History

CHAPTER X

Utilization of Personnel

ASSIGNMENT OF MEDICAL DEPARTMENT PERSONNEL

The accuracy of classification in large measure determinedthe adequacy of assignment, which was in turn the key to maximum utilization ofthe tremendous reservoir of skills and experience that made up the Army MedicalDepartment in wartime. Only because the classification of both officers andenlisted men-but particularly that of medical officers,including proficiency ratings-was by and large anoutstanding accomplishment, was it possible to place a very high percentagewhere each individual`s greatest potential could be realized.

The Surgeon General actually had assignment jurisdiction over only that smallpercentage of Reserve officers who belonged to the Army and Service AssignmentGroup. During the emergency period and until the creation of the Services ofSupply in 1942, he assigned officers to all named general hospitals (of whichthere were 15 by the end of 1941, 10 of them having been established since thebeginning of the emergency), medical supply depots, and the Medical FieldService School. Most Reserve officers, however, were in the Corps AreaAssignment Group, under the assignment authority of the commanding generals ofthe corps area, who acted on the advice of their staff surgeons. This divisionof authority did not ordinarily prevent a proper distribution of assignments.The Surgeon General could communicate with the corps area surgeon through thelatter`s commander and tell him what types of personnel could be made availableto him. If the corps area had vacancies for such personnel, the surgeon couldthen take steps to obtain them from outside the corps area.

The Problem of Proper Assignment, 1939-41

An officer`s assignment was not always, or entirely, based onhis classification, nor was he always kept fully occupied in the position forwhich he was best fitted. This gave rise to complaints of misassignment.

Letters from officers, and from civilians as well, told not only of themisuse of skills-they told, too, of the waste ofphysicians` time in idleness. Medical associations showed their concern byforwarding copies of these letters to the Surgeon General`s Office.¹That Office`s reply to such criticisms was that there

¹(1) Letter, Mrs. Margaret Black Warres, Harrington, Del., to Brig. Gen. Frederick Osborn, USA, Washington, D.C., 26 Nov. 1941. (2) Letter, Thomas A. Hendricks, Executive Secretary, Indiana State Medical Association, Indianapolis, Ind., to Olin West, M.D., Secretary, American Medical Association (and others), 12 Feb. 1941, with enclosure thereto.

290

would be small demand for some specialties during thetraining program; the soldiers were of an age at which very little surgery, forexample, was necessary. The picture, however, would change entirely if we becameengaged in war.²

There was little the Medical Department could do to keep many of thesespecialists constantly engaged in their own fields. A higher proportion ofcertain types of specialists existed in civilian life than the Army required(obstetricians, for example); consequently, some specialists had to performduties outside their specialty. Attempts were made to assign them so that theycould do some work in their special field, and they were assigned to hospitalswhenever possible. For a time, the position of specialists within the NationalGuard was particularly hard. They were inducted with the regimental medicaldetachments of which they were members and restrictions on their reassignmentprevented their transfer, even if outstanding specialists, from these units intohospitals giving the type of treatment where full use of their professionalskill could be made. This restriction was not removed until September 1941.³

The problem of proper assignment was further complicated by the necessity offinding a place for certain officers of the Reserve and the National Guard whohad been promoted to a rank higher than their professional capabilities.Finally, the shortage of medical administrative officers until well after PearlHarbor compelled the employment of doctors, dentists, and veterinarians inadministrative duties to a greater extent than was the case later on. However,the professional groups in the Army, as in civilian life, could at no timecompletely escape certain administrative functions.

Sometimes the cause of inappropriate utilization lay with theMedical Department, sometimes it was outside its control. Especially in the daysof building camps, recruiting personnel, and obtaining equipment, the matchingof need with supply was an intricate and at times impossible task. No doubt, theMedical Department sometimes erred on the side of safety. If, for example,medical officers arrived at a camp before other men and equipment, it wasprobably because the Department judged it better to have physicians presentbeforehand than to risk being without them when men needed treatment.

To prevent medical officers serving in field units fromlosing their skill, a plan of rotation was promulgated in February 1941; itprovided that after an officer had spent 6 months in a fixed installation hecould take a refresher course and be assigned to a tactical unit, or vice versa.⁴The plan affected few officers, however. It was voluntary, and although theOffice of The Surgeon General was swamped with requests for transfers from fieldunits to fixed installations, almost no one requested transfer in the oppositedirection; hence, the system proved unworkable.

²Letter, Col. George F. Lull, Office of The Surgeon General, to Dr. Edwin F. Lehman, Department of Surgery, University of Virginia, Charlottesville, Va., 25 Nov. 1941.
³Letter, The Adjutant General, to Commanding Generals of all Armies, Army Corps, Divisions, (and others), 19 Sept. 1941, subject: Transfer and Reassignments-Officers of National Guard of United States.⁴Letter, The Adjutant General, to Commanding Generals, all Armies and Corps Areas, 4 Feb. 1941, subject: Rotation of National Guard and Reserve Medical Department Officers.

291

Misassignment

Officers

Some of the same factors that hindered proper classification-rapidprocurement during the summer of 1942, insufficient information concerning theprofessional qualifications of the doctors procured, and lack of experience,with the established procedure-doubtless interfered withproper assignment; that is, the placement of officers in jobs that called fortheir best talents and that they were physically qualified to fill. In the fallof 1942, the Committee to Study the Medical Department as one of its "majorfindings" stated that it had heard numerous complaints of misassignment ofprofessional personnel by the Medical Department, involving for one thing"the assignment of doctors, either part or full time, to clerical or otheradministrative duties." Under established practice, however, most of theseduties were the direct responsibility of Army medical officers.

Although the committee heard complaints about "the assignment ofspecialists to the practice of general medicine or of other specialties nottheir own,`` the specialty boards themselves were on the whole well pleased andwere of great assistance to the Personnel Service. The Chief of The SurgeonGeneral`s Personnel Service received conclusive evidence of this in replies toqueries he had directed to them late in 1942-the greatmajority of officials replying for the boards expressed satisfaction with theclassification and assignment performed by the Surgeon General`s Office.⁵Spokesmen for the Army neuropsychiatrists asserted that, in spite ofconstant effort to keep neuropsychiatrists in jobs devoted to their specialty,the younger graduates were often assigned as general practitioners to groundforce units or organizations alerted for oversea movement. The criticsattributed this to The Surgeon General`s lack of power to reassign medicalpersonnel within certain commands, which made it impossible for him to compelproper use of these specialists. They compared the Surgeon General`s Office to afire department that procured and pumped water through a hose but was denied theright to direct the nozzle at the fire.⁶

It is true that The Surgeon General lacked authority for some time to orderthe reassignment of personnel within any service command, the Air Forces, theGround Forces, or the oversea theaters. So far as reassignment within theservice commands was concerned, however, the trouble was perhaps not entirelythe want of authority on the part of the Surgeon General`s Office but to someextent the situation within the service commands themselves, where the workingof the assignment system seems to have been hampered by lack of personnel withtraining adequate to perform the task most efficiently.⁷

⁵Letters, American Specialty Boards, to Col. George F. Lull, Chief, Personnel Service, Office of The Surgeon General, September-October 1942.
⁶Farrell, Malcolm J., and Berlien, Ivan C.: Neuropsychiatry, Personnel. [Official record.]⁷Letter, Robert W. W. Evans, M.D., to Col. C. H. Goddard, Office of The Surgeon General, 8 Dec. 1952, with enclosure thereto. (Dr. Evans was assigned to the Classification Branch, Military Personnel Division, Office of The Surgeon General, from 1942 to 1945, and served as its chief during the later war years.)

292

In spite of certain drawbacks, it is possible that thedecentralization of the power to assign officers was the best system during theearly war years. At that time, The Surgeon General was so largely occupied withadapting his Department to meet the demands of a two-front war and withprocuring officers that he no doubt needed the assistance of others in makingassignments. In the later war years, however, when he had improvedclassification procedures and acquired more thoroughgoing statisticalinformation on the distribution of Medical Department officers, he certainlyknew more about the relative needs for them, both as between the theaters ofoperations and the United States and within the United States itself. As thisbecame increasingly apparent to War Department authorities in the higherechelons, he regained more control of the personnel of the Medical Department.

Some of the causes of misassignment that had raised difficulties during theperiod 1939-41 still operated during the war. Among those which became moreobvious as time went on was one stemming from the Army`s system of promotion.Men who had entered the service before or in the early part of the war hadfilled the higher ranking posts in many units and installations. Those whojoined later were therefore sometimes placed in subordinate positions regardlessof professional ability.

There were plenty of reasons why misassignments should occur, but some of thecomplaints on that score were unjustified. Apparently, some doctors not onlybelieved they would practice medicine in the Army in much the same manner asthey had in civilian life but understood little of the need for any time spentin training. When they were assigned first for training and later to a job thatdid not duplicate their civilian practice, many objected that the Army waswasting their professional skills. Others raised the same objection simplybecause they overrated their own capacity.

An assignment feature was the use of officer replacement pools, establishedby the Army just after the outbreak of war.⁸The existence of pools facilitated the task of meeting promptly the need forofficers; they contained unassigned personnel who could be withdrawn forassignment to other units or installations as the occasion demanded. Many newlycommissioned officers were sent to pools pending their initial assignments. As amatter of convenience, unassigned officers not available for jobs-forexample, persons awaiting discharge or sick in hospital-mightalso be placed in the pools. Medical Department officer pools were located atreplacement training centers, certain general hospitals, and-forthe Veterinary Corps-at Quartermaster depots and portsof embarkation. When pools were first created, the Medical Department wasallotted a maximum strength of 1,500 for them. This figure was changed from timeto time as conditions required.

⁸Letter, The Adjutant General, to Chief of each Ground Arm and Service (and others), 19 Dec. 1941, subject: Officer Filler and Loss Replacements for Ground Arms and Services.

293

Enlisted men

Errors also occurred in the assignment of enlisted men. Forexample, men sent to technicians schools to receive specialized trainingsometimes received assignments on which such training was unnecessary. In August1942, The Surgeon General asserted that this mistake was being made in numerousinstances, due, he believed, partly to the errors of medical units in makingrequisitions on The Adjutant General and partly to the errors of The AdjutantGeneral in filling them. Although he himself lacked personnel who understood thesituation, The Adjutant General nevertheless failed to follow therecommendations of The Surgeon General, who had allocated certain numbers oftechnicians to these units. The Adjutant General had even assigned somegraduates to Zone of Interior installations that possessed technicians schoolsas their own sources of supply. According to The Surgeon General, 56 percent ofthe technicians graduating in July 1942 had been assigned to units andinstallations other than those he recommended. He therefore proposed that Zoneof Interior hospitals receive personnel direct from reception centers, thatcommanders of theater of operations units submit requisitions for MedicalDepartment technicians in the numbers authorized by their tables of organization(that is, only for those shown as "rated" in the tables), that theAdjutant General`s Office follow the recommendations of The Surgeon General inallotting technicians, and that a Medical Department officer be assigned to theReplacement Section of the Adjutant General`s Office "who has a knowledgeof permissible substitutions in technical specialties and who will maintainclose liaison with the Office of The Surgeon General in the disposition oftrained technicians." The response was generally favorable. Headquarters,Services of Supply, believed it unnecessary to assign a Medical Departmentofficer to full-time duty with the Adjutant General`s Office but suggested thata representative of The Surgeon General be designated to assist The AdjutantGeneral "when occasion demands." That headquarters also instructed theAdjutant General`s Office to follow The Surgeon General`s recommendations as tothe disposition of technically trained personnel "so far as possiblesubject to the priorities imposed by higher authority." It approved theremainder of The Surgeon General`s recommendations and ordered directives to beissued putting them into effect.⁹

These measures did not settle the question of misassignedpersonnel, if only because they covered something less than the whole field.Various efforts were made to cope with the problem, including the occasionalreclassification and reassignment of individual enlisted men.¹⁰

⁹(1) Memorandum, The Surgeon General, for Director of Training, Services of Supply, 28 Aug. 1942, subject: Dissipation of Trained Enlisted Personnel. (2) Memorandum, Director, Military Personnel, Services of Supply, for The Surgeon General, 14 Sept. 1942, subject: Request for Filler and Loss Replacements.
¹⁰Memorandum, The Surgeon General, for The Adjutant General, 14 Dec. 1942, subject: Reclassifications of Enlisted Men.

294

It would be difficult to estimate the precise extent of misassignment so faras Medical Department enlisted personnel were concerned, for one reason becauseproper assignment was a matter of degree and circumstances. An enlisted man wasin a sense properly assigned to the Medical Department if his civilianexperience or his training in the Army made him useful there, and his removalfrom the Department would constitute a misassignment. On the other hand, even ifhe remained in the Medical Department, he might be improperly assigned, eitherbecause he was actually needed more somewhere else or because the Department wasnot making the best possible use of his abilities.

The problem of transfers of qualified personnel was a serious one to theMedical Department. For example, in September 1943, The Surgeon General`sPersonnel Director cited the cases of 18 noncommissioned officers who had beentransferred to other branches after 3 to 25 years of service with the MedicalDepartment. The Surgeon General`s Office, he said, heard of only a smallpercentage of such transfers. Taken together they meant that "a serioussituation has arisen * * *. It seems uneconomical and foolish to train men forcertain duties and then transfer them to other branches where they know nothingof the technical work and have to be retrained. To replace them, we have totrain new men."¹¹ He pointed out that thetransfers were made by the service commands, and it was their interpositionwhich The Surgeon General`s Personnel Office at the end of the war singled outas being responsible for transfers of this kind as well as for other personnelpractices to which it objected. That office stated in September 1945:

Distribution of enlisted personnel to installations wassatisfactory until branch allotments [that is, bulk authorizations of certainnumbers of enlisted men according to their branch of service] were discontinuedduring the summer of 1943, and authority was delegated to local commanders tomake suballotments and assign personnel according to their own policies * * *.Operating policies were never uniform throughout the commands at such a lowlevel, and the pride, loyalty, and efficiency of medical enlisted men servingunder these conditions was greatly impaired. Perhaps the most demoralizing actwas the transfer of many high ranking noncommissioned officers of long trainingto other branches and the transfer of noncommissioned officers of other branchesinto the Medical Department. Competent though these men undoubtedly were intheir previous assignments, they were so inept, untrained and unskilled in theduties encountered in the Medical Department that some were reduced.¹²

In the middle of 1943, at any rate, the Director of Military Personnel, ArmyService Forces, felt that the assignment of medical technicians wassatisfactory. His office had investigated the "alleged misassignment"of technically trained personnel, particularly medical, and found itself inagreement with the Commanding General, Army Ground Forces, who had stated

¹¹Letter, The Surgeon General, to Director, Military Personnel, Army Service Forces, 13 Sept. 1943, subject: Transfer of Medical Department Enlisted Men to Other Branches.
¹²Report, Military Personnel Division, Office of The Surgeon General, to Historical Division, summer 1945, subject: Medical Department Personnel. (The statement goes on to say that the Surgeon General`s Office made a vigorous effort to recover the men so transferred and that the situation had improved "during the last eighteen weeks [that is, at the very end of the war] but only a return to the branch allotment system will fully correct the situation.")

