There’s the Medical Corps and the Dental Corps and the… Part 3 of a 5 Part Series on the Navy’s Nine “Corps” (of Which Five are “Medical”)

Of the 9 Corps in the U.S. Navy – I don’t include the Marine Corps (in some Navies referred to as Naval Infantry) here, for this is a topic for another day – you have read about the four that are “independent” staff Corps in previous posts:

–the Civil Engineer Corps, housed administratively in the Naval Facilities Engineering Command;

–the Chaplain Corps, the Chief of which reports to the Secretary of the Navy through the Chief of Naval Operations;

–the Supply Corps, housed administratively in the Naval Supply Systems Command;

–the Judge Advocate General Corps, the Chief of which reports to the Secretary of the Navy through the Chief of Naval Operations.

Now, I will take up the remaining staff corps, all of which are housed administratively within the Bureau of Medicine and Surgery, under the command of the Navy Surgeon General, serving in the role of Chief of the Bureau. “BUMED”, as it’s abbreviated in Navalese [Ed: my term, in no way “official”], is the only remaining of ten Bureaus that were in place when that system was gradually abolished in the 1960s, to be replaced by Systems Commands and Shore Commands. The Navy briefly established the Navy Medical Command around that time, but soon reverted back to the traditional (and comfortable) BUMED.

Medical Corps. The Rules for the Regulation of the Navy
of the United Colonies of North-America of 28 November 1775 implied the presence of surgeons aboard colonial men-of-war by specifying that ship Captains should set aside a space to which they could “remove sick or hurt men … with their hammocks and bedding when the surgeon* shall advise the same to be necessary.” Further, a Resolution of the Continental Congress, 25 November 1775 authorizing the “capture and confiscation of British armed vessels, transports and supply vessels” specified that the ship’s surgeon should receive 5 shares of the proceeds from any such capture or confiscation (the ship’s Captain was allotted 6). Until the Naval Act of 27 March 1794 specified that surgeons would be “commissioned” by the President of the United States, ship commanders hired the doctor of their choice, typically for the duration of a given cruise. Physicians continued to serve as “civil officers”, and it wasn’t until 1841 that “assimilated” or “relative” military ranks were ascribed to navy physicians, that of “surgeon”, “passed assistant surgeon”, and “assistant surgeon”. A year later, Congress instituted the Navy “bureau system” and henceforth, navy doctors were administratively organized within the Bureau of Medicine and Surgery. In 1846, surgeons with more that 12 years’ seniority were granted the relative rank of Commander; less than 12 years, Lieutenant Commander; Passed Assistant Surgeons were equivalent to Lieutenant and Assistant Surgeons, that of Lieutenant junior grade.

Medical Corps “device”, worn on left collar of working uniforms and above rank stripes on dress uniform sleeves and shoulder boards.

The Medical Corps dates its establishment as 3 March 1871, when legislation back-handedly mentioned the name, presumably for the first time, thus: “SEC. 5. That the officers of the medical corps on the active list of the navy shall be as follows: –Fifteen medical directors, who shall have the relative rank of captain…” [from Acts of the 41st Congress, Session III, Chapter 117, 1871, Approved March 3, 1871].

Navy General Order No. 418 of 15 August 1918 finally gave surgeons the same rank titles as navy line officers – Ensign, Lieutenant (junior grade), Lieutenant, and so on – “Applicable alike to regulars and reservists, the uniform of any given rank or rating in the Navy shall hereafter be identical in every respect throughout, except for the necessary distinguishing corps devices, and every officer in the Navy shall be designated and addressed by the title of his rank without any discrimination whatever” – though usage of the old titles of Medical Director, Medical Inspector, Surgeon and so on persisted well into World War II.

The Medical Corps underwent its largest growth during World War II, when, under the direction of Surgeon General Ross T McIntire, it went from 841 medical officers on 30 June 1939 to 14,191 by the end of the war. Traditionally, navy doctors have trained in and practiced all the usual medical and surgical specialties in navy hospitals, clinics, larger ships and in field hospital. Some Navy physicians train and practice unique service-related specialties like aviation medicine (supporting aviators and aircrew) and undersea / hyperbaric medicine (supporting submariners and divers). Today, however, such specialties as obstetrics and pediatrics may be undergoing a de-emphasis as military medicine adjusts to a more “operational” emphasis required by legislation that stood up the Defense Health Agency in 2013. The goal of these reforms is to assure a “medically ready force and a ready medical force” for combat operations. I plan to write more on the topic of military medical reform in the near future.

*“Surgeon” in the navy is a generic term, interchangeable with “doctor”, “physician” or “surgeon”. The term “medical officer” is a more modern usage. Navy etiquette calls for medical officers to be addressed in conversation as “doctor” (not “doc”, which is reserved for Corpsmen, see below) until they attain the rank of Captain, after which that honorific is generally used.

Hospital Corps. The Hospital Corps is not a staff corps in the standard sense, though it played that role for a time through the mid 20th century. It is the administrative home for enlisted sailors – corpsmen – who receive training in medical skills.

Historians generally assume that loblolly boys^ served in ships from the time of the Continental Navy, but the first one actually named in Navy records was in June 1798. The nomenclature for enlisted health workers has changed several times – to Surgeon’s Steward (~1828); Nurse (in “special service to the sick aboard ships, June 1861); Surgeon’s Steward, Hospital Steward and Nurse (November 1861); Apothecary (a Surgeon’s Steward who received pharmacy training, 1866; the caduceus replaced the Swiss red cross as the emblem); Nurse became Bayman (referring to duty in sick bay, 1873).

