In the summer of 1940, with Germany apparently triumphant in Europe and United States Congress instituting peacetime conscription, U. S. Army Surgeon General James C. Magee contacted a number of medical schools and hospitals about forming “affiliated” reserve units. The core personnel of the unit, physicians and some nurses, would be nominated by the civilian organization and only activated if war came, and the U. S. Army would then provide other personnel. Baylor University College of Medicine agreed to form a unit; Henry Winans, M.D., a professor of medicine, was selected as the commander.
On March 17, 1942, the personnel were mobilized to Fort Sam Houston, and the Baylor-based officers joined enlisted men from around the nation when the Fifty-sixth Evacuation Hospital was activated on March 29. A doctor from the regular army, Col. Henry Blesse, became commander on May 4, 1942. The unit ultimately had 94 officers and 315 enlisted men. They trained at Fort Sam Houston, then were sent to Louisiana to support the army’s largest maneuvers to date that tested and trained individuals, commanders, and units. That finished in October 1942, and they returned to Fort Sam Houston, where they were warned for overseas service in February 1943. The train left San Antonio at 1300 hours (1 p.m.) on March 31, 1943; nobody knew where they were headed.
They embarked in New York City and steamed on the liner SS Mariposa to Casablanca, Morocco, where they waited six weeks for transportation. After driving 1,300 miles over rough roads, they set up their hospital in Bizerte, Tunisia, and were ready on June 20, 1943. The first patient was one of their own staff, ill with leishmaniasis (also called sandfly fever), but they soon had other patients, at first transferred from other U. S. hospitals, then accident victims and the sick, and then battle casualties from the invasion of Sicily. When the Allied forces invaded the Italian mainland at Salerno, the Fifty-sixth was one of the hospitals sent to support the landings. It was operational on September 26, 1943, at Paestum, then moved to Avellino, where other units were attached to allow the Fifty-sixth (equipped and staffed for 750 beds) to handle more than 1,000 patients. So urgently needed was the Fifty-sixth that ambulances followed the convoy taking it to Avellino and unloaded patients before the hospital tents were even erected; many of the first patients were wounded and sick prisoners recovered from the enemy. During the winter of 1943–44, with Allied troops making little progress in bitter fighting up hills and mountains amid cold, wet conditions, the Fifty-sixth was constantly busy with wounded, sick, and trenchfoot cases. Malaria was also a problem.
In January 1944 they moved to Naples and embarked for an amphibious operation that turned out to be the Anzio landing, Operation Shingle. The Germans prevented any breakout, and Allied forces were stuck in a shallow beachhead under German observation. The hospitals were put in flat, open ground that was nicknamed “Hell’s Half Acre” because inadvertent shelling and bombing hit the hospitals. In its first thirty-six hours operating at Anzio, the Fifty-sixth received 1,129 patients, and it became the hub of the American hospitals at Anzio and routinely ran 1,200 beds. Except for blood, supplies never ran short, and the “walking blood bank” could provide enough whole blood. On February 7, 1944, one neighboring hospital was hit, and on February 10 another was hit. On February 12 the Fifty-sixth was hit and resulted in the Fifty-sixth’s first casualty, army nurse Second Lt. Ellen Ainsworth. Later that month First Lt. Mary Roberts was awarded the Silver Star for keeping the operating room functioning under shelling. According to The Story of the 56th Evac (1945), she was the “first American woman to be so decorated in the history of the U. S. Army.” In late March into early April, the Fifty-sixth was hit four times, and casualties had mounted so the hospital was rotated back to the main front on April 7. After barely a week out of action, the Fifty-sixth was operational at Nocelleto on April 12, 1944. That spring, when German resistance at Monte Cassino collapsed, the Allied forces advanced rapidly up the Italian peninsula. The Fifty-sixth moved several times, through Rome and up to the base of the Apennines, where the Germans managed to re-form a line that held through the winter of 1944–45.
The winter was again cold, but Allied preparations and training were better, so there were virtually no trenchfoot cases. In spring 1945, when fighting resumed, the Allies broke through the brittle German defenses and quickly drove across northern Italy towards Austria and what was then Yugoslavia. Col. Kenneth Ernst took over as commanding officer of the Fifty-sixth on March 18, 1945. As in the summer of 1944, the Fifty-sixth moved several times. While in Bologna, the Fifty-sixth received far more German prisoners than U. S. patients. They used two German surgical teams and had German ambulances delivering patients then going out, unguarded, for more. The Fifty-sixth moved to Udine, Italy, in late May to support U. S. troops who moved to the area to deter Yugoslav efforts to take over the Trieste area of northeast Italy. In June the U. S. Army started rotating personnel home and began a complicated points system to determine who went first, which broke up the cohesion of many units. High-point soldiers left the Fifty-sixth, and low-point men replaced them. On August 4, 1945, the Fifty-sixth admitted their 73,052nd, and last, patient. By autumn, the situation had stabilized, and the Fifty-sixth was moved out of Udine, and in October it shipped home.
The United States Army recognized the Fifty-sixth’s participation in four campaigns (Naples-Foggia, Rome-Arno, North Appenines, and Po Valley) with streamers on the unit flag and awarded the Meritorious Service Unit Plaque for actions in the spring of 1945. Six soldiers from the Fifty-sixth died in the war, four from enemy action.