MY MEDICAL EXPERIENCES IN THE SPANISH WAR By Dr. Gojko Nikolis
The Spanija series translates select autobiographical accounts by Yugoslavian and Montenegrin volunteers of their actions in the Spanish Civil War. Dr. Ray Hoff used Google Translate from Croatian to English and he edited the selections. As this is a machine translation, the idiomatic features of Croatioan or Serbian and the translation of names and places are “best effort.” The full five-volume collection was entitled The Participants write Spanija 1936-1939: Collection of Memories of Yugoslav Volunteers in the Spanish War. It was assembled by Editor-in-Chief Cedo Kapor and published by the Initiative Committee of the Association of Spanish Fighters, The War History of our Peoples, Book 130, Military Publishing Institute, Belgrade, Yugoslavia, 1971, 5 volumes.
MY MEDICAL EXPERIENCES IN THE SPANISH WAR
Dr. Gojko Nikolis, Spanija, Volume 3, pp 198-219
Although the conditions under which a possible war would be fought today are significantly different from those that existed in 1936-1939 in the civil and national liberation war of Spain, nevertheless, the experiences from that time cannot be without interest for a modern military doctor, especially a younger one, who will operate in the Corps area, even if under changed, certainly far more difficult conditions. Every war experience, although specific to certain wars and eras, also has some more general aspects of lasting value.
I spent 19 months in the Spanish war, four of which were at the front and fifteen months in rear hospitals.
PREPARATIONS IN YUGOSLAVIA
At the time of the Fascist uprising, in July 1936, I had just finished my studies at the Faculty of Medicine in Belgrade. My wish was to go to Spain immediately and make myself available to the Republic. I expressed this wish to a representative of the KPJ (the party was working in deep illegality at the time), but he advised me that it would be better if, before going to Spain, I served my term of service in the Yugoslav Army in order to prepare myself for the war as well as possible. According to the Party, the war will take a long time and there is no reason for me to be impatient.
So, at the beginning of the autumn of 1936, I found myself in the Yugoslav Army as a young doctor and I understood my entire military service, which lasted 9 months, as a preparatory period for going to the Spanish war. I questioned my knowledge of war medicine. Although war surgery, military hygiene and epidemiology were studied quite a bit at the Belgrade Faculty of Medicine, it still seemed to me that my knowledge and practical skills, necessary for war, were more than modest. That’s why I used every free moment to, in addition to the mandatory program that I had to master in the army, also study medical tactics (Vl. Stanojević) and war surgery from all available textbooks (Karl Franz, BorchardtSchmieden). The experiences of Serbian military doctors from the wars of 1912-1918 served me particularly well.
PONTONES
I arrived in Spain on July 19, 1937. Despite my request to be assigned to one of the operational units, I was assigned to the town of Pontones, according to the needs of the Service and according to the decision of the head of the medical service of the International Brigades, Comrade Dr. Oskar Telge. It was, in fact, a lonely farm, about 40 km northwest of the town of Albacete. A hospital for venereal diseases was located there. In the hospital, I found Dr. Matis Scheinberg as the Chief. He was a young doctor, from the USSR, and Lithuanian by nationality.
The support staff was multinational (Spanish, 1 Italian, 1 Austrian, 1 Belgian, 1 Chinese, 1 French, 1 Hungarian and others), but despite that, there was a great solidarity between us, which was never disturbed by anything. Accommodation conditions were quite unfavorable, but considering the war and the circumstances, they were still tolerable. We had enough medicines, certainly within the limits of medical science at the time.
In medical practice, gonorrhea caused us the greatest difficulties, both in terms of the number of cases and the duration of treatment. Standard treatment consisted of rinsing with potassium permanganate (according to Janet) and local injection of targesin {a silver proteinate treatment}. In the case of posterior urethritis, we administered (catheter) instillations of silver nitrate solution. Every third day we checked the patient (test in two glasses and microscopic examination of secretions). The results were quite weak. The fastest cure could be achieved in ten days, but very few patients were that lucky. The majority of cases were treated for about 2-3 weeks, but there were also those who spent 6-8 weeks in the hospital. Frequent complications from the prostate and epididymis prolonged the treatment. Many patients came to the hospital more than once, either due to relapse or re-infection.
Another disease will test our patience. It was lymphogranuloma inguinale or the fourth venereal disease (Nicolas-Favre). This disease was very common in Spain at that time, and we didn’t have any effective medicine at our disposal. Since the abscesses in the groin would open (most often through incisions, but also spontaneously), we would instill silver nitrate into the resulting ulcerations. This treatment would last a very long time, about 6 weeks.
