The United States Army Medical Service Corps
MEDICAL SUPPORT FOR A WORLD POWER
The success of the medical administrative and scientific specialty officers during World War II had a profound effect on the postwar development of their role in the U.S. Army. Congressional and departmental actions consolidated them into a permanent corps, greatly increasing career opportunities for these officers and giving the Army Medical Department a much-needed permanent improvement in its mission capability. Although the Medical Department shrank during the postwar demobilization, the new corps enabled it to put together a balanced, high-quality team on a permanent basis.
The expanding global responsibilities of the United States in the evolving Cold War did not prevent it from greatly reducing the size of its armed forces. Within a year of Victory over Japan (V-J) Day, the Medical Department had dropped from a bed capacity of 750,000 to 100,000, and by June 1948 the Army and Navy combined had a capacity of only 34,000 beds. The Selective Service Act expired at the end of March 1947, and in February 1948, when the Communists seized power in Czechoslovakia, the combined strength of the Army and the Marine Corps was only 631,000. A new Selective Service Act was enacted that year, but during its two years of operation only about three hundred thousand men were drafted. In June 1950 the strength of the Army was less than six hundred thousand. As historian Russell Weigley put it, the Army had 'faded to near impotence.'1
Euphoria over winning the war was complicated by the U.S. occupation of Germany and Japan and disrupted by growing tensions with the Soviet Union. The Berlin blockade in 1948 merely underscored the deteriorating relations between the Western democracies and their former wartime ally. In response, the Truman administration in 1949 put together the North Atlantic Treaty Organization, a regional European defense alliance, but in practice the United States relied on its growing arsenal of nuclear weapons to deter Soviet expansion. Overrating the new weapon's usefulness, the nation came to rely on its nuclear supremacy as the mainstay of its defense strategy, a reliance that ultimately was at the expense of conventional forces.
But reform also became a feature of postwar military policy. The war had demonstrated the necessity for a joint service structure, and postwar pressures to economize helped to spur unification of the armed forces through the National Security Act of 1947. That law created the National Military Establishment (in 1949 renamed the Department of Defense [DOD]) with separate Departments of
Army-Baylor Program in Hospital Administration bulletin
198
the Army, Navy and Air Force. Defense medical programs were integrated through the establishment of a Medical Services Division in the Office of the Secretary of Defense in May 1949. Soon renamed the Office of Medical Services, it was the seed of central control of the military medical establishment. Although it was controversial from the beginning, in time it would offer position opportunities for MSC officers who would figure prominently in the DOD medical policy formulation process.2
The postwar emphasis on centralized control and efficiency severely challenged the Medical Department's planners.3 Army medical programs now had to fit into the entire DOD medical apparatus, and issues of cost and efficiency figured prominently in planning decisions. At the same time, progress in medical technology had expanded demand for medical care from a peacetime army that was still larger than any other in U.S. history. Pressure for quality health care for both military dependents and an expanding retired military population magnified the effect. Growth in the number of eligible beneficiaries represented an increasing cost for the taxpayer and a loss of a potential source of revenue for the civilian health care industry. Nevertheless, the need to maintain a large standing army and the acceptance of the commitment to care for soldiers and their families ultimately forced the Army Medical Department to operate a substantial peacetime medical establishment.4
Congress' gradual acceptance of the Medical Department's expanded responsibilities, as well as the role of the nation as a world power, produced a series of policies that kept the organization of the Army's health care structure in flux. For example, Medical Administrative Corps and Sanitary Corps officers could apply for appointments in the Regular Army Pharmacy Corps, whose authorization was increased from 72 to 1,022 officers in 1946. The War Department waived the requirement for a pharmacy degree, but stipulated that applicants had to be graduates of colleges acceptable to the surgeon general and in fields that would qualify them for further training in sanitary engineering, office management, hospital administration, business administration, medical supply, parasitology, entomology, optometry, pharmacy, bacteriology, serology, clinical psychology, or social work.5
Over twenty-five hundred officers applied for integration into the Regular Army Pharmacy Corps. Col. Louis Williams, PC, a member of the selection board, said that the Army could pick and choose from a wide variety of candidates. He personally looked for applicants with a degree in business administration or a good background in administration-and anyone with a law degree. 'So far as I know, not a single one ever let us down in a single way.' Based on the board's recommendations, 728 officers were integrated into the Regular Army in 1946 and 1947. One, Capt. Jimmie Kanaya, was the first American officer of Japanese descent accepted into the Regular Army MAC. Another, Capt. William E. Gott, was the first black given a Regular Army commission in the Pharmacy Corps.6
Termination of the Army Specialized Training Program (ASTP) in 1946 and demobilization of the armed forces reduced the strength of the Medical Corps to a level that jeopardized the Medical Department's ability to perform its expand-
199
ed health care mission. The Army found that it could persuade very few physicians to remain on active duty in a system that offered no promise of clinical excellence. The problem was so great that the under secretary of war was concerned: 'Most of the civilian doctors in uniform were fed up with the Army. The situation was serious.7
Part of the solution to the problem resided in restoring the surgeon general's influence in management of the department's personnel so as to provide as much flexibility as possible in handling the Army's medical personnel assets. In other words it was necessary to regain the central medical direction lost during the war. In June 1947 the War Department returned career planning responsibility for all Medical Department personnel to the surgeon general and followed that up a year later with control over all assignment actions. The surgeon general now had the authority to 'assign and reassign Medical Department personnel across command lines, if necessary, quickly and expeditiously as necessity dictates.' It was a major policy shift.8
Another part of the solution was the return of physicians from administrative positions to the practice of medicine. When drafted physicians were released from military service, the Regular Army Medical Corps officers remaining on active duty had no choice but to resume clinical practice. However, all but six Regular Army physicians had been assigned to administrative positions during the war, and they had lost touch with medicine. Maj. Gen. Raymond W. Bliss, Kirk's successor as surgeon general from 1947 to 1951, believed that the prewar Medical Corps 'had been isolated from the main stream of American medicine.'9 He was determined to prevent that from happening again.
The department arranged for refresher training programs at medical schools and hospitals throughout the country to infuse contemporary clinical standards into the Medical Corps and to motivate senior physicians to seek specialty training. Forty officers were placed at thirteen institutions in 1946, and MAC officers replaced those who had been serving in administrative positions. The Army's Internship and Residency Program, begun in February 1946, was an important part of the sustained effort to improve the competency of Army physicians. Simultaneously, the department stepped up the recruiting of new physicians to fill Medical Corps vacancies. Furthermore, the department vigorously pressed for dependent care and residency training as incentives to attract the best physicians to a military career.10
The department had also learned lessons in field medical support from its wartime experience in eleven theaters of operation. The Medical Field Service School, which moved in 1946 from Carlisle Barracks, Pennsylvania, to Fort Sam Houston, Texas, sought to incorporate those lessons into current doctrine.11 In the process, the doctrinal dichotomy between conserving the fighting strength and clearing the battlefield was tilted in favor of the former with the idea that 'treatment should be conducted as far forward as possible' in order to stem the loss of troop strength from a combat zone.12 To put this into effect, the department estimated that the medical force available to the Army's regiments would have to be tripled.13
The first three echelons of medical service were thus beefed up based on the lessons of World War II. At the first echelon, the regimental level of medical ser?
200
vice, the medical sections of the maneuver battalions became medical platoons. The regimental medical detachment became a company that fielded two collecting detachments and an evacuation detachment. This company provided the regiment with two collecting stations as well as field ambulances for evacuating patients from the battalion aid stations of the maneuver battalions.
Division medical service was the second level of the combat zone. There, the division medical battalion was changed to provide a more elaborate treatment capability. The three collecting companies of World War II were gone. The battalion now consisted of three clearing companies and an ambulance company of thirty field ambulances. The clearing companies provided a clearing station for each regiment (to back up the regimental collection stations and the battalion aid stations) as well as an ambulance platoon in support of each regimental medical company.
The third level of medical service featured an important new unit, the Mobile Army Surgical Hospital, or MASH, a field hospital added in 1948. It evolved out of the 25-bed Portable Surgical Hospital, a self-contained unit for support of divisions that had been developed for jungle fighting and amphibious operations in World War II.14 The MASH was a mobile, sixty-bed, surgical hospital whose staff included two MSC officers, fourteen physicians, and twelve nurses. Field army medical service included other units that fleshed out the evacuation chain. Plans and operations officers could pick hospital units from the same array of hospitals used in World War II, including a 400-bed semimobile evacuation hospital established on the basis of one per division and a 750-bed evacuation hospital for each corps. Medical logistics support was to be provided throughout a theater by medical supply depots consisting of two advance platoons and a base platoon. The depot, a unit of 200 personnel, had doubled in size and its number of vehicles had increased. The fourth and fifth echelons-the communications zone and the zone of the interior-remained essentially unchanged.
There had been considerable progress during World War II in long-range air evacuation using large Air Force aircraft, but there was no comparable widespread development in forward air evacuation using light Army aircraft. Postwar progress in aviation technology advanced the capabilities of helicopters, the ideal vehicle for frontline air evacuation, and the Army tested Sikorsky H-18s for air evacuation in 1949. The tests of the helicopters, which carried two litters and an attendant, were successful, but there was no initiative to organize Army helicopter ambulance units. The stimulus for that would come later with combat action in Korea.15
Creation of the Medical Service Corps
There was no longer any question of the permanent need for administrative and scientific specialty officers, both to serve in positions formerly filled by physicians and to provide expertise in new technologies. The Medical Department quickly realized that it could not sustain its operations without permanent access to those specialties, but the Regular Army Pharmacy Corps was not sufficient for that purpose. As the department looked to the future, an important key to its abil?
201
ity to fulfill its mission would be the formation of a permanent corps for the officers on active duty in the administrative and scientific specialties, a group which numbered 3,155 at the end of 1946.16
In January 1946 the surgeon general, Maj. Gen. Norman T. Kirk, proposed the establishment of a medical service corps (MC) that would consolidate the officers of the Sanitary Corps, Medical Administrative Corps, and Pharmacy Corps. General Kirk believed it was an essential step in placing the postwar department on a solid footing. The Surgeon General's Office estimated a requirement of 1,500 Regular Army MSC officers for an army of 500,000 soldiers, or 2,325 officers for an army of 750,000 soldiers, or roughly three MSC officers per 1,000 active duty soldiers.17
Kirk's proposal was initially opposed by leaders of organized pharmacy, who, embittered by what they viewed as cavalier treatment by the Army, wished to preserve a separate pharmacy corps. However, Kirk undertook a campaign in 1946 to sell them on his plan through a series of meetings and bargaining sessions. He was assisted by Maj. Bernard Aabel, PC, whom he had made his assistant for pharmacy affairs. Aabel was a graduate pharmacist assigned to the Surgeon General's Office as an assignment officer for members of the Medical Administrative, Sanitary, and Pharmacy Corps. He became the go-between for pharmacy issues in his new additional duty.
Aabel's lobbying paid off. In June 1946 Arthur H. Einbeck, chairman of the Committee on Status of Pharmacists in the Government Service, issued a paper that identified positions throughout the Medical Department that could be filled by pharmacists.18 General Kirk accepted Einbeck's formulation and pledged a leading role for pharmacists in the proposed MSC. In November, Einbeck emerged from a summit meeting with the surgeon general to announce his committee's support: 'The flag of pharmacy would wave just as freely and importantly' in the MSC Pharmacy Section as it would in a separate corps.19 Harmony between the surgeon general and the leaders of organized pharmacy cleared the way for congressional action.
On 20 February 1947, the House Committee on Armed Services began hearings on H.R. 1982, a bill 'to establish a permanent Medical Service Corps in the Medical Department of the Regular Army.' The corps would consist of sections for pharmacy, medical administrative sciences, optometry, and other groups deemed necessary by the secretary of war. There would be a chief appointed by the secretary of war as well as assistant chiefs of the corps appointed as chiefs of the sections.
