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equipped to-day. I am planning to make the hospital ship, a medical storehouse or supply depot, so the ships in the fleet can have their supplies cut down without being hampered, and at the same tiine, if they needed additional supplies, they could go to the hospital ship and there be provided for.
Mr. ROBERTS. Do you have a surgical outfit on the submarines?
Dr. STOKES. A sort of emergency outfit--some drugs and a few dressings for first aid-work.
Mr. ROBERTS. How much of an outfit do you have on the destroyers ?
Dr. STOKES. An outfit that costs about $200. It includes surgical instruments, appliances of various sorts, and a drug supply, keeping the hospital furniture cut down.
Mr. ROBERTS. Is there a doctor on each destroyer ?
Dr. STOKES. In the fleet there are two doctors, one on a destroyer and one on the tender. Later on in this connection I would like to speak of the shortage of the Medical Corps. We are badly crippled.
The CHAIRMAN. You speak of a fleet of torpedo destroyers. How many vessels does that consist of ordinarily?
Dr. STOKES. It varies. I can not tell you just how many there are in a torpedo fleet. My recollection is that theoretically there should be six to a battleship, but of course we can make no such provision.
Mr. ROBERTS. Are not the destroyers classed in a division?
Mr. ROBERTS. Do you have a doctor for each division of the destroyers in addition to the tender that accompanies them?
Dr. STOKES. While such an arrangement is desirable, we have not been able to provide that number of surgeons. We have to employ proficient hospital stewards as a makeshift.
Mr. ROBERTS. If you had enough in your service you would do so ?
Dr. STOKES. Yes, sir; it would be a very proper assignment, but we are so short of medical officers that this is impossible. At the present time we have 53 vacancies, with 3 more in sight.
The CHAIRMAN. The vacancies you speak of; is that because you can not get men ?
Dr. STOKES. It is because we can not get men.
Mr. ROBERTS. Is it not due to the fact that you set the standard too high?
Dr. STOKES. No, sir; I do not think that it is. We can not make use of medical men who are not keyed up and absolutely competent. Our problems are entirely different from those of the Army and are very different from those of civil life. I believe one of the deterring influences is the fact that we have to go to sea. If a man goes through college, then through a medical school, and then through a hospital, he is 27, 28, or 29 years old when he finishes, and to him the Navy does not look attractive as conditions exist to-day. They do not like the idea of going to sea, as by that time many are married or are planning to marry, as they should.
Mr. ROBERTS. Is it because the pay is not sufficient?
Dr. STOKES. I think that has something to do with it. Something will have to be done in the near future to remedy this condition. We have been obliged to send ships to sea with a thousand men on board
and only one medical officer. There must be times when that medical officer goes ashore, and I do not feel that the men get the protection they should have. Of course, under battle conditions such a situation would be impossible.
Mr. ROBERTS. How would you suggest remedying that?
Dr. STOKES. Well, I believe that if we received exactly what the line gets to-day in rank, pay, and everything-all would be on a basis of equality—that it would help very materially. I have endeavored to point out to physicians the advantages of a career in the service. I have been to New York time and time and again and have talked before the big medical societies there; I have been to Harvard, I have been to the Boston Medical Library, I have talked in Philadelphia, at Johns Hopkins, here in the District, and down at Norfolk, but few men have come to us. The Army seems to get a number of men whom they deem desirable. In the Army the question of breaking up their homes by going to sea does not confront them. The British service has gone through the same thing as we, and they have had to offer greater advantages to get the right sort of men in sufficient numbers.
Mr. ROBERTS. I still think that you have too high requirements, based on my experience with men who have applied for the corps and were not admitted because they had not had the prescribed training, and, perhaps, did not quite come up to the standard set.
Dr. STOKES. We have to do a very special kind of work these days, and if we get men of indifferent professional qualifications-it is pretty hard to judge of their ability unless you have had experience with them in the service and on examining boards—they are dead wood. It is a pretty serious matter to send a single medical man to a big ship when you are in doubt as to his professional ability. He is left absolutely to his own resources.
Mr. ROBERTS. Is not the answer to the problem that you will have to take the young men who want a career in the corps and educate them just as at Annapolis ?
