The Overlooked Heroines: Three Silver Star Nurses of World War I

Transcription

1 MILITARY MEDICINE, 173, 5:493, 2008 The Overlooked Heroines: Three Silver Star Nurses of World War I LTC Richard M. Prior, AN USA; William Sanders Marble, PhD ABSTRACT As members of forward-deployed combat hospitals, World War I Army nurses Miss Jane Rignel, Miss Linnie Leckrone, and Miss Irene Robar received the Citation Star for gallantry in attending to the wounded while under artillery fire in the month of July In 1932, they were authorized to exchange their Citation Stars for the new Silver Star Medal. Nursing in the war was difficult and required caring for patients exposed to chemical weapons and trauma while in harsh field conditions. These women were among the many Army nurses decorated for their performance in World War I. INTRODUCTION Four World War II Army nurses have been considered the first female Silver Star recipients. Recently discovered documents offer an alternative perspective. Three Army nurses were awarded the Citation Star for gallantry in action in World War I. In 1932, Secretary of War Patrick J. Hurley authorized the Silver Star Medal and permitted Citation Star recipients to exchange their medal for the new Silver Star. Nursing in World War I required the care of both trauma and chemical weapons patients in austere combat conditions. Miss Jane I. Rignel was awarded the Citation Star for her service in France on July 15, 1918 with Mobile Hospital No. 2. Miss Linnie Leckrone and Miss Irene Robar were also awarded the Citation Star for their service on July 29, 1918 while attached to Field Hospital No. 127 as members of a specially trained shock team. THE CITATION STAR AND THE SILVER STAR It is a widely held belief that the first women in the history of the U.S. military awarded the Silver Star Medal were Army Nurse Corps officers who had served in World War II. 1 3 Lieutenants Mary L. Roberts, Elaine A. Roe, and Rita V. Rourke were presented the Silver Star for gallantry in action in February 1944 near Anzio, Italy. During a concentrated artillery bombardment of their unit, the 33rd Field Hospital, Lieutenants Roe and Rourke conducted an orderly evacuation of 42 patients in complete darkness using only flashlights. Lieutenant Roberts, a member of the 56th Evacuation Hospital who served as Chief Nurse of the Operating Room, encouraged the continuation of surgeries amid an artillery attack that damaged the surgical facilities and wounded two of the enlisted men in her charge. Lieutenant Ellen Ainsworth, who was mortally wounded while evacuating patients during the bombardment, died 4 days later and was awarded Office of Medical History, Office of The Surgeon General, U.S. Army, 5111 Leesburg Pike, Suite 401-B, Falls Church, VA The views expressed are those of the authors and should not be construed as representing the positions of the Department of the Army or the Department of Defense. This manuscript was received for review in May The revised manuscript was accepted for publication in January the Silver Star posthumously. The medals were awarded at a joint ceremony in Italy by Major General John P. Lucas. 4 Although their heroism richly deserved the honors received, they were not the first nurses or women authorized to wear the Silver Star. During the latter part of World War I, the Citation Star was authorized by Public Law 193, enacted by the 65th Congress on July 9, It was to be conferred for gallantry under enemy fire. It consisted of a small (3/16-inch in diameter) silver star device that was worn on the World War I Victory Medal. Members of the Army Medical Department comprised 381 of the approximately 4,800 soldiers, sailors, and marines individually cited 5 (Fig. 1). Cited World War I veterans were displeased that their heroism did not rate a full-sized medal and lobbied for a replacement to the Citation Star. On July 19, 1932, Secretary of War Patrick J. Hurley approved the Silver Star Medal to supplant the Citation Star. The Silver Star honors the legacy of its predecessor by incorporating its design into the center of the medal. World War I recipients of the Citation Star were authorized to exchange their medal for the Silver Star in a paperwork process that was considered a formality. 