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Ferdinand Phinizy Calhoun, Jr.

The Ophthalmological Service in

the 2nd General Hospital

by F. Phinizy Calhoun, Jr., M.D.

I finished my three year residency in Ophthalmology at the Eye Institute in early 1941 and returned to Atlanta to practice with my father and to join the faculty of Emory University School of Medicine. I received a commission as 1st Lieutenant in the U.S. Army Medical Corps on September 25, 1941. During the planning for various hospital units I was asked to join the Emory Unit which had signed two of my good EENT friends. They stated they would let me do the eye work but I felt that I would be excess baggage and so decided to accept the invitation of Dr. William Barclay Parsons to join the PH unit where I would be the sole ophthalmologist and Dr. Ned Fowler would be the otolaryngologist. I would feel more comfortable working in the group of people with whom I had recently finished training. This was a high compliment and opportunity for a young man (31) like me, and I suspect I was endorsed by my former chief Dr. John Dunnington, head of the Eye Institute. The decision was a good choice for me because the 2nd General Hospital would prove to always have a prominent and favored location and reputation in medical care among military hospitals and ophthalmology would develop along with it.

Our unit was activated on February 15, 1942 at Ft. George G. Meade in Maryland and there the doctors and nurses began their training to become soldiers. In the morning I worked in the Post EENT clinic relieving Dr. Peter of Philadelphia who had been transferred, and assisting Lt. Brandt, the Post EENT man. Occasionally interesting clinical cases were seen and rarely there was an opportunity for surgery. The work was chiefly that of measuring, testing, recording and treating minor eye problems. Outside the clinic our time was spent signing forms, getting inoculations, attending lectures, films, demonstrations, drills and marches. The doctors trained on the range to qualify with the Colt .45 pistol and doctors and nurses underwent gas mask drill in the tear gas chamber. On June 1st several important medical and surgical officers were transferred to head services in incomplete units.

Having cancelled my earlier plan to take the American Board of Ophthalmology examination in March, I was suddenly ordered on June 4th to report the next day in Baltimore for a special meeting of the Board which desired to certify as many qualified men as possible for overseas duty. I became certified by the Board following an oral examination on June 5th and a practical examination held at the Wilmer Institute on June 6, 1942.

On June 22nd, after changing from khaki to woollen uniforms and stripping down to our allowable baggage, we entrained in the heat for Camp Dix, N.J. where we sweltered in more barracks life and drill until June 30th, when we entrained again, this time to New York Harbor where we boarded the 18,000 ton British steamer the S.S. Duchess of Bedford along with infantry troops under the command of General Theodore Roosevelt. Sailing down past Sandy Hook on July 1 and not knowing our destination was an emotional experience and quite a spectacle joining the convoy of other vessels under the watchful dirigibles overhead.

After an evasive zig-zag course our vessel, out of the convoy from which several ships were reputedly lost, arrived at the mouth of the Mersey River at Liverpool twelve days later on July 12th. Upon entering the Irish Sea an anxious few hours had been spent during an alert for which we were sealed in our air-tight quarters below the water-line. Upon debarking the next day, we were bussed to Whittington Barracks at Lichfield near Birmingham. After two more weeks of spartan barracks life and diet, during which many doctors and nurses bought up all available bicycles from the nearby towns, we were transported to the clean Churchill Hospital, formerly the American Hospital in Britain located on a hill at Headington, near Oxford, and what a welcome sight it was.

Following the removal of the remaining British patients it was revealed that the Hospital was equipped only for orthopedic patients and it was our job to convert it into a true general hospital. It soon became apparent that the large shipment of special equipment obtained privately by the PH for our use had been lost at sea.

The challenge for ophthalmology was particularly severe. We would soon be getting patients whether equipped and prepared or not. Improvisation was the order of the day. First, Dr. Fowler for ENT and I for Eye had to find some small space in which to work. Having solved this, we began to assemble personnel and at least basic "GI" specialty equipment. Fortunately for me, the Table of Organization provided an Optometrist T/4 Milton Scheer and T/5 Silvio DiRoma, an Optician. As nurses, Captain Fowler had Lt. Doris Cone and I had Lt. Gertrude Martin, both experienced at PH for the special nursing care required in these fields. As far as equipment for ocular examination and surgery, I began with practically nothing except a few small things which I could carry in my pockets. I had brought along my own May battery ophthalmoscope, Schiotz tonometer, Pfeiffer foreign body localizing kit, a 50 cent wire eye speculum and a hand full of tubes of the latest in antibacterial treatment -- sulfathiazole. On several trips to medical supply stores in London I bought several Snellen vision test cards, a set of Traquair test objects for visual fields, a small spud to remove corneal foreign bodies, and a small hand-held illuminated magnifier.