Congresswoman Margaret Chase Smith, the committee chairman, opened the hearings by observing that H.R. 1982, the Army Medical Service Corps (MSC) legislation, was quite similar to two proposals for a Navy MSC: H.R. 1361, which would establish commissioned medical administrators in the Navy's Hospital Corps, and H.R. 1603, which would establish a Navy Medical Associated Sciences Corps consisting of 205 officers. Mrs. Smith had the three bills considered as a single group since they were all dealing with the same specialties. The Army and Navy proposals differed principally in their approaches to commissioning. The Army desired a college degree as a prerequisite while the Navy wanted to keep the way open for commissioning from the ranks of enlisted personnel.20
202
The committee heard testimony from representatives of national pharmacy organizations. They agreed to support the establishment of a separate pharmacy, supply, and administration section within the Medical Service Corps if certain conditions were met, including the appointment of a pharmacist as chief of that section and a requirement that pharmacists constitute a minimum of 80 percent of its strength. The surgeon general agreed to that stipulation and further promised that he would see to it that most accessions to the section each year would be pharmacists.21
Representatives of other scientific specialty guilds also had their say, and then threw in with Kirk's proposed corps. Henry M. Chick, representing the National Society of Professional Engineers, feared that sanitary engineers would become a minority group and lose the advantages they had enjoyed in the Sanitary Corps. Nevertheless, he agreed to support the MSC as long as it had a separate section for sanitary engineering. William C. Ezell, O.D., former president of the American Optometric Association, reiterated the arguments for a separate optometry corps, but acquiesced in the legislative proposal for an MSC by offering an amendment requiring that the chief of the optometry section be a graduate of a recognized school or college of optometry. The MSC proposal was rolling, and Lester A. Walsh, D.P.M., representing the National Association of Chiropodists, tried to include his specialty on the bandwagon. Walsh pointed out that chiropody was recognized by the American Medical Association, and he asked that the Army follow the Navy's lead in commissioning chiropodists. The timing was not right for the inclusion of chiropody, however, and Walsh's desire was not fulfilled.22
Some in the Medical Department opposed consolidation. Sanitary Corps scientific specialty officers assigned to the Headquarters, Seventh Service Command, did not like the idea of being integrated with MAC officers, many of whom were OCS graduates without a college degree. The Sanitary Corps officers believed they should have an advantage over MAC officers commissioned from the ranks without an educational level comparable to theirs. As matters stood, they received no credit toward promotion for the years they spent in training. Col. William A. Hardenbergh, SnC, the senior Army sanitary engineer, was outspoken. He strenuously opposed any efforts to dismantle the Sanitary Corps, believing that it would be impossible to merge scientific and administrative specialty officers in the same group. He claimed that sanitary engineers were uniformly against formation of the MSC, and he lobbied unceasingly for preservation of the Sanitary Corps. Hardenbergh never did reconcile himself to consolidation, and he remained a vocal critic after his retirement from the Army.23
General Kirk, gratified by the overall support for an MSC, testified that he now envisioned an active duty requirement for 1,650 MSC officers. He told Congress that he would accept the responsibility of seeing that the best individuals would head each section of the corps. To buttress his argument for an MSC, he had two young Pharmacy Corps officers testify in support of the legislation. Maj. James B. Baty, a sanitary engineer assigned to the Surgeon General's Preventive Medicine Division, believed the new corps would be advantageous for both the Army and the members of the corps. Kirk's assistant for pharmacy, Major
203
Aabel, agreed. Aabel, a pharmacist in civilian life, had entered active duty from the reserves in 1941 as a Medical Administrative Corps officer, later receiving a Regular Army commission in the Pharmacy Corps. He had received a purple heart as the S-2 and liaison officer for the 68th Medical Group in the ETO. Since March 1946 he had served in the Surgeon General's Personnel Division as the assistant to the chief of the Classification and Records Branch, in which capacity he was responsible for managing Sanitary Corps, Medical Administrative Corps, and Pharmacy Corps officers. He believed that it was appropriate to consolidate the three corps in order to develop the leadership and specialization necessary for the Medical Department's execution of its mission. 'I personally think it will work,' he testified.24
Kirk's proposal became law on 4 August 1947 when Congress passed the Army-Navy Medical Services Corps Act of 1947.25 The law established Medical Service Corps in both the Army and the Navy. It abolished the Army's Medical Administrative Corps, Sanitary Corps, and Pharmacy Corps and established the Army MSC with four sections: Pharmacy, Supply, and Administration; Medical Allied Sciences; Sanitary Engineering; and Optometry. The strength of the corps would be established by the secretary of war, but Congress set a ceiling on MSC colonels at 2 percent of the strength of the Regular Army Medical Service Corps. Unfortunately, the 2 percent figure was based on an estimate of the number of positions for Regular Army colonels which then existed among the precursor groups and was a figure considerably less than the 8 percent figure used for other branches of the Army. The 2 percent limit would bedevil the first chief of the corps.26
The move to establish a Regular Army Medical Service Corps for male officers paralleled the creation in 1947 of a Regular Army corps for female officers serving as physical therapists, occupational therapists, and dietitians, specialties that were at that time almost completely handled by women. It was necessary to create a separate corps because there was no provision for commissioning women in a male corps; otherwise they would have been included in the establishment of the Medical Service Corps. On 16 April President Truman signed the Army-Navy Nurses Act of 1947, which established the Women's Medical Specialist Corps (renamed the Army Medical Specialist Corps in 1955).27
Establishment of the Air Force led in 1949 to the formation of a third military medical department along with an Air Force Medical Service Corps. Maj. Leo Benade, MSC, along with Maj. (later Maj.Gen.) Ralph Richards, MSC, headed the Special Projects Branch of the Surgeon General's Personnel Division, which was set up to handle the transfer of Army Medical Department assets, including those of the Medical Service Corps, to the Air Force.28
The Formative Years of the New Corps
The formative years of the Medical Service Corps were characterized by efforts to increase the number of officers on active duty, the establishment of policies governing their employment, and planning for the variety of specialties that comprised the four sections. On 24 September 1947, a board appointed by the
204
surgeon general selected Col. Othmar Goriup, MSC, as first chief of the corps (see Appendix G). Colonel Goriup was a graduate pharmacist and a fellow of the American College of Apothecaries, and General Armstrong hoped the appointment would gratify the pharmacy profession. Goriup's wartime service had been principally with the Army Air Corps, and when selected chief of the MSC he was serving in the Office of the Air Surgeon on the War Department Staff. He said that when he moved to the Surgeon General's Office it was unfamiliar territory. 'I knew only about two people in the Army, and in addition to that, I knew nothing about Army operation.'29
For the first time the Medical Department's administrative and scientific specialty officers had a permanently appointed head responsible for their organization, administration, career planning, and employment. Goriup appointed Major Benade, a most accomplished officer, as his assistant, and the two officers constituted the Office of the Chief, Medical Service Corps. The selection of the four assistant chiefs did not go as smoothly. A board selected officers for three of the four assistant chief positions in October 1947, but only one successfully made it through the nomination process-Maj. Ludwig R. Kuhn, MSC, who was sworn in as chief of the Medical Allied Sciences Section in May 1948.
The surgeon general convened a second board. Its selections were acted upon on 14 March 1949, when Brig. Gen. George E. Armstrong, the deputy surgeon general, swore in three MSC assistant chiefs. Lt. Col. Charles S. Gersoni, MSC, replaced Major Kuhn as chief of the Medical Allied Sciences Section. Maj. John V. Painter, MSC, became chief of the Pharmacy, Supply, and Administration Section, and Lt. Col. Raymond J. Karpen, MSC, became the chief of the Sanitary Engineering Section. The optometry slot was not filled. The surgeon general had personally rejected the first board's choice, and, with just a few optometrists in the Army, the second board had little to choose from.30
All three assistant chiefs were assigned to the Surgeon General's Office where, in accordance with the board's recommendation, they handled corps responsibilities as an additional duty. Karpen noted that the assistant chiefs of the corps 'became excellent tight rope walkers' as they balanced the demands of their full-time positions with the additional duty of planning for their specialty areas. Colonel Goriup also relied on the Medical Service Corps Advisory Council, established in March 1948, for policy recommendations, but the body fell into disuse under subsequent chiefs and was ineffective.31
Excitement over the establishment of the corps was punctured by the reality of the hard work facing the chief's office. As Major Benade put it, 'we had the legislation, but now what?'32 Postwar demands on the Army and concomitant requirements for medical support meant that the new corps must grow. An essential task was determining how to achieve that growth. Goriup and Benade undertook the lengthy process of establishing position requirements for MSC officers in the Army's manning documents.33
The job of pulling disparate specialties into a cohesive whole was made more difficult by various vocal interest groups. In December 1947 Goriup was invited to speak at the annual meeting of the Association of Military Surgeons of the United States, representing quick acceptance of the new corps by a well-estab?
205
lished group.34 But such instant acquiescence was unusual, and Goriup found himself on the road for his first two years in office, mending fences and performing 'constant missionary work.' In the end, he believed that the effort was successful, welding 'the numerous professional groups of the Medical Service Corps into one harmonious whole.'35
One of the early problems the chief faced was an artifact of the 1947 legislation, which had unintentionally created a promotion inequity. As a result of a quirk in the law, about forty MSC officers who had been integrated into the Regular Army in 1947 became junior in permanent grade to other officers whom they outranked in their active duty temporary grade, creating a great deal of resentment. That imbalance was corrected in 1949 by special legislation.
The 2 percent cap on colonels was an irritant from the outset, and Colonel Goriup explored ways to seek relief from the inequity almost immediately after assuming office. He floated a proposal for a legislative remedy in 1949, but his effort was not fully embraced by the Medical Department's leaders. Brig. Gen. Silas B. Hays, chief of the Surgeon General's Supply Division, for example, disagreed strongly. Although proclaiming himself 'a strong booster of the MSC,' Hays believed the department should proceed slowly over a three- to four-year period before lifting the promotion cap. During that time it could create more slots for MSC colonels while it gradually groomed officers for promotion to colonel by placing them in more responsible jobs.36
In 1947 General Bliss instituted daily meetings with his key staff, who were encouraged 'to let their hair down.'37 They did, and the typed summaries of those morning meetings, prepared over the next twenty-two years by Arlyne Fransway,
206
Colonel Goriup (seated, center) and staff. Major Benade is seated at right
the surgeon general's secretary, are an invaluable historical resource. The proper role of the MSC was a frequent topic of discussion. General Bliss made it clear he desired that the four assistant corps chiefs should be 'dual-hatted' with a full-time assignment in their specialty, while performing their corps responsibilities as an additional duty. The exception would be Colonel Goriup, who worked full time in the Office of the Surgeon General.38
The demand for MSC officers quickly accelerated. As usual, the shortage of Army physicians was a major incentive. In February 1948 the Regular Army Medical Corps was authorized 3,000 officers, but only 1,200 were on active duty. The pressure to free up physicians for clinical duties became so intense that at one point Goriup listed the replacement of physicians as the sole mission of the Medical Service Corps. The urgency of the physician shortage was so great that in March 1948 the Army authorized a recall to active duty of 300 Medical Service Corps officers, a number that was raised to 800 in September. But at mid-month it had recalled only 165 officers, and the department was advertising vacancies for 500 lieutenants and captains in administrative and scientific specialties.39
Recruiting of physicians continued to lag significantly behind MSC recruitment, and some positions that legitimately required officers with medical training were of necessity filled by MSCs. Examples in 1948 were Maj. Gary C. Hill, MSC, division surgeon of the 7th Infantry Division, and Capt. William H. Thornt, MSC, division surgeon of the 6th Infantry Division.40 Some MSC officers assumed dispensary medical duties akin to the sick call responsibilities of battalion surgeon's assistants. This assumption of clinical duties was necessitated by the physician shortage and because many Medical Corps officers were dissatisfied
207
with dispensary duty. Col. Paul I. Robinson, MC, chief of the Surgeon General's Personnel Division, suggested assigning MSC pharmacy officers to dispensaries where they would provide routine medical care. This, he argued, would make pharmacists happier, while relieving the physicians of 'tedious work.'41 General Bliss rejected Robinson's idea because the use of MSCs to conduct military sick call was tantamount to 'poor house' medical care for soldiers.42
The department was scrutinized in a succession of probes. Physician manpower was a major issue each time, and the constant refrain was to use physicians only in positions that required medical training. The Committee on Medical and Hospital Services of the Armed Forces was typical in this regard. Called the Hawley Committee for its chairman, Maj. Gen. Paul Hawley, MC, USA, Ret. (chief surgeon of the European Theater of Operations in World War II), its report demanded the 'full use of non-professional officers in administrative positions in peace and in war.'43 A 1952 survey of 2,359 Medical Corps officers had a 75 percent response rate with an unequivocal message. Physicians assigned to field medical units-all in a peacetime garrison status-were overwhelmingly dissatisfied; 90 percent believed they had insufficient opportunity to use their medical training. The study recommended expanded utilization of MSC officers.44
Yet there were not even enough MSCs to fill all the positions opened by the policy of replacement and substitution of Medical Corps officers. As an example, sixteen MSCs at Fort Knox had diminished to eight, which prevented the release of physicians from administrative duties. 'Now MCs will do everything but professional work,' said a member of the surgeon general's staff.45 The department also considered adding chiropody to its commissioned specialties as a means of easing the demand for physicians. By the fall of 1947 there was agreement within the Medical Department's senior leadership that chiropodists would be acceptable for commissioning in the MSC. However, that would not actually occur for another decade.46
To complicate matters, the surgeon general's staff gave Colonel Goriup conflicting guidance on the problem of increasing the number of active duty MSC officers. Some said the department should 'lower its sights' in selecting officers for recall to active duty if it were to succeed in obtaining the number required.47 Others suggested it should be more selective. General Bliss, for one, cautioned that he had begun to hear disparaging remarks about MSC officers, a sentiment that was echoed by Maj. Gen. Paul H. Streit, MC, commander of Walter Reed General Hospital. Streit said he had some very ineffective MSC officers assigned to his command. 'Colonel Goriup should be informed to watch his corps most carefully and hand-pick his officers if possible.'48
In fact, Colonel Goriup had been extremely attentive to the concerns of the surgeon general and others about the need to improve the quality of MSC officers. At one point characterizing portions of the early corps as 'an army of gas station attendants and ex-shoe clerks,'49 he was determined to reverse that situation, selecting only 349 of nearly 2,000 applicants for MSC commissions from 1949 to 1950. Colonel Goriup and Major Benade thus elected to remain selective while trying to improve opportunities in the corps so as to make MSC careers more attractive to high-quality officers. Due to their attention, pharmacy ROTC pro?