Lues {old name, now syphilis-rmh}, fresh, in the primary and secondary stage, was very common in Spain. We used classical therapy with neosalvarsan and bismuth. We had enough of these means so that lues did not give us nearly as much headache as gonorrhea. To be sure, the differential diagnosis between hard and soft cankers was sometimes not easy at all, and it was made with great responsibility. The difficulty, among other things, was that the hospital had neither dark rooms for microscopic determination of the spirochete, nor serological laboratories. Blood was sent to Albacete for Wasserman’s Reaction, and the results we received from there were not always reliable. In 8 months of my work in Pontones, we didn’t have any incident with neosalvarzan. However, almost every second patient would, from the very beginning after the injection of neosalvarzan, get severe shivering and fever every time.
This discomfort would usually pass on the same day. Skin diseases in this hospital were mostly represented by itching, suppuration of the skin, especially on the lower limbs, and various forms of eczema. We treated itching according to Demja Nović’s method (sodium thiosulfate and hydrochloric acid), and suppuration with conventional mercury ointment and methylene blue.
It is worth noting an interesting case that we had the opportunity to operate in Pontones in the spring of 1938. We received a middle-aged patient, a volunteer from Scandinavia, diagnosed with lues latens {latent syphilis}. Antiluetic treatment was started. Soon after that, the patient developed a high fever, which we assessed as the “mentioned reaction” to neosalvarzan. However, the fever did not stop. Two or three days after that, a hemorrhagic exanthema {rash} spread over the whole body broke out in the patient. The general serious condition gave us the basis to make a diagnosis of pegavca {in Croatian, spotted fever, epidemic typhus?}. This is the only case of pegavca that I have seen in the Spanish War, with the remark that, to my knowledge, this disease did not exist there in an epidemic form.
MY WORK IN OPERATIONAL UNITS
From the middle of June to the end of September 1938, I spent in the 11th International Brigade, “Ernest Thaelmann” as a battalion doctor, first of the “Hans Beimler” Battalion and then in the “12th February”. From the end of January to the middle of February 1939, I was the doctor of the Yugoslav detachment that acted as a protector during the last fascist offensive in Catalonia.
At that time, I was not able to gain an insight into the functioning of the entire Medical Service in the operational units of the Republican Army, and even less would I be able to construct such a picture today. That’s why my notes will be limited to what I personally experienced or personally saw from the point of view of a battalion doctor. I will try to systematize my experiences according to the usual structure of the war medical service, because it seems to me that this way will best suit the didactic needs of our young military doctor. That is why I will divide my presentations into two parts: experiences during rest and during combat operations.
DURING REST
Having received the long-awaited assignment to the 11th Brigade, I found this unit bivouacked in the vicinity of the town of Falset, about 20 km behind the front that then stretched along the banks of the Ebro River. The Brigade was part of the 35th Division, and this Brigade was part of the 15th Corps. After Franco’s fierce offensive in the spring of 1938, which ended unhappily for us with the loss of Aragon and the severing of Republican Spain in two, there was now calm on the front. The units of the 35th Division, which were in the role of operational reserve, had to use this lull in order to replenish, reorganize and train. It was necessary in view of the significant losses the division suffered in defensive battles, retreating in front of a many times superior enemy from Zaragoza to Ebro.
The land on which my brigade bivouacked was rough, sandy and drained, overgrown with vines and almonds. Fighters slept under the clear sky or under shelters and huts (chabolas) improvised from branches and wicker. The huts provided good protection from the sun and light rain. Command and Staff were located in rare, lonely field houses. The Battalion’s infirmary was also located in some field house. It had one room on the ground floor, where we arranged an examination room, and an attic where we could keep the more seriously ill patients temporarily, for an hour or so, until they were evacuated to the Brigade infirmary. The Brigade ambulanta was located in a nearby village, about 4 km away from the Battalion.
The units are supplied with water partly from field wells, and partly using tanker trucks.
We could not boast about the hygienic condition of the bivouac. In fact, the state of hygienic discipline was weak, not so much the objective conditions.
Until my arrival in the battalion, mid-June 1938. the fighters defecated anywhere, in the open. At first it didn’t bother anyone. But in a longer bivouac and, especially due to the heat that arose, this kind of “freedom” began to shine: the bivouac was dominated by flies. An explosion of dysentery could no longer be avoided. Dysentery was joined by a couple of cases of acute food poisoning, with choleriform diarrhea, severe cramps and prostration. They showed particular sensitivity fighters from Scandinavian countries. Measures? First, I tried to improve the situation through the Battalion Headquarters. I demanded that the Headquarters order the digging of latrine pits. I did not achieve anything. Then I asked for and received several classes in the teaching program. I used the classes for health propaganda with the main theme: “The fight against flies”. At the same time, I called into action all company paramedics and stretcher bearers, of which there were 2-3 in each company. They took on the task of digging pits, although in fact it was the task of the fighters themselves, that is, the on-call service. But there was no more time for “principled” discussions about the question of “jurisdiction”. The results were not lacking. In the middle of July, the epidemic was stopped. The fighters became convinced of the value of hygienic discipline in action. The experience thus gained and paid dearly among the companies will have the most beautiful and the most hygienic bivouac, and their initiative developed, a competition was born.