Emblem of the Hospital Corps. It sits in the center of the rating patch on the Corpsman’s sleeve.

An Act of Congress, 17 June 1898 formally established the Hospital Corps and created or confirmed the titles of Warrant Pharmacist (a Warrant Officer), Hospital Steward, Hospital Apprentice first class and Hospital Apprentice. In 1912, Congress created a new rank of Chief Pharmacist; and in 1916, Chief Pharmacist and Pharmacist were created as Warrant Officer ranks in the Hospital Corps, while enlisted rates of Chief Pharmacist Mate, Pharmacist Mates 1st, 2nd, and 3rd Class, and Hospital Apprentices 1st and 2nd Class.

On August 4, 1947, Congress created the Medical Service Corps (about which next post). Now, Pharmacist Mates could advance beyond Warrant Officer and transfer to the new Corps. Gradually, all Hospital Corps officers moved to the Medical Service Corps, so that the Hospital Corps now consists only of enlisted personnel. The final change in nomenclature happened in April 1948, when the rating of Pharmacist Mate was converted to the current Hospital Corpsman, with rating structure that runs from the highest, Master Chief Hospital Corpsman to Hospital Apprentice.

Hospital Corpsmen (women carry the same designation) serve in a large variety of roles, from laboratory and X-ray technicians to tropical disease research assistants to duty as the sole “Medical Department Representative” aboard smaller ships like destroyers and submarines, to front line service with Marines in combat. As a group, Hospital Corpsmen are the most decorated group of men and women in the Navy. It is said that a Corpsman’s stethoscope is not only for listening to a sailor’s lungs and heart, but to his or her soul.

^Loblolly boy, a title imported from the British Royal Navy, refers to enlisted men typically drawn from a ship’s crew to assist the surgeon and surgeon’s mate in the care of sick and injured sailors. The name actually refers to the serving of warm gruel to their patients. In 1818, Naval Regulations specified loblolly boy duties, to wit, “The surgeon shall be allowed a faithful attendant to issue, under his direction, all supplies and provisions and hospital stores, and to attend the preparation of nourishment for the sick. . . . The surgeon’s mates shall be particularly careful in directing the loblolly boy to keep the cockpit clean, and every article therein belonging to the Medical Department. . . . The surgeon shall prescribe for casual cases on the gun deck every morning at 9 o’clock, due notice having been previously given by his loblolly boy by ringing of a bell.”

(c)2020 Thomas L Snyder

There’s the Medical Corps and the Dental Corps and the… Part 2 of a 5 Part Series on the Navy’s Nine “Corps” (of Which Five are “Medical”)

Civil Engineer Corps. Civil engineers have served the Navy or served in the Navy from its earliest years. From 1804 until 1836, individual engineers worked essentially as contractors to the Navy Department for design and construction of Navy Yards, dry docks and other facilities. In 1836, the Navy appointed William P. S. Sanger, “civil engineer for the Navy” to serve on the staff of the Board of Navy Commissioners, the early professional managers of Naval operations. An 1842 Congressional Act to reorganize the Navy Department abolished the Board and replaced it with five Bureaus, each with separate administrative responsibilities. It was to the Bureau of Navy Yards and Docks that civil engineering fell and thus Sanger became the first full time engineer staffer in that Bureau.

As the Navy expanded, Commandants of Navy Yards around the country hired their own civil engineers, often upon the advice of Sanger. The Navy created the Civil Engineer Corps on 2 March 1867 (the official CEC birthday); Sanger and his colleagues formed the nucleus of this new establishment. While these men received their appointments from the President – i.e., were “commissioned” – their status as Naval Officers was vague until 1871, when they were assigned uniforms and relative Navy ranks, and the symbol of their Corps (the modern version of which is displayed below). was introduced.

Civil Engineer Corps “Collar Device” – Worn on the Left Collar of Working Uniforms

It wasn’t until 1898 that a Civil Engineer actually became Chief of the Bureau of Yards and Docks. Through the first half of the 20th century, CEC officers carried out their usual activities of planning and overseeing construction and maintenance of Navy Yards and shore establishments. Individual officers also participated in Panama Canal construction, design and construction of the Navy’s worldwide network of pioneering radio towers, and development of a Texas plant designed to extract helium from natural gas for the burgeoning lighter-than-air programs in the U.S. Navy and elsewhere. During World War I, CEC officers oversaw construction of a huge office building in downtown Washington – the Army’s and Navy’s predecessor of the Pentagon.

While World War II saw the development of the famous “Seabees” – CBs / Construction Battalions – their precurser, the Twelfth Regiment (Public Works), was the brainchild of CAPT William A.Moffett when he commanded the Naval Station Great Lakes. In 1917, eager to rapidly expand the base to train sailors for a growing Navy, he enlisted the help of a series of CEC officers to organize and lead the 12th of the station’s training regiments, but this one manned entirely by recruits experienced in the construction trades. These men went on to speedily build out the capacity of Moffett’s command from 15,000 trainees to 50,000.

