SECURITY MEASURES have made the facility virtually impregnable. Nobody without authorization can gain access, even digitally. It’s kind of the Fort Knox of veterans’ vitals in the United States. That’s how impenetrable the National Personnel Records Center (NPRC) is today. In fact, even though I’m a member of my father’s nuclear family, the centre required full documentation of our blood connection. I had to provide cross-reference material on his working life, his military serial number, and his death certificate before officials would even consider my request for data on his service record. And they would provide me with nothing until each application form was complete, every document checked, and all my identity files verified. The NPRC is so particular about protecting its clients, living or dead, that each page of the centre’s outgoing correspondence includes its primary mission: “We value our veterans’ privacy,” it says, and, “Let us know if we have failed to protect it.”1
Only once did the National Personnel Records Center in Overland, a suburb of St. Louis, Missouri, fail its clients in that promise to protect. On July 12, 1973, the fail-safe system at what was then known as the National Archives and Records Administration could not prevent a fire from racing through its sixth floor—destroying the records of 80 percent of the US Army personnel discharged between November 1, 1912, and January 1, 1960. My father’s honourable discharge occurred in December 1945. I waited patiently for six months, not expecting that the NPRC would have salvaged much of my father’s records. When I finally received the return package in the mail, the contents showed just how close his records had come to incineration. The photocopies clearly reproduced the singe marks around the edges of his military records. Remarkably, though, some of my father’s wartime data survived.
I learned from them, for example, where my father had served in the US Army on Christmas Day 1942 and New Year’s Day 1943—in a military hospital at Camp Phillips, a base just outside Salina, Kansas. The singed NPRC records showed that as a member of the 319th Medical Battalion, 94th Infantry Division, he had been admitted to the base hospital just before noon on December 25, 1942, with a diagnosis of “pharyngitis catarrhal acute” and a temperature of 102 degrees.2 Not just a severe cold and fever, this bacterial invasion of his chest, throat, and sinuses was more like pneumonia or influenza.* It was so debilitating that he was admitted to the base hospital and confined to bed for most of the next ten days.3 No Christmas or New Year’s pass to Salina for him. The New York–born draftee in his first days as a medical corpsman—just a buck private in training—was himself in need of close medical attention.
Among the other fire-damaged documents enclosed, the record centre also sent details of my father’s service overseas—in particular, some of the actions of his medical unit, the 319th Medical Battalion, between January 15 and March 1, 1945. Previously “restricted,” the dossier was released to me as I pieced together the day-to-day experiences of my father as a wartime medic.
DECEMBER 1943—CAMP PHILLIPS, KANSAS
WHEN THE UNITED STATES entered the Second World War, my father was nineteen. Alex said a lot of his contemporaries volunteered, partly out of eagerness to serve and partly because those who enlisted had a better chance of getting into the branch of the service they preferred, rather than being drafted and told where to serve. He admitted, too, that many joined up seeking some sort of adventure. Nobody in his family was so bloodthirsty as to want to rush overseas to kill Germans, Italians, or Japanese right away. Nor did any of them consider shirking the service. They knew their country’s armed forces would eventually come calling. The husband of my father’s older sister, Jim Chilaris, was drafted and served in the Aleutian Islands. Alex’s older brother, Angelo Barris, answered his draft notice on his twentieth birthday, February 7, 1941, and eventually served with the US Army’s 67th Antiaircraft Artillery in North Africa, Italy, France, and Germany.
“From the time I was drafted in October of 1942,” Angelo said, “besides the odd letter that said, ‘I’m okay. Are you okay?’ I didn’t see my brother again for almost three years.”4
Alex followed suit. As required, on his twentieth birthday—September 16, 1942—Alex registered for the draft. The fall went by and the army didn’t call. He’d heard through the grapevine that if he weighed less than 130 pounds he wouldn’t be accepted. He weighed 125. So he tried a so-called weight-gaining diet of bananas and water. It didn’t help at all. By November he still hadn’t been called up, so he paid the draft office a visit. An exhaustive search for his file ensued, until it was found stuck to the underside of a filing cabinet drawer. For years afterward, his sister Irene chastised him for fussing enough to get his file unearthed at the enlistment office, else he might never have had to go to war.
If the army’s draft system seemed a mystery, my father was equally flummoxed in his attempts to discover the yardstick used for deciding which branch draftees were assigned to. It was pretty clear that a prerequisite—having a medical background, say, or at least an interest in medicine—had little or nothing to do with his being assigned to the medical corps. In his B Company of trainees at Camp Phillips in early 1943, Alex remembered only one or two pre-med students and another who’d worked as a hospital orderly. He came to the conclusion, therefore, that the yardstick was need. In other words, draftees were assigned to units that the army decided were below their prescribed strength, without regard for the trainees’ educational background, civilian experience, or specific aptitudes. Upon Alex’s arrival at Camp Phillips, those assigned to “the medics” reported to one or another of the units comprising the medical battalion—the 319th Medical Battalion—eventually attached to a combat unit, the 94th Infantry Division.
Within a day or two of his arrival, orientation lectures began. These were designed to explain the functions of a medical battalion and, more loftily, the spirit of the medical corps. Another lecture dealt with the meaning of the medical corps, stressing the good fortune he and his comrades enjoyed being in the branch of the army devoted to saving lives. My father wrote later that he took some comfort in the thought that as a medic he wouldn’t be expected to take lives. Not that he was either an outspoken pacifist or a conscientious objector, per se. He claimed he had never given the matter much thought before he landed in the medical corps and was forced to think about the basic function of a soldier, which was to kill. Alex sensed he did not have the “killer instinct” and wondered how many others were of the same frame of mind but who—unlike medics—would have to acquire it.
