ARMY SERVICE FORCES 
RECONDITIONING CONFERENCE 
SCHICK GENERAL HOSPITAL 
CLINTON. IOWA 
I \ 
21-22 MARCH 1944 RECONDITIONING CONFERENCE 
BRIGADIER GiKERAL C. C. HILII^N 
Colonel Winn, members of the' Conference and friends. Reconditioning 
is not a new idea. Over the years, physicians have realized that while 
their patients were recovering from illness or injury they night deteriorate 
physically and mentally so that when recovered from the primary cauoe ox 
their admission to hospital, they still might be far Iron well, has 
been amply demonstrated and doctors have attempted, possibly not to tne 
optimum extent, to keep; people occupied mentally and physically bo the 
limits of their abilities in order to maintain functional activity of 
those parts of the body not otherwise restricted. 
By appropriate effort to maintain the functioning of the parts of 
the body not incapacitated as the result of the primary illness or in- 
jury, the individual can be saved hospital days and can oe returned uo 
duty status in a functional capacity much higher than if attention wore 
not paid to these things. In the present conflict when conservation oi 
personnel is such a significant factor, the importance of reconditioning 
— in other words —• the importance of maintaining the individual’s men- 
tal and physical capacity at the highest point while he is coniindd was 
become of paramount importance, and, on this basis our Reconditioning 
Program is founded. 
This Conference has been called with a view to coordinating our 
various plans for carrying out reconditioning in military hospitals, «lth 
a view to permitting us in the Surgeon Genera. 1’ s Office to make contact 
with you gentlemen who are in charge of reconditioning in tne various 
Service Commands, in order that we may learn what your problems are, and, 
in this way, be better enabled to carry out our functions in the Surgeon 
General’s Office. Therefore, vie have come hare with a view to having a 
free discussion of our combined problems'and enabling us to learn from 
you, as well as permitting us to pass on, in a small way, some of the 
thoughts we have about the Reconditioning Program, 
I would like, before leaving the stand, to express* the deep grati- 
tude that the Surgeon General’s bffice feels and the personal gratitude 
of us who arc intimately concerned in directing the'Reconditioning Pro- 
gram, to the many individuals in. the War Department, and in other agen- 
cies, for the interest and the help that has been given us. We are par- 
ticularly indebted to the Assistant Chief of Stafi, G-i, and nssisbant 
Chief of Staff, G-3, of the War Department, to General Somervell himself, 
and to the military Personnel Division, the Special Services, and tne 
Horale Services of the Army Service Forces, and also to the American Rea 
Cross for the assistance and cooperation which has been given in the 
closely related mrbs and Crafts Program. We arc deeply indebted to the 
Commanding General of the Seventh Service Coamend for the careful pro- 
visions which have been made for recording this meeting, and to the 
Commanding Officer of Schick General Hospital for the arrangements he 
has made for carrying out this meeting. We are indebted also to the 
press for coming here to take note of our proceedings, and to properly 
report them. 
At this time it gives me special' pleasure to introduce our host 
on this occasion. Colonel Dean F, Winn, Comnianding Officer of Schick 
General Hospital. 
1 COLONEL DEAN F. WINN 
General Hillman and guests.' We’reel singularly complimented that 
Schick General Hospital has been selected for this Conference for the 
reconditioning of casualties in Army Hospitals, and that so many dis- 
tinguished guests are here and have interested themselves in the program. 
As l*ng ago as last June, three months after this‘hospital received 
its first patients, and well in advance of the receipt of directives on 
the subject, we realized the need of segregating convalescent patients 
and the establishment of measures tc fit them for duty. Accordingly, 
one barracks building was set aside for this purpose, and a convales- 
cent detachment organized. Through our excellent public relations we 
were able to provide in the City of Clinton, facilities for swimming 
classes and for work-outs in a we11-organized gymnasium under the dir- 
ection of a trained physical director. Transportation was provided 
by the generous cooperation of the Red Cross Motor Corps. Since then 
*ur program has expanded, and you will hear more about this later from 
Major Johnson. 
We are under no delusions as to the conduct of our Reconditioning 
Program. Circular 168 sets forth in a masterly manner the goal at 
which we are to aim. It is a relatively easy matter to prescribe a 
course to be set; it is a far different problem to put such a project 
into effect. The implementation of a training program for classes 
3 and 4 is particularly nebulous. We have found it, at best, a trial 
and error proposition. This Conference will result, no doubt, in the 
solving of certain basic problems, and will assist installations in 
overcoming obstacles peculiar to the station concerned. 
While you are here, every effort will be made to make you comfort- 
able, If you need help, the Executive Officer or the Adjutant will 
know the answers. Administrative Offices will be open this evening 
until 2100 to afford information to those who may be interested in 
hospital administrative procedures. 
There is one thing to which I would like to invite your attention 
before closing. This hospital is acutely food-waste conscious. You 
may be interested t» know that in February ®ur food-waste was only 
•079 lbs per man per day. This figure was attained in spite of the 
unpreventable waste incident to the feeding of sick patients. We 
have plenty of food and a menu second to none. Take all you want, and 
come back for "seconds", but — eat all you take. We do not expect 
to have any edible food left on plates. 
We bid you, for the Cammanding General of the Seventh Service Com- 
mand, and the Commanding Officer and Staff of this Hospital, welcome 
to Schick General Hospital. 
BRIGADIER GENERAL C. C, HILLMAN: The Surgeon General’s Office is 
particularly fortunate in having as its Director of the Reconditioning 
livision a Surgeon prominent in civilian life, who has been interested 
in this type of work for many years. In addition to his experience and 
interest as a civilian surgeon, he has been in the Medical Corps on 
active duty since the early days of the present struggle. He has had 
two years in one of the active theatres, and there he carried out his 
ideas in connection with reconditioning very effectively. 
It gives me great pleasure to introduce t# you Colonel Augustus 
Thorndike of the Surgeon General’s Office. COLONEL AUGUSTUS THORNDIKE 
General Hillman, and guests. This conference has been assembled for 
the purpose ef launching a reconditioning program designed to condition 
patients to such a state of health that when they return to a training or 
combat unit, they will resume their former assignment physically and men- 
tally fit. Furthermore, it should be clearly understocd there is an 
obligation to return those boys discharged by a certificate of disability, 
in the best state of physical and mental fitness that any individual handi- 
capped may permit. The Surgeon General has announced on 10 December 1943, 
and thereby directed, that this program will proceed and "should be 
carried out in the case of all patients, regardless of whether or not it 
is anticipated they will become fit for return to duty." 
Not only is it a Medical Department responsibility, it is the War 
Department responsibility. It has engaged the interest of the President, 
our Commander-in-Chief, It is very much tied in with the problem of 
"utilization of manpower." It is a significant honor to have Colrnel 
Lynch attend this pregram today as the representative of the assistant 
Chief of Staff G-l — Major General White. He has consented to inform 
us conterning matters pertaining to their interests in the salvage and 
training of army personnel. 
Because of difficulty in obtaining adequate personnel, results, to 
date, have not been produced to the extent desired. However, through 
the publication of Section II, Circular 73, the Commanding General, Army 
Service Forces, has now made provision for an organization with adequate 
personnel, as a result, there is a challenge to the reconditioning of- 
ficers, to the hospital commanders, and to the Service Command Surgeons. 
My own experience as Commanding Officer of a general hospital overseas 
has proven to me that even with a lesser number of officers and qualified 
enlisted personnel, it was possible to return over 1,500 patients to full 
military duty in a period of five months, by means of a reconditioning 
section (an average of 300 per month). The value of any Reconditioning 
Program is judged only by its actual results. The Air Force knows its 
results. Let us know ours. 
It behooves us to review our terminology. There has been too much 
confusion in the use of certain terms and classifications. It is most 
important that the word "rehabilitation" be dropped and the word "recon- 
ditioning" substituted and used in conjunction with all phases of this 
program except in the special case of the deaf and blind. There must be 
a common understanding that will not confuse "reconditioning" with the 
word "rehabilitation." The latter in military language suggests vocational 
training or a military detention camp. One will define the "Reconditioning 
Section" of a hospital as including all four classes of patients, classi- 
fied according to Circular Letter 166, SGO. Classes 1 and 2 will be de- 
signated as the "Advanced Reconditioning Section." We must have a uniform 
terminology. 
Excluding from this conference the special treatment which pertains 
to the blind and deaf and which is being carried out in especially 
equipped and staffed hospitals, the program is coordinated, so that 
Physical Reconditioning, Educational Reconditioning, Occupational Therapy 
and Recreational and Diversional Activities are all integrated into a com- 
posite schedule. It is of greatest importance that this coordination 
exist in all hospitals. You will hear from subsequent speakers today and 
tomorrow how this is accomplished. 
In concluding these opening remarks, it is my privilege, as Director 
of The Reconditioning Division in The Surgeon General*s Office to point 
out that this conference marks a milestone in Patient Reconditioning in 
the United States Army, 
3 Remember that every commander in the field, from squad leader to the 
highest headquarters, is interested in the success of the liedical De- 
partment's return to full military duty of patients physically and 
mentally fit. Remember, that every mother, every sister, every father 
and every brother is interested in the physical and mental welfare of 
his or her nearest of kin. This program is designed to product results 
in all Servicb'Commands, The responsibility is ours. We cannot fail! 
General Porter, General Hillman and Colonel Lynch, I assure you, we will 
not fail, * • . ‘ 
BRIGADIER GENERAL HILLMAN: Though wo must keep in mind that patients 
in the Reconditioning Program are still patients, and that first of all 
it is our obligation to give consideration to the ailment or injury that 
has necessitated the individual’s hospitalization; ‘ we must not forget 
that, while the individual is undergoing reconditioning, there is afforded 
a magnificient opportunity to instruct that patient — train him — and 
further prepare' him for the military task that lies ahead. Wo must keep 
in mind that training should be directed along military lines as far as 
possible, arid the ultimate goal should be to prepare the individual, 
either for a better effort in the military forces, or to enable him to 
better take .his place in civil life, and thereby "contribute to the 
military effort. 
•> * ■ 
In working up our'program, we have been especially fortunate in 
having the cooperation, encouragement, and help of Assistant Chief of 
Staff G-3, Major General Ray E, Porter. It is my pleasure at this time 
to introduce General Porter. e 
*' Gentlemen: These are busy days for me, as they are, in fact, for 
all of us; however, I feel entirely justified in devoting the time to the 
subject of Reconditiorfihg which was required for my attendance -ft your 
conference here. 
I came here with two purposes in mind. My first purpose is to evalu- 
ate for myself, and to be -able to report to the Chief of Staff, the Ade- 
quacy of the plans which have been announced fof our Reconditioning 
Program, and to judge the probable capabilities of the officers who have 
been charged with the execution of those plans, 
♦ * > 
The second purpose of my visit is to impress on you, by my pre- 
sence here, the importance that the Chief of Staff and entire War Depart- 
ment ascribe to the Reconditioning Program, 
The importance of the Reconditioning Program -is indeed one of thb 
first magnitude. The young man who has sacrificed any part of his mental 
or physical strength in the defense of his country is entitled to every 
opportunity to recover his impaired opportunities to the fullest pos- 
sible extent. His loved ones who gave him to their country are entitled, 
if humanly possible, to receive him back capable of contributing to their 
support and happiness rather than having him return as a burden, and as 
a cloud to overshadow their future joys. 
These men who go forth and sacrifice for their country are the men 
with sou£s and characters to make America worth the price in blood and 
tears that is being paid in her defense. Their loss, or their impaired 
usefulness*1will be an irreparable loss to our country. 
We owe a debt to our sick and wounded soldiers, to their families, 
and to future Merica which must be met if we are not, justly, to sacri- 
fice all confidence in our leadership. 
In another phase the Reconditioning Program is of tremendous * 
importance. 
MAJOR GENERAL RAY E. PORTER The magnitude of the present World conflict has impressed all of 
us, as we had not realized before, how definitely limited the manpower, 
resources of the United States really are. We are prone to deal in 
superlative adjectives, to think we have the greatest, largest, and 
mcstest of everything and I am sure most of us are already realizing 
we haven’t the mostest men, to the extent we once thought we had, I 
am convinced that, by employing our numbers fully, economically and 
wisely, our strength is equal to the demands of victory, .1 am just as 
thoroughly convinced that even relatively minor wastages in our man- 
power will seriously jeopardize our chances of complete victory. 
It is important that all of you should leave here knowing that we 
have in our Army today only 7,700,000 men and women. We can’t expect 
to ever get many more. To maintain the industrial demands made on our 
country, we cannot withdraw from.industry a much larger force and 
hope to continue to support our armed forces. It is important. for you 
to know before you leave, if you don’t already know it, that every 
man and woman of that 7,700,000 is definitely assigned to some place. 
There is no reserve. If it becomes necessary to provide a company of 
a new type, we must find a unit of equal strength, and inactivate that 
unit to provide personnel for the new unit. Every.man who has left 
his duty has left behind a vacant place for which there is no man to 
fill. These are alarming facts to me, and they certainly tend to 
emphasize the importance of the work you are doing. 
Those young men who will come to you for reconditioning were the 
cream of the crop. They will be the men who have already learned how * 
to win. Every one of them you lose for the Array, eveiy day that one of 
them remains away from duty linger than is absolutely necessary to his 
full recovery, is a damning charge against all of us and an irreparable 
loss of our cause, 
I am deeoly interested in every service we are able to render to 
our sick and wounded soldiers; however, it is the training of the con- 
valescent soldier who can be saved for the Army that is the official 
responsibility of my Division of the.War Department General Staff,. 
Training for men who are to return to duty must include: 
Mental reconditioning * " 
Physical reconditioning 
Retraining for new military duties, or refresher training for 
the military duties formerly performed by the soldier, 
I do not hesitate to say that mental reconditioning is the most 
important of the three activities you must undertake. In many cases, 
it will be the most difficult. 
Success will only be achieved through personalized effort'. Those 
conducting this training must have.their hearts and souls in their 
work. They must deal with each trainee as an individual. They must 
understand each individual; they must gain the confidence and respect 
of each individual; and they must.administer to the peculiar needs of 
each individual. I am sure problems of mental reconditioning cannot 
be accomplished through any mass methods. 
It is in the field of mental reconditioning that our Orientation 
Program and our Orientation Officers should make a noble and•effective 
contribution. If we could send each reconditioned soldier back to the 
Array with an unfaltering faith in the righteousness of our cause and 
an unbending determination to win, they would constitute the mightiest 
single force for victory available to us. And I ask you why can't we do just that? If Germany, with her propaganda 
of lies, has fired her youth with enthusiasm for their cause that burns in 
the heart of every German soldier with whom I have talked during this war, 
why should we, with the glorious truth to sell, fail to inspire every . 
single young American, We have failed to achieve full success- in that field 
but I don't believe we can justify our failures. 
With reference to the orientation work, you will probably be told by 
General Osborne's representative here about the General's intense interest 
in this program, and I can assure you that he is prepared to go all out 
in helping you making your work a success. In the fields of physical re- 
conditioning and military training, you will require both instructors and 
equipment. The War Department is prepared to help you to the limit of its 
resources in obtaining both, I have already promised things which 1 have 
not the slightest idea on earth how I am going to get, . I have even com- 
mitted some of my associate general staff divisions to do things that I 
haven't had the heart to tell them about. However, we will give you, I 
assure you, everything available to us to help you make*this program a 
success. ” “ 
In the matter of instructors, I think it is important that you 
use convalescent officers and soldiers to the maximum extent of, their 
ability as instructors. This will have two great advantages. Their records 
will give them a prestige among"their comrades that will make their instruc- 
tion far more effective than it would normally be, and I think that it will 
be of service to the instructors, themselves, in aiding their 
own recovery. They again will have something useful to do, and they again, 
will be assuming responsibilities, and I am sure those two facts will 
d# more to speed them aldhg toward more rapid recovery than any single 
thing we could possibly do for them* 
4*. 
You are entitled to receive every possible assistance from local 
commanders in the matter of instructors and training aids. However, 
many of you will be located in places where there are no field units or 
where there are only a few. You must solve your problems of military 
training and physical conditioning by working out a worthwhile program 
and asking for, and continuing to ask for, until you receive it, adequate 
assistance in the way of instructors, together the necessary military 
equipment.and training aids. 
I shall not attempt to enumerate the subjects which should be 
included in your training programs. My present thought is t 1 lat t r a in ing 
programs should not be rigidly standardized throughout the Army. You 
should be guided by the individual needs of your trainees, and you should 
take the fullest advantage of local facilities. You must not, under any 
circumstances, overlook the worthwhile military training or retraining 
of these convalescent soldiers. Probably the greatest importance that 
that training will have is that it again gets the man to thinking along * 
military lines. It will also serve a very useful purpose in preparing the 
man to do his job better when he goes back to duty, so please do not let 
the military training aspects of your program be weak or something that 
you just put in to fill in the morning. You don't kid the soldier. He 
doesn't mind doing something worthwhile, but he is terribly bored doing ■ 
something put in the program just to fill the morning. We have seen a 
lot of that done. Please don't do that. Get someone who is capable of 
managing it for you, and get the personnel and^equipment you need to make 
it a worthwhile program. 
There is one point on which I am probably not qualified to speak 
as an expert, but on which I have*very definite ideas. 9 It is this: During his reconditioning training, the soldier should be 
removed as far as possible from the hospital atmosphere. If possible, 
I think we should cease to refer to'him as a patient and find a place 
for him to sleep, cat and work as far removed from the other patients 
as possible. From my observations in life, without any scientific 
background for my conclusions, I have decided that for each and every 
one of us there is a time beyond which we cannot continue to be a 
patient and be anything else. It may be six weeks for one man and two 
months for another, but if we remain patients long enough, we will 
eventually cease to be anything else. 
Gentlemen, as I said in the beginning of my remarks, one of my 
purposes in coming here was to judge for myself the capabilities of 
the men to whom this work is being entrusted, I don’t hesitate to 
say, as I look out over your group this morning, that I am quite 
happy to see the type of officer who has been brought into this work. 
It shows the importance those responsible have placed on this program, 
I think the plans which have been prepared by Colonel Thorndike, ap- 
proved by the Surgeon General, and approved and published by the Com- 
manding General of the Army Service Forces, are certainly a long step 
forward toward an effective reconditioning'program. However, you 
must recognize that the most complete, most detailed and the soundest 
plans are of no importance whatsoever if they are implemented by in- 
capable men—by men who are not putting their best efforts into that 
implementation. You certainly have an inspiring task ahead of you. 
One of the regrets I have as I near the end of my life, is that I 
have devoted my life so wholly to the study of destructive measures, 
that it has seemed to me more and more in late years that it would be 
such a satisfaction to think I was contributing something construc- 
tive to life. With that thought so constantly in my mind, it is not 
surprising that I really envy you this great opportunity to do one of 
the most constructive pieces of work which can be assigned to any 
group of officers. Thank you very much. 
GENERAL HILLLAN: Thank you, General. In carrying out the re- 
conditioning program, a great many problems arise which have to do 
with the administration of personnel. In handling our personnel 
problems we are very fortunate in having the entire support of the 
Assistant Chief of Staff, G-l, who works in full accord and coopera- 
tion with us, and we profit much by the advice and assistance given. 
We have with us this morning, as representative of the Assistant 
Chief of Staff, G-l, Colonel E. C, Lynch. It is a pleasure to in- 
troduce Colonel Lynch. 
C0L03EL E, C. LYNCH; General Hillman, members of the conference 
and guests, 1 know that General White regrets very much not being able 
to be present with you this morning and at the subsequent meetings of 
this conference. Unfortunately he was unable to attend, I say he 
would regret being absent because he has an intense personal inter- 
est in the reconditioning program and the expected effects which , 
will result therefrom. 
General Porter has ably covered the War Department General Staff 
aspects of the reconditioning program. There is little that I can 
add to his remarks, except as repitition. From a personal point of 
view, there are two essential features in the reconditioning program 
which cannot be stressed too much. The first point is to preserve the ' 
quality of our soldiers. After we have spent months training a soldier, 
it is important that we keep his mental condition in a proper state 
so he will not deteriorate mentally while undergoing medical treatment. 
In that respect you have a most important part of the reconditioning of 
the man. The second point is that our experience thus far indicates that a 
well run reconditioning program will result in speeding up the conval- 
escent period for the average patient. Getting the man back into the 
flow sooner represents a considerable gain in manpower. As General 
Porter pointed out, we are now limited to a ceiling of 7*7 million for 
the Army, In order to got the full effectiveness from that 7*7 million, 
it is necessary that the maximum number be on the job. If the recondi- 
tioning program reduces the number of days a man requires in convalescence 
before he goes back on the job, we have made an equivalent saving in man- 
power, 
GEN, HILLMAN: In the station hospitals of the Amy Air Forces, a 
wonderful opportunity has boon presented to do constructive work'in re- 
conditioning, The Commanding General of the Army Service Forces, the Air 
Surgeon and his staff have taken full advantage of this opportunity and 
have developed, within the Army Air Forces and the station hospitals 
thereof, a very fine reconditioning activity. In personal charge and di- 
rectly responsible for this success is Lieutenant Colonel Howard A. Rusk, 
Medical Corps, Army Air Forces. I am pleased to introduce Colonel Rusk, 
LT. COL. HOWARD A, RUSK 
General Porter and. gentlemen: I appreciate very much, sir, the priv- 
ilege of coining to this conference and discussing with you and learning 
from you new ideas about the overall reconditioning program. I should like 
to tell you about the first survey made when this program was started in 
the Army Air Forces at one of our station hospitals. Wo sent enlisted men 
through the wards inquiring of the patients as to their reaction to this 
program. The first group said, "This is some Any where a man has to work 
in a hospital, I understand that there is something going on where you 
have to go to classes and take exercise and see training films, even when 
a patient." The other group said, "It looks like they arc going to do 
something for us and get us out of the hospital." In the entire hospital 
there wasn’t a single man who didn’t say ho wouldn’t welcome the ideas 
of the reconditioning program which is now in effect in the Amy Air 
Forces station hospitals. 
Our fifteen months experience has given us a number of interesting 
observations. The most interesting series has been our patients with 
virus pneumonia. In the survey of 1,850 patients, 600 were segregated 
and put into a special group. They were sent to alternate convalescent 
wards. In Ward 1, they did nothing but the old regime; they sat around 
the ward; went to the PX; walked to mess; and when they felt able, were 
sent back to duty. In hard 2, they were kept in bed 8 days longer than 
in the other ward. They were put in the twelve day reconditioning pro- 
gram which started with one-half hour the first day and ended on the 
twelfth day with a ten—mile hike with a full pack. Group 1 averaged 15 
days with a 30 % recurrence rate and Group 2 averaged 31 days with % 
recurrence rate. 
he recently have run a test on fifty patients and believe we know 
one reason why these boys get out sooner. We have found that if wo start 
convalescent virus pneumonia patients positive with x-rays or hyper- 
ventilation; give it every hour throughout the day and follow with 21- 
hour x-rays, of this group of fifty cleared up in 72 hours. It looks 
as though the reconditioning program with the exercises and natural hyper- 
ventilation was accomplishing the same thing. We are not absolutely * 
certain, but it seems to clear up the atelectasis which is believe re- 
sponsible for the delay in convalescence. In contagious diseases we have been able to drop the average of a 
week from their hospital time. In our orthopedics, where we have made a 
number of different physical checks and have checked time time on patients 
in casts .that have been kept in top physical condition, we found that when 
the cast is cut they can be back to duty in half the length of time. 
Keeping the muscles of the rest of the body active improves the rate 
and volume of blood supply to the fixed muscles and although not defini- 
tely proven, this probably prevents the atrophy of blood capillaries which 
otherwise occurs in atrophied nuscles. For this reason the recondition- 
ing of the fixed nuscles takes a much shorter time, Our readmissions 
have been cut as much as 25%. We have a series now of four months of 
observation of every patient discharged from the hospital and we find 
their physical fitness is 5% better than the average of the camp. We feel 
hopeful from that figure. 
The teaching, in this program, as General Porter has pointed out, 
must meet the need of the installation and that has been a problem in our 
Service because we vary in meeting basic needs. However, if you take 
advantage of the post or station facilities where you are and utilize 
the material at hand and key your program to that need, the interest 
maintenance will be at the top level. We have now been giving credit for 
hospital training in our Cadet Centers and Basic Training Centers so that 
the man can parallel the course he is pursuing in the hospital and when 
given an examination on discharge, if he passes, is given full credit 
for the time he spent in the hospital and will be losing no training 
time. 
All this goes back to the point of how to sell this program to the 
patient and I think it can be sold in one way - that is - "What does it 
do for me, Private John Doakes?" It does three things for him. First, 
it gets him out of the hospital sooner. In the second place, he has 
less chance of coming back because reinfections are less likely to occur 
and third, if he carrys on his work in the hospital, that he did in camp, 
he will be up with his outfit. He will get out sooner - he, probably 
won’t come back - and he mil keep up with his outfit and that is all a 
soldier needs. You will get wholehearted participation from this 
appro ach, 
As you know, we have set up eight convalescent centers in the Air 
Forces to receive patients from general hospitals for specialized conva- 
lescent training. It was done because the Air Forces had a special 
problem. We are dealing primarily with highly trained, technically skill- 
ed, individuals and young air crews. Our object is to attempt to get 
the men back to their original assignment with the same MOS number, or, 
even if they have to have a new MOS number to put them where they will 
be of most value to the Air Forces. This is our objective, so when we 
receive a man from a general hospital, he is put in a general overall 
program which includes retraining with a vocational trend. 
The opportunities section is a section for vocational guidance of 
casualties and is manned by men who have had special experience with Air 
Force personnel needs and needs of the aircraft industry. The vocational 
counselors follow the Doctor and have been a tremendous morale factor. 
They have four pieces of a puzzle to put together with these indivi- 
duals. The first is, what does the individual want to do? Second, what 
can he do with his disability; third, where can we place him in the 
Air Forces, and fourth; if he has to be discharged, how can we help him 
to be placed in a self-supporting, self-respecting civilian job. Up 
to the present we have gone only this far. The Air Service Command onploys some 400,000 civilians in its 
depots and runs 30 schools and teachs 700 specific jobs. Trained men 
may be placed here with a Civil Service rating and a priority of dis- 
charge, We have a backlog of jobs in the aircraft industry we are try- 
ing to fill with the men who have been discharged. In addition to 
these, we go through the usual agencies. These men start in a broad 
vocational training, whether it be radio, metal work or engine over- 
haul. If they are to be discharged so, we will have already started 
them in their vocational training for the work they mil follow in 
military or civilian life. 
I think, Gentlemen, that the success of failure of this program, 
both for us and for you, depends upon the heart that we have in it. No 
man, in my opinion, regardless of his training, will be of any help to 
you in this program unless he feels it first in his heart. If he has 
such a feeling and such a desire to serve, and if he has a little bit 
of imagination and an average amount of energy, he mil set up a program 
that nothing can stop. This program of reconditioning, of salvaging 
and of convalescent training, is not a program for the Air Forces, 
Service Forces or Ground Forces-, it is a pro gran for all of us toge ther 
to get to the soldier and, by working together, and by an exchange of 
ideas and by cooperation, we can go so much farther and so much faster, 
I feel that with such cooperation we can do what General Porter has 
suggested. It is the goal in this whole program, and is, MThe debt of 
disability which shall be paid in the currency of opportunity.” 
GENERAL HITMAN: Thank you, Colonel Rusk. Before introducing the 
last speaker, I vrauld like to remind you that we have a very busy sched- 
ule and it vdll be necessary to step lively to get from one part of the 
program to another in order to carry out the full program of the confer- 
ence, In selecting a place for this conference, two things were in 
mind. Primarily, we wanted to have this program at a hospital where 
reconditioning was being carried on in an exemplary fashion. Secondly, 
it was desired -to find a place in the center of the United States which 
was convenient. Colonel Winn, as an officer of long service in the 
Army, and keenly conscious of the professional side of medicine, is 
admirably fitted to set up such a program and, at this hospital - The 
Schick General Hospital - has established a fine program of recondition- 
ing. Under General Winn, acting in direct charge of the progr-m, as his 
Reconditioning Officer, • is Major E. G. Johnson. I think that after 
seeing the demonstrations you will soon have an opportunity to see, you 
will agree that Major Johnson has done a very excellent job at Schick 
General Hospital. 
MAJOR E. G. JOHNSON 
Colonel Winn has already given-you a brief statement of the history 
of the reconditioning program. We started to work with Glass I and II 
in June of last year and started work with Class III and IV in the 
early part of November, 
In order to present the demonstrations, in the order shown in the 
Agenda, there has been some shifting of our normal scheduled activities. 
You will notice certain activities which are ordinarily held outdoors 
will be held indoors, partially due to the climate and partially due to 
the fact that the actual location at which they are held is immaterial. 
First, I would like to tell you about the staff #10 is helping us with 
this program. 
I am Chief of the section receiving considerable advice and help 
from all of the sections of the hospital - Surgical, Medical, NP, Rod 
Cross, a very cooperative Chaplain’s office and many others. Captain ftosenfield, who has been working with as part time, repre- 
sents our morale services, opecial Services brings in civilian speakers 
from local communities for the patients or those on tour. 
Lieutenant Gagnon, convalescent detachment — that will be the first 
program you will see this morning — is in charge of Class I and IT. pa- 
tients in the gymnasium. 
Lieutenant Zimmerman is running the athletic part of the program, 
taking care of considerable part of our educational activities in con- 
nection with United States armed forces, university extension courses, 
occasional speaking courses, typewriting and what not. 
In addition to this permanent staff we have received considerable 
help from the Glassification Officer, the Chief of Physio-Therapy and 
Occupational Therapy Lections of the hospital and an officer whom we call 
a professional liaison officer who comes in and helps in the classifica- 
tion of our patients. 
I would like, for a moment, to explain more fully that the classi- 
fication officer is very important. He is a inember of the Adjutant Gen- 
eral's Department. ve obtained him as an aid to this program. He clas- 
sifies the patients according to our needs. The ward officer may find 
out that a patient has been misassigned or has been incapacitated parti- 
ally for further duty. There may be a question as to whether a man is 
worth anything from the standpoint of a military job. He is sent to the 
Classification Officer accompanied by his prescription — negative facts 
are given — the man cannot uo this, that or the other thing. He is then 
interviewed. Form 20 is examined and a positive recommendation is made. 
