February 2015 Book Reviews

Tuesday, January 13, 2015

Serving to Heal on the Battlefield

Between Flesh and Steel: A History of Military Medicine from the Middle Ages to the War in Afghanistan. Richard A. Gabriel. Potomac Books. 312 pages. $34.95.

By Kelly Kennedy

One of the few tangible benefits of war is the quickened advancement of medicine. As blades slice, bombs pulverize and bullets rip, doctors and inventors develop new ways to deal with amputations, blood loss and infection.

During the recent wars in Iraq and Afghanistan, many servicemembers came back with amputated limbs. After years of little improvement, scientists finally had the money to create better prosthetics that would allow a person to pick up an egg delicately and precisely enough not to crush it. Dental surgeons reconstructed faces while still in the war zone, allowing people to come home recognizable to their families. Emergency room doctors learned to stop a plethora of bacteria that had invaded a wound through intentionally dirty enemy weapons.

The advances, as in the past, came back to civilian practitioners who have lighter prosthetic devices for women who lose limbs in traffic accidents, who better know how to staunch the blood after a bombing at a marathon and who have better understanding of the mechanisms behind concussions sustained during a football game.

For those who geek out on medical history, Between Flesh and Steel by Richard A. Gabriel delivers everything from mortality statistics dating back to The Iliad to horrifying bits about encouraging infection in bullet wounds to try to force the “poisonous” bullet out.

As military technology advanced, so did medicine. Readers learn which types of weaponry induced certain wounds and how that changed the future of medicine. A sword wound with clean edges might be easier to care for—or it would have been, had there been any concept of how to take care of infections or stop bleeding—than a wound inflicted by a modern improvised explosive device. Communications also figured heavily in improvements. For servicemembers who believe it takes a while for modern military directives to reach skilled troops, imagine the time it took for a 16th-century medical book to reach illiterate barbers performing surgeries on the battlefield.

To tell the story, Gabriel goes deep, including when guns were first mounted on carriages and how far cannons could fire during Napoleon’s battles. He goes far beyond medicine:

“By the nineteenth century, the empowerment of new societal segments culminated in the rise of representative legislatures that gave these new classes some participation in public policy,” he writes. “The increased influence of these new domestic political actors, however, was in proportion to how valuable they were to the national authorities in conducting their war and foreign policies.”

Readers get a primer on every war since the beginning as well as the politics surrounding them before Gabriel gets to the good stuff. This good stuff, however, is accessible to the generally nerdy who believe visits to the National Museum of Health and Medicine to see hairballs extracted from human stomachs—or Maj. Gen. Daniel Edgar Sickles’ amputated leg—are the best thing ever, as well as to medical professionals who seek to apply knowledge to their practice.

The anecdotes are fascinating:

n During World War II, Soviet doctors treated facial burns with a paste of crushed onions and salt, as 16th-century barber surgeon Ambroise Paré did centuries before. According to his journals, it worked.

n For hundreds of years, doctors plunged amputated stumps into boiling elder oil mixed with treacle to stop the bleeding.

n Surgeons could not amputate above the knee until 1718 because they didn’t know how to stop bleeding from the femoral artery.

Beyond the gore, Gabriel provides a history of veterans’ affairs going back to the 16th century, during which the French opened a convalescent home for disabled veterans. It wasn’t always great. For example, in 1674, a French veterans’ home housed 4,000 people who slept three to a bed. It does speak, however, to society’s belief that those who fight its wars should be cared for.

Interestingly, volunteer armies brought about many changes seen today, such as rations that could keep a soldier nourished and uniforms that protected against cold or trench foot. Eventually, the military did begin advancing techniques ultimately used by civilians. For example, wounds should be cleaned rather than enlarged, though necrotic tissue should be cut away. Sailors should travel with limes to prevent scurvy. Troops should bathe—often.

In the recent battles in Iraq and Afghanistan, technology turned toward better helmets, goggles, body armor—including armor to protect the groin—and armored vehicles, but Gabriel points to a couple instances in which medical knowledge gained at war could instantly be spread throughout the battlefield as well as at home.

During the Second Battle of Fallujah in Iraq in 2004, there was no blood bank from which to draw, so casualties were treated with blood taken on the spot from fellow troops. As it turns out, all the casualties survived to be transported. This led to a study that found troops treated with whole blood had a survival rate nine times higher than those treated with red blood cells and IV fluid.

Gabriel steers clear of environmental exposures, such as Agent Orange, Gulf War Illness or the fear that the huge open pits used for burning trash—up to 240 tons a day—in Iraq and Afghanistan could account for an uptick in respiratory and neurological problems. He instead sticks with immediate wounds and diseases.

The book, however, does highlight what still needs to be done, stressing the importance of answers for both traumatic brain injury and post-traumatic stress disorder.

