October 2002 Bulletin

By Carolyn Rogers

World War II was not only a defining time in our country’s history, it was also the defining moment in the lives of countless young medics, doctors and litter-bearers who risked their lives to care for our fallen soldiers. These men, most in their 20s, were faced not only with their own mortality for the first time, but with the stark responsibility of saving the lives and limbs of thousands of wounded servicemen–often amid the chaotic stress of combat.

To commemorate the vital role orthopaedic surgeons and orthopaedic surgery played during World War II, the Academy has developed a special four-part program known as "Legacy of Heroes." Riveting stories of true heroics and of boredom, of military snafus and moments of medical brilliance are brought to light through a poignant documentary film, a commemorative book, a traveling exhibit and a special Web site.

The centerpiece of the "Legacy of Heroes" project is the stirring new documentary film, "Wounded in Action: Orthopaedic Surgeons in World War II," which will debut at the 2003 Annual Meeting. The documentary features the gripping battle accounts of 18 orthopaedic surgeons who served in WWII, including interviews filmed at the site of the Normandy invasion in France and at Pearl Harbor in Hawaii.

A three-minute highlight reel of the film will be shown at the Opening Ceremony on Wednesday, Feb. 5, 2003. The documentary will premier Thursday night at an invitation-only gathering held at the D-Day Museum in New Orleans. The film also will be available for viewing as part of the "Legacy of Heroes" exhibit at the convention center.

A handsomely illustrated commemorative book featuring the firsthand stories of 35 orthopaedists who served in WWII is the second major element of the "Legacy of Heroes" project. In addition to the stories and their accompanying visuals, the book features an essay on the cyclical nature of treating war wounds, details the advances in orthopaedic surgery that evolved out of WWII and recounts the development of hand surgery–a specialty that came into being as a result of the war. The book will be published in time for the Annual Meeting and will be available to all Academy members.

The project’s third element–the "Legacy of Heroes" traveling exhibit–will make its debut at the Annual Meeting as well. Located just outside the convention center’s La Nouvelle Ballroom, the exhibit will feature a number of eight-foot towers, each relating an individual doctor’s story. Another four towers will tell the overall "Surgeon’s Story." Numerous artifacts–such as Kuntscher nails, stacks of a featured doctor’s "V-mail," nurses’ diaries, a period penicillin bottle, plasma bottles, amputation knives, etc.–will be on display, and abbreviated versions of the "Wounded in Action" documentary will play on two video kiosks.

After the Annual Meeting, the "Legacy of Heroes" exhibit will be made available to state and specialty societies, and to any orthopaedic group that wishes to bring the exhibit to its hometown throughout the year. For information on booking the exhibit, or if you have access to any artifacts from that period–such as morphine curettes, photos of gas gangrene, a medics kit, shrapnel, cast cutters, surgical knives or other items of interest that would enhance the exhibit–please contact Sandra Gordon, director of the department of public education and media relations, at (847) 384-4030 or gordon@aaos.org.

Finally, a "Legacy of Heroes" Web site (www.legacyofheroes.aaos.org) will go "live" in time for the Annual Meeting. The site will contain original transcripts from the 85-plus telephone interviews with orthopaedists whose stories do not appear in the book or film, as well as all 35 first-hand accounts featured in the commemorative book. The site will include all the essays from the book, and will even feature a section for members to write in and post their own stories from the war.

This ambitious project grew out of a conversation between AAOS Executive Vice President William W. Tipton, Jr., MD, AAOS Deputy Executive Vice President Lawrence E. Rosenthal, PhD, and author/historian Stephen Ambrose, founder of the D-Day Museum in New Orleans and guest speaker at the 2000 AAOS Annual Meeting. Dr. Tipton and Dr. Rosenthal noted that orthopaedic surgeons played a significant role in treating WWII battlefield injuries, and that the subspecialty of hand surgery evolved from those experiences. With encouragement from Ambrose–and generous financial backing from Pfizer–a multi-faceted project honoring the role of orthopaedists in WWII was soon underway. Sandra Gordon has spearheaded the program from the beginning.

In the summer of 2001, the Academy sought assistance from its members in locating orthopaedic surgeons who had served in World War II. As a result, the AAOS was able to identify 120 orthopaedists who had served in the war. Telephone interviews were conducted with all 120, and the difficult task of choosing which doctors to feature in the documentary and commemorative book began.