Tony Mellaci had no better understanding of his posting to Camp Phillips than my father did. Born into an Italian working family in Rumson, New Jersey, Tony recalled living above a garage with his parents and older brother, Lou. The owner of the garage, a New York lawyer, had employed Tony’s father, Frank Mellaci, in the 1930s to tend the surrounding grounds and gardens. With his dad tending the estate vegetable garden and raising chickens and quail, and his mother, Barbara, jarring the produce, Tony said, “my family didn’t really know what the Depression was.”5 Still, the Mellaci elders instilled in both sons the need to be respectful, save their pennies, and study hard. Lou proved to be an A student and graduated second in the University of Pittsburgh’s dental class of 1941. Tony preferred sports to studies, and when the University of Miami invited him for a football tryout, he jumped at it. But in the meantime, the Japanese bombed Pearl Harbor, bringing America into the war, and the New Jersey draft board ordered Tony to report to the US Army at Fort Dix, ending his dream of starring on a college football team.
“What branch of the service do you want to be in?” the receiving officer asked at the New Jersey army base. “Signal corps? Machine guns?”
“I don’t give a damn where you put me,” snapped Mellaci, still smarting from losing out on the football scholarship.
“Okay, wise guy, it’s infantry for you.”6
That fall, instead of heading to Miami, Mellaci was posted to Fort Bragg, North Carolina, for six weeks of basic training, and then sent west. He didn’t know where he was heading until the train stopped in the middle of the country, where he read the station sign for Salina, Kansas. Off the train and into troop trucks, the draftees were transported to Camp Phillips—past the barracks for the rifle companies, Signal Corps, quartermaster’s, reconnaissance, and engineers to the tarpaper huts housing the medical corps. Mellaci figured that his mentioning an interest in teaching physical education in his draft papers had caught their attention, so they streamed him into the medical corps. There, in the winter of 1942–43, he met my father, who hadn’t figured out how they’d chosen him for medics either. But unlike so many of the others streamed into the 319th Medical Battalion at Phillips, Mellaci and Barris at least had a couple of things in common. They had grown up within a few miles of each other in New Jersey and New York; they both loved their Yankees come World Series time; and, at least initially, they had a common enemy.
“Ah, you Rebs,” Mellaci and Barris would taunt the Southerners in camp.
“You Yanks!” they’d shout back.
“What do you guys from the backwoods know anyhow?”7
My father’s wariness around some of his Southern comrades was amplified during a class on blood transfusion. The interaction between the rookie medics and the instructor somehow arrived at a discussion about whether blood could be pure or not. My father wrote that a young man from Alabama wanted assurance that no blood from a black man would ever be mixed with “white blood”; he was concerned lest he ever got wounded or had to administer blood plasma to an American in the battlefield. My father was astonished to learn that, at the time, the US Army did indeed give assurance that no blood from African-American troops would be transfused into whites, or vice versa. That seemed to satisfy the Alabaman’s concern,8 although it surely mystified Alex’s personal code of ethics.
To start with, at least, except for some of the real physicians who’d come from civilian medical practice, few of the draftees had much sense of their new roles in the medical corps. B Company of the 319th Medical Battalion, as my father remembered it, had five officers and some ninety-eight enlisted men. There were three medical corps officers—qualified doctors, who in army parlance would command medical units—and two medical administrative corps officers, non-doctors who were thus relegated to running the ambulance and litter-bearer platoons of the company. The medical battalion consisted of three “collecting” companies, a “clearing” company, and a headquarters detachment, some five hundred officers and men in all. But the finer aspects of becoming medical corpsmen lay ahead. For the newcomers, it was down to the basics in every respect.
“First it was a five-mile hike,” Mellaci remembered. “Then up to ten miles. Then fifteen. And the big test—the twenty-five-mile hike—with full pack, in the heat or the cold in the middle of the country, where there wasn’t a tree to be seen.”9
If the bald prairie wasn’t conducive to hiking, neither were the tarpaper shacks particularly stimulating as classrooms for the novice medical corpsman. And it didn’t seem to matter whether the new draftee was going to end up in the motor pool, as Tony Mellaci did, or orchestrating litter teams, as my father did. Everybody had to know something about first aid and anatomy. And the medical officer in charge of training B Company apparently made no distinction between those in the battalion who were training to administer drugs, dress wounds, and apply splints, and those keeping records, driving ambulances, or cooking meals. Alex recalled an instance when a major entered the classroom in the middle of a map-reading session. No matter, the major was on a mission. He walked up the centre aisle between the desks and chairs and handed out three human bones to three different soldiers.
“Who has the tibia?” grinned the major.
Each of the student medics looked at his piece of bone uncertainly. Then the medics looked at each other and back at the major; none of the three was able to identify if he had the tibia or not.
“Then let’s see who has the fibula,” the major continued.
More silence as the three men gazed at the bones they held with even more ill-disguised incomprehension.
“Speak up now,” said the major, losing his jolly demeanour. “Who has the femur?” But again, no answer came back. Finally, in frustration, the major ordered the three men to identify what they held.
“Tibia?” said one.
“No,” the major barked.
“Tibia?” said the second, holding his bone in the air.
“No.”
“Tibia!” blurted out the third man, holding his up with delight.
“A little late, soldier,” the major admonished. And he lurched at the three men, grabbed the bone samples from their hands, and stomped out of the classroom.10
Another of the vital foundation skills required in preparing medics for war, according to the Camp Phillips trainers, was guard duty. The routine called for the medical corpsman to march along the boundaries of his outdoor post for two hours, have four hours off, and then repeat the process. On an overnight posting that winter, my father recalled, he had the additional responsibility of waking up the officer of the day at six o’clock in the morning to take reveille; that is, to listen to the shouted-out responses of the first sergeants of each company, who would be assembled before the commanding officer (CO) out on the parade ground. That required the sentry on guard duty to wake the officer of the day—a Lt. Swigert—at 5:45 a.m. so that he could arrive on the parade ground in time to take the verbal reports. With that additional responsibility top of mind all night, Pte. Barris conscientiously went to the headquarters building while it was still dark and woke Lt. Swigert. He recalled the officer rising, putting on his boots and heavy coat, and striding out of the building into the still-dark Kansas morning.
