July 3, 1944
Sweetie pie,
If you are a doctor and you are fighting a war, how do you behave, as a doctor? as a combatant? Theoretically, of course, according to some rules and regulations hashed out at the Geneva Convention, you are a non-combatant. But yet, you get bombed, and shelled, and strafed, and sniped at - you certainly are a combatant on the receiving end of things. Then too, does the army doctor have an important  function in the total composition and maintenance of the combat forces?  Obviously yes, for many reasons - the determining of physical fitness, the protection of health of troops - guarding food and water supplies - the prevention of medical diseases, - the care of the sick, the repair of the wounded or injured (so that they may be fit as soon as possible to fight again). What modern army could even fight without its medical corps? To regard the doctor in this business as a non-combatant seems to me to be a pleasant myth - an obvious fallacy, like so many of the "rules" of war. I consider myself a combatant.
I'm glad that I do, because that makes certain things easy for me. Some joke at me because I am so intense about the issues of this war; but, then, - I can't understand those who aren't. I'm glad I'm here; I know what I'm fighting for; I know they are worthwhile - I want to fight. I am a combatant in desire and fact, if not by rules and regulations. Therefore, one can accept the hardships and risks without worry, even with joy. That is clear, and easy.
But my training, my ethics, my entire sensibilities as a physician are at constant odds with my thoughts and feelings as one who fights, - bitterly, and with hatred, as one must who feels these things. To fight is to destroy and injure and kill; to doctor is to heal, comfort, and alleviate pain. This conflict arises constantly in the ever present decision of daily action. In the case of the American wounded, which boy do you take care of? The one who has a minor wound, and who, if cared for soon, will be back in the fight directly; or the one with a grievous wound, who has a chance to live if you operate, but who, even if he lives, will never fight again? You can handle four or five of the first type, to one of the second; but you can't do both. Which is more important to Uncle Sam? Which would you do, as a soldier? as a doctor?
When you have seen their ashen, listless faces, their shattered limbs, their torn and bleeding guts, their haggard haunted eyes - those American boys, our best and strongest, that "They" shot and maimed; you no longer need ideologies, or the knowledge of past social crimes, mass murder, or human rapine - you have begun to hate; not abstractly, or in general, but personally and intently and, deeply, - those bastards who have destroyed human values and who are sending you daily shattered, dripping flesh to prove it. You hate their guts.
But, the next patient in that row of litters is a German soldier. His pain is real, and his bones are broken. Is there a doctor in the tent? Do you treat him because it's part of the Geneva Convention? because it's army policy (that they may treat our wounded too)? because that's what they tell you to do and you get paid for it? because that man is badly hurt and needs help? Do you treat him at all if there is an American boy on a litter waiting? Suppose caring for the former jeopardized the chances for life or limb of the latter? Is the leg of an American worth the life of a Jerry? Answer those questions as a doctor, if you can; and remember, they aren't abstract questions. On your answer depends what you do during the next two hours, and the lives of men are waiting.
As a soldier, the answers are easy, and I told you, I am a combatant in this war. But the doctor in me squirms, and I still find myself giving my last cigarette to that Jerry in the end litter. If only I could have been five years younger, I could have flown as well as I could operate; then my greatest skill and contribution could have been combined at the stick of a Thunderbolt. The lads there are lucky, because they fight with a warrior's tools, not those of a surgeon. If you can help me, write.
H