The impracticability of hiring civilian construction crews to build navy shore facilities and airfields in the South Pacific led to the development of what came to be known as Seabees. In January 1942, Construction Battalion BOBCAT (the code name for the island BoraBora, where it was to construct a navy fueling station) – actually only Company sized, with 8 officers and 250 men to start – was stood up. Subsequent units bore the official title of Construction Battalions, and the BOBCATs, as the original outfit’s members called themselves, took on the name SeaBees. So valued was the work of the Seabees in WW II that in 1947, they were made a permanent part of the Navy, and, for the first time, Civil Engineer Officers were made their commanding officers (previously, they were titled “officer in charge”, an important distinction). Seabees played important roles in the Inchon and Wonsan landings in Korea. In Vietnam, CB units built hospitals, landing strips, warehouses and roads, both for military and civilian use. During my time in the Reserves, CBs provided expertise in setting up our field hospitals, and operating and maintaining such necessary utilities as generators, and refuse systems.

In 1966, the Bureau of Yards and Docks was abolished and replaced by the Naval Facilities Engineering Command, under which rubric the Navy’s civil engineers and their enlisted tradesmen oversee construction and maintenance of Navy facilities and train Seabees for service in war and peace.

Judge Advocate General Corps. The fact the the “JAG Corps” is the Navy’s youngest, established by law only in 1967, belies the fact that lawyers have served the Navy, or in the Navy, since the Civil War. Before that time, simple, straightforward Naval Regulations adopted from the British Royal Navy, and relatively simple administration obviated the requirement for lawyers. By the Civil War, however, legal and administrative matters became complex enough that Navy Secretary Gideon Welles felt compelled to appoint a “Solicitor of the Navy Department”, initially to present the government’s case in complicated court martial proceedings. In March 1865, Congress made official the commissioning of a lawyer as “Solicitor and Naval Judge Advocate General” as a staff civilian in the Navy Department. In 1871, the office was moved to the newly established Department of Justice, as “Naval Solicitor”. 1878 saw the first uniformed chief lawyer, a Marine Corps Colonel, and in 1880, the naval billet of Judge Advocate General was created.

Judge Advocate General Collar Device – Worn on the Left Collar of Working Uniform. The “mill rinde” at the center is a traditional symbol of the law, denoting provision of a even grinding by the (mill) wheels of justice.

It wasn’t until after World War II that line officers serving in JAG roles were permitted to restrict their activities to the law only, and in 1950 Congress required that Judge Advocate General officers be actual lawyers and members of the bar. In 1967, President Lyndon Johnson signed legislation that finally established the Judge Advocate General Corps within the Department of the Navy. JAG officers handle any legal matters one might imagine in this complicated world. These include traditional admiralty law, but also environmental law, military justice, administrative law and international law. JAG officers also provide legal assistance to sailors and officers in such things as creating wills prior to deployments and similar services.

(c) 2020 Thomas L Snyder

There’s the Medical Corps and the Dental Corps and the… (Part 1 of a 5 Part Series of Brief Histories of the Nine Navy “Corps” – of Which Five are “Medical”)

A short while ago, I was reminded that 22 August was the 108th birthday of the U.S. Navy Dental Corps. And that got me to thinking: what’s the story about all these “Corps” in the Navy? [Editor’s note: the military term “corps” is pronounced “core” (singular) and “cores” (plural), but is spelled the same for both usages – hence “medical corps” – “core” and the several “staff corps” – “cores”.]

From the beginning of our Navy, officers responsible for navigating and operating our ships – we call them “line officers” nowadays – depended upon “civil officers” to manage the ships’ supplies and pay the crew – pursers; to render medical and surgical care – “surgeons”; and to tend to crewmembers’ spiritual and moral guidance – chaplains. The Naval Act of 27 March 1794 directed that the surgeon and the chaplain be “appointed and commissioned in like manner as other officers of the United States are”, but that the purser be “employed” as a warrant officer, “appointed [but not commissioned] by the President…”. It also specified their pay and subsistence. For instance, the ship’s Captain earned $75 a month plus 6 rations a day. His lieutenant received $40 and 3 rations. The surgeon fared pretty well at $50 and 2 rations, the chaplain rated $40 and 2 rations as did the purser. Note that a ration included a pound of bread and a pound and half of beef or pork each day, along with a variety of fillers like beans or rice, and a pint (that’s 16 oz!) of distilled spirits or a quart of beer, daily.

Despite their equivalent pay and subsistence, the line officers still looked upon these men as something less than “real officers”, and hence the notion of corps of “staff”, vice “line” officers had its origin.

Supply Corps. The Navy Supply Corps (“core”) dates its origin with the establishment, in 1795, of the office of Purveyor of Public Supplies in the Department of Treasury. This act was done to organize and supervise the purchase and distribution of all supplies purchased by the federal government. Ships’ pursers, who managed the supplies and money provided by the “public”, naturally fell under the purview of this office. Pursers functioned like today’s civil service personnel, with no formal rank, until 1841, when General Regulations of the Navy and Marine Corps of the United States adopted a system of “assimilated” (or “relative”) ranks: pursers of more than 12 years’ service would rank with commanders and of less than 12 years, with lieutenants. These ranks were “relative”, though, because a line officer, even of lower rank, would still have precedence in the command structures of naval establishments ashore and at sea. While not specified in the Regulations, one assumes pay followed rank.

Supply Corps “Device” or symbol. It is worn on the left collar of service and work uniforms, and above the sleeve rank stripes on dress uniforms.

