NAVY MEDICINE May-June 2001 Surgeon General of the ~ny ~BUMED NAVY MEDICINE VADM Richard A. Nelson, MC, USN Vol. 92, No. 3 May-June 2001 Deputy Surgeon General Deputy Chief, BUMED RDML Donald C. Arthur, ~C. US~ Department Rounds Editor 1 New Laser Vision Center Opens at NNMC Jan Kenneth Herman LCDR Ed Austin, USN

Assistant Editor Features Janice Marie Hores 3 New Medical Department Flag Selections

Book Re\iew Editor 6 NAMRU-3 and the 1967 Egyptian-Israeli Conflict LTY.H.Aboul-Enein, MSC, USN CAPT Donald C. Kent, MC, USN (Ret.)

10 "Navy Medicine at Normandy" Release JK.Herman

12 Patient and Rescuer .\:~IT MEDICI.\£. Vol. 92. ;>;o. 3 (ISS~ OS95-8~11 USPS 316-070) is pubhshed bimonthly b) the John F Fenwick, Jr. Department ofthe :"a')· Bureau of~tedicine and SurgCI) (<,tEI).{)')HI. \\a..hmgton. DC ~03n-5JOO . Periodzc-al postage pa1d at \\ashington. DC. 21 Disaster Relief and the Navy Entomologist POSP.\IASTER: Send address changes to ;>;a,y LCDR David M Claborn, MSC, USN Medzcme. Bureau of ~tedicine and Surgery. AlTS; MED-0911. 2300 E Street :'•iW, Washington. DC 20372- 5300. 24 Birth of the Helo Deck POLICY: Sa')' .\fedzcme is the official publication VADMJoelT Boone, MC, USN of the :"a\> !\.tedical Deparunent. It is intended for ~tedzcal Department personnel and contains professtonal mformation relati'e to medzctne, denlistf>. Book Review and the alhed health sciences. Opmions expressed are 28 The President's Doctor: An Insider's View of those of the author.. and do not necessanly represent the official position ofthe Department of the :"a'), the Three First Families Bureau of Medzcine and Surgery. or any other Janice Marie Hares go' ernmental deparunent or agency. Trade names are used for identzfication only and do not represent an endorsement b) the Department of the :-;a, y or the A Look Back Bureau of ~tedictne and Surgery. Although \'ary· .\fedirine may cne or extract from directi\es, authoril) 29 Navy Medicine 1953 for acuon should be obtained from the cited reference. DISTRIBUTJO~ : \my .\fetlicmc ts dzstributed to acti\ e duty ~ted zeal Depanment personnel 'ia the Standard ~a\) Distribution List. The follo\\lng distribution" authorized: one copy for each ~ted~e-al, Dental, Medical Semce, and :-.;urse Corps officer; one copy for each I 0 enlisted ~ledical Deparunent members. Requests to mcrease or decrease the number ofalloned copies should be fornarded to Xm)' ,\fedzcme \ ia the local command. ,\ :~IT MEDICI.\'£ IS published from appropriated funds b> 3Uiboril) ofthe Bureau o~lediClnc and SurgCI) m accordance "ith :\a\') Pubhcauoos and Pnnting Regulations P-35. The Secretary of the :-;a\) has determmed that this publicauon is neces5ar) in the transaction of business required b) Ia" of the Department of the !\a,y. Funds for prinllng thzs publication haH been appro\Cd by the !\a') Publications and Pnnting Policy Commmce. Anicles, leners. and address changes may be fornarded to the Editor, Sa•y Medicint!. Bureau of ~1edictne and Surgery, ATT:-.;, <,tED-09H. ~300 E Street !\W. COVER: "I came ashore right here." 6th Naval Beach Battalion veteran \\aslungton, DC ~oJn-5300. Telephone (Area Code 20~ I 762-324S 46: DS:-.; 76~- 3~48 46. Conlllbutions Dr. Lee Parker describes the landing on Omaha Beach to Navy Medical from the field arc "dcome and will be published a. space Department Historian Jan K. Herman. The Bureau ofMedicine and Sur­ perm1ts, subject to edmng and posszble abndgment. For sale by the Superintendent ofDo<:uments. U-'i. gery will soon release the second video in the series on Navy medicine GO\ernmcnt Pnnung Office. Washington DC ~040~ . in World War II. Story on page 10. Photo by John Lewin.

!liAHtED P-5088 Department Rounds

New Laser Vision Center Opens at NNMC

LCDR Ed Austin, USN

he National Naval Medical Center (NNMC) opened a laser refractive surgery center under the TNavy's Corneal Refractive Surgery Program, which makes the surgical procedure available to active duty Sailors and Marines. The new facility, located in the Ophthalmology Clinic at NNMC, started screening can­ didates for the surgical program in October and conducted its first laser surgeries in mid-November. The program is intended to serve those active duty members whose mission effectiveness and personal safety would be most enhanced by eliminating the need for wear­ ing eyeglasses or contact lenses while performing their military duties. Although active duty Navy and Marine Corps personnel may request evaluation to determine suit­ ability for surgery regardless of job specialty or warfare community, priority will be placed on Sailors and Ma­ rines whose military duties require them to work in ex­ treme physical environments that preclude the safe use of glasses or contact lenses. Among the first to have the procedure done at NNMC's new Laser Vision Center was a group of Sailors assigned to the Experimental Diving Unit in Panama City, FL. Ac­ cording to BMl Troy Larck, who wears contacts when he dives, this will eliminate the need for wearing lenses. "I have had a contact lens slip out of place during a dive, and there is not much you can do about it while you have your helmet on." QM2 Randall Chase, who has never been The center's director, CDR Joe Pasternak, MC, performs one of able to wear contact lenses comfortably due to his astig- the first PRK surgeries in the new NNMC Laser Vision Center.

May-June 2001 The most time-consuming aspects of the process are pre-surgical evaluations and post-surgical followup care. NNMC's new center has four specially equipped exami­ nation rooms to perform the pre- and post-operative vis­ its. The center has three refractive-surgery trained tech­ nicians and one optometrist to perform initial screening exams and counseling. There are currently nine doctors on staff at the center who will perform the laser proce­ dure. According to CDR Joe Pasternak, MC, director of the center, the NNMC Laser Vision Center becomes one of only three such centers available for corneal refractive surgery under the Navy program. He projected that with The corrective procedure is accomplished in less than 30 the new state-of-the-art equipment and available staff, minutes and is followed up by a visual exam. the center will be able to offer the procedure to approxi­ mately 80 Sailors and Marines a month. In addition to the new center at NNMC, the laser sur­ gery is currently available at Naval Medical Center San matism, looks forward to not having to worry about eye­ Diego and Naval Medical Center Portsmouth, VA. More glasses. Both Sailors looked on as their shipmate HM1 detailed descriptions about the priority groups, as well as Robert Huffman led the group getting the laser surgery. sample forms and letters used to request the surgery are LCDR Greg Wheelock, Director of the Navy Explosive available on the Navy Bureau of Medicine and Surgery Ordnance Disposal Fleet Liaison Unit located in Indian website at: navymedicine.med.navy.mil/PRK/ Head, MD, was also among the first to have the laser refractive_ surgery_ information.htrn. surgery. Shortly after a post-surgical exam, he was able For more information regarding the services offered to read words on a sign that he would not have been able at NNMC's Laser Vision Center, call (301) 295-1200. to read without his glasses before the surgery. His duties The clinic's hours of operation are 7:30a.m. to 4 p.m., require him not only to perform underwater dives, but Monday through Friday. 0 parachute jumping as well. He indicated that contact lenses can be awkward when parachute jumping, due to LCDR Austin is the Public Affairs Officer at the National Naval the airflow across the eyes. He will now be able to leave Medical Center, Bethesda MD. the lenses behind. NNMC's Laser Vision Center offers the corneal re­ fractive surgical procedure known as PRK or Photorefractive Keratectomy. The PRK procedure uses the laser to remove a small disc-shaped sliver of the cen­ tral cornea. PRK, one of two FDA approved refractive surgery procedures, is currently the only procedure of­ fered under the Navy program. LASIK, or Laser In-situ Keratomileusis, will not be offered until further studies being conducted in the military adequately establish its safety in the operational environment. Members requesting PRK will be screened by an op­ tometrist or ophthalmologist to determine if they are clini­ cally eligible for the surgery. If clinically suitable, the member's unit commander must endorse the request and determine the member's priority level. Once a command­ endorsed request is received, the NNMC Laser Vision

Center staff will review requests for final determination Preparation for the eye surgery includes removal of the surface of clinical appropriateness and priority. layer of the cornea using an a moil brush.