208
grams were established in July 1948 at four universities: California, Wisconsin, Minnesota, and Ohio State, and nine distinguished military graduates from ROTC programs were appointed in the MSC in 1949.50
Goriup believed that education and training were the best route to improving the recruitment and retention of the best officers. He took great pride in the establishment of opportunities for graduate training, which opened in 1949 for a wide variety of areas, particularly entomology, bacteriology, clinical psychology, public health, and other sciences. Eleven MSCs entered graduate programs that year, and by 1950 there were thirty-seven officers pursuing university training in fields ranging from hospital administration to radiochemistry, and two officers were in a training-in-industry program.
They also paid attention to the opportunities for military schooling. In 1950, a representative year, four officers attended the regular course of both the Armed Forces Staff College and the Command and General Staff College. One was Lt. Col. Floyd Berry, MSC, the first sanitary engineer to attend the Fort Leavenworth course. At the Medical Field Service School another eighty-five MSC officers attended various military courses in 1950, including a 26-week Officer Basic Course and a new Hospital Administration Course.51
The efforts in recruiting and retention paid off in rapid growth. In December 1948 there were only 1,022 MSC officers on active duty. By June 1950 the corps had more than doubled to 2,715, of which 588 were Regular Army officers. At the end of 1951 there were 4,976 officers on active duty, a number that included 70 Women's Army Corps officers detailed to the MSC and 621 Regular Army officers.52
The department was determined to have an insignia for MSC officers distinctly different from members of the Medical, Dental, and Veterinary Corps, all of whom could be called 'doctor'-even though some MSCs held doctoral degrees. The idea was that members of the Medical Administrative Corps, Sanitary Corps, and Pharmacy Corps were sometimes mistakenly addressed as 'doctor' because of their gold caduceus. Some physicians had the notion that this could prove embarrassing when someone unfamiliar with Army insignia asked medical questions.53
In fact, the Surgeon General's Office had broached the matter of an insignia with the War Department Staff while Congress was still considering the establishment of the MSC. The Quartermaster General's Office suggested using the same caduceus for both the Medical Service Corps and the Women's Medical Specialist Corps by superimposing an 'M' on the insignia in one case and a 'W' for the other. The Surgeon General's Office rejected the idea out of hand and proposed other designs. One was a black cross of Malta and a thunderbolt on a round shield. Another was a gold cross of Malta on a silver caduceus for the Medical Service Corps and a round shield with a thunderbolt on a silver caduceus for the Women's Medical Specialist Corps. The Quartermaster General's Office rejected those alternatives and fell back to its original proposal, which was the one finally approved on 11 December 1947.54 The MSC insignia became black enamel letters 'MS' superimposed on a silver caduceus. It was identical to the Women's Medical Specialist Corps with the exception of inverting the 'M' to form a "W."55
209
The story of the insignia did not end there, because the silver versus gold controversy persisted for years. Colonel Goriup, while on a visit to Letterman General Hospital in San Francisco, California, had an argument over it with the hospital commander, Brig. Gen. Leonard D. Heaton. The MSC chief raised Heaton's hackles when he brought up the subject of a single caduceus for all the corps of the Medical Department. 'I really got upset about it,' said Heaton, 'and let him know in no uncertain language that I would fight him to the finish if he proposed such a thing as that because we would never, never acquiesce to wearing the same insignia that the Medical Service Corps wore because that was downgrading the Medical Corps.'56
The Army-Baylor Program
A desire to improve the training of officers of all Medical Department officer corps, especially the Medical Service Corps, for management positions in Army hospitals led to the founding of the Hospital Administration Course in 1947 at the Medical Field Service School. The course, which in 1951 became the Army-Baylor University Program in Hospital Administration, was the twelfth such program established in the United States and one of ten formed in the rapid expansion of graduate programs in hospital administration between World War II and the Korean War.57
The Army-Baylor Program provided immediate returns to the Medical Department and served the Army well in the years that followed. It was championed by Maj. Gen. Joseph I. Martin, MC, commandant of the Medical Field Service School. Martin's wartime experience as the Fifth Army surgeon in Italy had convinced him of the need for trained administrators, and he persuaded the surgeon general to support establishing a course. Col. Byron L. Steger, MC, who had served with Martin in the Far East, was an important ally as chief of the Surgeon General's Education and Training Division.
The three-month-long Hospital Administration Course was organized according to a program of instruction developed by Lt. Col. James T. Richards, MSC. Richards had completed a master's in hospital administration at Northwestern University in 1947 and returned to San Antonio where he joined other MSC graduate hospital administrators such as Lt. Cols. Gordon McCleary, Howard Scroggs, and Sam Edwards to form a core faculty for the Hospital Administration Course.58
The first class began in November 1947 with 40 students: 1 Canadian, 25 Army Nurse Corps, and 14 MSC officers. The staff of eight officers and one civilian employee was headed by Col. Dale L. Thompson, MSC, the first director. The second class entered in 1948, when Richards replaced Thompson as the director. The third and fourth classes entered in 1949, the fifth in 1950, and one class entered annually thereafter. The course was lengthened several times: to 20 weeks in 1949, to 33 weeks in 1950, and to 39 weeks in 1951. The weekly course schedule was based upon eight hours of classes per day for five days a week; the class size ranged from thirty-six to sixty students. The curriculum covered academic subjects such as statistics and accounting as well as military medicine. Army Nurse
210
Corps officers made up 61 percent of the 178 students in the first four classes, and a separate nursing administration course to accommodate their special requirements began in 1950. Although the Medical Department also sent Medical Corps officers to civilian hospital administration programs after the war, including four officers in 1949, physicians subsequently attended the Army-Baylor Program.59
Initially, no students in the Hospital Administration Course possessed a baccalaureate degree, and not until 1950 were any officers enrolled who were eligible for academic recognition at the graduate level. Yet its supporters believed the course would have to affiliate with a university if it was to play an influential role in establishing the profession of hospital administration in the Army. Colonel Richards' desire for affiliation was facilitated by a friend of his, Professor Hardy A. Kemp, M.D., a bacteriologist who had wartime service in the Medical Corps and was a member of the Loyal Order of the Boar. During a chance meeting in the summer of 1949, Kemp, then the director of graduate studies of Baylor University's College of Medicine, suggested that Richards try to affiliate the course with Baylor. Richards discussed the idea with General Martin, who supported it, and in August 1950 he presented the proposal to the executive council of Baylor University's Graduate School.
Richards was assisted by Maj. Harry Panhorst, MSC. Panhorst, a military intelligence officer in World War II, was then associate director of the Washington University Program in Hospital Administration and a reservist on a three-week active duty tour at Brooke Army Medical Center. He provided the council a favorable report he had prepared on behalf of Malcolm T. MacEachern, M.D., who had been Richards' program director at Northwestern. MacEachern was a pioneer in hospital administration and a member of the Association of University Programs in Hospital Administration, and his sponsorship of the Army-Baylor Program carried a great deal of weight. The Baylor Executive Council voted its unanimous support, and the proposal then went to the Office of the Surgeon General for submission to the Army Staff. However, in a surprising setback, the Surgeon General's Office refused to forward the proposal because it believed the request would need a stronger justification in order to gain approval.60
The reversal was greatly disappointing to Colonel Goriup. 'To say this job of mine has been fraught with heartaches would be a further understatement. The action on Baylor affiliation is the greatest heartache of them all.' He told Richards
211
Officer graduates of the Hospital Administration Course, Medical Field Service School, May 1953
to wait for the right time to reopen the issue, and in the meantime to be patient. 'Please bear with us a little longer, Tommy. I can't but feel that we must charge our temporary setback off to growing pains.'61
General Martin provided a strengthened justification in September, and Colonel Steger submitted the proposal to the Army Staff, where it was disapproved. This time Martin called on friends in the Army Staff for help. He also asked for assistance from Fred A. McNamara, chief of the Hospital Branch of the Bureau of the Budget (forerunner of the Office of Management and Budget). McNamara, 'an unusually gifted man,' was an important influence on the Medical Department. He had been instrumental the year before in establishing another pioneering course, the Inter-Agency Institute of Hospital Administrators, later renamed the Interagency Institute for Federal Health Care Executives.62
Martin's efforts produced results. The Army Staff withdrew its objection in March 1951, but with a stipulation that prohibited any formal affiliation with Baylor of a contractual nature, including any appointments of the program's instructors to unremunerated Baylor faculty positions. The assistant chief of staff, G-3, harbored reservations over entanglements with universities, principally due to concerns over legal implications, and had turned down similar requests (including one from the Army War College) for affiliation with civilian universities. There was also a concern that the Army must pursue training with military requirements in mind and not fund graduate training for the personal benefit of officers who could enhance their civilian job opportunities at the Army's expense. Baylor accepted the affiliation on the Army's terms in September 1951.63
212
The connection with a respected university was an important step in the Army-Baylor Program's maturation. Richards was determined that the course be academically respectable rather than a diploma mill. That was a view shared by Goriup, who asked Richards if the students were motivated and 'striving to do just a little more than is expected and assigned to them.'64 Indeed, one of the concerns over affiliating with Baylor was that most students in the course were not eligible to matriculate in the Baylor Graduate School. So many students were academically deficient that the program had added a thirty-hour remedial reading course, and in 1950 only three students met Baylor's prerequisites for graduate school admission.65 Students who were not college graduates could enroll for a bachelor of science in business administration. Meanwhile, Baylor appointed Richards as an associate professor of hospital administration. This became the customary pattern for the program's faculty members, in spite of the original stipulations by the Army Staff.