The Naval Appropriations Act of 22 June 1860 declared, “That pursers in the navy of the United States shall hereafter be styled paymasters, and that all laws and regulations applying to them as pursers, and all responsibilities and obligations attaching to them as such, shall remain in full force, and continue to apply to them, under the title of paymasters…”. Paymasters apparently fell under a newly established Pay Corps, but I was unable to find any specifics despite a diligent internet search. A single line in the Naval Appropriation Act of 11 July 1919 provided that henceforth the Pay Corps would be called the Supply Corps. A Navy careers website details Supply Corps duties thus:

…[Y]ou will perform executive-level duties in inventory control, financial management, physical distribution systems, petroleum management, personnel transportation, and other related areas. You might:

• Analyze the demand for supplies and forecast future needs
• Manage the inspection, shipping, handling, and packaging of supplies and equipment
• Direct personnel who receive inventory and issue supplies and equipment
• Evaluate bids and proposals submitted by potential suppliers
• Study ways to use space and distribute supplies efficiently
• Determine the fastest, most economical way to transport cargo or personnel
• Oversee the handling of special items, such as medicine and explosives.

Chaplain Corps. [Continental] Navy Regulations of 28 November 1775 stated, “The Commanders of the ships of the thirteen United Colonies, are to take care that divine service be performed twice a day on board, and a sermon preached on Sundays, unless bad weather or other extraordinary accidents prevent.” Only two chaplains are known to have served in the earliest iteration of the American Navy. With the adoption of the new Constitution, and with our shipping suffering the depredations of Algerian corsairs and the French navy, Congress stood up a naval defensive force in 1794. Naval Regulations issued that same year for the first time specifically provided for the assignment of chaplains to ships of the navy. The first chaplains received their commissions in 1799. While commissioned into the Navy, Chaplains served essentially as civil servants, and only the stimulus of the Civil War brought about such reforms as rank equivalency and the right to wear a symbol of their ministry, the Roman cross (“corps device” in Naval parlance), promoted among those who served an increasing sense of common purpose led to an increasing reference to their being part of a “Corps”. An Act of Congress on 3 March 1899, stipulated that the words “relative rank” were amended to “the rank of”, thus giving full and official naval ranks to all staff officers, Chaplains included. It was only with the expansion of the Navy and Marine Corps incident to the runup to World War I that the office of head of the Chaplain Corps was established, in November 1917. Congress made this office official only in 1944.

Chaplain Devices / Symbols (l to r): Christian, Jewish, Buddhist, Muslim, Hindu (proposed). The Navy has not commissioned a Hindu Chaplain. One of these devices is worn on the left collar of service and working uniforms and above the rank stripes on dress uniforms, depending upon the faith of the Chaplain.

The early Chaplains were all Protestants. But an increasing number of Roman Catholic men joining Navy ranks after the Civil War made it sensible to admit priests to the Chaplaincy, and so it is that 30 April 1888 marks the first commissioning of a Roman Catholic priest. A total of four were admitted as the 19th century closed out. World War I saw the appointment of the first Jewish Chaplain, in November 1917. He had to wear the Roman Cross device until June 1918, when the Secretary of the Navy approved the use of a shepherd’s crook to designate Jewish Chaplains. The Navy adopted the current Tablet and Star of David device in 1941.

Despite the fact that about 120,000 women served in the maritime services during World War II, the Chaplain Corps and the Navy Secretary did not see fit to admit women into the Chaplaincy, even though Navy officials received a large number of applications from ordained women. It wasn’t until 1973 that a woman was admitted to the Navy Chaplaincy, and the first Black female in 1974.

The increasing religious diversity is now being reflected in the Chaplain Corps. Several Christian faiths are represented. The Navy’s first Muslim chaplain received his commission in 1996. The first Buddhist chaplain was commissioned in 2004. In 2018, Navy authorities gave preliminary approval for accepting a humanist / “non-theist” into the Chaplaincy, but rigorous condemnation of the idea from several Senators and Congressmen brought the idea to a halt. Currently, over 800 Navy Chaplains representing more than 100 faith groups are in service. A Navy Chaplain Corps brochure describes the duties of a Chaplain thus:

• Conduct worship services in a variety of settings
• Perform religious rites and ceremonies such as weddings, funeral services and baptisms
• Counsel individuals who seek guidance
• Oversee religious education programs, such as Sunday school and youth groups
• Visit and provide spiritual guidance and care to hospitalized personnel and/or their family members
• Train lay leaders who conduct religious education programs
• Promote attendance at religious services, retreats and conferences
• Advise leaders at all levels regarding morale, ethics and spiritual well-being.

Next Time: the Civil Engineer Corps and the Judge Advocate General Corps

(c)2020 Thomas L Snyder

War Risk Insurance and Sailors (and Soldiers)

From the earliest years of the Republic (and even before*), our Congressional representatives saw the need to provide for medical care for seafarers and sailors. The 1794 legislation that provided for the construction of the Navy’s first post-revolutionary ships also prescribed the number, pay, and rank of physicians to be called to serve aboard them. Follow up legislation in 1797 confirmed the assignment of medical men to care for sick or injured officers and men. This latter Act also outlined a scheme of compensation (though not medical care per se) for officers and men disabled in the line of duty. But Revolutionary soldiers and sailors pretty much had to fend for themselves, purchasing medical care from their own funds until Congress passed the War Pension Act in 1818. Even then, the overwhelming number of claims resulted in prompt reductions in benefits. And still, medical care wasn’t part of the benefits package. It took until 1833 before a Naval Asylum opened in Philadelphia. It was the nation’s first veterans’ retirement home and hospital.

