And if I perish book review

And If I Perish, by Evelyn M. Monahan and Rosemary Neidel-Greenlee, tells the stories of US Army nurses. The Allies were closing in on Berlin. The campaigns in North Africa and Italy gave the US military its baptism of fire, but inflicted relatively fewer casualties on the invasion troops compared to the possible consequences of an assault on Hitler’s Fortress in Europe. Although most readers believe that women did not serve on the front lines in World War II, closer examination shows that women did serve on the front lines providing vital care to wounded troops. Lastly, military medicine at the start of the war was woefully inept at managing combat-inflicted wounds, but eventually caught up to save most wounded troops.

The campaigns in North Africa and Italy are a testament to the courage and ingenuity of US troops, but they also revealed major discrepancies in Allied planning. At the start of the war for the Americans, medical personnel quickly became skilled at improvisation because the lack of medical supplies demanded it. At the start of Operation Torch in Arzew, Algeria, when supplies were running low, Lt. Helen M. Molony of the 48th Surgical Hospital “…out of suture material…took a spool of white thread from her musette bag and sewed up his bladder with it (p. 47)”. After exhausting any available thread, the 48th nurses began using their own alcohol-sterilized locks of hair to stitch up the wounds of the soldiers in their care. Before entering the war, the War Department did not foresee the need for large amounts of basic medical equipment, such as the Wangensteen apparatus used to treat abdominal and gastrointestinal wounds, or even IV fluid holders for recovering patients. Although North Africa and Italy showed the Allies their flaws, the lessons learned were factored into the subsequent planning of military operations.

Later operations, such as Overlord and Dragoon, were planned with the lessons learned from the Torch and Shingle operations. Forward-thinking nurses like 1st Lt. Marsha Nash required her staff to visit “…the experienced 128 Evacuation Hospital at Tortworth Castle to observe and learn the process of setting up and taking down a field hospital, and how to improvise in combat areas when necessary medical and surgical equipment was not delivered with supplies as scheduled”, to gain the most insight in training before learning lessons the hard way through combat (p. 333 ). In preparation for the resulting casualties on D-Day, military planners undertook Operation Neptune where “…the 82nd and 101st Airborne Divisions dropped special canisters of medical and surgical supplies at various locations in Normandy…soldiers who landed on D- Day carried medical supplies and equipment along with his usual backpack and weapons… he dropped the medical supplies and equipment on the beachhead, to be picked up later… “allowing medics to set up makeshift aid stations to treat the wounded to the hospitals could be taken ashore (p. 323-324). The lack of basic medical equipment will at least be addressed by military planners in an entirely separate medical logistics operation on D-Day, but it will never be fully remedied as the nature of war will forever prevent it. Unfortunately, the new troops that invaded Normandy did not heed all the lessons learned from the Mediterranean Theater where “5,700 combat soldiers had fallen victim to trench foot…losing their toes, one foot or even both feet”, and the D-Day troops would eventually lose “…a grand total of 29,389 casualties in the European theater.” (p.425-426)

American women played an indispensable role in World War II. Army nurses saved countless lives and “…the survival rate of wounded soldiers who reached a battalion aid station was a remarkable 95.86 percent; 85.71 percent were able to return to duty” . (p. 258)

Army nurses also served as a psychological boost to wounded troops who “gave how their own girlfriends, wives, and families might respond to them by how these women reacted to their injuries (p. 106-107)”. Army nurses, just a year or two apart in age, gave wounded men the confidence to write to their loved ones about their disfigurement. Volunteer nurses were expected to flee in the face of combat, but they demonstrated the same courage and commitment to duty as the men they cared for. For example, at the Anzio beachhead, when “…the shelling began, Roe and Rourke refused to leave their patients, though Rourke urged them to get out and find safety…not a single nurse to allow this bombardment of hospitals drives her away from the beach…” staying behind to care for the wounded and sometimes sacrificing herself to protect her patients (p. 271). The nurses gave their lives in the line of duty, “…the bombing of the 95th Evacuation Hospital caused twenty-eight deaths; twenty-two were hospital staff: three nurses, two officers, sixteen soldiers, and one Red Cross worker… ” earning the respect and admiration of the men with whom they served (p. 261). Although primarily women, the Army nurses “…spent hours working together in the operating room, dealing with difficult living conditions and surviving the ever-present dangers of war, forged a strong bond of friendship”, treating each other as equals in the war front (p. 367-368). Nurses played an invaluable role in the invasions of North Africa and Italy by providing physical and psychological care to troops carrying the hopes of the world.

Military medicine in World War II came in leaps and bounds to treat even the most devastating wounds inflicted on troops in battle. Private Berchard Lamar “Glant” suffered injuries so horrific that part of his right arm and half of his left leg were forcibly amputated. Glant was evacuated to a battalion aid station and “…was saved by the remarkably rapid and effective medical protocols established and perfected in North Africa and now being tested in Italy: first, immediate care wounded on the battlefields by medics and soldiers; then rapid transport of the wounded to a battalion aid station where medical teams could work to further stabilize patients; then transport to hospitals in evacuation for more extensive treatments and surgeries; and finally, the return of a cured soldier to the front, or his transfer to a hospital further back for a longer recovery period.” (p. 258)

Military hospitals and their planners developed an effective chain of care for wounded soldiers, ensuring vital treatment for those who survived long enough to reach the battalion aid station. World War II also developed solutions to age-old problems that plagued both the Allied and Axis armies. Malaria-stricken troops in North Africa refused to take Atabrine because the side effects were worse than the symptoms of the disease, but doctors in the Mediterranean campaign learned the proper doses to negate the debilitating side effects and free troops for combat. As with any war, Allied troops suffered from sexually transmitted diseases from the locals serving and military hospitals were “… riddled with sulfonamide-resistant venereal diseases…”, the number increasing increased number of affected troops forced the movement of penicillin production from England to the United States and increased production by the billions to cure the troops (p. 215). For troops suffering facial injuries resulting in the loss of an eye, they tended to be equipped with glass eyes prone to irritation and infection, but doctors began turning to the alternative acrylic prosthetic eye that caused less irritation and only took three weeks to produce compared. to the three-month production time of a glass eye.

Operation Torch and Shingle provided US forces with their first full-scale combat experience in World War II, learning invaluable lessons for the eventual invasion of Europe. The women provided vital care to wounded troops and increased the confidence of servicemembers to communicate with their loved ones about their physical and psychological injuries. Army nurses also willingly put themselves in the same danger that troops face to cure those same troops. Medicine and products progressed rapidly to care for the multitude of troops suffering from almost every possible injury. And If I Perish is a comprehensive story about the relatively unknown struggles of Army nurses in World War II.