(e) Such considerations as esprit de corps, personal preference, and the identification of the individual with the service of his choice are ignored.

The concept of a separate medical service for the Air Forces is by no means new. As a matter of fact, it was exactly 30 years ago that a research laboratory for studying the special problems of flying was authorized by The Adjutant General of the Army. A year later a special school for medical officers serving with the Air Arm was established and has functioned continuously since that time.

Also during all these years the successive Surgeons General of the Army have without exception recognized the unique nature of the medical service required by the Air Forces and have authorized a semiautonomous medical service for the force under the immediate supervision of an air surgeon.

This arrangement has been eminently satisfactory to all concerned and has served to advance immeasurably the science of aerial medicine. Any plan which tends to destroy this specialized service to the Air Forces is a retrogression medically and is bound to weaken the combat effectiveness of the Air Forces, for the Air Forces today, to say nothing of the future, have weapons beyond the capability of the average human to utilize effectively.

The question of selection, classification, maintenance, and protection of flying personnel and equipment has placed a great burden of responsibility on the Air Forces medical service, and it seems to me that we would indeed be short-sighted if we weakened our present vigorous efforts in this respect, in view of our great contributions in the past.

In peacetime, our concern with the routine care of the sick makes us inclined to forget that, in combat, aircraft radios do not hear, radars do not see, and automatic weapons do not operate automatically.

In these circumstances there must be a specially trained ear to hear, a particularly keen and highly trained eye to see, and especially nimble and trained fingers to twirl knobs and dials, during which time the individual is working at the upper margin of his physiological capacity.

In planning a medical service for our armed forces we should not forget that a thorough understanding of these important functions by medical officers is necessary for the proper selection and conservation of these highly technical personnel.

Next, let us consider the modern trend toward specialization in medicine. Before World War II the average Army Medical Corps officer was a jack-of-all-trades and master of none. It is generally recognized that no doctor has the capacity to be well-informed in all fields of medicine, and that it is extremely difficult to master a single specialty. General Kirk has recognized this and has instituted a splendid program of training for Medical Corps officers to permit a high percentage of them to become specialists.

In view of this, I am somewhat surprised that what he has so wisely instituted for the individual, he advocates destroying for the various services.

Personally I have found it difficult to keep abreast of medicine and at the same time keep abreast of the ever-changing medicomilitary aspects of the Air Forces.

Senator TYDINGS. I do not believe that you mean there would not be any doctors assigned to the Air Corps.

General GROW. No; there will be doctors assigned to the Air Corps. However, very often when a top man is in control of all these doctors, who does not understand the specialty of the Air Corps, either consciously or unconsciously many limitations can be placed

on their activities.

Senator TYDINGS. The only reason I asked that is I was getting the idea that the branch of the new Department called the Air Department, so to speak, would not have any doctors at all.

As I visualize General Kirk's plan, there will always be those three branches of the medical service maintained in these three Departments, but there could be a shift to fit the needs of the moment.

General GROW. My plea here, sir, is for service identification. My plea is that this military now has become so technical and so complex, that I believe each service should have a senior medical officer identified with that service who knows the special applications.

Senator TYDINGS. I agree with you, but I do not see where that would interfere with the coordination at the top of the three services. General GROW. Well, I say that the coordination, if I may proceed a little further, can be done at the top by three people getting together rather than by a single medical director.

Senator TYDINGS. Well, you would have what General Kirk outlines, then, except you would have three people directing it instead of one.

General GROW. I would, because within the spirit, I believe, of this plan, I understand that the whole military structure is run by three men getting together and agreeing on things.

If at times there is disagreement, there is a Secretary of National Defense who will make decisions.

Senator TYDINGS. In other words, you would have no objections to the shift of men from one arm to the other, or one department to the other, if you have to meet an emergency; but you would like it done with the approval of the head of that arm rather than by somebody who is detached from it.

Otherwise, you are in agreement with the plan. General GROW. Yes, sir; we are in agreement. ture of this bill, all these things can be done.

Within the struc

Senator ROBERTSON. General, you give me the impression that you feel if these three heads who should decide and direct all the medical services disagreed, then they should go to the referee or the Secretary of National Defense for a decision.

General GROW. Yes, sir.

Senator ROBERTSON. His job would be more of a referee's job and as an over-all coordinator.

General GROW. Yes, sir; that is my concept.

Senator ROBERTSON. That is your concept of this bill.

General GROW. Yes, sir.

Senator TYDINGS. But you do not object to the basic plan as outlined by General Kirk, assuming that the decisions are made by the head medical man of the Navy, by the head medical man of the Army, and by the head medical man of the Air Force. If they agreed, all right. If they do not agree, then you would appeal to the Secretary of National Defense for adjudication.

General GROW. Yes, sir.

Senator TYDINGS. But in other respects, you are in agreement with the plan outlined by General Kirk, assuming the mechanics as outlined are set up.

General GROW. Not entirely, sir.

Senator TYDINGS. Where do you differ?

General GROW. Possibly the Senator was not here.

Senator TYDINGS. Do not repeat it, then, if you have been over it. I came in a little late. I had to go to another meeting. Do not bother with it. I will read it in the estimony.

General GROW. Personally I have found it difficult to keep abreast of medicine and at the same time keep abreast of the ever-changing medico-military aspects of the Air Forces.

