When America sends sons and daughters into combat not all will return unscathed, and some will die. When a member of the United States military is injured in combat, it is up to healthcare professionals to take immediate life-saving measures. Today, an injured soldier’s care begins with brave medics (US Army) and hospital corpsmen (US Navy) who save them on the field of battle and take them to safety at the next level of care. These highly trained technicians, operating in the “golden hour,” know that getting the injured quickly to the next level of care is crucial for survival. Our medics and hospital corpsman have the skills, tools, and experience to save even the critically injured. The concept of pushing medicine forward – towards the front line, as soon as soldiers are wounded – was introduced during World War I when stretcher-bearers became the ancestors of today’s medics and hospital corpsman.
Prior to World War I, porters picked up casualties on the battlefield and took them away to be treated. It was later realized that care for casualties needed to begin sooner and on-site to save lives and preserve function. And, as the military improved care of the wounded, it also improved civilian emergency medical care. Today, tourniquets and hemostatic agents are routinely used by EMS providers. These were approaches that had first been tested and proved effective in combat.
In WW-I, before serving in combat, stretcher-bearers attended a ten-week course. Their training in medicine did not end when the course was complete, however. Many additional lessons came from guided experience in no man’s land when struggling to get a wounded man away from the battle. Bearers in combat knew that each wounded soldier’s survival depended on their decisions and actions.
Bearers worked in teams of four to six. In good conditions, it might take just two men to carry a casualty. However, conditions were not always favorable when these brave men went over the tops of the trenches unarmed, carrying a stretcher and medical supplies. As volunteers, they were motivated by a deep desire to save their brothers-in-arms. Once over the top, they looked for seriously wounded men and listened for shouts and screams from those they would later return to carry to safety. On the WW-I front bearers often would have to slog through deep mud – at times up to their knees – carrying their patients to safety.
In WW-I stretcher-bearers experienced life and death on static battlefields unlike any others in history. In many instances, they would carry a casualty through enemy fire only to find that when they finally got to an aid station or ambulance he was dead. After long and dangerous carries, bearers often bonded with their patients, became their friends, and were reluctant to part with them.
Medical officers viewed stretcher-bearers as assets when it came to caring for casualties and held them in high regard. They took time to learn their names, life stories, and understood their individual characteristics, to know which ones were fit to lead. Since bearers were held in such high regard, medical officers saw to it that they received additional medical training. Many of these training sessions focused on anti-typhoid inoculations, foot care, prevention of trench foot, frostbite, sores, blisters, and the misery of body lice, commonly called cooties.
As the war waged on, bearers became expert at giving morphine to casualties in proper doses when appropriate. They also learned the benefits of using “psychological first aid” by providing comfort and conversation to keep the wounded warrior awake and alert to his symptoms. Another lesson learned early – addressed in on-going training sessions throughout the war – was improvising a stretcher when one was not available. Improvising by using a coat or a blanket to carry an injured soldier proved to be a mistake. During a carry in a blanket or coat, the patient’s wounds would likely reopen because their bodies were limp and pliable. Bearers learned to carry casualties on their own backs. The comfortable weight of the casualty pressed the carrier forward helping him maintain a good pace.
Trenches were not designed with evacuating patients in mind. Often narrow, deep, and sharply angled, they were another challenge for bearers, especially at night. To overcome the obstacles that came with navigating the trenches bearers drew maps, which were updated when sections of trenches collapsed during a shelling. Before a major offensive new maps were issued.
Notes taken during training were often added to The Stretcher Bearer War Manual that bearers received as texts to carry in the field. This book was full of illustrations showing bearers how to splint limbs and dress wounds. This easy-access reference was meant to be reviewed and discussed during by bearers during periods of rest. A bearer could be easily spotted by the condition of his hands. Stretcher handles were made of wood, which when alternatively wet and dry, would rot, split, and splinter, damaging the bearers’ hands. Gloves were great to have but like trauma shears, were easily lost. In addition, gloves made getting a grip on wooden handles difficult. Thus, bearers’ hands were a mix of blisters, callouses, and splinters. With all of the trouble that rain brought to the trenches and to patient care it did allow bearers to hold up their hands to the sky so the rain could wash away the mud and provide comfort to their damaged hands.
The life of a stretcher-bearer during The Great War was a series of carries – mostly of the living, often of the dying. Carriers were skilled at saving lives in perilous places and then seeking safety for their precious burdens. The work done by stretcher-bearers during World War I and the relationship they had with doctors at the next level of care can still be seen today. Our medics and hospital corpsman communicate with each other on best practices used in combat medicine. Doctor’s train medics and corpsman on how to improve patient care. Moreover, stories of medics’ strong desire to put themselves in harm’s way so that others may live can still be heard from those who were saved by these practitioners of battlefield medicine.
Images and text references largely from Mayhew, E.R., Wounded, a New History of the Western Front in World War I.