TEACHING AND TRAINING
At the same time, the entire Division conducted very intensive teaching and training. Every morning there were exercises in shooting live ammunition. The afternoon was designated for political lessons, and at night the entire Battalion’s exercises were carried out on the theme: “Night attack and defense “. to follow the Battalion on the march, to develop in a certain place and to wait for any real wounded to appear. Since there were never any wounded {in training}, and the command never gave conditional “wounded” (which for our training would have been the greatest benefits) that during those night exercises we had nothing to do but to take a nap. We have much more successful methods and richer training content within our own curriculum. I focused the greatest attention on practical exercises in pulling the patient out of the fire, wrapping, immobilizing, folding and unfolding the stretcher. I demanded that these actions be learned precisely, quickly, to become automatic. It was practiced blindfolded. Time is controlled on the clock. A real competition developed. The whole collective of paramedics participated in the assessment of individuals. Such training methods have produced outstanding results. I can say that all the paramedics (enfermeros) and carriers of the wounded (camilleros) have perfectly mastered all technical operations.
But the highest form of our training was represented by our “medical maneuvers”! The idea for this was born in me during the night exercises of our battalion. Being at leisure and listening to the crackling of maneuver ammunition and firecrackers that imitated hand grenades, I came to the conclusion that we too can apply imitation fire. I gathered all the medics and bearers of the wounded from the entire battalion and divided them into three groups. One group imitated the wounded, the second played the role of bearer and medic, and the third took the position of the defenders and imitated the fire throwing pebbles at the “wounded” and the bearers! I must admit that this was such a successful imitation of fire that individuals among the paramedics wore knots on their heads for several days. But the didactic result of this very realistic “combined maneuver” of ours was extraordinary: the bearers, paramedics and “wounded”, if they didn’t seek shelter, if they didn’t crawl clinging to the ground, they couldn’t even survive under the rain of gravel and stones. One day the battalion commander came to visit us. After we performed the exercise in front of him, the commander spoke highly of it.
Since the middle of July, the intensity of military training has doubled. Day and night, shots and explosions echoed over the entire deployment area of the 35th Division. Theoretically, “forcing the river ” was worked on, and the units were also practically trained in this, although not on a real river, because there was no such thing nearby, but on the dried-up beds of winter torrents. Everything already smelled like some of our more serious movements, but specifically we didn’t know anything.
Indeed, on the night between July 20 and 21, 1938, the Brigade left the bivouac and, in full military readiness, headed in the direction of the Ebro, along a winding road over the mountains and through deep gorges. In order to understand some of the events on this march, it is necessary to mention a medical-tactical mistake that preceded it. Two days before the movement, an order was issued from the Brigade, and it probably came from the higher command, to vaccinate the entire workforce with the typhus vaccine. Done right. After only a few hours, strong febrile reactions started, which lasted for three days in some fighters. So the Brigade went on a night march across the Ebro in very poor physical condition. The consequences were quite miserable. On the road Falset-Gratalops-Vinebre, I found fighters from the front groups lying like bundles. Ambulances continuously drove exhausted fighters forward and returned to pick up a new group. That’s how it lasted during the entire march, two days, until the troop arrived at their starting positions. Fortunately, the reactions calmed down on the third day so that the Brigade was already recovered and able to cross the Ebro. Obviously, the order to inoculate against typhus fell at a tactically very inconvenient moment. The vaccine weakened the physical ability of fighters at a time when it was needed. Even the immunological effect of the vaccine, when changed immediately before the expected exposure of the body, can be subjected to harsh criticism, because the exposure coincided with the so-called negative phase of immunity.
The vaccination of the Ebro Army, just before its big offensive , and the consequences that arose, are an instructive example that in its own way illustrates one of the fundamental principles of military medicine, which says that there are very few such medical methods that, by themselves, would be effective in war the same value as in peace. Their value and usability in war are determined, above all, by the operational and tactical conditions in which these methods are applied. In some conditions, some method brings blessings to the army, and in others, it causes even greater misfortunes. The knowledge and skill of the military doctor and the command is also reflected in their ability to assess the medical-tactical and operational situation and to decide which medical method to choose, when and how to apply it, so that it brings combat readiness. more benefit than harm.
Looking back at the work of the paramedics during the period of calm before the offensive across the Ebro, I must highlight two important moments:
First, the paramedics of the “Hans Beimler” Battalion of the 11th Brigade were fully utilized this period for the purpose of their own training for the upcoming operation. Through their direct involvement in the implementation of elementary sanitary measures, essential sanitation contributed to the end of the dysentery epidemic and saved losses of personnel.
Second, during this entire time, the Battalion’s medical staff operated almost completely independently. Admittedly, there was a Brigade ambulance behind us to which we evacuated more seriously ill patients, but there were no other forms of help from higher medical institutions. No one visited us. Not a single conference of doctors from the entire division was held where they would get acquainted with the upcoming tasks. I didn’t even have the chance to meet my colleagues, the Battalion doctors.
