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You’re in the army now World War II flame‐thrower research at Fort Knox

2007; Wiley; Volume: 46; Issue: 3 Linguagem: Inglês

10.1111/j.1365-4632.2007.03188.x

1365-4632

Walter B. Shelley,

Engineering and Material Science Research

A telegram from Mayo Clinic voiding my deferment for 9 months of dermatology training came 3 days before I was to start. It meant that we were to get off the train in Minneapolis and not go on to Rochester. Saying goodbye to my mother, father and wife, Marguerite, was tearful. We had no idea when this war would end. It had encircled the world. The German siege of Leningrad had left one million Russians dead of starvation and disease. A single battle on Tarawa in the Pacific had taken the lives of 1000 American troops. My cousin, who had just landed in Italy 3 days before, narrowly escaped death when his recognizance Jeep, far ahead of our front line, was strafed by an American fighter pilot. His three companions were killed outright, and he hovered between life and death in a roadside ditch until rescued 3 days later. Where was I going? We knew Abilene was in Texas, and my army orders gave me a railroad ticket there, but on the train in my brand new uniform I still wondered where Abilene was. None of the atlases I consulted gave me a clue. On the long train ride I memorized every page of my shiny new officer's manual. The rules for saluting were strict. You salute officers of higher rank first. As a First Lieutenant, I could delay if I met a Second Lieutenant. I had learned the three-finger salute as a boy scout, but must now remember to keep the fourth finger straight. I arrived in Abilene at night and was taken by bus to the officers’ club, where they served the most delicious Texas steaks to the newly commissioned doctors. Then, off to one of the barracks housing the 2000 doctors. The cots were side by side and my footlocker sat at the foot of my cot, proudly displaying my serial number, 0–1766710, which I knew backward and forward. The next morning I wore myself out saluting scores of officers. Who salutes first? After breakfast, to avoid saluting, I walked in the back of the mess hall, only to bump into the very first general I had ever seen. He started to laugh when he saw how panicked I was trying to salute with both hands. My next crisis was a 6 inch snowstorm. There were no GI boots available in my large size 13, so I marched in ankle deep snow in my personal dress Florscheim shoes. The worst orientation challenge was the obstacle course. I squirmed under wires crawling on my belly to stay below the machine gun fire above me. Was it live ammunition? I was in no mood to find out. We were also taught how to use gas masks, and then sent out into the field where Air Force planes flew over and released clouds of “poison gas.” It was actually fun, because I met a happy carefree lieutenant who told me not to put on the gas mask because the ominous gray clouds were fake. “They wouldn't poison the very doctors they need, would they?” We sat on a hill watching hundreds of our compatriots hooded in masks, as he regaled me with stories of the exquisite joy of having a good bowel movement. He was fun to be with, and I am sorry our friendship was so fleeting. He reactivated my laugh center. Back at my barracks I was greeted with the terrifying news that the doctor in the next cot suddenly died that morning of Waterhouse–Friderichsen syndrome. Healthy the night before, he had developed meningitis and adrenal failure, a lethal disease that can be an epidemic. Each one of us was given a packet of “sulfa” pills. We were told that next morning we would go on an 18 mile hike, set up our pup tents, and spend the night in the field. I sat down on my cot and wrote a long letter to Marguerite. Then came lights out, so I stuffed the letter with its stamped addressed envelope into my canvas knapsack, thinking I would finish and mail it from the tent camp. The next day trucks with their painted Red Cross emblems were busy picking up stragglers and dropouts. I had no trouble hiking, but when I opened my knapsack to finish the letter I found that the light rainy mist had sealed the envelope. So, I simply put it in the mail truck. The last sentence of the unsigned letter Marguerite received was, “The doctor in the bed next to me died this morning of meningitis and I am taking sulfa.” She thought they had found the letter on my body. I cannot imagine the anguish she suffered until my next-day letter arrived. My new orders were to the Rayburn Army Hospital in McKinney, Texas where Marguerite could join me. The hospital was named to honor Sam Rayburn, a Democrat “without prefix, without suffix, and without apology.” He served our nation and Texas for 50 years in Congress, becoming Speaker of the House in 1940. We shared a pleasant three-room apartment with another couple who went on to have nine children because she felt well only when pregnant. We could enjoy nearby Dallas by taking a long streetcar ride on the most inhospitable rails, our “Toonerville trolley.” When I reported to the Colonel in charge of the army hospital I was greeted