# Doctors Aweigh/Chapter 4

​CHAPTER IV
Sea Duty
I'VE OFTEN been asked by interested, if not very well-informed, civilians — and not infrequently with a supercilious look — "What does a Navy doctor find to do aboard ship in peacetime?"
The answer is: plenty.
Even though his patients are all male, and practically all of them young, every kind of case comes to the sick bay in the course of a single cruise. We have a saying in the Medical Corps: "In the Navy you may get anything from harelip to twins." Perhaps this isn't such an exaggeration now, since we have the Waves.
Aboard ship, the chief medical officer is much more than a ship's surgeon. He is depended upon for adequate treatment of the sick and wounded, and his advice and recommendations for promoting the health and well-being of the men are sought by the Line officers. He is also a part of the ship's military organization, one of the members of the fighting team.
Sick call is sounded every morning about eight o'clock. This is the medical officer's morning office hours, when patients present themselves at the sick bay for examination and treatment. There is a second sick call in the evening. During the day and at night the doctor is on call for accidents or any emergency that may occur.
A modern battleship is perhaps the highest type of concentrated mobile power developed by the mind of man. It is a mass of machinery, controlled by steam and electricity which must be ​operated by man. On the most peaceful cruise in friendly waters, the ship's crew are liable to all the wide variety of accidents that happen to men employed in big industrial plants. Steam pipes burst, and men working near them are scalded by the escaping steam. The ship lurches suddenly, and a steward carrying a heavy tray misses his footing on the steel ladder, falls, and limps to the sick bay with a sprained ankle and an assortment of bruises. You have a long run of foul weather, and a dozen seamen develop colds that have to be treated and watched if you don't want to find yourself with several cases of pneumonia on your hands.
Officers and men are engaged in hazardous occupations at all times — in peace as in war, and night and day. They have to handle boats in bad weather, work around the machinery, engine, and firerooms, drill with guns and turrets, handle ammunition, operate aircraft and submarines, and perform a thousand-and-one things which go to make up daily life at sea. At any moment you may get a man brought in for surgical treatment whose arm has been mangled in a baking machine, a case of fracture caused by a fall from a mast or down a hatch, or one with foreign bodies in the eye. Most of these, naturally, occur during storms, when the ship is pitching and rolling. On a large battleship with 1,500 officers and men, two doctors and a dentist share the general practice. The medical officers are sufficiently busy. Twenty thousand patients were treated in the sick bay of one such ship, 10,000 prescriptions dispensed, and 4,500 dental treatments given in a year.
Most of the lads in the forecastle are young. They are husky and sound, as the searching physical examinations they have been put through at recruiting stations and boot camps have proved. But there is no insurance against sudden cases of appendicitis. As a matter of record, there is scarcely a cruise that you don't have at least one appendectomy to perform at sea. You are lucky when the case is brought to you in its initial stages, before the appendix has ruptured. One of the gravest problems facing medical officers aboard fighting ships just now is the men's unwillingness to admit ​they are sick and need hospitalization. They don't want to risk missing any of the fight. On one of the cruisers which has been on duty with the Atlantic convoys, a seaman fainted one day on deck. He was taken to the sick bay for examination, which revealed a ruptured appendix and evidences of peritonitis.
"But you must have suffered considerable pain for some time before you fainted," the medical officer remarked. "Why didn't you report at sick call this morning?"
"Hell, sir, I couldn't be bothered," was the reply.
No small part of the responsibility of the ship's medical officers, and the hospital corpsmen under them, is to see that all cases do answer sick call; that even minor accidents are reported promptly, and any suspicious skin infections and colds are brought in for examination and treatment.
The chief medical officer of one of our ships on the Atlantic, while the ship was operating off the African coast, was called one afternoon by a seaman who appeared in the door of the sick bay with his eyes standing out of his head like apples.
"Doctor," he gasped, "there's a guy lying out here bleeding to death in his own guts!"
