The Function of a Field Hospital in the Chain of Evacuation During WWII

Recently I received the following email from James K. Sunshine (One time T/3, 3rd Platoon, 42nd Field Hospital)  

I found your interesting site and read several pieces. One of them was by a Keith Winston who described in a v-mail the evacuation of casualties in France. He omitted the place of the field hospital in the chain of evacuation. I was with the 42nd FH (3rd platoon) from Utah Beach on D-4 to the end of the war.

A field hospital platoon supported an infantry division and was usually located at the level of the clearing station. Its function was to operate solely on casulties hit in the chest, abdomen, or large bone of the leg. Of course, other wounds were fixed at the same time, but the idea was to bring major surgery as close to the line as possible. All other casualties followed the route described by Winston, back to the evac hospitals. Each of the field hospital's three platoons consisted of about 60 enlisted men, six nurses, and about a half dozen surgeons.In the Korean Conflict field hospitals became MASH units. It would be good to have the work of the field hospitals accurately recalled on your site.

                                                                                                           Regards,

                                                                       James K. Sunshine (One time T/3  3rd Platoon, 42nd Field Hospital)   

So I ask Mr. Sunshine if he would kindly contribute some information about his experiences in a Field Hospital during WWII to the web site. He graciously reply with the following personal account. I thank him for his contribution.

Below is an excerpt from an article Mr. Sunshine wrote for the Providence (RI) Sunday Journal in 1994 for the 50th anniversary of the D-Day landings in Normandy. It tells you something of the typical field hospital operation.

    Beachhead Hospital, June 8-17: We disembark on June 8, climbing down the nets to a landing craft. I worry about falling into the sea, but I don't. We are put ashore without getting our feet wet. The beach is now more or less secure, and we march inland past fields marked with signs in German warning of mines and littered with crashed gliders. Our major, a self-important surgeon who imagines he is a paratrooper ignores his overlay and leads us inland until suddenly we are surrounded by mortar bursts. Diving headlong into the ditches, we become aware of infantry in foxholes shouting at us to get down and questioning our sanity.   We retreat, cursing, in haste and embarrassment, wishing that the major actually was a paratrooper and somewhere else.

    Two platoons of the hospital are already ashore. Together with a platoon of another field hospital they have set up near Montebourg, a mile or two in from the beachhead. With our arrival we have the makings of four complete tent hospitals in one big field.  
     Wounded men, tagged for identification, are lying on litters in rows all over the field. Walking wounded stand around waiting to be helped. Ambulances arrive with fresh loads.  Most are American paratroopers of the 82nd and 101st Divisions, but some are Germans, and others simply unidentifiable foreigners pressed into service by the Germans. The enemy soldiers have been at war a long time, and they stink of dirt and sweat and blood. They are given the same treatment as Allied casualties.

    I dig my hole beside a hedgerow and report to a tent surgery. I am a surgical technician, fifth grade, (a corporal) who works in a surgery and assists surgeons. A surgeon, a major, notices me standing uncertainly and says, "Let's go, corporal, get some blood on your hands." Not really funny, perhaps, but then we are all drunk with excitement and determined to do well. 
     I follow him through the blackout curtain into the surgery where three surgical teams are at work.  Generators outside the tent provid power for lights. I am told to hold a leg while a surgeon saws it off. I wonder why I don't throw up

