The invasion of Normandy on 6 June 1944 heralded the beginning of the largest amphibious landings in history. Using over 4,000 ships, these operations were designed to drive German arms from the Cherbourg sector on the northern French coast. Within a month after the initial landings the outcome was clear. The Allies had been successful in their landings, and the Germans were retreating in much the same manner as others had retreated before them during the earlier years of the war. The many months of planning, preparation, and training prior to the invasion had begun to pay dividends.
The story of the Navy Medical Department was principally one of planning for and participating in the assault on the Normandy beachheads. Medical services of the United States Navy were designed to support the operation. The primary responsibility, following the pattern of preceding invasion, was: (a) medical services to all attached and embarked personnel between the ports of embarkation and the assault beaches; (b) seaward evacuation and hospitalization afloat within the combat zone; and (c) medical service while operating jointly with the ground forces, to all personnel in the beach areas. To fulfill this mission, it was necessary to plan, prepare, organize, train, supply, and equip the medical elements of the force for the task. The final
medical plan was a natural culmination of this preoperational preparation.1
Arriving in the European theatre of operations in November 1943, the staff medical officer of the Western Naval Task Force began preparations for the coming invasion. From experiences derived in earlier operations, plans were drawn up, including tables specifying responsibilities as between the Army and Navy, estimates of casualties, casualty evacuation and recording plans, and matériel and personnel plans. Various facilities, including LST's, hospital ships, transports, sea rescue craft, air evacuation by the Army, and advanced amphibious bases, were planned for use. Medical personnel were augmented and given additional training.
The final Navy medical plan, following generally those formulated in earlier operations, was concerned with three main phases--the far-shore, afloat, and the near-shore. The far-shore phase on the coast of Normandy was concerned largely with the prompt exchange of medical supplies and equipment and the evacuation from the shore to ships of casualties. Afloat, medical care was to be given to casualties according to their needs and the medical facilities available. The near-shore phase was concerned with the Navy's responsibility for the delivery of casualties to the Army and near-shore ports or hards in the United Kingdom.
The principal task of the Navy Medical Department was that of shore-to-shore evacuation. Initially, there was to be a total evacuation of ineffectives except non-transportables, while later a 7, 15, 30-day, and longer policy of holding casualties ashore was to be followed, as directed by the Army. In the short-to-ship phase on the far shore, any boats used in amphibious operations were to be used in evacuating casualties from the beach. LST's were to provide the main casualty lift for shore-to-shore evacuation. LCI's were to carry ambulatory cases; transports were to provide casualty lifts as the military situation permitted; hospital carriers were to be available after D plus 1 day; and hospital ships were to be used for evacuation from major ports to the United States. Estimates provided for .17 of 1 percent sick and non-battle casualties, and 5 to 8 percent for the Army and 4 to 8 percent for Navy casualties. If chemical agents were resorted to by the enemy, casualty percentages would be higher. Complete reporting of casualties on arrival at the near shore was to be provided by signal, voice, dispatch, and hand.
The Navy being committed to cross-channel evacuation of all casualties, it was anticipated that LST's would comprise the main casualty lift. Because of the uncertainty as to beach characteristics, underwater obstacles, and mines, it was believed that LST's would be unable to beach in the early stages for the purpose of embarking casualties. Tests were conducted, therefore, to devise methods for embarkation over the side of the ship while unloading operations were in progress. In February and March 1944 the medical personnel designated for use aboard the LST's began arriving in the United Kingdom.
Special training courses were inaugurated for these personnel, and in April, practical demonstrations in casualty handling were held at Fowey, Cornwall. The final distribution of medical personnel to LST's included 90 LST's with 3 medical officers and 20 hospital corpsmen each; 13 LST's with 2 medical officers and 20 corpsmen; and 3 LST's with 1 medical officer and 20 corpsmen. Army surgeons and medical personnel were added in some instances. Each of these LST's was equipped with medical supplies and equipment to provide surgical and nursing care for 200 patients on the return to the United Kingdom. Medical Supply dumps were established at Southampton, Portland-Weymouth, and Brixham for the resupply of medical materials.2
In general, preparations for the Normandy landings were a refinement of those formulated for the North African and Italian invasions. The lessons learned at Sicily, especially, were drawn upon in preparation for Normandy. The anticipated reliance on LST's as casualty evacuation ships in the Normandy operation was the direct outgrowth of the lessons learned at Sicily, where the LST's had demonstrated their practicability for the evacuation of casualties in short haul operations. That the faith placed in their selection as casualty evacuation ships for the Normandy operation was not misplaced
was to be proved in the landings of 6 June and thereafter.