The Civil War produced a huge number of disabled veterans, including over 60,000 amputees. By and large, these men received care in military hospitals and homes operated by the U.S. Sanitary Commission. But the end of the war brought these provisions to a halt. Congress and the public debated whether pensions or homes and hospitals would be the best means of veteran support. Congress decided on both: legislation funded the creation of 11 federal veterans’ homes for long term care, starting, in 1865 with the National Home for Disabled Volunteer Soldiers, and several states and veterans’ organizations built similar homes; Congress also provided for veterans’ and widows’ pensions – the largest welfare system in the world at the time. Confederate veterans did not receive recognition for their wartime service until 1958.

World War I brought about a sea change in the whole matter of governmental responsibility for the compensation of veterans and their families for their service and their losses of life and limb. It all started with the War Risk Insurance Act of September 2, 1914. The sole purpose of this Act was to establish the Bureau of War Risk Insurance within the Treasury Department to indemnify U.S. commercial shipping and cargoes against losses due to acts war, which losses commercial insurance policies specifically exclude. The law was passed when the U.S. was still neutral, and we were exporting all sorts of products to both sides of the war in Europe. A 12 June 1917 extension of the Act provided for life and disability coverage for masters and crewmembers of ships of commerce.

Then in October 1917, the largest and most fundamental change in veterans care came into being, when Congress added provisions to provide for life insurance for servicepeople (recall that commercial life policies typically exclude coverage for losses due to “acts of war or insurrection”), for allotments of service members’ pay to their families, and, most significant to this post, for provision of health care, including such things as prosthetic limbs, for veterans of the war. This led to a patchwork of poorly coordinated programs, dissatisfaction with which led, on 9 August 1921, to a new organization, the Veterans’ Bureau. Another consolidation, by way of an Executive Order signed by President Herbert Hoover in 1930, created the Veterans Administration.

Thus did a simple desire to indemnify shippers from war losses morph into on of our nation’s largest social welfare programs.

*For instance, in perhaps the earliest attempt on this continent, civilians in Virginia established a hospital for the care of seamen near Norfolk in 1758-59.

Sources:

Langley, Harold D, A History of Medicine in the Early U.S. Navy, Baltimore, Johns Hopkins University Press, 1995.

Lindsay, S. M. (1918 Sept). Purpose and Scope of War Risk Insurance The Annals of the American Academy of Political and Social Science, 79, pp 52-68. https://www.jstor.org/stable/1013965?seq=1#metadata_info_tab_contents, accessed 19 Sep 2020.

U.S. Treasury Department. (1920). Annual Report of the Director of the Bureau of War Risk Insurance for the Fiscal Year Ended June 30, 1920. Washington, Government Printing Office. https://www.va.gov/vetdata/docs/FY1920.pdf, accessed 19 Sep 2020

U.S. Department of Veterans Affairs. History – Department of Veterans Affairs (VA). https://www.va.gov/vetdata/docs/FY1920.pdfhttps://www.va.gov/about_va/vahistory.asp#:~:text=The%20second%20consolidation%20of%20federal,activities%20affecting%20war%20veterans.%22%20At, accessed 19 September 2020.

Blakemore, Erin. (2018). Pensions for Veterans Were Once Viewed as Government Handouts. History.com, History Stories. https://www.history.com/news/veterans-affairs-history-va-pension-facts

(C)2020 Thomas L Snyder

Cadet Nurse Corps (1943-1948)

A short while ago, this image popped up on my screen:

Photo: Charity Hospital [New Orleans] School of Nursing Alumni Association – http://www.charityalumni.org/Nurse-Cadets.html

It’s well known that the demands of World War II produced a shortage of civilian physicians and surgeons as doctors were drafted in droves. What’s less well known is that a similar shortage of nurses occurred in the civilian sector, as nearly 30% of graduate nurses went into the Army and Navy Nurse Corps in the first year of the war. This created a shortfall of 17,000 nurses for work in civilian hospitals and agencies.

In response to this crisis, Congresswoman Frances P Bolton (R-Ohio), a long time advocate of nurse education, introduced a Bill to establish a national program of nurse education. Passed on 1 July 1943, the new law, with a Senate-added provision that prohibited discrimination based on race, led to the creation of the Cadet Nurse Corps, administered by the U.S. Public Health Service.

To be eligible for the program, prospective Corps members from age 17 to 35 had to graduate from an accredited high school with good grades, be in good health and agree to serve for the duration of the war. In return, the program provided full tuition support, room and board, a small monthly stipend,  summer (gray and white seersucker) and winter (gray wool) uniforms, and a gray velour overcoat and gray raincoat. The uniform was topped with a “Montgomery” beret.

For their part, nursing schools had to be accredited and agree to modify their programs to permit student graduation in 30 months instead of the usual 36.

