Navy Medicine May-June 1945
LCDR George Martin, USNR
By April, 1945 German resistance in the European Campaign was on the verge of collapse, but the Navy Medical Department's work was not yet done. The empire of Japan continued to defiantly resist American advances across the Pacific. The Navy Medical Department would meet its most monumental
challenge at the battle of Okinawa, the largest amphibious invasion of the Pacific campaign.
Three years of combat experience had given the Navy an idea of what to expect against the patented and fanatical Japanese defenses. Careful planning provided for the care for both military and civilian sick and wounded, evacuation of the sick and wounded, sanitation, and medical logistics.(1)
In order to bolster first aid capabilities, extra corpsmen were detailed to each line battalion and selected riflemen were trained in basic medical care and assigned as litter bearers to help evacuate the wounded to rear area aid stations. Two evacuation hospitals were to be attached to the Third Amphibious Corps. From there casualties could be moved to one of six hospital ships or specially equipped APHs and APAs for transfer to the Marianas and points in the United States.(2) During May and June the Navy commissioned five new
hospital ships of the Haven class to help fulfill the continuing need for casualty treatment and evacuation, Haven (AH-12), Benevolence (AH-13), Consolation (AH-15), Repose (AH-16), Sanctuary (AH-17).
Marine Corps units learned the value of sanitation, and sanitary squads operated with each combat unit in order to retard the ill effects of malaria and other anticipated ailments.(3) Fortunately, in the temperate
climate of Okinawa tropical diseases did not proliferate as they had on other Pacific islands. In fact, foot soldiers reported the island's cooler climate refreshing and somewhat invigorating. Only 1,200 cases of disease had to be evacuated in the course of the battle.(4)
The medical situation was further ameliorated by an efficient system of blood delivery which had been perfected by the Naval Air Transport Service.(5) The early capture of the airfields at Yonton and Kadena enabled blood to be flown in from Guam as well as to provide for the aerial medivac of the wounded. Additionally, surgery could be performed near the front lines by the use of a mobile surgical trailer.(6)
The uncontested landings of 1 April were part of the overall Japanese strategy to avoid casualties defending the beach against overwhelming Allied firepower. A system of defense in depth, especially in the southern portion of the island, would permit the 100,000-man-strong Japanese 32nd Army under General Ushijima to fight a protracted battle that would put both the attacking amphibious forces and naval armada at risk. The fatalist philosophy of the defenders is best illustrated by the slogan: One plane for one warship; one boat for one ship; one man for 10 of the enemy or 1 tank.(7)
By 19 April soldiers and marines of the U.S. Tenth Army under LGEN Buckner USA were engaged in a fierce battle along a fortified front which represented the outer ring of the Shuri Line. This fighting
contrasted dramatically with the unopposed landings and initial rapid advances of the previous weeks. The Shuri defenses were deeply dug into the limestone cliffs and boasted mutually supporting positions as well as a wealth of artillery of various calibers. As the battle dragged on, American casualties mounted. This delay in securing the island caused great consternation among the naval commanders since the fleet of almost 1,600 ships was exposed to heavy enemy air attacks. There developed a less than cordial scene when ADM Nimitz visited Okinawa on 23 April and threatened to have LGEN Buckner relieved if better progress was not forthcoming.
The most damage from the Japanese attacks came from operation Ten-Go (Heavenly Operation) which employed mass deployment of the fearsome kamikaze. The use of the kamikaze was not new. As early as 1943 Japanese army and navy pilots had made individual, uncoordinated suicide attacks against American
ships. By the Battle of Leyte Gulf in October 1944, suicide planes had become an instrument of Japanese
military policy.(8) These attacks against the allied fleet conformed perfectly to the Japanese strategy of destroying high value targets and inflicting massive numbers of casualties, thereby delaying the invasion of Japan. Loss of American aircraft carriers and logistics ships would set back the timetable and allow the Japanese home defenses to better prepare for invasion.(9)
Young pilots with only a modicum of flying hours and no combat experience were usually chosen to fly the suicide missions. More seasoned fliers accompanied the kamikazes as escorts to protect them from enemy fighters and, in a macabre imitation of "Judas Goats," lead them to their targets.
The surface fleet, the object of both conventional and suicide attacks, had been wisely prepared by a policy that provided for training sailors in first aid. This would prove to be valuable, especially on the larger platforms that could more readily withstand attack and provide for a secure casualty collection area. The smaller warships such as destroyers, especially those on the picket line, were not so fortunate. These ships suffered grievously and often medical care was not forthcoming because the assigned medical personnel were either killed or wounded, the sick bay knocked out, or the ship itself sent to the bottom. An example was the plight of the USS Morrison (DD-560) which was hit by four kamikazes in a 10-minute period. Only one wounded man reached a dressing station before the ship sank. The survivors floated on the sea for 2 hours while two out of three corpsmen assigned were either dead or disabled. The remaining corpsmen and the medical officer swam among the 90 survivors providing what little medical attention could be
administered.(10)
The kamikaze pilot's inexperience caused many to mistake the picket line destroyers for battleships or even larger platforms and expend themselves accordingly. Japan launched a total of 1,900 kamikaze missions, sinking 38 warships and damaging over 300 others.(11) No ships were immune from attack as witnessed by
the incident aboard the hospital ship Comfort (AH-6) which sustained 62 casualties due to a kamikaze.(12) Despite this, hospital ships continued their useful mission of treating the wounded and ferrying them to
hospitals in the Marianas.(13)
The most serious suicide attack against an aircraft carrier was the strike on the USS Bunker Hill
(CV-17) which was hit by two kamikazes while 30 fully combat loaded planes sat on deck. Exploding
ordinance touched off 12,000 gallons of aviation fuel which resulted in a highly destructive 4-hour fire,
costing the lives of 352 men, and putting the carrier out of the war.(14)
Navy policy during the battle was to evacuate the serious shipboard casualties to platforms that could provide necessary care such as hospital ships, APAs or APHs. This was accomplished by means of transfer whip while underway or the physical handing of litter-borne wounded over the rail from one ship to another
while dead in the water.