What had happened was that a sailor had slipped, fallen, been tossed by the roll of the ship and brought up against a bulkhead where the garbage cans were. He lay there, bleeding profusely, covered with potato peelings.
Even in war youngsters, when they get together off duty, play tricks on each other and have a tendency to roughhouse. Occasionally accidents happen, as these do among the undergraduates of any college. On one of the cruisers escorting military transports to northern Ireland, a lad was showing off by chinning himself on the pipes in the compartment. He lost hold and fell, injuring himself painfully. He was promptly examined, and it was found he had ruptured his spleen. The convoy was moving through bad weather and moving fast to keep away from enemy submarines and planes. It was impossible to slow down the ship, and the ​senior medical officer, an experienced surgeon, decided it was too dangerous to attempt to operate on the boy under those conditions and at that time.
He was bandaged and kept in bed until the convoy reached its destination. Then he was taken off by a British ship and sent to a British naval hospital for the operation. On the cruiser's next trip the sailor was picked up and brought home to finish his convalescence in a naval hospital in the United States.
Sailors show as many varieties of temperament as any other group of men. There are tough customers whose constitutions seem impervious to any injury. Such was the oiler who finally presented himself at sick bay and asked for a cure for chronic constipation.
"How is your appetite?" asked the medical officer.
"Oh, I don't let it affect my eating none," the man assured him.
"Well," said the doctor, "my advice to you is to go on eating plenty of food. In due course of nature you're bound to defecate or bust!"
"That's what I thought myself, Doctor," the sailor agreed.
Then there are the anxious natures, like the apprentice seaman, second class, who recited to the doctor a long list of symptoms, concluding with morning sickness and an inordinate desire for certain foods. "What do you think can be the matter with me, Doctor?" he inquired.
"If you hadn't been examined at the recruiting office and found a male, I'd say you had a slight touch of pregnancy," was the doctor's dry comment. "Are you married?"
"Not exactly, sir," was the reply. "But I've got a girl friend in Brooklyn."
Every ship's crew has its quota of gold-brickers who try to work the doctor for a sick badge which automatically lets them off duty as long as they wear it. There is a continual contest between their ingenuity in devising symptoms and your skill in detecting it. Eventually you acquire a nose for malingerers and invent ways of ​dealing with them or, better still, of letting their shipmates deal with them.
A man in the black gang came several times to the sick bay, complaining of heat exhaustion. Heat exhaustion is something our engine-room gangs used to suffer from a great deal. However, the discovery that the exhaustion was due to loss of salt from the body from sweat and that supplying salt tablets at the drinking fountains used by the men would make up this loss has made cases of heat prostration rarer in the Navy than in industry ashore.
There was no real reason why this particular oiler, who drank the salted water, should be overcome. It was clear that he was looking for a way of loafing. The medical officer gave orders that he would have to be acclimatized gradually to the heat of the engine room. He ordered him to sit there during his watch without working. It was extraordinary how soon the man reported himself recovered of his weakness and able to carry on with the rest of the gang.
The young medical officer usually has a tendency to transfer more cases than necessary to the hospital ship, or to naval hospitals ashore. He brings with him from civil life ideas of absolute quiet, "milk diets," and the need for a large, inexhaustible, and varied supply of drugs. However, as he becomes accustomed to naval life, he also becomes accustomed to the use of a small but carefully selected collection of medicines. His "milk diet" consists of evaporated milk from cans, or milk soups. He discovers that noise does not seem to have much effect on the bluejacket. A convalescent from appendicitis will sleep through the firing of a salvo of twelve-inch guns from the deck over him and not show a rise in temperature of even one tenth of a degree.
Suppose we follow the Navy doctor on some of his duties outside the sick bay. One of the first of these is to see that the ship's galleys and the quarters of the crew are clean at all times. This brings me to a story which occurred aboard one of our battleships.
