The American Ambulance in Paris, 1914 to 1917 Part IV: The American Ambulance and the American Red Cross.

Abstract

From August 1914 to early 1917, President Wilson struggled to preserve American neutrality. The slogan of his re-election campaign during 1916 was “He kept us out of war,” but in early 1917, the British naval blockade of the continent and German submarine warfare increasingly challenged the President’s determined efforts to preserve for neutrals the unfettered freedom of the seas. The last in a series of diplomatic crises concerning freedom of the seas came in February when Germany declared unrestricted warfare: the right to sink without warning any vessel, neutral or otherwise, trading with Allied nations. Within a month, seven American ships were sunk. On April 6, the United States declared war on Germany. That day, the American Red Cross (ARC) eschewed its neutrality and assumed its other federally chartered military role to provide medical assistance to the country’s armed forces in wartime. But it was woefully unprepared for its new mission. The year before, the national “preparedness movement” led by Theodore Roosevelt and General Leonard Wood, outgoing chief of staff of the Army, goaded the ARC into planning for war. It expanded the ARC Nurse Corps, a reserve of qualified nurses with minimum of 3 years of hospital training available for emergency service, to 8,000 and organized 26 ARC base hospitals. The base hospitals were developed according to a plan outlined by Dr. George Crile. Returning to the United States after his 3-month stint with the American Ambulance, Crile was firmly resolved to further the country’s medical readiness for war. His concern was matched by General William Gorgas, the Surgeon General of the Army. At Gorgas’ request, Crile created a prototype hospital, which became the blueprint for all ARC base hospitals. Six base hospitals were dispatched to support the British Expeditionary Force in May, 1917; the first of these to receive casualties was Base Hospital No. 4, the Lakeside Hospital unit, commanded by Crile. A month later, just a week before the lead elements of the 1st U.S. Army Division disembarked at St. Nazaire, France, a commission of the ARC led by Major Grayson M.P. Murphy had arrived in Paris to begin arranging support for the arriving American troops. An important responsibility of the commission was the development of a hospital system to care for sick and wounded American soldiers. The system designed split the echelons of care between the Army and the ARC. In the war zone, the Army controlled all casualty clearing and collecting stations, the field hospitals, and the evacuations hospitals. In the rear, the Army shared responsibilities with the ARC. Supplementing the Army base hospitals were 3 types of ARC hospitals: ARC Military Hospitals, ARC Hospitals, and ARC Convalescent Homes. The ARC Military Hospitals were the only ARC facilities that treated only American soldiers. These were equipped by ARC, but staffed and controlled by the Army. Most, if not all, of these Red Cross hospitals and homes were already operating as American sponsored independent institutions before America’s entry into the war. The first of these to be appropriated by the Army and ARC was the American Ambulance in Paris. The order came directly from Major General John J. Pershing, commander of the American Expeditionary Force. The official explanation for the transfer to the Army and Red Cross was “the military policy of uniting, co-ordinating, and controlling all American volunteer interests . . . under one supreme head.” Despite the Army’s legal authority to take over the Ambulance, the transition was not smooth. On June 28, a meeting of the Board of Governors of the American Hospital was called by Robert Bacon, its President and newly appointed major on the staff of the American Expeditionary Force, to discuss turning over the Ambulance to the ARC. Since the Hospital itself was operating under a federal charter, he explained, there really was no alternative but to accede to the Army request. However, many of the physicians and staff of the Ambulance who were not present for the Board meeting and some board members of the American Hospital resisted. Likely, the reasons for opposition were several: money donated to the Ambulance would go to the general fund of the ARC; physicians and nurses would lose their freedom to treat patients as they saw fit; all who stayed would become members of the Army and subject to its discipline. doi: 10.7205/MILMED-D-15-00408