PART V Medical Corps
1. Battalion Forward Aid Station
Lt. Rudolph A. Sarka, Medical Company, 7th Infantry
In December 1950 the 7th Infantry (3d Infantry Division) had one doctor in
each aid station and two at each collecting station. Some divisions were
critically short of doctors but we had enough because we had just arrived in
Korea.
To permit the doctors to work more freely, the Medical Service Corps officers
normally established battalion forward aid stations. Such an aid station was set
up on a ridge west of Hamhung in December 1950.
The 1st Battalion, 7th Infantry, was withdrawing eastward from Sachang-ni
toward Hamhung. When we reached the crest of the last mountain before Hamhung we
were much relieved. We knew that the enemy could not cut us off from evacuation
at the port. But then we were ordered to hold on this ridge.
Our infantry lines were along the forward slope, the battalion command post
was four or five miles back of us, and the trains were two miles beyond that.
This deployment kept our vehicles off the mountain where they might be caught if
we had to pull out in a hurry.
The battalion aid station, the surgeon, and the box ambulances were with the
battalion trains. The jeep ambulances were near the command post. I established
the forward aid station along the road, only a few yards behind the infantry
companies. The ridge was so sharp that I could be only a few yards behind the
riflemen and still have both concealment and cover. At one time I requested two
box ambulances, and they drove within thirty yards of the foxholes without being
observed.
An enlisted medic is qualified to apply a tourniquet, to bandage wounds, and
to give sedatives. In addition, as a Medical Service Corps officer, I was
authorized to administer plasma and blood. I could tell when a patient needed
immediate attention and could alert the doctor to be ready to treat the man when
he was evacuated. I was authorized to request helicopter evacuation from my
forward aid station when this
service was available. My job, then, was to fill the gap between the aid man
with his small kit, and the professional physician in an aid station, working
with more extensive equipment. On the front lines a doctor could have done
little more than I.
In any case, no one can complain that our forward aid station didn't give
immediate service to the infantry. I was so close that when I needed to make a
phone call, I just picked up the rifle platoon leader's sound powered phone.
2. Evacuation at Soksa-ri
Lt. Rudolph A. Sarka, Medical Company, 7th Infantry
On 19 May 1951 the 7th Infantry Regiment left Seoul and moved east to the
vicinity of Ami-dong. One battalion went into a blocking position that night and
the other battalions closed in assembly areas. The next day an attached platoon
of the division's reconnaissance company made contact with the enemy near
Soksa-ri. On the 21st all three battalions were committed in an attack.
The terrain where the 3d Battalion fought was rough. Litter evacuation of the
wounded was necessary, so the battalion surgeon (Capt. Gilbert S. Campbell) and
his medical assistants followed close behind the assault companies. It was
impossible to bring the aid-station equipment forward, and Captain Campbell
worked with the supplies from his aid kit. The battalion aid station, manned
only by two medics, was three miles to the rear.
Normally, litter jeeps from our medical company collecting station pick up
their patients at the battalion aid station. In this operation, however, the
litter jeeps passed the aid station and came up the road to a point only fifty
yards from the base of the mountain on which the 3d Battalion was fighting.
Between the road and the mountain were four channels of the Soksa River. The
main channel gave the litter bearers a great deal of trouble because the stream
was fast-flowing, waist-deep, and had large boulders in the stream bed.
A man wounded on the firing line was immediately treated by Captain Campbell.
Then he was carried down the mountain by a five-man litter team led by an
American or ROK soldier and using four Korean bearers. The trip took an hour and
a half.
Once the patient reached the jeep evacuation point his bandages were checked
and adjusted, and his general condition observed. Seriously wounded were loaded
two to a jeep; lightly wounded were often loaded
seven to a vehicle -- one in the front seat, four in the back, two on the
hood.
The jeeps bypassed the battalion aid station and took the patients to the
advanced clearing station. Here the seriously wounded were evacuated by
helicopter and the others by box ambulance.
Although this arrangement departed from the normal evacuation procedure, it
worked well.