“In 2002, 200,000 American soldiers sought mental health counseling for post-traumatic stress-related disorders,” Gabriel writes. “In 2011, the number of soldiers who actually received treatment or counseling from behavioral health specialists increased to 280,000.”

Kelly Kennedy is the director of veterans outreach at Bergmann & Moore, LLC. She is the author of They Fought for Each Other: The Triumph and Tragedy of the Hardest Hit Unit in Iraq, and she served as an Army communications specialist during Operation Desert Storm.


‘Hang Tough!’ The Making of a Legendary Leader

Conversations With Major Dick Winters: Life Lessons from the Commander of the Band of BrothersColonel (Ret.) Cole C. Kingseed, USA. Berkley Caliber. 281 pages. $26.95.

By Col. Kevin W. Farrell, U.S. Army retired

Without a doubt, for soldiers serving in the U.S. Army today, the most familiar tactical combat leader of World War II was the legendary paratrooper Maj. Dick Winters, who died in 2011. World War II historian Stephen E. Ambrose introduced the reading public to the combat exploits and heroic soldiers of Winters’ “Easy Company” in 1992 with his book, Band of Brothers: E Company, 506th Regiment, 101st Airborne from Normandy to Hitler’s Eagle’s Nest.

The HBO miniseries of the same name made Easy Company in general—and Winters in particular—an international phenomenon.

It is Cole C. Kingseed, however, a retired U.S. Army Infantry colonel, former professor of history at West Point and ARMY magazine contributor, who offers the most thorough and readable scholarship related specifically to Winters’ life and career. Kingseed’s Beyond Band of Brothers: The War Memoirs of Major Dick Winters, published to wide acclaim in 2006, made Winters’ war memoirs available to the entire world. Now, in his latest book, Kingseed revisits Winters’ life and career but this time for a purpose that extends beyond historical scholarship. Neither a work of history nor a standard biography, Conversations with Major Dick Winters is instead an engaging account of a remarkable friendship that provides indispensable insights to leadership and living a meaningful life.

Organized thematically rather than chronologically, the book runs the gamut of being sublime, touching and even funny. Along the way, the reader not only learns enduring lessons about leadership but also gains a far more comprehensive understanding of the man behind the legend. In essence, the book definitively answers the questions of who Winters really was and how he was able to achieve such extraordinary results as a battlefield leader. In discovering the answers, readers will note similarities between Winters and another great American combat leader, Brevet Maj. Gen. Joshua Lawrence Chamberlain, in that the lives these volunteers lived before the great test of combat equipped them well for the ultimate test. Sterling character and lives guided by purpose prepared these individuals to be extraordinary leaders, and long after the profound experience of war, character and purpose continued to shape their lives, informed deeply by the impact of combat.

Many of the events addressed in this book will be recognizable to those who are familiar with the battles of the 101st Airborne Division in World War II. What emerges that has not been addressed before, however, is not Winters the soldier but Winters the man. Whereas his heroism and inspired leadership are well-known, what comes through so clearly in Kingseed’s inspired work is the makeup of the person and the attributes that allowed Winters to lead in the manner that he did. Coming from a variety of remarkable sources—civilians, fellow soldiers, a platonic friend, the author of the book himself—is a remarkable man whose defining characteristics were “his calmness, serenity, integrity, and his courage.”

Arguably one of the most poignant revelations comes about when Kingseed queries Winters on his most prized item from his wartime service, assuming it would be the guidon from his command of Easy Company. Surprisingly, Winters identifies an edelweiss flower under glass that he had picked himself in the Austrian Alps, explaining, “After the loss of so many soldiers and after witnessing untold suffering during the war, the edelweiss symbolizes freedom to me.”

Employing an unconventional but effective structure, the book is organized into four sections. Part 1, “Spring,” focuses on Winters’ wartime leadership. Readers conversant with the history of the 101st Airborne will find this portion engaging and discover Winters’ inner thinking in training and in combat. Part 2, “Summer,” is focused more broadly on general leadership and character. This part forms the core of the work and is what makes it more than an interesting book, marking it as an essential read for anyone—soldier and civilian alike—who seeks to be a capable leader and live a more fulfilling life.

Part 3, “Autumn,” addresses Winters’ personal side and his closest relationships. A line that stands out is the suggestion that, “Ethel Winters was the only woman whom Dick Winters actually loved.” Their 62 years of marriage spoke volumes about how Winters lived his life. The final section of the book, “Winter,” though the shortest, is also the most touching. It brings together the last years of Winters’ life and his long-term legacy.

As compelling as Winters’ life story is, an unexpected pleasure of this book is exploring the bond that develops between two former Infantry officers. A relationship that begins formally with a foundation of respect and commitment transforms into one built upon the highest level of trust and friendship, expressed most powerfully and succinctly when at one point Winters provides encouragement to the author with his trademark phrase, “Hang tough!”