295

that every effort was being made to prevent misassignments,and that when they did occur it was generally because of temporary surpluses oftechnicians, who were appropriately assigned later. This condition, the Directoradded, existed "in the Services as well as in the Ground Troops."¹³

The problem of proper assignment was involved with that ofthe procurement and retention of personnel. The number of men with medicalbackgrounds who were assigned by the reception centers to the Medical Departmentor who were reassigned to it by other branches of the service constituted animportant part of the Department`s procurement. Regulations against thereassignment of Medical Department personnel to other branches or to jobsoutside the United States might have helped to reduce the amount of procurementthat had to be done for the Department, at least in the Zone of Interior. Fromthe early part of 1944 onward, the increased effort to channel critically neededmedical technicians into the Medical Department both from the reception centersand from nonmedical branches of the Army probably helped to reduce misassignmentnot only in the Medical Department but elsewhere.

Assignment Problems in the War Years

Toward the end of 1943, Army Service Forces headquarters,prompted by a report submitted by The Inspector General "and otherreports," ordered a survey of the classification and assignment of allmilitary personnel in its command. Two examples of the findings with regard toMedical Department officers appear in the surveys conducted at the Army MedicalCenter, Washington, D.C., and in the Fourth Service Command. These surveys givesome idea of how suitably officers were assigned and perhaps also howappropriately they were classified in the Medical Department as a whole up tothis time. At the Army Medical Center, the survey of 427 officers showed that366 (or 85.7 percent) had good assignments, 44 (10.3 percent) had fairassignments, and 17 (4 percent) had misassignments. The report on thisinstallation pointed out that there were three kinds of misassignments: (1) Anofficer might have substantially more skill and experience or substantially morerank than was required for his assignment; (2) he might have substantially lessskill and experience than were required for his assignment; or (3) he might beassigned to the wrong occupational field when his skill was needed elsewhere.¹⁴In the Fourth Service Command, a preliminary report covering somewhat more thanhalf the Medical Department officers showed that about 86 percent had goodassignments, over 13 percent fair assignments, and less than 1 percentmisassignments. The surgeon of the command stated that it was difficult totransfer

¹³Memorandum, Director, Military Personnel Division, Army Service Forces, to Director of Military Training, Army Service Forces, 15 July 1943, subject: Transfer of Medical Department Enlisted Men.
¹⁴Letter, Maj. Fred J. Fielding, Office of The Surgeon General, to Army Medical Center, 13 Jan. 1944, subject: Officer Assignment Survey.

296

men discovered to have fair assignments or misassignments as no replacementswere available.¹⁵

The Surgeon General`s Office and the various service commandheadquarters of Army Service Forces placed considerable reliance on theirprofessional consultants for assistance in assignment. Consultants in theSurgeon General`s Office advised personnel officers there on the staffing ofunits, and in August 1944, this function became mandatory when The SurgeonGeneral ordered that "assignments of key personnel will be made only withthe concurrence of the appropriate service or division particularly concernedwith, or possessing special knowledge as to the qualifications of the officersand the requirements of the specialty assignments."¹⁶While the order did not specifically mention consultants, the "appropriateservice or division" would be, in many cases, one of the sections of theoffice headed by the consultant (or his equivalent) in a professional branch ofmedicine. At that time, those sections were the Medical Consultants Division,the Surgical Consultants Division, the Neuropsychiatry Consultants Division, theReconditioning Consultants Division, the Preventive Medicine Service, the DentalDivision, the Veterinary Division, and the Nursing Division.

In the later war years, it continued to be more difficult toassign than to classify doctors according to their capabilities, if only becausethe needs of the Army did not always match the material it had at its disposal.An example of doctors assigned outside their specialty for unavoidable reasonswas the case of gynecologists and obstetricians. In November 1943,"considerably less than half" the 650 Army doctors so classified wereengaged in that type of work. Those who were employed in their specialtiesattended female members of the Medical Department and the dependents of Armypersonnel. The use of a larger percentage in their specialty had to await theentrance of large numbers of Women`s Army Corps members into the Army. Even inassignments requiring their professional skill, Army doctors were not able todevote all their time to their specialty. Administrative duties took a higherproportion of their time than it had done in civilian practice. In addition,some doctors found the Army system of evacuation unsatisfactory because itrequired passing many patients through a number of medical units beforedefinitive treatment was given, and thus prevented the individual physician fromfollowing certain cases through to the end.

There were cases of assignment which not only did not takequalifications fully into account but which can hardly be excused on the scoreof Army necessity-as, for example, that of the warsurgeon who was classified as a neurosurgeon although he had done nothing of thesort in his life.¹⁷ Despite continuingvigilance on the part of The Surgeon General, there were instances ofmisassignment as long as the war lasted. These were sometimes brought

¹⁵Annual Report, Surgeon, Fourth Service Command, 1943.
¹⁶Office Order No. 175, Office of The Surgeon General, U.S. Army, 25 Aug. 1944.
¹⁷Memorandum, Director, Resources Analysis Division, Office of The Surgeon General, for Chief, Operations Service, Office of The Surgeon General, 10 June 1945, subject: Visit to England General Hospital.

297

to light through the complaints of doctors or members oftheir families addressed to the American Medical Association or to the WhiteHouse. Whenever The Surgeon General learned of an actual case of misassignmenthe endeavored to rectify it.¹⁸ This, of course,was more difficult during the early years of the war prior to establishment offirm classification criteria and when his authority in connection withassignment and reassignment of Medical Corps officers in the United States wasconsiderably curtailed.

There is ample testimony that the assignment of doctors whowere specialists was on the whole well done. In April 1945, the surgicalconsultant in the Surgeon General`s Office reported that, of 922 surgicalspecialists certified by specialty boards or having equivalent qualificationswho were serving in Army installations in this country, 96 percent (or 885) weredoing surgery in their own specialty. The other 4 percent (or 37) who were notdoing surgery, he reported, were serving as consultants either in the SurgeonGeneral`s Office or in the nine service commands.¹⁹Referring to surgical personnel, the Chief of the General Surgical Branch of theSurgical Consultant`s Division, Office of The Surgeon General, wrote: "Thecompetent performance of the surgical personnel who participated in World War IIundoubtedly had more to do with the surgical results achieved than any othersingle factor. That performance was made possible, in turn, by the increasedavailability of such personnel, in comparison with World War I, and by properassignment."²⁰ Likewise, the consultant inneuropsychiatry estimated that at the end of the war only 3 percent of thespecialists in his field were misassigned.²¹

When in 1946 the Procurement and Assignment Service wassumming up its wartime experience with the organization and administration ofthe medical branches of the Armed Forces, it wrote as follows:

In spite of many difficulties the Office ofThe Surgeon General has accomplished a notable feat in the general assignment ofmedical personnel to work for which they have been especially trained. Muchcredit is deserved for overcoming an attitude formerly prevalent, "that anymedical officer was a medical officer and could do anything equally well."The great improvement in results of medical care in this war is due more to theeffective use of highly trained men than to any other single factor.²²

THE REPLACEMENT SYSTEM

Vacancies overseas could be filled by direct transfer of personnel from otherunits, which in turn created vacancies in those units; fromtable-of-organization units having an overstrength; and from the Zone ofInterior. The replacement system functioned with regard to enlisted men in thesame man-

¹⁸Letter, Maj. Gen. George F. Lull, Deputy Surgeon General, to Dr. Morris Fishbein, Secretary, American Medical Association, 5 Nov. 1944.
¹⁹Rankin, F. W.: The Mission of Surgical Specialists in the U.S. Army. Surg. Gynec. & Obst. 80: 441-444, April 1945.²⁰DeBakey, M. E.: Military Surgery in World War II; Backward Glance and Forward Look. New England J. Med. 236: 341-350, 6 Mar. 1947.²¹Information from Brig. Gen. William C. Menninger, Office of The Surgeon General, 11 June 1946.²²Memorandum, Dr. Frank H. Lahey, Chairman, Directing Board, Procurement and Assignment Service, for Watson B. Miller, Administrator, Federal Security Agency, 26 June 1946.

298

ner as it did for officer personnel-thetheater commander was responsible for requisitioning the necessary replacementsand the War Department for filling the requisitions as best it could. MedicalDepartment authorities in the various theaters had the responsibility forfinding suitable positions for such replacements or casuals as were allocated tothem; for correcting any errors in assignment made initially by the responsibleauthorities in the Zone of Interior; and for transferring personnel, even whensatisfactorily located, to assignments in which they could be of greatestservice.²³

Sources of Oversea Replacements

Replacement personnel for the Medical Department came fromthree main sources: (1) Personnel released from hospitals; (2) personnel madeavailable by administrative actions; and (3) casuals from the Zone of Interior.

Personnel released from hospitals

Probably, the chief source of replacement personnel for theMedical Department consisted of individuals who had been hospitalized anddropped from assignment to their former units. In the European theater, 46percent of the officers of the Medical Department entering the Ground ForcesReinforcement Command during the period of ground combat came from detachmentsof patients in hospitals. This was higher than the corresponding percentage ofall officers, that is, 38. It was also higher than that of Medical Departmentenlisted men, that is, 44, which, in turn, exceeded the percentage of allenlisted personnel by three points (table 24).

In the case of both enlisted men and officers, the percentage of men fromdetachments of patients who returned to their old units was greater in the Armyas a whole than it was in the Medical Department. For Medical Departmentenlisted men, the percentage was 53, while that of the Army in general was 60.Corresponding percentages for officers were, respectively, 51 and 63.

Among the replacements supplied to the Medical Department by the GroundForces Reinforcement Command in the European theater, a smaller proportion ofthe officers than of the enlisted men appear to have been limited assignmentpersonnel. The proportion of such officers seems to have been larger than thatwhich the Command provided the Army as a whole.

Because of the lengthy professional education required for medical, dental,and veterinary officers, it is probable that very few officers, other thanMedical Administrative Corps officers, whether suited for limited assignment orotherwise, were transferred to the Medical Department from any source outsideitself.

²³(1) War Department Field Manual, 100-10, Field Service Regulations, 9 Dec. 1940 and 15 Nov. 1943. (2) Annual Report, Surgeon, North African Theater of Operations, U.S. Army, 1943.

299-300

TABLE 24.-Movement of Medical Departmentpersonnel in and out of Ground Forces Reinforcement Command, European Theater ofOperations, D-day to V-E Day
(6 June 1944-8 May 1945)

Groups	Total officers	Medical Department officers	Total enlisted men	Medical Department enlisted men
Input
Total	55,966	2,484	1,259,046	45,002
On hand, 6 June 1944	4,520	122	71,506	2,749
Arrivals:
Total	51,446	2,362	1,187,540	42,253
From ZI:
Number	24,428	801	511,620	6,318
Percent of total arrivals	47.48	33.91	43.08	14.95
From theater sources:
Detachments of patients:¹
Number	19,766	1,079	484,873	18,547
Percent of total arrivals	38.42	45.68	40.83	43.90
OCS graduates:²
Number	792	---	---	---
Percent of total arrivals	1.54	0	0	0
Other sources:
Number	6,460	482	191,047	17,388
Percent of total arrivals	12.56	20.41	16.09	41.15
Output
Total	49,633	3,120	1,073,378	38,331
Shrinkage:³
Number	3,686	404	48,873	6,238
Percent of total output	6.59	16.26	3.88	13.86
Shipped for service in theater:
Total	45,947	2,716	1,024,505	32,093
Percent of total output	92.57	87.05	95.45	83.73
Returnees to units:⁴
Number	12,495	550	291,870	9,839
Percent of total shipped	27.19	20.25	28.49	30.66
White:
General assignment	11,934	485	266,647	8,843
Limited assignment	248	24	11,920	711
Negro:
General assignment	39	1	9,146	86
Limited assignment	---	---	519	9
Category unknown⁵	274	40	3,638	190
Others:⁶
Number	33,452	2,166	732,635	22,254
Percent of total shipped	72.81	79.75	71.51	69.34
White:
General assignment	25,465	1,233	564,002	16,039
Limited assignment	2,984	211	111,491	3,432
Negro:
General assignment	165	11	13,090	488
Limited assignment	6	---	1,474	67
Category unknown⁵	4,832	711	42,578	2,228
Percent of general assignment in number shipped	18.84	63.70	83.25	79.32
Percent of limited assignment in number shipped	7.05	8.65	12.24	13.15
On hand, 8 May 1945	6,157	152	188,669	8,425
Excess of output on hand (8 May 1945) over input⁷	-176	788	3,001	1,754

¹Arrivals from the detachment of patients who arescheduled for return to units (but also includes those limited assignment mennot eligible for return to combat units and who subsequently were assigned toother units).
²Enlisted men who became officers during the period of the report.³Losses through absent without leave, transfer to detachment of patients,evacuation to Zone of Interior, and like reasons; also 4,056 Medical Departmentenlisted men retrained under infantry retraining program and 16 MedicalDepartment enlisted men sent to officer candidate school.
⁴Individuals from detachments of patients who were returned to theunits in which they served prior to hospitalization. They are designated as"casuals" in the source.⁵Unreported as to race or ability to fill general or limited assignment.Represents shipments only from 10th Depot in United Kingdom for period from 6June to 31 December 1944.
⁶Designated as "reinforcements" in the source.⁷The following explanation of the discrepancies between output and inputoccurs in the source:
"4. The violent flow of stockage through the Command precluded any attemptto account for all assignments outside of the originally reported branch toanother branch * * *. A further factor * * * lies in the fact that the openinginventory (D-day) included approximately 35,600 men in packages prepared forInvasion Operations. Approximately 15,000 were returned to stockage afterestimated requirements were found to be too high. A good portion of these menwho were carried in packages as infantry, were members of branches other thaninfantry who subsequently shipped out in their original branches. Exactaccounting of these transactions is not available. FA [Field Artillery] and TD[Tank Destroyer] were the branches principally affected * * *."
The above quotation probably helps to explain the discrepancy in the case ofMedical Department enlisted men and, perhaps, officers. In the case of theMedical Department officers it is also possible that a certain number enteredthe replacement system as members of nonmedical services or arms and then wereassigned to administrative duties with the Medical Department. It is doubtful,however, whether these would account for the entire discrepancy.

Source: Headquarters, Ground ForcesReinforcement Command, European Theater of Operations, "Flow of Enlistedand Officers Stockage for Period D-Day to V-E Day (6 June 1944 to 8 May1945)." in History of the Ground Force Reinforcement Command,European Theater of Operations, U.S. Army, pt. II, ch. VI.