Dr. STOKES. I do not think that the burden should be put on the Government. I do not think that we could educate them as satisfctorily as at present, unless we built a plant like that at Annapolis, and then we should be short of hospital material. You might educate a man and find him temperamentally unfit for the Navy when he comes out. It is better to pick and choose from those who are educated outside.
Mr. ROBERTS. The difficulty seems to be that while you can pick and choose, you do not get the men and the shortage increased ?
Dr. STOKES. It has increased. I think that if we offered more inducements and more attractions that we would get the men. There has been an impression throughout the country that the medical men in the Navy have been discredited, and I think it has been justified in some cases. I believe that we can work out some scheme that will meet the situation if we are supported. In the British, German, Japanese, French, and Russian Navies the Surgeon General has the rank of vice admiral, and other medical officers have the rank of rear admiral. In the British service they have four rear admirals; the surgeon general is a vice admiral, and after two years he is knighted. They offer their medical men voluntary retirement at the end of 20 years' service. In other words, I think that we ought not to lower
the bars, but offer greater inducements. I have had, on and off, seven years' service on examining boards, and know pretty well the qualifications of desirable men. It is very difficult to determine whether a man is professionally fit by his measure of success in practice in civil life. Many men who stand, in the eyes of the layman, right at the top as gauged by their big practices, professionally ought to be pretty well down toward the bottom if their real worth were known; that is a fact.
Mr. ROBERTS. Do you see much hope, as a practical question, of getting men into your corps by an increase by legislation of pay and allowances in rank?
Dr. STOKES. That is my hope. I am going to try hard to accomplish it.
Mr. BUTLER. You have no other remedy to suggest ?
Dr. STOKES. No, sir. I feel that if we all had the same percentage in grade, same pay, same promotions, and all were eligible to the same grades, then there would be satisfaction and contentment all around, but when a man comes in from outside and begins to realize that he will run along with a man of another corps up to a certain point, his responsibilities increasing all the time, with a field of activity as broad as that of his so-called running mate, although possibly not so conspicuous in some ways, but just as important—when he reaches that certain point or grade, he stops and his mate keeps on running, he naturally feels discredited and dissatisfied. Allow me to point out some of the features of my own case for illustration. I do not think it is altogether right for one who holds my office to be demoted for all time at the end of four years; he should receive some recognition. He has the wear and tear of a very trying billet, and as a reward he steps down a grade and suffers a very material reduction in pay. Any of these things outside the service appear small, but to us of the Navy they mean a good deal. In a measure in the eyes of
your colleagues in the service you are discredited, and certainly so in the eyes of your colleagues outside in civil life. I know that the remedies I have suggested would be helpful and bring results. The bare statement that you will be on absolutely the same basis as all other officers would attract favorable notice. For instance, a midshipman going to the academy started in, we will say, as I did, in 1882. I had been in medicine as a student two or three years at that time and paying for my education. He gets the benefit in calculating his longevity for retirement from the day he enters the Naval Academy. I can not begin to calculate mine until I get my commission. The privilege of retirement comes to him 30 years from the date he entered the Naval Academy. I can not get that privilege until I have been 30 years a commissioned officer.
The CHAIRMAN. Do you not get the benefit of five years or four years constructive service as to your pay?
Dr. STOKES. Yes, sir; but not for retirement.
Dr. Stokes. No, sir. If that were the case I could retire from office with my present rank.
The CHAIRMAN. I thought the Staff Corps got the benefit of constructive service. Do you not get the benefit? Upon entering, are you not credited with four years of constructive service to balance the four years of service at Annapolis ?
Dr. STOKES. Simply in estimating pay.
The CHAIRMAN. It does not apply to retirement ?
Dr. STOKES. No, sir. It would be helpful, if such a measure were passed.
Mr. BUTLER. I always attend the sessions of the committee when you are here or any member of your corps. I think that your corps should have some help in order, if possible, to increase its efficiency and certainly to increase it in numbers. I was not present when you first spoke. Please tell me, Doctor, how many vacancies you have.
Dr. STOKES. We have at present 53 vacancies.
Mr. BUTLER. That is to say, you ought to have 53 more doctors in your service ?
Dr. STOKES. Yes, sir. The entire corps is made up of 345. We have at present 53 vacancies, with 3 more in sight; 3 medical directors who will retire inside of the next six weeks.
