertgen
about under heavy shelling treating Forest who similarly stayed on duty
his unit's many wounded until badly after being injured: "This man was
hurt himself. He refused evacuation perhaps an even greater morale aid
and, in great pain and slowly bleeding than a physical aid" to the hard-
to death, continued dragging himself pressed riflemen around him.15
15
ences. On EMTs, see Surg, 5th Infantry Division, Quotation from Interv, Capt D. Faulkner, in 4th
Annual Rpt, 1944, pp. 34-35, and Rpt No. 368, Infantry Division Combat Intervs, box 24021, RG
Army Ground Forces Board, 18 Nov 44, sub: Medi- 407, NARA. Wilson's citation is in U.S. Congress,
cal Information, 8th Infantry Division, p. 4. Continued
HARD FIGHTING AT THE WEST WALL 363
ing to the rear on his back two men out of spare medical troops, the
from an infantry company with which group obtained 190 nonmedical in-
he had worked for some time and to fantry replacements from one of the
which he had grown closely attached, depots. It issued them Red Cross
began muttering, "They're killing my brassards; sketchily trained them in
boys; they're killing my boys." He first aid, evacuation, and Geneva Con-
tried to find a rifle with which to fight vention rights and duties; and threw
back and "had to be evacuated for them into the line for several weeks.
combat exhaustion." 21 On another occasion the Advance
Infantry battalion and collecting Section sent the First Army a contin-
company litterbearers (the latter all
gent of litterbearers combed out of
but supplanted by ambulances for
staging general hospitals. Even with
work to the rear of the aid stations)
customarily combined forces to all this extra help, the rifle companies
remove wounded from the battlefield. often had to draft combat soldiers
They were far too few for the job from their own thin ranks to carry
during intense combat and when wounded at least part of the way to
weather, terrain, or the tactical situa- their battalion aid stations. These ex-
tion prevented vehicles from assisting pedients met the immediate require-
them. The Huertgen fighting, in par- ments. The necessity for them, how-
ticular, absorbed bearers at an almost ever, pointed up the inadequacy of
intolerable rate. The 1st Infantry Di- the existing division complement of
vision, during its time in the forest, bearers and also underscored how in-
used 240 additional litterbearers; the dispensable, under the prevailing con-
4th Division employed 140. Under ditions, evacuation by vehicle had
prearranged procedures division sur- become.22
geons obtained these extra men, and With so much first aid being per-
also casualty replacements, from their formed on the field, battalion aid sta-
corps medical battalions and the army tions concentrated more on evacuat-
medical groups. These units drafted ing casualties than on treating them.
bearers from their own attached orga- The aid stations, by the time the No-
nizations and, in emergencies, drew vember offensive began, had honed
upon any other medical personnel and perfected their operational tech-
within reach. The 68th Medical
Group, for example, which supported 22
First U.S. Army Report of Operations, 1 Aug
the VII Corps, provided infantry divi- 44-22 Feb 45, bk. IV, pp. 130-40 and 144; Surg, V
Corps, Annual Rpt, 1944, p. 19; VII Corps Medical
sions in the Huertgen Forest with Plan, pp. 89-91 and 97-98, encl. 1 to Surg, VII
over 450 reinforcement bearers, in- Corps, Annual Rpt, 1944; 68th Medical Group
cluding the enlisted personnel of two Annual Rpt, 1944, pp. 16, 19-21, 25; 134th Medical
Group Annual Rpt, 1944, p. 19; Surg, 1st Infantry
entire collecting companies. Running Division, Annual Rpt, 1944, pp. 22-23; Surg, 3d In-
fantry Division, Annual Rpt, 1944, encl. 1; Surg, 4th
21
Quotation from Tegtmeyer "Diary," pt. II, p. Infantry Division, Annual Rpt, 1944, p. 3; Surg, 8th
90. Second and third quotations from Intervs, As- Infantry Division, Annual Rpt, 1944, pp. 14-16;
sistant Surgeon and Aidmen, 1st Battalion, 22d In- Surg, 28th Infantry Division, Annual Rpt, 1944,
fantry, in 4th Infantry Division Combat Intervs, box encl. 5; Intervs, Company G, 22 Infantry, in 4th In-
24021, RG 407, NARA. See also Richardson Interv, fantry Division Combat Intervs, box 24021, RG 407,
tape 1, sides 1 and 2, CMH. NARA.
HARD FIGHTING AT THE WEST WALL 367
BATTALION AID STATION PERSONNEL READYING CASUALTIES for the next stage of their
rearward evacuation
niques. Because the stations, for radio contact with the company com-
safety reasons, had to keep their dis- mand posts. At night the telephone
tance from the rifle companies, battal- wires, and sometimes white tape
ion surgeons often established small stretched along the ground, guided
advance collecting points nearer the the rearward traffic of litterbearers
infantry. These typically consisted of and walking wounded. When casual-
an officer (frequently the assistant ties reached them, the surgeons and
battalion surgeon), a few litter teams, their enlisted technicians checked and
and a couple of jeep ambulances. replaced dressings, splints, and tour-
They gathered casualties and evacuat- niquets and dispensed additional
ed them to the main aid stations. The morphine. They filled out EMTs if
latter almost invariably found shelter company aidmen had not done so.
under roofs and preferably under- They normally administered the first
ground, in solidly constructed cellars plasma the wounded received. When
or abandoned dugouts, which afford- casualties came through in large num-
ed protection from shelling as well as bers, the aid stations, to get patients
the elements. To better direct evacu- out quickly, suspended tagging the
ation, battalion surgeons, whenever wounded and limited transfusion and
they could, established telephone or resuscitation to the minimum re-
368 EUROPEAN THEATER OF OPERATIONS
the disastrous attack of the 28th In- wounded in whatever vehicles were
fantry Division in the Huertgen Forest available to the 3d Battalion installa-
early in November. In this operation tion for relay on up the hill to the
the 1st and 3d Battalions of the 112th ambulance loading point.
Infantry seized a salient of key high As the American position at
ground around the villages of Schmidt and Kommerscheidt deterio-
Schmidt and Kommerscheidt, deep in rated, so did the evacuation situation.
German-held territory, and then came Linguiti and De Marco consolidated
under heavy infantry, tank, and artil- their two aid stations in the dugout.
lery counterattack from three sides. Disabled American tanks and other
The battalions' route of supply and vehicles along the trail and German
evacuation consisted of a narrow trail, shelling of the ambulance loading
muddy from the incessant rain, which point effectively halted evacuation of
wound its way down into the gorge of all but walking wounded, whom the
the Kall River and then up another surgeons sent to the rear in parties
ridge to the American-held town of led by medical troops. Litter patients,
Vossenack, some 2 miles northwest of eventually about sixty-five of them,
Kommerscheidt. Vossenack itself was accumulated in and around the
under intense German infantry attack, dugout. Linguiti and De Marco cared
as well as artillery bombardment from for them as best they could, helped
high ground to its northeast.
by their MAC assistant surgeons, the
The battalion surgeons, Captains
Paschal A. Linguiti, MC, of the 1st battalion chaplains, a dwindling con-
and Michael De Marco, MC, of the tingent of enlisted medics, and infan-
3d, faced a difficult evacuation prob- try stragglers whom the surgeons
lem. Ambulances from their support- disarmed and pressed into service as
ing collecting company—C, 103d attendants and litterbearers. The
Medical Battalion, which had its sta- medics had adequate food for their
tion near Vossenack—could not nego- patients and enough medical supplies
tiate the trail across the Kall. Hence, for what little treatment they were at-
the battalions had to send casualties tempting, but they were short of blan-
back in jeeps and weasels (the divi- kets and shelter. The dugout could
sion had large numbers of the latter accommodate only about twenty-five
attached for this operation) to an am- patients. The remainder, wrapped in
bulance loading point near the top of what coverings were available, lay
the ridge at Vossenack. Linguiti ini- along the trail in the cold, rain, and
tially set up his 1st Battalion aid sta- snow, protected by soldiers holding
tion in a basement in Kommerscheidt; Red Cross flags. This protection was
De Marco, with his 3d Battalion sta- needed because, during the final days
tion, took position about a mile far- of the battle, German troops infiltrat-
ther to the rear, west of the Kall, ing behind the 1st and 3d Battalions
sheltered in a cave-like 18-by-12-foot periodically visited the aid station.
dugout built into the steep hillside However, except for announcing that
that bordered the trail. The station in the medics were captured and making
Kommerscheidt in effect functioned sure that no armed Americans were
as an advance collecting point; it sent present, the Germans left the facility
370 EUROPEAN THEATER OF OPERATIONS
(see Diagram 4). Normally, the armies bypassed well over 50 percent of the
evacuated all patients who needed battle casualties they admitted.32
more than 10 days, on the average, of As the front stabilized, so did the
hospitalization. But they varied this locations at which patients passed
limit in response to the incidence of from the armies to the Communica-
casualties and the number of empty tions Zone. The First and Ninth
beds, with an eye always to keeping as Armies, during the fall and winter,
many salvageable men as possible sent casualties to ADSEC holding
within army boundaries until they re- units and general hospitals at Liege
turned to duty. Accordingly, during and to a holding unit at Verviers. The
the October lull in combat, the First Third Army evacuated through Toul,
and Third Armies adopted, respec- Etain, Nancy, and, as it approached
tively, 20- and 21-day evacuation poli- the German border, Thionville. The
cies. Under these they could retain Seventh Army, which continued to
the increasing number of soldiers rely on the separate Southern Line of
who came down with respiratory ail- Communications (SOLOC) for evacu-
ments as the weather turned cold and ation and long-term hospitalization,
wet, as well as their lightly wounded, evacuated through Luxeuil and Be-
their venereal disease cases, and sancon to Marseilles and Naples.
many neuropsychiatric patients. As Later in the campaign its holding
casualties increased again in Novem- units shifted northward to Bayon and
ber, the armies reverted to 14-day, Tantonville, about 10 miles south of
10-day, and even shorter policies. Nancy. With SOLOC slow to build up
The Ninth Army at one point ordered and short of hospital beds, the Sev-
the daily evacuation of all its trans- enth Army sent limited numbers of
portable patients, to clear beds for patients by air and rail to northern
fresh wounded from the front. At var- COMZ general hospitals in Paris, the
ious times during the offensive the Oise Base Section, and the United
First, Third, and Ninth Armies, their Kingdom. Increasingly, during late
evacuation hospitals rapidly filling to 1944, ADSEC and its southern coun-
capacity, all resorted to "bypassing." terpart, Continental Advance Section
When this policy was in effect, evacu- (CONAD), took over the operation of
ation hospitals stopped performing holding units in rear of the armies
surgery on all but the most severe and the ambulance evacuation of cas-
and urgent cases. They sent other ualties from army hospitals. Only the
surgical patients, after brief stabilizing Third Army continued to maintain
treatment, immediately to COMZ
general hospitals close in rear of the 32
First U.S. Army Report of Operations, 1 Aug
armies. By this means the army instal- 44-22 Feb 45, bk. IV, pp. 137 and 163-64; Surg,
lations reduced their own surgical Third U.S. Army, Annual Rpt, 1944, pp. 45 and 79;
Surg, Ninth U.S. Army, Annual Rpt, 1944, p. 28;
backlogs, while low-priority patients Surg, Ninth U.S. Army, Combat Experience Rpt,
actually reached the operating table November 1944, file HD 319.1-2; Memo, Kenner to
sooner than they would have in the CofS, SHAEF, 5 Dec 44, sub: Report of Inspection,
Medical Service, First and Ninth U.S. Armies, Inclu-
evacuation hospitals. First Army hos- sive Period 20-30 Nov 44, in Medical Division,
pitals, at the height of the offensive, COSSAC/SHAEF, War Diary, December 1944.
HARD FIGHTING AT THE WEST WALL 377
its own air-rail holding unit, and Army Hospitals at Work
its 69th Medical Group shared with
ADSEC the work of transporting pa- In each field army, during late
tients to the Communications Zone 1944, the hospital system reached full
(see Map 16). development. Field hospital platoons
All the armies continued to evacu- attached to division clearing stations
ate their severely wounded by air worked on the most urgent emergen-
from forward fields whenever possi- cy surgical cases. Evacuation hospitals
ble. However, as flying weather wors- handled the transportable severely
ened and rail service steadily expand- wounded, the patients with minor in-
ed, hospital trains carried the greater juries, and most of the sick. A conva-
proportion of patients leaving the lescent hospital in each army relieved
army areas. On the whole, the flow of the evacuation hospitals of nearly re-
casualties from the armies went covered patients and reconditioned
smoothly during the November and them for return to duty. Improvised
December battles. Interruptions of special facilities cared for soldiers
evacuation, such as had clogged army with contagious or communicable dis-
facilities at the end of the pursuit, eases and venereal infections, as well
became increasingly rare as ADSEC as for neuropsychiatric casualties.
and CONAD enlarged the quantity Surgical work in the armies cen-
and variety of their means of trans- tered in the field and evacuation hos-
portation, and as the slow progress of pitals. Field hospital surgeons spent
the offensive reduced the need to most of their time operating on men
move forward holding units and with massive chest and abdominal in-
extend rail lines. In evacuation, as in juries, severe compound fractures,
other aspects of medical support, bad and traumatic amputations. Their
news for the tactician was, paradox- principal objective was to keep their
ically, good news—in terms of oper- patients alive and to place them in
ational efficiency—for the logisti- condition for further evacuation.
cian.
33
Postoperative death rates in these in-
stallations ran between 12 and 25
33
Medical Division, COSSAC/SHAEF, War Diary, percent, higher than in any other type
October-December 1944; First U.S. Army Report of of hospital, and reflected the all but
Operations, 1 Aug 44-22 Feb 45, bk. IV, pp. 136-
37 and 140; Surg, Third U.S. Army, Annual Rpt, hopeless condition of many of the
1944, pp. 80-85; Surg, Ninth U.S. Army, Annual wounded who arrived on their operat-
Rpt, 1944, pp. 12-13; 69th Medical Group Annual ing tables. All too common were
Rpt, 1944, pp. 11-12 and 16-17; 134th Medical
Group Annual Rpt, 1944, p. 12; 41st Evacuation cases such as the Ninth Army soldier
Hospital Annual Rpt, 1944, pp. 59-60, which gives who died twenty-four hours after sur-
a hospital view on improving evacuation; HQ, gery in the 2d Platoon, 53d Field
SOLOC, History of the Medical Section, Headquar-
ters, Southern Line of Communications, ETO, U.S. Hospital: "S[hell] Fragment]
Army, 20 November 1944-1 January 1945 (hereafter W[ound] multiple with complete am-
cited as SOLOC Medical Hist), pp. 20-26; Surg, putation right foot; C[ompound]
CONAD, Annual Rpt, 1944, pp. 8-10; MFR, Col J.
H. Voegtly, 16 Nov 44, sub: Medical Service, South-
ern Group of Armies, and Memo, Anon, to Col both in DRAGOON 1944 file, CMH. See also ap-
Peyton, 18 Nov 44, sub: Notes Taken at Conference propriate pages in Chapter XIX of Smith and
on Medical Service for Southern Group of Armies, Clarke, Riviera to the Rhine.
HARD FIGHTING AT THE WEST WALL 379
F[racture] left fibula, soft tissue blood was partly in. ... After a major
wounds [right] thigh and left debridement, pockets containing manure
leg; . . . severe muscle damage both kept appearing in deeper and deeper
34 layers in all directions until there was not
legs. . . ." much left of the limb. Reluctantly I had
Evacuation hospital surgeons oper- to disarticulate [amputate] the limb at the
ated on the great majority of orthope- hip and debride the buttock. This man
dic patients, who usually were trans- developed kidney failure and died on the
ninth day. . . .35
portable enough to bypass the field
hospital platoons. By debridement Field and evacuation hospitals alike
and the application of plaster casts, depended for surgical reinforcements
the surgeons prepared these casual- upon teams from the auxiliary surgi-
ties for further transportation and laid cal groups; indeed such teams made
the groundwork for definitive treat- up the entire operating room staff of
ment in COMZ general hospitals. In the field hospital platoons. The Euro-
compound fractures, according to a pean Theater by late 1944 possessed
Third Army surgeon, "what we had five complete auxiliary groups, at-
to do was create a clean, organizable tached to the field armies and army
wound out of an indiscriminately groups, and the equivalent of half of
smeared up, messed up situation." another, assigned to COMZ. Each
Evacuation hospital surgeons, while group included about twenty-five
they handled a large number of minor teams of doctors, nurses, and enlisted
and moderately severe injuries, also technicians, the majority organized
encountered massive wounds, some for general surgery and the rest for
of which gruesomely illustrated the neurosurgery, maxillofacial work, X-
macabre mischances of modern ray, and dental prosthetics. These
combat. The same Third Army sur- teams contained an impressive array
geon recalled: of professional talent, and the theater
The French manure pile . . . came into took pains to maintain the quality of
the operating room. An infantryman had their personnel. Accordingly, when
hidden next to one when the shell blew the Ninth Army's 5th Auxiliary Surgi-
up in the pile filling his thigh from knee cal Group arrived in France with a
to buttocks with manure, all tightly substantial number of young, inexpe-
packed in as into a sausage, [and] smash-
ing muscle and femur bone. He was in rienced medical officers, the army had
critical condition. ... I started debrid- no difficulty restaffing it with better
ing after the second set of bottles of qualified men transferred from the
Communications Zone and the
34
Quotation from Surg, Ninth U.S. Army, Daily ground forces. Besides the teams, the
Journal, 9 Nov 44, Shambora Papers, MHI. For auxiliary groups included varying
other statistics, see Surg, Seventh U.S. Army,
Annual Rpt, 1944, pp. 118-20; 11th Field Hospital
35
Annual Rpt, 1944, app. B; 13th Field Hospital First quotation from Gosman Interv, 24 Mar 82.
Annual Rpt, ends. 4-5; 48th Field Hospital Semian- Second quotation from Joseph A. Gosman, MD,
nual Rpt, January-June 1945, p. 15; 51st Field Hos- "War without Blood" (1982), p. 150. Both in CMH.
pital Annual Rpt, 1944, p. 13; and Memo, Kenner to For other examples of evacuation hospital work, see
CofS, SHAEF, 5 Dec 44, sub: Report of Inspection, 3d Auxiliary Surgical Group Annual Rpt, 1944, pp.
Medical Service, First and Ninth U.S. Armies, in 33-35; 5th Evacuation Hospital Annual Rpt, 1944,
Medical Division, COSSAC/SHAEF, War Diary, De- pp. 12-13; and 41st Evacuation Hospital Annual
cember 1944. Rpt, 1944, p. 11.
380 EUROPEAN THEATER OF OPERATIONS
Field and evacuation hospitals alike the ambulance until he reached the
arranged their physical plants and postoperative ward. Hospitals, after
streamlined their procedures for initial episodes of confusion, learned
rapid reception, sorting, and treat- to put their most capable officers in
ment of a large volume of patients.
Most units, whether in tents or build-
charge of reception and triage. These
ings, tried to lay out their facilities so officers quickly examined each arriv-
that a casualty would move in a more ing casualty and dispatched him to
or less straight line from receiving the shock, preoperative, medical, or
through surgery to postoperative care immediate evacuation wards. In the
and evacuation. Many, by converting shock and preoperative wards, doc-
cots to work stands for litters, were tors, nurses, and enlisted technicians,
able to keep a patient on the same working with all possible speed, took
stretcher from the time he came off the necessary resuscitation and stabili-
382 EUROPEAN THEATER OF OPERATIONS
zation measures and moved the pa- keep all available surgeons and tables
tient to and from X-ray. Roentgenolo- continually busy. Surgeons, nurses,
gy constituted a perennial bottleneck and technicians worked in more or
when casualties were coming in rapid- less permanent teams. A field hospital
ly, and hospital technicians taxed platoon with two attached teams
their ingenuity to the limit to expe- could complete perhaps twenty major
dite the taking and development of operations a day. A 400-bed evacu-
pictures. One unit, the 107th Evacu- ation hospital could keep eight to ten
ation Hospital, sent patients in shock operating tables in action around the
to X-ray before resuscitation, in the
clock; the number of cases they
belief that a slight delay in starting
the latter process would be less harm- turned out depended on the severity
ful to the casualty than a subsequent of the casualties then being received.
interruption of it. Using such expedi- In theory, surgical teams working
ents, hospitals could process masses twelve hours and resting twelve hours
of casualties. On the night of 16 No- could keep up this pace almost indefi-
vember, for example, the 111th Evac- nitely; in practice, the regimen quickly
uation Hospital, located at Heerlen, took its toll. During periods of heavy
Holland, behind the Ninth Army, ad- action the 9th Evacuation Hospital re-
mitted 272 patients in four hours; its ported that "the staff was nearly
people examined, sorted, and placed always tired and too often lacking in
under shelter more that 1 wounded sleep." A surgeon in the 109th Evacu-
38
man each minute. ation Hospital recalled: "I began to
Field and evacuation hospitals orga- tire physically and psychologically
nized their surgical staffs to operate from the twelve hour operating
on the maximum number of cases stretch every day; then, eating after
within the shortest possible time. In the last surgery, writing letters and
field hospital platoons the attached going to sleep. ... I worked on in-
surgical teams, and in evacuation hos- 39
stinct when tired."
pitals normally the chiefs of surgical
service or the senior surgeons on 39
First quotation from 9th Evacuation Hospital
shift, scheduled patients for oper- Annual Rpt, 1944, p. 16. Second quotation from
ation. While each army set general Gosman, "War without Blood," pp. 151-52, CMH.
guidelines for establishing surgical See also Gosman Interv, 24 Mar 82, CMH; First
U.S. Army Report of Operations, 1 Aug 44-22 Feb
priority, the officers actually manag- 45, bk. IV, p. 162; Surg, Third U.S. Army, Annual
ing the traffic applied these rules with Rpt, 1944, pp. 102-03; 3d Auxiliary Surgical Group
Annual Rpt, 1944, pp. 33-34. For examples of sur-
great flexibility, their aim being to gical organization and operations, see 47th Field
Hospital Annual Rpt, 1944, pp. 9 and 11; 48th Field
38
First U.S. Army Report of Operations, 1 Aug Hospital Semiannual Rpt, January-June 1945, p. 8;
44-22 Feb 45, bk. IV, pp. 161-63, gives a general 59th Field Hospital Annual Rpt, 1944, pp. 10-11;
view of triage and resuscitation in that army. For ex- 11th Evacuation Hospital Annual Rpt, 1944, p. 4;
amples of hospital operations, see 48th Field Hospi- 59th Evacuation Hospital Annual Rpt, 1944, p. 4
tal Semiannual Rpt, January-June 1945, pp. 5, 8, and sec. III, p. 8; 91st Evacuation Hospital Annual
11-12; 91st Evacuation Hospital Annual Rpt, 1944, Rpt, 1944, pp. 59-61; 107th Evacuation Hospital
pp. 56-57 and 69; 107th Evacuation Hospital Annual Rpt, 1944, p. 16; 111th Evacuation Hospital
Annual Rpt, 1944, pp. 10-12; and 111th Evacuation Annual Rpt, 1944, pp. 15-16; and 24th Evac Hist,
Hospital Annual Rpt, 1944, pp. 11 and 13-14. October 1945, p. 93.
HARD FIGHTING AT THE WEST WALL 383
Inevitably, with surgery being done Colonel Rogers, the army surgeon,
under forced draft, errors occurred. among other changes revised his
Surgeons, especially in hospitals evacuation policies for men with chest
newly placed in operation, debrided and vascular injuries. Hospitals con-
wounds improperly or inadequately. stantly reviewed their own surgical
They neglected to split casts to allow practice, for example, by conducting
for swelling and permitted too early autopsies whenever possible in cases
evacuation of patients with abdominal of postoperative death. In general,
wounds or severe vascular damage. the quality of field and evacuation
The army surgeons and their consul- hospital surgery stood the test of
tants, who kept close watch on the review farther to the rear. During Oc-
quality of professional practice in tober, at a Paris meeting of Allied
their hospitals, labored continually to medical officers to discuss battle casu-
reduce the incidence of such mistakes. alty treatment, COMZ surgeons, with
The First Army temporarily stationed only minor reservations, pronounced
medical officers in ADSEC general themselves satisfied with the condi-
hospitals, to check on the condition tion of the patients reaching them
of patients arriving from the army. from the armies. Colonel Cutler, the
On the basis of these officers' reports ETO chief surgical consultant, de-
384 EUROPEAN THEATER OF OPERATIONS
clared that earlier and more effective services. Evacuation hospitals sent off
surgery—combined with widespread the majority of their patients within
use of whole blood and antibiotics less than ten days; field hospitals, be-
and the generally more robust physi- cause of the severity and complicated
cal condition of the troops—account- nature of their cases, had to retain
ed for the higher recovery rate of the theirs for longer periods, a require-
wounded in this war as compared to ment that perennially conflicted with
World War I.40 their need for mobility. The Third
Mobile army hospitals tried to evac- Army attached thirty-man holding
uate patients within as short a time as units, drawn from collecting and gas
possible after their condition was sta- treatment companies, to its field hos-
bilized, the minor postoperative cases pital platoons to stay behind with
almost as soon as they recovered nontransportable patients when the
from the effects of anesthesia. The main units moved.
41
the autumn and winter offensive, military camp rather than a hospital
neuropsychiatric cases accounted for environment. The Third Army used a
between 9 and 25 percent of total section of its convalescent hospital as
monthly hospital admissions. still another echelon of army-level
The armies, taking advantage of treatment that could hold patients for
lessons learned in North Africa and as long as two or three weeks. How-
Italy and of the First Army's early ex- ever, the other armies evacuated men
perience in Normandy, treated the still unfit for duty directly from their
emotional casualties of battle as tem- neuropsychiatric hospitals to the
porarily disabled soldiers rather than Communications Zone.
mental patients, normally categorizing In the United Kingdom Base most
them with the neutral diagnosis "ex- general and station hospitals main-
haustion." For the sake of both pre- tained fully staffed and equipped psy-
vention and cure they attempted to chiatric services. In addition, the
treat such patients as close as possible 312th Station Hospital (NP) and the
to the fighting line. Typically, infantry 96th General Hospital (NP), special-
battalion surgeons, trained in this ized psychiatric facilities, received the
work and supervised by their division most severely disturbed soldiers from
psychiatrists, held all but the most se- other installations for prolonged, in-
verely disturbed men at their aid sta- tensive treatment and rehabilitation.
tions for up to twenty-four hours of
The 96th also selected mental pa-
rest (often under sedation), hot food,
tients for evacuation to the United
a change of clothing, and rudimentary
individual and group therapy. Such States. On the Continent the Commu-
treatment sufficed for an unrecorded nications Zone attempted to set up
but very high proportion of men with neuropsychiatric hospitals close
combat reactions, allowing their im- behind the armies to take patients
mediate return to their units. from their exhaustion centers and to
Men needing a longer period to complete their treatment so that they
rest and more intensive therapy were could reenter the replacement system.
evacuated to their division clearing For this purpose ADSEC in mid-No-
stations. There, the division psychia- vember opened the 1,000-bed 130th
trist, with a pickup staff and impro- General Hospital (NP) at Ciney, Bel-
vised facilities, operated an "exhaus- gium, to serve the First and Ninth
tion center" that could hold patients Armies. At about the same time
for up to seventy-two hours of treat- CONAD established the 500-bed 51st
ment. The clearing stations also re- Station Hospital (NP) at Luneville to
turned to duty a substantial portion support the Third and Seventh
of the men they received. The rest Armies. However, given the shortage
went to the various specialized army of forward general hospitals, both
facilities mentioned above and, in the units were pressed into service to care
Third Army, to the neuropsychiatric for medical and surgical patients
wards of regular evacuation hospitals, during the American offensive and
for periods of up to seven days of the German December counterat-
therapy and reconditioning, ending in tacks. They began functioning primar-
a period of refresher training in a ily as neuropsychiatric facilities only
HARD FIGHTING AT THE WEST WALL 387
during the last weeks of hostilities. field hospital, giving the unit enough
Even without them, the armies and vehicles to move a platoon without
COMZ made an impressive record of outside help. All the armies employed
success in rehabilitating emotionally collecting and clearing company ele-
damaged soldiers. According to a ments, POWs, and French and Bel-
later estimate, out of every 100 psy- gian civilians to meet the insatiable
chiatric casualties in the theater, the requirements of their evacuation hos-
armies and the Communications Zone pitals for additional attendants and la-
44
restored 90 to some form of duty. borers. By late 1944 the typical 400-
Army hospitals, of whatever type, bed evacuation hospital had between
coped daily with manpower and fifty and eighty prisoners or civilians
equipment deficiencies. Ingenuity and attached to it. Civilians replaced the
improvisation facilitated their over- German POWs as units neared the
coming innumerable logistical and borders of the Reich.45
operational problems. Field hospitals Mud, rain, cold, and snow became
made do with standard allowances of major adversaries for army medical
people and equipment intended for a installations as the harsh winter
very different function from the one
closed in. Frequent downpours trans-
they were performing. They had a
formed hospital areas into seas of
constant battle to secure transporta-
tion for their many moves. The six mud, in spite of the best efforts of en-
nurses in each platoon were stretched gineers and medical troops with
to the limit of their endurance, caring gravel and bulldozers. In one Third
for as many as sixty-five postoperative Army hospital "a plow came in and
patients any of whom, in a civilian in- scraped mud into piles as if it were
stitution, would have required the ex- dealing with snow." As the days and
clusive attention of one or more nights grew colder, steam rose from
nurses. The Seventh Army, in an at- abdominal incisions in unheated sur-
tempt to alleviate these problems, re- gical tents. One unit resorted for
duced the bed capacity of each of its warmth to potbelly stoves placed
field hospital platoons to 60 and in- close to its operating tables. "Prob-
creased the nurse complement to ably due to the closed system of anes-
eight with ANC officers borrowed thesia and good outdoor ventilation,"
from the Communications Zone. This a surgeon recalled, "and adding a
army also issued additional trucks,
trailers, and weapons carriers to each 45
Surg, Third U.S. Army, Annual Rpt, 1944, pp.
92-93, 101, 124; Surg, Ninth U.S. Army, Annual
Rpt, 1944, p. 19; Surg, Seventh U.S. Army, Annual
44
The foregoing discussion is based on Albert J. Rpt, 1944, pp. 43 and 46; 68th Medical Group
Glass, ed., The Overseas Theaters, Medical Depart- Annual Rpt, 1944, p. 21; 134th Medical Group
ment, United States Army in World War II (Wash- Annual Rpt, 1944, pp. 11-12; Surg, XX Corps,
ington, D.C.: Office of the Surgeon General, De- Annual Rpt, 1944, pp. 22-23; 48th Field Hospital
partment of the Army, 1973), chs. VIII and IX; res- Semiannual Rpt, January-June 1945; 47th Field
toration-to-duty estimate is on pp. 273-74. See also Hospital Annual Rpt, 1944; 9th, 11th, 41st, 59th,
Surg, Ninth U.S. Army, Annual Rpt, 1944, pp. 32- 91st, 104th, and 111th Evacuation Hospitals Annual
33. The 130th General Hospital was caught up in Rpts, 1944; Memo, Lt Col A. W. Shiflet to CG,
the German Ardennes counteroffensive. See Chap- AGF, 11 Nov 44, sub: AGF Report No. 364—Medi-
ter XII of this volume. cal Information.
388 EUROPEAN THEATER OF OPERATIONS
factor of luck, there were no ether ex- needed still more transportation to
plosions." With wind and snow came move them.47
additional tribulations. Work details As army hospitals acquired cam-
swept accumulated snow off tents to paigning experience, their medics
keep them from collapsing, and they became adept at improvising, and at
struggled to secure stovepipes and obtaining—by one means or an-
46
tent pegs against battering gusts. other—what they needed. Each unit
To remove staffs and patients from developed its own individual plan for
such hardships, the armies during No- setting up. Colonel Gorby declared:
vember and December gave their hos- "I don't think I had a field hospital
pitals and other medical units first commander, or an evac hospital com-
claim on requisitioned buildings. Hos- mander, that would set [up] his oper-
pitals under roofs—in casernes, ating pavillion and his ward tents and
schools, hotels, monasteries, and even pre-ops and post-ops and receiving
a former German slave labor camp— and all that in exactly the same
encountered new problems. Unlike way. . . . We indicated that as long
tents, buildings could not be moved as it was effective it was all right."
to the most convenient points on the Foraging, as one hospital report put
routes of evacuation. Thus field hos- it, "by now had become instinctive."
pital platoons, for the sake of shelter, Medics regularly turned the refuse of
often perforce set up some distance war into objects that saved their pa-
away from the clearing stations they tients' lives or enhanced their own
supported. Hospitals usually had to comfort. In the 59th Field Hospital
do extensive cleaning and disinfecting discarded 5-gallon food tins, cut in
to make their quarters habitable. En- half, became operating room light fix-
listed medics of one evacuation hospi- tures, their polished interiors ready-
tal jokingly suggested that the letters made reflectors. A large box, a 20-
"SM" (Semimobile) in their unit des- gallon gasoline tank, two faucets, a
ignation really meant "Scrubbing and length of pipe, and a galvanized
Mopping." In nonmedical structures trough, all salvaged, became a sur-
floor plans left much to be desired geon's scrub sink. Scrap lumber went
from the hospital point of view. Dis- into back rests for chest-wound pa-
persal of patients among many small 47
rooms, for example, as in schools, Quotation from 111th Evacuation Hospital
Annual Rpt, 1944, p. 10. For hospital problems
meant harder work for nurses, ward from the army viewpoint, see An. 6—Medical Plan,
attendants, and litterbearers. Units p. 14, to FUSA Plan, 25 Feb 44, file HD 370 ETO;
required additional people and equip- First U.S. Army Report of Operations, 1 Aug 44-22
Feb 45, bk. IV, pp. 139 and 155; Surg, Third U.S.
ment, not included in T/O&Es Army Annual Rpt, 1944, pp. 39, 91, 122, 167; Surg,
designed for tented operation, to per- Seventh U.S. Army, Annual Rpt, 1944, p. 23; and
form plant maintenance and engi- Surg, Ninth U.S. Army, Annual Rpt, 1944, pp. 19-
20 and 23. For examples of unit difficulties, see
neering. With these augmentations, Surg, XX Corps, Annual Rpt, 1944, p. 23; 48th
evacuation hospitals, especially, Field Hospital Semiannual Rpt, January-June 1945;
93d Evacuation Hospital Unit Hist, 1944; 110th
Evacuation Hospital Semiannual Rpt, January-June
46
Gosman, "War without Blood," pp. 121 and 1945; and 5th, 51st, and 104th Evacuation Hospitals
130, CMH. Annual Rpts, 1944.
HARD FIGHTING AT THE WEST WALL 389
tients. Other hospitals built their own to all of the Ninth Army until the last
suction apparatus, as well as ward days of December, when the advance
desks and tables, folding water section of the 35th Medical Depot
towers, and portable showers. They Company relieved it. Beginning in
mounted their generators on captured late November, another Ninth Army
enemy trucks and appropriated what- depot company, the 28th, located at
ever other usable German matériel Maastricht, assumed the task of re-
came their way, including in one unit ceiving supplies from the Communi-
a couple of truckloads of liquor seized cations Zone and forwarding them to
in Cherbourg and carried across the advance element at Valkenburg.
France. Hospitals followed the cam- Elsewhere in the 12th Army Group,
paign philosophy: "Take what you army depots underwent little change.
can get and hang onto it; each set-up The 1st Medical Depot Company, in
will be a little different, a little better the First Army, shifted its base to
than the last; make your comfort and Dolhain, just west of its former site at
your amusements now—who knows Eupen, in order to find suitable build-
when you can again?" 48 ings. Advance sections of this compa-
ny operated medical supply points at
Sources of Supply Malmedy and Bastogne. The Third
By the time the offensive began in Army's 32d and 33d Medical Depot
November, the army supply depots Companies, located respectively at
had settled into positions within con- Verdun and Toul when the offensive
venient supporting distance of the started, moved eastward, the 32d to
front. They gradually edged forward Metz in late November and the 33d to
49
as the attacking divisions gained Chateau-Salins in mid-December.
ground. The Ninth Army brought The Seventh Army had its own sep-
with it from Brittany a single medical arate line of medical supply. Its 7th
supply unit, the advance section of Medical Depot Company followed the
the 33d Medical Depot Company, army across the Riviera beaches and
temporarily attached from the Third up the Rhone valley successively to
Army. This supply element, which es- Epinal, Luneville, and Sarrebourg.
tablished itself at Valkenburg, Hol- Throughout the summer and early
land, taking over stock of a former fall this company bore most of the
First Army dump, distributed supplies burden of hauling supplies the entire
distance from the Mediterranean
48
First quotation from Gorby Interv, 1962, pp. coast. During November the Southern
28-29, CMH. Second quotation from 106th Evacu- Line of Communications finally re-
ation Hospital Annual Rpt, 1944, pp. 14-15. Third lieved the 7th Company of that task
quotation from 8th Field Hospital Annual Rpt,
1944, p. 4, attributing the words to the 91st Evacu-
49
ation Hospital. See also 59th Field Hospital Annual First U.S. Army Report of Operations, 1 Aug
Rpt, 1944, p. 10. For other comments on improvisa- 44-22 Feb 45, bk. IV, pp. 154-55; Surg, Third U.S.
tions, see Surg, Third U.S. Army, Annual Rpt, 1944, Army, Annual Rpt, 1944, pp. 165 and 168-69; Surg,
pp. 126-27; remarks of evacuation hospital com- Ninth U.S. Army, Annual Rpt, 1944, p. 12; Surg,
manders in file HD:ETO:350.07:Battle Experiences; XIX Corps, Annual Rpt, 1944, encl. 19; 32d Medical
and 91st, 105th, 106th, and 111th Evacuation Hos- Depot Company Annual Rpt, 1944, pp. 2-3; 33d
pitals Annual Rpts, 1944. On liquor supply, see Medical Depot Company Annual Rpt, 1944, p. 7
Gosman Interv, 24 Mar 82. CMH. and an. 1.
390 EUROPEAN THEATER OF OPERATIONS
distribution presented few difficulties When the offensive began, the flow
beyond those inherent in the condi- of medical supplies from both com-
tions of combat. Divisional and corps munications zones into the army
medical units and detachments drew depots was still, from the armies'
expendable items on informal requisi- standpoint, less than satisfactory. In
tion from the nearest army supply the 12th Army Group medical supply
point, usually an advance section of deliveries to the armies regularly fell
the depot company or a small dump short of the daily SHAEF tonnage al-
maintained by the corps. Hospitals, locations. The army depots constantly
depending on their locations, requisi- reported shortages; those of the First
tioned either from the advance points Army at one point had zero balances
or from the main army depots. in over 400 inventory items. The
Among their liaison functions, the
51
Surg, Third U.S. Army, Annual Rpt, p. 169;
50
Surg, Seventh U.S. Army, Annual Rpt, 1944, Surg, Seventh U.S. Army, Annual Rpt, 1944, pp.
pp. 7-8, 48-49, 117; Surg, CONAD, Annual Rpt, 48-49; Surg, Ninth U.S. Army, Annual Rpt, 1944, p.
1944, pp. 13-14; Surg, Delta Base Section, Annual 38; Surg, Ninth U.S. Army, Daily Journal, 1 Nov 44,
Rpt, 1944, p. 1; Kendrick, Blood Program, pp. 447- Shambora Papers, MHI; 7th Medical Depot Compa-
52; Wiltse, Mediterranean, p. 409; Memo, Kenner to ny Combat Supply Operations Rpt, [1944], p. 9. For
CofS, SHAEF, 12 Oct 44, sub: Report of Inspection examples of corps supply points, see Surg, XII
of Medical Service of 6th US Army Group . . . , in Corps, Annual Rpt, 1944, p. 6, and Surg, XIX
Medical Division, COSSAC/SHAEF, War Diary, Oc- Corps, Annual Rpt, 1944, p, 19. For group supply
tober 1944; 7th Medical Depot Company Combat activities, see 68th Medical Group Annual Rpt,
Supply Operations Rpt, [1944], pp. 3-5. For details 1944, p. 28. On wing tanks, see Surg, XX Corps,
on the development of SOLOC, see Chapters IX Annual Rpt, 1944, pp. 7-8; Surg, 90th Infantry Divi-
and XIII of this volume. sion, Annual Rpt, 1944, pp. 18-19.
HARD FIGHTING AT THE WEST WALL 391
inspections, General Kenner declared Thus far in the campaign the field
flatly: "The medical service in the for- armies possessed the tactical initia-
ward area has been excellent." 53 tive, but in mid-December that condi-
tion abruptly changed. Ground force
53
Quotation from Memo, Kenner to CofS,
medics were about to undergo what
SHAEF, 5 Dec 44, sub: Report of Inspection, Medi- was, for most of them, a new experi-
cal Service, First and Ninth US Armies . . . , in ence: that of retreat before an enemy
Medical Division, COSSAC/SHAEF, War Diary, De- temporarily and locally superior in
cember 1944. This document also gives the 28th
General Hospital statistics. On evacuation times, see numbers and firepower and enjoying
Kenner memo previously cited and his other reports the advantage of surprise. The army
in ibid., as well as Surg, 4th Armored Division medical service had proved its ability
Annual Rpt, 1944, pp. 21-22. On army death rates,
see First U.S. Army Report of Operations, 1 Aug to support forces engaged in set-piece
44-22 Feb 45, bk. IV, pp. 199-200 and 204; Surg, battles and headlong pursuit. Now its
Third U.S. Army, Annual Rpt, 1944, pp. 97-99; adaptability was to be tested in with-
Surg, Seventh U.S. Army, Annual Rpt, 1944, p. 28;
and Surg, Ninth U.S. Army, Combat Experience drawal, encirclement, and hastily im-
Rpts, October-December 1944, file HD 319.1-2. provised counterattack.
CHAPTER XII
A Time of Adversity
In the early morning darkness and The enemy achieved complete sur-
fog of 16 December 1944 three pains- prise. Aided by several days of fog,
takingly marshaled German field rain, and snow, which kept the Allied
armies attacked the weakly defended air forces out of the battle, and by un-
Ardennes sector of the First Army orthodox tactics, including the use of
front in Belgium and Luxembourg. special commando units disguised in
Over 250,000 troops with 1,000 American uniforms and civilian cloth-
armored fighting vehicles and 1,900 ing, the Germans made their initial
artillery pieces, in 25 armored and in- breakthrough and gained consider-
fantry divisions, took part in this des- able ground. They destroyed one
perate counterstroke, for which Hitler American infantry division, effectively
and his military advisers had been crippled two others, and eliminated
planning and preparing since the late an armored combat command; and
summer. The Germans intended to they killed, wounded, and captured
pierce the thin American line in the thousands of American soldiers. Nev-
Ardennes, a wooded, hilly sector used ertheless, the German advance almost
by the First Army, with most of its at once fell behind schedule, slowed
strength concentrated farther north by the narrow roads and difficult ter-
for a drive toward the Roer River, to
rain and by the tenacious resistance
rest battle-worn divisions and to in-
of the American front-line units.
troduce green ones to combat.
Mechanized columns then were to On the northern wing of the offen-
cross the Meuse River and capture sive the Sixth Panzer Army, with a sub-
Liege and Antwerp. If successful, stantial component of SS troops, sup-
their drive would destroy many Allied posedly the main breakthrough force,
units; disrupt supply lines; and, Hitler pushed back but failed to rout the 2d
optimistically believed, induce the and 99th Infantry Divisions on the
British and Americans to break their right flank of the American V Corps.
"unnatural" alliance with Communist These divisions, rapidly reinforced by
Russia and make peace on terms ac-
ceptable to Germany.1 D.C.: Office of the Chief of Military History, Depart-
ment of the Army, 1965), passim, and Ruppenthal,
Logistical Support, 2:25-26. The German plan, in fact,
1
The following summary of operations is drawn was overambitious and even under the best of con-
from Hugh M. Cole, The Ardennes: Battle of the Bulge, ditions could not have been carried to success with
United States Army in World War II (Washington, the available forces.
394 EUROPEAN THEATER OF OPERATIONS
others, held firm around Elsenborn The Seventh Army, on the far south-
and fixed the northern shoulder of ern wing of the German attack, soon
the developing "Bulge." Kampfgruppe was brought to a standstill by the
Peiper, an advance element of the 1st rightmost VIII Corps formations,
SS Panzer Division, extricated itself which held the longer portion of the
from this fighting early on 17 Decem- American line in the Ardennes. In the
ber and drove 20 miles into First center of the VIII Corps front, how-
Army territory, in the process massa- ever, the Fifth Panzer Army enveloped
cring over 100 American prisoners the green 106th Infantry Division,
near Malmedy, but the U.S. 7th Ar- awkwardly deployed in a salient in the
mored Division came in behind Schnee Eiffel (the extension of the Ar-
Kampfgruppe Peiper to hold the St.-Vith dennes into Germany), capturing two
road junction for six crucial days. American regiments, and broke
This division and the units that rallied through the 28th Infantry Division, a
around it held up the advance of battered Huertgen Forest veteran,
most of the Sixth Panzer Army, while which was spread thin along the Our
other American elements isolated the River. The Fifth Panzer Army now was
Peiper force and broke it up. in position to roll northwestward
A TIME OF ADVERSITY 395
toward the Meuse. Fortunately for the First Army shifted divisions from its
Americans, the 101st Airborne Divi- left flank to its right to check the con-
sion, released from SHAEF reserve, tinuing German advance, bringing the
came into the gap on 19 December, Fifth and Sixth Panzer Armies to a stop
just in time to deny to the onrushing well short of the Meuse. The Third
Germans the important road junction Army, in a remarkable display of tacti-
of Bastogne. Completely encircled for cal and logistical flexibility, within
the better part of a week, the airborne days turned its axis of advance 90
troops, aided by elements of two ar- degrees and attacked the enemy's
mored combat commands and a mis- southern flank. On the twenty-
cellany of artillery and support units seventh, elements of Patton's army
that had straggled into Bastogne, held opened a corridor to the besieged
the town and further restricted 101st Division. The Germans had
German maneuver. driven a wedge into the First Army
The Allied high command, al- front that was 60 miles deep and 50
though surprised by the initial miles wide at the base, but they had
German onslaught, reacted to it swift- fallen hopelessly short of their ambi-
ly and effectively. SHAEF early com- tious objectives. During the first
mitted its main ground troop reserve, weeks of 1945 the First and Third
the XVIII Airborne Corps, then recu- Armies counterattacked in bitter cold
perating after leaving the line in Hol-
and snow. They steadily forced back
land. While the 101st Division of this
corps secured Bastogne, the corps the by now exhausted, dispirited
headquarters, with the 82d Airborne enemy. The Wehrmacht in mid-Feb-
Division, helped extend the American ruary was fighting on or behind its
line to the right of the V Corps, along 16 December start line. It had left
the northern flank of the German sa- behind on the ground so briefly won
lient. On 20 December, to improve over 100,000 men and uncounted
coordination of the forces on both quantities of equipment, and it had
sides of the breakthrough, General lost its ability ever again to resume
Eisenhower temporarily gave oper- the offensive.
ational control of the First and Ninth For the American armies the
Armies to Field Marshal Montgom- human cost of the Battle of the Ar-
ery's 21 Army Group. Montgomery dennes was substantial but difficult to
was to redeploy British and U.S. divi- determine exactly, due to the number
sions to stop the Germans at or in of commands involved and the re-
front of the Meuse and then counter- porting of casualties by unit and time
attack. South of the Bulge, the Third period rather than by engagement.
Army took over VIII Corps and pre- According to one authoritative esti-
pared to push forward to relieve Bas- mate, American combat losses in the
togne and help pinch off the salient. period of the German attack, 16 De-
The Allies gradually regained the cember to 2 January, amounted to at
tactical initiative, assisted mightily by least 41,000 officers and men, includ-
a period of clear weather after 23 De- ing some 4,100 known killed in
cember, which allowed their air forces action, 20,200 wounded, and over
to intervene with decisive effect. The 16,900 missing. Many of the missing
396 EUROPEAN THEATER OF OPERATIONS
luctantly gave up their St.-Vith sa- pany into three separate detachments,
8
lient. each of which handled casualties of a
The 28th Division, stretched thinly single regiment. This arrangement,
over a 20-mile front immediately to adopted to save time and transporta-
the right of the 106th, gave way tion in evacuating sick and wounded
under the full weight of the Fifth from the extended division front, for-
Panzer Army assault. During the first tuitously was of benefit during the
three days of the battle the division's German offensive. It ensured continu-
two flank regiments, the 112th Infan- ous clearing company support of the
try on the north and the 109th on the flanking regiments even as they
south, pulled back in reasonably good became separated from the division
order and joined the American forces and were attached for a time to other
rallying on the shoulders of the commands. The 103d Battalion man-
breakthrough. Their surgeons and aid aged to extricate all of its elements,
stations accompanied them and main- although it lost twenty-one men cap-
tained more or less normal operations tured in the retreat. Company B, the
throughout the offensive. In the divi- collecting company behind the 110th
sion center, however, the 110th Infan- Infantry, had to abandon much of its
try was all but destroyed in delaying equipment, as did one platoon of the
the enemy advance on Bastogne. Its clearing company. Battalion head-
surgeon, Maj. L. S. Frogner, MC, lo- quarters withdrew with the division
cated with the regimental command command post from Wiltz to a posi-
post at Clervaux, lost all contact with tion near Neufchateau, southwest of
his battalion aid stations during the Bastogne.10
afternoon of 16 December, as those The V and VIII Corps surgeons re-
installations were overrun or cut off acted quickly to the emergency. They
in the general wreck. Frogner and his tried to extricate their corps medical
aid station were captured late the fol- battalions from danger while keeping
lowing day, after German tanks and contact with their divisions and co-
infantry overwhelmed the patchwork ordinating evacuation. Colonel Brenn,
of headquarters and service elements the V Corps surgeon, and his medical
defending Clervaux.9 section remained at Eupen through-
The division's 103d Medical Battal- out the battle, under intermittent
ion, during the quiet period before German shelling and for a time
the attack, had split its clearing com- threatened by enemy paratroopers.
The headquarters, the clearing com-
8
Surg, 106th Infantry Division, Annual Rpt, pp. pany, and one collecting company of
4-5 and encl. 7; Dupuy, The 106th, pp. 61, 89-90, the corps' 53d Medical Battalion—the
98-99. Surg, 7th Armored Division, Annual Rpt,
1944, pp. 21-22, gives additional details of evacu- rear elements, ironically, as the battal-
ation from St.-Vith.
9
ion was oriented to support an Amer-
Cole, Ardennes, ch. VIII; Surg, 28th Infantry Divi-ican attack toward the northeast—
sion, Annual Rpt, 1944, p. 4; History of the 110th
Infantry Regiment (hereafter cited as 110th Infantry
10
Hist), sec. III, pp. 61-74, box 8596, RG 407, NARA; Surg, 28th Infantry Division, Annual Rpt, 1944,
Intervs, sub: Medical Units in vic Clervaux, in 28th ends. 5-6; Col D. B. Strickler, Action Report of
Infantry Division Combat Intervs, box 24033, RG Germans' Ardennes Breakthrough, ... in 110th In-
407, NARA. fantry Hist, app., box 8596, RG 407, NARA.
A TIME OF ADVERSITY 401
were in more danger; their location at termine how many medical personnel
Heppenbach was in the middle of the and how much equipment his divi-
99th Division battlefield. On 17 De- sions had lost.11
cember the battalion, by making two The VIII Corps surgeon, Colonel
trips using all available vehicles, evac- Eckhardt, lost contact early with the
uated its personnel, its 180 patients, flank divisions of his hard-hit corps.
and about 95 percent of its equip- His own section, with the corps head-
ment to Eupen. The trucks had to quarters, moved in haste from Bas-
travel over roads already under togne to Neufchateau on 18 Decem-
German observation, but the enemy ber and then on the twenty-first to
did not interfere with them. The bat- Florenville, still further south. There,
talion, however, did lose three ambu- "a very unmerry Christmas was faintly
lances and five men in an apparent observed and a not very joyous New
ambush during a separate evacuation Year was welcomed." The corps'
mission. With his medical battalion 169th Medical Battalion, which had its
safely repositioned, Brenn concentrat-
ed during the rest of the battle on su- 11
Surg, V Corps, Annual Rpt, 1944, pp. 21-22;
pervising evacuation and trying to de- 53d Medical Battalion Annual Rpt, 1944, p. 14.