The wounded awaiting evacuation (Ebro front)
WORK DURING COMBAT OPERATIONS
My participation in the operations of the Spanish Republican Army is related to two periods:
The first period: as a medic of two Battalions of the 11th International Brigade, Ernest Thaelmann, I participated in the battle on the Ebro River from July 21 to September 24, 1938. The battle had two phases: the Republican offensive that lasted a week and then the defense that lasted until November 15, 1938, i.e. three and a half months. Characteristics of the first phase: the sudden penetration of our forces into the enemy’s operational depth, the formation of bridge defenses, the lack of heavy weapons at the head of the bridge defenses (power and watercraft under the blows of superior enemy aviation). Characteristics of the second phase: persistent defense of the captured bridgehead, positional defense, with the aim of exhausting the opponent as much as possible, great superiority of the enemy in aviation, tanks, artillery and mortars. On the Republican side, about 100,000 fighters participated in this battle.
Second period: at the end of December 1938, the Fascists undertook their biggest and last offensive against Catalonia. International Brigade fighters were then in the rear, withdrawn from the front, in the expectation that, according to the decision of the Republican government, they would leave Spain. As it did not happen, and Franco’s troops tore off Republican soil piece by piece, the International Brigadists on January 24, 1939, decided to report back to the combat units. In those final battles, the Yugoslav detachment acted as a protector on the Barcelona-Granolers-Gerona-Figueras route, where the Spanish units and large masses of soldiers were retreating. I received the position of Doctor of this detachment and remained in that role until February 10, when I was evacuated due to illness. Characteristic of the fight in Catalonia: holding defense on successive lines.
THE PLACE OF THE BATTALION DRESSING STATION
In the Battle of the Ebro, the location of the Battalion dressing station (BP) was almost always fixed in relation to the Company’s layout and stable to the extent that the Company’s position was stable. Only on the second day of the offensive, due to the rapid advance of our units, the BP moved continuously and worked “on the fly.” During the retreat through Catalonia, we almost regularly worked “on the fly” or, at best, we could stay for an hour or so, behind some natural cover, in a half-developed state, just as ready to give first aid as for a quick retreat.
As the situation on the Ebro demanded that the 11th Brigade change positions often, not in depth but along the front, moving from one sector to another, our BP changed its workplace exactly twelve times during those 62 days of the battle. The shortest stay in one place (the night of July 31 north-west of the village of Corbera, Valdecanalles valley) lasted six hours, and the longest (positions below Hill 565, Sierra Caballs) lasted seventeen days, from September 7 to 24.
LAND SELECTION AND ARRANGEMENT
The hilly character of the land allowed us to always choose a favorable place for BP placement at a distance of 200-800 m from the front. The main condition was that the place provided us with maximum natural protection from the enemy’s eye and from fire. As is well known, the Battalion dressing station is located in an area that is regularly under heavy mortar and artillery fire. On the flat terrain BP will be found in the range of machine gun bullets. The steeper the slope of the hill, the cut, the ravine, the ravine (barranco) or at least some dry land, which is suitable for the Mediterranean terraced land, provided us with basic protection. We found finished engineering works, which we could have used to accommodate BP, only on two occasions (unfriendly trenches, occupied on the first day on the right bank of the Ebro and an underground shelter on the third kilometer of the road Venta Camposines-Corbera) while we arranged all the other places ourselves, exclusively with our own strength; special units for digging trenches (zapadores) were barely able to establish defense nodes and command posts. We could never count on them. The orderly sequence of our work was as follows: first, we would dig a trench 80-150 cm deep under a dry dune or some natural escarpment. Then, from the bottom of this trench, we dug in a horizontal direction under the hill. We dug two parallel underground trenches, about 2 m long. The distance between the parallels was about 1 m. The parallels would eventually be connected by a transverse trench, so that the end result of these works was an underground horseshoe, which provided a backup exit in case one collapsed. Such shelters, with all the natural conditions, provided absolute protection from pieces of mortar and artillery shells, and relative protection from a direct hit by artillery and aerial bombs, depending on their caliber and the thickness of the soil layer above the shelter. In practice, whenever we were in shelters, we felt safe, even though we were regularly in the area of very dense, so-called, drumming fire of mortars and cannons. Once, a grenade exploded in front of the entrance to the shelter, which had the only consequence that we were slightly dazed by the strong shock wave of air inside the shelter.
These shelters were only used for medical personnel, because they were too narrow to bring in the wounded on stretchers. We stayed in only two places for so long that we had time to arrange shelters of some sort for the wounded while they were in the dressing room. At the BP below Sierra Pandols (Hill 481) we built a circular parapet (parapet) made of sandbags. On Sierra Caballs , below Hill 565, where we were for seventeen days under a continuous shower of artillery, which literally wiped out a hundred-year-old olive grove in front of us, we remained unharmed and were even able to sleep comfortably despite the hurricane. We have the shelter that we dug with our own strength to thank for all of that. In addition, we had time to build a shelter for the wounded. It was partly dug into the hill, and partly built of stone walls and covered with pine logs and earth. We cut down the pines and dragged them from the nearby hill. The area of the shelter was about 4 m². It was more comfortable to work around the wounded.