2 NAVY MEDICINE Department Rounds

New Medical Department Flag Selections

CAPT Baker was commanding Iran-Iraq tanker war, where he officer ofNR Fleet Hospital Fort Dix, studied and published information on NJ, ( 1998-2000), executive officer of warm water diving which has been NR Fleet Hospital 9 in Everett, W A, included in the United Nations (1997 -1998), director of surgical Diving Manual. He was the staff services for NR Fleet Hospital 21 in medical officer for Special Boat Unit Dallas, TX, (1994-1997). 11 from 1982-1986, where he earned In 1996, CAPT Baker became the the "Officer in Charge Combatant first naval reserve officer to head the Craft, Riverine" insignia (NOBC Medical Civic Assistance Program 9279). (MEDCAP) Team for Operation He is Associate Professor of Cobra Gold in Thailand. In 1997 he Surgery on the faculty of the was part of the first naval unit to visit Uniformed Services University ofthe Cambodia in 22 years as a medical Health Sciences in Bethesda, and officer of the MEDCAP Team consults and teaches for the Center of deployed by Naval Special War­ Excellence in Disaster Management fare Group One. He also developed and Humanitarian Assistance at "Medical Response to Operations CINCPAC in Honolulu. CAPT MichaelS. Baker, MC, is Other than War," unique training for CAPT Baker's awards include the currently assigned as Staff Medical humanitarian emergencies and disas­ Legion of Merit, Meritorious Service OfficerforNR STRATCOM 1362 at ter relief that has become a template Medal, Navy and Marine Corps Offutt AFB, Omaha NE. for naval reserve training. Commendation (4 awards), Army CAPT Baker served with the 1st Commendation Medal, Air Force APT Baker received his Medical Battalion during Operations Commendation Medal, Navy bachelors degree at Univer­ Desert Shield and Storm in 1990-91, Achievement Medal, Combat Action Csity of California in Los and was recalled to the area as Force Ribbon, and Fleet Marine Force Angeles in 1971 and M.D. degree Surgeon (acting) for Naval Forces Ribbon. He also wears the OIC from Pennsylvania State University Central Command during Operation Combat Craft (Riverine) warfare at Hershey in 1975. CAPT Baker was Southern Watch in 1993. As staff insignia and the Commanding Of­ a resident in general surgery from medical officer for NR Naval Forces ficer Ashore Trident Pin. He was 1975-79 and completed a fellowship Central Command he worked on war awarded the Wellcome Medal and in cardiovascular surgery at Baylor plans for Persian Gulf contingencies Prize in 1994 by the Association of College of Medicine in Houston in from 1986-1990. He attended the Military Surgeons of the U.S. for 1981. He entered the Navy in 1980. medical management of diving at advances in military medicine. He has been a Fellow of the Panama City Navy Diving and American College of Surgeons since Salvage Training Center, and de­ 1985. ployed to the Persian Gulf during the

May-June 2001 3 and entered medical school at the Special Assistant to the Surgeon University of California, San Fran­ General in 1987 was followed by cisco, graduating in 1974 with a assignment as executive officer, Doctor of Medicine degree. He has Naval Hospital Pensacola, FL, in also earned the degree of Master of 1989. In 1991, he reported as Medical Management from Tulane commanding officer of U.S. Naval University in New Orleans. Hospital, Keflavik, Iceland, and in CAPT Hufstader's career as a 1994 returned to Washington, DC, as medical officer began in 197 4 with an Deputy Chief, Medical Corps, until internship at Naval Hospital, San 1998. Diego, and continued with assign­ In June 1998, CAPT Hufstader ments aboard USS Chicago (CG-11 ), reported as commanding officer of Naval Hospital Jacksonville, FL, Naval Hospital, Pensacola. where he completed family practice CAPT Hufstader's awards include residency training, Naval Medical the Legion of Merit, Meritorious Clinic, Annapolis, MD, and Naval Service, Navy Commendation, Navy CAPT Robert D. Hufstader, MC, Hospital, Millington, TN. Achievement, and Navy Good Con­ is Commanding Officer ofNaval Hos­ He then reported to Commander duct medals as well as Navy unit pital Pensacola. Fleet Activities, Chinhae, Korea, for citation, Navy "E", National De­ duty as medical officer, and followed fense, Sea Service Deployment, and APT Hufstader enlisted in the this with an assignment on the USS Overseas Service ribbons. He is a U.S. Navy in 1962. As a New Jersey (BB-62) as senior Fellow of the American Academy of Chospital corpsman he served medical officer. He returned over­ Family Practice, a member of the in San Diego and Japan during the seas, reporting as executive officer of American College of Physician early years of the Vietnam conflict. U.S. Naval Hospital Guantanamo Executives, and a diplomate of the He attended the University of Bay, Cuba, in 1985. A move to American Board of Family Practice. California, Irvine, graduating in 1970 Washington, DC, and assignment as

APT Lescavage is a licensed Inouye (D-Hawaii) for 21 months. registered nurse. She re­ Her main duties focused on being a Cceived a Baccalaureate De­ liaison with the White House and gree in Nursing from the University health care task forces concerning of Maryland and a Graduate Degree National Health Care Reform issues from the University ofPennsylvania's and becoming an authority on the School of Nursing/Wharton School legislative process and its application of Business. Her diploma in nursing to health care. is from Saint Joseph Hospital School From August 1989 to March 1993, of Nursing in Reading, PA. she was on the staff of the Assistant CAPT Lescavage's previous as­ Secretary of Defense for Health signments include: commanding of­ Affairs. As a Senior Health Facilities ficer, Naval Hospital Corpus Christi, Planner at the Pentagon, she was TX (1997 -1999), executive officer, responsible for the planning and Naval Hospital, Great Lakes, IL design of military medical construc­ CAPT Nancy J. Lescavage, NC, is ( 1995-1997). Prior to this assign­ tion projects worldwide. Addition­ Assistant Chief for Health Care ment, she served as a Congressional ally, she served as a nursing Operations, Bureau of Medicine and Fellow on Capitol Hill in the Office consultant to the Department of Surgery, Washington, DC. of United States Senator Daniel K. Defense on clinical matters and

4 NAVY MEDICINE performed comprehensive health London, Naval Hospital Philadelphia Navy Meri torious Service Medals, care and cost-benefit analyses m and the National Naval Medical the Navy Commendation Medal, the support ofDOD initiatives. Center Bethesda, MD. During these Tri-Service Achievement Medal, and Prior to her Department of assignments, she gained expertise in the Navy Achievement Medal. She is Defense assignments, she was in the specialties of Intensive Care, a member of Sigma Theta Tau, charge of the Recruit Medical Clinic Coronary Care, Operating Room, AMSUS, the Military Order of the at Recruit Training Command, Great Obstetric, Neonatology, Recovery World Wars, the Surface Navy Lakes, lL. This clinic was respon­ Room, Ambulatory Care, Cardiac Association, the Naval Institute, and sible for the med ical care of Smgery, Internal Medicine and the Navy Club. approximately 40,000 recruits annu­ General Smgery. ally. CAPT Lescavage is the recipient Other assignments include: Medi­ of the Legion of Merit, Defense cal Clinic, United States Embassy, Meritorious Service Medal, two