301

In the Southwest Pacific, theater headquarters in late 1944and the early part of 1945 attempted to make arrangements under which limitedservice officers no longer fit for duty in their original branches would be madeavailable for service in the Medical Administrative Corps. The scheme wascarried into effect to some extent but it not only aroused opposition on thepart of the services losing the officers but also failed, because ofinexperience of the officers transferred in matters pertinent to the jobs to befilled, to arouse much enthusiasm in the Medical Department.²⁴

Personnel made available by administrative actions

Units developed an overstrength in given types of personnel as a consequenceof table-of-organization changes. This overstrength might be used by otherunits. In the European theater, for example, the reorganization of generalhospitals under T/O 8-550, 3 July 1944, made available for other assignmentsparticularly in units arriving from the Zone of Interior short of Medical Corpsofficers or specialist personnel, 450 Medical Corps officers. Indeed, it waswith a view to meeting the needs of such units that the War Department directedthis reorganization.²⁵

By a directive of 30 November 1944, Headquarters,Communications Zone, European Theater of Operations, ordered 92 generalhospitals in that theater to be reorganized with substantial decreases in theauthorized nursing and enlisted personnel permitted for each and with minorreductions in male officer strength. The personnel thus made available was to bereported by the hospital commanders to the Commanding General, Ground ForcesReplacement System, through base or section headquarters, for transfer to anappropriate replacement depot.²⁶ As of 30November 1944, the reorganization of station hospitals under T/O 8-560, 28October 1944, had made surplus, according to an estimate prepared in December ofthat year, a total of 477 medical officers in all theaters.²⁷

In certain cases, units were abolished in order to supplypersonnel for others. Deactivation of six station hospitals in the North Africantheater made it possible to provide specialized personnel for the enlargement ofgeneral hospitals in that theater in 1944.²⁸

In particularly pressing circumstances, certain medical unitsgave up personnel, without abolishing the pertinent positions, to unitsconsidered to be in greater need of the personnel than themselves. In 1942,units in the

²⁴Memorandum, Deputy Chief Surgeon, U.S. Army Forces, Far East, to Chief Surgeon, 12 Apr. 1945.
²⁵Administrative and Logistical History of the Medical Service, Communications Zone, European Theater of Operations. [Official record.]
²⁶Organization Order 68, Headquarters, Communications Zone, European Theater of Operations, 30 Nov. 1944.
²⁷Letter, Office of The Surgeon General (R. J. Carpenter, MC), to War Department, Assistant Chief of Staff, G-1, through Commanding General, Army Service Forces (attention: Director, Military Personnel Division), 8 Dec. 1944, subject: Memorandum of Transmittal.
²⁸Logistical History of NATOUSA-MTOUSA, 11 August 1942-30 November 1945. [Printed in Naples, Italy, by G. Montanino, 1945.]

302

European theater designated to participate in the invasion ofNorth Africa were brought up to strength by drawing upon other medicalestablishments which were to remain behind in the United Kingdom.²⁹Subsequently, in 1944, when the cross-channel invasion of France was undertaken,personnel assigned to communications zone installations in the theater was sentforward into the combat zone in order to provide medical care in field units.When, on 22 June 1944, the First U.S. Army, spearheading the invasion of France,found it necessary to requisition 46 Medical Corps officer replacements, theywere obtained not only from replacement depots located in the United Kingdom butalso by transfer from general and station hospitals situated therein.Forty-eight hours after the requisition had been submitted, the replacementsbegan to arrive and continued to do so until 30 June.³⁰

At the time of the Battle of the Bulge in December 1944 and January 1945,there again was a heavy demand for both officer and enlisted replacements, andcommunications zone units were found to be virtually the only source of suchpersonnel. Despite the fact that conditions at the front were doubling andtripling their patient loads, these installations were called upon for and didsupply more than 300 medical officers for frontline units.³¹

Within a month and a half, more than 3,100 enlisted men also were sentforward to help provide the combat zone medical service. On several occasions,the Ground Forces Reinforcement Command, despite its responsibility to providemedical service to the personnel passing through the replacement system,supplied Medical Department officers to satisfy the more urgent needs of combatunits.³²

Some time in 1945, apparently, the Personnel Division of the Chief Surgeon`sOffice, European theater, stated that a base section might be renderedunderstrength by as much as 2 percent of its total medical strength in order tofill requisitions from an army.³³

Shifts also took place within the combat zone. Not long after D-day, theFirst U.S. Army found that it had a shortage of 28 medical officers within itscorps and divisions. Consequently, each 400-bed evacuation hospital in the armywas asked to designate two medical officers and each 750-bed evacuation hospitalwas requested to designate four to aid in filling the vacancies. In this way,the needed replacements were obtained with great rapidity.³⁴

Personnel obtained through transfers, overstrength, and deactivations ofunits constituted 20 percent of the whole number of Medical Department officersentering the European theater Ground Forces Reinforcement Command between D-dayand V-E Day, but only 13 percent of the whole number

²⁹Information from Col. James B. Mason, 1 Feb. 1952.
³⁰First United States Army: Report of Operations, 20 October 1943-1 August 1944, Book VII, pp. 106-107.
³¹See footnote 25, p. 301.
³²Annual Report, Surgeon, Ground Forces Reinforcement Command, European Theater of Operations, U.S. Army, 23 Oct. 1943-30 June 1945.
³³Memorandum, Col. A. Vickoren, MC, for Colonel Liston, 2 Mar. 1945, subject: Reference Cable UK 27386.
³⁴See footnote 30, p. 302.

303

of Army officers entering this command. The proportion ofMedical Department enlisted men thus entering the Reinforcement Command was verymuch greater than that of Medical Department officers and vastly in excess ofthe corresponding proportion of enlisted men in general.

In the case of medical officers at least, the personnel madesurplus by these procedures were not always satisfactory replacements. As arule, the reorganizations which produced the surpluses were designated torelieve such officers of administrative duties which could be performed bymembers of the Medical Administrative Corps and thus permit the former topractice medicine. Yet, in many cases, the men thus relieved were preciselythose least fitted to take up professional duties, for in the course of holdingadministrative posts, they had lost skills and acquired rank which greatlyreduced their eligibility to fill vacancies for men of professional competence.The change in the table of organization of general hospitals by War DepartmentCircular No. 99 of 1944 provided for the substitution of a lieutenant colonel ofthe Medical Corps by a lieutenant colonel of the Medical Administrative Corps inthe position of executive officer. In the European theater, however, it wasnoted in June 1944 that, while this reorganization would render 79 medicalofficers surplus, only about 14 of these would be qualified to fill professionalassignments suitable to their rank, since the great majority of them had beenpromoted strictly on the basis of their administrative ability.³⁵

Even when officers made surplus through reorganization ofhospitals were fully qualified to do professional work, there was difficulty inplacing them where the need for them was greatest. In the European theater, forexample, "the acute shortages that most needed to be filled and filledquickly," were positions of company grade in ground force combat units. Therevision of the tables of organization, however, created overstrengths whichconsisted largely of field grade officers who had served in positions"totally foreign to combat medical assignments." The result was thatthe "needs were just as acute after reorganization of hospitals as they hadbeen before."³⁶ Suchdifficulties account at least partly for the fact that some of the officers madesurplus by table-of-organization changes were returned to the United States.

Casuals from the Zone of Interior

Comprehensive data on the number of Medical Departmentreplacements that actually were provided by the Zone of Interior for overseaareas are lacking for most of the war period, completely so for the year 1942.We know, however, that because of the buildup of strength for the North Africaninvasion, it was not until the end of that year that any significant number ofnon-table-of-organization personnel arrived in the European theater.³⁷Statistics are available for the period March-November 1943 when a total of2,737

³⁵Memorandum, Col. C. D. Liston, for G-1, European Theater of Operations, 17 June 1944.³⁶Annual Report, Personnel Division, Officer of the Chief Surgeon, European Theater of Operations, U.S. Army, 1944.
³⁷See footnote 25, p. 36.

304

Medical Department officers and 14,820 Medical Departmentenlisted men were dispatched overseas as replacements. During the year 1944,2,906 male Medical Department officers were shipped overseas to all theaters, adecline from 1943.

In March to November of the latter year, the monthly shipments of suchofficers averaged 0.46 percent of the male Medical Department officer strengththroughout the world and 1.89 percent of the same strength overseas. In theEuropean theater, the monthly rate of shipments of Medical Department officerreplacements in March-November 1943 was 1.26 percent of the mean strength ofsuch officers in the theater. From the beginning of 1944 to the end of June1945, a total of 1,096 officers arrived from the Zone of Interior as MedicalDepartment replacements or casuals for use in other than units of the Army AirForces.³⁸ This amounted, on a monthly basis, to0.204 percent of the mean strength serving in Ground Forces and Services ofSupply units in the theater within the dates mentioned. For the period from thebeginning of the invasion of the Continent to V-E Day, the average monthlyshipment was equal to 0.214 percent. Not only was the rate of shipment lowerthan it had been in 1943, but it was vastly lower than that of the service andground forces as a whole; this, however, should occasion no surprise since theseforces taken together had far greater combat losses, proportionally, than didthe Medical Department.

Scattered information from other theaters also indicates the existence ofmeager replacement shipments in a stage of the war when they were needed most.Replacements for the Mediterranean Theater of Operations were scarce throughnearly all of the campaign in Italy.³⁹

The China-Burma-India theater in the summer of 1944 complained to the WarDepartment of a shortage of 91 Medical Corps officers. Not only was that theaterthen told that under revised tables of organization this shortage amounted onlyto 12, but it also was informed that no more than 9 men would be shipped fromthe Zone of Interior to meet this shortage. The shipment was to take placeduring October; when the rest of the deficit would be wiped out as not stated.The theater was urged to report to the War Department shortages of other typesof medical personnel although it was told that nurses, physical therapy aides,and dietitians might not be available until after January 1945.⁴⁰

³⁸(1) Memorandum, Army Service Forces, for Assistant Chief of Staff, G-3, War Department General Staff (attention: Colonel Stevenson), subject: Report of Overseas Replacements for the Period 16 September 1942 through 28 February 1944. (2) See footnote 32, p. 302.
³⁹Statement of Maj. Gen. Joseph I. Martin to the author, 19 Feb. 1952.
⁴⁰Smith, Robert G.: History of the Attempt of the United States Army Medical Department to Improve the Efficiency of the Chinese Army Medical Service, 1941-1945, vol. II, pp. 159-160. [Official record.] (The theater complaint was based on the fact that nearly all hospitals were operating far above rated capacities * * *. In the largest hospitals patients of the Chinese Army comprised from one-third to one-half of their totals. The shortage of medical officers (and units) at that time was so serious that the Theater Surgeon was sent by the Theater Commander to Washington for these conferences. Letter, Brig. Gen. Robert P. Williams, to Col. J. B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 22 Dec. 1955.)

305

Aside from the difficulties occasioned by lack of personnel,the provision of replacements by the Zone of Interior was complicated by delaysin the requisitioning process. Requisitions went through channels to the theaterG-1, or the replacement command, before being forwarded to the Zone of Interior.⁴¹Thus, although the surgeon of the Southwest Pacific theater submitted arequisition for 50 dental officers during December 1944, he was informed by aletter from the Office of The Surgeon General, dated 9 April 1945, that thatOffice had not yet received the requisition although it would be filled uponreceipt.

The average waiting period for the arrival of a replacementin the Mediterranean theater was 3 months.⁴² Inthat theater, at least, it was not possible to reduce the delay in fillingrequisitions by anticipating needs and calling for personnel from the Zone ofInterior before vacancies actually existed for such personnel. A requisition forseven Dental Corps officers submitted in November 1944 by the Twelfth Air Forcein anticipation of the establishment of new service groups and expectation oflosses occasioned by hospitalization and other factors of attrition wasdisapproved on the ground that the theater would not requisition replacementsunless a table-of-organization vacancy actually existed.⁴³

Lack of replacements from the Zone of Interior anddifficulties in obtaining such as were available forced the theatersincreasingly to resort to local sources of supply to fill vacancies in units orto establish new organizations. Obviously, the closer the source of supply theless was the likelihood of delay in obtaining what was needed. Thus, in thecourse of the war, the importance of a careful check of personnel requisitionsby representatives of the Medical Department on each level of an oversea commandin order to make certain that all available personnel was utilized beforeresorting to a higher echelon or the Zone of Interior became manifest. Itappears, however, that even in late stages of the war, this was not always done.⁴⁴

Nevertheless, there is good reason to believe that a greater proportion ofoversea replacements came from theater sources than from the Zone of Interior,and that the proportion was larger than in the case of Army replacements ingeneral. There can be little question of this as regards the European theater,particularly during the period of ground combat.

⁴¹(1) Letter, Col. Homan E. Leech, to Department of Army General Staff, Personnel and Administrative Division, 23 Oct. 1947, subject: Replacement System Study. (2) Semiannual Report, Surgeon, Twelfth Air Force, June-December 1944. (3) Semiannual Report, Personnel Division, Office of The Chief Surgeon, European Theater of Operations, U.S. Army, January-June 1945, with enclosure 5 thereto.
⁴²Munden, Kenneth W.: Administration of the Medical Department in the Mediterranean Theater of Operations, U.S. Army. [Official record.]
⁴³See footnote 41(2), p. 305.
⁴⁴(1) See footnote 25, p. 301. (2) Letter, Lieutenant General Devers to all concerned, 8 Aug. 1944, subject: Unit Personnel Requisitions for Medical Department Officers. (3) Pacific Conference, Panel III, Personnel, 31 July 1945.

306

Temporary Personnel

Personnel temporarily attached to a unit for training or inorder to be provided with administrative services might be used as a source ofmanpower above the assigned strength. In May 1943, for example, the percentageof the total Services of Supply Medical Department strength in the Europeantheater that was classified as "attached" exceeded 13 percent,dropping sharply as the time for the cross-channel invasion approached. Thecorresponding percentages for the Army as a whole were always higher than thoseof the Medical Department (table 25). A similar situation prevailed in theSouthwest Pacific Area, where the 118th General Hospital, which complained ofshortages of personnel in all categories, found, during the second quarter of1943, that it was able to tide over several difficult periods as a result oftemporary attachment of personnel of other organizations. The staff of the 9thPortable Surgical Hospital, consisting of 4 officers and 25 enlisted men, wasattached to the general hospital for purposes of training for a period of about1? months. Both the officers and men were utilized in operating the generalhospital.

Another method of obtaining additional personnel above assigned unit strengthwas to "borrow," on temporary duty from other organizations. This wasparticularly the case when it was desired to meet the requirements of frontlineunits. Thus, during periods of severe combat, personnel from corps and armymedical units in the European theater were attached for temporary duty todivisional organizations. Litter bearers, company aidmen, and medical andsurgical technicians were prominent among those attached.⁴⁵On occasion, general or station hospitals in the Mediterranean theater weredrawn upon for dental officers to serve temporarily in units lacking suchpersonnel.⁴⁶ In general, it was the practice inthat theater to fill vacancies temporarily with individuals from units that werenot operating at full capacity.