The Normandy landings, so far as the American forces were concerned, were concentrated in the Bay of the Seine on two main areas designated as OMAHA Beach and UTAH Beach. Navy medical personnel landed on these beaches as early as H plus 40 minutes. The military situation at OMAHA Beach was such as to limit operations to primary first aid until late on D-day, while on UTAH Beach initial casualties were relatively light, allowing for the establishment of a general medical organization.
The Normandy Beachheads
The Navy medical organizations assigned to OMAHA Beach were the medical sections of the 6th and 7th Beach Battalions. During the initial assault, severe enemy opposition resulted in the loss of a large part of the medical supplies brought to the beach by craft and DUKW's, as well as that which was hand-carried by personnel. Fortunately, medical supplies from other sources proved to be adequate, except for litters, the need of which became acute. At first, it was possible to give only first-aid treatment, owing to the tactical situation on the beach and the necessity of keeping the beach cleared of casualties.
Casualties on D-day at OMAHA Beach were placed on any available craft and dispatched primarily to LST's and APA's. It was impossible to keep a record of casualties during the early stages of
the assault. A time lag occurred on D-day, when casualties were not cleared from the beach for a period of from 4 to 8 hours. This was caused by the confusion and by the demands of military action which did not leave any small craft for evacuating the wounded. By D plus 1 day, however, the medical sections of the two beach battalions were established on their designated beaches, and medical supplies, including litters, were being sent ashore in sufficient numbers to meet the demand. Casualties were being evacuated over definite assigned areas, records were being kept, and the chain of evacuation from shore to sea was functioning according to plan. As the beachhead progressed, the Army far-shore medical battalions became established about one-half mile inland from the high-water mark. Casualties were evacuated by three main routes to the beach, where the Navy had established three evacuation stations.
Army transport planes began evacuation of patients by air from OMAHA Beach on D plus 4 days -- 10 days ahead of schedule. According to plan, however, the major portion of casualties was at first evacuated to any LST available. This slowed down reloading operations on the return to the United Kingdom, so certain LST's were designated as evacuation ships. British hospital ships were used to some extent, but difficulty was experienced in transferring patients to them. By D plus 10 days, it was impossible to evacuate patients by sea, and air transports succeeded in evacuating some 1,890 cases. By D plus 17 days air evacuation was of the utmost importance and sea
evacuation was held in a stand-by status, being used mainly for ambulatory cases. By D plus 13 days, one axis of casualty evacuation had become established, where patients were sorted according to types of wounds. Direct telephone communications were set up to the Navy beach evacuation station, from which the evacuation control center could be notified when a LST became available. This line was also available to the air evacuation center. The over-all results was greater efficiency and speed in handling cases and maintenance of records.
The general concept of casualty evacuation was carried out at OMAHA Beach essentially as planned. With the exception of a few hours on D-day, there was little delay in evacuating casualties. The changing normal back-drift of casualties and route of casualty flow was met by the elasticity and mobility of evacuation station organization. The cooperation between the medical units of the Army and Navy was of the highest. By D plus 17 days, the assault phase was considered to be over, and the casualty-evacuation system had become well regulated. The medical personnel of the far-shore party organization gradually took over the routine of dispatching casualties, and the Navy beach battalion medical sections were returned to bases in England by D plus 24 days. During the period covered, the percentage of casualties was 27 percent (2 medical officers and 20 hospital corpsmen) for the 6th Beach Battalion medical sections, and 13 percent (1 medical officer and 10 hospital corpsmen) for the 7th Beach
Battalion medical sections.
Navy medical service on UTAH Beach consisted of the medical sections of the 2nd Beach Battalion. Landing at about H plus 1 hour with the assault waves, the medical services were functioning well by H plus 2 hours. Organized after the initial phase under the senior medical officer acting as general supervisor, two medical officers were assigned to the 261st Medical Battalion of the Army as Navy liaison officers; two medical officers established and operated first-aid stations about 1,000 feet apart on the main beach, and two medical officers served as evacuation officers on the beach proper. Hospital corpsmen were allotted to the individual medical officers as needed by individual requirements. Casualties among the 2nd Beach Battalion medical sections were relatively light, with 1 officer and 7 men killed and 12 men evacuated because of wounds.
