One of the early accomplishments of the female nursing organizations was to exclude men from nursing in the military, partially as a result of the challenges women had as they sought acceptance by men, in this case, men in the military. Many women devoted years caring for military casualties and trumpeted the need for better care for these men without recognition.
In 1901 the Army Nurse Corps was formed where only women could serve as nurses. Many more decades passed before these female nurses received commissioned officer status. Men, during and prior to the Korean War, who were drafted or enlisted and were nurses, served in nonnursing capacities. Men were permitted to join the Army and Air Force Nurse Corps as commissioned officers in 1955, I believe partially as a spin-off from the women’s liberation movements. It was another ten years before the Navy commissioned men who were nurses and admitted them into the Navy Nurse Corps. Another hurtle for men fell in 1963, when men were admitted into the Army Student Nurse Program.
Merlan Owen Ellis at retirement.
In 1960 when the physician entered the charting area, nurses stood and the physician took the seat. The nurse did not speak unless the doctor spoke to her, a ridged rule for student nurses. Nurses were not permitted to do venous punctures. We took vital signs and felt fortunate to give routine injections. We sharpened needles on a whetstone prior to sterilization and reuse. It was an art to sharpen needles without creating curved barbs on the points. Almost everything was reused.
Many men who were nurses joined the military. In addition to better benefits than civilian nursing, the man was first an officer and then a nurse, which distanced him from social stereotypes.
After graduation in the fall of 1964, I went to Ft. Sam Houston (San Antonio), Texas for a two-month orientation to the Army Medical Department. The nursing section of the group was about one-third men from diploma and baccalaureate schools. It felt good to have male colleagues. However, a significant number of these men were privately homosexual, a preference totally foreign to this naïve Idaho potato farmer. To acknowledge their sexual preference would have resulted in an immediate discharge from the military.
Some of the male officers in other sections of the orientation group harbored the stereotypical image of men who were nurses. I remember one night the entire orientation group was in the field, each specialty tented together. It was a hot August Texas night; all tent flaps were raised. Loud sexual slanders were directed toward the tent with the male nurses for at least forty-five minutes. Comments were not reciprocated, only silence. Finally, with great relief, one of the instructors ordered the insulters to stop. This was my first personal exposure to intense prejudice, and it was to continue.
The nursing orientation included the various nursing specialties available in the Army. The student rotation I enjoyed most at Idaho State University was public health nursing. It was gratifying to work with public school students, provide guidance to families in their homes, and initiate needed preventive health measures. An application was submitted for an assignment in Army public health nursing, or community health nursing, as it was later called. There were about one hundred women in public health nursing in the Army at that time, but no men. The first three petitions to the Army Nurse Corps assignment branch in Washington were denied. After more communication between my advisor and assignments, I became the first man in public health nursing in the Army.
From San Antonio Merlan was sent to Fort Ord, California, for a year’s internship in public health nursing, working with Henrietta Herman Pfeffer. Lieutenant Colonel Pfeffer was one of the first lieutenant colonels in the Army Nurse Corps, the highest rank in nursing at that time. She was the only community health nurse with the rank of lieutenant colonel.
I was assigned to Ft. Ord, California four months prior to an opening in the public health nursing internship. During that time I rotated through all patient care units in the hospital. The head nurse of the medical-surgical ward was a retired Army major who had served on active duty during World War II when men who were nurses were enlisted and not officers. She refused to call me “Lieutenant” even though the insignia was conspicuously worn on the uniform. She addressed me as “Sergeant.”
The doctors had little experience working with men in nursing and had difficulty acknowledging me as a nurse. I was not addressed as “Lieutenant” but “Doc.” The corpsmen were addressed as “Specialist,” which corresponded with their rank. The doctors did not want to offend. They recognized the training and the contribution to patient care, but they just did not know quite how to relate to a man who was a nurse. I was independent as a public health nurse, doing assessments and bringing data back to the doctors as a colleague rather than the subservient role they assigned to hospital nurses. It was fascinating to experience the nurse/doctor relationship as it developed. The doctors eventually became comfortable with me as a nurse, in a male collegial sort of way.
The last rotation in the Ft. Ord Hospital was the emergency room, where I functioned as the head nurse. It was in that ER that I learned the value of the ward master, the senior enlisted person. I especially remember and appreciate one senior sergeant who took this neophyte officer under his wing and taught him the Army way. He would say, “Lieutenant, how about (this)?” When I made an administrative decision, he supported it almost without question. It was a great introduction to how officers and enlisted personnel function as a team.
There were no restrictions during the internship, even with mothers. Major tasks, assigned to me, included teaching new mothers how take care of themselves and their infants. Husbands were preoccupied with officer candidate school or other training in preparation for deployment to Vietnam. New mothers had little if any immediate or extended family support. Public health nurses attempted to fill the gaps by supporting these young mothers. The fathers, once they got over a man being the nurse, were very accepting and responded well to a man setting a parenting example for them. Trust and confidence developed. I was finally free to be a public health nurse. Being in homes with mothers and their children was not a concern.
