Part 31

The present organization of the Field Service units of the Motor Transport Corps is as follows: the personnel of a motor-transport company consists of a first lieutenant, a second lieutenant, eight sergeants, forty-four privates (ten first-class), and two cooks; the equipment consists of a light open motor-car, a motorcycle with side-car, twenty-nine cargo trucks, including one for light repair and one for company supply, two tank trucks, and a rolling kitchen. A motorcycle company has a first lieutenant, a second lieutenant, six sergeants, a corporal, thirty privates, first-class, and a cook, together with thirty-two motorcycles with side-cars, and two cargo trucks. A headquarters motor command is in charge of a captain, who has two first lieutenants, a second lieutenant, five sergeants, four corporals, and two privates, first-class; the rolling-stock includes two heavy motor-cars, two light closed cars, one light open car, one cargo truck, and two motorcycles with side-cars. Though there are no tables of organization for the larger units of the Motor Transport Corps, a Supply Train is composed of a headquarters motor command and not less than two or more than six motor-transport companies.

So much space has been devoted in the newspapers and magazines to the exploits of the combatant arms of the service that the public has heard little, if anything, of the less spectacular but no less arduous and important work of the men who wore the purple hat-cords of the M. T. C.

It was their endurance and resourcefulness which made possible the transfer by road to the St. Mihiel and Argonne sectors, in nineteen days, of more than half a million men, and this in spite of the unprecedented congestion as a result of the preparations in progress for the great offensives. It was the tireless, iron-hard drivers of the M. T. C. who got forward the food for the men and the food for the guns. It was the despatch-riders of the corps who, jeering at death, delivered the vital messages which were intrusted to them, tearing down the steel-swept, shell-pocked roads at express-train speed on their roaring motorcycles. No mud was too deep, no shell-storm too violent, no road too dangerous to stop the men of the M. T. C. They went wherever their wheels could find traction—and in some places where they could not. They did not possess so much as a bowing acquaintance with either fatigue or fear. They were the newest corps in the army and they made their own traditions. They were as unconventional in their methods of doing things as the old-time army teamster, the stage-coach driver, and the pony-express rider, whose qualities they have inherited and whose lineal descendants they are. When in doubt they stepped on the accelerator, for the motto of the Motor Transport Corps is “_Get There!_”

X

MENDERS OF MEN

Beneath the crest of the British Royal Artillery appears the word “_Ubique_”—“Everywhere.” It is a motto which might more fittingly be applied to the Medical Department of our own army, however, for that corps has its representatives in every branch of the service—on land, afloat, and in the air. It directed the designing and production of our first gas-masks and from it was drawn the nucleus of our original Gas Defense Service. It provided the medical staffs for the hospital ships and for the army transports. By means of the ingenious system of tests which it devised, it selected our flying-men, determined on the form of aviation work for which they were mentally and physically fitted, and, by a system of unceasing observation, kept them constantly in condition to fight the Boche in the skies. It organized an ambulance service which won the admiration of the world. No battery or battalion went into action without its quota of medical officers, who shared all the perils and privations of their comrades of the line and worked longer. Only two units in the American Army were granted by the French the coveted distinction of wearing the _fourragère_: one of them was an Air Service squadron, the other a unit of the Sanitary Corps of the Army Medical Department. Our medical officers were actually the first in the field and the first to sustain wounds; the first American killed after the declaration of war was a medical officer.

A list of the Medical Department’s activities would include the Dental Corps, the Sanitary Corps, the Veterinary Corps, the Nurse Corps; laboratories for the study and prevention of infectious diseases; organizations for the isolation and the special care of the tuberculous, the insane, the victims of war neuroses; convalescent centres and sanatoria; a division of psychology for gauging the mental capabilities of the army’s enlisted personnel; a division of physical reconstruction for the rehabilitation of the sick and wounded; a hospital division which planned and equipped hospitals to meet the constantly increasing needs of the army; a motion-picture industry which enabled the staffs of the various hospitals to see depicted on a screen the latest methods of surgery and medicine and which also illustrated to the soldier the danger of breaking sanitary regulations; the publication of a chain of hospital papers to strengthen the morale of the soldier patients; a system, working in co-operation with the War Risk Insurance Bureau and the Adjutant-General’s Office, designed to expedite the settlement of war claims, and a remarkable statistical classification of the sick and wounded, including a complete medical history of each individual case. To this array of extraordinary activities must be added, of course, the features usual to any well-organized medical department: services of internal medicine and surgery working in the closest harmony in every hospital unit; divisions of head surgery (including eye, ear, nose, and throat), orthopedics, urology, and Roentgenology; and finally that vast organization for the care of the wounded whose operations began with the stretcher-bearers out in No Man’s Land and ended only when the men had passed out of the great general hospitals in the homeland with the wound-chevrons on their sleeves.