3. Helicopter Evacuation
Lt. Martin Blumenson, in Special Problems in the Korean Conflict, published
by Eighth Army headquarters. (Based on interviews of Col. Thomas N.
,
Surgeon, Eighth Army; Lt.Col. Arne D. Smith, Medical Section, Eighth Army; Major
Sydney L. Fouts, Liaison Rescue Officer to Fifth Air Force; Capt. M. A. Mecca,
Rescue Controller, Fifth Air Force; Capt. James E. Childers, 8193d Helicopter
Unit.)
In the past, the tendency has been to move surgery as close to the patient as
possible. In Korea this was undesirable because of the fluid tactical situation,
the limited highway net, the rough roads, and the mountainous terrain. If they
used helicopter evacuation, the hospitals could stay longer in each location and
allow four or five days of postoperative care for a patient before further
evacuation.
Helicopter evacuation in Korea evolved out of circumstances. A detachment of
the ad Air Rescue Squadron, whose mission was to retrieve downed pilots, began
to receive occasional requests from Army units to evacuate wounded from
mountainous positions. Whenever its helicopters were not busy, the detachment
responded. During the rapid advance of the ground troops in the fall of 1950,
the helicopters were especially helpful in speeding evacuation over the
lengthened routes.
In January 1951 three Army helicopter detachments arrived in Korea with the
mission of evacuating seriously wounded from the front lines. Each detachment
consisted of 4 helicopters, 4 pilots, and 4 mechanics. Two detachments were
equipped with Bell H-13 helicopters; one had Hiller H-23s. Each craft carried
only a pilot and was equipped with two baskets or pods for litter patients.
Under exceptionally good flight conditions, one walking patient could be carried
at the same time.
The Eighth Army surgeon placed the first two detachments to arrive under the
control of the IX Corps surgeon. Since IX Corps was in the center of Korea, the
helicopters were also able to serve the other corps.
The first problem that arose was the necessity of teaching the helicopter
pilots what their aircraft could do in front-line evacuation. The pilots could
learn only by trial and error.
The ground forces then had to learn the limitations of helicopter evacuation.
In the popular conception, helicopters landed on mountain peaks, lifted straight
up into the air, and operated in all types of weather. It was necessary to
understand that helicopters could not fly at night, operate in bad weather, or
land on sloping terrain. They needed takeoff space; they could not fly in heavy
winds; they had limitations of range and altitude. They also had less lifting
power in the thin, warm air of summer.
Ground troops had to understand the importance of reporting accurate
coordinates to locate the patient. They had to be taught the necessity of
marking the landing site with panels and of using colored smoke grenades to
indicate proper location and wind direction.
Combat elements sometimes requested helicopter evacuation as a convenience.
By the fall of 1951, ground units had learned to request a helicopter only for
cases involving head, chest, and abdominal wounds, multiple fractures, and great
loss of blood. Even then, evacuation was available only if an ambulance could
not reach the patient, if a rough ambulance ride would seriously injure him, or
if it was necessary to get him to a medical installation quickly. As a working
premise, the local surgeon decided whether the patient needed helicopter
evacuation and the helicopter detachment commander decided whether the
helicopters could reach the patient.
Ground forces generally did not realize the extreme vulnerability of
helicopters. Their lack of speed and inability to fly at high altitude increased
the hazard of enemy ground fire. Furthermore, helicopters were extremely
sensitive to damage. Lack of the gliding characteristics of a conventional plane
and the increased problem of pilot control meant that almost any damage from
enemy fire was fatal to the craft. Pilots did not wear parachutes because of the
danger of falling into the blades if they jumped from a disabled craft. When an
area was under enemy observation the patient had to be prepared for quick
loading.
Because there was always a shortage of helicopters in Korea, Eighth Army
ordered that these craft not be used on missions involving danger from enemy
action. This did not prevent pilots from evacuating patients from units
surrounded by the enemy; nor did it prevent the evacuation of casualties
sustained by patrols operating forward of friendly front lines.