As predicted, we were quickly required to see and treat soldiers sent to us by military orders -- ready or not. Due to our limited facilities we began to form friendships with local British civilian and military ophthalmologists who proved to be most generous and cooperative in sharing their equipment and clinical assistance. During our early stay at Oxford, Major Bucknall and later Major Ritchie of the British 70th General Army Hospital were very helpful in sharing their examination and treatment facilities, especially a magnet, diathermy machine and slit-lamp. In 1944, Major Zorab of a prominent ophthalmological family in Britain would occasionally come up from the 70th General Hospital to assist in a retinal detachment operation, bringing with him the latest diathermy machine operated by Mr. Mostyn Brown of Keeler's in London. These ophthalmologists enjoyed accommodating us in this way because the reward was always a cocktail and American dinner at the Churchill. Through consultations on interesting patients, friendships developed with Mr. A. C. Houlton of Oxford and the world-famous Professor Ida Mann, the Director of the Nuffield Eye Research Institute. S/LDR Tony Palin, an ophthalmologist of the RAF also visited.

During the fall and winter of 1942 we gradually became better equipped and more self-sufficient due to the action of the first visit of our Senior Consultant, Lt. Col. Derrick T. Vail of Chicago who came with Brigadier Sir Stewart Duke-Elder, the famous British Senior Consultant. On September 28th our supply officer Capt. Smith wrangled from the British a set of trial lenses, and on December 3rd we received a GI perimeter and goose-neck operating light , made by AO. On October 26th we had received a second-class slit-lamp and corneal microscope. On November 3rd, Lt. Col. Vail visited again bringing with him Dr. Perrin Long, of Baltimore, the discoverer of sulfanilamide. Lt. Col. Vail wanted me to gather data on sulfanilamide in ocular infections. On October 29th all ward officers had to sign a warrant that we had no patients on our wards who were transportable. This was hard to interpret for even our most serious eye patients because most were ambulatory. Apparently the mind-set was being established for evacuation to the rear to free more beds, more important in the possible event of mass casualties.

Since we were at first the only general hospital for the 8th Air Force we learned to anticipate the evening's admissions from viewing overhead the gaps in the returning B-17 formations. The 2nd General would invariably get that night the most seriously wounded. There were many ocular injuries frequently combined with other injuries. We treated 33 cases of severe ocular injuries manifest as penetrating wounds due to blast, plexiglass, aluminum and shrapnel which were often accompanied by severe frost-bite affecting the face and extremities. Occasional cases of solar retinitis resulting in retinal damage or blindness were seen in tail-gunners who were forced to gaze into the sun for enemy fighters without the partial protection of lost, broken or forgotten sun glasses. Our treatment of war injuries in ground troops was to come later in France for this was the time before the invasion. However, the ordinary diseases, mostly infections, as well as trauma occurring in the service troops and ground troops in training were also a frequent source of patient admission since they could not be sent back to their units until fit for full duty. There was no way an eye patient could be treated in his own or convalescent unit, although there developed such convalescent units for certain surgical, medical and orthopedic patients.

During this time an interesting problem was presented by the one-eyed and completely blind soldier. The latter was sent to the British St. Dunstan's Hospital for the Blind then later to a similar institution at Valley Forge, Pa. For the soldier who had recently lost his depth perception from the removal of an eye the quickest aid to adjustment and adaptation to the loss of binocular was to begin training in acts of dexterity immediately after operation. The best exercise for this was the game of table tennis, or ping-pong, practiced daily until disposition could be decided. Another psychological boost for such patients was the custom-made plastic ocular prostheses provided by Capt. Robert Mason of our Dental Team. Such a soldier could be accepted into some non-combat duty, but later on such soldiers were automatically returned to the States. It was striking that during this time an occasional one-eyed soldier would be qualified in the U.S. for overseas duty and we were seeing one-eyed soldiers passing each other between the U.S. and England.