This is forwarded to his next station. It has proven a very valuable mor- 
ale builder — both in the cases of battle casualties as well as those 
post casualties who may consider himself misassigned, He can talk to him 
and straighten things out. 
we are very acutely aware of the morale problem of patients, assigned 
from overseas as well as those local stations end realize that the factor 
of individual personality enters very strongly, Ve must deal them as in- 
dividuals. We have a uestionnaire which has on it a number of questions 
which bring out the man's personal interest. He can indicate what he 
would like to do and what he has done and what his education was before 
he came in the Army. The ward reader fills the questionnaire out with 
him and through the questionnaire they get to know each other. In this 
way the ward leader knows the man's problems, and knows what he wants to 
do for continuing work. The ward leader also acts as a platoon leader for 
a group of ward sections and knows each man in it; is trained to give gen- 
eral calisthemics; sees that Glass III patients are sent down to the gym- 
nasium and if ho stays in the ward, gives them general calisthenic work 
and handles activities associationed with ASF aids. He fills out ques- 
tionnaires and helps them carry on with their studies. Any problems which 
may arise may be taken by this ward leader to the proper officer on our 
staff. 
The NP patients — the difficult problem — do not fit into a pro- 
gram of this nature; they are handled under the supervision of their own 
ward officers. They participate in certain activities provided for all, 
but if, for example, a battle film might interfere with their returning to 
a permanent foundation and it is to be shown and discussed, that period 
will be filled in with a gymnasium exercise period, he have obtained spec- 
ial films for the NP patients of a vocational guidance nature. A great 
many of these men do not return to duty, and these films in their way, help 
in readjustment. Gymnasium work has proved satisfactory as a group acti- 
vity. The Red Gross has been very helpful with the NP cases. 
11 The afternoon lecture series is a lecture series by civic 
in the community, a judge, perhaps a superintendent of the Duqo.nt indus- 
try or something of general interest. Our morning, lecture p-- ioa cu 
orientation and military training. With a large group ol patients 
all branches, it is rather impossible, except in small groups, to coordi- 
nate a balanced system of military training for Class HI patients, 
the lecture is used by our officer patients who preview the films <-nd uxo- 
cuss the branch of service to which the picture pertains, from the stand- 
point of orientation and military service and as to what sort of v.-ori they 
do. Then the film will be discussed afterward if it is appropi i_c.be. 
Group discussions are held in the afternoon with the patients parti- 
cipating in panel discussions. Three or four patients will wox-a up « veij 
pertinent problem of the day or some problem in which they all have shown 
interest. Class III patients — the advanced reconditioning section 
handled in a detachment barracks because we are unable to provide fciCxli- 
ties from the post. They are handled as a service detachment from a mili- 
tary standpoint. If they go on sick call or complain o: a head«.clu> oi a 
belly ache, they are classified and examined by the chief of the section or 
by the liaison officer. 
The training program for Classes X and ll is considerably easier ._>han 
for Classes III and IV; however, you have the problem in a general hospi- 
tal of a mixed group. This has been handled by using the review training 
series of lectures and demonstrations covering tne basic subjects common 
to all branches. For example, an air corps patient an air corps otxx- 
cer or cadet — will work up a little series on some suoject in ■••hioh be 
is particularly interested and carry it on for the patients. Code classes 
are utilized, typewriting classes, hikes. This is the usual pro ram 
for all Classes I and II. In addition we have had a few patients^who fall 
in between Classes II and III. They may have to stay in a reconditioning 
section a little bit longer — that is in the advanced section a j.ittxo 
lenger for healing purposes. 
Officer patients are participating in the program but not as much as 
they will in the future, kith our experience so far, C thinx we will nave 
very little trouble, with them. In the reconditioning section we have from 
three to eight officers who very ably assisted the training program, <e 
had a little trouble at first but it was soon ironed out regarding the ques- 
tion of staying close to the enlisted men. They were not in squad, 
they had rooms to themselves. We are rping to start a program in th^offi- 
cers ward, but you won’t see that today. They will run into oriental ion 
and be spread in small groups through the hospital. Orientalion classes am 
held in large groups in this auditorium here, 1 will be at one ol the roung 
tables tomorrow and will be glad to take up any unanswered problems •■‘■t this 
program. I think you all have the agenda of the day’s activities, bavc 
just about time enough to get down to the gymnasium to see tne first part ox 
the program. This morning the groups are all together, Tnis alt moon the 
groups will be divided into one and twos. 
COLONEL THORNDYSE; We will now conclude this morning’s session and 
follow Major Johnson to the gymnasium. 
END OF MORNING SESSION COL. THORNDIKE: The meeting will please come to order. For the next 
half hour or so, we have .planned a Question and answer period. T e have 
been taken through a very interesting tour of the hospital and seen the 
program as it can be put on. I am sure there are Questions concerning 
which that have come to many of us that we would like to perhaps obtain 
some special information. Colonel T inn has agreed to answer the Questions — 
■well, I think he has-. However, he has one of his patients here whom I think 
you would all like to hear from as to how successful the patient feels the 
program is. 
COL. TTNN: Sgt. Dorio, will you come forward, Fe're going to insert 
an unplanned item on this program. I thought you might be interested in 
hearing from a patient — what the patients think of the program, Fe 
thought this up on the.way up to the auditorium — this idea of having a 
patient tell you of what the patients think of this program. Sgt. Dorio 
was on his way to mess and is mad, so anything he will say wall be impromptu 
and not influenced by anything the staff has told him to say. 
SGT. CARL DORIO, 17th Bomb Wing; Thank you, Sir. Officers of the 
Army, distinguished guests, ladies and gentlemen. I consider, indeed, it 
a great pleasure to stand before you and tell you in my own words my person- 
al reaction to the reconditioning program here at Schick General Hospital. 
I have been separated from my organization, from my buddies, from my flying 
outfit in the Air Corps, since August, 1943, because of the accident I hap- 
pened to be in just before we were ready to take off on a mission against 
the enemy and help bring victory to our country and our people. I came to 
this hospital on October 6, last year. At that time there wasn’t any recon- 
dition program. Of course, I am not just a youngster about IB or 19, I'm a 
little older than some of the soldiers. I have social work background and 
I can, more pr less, navigate by myself. In other words, I can read and do 
a lot of things which take up time, but even so, I felt the need of some- 
thing else — something organized, something more constructive — than any- 
thing I could make by my individual effort. I was looking for something but 
there wasn’t anything here. Towards the latter part of October, as I remem- 
ber it, or along about in November, we began hearing of a reconditioning pro- 
gram. At first, the men in the wards poked fun at the idea. They were won- 
dering what some of the officers were up to. Between stories, the officers 
told us about a reconditioning program, about what some of us are fighting 
for and all that sort of thing, and in a little while some of the men, while 
still skeptical, were no longer cynical about the program. Captain Rosen- 
field started various activities and we cracked all kinds of jokes about him. 
Since then, however, most of us have learned to respect Captain Rosenfield 
because the men — all of them to my mind — feel that he and Major Johnson, 
•f ■whom we don't see so much, have been doing a splendid job. 
The Reconditioning Program, both physically and mentally, offers us a 
means to keep fit and to keep our morale high while patiently waiting for that 
day when we rejoin our outfits and go over and do the job which has to be done. 
Now, what are some of the things this program has done? Well, for my- 
self, I had a fracture of the right leg and a fracture of the right arm, so 
as far as my right side was concerned, it was practically useless. I was in 
bed for many months — I couldn't write a letter. I wanted to write letters 
and I had to do something about writing. I am also interested in writing 
fictional short stories and I didn’t want to l$se what skill I had, and so, 
with the help and encouragement of the officers, I learned to write left- 
handed and now I am ambidextrous. Of course, before this, no one could read 
my right hand writing and now they can't read my left-hand writing. I feel 
a little like an octopus — is it this or is it that? Anyway, it served me 
very well during that period. My cast just came off about two or three weeks 
ago. During that period, instead of just staying in bed, I was -able to learn 
to write, and now I can write practically as well loft handed as right- 
handed, I think that was quite an achievement, not only for mo person- 
ally but also for the program. 
Some of us yearned for some mental exercise. Some of us couldn’t 
march around — I still can’t — but we wanted something of an intellec- 
tual nature, so they started this panel discussion. They said that wo 
could discuss problems that might be of interest to us. We were given 
a lot of leeway and wo appreciated it. We rotated chairmanships, and 
we rotated the members of the speaking team. Wo have discussed all kinds 
of problems. For, example, we discussed the Baruch Report last week, 
which was very interesting to us men. We discussed the problems of war 
and the Teheran and Moscow Conferences, We have discussed the soldier 
voting bill — we have discussed rehabilitation, reconditioning after 
the war, and all the problems we are facing now and will have to face 
later. 
Some of us wanted to keep up with current events. We felt that 
while we were training and carrying on our activity in active service, 
we had sort of lost track of things and so it was made possible for us 
to have a forum every Wednesday night in the Hod Cross auditorium. We 
have had maps supplied us and all kinds of materials to carry out these 
discussions. We have two-hour sessions during which we review the war 
news of the week, highlights of national affairs in Washington, and 
questions of international importance which may have been propounded 
during that week. Now to some, who may have other activities, that 
may not sound like very much, but it was a great thing to us, who have 
not been out for so many months, to be able to exercise our ment' 1 
functions in that way. It was a great achievement., It afforded us 
great pleasure. 
Then something else — some of us, when we became ambulatory, 
wanted to do a little something extra and some of us who had radio ex- 
perience wanted to know if we couldn’t speak on tho radio and toll the 
good people of Iowa how we reacted to a number of things they were 
doing for us. We wanted to tell them what we were thinking bout, what 
we wanted to do when we got out, and it was made possible for us to have 
a radio program where we toll the people of tho surrounding country what 
the service man here at Schick Hospital is thinking about. We called 
the radio program ’’Personalities in the News at Schick Hospital’’, For 
instance, tomorrow evening, we are going to talk about the hospital or- 
ganization here which has done so much for us. This is one form of 
activity for us. It affords us groat pleasure and takes up our time. 
These are just some of tho things. 
Other boys are learning to mako various things in the wards' — boys 
who can’t get around -- such as rugs or bolts or many other things which 
are part of the occupntional’"therapy part of the program. Then, of 
course, when we are able to graduate to what is known as :,C” or conval- 
escent ward, we begin to take light exercises, I was sent over there 
Friday, and I am beginning to take some-light exorcises physically which 
is toning mo up very nicely, and I think-, it is going to stimulate tho 
growth of bone in my fracture. My-hand is getting stronger and I am 
feeling good. The only thing I feel bad about is that I can’t go out 
where the fighting is going on, I would say that in, my own humble judg- 
ment this program has tremendous possibilities, 
I understand that another -angle to this is tho development of the 
library facilities here, number of the boys like to read and review 
books and then get up before an audience and discuss them, I understand 
that they are going to have the opportunity to do this before other 
patients. It takes up time, but more than that, it develops intellec- 
tual powers. Some of the boys have to learn new skills. Some of us, unfortunately, 
will have to return to civilian life, and will have to be prepared to 
meet the problems of civilian life. As a result of our study, 1 think 
we will be able to make that readjustment more readily because of this 
program. In other words, those of us who leave here to return to 
either our fighting outfits or to civilian life will be better soldiers, 
better fighting men, or better civilians because of it. I want to go 
back to my outfit. My morale has never been any higher than it is 
right at this moment. If we go back to civilian life, we can go into 
a defense industry. We can help production so that we will have victo- 
ry as quickly as possible. That is my judgment of a reconditioning 
program. It is doing a great deal to help us recover much faster phy- 
sically and mentally. It is keeping us in trim physically and keeps 
us mentally on our toes. When we leave here, we will be better soldiers 
and better Americans to help free this country in the quickest possible 
time. rJhen it is all over we are going to be better citizens to help 
make a greater American democracy which will have liberty and pros- 
perity for everybody and lasting peace for the whole world. Thank 
you very much. 
COL WINN: Because we are a little behind on *ur program, I am 
going to have to forego the pleasure of hearing from another patient— 
Sgt. Storey—our non-commissioned officer who leads the panel discus- 
sions. He has expressed his desire to tell us his story about what he 
thinks, but I don't believe we have time. We certainly appreciate his 
willingness to do so. 
This meeting is open for discussion. I am inclined to think the 
eloquent story just given you has answered some of your questions already. 
COL THORNDIKE: Are there any questions from the floor? 
COL MOORE: Please discuss the merits and disadvantages, if any, 
of having reconditioning carried on through the appropriate sections 
of the hospital rather than centralized in one area where it will be 
all under close control of the operation heads of each section. 
COL THORNDIKE: Colonel Moore, I want to explain that recondition- 
ing involves all four classes and if you remove it to another area you 
will still have to have Class III and IV patients in the hospital. 
You meant, I imagine, the merits or disadvantages of having Class I 
and II patients separated from the rest. It is preferable to separate 
these two classes from the hospital atmosphere and move them out to 
a camp or barracks away from the patients. Such a camp has been es- 
tablished about fifteen miles from Walter Reed in an old CCC camp, 
and it seems to be working very ideally. There is a separate mess and 
separate administration for the reconditioning. The medical officer 
comes over and holds sick call for the patients. That is the ideal, 
I believe, but remember, they are still patients in the hospital and 
carried as patients. Does that answer your question? 
COL WINN; I would like to explain the operation of the system at 
this hospital. A survey was made of the community surrounding the 
hospital, and there were no available places we considered suitable 
for this activity. We did have barracks space. ’ne feel that having 
these patients close Mo us makes the program a little bit better 
integrated. I don't believe the fact that the barracks are near the 
hospital is detrimental. I believe it would be preferable to have 
these convalescent patients subsisted in a mess with duty personnel. 
In this hospital, that is precluded by higher authority xvhich insists 
that we conduct two separate kinds of messes: the field ration for 
duty personnel and garrison ration for patients. So far as we Know, no economy is effected by this method. On the con- 
trary, it is against work simplification. However, we have not been 
able t> influence anybody in changing the method of messing, 
COL THORNDIKE; Any other questions? The chair hearing no further 
questions, the meeting is adjourned. We will assemble at 1300 for the 
showing of a motion picture reel sent over from England by Colonel 
Dively, showing'the reconditioning program in operation in the European 
theatre. 
END OF AFTERNOON SESSION COL. AUGUSTUS THORNDIKE: Will the meeting please come to order. T e 
have prepared, and on the desk you will find a graphic organizational chart 
of reconditioning and how it pertains to the various headquarters. You vail 
note the dotted line is the staff line and the solid line is the line of com- 
mand. We have just obtained approval of these charts before I came out, so 
they are authorized officially and are the organizational charts of recondi- 
tioning. I have three slides which I will show and then I vail call on the 
next speaker. - 
(SHOES SHOVJN) 
Are there any questions on these slides? If not, I shall call on 
Colonel Winn to give us a talk on the subject of utilization of personnel. 
Colonel Winn. 
COL. DEAN F. WINN: General Hillman, Colonel Throndike, guests: I as- 
sume that the Program Committee intended this talk to be based on how the 
personnel which has been set up in ASF Circular 73 may be utilized rather 
than how this hospital is utilizing personnel now assigned to the recondi- 
tioning program. When I wrote this talk I had never seen these charts we 
have just looked at so ray remarks may be a little bit off in some places. 
The increase of current personnel ceilings to provide for recondit- 
ioning programs and the provision for keeping this personnel stabilized 
will be a tremendous help in the conduct of reconditioning activities. 
Circular Letter No. 168, SGO,-sets forth in a clear and stimulating 
fashion the purpose of the program and character of work to be performed. 
No program of reconditioning will be successful unless it receives the 
earnest, enthusiastic support of the entire hospital personnel. 
Commanding Officers. The Commanding Officer must take an active in- 
terest and must exert himself to sell the idea to his staff. 
Chief of Section. The Chief of the Reconditioning Section must have 
abounding enthusiasm, great Insight, and organizing and planning capacity. 
A background in training troops would prove useful. He should give his 
full time to the project. He, also, has a responsibility in selling re- 
conditioning not only to his assigned assistants, but to the hospital staff, 
new patient increments, and to all the auxiliary services whose help he will 
need. 
The utilization of a Medical Corps officer to at least initiate the 
program and get it going is desirable chiefly because of his familiarity 
with hospital operation and his vision and insight regarding the many medi- 
cal problems affecting the various types of patients to be serviced. 
In our orgaAnization chart the reconditioning section has .been rated at 
the same level as the several professional services. Experience may prove 
that an especially well-qualified officer of the Medical Administrative Corps 
could conduct a well-running section; or perhaps any properly qualified 
Branch Immaterial officer could be used. Such a non-professional officer 
should be qualified by training in educational and physical conditioning. 
He should have some formal or practical background in psychology. 
The Chief of the Section should be utilized to plan and organize the 
program and supervise its functioning in order to assure the full utilization 
•f his assistants and of ancillary services. He should not be tied down by 
any routine duties foreign to his job or even incident to his job. He should hold frequent conferences with his assistants and act as a t 
consultant to them and ta individual patients whose problems are•particu- 
larly difficult. He should keep the hospital Commander advised as to the 
conduct of the program and as to the results being obtained. 
Educational Officer. (2 enlisted or civilian assistants) This 
officer will bo responsible for the carrying out of academic educational' 
training, "quickie" language courses, illiteracy classes, typing classes, 
military training classes, and the like, 
academic Education. He should interest himself in seeing that selected 
patients take advantage of the educational facilities afforded by U, 3, 
Army Forces Institute Courses. He should devise means for getting infor- 
mation to patients of the existence of these courses. He should arrange 
for interested patients to contact him directly or through his enlisted 
or civilian assistants. From a guidance standpoint he should determine 
the advisability of a patient beginning the follow-up course desired or 
a modification of the patient’s choice, in some instances contacting by 
mail the high school or college at which the patient formerly was en- 
rolled, (Some high schools credit a man with one point for each promotion 
in grade). He should assist patients in preparing and dispatching their 
applications for these courses. He should make known to patients the 
availability of appropriate text books in the hospital library. He 
should organ!? e special classes for groups, perhaps obtaining the 
assistance of the services donated by professors or school teachers in- 
nearby institutions. He should catalog patient instructors who are un- 
covered by his assistants or by others who have been requested to be 
on the lookout for such individuals, 
"Quickie" Language Courses. He should stimulate interest in "quickie" 
language courses’. While these courses have proven their usefulness for 
individuals who undertake them seriously and with a sustained interest, 
one may expect sharp rises and declines in the utilization of this activity. 
In the conduct of this project he should encourage the use of other 
patients as instructors who know the language, and should not overlook 
the feasibility of utilizing gray ladies, civilian language teachers, and 
so forth. 
Illiteracy Classes. It is probable that the Red Cross staff will be 
the most fruitful source of aid in conducting these classes. 
Typing Classes. He should be prepared to maintain typing classes 
since this is an activity for which there wall nearly always be candi- 
dates. It not only has practical training application, but may well tie 
in as a form of occupational therapy. 
Lilitary Training Classes. Classes in camouflaging, identification 
of aircraft, radio code, hygiene and sanitation, and the like, must be a 
part of the continuing program.. Hospital staff personnel and patient 
officers and enlisted men of appropriate branches fit well into this type 
of instruction. 
Orientation. He should maintain close liaison with the- Post I'orale 
Services and Special Services Divisions in order to be certain to obtain 
and be able to disseminate the latest orientation materials to the patients 
through any available medium, such as movies, orientation talks,'discussion 
groups, posters, bulletin boards, and patient publications, this 
activity overseas officers and enlisted -patients may be used with great 
advantage to the instructors as well as to groups. The educational off:*cer 
may be able to arrange, if he maintains close liason with the Public Re- 
lations Officer, tours by groups of patients to industrial plants and points 
of historical interest. It has been observed that this activity has a fixe 
public relations effect. An attempt should be made to include in these, 
groups patients who are .prospective cases for separation from the service 
by C.D.D, He should assist the Public-Relations Officer in selectin': "battle casual- 
ties for attendance at public functions, such as bond rallies, patriotic 
gatherings, war plant flK" awards, and so forth. 
Physical Education - Class 3 and k. (1 IT CO per pGO normal beds) The 
assignment of 1 HCO per 500 normal beds vs probably predicated upon the idea 
that till Class p and k physical educational activities ore to be carried 
. out in the wards or in areas adjacent thereto. With such a conception thfs 
personnel should be used to train ward masters to supervise calisthenics 
for. bod patients and ambulatory patient exercises and games and to super- 
vise the execution of this program. The utilization of ward masters for 
this purpose has been reported to have been successful in some installa- 
tions, It has been used in this hospital in only a limited degree be- 
cause it has been felt that in active wards it might Interfere with the 
normal duties of ward attendants in the care of the sick and thereby 
preclude their unfailing execution of this duty; because of the frequent 
shifting, of ward attendants; and chiefly, because it has been our plan 
to carry on Class 5 physical education in the gymnasium rather than in the 
ward. If it is planned to give physical exercises to Clans 3 patients in 
the ward, at- is not clear how the most efficient use could be made of the 
■gymnasium which Is- provided for this purpose. Would it not be preferable- 
not to specialize these instructors but to utilize them, together with 
the two enlisted men allotted to the educational officer, in the coordina- 
tion and supervision of the participation of patients in all activities? 
We. have designated enlisted men assigned to the reconditioning pro- 
gram-as ward leaders to distinguish then from the ward masters. The 
term appeals to us and I am inclined it should be adopted. The giving of 
rank to these men is going to be a big help. As you noticed, this after- 
noon some- - of these men who arc loading these classes are still pri vates, 
I They would receive more consideration and more respect from patients if 
they had some rank. 
Physical Education - Class 1 and 2. (2 officers, MAC, 1 Tech, Sgt. 
qualified, in physical education, plus 2 Sgts.) One of those officers should, 
be utilized, in the administration of the Class 1 and 2 groups as Command- 
ing Officer. He should, be responsible for-.all-activities of the groups 
and with the necessary liaison with the hospital professional services, 
... ; \ ■ * : • ' ; 
One officer should be utilized as hie assistant. He should conduct'a 
largo part of the physical apd military training, including orientation- 
and an;y other activity incident to company training, using overseas officer 
patients as assistants. One non-commissioned,officer should be utilized 
as acting first sergeant and charged, with the conduct of physical educa- 
tion of Classes 1 and 2. The other two iJCOs should be utilized, as platoon 
leaders. Overhead, personnel, such as company clerk and supply clerk, 
should be, assigned from,the hospital Service Unit, 
Close, liaison with the hospital professional services must be main- 
tained by. the assignment, of a- medical officer, preferably from the ortho- 
pedic- section, to assist the training officer in the proper classification 
of patients, to make appropriate notes on clinical -records as to the pro- 
gress of patients, and to render advice as to limitations in exorcises 
applicable to selected eases. 
Adequate office space should be provided, for the Chief of the Section 
and- overhead office personnel furnished by assignment from the hospital 
Service Unit, • , .. 
COL.. THORHDUCFI; Thank you,' Colonel Winn, It is s. great pleasure for 
me to introduce the next speaker who probably needs little introduction as 
ho has. carried, the burdens of the Reconditioning Division for nine months. 
•Major Barton will talk on ”A Program for UP Patients." Major Barton. MAJOR WALTER E, .BARTON 
A PROGRAM FOR RECONDITION BIG THE NEUROPSYCHIATRIC PATIENT 
Last 'year approximately 167,000 patients with neuropsychiatric disorders 
were released from the Army with a certificate of disability discharge. Addi- 
tional thousands were lost to’the service thru Section VIII and Section X 
discharges. Estimates indicate that 53? to hyfi of the total ODD's from the 
service were neuropsych.iatric cases. Just how many patients had a history of 
previous nervous or mental Illnesses or emotional disturbances, or how many 
could have been salvaged through prompt and adquate treatment will never be 
known. The acute manpower shortage makes it Imperative to undertake inten- 
sive treatment of certain nervous and mental cases in all station and general 
hospitals. This is necessary in order to conserve a very Important source 
of manpower. 
An erroneous attitude has arisen to the effect that no neuropsychiatric 
patients should be treated. This is a misinterpretation of directives. For 
a long time it liras thought that admission to neuropsychiatric wards was 
tantamount to discharge. In order that recoverable patients may be dis- 
tingulsed from others some explanation of the common sources of mental and 
emotional upsets seems necessary. It is easy to understand how a soldier, 
fighting in Cassino, might break down mentally under stress of combat. Accord- 
ing to news accounts, men fought from living room to the kitchen of a house 
and if they stepped out into ten yards of open space they were sure to be 
killed. Very often in such an embattled house they experienced its being 
shot away stone by stone. Under such stress, continuing; day after day with- 
out relief, even the most normal person may break down emotionally. Every- 
one has a breaking point. The dazed and confused man who is burled by a 
shell may develop an emotional disturbance and become a neuropsychiatric 
casualty. The man who was ’’pinned down" by machine gun fire may also develop 
a.nervous illness under distress. Think of the term, "pinned down", as 
applied .to the men on Tarawa Beach, Hour after hour they were compelled to 
stand, in water with only their noses above the waves, gulping avid retching 
salt water while machine gun bullets whizzed overhead. Any attempt to get 
into a comfortable and tolerable position was certain death. Under such a 
terrific strain, even the most normal person may develop an emotional dis- 
turbance. In other words, the situation may be so terrible that it may In- 
duce a nervous illness. Situational mental illnesses, if properly handled, 
are usually recoverable. Too often we think of the neuropsychiatric patients 
only as the weak sisters or the fellows who slipped through the screening 
process. Some, of course, do fall into those categories, but there are 
other typos of cases as well. Insofar as treatment is successful in one 
group, it is important to make this distinction. 
Less than 15/--* of neuropsychiatric disabilities are of the type commonly 
associated with the term in the mind of the layman. These are the serious 
mental,disturbances or psychoses. Of these, are acute reaction types, a- 
typical confusion states, from which prompt recovery may be expected with 
adequate treatment. About 10*p are neurological disorders and have no asso- 
ciated. mental abnormality. The remaining 71?'/5 fall into the group of disorders 
known as psychoneurooes. More than l/P of the latter may be expected to 
recover with prompt treatment. 
In planning a reconditioning program for the neuropsychiatric patient, an 
understanding of certain primary concepts is essential. The first of these ‘s 
proper housing. Psychotic patients and prisoners should not be intermingled 
with others in the neuropsychiatric service. The person who is disturbed 
emotionally is all too ready to jump to the conclusion that,the doctor believes 
he has already lost his mind. It is something he may greatly fear. Do not 
lock, patients up on closed wards unnecessarily. A real barrier to treatment 
develops In the resentment engendered unnecessarily by harsh methods. It may 
be necessary, during the period, of evaluation and hospitalization for a lew 
days, to use closed ward.s. It will also, of course, be necessary to confine 
on locked, wards patients during the acute phases of their illness. Patients 
are to be pierced on open wards if it is at nil possible. In the average Army hospital, if there are six neuropsychlatric wards, we may 
expect that one or two should he closed locked wards, end one he set aside for 
the acute admissions. The other three or four ward.s should he used, for recon- 
ditioning. There are three neuropsychiatric officers assigned to the service 
'n most hospitals. One of these should devote full time to the reconditioning 
treatment program. Good attendants who are interested in their work and have 
a genuine desire to help a mental patient are absolutely essential. Too often 
the poor attendant, who has not made good on other services, and the misfits 
are assigned to neuropsychiatric wards. The attitude one has toward the neuro- 
psychiatric patient is fundamental in therapy.. The kind attendant, through his 
attitude and helpfulness, looms large in the success of any treatment program. 
It is important that there he a nucleus of personnel with experience in the 
management of the neuropsychiatric patient. The trained attendant may he ex- 
pected to educate others, who are assigned, in the proper approach and manage- 
ment of emotional problems. 
The expectancy of recovery •* complete recovery - should peimeate the 
atmosphere of a neuropsychiatric service. The patient should be treated in 
the same normal manner as one would treat patients suffering from any medical 
or surgical disorder. They should not he treated as fools or children, or re- 
ferred to by medical officers and hospital staff as "nuts”, "near nuts” or 
"screw halls". Pegretably such terminology is too often heard in hospitals and 
results in real harm in therapy. Patients on neuropsychiatric wards are suiter 
ing from the emotional disturbances of war. These disturbances have proper 
names by which they should be called. One cannot stress too frequently the 
fundamental nature of proper attitudes in therapy. 
A definite planned program of progressive character la an essential. It 
is a comfort to the patient to know that the physician has a plan for therapy. 
Confidence is built in this realization. A neuropsychiatric treatment program 
and reconditioning vary only in terminology. For years psychiatrists have been 
using what is now known as reconditioning as a part of the active therapy of 
the nervous and, mental patient. It has also been found that the patient must 
understand that the planned program is treatment for his disability. He must 
also realize that he has a share in the responsibility for getting well. His 
success is dependent upon his ability to follow the program as prescribed. 
Important to recovery from a nervous or mental disability is prompt 
attention by the physician. The initial interview should not be postponed. 
The first contact with emotional disturbances is all important. The opening 
Interview should be made while the emotional disturbance is still very active 
and before an adjustment to the hospital has been made. The physician builds 
conf idence in himself through his interviews with the patient and makes it 
possible for him to assure the patient and. to offer him suggestions. In 
any program for nervous and. mental disorders, there is no substitute for 
psychotherapy. To be sure, many short cuts will be necessary to cover the 
limitations in personnel. Pat lent-doc tor interviews cannot be displa.ee d. 
There are many specialized approaches to particular types of mental illness 
which are -important, but they cannot be mentioned within the limitations of 
this discussion. 
Group therapy will be found beneficial in the treatment program. 
Valuable assistance will be gained from the lectures which have been pre- 
pared .as guides and published in Medical'Technical Bulletin Ko. 12. In group 
therapy one may discuss personality development, the development of defenses 
which normal people build, against stresses, ,how defenses so built often fall 
and how that failure is expressed in symptoms. One can relate the symptoms 
so expressed to the bod.y systems such as the nervous system, gastro-intestinal 
system, cardio-vascular system, etc. Discussion should be encouraged on the 
part of the patients. 
