Medicine & Victory: British Military Medicine in the Second World War (review)

The performance of medicine in a military context, especially during a time of war, is complicated: massive numbers of civilian physicians enter the armed services with little or no knowledge of military hierarchies, standards, or forms of practice; military personnel, many of whom are also new enlistees, are not sure of their roles with regard to receiving medical attention or providing it for their men; armies are sent to fight in areas that require military and medical officers to think differently in order to address endemic and epidemic diseases and various battlefield conditions; and all personnel have to adjust rapidly to various operating conditions when an army is on the offense, on the defense, or in retreat. Historians of military medicine have paid more attention to the First World War than the Second, but Mark Harrison's Medicine & Victory seeks to remedy that gap and as such is a particularly significant text—the first, aside from official histories, to provide a comprehensive overview of British military medicine as practiced in all of the major allied campaigns (in which the British took a lead role) during the Second World War. This book is not about the practice of military medicine in its entirety; Harrison, as is clear from the titles of the core chapters ("Medicine in Retreat 1940–1942"; "The Western Desert, 1940–1943"; "North Africa, Sicily and Italy"; "Burma and North-East India"; and "Medicine Victorious: North-West Europe, 1944–1945"), is interested in wartime action, not medicine practiced on the home front or in hospitals located far from the battlefield. Fundamentally, Harrison is interested in the ways in which various sorts of medical practices affected and contributed to British military action, especially given the intensely mobile nature of the Second World War.

In some respects what Harrison tells us in his book is not altogether new: British medicine, in contrast to Japanese and German medicine, worked well in support of Britain's overall military objectives. The development of penicillin and immunizations, the advent of blood storage and transfusion, and the rapid care of injured and ill soldiers later in the war led to a significantly decreased morbidity and mortality in the armed services, guaranteeing a relatively fit and effective British fighting force. Though British medicine was successfully overall, Harrison does show the ways in which the effectiveness of military medicine varied considerably in different campaigns (there were greater problems in North Africa and Italy) and in different environments (the dry nature of the desert campaigns compared with the malaria-ridden areas of the tropical campaigns), sometimes so much so that British medical care was no better than that of other combatants (both the British and Japanese suffered greatly from malaria in the early part of the Pacific war). Harrison repeatedly highlights the critical ability of the Royal Army Medical Corps (RAMC) to rapidly re-organize itself in the face of diverse working conditions throughout the war as well as the notion that the "'culture of command,' rather than simply advances in science and technology, … was the crucial variable in the success of medical arrangements" (278). Instead of treating military medicine as a uniform practice throughout all campaigns, Harrison demonstrates how the RAMC established expansive and adaptable medical structures to suit the needs of soldiers and commanders fighting on different battlefields.

While I was a bit concerned that the deconstruction of the book into chapters focused on the major campaigns had the potential to give the impression that the medical aspects of the war were isolated and episodic, rather than a part of a comprehensive and fluid system, Harrison infuses his text with enough material concerning the interconnections to make it quite clear how the medical aspects of the various campaigns related to each other, how, for example, beliefs about psychiatry and psychiatric practice reflected both campaign-centric views as well as more general wartime views of mental health and healthcare. In addition...