ORGANIZATIONAL AND PROCEDURAL CHANGES

During the emergency and war periods, various methods were developed whichled to a more efficient utilization of medical personnel. Primary among thesewere measures permitting freer use to be made of personnel, such as theextensive use of Medical Administrative Corps officers to relieve medical,dental, and other professional personnel of nontechnical duties; the use oftrained medical technicians; and the shifting of minor nursing functions fromArmy nurses to nurses` aides and to some extent to members of the Women`s ArmyCorps. The use of stenographers at certain hospitals to aid the doctors inpreparing clinical records relieved the latter of much routine

⁴⁵(1) Annual Report, Surgeon, Ninth U.S. Army, 1944. (2) Annual Report, Surgeon, Third U.S. Army, 1944.
⁴⁶Report, Col. Lynn H. Tingay, of Dental Activities in North African Theater of Operations, 29 Dec. 1944.

307

clerical work, although such assistance was never widelyfurnished. Other expedients to meet the growing demands of the Army withoutlowering the standard of medical service or unduly increasing the number ofmedical personnel employed included undermanning of theater of operations unitsin training; changes in the Zone of Interior hospital system and its procedures;readjustment of personnel allowances to theater of operations units and Zone ofInterior installations; redistribution of Medical Department officers amongmajor commands in the Zone of Interior; and shipment of hospitals overseas withless than full complements.

Undermanning Theater of Operations Units in Training

A policy of deferring the assignment of part of the officercomplement of newly activated theater of operations medical units anddetachments which was gradually put into effect in 1942-43 doubtless resulted insome saving of personnel. Before this, it had been the practice to assign a fullcomplement of officers to these units immediately upon activating them. Thismeant that while the unit or detachment was taking unit training and waiting togo into operation, the officers were not fully occupied, since there was littleprofessional work for them to do unless they could be used to assist the stationcomplement of the hospital at that post. This constitued a waste of professionalpersonnel, and the complaints of officers so assigned was one reason for thechange of policy.

The new policy was applied first to affiliated hospitals whenin May 1942 The Adjutant General issued a directive providing for the assignmentof only a small percentage of the authorized officer strength to these hospitalswhile in training.⁴⁷ Similar steps were takento conserve the supply of medical officers in nonaffiliated hospitals-officerswere to be assigned to these units only in the numbers needed and as they wereneeded.⁴⁸ The heavy demand for medical officers dictated the application ofthis policy to nonmedical units having assigned medical personnel.

In March 1943, a War Department directive announced that each table oforganization calling for attached medical and dental officers would be revisedto include a notation that this personnel was to be furnished only as requiredand available within the continental limits of the United States, but would befurnished in full prior to departure for oversea duty.⁴⁹

⁴⁷Letter, The Adjutant General, to Commanding Generals, Army Ground Forces, Army Air Forces, Services of Supply, and others, 29 May 1942, subject: Allotment of Officer Personnel to Medical Units of the Field Forces, Continental United States.
⁴⁸(1) Memorandum, The Surgeon General, for Officers Branch, Office of The Adjutant General, 19 Dec. 1942. (2) Memorandum, Col. Francis M. Fitts, Office of The Surgeon General, 3 Jan. 1943, subject: Plans for Bringing Theater Hospital Units and Named General Hospitals to T/O or to Authorized Allotted Strength.⁴⁹Memorandum, Deputy Chief of Staff, for Commanding General, Services of Supply, 10 Mar. 1943, subject: Availability of Physicians.

308-311

TABLE 25.-Monthly Medical Departmentstrength in Services of Supply or Communications Zone, European Theater ofOperations (exclusive of Iceland), 30 September 1942-31 October 1944¹

312

Changes in the Zone of Interior Hospital System

Use of specialty centers

As the Army and therefore the number of patients increased, agreater diversity of specialty centers in the general hospitals was establishedfor the treatment of particular diseases, wounds, and injuries. In such acenter, patients requiring a highly specialized type of care were concentratedin order to make the best use of the available specialists. Several centers ofthis sort had been in operation before the war; others were added in 1942, andthe number was further increased in 1943, when the practice was announced as asettled policy. The system, which continued throughout the war, permitted theArmy to place its limited number of specialists to the best advantage.⁵⁰

Creation of convalescent hospitals

In April 1944, the War Department authorized convalescenthospitals, as distinct from convalescent centers, annexes, and facilities, whichhad been in operation since the preceding June. It was felt that theconvalescent patient did not need the highly specialized care he was receivingin a general hospital and that the removal of patients from general toconvalescent hospitals would permit fuller use of the former`s highlyspecialized staff. A guide for the utilization of personnel in convalescenthospitals in the Zone of Interior was recommended by The Surgeon General andapproved by the War Department (see table 7).⁵¹Comparison of this table with the guides for named general hospitals(table 6) will indicate the saving in Medical Corps officers that could be madeby placing convalescents in the new type of hospital instead of keeping them ingeneral hospitals.

Closure of station hospitals

Early in 1944, as the military population in the Zone ofInterior was shrinking due to oversea movement of troops, The Surgeon Generaleffected the closure or reduction in size of station hospitals. As this wasdone, doctors assigned to these hospitals could be reassigned either tohospitals scheduled for oversea service or to general hospitals in the Zone ofInterior. Although in 1944, the General Staff sanctioned the establishment ofso-called regional hospitals in the Zone of Interior by both the Army Air Forcesand the Army Service Forces, general hospitals remained under the jurisdictionof the Army

⁵⁰Memorandum, Director, Resources Analysis Division, Office of The Surgeon General, for Deputy Surgeon General, 19 Aug. 1945.
⁵¹(1) Memorandum, Brig. Gen. R. W. Bliss, Assistant Surgeon General, for Commanding General, Army Service Forces, attention: Director, Personnel Division, 18 Apr. 1945, subject: Personnel Guides for Convalescent Hospitals. (2) War Department Circular No. 170, 8 June 1945.

313

Service Forces, more exclusively for the care of highly specialized cases andof patients brought home from overseas.⁵²

Reduction of time of hospitalization

During the war, the Medical Department initiated a number ofmeasures designed to reduce the period of hospitalization to the absoluteminimum. This released not only beds for incoming patients, but the personnel tocare for them. In addition, The Surgeon General succeeded in having convalescentfurloughs granted for periods not to exceed 90 days. On 1 June 1945, there wereapproximately 70,000 patients on furlough from the general and convalescenthospitals for whom otherwise beds would have had to be provided.⁵³

Readjustment of Personnel Allowances

Oversea units

The overall personnel requirements of the Army are set forthin published tables of organization by type of unit. Revisions of the medicaltables for oversea theaters during 1940-41 were made on the basis of World War Iexperience and partly as a means of adjusting medical units to the newtriangular organization of the combat divisions.⁵⁴The 1942-43 revisions reflected the difficulty in procuring Medical Corpsofficers and therefore authorized a smaller percentage of such personnel inproportion to the rapidly expanding Army as a whole (tables 9 and 10).

When the number of personnel available in certain categoriesproved insufficient to meet the requirements of all units that were beingactivated under these revised tables, further revisions were made during thelater war years. For example, after it became permissible to substitute aMedical Administrative Corps officer for one of the two Medical Corps officerswho served as surgeons in every infantry battalion, the tables of organizationof the infantry regiment were revised to that effect (table 9).⁵⁵Table 8 shows personnel changes in the tables of organization for selectedhospitals. In all but two cases, the number of Medical Corps officers, nurses,and enlisted men was reduced while the number of Medical Administrative Corpsofficers was increased.

⁵²Smith, Clarence McKittrick: The Medical Department: Hospitalization and Evacuation, Zone of Interior. United States Army in World War II. The Technical Services. Washington: U.S. Government Printing Office, 1956.
⁵³(1) War Department Circular No. 111, 7 Apr. 1945. (2) Memorandum, Director, Hospital Division, Office of The Surgeon General (Col. A. H. Schwichtenberg), for Director, Historical Division, Office of The Surgeon General, through Chief, Operations Service, Office of The Surgeon General, 18 June 1945, subject: Additional Material for Annual Report Fiscal Year 1945, with Tab A thereto.
⁵⁴(1) Letter, Maj. Gen. Alvin L. Gorby, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 3 Apr. 1956. (2) See footnote 56, p. 314.
⁵⁵(1) TOE 7-11, 1 June 1945, Infantry Regiment. (2) TOE 7-95, 12 July 1944, Infantry Battalion (Separate).

314

The tables issued in 1943 and 1944 also show for the first time small numbersof dietitians and physical therapists as military personnel.

Another device for making the most efficient use of thelimited personnel available was the development of the "team" or"cellular" concept, which grew out of the auxiliary surgical groupsand attained its most general usefulness in the 8-500 series of tables oforganization. The basic principle was to so balance specialists and techniciansin teams for specific purposes that each man`s skills were extended by thecomplementary skills of those who worked with him. Such groups as malariacontrol units, dental operating detachments, and food inspection detachmentswere refined under the new concept of specialized group effort. Carried overinto civilian medicine, the team concept has spread throughout the profession.⁵⁶

Zone of Interior installations

In 1943, the War Department Manpower Board, in investigatingall Army installations in the Zone of Interior to determine where savings inpersonnel could be made, developed "yardsticks" or criteria formanning various types of installations.

The General Staff used the yardsticks in making its bulkauthorizations of personnel for the Army Service Forces and, to provide a guidefor subordinate commanders, developed manning tables for hospitals of varioussizes which were promulgated as War Department Circular No. 209, 26 May 1944. Ingeneral, these manning tables, or guides, agreed with the Manpower Board`syardsticks and the recommendations of the Inspector General`s Office. They werenot, however, meant to be followed as rigorously as tables of organization, andif in any particular case they failed to provide enough personnel for adequatemedical care, a written request for increases could be submitted. The guideswere announced as subject to correction by any future surveys made by theManpower Board (tables 6 and 7). In general, these guides indicate that thegreater the extent to which beds could be concentrated in large hospitals, thegreater would be the saving in medical officers and in certain other categoriesof personnel.

The issuance of manning tables seems to have achievedconsiderable success in conserving medical personnel so far as general hospitalsin the Zone of Interior were concerned. In July 1943, the number of personnel(military and civilian) assigned to these hospitals per 100 authorized beds was94. By June 1944, the number had fallen to 68.6 and by July 1945, it had risen to71.1; in the former month, however, less than half the beds were occupied, whilein the latter month the general hospitals were operating at 122 percent of theirrated capacity.⁵⁷

⁵⁶Statement of Durward G. Hall, M.D., to the editor, 27 May 1961. ⁵⁷See footnote 52, p. 313.

315

Redistribution of Medical Department Officers

As has been noted, when in 1942 the Army Air Forces wereauthorized to procure their own doctors, their recruiting program was moresuccessful than that of Army Service Forces. As a result, The Surgeon Generalfelt that some of these medical officers should be transferred to understrengthArmy Service Forces installations in this country or to units scheduled foroverseas.⁵⁸ However, there was no singleauthority to distribute doctors to the Army Service Forces, Army Ground Forces,and Army Air Forces according to need, and the Deputy Chief of Staff at firstrefused to take any action leading to the transfer of doctors from the Air tothe Service Forces. He was said to believe that some general hospitals (all ofwhich were under the jurisdiction of the Army Service Forces) were overstaffedand that the Service Forces should "make a thorough canvass of thesituation" to utilize to the best advantage all its own doctors beforecalling on either the Ground or Air Forces for any of theirs. Army ServiceForces headquarters thereupon urged The Surgeon General to continue his surveyof medical personnel with a view to releasing the number necessary for overseaduty and at the same time retaining the minimum required to operate U.S.establishments.⁵⁹

In the fall of 1943, when The Surgeon General declared thathe did not have in Army Service Forces enough doctors to man all the hospitalunits scheduled for oversea movement the following January, he recommended thatthe Air Forces be directed to supply the doctors needed for nine such hospitals.⁶⁰Approximately 10 days after these recommendations, the Air Forces having lostcertain of their hospital functions, voluntarily transferred 200 Medical Corpsofficers to the Army Service Forces.⁶¹

Shortly after this the Personnel Planning and Placement Branch, Office of TheSurgeon General, submitted a report on the numbers of medical specialistsavailable and required in the Army Ground, Air, and Service Forces in thiscountry; it showed that the Air Forces had 3,271 available against 1,271required, whereas the Service Forces required 8,014 and had available only6,571. The report showed no excess in Army Ground Forces. Based on this study,the General Staff ordered the Air Forces to transfer 500 Medical Corps officersto the Service Forces.⁶² Of the 700 transferred altogether, a large

⁵⁸Memorandum, Lt. Col. Francis M. Fitts, Office of The Surgeon General, for Colonel Lull, Office of The Surgeon General, 11 Jan. 1943, subject: Availability of Physicians.
⁵⁹Memorandum, Maj. Gen. W. D. Styer, Services of Supply, for The Surgeon General, 3 Oct. 1943.
⁶⁰Memorandum, Military Personnel Division, Army Service Forces, for The Surgeon General, 17 Nov. 1943, subject: Filling Officer Shortages in Medical Units Committed, with 1st endorsement thereto, 26 Nov. 1943.
⁶¹Memorandum, Headquarters, Army Service Forces, for Commanding General, Army Service Forces, attention: Military Personnel Division, 30 Nov. 1943.
⁶²(1) Memorandum, Office of The Surgeon General (Maj. Fred M. Fielding), for G-1, 28 Dec. 1943. (2) Memorandum, G-1, for Chief of Staff, 4 Jan. 1944, subject: Requirements for Medical Corps Officers. (3) Letter, Brig. Gen. J. M. Bevans, Assistant Chief of Air Staff, to Commanding General, Army Service Forces, 26 Jan. 1944, subject: Reassignment of Medical Corps Officers to Army Service Forces, with endorsements thereto.

316

proportion were specialists, whom the Service Forces mostneeded to staff units destined for overseas. Other transfers of doctors occurredthroughout the war period.⁶³ In addition to itsrelinquishment of doctors, the Air Forces during the year ending on 30 June 1945transferred approximately 1,500 Army nurses, 72 Medical Administrative Corpsofficers, and 17 Medical Department dietitians to the Army Service Forces.⁶⁴

Shipment of Hospitals With Less Than Full Complements

When, in 1944, The Surgeon General concluded that, despiteall efforts to make the personnel supply meet the demand, the Army would nothave enough medical specialists and nurses to staff both Army Service Forceshospitals in this country and units yet to be shipped abroad, he used theexpedient of shipping some hospitals without their full table-of-organizationcomplement of specialists and nurses. While no theater chief surgeon ever agreedthat he possessed an excess of specialists, The Surgeon General considered thisexpedient feasible because the theaters in his judgment did possess a relativeexcess of specialists who could be used to balance the staffs of thesehospitals. Accordingly, in early 1944, The Surgeon General received permissionto ship general hospitals overseas with a full complement of doctors but withgeneral practitioners in place of seven of the specialists authorized by thetables of organization; that is, the chiefs of medicine, surgery, orthopedicsurgery, neurosurgery, psychiatry, radiology, and laboratory service. Thispolicy was followed for several months; eventually, certain units were sentoverseas with even fewer specialists.⁶⁵

By July 1944, with an accelerated shipment of approximately53 general hospitals requested by the European theater, it was consideredimpossible to staff all these units at full table-of-organization strength evenby substituting nonspecialists. Consequently in that month, The Surgeon Generalrecommended to the Commanding General, Army Service Forces, that generalhospitals be shipped to the European theater with only 16 instead of theauthorized 32 Medical Corps officers, until the excess of such personnel in thetheater should be absorbed. This recommendation was returned informally withoutaction. Later, however, units were shipped with only 16 doctors, but withattempts to balance the staffs. Proper classification and accurate accountingprocedures enabled The Surgeon General to make such adjustments.