Constructive.activity should be prescribed as a part of the recondition- 
ing program for its value in the sublimation of symptoms. The types of 
activity, with very little change, can be those already outlined in the 
basic reconditioning program. There are differences only of emphasis. Too 
21 strenuous physical activity should he avoided. Frequently,it is found that 
many patients do not participate wholeheartedly in calisthenics. Similarly, 
combative games with body contact, especially the-more vigorous ones, are 
avoided. The nervous and mental patient may also cooperate poorly in 
military drill. The patient will find excuses in his aches and pains’ for 
inability to participate. Ke is, however, drawn more easily into sports and 
game The pain in the back which prevented his stooping in calisthenics 
is no handicap in an exciting, game of basket ball. Physical recondition- 
ing may b© introduced through games and. sports. Soon the patient realizes, 
without his being told so, or his attention being called to the fact, that 
his disability no longer troubles him so greatly. The sports, games, grass 
drills, .and assigned general■ work activities are usually accepted. 
Occupational therapy plays, a more Important role in the recondition- 
ing of a nervous and mental patient than in any other group. In the term, 
occupational therapy, one should include an extension beyond art work and 
handicraft to all occupational activities that may be prescribed for their 
therapeutic benefit. What is known as occupational therapy merges into in- 
dustrial therapy, There are many opportunities for work assignments around 
the hospital which make it possible for patients to work at specific tanks 
that are usually assigned, only to duty personnel. In this group fall work 
out of doors on the grounds, landscaping, gardening, work in utilities, 
maintenance and in offices. This Is not to minimize the value of other 
types of occupational therapy as well. Art work, music, drama and the edu- 
cational program also have increased in value in therapy to the nervous 
and mental patient. In recreation, one plans to develop group participation 
rather than passive observation of movies and entertainers. 
The IIP patient will profit if he can be put back into a duty uniform. 
Anything that diminishes the feeling that he is sick is helpful. There 
is too much inclination to sympathize and. to over-examine the emotionally 
disturbed patient. Ee is usually quite willing to accept sympathy and 
seeks for evidences of organic proofs of. his discomfort. Wearing a duty 
uniform is.one small but important step of taking away the implication of 
illness. - .... . , 
‘t**’.' • J . i 
Another point of importance in the reconditioning of patients with, 
nervous and mental disorders is the proper reclassification and assign- 
ment upon return to- duty. There is, a sense, of security to be gained from 
the knowledge that even in so vast an organization, as the Army pro or use 
of one’s skills and talents can-be made, A valuable,step in this directi on 
has been achieved through WD Circular FOj,- 100, dated 3 March lit A Section 5 
of this circular prescribes*- a • form for, the, description. of patlent' s d ; s- 
ab ill ties which; may be forwarded ,tp the bine... off icer and may serve as a 
guide in reclassification. • ' 
At the present time, there are several experimental set-ups' develop- 
ing a reconditioning process for NP patients. In the Second Service 
Command, the England General Hospital has a reconditioning section where , ; 
the NP patient In Classes 1 and 2 may be specially processed and'handled.' 
When it is certain that he may be expected to return to duty as a Class 1 
patient, he is transferred to the general group of reconditioning trainees 
and. his identity as an NP patient lost. Three Replacement Training Centers 
are also operating a special program. These are Camp Leo for the Quarter- 
master Corps, Aberdeen Proving Ground for Ordnance, and Fort Pelvoir for 
the Engineer Corps. Patients convalescent from NP wards are sent to one 
of those three centers from hospitals. At the center reclassification is 
made on the basis of training, experience, interests and the limitations 
induced by his illness. Trainees are assigned to some of the following 
courses; clerks, bakers, welders, truck drivers, mechanics, instrument 
repair work, refrigeration, gun repair, train operators, ness and others. 
It was at first thought that persons with emotional disturbances might 
22 require a, slower rate of school training* If was, however, found that usually 
most men can continue at the same speed* Preliminary estimates indicate 
that from hOcf to 90 £ of the patients sent to these replacement centers may 
he successfully returned to duty. In other words, It is possible to take 
men who have suffered an emotional breakdown in one assignment and after a 
period of initial treatment to screen then, resurv.qy them, and place them 
in new retraining assignments. 
It is necessary at this time to emphasize the importance of a treatment 
program for nervous and mental cases and to expand the reconditioning pro- 
gram to meet their particular needs. The Medical Department has under 
consideration now a plan which greatly extends the type of activities that 
have been described in this discussion. In the proposal under considera- 
tion, when a patient is received at the evacuation hospital from overseas 
he will appear before a screening board that nay send him to one of four 
different places. About 10f/ may be expected to return directly to duty. 
Borne patients, by the time they reach the evacuation hospital, have com- 
pletely recovered, from their emotional upsets. Hospitalization Is, quite 
unnecessary, in fact it can do an actual harm. It may be expected that 
10d would require no hospital care other than the Initial classification 
and screening process. Secondly, about 20 f will be found who are obviously 
unfit for further service. These will include the serious mental cases 
and those with a poor history. These are to be sent to designated general 
hospitals which have provisions for nervous and mental cases. The general 
hospital may discharge those which do not respond to treatment. Thirdly, 
about 50/I of the patients received in the evacuation hospital for initial 
screening may go directly to the reconditioning units of a general hospital 
- the advanced reconditioning section or the NP reconditioning.section. 
Many of this group may be expected to be able to return to duty after such 
treatment. Fourthly, about of the patients received may be expected 
to go directly to a Heplacement Training Center, Here it would be anti- 
cipated that probably 2CKI would, be unable to adjust. These would be sent 
to the station hospital for discharge from the service. About 80$ of the 
group, however, might be expected to be retrained for further duty assign- 
ments., It is to be understood that those figures are only rough estimates 
based upon the results to date in the trials now und.er way. 
■ . / . ; . h.‘ - i . i 
... In the attack on the important problem of NP disability, the Medical 
Department has placed great emphasis upon prevention. Greater care has been 
taken.at the induction point to eliminate the unfit and those likely to break 
down und.er stress. Psychiatrists have been assigned to divisions in order 
that early problems of maladjustment may be detected and. also to assist line 
officers In the prevention of emotional disturbances through his contacts. 
Heplacement Training Centers have established mental health clinics for 
the treatment of early emotional disturbances, for education of personnel, 
and for screening. lixporlence has shown that intensive treatment at the 
front results in a high proportion of successful cures from emotional 
disturbances. It is reported that from 60c,j to 80 yj may be returned to duty 
overseas without evacuation. The planned expansion In reconditioning 
of the NP patient is aimed at those who d.evelop mental and emotional 
disturbances in this country or who are evacuated from overseas. It is 
hoped that by screening at the receiving many can be kept out of 
hospitals; that others will require but short periods of observation, 
and that most, through reconditioning and reclassification, may be returned 
to duty. Under such a plan, it might be expected that the nervous and 
mental patient will have a much better chance of recovery than he has 
had up to now. 
22-a ■ COLONEL THORBIDIKE: Thank you, Major Barton. Nov;, we.will tall on 
Major Johnson who has had very wide experience on the subject "Flaming 
for the ODD.” Major Johnson. 
MAJOR E. G. JOHNSON 
Planning for the CDD patient is a problem that presents many puzzling 
situations. A number of agencies have been set up to, or are assisting in, 
this very important social problem -- Chaplain, Red. Cross, United States 
Unemployment Service, Veterans Administration, Army Emergency Relief, Re- 
employment Comraittemon of Local Selective Service Soar'd, Vocational Re-, 
habilitate on and Training Division of Federal Security Agency, Legal 
Assistance Officer, and Personal Relations Branch. From what I have been 
able'to learn, the perfect solution for all has yet to be found -- certain 
cases', A large number appar'ently, have been satisfactorily handled. The i, 
actual solution of each individual problem; of course, is eventually in 
the realm- of these several social’agencies, the Veterans Administration, 
and the individual himself. 
It is, in its' basic concept, a problem of. readjustment to civilian 
life. One doesn’t suddenly become adjusted to civilian life the minute 
he receives his discharge' certificate. Hero too, it is necessary to pre- 
pare one’s mind' for a new way* of life' and frequently with the knowledge 
ahd sudden' realization that physically or mentally all is not just as it 
used to soCm. It is a strange world to which the ODD returns -- perhaps 
because it has1 changed and- partially because his view point has changed. 
Gomehow,-somewhere during hospitalization, by some person or persons it 
■'s necessary to did this man in his readjustment. 
The logical answer seems to be that this prospective CDD should be 
placed in with others of like nature and. there the entire group prepared 
for the transition. A program of physical activity and conditioning, 
academic training if- indicated., occupational therapy -- .especially de- 
signed to provide means of vocational sampling when available, recreation, 
talks- by representatives of the .social agencies, group therapy for the 
physically- unfit,- as' well as the IIP cases, special rehabilitation for the 
partially 'or completely disabled In the various centers specializing in 
such cases -- all of these have definite value and should .be started as 
early as'possible. We have been using some of the methods, in part or 
in whole. Certain events’ transpired which mode the effective utilization 
of a CDD ward, impracticable. The pressure of more effective utilization 
of -manpower, the reduction in-ODD-’s the speed- up system in processing 
CDD ’C 'after: the final'decision ha!d been made by the board,, combined with 
the fact that the greatest per-cent.’ of CDD ward patients leave the hospital 
within three1'days of the final board-proceedings.' The, straight CDD ward 
was discontinued to reduce a need less a(hnini.Strative burden. 
23 The planned expansion in neuro-psychiatric reconditioning stresses 
the importance of preventing, at division levels, anticipated emotional 
disturbances to insure proper handling of the soldier. In order to 
prevent nervous disability at Replacement Training Centers there must be 
a proper screening of emotional problem people. Secondly, there must be 
intensive in the front lines, V.e have seen statistics/coming 
back to us from oVqrseas, that, with prompt care, 60$ to 80$ aiV return- 
ing to duty overseas without evacuation. Those who are returned to the 
zone of the interior b$n be screened at the receiving point srb that they 
will not stay in hospit&.l for additional observation as neuropsychiatric 
patients really require Wry little in the way of active treatment. I 
hope that under such a plaK the nervous and mental patient will have a 
very better chance of recovery than he has had up to nof'. 
COLONEL THORNDIKE: Thank you, Laior Barton. we will call on 
Major Johnson who has had very wide experience on thf subject "Planning 
for the CDD." Major Johnson, / 
KAJOR E, G. JOHNSON 
Planning for the CDD patient is a presents many puzzling' 
situations, A number of agencies have been sjn: up to, or-are assisting in, 
this very important social problem — ChamLajSi, Red Cross, United States 
Unemployment Service, Veterans Administrate#!'!, Army Emergency Relief, Re- 
employment Comraitteman of Local Selective Service Board, Vocational Re- 
habilitation and Training Division of Federal Security Agency, Legal 
Assistance Officer, and Personal Relations Branch, From what I have been 
able to learn, the perfect solution foaf all has yet to be found — certain 
cases, a large number apparently, hav# been satisfactorily handled. The 
actual solution of each individual problem', of cdurso, is eventually in • 
the realm of these several social agencies, the Veterans Administration, 
and the individual himself. J 
It is, in its basic concept, a problem of readjustment to civilian 
life. One doesn’t suddenly become adjusted to civilikn life the minute 
he receives his discharge certificate. Here too, it % necessary to pre- 
pare one's mind for a new way of life and frequently with the knowledge 
and sudden realization physically or mentally all as not just as it 
used to seem. It is a strange world to which the CDD returns — perhaps 
because-it has changed add partially because his view point has changed, 
Somehovif, somewhere during hospitalization, by some per senior persons it 
is necessary to aid tMs man in his readjustment. 
The logical anp/er seems to be that this prospective Cm) should be 
placed in with others of like- nature and there the entire giwup- prepared 
for the a program of physical activity and conditioning, 
academic training if indicated, occupational therapy — especially de- 
signed to provide means of vocational sampling when availablerecreation, 
talks by representatives of the social agencies, group therapy!for the 
physically unfit, as well as the NP cases, special rehabilitation for the 
partially or completely disabled in the various centers specializing in 
such cases f- all of these have definite value and should be stfrted as 
early as possible. Wo have been using some of the methods, in efirt or 
in whole. Certain events transpired which made the effective utilization 
of a CDD ward impracticable. The pressure of more effective utilization 
of manpower, the reduction in CDD1s — the speed up system in processing 
CDD’s after the final decision had boon made by the board, combined with 
the fact that the greatest percent of CDD ward patients leave the hospital 
within three days of the final board proceedings. The straight CDD ward 
was discontinued to reduce a needless administrative burden. This was a little disconcerting and the possibility of lengthen- 
ing the administrative days for this processing was discussed but not 
considered advisable. Of course, it is known before a patient is 
boarded that he may be discharged, but for the sake of the morale of 
those probable CDD’s who later are decided capable of useful service, 
it does not seem advisable to assufie too much and thus cause confusion 
and thereby instill seeds of dissatisfaction, I shall come back to 
this local problem later. 
The group approach may, in some instances, be utilized in NP cases 
but here also, even more perhaps than in other erases, the "mild" case, 
if he is going to be of value, should begin as early as possible to 
make up his mind‘that he is going back to duty and do a good job of being 
a soldier. The local situation must be studied. In many sections it 
may very well be determined that the war officer in his contacts with 
the NP patient is afforded the best opoortunity to begin this re-cduca- 
tion. It may require a little missionary work on someone’s part but 
the end is justified. Group therapy must be cautiously applied to 
avoid instilling dissatisfaction and dissent. 
The streamlined system evolved at this hospital for processing CDD 
patients has been adopted by the SGO end a directive that it be used in 
all Army hositals has been promulgated to all Service Commands. There- 
fore, the problem to be brought out now wi11 in the future be met by 
other reconditioning programs. For a moment I shall,discuss the system 
of CDD proceedings at this hospital. The usual notice is given to the 
Registrar by Ward Office and the information and names then listed nd in 
turn sent to the Red Cross and Veterans Administration Representative, 
The man goes before the Board and ’when CDD is decided, leaves the bPard 
and is immediately sent to the Representative of the Veterans Administra- 
tion for discussion of his problems — insurance, pension claims, etc. 
He is sent from there to the Discharge Section of the Military Personnel 
Branch where his WD AGO Form 53 is completed. Next, he sees the U.S. 
Employment Representative where the usual processing occurs, then to the 
Red Cross, The following day he returns, with other CDD patients 
(to be CDD’d) to visit the Veterans‘Administration Representatives end any 
questions are taken up for discussion mid unfinished business attended to 
at once. He is also being cleared administratively and in three days 
he is out. Not much time for processing.’ Incidentally, if the Board 
has any question in its mind as to whether or not the man can be of use 
to the service in any capacity he is to the Classification Officer 
(of the Adjutant General’s Department Branch) and expert advice is 
secured. Thus the routine CDD case has little chance for group dis- 
cussion. Our planning for this type of case has evolved into a system 
of checking with the various agencies to determine several pertinent 
facts at about two or three weekly intervals — i.e,, do the patients 
know the nature of their illness or'injury and the limitations; arc 
they being informed of their rights, etc. 
All these agencies are given time on our lecture program periodi- 
cally to talk about their duties and how they can help patients in the 
Army and also how those leaving the Army may be helped. This is a very- 
strong morale factor for the average patient going back'to duty mid for 
the patient who suspects that he may be CDD’d presents him with the 
agencies through which he will be aided in readjustment. 
The long term CDD or patient who is known to be certain CDD 
material is handled by the Red Cross through the social workers. Infor* 
mation of their problems get to the Red Cross in several ways, (1) from 
the Ward Officer (2) from the "ward leaders", (3) Grey Ladies and (4) 
frequently from the patient himself because so many of them have family 
problems or social readjustments which come directly to the attention 
of the Red Cross or the Chaplain who in appropriate cases refers them 
to the Red Cross. Since the Ward Leaders make out the questionnaire on each patient and 
learn his story and then consult the Ward Officer as to physical classi- 
fication and probable disposition and date, frequently the problem comes 
to the attention of the educational officer and active planning is insti- 
tuted from several angles. Our study exhibit in the library on "Your 
Future Job" gets the attention of many patients who subsequently come to 
the educational officer for advice. This type of case almost invariably 
knows his probable disposition long in advance and has considerable time 
to think about the future. Key individuals must be made conscious of 
this problem and pass the information along to the proper persons. 
On our weekly tours of which we have from two to three, in the 
various industrial plants in Clinton, 50% of those participating are 
CDD patients or probable CDD patients. That is giving some of them, 
at least, an opportunity to observe civilian workers and to begin 
thinking along the line of a civilian job. Lectures are given in the 
afternoon - a series by various industrial and civic leaders in the 
community - a local judge, highschool teacher, superintendent of a war 
plant, etc. Whereas every patient to be returned to civilian life may 
not be included in these tours, discussion is created on certain points 
and brought up in local ward "bull sessions" (and serve a useful pur- 
pose), In the NP wards, especially, films of vocational guidance nature 
have been secured through the visual aids departments of nearby uni- 
versities handtools, machineshop work, mining, lumbering industry, 
etc. 
In conclusion, planning for the CDD one may break it down in three 
classifications: 
1, The cripple or disabled from blindness, deafness, amputation, 
etc,, who can be cared for by; 
a. Education. 
b. Occupational therapy and vocational training, 
c. Special centers for their respective disability. 
2, The long term CDD who requires considerable time for maximum 
hospital benefit: 
a. It can be planned for by thorough training, 
b. Early notification of auxiliary services by any satis- 
factory system. 
c. And finally Education - formal, lectures, tours group, 
talks and vocational therapy where indicated. 
3, For the short term CDD it is essential that an efficient 
system is set up for the operation of the ancillary services, 
COLONEL LYNCH; Colonel Thorndike, I would like to inject a few re- 
marks with particular respect to CDD’s. 
Major Johnson brought up several points which I thought I might clar- 
ify particularly with regard to the views of the War Department, With 
respect to the coordination of the information as to the re-employment 
and rehabilitation of veterans in connection with the War Manpower Commis- 
sion and the Selective Service System and numerous other agencies, the 
President appointed an In-Service rehabilitation committee which operates 
on the level of the various executive agencies concerned. At the present 
time the 'Aar Manpower Commission is operating several veterans’ demonstra- 
tion centers. The Second Service Command is cooperating in that, as a part 
of an overall study being made by the ASF in connection with discharge pro- 
cedures, As a result of the experiences obtained in the operation of those centers, more concrete and specific instructions should issue before 
the problem of CDD's builds up to an extent that it may make our present 
system unworkable. It is the personal interest of the Chief of Staff that 
no battle-wounded man who has been disabled as the result of a wound re- 
ceived in battle be discharged if he can render useful service in the Army. 
Accordingly before you CDD a battle-wounded man — if he wishes to stay 
on — providing he can render useful -service, he will be sent to one of 
the three War Department reassignment centers and a determination made at 
that point. This is somewhat of a departure from our ODD policy and you 
will find this change in W.D. Circular 293 which was included in Circular 
100, I believe. 
However, under Circular 293, a man who can render useful service 
would not be CDD'd so you will find in the circular the exception appears 
that a man who has been disabled as a result of a combat wound will be 
CDD'd if he so desires. The point is that the Chief of Staff is person- 
ally interested in seeing that those men are allowed to stay on if they 
want to and if they are usable. 
Now as regards CDD, the ratter of introducing the fact that he is 
about to be CDD'd to the enlisted patient in the hospital has been a mat- 
ter of concern to quite a few officers on the staff. We have discussed 
it with the officer in charge of rehabilitation in the Marine Corps Staff 
and also with several in the Bureau of Medicine and Surgery in- the Navy. 
From the time we bring a man into the service until he gets into the 
hospital a soldier is under the guidance, command, and control of officers 
and non-commissioned officers. In many instances we have found, in general 
and in station hospitals — in making staff visits — that the patient 
learns he is to be discharged on a CDD by various devious and remote means, 
sometimes the Red Cross Director makes the initial step to advise him as to 
his rights as a veteran. We think that there should be a specific mili- 
tary procedure; preferably the news should be broken to the patient by an 
officer who would then make the necessary provision to have the advisors: 
either the Red Cross, Veteran's Administration, U.S. Employment Service, 
or those available to the hospital or other facility take the man over and 
give him specific specialized advice as to what he can expect and- do as a 
veteran. In other words, the initial step we feel should be made as a 
military job and handled by an officer. As to the technique of procedure, 
I am not competent to go into details. I will leave that to some of you 
who are much more familiar with the details but from our point of view on 
the staff, we feel that it is essential that* the initial contact be made 
on the command level, that is, as an officer to an enlisted man. 
Army Service Forces are working on a pamphlet which will coordinate 
and combine all of the facilities available to the discharged veteran. It 
is an information pamphlet. Action on it was started some months ago and 
was suspended but it has been revived and is being worked on. I do not 
know.the status of that pamphlet but it is another step under way in con- 
nection with the discharge procedure. 
COLONEL THORNDIKE: Thank you. Colonel Lynch. Do I understand that 
we are to proceed at once and have the officer give that information to che 
CDD patient? 
COLONEL LYNCH: Well, there has never been any standardized procedure 
we could find, but we feel that it would certainly bo the soundest a;- .roach 
rather than to have the man learn by rumor that he is to be discharged. He 
should be brought in and talked to and that is the opportunity that the of- 
ficer has to get over the fact that he is still a useful citizen; tlmt the 
training he has had in the army, in spite of the fact that he has been dis- 
abled, will make him a better citizen; that he can go back and do a job. 
It is important to his mental attitude to be convinced. BRIG- GEN HILLMAN: I think part of that is the Ward Officer’s job, 
COLONEL THORNDIKE: I think the officer has not finished his job 
until he has done that. It is the duty of the administrative officer 
to do his job and not rely on the Red Cross or anything else to in- 
form him. 
We come now to the final paper of the evening, ’’Disciplinary 
Problems and Their Management," Colonel Winn, 
COLONEL WINN: General Hillman, Colonel Thorndike, and Guests, 
I feel almost like apologizing for being up here so often but I 
had nothing to do with it myself — I am rather being picked on. 
Before I start my discussion on this problem, I woulk like to ex- 
press myself on this OLD problem, 
I have been an officer assisting in surgical wards in general 
hospitals and large station hospitals throughout my army career, I 
have never discharged a man or recommended e discharge for CDD without 
talking to the man personally and oing over all his problems with 
him. That is part of your duty os a ward officer, and I don’t quite 
understand how the impression has gotten out that the soldier is not 
informed by an officer that he is going to be CDD’d. Of course, he 
is informed by a CDD Buurd when he appears before it and he realizes 
the Board is carried on in a dignified manner and vnth an interest 
in the soldier as well as an obligation to'the government. This Board 
always tells the man what the story is and, in this hospital, the 
Veteran’s Bureau contacts the man within five minutes after he 1 >aves 
thet Board and his processing as to his rights and privileges begins 
right there. I don’t believe the patients in this hospital have had 
that complaint. 
Now as regards disciplinary problems. 
A hospital is a military installation. There is the same neces- 
sity for military discipline that there is in a company or squadron. 
The disciplinary problems in a general hospital are such that it is 
difficult to discuss them in connection with the Reconditioning Pro- 
gram per se. 
In the class 1 and 2 group, which is conducted as a convalescent 
detachment and in much the same manner as a company or similar unit 
is administered, the disciplinary problems are little different from 
those ordinarily encountered in such units. They, consist chiefly of 
absence without leave, overstaying of passes, occasional drunkenness 
and disorderly conduct, and lack of cooperation (goldbrieking), Every 
effort is made to produce and maintain a high state of morale, among- 
this group, v/hen a patient first enters the group, he is given a copy 
of the rules to which he .is to conform and the privileges he may enjoy. 
The Commanding Officer of the detachment explains these things in.an 
interview with the man who is made to understand that there is a Com- 
manding Officer. The purpose of the program, as outlined in Circular* 
Letter No. 293, SGO, is explained to him in an effort to make him clear- 
ly understand what we are trying to accomplish. Passes after duty hours 
are given more liberally than to ward patients. Ordinarily a man gets 
a pass twice a week from 1600 to 2300 and on Saturday from 1300 to 
0100 Sunday. About every other week a weekend pass from 1300 Saturday 
to 2300 Sunday may be given if the soldier has a special place to go. 
Passes are denied for breaches of discipline, A company punishment 
record is maintained. However, reprimand, admonition, and company 
punishment are utilized to the fullest extent and are usually suf- 
ficient. For serious breaches of discipline patients are tried by 
summary court, sentences being limited to restrictions end fines. It has been a common experience to note a distinct change for the 
better in the soldier's attitude towards his treatment, as well, as his 
zeal for service, following his transfer from hospital environment. The 
change usually begins when he dicards his hospital clothing and resumes the 
uniform. Little trouble is encountered by lack of cooperation. The soldier 
usually eventually falls in line when he finds himself out of step with the 
spirit of his comrades. 
Disciplinary problems of Class 3 and 4, of course, are those conmon 
to all hospitals whether a Reconditioning Program is conducted or not. 
There are a few patients who refuse to participate in the Reconditioning 
Program. This sales resistance is usually overcome by the proper sort of 
persuasion. Limitation of passes and extra ward fatigue may be necessary. 
This problem is usually handled by the administrative ward, officer. Fail- 
ure to report for scheduled activities is a constantly recurring problem. 
Its incidence is directly in proportion to the degree of organization of 
the Reconditioning Program. It is combatted by encouraging increased co- 
operation on the part of war'd personnel and by limitation of privileges. 
It may be considered an index of the efficiency of the ward officer and 
administrative ward officer. Absence without leave is an ever present 
problem. Its incidence varies from time to time and it is influence by 
the type of patients making up the several convoys. It usually occurs in- 
patients who have been given passes, although there have been occasions 
when patients secured their clothing through lax ward administration. 
Restriction of privileges and company punishment by the Commanding Officer, 
Detachment of Patients, has not been markedly effectual. Trial by summary 
court is resorted to in the case of chronic offenders. If the habit of 
going AWOL or being guilty of drunkenness is interfering with the proper 
treatment of a patient, measures are provided to transfer him to the en- 
forced treatment ward where, of course, no privileges are extended. Over- 
staying of passes is a fairly common problem, 
Company punishment and limitation of privileges do not have the salutary 
effect which might be expected in an organization with a stable personnel. 
There are occasional cases of drunkenness. The sale of beer on the Post 
is limited to individuals in uniform. The introduction of alcoholic liquors 
to the hospital is carefully watched, but measures adopted so far have not 
been completely successful. Practically all of the drunkenness occurs in 
patients while on pass. This occurs in spite of the efforts of the author- 
ities in this community to limit the sale of whiskey to men in uniform. 
Many measures are taken at this hospital to orient the patient and 
improve his morale. Participation in the reconditioning program is one 
of the most important, While I have no exact figures to quote, it is the 
concensus of those concerned'with the question that disciplinary problems 
have definitely decreased as a result of the reconditioning program, I 
don't think there can be any doubt about it 
Upon admission to the hospital each patient is furnished a mimeographed 
information sheet explaining the policy of this hospital on the granting 
of passes and furloughs. This is one of the most important things in the 
soldier's mind when he comes to this hospital, "When can I get a furlough?" 
In addition to this, the same subject is explained by an administrative 
officer to groups of patients received in convoys as soon as they are ad- 
mitted to the receiving section. 
Machinery has been set up to insure the prompt payment of patients. 
We have patients in this hospital who haven't been paid for months when 
they arrived here f We pay them. ■ 
An informative booklet, which has been puL.on your dq-s;&,.donated . 
by the Northwestern Bell Telephone' Co., .giving information about the 
hospital and the community, which we hope will help the morale a little. The Telephone Company has provided, at its own expense, a telepnone . 
center with full time employees where patients may conveniently obtain 
proper change and where they nay sit comfortably while availing, long dis- 
tance telephone connections. ;In addition to this, each ward nas.reen 
wired so that it is possible .for any bedridden patient to use the long 
distance’telephone at any hour. This has proven on excellent morale fac- 
tor and one which"is frequently commented upon by patients. I mention 
tliis because they are-some of the reasons perhaps -day disciplinary pro- , 
blems are decreasing. ■ 
Through the courtesy of B* nai B'rith of Iowa there .is non being in- 
stalled throughout the hospital a centrally controlled radio system. It 
will be completed around the.first of April. Then completed, this 
system will make it possible to transmit to the wards programs carried 
on in the Red Cross Auditorium, selected recorded music, and such radio 
programs as may be selected. 
It is believed that all of the foregoing activities will strengthen 
morale and reduce disciplinary problems. 
There is another problem which might well be discussed at tnis time. 
It borders on some of the remakrs- which have just been m.. ue by previous 
speakers. As increasing numbers of overseas casualties are admitted to 
general hospitals, there is a necessity for a more flexible concept with 
respect to disciplinary management of hospital cases. During the past 
six weeks aporoxi nately 500 overseas cases have been admitted to this 
hospital. Approximately 85 percent of these cases were either convales- 
cing or had completely recovered from the disability which required their 
evacuation. A considerable number of these• patients worm either misin- 
formed or misinterpreted information with respect to present policies 
regarding transfer to general hospitals in die vicinity of their homes. 
They were likewise misinformed at some place along the evacuation line 
of their furlough privileges. Most of them expected to be jiven a 30 
day overseas furlough immediately upon their arrival at this hospital, 
because, they stated, they had.been assured at previous stops that tnis 
would be'done. One can easily imagine the effect of such' - state of 
affairs on the general morale of the hospital. At a panel discussion 
hold shortly after we received a convoy, a patient asked tnis question, 
although it was entirely irrevelant to the meeting: "ihy do our doctors 
lie to us about furloughs?" He then explained that he had been assured 
at the time of his evacuation from overseas that he would receive a 30 
day overseas furlough immediately upon reaching a general hospital in 
this country] that he was again assured by the transferring general hospi- 
tal that he would receive the furlough as soon as he reached this hospital. 
Of course this hospital does not grant overseas furloughs, oven after a 
man’s treatment is completed and he proceeds to his reassignment station. 