We had to pay great attention to camouflage. We covered the low-lying ground, which could be easily noticed by observers from the ground and from the air, with branches and grass. The entrances to the shelter, which stand out from the surrounding ground with their darkness, also had to be covered with branches. We put the used bandage material away immediately – in a sack and then, at night, we burned it. Bandaging the wounded, if we could not bring them into the shelter, was most often done under a tree with a dense canopy.
(top) The dressing room of Battalion “12 February” in the fighting on the Sierra Pandols 1727.VIII 1938.
(Bottom) The dressing room of Battalion “12 February” in the battles on the Sierra de Caballs 724.IX 1938.
LIFE AND WORK IN THE DRESSING STATION
When there are no wounded, during short breaks at the front, life on the BP should not be any less intense than during combat. Complete leisure should be avoided at all costs. We mostly had fun constantly expanding and improving our shelters. Then we read the daily press that regularly arrived at the front. From the newspapers, we were able to find out how the operations were going on the Ebro and on the Spanish battlefield as a whole, so we could more easily understand our own role. We understood that the main purpose of persistent defense of the Ebro bridgehead was to attract as many enemy forces and equipment as possible, in order to ease the situation on the other fronts of the Republic. From there, the main slogan of that time became quite clear to us: “Fortificar es vencer!”[1]
Sierra Caballs saw the need, and the possibility, to publish a wall newspaper with humorous content under the name “El pajaro”, which means “The Bird”. This name positively alluded to our stretcher bearers who “flew” like birds, like wings, carrying the wounded through the barrage of artillery fire.
I devoted the greatest care to the regular rest of my staff. Taking every opportunity to deep sleep — is one of the golden rules for any warrior. When we finished all the work, we would leave one observer on duty, and all the other people would retreat to the shelter to rest. Thanks to such a practice, the work ethic of my paramedics was so high that sometimes I had to force them to lie down to rest! Otherwise, they would simply invent some jobs.
I maintained contact with the command post (PM) of the Battalion by personally going to the PM. Thanks to the great understanding of the Battalion Commander[2] {Willi Benz at this point} for the needs of the medical services and the possession of extraordinary human qualities, I was always in the course of events. In addition, I received the latest information about the situation at the front from the soldiers and their chofers. They are often irreplaceable couriers and intelligence agents. The telephone connection between BP and PM is not perfect. On several occasions I also visited the Companies in the trenches at the front. And that is extremely useful for gaining mutual trust between the fighters and the Corps Doctor. The fighters were sure that we would help them in case of injury, maximum in the given conditions, and I was sure of them that they would not forget me in case of sudden enemy penetration.
Working around the wounded. At BP, there is no regularity in time when the wounded arrive. Of course, if it is done in our attack, or repulsing the enemy’s counterattack, it is known that within half an hour the wounded will also begin to arrive. But it is not uncommon for BP to be suddenly “choked” by a large number of wounded even in the middle of several hours of calm. This happens, for example, after a full hit of a single shell fired, perhaps completely at random, at a group of fighters gathered around the cauldron. That’s why BP must be constantly ready for work. My role was primarily to examine and triage the wounded (if there were more). The very appearance and expression of their faces gave me the first and quite reliable orientation about the general condition of the soldiers. A calm or completely absent and disinterested look in the eyes, a pallor of the face and rapid breathing were usually enough for me to rate such a wounded person as serious. I would immediately separate him from the group for a more detailed examination, call for emergency help and the fastest evacuation. Otherwise, the behavior of the wounded in Spain, both Spaniards and Internationals, was very stoic and calm. During the entire time of my work at the front, I did not face a single case where a wounded person would wail or react hysterically at the BP.
The basic actions that were expected to be performed in the BP of that time – changing bandages, immobilization, injections – were performed by my paramedics.³ The wounded came from the first position, reinforced, when necessary, layer of gauze and cotton wool. Fractures were immobilized with Kramer splints. At BP, we removed the first bandages in cases: when the general condition of the wounded neck is severe; when the bandage is very wet, dirty or when it has run out. In the case when Kramer’s splint was placed incorrectly, we put a new one. We stopped Esmarch’s tourniquet and tightened it again even after we were sure that the artery was no longer bleeding. We were afraid that he would bleed again in the transport! That was the general attitude towards Esmarch. We almost routinely gave injections to the wounded: anti-tetanus serum, morphine (for fractures) and camphor with caffeine.
The wounded card was filled out at BP. Its composition was very practical. It consisted of two parts: a smaller part, which remains in the BP with basic information about the wounded, and a larger part, which is sent with the wounded. For the most part, in addition to the descriptive diagnosis, there was also a diagram of the human body; the Doctor traced with a pencil the part of the body that was hit. Such a scheme made the work of the triage Doctor easier at the next stage of the evacuation. Smaller part of the ticket (coupon) served in BP as the only document on losses; no protocol was followed. A daily report on losses (bajas) was sent to headquarters. For my own personal needs, I kept a notebook on observed mistakes in the work of company paramedics.