In 1943 as the utilization and reputation of the 2nd General Hospital increased so did the Ophthalmological Service. Our out-patient service was very busy and our eye bed census averaged 15-30 patients with significant surgical cases of all kinds. [Fig. 1] Our service had frequent visits from other military ophthalmologists, U.S., British and Canadian. Lt. M.C. Joseph Krug of New York City who has until recently headed a surgical service at the New York Eye and Ear Infirmary began his early training in Ophthalmology with us. Capt. Sidney J. Karash of New York City became detached to us and it was at this time in February '43 that I was granted a week's detached duty to observe the work at Moorfield's Hospital in London. There I attended the clinics of Mr. Neame, King, Savin, Doyne, Davenport and others and observed the surgery of young Trevor-Roper who was to become prominent after the war. The difficulty was that several times I had to make the three-hour trip back to Oxford to handle some urgent medical or administrative emergency. On February 15th our service had a surprise visit and ward rounds on all patients from Lt. Col. Vail, Brigadier Sir Stewart Duke-Elder and the Free-French Eye Consultant Mlle. Susan Vallon. [Fig. 2]

Despite the heavy load of our work during this time, Lt. Col. Vail emphasized the need to keep our scientific minds active and encouraged the continuation of our academic interest. On May 1st, I was ordered to the Park Lane Hotel in London where Vail held an organizational meeting for an ETO Ophthalmological club whose elected officers were Maj. Don Marshall, chairman, Capt. Carlisle E. McKee, secretary, and Capt. Eugene W. Anthony, editor. This resulted in several scientific meetings held first at the 2nd General Hospital to which officers from all over the ETO doing ophthalmology were ordered to attend. At the first meeting on July 10, 1943, thirty-five officers including Lt. Col. Vail of the Army, Lt. Cdr. Edward E. Dunphy of Boston, Senior Consultant for the U.S. Navy, and several officers of the British and Canadian Forces attended. [Fig. 3] The publication of the ETOUSA Journal of Ophthalmology of which there were issues in July, September and December 1943, provided interesting case reports, useful interpretation of Army directives pertaining to standards for treatment of eye injuries and helpful hints for improving eye equipment and instruments in the field, such as how to set up an eye clinic in a squad or ward tent and how to construct a slit-lamp and corneal microscope from spare parts. I was able to submit an article in each issue. [Fig. 4]

A very time-consuming responsibility of the Eye Service was the matter of eye glasses. Troop commanders would send their men to 2nd General Hospital for refraction and replacement of lost or broken glasses. These groups of soldiers would arrive at the Eye Clinic at all times of the day or night and frequently would have to be boarded in the enlisted men's quarters. Some commanders would send selected soldiers hoping to find ocular reasons for transferring them. The presence of an Optometrist and Optician was a great help with this chore once we got adequate examining and fitting equipment but GI glasses could not be made on the spot. They were ground and fitted into simple metal frames at the Optical Dispensary run by Capt. Mangold in far away Blackpool. Delivery by mail to the soldier was uncertain and usually unsatisfactory because of his frequently changing post, and there was no chance to confirm or properly fit the frames. They were usually uncomfortable and disliked by the soldiers. GI glasses could not be put into civilian frames which was particularly irritating to officers who were very demanding in their eye care. For glasses they were given a prescription to be filled in London by my friend Mr. Everett Vogt of E.B. Myerwitz who was especially accommodating to them.

On May 3rd, Lt. Krug and I received permission to attend the didactic course of lectures and demonstrations in ophthalmology to qualify for the lesser of two certificates required of all British ophthalmologists. The course consisted of a series of approximately 30 lectures and demonstrations by various authorities on basic and clinical subjects. The sessions were given almost daily beginning at 4:00 p.m. in the Nuffield Institute requiring us to leave our busy clinic and dash down Headington Hill on our bicycles barely in time to make class. The course ended on June 7th and I was admitted to the written and oral examination given on July 6th. Later I was told that I was number 4 of the 8 out of 12 who passed and so received the Diploma of Ophthalmology (Oxon).

