The Horrors of War – Navy Medicine at Pearl Harbor (1942 Reflection)

 

One of my earliest memories of Pearl Harbor was reading books about the attack. I grew up in a firefighter’s family so was aware of the dangers of fire in the civilian world. But reading the many books included in Samuel Eliott Morrison’s collection “The Rising Sun in the Pacific, 1931 – April 1942 (History of United States Naval Operations in World War II, Volume III) Hardcover – September 1, 1948”

In 1942, Morison met with his friend President Franklin D. Roosevelt and offered to write a history of United States Navy operations during the war from an insider’s perspective by taking part in operations and documenting them. The President and Secretary of the Navy Frank Knox agreed to the proposal. On May 5, 1942, Morison was commissioned a lieutenant commander in the US Naval Reserve, and was called at once to active duty. Gregory Pfitzer explained his procedures:

He gained berths on patrol boats, destroyers, and heavy cruisers; participated in planning sessions for invasions; witnessed sea battles; narrowly escaped death at the hands of a kamikaze pilot; and conducted post-operational interviews with commanders in the Pacific theater.

Morison worked with a team of researchers to prepare the History of United States Naval Operations in World War II, published in 15 volumes between 1947 and 1962, documenting everything from strategy and tactics to technology and the exploits of individuals. British military historian Sir John Keegan called it the best to come out of that conflict. Issued as The Rising Sun in the Pacific in 1948, Volume 3 won the Bancroft Prize in 1949.

Morison was promoted to the rank of captain on December 15, 1945. On August 1, 1951, he was transferred to the Honorary Retired List of the Naval Reserve and was promoted to rear admiral on the basis of combat awards.

The horrors of war

Between the works of Morrison and many other authors that followed, I can barely imagine the horrors that the men and women at Pearl Harbor witnessed. The mixed smells of burning material and flesh must have been horrendous. In the clinical descriptions of casualties, it’s hard to factor in the emotional content and the sounds of men screaming in agony. Like any mass casualty, the human element is the most meaningful. Ships can be rebuilt for the most part and planes can be replaced. But the men and even some women who went through the struggles were scarred both internally and externally for the remainder of their lives.

The people of the United States were given small glimpses of the tragedy well after the horrible attack. Government sources stated that the extent of the damage was intentionally shielded from the Japanese so as not to encourage further attacks on a crippled fleet. But it is my belief that the extent of the death and chaos caused on the sailors and soldiers was also not fully shared. The public would have plenty of time to adjust later but not losing the will to fight back was critical.

Today’s story comes from an article printed over a year after the Pearl Harbor attack. The conclusions are interesting to read and navy doctrines were re-written based on what they learned that day. As someone who was trained as a damage control petty officer and later Damage Control Officer, I can see where many of our traditions were strengthened if not invented.

January 04, 1942, Washington Evening Star

Heroic and Fruitful Chapter in Navy Medicine Written in Pearl Harbor’s Grueling Stress

By Thomas R. Henry

“One of the most colorful chapters in the history of American medicine was written at Pearl Harbor on December 7 when a little group of United States Navy doctors and nurses, aided by assistants who rushed to their aid from the city of Honolulu, cared for 960 casualties—in many cases terribly burned and wounded men—by working constantly for 16 hectic hours.

Bad as was the Pearl Harbor disaster, the loss of life and the suffering would have been far worse had It not been for the heroic work of these men and women, whose story has come to Washington in letters and reports to the Navy’s Surgeon General, Rear Admiral Ross T. McIntyre.

The newest weapons in medicine’s armament were used in this struggle against death and pain. Even a few months ago many would have died who now are out of danger and having uneventful recoveries. Most notable of these were the various sulfa drugs placed directly in open wounds and the recently developed liquid and dried blood plasma.

Mobile Hospital Ready.

However far from anticipating any such disaster, the Navy Medical Corps was ready for it. Fortunately one of the mobile hospitals, the first of which was turned out little more than a year ago, had just arrived and been set up. There was also a hospital ship at Pearl Harbor to add to the available hospital facilities. Otherwise, the ordinary facilities at the station would have been hopelessly swamped by the sudden demands.

