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HEADQUARTERS
3RD PORTABLE HOSPITAL
APO 923

May 14,1943

SUBJECT: Report for History of Medical Activities, SWPA.

TO: The Surgeon General, U.S. Army, Washington, D.C., U.S.A.

In compliance with AR 40-1005, the following report of the activities of the 3rd. Portable Hospital up to December 31, 1942 is submitted.

The 3rd Portable Surgical Hospital was created from personnel of the 42nd General Hospital on September 19,1942. Four officers and twenty-five enlisted men were chosen in compliance with the directive and orders of September 20,1942. The officers were chosen for their particular training, temperament, ability to get on with each other and command the respect of enlisted personnel, and their emotional stability.

The Commanding Officer and Surgeon was William L. Garlick, Major, a graduate of George Washington University Medical School in 1937. Post-graduate training consisted of four years of surgical training at Church Home and Infirmary and Mercy Hospital, Baltimore, Md, and one year with Dr. William F. Rienhoff, Chest Surgeon, Johns Hopkins University.

S. Edwin Muller, Captain, Assistant Commanding Officer, and Chief of Medicine, graduated from University of Maryland in 1937, and interned three years in Medicine at Mercy Hospital, Baltimore, Md. The following two years he did clinical work at University of Maryland and Mercy Hospital, and was in charge of medical clinic at Mercy Hospital. He was trained in Tropical Medicine at the Tropical Disease School, Walter Reed Hospital, Washington, D.C.

Captain William B. Long graduated from the University of Maryland  in 1937, was “gold-medal”  man of his class for scholarship, and interned at University of Maryland in Surgery for four years, was then sent to Lahey Clinic in surgery for one year. In  this organization he was orthopedic surgeon and commander of detachment of enlisted men.

Captain James K. Karns graduated. from the University of Maryland Medical School in 1940; was also the “gold-medal” man of his class; interned two years in general rotating internship at University of Maryland, and functioned as personnel officer, finance officer, and general medical man and anesthetist in the Portable Hospital.

The twenty-five enlisted man were chosen for their training in the required T/O positions and for their physical stamina. As Commanding Officer of the 3rd Portable Hospital I am very proud of the calibre of officers and enlisted personnel of the organization.

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Immediately on activation the organization took to the field. We located in a tract of land along the Brisbane River near Darra, on the hill of the river bank, laying our tents among the knolls and trees to fit the landscape and take the best possible camouflage. The camp site was chosen by Col. Maurice C. Pincoffs, for several reasons, and he rented and paid for it out of his own pocket. It was an ideal location for a camp, away from any other army camp, with many areas in which to train and the river to swim in. The only drawback was that water had. to be transported from Camp Columbia, three miles away, but this was easily done, when rations were picked up each day.
    
As quickly as possible we gathered together the T/Ba. requirements and began packing two separate hospitals – one, the portable, the other, station hospital equipment. Our chief concern was a method of carrying the portable hospital. The original directive suggested that the hospital equipage be carried on litters between two men, about 90 lb. to the litter. We found this impractical. Going up and down hills with a routine pack on the back and a litter between was difficult and we thought could be simplified. With the help of Col. Pincoffs, who suggested it, we developed a canvas bag with a tump strap for the head and packed the hospital supplies and personal equipment in this. For a pack of 30-35 lb. this would have ridden well on the back, but no pack weighed less than 50 lb. and the weight would shift heavily across the small of the back and rub blisters, and become very uncomfortable after the first mile.  T/Sgt. Andrews suggested a pack frame, which we built, and found the ideal solution to carrying weight.  It was this method which we adopted to carry the portable equipment. The station hospital equipment was packed in sturdy, “foot-locker” like cases of equal size. Twenty cases were required to hold the entire outfit except tents, stove, refrigerator and other heavy equipment.