The ship had been in yard overhaul for many months and as a ​result had become infested with cockroaches. The senior medical officer was very much perturbed over this insanitary condition. He organized a spray-gun squad which made war on the roaches in all the galleys and pantries every night after the lights had been put out. Pressure was put on the cooks and stewards to keep the food-cooking and food-storage compartments clean. The skipper and the exec were loud in their praises of a job well done.
Then came a Saturday morning and captain's inspection. As they went through the ship, the doctor was proud of his part in the roach-prevention campaign. The inspection had progressed to the captain's own little galley. Everything was immaculately clean. The Filipino steward was standing at attention in a corner, resplendent in his starched white uniform. At that moment the grandfather of all cockroaches, an enormous and perfect specimen, ambled out from under the range and started a leisurely walk across the spotless white-tile deck. The captain looked reproachfully at the doctor, then at the steward, and pointed an accusing finger at the roach. The steward bent down and scrutinized the insect. Then he announced with dignity, "Yes, Captain, I see him, but he is not mine. He is merely passing through on inspection."
Navy regulations for supply officers are precise in decreeing inspection of all foods. All fresh provisions procured for use in the commissary department are required to be inspected by the commissary officer to determine whether the articles delivered conform to the requirements. Meats are required, by Navy regulations, to be passed by an inspector of the Bureau of Animal Industry, U.S. Department of Agriculture, and must show his blue stamp of approval. The Navy is particular about the sex of animals from which the meat comes. No meat from bulls, boars, stags, or cows is acceptable. Naturally, this regulation in favor of castrated animals provides a lot of jokes, but it also ensures the men aboard ship and in training camps prime meat.
As a matter of fact, the men in our Navy are the best-fed body of men anywhere in the world. The Navy ration, as laid down by ​Act of Congress, gives the sailor — if he eats it all — fully 4,000 calories a day. The foods served at all messes aboard ship include all fresh vegetables and fruits, Grade-A milk and dairy products, and only the best meats. A cruiser, which has a complement of about 1,200 men, carries in her food-storage compartment sufficient foods to feed all messes fresh vegetables and fruits, fresh meat and dairy supplies for six weeks at a time. Using emergency rations, she can stay out at sea for three months without revictualing.
The food-storage compartments, refrigerators, the butcher shop, bakeshop, and the galleys all come under the doctor's jurisdiction as the ship's public-health officer. He inspects them from time to time and issues orders relative to keeping these and the heads (toilets) clean. The master-at-arms, who is the ship's chief of police, sees that these orders are carried out.
The orders go into careful housekeeping details. No meat may be chopped and set aside to be cooked and served the next day. Chopped meat may not be kept in the refrigerators in containers deeper than three inches. Hash and ham seem to be two foods which cause a great deal of food poisoning. Therefore, the Navy rules that boiled ham should be served hot. If it is intended to be served cold, it must be placed in the chill box shortly after boiling and kept there until time for it be served to the men. Cream puffs and chocolate eclairs are taboo in the tropics.
Fighting on this front, the medical officers teach the mess cooks and food handlers to watch carefully for spoiled food, some of which can be detected by its appearance and smell. Cans of food which are dented or show bulges or nail holes must be discarded. All meats must be thawed in the chill box. Dish towels must be sterilized and dried on deck in the sun and air.
Few home kitchens are as spotless and sanitary as a ship's galley. It is not unusual to find that the master-at-arms has stationed a guard by the dishwashing machine to see that the water used in it is of the high temperature required by Navy regulations.
Red tape? Not a bit of it! Just preventive housekeeping, which ​is one step in the Navy's great campaign of preventive medicine.
Aboard ship every man of the crew is needed all of the time. If half a dozen of them are on the sick list due to food poisoning or some other illness resulting from neglect and insanitary living conditions, their work must be divided among the other men.
The Medical Department of the Navy is officially pledged: "To keep as many men at as many guns as many days as possible."