When, in the past, we have been suddenly confronted by the necessity of making war, we have had to do our organizing after the beginning of hostilities. And, though the titanic conflict had been in progress for more than two years and a half before we entered it, we ran true to form, being as unprepared for war from a medical standpoint as we were from an ordnance, an artillery, or an aviation, point of view. Barring the superficial experience gained by some of our medical officers during the mobilization on the Mexican border, our medical preparations were all made after war had been declared. This unpreparedness was not the fault of the heads of the Medical Department, mind you; it was not due to carelessness or lack of foresight, but was, instead, the logical result of a deliberate policy of those who held that to be prepared for war was to invite war. When the war-cloud broke, it became necessary, therefore, to build overnight, and virtually from the ground up, a mammoth and highly complex organization. When war was declared, the Medical Department, including the Medical Corps, the Dental Corps, the Veterinary Corps, and their respective reserves, had barely 700 commissioned officers on duty in the United States and its possessions. Though the regular Medical Corps included many officers whose achievements had contributed very largely to the prevention of disease and the amelioration of suffering in all parts of the world—it has been said of former Surgeon-General Gorgas that he “made the Canal possible and the tropics habitable”—and though these officers were skilled in preventive medicine, field sanitation, and other phases of the work of the army surgeon, there was, after all, only a handful of them. It became necessary, therefore, to provide, on the instant, not only for an enormously augmented personnel but also for new and unconsidered conditions. An ambulance service had to be organized and vehicles for it had to be designed and manufactured; hospital trains had to be built—there was only one in the United States when the war began; antiseptic methods in field surgery had to be devised as a substitute for the complete surgical cleanliness possible only under peace conditions; a system had to be devised and put in operation which would insure the prompt collection of the wounded on the battle-field and their rapid evacuation; measures had to be taken for the reconstruction of the severely wounded and their training for future efficiency in civil life.

Beginning, as I have already said, with a peace-time personnel of barely 700 officers, and a peace-time organization, the Medical Department expanded as the army expanded, until, when the Armistice was signed, it was serving 4,000,000 American soldiers at home and overseas and had, in addition, spread its safeguards over millions more of the civil population on both sides of the Atlantic. Several years prior to the war there had been organized a Medical Reserve Corps which included in its membership many prominent physicians and surgeons. The National Guards of the several States also had their respective medical organizations. The Medical Department at the outbreak of the war consisted, therefore, of nine corps: the Medical Corps, the Medical Reserve Corps, the Medical Corps of the National Guard, the Dental Corps, the Dental Reserve Corps, the Dental Corps of the National Guard, the Veterinary Corps, the Veterinary Reserve Corps, and the Veterinary Corps of the National Guard, to which were added before the war had been in progress a month a Medical Corps, National Army, a Veterinary Corps, National Army, a Sanitary Corps, and an Ambulance Corps, making a total of thirteen distinct services in the Medical Department. By the act of August 7, 1917, however, all of the above were merged into the Medical Corps, United States Army, thereby greatly simplifying administration. But it was quickly realized that, even by calling to the colors every medical officer in the Reserve Corps and the National Guard, the personnel would still fall far short of the number required to provide for the proper care and treatment of the enormous armies which were rapidly being placed in the field, for already the Secretary of War had made his celebrated remark: “Why stop with an army of 5,000,000 men?” Some conception of the problem confronting the surgeon-general may be had when I explain that the Medical Department was expected to furnish each infantry division with approximately 111 officers and 1,400 enlisted men. In addition, an enormous number of medical officers was required for the camp, base, and general hospitals which were springing up like mushrooms, almost in a night, throughout the land. In order to obtain these officers it became necessary, therefore, to appeal to the medical profession of the United States and to the various medical societies, the American Medical Association taking a particularly energetic and enthusiastic part in the work of recruiting. The response of the medical men of America was as prompt as it was gratifying. Specialists whose names were as familiar to the public as those of Cabinet officers and who for a single operation received fees equal to the annual salary of an ambassador; obscure country practitioners who made their daily rounds in mud-bespattered buggies and who, as often as not, received their pay—when they received it at all—in produce; prosperous middle-aged physicians with established and lucrative city practices; struggling young internes; lecturers on medicine and surgery at universities and colleges, put aside their private affairs and offered their services to the nation. So universal was the response, indeed, that numerous communities found themselves facing the prospect of being wholly without medical attendance, for all their physicians were in or were trying to get into khaki.

