Battle Field Angels (2 page)

Battlefield Angels
is about the people who practiced battlefield medicine as it evolved from one war to the next: military medical personnel from Lexington to the Shenandoah Valley, from Vietnamese rice paddies to Middle Eastern deserts. It recounts the shattering effects of low-velocity Minié balls and the battlefield care limitations that produced thousands of one-armed and one-legged Civil War veterans, and it reveals the sophisticated battlefield treatments our modern warriors receive for wounds inflicted by snipers and remote-controlled land mines.

This book illustrates how survivability in war has improved dramatically in the face of increasingly lethal weaponry. During the Revolutionary War, more than 40 percent of soldiers wounded by the enemy died from their injuries. By the Vietnam War, that percentage had dropped to 25 percent. Today in the Middle East, it is about 10 percent. Beginning with the Revolutionary War, the total number of wounded who have survived their injuries is the equivalent of every resident in San Diego, California.

The genesis of
Battlefield Angels
lies in another book I wrote,
Midway Magic
, which is about the unprecedented forty-seven-year odyssey of the now retired USS
Midway
aircraft carrier. More than 200,000 sailors (their average age was nineteen) deployed on the longestserving U.S. Navy aircraft carrier of the twentieth century (1945–92). On several occasions, horrific flight-op accidents left dozens of men broken, burned, and bleeding on the flight deck. Young corpsmen new to the ship sprinted toward billowing infernos and one-thousand-pound bombs lying in pools of jet fuel. Their bravery and devotion humbled as much as it inspired, though recognition often was sparse and fleeting. It led to another book,
USS Midway: America’s Shield
, in 2011, written specifically for high school students and young adults.

I soon discovered dozens of other instances in which young men only a few years out of high school had been equally selfless, heroes who masqueraded later in life as insurance salesmen, hospital administrators, and dentists. The path of discovery led to the operating room as well as the laboratory, where assumptions about gangrene, malaria, third-degree burns, and amputation were challenged.
Battlefield Angels
reflects their collective legacy in military medical science. It also provides a deeply personal context to the war experience of more than 40 million Americans who have served on the battlefield.

The core of the book is based on interviews with some of the frontline corpsmen and medics who survived, with the men they saved, and with those who served alongside them in foxholes, submarine compartments, prison cells, and Humvees. The conversations with these heroes in places like Oceanside, California, and Boone, Iowa, often stretched into the night as they relived ingrained nightmares they had previously shared only in lowered voices at reunions with their buddies. Genuine humility occasionally prevented some from sharing their personal stories directly with the author.

Many times the interviews became especially difficult for the spouses, who often sat quietly off to the side. Some cried. Others grew angry upon discovering that nightmares had long haunted their husbands, who spoke of them for the first time to a stranger sitting on their couch. “It was just my job,” a man often shrugged as he avoided eye contact with his shocked wife.

Many interviews with World War II soldiers and corpsmen as well as active-duty military personnel today provided remarkably precise detail. I discovered that in battle, many soldiers, corpsmen, and medics experienced a heightened awareness that allowed them to remember a particular sunrise, weather conditions, and even what they were thinking at specific points in time. Decades later in some cases, they were able to recall those details as clearly as if they had experienced them just the day before.

In some cases involving active-duty personnel serving in remote locations, direct interviews were not possible. Some politely declined out of modesty. Yet their stories are included based on extensive documentation and eyewitness accounts.

I also relied on recorded and written firsthand accounts from every war fought by Americans. The U.S. Navy’s Bureau of Medicine and Surgery’s collection of transcribed oral histories from hundreds of twentieth-century medical personnel was invaluable. Medical professionals such as Revolutionary War doctor William Buchan and Civil War surgeon William Williams Keen published reports and memoirs filled with detail. The diaries kept by doctors who were prisoners of war during World War II, official military records including after-action battle reports, medical training manuals, and other material in the collections of the U.S. Marine Corps, National Library of Medicine, Naval Historical Center, and the National Archives proved extremely useful. Empirical analyses and reports published by the federal government and medical journal articles provided a wealth of statistical data.

I have utilized information from all these sources—the most important of which are included in the selected bibliography—as accurately as possible. Where dates or statistics inevitably varied by source or estimation, I selected the most commonly used figures. The word choice and narrative are my own. I welcome any suggested corrections and clarifications.

Although the medical ranks on the front lines have been called different names dating back to the Revolutionary War, for the sake of clarity and consistency, I refer to them as surgeon’s mates in America’s early history and then as corpsmen in the U.S. Navy and Marine Corps and medics in the U.S. Army. Similarly, I frequently use “soldier” to refer to all those serving on the battlefield.

Many of the individuals profiled in
Battlefield Angels
received the Medal of Honor, America’s highest award for bravery in war; the Navy Cross or its Army equivalent, the Distinguished Service Cross; the third highest honor, the Silver Star; or the Purple Heart, awarded to those wounded or killed in combat. Sometimes a pat on the back or a nod from a chief petty officer or sergeant had to suffice. In the end, judging valor and courage in battle has always been subjective, given the era, politics, the propensity to award medals, and the standards of military medical care.

Regardless of official recognition, the real story of military medicine begins with those who breathe life into others alongside a road, deep within a jungle, or at the bottom of a foxhole. That’s where readers will find the most important insights of
Battlefield Angels
, the revelations of character defined by courage, duty, optimism, focus, and ingenuity. With these revelations comes the hope that each of us carries seeds of heroism buried deep within, that we all somehow have the capacity for greater courage and compassion than we dare imagine.

To the millions of fighting men and women who owe their lives to these heroes, they will always be battlefield angels.

