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Before M*A*S*H: Portable Army Surgical Hospitals in World War II

by Glen Barnett

Mobile Army Surgical Hospitals, or M*A*S*H units, were popularized by Richard Hooker’s novel series, the 1970 film starring Donald Southerland and of course the long-running television show starring Alan Alda. But the idea for a portable surgical or field hospital came decades before the Korean War. The idea came from General Percy J. Carrol, chief surgeon of the U.S. Army. He envisioned a hospital unit housed in tents whose personnel could strike camp and carry all of the unit’s equipment and supplies to a new site and set up again, saving valuable time for treating patients close to the battlefield. His idea was first put into practice in June 1942.

Australia Receives the First pre-MASH Units

Two such hospitals were equipped and sent to Australia with American troops. More would follow. Each hospital consisted of four officers, three of whom were surgeons, and 25 enlisted men, including medical, surgical, laboratory, administrative, and mess personnel. While awaiting orders to move out from Australia they practiced packing up and moving, refining the procedures to be used in the jungles of New Guinea.

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The station hospital at Port Moresby was a busy place. “Four days after we were given this real estate, which was covered by high kunai grass, we had 500 patients,” remembered Lt. Col. C.T. Wilkinson, one of the doctors who served there. “They had to bring in water from miles away and there were Japanese air raids every night. Doctors did the carpentry for the operating room and the nurses painted the interior.”

In October the portable medical units moved to Port Moresby with the 32nd Division. They were subsequently located with the active units until the victory at Buna in January.

Surgery Within Earshot of Combat

There were no nurses at the forward portable hospitals at Buna. Here surgery took place within earshot of the firing. Sometimes enemy patrols were found at night inside the hospital area. On more than one occasion enemy planes used the red crosses on the hospital tents as targets for treetop-level strafing runs.

The first attempts to provide medical care at the front were dashed when the 22nd Portable Hospital was shipped in on boats that were sunk by the Japanese on November 16. All of the supplies and equipment and some of the personnel were lost.

Conditions were appalling for the next month. There were shortages of everything. Swarms of malarial mosquitoes blackened the skin of patients. Bold swamp rats did not care if they chewed on the living or the dead. Fever was treated by placing a shivering man in a stream until his temperature came down. Maggots infected wounds. Records were lost, and evacuation by litter or on the hood of a jeep was torturous.

Infections As Well As Battle Wounds

Fully 70 percent of the battle wounds at Buna were in the limbs. The Japanese .25-caliber bullet tended to wobble in flight and strike slightly off-center. This resulted in a large exit wound, causing more damage than a bullet with a perfect trajectory.

All types of battle and personal injuries were treated in the portable hospitals. Plaster of Paris casts were routinely applied to immobilize fractures. Sodium pentathol was the most common anesthetic used at the front due to the flammable nature of ether.

Infectious jungle-borne disease was perhaps more prevalent than battle wounds at the portable hospitals. At Buna, the doctors as well as the patients were infected with malaria, dysentery, jungle rot, and other maladies. Two hundred men at Buna died of typhus alone. Almost every man on both sides contracted malaria. Other diseases claimed their share of victims as well.

The Battle of Buna was an overwhelming experience for those who lived through it. The hospital personnel could not have anticipated the thousands of casualties that came through their tents in the months of November and January 1942-1943. The painful lessons learned, and the progress made in medical technology, helped to save thousands of lives in later battles and future wars.

In fact, the Portable Army Surgical Hospital was so successful that it was adopted on every front of the war where Americans fought. During the Korean War the name of these medical units was changed to the more familiar Mobile Army Surgical Hospital (M.A.S.H.), made famous by the movie and television series.

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