A portion of the medical supplies was lost at UTAH Beach in the early stages because of enemy action, but needs were adequately met from beach bags (medical resupply units). Later needs were met by generous supplies from the ships, and from the pool maintained by the 261st Medical Battalion of the Army. With the exception of the first few hours, no particular shortages developed. One-fourth ton trucks supplied to the medical officers of the 2nd
Beach Battalion proved invaluable in transporting supplies, as did jeeps. Communication needs were met by radio sets providing contact with dispersed medical activities, with signals being transmitted every 15 minutes. Clearing companies were located 500 yards inland from the beach, but by use of hand radio sets, close and efficient contact was maintained between the various medical units.
During the early hours of D-day on UTAH Beach, all possible means of seaward evacuation were used, including DUKW's, LCVP's, and LCT's. Jeeps fitted to carry litters were used to transport patients to evacuation craft, with as many as 200 casualties per hour being loaded in this way. Most of the casualties were transferred off-shore to LST's, although in some instances, patients were conveyed to hospital carriers and other ships, particularly during the early hours when LST's could not beach. At times it was necessary to transfer casualties from DUKW's to LCT's while afloat. Hospital carriers proved to be unsatisfactory, largely because they had to anchor far from the shore, which necessitated additional handling of patients. The Navy organization for evacuating casualties from UTAH Beach was well organized, and a minimum of divided responsibility was encountered. On D plus 29 days, the 2nd Beach Battalion was relieved of the duties of casualty evacuation, and a medical officer of the staff of the NOIC UTAH was charged with the responsibility of evacuating casualties.
Far-shore medical units were well supplied with emergency matériel from stocks maintained in vessels of the naval force -- mainly LST's. Although some was lost during the early landings, beach bags of the medical resupply unit were sufficient to fill the gap until Army medical resupply dumps were established ashore. Localized shortages did exist or became imminent in some instances. Part of this was due to the fact that LST's could not beach in the early assault phases, and Army unloading details did not like to accept the exchange units as part of the cargos to be unloaded. Later, when LST's beached, this difficulty was not experienced. Among the items furnished to shore medical units by Navy vessels were litters, blankets, whole blood plasma, and beach bags.
Afloat, staff medical officers in key command echelons were located on the USS Augusta, USS Ancon, USS Bayfield, and in the Shuttle Control Headquarters Ship. During the approach to Normandy, very few personnel casualties were experienced in the assault force. Those which occurred were largely air-borne and air-force personnel. Sea rescue work was efficiently effected by Coast Guard-manned sea rescue craft. Casualties from enemy action were handled in some instances until sorting was completed. Evacuation to England was accomplished primarily on LST's, with lesser numbers being carried by transports and hospital carriers.
The fundamental task of the medical service afloat was that of cross-channel evacuation to England. On D-day, the 103 LST's assigned to the Western Naval Task Force performed as anticipated. Fifty-four of these had been converted for casualty handling. The remaining 49 were implemented with additional medical personnel and supplies. The original idea of using all LST's for evacuation of casualties proved unsound, because of the loss of time required to unload patients from LST's needed for carrying additional military matériel across to Normandy. Consequently, as evacuation became better organized, only designated LST's were assigned the evacuation task.
The first casualties were received afloat by H plus 2 hours. At H plus 6 to H plus 8 hours, the seaward evacuation organization had begun to function. In the UTAH section, early beaching of LST's facilitated evacuation, while in the OMAHA sector, evacuation was delayed by beach obstacles and enemy resistance. The actual drying-out of LST's was possible in the UTAH area, which materially facilitated casualty loading. Drying out LST's was not expedient at first in the OMAHA-area, however, thus necessitating the use of specially developed handling equipment and technique. While not having specific responsibilities for evacuation, certain ships, particularly the USS Bayfield and USS Achenar, rendered invaluable service in receiving and caring for casualties until they could be transferred to
LST's and hospital carriers. Of the 5 British hospital ships, 4 were available for receiving casualties from D plus 1 day onward, 1 having been damaged by a mine while proceeding on its way to the assault area.
Near-shore medical facilities were adequate to accomplish the task of receiving casualties brought from the far-shore. Beginning with the arrival of a few casualties at Portland, England, on D-day, and at Southampton on D plus 2, the heaviest loads for both ports occurred on D plus 3 and D plus 4 days. Lesser numbers were received at Plymouth and Falmouth. These were casualties from the initial landings. Most of the wounded arrived in England in good condition, having received first aid on the far shore and additional treatment during the cross-channel trip. Life-saving surgery had been resorted to when necessary, and non-transportables had been detained at holding units. Naval casualties were sent ashore to Naval Base Hospital No. 12 when possible.
