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Between 1972 and 1983 the heralded tele vision series M*A*S*H brought America’s public face to face with one of the most engaging elements of citizen soldiery: life inside an e vacuation hospital. Even today reruns depicting the fictional 4077th evac enjoy a virtual cult following. A website permits international debate on the “true intent” of key monologues, and M*A*S*H theme parties punctuate wide-ranging social life. Regardless of his striking talents as actor, director, and producer, Alan Alda forever remains Benjamin Franklin (“Hawkeye”) Pierce. On the night of February 18, 1983,I was among those millions who watched the final M*A*S*H episode—“Goodbye, Farewell, and Amen.” As a young historian I was self-consciously enthralled at being “present” at “the end.”I had gone to Washington, DC, to a conference. With three old friends I went down to Georgetown to a pub with a small tele vision set back in a smoky nook. After “the end” we ruminated about the way M*A*S*H people used br illiant humor to hook an audience into lucid lectures on changing values in Amer ican life, as if outlining James H. Whittebols’s superb Watching M*A*S*H, Watching America (1998).But we also talked about the 4 077th’s evac story as a metaphor for war m uch as William Faulkner used a “postage stamp” of a Mississippi count y to explore “universals.”For through M*A*S*H many of the essential ingredients of war got center stage—if less so actual combat, still war’s comedy and tragedy, courage and cowar dliness, humility and hubris, and even deeper its life, death, necessity, and futility. Heavy thoughts that night in Georgetown. A quarter of a century later I am thinking diff erently.Though still mesmerized by M*A*S*H reruns, I am thinking that while this noted fictional evac lives on, the historical evac of World War II, Korea, and Vietnam— whether a metaphor or simpl y a profound vehicle for saving liv es—is dead. Indeed, it’s past time we said goodbye, farewell, and amen and for Overture Goodbye, Far ewell, Amen 2 over tu r e the most part “job well done” to one of the most signifi cant things ever adopted by the US Army.In the 1970s the army b y necessity began focusing more on asymmetrical or guerilla warfare as opposed to conventional warfare with fighting on one side of a line and nonfighting on the other. In turn, as found in recent Middle East fighting, the evacuation hospital gave way to the“buddy aid”and “self-aid”strategies of every soldier—not just a member of the Army S pecial Forces—trained and equipped as a sophisticated emergency medical technician and helicopters tr iaging wounded back to a combat support hospital well removed from the fighting . Certainly “evacuation” remains a key ingr edient of army medicine . However, it would take a return to old-style warfare to justify the rebirth of the historic evac, and just a glance at modern war technologies, not to mention contemporary geopolitics, makes this prospect unlikely. History’s farewell salute to the noble evac evokes complex memories. From army documents, several key books on US militar y medicine, and memoirs of doctors and nurses we recall that the US Army urged gearing up evacuation hospitals, or evacs, in the earliest stages of World War II. As the fighting commenced in North Africa, however, the evacs did not just appear. They had long been evolving out of the “flying hospitals” of Napoleon Bonaparte’s chief of military surgery, Dominique Jean Larrey, then f rom Jonathan Letterman’s lifesaving strategies of the Amer ican Civil War, and further refinements by both American and French doctors in World War I. In that context, the army’s chief surgeon overseeing medicine in the N orth Af rica, Mediterranean and Eur opean theaters, Maj. Gen. Paul R. Hawley, carefully analyzed lifesaving in North Africa campaigns. Then, in early 1943 he further refined the “chain of evacuation ”concept into that famous sequence of military health care: from the field hospital to the e vacuation hospital and on to station and general hospital, with the e vac treating soldiers who might be r eturned to the front while evacuating on up the chain the mor e seriously wounded. As World War II unfolded, the army ultimately mounted some 107 of...

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