An aggressive recruitment program followed. This included a series of advertisements like the one featured here, sponsored by the Eastman Kodak Company of Rochester, NY. They appeared in woman-read periodicals such as Cosmopolitan, Vogue and Ladies Home Journal

Source: http://www.charityalumni.org/Nurse-Cadets.html

The program exceeded its recruitment goals of 65,000 annually from the beginning, and by the time it was disestablished in 1948, more than 124,000 women had joined. The non-discrimination clause had an effect too: as many as 3,000 Black women enrolled; 350 Japanese Americans gained acceptance, despite rampant discrimination even before, but especially after the attack on Pearl Harbor; and in 1945, 40 Native American women from 25 tribes entered the program at the Sage Memorial Hospital School of Nursing, located in the Navajo nation in Arizona. Of  the then 1,300 U.S. nursing schools, 1,125 participated in the program. The federal financial support they received permitted them to expand and modernize their facilities; the antidiscrimination clause integrated the Cadet Nurse Corps, the first federal professional group to be so integrated.

At the end of 2019, Congress granted CNC graduates “veteran status”. Contained in the 2019 National Defense Authorization Act, the bill requires SecDef to issue honorable discharges to the CNC alumnae. They will now be eligible for burial benefits and medals, but not for health care or any veteran pension. A belated but well-earned recognition of service in response to a critical need.

©2020 Thomas L Snyder

Sources (all accessed 1 Sep 2020):

http://www.charityalumni.org/Nurse-Cadets.html

https://uscadetnurse.org/node/4

https://en.wikipedia.org/wiki/Cadet_Nurse_Corps

https://www.wsna.org/news/2019/the-push-to-recognize-the-u-s-cadet-nurse-corps-as-veterans

https://www.womenshistory.org/articles/making-difference-us-cadet-nurse-corps

https://connectingvets.radio.com/articles/wwii-cadet-nurses-get-veteran-status-under-ndaa

Society Instigator, Mentor Dies

We are sad to note that historian Harold D Langley, an early instigator of the notion of a society to support scholarly work in the history of maritime medicine and a mentor, Board member, and the namesake of our Harold D Langley Book Prize for Excellence in the History of Maritime Medicine, has passed away at age 95.

Here is his obituary. It details a rich and accomplished life:

HAROLD LANGLEY

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Harold D. Langley, diplomatic and naval historian who was Associate Curator of naval history at the Smithsonian Institution from 1969 to 1996, died on Wednesday, July 29, 2020 after an extended illness. He was 95. As a naval historian, he was a pioneer in exploring American naval social and medical history. Born Harold David Langley, the son of Walter B. Langley and Anna Mae McCaffrey and the fourth of six children, he grew up in Amsterdam, NY. Upon his graduation from high school, he was drafted into the Army of the United States and served from 1943 to 1946, receiving, along with his unit, the Army Meritorious Service Medal and the Asiatic-Pacific Campaign Medal. After his military service, he attended the Catholic University of America (CUA), where he earned his B.A. in 1950. He then earned his M.A. in 1951, and his Ph.D. in 1960, from the University of Pennsylvania, the latter with a dissertation which became his first published book, Social Reform in the United States Navy, 1798-1862. He began his professional career at the Library of Congress, Manuscripts Division, in Washington, DC in 1951. After working as a manuscript specialist in Washington and Pennsylvania, in 1955, Marywood College in Scranton, Pennsylvania, appointed him Assistant Professor of history. He was next appointed as a Diplomatic Historian in the U.S. Department of State in 1957. In 1964, CUA appointed him Associate Professor, and in 1968 promoted him to Professor, which he held until 1971. In 1969, the Smithsonian appointed him Associate Curator of Naval History. While holding that position, he was also an Adjunct Professor at CUA beginning in 1971. In 1965, he married Patricia Ann Piccola. The couple settled in Arlington, VA and had two children. In 1996, he retired from the Smithsonian, and continued teaching at CUA until 2001. After he retired from teaching, he remained active in the history field, writing articles for historical journals, reviewing books, and working on a book. He also traveled regularly to history conferences in the United States, contributing presentations and helping with others. In 2017, he was diagnosed with dementia and curtailed his travels to conferences. Despite the challenges this condition presented, he continued writing articles and book reviews for historical publications. As his condition progressed, he moved to an assisted living facility in Alexandria, VA in late 2019, where he lived for the remainder of his life. He is survived by his sister, Dorothy Sweeney, of Albany, NY; his brother, Roger Langley, of Rockville, MD; his son, David Langley, of Alexandria, VA; his daughter, Erika Langley, of Bremerton, WA; and many nieces, nephews and cousins, along with their families. His wife, Patricia, predeceased him in 2013. The family will receive friends and relatives at a viewing at Advent Funeral and Cremation Services, 7211 Lee Highway, Falls Church, VA 22116 on August 6, 2020 from 4 p.m. to 8 p.m. A Mass of Christian Burial will be held at St. Agnes Catholic Church, 1910 N. Randolph St., Arlington, VA 22207 on August 7, 2020 at 10:30 a.m., followed by the interment ceremony at Quantico National Cemetery, 18424 Joplin Rd., Triangle, VA 22172, at 1 p.m. More information about Harold D. Langley’s life and accomplishments can be found online at www.adventfuneral.com. www.adventfuneral.com.

