by Jon Erwin
As he lay on the deck of the B-29, Red’s crewmates saw smoke coming out of his mouth, indicating a possible smoke inhalation injury, which also increases the risk of death. The ignition of white phosphorus creates phosphorus pentoxide, a severe pulmonary irritant. When concentrated in an enclosed space such as the B-29 cabin, it can inflame the respiratory system and interfere with breathing.
Crew members kneeled next to Red, opened the first aid kit, and pulled out needles and medical packs. Through his pain, Red guided Bill Loesch through the process of giving him a shot of morphine and a shot of plasma to try to replenish the copious volume of blood and essential body fluids he was hemorrhaging. But the massive extent of Red’s wounds meant these efforts were like drops in the ocean.
In 1945, the standard practice was to inject morphine straight into a muscle rather than a blood vessel. It was not understood that this resulted in most of the morphine simply sitting in the muscle rather than circulating through the bloodstream. So after Loesch injected the morphine shot, Red would have experienced little, if any, immediate pain relief. But this held an advantage. If too much morphine was absorbed into Red’s bloodstream too quickly as it hemorrhaged fluids, his blood pressure, which had already plunged, could drop and render him unconscious. Another factor working to Red’s advantage was that he was healthy when he was injured, which increased the odds of his withstanding his injuries.
White phosphorus is fat soluble, meaning it can be absorbed through a burn. Contemporary burn doctors understand the best intervention possible is to surgically debride the burns, or remove all the affected tissue, in less than an hour, which is rarely feasible but definitely necessary within the first twenty-four hours. But in 1945, this was not known.
Burn injuries have plagued mankind throughout history. Most of the ancient remedies for burns consisted of topical treatments. An Egyptian papyrus from 1600 BC suggested using salves of honey; Chinese records from 600 BC proposed tea leaves; and Hippocrates in 400 BC proposed pig fat, warm vinegar soaks, and oak bark lotions. In the first century AD, the Roman medical writer Celsus reported the use of wine as a burn solution, and the Arabian physician Muhammad ibn Zakariya al-Razi (also known as Rhases) advocated cold water for pain relief. Few of these methods helped burn victims, though vinegar has antibacterial properties that can prevent infections, one of the major causes of death.
In the sixteenth and seventeenth centuries, some European doctors sensed the importance of early burn removal by surgical excision, but poor hygiene and the lack of antiseptic surgical techniques doomed what was a profound insight.
As for the now-common practice of skin grafting, the first record of it dates from India in the fifth century AD, when a surgeon named Sushrutha used skin strips from the forehead and buttocks and grafted them over the wounds of noses that had been amputated as punishment for crimes. In the 1800s, experiments in skin grafting took place across Europe, and grafting for burns was used by some surgeons into World War II.
But according to contemporary burn surgeon James Holmes, “They got poor results, and surgeons didn’t understand what they were doing. From World War I until the 1970s, we went back in time in terms of burn care. The standard treatment for a big burn was to just literally let the burn rot off, as it got picked at and cleaned every day.”
There were, however, two fire disasters that led to research breakthroughs in burn care and insights that would help to save Red Erwin’s life. The first was the 1921 fire at the Rialto Theatre in New Haven, Connecticut. In studying the cases of the seven fatalities and eighty injured survivors, pharmacologist Frank Underhill suggested that burn deaths may be due to the rapid loss of fluids from the body and that early fluid resuscitation was critical. His conclusion was widely published and adopted into practice.
The second disaster was the 1942 Coconut Grove nightclub fire in Boston that killed 492 people, injured more than 150, and triggered several critical burn care innovations. Intravenous drips of penicillin, which was only then entering mass production, were used successfully to combat staphylococcus bacteria and prevent infection in a number of the victims. This was the first time penicillin was used on non-test subjects.
Doctors confirmed the fluid shift theory of early fluid resuscitation first observed from the Rialto fire victims, and they improved on it by developing precise formulas for giving patients certain amounts of plasma and saline, based on the percentage of body surface area that was burned.