I think it would be a good thing if wo were allowed to jive these furloughs. 
You assign a man to a reassignment station - say he lives in Oregon and 
is stationed in New York - ho has to pay his faro all the way from New 
York to Oregon and back. An officer patient who was participating in the 
program and who arrived with the same convoy volunteered to answer this 
question and satisfied the soldier by explaining existing policies and 
the reasons for misunderstandings. The practice of disseminating this 
type of incorrect information should be discontinued. Ta soldier's 
chief concern is when a furlough can be given him, He is much less con- 
cerned about getting well. Because of the necessity of working up and 
evaluating the case, it has been our policy not to grant passes during 
the first seven days in the hospital. This allows'the-war officer time 
to work all of the cases up even when a large convoy is admitted, Many 
patients telephone their families as soon as they arrive and tnfamilies 
promptly entrain for Clinton. The patient insists that he be given a pass to spend with his relatives* 
Recently an officer went MOL from this hospital stating upon his return 
that he was sure a request for a pass would be refused and therefore 
knowingly committed this breach of discipline* When enlisted men hear 
of such conduct on the part of officers, the disciplinary problem for the 
hospital becomes most difficult, host of these difficulties are duo to 
the fact that the patient upon arrival at the general hospital is not 
in a true sense a general hospital case. The same personnel and fac- 
ilities which are designed to process and treat the injured and sick are 
required to process these cases. This is time consuming and wasteful 
of facilities which are needed for the purposes for -which they wore de- 
signed, War'd officers cannot ascertain merely by a casual inspection 
whether a patient should remain in a hospital or whether he should be 
returned to duty. It is necessary to work the case up, evaluate and 
make a decision as to disposition. It is believed that these difficul- 
ties will increase as time goes on and that consideration should be 
given to the advisability of establishing large’ convalescent centers for 
the direct admission of overseas casualties by transfer from ports of 
debarkation. General hospital personnel thus would be spared the time 
consuming efforts involved in processing non-general hospital cases. 
Oiir own policy on the furlough is this; if a man has been here a 
week and we have had time to evaluate him, and providing his ward officer 
recommends it, and providing he is probably going to have a prolonged 
hospitalization, he is given a seven day furlough plus travel time. 
Call it what you want; it isn’t sick furlough, it isn’t overseas furlough, 
and we don’t give ordinary furloughs. This is a psychological furlough. 
He gets his furlough, his morale is much better and he comes back, and we 
have less trouble in handling him. Thank you very much, 
• COL, THORNDIKE: Thank you Colonel Winn, That closes the program 
for the day. We have had a very long day and I wish to call your attent- 
ion to the hour and to the fact that'the program was completed five 
minutes ahead of time. Colonel Winn, we thank you very much for the 
efficient way you have taken us around today very much on schedule, It 
was very interesting. 
End of part One COLOKLL AUGUSTUS THORNDIKE 
•' Will the meeting please come to order? This mom.I: 3’s program is 
divided into two sections -- the Physical F Vines s Progr*.in and the Edu- 
cational Reconditioning Program, I hope everyone will participate in this 
discussion as I believe it is important that we have a ircc exchange 
of -ideas; The first speaker Js Dr, 0, E. McCloy, Preferaor of Physical 
Education at the State University of Jowa. Ee is the consultant in 
physical training to The Surgeon General. Els subject is, "Physical Fit- 
ness Program". Dr. McCloy. *; ; . 
DOC.OR C. E. McCLOY 
Very obviously, physical fitness is not the only of the total, 
fitness of a soldier. I think that that is one of the 'thgngs of which.- wc 
need to remind ourselves occasionally. Because of the fact that the . * , 
physical fitness program occupies such a large part In the recondite, oning 
of the soldier'in our hospitals, all too frequently it i s looked upon as 
be ins the one major thing, Actually, to recondition a. man to go baci.: and 
be the most effective soldier, his mental, his emotional, and his military 
reconditioning are just as -important, 
As far as the Physical Reconditioning Program is concerned, we arc not 
too much worried by the minor ills we find in hospitals. The man who is 
going to be at the station hospital for only four or five days does not . 
usually need to go through very much of a reconditioning program before 
he goes back to duty. He recovers very quickly and usually has relatively 
little residual weakness. 
I want to take up a number of major points. In the case of surgery, 
I thin}-: that most physicians and surgeons do not realize how much heavy work 
an individual can d.o almost immediately after an operation. We see bed 
exercises in most of our hospitals as a. rather gentle procedure. Let us 
take the case of an individual who has been operated for hernia. He has 
an injury caused by the operation but all the rest of his body is just as 
sound as it was before he was operated-. A .great deal of the feeling of 
prostration and that sort of thing exhibited- by the man, is emotional, fart 
of it is a sympathetic response which can be rather readily controlled, but 
he has been so accustomed in civilian life to thinking of tiijaseif .as an ; 
invalid when he goes into the hospital — he possibly was frightened before 
he was operated, and the emotional effect of,that fr lght; has affected his 
sympathetic responses — that he feels prostrated, But - there reason,, 
in the world why that man can’t do pretty heavy exercise with t^e.parts-qf 
the body:not'concerned with the operation,’ ’ ’ , . ... 
' . . v •:.£ „ *■ 7 l'’d f 
i am ygoTnig to succumb to the temptation to tell yop one .pieceof .per- 
sonal experience to show you tha/fc it aim not just .an! optimist and not just ■ ; 
talking-out'‘Of- non -medical - experience and theory,, ' I was’ operate,d-vfpr 
double herni&-'about fourjyearS aho at ah age quite.a’bit past the time..you. 
are getting these soldiers :in the hospital. My ' surgeon nslsted that i ..stay- 
in bed. Tor tHree weeks,; which .With his Ipemipsibn, however, at the 
end of the second dayf I began ’to fetlie Vorkouts .In bed much more strenuous 
than you saw in the gyimasium ye sturdily,” I did three th rty-five minute 
workouts a day, using largely tension exercises because I had no dumbbells 
or other equipment but simply worked one muscle group against the other. 
I worked as herd as I would, have worked had I been lifting weights, I worked 
everything but my abdominal muscles. I even "bridged" on my head and feet, 
with my knees straight, /my of who has tried this know that it is a 
rather sevcie strain on the back muscles. At the end of three weeks I was 
stronger muscularly than when I went to bed. I got out of bed at the end of 
three weeks and. had no unpleasant symptoms, though I had not even been out of 
bod. to to to the bathroom; I obeyed my doctor. I wasn’t dizzy; and I had. 
none of the usual symptoms of post-operative weakness. I then went out in 
the yard, and did a half-hour’s workout about like the one in TC 87* Then I took a five-mile hike over,the golf course, shot two hours of 
archery, walked another mile hack homo, arid felt fine. There I was, three 
weeks in bed without getting up at all, and I didn't even have sympathetic 
disturbances when I did fret up. The point is that the man who has been 
operated can work the non-injured parts of his body just as well as If he 
were a well man, j '■ . . .. r> 
One important function of this type of bed exercise Is to, combat the 
fooling that'-a- man Is an invalid. I am quite sure that -if we start with 
these fieri in- such a way, that they will never get the feeling that they arc 
in a hospital; at least those who are not too badly shot up, old cripples or 
too badly disabled. We should..get them to feel that, "Well, now I have this 
arm, this leg, or this shoulder broken, I have been operated for a hernia or 
had an appendectomy, or whatever it is, but the rest of me is all right." 
In the Army one should not consider himself an invalid. . I believe 1 may have 
emphasized this a little too strongly, perhaps, but one of the functions of 
this program is to cause a man never to think of himself as a person who Is 
badly incapacitated, all over, and consequently, the program should be 
strenuous enough in bed, at the beginning, and should so continue when he 
gets out of bed, so that he will have maintained his physical condition. 
The kind of bed exercises we usually see will not maintain a man in 
condition. He will continue to slip and I will tell you why. The reason why 
he continues to slip is because of the fact that If wc wish to maintain 
physical, condition, we must make a physical demand at least as great as 
wc have been commonly making simply to maintain condition. If you want to - 
improve, you must make a physical demand greater than has been your custom 
Let me illustrate. Suppose I wanted to develop a considerable amount of 
muscle in my am -- I wanted to get to look like Charles Atlas.* I could 
take a one-pound dumbbell and exercise with it every day, I would gain 
some muscular endurance. It has been found that in prolonged exercise of 
that kind the vascular system has an increase of about fifty per cent in the 
number of capillaries; but I would;, gain no particular strength because I 
already have much more than enough strength to handle a one-pound dumbbell, 
and I would be* making no demand which is in excess of what I am already con- 
stantly doing. If I used a thirty-five pound dumbbell, the result would be 
very differenti■: Atpresent I happen to know I can lift It only about five 
times with ray left arm before having to stop. I would, use it.each day until 
I could lift it a do£en times. I would then take a forty-pound, dumbbell., then 
a forty-five-pound dumbbell and lift it each day and one could, almost see*'the 
muscular growth; for X am making a demand in excess of my common demand. ;. IT 
I continue to make a demand less than my common demand,.I will retrogress. 
'Another Illustration of this. All of you are sufi’Jciently acquainted 
with school athletics to know this to be true. Suppose a track man wanted 
to be able to run a uric in ri;20, He could run a mile in ten minutes every 
day for ten years and still he couldn’t run one in six.- Fe has to run regular 
ly until it hurts. He has to make much more demand than he has been making 
before; then, when he gets up to that demand, he d.emands a little more and a 
little more -- that is the way in which he gains. If one simply: continues 
the demands he has been making, he maintains his physical status,. .If he 
makes an Increased demand to improve it, there isn’t any reason why he, or for 
that matter* any man coming to us In this hospital, can’t be improved a good 
deal because the Army doesn’t always turn them over;to us in too.good condition 
This is called the "over-load" principle. This Is an. -unfortunate tern. It is 
not an over-load in a real sense - it is an over-load,beyond what cine has- 
been accustomed to carrying. : ,t . ; -- .• : 
The next thing in any physical development program is that we, need, to ; !- 
have the program progressively built-up -- a little more this week-and a 
little more next week. , V ... . >-■ In order to Implement this over-load principle, we must classify these men.. 
For example, let us take Class III patients to malcq it s mple. We may have 
patients in Class III A, B, or C. The III A’s are ;n ju b as good shape as 
the ‘It’s except that the III A’s arc still In the hospital - they are under 
treatment; the III B’s are not quite In such 300d shape and the III C’s are 
in poor shape. .1 
We can start in x/ith a group of exercises which will last for about ton 
exercises, and the IIIC’s will then fall out. Another half dozen and the III 
B’s will fall out. The HI A'a continue doing more of them. After a few days 
the present C’s will continue through the B’s exercises and the B's will con- 
tinue through the A’s, making a continuous Improvement. Since, in a hospital 
wc>have new men coming in all the time, we can’t continue simply to increase 
repetition and cadence, but in Class II when they go up from section to sec- 
tion, we can increase the load. In cases so severe that they have had to slip, 
for example; the pneumonias of which Colonel Rusk spoke yesterday, or a rather 
bad surgical case, or where a man Is in bed with a broken femur for a long t’mc 
they will, of course, take much more time. They will have to start much eas cr 
but don’t let us get our* minds set by these relatively few bad cases through- 
out all the hospitals of the Service Command. They don’t make up the majority 
of the cases: most of the men progress much more rapidly. I just wanted to 
bring out the fact that one shouldn’t rather unintelllgcntly give this program 
in the somewhat exceptional cases with the severity which I have Indicated. 
In Orthopedic cases, the general maintenance of the rest of the body is an 
Important thing. It is necessary, in working on this type of disability to 
employ physio therapy, occupational therapy and bed exorcises. When the ward 
surgeon 1s convinced that it is justified, and proscribes it, he can keep 
these men from slipping very much. When they get to improving, they should 
then work on the part which has been operated. This is the part wc have to 
get back in shape. 
In medical cases we have considered the matter of tests, such as cardio- 
vascular teats. I have investigated the present tests - looked up what was 
written on the subject - and it did not seem to us there was anything which 
gave promise of enough help to justify putting it in the program, particularly 
in view of the fact of how busy the staff In the hospital is, I believe the 
clinical judgment of the physicians, supplemented by such evidence as sedimen- 
tation rate, and things of that kind are probably enough. When you get these 
men to where those in the medical service are. willing to lot them start in with 
a physical educational program, they can start sufficiently gently at the be- 
ginning, Let us say with the IV C program, he con make progress without over- 
doing It. I.don’t think we should do too much with the cardiovascular tests. 
We can just begin easily and then step it up. 
Let mo call your attention to one other thing concerning these bed exer- 
cises,' When you have a man in bod and are. working on only one set of muscles 
at one time, you are not getting the tendency towards prostration that you 
would.1.get’with a man out of condition when he is out of bod. When he Is out of 
bed he is having, to carry all the weight of himself. In the second place as yoi. 
all know, when ho gets out of bod the sympathetic control of his splanchnic arc? 
is not adequate. Ee very easily gets little .brain anemia and the splanchnic 
circulatory system is too much dilated for strenuous exercise, and he tends to 
feel nauseated. When you ‘/have that same.,man in bed and the blood is flowing in 
his. veins just as freely as before' he,’.started exorcising, he can take a much 
bigger dose of exercise on the Tbcal muscle; groups* These.medical .-cases, even 
though they can get up .and-move around the ward., ahobld: bp i^ept: in the Class TV 
program - that is, doing most of their exercises lb bed, - imtjll they iget enough 
splanchnic control to justify their getting up for their exei’^ise■. Remember 
that the Army does net always give you men in good cohclition. The directive 
that the Army should get'its men in good physical condition is more honored in 
the breach than in the observance.r We have n lot of evidence of that based on 
tests given to the Army. You are going to get men, some of whom are in ex- 
cellent condition -- splendid athletes -- and then, again, some individuals who 
arc in terrible condition when they come to you. You have to take that into account. You can’t say, "This man has been in the Army a year and a half and 
therefore he should ho in pretty good shape.” It depends very much on the out- 
fit he was in. • 
ij ■ .- 
Remember that ‘because of the overload principle, you need some exarchate 
that is pretty intense. Ifhon you have them in Class IV, you cannot give much 
intense exercise of the cardio-respiratory typo. But you can give voipy 
strenuous exercises for the local muscle groups which will strengthen them and 
will make for real fpiprovexiient. As soon as you can get him and'he can be- 
gin to take it, put' the.pressure on for part of the’ time for: endurance of the 
cardio-respiratory typo. The host way to .-exert iso' the heart Is through the 
legs.. ' The,class drills you saw yesterday for/CIojss'-ii u/lll begin to put that 
’.pressure on. You need some time — not too ,longr— of- relatively intense 
exorcise for this overload to push the strength up. You need a lot more of sub 
maximal types of exercise such as we saw yesterday, particularly' games like 
volley hall whjich-isn’t very strenuous, or other gamed that aren’t too strenu- 
ous, for the development of stamina. There is a lot of-difference between the 
athlete who can go out and do an excellent Job on a cross country run for 
twenty minutes and. a man who can go out with a lumber Jack and do a long hard 
day’s work. One thing is the athlete;’s ability of a short time nature - the 
other is stamina that will carry him through a long grind. The soldier needs 
stamina. He can’t quite get it by those half hour or one hour spurts of exer- 
cise. The Array has long put emphasis on marching greater distances, carrying 
full packs. Hence we need some of that for what we call stamina. 
Third, you need special exercise for special disabilities. A Nicola 
operation needs something that will work the shoulder and get its strength back 
again. Or a leg has become atrophied, and needs special attention. The way 
to do this is to exercise for the special disability. 
If all that wore involved was simply to get that man physically in con- 
dition, wo could do a pretty good Job In, say, forty minutes a day of calis- 
thenics and running and a bit of double timing in addition. The Army con- 
ducted. an experiment at Fort Riley a year and a half ago. Three of us went 
down there at General McNair’s invitation. We tested first one squadron of 256 
men who wore picked, by a census bureau statistician as being a good represen- 
tative sample of the whole United States population. This group was tested 
with the physical fitness tests that we d.cvclopcd. for the Army at that time, 
and then they were matched by three times that, number from other parts of the 
fort. We chose another from them who also matched this first 256 in 
physical fitness scores. These others took their regular physical training 
which consisted largely of easy calisthenics, and. that was about all. We found, 
in the ground forces, that the calisthenics were then not too well conducted. 
We timed them in about ten different camps, They averaged, about three minutes 
of rest to thirty seconds of exercise, hence they were not very conditioning. 
This was about all those people got. This experimental group was given the 
program which we wrote up for that occasion and which was later adopted as TC 
87. This group was tested when they first came to the Replacement Training 
Center, They were given the program prescribed: in TC 87 and in six weeks they 
had gone up to the point they were In as good condition as the paratroopers 
were in nine months, tho it pretty nearly killed them for the first two weeks! 
They only had one hour a day plus a good deal of double timing. If they marched 
out to the rifle range, they doubled back. Those two things put them into that 
excellent condition. The only activity other than their regular marching was 
only an hour a day, but they got that hour a day in well conducted strenuous 
exercises. In forty to sixty, minutes a day you can condition your patients 
adequately, but it would be a hard.cr grind than they* should have, and you need 
something else. You need pome marching. These men are soldiers as well as 
patients, getting reconditioning. They -need some; fun in addition. They need 
some games and things, of that kind,;and a lot of additional sub-maximal 
activity for stamina,,.- -f : I should like the advice of some of you people from the standpoint of 
military effectiveness, of close order drill such as you saw yesterday. 
Should we have the cripples mixed In with the other men? They can’t keep 
step, and it makes it look awfully sloppy. I wonder if it is good military 
procedure to conduct this type of training or whether they should be segre- 
gated by types. I would like some advice on that before we finally finish 
this manual on which we are now working. But these patients need discipline; 
they are in the Array. 
The next thing is, there should be considerable stress on the psycho- 
logical phase of this physical strength program. I have seen a great many 
men leading this program who tried to drive too hard. You can lead men ' 
places that you can’t drive them. You need some good old enthusiasm - the 
old advertising - a person who believes in this program himself, who is 
himself a vgood example of fitness - who is so enthusiastic about this fitness 
that ho just pulls the men along. Every time I hear Colonel Rusk talk about 
this program I just straighten up and my chest gots about an inch bigger. Wo 
need spirit. In Halloran General Hospital some of the ward, leaders wore most 
enthusiastic about what they were doing. The men would say, "This is a good 
exercise, fellows". They got in there and went through some of the exercises 
so sincerely themselves one could just see those patients feeling, "It must 
be a good exercise or this man wouldn’t love it so much". It was a good 
leadership - good salesmanship. Charles Atlas has a hundred women in New York 
sending out materials, sixty more in London and sixty more in Buenos Aires, 
He sells things. There arc many scientific fallacies in his presentation;., 
he thinks it is all correct. But he has salesmanship. You read his material 
and you want to do something. Let us hove similar, but scientifically correct 
salesmanship that can make those men want to do things, not just do them 
because they are required.. ; 
It has to be adapted to the individual. One must have different dosages 
for the A’s, 3’s and C’s, Some will be C’s because they came- to the hospital 
in bad condition. Different gymnasium squad projects, work projects and the 
like will accomplish this. I think we also want to remember that when we get 
a man Into the reconditioning program it doesn’t: necessarily moan he is in 
for a four weeks’ course. If you can.get him out in four days or two weeks, 
don’t think he has to take the full four weeks' course. Many men can 
graduate from III-A to II-A and then to I-A' in two weeks. The courses must 
be adapted to individual differences, 
I will take up these .individual activities by classes. I spoke of 
the matter of dividing Class III and IV patients into A, B and C groups. 
The' TV's can be geared into groups together with Ill's. What I mean is 
this: In many hospitals, you do not have the fortunate conditions existing 
in' this hospital, where it is relatively easy to get your Ill's intp the 
gymnasium. In some cases patients may have to go out of doors to get to the 
gymnasium, or they may have to go quite a distance. The weather is an 
important factor and in bad weather you may have to exorcise, the Ill's in 
the wards. Where that is true, you can very readily have exercises for the 
Ill’s and IV’s geared together so the IV’s can do approximately the same 
thing in bed that the Ill's are doing standing up. This) matter will be 
treated in the manual on this subject which is being prepared. The two 
groups can be lead at the same time by the same man and have the inspiration 
of working with a larger group. The III and IV-C's will fall out at the end 
of a certain number .of exorcises. That is all they can take. A few days later 
they will progress to the B group. 
35 In this -program for Class TV's, I think one of the things we con Jog* '. 
gin to teach then .1 s hw to, relax., A rasny,. of. then, will raeet condi- 
tions from then on when relaxation is a very valuable thing. You know 
how tense we all can get when under strain. We are going to have one 
small section In the manual to teach ■people how to relax -- how to let go, 
how to go to sleep. Thib Is an excellent time to teach it while these 
men are in bed. 
We have spoken of bed exercises. Bed recreation is not too hopeful, 
I think. We will have to depend to a large extent upon our friends in 
the Red Cress to keep our men interested and amused.. Occupational therapy 
can do the same tharig, but physical recreation in bed is very limited. 
With the cooperation"bf some Class Ill’s, the bed patients can do a few 
things such as‘pitching. rope quoits, etc., but it cannot be a very large 
part of the program. The main thing ,io to, have the bed exercise programs, 
plus the mental and emotional therapy supplied by. the Red Cross and by 
Occupational Therapy. 
When wc have the Class Ill’s out of bed, I think we should begin to 
stress another thing, and that is better posture. Many of these men have 
difficulties because of bad foot posture or trouble with their backs. 
While they are :n the hospital, wc have time to teach them things,along 
that line. Some of these men should still have some bed exercises because 
such exercises cun be made more intense. They can take a stiffer dosage 
when they are lying down than when they are standing up Just after they 
are up out of bed, I-- 
- i 
I will not comment on Class III calisthenics. You all know what 
calisthenics are. Do them in the gymnasium, if possible, as they are doing 
here. It gets the men out of the wards, out of the hospital atmosphere. 
At times you can have the men doing resistance ..exorcises in pairs. Those 
are exercises where one man resists another and , this, malics it hard to 
do any goldbrl eking. . 
We can have a good many games in the wards., You saw a few samples .of 
that yesterday but there arc.many other games of some strenuousness which, 
will keep the men busy for'quite a while. I hope eventually, through the r. i 
Red Cross and occupational therapy groups, that,every, ward will have enough 
games so that you will not have to move them around the wards on a cart, 
Then whenever it seems desirable, the games can be brought out and used. 
When the Ill's get out of doors or over to the gymnasium, there are 
a good many things you can do that you can’t do in the wards. If there is 
nothing else available, you can use the space between two wards for them 
to play-pepper ball, volley ball, 'deck tennis, fly and bait casting, and 
lots of other things to keep them busy and got them in condition. In the 
wards you can also do something which I have seen done best in the station 
hospital at Camp Crowder, There they bring a cart around once a day to the 
ward with something like four medicine balls on it (two of those should be 
rather light), (incidentally, there Is something at Ha11oran General 
Hospital I hadn't seen before. They had some full sized medicine balls 
stuffed with curled hair so that they weighed about three pounds). The carts 
I mentioned also contained volley balls not pumped up too tightly, four 
skipping ropes, some iron dumbbells, wooden dumbbells, a few Indian clubs 
for those who need to exercise their arms and wrists. The men wore re- 
quired to take various exercises with this equipment. It was like a small 
gymnasium. The cart stayed in the ward, half an hour and the men got a lot 
of good exercise in a much more interesting way than by calisthenics. 
They also had a couple of these ankle discs such as you saw in Colonel 
Dively's film yesterd.ay for limbering up and straightening stiff ankles. 
In this film you also saw the rope back pulls. The men sit on the floor 
and pull oach other. People with abdominal wounds can get back exorcise 
this way and, with the other man pulling forward., they don’t strain the 
abdominal muscles. These men can go to the. gymnasium or got out and hike in good weather 
if they take It easy, because riany of these arc in just as good shape as 
some of the, XI’s except that they are still under medical treatment. 
Get them into uniform just as quickly as possible. 
PROGRAMS FOR CLASSES I and II 
In most places we try to divide the I’s and II’s into A*a and. B’s 
simply to keep the activities at about the same degree of strenuousness 
and to obviate the necessity of making too many individual allowances. 
Got these men away from the hospital as quickly as you can. 
I am going to speak of several types of activities. 
The first, I will call mss activities - where you can exercise the 
whole group at once. ; Calisthenics, of course, is one of that type. You might 
try a substitute for calisthenics from time to time, as the groups get fed up 
on the same calisthenics every day. About every other day, do something else; 
for example, the guerrilla, activities. This is sometimes done in circular set- 
up or1 in column formation. These are ouch activities as walking bent over, 
walking with kicks, and grass drills. The men got a lot of exercise from this. 
Then there is shadow boxing, and partner boxing (l don’t mean where they actual 
ly box I am not particularly enthusiastic about boxing in the Recond;*tioning 
Program because there are too many chances for injury, but they can peA.r off 
and learn about footwork and defense). Wo saw some slides from Falloran of 
people shadow boxing. Something like that can often take the place of calis- 
thenics and do just as good a job. 
The second type is marching and running. Running is one of the best ex- 
ercises in the world. Professional athletes do a lot of walking and double 
timing. They refer to it as "roo,d work,” In Army parlance, it is marching, 
with double time used an increasingly large percentage of the tine. If they 
march six milos, they might, at first jog one-half mile in broken doses at 
double time. This could later be increascdto a mile although not, of course, 
all at one stretch. There are grass drills, or "wind sprints" an they arc 
sometimes called in football, and relay races. If you use those don’t pay too 
much attention to twenty-yard races in a gymnasium: Put them out of doors, wher 
they can run at least one hundred yards. The short races arc of little value. 
Obstacle courses arc excellent. I want to speak about this activity-a 
moment, and., wc will show some slides when I have finished, I have boon through 
a great many hospitals and talked to patients and asked them how they were 
hurt. Many of them said they were hurt on obstacle courses. I find, in- some, 
hospitals, many are getting rehurt on the obstacle courses. They should not be 
run-for speed. Don’t lot the men race over them. I met one man here in the 
hospital who was hurt going over an obstacle course in California. He had,a 
broken leg* He said, "I had run that thing a dozen times, but I got careless 
in going over the wall and fell.". He was racing. If possible, build your ob- 
stacle course so you have a primary course for your II’s and another more diffi 
cult one for your I’s. Walk them over it slowly at first, teach them how to 
negotiate it, then have them go over it faster and faster, but don't have them 
go over it so fast that there is a probability of injury. . 
% 
Close order drill is just as good a conditioner for Class I and II 
patients as for.the well soldier. They can later graduate into longer 
marches with, packs. 
The combative activities, of which you saw a few yesterday, arc good. 
They give back a lot of. the old fighting spirit. If a man is defeated by 
his opponent fifty times and on the fifty-first trial explodes in the op- 
ponent’s face, he has learned something of value. That type of activity 
is an excellent one to put in. It works into much tougher exercise than 
you saw yesterday. Most of that should be done outside on the grass. Next, about games and athletics. Athletics can be placed in the 
strenuous typo. Basketball is particularly good; spocdball is very 
strenuous also. Then there ere other types that are not so strenuous 
but are good exercise; the fellows get fun out of them and a good deal of 
action, too. If you have access to a swimming pool as you have here, by 
all means use It for this work. It is an excellent conditioning Program. 
The second general typo-is what \tg call group activity, or "small 
group rotating gymnasium activities". These are usually carried on in an 
indoor or outdoor gymnasium, Yesterday you saw one example of this 
that wans’t too complete, not because it wasn’t well organized and 
well planned, but because there wasn't enough equipment. The equipment 
has been ordered but Just hasn’t arrived. If the gymnasium is well 
equipped, it can be much better. 
Now about bar bells and heavy dumbbells: Many people seem to have 
a misconception of weight lifting. All weight lifting isn’t the type 
where you strain everything that you have and over-exert yourself. 
There is another that is a much bettor type, where one can stick to 
the type of lifting that is moderate enough for the man. Have enough 
repetition - say ten or fifteen repetitions - enough to tire that group 
of muscles very rapidly. That type will build strength faster than, 
anything I know of. I would guard, against the type where the veins stand 
out and one strains everything he has; that is not as good for our purpose. 
Spring exercises are very good for certain muscles, horizontal bars and. 
parallel bars, when properly used, are very good for many excellent 
developmental activities, 
The use of rowing machines, medicine balls and the heavy punching 
hag provides very strenuous exercise and. is particularly'good, for people 
'getting up into Class I who need to strengthen upper trunk muscles, wrist, 
shoulders and elbows. 
A man Is about as old as his abdominal muscles. o Feel yourself there 
and see how old you arc I When you get a group of mien who ere soft in front, 
they are not 'in good condition for the Army. Reported surveys have shown 
that America'is soft in the belly. y.V 
» '• * ’ ■■** ’ ' * . . . • .* ■* • 
• ’ ■- r •'•.• . • • *■ * * i 
Tumbling and stunts of various kinds, rope skipping and light bag 
punching arc.excellent. For strengtheningrspecific disabilities wc have the 
Indian clubs, shoulder wheel, wrist rollers, -finger pullers, bicycles and, 
pulley weights, the knee rockers that are used for log disabilities, and ,, 
'special palisthenic exercises on the mat. This kind of small group rotating 
■exercises is definitely prescribed. We do not Just send the men on a routine 
march around the gymnasium. With proper prescription'of what the man heeds, 
he can be put in a particular group.c, Somebody has to do a little scheduling, 
as one hen to do in everything else. This type of exorcise is -one of the 
finest things to build a man up where, he is weak and get Mm back into good 
condition. An hour a day in Classes IV, and III and II arid three hours a 
week in Class I is very valuable. 
t f.y /a ./ ! ..... 