The first two Army helicopter detachments to arrive in Korea were attached to
the 8076th Mobile Army Surgical Hospital (MASH). At that time IX Corps
headquarters was at Chungju; the hospital was forty miles to the rear. This
arrangement left long distances between
the helicopters and the combat lines. It then decided to dispatch the
helicopters from corps headquarters. Later, all the helicopters moved into the
division areas. Normally, one helicopter was stationed at each division clearing
station. From there it was but a few miles to the front lines.
Certain expedients adapted the helicopters for evacuation. Plastic bags were
used to keep the patients warm. Flexible tubes were fitted from the engine to
heat the patients in flight. Covers for the pods were devised to keep the wind
off their faces. The fact that the patients in the pods could not receive
medical care while in flight remained one of the serious limitations of the
helicopter, even though a mechanical device permitted them to be given plasma.
The limitation on medical care and the short fuel-range of the craft make it
necessary to keep helicopter flights short.
Helicopters in Korea had evacuated eight thousand casualties by 1 November
1951. Many of these men would not have survived without this transportation. The
smooth ride and the rapid arrival at a clearing station or hospital possibly
caused a lower rate of shock fatalities than in World War II. The treatment of
head injuries was expedited because helicopters carried patients swiftly to
neurosurgical teams.
The presence of helicopters in Korea helped morale. Although much
experimentation in the use of helicopters for evacuation remains to be done,
this "ambulance of the air" has proved its usefulness in the Korean
conflict.
4. Optical Treatment in the Field
Capt. Daniel B. Sullivan, 24th Medical Battalion. (Interview by Lt. Martin
Blumenson, 3d Historical Detachment.)
Before May 1951 there was no medical officer in the 24th Infantry Division
qualified to do refracting and no equipment for adequate eye examination. Men
needing glasses were evacuated through medical channels, often as far as Taegu
and Pusan. This wasted a great deal of time and sometimes caused individuals to
be permanently lost to the division because they were returned to duty through
replacement channels.
Early in 1951 the Eighth Army surgeon recommended that refracting be done in
the division medical battalions. The 24th Medical Battalion (24th Infantry
Division) received a trial lens set, but there was no other equipment.
In April 1951, the commanding officer of the Clearing Company (Major Samuel
Rothermel) determined to implement Eighth Army's
recommendation. He sent Capt. Daniel B. Sullivan to the 4th Field Hospital at
Taegu for a refresher course in refracting. All medical officers know the theory
of refracting, and the refresher course provided a review of theory and a chance
to develop skill in practice.
Returning to the battalion with eye charts, eye drops, and a retina-scope
obtained from the 4th Field Hospital, Captain Sullivan arranged for space for an
optical shop, and then trained an enlisted assistant. Units were told of the new
service and on 9 May optical examinations began.
Each refraction took only a few minutes. If glasses were needed the
prescription was recorded in the soldier's immunization record (his Form 66-1)
and in the records of the medical battalion. The soldier was sent to the 8076th
MASH, where his prescription for glasses was filled immediately. The hospital
maintained a stock of lenses and ground special ones when needed. The entire
process took less than a day.
Whenever the division went into reserve, the 6th Army Mobile Optical Unit,
operating from an optical van, moved into the medical battalion's area and
filled a prescription for glasses within a matter of minutes. It was not unusual
for a soldier to have his eyes examined and be fitted with glasses within an
hour.
After the optical section began its work, the enlisted assistant gained
enough training and experience to do the refracting himself. Examination of the
eyes for pathology remained the duty of a medical officer, however.
From 9 May to 16 September, 897 men were examined and 768 had glasses
prescribed and fitted. Only 34 -- those with pathology or needing other
treatment -- had to be evacuated. These figures include not just men of the 24th
Division, but soldiers of the 7th Division, Eighth Army and its corps units, as
well as British Commonwealth units.
The saving of man-hours within the 24th Division has been tremendous. The
increase in speed has led to an increase in the number of soldiers seeking
treatment and, therefore, to an improvement in health and morale.
