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From the World War I Centennial News Podcast 

The Ambulance 

ww1 Centennial News Podcast LogoOur major theme for July 20th's WW1 Centennial News Podcast, Episode 82, was the Ambulance: the experience of Americans who drove one, its effect on battlefield medicine, and even the evolution of the word. In 100 Years Ago, host Theo Mayer provided essential background information on the American Field Service (AFS). Nicole Milano, an archivist and editor at the AFS, joined the show to discuss the vital contributions of that organization during the war. In addition, we combined Speaking WW1 and War Tech into one cohesive, ambulance-focused segment. The following is a transcript of 100 Years ago, the interview, Speaking WW1, and War Tech: 

100 Years Ago: The American Field Service with Theo Mayer and Nicole Milano

Theo Mayer: The scale of injury and physical trauma in World War I hit new heights, previously unimaginable in human history. In response, the treatment of the wounded and battlefield medicine were completely transformed. However, before you can treat a wounded warrior, you need to get them from the battlefield to the doctor, and that's the theme for this week's show. Our catchphrase is ambulance, and as you'll learn by the time the show's finished, the term itself has a history that predates vehicles. With that as a premise, we're going to jump into our centennial time machine and go back to the years just prior to World War I to see how a hospital in Paris was the foundation for how the wounded were transported from the battlefield in the war that changed the world...

We've landed in pre-war Paris. It's very popular for wealthier Americans, as well as aspiring artists, to come here. It's exciting, it's cultured, and it's naughty, all at the same time. The expatriate, or the American overseas community in Paris, is defined by the River Seine. On the Left Bank, you have the artists, musicians, philosophers, and writers. The Right Bank is inhabited by the Gilded Age upper class families like the Vanderbilts, Goulds, Morgans, Whitneys, and so on. These Americans want American doctors and American medical care as well, so they come together to establish and fund a hospital in Paris for themselves: L'hôpital Américain. The hospital is paid for entirely with private donations, much of it coming from the Right Bank families.A Piatt Andrew at AFS headquartersInspector General A. Piatt Andrew and Assistant Inspector General Stephen Galatti in front of a row of ambulances at 21 rue Raynouard, the location of the AFS headquarters in Paris, France. Photograph by H.C. Ellis. Individual contributions worth about $10 million build, staff, and supply the hospital, which opens to much excitement. Sterling Heilig of the Chicago Record-Herald describes it as, "The jewel of Paris, the most spic-and-span, luxurious, scientific, brand-new little hospital in Europe."

Okay-  back to history. Now it's August of 1914. A war breaks out because a radical kid assassinates the Crown Prince of Austria. Nobody thinks of it as a big deal at the time, but Germany decides to take the opportunity to roll through Belgium and push into France, expecting an easy military snap and grab of Belgium and France to expand their empire- because after all, that's how you expand empires. Well, in early September, the invasion gets to within 30 miles of Paris. That's when the French and the British muster up, counterattack, and stop the German advance at the First Battle of the Marne. It's a turning point that precedes the four years of global mayhem that will become known as World War I.

Meanwhile, the hospital prepares itself to receive patients, but a problem remains. The French are struggling to evacuate their wounded to the rear. Instead, they're being clustered in churches and farmhouses and little villages all across the Front. Hearing this, the hospital summons anyone with a car. Now, remember, in 1914, the car is a brand new idea. It's mostly for the wealthy and the totally cutting-edge. Those that have them are gathered together, and they take off west towards the Front, including members of the Governors' Board. The cars arrive in the dead of night near the Front, and the volunteers bring back 34 soldiers on their first run, turn around, and immediately head out for more. With the railroads blocked or damaged, this improvised excursion serves as an example of what the motor car is capable of doing in the rough terrain of war.

Along comes A. Piatt Andrew, the former director of the United States Mint, and an assistant professor of Economics at Harvard. He volunteers as a driver for the American Ambulance Hospital in January of 1915.Lycee pastuer The Lycee Pastuer building in Paris, home to the American Ambulance Hospital during WW1 Piatt finds himself primarily ferrying patients from the train stations in Paris to the hospitals around the city. However, he's a pretty sharp cookie, and quickly realizes that more can be done to save lives. In April of 1915, he successfully negotiates with the French Army to allow some ambulance sections of the hospital to operate closer to the front lines of the battle. This is the birth of the American Field Services, also known as the AFS. The AFS becomes an absolute icon of the First World War, and it offers the opportunity for many Americans to serve in France, Belgium, and the Balkans before the U.S. Involvement in the war. Their Ford Model-Ts used to transport the wounded become known as "ambulances," and they shepherd hundreds of thousands of men to medical care in the course of the conflict.