The same patriotic enthusiasm was shown by the dental profession. At the outbreak of the war there were only 86 dental officers in the Regular Army, this number being based upon the ratio of one dentist to each thousand enlisted men. And, though the importance of a clean, healthy mouth was fully recognized as being essential in maintaining the health of the individual soldier, no Dental Reserve Corps existed at this time. It was evident from the very beginning, therefore, that, in order to care for the teeth of millions of fighting-men, it would be necessary to strain to the very limit the resources of the dental profession. Moreover, before the war had been in progress half a year, it was found necessary to raise the authorized quota of one dentist to every thousand men to one dentist to every 500 men. But the dentists lagged not a whit behind their fellows of the medical profession, so that when Germany threw up her hands and cried “Kamerad!” there were 6,284 officers in the Dental Corps.

When the Secretary of State intimated to the German Ambassador that his immediate departure for the Fatherland would cause no tears, there were barely 400 members of the Army Nurse Corps, 170 of whom were reserve nurses, having been called into active service as a result of the mobilization on the border. Yet when the war ended, the corps carried on its rolls the names of 21,480 nurses, nearly half of whom were serving overseas. As long as a veteran of the Great War lives, the work of these young women will be referred to with something akin to reverence. They displayed a courage, self-sacrifice, and devotion beyond all praise. Among them were capable, experienced executives who wore on the breasts of their trim blue jackets ribbons showing that they had seen previous service in Cuba, in the Philippines, and on the Mexican border. Others, hundreds upon hundreds of them, came from the hospitals of the larger cities. But by far the greater number of them were graduate nurses who left assured and lucrative private employment for the fatigues, the discomforts, and ofttimes the dangers, of army work. Nurses with wide executive experience were brought into the service as chief nurses of the great army hospitals, some of which had from 300 to 600 nurses on their staffs while the influenza epidemic was at its height. Their work in this emergency requires no comment, for they were untiring in their efforts, taking no heed of the number of hours they worked and frequently staying at their posts until they dropped from exhaustion. During the epidemic 127 nurses died in this country and 35 overseas from influenza or pneumonia resulting from it. Though a number of American nurses have been decorated by foreign governments, our own government has seen fit to recognize the heroism of only four: Miss Beatrice McDonald, who received the D. S. C. for staying by her patients when the hospital in which she was on duty was bombed by German airmen, though severely wounded herself, Miss Helen G. McClelland, Miss Isabelle Stambaugh, and Miss Julia Stimson, who received the D. S. M.

Meanwhile the enlisted personnel had increased enormously. At the outbreak of the war there were in the Medical Department approximately 6,900 men. During the nineteen months of hostilities this force steadily expanded, the recruits including medical students, pharmacists, and others of a medical turn of mind. Not every one in the corps had had experience in medicine or kindred subjects, however; the chief orderly at the hospital in which I was in France had been one of the editors of _Vanity Fair_, another had been engaged in the importing business, and one of the enlisted men at Fort McHenry Hospital, Baltimore, was a motion-picture actor whose features are known to “movie” fans all over the United States. The Medical Corps reached its maximum strength in November, 1918, when its records showed a total of 264,181 officers and men. Thus it will be seen that the personnel of the Medical Corps alone at the close of the Great War was much greater than that of the entire Regular Army before the beginning of hostilities.