402 EUROPEAN THEATER OF OPERATIONS
headquarters and clearing station at of two medical groups: the 134th, lo-
Troisvierges, close behind the center cated at Malmedy, which evacuated
of the corps front, and its collecting the V Corps; and the 64th, at Trois-
companies widely spread out, with- vierges, supporting the VIII Corps.
drew relatively intact and eventually Platoons of two field hospitals, the
reassembled near Florenville. This 42d and 47th, were spread across the
battalion, besides supporting the re- front, receiving nontransportable cas-
maining units of the VIII Corps, also ualties from the infantry divisions.
served the 101st Airborne Division Evacuation hospitals were clustered
12
after it moved into Bastogne. on the northern and southern fringes
In addition to divisional and corps of the Bulge. In the north the 44th
units, the breakthrough area con- and 67th, at Malmedy, were receiving
tained a number of First Army medi- wounded from a local attack by the
cal installations. They included the left-wing divisions of the V Corps.
headquarters and attached battalions Behind the VIII Corps the 107th
Evacuation Hospital, as the German
12
offensive began, had just ceased oper-
Quotation from Surg, VIII Corps, Annual Rpt,
1944, p. 8. See also 169th Medical Battalion Annual ations at Clervaux and was preparing
Rpt, 1944, pp. 10-12. to move. The 102d at Echternach and
A TIME OF ADVERSITY 403
MAP 17
the 110th at Esch were open for pa- maintained supply dumps at Malmedy
tients from the VIII Corps right wing. and Bastogne.13
The Bulge also contained a couple of The First Army surgeon, Brig. Gen.
specialized army hospitals. At Mal- John A. Rogers, MC, located at army
medy the 618th Clearing Company headquarters at Spa, north of the
operated a center for treatment of breakthrough area, received his first
combat exhaustion casualties; at hint of the enemy offensive early in
Grand-Halleux, west of St.-Vith, the morning of 16 December (Map
Company C, 91st Medical Gas Treat- 17). It came in the form of reports of
ment Battalion, cared for malaria, heavy shelling from the evacuation
contagious disease, and self-inflicted
wound patients. Advance sections of 13
This section is based on the annual reports,
the 1st Medical Depot Company 1944, of the units mentioned.
404 EUROPEAN THEATER OF OPERATIONS
hospitals at Eupen and Malmedy. with the divisions, the platoons were
Around 1900 Rogers learned that the under the command of the medical
Germans during the day had made groups. In the confusion of the first
"some penetration" of the VIII Corps days of the battle they had difficulty
line and along the boundary between in obtaining timely orders and infor-
it and V Corps. "A request for infor- mation; their movements were not
mation to the army G-3 elicited the always well coordinated with those of
response that the action was thought the divisions. Surgeons with the pla-
to be local, and the penetration not toon at St.-Vith, for example, learned
considered serious." Three hours of the offensive only when the hospi-
later, however, the G-3 indicated to tal was engulfed by 106th Division
Rogers that the Germans attacking wounded, by which time, according to
the VIII Corps were gaining ground. them, the division clearing station al-
On the basis of this information ready had left for Vielsalm. The divi-
Rogers gave orders for the withdraw- sion surgeon, on the other hand,
al of the platoon of the 42d Field claimed that the platoon "took off"
Hospital at Wiltz and of the 102d and without warning, leaving him with no
107th Evacuation Hospitals, his most emergency surgical capability. On 17
exposed units in the rear of the VIII December all these units extricated
Corps. The next day, as word came of themselves from their exposed posi-
growing pressure on the V Corps, the tions, but with a nearly total loss of
army surgeon also began sending re- equipment and, in some instances,
treat orders to medical units in the with casualties among patients and
path of the Sixth Panzer Army." 14 staff. Regrouped in rear areas, they
Most immediately threatened by the were out of action for the rest of the
German breakthrough were four field battle, their personnel in bivouac or
hospital platoons. In the V Corps temporarily attached to other medical
area the 1st and 3d Platoons of the units.
15
47th Field Hospital, located respec- Two platoons, the 1st of the 47th
tively at Waimes and Dom Butgen- Field Hospital at Waimes and the 1st
bach, received wounded from the 2d of the 42d at Wiltz, had particularly
and 99th Divisions. Behind the VIII dramatic and, in the latter case, tragic
Corps the 1st Platoon of the 42d experiences. The 1st Platoon at
Field Hospital at Wiltz supported the Waimes continued working through-
28th Division clearing station; the 3d out the morning of the seventeenth,
Platoon, in St.-Vith, served the 106th the staff increasingly agitated by the
Division. These units, unlike the divi- stories told by incoming wounded of
sion clearing stations with which they
were located, did not possess organic 15
42d Field Hospital Annual Rpt, 1944, pp. 4-5
transportation for rapid withdrawals. and encl. 1; 47th Field Hospital Annual Rpt, 1944,
ans. 7-8; 64th Medical Group Annual Rpt, 1944, p.
Further, although working closely 8. On the platoon at St.-Vith, see Clifford L. Graves,
Front Line Surgeons: A History of the Third Auxiliary Sur-
14
Rogers was promoted to brigadier general ef- gical Group (San Diego, Calif.: Frye & Smith, 1950),
fective 10 November 1944. Surg, First U.S. Army, p. 242, and Interv (source of quotation), Lt Col Carl
Annual Rpt, 1944, pp. 53-54, gives a chronology of Belzer, 6 Jan 45, in 106th Infantry Division Combat
the surgeon's initial decisions. Intervs, box 24081, RG 407, NARA.
A TIME OF ADVERSITY 405
ride. The hospital platoon command- group lost several ambulance crew-
er, Major Huber, however, insisted men killed in the Malmedy massacre.
that these patients had to stay put. Nevertheless, its 179th and 180th
According to the auxiliary surgical Medical Battalions withdrew generally
group historian, "Serbst was right but intact and continued evacuating, re-
Huber prevailed." If patients stayed, spectively, the left and right flank di-
it was First Army policy that medical visions of the corps. The 64th Medi-
personnel must remain to care for cal Group, supporting the VIII Corps,
them. Huber, to his credit, adhered to pulled out of Troisvierges early on
the letter of this regulation also. He, the seventeenth. While an advance
with another officer and sixteen men group command post remained with
of the platoon, and with Serbst and the corps surgeon at Bastogne, the
his auxiliary team, remained with the balance of the unit continued on far-
casualties and went into captivity ther south to Martelange. Several
early on the nineteenth, when
more retreats followed until the
German troops entered Wiltz. The
group, on the twenty-first, finally
rest of the personnel, with several
truckloads of hospital equipment, left reached Sedan. Four days later, as the
during the night of the eighteenth. VIII Corps front at last stabilized, the
The medics, running a gauntlet of 64th Group moved to Gerouville, on
American roadblocks and German the Franco-Belgian border east of
fire, made their way back to VIII Sedan, more centrally located for
Corps lines. However, the trucks car- control of evacuation. Throughout
rying the equipment, diverted to an- the crisis of the battle the attached
other mission, unloaded their cargo ambulance and collecting companies
in Bastogne, an occurrence for which of these groups, in spite of frequent
101st Airborne Division medics soon displacements and bewilderingly rapid
would have cause to be grateful.17 changes in the divisions to be sup-
Both medical groups moved hur- ported, managed to keep casualties
riedly to escape the attack. The 134th moving back from the clearing sta-
Medical Group, which evacuated the tions. The groups also did much of
V Corps, retreated to Spa during the the work of mustering trucks to move
afternoon of the seventeenth. This field hospital platoons and other less
mobile organizations.18
17
The First Army considered the decision on re- On the northern edge of the Bulge
moval of patients from an endangered hospital to the westward drive of Kampfgruppe
be "a command function," but insisted that "from a
medical viewpoint, if patients are not evacuated, suf- Peiper compelled a series of medical
ficient medical personnel must stay behind to care unit withdrawals. On 17 December
for the patients even at the risk of capture." See the 44th and 67th Evacuation Hospi-
Surg, First U.S. Army, Annual Rpt, 1944, p. 70.
Quotation from Graves, Front Line Surgeons, p. 259.
18
See also ibid., pp. 258 and 260-61; 42d Field Hos- 134th Medical Group Annual Rpt, 1944, pp.
pital Annual Rpt, 1944, pp. 4-5; 64th Medical 14-17; 64th Medical Group Annual Rpt, 1944, and
Group Annual Rpt, 1944, p. 8; Surg, Third U.S. Semiannual Rpt, January-June 1945, p. 1. For ex-
Army, Annual Rpt, 1944, pp. 55-56; 110th Evacu- amples of the work of attached medical battalions,
ation Hospital Semiannual Rpt, January-June 1945, see 180th Medical Battalion Annual Rpt, 1944, p. 3,
p. 12; 240th Medical Battalion Annual Rpt, and 240th Medical Battalion Annual Rpt, 1944, pp.
1944, p. 7. 7-10.
A TIME OF ADVERSITY 407
tals, the 618th Clearing Company ex- were detailed to work in other medi-
haustion center, and the 2d Advance cal installations.19
Section, 1st Medical Depot Company, By midmorning on 18 December
retreated in haste from Malmedy, elements of Kampfgruppe Peiper's SS ar-
generally heading for Spa. The fol- mored force had reached Stavelot,
lowing day, the contagious disease less than 10 miles by road from Spa.
and malaria hospital, Company C, Few American troops then were be-
91st Medical Gas Treatment Battal- tween the Germans and First Army
ion, pulled out of Grand-Halleux. All headquarters with its cluster of ser-
these units removed their personnel vice installations. The army, accord-
and patients, most of them in ambu- ingly, directed all logistical units in
lances and trucks provided by the Spa, including those of its medical
134th Medical Group and the First service, to withdraw to Huy, a city on
Army Provisional Medical Department the Meuse about 25 miles to the west,
Truck Company. They also made where they would be well situated
much use of self-help. The 618th either to support a new defense line
Company, for instance, secured rides or for further retreat. Army headquar-
for about half of its 200 patients by ters at the same time moved to the
flagging down passing trucks. For lack environs of Liege.
of time and transportation, the units This withdrawal involved a number
for the most part left in place their of working medical units and others
equipment and, in the case of the earlier displaced from farther south.
depot section, their stock. On the The 134th Medical Group, previously
twenty-first and twenty-second, after pushed out of Malmedy, joined the
the battle line stabilized just south of new exodus. So did the 57th Medical
Malmedy, the 134th Medical Group, Battalion, heretofore located at Spa,
using vehicles and men of several which constituted the army reserve of
evacuation hospitals, retrieved most collecting and ambulance companies
of the outfit of the units withdrawn and controlled the now heavily com-
from that town. The depot section, by mitted Provisional Truck Company.
sending in a few trucks at a time, The commander of the 57th prudent-
managed to haul its stores back to the ly had stationed liaison officers at
base depot at Dolhain. A salvage de- 19
tachment of the gas treatment compa- Surg, First U.S. Army, Annual Rpt, 1944, pp. 22
and 53-54; First U.S. Army Report of Operations, 1
ny, on the other hand, came under Aug 44-22 Feb 45, bk. IV, p. 156; 134th Medical
German fire at Grand-Halleux and Group Annual Rpt, 1944, pp. 14-15; Surg, V Corps,
Annual Rpt, 1944, p. 22; 44th Evacuation Hospital
only secured a portion of that unit's Annual Rpt, 1944; 67th Evacuation Hospital Annual
equipment. Regardless of how much Rpt, 1944, and Semiannual Rpt, January-June 1945;
of their equipment was recovered, the 618th Clearing Company Annual Rpt, 1944, pp. 5-
6; 91st Medical Gas Treatment Battalion Annual
withdrawn hospitals effectively were Rpt, 1944, p. 5; 1st Medical Depot Company Annual
out of action for the rest of the battle. Rpt, 1944, p. 7. For an example of trucks used in
Most had to retreat a couple of times equipment recovery, see 45th Evacuation Hospital
Annual Rpt, 1944, p. 175. For the origin of the First
more as the First Army regrouped. Army Provisional Medical Department Truck Com-
Their people remained in billets or pany, see Chapter IX of this volume.
408 EUROPEAN THEATER OF OPERATIONS
General Rogers' office and at other brought the 42d Field Hospital equip-
headquarters in Spa, to ensure that ment from Wiltz. A four-man detach-
he would receive up-to-date intelli- ment stayed behind with the rest of
gence and timely orders. He started the supplies. The main body of the
his battalion off as soon as the enemy unit halted briefly at Libin, some 20
was reported at Stavelot. Most impor- miles west of Bastogne, then retreat-
tant of these new displacements was ed again southwestward to Carls-
that of the 4th Convalescent Hospital bourg on the twenty-first. Five days
at Spa. Since the offensive this large later, after the Third Army had taken
installation, besides performing its over medical support of the southern
main mission of patient recondition- flank of the Bulge, the section moved
ing, had housed and fed the person- north and rejoined the base depot at
nel of withdrawing medical units. Dolhain.
21
unit found shelter in a former voca- than 1.5 percent among the over
23
tional school and resumed operations 2,200 admitted for surgery.
on Christmas Eve. During the follow-
ing week, it handled over 1,000 pa- Medical Realignments
tients.22
The remaining evacuation hospital Even as the last medical units extri-
in rear of the VIII Corps, the 110th at cated themselves from the break-
Esch, well south of the breakthrough, through area, the First and Ninth
stayed in place. During the first week Armies were shifting forces to build a
of the German offensive this 400-bed solid line between the Germans and
hospital received most of the Ameri- the Meuse. The Ninth Army relin-
quished four infantry and two ar-
can casualties from the southern flank
mored divisions to its southern neigh-
of the Bulge, and in addition it fed bor. At the same time its XIX Corps
and temporarily sheltered thousands extended to its right to take over
of troops separated from their units. most of the territory and several divi-
Patients arrived at a rate of about 300 sions of the First Army's VII Corps,
a day. The surgical backlog at one freeing the latter headquarters and its
time also exceeded 300. As no field corps troops for commitment on the
hospitals any longer were in front of northern flank of the Bulge. The First
the 110th, these surgical patients in- Army on 19 December transferred the
cluded many men with severe chest VIII Corps, with which its headquar-
and abdominal injuries. To cope with ters no longer had effective communi-
this influx, the hospital pitched tents cation, to the Third Army for both
in the paved courtyard of its building operational control and logistical sup-
to house the sick and lightly wound- port. At the same time the First Army
ed. The receiving section culled all acquired the XVIII Airborne Corps,
the immediately transportable pa- which went into line immediately to
tients from among the incoming casu- the right of the V Corps controlling
alties, filled out the basic medical the 82d Airborne Division and others
forms on them, and at once placed from the Ninth Army and VIII Corps.
them in ambulances and sent them Finally, on the twenty-fourth, the VII
toward the rear. By such expedients, Corps shifted its headquarters from
Aachen to Huy. With one armored
and by strenuous round-the-clock
and two infantry divisions it formed
effort, the staff, heavily reinforced the right wing of an army front an-
with auxiliary surgical teams, coped chored on Elsenborn Ridge, and ex-
with the overload. The 110th handled tending from there generally south-
over 5,000 patients within a month, westward.
with a mortality rate of a little less Medical rearrangements accompa-
22
nied this reorganization. In the Ninth
Quotation from 102d Evacuation Hospital
Annual Rpt, 1944, p. 2. See also 107th Evacuation
Army the 31st Medical Group and
Hospital Annual Rpt, 1944, pp. 6-8; 92d Medical
23
Gas Treatment Battalion Annual Rpt, 1944, pp. 6-7; 110th Evacuation Hospital Semiannual Rpt, Jan-
Surg, Third U.S. Army, Annual Rpt, 1944, p. 56. uary-June 1945, pp. 3, 18, 42 and encl. 3.
410 EUROPEAN THEATER OF OPERATIONS
several field and evacuation hospitals and XVIII Airborne Corps. The army
changed position to support the used the additional battalion head-
southward extension of the XIX quarters, with a collecting company
Corps and to evacuate casualties of and a clearing company platoon at-
divisions formerly under the First tached, as a provisional medical bat-
Army. At the same time the Ninth talion for the airborne corps, which
Army surgeon, Colonel Shambora, hitherto had lacked one. During the
and his staff made preparations for VII Corps redeployment the 68th
withdrawal in the event that the Ger- Medical Group, which supported the
mans extended their offensive to their corps, moved its headquarters 50
army's hitherto quiet front or broke miles; disengaged from support of
clear through the First Army and five divisions and as many evacuation
crossed the Meuse. Shambora select- hospitals; and assumed responsibility
ed an alternate medical concentration for eight new divisions, belonging to
area just east of Brussels. He rede- the VII and XVIII Airborne Corps, as
ployed two evacuation hospitals, and
well as two evacuation hospitals. The
platoons of two field hospitals closed
and pulled back. Shambora also had group commander observed: "Prob-
his forward evacuation hospitals send ably at no previous time had the flexi-
all their unused heavy equipment, bility and ease of adaptability of a
such as tentage, back to the 35th Medical Group been more clearly il-
Medical Depot Company for storage, lustrated than during this emergen-
25
thereby reducing the transportation cy. . . ."
requirements in any retreat. The To the rear of the fighting line
Ninth Army front, however, remained General Rogers attempted to put
largely inactive.
24 back together an army evacuation and
The First Army, in addition to re- hospitalization system disrupted by
linquishing its VIII Corps to the the rapid movement of the front and
Third Army, transferred its 64th Med- the displacement of so many medical
ical Group (to include its two battal- units. Even though most threatened
ion headquarters, a collecting compa- installations, or at least their person-
ny, four ambulance companies, and a nel, escaped the advancing Germans,
clearing company) and the corps' Rogers within forty-eight hours of the
medical battalion and one field and start of the attack no longer had
three evacuation hospitals. In return, enough beds in operation for normal
on 21 December, the First Army hospitalization and evacuation of his
picked up from the Ninth Army a
25
medical battalion, the 187th, with one Quotation from 68th Medical Group Annual
ambulance and three collecting com- Rpt, 1944, p. 22. On 21 December the 134th Medi-
cal Group moved forward from Huy to Verviers to
panies. The companies went to rein- be closer to the V Corps. See 134th Medical Group
force the 134th Medical Group, now Annual Rpt, 1944, pp. 15-16. See also Surg, First
U.S. Army, Annual Rpt, 1944, pp. 54-55 and 57-78;
responsible for evacuating both the V VII Corps Medical Plan, pp. 103-04, encl. 1 to
Surg, VII Corps, Annual Rpt, 1944; 187th Medical
24
Surg, Ninth U.S. Army, Annual Rpt, 1944, pp. Battalion Annual Rpt, 1944, p. 2; Surg, XVIII Air-
10-11 and 13-16; 31st Medical Group Annual Rpt, borne Corps, Semiannual Rpt, January-June 1945,
1944, pp. 19-20. pp. 1-3.
A TIME OF ADVERSITY 411
casualties. Well over half of the First ing stations. One of these, the 77th
Army's dozen evacuation hospitals by Evacuation Hospital, a 750-bed unit
that time had closed for movement, located at Venders, had been func-
had lost their equipment, or—in the tioning as a holding unit and hastily
VIII Corps area—had become inac- reorganized to perform its original
cessible to the majority of divisions. mission. Just behind the center of the
In addition, the displacement of the new First Army front, the 77th, assist-
4th Convalescent Hospital, the 618th ed for a time by the 9th Field Hospi-
Clearing Company exhaustion center, tal, for about a week handled most of
and the 91st Medical Gas Treatment the casualties from divisions trying to
Battalion communicable disease facili- stop the German advance toward the
ty left the army unable to retain and Meuse. The staff, augmented with
care for short-term cases. Perforce, auxiliary surgical teams and medics
then, Rogers on 19 December estab- from nonoperating First Army hospi-
lished a total evacuation policy in tals, worked eighteen-hour and longer
place of the ten-day one hitherto in days to sort, treat, and evacuate the
effect. Under the new policy, army flood of patients. They keep eight op-
hospitals evacuated all their patients erating and two fracture tables busy
as soon as they were able to travel day and night. Verviers, a major road
and sent new arrivals whose condi- center, came under daily enemy artil-
tions permitted it, without treatment, lery fire, V-1 bombardment, and
directly to COMZ facilities. Most of Luftwaffe raids. This danger forced
the bypassed patients, under an off-duty personnel to spend their few
agreement between Rogers and the hours of rest in crowded, fetid under-
ADSEC surgeon, Colonel Beasley, ground shelters. On 20 December a
went to the by now well-developed shell blew off a corner of the school
cluster of general hospitals around building that housed the 77th, wreck-
Liege. Those hospitals, according to ing a bathroom; damaging the nurses
General Hawley, "saved the First quarters, laboratory, and pharmacy,
Army medical service during the and one medical ward; and mortally
counteroffensive," for without them wounding a Red Cross worker. The
Rogers could not have kept his re- hospital staff cleaned up the wreckage
maining evacuation beds open for and continued in operation. A week
fresh casualties or cleared his endan- later, in addition to the regular pa-
26
gered units for withdrawal. tient influx, the 77th had to care for
Two ADSEC units close to the the 14 dead and 50 wounded from a
combat zone temporarily served as direct bomb hit on the 9th Field Hos-
army evacuation hospitals, receiving pital. "For hours the receiving room
wounded brought from division clear- was in a turmoil as the differentiation
26 and treatment went on. Among the
Quotation from Ltr, Hawley to TSG, 27 Jan 45,
file HD 024 ETO O/CS (Hawley-SGO Corresp). dead, decapitations and amputations
See also Surg, First U.S. Army, Annual Rpt, 1944, made the task gruesome, even for the
pp. 54, 56-57, 69-70. Some individual hospitals men who had seen many hundreds of
went to total evacuation even before the army
change of policy. See 5th Evacuation Hospital wounded." Enemy bombardment for
Annual Rpt, 1944, p. 15, for example. a time prevented hospital trains from
412 EUROPEAN THEATER OF OPERATIONS
reaching Verviers. The Advance Sec- tal received and treated or bypassed
tion maintained evacuation of the over 3,000 patients. It evacuated most
77th with ambulances, which shuttled of them by train from a nearby siding.
patients back to the Liege general The unit performed surgery on about
hospitals. The burden on the weary 200 casualties. The German advance
77th staff eased only in the last days rolled almost literally up to the door;
of the year, as First Army27 hospitals fighting occurred in the hospital
began opening in Verviers. grounds as the 2d Armored Division
The 130th General Hospital, al- and other units moved in to engage
though an ADSEC unit, lay just within and throw back the enemy. On the
the First Army area. As it turned out, twenty-third the 130th evacuated all
this hospital, set up in a large school but a skeleton staff and its nontrans-
building at Ciney, was positioned
almost exactly at the westernmost tip portables. The remaining staff and
of the Bulge and was well placed to patients all left or were evacuated
receive casualties from the VIII during the next four days, along with
Corps. That, however, was not its the most vital items of equipment. An
function. The 130th had been reorga- armored combat command treatment
nized before leaving England as a station temporarily occupied the plant
specialized neuropsychiatric facility. until the twenty-eighth, when an ad-
At Ciney it treated combat exhaustion vance28
party of the 130th moved back
casualties from the First and Ninth in.
Armies. The hospital's mission While these ADSEC hospitals, and
changed abruptly on 19 December, the few First Army ones still active,
when ambulance loads of wounded coped with the immediate flow of cas-
began arriving, both from retreating ualties, General Rogers tried to rede-
evacuation hospitals, such as the ploy and reopen his evacuation hospi-
107th, and directly from division tals. He worked within the constraints
clearing stations. According to the of an army G-4 order, issued on
unit report, the hospital found itself Christmas Day, to withdraw all logisti-
"acting as a cross between a clearing cal units except those absolutely es-
company and an evacuation hospital sential for operations to positions
which required revamping . . north.and[the]
west of the Meuse. Under
entire setup." The 130th discharged this directive First Army hospitals and
its exhaustion patients to an ADSEC other medical units redeployed to a
replacement depot, sent its psychiat- concentration area about 15 miles or
ric staff to the rear, and enlarged its
surgical service with people from the so west of Liege. These included two
12th Field Hospital and the 3d Auxil- of the three evacuation hospitals that
iary Surgical Group. Between the had been working in Eupen through-
twentieth and twenty-third the hospi- out the battle, under bombardment
27
comparable to that endured by the
Quotation from Allen, ed., Medicine Under
Canvas, pp. 142-48. See also Surg, ADSEC, COMZ,
28
Annual Rpt, 1944, p. 20; 77th Evacuation Hospital Quotation from 130th General Hospital Annual
Annual Rpt, 1944, pp. 7-8; 134th Medical Group Rpt, 1944, pp. 4, 11, 16-17, 28-30. See also Surg,
Annual Rpt, 1944, p. 16. ADSEC, COMZ, Annual Rpt, 1944, p. 10.
A TIME OF ADVERSITY 413
77th at Verviers. This final withdrawal uation policy in effect until mid-Janu-
29
crowded First Army units back into ary.
towns already occupied by numerous The First Army also redeployed its
ADSEC facilities. As a result, the hos- medical supply installations during
pitals sent there could not reopen for the last week of December and began
lack of usable buildings, tented open- rehabilitating those of its units that
field operation being out of the ques- had lost equipment in the retreat.
tion in the cold wet weather. By the Under the 25 December withdrawal
order the base depot, with most of its
end of the year the First Army had a stock, moved by rail from Dolhain to
few evacuation hospitals working: the Basse Wavre, southeast of Brussels.
102d and 51st (field acting as an As later described by the army sur-
evacuation) at Huy, the 97th and geon, "A series of incidents, some hu-
128th at Verviers, and the 2d at morous and some serious, including
Eupen. The other six evacuation hos-
29
pitals then under the army, however, Surg, First U.S. Army, Annual Rpt, 1944, p. 56;
First U.S. Army Report of Operations, 1 Aug 44-22
remained inactive, as did the conva- Feb 45, bk. IV, pp. 144-45; 68th Medical Group
lescent hospital and most of the spe- Annual Rpt, 1944, p. 23; 134th Medical Group
cialized medical facilities. General Annual Rpt, p. 16; 2d, 5th 45th, 97th, and 102d
Evacuation Hospitals Annual Rpts, 1944; 51st Field
Rogers, accordingly, kept a total evac- Hospital Annual Rpt, 1944.
414 EUROPEAN THEATER OF OPERATIONS
Army medical units farther to the rear During the first two weeks of the
for a while drew directly upon COMZ German offensive, the First Army
depots, notably M-409 at Liege. By medical service redeployed most of its
the end of the year the base depot nondivisional units while maintaining
was engaged in replenishing its much continuous evacuation of the regroup-
depleted stock. General Rogers sent ing combat forces. Its relative success
liaison officers to divisions and other
organizations to determine the extent in both endeavors may be attributed
of their medical equipment losses, to a favorable starting position, to the
which in many units approached 100 delays in the German advance, to an
percent of their basic allowances. His abundance of transportation, and to a
office then worked directly with the high standard of unit and individual
chief surgeon's Supply Division to initiative and resourcefulness. By the
speed replacement items forward.
30 end of December, however, the army
Throughout the medical unit move- for all practical purposes had lost its
ments resulting from the Ardennes ability to hold and treat casualties; its
battle, the First Army Provisional medical service perforce had been re-
Medical Department Truck Company duced to little more than a conduit
performed indispensable service. This between division clearing stations and
unit, attached to the 57th Medical COMZ hospitals.
Battalion, had been formed during
the pursuit by pooling vehicles, pri- Bastogne: Encirclement and Relief
marily taken from evacuation hospi-
tals, as a transportation reserve for The battle for Bastogne began on
moving the larger army installations. 19 December, when the 101st Air-
Its work, and vehicle strength, had di- borne Division went into action to the
east of that strategic road junction.
30
Quotation from Surg, First U.S. Army, Annual
Rpt, 1944, p. 22. See also ibid., p. 23; First U.S.
31
Army Report of Operations, 1 Aug 44-22 Feb 45, Surg, First U.S. Army, Annual Rpt, 1944, p. 61;
bk. IV, pp. 156-57; 1st Medical Depot Company 57th Medical Battalion Annual Rpt, 1944, pp. 22-
Annual Rpt, 1944, p. 7. 23.
A TIME OF ADVERSITY 415
The following day the VIII Corps Division. In addition, Combat Com-
gave Brig. Gen. Anthony C. McAu- mand B of the 10th Armored Division
liffe, acting division commander, suffered about 500 battle casualties,
overall charge of the defense, with and there were still more among the
control also of Combat Command B, other commands, and fragments of
10th Armored Division; of Combat commands, that defended the city.
Command R, 9th Armored Division; The great majority of the sick and
and of an assortment of artillery, tank wounded were trapped in Bastogne
destroyer, and other units that had for the duration of the encirclement.33
collected in Bastogne. On the twenty- The 101st Division medical service
first the Germans closed their ring was organized and equipped for self-
and made their first attacks on the sufficient operations out of contact
American perimeter. The enemy sur- with the normal ground chain of evac-
render demand came on the twenty- uation. Its medical detachments went
second and elicited General McAu- into action at full strength in men and
liffe's immortal one-word rejection.
equipment and carrying along extra
For another four days the defenders
fought off repeated assaults by the reserves of litters and blankets. The
Fifth Panzer Army, making effective use division's 326th Airborne Medical
of well-directed artillery fire to break Company included both collecting
up German attacks. At night they en- and clearing elements and had an
dured Luftwaffe bombing raids on the auxiliary surgical team attached so
city. The American units within the that it could perform the functions of
perimeter had enough food, ammuni- a field hospital platoon (see Map 18).
tion, and other necessities, brought in An early stroke of misfortune de-
with them or foraged from aban- prived the division of its hospital. The
doned First Army and VIII Corps 326th Company, accompanied by the
dumps, to carry them through until division surgeon, Colonel Gold, and
23 December, when large-scale supply his staff, set up its clearing and surgi-
airdrops began just in time to avert a cal station early on 19 December at a
critical shortage of artillery shells. At crossroads about 8 miles west of Bas-
1645 on the day after Christmas ele- togne. Gold, in consultation with the
ments of the 4th Armored Division of division supply officer, placed the sta-
the Third Army opened a road into tion there, in what he expected would
Bastogne from the south. This break- be the division service area, on the as-
through ended the siege, although sumption that the 101st would be
heavy fighting continued around the fighting as a part of a continuous
city for several more weeks.32 front line. Around 1030 the company
American casualties during the deployed its collecting elements,
siege amounted at least to 189 offi-
cers and men killed, 1,040 wounded, 33
101st Airborne Division After-Action Rpt, IT-
407 sick and injured, and 412 miss- 27 Dec 44, box 14335, RG 407, NARA. Cole, Ar-
ing—the loss reported by the 101st dennes, pp. 480-81, provides figures on casualties in
other organizations. His figures for the 101st Divi-
32
sion differ from those in the report first cited, as do
For tactical developments, see Cole, Ardennes, those given in Surg, 101st Airborne Division,
ch. XIX. Annual Rpt, 1944, pp. 12-13.
416 EUROPEAN THEATER OF OPERATIONS
MAP 18
sending four or five ambulance jeeps tion. On the return trip Barfield and
and an evacuation officer to each of his group found their road to Bas-
the four infantry regiments. The first togne blocked by a blown bridge and
patients arrived at about 1100. Late columns of tanks and spent the night
that afternoon the 326th Company at the 107th.34
commander, Major Barfield, left the
34
crossroads with an ambulance convoy Surg, 101st Airborne Division Annual Rpt,
1944, pp. 9-10; 326th Airborne Medical Company
to take patients to the 107th Evacu- After-Action Rpt, Belgium and France, 17-28 Dec
ation Hospital at Libin and to contact 44, p. 3; G-3 Account of Bastogne Operation, in
101st Airborne Division Combat Intervs, box 24075,
the 64th Medical Group about addi- RG 407, NARA; Crandall Interv, 8 Jun 45, box 222,
tional ambulances for the clearing sta- RG 112, NARA.
A TIME OF ADVERSITY 417
At around 2200 a German force of borne Division lost its hospital and its
perhaps half a dozen armored vehi- emergency surgical facility.35
cles and 100 troops, some dressed in Division headquarters learned of
civilian clothing, attacked the 326th this misfortune shortly after midnight,
Company clearing station. Evidently a from infantry patrols sent to investi-
reconnaissance element of one of the gate the shooting at the crossroads
columns beginning to encircle Bas- and from escapees of the 326th Com-
togne, it had come down a road from pany who made their way into Bas-
the northeast and caught the medical togne. The G-4 and the evacuation
company totally by surprise. After a officers of the medical company in
few minutes of sporadic automatic town, together with the regimental
weapons fire, the Germans realized surgeons and Major Barfield, now
that they had run into a medical in- acting division surgeon, quickly im-
stallation. An enemy officer came for- provised a new evacuation system.
ward and demanded the Americans' They designated the regimental aid
surrender. Colonel Gold, who had no station of the 501st Parachute Infan-
alternative, complied, but a few offi- try, centrally located within the city in
cers and men on the west side of the a convent, as the collecting point for
company area ran off into the nearby all division casualties. Meanwhile, the
woods. As the Germans were round- VIII Corps surgeon, at division re-
ing up their prisoners, a truck column quest, deployed a collecting company
headed out of Bastogne to pick up and the clearing company of the
supplies rolled unsuspectingly into corps medical battalion to move pa-
the crossroads. Firing broke out tients from Bastogne to evacuation
again, from the Germans and from at hospitals. Some 170 men passed
least one of the trucks. The medics, through this improvised evacuation
caught in the crossfire, ducked for chain on the twentieth. By 2330 on
cover. Some were killed or wounded that day, however, the Germans had
by stray bullets; a few managed to blocked the last road out of Bastogne.
escape in the confusion. Soon the Completion of the encirclement left
flames of burning American vehicles the VIII Corps collecting and clearing
lighted the area. Americans and Ger- units outside the ring, along with
mans alike made futile efforts to save Major Barfield, who had gone back to
the screaming wounded trapped corps headquarters to report on the
inside the wrecks. The Germans with- loss of the medical company and
drew toward the northeast, taking 35
with them the remaining medical per- 27 Dec 101st Airborne Division After-Action Rpt, IT-
44, box 14335, RG 407, NARA; Surg, 101st
sonnel and patients, as well as any Airborne Division, Annual Rpt, 1944, pp. 10-11;
equipment and supplies they decided 326th Airborne Medical Company After-Action Rpt,
not to destroy. The prisoners includ- Belgium and France, 17-28 Dec 44, p. 4. For eye-
witness stories, see Crandall Interv, 8 Jun 45, box
ed Colonel Gold and his staff, an 222, RG 112, NARA; Rapport and Northwood, Ren-
entire auxiliary surgical team, and 11 dezvous with Destiny, pp. 467-68; Graves, Front Line
Surgeons, p. 278; and Statement of Pfc E. E. Lucan,
officers and 119 men of the 326th in 101st Airborne Division Combat Intervs, box
Company. With them, the 101st Air- 24075, RG 407, NARA.
418 EUROPEAN THEATER OF OPERATIONS
bring forward additional supplies and room fed both staff and patients. The
equipment. Wounded soon began to wounded "were laid in rows on saw-
accumulate in the regimental aid sta- dust covered with blankets. Each row
tion; as early as 0630 on the twenty- had a shift of aidmen, and an attempt
first about 150 were on hand.36 was made to segregate incoming cases
The 101st Division now was totally into specified rows depending upon
cut off from evacuation. Its medical the seriousness of their wounds."
officers, to give the steadily growing Those deemed unlikely to survive lay
number of casualties at least essential nearest the wall. "As they died they
life-saving treatment until American were carried out to another building
forces broke the German siege, im- where an impromptu Graves Registra-
provised a hospital at the convent tion Office was functioning." Wisely
housing the regimental aid station.
Maj. Martin S. Wisely, MC, regimen- and his assistants worked 24-hour
tal surgeon of the 327th Glider Infan- shifts trying to keep their patients fed,
try, headed a pickup staff made up of reasonably warm, and in stable condi-
doctors and aidmen from the division tion. They attempted no major sur-
antiaircraft, engineer, artillery, and gery. According to the participants,
tank destroyer units. To obtain more morale among the casualties was "ex-
space and better protection from ar- tremely high." On Christmas Eve a
tillery and air attack for his patients, ration of cognac and the voice of
Wisely moved the hospital from the Bing Crosby singing "White Christ-
convent to the basement garage of a mas" from a salvaged civilian radio37
Belgian Army barracks. As the hospi- provided some holiday atmosphere.
tal population increased, he placed Although the 101st Division hospi-
ambulatory patients in the barracks tal handled most of the casualties of
rifle range and used still another the siege, it was not the only impro-
building for trenchfoot cases. Eventu- vised medical facility in Bastogne.
ally, patients were distributed among Combat Command B, 10th Armored
basements all over the city, with the Division, a Third Army unit that had
barracks garage reserved for the most entered the city from the south, im-
severely wounded. provised its own holding and treat-
These facilities were, to say the ment station after being cut off from
least, primitive. The main garage its supporting armored medical com-
ward, for instance, had no latrine and pany. On Christmas Eve the hospital
only a single electric light. A field took a direct hit from a German
kitchen set up at one end of the large
37
Quotations and most details from Rapport and
36
Surg, VIII Corps, Annual Rpt, 1944, p. 8; Surg, Northwood, Rendezvous with Destiny, pp. 469-71. See
101st Airborne Division, Annual Rpt, 1944, p. 11; also Surg, 101st Airborne Division, Annual Rpt,
326th Airborne Medical Company After-Action Rpt, 1944, p. 11; 326th Airborne Medical Company
Belgium and France, 17-28 Dec 44, pp. 3-5; G-3 After-Action Rpt, Belgium and France, 17-28 Dec
Account of Bastogne Operation and Narrative, 44, p. 5; 501st Parachute Infantry Draft After-Action
"Medical Evacuation and Supply," both in 101st Rpt, in 101st Airborne Division Combat Intervs,
Airborne Division Combat Intervs, box 24075, RG box 24075, RG 407, NARA. History of the 12th
407, NARA; 169th Medical Battalion Annual Rpt, Evacuation Hospital, 25 August 1942 to 25 August
1944, p. 12; 429th Collecting Company Annual Rpt, 1943 (hereafter cited as 12th Evac Hist), pp. 111-
1944, p. 3. 12, contains additional eyewitness reports.
A TIME OF ADVERSITY 419
bomb. The resulting roof cave-in and them all rifles, and led them to join a
fire killed a number of patients and scratch force of headquarters person-
also a Belgian woman nurse, who had nel in repelling the attack.39
volunteered to help tend the Ameri- During this week of encirclement
can wounded.38 the hospitals in Bastogne faced two
Around the perimeter the infantry major problems: medical supply and
battalions set up their aid stations in the provision of emergency surgery.
the standard manner, with the main Of these the supply problem proved
installations well sheltered in farm- the easier to solve. A few tons of
houses or other structures and for- stores and a small issuing detachment
ward collecting elements close to the of the 1st Medical Depot Company
foxhole line. Short of litterbearers, remained in Bastogne, and paratroop-
the airborne units relied heavily on ers also found an abandoned VIII
their ambulance jeeps to move their Corps medical supply point. From
casualties. Where jeeps could not go, these sources the surgeons obtained
some units used toboggans, made of
sheet metal torn off roofs, to slide necessities for the first few days. Nev-
wounded men across the snow. Jeeps ertheless, by the end of the third day
of the division's 326th Company car- of the siege, the hospitals were run-
ried patients from the battalion aid ning short of penicillin, plasma, mor-
stations to the central hospital in Bas- phine, dressings, litters, and blankets.
togne. One regimental surgeon, Maj. To keep patients warm in the unheat-
Douglas Davidson, MC, of the 502d ed wards, the division collected the
Parachute Infantry, thought he could blankets of its dead and sent parties
do as much for his wounded as the of men to salvage quilts and bed
ill-equipped division facility; hence, clothing from ruined dwellings. Food
he maintained his own holding hospi- also was short, although the division
tal in the barn of the chateau housing reserved for the hospitals the limited
the regimental command post. David- available quantities of sugar, coffee,
son used horse stalls for wards and Ovaltine, and ten-in-one rations. The
pressed the chaplains and a dentist large-scale airdrop, which began on
into service as cooks. He estimated 23 December, alleviated most medical
that "only about 5 men died of supply deficiencies. Penicillin and
wounds who might have been saved other medicines, plasma, Vaseline
had they been given medical care." gauze, anesthetics, morphine, distilled
On Christmas Day, when German water, syringes, sterilizers, litters, and
tanks and infantry broke through the blankets arrived in the parachuted
main line of resistance and momen- bundles. The parachute cloth itself,
tarily threatened the command post, and the wrapping of the bundles,
Davidson routed out all of his wound- went to the hospitals to provide addi-
ed men who were able to walk, gave
39
Rapport and Northwood, Rendezvous with Destiny,
38
Surg, 10th Armored Division, Annual Rpt, pp. 470-71. For Davidson, see S. L. A. Marshall,
1944, p. 15; 101st Airborne Division After-Action "Bastogne," pp. 197-98, and Narrative (source of
Rpt, 17-27 Dec 44, box 14335, RG 407, NARA; quotation), 592d Parachute Infantry, both in 101st
Rapport and Northwood, Rendezvous with Destiny, pp. Airborne Division Combat Intervs, respectively box
471 and 546. 24074 and box 24075, RG 407, NARA.
420 EUROPEAN THEATER OF OPERATIONS
tional warm covering for patients. Even as Wisely was trying to ar-
Whole blood also was among the air- range for the wounded to come out
delivered supplies, but the bottles of Bastogne, Third Army efforts to
broke on landing or were destroyed send surgeons in bore fruit. The army
when a German shell blew up the surgeon's office obtained six medical
40
room where they were stored. officers and four enlisted technicians,
As the days of encirclement went all volunteers, from the 4th Auxiliary
by, the division surgeons realized that Surgical Group and the 12th Evacu-
the number of wounded awaiting ation Hospital to go into Bastogne
treatment was increasing and that and set up an emergency surgical fa-
they were going to die unless they un- cility. The army at first intended to
derwent major operations immediate- drop these men into the perimeter by
ly. Equipment for such surgery was at
hand: the operating theater outfit of parachute; but, to their relief, they
the 42d Field Hospital platoon that were able to travel by less hazardous
had withdrawn from Wiltz. However, means. One officer was flown in on
the few surgeons in Bastogne either Christmas Day in a light plane and
could not be spared from other tasks the rest followed by glider during the
or lacked the qualifications to per- afternoon of the twenty-sixth.
form the work required. Seeking a When the main body of the surgical
way out of this dilemma, Major group walked into the garage hospi-
Wisely on 26 December obtained au- tal, about 150 patients, all severe
thority from the division to try to ne- cases, remained, the rest having been
gotiate the passage of the most se- moved elsewhere. The need for the
verely wounded through German reinforcements' services was all to ap-
lines. Wisely, assisted by a captured parent, as "the odor of gas gangrene
German medical officer, made contact permeated the room." Using the 42d
with the enemy commander opposite Field Hospital equipment, which in-
the southwest sector of the perimeter. cluded an operating lamp and an
The German responded favorably to autoclave, the surgeons and techni-
the evacuation proposal but post- cians set up a four-table theater in a
poned a final answer until the next small tool room adjoining the garage.
day. By that time Third Army troops They examined and sorted the pa-
had ended the siege.41 tients and by nightfall had the first
40
men on the tables. The volunteers,
Surg, First U.S. Army, Annual Rpt, 1944, p. 22; assisted by three Belgian women and
Surg, Third U.S. Army, Annual Rpt, 1944, p. 171;
Surg, 101st Airborne Division, Annual Rpt, 1944, by a 10th Armored Division battalion
pp. 11-12; Rapport and Northwood, Rendezvous with surgeon who was a qualified anesthe-
Destiny, pp. 469-71; Narrative, "Medical Evacuation tist, operated all through the night
and Supply," and Interv, ACofS, G-4, and Others,
both in 101st Airborne Division Combat Intervs, and until around noon of the twenty-
box 24075, RG 407, NARA; 101st Airborne Division seventh, trying to repair wounds that
After-Action Rpt, 17-27 Dec 44, box 14335, RG had gone from two to as many as
407, NARA.
41
Rapport and Northwood, Rendezvous with Destiny,
p. 471; Narrative, "Medical Evacuation and Supply," 24075, RG 407, NARA. The Third Army's chief of
and 327th Glider Infantry Journal, 26 Dec 44, both staff had plans for moving surgeons into Bastogne
in 101st Airborne Division Combat Intervs, box under a white flag. See Cole, Ardennes, p. 609.
BUNDLES OF MEDICAL SUPPLIES, air-dropped from C-47s over a field near Bastogne and
retrieved by 101st Airborne Division troops
422 EUROPEAN THEATER OF OPERATIONS
break the encirclement, joined in the As it turned out, all the accumulat-
preparations. Besides arranging for ed casualties came out through
aerial resupply and surgical reinforce- Villers-devant-Orval. Early on 27 De-
ment of the besieged division, the cember the first evacuation convoy of
Third Army and its subordinate com-
twenty-two ambulances and ten trucks
mands prepared to evacuate an antici-
pated 1,000 sick and wounded as rolled out of Bastogne carrying 260
soon as a way out of Bastogne was patients. Men of the 635th Clearing
opened. After a couple of false starts, Company unloaded the casualties,
resulting from reports that there was tagged them, and transferred them to
64th Medical Group ambulances for
42
Quotation from 12th Evac Hist, pp. 111-12. Seemovement to evacuation hospitals.
also ibid., pp. 63 and 110; Surg, Third U.S. Army, The vehicles from Bastogne then
Rpt, December 1944, p. 31, in Third U.S. Army
After-Action Rpt, 1 Aug 44-9 May 45; 4th Auxiliary went back to the city for another load.
Surgical Group Annual Rpt, 1944, p. 16; 101st Air- In two days the medical units evacuat-
borne Division After-Action Rpt, 17-27 Dec 44, box ed all of the 964 patients in the Bas-
14335, RG 407, NARA; Surg, 101st Airborne Divi-
sion, Annual Rpt, 1944, p. 12; 326th Airborne Med-
43
ical Company After-Action Rpt, Belgium and Surg, Third U.S. Army, Annual Rpt, 1944, p.
France, 17-28 Dec 44, p. 5; Rapport and North- 79; Surg, III Corps, Annual Rpt, 1944, an. 1; 169th
wood, Rendezvous with Destiny, p. 471; Editorial Advi- Medical Battalion Annual Rpt, 1944, p. 12; 240th
sory Board, 1962, pp. 211-12. Medical Battalion Annual Rpt, 1944, pp. 8-9.
A TIME OF ADVERSITY 423
Bastogne for lack of early surgery or eral Patton's army performed the con-
as the result of other deficiencies of siderable tactical and logistical feat of
the improvised hospitals cannot be disengaging from a planned offensive
determined from the fragmentary northeastward across the Saar River,
records of those ephemeral organiza- shifting a good part of its combat
tions. One firm figure is the 101st strength from its right to its left wing
Airborne Division report of 33 deaths and making a 90-degree change in the
under treatment in its facilities be- axis of its line of communications.
tween 19 and 31 December. The Patton received directions for this
Third Army surgical consultant, after movement from SHAEF and the 12th
examining the wounded brought out Army Group on 18-19 December and
of Bastogne, concluded that "other at the same time took over the VIII
than the physical discomforts, the cas- Corps from the First Army. Three
ualties had not unduly suffered for days of hasty consultation, planning,
lack of Medical Department treatment and staff work ensued. On the morn-
and that the mortality was extremely ing of the twenty-second, the day
low." Whatever the clinical verdict, a Patton had promised Eisenhower he
Stars and Stripes correspondent who would attack, the III Corps,47 with the
watched one of the first evacuation 4th Armored and the 26th and 80th
convoys come out of Bastogne ex- Infantry Divisions, opened its drive
pressed the human reality of the toward Bastogne. The XII Corps re-
siege: arranged its forces and attacked on
The convoy of wounded came out of Bas- the right of the III Corps. The re-
togne in a slow trickle. The day was beau- maining Third Army corps, the XX,
tiful if you like Belgium in the winter extended its line to defend what had
time. The snow on the hills glistened in been the main army front east of the
the sun, and the planes towed vapor trails Moselle.
across the big, clean sky. The wounded
sat stiffly in the trucks, and they rose With the other army staff agencies,
tautly when they came to a rut in the the army medical service hastily made
frozen road. The dust of the road had plans and preparations to support the
made their hair gray, but it did not look new attack. The army surgeon, Colo-
strange because their 46faces were old with nel Hurley, with his staff section,
suffering and fatigue.
throughout the campaign remained at
Nancy with the rear echelon of Third
The Third Army Attack Army headquarters. A small medical
liaison group, headed by the chief
The relief of Bastogne was one surgical consultant, Colonel Odom,
consequence of the Third Army coun- joined Patton's forward tactical com-
terattack against the southern flank of mand post at the city of Luxembourg.
the Bulge. To launch this attack, Gen- Hurley also dispatched liaison officers
46 47
Surgical consultant quoted in Surg, 101st Air- The III Corps joined the Third Army just
borne Division, Annual Rpt, 1944, pp. 12-13. Stars before the Ardennes battle and controlled the
and Stripes quotation from Rapport and Northwood, troops reducing the last forts around Metz until the
Rendezvous with Destiny, pp. 596-97. army's turn northward.
A TIME OF ADVERSITY 425
to the III and VIII Corps, to keep ny, the 33d, also was shifting east-
him informed about the rapidly ward from Toul to Chateau-Salins.
changing situation. He especially Within about a week Hurley and
needed information about the newly Coates transferred six evacuation hos-
acquired and badly disorganized VIII pitals to Arlon, the city of Luxem-
Corps. Hurley's executive officer, Lt. bourg, Longuyon, and Montmedy,
Col. John B. Coates, MC, who now, close behind the III and VIII Corps.
as he had throughout the campaign, Two medical groups, the 65th and
bore the burden of directing day-to- 69th, went to Esch, south of the Lux-
day army medical operations, report- embourg capital and on the new main
ed that at first "nobody in Third line of evacuation to the army and
Army knew where VIII Corps was, ADSEC holding units at Etain and
specifically. We didn't even know Thionville. The 33d Medical Depot
where the VIII Corps headquarters Company changed its destination to
was." The corps, in turn, was equally Longuyon.
uncertain of the whereabouts of its To make these movements in so
medical units. Coates, therefore, sent short a time, over a constricted road-
two officers of his section forward to net jammed with thousands of other
find the corps and establish commu- troops, Colonel Hurley and his subor-
nications with them, a task which took dinates dispensed with most adminis-
three or four days.48 trative formalities. Organizations
With the VIII Corps the Third acted on verbal instructions. "The
Army acquired a few nondivisional written orders," Hurley reported,
medical units in its new main area of "were confirmatory." Colonel Coates,
operations, notably the 64th Medical who directed much of the operation,
Group and the 107th and 110th Evac- recalled that "everybody picked up as
uation Hospitals. To reinforce these, they could pick up, and started
the army surgeon conducted a rapid moving as quickly as possible. ... It
large-scale redeployment of forces. As was first come almost first served that
of 16 December the army's eleven got on the roads." Much depended
evacuation hospitals and three medi- on the resourcefulness of veteran
cal groups all were located along or medical group, hospital, battalion,
east of the Moselle; a number of hos- and depot commanders. These men,
pitals were moving, or preparing to according to Coates, "with minimum
move, still farther to the eastward to direction . . . were able to p
support the projected attack across and on their own carry out a broad
the Saar. One medical depot compa- directive to get to some place at such
and such a time the best you can."
48
Evacuation hospitals, for instance,
Quotation from Editorial Advisory Board, 1962, rushed advance parties, often recalled
pp. 209-10. See also Surg, Third U.S. Army, Annual
Rpt, 1944, pp. 57-58. For tactical developments, see from scouting trips east of the Mo-
Cole, Ardennes, chs. XX, XXI, and XXIV. Martin Blu- selle, to the new locations to find
menson, The Patton Papers, 2 vols. (Boston: Hough- usable buildings. They borrowed
ton Mifflin Co., 1972-74), vol. 2, 1885-1940, pp.