6 Three World War I Army nurses were awarded the Citation Star in 1919 and 1920 and would have been authorized the wear of the Silver Star in Their story follows. ARMY NURSING IN WORLD WAR I Army nursing in World War I was quite different from how it is today. The all-female members of the Army Nurse Corps lacked rank and were simply referred to as Miss or Nurse. Army nurses did not receive relative rank, which provided a military title but lacked full pay or the authority to issue lawful orders, until Of the 21,480 women who were members of the Army Nurse Corps during the war, 10,245 served in France. 7 These Army nurses were primarily assigned to American Expeditionary Forces (AEF) base hospitals, camp hospitals, evacuation hospitals, mobile hospitals, hospital trains, and occasionally field hospitals. 8 By design, nurses were not to MILITARY MEDICINE, Vol. 173, May

2 morphia for extreme pain. 11 Available medications were limited, as the widespread use of antibiotics was more than two decades away. World War I was the first war to require extensive nursing care of patients exposed to chemical weapons. On March 10, 1915 at Ypres, Belgium, the Germans discharged 168 tons of chlorine gas from cylinders. The cloud drifted toward Allied trenches, inflicting over 5,000 casualties. As the war matured, more effective gasses (such as phosgene and sulfur mustard) were weaponized and employed. Care of patients who survived gas attacks was largely supportive and consisted of rest, morphia, oxygen, and stimulants. Removal of exudate from the lungs was accomplished by inducing vomiting and later by the use of benzoin steam tents. By the end of the war, chemical weapons would produce over 72,000 U.S. casualties, of whom approximately 1,200 died. 12 FIGURE 1. Silver Star: The 3/16-inch Citation Star is incorporated into the center of the Silver Star Medal. serve in the frontline treatment areas, known as advanced dressing stations, and they rarely served in the hospitals closest to the battle. 9 Yet, nurses were critical for surgery and caring for surgical patients, and, as it became clear that surgery had to be done closer to the line to improve outcomes, nurses were moved forward. Stars and Stripes showed the Army s attitude in commenting, These nurses, smack up in the combat zone, will hold the frontest front record for American women. 10 Work was arduous both at the front and at the rear, but it was more rewarding at the front and there were more volunteers than positions to fill; it was the goal and prize for which every nurse... longed. 7 Field conditions could be harsh. The winters in France were cold, the summers were hot, and mud was a nearly constant annoyance. Many combat hospitals operated out of canvas tents or abandoned buildings. If they got a building, the nurses quarters generally consisted of appropriated factories, schools, barracks, or hotels. Often times, the quarters lacked a reliable roof or functional plumbing. Laundry facilities were rare in forward hospitals, and the women often did their own laundry by hand after their shift. Despite the hardships, the nurses procured comfort items for their living areas and made the best of their situation. 8 Shift work for the AEF nurses was long, exhausting, and provided little opportunity for relaxation. 7 Nurses tended medical patients with diseases like influenza, they changed the complex carbonic acid-soaked dressings that prevented or limited gas gangrene, and they administered OVERALL TACTICAL SITUATION, SUMMER 1918, AND THE 42ND DIVISION In March 1918, after nearly 4 years of fighting, Germany initiated the Spring Offensives of 1918 in an attempt to break the stalemate and decisively win the war. As the summer began, nine U.S. divisions (comprising over 250,000 soldiers) were dispersed under French command, mainly training in quiet sectors. On July 15, 1918, the last great German offensive began their final attempt to break the Allied line and take Paris. 13 That day the U.S. 42nd Division occupied a position east of Reims, in the Champagne sector, where it served under the French Fourth Army. In the crisis of the German offensives, partially trained U.S. divisions were moved to the decisive sector. The division was subjected to heavy preparatory artillery bombardments, German infantry assaulted the front lines, and five battalions of 42nd Division infantry became engaged in the battle that would be officially called the Champagne-Marne Operation. 