To provide us more insight, we've asked Nicole Milano, the head archivist and historical publications editor at the American Field Service Intercultural Programs, to join us and tell us more about the AFS during the war, and throughout the 20th century. Nicole, welcome to our history segment.

Nicole Milano: Thank you for having me today.

Theo Mayer: Nicole, even though we just provided an overview of the AFS, can you tell us a little bit about the American Field Service during the war, and how it grew over the course of the war?

Nicole Milano: Now, AFS worked with representatives back in the U.S. To recruit ambulance drivers, and also raise money for their growing ambulance service. It was so successful that AFS ultimately broke away from the America Ambulance Hospital to become an independent volunteer organization with headquarters in the heart of Paris.

Theo Mayer: Motorized vehicles were kind of rare at the time. How did the AFS decide that that was the way to go?

Nicole Milano: That's a great question. AFS was really revolutionary in their use of the Model-T Ford ambulance, and particularly in their standardization of this vehicle. By standardizing the kind of ambulance, it just simply made more sense. The ambulances had interchangeable parts, which made them easier to repair. They were also small, meaning that they were quicker and more efficient at driving over the shell-pocketed roads. Officially, three stretchers, or four seated soldiers, could fit in the back of one of these ambulances, though they often squeezed in many more. We've even heard stories of some of them riding on the top of the wheels on the way out, just so that they could really evacuate as many men as possible. The volunteers had a very close relationship with the these ambulances, and they often gave nicknames to them. Many of them actually slept in these cars during the war, and actually, there's an interesting story as well. What they did was they ran the motor very quickly, which made the water in the radiator boil, and they actually made something called radiator water cocoa from this water.AFS ambulancesAFS ambulances in the Lycee Pastuer garage, c. 1914-15 (courtesy of the AFS Archives)

Theo Mayer: It sounds like it would have a taste to it.

Nicole Milano: Yes, I would imagine. Maybe not the best cocoa you've ever had.

Theo Mayer: I imagine, under the circumstances, maybe it was. Well, we just got a question from our live audience. Henry Ford was publicly against the U.S. Entering the war. Did he ever change his mind and donate some of the ambulances to the AFS?

Nicole Milano: That's a great question, and actually, we never got a discount from the Ford Motor Company for the thousands of ambulances that we purchased during the war. However, as a volunteer organization, our drivers were unpaid. We actually recruited and also fund-raised for money on the home front from communities and families like the Vanderbilts, the Fricks, the Whitneys, who donated money to buy ambulances during the war. We may not have had Ford himself, but we did have a lot of supporters that did help us.

Theo Mayer: One of the fascinating things about the ambulance drivers is that we know the names of a lot of them. Can you tell us about that?

Nicole Milano: We had a number of famous AFSers, including several who belonged to the famed Lost Generation. The writer Harry Crosby and the artist Waldo Pierce both drove an ambulance with AFS. Also, Malcolm Cowley, who was actually a truck driver with AFS and not an ambulance driver, is often regarded as the unofficial historian of the Lost Generation. We also had a number of volunteers who went onto do other great things, and perhaps may not be quite as famous as these Lost Generation writers. Now, one of the questions that I'm asked the most is whether Ernest Hemingway was an ambulance driver with the organization, and I have to say he was not. He was actually a volunteer with the Red Cross in Italy. Similarly, Dos Passos and E.E. Cummings were also volunteers with other ambulance corps during the war.

Theo Mayer: Now, some of the Lafayette Escadrille pilots, the pilots that flew for the French before America entered the war, some of those were AFS drivers first, weren't they?

Nicole Milano: Absolutely. Eight of the Lafayette Escadrille pilots were actually former AFS drivers, including James McConnell, who was tragically shot down in 1917 during aerial combat.

Theo Mayer: What was the typical day in the life of an ASF driver?

Nicole Milano: The typical day could be long and tiring. They worked at dressing stations that were located around 800 yards from the first line trenches, and wounded soldiers were carried by French stretcher-bearers from the trenches to these dressing stations, where they would then receive basic medical attention before AFS transported them to hospitals farther along. The AFS volunteers couldn't use lights when driving on the road at night, for fear of an attack from above, and they also sometimes had to wear gas masks because they were driving through very difficult conditions. In Verdun, one of our drivers writes in his diary that he couldn't sleep for 35 hours due to the number of soldiers they transported.

Theo Mayer: The AFS operated ambulances again in World War II. What happened between the wars, and then what happened after?