595-604, recounts army headquarters conferences trucks from each other to haul people
and planning. and equipment. Their personnel
426 EUROPEAN THEATER OF OPERATIONS
to cover part of the ground formerly The abortive general withdrawal re-
held by the Third Army. The Ger- sulted in much marching and counter-
mans planned to exploit American marching of Seventh Army medical
weakness in this area by a three- units. Under the late-December con-
pronged drive from the north, from tingency plan the Seventh Army was
the east across the Rhine, and from to pull back almost all its medical in-
the south out of their Colmar bridge- stallations in the Alsatian plain to
head, aimed at destroying divisions towns on the western side of the
and recapturing the politically sym- Vosges. Accordingly, during the first
bolic city of Strasbourg. SHAEF, the days of January, the 2d Convalescent
6th Army Group, and the Seventh and 9th Evacuation Hospitals fell back
Army anticipated this blow. Late in from relatively exposed Sarrebourg,
December the army developed contin- respectively to Epinal and Ramber-
villers. The 117th Evacuation Hospi-
gency plans for withdrawing its right-
tal at the same time retreated from its
flank corps, the VI from the Alsatian
advanced position at Phalsbourg to
plain to a better defensive position on Epinal. At that point, cancellation of
the eastern slope of the lower Vosges. the strategic withdrawal interrupted
When the Germans launched their the medical redeployment, to the con-
attack form the north, around mid- fusion of some units. The 95th Evacu-
night on 31 December, hitting the ation Hospital, for example, left
junction between the XV and VI Mutzig, just west of Strasbourg, on 3
Corps, the 6th Army Group, at January and made its way to Epinal in
SHAEF recommendation, directed the bitter cold, over mountain roads slip-
Seventh Army to execute the with- pery with ice. Hardly had it reached
drawal. The Free French government its destination when the commanding
of General Charles de Gaulle, howev- officer received telephone orders to
er, objected vehemently to this ma- return to Mutzig at once, as the Sev-
neuver, which entailed abandonment enth Army wanted forward hospitals
of Strasbourg. At the same time the after all. The 95th left that night for
front-line divisions of the Seventh its old station and the next day was
Army contained and blunted the back in at least limited operation
initial German assault while surren- there. It continued work in Mutzig
dering a minimum of ground. On 4 until the eighth, when it moved
January 1945, in light of these facts, northwestward to Sarrebourg to help
the Allies reversed their earlier deci- handle casualties from the main
sion. The Seventh Army received German attack on the XV and VI
orders to hold its line in Alsace and Corps. The 132d Evacuation Hospi-
defend Strasbourg. It did so in a tal, also located at Mutzig, withdrew
month of bitter fighting, which ended to Epinal on the third, spent one
in the complete defeat of the NORD- night in bivouac there, and then
WIND attack.52
943 and 977-78; History of the Medical Activities of
52
Seventh U.S. Army Report of Operations 1944- VI Corps, January-June 1945 (hereafter cited as VI
1945, vol. II, chs. XXII and XXIII, and vol. III, pp. Corps Hist), p. 1.
428 EUROPEAN THEATER OF OPERATIONS
moved to Sarrebourg,
53
where it went Overcoming Adversity
into operation.
In spite of all this backing and fill- Taken as a whole, the field army
ing, Seventh Army medical units han- medical service suffered comparative-
dled the roughly 9,000 wounded and ly little damage from, and responded
17,000 sick and injured of the NORD- efficiently to, the German counterof-
WIND battles with no more difficulty fensive. The First Army lost signifi-
than was to be expected in winter cant numbers of patients, medical
combat. Several infantry regiments personnel, and equipment in the divi-
gave ground under the impact of the sions initially overrun, although the
German assault; they did so gradually, great depth of the division support
evacuating their wounded and pulling areas normally permitted collecting
back their aid stations in good order. and clearing stations to extricate
As had been the case in the Ardennes themselves more or less intact. As a
withdrawals, the field hospital pla- result of unit withdrawals and rede-
toons attached to clearing stations ployment, the First Army also tempo-
had difficulty coordinating their rarily became unable to hold and
movements with those of the divisions treat its sick and wounded. Neverthe-
and complained of a shortage of less, emergency care and evacuation
transportation, but Seventh Army within the army went on throughout
field hospital elements, in contrast to the battle, and, when necessary,
those in the Ardennes, suffered no COMZ facilities assumed some of the
equipment or personnel losses. The functions of army hospitals. The
lot of the casualties in this winter Third Army medical service speedily
fighting, nevertheless, was far from altered its focus of operations and
easy. Cold and exposure worsened took over support of those First Army
the condition of many wounded men,
elements cut off from their parent
as did the long ambulance hauls ne-
cessitated by the early retreat of some command by the enemy break-
field hospital platoons and evacuation through. In addition, it assembled
hospitals. Yet thanks to the Seventh medical personnel and supplies for
Army's success in checking the the relief of Bastogne. Within Bas-
German drive almost before it got togne 101st Airborne Division medics
started, the medical support problems overcame an initial disaster, success-
of this southern encore to the Ar- fully improvised hospitals, and kept
dennes counterblow were minor ones most of their wounded in reasonably
and rapidly solved.54 good condition until they could be
evacuated.
53
Surg, Seventh U.S. Army, Annual Rpt, 1944, p. These achievements resulted in
22, and the Semiannual Rpts, January-June 1945, large part from a high order of army
for the following units: Seventh U.S. Army, pt. 1; medical service performance, on the
95th Evacuation Hospital, encl. 1; 116th Evacuation
Hospital, p. 1; 117th Evacuation Hospital, p. 1; and
132d Evacuation Hospital, p. 8 (see also pp. 1-2). Surg, 44th Infantry Division, Semiannual Rpt, Janu-
54
Seventh U.S. Army Report of Operations, ary-June 1945, pp. 1-2; Surg, 45th Infantry Divi-
1944-1945, vol. II, pp. 563-74, and vol. III, pp. sion, Periodic Rpt, January-June 1945, pt. 1; VI
1,033-34; Surg, Seventh U.S. Army, Semiannual Corps Hist, p. 1; 57th Field Hospital Semiannual
Rpt, January-June 1945, pt. I and pt. III, p. 34; Rpt, January-June 1945, pp. 1-3 and 6-7.
A TIME OF ADVERSITY 429
part of both individuals and organ- aspect of the battle as in others, "the
izations, but a number of other cir- much criticized weight of the Ameri-
cumstances also contributed to the can logistic 'tail'" enhanced the
outcome. One was German tactical army's capacity to cope with unantici-
failure. The enemy never penetrated pated contingencies.55
beyond the rear boundaries of the The army medical service in the Ar-
First Army and fell entirely short of dennes possessed still another advan-
their goal of disrupting the Allies' lo- tage: the proximity of well-developed
gistics system. In addition, the Ger- COMZ evacuation facilities, hospitals,
mans lacked the air power to interdict and supply depots. By mid-December
American road movements, including the long effort to fill out the logistical
movement of casualties and medical support system attenuated by the
units. The medical service benefited summer pursuit largely had achieved
from the lavish transportation re- its objective. The medical Communi-
sources of the American army. The cations Zone was in a position to re-
First Army alone had the use of lieve the armies of their casualties and
almost 50,000 vehicles during the replace promptly their personnel and
first week of the offensive. By regular equipment losses. The effort to do so,
or irregular means, enterprising however, combined with the strains of
medics obtained enough of these, supporting the earlier American of-
most of the time, for themselves, their
fensive and building up COMZ facili-
patients, and their equipment. The
medical service itself had a plethora ties, brought to a head for the COMZ
of resources at every level. At Bas- medical service a number of problems
togne, for instance, the 101st Air- and deficiencies that had existed since
borne Division could spare enough the beginning of continental oper-
doctors and technicians from its tacti- ations.
cal units to staff a hospital and could 55
For discussion of American transportation and
equip and supply it with the residue logistical advantages, see Cole, Ardennes, pp. 665-66.
left from earlier retreats. In this Quotation on p. 666.
CHAPTER XIII
Completing COMZ
When the heavy fall and winter field force agencies. They finished
fighting began in November 1944, the their troop buildup and coped with a
Communications Zone still was in the variety of personnel shortages and
process of developing intermediate problems. They rounded out their
and forward logistical support facili- continental depot structure, estab-
ties and moving men and matériel lished uniformity and efficiency in
inland from the beaches. It continued depot operations, and transferred the
these efforts during the months of bulk of their supplies forward from
Allied attack and German counterat- the beaches and ports. They expand-
tack, and at the same time it shifted ed and filled in their continental hos-
its main logistics axis northward from pitalization and evacuation systems
Normandy to Antwerp and kept ne- and managed, though with difficulty,
cessities flowing to the hard-pressed to accommodate the heavy, sustained
armies. As the First and Third Armies flow of casualties from the winter bat-
completed the eradication of the tles. At the same time they resolved
Bulge late in February 1945, the policy controversies over evacuation,
Communications Zone at last was especially from the theater to the
coming into its full powers. Having United States, which had persisted
mastered most of its major problems since D-Day.
of supply, transportation, and evacu-
ation, it was ready to provide the The Chief Surgeon and Command
wherewithal for the coup-de-grace Relations
against Nazi Germany. This achieve-
ment, however, came at the cost of a Throughout the vicissitudes of the
winter of turmoil, controversy, and continental campaign General Hawley
crisis. maintained his dominance over the
The theater medical service en- increasingly widespread and organiza-
dured and overcame its share of these tionally compartmentalized theater
troubles and contributed its share of medical service. By early 1945 he had
the achievements. During the winter under his supervision almost a quar-
ETO medics completed their organi- ter of a million people—in two army
zation and established and confirmed groups, four field armies, a fluctuat-
command relations among their own ing number of base sections, and
elements and with other COMZ and hundreds of individual units. To hold
COMPLETING COMZ 431
onto his authority over all these Combining the ETO and COMZ
forces, Hawley had to navigate headquarters early in 1944 did not
through continuing crosscurrents of end the jockeying for power between
administrative conflict. air, ground, and service commands.
He had the advantage of a large, Indeed, the SHAEF and 12th Army
comparatively stable, and expert Group staffs asserted their claims with
corps of assistants. His Paris staff con- increasing force. As a result, the
sisted, in December 1944, of 102 United States high command went
officers, 269 enlisted men, and 26 into operation on the Continent amid
civilians—the largest in the Medical continued wrangling about the distri-
Department outside that of the Office bution, boundaries, and dimensions
of the Surgeon General (see Chart 10). of authority, especially in matters of
Key division chiefs, such as Gordon in theater administration and logistics.
Preventive Medicine, Hays in Supply, Shortly before D-Day the American
and McNinch in Medical Records, had staff at Supreme Headquarters made
learned their jobs during the long an attempt, which General Lee
buildup in Great Britain and stayed in blocked, to take over the theater-level
their positions throughout the cam- functions of the Communications
paign. The most significant high-level Zone. On D-Day itself Eisenhower, in
change came in February 1945, when his order formally redesignating the
Colonel Kimbrough left Professional Services of Supply as the Communica-
Services to return to the United tions Zone, relieved Lee of his duties
States; he was replaced by the equally as deputy ETO commander. But
experienced Colonel Cutler, who also Lee's headquarters continued to per-
continued as chief consultant in sur- form most theater administrative
gery. The staff divisions also re- tasks, and Lee's chiefs of technical
mained stable, except for the addi- services, such as Hawley, remained
tion, early in January, of a new Field the theater chiefs of services. Never-
Survey Division, created by Hawley to theless, the Americans on the SHAEF
seek out and report deficiencies in all staff claimed extensive but loosely
nonclinical aspects of the medical ser- defined rights to intervene in ETO
vice. This able staff, with a wealth of matters, especially those involving co-
information and an extensive network ordination or resolution of disputes
of acquaintances and contacts between the air forces, the 12th Army
throughout the American and Allied Group and its component armies, and
forces, decisively strengthened Haw- COMZ.
ley's hand in the persistent Resentment and distrust abounded
theater squabbling over administra- between General Bradley's 12th Army
tive authority.1
Group headquarters and that of the
1
Armfield, Organization and Administration, p. 341;
Communications Zone. The tension
Professional Services Division, OofCSurg, HQ,
ETOUSA, Semiannual Rpt, January-June 1945, p. 2; principal subordinates at the end of 1944. Personnel
Field Survey Division, OofCSurg, HQ, ETOUSA, Division, OofCSurg, HQ, ETOUSA, Annual Rpt,
Semiannual Rpt, January-June 1945, pp. 1-7 and 1944, encl. 4(b), gives the strength of the staff. Mid-
10-11. Administration Division, OofCSurg, HQ, dleton Interv, 1968-69, vol. 1, pp. 249-50, NLM,
ETOUSA, Annual Rpt, 1944, encl. 3, lists Hawley's comments on Kimbrough's removal.
432 EUROPEAN THEATER OF OPERATIONS
stemmed from the army group staffs Throughout the arguments over
conviction that, like its British coun- administrative authority General
terpart, it should control COMZ, Hawley consistently asserted the prin-
rather than being coordinate with the ciple that "there is no Chief Surgeon
service forces under a theater head- C[OM]Z. There is a Chief Surgeon,
quarters that in fact was also the lo- ETO, who is also Surgeon, C[OM]Z."
gistical headquarters. For a month He made his position prevail through
after its activation on 1 August the a judicious mixture of firmness and
12th Army Group actually possessed conciliation. With General Kenner at
authority over COMZ, but this ar- SHAEF, Hawley had what he later
rangement ended when SHAEF characterized as "very friendly
moved to Versailles in September and associations . . . , but no
took direct command of land oper- close." On the Continent, as in Brit-
ations. Essentially, the army group ain, Kenner and his small staff kept
busy with a constant round of inspec-
staff accused the Communications
tions of British and American medical
Zone of conflict of interest. They
installations. He conferred frequently
claimed that COMZ consistently fa- with Hawley and Hawley's division
vored its own requirements, and often heads on ETO problems of hospitali-
its creature comforts, over the needs zation, evacuation, and supply.
of the fighting forces and blamed this Kenner reported regularly to Eisen-
fact for the supply shortages that hower, who considered him "one of
dogged the armies throughout late the finest medical officers I have ever
1944. They condemned Lee's early met." 3
transfer of COMZ headquarters to Nevertheless, Kenner's authority
Paris for disrupting the supply ser- over U.S. Army medical matters re-
vices at a crucial point in the cam- mained more formal than substantive.
paign. Similar resentment of the ser- His office transmitted policy direc-
vice command permeated the armies. tives to the armies; he tried to impose
The field forces tried to promote his views in a few instances, notably
their interests by increasing SHAEF's in reducing theater evacuation policy
involvement in theater affairs, espe- from 180 to 120 days and in changing
2
cially in the allocation of supplies. the cross-Channel sea evacuation
route. For the most part, however, his
2
Ruppenthal, Logistical Support, 1:222-27, 2:26-27 instructions and recommendations
and 349-51, summarizes the continuing conflicts. paralleled or repeated those of Gen-
For an example of the 12th Army Group's view, see
Memo, Brig Gen R. G. Moses to Gen Bradley, 26 eral Hawley, and Hawley managed to
Sep 44, and Paper by Moses, October 1945, both in sidetrack them when they did not.
Moses Papers, MHI. The Supreme Commander's Hawley, on his part, appears to have
views on how the system should work can be found
in Dwight D. Eisenhower, The Papers of Dwight David
3
Eisenhower (hereafter cited as Eisenhower Papers), eds. First quotation from Ltr, Hawley to CofS,
Alfred D. Chandler, Jr., et al. (Baltimore: Johns ETOUSA, 29 Sep 44, file HD 024 ETO CS (Hawley
Hopkins Press, 1970-), vols. 1-5, The War Years Chron). Second quotation from Editorial Advisory
(1970), 4:2,206. Memo, Maj Gen LeRoy Lutes to Lt Board, 1962, p. 224. Third quotation from Ltr, Ei-
Gen Somervell, 31 Dec 44, box 24, RG 160, NARA, senhower to Gen Marshall, 28 Sep 44, in Eisenhower
reflects SHAEF's dissatisfaction with COMZ. Papers, 4:2,196.
COMPLETING COMZ 433
dence of the theater chief surgeon. . . . you really find out what's g
Hawley, on his part, carefully respect- on." Most important, he sought to
ed the position of the group sur- demonstrate his concern for the
geons, such as it was, in the medical front-line surgeons and aidmen who
chain of command and sometimes bore such a disproportionate share of
called on them for assistance in re- the hardship and danger. When at the
solving difficulties with the armies, front, Hawley emphasized helpfulness
which dealt directly with the Commu- to the field army medical service,
nications Zone on many medical as rather than criticism of it. This atti-
well as other logistical matters.5 tude, which the chief surgeon tried to
Hawley dealt circumspectly with the instill throughout the COMZ medical
army surgeons. When necessary, he organization, at least minimized in the
emphatically reminded them that he
was the theater, not merely COMZ, theater medical service the endemic
chief surgeon and that the entire combat force distrust 6
of the Commu-
medical service, from front to rear, nications Zone.
had to work as a unified system. How- Within the Communications Zone,
ever, he preferred to rely on concilia- base section boundaries changed re-
tion to secure cooperation, exploiting peatedly as the armies advanced and
to the limit his range of contacts and the Allied logistical base moved
acquaintances within and outside the northward from Normandy toward
Medical Department. He was willing the Channel ports and Antwerp (Map
to overlook minor infringements 19). On 1 December 1944 the Britta-
upon his prerogatives. He comment- ny Base Section absorbed the terri-
ed after the war: "I just rode out tory of the underemployed Loire Base
these little things and they all eventu- Section, and the Normandy Base Sec-
ally straightened out. I thought it tion extended its jurisdiction toward
would do more harm in the long run the northeast, to include the Ameri-
than good to make an issue out of can installations at Le Havre and
things." As often as he could, Hawley Rouen, which had become major dis-
visited the army surgeons and their embarkation ports for troops and
medical units. Several times he supplies. The Channel Base Section,
worked his way forward as far as the after giving up Rouen and Le Havre
infantry battalion aid stations and to Normandy, oversaw American ac-
came under German fire. He made tivities in Antwerp and in a strip of
these trips partly, he admitted, be- Belgian territory between the British
cause "I was curious. . . .logistical
I'd gonearea
to and the Advance Sec-
war. I wanted to see the fighting." He tion. The other three base sections—
believed that when "you go forward ADSEC, Oise, and Seine—continued
to the battalion aid station and what's
ahead of the battalion aid station, 6
Quotations from Hawley Interv, 1962, pp. 68-
71, 87-88, 98-102, CMH, which also contains com-
5
Ltr, Hawley to Gorby, 11 Aug 44, file HD 024 ments from army-level medical officers. For Haw-
ETO CS (Hawley Chron); Gorby Intervs, 1949 and ley's sterner approach, see Ltr, Hawley to Gorby, 11
1953, file HD 000.71, and 1962, pp. 7, 9-11, 13-14, Aug 44, file HD 024 ETO CS (Hawley Chron). See
37, CMH; Hartford Interv, 7-8 Oct 80, tape 1, side also Hartford Interv, 7-8 Oct 80, tape 1, side 1,
1, CMH. CMH.
436 EUROPEAN THEATER OF OPERATIONS
their earlier functions, in some cases However, I have also a great responsi-
with slight boundary revisions.7 bility to my own commander. So long as
Authority over COMZ medical units my technical policies are carried out in
any echelon, and medical units are not
and installations continued to be di- hampered in their functions, I shall
vided between the base section com- accept full responsibility for all medical
manders, who had formal operational failures. But, if the technical operations of
and administrative control over them, the medical service are interfered with by
the commander of any echelon, I have no
and General Hawley, who exercised alternative than to place squarely upon
technical supervision. In practice, him the responsibility for any medical
Hawley, as he had in Great Britain, failure in his echelon.8
managed to expand technical supervi- After moving to Paris in June 1944,
sion into what amounted to day-to- Hawley enlarged upon his formal and
day direction, especially of the work informal techniques for keeping close
of base section general hospitals. He watch over the medical service and
resisted vigorously, and usually with enforcing high standards of profes-
success, occasional base section ef- sional care and compassion for the in-
forts to interfere in hospital command dividual casualty. He continued to
and administration. When necessary, employ his consultants, and those of
Hawley appealed directly to the ETO- the armies and base sections, as a
COMZ staff to overrule encroaching communication and control network,
section commanders, but he relied and he supplemented them in early
more often on his ability to convince 1945 with the new Field Survey Divi-
the commanders that they would sion. This division, Hawley told its
serve their own interests best by chief, Lt. Col. Clark B. Meador, MC,
doing what he wanted. He demon- one of his veteran troubleshooters,
strated this method in persuading the was to "act as the eyes and ears of the
Normandy Base Section commander, Chief Surgeon; and to assist Medical
Col. Theodore Wyman, to replace an commanders in the field in carrying
inexperienced section surgeon with out the policies dictated by this office
one better qualified and selected by or higher headquarters." Hawley re-
him. The chief surgeon wrote to sponded forcefully to patient com-
Wyman: plaints, from whatever source. For ex-
I am too old a soldier not to know that ample, late in 1944 a number of GIs
the authority of a commander is practical- in letters to the Stars and Stripes made
ly unlimited, and that, if he so desires, he allegations of poor food, excessive in-
can dictate the technical operations of the spections, and lack of amenities in
services without regard to the policies of
the Chiefs of Services. I also have great general hospitals. Hawley at once di-
respect for the responsibilities and pre- rected members of his staff and the
rogatives of command. base section surgeons to survey the
7 8
Troops Branch, Operations Division, OofCSurg, Quotation from Ltr, Hawley to Col Theodore
HQ, ETOUSA, Semiannual Rpt, January-June 1945, Wyman, Jr., 1 Aug 44, file HD 024 ETO CS
p. 10; Surg, Normandy Base Section, Semiannual (Hawley Chron). For other examples of his meth-
Rpt, January-June 1945, p. 2. Ruppenthal, Logistical ods, in same file, see Memos, Hawley to AG Person-
Support, 2:37-38, summarizes base section boundary nel, ETO, 27 and 29 Jul 44, and Memo, Hawley to
changes. CofS, ETO, 30 Nov 44.
COMPLETING COMZ 437
nonclinical aspects of patient care. nel did not escape the chief surgeon's
Then he pressed section surgeons sharp eye. He warned the commander
and hospital commanders to correct of the 12th Field Hospital: "A group
the minor but irritating deficiencies of your nurses was seen in Paris a few
9
the surveys revealed. days ago in improper uniform and
Hawley himself frequently inspect- generally untidy. I am very sorry to
ed COMZ medical installations. When have heard this and I do not want to
doing so, the chief surgeon, besides hear such a report again." 11
making ward rounds and discussing During the autumn and winter of
professional matters with command- 1944-45 Hawley maneuvered to
ers and chiefs of services, also paid extend his authority over the medical
attention to aspects of unit operations units of the separate communications
that many medical officers would have zone behind the 6th Army Group.
overlooked. At the 21st General Hos- That group, while it came under
pital, for instance, Hawley and his SHAEF operational control in mid-
staff were invited to inspect the guard September, continued to draw its
detachment.10 To the amusement of
logistical support largely from the
the hospital commander, Hawley "did
Mediterranean Theater of Operations,
a good infantry officer's job of the de-
tails of seizing the rifles and upending which had mounted the invasion of
them to squint through the barrels. southern France. By 1 October the
Then he slammed the rifles almost vi- Mediterranean Theater had estab-
ciously into the guard's hands. The lished two base sections to operate
guard and all the onlookers were sur- the line of communications running
prised and pleased. He did not ne- from Marseilles northward up to the
glect to say a few words to the officer Rhone valley. The Delta Base Section,
and his detail which made them feel under Brig. Gen. John P. Ratay, con-
well flattered." Hawley came down trolled the installations around Mar-
hard on the commanders of installa- seilles. The Continental Advance Sec-
tions that fell short of his standards, tion (CONAD), under Maj. Gen.
on the principle that "there are no Arthur R. Wilson, performed func-
poor units; there are only poor lead- tions for the 6th Army Group similar
ers." He wrote personal letters of ad- to those of ADSEC. Both sections
monition to delinquent commanders were part of the Mediterranean Thea-
and, if deficiencies in their units per- ter Communications Zone, which es-
sisted, had the officers reassigned. tablished a forward headquarters at
Even minor lapses by medical person- Dijon to supervise their work.
9 11
Quotation from Field Survey Division, First and second quotations from Cady, "Notes
OofCSurg, HQ, ETOUSA, Semiannual Rpt, Janu- on the 21st General Hospital (AUS)," pp. 507-09,
ary-June 1945, p. 1. For hospital complaints and Cady Papers, MHI. Third quotation from Ltr,
Hawley's response, see letters and memorandums Hawley to CO, 12th Field Hospital, 14 Sep 44, file
for December 1944 in file HD 024 ETO CS (Hawley HD 024 ETO CS (Hawley Chron). For examples of
Chron). Hawley's dealing with delinquent commanders, see
10
Hospital units maintained armed guard forces Ltrs, Hawley to CO, 90th General Hospital, 14 Sep
to protect their property and to supervise POW la- 44, and Hawley to Col H. H. Price, 10 Nov 44, file
borers. HD 024 ETO CS (Hawley Chron).
438 EUROPEAN THEATER OF OPERATIONS
General Lee and his staff wanted to Under the terms of this agreement,
assume command over the southern and of General Lee's letter of instruc-
line of communications as soon as tions to General Larkin, Hawley could
possible. They intended to enforce deal with the CONAD surgeon, Col.
uniform policies and procedures Harry A. Bishop, MC; the Delta Base
throughout supply organizations that Section surgeon, Col. Vinnie H. Jef-
they assumed would become increas- fress, MC; and the commanders of
ingly interdependent. The SHAEF the fifteen fixed hospitals, two depots,
staff, however, preferred to delay the and other medical installations in
merger in order to take maximum ad- southern France only through Col.
vantage of the surplus supplies avail- Charles F. Shook, MC, the SOLOC
surgeon. Hawley's staff division chiefs
able in the Mediterranean Theater
could not correspond directly with
during a period when the northern their southern counterparts on any of
Communications Zone barely could the innumerable details of bringing
support the 12th Army Group, not to SOLOC medical policies and proce-
mention the 6th. After weeks of nego- dures, derived from the Mediter-
tiation the two theaters agreed on a ranean Theater, into line with ETO
compromise. They created a new or- practices. Problems resulted, for dif-
ganization, the Southern Line of ferences among the theater medical
Communications (SOLOC) around organizations were many, ranging
the nucleus of the Mediterranean from broad matters of supply man-
COMZ advance headquarters at agement to questions of clinical
Dijon. This agency, activated on 20 procedure. SOLOC hospitals, for
November under Maj. Gen. Thomas instance, treated many long-bone
B. Larkin, was a subdivision of the fractures by internal fixation (plating
ETO Communications Zone, with and pinning), whereas those in the
Larkin designated a deputy com- European Theater followed the pref-
mander COMZ under General Lee. erences of Surgeon General Kirk by
However, SOLOC had the right to relying exclusively on traction, fol-
communicate directly with the Medi- lowed by application of casts. Dis-
terranean Theater on matters of lo- tressed at this and other SOLOC
practices, Hawley periodically lament-
gistical support, and it was the sole
ed the limitations on his authority in
channel for contact between the the southern area. He complained
ETO-COMZ headquarters and that the Southern Line of Communi-
CONAD, the Delta Base Section, and cations "was given what amounts to
their subordinate units.12 complete autonomy. Believe it or not,
12
I practically have to be invited before
Southern France, until September 1944, had
been part of the North African (later Mediterra- I can visit SOLOC." 13
nean) Theater; it reverted to the ETO on 18
13
September. Larkin had been commander of the Quotation from Ltr, Hawley to Maj Gen J. E.
Mediterranean Theater COMZ before taking over Dahlquist, 11 Jan 45, box 2, Hawley Papers, MHI.
SOLOC. For details on the formation of SOLOC, See also Ruppenthal, Logistical Support, 2:42-45; Ltr,
see Ruppenthal, Logistical Support, 2:29-30 and 38- Lt Gen Lee to Chiefs, General and Special Staff
42. Continued
COMPLETING COMZ 439
conferred with Shook and his base tablished during the buildup survived
section surgeons, and also with Colo- the entry into combat, the full activa-
nel Rudolph, the Seventh Army sur- tion of SHAEF and the 12th Army
geon, and they inspected numerous Group, and the incorporation of the
medical installations. During this trip forces from the Mediterranean.
Cutler secured SOLOC's agreement Throughout, the chief surgeon, while
that its base section consultants could surrendering none of his preroga-
communicate directly with their ETO tives, managed to keep up smooth
counterparts, integrating the southern working relations with such potential
consultants into the informal network rivals as General Kenner. Hawley's
so important in holding the theater success earned the ETO medical ser-
medical service together. Hawley and vice the praise of Surgeon General
Cutler at the same time gave a little Kirk, who declared that this organiza-
ground on internal fixation of frac- tion, compared to those of other the-
tures, authorizing use of the proce-
aters, was the "only [one] ... set up
dure in certain types of cases.
and operating the way it should
Through such arrangements the chief
surgeon and his staff cleared the way [be]. ... It is so far ahead of the
16
for a full merger, and the two com- others there is no comparison."
munications zone medical services The chief surgeon attained this favor-
became ever more closely integrated able result despite blurred lines of au-
in supply, evacuation, and other ac- thority and persistent feuds. His
tivities. Formal merger followed on 6 system, in the end, depended more
February 1945, when the theater dis- on personal and professional doctor-
banded SOLOC and placed CONAD to-doctor relationships than on sound
and the Delta Base Section directly structure. Nevertheless, it was suffi-
under the northern Communications cient to support the armies in their
Zone. Colonel Shook then moved to drive to final victory.
Paris and became the ETO deputy
chief surgeon.15 The Continuing Buildup
By the time the ETO-COMZ ab-
sorbed SOLOC, theater medical ad- During the six months after D-Day
ministrative and command relations the European Theater medical estab-
had assumed the shape they would lishment expanded from about
retain during the rest of the war in 130,000 officers, nurses, and enlisted
Europe. The primacy in the medical men to over 212,000—an average of
service that General Hawley had es- 5.5 doctors, 1.2 dentists, 6.3 nurses,
and 68.35 medical enlisted men for
15
Hawley's remarks on Shook in Ltr, Hawley to each 1,000 soldiers (Table 9). It was,
Kenner, 19 Dec 44, file HD 024 ETO CS (Hawley by the end of 1944, the largest single
Chron); in same file, see Ltr, Hawley to Col C. F.
Shook, 23 Dec 44. Hawley's January visit is recount- theater medical service, containing
ed in detail in Carter, ed., Surgical Consultants, 2:292 nearly 40 percent of all the Medical
and 301-06. Ltrs, Hawley to TSG, 24 Jan 45, and Department personnel in the Army.
TSG to Hawley, 17 Mar 45, file HD 024 ETO O/CS
(Hawley-SGO Corresp), reflect the compromise on 16
internal fixation. See also Ruppenthal, Logistical Sup- Ltr, TSG to Hawley, 18 Aug 44, file HD 024
port, 2:45. ETO O/CS (Hawley-SGO Corresp).
COMPLETING COMZ 441
TABLE 9—MEDICAL PERSONNEL STRENGTH, ETOUSA, LATE 1944
Source: Personnel Division, OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, chart 5(d).
About 60 percent of the ETO medical satiable need for separate medical de-
personnel worked in the Communica- tachments and for casuals to staff
tions Zone, another 35 percent served base section and hospital center head-
in the field armies, and the remainder quarters. Accounting changes brought
were in the air forces.17 troop basis alterations. Late in 1944
The composition of the medical the War Department reclassified
service, in numbers and types of 14,400 field hospital beds as mobile
units, more or less conformed to the instead of fixed, allowing the ETO
troop basis established before the in- the same number of additional beds
vasion. However, the theater and the in general or station hospitals. To
War Department continually added, absorb part of this extra allowance,
deleted, formed, and disbanded orga- the theater disbanded three
nizations as they reconciled the pro- newly arrived general hospitals in
jected with the actual needs of the order to reorganize eight veteran
campaign. The theater, for example, ones as 1,500-bed hospitals and an-
gained ten more general hospitals other as a 2,000-bed installation.
18
and almost fifty ground force medical New medical units of all types
units to support nine additional infan- flowed into the theater during the last
try divisions assigned during 1944. It
broke up several station hospitals to 18
Troop Movements and Training Branch, Oper-
create new T/O convalescent rehabili- ations Division, OofCSurg, HQ, ETOUSA, Annual
tation units and constantly shuffled Rpt, 1944, pp. 6-10 and 38-39; Personnel Division,
manpower to meet the seemingly in- OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, pp.
5-6 and 12-13; Troops Branch, Operations Divi-
sion, OofCSurg, HQ, ETOUSA, Semiannual Rpt,
17
Personnel Division, OofCSurg, HQ, ETOUSA, January-June 1945, pp. 4, 6, 8-17, 34. Ruppenthal,
Annual Rpt, 1944, app. D; McMinn and Levin, Per- Logistical Support, 2:289-90, describes the general
sonnel, p. 358. changes in the service troop basis.
442 EUROPEAN THEATER OF OPERATIONS
half of 1944 and the first few months compelled diversion of most units to
of 1945, adhering generally to rein- Great Britain during the last half of
forcement schedules worked out 1944. Most medical units, therefore,
before D-Day. Once these reinforce- entered the ETO at Scottish ports,
ments reached Europe, General Haw- staged in Britain for periods varying
ley's Troop Movements and Training from a few hours to a couple of
Branch staff, in coordination with the months, then went by train to the
ETO G-4 and the base sections for south coast, where they boarded land-
COMZ units and with the 12th Army ing craft or other shallow-draft vessels
Group and later the Fifteenth Army for the cross-Channel voyage. During
for field force organizations, directed the summer the reinforcements
their movement and assignment. landed at Cherbourg or the Norman-
During the autumn of 1944 the dy beaches and bivouacked in the Co-
Southern Line of Communications re- tentin until called forward to begin
peatedly demanded more field and operations. Units arriving after the
communications zone medical units to beginning of November usually dis-
support the additional divisions being embarked at Le Havre and staged in
sent to the 6th Army Group. The the nearby RED HORSE cantonment
ETO-COMZ, in negotiations with area, which included a theater tran-
SHAEF and SOLOC, managed to sient camp for medical troops at Etre-
scale down these requests, on the tat, a small seashore resort.
grounds that all theater medical re- For the new arrivals life in the stag-
sources should be treated as a single ing areas was often difficult. Fre-
pool, rather than each communica-
quently, units became separated from
tions zone being set up as a self-suffi-
cient entity. Medical reinforcements,
their personal baggage and TAT (to
nevertheless, did go to SOLOC, accompany troops) equipment during
either diverted to Marseilles while at their journeys to France. Without
sea or sent across France after land- cooking and mess gear, tentage, bed-
ing at Channel ports.19 ding, or vehicles, the unfortunate per-
Preinvasion plans called for new sonnel set up housekeeping with what
medical units, like most other rein- they could salvage and borrow. Offi-
forcements from America, to bypass cers, nurses, and enlisted men alike
the United Kingdom after about prepared C-rations over driftwood
D+60 and land at ports on the Conti- fires, shivered under too few blankets,
nent. Delays in opening deep-water and at times went for weeks without a
French and Belgian harbors, however, change of clothing until their equip-
ment finally caught up with them.
19
Troop Movements and Training Branch, Oper- Medical personnel awaiting move-
ations Division, OofCSurg, HQ, ETOUSA, Annual ment orders at Etretat lived austerely
Rpt, 1944, pp. 13-15 and ends. 5 and 8; Troops in requisitioned homes, chateaus, and
Branch, Operations Division, OofCSurg, HQ,
ETOUSA, Semiannual Rpt, January-June 1945, pp. hotels, contending with shortages of
2-3, 12, 14, and encl. 1. For negotiations about fuel for cooking and heating and
units for SOLOC, see correspondence in DRA- coping with insufficient latrine and
GOON 1944 file, CMH. For similar arguments
about field units for the Seventh Army, see Chapter bathing facilities. A few units suffered
XI of this volume. major accidents during disembarka-
COMPLETING COMZ 443
tion, staging, and forward movement. ations. Those that landed in Britain
The 553d Medical Ambulance Com- just before D-Day were short-trained
pany lost fifty-six men (thirty-two only in the sense that a few individ-
killed, twenty-four injured) in a train uals had not completed all require-
wreck near Le Havre. Staging could ments or that the unit perhaps lacked
be prolonged, especially for general a week or so of field exercises. Such
hospitals, which had to wait for sites organizations could, and did, go right
to become available, for equipment to work. The units that arrived later
assemblies to arrive, and for transpor- in 1944 were in worse shape. Most,
tation to appear. The base sections activated only three-four weeks
tried to keep units busy during their before embarkation, were random ag-
time in staging, conducting orienta- gregations of medical officers and
tion and training programs and send- nurses with limited Army experience;
ing personnel, particularly from the enlisted detachments, except for a
hospitals, to reinforce hard-pressed few key men, came directly from basic
organizations already in operation.20 Medical Department training. One
The medical troop buildup substan- such unit, the 166th General Hospi-
tially achieved its objectives, in terms tal, which arrived in the Loire Base
of gross numbers of personnel and Section in November, "had never
units. Strength totals, however, con- functioned as a hospital and
cealed many quantitative shortages only a small percentage of the enlist-
and qualitative deficiencies. To begin ed men had ever worked in a
with, the War Department, in order hospital. . . . The nurses had
to place units in the theater on sched- the unit at the Port of Embarkation.
ule, sent many of them overseas They had never worked as a group."
before they had completed their train- As these units reached the United
ing. In all, 78 of the 151 general hos- Kingdom and France, base section
pitals called for in the troop basis ar- and army surgeons surveyed their
rived "short-trained," as did 7 of the state of training; prescribed remedial
46 400-bed evacuation hospitals, 11 programs of instruction; and, when-
of the 61 ambulance companies, and ever possible, put their personnel to
smaller proportions of other unit work in functioning installations of
types. The short-trained organizations the same type, remedying manpower
varied greatly in readiness for oper- shortages while providing on-the-job
training for the new arrivals. Eventu-
20
Operations Division, OofCSurg, HQ, ETOUSA, ally, most short-trained organizations
Annual Rpt, 1944, p. 5; Troop Movements and
Training Branch, Operations Division, OofCSurg,
went into satisfactory operation,
HQ, ETOUSA, Annual Rpt, 1944, pp. 26-27; though a few of the worst were
Troops Branch, Operations Division,broken up and their manpower used
OofCSurg, HQ, ETOUSA, Semiannual Rpt, Janu-
ary-June 1945, pp. 2-3, 6, 12-14; Surg, Channel to reinforce more experienced units.21
Base Section, Annual Rpt, 1944, pp. 9-10 and 86-
21
89. For examples of units in staging, see John C. Quotation from Surg, Loire Base Section,
Burwell, Jr., "Memoir," pp. 3-10, John C. Burwell Annual Rpt, 1944, p. 3. See also ibid., p. 5; Troop
Papers, MHI, and 170th General Hospital Annual Movements and Training Branch, Operations Divi-
Rpt, 1944, pp. 2-6 (this unit also was separated sion, OofCSurg, HQ, ETOUSA, Annual Rpt, 1944,
from its TAT equipment). Continued
444 EUROPEAN THEATER OF OPERATIONS
Most late-arriving medical units, be- MC specialists were spread ever more
sides being short of training, were thinly. For instance, in early 1945, the
short of people, either in absolute theater had available only 63 board-
numbers or in important specialities. certified orthopedic surgeons out of
As a result of the policy forced on the 460 called for in the T/Os of
Surgeon General Kirk by the doctor army and COMZ hospitals and auxil-
shortage in the United States, most iary surgical groups. They were sup-
new hospitals arriving in Europe after plemented by 95 partially trained or-
D-Day lacked qualified chiefs of surgi- thopedic surgeons and by 85 others
cal and medical services and con- who had some background in trauma.
tained general practitioners in place Shortages also existed among dentists
of many specialists. Some general and MAC officers. The theater nurse
hospitals arrived in the theater with complement had fallen 345 below au-
only 16 of their authorized 32 MC of- thorized strength by the close of
ficers. Kirk expected the theaters—es- 1944, partly because the War Depart-
pecially the ETO with its large com- ment, confronting a slowdown in re-
plement of affiliated units top-heavy cruiting and the probable need for a
in professional talent—to make up nurse draft, as a conservation meas-
these deficiencies by redistributing ure dispatched 12 general hospitals to
their own personnel. Typical of the Europe without nurses, to be staffed
units that this policy created, the
from theater resources. Medical en-
170th General Hospital embarked for
listed personnel also fell below
Europe in September with "no Chief
strength at the end of 1944, largely as
of Surgery, Medicine, Orthopedics,
a result of heavy casualties among in-
Neuropsychiatry, [and no] Urologist
fantry division aidmen and litter-
who was considered professionally 23
bearers.
qualified"; the orthopedic staff con-
The ETO medical service did its
sisted of "two young officers with lim-
best to remedy the shortages and de-
ited experience." 22
ficiencies from its own resources.
The arrival of an increasing number
Colonels Cutler and Middleton and
of, in effect, undermanned organiza-
their assistants visited each newly
tions aggravated shortages in many
landed general hospital to evaluate its
categories of ETO medical personnel.
professional staff. Using the Person-
pp. 9-10 and 25-26; Training Branch, Operations nel Division's machine readable
Division, OofCSurg, HQ, ETOUSA, Semiannual
23
Rpt, January-June 1945, pp. 5-6. On training ef- Personnel Division, OofCSurg, HQ, ETOUSA,
forts, see Surg, Normandy Base Section, Annual Annual Rpt, 1944, app. D; Professional Services Di-
Rpt, 1944, p. 3; Surg, Seine Section, Semiannual vision, OofCSurg, HQ, ETOUSA, Semiannual Rpt,
Rpt, January-June 1945, pp. 21-22; Surg, Seventh January-June 1945, pp. 4-5; Troop Movements and
U.S. Army, Annual Rpt, 1944, p. 20. Training Branch, Operations Division, OofCSurg,
22
Quotation from 170th General Hospital Annual HQ, ETOUSA, Annual Rpt, 1944, p. 9; McMinn
Rpt, 1944, pp. 1-2. See also Ltr, TSG to Hawley, 6 and Levin, Personnel, pp. 227-31; Ltrs, TSG to
Oct 44, file HD 024 ETO O/CS (Hawley-SGO Cor- Hawley, 6 Oct 44, and Hawley to TSG, 13 Apr 45,
resp); Personnel Division, OofCSurg, HQ, file HD 024 ETO O/CS (Hawley-SGO Corresp);
ETOUSA, Annual Rpt, 1944, p. 7 and app. D; Memo, Hawley to DepTheaterCdr, 6 Jun 44, sub:
McMinn and Levin, Personnel, pp. 316-17. On the Shortage of Nurses, file HD 024 ETO CS (Hawley
doctor shortage, see Chapter V of this volume. Chron).
COMPLETING COMZ 445
records of the qualifications and ex- teams of enlisted men skilled in ap-
perience of every MC officer in plying plaster casts.
24
Whether in the armies or the Com- the theater and of their own devising
munications Zone, medical units em- to give staff and patients some respite
ployed every resource provided by from the often grim daily routine.
They sent officers, nurses, and enlist-
Corps, Annual Rpt, 1944, p. 11; Surg, 1st Infantry
ed men on pass to nearby towns,
Division, Annual Rpt, 1944, p. 34; Surg, 5th Infan- when such were not off limits to
try Division, Annual Rpt, 1944, p. 39. On rotation American personnel. Other medical
within the armies, see First U.S. Army Report of
Operations, 1 Aug 44-22 Feb 45, bk. IV, p. 194; people received much-coveted 48-
Surg, V Corps, Annual Rpt, 1944, pp. 16-17; Surg, hour passes to Paris, and a few ex-
2d Armored Division, Annual Rpt, 1944, p. 49; tremely fortunate individuals went
Surg, 3d Infantry Division, Annual Rpt, 1944, p. 10.
On theater rotation, see McMinn and Levin, Person- home to the United States on thirty-
nel, pp. 332-36; Personnel Division, OofCSurg, HQ, day leaves. Within units, Special Ser-
ETOUSA, Annual Rpt, 1944, p. 13; Professional vice detachments scheduled films and
Services Division, OofCSurg, HQ, ETOUSA, Annual
Rpt, 1944, Chief Consultant in Surgery sec., ex. L, an occasional traveling USO show for
Medical Consultation Service sec., p. 14, and Chief staff and patients. Radios and record-
Consultant in Anesthesia sec., pp. 2-3; Middleton
Interv, 1968-69, vol. 1, pp. 205-06; Surg, 1st Infan- players, both government issued and
try Division, Annual Rpt, 1944, pp. 24 and 34-35; "liberated," were precious posses-
Editorial Advisory Board, 1962, pp. 215-17. On sions. Clubs, for officers, nurses, and
cases of addiction and alcoholism, see Ltr, Hawley
to Col J. A. Rogers, 20 Nov 44, file HD 024 ETO enlisted men, ranged from austerely
CS (Hawley Chron). furnished recreation tents to com-
456 EUROPEAN THEATER OF OPERATIONS
STATION HOSPITAL DAYROOM, used by staff and patients for recreational purposes
needed. The theater insisted that the eral Hawley, as agent of the theater
War Department was not sending commander, directed the disposition
enough; the Washington authorities of all medical stores in continental
replied that they were furnishing suf- depots, treating them as a single pool
ficient supplies and demanded that of goods rather than as the property
the theater put its own administrative of the individual base sections. He
house in order so that it could find also exercised technical supervision
them. over depot operations. This amount-
In December General Somervell, at ed in practice very nearly to full oper-
Eisenhower's request, sent the Army ational control, as neither the base
Service Forces director of operations, section commanders nor their sur-
Maj. Gen. LeRoy R. Lutes, to survey geons had the staff or the expertise to
the ETO supply situation. Lutes and manage the details of depot work.
his delegation spent several weeks in Closely overseen by the chief sur-
the theater. They documented the lo- geon's Supply Division, COMZ
gistical deficiencies and recommend- depots, including eventually those of
ed remedies that the Communications SOLOC, all followed uniform operat-
Zone, under constant pressure from ing procedures prescribed in the
SHAEF and the War Department, Medical Department Depot Manual,
gradually implemented. By the time which the Supply Division revised late
the armies prepared to cross the in 1944 to incorporate the lessons of
Rhine, the supply system behind them continental experience. These proce-
was functioning in relatively good dures included a simple, accurate
order.39 method for determining and report-
By contrast with the general situa- ing regularly the amount of stock on
tion in the theater, the ETO medical hand, due in, and issued. In Paris the
service had already gone through its Stock Control Branch of the Supply
own experience of mismanagement Division consolidated reports from
and reform. Thanks to the work of the depots on automatic data process-
the Voorhees mission early in 1944, ing machines to produce timely statis-
and to the subsequent efforts of Colo- tics for a variety of purposes. Among
nel Hays and his assistants, the medi- other things, this information helped
cal service had solved before D-Day Supply Division transfer stock be-
many of the supply problems that still tween depots, maintaining adequate
plagued the other technical services working levels computed on the basis
and the theater as a whole six months of the number of troops and the type
after the invasion. It possessed, for of installations the depot served.40
instance, an efficient system of depot Because the Supply Division could
management and stock control. Gen- furnish stock information that all con-
39
Discussion based on Ruppenthal, Logistical Sup-
port, 2:96, 103-16, 126-33, 176-86, 348-63. Lutes
40
report and supporting documents in Maj Gen Supply Division, OofCSurg, HQ, ETOUSA,
LeRoy R. Lutes, Official Report: Mission to Europe- Semiannual Rpt, January-June 1945, sec. II, pp. 5-
an Theater of Operations, 4 December 1944-13 7, sec. III, pp. 4-6, sec. IV, pp. 5-6; Wiltse, ed.,
January 1945 (hereafter cited as ETO Rpt, 1944- Medical Supply, pp. 314-17; Kelley Interv, 27 Jan 45,
45), box 44, RG 200, NARA. box 221, RG 112, NARA.
COMPLETING COMZ 459
cerned judged reliable, the requisi- time for Quartermaster stores was
tioning and shipment of medical sup- 145 days. The mission had also found
plies from the United States involved only three minor medical items in
little confusion or conflict between short supply in the theater. Separate
Washington and the theater. For its from the rest of the supply system,
initial continental buildup the Supply transatlantic blood flights also went
Division, before D-Day, ordered large without a hitch, reaching a delivery
prescheduled shipments of goods for rate of over 8,000 pints per week
delivery to French ports beginning during January.41
about 1 September 1944. Thereafter, The distribution network kept pace.
the division issued biweekly mainte- By late October 1944 a chain of
nance and replacement requisitions to depots stretched from Normandy
keep up a 60-day reserve of all items and the Riviera to Belgium and
as well as a 120-day reserve to cover northeastern France (see Map 20).
ordering and shipping time. During Depot M-402, at Chef-du-Pont and
late autumn Colonel Hays' office inte- Carentan, besides supporting the
grated the Southern Line of Commu- Normandy Base Section, received
nications into this system. Under a supplies landed at Cherbourg and
provision of the mid-November shipped them forward to other
agreements SOLOC computed its re- depots. Depot M-405 at Le Mans dis-
quirements on the same basis as its tributed supplies to the Loire and
northern counterpart and submitted Brittany Base Sections. At the center
its requisitions through the theater of the supply network Depot M-407
Communications Zone, which partial- at Paris, in addition to serving the
ly filled them from its own surpluses many Seine Section medical installa-
before passing the reduced, or tions, received matériel sent forward
"edited," requisitions on to the New by rail from M-402, by barge up the
York Port of Embarkation. After the Seine from Rouen and Le Havre, and
February 1945 merger of COMZ and by air from Great Britain and the
SOLOC, the Supply Division devel- United States. This depot, largest in
oped requirements for the entire the- the system, forwarded supplies to the
ater and arranged for deliveries to Advance Section and the armies by
Marseilles and the Channel ports in
proportion to the respective troop 41
Supply Division, OofCSurg, HQ, ETOUSA,
strengths of the 6th and 12th Army Annual Rpt, 1944, sec. II, ex. III (Memo, Col S. B.
Groups and their supporting base Hays to Hawley, 24 Dec 44, sub: Difficulties in
sections. This procedure kept sup- Moving Medical Supplies and Equipment), and
Semiannual Rpt, January-June 1945, sec. II, pp. 1-
plies flowing across the Atlantic with 3; Wiltse, ed., Medical Supply, pp. 315-16. For
a minimum of delay, duplication, and SOLOC arrangements, see correspondence in DRA-
dispute. In December the Lutes mis- GOON 1944 file, CMH. On Lutes report and short-
ages, see Ruppenthal, Logistical Support, 2:353;
sion had reported that an average of Lutes, ETO Rpt, 1944-45, box 44, RG 200, NARA;
45 days elapsed between the requisi- and Memo, Lutes to CG, SHAEF, via CG, COMZ,
tioning of medical supplies from 25 Dec 44, sub: Report on Supply Situation—North-
ern France, tab 2E, box 44, RG 200, NARA. On
America and the first deliveries to blood flights, see Ltr, Hawley to TSG, 27 Jan 45,
COMZ depots; the corresponding file HD 024 ETO O/CS (Hawley-SGO Corresp).
COMPLETING COMZ 461
MEDICAL SUPPLIES AT MEDICAL DEPOT M-407, the largest facility of this type on the
Continent served by barges as well as railroads
air, road, and rail; it was the central supported CONAD and the U.S. Sev-
continental issuing point for Medical enth and French First Armies.42
Department forms, spare parts, and The theater medical service pos-
items in short supply; and it repaired sessed both sufficient supplies and
major pieces of hospital equipment. well-located depots for their storage
Two advance depots—M-409 at and issue. What was lacking during
Liege, which went into operation the autumn and winter was reliable
early in November, and M-408 at transportation. Difficulties began at
Reims—directly supported ADSEC the overworked continental ports,
and the First, Third, and Ninth where the theater gave unloading pri-
Armies. Depot M-412, also at Reims, ority to ammunition, rations, and
continued its specialized work of col-
42
lecting, processing, and issuing cap- Fenton Interv, 7 Jun 45, box 222, RG 112,
tured German medical supplies. With NARA. Locations and functions of depots summa-
rized in Supply Division, OofCSurg, HQ, ETOUSA,
SOLOC the theater acquired two ad- Annual Rpt, 1944, sec. II, pp. 10-17 and ex. VIII.
ditional depots: M-352 (later redesig- The SOLOC depots were redesignated in February
nated M-452) at Marseilles, with func- 1945 to conform to the ETO numbering system.
See Supply Division, OofCSurg, HQ, ETOUSA,
tions similar to those of M-402, and Semiannual Rpt, January-June 1945, sec. III, p. 16,
M-351 (later M-451) at Dijon, which and Wiltse, Mediterranean, pp. 406-08.