Following the year at Fort Ord, I was transferred to Fort Belvoir, Virginia, fully oriented, fully expecting complete recognition and freedom to function. The greeting by the director and the other public health nurses who were all women reflected the same old quandary: A male public health nurse? What are we going to allow him to do? For the first year, I was not permitted to visit in most homes. My supervisor was more than willing to send me to visit the very elderly male retirees to change their catheters, but to be in a home with a new mother to reinforce breast and perineum care was not permitted.
The public health nursing section at Ft. Belvoir was designated a clinical training site for the Walter Reed Army Institute of Nursing (WRAIN). WRAIN was created to provide the increasing number of nurses needed by the Army Nurse Corps to fulfill its mission during the war in Vietnam. Students accepted to WRAIN received fully funded scholarships for their four years of college to include a military salary. A significant number of these students were men.
The public health nursing staff at Fort Belvoir was increased from four to ten with the charge to be ready to receive WRAIN students one year after I arrived. Each public health nurse was to have an expanded caseload of at least 40 families from which a broad range of experiences could be tailored for each WRAIN student. Since many WRAIN students about to arrive were men, the restrictions that remained on my practice had to be lifted.
The greater geography around the post was divided into public health nursing districts. My assigned area was south of Fort Belvoir in the Woodbridge and Manassas, Virginia, communities. We nurses fine-tuned our newborn and infant assessment skills, focusing on normality and identifying what was not normal. Within a short period of time, we were independently holding in depth well-baby clinics. Ten of us assessed newborns from our respective geographical areas and fed the information to the one pediatrician in the clinic. He was very supportive. We found the clicks in the hips indicating possible
congenital hip dysplasia. We found the heart murmurs and birth defects though we did not diagnose. We sent each child to the doctor for confirmation of our assessments and diagnosis. His most frequent feedback was “Good find.” It was a wonderful collegial relationship. We, the nurses and doctor, had many discussions on topics of mutual interest, which greatly contributed to our knowledge base and confidence.
Many patients from my nursing district would receive services in a hospital clinic and then come to me for verification of the diagnosis and the care plan. In the mid–1960s private practice for nurses had not been conceived; however, we were essentially in private practice. We pioneered many areas of nursing, which was permitted under the broader Army umbrella.
During the late 1960s many military families were of the lower enlisted and officer ranks living off post with one or more children. For the junior officers, a family was considered a “luxury” not supported by the military. The officer could live in bachelor officer quarters but there was no place on post for his family. He received no additional financial support from the military if he lived off post with his family. The same was true for the lower-ranking enlisted soldiers. Many, both officer and enlisted, were living in extreme poverty given their low pay structure. Jobs for the wives were very hard to find and were mostly menial. The area was flooded with military personnel as a result of the buildup for Vietnam. Fort Belvoir was an enlisted training center with a large officer candidate school.
Nurses have historically been patient advocates, so as we became aware of the destitute situations facing these families, we felt something had to be done. We quantified hard data, which our director carried up through public health nursing command channels to the chief of the Army Nurse Corps and to the doctor over the Medical Department, the Army surgeon general. She was essentially told at each step that nothing could be done, to go home and to not be concerned. Such advocacy was not in her or our job description.
There is one attribute frequently given to public health nurses; they are very independent. Air Force personnel were also living with the same pay structure. The Air Force did not have public health nurses. With our encouragement, our director crossed services to the Air Force and again proceeded up through channels with the data. A little bit more empathy was given but the response was the same. The Navy was next. Again the data was taken through channels to top Naval officers who then crossed to the Army and Air Force commands and sought a combined effort to change the pay rates. As a result, there were eventually increases in the military pay structure up to at least the poverty level with family allowances. My wife and I would have had difficulty living on the local economy with two children on a first lieutenant’s salary of $300 per month if my wife had not been an employed schoolteacher.
At Fort Belvoir I mentored many WRAIN students who were eager to learn public health. We worked with families, identified adults and children with medical deviations from normal, and advocated for their care. We assisted mothers with babies while dads were at war. We worked with the retiree population and their families and obtained hospice care and other services for them when needed. In addition while at Fort Belvoir I taught disease prevention to men and women in groups of 1,000 to 1,500 individuals as they completed their brief stateside training before heading to Vietnam. This learning environment was one of the highlights of my military career.
After Ft. Belvoir came an assignment to the University of North Carolina at Chapel Hill School of Public Health for a superb year of study for a master’s degree in public health. There were 12 experienced international nurses in the public health nursing section, which made for a rich experience pool. Again, I was the only man. After graduate school came an assignment as the only military public health nurse in South Korea.