graduated from the University of 1994. In 1996 CAPT Libby was Maryland School of Dentistry in selected as staff dental officer Naval 1976, and was assigned to active duty Reserve Readiness Command Re­ at Naval Air Station Key West, FL. gion Six. In 1998 CAPT Libby was CAPT Libby was released from assigned as Reserve Staff Dental active duty in June 1978 and entered Officer Headquarters Marine Corps, private practice in Baltimore, MD. Washington, DC. He reported to VTU Dental 0614 in CAPT Libby is a Fellow of the May 1979 and was assigned to FTL American College of Dentists and a Dent 106 in October 1979 .In 1981 he Fellow of the Academy of General was assigned to NNDC Bethesda 106 Dentistry. He is a member of the as Training Officer and in 1985 American Dental Association and reported to 24th Dental Company has been active in organized dentistry Detachment 2 as administration on the state and local level. CAPT CAPT Lewis S. Libby, DC, is officer and later served as executive Libby is also a member of many Commanding Officer, 4th Dental officer for 3 years. In 1988 he was other professional and military asso­ Battalion, 4th Force Service Support reassigned to NA VMEDCOM ciations. Group, Marietta, GA. NATCAPREG 106. In October 1989 He was selected as 4th Dental CDR Libby was selected as Officer­ Battalion Officer ofthe Year in 1989 In-Charge of Detachment 2, 24th and was selected as the Naval APT Libby graduated from Dental Company, Washington, DC. Reserve Dental Officer oft he Year in Loyola College with a Bach­ He was assigned to NR BUMED 106 1990. His decorations include the Celor of Science degree in in October 1992 and served as unit Meritorious Service Medal, Navy 1972. He was commissioned an en­ administrative officer. CAPT Libby and Marine Corps Commendation sign in the U.S. Naval Reserve in 1973 was assigned as Commanding Of­ Medal (3 awards), Meritorious Unit and completed Officer Indoctrination ficer, 14th Dental Company, 4th Commendation, Fleet Marine Force School at Naval Education and Train- Dental Battalion, 4th FSSG, head- Ribbon, and other awards. 0 ing Center, Newport, RI, in 1975. He quartered in Fort Dix, NJ, in October

May-June 2001 5 Feature

NAMRU-3 and the 1967 Egyptian-Israeli Conflict

CAPT Donald C. Kent, MC, USN (Ret.)

n 1996 Naval Medical Research Cairo in mid-1967 and I was offered nent research related to NAMRU- Unit Number Three (NAMRU-3) the position, which I gladly accepted. 3 's research programs. I celebrated its 50th year anniver­ Over the upcoming months I would During this time troubles were sary. Having been first established in spend considerable time preparing brewing in the Middle East. Despite Egypt in 1946 as the U.S. Typhus myself with visits to BUMED, NIH political problems, research at Commission by presidential order, it (National Institutes ofHealth), CDC NAMRU continued through coop­ was originally made up of a compos­ (Centers for Disease Control), meet- eration between the American and ite of American and Egyptian scien­ tists and technicians working jointly toward the prevention of a possible post World War II typhus epidemic. Following the War it remained as NAMRU-3 under the auspices of the U.S. Navy to involve research deal­ ing with most of the endemic and nu­ tritional disorders which exist in the Middle East. During the 55 years of its existence serving as one of the Navy' s overseas laboratories, NAMRU-3 has been highly produc­ tive in research developments as well as educational opportunities for both American and Egyptian scientists. During that period it has had its good

years, but also its difficult ones. The Entrance to NAMRU-3 Cairo, Egypt 1967. year 1967-1968 was one of these. Late in 1966, I was serving as Chief of Medicine at Naval Hospital, St. Albans, NY. A change of ings with the Epidemic Diseases Egyptian scientists. However, a short command was due at NAMRU-3 in Control Board, and reviewing perti- time before the outbreak of the June

6 NAVY MEDICINE Six-Day War it was becoming until some decision could be made as their parent services for reassign­ evident that a conflict was to be to our eventual next duty station. ment. A few researchers remained in anticipated, and consequently fami­ After several visits to Washington Greece, and I was able to find them lies of the American NAMRU staff and conferences with BUPERS and Greek research facilities in which to were evacuated and sent to safe­ BUMED, it was decided that my work while awaiting return to Cairo. haven in Athens, Greece. travel to Cairo was problematic and Upon completing these adminis­ With the eventual outbreak of that instead I would be ordered to the trative matters, we proceeded to armed conflict, all Americans in NAMRU field facility in Addis Addis Ababa. Settling there involved Egypt were grouped together and Ababa, Ethiopia. This would be a getting my family into proper taken by rail to Alexandria, Egypt permanent change of duty so I could quarters and acquainting myself with and thence by ship to Athens. All move my family there, begin at­ the research program at the field Americans, including NAMRU staff, tempts to secure permission to re­ facility. As I noted previously, each closed up their homes and took with enter Egypt, and thence take over week requests for an Egyptian entry them only what they could carry with command of the facility. This visa were made in Addis Ababa, them. The homes in which they lived involved re-packing our household Athens, and Washington; each met were sealed and put under the effects into three parcels, one to go to with a negative reply. protection of the Spanish ambassa­ Ethiopia, one to go into permanent Having no word as to what was dor, since diplomatic relations had storage, and one to go into temporary happening in Cairo, and anxious to been severed with the United States. storage until I was able to secure get there and resume operation of the Our embassy was then converted to Egyptian permission to move my facility, I decided to proceed to Cairo an interest section under Spanish family to Cairo. Needless to say, we with no entry visa in hand, flying administration. didn't know how long it would be from Addis Ababa via Ethiopian Upon departure of the American before we would again see our Airlines. This was rather difficult staff, NAMRU was placed under household effects and our car. because, under usual circumstances, protection of the Egyptian Ministry Over the ensuing weeks, I applied one required an Egyptian visa to of Health. Dr. Imam Zagloud, a to the Egyptian government weekly board a flight in Addis Ababa. virologist and Director of the for entry visa permission, each time However, the station manager of Egyptian Virology Laboratory, was receiving negative replies. Finally, Ethiopian Airlines in Addis Ababa in charge, pending return of the on 5 August 1967, we flew to Athens was an American TWA employee American staff. However, he had to meet with our evacuated NAMRU who happened to be a commander in previously been an employee at families. the Naval Reserve. He got me on the NAMRU in the Virology Department During the ensuing weeks I had to flight without the required visa. On and was well known and liked by the make decisions regarding plans for an early morning in September, I NAMRU Egyptian staff. In the NAMRU staff members. At that boarded a flight to Cairo, accompa­ absence of the American staff, the point, we had no idea when Egypt nied by Dr. Harry Hoogstraal, a long­ remaining Egyptian researchers con­ would allow any of us to re-enter, and term NAMRU scientist, who had tinued work on a number ofNAMRU calculated it would probably be many spent some 15 plus years as head of research projects. months for most of them. On this the Department ofZoo logy. He was a In the meantime, with NAMRU supposition, some were returned to long time friend of Egypt and a having been evacuated, my orders CONUS for reassignment, some world-renowned expert in entomol­ were put on hold. When the conflict were returned to CONUS to other ogy and tick-borne diseases. began, I had been relieved at St. Navy activities to await return to We arrived in Cairo late afternoon Albans, and several days before the NAMRU, a few were reassigned to and remained in the waiting area beginning of hostilities, packers had the field facility in Ethiopia. A few, since we had no entry visas. We were arrived at our quarters at Mitchell particularly administrative staff, were able to get word to Abdel Azis Saleh, Field, Long Island, in the process for to remain in Athens to carry out the Egyptian administrative assistant our departure for Cairo in mid-June. NAMRU administrative duties. to the commanding officer, that we With orders on hold, household Army, Air Force, and U.S. Public were at the airport. Through his effects were returned to the quarters Health Service personnel returned to connections with the Egyptian For-