In addition to the three messes a day which are now served cafeteria style on all ships, and at which a man can have as much of anything as he wants, each ship has its "gedunk" stand. This is the canteen where the men buy ice cream, soft drinks, candy, sweet cakes, cigarettes, et cetera. To their 4,000 daily calories of Navy ration the lads frequently add 6,000 calories from the gedunk stand. Considering the unholy combination of sweets they stuff themselves with, between watches, it is extraordinary there aren't more cases of illness than there are. At all times, and in all places in the ship, pots of Java are brewing. A seaman will stuff himself at the gedunk stand before going on watch, drink several cups of scalding-hot coffee, and at the end of his four hours' duty take another cup or two of coffee before turning in to his hammock, to sleep like a baby.
At Panama and in all the ports of Central America and the West Indies, the bumboats are a familiar and welcome sight. Tempting, indeed, are the pineapples, mangoes, and fresh coconuts which they carry. In the West Indies it used to be the custom for the bumboat men to drill holes in coconuts, empty out the milk, and fill the shells with good Haitian rum. Those coconuts were greatly in demand among sailors who had been in those waters before. They would drain the liquor from the nut in a long pull. "Sucking the monkey," we called it. Every junior Line officer has gone through the experience of suddenly finding some of his men, who seemed to have been innocently enjoying a few drinks of coconut milk, staggering around about the deck, dead drunk!
​To any writer of mystery stories in search of a good opening for a tale I recommend what happened aboard the U.S.S. Spica during three days in December a year ago.
One morning a gunner's mate was telephoning on the forecastle. Suddenly those around him saw him sway, as though overcome by dizziness. Then he fell forward on his face in a dead faint. One of the ship's hospital corpsmen came, administered first aid, and, when the man regained consciousness, helped him down to the sick bay.
The gunner's mate was a healthy lad, aged twenty-two, who had an excellent health record. The doctor's examination disclosed nothing to cause him to have an attack of vertigo and no injury except a bruise over his right eye resulting from his fall. He could not remember ever having fainted before. Presently he developed all the symptoms associated with shock — pallor, a rapid, feeble pulse, low blood pressure, and a cold, clammy skin.
The Spica's medical officer put him in the hospital under observation.
Next day a fireman on watch in the fireroom exhibited the same symptoms. He, too, fell forward in a faint, bruising his face considerably. He was carried to the sick bay, where it was discovered he had the same shock symptoms as the gunner's mate. He, too, was hospitalized.
Meanwhile, an undercurrent of horror ran through the U.S.S. Spica. What was this mysterious malady which had struck the ship? It lacked two days of Christmas which, even in wartime, is always a season for some festivity aboard ship. And here were two members of the crew struck down by an illness the doctor could not diagnose. The question each man asked his mates was: Who will get it next?
The doctor ordered an examination of the patients' stools for occult blood. The test was positive. It was clear, therefore, that both men had suffered a hemorrhage of the intestinal tract.
​Three days later, after the Christmas dinners had been cooked and eaten, a ship's cook while on duty in the galley suddenly became dizzy and weak, broke out in a profuse perspiration, and began to vomit a quantity of red blood. In all, he vomited about two cupfuls. Examination revealed the signs of acute circulatory collapse, as in the other cases.
Here the cause was quite evident — namely, hemorrhage.
Next day a fourth man answered morning sick call, complaining of dizzy spells, and was hospitalized with the others.
Meanwhile, the doctor and the ship's officers instituted a careful search for something that could get into the men's food and cause the hemorrhages. They found it — a faulty can opener which caused small, sharp-edged pieces of tin to fall into the food of an opened can. The U.S.S. Spica was running in a danger zone at the time, which meant all ports closed and the ship continuously darkened. This, undoubtedly, had made inspection of the food difficult. Meanwhile, the can opener was becoming more defective, causing larger bits of metal to drop into the food. The cook's symptoms were the most severe, perhaps because he was sampling the food as it was opened.
