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Authors: Cate Lineberry

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Physical training was as important as the lectures and demonstrations, and the nurses performed daily exercises and long marches, where they were sometimes pelted with flour bombs in simulated air attacks to teach them to take cover. Military drills included navigating obstacle courses that required them to crawl under barbed wire with live machine-gun fire overhead, first on their stomachs and then on their backs. As they practiced on one particularly hot and humid Kentucky day, Watson watched as several of the nurses struggled to finish and passed out on the course after completing it.

Unlike the very first flight nurses, the women of the 807th didn’t have to fight to be able to wear pants rather than skirts as part of their uniforms. Months earlier, Col. Florence Blanchfield, the assistant superintendent of the ANC, had ordered flight nurses who were wearing the more practical men’s one-piece flight suits without authorization back into their regulation skirts. That policy changed after Blanchfield showed up at Bowman Field wearing the popular “pinks and greens” dress uniform, an olive-drab jacket with a taupe skirt. Having never flown before, the colonel accepted the offer of a demonstration flight. As she awkwardly tried to put on the required parachute while wearing a skirt, the nurses on board explained to her that she would only need to lace it into position in an emergency. Soon after takeoff, the plane experienced engine trouble and the pilot announced that all on board should prepare to jump. Blanchfield fumbled with fastening her parachute until the pilot was able to restart the engine. Shortly after, flight nurses were allowed to forgo their skirts and were given slate-blue uniforms consisting of short Eisenhower jackets with waistbands and matching pants and caps.

Unlike the nurses, the medics, all enlisted men, had received basic military training before volunteering for the air evacuation program. Their specialized instruction in air evacuation covered some of the same material the nurses’ program did, including survival skills and additional physical conditioning; but their medical experience, which included working with the nurses for a few weeks in local hospitals, was limited mostly to first aid. Their main focus was learning how to quickly and smoothly load and unload patients, which would be one of their primary tasks. To test their skills and to have a little fun, the medics in the various squadrons often challenged one another to see who could load and unload planes the fastest on practice runs. The 807th couldn’t be beat.

Though air evacuation was still new in 1943, medical evacuation itself had only been around since the Civil War. In 1862, the medical director of the Union Army of the Potomac, Maj. Jonathan Letterman, created a system to manage mass casualties, which included first-aid stations on battlefields, mobile field hospitals, and ambulance services. In late August 1862, it took a week to remove injured soldiers from the battlefield at Second Manassas, with many young men succumbing to their injuries as they waited alone and in pain for help to come. Less than a month later, the Battle of Antietam left twenty-three thousand casualties after twelve hours of bloody combat. With Letterman’s new triage system in place, medical personnel were able to remove all injured soldiers from the field within twenty-four hours. Though the lifesaving system was refined during the Spanish-American War, it remained virtually unchanged until the age of the airplane.

In 1910, seven years after the Wright brothers made the world’s first successful powered flight at Kitty Hawk and one year after the Army received its first plane, Capt. George H. R. Gosman and Lt. Albert L. Rhoades built an aircraft for the sole purpose of transporting wounded soldiers from the battlefield to the hospital. Though the plane they built crashed during its test flight and the War Department turned down Gosman’s pleas for financial assistance, the idea of an air ambulance had been born.

Despite the advantages of rapid evacuation that air ambulances could offer, concerns regarding the safety of planes, a technology still in its infancy, would linger for years to come. When Col. A. W. Williams, a retired Army officer, recommended at a meeting of the Association of Military Surgeons in November 1912 that the airplane be used to evacuate patients, the
Baltimore Sun
responded with an editorial stating, “the hazard of being severely wounded is sufficient without the additional hazard of transportation by airplane.”

Undaunted by the risks, French physicians and aviation enthusiasts began exploring the use of air ambulances, even proposing a monoplane that carried patients in a box under the fuselage. When French military surgeon Dr. Eugene Chassaing asked for government funds to develop a modified plane, one critic responded, “Are there not enough dead in France today without killing the wounded in airplanes?” Chassaing persevered, however, and using a Dorand AR.2, a French observation biplane, he designed a side opening that allowed room for two stretchers to be placed in the fuselage behind the pilot. In April 1918, two of his planes helped evacuate wounded from Flanders, marking the first successful use of air evacuation on specially equipped aircraft, a victory that helped ensure air evacuation’s future.