Conversations With Major Dick Winters is a must-read—not only for serving soldiers but for anyone with an interest in leading a life with purpose. Perhaps the best answer to the question of what made Winters such a great leader is revealed in his own words that he hoped would be his epitaph: “Wars do not make men great, but war sometimes brings out the greatness in good men.”

Col. Kevin W. Farrell, USA Ret., Ph.D., is the former chief of military history at West Point. He commanded a combined arms battalion in Iraq, and his most recent book is The Military and the Monarchy.


The Man Behind the Curtain:
Meeting the Real Clausewitz

Clausewitz: His Life and Work. Donald Stoker. Oxford University Press. 368 pages. $27.95.

By 1st Lt. Jonathan D. Bratten

In The Wizard of Oz, the man of the same name instructs: “Pay no attention to the man behind the curtain.” The (literally) larger-than-life Wizard feared that Dorothy’s investigations would out him as a fraud. In actuality, the Wizard proved to be kinder, more sympathetic and an all-around better man than his public persona. Oftentimes it is best to take that look behind the curtain and get face-to-face with the greats of history.

So why not pull up a chair with arguably one of the greatest military minds of the second millennium, Carl von Clausewitz? This is exactly what Donald Stoker, professor of Strategy and Policy for the U.S. Naval War College’s program at the Naval Postgraduate School, has done. Cock an eyebrow at the idea of a naval strategist addressing land warfare if you must, but Stoker has already established his credentials as a cross-pollinating warrior with The Grand Design: Strategy and the U.S. Civil War. He brings a perspective to land warfare that only the Navy can: sheer amazement at what Infantrymen and their ilk endure.

Clausewitz, as Stoker points out immediately, was a soldier first and a strategist second. Enlisted into the Prussian army at the tender age of 11, Clausewitz was as much a child of the military as he was of his family or his country. Stoker endeavors to bring out the human element of Clausewitz, which is oft-overlooked in favor of reading On War ad nauseam. For Stoker, Clausewitz is not a detached strategist, coldly viewing the world from his lofty tower. No; he is a passionate man, very much a young man, concerned with career, love and glory. These do not take away from his character as a strategist, says Stoker, but instead add to it.

Following the 11-year-old from his first induction into the rusty Prussian military machine in 1792, Stoker tracks his professional and personal career all the way through the Napoleonic Wars. A product of a stultified and self-satisfied military that had not modernized since Frederick the Great in 1756, Clausewitz was painfully aware of the Prussian army’s shortcomings. His writings as a young staff officer would be recognizable to many within the military as the champing at the bit that characterizes the young, driven and innovative officer who is stuck within an organization that does not adapt well to change.

Not even Clausewitz, however, could have predicted the reversals and humiliations the Prussians would receive at the hands of the young Napoleon Bonaparte in 1806 or the years of near-vassal standing to which Prussia would be subjected. The military powerhouse of Europe was so cowed by the French that Prussian officers, Clausewitz included, left for service in the Russian army in preparation for the 1812 campaign.

This tore deeply at Clausewitz, for whom the Prussian army was like family. Even as he chased after glory in Russia, he still kept an eye toward returning to the Prussian army that he felt as though he had a hand in creating. In the interim years of 1807–1811, Clausewitz had worked with men such as August Neidhardt von Gneisenau and Gerhard Johann David von Scharnhorst to reform the military, promoting innovation and small-unit tactics and making the promotion system fairer. Denied the chance for battlefield glory for Prussia and afraid of what Napoleon would do to Europe, Clausewitz spent the years between 1812 and 1814 fighting for the Russians.

Ever mindful of how glory on the battlefield can translate into promotions and recognition, Clausewitz sought a field command. Due to his skill as a logistician, however, he was kept on staff during the majority of the campaigns. Clausewitz’s letters to his wife, Marie, are often full of the cynical musings of a man stuck in the staff. Again, his laments will fall on sympathetic ears to officers of the present day.

Second only to his desire for battlefield success is Clausewitz’s devotion to Marie. Their romance was not stormy but instead served as the bedrock on which a moody and sickly man could build his life. Marie served as Clausewitz’s sounding board and continued to collect his works for publication following his death in 1831.

Clausewitz’ continuous desire for more action was satisfied: He saw battle firsthand dozens of times. He was captured and wounded, fought hand-to-hand and yet was still able to see the larger operational picture. This most likely came from his years as a teacher and a historian. Clausewitz was known for his histories far more than for his strategy during the 19th century.

Stoker paints the picture of a man who felt the world around him very keenly. Clausewitz never attained the fame he thought he deserved in his lifetime, ending his days as the head of Prussia’s War College. As Stoker points out, however, Clausewitz is still remembered today; the field commanders of the Prussian army that he so envied are not. His writings have survived the nuclear age and can be found in every service academy in the U.S., a thought that might prove comforting to the young Prussian who was continuously spoiling for a fight.