"We were looking for a broad base of experience for the documentary," says producer David Berez of Post Office Editorial, the Maine-based film and video company hired to produce the documentary. "We knew we wanted some doctors who were in the European Theatre of Operations, and others in the Pacific Theatre."

Ultimately, six orthopaedists were chosen to film "on location." Paul W. Brown, MD, Zachary B. Friedenberg, MD, and Samuel H. Fraerman, MD, traveled to Normandy, France, for filming and John T. Hayes, MD, George M. Boswell, MD, and Barry Friedman, MD, filmed in Pearl Harbor, Hawaii. (See Bulletin, February 2002.)

"In retrospect, they were the perfect six," Berez says. "We wouldn’t have changed anything."

Filming began in November 2001. The experience was extraordinarily moving for all those involved, says Berez. "This was the first time many of them had fully shared their stories. It was very emotional."

Upon meeting in Normandy, Drs. Friedenberg, Fraerman and Brown were surprised to discover they’d had very similar experiences in the war. The men were on the same beaches, just a couple of miles apart, and they’d landed within days of each other. But they’d never met until they flew to Normandy to film this documentary.

"It was wonderful to talk with the other two orthopaedic surgeons," says Dr. Brown, who functioned as a G.I. medic during the war and later became an orthopaedic surgeon. "Like me, they’d both been in Northern Africa, Sicily and all over Italy. We’d been at the same beaches, just miles apart, but we didn’t know each other. Discussing their experiences and how they believe the war influenced their later practice of orthopaedic surgery was fascinating."

In France, the crew shot in three locations–on the beaches of Normandy, in the nearby U.S. military cemetery and in a gorgeous 14th century chateau just up from the landing site on Omaha Beach. The chateau had been taken over by the Nazis during the war and was used as a communications base and distribution center.

"The chateau was just a fantastic place to shoot," Berez says. "When you drive up you can still see Nazi and American artillery pieces in the barn."

The chateau’s owner, Mr. Hauserman, offered the use of his home as "a gift to Americans" for liberating him and his family, Berez says. His family had been living back in the barns behind the chateau, so Hauserman had met not only all of the Nazi generals, but also General Eisenhower and several other American generals.

"The doctors were understandably thrilled to film there, and the setting added a real richness to the interviews," Berez says.

Dr. Brown describes the entire filming as very emotional. "To walk on the Omaha Beach and in the cemetery with over 9,000 Americans buried there…it was very moving," he says.

The doctors’ wives accompanied them on the trip–which was a good thing, Dr. Brown says. "The filming and recording crew was very professional, but they worked us hard," he jokes. "All three of us are in our 80s, so our wives tried to protect us from overwork!"

Orthopaedic surgeons George M. Boswell Jr., MD, Barry Friedman, MD, and John T. Hayes, MD, traveled to Honolulu to share their experiences serving in the Pacific Theatre of Operations. The filming took place in Honolulu at the Punch Bowl National Memorial Cemetery and in Pearl Harbor on the U.S.S. Missouri–the site of the Japanese surrender that brought an end to World War II.

With a naval officer assigned to provide the group with unfettered access to restricted sites, "We shot right there on the surrender deck of the U.S.S. Missouri and we were able to film Dr. Hayes in the captain’s quarters," Berez reports.

Dr. Boswell, for one, thoroughly enjoyed himself.

"To revisit places like Ford Island and Barber’s Point that I’d remembered so fondly, to see the Missouri and all the places around Honolulu I’d been to a million times during World War II…It was fabulous," he says.

Dr. Boswell’s first assignment in the Navy was as a courier assigned to take secret documents to Pearl Harbor. He arrived just days before Dec. 7, 1941 and had a ringside seat that infamous Sunday morning.

At first he thought a boiler had burst by accident on a ship–then he heard and saw the planes and bombs falling. "Scared the hell out of me," he recalls. "Nobody told me when I joined the reserves and was marching around the football field that something like this was going to happen! I was in total disbelief."

Dr. Boswell was made a line officer and served on four different attack transports during the war. "Iwo was hell," he says. "The landings were horrific. We had one Higgins boat float by us with nine decapitated sailors on board."

Still, the twice-injured Dr. Boswell recalls one Iwo Jima experience with pleasure. As a senior officer and ship photographer, no one could access the ship’s impressively equipped darkroom without his permission.