Near-Shore Operations in England
The near-shore medical facilities functioned satisfactorily for the most part. One exception occurred at Portland from D plus 4 to D plus 7 days, when 3 convoys of 67 LST's awaited unloading facilities. Operational units responsible for the Military success
of the Normandy landings insisted on the priority of loading, regardless of casualties. Because of this congestion, the LST's were retained outside the breakwater, which necessitated unloading of casualties to LCT's, from which they were unloaded onto LCT hards made available for this service. In one period of 3 hours, 1,100 patients were unloaded by this means. Approximately 12, 834 patients were unloaded at Portland by D plus 22 days, and 6,065 at Southampton.
Running records of battle casualties were efficiently recorded, with information being supplied to the central recording section within a few hours after debarkation in the near-shore ports. By 5 July (D plus 29 days), 23,377 casualties had been reported to the Service Force Casualty Section; 22,455 casualties were known to have debarked in England. A break-down of the 23,377 casualties included: U.S. Navy, 2,078; U.S. Coast Guard, 76; U.S. Army, 17,247; Allies, 1,298; and POW, 2,678.3
During the first 11 days, certain additional statistics were available, which, though not conclusive, give a general picture. The ratio of Army to Navy wounded analyzed was approximately 11 to 1. The Navy received slightly more wounds per man, and of the Navy wounded, a higher percentage was severe. Burns and blast injuries, wounds of head, face, and neck, and simple fractures were higher among Navy
personnel. Extremity wounds in the Army were 13 percent higher than in the Navy. Injuries of the extremities, due to accident, were approximately 4 times as high in the Army as compared to the Navy. The percentage of chest wounds among Army personnel was nearly twice that of the Navy. Casualties caused by disease among Army personnel approximately doubled that of the Navy.
Casualty evacuation statistics through D plus 11 days are interesting, especially as they show the predominant part played by LST's. Of the 106 LST's in the Western Naval Task Force, 95 carried casualties on one or more return trips from the far shore; 49 of these made 1 trip, 41 made 2 trips, 4 made 3 trips, and 1 made 4 trips. An average of 70.24 casualties per LST were carried on the first trip, 106.56 average on the second trip, and 76 average on the third trip. Only 1 LST carrying 179 casualties made a fourth trip. The average per LST for the period was 78.4 casualties, with the greatest single load recorded being 331. two loads of over 300 casualties were carried; 16 loads of over 200; 288k, over 100; and 101, of less than 100. Of the transports in the operation, 2 made 2 evacuations to the near-shore, 6 made 1, and 2 made none. The total number of casualties evacuated by transports was 560, the average being 56 per load. One hospital carrier completed 1 evacuation, 2 completed 2, 1 completed 3, and 1 made none. The total evacuated by hospital carriers was 2,272 -- the average load being 284, and the largest single load, 643. LCT's returned 6 casualties to the near-shore. Summarized percentages
were: LST's -- 79.6 percent, transports -- 3.86 percent, hospital carriers -- 16.46 percent, and LCI's -- 0.04 percent.4
Medical material proved sufficient to meet the demands of the near-shore. Use of reserve materials was not required, as no loss on the near-shore was experienced as a result of enemy action. The use of air transportation to evacuate casualties from the assault area 10 days ahead of schedule also helped to reduce the amount of medical material required by ground and naval forces concerned with the evacuation of casualties. LST's usually received medical supplies on board in less than 30 minutes after docking at the port loading point. A need for a few supplies not provided int he planned supply list developed as the assault progressed. Direct shipment of those items was accomplished by special truck from Exeter or from Army supply depots direct to port issue points.5
The following casualty figures, based on data available on D plus 114 days, further emphasize the importance of LST's in cross-channel evacuation. Casualties for all services included: U.S. Navy, 2,433 (363 dead and 2,070 wounded); U.S. Coast Guard, 117 (25 dead and 92 wounded); U.S. Army, 41,147 (1q24 dead and 41,023 wounded); Allies, 1,899 (5 dead and 1,894 wounded); and prisoners of war (POWs), 9,101 (4 dead and 9,097 wounded). Of these, LST's carried a total of
41,035, the average casualty lift being 123. The maximum lift was 425 casualties, and the minimum lift was 1.6
The experiences of U.S. naval medical units at Normandy were not radically different from those of earlier invasions. There were, however, a few incidents which emphasized the scope of operations and the types of treatment given.
