A History of the U.S. Army Nurse Corps (review)

Mary T. Sarnecky. A History of the U.S. Army Nurse Corps. Studies in Health, Illness, and Caregiving. Philadelphia: University of Pennsylvania Press, 1999. xiv + 518 pp. Ill. $55.00; £41.00.

For many years, the nursing care that the Army offered its patients was handled in a completely haphazard manner, reflecting the way in which medical care in general was provided to those unfortunate victims of wounds and disease. As Mary Sarnecky, a retired Army Nurse Corps colonel, demonstrates in this long-awaited history, the history of nursing in the Army has always reflected the history of military medicine as well as that of civilian nursing and the status of women in the United States. Unfortunately, these and related themes, highlighted in her last chapter, were not used to frame the organization of the chapters that preceded it; as a result, in the major part of the book the trees tend to overwhelm the forest. Ironically, the same wealth of detail that complicates the organization forms the main strength of the book, making it a valuable resource for researchers and providing real insight into the day-to-day challenges faced by those caring for the Army's patients. The feeling of "you-are-there" is enhanced by the use of numerous quotations from the papers of the nurses.

Few histories, if any, are without their factual errors, and unfortunately this volume is no exception. The only really distressing errors, however, involve Sarnecky's handling of the story of Walter Reed's yellow fever research that followed in the wake of the Spanish-American War. She speculates (p. 45) that "doubtless, some of the nonimmune study participants perished"--yet in fact, all survived; the only death that occurred among those working with Reed was that of contract surgeon Jesse Lazear, who was not part of the experiments and who submitted himself entirely without authorization to the mosquito bite that proved fatal. She maintains that the nonimmune individuals involved in the experiments came down with yellow fever within five days of being bitten; the incubation period for yellow fever is at least ten days. She states that contract nurse Clara Maass died as a result of experiments conducted by Reed and contract surgeon Juan Guiteras, but Reed was in no way involved in the experiments that led to Maass's death; indeed, he was distressed by them. They were conducted by Guiteras and Major William Gorgas, who were attempting to discover whether subjects could be safely immunized against yellow fever by inoculation with material taken from a patient with a mild case of the disease--an approach used successfully to immunize against smallpox in the period before the adoption of vaccination with the cowpox virus early in the nineteenth century. Finally, the author's claim that Reed's work was "a textbook example of the unethical abuse of research subjects" (p. 45) is hardly sustainable: all participants in Reed's experiments were informed of the dangers involved, and their written consent was obtained in advance. The facts about the work of Reed, Guiteras, and Gorgas are easily obtainable, and thus these errors are difficult to understand.

The total absence of a bibliography is also much to be regretted. The footnotes, which are copious, list the complete facts concerning the publications they cite only once, and the citations that follow are almost cryptic. Thus the reader interested in a specific source cited is often required to search back through page upon page of notes to find the details needed to fully identify it. All things considered, however, Colonel Sarnecky's volume is a significant contribution to the history of military medicine in the U.S. Army, one that will prove invaluable to students and researchers alike.

Mary C. Gillett
U.S. Army Center of Military History, retired

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