Revolutionary War

T
he night air chilled Caspar Wistar as he walked alongside a wagon filled with medical supplies, part of an eleven-thousand-man army creeping toward a small Pennsylvania hamlet. He wondered if General George Washington’s medical corps would again run short of wound dressings when battle met the sunrise.

Washington had divided his army into four columns for a coordinated attack against nine thousand British soldiers bivouacked at the southern end of Germantown, about five miles north of Philadelphia. With luck, Washington’s army would be in position by 0400 hours, rest two hours, then attack. More than twenty thousand soldiers would occupy a two-square-mile village, firing muskets and artillery practically at point-blank range. Nurse Caspar Wistar and a handful of surgeons, surgeon’s mates, and other volunteers soon would be confronted by hundreds of wounded and dying men on October 4, 1777.

Two weeks earlier, on September 26, Lord Charles Cornwallis had led British troops into undefended Philadelphia and taken control of the colonies’ capital. Losses by the Continental Army at the Battle of Brandywine and the Battle of Paoli had left Philadelphia susceptible to the British invasion. The British repeatedly defeated a Continental Army that was malnourished, poorly trained, and so ill equipped that some men fought barefoot. One year after declaring independence, the colonists had now lost their capital, usually a death knell in war. Once the British had secured Philadelphia, they left a force of three thousand men there to defend it and moved nine thousand soldiers north to Germantown.

General Washington saw an opportunity in the divided British army. If he could defeat the British at Germantown before the onset of winter, the Continental Army would be in a stronger position to retake Philadelphia the following spring. Equally important, a victory at Germantown would end the series of defeats the colonists had suffered on the battlefield and begin to restore the army’s plummeting morale. Washington believed his troops were sufficiently trained and experienced enough to launch a complicated, four-pronged attack against the British.

Shortly after sunset on October 3, thousands of Americans on foot and some in wagons advanced through the misty, forested hills toward the British encampment. One was Isaiah Strawn, a Quaker from nearby Bucks County. Another was John Hoskins Stone, a colonel in the 1st Maryland Regiment. Just as the sun lightened the thickening fog at dawn, the woods around Strawn and Stone exploded with British musket fire and the cries of wounded Americans. Washington’s attack had been detected by a British outpost. Men fell, bleeding onto a forest floor blanketed by fallen leaves. Whitish-blue smoke from muskets and cannon joined with the fog to reduce visibility even further. The Continental Army had lost the element of surprise.

The battle for Germantown quickly unraveled. One column of Washington’s army somehow got lost on its way to the staging area. A second, advancing on British defensive positions, veered off toward another American column. Although the attackers had been told to wear a piece of identifying white paper in their hats, visibility had deteriorated so much that Americans began firing at each other. Casualties mounted as the sun rose.

Isaiah Strawn fell wounded after he rushed to pick up the musket of a friend who had been shot dead. Strawn was three weeks short of his nineteenth birthday and had enlisted only a few weeks earlier. Not far away, John Hoskins Stone dropped to the ground in agony and clutched a bloodied leg. A relatively old man in the army at twenty-seven, he had been fighting the British for two years. He was the son of a prominent Maryland plantation owner. An older brother had signed the Declaration of Independence.

Both Strawn and Stone had been wounded in the leg by lead buckshot, a common battle wound during the Revolutionary War.

Nearly two hundred years earlier, gunpowder had transformed the battlefield. For centuries, warfare had resulted mostly in cuts to the head, legs, and arms, as well as fractures and concussions. Punctures in the torso from arrows and javelins were less common. Gunpowder, however, caused unprecedented trauma to the human body. The shattering effects of bullets and artillery shells were so profound that military doctors believed the projectiles were poisoned by the gunpowder: for decades they treated gunshot wounds as poison cases.

By the outset of the Revolutionary War, some types of artillery could fire explosive hollow shells filled with gunpowder and shrapnel more than eight hundred yards. They were utilized at the beginning of many battles. As the opposing forces converged to within fifty yards of each other, soldiers opened fire with smooth bore muskets of limited range and accuracy. Large, round musket balls hit bodies hard, sometimes burrowing deep and shattering bone. The slice of the blade in hand-tohand combat had been replaced by the concussive thunder of cannon and muskets from behind hills and in open fields. General Washington’s troops walked into a storm of flying lead and iron.

After about three hours of battle, it became clear that the American assault on Germantown had failed. The four American columns retreated, carrying as many injured with them as possible. Some members of Washington’s medical corps remained on the battlefield to treat the wounded while the remainder withdrew nearly ten miles to Pennypacker’s Mill before the British gave up the chase.

The Continental Army was plagued by a paucity of qualified medical personnel, a dearth of medical supplies, and an understanding of battlefield medicine that in some ways was less informed than that which had been practiced by the ancient Greeks and Romans.

In 1700 B.C., treatment practices were first recorded on Egyptian papyri. One document listed forty-eight specific battlefield injuries and prescribed treatment for each. A skull fracture, for example, was treated with fresh meat the first day, and the patient was kept on a full diet. Grease, honey, and lint were applied daily thereafter.

The ancient Greeks also took care to prevent disease. They instinctively demarcated dining areas from bathroom facilities. That reduced the likelihood of epidemics that left weakened soldiers more susceptible to their battle wounds. More than one thousand years later, around 400 B.C., Hippocrates wrote seventy-two medical books that reflected the state of Greek military medicine. In addition to codifying medical ethics for the first time, he documented the use of wine to moisten and disinfect a wound, chest tubes for drainage, and traction for fractures. Regrettably, he advocated facilitating the development of pus in a wound as a means to reduce inflammation. Greek army doctors were pleased if, by the third or fourth day, the lips of a grizzly gash on a thigh turned white and the exposed flesh warmed to the touch and glowed pinkish red. They considered it a necessary part of the healing process, failing to recognize it as the onset of a frequently lethal gangrenous infection.