The remedy prescribed savors of Mother Goose. All hands were fed large quantities of thick oatmeal mush to gather up any bits of tin in the intestines. The drink with this was strong tea, for its astringent action.
But the remedy, plus a new can opener, cured the crew, and the mystery of the U.S.S. Spica was solved.
When food supplies are taken aboard ship in a foreign port, the ship's medical officer inspects these in company with the supply officer. Certain foods from certain places are taboo. This taboo extends to certain fishes which are in the fishing grounds of the Puerto Rico and Virgin Islands' area. Though these are safely edible at some periods of the year, they would seem to be poisonous at other times. Among these temperamental sea foods are the ​barracudas, kingfishes, red snappers, and a fish called the horse-eyed jack. The way the natives of the islands ascertain whether the fish is fit to eat is by trying it on a duck. If the duck dies, the islander makes his dinner that day off plantains.
One of our Navy doctors stationed at St. Thomas, V.I., heard there had been recent cases of fish poisoning on Culebra Island. He visited the island and found that earlier in the week ten natives who were dining off a twenty-pound male barracuda were all ill with symptoms of nausea, vomiting, and diarrhea. Cats, who had eaten of the same fish, died. Immediately warning was broadcast by means of the Fleet News Letter, a mimeographed sheet circulated to all ships' officers in the Fleet, not to buy any fish while in the Puerto Rico and Virgin Islands' area.
Every medical officer has an opportunity for a life of varied adventure during his service aboard ship, if he has a taste for adventure. Of course there are doctors whose interest is narrowed down to their strictly professional duties. In consequence, these men live a narrow and lonesome life aboard the smaller ships, where the personnel is limited. I have known medical officers so bored that when the ship put in to foreign ports where these men had never been before, they had not sufficient interest to go ashore. Once when the U.S.S. Illinois was going through the Magellan Strait and most of us were spending our time on deck, looking at the awesomely rugged and magnificent scenery, I went down to the wardroom for something. There lay one of our senior officers, stretched out on the transom. He raised himself on one elbow and demanded with a yawn: "Well, what ocean are we in now?"
Some of us enter into the life of the ship, learn the rudiments of navigation, stand watch on gunboats, take boats out for sailing and rowing during the various drills, and become interested in target practice. In the beginning of modern gunnery in the Navy, between 1904 and 1910, target practice was not the perfected affair it is today. I used to be considered an excellent spotter on the ​U.S.S. Ohio, and would sit in a boatswain's chair, rigged between the smokestacks, and call: "Up 500, right 1,000," and so on, down through a speaking tube, which consisted of a large hose, like the most experienced Line officer.
During the first years of my Navy service, back in March 1902, I accompanied a detachment of Marines to the Asiatic station. Part of my service at that time was aboard the gunboat Frolic, a beautiful ex-yacht of about 450 tons. She was small and she rolled considerably, but we loved her. We cruised in and around the maze of 3,000 islands that choke the sea between Luzon and Sulu, on a lookout for insurrectionists and carrying mail and supplies to isolated Army and Marine posts. During that time it was part of my job to pass on the fresh foods which we bought from the natives' bancas which would put out from shore at sight of us in hopes of selling fish, vegetables, and fruits. In those days the world had only recently been made aware of the cholera germ which may lurk fatally in an innocent-looking head of crisp lettuce. All the Spartan in my make-up was required to wave away the vegetable peddlers and their wares, and all the discipline vested in me as a naval officer was needed to keep the Frolic's officers and crew, tired of their "iron rations," from bargaining for death in the shape of fresh fruits and greens.