⁶³Letter, The Adjutant General, to Commanding General, Army Air Forces, 23 Sept. 1944, subject: Medical Officer Requirements. (2) Weekly Diary, Operations Branch, Military Personnel Division, Office of The Surgeon General, for week ending 5 Mar. 1945. (3) Letter, Military Personnel Division, Army Air Forces, to Commanding General, Army Service Forces, 17 July 1944, subject: Transfer of Medical Corps Officers.
⁶⁴(1) Letter, The Surgeon General, to The Adjutant General, 11 Feb. 1944, subject: Army Nurse Corps. (2) Letter, The Surgeon General, to The Adjutant General, 18 May 1944, subject: Designation of Medical Corps Personnel for 124th and 125th General Hospitals. (3) Annual Report, Personnel Division, Air Surgeon`s Office, 1944-45.
⁶⁵Memorandum, Military Personnel Division, Office of The Surgeon General, for Colonel Love, Historical Division, Office of The Surgeon General, 19 Oct. 1944.

317

The procedure of shipping hospitals without all of theirMedical Corps officers was continued until practically the end of hostilitiesagainst Germany. In March 1945, The Surgeon General informed the OperationsDivision, General Staff, that orthopedic surgeons of grade C or better were notavailable to the European theater in April of that year and added that theywould not be available for shipment from the United States at any future date.⁶⁶The next month, April 1945, he recommended that 5 general hospitals, short 16Medical Corps officers each, be shipped to the Pacific Ocean Areas. He basedthis recommendation on his knowledge that that theater had more doctors per 100hospital beds occupied than either the Southwest Pacific Area or the Zone ofInterior; and stated that in August or September he would ship sufficientMedical Corps officers to staff the hospitals fully.⁶⁷

The Surgeon General also felt compelled to ship certain hospitals withoutnurses, thereby permitting the assignment of nurses to these hospitals fromexcess numbers resulting from cuts in tables of organization. In 1944, hereceived approval to ship several general hospitals without nurses to theEuropean theater. (At that time, a 1,000-bed general hospital carried acomplement of 83 nurses.) At least two general hospitals lacking nurses wereshipped to the Southwest Pacific Area.⁶⁸

UTILIZATION OF NEGRO PERSONNEL

In late 1940, when Selective Service was about to bring largenumbers of Negroes into the Army, the Medical Department contained only a fewNegro enlisted men and no Negro officers or nurses on active duty. Negropatients in Army hospitals were therefore attended by white doctors and nurses,and there was no segregation of Negro from white patients. In September 1940,the Medical Department Officers Reserve contained a small number of Negroofficers eligible for service (that is, physically qualified and not overage):60 Medical, 8 Dental, and 3 Veterinary Corps officers. About the same time, 40nurses were in the Reserve maintained for the Army by the Red Cross.⁶⁹

When, in 1940, it became likely that the Army would take in many moreNegroes, the Surgeon General`s Office made plans to place its share of the newpersonnel in the Medical Department. The Surgeon General recognized hisresponsibility in a memorandum to the General Staff in October 1940: "It ap-

⁶⁶Memorandum, The Surgeon General, for Assistant Chief of Staff, Operations Division, through Commanding General, Army Service Forces, 9 Mar. 1945, subject: Inclusion of Orthopedic Surgeons for Staffs of General Hospitals.
⁶⁷Memorandum, The Surgeon General, for Commanding General, Army Service Forces, attention: Director of Plans and Operations, 20 Apr. 1945, subject: Staffing of the 303d, 304th, 308th, 309th, and 310th General Hospitals.⁶⁸Letter, Office of The Surgeon General (Brig. Gen. Bliss, Chief, Operations Service), to Commanding General, Army Service Forces, 6 May 1944, subject: Staffing of Medical Units of July, with endorsement thereto, 31 May 1944.⁶⁹(1) Memorandum, Assistant Chief of Staff, G-1, for Chief of Staff, 28 Sept. 1940, subject: Use of Negro Reserve Officers Under 1940-41 Military Program, Tab C. (2) Blanchfield, Florence A. and Standlee, Mary W.: The Army Nurse Corps in World War II. [Official record.]

318

pears that * * * the Medical Department will have to utilize* * * around 4,000 Negro enlisted men and several hundred officers."⁷⁰Six months later, The Surgeon General and his advisers had agreed amongthemselves that the Medical Department would be prepared to go as far in the useof Negro troops as any other service and could conform to any Army-wide policyof employing Negroes segregated from or in combination with whites. TheDepartment, however, would "not willingly accord to a policy whereby anydetachment will be part White and part Black unless this policy is adopted notonly by the services but by the line." The Medical Department did, in fact,go further than any other service in the use of Negro officers.⁷¹

During the course of the war, the Medical Department usedNegro enlisted men and male Negro officers in the medical detachments ofall-Negro combat divisions, in a number of all-Negro theater of operationshospitals, in sanitary companies, in the Negro wards of certain Zone of Interiorhospitals, and in at least two all-Negro hospitals in the United States. TheDepartment used Negro members of the Nurse Corps in a number of hospitals athome and overseas and Negro members of the Women`s Army Corps in some Zone ofInterior hospitals. Negro Medical Department personnel constituted, at itswartime peak, about 4.2 percent of the Medical Department`s overall strength. Inthe Medical Corps, the highest proportion was about 0.76 percent; in the DentalCorps, 0.78 percent; in the Veterinary Corps, 0.39 percent; in the SanitaryCorps, 0.34 percent; in the Medical Administrative Corps, 1.1 percent; in theNurse Corps, 0.88 percent; and among enlisted men, 5 percent (tables 1 and 26).In the assignment of Negro medical personnel, Dean John W. Lawlah of the HowardUniversity Medical School was of inestimable assistance to The Surgeon General.⁷²

Hospital Personnel

As early as October 1940, the Surgeon General`s Officeproposed the establishment of Negro wards in certain hospitals in the UnitedStates.⁷³ When such wards were organized in thehospitals at Fort Bragg, N.C., and Camp Livingston, La., in May 1941, twice asmany medical officers were at first allotted to them as were customarilyassigned to ward duty. The commanders of both hospitals, however, later foundthat one Negro doctor instead of two per ward was sufficient, and the SurgeonGeneral`s Office revised its estimates accord-

⁷⁰Memorandum, The Surgeon General, for The Adjutant General, 25 Oct. 1940, subject: Plan for Utilization of Negro Officers, Nurses, and Enlisted Men in the Medical Department, 1940-41 Military Program.
⁷¹(1) Memorandum, Lt. Col. C. B. Spruit, Office of The Surgeon General, for Colonel Love, Office of the Surgeon General, 10 Apr. 1940, subject: Use of Negroes in the Medical Department Under the PMP. (2) Letter, Maj. Ulysses G. Lee, Jr., Office of the Chief of Military History, to Col. C. H. Goddard, Office of The Surgeon General, 22 Aug. 1952.
⁷²Statement of Durward G. Hall, M.D., to the editor, 27 May 1961.
⁷³Memorandum, Office of The Surgeon General (General Love), for The Adjutant General, 22 Oct. 1940, subject: Assignment of Negro Medical Officers.

319

TABLE 26.-Negroes in the MedicalDepartment , 1943-45

Date, end of month	Male officers							Female officers				Enlisted men
Date, end of month	Medical Corps	Dental Corps	Veterinary Corps	Medical Administrative Corps	Sanitary Corps	Pharmacy Corps	Total	Army Nurse Corps	Hospital Dietitian	Physical Therapist	Total	Enlisted men
1943
October	276	73	4	115	4	---	472	198	9	1	208	25,296
December	284	76	2	126	6	---	494	198	9	1	208	25,431
1944
March	297	70	2	117	5	---	491	219	10	2	231	23,720
June	340	102	6	146	6	---	600	213	8	2	223	23,347
September	327	101	2	118	5	---	553	247	9	2	258	20,544
December	342	104	8	178	5	---	637	256	9	6	271	19,587
1945
March	326	95	2	189	6	---	618	336	7	9	352	19,352
June	325	114	1	210	6	---	656	464	9	11	484	18,534
September	307	101	2	213	8	---	631	466	8	10	484	18,213
December	208	79	6	116	1	---	410	318	8	7	333	7,440

Source: "Strength of the Army" for correspondingdates.

ingly.⁷⁴ This separation into white andNegro wards was abandoned before the end of the war.

At the same time, The Surgeon General recommendedestablishing all-Negro hospitals in the Zone of Interior and commissioningNegroes as Medical Administrative and Sanitary Corps officers. The General Staffinformed him that no all-Negro hospital was planned and that commissioningNegroes in the two corps named was "not favorably considered."⁷⁵Later on, however, Negroes were commissioned in the Medical AdministrativeCorps, and two all-Negro hospitals were eventually established.

The Air Forces Station Hospital at Tuskegee, Ala., activated in 1941, was thefirst of these two hospitals to receive its personnel, and played an importantpart in utilizing Negro doctors and nurses. It also supplied some of the firstpersonnel to report to the Negro Station Hospital at Fort Huachuca, Ariz., whichbegan operations in 1942.⁷⁶

⁷⁴Letter, Secretary, General Staff, to Judge William H. Hastie, Civilian Aide to Secretary of War, 1941, subject: Redistribution of Negro Medical Department Personnel.
⁷⁵3d endorsement, The Adjutant General, to The Surgeon General, 31 Jan. 1941, to memorandum cited in footnote 70, p. 318.
⁷⁶(1) See footnote 52, p. 313. (2) See footnote 71(2), p. 318.

320

Fort Huachuca was the training center for the 93d (Negro) Infantry Division.The National Medical Association (the Negro counterpart of the American MedicalAssociation) was requested to assist in procuring medical officers for itshospital, which by the end of 1942 had 676 beds and a staff of 37 Medical Corpsofficers, 1 Sanitary Corps officer, 2 Medical Administrative Corps officers, 100nurses, and 243 enlisted men. At that time, also four Negro Dental Corpsofficers had been assigned to the hospital dental clinic, which functioned underthe post dental surgeon. Two Veterinary Corps officers were assigned to the postsurgeon`s office at that time. The commanding officer of this hospital from June1942 until his return to civilian life in October 1945 was Lt. Col. Midian O.Bousfield. Chief of the medical service until March 1943 was Maj. Harold W.Thatcher. Both of these men, as well as many others on the Fort Huachucahospital staff, made outstanding records under particularly difficultcircumstances.

Sanitary Companies

In October 1940, also, The Surgeon General recommended a newtype of unit which was to absorb most of the Negro enlisted increment and someNegro officers as well.⁷⁷ This was the "sanitary company" authorizedin November 1940 for the purpose of performing "such general duties as thecommanding officer [of the theater of operations general hospital to which acompany was assigned] may prescribe."⁷⁸ The Surgeon General`sOffice insisted that activation of these companies should not reduce the medicaldepartment`s overall requirements for enlisted men.⁷⁹

The sanitary companies, established under T/O 8-117 (November1940), found difficulty in obtaining useful work. In July 1942, after severalhad completed their training, The Surgeon General adopted the policy ofassigning one to each named general hospital and Medical Department ReplacementTraining Center in this country. Large numbers of these companies remainedunemployed, however, because the theaters and defense commands refused torequisition them when informed by The Surgeon General that they were ready forshipment.⁸⁰

In January 1943, the Commanding General, Services of Supply,directed The Surgeon General to consider widening the scope of the work to beperformed by the companies in order to obtain more useful employment for them.The Director of The Surgeon General`s Sanitary Engineering Division voiced abelief that these companies could do valuable work in environmental sanitationat larger War Department installations, particularly in the South. He

⁷⁷(1) Memorandum, Office of The SurgeonGeneral (Col. A. G. Love), for Executive Officer, Office of The Surgeon General,1 Oct. 1940, subject: Policy of The Surgeon General re Colored Troops (9%).(2) See footnote 75, p. 319.
⁷⁸T/O 8-117, 1 Nov. 1940.⁷⁹Memorandum, The Surgeon General, for Assistant Chief of Staff,G-1, 5 May 1941, subject: Plan for the Use of Colored Personnel in the MedicalDepartment.
⁸⁰Letter, The Surgeon General, to all Surgeons, Defense Commands, and U.S. ArmyForces in Oversea Bases, 18 Nov. 1942, subject: Sanitary Companies.

321

suggested that such work might consist, among other things,of mosquito and other insect control; constructing, maintaining, and operatingthe sanitary demonstration areas; and maintaining proper conditions at theincinerator, the dump, and the sewage disposal plant.⁸¹ Thisrecommendation led to a revision (June 1943) of the table of organization whichwould appear to have these companies used largely on mosquito control. In thenew table, each of the two platoons now had two drainage, two oiling, and twospraying teams. None of the other suggested functions were ever incorporated ina table of organization.