Our next problem was to develop a bed that could be quickly set up, lightly carried, that would keep the man off the ground and could be placed under a shelter half. It was suggested that we adopt a conventional bed used in the gold mining area of New Guinea. It consisted of a six-foot canvas sleeve, three feet wide, with a long flap on one end and short flap on the other. The bed was constructed with two long sturdy poles slipped into the envelope, and being spread by crossed slanting poles supported by a centre forked log on which it rested. A mosquito bar was easily tied above this and one shelter half was stretched over the top for cover, the point being placed at the opposite end of the bed from the long flap, which is tied up to protect the head. Any clothing to be kept dry was placed at the head as a pillow. When the bed was down, the canvas sleeve was rolled about the clothing and personal articles and strapped to the top of the pack frame for carrying.

When the pack frame was loaded with personal equipment and hospital supplies the weight varied between 60-70 lb. per man. Hospital equipment averaged 50 lb. per pack for twenty-five packs, a total portable weight of 1250 lb., which we felt was not excessive, and which we eventually carried through the Buna campaign without any great difficulty.

We next added certain drugs to our armentarium, which we thought were necessary, and which did not appear on the T/Ba, such as quinine, dehydrochloride, emetine, sedatives, neoaraphenamine and sodium citrate. We were also able to obtain a microscope, which we found invaluable in the treatment of the large numbers of fever patients which we subsequently handled.

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We remained in this camp, which was named “Camp Shipley” after the Chief Surgeon, University of Maryland, for six weeks, spending our time hiking with loaded pack frames, setting up jungle beds and various quick camps with latrines and garbage and disposal pits. We held individual classes in malaria and malaria control, tropical diseases, living in the tropics, conduct in the combat zone, and various other allied subjects. By VOCO we moved from Camp Shipley to Camp Columbia for several days and then to Camp Doomben for two days. All of our equipment had. been crated and labeled, and every step necessary for embarkation was complete.

On November 15,1942, we boarded the S.S. “Anhui”, a Chinese freighter under British command, with our entire equipage and men. The Portable Hospital equipment was placed over hatch #3, and we immediately set up a dispensary and hospital of ten beds in the sick bay. Col. Pincoffs and Major Chambers came down to see us off and inspect the ship which was very strange. It had been built in China in 1925 and had been used  as a coastal trader until the Japanese came. With refugees she had run first to Mandanao [Mindanao] and then to India, always just ahead of the Japs. Eventually, she had become part of the transport service out of Australia. She was loaded, on our journey, first, with gasoline, on top of which was placed ammunition, and then battalion and hospital supplies, then a short battalion of 800 men of the 127th Infantry, and the 3rd Portable Hospital. The officer and enlisted  men's accommodation was comfortable. The enlisted men were in hammocks or cots and. there were enough cabins to bunk all of the officers and some of the sergeants.

Our journey was extremely pleasant. The weather was good, the food poor, but morale was high, and the British captain, Australian pilot, Russian third mate and Chinese crew were congenial. We lay over in Townsville for two days and proceeded in convoy along the Great Barrier Reef to Port Moresby.

The hospital on board ship was filled within twenty-four hours of leaving Brisbane with one head injury, several cases of acute septic throats, and many cases of very acute urticaria and asthma. No serious injuries occurred en route.

We landed in Port Moresby on Thanksgiving Day, November 26,1942, and disembarked by barge about 12 noon. None of our equipment was allowed to go ashore with us at this time, only personal baggage. We were loaded into trucks and carried through the town, past the 7-mile drome, and bivouaced in the area recently evacuated by the 126th Infantry.

The 3rd Portable Hospital immediately set up jungle beds and had a Thanksgiving dinner of “C” rations. The infantry got settled on the ground with the unpleasant result that 3,000 men were soaked through their entire equipment in the course of the night by the tropical deluge which washed in torrents off the hills. On the heels of the storm came three Jap bombers, which kept everyone out in foxholes for the mosquitoes to feed on for about an hour. They continued overhead going to Moresby and were caught in the lights and kept high by antiaircraft fire. No damage was done.