At Massachusetts General Hospital, according to the British Medical Journal, plastic surgeon Bradford Cannon developed a new way to treat the burn victims of the Coconut Grove fire. “He discarded the accepted approach2 of using dyes and tannic acid as the primary treatment for burned tissues, having shown it to be harmful,” the article related. “Instead, he and colleagues used gauze containing boric acid and coated with petroleum jelly.” The doctors also removed the most severely damaged flesh and used skin grafts.
These innovations were circulated throughout the civilian medical community and widely practiced by military doctors and surgeons, for whom burn injuries became a top priority during World War II.
Two months earlier, on February 19, 1945, seventy thousand US Marines had hit the volcanic black-sand beaches of Iwo Jima (which in Japanese means Sulfur Island). According to one journalist, the extraterrestrially rocky, barren island projected “a sullen sense of evil.”3 Now, Red’s hopes for survival lay with a small team of military doctors on Iwo Jima, where so many had died so that others, like Red, could live.
The island was just 650 nautical miles south of Tokyo, directly on the B-29 flight path to Japan, and was used by Japanese fighters to attack the bombers. As a precaution, B-29s flying from the Marianas zigzagged hundreds of miles away from Iwo Jima to minimize the threat. Japanese small and medium bombers also used the island’s two operational airfields as a base to stage harassment raids on the B-29 bases themselves, especially on Saipan.
If the Americans could capture the island, they would eliminate these threats, provide a closer base for B-29 raids on Japan, enable fighter escorts to protect the bombers, and provide an emergency landing strip for crippled or low-on-fuel B-29s.
On February 19, D-day of Operation Detachment, marines of the veteran Third, Fourth, and Fifth Divisions stormed ashore against light opposition, which led to a false sense of an easy victory. They were accompanied by shiploads of ammunition and supplies,4 including a year’s supply of toilet paper, one hundred million cigarettes for the Fourth Division alone, and enough food to feed the city of Columbus, Ohio, for a month.
Waiting for them were more than twenty-one thousand Japanese troops commanded by Lt. Gen. Tadamichi Kuribayashi, a brilliant strategist who, before the war, had traveled extensively in the United States and believed it was “the last country in the world that Japan should fight.”5 They had spent months creating an ingenious network of above-ground concrete blockhouses and pillboxes, subterranean bunkers, tunnels, and spider holes, and roll-out guns hidden in cliffside caves to inflict maximum carnage on the invasion force.
At 10:00 a.m., Kuribayashi sprang his trap. “Mortars fell in cascade from hundreds of concealed pits,”6 wrote Sgt. Bill Ross. “Heavy artillery and rapid-firing antiaircraft guns, barrels lowered to rake the beaches, slammed shells into oncoming landing craft and support vessels.” Marines were pinned down on the beach, crawling on their bellies and praying.
“The worst was that first night,” recalled Col. Frank Caldwell.7 “We were packed in so tight there was no room to move. They knew right where we were, and of course we were all so concentrated we made a perfect target. They used to fire something we called a ‘burping betty,’ which looked like a 55-gallon oil drum coming through the air at you. They shot it with rockets off railroad tracks coming out of a cave. It wasn’t accurate, but it made enormous craters and was a terrifying weapon until you got used to it.”
On February 23, the fourth day of combat, the first marine patrol reached the 556-foot summ
it of Mount Suribachi and raised the American flag. An image captured by Associated Press photographer Joe Rosenthal of a second marine detachment raising a larger flag became one of the most iconic photographs in American history.
But weeks of brutal fighting would follow. “There were no trees left or brush, really, no cover of any kind,” Colonel Caldwell recalled. “It was just throwing flesh against concrete, yard by yard: frontal assault the whole time.”
A lone Japanese officer ran out of a cave and charged a flame-throwing tank armed only with his samurai sword. Caldwell marveled, “All by himself. Against a tank. I don’t know what the hell he thought he was doing, but the tank just moved that stream right up his body and burned him to a crisp.”