As it was, adequate treatment had been given every injured man by midnight. The magnitude of the task can hardly be overestimated.

No bombs were dropped on hospital buildings. The planes were not immediately recognized as enemy craft, and when they were it was too late to give warning by telephone until they had started firing on their objectives.

Members of the Medical Corps, many of them at their own homes, immediately began assembling at the hospital stations. Within a few minutes all of the staff were on duty. Shortly afterward a blazing plane seemed to be flying directly into the main hospital. Just before it would have struck, the Jap pilot swerved slightly and crashed into the chief petty officers’ quarters a few feet away. This building was set afire and destroyed.

Almost at once the casualties started coming in—by ambulance, truck, private car and delivery wagon. Many of these ran through raining shrapnel.

Began Check on Dead.

One of the major jobs undertaken by the Navy medical and dental officers was that of identifying the dead who were brought in from the ships. They worked all night in the temporary morgue established in the hospital basement. The dead were identified by clothing, papers found on the bodies, patterns of dental work which could be checked against records and fingerprints.

Work of Navy dentists was outstanding, it is shown by reports from Pearl Harbor.

In one case a dentist directed all the first aid work on a bombed ship whose senior medical officer happened to be ashore and whose junior medical officer was killed early in the action. A major Job of the Navy Medical Corps was to get these dead buried. A new cemetery has been opened for them. It probably will be their final resting place and tentatively has been named the Halawa National Cemetery.

Many instances of individual heroism have been reported on the part of the Medical Corps personnel. One medical officer, for example, had undergone an appendicitis operation three days before. Hearing of the emergency, he got out of bed, assembled his kit, and worked steadily for three days and nights, until he finally collapsed from exhaustion.

Volunteer Nurses Respond.

Volunteer nurses appeared as if from nowhere and began aiding the physicians very efficiently.

Many of them were wives of enlisted men at the station, who had had nursing experience.

By nightfall Sunday, according to the reports to Surg. Gen. McIntyre, 90 per cent of the casualties brought in had been treated and made as comfortable as possible, although much of the surgery remained to be done. More than 300 less seriously burned had been treated and had been returned to duty.

The Navy learned many lessons from Pearl Harbor, the greatest single disaster the service doctors ever have been called upon to deal with. Doctors were called on suddenly to apply all that had been learned from European experience in the present war under conditions with which hitherto they had had no personal contact.

The spirit and morale displayed in the face of this unparalleled task leave no doubt of the extremely high quality of the corps, the reports from Pearl Harbor show clearly.

The lessons learned there are expected to save many lives during the course of the war.

Majority of casualties burns.

“It was burns, burns and more burns,” says the chief report received by Surg. Gen. McIntyre.

More than 60 per cent of the 960 injuries treated by the Navy doctors between 8 am and midnight December 7 were due to burns.

A lesson was learned which will never be forgotten. The majority were what are known as “flash burns,” to which the flesh had been exposed only a second or so. It was found—and this fact also was noted by the National Research Council doctors who looked over the situation a few days later—that the burned areas followed closely the outlines of the clothing. If the sailors had been wearing full-length pants and shirts with long sleeves they would hardly have been burned at all. There were no chest burns on men who had been wearing undershirts. There were few arm bums found on men who were wearing shirts. Only those wearing shorts instead of full-length breeches suffered leg burns.

Unfortunately, many sailors were very lightly clad at the time of the attack. This was largely responsible for hundreds of painful injuries.

The burned sailors at Pearl Harbor were treated in a new fashion with the use of two sovereign remedies for the first time on a large scale. One was a mixture of mineral oil and sulfanilamide or sulfathiazole. Large dressings were dipped in this mixture and applied directly to the burned surfaces. The oil acted as a soothing lotion while the sulfa drugs prevented the development of infections. In other cases dressings were dipped in gun tubs filled with tannic acid solution and applied. In still other cases tannic acid jelly was rubbed gently over the burned surfaces. It was found that sulfanilamide powder tended to cake over the wound surfaces and its use was discontinued.

Forestalled Infections.

At the same time large doses of sulfathiazole were given by mouth. By this means the danger of infection from burns was reduced to a minimum and in only a few cases did any infections develop. Death from burns most frequently is due to shock—perhaps caused primarily by the escape of liquids from the body through the formation of blisters.