with a kiss on each cheek, as he was delighted when I told him I only knew dermatology (from medical school, and 1 month at Henry Ford Hospital during my 9 month internship). He took me down the long halls of the sprawling one story 750 bed hospital and made me chief of dermatology with 80 beds. The beds were filled with soldiers evacuated from the tropical Pacific Theater. Although there were a few cases of elephantiasis, most of the men looked healthy to me. I also ran the skin clinic for the entire hospital and staff. I was given a copy of the Armed Services Military Manual of Dermatology by Pillsbury, Sulzberger, and Livingood (Fig. 2). Here was a book my old professor, Henry Michelson, at the University of Minnesota would approve. A simple straightforward text coupled with full-page black and white portraits of skin disease (Fig. 3). I studied it every day, flipping through the 81 illustrations until each one became an old friend, easily recognizable. But the diagnostic and therapeutic demands of my little practice soon went beyond my expertise. Lt. Shelley's Bible at Army Hospital, McKinney, Texas: Manual of Dermatology, Military Medical Manuals, National Research Council. Donald M. Pillsbury, Marion B. Suzberger, and Clarence S. Livingwood. W.B. Saunders, Philadelphia, 1942 Widespread miliaria (heat rash), a disabling problem leading to heat collapse, common in the tropics prior to air-conditioning. Figure 61., Manual of Dermatology, 1942 The Colonel came to my rescue. Confined to the psychiatric wing was a splendid experienced dermatologist who had decompensated when, at age 39, the Draft Board had taken him away from his practice, wife, and young children. He had to be locked up, but the Colonel recognized the treasure of his experience. So, every Friday from 12 to 1 p.m., the “disturbed” dermatologist was my consultant. I paraded all of my difficult patients before him, and he had all of the answers, from 3% ichthammol paste to the curative army discharge. Indeed, one of my patients had such severe disabling dyshidrosis that his sweaty eczematous palms could not hold a rifle. When told I would secure his discharge, his hands slowly returned to normal. The day before his discharge, when the Colonel was making rounds with me and was to sign the discharge orders, he refused when he saw the sergeant's normal hands, saying, “Send him back to full duty.” The next morning the poor sergeant's palms were again covered with blisters. This taught me that the role of emotional sweating in dyshidrosis is indeed impressive. The moment I walked through the 80 bed skin ward I realized most of the patients had recovered from their original disabling dermatitis. By working night and day I was able to fill out reams of forms and discharge 55 of my 80 patients, but this was my undoing. The soldiers and staff had a pleasant symbiotic relationship that protected everyone from being sent to the war zone. Before a soldier could return to active duty, he had to have “dental clearance.” Because of a shortage of dentists at the hospital there was a 6 month backlog of dental appointments, making it virtually impossible to discharge anyone rapidly! It was my first encounter with the “Catch 22” of army regulations. I came to realize that the whole hospital had an abundance of faux patients. About a month after the mass exodus of my 55 “paper” patients, Walter Bauer, md, a professor of medicine from Harvard and now chief consultant for the 8th Service Command, came to our hospital for inspection. With the entire staff brought together in the assembly hall, General Bauer called out, “Lieutenant Shelley, stand up.” I was mortified. Was my uniform on backwards? He continued, “I want you all to know that Lieutenant Shelley discharged 55 patients last month. Now, all of you go back to your wards and do as he did. I want every healthy soldier back to full duty. In less than a week I had orders to go to Fort Dix to be shipped overseas to serve with the Tenth General Hospital Surgical Unit. Once again, there was a tearful goodbye to Marguerite on the railroad platform. Just then, a Jeep roared up with a messenger screaming, “Lieutenant Shelley! Lieutenant Shelley! New orders!” Instead of going overseas, I was being sent to the Army Medical Research Laboratory (AMRL) at Fort Knox, Kentucky. The laboratory had requested a high-temperature physiologist, and I filled the bill. The rest of my Army experience resembled a 3 year postdoctoral fellowship, working with distinguished professors of medicine recruited from Cincinnati (William B. Bean, md) and New York City (Ludwig W. Eichna, md). Meanwhile, my apartment mate at McKinney got orders to go to the Tenth General Hospital Surgical Unit in Italy. He emerged from the war with 10 battle ribbons, in contrast to my single ribbon for meritorious service in the Hot Room at Fort Knox. Arriving at Fort Knox, we quickly realized apartment hunting would be difficult, with no housing available on the base. Someone in the laboratory loaned us a car, although I did not know how to drive. Marguerite had driven us all the way to Hodgenville, KY, birthplace of Abraham Lincoln, before we saw a