Civilian Service of Navy Hospital Ships

USNS Mercy Under Way (US Navy Photo)

News of hospital ships Mercy and Comfort being deployed to provide care for civilians during the current Covid-19 pandemic has made the headlines time and again. This prompted me to research the history of such deployments for a post here when, lo, and behold, I came across a blogpost on the topic, written by BuMed historian Andre’ Sobocinski, and posted on the Navy History and Heritage Command blog The Sextant. With Andre’s permission, here is the link to that post.

https://usnhistory.navylive.dodlive.mil/2020/03/31/answering-the-call-stateside-deployments-of-u-s-navy-hospital-ships/

On Social Distancing – Learnings from Naval Training Station, Yerba Buena Island, 1918

I submitted this OpEd piece to the San Francisco Chronicle and the San Jose Mercury-News a week or more before the San Francisco Bay Area counties invoked shelter-in-place orders. Neither outlet picked it up, so you get to see it, well after it was prescient; but it’s still relevant. It’s based largely on work by the History of Medicine shop at the University of Michigan, a result of pandemic research they did during the Bush II Administration.

We beat a viral pandemic 100 years ago the hard way.

Fortunately, we learned from that experience.

By Thomas L. Snyder, MD

Thomas Snyder is a retired surgeon and Naval Reserve Medical Corps officer. He is executive director of the Society for the History of Navy Medicine.

This week the Centers for Disease Control and Prevention (CDC) confirmed a case of community-acquired COVID-19 in Solano County.  This marks the first indication that the coronavirus now spreading around the world has a toehold in the United States.  The prospect of a pandemic is frightening, but it is not novel.  Indeed, many of the public health measures now being implemented were innovated in the Bay Area following the 1918-19 Spanish Flu outbreak.

COVID-19 appears to have emerged in animals, jumped to humans in Wuhan, China, and then spread throughout the world from person to person.  Like the Spanish Flu, mass globalized travel helps the virus spread far very quickly.  At the end of World War I, huge troops movements, War Bond rallies, and the novel popularity of movie theaters and dance halls all abetted the flu’s spread.  By comparison, today millions of newly prosperous travelers can fly across the globe in a single day, taking the virus to nearly every continent.

The Spanish Flu overwhelmed hospitals in the Bay Area.  The Naval Hospital at Mare Island alone cared for more than 1,500 cases at the height of the epidemic.  The Mare Island hospital isolated sick sailors in tents set up on hospital grounds in the hope that removing infected men from the community would help slow or stop the contagion. Desperately ill men suffering from pneumonia were hospitalized.

Curiously, an island in the middle of the San Francisco Bay remained free of the contagion. One day prior to the first reported flu case in San Francisco, the commander of the Naval Training Station on Yerba Buena Island imposed a strict quarantine.  He prohibited travel to and from the island and imposed a “twenty foot rule” – the distance between island personnel and those delivering food and other supplies by boat (it would be nearly 20 more years before the Bay Bridge was constructed).  Only after the worst of the epidemic passed was the quarantine lifted.  Like clockwork, several cases of the flu on the island immediately developed.

While today we have rapid communications, advanced medical treatments, molecular understanding of the virus, and teams worldwide racing for a vaccine, these were not available to medical professionals a century ago.  But remarkably, the public health lessons from the Spanish Flu remain the same today.  We still promote good hygiene, restricted travel and human contact, isolation of the sick and, under extreme circumstances, quarantine of the well.

The Yerba Buena prescription of keeping a distance of 20 feet is not much different from the CDC’s current recommendation of six feet.  The CDC and U.S. State Department have issued “Do Not Travel” warnings for all of China.  To date, they have not recommended limiting domestic travel or attending large public events.  Nor have there been mass quarantines.  But these remain options that are not much different from how public health authorities tried to stem the Spanish Flu by barring sick people from theaters, inspecting ships’ crews for signs of illness, and isolating victims from the general population.

We do have some tools that weren’t available then.  Face masks proved useless in preventing infection during the Spanish Flu.  Today you can buy N95 face masks off the shelf rated to block even tiny viruses from passing through, unlike cloth or common surgical masks.  [NOTE: We want to reserve N95 masks for health workers at high risk for infection. The CDC just announced a change in policy to encourage the general wear of cloth “face covers” (not surgical masks, which also must go to health workers given the current shortage of personal protective equipment) whenever we are out and about. This is to prevent people who have no symptoms but may nevertheless be carrying and shedding virus from spreading the contagion. We understand hygiene better: wash your hands, frequently, for at least 20 seconds using soap and warm water.  If you don’t have access to soap and water, used a hand sanitizer containing at least 60 percent ethanol.  The rest of the advice is common sense.  Cough into your elbow or a tissue if you don’t have a mask. Stay home if you’re sick. And keep your distance.

The Spanish Flu killed at least 20 million worldwide in 1918-19 and 675,000 people in the United States.  It infected a third of the global population.  Medical science and public health have come a long way since then and we have made tremendous progress in destroying diseases like smallpox, polio, malaria, and HIV/AIDS.  We learned some of the lessons the hard way.  But everything that we learned helps us face the COVID-19 virus we see today.

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©2020 Thomas L Snyder

Navy Medicine in Support of Civilian Authorities

In the past, I’ve published a couple of articles on the Navy’s support to civilian medical authorities during the 1918 influenza epidemic, when civil facilities and personnel were overwhelmed by the sheer volume of sick people who needed care. In another article , I added a “what of today” piece in which I discussed civil-military lessons learned from the Hurricane Katrina disaster, and  then-current directives directing or permitting military installations and their personnel to support civil authorities in planning and responding to medical and natural disasters. I also pointed out that such arrangements, at the time, were based pretty much on “handshake” agreements between local military bases and surrounding civilian health and disaster planning agencies.