With the program affiliated with Baylor, the next step in ensuring academic respectability was to seek accreditation from the Association of University Programs in Hospital Administration (AUPHA), the national organization that set standards for training in health care administration. Richards undertook an aggressive campaign. A key part of his strategy was the cultivation of prominent leaders in the health care industry, whom he invited to San Antonio as guest speakers in the course. He was assisted in this by Colonel Steger from Steger's position in Washington. Richards was able to use those visits as opportunities for personal diplomacy, and the efforts paid off.66
Professor MacEachern agreed to sponsor the program's application for accreditation, and the AUPHA granted provisional accreditation at a special meeting in September 1951. Students who met the prerequisites of Baylor Graduate School were then eligible to work toward an accredited master's degree. Baylor submitted the program for full AUPHA membership the following January, and Colonel Richards and his staff hosted the association's annual meeting that spring in a smoothly organized event at Fort Sam Houston. Richards was pleased. 'By now we were 'accepted' and had a group of nation-wide ambassadors of good will.' The application was approved and the Army-Baylor Program became a member of the AUPHA. The accreditation by an external agency followed the examples of hospital accreditation surveys and approval of physician residency training programs, a pattern of external certification that became fully accepted throughout the military medical services.67
Administrative Specialty Officers
MSC administrative specialty officers continued their service to the Army in the tradition of expanded roles pioneered by their predecessors. The inspector general (IG) position in the general hospitals was one opportunity opened to MSC officers during this period. The prerequisites desired by the Surgeon General's Office for detail to an IG position were high, specifying an officer who was a graduate hospital administrator and had broad experience at all levels of the hospital organization, including a tour as an executive officer.68
213
Another out-of-the-ordinary position opportunity was medical intelligence. Four officers were assigned as assistant attaches to Finland, Iraq, the Soviet Union, and Thailand during this period. Major Aabel was one of those, being assigned to the American embassy in Finland shortly after testifying for the formation of the MSC in 1947. Aabel completed a training and orientation program en route, including the Strategic Intelligence School in Washington, D.C., and reported to Helsinki in March 1948 as the assistant military attache. He held that position until July 1951 when he returned to the United States to attend the Army War College. Fluent in Norwegian and Swedish, Aabel studied Russian while in Finland, where he was quite popular with both the Finns and the Americans. He was praised by the U.S. military attache for having a better understanding of the Finnish people than anyone else in the American legation, and upon his departure he received Finland's Order of the White Rose.69
The war had also again demonstrated the necessity for medical control of the medical logistics system, a lesson reaffirmed by the Hoover Commission in 1949.70 Training opportunities for medical logistics officers in the postwar period included courses for medical supply officers conducted by the St. Louis Medical Depot, Missouri, and the Army-Navy Medical Procurement Office, Brooklyn, New York. Other training was offered by the Industrial College of the Armed Forces (ten months), civilian business schools (six to nine months), and various civilian industry programs (ten to thirty days). Medical equipment maintenance officers could take advantage of the Joint Army-Navy Medical Equipment Repair Course, a six-month course open to officers and enlisted personnel at the St. Louis Medical Depot.71
Administrative specialty officers assigned to field medical units maintained the Army's field medical apparatus while in garrison. In Japan Lt. Col. Frederick H. Gibbs, MSC, served as the executive officer and 'tower of strength' for Col. James A. Bethea, MC, the chief surgeon of the Far East Command. The shortage of physicians became so acute that Bethea had to assign MSC officers as division surgeons of the 6th and 7th Infantry Divisions, a stopgap measure that worked out very well. The MSC officers were preferred by both division commanders over young, inexperienced medical officers.72
Maj. Matthew Kowalsky MSC, was one of the MSC division surgeons. He served in Korea from 1947 to 1949, both as commander of the 7th Medical Battalion and as the 7th Infantry Division surgeon. In January 1949 the division redeployed to Japan as part of the U.S. withdrawal of forces. There, they were visited by Col. Chauncey E. Dovell, MC, the newly assigned Eighth Army surgeon, who was 'completely taken aback' when he learned of Kowalsky's duty position, especially the fact that he supervised four physicians. Colonel Dovell complained about it to the division commander, Maj. Gen. William F. Dean. But Dean would brook no interference, telling Dovell that he would retain Kowalsky as division surgeon as long as he was the commander.73
Hospital administration began to mature in the Army as it benefited from the postwar expansion of the health care industry. The field was progressing toward professional recognition in civilian life; more individuals pursued it as their life's work, and hospital trustees and administrators sought individuals qualified as
214
managers. Its numbers grew to meet the increased number of hospitals, a growth fueled by passage of the Hospital Survey and Construction Act of 1946 (Hill-Burton). Another milestone was passed in 1951 when representatives of the American College of Surgeons (ACS), the American College of Physicians, the American Hospital Association, and the American Medical Association formed the Joint Commission on Accreditation of Hospitals (JCAH). The JCAH took over the hospital accreditation program begun by the ACS.74
In 1948 the American College of Hospital Administrators (ACHA), then in its fifteenth year, portrayed the profession as a 'unique and complex activity' which required the ability to deal with finance, general management, personnel, hospital care of patients, and the interrelationships among professional groups involved in the delivery of health care. Above all, the profession demanded sound judgment and skill in human relations. The shift toward professional administrators was apparent in civilian industry, as nurse and physician hospital superintendents were replaced by graduate hospital administrators. The profession had changed in other ways, from predominantly female to predominantly male. The trend accelerated as Medical Administrative Corps officers were discharged from the Army and sought careers in hospital administration. The ACHA had stimulated their interest during the war by sending a questionnaire on career desires to some ten thousand Medical Administrative Corps officers. About fourteen hundred responded that they were interested in civilian careers. Many took advantage of the GI Bill to go to graduate school. The veterans were a promising market for universities hungry for students, and both hospital administration graduate programs and the ACHA turned to a common goal of providing them the graduate training and professional certification they would need to assume leadership roles in the health care industry.75
Scientific Specialty Officers
With the creation of the Pharmacy, Supply, and Administration Section, pharmacy officers had a home in the MSC, an important step in their striving for professional recognition that was saluted by the American Pharmaceutical Association as 'among the major achievements of the 80th Congress.'76 In 1948 the surgeon general directed commanders of the general hospitals to appoint MSC pharmacy officers as the chiefs of their pharmacies. The first ninety pharmacy ROTC cadets attended summer camp in 1949 at the Medical Field Service School. MSC pharmacy officers headed the ROTC programs as professors of military science and technology, and Colonel Goriup received good reports on their performance.77
Maj. Ludwig R. Kuhn, MSC, chief of the Medical Allied Sciences Section, chaired a meeting at the Pentagon in May 1948 that was important for the future of MSC scientific specialty officers in the Medical Allied Sciences Section. Kuhn called the meeting to address the major issues of the day, principally career planning, promotions, and pay. Officers representing the section's fourteen specialties (see Appendix E) were invited as well as representatives of fourteen national organizations (see Appendix F). The meeting opened with welcoming remarks by
215
General Bliss, the surgeon general; Maj. Gen. Malcolm C. Grow, the air surgeon; and Vannevar Bush, D. Eng., chairman of the Research and Development Board of the National Military Establishment. The Pentagon meeting set the tone for the management of Medical Service Corps scientific specialty officers in the postwar era.78
Lt. Col. Fred J. Fielding, MC, chief of the Surgeon General's Career Management Branch, described the development of career guidance patterns for all Medical Department officers. Those had been made possible by the War Department action in June 1947 that had assigned career planning responsibility for Medical Department personnel to the surgeon general. The plans were projected on a thirty-year basis. The first five years of an officer's service were a basic training period, followed by fifteen years of specialized training. The period from the twenty-first year until retirement was the 'definitive period' in which officers would reach the peak of their specialty.79
The conferees raised several controversial issues. Certainly the most dramatic was a proposal for a separate science corps outside the Medical Department. The principal reason was a perception of second-class citizenship for MSC scientific specialty officers. Norman Laffer, Ph.D., representing the American Society of Professional Biologists, expressed some bitterness over the department's treatment of scientists. Laffer and others related demeaning attitudes of physicians toward bioscientists, a complaint that was frequently voiced during the meeting. Such experiences diminished the attractiveness of a military career to such a degree that some found the title Medical Service Corps objectionable, seeing in this an implication of subservience.
Many believed there was an institutional bias in the Medical Department against nonphysician scientists that generated career limitations. An example was the inability of MSC laboratory officers to advance beyond the position of assistant laboratory chief, because the Medical Department continued to require a physician as chief. They also believed the bias was manifested in the 2 percent cap on MSC colonels. Additionally, there was a fear that scientists, by being mixed in with MSC administrative specialty officers, would have to serve in administrative assignments in order to be promoted.
Some conferees at the Pentagon meeting stressed the advantage of broader assignment possibilities outside the Medical Department that an Army general science corps would offer. Others expressed dissatisfaction with federal service of any kind. Gilbert F. Otto, Sc.D., a Johns Hopkins University parasitologist, related that whenever he asked graduate students who were veterans if they would consider a government position, their reaction was that they would accept 'almost anything else but a federal job. We got fed up with that during the war.' The attitude was confirmed by a National Research Council survey of biomedical scientists. As reported to the Pentagon meeting, only 32 percent of the 2,519 World War II veterans who responded had military duties that had required their specialized training.80
Others at the meeting were more optimistic. They saw promise in the inclusion of medical scientists within the Medical Service Corps. Gustav J. Dammin, M.D., a Washington University pathologist, recalled the difficult task of Arthur
216
Stull, Ph.D., the laboratory officer consultant who, as a Sanitary Corps major, had served with Dammin in the Surgeon General's Office during the war. Stull had looked after the fortunes of the laboratory officers, but had been limited in what he could do since there was no formal structure within which he could operate. Now, as the conferees at least agreed, scientific specialty officers were no longer improperly assigned and there was a permanently established mechanism to plan for their appropriate use. Indeed, as Colonel Goriup pointed out, an allied scientist could become chief of the corps. Dr. Stull, for one, saw promise in the corps, telling his fellow scientists that they were in on 'the birth of a new organization."81
Colonel Goriup emphasized the importance he attached to the Medical Allied Sciences Section. It was a concern so deep that Major Kuhn was the first assistant chief he had appointed, and they had called the Pentagon meeting just six months after the corps was formed. The chief addressed some of their concerns, and further stated that removing the 2 percent cap on colonels was high on his project list and that his 'very able assistant,' Maj. Leo Benade, MSC, was tasked with drafting legislation to correct that inequity.82 Promotion opportunity would be maintained for the officers of the Medical Allied Science Section whether they went into administrative positions or not. Promotions would be based on performance in assignments that would follow the career pattern for the scientific specialties, not some other field. Further, the Medical Department would conduct its own promotion boards. That was an additional protection for bioscientists, because the medically dominated boards were expected to have a greater understanding of the duties and responsibilities of MSC scientific specialty officers. In time, he foresaw that MSCs would serve on those boards (as they eventually did), once there were sufficient senior MSC officers to form a pool for board membership. That would be another guarantee that the scientific specialty officers would receive a fair shake.
The department had 62 Regular Army Medical Allied Science officers and was working toward a procurement objective of 300. As the department's representatives pointed out, their assignments included new career opportunities, especially in research. The military medical research establishment had a growth spurt in the postwar era as new funding became available and as civilian consultants to the Surgeon General's Office took on a permanent advisory role.83
Col. Rufus L. Holt, MC, commandant of the Army Medical Department Research and Graduate School (formerly the Army Medical School), told of the exciting programs at his institution of about two hundred fifty people. In fact, he was prevented from undertaking some research projects because of a shortage of scientists. In all, he described twenty-five major research areas, including basic research in disease immunity, viral and rickettsial vaccines, dysentery studies, and development of new tests and reagents. Researchers at Brooke General Hospital were conducting a study of Bacitracin, an antibiotic ointment.
A new specialty of nuclear science was emerging as developments in nuclear research were applied to medicine. Lt. Col. Roy D. Maxwell, SnC, a pioneer in the field, had participated in the Bikini atomic bomb tests in 1946 as a radiological safety officer, and in 1947 he began postgraduate work at the Crocker Radiation Laboratory of the University of California at Berkeley. Another
217
research opportunity was at the U.S. Army Prosthetics Research Laboratory, established in 1946 at Walter Reed General Hospital under the directorship of Lt. Col. Maurice J. Fletcher, OD, an Ordnance Corps officer who later transferred to the MSC. It was set up by the Army because the United States had essentially no prosthetic research program but it now had thousands of amputee veterans. The available prosthetic devices were little more than peg legs with crude leather sockets and 'simple 'baling' hooks, a la Captain Hook, for hands.'84
The report of the Medical Allied Science Conference made eight recommendations:
1. Convert the Medical Allied Science Section into a separate Medical Science Corps.
2. Take actions to provide equity in positions, promotions, and pay.
3. Expand research and training opportunity.
4. Carefully delineate initial assignments of scientists.
5. Ensure a supply of trained scientists, including student deferments from the draft.
6. Establish civilian advisory boards for the various scientific specialties.
7. Establish a reserve program for medical allied scientists.
8. Rapidly implement the committee's recommendations.
The report concluded that adoption of the recommendations would preclude the need for establishment of a general science corps in the Army.85
The Surgeon General's Office digested the recommendations and took action on some of them. These included initiating a study of position designations in Army organization documents, reviewing personnel management practices, appointing civilian consultants for the MSC scientific specialties, and encouraging research activities and graduate training. As an example of the latter, in 1947 Capts. Philip R. Carlquist, MSC, and Warren C. Eveland, MSC, began doctoral programs in bacteriology at Yale and the University of Maryland, respectively. They were the first two officers in their specialty funded by the Army to attend civilian universities at Army expense.86
Other recommendations were rejected. The proposal for a separate corps was not accepted, because the surgeon general believed that establishment of the Medical Allied Science Section along with continued improvements in the management of Medical Department scientists would achieve the aims expressed by the committee. However, proposals for a separate medical science or general science corps would come up again.