Caldwell’s troops dropped a phosphorus grenade into a suspicious hole in the rocks, “and in a minute the rocks came all apart and out came this Japanese soldier with a hand grenade, smoking from the phosphorus burns, right at us. We all turned and shot him, just another dirty Jap, you know. Except his helmet came off, and there in the top, inside was a picture of him and his family. He had six kids. There he was with his wife and kids, all dressed up, looking proud. Like one of us. I still remember that.”
It took six weeks of savage combat to take the island from the Japanese. In one engagement dubbed “the Meat Grinder,” more than eight hundred marines perished while trying to overrun a Japanese position.
Robert Sherrod, a Time and Life journalist, reported, “Iwo Jima can only be described as a nightmare8 in hell.”
On March 4, 1945, the first emergency landing by a B-29 on Iwo Jima was made when the Dinah Might, low on fuel, touched down. On March 26 the Americans declared the island secure, but skirmishes with Japanese holdouts continued for weeks.
Twenty-seven marines and sailors were awarded the Medal of Honor for their actions during the fighting for Iwo Jima, and more than half were posthumous. It was the highest number of Medals of Honor given in any World War II battle. Adm. Chester W. Nimitz, commander of the US Pacific Fleet, declared that “uncommon valor was a common virtue”9 on Iwo Jima.
But the cost of victory was horrific. The battle caused 26,040 US casualties, including 6,821 fatalities, with another 2,600 Americans incapacitated due to combat fatigue. It was the deadliest battle of the war for the marines, and one general dubbed it “the most savage and the most costly battle10 in the history of the Marine Corps.” Most of the twenty-one thousand Japanese troops on the island were killed.
Was it worth it? Unfortunately, one of the main justifications for Operation Detachment—to provide fighter escorts for B-29 raids—was achieved only minimally, as only ten such escort missions ever occurred. Even the newest American fighter, the P-51D Mustang, didn’t have adequate navigational equipment and range for the 1,500-mile round trip necessary to reach most Japanese targets.
The victory, however, did provide an emergency landing strip for crippled B-29s, but less so than has often been reported. After the war, many accounts noted that 2,251 B-29s landed on the island through the rest of the war, and because each plane carried eleven crewmen, the lives of a total of 24,761 airmen were saved. But military historian Capt. Robert Burrell analyzed the evidence and concluded that most of the landings were not major emergencies but minor repairs, reloading bombs, training, or refueling. “Of the 2,251 touchdowns popularized11 in most history texts, the vast majority did not result from crucial or unavoidable crises,” he wrote. “Most landings were for the purpose of refueling, planned or otherwise.” He concluded that capturing Iwo Jima was helpful to the B-29 effort but not worth the cost in American lives.
Yet, for Red Erwin, the sacrifice of those marines created a possibility for his salvation.
When the City of Los Angeles landed at Iwo Jima, Red was lowered by a crane, using the B-29’s side hatch adjacent to the flight engineer’s position, and rushed to a field hospital complex consisting of wooden shacks and tents dug into the volcanic soil and a medical station that had originally been dug into a cave by the Japanese defenders.
Red heard the panicked voice of a doctor. “We’ve got to get this phosphorus out of his eyes. Otherwise he’s going to be blind!”
The doctors and nurses went to work on his horrible wounds, and he drifted in and out of consciousness.
Several things happened quickly, almost simultaneously. The doctors and nurses monitored his heartbeat and conducted an airway and breathing evaluation to check for obstructions. They asked Red’s crewmates for all the details of the injury. They administered morphine. They hooked Red up to an intravenous plasma drip and injected him with Ringer’s lactate solution, a water-based solution of sodium chloride, sodium lactate, potassium chloride, and calcium chloride. These steps were intended to offset the loss of blood, water, and electrolytes and to keep his blood pressure up and reduce the very high risk of sudden heart failure.
The medical team removed Red’s phosphorus-embedded shirt, pants, and flotation device. They focused on removing pieces of phosphorus from his head, face, hands, right arm, and right torso. They irrigated his wounds with water, spread anti-infection boric acid cream on them, and closed them with saline-soaked gauze to stop oxygen from reigniting the phosphorus particles.