462 EUROPEAN THEATER OF OPERATIONS
POL while cargoes of medical sup- On the Continent the railroads sup-
plies remained offshore in vessels' planted trucks for most long-distance
holds for as long as four months. supply hauling, a shift signaled by
When this logjam finally broke in No- theater discontinuance, on 14 Novem-
vember with the opening of the Seine ber, of Red Ball operations. The
ports and Antwerp, it did so with dis- change from trucks to trains did not
ruptive suddenness. Within a few eliminate difficulties with transporta-
days a dozen ships discharged tion. After the end of the Red Ball
over 9,000 tons of medical freight at Express the COMZ G-4 daily author-
Cherbourg, overwhelming the Chef- ized the medical service to send a cer-
du-Pont receiving facilities. Other tain number of tons of supplies from
medical matériel destined for the Normandy to the front by train. Days
Continent went to Great Britain in- went by, but no rail cars appeared at
stead, as the theater diverted ships to Depot M-402 and no supplies moved.
reduce its backlog. The United King- Finally, late in November, Colonel
dom Base, with its limited allotment
Hays discovered the reason: The daily
of cross-Channel shipping already
medical tonnage was not enough to
committed to prescheduled transfers
of supplies from its own depots to the fill an entire train, and "because of
Continent, could not readily trans- rail operating difficulties" the trans-
ship the diverted cargo. The base also portation authorities moved from
had little warehouse room available, Normandy only fully loaded trains
for it was reducing the number and bound for a single destination. "In
capacity of its depots as part of a gen- other words," Hays stressed in his
eral scaling down of American instal- report to General Hawley, "although
lations in Britain. Base medical supply G-4 was setting up tonnage alloca-
officers sent as much tonnage as they tions and forwarding them to Nor-
could to France by air, or by expedi- mandy Base, no provision was made
ents, such as loading goods on trucks to move these supplies." The Supply
and hospital trains being ferried Division chief negotiated with the
across the Channel. They perforce G-4 a rearrangement of his allocation,
stacked the rest of the overflow in under which, every few days, the Nor-
open fields. Fortunately, the New mandy Base Section could send a full
York Port of Embarkation packed trainload to Paris, where Depot M-
ETO-bound medical supplies to with- 407 then would reconsign individual
stand at least 90 days of outdoor stor- cars to the armies and ADSEC. Such
age. In both the United Kingdom and small shipments, however, were prone
France large quantities survived expo- to loss and delay. One group of eight
sure to the elements for much longer cars dispatched from M-407 took
than that.43 three to fourteen days, depending on
the individual car, just to get through
43
Supply Division, OofCSurg, HQ, ETOUSA, the Paris switching yards. On another
Annual Rpt, 1944, sec. II, p. 11 and ex. III, pp. 2-4;
Wiltse, ed., Medical Supply, p. 321; Kelley Interv, 27
occasion, only fourteen cars of a spe-
Jan 45, box 221, RG 112, NARA. cial forty-car train from Chef-du-Pont
COMPLETING COMZ 463
actually reached their destination at stock accumulated in the COMZ
44 45
Reims. depots nearest the front.
To keep tonnage moving forward, During the last weeks of 1944 and
the Supply Division, the base sec- the early months of the new year the
tions, and the armies continued to ETO medical service, assisted by a
employ the expedients of the summer general improvement in the theater
pursuit. The Supply Division late in logistical situation, largely resolved its
1944 borrowed 150 trucks from the supply movement and distribution
Ninth Air Force to haul 300 tons of problems. The port of Antwerp went
badly needed items from Chef-du- into full operation, in spite of harass-
Pont to Reims. The armies, as they ing bombardment by German V-
had earlier, sent their own vehicles weapons, and the shipping backlog
long distances back to the Communi- rapidly diminished, as did the fre-
cations Zone to collect what they quency of cargo diversions to Great
needed. Between 1 and 15 December Britain. The United Kingdom Base
Third Army trucks picked up 50 tons managed to move across the Channel
of medical supplies in Paris and about much of the excess stock it had accu-
100 in Reims. Hospital trains evacuat- mulated. On the Continent the end of
ing casualties from Liege to Paris car- the SHAEF tonnage allocation system
ried emergency supplies for the First freed more of the available transpor-
and Ninth armies, and for Depot tation for the movement of reserve
M-409 and the Liege general hospi- supplies.. To expedite medical ship-
tals on their northbound runs. At ments and reduce losses in transit,
times, also, the Paris depot coupled the Supply Division in December es-
regular freight cars to these trains for tablished a Movement Control Sec-
the trip to Liege. Aircraft—C-47s tion. Officers of this section, stationed
across the Channel to Le Bourget at strategic road and rail junctions,
field and the UC-64s of the 320th Air followed each truck convoy or rail car
Transport Squadron from Paris to the carrying medical supplies from origi-
front—hauled millions of pounds of nating depot to final destination.
blood, biologicals, and high-priority Colonel Hays admitted that these ef-
cargo. All these expedients, however, forts duplicated "to a large extent the
contributed little to the heavy-duty work of the Transportation Corps but
job of filling the forward depots. Be- 45
Supply Division, OofCSurg, HQ, ETOUSA,
cause of lack of transportation, at the Annual Rpt, 1944, sec. II, pp. 19-22 and ex. III, pp.
end of November the great bulk of 13-15, and Semiannual Rpt, January-June 1945,
sec. II, p. 11 and exs. X and XI; Surg, Seine Sec-
reserve medical supplies still were tion, Annual Rpt, 1944, pp. 39-41, and Semiannual
concentrated at Chef-du-Pont and Rpt, January-June 1945, p. 40. Hawley thanks the
Paris, with only comparatively small Air Force for its support in Ltr, Hawley to Lt Gen
Carl T. Spaatz, 14 Nov 44, file HD 024 ETO CS
(Hawley Chron). For continental reserve distribu-
44
Quotations from Supply Division, OofCSurg, tion, see Memo, Col S. B. Hays to Operations Divi-
HQ, ETOUSA, Annual Rpt, 1944, sec. II, ex. III, sion, OofCSurg, HQ, ETOUSA, 25 Nov 44, sub:
pp. 9-10 and 12-13. See also ADSEC Hist, p. 76; Tonnage Reports at Depots, box 63, RG 112,
Wiltse, ed., Medical Supply, pp. 339-40. NARA.
464 EUROPEAN THEATER OF OPERATIONS
theater remedial efforts and improv- hard work. At Depot M-402 the 11th
ing transportation facilities. Under Medical Depot Company used bull-
new staging procedures, adopted on 1 dozer-drawn mud sleds and 750 POW
November, units that disembarked in laborers to sort out and ship forward
Britain remained there until both the mass of supplies suddenly unload-
their TAT equipment and their as- ed at Cherbourg during November.
semblies were on hand and ready to In mid-January 1945 the same compa-
accompany them across the Channel. ny took over Depot M-407 at Paris.
The New York and Boston port au- Here its men, reinforced by a second
thorities, after a barrage of letters, company and by more than 260
telegrams, and teletype messages French civilians, in six weeks unload-
from Hawley, on the twenty-ninth ed a backlog of 120 freight cars and 7
agreed to a plan that at least ended barges. Working in cold and snow,
the practice of splitting general hospi- they filled over 850 accumulated req-
tal outfits among several ships and uisitions and thereafter more or less
ensured delivery of "functionally kept abreast of the new ones, which
complete" assemblies. Diversion of arrived at a rate of about 100 a day.
assemblies to Great Britain ended They acquired additional buildings
early in 1945, and they received for the equipment repair shop and for
higher unloading priority at continen- storage of slow-moving items, and
tal ports. The Supply Division estab- they rearranged the shipping and re-
lished procedures for following each ceiving sections for more efficient op-
assembly from its departure from the eration in less space. At Depot M-452
United States to an operating site. It in Marseilles the 46th Medical Depot
also secured permission from the Company, an ETO unit, early in Janu-
Transportation chief to send escort ary reinforced the 231st Composite
officers from the owning unit with Medical Battalion, a veteran Mediter-
each assembly during both cross- ranean Theater organization. The
Channel and continental movement. new company, besides providing
This practice, long informally fol- badly needed additional manpower
lowed by veteran units, greatly in- for this busy port depot, introduced
creased the chances that an assembly the European Theater stock control
would arrive at its destination com- system. With the 231st Battalion it
plete and on time.49 developed M-452 into the most com-
Meanwhile, the major medical pletely mechanized depot in the thea-
depots improved their operating effi- ter, with stock stored on pallets for
ciency and solved a variety of practi- movement by forklift trucks and with
cal problems, sometimes by sheer over 3,000 feet of roller conveyor.50
49 50
Supply Division, OofCSurg, HQ, ETOUSA, Supply Division, OofCSurg, HQ, ETOUSA,
Annual Rpt, 1944, sec. II, ex. III, pp. 16-17, sec. Annual Rpt, 1944, sec. II, p. 12, and Semiannual
IV, p. 7, sec. V, pp. 5-6 and exs. VI and VII, and Rpt, January-June 1945, sec. III, pp. 9-11 and 16;
Semiannual Rpt, January-June 1945, sec. IV, pp. 2- Surg, Delta Base Section, Annual Rpts, 1944, p. 1,
3 and 6-8; Surg, Normandy Base Section, Annual and 1945, p. 4; Surg, Normandy Base Section,
Rpt, p. 20. For an example of the practice of escort- Annual Rpt, 1944, encl. 8; Surg, Seine Section,
ing assemblies, see 28th Field Hospital Annual Rpt, Annual Rpt, 1944, p. 41, and Semiannual Rpt, Janu-
1944, pp. 15-16. Continued
466 EUROPEAN THEATER OF OPERATIONS
MAP 21
and sorted them. Continental pa- volume of casualties by surface means
tients, if not retained in the Paris gen- alone. By varying the evacuation poli-
eral hospitals, traveled by rail to hos- cies of the general hospitals in Paris,
pitals in the Normandy and Brittany Liege, and Bar-le-Duc Colonel
Base Sections. Patients destined for Mowrey could open up reserves of
the United Kingdom and the United beds for sudden surges of casualties
States went directly to Britain by air from the armies, while in quieter
from Le Bourget field or to Norman- times he could keep many short-term
dy by train for embarkation at Cher- patients near the front for rapid
bourg. return to duty (Map 21).1
The entire system was highly flexi-
ble and opportunistic. It gave prefer- 1
Memo, Hawley to G-4, ETO, 19 Jan 45, file
ence to air evacuation whenever craft 705:Admission to and Operations in Hospitals;
Evacuation Branch, Operations Division, OofCSurg,
could be obtained and weather per- HQ, ETOUSA, Annual Rpt, 1944, pp. 5 and 10;
mitted, but it also could move a large Continued
470 EUROPEAN THEATER OF OPERATIONS
Behind the 6th Army Group, the fined their techniques for maximum
Southern Line of Communications efficiency and patient comfort and
maintained a separate but similar safety. Holding units learned to place
evacuation system. From air and rail in different wards their "COMZ
holding units in the Continental Ad- short," "COMZ long," and "UK"
vance Section, patients, depending on cases. They took hourly patient cen-
their expected length of time in the suses to facilitate the rapid makeup of
hospital, went to forward general hos- train- and planeloads. By various ex-
pitals around Epinal, Besancon, and pedients they mastered the always dif-
Dijon or to rear installations at Mar- ficult problem of keeping each man
seilles, which was also the evacuation and his records together through re-
port for SOLOC patients bound for ception, sorting, and evacuation.
the United States. SOLOC initially
Through channels both official and
did not send casualties to Great Brit-
ain or to the northern Communica- unofficial, evacuation officers secured
tions Zone, but this practice changed the earliest possible notice of the ar-
under the November agreement be- rival of planes and trains. This infor-
tween the two logistical commands. mation was necessary to prepare for
From then on, SOLOC, while retain- air evacuation, because flights of C-
ing its separate line of evacuation, ac- 47s often landed on a few minutes'
cepted the principle that all its facili- warning and could stay on the ground
ties were part of a single theater pool. for only a short time. Also important
In return, it received assurance that were such details as the number of in-
COMZ would evacuate and hospital- coming "strap" and "bracket" craft,
ize a portion of its patients if the lim- for the method of on-board litter sus-
ited facilities in southern France pension was critical in load plan-
became overloaded. When this oc- ning—the two types had different
curred, aircraft and hospital trains patient capacities. Once the transpor-
from Paris collected the overflow di- tation was at hand, quick transfer of
rectly from forward CONAD installa- patients from wards to airstrips and
tions.2 platforms and then to airplanes and
At each link in the evacuation rail cars became the main consider-
chain, medical units, as they gained ation. Ambulance crews and litter de-
experience, steadily improved and re- tachments, their every movement pre-
cisely choreographed, became expert
Surg, Seine Section, Annual Rpt, 1944, pp. 18-19; at combining speed and gentleness in
Surg, Normandy Base Section, Annual Rpt, 1944,
pp. 5, 8-9 and encl. 3; 819th Hospital Center this process.3
Annual Rpt, 1944, pp. 5-6; 15th General Hospital In Paris Colonel Mowrey's Evacu-
Annual Rpt, 1944, pp. 4-5; 94th Medical Gas Treat- ation Branch, after some initial confu-
ment Battalion Annual Rpt, 1944, p. 34; 186th Med-
ical Battalion Annual Rpt, 1944, pp. 14-16; 552d sion, delegated most of the day-to-day
Ambulance Company Annual Rpt, 1944, pp. 6-7.
2
conduct of evacuation to Colonel
Evacuation Branch, Operations Division, Rich, the Seine Section surgeon, and
OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, p. 14;
Wiltse, Mediterranean, pp. 401-04; MFR, Col D. E.
3
Liston, 4 Dec 44, sub: Agreements Made at Confer- 94th Medical Gas Treatment Battalion Annual
ence, 15-16 November 1944, DRAGOON 1944 file, Rpt, 1944; 28th Field Hospital Annual Rpt, 1944, p.
CMH. 21.
HOSPITALIZATION AND EVACUATION CRISIS 471
his staff. The two offices jointly estab- Means of casualty transportation
lished an evacuation priority for each were in steadily increasing supply. Air
class of patients so that the Seine Sec- evacuation, the first choice of sur-
tion, by loading low- as well as high- geons for moving the seriously ill and
priority cases when large numbers of injured, continued on a large scale
casualties were due in from the front, throughout the late autumn and
could fill all available outgoing trans- winter, in spite of worsening weather
portation and quickly clear hospital and persistent administrative uncer-
beds. Late in the year the Seine Sec- tainties. C-47s of the IX Troop Carri-
tion placed the headquarters of the er Command and the 302d Air Trans-
343d Medical Battalion in administra- port Wing during the last three
tive and operational control of its months of 1944 carried the majority
hospital train units, ambulance com- of patients who crossed the Channel.
panies, litter detachments, and air On one peak day in November they
holding units. This action relieved the evacuated more than 3,000 casualties
overburdened section surgeon's staff from France to Great Britain. By late
of most details of evacuation manage- 1944 the air forces and the chief sur-
ment, and it permitted more efficient geon's office had established work-
use of resources. The battalion orga- able procedures for timely transmis-
nized a centrally dispatched pool of sion of aircraft requests from forward
more than 100 ambulances, drawn holding units to SHAEF's Combined
from units throughout the section, for Air Transport Operations Room. Air
mass movement of patients between Force authorities were increasingly
medical installations, airfields, and generous in allocating planes for
railway stations. The Seine Section evacuation, and the basing of a C-47
made the most efficient use possible wing at Le Mans made more craft
of its general hospitals. Those closest regularly available.
to the stations were assigned to casu- By formal or informal means,
alty reception and triage, while others medics and cooperative air liaison of-
performed specialized surgical work, ficers almost always managed to
reducing the waste of professional produce planes where and when they
talent that resulted when the big hos- were needed. Late in the year the
pitals were used as holding and tran- 302d Wing converted the theater's
sit facilities.4 only designated aeromedical transport
4 squadron, the Paris-based 320th,
Evacuation Branch, Operations Division,
OofCSurg, HQ, ETOUSA, Daily Diary, 16 and 25- from single-engine UC-64s, which
26 Oct 44, file HD 024 ETO; Surg, Seine Section, had proved less than totally suitable
Annual Rpt, 1944, pp. 21-22, 28-29, 49-50; 40th for evacuation and resupply, to the
General Hospital Annual Rpt, 1944, pp. 55 and 81;
48th General Hospital Annual Rpt, 1944, pp. 35-36; larger C-47s, further increasing medi-
425th Ambulance Company Annual Rpt, 1944, pp. cal service airlift capacity. SHAEF pe-
2-3, and Hist, January-June 1945, pp. 3-4. See also, riodically reiterated that air evacu-
in file HD:ETO:370.05:Evacuation, Sep-Dec 44,
MFR, Col Mowrey, n.d.; Memo, Col Cutler to Chief, ation should be considered only a
Professional Services Division, OofCSurg, 26 Oct
44, sub: Meeting of Surgical Chiefs, Paris Hospi-
tals . . . ; Memo, Maj D. J. Twohig to Oct Chief,
44,Evacu-
sub: Evacuation of Patients From Paris Gen-
ation Branch, Operations Division, OofCSurg, 31 eral Hospitals to Cherbourg.
472 EUROPEAN THEATER OF OPERATIONS
bonus, but by the end of the year its medical crews, who added furniture
transportation agencies were treating and enlarged kitchens and water stor-
medical evacuation flights as a perma- age facilities.
nent and indispensable element in Train running times remained ir-
their planning.5 regular and usually slow. The French
The ETO medical service acquired railroads were battle-damaged and
more hospital trains during the fall congested, and subject to interruption
and winter and operated them with by accidents and occasional enemy air
increasing efficiency. Between 30 Sep-
tember and the end of the year the attacks. Nevertheless, General
northern Communications Zone dou- Hawley, by constant pressure on the
bled its medical rolling stock from 17 Transportation Corps, gradually se-
trains to 34. Most of the additional cured higher scheduling priority for
trains were brought over from Great his trains. In late December the aver-
Britain; others were built on the Con- age round trip between Paris and
tinent, to medical service specifica- Cherbourg took about 47 hours, com-
tions, by the reconstituted French pared to 96 to 120 earlier in the cam-
railway authorities. The Southern paign. Hospital train units and dis-
Line of Communications in the same patching and receiving hospitals and
period acquired six trains of its own, holding units, as they acquired great-
four shipped directly from the United er proficiency in their work, steadily
States and two constructed by the reduced turnaround times in the for-
French. The trains of both zones had ward areas and at Paris. The Seine
an aggregate capacity of over 8,000 Section, which provided stabling and
litter and 3,700 ambulatory patients servicing for the entire COMZ train
and well exceeded in numbers the complement, during October ac-
theater's planned ratio of trains to di- quired trackage at a second station,
visions. Except for a chronic lack of the Gare de l'Est, as the terminal for
heat in the cars, the equipment was trains shuttling between the capital
adequate for the task, especially when and the Third Army area. The section
improved by the ingenuity of the thus reduced congestion at the Gare
St.-Lazare, which continued to handle
5
Admin Memo No. 147, OofCSurg, HQ, all trains from the First and Ninth
ETOUSA, 2 Nov 44, AirEvacCorresp, file HD 580 Armies and also those running be-
ETO; Evacuation Branch, Operations Division,
OofCSurg, HQ, ETOUSA, Daily Diary, 30 Dec 44, tween Paris and Cherbourg. To speed
file HD 024 ETO, and Annual Rpt, 1944, pp. 12-14 the turnaround of trains, the section
and encl. 10; Robert F. Futrell, Development of Aerome-
dical Evacuation in the USAF, 1909-1960, USAF His-
set up a medical supply point for
torical Study no. 23 (Maxwell Air Force Base, Ala.: them at the Gare St.-Lazare, as well
USAF Historical Division, Research Studies Insti- as rest and bathing facilities at both
tute, Air University, 1960), pp. 238, 240, 242-43.
On SHAEF acknowledgement, see Extract from terminals for the hard-worked staffs.
Thirtieth Weekly Military Shipments Priority Meet- Even with these improvements, the
ing, 16 Dec 44, EvacCorresp, 1944-45, file HD
370.05 ETO, and Memo, HQ, COMZ, to SHAEF, combination of slow runs and increas-
26 Dec 44, file 370.05 Evacuation (Planning). ing casualty flow kept every train in
HOSPITALIZATION AND EVACUATION CRISIS 473
almost constant service, with little 1944-45. The theater faced a short-
time between trips for maintenance ofage of fixed hospital beds, largely re-
the equipment or leave for the medi- sulting from delays in setting up
cal personnel.6 enough general hospitals on the Con-
tinent. At the same time a lack of
Persistent Problems cross-Channel shipping, combined
with the long, inefficient line of evac-
Despite much progress, three per- uation through Cherbourg, jeopard-
sistent problems hampered—and, on ized the smooth flow of patients to
occasion, almost paralyzed—the thea- the more numerous hospital beds in
ter hospitalization and evacuation England. Finally, the United Kingdom
system during the winter battles of
Kenner to G-4, SHAEF, 11 Nov 44, Medical Divi-
6
Evacuation Branch, Operations sion, COSSAC/SHAEF, War Diary, November 1944;
Division,
OofCSurg, HQ, ETOUSA, Daily Diary, 6, 9, 10, 23 Memo, HQ, COMZ, to SHAEF, 26 Dec 44, file
Oct 44, file HD 024 ETO, and Annual Rpt, 1944, 370.05:Evacuation (Planning). For details of train
pp. 10-11 and encl. 4, and Semiannual Rpt, Janu- operations, see 14th, 16th, 18th, 43d, and 45th Hos-
ary-June 1945, encl. 2, pp. 2-3; Surg, ADSEC, pital Trains Annual Rpts, 1944; 99th General Hos-
COMZ, Annual Rpt, 1944, pp. 17-18; Surg, Seine pital Annual Rpt, 1944, p. 17; and 552d Ambulance
Section, Annual Rpt, 1944, pp. 39-40; Memo, Company Annual Rpt, 1944, p. 10.
474 EUROPEAN THEATER OF OPERATIONS
who passed through the vast RED Verdun, and Luxembourg. However,
HORSE staging area around Rouen. 8 as winter descended, the medics had
The delay in setting up more hospi- to compete for space under roofs with
tals was not due to a lack of operating other Army elements and with French
units. At most times during the and Belgian civilian agencies. Elabo-
autumn and winter between twelve rate negotiations, conducted through
and twenty general hospitals were idle SHAEF, were often needed before the
on the Continent and in Britain, civilian authorities grudgingly gave
awaiting equipment and plants. The way. The field armies, needing shelter
latter proved increasingly difficult to for their own medical and other units,
secure. The Hospitalization Division also resisted handing over facilities,
reconnoitered and requested more and the slowed pace of the advance in
than enough sites, almost all with late autumn further delayed medical
suitable standing buildings, at loca- service occupation of forward sites.
tions as far forward as Aachen, Hospitals that did get into their
plants then had to cope with the ef-
8
Hospitalization Division, OofCSurg, HQ, fects of battle damage and German
ETOUSA, Semiannual Rpt, January-June 1945,
encl. 4; Surg, Channel Base Section, Annual Rpt, sabotage; the difficulty of obtaining
1944, pp. 7-9 and enclosures. engineer construction support; the
476 EUROPEAN THEATER OF OPERATIONS
beds for its POW patients, and per- sion improved the handling of hospi-
sonnel to attend them, when the War tal assemblies. Nevertheless, com-
Department in mid-November com- mand attention and directives could
pounded its troubles. Anticipating an not at once overcome manpower and
early collapse of the Reich, the de- matériel shortages, ice and snow, and
partment ordered a halt to movement tactical setbacks.12
of almost all prisoners, including pa- Inefficiencies in cross-Channel sea
tients, across the Atlantic. As a result, evacuation also concerned General
by late December United Kingdom Kenner. Under army-navy arrange-
Base hospitals contained over 14,000 ments made soon after D-Day, all cas-
Germans. General Hawley's planners, ualty movement over the Normandy
looking ahead to another Allied beaches and most transportation of
breakthrough, produced astronomical
patients on LSTs ended in late
estimates of the number of captured
autumn. At the same time the United
enemy to be cared for and warned
that a high proportion would likely be Kingdom Base discontinued casualty
severely ill or suffering from untreat- reception at Portland-Weymouth.
ed, infected wounds. The stabilization From then on, all American patients
of the front and the German counter- not sent to Great Britain by air trav-
attacks made this a future rather than eled on British hospital carriers shut-
a present problem. Nevertheless, the tling between Cherbourg and South-
need to make decisions and take ampton. The Normandy Base Section
measures on POW hospitalization surgeon, who had charge of embarka-
hung ominously over all discussions tion, established the 280th Station
11
of the theater bed shortage. Hospital at Cherbourg to hold train-
Whether for POWs or American loads of patients from Paris until a
casualties, additional hospital beds on carrier came in; he employed ambu-
the Continent obviously were needed. lance and sanitary companies to move
But no quick way could be found to evacuees to the docks. Late in the
put more plants in operation. General autumn he acquired hospital train sta-
Kenner, through SHAEF, pressed the bling facilities at the dockside Gare
12th Army Group to give up some Maritime, which in peacetime served
sites in its possession and expedited passengers on the French transatlan-
negotiations with the Allies to obtain tic liners. This arrangement permitted
others. He and Hawley both worked direct transfer of patients from rail
through every possible channel to win cars to ships when schedules dove-
the hospitals higher priority in the al- tailed. When they did not, the station
location of engineer support and hospital in Cherbourg, and in emer-
transportation. Hawley's Supply Divi- gencies the Normandy general hospi-
12
For examples of efforts to speed up the estab-
11
Smith, Hospitalization and Evacuation, pp. 234-35; lishment of new hospitals, see MFR, Kenner and
Surg, United Kingdom Base, Annual Rpt, 1944, p. Hawley Conference, 22 Dec 44, sub: Evacuation and
15; MFR, Planning Branch, Operations Division, Medical Problems, in Medical Division, COSSAC/
OofCSurg, ETO, 29 Nov 44, file HD 383.6 (Hospi- SHAEF, War Diary, December 1944; Memo, HQ,
talization and Medical Services for Prisoners of War, COMZ, to SHAEF, 26 Dec 44, file 370.05:Evacu-
1942-45). ation (Planning).
478 EUROPEAN THEATER OF OPERATIONS
ETOUSA, 18 Jul 44, sub: Inter-Theater Evacuation face means. After much negotiation,
of Casualties, and Lt Col E. C. Andreassen to G-4, General Hawley by late autumn had
United Kingdom Base, 15 Sep 44, sub: Responsibil-
ity of Surgeon, UK Base, for ... Evacuation . secured
. . from the British seven of
thru . . their hospital carriers and two small
. Portland-Weymouth, EvacCorresp, 1944-
45, file HD 370.05 ETO; Evacuation Branch, Oper-
ations Division, OofCSurg, HQ, ETOUSA, Daily
hospital ships for the cross-Channel
Diary, 5 Oct 44, file HD 024 ETO, and Annual Rpt, run. These vessels, on the rare occa-
1944, p. 11; Surg, Normandy Base Section, Annual sions when all were in service at the
Rpt, 1944, pp. 4-6; 298th General Hospital Annual
Rpt, 1944, p. 108 (the 298th preceded the 280th as same time, could carry about 1,000
the holding unit at Cherbourg). patients per day, roughly half the rate
HOSPITALIZATION AND EVACUATION CRISIS 479
(GFRC). Late in 1944, after the War had difficulty obtaining clothing and
Department adopted a T/O for con- equipment for soldiers ready for dis-
valescent center units, the medical charge; at times they had to hold fit
service organized five to operate the men for as long as a week for lack of
United Kingdom facilities, using per- small but indispensable items, such as
sonnel from four disbanded station canteen cups. Making matters still
hospitals. Besides the centers, the Re- more difficult for the Normandy hos-
habilitation Division in Great Britain pitals and convalescent camp, the
oversaw reconditioning activities in Ground Force Reinforcement Com-
thirteen station hospitals assigned to mand closed its Cotentin depot
relieve general hospitals of nearly re- during the autumn. The medics then
covered patients, as well as programs had to secure rail transportation for
in many of the general hospitals the returnees to the Paris reinforce-
themselves. On the Continent the 7th ment depot, and also find them ra-
and 8th Convalescent Hospitals, field tions and mess gear for the trip.16
army units under COMZ control, lo- When discharged patients entered
cated respectively at Etampes near the reinforcement system, the medical
Paris and at Valognes in the Cotentin, service still had some responsibility
prepared recovered soldiers from two for them. The close relationship be-
of the largest general hospital clusters tween the Reinforcement Command
for return to the front. The facilities and General Hawley has already been
in the United Kingdom Base and on noted.17 In England the command's
the Continent could accommodate in headquarters and Hawley's office had
all about 31,500 trainees. About 85 occupied adjacent buildings in Chel-
percent of their graduates returned to tenham and were only a block apart
some form of duty.15 in Paris. Physical proximity made
But moving patients out of conva- easier the informal cooperation that,
lescent centers and hospitals into here as elsewhere in the European
GFRC depots did not always go Theater, took up the slack caused by
smoothly. General hospital command- organizational confusion. Each GFRC
ers at times were less than prompt in depot centralized and controlled the
clearing their wards, either out of flow of replacements—former hospi-
professional desire to follow through tal patients and also new arrivals from
on particularly interesting cases or the States and returning AWOLs—
because able-bodied convalescents and each had a depot surgeon and a
helped to solve their perpetual short- small complement of enlisted corps-
age of labor. The chief surgeon, men, themselves often Limited As-
through his consultants, made con- signment men retained by the depot
stant efforts to suppress such prac-
tices. Some delays were not the hospi- 16
For use of convalescent labor, see Cady, "Notes
tals' fault. General hospitals in the on the 21st General Hospital (AUS)," p. 449, Cady
Normandy Base Section, for example, Papers, MHI, and Ltr, Hawley to Consultants, 10
Dec 44, box 3, Hawley Papers, MHI. On Normandy
difficulties, see Surg, Normandy Base Section,
15
Rehabilitation Division, OofCSurg, HQ, Annual Rpt, 1944, p. 9, and 298th General Hospital
ETOUSA, Annual Rpt, 1944, pp. 10-21, 23-24, and Annual Rpt, 1944, pp. 108-09.
17
Semiannual Rpt, January-June 1945, p. 1. See Chapter XIII of this volume.
HOSPITALIZATION AND EVACUATION CRISIS 481
to free able-bodied medics for front- men, if possible. For a time in mid-
line duty. The surgeons, under tech- 1944 the theater brought chaos to the
nical direction from both the base depots by allowing combat exhaustion
sections and the GFRC surgeon, Col. centers to dump on the replacement
George G. Durst, MC, were the only system thousands of men recently re-
medical men in daily contact with the leased from narcosis therapy but
stream of replacements.18 unable to control their tremors long
Depot surgeons spent much of their enough to stand inspection—and still
time on preventive medicine, because far from able to resume combat. Gen-
the pooling of men from many differ- eral Layman insisted that such cases
ent sources raised the specter of com- not be sent to his facilities until they
municable disease and demanded had "completed their full period of
constant vigilance. "Repo depot" convalescence in suitable Medical De-
transients were particularly apt to partment installations," and he won
catch and spread venereal disease, to his point. The General Assignment
which depot surgeons responded with men sent forward to the divisions
the customary devices of propaganda, were again checked by unit surgeons
physical inspection, and treatment as and dentists, and complaints came
necessary. back to the depots if any were found
More fundamental was the depot unfit for duty. In spite of difficulties
surgeons' task of examining each re- the system moved men in large num-
placement, making a medical profile bers. During November, December,
of the man, and rating him as either
and January about 207,000 U.S. Army
General or Limited Assignment, if
patients returned to duty through
screening revealed a more permanent
COMZ hospitals, about half of them
defect. In many instances, it did. Ac-
cording to the GFRC commander, in the United Kingdom and half on
Brig. Gen. Walter G. Layman, about the Continent.19
18 percent of hospital returnees had Compared to the flow back to duty
"some physical or emotional condi- via the Reinforcement Command, the
tion," usually directly related to the number of patients evacuated from
injuries that had caused their evacu- the theater to the United States, a
ation, and required "special consider- little over 78,000 during all of 1944,
ation in reassignment." Limited As- was small. General Hawley, in adopt-
signment men piled up in the depots ing his 180-day evacuation policy, had
because many jobs were closed to intended it to be, for he wanted to
them and because commanders pre- 19
ferred to take General Assignment Quotations from Medical History of the Ground
Force Reinforcement Command, ETO, 23 October
1943-30 June 1945, pp. 4, 13, 16, 18, 32-34, file
18
Depot surgeons received technical direction on 319.1-2 (GFRC). For an example of division proc-
routine matters from the base section surgeons and essing, see 76th Infantry Division SOP (Medical
special guidance on physical standards and other Processing of Division Reinforcements), in Surg,
such questions from Colonel Durst. This somewhat 76th Infantry Division, Semiannual Rpt, January-
anomalous dual responsibility worked out well in June 1945. See also Memo, Anon, to Col Doan, 22
practice and, at Durst's recommendation, survived Feb 45, sub: Status of Hospitalization and Evacu-
the July 1944 redesignation of the Reinforcement ation, file 705:Admission to and Operations in Hos-
Command as a major command of ETOUSA. pitals.
482 EUROPEAN THEATER OF OPERATIONS
cause Kenner was unwilling to seek a General Hawley considered the new
SHAEF directive forcing a change. In
evacuation policy "a fine example of
the end, therefore, the decisive action
an order that cannot be carried out"
came from the Office of the Surgeon
for lack of transportation. In the
General and the Army Service Forces
case of transatlantic air movement of
20
Figures from Evacuation Branch, Operations
patients, he clearly was correct. Evac-
Divison, OofCSurg, HQ, ETOUSA, Annual Rpt, uation by long-range four-engine
1944, encl. 11. On Kenner's views, see Notes of C-54s of the Air Transport Com-
Kenner-Hawley Conference, SHAEF Main, 14 Aug mand, initially promising, proved dis-
44, and MFR, Kenner, 4 Sep 44, sub: Evacuation
Policy . . . , in Medical Divison, COSSAC/SHAEF,
21
War Diary, August-September 1944. On Hawley's For background to this decision, see Smith, Hos-
views, see Memo, Hawley to Inspector General, pitalization and Evacuation, pp. 228-30, and Ltr, TSG
WD, 10 Oct 44, and Ltr, Hawley to TSG, 13 Oct 44, to Hawley, 4 Sep 44, file HD 024 ETO O/CS
file HD 024 ETO O/CS (Hawley-SGO Corresp). (Hawley-SGO Corresp).
HOSPITALIZATION AND EVACUATION CRISIS 483
appointing after D-Day. Before the in- restricted the total number of men
vasion the Transport Command as- lifted to 351. As 1944 ended, transat-
sured the medical service of space on lantic air evacuation remained more
23
its planes for 6,000-10,000 patients promise than reality.
per month; at its best, it delivered With airlift negligible, most evacu-
only about one-third of that. Making ees to the United States had to travel
matters worse, the command, for lack by ship. Sea transportation, especially
of medical attendance on board and of bed patients and of ambulatory
at stopovers, would take litter pa- cases who still required considerable
tients—those most needing air evacu- medical attention (respectively Class-
ation—up to only 30 percent of the es II and III in the War Department
average planeload. The medical ser- classification system) long had been a
vice, too, encountered difficulty in matter of contention between General
moving patients from hospitals to the Hawley and his Washington and ETO
remote transatlantic air terminal at superiors. The chief surgeon from the
Prestwick.22 earliest days of the theater had insist-
Most important, the theater Air ed, on grounds of patient welfare and
Transport Board gave relatively low safety, that bed-confined men should
priority for space to casualties as op- be sent to sea only on specially outfit-
posed, for example, to air crews rotat- ted hospital ships, marked and pro-
ing back to the United States after tected as required by the Geneva
completing their required number of Convention. During 1943 the War
combat missions. During autumn the Department had adopted Hawley's
board actually cut medical evacuation position as its own and had undertak-
space allocations to a little over 1,000 en an ambitious hospital ship pro-
a month. In partial compensation the curement program. The effort, how-
Air Transport Command in October ever, fell far short of its goals during
committed itself to move 2,000 pa- 1944, and most of the vessels that
tients per month directly from France were obtained were sent to the Pacif-
to the United States via its new trans- ic. With too few hospital ships to
atlantic terminal at Orly Field, just move even the nonambulatory frac-
south of Paris. While the Air Force tion of its over-180-day patients, the
restored the heavily sabotaged air- European Theater obviously had to
port, the Seine Section established a rely for further evacuation on west-
400-bed holding unit for United bound troop transports. These were
States-bound casualties at a nearby in ample supply due to the continuing
general hospital. The new airlift flow of reinforcements to Europe.
began on 7 December when a C-54 Following standard War Department
took off, carrying 16 patients. Other
flights soon followed, but inclement 23
Memo, Col. F. H. Mowrey to Chief, Hospitaliza-
tion Division, OofCSurg, 26 Sep 44, sub: Air Evacu-
weather during the rest of the month ation to the U.S., AirEvacCorresp, file HD 580
ETO; Evacuation Branch, Operations Division,
22
Quotation from Ltr, Hawley to TSG, 13 Oct 44, OofCSurg, HQ, ETOUSA, Annual Rpt, 1944, pp.
file HD 024 ETO O/CS (Hawley-SGO Corresp). In 15-16; Surg, Seine Section, Annual Rpt, 1944, p.
same file, see also Memo, Hawley to Inspector Gen- 28; Futrell, Aeromedical Evacuation, pp. 379-82; Dar-
eral, WD, 10 Oct 44. nall, "Sidelights," p. 26.
484 EUROPEAN THEATER OF OPERATIONS
mulated in Britain. Behind the near- wounded men to sea under condi-
deadlock, reported an inspecting offi- tions that he deemed to be substand-
cer sent by the surgeon general, was a ard and unsafe.25
fundamental difference in outlook.
Washington saw transoceanic evacu- 25
ation as "basically an ambulance Quotations from Rpt (to TSG), Lt Col John S.
Poe, 12 Nov 44, sub: Visit to ETOUSA, box 256,
ride" on a grand scale, while Hawley RG 112, NARA. See also Memo, Chief, Passenger
viewed it as a continuation of the "de- Branch, ETO, to ACofTrans (Movements), ETO, 2
finitive general hospitalization" that Mar 44, sub: Evacuation of Sick and Wounded From
the Continent . . . , EvacCorresp, 1942-44, file
had begun in the United Kingdom 024 ETO; Notes of Kenner-Col Davis-Col Mowrey
Base or the big continental hospitals. Conference, 20 Oct 44, and Memo, Kenner to CofS,
A tenacious fighter on what he con- SHAEF, 26 Oct 44, sub: ZI Evacuation Problem, in
Medical Division, COSSAC/SHAEF, War Diary, Oc-
sidered matters of principle, Hawley tober 1944; Ltr, Hawley to TSG, 25 Oct 44, file HD
was also a shrewd administrator who 024 ETO O/CS (Hawley-SGO Corresp); Memo, Col
kept a close eye on public relations. F. H. Mowrey to CSurg, ETO, 2 Oct 44, sub: Utili-
zation of the Queens, EvacCorresp, 1944-45, file
Very likely he held out in order to HD 370.05 ETO; Evacuation Branch, Operations
force the higher authorities to take Division, OofCSurg, HQ, ETOUSA, Annual Rpt,
1944, pp. 14-15. For background on the shipping
unequivocal (and documented) re- problem, see Joseph Bykofsky and Harold Larson,
sponsibility for sending sick and Continued
486 EUROPEAN THEATER OF OPERATIONS
The War Department, after weeks Kingdom Base borrowed six British
of inconclusive exchanges, finally hospital trains to supplement the
gave Hawley the direct order he ap- eight already in its possession. Evacu-
peared to want. On 3 December the ation from the European Theater visi-
Army chief of staff, General Marshall, bly accelerated. Under Washington's
instructed the European Theater to prodding, even before Marshall's
make full use of United States trans- order, the theater, which had evacuat-
ports for evacuation, filling them to ed a little over 8,200 men in Septem-
their capacities as defined by the War ber, shipped out over 12,500 in Octo-
Department. The theater was to do ber and 11,300 in November. After
the same with the Queen Elizabeth and the chief of staffs directive, the out-
Queen Mary, as soon as it could make ward flow during December increased
satisfactory arrangements with the to 20,800.
27
British. If necessary to fill transport At the end of 1944 the theater and
space, the theater was to reduce its the War Department also made basic
evacuation policy temporarily to 90
policy decisions on POW hospitaliza-
days.26
tion. General Hawley late in the year
Marshall's order had immediate ef-
fects. General Hawley on 10 Decem- sent a request to the War Department
ber instructed United Kingdom Base for 100,000 additional general hospi-
and SOLOC surgeons to use 100 per- tal beds to accommodate POWs and
cent of the available evacuation lift the large number of displaced per-
and to include patients who needed sons expected after the surrender of
90 days of hospitalization, or even Germany. However, realizing that the
less, if necessary. He directed his con- chances of obtaining such a medical
sultants to scrutinize hospital disposi- reinforcement were slim, he and his
tion procedures, to make certain that staff also explored the only remaining
commanders sent off promptly all alternative: use of the over 350 cap-
evacuable patients. Even before the tive German medical officers, 390
Marshall directive arrived, Hawley nurses, and 7,200 medical enlisted
and the ETO Transportation chief, men in the theater to care for their
Maj. Gen. Frank S. Ross, completed own countrymen, either in separate
arrangements with the British to aug- wards of American hospitals or in all-
ment the medical staffs of the Queens prisoner facilities. Theater hospitals
and to improve their hospital facilities already had begun using limited num-
so that each liner could accommodate bers of Germans for this purpose.
about 1,700 Class II and III patients. One SOLOC general hospital, the
To speed movement of evacuees to 21st, in November organized an
the embarkation ports, the United entire prisoner section with a German
27
The Transportation Corps: Operations Overseas, United Ltr, Hawley to Surgs, SOLOC and United King-
States Army in World War II (Washington, D.C.: dom Base, 10 Dec 44, sub: Evacuation to the ZI, file
Office of the Chief of Military History, Department HD:ETO:370.05:Evacuation, Sep-Dec 44; Ltr,
of the Army, 1957), pp. 365-66. Hawley to Consultants, 10 Dec 44, box 3, Hawley
26
Msg, Marshall to ETOUSA, 3 Dec 44, copy in Papers, MHI; Bykofsky and Larson, Transportation
file HD:ETO:370.05:Evacuation, Sep-Dec 44. See Corps, pp. 366-67; Memo, HQ, COMZ, to SHAEF,
also Smith, Hospitalization and Evacuation, p. 236. 26 Dec 44, file 370.05:Evacuation (Planning).
HOSPITALIZATION AND EVACUATION CRISIS 487
for by their own people. Sams con- By breaking the transatlantic evacu-
cluded, confirming what Marshall al- ation deadlock and deciding to estab-
ready had decided, that equipment lish German-staffed POW hospitals,
for the 100,000 additional beds the War Department assured the
should be sent to Europe, but no eventual solution of two major ETO
staff. As the new equipment arrived, medical logistical problems. These ac-
it should be issued to the rearmost tions, however, had only a marginal
American hospitals that would be sent impact on the medical service's ability
forward to support the armies. The to respond to the German attack in
equipment and plants left behind the Ardennes. Indeed, setting up
should be turned over to the POW POW hospitals depended upon the
medics, who would work under no ability of American general hospitals
more than general American supervi- to occupy new sites farther forward.
29
sion. The delay in securing such sites was a
On 28 December, even before principal component of the winter
Sams returned and reported, the War crisis. Theater medical personnel had
Department directed the European to rely on resources and facilities al-
Theater to implement essentially the ready on hand, as they coped not
policy he recommended. General only with battle casualties but also
Hawley, with a new flood of prisoners with victims of a pernicious combina-
in prospect from the cleanup of the tion of severe weather, poor supply
Bulge and the resumption of the planning, and inadequate health pre-
Allied offensive, lost no time in doing cautions.
so. The United Kingdom Base con-
verted half a dozen more station Trenchfoot: The Other Enemy
hospitals into POW facilities. On
the Continent the Normandy Base The winter of 1944-45 was the
Section in January 1945 began reor- coldest and wettest that Europe had
ganizing its general hospitals in the seen in many years. To plague the al-
Cotentin and near OMAHA beach into ready miserable American front-line
prisoner hospitals. Except for one infantry, winter brought an undrama-
unit, which remained to supervise the tic but crippling ailment: trenchfoot.
Germans, the American hospitals that Cases began to appear in October,
had occupied these sites moved to and rapidly increased thereafter. In
new plants nearer the front, leaving December, when the systems of evac-
behind their tentage and equipment uation and hospitalization were strain-
and receiving new outfits as they went ing under the weight of wounded, the
30
forward. casualties of cold injury resulting
from the Ardennes battle arrived in
29
Sams, "Medic," pp. 293-322, CMH.
30
numbers that exceeded all expecta-
MFR, Planning Branch, Operations Division, tions.
OofCSurg, ETO, 10 Feb 45, sub: Prisoners of War
Held by U.S. Forces in ETO; Memo, Planning
Branch, Operations Division, OofCSurg, to Chief, oners of War, 1942-45). See also Smith, Hospitaliza-
Operations Division, OofCSurg, 13 Jan 45; Ltr, Col tion and Evacuation, p. 236; Surg, Normandy Base
D. E. Liston to G-1, ETO, 13 Jan 45. All in file HD Section, Semiannual Rpt, January-June 1945, pp. 2-
383.6 (Hospitalization and Medical Services for Pris- 4.
HOSPITALIZATION AND EVACUATION CRISIS 489
Cold injury took various forms de- Americans met cold injury in three
pending on the depth of the chill and areas during the war—the Aleutians,
the length of exposure. Severe cold, Italy, and the European Theater.
notably at high altitudes where some Little information moved from one
bomber crewmen were subject to the theater to another and the lessons
direct blast of freezing winds, could learned in one region had to be re-
cause quick tissue death. Milder frost- learned elsewhere. Troops in Italy
bite occurred among the infantry as underwent their most severe trial in
well. Slower and subtler was the the winter of 1943-44, when more
ground type of cold injury, which did than 5,700 cases occurred. By the
not even require especially low tem- time of D-Day the Mediterranean
peratures. In chilled feet the small Theater had worked out methods of
blood vessels initially contracted, re-
control that reduced the number of
ducing the oxygen supply to the tis-
cases in the following winter by
sues; in serious cases the arterioles
and the nerve endings were "irrevers- almost three-fourths: Cases fell to
ibly damaged" so that the effect of 1,572, and admission rates tumbled
the injury persisted. Wetness in- from 54 per 1,000 troops per annum
creased the speed and severity of to 20. Better equipment and more
injury by conducting heat away from rigorous discipline were the primary
the body. Anything, such as tight factors. Commanders ensured that
shoelaces, that obstructed the flow of boots were not laced too tight, that
blood likewise hastened the onset of socks were changed as frequently as
trenchfoot's unpleasant symptoms— possible, that feet were massaged
numbness followed by swelling; then daily, and that warm tents were avail-
by intense pain; and, in some cases, able where forward troops could gain
by tissue death, with gangrene. Once a few hours' rest, whenever possible.
injury occurred, the victim could look The Mediterranean Theater's official
forward to a long course of treat- report on trenchfoot was in the hands
ment, and possible recurrence of the of its chief surgeon in January 1944
condition caused by the inability of but failed to reach the European The-
damaged tissue to resist cold. Trench- ater until a year later, and then only
foot proved to be most dangerous to in response to a direct request. The
the front-line troops, who lived for ETO chief consultant in surgery,
long periods without shelter or dry Colonel Cutler, visited the Mediterra-
clothing and who were often immobi- nean and returned to urge timely
lized under enemy fire. No one died preparations for meeting cold injury.
of trenchfoot, but its impact was But ETO medical officers were too
heavy, both upon fighting regiments preoccupied to heed his warning.
that lost their riflemen and upon the Cold injury approached the Euro-
hospitals that cared for them.31
pean Theater as a silent crisis, its pos-
31
Unless otherwise noted, this section, to include
sibility dimly foreseen but its poten-
statistics, is based on Tom F. Whayne and Michael
E. DeBakey, Cold Injury, Ground Type, Medical De- Department of the Army, 1958), pp. 127-210. Quo-
partment, United States Army in World War II tation from Whayne Comments, 4 Dec 86, p. 17,
(Washington, D.C.: Office of the Surgeon General, CMH.
490 EUROPEAN THEATER OF OPERATIONS
tial for havoc unappreciated. The vember, massive losses from cold
problem became lost in the vast com- injury had already been sustained.
plexity of the planning and buildup Conceptual problems helped to
for invasion, when medical planners confuse the issue. To many doctors
were occupied with more pressing "injury" seemed a different category
needs. The medical annex to OVER- from "disease." Forms used to report
LORD did not mention cold injury; cold injury were ambiguous and no-
COMZ's NEPTUNE plan remarked only menclature varied; at one time or an-
that "the cold, wet weather prevailing other trenchfoot and immersion foot
during the winter season in the area were reported as nonbattle injuries or
will predispose combat troops to this as disease, and frostbite as battle or
affection" and that "supplying sea- nonbattle injury, all depending on the
sonal changes of clothing opportune- outlook of the individual unit or com-
ly, giving particular attention to the mand. In consequence, the dimen-
furnishing of proper footwear" was sions of the problem were not at first
34
important in preventing trenchfoot.32 perceived.
Several ETO publications recom- While commanders and surgeons
mended that shoes be laced tightly. alike thought of other things, Ameri-
The 1944 Manual of Therapy, issued can soldiers in the European Theater
over Hawley's signature, summed up entered the winter fighting inad-
its contribution to the prevention of equately clothed. Disagreements in
cold injury in a single sentence: "The the hierarchy, errors fostered by the
importance of a footbath with soap course of battle, and inadequacies in
and water cleansing, vigorous mas- the footgear on hand contributed to
sage (20 minutes), dry socks, and a the situation. The theater Quarter-
change of shoes in the prophylaxis of master chief, Maj. Gen. Robert M.
foot disability resulting from expo- Littlejohn, disagreed with the quarter-
sure to cold and moisture, cannot be master general in Washington over
overemphasized." 33 A comprehensive the composition of the winter uni-
command directive on care of the form. This circumstance, combined
feet, prepared by Colonel Gordon, with optimistic midsummer expecta-
the Preventive Medicine Division chief tions of an early end of hostilities—
was disapproved for publication by the First Army commander asked a
the Adjutant General, ETOUSA, on medical officer in mid-September,
the ground that existing manuals cov- "Don't you know that this war is
ered the subject and that, in any case, going to be over in a few weeks?"—
cold injury prevention was the re- led to delayed and insufficient winter
sponsibility of subordinate com-clothing requisitions by the theater.
mands. By the time publication of a Making matters worse, the armies
circular letter took place on 24 No- during the pursuit gave low priority
to the shipment forward of what cold
32
An. 9—Medical, p. 23, to FECOMZ Plan, 14
34
May 44, file HD 370 ETO. Above paragraphs based on Cir No. 108, HQ,
33
ETO, Manual of Therapy, 5 May 44, file Manual ETOUSA, 24 Nov 44, reproduced in Whayne and
of Therapy, ETO, box 405, RG 112, NARA. DeBakey, Cold Injury, pp. 525-28.