If to this were added the task of acquiring a knowledge of medical services with the infantry, tanks, artillery, the fleet air arm, the submarine services, and others, I fear that I should not be qualified to serve in any one of them, nor do I know of any man with the capacity to intelligently and effectively direct such a conglomeration of specialties.

May I refer now to the chart which illustrates the organization of the three Departments.

General GROW. The National Security Resources Board of course is there, in which you apportion out personnel; and you have the civilian representation and the military representation in the event of an emergency.

In fact, as the Navy Surgeon has suggested, I think that should be going on now, some scheme of protection of civilian population by civilian doctors and apportionment of doctors to the medical service of the armed forces, but done at the level of the National Security Resources Board.

In relation to supplies, I think there should be tripartite representation there, and also civilian representation there, because after all, the military will need medicines, bandages, and so forth, and so will the civilians.

So, I think there should be civilian representation there.

On the Research and Development Board I would again suggest that there be civilian representation because there is some research being done in civilian institutions which could be applied to the military; and also between the three services overlapping of research problems could be avoided.

As you will notice, over here I have put in one thing. Under the Joint Chiefs of Staff, you will find a Medical Advisory Board which is composed of the Surgeon General of the Army, the Surgeon General of the Navy, and the Surgeon General of the Air Force, who meet together, endeavor to adjust things; and if they cannot be adjusted there, it is taken up to the Secretary of National Defense.

That is the medical component.

The CHAIRMAN. May I interrupt there? Is it provided in the bill that this Medical Advisory Board to the Joint Chiefs of Staff will report directly to the Joint Chiefs of Staff?

General GROW. Sir, I would say it has always been a policy. For instance, the Surgeon General of the Army is the adviser to the Chief of Staff of the Army and to the Secretary of War on medical matters. The CHAIRMAN. But in this last war, I remember that the Surgeon General reported to the Army Service Forces, never directly to the Joint Chiefs of Staff. Is that right?

General GROW. I think, sir, that was a mistake.

The CHAIRMAN. A mistake, but was it not a fact that that was the way they reported?

General GROW. It was a fact, but I still think the Chief of Staff of the United States Army is charged with the health of that entire force and the Surgeon General should report directly to him. The CHAIRMAN. The Chief of Staff of his particular branch. General GROW. Yes, sir.

The CHAIRMAN. Is it provided in this bill that he shall report?
General GROW. Only by implication, I should say.

The CHAIRMAN. By implication. Can it be so ordered inside the Air Forces, for instance, that the Surgeon General of the Air Forces should report directly to the Chief of Staff of the Air Forces? General GROW. That could be done within the Air Forces; yes, sir. The CHAIRMAN. It could be done.

General GROW. Yes, sir.

The CHAIRMAN. In each instance of the Army, Navy, and Air Force, do you not believe it should be provided in this bill that they shall report only to the Chief of Staff of their particular branch?

General GROW. I see no reason why that could not be done, sir. I think it should be done.

Senator ROBERTSON. General, would you correct me or help me to understand this chart. As I see it, the Medical Advisory Board, consisting of the Surgeon General of the Army, the Surgeon General of the Navy, and the Surgeon General of the Air Force, have no connection with anyone at all except the three services; and that connection is below the Chief of Staff of the Army, the Chief of Naval Operations, and the Chief of Staff of Air.

General GROW. They have a connection with the Joint Chiefs of Staff, sir. They should have.

Senator ROBERTSON. This looked to me as if a line has been cut out here purposely. That was what I was asking you for.

General GROW. They should have connection.

Senator ROBERTSON. Then there should be a line going from here up to the Joint Chiefs of Staff.

General GROW. Yes, sir. They should be advisers to the three Secretaries and major force commanders individually and jointly to the Joint Chiefs of Staff.

The CHAIRMAN. I would suggest that the Surgeons General of the three services get together in an agreement and make a recommendation to the men responsible, officers responsible in the Army and Navy presently with the getting ready of the wording of this bill so as to provide what evidently is certainly a mutual agreement between the three of you that you should all report to the Chief of Staff of the particular branch.

I understand that presently in the Navy he does report directly to the Chief of Naval Operations.

Admiral SWANSON. In the Navy the Surgeon General, who is the Chief of the Bureau of Medicine and Surgery, reports to and is responsible to the Secretary of the Navy, as is also the case with all other chiefs of bureaus. The Chief of Naval Operations coordinates the activities of the Bureau of Medicine and Surgery along with those of all other bureaus in matters pertaining to the support required by the operating forces.

The CHAIRMAN. But in the Army, no; and in the Air Corps, no, presently.

Admiral SWANSON. In the Navy Department, Admiral Nimitz is in complete consonance with the principle that there should be medical representation on the Joint Staff, the Munitions Board, and on the National Security Resources Board. He believes very firmly in that concept.

The CHAIRMAN. The point I want to make, though, in bringing it to your attention as forcibly as I can, is that we want to get the most good possible out of S. 758; and therefore if there is any language needed to assure that there will be direct reporting to the Chief of Staff of each branch, it should be in the bill.

Admiral SWANSON. Mr. Chairman, it could be done administratively, the way the bill is written. If the committee saw fit, they could put a little more teeth in it and actually put it in the bill.

The CHAIRMAN. I would suggest, then, the three Surgeons General get together to see if they could suggest some language that you might think necessary.

Senator ROBERTSON. Might I say that while all this is being presented under a unification bill, there is a complete lack of unification at the various places. There are three distinct plans presented.