Nicole Milano: That's a great question, because many people don't realize the connections between AFS and World War I, and AFS Intercultural Programs, an international organization of today. Between the world wars, AFS actually started a graduate fellowship program that sponsored graduate students to travel between French and American universities. One of our French fellows was actually Raymond Aubrac, who was a French Resistance fighter during World War II. Now, as you mentioned, AFS of course was reactivated as an ambulance corps during World War II, and at the end of World War II, the drivers from World War I and II got together and tried to decide what they could do with this organization. They had witnessed the horror of two world wars, and wanted to create an organization that might actually contribute to a more peaceful world. By working together, in 1946, they created an intercultural and student exchange organization that is now known as AFS Intercultural Programs, an international nonprofit organization that helps people develop the knowledge, skills, and understanding needed to create a more just and peaceful world. We still consider ourselves a volunteer organization, with 40,000 AFS volunteers around the world, more than 100 years after our founding.Amb driver  Stephen Galatti, 1915 (courtesy of the AFS Archives)
Theo Mayer: That's great. From radiator cocoa-

Nicole Milano: To international exchange. Exactly.

Theo Mayer: I love it.

Nicole Milano: AFS does focus a lot on education now, and we did create a curriculum about these World War I volunteer efforts. It's available for free for secondary school teachers worldwide, so if they want to learn more about that, they can go to

Theo Mayer: Thank you so much for joining us today. It was a great interview.

Nicole Milano: Thank you for having me.

Theo Mayer: That's the story of how the transportation of the wounded changed the very definition of the word ambulance, the structure of battlefield medicine, and volunteerism 100 years ago, in the war that changed the world.



Speaking WW1 and WW1 Tech 

Ambulance originally comes from the Latin word ambulare, which simply means, "To walk or move." The word was used in a medical military context hundreds of years before WW1. For example, in the 1400s, Spain's Queen Isabella organized support for the wounded in battle. According to historian John S. Haller, the Spaniards used transport wagons and field hospitals known as ambulancias. As we head into the 1800s, a French military surgeon named Dominique-Jean Larrey pioneered modern battlefield medical practices and brought the word into the French military lexicon.flyingambulance A depiction of a 19th century French Flying Ambulance Not only did he invent and coin the term triage, but he also organized ambulance volantes, or flying ambulances, which were a system of men, supplies, and horse-drawn carriages designed to moved wounded soldiers from the battlefield as fast as possible. Meanwhile, for English speakers, the word ambulance came to mean just the vehicle part, a development that Haller calls a corruption of the word.

As the British and the Americans corrupted the word ambulance, the subject referred to also underwent an evolutionary leap. The first motorized ambulance debuted in Chicago in 1899, signaling the end of the horse-drawn version. On the battlefield, while there are some disadvantages and very rough terrain, the motorized ambulances proved to be faster and easier to support than a horse. Early on in World War I, ambulances were often regular cars retrofitted to carry combat wcurtains Later, military and volunteer ambulance services such as the Red Cross, the American Field Service, and the Norton-Harjes Ambulance Service operated especially designed ambulances, produced by some of the world's foremost automotive manufacturers. According to the U.S. Army's official history of the Ambulance Service in World War I, "Ford, Fiat, Peugeot, and General Motors Company ambulances were severely tested under combat conditions that demonstrated their advantages in speed and patient comfort."

While Peugeot and Fiat ambulances could carry more men, their weight and complexity became a problem the closer one got to the Front. On the poor roads near the front, "Model-T based Ford ambulances proved to be light, maneuverable, and amazingly robust", according to Professor Chris McDonald. It was Yankee ingenuity at work. They served the American Field Service, and later the U.S. Army Ambulance Service, extremely well in adverse conditions. In a letter from a young driver, Kent Hagler, found in a book by Professor McDonald, he describes the "half-obliterated" roads covered by all manners of debris that drivers had to navigate. The ambulance motors sometimes choked on the "poisonous fog" of gas, forcing the drivers to "move their wounded to the nearest shelter and wait for the day." On one particular mission, Hagler and his unit were quite literally drive to exhaustion, rescuing the wounded in the midst of poisonous gas and relentless artillery fire for days on end. At the end of the letter, Hagler noted that his car was practically unharmed, and after it had "some minor repairs and had been washed of all the blood, it was as good as new". In the next sentence, he remarked proudly that he "carried more wounded than any other car by a considerable margin."

Ambulance drivers like Hagler and Ernest Hemingway ferried a staggering number of soldiers on the French and the Italian fronts. The American Field Service estimates that their volunteers drove more than a half a million wounded men. The job that these men and women performed not only avoided the permanent loss of a soldier's service, but maintained the morale of those who remained to fight. A wound in combat, even a serious one, was no longer an automatic death sentence, and injured soldiers survived at a much greater rate than in past conflicts. World War I is frequently, tragically, a story of unprecedented slaughter, but the story of the ambulance is quite the opposite. It's a story of a recent innovation, the automobile, turned to save lives. The ambulance, an interesting word, an interesting war tech, and an interesting topic.

 Links  (start around 2 minutes)