“Battaaalion . . . reeeport!” he heard Swigert roar.
There was no answer from the opposite side of the parade ground, where the company sergeants were supposed to be shouting back their status. Nothing.
Swigert repeated the call even more loudly. Even with the wooden door of the headquarters building shut tight, my father could hear Swigert calling again and again, his voice growing increasingly hoarse. Both the officer outside and the private inside were baffled by the lack of response. After five minutes of this painful experience my father realized in horror that it was now 4:55 a.m. In his anxiety to get the lieutenant up in time, he’d misread his own wristwatch and woken the poor man a full hour too early. The officer must have realized the same thing; a few moments later, he appeared in the doorway looking for an explanation.
“Private Barris,” he said, looking at my father in disgust, “the United States Army assumes, perhaps unwisely, that the minimum requirement for a soldier to perform guard duty is that he be able to tell time.”
“Yes, sir. Sorry, sir.”
“Dismissed!”
Perhaps the motto on the crest of the 319th Medical Battalion—Prodesse quam conspici, or “Accomplish without being conspicuous”—was more a rationalization of limited skill than a recognition of selfless service. At least in basic training, Privates Barris and Mellaci and their comrades had left a lot to be desired that winter at Camp Phillips, Kansas. Nevertheless, in just months, their instructors had imparted sufficient knowledge and skill for the draftees to graduate. And later that year the battalion moved to manoeuvres in Mississippi and Tennessee. In name, at least, the army now considered them medics.
JANUARY 11, 2007—MASUM GHAR, AFGHANISTAN
AS A GREEN PRIVATE in basic training in the infantry—fifty years later—Jody Mitic had an attitude toward medics that was pretty common among newcomers to the Canadian Armed Forces, in which he served. He and the others looked at medical personnel, at least during their basic training, as a necessary inconvenience. Medics regularly inspected the recruits’ uniforms and their barracks for bugs. Often they went even further, checking the soldiers’ feet, underarms, and crotches, looking for rashes or fungus or worse. Mitic recognized that the medics’ hearts were in the right place. When they got a chance to talk to the recruits, the medics asked how they were feeling. Were they getting enough sleep, sufficient food? Still, at that stage of his young military career, Jody Mitic generally dismissed medics who seemed purely interested in the troops’ well-being. They were “kind of like your mommy,” he wrote, even if they happened to be men.11
Cpl. Mitic’s view hadn’t changed a great deal through his time in the militia, or even after he joined the regular army in 1997, when he was twenty. As a combat soldier, he considered it his job to be tough, to dismiss any discomfort, even if he actually had blisters running the entire length of his foot, churning guts, or a rash on his backside. It was a matter of turning the other cheek, so to speak. After his first full deployment overseas, when he came home to take specialized training as a basic reconnaissance patrolman and then a basic sniper, that sense of mind over matter took on even greater significance. During sniper training, for example, Mitic learned that the job wasn’t just about marksmanship. Being a capable sniper meant more than proficiency on the shooting range, making an accurate shot at 6,500 feet. It demanded that a marksman on a mission, almost as an involuntary reflex, could deny his own needs and put the mission first. As Mitic put it, if occupying a two-man snipers’ position required him to “sit in a hole, get rained on, not eat, piss on each other, and still make an accurate shot four days later,” so be it.12 The objective of the mission trumped just about everything. And coincidentally, if it meant hiding an injury or malady from medical personnel along the way, well, suck it up.
Mitic gained a grudging respect for the medical side of soldiering during his first operational tour of duty in Afghanistan, as part of Task Force Kabul at Camp Julien. In the fall of 2003, an Iltis Jeep containing three fellow Royal Canadian Regiment (RCR) troops ran over a land mine. Two of the occupants—Cpl. Robbie Beerenfenger and Sgt. Robert Short—died immediately in the explosion; they were the first Canadian soldiers killed by enemy fire in the post-9/11 Afghanistan mission. Meanwhile, the driver, Cpl. Thomas J. Stirling, was rushed into surgery. Afterward, Mitic and other members of the mission visited him to offer moral support. Not only was Stirling the first comrade-in-arms Mitic had ever seen injured by a land mine, he was also the first casualty Mitic had ever seen. As Mitic explained in a memoir several years later, with his buddy conscious, there was time for small talk among fellow Royals and even a chance to give Stirling a few puffs on an (illegal) cigarette.* Oddly, it wasn’t the smell of the cigarette smoke that remained in Mitic’s nostrils.
“I took in every detail,” Mitic said, “what it smells like when someone’s been wounded as badly as he was and the look in his eye. And the swelling in his face; his teeth had been all smashed by the concussion of the explosion. . . . You need to see that. The first time shouldn’t be when you’re putting your buddy in a body bag.”13
That “wounded” smell would indeed come back to Mitic, on his next deployment three and a half years later. After the improvised explosive device (IED) incident in October 2003, there would be numerous similar attacks against Canadian troops by the Taliban—one in 2004, six in 2006. With another sniper course behind him and a promotion to master corporal on his record, Jody Mitic returned to Afghanistan in August 2006 for a second tour of duty. This time, however, M/Cpl. Mitic arrived at the Canadian base at Kandahar Airfield as part of an elite sniper team. The group participated in several different missions—Operation Rocket Man to track down Taliban targeting the airport with rockets, and Operation Medusa attempting to push the Taliban out of Panjwaii district—partnering with Joint Task Force troops. His sniper team included Barry, whom Mitic called “a real soldier’s soldier,” Kash, “a laid-back Jamaican killing machine,”14 and Gord, who joined Mitic later on the tour in a stakeout during which all they tangled with was a mouse that ran up Gord’s leg. Any levity on that tour ended in the middle of the night on January 11, 2007.
