World War II Day by Day

Washington, D.C • December 16, 1940

The late 1930s saw storm clouds and thunder rumble over both main­land China and Europe. The 8‑year Second Sino-Japa­nese war erupted in July 1937, shattering an uneasy truce between the Nationalist Chin­ese and the Empire of Japan. In mid-March the following year events in Europe threa­tened full-scale war when Nazi Germany annexed Aus­tria (Anschluss) and invaded the tinder box coun­try of Czecho­slo­vakia. Then light­ning stuck Poland on Septem­ber 1, 1939, when Adolf Hitler’s blit­zkrieg rolled up Poland’s army in just over a month. On Septem­ber 3, 1939, Great Britain and France, followed with­in days by Canada and much of the British Common­wealth, declared war on Nazi Germany. Only two oceanic moats and America’s declared neu­tral­ity pro­tected the coun­try from being burned by con­fla­gra­tions originating thousands of miles away.

U.S. President Frank­lin D. Roose­velt, with cool cal­cu­la­tion, watched the sad hap­penings beyond his nation’s borders. He worked tire­less­ly to success­fully repeal the isola­tionist Neu­tral­ity Acts (1935–1939), which limited his admin­is­tra­tion’s abil­ity to aid demo­cra­tic Britain and France against a fascist Germany arming to the teeth. He approved the “destroyers for bases” deal with Great Britain in Septem­ber 1940 through which the U.S. trans­fer­red 50 World War I‑era destroyers to the British Navy in exchange for leases for British naval and air bases in both the East­ern and West­ern Hemis­pheres. He signed the Lend-Lease Act in March 1941, a policy under which the U.S. supplied the United Kingdom, France, China, the Soviet Union, and other Allied nations with food, oil, and essen­tial materiel free of charge between 1941 and 1945.

It was anybody’s guess when the U.S. would become a bel­lig­er­ent. An edu­cated guess, how­ever, was sooner than later. The estab­lish­ment of new U.S. mili­tary bases in the North Atlan­tic (Ice­land, North­ern Ire­land, and Great Britain), the Carib­bean, and South Amer­ica, along with extant bases in U.S. posses­sions in the west­ern and cen­tral Pacific Ocean area weighed on the minds of mili­tary brass. The pas­sage of selec­tive ser­vice legis­la­tion in Septem­ber 1940 added to the pres­sure of devising a success­ful, all-encom­pas­sing plan for moving likely Amer­i­can casual­ties from ports of entry on the east, west, and gulf coasts to gene­ral hos­pi­tals, spe­cial­ty care, and rehabil­i­ta­tion cen­ters closest to the soldiers’ home­towns when­ever pos­si­ble. The last time simi­lar contin­gency plan­ning had occurred was in the First World War.

In the late inter­war years planning for new U.S. Army hos­pi­tal trains and rein­ven­ting and re­imag­ining the First World War’s domes­tic “ambu­lance trains” gained momen­tum. In Septem­ber 1940 the Sur­geon Gen­er­al’s Office sug­gested the Army try con­verting com­mer­cial Pull­man sleeper cars to trans­port wounded ambu­la­tory and litter (stretcher) patients from Amer­i­can ports to care facil­i­ties through­out the coun­try. On this date, Decem­ber 16, 1940, Army Engi­neers ordered enough 20‑ton sleeper cars to test some for use in Army hos­pi­tal trains. When the U.S. entered the global war on Decem­ber 8, 1941, the nation had just 6 funct­ioning Army hospital train cars.

Hospital trains were mini-hospitals on rails that pro­vided casual­ties of war in need of either emer­gency treat­ment imme­di­ately or expert care or both while they were being trans­ported to per­ma­nent medi­cal facil­i­ties. Con­struc­tion of new hos­pi­tal cars was expanded to the greatest extent pos­si­ble. By the end of the war the nation had 380 purpose-built cars (see photo essay below). But the logis­tics of moving patients around the coun­try by rail was exceedingly com­plex. So too was staffing these trains and cars. Hos­pi­tal trains typi­cally carried 190 patients and were staffed by 6 doctors, 3 admin­is­tra­tive offi­cers, 5 nurses, and 57 enlisted men who served as medics, cooks, and similarly essen­tial per­son­nel. Nurses assumed day-to-day care of patients and passed orders on to the medics.