Labor projects: We should; guard against thinking that reconditioning; 
patients are Just labor battalions. The be something that is 
very definitely,planned to bear, on the reconditioning of the trainee, the 
specific reconditioning needs;of .each individual person. As Jobs are 
available around the hospital, they should be carefully analyzed. What 
will this Job do for any given man? You may find a man sotting type. He 
is not a good typesetter, because he can’t set as much typo in a day as a 
good typesetter would set in fifteen minutes - but he has a nerve injury in 
his hand and he needs that type -of work. The man who is a good printer may he hammering some soles on Shoes in the 
orthopodic shop .because he can’t get a good grip on a hammer* Wo 'give him 
a hammer with a very large handle and put him on that job because it is the 
host job for him. If all the tasks arc analyzed as to what they will do for 
them, and the men are distributed to these tasks in accord with their needs, 
those labor projects arc then planned constructively. This is occupational 
therapy just as much as labor therapy. It is important and should be kept 
in mind. One should not use work therapy to the exclusion of everything else. 
Now, that, is in general the major list of subjects I wanted to discuss; 
but i .want to speak of one or two other miscellaneous items. First, the 
NP patient that Major Barton covered so very comprehensively last night. 
I have just a couple of observations that I would like to add. One of the 
things we want to remember is that the physical type of activities, such 
as athletics and games, etc., go back to the oldest phylogenetic aspects of 
the organism*. Our trunk muscles date as far back as the earth worm; shoulder 
and arm back from the fish, and the other muscles date as far back as the 
apes and the monkeys. The nervous system that controls them is very easy to 
handle'as compared with the more recently evolved nerves of higher emotions 
and intelligence which have often received the greatest impacts in battle 
exhaustion cases. We want to remember that the simplest fundamental exercise 
progrtims are Important to people who have these functional upsets in their 
psychonotor systems. The men in the IIP service are agreed, that they should 
get them back into the firm? and out of a hospital as rapidly as possible, I 
have talked to dozens of these men and find that they arc often afraid just be- 
cause they arc in a neurophsyciatrlc ward, They don’t believe they are not 
crazy even though.the.psychiatrist assures them they aren't. It is important 
that we get them back in an Army camp where the signs of a hospital are absent. 
We need to start those people with a great deal of recreational 
activities. I was a bit impressed, when at Halloran General Hospital, to 
see that4they are starting those people on ward calisthenics.. They go 
into these activities like anyone else, and they enter into a going 
routine and. absorb it very well. I agree wholeheartedly with Major Barton 
that we need to emphasize very strongly the recreational and athletic•types 
of activity. Put them in tournaments and. activities where there is some 
competition end motivation behind it. The rest of the program should be 
about the same as Class I and IT but since most of them-won't have many 
other specific disabilities, they won't need■ much of these special rotator 
group exercises, ... 
I • • • 
I am not going to discuss the personnel that we need, because that is 
being cared for by the proper authorities, but I do want to stress the 
utilization of what wo have available. I am going to tell you a little 
story." I was,in a goup making a study,of physical education and after a 
certain length of time I was sitting at the table with the senior officers. 
An officer of the group said to me "Dr. McCloy, I suppose by this tine you 
have found that there isn’t much you oan do here in physical training.". I 
said, "To .the contrary, there is a lot you can do. There .is one impression 
I have ..gained here "and that is, I have never - seen a group of men of ouch high 
Intelligence 'that can find so many reasons why things can’t be- done." I 
hastened to add that’it wasn’t any. reflection on their . intelligence but.“.it.was 
a new thing land, that every man there would have to spend much time revising 
his schedules .to .take care of the work and they did not •-.relish the prospect. 
I think that same ..mental attitude- sometimes creeps into’a hospital 
when a program .is now and inconvenient to schedule. People, have a tendency : 
to think up .reasons why lit .can’t be done rather than say "This thing is 
going to be done. Let rus find ways to do it," I was told at the beginning•• 
that ward masters could not be-.used for this program. Everybody said it was imposeiblc, but Colonel Thorndike said that at 
Ualloran General Hospital it was being done. Bo I went up to see and 
found out they were doing it and, doing a very good job. They had found 
ways to study what the ward master's duties were, how they could shift a 
fciw things, and do things a little better, just as Kaiser found how to 
build a ship faster. They released the ward roasters an hour and a half 
a day. One hour they trained on how to do the job and the other half 
hour they were giving the program. They were filled with enthusiasm. I 
think wo. are going to have to utilize what manpower wc have. The present 
manpower setup doesn't give us enough manpower in the hospital unless we 
use ward masters.• The question is not to say "It can't be done" but "How can 
it be done?" 
This really hasn't very much to do with what I should say here. 
But there is one other thing that is in my notes, and that is, I think 
wc should use the patients we have in our hospital. We have in the 
YMOA or college programs, stud.ent leaders. That is easy because wc 
have those people for a.year at least. When you are training patients, 
you don't have them for a year, wc hope. Instead of that, we hope that 
you foci when you train a good patient that ho should be out of there in 
a week. You want to put him out to help the Army, 
So I think this training program which you men will have to face 
is a much harder job than we people in the schools have, but it is one 
of the most important things in connection with reconditioning. 
.. i . 
Two things happen. First, when you train a patient, you have the 
same situation as when one makes a leader out of a bad boy. Years ago 
I used to be a YMCA physical director. Whenever I had a bad boy, I 
usually made a leader out of him, and he made a better leader because 
he had leadership and initiative -- he made a better leader than the 
kid. There are certain boys you don't know are even there. 
They aren't naughty, or disciplinary problems; they are not obstreperous. 
They keep their gym clothes clean. You never notice them. I don’t 
like a soldier in this Army you don't notice. I like a soldier who is 
bad once in a while. He makes a better leader because he has something 
on the ball. That means more work for.some of these WCO's to help sell 
things to.patients. They will do it because they believe in it and 
then the patients help to carry the crowd with them. I think leader- 
ship training of patients -- officers and enlisted men -- is one of the 
most important things wc had to do. 
I would like to take about two minutes to speak about the physical 
training program for1 the blind, because I think you will be.interested. 
Wo arc planning not to prepare a man to be a blind man in a blind school 
or institution but to prepare him to live in Clinton, Cedar Rapids or 
West Liberty as a citizen in that'- community. He must keep himself in good' 
shape. If he is in poor condition, with a poor posture, he has two strikes 
.against ..him already, 'What we need, is-a man with good color, good shape and 
good development,' -What can he do at hone? sThere are a lot of things he can 
do at home besides calisthenics, and we can teach him those things, I have 
been export renting around the YMCA, punching a bag with my eyes shut. One 
can also punch the heavy bag without use of the eyes, keeping in touch with 
one hand. ‘ He con do weight lifting aula lot more things more interesting; than 
setting-up exercises. What can he do in the local athletic group or local 
YMCA? The blind wrestle beautifully. They have wrestling matches — the 
blind schools against the sighted schools, and the blind schools often mop up 
on the sighted schools. The only handicap, the only consideration, that they 
ask is that the opponent snap his fingers or slap his leg until they make con- 
tact. Then the blind ask no special favors. They can engage in many sports. 
They can swim in a pool. It would probably be best if a blind man wore a. 
white cap so that some careless person will not dive on top of him. He 
usually swims along the edge of the pool. ■ft side -from that he is alright and can row, paddle, canoe, take hikes and 
play quite a number of yam.es. Many bowl beautifully. I bowled with a boy 
in blind school who made seven strikes in twelve frames. If right handed, 
he must have the alley where the ball rack Is on his,left and he keeps 
track of his direction with his loft hand on the ball rack. He has to be 
told what pins are up. Ho has to throw a straight ball, for ho cannot 
see what his hook might do. 
I,1hat we arc trying to do Is build a program where these men can go 
right ahead in local communities and do the kind of things they would do 
If they had eyes, if they have only one sighted companion with them. 
I thought that might be of interest to you so I just threw it in. 
In summarizing, first, maintain what they have strength and muscular 
endurance: don’t let the program be too light. But don’t conduct foolish 
activities that they cannot and should not do. Get a program that is well 
planned, well diversified and one which is planned not only to give 
strength and endurance, but which also builds up special disabilities as 
is done :n the rotating gymnasium programs. What they want is strength, 
strenuous fun and morale. Be sure to push the men through as rapidly as 
Is consistent with their best interest. Don’t set a four week program 
for Class I and II patients and expect them always to complete it in 
just' four weeks. Some will take six while some will take only one week. 
I have a few slides which illustrate certain aspects of this program. 
I will run them through very rapidly to give you a version in pictures 
which will supplement the demonstration we saw yesterday. 
COL. TH0KI1DIKE: Thank you. Dr. McCloy. Dr, MeCloy has stimulated 
mo to expand perhaps a little further than he did on the normal physiology 
of physical fitness. I think It is well for us to review known physiolog- 
ical facts and the ways we can train individuals to be efficient organisms 
for the production of physical work. Wo have a muscular system; we have a 
card I o-vascular system; wc have a central nervous system -- all involved- 
in the picture, and all concerned with the efficiency of physical effort. 
If the organism did not- operate efficiently, endurance would be completely 
loot. By physical training -- by whatever maneuver you are training for — 
you teach and develop an efficient organism. We hear much of athlete’s 
heart. Demember the card.lac muscle enlarges with physical effort. The 
heart muscle -Is hypertrophied- directly In proportion to the total mass of 
skeletal muscle of the individual. If you have one of these large in** 
dividuals, such as Charles, his heart size develops only in direct,ratio 
with his-muscular development,' What is training, and what is over-training? 
Training, of course, consists of feeding a. sufficient diet so that that 
sufficient product of digestion and, in this way oxygen and other things 
may bo carried to the working muscles. Over-training is a fatigue mainly 
of the nervous system. It is not physical fatigue. It is mental fatigue. 
The Individual gets stale, aswc say. It signifies only one thing and 
that is that he has lost his keenness of mind and his reflexes, developed 
to be automatic by training. Things are going worse; ho tries to do what 
he did a week ago and can’t do it as wall; he gets discouraged and the 
efficiency of his physical effort is lost, 
Wc have some figures worked out on the metabolic rates of different 
types of physical work. These have been published and I will just repeat 
them. The lumberjack or the soldier does eight times the normal metabolic 
rate for a period of over eight hours. The marathon runner’s metabolic 
rate will increase fifteen times the normal rate but he can mintain that 
only two or throe hours. The hundred-yard sprinter has the highest known 
metabolic rate - during his run, it increases twenty times the normal rate 
but he can only maintain it for ten seconds. So there id a direct difference between the training you give a soldier 
and the hundred-yard sprinter. The Arm?/ training program is aimed at endurance 
and a Metabolic rate-which can be’maintained for eight hours or longer. One 
other thiftg'that Dr. McCloy"stated; which is very Important, in running these 
obstacles races, is that the individual must use care and not be careless. 
Too many recurrent injuries- are developed by the individual's losing his 
self-control and getting injured. Perhaps he thinks it is fun to take a 
sidestep hero but that must be done in a disciplined and directed manner. 
Now wo will go on to open the discussion. Colonel Busk, have you anything, 
you would like to say concerning Dr, McCloy*s subject? If so, will you 
please come up here so we can all hear you? 
COLONEL BULK; I prinlcpally would like to express my appreciation 
for the masterly approach to this whole thing, I would like to thank him, 
not only for his talk, but for the help the manual in preparation is going 
to be to this whole program and would like to hear some discussion about 
the reconditioning or the fitting for life of the severely disabled — that 
10 or who are going to be our great problem. Primarily, the back injury, 
the amputee and the brain injury, with paralysis. What can wo do for these 
men while they are still in the military service and before they are dis- 
charged from hospitalization? I would like to stress the fact that we have a 
great deal we can offer those severely Injured individuals. First, they 
should not be made to feel that they arc hopeless, bed.-rridden invalids. They 
should be taught that there are many things they can do, with close coopera- 
tion with our orthopedists and with walking Irons made for them. They can 
be taught the swinging gate on crutches and by stressing the reconditioning 
of the uninjured parts by keeping them from gaining too much wc-ight while in 
bed, by keepingshoulder and arm muscles in top condition, you get them on their 
foot and. started much more quickly than if that particular phase is neglected. 
I think that Is also true of the amputees and will help then in their learning 
to walk end balance much more quickly, I should like to cite one case which 
illustrates very- definitely this point. 
There was a flight officer who crashed.in a B-26 last July. He frac- 
tured his arm, leg, collarbone> and 12th dorsal vertabrac and was completely 
paralyzed from the waist down. He lost control of his bladder and a 
suprapubic tube had to be used. 
He- was three-months in bed and that was -before the days of any re- 
conditioning program and because nothing had. been done to recondition him 
and because-no one' had. talked to him about the possibilities, he felt he 
was a bed-ridden- invalid for the rest of his life. He was started on a 
program of upper arm and chest exercise .for a period of six-weeks. When 
his-braces were- fitted, he got on his feet ..and learned the swinging gate ■ 
and' in "twenty " days' was able to take fifteen . steps by himself. At the end 
of six weeks die could get around pretty well by himself and he could go - 
back arid forth to the lavatory without help. In regaining the upright 
positibhy -'and’igfvirlg: him some automatic bladder control, the suprapubic tube 
could" be --removed i -This man who had looked forward to a life of complete, 
invalidism' was-discharged.1 not to a hospital facility, but to his own home 
and- I 'had a personal letter from him saying that he had a chicken farm 
before' he -came Into the Army. -His wife said they had,?50O chickens now and 
he f elt that wltMft a short time (they would have TOGO and nobody had to 
worry about him anymore. He could, live with his disability and not be a 
burden to anyone. I think we should pay particular attention to this 10 - 157 
group because there Is: a-'great deal which'can be done for then by us. COL. TKCRNDIK..: Thank you, Colonel. That problem is very much in 
our minds and, in my opening remarks, I referred to the reconditioning 
of the CDD cases. This xs an example of what can be done with on appar- 
ently hopeless case. Is there any one from Camp Grander who would care 
to discuss Dr. LcCloy’s paper? 
IT. COL. JINSLH: I'm Colonel Jenson from Camp Crowder. Just a fev; 
things I thought I might say about Dr. LcCloy’s remarks. Dr. I.cGloy 
visited us several months a,o and at that time gave us an idea of what 
could be done* physically for Class III and IV patients. Trie Class III 
program, has worked bettor with us than the Class IV program due to the 
interruption that Circular 26 caused in our ward master staff as those 
men were general service and wo have lost most of those we had trained. 
Now we must train another group. I have before me a statistical analy- 
sis of tho participation by Class III pa,tients using the mobile gymnasium 
equipment in their wards. 
Ward D-A is a NP ward. The first week only fifty-five participated 
or in six days that would be approximately ton each day who felt able to 
take part in the exercise. However, during the eleventh week, one hun- 
dred thirteen took part, -These wards run about twenty to twenty-five 
patients. Thus, by the end of thirteen weeks we had gained approximately 
100% cooperation, all on a voluntary basis. In the surgical recovery 
wards, the patients stay no longer than seven days as they come to these 
wards from the operating rooms. As soon as they are well enough not to 
need special nursing care, they are transferred. In these wards only 
forty-two participants were gained the first week, but by the end of thir- 
teen weeks, about 100% participation was also gained here. 
This was net made compulsory. We feel it is a problem of getting 
voluntary cooperation. This program is now carried out in all the major 
wards in the hospital and the same increase in activity has occurred in 
each ward, primarily because there is usually one or two courageous souls 
who will try with you, end if you go back the next day there are usually 
two or three more, and finally, most of the men feel that they arc well 
enough to participate. Over the obstacle course, pictured by the slides 
that Dr. LcGloy showed, we have run over ton-thousand men. We have had 
one accident and that was due to carelessness. You have to make a .lit- 
tle division on the obstacle course on i hat things you arc going to have 
some of your men do. You certainly aren't anxious to have a man that has 
had an injury to his hand crawling.hand over hand on a long bar until he 
is quite well. He may very well become a casualty. On the knee runs. 
Internal doarrangements of the knee you will try to keep off the inverted 
runs until about the end of the.fourth week — get the muscles of the 
thigh well developed with other exercises so that they can support their 
knee before they start on this strenuous program. Dr. KcCloy pointed out 
in his visit to Camp Crowder that the program of bed exercises prevented 
atrophy of musculature. He told the story about himself of how he was 
able to get out of bed and return to almost normal activity, and’follow- 
ing that through gradually, we have learned that you can remove the cartil- 
age of a knee and by the time the stitches arc removed, the man will, walk 
without a limp if muscular atrophy is prevented during the time of early 
recovery. The knee cases are usually up walking around the ward with 
crutches but bearing some weight, the weight of the extremity on the af- 
fected side, three days after operation. 
There is one thing I would like to ask — I hope someone here can 
answer — under Circular 73, it is pointed out that men who arc trained 
as physical educational non-commissioned officers will not be lost on over- 
seas assignment even though they are on general service. Now would that 
apply to ward masters who have been trained to carry out these programs 
in the ward? 
A3 BRIG. GEN. KILL! AN: Do you want an answer to that now? 
LT. COL. J3KSSW: Yes, I would like to have an answer. 
BRIG. GEN. HILLMAN: I an inclined to think there is no privilege 
extended to all of those men, I think this only applies to the physical 
education instructors that are designated in this Directive 73. 
LT, COL, JENSjEN: I think this might be quite a problem for many 
of us because we are right at this stage now, for example, at Camp 
Crowder. 0ut of about 750 men 600 are general service men. They once 
were limited service but under Circular 293* they are qualified for 
overseas movement with a unit so we have a problem program of retraining 
our entire personnel, and that makes the Group IV program very difficult. 
Do you have anything to add, Captain Dueller? 
CAPT JM VERN.ETTE A. kULLLDl, JR.: No, sir. 
LT. COL. JENSEN: I want to say that Dr. McCloy, if he comes to 
your institution .and works out in your gymnasium with the men and with 
your physical training people, will teach you in a half a day the 
things he is talking about really can be done. One other thing he 
pointed out to us is that the best utilization of the gymnasium was 
to have a standard progressive routine through the gymnasium. The men 
going from one piece of equipment to the next, and he also pointed out 
that they would use the equipment much better if they had diagrams as to 
how to use the equipment. He was correct. The gymnasium has been much 
better utilized since that tame, I would encourage everybody to do this. 
Lake the diagrams large enough and simple enough that the average soldier 
can immediately catch on to what different things he can do with dumb- 
bells, for example, and the overhead bars. Thank you, 
COL. THORNDIKE: Re would like to hear from Camp Grant. Is Major 
Smith here? 
LAJ. HARRY A. SLITH: General Hillman, Colonel Thorndike, and 
Guest Officers, this is ray second encounter with Dr, KcCloy, The first 
one consisted of five minutes at Camp Grant when he came up to study 
special training units, and I met him and as he left Colonel LcEnamy 
said, VTish you had been here to meet Dr. LcCloy a little more because 
you are going to train some men for him," I said, What are we going 
to do?" He said, "Darned if I know. Dr. McCloy is going to write you 
a letter and that is what you are going to work on." About four days 
later I got a letter from Dr, LcCloy, and if I hadn’t had that letter, 
I still wouldn’t know what I was to do. That is what we based our 
training on the physical educators that you people now have. We got 
these men that wore selected by Dr. McCloy and Major Barton and they 
were to stay with us just a few days before going out and we thought, 
’Well, we better give them something that will help these men before 
they go," and in the meantime Circular Letter 163 came out and that 
clarified it a good bit for us so we developed what Major Barton 
laughingly refers to as "command presents" to me. Every time he 
sees me, he says, "Hello, have you got command presents?" I don’t have 
it but I know what "command presents" is and wc continually harp 
on "command presents," Corporal Amic of this group who put on a demon- 
stration for you yesterday was one of the choice people we had. I 
would like to tell you how wo get those men. So far Colonel Peck 
up at Camp Grant is the Classification Officer, and every time a man 
comes in that looks good on paper he hauls him right in. If they have 
a physical background, he sends them down to me and we tell them right 
off the bat that this is going to be tough. They are going to go out and work on a program where, people up to thi s 
tine have not boon too interested in developing this pro'trom, end the 
question has been brought up since I have been here, "Are-' these men 
Gohxi to be given ratings?" Now that is all clarified. Last week I 
had. six letters from different men asking, "Are you goinfTto ship us? 
lie have been reclassified as physically able to go overseas." We 
called Major Barton and that was straightened out. Yesterday morning 
I talked to Dr. MeCloy and got some excellent ideas for developing 
this program much more than we have now. Wo arc going to have to expand 
and include many more things than wo have in the past. My experience 
In this has been limited, but fortunately I was sent around to visit a 
few hospitals, not to view what they had in the physical education program 
bu.t to visit their personnel set-up. While there I found out that there 
were a lot of things we could teach these men to do that aren’t in this 
program. Me could teach them how to run the moving picture projector1 and 
how to conduct a training schedule so that each man we send, out is able 
to sit right down end plan Class I, II and III programs, I will admit wo 
have been weak on Class IV. I do not think wo have had a good program, and we 
have not given our men adequate training for bed-bound patients. However, I do 
think with this now manual that Dr, MeCloy is putting out we will bo able to 
strengthen that, and I believe Camp Grant can give a high type of Instructor, 
Some of you have used the men who have been trained'. We have Sent out 
letters asking how they worked out. We asked for your criticism end 
suggestions, and.. I think we have had Just enough background now so that we 
arc about ready to go ahead and do our part in this program. 
LT. Col.. Jensen: May I ask your a question. Major Smith? 
MAJOR SMITH; Yea, sir. 
. LT* C.OL*. JENSEK: By what machinery can we get men flow at our stations 
to. Cemp Grant :f or training? 
r;' J-IA.J.0E SMITH; That is a good idea. I have a number of my men - 
cxtesQJLe&t men - who would otherwise have been shipped Into this program. 
;I thinkr Major Barton i.s better qualified to answer that then I. I hope 
icrhb will correct mo. . If- you.have somebody who was especially qualified - 
in ;tOje-past, I have ref Hr red-these men to Major Barton, who in turn has sent 
thcsv-imcii; to me throw-b The Ac jutant . General in Washington, but at present - 
'-but'isaybc-.I am infringing on someone else ’s talk to be given this afternoon. 
I believe?-/they will explain to you. how these men can bo procured. There is 
r la personnel survey set-up; it is preliminary and not complete. However, I 
;bclievc;that steps will be taken so these men can be sent to us. Is that 
• right, -'Major Barton? , ' ; . • ■ 
MAJOR BARTOW: Yes, sir, ....To answer Colonel Jensen’S question, he 
.-thokld direct a.request that his ,non be sent to Camp Grant through 
a channels. If , that is--approved by headquarters, we will secure The 
Adjutant General*s confirmation. , 
• LT. COL, JRNSM; , Thank you, sir. - * 
COL. THORKDIKE: Arc there'any further questions? 
COL. WIHH; In regard to these men who are being trained at Camp 
Grant, I would like to know whether a .special effort is being made to 
orient them on the entire program, or whether there is emphasis placed 
upon the physical training they arc given. I believe they should be 
used in the entire program so they can assist the educational officer. I think they should not he sent out unless they demonstrate some en- 
thusiasm for this work. I don't think they should he selected because 
they may have been prize-fighter and lack the intellectual and leader- 
ship qualities required for this type of work. I think they should be 
thoroughly familiar with the scope of the program, and I an interested 
to know whether these points arc broughtout, They should also bo 
Interested to .know whether these points are brought out. They should 
also be instructed in certain phases, at least, of hospital admininstra- 
tlon, and Just what a hospital is like. They .are not medical troops 
and have- not head medical training. They will function better if they 
will come to the hospital with sons idea as to what the whole thing is 
all about as far as the conduct of the hospital is concerned.. So much 
for that. : ■ 
Dr. McCloy has been with us several days prior to the opening of 
this conference, and wo have profited accordingly. I want to say that 
I am sure his talk here was stimulating to all of us. 
COL, THORNDIKE: Any questions? . ■ 
< MfttTOR B9OTQH; I would like to ask Dr. McCloy. about bed exercises 
for specific types of surgery. In other words, when do you start exor- 
cises after an appendectomy or a hernia and when do you start after a 
Nicola.? It would certainly be of interest to me and, IT you have the 
time, it certainly would be appreciated. 
COL, THORNDIKE; I am going to turn this over to Dr. McCloy. I 
can see I am getting into hot water. 
DR. McCLOY: I will take this first question last. The manual has 
not been completed with regard to post-operative procedures, because 
of the fact that we are clearing that very carefully with the surgical 
staff of The Surgeon General * s Office, Wo have been preparing specific 
kinds of programs for these various kinds of disabilities, though in 
general the bed exercise program will put most of the people through 
about the same program, but with some prohibitions. In those bed exercises, 
when we come to a Juice exercise, the men with knee disabilities will not 
do this exercise; the man with an affected shoulder will not do the shoulder 
exercise; the one with an abdominal operation - when they come to the part 
that uses the abdominal muscles - will be told not to engage in that parti- 
cular cxercisc. Just exactly when they will start on each one will be 
decided on two bases: First, insofar as specific recommendation in this 
manual is concerned, they will bo made’by the Orthopedic Surgeon, cither’. 
Colonel Peterson or. a surgeon appointed by him. That is something for which 
I certainly would not take the responsibility. The decision as to when, any 
patient may start an exorcise is a function of the ward surgeon. The 
Orthopedic Surgeon will decide .when a patient with a Nicola may start, .It 
will take a little; time to educate all tho physicians In our hospitals to. 
be willing to try .many of' these, things.; • That is no criticism of organized 
medicine. Nobody paid -you when you were a civilian doctor to keep.him in . .. 
apple pic shape; you were paid to get him out of danger, and. -then he quit 
paying. You never had a clock hour of training on this in medical school.. 
It goes back to your common sense, your cautious experlemntlng; and what 
you can learn from other people who are experimenting. I can't 90c.any other 
solution as to when a man can start with a Nicola except the judgment of the 
surgeon in charge of that ease; but I hope that in this manual there will be 
certain general, statements put out by tho surgeons in our office. If not I 
certainly would not be willing to state when any one case would start, except 
that I would say, unless he has an infection or something of this kind., he 
can start immediately, as soon as he has been afebrile for twenty-four hours 
with exorcises of the other parts of the body. Colonel Winn commented on the experiment of mine. I very carefully 
avoided any exercise of; the abdominal muscles for two weeks. You 
can tell when you start exercising an injured part because it hurts 
when the muscles are being used. I knew what not to try. At the 
end of two weeks with the permission of the surgeon) I started first 
lifting my head and looking at .ray feet. I li f’ted ray right shoulder 
and left foot until I had a little tension on the muscles. I had it 
on both sides, so I worked both ways. That was gradually increased so 
that at the end of three weeks I was doing relatively gentle exercises 
but trying not to contract the scar. I just put tension on it and kept 
my chest high. 3y keeping the chest high and the abdomen sucked up, no 
intra-abdominal pressure was exerted. With caution, anything, I tun 
sure, that any surgeon with common sense would forbid any attempt to. 
engage in dangerous activity. ; 
I have omitted'two or three things I would like to say here. I 
had an hour in-which to give ray speech this morning, but ran over to 
an hour and five -minutes, and had to oulta few things. 
I want to mention that when I first came into this program on 
the 2oth of December, there was little or no literature. I skimmed the 
hospitals and I am very greatly indebted to many organizations, I am 
particularly indebted to Colonel Rusk and the Air Force group. They 
have boon at this for a longer time. Colonel Rusk gave me letters of 
introduction to a number of Air Force units. I learned a great deal and 
I .had no hesitancy in swiping anything that looked good. We arc all 
fighting in common and are all working for the American soldier, and the 
Air Forces have been most generous with their cooperation and wo hope to 
be as’ generous in return where we have anything to offer. The A, B, C 
classification of Class III and IV, dropping out seriatim came from 
Mitchell Field, The other hospitals where I went told me many things. 
There wear places where they already had good, programs. Almost all of 
them had something good and many of them had many things that were very 
good. While everything is not acknowledged, in Army manuals, I want to 
express indebtedness to many of these people right now. This cart idea 
came from Comp Crowder. I saw excellent work therapy under Major Preston 
at '.Nichols-who has done excellently what I have been talking about. 
I went to say a couple of other things. There is a kind of surgery 
that .has not received very much emphasis in general surgical work. If . 
you have boon a doctor in charge of athletic teems, you have had a diff- 
erent problem than if you, wore a surgeon in general practice. In general 
practice. If ‘a men had a badly sprained ankle, you could keep him off it 
for a while. A--surgeon in charge of a football teem wants to get his man 
back: on the team just as soon as it is compatible with the welfare of the 
man. There ere a number of things that one can learn through experience 
of that sort. Colonel Thorndike has had. probably more experience along 
that line .than any other man -in America. lie has written an excellent 
book on.it. There is another one by-. Lloyd, Denver and. Fastwood, Colonel 
Thorndike has procedures in his book which, if. they arc studied carefully, 
will give methods of treatment of "athletic injuries" that should be of 
help , in getting many soldiers out of bed. find into circulation much sooner. 
They have done just that in Colonel Thorndike*s set-up at Harvard which, 
I think, is far the best of any place in the world. It is an extraordinary 
medical set-up. They take care of the most insignificant injury .on the 
intra-mural team as well as they care for the star athlete.. 
On this prospective ODD, Colonel Rusk brought out something very 
important. Because of the lack of time, I didn’t touch on that. That is. one of the things General Kirk and General Hillman are very 
much concerned about and it takes more manpower than the hospitals have 
available now. That is one thing the hospitals will have to take into 
account and a program is being worked out. At tho present time we arc 
hitting the program hardest that will get the most men hack into active 
duty as soon as possible* At the*present time, the others are getting 
all wo can give them. 
On the matter of these diagrams that Colonel Jensen brought up, 
let me illustrate. Let us take things like bag-punching. I went around 
the hospitals and saw two things done- ordinarily — they always have a 
boxer or two. They do straight-away punching and things like that (he 
illustrates) which are very hard to do -- you can’t master it in three 
or four weeks. How these things where you use elbows, where you get an 
excellent shoulder and arm movement, here, (illustrating) side-bending 
makes it much more effective. This wasn’t being used in. any place be- 
cause most people didn’t know about it. When those diagrams were put 
up by the platform, the men' see what they are; nobody has to say, "Do 
this" or "Do that", they say, "Go on to Number 3 or k". You can work 
your way through this with a much more extensive curriculum and it can 
be done with a much more economical use of manpower. You know what 
that; means.. I think that some graphic aide can be prepared with ODD 
patients and many of the others. I would, also like to see more 
experimenting done with resistance exercises In bed., 
a. f . 