This was reduced to a minimum through the use of the most recent of war remeries—blood plasma. The Navy had supplies of its own. Also it was fortunate that the city of Honolulu had a large blood plasma bank from which supplies could be drawn for the emergency. A total of 750 units of plasma, both liquid and dried, were used on December 7 and by December 17, 1,450 units had been employed. A unit is the amount of plasma obtained from a pint of blood.

One of the first considerations was to replace at once the plasma drawn from the bank. Within 15 days after the Pearl Harbor attack, blood had been donated by 3.500 citizens of Honolulu and Navy and Army personnel.

Many of the dressings also were supplied by the citizens of Honolulu. The Red Cross chapter there had insisted on making these supplies after it had been told that its quota was filled. This was a godsend in the treatment of the burned sailors whose dressings had to be changed frequently and the used ones thrown away.

“Hopeless” Cases Saved.

Next to bums, the most frequent wounds were caused by shrapnel and flying debris. The Army, especially, suffered many abdominal gunshot wounds. There were many intestinal perforations. A few years ago many of these cases would have been hopeless. A prime necessity would have been immediate operation before the onset of infection.

With the wounded piling into the hospital, this was impossible. After the wounds were cleaned, from 10 to 20 grams of sulfanilamide powder were dropped in and the incisions closed, without providing for drainage in most cases. Most of the men are making normal recoveries.

Shrapnel wounds could not be handled fast enough. Many had been caused by bomb fragments so hot that they cauterized the wounds they made, cutting down somewhat the risk of infection. The patients were given morphine immediately to reduce the suffering, gross hemorrhages were stopped, and sulfanilamide powder placed in the wounds. Then they were put to bed until they could be operated on. In some cases this period was as great as 72 hours. In most cases the men are making excellent recoveries. Until two or three years ago, many of them would almost certainly have died.

National Research Council physicians sent to Pearl Harbor to study the situation were especially impressed by the lack of fever reactions. This shows that the sulfanilamide was successfully pre[1]venting infection.

Morphine Flasks Invaluable.

Of priceless value, report the Navy doctors, were “morphine syrettes”— small plastic flasks with hypodermic needles containing singles doses of morphine solutions. These have recently been introduced into Navy practice.

On December 7 there was no time for the preparation of hypodermics or hypodermic solutions.

One of the lessons learned was the necessity of having supplies of these syrettes distributed over a ship where they will be immediately available. Morphine supplies must be guarded closely and the usual practice has been to keep the entire supply under lock and key in one place.

The lesson of Pearl Harbor was that distribution in many places is essential, regardless of the inconvenience to individual commanding officers or medical officers due to the necessity of providing proper safeguards.

Morphine was an angel of mercy at Pearl Harbor. Without an adequate supply, the burned men would have suffered horribly.

Shows Need of Masks.

The same need of distribution, it was found, applies to other medical supplies and first-aid equipment and to the medical personnel aboard ship. There were several instances at Pearl Harbor where sections of ships were completely isolated by fire and locally stored first-aid boxes were the only ones obtainable.

As never before, the necessity of gas masks was demonstrated, although the Japanese used no gas. Fuel oil fires caused a thick, impenetrable black smoke mixed with explosion gases. Many sailors were overcome as they rushed into smoke-filled compartments without their gas masks to rescue wounded comrades.

Another lesson was that flash lights or electric lanterns should be worn at all times by hospital corps men, and probably by other Navy personnel, attached to cords about the neck or “lanyards” as the Navy calls them.”

Flash burns would be revisited in my generation as equipment was modified and updated.

The lessons learned from some notable submarine fires proved that we had gotten a bit slack from those early learnings.  I hope that all Navy men and women take these lessons seriously and learn from them. You never know when an enemy might attack again without much warning.

I hope and pray that our current generation spends more time on this then they do on DEI.

(sorry, just couldn’t help myself… Old Chiefs die hard.)

From the old Navy:

Bullets fly fast, 

and missiles fly faster;

The wrong kind of training

Will cause a disaster. 

Mister Mac

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