HOSPITALIZATION AND EVACUATION CRISIS 491
soles wore out quickly in field use; the snow and mud suffered the equiv-
most were too large; and the need to alent of a major epidemic. Soon the
wear multiple socks and felt insoles Army faced the loss of what amount-
made them unsuitable for men in ed to several divisions of front-line
battle. Inside the Shoepacs the sol- soldiers.
dier's feet were not ventilated and ex- Reports in November painted a pic-
cessive sweating soaked the skin as ture of radical discomfort for the ri-
thoroughly as if the wet had come flemen. Heavy rains ran off over satu-
from the outside. In time, a form of rated ground, streams and marshes
injury—shoepac foot—was named for flooded, and the first frosts struck at
the footgear; surgeons complained men who were almost never dry or
that sweating and maceration of the warm. In the Third Army, men waded
skin produced "a foot which is as bad rather than marched, fought in deep
as any seen thus far," often bringing mud, and rested in water-filled fox-
hospitalization for ten to fifteen days. holes. As the month advanced, night
When the victim returned to duty, the frosts became commoner. Vehicles
cycle then repeated itself. In February churned roads into sloughs. The 5th
the perspiration problem caused the Infantry Division ordered 11,000
8th Infantry Division to order its pairs of galoshes that were badly
troops to turn in Shoepacs previously needed. In the 90th Infantry Division
issued. In other units, surgeons ren- all trenchfoot victims were evacuated
dered more favorable verdicts on the as litter cases. In the Seventh Army's
shoepac; unquestionably, it was the 3d Infantry Division the surgeon
best footwear that the American Army wrote a sharp criticism of the shoe-
then possessed for wet and cold pac: With the issue of the winterized
weather. But there was also much to boots he had anticipated that trench-
be said for Hawley's blunt assess- foot would decrease; instead, ill-fitted
ment: "The plain truth is that the water-soaked Shoepacs were them-
footwear furnished U.S. troops is, in selves injuring feet. All along the line
36
general, lousy." dry socks became a critical item and
In late November and early Decem- units struggled to obtain supplies and
ber 1944 many factors, large and to provide some means of drying and
small, combined to produce a crisis. cleaning wet socks. Unit reports often
Startled officers—in the medical ser- spoke reassuringly of corrective meas-
vice, the supply chain, and the line— ures; men were instructed to remove
learned first-hand how General their shoes or boots daily, massage
Winter could disable an army. Then their feet, and so forth. But the 79th
the Germans launched their counter- Infantry Division of the Seventh Army
offensive, and troops pinned down in had 1,400 battle casualties and 210
cases of trenchfoot for the month. In
36
First quotation from Essential Technical Medi- the Third Army six men were evacu-
cal Data Rpt, HQ, ETOUSA, December 1944, p. 9. ated for cold injury for every ten
Second quotation from Ltr, Hawley to TSG, 29 Dec evacuated as battle casualties. Losses
44, file HD 024 ETO O/CS (Hawley-SGO Corresp).
See also Surg, 8th Infantry Division, Annual Rpt, of 10 to 15 percent of unit strength
1945, p. 10. became common.
HOSPITALIZATION AND EVACUATION CRISIS 493
Too often men on the line were worn over combat boots that 60 per-
obliged to improvise their own pro- cent of the cold injury victims in the
tective gear while the battle raged. In division were found to have become
the Third Army, officers of the 35th disabled while wearing them. The
Infantry Division had been unable to best protection resulted from discard-
get Shoepacs for their men. Combat ing the combat boots altogether and
boots and overshoes proved inad- wearing six or eight pairs of wool
equate protection for front-line sol- socks or a kind of homemade boot
diers pinned down by hostile fire. made out of two thicknesses of a GI
Men tried putting paper between two blanket, inside the overshoes, which
pairs of socks, but found it insuffi- were waterproof and large enough to
cient; besides, their boots were not hold such a mass of material. But the
large enough to permit wearing more clumsy multilayered wrappings re-
than two pairs of socks without con- duced the soldier's mobility, and the
stricting the feet, reducing the blood overshoes were noisy and unsuitable
supply, and causing cold injury. Over- for stealthy movements in close
shoes were so unsatisfactory when combat. From the end of December
494 EUROPEAN THEATER OF OPERATIONS
to mid-January the division lost 479 Yet the many replacements who filled
front-line riflemen to cold injury. 37 the ranks appeared to suffer severely.
Many units could have told similar Some enemy front-line units reported
stories. Fighting in Lorraine during 10 to 15 percent losses to cold injury.
the German offensive, the 328th In- The German Army possessed a field
fantry lost 500 men to trenchfoot and boot without laces, but most of its
exposure during the first days of the men who fell prisoner to the Ameri-
battle. One company of the 11th In- cans were found to be wearing laced
fantry had only 14 men available for leather field shoes. German surgeons
duty, and the chief cause of ineffec- understood, as did their American
tiveness was trenchfoot. Cold injury counterparts, the importance of not
combined with heavy battle losses to constricting the blood flow and
render the 358th Infantry unable to placed some faith in an ointment
continue an attack on the German called Pernionin. The salve was
line. For the same reason the 357th simply oil of wintergreen and aromat-
Infantry had to be pulled back. ics in a lanolin base, but its smell and
During November and December feel may well have encouraged more
losses to cold numbered 23,000, frequent massage. Nevertheless, 12th
almost all combat infantrymen. Be- Army Group medical officers who
cause an infantry division contained surveyed four POW enclosures con-
about 4,000 such soldiers the loss was cluded that, in most enemy units, foot
equivalent to the total infantry discipline was poor and the "preven-
strength of at least five and a half di- tive program . . . similar t
visions. Striking selectively, cold own."39
injury, said General Bradley, "sapped The impact of cold injury losses
assault strength and thus weakened upon American hospitals and the
the offensive." 38 evacuation system was heavy. During
In this respect Americans seemingly October and November more than
fared worse than both their Allies and 11,000 trenchfoot casualties were ad-
their enemies. The British record, mitted to the Paris general hospitals
among the few units engaged in the from the four American field armies.
winter fighting, was far better and re- Cold injury accounted progressively
sulted, at least in part, from their for 1.3, 4, 20, and 24 percent of
practice of rotating units on the line weekly admissions during November.
to rest areas. The enemy's situation The nature of the injury worsened its
was less clear. German regular units effects upon the patients, the hospital
apparently prevented cold injury staffs, and the capabilities of the field
more successfully than Americans be-
39
cause their veterans, at least, had Quotation from "Frostbite Problems in the
German Army During World War II," OCMH Ms
longer experience of winter warfare. P-602, pp. 25-27, MHI. See also Surg, 303d Medi-
cal Battalion, After-Action Rpt, February 1945, pp.
37
Surg, 35th Infantry Division Semiannual Rpt, 5-7, encl, to History of the Medical Units of the
January-June 1945, p. 1. 78th Infantry Division for the Year 1945; Surg, 12th
38
Quotation from Bradley, Soldier's Story, p. 445. Army Group, Hist, January-June 1945, an. 16, p. 7;
See also Essential Technical Medical Data Rpt, HQ, Army Service Forces Monthly Progress Rpt, 31 Mar
ETOUSA, December 1944. 45, sec. 7 (Health), p. 6, file HD 700 (Health).
HOSPITALIZATION AND EVACUATION CRISIS 495
armies alike. Victims, unable to walk control the epidemic. General Pat-
upon exquisitely painful feet, required ton's memorandum to the Third
litter carry at the front and bed care Army's corps and division command-
in the hospitals. As already noted, the ers declared with characteristic vigor
disability was long-term, and apt to that "the most serious menace con-
recur upon exposure—nature's most fronting us today is not the German
ingenious contrivance for the embar- Army, which we have practically de-
rassment of the foot soldier and those stroyed, but the weather which, if we
who cared for him. do not exert ourselves, may well de-
As early as September and October stroy us through the incidence of
42
the medical service attempted to trench foot."
make up for earlier omissions by dis- By December, admission of past
tributing War Department publica- errors and assumption of responsibil-
tions that gave concise instructions to ity by commanders was general. To
troops and commanders for avoiding Gorby, Hawley admitted, "I am not
injury. Various command directives sure that the Medical Department has
and memoranda followed, drawing at- been aggressive enough. . . .
tention to the problem, repeating of- have published long dissertations on
ficial policies, and underlining the the prevention of trench foot which
fact that (as a Third Army circular are too long for anyone to read." In
dated 9 November phrased it) "exces- January General Eisenhower empha-
sive development of trenchfoot in an sized the need for commanders to pay
organization will be considered as in- "unremitting attention" to the prob-
dicative of inadequate [command] su- lem, and officers of lesser rank fol-
Unfortu- lowed their chiefs lead. A barrage of
40
pervision and control."
nately, such action came late in the publicity began, with articles and edi-
day for an army in which large num- torials in the Stars and Stripes and
bers of officers, NCOs, and enlisted other publications widely read by the-
men were ignorant of the nature and ater soldiers. Radio broadcasts carried
potential seriousness of the threat. 41 the message to front-line troops. The
November found General Bradley theater prepared and circulated mil-
taking action at the urging of his sur- lions of copies of a brochure and ini-
geon, Colonel Gorby. Bradley fol- tiated efforts to indoctrinate replace-
lowed up a command directive with ments. The armies 43
set up trenchfoot
personal letters to the commanders of control teams.
his field armies. In turn, the com- Yet all of these measures, necessary
manders ordered immediate action to and helpful as they were, came too
late to modify the impact of cold
40
As quoted in Whayne and DeBakey, Cold Injury, injury upon the winter fighting. In-
p. 167.
41
stead, after reaching a new high in
Polls of the overseas army, wrote Assistant Sec-
retary of War John J. McCloy to the surgeon gener-
January, the cold injury casualty rate
al on 16 August, showed that 85 percent of those
42
questioned felt that they had received little training Quotation from the memorandum (21 Nov 44)
in avoiding or treating trenchfoot. The only other reproduced in ibid., p. 529. See also Gorby Interv,
training failure equally marked was in the handling 1962, p. 20, CMH.
43
of land mines. See ibid., pp. 66, 166-67, 509-15. Whayne and DeBakey, Cold Injury, p. 169.
496 EUROPEAN THEATER OF OPERATIONS
fell in response to the reduced level Hawley hastily issued instructions for
of combat, perhaps aided by a thaw evacuation of hospitals in danger of
that arrived providentially during the being overrun, and the ADSEC sur-
second week of February. (Because geon, Colonel Beasley, made plans
the weather remained chilly and the for withdrawing his people and equip-
thaw increased wetness, its effects are ment. But neither had to be imple-
difficult to assess.) By that time the mented. As a result of the stout de-
European Theater had suffered a fense put up by the First Army, the
medical misfortune that cost the German attack columns barely pene-
ground forces a total of 45,283 casu- trated the fringes of COMZ territory.
alties at a most critical period. In Some disorder followed; the 130th
searching for the causes of that ex- General Hospital at Ciney was tempo-
traordinary failure, no simple assign- rarily displaced, and another field
ment of blame is possible. Errors, hospital holding unit closed and
mainly of omission by medical, quar- moved because of bomb damage. But
termaster, staff, and line, gave a new all other COMZ medical units re-
meaning to the old formula for disas- mained in place, and continued work-
ter of too little and too late. Now the ing.45
medical service could only try to deal Yet the impact of the offensive
with the results.44 spread far and wide. Some units, hos-
pitals and holding units in and
Coping With the Crisis around Liege, suffered casualties and
During the autumn and winter dis- plant damage from enemy V-weap-
cussions of hospitalization and evacu- ons, conventional bombing, and long-
ation policy, none of the participants range artillery fire. Hardest hit was
expected a major enemy counterat- the 76th General Hospital, struck on
tack. Their concern rather was with 8 January 1945 by a V-1 that killed
the implications for the ETO medical 24 patients and staff, injured 20, and
service of the imminent German col- heavily damaged buildings and equip-
lapse that all anticipated. The Ar- ment. This unit, and most others that
dennes attack caught senior theater were struck, cared for their own casu-
medical officers, like everyone else, alties, cleared away rubble, and kept
off guard. General Hawley recalled on working. These same Liege hospi-
his own complete surprise. "All I can tals, because of the closing and move-
remember," he said, "is the ment of most First Army medical
chaos. . . . Nobody knew units, in effect assumed the functions
anything.
We were pretty much in the dark." of that army's evacuation hospitals
and holding units. Occasionally re-
44
Ltr, HQ, ETOUSA, to CGs, 30 Jan 45, sub:
45
Trenchfoot Control Officers, reproduced in 12th Quotation from Hawley Interv, 1962, pp. 106-
Army Group Report of Operations, vol. XIII (Medi- 07, CMH. See also Memos, Hawley to CofS, ETO,
cal Section), pp. 204-05. The rate per 1,000 troops 22 Dec 44, sub: Destruction of Medical Supplies To
per year was 127.7 in November, 135.2 in Decem- Prevent Capture by the Enemy, and Hawley to Surg,
ber, 139.8 in January, and 84.9 in February, after ADSEC, 24 Dec 44, sub: Abandonment of Fixed
which it rapidly declines. See Preventive Medicine Hospitals, file HD 024 ETO CS (Hawley Chron);
Division, OofCSurg, HQ, ETOUSA, Semiannual Surg, ADSEC, COMZ, Semiannual Rpt, January-
Rpt, January-June 1945, pp. 43-44. June 1945, p. 8.
HOSPITALIZATION AND EVACUATION CRISIS 497
ceiving wounded directly from the nel air and sea evacuation were pro-
battlefield without any preliminary ceeding with only minor delays and
treatment except first aid, the general mishaps; the Paris general hospitals
hospitals and the controlling 818th had 3,600-5,600 empty beds each
Hospital Center, which had been in day; and the Liege and Bar-le-Duc
operation for only two days when the hospitals were far from full. Farther
offensive began, hastily reorganized to the rear, the situation was less fa-
for quick triage, rapid-fire stabilizing vorable. The Normandy Base Section
surgery, and mass evacuation. The reported few empty beds, except in
Battle of the Bulge also affected med- the Cherbourg holding unit, and
ical communications, especially the United Kingdom Base hospitals con-
Advance Section, where telephone tained almost 117,000 patients.
47
contact with the armies became spo- On 17-18 December large numbers
radic due to bad weather as well as of casualties, including about 2,000
enemy action. To keep in touch with patients hastily unloaded by First
the army surgeons, Colonel Beasley Army installations, began flowing
had to send liaison officers on fre- toward Paris from the Ardennes bat-
quent dangerous journeys over the tlefields. On the nineteenth the Evac-
snow and ice-clogged roads, often uation Branch reported that the situa-
under fire.46 tion was "becoming tense." The
Throughout the weeks of bitter Liege hospitals were filling; thirteen
fighting, all COMZ medical elements trains were on the Liege-Paris shuttle;
had one overriding task: keeping the and the weather was curtailing both
field armies cleared of casualties and air and sea evacuation. Colonel
free to maneuver. Conditions as the Mowrey, trying to minimize the pa-
battle began were relatively favorable: tient load in endangered First Army
a temporary pileup of casualties in hospitals and in the ADSEC holding
the armies during late November, units immediately behind them, gave
caused mainly by a shortage of trans- those facilities priority for evacuation,
portation, had soon been alleviated further increasing the pressure on
and the flow of patients from the transportation and on installations
front went relatively smoothly until farther to the rear.48
16 December. By that time enough For the rest of the month the Evac-
hospital trains were in service to uation Branch and the Seine Section
permit idling some for crew rest and lived from hand to mouth. As train-
equipment maintenance; cross-Chan- load after trainload of wounded from
46
Liege rolled into the Gare St.-Lazare
Surg, ADSEC, COMZ, Semiannual Rpt, Janu- and a lesser but increasing flow from
ary-June 1945, p. 8; Evacuation Branch, Operations
Division, OofCSurg, HQ, ETOUSA, Annual Rpt, the Third Army arrived at the Gare
1944, p. 12; 818th Hospital Center Semiannual Rpt, de l'Est, the reserve of empty beds in
January-June 1945, p. 9; 298th General Hospital
Annual Rpt, 1945, pp. 8, 11, 137; 32d General Hos-
the capital dwindled to 2,600 or fewer
pital Semiannual Rpt, January-June 1945, pp. 1-6.
47
Liege, a major target because of its key logistics Evacuation Branch, Operations Division,
role, was hit by over 1,000 V-bombs between mid- OofCSurg, HQ, ETOUSA, Daily Diary, 16-30 Nov
September 1944 and early 1945. See MacDonald, and 1-16 Dec 44, file HD 024 ETO.
48
Siegfried Line, pp. 229-30. Ibid., 16-19 Dec 44, file HD 024 ETO.
498 EUROPEAN THEATER OF OPERATIONS
per day. To keep the Paris regulating Zone routinely transferred 2,000 pa-
tank from overflowing, the Seine Sec- tients per day from forward areas to
tion rushed patients to Le Bourget its continental and United Kingdom
field whenever the skies cleared and hospitals. On a record day, the
C-47s came in; it sent daily trainloads twenty-first, over 4,800 casualties
to Cherbourg, where patients at times crossed the Channel, 2,200 of them
waited twenty-four hours or more in by air. These patients included a
the ward cars for the arrival of fog or growing number from the 6th Army
storm-bound hospital carriers. Enemy Group, diverted to the northern
action compounded the section's diffi- COMZ from SOLOC, where casual-
culties. On the night of 26 December ties of the NORDWIND offensive had
German bombs destroyed a hospital swamped the available medical facili-
train at the Gare St.-Lazare and put ties. To keep the ADSEC holding
the station out of service for forty- units clear and to maintain empty
eight hours. With all medical rail op- beds in Liege, Bar-le-Duc, and Paris,
erations shifted to the Gare de l'Est, the Evacuation Branch tried to crowd
the loading of trains for Cherbourg the system toward the rear, filling the
temporarily stopped due to yard and Normandy and Brittany Base Section
station tieups. By the twenty-eighth general hospitals and deliberately
the Seine Section, with 14,000 pa-
overloading the United Kingdom
tients in its wards, effectively was out
Base. This policy worked, but at the
of empty beds. Then, as was to
happen repeatedly during the crisis, cost of evacuating many less serious
the jam broke. Planes began flying casualties too far back for convenient
again from Le Bourget and the for- return to duty. Inclement weather,
ward airstrips; trains for Cherbourg which hampered both air and sea
began moving; and carriers pulled transportation, periodically blocked
into the harbor. The Seine Section the rearward flow of patients, causing
hastily opened two more general hos- the Paris bed reserve to shrink alarm-
pitals, one a temporary convalescent ingly. On two occasions during the
facility in a commandeered Paris hotel month, when the Continent had more
formerly used as a SHAEF officers beds open than the United Kingdom,
club. By the thirty-first, with 1,200 General Hawley temporarily halted
empty beds reported in Liege and cross-Channel evacuation. At the end
3,600 in Paris, evacuation officers of the first of these embargoes, dete-
could breathe a little easier.49 riorating weather prevented an imme-
During January 1945 evacuation diate resumption of air and sea move-
continued at a hectic pace. "Hospital ment, giving the Evacuation Branch
trains were overworked," the Evacu- its worst days of a bad month. After
ation Branch reported, "all available each natural or man-made stoppage,
planes were utilized; Paris was a hub however, the patient flow resumed
of activity; and the port of Cherbourg and evacuation conditions returned to
was busy day and night outloading normal—if a constant high volume of
patients. . . ." The casualties, interminable hard work for
Communications
all hands, and the need to stretch
49
Ibid., 20-31 Dec 44, file HD 024 ETO. human and material resources to and
HOSPITALIZATION AND EVACUATION CRISIS 499
beyond the limit could be so charac- froze steam lines and switches and ex-
terized.50 posed the inadequacies of car heating
The Ardennes crisis put the medi- systems, in spite of equipment break-
cal service's rail transportation facili- downs from overuse and lack of main-
ties to the severest test they yet had tenance and in spite of damage and
faced. Hospital train personnel and casualties from air raids and acci-
equipment operated at full capacity dents. (On 11 January, for example,
day after day, week after week. They an ammunition dump explosion in
did so in spite of cold and snow that Normandy temporarily put three
trains out of action and caused 70
50
Quotation from Evacuation Branch, Operations
casualties.) The Evacuation Branch
Division, OofCSurg, HQ, ETOUSA, Semiannual tried to shorten running times on the
Rpt, January-June 1945, pp. 3-4. See also ibid., pp. most important routes, but an effort
1-2, and Daily Diary, 1-31 Jan 45, file HD 024
ETO; Surg, Seine Section, Annual Rpt, 1944, p. 28;
in January to establish regular sched-
Surg. CONAD, Annual Rpt, 1944, pp. 9-10, and ules governing the Paris-Cherbourg
Semiannual Rpt, January-June 1945, p. 7. On the and Paris-Nancy runs brought little
triage problem see Ltr, Brig Gen T. J. Davis, AG,
SHAEF, to CG, COMZ, 13 Jan 45, file 705:Admis- improvement. Only in late February,
sion to and Operations in Hospitals. after the shift of cargo shipments to
500 EUROPEAN THEATER OF OPERATIONS
Throughout the theater, extra pa- equately trained general hospitals not
tients overcrowded recreational and yet in operation.55
Red Cross facilities in many hospitals Besides enlarging existing hospi-
and overtaxed water and sewage dis- tals, General Hawley and his Hospi-
posal systems. They also placed a talization Division chief, Colonel Dar-
strain on hospital personnel who, nall, struggled to place more units
after the various T/O reductions, and plants in operation. They re-
were barely adequate to handle even ceived considerable assistance from
their regular patient loads. To staff General Kenner and his staff, espe-
cially in prevailing upon the armies
additional beds, hospitals drew heavi-
and Allied governments to turn over
ly upon civilian and POW labor and
sites. As a result of these efforts,
obtained additional people from hos- during January and February, the
pital units not yet in operation. The Communications Zone opened
21st General Hospital at Mirecourt, twenty-six new continental general
operating 3,500 beds despite its T/O hospitals at locations selected in late
strength of 2,000, for a while had the fall, around Verdun, Nancy, Toul,
personnel of an entire newly arrived Evreux, and Soissons. Between mid-
1,000-bed unit attached to it as rein- December and mid-February the total
forcements and for on-the-job train- number of T/O fixed beds in COMZ
ing. Some augmentations became per- and SOLOC, exclusive of emergency
manent. The War Department late in beds, rose from about 50,000 to over
December allowed the theater to add 76,000. Planning for still further ex-
14,400 general and station hospital pansion of the hospital system to sup-
beds, provided it could find within its port the eventual push across the
boundaries the required plants and Rhine, Hawley's staff picked out addi-
personnel. Due to a lack of both, the tional locations along the lines of
theater made only limited use of this communication radiating from Paris
and made plans with the theater G-4
authority. However, it did expand
and Engineer chief for their phased
nine veteran 1,000-bed general hospi- development. These sites, clustered
tals, the majority in Paris, which around Aachen, Luxembourg, Mour-
already were working above rated melon, and Chalons, would accommo-
capacity, into T/O 1,500- and 2,000- date all the remaining general hospi-
bed units. To increase their person-
nel, the theater disbanded three inad- 55
For plant problems of expansion, see Surg,
United Kingdom Base, Annual Rpt, 1944, pp. 11-
13; Cady, "Notes on the 21st General Hospital
and 84; Surg, CONAD, Annual Rpt, 1944, pp. 7-8; (AUS)," pp. 477-78, 495, 501, Cady Papers, MHI.
Cady, "Notes on the 21st General Hospital (AUS)," On hospital reorganization, see Smith, Hospitalization
p. 492, Cady Papers, MHI. For policy on use of and Evacuation, pp. 236-37; Troops Branch, Oper-
emergency expansion beds, see, Ltr, HQ, SHAEF, ations Division, OofCSurg, HQ, ETOUSA, Semian-
to CG, COMZ, 6 Feb 45, and MFR, Col D. E. nual Rpt, January-June 1945, p. 34; Surg, Seine
Liston, DepCSurg, ETO, 12 Feb 45, both in file Section, Semiannual Rpt, January-June 1945, p. 10.
705:Admission to and Operations in Hospitals. Day- Enlarged units were the 1st, 48th, 50th, 62d, 108th,
to-day figures on beds and patients may be found in 178th, 191st, 217th (1,500 beds), and 203d (2,000
Status of Hospitalization, UK-Continent, March beds). Disbanded units were the 190th, 252d, and
1944-February 1945. 253d.
HOSPITALIZATION AND EVACUATION CRISIS 503
tals in the ETO troop basis scheduled ignate more Class II and III patients
to arrive through mid-April, as well as as Class IVs so that fuller use could
some veteran organizations brought be made of the ordinary troop accom-
forward from Normandy and the modations on returning transports.
United Kingdom. When all these Hawley, successfully in the main, re-
plants were occupied, the Communi- sisted these pressures. More produc-
cations Zone would have over tive were efforts to obtain additional
118,000 fixed beds in operation on hospital-type accommodations. Early
the Continent, well in excess of the in 1945 the British, at American
number declared necessary by Gener- urging, further enlarged the capacity
al Kenner back in December.56 of the Queens to accommodate 2,500
Additional hospital centers went Class Us and IVs and 1,000 Class Ills
into operation during the crisis. The on the Elizabeth and a slightly smaller
811th and 812th, activated in January, number on the Mary. The Joint Chiefs
took control of hospitals and other of Staff, meanwhile, authorized the
medical installations in the Normandy conversion of six troopships into am-
Base Section. The Seine Section by bulance vessels, less completely
late February also contained two cen- staffed and equipped medically than
ters. The 814th coordinated hospital hospital ships but better able to care
activities north of the Seine, while the for patients than regular transports.
815th did the same south of the river. These ships, however, were not avail-
Other center headquarters were pro- able until March.
jected to oversee the new hospital Of more immediate help was air
clusters forming north and east of evacuation, which finally came into its
Paris.57 own. Beginning in February the Air
Providing limited relief to the Transport Command, dispatching
crowded theater hospitals, transatlan- C-54s from both its Orly and Prest-
tic evacuation increased during the wick terminals, finally achieved its
winter. General Kenner especially long-promised evacuation rate of over
concerned himself with this problem. 2,000 patients a month. The airborne
He repeatedly pressed Hawley to des- flow of casualties from Europe
became so rapid that it overloaded
56
Status of Hospitalization, UK-Continent, March Air Force medical reception facilities
1944-February 1945; Memo, Hawley to G-4, ETO, at New York, compelling diversion of
19 Jan 45, file 705:Admission to and Operations in
Hospitals; Evacuation Branch, Operations Division, flights to other East Coast points. In
OofCSurg, HQ, ETOUSA, Daily Diary, 5 and 12 March, at the request of SHAEF, the
Feb 45, file HD 024 ETO; Surg, CONAD, Semian- Transport Command more than dou-
nual Rpt, January-June 1945, p. 5; 819th Hospital
Center Semiannual Rpt, January-June 1945, pp. 1- bled even this rate, moving nearly
2; Staff Study, OofCSurg, HQ, ETOUSA, 20 Feb 4,700 patients across the ocean. By
45, sub: Medical Service in the Operation to, and plane and ship 24,666 evacuees
East of, the Rhine, pp. 8-10.
57
Surg, Normandy Base Section, Semiannual Rpt, crossed the Atlantic in January,
January-June 1945, p. 3; Surg, Seine Section, Semi- 29,743 in February, and 30,410 in
annual Rpt, January-June 1945, pp. 32-33; Staff March. Yet, despite continuation of
Study, OofCSurg, HQ, ETOUSA, 20 Feb 45, sub:
Medical Service in the Operation to, and East of, the 90-day theater evacuation policy,
the Rhine, pp. 9-10. the United Kingdom Base patient
504 EUROPEAN THEATER OF OPERATIONS
census declined only slowly, appar- ported to General Marshall that Medi-
ently because the accelerated outflow cal Department deficiencies in the Eu-
during December and January served ropean Theater were the result, not
mainly to remove a backlog of men of personal failures by either man,
awaiting evacuation under the old but rather of the absence of a true
120-day policy. Only the figures for theater headquarters able to control
February and subsequent months rep- both the armies and the Communica-
resented a real increase attributable tions Zone. He emphasized that
to the December War Department Kenner and Hawley were working to-
mandate (Chart 11).58 gether effectively to overcome their
Throughout late December and problems. Indeed, Sams could find
January Colonel Sams, General Mar- few things in the medical service to
shall's representative on the POW criticize. His major recommendations,
hospitalization question, circulated that general hospitals be set up closer
around the theater on his other larger behind the armies and that the inter-
mission: examining the overall work- mediate medical COMZ between
ings of the medical service. Hawley ADSEC and the United Kingdom
viewed Sams' activities with consider- Base be strengthened, were simply re-
able suspicion. He feared that Sams iterations of what Kenner and Hawley
represented an effort within the War had been recommending, and work-
Department to undermine and possi- ing to accomplish, since the breakout
bly unseat both himself and Surgeon from Normandy. 59
General Kirk. Hawley's assessment The anticlimactic outcome of Sams'
contained a grain of truth. Marshall's mission was only one indication of a
sending of Sams to Europe did reflect fundamental reality: By early Febru-
the chief of staffs distrust of Kirk, as ary the ETO hospitalization and evac-
well as his dissatisfaction with the uation crisis was over. Lighter battle
Army Service Forces in general. casualties, a declining number of
These internal War Department polit- trenchfoot cases, and the opening of
ical machinations, however, in the more continental general hospitals
end had little effect on the ETO med- produced a steadily growing bed sur-
ical service. Sams expressed the high-
59
est regard for both Kenner and Marshall's distrust of Kirk stemmed from the
political battle in 1943 over the replacement of Sur-
Hawley. At the end of his trip he re- geon General Magee, in which Marshall and his can-
didate, Kenner, had been outmaneuvered by the ci-
58
Evacuation Branch, Operations Division, vilian and medical profession, which backed Kirk.
OofCSurg, HQ, ETOUSA, Semiannual Rpt, Janu- See Chapter III of this volume and Interv, OSG
ary-June 1945, encl. 8; Memos, Kenner to CofS, with Brig Gen Crawford F. Sams, USA (Ret.), 18 Jan
SHAEF, 31 Jan 45, sub: Evacuation of Casualties to 50, CMH. For Sams' mission and recommendations,
ZI, and Hawley to CG, COMZ, 24 Mar 45, sub: Cas- see Sams, "Medic," pp. 293-324, CMH. For Haw-
ualty Evacuation to ZI and Conservation of Theater ley's suspicions, see Ltr, Hawley to TSG, 27 Jan 45,
Manpower, EvacCorresp, 1944-45, file 370.05 ETO; with postscript, 2 Feb 45, file HD 024 ETO O/CS
Memo, Col R. E. Peyton to DepCSurg, ETO, n.d. (Hawley-SGO Corresp). Kirk, ironically, welcomed
fca. February 1945], file 705:Admission to and Op- Marshall's intervention in Army Service Forces af-
erations in Hospitals; Bykofsky and Larson, Trans- fairs, on the grounds that the Medical Department
portation Corps, pp. 367-68; Futrell, Aeromedical Evacu- had "pretty near lost our pants to ASF." See Ltr,
ation, pp. 383-84; Theater Service Forces, ETO, TSG to Hawley, 7 Mar 45, file HD 024 ETO O/CS
Progress Rpt, July 1945, sec. 1, p. 35. (Hawley-SGO Corresp).
HOSPITALIZATION AND EVACUATION CRISIS 505
plus, even though SOLOC continued the new evacuation policy went into
60
to evacuate large numbers of its pa- effect on schedule.
tients to the main Communications Throughout the winter battles the
Zone. With little strain on continental COMZ medical service accomplished
hospitals, General Hawley again its principal task of keeping casualties
stopped cross-Channel evacuation for moving steadily rearward from the
a couple of days in order to relieve armies. General Rogers, the First
the United Kingdom Base, whose pa- Army surgeon, attested: "Evacuation
tient census had at last begun to de- to the rear of First U.S. Army kept
cline. By mid-February, as the rail- pace with all demands placed upon
heads advanced behind the armies, it." 61 The medical service overcame
hospital trains began picking up in this process the effects of bad
wounded as far to the east as Aachen. weather, delays in completing its con-
A surplus of medical rolling stock tinental hospitals, an unplanned-for
now was available; the Evacuation volume of cold injury victims, and the
Branch stabled the majority of its shutdown of most of one field army's
trains for long-needed repairs and hospital system. The favorable result
welcome rest for crews and medical stemmed in good measure from the
staff. Late in the month, with over basic soundness of the hospitalization
30,000 T/O and expansion beds and evacuation structure that General
empty in France and Belgium, Hawley Hawley and his associates had built
and his staff adopted a sixty-day evac-
uation policy for the Continent, to go 60
Evacuation Branch, Operations Division,
into effect on 1 March. Even though OofCSurg, HQ, ETOUSA, Semiannual Rpt, Janu-
new First and Ninth Army attacks ary-June 1945, pp. 5-7, and Daily Diary, 1-28 Feb
45, file HD 024 ETO. See the 19 Feb 45 diary entry
during the last week of February for the decision on the sixty-day policy.
again increased the flow of casualties, "Surg, First U.S. Army, Annual Rpt, 1944, p. 58.
506 EUROPEAN THEATER OF OPERATIONS
since the St.-Lo breakout. It also air and sea evacuation. War Depart-
stemmed from the fact that those por- ment decisions and interventions also
tions of the structure in place when helped. This was especially true of
the crisis erupted had been substan- General Marshall's breaking of the
tially overbuilt, thanks to Hawley's transatlantic evacuation deadlock,
consistent practice of setting the high- which increased the flow of patients
est attainable quality standards and out of the United Kingdom at just the
making the largest possible demands right time.
for personnel, units, and matériel. As Finally, as at every stage of the
a result, the medical service by late campaign, credit belonged to the
1944 had enough extra at so many ETO medics of all ranks and in all
points that it could ride out tempo- jobs. They willingly endured weeks of
rary setbacks and overloads with mini- overwork, discomfort, and occasional
mal loss in efficiency or quality of pa- personal danger in order to provide
tient care. Then, too, throughout the their wounded comrades with an im-
winter, Hawley, strongly supported at proved chance for life. Their days of
SHAEF by General Kenner, was able adversity now were ending. With
to continue building his medical infra- ample resources at last on hand, they
structure; he set up new hospitals and began planning and preparing to sup-
supply depots, obtained additional port the final offensive against the ex-
hospital trains, and further improved hausted and depleted German armies.
CHAPTER XV
ranging from medical officers to lit- cers, some of whom still believed Nazi
terbearers were called up for the divi- promises of ultimate victory. Civilians
sions that were expected to bear the in the Rhineland were "totally pas-
brunt of the fighting. The command- sive" and content to have their
er of the auxiliary surgical group villages taken with as little fuss as
planned the most effective disposition possible. While some enemy troops
of his teams to provide support for continued desperate rearguard ac-
the field hospitals. The engineers tions, most lacked spirit and the Volks-
were alerted to medical needs for
sturm militiamen were "of no military
hospital construction, road building,
and repair. Ambulance control posts value and reverted to civilian life at
were established to ensure an even our approach." Americans would still
flow of casualties to the various hos- be wounded and would die in the last
pitals, and medical truck companies battles, but the outcome was not
readied their vehicles to move the really in doubt, even to the enemy.2
evacuation hospitals forward as
ground was gained and as new sites Medics in the Attack
were selected. In armored divisions
special arrangements were necessary, First Army Units
because these units normally did their
fighting divided into three combat Under these conditions the First
commands, one of which remained in Army struck at Cologne. Early attacks
reserve. Medical support followed over clogged roads and through
suit, one company supporting each sometimes waist-deep snow brought
command, while the division psychia- the forward units toward the Roer
trist served with the reserve in order River with its seven flood-control
to care for combat exhaustion cases.1 dams. Volkssturm battalions, replace-
Encouraging were the weather and ments, and other makeshift forces
the state of enemy morale. The end only partly manned the West Wall de-
of the deep snow and bitter frosts fenses in the army's path, and many
meant much reduced danger of cold pillboxes and bunkers were captured
injury. Among the German troops, a empty. Yet stiff resistance developed
spreading fatalistic acceptance of in some areas. In the first week of
defeat likewise brought hopes for less February 1945 the VII, XVIII Air-
bitter fighting and fewer wounded.
borne, and V Corps led the way. The
"Noncommissioned officers and men
last, under Maj. Gen. A. Ralph
had reached a state of indifference,"
and even battalion and regimental Huebner, struck at the dams. Here
commanders increasingly faced up to early good fortune quickly faded in
the inevitability of losing the war. the face of a dogged defense. Advanc-
Almost the only exceptions to the ing troops fought in gloomy forests of
general rule were young junior offi- wintry fir trees, slowed by mines
hidden by the snow. Nevertheless, by
Combat Operations Data, First U.S. Army, sub:
2
Europe, 1944-1945, file 319.1-2 (12th Army First U.S. Army Report of Operations, 23 Feb-8
Group). May 45, p. 11.
THE LAST CAMPAIGN 509
10 February the dams had fallen to lengthy trips by road to the landing
3
the American advance. strips.
Evacuation problems met varied re- On 1 March the First Army won
sponses. The West Wall proved to be new crossings over the Roer River
"a mass of dragon's teeth, pill boxes, and followed the enemy as he with-
barbed wire, and mine fields." The drew toward the Rhine. Resistance
First Army's 2d Infantry Division, at- varied from none to bitter house-to-
tacking toward the Schwammenauel house fighting that left some villages
Dam, had sleds especially made to in ruins. As American forces invested
pull the wounded over the snow. Cologne during early March—the
Mounted on broad runners to reduce city, except for its ancient cathedral,
friction, and fitted with litter stirrups, was all but leveled by bombing and
the devices were a marked improve- artillery fire—the importance of the
ment over the simple toboggans fur- remaining Rhine bridges increased.
nished by the medical supply depots. Four still stood, at Cologne itself and
4
The weasels again put in an appear- at Bonn, Engers, and Remagen.
ance, winning praise especially for Then, on the seventh, quick-moving
their performance in deep snow. First Army forces seized intact a
Moving forward to the battle line, the planked railway bridge at Remagen.
"strange looking contraptions" car- Fortunately, two elements of the 51st
ried blankets, litters, drugs, bandages, Field Hospital were moving by chance
plasma, food and water. Returning, in the direction of Remagen, and
they brought two patients on litters within a week of the capture, hospital
and pulled one or more on sleds over personnel were at work east of the
landscape so rough and snowy that Rhine (see Map 22).
hours would have been required for a American troops poured across, re-
litter carry. Broad treads, spreading inforcing the first foothold the invad-
their weight, enabled the weasels to ers had won. Typical of many were
move over minefields without setting the adventures of division medics in
off a blast. They were, to be sure, Maj. Gen. Walter E. Lauer's 99th In-
cranky vehicles, and the rule in the fantry Division. Elements of the 99th
78th Infantry Division was 2 running began crossing the Rhine on 10
to 1 undergoing repairs. But for sup- March, using the newly captured Lu-
porting the advance against the dams dendorff Bridge. Applying steady
they proved indispensable. Working pressure, they reached the Wied River
together, weasels and sleds were twelve days later, assaulted the de-
judged by the 2d Division surgeon "a fenders' line, and established a beach-
'must' in deep over-snow operations."
The First Army also experimented 3
First quotation from History of Medical Units of
with light planes—cub liaison craft— the 78th Infantry Division for the Year 1945, p. 2.
Second quotation from Surg, 303d Medical Battal-
to evacuate the seriously wounded. ion, After-Action Rpt, February 1945, pp. 2-3, encl,
But the attempt encountered great to ibid. Third quotation from Surg, 2d Infantry Di-
difficulties: Dispatching the planes vision, Annual Rpt, 1945, pp. 4-5.
4
The Hohenzollern Bridge at Cologne and the
when and where needed was a prob- spans at Engers and Bonn were destroyed by
lem and casualties had to endure German engineers.
THE LAST CAMPAIGN 511
head beyond it. Medics quickly found within the army area. On 22 March,
that the light casualties typical of the however, the convalescent facility
new campaign could suddenly reopened in the Rhineland at Euskir-
become concentrated around surviv- chen, and the other units moved for-
ing enemy strongpoints and especially ward to resume their primary func-
6
at the rivers, all of which had to be tions.
crossed under fire. Thus enemy As the hospitals moved up, a pow-
planes and artillery zeroed in on the erful three-corps attack broke out of
Ludendorff Bridge, and many wound- the Remagen bridgehead and shat-
ed had to be carried back. At the tered the thin crust of defending
crossing of the Wied litterbearers units. The first days of April found
splashed through fords, hand-carrying the First Army fighting in two direc-
the injured until ponton bridges tions: Two corps sought to make con-
could be thrown across to facilitate tact with the Russians to the east,
ambulance evacuation. Meanwhile, while the other two cooperated with
field hospital units set up in villages the Ninth Army in the encirclement of
near Remagen to receive casualties enemy forces caught in the Ruhr
5
from the expanding front. pocket. Five evacuation hospitals, the
The growth of the bridgehead 51st Field Hospital, and the 64th
brought the 45th Evacuation Hospital Medical Group supported the action
across the Rhine to Honnef, where it in the Ruhr, while the 68th and 134th
opened on 25 March. Four more Medical Groups and the remaining
evacuation hospitals followed, while field hospitals backed up the eastward
five clustered near the west bank to line of advance. In either case, the
receive casualties from both sides of evacuation hospitals encountered the
the river. The First Army had evacu- usual difficulties of semimobile orga-
ated all its casualties to the Commu- nizations operating in a blitzkrieg.
nications Zone during the height of Leapfrogging in two echelons was the
the Ardennes offensive but, faced best method that had been found to
with personnel losses and inadequate compensate for insufficient organic
replacements, had been quick to rees- transport; only half the hospital had
tablish a convalescent capability as to be moved at a time, and in theory
the level of fighting dropped. For a half was always in service. Despite this
time, when the advance left the 4th expedient, the speed of the advance
Convalescent Hospital far to the rear,
and the lack of adequate Transporta-
two evacuation hospitals, a clearing
tion Corps support often left the
company, and the 91st Medical Gas evacuation hospitals out of contact
Treatment Battalion inherited the
with the fighting units. Hence,
task of holding the lightly injured
throughout the campaign, the autono-
through brief periods of recovery
mous units into which the field hospi-
5
Surg, 99th Infantry Division, Hist, January-
tals had been split served as evacu-
August 1945, pp. 28-29; Francis P. Kintz and John ation hospitals, while the latter some-
Edgar, "Medical Group ... of First U.S. Army in
European Campaign: Siegfried Line, Ardennes,
6
Rhine River, and German Collapse," The Military Surg, First U.S. Army, Annual Rpt, 1945, pp.
Surgeon 106 (February 1950): 139-47. 23-24.
512 EUROPEAN THEATER OF OPERATIONS
8
times lost all mobility, becoming the war roll by them." Some
holding units at airstrips or station hos- 300,000 POWs, many ill or wounded,
pitals for the care of noncombatants. swamped the two victorious armies as
The problem posed by such pa- they attempted to finish the war.
tients appeared early and swiftly grew Three evacuation hospitals took on
larger. Already in March hospitals the rapidly increasing burden of su-
were being diverted from the support pervising German military hospitals
of operations to care for recovered that had been overrun by the ad-
Allied military personnel (RAMPs). vance. The quality of these enemy fa-
The 99th Division began to liberate cilities varied greatly. The 110th
Allied prisoners while still in the Re- Evacuation Hospital moved into a
magen bridgehead, where its troops plant that was "splendidly
overran a train with 227 sick and equipped," 9 and the ingenuity of
wounded Americans aboard, freed a German surgeons in using nails to fix
POW enclosure, and overtook a fractures of the long bones won
column of some 1,200 American and praise from American doctors. But
British airmen on the road near Gies-
sen, scattering the guards. More dis- other captured hospitals were small,
coveries followed as the advance to housed in schools or in the cellars of
the east began. Conditions in camps public buildings, and suffered from
where Allied prisoners had been held vermin, deficient supplies, and un-
ranged from acceptable to indescrib- skilled staffs whose doctors had re-
able; quick action was demanded to ceived preferment on political not
delouse, clean, immunize, and treat medical grounds. Patients had to be
the inmates. At Nordhausen the VII sorted and moved, and dumps of
Corps liberated a concentration camp, enemy medical supplies had to be
where personnel of the medical taken over, inventoried, moved and
groups viewed—for the first but not reissued for the care of prisoners and
the last time—scenes that they found displaced persons (DPs). After a high-
"very difficult to describe"; 7 some ranking German medical officer, Maj.
2,500 emaciated bodies were strewn Gen. Walter Scherf, surgeon of the
over the camp or piled like firewood enemy's Army Group B, was captured,
for disposal in the crematory. But the he was placed in a central headquar-
liberated formed only part of the ters at Weimar and given charge,
burden. New throngs of POWs were under American oversight, of civilian
also swept up from the beginning of and military patients from his own
the advance, growing to an inunda- nation. While Scherfs group strug-
tion as the Ruhr pocket collapsed. gled to organize itself, and to find
German soldiers began to surrender personnel and transport to carry out
en masse—"in some cases straglers its duties, First Army medical groups
[sic] trying to reach their own lines increasingly took on the responsibil-
and in other cases . . . deserters or ities it was unable to assume. By the
individuals who were content to let
8
Ibid., an. 11, p. 104.
9
'First U.S. Army Report of Operations, 23 Feb-8 110th Evacuation Hospital Semiannual Rpt, Jan-
May 45, p. 28. uary-June 1945, p. 4
THE LAST CAMPAIGN 513
end of April First Army groups con- The fighting of March and April
trolled 216 German military hospitals, and the changeover to occupation
4 POW camps, 22 DP centers, and 3 duties in early May demanded utmost
RAMP hospitals—in all, about 90,000 flexibility in evacuation as well. All
patients. Several evacuation hospi- cases requiring 10 or less days of
tals—notably the 5th, 45th, 67th, treatment were retained in the army
96th, 118th, and 127th—served both area while the fighting continued. For
the combat forces and the noncom- more seriously wounded soldiers the
batants, the changeover from direct first reliance was now upon air evacu-
support to the care of noncombatants ation. Even west of the Rhine poor
and prisoners coming for most about road conditions gave new importance
1 May. Thereafter, the 5th aided tran- to air, and the First Army arranged
sient RAMPs at Gotha; the 45th with the IX Troop Carrier Command
became a station hospital for the Bu- to make C-47s available to carry
chenwald Concentration Camp near wounded. East of the Rhine the rail
Weimar; and the others saw similar
service.10 Feb-8 May 45, pp. 43-84 and 105-07; Surg, V
Corps, Annual Rpt, 1945; Kintz and Edgar, "Medi-
cal Groups," p. 142. The typhus threat and the
10
Surg, First U.S. Army, Annual Rpt, 1945, pp. treatment of liberated prisoners and DPs are re-
26-27; First U.S. Army Report of Operations, 23 counted in some detail in Chapter XVI.
514 EUROPEAN THEATER OF OPERATIONS
system, due to the bombing of its its advance section across the Roer,
tracks and bridges, could no longer from Malmedy to the German town of
support the armies. Motor transport Zuelpich, with 50 tons of supplies. On
could not entirely compensate. 16 March the section crossed the
Bridges over the Rhine were few, with Rhine, to provide close support to the
priorities given to the eastward flow units in the newly created Remagen
of men and supplies in support of the perimeter. As other depot advance
attack; and roads were poor, with dis- sections moved deeper into Germany
tances to the front ever increasing be- they encountered damaged and con-
cause of the rapid advance. gested rail lines and widespread
Various expedients were tried. In a bomb and shell damage to potential
few cases L-5 reconnaissance aircraft warehouses. Clearances at the crowd-
were exploited as light litter planes to ed bridgeheads were hard to get, but
concentrate casualties at the airfields. toward the end of the month trucks
In an experiment on 22 March a were able to move two sections for-
C-47 picked up two gliders, each ward to Dollendorf and Honnef.
holding twelve litter patients, from a Though low-priority items were often
small airstrip on the east bank near stranded along the railways to the
the 51st Field Hospital and success- rear, essential supplies were kept
fully delivered them to an airfield on
moving from the ADSEC depots into
the west. But the main reliance was
the fighting zone. Air evacuation, a
upon the "big birds," and upon their
now proven ability to take over the blessing to the wounded, brought a
routine movement of patients hitherto new version of one familiar problem
entrusted to railways. New airfields at for medical supply: Casualties were
Eudenbach and Giessen became casu- put aboard on litters covered with
alty shipment points, each with its blankets, essential items which there-
holding unit—the 618th Clearing upon vanished into the COMZ, de-
Company and Company A, 91st Medi- pleting supplies needed for the fight-
cal Gas Treatment Battalion, respec- ing men. Hence, special supply points
tively—and hard-driven ambulances had to be set up in conjunction with
brought in the wounded from the holding units at the airstrips.
rapidly moving front. Despite every effort, during April
Medical supplies proved adequate the front moved too rapidly for medi-
to the needs of the army. February cal supply to keep pace. Supply offi-
was a time devoted largely to restock- cers would select a site for a forward
ing after the Ardennes. When the depot; clear their choice with division,
First Army moved into the Roer corps, and army headquarters, and
region, supply operations were handi- with the military government; get
capped by the miserable roads, the transport; pack their goods; and
winter weather, the ruin of the rail move—only to find that the new loca-
lines, and the destruction of buildings tion had become obsolete before
that left few protected places to store issue could begin. The main depot
medical matériel, whose packaging chose a site at Giessen, but on open-
was not waterproof. Nevertheless, the ing for business found itself too far to
1st Medical Depot Company moved the rear to supply the forces ade-
THE LAST CAMPAIGN 515
quately. It moved again to Korbach, ation. Yet, though stressed, the
leaving behind some 20 long tons of medics contrived to meet their com-
excess and slow-moving items to be mitments, aided by the declining
taken over by the Advance Section. In needs of a victorious and largely
this case air transport came to the healthy army. Ironically, triumph was
rescue in supporting the fight for the followed almost immediately by disso-
Ruhr pocket. Forty-eight tons of med- lution. On 15 May the First Army's
ical matériel—enough to stock a com- role in the European fighting came to
plete depot advance section—were an end, as all assigned and attached
flown in from the United Kingdom, medical units were transferred to the
enabling the 47th Medical Depot Ninth Army. The army surgeon and
Company's first advance section to his office departed with the rest of
open at Siegen in support of the the headquarters for the United
XVIII Airborne Corps. One big States, and then Manila, there to com-
German dump became an American mand a new First Army in the
base, where captured supplies were planned invasion of Japan.
concentrated. During April alone,
more than 100 tons were issued for Ninth Army Units
the care of POWs and DPs. German
supplies were all-important to the To the north of the First Army
care of noncombatants. Without zone, medics of the U.S. Ninth Army,
them, the First Army surgeon report- after spending the Ardennes battle in
ed, meeting the needs of such unfor- defensive positions with Montgom-
tunates "would have been impossi- ery's 21 Army Group, experienced a
ble." Another massive enemy depot spectacular final campaign. Prepara-
was turned over to the Third Army, tions began in January as the Bulge
and the stock transported by ADSEC disappeared. The Ninth Army shifted
vehicles and labor to the American to the American-led 12th Army
forces then engaged in liberating the Group, and units that had been sent
newly discovered concentration camps south to aid the First Army's stand re-
11
in Bavaria and Austria. turned. Medical organization in the
Overall, the final campaign experi- Ninth Army had not changed signifi-
ence of the First Army was one of cantly from earlier campaigns. Seven
great difficulties overcome by a evacuation hospitals supported the
medical service that had reached its army, and field hospital platoons at-
highpoint of clinical and military com- tached to clearing stations provided
petence. The need to fight in two di- direct support to its five divisions
rections at once, with half the army spread along the west bank of the
engaged in a headlong advance, Roer River from Wuerm to Mons-
stretched to the limit medical capac- chau. Three medical groups con-
ities for communication and evacu- trolled a variety of separate battal-
ions, companies, and small cellular
"Quoted words from Surg, First U.S. Army, units, such as laboratories and dental
Annual Rpt, 1945, p. 70. See also ibid., pp. 62 and
78; First U.S. Army Reprt of Operations, 23 Feb-8 prosthetic units. Divisional units man-
May 45, pp. 111-13. aged evacuation up to the clearing
516 EUROPEAN THEATER OF OPERATIONS
station level; above, the groups were Maj. Gen. Matthew B. Ridgway's
in charge. Delayed by floods on the XVIII Airborne Corps was to carry
Roer (the Germans had expertly dam- out the action; its chief American
aged the dams before yielding them, component was the 17th Airborne Di-
to ensure high water), the army vision, blooded in the Ardennes. Divi-
moved from its positions on 23 Feb- sion medics began their preparations
ruary, at 0330, as elements began to during March in rest billets near Cha-
cross in a three-corps front. lons in France. Two surgical teams
Initially, tough enemy resistance were attached to the division; their six
cost 6,000 casualties. While medics surgeons and four enlisted corpsmen
evacuated the injured and some 4,300 were to accompany the medical com-
cases of disease, German resistance pany into combat by glider, to per-
faded and the army swung north to form stabilizing surgery on the
meet Canadian forces that had broken wounded who would necessarily be
out of their own bridgehead. Moen- cut off for a time behind enemy lines.
chen-Gladbach fell on 1 March, and Gliders were equipped with blankets
the Ninth Army reached the Rhine and litters, and every officer and man
the next day. By midmonth the bank in the division received additional
from Neuss to Wesel was under its first aid packets and bandages. Medics
control. The medical section moved laid in ample plasma supplies, and on
with the forward echelon of the army D-1 the ETO blood bank delivered
command post to Moenchen-Glad- whole blood in thermos containers.
bach, where planning for the invasion Between 0700 and 0800 on 24 March
of the inner Reich began. Among the first combat elements took off, ac-
other plans, Colonel Shambora, the companied by their own medical de-
army surgeon, projected the use of tachments and liaison men from the
provisional holding detachments on medical company, who would jump or
the east bank to allow divisional units glide in with them. Ground troops,
to remain mobile, once the invasion then engaged in forcing their way
had begun (Diagram 5). However, across the Rhine, raised their eyes to
early success and the role of air evac- see an awesome sight—a "vast air
uation soon ended all problems armada" that required two and a half
except those of supporting a rapid hours to pass overhead.13
advance.12 Across the Rhine the medical com-
After a thunderous artillery bar- pany, surgical teams, and the division
rage, Ninth Army forces crossed the surgeon in their gliders encountered
Rhine on 24 March and poured into intense fire from small arms, machine
the Westphalian plain. An airborne guns, and 20-mm, and 88-mm, anti-
drop had been planned to support aircraft guns. Some medical gliders
the movement by seizing a strategic burst into flame. The surviving
area on the east bank near Wesel. medics landed in their designated
12 13
Surg, Ninth U.S. Army, Semiannual Rpt, Janu- Charles B. MacDonald, The Last Offensive, United
ary-June 1945, pp. 1-2, 14 and sec. Ill, p. 4; ibid., States Army in World War II (Washington, D.C.:
Daily Journal, 1 Feb 45, p. 3, Shambora Papers, Office of the Chief of Military History, Department
MHI. of the Army, 1973), p. 309.