The Medical Corps naturally divides itself into two main branches: the Division of Surgery and the Division of Internal Medicine. The latter, as its name indicates, deals almost entirely with non-surgical diseases and conditions; in other words, medicine as distinguished from the knife. One of the principal functions of the Division of Internal Medicine consisted in obtaining, training, if necessary, and assigning to duty in the various hospitals and camps expert examiners in diseases of the heart and lungs, these officers being charged with the duty of determining the fitness of recruits for military service and their condition on discharge, with special reference to heart disease and tuberculosis. This latter phase of their work assumed such important proportions, however, that it was eventually taken over by a separate division. Another function of the division was to obtain mature and highly trained internists of long experience to serve as Chiefs of Medical Service in base and general hospitals, these officers, who included many of the ablest physicians in the United States, being responsible for the professional care of all medical patients. For a time a school was maintained to train these medical chiefs, practically all of whom were fresh from civil practice, in the details of army-hospital administration. Younger men, usually with little or no hospital experience and, therefore, less highly qualified, were assigned to serve under the medical chiefs as ward surgeons in direct charge of sick soldiers. A small number of highly experienced men were also brought into the service as medical consultants, their duties being to visit the various hospitals and to maintain helpful and sympathetic relations between the medical staffs and the surgeon-general in Washington. The above is, of course, merely a hasty sketch of the great work done by the medical internists. The vast majority of them were desperately anxious for service in France and moved heaven and earth to obtain overseas assignments, being bitterly disappointed when they found that the needs of the army required that they should remain on duty in the homeland. By comparison with those of their fellows who were serving within sound and often within range of the guns, domestic service seemed quiet and prosaic. But, as a matter of fact, there was nothing commonplace about it at any time. The nearest approach to it was after the Armistice, when the main impulse and motive for military service, the winning of the war, became a thing of the past. But during the continuance of the war the medical officer, whether his duties kept him on the firing-line itself, in the camp and base hospitals in the rear, far from the thunder of the cannon, or at the cantonments on this side of the Atlantic, never had reason to complain of his work being monotonous or uninteresting, for every day, almost every hour, indeed, brought new experiences and new problems. I doubt if there is a single officer who wore the uniform of the Medical Corps who will not willingly admit that his army work better fitted him for civil practice and afforded him a deeper understanding of the needs of suffering humanity.

The great and crowded days of the medical internist in the United States came with the influenza epidemic. Thrilling, trying, and tragic was this period. At first in driblets, then in streams which increased with appalling rapidity, the men poured into the hospitals. In civil life a hospital with 250 beds is considered a very considerable institution and one of which the community it serves has reason to boast, yet the great base hospitals, sometimes with as many as 2,500 beds, were literally swamped with new cases, occasionally as many as 1,000 “flu” patients being brought in during a single day. These men had to be cared for and carried through. But how? Not only were there not enough hospitals in the land to hold them, but the medical profession, already drained of its practitioners by the demands of the army overseas, was unable to find enough, or nearly enough, physicians, nurses, and attendants, for the influenza, remember, showed no discrimination, attacking soldiers and civilians alike. When the epidemic descended upon the cantonments, barracks near the hospitals were taken over by the medical authorities, the well men being evacuated to tents in favor of the sick. In many instances buildings which did not have a stick of furniture in them in the morning were ready to receive patients by mid-afternoon. In the meantime cots, pillows, sheets, and blankets, three or four to each cot, had been moved in. Medicines, glasses, and all the other paraphernalia of modern medicine had been obtained. Fires had been started. Cooks, stoves, cooking utensils, food, and dishes appeared as at the wave of a magician’s wand. Medical officers and nurses had been assigned and had reported for duty. The Red Cross and other war service agencies were on hand. Arrangements had been made to care for the clothing and valuables of the patients and a hundred other details had received attention. And all this, mind you, in a few short hours. Surgical officers volunteered for medical service. Officers from the training-camps of the Medical Corps were sent by tens and twenties to help out. Every city, town, and village between the oceans was combed for nurses. There were not enough ambulances to transport the sick, so private motor-cars, taxicabs, even motor-trucks, were pressed into use. The drivers sat at their steering-wheels day and night until they could no longer keep their eyes open. Medical officers were on duty from daybreak until long after midnight, day after day, week after week. Nurses and orderlies kept at their work until they dropped from sheer exhaustion. This was the home equivalent of battle service. No sterner, no more gallant, resistance to the Hun assaults was ever made by the men on the firing-line in France than the battle which was waged against an equally formidable, equally treacherous, enemy by the men and women who wore on their sleeves the silver chevrons of home service.