In connection with another project, I investigated Charles Atlas. 
He'was very cooperative. Many of the types of things he puts,out seem 
to interest literally hundreds of thousands of American men. , Shoving 
one way or another, one can goldbrick beautifully on it. We will have 
to motivate then to do It. Atlas gives you a little handbook and makes 
you feel you- con blow your muscles up with a little manpower of your own. 
We can’t go around and blow up their muscles, we don’t have enough man- 
power for that, Eow can we inspire some of these fellows to want to do 
some of these things in bed? 
One of the officers with me was talking with a Class III patient 
who is.a boxer. He had a bad lower leg in a cast. He was excellently 
developed. We were looking at him and. wonder:*ng how he got that way, 
Ec got that way by working on himself — of course, he had something to 
start with, but ho has also inspired a whole flock of other follows 
around his bed to do the same. You can’t put all your Charles Atlases 
in-hospitals just to inspire other boys. How can we inspire people to 
do more than tho minimum to keep In shape? That is a psychological 
problem. Colonel Winn emphasized• that’'very Well. It is a part of 
morale-. The man who gets- in there’ with a good physical attitude and 
stfiavlatcs himself to want to be - a better soldier' stimulates morale. 
The man doing the educational Job can stimulate him.; I can think of 
some of . these young Rod Cross ladies Who would make him want to throe 
inches on .his chestI I don’t sec why we shouldn’t use every means pos-' 
.sable, to accomplish this 
■mCOLDIOT. TEOmiDIKE:' I think wfe are very much indebted to Dr. Me Cloy 
for his contribution to this program. 
Colonel Winn, I ‘think your suggestion concerning widening and expand- 
ing the program at Camp Grant will be undertaken right away, so those in- 
structors will not only bo qualified in physical reconditioning but also 
will know the whole program and how it is- coordinated. 
In answer to Major Boynton’s question on starting hernia convalescents 
on rccondtioning, we have a directive which limits the speed with which 
we can return hernias to duty. This is the only directive which limits the 
program, so far a.s I know. 
2k-801^5-600 However, it is not the reconditioning officer's decision as to when to 
start; it is the decision of the professional service; it is the medical 
or surgical chief who will release the patient. That decision belongs 
to the professional service. 
GENERAL HILLMAN; May I say a word? 
COLONEL THORNDIKE: Yes, General Hillman. 
GENERAL HILLMAN: It has been our experience in the War Department 
and the Surgeon General*s Office that if we get out a directive or start 
a policy on certain professional matters, it is very difficult to pre- 
vent the pendulum from swinging too far. While we know that, in the 
past, we have coddled our patients too much or permitted them to remain 
inactive too long, I would dislike very much to have the opinion become 
widespread that we should not be conservative in the time for them to re- 
main in bed and, swinging over too far, find that people .are being taken 
out of bed and exercised earlier than sound surgical and medical judgment 
dictates. 
Another point concerns the ODD oases. We feel just as much obliga- 
tion to the man who is going to leave the service as to the man who is 
going to be retained for military duty. Don't let anybody get the' 
idea we are less interested in that group. The approach to that group, 
however, will be somewhat different. The emphasis on military subjects 
can give way to emphasis on restoration to useful work in civil life. 
In our amputation centers, special problems present themselves and we 
have not gone into a wide discussion of them here. The orthopedic sur- 
geon who handles the amputee knows that a special effort and a special 
technique must be applied to teach him to use hits-one or in some cases, 
two artificial legs, or his hand with a hook. These are special problems 
and we have omitted any detailed discussion of them here because the time 
would not permit. Furthermore, they are not problems which one generally 
meets in hospitals. The same thing applies to our management of individu- 
als with defective hearing and blindness. They require special approaches 
to their reconditioning problems. It is not to be thought that because 
those matters have not been discussed here, there is any lack of interest 
or lack of planning for the proper handling of such cases. 
COLONEL THORNDIKE: Thank you, General Hillman. We will now proceed 
with the Educational Reconditioning Branch, and I am going to turn this 
part of the meeting over to Major Briscoe, who will carry on for the rest 
of the morning. Or would you rather have a rest now? 
(RECESS) 
COLONEL THORNDIKE; Will the meeting please come to trdor. 
MAJOR WILLIAM 3. BRISCOE 
The rest of the meeting this morning is going to be divided up be- 
tween a number of people whose names I would like to mention now, and 
who will, in turn, re-introduce each other. 7/o have with us Major West 
and Lieutenant Humphrey from the Morale Services Division, Major Bendow, 
Captain Evans, and Major Bishop from the special school for Morale Ser- 
vices, Colonel Ramsey and Lieutenant Kohn from the Special Services Divi- 
sion. We are going to cover four topics this morning. We should first like to ask the question, what is the place and 
primary function of education in the reconditioning program? Second, 
what specific objectives does the education prog rain hope to achieve 
for convalescent Class IV, III, II and I patients. Third, in plan- 
ning our attack on the problems of reconditioning patients, what 
are some of the essential things to keep in mind concerning person- 
nel, program and methods. Fourth, in calling your attention to the 
tools with which you may do this job successfully. 
I should like to cite an example from WorldStar No, I, medical 
history reports a soldier who was "wounded in his left arm and .log. 
His leg was amputated and his arm was long immobilized by a drain- 
ing wound. While his wounds were healing he lay abed for a Ipng 
time on his back. The nurse seeking to relieve tension on the 
flexor tendons of his right leg placed a pillow under his knee. The 
soldier lay in this position for several months, so that by the time 
his wounds were healed his right log was crippled because of muscle 
atrophy from disuse and from having his leg in a bent position, for 
so long a time. The medical reporter of that day in describing thev 
cases explains how many months of physiotherapy brought function 
back to his right leg again, while casually mentioning that the man1 s 
right arm, which he used to wait on himself, was all right, and miss- 
ing the point that had the soldier's right leg been exercised as his 
right arm was it, too, would have been all right. 
If the man's mind was as unexercised during these months as 
his body was, it is entirely conceivable that great mental harm was 
also done him. 
Today things are different. As soon as a man recovers from 
shock and is on his way to recovery, general exercises are begun to 
keep the body in condition and at the same time mental diversion, 
recreation and education are given the patient to keep his mind 
healthy and well. Not only docs exercise of body-and mind prevent 
the debilitating effects of disuse which can amount to positive and 
lasting injury, it also promotes healing and speeds general recovery. 
The Body is Reconditioned Through Exercise 
When the soldier is able to move without ’pain or injury to him- 
self, trained physical education experts come to the ward and give 
to each man the exercises which are especially designed to keep his 
general physical condition as near normal as possible. The muscle 
tone which is maintained improves his whole body, the injured as 
well as the uninjured parts. His heart muscle is strengthened and 
general circulation improved. His lungs and other organs arc kept 
in better £one. Hence the body is a better functioning unit and 
so its powers of recovery are heightened and illness shortened and 
healing hastened. 
Such exercises are not merely calisthenics but may be, in fact 
often are, in the nature of interesting games which also divert the 
mind from thoughts of self and sickness and injury, and thus serves 
a double purpose, being mental therapy as well as physical. 
The Mind is Also a Part of the Body and is 
Reconditioned by Exercise 
It has been mentioned that when one's body has been injured or 
severely ill his mind also has suffered shock. Particularly is this 
true in war, where often there are added strains of battle and the 
ordinary anxieties of war all soldiers suffer in some degree. So in 
the beginning of convalescence it is advisable for a while at least 
to forget about the war and to put one's mind on things which for 
him represent peace and security. This differs for different people. Even the nature of the illness 
may be a difference in this respect. 
In the beginning of convalescence, therefore, the patient nay bo 
given things to think about which divert the mind from anxieties or from 
thinking about himself> or his illness or injury, to things outside him- 
self, This may be recreation, entertainment, or it may be some form of 
education, for if a man has intellectual Interests an appeal to these is 
generally to appeal to‘areas of thought v/hich represent security. As a 
patient recovers physically and grows stronger more sustained intellec- 
tual effort is encouraged and finally specific and increasingly intensive 
reorientation to the job of being a soldier is begun, first through 
studying the progress of the war, later through specific military study 
or training. While this may bo the general pattern, for some men the 
best thing may be to olaco a weapon in tlieir hands as soon as they re- 
cover from shock, which they can assemble‘and study - even play with, 
A gun is a mechanism which is interesting to most men. Many interesting 
activities can be carried on with a rifle or machine gun, such as dis- 
mounting it blindfolded and reassembling it, for example. Seeing who can 
do it best is often a fascinating diversion. 
% * ' I 
For others to* talk out their anxieties through discussions or 
classes may be the thing necessary, Whatever mental activity is best 
should be provided as directed by the physician in charge• 
To serve these mental needs adequately the educational program 
must be a broad one applied with intelligence and shaped to the rfc— 
quircments of individual patients. Library reading, selected radio 
programs, movies, discussion classes, correspondence courses, drama- 
tics, music, art, opportunity for shop experience, arc typical of the 
broad program v/hich must be offered. It is obvious that so conceived 
the program will involve the joint planning arid cooperation of the Ed- 
ucation Officer, occupational therapist, Red Cross worker and physician,. 
Reconditioning is not merely physical - it is also mental. Educa- 
tional Reconditioning aims primarily at preparing men to go back to the 
most active duty possible for then. Reorientation is therefore the 
During early convalescence the a in is 
a. To divert the patient from thinking of his illness or from thoughts 
related to shock, fear, and anxieties of battle by offering educa- 
tional and recreational experiences calculated to promote feelings 
of security, 
b. To explore the possible educational interests and needs of non and 
to explain to then individually these various educational opportuni- 
ties. , 
c. To incite a spirit of inquiry concerning subjects in which men are 
interested, 
d. To reintroduce gradually interest in the progress of the war, prob- 
lems on the hone front and general interest in every day happen- 
ings . 
During the ambulatory convalescent period while patients are still 
on the ward the aim is; 
a. To reintroduce the idea of duty by requiring that some tine daily be 
spent in study and reading or other educational pursuits appropriate 
to the needs and abilities of the individual. 
THE L. IS SION b. To stimulate serious educational activity by offering short 
unit courses, lectures, movies, promoting discussions, correspondence 
courses, etc. 
c. To promote solidarity of purpose and spirit through enlisting 
patient participation in the program in preparing assemblies, assisting 
with teaching, giving lectures, entertaining, etc, 
d. For those who must retrain themselves for participation in a 
new field in or out of the Army, opportunity should be offered them to 
explore their possibilities and they should be helped to assess their 
qualifications and their interests and should be aided in planning the 
steps they should take to secure help available to them in re-planning 
their lives. 
During the convalescent training period in Sections 1 and 2 the aim 
should be: 
a. To offer military subjects on duty time which will be of value 
fcr all men regardless of the status of their training, 
b. To offer subjects so arranged as to parallel the physical 
training program, i.e., requiring increasing physical activity. 
c. To continue in off duty time the educational and recreational 
opportunities offered on the wards, 
a. PERSONNEL, The success of the program of educational recondition- 
ing will depend in large measure on the wisdom shown in the selection 
of personnel to cany it on. Probably no one of us is really qualified 
to do the job adequately, - that the completely right man 'will be found 
for any job is too much to expect. However, there are a few important 
facts to keep in mind in selecting educational officers: 
1. The Education or Orientation Officer’s job is to incite 
other people to activity. In proportion as he can get the 
men themselves to carry on their own program of educational 
activities will be successful, 
2, The Education or Orientation Officer is not a teacher in the 
school sense, but rather in the sense of being a leader of 
adults. He will seldom find it necessary to re.sort to 
orders to accomplish his aims. 
It follows that three qualities among others are necessary for the 
officer who is to be a teacher of adults: 
1. He must have an attractive personality. He must be liked by 
the men (Personality may be defined as the way the other 
fellcw sees us), 
2. He must be a mature person, Since the education .and reorientation of 
wounded soldiers is more than an intellectual process it follows 
that the educational officer should have had some experience in 
living as a prerequisite for leadership, 
3. He must be a man of character and of conviction in whom one 
feels the security of stability which is based on understanding of • 
what the war is about and on even deeper personal orientation 
to things which count. 
4. The Education Officer should possess a good general education 
and cultural background. 5. He should have been trained for his job by.his previous ex- 
perience in education, though this is very•secondary to the 
qualifications named above and if lacking:can be corrected 
by training which will be made available. 
PROGRAM 
You have in your hands a program for Groups 1 and*2 and one for 
grouos 3 and 4. I shall not take time to go into detail regarding these 
except to point out a few principles which it seems to us in the Recon- 
ditioning Division should be observed. ' ■ • 
GROUPS 1 and 2 
1. For groups 1 and 2 education during duty hours should be mil- 
itary instruction, 
2. Subjects for study in convalescent sections attached to general 
hos vitals should be selected which can be justified on the basis 
of their value to all soldiers irrespective of branch of sqrvi.ee 
or status of training. 
Question for training: We are not sure whether this should 
• apply in the case of the station hospital or whether plans should 
be made to continue training. In the case of station hospitals 
it would seem highly advisable to contact the Post Plans and 
Training Officer for advice as to subjects to be taught and as 
to methods to be employed. 
3. Mental hygiene, personal and sex hygiene, sanitation, first aid 
and similar subjects can be taught effectively in a medically 
supervised unit and should, therefore, be stressed. WD Circular 
48. 
GROUPS 3 and U 
The program for Groups 3 and 4 you also have in your hands. The 
major military emphasis in this program is orientation. 'The wide 
differences which exist between patients as respects military discipline, 
training, education and ability as well as the specific natures of 'their 
illnesses or injuries require that any program of reconditioning on wards 
of necessity consider the individual patient. The implications of this 
are that first, there'should be a wide variety of activities available to 
patients, and, second, there should be selection of method as to teaching 
and application of the program. 
In the field of physical reconditioning it is necessary to recondi- 
tion men in terms of their physical abilities and disabilities,. The same 
is true in mental reconditioning. The program for reconditioning on wards 
will consist of the following activities: 
A. Physical training including calisthenics and games. Amount of 
time daily to be determined by the ward physician. This program to be 
carried on by the physical training sergeants at least twice daily for 
all those patients for whom the ward officers feel such program is appro- 
priate, These activities will include bed exercises, exercises on the 
wards, and for those who are capable, outdoor exercises, especially 
designed games for wards, as well as exercises especially designed for 
individual patients, 
B. Education will include the following: 
A. Supervised study - 1 hour daily. 1, USAFI Correspondence courses 
2. Group discussions 
a. Self-teaching texts 
b. Special Editions of Standard Texts 
c. Special training materials. 
3, Language records 
4. Educational films 
5. Subjects for which materials may be available through 
educational institutions, local schools, etc. 
6, Directed library reading. 
B. Orientation and Information - 1 hour* daily 
1, One unit lessons or lectures on subjects of interest to 
men, 
2, News reviews and radio programs selected in advance for 
their educational content, through use of FREC radio 
service. 
3. Discussion groups on topics of interest to men. 
4. G, I. Movies and educational films. 
C. Military Subjects - 1 hour daily 
1, Lectures, demonstrations and discussions covering: 
a. Selected subjects taken from VJD Circular No. 48, 
dated 4 February 1944 
b. Defense against mechanized, air and gas attack 
c. Mapping, and other subjects found to be pertinent 
and of interest to soldiers, 
2. Training films 
a. Showing of new films 
b. Review and discussions of films already shown 
D. Orientation and activities directed by Occupational Therapists 
and the Rod Cross 
E. Ward fatigue and duties, 
METHOP« There are a few psychological principles which should be 
kept in mind in respect to reconditioning soldiers for duty or for return 
to civilian life, 
1. In conditioning men no lapses from standards of desired response 
should be permitted. To illustrate what is meant one may cite the fact 
that military drill and military ceremony when employed in recondi- 
tioning should conform to correct and proper military standards. The 
tendency to excuse men from proper observance should be strictly avoided. 
If men cannot do what is expected of them it ’would be better to avoid 
the requirement than to condition them to an inferior standard, for to 
do so not only lowers standards of proficiency but breeds poor moral 
as well, 
2. Interest is necessary to efficient performance in learning. 
This is especially to be borne in mind in respect to military educa- 
tion, For example, trainees who have been in combat will resent 
being forced to view again training films which they may have seen 
in their preliminary training. It is safe to say that any showing 
of training films to experienced soldiers should be for the purpose 
of reviewing or emphasizing a point which has arisen during a previous 
discussion of the topic being considered. Certainly the audience 
should be carefully prepared in advance for re-showings, 
3. With adults interest is more easily sustained if problems 
are considered and if the individual has a part in planning and 
executing the solution. In his studies of the normal mind, William Burnham, out of the 
wisdom of a long life of study of what makes humans behave as they do, 
stated a basic formula for mental health as being "a purpose, a plan, 
and freedom to carry it out". This formula works equally well in 
adult education. In Army language the philosophy is recognizable as 
being a ‘clear cut mission, a plan of action, and the freedom and re- 
sponsibility for its execution. 
4. Reward, especially if it is intrinsic, that is to say inherent 
in the satisfaction that comes from the recognition of a job well 
done, is very effective in promoting educational activity. Several 
hospitals have found it effective in promoting cooperation of trainees 
to prepare a letter for inclusion in their 201 file evaluating the 
trainee's cooperation and success while in the convalescent program. 
5. Adults as a rule are not so docile or curious as children are. 
They must see a practical value for. them in what they are being taught; 
it must be related to their pattern of interests. Someone has remarked 
that for the most part "adult education is the job of teaching people 
to do better what they are going to do anyway". 
6. The more heterogeneous the group is in respect to the matter 
presented, the simpler, more concrete and less symbolic should be the 
mode of presentation. 
In considering education in relation to reconditioning let us 
raise these questions for thought: 
1. What is the place and primary fmiction of education in the 
reconditioning program? 
2. What specific objectives does the education program hope 
to achieve for convalescent groups IV, III, II and I? 
3. In planning our attack on the problems of reconditioning 
patients, what are some of the essential things to keep in 
mind as respects: 
a. Personnel 
b. Program 
c. Method 
4. What auxiliary support may we expect in the way of materials 
and services from Morale Services, Training, Special Services 
and the Red Cross? 
I should like to repeat again that the program will be successful 
only in proportion as you pick good men to run it, and if these men 
recognize that it is the responsibility of the patient himself to 
educate himself, and that nobody else can do it. Then, finally, we 
have found in school work, the type of tools you place in a man's 
hands are very important. The matter of teaching of reading has 
improved tremendously in the last twenty years chiefly because better 
textbooks have been placed on the market. If you put a hoe in a man's 
hands, he can't do much with it except hoe. The Morale Services Divi- 
sion, Training Division and Special Services Division are going to 
tell us about some of the things we can use in this program and how 
we can get them. The first speaker is Major Reed. MAJOR ERNEST H. HEED 
I would like to take just a second to express my appreciation, 
even my amazement at the arrangements that have been made for this 
conference. It certainly bespeaks nothing but praise for the Surgeon 
General’s Office and to Colonel Winn for the local arrangements. I, 
as an outsider, appreciate them and marvel at them very greatly. I 
thought I was an outsider, X should say, until last Friday when I sudden-* 
ly discovered I was on the program, -As such, I assure you, I have no 
intention of trying to give you a panacea for all military training 
problems. Even in the labyrinth, commonly referred to as the Pentagon 
Building, we who have recently been out in situations where we were act- 
ually doing the training have not forgotten what some of the problems are, 
Wc also realize that we can’t accomplish everything there within those 
winding halls and that we can’t solve everything or even a major portion 
of it by a lot of directives emanating from Washington. The big job is 
going to have to be done by you people doing the operating work, carry- 
ing out the training* Certainly those of us who have been out where you 
are know that very well. I have a sneaking suspicion, however, although 
I h-ve no idea as to what General Porter has promised, that the -ASF will 
be called upon to produce some of the things he has promised. I assure 
you, General Porter, wo will do the very best we possibly can to see that 
those things get provided. 
In the first place, something which has been touched upon already is 
the necessity of selling ourselves and selling the trainee upon this en- 
tire training program. I am personally conscious of the fact that in sell- 
ing ourselves there are going to be a lot of difficulties arising, which 
will make it sometimes a pretty blue situation as far as facing the prob- 
lems you are going to have to face. Also I am personally conscious of 
the fact that you are not going to have all the personnel to conduct this 
program you would like to have. Tvey are going to be jerked away in a 
rotation policy, making it seem very discouraging. Despite that, I think 
we are going to have to keep in mind the manpower needs General Porter 
mentioned yesterday morning. By such a program as this we are going to 
make it possible for men to be available for full duty sooner because 
they will need loss military training after leaving the hospital. They 
will be able to continue their work better because of this training they 
have had in the reconditioning program. 
Most important of all we are going to avoid dissipating some very 
costly training. It costs a lot of money to produce a trained soldier. 
This intensive education dissipates very rapidly when not used in tho 
hospital, even though the man may be reconditioned physically. 
fore, if, for any reason the military training side of his education is 
neglected for even a short period of time, it results in a groat train- 
ing loss. We need to .avoid that as much as possible. Onea we have sold 
ourselves, it is going to be much easier to go out and sell the man on 
the need for a military training program in this whole reconditioning 
program. All of us need refresher training, picking up new ideas that 
are presented from time to time. Trat is just natural. A nan can be 
sold on the basis that it is going to be a shorter time before ho is re- 
leased from the hospital and goes back to his training unit. Ho is ready 
sooner to take his full place in the military program after he leaves the 
hospital. Also a very very strong inducement to the individual soldier 
can be placed on the fact that the things he learns while the recondition- 
ing program is in process may be a source of advancement for him when he 
g*GS out into a unit. He knows things and he knows them better than he 
knew them when he came into the hospital. As such, he has possibilities 
for additional stripes, and can become a leader when he goes back into a 
unit. To me that is a very strong motivating force that can be used to 
sell many of these men on the program. Perhaps some of them can learn about new subjects, new military training 
skills which they haven’t had. I think even there you can utilize Class 3 
and 4 people. Major Briscoe has-mentioned keeping their minds diverted. 
Maybe I am a*.little prejudiced because X happen to be associated with the 
Military Training Division, but I think we can do a tremendous amount of 
that with military subjects. If a man can be sold on the idea, we can give 
him a great deal of the military training and keep has mind on work even 
though he is flat on his back in bed. Cur major emphasis .tor those‘men 
who are going back to duty still must be on preparing men for duty and not 
preparing them for civilian life yet. That will have to come later. How 
soon training can be given? To what men? Your own experts can decide 
better than anybody else, 
f.» 
Make the training meaningful with just as much practical application 
as you possibly can, I am just a little bit afraid of the term ’’military 
education" because I am afraid it may be misunderstood, by some of the 
people in the ground forces and even by sonm of our own people. Ihe second 
reason is that I think it is perfectly impossible to split completely tnat 
training wh_ch we normally think of as academic end that which is practical. 
The marches that you give most certainly ought to include practical train- 
ing in defense against air attack, field sanitation, perhaps defense against 
chemical attack, and other training subjects included in Mobilization 
Training Program 21-2. Make it fit into the situation and tie whose things 
together wherever you can. The >/ar Department and General Porter's office 
is quite interested in this question of map reading, war Department Train- 
ing Circular Mo. 6 takes it up in considerable detail. Then you go out on 
a march, practice those principles of map reading out there. You can’t do 
it all in the classroom. It doesn't mean anything. Teach a man white on 
the march to observe the terrain — perhaps make a rough sketch of it. 
If you don’t have maps of the territory, you can use a roughwsketch very 
nicely. It is going to be a great help as for- as making that training 
meaningful to the man and making it amount to something. 
•Utilize everything you have. There has already‘been stress here about 
using convalescents. I would inject one word of warning; don’t, just burn 
them loose. It is going to take close supervision. It is gping to be 
worthwhile to use them more in the program. Patients are going to accept 
them very well because it is going to come from somebody who has been there 
and has seen what happened, but we must be careful not to assume that just 
because a man knows something he can4beach it to someone else. That isn't 
always true. 
Go back keep digging into Field Manuals 21-o and 21-7 to see wMt 
is available in training aids. There are new ones just out, by the way. 
Continually, new training aids are appearing. This list of training films 
which has been-.given to you this morning is excellent, but don’t start 
depending on it entirely because it has already been supplemented by a new 
film. I saw training films being used very nicely here yesterday. Me're 
rather proud of those training films as far as the Army is concerned. They 
have done an excellent job, but they are not a lazy man’s answer to military 
instruction. You are still going to have to prepare the way for them; still 
have to summarize and emphasize points that have been brought out. You 
shouldn't think of training films as things of entertainment, when we’re* 
using it in intensive military training, we aren’t going to sit on'the back 
of our necks and enjoy what ..goes on. 
<. There is one thiiqg I ha.ven't seen here — I don't know whether you 
have them or not. Colonel Winn -- and that is graphic portfolios, which I 
think should be very useful in this program. You are all familiar with 
them, I am sure. They are a series of charts set on a stand and may be used very well in 
training small groups of men or an individual who is interested in a 
particular thing. They are more or less new. We are bringing out more 
all of the time. I think you will find them extremely useful for class 
3 and 4 men as well as others. Those things can be and will be made 
available if you will ask for them, if you can use them, and I am sure 
you can. 
We have a definite obligation to utilize our manpower as efficiently 
as possible. I think we can best do that if we keep this man trained as 
a soldier. Avoid dissipation of costly training. Most of it I think is 
going to be basic training. However, some specialized training may be 
given; if a man comes to you as a radio operator if you can provide him 
with a little practice set so that he can keep his hand in during the 
period of time in the hospital, that will be excellent. It is going to 
keep him interested in the program and he will make a definite contri- 
bution when he gets out of the hospital. 
We in the Military Training Division certainly hope we may be of 
help, and I know General Weible would have liked very much to have been 
here. If any of you have any questions to ask while I am here, I assure 
you I would be very glad to hear them. We hope to work very closely with 
the Surgeon General in this program. 
COLONEL THORNDIKE; Thank you very much, Major Reed. We have 
already received a great deal of help from the Training Division. We 
have exactly forty-five minutes and we have to all the rest of the 
speeches in that forty-five minutes. So I will call on Major Benbcw 
cf the Morale Services. 
MAJOR BENBOW: The Morale Services Division is responsible for the 
provision of materials and services which relate to the maintenance and 
improvement of morale. The Division is specifically charged with three 
functions which are of particular importance in the reconditioning pro- 
gram, One - the provision of non-military educational facilities. Two - 
procedures and materials for orientation and information of military 
personnel, and three - procedures for the selection, training, and 
assignment of officers for morale duties. 
The materials and services developed for orientation, information, 
and education of Army personnel generally have been and will continue 
to be available t® personnel in hospitals, ASF Circular No. 73 now 
makes it possible for these morale services to be utilized to a much 
greater extent than was heretofore possible. 
General Osborn, Director of the Morale Services Division, is in- 
tensely interested in reconditioning and will continue to see that every 
possible aid is made available to the program. Since the original 
directive on reconditioning was issued more than a year ago, officers 
of the Morale Services Division have worked closely with officers of 
the Surgeon General and Air Surgeon, For many months now the quantity 
of materials supplied to hospitals has bulked large in our total supply 
program. Vie are looking forward to this demand being doubled and tripled. 
In addition to the services from Washington, each Service Command 
Headquarters now has a Morale Services Division and it is expected that 
these divisions will work with Service Commands Reconditioning Divisions 
in the same fashion as'their Washington counterparts. 
Specific materials and services for use in reconditioning are pro- 
vided by the three operating branches of the Morale Services Division — 
Education, Orientation, and Information — and by the School for Special 
Services. The Education Branch or Education Program of the Morale Services 
Division provides six services or materials which may bo used in the 
education part of reconditioning* 
1, Correspondence courses in hundreds of high schools, technical 
schools, and college subjects, through the TT.S. Armed Forces Institute. 
Complete information about these courses and other services of U,S, 
Armed Forces Institute is contained in an envelope of materials which 
will be distributed during the noon recess. You have already seen the 
display of materials at the rear of the room. 
2, Self-teaching course. These differ from correspondence courses 
in that lesson service is not provided. Insofar as possible the teacher 
is "in the book” in the form of detailed instructions, step-by-step 
directions to the student, self-administering tests, problems and questions 
with answers. To obtain a certificate the Institute provides an end-of- 
course test, administered by an officer. Though these self-teaching 
courses were designed for oversea use they are admirably suited to use in 
hospitals. 
3, Textbooks for class use, These are special Army editions of 
standard civilian textbooks. Each book is selected for Army use by ex- 
pert civilian consultants. Thousands have been distributed to hospitals 
for use in classes. 
4, Foreigh language materials deserve special mention. Completely 
self-teaching spoken language materials have been developed in more than 
thirty foreign languages on the elementary level. Using phonograph records 
and a text that spells out the foreign word or phrase as it sounds in Eng- 
lish these language materials teach the student to speak common words and 
phrases in a few hours practice. Advanced materials that make it possible 
to obtain a good command of the spoken language arc now available in French 
and Chinese, will soon be available in a dozen languages, 
5, G.I. Movies, Most of you are familiar with this weekly movie 
feature. Containing 1G mm shorts on education, information, and orienta- 
tion topics GI movies supplements and aids the orientation - education 
program. Complete information about GI movies and expert advice on the 
selection and use of films in the education program may be obtained by• 
writing to the -u-udio-Visual Aids Dopt,, TT.S, Armed Forces Institute, 
Your envelope of materials contains additional information, 
6, School and. College Credit Service, -This service is especially 
valuable for men who are to be discharged to civil life. It provides, 
through the U.S. Armed Forces Institute, and official report of military 
educational achievement for transmission to civilian schools and colleges 
for evaluation in terms of academic credit. The report may also be sent 
to employers. The report includes service schools attended, service jobs 
performed, courses completed with USAFI, and results of special educational 
development tests. This school and college credit service has proven to 
be very popular in the test discharge centers described by Col, Lynch last 
evening. 
Detailed information on all these education materials and services 
may be obtained from the U.S. Armed Forces Institute, Madison, Wisconsin*. 