Field hospital under a rock on the Ebro front, July-September
TRANSPORT AND EVACUATION SYSTEM
The Battalion infirmary did not have any means of transport. We carried the entire sanitary material in bags. I used to carry bandages, gauze and cotton in my pockets. So, I was always ready to help “on the move” during the march. This is how I worked, and it turned out to be very convenient, also during the retreating battles through Catalonia in February 1939. Company paramedics, in addition to purses, also had special leather, “fishes” for bandage material that were fixed to the belt. The paramedic could move them along the belt as needed, depending on whether they were crawling sideways or on their stomachs towards the wounded. I don’t know how it was in other units of the Republican army, but in our brigade the principle of “self-evacuation ruled.” As far as communication allowed towards the Battalions in order to accept the wounded and take them to the Brigade dressing station. In the battle for Gandesa, on July 28, 1938, my dressing station was located in the valley of Valdecanalles, and the PM of the Brigade was located on the western edge of the village of Corbera. The distance from us to the reception area {from the front} was up to 2 km. My stretcher bearers had to cover this distance. In the battles on Sierra Pandols, elevation 481, the Brigade sent the dressing station all the way to the foot of the mountain, on the Pinell-Gandesa road. There was only one-horse trail leading from that shelter to the Battalion, through the gorge, below the Hermita San Marcos (Hill 504). In order to overcome that very difficult mountain terrain, the Brigade assigned us one mule with a samara and two cacolettes on its sides. The services rendered to us by this hard-working “bird” were irreplaceable. In one move, the mule could carry two seriously wounded people.
Locations of Batajonsko Previjaliste (BP) – Battalion infirmaries or dressing stations – rmh
LOSSES
Today, I am not able to provide accurate information about the losses in my two battalions, “Hans Beimler” and “February 12”. I can only reconstruct them from memory. On the first day of the battle (forcing the Ebro River and penetrating the enemy’s operational depth) the losses were relatively low, thanks to the help achieved from outside and the complete disorganization in the enemy’s command. On that day, about 30 wounded men passed through the BP “Hans Beimler “. This Battalion suffered greater losses from the fourth to the tenth day of the offensive (between July 28 and August 3), i.e. on the days when the entire 35th Division attacked, unsuccessfully, the city of Gandesa. In those days, our dressing station received a total of about 80 wounded. On the fourth of August, the entire 11th International Brigade was withdrawn to rest and reserve. Around August 12, I was transferred to the Battalion, “12th February” which was still in reserve at the time, so that on the 16th I would be sent to the Sierra Pandols-Sierra San Marcos, where our front was in danger of being penetrated by the enemy from Gandesa. With very short breaks, my Battalion, as well as the entire Ebro Army, was engaged in the fiercest battles recorded in the entire Spanish war. For my battalion, the most difficult trials occurred from September 20 to 24 in the battles for Hill 565 (Sierra Caballs) when it attacked in vain the mentioned elevation, which represents an almost vertical cliff, and repelled the fierce attacks of the Fascists, with the help of the real sledgehammer of aviation and artillery. There were times when the positions were held only by protection units with the Battalion Headquarters. I calculate that from August 17 to September 24, the Battalion lost two thirds of its composition, but, thanks to the constant recruitment of recruits, it maintained the profile of a combat unit until the end. Through ”12 February” BP during that time, at least 200 wounded could have passed, most of them seriously, because in those days hand grenades, heavy artillery and aerial bombs were the main weapon.
From my war understanding, I will have a permanent memory of not many seriously wounded people whose condition can be of interest to every young doctor:
At dawn on the first day of our offensive, immediately after crossing to the other bank of the Ebro, the commander of the Scandinavian company, Karl Ernstedt, was brought to me in the tent. There was a palm-sized wound on the left side of his chest. An exposed heart was seen. The wounded man was breathing hard, drenched in cold sweat. Open pneumothorax syndrome. I covered the wound with thick layers of gauze and taped the whole surface with plaster. The wounded man was immediately rushed across the river to the rear. In 1966, at the Congress of Spanish volunteers in Zagreb, I learned from the Swedish delegate that Ernstedt did not survive this severe wound.
On the way up to Gandesa in the Valdecanalles valley, my Spanish paramedic was wounded right next to me. He was wounded stray bullet in the very linea alba below the navel. His fate is unknown to me.
On the 28th of July, the German Emil was wounded in the face in the battle for Gandesa. A typical, terrifying image of a man without half of his head. Only the eyes and forehead remained of the face. The wounded man came from his position on foot and walked to the brigade, refusing to be carried. The highest level of consciousness of a fighter who saw that practicantes are needed more by other wounded. Further fate unknown.