Regardless of how heroic and skilled the doctors and nurses were, given the severity of his wounds and the relatively primitive state of burn care in 1945, it would be a miracle if Red survived the first day. His crewmates visited him at the medical station, and then they flew the City of Los Angeles back to Guam to resume their duties.
At one point, Red heard sad, dirge-like music, the kind you hear at funerals. Oh no, angels! he thought, speculating that the angels who accompanied him during his encounter with the phosphorus bomb were returning to escort him to another world. He addressed his thoughts directly to the Creator: God, You saved me. Surely You’re not going to come get me now. I want to go home!
But the music turned out to be from a radio announcement of the death of President Franklin D. Roosevelt. When much of America was praying for the soul of the late president, Red Erwin was praying for the strength to conquer death.
Four months before Red Erwin made his desperate plea for divine intervention in the sky over the Pacific Ocean, another soldier’s prayer may have shaped the course of World War II in Europe.
On the morning of December 8, 1944, at Third Army headquarters in an old barracks in France, Lt. Gen. George S. Patton Jr. placed a call to chaplain James O’Neill,12 a Roman Catholic priest, stationed in a nearby building. Weeks of heavy rains had stalled the Allied advance across Western Europe. The legendary Patton, a churchgoing Episcopalian, was furious and desperate. He decided it was time to ask for God’s help.
“This is General Patton,” he announced to the priest. “Do you have a good prayer for weather? We must do something about those rains if we are to win the war.”
The chaplain noted, “It usually isn’t a customary thing among men of my profession to pray for clear weather to kill fellow men.”
Patton ignored the comment and insisted, “We’ve got to get not only the chaplains but every man in the Third Army to pray. We must ask God to stop these rains.”
The chaplain went off to check his prayer books but couldn’t find any weather prayers. So he composed one and typed it on an index card, writing in the grandiloquent style he figured Patton would like.
Almighty and most merciful Father, we humbly beseech Thee, of Thy great goodness, to restrain these immoderate rains with which we have had to contend. Grant us fair weather for Battle. Graciously hearken to us as soldiers who call upon Thee that, armed with Thy power, we may advance from victory to victory, and crush the oppression and wickedness of our enemies and establish Thy justice among men and nations.
O’Neill strode across the rainy courtyard in a heavy trench coat and delivered the draft to the general.
Patton loved the prayer. He told the chaplain, “Have 250,000 copies printed and see to it that every man in the Third Army gets one.”
The surprised chaplain replied, “Very well, sir!”
“Chaplain, sit down for a moment,” said Patton. “I want to talk to you about this business of prayer.”
Years later, O’Neill described the scene: “He rubbed his face in his hands, was silent for a moment, then rose and walked over to the high window, and stood there with his back toward me as he looked out on the falling rain. As usual, he was dressed stunningly, and his six-foot-two powerfully built physique made an unforgettable silhouette against the great window. The General Patton I saw there was the Army Commander to whom the welfare of the men under him was a matter of personal responsibility.”
Patton asked, “Chaplain, how much praying is being done in the Third Army?”
“Does the General mean by chaplains or by the men?”
“By everybody,” Patton replied.
O’Neill said, “I am afraid to admit it, but I do not believe that much praying is going on. When there is fighting, everyone prays, but now with this constant rain—when things are quiet, dangerously quiet—men just sit and wait for things to happen. Prayer out here is difficult. Both chaplains and men are removed from a special building with a steeple. Prayer to most of them is a formal, ritualized affair, involving special posture and a liturgical setting. I do not believe that much praying is being done.”
Patton sat down at his desk and leaned back in his chair, fiddling with a pencil. “Chaplain,” he explained, “I am a strong believer in prayer. There are three ways that men get what they want: by planning, by working, and by praying. Any great military operation takes careful planning or thinking. Then you must have well-trained troops to carry it out: that’s working. But between the plan and the operation there is always an unknown. That unknown spells defeat or victory, success or failure. It is the reaction of the actors to the ordeal when it actually comes. Some people call that getting the breaks; I call it God. God has His part or margin in everything. That’s where prayer comes in.”