Medical Administrative Corps Officers

In the Medical Administrative Corps, Negro officers almost without exceptionobtained their commissions on graduating from officer candidate school insteadof by direct commissioning either from civil life or from the enlisted ranks ofthe Medical Department. By 1 April 1945, the school located at Camp Barkeley,had graduated 158 Negroes. At that time, a total of 189 had been admitted to theMedical Administrative Corps, some of whom had undoubtedly been commissioned bythe school at Carlisle Barracks.⁸²

The Surgeon General experienced difficulty in placing Negromembers of the Medical Administrative Corps. In early 1943, the War Department,at his suggestion, established a pool of 100 Negro Medical Department officersat Fort Huachuca. The Surgeon General controlled the assignment, relief, andtransfer of officers assigned to the pool. Those in it were used in the localstation hospital, the 93d Infantry Division, and in other duties at that stationwhile awaiting transfer to other posts.⁸³ But The Surgeon Generalhad trouble in finding assignments elsewhere for many Medical AdministrativeCorps officers in the pool. His Office finally arranged with the Army GroundForces to have certain numbers attend the special basic course for infantryofficers. The understanding was that those who completed the coursesatisfactorily would be detailed to the infantry; at least 16 and possibly morewere so detailed; the remainder were returned to the pool at Fort Huachuca.⁸⁴

⁸¹(1) Memorandum, Services of Supply (Assistant Chief ofStaff for Operations), for The Surgeon General, 16 Jan. 1943, subject:Sanitary Companies. (2) Memorandum, Col. W. A. Hardenbergh, Office of TheSurgeon General, for Brig. Gen. L. B. McAfee, Office of The Surgeon General, 25Jan. 1943, subject: Use of Medical Sanitary Companies.⁸²(1) Annual Reports, Army Service ForcesTraining Center, Camp Barkeley, Tex., 1944-45. (2) Strength of the Army, 1 Apr.1945. Prepared for War Department General Staff by Machine Records Branch,Office of The Adjutant General, under direction of Statistical Branch.
⁸³(1) Memorandum, Office of The Surgeon General (Col. F. B. Wakeman,Director of Training), for Director of Training, Services of Supply, 10 Mar.1943, subject: Training Pool for Colored Medical and Dental Officer Personnel,with endorsement thereto, 8 June 1943. (2) Memorandum, Lt. Col. D. G. Hall,Office of The Surgeon General, for Colonel Wickert, Office of The SurgeonGeneral, 20 Mar. 1943. (3) War Department Circular No. 132, 8 June 1943.
⁸⁴(1) Weekly diary, Sanitary Corps and MedicalAdministrative Corps Section, Classification Branch, Military PersonnelDivision, Office of The Surgeon General, for weeks ending 3 Mar. and 11 May1945. (2) Semiannual History of Medical Administrative Corps and Sanitary Corps,Military Personnel Division, Office of The Surgeon General, U.S. Army, 1 Jan.-31May 1945. (3) Semiannual Report, Records and Statistics Branch, MilitaryPersonnel Division, Office of The Surgeon General, U.S. Army, 1 July-31 Dec.1944.

322

When hostilities came to an end in August 1945 and thereappeared to be little likelihood of any demand for these Medical AdministrativeCorps officers, the Surgeon General`s Office took steps to release them as beingsurplus to the needs of the Army.⁸⁵

Army Nurse Corps

As to Negro members of the Army Nurse Corps, the Secretary ofWar in late 1943 committed himself to enlarging this group, which then consistedof about 200 individuals. The Surgeon General`s Office, however, argued thatthere was no apparent demand for more on the part of commanders and suggestedthat, before additional Negro nurses were commissioned the service commands andoversea theaters should be asked how many more they could use.⁸⁶Whetheror not this suggestion was followed, more Negro nurses were actually brought in,especially during the recruiting drive at the beginning of 1945.

During the early years of the war, Negro nurses had been restricted to thecare of Negro patients and had therefore served with white nurses only in thetwo hospitals that for a time possessed wards devoted exclusively to the care ofNegroes. Later, however, Negro nurses were assigned to work alongside whitenurses in at least 16 hospitals in the United States, where they attended notonly Negro but white patients. According to the report of one of thesehospitals, "no case was found where a white patient objected to a colorednurse taking care of him."⁸⁷

Women`s Army Corps

The early campaigns to recruit Women`s Army Corps members forthe Medical Department seem to have resulted in the acceptance of few Negrowomen but there was a Women`s Army Corps detachment composed of Negroesstationed in at least one general hospital (Halloran) in 1943.⁸⁸ Sixand possibly more Women`s Army Corps hospital companies were formed of Negroesin 1945 after the War Department General Staff had authorized this type of unit.They functioned at the following general hospitals: Lovell, Fort Devens, Mass.;Tilton, Fort Dix, N.J.; Halloran, Staten Island, N.Y.; Wakeman, Camp Atterbury,Ind.; Thomas M. England, Atlantic City, N.J.; and Gardiner, Chicago, Ill.⁸⁹

⁸⁵Memorandum, Chief, Classification Branch, Military PersonnelDivision, Office of The Surgeon General, to Chief, Personnel Service, Office ofThe Surgeon General (attention: Procurement, Separation, and Reserve Branch,Office of The Surgeon General), 3 Sept. 1945, with endorsement thereto, 8 Oct.1945. (2) War Department Circular No. 290, 22 Sept. 1945.
⁸⁶(1) Memorandum, Maj. Gen. W. D. Styer, Army ServiceForces, for The Surgeon General, 14 Dec. 1943, subject: Utilization of NegroNurses. (2) Memorandum, Brig. Gen. R. W. Bliss, Chief, Operations Service,Office of The Surgeon General, for Commanding General, Army Service Forces(attention: Planning Division), 27 Dec. 1943, subject: Utilization of NegroNurses.
⁸⁷(1) See footnote 52, p. 313. (2) Annual Report, Station Hospital, Camp Livingston, La., 1944.
⁸⁸Annual Report, Halloran General Hospital, N.Y., 1943.
⁸⁹Directory of the Army of the United States (Exclusive of Army Air Forcesand Attached Services), 1 Sept. 1945.

323

This did not represent any great demand for Negro enlistedwomen on the part of Medical Department commanders. The Enlisted Branch of theSurgeon General`s Military Personnel Division reported in the fall of 1944 thatwith one exception there had been practically no demand for these women and"it has been found almost impossible to find suitable assignments for thefew that had been enlisted. Many of the few installations that do have coloredWAC`s seem desirous of releasing them."⁹⁰ On the other hand,the surgeon of one service command reporting for 1943 declared: "Especialmention should be made of the success had in this service command with coloredenlisted women."⁹¹

Demands for Use of More Negro Medical Officers

During the emergency period and the war, Negro leaders and others urged that more Negro members of the medical profession, especially doctors and nurses, should be brought into the Medical Department.⁹² The Surgeon General`s Office gave a number of reasons why the use of Negroes was limited as to numbers and range of jobs. One was the substandard ratings of the Negro professional schools.⁹³ Another was the results of the Army General Classification Tests, which were unfavorable to Negroes. These and the proposed demobilization of certain Negro combat units for lack of intelligence were cited as reasons for assigning most of the Medical Department`s quota of enlisted Negroes to the sanitary companies.⁹⁴

Moreover, with reference to Negro doctors, the Office of TheSurgeon General had pointed out even earlier that the Army`s requirements wouldhave to be considered in relation to civilian needs and that the ratio ofphysicians to population was smaller in the case of Negroes than in that ofwhites.⁹⁵

In the course of the war, it became plain that, despite theinsistence by Negro doctors and their professional organization that the Armyaccept them, the country`s total supply of Negro doctors was not great enough tospare many from civilian life. Estimates of the number of Negro physicians inthe country ranged from about 3,300 to about 5,000. As late as October 1942,using a figure of 3,800, the Assistant Civilian Aide to the Secretary of War,Truman Gibson, stated that about 25 percent of the 1,900 who were practicing inthe North "could be rather easily spared for Army service" and thatabout 5 percent of the 1,900 practicing in the South could be spared. This wouldgive a total of 570, in addition to those already in service, although it isalmost

⁹⁰History, Enlisted Personnel, Military Personnel Division, Office ofThe Surgeon General, U.S. Army, July-September 1944.
⁹¹Annual Report, Surgeon, Fifth Service Command, 1943.
⁹²Memorandum, Maj. Gen. James C. Magee, The SurgeonGeneral, for Assistant Chief of Staff, G-1, 17 Mar. 1941, subject: Synopsis ofMeeting Held Between The Surgeon General and Representatives of Negro MedicalAssociation, 7 Mar. 1941.
⁹³Letter, Brig. Gen. Albert G. Love, USA (Ret.), to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 29 Nov. 1955.
⁹⁴See footnote 79, p. 320.
⁹⁵Memorandum, The Surgeon General (Col. G. F. Lull), for Colonel Wharton, G-1, 28 Dec. 1940.

324

certain that not all of these could have qualified physicallyfor Army service or would have volunteered for it, even though the Procurementand Assignment Service had classified them as available. The Chief of TheSurgeon General`s Personnel Service confirmed the 25-percent estimate ofavailables in June 1943 when he stated that 75 percent of the names ofapplicants which he submitted to a member of the Subcommittee on Negro Health ofthe Procurement and Assignment Service were turned down as being needed in theirrespective communities.⁹⁶

UTILIZATION OF PRISONERS OF WAR AND NATIVE LABOR TROOPS

Zone of Interior

In accordance with the provisions of the Geneva Convention of1929, the Medical Department as well as other branches of the Army used capturedenemy personnel as they became available in this country. The two categories ofsuch personnel assisted the Medical Department in different ways."Protected" personnel, which included enemy nationals who had beenemployed in medical work, took over to an increasing extent the care of the sickand wounded of their own nationality, under the administration and supervisionof members of the U.S. Army Medical Department. Except in cases of emergency,protected personnel were not to treat U.S. Army personnel who might be patientsin the same hospital.⁹⁷ "Nonprotected" prisoners of warwere used for other types of work according to their capabilities, the MedicalDepartment`s need, and the stipulations of the Geneva Convention as to the kindof duties they might perform.

In 1945, the War Department directed that protected personnelshould be assigned to each service command in the ratio of 2 doctors, 2dentists, and 6 enlisted men for each 1,000 prisoners. This quota did notinclude protected personnel in general hospitals that cared for sick and woundedprisoners of war.⁹⁸ As early as November 1943, the Secretary of Warhad directed that maximum use be made of enemy personnel in the care andtreatment of prisoners of war of their own nationality and that so far aspossible U.S. medical personnel should be relieved from duty in prisoner-of-warhospitals, wards and dispensaries.⁹⁹ In 1945, the question arose asto whether this injunction was being followed to the letter.

The two general hospitals devoted exclusively to the care of prisoners of war(Prisoner of War General Hospital No. 2 at Camp Forrest, Tenn., and

⁹⁶Report of the Surgeon General`s Conference With Chiefs, Medical Branch,Service Commands, 14-17 June 1943.⁹⁷War Department Technical Manual 19-500, "EnemyPrisoners of War," 5 Oct. 1944, with changes thereto.
⁹⁸Annual Report, Prisoner-of-War Liaison Unit, Office of Provost Marshal General, 1945. ⁹⁹War Department Prisoner-of-War Circular No. 6, 6 Nov. 1943.

325

Glennan General Hospital, Okmulgee, Okla.) for a timepossessed duplicate staffs of American and German personnel.¹⁰⁰Liberal use of American personnel along with protected personnel also seems tohave characterized other hospitals receiving prisoner-of-war patients, for inFebruary 1945 The Surgeon General sent a message on the subject to four servicecommands. Data in his Office, he stated, showed continued assignment ofconsiderably more Americans to prisoner-of-war hospitals than appeared to benecessary if protected personnel were fully utilized; the needs of Americanpatients made it essential that all American personnel at these hospitals beyondthe minimum required for supervision be assigned elsewhere. The Surgeon Generalseems to have found it necessary to repeat this admonition five months later, inJuly 1945. At that time, a total of 345 officers and 3,300 enlisted men had beencertified as protected personnel in the nine service commands.¹⁰¹

"Nonprotected" prisoners of war as distinct fromprotected personnel performed a variety of tasks in hospitals and other MedicalDepartment installations. One service command reported that it was using them tothe number of 191 officers and 2,875 enlisted men for cleanup work, care ofgrounds, landscaping, and mess duties. Hospital authorities seem to have foundthe work of prisoners of war generally satisfactory. The Director of Personnelat Valley Forge General Hospital, Pa., Capt. Francis E. Baker, MAC, went so faras to say: "As the prisoners of war learned their assigned jobs and becameaccustomed to the required standards, their services became invaluable and inalmost every instance supervisors preferred them to any other type ofpersonnel."¹⁰²

Oversea Theaters

As in the Zone of Interior, the Medical Department overseasavailed itself of the services of prisoners of war, using them in constructionas well as in the operation and maintenance of medical installations. Prisonersof war used in these ways were in addition to those protected personnel who weregenerally assigned only to prisoner-of-war hospitals or to prisoner-of-war wardsin Army hospitals. Prisoner-of-war labor, as long as hostilities endured, wasimportant only in the European and North African theaters, since few or noJapanese captives were used by the Medical Department until after V-J Day,except to care for Japanese prisoner-of-war patients.¹⁰³

¹⁰⁰See footnote 52, p. 313.
¹⁰¹See footnote 98, p. 324.
¹⁰²(1) Annual Report, Eighth Service Command, 1945. (2) Annual Report,Valley Forge General Hospital, Pa., 1945. (3) See footnote 52, p. 313.
¹⁰³(1) Letter, Col. I. A. Wiles, to Col. C. H. Goddard, Office of The Surgeon General, 17 Sept. 1952, andletter. Col. Paul O. Wells, to Col. C. H. Goddard, 26 Sept. 1952. (2) Thesections which follow, dealing with prisoners of war and native labor troops,are based largely on a manuscript account of "Medical DepartmentUtilization of Civilian and POW Labor Overseas in World War II," preparedunder the supervision of the authors of this volume by Cpt. Alan M. White.

326

Italian service troops

After the Italian armistice on 8 September 1943, Italianprisoners of war were organized into "Italian service units" undertables of organization and equipment established by the War Department. Some ofthese organizations, including "Italian sanitary companies" set up underTOE 8-117 (the only Medical Department table of organization utilized toestablish Italian service units), were assigned to Army hospitals and othermedical units throughout the communications zone, largely to supply commonlabor; although, occasionally, these units contained medical technicians orskilled artisans whose services were especially valuable.

Normally, at least one Italian sanitary company, consistingof approximately 3 officers and 115 enlisted men, would be assigned per generalhospital, and frequently this company would be augmented by a platoon or more ofa second. Such assignments usually meant the discharge of at least an equalnumber of Arab, French, or Italian civilians since it was more advantageous forthe Medical Department to use personnel under military control who could begiven longer and more thorough training in their duties. The fact that theycould be required to work longer hours than civilian employees and could bemoved with units to new locations probably reinforced their acceptability. Manycommanders felt that Italian troops exhibited superior efficiency and a morecooperative attitude than civilians. Few, if any, disciplinary problems wereencountered in the use of these troops, and they were described as "honest,industrious, and faithful," "willing and cooperative," and having"rendered inestimable service."

In addition to the Italian troops, Yugoslav service troops, who had beenbrought by the Germans to Sardinia as forced labor, "because," by allaccounts, "the most effective and dependable source of labor available inthe theater," when their "detested" Italian officers werereplaced by Americans and they were given proper nourishment and medical care.

On 1 May 1945, medical service-type units in theMediterranean theater employed more than 400 civilians and approximately 5,000prisoners of war (table 21).

The invasion of southern France in August 1944, which wasbased on the North African theater, brought some Italian service troops into theEuropean theater. However, they played a comparatively insignificant role in thelatter area. In June 1945, they accounted for but 1.8 percent of the entireMedical Department communications zone personnel (exclusive of headquartersinstallations), the corresponding figure for the Army as a whole being 3.5percent (table 23).

