ple Historically Speaking AUS Army Medical Department Hospital Ward C: Photo courtesy of the US Army Office of Me ‘ofthe World War I era. edical History World War II Hospital Trains by George D. Porter 1c was in the mid-fify’s on a trip with my father to Now York on the Missouri Pacitie Texas Eagle that 1 saw my First hospital sain as we pulled into the stan in Saint Louis, It as impressive with its very large red crosses at each end, large windows, and multiple stacked beds inside. It was unoccupied Recently at our Houston Railroad Museum while with The Wednesday Gang and helping Bill Willits, our fearless editor, in the library, Lan large envelope that was addressed to the late Dr, Thomas Matney and is preserved ia the Matney Collection, Also in the collection are several drawings of hospital cars of various configurations. Oddly enough Dr. Matney and 1 her on a projeet at The University of Texas M.D. Anderson Cancer Center many years ago, fundraising and moving Hospitality Apartments to a new location as we were expanding our South Campus. Dr Maney was also a past-president (1971) of our Gulf Coast Chapter, NRHS. Having known him I picked up the envelope and started reading its contents, which is I keep telling Bill while work- ing in the library. Ifyou sitand read you don' get any work done! Apparently Dr. Matney was very interested in hospital trains, which fitted into his work at M, D. Anderson and also at the University of Texas Sehoo! of Public Health, Twas also interested in hospital trans, as riy wife is Nurse Practitioner and we both retired from M.D. Anderson. Since this is un aspect of railroading, history that you don't hear oF read much about, I thought 1 ‘would transeribe it into this article, as itis interesting from both a railroad and a military medical history aspect. absolutely contra 10 Wh al The following is from a unit history report June 1945 from Headquarters (Operating Train Number 83) of the United States Army. ‘The report is from Major Angelo S. Geraei, Commanding, to the Surgeon General of the U. S. Army in Wa D.C. Iis Unclassified, 1 ACTIVATION AND TRAINING Shorlly after the “Ardennes Bulge” the 108th General Hospital was one of ten hospitals called upon to furnish the Personnel for the operation of a Hospital Train, On 16 February 1945, Detachment “A” of the 108th General Hospital was created for the purpose of operating a hospital train for the evacuation of the sick and wounded. Accordingly, the Commanding Officer, Colonel Rousselot, Submitted list of Officers and Personnel 1 Major A. S, Geraci, who was designated as Commanding Officer of Detachment “A”. Aer reporting to the Commanding Officer of the 34431d Medical Battalion, Li. Colonel Maher, we started ‘out, with the assistance of the Plans and Training Otlicer, ‘on a two week period of training which was covered in three phases 1. Physical Training - in which we included courses, ‘of conditioning in calisthenics, drill and hikes. 2. Didactic Training - which included courses of instruction in the handling and care of patients and the problems arising in the transportation their destination, Refresher courses in sanitation, water sterilization and chlorination, gxs warfare, bombing, strafing and fire control and methods of care and protection for the plients as well as the personnel. Medical and su B Gulf Coast Railroading + April 2012technicians and supply men were given intensive instruc- tion in their respective Fields of training 3. Practical Training - which included the instruction precaution of loading and unloading patients oute: this phase of training was largely given by hospital rain Commanders, whose broad experience enabled us to avoid the usual mistakes and poitfalls that are learned the hard and often expensive way. I1- EQUIPMENT AND SUPPLY On 7 March 1945 the Detachment got on board and wok possession of U, S. Army Hoxpital Train Number 83 atthe Pantin Yards, Paris, and proceeded immediately to luopack and check equipment and supplies and to distrib- tue them throughout the length of the sixteen coaches, which compromised the Train, with readiness for opera- sions within 72-hours. The Hospital Train consisted of 16 French cars of class passenger rolling stock and from the head sngine) appeared in the following sequence - Baggage car, officers’ sleeping car (Wagon Lit) for key sergeants, enlisted men’s sleeping car, diner, compo- sition ear, four ward cars (Liter), pharmacy and surgery four more ward ears and finally two ambulatory cars, stretching out to over a quarter mile in engi and repre million senting, according to French estimate, almost dollars rolling stock and equipment, ‘Car - This car was designed for the storage ‘ofthe baggage of the personnel and for supplies for the train by the construction of suitable shelves from salvage lumber picked up along our travels in France, Belgium, nd Germany Officers” Sleeping Car - (Wagon Lit) - This French version of our Pullman car had ten comfortable compart- iments, seven of which were assigned to individual officers (1 Medical Olficer, Administra tive Officer and four nurses, one of which was the Chief Nurse) andl the key sergeants, (6) doubled up to occupy the three remaining compartments, Enlisted Men's Sleeping Car - (Couchette) men were assigned to each of six compartments, tally twenty-four in the eat Dining Car - Besides serving as a diner for the personnel this ear served as a clubroom and combination Red Cross for the EM’s. Here they read, wrote letters, played cards, checkers, dominoes, darts, enjoyed the ‘aul, the phonograph and its variety of records and the public address system, which was eonneeted thru the centize length of the (rain, These supplies were furnished