Social Work
A larger peacetime Army than in the past and an increasing number of family members produced a day-to-day need for social workers. Brig. Gen. William C. Menninger, MC, the champion of the expanded mental health team, left wartime active duty and returned to the Menninger Clinic in Topeka, Kansas. His replacement, Col. John Caldwell, Jr., MC, carried on his predecessor's initiatives. He established a Psychiatric Social Work Branch in the Surgeon General's Office, and Maj. Daniel E. O'Keefe, MAC, became the first chief. In 1947 Colonel Caldwell arranged for Maj. Elwood Camp, MSC, to return to
218
active duty to replace O'Keefe. Camp, an infantry officer during World War II, became the only Army officer on active duty who possessed a graduate degree in social work.87
Major Camp oversaw the establishment of a program to recall qualified officers to active duty as MSC graduate social workers. By May 1948 there were four on active duty and plans for forty. As an additional measure to meet the immediate need, he established a 26-week course to train officers with college degrees as partially trained social workers to work in Army hospitals in a 'case aid' role. Two-thirds of the course consisted of classwork, and the remaining third covered the supervision of neuropsychiatric technicians. Several of the first graduates were Women's Army Corps officers who had received Regular Army commissions under the provisions of the Women's Armed Services Integration Act of June 1948. One of those officers was posted to the 82d Airborne Division at Fort Bragg, where her assignment caused "a ruckus."88
By the fall of 1947 Camp had arranged to send officers for graduate training in social work and was recruiting reserve officers then in graduate programs for return to active duty. He visited thirty graduate schools for this purpose in the days before commercial jet liners, and at a time when stoicism was a necessity for air travelers. This was illustrated by one of Camp's trips from Washington, D.C., to San Antonio, Texas. His first stop was 100 miles away in Richmond, Virginia. Thirteen stops and two plane changes later he arrived at his destination.
Camp especially sought officers with line experience since he believed that social workers in the Army were most effective when they were fully qualified as Army officers. He also believed that a strong identification with Army life facilitated handling the problems of soldiers and their families. For that reason he expected that social work officers would not neglect their military education and training. Among the officers who met Camp's specifications were a former Army Air Corps fighter pilot, a former infantry company commander, and a former Navy combat pilot.
Camp advertised in professional journals and served in national leadership positions to enhance his recruiting efforts. In 1949 he instituted a program for two-year graduate master's degree training in social work whose graduates were commissioned in the Regular Army. The first officers to benefit from this opportunity were Capt. Fernando Torgerson, MSC, who enrolled at Columbia University, and Capt. Herbert Richek, MSC, who attended the University of Pennsylvania. By 1951 Camp's efforts had resulted in 129 social work officers on active duty, including 7 women. Another 89 officers were in the reserves.89
Psychology
Robert M. Yerkes, Ph.D., a Yale University professor who as a Sanitary Corps officer had headed the psychology program in World War I, chaired military psychology planning meetings at the National Research Council in 1944. His committee made recommendations to the secretary of war on psychological services in the postwar Army. Dr. Yerkes cautioned that the Army had failed to capitalize during the interwar years on the progress it had made during World War I, but that it would be difficult to prevent another period of stagnation since very few
219
psychologists planned to stay on active duty after World War II ended. The Army needed a strong research program to overcome that tendency by ensuring that it remained abreast of advances in the field and able to adopt new methods and technology. This would require the retention of talented psychologists, but in order to successfully compete with the civil sector for their services the Army would have to establish a well-defined professional status for the specialty and guarantee research opportunities. Therefore, Yerkes proposed forming a research and development corps to serve as their institutional guardian and advocate.90
Yerkes' recommendation for a separate corps made no headway, but his prediction of difficulties in retaining psychologists was borne out in the years after the war. By 1949, although the department had requirements for ninety psychologists, it had only three on active duty. The Medical Department was unable to successfully compete with other federal agencies for the 800 graduates from accredited programs in the United States each year. It tried every means it could, but was unsuccessful in obtaining a single applicant for a tour of duty.91
Lt. Col. Charles Gersoni, MSC, the psychology consultant for the surgeon general, developed a proposal to subsidize students in doctoral training. The Army, acting upon his concept, established the Senior Psychology Student Program in August 1949. Selected psychology students who had completed at least two years of their studies were commissioned and allowed to continue in their university program for up to two more years. The students received a second lieutenant's pay and allowances, from which they paid the tuition, fees, and expenses of their third and fourth years of the doctoral programs. They completed an Army internship at Walter Reed, Fitzsimons, or Letterman Hospitals during their third year, and returned to their universities for their fourth year. The program produced about seventy clinical psychologists during the period of its existence that ended in 1954.92
Sanitary Engineering
Attention was directed to U.S. capabilities for cold weather operations as tensions increased between the United States and the Soviet Union. The Arctic posed its own special preventive medicine challenges. In 1948 Maj. Raymond J. Karpen, MSC, participated in a survey of environmental conditions in Alaska, Nova Scotia, Greenland, and Iceland. Two years later he contributed to a study that evaluated the operation of an evacuation hospital set up under arctic conditions at Fort Shilo, Manitoba, Canada. Col. Ralph R. Cleland, MSC, headed a team sent to Fort Churchill, Canada, to study the problem of waste disposal in the Arctic. Among other things, Cleland's team found that typhoid organisms remained viable for extended periods under those conditions.93
The principal sanitary engineering issue during this period centered around a controversy led by Col. William Hardenbergh, SnC, USA, Ret., over the control of his specialty by the surgeon general rather than the chief of engineers. The demise of the Sanitary Corps still rankled Hardenbergh, and his opposition to the Medical Department's actions became a vitriolic dispute. In October 1948 the retired sanitary engineering chief castigated General Armstrong, now the deputy surgeon general, for rejecting the proposal for an Army science
220
corps. He accused Armstrong of a 'doublecross' for not supporting a separate Medical Department corps and assured him that a split would develop between the nonphysician medical professions and the department. Hardenbergh rejected Armstrong's offer to support legislation to remove the 2 percent cap on colonels as a 'red herring.' He insisted that unless Armstrong could persuade the new surgeon general, Maj. Gen. Raymond W. Bliss, MC, to accept Hardenbergh's position, Hardenbergh would soon make himself unwelcome in the Surgeon General's Office. 'I'm sorry, Army, but there she is. I will not bother you with the matter any further.'94
To the contrary, Hardenbergh bothered Armstrong a great deal after that as the editor of Public Works Magazine, a position he assumed following his retirement from the Army. Hardenbergh regularly used his editorial forum to berate the Medical Department. He made charges of broken promises, and he lamented that sound sanitary engineering would be impossible in the Army. He criticized the Medical Department for its lack of leadership and failure to do things his way. He echoed his public pronouncements in his correspondence, voicing a conspiratorial view of the Medical Service Corps' formation, which he said was done to spite him. He fulminated over 'an official record of delay and brushoff.'95 Hardenbergh engendered so much emotionalism that Francis B. Elder, the engineering associate of the American Public Health Association, joined the silver versus gold insignia controversy and challenged the use of a symbol of lesser quality.96
An exasperated General Armstrong complained that he had wracked his brain to find some way to mollify his critics but without success.97 However, he did not budge from his basic position. 'Sanitary engineers are carving a definite place for themselves on the preventive medicine team. I fail to see how the surgeon general could fulfill his mission without control and outright ownership.'98 Further, he believed that because of the department's actions, sanitary engineers were much better prepared for the department's wartime requirements than their predecessors in the Sanitary Corps had been at the beginning of World War II.
The controversy caught the attention of the National Research Council. In September 1948 the chairman of its Committee on Sanitary Engineering and Environment, Abel Wolman, Ph.D. (who had overseen the Army's use of sanitary engineers in World War II as a director of the Procurement and Assignment Service), invited the surgeon general to present to the committee the concept of career planning for sanitary engineers. They met with a delegation led by Colonel Goriup.99
The committee's report, issued in December, criticized the absence of any general officer promotion opportunity for MSCs, an opportunity that they would have in the Corps of Engineers. The Medical Corps had 16 generals out of 3,000 officers; the Dental Corps had 4 generals out of 743 officers; and the Veterinary Corps with just 186 officers had 1 general. The Medical Service Corps, with 1,022 officers, had none. Further, Wolman's committee voiced concern that lines of authority and responsibility for sanitary engineering were not clearly delineated, a situation that could infringe upon professional prerogatives. Having said all that, the committee believed that no action was called for on its part. The members agreed to let the matter rest 'for the present."100
221
(Photo taken in 1951.)
Optometry
Creation of the Medical Service Corps gave the Medical Department a mechanism for commissioning optometrists, and the department began recruiting to fill the Regular Army authorization of twenty optometrists. Capt. John W. Sheridan, MSC, an Ordnance Corps officer in World War II, became in September 1947 the first optometrist commissioned in the MSC.101Sheridan was "tickled pink" with his assignment to Walter Reed General Hospital where he was joined by Capt. Milton A. Lewis, MSC. All optometrists brought on active duty were temporarily placed with Sheridan for initial training prior to reporting to their duty stations. Many of the newly appointed officers were veterans like Sheridan; others were recent graduates of optometry schools. Organized optometry was so pleased with the new corps, the commissioning opportunities, and the opportunity for military careers that several associations provided flowers for an MSC anniversary dinner dance held in Washington in 1950.
Summary
A lot happened very quickly after the war. Within two years the MSC was formed, a permanent office organized, career programs established, and a blueprint of sorts sketched for the future of scientific specialty officers. Formation of the corps was both a culminating and a beginning point for the Medical Department's administrative and scientific specialties. It culminated three-quarters of a century of precursor organizations since Letterman's ambulance corps in the Army of the Potomac. It was the beginning of a permanent organization that would nurture those officers in peacetime as well as wartime.
Military medicine had become much more complicated, and the Medical Department had to have a permanent source for the specialties included in the MSC if it was to meet its new combination of responsibilities. The peacetime mission, in both the wartime readiness and peacetime operating aspects, was much larger than before the war. Emergence of the United States as the leading world power gave the Medical Department global requirements, including a standing research and development effort. This was accompanied by an expanded day-to-day health care mission in a larger Army that increasingly assumed responsibility for the care of family members and retired military personnel.
222
There was another factor to consider. The United States, acting upon the insistent recommendations of its wartime leaders, had unified its military establishment into the Department of Defense. Military medicine was caught up in the movement to unify U.S. air, naval, and ground forces, along with concomitant concerns for efficiency and effectiveness. The Medical Department's peacetime mission, and to a lesser extent planning for wartime medical support, were subject for the first time to the scrutiny of a higher medical authority, the DOD Office of Medical Services. The old ways of doing business had changed for good, and with those changes had come new requirements for greater sophistication in the management of the military medical enterprise. The surgeon general needed talented MSC officers to stay even, for the game demanded players of great administrative and organizational ability.
Unlike the period after World War I, the post-World War II period did not release the Army Medical Department from the pressures it had been under in wartime to ensure the appropriate use of physicians. The ending of the draft and the small number of physicians interested in joining the Army dried up the medical manpower pool at the same time that the demand for health care was increasing. The department turned to the MSC for replacement of and substitution for physicians as it scrambled to fill voids left by shortages in the Medical Corps.
Tension between Medical Service Corps and Medical Corps officers was inevitable, but it was much less significant than the teamwork that went on between the groups. A mutual respect had contributed to the formation of the corps. It was often expressed through close personal bonds between MSC and MC officers, ties that had been forged during difficult assignments together. Medical Corps officers in key positions were influential in forming the MSC and in opening up training, position, and promotion opportunities for its members. They were instrumental in improving the quality of the Medical Service Corps.
At the same time there were tensions internal to the MSC. The formation of a permanently constituted corps for both the administrative and scientific specialties was accompanied by some friction between the groups, the origins of which predated the formation of the corps. Scientific specialty officers now had a permanent place on the Regular Army team, but they did not participate without some misgivings and they would continue to have second thoughts. Proposals for a separate bioscience corps or secession from the Medical Department had an irresistible allure for some, both then and later.
Internal tensions were both transmitted to and shaped by groups external to the Army. The opposition of a retired sanitary engineer, Col. William Hardenbergh, was the most pronounced manifestation of that, as well as an example of how the corps and the Medical Department could be affected by external pressures. The influence of outside groups was at work throughout the formation of the corps and during its early developmental period. The representatives of the guilds who testified at the congressional hearings were midwives to its birth; the spokesmen for the associations who attended the Pentagon meeting of the Medical Allied Sciences Section represented the attending staff. Moderating the dissatisfaction of those groups was high on the list of concerns of Col. Othmar Goriup, the first chief of the corps, and it occupied much of his time. External
223
associations would remain keenly interested in the affairs of their individual specialty groups as the youthful corps stepped off into an uncertain future. They were both blessing and bane to the chiefs of the corps.