That night, about 3:30 a.m., the sniper team left a friendly position called the “Ant Hill” near Masum Ghar to set up sniping positions in a village before daybreak. En route, the foursome came to a doorway that would give them easier access to the village. At intervals about thirty feet apart, the snipers moved through the darkness up to and through the opening, each assuring the next in line that the way was clear. Mitic was the last of the four to reach the doorway, stop, let the man ahead advance, and then step ahead himself. As his next step touched the ground a fireball erupted in front of him—a land mine.15 Mitic remembered being airborne and weightless for a moment, and then hitting the ground and blurting out “oh my God” several times. His foot had triggered a mine “about the size of a hockey puck”16 that accomplished only half of what was intended. The explosion blew off Mitic’s right foot. It also triggered a second explosion—a mortar shell beneath the mine. Had any of the three men ahead of him stepped on the initial mine, the additional mortar shell would likely have severely injured or killed those following. But since he was bringing up the rear, the mortar shrapnel cost Mitic his other foot too.
As soon as the rest of the patrol realized the explosion wasn’t the start of a Taliban ambush, they launched into rescue mode. One began first aid, applying a tourniquet to Mitic’s leg and wrapping his wounds, while another pulled the radio from Mitic’s pack and called for a medical evacuation.
Mitic remembered the next hour as “the longest of my life,” trying to stay conscious and calm so as not to go into shock.17 Not surprisingly, he worried aloud about the extent of his injuries and how far up his body the explosion had inflicted damage. The thought crossed his mind that no one on the sniper team had bothered to take a tactical combat casualty care course in first aid. He even flashed back to the 1970s TV show M*A*S*H, in which the Alan Alda character, Hawkeye, would tell his wounded patients not to gulp down water. But the realities of the situation—it was the middle of the night, some distance from actual medical assistance, and an even greater distance to where a chopper could land and then fly him out—began to play on his thoughts even more. A recce platoon arrived with a medic, who applied more tourniquets—he now had three on each leg—to reduce the amount of blood Mitic was losing. In response to the pain Mitic was feeling, the medic administered a shot of morphine. Minutes later, because he couldn’t feel any difference, Mitic demanded another. The medic hesitated but then, unsure of Mitic’s chances, gave him the second dose. Then Mitic became aware of a new player on the scene. He recognized a voice from the base.
“What’s going on here?” the female voice asked. “Give me an update.”
The leader of the recce platoon responded: “It’s all good. Our medic has it under control.”
“That’s great,” said the female voice, “but I’m taking over from here, so I need an update.”
This wasn’t about pulling rank and it wasn’t about machismo. This was about situation awareness. M/Cpl. Alannah Gilmore needed to know details of the injury, that tourniquets had been applied, and what medication Mitic had received: tactical combat casualty care—what every infantry soldier in theatre is supposed to know, but certainly medics. Gilmore discovered that the medics at the scene did have things under control; they’d stopped the bleeding on both of Mitic’s legs, packed the wounds, and done their best to prevent the patient from slipping into shock.
“I heard the patient talking,” Gilmore said. “My focus, as soon as I hear someone talking, is breathing. Good, he’s conscious. But my brain has moved on. I’m thinking, ‘What more does he need? How do I get him out of here? Where do I have to go?’ My job is extrication, getting him to a safe landing zone for evacuation. That’s my priority.”18
It was going to be complicated. Just getting to the Ant Hill had been a challenge. An armoured bulldozer, called a Badger, had literally plowed a roadway into the site—with a light armoured vehicle (LAV) and Gilmore’s Bison ambulance following—in total darkness. Next, the medical response team would have to retrace that drive to a landing zone. By the time the Bison reached the chopper, Gilmore had put an IV into Mitic’s arm and prepared him for air evacuation to Kandahar Airfield.
“I felt awful,” Gilmore said, because she knew what the loss of both legs below the knee would mean to Jody Mitic’s soldiering career. “But I wasn’t fearful. You’re running on such a level of adrenaline. It’s constant. The whole time you’re in react mode.”
Despite this natural adrenaline, in Alannah Gilmore’s case there was much more at work. First, she’d acquired a healthy sense of self-confidence; she said that operating in a male-dominated environment suited her perfectly. She’d grown up with two older brothers, while her father, Maj. Ben Gilmore, had served thirty-four years in the Canadian Forces with the Royal Canadian Regiment. She’d trained as a gymnast, excelled at dance, and at age seventeen had visited an army recruiting centre to inquire about service in the reserve; at the E.J.G. Holland VC Armoury in Ottawa they had a medical platoon, so on weekends and one other night of the week she trained as a medic. And she learned to deal with the unspoken suggestions that as a woman she’d be slower, weaker, or a liability to the platoon.
“I had to work a heck of a lot harder to prove my ability,” she said, “but I always loved the challenge.”
By 1999 she’d completed post-secondary education, gone to Japan to teach ESL, and come home to enter Canada’s regular armed service. But she never stopped upgrading her medical skill set; as a medical technician in the army, she took courses and instructed others, all the while acquiring what she called “muscle memory” on the job. In 2003 the army deployed her “as the mini doc” to Alert, Nunavut, about 460 miles south of the North Pole. Naturally she dealt with seasonal affective disorder and frostbite, but on the base they also trained for the possibility of a fire or a plane crash.
Gilmore treated every aspect of her work as a way to sharpen her ability to react without having to think. The less she felt she had to rely on what her head told her hands—the greater her muscle memory—the more effective her ability to react to anything new. By the time the army deployed her to Afghanistan in 2006, M/Cpl. Gilmore was bringing all her innate and acquired skills—her competitiveness, her thirst for knowledge, her leadership, her muscle memory—to the job of saving lives in a war zone.
During the first weeks of September that year, the 1st Battalion of the RCR battle group led an offensive against the Taliban in Panjwaii to establish government control over that area of Kandahar Province. Operation Medusa tested the mettle of both the front-line troops and the support units, including M/Cpl. Gilmore’s Bison ambulance crew. Stationed at a command post known as Patrol Base Wilson, Gilmore was now crew commander in the Bison, assisted by junior medic Dave Pridham and driver Kurt Nelson.