May-June 2001 7 eign Office he was able to get us one­ the exception of a single 15-year-old sonnel had evacuated. So we pro­ time entry visas. And so we were typewriter that was probably lost ceeded to forge ahead, awaiting at back in Cairo. sometime earlier. The Egyptian staff some future date a return of our The next morning we had a change had taken wonderful care ofour Navy American colleagues. of command at NAMRU in which I property, which included substantial Next I set out to take care of relieved CAPT Lloyd Miller. He was and expensive research equipment. household effects and automobiles on his way back to Washington to Even more gratifying was the belonging to the Americans who had assume charge of the Research wonderful news that our Egyptian gone back to CONUS, never to Division in BUMED. It was a very research staff had carried on with a return. Those coming to Cairo would happy day for me. At last I had number of ongoing projects. Moun­ live in individual houses, and thus assumed command despite the fact tains of data, reference materials, and had to bring household appliances that I had no American staff other a research library were completely compatible with Egyptian electric than Dr. Hoogstraal. My researchers intact. Manuscripts were continuing current but not suitable for use back were all Egyptians, none whom I to be prepared. in the U.S. Likewise, those who had knew, my American staff was A large animal colony was also already departed had automobiles scattered, for how long I did not intact and healthy, having been especially procured for use in Egypt, know, and my administrative staff maintained with proper diets despite with plans to sell them when they was across the departed Egypt. Mediterranean in All these ve­ Athens, out of di­ hicles remained rect contact. There behind. was no U.S. am­ We there­ bassador, we had fore invento­ no diplomatic im­ ried all the munity, and my abandoned pos­ task to rebuild sessions re­ NAMRU lay maining in the ahead. now unoccu­ The first night pied homes and Dr. Hoogstraal and communicated I hosted a dinner with the own­ party on the roof ers as to of the Semiramis whether they Hotel in down­ wished items to town Cairo for a be shipped or number of our se­ sold in Egypt. nior staff and their Entering those wives. The favorable response that the difficult days from June through dwellings required getting permis­ followed was particularly gratifying. September. sion from the Egyptian government The next day we had dozens of After becoming familiar with the to sell the items if requested. We then telephone calls from Egyptians talents of the Egyptian personnel, my had to prepare the remainder of their welcoming us back to Cairo and nexttaskwas to redevelop NAMRU's household effects for return to wishing us well. I knew that my stay research programs to accomplish CONUS. All this was accomplished was going to be successful. BUMED's goals as well as the needs with no administrative staff, and with My first job was to check the ofthe Egyptian government. Because minimal help from the interest equipment present in NAMRU against of the Egyptian staffs breadth of section which now consisted of on ly a list of what was known to be there training and experience, this did not 12 State Department members. when the American staff left. require varying what had been Most former staffmembers wanted Everything was there and intact, with underway when the American per- their major items sold. I became a

8 NAVY MEDICINE Ward Rounds, Schistosomiasis Ward, NAMRU, 1968. VADM George Davis (left), Surgeon General, Dr. Zohair Farid, Admiral R. Rafetto, and Admiral Ralph Faucett, Assistant Chief for Research and Medical Specialties. middleman, selling items to the Over the ensuing months, we were We set up a bachelor quarters, so highest bidder, but only selling if I finally able to get Egyptian permis­ unmarried members no longer had to could get at least the minimum sion to re-admit key members of acquire extensive household equip­ amount requested by the member. NAMRU's staff. The first was my ment to set up living arrangements. In Needless to say, this process occu­ administrative officer, followed by July 1968 I was able to move my pied most ofmy time during my early the executive officer and senior family to Cairo. weeks in Cairo. pathologist. Over subsequent months We all lived through the turmoil of During this time, research projects other key personnel returned. I was the Six-Day War and its aftermath, were being developed, and already finally able to secure a visa with re­ and NAMRU has continued to existing ones completed. NAMRU entry permission after 4 months and remain productive ever since. De­ was able to fulfill its mission only returned to Addis Ababa to see my spite the crisis and tense relations with the constant cooperation of family. I had left 4 months before, between the Egyptian and U.S. Egyptian officials, especially those expecting to be back in a few days. As governments, Egypt remained ofthe Ministry ofHealth. And it was American staff members returned, friendly to all who served there. Even the existence ofa firm, loyal group of we set up each department to be today, NAMRU and Cairo remain Egyptian scientists and technicians managed by two members, one high on everyone's list of favorite working within NAMRU that pro­ American and one Egyptian in case and special duty stations. D vided for continuity and cooperative diplomatic problems again required research. the Americans' departure. Dr. Kent is a consultant to Pfizer World Research and Lawrence and Memorial Hospital, Groton, CT.

In the March-April 2001 issue the following information was omitted in error: James R. Armstrong, RN, BSN, CCRN, author of Philadelphia, Nurses and the Spanish Influenza Pan­ demic of 1918 is a Lieutenant Commander in the Navy Nurse Corps Reserve. He drills with Fleet Hospital, Fort Dix, NJ.

May-June 2001 9 Feature "Navy Medicine at Normandy" Release

t"

c ! c .::; ...,0 ~

£0 .::; Q. D-Day veteran Dr. Lee Parker and Navy Medical Department Historian Jan K. Herman pay their respects at Normandy's American Cemetery.

10 NAVY MEDICINE leven and a half minutes into the film, "Saving E Private Ryan," a demoli­ tions man shouts for Captain Miller, played by Tom Hanks, to get out of the way. In the midst of slaughter and chaos, the man and his comrades are about to demolish some nearby obstacles to create a path for the tanks to come ashore. Most viewers would not have recognized the red rainbow on the man's helmet identifying him as a member of a Naval Beach Battal­ ion. A popular misconception exists that once the Navy accomplished its mission of transporting the armies to France, and bombarding the German defenses with naval gunfire, the ships returned to

Director Jack Lewin of the Naval School of Health Sciences checks sound levels during the shoot on Omaha Beach (above) and directs Jan K. Herman and cameraman Wayne Paull in a German bunker at Normandy's Pointe du Hoc (left).

England. In fact, it was the men of the Naval Beach Battalions- the so-called "sailors dressed like soldiers"-who cleared the obstacles, "directed traffic," set up communications with ships offshore, and repaired damaged landing craft. Beach Battalion physicians and hospital corpsmen had the unique responsibility of treating casualties where they were hit and getting them evacuated off the beach aboard the now empty landing craft. (Navy Medicine, November-December 2000.) The soon to be released hour-long video, "Navy Medicine at Normandy," in the Bureau of Medicine and Surgery's seven-part series, Navy Medicine at War, not on ly tells the story of these unsung heroes, but also highl ights the vital role Navy medical personnel played aboard LSTs that received the wounded offshore, and in medical facilities back in England. You may order "Navy Medicine at Normandy," by contacting Mr. Jack Lewin at email: [email protected]. Use Normandy in the subject line.

May-June 2001 11 Oral Historv

Patient and Rescuer

John F. Fenwick, Jr.

COMBRT- .SERSON£D j Jli.T. :T;I\CJ( FENUiictr A -1• .,-

SGT John F. Fenwick, Jr. is lucky to be alive. It was a misty morning in October 1951 when his patrol, on a mission to capture a prisoner to interrogate, accidently collided with a superiorforce ofNorth Koreans. Most ofhis Marine comrades perished in the savage firefight that followed. The exchange left Fenwick bleeding and near death as at leastfour machine gun bullets ripped through his body. As a hospital corpsman pulled him to safety, he too was severely wounded. Despite his own injuries, he did what corpsmen are trained to do--protect their patient, administer first aid, and see the wounded Marine safely to the rear. The story does not end there. It took a skilled Navy surgeon and his team many hours to repair the damage and put SGT Fenwick on the long road to recovery. He recalls that unforgettable time nearly 50 years ago when Navy medicine came to his rescue.-Ed.

12 NAVY MEDICINE t was 5 October '51. I'll never forget it. I was a We ran behind a nearby knoll but they continued to fire machine gun squad leader in Co. A, 1st Battalion, at us from two sides and the front. We got the machine I 5th Marines. The captain called us in and told us he gun set up on the knoll and began to answer fire. But it wanted a prisoner to interrogate. He told me that I was was like taking a motorcycle and running up against a short and would be relieved in 2 days, and then would tractor trailer. We had literally hundreds ofthem shooting probably be going at us. The whole home. He then said I platoon got shot to didn't have to go on pieces. The lieuten­ this patrol. We had a ant then called in brand new green lieu­ supporting artillery tenant who had only and when they regis­ been with us 2 days. I tered in, the shells figured I had better landed right on top of go because he'd need us on that hill. I guess some advice. A good he fouled that up too. officer will listen to Finally, they cor­ his NCOs who had rected, and the shells some combat experi­ began landing on ence. enemy lines. We were north­ By then, just about east of Inje, close all of us were hit. Our enough to the ocean machine gun was out to have naval gunfire of ammunition and from the battleship was knocked out. I Missouri supporting was the last guy alive us. We went out on that knoll. I saw before dawn. The some of the enemy lieutenant disobeyed trying to work their orders and got us all way around our right fouled up. We ended and get behind the up in the enemy hill where all our lines. You could hear • r wounded were. Our them talking and corpsman, Glen starting their cooking Snowden, was treat­ fires. It was scary as ing the wounded be­ hell. We then pulled low. So I grabbed an off that hill and instead of going right back to our lines M 1 off the dead kid who was lying beside me and I raised and taking advantage of the heavy ground mist, the myself up to shoot at the infiltrators trying to outflank us. lieutenant said, "Let's try that other hill." The platoon That's when I got it- four hits in the body- machine gun sergeant who outranked me kept telling him we had to get bullets. We were so close I could feel the muzzle blasts. back to our lines. "You can't make a name for yourself It was a Russian light machine gun. When you were in out here because you're gonna get everybody killed," he Korea awhile you could tell every weapon firing at you. said. It's indescribable the way it felt. It was like being run The mist burned off and we were exposed out there, over by a train. I was bent backwards. It turned out that almost like someone had turned on a light switch. Then two ofthe bullets grazed my spine. I could feel everything one shot rang out. Lyons, a friend of mine, was at the else except for my legs. It was horrible pain. point and got one right between the eyes. We were only Doc Snowden came running up and grabbed me. He 50 yards from some of their bunkers, maybe even closer checked everyone else real quick but saw that everybody than that. else up there was dead. He said, "I've gotcha; I'll get you