Battle Medical Experiences
One of the medical incidents worthy of comment was the sinking of the transport, USS Susan B. Anthony. Proceeding in convoy on 7 June of OMAHA Beach, this vessel experienced a violent explosion at 0757, just prior to her estimated arrival time at 0800. According to survivors, "The ship lifted and hogged, and then settled and sagged." A high column of water was noted abreast of Number 4 hatch. All power, including the emergency power, was lost as a result of the explosion, and the steering gear was useless. The rudder indicator went to hard left and remained there, while the ship veered to the left, losing way. The international signal, "not under command", was hoisted, as was the Morsig signal, "I have been mined." The whistle and the siren were inoperative. A list to the starboard was temporarily corrected by shifting troops to the port side. Numerous vessels, including the USS Pinto, 2 LCT's, and 1 LCI, and 2 British escort vessels, proceeded to her aid. By 0830, the commanding officer ordered
the senior medical officer to prepare to evacuate casualties, and the troops were being evacuated. By 1010 the USS Susan B. Anthony had sunk, but not before all hands and a large proportion of equipment had been safely transferred to other ships. Fortunately, no troop loss of life had resulted. One officer and 14 men of the ship's complement were injured, but none were killed.
After the explosion, an inspection of the ship was made by the senior medical officer. The medical office was found to be in a state of wreckage, with files opened, decks uptorn, the bookcase smashed, the safe wrenched out of position, and cabinets upset. In the sick bay. all bunks were torn from the bulkheads, cabinets were upset and their contents spilled onto the decks. In the operating room, the head and its bulkhead were destroyed. Plumbing connected with the stablizers had been pulled apart, but the autoclave remained in position. Broken batteries resulted in the emergency battery light being inoperative, lockers lay on the deck, but the water tank and oxygen unit remained intact. The storerooms were demolished, with supplies scattered along the deck in a useless condition. Strong fumes from the contents were observed. The diet kitchen was the least damaged place, there being only a few broken dishes. In the pharmacy, all bottle racks had broken loose, the bottles were smashed on the deck, the safe and microscope had fallen to the deck, and the scales were broken. The isolation ward was wrecked and all bunks and lockers were lying on the deck. The dental office was upset, but little
damage was done to the apparatus, which had remained in place.
Patients were sent to the various stations. At 0840, a message was received to evacuate casualties at the port side of Number 4 hold, and about 20 stretcher cases were rigged and lowered to the deck of the USS Pinto, and almost immediately transferred therefrom to the British DD< L 60. The health records of the officers and crew were placed in a canvas bag and transferred to the care of the PhM1/c aboard the USS Pinto. The types of injuries sustained were 7 fractured legs, 1 fractured arm, 12 head injuries, 2 nose injuries, 2 crushed chests, 6 back injuries, 3 knee injuries, 1 hip injury, 1 crushed hand, 1 abdominal injury, and various contusions, lacerations, and abrasions. By 0915 all casualties had been evacuated, and first aid was continued for minor cases. Hospital personnel were transferred to USS LST 134 by 0950, with the exception of two who went to USS LST 375. Aboard the LST's, these men aided in the care of casualties.7
The report of the USS Baldwin (DD-624) is illustrative of the problem of keeping up the efficiency of personnel under the strained conditions of almost continuous general quarters. Although there were no casualties, this vessel stayed at general quarters from 2200 5 June to 1430 8 June. Messing was greatly facilitated by use of Army K rations,
of which there were 900 units aboard. These were supplemented by soup, sandwiches, and coffee at noon on the second and third days, and frequent distribution of coffee and water by the repair parties. The use of heads was limited ot the fourth hour of every four. Ventilation was started at intervals, and then stopped. Rest periods for the men were taken at every opportunity during lulls in fighting by letting a portion of the men at stations relax or sleep, while the others remained alert.8
The USS Bayfield, although not designated to handle casualties, performed creditable work. By D plus 10 days, a total of 419 casualties had been brought aboard, of which 307 were received on one night. These men were distributed throughout the ship in the junior officers' quarters, troop officers' quarters, troop quarters, mess deck, and sick bay. These casualties were removed to other vessels the following day, after having received examinations and medical care.