by Special Service. ‘Composition Car - Meals for the patients were prepared here from the rations and equipment for its preparation, This car also provided bunks for the sleep- ing quarters of the KP’s and the two attached mainte- ‘Ward Car (Litter) - Each of eight such cars were equipped with swiveled brackets in layers of three to hold, total load of 30 litters per ear (making a total capacity ‘of 240 litter patients). The litters were securely clamped in a fixed position and the bed consisted of a mattress pad with two sheets (made asa sock bed) and four blankets per bed, Each ward ear was equipped with dressing (ray. linens, food containers and ordinary routine medical supplies as well as with brooms, mops and pails for cleaning purposes. Two medical technicians were assigned to each ward ear and functioned on a 6-hour basis when making operational runs. Both assisted at feeding time, ‘Surgery and Pharmacy Car - This car is placed in the center block of the 8 ward cars for reasons that are to be seen later. ‘Three sections are found in this car. 1, Surgery - The center half of this car has all the necessary equipment to perform minor surgery. Some of the emergencies that arise in the evacuation of patients are; bleeders, cases where the sutures have slipped or ‘eroded; chest emergencies such as misplaced or mi placed tubes in sucking wounds of the chest; cast cuting, and adjusting, and cardiac emergencies requiring oxygen, lc. It must be said that these emergencies are few and Far between, 2. Pharmacy - One section is given to a completely ‘equipped pharmacy with the usual and routine medica tions, plus glucose, saline, plasma and a minimum of 25,000,000 units of penicillin. Usually a registered pharmacist is in charge of this department, Chlorination of all drinking water is also a duty of the pharmaci 3, Detachment Olfice - In this section are found all the records of the personnel, operation reports which average between 50 and 60 per month, and the secret, resiricted and confidential files as well as stock ‘and property records and all correspondence. Iti her the Administrative Officer and the detachment clerk spent Tong tedious hours on the records and repor “Ambulatory Cars - These cars (two in number) are ‘designed for the evacuation of patients not requiring bed ‘care such as upper extremities. N.P.'s and convalescent Each compartment (12 10 a ear) can carry 3 patients who ‘can sleep at night on the seats and a cushion on the floor to provide room for the third person, Two cars carry a ‘maximum load of 72 patients coupled with 240 liter patients making a total load of 312 patients. runs, routine UI - OPERATIONAL RUNS. Detachment “A” of the 108th General Hospital became Provisional Hospital Unit Number 6993 Oy ing Train Number 83 and made its first operational run on 14 March 1945 10 Liege, Belgium, and brought back 289 paticnts (o Paris. A total of six operational runs were made from 14 March to 29 April. ‘The remaining five ‘operational runs included Sarrebourg, France; Munchin- Gladbach, Germany: Cherbourg, Le Mans. and Boulogne, France, The total patient load transported was 1,612 and Gull Coast Railroading * April 2012 9total miles traveled 3,847. A break dowa of the patient Is 772 liter eases most of which were baile casualties, 289 mental patients several of which were taeute psychotics, and 551 ambulatory patients mostly ‘medical patients und upper extremity injuries. The ‘organization was disbanded at Chalon-Sur-Marne, France fon 3 June 1945, IV - CARE OF PATIENTS LOADING - This process was usually castied out at the railhead by a Sanitary Battalion or hospital atendanis, ‘rained in the handling of the sick and wounded. The limited facilities of a train ereate problems unlike those of ‘hospital, and train ward men are quick to improvise for the comfort ofthe patient and the convenience of the Nurse and the Medical Officer. The very sick and those patients requiring close supervision enroute are placed in the middle or lower bunks where they are under constant load reve Stationary Beds in Hospital Ward C: Courtesy of the US Army Office of Medical History WWI Army Office of Medical History Hospital train, Kor Courtesy of the b observation, those not too ill are placed in upper berths. The affected arm or leg is usually placed towards the center of the aisle for the convenience of those working ‘with him and also for closer observation. As soon us the Ward car is loaded the two technicians assigned fo that particular car provide the necessary comfort and care and ‘emergency medication until rounds are made by the Nurse and Medical Officer. The patien Tully observed for the diagnosis and necessary care nroute, penicillin, sulfa drugs being the most common ion given for mental patients with notation made on the record of all medications given enroute In one operational run 1 Cherbourg, evacuating ‘almost 300 mental patients of all categories a near riot was averted by quick action on the part of the Officers and Personnel. The patients mostly ambulatory, alter artiving at the evacuation port, secretly plotted “to get all the Heinies" that were used to unload the train, Cooperation of the armed guards assisted in their evacuation with no incident. CARE ENROUTE - Hospital Train evacwa tion of patients may vary from 12 10 30 hours oF ‘more depending upon the distance that they ane evacuated. From the standpoint of time our shortest trip was less than 12 hours from Surrebourg to Paris while our longest crip was ‘almost 30 hours from Munchin-Gladbach, Germany to San Quentin, France. I is the function of the hospital train to continue medications enroute that were initiated at the point of evacuation. Accordingly, sinee