Navy Medicine September-October 1945
LCDR George Martin, USNR

On 2 Sep 1945, representatives of the Empire of Japan signed the instrument of surrender on board the USS Missouri (BB-63) in Tokyo Bay, formally bringing to a close the most destructive war in human history. The conflict's total cost in human life was staggering. Out of 70 million combatants, 17 million were killed. However, the devastation was not limited to armed forces; in fact, more civilians than soldiers perished. All told, the Soviet Union lost over 20 million, Germany over 4.5 million, Japan 1.6 million, France counted 600,000 lives lost, while Great Britain claimed 400,000 dead. Fatalities in China were uncountable with some estimates as high as 13 million. The United States suffered 300,000 dead, all military and equally divided between both theaters of operations.(1)

At the time of the surrender the U.S. Navy had grown to a size of unprecedented proportions. More than 4,000,000 officers and men, including 80,000 WAVES (Women Accepted for Volunteer Service) wore the Navy uniform. Fifty thousand vessels of all types, as well as 40,000 aircraft were deployed to assist in the war effort. The Navy Department required the sum of 30 billion dollars per year to run its operation.(2)

With the war over, many military personnel looked forward to mustering out and returning home. For many others including the seriously wounded, prisoners of war, civilian casualties, and the medical personnel who cared for them, the trials of war were not yet concluded. As previously discussed (Navy Medicine July- August 1945), the repatriation and rehabilitation of wounded and prisoners of war was a major postwar mission of the Navy Medical Department. These duties would occupy medical personnel for many months more and, of course, the blind, crippled, maimed, and mentally scarred would have a lifetime to try to overcome their handicaps.

As horrible as the war proved to be, many medical developments arose from the carnage. Some of the most significant advances came in the fields of aviation medicine, submarine medicine, and air evacuation and transport of casualties.

Aviation medicine was a direct product of the war effort. What was a small group of flight surgeons in 1939 had expanded to 1,200 medical officers by war's end. These men staffed over 100 aviation type ships and provided medical services for all Marine Corps units. Their record of sacrifice is borne out by the fact that the death rate for flight surgeons was two and a half times higher than any other group of medical officers.(3) Naval aviation met its challenge in the Pacific Theater of Operations which provided a wide array of combat scenarios. The possibility of being shot down in the vast expanses of the Pacific Ocean and facing climatic differences presented by the temperate South Seas as compared to the frigid latitudes of the Aleutians required the development of better flying clothing for survival and a more effective program of sea/air rescue. Also, a realistic, medically supervised rotation policy was needed to keep morale high and transfer weary pilots out of the combat area. Medical screening was implemented to dispose of incompetent or physically depleted personnel. The Medical Department employed new psychological techniques to root out unsatisfactory aviators. In May 1944, the Navy established a Physiological Test Center at the Naval Air Test Center, Patuxent River, MD. The program was headed by flight surgeons and physiologists who flew planes in the conduct of their tests.(4)

Extensive altitude training programs, which included low pressure chambers, were established. Under the direction of flight surgeon administration there were many new programs for the training of aviation
medical technicians, low pressure chamber technicians, and medical personnel in sea/air rescue units. Training aids were created and manuals developed to assist pilots in survival techniques.(5)

As planes flew faster and higher, combat aerobatics became more sophisticated. This led to the serious problem of "blackouts." Navy medicine took the lead in the development of the "anti-blackout" suit. Similarly, the movement toward night fighting created the need for the Navy's night vision training program for combat pilots.

The intensity of the Pacific campaign required the development of airborne evacuation of wounded troops. In December 1944, a school for the training of flight nurses opened at NAS Alameda, CA. These flight nurses provided invaluable service during the height of the island hopping campaign. More about their efforts will be discussed later.