In the winter of 1943 and first three months of 1944 the troop movements and hospital activities were at a peak. We were ordered to fit gas mask glasses on every soldier who was dependent on glasses. This was a fair idea with a very poor solution and result but was necessary as the standard masks did not fit over frames. The lenses had to be of flat glass and fitted into a round holder to be fitted into the inside of the standard mask. They could not be made locally and were to be formulated in the Optical Dispensary in Blackpool and mailed to the constantly moving soldier. Delay, loss and damage in use made the result chaotic. Later, the problem was somewhat relieved by strategically placed Mobile Optical Units.

In May, all ophthalmologists were ordered to a special dinner meeting in London where we were given a long pep talk by Lt. Col. Vail and Brigadier Sir Stewart Duke-Elder in preparation for overseas duty. At the conclusion, 21 general hospitals were each issued a superb water-proof metal field kit of Weiss ophthalmic instruments which was standard equipment for all British General Hospitals. Each ophthalmologist was to carry this precious case of instruments with him personally the rest of the war and I literally slept with this flat carrying case beneath my pillow whenever I was in transit from one station to another. Today it is one of my proudest mementos of the War. [Fig. 5]

During our 18 months at the Churchill Hospital our patients consisted of ground and air combat personnel of the 8th Air Force and of combat and service personnel of the U.S. Army in training. These patients were quite different from the combat casualties of the ground troops to be treated by us later during our 6 months in France under battle conditions.

In England from October 1942 to April 1944, the Ophthalmological Service examined a total of 4,857 patients of whom 2,432 were new patients. There were 350 hospital admissions and 117 operations of great variety. Among them were 12 enucleations, 10 intra-ocular foreign body removals, 8 retinal detachment operations, 10 eye muscle operations, 5 traumatic cataract operations, plus numerous others.

Finally on April 24, 1944, it came time to turn over our beloved Churchill Hospital and its patients to the care of the 91st General Hospital. With our foot-lockers and bedding rolls, the doctors were transferred for training to a tent bivouac and folding cots at Pinkney Park. The 83 nurses were sent to the 25th General Hospital at the large Cirencester Hospital Center. After two weeks they joined the doctors and for another week we all underwent physical training, marching and real field living conditions on the Salisbury Plain near Tidworth. On July 24th, D plus 48, we embarked from nearby Southhampton in two groups stuffed into filthy small steamers for the overnight channel crossing and debarked on Utah Beach in landing craft the following morning. With the officers on foot and the nurses in trucks, we were led through the mine tapes to our bivouac near Carentan and Isigny and not far from St. Mere Eglise where we resumed tent life in the field. We waited for several days in this position beside the main road to St. Lo waving to the stream of gallant young troops of Patton's army rolling past us toward that city while the concrete slabs were being laid for our tent hospital in an apple orchard down the road near Lison. The rumble of artillery and the nightly show of searchlights and anti-aircraft fire made us wonder what a general hospital was doing this near the enemy action. We were ready to receive patients within two weeks after the concrete cured and this is where improvisation took over again. [Fig. 6] In addition to seriously wounded American troops we treated many unfortunate French civilians and hundreds of arrogant German prisoners whose dirty neglected wounds were major therapeutic problems. My first surgical patient here was a 9 year-old local French boy, Daniel Nicolle [Fig. 7] who required the closure of a penetrating laceration of the cornea and excision of an iris prolapse. The finest suture material available to us at that time was 8-0 braided silk. Treatments of wounded soldiers were directed toward stabilizing the conditions for evacuation to England of Americans and Germans alike in order to make room for more patients.

On November 24th, when the 189th General Hospital took over our tent hospital, the nurses were sent on detached service to various hospitals in Paris and the doctors to bivouac in the little town of Revigny near Bar le Duc about 100 miles directly east of Paris where, during Christmas, we were threatened by the infiltration of American-speaking German para-troopers and terrorists who spear-headed the German breakout attempt.

