Because of the withdrawal of all C-47 planes of the Troop Carrier Command from air evacuation without notice, General Hawley considered the evacuation problem to have reached critical proportions. The inability to obtain planes on a lower echelon of command, with the resulting threat of a complete breakdown in the whole system of evacuation of casualties, made the issue a matter for consideration by the Supreme Commander. In a memorandum to the Commanding General, Combat Zone, dated 20 September,182 he warned that "unless decisive action is taken without delay" the whole evacuation system would be stalled. Owing to the fact that the backlog of casualties was increasing at an alarming rate, he requested an assignment of 200 C-47 planes for evacuation until the backlog of patients could be cleared out. Again, he kept emphasizing reason that air evacuation had been "most unsatisfactory": the complexity of control of planes and the fact that evacuation had no priority.1

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On the same day a memorandum from Headquarters, Communications Zone, AC/S, G-4, was addressed to General Lee,184 Commanding General, Com-. munications Zone, stating that since air evacuation was dependent upon air transport of supplies,185 experience had shown that the haphazard arrival of supply planes simply would not meet the needs of the evacuation system. As a result of this situation, and based on General Hawley's estimate of 2,000 patients to be evacuated daily, it was recommended that 50 C-47 planes be allocated exclusively for air evacuation. These planes, he said, could serve double duty by carrying medical supplies forward.

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Lt. Gen. W. B. Smith, Chief of Staff, SHAEF, answered General Lee's request for the allocation of air lift for the evacuation of casualties. He said: "Due to airborne operations now in progress, it is impossible to provide the air lift you deem necessary. In any event, your medical evacuation plans must not be predicated on any fixed air evacuation. Rather, air evacuation must be considered as a bonus to be available from time to time as conditions permit.' In a discussion of the evacuation problem with Generals Hawley and Kenner, it was suggested that the equipment of not less than 8 and not more than 10 of the general hospitals on ships off Cherbourg be unloaded; that rail transport be provided from Normandy to farthest forward railheads for hospital units. and equipment, and truck transport from railheads to hospital sites; that hospital trains be moved to the Continent beginning with 10 by 30 September, 15 by 15 October, and 20 by 30 October; and that 3 hospital trains be improvised from French passenger equipment. General Lee was directed to give this matter his immediate attention and was assured of the necessary priorities.

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On 21 September General Hawley immediately advised General Kenner by memorandum of the failure of his efforts to get the necessary planes allocated to

relieve the evacuation situation even though an estimated number of between 6,000 and 7,000 casualties was awaiting evacuation, the majority of which required immediate definitive treatment and with conditions "steadily deteriorating." The Commanding General, Communications Zone, he noted, had presented his requests for the temporary use of 200 planes and for the indefinite assignment of 50 C-47 planes for air evacuation to the theater comamnder. He had received the answer that it was doubtful if any planes could be furnished, and that other means of evacuation should be used. With reference to "other means," General Hawley stated that, with the exception of three hospital trains of a daily lift of 500, "there are no other means," and concluded his memorandum with this statement: "I do not know whether the Theater Commander fully realizes the seriousness of this situation." 188

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Four days later, on 25 September, Lt. Gen. O. N. Bradley, 12th Army Group Commander, called the evacuation problem to the attention of General Eisenhower.189 The long lines of communications in the U. S. sector, he said, made air evacuation a necessity; that he had not "been able to overcome the difficulties introduced by sudden and complete withdrawal of aircraft for proposed airborne operations," because land transportation could not be efficiently and quickly produced. He requested that "a minimum of 40 C-47 aircraft be firmly allotted to the mission of evacuating casualties from Twelfth Army Group.' General Bradley was advised by General Smith that the only C-47 aircraft which could be allocated to the evacuation of casualties were those of the Troop Carrier Command or those of the 302d Transport Wing, Air Service Command, USSTAF. The mission of both of these agencies was operational and to reassign the function of the agencies would be at the expense of operational needs. It was pointed out that a large number of C-47's from the Troop Carrier Command were engaged in emergency supply to Army areas and would be available for evacuation until such time as they would be required by the First Allied Airborne Army. Again, as he had to General Lee, he stressed that: 91

Air evacuation of casualties must be considered as a bonus to be available from time to time as conditions permit and not as a sceduled lift to be available under all conditions. Even if not interrupted by operational requirements, it is subject to interruption without warning, and for indefinite periods, by the weather, and any evacuation system based on air transport will break down.

Although SHEAF policy on air evacuation remained unchanged—that air evacuation must be considered a bonus and dependent upon resupplythere were enough unofficial variations in this policy on lower echelons to move

the patients to be evacuated. The phrase "no resupply, no evacuation of casualties" was hardly accurate inasmuch as there were supplies which, although not scheduled to be moved at any specific time, could be sent to forward areas at times when it was necessary to have planes for the movement of casualties. One method which apparently worked well was to use new planes for evacuation purposes before they were listed officially with theater headquarters. Inasmuch as a considerable number of planes were constantly arriving, this method would provide for emergency movement of casualties.192

And though efforts to secure the allocation of C-47 aircraft for exclusive use in the evacuation of casualties were never successful, General Grow did succeed in getting a squadron of 20 UC 64 planes for purely medical purposes. These planes had gained their reputation chiefly as a "bush" airplane in Northern Canada and had been used chiefly for floats and skis. They had been relatively inactive because they were not very satisfactory for resupply, nor were they particularly well suited for the evacuation of casualties. They were based on Le Bourget Airdrome and used to carry critical items of medical supply to forward areas and bring back patients on the return trip. Each plane was equipped with litters to accommodate three patients, and there was room for two sitting patients, the pilot, and surgical attendant. Notwithstanding operational and structural difficulties with these planes, much important work was accomplished with them. During the period from 23 September through 29 December 1944, 36,008 pints of blood, 387,918 pounds of miscellaneous cargo, and 567,059 pounds of medical resupply were transported, along with the evacuation of 1,168 patients.'

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The esprit de corps of this squadron remained high. The esteem and affection in which this squadron was held by Medical and Air Force personnel, was demonstrated in one of the nicknames applied to the squadron: "The Grow Escadrille."

Another activity of particular interest was the glider evacuation of patients from the Remagen bridgehead which demonstrated the practicability of evacuation of casualties in areas where no landing fields existed. Litter installations for 12 patients were put in the gliders, and methods devised for restraining patients on the litter. Bulldozers cleared an area for a landing strip for the gliders, which were loaded with medical supplies. Two of the gliders were loaded with 24 patients, 3 of whom were unconscious from head injuries. Medical attendants were placed on the gliders to render medical aid in flight. The gliders were “snatched" and landed 15 minutes later in front of an evacuation

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hospital across the Rhine. None of the patients suffered any harmful effects from the flight. This operation was carried out under the supervision of Col. Ehrling L. Bergquist, then Surgeon of the IX Troop Carrier Command." This added potential which could be used when the occasion arose was demonstrated to be operationally feasible. Heretofore planners had tended to regard this type operation as being in the stunt category and had not planned to use this capability.

From D Day through 22 June 1945, 391,012 casualties were evacuated by air in ETO. Of this number, 117,207 were evacuated intra-Continent; 254,609 were evacuated from the Continent to the United Kingdom; while 19,196 were evacuated within the United Kingdom.195 The following table shows this data by monthly periods."

Air evacuation of casualties from the European Theater to the United States was a responsibility of the European Division of the Air Transport Command, with the IX Troop Carrier Command responsible for making available the