As a practicing surgeon for over 30 years, I became inspired with the history of medicine and especially World War II through my own mentor and hero, Dr. Alfred Hurwitz. Dr. Hurwitz was a front line surgeon who landed during the D-Day invasion, and with his field hospital followed the war through France, then Belgium during the Battle of the Bulge, to the Malmédy Massacre and finally the liberation of the concentration camps. After his death, his wife gave me the diaries he kept during the war.
Reading about his experiences on the front lines and the detailed history of his and other surgical field hospitals of WW II, I was so struck by the extraordinary valor of these men and women of the medical corps (the life expectancy of the medics was a mere 19 minutes) as well as the GIs fighting the war, that I felt compelled to write a historical fiction account of Dr. Hurwitz's experience, titled, None But the Brave: A Novel of the Surgeons of World War II.
One of the unique things about surgical practice during World War II was that this was a major turning point for advances that were destined to save thousands of our wounded both back then and for years to come.
Prior to World War II, many soldiers died from infections rather than from the grave wounds that they sustained on the battlefield. It was a source of terrible frustration for the surgeons and medical teams to be able to save the soldiers initially only to lose them later from overwhelming infections.
But the new miracledDrug, Penicillin, changed everything. Although discovered in 1928 by Alexander Fleming in England, it was not used clinically until about 10 years later, when Australian Howard Flory and others developed practical means for its extraction at Oxford, England. But difficulties in mass production made it so scarce and so precious at that time that on the battlefields -- whenever possible -- the urine of the soldiers on penicillin was collected so the drug could be re-extracted and then used again. Surgeons also had to be given specific instruction on its use, as the very idea of "antibiosis" was totally new to most of them.
About the same time, doctors and surgeons discovered the value of using plasma (the fraction of blood that does not contain red cells) to resuscitate those injured from severe burns, initially in the battlefields of the Pacific, and then in the European Theater of Operations. Plasma was subsequently used on the critically wounded soldiers beyond those who had severe burns which helped save more lives than the doctors could have ever imagined.
Finally, surgeons and medics during World War II quickly realized the strong relationship between getting the wounded quickly to a major medical facility and that soldier's survival. Since the use of helicopters to transport the wounded was not widely possible until the Korean and Vietnam wars, the answer in World War II was to keep the surgeons and their field hospitals as close to the fighting as possible. This challenge was met by developing very efficient teams that could dismantle the tents and equipment, packing them up and moving them closer to the front lines; then unpacking them and setting up the field hospital in the shortest possible amount of time. I recall Dr. Hurwitz telling how his field hospital could be dismantled and moved in a matter of only a few hours. In fact during the war, battle lines changed so fast that his own medical team more than once found themselves on the wrong side of the fighting. But in the end, again, this rapid response time saved uncountable lives.
There was also a dark side to these advances in medicine. For one thing, a fact often missed in the history of war time medicine is that it was generally far better to severely wound the enemy than to kill them. A dead soldier is dead. There is nothing more to do. A severely wounded soldier however takes up an enormous amount of time, personnel and supplies.
Unlike today, those resources were limited in World War II. So there was always the issue of "Battlefield Triage," which was the most awful decision that the chief surgeons of these field hospitals had to make. Deciding the allocation of supplies and personnel that would help some soldiers and be withheld from others. When I was not yet even in medical school, Dr. Hurwitz told me about the importance of tending to the dying patient. "You are not going to want to spend time with those patients you can't help. It is easier to sit and chat with the patient whose gall bladder you took out and who is going home in a few days all cured. But the patient in the next room -- the one who will surely die --is the one who really needs you company."
The most touching piece of World War II history was sent to me by Dr. Hurwitz's wife in a letter he sent just a week after landing on Omaha Beach:
The soldiers have been wonderful, never a whimper. Always "Yes, Sir," even with their last breath. It is the amazing courage of these boys that spurs us on. We can't sell them short. They must always be our prime consideration.
This has made me a wiser man. It has imbued me with the realization that petty things won't disturb me in the future, that there is an indescribable beauty in just living.