My second paramedic, a Spaniard, was wounded by a shell in front of my BP when we had not dug in yet. Wound in the region of the right kidney. The kidney has fallen out of the back and is hanging down the loin on the stalk. Bandage and quick dispatch to the brigade. Fate is unknown.
The company commander, a Spaniard, was shot through the skull with a rifle bullet. He was brought to BP in deep unconsciousness with Cheyne-Stokes breathing. He died in the BP after a few hours. A Spaniard, whose leg was amputated by a shell at a height before arriving to the BP, the wound did not show even a drop of blood. Remains of the gluteal musculature completely dry, gray as if cooked. Wounded man was completely calm, he asked for a cigarette. This wounded man I must have it on my soul, because I was so impressed due to his condition that, after the bandage, I immediately shipped him in the Brigade, and I didn’t give him a paean à demlure {as written in text??} (the only thing that I could do). Inevitably, he had to bleed to death during transport.
A wounded man whose shoelaces and shoe soles were cut off by a shell. The wound was smooth and clean as if was done with a surgical knife.
PATIENTS
I don’t remember a single “real” patient. I don’t think there were any. This is the result of the enormous mental, conscious engagement of the fighters during this operation, which was characterized by our great moral superiority over the enemy. The only case that I have remained in my indelible memory: during the critical days of September 1938, during the fighting on Hill 565, an Austrian fighter repeatedly came to me from his position, under a typical picture of a nervous breakdown: a severe depressive state, a bearded, worn-out face, with deep sunken eyes. Once I had to return him to his position. Such is the law of war.
Something about fighting morale, viewed from the point of view of my experiences in the Spanish war.
The relationship of man, the individual, towards war, the meaning of his existence in the cataclysm of war, is the subject of constant consideration by military theorists, psychologists, sociologists and philosophers. When we know the basic phenomena of war that he faces (physical efforts, starvation, psychological tension, constant threat of life from injury and death), then one can justifiably ask questions: how is it even possible for a person to endure all this, to fight and to win? What should be done so that an individual can withstand the hardships of war as easily as possible? Answering these questions, each army envisages a whole system of educational and training measures to which an individual should be subjected in order to develop in him the qualities necessary for war: awareness of the just goals of war, physical endurance, knowledge, skill, etc. (Each army before the eyes, “just” goals and many armies succeed, more or less, in instilling the awareness of “just” goals in their troops, even when those goals are objectively historically not even close to such). If we exclude the actual or potential deformations in the system of training and education (drill, forced indoctrination, devaluation of personality, etc.) more or less present in certain epochs and armies, then it should be said that training and education themselves have an extremely great importance for combat soldiers’ morale. Knowledge and, especially, experiential knowledge, personal experience about the shielding value of an ordinary trench, barely 40 cm deep, or about the vulnerability of a tank have a stronger and more beneficial effect on a person’s combat morale than a whole series of purely moral lessons. That is why the role of the training and education system cannot be overestimated, of course, provided that the student in that system has an active thinking role and is not degraded into plastic matter.
And yet, my personal experience from the war tells me that the entire system of training and education, especially in a people’s army, can have a completely relative, transitory and doubtful value, if it is conceived and realized for itself, independently of the basic factor on which it should rest, and that is the relationship between people. The educational component of this system (moral-political education, building combat morale, etc.) would be almost pointless and in vain if it were only studied, clarified, codified, preached, if it was not confirmed in the everyday practice of relations between people. If fighting morality is a function of social relations – which means that more just social relations will result in a stronger fighting need to confirm these more just relations on a daily basis, then morality is imperatively imposed and not denied, on a “small” scale, i.e. in human-to-human relations. Initially, you are on a more or less rational though acquired belief in the justification of war and the justice of its goals can be seriously shaken if the soldier is exposed to experiences of the opposite nature (drill, brutality, pranks, hypocrisy, half-heartedness, etc.).
Therefore, man’s attitude towards war, the ability of an individual to withstand the hardships of war depends, first of all, on the relationships that are established between the people themselves. The readiness of the individual fighter to resist and overcome all kinds of material deprivations is limitless, but only on the condition that he is convinced of the absolute necessity of these deprivations, on the condition that he is convinced in action that his seniors have done the maximum for him, and that consistently fair interpersonal relations prevail in the collective. “All for one, one for all” is a motto that has lasting value for all situations when people find themselves in trouble.
I would support the presented considerations with several examples from my practice during the battle on the Ebro. I have already said that the strategic idea of the Republican Command consisted in turning the second phase of this battle (the defense of the captured bridgehead) into a battle to wear out the opponent. As part of such a strategy, fortification gained the greatest importance. A young and inexperienced fighter could in a short time gain confidence in the protective power of the country (a principle whose actuality is even more potent in nuclear conditions), but the speed in gaining that confidence depended primarily on the seniors. It is up to the leader to use his example to help the unit overcome the crises it occasionally falls into.