13 Rignel and her unit supported the stout resistance as the Germans were repulsed. RIGNEL AND MOBILE HOSPITAL NO. 2 Miss Jane I. Rignel, Army Nurse Corps, was the Chief Nurse of Mobile Hospital No. 2 (or Mobile 2, in period slang), attached to the 42nd Division. She was awarded the Citation Star for gallantry in giving aid to the wounded soldiers under heavy enemy fire on July 15, 1918 in Bussey le Chateau, France. 14 Mobile hospitals were a doctrinally new concept that had not existed before World War I. With all of their equipment packed in trucks, these hospitals were designed closely to follow the combat units they supported and to be able to care for patients on a few hours notice. Conceptually based on a French mobile hospital known as an auto-chir, AEF mobile hospitals had a capacity of 120 beds and could simultaneously support six surgical teams. Mobile hospitals could function independently or could be attached to another hos- 494 MILITARY MEDICINE, Vol. 173, May 2008

3 FIGURE 2. Mobile Hospital 2 trucks: Mobile Hospital No. 2 was selfsufficient and could operate on a few hours notice (U.S. Army Military History Institute). FIGURE 3. Mobile Hospital 2 personnel: Miss Jane Rignel, Chief Nurse, and Captain Fordyce St. John, Commander, highlighted, with officers and nurses of Mobile Hospital No. 2 (U.S. Army Military History Institute). pital as reinforcements where combat was heaviest. They frequently supported field hospitals, which lacked significant surgical capability 13 (Fig. 2). The chief nurse was an appointed, titled position required wherever two or more nurses were simultaneously serving. When enough qualified candidates could not be found for this important role within the organization, recruiting calls for chief nurses went to the civilian nursing community. Promotion to the grade of chief nurse required passing an examination that included elementary hygiene, arithmetic, and the regulations of the Army Medical Department. Their duties included being placed in charge of the nurses quarters and mess as well as the assignments and duty schedules of subordinate nurses. Doctrinally, Rignel would have supervised 22 Army nurses. 8 Many World War I hospitals were organized around stateside civilian institutions. Mobile 2 was comprised primarily of staff from the Presbyterian Hospital in New York. Rignel s future husband, Captain Fordyce B. St. John, was the unit s commander 15 (Fig. 3). On July 5, 1918, Mobile 2 was ordered to Bussey le Chateau under the control of the 42nd Division. There, they joined the 165th and 167th Field Hospitals and prepared to provide medical support to the division. The site they occupied had been a 1,350-bed French evacuation hospital. One of the field hospitals was designated for gas patients and the other for medical patients. Mobile 2 was to receive the surgical patients. 16 Fortunately, accounts exist from the July 15, 1918 period during the Champagne-Marne Operation in which Rignel s performance led to the awarding of the Citation Star. According to an after-action report written by Captain St. John, the artillery barrage began at 11:40 on the night of July ,18 Despite shelling on the roads, ambulances began arriving approximately 2:15 a.m.; by 3 a.m., the shock ward was full and by 6 a.m. there were 75 patients and eight operating teams working. After working through the night caring for causalities, the order was given at 7:30 a.m. on July 15 to evacuate the patients to a dug-out because of explosive shells landing on the hospital. Captain St. John related: During the first two hours of the barrage, the shells were landing approximately 125 yards beyond us and causing no trouble but at about six in the morning the enemy changed his range and the shells began dropping short and long, the typical range-finding method used, and it was now impossible for the wounded to reach us. This situation continued until seven o clock, when high explosives began falling among the thin wooden sheds of the hospital itself, so that it became necessary to issue an order to evacuate the wards and to remove all patients to the underground dugout. Before this could be accomplished, the shock ward... was pretty well demolished by two direct hits. Several casualties had already occurred, and, before the shacks could be