Day to Day Functioning of Base Hospital #28
Kansas City Star and Times Newspaper Clipping
With construction mostly completed and the organizational units of Base Hospital #28 in place, the rhythm of the hospital was largely determined by the arrival of ambulance trains from the front. With but few exceptions the wounded and sick were American soldiers who came directly from front-line evacuation hospitals. American army medical units were carefully stratified and organized. A wounded or sick soldier went to a company aid post then – if necessary – on to a battalion aid station, ambulance dressing station, field hospital, and evacuation hospital. Acute surgery was done at both field and evacuation hospitals. Soldiers with wounds that would inevitably be mortal were made comfortable and given morphine to ease their deaths. Evacuation hospitals collected patients, readied them for transport by rail – or even river barges in some instances – and sent them in large groups to the base hospitals far in the rear.
Typical Ambulance Train
Evacuation Routes from the Front Line
On 27 July an ambulance train with 600 wounded and sick soldiers arrived at Base Hospital #28 at 9:30 PM. In spite of the hospital station platform being dark, Dr. Hibbard and all available staff triaged patients quickly and by 3:00 AM all patients, including some with very serious wounds, were in appropriate wards in their beds. The single record day for admission of patients occurred when the hospital was essentially half empty, with only 1,400 patients in its beds. On that day, at 3:00 AM, 400 patients arrived by train. At breakfast time another 300 arrived, and an additional 400 showed up in the afternoon, for a total of 1,100 new patients triaged and admitted within the space of less than a day.
Kansas City Star and Times Newspaper Clipping
In the final official report of activities of Base Hospital #28 during the period of its functioning in France - late July 1918 through the end of January 1919 - the total number of patients admitted was 9,954. Of these 6,087 (61%) were medical cases and 3,867 (39%) were surgical cases. Of the total number of cases, 4,321 (43%) were returned to their units while the remainder were either evacuated home or died. Available records show only 69 hospital deaths in the six months of its operation, possibly an incomplete recording. Surprisingly, only 2,435 (24%) were described in the master patient list as GSW, the diagnostic notation that apparently included all injuries by weapons of war, whether bullets, shrapnel, or other projectiles. It is not possible from extant records to know how many of these patients had surgery in a field hospital before arriving at Base Hospital #28. From the many images available some patients had multiple surgeries and many surely had emergency surgery - perhaps life saving - at a field or evacuation hospital, and then definitive surgery at the base hospital. Stratification of treated wounds by location showed 17% to be of upper extremities, 46% lower extremities, 16% head and neck, 3 % of the abdomen and genitals, 6% of the back and side, 4% of the chest, and 6% were of multiple wounds. There were only six cases of gas gangrene, a significant and fearful infection of wounds from Clostridial bacteria in the soil which was disturbed by artillery shells and trenches lacing the farm fields. This had been a common problem in French and British hospitals and usually ended in death.
Typical Patient Medical Record, Essentially Complete
With about one hundred nurses, some from the US Army and the majority from The American Red Cross, Base Hospital #28 had a ratio of nurses to patients of about one to ten or twenty, depending on the hospital census at any given time. Nurses worked under the direction of the medical officers and, themselves, supervised the corpsmen who served as orderlies and nurse assistants on their wards. It is apparent from hospital statistics that excellent nursing was principally responsible for the efficiency and superb care provided by Base Hospital #28. Beyond this the tenderness and mercy projected by these dedicated young women remains one of the enduring images of the First World War. The Red Cross Nurse was celebrated in the press, popular songs, and films of the day. She was an icon of gentleness, calmness, and beauty in contrast to the wretchedness, horror, and ugliness of trench warfare
Cartoon of Ward 13 of BH #28
The influenza epidemic of the autumn of 1918 put an unanticipated strain on the medical wards of the hospital. In all, 1,295 patients were discharged with a diagnosis of influenza. This challenge will be described in a separate section of this website. Venereal disease - gonorrhea and syphilis - was not a common discharge diagnosis, only 84 of the former and 48 of the latter were recorded. The draconian policies of the U S Army, in respect to venereal disease, probably were largely responsible for the paucity of hospitalized cases. A soldier who failed to report sexual contact with a local woman within one hour of exposure and who subsequently developed either gonorrhea or syphilis was confined to the stockade with loss of pay and allowances for three months.
Winter Scene of BH #28
As shown in the timeline, the hospital census figures declined steadily after the 11 November 1918 armistice and the waning of the initial wave of epidemic influenza cases. However, Base Hospital #28 continued to function until 31 January 1919 when it was closed to admissions and the few remaining patients transferred to other, still-functioning hospitals. In the spring of 1919 hospital staff and nurses of all ranks enjoyed furloughs in Paris and other less affected parts of France, even the Mediterranean Coast. Hospital personnel were sent to French ports in April and May and by June the hospital company was back in America and demobilized. Thus, after a year of intense, unimagined medical activity, the doctors, corpsmen, and nurses were returned to the bosoms of their families. They became the leaders of Kansas City Medicine and Nursing and not a single one would ever forget the challenges faced and overcome in France.
Images and statistics in the section are from the National World War I Museum, Kansas City, Missouri, USA.