The Mobile Army Surgical Hospitals...

Part One:

the roots of their pride and their glory

Next to helicopter evacuation, the Mobile Army Surgical Hospital is surely the most famous and vivid icon of Army Medicine in the Korean War. Improvisation marked its every step, but in the end its lessons-learned benefited the world.

The basic MASH idea — pushing surgeons as far forward as possible — was not new, having been proved in World War II by the field hospital/auxiliary-surgical-group teams working next to division clearing stations.

The post-war MASH — initially conceived as cutting an evacuation hospital into three 60-bed units — was written up in 1946 or 1947.

By 1948, the AMEDD (from 1950-1968 it would be called "Army Medical Service") had created some MASHes and the Medical Field Service School, Fort Sam Houston, Texas, had tested two in exercises.

The design (TO & E 8-571) included a headquarters; preoperative/shock, surgery and post-op sections; pharmacy; x-ray; and holding — staffed by 14 medical officers; 12 nurses; two Medical Service Corps officers; one warrant officer; and 97 enlisted medics.

But, in the hectic summer of 1950, existing MASHes could not get to Korea fast enough. So, at Yokohama medical depot, Eighth U.S. Army hastily lashed up three emergency MASHes under Tables of Distribution.

The 8th Army surgeon chose the MASH configuration because it was small and had its own vehicles. Medics were unlikely to get any help from transport-strapped units in Korea, he reasoned.

One commander, MAJ Kryder Van Buskirk of 8076th MASH, found a small office in Yokohama, set up a field table and folding chairs, posted a handlettered sign and waited for his troops to arrive. Meanwhile, he tried to figure out what a MASH did. It would take months of trial-and-error to answer that question.

The improvised MASHes mimicked the manning of TOE ones, theoretically. It was not enough, even when all slots were filled — and they rarely were.

Therefore, only five months later, on Nov. 24, the 8th Army would increase MASH authorizations to 15 medical officers; 17 nurses; five Medical Service Corps officers; and 121 enlisted (augmented by Koreans).

Still the MASHes remained understaffed and under-qualified. Trained surgeons were so scarce that MASHes were filled by residents called from stateside residency programs, based on leftover World War II obligations. Later the Doctors Draft Act supplied most surgeons.

Moreover, the MASHes routinely handled several times as many as the 60 patients they were designed for, sometimes hitting censuses of 300-400 casualties.

Medically, the units were crude. Tents were frigid in winter, hot in summer, and dark all year. Incandescent bulbs provided dim light. Passages were non-sterile.

Eighth Army creations

As 8th Army creations, all were numbered in the 8000 series — the 8055th, 8063rd, and 8076th MASHes.They remained 8th Army units throughout the war, each being attached to a division for logistical support and general court-martial jurisdiction.

July 6, 1950, the 8055th MASH sailed from Sasebo, Japan, to Pusan. There its trucks were lashed to flatcars and its people boarded Korean railcars and chugged off to Taejon. The 24th Division surgeon, waiting on the platform to tell them a school had been chosen as their site, was dismayed to see nurses. He had just learned of the first cases of GIs murdered by the enemy and felt the nurses were being placed too close to the front line.

"But our MASH would be the only hospital facilities the 24th Division has, so we wanted to stick with our unit, and our CO said we could stay," CPT Margaret E. Tollefson reported.

The 8055th moved into the school, where desks had been tossed out windows to make room but children's drawings were still tacked to a bulletin board.

On July 18, the 8063rd made an amphibious landing at Pohang-Dong about 60 miles north of Pusan to support 1st Cavalry Division.

The 8076th had gathered nurses, a few officers, and enlisted men from hospitals all over Japan. It got 10 medical officers flown in from the States. All were assigned to 155th Station Hospital, Yokohama, for several days until the 8076th was officially activated. The 155th also helped equip the 8076th.

The MASH sailed July 21, and several days at sea were taken up with planning and briefing. July 25, the 8076th moved through Pusan to support units in the Taejon-Taegu corridor, the path being followed by retreating U.N. forces.

After several moves, they settled at Miryang and stayed two months, as the main MASH supporting the Pusan Perimeter, taking patients from every division except the 25th Infantry Division. (For more on the 8076th, see the next chapter in this series.)

First stateside MASH arrives

The first stateside unit, 1st MASH, arrived in September. At Inchon, its people, including nurses, debarked over the side of their ship on rope webbing like the combat forces, dressed in battle gear. The women stuffed their made-for-men combat boots with socks to keep them on. The MASH opened in a school, using borrowed Marine gear, as its own had been shipped separately. Initially it cared mainly for Korean civilians.

