Combat Medics

The editors wish to thank John T. Greenwood, Ph.D., Chief, and Maj. Jennifer L. Petersen, Army Nurse Corps Historian, Office of Medical History, Office of the Surgeon General, U.S. Army, for help in preparing this gallery of combat medic images and Maj. Lewis L. Barger, Office of Medical History, for writing the article on combat medics. (Photographs: U.S. Army; art, Army Art Collection, Center of Military History.)

The formation of the Army Medical Department predates the Revolutionary War. In july 1775 the Continental Congress established a Hospital Department to provide care for the sick and wounded of the Continental Army. It was not until the Civil War, however, when the reforms of Medical Director Jonathan Lettermen were enacted, that the foundations of our current system of medical support to the soldier on the battlefield were laid. Lettermen established a corps of trained enlisted assistants, dedicated ambulance support and a system of hospitals staffed by surgeons that vastly improved the evacuation and rapid care of battlefield casualties.

Following the Civil War, the Army Medical Department adapted its methods to support the Army's campaigns in the far-flung outposts of the West and, during the Spanish-American War, had its first experience supporting a large expeditionary force. Following the Army's campaigns in Cuba, Puerto Rico and the Philippines, the Medical Department turned its attention to providing for the health of the soldier, searching for the causes of the diseases that had felled eight men for every combat death during the war.

During World War I, American physicians incorporated the medical lessons learned by French and British surgeons during four years of fighting. Battalion and regimental aid posts received gas, trauma, disease and psychiatric casualties in the vicinity of the fighting. Litter bearers and ambulances then transported casualties back to the division hospitals, which included a hospital designated for surgical patients. During the half century since the end of the Civil War, the practice of medicine had diversified and hospitals were established that specialized in treating distinct types of injuries and dis ease, reflecting this specialization in surgical technique and medical care. Hospitals were also positioned on the battlefield with respect to the casualty's needs. Those that could provide rapid, lifesaving care were placed close to the front where the casualty's needs were immediate, while those that provided definitive care and long-term recuperative care were located further to the rear. The motorized ambulance, first deployed operationally in 1916, began to replace horse-drawn ambulances in the Medical Department, facilitating the movement of patients away from the fighting, and the establishment of specialized evacuation hospitals at railheads made possible the efficient sorting and movement of patients to hospitals in the zone of the interior.

The Medical Department faced new threats during World War II, but brought new technologies and skills to the battlefield in its fight against trauma and disease. Antibacterial sulfa drugs carried by individual soldiers helped prevent infection to combat wounds and the introduction on the battlefield of penicillin, the first antibiotic, revolutionized military wound care. Combat medics carried plasma and saved the lives of those who in earlier wars would have died from loss of blood before they could reach a surgeon. In the Pacific, small portable surgical hospitals accompanied the troops and provided lifesaving forward surgery in areas where travel by litter to a field hospital could take hours or days. Landing ships were outfitted as surgical hospitals during island invasions and were set up to operate as soon as the troops on board hit the beaches.

In Europe, larger fronts and more secure lines of communication allowed a more traditional system of support. In both theaters, aerial evacuation of the wounded on fixed-wing transports helped speed casualties to hospitals and recuperation centers that could provide long-term care for the severely wounded.

Aerial evacuation entered a new phase during the Korean War with the large-scale introduction of helicopters for evacuation from near the front lines to the mobile Army surgical hospital (MASH). Developed during World War II, the MASH saw its first service in Korea, providing surgical support in close proximity to the front lines as they moved the length of the peninsula during the first year of fighting. As maneuver turned to a more static front, the MASH became more of a fixed facility, but continued to provide state-of-the-art care to the fighting force.

In Vietnam aeromedical evacuation became the standard for evacuating casualties from the battlefield. The combination of the UH-I (Huey) helicopter ambulance that could pick the wounded up at the point of injury and a system of fixed hospitals dispersed throughout the country resulted in wounded soldiers receiving lifesaving surgery, often within the hour of their wounding.

The Army made the transition to an all-volunteer force after Vietnam. In the 1980s the nation invested in Army modernization, and the Medical Department restructured its units to support the Army's AirLand Battle doctrine, fielding the forward surgical team and the combat support hospital to provide greater surgical support in the division and corps areas of the battlefield. Operation Desert Storm was the largest deployment of medical forces since Vietnam, but since that time, medical units have also deployed in support of operations in Somalia, Bosnia, Kosovo, Afghanistan, Kuwait and Iraq, and to support numerous medical assistance and partnership for peace missions.

By Maj. Lewis L. Barger

Copyright Association of the United States Army May 2004
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