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Surgical hospital
SURGICAL HOSPITAL* BOARDMAN M. BOSWORTH, M.D.* BRONXVILLE,NEW YORK OR ten days to two weeks we are in the doldrums, bivouaced in a corktree grove, sitting around writing letters, washing clothes, sketching, studying anatomy and just rumor-mongering or specuIating on our next move. During this time there has been increasing heavy gunfire in the distance and frequent commutation of plane squadrons overhead to and from the front. We are in the hills and at night the sky over the mountains flashes intermittently with brightness that is not lightning. Then comes the alert we have al1 hoped for and yet dreaded. We are up at 3 :30 A.M. for a messline breakfast of powdered eggs, hardtack and coffee. After that valpacks are strapped, air let out of mattresses, beds rolled and strapped tight with much heavtents struck and all ing and sweating, loaded with convoy ready to move sharp on the dot of nine as ordered. The usual happens, however, and we sit in the loaded trucks till noon before starting. Perhaps you do not have a clear picture of what a surgical hospital, when on wheels, looks like. It takes over IOO two-and-a-half ton trucks, ambulances, weapons carriers, carryalls, command cars and jeeps to transport just this one outfit of some fifty ofhcers, sixty nurses and three hundred enlisted men with equipment. Of course all those vehicles do not beIong to us; some of them do but the rest have to be assembled from other outhts to move us. Maintaining the required interval of 200 yards between vehicles on the road, our convoy alone covers over ten miles. Officers are called together, told the route and each assigned to the cab of a twoand-a-half to ensure keeping intervals and to avoid getting lost should we happen to mix up with other convoys on the road. I
F
ride the truck carrying operating room equipment and have a pleasant coIored boy from Georgia as my driver. The inside of his cab is studded in typical soldier fashion with pictures of beautiful girls in the nude, semi-nude or simply Hollywood sweaters. He is good fun, always humming or singing, and during stops he runs ahead to get cans of grapefruit juice and boxes of graham crackers from the ration truck which, as Iuck would have it, immediately precedes ours. Lunch apparently has not been planned but I had been foresighted enough to pick up some cans of C-rations so we make out with cold stew, hash and “iced” coffee. The latter is produced by dissolving the ration powdered coffee and lump sugar in canteen water, mixed with lots of imagination. Rather lumpy but good nonetheless. The trip is slow, dusty and hot. Cold as it is in the mountains of North Africa, the sun gives you a good going over from nine to four. We form only a smaI1 link in an endless chain that bumps along in white cIouds of choking dust, stops and waits every little while and then bumps along again with much shifting of gears and sw-earing of driver. One pause lasts over an hour in shimmering heat waves while a whole convoy of heavy guns rolls slowly past round the curve and up the hiI1, the gun crews white with dust clinging precariously to their perches on trucks and carriages. At each stop flies swarm over us, vicious insects with bites that sting. Another pause and a division of engineers goes by, queer looking trailer trucks loaded with heavy bridge sections all ready to be slapped together when needed. As each vehicIe passes we automatically hold our breaths and then Ii11 our Iungs with only half dusty air before the next comes along.
*This has been excerpted from a diary that was kept throughout 565
the war by the author.