While the Navy faced its purgatory afloat, the situation on land was becoming more savage by the day. American losses mounted as soldiers and marines assaulted points on the Shuri line with the deceptive names of Sugar Loaf, Chocolate Drop, Conical Hill, Strawberry Hill, and Sugar Hill. During the course of the battle American forces were informed of two pieces of dramatic news, one tragic and the other joyous. The first was the death of president Franklin Roosevelt on 12 April and the latter the surrender of Nazi Germany on 8 May.
By the end of May monsoon rains which turned contested slopes and roads into a morass exacerbated both the tactical and medical situations. The ground advance began to resemble a World War I battlefield as troops became mired in mud and flooded roads greatly inhibited evacuation of wounded to the rear. Troops lived on a field sodden by rain, part garbage dump and part graveyard. Unburied Japanese bodies decayed, sank in the mud, and became part of a noxious stew. Anyone sliding down the greasy slopes could easily find theipockets full of maggots at the end of the journey. The environment became extremely septic, minor bruises turned into infections and even trench foot make an appearance.(15)
Navy corpsmen suffered staggering casualties; the 1st Marine Division alone counting almost 500. This caused an especially serious situation when their partially trained or untrained comrades were forced to treat them. The 6th Marine Division lost so many corpsmen that in some sectors there was an unofficial
agreement that the wounded who could do so would evacuate themselves.(16) Corpsmen heroism is
evidenced by the fact that three were awarded the Medal of Honor for their service on Okinawa.
Heavy pressure on the Shuri Line finally convinced GEN Ushijima to withdraw southward to his final defensive positions on the Kiyamu Peninsula.(17) His troops began moving out on the night of 23 May but were careful to leave behind rear guard elements that continued to slow the American advance. Japanese
soldiers too wounded to travel were given lethal injections of morphine or simply left behind to die. The fact that few Japanese surrendered (approximately 6,000 out of the entire garrison) actually relieved the Medical Department from much of the burden of POW care. By the first week of June, U.S. forces had captured only 465 enemy troops while claiming 62,548 killed.(18) It would take 2 more weeks of hard fighting and an
additional 2 weeks of "mopping up " operations pitting explosives and flamethrowers against determined pockets of resistance before the battle would finally be over.
During the later stages of the fight, shrapnel from an enemy shellburst killed LGEN Simon Bolivar Buckner, Commanding General of the Tenth Army. He was the most senior American officer lost in the entire Pacific campaign. General Ushijima committed ritual suicide (hara-kiri) on 16 June, convinced that he done his duty in service to the Emperor. The so called "mopping up" fighting between 23 and 29 June netted an additional 9,000 enemy dead and 3,800 captured.
American losses at Okinawa were so heavy as to illicite Congressional calls for an investigation into the conduct of the military commanders. Total casualties in the operation numbered over 12,000 killed, 36,000 wounded, and 26,000 non-combat injuries.(19) Navy casualties were tremendous, a total of 9,973 with a ratio of one killed for one wounded as compared to a one to five ratio for the Marine Corps.(20) Navy
medicine rose to the challenge by treating and evacuating 25,000 men, 11,000 by air and the rest by hospital ships and other surface transport.(21)
In addition to physical injuries, medical authorities faced the problems of caring for thousands of
civilians as well as handling cases of combat fatigue which took their toll on Okinawa. Doctors postulated that the single greatest cause of stress was the accuracy of enemy artillery fire. Those "fatigue" cases
]diagnosed as exhaustion or anxiety were treated with sedatives, food, and rest and normally were sent back to the line in 24 hours. More serious cases went to "rest camps" located directly behind the firing lines. The
theory behind this treatment was that exposure to the sound of the guns would enable soldiers and marines to become more quickly reacclimated to battle. Despite this approach, over 3,000 fatigue cases were evacuated as being unrecoverable and because their sickbeds were needed.(22)
The atomic bombing of Japan in August and sudden end of the war precluded the invasion of the Japanese home islands planned for November 1945. As a result, the medical lessons learned on Okinawa would not be applied to any additional battlefields of World War II.
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References
1. History of the Medical Department of the United States Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 104.
2. Ibid., p 106.
3. Ibid.
4. Ibid., p 109.
5. Cowdrey AE. Fighting for Life, p 311.
6. History of the Medical Department of the United States Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 106.
7. Frank B. Okinawa: Capstone to Victory, p 20.
8. Van der Vat D. The Pacific Campaign, p 350.
9. Wheeler K. The Road to Tokyo, p 100.
10. Cowdrey, p 306.
11. Keegan J. The Second World War, p 571.
12. History of the Medical Department of the United States Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 109.
13. Ibid.
14. Wheeler, p 171.
15. Cowdrey, p 309.
16. Lane E, Sgt. "They Made an Agreement," Hospital Corps Quarterly; 1945 18(10), p 65.
17. Frank B. Okinawa: Capstone to Victory, p 136.
18. Ibid., p 139.
19. Ibid., p 157.
20. History of the Medical Department of the United States Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 109.
21. Ibid., p 113.
22. Cowdrey, p 314.