In early January 1945, we were all reunited further east in the city of Nancy in the hospital of several buildings of a former military barracks called the Caserne Laundremont on the Rue du Sergent Blandon. There these buildings had been formerly utilized as a German hospital, then by the 12th Evac Hospital of Patton's army and, although full of litter, the warmth was a welcome luxury and the walls and space gave us the opportunity to use our precious eye equipment carried in empty German howitzer shell boxes. There I was finally promoted to Major on March 1, 1945. Soon the ambulances brought from the battles in the Hurtgen Forest and Bastogne, terrible shrapnel wounds with magnetic intra-ocular foreign bodies, hundreds of open debrided wounds of all kinds coated with sulfa powder and ready for secondary closure, and hundreds of severe extremity frost-bite cases. Acting now as a general medical officer I had to care for a ward of about 50 eye cases, a similar one requiring secondary closures, and a third ward of frost-bite cases.

Another serious acute medical problem encountered at the Lison hospital and later in early 1945 at Nancy was that of methyl alcohol poisoning incurred by drinking cognac, mirabelle and creme de prunelle made illicitly by local distributors with methyl alcohol. These cases occurred largely in the drivers of truck convoys called the Red Ball Express which supplied Patton's army ahead of us. The illness was characterized clinically by blurred vision or blindness, acidosis, shock, and death in 5 of 11 cases admitted to the hospital. These cases were reported by Majors Province, Kritzler and Calhoun in the U.S. Army Medical Bulletin. In Nancy, Maj. Calhoun collaborated with local civilian ophthalmologists in reporting 16 civilian and military cases in the local medical journal.

Our senior consultant Lt. Col. Vail had returned to the U.S. for detached duty in late 1944 and did not go to France. He was replaced by Lt. Col. James Greear who arrived on March 29th and who first visited us in Nancy in July after VE Day on May 8th. For a time then we were without a consultant.

Following VE Day and the capitulation of the German military machine, the national military strategy turned toward plans to shift the military effort from the European to the Pacific and the China-Burma-India Theater. In the brief lull following VE Day, preparations were formulated to retrain combat and supply troops for possible deployment to the Pacific, and this included the medical corps. Although fatigued along with others by almost four years of continuous overseas duty, I accepted the request of Lt. Col. Greear to organize a Post-Hostilities Training Course for Ophthalmologists in the ETO. This involved the recruitment of a faculty of prominent British ophthalmologists and the scheduling of time and subject dates as well as getting together a group of trainees. Arrangements having been made by Professor Ida Mann at Oxford, I and 14 other ophthalmologists set out for England on July 12 visiting clinics in London, Oxford, Edinburgh and Glasgow where we attended lectures and demonstrations from such eminent authorities as Foster Moore, D.C. Shapland, McCallan, Greeves, E. Wolf, Loewenstein, Riddell, Ballentyne, Traquair and others. [Fig. 8] This excellent educational experience terminated rather suddenly in Glasgow with the announcement of VJ Day August 15th. [Fig. 9]

On August 25th, the 2nd General Hospital closed, leaving 1000 patients still under treatment. All doctors and nurses were then transported by train for a three-day coach ride to the Marseilles area in southern France. The doctors went to a large staging barracks on a plain outside the city and the nurses went to a recreational resort near the city. The doctors were then sent to Paris for staging at the Dufayel Department Store and, on October 2nd, flown on C-54s to Washington on the Green Project. The nurses sailed on October 3rd from Marseilles aboard the General Meigs arriving at Hampton Roads on October 12th. From there at Camp Patrick Henry they were then discharged at Camp Dix, N.J. From Washington I went by train to Atlanta and was discharged at Camp Gordon in Augusta on October 4, 1945.

In the retrospection of 50 years, reinforced by personal notes, diaries, photographs, Army records and abstracts of patient records, the author believes that the Ophthalmological Service of the 2nd General Hospital provided the function expected of it. Functioning sometimes under difficult field conditions we learned to improvise and we met all our challenges. During the times when we were fully equipped we could perform on a par with that available in civilian life and above that commonly present in war-time ophthalmology. This was due to the supportive medical staff of the 2nd General Hospital, the backing of the Senior Consultants and the assistance and cooperation of the British military and civilian ophthalmologists and to some extent, the French. The field conditions in France did not permit the recording of the volume and scope of our work in various situations while there, but because of the number of 8th Air Force casualties we treated in Oxford, our total varied experience equalled, if not exceeded that of other general hospitals.