evacuated, two more men were killed, one of whom was decapitated. A Presbyterian Hospital nurse in charge of this ward was dragged protesting from her post forty seconds before the shell hit the frail building. Patients were being killed as they were unloaded from ambulances. Some ten minutes later another shell demolished the corridor connecting the operating shack with the wards and one wall of the operating room was badly splintered. As it was becoming apparent that it was impractical to carry on, orders were given to cease operating and all personnel were ordered to the dugout after the last patient had been placed there. A nurse recalled: Stretcher after stretcher was brought in until it seemed as if there were no more beds to hold them. They came in filth and grime torn, weak, exhausted masses of tortured flesh and broken bones, their faces pale and ghastly with the agony of their terrible ordeal...no sooner had we ministered to one than another was at MILITARY MEDICINE, Vol. 173, May

4 hand...butthrough it all splendid bits of heroism that brought a catch to the throat. All the work was done under continuous shell fire, but operations continued until the operating theater was hit. 15 After the shelling eased, the hospital group evacuated its patients and staff to the nearest evacuation hospital. In keeping with the ideas of the time, the patients and nurses were evacuated first, then enlisted men, and officers followed last. St. John remarked on how the staff male and female, many under fire for the first time, and all part of a brand-new unit had coolly handled the situation, working quietly and carrying on throughout the hellish night. In the following weeks, Mobile 2 continued to execute its mission in hazardous combat conditions. On July 18, midnight artillery attacks on the hospital again woke the staff and forced them to care for casualties despite the danger to themselves and their patients. 16 On August 14, 1918, General John J. Pershing, AEF Commander, sent a commendation to Captain St. John and the whole staff of Mobile Hospital No. 2, recognizing them for their courage under fire. 19 THE ACTIVITIES OF THE 32ND DIVISION IN LATE JULY The Allied counterattack after the Champagne-Marne Operation was known as the Aisne-Marne Offensive and took place from July 18 to August 16, The German s Marne salient was weak after their failed attack and provided an opportunity for exploitation. From July 30 to August 2, the 32nd Division took part in the offensive when it relieved the French 3rd Division at Roncheres Wood. The 32nd Division advanced alongside the 42nd Division toward the Vesle River. As a result of this operation, the Germans were driven from the Marne back over the Vesle and the threat to Paris was over. 13 LECKRONE, ROBAR, AND FIELD HOSPITAL NO. 127 Miss Linnie E. Leckrone and Miss Irene Robar, both of the Army Nurse Corps, were at Field Hospital No. 127 (or Field 127), a unit of the 32nd Division. They were awarded the Citation Star for gallantry while attending to the wounded during [an] artillery bombardment on July 29, 1918 in Chateau-Thierry, France. 20,21 Nurses Leckrone and Robar were the two nurses of Shock Team No. 134, an ad hoc group with no unit records, and they were attached to Field 127, not assigned to it. In the schema of medical care during World War I, field hospitals were intended to be closest to the front line. Although nurses were initially not assigned duty in a field hospital, an unknown number of them were temporarily attached as members of specialty teams that augmented hospitals in times of need. 8 The categories of common specialty teams included shock, splint or orthopedic, and surgical or operating teams. 22 The primary function of shock teams was the resuscitation of wounded soldiers who were hypotensive secondary to blood loss, usually as a result of a femur fracture or multiple trauma, and therefore too ill to survive immediate surgery. Those soldiers suffering from significant hypotension were placed in a segregated area known as the shock ward. Typically, a patient with a blood pressure below 100 systolic was triaged to the shock ward where a team of specially trained physicians, nurses, and enlisted men attempted to stabilize them. The therapies used were primarily warming and intravenous fluids, which included either citrated blood or use of gum solution, a plasma expander. Their efforts predated the type and cross-match of blood products. Occasionally, a patient who deteriorated while undergoing surgery had to be removed from the operating room and transferred to the shock ward to be stabilized before the surgery could resume. 