"While we were on deportation at Iwo, there was an interesting young man on board; a pushy AP photographer assigned to the Marines named Joe Rosenthal," he recalls. "I was in the darkroom with him when he came back with his photograph of the flag raising at Mt. Suribachi. We watched that print come up in the tray. Neither one of us thought it was anything great–honest to God."

That photo later became famous worldwide.

Clearly, Dr. Boswell has an amazing story to tell, but until he flew to Pearl Harbor to participate in the filming of "Wounded in Action," he hadn’t talked about it much. (continued on p. 34)

"When I came back from the war, I went immediately into medical school and then residency," he explains. "I never had time even to think about thinking of the war."

Although he’d returned to Honolulu as a tourist several times since the war, Dr. Boswell says he’d never associated those visits with his time in the service.

This trip was different, though. All of the memories came flooding back.

"It was absolutely the greatest experience of my life," he says, referring to the filming. "That David Berez pulled things out of me I hadn’t thought about in 60 years," he exclaims. "Things I’d never really put together. As we began to assimilate things–to pull together all the pieces, the memories–it came to form a picture. It was overwhelming. It was very emotional for me."

Dr. Boswell’s children and grandchildren knew little of his war experiences. "I’d never talked about it," he says. "I’d just never had the occasion to do so."

Since the filming, that’s all changed.

"We pulled out a bunch of mementos and we’ve all had a good time talking about it," he says. "The kids saw the first runs of my interviews and they were amazed–they didn’t have any idea. My grandkids were so amazed that on the 4th of July, the parade theme was ‘Honoring Heroes,’ so they reenacted the raising of the flag on Iwo Jima and put me on the float. It won first prize!"

Dr. Boswell isn’t the only doctor who was deeply affected by the filming of this documentary. Dr. Hayes also described it as one of the greatest experiences of his life.

"That was shocking," Berez admits. "You’re talking about men who are enormously accomplished–who’ve lived amazing lives. To say their experience on this film shoot was one of the greatest experiences of their lives made us all feel pretty good."

After returning from Pearl Harbor, the film crew shot an additional 12 orthopaedists domestically, bringing the total appearing in the film to 18.

However, as Berez points out, "There are many, many doctors who were not involved in the filming whose experiences are as just as rich as those filmed. These simply serve as an example of the stories that are out there."

Ironically, the "Legacy of Heroes" project features a group of men who universally reject the term "hero." They believe that designation should be reserved for those who did not survive to tell their stories.

"The doctors always chafed at that term," Berez says. "When you think of what these men went through–five amputations in a night, a macabre assembly of body parts and ruined GIs, operating with shells whistling overhead. They’re just immeasurably modest."

"The thing is, I had a ball during World War II," Dr. Boswell explains. "Sure, I got my pants scared off me many times, but then we all did. A youngster just doesn’t have the understanding a mature person does. It scares me more now to think about it than it did when I was there!"

As impressed as Berez is with these veterans, whom he repeatedly refers to as "truly great men," Berez is quick to point out that the "Legacy of Heroes" project is not just an AAOS version of "The Greatest Generation."

"The war was really a defining moment in the development of modern day orthopaedics," he says. "World War II was when orthopaedic surgery came into its own."

Dr. Friedenberg concurs.

"When I was at Columbia, no good medical student wanted to go into orthopaedics," he recalls. "Orthopaedic surgery, before the war, was surgery for congenital malformations, osteomyelitis–the infections of the bone. It was the surgery of tuberculosis, which was rampant at the time…orthopaedics surgeons didn’t do much in trauma or fractures. The medical students used to derisively call orthopaedic surgeons the ‘strap-and-buckle doctors’ because all they did was put people in braces–they didn’t do ‘real surgery.’"

World War II changed all that. The war provided material and personnel support to the orthopaedics establishment that enabled the specialty to grow. Many of the exciting orthopaedic advances of the late 1990s have their origins in WWII.

Dr. Tipton and Academy President Vernon T. Tolo, MD, emphasize this point in a letter to AAOS veterans that appears in the commemorative book.

"Your wartime experiences changed the course of orthopaedics," they write. "The sheer numbers of the wounded; the opportunities to attempt bold new surgical techniques; the creation of hand, burn and amputation centers and the tremendous need for rehabilitation challenged every medical professional, but particularly orthopaedists. Orthopaedic surgery, quite literally in your hands, came of age in the Second World War."