Special provision for hospitals is made in ASF Circular No, 7.4, dated 13 
Maruh 1944, Materials and Service of the Orientation and Information 
Branches of the USD will be described by Lt. David H, Humphrey, Lt, 
Humphrey has just completed a tour of the nine service commands as a 
member of an orientation team that organized a pilot orientation .program 
in one camp in each service command. He will preface his description of 
materials and' services with a general description and definition of..orienta- 
tion. 
59 LT. DAVID H. HUMPHREY: As the Major stated, I have^just returned 
from a tour through the country to set up pilot orientation programs. 
We feel that we did accomplish our mission. However, in the field wc 
found generally that the officers did not understand what we meant by 
orientation, and for that reason I would like to take a few brief 
moments to explain the orientation program before I go into the subject 
of materials. Before I do that though I would like to say that the 
orientation officer who I will mention_ throughout this report as <_ilso 
known as the Morale Services Officer, and he is also known' the Ed- 
ucational Reconditioning Officer. Those three names, then, fit the 
same man. 
For the sake of clarity the Army Orientation Program is divided 
into six objectives, 
’The first objective — to know why we fight. Obviously behind 
this lies the motivation for the whole conduct of the war, li■a . 
soldier really understands why we fight our problem is greatly 
simplified. General Montgomery, in Africa, made'the statement that 
he thought perhaps the morale was too high among his men, and the reason 
was that the men did not report for sick call. They did not take care 
of themselves. They did not want to get out of the line of duty, II 
a man understands well enough why ho is fighting he will, want to get 
back into' the line of duty as soon as possible, and the Reconditioning 
Program will be greatly.facilitated. To know why they are fighting, 
that is the whole thing, in fact that is the basic objective of the 
Orientation Program. To really understand what is the background of 
this war, and what we are now engaged in trying to do. 
The second of our objectives is to know the enemy and by that wo 
don't mean just his training, his equipment and the size of his forces. 
We moan to really understand that the enemy is waging an insidious 
psychological warfare aimed at us at this particular moment, and has 
been waging'that warfare for a long tine. Wo know that the enemy is 
dividing us, one ally from another and internally within our nation. 
We know that the American soldier is told in many seemingly innocent 
ways that perhaps we are fighting for the British Empire, We know the 
British soldier is told that they are fighting perhaps to have the 
British Empire annexed to Wall Street, Wo know that the Russian soldier 
is -told that they are fighting for Capitalism because they are told that 
Stalin has betrayed the revolution. In other words propaganda is direct- 
ed where and how it will do_the most good. Wo know it is propaganda 
and we know it is based upon lies. We also know that internally we are 
being divided among ourselves. We know that in America the very nature 
of our country is such that we provide a fertile field for racial, re- 
ligious, political, and economical antagonisms and we know -that we are 
being torn asunder by deliberate planned methods. We must be aware of 
that and our soldiers must be aware of that. They must know that by 
using terms, such as, ".Damn Nigger, damn Catholic, damn Jew, or damn 
anything else" they are playing Hitler’s game and not ours. There are 
men being paid by Hitler and Tojo to do exactly that "same thing, and when 
we do that without thinking we may just as well be paid-from the same 
source. We know7 the propaganda warfare of the enemy takes other channels. 
For instance, we were told for a while of the invincibility of the 
German Worroacht, It didn’t work to well with us as in some other 
countries. But we know there are some hang-overs from that even here 
because when.such things as reports about secret weapons come out wo 
find them thinking to themselves or saying "This is where the German 
strength really lies", Nov; they are coming out with secret weapons we 
must fear. We know that that is. a propaganda technique. Wo know when 
that didn’t work very well the Germans are trying the other attack, Wc 
are being told that the Nazi Party and the German army is at odds and 
they are going to b« split internally — it is not being used now, 
but it will bo and has been used before. We are told all sorts of 
things about the breakdown in Germany, We knov; that again this is a 
propaganda method to make us complascent. You men know what a terrible problem we have to overcome compla- 
cency. Tho fact that our troops are aware of it and understand 
it*, at least, they cannot bo as affected by it. be know also that 
another technique is- the technique of ra negotiated peace. Thu 
Germans, say they can’t lick us and we can’’t lick than so why fight? 
he also know that tho Jar Department tolls' us our definite aim is 
Unconditional Surrender. A negotiated peace, peace now, as sometimes 
stated, means Fascism later. Jo know that if we give the German army 
time to correct their mistakes that all too narrowly lost them the 
war, maybe next time they won’t make" those mistakes. Th/by are not 
asking for peace now because they are licked, but because they feel 
that is the way to accomplish their eventual mission - the domination 
of the world. 
Another objective of the Orientation Program is to know" cur 
allies and by that we certainly do not mean bo white-wash our 'allies. 
Je mean to arrive at a workable understanding - to arrive at an 
understanding that our allies, whatever our differences, are fight- . 
ing for the same thing we are fighting for - that is to wipe out 
Fascism. Our differences must be-overlooked. Je must put aside 
prejudices, we must not let the psychological warfare build up 
within us things which arc not time. 
Another objective is to establish pride in outfit. By that 
we mean-.not just a feeling that this is the best outfit but a real 
faith in the training and equipment that goes with that outfit. A 
job satisfaction, a realization that no matter what job a soldier 
has, even not to his liking, it is a necessary job and must be done, 
and that is how he should contribute to winning the war, and that is 
a good thing for him to do it. It gives him a sense of participation, 
not - only in his unit, but in the entire war, if he feels that he is 
working with other men to achieve something purposeful. 
The next objective is to know the news of the world and its 
significance. By that I'mean, of course, what is behind the news, 
not only the mere fact that the news states that so many bombs have 
been dropped on Germany. ..'hat is the purpose of that, why are we 
spending the time and effort on that? If we are going to have the 
best informed soldier in the world, which is one of our aims, wo 
must realize that the current events of today arc tho historical 
background for the events of tomorrow. There is no easy way to 
teach a man history, but if we teach him day by day, then when the 
time comes to make his decision he’ will have had the history. He 
himself will have known it. - 
The last of the six objectives of the Orientation Program is 
something which shouldn’t even have to be stated. It is to have 
faith in the United States and in 'the future of this country. Jo 
know some people don’t have that faith, and we know some people arc 
telling our soldiers that they should come home and take over this 
or1 that; that they should come back as storm troopers, which is tho 
thing we are fighting against. If a man has faith in the United States 
and its future, he will ccme home and participate in that future as a 
citizen and certainly not as a storm trooper, Thu very potentialities 
of our country have hardly been tapped. Our democracy has a long, way 
to go, and if our soldiers realize that, they will have a greater 
understanding of what wo are trying to achieve, 
* 
* 
To accomplish the objectives the.Orientation Program we set up 
a ten point program within each caAip, That program has to be adapted 
to the unit and in case of the hospital, it again would have to have 
further adaptation, but the Orientation Program is a directive which 
is required of all military personnel, officers, enlisted men, hos- 
pitalized or otherwise - it is all military personnel. 
The first of the ten points is the one-hour per week orientation 
discussion. That is, of course, the basic orientation program. It 
is a part of the regular training, and it is to be given during duty 
hours, This hour belongs to the men. It is not by any manner of means a propo- 
ganda hour; it is a discussion directed along channels by as expert a 
leader as you can get from'your own unit. It is'to be directed along 
basic orientation material, slang current events, but it is a * discussion; 
it is a democratic method of bringing ideas out into the open, rather 
than letting them wrangle over it in his mind and cause him to arrive at 
warped and exaggerated ideas. 
The second part of the ten-point program is a meeting between the 
orientation officer and the part-time men who are conducting orientation 
within the wards or within the units. The reason we suggest that meet- 
ing is because we know that the part-time men or enlisted men do not 
have time to conduct research and preparation that is necessary to put 
on a good orientation hour. The orientation officer has prepared that 
material. If he can meet with those men before their orientation 
hour, he can brief them and get across the information. 
The third point is to establish one or more orientation centers. 
You have seen at the back of the room a partial orientation center 
set up, so you can see what we mean, -Actually it is a center located 
where'the men congregate in groups. It consists of source materials, 
books, pamphlets, pictures and’posters which graphically illustrate 
the orientation program, /in important thing which wo do not have here 
is the news items. By news items we do not mean newspaper clippings; 
the men can read newspapers themselves. We mean to interpret, simplify, 
and clarify the news so the men can get the news without effort they 
have to do by reading the newspaper. We do not mean coloring the news. 
We do this so that the soldier can understand what the news means to him. 
The fourth point of the ten-point program is the use of the news 
summaries. Most units have either a daily or weekly news summary. This 
summary is not an attempt to beat the newspapers at their game. It is 
merely a simple and clear resume of the nows that the men can pick up 
quickly. This summary is sometimes given over a loud speaker system; 
sometimes it is mimeographed and distributed. 
The fifth point is the'use of the unit newspaper for orientation 
material, such as editorial, news analysis, cartoons, quizzes, etc. 
The sixth point is the liason relationship between the orientation 
officer and the men concerned with morale. The orientation officer is 
a morale officer, The relationship'between himself, the Medical men, 
the Red Cross workers, the Chaplain, the librarian and the provost 
marshal - all of these relationships will be of great aid to the 
orientation officer. 
The seventh point is the morale report that the orientation officer 
prepares for the commanding officer. Of course this depends upon the 
Commanding Officer as to how often he wishes them and in what detail. 
The eighth point is off-duty discussion groups, which is part of 
the educational program. Often in the regular orientation hour 
questions come up which the men would like to discuss further, and they 
would like to have time to have some of them presented. Very often 
groups start with four or five men. I know of cases where they, have 
grown into the hundreds. 
The ninth point is the use and presentation of dramatic skits, 
programs, etc. These are not to be used during orientation hours, 
but are to be used on off-duty time, or other curricula time. These 
methods can be a very effective method of getting over orientation 
subjects. The tenth point is the orientation of officers themselves by the orien- 
tation officer. This does not necessarily need to be a formal meeting. 
It is the definite responsibility of the orientation officer. 
As fer the material sent out by the Morale Service Division to aid 
the orientation officer in conducting these programs. In addition to the 
educational materials previously mentioned, we have first films, the "Why 
We Fight" series which you have all seen. Another series "Know Our Allies" 
— the first of which has been issued about Great Britain. The GI Movies 
have already been mentioned. News maps have been issued on the basis of 
one to every two hundred men. Those are not enough if they are being put 
in offices remote from the men. After they are no longer current, the 
officers can use them for whatever they want. Recordings have been 
sent out. They are orientation subjects — for instance "The Nazis Speak". 
It is proposed they will send out other recordings as soon as it is de- 
termined how effective they are and in what way they can be used. 
There are the orientation kits which have been posted on the walls 
in the back of the room. We put a copy of Fat #3 on your desk. These 
orientation kits have books, pamphlets, maps and what we call fact sheets. 
Fact sheets are what we write to get to the orientation officer and part- 
time men information they could not get easily from books or other refer- 
ences. We are also sending out a basic library to the orientation of- 
ficer. It contains eighteen volumes selected by a civilian committee of 
experts on international relations. Additional volumes will be sent 
out from time to time in orientation kits. 
We published a digest for the orientation officer. For instance, 
the March issue includes a photographic explanation and drawings on how 
to set up an orientation center such as we have set up here. Then there 
are the newspaper services which are not necessarily the concern of the 
orientation officers. There are such things as the "GI Galley" and 
"Clip Sheet". Those provide him — for instance one case — with maps 
which he can put in newspapers to bring the men up on the war. Certainly, 
not least, is the issue of "Yank" with which I think you are all familiar. 
MAJOR BENBOW: Circular 73 provides an educational program by the 
Morale Service Training Division. To give you a description of the 
training facilities, Colonel Quarterman has sent Major Bishop, 
MAJOR W. A. BISHOP 
The school for Special Service is a Class IV installation operat- 
ing under the control of the Director of Personnel, and the joint super- 
vision of the Director of Training and the Directors of the Special Ser- 
vices and the Morale Services Divisions, Array Service Forces. It is 
located on the campus of Washington and Lee University in historic 
Lexington, Virginia, and is commanded by Colonel William K. Quarternan, 
Field Artillery, 
Hie mission of the School for Special Service is to provide appro- 
priate training for officer and enlisted personnel assigned to duty in 
the Army Athletic and Recreation Pro grain, and the Army Orientation and 
Education Program. Two distinct courses — each of twenty-eight days 
duration — are provided for classes which average three hundred stu- 
dents each. Students are sent to the School by commanding officers 
from the three major elements of the Army ih accordance with quotas 
allotted to service commands, air service commands, theaters of opera- 
tion, and the Directors of the Special Services and Morale Services 
Divisions, 
It is the experience of the Headquarters Divisions in Washington 
and the School itself that a more careful selection of these special staff officers - the Athletic-Recreation Officer and the Orientation- 
Education Officer - is essemtial if not indispensable to the achieve- 
ment of their important missions in the field. I® Circular 28? de- 
scribes the duties and qualifications of the A&R officer while 1/® 
Circular 261 describes the duties and qualifications of the Orienta- 
tion-Education Officer. 
The ideal educational reconditioning officer is conceived as an 
individual with a consuming interest in presenting the justice of the 
cause for which we fight, and will be acquainted with the facts con- 
cerning the causes, issues and course of the war. He will be capable 
of organizing and administering a well rounded orientation and edu- 
cational program and to advise and guide the convalescent in the solu- 
tion of his educational problems. He will preferably be a college 
graduate and will possess the ability to present his views clearly 
and convincingly. Whenever practicable he will have been a company 
commander and, as is suggested by WD Circular 73, may be found in 
considerable numbers among the recovered casualties of the fields of 
battle. 
The instructional program, of the School for Special Service is 
designed to train selected military personnel so that they may effect- 
ively assist commanding officers in developing and maintaining the 
high levels of mental and physical stamina in troops for combat. It 
is therefore reasonable to suppose that this program, with minor 
revisions and necessary adaptations, might be appropriate for educa- 
tional reconditioning personnel as well. 
The Athletic-Recreation Course provides administrative and leadership 
training in athletic sports and games (based on TM 21-221); physical 
conditioning (based on TC 87); soldier theatricals; soldier music; and 
the procurement and use of the Special Service funds and facilities. 
The Orientation-Education Course offers leadership training in methods 
and procedures designed to create in every fighting man a feeling of 
individual responsibility for participation in the war; for keeping 
him well informed as to the cause of the war and news of the world; 
and to give him an opportunity to add to his effectiveness through 
off duty individual or group study. All of these elements, and others 
too, are included in the Reconditioning Program. 
It is axiomatic that the resources of service schools are available 
to whomever proper authority assigns them. I know that Generals Porter, 
Dalton, Osborne, Byron and Weible, and Colonel Quarterman would con- 
sider it a privilege to have the School for Special Service contribute 
to the training of selected reconditioning personnel. 
MAJOR BSNBOW: Thank you, Major Bishop. Major Bishop will be 
available during the discussion period. 
MAJOR BRISCOE: I am not sure if all of us realize that there 
are two divisions of the ASF represented here. We very often refer 
to the Special Services Division, but there is another - the Morale 
Service Division - which is in charge of Army educational orientation, 
music, art and libraries. I am going to ask Lieutenant Kohn, Morale 
Services Division, to tell you about that service. 
LT HENRY KOHN 
The Special Services Division is grateful indeed for the opportunity 
to participate in this splendid conference. The attitude of Special 
Services toward the convalescent program is briefly this. We agree 
with you that when GI Joe becomes a patient he deserves the utmost 
service that the Army can furnish him. Consequently, if there is anything that the Special Services Division 
has to offer that you can use, lot us know and wo will make every effort 
to supply it in the quantity and quality desired, lie would like, in 
other words, for you to toll us what you want us to do. 
To aid you in this determination, I am going to sketch briefly our 
present activities so that you can decide whether or not we can make any 
additional contribution to your program. As you may know, our job as a 
staff division is to assist commanders in building■morale through athle*- 
tics, physical training, live entertainment, music, movies, manu 1 .rts, 
libraries, and Artiy Exchanges, We assist commanders in those various 
fields by offering them specialists who are skilled, for example, in music, 
theatrical, arts or physical training. In addition, wo-publish materials 
to provide ideas and programs, and we make available certain equipment 
and supplies. 
To be more specific, let us consider each one of these morale build- 
ing activities separately to observe to what extent they may fit into your 
program. In one of the most significant phases of the convalescent program'— 
physical fitness — wo can perhaps lend a hand. As you know, one of the 
functions of the School for Special Service is to train officers and en- 
listed men for leadership in sports and physical training. In fact many 
MAC officers have attended the course; but to date, the course has'been 
designed and oriented for training healthy troops. We stand ready, how- 
ever, if you so desire, to change the faculty and the curriculum so that 
men who are earmarked for hospital work receive the most advanced knowledge 
on graded exercise and physical training for orthopedics or other dis- 
abilities, Because of the proximity of the school to Woodrow Wilson 
General Hospital, students might participate-in the reconditioning program 
there as a part of their training. Moreover, if"wo can aid you in the 
purchasing of athletic■or recreational equipment, we would be glad to let 
our procurement specialists in this field assist you in any way practi- 
cable. 
Turning to the field'of live entertainment, most of the hospitals 
already receive camp shows, which operate under the direction of our 
division. At present, entertainment is being provided on a monthly basis 
through regularly established circuits. In addition, about May 1st or 
before, a special hospital circuit — initially for general hospitals — 
will increase the entertainment in those installations to once every two 
weeks. This is in accordance with the great majority of preferences as 
to frequency expressed by commanding officers. The entertainment on this 
hospital circuit will be carefully reviewed as to quality and style and 
a particular effort will be made to include entertainment having a 
beneficial effect upon the patients. 
Among healthy'troops, Special Services has sponsored and fostered 
self-entertainment, through soldier shows. We have sent scores of 
theatrical advisors- to the field armies to stimulate and direct self- 
entertainment among the troops. The number of such soldier shows pre- 
sented in this country alone literally runs into the' thousands every 
year. If you have a place for them in your program, you can have officers 
and enlisted men who are specialists in soldier entertainment, In addi- 
tion, subject to approval, the Special Services Division will prepare a 
monthly folio of entertainment material similar to the one we send over- 
seas, comprising little skits, sketches, games, quiz shows and other 
material carefully selected .and reviewed as to its practicability and 
utility for soldier shows in hospitals* 
In the music field. Special Services Division again can furnish of- 
ficers and enlisted men who are specialists. These men acting under 
medical supervision could make music an integral part of the recondit:) err- 
ing program. Whether the music is made available to patients by ph.n - 
graphs, public address systems, radio or by organized teaching of the 
playing of small pocket instruments and fretted string instruments which 
provide muscular exercise - whatever the method - trained technicians are avail- 
able to lead the program. Again, any personnel sent to hospitals for 
this type of work could be given special training at our school to ac- 
quaint them in the particular needs of the hospital situation. 
Before leaving the music field, it might also be mentioned that at 
the present time, certain music services in which overseas troops are 
preferred, have not been available for hospital patients in this country. 
I refer to the latest phonographic recordings known as V~discs which are 
procured and distributed by the Division, Hit kits, moreover, are gen- 
erally only issued to the permanent party, not to the patients in hos- 
pitals. If you desire these supplies to be issued to hospitals in this 
country, steps might be initiated to effect this objective. 
Now let us turn a moment to hospital libraries. They are under the 
staff supervision of Special Services and provide an important source of 
diversion and therapy. A recent survey of hospital libraries indicates 
that the service in the general hospital has been generally satisfactory. 
But service has suffered recently from cutting the number of library 
assistants. Incidentally, the survey illustrated that hospital library 
service in station hospitals of less than 1000 beds is generally inade- 
quate. Therefore, to the extent that reconditioning w;ould be carried on 
at such hosoitals, there would be even a greater need than now exists 
for improving library service at such places. Seeking to improve the 
hospital library service, the Office of the Surgeon General has requested 
that the special paper bound reprints, popularly called council books, 
containing thirty new titles each month, be made available to soldiers 
. in domestic hospitals as well as to troops overseas. Special Services 
Division is anxious to make this possible. It is for the far‘Department 
to decide, however, whether it is feasible from a financial point of 
view to make these great little books’available to the hospital libraries. 
If it can be done, it would indeed be a major advance in bettering hos- 
pital library service. 
In the field of arts and crafts, Special Services procures for 
troops overseas a variety of handy-craft kits which includes leather- 
craft, metalcraft, model airplanes, show card kits, lettering and artists1 
sketch kits. Our division has trained personnel in the field of manual 
arts and at present the curriculum of the Special Service school now 
includes instruction in the use of handy-craft kits. But these kits 
are not now available for domestic distribution. If you believe, however, 
that our division can help in providing an active and masculine manual 
arts program then we would be happy to assist in obtaining supplies and 
trained personnel. 
Finally, there is another segment of our activities which already 
plays a vital and immediate role in maintaining hospital, morale, I mean 
the Army exchanges. The Special Services Division has almost completed 
a field survey of hospital exchange operation to see to what extent serv- 
iceman be improved. In view of dietary limitations and the fact that 
patients are confined to beds,or are unable to purchase at stores in town, 
special procedures have been devised to make the exchange as efficient as 
possible in satisfying the needs of the patients. Results will, soon be 
published so that commanding officers and exchange officers will be in- 
formed of those operating techniques found most popular in other hospitals. 
These in brief are the activities in which the Special Services 
Division might be of use in your program. At the present time, a 
Special Services of,ticer is authorized as a full time'job for every hos- 
pital ol two thousand population or over. Sometimes, however, the duty 
of an athletic and recreational officer has been assigned as an addition- 
al duty and the results have been correspondingly unsatisfactory. More- 
over, the scope of a Special Services officer is generally restricted to 
duty personnel, with the Red Cross and occupational therapists handling 
the recreational program for the patients. The Special Service Division, as you know, has a mammoth job in 
servicing healthy troops, so we do not search for new fields of endeavor. 
It is for you to decide whether we can be ®f any additional aid to you. 
If we can, please feel free to call on us. To repeat, if it is your wish, 
we will modify the training program of our school so that the various 
athletic and recreational specialists will come to your hospitals with 
a thorough understanding of the problems and objectives of the convales- 
cent program. 
COL. THORNDIKE: I think the Morale Services and Special Services 
have informed us of everything they will do to help us, and I assure you 
from my personal contact with General Osborne that he is vitally interest- 
ed in all the aspects of the reconditioning program, 
• 
We will adjourn for lunch and meet at 1:15 here, I think there 
are some things that -Lieutenant Kohn has in the way of materials and 
equipment which he will tell us about. General Dalton has not come 
in, so I presume official business has kept him elsewhere. The meeting 
is adjourned. 
(LUNCH) 
COL. A. THORNDIKE; Will the meeting please come to order? We have 
a busy afternoon and certain speakers, members in the conference, are 
planning to take the 5 o’clack train. Just a word of explanation. Any- 
one attending the conference who has not signed in or out with the Adjut- 
ant is requested to do so. There is a very important plan scheduled to 
be followed this afternoon. Just a word about the round-table discussion, 
Cn your blotter you will find the section to which you are assigned and 
you are to stay in that section one half hour and to proceed to the next. 
This evening’s conference is directed to reconditioning in the service 
command and is naturally to include all members of the service command 
staff whether they are reconditioning directors, surgeons or otherwise. 
Anyone who is confused as to which group of the round-table he goes, 
can stop at the information desk which is directly outside the door, I 
left open this morning a little time for Lt. Kchn and so many people want, 
to use this time I am going to ask him to come up and be as brief as he 
can. 
LT. KOHN; I just want to call your attention to a mimeographed ref- 
erence list for Special Service activities in hospitals which will indi- 
cate to you everything now available and can be had by either writing to 
us or to the normal distribution depot of the Adjutant General. That is 
all I wanted to say. If you do not have one of titeee lists, you can pick 
one up at the table to the rear to your left. Thanks very much. 
COL. THORNDIKE; The next speaker is Colonel Reed, Seventh Service 
Command Public Relations Officer, who has some very important points that 
I. think this conference should hear concerning the importance of Public 
Relations in hospitals, 
LT. COL. R.VJ. REED; Thank you. Colonel Hillman. Gentlemen. I feel 
something like the guy that wore out the end of the bench for three years 
and then caught the eye of the coach. 
I have been listening to the proceedings of this conference with a 
great deal of interest. I have listened to some of the discussion in the 
corridors and in the quarters, and it seems to me that you have here in the 
discussion of this program of reconditioning a very definite Public Relations 
problem. 
6? Of1course, Army Public Relations are involved at all Army hospitals to some 
extent but I think wo are coming into a more acute"period now, because the 
war has too many of our people, gone far away and is remote to them. They 
know it mostly and somewhat in a distorted fashion through the impressions 
they have gained from headlines, from the radio, and from the movies. 
They know little of the actual, reality of it. So it is, therefore, that 
the hospitals present a specific Public Relations problem because they are 
the first to be caught, as it were, in the backlash of the war to an ex- 
tent that causes their functions and activities to have a direct and de- 
finite impact upon the public. Consequently, the reconditioning program 
is one that requires the most qareful consideration and planning from a 
Public Relations standpoint as well as from all others. It is here that 
the Army can achieve good Public Relations that will be helpful all along 
the line from training to combat. 
It seems to me, in thinking it over, that the reconditioning program 
presents two distinct Public Relations phases. The first of these is the 
internal Public Relations of the hospital itself. Among the patients and 
their families and friends that come to visit them in the hospital; the 
impressions that they gain, not only by the visual observation of condi- 
tions and activities at the hospital, but also of the things that they 
are told by the patients themselves. You can imagine, I think, all of 
you, how a dobing mother who comes to visit her son would feel-about 
some things that she might learn at the hospital,. When 'she learns, for 
instance, that her son might possibly be going back into combat, her imme- 
diate desire would be to take the boy home; she wants to do a little more 
mothering. She forgets that he has been'a soldier and is expected to go 
on being one. People who come to* the hospital must be made familiar ’with 
the problems of the reconditioning program and its objective*.*;, so that 
their approval is won, so that they understand its importance and so that 
they will not incite the patient’s mind with a constantly expressed wish 
that they should be homo with their families and friends. 
Second, the external phase is very important for several reasons. 
To begin with, there is the community in which the hospital is located. 
The local press and radio can help greatly in getting over the idea of 
the purposes and results of reconditioning to the patients themselves and 
to the people of the community in which they circulate while out on pass. 
More than that, however, correct handling of the presentation of news, pic- 
tures and featured articles from the hospital to newspapers throughout its 
immediate area can help in another important way. It can help condition 
the public mind generally to first, the fact that there is a military 
need for reconditioning and that as many men as possible must be restored 
to full duty. General porter’s remarks yesterday stressed this need as 
imperative, and that thought should point up much of the Public Relation 
activity in the hospital* Then there is the problem of the ODD. If he 
can be returned to his community sufficiently reconditioned physically 
to take on a job and do it well, he will be an asset, but the people in 
the community must also know that they have a responsibility to that man. 
His family and friends will greet him as a hero, they will pour sympathy 
on him and encourage him to take the attitude that "I have done enough", 
and soon you will have that type of patient back on the government such 
as we have had in the Veterans’ Hospitals since the last war. 
It seems to me that in projecting this program to the public, the 
reconditioning officers must, ox course, keep in close touch with the 
Public Relations officers. There are a lot of human interest .angles. 
I have seen a great many of them myself in brief visits around the wards. There arc some very inspiring stories hero in a hospital like this, so 
not only should the Public Relations Officer be thoroughly familiar 
with the program, but ho should have tho sympathetic help of the recon- 
ditioning officer and also Morale Services Officer, tho Chaplain and 
everybody els ,, to got this thing over. I am sure that at the Ser- 
vice Command, the Surgeon and Reconditioning Officer on his staff and 
tho Service Command Public Relations Officer should work together to 
see that there is a smooth and efficient handling of this as a matter 
of considerable public interest. I leave those suggestions vdth you 
and I thank you very much for the time, Sir. 
COL THORNDIKE: Thank you, Colonel Reed. Colonel Lynch has a 
few words he would like to say to us concerning some personnel problems, 
COL LYNCH: Colonel V/right of the Sixth Service Command was dis- 
cussing with me the other evening a problem which appears to be rather 
universal and I request Colonel bright to state that question and then 
I will take it up, 
COL WRIGHT: Colonel Lynch, tho reconditioning program, as exempli- 
fied here and in many hospitals, is certainly a step forward. There 
aim, however, many individuals who will be returned to duty not fully 
able to carry on active combat duty and yet, because of their useful- 
ness and specifically because of the directions in Circular No. 293, 
they cannot be discharged from the Army by medical officers. Every 
consultant has seen a large number of taose patients and every hospital 
has some who upon return to duty have been met by a rather unsympathetic 
end non-understanding attitude on the part of their line officers or 
equivalent commanding officers who havw either assigned them to work for 
which they were not suited or told them there was no job for them in that 
particular unit and they didn't know what to do with them. 
The result -has been that many of those patients have been returned 
to the hospital, I personally have seen some who have been through this 
rather vicious cycle from six to eight times. It is bad for morale of 
tho patient, the medical officers, and also for the other patients who 
have listened to tho stories of these individuals. 
The question, therefore, is this: May we have a discussion re- 
garding what is being done or con.tempis.ted in the way of education or 
to influence the line officer to attack this problem of reassignment 
more intelligently and more seriously. 
COL LYNCH: The problem as stated by Colonel Aright has been in 
the minds of the staff of the War Department for some time. Ye have 
no panacea for solving the problem as a whole. We have taken certain 
definite steps that we think will be of great help in solving the partic- 
ular problem. As General Hillman stated yesterday, we have a tendency 
to swing from one side to the other on our various problems as though we 
wore on a pendulum. Last summer and fall we were discharging men from 
the Army faster than we could get them in through Selective Service, which 
was a condition that could not be tolerated. Circular No, 293 was 
issued as a result of experiences obtained with Circular No. l6l. It 
has been a matter of personal concern to me as Chief of the Enlisted 
Branch, G-l, as to whether or not we wouldn’t swing too far the other 
way and end up with too many people that were non-usable. However, we 
are very wary of issuing too many changes in policy tc the field be- 
cause it not only creates confusion, but also starts minor swings in 
the pendulum. We have taken three definite steps in connection with 
correcting tho situation referred to. The first step was a letter issued 
by the Chief of Staff to his major commanders on the utilization of 
personnel. It was an extension of the policies published generally in Circular 
No. 293. The realization of the manpower situation has been rather 
forcibly brought to the minds of the major commanders in the last few 
months and we expect these effects to trickle down through the echelon 
of command. They should be down there by this time. 