Mr. BUTLER. That will make 56 ?
Dr. STOKES. Yes, sir. We got 7 assistant surgeons last year and they are now under instruction at the Naval Medical School here. In order to piece out I have had to have appointed 25 acting assistant surgeons, which the law allows, and they are assigned to the recruiting stations. They are first specially instructed for this work. That is not efficacious; recruiting is a very important feature of our work; the kind of personnel we are going to get depends largely on the recruiting officers.
Mr. BUTLER. If the service is efficient, it perhaps saves you from desertion?
Dr. STOKES. Yes, sir; and invalidism.
Mr. ROBERTS. Would it not help out if you used the retired surgeons for recruiting?
Dr. STOKES. It would help some, but not very much. Few are available, and most of them are in the upper grades, so that their assignment to duty would not be an economical measure.
Mr. BUTLER. In some instances you do so?
Mr. ROBERTS. I had in mind surgeons who can work in certain climates, but who, through the ailments for which retired, can not stand tropical service, and so they do not go back for that very reason. They could work in certain climates and would be very glad if they could get the employment. It seems to me that might help out some if we made a change in the law?
Dr. STOKES. Yes, sir; it would help some.
The CHAIRMAN. The legislation which we put in the bill last year with reference to the employment of retired officers, does not that reach you as well as the other bureaus ?
Dr. STOKES. It might if they applied.
Dr. STOKES. Yes, sir; with the greatest difficulty we can fill vacancies at the different posts and on the ships, but when we receive
an emergency call like the expedition to Santo Domingo and others down in the West Indies we are very hard pushed. Ten medical officers are serving on these expeditions now. The hospitals are undermanned. At Norfolk, for example, with nearly 300 patients we have only 5 medical officers to do all the administrative, executive, special, and professional duties. There should be 9. The medical officers are standing this undue pressure and activity cheerfully and well. Many are standing by us in the hope that relief will come later on, but some have resigned. I do not think we are giving the patients the proper care; that is, I mean a man who is overworked can not do as good work as one who is afforded relaxation and rest. We should have altogether, instead of 345, at least 400 in the Medical Corps to-day. The fleet is increasing all the time. There is new work that I am very anxious to see pushed through, not only in the care of the sick, but work in the turrets, in submarines, and in connection with physical training; in other words, special medico military work of great importance.
Mr. BUTLER. And sanitation ?
Dr. STOKES. Sanitation as well. In regard to sanitation, if I may at this point talk of it, I would like to say something as to what has been accomplished this year especially in connection with typhoid fever. In 1911 we had 222 cases of typhoid fever in the Navy, with 15 deaths. Two hundred and twenty-two sick people ordinarily does not mean a very startling and large number, but 222 ill with typhoid fever means a long period of invalidism and much attention; of course the 15 deaths are deplorable. Military efficiency is thus very materially impaired. Aside from the humanitarian point of view just so many men are taken out of the fleet. We started this prophylactic about a year ago, and up to November 1 in the entire Navy we have had but one mild case of typhoid fever.
Mr. BUTLER. In a year?
Dr. STOKES. Yes, to this, and by keeping up the sanitation. Everything I have recommended has always been with the statement that this must be considered as supplementing the strictest kind of sanitary precautions. The other day the Delaware was sent up from Charleston to Norfolk with a case of typhoid fever. I ascertained that the ill man was the surgeon of the ship, who had had typhoid fever in childhood and did not take, as he was not required to take, the typhoid prophylactic. It was a case of the exception proving the rule. It strikes me as a marvelous triumph. I may add that there was only one medical officer attached to the Delaware, and if this ship had been cruising alone there would have been no one on board to properly care for the sick.
Mr. ROBERTS. Does that apply to officers and men? Dr. STOKES. Yes, sir; under 45 years of age. Mr. ROBERTS. How often is it necessary for them to take it? Dr. STOKES. The protection lasts positively, as demonstrated by laboratory methods, two and one-half years; but judging from the experience we have had it will last five or six years. So it is necessary only once in an enlistment. The danger is practically nothing. Occasionally there is a little reaction and discomfort. There may be a little local soreness where the injection is made. It is certainly ustified as a military move aside from the humanitarian feature.