518 EUROPEAN THEATER OF OPERATIONS
drop zone only to find that combat ing station, while enemy patrols blun-
troops had not yet cleared it of the dered past in the darkness. Firefights
enemy, and they took heavy casualties erupted, and enemy artillery blocked
until the zone was secured. Small a truck and ambulance convoy trying
groups of medics, which grew in size to reach the embattled division from
as isolated personnel found one an- the west bank of the Rhine to evacu-
other, made their way across 2 miles ate its wounded. Despite the alarms,
of enemy-held fields and woods to set the hours of darkness passed without
up a clearing station at a predeter- further injury or death among the
mined site. Within an hour of landing wounded, though the ground was
the station was functioning under covered with helpless patients. By
canvas; within two, major surgery was 0800, 25 March, the convoy was roll-
under way. Meanwhile, combat forces ing, and by 1000 hours the wounded
had contacted British paratroopers to were being loaded into ambulances,
the north, and by 1800 had linked up some American issue, some captured
with ground troops in the Rhine German machines; into jeep ambu-
bridgehead. Throughout the night a lances; and into enemy trucks that
platoon of infantry guarded the clear- now displayed the Red Cross. In the
THE LAST CAMPAIGN 519
convoy rode German as well as Amer- fered heavily, but were able to save
ican wounded, for all prisoners had many lives nevertheless. Able execu-
received treatment either by their tion of a doubtful tactical plan
own captive doctors and aidmen or by marked the last hurrah of airborne
clearing station personnel. medics in the European war.14
Now armored units swept through Henceforth the course of the inva-
the bridgehead into the roadnet sion was an itinerary of sites famous
around captured Wesel, and the race in German history—Muenster, the
to the east began. The airborne
troopers did more walking than Teutoburg Forest (on whose ridge
line the 2d Armored Division met stiff
flying, and the chief task of their med-
ical support was the usual one of resistance), Magdeburg, the Elbe
trying to keep up. The initial drop River—as the Americans gained 225
had exhibited bravery and skill, but miles in nineteen days. The problems
the cost was high—392 casualties the encountered by the medics were the
first day, with many more to follow— technical ones of supporting two
and the necessity for the bravura corps advancing through a third that
show would later be seriously ques- 14
Surg, 17th Airborne Division, Final Rpt, 1 Jan-6
tioned. The medics themselves suf- Sep 45.
520 EUROPEAN THEATER OF OPERATIONS
was engaging the enemy; then of sup- chief problems noted with the groups'
porting a divided army as two corps many cellular units were in personnel
attacked eastward against little oppo- administration, vehicle maintenance,
sition, while a third struck south into and messing; for these flexible units,
the Ruhr, against stiff resistance; and despite their fitness for operations,
finally and always of keeping contact the lack of a settled home in the com-
with line units that felt victory in their mand structure still created unre-
grasp. Evacuation distances stretched solved difficulties.
out despite the common practice of The theater-directed practice of ro-
splitting the divisional medical battal- tating Medical Department officers
ions into forward and rear elements. and enlisted men, initiated in Novem-
In the 2d Armored Division average ber 1944, continued to demonstrate
ambulance hauls in early April its value. Each month the Ninth Army
reached 93 miles, and in the 15th Ar- transferred five Medical Corps offi-
mored Division medical companies cers, five other Medical Department
reported ambulance roundtrips of officers, and twenty-five enlisted men
200 miles. Linking up to the First to the Communications Zone, at-
Army in the south, Ninth Army forces tempting to select those who had en-
helped to complete the liquidation of dured the "most prolonged and
the Ruhr pocket. During ten days, 4- trying combat experiences." In turn,
14 April, its hundreds of thousands of COMZ supplied replacements whose
defenders were killed or captured. At quality drew praise from Colonel
1330 on 30 April troops of the XIX Shambora. The need for physically fit
Corps encountered Russian forces, replacements meant that professional
halted, and began to scoop up thou- skills alone could not exempt a physi-
sands of Germans who were in flight cian from forward service, if he was
from the Red Army. By this time the otherwise qualified. This produced
enemy forces had virtually dissolved, some problems in utilizing specialists
and ceasefire orders came a little after in forward units. Overall, however,
sunrise on 7 May. the program's main difficulty was that
Few innovations marked the cam- many more officers and men applied
paign. Instead, practice in 1945 rep- for transfer to COMZ than could be
15
resented the matured employment of accommodated.
methods earlier developed. The Ninth Evacuation took many forms. As in
Army's three medical groups, besides the other field armies, evacuation
coordinating the activities of their hospitals proved in practice to be
component units, provided Sham- somewhat less than semimobile, and
bora's medical section a means of field hospitals augmented by auxiliary
maintaining liaison with the medical surgical group personnel took over
service at all echelons. Each group
headquarters ran a courier system, 15
Surg, Ninth U.S. Army, Semiannual Rpt, Janu-
enabling the army surgeon to keep ary-June 1945, sec. II, p. 1. Similar limited rotation
abreast of the changing tactical situa- policies were adopted by the Third Army, extending
in some cases to the level of corpsmen, who were
tion when signal communications rotated to service companies out of artillery range
became overloaded or failed. The of the enemy for a few days of rest.
THE LAST CAMPAIGN 521
many of their normal duties. For the From the hard-fought opening of
most seriously wounded, the bomb- the campaign, losses declined rapidly.
battered but still functioning general In the first half of March the army re-
hospitals of Liege were the usual des- corded about 5,600 casualties from
tination, with ADSEC ambulances wounds, injuries, and stress. Despite
providing transport. For the Ninth the Rhine crossing, the number fell in
Army air evacuation from Germany the second half of the month to
began in March 1945. The army sur- 5,200. Sometimes, desperate last-
geon selected airstrips near field and ditch resistance raised the total for
evacuation hospitals, and SHAEF dis- early April to about 6,600, but it fell
patched a flight surgeon to each to to 4,300 in the second half of the
supervise the loading of wounded. month and in early May to 1,900, of
Holding units capable of handling whom only 284 were wounded.
300 to 600 patients were set up and Instead, POWs, DPs, and RAMPs
staffed by the medical gas treatment burdened the evacuation system. Oc-
battalions and the field hospitals. For cupation duties began to replace the
reasons that are unclear, communica- problems of speed, changing front,
tions presented a difficulty. The hold- communications breakdowns, and
ing units requisitioned aircraft from long ambulance hauls that had bedev-
the army, which in turn forwarded re- iled the invasion. Medical supply kept
quests to SHAEF's air evacuation sec- up with the rapidly moving front by
tion. Because radio communication the well-tried device of leapfrogging
between forward units and the army depot sections. As supply lines
surgeon failed, TWX (teletype) mes- lengthened and railroads became un-
sages had to be used to dispatch usable, the inadequacy of the depot
planes. Movement of wounded con- companies' organic transport became
tinued, however, and by mid-May increasingly evident and compelled
RAMPs and some western European them to depend upon the Quarter-
DPs were also being flown out of master truck companies. But, though
Germany. Except during a brief gas spot shortages developed in all class-
warfare alert, the medical gas treat- es of supplies, no critical failures oc-
ment battalions performed their usual curred to impede operations.17
variety of tasks—mainly setting up As in the other armies, the change-
and staffing provisional centers for over to occupation duties in the Ninth
treatment of venereal and communi- Army began even as the attack pro-
cable diseases, self-inflicted wounds, ceeded. By V-E Day army units had
neuropsychiatric cases, or convales- taken on aspects of area commands
cents. Aided by elements of the and were carrying out many duties of
army's 3,000-bed convalescent hospi- military government. In June the ex-
tals, such centers absorbed casualties
who might otherwise have been evac- mored Division, Semiannual Rpt, January-June
uated out of its control.16 1945, p. 39; Surg, Ninth U.S. Army, Semiannual
Rpt, January-June 1945, sec. II, p. 45.
17
Surg, Ninth U.S. Army, Semiannual Rpt, Janu-
16
Surg, 2d Armored Division, Semiannual Rpt, ary-June 1945, sec. Ill, pp. 18, 22, 26, 31, 33, 37
January-June 1945, pp. 6 and 30; Surg, 5th Ar- and sec. IX, p. 1.
522 EUROPEAN THEATER OF OPERATIONS
istence of the Ninth Army as a sepa- the 4th Infantry Division had
rate force ended, much of its area breached the main line of resistance.
passing to the British Zone of Occu- On the twelfth Pruem fell, while in
pation, and the remainder to the Sev- the XII Corps sector the 5th and 80th
enth Army, along with its soldiers. Infantry Divisions, crossing the Our,
consolidated a wide beachhead whose
Third Army Units depth of more than 2 miles promised
a durable lodgement. Meanwhile, the
Meanwhile, General Patton's Third XX Corps assaulted an enemy salient
Army had written its own epic. Fol- called the Saar-Moselle Triangle,
lowing the reduction of the Bulge, gaining the high ground overlooking
many of its units were shifted north the Saar River by the twentieth. So
to support the planned main attack. far the campaign featured a grinding
Those that remained were assigned a advance in dreadful weather against
limited defensive mission. The VIII, prepared defenses, and the Third
III, and XII Corps confronted the Army was fortunate that the foe was
flood-swollen Our River, beyond already more than half beaten. Mines
which lay the rugged snowy uplands and booby traps were a continuing
of the Eifel. Here the fixed fortifica- danger, for the defenders wired ex-
tions of the West Wall were anchored plosives to corpses, both German and
in the towns of Pruem to the north American. The army counted nearly
and Bitburg to the south. The coun- 16,000 evacuees, of whom more than
try was "studded with steep broken 10,000 had to be moved out by road.
hills and ravines," roads were poor, Weather and war combined in famil-
and the "cold, wet, muddy February iar fashion to harass the troops; cold
weather" lowered over all. Seldom injury remained common; and the
had a roof and walls been more desir- Shoepacs issued in January caused the
able for the wounded, but buildings usual difficulties.
for hospital use were few. Fierce The problems of evacuation mir-
fighting had reduced most to rubble, rored those of the fighting. Road con-
and "ventilated [the others] to such ditions were wretched. Heavy traffic
an extent that they were unusable." during the Ardennes battle had
Under these conditions the advance churned the roadbeds, and in the
into Germany began, an aggressive second week of February a sudden
defense aimed at preventing the thaw turned them into channels of
enemy from consolidating and mud and slush. Carrying wounded
moving his own forces to meet the over the soft, slippery surfaces
northern threat.18 became one of the major difficulties
While the VIII Corps pushed for- of the advance. Ambulances labored
ward into the West Wall east of St.- hub-deep toward evacuation hospitals
Vith, aiming at Pruem, the XII Corps that, impeded by the same conditions,
moved against Bitburg. By 5 February were until midmonth located too far
to the rear. Hence, division medical
18
Surg, Third U.S. Army, Semiannual Rpt, Janu- officers experimented with weasels
ary-June 1945, pp. 13 and 20. and made use of litter sleds or tobog-
THE LAST CAMPAIGN 523
MEDICS PULLING AN ASSAULT BOAT FILLED WITH MEDICAL SUPPLIES for wounded
troops on the other side of a nearby stream
gans. In the 90th Infantry Division it vision. Serving with the XII Corps,
was "necessary to relieve litterbearers the division on 7 February attacked
at frequent intervals because of physi- across the Our River and its tributary,
cal exhaustion brought on by travel- the Sauer, into prepared defenses. In
ling in the deep snow." The Third the 318th Infantry's sector only one
Army ordered thirteen dog teams passable road led down to the river,
from the Air Rescue Squadron in and it was under heavy fire. While lit-
Labrador, but by the time the contin- terbearers manhandled the wounded
gent of 130 dogs, 14 enlisted men, up the banks of a steep ravine to
and 13 officers arrived at Thionville, avoid the road, medics pulled back
on 13 February, the weather had the aid station as enemy artillery
broken, the snow was melting under zeroed in. From the head of the
the thaw, and the teams were never ravine, over ground too muddy to
employed.19 support a jeep, a weasel carried the
Typical of the campaign were the patients back to an advance ambu-
experiences of medics in the 80th Di- lance loading point. Not until the
19
second day of the attack were the
Quotation from Surg, 90th Infantry Division, Germans pushed back far enough to
Periodic Rpt, January-June 1945, p. 6. See also
Surg, Third U.S. Army Semiannual Rpt, January- allow a collecting point to be estab-
June 1945, pp. 16-22. lished on the riverbank. The road
524 EUROPEAN THEATER OF OPERATIONS
20 21
Surg, 80th Infantry Division, Semiannual Rpt, MacDonald, Last Offensive, p. 201. See also pp.
January-June 1945, pp 2-4. Quotation on p. 2. 202, 205, 259.
THE LAST CAMPAIGN 525
panics of the first medical battalion to the water's edge. Each had a litter
cross. The first wounded were evacu- jeep, ferried by an LCVP across the
ated by assault boats; later, when the Rhine to speed evacuation to the col-
bridgehead had been firmly estab- lecting stations on the west bank.
lished, by DUKWs and LVT-1s. Fer- When the aid stations moved east,
rying operations continued for four following the troops, a collecting
days, because engineer-built ponton point at the site of the original land-
bridges were filled with eastbound ing received casualties by ambulance.
22
traffic. Meanwhile, the engineers constructed
A swift advance followed, through a treadway bridge, and in due course
Bavaria into Austria and Czechoslova- the collecting stations shifted to the
kia—one which, as far as the medics far shore. With fewer casualties and
were concerned, created a repetition excellent roads opening out before it,
of the difficulties they had faced in the Third Army evacuated about 75
the sweep across France in August percent of its 23,192 patients by road,
1944. Yet the thrill of approaching about 5,700 by air, and only 2,000 by
24
victory compensated for many prob- rail.
lems. "It was France all over again," Patton's forces slashed across
recalled Col. James C. Van Valin, MG, southern Germany (see Map 23). Be-
commander of the 110th Evacuation hind armored spearheads the motor-
Hospital, "save that this time the end ized or marching infantry followed
was in sight, once and for all." Trucks (the 80th Division, for example, cov-
loaded with medics and hospital gear ered 125 miles in six days). In gener-
thundered down "the fabulous auto- al, casualties were few, the problems
bahns, which brought back the sight of field medicine reduced to a matter
and smell of the Jersey plains" to of logistics—keeping up with the ad-
homesick soldiers who had under- vance, moving supplies, hauling evac-
gone their first military training at uees over long distances. Three medi-
Fort Dix nearly two years before.23 cal groups supported the advance:
Three days after the Rhine cross- The 65th evacuated casualties of the
ing, Patton's armor bridged the river VIII and XII Corps; the 66th support-
Main. The 80th Division crossed at ed the XX Corps; and the 69th,
Mainz in darkness, in an operation strengthened by ambulances from
bearing little resemblance to its epic ADSEC, evacuated wounded from
struggles at the small rivers of the Third Army hospitals. On 1 April,
Eifel a month before. Resistance however, the 65th, strengthened by
faded quickly, and the aid stations an additional battalion headquarters,
crossed and set up in buildings near undertook to provide evacuation for
all tactical units of the army. By this
22
time casualties were low but liaison
Surg. Third U.S. Army, Semiannual Rpt, Janu-
ary-June 1945, pp. 28-30 and 32; Surg, 4th Ar-
difficult, because of the fluidity of the
mored Division, Semiannual Rpt, January-June front. With one battalion headquar-
1945, p. 4: Surg, 5th Infantry Division, Semiannual
Rpt, January-June 1945, pp. 3-4.
23 24
110th Evacuation Hospital Semiannual Rpt, Jan- Surg, 80th Infantry Division, Semiannual Rpt,
uary-June 1945, p. 5. January-June 1945, p. 5.
THE LAST CAMPAIGN 527
ters for each corps, the group com- their patients. Only the weather aided
mander, Col. Carl G. Griesecke, felt them, for as the season warmed they
that "the ideal utilization of a Medical were freed of the necessity to search
Group was at last being carried out," out suitable buildings to house the
26
enabling him to exercise maximum wounded.
flexibility in shifting vehicles and sub- Fighting continued. Despite light
ordinate units as needed. Internally, casualties the ratio of serious wounds
the group, having no fixed makeup, was high, with many puncture wounds
needed firm control as well, if its of the chest and abdomen caused by
array of separate medical units was to small arms. Bloody little actions de-
function as a team. Unified evacuation veloped to mar the general picture of
had come late to the Third Army in minor resistance and few losses. The
response to the problems of the rapid last gestures of the Luftwaffe were
advance and the reassignment of random strafing attacks by Hitler's
medical personnel to the care of pris- new jet planes. On the ground, resist-
oners and DPs. Under the special ance took many forms—from absurd
conditions of the campaign, it suc- wooden barricades to sharp skir-
ceeded well.25 mishes with determined fighters. Dis-
Despite the organizational simplici- organized groups of enemy, cut off by
ty, the speed of the advance created the advancing armor, lingered in the
unorthodox situations. Evacuation woods and mountains between Wies-
was more than ordinarily confused. In baden and Bad Nauheim. On 1 April
some divisions, clearing stations got SS troops ambushed a platoon of the
ahead of aid and collecting stations so 16th Field Hospital, supporting the
that casualties were evacuated for- 4th Armored Division. The Germans
ward. In others, ambulances absent killed the chief of surgery and cap-
for a few hours found on their return tured the unit, only to see it liberated
only empty fields where their units the following day by American forces.
had been. At one point six Third Despite such alarms, the Third
Army evacuation hospitals found Army found itself changing willy-nilly
themselves in what had newly been into an occupation force as it con-
defined as the First Army zone, and quered German cities, liberated
the closing, moving, and reopening prison camps, and entered Hitler's
that resulted put all out of operation homeland, Austria. The confused last
for a time, leaving only three to sup- days of the war overlapped the
port all of General Patton's forces. coming postwar period; both had
Struggling to stay mobile, medical urgent problems demanding the same
units pressed into service every avail- scarce resources, and neither could
able vehicle; they set up as seldom as be ignored. "The scope of govern-
possible, under the least amount of mental problems, including much
canvas that would protect them and needed treatment of those suffering
25
from illnesses, both Allied and
Quotation from 65th Medical Group Semiannu-
al Rpt, January-June 1945, p. 3. See also ibid., pp.
26
12-13; 94th Medical Gas Treatment Battalion Semi- Surg, Third U.S. Army, Semiannual Rpt, Janu-
annual Rpt, January-June 1945. ary-June 1945, p. 42.
528 EUROPEAN THEATER OF OPERATIONS
enemy, were the most complex that technician waited aboard. Each plane
have been faced, perhaps, in all histo- could hold either 24 litter cases or 27
ry," recalled the Third Army surgeon. "walkers" (ambulatory patients). In
"[Yet] the operational end of the war loading, litterbearers arranged pa-
was a dire necessity. Each problem tients under the flight nurse's direc-
was huge in itself." 27 tion for the most convenient care
In clearing casualties from the army during the trip; men with bulky casts,
area, air evacuation played a larger for example, were placed in the
role during April. Nearly four-fifths of lowest litter row, at floor level. When
the 15,000 patients rode by ambu- all was secure, the plane returned
lance to five airfields, where ADSEC to the United Kingdom or to COMZ
28
or army holding units waited to re- airfields.
ceive and send them on. As usual,
such units were frequently drawn Seventh Army Units
from medical gas treatment battal-
ions. The 94th had served in this way Among the 6th Army Group forces
before crossing the Rhine, and might to the south, the Seventh Army began
have continued to do so until the end to prepare for its advance in the lull
of the war. But in March, alarms over that followed clearance of the Colmar
possible use of gas by the Nazis pocket. For a time its units operated
caused the Third Army to order the in a sea of mud caused by the Febru-
unit and its counterpart, the 92d ary thaw, for many rivers were swell-
Medical Gas Treatment Battalion, to ing and water rose in low-lying areas
resume close support of the divisions. and swampy bottoms. Drainage
Failure of the Germans to resort to became a medical problem; sanitation
chemical weapons then sent the 94th was difficult in unit areas, and con-
back to its former occupation, and it stant vigilance by the trenchfoot con-
established a holding unit at Rothen- trol teams was needed. Though cold
bergen beside an airfield designated injury fell off rapidly in consequence
Y-67. Here almost 6,000 recovered of the thaw, the teams were obliged
American and British prisoners were to remain active throughout March.29
processed along with 3,000 U.S. Meanwhile, the medical units read-
Army patients. ied themselves. Three 750-bed evacu-
As elsewhere east of the Rhine, ar- ation hospitals moved forward as far
rival of the "big birds" signaled quick as possible in the XV and XXI Corps
evacuation for many a wounded man. areas, where the advance was to
The workhorse cargo-carriers were begin, and a supply buildup brought
equipped either with roll-down straps all stocks to the maximum operating
or with brackets to hold litters in levels. The medical section acquired
place. A flight nurse and a medical
28
On air evacuation, see 94th Medical Gas Treat-
27
Surg, Third U.S. Army, Semiannual Rpt, Janu- ment Battalion Semiannual Rpt, January-June 1945,
ary-June 1945, pp. 26 and 35 (source of quotation); Evacuation app.
29
Surg, 10th Armored Division, Semiannual Rpt, Jan- Surg, Seventh U.S. Army, Semiannual Rpt, Jan-
uary-June 1945, p. 16; Surg, 76th Infantry Division, uary-June 1945, p. 1, and Preventive Medicine sec.,
Semiannual Rpt, January-June 1945, tab April, p. 1. pp. 1 and 3-5.
THE LAST CAMPAIGN 529
two pilots for air evacuation missions road, ambulances shuttled them back
and two boats to move the wounded to the next roadblock, where they
by water. Resuming its attack in mid- were unloaded, carried to other vehi-
March, the Seventh Army rapidly ad- cles waiting beyond, and reloaded
vanced to the Rhine's left bank. On again for the trip to the clearing sta-
the twenty-sixth the XV Corps tion. The bitter skirmishes were brief.
crossed the river near Worms, and On the following day the remnants of
soon a blitzkrieg advance like that of the German Nineteenth and Twenty-
the First, Third, and Ninth Armies fourth Armies surrendered, and the
was under way. As with those forces, Americans resumed their march.31
the basic medical problem was soon Evacuation hospitals apparently
reduced to one of keeping up. In the moved every ten to fourteen days
4th Division, where combat elements during the campaign, aided by the
were making 20 miles a day, "the Seventh Army surgeon who obtained
Clearing Station moved almost every more than a hundred trucks. With
day and the Field Hospital about once adequate transport, the hospitals fre-
in five days." With each advance, hos- quently moved as units, rather than
pitals faced the chores of packing, leapfrogging by echelons. Medical
loading, unpacking, and setting up groups played a role like that in the
again. Nurses found their hours "long northern armies, evacuating corps
and busy . . . under great strain," and division casualties to Seventh
for new casualties often arrived while Army installations, strengthening the
the unpacking was under way, and evacuation hospitals with additional
there was no break between the labor personnel as needed, and performing
of movement and the care of pa- a variety of other duties, including ve-
tients.30 nereal disease control through pro-
Fresh wounded continued to arrive. phylactic stations that they staffed and
The 10th Armored and 44th Infantry operated. Combat had not ended
Divisions rolled through Ulm, across when other duties crowded in. The
the Danube and into the Tyrolean 31st Medical Group took on the
Alps, only to encounter dynamited added mission of setting up hospitals
roads and machine-gun nests, where for POWs, RAMPs, and DPs, to in-
diehard Germans offered "fanatic clude a 10,000-bed hospital at Goslar
hostile resistance." Infantry out-to serve the German wounded. The
flanked the defenders on steep slopes Seventh Army's line of advance
and in defiles, where no vehicle could through southern Germany enabled
follow them. Litterbearers accompa- its forces to liberate (or uncover, as
nied the assault forces, and unit the records usually say) many concen-
medics packed in supplies on their tration camps and to occupy and ad-
backs. When the wounded had been minister others after initial liberation
manhandled to an open section of by Third Army spearheads. Here doc-
tors, nurses, and corpsmen worked
30
First quotation from Surg, 4th Infantry Division,
Semiannual Rpt, January-June 1945, p. 2. Second
31
quotation from Surg, Seventh U.S. Army, Semian- Surg, 44th Infantry Division, Medical Hist,
nual Rpt, January-June 1945, ANC sec., p. 1. 1945, p. 2.
530 EUROPEAN THEATER OF OPERATIONS
35
Fifteenth U.S. Army in Germany, 16 April-10 July Surg, Third U.S. Army, Semiannual Rpt, Janu-
1945, pp. 37-38. On the Occupation, see Chapter ary-June 1945, p. 92.
36
XVII of this volume. Ibid., p. 83.
532 EUROPEAN THEATER OF OPERATIONS
erate as theory demanded. The hospi- For evident reasons, army surgeons
tals also lacked surgeons to handle judged that the even larger 750-bed
peak loads so that surgical teams had evacuation hospital had "little or no
to be added to their complements to place in a field campaign in a war of
cope with the demands of heavy fight- movement." On the other hand, the
ing. Inadequate holding capacity convalescent hospital, "large and im-
during forward displacement also mobile though it may be," was an im-
meant adding a clearing company pla- portant unit when well-trained re-
toon as a holding unit. The tendency placements for the wounded were not
of the "semi-mobile" evacuation hos- available. It sopped up patients who
pital to grow in size and decrease in would have been lost to field army
mobility apparently was not solved, control and returned them to their
for ambulance hauls increased when- units with a minimum of fuss. Here
ever the army was in rapid motion, too venereal disease cases often were
and only the fact that casualties usual- concentrated and treated, relieving
ly decreased at the same time kept se- the evacuation hospitals of a burden
rious problems from developing.37 while preventing patients from being
evacuated to the COMZ.38
37
Ibid., pp. 82-83 (quoted words on p. 82); Surg,
10th Armored Division, Semiannual Rpt, January-
38
June 1945, p. 37; Surg, 5th Infantry Division, Semi- Surg, Third U.S. Army, Semiannual Rpt, Janu-
annual Rpt, January-June 1945, p. 5. ary-June 1945, p. 85.
THE LAST CAMPAIGN 533
Ambulance evacuation required ed, hilly regions of the front there
special attention in warfare like that were few depots or supply lines to be
of the spring of 1945. The durable, disrupted. The German advance had
ubiquitous jeep again proved its been halted short of the Meuse River,
worth as an impromptu ambulance. and thus of the main logistical net-
But methods changed as the initiative work. What losses did occur were
for evacuation shifted forward. The easily replaced: some forward dumps,
notion that the higher echelon in a few rail lines and trains damaged by
each case could evacuate the lower on strafing or bombing, lost equipment
request proved to be nonsense when in a few truck companies. At the rear
the front was in such rapid motion. the most serious damage to ADSEC
Instead, each echelon had to consign generally and to the medics in par-
its vehicles to the next lower one so ticular was caused by V-l "buzz
that evacuation could be constant and bombs," for almost 2,500 beds suf-
instantly responsive to need. The fered some degree of injury, especial-
Third Army surgeon reported: ly in and around Liege. Yet the Ad-
vance Section was able to begin its
This same concept of constant evacuation
carried down to the first and second ech- planning for the new campaign with-
elon medical service. Collecting company out the need of a period of recovery
ambulances were kept or near battalion and without replacing extensive
aid stations where possible or the one- losses.40
quarter-ton truck ambulance was used. Certain installations were re-
Litter bearers of the medical detachments
were kept available near company CP's grouped to provide backup for the
and aid stations, rather than waiting for anticipated Allied offensive. Thus the
someone to locate the aid stations prior 12th Field Hospital moved to Namur,
to sending up litter bearers. where it opened a railhead holding
unit to serve the evacuation hospitals
Overall, however, the lessons of med-
of the First Army. The 77th Evacu-
ical mobility had proved hard to ation Hospital relocated to La Lou-
learn, easy to forget, and difficult to viere to speed the return of the light-
implement when a whole army cried ly wounded to replacement centers.
simultaneously for transport in a The hard-pressed 130th General Hos-
lightning campaign.39 pital, driven out of Ciney by the
German attack, resumed operation in
Supporting the Front mid-January. But the primary change
was a shift in the character of ADSEC
Behind the Fifteenth Army the itself. Recognizing the need for mo-
Communications Zone reached its bility to support the invasion of Ger-
final form. The Advance Section, many, the Communications Zone
which supported the 12th Army
Group, had been little affected by the began to restructure its Advance Sec-
Ardennes fighting. In thinly populat- tion, transferring to the rear base sec-
tions the chain of general hospitals
39
Ibid., p. 86. See also Surg, 10th Armored Divi-
40
sion, Semiannual Rpt, January-June 1945, p. 36. ADSEC Hist, p. 111.
534 EUROPEAN THEATER OF OPERATIONS
running south from Liege to Nancy. ally all the supplies that fueled Brad-
42
Between January and May ADSEC ley's 12th Army Group.
lost 82 percent of its general hospitals Under General Lee's orders, plan-
but almost doubled its number of ning began in the latter part of Feb-
field hospitals, and also increased its ruary. The medical plan went to G-4
ambulance companies, sanitary com- a few days later. The assumption at
panies, and its medical and dental de- the time was that the main attack
tachments. This was a lesson the Ar- would be launched north of the Ruhr,
dennes fighting had taught. The with a secondary thrust south of the
effort to support a rapid advance with Moselle. The opportunistic character
41
fixed facilities had ended. of the actual Rhine crossings could
Transport, despite the battle and not be foreseen, but many of the
the winter weather, promised to be problems presented by the river were.
adequate for the advance to the The medics asked for 125 C-47s a
Rhine. The area of the Bulge itself day for air evacuation. Colonel Beas-
was devastated by Allied bombing ley, the ADSEC surgeon, planned to
and by demolitions carried out sys- establish holding units both east and
tematically by both sides. The rail west of the Rhine. Those to the east
bridges were mostly gone, the lines would receive the wounded by jeeps
out of commission. However, repair or, if necessary, by returning supply
got under way quickly. The lines had vehicles, such as the weasel. West of
been pushed as close to the front as the river the holding units were to be
ADSEC engineers could manage, set up at railheads. As the Rhine
often within medium artillery range. bridges were repaired and trains
Maintenance crews had kept roads began to run again, the need for the
43
and tracks fairly clear even during the western units would gradually cease.
deep snows, and the only real obsta- The events of March demonstrated
cle to resupply by rail had been that the end of the war was rapidly
caused by frozen switches. The approaching. In April the Advance
coming of warmer weather both aided Section prepared its ECLIPSE plan, fol-
and slowed the buildup. The Meuse lowing SHAEF's more general plan
thawed in February, and thereafter for dealing with the final collapse of
dropping flood stages permitted the Germany. Rapid occupation of the
gradual resumption of barge traffic Reich, followed by redeployment to
that moved heavy bulk supplies south the borders of the American Zone,
from Antwerp. However, heavy vehi- formed the two phases of the plan. At
cles had to be barred from roads the collapse or capitulation of the
made impassable by the thaw. Mean- major German forces—or the surren-
while, express supply trains—called der of the government or high com-
"Toot Sweet Express"—rolled into mand—the Supreme Commander
Liege daily at 1000 hours. From
Liege and Verdun in turn came virtu- 42
ADSEC Hist, p. 115. The name was a pun on
the French phrase toute de suite (quickly).
43
Directive, COMZ, ETO, 19 Feb 45, sub: Emer-
"Surg, ADSEC, COMZ, Semiannual Rpt, Janu- gency Plan for Support of Rapid Advance, with
ary-June 1945, pp. 1 and 9-10. ends., file HD:ETO:320.
THE LAST CAMPAIGN 535
would announce "A-Day," when the the effective limit of rail transport.
plan would go into effect. By that During the advance to the Rhine
time ADSEC expected the First, ever-lengthening ambulance hauls,
Third, and Ninth Armies to be com- improving weather, and the conquest
pletely east of the Rhine; the Fif- of enemy airfields brought increased
teenth to be performing occupation evacuation by plane. Near Moenchen-
duties west of the river; and its own Gladbach both rail and air holding
sphere of action to be entirely inside units were established. When the
44
Germany. armies crossed the Rhine, forward air-
The actual course of operations al- fields were used whenever weather
lowed the Advance Section to turn permitted, and as soon as the engi-
over its former territory and responsi- neer-built bridges spanning the river
bilities to other base sections, to enter were operational, casualties were car-
Germany, and to establish its head- ried by ambulance to the railheads on
quarters at Bonn during April. Here the west bank. Even when trains
it was no longer an area command— began to cross the Rhine, however,
territorial control was swiftly vested in priorities denied passage to hospital
the armies—but it continued to be a trains. Not until late April, when the
logistical command. In consequence, armies were deep in Germany and the
control of road and rail traffic also war nearly ended, did the first hospi-
passed largely to the armies. ADSEC tal train cross into the inner Reich.
found that its supply responsibilities Beasley's medics found themselves
were least burdensome in the north, facing few surprises in hospitalization.
where the reduction of the Ruhr Plans for new construction went
pocket slowed the invaders; in the ahead as long as the fighting contin-
south, where American armor pressed ued. ADSEC officers sought out
deep into central Europe, supply was hospital sites in the wake of the ad-
far more difficult. The major techni- vancing armies, and construction or
cal problem, however, came from the rehabilitation got under way with the
capture of vast quantities of German aid of the engineers. But such prob-
matériel. As already noted, such sup- lems belonged essentially to the
plies were crucial to meeting the period of occupation. The complex
needs of sick and injured noncombat- and very rapid changes in ADSEC's
ants of all types, but the job of inven- status brought on by the last cam-
torying and controlling the vast stocks paign gave way to the general trans-
proved too much for ADSEC's medi- formation brought by peace and civil
45
cal supply officers. Completing the governance of a conquered people.
work would be a task for the occupa- The Continental Advance Section
tion authorities to come. provided immediate support to the
Evacuation mirrored the experience Seventh Army—fixed hospitalization,
of the field forces. Two 1,000-bed
holding units at Aachen represented 45
Ibid., pp. 131 and 149. For the problems pre-
sented by POWs, RAMPs, and DPs, as well as an ac-
44
ADSEC, COMZ, Operation Plan "ECLIPSE," in count of the military government, see Chapter XVI
ADSEC Hist. of this volume.
536 EUROPEAN THEATER OF OPERATIONS
the fighting forces but the fact that air facilities and in April the liberation of
transport often returned casualties large numbers of Allied prisoners
direct to the Paris airfields, skipping caused the section to redesignate
the system of railheads and hospital Camp Lucky Strike, heretofore used
trains entirely. COMZ patients went by replacements entering the Conti-
to the hospital appropriate for their nent, as RAMP Camp No. 1. Mean-
injury within the center where they while, the Channel Base Section ad-
were triaged; United Kingdom pa- vanced into Belgium, taking over
tients were usually evacuated by air; areas formerly controlled by the Ad-
and zone-of-interior patients were vance Section. Its surgeon was re-
sent to the air holding unit of the 1st sponsible for American medical needs
General Hospital, at Le Bourget air- in the area of British control along
port, for loading on planes bound for the Channel coast that included Ant-
the United States. Like ADSEC and werp. Indeed, by the end of the war a
the other base sections closer to Ger- good third of the section's medical in-
many, the Seine Section also handled stallations lay in British areas. Its RED
an increasing burden of sick and in- HORSE expansion staging area mush-
jured Allied nationals, though here roomed, becoming for a time the key
mainly civilian DPs. Russians had to debarkation point for reinforcements
be sent to Germany for transfer to arriving from the United States; DP
their own medical services, while hos- camps were established, using civil af-
pital trains bore Belgians to Liege fairs medical supplies, and staffed by
and Italians to Marseilles, while air- Belgian nurses and doctors; and sec-
planes returned recovered British and
tion doctors and nurses, working at
Canadian prisoners to the United
Kingdom.47
Camp Lucky Strike, treated liberated
Americans whose condition they
The Normandy Base Section, like found to be worse than anticipated.
Oise, grew rapidly in 1945, absorbing At COMZ's request the section sent
the Brittany Base Section, taking over six teams—each consisting of three
the ports of Le Havre and Rouen doctors, a medical administrative offi-
from the Channel Base Section, and cer, and twelve enlisted technicians—
providing support to Fifteenth Army to ADSEC in Germany to aid in pro-
troops whose mission was to contain viding immediate medical care for
the holdout German garrisons in the RAMPs. Thus the burden of aiding
coastal enclaves of Lorient and St.- noncombatants stretched from the
Nazaire, on the Bay of Biscay. In most forward areas back to the rear
March an influx of German battle cas- sections. Even in the Delta Base Sec-
ualties compelled the conversion of tion, around Marseilles, whose small
hospitals serving Americans to POW
medical establishment served primari-
47
Surg, Oise Intermediate Section, Semiannual
ly its own forces, the number of
Rpt, January-June 1945, pp. 2-3 and 10-11; Surg, POWs rapidly increased, and German
Delta Base Section, Annual Rpt, 1945, p. 1. See also prisoners built a model 1,000-bed
Surg, Seine Section, Semiannual Rpt, January-June
1945, pp. 16-17. general hospital adjacent to their en-
538 EUROPEAN THEATER OF OPERATIONS
closure, where their own medical per- handle all the severely wounded who
sonnel cared for their needs.48 still required treatment in the United
No aspect of the medical system Kingdom, and whole weeks passed in
saw more striking changes than evac- which no casualty had to endure the
uation during the last offensive. The delays and frequent rough water of
transformation from the crisis condi- the Channel crossing.
tions of midwinter was extraordinary. By 8 May, when Mowrey noted in
Even when casualties began to rise in his diary that "La Guerre est finis,"
late February as a result of action he and Hawley had formulated and
along the West Wall, Paris still count- set in motion a new policy for the im-
ed 11,000 empty beds and the hospi- mediate postwar period. Patients on
tals of the United Kingdom recorded a the Continent were to be held there,
falling census. With ample bed until their cases could be reviewed by
strength, the temptation for forward medical boards. Those tagged for
surgeons was to evacuate too many quick return home were then to be
patients, rather than too few. Com- taken to the 1st General Hospital at
plaints registered at Colonel Mow- Paris, airlifted to the embarkation
rey's Evacuation Branch indicated hospitals at Cherbourg and Mar-
that triage decisions were also being seilles, and returned to the United
distorted by an overabundance of States by sea. The status of some DP
transport—a remarkable fact, given patients and the disposition of POW
the conditions of the months just patients remained to be decided, and
past. Air evacuation was, with few and some shuffling of cases among the
brief exceptions, consistently good various hospitals in Germany would
throughout the system. Poor weather become necessary as soon as occupa-
in late April did impose some delays, tion authorities determined the fate of
but the first week of May found hos- various categories. But these were
pital trains at last across the Rhine, little more than details. The systems
while improving weather enabled of evacuation and hospitalization,
C-47s to join in clearing out the overbuilt in the planning phase and
choked forward holding units, evacu- stretched to their limits during the
ating nearly 5,000 patients on the winter, provided a surplus of every-
third of the month. Air evacuation to thing for the casualties of the last
Great Britain became ever more im- campaign.49
portant, not because alternatives were
unavailable but because it was better
for the wounded. In an effort to fill Triumph of Preventive Medicine
its empty beds on the Continent,
Despite appearances to the con-
ETOUSA raised the evacuation trary, the same good fortune accom-
policy. The planes flying out of Liege, panied the Army in regard to
Paris, and Thionville were able to sickness. By comparison with the
48
Surg, Normandy Base Section, Semiannual Rpt,
49
January-June 1945, p. 4; Surg, Channel Base Sec- Above paragraphs based on Evacuation Branch,
tion, Hist, January-June 1945, pp. 2 and 5-6; Surg, Operations Division, OofCSurg, HQ, ETOUSA,
Delta Base Section, Annual Rpt, 1945, p. 2. Daily Diary, May 1944-May 1945, file HD 024 ETO.
THE LAST CAMPAIGN 539
England during the buildup provided The stubborn belief in licensed broth-
few useful guides on the Continent, els, protested some medical officers,
where, even apart from the prevailing "is based on the sort of faith that
disorder, cultural norms differed leads a small boy to believe that if he
widely from those of the British Isles. places a horsehair in a bottle of water
On the Continent prostitution was a it will turn into a snake." 52 But the
recognized endeavor, legally protect- existence of an official policy merely
ed and regulated, and brothels inhibited open and rational debate,
formed a normal part of the urban without securing compliance. It was
scene. Medical officers, looking pri- fortunate, then, that many factors
marily to the health of the troops, conspired to keep continental sick
tried to control disease by suppress- rates from venereal disease low—
ing the brothels. Commanders, on the indeed, lower than those of the Brit-
other hand, often viewed sex as a ish Isles. Many women of the type
recreation needed and deserved by who would normally have served the
fighting men, and some attempted to needs of the Army had compromised
provide it through regulated prostitu- themselves with the Germans and fled
tion. On 6 July 1944 Colonel Gordon, to escape the wrath of the Resistance.
visiting France, found in Cherbourg Friendly, noncommercial sex was in-
"houses of prostitution being run for, hibited by the language barrier, which
and indirectly by, U.S. troops." One made the early stages of acquaint-
establishment had been designated anceship difficult, especially for GIs
for black soldiers, the others for on the move. Americans who did suc-
whites, and "military police [were] ceed in finding partners had seeming-
stationed at the doors to keep order ly been sufficiently impressed by the
in the queues which formed." The perils graphically presented to them
next day Cherbourg passed to during training to make use of excel-
ADSEC's control, and the new com- lent prophylactic stations, which the
mander, on advice of his surgeon, Germans had built and equipped for
51
Colonel Beasley, closed the houses. their own forces and which now fell
During the summer campaigns, to the Allies as prizes of war.
policy continued to depend largely Behind the lines, however, the po-
upon the attitudes of local command- tential for future trouble was easy to
ers. War Department and ETO policy see. Some commanders remained ad-
requiring that prostitution be sup- amant in favor of military brothels.
pressed was not always enforced. In Civil affairs officers held varied opin-
the medical view, inspection of prosti- ions and seemingly had no consensus
tutes formed no real protection on which policy was best. French civil
against the spread of venereal dis- officials, while anxious to please their
ease, for a woman could harbor the liberators, viewed efforts to suppress
disease with no apparent symptoms. prostitution as "mildly mad" and in
51
any case tended to follow the norms
Information on venereal disease, except as oth- of their own country. Often the men
erwise noted, from Hoff, ed., Diseases Transmitted
Through Contact, pp. 242-66. Quoted words on p.
243. "Ibid., p. 245.
THE LAST CAMPAIGN 541
themselves could give little practical sented with the opportunities of Paris,
help in tracing their sexual contacts. some remarkable performances re-
sulted. A private from a Quartermas-
In a foreign country where the soldier is ter company picked up, according to
contacting a girl who speaks a different his VD contact form, nine different
language, lives on a dark street, has a
name which the soldier cannot spell or women in the vicinity of the same
pronounce, it is difficult for him to have corner, took them to six different
her name and address. The towns are all hotels, and actually managed seven
blacked out, the streets are not laid out in sexual exposures. Total time elapsed:
squares but in a circular fashion and it is eight hours. The VD rate in the Euro-
not unusual for a street to have six un-
pronounceable and unspellable names in pean Theater doubled during the
six blocks.
53
year, and studies showed that more
than two-thirds of all venereal infec-
The liberation of Paris in August tions acquired in France originated in
1944 brought within Allied lines a Paris. The Seine Section officers were
world metropolis that quickly became less than sympathetic to medical
SHAEF headquarters and a gigantic alarms. One medic recalled that in
magnet for every soldier on furlough. September 1944 the provost marshal
Medical officers told of entire convoys of the section made a tour of Paris
that "got lost" on their way to this or brothels to select some for officers,
that objective and wound up in Paris. others for white, and still others for
Traditionally an easygoing city, the black enlisted men. Despite their rep-
French capital in 1944 was particular- utation for sexual puritanism, Ameri-
ly attractive to Americans in search of cans showed a marked preference for
sex, for food was in short supply and the other national faith of pragma-
even the lowliest GI found himself in tism, tempered by racial taboos.55
"an unbeatable bargaining position." However, VD control officers suc-
Wartime psychology was a factor: ceeded in setting up additional pro-
"The soldier cannot possibly worry phylactic stations, often in Red Cross
about venereal disease when he has to hostels, and programs of education
worry about getting shot," remarked and propaganda got under way with
the Ninth Army surgeon. GIs on leave an assist from Stars and Stripes. The
sought a last fling before possible French government was cooperative
54
wounding or death. and helpful, and its aid proved to be
When the fighting man who had essential, not only for reasons of lan-
undergone a lengthy period of en- guage but because familiarity with
forced continence found himself pre- French cultural norms was necessary
53
in overcoming the reluctance of
Quotation from Surg, Ninth U.S. Army, Daily women to admit the problem and
Journal, 30 Jan 45, p. 7, Shambora Papers, MHI.
See also Ltr, Hawley to CG, ETOUSA, 9 Jan 45,
seek treatment. In fact, the police and
sub: Official Recognition of House of Prostitution, the theater medical service were
file HD 024 ETO CS (Hawley Chron). Further in- closely tied together despite the ef-
formation on civil affairs will be found in Chapter
XVI of this volume.
54 55
Hoff, ed., Diseases Transmitted Through Contact, p. Surg, Ninth U.S. Army, Daily Journal, 30 Jan
246. 45, p. 7, Shambora Papers, MHI.
542 EUROPEAN THEATER OF OPERATIONS
forts of the latter to claim otherwise. ated by the 95th Medical Gas Treat-
Medics did not as a rule supply infor- ment Battalion returned 99.9 percent
mation directly to the police, but they of its patients to duty within the army
turned their information on venereal area, underlining the fact that re-
contacts over to French health agen- duced treatment time enabled line
cies, knowing that they would do so. units to exploit forward holding facili-
Belgian authorities were similarly ties to prevent manpower loss.
helpful in prevention and treatment, The revolution in treatment gained
especially in the road and rail hub of in significance as the end of the war
Liege. Throughout the war, rates re- approached in the spring of 1945.
mained highest among base section Command support for VD control
troops, replacement commands, and continued to vary from one organiza-
in the Air Force units that continued tion to another, with the First and
to operate from the British Isle a.56 Ninth Armies providing strong sup-
But the most important develop- port for the control efforts of the
ments in VD control during the war 12th Army Group surgeon, while the
were in the area of treatment, not of Third Army manifested little interest
prevention. Even as late as 1943 an in the problem. The impending end
uncomplicated case of gonorrhea of the conflict meant that soldiers of
could occupy a hospital bed for 30 the field forces would soon enjoy the
days, while the treatment of syphilis same opportunities to find sex as the
remained a tedious six-month ordeal. support troops and could be expected
While sulfa drugs improved the pic- to take advantage of them in the same
ture, sulfathiazole rapidly lost its ef- manner. But even as the postwar VD
fectiveness as resistant strains of the epidemic impended, the significance
gonococcus developed. Then the sur- of the venereal diseases had been
geon general's Preventive Medicine radically transformed by improved
Service learned that the new antibiot- therapy to the point that gonorrhea,
ic, penicillin, had proved useful at least, had become an insignificant
against sulfa-resistant gonorrhea. A cause of ineffectiveness among the
large-scale study led to the adoption men of the European Theater.57
of penicillin treatment throughout the Apart from venereal disease, few ill-
Army. The results were startling: The ness afflicted the troops. Influenza
number of days needed to treat the failed to reappear in epidemic form;
average case of gonorrhea was re- the incidence of primary atypical
duced from 20 to 5, and many cases pneumonia remained low; meningo-
could be treated while the patient re- coccal infections did not become
mained on duty status. Penicillin widespread; and even the fatalities
treatment of syphilis began in 1944.
In the Ninth Army a VD center oper- 57
VD Control Branch, Preventive Medicine Ser-
vice, OSG, WD, Annual Rpt, 1943, pp. 135-57;
56
Medical History of the Ground Force Reinforce- Memo, sub: Penicillin Treatment of VD, in Preven-
ment Command, ETO, 23 October 1943-30 June tive Medicine Service, OSG, WD, Annual Rpt, 1945.
1945, file 319.1-2 (GFRC); Ltr, Hawley to Le Min- Both in box 24, RG 112, NARA. See also Technical
istre, Ministere de la Sante Publique, 3 Mar 45, file Bulletin MED 106, 11 Oct 44, sub: Penicillin Treat-
HD 024 ETO CS (Hawley Chron). ment of Syphilis, CMH.
THE LAST CAMPAIGN 543
among American troops caused by more palatable than the old; hot B-ra-
diphtheria apparently resulted mainly tions became commoner in the field;
from the fact that the younger Ameri- and fresh fruits and vegetables were
can doctors had never encountered often available, especially for hospital
the disease and, awaiting positive lab- patients. Well fed, inoculated, fight-
oratory diagnosis, delayed too long ing in the heartland of their civiliza-
before administering antitoxin. Care- tion, American soldiers faced no sig-
ful screening of American soldiers nificant peril of disease for which
58
helped to keep tuberculosis from be- medical science lacked an answer.
coming a significant problem, though The last campaign was a showpiece
liberated American POWs were an ex- for the ETO medical service, rather
ception, their susceptibility apparently than a test. The innovations that ap-
caused by exposure to the disease and peared—the abandonment of fixed
by malnutrition while in the enemy's hospitals in forward areas; and the
hands. Soldiers from the Mediterrane- heavy, in some areas exclusive, de-
an Theater brought not only malaria pendence on air evacuation—indicat-
but also infectious hepatitis to the Eu- ed a willingness to learn and to im-
ropean Theater, spreading the disease provise. But no severe test of the ser-
to units new from the States and vice occurred in the handling of
causing 12,509 cases between Octo- American sick and wounded. The true
ber 1944 and early May 1945. A few test of the system came rather in the
cases of typhoid and paratyphoid oc- care of noncombatants of every type,
curred, and units suffered occasional and it was here that Army medics
outbreaks of food poisoning. Diarrhe- found their most poignant experi-
al diseases, after reaching epidemic ences, their worst failures, and some
peaks in December 1944 and Febru- of their finest hours during the mem-
ary 1945, were sharply reduced orable spring of 1945.
among the troops, perhaps by tighter
water discipline in the forward zones. 58
Larkey "Hist," ch. XVI, pp. 1-6; Army Service
Frequently of obscure origin, this Forces Monthly Progress Rpt, sec. 7 (Health), 30
class of ailments caused about 45,000 Apr 45, p. 12, file HD 700 (Health). See also Pre-
hospital admissions in the European ventive Medicine Division, OofCSurg, HQ,
ETOUSA, Semiannual Rpt, January-June 1945, Nu-
Theater throughout the war, but only trition Branch sec., p. 2; Grodon "Hist", vol. 1, pt.
about 5 deaths. 3, pp. 10 and 32; Surg, Ninth U.S. Army, Semiannu-
Overall, this was an extraordinary al Rpt, sec. IV, p. 3, and sec. VI, p. 3. On the Third
record for a combat zone. Undergird- Army and venereal disease, see Surg, 12th Army
Group, Hist, January-June 1945, p. 16. On hepatitis,
ing the health of the troops was good see also Surg, Seventh U.S. Army, Semiannual Rpt,
nutrition. A new C-ration proved January-June 1945, Preventive Medicine sec., p. 1.