566
American
Journal
of Surgery
Bosworth-SurgicaI
This is a11 country which has been bitterIy fought over onIy a short time before. The road is rough and pocked with bomb hoIes which have hastily been fiIIed in. AI1 aIong on either side are huge and smaI1 craters and here and there a Iorry or other vehicIe which has been burned or smashed and pushed off the road. Some are wrecks which had simpIy gone off a turn and over the bank in the bIackout. It is evident that both Americans and British have been through here. Signs such as “ BrookIyn Bridge” and “ Pa11 MaII” have been stuck up on crude posts or scrawIed on the waIIs of shattered buiIdings. At one pIace we pass a dozen Mark VI tanks which have been shot up. Some of the tanks are compIeteIy overturned, some up-ended, some on their sides, some with three-inch she11 hoIes through four-inch stee1. Most of them are burned out. IncidentaIIy, it was in one of them that I had been strafed by three Messerschmitts onIy a few days previously. I had gone up to Iook through them for parts I needed in buiIding a suction pump for the operating room. I had just cIimbed into the Ieast damaged tank and was having a wonderfu1 time eIevating and depressing the cannon and wheeIing the turret around from the contro1 tower when I heard the pIanes coming. They did not sound Iike ours and furthermore the ack-ack set up a terrific cIatter so I dove for the bottom of the tank without looking up, figuring it was the safest pIace I couId find. I just made it as my two enIisted men piIed in on top of me. Then came the trump-trump of bombs and chatter of machine guns but fortunately nothing Ianded nearby. It was onIy afterwards I noticed the sheIves around the inside of that tank were loaded with unused cannon sheIIs. About 5:30 P.M. we reach our destination, a beautifu1 srte on a gentIy sIoping hiIItop in the open, midway of a Iong vaIIey ringed on a11sides by mountains. The Iatter are arid, rockridged and treeIess. The wheat fieIds through which we bump and jog off the main road have obviousIy been
HospitaI
APRIL,
,946
used recentIy by tanks, artiIIery and infantry. Tracks run off aimIessIy here and there and foxhoIes are numerous, each suppIied with its teIItaIe mound of empty ration tins, ammunition casings, waste Iitter and blackened stones. Down the hiIIside from us Iie the tragic remains of an aIIied bomber where it had crashed and burned, engines, propeIIors and bits of wings scattered in a11 directions. The first part of the convoy has aIready set up the O.R. and the mess tent when we arrive. The generator is hooked up and going. The place seems a bedIam of grinding trucks and shouting confused men. But the genera1 Iayout of areas for operating rooms, wards, Iiving quarters for officers, nurses and enIisted men has been pIanned and in remarkabIy short order a tent city springs up as though by itself with unseen power. The C.O. says we are due to start receiving cases at six. I think to myseIf, “Yes, yes, I know-that means we probabIy won’t see a thing tiI1 tomorrow.” So I sIip off to my piIe of baggage and get messkit and canteen cup. Chow is aIready being passed out but right on the dot of six and before I can eat a sergeant comes running to say that we have received a haIf dozen wounded, two major cases among them, and other ambulances are arriving. This is certainIy one time the army knows what it is doing and does it. So I check on shock treatment for the two worst cases, a beIIy and a shattered knee. Both have had pIasma forward and need bIood. WhiIe the transfusions are running I get my stew and coffee. Then to work: a chest wound to be taken care of, a beIIy expIored, fractures for reduction and spIinting after x-ray, jagged wounds to be cIeaned up and hemorrhage controIIed and burns to be dressed under anesthesia. Now and then an extremity is damaged beyond hope of saving; somehow these seem the most pitifu1 cases. Patient after patient is brought in; six tabIes are fiIIed aII the time; an endIess procession of new “What’s the matter faces and injuries. with you, Iad? Hurt badIy?” “No, Sir,
VOL.
LXXI.
No
4
Bosworth-SurgicaI
Hospital
American
Jourrd
of Surgery
567