Of the three measures of opportunity-position, promotion, and education-education took the largest strides in this period. Graduate training opened, and a major step was the formation of the Army-Baylor University Program in Hospital Administration. It was an important influence in the maturation of hospital administration within the Army, as well as in the Navy, Air Force, Public Health Service, and Veterans Administration. The Army-Baylor Program expanded opportunity for MSC officers and, perhaps more important, provided an intellectual center for the specialty within the Army. It represented a pioneering affiliation between the Army and a university and set a precedent for later affiliations. The program was so successful that the label 'Baylor graduate' would become a source of envy within the corps.
The question of the future of the Medical Department's administrative and scientific specialty officers after World War II was answered in a much more satisfying way than it was after World War I. This time there would be a place in the peacetime Medical Department for MSCs. There would be opportunities for attending both military and civilian schools, and there would be opportunities to serve in meaningful positions. Nonetheless, those opportunities were abridged. There was schooling, but there was no opportunity for senior service college, the sine qua non of military education. There was opportunity for substantive positions, but the highest positions remained blocked. Promotion opportunity was available, but opportunity to become colonel was capped at 2 percent of the MSC Regular Army strength. The abridgment of opportunity both caused and manifested underlying tensions that would carry forward into future years.
224
Notes
1Medical demobilization: Eli Ginzberg, 'Federal Hospitalization; II-Current Trends,' Modern Hospital 73 (August 1949): 73. Quoted words: Weigley, History of the United States Army, p. 501.
2Unification: See Richard V. N. Ginn, 'Organization of the Military Health Care System,' Military Medicine 151 (June 1986): 300-302; Ginn, 'Of Purple Suits and Other Things; An Army Officer Looks at Unification of Defense Medical Services,' Military Medicine 143 (January 1978): 18; U.S. Congress, Senate, National Defense Establishment-Unification of the Armed Services, 80th Cong., 1st sess., 18 April 1947, pp. 400-408; Department of Defense, Telephone Directory, 1949, copies in USACMH; Kendrick, Blood Program in World War II, pp. 715-16.
3Challenges: It was a 'rugged' period according to a principal staff member who was there. See Interv, Nepthune Fogelberg, Comptroller, OTSG, with Samuel Milner, THU, OTSG, 23 Oct 63, MSC-USACMH.
4Economic pressures: Ginzberg, 'There's a Place in the Sun for Federal Hospitals,' Modern Hospital 73 (December 1949): 47.
5Regular Army (RA) integration: WDSO 255, 25 Oct 45, and WD Cir 392, 29 Dec 45, both in PL; McMinn and Levin, Personnel in World War II, pp. 505-09.
6RA integration: Maj William V. Davis, MSC, Technical Liaison Office (TLO), OTSG, folder 238, box 15/18, MSC-USACMH. Williams' comments: Interv, Col Louis F. Williams, MSC, Ret., with Lt Col Richard V. N. Ginn, MSC, Clearwater, Fla., 15 Nov 84, MSC history files, DASG-MS. Kanaya: Col Jimmie Kanaya, MSC, Ret., to Ginn, 12 Oct 84, DASG-MS. Gott: Interv, William E. Gott with Samuel Milner, THU, OTSG, 15 Mar 67, USACMH.
7Quoted words: Voorhees, 'A Lawyer Among Army Doctors,' p. 240.
8Personnel authority: WD Cir 143, 5 Jun 47, PL; Memo, Maj Gen George E. Armstrong, Deputy Surgeon General, for CSA, sub: Medical Service for the Army and the Air Force, 28 Jun 48, MSC-USACMH. Weakening of the surgeon general's authority in World War II had complicated management of the medical support system. See Interv, Maj. Gen Raymond W. Bliss, MC, TSG, Ret., with Samuel Milner, THU, OTSG, 14-16 Jul 63, USACMH; Eli Ginzberg, 'Army Hospitalization, Retrospect and Prospect,' Medical Bulletin (January 1948): 39; Samuel Milner, draft chapter, sub: World War II Leaves a Legacy, in CMH project, The U.S. Army Medical Service in the Post-World War II and Korean Eras, undated (1965), box 1/18, MSC-USACMH. Quoted words: Armstrong to CSA, 28 Jun 48.
9Quoted words: Bliss, Milner Interv, USACMH.
10Physician training: 1958 MSC History Project; Maj Gen George E. Armstrong, Israeloff Interv, 12 Mar 76, MSC-USACMH; WD Cir 392, 1945. MC substitutions: Brig Gen Floyd L. Wergeland, MC, in 1958 MSC History Project.
11MFSS: Medical Field Service School, Historical Rpt, 1946, folder 141, box 9/18, MSC?USACMH; Rpt, 1st Lt France F. Jordan, MSC, sub: A History of the Medical Field Service School at Carlisle Barracks, 1920-1946, 24 Apr 51, DASG-MS. The school had outgrown the limited space at Carlisle, and Fort Sam Houston offered more facilities and space. It moved into four permanent Spanish-style buildings of the former 9th Infantry quadrangle, supplemented by other buildings at Fort Sam Houston. Lt. Col. Allen J. Blake, MSC, was commander of the student detachment. The school used a large, nearby training area, Camp Bullis, for field exercises and demonstrations where the newcomers found that 'biting and stinging insects abound, including chiggers, mosquitoes, ticks, spiders, and scorpions.'
12Quoted words: Silas B. Hays, 'The Army Medical Service,' U.S. Armed Forces Medical Journal 4 (February 1983): 170. The noted economist Eli Ginzberg, Ph.D., served in OTSG as an influential civilian adviser during the war as head of the Facilities Utilization Branch, later the Resources and Analysis Division. He agreed with Hays. 'Experience disclosed in this war the need for throwing as much medical means and talent into the forward areas as possible.' Memo, Ginzberg for Dir, Hist Div, OTSG, 25 Sep 45, MSC-USACMH.
13Medical doctrine: The discussion is based on Hays, 'The Army Medical Service,' pp. 167-74; Cowdrey, The Medics' War, pp. 133-37, 149-54, 197-207, 213-17, 257-60; Joseph R. Darnall, 'Medical Evacuation System in a Theater of War,' Military Surgeon 105 (September 1949): 191-95; W. H. Thornton, 'The 24th Division Medical Battalion in Korea,' Military Surgeon 109 (July
225
1951): 13; Military Medical Manual, p. 471; OTSG (Secretary to TSG), Surgeon General's Early Morning Conference Notes, 6 Oct 52 (hereafter referred to as SG Conference plus the date); Interv, Col Gene Quinn, MSC, with Samuel Milner, THU, OTSG, 28 Oct 63; Interv, Col John W. Wisearson, MSC, with Samuel Milner, THU, OTSG, 22 Sep 66; Interv, Lt Col Raymond E. Adams, MSC, with Samuel Milner, THU, OTSG, 16 Jun 65, all in USACMH; Rpt, 25th Medical Bn, 25th Inf Div, sub: Transmittal of Command Report, 1 Oct 1951, RG 407, Entry 429, Box 3870, NARA-WNRC.
14PSH: Portable Surgical Hospital, T/O 8-572S, Military Medical Manual, pp. 643-44. The ETO General Board said it was essential for support of division clearing stations. ETO, Rpt no. 89, p. 27.
15Air ambulances: Tierney and Montgomery, The Army Aviation Story, pp. 206-07; Richard P. Weinert, Jr., A History of Army Aviation-1950-1962 (Fort Monroe, Va.: Training and Doctrine Command, 1991), pp. 210-11; David M. Lam, 'From Balloon to Black Hawk: World War II,' pt. 2, U.S. Army Aviation Digest 27 (July 1981): 47-48. The tests were by an Army board at Fort Bragg, North Carolina, with the 82d Airborne Division.
16Numbers, 1 January 1947: Sec War to Sen Elbert O. Thomas, Chm, Committee on Military Affairs, U.S. Senate, 1 Aug 47, box 3/18, MSC-USACMH.
17Early proposal: Memo, TSG for ACS, G-1, ASF, sub: Establishment of Post War Medical Service Corps as Part of the Medical Department, 8 Oct 45, MSC-USACMH. Kirk: 'Proposed Postwar Medical Department Plan,' Medical Bulletin (January 1946): 43-47. MSC requirements: Staff study, OTSG, sub: The Procurement of Medical Officers, 1 Jul 46, MSC-USACMH. MSC consolidation: Robert L. Black, 'The Army's Medical Service Corps,' Military Surgeon 115 (July 1954): 11-13.
18Blueprint: Rpt, Arthur H. Einbeck, Chm, Committee on Status of Pharmacists in Government Service, sub: A Blue Print: The Pharmacy Corps of the United States Regular Army, 14 Jun 46, folder 78, box 6/18, and Paper, Maj Einbeck, MSC, USAR, sub: The History of the Pharmacy Corps, 29 Feb 56, folder 72, box 6/18, both MSC-USACMH.
19Quoted words: Arthur H. Einbeck, Report of Steering Committee, 20 Nov 46; Kirk to Einbeck, 14 Jun 46, folder 78, box 6/18, MSC-USACMH.
20Hearings on MSC: U.S. Congress, House, Committee on Armed Services, Hearings on H.R. 1982, 'To Establish a Permanent Medical Service Corps in the Medical Department of the Regular Army,' beginning February 20, 1947, and hearings on HR. 1361 and H.R. 1603, Navy Hospital Corps and Navy Medical Associated Sciences Corps, 80th Cong., 1st sess. All three bills were considered at the same time by the committee as HR. 3215, 'The Army-Navy Medical Services Act of 1947,' and are hereafter cited as House, MSC Hearings. Name: A proposal to name it the 'Medical Auxiliary Corps' was rejected because it would make it 'too much like a ladies' branch of this outfit.' 1958 MSC History Project. Army and Navy approaches: Interv, Rear Adm Clifford A. Swanson, Surg Gen, USN, with Samuel Milner, THU, OTSG, 14 Nov 67, USACMH.
21Testimony: Arthur H. Einbeck, Chm of the American Pharmaceutical Association's (APA) Committee on Pharmacists in Government Service; Robert P. Fischelis, Pharm.D., APA Secretary; Robert L. Swain, Pharm.D., Editor of Drug Topics; and Andrew G. Du Mez, Ph.D., Dean of the University of Maryland School of Pharmacy, House, MSC Hearings. See also Armstrong, Israeloff Interv, USACMH. Agreement: Rpt, Col Robert L. Black et al., sub: Committee Study: Pharmacy in the Army, OTSG, 9 Mar 55, citing Ltr, Kirk to Chairman of Committee on Status of Pharmacy in Government Service, 9 May 47, folder 78, box 6/18, MSC-USACMH.
22Testimony: Chick testified on 26 February, Ezell testified on 27 February, and Walsh submitted a written statement that was read to the committee on 12 March. House, MSC Hearings.
23Criticism: Statement by a group of officers at Seventh Service Command headquarters, with memo routing slip, Capt Allen, Nutrition Branch, ASF, to Lt Col Regan, Sanitation Division, SGO, ASF, 29 Mar 46; Memo, Col William A. Hardenbergh, SnC, for Ch, Pers Svc, OTSG, sub: Personnel Plans for the Sanitary Corps of the Medical Department of the Post-War Army, 19 Oct 44, and Memo for Brig Gen Simmons, sub: Recommendations Pertaining to Sanitary Engineers and Other Technical Men in the Postwar Regular Army, 15 Nov 45, all in folder 89, box 6/18, MSC-USACMH; Hardenbergh, 'Sanitary Corps Functions and Organization,' Military Surgeon 100 (March 1947): 224.
226
24Quoted words: House, MSC Hearings, 12 Mar 47.
25Law: 61 Stat. 134, 4 August 1947.
262 percent cap: 61 Stat. 734, 4 August 1947; Col. Othmar F. Goriup, the first chief, would soon be writing the surgeon general complaining of this injustice in terms of 'equity and merit.' See Col Othmar F. Goriup, Chief, Medical Service Corps, to Brig Gen Armstrong, 4 Feb 48, Lend Lease file, folder 42, box 4/18, MSC-USACMH.
27WMSC: 61 Stat. 41, 16 April 1947; Col. Robert S. Anderson, MC, ed., Army Medical Specialist Corps (Washington, D.C.: Office of the Surgeon General, Department of the Army, 1968), pp. 1-9, 309, 344, 402; Gibbs, Milner Interv, 8 Nov 63, USACMH; Maj. Walter F. Robbins, MSC, draft chapter, sub: Reconditioning, THU, OTSG, 1958 MSC History Project, p. 76.