LST's, playing a major part int he invasion of Normandy, went through diversified experiences. In addition to receiving Allied casualties, many POWs were received; they were given the same treatment as Allied patients. A description of some of the POWs is given by one LST medical officer, who reported:
Our Army in one big drive captured an enemy field hospital and we received the largest part of the patients. These patients were sadly in need of care. In some of the cases maggots were found eating away the dead tissue. We transplanted some of these to wounds of other patients for further cleansing of dead tissue.8
Continuing, the report mentioned that 1 emergency appendectomy, 3 guillotine amputation of legs, and 57 debridements were performed, mostly bullet and shrapnel removals. These major operations were done under pentathol sodium anesthesia, except for exploratory cases in which ether was used. In minor surgery, 2 percent procaine hydrochloride was employed. No ill effects were noted from any of these agents. Sulfa drugs, penicillin, and bartiburates were given freely to those requiring them, and no sensitivity developed. Gas gangrene serum and tetanus vaccine were used when necessary, and no cases were lost due to these causes.9
The report of USS LST 7, commenting further on the condition of German wounded brought aboard, declared:
On one occasion this ship transported a load of German wounded with their own medical officers. There was not a single wound redressed during the trip that was not terribly septic or gangrenous. It is doubtful if any medical officer of the U.S. Navy has ever seen anything quite as revolting en masse and certainly not on our own boys. Thank God we are Americans!!10
This report of USS LST 346 is illustrative of conditions met
during the early assault stages. So far as this ship was concerned, there was some delay in getting LCT's to approach to take off supplies and equipment while the LST was at anchor. Furthermore, hardship to casualties was experienced when they were brought aboard prior to the unloading of troops and vehicles. Makeshift arrangements were resorted to by using crew quarters, but many casualties were forced to remain in the damp and cold on the weatherdeck. Furthermore, this LST did not have hospital accommodations, and did not fly the "Mike" flag, but was sent more casualties than were sent to LST's designated as hospital ships. DUKW's returning to the beach, after unloading casualties, would not take medical gear and blankets, thus making it necessary for the LST to return to England without disposing of them. All cases with wounds of the thighs, buttocks, and extremely dirty wounds, and compound fractures, received 20,000 units of penicillin every 4 hours, with a total of 1,000,000 units being administered.12
Sea rescue boats were used extensively in the Normandy operations, while in the Salerno landings LCI(L)'s had been used. This was the first known use of 83-foot Coast Guard cutters in amphibious landings. Between D-Day and 19 July 1944, over 1,000 men were rescued by these cutters. A total of 194 survivors were picked up off OMAHA Beach and 157 off UTAH Beach during the first hours of operation on D-Day, while in the eastern area cutters picked up 133 survivors. From D-Day through 17 June, they rescued 535 survivors. The following
extract from the log of one of these boats illustrates the duty performed by them:
Cutter Sixteen 1730, 5 June joined invasion task force (Convoy U-1A) off Portland Bill. 0300, 6 June, arrived area -- 0530, accompanied invasion barges into shore under severe shelling attacks and with mines going up all around us. 0730, LCF-31 hit by shell 800 yards off shore, sinking immediately. While engaged in picking up survivors, shell struck PC-1261, which disintegrated, scattering men and debris over a wide area. While so engaged, shells and bullets were falling near by, and just after last man picked up, small landing craft only few hundred yards off shore blew up. Proceeded to spot and picked up all living survivors. Then proceeded to APA Dickman and unloaded survivors. Two men pronounced dead, but one was revived later and put aboard an LST. Departed again for invasion coast. 1045 sighted LCT-777 down by stern 1500 yards from the beach. Moored alongside and took off all wounded. After leaving this ship, which was being used as an ammunition ship, was told by one of the survivors (soldier) that a wounded man with two broken legs was still inside one of the gun tubs, so returned alongside for the second time. Crew passed line under wounded man's arms and haled him clear just as LCT turned turtle. Those survivors turned over to an LST which was acting as a hospital ship. No more rescue work during balance of day or following night. Received orders to return to base. Arrive 1700, 7 June, 1944.13
The majority of survivors were so weak that help had to be provided in bringing them aboard. Davits for hosting 400 pounds of weight were on some of the cutters, and RAF valise type life rafts, scramble nets, and life lines were also used. Reports indicated that approximately 50 percent of all survivors picked up during the first 48 hours were either seriously wounded or suffered from shock. Although pharmacists mates were not aboard, first aid on the cutters saved a number of survivors. In some cases, even where two limbs had
been blown off, survivors were kept alive until transferred to hospital ships. In addition brandy issued as a stimulant, coffee and tea were available to each unit, as were blankets. As the brandy and blankets proved insufficient in some instances, several crew members gave their own clothing to keep survivors warm and dry. In addition to straight rescue work, an assortment of miscellaneous duties was performed, including the urgent transfer of blood plasma, spotting of mines, and engagement with enemy aircraft.
