By Susan Speaker ~
“Operation Overlord”—the invasion of France’s Normandy coast that began on June 6, 1944—was the largest amphibious military operation in the history of warfare, and the turning point for the Allied Forces in World War II. Among the thousands of troops that waded onto the beaches, there were over forty surgical teams from the U.S. Army’s Third and Fourth Auxiliary Surgical Groups (ASGs). Dr. Henry Swan, a surgeon in the 4th ASG, described his team’s initial experience in a letter to his wife:
“On June 7 we arrived off the British beachhead from which they were attacking Caen. The channel crossing was calm. A solid bridge of boats of all sizes shuttling back and forth. We stayed aboard that night, and there was considerable activity overhead that night. The next morning, we sailed toward our landing area on the extreme rt-wing of the American beach out along the peninsula. Thus we had a birds-eye view of the entire length of the landing operations – the thousands & thousands of boats, navy vessels from battleships to E boats, LST, LSI’s, landing craft of all sorts. Not all of them were afloat, and the noise of the naval barrages was deafening at times. That night, i.e., D 2, we went ashore on an LCT, wading in up to our waists in the late evening. We dug in on the beach, wet & cold. The next three days we worked like beavers at various places. It was a hot spot then, as we are only about 1/2 mile from the flank. The details I’ll tell you some day, but all I know is that I never want to look up from the operating table again and see a neat little row of holes appear in the tent! The first morning, we hit the dirt in the O.R. when they came over, but when I saw the patient lying on the table with his hands over his face just sweating it out, I resolved that never again would I duck and leave the patient with the feeling of helplessness and desertion. Nor have I since.”
The ASGs were a major innovation in military medicine, designed to get skilled surgical care to wounded soldiers close to the front lines. The first ASGs, deployed in North Africa, Sicily, and Italy in 1943, dramatically increased the survival of wounded troops. Each team consisted of two surgeons, an anesthetist, two or three operating technicians, and several nurses when possible, working in large tents. The units were largely self-contained and could be moved around near battlefields as needed.
In the weeks after D-Day, Dr. Swan’s team moved from the medical clearing stations on the beach to field hospitals farther behind the lines. Though Swan enjoyed the challenges of so many surgical cases, the work was often grueling; on June 15th he wrote:
“The work continues heavy – Arnie [Dr. Arnold Segal, the team’s senior surgeon] turns lots over to me and I am rapidly accumulating quite a series. We work 8 hour shifts – on eight, then off eight. That allows but little time to get your eating, washing, digging, etc. done and I am still dog-tired. Haven’t caught up on those first 3 days yet, with no sleep, continuous work, punctuated only by occasional dives into the ditch. Our present set-up is much more quiet, however, and we only get attention from Jerry at night when he lays a few eggs around just to keep us alert. No strafing for the past 3 days.”
After several weeks of intensive battlefield surgery, Swan confided to his wife that it also raised conflicted feelings and ethical concerns for him:
“… my training, my ethics, my entire sensibilities as a physician are at constant odds with my thoughts and feelings as one who fights…. To fight is to destroy and injure and kill; to doctor is to heal, comfort, and alleviate pain. This conflict arises constantly in the ever present decision of daily action. In the case of the American wounded, which boy do you take care of? The one who has a minor wound, and who, if cared for soon, will be back in the fight directly; or the one with a grievous wound, who has a chance to live if you operate, but who, even if he lives, will never fight again? You can handle four or five of the first type, to one of the second; but you can’t do both. Which is more important to Uncle Sam? Which would you do, as a soldier? as a doctor?”
The Auxiliary Surgical Groups were a great success during World War II, and in the Korean and Vietnam conflicts were renamed Mobile Army Surgical Hospital (MASH) units. Dr. Henry Swan operated on over 1400 patients from June 1944 to August 1945, and went on to become a pioneering cardiac surgeon.
The National Library of Medicine is the repository for the Henry Swan Papers, which range from 1915 to 2009. The collection contains surgery records, correspondence, reprints, book drafts, speeches, reports, and biographical material. Many of Swan’s wartime letters (and the rest of his story) can be found on NLM’s Profiles in Science site.
Susan Speaker, PhD, is Historian for the Digital Manuscripts Program of the History of Medicine Division at the National Library of Medicine.