German prisoners of war

During the Normandy campaign (June and July 1944), Germanprisoners of war were used as litter bearers, sanitary details, and other"general work" at the evacuation hospitals of the First U.S. Army.Usually, 40 of these

327

men were assigned to each evacuation hospital. In August andSeptember 1944, the Third U.S. Army used 40 prisoners of war per 400-bedevacuation hospital, 50 prisoners of war per 750-bed evacuation hospital, andabout twice that number in each medical depot company. The general policy of thetheater was that prisoners of war in the evacuation hospitals could be retained7 days only, at the end of which period they had to be exchanged for a new groupof prisoners. However, after October 1944, evacuation hospitals and medicaldepots in the Third U.S. Army were permitted to retain prisoners "afterproper screening" for an indefinite length of time. The successful use ofprisoners of war in the First U.S. Army evacuation hospitals during the earlystage of continental operations suggested their further use in communicationszone medical installations, and they were used extensively at general hospitalsand depots on the Continent.

Probably, the average number of German prisoners used pergeneral hospital was 250-300, although there are many instances where more wereassigned. The 813th Hospital Center at Mourmelon, France, in 1945 had 7,321German prisoners of war working in its 10 general hospitals. In April 1945,German prisoners of war working for the Medical Department in nonheadquartersinstallations of the communications zone of the European Theater totaled nearly40,000. In May, this number increased considerably, perhaps because ofredeployment of Medical Department troops. At the end of August, it amounted to29 percent of the entire Medical Department personnel of the zone. Nevertheless,this proportion was smaller than the equivalent ratio for all branches of theArmy, the same being true of all other months between June and October. Theactual number used also began to decline after May, and whereas in the monthsApril-June, inclusive, the Medical Department was utilizing in the vicinity of13-15 percent of all nonheadquarters communications zone prisoner-of-war labor,this percentage fell well below 10 percent in subsequent months (table 23).

In the United Kingdom Base Section, the original plan was for 10 hospitals touse 250 German prisoners each and 30 hospitals to use 50 each; it was laterdecided that 100 was the minimum number that could be profitably utilized in asingle hospital. In this base section, however, the Medical Department madelittle use of such labor until March 1945, but, thereafter, its importanceincreased greatly.¹⁰⁴ Even in May 1945, however, when more than 40 percent ofnonheadquarters Medical Department communications zone troops were stationed inthe United Kingdom, only slightly more than 15 percent of the German prisonersused in nonheadquarters communications zone medical installations were locatedthere (table 23).

German prisoners of war performed the same general duties for the MedicalDepartment as did civilian employees; that is, primarily manual labor (fig. 39).Sometimes this included ward duties although, generally, they were not employedin such duties. Enlisted prisoners with experience

¹⁰⁴For the first half of 1945 the hospital employment figures were asfollows: January, 317; February, 415; March, 2,525; April, 5,726; May,8,228; and June, 7,236.

328

FIGURE 39.-German prisoners of war assist in unloading a hospital train. Li?ge, Belgium, 18 March 1945,
Hospital Train No. 8.

in repair and maintenance of medical equipment were assigned to many of themedical depot companies in the theater.

In 1944 on the Continent, medical units drew their prisoner labor from thenearest prisoner-of-war stockade. In the communications zone, such enclosureswere constructed at or near most general hospitals. As the need for prisonerlabor increased, the European theater organized it in a more formal manner thanpreviously. A directive of 2 October 1944 assigned to the base sectioncommanders of the communications zone the responsibility for "formation ofPOW`s into labor companies of approximately 250 each," and "militarylabor service companies" were organized accordingly. U.S. officer andenlisted personnel were attached to the prisoner-of-war labor companies foradministration and supervision.¹⁰⁵ Displaced persons were recruitedto replace American units on guard duty with the prisoners-of-war laborcompanies. In 1945, the 10 general hospitals of the 813th Hospital Centeremployed 935 Dutch guards and 788 Polish women.

¹⁰⁵Lewis, George G., and Mewha, John: History of Prisoner of WarUtilization by the U.S. Army, 1776-1945. Washington: U.S. Government Printing Office,1955. [DA Pamphlet 20-213.]

329

In Italy, German prisoners of war were available only inisolated cases for Medical Department work before the end of the fighting inthat country (2 May 1945) but many were used to replace civilians and Italiantroops in Army hospitals in the summer of 1945. Indeed, Germanprisoners of war were regarded as the most skillful, efficient, and cooperativeof all local labor groups at least in Europe.

Native labor troops

In addition to displaced persons and prisoners of war theMedical Department was able to obtain the services of native labor troops incertain areas. During the latter part of the war, such troops were sent intoAssamfrom southern India and used by a medical supply depot.¹⁰⁶

After the capitulation of Italy and the assumption by the Italian Governmentof a quasi-Allied status, that government supplied troops to the MedicalDepartment who, unlike the Italian service unit personnel, were not technicallyprisoners of war. These were used in the combat zone of the Mediterraneantheater; as has been stated, the service units were not expected to serve inthat zone. Most evacuation hospitals in that theater had from 30 to 60 Italiansoldiers working for them. Some Italian soldiers were reluctant to serve aslitter bearers in forward areas but others performed this function with skilland courage. The attachment of the so-called military companies to Army malariacontrol detachments, where "they were organized as labor crews forditching, larviciding and house spraying," was said to be "verysatisfactory" and to have "enabled the control units to increase theirwork schedules many fold.``

MORALE FACTORS IN EFFICIENT UTILIZATION OF PERSONNEL

Living and working conditions in the Army were sufficiently different fromthose in civilian life as to require considerable adjustment on the part of thenew officer or soldier, whatever his branch of service. Conditions overseasmight make the problem of adjustment a good deal more difficult. Very frequentlyprolonged service in unfamiliar surroundings was in itself a depressing factor. Even a year overseas was long enough for some MedicalDepartment officers to reveal a distinctly "fed-up" attitude towardtheir environment, although the dissatisfaction appeared more often after aperiod of 18 months. The extent to which the condition manifested itselfdiffered among individuals and probably many escaped it altogether. Others showedloss of interest in routine duties, irritability, and general inefficiency.Nurses found the first year of their service overseas both interesting andstimulating despite the attendant hardships and discomforts. At the end of 18months of service,

¹⁰⁶Letter, Lt. Col. Irvine H. Marshall, to Col. C. H. Goddard, Office of TheSurgeon General, 1 Aug. 1952.

330

however, nurses serving in forward hospitals began to displaysigns of restlessness and homesickness. Enlisted men of the Medical Departmentdisplayed similar signs of discomfort, but when these most frequently appeared has not been ascertained.

Methods of Combating Morale Problems Overseas

Value of continued professional activity

Despite war weariness, the effect of long stays overseas wasmitigated in the case of nurses if they had a sufficient amount of satisfactorywork to keep them busy. Morale remained at a high level when the patient loadand demands for the services of these women were heaviest. When there was little to do, it dropped drastically even after hostilities had ceased, as inthe European theater in July 1945. Nurses were also anxious to care for battlecasualties. Those who found themselves on protracted duty in Panama, forexample, were unhappy because they had no opportunity to do so. Thus, althoughnurses could expect to withstand the conditions in rear areas for as long as 2years without suffering harm, they were eager for forward duty, and their moralesagged when it was denied them. Many combat unit nurses were reluctant to moveinto rear areas, although they were unable to escape the wearing effects of theservice they were performing.¹⁰⁷

The value in terms of morale of keeping personnel busy in theprofessional tasks to which they were primarily suited was not confined tonurses. It was of demonstrated weight in the case of medical officers andothers. When the immediate professional duties were not sufficient for thepurpose, as well as at other times, library facilities, the circulation ofprofessional journals, clubs for the discussion of such periodicals, andprofessional conferences and meetings all served to bolster morale. In theEuropean theater, before D-day, a number of opportunities for professionalrefreshment were afforded: A theater medical society and several area medicalsocieties meeting at short intervals; an Inter-Allied medical society which metin London every month and to which the Chief Surgeon could order 200 medicalofficers, thus affording them transportation; and weekly visits to the greatteaching hospitals in London for 10 officers at a time. After V-E Day, groupsfrom the European theater were sent to medical centers all over western Europe.¹⁰⁸

In 1943, the Twelfth Air Force reported from the NorthAfrican theater that among its medical personnel flight surgeons, beingintensely interested in aviation medicine and flying, had shown the leaststaleness and loss of morale.

¹⁰⁷(1) History of Medical Department Activities in theCaribbean Defense Command in World War II. [Official record.] (2) See footnote45(2), p. 306. (3) Parsons, Anne F.: History of the Army Nurse Corps in theMediterranean Theater of Operations, 1942-45. [Official record.] (4) AnnualReport, 814th Hospital Center, European Theater of Operations, U.S. Army, 1945.(5) Report, Lt. Col. Alan P. Parker, MC, Executive Officer, 38th GeneralHospital, on Medical Department Activities in the Middle East, 23 Dec. 1943.
¹⁰⁸Letter, Maj. Gen. Paul R. Hawley, USA (Ret.), to Col. John B. Coates,Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 12 Mar. 1956.

331

On the other hand, dental officers in the Air Forces,although they were engaged in work quite similar to that which had occupied themin civilian life, still developed mental depressions of varying degree. Even theinterest of flight surgeons in their work began to wane after they had beenoverseas in excess of 20 months.¹⁰⁹ It was in respect tonurses that the value of continued professional activities as a means ofmaintaining morale was considered greatest; nevertheless, even in their case,these activities served only to retard the cumulative effects of prolongedoversea service.¹¹⁰

Recreation

Personnel of the Medical Department, under other than combat conditions andjust as in other branches of the Army, usually had access to various typesof recreational facilities, including officers` and enlisted men`s clubs, whichwere provided as a means of maintaining morale and alleviating the adverseconditions under which troops had to live in oversea theaters. Indeed, becauseof their proximity to the facilities provided for patients, Medical Departmenttroops were perhaps better off in regard to spectator activities than those ofmost other arms and services. Recreational facilities of course were not always available. This was true particularly on some of the small islands in thePacific. On Guam, for example, there were few recreational facilities and noclub.¹¹¹

Leaves, furloughs, and reassignments

Besides steady occupation and proper recreation, anothermeans of restoring morale and efficiency was temporary or permanent relief fromassigned duties. This could be accomplished without discharging a man from theservice, by various administrative means which were used by the MedicalDepartment as by other branches of the Army. Only scattered data are availableas to the extent to which these devices were used overseas. Among them wereleaves of absence for officers and their equivalent, furloughs, for enlistedmen, both of which however were probably of much shorter duration, as a rule,than the standard 7 days in 4 months suggested by the field service regulations.Several medical officers who saw service in the Pacific and Mediterraneantheaters believe that medical personnel in those areas fared about the same asothers with respect to leaves and furloughs, although distances in the Pacificsometimes made return from leave areas unpredictable.¹¹²

¹⁰⁹(1) Report, Col. Abram J. Abeloff, MC, on Medical DepartmentActivities in the Persian Gulf Command, 29 May 1945. (2) Flick,John B.: Activities of Surgical Consultants, Pacific Theater, In Historyof Pacific Ocean Areas and Middle Pacific. [Official record.] (3) AnnualReport, Surgeon, Twelfth Air Force, 1943. (4) Letter, Col. W. F. Cook,Surgeon, to Maj. Gen. D. N. W. Grant, Air Surgeon, Army Air Forces, 8 Aug. 1944.
¹¹⁰(1) Stone, James H.: History of the Army Nurses, Physical Therapists, andHospital Dietitians in India and Burma. [Official record.] (2) Annual Report,36th General Hospital, 1944.
¹¹¹(1) See footnote 109. (2) The annual reports of hospitals during the warmentioned the sharing of facilities with patients.
¹¹²(1) Letter, L. K. Pohl, MC, USAF, to Col. C. H.Goddard, Office of The Surgeon General, 1 Aug. 1952. (2) Letter, G. H. Yeager, to C. H. Goddard, Office of The Surgeon General,29 Sept. 1952. (3) Letter, T. C. Keramides, to Col. C. H. Goddard, Office of The Surgeon General, 12 Sept. 1952.

332

Reassignment in or outside an individual`s organization anddetached service or temporary duty away from it were other means of relief fromassignments involving heavy strain, although, unlike leaves and furloughs, theyserved various additional purposes. Reassignment was practiced extensivelywithin the Medical Department overseas as well as in the United States andbetween the United States and oversea areas.

Rotation

In popular parlance within the Army, some of the forms of transfer orreassignment-such as placing oversea personnel on temporary duty in the UnitedStates when that practice was instituted as a policy toward the end of the war-were loosely comprehended in the term "rotation." As defined byWar Department Circular No. 58, 9 February 1944, rotation was "the exchangeof personnel in theaters for replacements furnished from the United States assubstitutes therefor in accordance with advance requisitions submittedperiodically by theater commanders." Rotation within the theaters, to whichthe directive also referred, was presumably to be understood as also requiringthe provision of substitutes for persons being sent elsewhere, in accordancewith advance requisitions submitted by the units from which the transfers wereto be made. An earlier directive (28 June 1943) was the beginning of anArmy-widerotation policy. Among the persons it specified as eligible for transfer to theUnited States were (1) those "whose morale or health has been adverselyaffected by prolonged periods of duty under unusually severe conditions, eventhough not requiring hospitalization," and (2) those whose experience andtraining would make them useful "in the training and formation of newunits, or for other purposes." The directive of February 1944 added a thirdcategory-"personnel considered by the theater commander as deserving ofsuch return." Both circulars provided that persons in the first category bereturned to the United States only when their effectiveness could not berestored by rotation within the theater. In general, theatercommanders were directed to rotate personnel within their jurisdiction in orderto maintain the efficiency of their commands.

The Medical Department had practiced intratheater rotation tosome extent even before the Army-wide policy was instituted. In the Europeantheater, a program involving temporary exchanges of medical officers of companygrade between the 5th General Hospital and tactical units training in NorthernIreland was carried on as early as 1942. Although the advantages of the schemewere generally acclaimed, a wider application of it did not follow for a longtime.¹¹³

On 30 September 1943, 3 months after the first War Department directivefavoring intratheater rotation appeared, instructions to apply it to medical

¹¹³Middleton, W. S.: Medicine in the European Theater ofOperations. Ann. Int. Med. 26: 191-200, February 1947.