May-June 2001 13 out of here." As he started pulling me, the machine gun Right about then there was an air strike on the enemy got him twice in his left shoulder and knocked him right position and that pulled me out of it. It really made me down the hill. He scrambled right back up again. One arm feel good thinking that the ones who got me were getting was hanging down and useless but he still grabbed me and fried with napalm. got me out of the line of frre. When we got back to our own lines I was still He began telling the unwounded riflemen how to dress conscious. A helicopter landing pad had been dug out on guys' wounds. I had an artery severed on my left flank, the reverse slope of a hill. They didn't think I was going and the exit wound in my back was the size of a fist. to make it. Only one chopper could be brought in there at Apparently the bullets had hit my ammo belt and tumbled. a time, and there was only room for two wounded on Some hit my small intestine and I eventually lost 18 feet each. There were so many wounded, they could only take ofmy small intestine, which is nothing. Ifthey had hit my the ones who had a chance of making it. Some of them large intestine, that would have really been bad. went down the hill on stretchers. Snowden dragged me out of there with one hand. A chief corpsman told one of the surgeons to look at When I finally got back to our lines I told the guys to write me. I remember he had a big walrus moustache. "Sir, you him up for a Silver Star, at least. He saved a lot of guys had better look at this man. It looks like his color's still besides me. He grabbed a jacket off one of the dead good." The doctor then said, "Take one ofthem out ofthe Marines and rolled it up into a ball. He was all out ofbattle basket and put him in." The other guy was a rifleman dressings. He then put it against that hole in my back and from Texas. He had four bullet wounds stitched across took another jacket and tied it around me real tight, like a his chest. He was in one basket and I was in the other. He compress, to stop the flow of blood. And that's what didn't make it. And he had three kids at home. saved me. He had some morphine syrettes left, and told a They flew us back to Easy Med. I remember being BAR (Browning Automatic Rifle) man, [CPL very scared. They put me on a slanted wooden table and Richard]Baiocchi to give me some morphine. Baiocchi cut all my clothes off. Then they put a catheter in my then said, "Here, I'll give you some morphine." He stuck penis. The surgeon's name was [LTJG Howard] Sirak. the morphine syrette in my shoulder. I was looking into He really put me at ease. And then with his finger he drew his face and saying "Thank you, pal," or something like a line on my stomach and said they were going to make a that, and just then a machine gun burst hit him right in the small incision. That was no small incision. They ended jaw and sheared it off. His whole chin was gone. He also up cracking me open-a laparotomy! Dr. Sirak later told took six rounds between his wrist and elbow. me they put 837 sutures in me. Rather than making a Unfortunately, I didn't get the morphine because as he colostomy, they kept snipping perforated small intestine got hit, the impact snapped the needle offwhile it was still off and re-sewing [the ends] together. in my arm. The pain was unbelievable. It was like When I woke up, it was night. I only saw one Coleman someone had opened me up with a scalpel without any lantern at one end of the tent. I was lying on the cot and anesthetic and then filled up my insides with red hot felt all warm and sticky on one side. I had dysentery once embers. I forgot to mention that when Doc Snowden and thought I had messed myself. I called a corpsman grabbed me, two more bullets got me in my left upper who came to me with the lantern. He said, "Don't worry, arm. One was a graze and the other went through the flesh it's just blood." I had blood and plasma going in both feet real quick. and both arms- IVs. There was a catheter tube coming After Snowden got through with me, two Marines out of my nose, another tube in my penis, and another grabbed each of my feet and dragged me face-down back coming from the exit wound in my back. through the rice paddies. They were under such fire that The next morning both surgeons and Doc Snowden they had to run, dragging me on my face through all that came in. He was all patched up with his arm in a sling. muck. It's a wonder I didn't drown. They told me they had to get me up on my feet. I said, When we got back a ways they put me on a litter. I "You've gotta be kidding me. I'm dyin' here. I can't feel really thought I had died because when we got halfway my legs; I can't move. He said, "When we got in there we back, I felt warm and peaceful. All the pain left me. While found three vertebrae that were just grazed by the bullets I lay face down on the stretcher, I saw a real bright orange and were fractured. But you have what they call spinal hazy light but there was no pain. I remember thinking, shock. The feeling will return. We can practically "Thank God, it's all over." guarantee it."

14 NAVY MEDICINE But I was really worried I was going to be a paraplegic. ward was so clean and beautiful. I think it was even air­ But for the grace of God, another eighth of an inch, I conditioned. I didn't want to get in that bunk. It was so would have been. The bullets had tumbled their way clean and I was so filthy. There was all the crud from the through me. Then I got peritonitis real bad. I remember by front plus blood caked all over me. I hadn't been in a bed the time I got to the hospital ship I was getting 500cc's of in over a year. When they got me all cleaned up and in a penicillin a day. It could have been fragments of filthy bunk, gave me all my shots, and changed my dressings, clothing going through with the bullets, or stuff from the the nurse, a lieutenant commander, said, "How would rice paddy, and of course perforated intestines. I you like to have some ice cream?" I couldn 't believe it. I remember the day I got hit I hadn' t had anything to eat, thought, I'll really fool her. So I said, "Yeah, I'd love to just a sip of water. The surgeon said that had I had food in have some." And she said, "What flavor?" And knowing my intestines, that probably would have been it. I they wouldn't have it, I said, "Rocky fudge." And then wouldn't have survived. she said, "Coming right up, Sarge." Then I completely From there they sent us to the hospital ship-the lost it. I grabbed her hand and kissed it. Then I broke Consolation. They put us in slings and hoisted us aboard. down crying. "You Navy nurses are really angels of It looked great. It was snow white- unbelievable! The mercy."

SGT Fenwick incurred six machine gun bullet wounds. Two were through and through wounds ofthe left upper arm with no permanent bone, muscle, or nerve damage. Four were through and through wounds ofthe left flank, involving the small intestine, left pelvis, left iliac crest and iliac joint, which was destroyed by direct trauma. There was a large exit wound in the lower, left back adherent to the lumbar spine with fractures ofL-3, L-4, and L-5. The left artery was severed. Two ofthe gunshot wounds were "keyhole" rounds, which tumbled, causing large muscle and tissue damage and loss in the lumbar spine region. After a long hospitalization, he was declared permanently disabled, and was dischargedfrom the Marine Corps in 1954. He currently resides in Delaware. When asked about his care then and since, he says, "I told my wife that ifanything happens to me, the hell with these civilian or VA hospitals. Get me overto Bethesda [National Naval Medical Centerf. I have the highest regard in the worldfor Navy medicine." 0

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During his long convalescence at NNMC, SGT Fenwick penned some of the drawings accompanying this article. Fifteen years later he produced the rest.

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19

May-June 2001 On 26 October 2000. Navy Medicine interviewedformer hospital corpsman HM3 Glen C. Snowden. Co. A. I st Battalion, 5th Marines, 1st Marine Division, about his rescue and treatment ofSGT John Fenwick.