Various observations may be made on the medical aspects of the Normandy landings, so far as the Navy was concerned. Medical personnel of the Navy were assigned operationally to LST's in April and May as they became available in the theater. Army medical personnel arrived on board on 25 May, and were generally detached about a month later, during which time they participated in an average of 3.8 trips and carried patients on 2.2 trips. 84.8 percent of the medical officers considered the distribution of medical personnel to LST's as adequate, 13.4 percent considered distribution as inadequate, and 1.8 percent considered it to be excessive. The preliminary training and indoctrination of medical personnel proved to be of value. For future operations, it was believed that minimum medical personnel requirements for LST's for an average casualty load of 150 casualties for 36 hours should be 2 medical officers (including 1 surgeon) and 20 hospital corpsmen (including at least 2 surgical technicians),
Comments, Conclusion, and Recommendations
reinforced by surgical teams, to be available in the early assault stages. Later, if LST's were to be used as ambulance ships, 1 medical officer and 10 hospital corpsmen would be sufficient.
The operational distribution of medical matériel was considered to be adequate by 86 percent of medical personnel, excessive by 12.6 percent and inadequate by .06 percent. Although basic normal requirements were met, resulting in a reduction of transporting, storing, issuing, and requisitioning, it was believed that there was some need for modification of medical allowances. Particularly, revision of LST casualty treatment units and medical officers' emergency surgical outfits, supplying wider plaster of paris bandages, pre-packaging of sterile burn dressings, and a standardized uniform type of "Running Record of Battle Casualties" were stressed. In general, basic medical supply and resupply units were adequate for the Normandy operation. however, it was recommended that a standardization of a uniform basic allowance,l supplemental to the ships' allowances for LST's, be established. Specifically, it was suggested that whole blood, penicillin, biologicals, etc., be issued to each LST, and the allowance for LST's be increased, as should the allowance of bleaching powder for purifying water, and the emergency ship's toilets for sanitary reasons.
Structural characteristics were inadequate in some instances. Toilet facilities were insufficient on tank decks. The transportation of litter cases was difficult, and the top tiers of
stretcher racks on LST's were inaccessible because of their height from the deck. The platform at the after end of the tank deck was located directly below the forced draft ventilators, which caused undesirable air circulation and precipitation of moisture in the surgery area. In general, however, structural arrangements were an improvement over those in earlier operations. For future operations, it was recommended that all LST's be converted for casualty handling; improvement be made in sanitary facilities; alterations include openings from the tank deck into the troop spaces; better access be provided for handling litter cases; the receiving ward, wash room, and operating room be located in the troop spaces with ingress and egress provided to and form the tank deck; demountable ladders be provided to escape hatches; and permanent stowage space be allocated in each ship for supplemental medical matériel.
Casualty evacuation demonstrated the usefulness of LST's. A compilation of casualty figures received from 83 LST's from the first 3 round trips showed 4,480 (32.5 percent) ambulatory cases, and 9,293 (67.5 percent) stretcher. Of LST's afloat, 5,682 (55.7 percent) casualties were loaded over the ramp, 3,484 (34.1 percent) were hoisted by sling, and 1,031 (10.2 percent) were hoisted in boats to the deck level; 3,576 (26 percent) were loaded over the ramp on LST's and dried out or beached. Individual officers criticized the unequal distribution of LST's for casualty evacuation during the landings. However, military necessity decreed concentration of casualty evacuation
in certain LST's to free the remainder for other duties. The LST provided an excellent means of casualty evacuation where only short hauls were required. Loading of LST's was best accomplished over the ramp when the ship was beached or dried out; and the other methods of loading casualties were of practical value in meeting variable situations.
Hospital ships were unsatisfactory in general, although they did free a larger percentage of LST's for other uses. Some of the difficulties encountered were due to the fact that these ships were not fitted for amphibious casualty evacuation. Ambulance boats assigned to these ships were not adapted to carry standard pole litters, and were difficult to load. Casualty-handling equipment was lacking. Furthermore, medical personnel had no special training for the task of evacuation, and confusion was experienced because these ships were controlled by the British Ministry of War Transportation. Despite these considerations, these vessels completed 6 trips by D plus 11 days, and carried some 2,272 casualties. For future operations, it was recommended that these vessels be under the operational control of the Task Force; assigned personnel should be thoroughly trained in the duties involved; and casualty handling equipment should be provided, including the refitting of ambulance boats to handle standard U.S. stretchers.
