by Ernie Pyle
Reprinted with the generous permission of the Scripps Howard Foundation
SOMEWHERE IN SICILY, August 11, 1943 - Probably it isn't clear to you just how the Army's setup for the care of the sick and wounded works on a battlefront. So I'll try to picture it for you.
Let's take the medical structure for a whole division, such as the 45th, which I have been with recently. A division runs roughly fifteen thousand men. And almost a thousand of that number are medical men.
To begin right at the front, three enlisted medical-aid men go along with every company. They give what first aid they can on the battlefield. Then litter-bearers carry the wounded back to a battalion aid station.
Sometimes a wounded man is taken back right away. Other times he may be pinned down by fire so that the aid men can't get to him, and he will have to lie out there for hours before help comes. Right there in the beginning is the biggest obstacle, and the weakest feature of the army's medical setup.
Once a soldier is removed from the battlefield his treatment is superb. The battalion aid station is his first of many stops as he is worked to the rear and finally to a hospital. An aid station is merely where the battalion surgeon and his assistant happen to be. It isn't a tent or anything like that - it's just the surgeon's medical chest and a few stretchers under a tree. Each station is staffed by two doctors and thirty-six enlisted men. They are very frequently under fire.
At an aid station a wounded man gets what is immediately necessary, depending on the severity of his wounds. The idea all along is to do as little actual surgical work as possible, but at each stop merely to keep a man in good enough condition to stand the trip on back to the hospital, where they have full facilities for any kind of work. Hence if a soldier's stomach is ripped open they do an emergency operation right at the front but leave further operating to be done at a hospital. If his leg is shattered by shrapnel they bind it up in a metal rack, but the operating and setting isn't done till he gets back to the hospital. They use morphine and blood plasma copiously at the forward stations to keep sinking men going.
From the battalion aid station the wounded are taken by ambulance, jeep, truck or any other means back to a collecting station. This is a few tents run by five doctors and a hundred enlisted men, anywhere from a quarter of a mile to several miles behind the lines. There is one collecting station for each regiment, making three to a division.
Here they have facilities for doing things the aid station can't do. If the need is urgent they redress the wounds and give the men more morphine, and they perform quite a lot of operations. Then the men are sent by ambulance on back to a clearing station.
The 45th Division has two clearing stations. Only one works at a time. While one works, the other takes a few hours' rest, then leapfrogs ahead of the other one, sets up its tents and begins taking the patients. In emergencies both clearing stations work at once, temporarily abandoning their rest-and-leapfrog routine.
All these various crews - the company aid men, the battalion aid station, the collecting station and the clearing station - are all part of the division. They move with it, fight when it does, and rest when it does.
Then back to the clearing stations the hospitals begin. The first hospitals are usually forty miles or more back of the fighting. The hospitals are separate things. They belong to no division, but take patients from everywhere.
They get bigger as you go back, and in the case of Sicily patients are evacuated from the hospitals right onto hospital ships and taken back to still bigger hospitals in Africa.
The main underlying motive of all front-line stations is to get patients evacuated quickly and keep the decks clear so they will always have room for any sudden catastrophic run of battle casualties.
A clearing station such as the one I was in is really a small hospital. It consists of five doctors, one dentist, one chaplain, and sixty enlisted men. It is contained in six big tents and a few little ones for the fluroscope room, the office, and so forth. Everybody sleeps outdoors on the ground, including the commanding officer. The mess is outdoors under a tree.
The station can knock down, move, and set up again in an incredibly short time. They are as proficient as a circus. Once, during a rapid advance, my station moved three times in one day.