battle es composed the greatest purt of the hhaul, penicillin and sulfa drugs were the most ‘lien given and the amounts recorded on the patients records. On a trip from Sarrebourg, loaded with fresh casualties, while crossing the Rhine, some only six hours old, a total of over 10,000,000 units of penicillin were adminis tered in less than 12 hours. Quite often, changes of dressings were warranted, In the evacuation of patients afflicied with ‘mental disease ranging from the relatively mild to the psychotic with suicidal tendencies, new problems confront the Tra roquiring additional attendants trained in this phase of medicine. Most often an adequate fhumber were sent along with these types of patients, To illustrate thi cited. On one other train, a psychotic entered the toilet of the car while in motion, locked th door and calmly proceeded to commit suicide by slashing his wrists and throat and only the alertness of a nurse passing by, observing the blood oozing under the door, had the door battered down and his life was saved by transfusion. He was taken off the (rain and s chart is eare- ‘Commander, need, a case FO Guir Coast Raliroading + Apri 2072the next stop where a General Hospi Patients with brain injuries fare worst of all, as the vibration and perhaps the jarring intensify their discom- fort UNLOADING - This phase is relatively simple ‘except unloading mental patients. It was found best to unload this type one car ata time with a cordon of attendants around them, V.- MEDICAL SERVICES As previously mentioned the scope included the continuance of treatment initiated, and the keen observa tion for the detection of any new Symptoms or eomplic: tions with proper connotations on the chart. Medical such as hemorrhages. perforating wounds of idal altempis, etc. were fortunately very rare. Medical rounds were made onee every six hours ‘with one of the medical officers constantly in attendance. VI. - NURSING SERVICES ‘The Chief Nurse and her three associates admini tered all penicillin, sulfa drugs and hypodtermics in audition to changing dressings and other duties such a sterilizing dressings, ete. By a system of rotation con- ‘tant nursing service was given day and night VII.- MESS AND FOOD, This phase of train life was administered by a Mess nt and eight assistant cooks and helpers under the guidance of the Mess Officer. Messing of the personnel was conducted in the diner while the patients were fed in their respective ward cars, ‘The meals were prepared in the Composition car and brought in properly heated containers by the ward men to their respective cars and) served hot, All meals consisted of a well-balanced and nourishing diet with assistance given those incapable of feeding themselves. Daily inspection of messing gear and apparatus were conducied to avoid any gastro intestinal upsets. A ‘minimum of 900 patient rations and ration for personnel for 4 days were carried at all times with fresh meat, bread ‘and perishables obtained just before departure time. VILL, - SANITATION All drinking water was chlorinated and tested by the Pharmacist except potable Paris water and containers ‘were [illed with fresh water prior to depariure time. While in Paris adequate facilities were provided for ‘garhage disposal. When stabled out of Paris, garbage was disposed of by digging a pit and burying it, Bathing and toilet facilites seemed to be the chief source of annoyance when stationed outside of Paris as ro adequate provision is made for these needs. IX. - V, D, CONTROL Control was exercised by frequent lectures and the acceptance of prophylactic package when on a pass. four three and a half months of operation we were proud we had nota single case of Gonorrhea. Men who were exposed accepted prophylactic treatment at pro stations or by the medical officer of the unit on duty. X. = CLOSING OF INSTALLATION In the later part of May rumor was strong about provisional trains to be dishanded and returned to their parent organizations. On 1 June the advanced group of 20 men left the train with orders for Paris and the 108th General Hospital, Another group followed the next day \ on 3 June a complete transfer of the property was affecied (o aT/O Hospital Train Unit Number 75, thereby closing a very interesting chapter in one of the various. activities of the men of the 108th General Hospital on detached service. XI.- REDEPLOYMENT Redeployment was no problem as no member of this detachment was eligible for discharge. The Nurses who ‘were assigned to us were likewise returned to their parent organizations. Conelusion This history of U. S. Army Hospital Train 83 was interesting from both a medical and a railroading point of view. These men and women worked under extreme stress, but cared for the wounded and got them to hospi- tals in France and England for eare, These troops were the silent heroes during this tim ‘This article is about an actual hospital train, but what did the members of hospital tain units do before they could actually get to France after D-Day, June 6, 1944 In a future article I will describe how a hospital train unit acted aboard a hospital ship bringing the wounded from France back to England, especially right at D-Day and the months afterwards. The front into Europe had to be firmly established before an actual hospital train could be set up and made operational. Traveling American highways in the 1940s, *50s and. 60s often brought motorists litle reminders like the one below along the way. In addition, there were often railroad tracks just over the fences at the same time. IL ‘was fun to watch for trains and signs! PASSING SCHOOL ZONE ‘TAKE IT SLOW LET OUR LITTLE SHAVERS GROW BurmaShave ‘Gulf Coast Railroading + Apri 201214