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67th Evacuation Hospital, History
67th EVACUATION HOSPITAL
1 JANUARY 45 TO 30 JUNE 45
TABLE OF CONTENTS
SOURCE: National Archives and Records Administration, Record Group 112, Records of The Surgeon General, US Army, HUMEDS, Box 404, 67th Evacuation Hospital, Annual Reports, 1943-45.
1 January 1945 to 30 June 1945
67TH EVACUATION HOSPITAL (SEM)
Number of Days in
[PERIODIC REPORT, 1 JANUARY- 30 JUNE 1945]
The 67th Evacuation Hospital spent the first ten days of the year 1945 at Namur, Belgium, in bivouac. Eagerness to participate in another operation mounted as unit and personal equipment was gradually replaced and recovery from the somewhat gruelling events of the withdraws from Malmedy, 17-23 December 1944, which had been forced on the unit by the German counter-offensive was completed. The usual administrative duties were carried out with all equipment being checked, repaired when necessary, salvaged and inventoried.
On the afternoon of 4 January at the first ceremonial formation on the Continent of the entire unit, Brigadier General JOHN A. ROGERS presented Bronze Star Medals to the followings
Staff Sergeant Lawrence B. Botohe MD
Staff Sergeant Winford L. Graham MD
Captain Frank A. Jones MC
Captain Stephen A. Larrabee MAC
Captain William T. Van Huysen MC
Captain Jean R. Truckey ANC
1st Lt Mary C. Willhide ANC
Certificates of Merit were awarded to the 4 officers, 6 nurses, and 40 enlisted men who regardless of the approach of the enemy had accomplished the evacuation of over 200 patients from the Malmedy setup on 17 and 18 December 1944, and also to the 7 enlisted men who had remained behind with Captain VAN HUYSEN as the rear guard to protect the unit equipment.
Having received orders to open near Huy, Belgium, for operation I, 1945, the hospital returned on 10 January to the northwestern edge of what had been "The Belgian Bulge" and took over the patients then under the care of the 51st Field Hospital.
The main barracks of a former Belgian Caserne served for wards and quarters for enlisted personnel, with adjoining buildings being utilized for the operating ward section, X-ray and Laboratory Departments,
and clinics. A small building housed headquarters and quarters and club room for officers. Nurses were housed in another separate building. The Receiving Department used a large garage-like building with the Registrar's Office in a small bui1ding nearby. Severely wounded battle casualties were received for several days. A large number of cases of frost bite, especially among prisoners of war, were received. All but the mildest cases were evacuated for definitive treatment. For the last two weeks of the operation, which ended 13 February, the hospital functioned primarily as a communicable disease hospital.
An enlisted dance for a group of Belgian girls was held toward the close of the operation.
Moving by infiltration over a period of days, the hospital at last entered Germany, the command post opening 13 February at Brand, Germany. Several other medical units of the First US Army were set up in adjacent buildings; a group of brick modern buildings, reported to have been an OCS for the Wehrmacht. The 67th Evacuation Hospital received no patients but was held in reserve. For nearly a month the unit was subject to two hour alert orders. Since only the X-ray and Laboratory Sections and the Dental and EENT clinics were called to assist the 44th and 102nd Evacuations Hospitals and the 633rd Medical Clearing Company, a full recreational and training program was instituted.
At least three small groups of officers and enlisted men went on special training trips to the forward medical installations of the 104th Infantry Division, on the west bank of the Roer River, to witness something of medical treatment of casualties before they reach an evacuation hospital.
Good Conduct Medals were given to some thirty enlisted men in a formation of one detachment.
On 6 March, the unit was honored by a visit by the Superintendent of the Army Nurse Corps, Colonel Florence A. Blanchfield, who was accompanied by General Rogers and Major MacCafferty, Chief Nurse, FUSA. The nurses of the hospital entertained the nurses of five other FUSA hospitals at a very enjoyable tea for Colonel Blanchfield.
After the Roer River had been crossed by American troops, several reconnaissance trips for possible future sites were undertaken. A group of badly bombed buildings, formerly the city hospital of Duren, eventually became the setting for OPERATION 2, 1945. Several days of arduous labor were needed to remove the debris from the lower floors and to clean up the surroundings. Practically every department was forced to function under crowded and difficult conditions. Fortunately, casualties were lighter than anticipated, and the unit functioned as successfully as it had in many better physical set-ups. For more than a week the hospital handled principally venereal patients, with an officer from the 4th Convalescent Hospital attached to supervise the work on the venereal ward.