1st MASH landed on Korea's east coast Nov. 1 during the pursuit to the Yalu. It set up inland in a school, near 7th Division's clearing station. For a month, it operated by doctrine, except for being up to 100 miles behind the moving front, treating a light flow of surgery cases. Other patients went directly to evac hospitals.

However, upon Red Chinese intervention, doctrine collapsed. 1st MASH was no longer a 60-bed unit for 7th Division wounded. Now it was a 200-bed hospital for all kinds of patients from 7th and 2nd Infantry Divisions, 1st Marine Division, and 18th Airborne Regimental Combat Team. Yet physician and nurse staffs grew only from about 16 each to 20, and enlisted troops from 100 to 120.

In 1951, 1st MASH was renamed 8209th MASH.

Meanwhile, Nov. 27, 1950, for vague reasons, the straightforward MASH names were mangled to bureaucratic mush. The pattern: 80__th Mobile Army Surgical Hospital became Mobile Army Surgical Hospital, 80__th Army Unit. This technical change sees to have been largely ignored, except in official reports.

In the first year of cobbled-together units, the MASHes often had mixed teams of U.S. Army, U.S. Navy, and Republic of Korea medical personnel.

March 28, 1951, the 2nd MASH arrived. It had been cobbled together at Fort Bragg, N.C., from 82nd Airborne Division and 188th Medical Battalion medics and surgeons levied from various sources (including five from the Navy). By April it was working in tents at Hoengsong, supporting four divisions previously supported by 1st MASH. In May it was renamed 8225th MASH.

Sincerest form of flattery

By now the MASH was a proven success, inspiring emulation. A Norwegian MASH was created in Japan from medical assets contributed by Norway to the U.N. effort. It set up next to a U.S. general hospital, and sent members to visit the 8076th before deploying to Korea, touring the facility to make sketches and notes on the Americans' layout, operations and lessons learned.

It soon deployed to a site near 8055th MASH just north of the 38th parallel. It opened at Uijongbu in early July and mainly served non-U.S. casualties.

The ROK army established its own MASH. Like the Norwegians, they sent their people — doctors, nurses and administrators — to the 8076th to learn all they could.

By spring 1952, the Korean MASH was operating near the 8076th, taking a big share of casualties. The ROK facility was laid out exactly like the 8076th and staffed with bright, eager surgeons, 8076th visitors said.

"They were very eager to provide their countrymen with the best medical care possible," wrote one-time 8076th surgeon Otto Apel.

In April 1952, the 8228th MASH, which had been around on paper for a while, came to life to serve as 8th Army's designated hemorrhagic-fever center. It was located at Songu-ri northeast of Seoul.

By June 1952, each U.S. corps had two MASHes in support:

I Corps — 8055th MASH at Sochon-ni; Norwegian Surgical Hospital at Tongduchon-ni.

IX Corps — 8076th MASH at Hwachon; 8063rd MASH at Unchon-ni.

X Corps — 8209th MASH at Tachon-ni; 8225th MASH at Kwandae-ri.

Returning to doctrine

The Fiscal Year 1953 Army troop list authorized reorganization of the Korean MASHes back into what they were supposed to be all along...60-bed surgical hospitals. They were now organized under the MASH TOE, abandoning the ad-hoc TDs of 1950 and the unwieldy 200-bed structure that had evolved later.

In conjunction therewith came name changes. In the winter and spring of 1953, the 8055th MASH became the 43rd Surgical Hospital (Mobile Army); the 8063rd became the 44th SH (MA); the 8076th became the 45th SH (MA); the 8209th became the 46th SH (MA); and the 8225th became the 47th SH (MA).

This was all part of Eighth U.S. Army surgeon BG L. Holmes Ginn's plan to restructure surgery in-depth. Ginn wanted to push surgery even closer to the front, into the clearing stations. Clearing stations would do more minor surgery. MASHes would get just serious non-transportable cases. This scheme started in late 1952.

(Interestingly, MASHes remained behind clearing stations instead of adjacent. One reason: to keep them out of the combat zone, where their personnel would get more combat-exposure credit and rotate sooner.)

With the front stable, Ginn's goal was logical, but may have damaged MASH morale. Still, his plan was at least an attempt to take MASHes back to their roots.