22 Little is known about the activities of Field 127 on July 29, 1918, in support of the Aisne-Marne Offensive or the exact circumstances under which Leckrone and Robar would be awarded the Citation Star. From June 25 to July 20, Field 127 was executing its mission at Massevaux, Alsace. With the crisis in front of Paris, the division was moved to the Marne sector and Field 127 moved 450 kilometers to the École Jean Mace at Chateau-Thierry where they operated a 500-bed hospital for the seriously wounded from July 28 to August 3. The hospital occupied the second floor of the large, old school located 22 kilometers behind the front line of the 32nd Division, close enough for regular shellfire and occasional bombing raids since the city was a communications hub (the first floor was occupied by Field 166 of the 42nd Division.) During the same period, Field 127 received 113 wounded patients and operated on 21 of them 13 (Fig. 4). A report written by Major J.W. Vaughn from the 32nd Division Surgeon s office, dated August 10, 1918, lauded FIGURE 4. Operating room scene: The operating rooms of Field Hospital No. 127, similar to the one depicted above, operated around the clock on July 29, 1918 (National Archives). 496 MILITARY MEDICINE, Vol. 173, May 2008

5 Shock Team No. 134 for their performance during the previous 10-day period. They were congratulated on their service giving aid for shock and hemorrhage on a day and night basis. Miss Leckrone and Miss Robar are mentioned by name alongside the other four members of the team. 23 DISCUSSION Despite every intention to keep hospitals and women out of harm s way, the circumstances of war and the practice of medicine brought nurses under the maelstrom of World War I artillery bombardments. Rignel, Leckrone, and Robar were not the only Army nurses in World War I to be recognized for valor. Three nurses were awarded the Distinguished Service Cross, the nation s second highest award for valor, one of whom was Beatrice MacDonald. MacDonald, who in 1917 received a shrapnel injury to her right eye that ultimately resulted in enucleation, remained at her post despite her injuries, recovered, and rejoined her unit as a nurse until after the armistice. By the end of the war, 26 Army nurses received the Distinguished Service Medal. Additionally, the French awarded the Croix de Guerre to 28 Army nurses and Great Britain presented 69 Army nurses with the Royal Red Cross Medal. 7 The manner in which these women were awarded the Citation Star seems to suggest that their gender was a consideration in the choice of their awards. In reviewing citation orders, Rignel, Leckrone, and Robar appear to be the sole members of their units to be recognized for heroism. No other members of Shock Team No. 134 or Mobile Hospital No. 2 were awarded Citation Stars for gallantry on the days in question. Whether the men associated with these actions were given alternative awards is not known, nor is it clear whether these women performed gallantly in unique or different ways from their male colleagues. It is likely that Rignel, Leckrone, and Robar never knew that they had been awarded the Citation Star. Discussions with the family of Miss Rignel revealed that she was never aware she had been cited, although she knew she had been awarded the Croix de Guerre and the British Royal Red Cross. The family of Miss Leckrone possesses her citation certificate, but it appears that Miss Leckrone did not fully understand its significance. Close examinations of Miss Rignel s and Miss Leckrone s World War I Victory Medals reveal no evidence that the Citation Stars were ever affixed. Citations and supporting documentation for the Citation Stars were only occasionally mailed to the recipients and demobilization was already well under way before the general order authorizations were written. This lack of ceremony was an additional reason the Citation Star was replaced with the Silver Star. It is unlikely the women were among the approximately 10,000 service members who requested to have their