deft examination of the endless stream of I’m a11 right; just a bit of shrapnel from an wounded foIIows; these are sent to shock let’s 88.” “ You’11 be O.K.in a jiffy-here, ward, those to O.R. stat, others to x-ray; have a Iook at it; we’11 put you to sIeep there is no time to ponder; the IightIy first.” wounded go directIy to wards for hot A pause for hot coffee and food at midmy first night; then we go back at it. We lose a11 coffee, soup and food. “Man, mea1 in three days and is it good!” track of time. The Iong tunne1 of operating tent Aooded with light, the smaIIer tent In another tent a group of surgeons work silentiy and swifty to take bIood for countIeading to it where we scrub and patients A poo1 of voIunteer siIentIy wait their turn, stretchers side Iess transfusions. donors from suppIy services is aIready on by side on the canvas covered dirt floor, hand; as soon as some have given others the trickIe of coId water over our bare arms take their pIaces. BIood flows through the and the sting of bristIes on raw skin, the Iaboratory to the shock ward and O.R. in sea of white drapes beneath caps and masks a steady Iife-giving stream. bent over tables, the hasty cutting away I am off duty and due to get some rest of clothing caked with dirt and clot, the the next evening when the C.O. greets me stickiness of blood partiaIIy dried on fresh wounds, the sight of marbIe skin surroundat supper: “Come and see a case with me; ing isIands of scarIet or innocent Iooking teI1 me what you think ought to be done.” toxic and delirious, puncture wounds reveaIed as the fiIth is A Iad of twenty, removed-a11 make a confused picture strafed by a pIane two days before, has a compound fracture of both ankles. His feet that seems unrea1; and yet here we are, are swollen and discoIored, the wounds here I am, a part of it, going on and on. We are working under bIackout; and green and stinking, with teIItaIe bubbIes such pitchbIack darkness it is. It has combeneath the skin-gas gangrene. He needs attention and in a hurry. Transfusions are menced to rain and in a short time the anti-gas gangrene serum and ground is a slippery, sIimy sea of clay started, which cIings in great sticky knobs to sulfonamides given intravenousIy in masshoes. FIashIights are banned; we are near sive dosage, along with ffuids and glucose. the front now. Poor Iitter bearers struggIe BIankets and hot water bags are used for through the dark with their loads from shock. MeanwhiIe a separate pyramidal receiving to x-ray to O.R. More loads, often tent is set up for isoIation; a stretcher heavier due to plaster casts, are carried serves for a tabIe and within an hour both from O.R. to wards. Stumbling and sliplegs are removed beIow the knee. A special shoulders strained, muscIes long nurse and ward boys are assigned but the ping, since numb with fatigue, these men carry patient is too sick for me to leave; he is on. Tents are invisible in the black; one stil1 toxic, delirious and violent as reaction works by instinct in a seeming void, comes from the anesthesia. chilIed and wet to the skin. “Hey, is this The needIe cIogs; the veins are thromx-ray?” “No, dope, its Surgery Three.” bosed and the low pressure, due to shock, “Well, where the h . . . is x-ray then?” keeps them coIIapsed. I try to get into “Dunno, Joe, try second tent in the next another vein but cannot; I cut down and row.” And off again they go with heavy expose another but that is clotted sorid. burden. The third try succeeds but it is a11 we can Long Iines of ambuIances Ioaded with do now to hoId his arm steady and keep the torn humanity, their dim lights Iike pale needIe in the vein. It is early morning and watery eyes peering through the rain, inch the patient is restIess and screaming. Morforward bumper to bumper to discharge phine does not touch him, nor does sodium their pain-ridden cargoes into overflowing amytal. He does not seem so good; he is receiving tents and be off again. Quick, paler and coIder. A glance beneath the
568
American Journal
of
Surgery
Bosworth-SurgicaI
blankets reveaIs a secondary hemorrhage; the dressing on the Ieft stump is soaked with fresh bIood. An emergency tourniquet is quickIy tightened; fresh instruments and dressings are brought from the O.R.; the stump is bared, the bIeeder found and sutured and a new dressing appIied. Over and over I keep thinking, “Why bother-the kid can’t make it anywayhe’s cooked-no bIood pressure, puIse like a trip hammer and bareIy feIt at thatrespirations way up-skin Iike parchment -nose pinched and nostriIs sucked in with effort to breathe-Iips bIue-hands cold as ice. Besides, if he does he’11 be a crippIe for Iife.” I cannot shake these thoughts but I keep on, automaticaIIy, as one possessed. Oxygen is tried but he does not get much; he is too vioIent and wiI1 not toIerate the mask. Another transfusion is given whiIe the needIe remains in the vein. It is bitter coId in that tent and there is no means of getting heat. An overcoat helps but it gets in the way. Heavy thunder storms and pouring rain continue unabated outside; it makes an incessant rattIe on the canvas. There is a caI1 for me-1 am wanted in the O.R. This time they wiI1 have to do without me; someone else wiI1 have to take it for I am not Ieaving. A major comes over; there is a bad case, compound fracture of both thighs, to be done. “OK, get so-and-so; I’d Iike to help you but I can’t drop this yet.” Three days Iater our lad is stiI1 with us and for the first time he asks for water.