333

officers in the China-Burma-India theater were issued by thetheater commander. Under these regulations, officers of the Medical Corps whohad served with troops in the field for more than 12 months might apply fortransfer to hospital duty, and officers with at least the same amount of servicein hospitals might request transfer to a combat unit. In general, however, suchrotation was not to be applied to specialists and flight surgeons, nor wereapplications for transfer to be approved if the transfer would lower theefficiency of a unit engaged in combat or one about to become so engaged. Eachcommander was directed to effect transfers within his own command if it waspossible to do so, and if applications were not forthcoming, he was instructedto initiate such transfers as he believed good for the service.¹¹⁴

It was not until a year later that this policy was formallyadopted by the Medical Department in the European theater. Two types ofintratheater rotation were formulated by the theater surgeon. Permanent rotationfrom ground force units to communications zone installations was provided forofficers and men who had served with line units for extended periods and whosevalue to the medical service in the opinion of the respective army surgeonswould be enhanced by such reassignment. At the same time, rotation ofspecialists was introduced. Specialists were to be transferred for a 3 months`tour of duty from general and station hospitals to field and evacuationhospitals and auxiliary surgical groups operating in the army area, or viceversa. This program was adopted primarily for professionalpurposes, being designed to enable medical officers to follow the progress oftheir patients through various echelons of treatment.¹¹⁵

Precisely how much advantage was taken of these programs is not known, but itis certain that they were curtailed as a result of the German counteroffensiveof December 1944. At that time, as has been stated the communications zone wascalled upon to supply large numbers of officers and men to army units withoutreceiving replacements in return. The permanent type of rotation was especiallyaffected by this development.¹¹⁶ Nevertheless, on 5 January 1945, theaterheadquarters again authorized rotation of Medical Department officers andenlisted men between army area and communications zone units. The minimum periodof service in a field army unit required to establish eligibility for suchrotation was 1 year, of which 3 months had to be subsequent to D-day. The agelimit for men transferred to an army was fixed at 35, except in special cases,and they were to possess grades and professional or technical qualificationssimilar to those of the men they were replacing. Before a man could betransferred from an army to the communications zone, his replacement had to beimmediately available. The monthly quota of trans-

¹¹⁴Circular No. 75, Headquarters, Rear Echelon, U.S. Army Forces,China-Burma-India, 30 Sept. 1943, subject: Rotation of Officers.
¹¹⁵(1) See footnote 36, p. 303. (2) Annual Report, Professional ServiceDivision, Office of The Chief Surgeon, European Theater of Operations, U.S.Army, 1944.
¹¹⁶See footnote 36, p. 303.

334

fers for each army was fixed at 5 Medical Corps officers, 5 other MedicalDepartment officers, and 25 enlisted men.¹¹⁷

Intratheater rotation of medical officers was practiced in the NorthAfrican-Mediterranean theater as early as 1943. Company grade officers in combatunits who were more than 35 years of age were moved to communications zoneunits and replaced, insofar as possible, by general service officers under 30.In most cases personnel wounded in combat or otherwise hospitalized also werereassigned to the communications zone if they so desired. Two or more years ofconstant field service, especially if a part of this was rendered in combat,gave an individual a strong claim to rotation from a field unit to acommunications zone hospital.¹¹⁸

In the Mediterranean theater, it was reported that, up to 1March 1945, 365 Medical Corps officers had been rotated between field units andcommunications zone hospitals. The impression of a former consultant in thetheater was that more officers moved from field units to hospitals than in theopposite direction and that the losses of the former were made up byrequisitioning replacements from the Zone of Interior.¹¹⁹ In view ofthe charge that Zone of Interior replacements in the theater were scarce duringthe Italian campaign, there is some doubt as to how well the process ofreplacement was accomplished.

In the European theater, the exchange of personnel within thetheater was not without its morale problems. Difficulties arose when men withrelatively high rank who had served in forward units were rotated toestablishments further in the rear where they outranked personnel withgreater experience and talent in specialized work.¹²⁰ This situationhas been attributed at least in part to the fact that interchangeability ofpersonnel, as regards rank, was less possible in table-of-organization generalhospitals than in evacuation hospitals.¹²¹

Not much information is available about the amount of rotation of MedicalDepartment personnel between the theaters and the Zone of Interior. In early1945, The Surgeon General asserted that the rate of rotation of medical officersfrom oversea theaters had been much higher than that of any other arm orservice.¹²² Yet there were complaints that the rotation of both medicalofficers

¹¹⁷Letter, Brig. Gen., R. B. Lovett, Adjutant General, European Theater ofOperations, to Commanding General, each Army Group, and Commanding General, each Army,4 Jan. 1945, subject: Rotation of Medical Personnel Between Communications Zoneand Armies.
¹¹⁸Letter, Stewart F. Alexander, to Col. John B. Coates, Jr., MC,Director, Historical Unit, U.S. Army Medical Service, 3 Dec. 1955.
¹¹⁹Letter, E. D. Churchill, to Col. C. H. Goddard, Office of The SurgeonGeneral, 4 Sept. 1952, with extract from Lt. Col. M. E. DeBakey, for The SurgeonGeneral, 5 Mar. 1945, subject: Report of Visit to the Mediterranean Theater ofOperations.¹²⁰(1) Letters, to Col. C. H. Goddard, Office of The Surgeon General,from J. S. Skobba, M.D., 10 Oct. 1952; T. L. Badger, M.D., 3 Sept. 1952; M. E. DeBakey, M.D., 7 Aug. 1952; and C. S. Drayer, 3 Sept. 1952. (2) AnnualReport, Professional Service Division, Office of The Chief Surgeon, EuropeanTheater of Operations, U.S. Army, 1945.
¹²¹Letters, to Col. C. H. Goddard, Office of The Surgeon General,from W. S. Middleton, M.D., 26 Aug. 1952; Alan Challman, M.D., 11 Sept. 1952;J. M. Flumerfelt, M.D., 8 Sept. 1952; and C. H. Bramlitt, M.D., 24 July1952.
¹²²Letter, The Surgeon General, to Dr. Olin West, Secretary and GeneralManager, American Medical Association, 31 Mar. 1945.

335

and other medical personnel was insufficient. About March1944, the Surgeon of the Twelfth Air Force (Mediterranean theater), expressinghis belief that "the rotation policy has not been adequate," calledattention to the fact that since the inception of that Force only one dentalofficer in it had been returned to the United States for any reason exceptmedical.¹²³

In answer to criticism of the low rate of rotation of nurses,the Deputy Surgeon General pointed out that the rotation policy for thesewomen was the same as that for other personnel.¹²⁴ He stated thatalthough the Surgeon General`s Office had concurred in a special policyproposed by the Mediterranean theater whereby 30 nurses would be returned to theUnited States each month, sufficient replacements for these women could not besupplied. As there were approximately 2,500 nurses in the Mediterranean theaterin November 1944, it is readily seen that 30 rotations a month would havebenefited only a small percentage of the nurses in the theater.

Despite widespread agreement on the physical andprofessional benefits of rotation, various medical commanders in the theaterssaw drawbacks in the practice. They were disturbed by the prospect of losing anexperienced member of a team and having to spend time training aninexperienced replacement. Such a task would, of course, be more difficult ifthe hospital or other type of unit was operating with a heavy patient load. Thetheaters, as already noted, had to wait until a replacement arrived beforepermitting a mall to leave for the United States. Although authorities in theUnited States endeavored to send men with the same qualifications as those theywere to replace, instances occurred in which the replacement lacked theattainments of the man being relieved.¹²⁵

The North African theater refused to rotate within thetheater a man of particular value in either a combat zone or communicationszone assignment.¹²⁶ With reference to oversea rotation, the theatersurgeon in a statement issued in early 1944, declared that "only underunusual circumstances should key professional personnel be recommended forrotation. Chiefs of professional services, psychiatrists, surgeons, medical orsurgical specialists should be considered as key professional personnel."¹²⁷There was a feeling in the theater that the policy of rotation hadresulted in the loss during 1943 of many well-trained, experienced medicalofficers, and that replacements frequently had been relatively inexperienced men.¹²⁸ As a result of this feeling, and of the theater surgeon`s directive, themore competent officers ceased to be nominated for rotation, which thus became areward to the less deserving.^l29 Indeed, in the European theater,the Chief Surgeon`s Office, while not actively discouraging intratheaterrotation, long looked upon it with suspicion because it might lend itselfto efforts of

¹²³See footnote 109(3), p. 331.
¹²⁴Letter, Maj. Gen. George F. Lull,Deputy Surgeon General, to Hon. Edith Nourse Rogers, 16 Feb. 1945.
¹²⁵Annual Report, 15th Field Hospital, 1944.
¹²⁶See footnote 118, p. 334.
¹²⁷Annual Report, Surgeon, Mediterranean Theater of Operations, U.S. Army, 1944, vol. I.
¹²⁸Annual Report, Surgeon, Mediterranean Theater of Operations, 1944, vol. II.
¹²⁹Annual Report, 70th General Hospital, 1944.

336

commanders to rid themselves of undesirable officers or tocreate promotion opportunities for personnel within an establishment byrequisitioning a replacement in a grade lower than that of the individual to berotated out of the unit.¹³⁰

Toward the end of the war, the War Department adopted an alternative torotation in the form of temporary duty in the United States. This gave thepersons so assigned a break in oversea service without ending it for them entirely. One method by which this was accomplished, particularly in the case ofnurses, was to assign the officers as medical attendants of patients beingevacuated to the Zone of Interior and upon their arrival in the United States togrant them emergency leave.¹³¹

Many officers in the Mediterranean theater preferred temporary duty in theUnited States to rotation, for they wished to continue as members of their unitsrather than be separated from them and risk being sent to another theater.¹³²Commanding officers recognized certain advantages to this temporary-dutyassignment, for it not only permitted them to give their subordinates a leave athome without the necessity of obtaining a replacement beforehand, but alsoassured them of the return of experienced personnel after a time.¹³³In the very merits of the system, however, lay its disadvantages, for the samecommander might be deprived of a valuable officer`s service for a period of 60to 90 days without any kind of substitute.¹³⁴

Thus, in the Mediterranean theater at least, commanding officers becameincreasingly favorable to rotation as a method which was more likely thantemporary duty to provide them with replacements.¹³⁵ Perhaps theyalso felt that it was better to have fresh personnel than war-weary veterans ofoversea service, even after a period of leave at home, particularly since theapproaching termination of the war made it less necessary than formerly todepend on experienced officers.

Although rotation was of limited scope, its influence,according to Col. Stewart F. Alexander, a former chief personnel officer in themedical service of the North African theater and the Seventh U.S. Army,"was a vital factor in maintenance of morale * * *. The benefits * * *extended far beyond the actual number of men rotated. The men in forward orunfavorable areas often were dominated by the thought that they were doomed inperpetuity to their assignments. Rotation was a very concrete expression thathigher echelons were interested in their problems, and was a potent influencefor good. This was particularly true in that rather small but very importantgroups were de-

¹³⁰Memorandum, Col. D. E. Liston, Office of the Chief Surgeon, EuropeanTheater of Operations, for Adjutant General, Personnel, European Theater ofOperations, 11 Mar. 1944.
¹³¹(1) Annual Report, Chief Surgeon, U.S. Army Services ofSupply, Southwest Pacific Area, 1944. (2) Annual Report, Surgeon, United KingdomBase, Communications Zone, European Theater of Operations, U.S. Army, 1944.
¹³²(1) Annual Report, 43d General Hospital, 1944. (2) Annual Report,Surgeon, Fifth U.S. Army, 1944.
¹³³See footnote 131(2), above.
¹³⁴(1) Annual Report, Surgeon, Mediterranean Theater of Operations, U.S.Army, 1944, vol. II. (2) See footnote 132(2), above.
¹³⁵(1) See footnote 132(2). (2) Annual Report, Surgeon, Fifth U.S. Army, 1945.

337

tailed overseas early in the war, when neither the physical aids nor theincentives of imminent victory were present."¹³⁶

Authorization of a medical badge

Promotion was not the only reward for exceptional service. In1945, the Medical Department`s enlisted men and lower ranking officers whowere serving with troops in combat received something approaching therecognition that had already been accorded infantrymen. For the latter, the WarDepartment in October 1943 had authorized an Expert Infantryman Badge and aCombat Infantryman Badge, and in June 1944, Congress had awarded $5 a monthextra pay to holders of the first and $10 a month to holders of the second.¹³⁷In late 1944, a Medical Department observer returning to the Surgeon General`sOffice after a visit to the European theater proposed serious consideration ofincreased pay for medical troops in the infantry. He added that many infantrycompanies made special arrangements by which medical aidmen were paid out ofcompany funds, and said it was generally felt that such men did daily what, ifthe infantryman did it, would have brought him a Bronze Star award.

As it happened, a special badge had already been proposed for the medicalaidmen. On 1 March 1945, the General Staff authorized a Medical Badge to be wornby Medical Department officers of company grade, warrant officers, and enlistedmen who were "daily sharing with the infantry the hazards and hardships ofcombat." The badge could be temporarily withdrawn when the bearer wastransferred or assigned outside the Medical Department to duties in which hemight come into contact with the enemy. This, it was explained, was ordered soas not to impair the protected status of regularly assigned Medical Departmentpersonnel. In such cases, the right to wear the badge was restored on relieffrom combat duties or on reassignment to the Medical Department. The badge wasof oxidized silver and showed a stretcher placed horizontally behind a caduceuswith a cross of the Geneva Convention at the junction of the wings, the wholeenclosed by an elliptical wreath 1 inch in height and 1? inches in length. Like all ground badges, it was worn on the left breast of the servicecoat, jacket, or shirt.¹³⁸ At first, these badges were not awardedposthumously; later, the badge might be awarded to any individual eligible toreceive it who had been killed in action or died as a result of wounds receivedin action on or after 7 December 1941. In 1945, Congress authorized pay of $10per month to enlisted men (but not officers) entitled to wear the badge.¹³⁹

For bravery in action, in World War II, as wellas for meritorious service, many personnel of the Medical Department receivedcitations ranging from the highest award conferred by the U.S. Government, theCongressional Medal of Honor, to the Bronze Star medal-as well as decorationsfrom foreign governments. At least nine of these unarmed soldiers received theCongressional Medal of Honor (fig. 40).

¹³⁶See footnote 118, p. 334.
¹³⁷(1) War Department Circular No. 269, 27 Oct. 1943. (2) 58 Stat. 648.
¹³⁸Army Regulations No. 600-70, 18 Apr. 1948.
¹³⁹(1) War Department Circulars No. 66, 1Mar. 1945, and 151, 23 May 1945. (2) 59 Stat. 462.

338

Figure 40.-Medical Department enlisted men awarded the Congressional Medal ofHonor, in World War II. Upper row, left to right: Pfc. Desmond T. Doss, Okinawa; Pvt. Harold A. Garman, France; Pfc. Lloyd C. Hawks, Italy. Center row, left toright: Cpl. Thomas J. Kelly, Germany; Pvt. William B. McGee (died of wounds),Germany; Pfc. Frederick C. Murphy (killed in action), Germany. Lower row, fromleft to right: T4g. Laverne Parrish (died of wounds), Luzon, Philippine Islands;Pfc. Frank J. Petrarca (died of wounds), New Georgia, Solomon Islands; T5g.Alfred L. Wilson (died of wounds), France.

RETURN TO TABLE OF CONTENTS