CHAPTER XVI
Victims of War
How were noncombatants to be early 1942 it established a school of
cared for once the tide of battle had military government at the University
passed them by? Facing the prospect of Virginia, with public health experts
of fighting in many populated regions as part of its faculty. Army policy
around the world, American policy- made the commanding general of a
makers from the early days of World theater of operations the "military
War II were aware that some provi- governor of the occupied territory,"
sion must be made for the govern- his "supreme authority . . . limited
ance of liberated peoples (civil affairs) only by the laws and customs of war."
and ultimately for that of conquered He was to select personnel to be
nations (military government). Yet charged with establishing a govern-
Americans traditionally viewed civil ment that was "just, humane, and as
rule by the military almost as a con- mild as practicable." Their
tradiction in terms, limited to extraor- work included many medical responsi-
dinary times—the aftermath of natural bilities: to oversee sanitation; to con-
disaster or civil war. At first opposed, trol communicable diseases; to pro-
President Roosevelt, because he could tect food, milk, and the water supply
see no other way, committed himself from contamination; to manage the
to a period of military rule in order to
hospital system; and to organize the
avoid having both a military com-
health care professions. Under Army
mander and a civil governor at work
in the same territory at the same time. guidance the civilian health officers of
"It is quite apparent," he remarked in states, provinces, counties, and cities
1943, "that if prompt results are to were to continue their duties. Anyone
be obtained the Army will have to who failed to obey the laws and regu-
assume the initial burden." l lations promulgated by the military
So much had long been clear to government faced punishment by a
military planners. The Army em- military tribunal. 2
bodied its basic policy in Military Gov- Yet civil affairs and military govern-
ernment, Field Manual 27-5, and in ment remained a concept, rather than
a functioning part of the Army
J
As quoted in Earl F. Ziemke, The U.S. Army in the
2
Occupation of Germany, 1944-1946, Army Historical Basic Field Manual 27-5, Military Government, 30
Series (Washington, D.C.: U.S. Army Center of Mili- Jul 40, pp. 4, 8, 44-45. The first class at the Char-
tary History, 1975), p. 22. lottesville school met on 1 May 1942.
VICTIMS OF WAR 545
system. In any combat area military ECAD medical personnel were gath-
imperatives were likely to conflict ered into the European Civil Affairs
with the care of civilians. The idea of Medical Group. At this time the
a separate civil affairs organization ECAD surgeon, Lt. Col. James P.
was new to American military doc- Pappas, MG, a meticulous organizer
trine and formed no part of Army who demanded superior work ("I
training, either in staff exercises or shall not tolerate lackadaisical nor sat-
maneuvers. If it was to become a isfactory nor even very satisfactory
functioning aspect of the Army's ac- performance on anyone's part," he
tivities, its practice had to be worked warned) also assumed command of
out in the field. the group.
4
cept of civil affairs, if only because over the destruction of lives and
the health of troops was closely linked property—beyond the demands of
to that of the people among whom military necessity, many inhabitants of
they lived and fought. But sources of Normandy believed—and over the
friction also existed. The theater chief loss of often profitable arrangements
surgeon did not set civil affairs policy, by which local farmers had supplied
and yet unit surgeons, controlling German occupiers with food. None-
most manpower and transport, were theless, cooperation developed out of
often called upon to aid at least the necessity. Within a few days after a
emergency care of civilians. Confu- town's liberation, refugees began to
sion, if not conflict, was systemic filter back. With homes wrecked, and
because civil affairs units had the mis- often with heavy rains falling (the
sion but not the means to meet civil- summer of 1944 was wet), French au-
ian needs and the field forces had the thorities and civil affairs personnel
means but not the mission.
found shelter for the returnees in
Despite a situation prolific of minor
ruined buildings, which were often
irritants, civil affairs personnel made
many positive contributions to the dangerous as well as cheerless lodg-
Allied cause, from the beaches of ings because of German booby traps.
Normandy to the borders of the Only limited quantities of Army food
Reich. The first physician with a civil were needed because Normandy, a
affairs detachment came ashore on 14 farming region, possessed resources
June 1944 and, shortly afterward, of its own, even in the aftermath of
began work in newly liberated Cher- battle. The end of fighting brought
bourg. Here the detachment made better health conditions. Venereal dis-
contact with the French authorities ease declined as the troops moved
and assisted in the repair of the water out, and outbreaks of diarrhea among
system. Finding medical supplies was the refugees 7
ended as sanitation im-
an important duty. Civil affairs per- proved.
sonnel broke down medical mainte- As they worked, civil affairs officers
nance units, obtained captured sup- came to appreciate their own good
plies from German dumps, and made fortune in finding a farming region,
French stocks that had survived the rather than a populous industrial
Occupation available to the towns and area, as the first place to put their
refugee camps of Normandy. They classroom lessons into practice. The
also tracked down reports of commu- region produced much of its own
nicable disease outbreaks and served food, and the people were sturdy and
as middlemen between the civil au- self-reliant. "Stolid, almost impossible
thorities and the military command- to panic," the tough, durable Norman
6
ers.
7
Problems were varied. Many civil- Rpt, G-5, SHAEF, 1 Jul 44, sub: Summary of CA
ians felt more than a little bitterness Field Operations for Period Ending 30 Jun 44, file
HD 014 (CA/Public Health, ETO-CA Branch, May
44-Mar 45); Study No. 35, G-5, USFET, sub:
6
Thomas B. Turner and Glen W. McDonald, Report of General Board, USFET, on Displaced
"Civil Health in Theaters of Operations," The Mili- Persons, Refugees, and Recovered Allied Military
tary Surgeon 96 (January 1945): 131-34. Personnel, pp. 4-5, file HD 319.4
VICTIMS OF WAR 547
peasants—even with their large pro- but his French counterpart, a military
portion of children, women, and the port surgeon, and the surgeon of the
aged—proved to be thoroughly Channel Base Section were all at-
"imbued with the will to live despite tempting to do related and overlap-
the catastrophe that [had] swept down ping tasks and that none were talking
upon them." 8 to the others. Yet there was work in
Difficulties were greater in towns, plenty for all of them. One section of
where heavy bomb damage and the the town had been totally demolished;
organizational confusion caused by thirty of the fifty-two local doctors
the presence of multiple occupying had been bombed out of their offices,
units plagued efforts at reconstruc- and three had been killed; a third of
tion. In Le Havre an EGA detach- the water supply was nonpotable. The
ment's public health officer was at problem was coordination, and for
work. But so were many others. An this no comprehensive solution exist-
EGA regimental surgeon reported ed.
9
During the breakout and pursuit bored at Nice and Cannes, fighting a
the number of people for whom civil typhoid epidemic traceable to broken
affairs was responsible expanded with sewer lines. Despite the impact of
the size of the liberated area. Yet its war, however, the public health situa-
medics seemingly kept abreast of ci- tion had begun to stabilize by autumn
vilian needs, if only because the bitter in both the cities and the rural towns
fighting of the Battle of Normandy of liberated France.10
was over. The major diseases were While EGA detachments operated
enteric infections—dysentery, diar- in localities affected by war, other
rhea, and typhoid fever. civil affairs organizations offered
Other widespread ills—venereal dis- advice to the governments of liberat-
ease, diphtheria, tuberculosis, and ed nations as they sought to restore
scabies—reflected the conditions of normal conditions. SHAEF estab-
the German occupation and the pres- lished special missions to provide liai-
ence of both enemy and Allied son between national governments
armies. Lack of penicillin for combat- and the Allied military authorities.
ing venereal disease among civilians Headed by an American or British of-
was a persistent difficulty. The war- ficer, each mission had two medical
time spread of diphtheria, caused by officers plus a variety of specialists
the lapse of vaccinations, was more (venereologists, sanitary engineers,
easily met. Civil affairs personnel la- nutritionists), who were added as
bored to stimulate programs of im- needed. The missions served under
munization, especially among chil- two headquarters: ETOUSA, for
dren, using military supplies of toxoid
France and Luxembourg; and the 21
until civilian laboratories could
Army Group, for the conquered na-
reopen and reestablish production.
tions of northern Europe. However,
Paris fell with little fighting. Alarm-
the European Civil Affairs Division
ing forecasts of mass hunger proved
to be greatly exaggerated, though de- loaned the British twenty-four Ameri-
ficiencies were real enough and civil can experts—fourteen doctors and
affairs officers dispatched 11,000 tons ten Sanitary Corps officers—to serve
of food in truck convoys as an emer- with Montgomery's headquarters.
gency measure. Shortages of fuel Problems varied from nation to
were serious notwithstanding the nation. Belgium requested consult-
summer weather, for without fuel the ants in nutrition, while France wanted
city could not cook its food, pump its experts in veterinary medicine and
water, light its streets, or flush out its 10
John W. Bailey, "An Outline Administrative
sewage. Yet Paris' own resources History of Civil Affairs in the ETO" (hereafter cited
were great, and were quickly applied as "Civil Affairs Hist"), p. 198, file 314.7-2; Rpt, Lt
to its medical needs. The Pasteur In- Col H. R. Hennessy, G-5, COMZ, 30 Dec 44, sub:
Summary of Public Health, COMZ, ETO, box 1, H.
stitute supplied serums, medical and R. Hennessy Papers, MHI; Harry L. Coles and
surgical equipment was abundant, Albert K. Weinberg, Civil Affairs: Soldiers Become Gov-
and trained personnel were numerous ernors, United States Army in World War II (Wash-
and sophisticated. Meanwhile, in ington, D.C.: Office of the Chief of Military History,
Department of the Army, 1964), pp. 722 and 759-
southern France an EGA regiment ac- 82; Surg, ECA Medical Group, Annual Rpt, 1944,
companying the Seventh Army la- sec. 3, p. 13.
VICTIMS OF WAR 549
narcotic drug control, among others. ently, the distinction between military
In all nations the missions deter- and civil affairs medicine was break-
mined from civilian authorities what ing down at the ETOUSA level. At
medical supplies were needed and the level of the field forces, however,
sought to obtain adequate quantities unit surgeons continued to resent the
from military depots and other civil affairs medics who operated in
sources. They also recruited medical their commands, demanding their as-
workers for refugee camps, investigat- sistance but on occasion rejecting
ed sanitary conditions, and monitored their advice.
disease outbreaks. The commonest For their part, civil affairs medical
problems among civilians were those officers sometimes expressed fore-
classic accompaniments of war, mal- boding over the inadequacy of their
nutrition and venereal disease, and organization in view of the monumen-
both entailed policy recommendations tal tasks that lay ahead. "I feel," em-
to Allied governments as well as ef- phasized one high-ranking officer of
forts to obtain supplies of food and the Public Health Branch, G-5,
medication. At the top as at the SHAEF, "that the Tables of Organiza-
bottom, civil affairs medics proved an
essential lubricant in the process of tion have been totally inadequate
starting once more the paralyzed from the top to the bottom in our
wheels of civil government health public health program. They have
care. By September French public been inadequate in SHAEF and at
health departments had resumed op- every staff level below us." As the re-
eration in many areas, and officials conquest of Europe proceeded, men
had once again begun to collect com- and supplies not only were spread
municable disease reports.
11 thinner but encountered worse prob-
To this point success keynoted the lems. In the late autumn severe fight-
civil affairs story, for much good was ing began again, and in December the
accomplished with modest means. Yet Ardennes attack fell with full fury
organizational problems lingered. upon disordered regions, where re-
Contradictory directives emanated covery had only begun.12
from ETOUSA and SHAEF. In late The German eruption during one
September ETOUSA attempted to of Europe's coldest winters pushed
clarify the chief surgeon's civil affairs hordes of suffering refugees and DPs
responsibilities. Hawley was thence- into the region just behind the lines,
forth to be responsible for the requi- already crowded with Allied troops.
sitioning, storage, and bulk issue of In front-line cities like Liege, bomb-
medical supplies for civilian use; for ing forced the homeless into under-
supervising public health and sanita- ground air raid shelters that
tion, as necessary, to safeguard the were potential incubators of epidemic
health of the military command; and louse-borne typhus. Food stores were
for furnishing tactical advice and sup- lost; freezing weather impeded trans-
port to civil affairs personnel. Appar- port; military needs monopolized
11 12
Hoff, ed., Civil Affairs/Military Government, pp. Interv, OSG with Lt Col Leonard A. Scheele,
427-29 and 452-67. USPHS, 8 Dec 44, file HD 000.71, CMH.
550 EUROPEAN THEATER OF OPERATIONS
prebend and to repair. As a whole, for they were well aware of the many
the region conquered by the Western essential tasks still performed by
Allies was a food-deficit area, accus- trained military government person-
tomed to draw sustenance from the nel. They still provided guidance and
East, now devastated by war and oc- advice, worked with the field forces in
cupied by the Russians. a variety of jobs, investigated reports
To meet such unprecedented diffi- of disease outbreaks, and aided in
culties, SHAEF was obliged to turn to medical supply. Through G-5,
the field forces because they alone SHAEF, they retained a direct wire to
had the necessary medical troops, the Supreme Commander and
trucks, and supplies. The change through European Headquarters,
came quickly in the early spring of United States of America Typhus
1945. Apparently the immediate Commission, a direct connection to
cause was pressure form the field the organization that provided most
force surgeons, notably Colonel of the vaccine and other antityphus
Gorby of the 12th Army Group and supplies used in the theater. Unwor-
his preventive medicine officer, Col.
thy gloating by some of those who
Tom F. Whayne, MC. These two per-
suaded General Kenner, already con- had now taken charge did nothing to
vinced by his own observation that salve their feelings. Hawley himself
civil affairs could not meet its new re- averred that "the medical service of
sponsibilities, to seek new directives Civil Affairs broke down completely
from the Supreme Commander. In at the first small problems," perhaps
orders issued on 12 and 14 April the only time that the difficulties of
SHAEF determined that "partial conquered Germany were described
19
ECLIPSE conditions" existed and as small.
concluded that civilian health must Implementation of the new ar-
henceforth be a command responsi- rangement varied in detail from one
bility.
18 headquarters to another. In the 12th
Field army surgeons now took Army Group, discussion between
direct supervision and control of Colonel Gorby and the G-5, Brig.
ECAD medical personnel. The re- Gen. Cornelius E. Ryan, led to an am-
sponsibility for achieving results also icable agreement. On 26 April 12th
passed to the field forces, for each Army Group G-5 medical officers
commander became responsible for
plans, policies, and supervision of
19
public health work in his area within Quoted words from Ltr, Hawley to TSG, 20
Apr 45, file HD 024 ETO O/CS (Hawley-SGO Cor-
the existing framework of policy. This resp). See also Ltr, Draper to "Steve" [Brig Gen
departure was and remained contro- James S. Simmons, Chief, Preventive Medicine
versial. Some G-5 officers were bitter, Service, OSG, WD], 9 Apr 45; Rpt, Col Philip R.
Beckford, Surg, 99th Infantry Division, to Chief,
Public Health and Welfare Branch, OMGUS, 3 May
46, sub: Experiences in and Impressions of Military
18
Directive, HQ, SHAEF, to CGs, 6th and 12th Government Public Health Operations in Germany,
Army Groups, and HQ, 21 Army Group and COMZ, May 1945 to May 1946; 12th Army Group Report of
ETO, 14 Apr 45, sub: Public Health Functions in Operations, vol. XIII (Medical Section), pp. 238 and
Occupied German Territory, file G-5/OMGUS 240; Hoff, ed., Civil Affairs/Military Government, pp.
Records, PHB/PWB, box 471, RG 260, NARA. 472-81.
VICTIMS OF WAR 553
The Americans cleaned out the Ge- riedly, the military government teams
stapo prison, moving the sick to hos- dusted the entire town and immu-
pitals and dusting and immunizing nized those who had used the shelter.
the healthy former inmates (Diagram Other outbreaks flared in the Mo-
6). German civilians were organized selle region and the Palatinate, only
into teams to assist. Spot checks on to be stamped out by similar quick
the streets of Cologne showed that action. Reports of new cases declined
typhus was commoner among labor- rapidly during April and May and
ers and prisoners simply because they vanished during June. About 700
were far more likely than German ci- cases had been spotted in all. By the
vilians to be infested with lice. Again first week of summer the Rhineland
and again, the spread of the disease was substantially free of the disease.
proved to be directly caused by the Two-thirds of the cases occurred
large drifting population. A party of among DPs, a group only one-tenth
Ukrainian laborers left Cologne early the size of the German population.
in March and stopped for two days in But because previous infections had
the town of Hermuelheim, sleeping in served to create some degree of im-
a small air raid shelter. On 24 March munity, the DPs who became sick
thirty residents who shared the shel- were more than ten times as likely to
ter came down with the disease. Hur- survive as infected Germans (3 per-
VICTIMS OF WAR 557
cent mortality as against 35 per- dusted with DDT. Anyone showing
25
cent). symptoms was sent at once to U.S.
For the result, credit went to DDT, Army medical installations. Shortly
the accidents of battle, and the reor- afterward, Brig. Gen. Leon A. Fox,
ganized medical service. The Ar- field director of the Typhus Commis-
dennes battle had delayed the erup- sion, met with representatives of
tion of the Allied armies until the end ETOUSA and the 12th Army Group
of winter, allowing the Reich to main- at Hawley's office in Paris to formal-
tain some measure of control through ize the policy, and a SHAEF directive
the season when typhus might have followed on 31 March. Hundreds of
been most devastating. When the thousands of refugee Rhinelanders
Rhineland fell, Americans were ready returning from the inner Reich were
to take charge. Adequate personnel, deloused at ports of entry established
guided by experts and employing the in Oberkassel, Wiesbaden, Mannheim,
technique of isolating contacts, mass and Wesel. POWs were deloused in
dusting, and selective immunization,
prison enclosures, and sometimes
had knocked out the epidemic. Only
issued dust guns and taught to de-
two Americans caught typhus. Both
were medical officers engaged in con- louse their comrades. But even as
trol work, and their cases were mild. these measures took shape, medical
As the military government took personnel knew that a new test would
26
hold, orders were issued to keep DPs come to the east of the river.
in their camps pending repatriation to
their own countries. The roads emp- Uncovering the Reich
tied, except for necessary military and
civilian traffic, and the turmoil of the "It was France all over again,"
late winter and early spring came to wrote an American medic in April
an end. The Allies now turned the 1945, "save that this time the end was
Rhine itself into a barrier against the in sight. Across the Rhine were the
reintroduction of typhus. The danger famous autobahns . . . , spe
that the disease might spread west- back to travel, and distances were not
ward, created by the first crossing at so important anymore." American
Remagen on 7 March, caused the forces liberated Allied soldiers who
chief surgeon's office to seek a verbal had endured anything from days to
agreement with the First and Ninth years as POWs. Not surprisingly,
Armies to prohibit movement of civil- most were in poor condition. The
ians across the river. On the twentieth Germans had moved prisoners about
the armies established a cordon sani- on forced marches, trying to prevent
taire from the Swiss border to the them from falling into Allied hands;
North Sea along the east bank of the those who were sick or injured they
Rhine and its distributary, the Waal.
26
All who crossed from east to west, Preventive Medicine Division, OofCSurg, HQ,
except Allied military personnel, were ETOUSA, Semiannual Rpt, January-June 1945, pp.
28-29; Ltr, HQ, ETOUSA, to CGs, Section Cdrs,
and COs, 12 Apr 45, sub: Establishment of a
25
Essential Technical Medical Data, HQ, "Cordon Sanitaire," file 383.7 (DPs: General Poli-
ETOUSA, April 1945, pp. 3-4. cies and Procedures).
558 EUROPEAN THEATER OF OPERATIONS
left behind, to be overtaken by the in- but they were generally deficient and,
vaders and to become a burden upon in combination with overcrowding
them. In either case, a new medical and an erratic diet, produced much
task fell to American field units and sickness. Medical treatment usually
to ADSEC and COMZ hospitals: conformed to Geneva Convention
Wounded, ill, or hungry, the RAMPs norms; the less serious cases were
required quick attention.27 treated in camp by Allied medics, the
What nearly all had in common was more serious in well-equipped
malnutrition. But differences were German hospitals. But generalization
marked between Westerners and east is difficult in the face of variations so
Europeans. Both the Germans and great that a prisoner's life, as well as
their own nations had treated the two his comfort, might depend on wheth-
groups quite differently. Western er he was sent to the "remarkably
countries had attempted to support well equipped" Stalag II-B or to the
their soldiers in enemy hands, mani- "notorious Stalag IX-B," where "one
festing interest in their welfare and needle holder, one pair of forceps,
sending them great quantities of sup- one pair of scissors, and a spool of
plies through the Red Cross. The black cotton thread" were said to rep-
Soviet Union, on the other hand, had resent all the surgical equipment
not signed the Geneva accords; dis- available. Overall, however, American
owned its prisoners; and, until the prisoners did well in German camps;
end of the war, showed no concern only about one-half of 1 percent
for their fate. Poles, Serbs, and many died.28
other captives had no spokesman at A report by three army doc-
all, for their nations had disappeared tors, repatriated in September 1944,
before the Nazi invaders. provided a glimpse of life in an Oflag
The experiences of American (officers camp) in the Polish Corridor.
POWs were complex and contradicto- Red Cross and YMCA packages ar-
ry. Within the camps poor and inad- rived regularly. In consequence,
equate food was a perennial problem, Americans could buy delicacies on the
perhaps the worst that prisoners black market with cigarettes, trading
faced. Moreover, the ration declined with Polish laborers in the camps or
steadily from the fall of 1944, as air through friendly guards. "The prison-
strikes disrupted German transport. er of war," reported Capt. H. J. Wein-
Red Cross packages provided an es- traub, MC, "is the richest man in
sential supplement (supposedly Germany." Though buildings were ill-
1,000-2,000 calories a day), but deliv- heated, clothing was old and poor,
ery was irregular and became less re- and medicine was in short supply,
liable as the ration declined, for the Americans were constantly reminded
same cause. Sanitary conditions of their relatively prosperous lot by
varied greatly from camp to camp,
28
David A. Foy, For the War Is Over: American Pris-
27
Quoted words from 110th Evacuation Hospital oners of War in Nazi Germany (New York: Stein and
Semiannual Rpt, January-June 1945, pp. 5-6. See Day, 1984), pp. 114-15. See also pp. 17-81. By
also Surg, Third U.S. Army, Semiannual Rpt, Janu- comparison, about 38 percent died in Japanese
ary-June 1945, p. 35. prison camps.
VICTIMS OF WAR 559
observing their fellow prisoners. The As prisoners of a retreating army,
British were worse off in their camps; they had also been subjected to
the French and Poles fared miserably; random brutality by individual guards
and "horrible conditions" existed or officers. At Heppenheim the Sev-
among the Russians, caused by starva- enth Army overran a German camp
tion, tuberculosis, and typhus. When for Allied prisoners, where 283 Amer-
Russians were sent to the American ican patients were found in "terrible
camp as hospital workers, the doctors condition due to brutal treatment
put the worst cases to bed, ignoring rendered by a German Major, Medical
German orders to make them work.29 Corps, who admitted his hate for
Beginning with the Ardennes, how- Americans." After a Good Friday visit
ever, treatment of American prisoners by General Devers, the 6th Army
declined and soon approximated that Group commander, the men were
endured by the Russians for many quickly transferred to general hospi-
years. The reason lay not in any tals. In custody, the German medical
change of policy, but in the advanced officer committed suicide.31
state of disintegration of the German Initially, policy emphasized holding
Army and nation. Americans captured all RAMPs in place, as long as mili-
in the Bulge were in poor condition tary operations continued. Responsi-
when retaken. "Many," noted a hospi- bility fell upon the American and
tal report, "were nothing more than British medical services, but other
Allied nations were encouraged to
wraiths of skin and bone, too weary provide medical assistance, to the
to rise from their cots, and too emaci- extent possible, and to evacuate their
ated to be able to eat a solid meal." compatriots "expeditiously" in order
Ceaseless marching without sufficient to relieve the two principal western
food or rest was the basic cause. "We Allies to the burden. Because no Rus-
marched, starved, froze, scratched sian or Yugoslav hospitals existed,
lice, suffered from sickness and . . RAMPs
their . were cared for in
marched some more," recalled one German facilities. Russians were re-
American. "We lived in fields, slept in tained in the western zones of Germa-
barns or fields, and dodged aerial ny, pending the junction of American
strafings. We covered 600 miles in 87 and British forces with the Soviet
days, and I had joined the Air Force armies. By international agreement
so I wouldn't have to walk." 30 the Russians were separated from
29
others, granted special privileges, and
Quoted words from Interv, ETO with Capt placed in camps where soldiers and
H. J. Weintraub, 30 Sep 44, file 383.6 (Intervs, Re- 32
patriated POWs) ETO. See also W. Paul Havens, civilians were mixed together.
Jr., ed., Infectious Diseases, Medical Department,
31
United States Army in World War II (Washington, Surg, Seventh U.S. Army, Semiannual Rpt, Jan-
D.C.: Office of the Surgeon General, Department of uary-June 1945, p. 7.
32
the Army, 1963), pp. 390-92; Larkey "Hist," ch. 14, Admin Memo No. 48, HQ, SHAEF, 26 Feb 45,
p. 15; Havens, ed., Medical Consultants, pp. 452-55. sub: Hospitalization and Evacuation of RAMPs, in
30
First quotation from 110th Evacuation Hospital Book II, Planning Branch, Operations Division,
Semiannual Rpt, January-June 1945, p. 5. Second OofCSurg, HQ, ETOUSA, 1945, file 383.6 (ETO);
and third quotations from Foy, For You the War Is ADSEC Hist, p. 158; Historical Division, European
Over, p. 144. Continued
560 EUROPEAN THEATER OF OPERATIONS
Before D-Day Axis prisoners were lived without shelter and ate canned
transported to remote rear areas, in- rations with sticks for spoons. Enteric
cluding Great Britain and the United and respiratory illnesses followed.
States, where their treatment was in Major lacks existed in the medical
general excellent. Similarly, the first support system through the early
prisoners taken after the invasion stages of capture, detention, and
were shipped back across the Chan- transport to the rear. Neither the
nel. But when large numbers began military police battalion, the escort
to fall under the Army's control guard company, nor the POW proc-
during the breakout and pursuit,
POW camps were set up on the Con- essing company had organic medical
tinent, some in the very buildings ear- elements. Added to the confusion and
lier used by the Germans to house disorder of war, and the battered
Allied prisoners. Military police units state of many railways, the lack of
ran the camps, and provisional POW professional advice to commanders
overhead detachments saw to the helped to make for some rough jour-
prisoners' medical needs, which were neys. Prison trains rolled for days
usually great. POWs arrived in without adequate provisions for
masses, many ill or injured in battle. water, sanitation, rest, or even ventila-
Camp construction went slowly, and tion, and their arrival in the rear
overcrowding, insufficient shelter, and threw new waves of sick and exhaust-
38
cold rations were the rule. For these ed men upon the prison camps.
camps in liberated France, the coming The masses who surrendered in the
of the year 1945 at first meant vastly spring of 1945 presented a new and
improved conditions of life, while es- stunning challenge. ETOUSA plan-
tablishment of the POW hospital ners had failed either to foresee the
center near Cherbourg offered expert dimensions of an unconditional sur-
treatment for those needing medical render or to allow for the disintegra-
or surgical care.37 tion of the German Army that
Yet some basic problems were not accompanied it. Treatment of
addressed. Field forces often stripped
German prisoners by Americans mir-
POWs of their personal equipment,
including tents and even mess gear, rored the experience of Americans in
apparently in order to cram the maxi- enemy hands: Those captured last
mum number into the available trans- suffered most. Improvisation became
port. Because the camps often had no the rule in Germany and resulted in
equipment to issue, many prisoners the creation of POW transient enclo-
sures—institutions that did no credit
37
On POW camp conditions, see 2029th PWOD
38
Annual Rpt, 1944, pp. 2-3, and Semiannual Rpt, For the makeup of military police formations,
January-June 1945, pp. 7-8. See also 2021st PWOD see T/O&E 19-35 (August 1943), T/O&Es 19-47,
Annual Rpt, 1944, p. 5; 2018th PWOD Periodic 19-55, 19-57, 19-237 (November 1943); T/O&E
Rpt, April-December 1944, p. 3; 6832d PWOD 19-500 (April 1944); and T/O&E 19-7 (September
Periodic Rpt, 25 Aug 44-30 Jun 45, pp. 2-3; and 1944). In March 1945 124 POWs suffocated in tran-
2024th PWOD Semiannual Rpt, January-June 1945, sit, provoking an IG investigation and an American
p. 2. All in box 383, RG 112, NARA. Information apology to the German High Command. See report
on POW general hospitals will be found in file of investigation in file 383.6/3-16, box 26, RG 331,
319.1-2, box 440, RG 112, NARA. NARA.
VICTIMS OF WAR 563
crammed into spaces initially meant By June the 106th Division was run-
for 20 to 50 thousand was not a ning all seventeen POW transient en-
pleasant picture." Shelter was non- closures, two of which contained not
existent, even for the old and young. POWs but Russian and Czech DPs.
Rain soaked the prisoners, and the The surgeon counted 10,000 beds in
nighttime cold indirectly caused the the fifteen attached hospitals, staffed
deaths of a few by carbon monoxide largely by German medics. On the
from the small fires they had built twelfth the British took over the en-
inside the foxholes where they lived.42 closures, with some 200,000 inmates,
Medical progress was halting—rich in their zone. Rapid discharges in the
in personnel, poor in supplies. camps that remained combined with
German medics were rapidly screened warm weather to bring about a sharp
and organized, and delousing teams decline in sick rates. On 10 July the
were set to work. But neither the French 10th Infantry Division took
106th Division nor the camp com- over the remaining POW enclosures
manders could obtain medical sup- along the Rhine in what was now the
plies from higher headquarters during French Zone. Adding up the totals of
April and May, though all the vehicles its prisoner patients, the 106th Divi-
controlled by the division surgeon sion recorded 1,817,393 cases on sick
and the medical battalion "were on a call and 1,697 deaths, of which 1,404
constant 24-hour medical supply had occurred in May, 214 in June,
44
hunt." The division obtained some ci- and 79 in July.
vilian nurses through the German Complicating prisoner health prob-
Red Cross and local officials. Hospi- lems in the European Theater were
tals were set up in buildings or tents. changes in the food ration. During
All were in close proximity to the en- the early fighting on the Continent
closures, and all had an adequate prisoners had been more than ade-
supply of water. The primary causes quately fed, receiving under Geneva
of admission were dysentery and rules rations equivalent to those of
upper respiratory infections, as might American soldiers. As a result, even
be expected. "Thank God for this nonworking prisoners ate better than
mercy!" exclaimed a POW who found Allied civilians. In response to an
himself in a hospital on 28 May. "I outcry against coddling POWs, the
rest again—for the first time since the ration was reduced in December
beginning of April—in a bed! I can 1944. Yet prisoners were still report-
cover myself with a good big brown ed to be gaining weight in captivity.
American blanket!" 43 They were also increasing in number,
44
Surg, 106th Infantry Division, Annual Rpt,
42
Surg, 106th Infantry Division, Annual Rpt, 1945, p. 17, file 319.1-2, box 392, RG 112, NARA.
1945, pp. 5-6, file 319.1-2, box 392, RG 112, On the internal economy of the camps, see policy
NARA. memoranda in ibid., plus Daily PWTE situation re-
43
First quotation from ibid., p. 8, file 319.1-2, ports in Medical Branch, COMZ, ETO, POW Enclo-
box 392, RG 112, NARA. Second quotation from sure Rpts, box 17, RG 332, NARA. See also Fred
Kurt W. Boehme, Die deutschen Kriegsgefangenen in Clinger, Arthur Johnston, and Vincent Masel, The
amerikanischer Hand: Europa (Munich: Verlag Ernst History of the 71st Infantry Division (Augsburg: E.
and Werner Gieseking, 1973), p. 316. Kieser KG, Druckerei und Verlag, 1946), p. 101.
VICTIMS OF WAR 567
end of the month, however, a report sules to all prisoners with signs of
from the Koblenz camp surgeon malnutrition. At his instance Eisen-
revealed that nonworkers were receiv- hower's headquarters sent a letter to
ing inadequate rations. Extensive mal- all commanding generals, revising the
nutrition was recorded in the stock- categories of prisoners into workers,
ades of the Third and Seventh Armies light workers, and nonworkers, and
and the Communications Zone in prescribing menus for feeding each
August. Avitaminosis appeared in group. Working rations were ordered
florid deficiency syndromes, caused for all prisoners under 21 years of
by not only the reduced ration but age, and dietary supplements were
also the fact that fine-ground unen- specified for all prisoners found by
riched American flour formed a large medical officers to be malnourished.
part of it. Prisoners showed early A survey team was ordered to make
symptoms of pellagra and beriberi, periodic checks to ensure compli-
and weight loss was common. Condi- ance.
47
tions also varied widely from one With many hospitals under their
camp to another, making a mockery control, and a variety of liberated
of official policy. A new survey, or- peoples to provide care for, the
dered in August by Kenner with the armies continued to use both cap-
concurrence of the provost marshal,
found that nonworkers received any-
tured supplies and captive labor.
German medical supplies were inven-
where from 1,250 to 2,040 calories a
toried and consolidated, and
day, workers from 1,450 to 2,882.
Furthermore, worker and nonworker ETOUSA notified its units that cap-
were variously defined. In some tured stocks were available for POW
camps young prisoners received die- enclosures, DP camps, RAMP facili-
tary supplements in recognition of ties, and German civilian hospitals,
their greater metabolic needs; in and set forth a standard procedure
others they did not.
46 for ordering needed items.
This survey resulted in immediate Under Geneva rules enlisted POWs
action. Kenner issued a letter order- could be required to work at specified
ing the surgeons of all major com- jobs, and many found employment in
mands to provide multivitamin cap- the hospitals. Hospital centers housed
German laborers in their own com-
46
Kenner became theater chief surgeon in July. pounds, or drew them daily from
See Rpt, Nutrition Survey Team, SHAEF, to CSurg, local POW enclosures. DPs served
ETOUSA, 15 May 45, sub: Nutritional Survey of also, sometimes as guards for the
German Prisoners of War Under Control of United
States Army on the European Continent, p. 2, in Es- Germans. By and large the captive
sential Technical Medical Data, HQ, USFET, July workers made good records, and on
1945; Hoff, ed., Special Fields, pp. 389-94; Memo, occasion were rewarded with letters
Nutrition Survey Team, SHAEF, to Chief, Preven-
tive Medicine Division, OofCSurg, ETO, 31 Aug 45,
47
sub: Report of Nutritional Survey of German Pris- Ltr, CSurg, TSFET, to Surgs, All Major Com-
oners of War and Disarmed Enemy Elements Under mands and Sectors, 15 Sep 45, sub: Multivitamin
Control of the United States Army on the European Capsules for Prisoners of War and Disarmed Enemy
Continent, box 327, RG 112, NARA; CampSurg, Elements, and Ltr, HQ, USFET, to CGs, 25 Sep 45,
PWTE A-10 [Koblenz], Weekly Sanitary Rpt, 21 sub: POW Menu #2, Fifth Revision. Both in box 36,
May 45, box 392, RG 112, NARA. RG 112, NARA.
VICTIMS OF WAR 569
of appreciation from grateful com- rode bicycles; some crowded into
manders. Some kept hospital medical German Army vehicles. Some
records, but apparently none provid- dragged rickety homemade carts,
ed hands-on care to Allied soldiers. heaped with personal belongings—or
When in May Kenner complained to with loot, for the DPs were not scru-
Hawley of the great number of POW pulous in dealing either with German
and DP workers, Hawley pointed out property or with German lives. Nei-
that the command had no alternative ther tractable nor gentle, the wander-
to employing them. "Demands upon ers exhibited what Americans came to
the enlisted personnel of fixed hospi- call the "Liberation Complex," a min-
tals," he wrote, "have made it impos- gling of hunger, exultation, and
sible to operate ... on an accepta- vengefulness that made them a
ble standard without additional help." danger to their onetime rulers and a
Because many prisoners were only burden to their liberators.
49
too happy to work under the better DPs had been drawn into Germany
living conditions of the hospitals, and from almost every nation of Europe
to eat the more abundant food, and to labor for Hitler's war effort. Some
because the hospitals needed the pris- had been volunteers, some conscripts,
oners, there was in fact no alternative some little better than slaves. Their
to the system, even if one had been treatment varied widely. Farm labor-
48
desirable.
ers fared best, sharing the food they
helped to raise or, at worst, finding
DPs and Slave Laborers
opportunities to glean or steal suste-
Wherever they went in Germany nance. In Prussia a Western corre-
during the spring of 1945, Americans spondent covering the Russian ad-
wondered at the numbers of dis- vance heard a Frenchman boast, "It
placed persons. The historian of the was we ... who ran the agriculture
108th Evacuation Hospital remarked of East Prussia in the last two years."
upon "the great migration of these At Hadamar, in the state of Hesse, a
liberated people" as they "made haste former insane asylum turned Gestapo
to leave this hateful country which prison held both well-fed Poles and
had been their prison for many starving Germans. The Poles were
years." Some trudged afoot; others farm workers; the Germans were po-
litical prisoners restricted to the
48
Quoted words from Ltr, Hawley to Kenner, 1 prison ration. Civilian and military
May 45, box 2, Hawley Papers, MHI. See also GO prisoners were often found mixed to-
No. 29, Oise Section, COMZ, 4 Mar 45, sub: Esti-
mate of Labor Service Companies, file 383.6; 803d gether, for some RAMPs had been
and 819th Hospital Centers Semiannual Rpts, Janu- compelled to labor and some had
ary-June 1945; Cady, "Notes on the 21st General sought it as an alternative to starva-
Hospital (AUS)," p. 585, Cady Papers, MHI; Gorby
Interv, 1962, CMH. On SHAEF opposition to allow- tion. Though the overall state of mil-
ing POWs to provide medical care for Allied sol- lions of individuals defies summary,
diers, see Ltr, HQ, ETOUSA, to Section Cdrs, DPs and RAMPs in good physical
COMZ, 9 Feb 45, sub: Utilization of German Pro-
tected Medical Personnel. For information on earli-
49
er POW service in hospitals, see Chapter XIV of The 108th Evacuation Hospital Travelogue,
this volume. June 1945.
570 EUROPEAN THEATER OF OPERATIONS
condition were rare, with the Russians as possible to their own countries de-
among them having suffered the sirable. An international organization,
50
worst. the United Nations Relief and Reha-
Dealing with severely malnourished bilitation Administration (UNRRA),
and often tubercular patients in the began making plans to assume con-
midst of war proved a difficult task. trol of the remaining DP hospitals,
With their own wounded to care for, except those holding Soviet citizens
the field forces often turned for as- who were to be returned to their own
52
sistance to doctors and nurses among nation.
the DPs. They also moved patients With the end of the fighting, the
into German hospitals and, in some field armies became occupying forces
cases, when Allied nurses and doctors responsible for defined regions in the
were available, set up special hospi- American Zone of Occupation. Their
tals. More rarely, mobile hospital division surgeons were now responsi-
units took on the task of caring for ble for the DP, RAMP, and POW hos-
51
sick and starving DPs. pitals in their division areas and for
Typhus was common east of the medical care of the camps. Even with
Rhine, just as it had been to the west. the advent of UNRRA, the Army
Every effort was made to delouse DPs found itself still in charge of many fa-
in their camps and at shipping points, cilities—even of the DP camps, be-
where they gathered to go home. cause the international organization
Teams equipped with power dusters could not at first find the manpower
set to work at Neubau, where many to assume full responsibility. Thus the
western Europeans were evacuated by surgeon of the 2d Armored Division
air, or at Wuerzburg and Bamberg, was still charged with two RAMP hos-
where rail transport to countries east pitals, ten DP hospitals, and fifty-
of the Rhine was centered. As the three German military hospitals.
number of hospitals for POWs and Because Army personnel were clearly
American military fell, those for DPs inadequate to handle the load—645
increased, reaching a total of twenty- RAMP patients, 937 DPs, and 11,409
two in the Third Army area in Sep- POWs—dependence upon the various
tember 1945. But depleted American groups to help care for their own
manpower made consolidation of the members also continued. DP dispen-
patients and the discharge of as many saries were maintained by camp in-
50 mates under the eye of the division
Quoted words from Alexander Werth, Russia at
War (New York: E. P. Dutton, 1964), p. 958. See surgeon, and the Americans viewed
also Coles and Weinberg, Civil Affairs, p. 858, and with gratification and surprise the
surveys at end of Larkey "Hist," ch. 14, pp. 104 et "high standards of sanitation . .
seq. General policy is set forth in Ltr 383.7-1, AG,
SHAEF, to HQ, 21 Army Group (Rear), CG, 6th maintained by the same people who
Army Group (Rear), and CG, COMZ, 27 Mar 45, had been taken out of the indescrib-
sub: Medical Care for DPs and Refugees in Germa- able filth of the concentration camps
ny, in ETOUSA.
51
Havens, ed., Infectious Diseases, pp. 347-48; Rpt,
52
SrConsultant in TB to CSurg, ETOUSA, 3 Apr 45, Surg, Third U.S. Army, Semiannual Rpts, Janu-
sub: Tuberculosis in Russian RAMPs at 46th Gener- ary-June 1945, pp. 90 and 140, and July-December
al Hospital, p. 1. 1945, pp. 1-2 and 33-34.
VICTIMS OF WAR 571
and [prison] hospitals under German Mingled with the DPs, Americans
53
control." also began to find concentration
Yet DP camps, because discipline camp inmates. Some were on the
was less severe and because they con- roads, in flight with their guards from
tained many women, formed a tough- advancing Russian spearheads: In the
er problem for the occupation au- small south German town of Cham,
thorities than either the hospitals or Third Army units found 6,000 survi-
the POW camps, especially as the vors of a march from the Flossen-
postwar VD rate began to rise. DPs buerg Concentration Camp and as-
were not responsible for all, or even signed the 120th Evacuation Hospital
most, of the venereal disease that af- to their care. Others had reached a
flicted defeated Germany: American temporary haven. At a Luftwaffe air-
troops and German civilians were the field in Austria, designated by military
most numerous victims and carriers. government units to receive the liber-
Yet, of the ten DP hospitals in the 2d ated, the 121st Evacuation Hospital
Armored Division area, one was for found about 14,000 people whose
venereal disease alone. The atmos- condition was that of "starved, half-
phere of the camps was not conducive crazed animals." Thousands had al-
to high personal standards in any re- ready been hospitalized in hangars
spect. DPs differed greatly from one and barracks by the 646th Clearing
another in culture and education; in- Company, the first medical unit on
tellectuals and plain folk mingled with the scene. The evacuation hospital
peasants from the most primitive re- admitted 3,000 patients during the
gions of eastern Europe. Inevitably, first week. Medics drew supplies from
though unfairly, the image too many a large consolidated depot at St. Flor-
Americans carried away was of an in- ian and also scoured the countryside
distinguishable mass of "sleeping, for milk and food. Over 300 cases of
eating and scratching people," infest- typhus were identified, as well as tu-
ed with lice and defecating at berculosis and dysentery. Despite all
random. Though systematic attention efforts, the mortality rate was high
to cleanliness changed the picture in during the first days, and a tenth of
some camps, others, especially those the patients died overall. But many
marked for transients, showed little survivors owed their lives to the
lasting improvement. The soldiers American units and to a German
were happy to see UNRRA take over Army field hospital that had arrived
care of the DPs in the fall of 1945 to give assistance. "Order replaced
and still happier to see the majority chaos," reported the commander of
of the displaced depart to their the evacuation hospital, "and it was
54
homes. gratifying to see the improvements in
53
the patients, both physically and men-
Surg, 2d Armored Division, Semiannual Rpt, 55
January-June 1945, p. 7. tally."
54
Quoted words from Surg, 29th Infantry Divi-
55
sion, Semiannual Rpt, January-June 1945, p. 8. See Quoted words from the 121st Evacuation Hos-
also Surg, 5th Armored Division, Semiannual Rpt, pital Semiannual Rpt, January-June 1945. See also
January-June 1945, and Surg, 4th Armored Divi- 120th Evacuation Hospital Semiannual Rpt, Janu-
sion, Semiannual Rpt, July-December 1945. Continued
572 EUROPEAN THEATER OF OPERATIONS
Most inmates, however, were still the western camps was an extermina-
behind wire when the Americans ar- tion facility, like Auschwitz and other
rived. April brought the opening of camps in the east, killing undesirables
two major concentration camps, or remained an important function. Rus-
rather camp systems, around Buchen- sian POWs were shot on occasion
wald and Dachau. In early May Army and, like Poles and Jews, used by Nazi
units "uncovered" (as the records doctors as human guinea pigs in bi-
usually say) Mauthausen, near the zarre experiments.
Austrian town of Linz, where Adolf In the spring of 1945 the primitive
Hitler had spent much of his discipline of the camps enforced by
boyhood. Meanwhile, British troops the SS broke down. The food ration,
captured two large camps at Bergen- always inadequate, apparently fell
Belsen in Hannover (Map 25). Medi- from about 1,000 calories a day to
cal conditions among many inmates 600 or less. Mains, broken in some
were outside the experience of the cases by Allied bombs, ceased to de-
medical personnel compelled to deal liver water. The invasion of the Reich
with them; the tasks they faced caused the SS to shuffle prisoners
proved to be loathsome and laborious
from one camp to another in unheat-
in the extreme.
The general history of the concen- ed boxcars or in forced marches
tration camps is well known. The afoot, to prevent their capture. Over-
first, the main camp at Dachau, was crowding increased in the barracks,
established in 1933, a few months where the well, the sick, and the dead
after the Nazis took power. During sprawled together indiscriminately.
the 1930s concentration camps served Fuel shortages slowed the inciner-
no purpose but to confine, torment, ation of bodies. Filled with people
and destroy enemies of the regime who were starving and ill, the remain-
and members of groups defined as ing camps became charnel houses,
antisocial. Inmates produced little, in whose images confronted an unbe-
order not to compete with free labor. lieving world in the photographs and
When war came, German conquests newsreels made by journalists who
56
brought an international influx of followed the Allied armies.
prisoners. By 1942 increasing short- Administratively, the concentration
ages of manpower in the Reich began camps fell first under the field armies
to transform camp inmates into true The early days following liberation
slave labor. Satellite camps sprang up. were chaotic. Quarantine was im-
At the war's end Dachau and many posed, and available medical units
other camps ran industries that were
56
profitable to the SS and important to Heinz Hoehne, The Order of the Death's Head: The
Story of Hitler's SS (New York: Coward-McCann,
the war effort. Among the prisoners, 1970), pp. 88 and 199-203. On Buchenwald, see
conditions of life remained bad be- Rpt, 3 May 45, sub: Visit to Buchenwald Concentra-
cause endless new labor was available tion Camp, Weimar, Germany, file 383.6 ETO (Bu-
chenwald Camp). On Bergen-Belsen, see William A.
to replace the dead. While none of Davis, "Typhus at Belsen," The American Journal of
Hygiene 46 (July 1947): 66-83. Information on the
ary-June 1945. Both in file 319.1-2, box 408, RG medical experiments in the camps may be found in
112, NARA. Chapter XVII of this volume.
574 EUROPEAN THEATER OF OPERATIONS
were thrown in, using their own sup- Morbidity ran about 25 percent of the
plies and calling on the armies for ra- 32,000-odd men and 300 women in
tions to feed the starving. At some the main camp. The prison hospital,
camps German medics were brought wrote one of the first doctors into
in; at others inmates were sent to ci- Dachau, was surprisingly clean and
vilian or German Army hospitals. orderly under inmate control.58
Throughout, former prisoners with Autopsies on the bodies of typhus
medical training were called upon to victims revealed widespread and
help their fellows. Inmate doctors, varied ills: local hemorrhages, liver
who had been working for years with and kidney damage, the mucosa of
virtually no supplies, provided knowl- the colon and rectum eroded or
edgeable assistance.57 deeply ulcerated, tuberculosis of the
Liberated prisoners suffered from lungs, and pneumonia. "The heart,"
complex interacting pathologies, ad- reported the 116th Evacuation Hospi-
vanced starvation, and frequently tal commander, "was generally pale
traumatic injury as well. Those at Bu- and very soft so that a finger could
chenwald were the first in a haunting easily be thrust through it." Doctors
army tens of thousands strong. concluded that the patients' typhus
"There was no adipose tissue on was fairly mild, but superimposed
these people," reported the Third upon tuberculosis, severe malnutri-
Army surgeon, "and nutritional tion, and chronic diarrhea. Under
edema . . . was present in such all indi- the ubiquity of death
conditions
viduals." At Dachau the workers had was hardly surprising. Troops of the
received enough food for survival, but 42d Infantry Division entering
other prisoners were in poor shape. Dachau found the last shipment of
Many exhibited ulcerated gums, prisoners still at the railhead—appar-
pallor, and swollen feet; their skin, ently Polish Jews from Birkenau who
thin and fragile, had been worn by were sent west to evade the Red
the hard wooden slabs they slept Army. Flatcars and open boxcars held
upon. Abrasions became infected, re- about 2,500 emaciated bodies, piled
sulting in boils, abscesses, and ulcers. on one another. "Their cadaverous
Small local infections, under camp arms and legs seem[ed] dispropor-
conditions, resulted in "massive non- tionately long compared to their
purulent edema . . . with sloughing
sunken abdomens, narrowed bony
and gangrene." Tuberculosis was chests, visible ribs, protruding shoul-
widespread, diarrhea ubiquitous.
der blades, and withered necks. . . . "
Some inmates, shot or beaten, bore
injured limbs in makeshift slings. 58
First quotation from Surg, Third U.S. Army,
Semiannual Rpt, January-June 1945, p. 139. Second
57
120th Evacuation Hospital Semiannual Rpt, Jan- quotation from Rpt, 1st Lt Marcus J. Smith, MC, to
uary-June 1945, file 319.1-2, box 408, RG 112, PostSurg, Dachau Concentration Camp, 5 May 45,
NARA; Havens, ed., Medical Consultants, p. 452; sub: Health and Sanitation Rpt, file 383.6 ETO
Press Release, "Underground Medical Unit Operat- (Dachau Camp), in Source Materials Collected by
ed in Nazi Prison Camp," file 383.6 ETO (Buchen- Col M. P. Rudolph, MC, box 312, RG 112, NARA.
wald Camp). The head inmate surgeon at Buchen- See also Marcus J. Smith, The Harrowing of Hell:
wald had unique status: The SS guards, respecting Dachau (Albuquerque: University of New Mexico
his skill, had required him to treat their own men. Press, 1972), p. 91.
VICTIMS OF WAR 575
LAST SHIPMENT TO DACHAU. The bodies of starved prisoners, who died en route from
another camp, lie grotesquely in a boxcar.
Some wore striped pajama-like gar- railway ran from the camp to the cre-
ments; many were naked. Bodies and matory. Each morning, those who had
freight cars were lightly coated with died the night before were collected,
59
white morning frost. dumped into the cars, and pushed to
Survivors gave their liberators the furnace. When the Americans ar-
guided tours of the camps. Living rived, fifteen or twenty naked skeletal
quarters were squalid: "The well, the bodies lay stacked and waiting to be
sick, the dying, and the dead lie next burned. "It was a weird place," re-
to each other in ... poorly ventilat- called a battalion surgeon, "the crack-
ed, unheated, dark, stinking build- ling furnace and the naked corpses
ings." The dead were everywhere. A with their lolling heads and stiff arms
nurse at Dachau saw bodies in "huge and legs. ... I opened the door of
stacks like so much kindling wood." the blazing furnace and inside I saw
Each camp had a crematory, for, as three corpses sizzling and burning." 60
the universal joke went, the only way
60
out was through the chimney. At First quotation from 116th Evacuation Hospital
Flossenbuerg a little hand-operated Semiannual Rpt, January-June 1945, an., p. 2.
Second quotation from Smith, Dachau, p. 80 (see
also pp. 90-91). Third quotation from William M.
59
First quotation from 116th Evacuation Hospital McConahey, Battalion Surgeon (Rochester, Minn.: Pri-
Semiannual Rpt, January-June 1945, an., p. 12. vately published, 1966), p. 145. See Surg, Seventh
Second quotation from Smith, Dachau, p. 79. U.S. Army, Semiannual Rpt, January-June 1945.