Other casualty evacuation facilities, including APA's
and AKA's, LCI(L)'s, sea rescue craft, and air evacuation served a useful purpose. Medical personnel and matériel were more than adequate on transports, but, with the exception of the USS Bayfield and the USS Achenar, these ships played only a minor part in casualty handling, with only 560 casualties evacuated to England. LCI(L)'s were not generally utilized for casualty evacuation, although they performed a creditable job of handling casualties temporarily coming under their care. Sea rescue craft carried out their tasks in a satisfactory manner. Evacuation of casualties by Navy planes was not tried, although the transportation of evacuees by Army planes was followed with excellent results.
Inspection of the far-shore combat beaches indicated that mobility was limited and casualty evacuation control was hampered in Navy beach medical by having to designated means of transportation assigned. These inspections resulted in closer cooperation and understanding of immediate medical problems, thus enhancing a greater joint efficiency of the Army-Navy medical service in the vicinity of combat beaches. The utilization of a Navy evacuation control officer on each beach contributed to casualty evacuation efficiency. It was recommended for future operations that one jeep per beach platoon and two DUKW's per beach company be assigned for exclusive medical use, and that amphibious medical service doctrine include the services of a Navy evacuation control officer.
The performance of Navy medical personnel in beach battalions was generally effective. However, Army medical facilities took over practically all functions in the beach area about D plus 8 days with additional service being rendered by naval personnel during and immediately after the storm between D plus 13 and D plus 16 days. Medical sections of beach battalions were composed of especially designated naval personnel, not from APA complements. Additional beach battalion personnel had been requested, but none were provided. The high casualty rate among medical personnel of beach battalions on OMAHA Beach indicated that planning for these reserves had been sound. Had APA personnel been provided, and had APA's performed their usual role in evacuation, the medical services of the transports would have been seriously hampered. Although the services performed by beach medical personnel were exemplary, it was believed that trained landing force personnel could have performed the task equally well. Such assignment in the future would conserve medical personnel by virtue of "phasing in" the usual medical organizations existing in the landing force. Recommendations after the Normandy landings suggested that existing doctrine, as relating to beach party medical personnel, be reviewed to establish unity of control, eliminate duplication of function, and promote general efficiency of medical service on the assault beaches. The landing force should assume full responsibility for all medical duties landward of the high water mark, including the actual loading of craft and other boats in seaward evacuation.
Afloat, the loss of supplies in early assault phases was compensated
by provision of critical material in beach bags, and by litter units of landing craft -- through emergency issues made by LST's and from salvaged matériel. Despite loss, the supplies provided were adequate. It was recommended that the beach bag (Stock No. S13-468) be retained as the means of effecting emergency resupply to beach medical units during the assault stages of amphibious operations.
Pn the near-shore, the U.S. Army chain of evacuation and hospitalization facilities as established in the British Isles was effective. These facilities were supplemented by medical installations in various U.S. naval bases and by the 1,000-bed U.S. naval Hospital at Netley, Hants. Although not in the direct chain of evacuation, these naval activities played an important part in the care of casualties coming under their cognizance. Medical matériel proved to be adequate, and the medical resupply set up conjointly with the U.S. Army functioned most satisfactorily.14
1. G.B. Dowling, Captain, (MC), USN, Special Report to the Chief of the Bureau of Medicine and Surgery, U.S. Navy, of United States Naval Medical Service in the Invasion of Normandy, 6 June 1944, pp. 3-14, gives a thorough survey of preparatory phases.
2. "Medical Preparation and Casualty Handling, Operation Overlord," from the Staff Medical Officer to P.E. Howard, Commander, USN, pp. 1-3.
3. G.B. Dowling, United States Medical Service in the Invasion of Normandy, pp. 15-20.
4. Ibid., Appendix N, pp. N7-N10.
5. Ibid., pp. 20-21.
6. "Medical Preparation and Casualty Handing, Operation Overlord", pp. 3-4.
7. "Report of Loss of the USS Susan B. Anthony (AP72)", from the Commanding Officer to the Secretary of the Navy, 7 June 1944, pp. 21-24.
8. "Action Report for June 6-8, 1944, USS Baldwin (DD624)", from the Commanding Officer to the Commander in Chief, United States Fleet, p. 12.
9. "Annual Sanitary Report, LST 516, 1944", p. 9.
10. Ibid., p. 7.
11. Historical Data Report, USS LST 7, 1944, p. 2.
12. "Medical Report, USS LST 346", from the medical officer to the commanding officer, 17 June 1944, pp. 1-4.
13. "Action Report -- U.S. Coast Guard Rescue Flotilla One, during assault on American sector, Coast of Normandy," 19 July 1944, p. 4.
14. G.B. Bowling, United States Naval Medical Service in the Invasion of Normandy, pp. 23-28, is the basis for the above summary.