The next move took the hospital to Bonn on the west bank of the Rhine. Here the hospital set up for OPERATION 3, 1945, in a large modernistic building which had housed several clinics of the University of Bonn and, apparently, certain offices of the local Nazi party. From two wards one looked directly out onto the Rhino. Officers and Nurses lived in nearby houses.
On 30 March the unit suddenly received orders to move to the vicinity of Edingen, Germany and. to open as soon as possible. The mission was to hospitalize battle casualties among the troops closing the "Ruhr Pocket" from the south.
A move of more than 80 miles was completed and the entire hospital
was set up under canvas (for the first time since October 1944) and functioning within 24 hours. The 46th Field Hospital took over the patients remaining at Bonn.
During the first three weeks of OPERATION 4, 1945, the hospital received a load of patients which rivalled its first Continental operation on the Cherbourg peninsula in the continuous intensity and in the severity of the casualties. For two days during the rapid eastward thrust all casualties in the First US Army came to this hospital. Many recovered Allied prisoners of war were received and evacuated to airfields. Admissions ceased on 20 April 1945 with the closing of the Ruhr Pocket, the last patient leaving the hospital four days later.
A brief period of rest proved most welcome.
On 6 May the hospital opened OPERATION 5, 1945 on an extensive level area field-part of the civilian airfield-at Bayreuth, Bavaria, Germany, after completing a 300-mile movement by unit and for the first time, ADSEC transportation. The original plan to operate a holding unit for Russians to be returned via a nearby air strip did not materialize, and the hospital functioned normally for a very few days.
This operation was notable only for the scarcity of patients and the arrival of V-E Day, which was celebrated with somewhat restrained joy.
On May 12 the hospital moved by infiltration to the 1st Infantry Division PW Enclosure, near Cheb, Czechoslovakia, and for OPERATION 6, 1945, set up a relay and sorting station for German prisoners of war. Nurses of the unit were quartered about fifteen miles away in the Germania Hotel, Marienbad, and several medical officers were placed on detached service at "overrun" hospitals 'with German prisoners of war. About 10 German medical Officers and 80 German enlisted men stayed at the hospital area and did the major share of the work under the advice and supervision of the staff. The Receiving end Registrar's sections had particularly difficult tasks in preparing the records and
in evacuation the 2213 patients who were admitted in two weeks. 1745 patients went thru the operating room, 174 having incisions, drainage, and applications of casts. 301 patients were evacuated on 21 May, the largest number in a single day. Captured medical supplies were utilized, and prisoners were fed from their own mess operated with prisoner personnel in coordination with the rest of the enclosure.
The last German patients were evacuated on 25 May. On the same day the remaining personnel of the hospital moved into Marienbad. Enlisted men moved into the Marienbader Muhle Hotel. Officers moved into a villa nearby.
After two days of inactivity, preparations were made to open the hospital in a large hotel on a hill behind the enlisted quarters. Prisoners cleaned out the five-story building and helped set up the hospital. On 1 June the unit received the first patient of OPERATION 7, 1945. The unit continued to function as a station hospital throughout the month of June. On l7 June the unit celebrated one year of service on the Continent.
An enlisted men's party for some 50 Czech girls brought the social events of the year to a satisfying close.
67th Evacuation Hospital
During the summer and fall campaigns the surgical service operated essentially as planned. From January 1945 to the present, however, each setup has been different and has called for extensive improvisation. At Huy, Belgium, a long corrugated metal shed housed the surgical section. A total of 3 operating and 4 prep-tables was adequate, but continuous efforts to obtain sufficient heat met with disappointing results. All members of the service are in accord in recommending a different and more adequate heating system since the exposure of the patients to cold during the more serious operations increases their shock condition. The connection of the shock ward directly to the operating room was a distinct advantage at this time.
At Duren, Germany, a ward of a bombed municipal hospital was converted into an operating room, which proved satisfactory, inasmuch as the number of casualties proved to be small. Again Sibley stoves were found to give adequate heating.
At Bonn, Germany, the hospital was housed in a modern building. A suite of 3 rooms furnished ample space for operating rooms, central supply, and prep-room. The central heating proved inadequate at night since doors had been removed to permit passage of litters.