HospitaI
APRIL, rg46
What a wonderfu1 sound those few words made; 1’11 never forget. He has gone further back now and I do not know what has happened to him but I’m sure he made the grade. What a tragedy the Ioss of his feet but he wiI1 walk again and, as we toId him, it is not as bad as an arm. Then comes a gIorious spring day, with bright sun, cIoudIess skies, wheat fieIds r&led by a gratefu1 breeze and a yeIIow green countryside deceptiveIy peacefu1. SuddenIy there is a loud expIosion and heavy smoke rises in an inverted cone from a fieId nearby. Arabs, horses, cattIe and sheep scatter in a11 directions, their paths cIearIy marked by fresh furrows in the waist-high grain. A Iand mine has been touched off. Soon detaiIs are known: Three Arabs have been kiIIed outright and there are five others for us to patch up. There is nothing unusua1 about this. The fieIds were sown with mines by the Germans. Now that the Arabs are returning to their homes accidents are bound to happen. Unused hand grenades, left behind in the rush of advance, are devil’s bait for Arab kidschiIdren with knees blown through, hands mutiIated, faces crushed-a bIoody to11 of the innocent. One week passes and the heavy rumbling that has formed a part of our Iife day and night since arriva1 has dwindIed in the distance. Admissions taper off. In two days no more casuaIties appear. Bizerte is taken, Tunis has faIIen, the campaign in North Africa is at an end and we are ready to move.
F
ride the truck carrying operating room equipment and have a pleasant coIored boy from Georgia as my driver. The inside of his cab is studded in typical soldier fashion with pictures of beautiful girls in the nude, semi-nude or simply Hollywood sweaters. He is good fun, always humming or singing, and during stops he runs ahead to get cans of grapefruit juice and boxes of graham crackers from the ration truck which, as Iuck would have it, immediately precedes ours. Lunch apparently has not been planned but I had been foresighted enough to pick up some cans of C-rations so we make out with cold stew, hash and “iced” coffee. The latter is produced by dissolving the ration powdered coffee and lump sugar in canteen water, mixed with lots of imagination. Rather lumpy but good nonetheless. The trip is slow, dusty and hot. Cold as it is in the mountains of North Africa, the sun gives you a good going over from nine to four. We form only a smaI1 link in an endless chain that bumps along in white cIouds of choking dust, stops and waits every little while and then bumps along again with much shifting of gears and sw-earing of driver. One pause lasts over an hour in shimmering heat waves while a whole convoy of heavy guns rolls slowly past round the curve and up the hiI1, the gun crews white with dust clinging precariously to their perches on trucks and carriages. At each stop flies swarm over us, vicious insects with bites that sting. Another pause and a division of engineers goes by, queer looking trailer trucks loaded with heavy bridge sections all ready to be slapped together when needed. As each vehicIe passes we automatically hold our breaths and then Ii11 our Iungs with only half dusty air before the next comes along.
*This has been excerpted from a diary that was kept throughout 565
the war by the author.
566
American
Journal
of Surgery
Bosworth-SurgicaI
This is a11 country which has been bitterIy fought over onIy a short time before. The road is rough and pocked with bomb hoIes which have hastily been fiIIed in. AI1 aIong on either side are huge and smaI1 craters and here and there a Iorry or other vehicIe which has been burned or smashed and pushed off the road. Some are wrecks which had simpIy gone off a turn and over the bank in the bIackout. It is evident that both Americans and British have been through here. Signs such as “ BrookIyn Bridge” and “ Pa11 MaII” have been stuck up on crude posts or scrawIed on the waIIs of shattered buiIdings. At one pIace we pass a dozen Mark VI tanks which have been shot up. Some of the tanks are compIeteIy overturned, some up-ended, some on their sides, some with three-inch she11 hoIes through four-inch stee1. Most of them are burned out. IncidentaIIy, it was in one of them that I had been strafed by three Messerschmitts onIy a few days previously. I had gone up to Iook through them for parts I needed in buiIding a suction pump for the operating room. I had just cIimbed into the Ieast damaged tank and was having a wonderfu1 time eIevating and depressing the cannon and wheeIing the turret around from the contro1 tower when I heard the pIanes coming. They did not sound Iike ours and furthermore the ack-ack set up a terrific cIatter so I dove for the bottom of the tank without looking up, figuring it was the safest pIace I couId find. I just made it as my two enIisted men piIed in on top of me. Then came the trump-trump of bombs and chatter of machine guns but fortunately nothing Ianded nearby. It was onIy afterwards I noticed the sheIves around the inside of that tank were loaded with unused cannon sheIIs. About 5:30 P.M. we reach our destination, a beautifu1 srte on a gentIy sIoping hiIItop in the open, midway of a Iong vaIIey ringed on a11sides by mountains. The Iatter are arid, rockridged and treeIess. The wheat fieIds through which we bump and jog off the main road have obviousIy been