28Air Force MSC: Jack Buel, 'Recent Contributions of the Medical Service Corps to Military Medicine,' Military Surgeon 114 (February 1954): 115. The first chief of the AF MSC, Col. Philip G. Fleetwood, was not appointed until 1953. Special projects: SG Conference, 1 Jun 49. This branch, called variously the Personnel Projects or Personnel Policy Division, attracted uniquely talented officers until it was abolished in a 1985 reorganization. It was later resurrected under another name.
29Goriup appointment: George A. Armstrong, 'Your Profession in the Army,' Journal of the American Pharmaceutical Association 9 (January 1948): 33. Goriup: Goriup obituary, Washington Post, 3 August 1980; Roderick M. Engert, USACMH, Biography of Col. Othmar Frank Goriup, MSC, May 81; Goriup, Standard Form 57, Application for Federal Service, 30 Dec 61; and Biographical summary, THU, OTSG, 30 Sep 60, all in DASG-MS. Quoted words: Goriup in 1958 MSC History Project.
30Selections: Memo, Cols Paul I. Robinson, MC; Tom F. Whayne, MC; and Othmar F. Goriup, MSC, for Maj. Gen Bliss, sub: Chiefs of the Medical Service Corps, 19 Dec 47 (as amended), folder 41, box 4/18; Rpt, Robinson, Whayne, Goriup, sub: Minutes of the Board of Officers, 7 May 48, folder 158, box 10/18, all MSC-USACMH. The first board recommended Capt. John W. Sheridan, MSC, as chief of the Optometry Section. It is not clear why Bliss rejected the nomination. A likely reason could be that when the first board convened, Sheridan had been an MSC for just one month and there was only one other MSC optometrist on active duty. Bliss may have decided that, with such a limited field and a junior officer nominee, it would be better to wait awhile.
31Assistant chiefs: Memo, Goriup for Chief, Hist Div, OTSG, sub: Report of Activities, MSC Division, 2d half Fiscal Year 1949, 26 Sep 49, DASG-MS. See also Medical Bulletin (May 1949): 446. Quoted words: Karpen to Israeloff, 14 Apr 76, MSC-USACMH. Advisory council: Memo, Goriup for Chief, Hist Div, 26 Sep 49, MSC-USACMH; THU, draft chapter, sub: Establishment of the Medical Service Corps, in 1965 MSC History Project.
32Quoted words: Benade, Ginn Interv, 25 Jan 84, DASG-MS.
33Manning requirements: Interv, Lt Gen Leo Benade with Samuel Milner, THU, OTSG, 5 Nov 63, USACMH.
34Resistance: Goriup in 1958 MSC History Project. Also see Goriup, Annotation of Ltr, Col William A. Hamrick, MSC, to Goriup, 3 May 66, DASG-MS. AMSUS: Goriup, 'The Medical Service Corps,' Military Surgeon 100 (May 1949): 362.
35Quoted words: Speech, Goriup, sub: The Role of the Optometrist in the Army Medical Department, New Jersey Optometric Association, 15 Oct 47, DASG-MS. See also Col James T. Richards, USA, Ret., to Ginn, 28 Feb 86, DASG-MS.
36Promotion inequity: Goriup, 'Realignment of the Medical Service Corps Promotion List,' Medical Bulletin (November 1949): 898, 913. 2 percent cap: MSC Historical Rpt, 1st half FY 1948, folder 234, box 14/18, MSC-USACMH; Goriup to Brig Gen Armstrong, sub: Recommendations for Internal Organization of the Medical Service Corps Division, SGO, 4 Feb 48, folder 42, box 4/18, MSC-USACMH. Quoted words: MSC Historical Rpt, 1st half FY 1950, Post WWII file, box 2/18, MSC-USACMH. Hays' position: Brig Gen Silas B. Hays, MC, Chief, Supply Div, OTSG, Comment (Cmt) 2, 18 Aug 49, to DF, Chief, Medical Plans & Operations Div, OTSG, sub: Possible Legislation Affecting the Medical Service Corps, 11 Aug 49, folder 156, box 10/18, MSC-USACMH.
37Quoted words: Bliss, Milner Interv, 14 Jul 63, USACMH.
38Quoted words: SG Conference, 28 Aug 48.
227
39MC strength: George E. Armstrong, 'Current Personnel Problems,' Military Surgeon 101 (February 1948): 100. The Army unleashed an advertising barrage often thousand radio releases and two million pieces of literature. Paul I. Robinson, 'About the Medical Department Public Information Program,' Medical Bulletin (November 1948): 861. Use of MSCs: Memo, Brig Gen George E. Armstrong, DSG, for CSA, sub: Medical Service for the Army and the Air Force, 28 Jun 48, MSC-USACMH. Goriup wrote that the MSC mission was 'to augment, supplement and replace the medical officer within the Medical Department whenever and wherever possible.' Goriup to Armstrong, sub: Recommendations for Internal Organization of the Medical Service Corps Division, SGO, 4 Feb 48, folder 42, box 4/18, MSC-USACMH. MSC recall: SG Conference, 8 Mar 48; Medical Bulletin (June 1948): 419-20 and (October 1948): 821. 800 officers: 250 laboratory officers, 65 psychologists, 45 social workers, 45 pharmacists, 25 optometrists, 40 sanitary engineers, 20 physical reconditioning officers, and 310 administrative specialty officers. Goriup to Pers Div, SGO, sub: Rejection Boards, 21 Sep 48, folder 158, box 10/18, MSC-USACMH. 500 vacancies: 'Medical Service Corps Vacancies,' Medical Bulletin (September 1948): 672.
40Division surgeons: The 7th Infantry Division assistant division surgeon from 1947 to 1948 was also an MSC. Dwight Oland, draft Ms, 1973 MSC History Project, citing from 7th and 6th Divisions' medical historical rpts, 1947-48, folder 234, box 14/18, MSC-USACMH. In both cases the medical battalion commander was an MSC.
41Quoted words: SG Conference, 5 May 48.
42Quoted words: SG Conference, 24 Nov 48.
43Quoted words: Hawley Committee. Hawley became chief medical director of the Veterans Administration after the war.
44MC survey: Rpt, DOD and Human Resources Research Office, George Washington University (GWU), sub: Medical Officers' Opinions on Professional and Personal Problems of Army Service, in Memo, Don Calahan, HRRO, GWU, for Lt. Col. Z. A. Zehrer, OTSG, 28 Jul 53, MSC-USACMH.
45Quoted words: SG Conference, 6 Jan 48.
46Chiropody: SG Conference, 17 Nov 47.
47Quoted words: SG Conference, 14 Sep 48.
48Bliss and Streit: SG Conference, 10 May 48 (including quoted words).
49Quoted words: Cited in Intervs, Col Vernon McKenzie, MSC, Ret., PDASD (HA), with Ginn, the Pentagon, 17 May 84 and 20 Jun 84, DASG-MS.
50Applicants: 1,440 were applicants for direct appointment, 288 for transfer into the MSC, and 158 for recall to active duty. MSC Historical Rpts, 2d half FY 1949 and 2d half FY 1950, Post WWII file, box 2/18, MSC-USACMH. ROTC: MSC Historical Rpt, 2d half FY 1948, Post WWII file, box 2/18, MSC-USACMH. Appointments in 1949: MSC Historical Rpt, 1st half FY 1949, Post WWII file, box 2/18, MSC-USACMH.
51Training: Goriup, Standard Form (SF) 57, 30 Dec 61, DASG-MS; Historical Rpt, 1st half FY 1950, 26 Sep 50, Post WWII file, box 2/18, MSC-USACMH. 1950: Andrew J. Colyer, 'Career Management for the Medical Service Corps,' US Armed Forces Medical Journal 1 (June 1950): 710; Weidenkopf, Sanitary Engineering, 1958 MSC History Project, p. 76. Thirty officers were in civilian programs in 1949. MSC Historical Rpt, 2d half FY 1949.
52Numbers: (1948) National Research Council, Committee on Sanitary Engineering and Environment, sub: Minutes of Twelfth Meeting, 21 Dec 48, DASG-MS; (1950) Colyer, 'Career Management for the Medical Service Corps,' p. 709; (1951) MSC Historical Rpt, 1st half FY 1952, 31 Jan 52, Post WWII file, box 2/18, MSC-USACMH.
53Insignia: DF, Army-Navy General Hospital, to TSG, sub: Proposed Insignia for the Medical Service Corps, 15 Aug 47, recapitulated in Memo for Record (MFR) of Ltr, TSG to Quartermaster General (QMG), 4th Ind to Ltr, sub: Insignia for Women's Medical Specialist Corps, 2 Oct 47, and subsequent correspondence on insignia, in RG 112, Entry 64A-2161, Box 103/162, NARA?WNRC.
54Insignia alternatives: SG Conference, 19 Aug 47. TSG request: TSG to QMG, sub: Insignia for the Women's Medical Specialist Corps, 9 May 47, with 1st Ind, Brig Gen W. H. Middleswart, QMC, Military Planning Div, QMG, to TSG, 18 Jun 47; 2d Ind, TSG to QMG, 24 Jun 47; 3d Ind, QMG to TSG, 30 Jul 47; 4th Ind, TSG to QMG, 2 Oct 47, all in RG 112, Entry 64A-2161,
228
Box 103/162, NARA-WNRC; SG Conference, 19 Aug 47. The Quartermaster General said the best idea was something totally different-use the same insignia for all corps of the Medical Department.
55Insignia authorized: DA Cir 67, 11 Dec 47. When the Women's Medical Specialist Corps was renamed the Army Medical Specialist Corps in 1955, its insignia was changed to a black "S' superimposed on a gold caduceus, formerly the insignia of the Sanitary Corps and the design originally preferred by the Women's Medical Specialist Corps in 1947. The name change was occasioned by congressional action that provided authority for the commissioning of male nurses and medical specialists in the formerly all-female ANC and WMSC. Goriup on rationale: Goriup to Dr. E. R. Serles, Dean of Pharmacy, University of Illinois, 21 Feb 43, RG 112, Entry 64A-2161, Box 103/162, NARA-WNRC.
56Quoted words: Interv, Lt Gen Leonard D. Heaton, MC, Ret., with Col Robert D. McLean, MC, U.S. Army War College and USAMHI Senior Officer Oral History Program, 7 Dec 78, USAMHI.
57HCAD course: Discussion principally drawn from Rpt, MFSS, sub: History of the Hospital Administration Course, undated, MSC-USACMH, hereafter cited as MFSS, History of the Hospital Administration Course; and AHS, Baylor File, a collection of documents assembled in 1986 by the Army-Baylor Program, in DASG-MS. Several documents in the Baylor File by Col. James T. Richards, USA, Ret., are particularly useful, including Richards to Ginn, 'Here's My Story,' 28 February 1986, and Richards to James P. Cooney, 'Dear Jimmy,' 30 April 1954. Early programs: Neuhauser, Coming of Age, p. 93. Nine years separated the founding of the second program at Northwestern University in 1943 and the first program at the University of Chicago in 1934.
58Establishment: See also Maj Gen Joseph I. Martin to James P. Cooney, 27 Sep 54, and Col Melvin A. Modderman, MSC, Dir, Army-Baylor Program, to Ginn, 23 Apr 87, both DASG-MS.
59Physicians: Armstrong, 'Current Personnel Problems,' p. 101.
60Baylor affiliation: Col James T. Richards to Byron Steger, 18 Aug 50; Hardy A. Kemp to Bliss, 5 Sep 50 and 1 Nov 50, all in DASG-MS.
61Heartache: Goriup to Richards, 10 Oct 50, DASG-MS.
62Affiliation approval: Martin to TSG, sub: Affiliation of Hospital Administration Program with Baylor University, 14 Sep 50; TSG to Martin, same sub, 27 Sep 50; Fred A. McNamara, Bureau of the Budget, Executive Office of the President, to Richards, 8 Mar 51; DF, Col Raymond E. Duke, MC, Asst Commandant (Cmdt), Army Medical Service School (AMSS), to Dir, Dept of Admin, AMSS, sub: Extract of TELECON from AMSS to SGO-1430 hrs-25 Jun 1956, DASG-MS; DF, Lt Col Willard E. Thompson, MSC, Ch, Operations Div, AMSS, to Dir, Dept of Admin, AMSS, sub: Baylor University and AMSS Agreement Relative to 8-0-6 Course, 22 Jun 56, including Msg, OTSG R 201330Z to CG, Brooke Army Medical Center (BAMC), all in DASG?MS. Quoted words: 'Citation for Fred A. McNamara,' ACHA News 15 (October-November 1952): 13. Institute: Federal Health Care Executives Institute Alumni Association Newsletter, January 1986, DASG-MS; SG Conference, 8 May 50.