Right after they joined the operation, her crew received a LAV full of patients who’d sustained shrapnel wounds from a rocket attack. Working with an officer, Gilmore triaged the five wounded, their mantra being identify, recognize, treat. At the same time, Nelson, her script, made note of casualty names and medical information, while Pridham and the rest of the medical team checked vital signs, cleaned wounds, set up IVs, and administered painkillers. It was the first time they’d faced a “mass cals” situation, but whether it was individuals or “mass casualties,” the principle was the same.
“I didn’t have to think about it; it just happened,” she said. “I just calmed right down and did what I had to do. I was doing muscle memory.”
Gilmore and her crew took a three-week leave during their tour, but when they returned to duty, their enemy had introduced a new array of weapons and methods of attack. The Taliban were now packing civilian vehicles with explosives and detonating them where people gathered, or using children as suicide bombers and secondaries; in other words, one suicide bomber would set off a device and a second would wait for a crowd to gather and set off another one in the same place. As well, setting IEDs and laying land mines had become the Taliban’s tactics of choice. Sniper Jody Mitic had triggered one such land mine at the Ant Hill that night in January 2007 —dispatching medic Alannah Gilmore to treat and extricate him to the landing zone for safe evacuation.
Despite his semi-conscious state, M/Cpl. Mitic remembered hearing the unmistakable sound of a Black Hawk medevac helicopter and being lifted aboard.
“These American medevac guys are highly trained,” Mitic said later. “They’re called air rescue. If they have to, when they land, they will go into a gunfight to extract you. That’s how hard-core these guys are. Then you’re into a helicopter and it’s basically like a flying surgical room.”
With another IV line in him as the medevac helicopter flew toward Kandahar Airfield, about twenty minutes away, Mitic felt revived enough to carry on a conversation with the flight surgeon. And he obliged, keeping Mitic engaged and talking about Afghanistan, the war, anything to distract him until the chopper arrived at the base, where he was rushed into surgery. As they wheeled Mitic into the operating room, the medical team passed him a phone to call his parents back in Canada, to let them know what was happening and that he’d be okay. It was only on the other side of the anesthesia and surgery, hours later, that he learned the OR surgeon had had to remove both feet. Mitic recognized that the decision had not been easy, but that, in the surgeon’s view, amputating both limbs below the knee would give Mitic a fighting chance to function one day on two roughly similar prosthetics.
It didn’t take M/Cpl. Mitic long to begin thinking ahead—perhaps more optimistically than most—about getting home, doing some rehabilitation, acquiring a set of prosthetic legs, and, after some rehabilitation, getting redeployed to Afghanistan for another tour of duty. “After all,” he said, “most prosthetics for legs, besides what they’re made of, they’re almost the same design as they were during the Civil War. Now they’re carbon fibre and stainless steel . . . Back then it was wood and plaster.”
He was right. Prosthetics had not changed much in their functionality since the war between the northern and southern states. But everything else had. In 2007, M/Cpl. Mitic had the evolution of nearly 150 years of military medicine to help save his life in the field, get him to an operating theatre to repair catastrophic damage to his lower body, and then facilitate his physical and mental recovery to relative normalcy. In the 1860s, wounded soldiers might never make it off the battlefield.
DECEMBER 13, 1862—FREDERICKSBURG, VIRGINIA
IN A SPACE barely large enough to erect a small block of downtown buildings, about 8,000 soldiers of the US Federal Army were killed outright, maimed, or died of wounds in the hours after just one battle. In that space—about six hundred yards west of the mid-nineteenth-century city of Fredericksburg, Virginia—the open ground features a gentle incline rising to about forty or fifty feet above the town, known as Marye’s Heights. As fog lifted from the area on the morning of December 13, 1862, Union Maj. Gen. Ambrose Burnside launched what he considered a diversionary attack toward a four-foot-high stone wall with an impromptu trench and sunken road behind it. From relative safety behind that wall, about 2,000 Confederate troops, under Gen. Thomas Reade Rootes Cobb, stood four ranks deep. They poured down continuous rifle fire, while from higher ground 3,000 more men in reserve and artillery rained shells on the advancing Federals. Attempting to make his way over about a half-mile of open field to his enemy’s lines, a Union soldier recorded that he and his comrades ran forward “as though breasting a storm of rain and sleet, our faces and bodies being only half-turned to the storm, our shoulders shrugged.”19 Confederate artillerist Edward Alexander told his superiors before the battle, “We cover that ground now so well . . . a chicken could not live on that field when we open on it.”20
He was right. In one hour, the Union Army of the Potomac lost nearly 3,000 men. Still the madness of the Union assault continued. Through the afternoon, no fewer than fifteen Union brigades attempted charges against Marye’s Heights. Not a single Northern unit reached the stone wall. That day the Southerners recorded fewer than 1,200 casualties,* but that included the death of Gen. Cobb. That December evening, as the sun set, the temperature dropped, and some light snow fell on the battlefield, thousands of Union wounded lay out in the open within range of Confederate guns. American poet and journalist Walt Whitman later met a survivor at a hospital in Washington, DC.
“He got badly hit in his leg and side,” wrote Whitman, then a Civil War hospital volunteer. “He lay the succeeding two days and nights helpless on the field between the city and those grim terraces of batteries; his company and his [Pennsylvania] regiment had been compell’d to leave him to his fate.” Unable to move because of his wounds, the rifleman was forced to spend nearly fifty hours lying with his head facing downhill. Just when the scenario seemed at its worst, the Pennsylvanian awoke in this no man’s land to find a man leaning over him. “Moving around the field among the dead and wounded,” Whitman continued, “[he] treated our soldier kindly, bound up his wounds, gave him a couple of biscuits, and a drink of water.” Remarkably, the Confederate soldier knew enough about first aid not to move the Union soldier, else blood that had clotted might burst from his wounds. In his journal, Whitman referred to the benevolent soul as “this good Secesh,”21 or Secessionist. He was, in all likelihood, Sgt. Richard Kirkland.