Though most of the world had been at war since 1914, the United States didn’t officially enter the fray until April 1917. With the rush to train thousands of new pilots at temporary flying fields in the States, the inexperienced flyboys crashed regularly, and getting medical care to the injured proved difficult because of poor roads. A surgeon was typically flown to the accident scene and provided medical care on site before transporting the flier to a base hospital in a motor ambulance over bumpy and unpaved roads. It took hours to deliver a patient, and many died along the way.

By 1918, Capt. William C. Ocker, the officer in charge of flight training at Gerstner Field in Louisiana, and reserve medical officer Maj. Wilson E. Driver modified a standard Curtiss JN-4, a biplane called a “Jenny,” to allow the craft to carry a patient in a litter, or stretcher, in the rear cockpit. That same year, they transported the first patient to be flown by plane in the United States. News of their success traveled, and air service personnel at nearby Texas airfields replicated their efforts and made their own modifications. On July 23, the Director of the Air Service ordered all flying fields in the United States to employ air ambulances.

Overseas, however, the U.S. Army Medical Department continued to evacuate troops using litter bearers, horse-drawn and motor ambulances, and hospital trains. Many patients, who frequently couldn’t be moved from trenches until dark, suffered long and difficult journeys over war-torn roads to get to a hospital.

When the war ended, several European countries continued experimenting with air evacuation and developed equipment and procedures for transporting casualties. The U.S. military, however, still continued to favor ground evacuation. In May 1921, the War Department stated, “In case of accident, the use of airplanes for the transportation of sick and wounded soldiers, when other safer means of transportation is available, could not be justified.”

In an effort to promote air evacuation and flight nurses in the United States, Lauretta M. Schimmoler, one of the few female pilots in the country in the 1930s, founded a commercial organization called the Aerial Nurse Corps of America in 1936. She began lobbying the military and the Red Cross to have her organization recognized as a military specialty but was repeatedly turned down. Despite the rejections, Columbia Studios made a movie called
Parachute Nurse
in 1942 in which Schimmoler served as a technical consultant and played a captain. The
New York Times
said the film “hardly makes for either instructional or entertaining fare,” but it helped further publicize both air evacuation and flight nurses. The military ultimately recognized Schimmoler’s contributions, and three decades later, the Air Force honored her as a pioneer in air evacuation.

The United States’ strategy for getting patients from the battlefield to medical facilities finally changed after America entered World War II. The demand for medical air evacuation and its success rate in saving lives overruled any remaining doubts about its safety or practicability. In early 1942, volunteer medics in C-47 cargo planes began mass evacuations of sick and injured construction troops building the Alaska Highway in freezing temperatures. When completed, the 1,500-mile road, which traversed some of the harshest landscape in North America, provided a vital ground route that connected the United States to Alaska through Canada, but it took a significant toll on the men who built it in just eight months. In that year, 223 of them were air evacuated within Alaska and 212 were taken to the continental United States. Some six thousand miles away, Allied soldiers fighting the Japanese were serving in such remote areas of Burma that only cargo and troop carrier planes could reach them. Using American-built C-47s, the Royal Air Force No. 31 Squadron flew some 2,600 sick and wounded patients to airfields in India in early 1942.

As these and other improvised rescues rallied support for air evacuation, the Army took notice. In May 1942 it activated the first U.S. air evacuation unit, the 38th Medical Air Ambulance Squadron, stationed at Fort Benning, Georgia. By the summer, the War Department officially designated responsibility for developing an air evacuation program to the AAF, the successor to the Air Corps and a forerunner of today’s modern Air Force.