The next morning orders were received to be ready to fly over the mountains. We had no equipment, as was the situation with the infantry. The boats had not been unloaded. I requested permission to see the Base Surgeon, Col. Blank, to see if he could help get just the 1,200 lb. of portable equipment. He could not

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help.  The unloading was under control of the Australian Forces. I visited them but they felt there was a routine to be followed and would do nothing. I felt we were less than useless without the equipment and took matters into my own hands. There were two American soldiers fishing in a motor boat close to shore. They took me out to the “Anhui”. Captain Evans understood my plight and lowered his motor launch and a life boat. We piled the portable hospital equipment into these and took it to land. The Major in charge lent us the 6 o'clock mail truck and we arrived back in camp ready to go into combat, but, unfortunately, that didn't occur for many days.

Each day was spent on the alert, keeping everything packed and ready to fly at a moments notice. Meals and food preparation were poor and latrines open. Dysentery ran through the regiment. Some of the cases ran high temperature and blood in the stool. Cases among our enlisted men were quickly controlled with sulfaquanidone, but the infantry generally were not so fortunate. Attempts at fly control and closed latrines were made, but not very efficiently, as everyone always expected to fly away the next day.

On about the eighth day Colonel Schmidt [Lt. Colonel Edwin J.], the C.O. of the 127th Infantry, announced that all was in readiness to go into combat and that the three portable hospitals would be left behind because they were not mobilized sufficiently to travel with the regiment in the terrain on the other side. It seems that the portable hospitals had been discussed at a meeting the night before, and because of their weight of equipment and the fact that they were not “portable” the regiment decided not to carry us. To my way of thinking that decision could not stand. We had spent too much time in preparation to be left behind on the threshold. I went to see Colonel Schmidt to plead our case. He said it was not his decision, but the Australians' decision that there was too much weight. I asked him to let me go to see the Base Surgeon to see if he would change it. Colonel [Julius M.] Blank was surprised and called someone to check on it; he then said we were going over on the “second wave” of the movement. On the way back to camp it occurred to me that the regiment was badly undermanned. Why not go over as part of Headquarters Company of our Battalion to circumvent such a circumstance. I delivered this idea to Major Schraeder [Edmund R. Schroeder], 1st battalion commander, and he took it to the Colonel. We were booked as Headquarters Company medicos for the flight. The 4th and 5th Portables were to be left behind because it was they who had convinced the regiment of the importability of the portable hospitals. A week later the situation had changed again. Everything, even the 8 ½  tons of station hospital equipment, was to be carried and all personnel including the 4th and 5th portables were to go. And so we went.

I arrived in Dobodura with six men and four tons of equipment, having had an uneventful forty-five minutes' flight across New Guinea and waited four days until the next group of my officers and men arrived. We had been working in combat almost two weeks before the last of my men and equipment were flown over.

We camped in a swamp about a mile from Ango, waiting for the regiment to be collected after landing at various air strips, three to eighteen miles away. Our kitchen was the only one in the area and we ran a continuous sick call and first aid station. Patients from the 128th Infantry even wandered through our camp for treatment on their way back to Dobodura to the 2nd Field Hospital. As fast as fifteen or twenty infantry soldiers arrived they were sent forward into combat and consequently the regiment was never collected.

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For two or three days we were forgotten, not even included on ration supplies. So, we decided to move ourselves forward where ever the 1st Battalion was located. We carried our complete portable hospital and personal belongings on pack frames, and joined the battalion about twelve miles toward the coast from Ango.

The 5th Portable about this time took over the area of the 19th Portable and the 4th Portable cleared out the jungle and set up a beautiful camp about a mile back of the 5th. I went forward from the site of the 5th Portable to the fighting lines, a distance of about 2 ½  miles through dense jungle, many streams, and much mud. In that distance I saw four patients bleed to death or die of shock which I felt could have been saved if there was a hospital set up closer to the actual fighting. We were the only hospital equipped to carry easily on pack frames our equipment, for native bearers would go no further than the Fifth's camp.