5. Dental Treatment in the Field
Major Peter M. Margetis, Dental Surgeon, 24th Infantry Division. (Interview
by Lt. Martin Blumenson, 3d Historical Detachment.)
The division dental surgeon has authority to distribute his dental officers
as he wishes. Each division is authorized 18 dentists, but in January 1951 the
24th Division had only 15 -- enough for combat, but
not enough for garrison duty. When Major Peter M. Margetis arrived at the
24th Medical Battalion, all of the 24th
Division's dentists were on duty at a central clinic except one at division
rear and another at the advanced clearing station.
Major Margetis saw no advantage in keeping the dentists centralized away from
the troops. A man needing dental treatment might have to spend a whole day
traveling from his unit to the dental clinic. Under this system of distribution,
only one thousand dental operations (fillings, extractions, and prosthetic work)
were performed each month.
Major Margetis distributed the dental officers one to each regiment, division
headquarters forward, division headquarters rear; two each to the replacement
company and division artillery; and three each to the clearing company and the
medical battalion (including the division dental surgeon).
Each dental officer has an enlisted assistant and a No. 60 dental chest. The
chest is only slightly larger than a foot locker, but it contains a folding
dental chair, electric motor, instruments, lights, trays, and medications.
Mobility is no problem and definitive dental treatment can be performed.
Although it had been the practice to send all impaction cases to rear medical
installations (usually the 8076th MASH), Major Margetis insisted that all such
work be done by the division's dental officers. Only four patients were
evacuated as dental cases (gunshot wounds are considered medical cases) in six
months.
As a result of the new distribution of dental officers, dental operations
increased from 1,000 to 8,000 a month. More dental work has been accomplished
and less time has been lost by soldiers seeking dental work.
6. Changing the Mission
Capt. John M. McGuire, 1st Mobile Army Surgical Hospital
Early in November 1950 the 1st MASH landed at Iwon, on the northeast coast of
Korea, and moved inland to Pukchon. Here we worked for thirty days attached to
the 7th Infantry Division. This month was unlike any other period for us. Our
hospital "followed the book" in both organization and operation at Pukchon.
We were set up in a two-story school building which we shared with the 7th
Medical Battalion. Although the 7th Division had infantry regiments near the
Yalu River and Changjin Reservoir, relatively few casualties were evacuated to
Pukchon. The 7th Medical Battalion was
able to receive and care for the nonsurgical casualties. This allowed the 1st
MASH to limit its admissions to patients requiring surgery. During November we
received a total of 171 surgical cases and were successful in treating them
without a single death. We gave each case maximum attention.
At Pukchon, although we were more than a hundred miles from many of the units
we were serving, only two patients -- both extremely serious cases -- were
air-evacuated to us. Shortage of airfields near the infantry regiments was the
major reason for limiting air evacuation.
After our withdrawal from North Korea we moved near Kyungju. We were assigned
to X Corps and our responsibilities were increased. Instead of operating as a
mobile army surgical hospital -- that is, a small, sixty-bed hospital assigned to
one division -- we were called upon to care for the casualties from the 1st Marine
Division, the 2d and 7th Infantry Divisions, and the 187th Regimental Combat
Team.
We rapidly expanded from a 60-bed to a 200-bed hospital, but our personnel
increased from only 16 medical officers, 16 nurses, and 100 enlisted men, to 20
medical officers, 20 nurses, and 120 enlisted men.
The expansion of the hospital meant that our primary mission was enlarged.
Instead of handling only surgical cases, we began to receive medical cases as
well. Because the increased work load had not been accompanied by a
corresponding increase in personnel, it occasionally became necessary for us to
evacuate some patients without operating. In no case, however, did this
jeopardize a patient's chance of survival or return to duty, for air and
hospital-train evacuation to the next medical installation was always
available.
Lt.Col. John L. Mothershead and Capt. Samuel L. Crook. (Interviews by Lt.