The medical and surgical experience for this young author was an eventful, exciting and unforgettable period of his life. In the middle of it all to be able to keep up his interest in academic and scientific ophthalmology by sitting at the feet of eminent authorities in Oxford, London, and Glasgow was a bonus which stood him in good stead in later life when he became Professor and Chairman of the Emory Department of Ophthalmology from 1950-1977.

Finally, the author considers it an honor and privilege to have served with this outstanding medical organization. He has been rewarded by 47 years of subsequent success and happiness due to his marriage in Nancy, France on July 11, 1945 -- between VE Day and VJ Day -- to Lt. Mary Ellen Van Horn, a Presbyterian Hospital graduate, nurse, and member of the 2nd General Hospital.

 

October 20, 1992

 

 

Legends (Photographs)

 

 

Fig. 1 - Oxford 1944. The Ophthalmological Staff at its peak. Seated, at left, Lt. Gertrude Martin, chief nurse; Lt. Clarissa Walsh; in center, Capt. F. P. Calhoun, Jr.; standing in center, T/4 Milton Scheer, optometrist; far right, T/5 Silvio DiRoma, optician; the others are an assistant nurse and corpsmen ward orderlies.

Fig. 2 - Oxford, February 5, 1943. Visit by Lt. Col. Derrick T. Vail, Senior Consultant, USA; Brigadier Sir Stewart Duke-Elder, Senior Consultant, UK; Mlle. Susan Vallon, Senior Consultant, Free French Army.

Fig. 3 - Oxford, July 11, 1943. First meeting of the ETOUSA Ophthalmological Society at the 2nd General Hospital. Pictured are: Left to Right - Front Row: 1. Maj. Nathan S. Rubin, 2. Maj. Sloan M. Sanford, 3. Capt. H. W. Hawn, 4. Lt. M. H. Miller, 5. Maj. George B. Green, 6. Capt. Victor Mozersky, 7. Capt. H. D. Bochoven, 8. Capt. Frank Goldstein, 9. Capt. Van Dorf, 10. Maj. Wolstein RCAMC, 11. Capt. F. P. Calhoun. Left to Right - Second Row: 1. Capt. Isadore Katz, 2. Maj. E. L. Wilds, 3. Capt. S. J. Karash, 4. Capt. Ephrain Mannsing, 5. Capt. Monty S. Schwader, 6. Lt. Col. Derrick Vail, 7. Lt. Col. E. B. Dunphy USNR, 8. Capt. I. M. Schnee, 9. Capt. C. B. Tibbetts, 10. Capt. John E. Smith, 11. Capt. Carlisle E. McKee. Left to Right - Rear Row: 1. Lt. J. W. Sacks, 2. Capt. J.D. Schwartyman, 3. Maj. Don Marshall, 4. Maj. Charles Thompson, RCAMC, 5. Dr. Walt Roberts, Lockheed Aircraft Co., 6. Capt. Eugene Anthony, 7. Capt. Tom Cavanaugh, 8. Capt. Sakis, 9. Capt. G. L. Sullivan, 10. Capt. George H. Petti, 11. M. W. Erdel, 12. Capt. Anton J. Hummell.

Fig. 4 - Cover of the first issue of the half-page size, mimeographed ETOUSA Journal of Ophthalmology of which there were three issues.

Fig. 5 - Case of exquisite ophthalmic instruments made by John Weiss of London in water- proof metal carrying case and issued to selected general hospitals going to France.

Fig. 6 - Lison, France, August 1944. The author at the gate of the 2nd General Hospital.

Fig. 7 - Lison, France, August 1944. Daniel Nicolle, a 9 year-old French boy, our first surgical eye patient in France, recovering from repair of a penetrating corneal laceration and excision of iris prolapse, posing in borrowed over-sized GI combat jacket between Lt. Gertrude Martin on left and Lt. Doris Cone on right.

Fig. 8 - Oxford, July 1945. The group of American ophthalmologists ordered to attend the Post-Hostilities Training Course in Ophthalmology arranged by Professor Ida Mann who is seated in white coat.

Fig. 9 - Glasgow, August 1945. Some of the American ophthalmologists attending the Post- Hostilities Course at the Tennant Eye Institute, interrupted by VJ Day, August 15th. Among the faculty shown are Professors Loewenstein, Riddell and Ballentyne.

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