What do you remember about October 5th, 1951, the day you and a whole bunch of other people got pretty badly hurt? Do you remember a Marine named Fenwick who was very badly wounded that day? He was hit in the stomach. He remembers you trying to drag him out of the line of fire while the North Koreans were shooting at the both ofyou. He also recalls that you were shot in the arm and tumbled down the hill. But that you got right back up again and dragged him the rest of the "ay to safety. I remember that. I had to get him up over the hill because he had slid down on the enemy side. If we stayed there we'd both have been shot. So I grabbed him by the ankles and told him, ''Put your arms on your stomach and hold them down real good." And then I said, "I'mgonna pull you up." He said, "No. I don'tthink I can make it." And I told him, "You're gonna make it because I'm going to start pull in' right now." I tied his hands together and put both my hands underneath his armpits as far as I could. Then I got his head up on my chest, and started moving. I wanted his head up high where I could see whether he was breathing or not. You don't want [your patient] to bleed from the mouth.Ifthey do, they can choke. And that's the v,:ay I pulled him back up. The only thing that stayed on the ground as I pulled him were his heels. And you were already wounded yourself at the time. Oh, yes, but I wasn't bleeding. I had already plugged that up. I put a peg in it. You did what? I pegged it. What do you mean you pegged it? I'd take a limb and kind ofsmooth it with my knife. Then I'd break it off. I'd make a couple ofthem and put them in my pocket. Then iff got shot, I'd just stick one in the wound real fast. Like a cork? Yes. And it wouldn't bleed. You'd be surprised how that worked. I'n nenr heard of that before. So I got him up there [on the back side of the hill], and the first thing I had to do was bandage him. I tore his shirt in the back where the bullets had come out and patched him up there. I put a great big [battle dressing] on him and tied it as tight as I could get it. And then I turned him over and patched up his stomach. That's when the corpsmen started yelling that they had a vacant litter. We grabbed him underneath the arms and put him on that litter and they took off. I yelled, "Good bye. You're go in' back to the states. I wish you all the luck in the world. I know you're goin' to make it back, so take it easy." And he waved at me. Did you ever find out what happened to him after he left? I never found out. I called after I got back down to the base but they must already have taken him. I guess they put him right on that hospital ship. When I called you yesterday and told you I had talked to ~r. Fenwick, and be was nry happy you had saved his life, was that the first time you enn knew he was still alive? Yes. That's the first time. As long as I was over in Korea, nobody would send any information through on the radio telling me what happened to him. Well, Mr. Fenwick is okay thanks to you and wants to say thank you. I appreciate \\hat he said. I guess I probably saved quite a few lives over there, but I sure put evel)1hing in it when I saved him. 0 Glen Snoll'den, ll'ho is also a World War II veteran, resides in Houston, TX

20 NAVY MEDICINE Feature

Disaster Relief and the Navy Entomologist

LCDR David M. Claborn, MSC, USN

n often-forgotten consequence of natural and disaster damage and consultation with local public health man-made disasters is a subsequent increase in officials. One example is provided by entomological Athe risk ofvector-borne diseases. Major disasters support after Hurricane David in the Dominican destroy housing and water containment systems that Republic. That storm caused an estimated 1,000-1,500 normally protect people from mosquitoes, flies, and deaths and injured nearly 4,000 people. The Navy helped vermin. As a result, survivors must cope with swarms of survey the storm damage and provided an assessment of insects and rodents that thrive in a soup of waste water, vector-borne disease. As a direct result of after-action unburied garbage, and the carcasses of man and animals. reports from Hurricane David, the public health Communities recovering from hurricanes, earthquakes, community became more aware of the potential for floods, and wars must also deal with accompanying disastrous disease outbreaks after natural disasters. As epidemics of malaria, dengue, cholera, and other would be seen with later efforts at humanitarian diseases. Unfortunately, local governments often lack the assistance, logistical impediments and poor transporta­ capability to respond adequately to the need of the tion limited the Navy's ability to control the vector stricken populations because vector control services may populations in the Dominican Republic. have been destroyed by the disaster, ifthey ever existed at Later storms, however, demonstrated that insect all. In such situations, local officials need access to expert surveillance alone can be tremendously beneficial in the consultation, insect surveillance, public education months immediately after a disaster. Following the expertise, and effective vector control. Rarely are all of Midwest floods of 1993, for example, a team of Navy these capabilities available from one source. entomologists responded to a request for assistance from Over the last several years, the Navy has developed the the state of Missouri. Extensive mosquito surveillance ability to respond with a more comprehensive array of was used to evaluate the risk of St. Louis and Western weapons in the fight against vector-borne disease equine encephalitis to local inhabitants. Over 250,000 following disasters. More importantly, Navy entomolo­ mosquitoes were trapped, identified, and analyzed during gists continue to seek ways of improving disaster relief this study, which eventually concluded that risk to efforts not only with advice and consultation, but also humans was very low. One tangible benefit of the with meaningful capacities to change the disease surveillance program was that Missouri decided to environment through effective vector control. forego a proposed mosquito control program that would have blanketed the area with insecticides at a cost of Surveillance efforts following natural disasters nearly $20 million dollars. The surveillance program cost Some of the earlier disaster relief efforts by Navy only $100,000, but it allowed public health officials to entomologists were necessarily limited to surveys of make an informed decision that saved money and

May-June 2001 21 reduced the chances for further environmental disrup­ tion, all without increasing the risk of disease to human inhabitants. Similar surveillance and consultations have been performed for outbreaks of disease. In 1993, Navy entomologists were part of a team that investigated an epidemic of Rift Valley fever at the request of the Egyptian Ministry ofHealth.ln 1995, the Navy consulted with public health officials on the island ofPalau during an epidemic ofdengue. Even Vietnam has benefited from recent Navy efforts in malaria control. These efforts were instrumental in identifying the disease vectors and

providing advice on how to disrupt the disease cycle, but Helicopter flown by local pilots damaged during aerial spray op­ they did not get directly involved in vector controL Other erations in Maracay, Venezuela in 1990. Fortunately, no one disasters, however, provided ample opportunities for was seriously injured. vector control. teams must travel lightly in order to obtain flights into Vector Control Efforts disaster zones, entomologists must often rely on either Vector control capabilities in the Navy are local transportation or on vehicles provided by other concentrated in two units called Disease Vector Ecology military units. This reliance results not only in and Control Centers (DVECCs}--one in Jacksonville, inconsistent transportation, but also in some danger. FL, and the other in Bangor, W A. Manned primarily by That danger was best demonstrated in 1990, when two commissioned entomologists and preventive medicine vector control teams went to Venezuela at the request of technicians, these units serve as training, testing, and the Pan American Health Organization. The teams operational centers for most aspects ofvecto r control that established aerial spray programs to control mosquitoes are required by the Navy and Marine Corps. In addition, during an epidemic of dengue hemorrhagic fever. One of a complete inventory of insecticide dispersal equipment the helicopters, flown by local pilots, crashed after hitting is maintained at these centers for contingency uses like a high-tension power line. Amazingly, no one was wartime vector control and humanitarian assistance. seriously injured, although the two Navy entomologists Equipment ranges from backpack sprayers to trailer­ on board were kept in the hospital overnight for mounted turbines capable of spraying a stream of liquid observation. insecticide dozens of feet into the air. The units even The incident emphasized the extraordinary care maintain aerial spray equipment for use in helicopters. required to work in areas where traffic laws, equipment All of this equipment has been used for disaster relief in maintenance, driver training, and other aspects of public the last 10 years. safety are different from those in the U.S. Unfortunately, One of the biggest responses was after Hurricane the situation often dictates that disaster relief workers Hugo when three teams of entomologists and technicians rely on vehicles in short supply driven by reckless local deployed to Puerto Rico, St. Croix and Charleston, SC. drivers on crowded roads that are severely damaged by These teams performed numerous tasks, from surveil­ the disaster. Great care must be taken to ensure the health lance to fly and mosquito control. These areas had and well-being of relief workers so that they do not experienced outbreaks of dengue and eastern equine become victims of the disaster themselves. encephalitis just prior to the hurricane, so the possibility of increased disease risk was very real. Hurricane Hugo Public Education and Vector-borne Disease served as a harbinger of several other tropical storms to A common concern for many disaster relief workers, which the Navy responded. including entomologists, is the temporary nature of their Most recently, several entomologists were involved in efforts. Vector control during an epidemic may mitigate disaster relief after the enormous destruction of the immediate situation without addressing the Hurricane Mitch in Central America. This last underlying factors leading to the outbreak. In other deployment reflected one of the recurrent problems with words, how much real benefit do relief efforts really disaster reliefeffort s: reliable transportation. Because the provide? One approach to reducing the need for