What makes Stoker’s book remarkable is that Clausewitz is turned into a very approachable and recognizable person. It is organized in such a way as to follow Clausewitz and his various works through his tumultuous career, delivering a seamless exposition that pairs well with the pictures and maps provided for each operation. This work speaks to younger officers in particular but has a broad appeal to all those interested in the development of strategy.

1st Lt. Jonathan D. Bratten is an Engineer officer in the Maine Army National Guard, in which he serves as the command historian. He has bachelor’s and master’s degrees in history.


Thinking Big

No End Save Victory: How FDR Led the Nation into War. David Kaiser. Basic Books. 408 pages. $27.99.

By Lt. Col. James Jay Carafano, U.S. Army retired

Strategy has so fallen out of favor. These days, Washington pays it lip service. Many academics appear indifferent. The budget crunch increasingly marginalizes professional military education while curriculum gets junked up with all kinds of topics. No End Save Victory by David Kaiser, a visiting professor at Williams College, stands as a welcome respite from the dismal decline of the strategist’s lot.

This book studies President Franklin D. Roosevelt’s effort to redirect American grand strategy away from hemispheric defense. Kaiser’s main focus is detailing how the President dealt with geostrategic issues from the outbreak of World War II to the U.S. entry into the conflict after Pearl Harbor.

One of the most striking features of the book is Kaiser’s good-faith effort to deal with all the elements of national power and show how they intertwine with one another. Choices of war and peace are never cordoned off as isolated issues. Everything comes at the White House at once. Kaiser, for example, doesn’t neglect the challenges Roosevelt faced in dealing with Congress or the influential “America First” coalition that campaigned against U.S. entry into World War II. He gives space to trade and industrial policy as well as diplomacy, military affairs and strategic intelligence: all the kinds of conundrums, questions and choices strategic leaders have to grapple with in real life.

Kaiser also wraps strategic and social issues into one narrative. That is important as well. New military history—research into social and cultural issues rather than traditional tomes about battles and bullets—adds an important new dimension to studying war. One of the great failings of these narratives, however, is that they are often disconnected from, or try to overshadow, the wars themselves. That is not how real history happens. It’s all one messy reality for strategic leaders.

No End Save Victory rightly tries to connect seismic shifts in culture and social change to strategic leadership on the eve of World War II. For example, there is an appropriate discussion of the role African-Americans played. They had become a crucial pillar of the President’s party. The mass migration of blacks to the industrial North ensured they would be a critical component of the arsenal for democracy. They also suited up for war in big numbers. As a result, how to handle the increasingly prominent roles of blacks in American society was an issue never far from the President’s desk.

Matters of “proper” strategy are also not neglected. One in particular stands out. The issue of freedom of the seas played perhaps the most pivotal role in the President’s strategic calculus that made entering the war virtually inevitable. If England was defeated, Germany could dictate the future of the Atlantic sea-lanes. Roosevelt also knew full well that Japan considered the U.S. naval presence in the Pacific an intolerable threat to its vital interests. The U.S. simply didn’t have the capacity to ensure freedom of the seas in the face of these threats. Such losses would mean America would no longer be a free nation able to control its own destiny. Long before Pearl Harbor, these dangers took away realistic options the President had to opt out of war.

Today, America can be no less concerned about freedom of the seas. The free oceans are more critical to the U.S. than ever. The vast majority of U.S. trade goes by sea. As one of the world’s leading energy exporters, freedom of the seas is essential. There are massive environmental issues, from pollution to overfishing, that demand respectful use of the commons. Piracy is a problem. China is developing specific military strategies to close access to sea-lanes to outsiders. Iran routinely muses about how to close passage of the Strait of Hormuz. Any realistic U.S. grand strategy has to include ensuring freedom of the commons as a central pillar.

If the U.S. military gets too small, that pillar could be in jeopardy. It’s a bigger problem than just not having enough ships. The Marine Corps is important because it offers the capacity to project power from the sea. The Air Force has a major role to play in keeping sea-lanes open, particularly over vital choke points. The Army delivers the capacity to make sure the nation can defend its interests where the sea-lanes are anchored in critical parts of Asia, Europe and the Middle East, and it provides a vital logistical backbone for the other services.

No End Save Victory reminds us that thinking about the big strategic challenges of the past is helpful for thinking about big strategic problems of the future.

Lt. Col. James Jay Carafano, USA Ret., Ph.D., served in Europe, Korea and the U.S. Before retiring, he was the executive editor of Joint Forces Quarterly, DoD’s professional military journal. A graduate of the U.S. Military Academy, Carafano holds a master’s degree and a doctorate from Georgetown University as well as a master’s in strategy from the U.S. Army War College.