The Surgeon General's Great Organization
By Caswell A. Mayo
[This account of the first year's work of the United States War Department in mobilizing the medical talent of the nation was prepared in March, 1918, for The New York Times, publishers of Current History Magazine]
In April, 1917, the executive offices of the Surgeon General of the United States Army occupied four rooms in the great War, State and Navy Building at Washington, and the functions of the office were performed by six officers and twenty clerks. Now there are attached to the Surgeon General's office 165 officers, who employ 545 clerks, and the staff fills five entire buildings and parts of other buildings, exclusive of the Surgeon General's library, the Army Medical Museum, and the Army Medical School. Within a day 6,000 telegrams and 5,000 other communications have been received, replied to, and filed. The latest and most approved systems of filing records and correspondence have been installed under expert supervision, for the Surgeon General has called to his aid specialists in other fields as well as in the field of medicine. He has called chemists and statisticians, bankers and efficiency engineers, sanitarians and electrical experts, architects and engineers, and assigned them to duty in his office.
The Surgeon General himself, Major Gen. W. C. Gorgas, was appointed to the office in recognition of the invaluable services rendered by him as Chief Sanitary Officer of the Panama Canal Zone. The story of his work there in protecting the laborers in the Panama Canal from infectious diseases is one of the most brilliant chapters in the history of American medicine. Without that work the efforts of Goethals would have been as fruitless and as costly in lives and money as those of De Lesseps. The Surgeon General's still greater task now is to provide against every emergency which may affect the health and lives of millions of men taken from the fields, the farms, the factories, and the counting houses of the country, gathered into camps for organization and sent across 3,000 miles of ocean. He must know how many men will be taken sick, and where. He must know how many men will be wounded, and where, and he must have at those points adequate provision of expert surgeons and enlisted men, of medical and of surgical supplies, of food and of clothing, of housing and of transportation, so that at no time will any American soldier be sick without succor, or lie wounded without aid.
In carrying out this gigantic task the Surgeon General has mobilized the medical forces of the country, calling into his office the leaders in every specialty of medicine and of surgery. At their desks as early as 7 o'clock in the morning will be found medical specialists whose professional incomes are written in five and six figures, but who have abandoned these incomes for the modest pay of a Major, who have given up their luxurious homes for a Washington boarding house, and who, instead of enjoying a well-earned leisure, toil ceaselessly from early morning until late at night in their efforts to co-ordinate most effectively the work of the doctors in the war. It is for the purpose of doing justice to the attainments of these men that General Gorgas is advocating scores of new commissions of high rank in the national army.
Every morning at 7:30 the Surgeon General's truck delivers his mail at the Mills Building, at Seventeenth Street and Pennsylvania Avenue, Washington, in which are situated the central executive offices. The mail is distributed and on the desks of the officers for final disposition not later than 9:15. Within twelve working hours practically every communication received will have been acted upon and returned to permanent files. Here, as in every other phase of the work, a specialist has been employed, Captain J. L. Gooch having been called from his position as subscription manager for the Butterick Company to organize the office routine. The most approved mechanical devices, including statistical machines, have been installed under Captain Gooch's direction.
A complete medical history is kept of every soldier and of every officer from the time he enters the service until he retires, resigns, or dies. A special fireproof building is now being erected which will be devoted exclusively to the care of these records, the preservation of which may be a matter of vital importance fifty years hence.
Attached to the Surgeon General's office are three representatives of the Royal Army Medical Corps of Great Britain—Colonel T. H. Goodwin, C. M. G., D. S. O.; Captain John Gilmour of the Royal Army Medical Corps, and Lieut. Col. J. J. Aitken of the Royal Veterinary Corps—and two representatives of the French Army Medical Service—Colonel C. U. Dercle and Major Edouard Rist. These four surgeons act as liaison officers, keeping the Medical Department of the United States Army in touch with the medical services of Great Britain and France. They have made many informing addresses to medical societies all over the United States and have given lectures at the Army Medical School.
The immediate staff of the Surgeon General comprises his personal aid, Major M. C. Furbush, M. R. C., of Philadelphia; Colonel George E. Bushnell, M. C., (Medical Corps of the regular army;) Colonel Deane C. Howard, M. C., and Lieut. Col. James V. Van Dusen, M. C. Colonel Bushnell, besides being chief assistant to the Surgeon General, has devoted his special attention to the field in which he has won a unique reputation, that of the treatment of tuberculosis.
General Gorgas has enlisted the co-operation of the leading surgeons of the United States as members of the "Rotary Surgical Staff." Among those Medical Reserve Corps officers who have already served for a period at the Surgeon General's office and who are still subject to call from time to time as occasion requires are Major William J. Mayo, former President, and his brother, Major Charles H. Mayo, now President of the American Medical Association.
The work of the Surgeon General's office is divided up among seventeen general main divisions. The work of each division is practically independent of the others, though the work of all is co-ordinated. At the head of each of these divisions is an expert in that particular field, usually a medical officer of the regular army, who has around him a group of expert associates, many of whom are drawn from civil life.
On April 1, 1917, there were 700 medical officers and about 10,000 enlisted men in the Medical Department of the United States Army. There are now more than 17,000 medical officers in active service and about 150,000 enlisted men in the Medical Department.