22 NAVY MEDICINE emergency relief is to develop more self-sufficiency in It should be noted that the primary mission ofthe Navy local communities that are prone to disruption. This goal entomological community is to support the Navy and can be obtained with simple technologies like Marine Corps in issues of public health and pest control. insecticide-treated mosquito nets and sanitation to reduce In that role, they may accompany Marines and Sailors the number of larval breeding sites. The Navy has throughout the world, providing vector control and participated in two Army efforts to accomplish these expert advice. They also provide pest control and long-term goals in Haiti and Jamaica with the hope of environmental expertise to existing military bases and establishing a continuing education program in vector they conduct research on medically important insects in control for public health in these countries. the overseas research laboratories of Egypt, Indonesia, One unique aspect of such training was the added goal and Peru. However, the increasing use of the American of developing environmentally friendly techniques to military in operations other than war has dictated the replace others that may be more disruptive, such as the development of "one-stop-shopping" for matters use of sanitation to reduce mosquito numbers rather than involving vector-borne diseases in disaster relief the common practice of using extremely toxic operations. The Navy is not unique in having developed agricultural chemicals in local public health initiatives. a complete spectrum ofresponses to such scenarios; other Entomological support by Navy personnel after military and civilian organizations can respond with disasters now includes a more complete spectrum of similar capabilities. The degree to which these appropriate responses, including surveillance, public capabilities will be maintained, improved, or even education, expert consultation, and operational vector utilized will depend on future political and organizational control. Because the Navy can respond quickly with such support, as well as the need generated by future disasters. expertise, entomologists have deployed numerous times in the last 20 years to provide relief from epidemics, Dr. Claborn is assigned to the Department of Preventive Medicine zoonotics, and disasters, both man-made and natural. and Biometry, Uniformed Services University of the Health Sciences, Table 1 is a partial list of such deployments since 1979. Bethesda, MD.

Table 1. U.S. Navv entomoloeical suoport to civilian oreanizations (1979 to 1998)

Year Supported Group Reason for support 1979 Dominican Republic Hurricane David 1986 San Diego County Public Health Dept. Autochthonous malaria outbreak 1989 California Public Health Dept. Zoonotic outbreak of plague 1989 St. Croix Hurricane Hugo 1990 Venezuelan Ministry ofHealth Dengue hemorrhagic fever 1991 Department of Energy Resettlement of Marshall Islands 1991 Bangladesh Typhoon 1991 Haitian refugees Refugee interdiction 1993 Egyptian Ministry of Health Rift Valley fever outbreak 1993 State ofMissouri Floods 1993 U.S. Public Health Service Hurricane Andrew 1993 People's Republic of Vietnam Malaria epidemic 1995 Centers for Disease Control & Prevention Hantavirus pulmonary syndrome 1995 Cuban refugees Refugee interdiction 1995 Palau Dengue outbreak 1996 Haiti Public education 1996 Jamaica Public education 1998 Puerto Rico Hurricane Georges 1998 Guatemala Hurricane Mitch 1998 Nicaragua Hurricane Mitch

May-June 2001 23 Feature

"Tfle name Joel T. Boone is legend­ _.1 ary in the Navy Medical Depart­ ment. By the time he retiredfrom gov­ ernment service in 1955, VADM Boone had earned the Medal ofHonor for valor on the Western Front dur­ ing World War I, was White House physician for three presidents, and served on ADM William Halsey's staff as Third Fleet medical officer during World War IL Following Japan's ca­ pitulation, Boone was the first Navy physician to enter Japanese prisoner of war camps with orders to liberate Allied survivors. Even today, Dr. Boone remains the Navy's most deco­ rated medical officer.

Birth of the Helo Deck

V ADM Joel T. Boone, MC, USN

Tn September 1950,following the successful Inchon operation, Dr. Boone, accompanied by an aide and long ..l. time associate, CDR Allen Bigelow, MSC, went to Korea to assess the state ofNavy medicine's support of U.N. operations. After a good night's sleep aboard the USS Rochester (CA-124), Boone went ashore to find Inchon virtually destroyed. He was also shocked to find tremendous numbers of wounded, mostly Korean civilians and defeated North Korean soldiers. To Boone's practiced eye, what seemed most laclt.ing was a quick and efficient evacuation system that could move casualties from where they were injured to advanced medical care in the shortest possible time. The presence at Inchon ofthe hospital ship USS Consolation (AH-15) was comforting, but getting patients aboard was problematic. Because of a continuing enemy presence, the white ship had to remain out ofartillery range and a bit too far from where she was most needed. Dr. Boone tells the story ofhow all that changed.

24 NAVY MEDICINE nemy wounded and the tember 18. I told [VADM Arthur D.] did not see how I could make the wounded of our American Struble* of my observations and deep round trip and accompli sh my mis­ E forces were brought to the concern. I observed that the hospital sion in less than three hours. beach landing area in Inchon. The ship Consolation was too far removed It was almost mid afternoon when roads were becoming very heavily from beach landings. He said they he and I were having our conference congested with various forms oftrans­ were about six miles down the bay about my trip to the hospital ship. portation hurrying in both directions. and could not be brought up closer Struble said that would bring me back There were many, many wounded because the firing at night on our ships to the Rochester, with exposure to being conveyed to the landing down was so intense that we might lose the possible fire, after sundown, and no on the waterfront. only hospital ship we had there (the boats were allowed to be underway I recognized that the progress of Consolation) and then be without any. in Inchon waters after sundown. He evacuating wounded was very re­ I told Struble that I wished to visit the did not believe the trip could be made tarded under such circumstances. If Consolation and inquired how I could under those conditions as enumerated. relief was not forthcoming expedi­ get aboard her, except at the expense I asked him if there weren't some tiously, many of the wounded would of a great deal of time. other way for me to get to the hospi­ die who had a chance to live other­ He said that he could loan me his tal ship. For example, did he have a wise, and the wounded conditions fastest boat, which would take from helicopter aboard. Struble looked very would be aggravated. I knew some­ an hour to an hour and a half to go surprised and said, "Why, yes, I have thing had to be done to speed up from the Rochester to the Consola­ one on the fantail ofthe ship." I asked evacuation of casualties, both Ameri­ tion. I knew I would need about an if I could talk to his pilot. He said, can and the enemy- North Koreans. hour aboard the hospital ship to see "Certainly," so he sent for his pilot Also a multitude of civilians had been the patients and confer with the com­ and I talked to him in Struble's cabin. wounded, and relief should be ef­ manding officers, that is, of the ship I asked the pilot if he were willing to fected for them as quickly as possible. and of the hospital part of the ship. I fly me down to the hospital ship, and Bigelow and I returned to the he said he ce1tainly would, bull had Rochester in mid afternoon of Sep- *Struble was Commander, 7th Fleet. to remember that there were no land-

H03S helicopter aboard Consolation's new helo deck.