The day after the Union attack on Marye’s Heights, Confederate Gen. J.B. Kershaw sat in a makeshift headquarters in an upstairs room of a farmhouse about 150 yards behind the sunken road and stone wall. From his vantage point he could see most of the half-mile of fields over which nearly 8,000 Union troops had dashed in vain to reach the sunken road where Kershaw’s brigade had stood its ground. In a memoir about the aftermath, Gen. Kershaw recalled that a soldier had suddenly arrived in his office with “an expression of indignant remonstrance.” The nineteen-year-old wore the insignia of the 2nd South Carolina Volunteers.
“What is the matter, Sergeant?” the general asked.
“General, I can’t stand this,” Kirkland blurted out. “All night and all day, I have heard those poor people crying for water. . . . I come to ask permission to go and give them water.”
“Don’t you know that you would get a bullet through your head the moment you stepped over the wall?”
“I know that,” Kirkland said; he was a veteran of battles at Manassas, Savage Station, Maryland Heights, and Antietam.22 “But if you will let me, I am willing to try it.”
The general paused a moment and said, “I ought not to allow you to run a risk, but the sentiment which actuates you is so noble that I will not refuse your request.”
According to Kershaw’s account of the dialogue, the sergeant stopped on the stairs outside his office. Kershaw listened in case Kirkland might have changed his mind. Instead, the young sergeant called out a final request.
“General, can I show a white handkerchief?”
“No, Sergeant, you can’t do that,” Kershaw said definitively.
“All right,” Kirkland said. “I’ll take my chances.”23
In the next few minutes, Kershaw and some of his South Carolinian comrades watched “with profound anxiety” as the sergeant filled as many canteens as he could carry. Then, shortly after noon on December 14, Kirkland stepped over the stone wall that had been witness to the worst one-day carnage of the Civil War to that point and moved to the first wounded Federal soldier. Some reports said that when troops on the Union side saw the Confederate sergeant out in the open, several took shots at him, but they were too distant to be effective. And once they saw Kirkland cradling the first of the wounded and offering water, they ceased firing. Sgt. Kirkland’s mission of mercy went on for ninety minutes. He tried to deliver blankets to as many as he could and made certain every wounded man’s cry for water was answered. Kirkland later died at the Battle of Chickamauga and was buried at his family’s White Oak plantation in South Carolina.*
In 1965, a sculpture by Felix de Weldon was unveiled in front of the stone wall at Fredericksburg where Kirkland had performed his humanitarian act.24 “At the risk of his life, this American soldier of sublime compassion brought water to his wounded foes at Fredericksburg,” the inscription beneath the sculpture reads. “The fighting men on both sides of the line called him the Angel of Marye’s Heights.”
Despite the compassion shown by Sgt. Kirkland in front of that infamous stone wall, the odds did not favour survival for a soldier wounded in the American Civil War. In spite of the availability of qualified battlefield medical officers and limited anesthetics, some of the most inhumane conditions awaited troops injured in combat as they were transported from the battlefield and attended by surgeons behind the lines. Ambulances consisted of little more than crude wagons, and they were generally overflowing with wounded men being tossed about like rag dolls; the civilian drivers had no battlefield experience and often bolted from the scene without bringing out the wounded.
And if transport to field hospitals wasn’t detrimental enough, the treatment, considered the realm of military surgeons, proved little better. Even though the opposing armed forces claimed extraordinary numbers of surgeons in their ranks, most of them had little experience treating gunshot wounds, nor had they conducted battlefield surgery. Of some 11,000 physicians in the service of the Union, only five hundred had actually performed in-theatre operations; of the 3,000 doctors serving the Confederacy, only twenty-seven had operated on wounded soldiers. The medical men signed up for army service were often political appointments or “quacks” admitted by ill-informed medical boards.25 Too often, that meant a surgeon, sometimes with less than two years’ experience, learned how to operate on the job. The patients paid the price.
The Civil War infantry used the cylindrical soft lead, slow-moving Minie bullet in their muskets. At 1,000 yards, such projectiles had the capacity to kill, due to the gaping holes, shattered bones, shredded muscles, and torn arteries they inflicted on a victim. If a soldier took a Minie ball to the head or torso, doctors would not expect him to live. When the roughly .58-calibre bullet hit a man in the gut, it tore intestines or other internal organs irreparably; when it struck a limb, it expanded, crushing or smashing a man’s bones, leaving doctors little alternative but to amputate. When army statisticians got around to tallying battlefield injuries, they concluded that nearly three-quarters of all wounds occurred to soldiers’ extremities, their arms and legs. Amputation became the most common procedure performed by Civil War surgeons.
Among the Union commanders serving in the Army of the Potomac in 1862 was a former journalist and future senator of Missouri, Gen. Carl Schurz. Amid his eloquent accounts of courage and prowess on the battlefield, he found space in his memoirs to include scenes behind the front lines, where the wounded fought for their lives on the operating tables of military surgeons—hell on earth.
Schurz admitted to becoming conscious of a strong sympathetic emotion to the scenes of death and dying before him. Suddenly he heard the moans and exclamations of the men going under the knife. He noted “the stretchers coming in dreadful procession” to operating tables placed out in the open, where the light was best, or occasionally protected from the elements by blankets stretched over poles. There beside their medicine chests and piles of bandages, Schurz depicted the surgeons, “their sleeves rolled up to their elbows, their bare arms as well as their linen aprons smeared with blood, their knives not seldom held between their teeth, while they helped a patient on or off the table.” His gaze caught the heaps of cut-off legs and arms and “the beseeching eyes of the dying boy who, recognizing me, says with his broken voice: ‘Oh, General! Can you not do something for me?’ And I can do nothing but stroke his hands and utter some words of courage and hope, which I do not believe myself. I feel a lump in my throat which almost chokes me.”26
Despite the horrific conditions Gen. Schurz described, there was actually more to offer those beseeching eyes and dying pleas than ever before. Remarkably, a revolution in military medicine was about to begin on the very battlefield where Union wounded languished that cold December night in 1862. In May of that same year—for the first time since he’d been posted to serve as a full surgeon and major in the Army of the Potomac—Jonathan Letterman had successfully gained the attention of the US War Department and the military brass leading the Army of the Potomac. His painstaking work gathering data on casualties and crafting the logistics of a medical response, as well as his resulting recommendations, were about to get a chance to prove themselves—and perhaps save lives.