We were ordered to survey the harbor of Maibun Bay. This is on the southern coast of the island of Sulu. The sultan lived there, and his Moros were famed throughout the Pacific for their ferocity. We had several small brushes with them. They would tear down our signals as soon as we could get them up. We then resorted to driving pipes into the ground to enable us to find our position. The pipes were as promptly dug up. Turned into bolos, probably. I was the recorder of this survey, noting every sounding and the location given me by the two midshipmen who took the angles by instruments. Rather an unusual duty for a doctor, but interesting.
​One day a few of us were ashore and the ship's carpenter was nailing the boards on a tripod signal. He had a pair of nippers which he used to bite off the ends of the nails. A group of husky Moros, clad in G strings and knives, stood by, fascinated by the nippers. Finally the carpenter passed the instrument to one of them and motioned him to try it. The native failed. The carpenter then took back the nippers, put it to his mouth, and pulled out a false tooth on a plate. He calmly passed this around the staring Moros and then, as nonchalantly, replaced it in his jaw. The natives looked on him as a miracle worker and gave us no more trouble after that.
One day a boat put out from shore and came up alongside the Frolic. The rowers called up to ask for the medico to come ashore. They made me understand that one of the sultan's soldiers had been shot the night before. These Moros had rifles and plenty of ammunition which they had smuggled in from near-by Borneo. When they weren't knifing at us, they would have a little scrap among themselves. I strapped on my revolver, took a couple of men, and went ashore. A guard was waiting for me on the beach and escorted me to a nipa shack. There I found a couple of Moros well armed, two or three women, and, on a pile of dirty mats, my patient. He had been shot through the arm and the chest and was in bad shape.
It was obvious that while the natives had sent for the white medico, they were suspicious of me and what I might do. To allay their suspicions, I unbuttoned my holster and laid the gun aside. I then gave the man a hypodermic, which caused him to twitch. There was a threatening movement and mutter in the group behind me. I imagined I could feel the prick of a bolo at the back of my neck.
I probably would have felt it if my patient had shown a bad reaction to the hypodermic and the surgery I had to do; but he was a husky savage, in spite of his filth, and stood the treatment successfully. I dressed the wound, gave instructions for his care, ​and left. Next day we sailed to another island and it was several days before we were back and I could go ashore to see my patient. I found him sitting in front of the shack, with his wives around him, looking hale and hearty. He was demanding, and getting, all the attention a man wants when he is convalescing.
Evidently he was a man of importance to the sultan, because His Highness sent me a number of pearls and a hatful of silver dollars.
At that time one of the most disastrous cholera epidemics that ever swept the Philippines was raging. The surgeon general of the United States Army reported 128,000 cases in Luzon, with 81,500 deaths among the Filipinos. The natives had no idea of sanitation, the water supply of Manila and other towns was primitive, and their superstitions led them to hide the dead. I inspected the old fort in Cavite daily with the captain of the yard, and we would constantly find bodies hidden in corners of the wall and behind heaps of rubbish. Of course we watched our men carefully, provided distilled water, never drank out of a glass in a public place, above all, never ate fresh fruit. It became a ritual always to burn the tip of a cigar before placing it in your mouth, and to burn the top of a soda-water bottle before drinking. The epidemic gradually spread southward among the islands, and I followed. At that time we had a small coaling station and a hospital on the island of Basilan, south of Zamboanga toward British Borneo. The island was garrisoned by 150 United States Marines. As in most of the Coral Sea islands, there was a fairly large Chinese population. The Chinese were the merchants. They maintained small stores where they sold fruits, nuts, mats, tobacco, et cetera.
I became quite chummy with one of them. On my afternoon strolls away from the hospital I would stop at his shop, buy a cigar and smoke it there with him while we talked. He had the wisdom, the shrewdness in appraising character, and the inimitable sense of humor that distinguish the Chinese among all the peoples of the Orient, and I valued his friendship. One night I was called by one ​of my men at the hospital who reported another death from cholera in the village. I got up and went with him to see the body. There lay my friend, dead from cholera. I had seen him, shaken hands with him, and smoked the cigar which he had handed me only about eight hours before.