When, in the middle of August 1938, we carried out a very tiring night march from the central sector to the left wing of the front (Sierra Pandols), dawn found us on the bare plain. My men gave up like a bundle and wanted to surrender to an “irresistible ” sleep. I was also terribly sleepy. The critical moment had come: either start digging in immediately or “just a little ” sleep, with the huge risk of exposing ourselves to mortar fire without any protection and the artillery fire that could start at any moment. Sensing the criticality of the moment, which was as dangerous as it was psychologically favorable for gaining trust in the senior officer, I was the first to grab a pickup and let the people sleep. It didn’t last even a minute, and my men snatched the pickaxe from me and continued with the digging. In less than an hour we had a trench ready, deep enough to protect us from indirect hits. From then on, I was never near the point of ordering a funeral. People’s own belief in necessity and usefulness, helped by theirs with a positive attitude towards as an elder, they were driven to complete this job.
I have already said how the morale of the paramedics was affected by my stipulation that they must sleep whenever there was a free moment for it. Some of them neglected this provision and gave their turn to others who they thought needed more sleep.
During the distribution of lunch, there was once a scene in which there are comedic elements, but in essence it is very serious and serves to be remembered. We sat in a circle and the attendant distributed the meal. At the end of the division, he added the remaining excess meat to me. I put it in my neighbor’s portion. This one immediately added to the next, and so the game continued until a piece of meat, having gone around the entire circle, was thrown back into my portion!
Certain privileges in war are inevitable and justified. Ethically, it is completely in its place, and above all it is in the interest of the collective, that the officer – in compensation for his greater responsibility, for his physical and moral efforts, which sometimes many times exceed what an ordinary fighter does, gets better conditions for the restoration of his spent energy. The only question is who, how and when these privileges are obtained. Whoever takes them by himself, arbitrarily, is fatally playing with his authorities and the fighting morale of the fighters.
Privileges can only be given, and the military collective, if it depends on it, will hardly ever make a mistake in its attitude to whom and why they should be given. In a regular army, this issue is more or less regulated by written and unwritten norms. However, since there inevitably remains enough free space for various deviations, the spirit of the collective will have to act as a constant corrective in the regular army, in war. Each individual senior will have to confirm again and again through his personal work that he is “conquering” what is guaranteed of him by the regulations.
The wounded had a great influence on our combat morale. Their, almost without exception, dignified and calm demeanor at the dressing station, despite indescribable suffering, revealed to me a new dimension of humanity and the ability to endure suffering. The presence of the wounded always brought us to an extremely positive excitement, it calmed our concern for our own personal safety. I don’t remember any case where I had to apply any provision of military discipline, in the sense of coercion, to my subordinates in Spain. Military discipline had been ingrained in us somehow imperceptibly and secretly, becoming an integral part of ourselves. Cadre training in Spain bore all the characteristics of a young, revolutionary army. Selection and promotion of personnel depended solely on their quality and the experience they had already achieved in the fight. Their positive motivation for learning made any means of coercion unnecessary in class.
During the Spanish War, I became convinced that the unselfishness of the veterans in passing on their knowledge to the young is of great importance. A young man must not get the impression that the elder is giving him “only one part of his experience, drop by drop” – keeping him in constant and intellectual subordination and dependence. In Spain, we succeeded in training excellent paramedics from semi-literate pauper peasants in a very short time.
DOCTOR AND WAR
This question really contains many problems and dilemmas of a professional, ethical and psychological nature. The answer to it should start from what has been said about man’s attitude towards war in general. The relationship to war is reduced to the relationship between people. It seems to me, when it comes to a young doctor, that the mentioned thesis deserves to be specially and a bit more intoned. Why? Because, knowing myself to some extent, I know the tendency of doctors to try to find a cure for all the trials and conflicts they experience in war in the bunker of themselves and their expertise. I must say that such a bunker becomes a fatal dead end. The solution lies in opening the doctor’s personality in front of the military team, in integrating him with all the streams of the unit. A doctor in war is first of all a man, an elder, who enters into regular relations with other people, and only then is he a doctor (expert) in the narrower sense. That is why the beginning of his medical function in the military unit should be marked by “laying the foundation stone” or “moral and psychological organization of the workplace”. By this I mean: getting to know people, Officers, fighters, collaborators and immediate subordinates, the Doctor must not claim any kind of a priori, intellectual superiority before the military collective. On the contrary, in order to be able to perform as a superior expert and elder, he must first “sit down” to the level of his environment, always remaining a member of it. A military doctor must not shy away from any work when the moment requires it. They stand next to each other in his instrument. That is one of the dearest lessons that the Spanish war taught me.
Dr. Gojko NIKOLIS
2 Willy Benz, alias Heinrich Schurmann, lives today as a pensioner in Berlin (GDR). I express great respect and friendly feelings to him on this occasion as well.
3 I must mention here the name of Walter Vahz, my first assistant in the “12 February“ Battalion, then a student, and today a member of the Central Committee of the Communist Party of Austria.