possible house on a lonely road. We would try anything, as it was better than sleeping in the car. At 10:00 pm, in a torrential rainstorm, a lady came to the door and burst out laughing, “You are Mutt and Jeff.” (I am 6 feet 4 inches tall, and Marguerite was 5 feet 4). We didn't care what we were … we wanted in. Finally, she let us come in, where we stayed overnight in her parlor, whereas from an adjoining bedroom she told us Kafka-esque stories in the dark until long after midnight. Morning dawned with bright sunlight, and strengthened our firm resolve to leave the home of this very strange woman. We drove back to Elizabethtown, home of William Allen Pusey (1865–1940), the only dermatologist ever to become President of The American Medical Association (AMA), and whose house remains a museum (Fig. 4). In “E-town” we saw a stunning white Southern mansion, the Helm House, whose architectural elegance has graced a series of full-page liquor advertisements. We knocked and were told we could have a room until the regular boarders returned from vacation. There were nine guests living in these regal quarters, and our room was the only one with a private bath. People hated us for getting out so easily in the morning, as they waited in line for the only other bathroom. William Allen Pusey, MD (1865–1940), the dermatologist who introduced X-ray therapy for skin cancer. Shown here in his study in Elizabethtown, Kentucky, the first place Lt. Shelley visited with a thrill after finding slave quarter housing nearby At 10:00 pm one November night in 1944 Marguerite was ironing and I was planning the next day's experiments. Suddenly, she said, “We have got to get to the hospital. I have labor pains.” The hospital was Norton Memorial in Louisville, 50 miles away, and we had no car. I ran through the streets of “E-town”, but no taxi would take us, as rubber tires were too precious to waste on long trips. However, one cabby had a solution. He arranged to take Marguerite to Louisville in the funeral home's hearse. I was ecstatic, but once Marguerite learned her trip would be in a hearse, she refused to go and her pains stopped. We went to bed, but by 5:00 am the pains were back. I packed a suitcase of towels, preparing for the bumpy 6:30 am train ride to Louisville. I was sure I would have to “catch” my newborn while swaying in the coach. We got to the hospital and delivered Marguerite safely into the hands of her obstetrician. All day long I stayed by her bedside, but the verdict was “false labor.” She was kept drugged and unable to respond, so I left that evening for the bachelor officer quarters at Fort Knox. On the way home I went to a movie, quixotically entitled, “Vacation from Marriage.” I had given the obstetrical nurses my barracks and laboratory phone numbers, but there were no messages that night. After Saturday morning hours in the laboratory I was waiting in line for a bus to Louisville when my sergeant drove up and offered me a ride. As we drove he inquired if I had a “big night” planned. “Why no, my wife is in the hospital having a baby.” At that point he put the pedal to the metal and we roared 90 miles an hour to Norton Memorial. It was the best “Nascar” day he had had in the Army. I ran to the obstetrics floor to find I had a son, delivered as I was at the movies the night before … In 1944 a 10-day postpartum hospital stay was mandatory. We christened our son “Peter Bennett Shelley,” our “Peter the Great.” He was named “Bennett” after my fellow researcher in the laboratory, Dr William Bennett Bean, later to have the distinguished Chair of Internal Medicine at the University of Iowa. Marguerite's family thought we had named him after my family, and my family thought the opposite. Both were surprised that we were not honoring family tradition. Our life was restricted, with no car, no phonograph player, no radio, and no library. We had no social contacts, and it was before the age of television. In our 3 years at Fort Knox the only automobile ride for pleasure we ever had was with friends who took us on a tour of the great horse farms of Kentucky. White fences surrounding horizon-hugging green pastures were the images of that exciting day. Before that, on my daily bus ride to the laboratory, I would see only the massive iron gates guarding the U.S. gold vault of Fort Knox. The Armored Medical Research Laboratory had its own two-story building down the hill from the base hospital, with a huge two-story hanging door. It was dedicated to the study of environmental stress on the tank corps. My research career had now evolved from my PhD work with a small dog-sized chamber immersed in a water bath at the University of Minnesota, to an impressive Army hot room that could house an M-3 tank (Fig. 5). I had 200 volunteer subjects, and a group of engineers to set the ambient temperature to 120 °F, with humidities up to 100% (Fig. 5). We also had a treadmill to provide any degree of physical stress. We recorded a variety of parameters from blood pressure to sweat rate, the latter revealing the Olympian level sweating of 2 quarts an hour, with sweat even squirting out through the leather boots (the only clothes worn by