Later described as “the father of battlefield medicine,” Letterman had followed in his father’s footsteps as a civilian surgeon, gaining his medical certificate in 1849. But Letterman had also passed his exams at the Army Medical Board, which promoted him to officer in the field and assistant surgeon behind the lines. Between 1853 and 1860, Maj. Letterman received his baptism of fire as a surgeon during US military campaigns against the Navajo, Gila Apache, and Pah-Ute bands in the western and southern US territories. However, from the moment of his installation as a full surgeon and major in the Union Army, his attention shifted to the woeful conditions of field medical care, inadequate supplies of medicine, jury-rigged hospital facilities, and insufficient numbers of qualified medical officers. During the Peninsula campaign in the spring and early summer of 1862, the Union’s Army of the Potomac had sustained unprecedented casualties—as many as 27,000 killed, wounded, or missing—attempting to capture the Confederate capital, Richmond, Virginia. In the wake of such carnage, as the newly installed medical director of the Army of the Potomac, Maj. Letterman had to find a better way to deal with the wounded. “To accomplish [this],” he said in his report, “the entire system then in vogue must be abolished.”27
In August 1862, based on his analysis of the campaign and his template for change, Maj. Letterman introduced a new and far more qualified medical player to the Civil War battlefield, the field ambulance. His Special Orders No. 147 document offered a template for saving lives: an ambulance corps and the management of ambulance trains. In the revised system, all ambulances came under the control of the medical director (in this case Letterman). His principal initiative was to introduce non-physician officers—captains, lieutenants, and sergeants—to command ambulance units, to relieve physicians from duties that distracted them from the primary mission of patient care and to give higher priority to attending to the needs of the wounded. In addition, the Letterman plan assigned vehicles to the direct control of the medical director, three for each infantry regiment, two for each cavalry regiment, and one for each artillery battery. Only medical personnel were permitted to accompany the sick and wounded to the rear, and only patients were allowed to ride in the ambulances.
A Union Army chaplain, recognizing the seismic shift in control over the wounded, described Letterman as “virtually a medical dictator.”28
Following the implementation of Letterman’s field ambulance concept, the Army of the Potomac accepted and implemented his subsequent recommendations for field hospitals too. In October 1862, Letterman’s directives assigned a field hospital to each division, each housing a surgeon to provide food and shelter and an assistant to keep records. Each facility would include three medical officers to perform operations and another nine medical officers to assist the three. In addition, an administrative staff was responsible for pitching the hospital tents; providing straw, fuel, water, and blankets; and organizing kitchen facilities with staffs of hospital stewards, nurses, and cooks assigned to each. Staff would also triage to determine the expediency and character of serious operations and record interment of the dead (complete with a headboard showing name, rank, and company “legibly inscribed upon it”). Letterman accounted for discipline, guard duty, inspection, regular reporting, and medical service to enemy wounded. “These institutions,” Letterman commented in his memoirs, “were the first of the kind attempted in this country.”29
The efficiency and efficacy of Letterman’s concepts were borne out in the major Civil War battles that followed in the fall of 1862 and into 1863. Even though the Battle of Antietam, on September 17, 1862, resulted in 23,000 casualties—the bloodiest single engagement of the war to that point—the field ambulance and field hospital system managed to remove and attend to all of the wounded within twenty-four hours. At Fredericksburg, even as the Union troops fell by the hundreds attempting to overrun the stone wall, Maj. Letterman supervised as his medical officers set up field hospitals in sheltered areas along both banks of the Rappahanock River, easily within cannon shot of the Confederate artillery. Nevertheless, he ensured that each field location had three operating tables, as well as surgeons, attendants, instruments, and dressings “all arranged with order, precision, and convenience rarely excelled in regular hospitals.”30
Letterman recognized the futility of the assault but marvelled at the enthusiasm of his field ambulance medics as they recovered and carried the wounded to the riverside field hospitals as quickly as stretcher-bearers could move them. He noted the difficulty his corpsmen faced after dark on December 13, since “they could not use their lanterns, as the glimmer of a candle invariably called forth a shot from a sharpshooting picket; they were obliged to grope their way and search for their wounded comrades, who lay on the field covered by the fire of the enemy’s musketry. . . . The officers and men of this corps persevered so well, that before dawn all the wounded were taken to the hospitals prepared for them in the rear.”31 Maj. Letterman’s novice ambulance corps managed to process almost 10,000 wounded during three intense days of close combat at Marye’s Heights.
Among the lessons Letterman delivered between the lines of his Special Orders recommendations was the paramount need for sanitation among procedures of the field ambulance corps, and even more so at the field hospitals. For every Civil War soldier who died in battle there were two who died of disease; on the Union side 620,000 troops died in total, and 250,000 of them died from disease.32 The unsanitary conditions of the campsites, sleeping quarters, kitchens, and overcrowded hospitals bred all manner of disease, including malaria, typhoid, scurvy, pneumonia, smallpox, measles, skin infections from mosquitoes and lice, and intestinal infections; dysentery and diarrhea on their own killed more men during the Civil War than did battle injuries. In his reports to the chief army surgeons that same autumn of 1862, Letterman noted that the sick soldiers in the Army of the Potomac numbered 200,000 men, or 8 percent of the force. Early in 1863 Letterman called for a hospital in Washington, DC, dedicated to attending the Army’s sick soldier population.
