"Medic": The Mission of an American Military Doctor in Occupied Japan and Wartorn Korea (review)

Brigadier General Crawford F. Sams, Medical Corps, U.S. Army (1902–94), was a soldier-physician of the old-school, Sam Browne-belt Army, with enlisted service in World War I, as a National Guard Infantry officer, and an active-duty Artillery officer. In medical school he was tempted by offers of a research career, but the pull of the Army was too strong and he joined the Army Medical Corps with postgraduate training at Letterman General Hospital.

Sams had an unusual mixture of medical and combat-arms officer education: Artillery and Infantry Officer Schools (instructing at the latter), Army Medical School and Medical Field Service School (instructor, company commander, department chief), and the Command and General Staff College. A devotion to horses and polo and his line-officer schooling made him friends with many of the future generals of World War II and the Korean War. He then began a career as a staff officer with a focus on infectious diseases, in Panama and Egypt, and then as the Middle East Theater Surgeon. He had two tours as a staff officer on the Department of Army logistics staff, and a three-month assignment assessing Army hospital care in Europe. Sent to the Pacific at the end of the war, he was assigned to MacArthur’s Supreme Command of the Allied Powers (SCAP) in Japan as Chief, Public Health and Welfare—the job that is the subject of this book.

All those years of military and medical education, of staff work and planning, of the study and control of disease, of directing and assessing hospital organization, prepared Sams to spend five years very successfully rebuilding Japanese medicine, and another year doing similar work in Korea during the first year of that war. SCAP came to a Japan devastated by a failed war economy, by food and manpower shortages, and—in the cities—by bomb damage. Sams built a staff, initially military but later mostly civilian, that was 150 strong at its peak. He allocated local and U.S. resources and people, with particular attention to the organizational capability and potential of Japanese medicine, nursing, pharmacy, drug and vaccine production, preventive medicine, hospital facilities, and the education of health-care personnel. He ensured the production and distribution of food, established basic nutritional requirements, and arranged for food imports; children received special attention with a school lunch program, and famine was averted.

SCAP guided the development of a new constitution and government, and Sams developed the operations of the new government’s Ministry of Health and Welfare on an American model. Health centers were made responsible for preventive medicine, patient care, welfare, and social security. An Institute of Public Health for educating public health workers and a National Institute of Health for biologics control and research were established. Statistical agencies and programs were put in place. In the first two years, refugees returning from Japanese “colonies” or moving about the country were potential tinderboxes for the “wildfire” epidemic diseases—smallpox, epidemic typhus, cholera; these did occur in outbreaks, but immunization, quarantine, sanitation, and delousing prevented massive epidemics. Typhoid, the dysenteries, diphtheria, and tuberculosis all had high incidence in a country where sanitation had failed and the people were worn down by war; it took time and targeted programs, but over three years these more-chronic diseases came under better control than Japan had ever known. Vaccine laboratories and production facilities were established, hospitals were restructured to Japanese-American models, medical and nursing education were gradually changed and brought to American standards. Charged with welfare responsibilities in addition to health, Sams integrated Japanese, international, and U.S. organizations to deal with disasters, child care, employment, and health insurance programs. He was promoted to Brigadier General in 1948.

The SCAP programs were working well to rebuild Japan when in June 1950 the Korean...