Commanding General of the AAF Henry “Hap” Arnold asked his air surgeon, Brig. Gen. David N. W. Grant, a Virginian who had entered the Army Medical Service in 1916, to create the new program. A longtime champion of air evacuation, Grant ordered the 38th’s officers and enlisted men transferred to Bowman Field Air Base, built in 1940 on the east side of the commercial airport in Louisville. Grant’s new program, however, soon had to be scrapped. The AAF Director of Military Requirements insisted that “the activation of any puddle jumper squadrons” to evacuate sick or wounded was unnecessary. It was also at odds with AAF policy, which dictated that aircraft could not be designated only as ambulances—in part because in 1942 the AAF was operating with a vast shortage of planes.

Before the Second World War, the Army had fewer than 2,200 planes and 26,500 men. By January 1939, Hitler’s continued aggression and Germany’s expanding air force so alarmed President Franklin D. Roosevelt that he asked Congress to appropriate $300 million for the Air Corps. Congress agreed three months later and approved as many as 6,000 serviceable planes. The expansion continued as the country quickly recognized how much of the war would be fought in the skies. In June 1941, the U.S. Army Chief of Staff Gen. George C. Marshall established the AAF to control the Air Corps and the Air Force Combat Command. By the end of the war, the AAF would be considered a major military organization and would boast 63,715 planes and more than two million men and women.

Without the use of dedicated air ambulances, Grant reorganized the fledgling air evacuation program into the Medical Air Evacuation Transport Squadron (MAETS), which would be renamed the Medical Air Evacuation Squadron (MAES) in July 1944. Under Grant’s revised plan, first issued in late November 1942, which included the use of flight nurses for the first time, medical personnel would accompany their patients on available transport planes that were already delivering troops and supplies to forward areas. The transport planes could be converted into air ambulances in a matter of minutes on return flights by folding up their bucket seats and adding either web-strapped or metal-bracket litters to hold patients.

Though the medics and nurses of the 807th would have to rely solely on their medical kits during their first few months, each plane would eventually carry a chest of supplies that included everything the medical personnel might need to treat patients, including medications, bandages, equipment for administering intravenous medications and blood plasma, oxygen tanks, and chemically heated pads for flying at high altitudes. Most of the in-flight medical work allocated to the nurses would include adjusting dosages of certain drugs based on the effects of altitude, applying and readjusting splints, giving sedatives and stimulants, treating shock, and administering oxygen. Because the planes served dual functions, however, they could not be marked with a red cross on a white background as outlined by the Geneva Conventions and would be fair game for the enemy.

Medics were assigned from existing troops, but to fill the MAETS rosters with nurses, Grant had to publicize his need for registered nurses willing to fly at a time when most people in the country had never been on a plane. It wasn’t until January 1943, several months later, that sixty-year-old Roosevelt became the first American president to travel by aircraft on official business when he crossed the Atlantic to attend the Casablanca Conference with Allied leaders, a meeting which resulted in the demand for nothing less than “unconditional surrender” of Axis powers. With the waters of the Atlantic infested with German U-boats, Roosevelt’s advisors had reluctantly agreed to let him travel to the meeting on a Pan Am Boeing 314 flying boat accompanied by fighter planes.

On top of concerns over flying, Grant also faced a nursing shortage. The day the Japanese attacked Pearl Harbor, the Army’s roster listed only 7,043 available nurses. A massive propaganda campaign urging young women to join the Army or Navy nurse corps had been unleashed to help fill the need. Posters with slogans like “Become a nurse: Your country needs you” and “Save his life… and find your own” were distributed throughout the country. High school and college students watched filmstrips like
Uncle Sam Needs Nurses
and
No Greater Glory,
while radio and magazine advertisements and stories bombarded young women with patriotic appeals. The January 5, 1942, cover of
Life
magazine pictured the face of a young nurse and the line “Wanted: 50,000 nurses.” Even First Lady Eleanor Roosevelt, who had four sons serving in the military, pleaded in an editorial in the
American Journal of Nursing
in August 1942 for young women to join. “I ask for my boys what every mother has the right to ask—that they be given full and adequate nursing care should the time come when they need it. Only you nurses who have not yet volunteered can give it.… You must not forget that you have in your power to bring back some who otherwise surely will not return.”

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