May-June 2001 25 ing facilities on the hospital ship; and you will find a rod underneath the place on which I had landed on the however, he said I could be lowered doorway on which you place your deck, I signaled to the helicopter pi­ from the fuselage ofthe helicopter by foot." lot to pick me up. He sent down on a steel guide wire using a controlled Having done this, I reported to the the guide line a life preserver and a hydraulic pulley. I said it would be a pilot that I was holding on to the rod Mae West. These I put on and sig­ novel trip for me but prove of much back of his seat and my foot was on naled that I was ready to be hoisted value, I was sure. the rod under the doorway. He said, aboard. As I was hoisted from the I told AI Bigelow he did not have "Now release yourself from holding deck and came nearer and nearer to to accompany me if he didn't wish to on to my seat and keep your foot on the helicopter, I naturally, because of do so; but, if he did, it would require the rod outside the door, and the metal my weight, spun faster and faster, and, two trips of the helicopter from the line will be swung out, held tight by a when I was hauled up near the door I Rochester to the hospital ship andre­ hydraulic control; then take your foot had to, as I had been instructed, make turn, because the helicopter only car­ offthe rod outside ofthe doorway." I a grab for the door frame and pull ried a pilot and places for two pas­ said, "And then what?" He said, myself into the cockpit. I missed the sengers in the cockpit. A mechanic "Then you float into space," and I was doorway by not being able to grab it had to make the trip with us, handling aware: "That's when you really get three times before I successfully got the lowering and hoisting lines for your thrill." myself into the cockpit area. It was a whoever would make the landing and Before I left the cockpit, I was told big relief to be safely back in the cock­ be returned to the helicopter. It was to put on a life preserver and a "Mae pit. arranged that I would fly first with the West," named for the well known be­ Before leaving the hospital ship, pilot and the mechanic, and on a sub­ bosomed actress, which would be in­ Captain [Robert E.]Baker, the com­ sequent trip Bigelow would do like­ flated in case I would be dropped into manding officer of the hospital part wise. the water. of the ship, asked me to fly over and After taking off from the deck of As I was swinging around in my around the ship before I departed to­ the Rochester, we flew toward the descent from the cockpit of the heli­ ward the Rochester, so that they could Consolation and circled it from about copter to the deck of the Consolation, get pictures of me in flight. This we 300 feet elevation. Due to the masts, I felt like the man on the flying tra­ did, and then made our successful the guy lines, antennas, stack, etc., it peze and thought ofmy wife and what flight [back] with a feeling of relief would appear there would be no place her comments would be on my un­ that our mission had been successfully where a passenger could be landed. dertaking such an expedition. I accomplished. Looking down, I spotted what I felt thought she would be thinking to her­ Admiral Struble and, I think, most was a large enough space near the self, "What a fool her old admiral all officers and many ofthe members deckhouse on the fantail. The pilot felt husband was to undertake such a mis­ of the crew were out to see this expe­ sure he could land me there so he in­ sion." dition return. I thought [they] were structed me what to do. There was great excitement at see­ apprehensive that we would not safely The mechanic and I were sitting on ing my arrival. Many cameras ap­ return. a seat just behind the pilot. A canvas peared, as they wanted to see this un­ strap was handed to me which I placed dertaking I had embarked upon. I was *Following Boone's visit, CAPT Baker under my arms and which was at­ pleasantly greeted, escorted to the sick sent a report to Surgeon General of the Navy RADM H. Lamont Pugh. "18 Sep­ tached by a snaffle to the arm of a quarters to see patients. I knew time tember 1950. Admiral Boone and Com­ sling and then was swung out from was a very important factor, so I did mander Bigelow came aboard via heli­ the helicopter's doorway. There was not delay too long over beyond what copter for a short visit and Admiral Boone no closed door. Having done this, I I thought would be necessary to ac­ stated that he would try and arrange for so reported to the pilot. He said, "Now complish my mission. I saw most of us to move (the hospital ship Consola­ take a hold of a rod on the back of my the patients and talked to many of the tion) closer to the beach since the long boat ride was believed to be detrimental seat and have one of your feet find a staff members in addition to the com­ to the patients' welfare. On 21 Septem­ rod underneath my seat. Hold firmly manding officer of the ship and the ber our anchorage was shifted to a posi­ to the rod on the back of the seat and commanding officer of the hospital tion off Wolmi Do Island, providing a with your foot reach out the doorway part of the ship.* In returning to the much shorter boat ride for casualties."

26 NAVY MEDICINE Having been greeted by Admiral screwball idea. I said no doubt many the provision made on hospital ships, Struble, I asked if I could come into people thought I was at times, but in would greatly speed the evacuation of his cabin. I wished to talk to him. I this instance I certainly was not. I felt wounded and innumerable lives should have said [previously] that my proposal was a very sound and would be saved. As a result, it was before I began to be hoisted from the practical measure. recommended that landing platforms deck of the Consolation, flying He said, "I'll prove to you, Joel, be built on hospital ships. I was around the hospital ship two or three how crazy you are." Thereupon he pleased to learn later that Vice Admi­ times, and then landing on the Roch­ sent for his engineer officer, Rear ral Struble and Rear Admiral J.H. ester, I happened to look at my watch. Admiral George Henderson. Struble Doyle [Amphibious Force Com­ The consumed time to make that en­ then narrated to Henderson my pro­ mander] favored the installations. 0 tire trip was ten minutes. posal. Instead of his agreeing with As soon as Struble and I entered him, Henderson said, "Hell, why Bibliography his cabin, I said, "Why not build a didn't we line officers think about it Boone, Joel T. Joel T. Boone Papers­ landing platform on the fantail of the instead of some medical officer! It Memoirs , Library ofCong ress, Washing­ hospital ships for helicopters to land certainly is a practical idea." His ob­ ton, DC, ch. XXXVII, pp.171-180, box 60. Courtesy of Milton F. Heller, Jr. thereon?" servation naturally was a surprise to Struble thought I was crazy as hell, me, but was very gratifying. I knew he said, for even proposing such a the proposal, if it were carried out and

The Consolation returned to Long Beach where a helicopter deck was installed on her fantail. Back in Korean waters, the Consolation, the first ho~pital ship to be so equipped, took its first patimt aboard by helicopter on 18 December 1950, inaugurating a new era in patient care.-Ed.

May-June 2001 27 Book Reyjew

Heller, Milton F., Jr. The Presidents' Doctor: An Insider's View of Three First Families. Vantage Press. New York. 2000, 200 pages.

oel Thompson Boone was born on 29 August 1889 Boone eventually served two terms as Assistant in St. Clair, PA, of Quaker parents. Three events Physician to the White House under Presidents J influenced his future: his stepmother's suggestion Harding and Coolidge, and then a third term as that he attend Mercersburg Academy, which led to a Physician to the White House under President lifelong association with that institution, his meeting Hoover. Boone's White House years were both Helen Elizabeth Koch at the age of I 0 (she later rewarding and painful. He was with President became his wife), and, finally, his experience with his Harding at his death. His relationship with the uncle, Dr. George Boone, a country general practice Coolidges was an enduring one, but the death of physician. It was that association that led the young Calvin Coolidge Junior to infection brought him great Boone to attend Hahnemann Medical College in sadness. Philadelphia. During World War II, Boone served as the Medical After graduation and a year of internship, another Officer ofthe Third Fleet under ADM William Halsey road opened for him at a dinner with his fiance, Helen, and represented the Navy Medical Department on the and a distant relative, Uncle Charlie Dyson, who was deck ofthe USS Missouri at the Japanese surrender on a captain in the Navy. Dyson told Boone that doctors in 2 September 1945. the Navy received a regular paycheck. The prospect of Joel Boone served in several capacities after the having some financial security meant that a wedding war before retiring from the Navy in 1950. He then date could be set. Despite Helen's reservations, Dr. was Chief Medical Director of the Veterans Boone received a naval commission, and he and Helen Administration until retiring from that post and from were married on 20 June 1914. government service in 1955. Boone's first assignment was at the Portsmouth VADM Boone's career and life epitomize the Naval Hospital in New Hampshire. Upon arriving values ofintegrity, patriotism, service, and dedication there, Boone found himself chief of medicine, chief of to his patients, values that provide the foundation for neuropsychiatry, assistant in the Department of Navy medicine. This biography of Joel Boone, the Surgery. and the pathologist. indispensable Navy physician, highlights the life of a From Portsmouth he was sent to the Navy Medical man whose extraordinary career transcended many of School in Washington, DC, and from there to Norfolk the cataclysmic events of the first half of the 20th for assignment on the USS Tennessee to Haiti. In Haiti century. he was involved in the Caco uprising \\·here he The author, Milton Heller, is eminently qualified to contracted estivo-autumnal malaria, which became so write a biography of VADM Joel T. Boone. He not severe that on 20 June 1916, his second wedding only knew him personally, he was also married to anniversary, he was evacuated aboard the USS Solace. Admiral Boone's daughter, Suzanne. Because ofhis After recovery he was assigned to the U.S. Second access to Dr. Boone's personal papers and journals as Division and sailed for France and World War I. well as being a member of the family, the author is His tour in France netted him two Croix de Guerre, able to afford the reader a rare glimpse into the life of the highest military honor bestowed by the French on a the Navy's most decorated physician. 0 foreign military member, and the Medal of Honor, which helped lead him to his first assignment as Assistant Physician to the White House under President Harding, and medical officer of the -Janice ~arie Hores is Assistant Editor for SA IT JIEDICJSE Presidential Yacht, Mayflower. Magazine, Bureau of Medicine and Surge!) (MED-09H).

28 NAVY MEDICINE Look Back

Navy Medicine 1953

Bird's eye view of hospital ship USS Haven (AH-12) from a helicopter about to land on the helo deck. USS Consolation (AH- 15) lies off her starboard bow. The photo was taken on 14 August 1953 off the Korean coast by a Marine Corps photogra­ pher.

May-June 2001 29 DEPARTMENT OF THE NAVY BUREAU OF MEDICINE AND SURGERY Periodical ATTN: MED-09H Postage and Fees Paid 2300 E STREET NW USN WASHINGTON DC 20372-5300 USPS 316-070

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