63Affiliation: TSG to CG, BAMC, sub: Affiliation of Hospital Administration Program with Baylor University, 3 Apr 51, including quotation from Asst C of S, G-3, Comment to TSG, 16 March 1951. Baylor accepted the arrangement in: Wilby T. Gooch, Administrative Vice President, Baylor University, to Martin, 13 Sep 51 (Responding to 6 Sep 51, Martin to Gooch), both in DASG-MS. Queries in 1956 revealed that the program continued five years later without formal affiliation, and the program director was still looking for a copy of a formal agreement in 1962. Msg, OTSG, 201330 to CG, BAMC, and DF, Col Raymond E. Duke, MC, to Dir, Dept of Admin, BAMC, 25 Jun 56; Jefferson D. Bragg, Dean, Baylor University Graduate School, to Col Sam A. Edwards, BAMC, 4 May 62, all in DASG-MS. Appointments: W. T. Gooch, Dean, Baylor Graduate School, to Richards, 13 Sep 51, DASG-MS.
64Concerns: Goriup to Richards, 10 Oct 50 (including quoted words); Richards to Steger, 18 Aug 50; Richards to Lt Col Francis C. Nelson, Ch, Technical Information Office, OTSG, 19 Feb 52; Memo, Col Frederick H. Gibbs, MSC, 7 Nov 52, all in DASG-MS. Richards did not want it to be a 'laughing stock' (Richards, 'Here's My Story').
65Remedial course: MFSS, History of the Hospital Administration Course.
229
66Accreditation: MacEachern to Martin, 25 Aug 50, and Martin to Gooch, 6 Sep 51, both in DASG-MS; SG Conference, 21 Sep 51 and 25 Oct 51.
67AUPHA membership: Wilby T. Gooch to Dr. John Gorrell, Dept of Hospital Administration, Columbia University, 22 Jan 52, DASG-MS; Rpt, AUPHA, sub: The Development of the Association of University Programs in Hospital Administration, 1958, Simpson Library (SL), Academy of Health Sciences, U.S. Army, Fort Sam Houston, Tex.
68IGs: Memo, Lt Col Fred J. Fielding, MC, Asst Ch, Pers Div, OTSG, for Ch, Pers Div, 12 Nov 48. Also see Col H. W. Glattly, Inspector General Department (IGD), to TSG, sub: Replacement of MSC Officers Detailed in IGD, and Memo, Goriup for Asst Ch, Pers Div, OTSG, 5 Nov 48, all in folder 133, box 9/18, MSC-USACMH.
69Attaches: Col. Bernard Aabel, Finland; Lt. Col. Raymond J. Creamer, Iraq; Lt. Col. James W. Dean, USSR; and Maj. Kenneth L. Hoffman, Thailand. Raymond Creamer, draft chapter, sub: Intelligence, 1958 MSC History Project. Aabel: Rpt, Norman D. Moore, THU, OTSG, sub: Curriculum Vitae of Colonel Bernard Aabel, May 1968, DASG-MS.
70Hoover Commission: See U.S. Commission on Organization of the Executive Branch of Government, The Hoover Commission Report (New York: McGraw Hill, 1949), ch. 7. Also see SG Conference, 12 Mar 54, for discussion of the second Hoover Commission, which had the same finding.
71Medical supply: 'Supply Training of Medical Service Corps Officers,' Medical Bulletin (December 1947): 998; 'Training of Medical Equipment Maintenance Officers,' Medical Bulletin (August 1948): 665.
72Substitutions: Interv, Maj Gen James A. Bethea with Samuel Milner, THU, OTSG, 15 Nov 63, USACMH.
73Kowalsky: Interv, Col Matthew Kowalsky, MSC, with Samuel Milner, THU, OTSG, 29 May 66.
74JCAH: George W. Stephenson, 'The College's Role in Hospital Standardization,' Bulletin of the American College of Surgeons (February 1981): 28.
75Hospital administration: Monograph, American College of Hospital Administrators, Hospital Administration: A Life's Profession (Chicago: American Hospital Association, 1948), p. 7; Neuhauser, Coming of Age, pp. 41-42, 69. MAC impact: Notes from Interv, Weir Richard Kirk, Director of Developmental Credentialling Programs, ACHA, with Ginn, Chicago, 12 Feb 85, DASG-MS. Survey of officers: Dean Conley, 'Professional Education in Hospital Administration,' Higher Education 9 (1 May 1953): 195; Neuhauser, Coming of Age, p. 69. Merging of missions: Editorial, James O. Hepner, 'A Lifelong Hunger,' Health Care Executive 5 (March-April 1990): 5.
76Quoted words: 'At the 93d A.Ph.A. Convention,' Journal of the American Pharmaceutical Association 8 (October 1947): 493.
77Pharmacy: Editorials, Robert P. Fischelis, Secretary, APA, 'Pharmacy in the Armed Services,' Journal of the American Pharmaceutical Association 8 (May 1947) and 'Army Pharmacy Takes on New Significance,' Journal of the American Pharmaceutical Association 8 (Sep 1947). George E. Armstrong, 'Your Profession in the U.S. Army,' Journal of the American Pharmaceutical Association 9 (January 1948): 32-35; Memo, Goriup, sub: Report of Activities, FY 1949, MSC-USACMH; Henry D. Roth, 'Utilization and Training of Pharmacists in the Army Medical Service,' Military Surgeon 115 (July 1954): 43-45.
78MAS meeting: Discussion is based on Memo, OTSG, sub: Agenda for Conference on the Medical Allied Sciences Section of the Medical Service Corps, 27-28 May 1948, and Rpt, OTSG, sub: Transcript of the Medical Service Corps Conference, Medical Allied Sciences Section, 27-28 May 1948, hereafter cited as OTSG, Medical Allied Science Meeting, 1948, both in DASG-MS. See also Memo, Goriup for Hist Div, SGO, sub: Report of Activities, Service Corps Division, 2d half of FY 1949, 26 Sep 49, MSC-USACMH.
79TSG responsibility: WD Cir 143, 5 Jun 47, PL.
80Quoted words: OTSG, Medical Allied Science Meeting, 1948. Survey results: Ibid.
81Quoted words: Ibid.
82Quoted words: Ibid.
83Research funds: Eli Ginzberg, Milner Interv, 10 Sep 63, USACMH.
230
84Maxwell: TLO, OTSG, Biography of Col. Roy D. Maxwell, MSC, Feb 1962; and Rpt, Col Charles R. Angel, MSC, sub: Development of Nuclear Science Within the MSC, undated (1976), both in DASG-MS. Prosthetics: Col Maurice J. Fletcher, MSC, draft section, sub: Prosthetics, 1958 MSC History Project. Col. Robert S. Allen, who lost an arm as the G-2 of Patton's Third Army, led the fight that resulted in formation of the laboratory.
85Science corps: The same idea resurfaced periodically in subsequent years.
86First students: Lt Col Charles A. Pendlyshok, MSC, to Lt Col John P. Ransom, MSC, 29 May 60, box 19/18, MSC-USACMH.
87Social work: Elwood H. Camp, 'The Army's Psychiatric Social Work Program,' Social Work Journal: 29 (April 1948): 76-77, 78, 86; Rpt, Camp, sub: As I Remember Army Social Work from April 1947 to June 1951, in Ltr to Ginn, 20 Sep 84, DASG-MS, hereafter cited as Camp, As I Remember Social Work; MSC Newsletter, October 1960; Camp, 'Psychiatric Social Work in the Army Today,' in Henry S. Maas, ed., Adventures in Mental Health (New York: Columbia University Press, 1951), pp. 203-20; Lecture, Camp, Notes for Presentation at the Army Social Work Meeting, National Conference of Social Work, Atlantic City, New Jersey, May 1951, DASG-MS; WD SO 50, 12 Mar 47, DASG-MS; 'Clinical Psychology and Psychiatric Social Work,' Medical Bulletin (September 1947): 755-56; 'Psychiatric Social Worker's Program,' Medical Bulletin (January 1948): 22; Col Henry W. Adams, MSC, and Lt Col Ralph W. Morgan, MSC, draft chapter, sub: Social Work, in 1958 MSC History Project.
88Women: Camp, As I Remember Army Social Work.
89Social work graduate program: SR 605-60-42, 2 Sep 49, PL. Camp was assigned to Fitzsimons from 1951 to 1954 as chief of social work. He later entered hospital administration and served as the executive officer of Triplet Army Hospital in Hawaii from 1955 to 1958.
90Yerkes: Robert M. Yerkes, 'Post-War Psychological Services in the Armed Forces,' Psychological Bulletin 42 (1945): 396-97.
91Recruiting failure: Maj Gen R. W. Bliss, TSG, to Lt Col E. E. Beauchamp, Dir Programs and Analysis, sub: Regular Army Procurement and Specialty Training of Medical Service Corps Officers, 12 Apr 49, folder 160, box 11/18, MSC-USACMH.
92Psychology graduate program: SR 605-60-40, 16 May 49, PL; 'The U.S. Army's Senior Psychology Student Program,' American Psychologist 4 (1949): 424-25; Bliss to Beauchamp, 12 Apr 49. Number: Paper, Harold D. Rosenheim, 'A History of the Uniformed Clinical Psychologist in the U.S. Army,' presented to the American Psychological Association, Montreal, Canada, 2 Sep 80, DASG-MS.
93Cold weather: Col Raymond J. Karpen, MSC, to Israeloff, 14 Apr 76; OTSG, Travel Orders, 14 Jul 48 and 19 Jan 50; App B to Rpt of Subcommittee on Waste Disposal, National Research Council, 6 Oct 49, all in Karpen Files, DASG-MS.
94Hardenbergh's opposition: Hardenbergh to Karpen, 21 Oct 48, and Ltr, Karpen to Col Earl Herndon, MSC, 7 Nov 83, both in DASG-MS; also see Rpt, Col George W. Hunter III, MSC, sub: Reminiscences, 1971, MSC-USACMH. Quoted words: Hardenbergh to Armstrong, 15 Oct 48, DASG-MS.
95Complaints: Hardenbergh, 'What's Wrong with Army Engineering?' Public Works Magazine 79 (October 1948): 7; Hardenbergh, 'I've Had Enough,' Public Works Magazine 79 (December 1948): 7; 'For Your Information and Amusement,' Public Works Magazine 81 (October 1950): 14; Hardenbergh to Karpen, 12 May 49, and Hardenbergh to Col Tom Whayne, 19 Aug 59, both DASG-MS; Editorial, Hardenbergh, 'The Army Reserve,' Public Works Magazine 79 (December 1948): 14.
96Elder: Armstrong to Francis B. Elder, 17 Aug 50, responding to Elder's 14 Aug 50 letter, DASG-MS.
97Quoted words: Armstrong to Hardenbergh, 19 Jun 50, DASG-MS.
98Quoted words: Memo, Goriup for Armstrong, 15 Jun 50, DASG-MS.
99Wolman: Abel Wolman to Lt Col Fred F. Fielding, Ch, Career Management Br, Pers Div, OTSG, 27 Sep 48; Karpen to Herbert M. Bosch, Environmental Sanitation Div, Minnesota Dept of Health, 24 Nov 48, both in DASG-MS. Wolman died in 1989 at the age of ninety-six. He had pioneered the use of chlorine in water purification and advised fifty nations on their water systems. U.S. News and World Report 113 (6 March 1989): 16.
231
100. Quoted words: National Academy of Sciences-National Research Council, Committee on Sanitary Engineering and Environment, sub: Minutes of Meeting, 21 Dec 48, DASG-MS.
101. Optometrists: Speech, Goriup, sub: The Role of the Optometrist in the Army Medical Department, New Jersey Optometric Association, 15 Oct 47; Speech, Lt Col John W. Sheridan, MSC, Ch, MSC Optometry Sec, sub: Military Optometry, undated (late 1950s), both in DASG?MS; Goriup to Andrew F. Fisch, O.D., Secretary, New Jersey Optometric Association, 11 Aug 50, folder 39, box 4/18; OTSG, Biography of Lt Col John W. Sheridan, MSC, 1958, folder 55, box 5/18, both in MSC-USACMH. Sheridan received his O.D. from Ohio State in 1935 and was commissioned from the Ordnance OCS in 1942. Not all optometrists were pleased, such as those who were over thirty years old and thus ineligible for a Regular Army commission. See Ltr to editor, Elmer S. Friedberg, 'Optometric Progress in Army Medical Service Corps Questioned,' Optical Journal-Review 85 (15 February 1948): 50.