We chose an area about three hundred yards in front of the Regimental Aid Station and about 100 yards in front of the Regimental C. P., which afforded ideal cover for our needs. It was surrounded by tall black-rubber trees and fairly open in the center. The swamp surrounded three sides and its luxuriant growth shielded any view from outside or above. About 100 yards down the trail was located the 2nd Battalion Aid Station, and about 200 yards from there were the Japanese forces located in the area known as the “Triangle” and the “Coconut Grove.”

We cleaned out the underbrush and had a quite considerable camouflaged area in which to set up a hospital. On Christmas Day l942 we put up our first fly and before we could break out and sterilize the instruments we had our first patient, a boy shot through the pulmonary artery, who arrived in an extreme state. We successfully ligated his artery but blood loss and shock resulted in his early death. From that case on, we received one continuous stream of casualties while setting up and expanding our camp.

The tentage we put up consisted of a fly for the day operating room, a fly for the kitchen, a medium wall tent for a black-out night operating room and one for a supply tent, three fully spread pyramidal tents, two wall tents and a fly for wards. Even with the amount of tentage we did not have enough cover for the numbers of patients we held each night. We kept no injury that could safely travel back to the 5th Portable and no fever case that came during the day, but were forced to keep anything which came after dark.

The hospital was located dangerously near the Japanese lines. At all times of the day and night there were “explosive” bullets in the trees or making holes in the tops of the tents. If the Japanese had had any amount of artillery we would have been unable to maintain such a close position. As it was, the depressed area of the camp site and the thick foliage gave us adequate protection.

From the day of the opening, Christmas Day, until December 31,1942, our hospital was entirely surgical. In those days we did sixty-seven major surgical procedures, the majority of which were abdominal or chest cases. In that time we had one mid-thigh amputation, five jejunal resections and four thoracotomies, besides numerous extremity wounds and head injuries.

The four thoracotomies were interesting in that each was a bullet wound of the right lower chest which split the diaphragm, fragmenting the dome of the liver, lacerating the lung, and proceeding out of the back. They differed only in the amount of liver damage. In each case a thoracotomy was done, the capsule of the

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liver sutured to control bleeding, the diaphragm sutured, the pleural cavity emptied of blood and the chest and back wound debrided and closed. We used pentothal and ether, open drop, anesthesia, and were fortunate in having two of these cases recover.

There were few cases of large shrapnel wounds which required extensive debridement. One was very severe. The left side of the face was completely torn away. The dura was exposed, the orbital cavity, nasal cavity and pharynx one big hole. The left mandible was gone. There was nothing to do but stop the bleeding and hope the patient failed to recover, but he had an uneventful convalescence until he was evacuated.

Our water came from a two-foot well which was dug conveniently near the kitchen. It was fenced off and was very clear even after rain. The water was placed in a water bag and chlorinated before using. The latrine was a closed, make-shift box-top affair sixteen feet deep, which was burnt out as need be. Our cooking was done during this time on a stove made of cracker tins in which wood was burnt. Food consisted usually of “C” rations and occasionally “B” rations of bully beef and turnips. Everyone lost weight from food lack.

However, we got everything that we requested that was obtainable. One night we asked the regimental supply for an oxygen tank for a patient shot through the chest. Within four hours an oxygen tank had been moved from the 2nd Field Hospital to our camp. We were also able to get sodium citrate for whole blood transfusions.

By December 31, 1942, we were well on our way to prove the value of our existence as a portable surgical hospital, that could function as a front line unit and could do definite definitive treatment in surgery under enemy fire and save lives.


[Signed]
WILLIAM L. GARLICK,
Major, M.C.,
Commanding.


SOURCE:  National Archives and Records Administration, Record Group 112, The Army Surgeon General, Entry 54A, 3d Portable Surgical Hospital History, Box 611.