HospitaI
APRIL,
,946
used recentIy by tanks, artiIIery and infantry. Tracks run off aimIessIy here and there and foxhoIes are numerous, each suppIied with its teIItaIe mound of empty ration tins, ammunition casings, waste Iitter and blackened stones. Down the hiIIside from us Iie the tragic remains of an aIIied bomber where it had crashed and burned, engines, propeIIors and bits of wings scattered in a11 directions. The first part of the convoy has aIready set up the O.R. and the mess tent when we arrive. The generator is hooked up and going. The place seems a bedIam of grinding trucks and shouting confused men. But the genera1 Iayout of areas for operating rooms, wards, Iiving quarters for officers, nurses and enIisted men has been pIanned and in remarkabIy short order a tent city springs up as though by itself with unseen power. The C.O. says we are due to start receiving cases at six. I think to myseIf, “Yes, yes, I know-that means we probabIy won’t see a thing tiI1 tomorrow.” So I sIip off to my piIe of baggage and get messkit and canteen cup. Chow is aIready being passed out but right on the dot of six and before I can eat a sergeant comes running to say that we have received a haIf dozen wounded, two major cases among them, and other ambulances are arriving. This is certainIy one time the army knows what it is doing and does it. So I check on shock treatment for the two worst cases, a beIIy and a shattered knee. Both have had pIasma forward and need bIood. WhiIe the transfusions are running I get my stew and coffee. Then to work: a chest wound to be taken care of, a beIIy expIored, fractures for reduction and spIinting after x-ray, jagged wounds to be cIeaned up and hemorrhage controIIed and burns to be dressed under anesthesia. Now and then an extremity is damaged beyond hope of saving; somehow these seem the most pitifu1 cases. Patient after patient is brought in; six tabIes are fiIIed aII the time; an endIess procession of new “What’s the matter faces and injuries. with you, Iad? Hurt badIy?” “No, Sir,
VOL.
LXXI.
No
4
Bosworth-SurgicaI
Hospital
American
Jourrd
of Surgery
567
deft examination of the endless stream of I’m a11 right; just a bit of shrapnel from an wounded foIIows; these are sent to shock let’s 88.” “ You’11 be O.K.in a jiffy-here, ward, those to O.R. stat, others to x-ray; have a Iook at it; we’11 put you to sIeep there is no time to ponder; the IightIy first.” wounded go directIy to wards for hot A pause for hot coffee and food at midmy first night; then we go back at it. We lose a11 coffee, soup and food. “Man, mea1 in three days and is it good!” track of time. The Iong tunne1 of operating tent Aooded with light, the smaIIer tent In another tent a group of surgeons work silentiy and swifty to take bIood for countIeading to it where we scrub and patients A poo1 of voIunteer siIentIy wait their turn, stretchers side Iess transfusions. donors from suppIy services is aIready on by side on the canvas covered dirt floor, hand; as soon as some have given others the trickIe of coId water over our bare arms take their pIaces. BIood flows through the and the sting of bristIes on raw skin, the Iaboratory to the shock ward and O.R. in sea of white drapes beneath caps and masks a steady Iife-giving stream. bent over tables, the hasty cutting away I am off duty and due to get some rest of clothing caked with dirt and clot, the the next evening when the C.O. greets me stickiness of blood partiaIIy dried on fresh wounds, the sight of marbIe skin surroundat supper: “Come and see a case with me; ing isIands of scarIet or innocent Iooking teI1 me what you think ought to be done.” toxic and delirious, puncture wounds reveaIed as the fiIth is A Iad of twenty, removed-a11 make a confused picture strafed by a pIane two days before, has a compound fracture of both ankles. His feet that seems unrea1; and yet here we are, are swollen and discoIored, the wounds here I am, a part of it, going on and on. We are working under bIackout; and green and stinking, with teIItaIe bubbIes such pitchbIack darkness it is. It has combeneath the skin-gas gangrene. He needs attention and in a hurry. Transfusions are menced to rain and in a short time the anti-gas gangrene serum and ground is a slippery, sIimy sea of clay