I wanted to go to Vietnam. I could see all sorts of public health activities that needed attention in Vietnam: venereal-disease awareness and prevention along with many other communicable diseases and health challenges. There were reports of 100 percent of companies with a venereal disease at the same time. I never assumed I would not go to Vietnam. I thought I would rotate there like everyone else but there were no public health nurses stationed in Vietnam. I supported the war, but in a different way: I helped sustain families of the men and some women who were in Vietnam.
The closest I got to Vietnam was South Korea. The assignment came immediately after graduate school. Primary tasks included disease investigation and prevention, services to mothers and infants (mostly Korean wives and girlfriends), school health for children of US personnel in Korea, inspection of health and dining facilities, and general community health.
Servicemen frequently fell in love with Korean women, married them, and had children or vice versa. A lot of these soldiers were quite immature with minimal education and experience. They now had a wife who spoke no English and usually a child. The social and cultural challenges for them were almost insurmountable. Helping the couple bridge the cultures and health practices was a monumental task.
Customarily when the Korean mother went home after delivering a baby, she would occupy the bed with the baby, father slept on the floor, and the Korean mother-in-law was in charge. The serviceman was expected to comply. I made home visits throughout South Korea to mothers and children to promote health. There were opportune times to also meet with servicemen as they faced family and cultural challenges. Travel to these homes was usually by jeep. Guards were left with the jeep. If a vehicle remained unguarded, it would be totally stripped by the time I returned.
Chaplains welcomed assistance as they counseled servicemen about to enter into matrimonial arrangements. Before the servicemen could get military permission to marry a Korean, they had to receive extensive counseling. My job was to introduce the potential wives to the American culture, a most challenging situation given the language barrier and women with no formal education.
If a Korean family had girls, the fathers were known to sell the girls into prostitution and slavery. The pimp would pay the family 200,000 wan for her. She was not freed from the pimp until she had earned an equal amount of wan and much more. Some of the girls did whatever was necessary to earn the money as quickly as possible. Some of them, whom I admired somewhat given their situation, desired a more acceptable lifestyle: They sought a serviceman with whom they could live all the time he was in Korea, or as long as he would have her, even if he had a wife in the States. The serviceman paid the pimp for her complete servitude without personal compensation. The Korean woman served the serviceman with intense devotion, interpreted by some men as love. The serviceman then reciprocated with a marriage proposal. Once a woman entered prostitution she was diminished to the lowest cultural stature. Marriage was a way to escape to a better life.
There were other servicemen, however, who used these women as slaves and treated them like slaves. I had the opportunity to offer assistance to some of these unfortunate women and counsel their keepers. They were ever so willing to please and to do anything they possibly could to stay with the serviceman even while being treated like something disposable. The serviceman might rotate to another assignment and leave the woman destined for a life of prostitution, an outcast from her culture. I have often wondered how these men, with these learned behaviors toward women, treated their wives when they returned to the States.
There was a ploy some of these women took. They willingly married the serviceman. As the couple was about to depart for the States, on a preplanned schedule, their family would come rushing saying something like, “Your mother is dying. You have to stay.” The wife would leave her husband on the tarmac promising to join him later but then never go to the States. He was married but without a wife and she had a military identification card with full military dependent benefits to include automatic pay deductions for wife support sent directly to the wife. Some women had multiple ID cards from previous marriages receiving wife support from all her husbands. She would buy items in the military exchanges that were hard to acquire in Korea
and sell them on the black market. Trying to convince the serviceman, who thought he was in love and wanted to get married that this could happen to him, was a real challenge.
Many homes in Korea were heated with charcoal. The burning charcoal was outside next to an opening to an air flue that crisscrossed underneath the floor, heating it, and exited the other side of the building if everything worked well. Due to unsophisticated construction, noxious fumes frequently leaked into the house, resulting in carbon monoxide poisoning. Military rescue helicopters were dispatched to bring overcome individuals to our hyperbaric chamber. Some elderly men and women who were less sensitive to heat and who slept on the hot floor receive severe burns. Many of these patients were treated at the Army hospital. Service personnel were oriented to these dangers when they elected to live on the local economy with their Korean wives or girlfriends in her family home or in their own apartment.
The Korean culture is unique among Asian nations. There are fond memories of hiking through rice fields, visiting isolated silk factories and farming communities, enjoying the unique cuisine, and sitting on top of a mountain with a military radio listening to helicopter chatter in Vietnam. I will fondly remember my year in Korea and would like to have gone to Vietnam.
After the one-year assignment to Korea I was assigned as a member of the WRAIN faculty at Walter Reed Army Medical Center with a dual assignment to the University of Maryland School of Nursing as an assistant professor. Half of the 40-member WRAIN nursing faculty consisted of men. Members of the faculty were from 39 different graduate schools, which lead to some fascinating discussions as we attempted to define nursing as a unique profession. I was now one of the instructors who guided these gifted WRAIN students through didactic topics and accompanied them to their field experiences in my chosen profession of public health nursing.
Vietnam War Nurses Page 12