the volunteers). Armored Medical Research Laboratory personnel posing with tank at Fort Knox. Lt. Shelley is in front row, third from right Our major contribution to the war was convincing our generals in the tropics that water must be constantly supplied to the troops, in or out of tanks. Hundreds of studies showed that a soldier's performance in battle correlated with his hydration. For generations, conventional wisdom held that you could acclimatize to lack of water. The war planners liked this view because it meant one less burdensome supply item. We proved that acclimatization to heat developed in about 3 days, but adaptation to lack of water was impossible. Without water in a buttoned-down tank, where wall temperatures reached 165 °F, collapse was inevitable. Even into the 1980s the mistaken view insisted that “tough” football players did not have to drink water, despite losing 10–20 pounds of sweat on a hot afternoon. One of my friends who played football intuitively knew it was wrong to deny water. He yearned for water so much that he would drink what he could wring out of his sweat-soaked shirt. Today, the pendulum has swung so far that runners collapse because of over-hydration. General MacArthur would never allow studies in the field, but we did get to spend six weeks with the Second Armored Division at Camp Polk, Louisiana. These men were about to go overseas, and their skills were the finest. I saw them drive a tank full speed between two trees with only inches to spare. The tanks were not air-conditioned, so the corpsmen often spent their nights outdoors. I recall two men who sought refuge under their tank from the heat and rain. During the night the tank slowly sank into the soft ground, burying them alive. To avoid having a Molotov cocktail being tossed into the tank, it was necessary to close the hatch, no matter how high the temperature. I rode in these closed ovens for hours, measuring the other four men's temperatures, pulses and blood pressures (Fig. 6). In turn, they taught me how to drive their M-3 tank … before I had learned to drive a car! At night, totally exhausted, I would drink quarts of a sweet drink made from packets of powder sent to me by Marguerite. She was in delightfully cool Duluth, playing with baby Peter and promising him I would give him a ride in “my” tank when I got back. And later, he did get to ride in “my” tank. Lt. Shelley in gas mask emerging from M-3 tank. Note hatch cover and water canteens. Camp Polk Louisiana, 1945 After the surrender of the German Army in May, 1945, our research mission shifted from tanks to caves. My next job was ill-fitted for a research physiologist. The hazardous assignments actually peaked when I was physically stationed in a cave, whereas a flame-thrower tank shot at the cave entrance. Once again, I was Wilhelm Tell's son with the apple on his head, but my mother was far away in Wisconsin and could not protect me. The flame-thrower spewed out long plumes of flaming napalm, an inflammable semisolid mixture of aluminum soap and gasoline, considered to be a superb incendiary antipersonnel weapon. Standing at the entrance as a dummy, I proved the flame-thrower was worthless for cave warfare. Only a direct hit would have baked me (and the apple on my head), as the bandwidth of the napalm flame was narrow enough to allow both of us simultaneously in the cave entrance. I should have received some sort of medal for what I did, e.g., stupid conduct medal. I was allowed to use goats instead of myself for the next experiment. I staked several dozen goats into the entrances of caves dug in a treeless field, as assorted tank corps generals watched a squad of tanks roll in pushing their long snakes of two tons of TNT. When the goat battle was over, the goats won, with only the loss of their eardrums. In September, 1945, the Second World War ended with the surrender of Japan. The rush of petitions for discharge orders rivaled the rush of women trying to buy the newest thing – nylon stockings. Although my position on the AMRL organization chart called for a Major, I had served as a First Lieutenant. Now they promoted me to Captain, and promised that by staying I would be made the commanding officer. There was a General's star in my future. But the position held no allure, for now the laboratory's mission had turned to studying Army clothing. By the following spring, after several disappointing denials for discharge, I finally went to the separation center in Indiana, after 2.5 years of service. Then I went to the University of Pennsylvania, where I got a job as instructor at the Department of Physiology, under the Chairman, Henry C. Bazett, who admired my work on hyperthermia. My salary was $2400 a year. When I discovered that the janitor made $2500 a year, I decided to look for a residency in dermatology. Financially, there was no contest. With the Veterans Bill of Rights, I could make more money than a janitor while I studied to be a dermatologist. With a wife and child to support, that path was very attractive, and I took it by walking across the street to the University Hospital. On July 1, 1946, I became a first-year resident at Penn.