Life on board a submarine presented its own unique problems of safety, sanitation, and hygiene. Even though the submarine was deployed as a weapon during the First World War, there were only a handful of Navy medical officers who were qualified in submarine medicine in the 1930's. These men had expertise in deep sea diving and were familiar with submarine construction and operation, as well as underwater escape and salvage. At the outbreak of war, facilities to train officers in submarine medicine were activated at the Deep Sea Diving School, Washington, DC, and Submarine Base, New London, CT.(6) Because these early courses proved to be inadequate, in June 1943, the course was extended 3 weeks and included "tank instruction and escape, inspection and instruction trips on submarines, dark adaptation instruction, and similar matters," as well as "demonstration of diving equipment, lectures, and demonstrations and participation in the submarine personnel and sound listening personnel selection program.(7) By March 1944, formal qualification in submarine medicine became a prerequisite for submarine force assignment.

At the beginning of the war Hospital Corps personnel received rudimentary training for the submarine service at New London. However, it became apparent that these young men had not been adequately prepared for the arduous tasks ahead. Therefore, in June 1943, a pool of corpsmen enrolled in the "school of pharmacist's mates entering the submarine service," which provided both necessary initial as well as periodic refresher training. The school presented a 6-week curriculum including didactic and practical instruction in first aid, minor surgery, hygiene, sanitation, toxicology, anesthesia, pharmacy, chemistry, and indoctrination in environmental factors of life on a submarine. The submarine's pharmacist's mate was a critical component in the success of the mission. As the only medical person on board he was responsible for the health and welfare of the crew. A typical cruise could present the problems of crushed fingers, broken ribs and limbs, dislocations, bruises, lacerations, eye injuries, gastrointestinal disorders, and appendicitis. In addition to meeting these dilemmas the corpsman was expected to take his place among the ship's crew and perform operational duties such as sonar operator, radarman, lookout, and librarian.

Navy Medical Department personnel were responsible for providing both pre-patrol and post-patrol examinations of all officers and men assigned to the submarine force. Candidates received complete physicals which included chest x-rays and complete dental exams. The pharmacist's mate on board the vessel kept records on each man's physical condition.

Because of the stress of undersea warfare, special intelligence and psychological tests were administered in the initial personnel selection phase. At first this was a very disjointed process earmarked by a lack of standardization and professional cooperation between units, and where corpsmen with no training in psychiatry examined recruits. By 1943, a traveling "Interview Board" began visiting various indoctrination units. In cooperation with the local medical departments they interviewed candidates and decided on the desirability of each man for submarine duty. These and other measures greatly streamlined the selection process and were instrumental in the low psychiatric attrition rate among submariners during the war.

As the war progressed, the Medical Department became involved in a number of issues of submarine medical treatment and research. Studies were conducted and recommendations made in such areas as overcrowding, protective clothing, food and water supply, toxic gases, length of operations, sanitary tank-head systems, oxygen depletion, skin diseases, night vision testing, lookout training, sonar training, and escape "lung" training. There is little doubt that the success of the U.S. submarine effort in World War II and the development of today's strategic force would not have been possible without the dedication and expertise of the Navy Medical Department.

World War II saw the development of air evacuation and transport of sick and wounded. The excellent military medical evacuation system of our modern force traces its lineage to this era. Early in the war, American observers took interest in the efforts of Germany and Russia, who pioneered airborne operations. By the beginning of the war the Bureau of Medicine and Surgery (BUMED) cooperated with the Bureau of Aeronautics to procure specially equipped ambulance planes for air evacuation. The factors that contributed to the reduction of mortality from wounds and supported the use of air evacuation were:

1) Immediate first aid treatment
2) Prompt treatment of shock and control of hemorrhage
3) Earliest possible evacuation of patients for definitive treatment.(8)

Originally, aerial transportation was the purview of local commands, but it was the major action at Guadalcanal that demonstrated the need for a centralized authority. At Guadalcanal often there were no medical personnel available for evacuation aircraft or for supervising the loading of casualties. Moreover, there were no facilities for the handling of patients at unloading terminals. By November 1942, a sufficient number of medical personnel were available to permit doctors to ride planes carrying seriously wounded while corpsmen were assigned to air transports carrying less serious cases.