        Isolation Tent, June 10: The German is dying, but it is taking a long time.
     I have been sent to a tent at the end of the field, next to a hedgerow, and as far from the hospital tents as possible. The reason is gas, gas gangrene.
     I am supposed to stay with the German until he dies.  There is nothing I can do to help him except to give him water. I cannot speak his language beyond the simple words of yes and no and does it hurt. And he cannot speak mine, except to moan and say ``Ja.'' He is blond and young and filthy  dirty.  His wounds exude the odor of gangrene. He does not seem to be a monster.
     Gas gangrene is our terror. It is a foul infection that flourishes in damaged flesh in the absence of oxygen. Death is virtually certain.   Usually you don't know it is there until you open up a wound. Then it smells to high heaven, someone shouts ``Gas'',  and everything in the surgery stops. The man is hurriedly finished and moved away as far as possible from other wounded lest he infect them. The tent then has to be scrubbed down with disinfectant, and all instrument packs re-sterilized.
     The night sky is lit by flashes of artillery fire. A lone German plane buzzes overhead, drawing a few bursts of anti-aircraft fire, which falls back on us in the form of shrapnel. A few yards away, the steadily growing hospital dump smells of burning bloody bandages and discarded flesh and limbs.  I stare at the German boy, not knowing what to do. Finally, toward morning, he dies.
     Battlefield Surgery: The 42nd is a field hospital, each of its three platoons small enough to pack into six trucks or so that keep up with the advancing battle line, one platoon to a division. Each platoon has 60 men, a half dozen officers, and six nurses who have been brought from England now that the beachhead is secured. Many of the enlisted men are non-commissioned technicians of one sort or another trained back in the states in army schools and hospitals to be surgical, x-ray, laboratory and medical technicians. With the exception of an occasionl undertaker's assistant, none of the technicians has had previous medical experience.
     Building on the experiences of World War I, the army has decided to move major surgery as close as possible to the most seriously wounded, operating on them immediately,  while less seriously  wounded are moved back to evacuation hospitals in the rear.
     Most seriously wounded means men shot through the head, lungs, bowels, or large bone of the legs, wounds that in World War I were usually fatal.
    
     Our basic technique is to open up a man's abdomen with an 8-inch incision, go through his intestines and other organs carefully looking for holes made by bullets or shell fragments. Damaged organs and bowel are removed, the holes sewed shut and the incision closed except for a loop of bowel that serves as a temporary outlet. Minor wounds are cleaned of damaged flesh and packed with vaseline gauze. We do chests as well as bellies, sometimes on the same man. We use great quantities of whole blood.  We have sulfa, which we smear liberally everywhere we can, and everybody who lives gets the new drug penicillin every four hours.
     The surgery tent is large enough for two operations at once. The patients' litters on sawhorses form the operating tables. Outside generators power lights and other equipment. There are two surgeons, an anaesthetist, and a surgical scrub technician to each patient. Another technician stands by to replenish instruments and supplies and carry out non-sterile tasks. Each operation takes one or two hours

We move as the line moves. The patients stay where they are for 10 days by army regulation, but we move the hospital every two or three days, leaving the operated patients in tents to be cared for by holding companies who move up and give us new tents.   Unload, set up, operate, tear down, load, move, and set up again. 
     
     The Ward Tent: A quiet night. Sixty men fresh out of surgery are sleeping on canvas army cots. I have drawn ward duty, and dutifully go from cot to cot with a syringe loaded with penicillin, thrusting it quickly into each man's buttock. It's a real wakeup call, but most of them are too sick to care. I check IV fluids and suction, give water, take temperatures, and try to ignore the subdued moans of pain that has become a steady background sound.  Men who have lost arms and legs are the worst. Some of them, I think, simply talk themselves to death. On most nights, two or three men in each tent die, and their bodies are placed in a truck that waits outside. Each morning it makes the trip to Graves Registration where digging crews bury them in temporary cemeteries. Once, we place a French woman in the truck thinking she is dead. She wakes up and there is hell to pay.  The Third Platoon has four tents like this. Each is 60 feet long, is supported by 4 poles, and weighs 350 pounds rolled up. Putting it up is an hour's work for four men. 
     To Paris, August 4: Breaking out of the beachead, the army grinds on, gathering speed with experience. We become expert at our medical jobs and efficient at setting up the hospital in a two hours and taking it down  a few days or a week later. The landscape around us is littered with half-destroyed tanks and trucks, blasted houses, dead cows, and in the hedgerows and woods, German and American bodies turning black and bloating in the summer sun.
     We keep moving. Pont L'Abbe on June 17, St. Sauver on June 22, St. Mere Eglise on July 6, Carentan on July 10.  Without knowing why, we are told to change shoulder patches from the First Army to the Third Army and are given over to the newly arrived General George S. Patton whose idea of war consists of speed, violence and always wear your helmet, soldier.  Our trucks roll through the devastated rubble of St. Lo, through villages whose streets are lined with cheering crowds who push bottles of Calvados and fresh vegetables into our hands, welcome after a diet of K-rations. Villedieu on August 6, Senoches on August 25, and finally Paris  on August 28, where we set up in the outskirts on the Orleans road and watch the Maquis race by in trucks, firing wildly in the air just to celebrate Liberation

 

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