Bringing the Wounded Home: Hospital Trains, 1940–1945

Above: Floor plans of purpose-built (not converted) hos­pi­tal unit and ward cars, 1941–1942. The U.S. Army and Office of the Sur­geon Gener­al settled on four (later three) types of hos­pi­tal cars: unit, ward, ward dres­sing (dropped), and kit­chen. In 1944 the unit car, measuring 84.5 ft (25.8 m) long, became self-con­tained, with berths for up­ward of 36 wounded soldiers, a kit­chen, a receiving room that func­tioned as a phar­macy, an admin­is­tra­tive office and emer­gency oper­a­ting room, two toilets, and a storage area. The unit car was air-conditioned—a luxury at the time. The 1944 unit car could be detached from mili­tary trains (troop and hos­pi­tal trains) and attached to com­mer­cial trains with­out jeop­ar­dizing patient care. By the end of World War II, the U.S. Army owned 202 unit cars, 80 ward cars, 38 ward dressing cars, and 60 kitchen cars.

Left: A photo from early in the war shows what had been a com­mer­cial Pull­man sleeper con­verted into a hos­pi­tal ward car. Securing space on domes­tic rail­road lines to carry injured troops in Pull­man sleeper cars could take as long as 2 weeks when it was tried. Even when space was avail­able, it was a struggle to load litter patients into the con­verted Pull­mans (some­times through win­dows) and nego­ti­ate the outside vestibules and narrow aisles inside.

Right: Cramped late‑war 3‑tiered bunk beds on either side of the aisle accom­mo­dated 24–36 patients. Bunk beds had springs and folded up, turning into tables for card­players. Litter patients lying on stretchers suffered because they had no cush­ioning or padding under them. For litter patients train jour­neys were agonizing. By way of example, in France litter patients faced a jour­ney of up to 50 hours from Paris to English Channel embar­ka­tion ports. Any jour­ney in a hos­pi­tal train inev­i­ta­bly turned into one or a mixture of bore­dom, cama­ra­derie, humor, emotional trauma, and tension.

Left: A smiling Private Thomas M. Ware on a hospi­tal train at Hamp­ton Roads Pier in New­port News, Vir­ginia. During a German air raid in Italy on April 26, 1944, the 19‑year-old Ware suf­fered a severe shrap­nel wound to his leg. The wound turned gan­grenous and led to the lower third of his leg and his foot being ampu­tated. Ware was dis­charged from the U.S. Army on December 23, 1944.

Right: Demonstration illustrating a stretcher patient being helped through a double door and into a British hos­pi­tal train ward car. The British, Free French, Germans, and Amer­i­cans operated hos­pi­tal trains and cars that evac­u­ated sol­diers from com­bat zones to more “spe­cial­ized” medi­cal facil­i­ties out­side the theater of com­bat oper­a­tions (about 50 miles/­80 km behind the front lines). A British hos­pi­tal train typ­i­cally con­sisted of 14 cars, 7 of which were ward cars equipped to accom­mo­date 250–317 casual­ties, depending on whether they were litter, ambu­la­tory, or PTSD or other psychi­a­tric cases. The phar­macy car was the most impor­tant com­ponent, pos­sessing an oper­a­ting room with all the neces­sary equip­ment; the rest of the hos­pi­tal train con­sisted of a kitchen car and sleeping quarters for the medical staff. By Septem­ber 1, 1943, 15 hos­pi­tal trains were oper­a­tional in the United King­dom; another 10 were even­tu­ally oper­a­tional over­seas moving the wounded from so-called transit hos­pi­tals to gene­ral hos­pi­tals where staff took care of their patients’ specific needs.

U.S. World War II Hospital Trains