576 EUROPEAN THEATER OF OPERATIONS
and beating to death those they At Dachau the 116th and 127th
found. Some accounts of the Dachau Evacuation Hospitals worked in the
liberation assert that American troops SS barracks, after tearing out parti-
machine-gunned several hundred tions to make large wards. The kitch-
61
guards. ens of the excellent SS mess hall pro-
Care of the sick followed essentially vided food for patients and staff.
the same pattern in all camps. At Bu- From this center, order began to
chenwald the 120th Evacuation Hos-
spread to the shambles outside.
pital took over the SS barracks as a
Thirty-two thousand prisoners were
hospital: sturdy buildings, with la-
crowded into an area intended for
trines and heated showers. Inmates
had already occupied the barracks, about 10,000; water, sewers, and
however, and in consequence the fur- lights had all failed; starving inmates
niture, rugs and bedding were infest- had broken into SS warehouses and
ed with lice. Hospital personnel gorged themselves on food they could
stripped the rooms and scrubbed not digest. A sanitary company, a
walls and tile floors with soap and quartermaster laundry, an engineer
water. Canvas cots were moved in and unit, and a fumigation and bath unit
covered with German or American arrived to help out. Healthy inmates
army blankets. German civilians were set up an International Prisoners
drafted and instructed in the use of Committee to present their griev-
ances to the Americans, to defuse na-
61
116th Evacuation Hospital Semiannual Rpt, Jan- tional antagonisms, and to assist the
uary-June 1945, an., p. 5. See also Howard A. cleanup. Inmates removed rubbish,
Buechner, Dachau: The Hour of the Avenger (New Orle- and the committee ensured that all
ans: Thunderbird Press, 1986), and Nerin E. Gun,
The Day of the Americans (New York: Fleet Publishing
62
Co., 1966). Buechner was a 45th Division medical 120th Evacuation Hospital Semiannual Rpt, Jan-
officer, and Gun was an inmate of Dachau at the uary-June 1945, p. 20, file 319.1-2, box 408, RG
time. 112, NARA.
VICTIMS OF WAR 577
water was boiled, until chlorination of The typhus threat caused the Sev-
a restored water supply could begin. enth Army, upon taking over the
By the end of May it was possible to camp, to quarantine it and appoint a
assume, for the first time in Dachau's camp surgeon. Soon representatives
twelve-year history as a concentration of the Typhus Commission arrived to
camp, that the well would not need- observe, investigate, and assist. A
lessly become sick. commission officer reached Dachau in
Yet scenes within the hospitals were May and took over a section of one
grim. When the Seventh Army liber- ward for study and treatment of se-
ated the camp, about 140 inmates lected cases. The commission ar-
were dying every day. The 127th ranged for supplies of vaccine and
Evacuation Hospital admitted about para-aminobenzoic acid, then the
most effective medicine known for
1,900 patients during May, of whom
treating the disease. Another of its of-
900 had multiple diseases, and an-
ficers assisted the British at Bergen-
other 260 in June. From early May Belsen. Abandoning an early attempt
until mid-June the unit lost 246 pa- to do research under the conditions
tients. The 116th Evacuation Hospital of Dachau, the commission instead
admitted over 2,000 patients, of emphasized measures of treatment
whom nearly 1,800 either had typhus and especially of prevention. General
or were suspect. Bacillary dysentery Fox, its field director, declared that
was common. During May 140 pa- the concentration camp represented a
tients died of typhus, 28 of tuberculo- "menace to the whole of northwest-
sis, 15 of starvation, and 7 of enteritis ern Europe" because of conditions
(inflammation of the bowels). Malnu- outside the barbed wire as well as
trition was a contributory factor in all within.64
deaths, and the hospital staff strug- As stories of the camp spread,
gled not only to feed their patients— Allied journalists arrived to explore
at first GI rations supplemented by the homes of the SS officers and the
milk chocolate, and eggnog, and later scoured but still oppressive and ill-
German Army rations—but also to smelling barracks. A woman reporter,
keep them from eating too much. Elizabeth May Craig, penned a de-
Multivitamins were given to counter- scription of the place on V-E Day. At
act the effects of starvation, plasma to the 116th Evacuation Hospital the
increase body proteins, and intrave- nurses wore olive drab trousers and
nous fluids to reestablish fluid bal- shirts, aprons and gauze masks. As a
penicillin squad was giving injections,
ance. All who survived gained weight
its blonde leader complained: "I can't
rapidly, and within two weeks the
living skeletons that had filled the 64
Ibid., an., p. 7; Hoff, ed., Arthropodborne Diseases
camp at the end of April had recov- Other Than Malaria, pp. 206-07; Davis, "Typhus at
Belsen." In Records of the USA Typhus Commis-
ered their human appearance.63 sion, RG 112, NARA, see Ltr, Brig Gen Bayne-Jones
to Col K. R. Lundeberg, 7 Sep 44, box 69, and Ltr
63
116th Evacuation Hospital Semiannual Rpt, Jan- (source of quotation), Fox to Bayne-Jones, 18 May
uary-June 1945, an., p. 8. 45, box 70.
578 EUROPEAN THEATER OF OPERATIONS
find enough muscle to get a hypoder- were left to record in official reports,
mic in." A surgeon remarked that he private letters, and diaries their recol-
could not perform operations; the lections of a situation that is fortu-
shock would kill the patients. The nately without an exact parallel in
chief nurse, in a soft South Carolina recent, or perhaps any, history.
drawl, told Craig that as yet no hospi- A system of organized inhumanity
talized patients had recovered. fell apart in a chaos almost worse
"There is no disposition except than what had gone before. Uncover-
death," she said.
65
ing the camps and political prisons of
Gradually Dachau was cleared, the the Third Reich revealed conditions
epidemic controlled, the living placed to which even a war-jaded world re-
under treatment, and the dead sponded with disbelief. Medical work
buried. Cheering groups of prisoners was grim and summary, but its signifi-
began to depart for home. Allied sol- cance went beyond even the saving of
diers who had liberated the camp and lives. The compassionate treatment of
Army medics who had worked there the camp survivors marked the resto-
ration of moral order amid the worst
68
116th Evacuation Hospital Semiannual Rpt, Jan- scenes that Nazi tyranny had been
uary-June 1945, an. able to devise.
CHAPTER XVII
typhus cases, and Maj. David Greely service and the reemergence of a civil
of the United States of America public health establishment. Kenner
Typhus Commission drew up a com- made public health a function of the
prehensive program that, once ac- ECA detachments attached to the two
cepted by the Americans, Russians, military districts into which the Amer-
British, and French, became part of ican Zone had been divided—the
the city's law. Under direction of the Western, under the Third Army, with
Central Health Office, dusting teams headquarters at Munich; and the East-
and medical workers in every district ern, under the Seventh Army at Hei-
were immunized; refugees and bath- delberg. G-5, USFET, set policy; the
houses were deloused; all cases were chief surgeon provided overall techni-
isolated; and their contacts were cal supervision. Each district com-
dusted and observed.4 mander, through his own G-5 sec-
By such vigorous action the occupy- tion, set policy for public health work
ing powers suppressed the immediate in his own area, while the military dis-
threat of epidemic outbreaks. Aiding
them was the tradition of discipline trict surgeon, who was also the field
among the Germans, who, to the sur- army surgeon, provided technical
prise of the Americans, remained oversight. To ensure adequate per-
law-abiding except in the areas of sonnel, General Eisenhower ordered
prostitution and the black market. En- that field command medical person-
couraged by the Potsdam agreement, nel were to be made available to the
the military government sought the military government as necessary.
maintenance of good health and med- With the approval of military public
ical services by the Germans. With health experts, the German system of
combat over and conditions less organizing public health began to
threatening, the influence of military revive at the local level, and by Sep-
government specialists grew steadily, tember 1945 efforts were under way
and in August Kenner decided to re- to reestablish the German Red
5
lieve the field commands of direct re- Cross.
sponsibility for public health. But the revival of the German med-
The result was the emergence in ical profession—an absolutely essen-
late summer of a reorganized medical tial element in restoring and safe-
guarding public health—was a more
4
Ziemke, Occupation of Germany, p. 304; Rpt, USA/ complex problem. Many factors con-
MC, 3 Aug 45, app. A, file U.S. Group Control
Council, and Ltr, Greely to Bayne-Jones, 24 Aug 45,
spired to weaken the profession's
file Paris #III, box 70, Records of the USA Typhus
5
Commission, RG 112, NARA; Memo, HQ, USFET, Directive, HQ, USFET (to CGs, Eastern and
7 Sep 45, sub: Program for the Prevention and Con- Western Military Districts and Berlin District), 6
trol of Typhus Throughout Berlin, file Preventive Aug 45, sub: Public Health Functions in the U.S.
Medicine, box 471, and HQ, USFET, Weekly MC Zone of Germany, in Kenner Diary, bk. 3, following
Rpt, 20 Jul 45, file Weekly CA/MG Rpts, box 541, p. 408. See also Memo, Wilson, DepC, PHB, G-5,
OMGUS, PHB/PWB, RG 260, NARA. For a general USFET, to DepACofS, G-5, USFET, 21 Aug 45,
study of bombing and German health, see Special sub: Military Government Conference, 9 August
Rpt, HQ, USFET, January 1947, sub: The Effect of 1945, file Public Health, box 471; HQ, USFET
Bombing on Health and Medical Care in Germany, (OMGUS), Weekly Rpts, 9 Aug and 21 Sep 45, file
file Preventive Medicine (General), box 541, Weekly CA/MG Rpts, box 541. Both in OMGUS,
OMGUS, PHB/PWB, RG 260, NARA. PHB/PWB, RG 260, NARA.
FROM WAR TO OCCUPATION 583
provide. The VD rate among former XIII 12th Army Group Report of Operations, vol.
(Medical Section), pp. 244-45 and 256-58;
Padget Interv, 1 August 45, box 223, RG 112,
8
Ziemke, Occupation of Germany, pp. 182 and 387- NARA.
11
88. As quoted in Ziemke, Occupation of Germany, p.
9
As quoted in ibid., p. 220. 324.
FROM WAR TO OCCUPATION 585
considered evidence of fraternization The end of nonfraternization did
at first produced no clear policy. not, however, halt the VD epidemic.
Some commanders refused to set up Despite the rapid repatriation of hun-
prophylactic stations lest soldiers be dreds of thousands of DPs during the
encouraged to fraternize, and some summer, some 500,000 remained in
men were court-martialed and fined Germany, at least half nonrepatriable
$65 merely for going on sick call with for political reasons. The fundamental
venereal disease. Contradictions source of the epidemic, however, was
abounded, as SHAEF's judge advo- the poverty of the Germans that made
cate pointed out in May: sex easy to obtain, as well as the con-
The very establishment of prophylactic fusion and upheaval that attended the
stations and the directives requiring re- organizational changes in the theater
ports of the contraction of venereal dis- and the dispatch of troops to the Pa-
ease are indicative of the realistic view
which the Army has heretofore taken of cific or to home. Commands disap-
the problem. Soldiers will fraternize in peared, boundaries shifted, new orga-
the manner indicated, in spite of any nizations were erected in the place of
rules to the contrary, and should they, old, and green troops replaced veter-
fearful of being tried by court martial for
ans. Control of venereal disease had
such fraternization, avoid the use of pro-
phylaxis or checkup, venereal disease mayalways depended upon command re-
become 12rampant and completely out of sponsibility. For the moment, lines of
control. authority were hopelessly confused,
In fact, the VD rate among troops in and low-score men 14
were undisciplined
the theater rose from 56 in April to and disorderly. To add to the prob-
177 per 1,000 per year in August lem, the War Department suddenly
1945, and to 233 in January 1946. withdrew the familiar V-Packette pro-
On 4 June, bowing to the inevita- phylactic kit and substituted a new,
ble, SHAEF issued orders that con- supposedly more effective, item with-
tracting venereal disease could not be out providing adequate supplies. Only
used either directly or indirectly as penicillin therapy prevented venereal
evidence of fraternization. In July disease from becoming a serious
General Eisenhower modified theater drain on job performance, for person-
rules to allow fraternization in public nel turbulence, supply failures, and
places, and on 1 October the policy the conditions of postwar Germany
ended. Nonfraternization split and defeated the traditional methods of
sank upon the reef of sex, but not prevention.
until it had allowed the Germans,
during the particularly trying year, to January-July 1945, VD Control Branch sec., p. 1;
Ltr, HQ, ETOUSA, to CGs of Major Commands, 4
enjoy the spectacle of their conquer- Jun 45, sub: Policy on Relations Between Allied Oc-
ors "engaged in the most widespread cupying Forces and Inhabitants of Germany, in 12th
violation of their own laws since Pro- Army Group Report of Operations, vol. XIII (Medi-
13 cal Section), pp. 225-29. VD rates are given in Es-
hibition." sential Technical Medical Data Rpts, HQ, TSFET,
October 1945 and April 1946, boxes 36 and 37, file
12
Ibid., p. 325. 350.05, RG 112, NARA.
13 14
The subject of redeployment is covered later in
Ibid., p. 324. See also Preventive Medicine Divi-
sion, OofCSurg, HQ, ETOUSA, Semiannual Rpt, this chapter.
586 EUROPEAN THEATER OF OPERATIONS
With good reason, the military gov- The most serious long-run danger
ernment sought to attack the VD to German health was the shortage of
problem among civilians. In August food. The medics could do little but
USFET directed compliance with a monitor the situation. Apparently, oc-
1927 public health law, enacted by cupation authorities did not at first
the Weimar Republic. As a result, fa- grasp the dimensions of the problem.
cilities for isolation and treatment of During the war German civilians had
victims were established in hospitals, fared better than those of conquered
physicians were ordered to report nations. Especially in towns and small
cases, and German health officials cities that had escaped bombing,
were tasked with promoting a VD survey teams in the spring and
education program. Because penicillin summer had found shops well stocked
was not yet available for German with basic foods and streets thronged
use, treatment for syphilis followed with people who appeared adequately
the old course, with patients taking clothed and nourished.
arsenicals or mercury preparations. However, wrecked transport sys-
Gonorrhea patients received sulfa tems had, in fact, created a spotty pat-
drugs; unfortunately, many cases re- tern of local excess and local need.
sisted treatment, and hospital space Early reports from the cities were
set aside for venereal disease cases bleak. In April a nutrition survey
filled rapidly, all the more so because team, sent by ETOUSA, had found
shelter and food were available there. only a ten-day supply of food on hand
On 28 October the Army made peni- in major cities; in industrial Duessel-
cillin available to the detention hospi- dorf and Essen children were in poor
tals on the grounds that curing gon- condition and civilians were receiving
orrhea was essential to the protection a basic ration of only 1,000 calories a
15
of American troops. The detention day. But Allied policy-makers at the
wards and buildings now cleared rap- time were convinced that the problem
idly, and soon cases were being treat- of the German economy was to pre-
ed on an outpatient basis, enabling vent its resurgence, rather than to re-
working-men who caught the disease store it to meet the calamitous
to seek treatment without leaving changes that defeat entailed.
their families to starve. One ironic The Occupation intensified supply
side effect of penicillin treatment was problems by drawing arbitrary mili-
noted: Prostitutes were able to ply tary boundaries that divided farm
their trade with briefer interruptions
from market areas. Remaining food
because their "turn-around time" in
16 stocks in the cities were looted by
hospitals had been shortened.
Allied troops, DPs, and the Germans
15
Because penicillin also cured other and more
themselves. And throughout western
serious illnesses, the military government instituted
strict controls to prevent German physicians from Gonorrhea Among Civilians, file Penicillin Direc-
diverting it for unauthorized purposes. tives, box 539, OMGUS, PHB/PWB, RG 260,
16
Quoted words from Ziemke, Occupation of Germa- NARA; Morrison C. Stayer and William A. Brum-
ny, p. 422. See also Directive, HQ, USFET (to CGs, field, Jr., "Venereal Disease Control in the United
Western and Eastern Military Districts and Berlin States Occupied Zone of Germany," The Military Sur-
District), 28 Oct 45, sub: Penicillin for Treatment of geon 100 (May 1947): 375-81.
FROM WAR TO OCCUPATION 587
Germany, an area too heavily populat- 2,800 calories a day, normal consum-
ed to feed itself even in normal times, ers received rations whose caloric
fields lay abandoned while the DPs value apparently varied from about
who had worked them took to the 800 to about 1,150. As a result of
roads and the German men who had quantitative and qualitative deficien-
plowed and harvested them before cies, avitaminosis and marked weight
the war sat in prison pens.17 loss had already appeared in both
At the end of August Maj. Gen. adults and children. The inevitable
Morrison C. Stayer, director of Public consequence of hunger was a vast
Health and Welfare for the military black market, to which farmers sent
government, reported that nutritional their surplus crops and city dwellers
survey teams had found "60 percent
sacrificed their prized possessions.
of the Germans living on a diet that
GIs, too, were quick to make money
would inevitably lead to diseases
caused by malnutrition." Though by selling food and cigarettes, and as
workers doing heavy labor got up to a consequence Quartermaster depots
suffered major losses. In this way
17
12th Army Group Report of Operations, vol. Americans supported Germans with
XIII (Medical Section), pp. 267-74 and 280-82. Army food supplies, but in such a way
588 EUROPEAN THEATER OF OPERATIONS
as to allow both German and Ameri- provided imports to maintain the new
can criminals to profit in the proc- ration. An expected influx of German
ess.18 refugees from the East did not mate-
In October G-5, USFET, summa- rialize until late in the winter. Many
rized bleakly the nutritional state of individual Americans proved to be
the civil population in the American more generous to their former en-
Zone: The worst conditions were emies than the formal policies of their
among children, pregnant and nurs- government might have suggested.
ing women, and city dwellers. Street Private contributors in the United
weighing indicated losses among States organized under the Council of
males of up to 13 percent of body Relief Agencies Licensed To Operate
weight, depending on age, and up to in Germany and, with official sanc-
15 percent among women. Vitamin tion, consigned substantial tonnages
and protein deficiencies were also ob- of food and medical supplies to
served. The worst conditions were in German church and labor groups. By
Berlin; the best, as might be expect- the spring of 1946 a German Central
ed, in the rural regions of Bavaria. Committee for the Distribution of
In general, no reserves of body weight Foreign Charitable Gifts was in oper-
exist and caloric intakes remain inad- ation, and the military government
equate. Protein is often relatively, if not had begun to accept contributions
absolutely, inadequate. Such improve-
ment as has occurred is mainly in vita- from non-American voluntary agen-
mins and minerals, the cumulative effect cies, notably in Switzerland. Most
of the summer's supply of non-rationed gifts came from people of German
fruit and vegetables, a source which background and language, and from
cannot be depended on in the coming labor and religious groups, many of
months. The effects of deficiencies are
cumulative and often not at once appar- which—like the Mennonites and Luth-
ent.19 erans—had ties to a Germany that
long antedated Hitler.20
Vigorous efforts by Clay and the Nevertheless, hand-to-mouth living
Germans produced supplies to raise was the rule. By March 1946 food
the ration to an official 1,550 calories. stocks were available for only sixty
Yet, as matters developed, the Ameri- days, and on 1 April Clay was obliged
can Zone squeaked past the time of to reduce the ration again, under
worst privation as much by luck as by
pressure from a worldwide food
policy. In contrast to the previous shortage caused by the disruptions of
year, the winter was mild. The harvest
the war. In May and June the normal
was unexpectedly good. Washington
consumer received only about 1,180
18
As quoted in Ziemke, Occupation of Germany, p.
calories a day, and even this low level
352. See also p. 353. Stayer's position is misidenti-
20
fied in this source. On Stayer, see Name-Rank file, Ltr, Edward M. O'Connor to Lt Col Alden E.
CMH. Bevier, PH&W Branch, OMGUS, 25 Mar 46, sub:
19
Special Rpt, HQ, USFET, 3 Oct 45, sub: Sum- CRALOG, in file Public Health, box 472. See also
mary of Nutritional State of the Civilian Population Memo, PH&W Branch, OMGUS, 4 Mar 46, sub: Im-
in the American Zone of Germany, file CA/MG portation of Relief Supplies, in file Centre d'En-
Rpts, box 541, OMGUS, PHB/PWB, RG 260, tr'Aide, box 477. Both in OMGUS, PHB/PWB, RG
NARA. 260, NARA.
FROM WAR TO OCCUPATION 589
Medical Intelligence
While most Army medical person-
nel concerned themselves with the
health of the troops, or with that of
the civil population, a select group
helped to carry out an elaborate pro-
gram of technical intelligence. During
the war medical intelligence units had
developed both in the surgeon gener-
al's office and in the medical sections
of theater and field commands. In
Washington the wartime mission of
collecting health information on for-
eign countries grew into a complex
effort, highly integrated with the
Army Staff's other technical intelli-
gence-gathering programs. Ultimate-
ly, the once modest files of the sur-
geon general's unit constituted a
worldwide geography of disease. On
the war fronts medical matériel was
collected and forwarded to the Medi-
FOOD ASSISTANCE FOR GERMAN cal Equipment Laboratory at Carlisle
REFUGEES from the East Barracks, Pennsylvania, where cap-
tured drugs, biologicals, and equip-
could be sustained only by distribut- ment were assembled, tested, and
ing Army surplus stocks. In May a analyzed. In ETOUSA Hawley's Medi-
health survey in Mannheim showed cal Intelligence Branch sought out in-
that 60 percent of infants had rickets, formation on German diseases and
and random weighing of adults pro- methods of control, on enemy casual-
vided evidence of malnutrition in the ty statistics, and on the Nazi biologi-
general population as well. A famine cal warfare program. In the 12th
had been avoided, but only a general Army Group an elaborate field pro-
revival of the German economy could gram developed, as army surgeons at-
prevent recurrence of the danger. tached technical intelligence teams to
Though a new crisis would strike in their S-2 sections and the gathering
the spring of 1947, the best sign for of information and matériel extended
the future of the American Zone was down to the medical groups and bat-
22
that the United States government talions.
had tacitly come to accept the need 22
for such a revival.21 See Preventive Medicine Division (or Service),
OSG, WD, Annual Rpts, 1943-45, boxes 17 and 18,
RG 112, NARA; James M. Simmons et al., Global Ep-
21
Lucius D. Clay, Decision in Germany (Garden City, idemiology: Geography of Disease and Sanitation (Philadel-
N.Y.: Doubleday, 1950), pp. 266-69. Continued
590 EUROPEAN THEATER OF OPERATIONS
Who Goes Where, When, and How? pended. The logistical problem was
immense, but official policy made it
The work done by Army doctors more complex still. For years the
ranged from protecting the health of Army had been developing a scheme
the German people to uncovering the based on the general principle that
details of war crimes. But for most those who had fought longest and
medical personnel, officers and enlist-
hardest should be returned home for
ed alike, the months that followed
discharge. Termed readjustment, this
V-E Day had little to do with the con-
quered people. For the majority the attempt at fairness led quickly to
central concerns were the war that monumental practical difficulties and
still went on in the Pacific, and the endless paperwork. When combined
seemingly endless processes of rede- with the transfer of units, it created a
ployment and readjustment that ac- logistical nightmare.40
companied the transfer of troops to The Army divided units of the Eu-
battlegrounds on the other side of the ropean Theater into four categories.
world. In the first were those (like the Third
Invasion of the Japanese home is- and Seventh Armies) designated as
lands impended, and the desperate occupation forces. In the second were
struggle waged by the defenders of those overseas less than one year that
Okinawa in the spring of 1945 prom- were to be transferred to the Pacific,
ised resistance of suicidal fury. But either directly or by way of the United
for some fortunate veterans of the States. In the third were units to be
European and African fighting, demo- organized in the theater, either as oc-
bilization rather than a new war cupation forces or as transferees to
seemed to be in the cards. In particu- the Pacific. In the fourth were units
lar, the surgeon general was feeling with long overseas service that were
"urgent pressure by Congress and ci- to remain in the theater only while
vilian communities to relieve from needed and then to be returned to
active duty all medical officers not ac- the zone of interior for demobiliza-
tually professionally engaged." Faced tion. Green troops from American
with demands both from the Pacific training camps would arrive to re-
and from the home front, General
place departing veterans. Millions of
Kirk drew the obvious conclusions:
tons of equipment awaited crating
"ETO repeat ETO—MTO repeat
MTO—alone is [sic] surplus." 39 40
On the planning process for redeployment, see
Medical Department personnel Readjustment Regulation 1-1, WD, 15 Feb 45, sub:
formed, of course, only a small part Personnel Plan for Readjustment of Military Person-
of the vast redeployment that im- nel After the Defeat of Germany; Readjustment
Regulation 1-2, WD, 15 Sep 44 and 5 Mar 45 (rev.),
sub: Personnel Procedures for Readjustment Move-
the liberation of Dachau, apparently on Himmler's ments, file HD 300, HQ, ETOUSA; and Basic Plan
orders, either because he had attempted to fake ex- for Redeployment for Readjustment, 31 May 45. All
perimental results or because he knew too much. in file Redeployment Directives ETO '45. See also
See also ibid., pp. 41 and 47; A. Mitscherlich and F. Rpt, Richards and Fenton to CSurg, HQ, ETOUSA,
Mielke, The Death Doctors, trans. James Cleugh 15 Apr 45, sub: Visit to Headquarters, Army Service
(London: Elek Books, 1962), pp. 23-91. Forces, on Redeployment Problems, file 334 (Rede-
39
TWX Conference, 7 Aug 45. ployment Problems).
FROM WAR TO OCCUPATION 597
with the individual soldier, by de- cers before the surrender of Japan,
mobilizing those with the longest and their point score had to be taken into
most difficult service. The Army account in determining whether they
planned a partial demobilization of would serve again in combat. Provid-
about 1 million men to follow the ed that no pressing need existed, the
defeat of Germany. Not only units but high-score officer might reasonably
men and women had to be catego- hope for early discharge.
43
rized, on the basis of individual ad- But how, in practice, was readjust-
justed service ratings (ASR). Elements ment to be combined with redeploy-
of this point score included total time ment? Personnel officers from major
of service since 1941, number of commands—the Army Air Forces, the
months served overseas, combat ser- field armies and army groups, and the
vice, decorations, and number of de-
pendent children. With 85 points an 43
John C. Sparrow, History of Personnel Demobiliza-
enlisted man or woman would be dis- tion in the U.S. Army, DA Phamphlet 20-210 (Wash-
charged; with fewer, further service ington, D.C., 1954), pp. 64-84. The critical score
was reduced to 80 points after V-J Day and, in re-
would be required. While no similar sponse to political pressures, repeated downward
critical score was established for offi- revisions followed.
FROM WAR TO OCCUPATION 599
for each element on a scale that ran posed of. The first task was to reverse
from "normal" to "serious defect." the schedule of deployment. Instead
The resulting score, in turn, was of hastening low-score units to the
translated into the profile: A or B in- Pacific, the theater must retain them.
dicated General Assignment troops; High-score units took their place in
C, Limited Assignment troops; and D, the pipeline, bypassing the Assembly
disqualified for future assignment. Area Command and moving directly
Doctors involved in the work needed to ports for shipment home. While
sharp eyes, not only to spot malinger- most Category II units returned to
ers but to prevent collusion between their former commands, a few, al-
commanding officers and unit sur- ready in transit to the Pacific, were di-
geons who sought to rid their units of verted home to the indignation of
men who were physically fit but mal- high-score men still awaiting trans-
adjusted. While profiling implied portation in Europe. By the end of
much tedious routine work, and while September the categories had been
errors did occur (the chief surgeon abandoned, and the War Department
cited a frostbite victim whose L-3 redesignated its units in Europe as
rating did not prevent a reinforce- occupation forces; as redeployment
ment depot from rating his general forces, whose next stop was home; or
condition P-1), the system was funda- as liquidation forces, technical service
mentally simple and workable, a for- units whose special task consisted in
tunate circumstance under the condi- closing out facilities that were no
tions that existed in the theater longer needed.50
during the summer of 1945.49 Under the new dispensation, the
ASR continued to be of some impor-
A New Upheaval tance. Those with the highest scores
supposedly returned home; those with
Army planners anticipated that a
the middling scores (60-79 points)
year would elapse between the sur-
served as liquidation forces; and those
render of Germany and the fall of
with the lowest scores, along with
Japan. The explosion of two atomic
professional soldiers who volunteered
bombs during August 1945 left the
to stay in Europe, entered the Occu-
whole structure of planning—for par-
pation. However, theory often failed
tial demobilization, systematic read-
to square with practice. Because the
justment, the Pacific buildup, and the
theater had precipitately shipped out
invasion of the enemy's home is-
its lowest-score men, many were now
lands—one ruin among many.
permanently lost to the occupation
The vast medical establishment
forces that needed them. Their loss,
built for the war must now, in large
the departure of high-score person-
part, be collapsed like a tent and dis-
nel, and normal attrition caused by
49
Charles M. Wiltse, ed., Physical Standards in
sickness, compassionate leaves, and
World War II, Medical Department, United States
50
Army in World War II (Washington, D.C.: Office of Resume of Activities of Divisions of Medical
the Surgeon General, Department of the Army, Section, HQ, TSFET, p. 1; Directive, HQ, USFET,
1967), pp. 68-71; Surg, Channel Base Section, Hist, 6 Oct 45, Redeployment and Readjustment Follow-
January-June 1945, p. 6. ing Cessation of Hostilities.
602 EUROPEAN THEATER OF OPERATIONS
Kenner, "ten hospital units were or- tria it expanded. In August 1945 the
dered to be ready for movement American Zone of Occupation was
within ten days." Indecision, followed created in Hitler's homeland, bring-
by sudden demands for mass move- ing the 124th General Hospital to
ment, posed special problems to med- Salzburg, the 110th Station Hospital
ical units that had to assist the proc- to Vienna, and a medical depot to
57
essing of others. Wels. Revised post-V-J Day plans for
Disposition of patients depended hospitalization in Germany provided
primarily on whether or not they were 38 hospital units to serve the occupa-
battle casualties. The latter departed tion forces, including 8 general hospi-
quickly for home, 42,000 in May tals, 10 field hospitals, and 1 conva-
alone. RAMPs likewise headed for the lescent facility. This was a far cry
zone of interior. On the other hand, from V-E Day, when the theater had
the theater had obvious reasons to contained 200 fixed hospitals, with
retain patients from among its occu-
195,000 beds; 118 evacuation, field,
pation troops and, despite the hospi-
tal closings, ample resources to do so. and convalescent hospitals, with
Normally, few who were injured 63,000 mobile T/O beds; and over
during peacetime found any quick 700 other medical units of all types.
road home. For this reason, evacu- And in time the new estimates were
ation totals fell rapidly after the de- revised downward as well. By January
parture of the battle wounded. By 1946 the theater held 35 evacuation,
autumn the theater was virtually field, and convalescent hospitals, with
empty of the men whose injuries had 19,955 beds; of these, 16 were non-
helped to bring the victory. However, operational, awaiting redeployment or
a considerable patient load remained. inactivation. By mid-1946 only 4 such
Theater hospitals were filled with not units remained, with 1,600 beds, and
only the sick and those with common- 17 fixed hospitals, with 10,400. With
place injuries but also collectors who declining numbers went consolida-
shot themselves with souvenir weap- tion, as USFET took over the remain-
ons and new replacements who were ing medical services of the Mediterra-
59
ill-trained and unhandy in the use of nean Theater.
firearms. The disorderly state of Ger- Medical training was obliged to
many was also a source of injuries, for keep pace with the rapidly changing
some casualties resulted from "skir- course of redeployment and readjust-
mishes with the civil population or ment. With the coming of V-E Day,
Displaced Persons." 58 special courses began to prepare doc-
After the defeat of Japan the pace tors, nurses, administrators, and en-
of hospital closures slowed. In Ger- listed men for service in the Pacific.
many the system stabilized at a level Tropical medicine, the effects of Japa-
much reduced since the war; in Aus- nese weapons, and the problems of
57
sanitation and preventive medicine in
OofCSurg, HQ, TSFET, Quarterly Report of
Operations, 8 May-30 Sep 45, p. 31.
the Pacific were taught until 15
58
Chief Consultant in Surgery Rpt, January-June
59
1945, file Professional Services 1945/1, Shambora Resume of Activities of Divisions of Medical
Papers, MHI. Section, HQ, TSFET, Operations Division sec., p. 3.
FROM WAR TO OCCUPATION 607
August 1945, then dropped. But the proven so useful were being rapidly
main theme and most significant sent to their homes. Some discharged
problems of the time were those con- Americans also stayed in the theater
nected with the training of new arriv- to work as civilians in Army installa-
als in the theater. Of these there tions. But this, too, was a stopgap.
seemed to be no end. Heavy empha- To fill the gaps, hospitals turned
sis upon on-the-job training reflected increasingly to German civilians, es-
the haste and confusion of the proc- pecially for record-keeping and secre-
ess, which left no time (and very tarial work. Thus the 101st General
often, no qualified instructors) to give Hospital at Berlin on 10 July opened
formal courses in the many duties the a civilian labor office, which quickly
newcomers had to learn. The rapid hired 125 Germans as kitchen help-
loss of experts in all fields and in all ers, laborers, typists, electricians,
ranks made training more and more plumbers, cabinetmakers, tailors, and
burdensome and difficult as the year carpenters, among other jobs. As per-
advanced. Not only were veteran sonnel losses continued, more were
Americans leaving the hospitals, but hired, and by early December 651 ci-
the German POW workers who had vilians were being "used in almost
608 EUROPEAN THEATER OF OPERATIONS
Marseilles, Rouen, Le Havre, and trol. Between July and October the
Antwerp carried their authorized Supply Division prepared a master
equipment with them, replacing lost catalogue of some 6,400 medical
or unserviceable items from base sec- items, with standard nomenclature
tion depots in the staging areas. Hos- and stock numbers. Instead of han-
pitals turned in their equipment and, dling out supplies as needed, medical
in exchange, received complete pre- supply officers brought to former
packed assemblies that were prepared Wehrmacht stocks the same sort of
at the main depots and shipped to the centralized management that now
ports. Some of these procedures characterized the handling of Ameri-
changed after the Assembly Area can goods, and with it more effective
Command began to function, but the means of preventing losses and sup-
general shape of redeployment re- plying the needs of German civilians
mained unchanged until V-J Day. through the military government.
After that units no longer needed any Captured stocks were consolidated,
but basic equipment, for they no first to nine and then to six installa-
longer faced the possibility of combat. tions; by the end of September the
The outmovement of supplies dwin- total tonnage of medical supplies on
dled, and tonnages on hand in medi- hand had sunk from a high of 31,000
62
cal depots rose dramatically. tons to about 18,000.
Until V-J Day the War Department,
after receiving reports of goods on
In the onetime arsenal of Great
hand, forwarded shipping orders to Britain the seventeen depots of early
guide their redistribution. But after 1945 were rapidly consolidated to six
V-J Day most of the orders were can- after V-E Day. As the almost 100 hos-
celed. The theater now forwarded to pitals and dispensaries that had drawn
the Government Procurement Agency upon them began to close, and as
declarations of surplus items. Goods troops were shipped away, the famil-
obtained under reverse lend-lease iar outflow of matériel reversed. Clos-
were especially likely to be in this cat- ing hospitals turned in their equip-
egory, because the implements and ment, and the depots used turn-ins,
supplies were unsuitable for use in plus stocks on hand, to fabricate new
the United States. The wartime Allies assemblies for shipment to the Pacific
were the main beneficiaries of sur- and returned British items to the
pluses, though arranging for pay- Government Procurement Agency.
ments with their financially strapped While the three major duties of re-
governments interposed many delays. ceiving equipment, constructing as-
Nevertheless, even in 1945 USFET semblies, and issuing supplies went
turned over fifty 1,000-bed general on, the workers were themselves
hospital assemblies to the French gov- being pulled away for redeployment.
ernment, eight to the Belgian, and German POWs were essential during
three to the Dutch. this period, readying equipment for
Additionally, mountains of captured use against their former allies. Their
German war matériel required con- numbers rose steadily at Depot M-24,
the last to survive, until 1,200 prison-
62
Wiltse, ed., Medical Supply, pp. 383-87. ers and their American supervisors
FROM WAR TO OCCUPATION 611
was Marseilles. Lying amid an endem- quick replacements for the departing
ic malarious region, the old port city veterans, the Army reduced the
of southern France and its environs length of the basic training cycle for
were filled with natural breeding new recruits and pushed them quickly
places for Anopheles mosquitoes. through the training centers. Crowd-
The theater launched an all-out ma- ing, rapid turnover, and cold weather
laria prevention program, employing resulted in epidemic outbreaks of res-
airplanes to spray the local area with piratory complaints and childhood
DDT and forming a provisional ma- diseases—chiefly measles, German
laria control unit with Italian POWs measles, scarlet fever, mumps, and
to augment the effort on the ground. meningitis. Many men who were incu-
The program, supplemented by an in- bating such complaints filed aboard
formation campaign among the the troopships bound for Europe.
troops and by French authorities Here crowding was at its maximum
among the population, forestalled an during voyages prolonged by bad
outbreak. weather. Either on shipboard or soon
Diphtheria, a nagging problem after arrival many fell ill, spreading
since the previous year, remained a their contagions to others. To this sit-
medical burden during the Occupa- uation there was no fundamental
tion. No epidemic broke out, but inci- answer, except to isolate and treat the
dence remained high and the illness sick. By April the declining incidence
was highly virulent and life-threaten- in zone-of-interior training centers
ing, especially because of complica- promised a healthier crop of young
tions such as myocarditis (inflamma- soldiers to fill depleted formations
tion of the heart muscle). Indeed, overseas.
66
Other aspects of the buildup caused an transport system to handle the de-
sharp, though transient, difficulties. mands of war. Many general hospitals
The program of American hospital became separated from their gear,
construction in England burdened the and when they arrived near the front,
resources of the host nation, and the they were difficult to house and sub-
ensuing delays strained Hawley's pa- ject to enemy attack. In the event, the
tience. Demands by the theater for advanced general hospitals were used
medical personnel were large, per- in ways that had not been foreseen,
haps excessive, and the priorities ac- some as "little more than holding
corded to service troops in general units." 2 Hawley's somewhat cumber-
and to medics in particular were low. some and grandiose conceptions,
The result was a buildup that moved based perhaps on the experience of
by fits and starts. In succession, the World War I, might have fared better
theater had too few medical facilities under a commander like Britain's
for the rapidly expanding army; then Montgomery than under Bradley and
too few professionals to staff its hos- Patton, masters of improvisation and
pitals; and, finally, too many and too the armored thrust.
much of everything to support forces Indeed, as the chief surgeon's Op-
largely engaged in training, not fight- erations Division admitted after the
ing. war, the struggle waged in Europe
In its prime mission—the accumula- was so unlike World War I that "com-
tion of overwhelming forces to strike parison is hardly of value." The Medi-
a knockout blow—the buildup was a cal Department learned that availabil-
great success, in which the medical ity of fixed beds meant little in the
service shared fully. Yet some of absence of transport. Hence, reported
Hawley's decisions cast long shadows. the medical section of the General
Presented with some two and a half Board established after the war to
years to prepare his forces, the chief analyze the theater's accomplishments
surgeon was able to devise and imple- and failings, "the experience of the
ment a correspondingly elaborate European Theater of Operations indi-
plan of medical support. One of the cates that field hospitals and semi-
most questionable parts of the plan mobile, 750-bed evacuation hospitals
provided for the transportation of can be used much more effectively by
large numbers of fixed hospitals to the Advance Section . . . and that
the Continent after D-Day and for general hospitals should be estab-
their utilization as far forward as the lished only in the base, and possibly
Advance Section of the Communica- the intermediate, section of the Com-
tions Zone. Early movement forward munications Zone." 3
was essential for such units, because
2
general hospitals required time to Study No. 95, General Board, USFET, sub: Med-
make their bed strength operational. ical Service in the Communications Zone in the Eu-
ropean Theater of Operations, Medical Section, p.
But the effort to advance their com- 4, file HD 334.
plex equipment and marry it to the 3
Ibid., p. 3, file HD 334. The General Board was
units encountered great difficulties. established in ETOUSA in June 1945 and continued
by USFET. See GO No. 128, HQ, ETOUSA, 17 Jun
Hawley consistently overestimated the 45; GO No. 128, HQ, USFET, 7 Aug 45; and GO
ability of the bomb-shattered Europe- No. 312, HQ, USFET, 20 Nov 45.
616 EUROPEAN THEATER OF OPERATIONS
and all too many wounded were aban- Western Front in World War I seem-
doned to the enemy. Persistent short- ingly had little effect on the Ameri-
ages in vehicles and fuel stymied at- cans in the European Theater. Here
tempts to improve mobility. A special the same units were committed to
case was the air transport of the battle, month after month, by a thea-
wounded. The Royal Air Force ter that possessed a huge support
blocked efforts by the British Army to system but few reserve combat forces.
gain dedicated aircraft for medical The result was extremely wearing on
use. Ad hoc air evacuation developed the men who bore the brunt of the
anyway during the African campaigns, fighting.
with Britain's wounded riding trans- In February 1945 the 12th Army
port planes—many of them Ameri- Group surgeon, Colonel Gorby, invit-
can—on return trips. The usual prob- ed the attention of his superiors to
lems had to be faced in moving the the "continued high loss of manpow-
wounded to airfields, in holding er from combat exhaustion." Key per-
them, and in responding to the often sonnel were beginning to be affected,
unpredictable arrivals and departures including small unit leaders with ex-
of nondedicated aircraft. In the event, cellent records in combat. Studies
reforms in the British medical service carried out in the harassing condi-
were not fully implemented in any tions of the Italian campaign had al-
theater prior to the D-Day invasion,
ready shown that healthy men could
and throughout the war dedicated
medical aircraft never played the role endure combat stress only for 200-
they might have. The British Army as 240 days, after which their efficiency
a whole adapted less to the era of the declined sharply. Studies in the Euro-
blitzkrieg than that of any other major pean Theater confirmed these find-
combatant, and the Americans, ings, and Gorby compared the needs
during their years of residence in of men to those of trucks: "Relief
Great Britain, may well have learned after 130 to 150 combat days," he
bad lessons from their hosts as well as wrote, "is comparable to the 10,000
good ones.5 mile overhaul." He argued that rota-
Uniquely American, however, was tion was necessary to retain men in
the way that replacement policy inter- service. The British rotated personnel
acted with the stresses of the Europe- out of the line after 12 days, for a rest
an fighting to produce a large and, in period of 4 days, and the U.S. Air
substantial part, probably preventable Force rotated fliers home after a cer-
burden of neuropsychiatric casualties. tain number of combat missions. The
While some units had been hard used medical service in various units made
in all American wars, the experience provision for its own personnel, so far
of continuous combat by large forces as it was able, returning doctors in
against a determined, well-equipped front-line units to COMZ hospitals
enemy was rare in the nation's annals. and replacing them with men who
The lessons that other armies, includ- had not seen combat, and in some
ing the British, had learned on the cases rotating hard-pressed unit
medics at least out of the range of
5
Crew, AMS, Administration, 1:462-505 enemy shells. But no comprehensive
618 EUROPEAN THEATER OF OPERATIONS
system of rotation for the troops was rate of 3.2 percent, the lowest for any
installed during World War II in the theater of operations.7
6
theater. Not all of this distinguished record
Despite its errors, the theater could can be credited to the medical system
point to a superlative achievement in that Hawley built. The European
lifesaving under what were often most Theater profited by the experience of
difficult circumstances. The job it did other theaters in many respects, in-
was of staggering size. Direct hospital cluding the care of neuropsychiatric
admissions for all causes between 6 casualties. Above all, it was fortunate
June 1944 and 11 May 1945 totaled in its environment, despite the cold
1,052,659, by far the highest for any injuries that marked its one great fail-
theater of operations. A total of ure to heed and apply preventive
381,433 patients were evacuated to measures. Northwestern Europe was
the United Kingdom during that time: comparatively compact, contained
148,229 by sea and 233,204 by air. Of many friendly people who aided their
liberators, lacked jungles, and pos-
183,121 patients carried to the zone
sessed (even if in damaged form) all
of interior, 154,383 went by sea and
the physical substructure of industrial
28,738 by air. The First Army, with civilization.
249,090 casualties from all causes, Nevertheless, medical organization
suffered far more than the other field and clinical skill exploited the advan-
forces. The Third Army had 139,240; tages and compensated for many of
the Seventh Army, 80,099; and the the failings of the wartime environ-
Ninth Army, 54,877. Despite the evac- ment. In the early critical phases of
uation crisis of the winter, the theater evacuation, when the wounded man
could properly boast at the end of had to be dragged, carried, or assist-
1944 that "at no time have any of the ed to safety under fire, the basic con-
armies we supported been embar- tribution of the medics was physical
rassed, hindered, or their combat effi- strength and raw courage. Hailing the
ciency adversely affected by an inabil- aidman at the end of the struggle,
ity to clear themselves of casualties." Hawley's headquarters declared that
The European Theater enjoyed the he "must face the same danger as
lowest nonbattle and disease death armed troops without recourse or de-
rates of all overseas theaters. Of pendence upon weapons of any sort.
393,987 battle wounded admitted to He 'takes,' he never 'gives'—except
its hospitals, 12,523 died—a mortality that he gives himself in order that his
mission may be accomplished."8
6
Quoted words from Surg, 12th Army Group,
7
Hist, January-June 1945, an. 18, p. 1. See also ibid., Quoted words from Extract, Operations Rpt,
an. 19. A limited policy of granting leaves to the 1944, attached to Study No. 95, General Board,
United States and to rear areas was in force in the USFET, sub: Medical Service in the Communica-
European Theater at the time. On neuropsychiatric tions Zone in the European Theater of Operations,
rates, see Albert J. Glass and Robert J. Bernucci, Medical Section, file HD 334. See also Reister, ed.,
eds., Zone of Interior, Medical Department, United Medical Statistics, pp. 32 and 322-23.
8
States Army in World War II (Washington, D.C.: Operations Division, OofCSurg, HQ, ETOUSA,
Office of the Surgeon General, Department of the Semiannual Rpt, January-June 1945, p. 6. The fact
Army, 1966), p. 406. Continued
THE THEATER IN RETROSPECT 619
Above all, the technical competence pacted upon the battlefield. The de-
of the Medical Department could velopment of the blood program was
hardly be faulted. "In the ETO," a landmark, and the increased use of
Hawley was to admit later, "I never whole blood as well as plasma was
hurt for clinical talent but I was con- fundamental to medical success in
stantly hurting for leadership of this saving the lives of wounded men.9
talent half as good as the talent A distinctive feature of the theater
itself." Throughout the theater Regu- was the fact that virtually all its fight-
lar Army medical officers assumed ing was done in heavily populated
command positions, turning over areas. Among the Allied nations of
hands-on care to the highly qualified Europe, close ties developed between
civilians who, as reserve officers or as
the civil and military medical estab-
wartime volunteers, brought to the
lishments. Venereal disease control
Army a multitude of sophisticated
skills. Their efforts on behalf of the was a sensitive sociomedical issue that
wounded and sick were eased im- demanded tactful handling on the
mensely by new discoveries that Continent, as it had in Great Britain,
either accompanied the war or imme- in the face of social norms that varied
diately preceded it. The development drastically from one nation to the
of sulfa drugs in the late 1930s by next. Devastation by Allied bombs, as
French researchers exploiting a well as by German shells, left formi-
German discovery "opened the treas- dable problems in public health and
ure house of bacterial chemothera- disease prevention. Army medics
py," in the words of a recent historian trained in civil affairs took the lead in
of medicine. During the early 1940s confronting these problems, but com-
mass production methods turned pen- mand responsibility and the interven-
icillin, discovered in 1928, into a rev- tion of the field forces was essential
olutionary new weapon against bacte- to their solution.
rial infections and made it available to In Germany the Medical Depart-
the theater from D-Day on. The dis- ment met a situation new to American
covery in 1938 of the insecticidal armies: the surrender and imprison-
properties of DDT made control of ment of a whole enemy army, num-
typhus incomparably easier than in bering in the millions; the liberation
the past, and aided the control of of other millions of prisoners and dis-
mosquito-borne and fly-borne dis- placed persons; and the care of a
eases as well. The number of lives conquered people who were both in-
saved by these innovations alone was dustrialized and highly urbanized. Of-
beyond computation. The introduc- ficial American policy in the form of
tion of synthetic antimalarials and ad- nonfraternization and the initial deci-
vances in vascular surgery likewise im-
9
First quotation from Press Release, "Better Fed-
that the European Theater was the last theater to eral Medical Service," 13 Dec 49, box 5, General
see major combat apparently was the reason why Green's Office Reference Files, AGO, RG 112,
the basic studies on combat stress and preventive NARA. Second quotation from Harry F. Dowling,
psychiatry, which helped to prepare the way for Fighting Infection: Conquests of the Twentieth Century
later rotation policies, were all based on data from (Cambridge, Mass.: Harvard University Press, 1977),
the Mediterranean and Pacific theaters. p. 107.
620 EUROPEAN THEATER OF OPERATIONS
407, Records of the Adjutant Gener- alities and policy at a time when the
al's Office, 1917-, provided extensive theater's problems were still fresh in
human interest detail on division-level the minds of those who had been its
medical service. The reader should leaders. In addition, we conducted
note that, upon publication of this other very helpful interviews with
volume, all materials deposited in the Honorable Elliot Richardson, Col.
Center of Military History will be re- Virginia Brown, Col. Tom F. Whayne,
turned to the Army collection at Brig. Gen. Crawford F. Sams, Maj.
NARA for refiling into the appropri- Gen. Thomas J. Hartford, Brig. Gen.
ate record groups in accordance with Sam F. Seeley, Maj. Gen. Collin F.
NARA's record-keeping system. Vorder Bruegge, Jane Lee, Joseph A.
The sources in other repositories Gosman, M.D., Lester Wallman, M.D.,
are less voluminous but no less valua- and Herbert F. Wing. General Sams
ble. The collections of the U.S. Army also supplied a valuable manuscript
Military History Institute at Carlisle autobiography. Again, with the publi-
Barracks, Pennsylvania, were essential cation of this volume, these docu-
in many ways. This repository con- ments (except Sams' manuscript) will
tains numerous medical unit histories be transferred to Carlisle or retired to
and also the papers of Paul R. NARA.
Hawley, Charles H. Beasley, John C. The emphasis upon primary
Burwell, William E. Shambora, and
Lee Cady, which are both of a per- sources should not obscure the im-
sonal and an official nature. No one portance of secondary materials as
writing on medical history can fail to well. The vast literature that covers
take advantage of the remarkable col- the military history of the European
lections of the National Library of Theater offered us a framework
Medicine in Bethesda, Maryland. within which the medical events could
Here we found many important in- be made meaningful. While a variety
sights in the William S. Middleton of sources will be found in the foot-
Papers, diary, and interview tran- notes, we must emphasize the special
script. Further materials on the fight importance of the earlier volumes in
against typhus are abundant in the the Center's United States Army in
Stanhope Bayne-Jones Collection. World War II series. Especially useful
The Center of Military History has in gaining an understanding of strate-
in its custody, in addition to the His- gy, theater structure, and logistics
torical Unit's collection of documents, were Roland G. Ruppenthal's two-
other pertinent records. These in- volume work Logistical Support of the
clude several groups of oral history Armies; Maurice Matloff and Edwin M.
materials. The oldest are memoranda Snell's Strategic Planning for Coalition
of interviews with key medical person- Warfare, 1941-1942; and Maurice
nel, completed by the Historical Unit, Matloff's Strategic Planning for Coalition
OSG, as well as transcripts of the dis- Warfare, 1943-1944. The combat his-
cussions of the Editorial Advisory tories were used as guides to the
Board during the early planning course of events, once the invasion
stages of this volume. This material had begun. Essential to this study
offered revealing insights into person- were Gordon A. Harrison's Cross-
BIBLIOGRAPHICAL NOTE 623
Bde Brigade
Bn Battalion
BTNI British Troops in Northern Ireland
Dep Deputy
DPs Displaced persons
DUKW Amphibian truck
Hist History
HC Hospital center
Hosp Hospital
HU Holding unit
VD Venereal disease
Hospital train
Hospital ship
Platoon or detachment
Company
Battalion
Regiment or group; combat team (CT following identifying
numeral)
Brigade
For complete listing of symbols in use during World War II period, see FM 21-20, dated October
1943, from which these are taken.
2
Includes collecting and clearing elements.
3
includes nontreatment facilities, other than supply, such as laboratories and headquarters of various
medical facilities.
Army
Army group,
Communications zone
Airfield
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