Late last week, Captain James Bloom, MC, USN (Ret), who regularly emails short naval historical vignettes under the rubric “Today in Naval History”, posted this piece on a Navy diving medicine response, to wit (with Captain Bloom’s permission):

28 JULY 2002

TRAPPED MINERS

The evening of 24 July 2002 was unremarkable for 18 miners working the Quecreek deep shaft coal mine near Somerset, Pennsylvania; that is until they accidentally broke through a thin wall separating them from the nearby Saxon mine. The abandoned, flooded Saxon shaft was errantly shown on maps to be several thousand feet away, but in seconds 150 million gallons water poured into the Quecreek shaft. Nine miners scurried to safety; nine more struggled to reach the highest point within their subterranean tomb. Here the rising water compressed the residual air into a bubble just large enough to keep the nine from drowning. Within hours a six-inch pipe reached the miners through which heated, pressurized air was pumped to hold the chilly, rising water at bay.

Breathing pressurized air at their position 240 feet below the surface made the miners effectively divers, equivalent to an air-saturation dive 40 feet below the sea. Experience with even shallow water marine rescues had taught that the sudden decompression of rescue was likely to result in death or serious injury from “the bends.” The Navy was called and within hours CAPT Dale Molé from the Bureau of Medicine and CAPT Henry Schwartz from Naval Sea Systems Command joined emergency physician LCDR Nick Colovos and 60 Navy personnel from eight commands at the scene. Recompression chambers were quickly flown in–nine multi-place chambers and five transportable “Hyperlite” chambers. Set up in a nearby barn, the assemblage represented the first time so much recompression capability had been assembled in one location.

A special drilling rig had to be transported from West Virginia to sink a 32″ rescue shaft. It would be used to lower a cylindrical basket through which the nine could be raised one-by-one. A steel cap, the “iron maiden,” was built over the site to maintain air pressure in the shaft while the rescue proceeded. At the mine entrance over a mile away high-volume pumps strained to drain as much water as possible from the flooded mine. This paced removal of water proved very helpful as it lowered the pressure in the miner’s air bubble about one foot of seawater each hour–the perfect rate for decompression. But nothing more had been heard from the miners. For two torturous days Navy personnel worked, sympathized with families, and rehearsed their rescue scenarios.

Finally at 2215 on the 27th the rescue shaft reached the trapped miners. Video equipment borrowed from the Navy-Marine Corps News crew and attached to the first rescue basket recorded all nine alive! CAPT Schwartz escorted the first rescued miner to a nearby trauma center, where one of the recompression chambers proved necessary and helpful. By 0245 all nine had been rescued.

Watch for more “Today in Naval History” 1 AUG 19

CAPT James Bloom, Ret.
Molè, Dale, “Steaming to Assist at the Quecreek Mine Disaster.” Navy Medicine, Vol 93 (5), September/October 2002, pp. 18-29.

Oral History, CAPT Dale Molè, MC/USN, August 2002.

ADDITIONAL NOTES: This rescue was the first in the 20-year experience of Pennsylvania Bureau of Deep Mine Safety representative Jeffrey Stancheck in which all the trapped miners were rescued safely. The assistance of the US Navy proved invaluable. Indeed, when the first miner was brought to the surface it quickly be came apparent that some visual screening would be necessary to preserve the privacy of the miners being transported from the shaft opening to the decontamination station. Initially Navy personnel on the scene formed a 70-foot “human shield” until within 15 minutes the SeaBees had constructed a 12′ barrier of wood and “cumshawed” tarpaulins.

Though we usually associate “the bends” with diving activities, the disease was originally described in the 19th century in underground constructions workers building the massive caissons that support the Brooklyn Bridge. It was originally called “caisson’s disease.”

Ironically the site of this Quecreek mine disaster and miraculous rescue is only 15 miles from the crash site of the September 11th, 2001, highjacked United Airlines Flight 93.

I think this is a terrific example of the special expertise the Navy and the other military medical services can bring to bear in emergencies. (I also wrote a short piece on the Army’s medical response to the San Francisco earthquake and fires of 1906 here.)

(You can subscribe to Captain Bloom’s vignettes by emailing him at navalist@aol.com; put Subscribe to “Today in Naval History” in your subject line.)

©2019 Thomas L Snyder

USNS Mercy Completes Mission in Perú

Today, the hospital ship Mercy completed a 6 day visit to the Peruvian port of Callao. While there, according to U.S. Embassy and U.S. Southern Command reports, the medical staff worked in partnership with other Western Hemisphere personnel. They provided health care – including an average of 20 surgeries a day – for more than 4,000 people in “vulnerable populations”, including, explicitly, refugees from the humanitarian disaster in Venezuela. Reportedly, Perú currently harbors about a million Venezuelans who’ve escaped hardship in their home country.

Mercy has made 7 visits to the region since 2007. Over this time, her people have helped build and equip emergency treatment centers in 15 Peruvian locations, and assisted in training the local health professionals who would staff them.

I’ve written about medical diplomacy before. Such activities seek to build friendly relationships with other nations. They can also play interesting propaganda roles, as in this case, where the explicit mention of care for Venezuelan refugees is intended to embarrass the Venezuelan government and help strengthen the coalition of nations opposing that regime.

Perú was the second stop in the ship’s five month mission to visit 12 nations in Latin America and the Caribbean.

(C)2019 Thomas L Snyder