Martin Blumenson, 3d Historical Detachment)
The primary function of a mobile army surgical hospital is to do emergency,
life-saving surgery and to make the patient transportable to rear medical
installations. The MASH was originally a 60-bed hospital with the mission of
supporting one division. Because there were not enough evacuation hospitals in
Korea, the surgical hospitals were expanded to 200-bed capacity. With the
increased patient load, personnel, services, and tentage, there has been a
decrease of mobility.
To improve the mobility of the 8076th MASH, the officers designed a
new tent plan. Hospital tents are formed of detachable sections.
Using 41 main sections and 16 end sections, the 8076th designed a unique
hospital which was especially adaptable to displacement. The core of the
hospital is shaped in a U. Around this basic center, tents are added and
subtracted as the situation changes.
Arrangement of Tents: 8076th
Mobile Army Surgical Hospital (14K)
The hospital is moved in two phases. In Phase I, the tents housing the
registrar and receiving-and-holding are taken down. The laboratory, the
pharmacy, and the admitting functions of receiving are moved into the
preoperative ward. The tentage that has been struck is then moved to a new
location with half of the personnel of preoperative, postoperative, surgical,
and central supply, plus one receiving clerk. At the new location a second basic
U is formed, consisting of preoperative, postoperative and surgical. Central
supply functions of sterilizing instruments and dressings are carried out in the
surgical tent.
At one point, therefore, there are two functioning hospitals. The hospital in
the rear continues to admit patients until the forward installation is complete.
When the advance unit begins to receive patients, the rear installation stops
all admissions. When its patients have been evacuated, the rear unit moves up
and joins the advance hospital as Phase
II of the move. The tentage of Phase II is added externally to the basic U in
its new location. The medical officers and enlisted men who have not yet moved
come with Phase II. All nurses move with the rear element.
Moving from Chunchon to Hwachon, the 8076th relocated its installations in
this manner:
19 September
0900 Capt. Samuel L. Crook left Chunchon to check several sites in the
vicinity of Hwachon.
1000 Lt.Col. John L. Mothershead received final orders to move to the
vicinity of Hwachon. Key personnel notified of impending move. 1200 Captain
Crook notified that the move would be that day.
1300 Tentage at Chunchon began to be struck.
1330 Captain Crook notified Colonel Mothershead of new site and its
location.
1530 Phase I convoy left Chunchon. 1730 Convoy arrived at Hwachon.
2230 Basic U set up at Hwachon. Ready to receive patients. 2400 Advance unit
opened; rear unit closed.
20 September
0800 Patients at rear unit transferred to 629th Clearing Company, which moved
into Chunchon to assume the function of evacuating patients to the Chunchon
railhead and airstrip.
1300 Phase II convoy left Chunchon.
1500 Rear unit arrived at Hwachon. Basic U expanded to form complete
MASH.
Several modifications have been made to equipment to adapt it for local
conditions. To increase the hauling capacity of the hospital vehicles, trailer
hitches were taken from abandoned trucks along the road. The hospital had
Ordnance weld these hitches to a butt plate on the rear of each l-ton trailer.
Each 2-1/2-ton truck now safely hauls two trailers, thereby doubling its hauling
capacity.
The tents have been made warmer by the use of Air Force gasoline burning
heaters which blow hot air to the tents through ducts. A sliding light system
has been devised so that illumination can be moved to the best advantage in
surgery. A sprinkler system has been developed to keep down dust. A food box has
been developed to keep flies off food carried from the kitchen to the ward. The
hospital has had no diarrhea attributable to fly contamination.
In the medical field, one of the expedients developed by the 8076th is the
upright which has been welded on the bar holding the Thomas splint to the
litter. This modification permits giving intravenous fluids
while the patient is being moved. Because some type of holder for litters was
needed to support them at a higher level than the cot, an iron-pipe tripod was
improvised. This improved the hydrostatic pressure in certain types of lung
surgery cases where drainage was needed.
Causes of the Korean Tragedy ... Failure of Leadership, Intelligence and Preparation