At Sinn, Germany, the surgical section functioned once again in tents and with the routine set-up. What with the changeable spring weather of rain, cold and snow, the chief problem was obtaining adequate heating. A roaring Sibley stove gave too great heat for the near table, while the other tables remained too cold. Therefore, serious cases were scheduled so that the operations could
be done near the store. Outlets for stovepipes in ward tents were found to be situated so that they allowed insufficient space in that section. Attempts to overcome this condition by employing elbow offsets resulted both in diminished heat and in increased smoke in the operating room. Nevertheless, faced with a schedule the section had to continue irrespective at discomfort to patients and staff.
At Bayreuth, Germany, the hospital was set-up on an airstrip with only a ward tent end two storage tents tied together for sterile supply and an operating room. This proved adequate for the small amount of work.
At Eger, Czechoslovakia, the hospital was set up inside a prisoner at war enclosure. The surgery section consisted of one storage tent, one ward tent, and a ward fly with seven tables set up. The mission of the hospital was to screen the wounded and sick prisoners and to determine whether they were convalescent cases, emergent cases, or cases requiring further surgery or prolonged hospitalization. The section functioned primarily as a dressing room where all wounds were exposed for evaluation. Such additional procedures as were necessary were performed, namely, reapplication of casts, incision and drainage, application of skin traction to stumps, et cetera. 10 German doctors were employed under supervision of unit surgeons. The great number of amputations impressed the staff. The German doctors stated that they had not had penicillin or adequate sulfa and that had done amputations in lieu of attempted conservation of severe wounds. Only rarely had skin traction been applied. They stated preference for reamputation if necessary. Some stumps, twelve to fourteen months old, still had granulating areas. The Germans did not advocate skin-grafting or secondary closure. Preferring healing by granulation, infection was present in all wounds, large and small. They
attributed the infection to the paucity of sulfa drugs and penicillin. However, an utter disregard for aseptic and antiseptic technique was noted on the part of all ten German doctors who would have been content to use the same pus-laden forceps on several cases, if they had not been removed by our technicians.
In Marienbad, Czechoslovakia, the hospital functioned as a 300-bed station hospital in a converted hotel, a 15-day evacuation policy was followed. The operating room was set up in the ballroom where three tables were adequate to take care of accidents, appendectomies, circumcisions, tonsillectomies, and other minor operations. The outpatient clinic was heavy with surgical consultations of all kinds.
By the beginning at 1945 the whole surgery section had been formed into coordinating teams capable of being reshuffled with little less in efficiency. All enlisted men know what was necessary to set up quickly for operation as well as how to carry out the various surgical operations. Technicians did the scrubbing, except in unusual circumstances. Concerted efforts to eliminate delay and waste motion resulted in more work being done with less effort. Each case was given whatever was necessary to complete the job efficiently, even though it sometimes required four teams on one patient to lessen the shock and shorten the operation time. In other words, the philosophy of treatment had been altered to complete attention to the case at hand irrespective of backlog, relying on increased efficiency to maintain volume. Triage was better employed to assure getting the more seriously wounded operated on at the optimum time in shock therapy - a good surgeon being responsible for the shock ward. This care was considered essential in conserving not only time in the operating room but also, sometimes, the life of the patient.
Utilized in so far as possible for their specialties specialists were not allowed to remain idle and took cases as they came. Twelve-hour shifts were used, with ward rounds made during "off" hours. Team chiefs remained constant with assistants being rotated between wards and operating room.
67Th EVACUATION HOSPITAL, SEMIMOBILE
The Ward Section during the first six months of 1945 has continued to function in the same manner as in 1944. All Wards - Shock, Pre-Operative, Post-Operative, Medical, and Non-Operative Surgical - have been the direct responsibility of this section. The selection of the patients for evacuation each day has also been a part of its duties. Five and occasionally six officers were assigned to this work.
The first period of activity in 1945 took place at Huy, Belgium. A considerably greater percentage of diseases as against injuries were admitted during this period. Many cases of trench feet were admitted to the wards. A large number of German prisoners of War were treated for this and other conditions, when one considers the severity of the weather during this period the low incidence of serious respiratory infections is worth noting.