Volunteer hospital worker Walt Whitman witnessed this carnage during his regular stops along “hospital row” in Washington, DC. On the afternoon of July 22, 1863, Whitman visited with Oscar Wilber, who’d served with the 154th New York Volunteers at the Battle of Chancellorsville. Along with a fractured femur, chronic diarrhea had left the young soldier bedridden. During one of several visits, Wilbur asked Whitman to read from the New Testament. Whitman wondered which passage.
“Make your own choice,” the patient said.
Whitman chose to read chapters describing the final hours of Christ’s life and the scenes of the Crucifixion.
The New Yorker asked Whitman to go on to the following chapter, when Christ rose again. Tears welled in his eyes as Whitman finished the passage. Wilber and the young volunteer spoke about death.
“Why, Oscar, don’t you think you will get well?” Whitman asked.
“I may, but it is not probable,” he said. He talked about his wound, but more so about the diarrhea that had prostrated him. Then Wilber gave Whitman the address of his mother in Cattaraugus County, New York.
Whitman gently embraced and kissed the man, who returned the affection. But it was the last time they saw each other. Wilber died a few days later of the diarrhea and infection from his wound.33
If the blow of the wound didn’t kill a soldier, then in many cases spreading infection would. Since doctors often took over barns to function as hospitals, and since the battles took place in farmers’ fields enriched by animal manure, the majority of battlefield wounds became infected. Often the field surgeons did have anesthesia, in the form of ether or chloroform administered via a soaked cloth placed over the patient’s nose and mouth. But at best the surgeons probed battle wounds with their fingers, used knives repeatedly as scalpels, and performed operations in coats smeared with what doctors called “laudable pus,”34 whose appearance they calculated was a good sign. However, pus in a patient’s blood—or blood poisoning—usually triggered fevers and gas gangrene. Without oxygen present, bacillus microbes from manure or other toxic sources quickly multiplied and mixed with severed blood vessels, shattered bone, and ripped muscle tissue to form a septic swill bubbling up like gas in a wound, turning green in the process. Gas gangrene proved as much a killer as any Minie bullet or piece of cannon shrapnel. If patients survived the operating table under these conditions, they still might face deadly surgical fevers and agonizing pain until they died. A full three-quarters of those whose limbs were amputated in the Civil War died of complications from infection.
Despite the experience that nearly a year under his new field ambulance/hospital system gave him, what may have been Maj. Letterman’s greatest test came in the summer of 1863, as the Confederate and Union armies clashed at Gettysburg, Pennsylvania. With the battle looming, Letterman faced problems he thought he’d solved in previous campaigns. Maj. Gen. Joseph Hooker, Burnside’s replacement as commander of the Army of the Potomac, appeared to commandeer Letterman’s ambulance corps wagons for his own supplies, tents, and manpower. The ambulance corps also lost access to rail transport and had most of its supplies sent to the rear of the battle formation, in lieu of ammunition and artillery transport. In Letterman’s view, “this order would deprive the department almost wholly of the means for taking care of the wounded until the result of the engagement was fully known.” What wasn’t fully known, until the Ambulance Corps arrived on July 3, was that the battle had caused 22,000 casualties. And when “Camp Letterman” finally opened its medical-aid campsite about a mile from Gettysburg, the doctor who had so thoroughly reconfigured ambulance and hospital services in his army faced what he called “a field of blood, on which the demon of Destruction revelled.”35
Nevertheless, in the middle of it all, Letterman’s reorganized and rejuvenated medical corps soldiered on. Letterman’s legion of ambulance corpsmen—some 650 of them—rushed to their field positions right behind the front-line fighting and led their ambulance crews through the next three days and nights, some of them fainting from exhaustion and overexertion.
“The ambulance corps throughout the army acted in the most commendable manner during those days of severe labor. Notwithstanding the great number of wounded, amounting to 14,193 . . . from my own observation . . . not one wounded man of all that number was left on the field within our lines early on the morning of July 4,” Letterman reported. “The corps did not escape unhurt; one officer and four privates were killed and 17 wounded while in the discharge of their duties. I know of no battlefield from which wounded men have been so speedily and so carefully removed.”36
Camp Letterman had attended not only to all of the Union wounded, but also to the Confederate, numbering 6,802; the total attended to was 20,995 wounded.
In January 1864, at his own request, Jonathan Letterman was relieved of his position as medical director of the Army of the Potomac, and his connection with the army ceased. He offered a summary of his feelings about the work completed in his Medical Recollections of the Army of the Potomac. He wrote that his time with the army had proven to be arduous and eventful, yielding friendships with the best and the bravest comrades on the road to restoring peace and the Union. “But whether the grass grows over them, or they are wanderers, far from the scene of their perils and victories,” he concluded, “those who labored together with but one heart, in their country’s hour of agony, will live among [my] many memories.”37
In March 1864, Brig. Gen. William Hammond, the War Department surgeon general who had appointed Letterman to come up with logistical solutions for evacuating the wounded, shared the limelight with the “medical dictator.” Petitions and lobbying efforts had finally moved Congress to establish a permanent ambulance corps in the US Army. The law authorized corps commanders to direct officers and enlisted soldiers to form ambulance organizations and ensured that boards of medical officers would search long and hard to find ambulance corps candidates to “at least equal the best of the fighting men in gallantry.”38 The War Department also issued a directive giving commanders the authority to create a distinctive ambulance corps uniform.
THROUGH THE NINETEENTH CENTURY and into the twenty-first, Jonathan Letterman’s protocols have persisted. They dictated the way Second World War medical corpsmen evacuated a war zone in the Rhineland and they provided for the rapid high-tech removal of IED victims in the war in Afghanistan—with the equivalent of a surgical theatre at the flight surgeon’s disposal.
It’s safe to say that, innovative as he was, Jonathan Letterman could never have imagined Jody Mitic’s evacuation from Masum Ghar; that scenario would have been beyond my father’s comprehension as well. But it’s just as unlikely that my father or Mitic were aware of how much they owed to Maj. Letterman’s innovations.