The second step in connection with Circular No. 293 was to make 
an amendment which I have referred to already. It appears in Circular 
No. 100—a policy stating the command1s duty, with respect to enlisted 
men's physical condition. Unfortunately this was buried in a paragraph 
which referred to physical standards for men going overseas and its posi- 
tion escaped our notice in getting out the original 293* The revision 
which I will read, has now been placed in the policy part of the circular, 
and includes provisions for implementation. The policy now reads: "Each 
commander must evaluate the physical condition of his men and apply prompt 
corrective measures through training or medical treatment. Wren a defect 
is discovered which disqualifies a man for oversea service, or which re- 
quires special consideration in assignment, the examining authority will 
notify the man’s unit commander of the defect and appropriate notation 
will be made on Soldier’s Qualification C-’iu under "Remarks” and on Ser- 
vice Record under ’’Remarks, ir.-inistrative.” W*'or. a disqualifying de- 
fect has been corrected or materially improved, the proper agency will 
notify the man’s unit commander and appropriate action will be taken to 
modify the previous notations.” 
To implement that, a form letter has been prepared and instructions 
for that follow in the next section: ”When a defect which requires 
special consideration in the assignment of the individual concerned or 
which disqualifies him for overseas service is discovered at a hospital 
or other medical installation, the medical officer concerned will trans- 
mit to the man’s unit commander data necessary to permit proper reclassi- 
fication and reassignment in keeping with the man’s mental and physical 
capabilities. 
’’Similar notification will be furnished when the medical officer 
determines that a previous defect has been corrected or materially im- 
proved . 
”Unon receipt of the information mentioned above, the unit com- 
mander will take the action required by paragraph 2i (which I have just 
road to you). 
”It is the commander’s responsibility to give the individual an 
assignment appropriate to his mental or physical capacity as outlined 
in the notification.” 
The text of the letter is not particularly important. The third 
action that has been taken was, effective the 13th of February, to es- 
tablish three War Department reassignment centers. These reassignment 
centers are to take care of certain categories of personnel, only two 
of which are of particular interest to this conference. Battle casu- 
alties other than -Army Air Forces discharged from the hospital who are 
capable of performing useful service other than in the arm or service 
to which currently assigned, are assigned to a VN-r Department reassign- 
ment center from the General Hospital in order to be properly reassign- 
ed to include retraining if necessary, before they are disposed of. 
Those reassignment centers operate at W«r Department level similar to 
Reception Centers. -Another category of personnel includes those whose 
physical and mental capacities might be utilized if reassigned. It does 
not include those clearly below the minimum standards. In review: The policy is that each of the three major commands must 
exert every effort within their jobs and assignment capabilities bo re- 
assign the man in accordance with his physical condition and bis other 
training and capacities. If they find a man is non-usable, they report 
him to the War Department, The Adjutant General issues orders trans- 
ferring him to a reassignment center. There he is reevaluated by an 
experienced and selected personnel, both medical and classification and 
the man is reassigned. He may be sent back to his own branch. The 
question of keeping these from bouncing has not yet been solved under 
the new set-up. We have not yet had sufficient experience but it will 
probably end up by the commander being told he has the man and it is his 
problem to use him in accordance with the new version of Circular Ho. 293. 
There is another aspect which has not been solved'as far a.s a publi- 
cation is concerned. ve have a category of personnel discharged -from 
General Hospitals and other medical installations which, with this letter, 
are qualified to go back to their unit but not for full duty. A plan lias 
been discussed heretofore but concurrence has not been obtained from the 
Ground Forces. The plan is to return such personnel to a replacement 
training center of their arm or service, at which place they may be used 
as trainers or given refresher training which will permit them to develop 
technically as well as physically in that carry-over period until they are 
- ready to assume full duty. That plan has not yet crystallized into any 
publication. That about covers the point on the question that Colonel 
Wright raised. I know it is not a complete answer, but we hope that 
general indoctrination plus what we have done will solve it. While I 
have the floor, I'd like to thank Colonel Winn and representatives of 
the Seventh Service Command for the excellent accommodations and facilities 
which have been provided for this conference, I would also like to review 
from a layman's and from G-l's point of view, certain aspects of the re- 
conditioning problem. General Hillman touched on it in general terms last 
evening. Our principle objective is to restore the patient to his place 
in the ranks with the least possible loss in time... We must keep our eyes 
on the ball and not let the reconditioning program become so elaborate 
that it detracts from the essential point of our mission. 
The second feature is that in my opinion, it should be constantly 
emphasized to the patient — which is a term I do not particularly like — 
that -he is still in the Army, I noticed that at the roundtable discussion 
yesterday they used the term "fellow patients," That should be discarded. 
They should either be referred to as "men" or"fellow soldiers." I think 
a great deal of the problem can be solved if you develop the "can do" 
attitude. That is merely a term that is used by some professional military 
men to describe a state of mind. You have referred to it when you stated 
that your leaders in this reconditioning program must be sold on their 
part of the work. The "can do" attitude means that you not only can do, 
you will do it, and you are going to do it. I happened to be reading a 
piece in the paper this morning which, I think, exemplifies the point of 
view. It refers to a story of building bridges across the Dniester River. 
The men usually cut their own timber and rely on pioneers to build the 
■bridges. These pioneers aren't specialists. I once asked a Pioneer officer 
■ where he learned to build bridges. 
"Nowhere",, he said, "anybody can build a bridge." I said I thought 
it depended on what sort of bridge you wanted. He said no, if you had to 
have a bridge you had to have it, and that he could build a bridge across 
the English Channel if he had to. "That's' the way they look at it. If there's a river to cross the 
Red troops have got to cross it, and the Pioneers do the bridge-building 
job with what is available." 
That's what I mean by the "can do" attitude. Instead of sitting 
around and complaining that you don't have the facilities and equip- 
ment to do a job, you find out what the job is, what you have to do, 
then you ‘say "can do" and do it. 
COL THORNDIKE: Thank you, Colonel Lynch. Colonel Winn, do you 
want to explain to the conference how you handle the placement of 
cases that might be troublesome? 
COL WINN; I don't know that I can add very much to the subject. 
When we first began operating under Circular 293 we had considerable 
doubt in our minds as to how we could implement that document. Vile 
had been discharging men by CDD in accordance with the directives 
existing at that time. When this circular came out, of course, there 
were large numbers of those men who were fitted for some kind of duty 
and we made an attempt to salvage them. In order, in our minds, to 
help the reassignment centers, we had these men interviewed by a 
Classification Officer of the Adjutant General's Department whom I 
had made special efforts to obtain from the Seventh Service Command. 
He is a psychologist, one who has had training in vocational direc- 
tion and in War Department classification. In addition to the other 
duties of this officer, he interviews soldiers at the request of their 
own officer before the soldier's appearance before a Disposition Board, 
or if he hasn't seen fit to request this assistance - it frequently 
happens that a disposition board feels the need for some sort of 
advice and sends the soldier to this officer. The Classification 
Officer makes a written statement which becomes a part of the soldier's 
clinical record and which is available at the time he appears before 
the Disposition Board. It is shown so that the Disposition Board 
states definitely what types of duties the soldier cannot perform. 
We haven't felt that it was feasible to enumerate the jobs a man can 
do. We have preferred to state his limitations. I notice that the 
new circular provides that that be done rather than state duties that he can 
do. To go a bit further, we attached a copy of this Classification 
Officer's recommendation to the Form 20. We have been doing this for 
several months and now it has been made a part of the Form 20 and a 
part of the service record. However, we have simply been acting on 
our own initiative and have stapled to the Form 20 this Classification 
Officer's opinion, hoping it would help in the reassignment of these 
men. I can't say exactly how successful it has been. We have not been 
too encouraged because of letters we have received from these soldiers 
who have gone. Some of them have voluntarily written back. One man 
who certainly shouldn't be in an overseas combat unit and shouldn't be 
in a cold, damp climate, and who was recommended for duty in a warm, 
dry climate, sent me his reassignment orders and had written across the 
top, "And this is what you call a warm, dry climate". He was assigned 
to Camp McCoy, Wisconsin,in a combat division. There have been other 
instances of men with rheumatic fever where we have made the same sort 
of recommendations. They have been returned to the same source from 
which they came to us. They then have again contracted rheumatic 
fever and they have returned to the hospital suffering with it a second 
time. 
COL LYNCH: I might explain, Colonel Winn, how some of those things 
come about. We ran into that only recently. When those men were re- 
ported to The Adjutant General, most of them were assigned to the Army 
Ground Forces based on information furnished to The Adjutant General 
and the assignment people didn't have all of that information. They 
sent him to a division, and after he got to the division the correspond- 
ence with the Ground Forces began and some of it is still going on. That accounted for the men with rheumatic fever because we have been 
checking up on those particular angles. They were just reported^in 
as infantrymen, qualified to go sack to duty '<>ithout any qualifying 
remarks at ail. Now, I think that with the instructions for assign- 
ment of-patients to reassignment centers or to R.T.C.’s, we can over- 
come most of that. 
COLONEL WINN; We have made an effort for quite a long time now to 
give as much information as we could to the post to which the man is re- 
turning, We have sent them copies of the Disposition Board to which was 
attached a transcript of the soldier’s clinical record. Wo lound to our 
dismay that at one center to which we were sending men that about $0% 
of them were given C.D.D.’s. Cur Disposition Board record was being 
thrown into the waste basket and the surgeon never saw it, so we 
started sending it to the surgeon, I would like to give this rough 
estimate. I am not quite sure of these figures. We have had little 
private arrangement between our Classification Officer and the indi- 
vidual because we are interested in this proposition. He has asked 
them to write to him a personal letter, tolling him whether or not he 
was satisfied or whether he thought he had been properly assigned. 
Cf the replies which have been received - I think Major Johnson can 
correct me if I am wrong - about 20% have apparently been assigned • 
satisfactorily. 60% were fairly satisfied, 
MAJOR JOHNSON; We received about 20% informal replies from those 
who left here, and 60% of -those soldiers said they were satisfied; d.0% 
considered it fair enough, find 2Op felt they had been poorly assigned, 
COLONEL THORNDIKE: I think this problem has been pretty well 
aired. I think we all understand the difficulties under which we 
work and will lock for a solution as promptly as possible, but it is 
only by cooperation and not by informally discussing this problem 
that we get results. I am sure that Colonel Lynch understands the pro- 
blems that th~ Medical Department is having. Wo now go on with the 
program. The next speaker is Major Buss, Military Personnel Division, 
ASF Headquarters, who will speak on the subject, "personnel Require- 
ments in the Reconditioning Program". Major Dues. 
MAJOR PUES: In personnel requirements for the reconditioning pro- 
gram, it seems to me there are four things which have to be considered 
in arriving at a yardstick. First, 1 think we will have to admit that 
they are unknown quantities but when combined will furnish us with in- 
formation upon which to base an over-all personnel requirement. 
First, it is the motivation of the trainees. 
Second, the activities which must be supervised. 
Third, limitation on size of groups, and 
Fourt-h, individual contact required for both physical and mental 
development. 
The motivation of the trainee in many instances can cut down an 
untold number of men required for the total reconditioning program 
throughout the country. Insofar as the reconditioning officer is 
successful, along with the help that he has in motivation, by that 
much will the-need for additional.personnel be reduced. There are 
certain activities which, regardless of motivation, must be supervised, 
I recall quite well, back in the days of the Civilian Conservation Corps, 
that during the spring season in some camps more men reported for sick 
call because of injuries on the athletic field than because of injuries 
on the work projects; also, at least an equivalent number of hand in- 
juries took place in the woodworking shop as took place on the wqrk 
projects. The answer was fairly obvious. The work project was much more ade- 
quately supervised than were either of the two other activities. 
There are but two reasons why the requirements are unknown. 
The constant pressure which all of us have felt for re- 
duction of personnel on overhead activities, with the constant pressure 
for increase in efficiency have confused many of us in the personnel 
business because the tugs and pulls and the pushes come from so many 
different sources at so many different times. Frankly, I have no idea 
how many people will be required and I doubt that the number required 
will be a very straight-line function of the number of trainees in the 
program, I believe that the number required per trainee of personnel 
will be reduced as experience is gained, I am sure you know in Service 
Command installations, that there is a bulk allotment of personnel, 
both commissioned• and enlisted, made from the War Department to the 
Service Command as a whole, ?,here. that personnel is used is not a 
function of Headquarters, ASF, It is a function of the Commanding 
General of the Service Command. In T/0 organisations, it is determined 
through experience that a certain number of men with certain types of 
skills are required for the formation of a unit Therefore, there is 
a definite number of men for a kind of unit which will have a specific 
mission to perform. As is the case in Service Command installations, 
so it is with T/0 units, however bulk allotments permit greater freedom 
and therefore seem more logical for service command use, They do per- 
form many missions which were not contemplated for them, I will say 
that the Military Personnel Division of the ASF will do all in its 
power to make the necessary over-all adjustments that might be required 
by Service Commands, At the same time, however, because of the decrease 
of activities in the Servi.ce Commands, the overhead personnel will be 
reduced each quarter of the year. 
From a classification and assignment standpoint of the recondi- 
tioned men, there is quite an interesting, history which perhaps you 
know and perhaps you don't. In the beginning days when the Selective 
Service law first started to operate, those of us who were engaged in 
the vocational classification and assignment of personnel had. very 
close contact with the Office of the Surgeon General, mainly for ed- 
ucational purposes on the part of all concerned. However, from a 
functional point of view, as soon as the physical standards had been 
set and Induction Station Commander said a man was in, the classifi- 
cation officer became the key man and said, if a man was a lawn mower 
‘in civilian life, he should be a lawn mower in the Army, thus we 
capitalized on, and I believe properly so, civilian skills. We were 
a long way from combat as we now think of it. We had to find men to 
interview; we had to find men to type the records, etc., until wo had 
our service built up to where we could be of real service to the men 
who were going to be trained as combat and combat support troop. 
Now we have come to the tag end of that operation and we find our- 
selves being much more closely allied with the Office of the Surgeon Gen- 
eral because of the terrific physical implications that must be taken 
into account when a man is reassigned within the Army after he has been 
hospitalized. We are not in a position to worry too much about capital- 
izing on his civilian skill as we were in the beginning days* As a 
matter of interest, I believe General Hillman will back me up in 
this, our Division has had more conferences with the Surgeon General's 
Office since about the 9th of February thin it has had in any equivalent 
period' since the war started, due to the fact that we are at the con- 
servation angle from a physical point of view rather than a capita- 
lization on the civilian ability that might be represented by military 
personnel. 
Where in the process of reconditioning should there be a classi- 
fication officer? It is questionable in my mind that every general hospital would have use 
for a classification officer, at least on a fulltime basis. I believe, 
however, the traveling teams that have been set up in the service commands 
with their key officers can be of great assistance in training certain per- 
sonnel within the hospital to assist in interpreting what the medical pro- 
fession has to say about the limitations of this man physically and in at- 
tempting to interpret those into "What can this man do vocationally when 
he is reassigned?" There have been some developments of a positive nature 
along the CCD line. They are still in the experimental stage, but I be- 
lieve are available for such hospitals as would care to request them. They 
are rather extensive and are essentially AR 615-26 in reverse. The mili- 
tary occupations have been broken down on one side of the page and a cor- 
responding civilian field or fields listed on the opposite side of the 
page. In other words, in the beginning, we capitalized on civilian skills 
and tried to interpret them into the military skills. Now we have men who 
havu military occupations with skills which are utilizable, by interpre- 
tation, back in civilian life. I think those might be helpful in the ODD 
cases. 
In the reconditioning Program in terms of both the personnel require- 
ments and the assignment of personnel after they are released from recon- 
ditioning, there must be an ideal program. However, as v/e now are operating, 
it is my opinion that the control will be and must be the number and kind 
of personnel that v/e have that can be allotted as additional help in the 
program as well as the exploitation of the trainees and the capitalization 
on what they represent as trainor personnel. 
In conclusion, I would mention that in the beginning days of activa- 
tions it was a rather common saying that a division commander who did not 
train his cadre four deep would have no cadre at the end of six months be- 
cause new divisions were used as a parent organization for the formation 
of other new divisions. By that very method of training, three or four 
deep, he not only speeded up the training of these men, he not only trained 
more of them, but he ended up with a better organization. Insofar as that 
can be applied in whole or in part to the trainees in the reconditioning 
program, it should be. By that I mean the more of them you are training as 
instructors, the more rapidly will all ©f them be available for reassignment. 
Thank you. 
COL. 'JINN: Colonel Thorndike, I would like to say this in explanation 
of this Classification Officer we have acquired. We haven’t felt that any- 
body on this post should have a full time job. This officer is used as Ad- 
ministrative Ward Officer for three NP Wards. Ho relieves the medical offi- 
cer of all routine duties such as property responsibilities, passes, etc. 
He is a psychologist and is competent to make psychometric tests which are 
necessary in NP cases. If he doesn’t make them, the doctor has to make them, 
so v/e are saving the doctor’s time again. He assists our own Personnel Divi- 
sion in reclassifying our duty personnel, and, in addition, does the work as 
I described for Questionable patients. 
COL. THORNDIKE: Next on the program is Miss Eleanor C. Vincent of the 
National Headquarters of American Red Cross, Most of us in Washington have 
come in contact with Miss Vincent, She is very busy doing a lot of good work 
and v/e know that the Red Cross in the hospitals is a most important activity. 
Miss Vincent. 
MISS ELEANOR C. VINCENT 
General Hillman, Colonel Thorndike, and Colonel Winn, Red Cross workers 
in hospitals and volunteers greatly appreciate the privilege that Mrs, Swig- 
gert and I have to attend this conference, and we hope as a result of the 
discussion which we have heard that we, as Red Cross Workers in the hospi- 
tals, will further the Reconditioning Program. Red Cress no dice 1 social work was established in .insiy and Wavy 
hospitals to meet a need similar to that which had been recognized in 
civilian medical practice. .t need existed i.'or social data regarding 
patients, which enables the physician to know the patient as well as 
his disease and for assistance in solving those social problems which 
are retarding the patient's response to medical care. 
The first psychiatric social worker was requested by The Array Hos- 
pital for Functional Neuroses, Plattsburg, Now York, in 191?. Immediately 
thereafter, a request for a medical social worker was received from the 
Commanding Officer at Chelsea, 1 aval iiosoital. Because of the chartered 
obligation of the ...ed Cross to serve the sick and wounded of armies, the 
National Organization immediately complied with the requests of the Car 
and Wavy Departments, -i professional social work staff was then assigned 
to which v ....re added recreation personnel, to plan and supervise medically 
approved recreation for convalescents and to coordinate the activiti s 
of individuals and groups who desired to serve hospitalized men. 
The ,u.-d Cross social service unit is a department of the hospital, 
responsible to the commanding officer for the conduct of the Red Cross 
Program as agreed upon between the Office of The Surgeon Tenoral and the 
American National Bed Cross, and as outlined in xcrmy iemulations 850-75• 
The worker who heads the staff also is administratively responsible to 
the hospital unit of Hit ary -rid naval -..'elf are Service in the Red Cross 
area office for the operation of the program and the quality of •perfor- 
mance. She in turn receives professional guidance and supervision from 
the area hospital executive and advice from the consultants in the psy- 
chiatric casework, recreation and educational fields. 
The function of the Bed Cross in'military hospitals is social case- 
work for patients and duty personnel, medically approved recreation for 
convalescent patients, and the recruitment, training and direction of 
volunteers. 
Since reconditioning emphasizes recognition of the patient as an in- 
dividual., the significance of the doctor-patient relationship and the 
importance of the patient's understanding about his condition, it parallels 
completely the basic concept of'medical social work—that the social worker 
should hoip the sick or injured person to adjust to the limitations which 
his condition involves and encourage him to carry out the treatment recom- 
mended. 
The social worker also supplements the medical officer's understanding 
of the patient through knowledge obtained from the patient or his family 
through the home chapter. Her assistance may be sought by the medical 
officer to further the patient's understanding through repetition or re- 
statement of his recommendations, and when indicated, she interprets to 
the medicr.l officer the subject upon which the patient needs more assurance 
from him. This supplemental assistance from the social worker is just as 
important to the man returning to active duty os to the man who is deter- 
mined unfit for further military duty and who, handicapped, must resume 
community life. 
Another function of the social worker is to adjust those personal 
and family worries which disturb many patients and thereby affect their 
response to medical treatment. The fact that duty hours are prescribed 
for all patients throughout the day imposes upon the medical, nursing 
and reconditioning staffs the need for a keen awareness of tension due 
possibly to worries real or without foundation; to make sure that contin- 
uous physical and mental activity does not leave the patient without 
opportunity to present those'worries to the member of the hospital staff 
whose concern they arc. 
It is important for us to remember that whereas physical and mental 
activity may relieve tension, it does not solve personal and family problems; therefore medical, nursing and reconditioning officers should be ' 
alert to possible social ills and ask the Red Cross Worker to see 
the patient .to offset the possibility that the patient may not hive 
time to seek out the social worker. 
The family worries of the patient to be returned to duty, the 
patient to be discharged for disability, and the patient to be dis- 
charged upon expiration of term of duty are all similar, whereas 
the personal needs of the man to be discharged for disability de- 
mand the social worker’s specialized effort in that he requires 
assistance in recognizing and accepting his disability.; explanation 
of and assistance in applying for government benefits. Further, it 
may be supremely important for the social worker to interpret to his 
family the patient* s attitude toward his condition, and all the im- 
plications of his physical limitations. 
Recreation is part of all normal living; therefore, the War and 
Navy Departments, when requesting social service of the Red Cross, 
asked that our organization assume responsibility for planning and 
conducting medically approved recreation for patients. In military 
hospitals this has been of importance since patients remain until 
returned to duty or until they have reached the maximum benefit of 
hospitalization. 
The Rod Cross also was asked to coordinate the activities of in- 
dividuals and groups who wish to serve hospitalized men. It has been 
the function of the Red Cross recreation worker to discover the re- 
creational needs and interests of patients, and on this basis to plan 
and conduct a recreation program which sustains morale and provides 
emotional release. This 'program is adjusted to the disabilities of 
the patient and the necessary restrictions of the hospited, setting. 
The Rod Cross recreation worker stimulates patient participation and 
utilizes in the recreation program the leadership abilities of patients, 
hospital personnel and volunteers from the community. 
As the Red Cross Department of the hospital reports to the Command- 
ing Officer, recreation, as social service to individual patients, is 
under the direction of the Ward Medical Officer. In addition to re- 
ports to the Commanding Officer regarding the total Red Cross program, 
approval is requested of the Executive Officer, of each week* s 
schedule of recreation activities. The Red Cross hospital executive 
and the head recreation worker consult frequently with the Chiefs of 
Services regarding ways and moans of improving the quality of group 
recreation as regards both patient and community participation. 
Recreation as conducted in military hospitals varies from that in 
state and private hospitals. In civilian institutions, recreation, 
with few exceptions, has been conducted by the occupational therapy 
department. In Army and Navy Hospitals since 1917 and 1913, recreation 
has been included in the social service program of the Red Cross, It 
is interesting to remember that at one time the American Red Cross, 
through funds and professional personnel, sponsored occupational 
therapy in hospitals’of the Wavy, the U. S, Public Health Service and 
the Veterans' Bureau, and at the same time conducted social case work 
and recreation. 
Whereas Circular Letter Mo. 149 states that "Red Cross recreation 
may include arts and crafts and hobby activities when used for di- 
version and leisure-time recreation," the recent War Department letter 
from The Surgeon General, dated 26 January 1944, provides that all 
handicraft shall be under the direction of the Occupational Therapy 
Department. Therefore, effective immediately, wherever an Occupational 
Therapy Department has been established, irrespective of the number 
of staff, the Red Cros.s will discontinue rill diversional handicraft, 
including crafts and hobby shops in rooms assigned to the Rod Cross 
for recreation activities. The Red Cross will continue handicraft as one of its divcrsional 
activities only in those Army Hospitals where there is no occupational 
therapist. 
AR 850-75, paragraph g, lists as one of the services to be performed 
by the Red Cross in Army hospitals: "To represent the Commanding Officer 
in coordinating the efforts of individuals and groups in the community 
who desire to serve the hospital". Therefore, through volunteer special 
services of Red Cross Chapters adjacent to military hospitals, qualified 
women have been recruited and trained in the hospital desiring their 
services in order to render such supplemental assistance as may be re- 
quired by the Red Cross professional staff. These volunteers represent 
the membership of Hospital and Recreation Corps or the Gray Lady Unit 
thereof, and the Arts and Skills Corps. Until the present time, both 
of these groups have aided the Red Gross recreation staff in all of its 
activities. The Motor Corps os well as Canteen Corps render supplemental 
assistance as required. 
Upon the request of The Surgeon General for the continued interest 
of Red Cross volunteers in the handicraft program of the Occupational 
Therapy Department, the National Director of Volunteer Services has 
agreed that members of the Arts and Shills Corps recruited and reporting 
to the Red Cross hospital executive, when so requested may be assigned 
to work under the supervision of the Chief Occupational Therapist, Also, 
members of the Gray Lady Unit who have been trained to perform varied 
duties for the social workers and recreation workers may give part of 
their duty time in the handicraft program under the Occupational Therapy 
Department. In the event there are an insufficient number of volun- 
teers to render the service requested by the Commanding Officer and 
occupational therapist, the number of persons and the particular skills 
desired will be reported to the Red Cross hospital executive, who will 
secure the cooperation of the local chapter in strengthening the mem- 
bership of the corps. 
The hospital Rod Cross executive, upon request will make available 
to the Reconditioning Officer the services of selected members of the 
Gray Lady Corps to aid in the educational program, and when specialized 
instructors are desired, will seek to obtain them through the coopera- 
tion of the local Red Cress chapter. These volunteers may be men or 
women, and it has been agreed that any orientation to the Army setting 
will b.e provided by the Chief of the service to whom the volunteer is 
to report for duty. The Army will be responsible for their military 
clearance. 
The American Red Cross, in its recreation activities, has agree- 
ments with several national organizations interested in serving hospi- 
talized men;.these include, the National Garden Clubs of A. crican, and 
the National Federation of Music Clubs. The latter project - ill re- 
ceive added impetus as soon as a pamphlet describing music as a phase of 
the Red Cross recreation program in Army and Navy Hospitals is released 
to its membership. The possibility of using selected volunteers from 
the Garden Club in a reconditioning program is a matter to which we ore 
calling the attention of our hospital executives for consideration with 
the Commanding Officer and reconditioning staff. 
Whereas, it is understood that there are federal monies allocated 
for the purchase of all necessary equipment and supplies for the recon- 
ditioning program, any items not available through this resource may be 
discussed with the Rod Cross hospital executive who, through any exist- 
ing Camp and Hospital Council Service, may find it possible to obtain 
the articles desired. As you know, in an effort to correlate the in- 
terest of'communities desiring to make material gifts to camps and 
hospitals, Red Cross chapters assumed leadership in organizing Cw-.o 
and Hospital Councils through which the Commanding Officer and Red Cross as executive could make known 
those supplemental items which would add to the comfort ol duty 
personnel and hospitalized men. Such articles not available 
through military channels may be requested by tno Commanding Officer 
vj.ith the understanding that no public appeal for funds for the pur- 
chase of such items will be made, but rather the opportunity proffered 
to the Council membership to meet the request. 
Jo have urged the Chief of Hospital Service in each area office 
of the Red Cross to make herself known to the Chief Surgeon of the 
Service Command, She will now be advised that in her visits she 
should ask the Surgeon to arrange a joint conference with you so that 
problems as well as achievements may be shared. This should be one 
additional means of enabling us all to achieve our common goal, 
namely, the best possible service to the disabled men of our Armed 
Forces. Thank you. 
COL THORNDIKE: Thank you very much, Miss Vincent. The meeting 
is now open for discussion. Are there any questions? No more dis- 
cussion? General Hillman has a few remarks, 
GENERAL HILLMAN: I believe that this is the last session at 
which all of the members of the conference and their guests will be 
present. I would feel very much amiss if I did not take this occasion 
to express the great satisfaction I foci as a result of this confer- 
ence/ It has given me an opportunity to become very much better 
acquainted with our problems and to lx.conm -acquainted with you who 
have directed the reconditioning programs in your respective service 
command hospitals. I shall go away from here with the feeling that 
this two-day conference has been very much worth while. 
The success of the conference is attributable to the interest 
and alertness all of you brought here—the delegates, the represent- 
atives of the various divisions in Washington, as well as to the 
fine demonstrations which have been staged here bp Colonel Winn and 
his staff, and to the efforts of everyone who has been in attendance. 
I wish particularly to express my appreciation for the work of the 
press in covering this conference and their very apparent desire to 
attain a full understanding of what our objectives are and of what 
our approach to our many problems is. I wish to express my keen 
appreciation of the arrangements which have been made through the 
Commanding General of the Seventh Service Command for carrying on this 
conference. I wish to express personally to Colonel Connor the thanks 
of the Surgeon General for the untiring effort he has shown in setting 
up the details and making a transcript of this conference so we may 
all take home a complete record of all that has been said and, in 
this way, have it for reference in the future. Lastly, I wish to 
thank Colonel Winn personally and the staff of the Schick General 
Hospital for the very fine care that we have received here. I want 
to thank him for the arrangements for the conference in this build- 
ing, the demonstrations which have been given us, the fine quarters 
he has provided and the fine mess he has served, as well as for the 
smoothly working administrative machinery which has caused all these 
things to be supplied us without concern on our part. I wish to 
thank each and every one of you for your contribution. 
COL THORNDIKE: The meeting will adjourn until three o'clock when 
the round table conference will be held. This evening's conference 
at seven thirty will be held in the Medical Library. 
END OF CONFERENCE 
79