During the brief period of operation at Duren, Germany, a number of seriously ill post-operative cases were transferred to this hospital from a Field Hospital and their care was quite a problem for a few days. A proportionately, greater number of cases of diphtheria were encountered here than during any other period of operation. During the last half of this phase the hospital functioned as a venereal disease unit.
The stay near Bonn, Germany, was brief and there was nothing unusual encountered though our physical set-up was very ample and we were will equipped to handle a much larger number of cases.
The operation at Sinn, Germany, proved to be the longest and most active during the six month period. The physical set-up of the hospital, in the fields for the first time since October 1944, was very satisfactory and enabled a large number of cases to be cared for promptly and efficiently. During
this campaign the hospital was visited by the consultants in medicine from ETOUSA and FIRST ARMY. Liberated American and Allied Prisoners of War were encountered for the first time. Diphtheria and pneumonia were seen frequently on the Medical Wards. Our first three eases of typhus, in Russians, were admitted here. The battle casualties seemed unusually severe and recalled those treated in Normandy.
The next phase of activity occurred near Bayreuth, Germany, and was characterized chiefly by its brevity.
Near Eger, Czechoslovakia, the hospital functioned as a relay and sorting station for a large number of German prisoners of War. In addition to many inadequately treated or healing battle casualties, diseases, infrequently seen in our own troops, were encountered. Typhus, diphtheria, post-diphtheria, paralyses, and chronic dysentery fell into this group. The unavailability of laboratory service and the brief stay of these patients prevented adequate study. German medical personnel were largely responsible for the care of the patients while our own medical staff acted in an advisory capacity.
In Marienbad, Czechoslovakia, this unit functioned as a Station Hospital with a capacity of 285 beds. Cases with chronic or recurrent partially disabling conditions, such as are commonly seen in garrison, formed a large percentage of the total. A greater number of cases of scabies were treated suggesting that this disease is more prevalent among stationary troops than those in more active phase. The current evacuation policy permitted the retaining of cases up to a limit of fifteen days thus enabling us to follow more patients throughout their entire illness. This policy also permitted and encouraged a more adequate study of the less acutely ill. Our neuro-psychiatrist worked with the unit for the first time on the continent and was of great assistance. SIW's were encountered in unexpected numbers.
It is felt that as our experience has increased and become more varied the
quality of care given patients has improved greatly. Directives concerning therapy from higher headquarters have been most helpful and have been adhered to. Aside from the possible physical discomfort of operating in tents all agree that it is more ideal than a make-shift set-up in buildings. The advantages of placing tarpaulins over the more commonly used lanes between tents has been amply demonstrated. The problem of black-out of entrances to the ward tents has
not been entirely adequately dealt with an warrants further consideration prior to another campaign.
STATISTICAL TABLE OF DIRECT ADMISSIONS
67th EVACUATION HOSPITAL, SEMIMOBILE
STATISTICAL TABLE OF INFORMAL ADMISSIONS
67TH EVACUATION HOSPITAL, SEMIMOBILE
STATISTICAL TABLE OF OUT PATIENTS
(37 Physicals are not included in the X-Ray, Laboratory, EENT and Dental totals, and they all went to these clinics.)
CLASSIFICATION OF WOUNDS
*(Note: B thru E pertains to US Army troops only.)
67th EVACUATION HOSPITAL, SEMIMOBILE
a. All procedures in this department were done according to the U.S. Army directives and circulars. Anterior-posterior and lateral films were taken on all extremities. The same procedure was followed with injured chests abdomens and skulls.
b. Fluoroscopic examinations, gastro-intestinal series were done when we operated as a Station Hospital. One patient had a fracture reduced with the ad of a fluoroscope. He was anesthetized, reduced, and had a cast applied. All precautions were taken to avoid overexposure of the patient and those employed in the procedure.
c. Duplicate reports were rendered. The duplicate report was glued to the preserver which contained the patients films and the original was placed in the Field Medical Record.
The statistics are listed and broken down as the various parts of the body X-rayed.
a. Fluoroscopic Hoods: The devised hood was used during the reduction of a fracture. The operator found it a useful device for immediate blackout,
when as was the case, a permanent darkroom was not available.
b. Technique: It was found that technique had to be varied from time to time. Films, although diagnostic, were subject to varied densities due to the frequent change in the current being supplied by the 2.5 KW generator.
All supplies were received as necessary. At no time did we have any shortage of film or solutions.