Task force commanders and the commander, forward area, divided responsibility for air evacuation of combat casualties. This inefficient arrangement existed until the Air Evacuation Service was established under the auspices of BUMED. The service moved toward "jointness" in October 1942, when the Army participated with Marine Air Group 25 in the South Pacific.(9)

As the war progressed the efficiency of air transport increased and was responsible for the saving of many wounded who otherwise would probably not have survived. General orders standardized evacuation procedures. It became policy that hospital receiving units establish facilities and detail personnel to receive patients at airfields. Medical personnel should accompany every flight if available, flight surgeons should be detailed as loading officers, a formal flight log be kept, and liaison corpsmen at each receiving airport ensure the exchange of medical equipment. Between September 1942 and March 1943, 12,017 patients were evacuated by air from Guadalcanal. Nevertheless, problems were still being encountered as witnessed by the high mortality rate of patients being evacuated from the battle of Saipan. The reason was that the airlift was unplanned and was executed without the benefit of proper medical screening, necessary equipment, or sufficient numbers of medical personnel. By contrast the planned evacuations from Iwo Jima and later Okinawa were wildly successful. At Iwo Jima 2,500 casualties were airlifted with very few fatalities, and only three patients died out of over 15,000 evacuees on Okinawa.(10)

The air evacuation and transport of casualties had become a science in itself in which the many advantages significantly outweighed the disadvantage of requiring a secure airfield near the battle area. Troops transported by air had much higher morale because of their speedy removal from the combat zone. Air transport proved to be extremely flexible, being able to change schedule and destination on short notice. Patients arrived at receiving areas in smaller numbers and therefore reduced the problem of overcrowding. The numbers of medical personnel required for evacuation operations was only a fraction (approximately 10 percent) of those needed to attend to the wounded on board a hospital ship.

The aforementioned developments cover just a few major areas of the total expansion of the Navy Medical Department during the Second World War. Many other advances were made in the fields of air/sea rescue, amphibious warfare, field medicine, dentistry, medical logistics, and mobile and base hospitals.

The success of American military medicine during World War II eclipsed all previous wartime accomplishments. The Navy Medical Department expanded from 13,000 personnel in 1941 to a peak in 1945 of 169,225 men and women. The recovery rate for casualties was an astonishing 98 percent as compared to 90 percent in World War I with death from wounds of the head, chest, and abdomen an amazing 65 percent lower than in World War I.(11) The medical advances and innovations that resulted were numerous and noteworthy. The building of new hospitals, the use of mobile hospitals at the battlefront, and the conversion of landing craft and transports as facilities for the collection and treatment of casualties were instrumental in the medical effort. The use of the hospital ship as both treatment facility and medical storage warehouse proved an invaluable asset. Measures taken for the prevention and treatment of epidemic disease, the greatest single killer of military men since the dawn of warfare saved countless lives and undoubtedly enabled the successful conclusion of many campaigns. The war emphasized the need for specialties such as submarine, aviation, and amphibious medicine. The latter was so successful that medical care of all types was brought to the men at the front earlier than ever before thought possible. The procurement and transport of medical necessities such as drugs, vaccines, serums, surgical dressings and instruments, and hospital equipment of every kind was a feat unmatched in the annals of military history and proved to be the foundation for victory.

The continuous research carried on in the fields of surgery, physiology, psychology, chemistry, botany, bacteriology, and entomology contributed to the saving of lives of not only wounded sailors and marines but benefited future generations to come. However, all these magnificent accomplishments would not have been possible without the dedication, professionalism, and sacrifice of the doctors, dentists, nurses, and corpsmen who gave so much of themselves in the victory over totalitarianism. It is ultimately to them that this World War II commemorative series has been dedicated.

Further Back in the War

Return to WWII History index page

References

1. Pratt F. The Compact History of the United States Navy, p 175.

2. Taylor A. The Second World War: An Illustrated History, p 229.

3. History of the Medical Department of the United States Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 209.

4. Ibid., p 212.

5. Ibid., p 211.

6. Ibid., p 42.

7. Ibid., p 43.

8. Ibid., p 203.

9. Ibid., p 204.

10. Ibid.

11. Cowdrey AE. Fighting for Life, p v.

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