The Medical Department: Medical Service in the War against Japan (review)

Mary Ellen Condon-Rall and Albert E. Cowdrey. The Medical Department: Medical Service in the War against Japan. The United States Army in World War II: The Technical Services. Washington, D.C.: Center of Military History, United States Army, 1998. xx + 485 pp. Ill. $37.00 (0-16-049265-3).

When thinking about U.S. military activity in the Pacific during World War II, the United States Navy comes immediately to mind. Students of that conflict are aware, however, that the United States Army also played a crucial role in the Pacific Theater, working in concert with the Army Air Corps, the Marine Corps, and the Navy. The Medical Department chronicles the travails of the Army Medical Department throughout the war, beginning with the bombing of Pearl Harbor in December 1941 and ending with the incineration of Hiroshima and Nagasaki in August 1945. The book follows a traditional institutional and organizational format that traces the Army Medical Department chronologically and geographically across the Pacific through the various campaigns of the war. This format, which examines military medicine with a lens focused on labyrinthine organizational detail, is the source of the book's greatest strengths and corresponding weaknesses.

The authors thoroughly explain the institutional structure and organizational make-up of the Army Medical Department, in addition to identifying the key military and medical personnel who made command decisions. In describing the medical history of each military campaign the various chapters detail, albeit redundantly, the integration of medical, logistic, and technological innovations, which resulted in a system that both cared for the wounded and evacuated them from the battlefield to rear areas. The authors note that tropical disease outbreaks and a high incidence of neuropsychiatric disorders among combat troops were of particular concern throughout the war. The text also deals in varying degrees with other aspects of military medicine, including surgery, public health practice, nutrition, biological warfare, the care of prisoners of war, and civilian casualties.

The difficulty the Army had in providing medical care in the Pacific is perhaps best summed up in a chapter entitled "A New Kind of War," which notes that the "war against Japan was fought in an area that covers roughly one-third of the Earth's surface, from Burma to Hawaii and from Alaska to Australia" (p. 44). This vast geographic area contained a myriad of hostile environments that challenged medical personnel as much as, and often more than, the war itself. Medical care was adversely affected not only by the vast size of the Pacific Theater, but also by strategic and political decisions in Washington, which relegated the Pacific war to a secondary rank behind the war in Europe. Army medical personnel encountered tremendous logistic and environmental difficulties in campaign after campaign, whether in the jungles of Guadalcanal, the mountains of Burma, or the frozen Aleutian Islands.

Unfortunately, the richly detailed description of the machinations of the Army Medical Department often blurs the distinction between what is important and what is irrelevant. In addition, the volume's historiographic reliance on previous military publications in the U.S. Army series limits the development of a conceptual framework that addresses broader historical themes such as race and gender. What role, for example, did African Americans play in the organization of the Army Medical Department? The absence of African Americans from the book's more than ninety photographs raises questions not only about how the Army dealt with segregation, but also about the ramifications for the type of medical care that African Americans received, and how this may have affected patient evacuation.

Nevertheless, this volume is essential reading for any historian seeking to understand Army Medical Department activities in the Pacific during World War II. Perhaps more importantly, it demonstrates that for historians interested in the complex relationship between environment, disease, and technology, the practice of military medicine in the Pacific offers...