started, which cIings in great sticky knobs to sulfonamides given intravenousIy in masshoes. FIashIights are banned; we are near sive dosage, along with ffuids and glucose. the front now. Poor Iitter bearers struggIe BIankets and hot water bags are used for through the dark with their loads from shock. MeanwhiIe a separate pyramidal receiving to x-ray to O.R. More loads, often tent is set up for isoIation; a stretcher heavier due to plaster casts, are carried serves for a tabIe and within an hour both from O.R. to wards. Stumbling and sliplegs are removed beIow the knee. A special shoulders strained, muscIes long nurse and ward boys are assigned but the ping, since numb with fatigue, these men carry patient is too sick for me to leave; he is on. Tents are invisible in the black; one stil1 toxic, delirious and violent as reaction works by instinct in a seeming void, comes from the anesthesia. chilIed and wet to the skin. “Hey, is this The needIe cIogs; the veins are thromx-ray?” “No, dope, its Surgery Three.” bosed and the low pressure, due to shock, “Well, where the h . . . is x-ray then?” keeps them coIIapsed. I try to get into “Dunno, Joe, try second tent in the next another vein but cannot; I cut down and row.” And off again they go with heavy expose another but that is clotted sorid. burden. The third try succeeds but it is a11 we can Long Iines of ambuIances Ioaded with do now to hoId his arm steady and keep the torn humanity, their dim lights Iike pale needIe in the vein. It is early morning and watery eyes peering through the rain, inch the patient is restIess and screaming. Morforward bumper to bumper to discharge phine does not touch him, nor does sodium their pain-ridden cargoes into overflowing amytal. He does not seem so good; he is receiving tents and be off again. Quick, paler and coIder. A glance beneath the
568
American Journal
of
Surgery
Bosworth-SurgicaI
blankets reveaIs a secondary hemorrhage; the dressing on the Ieft stump is soaked with fresh bIood. An emergency tourniquet is quickIy tightened; fresh instruments and dressings are brought from the O.R.; the stump is bared, the bIeeder found and sutured and a new dressing appIied. Over and over I keep thinking, “Why bother-the kid can’t make it anywayhe’s cooked-no bIood pressure, puIse like a trip hammer and bareIy feIt at thatrespirations way up-skin Iike parchment -nose pinched and nostriIs sucked in with effort to breathe-Iips bIue-hands cold as ice. Besides, if he does he’11 be a crippIe for Iife.” I cannot shake these thoughts but I keep on, automaticaIIy, as one possessed. Oxygen is tried but he does not get much; he is too vioIent and wiI1 not toIerate the mask. Another transfusion is given whiIe the needIe remains in the vein. It is bitter coId in that tent and there is no means of getting heat. An overcoat helps but it gets in the way. Heavy thunder storms and pouring rain continue unabated outside; it makes an incessant rattIe on the canvas. There is a caI1 for me-1 am wanted in the O.R. This time they wiI1 have to do without me; someone else wiI1 have to take it for I am not Ieaving. A major comes over; there is a bad case, compound fracture of both thighs, to be done. “OK, get so-and-so; I’d Iike to help you but I can’t drop this yet.” Three days Iater our lad is stiI1 with us and for the first time he asks for water.
HospitaI
APRIL, rg46
What a wonderfu1 sound those few words made; 1’11 never forget. He has gone further back now and I do not know what has happened to him but I’m sure he made the grade. What a tragedy the Ioss of his feet but he wiI1 walk again and, as we toId him, it is not as bad as an arm. Then comes a gIorious spring day, with bright sun, cIoudIess skies, wheat fieIds r&led by a gratefu1 breeze and a yeIIow green countryside deceptiveIy peacefu1. SuddenIy there is a loud expIosion and heavy smoke rises in an inverted cone from a fieId nearby. Arabs, horses, cattIe and sheep scatter in a11 directions, their paths cIearIy marked by fresh furrows in the waist-high grain. A Iand mine has been touched off. Soon detaiIs are known: Three Arabs have been kiIIed outright and there are five others for us to patch up. There is nothing unusua1 about this. The fieIds were sown with mines by the Germans. Now that the Arabs are returning to their homes accidents are bound to happen. Unused hand grenades, left behind in the rush of advance, are devil’s bait for Arab kidschiIdren with knees blown through, hands mutiIated, faces crushed-a bIoody to11 of the innocent. One week passes and the heavy rumbling that has formed a part of our Iife day and night since arriva1 has dwindIed in the distance. Admissions taper off. In two days no more casuaIties appear. Bizerte is taken, Tunis has faIIen, the campaign in North Africa is at an end and we are ready to move.