Citation Stars exchanged for Silver Stars. To this day, the provision continues to exist within Army Regulation , Military Awards, to convert the Citation Star to the Silver Star. Pursuant with this regulation, the families of Miss Rignel and Miss Leckrone were provided the Silver Star Medal. Despite extensive research, the surviving family of Miss Robar was not identified. CONCLUSIONS For their actions in July of 1918, World War I Army nurses Miss Jane I. Rignel, Miss Linnie Leckrone, and Miss Irene Robar were awarded the Citation Star. All would become eligible to wear the Silver Star in They served in front line hospitals supporting tactical units and cared for the wounded in battle under combat conditions. Despite doctrine that attempted to keep women away from the front lines, they are among the many Army Nurse Corps members of World War I who distinguished themselves in action. ACKNOWLEDGMENTS We thank Dr. John T. Greenwood for his invaluable research guidance. REFERENCES 1. Brokaw T: The Greatest Generation, pp New York, NY, Random House, Smith JH: Dressed for Duty: America s Women in Uniform , Vol I, p 175. San Jose, CA, R. James Bender Publishing, Silver Star. Available at accessed March 27, Anonymous: Medicine and the war. JAMA 1944; 124: Borch FL III, Westlake WR: The Silver Star: A History of America s Third Highest Award for Combat Valor, pp Tempe, AZ, Borch and Westlake Publishing, Kerrigan EE: American War Medals and Decorations, pp New York, NY, Viking Press, Sarnecky M: The History of the Army Nurse Corps, pp Philadelphia, PA, University of Pennsylvania Press, Crane AG, Stimson JC: The Army Nurse Corps. In: The Medical Department of the United States Army in the World War, Vol XIII, Part II, pp Washington, DC, U.S. Government Printing Office, Donahue MP: Nursing: The Finest Art: An Illustrated History, p 404. St. Louis, MO, C.V. Mosby Company, Anonymous: On-the-spot aid for our wounded mobile surgical unit will go straight to battle front. Paris, France, The Stars and Stripes, June 14, Higonnet MR: Nurses at the Front, pp Lilington, NC, Edwards Brothers, Sidell FR, Takafuji ET, Franz DR: Medical Aspects of Chemical and Biological Warfare, pp Washington, DC, Borden Institute, Lynch C, Ford J, Weed F: Field Operations. In: The Medical Department of the United States Army in the World War, Vol VIII, pp Washington, DC, U.S. Government Printing Office, Citation Orders No. 4, General Headquarters, American Expeditionary Forces, France, June 3, Record Group 120, Entry 458, Box College Park, MD, National Archives. 15. Lee E: Neighbors : A History of The Department of Nursing, Faculty of Medicine, Columbia University and its predecessor. The School of Nursing of the Presbyterian Hospital New York , pp New York, NY, G.W. Putnam and Sons, Personal Communication from Commanding Officer, Mobile Hospital No. 2 to Lt. Col. Garcia, August 2, Record Group 120, Entry 2129, Box College Park, MD, National Archives. MILITARY MEDICINE, Vol. 173, May

6 17. After Action Memo on the Events of July, 1918 by Capt. Fordyce B. St. John, Commanding, Mobile Hospital No. 2. Record Group 120, Entry 2129, Box College Park, MD, National Archives. 18. St. John F: Yesterday. Proceedings of the Charaka Club, Vol 10. New York, NY, Commendation. Available at jpg; accessed February 21, Citation Orders No. 8, General Headquarters, American Expeditionary Forces Washington, DC, March 1, Record Group 120, Entry 458, Box College Park, MD, National Archives. 21. Citation Orders No. 9, General Headquarters, American Expeditionary Forces, Washington, DC, August 1, Record Group 120, Entry 458, Box College Park, MD, National Archives. 22. Cutler EC: The organization, function and operation of an evacuation hospital. Milit Surg 1920; 46: Surgical Aid Given to Wounded by Field Hospitals 125 and 127 during Offensive from August 1st to August 8th, 1918, August 10, 1918, from J.W. Vaughn to Headquarters, 32nd Division, Office of the Division Surgeon. Record Group 120, Entry 2144, Box College Park, MD, National Archives. Don t Miss Your Next Valuable Issue of Military Medicine We know many of our members frequently change locations. Keep your Military Medicine coming to your mailbox every month by letting us know when you move. You can notify us online at: or membership@amsus.org. 498 MILITARY MEDICINE, Vol. 173, May 2008