The Army I Knew: M*U*S*T

If you remember, last time we heard from young Doc Chief was in the winter of 1987 when I had reported to my Army Reserve unit, a combat support hospital in Lancaster, Pennsylvania.

In 1987 the 99th Combat Support Hospital (USAR) MTO&E was what was known as a "MUST" unit.

The acronym stands for "Medical Unit, Self-Contained, Transportable", and stood for the physical type of facility that was used to house the patients in the wards as well as all the medical, surgical, lab, and administration of the hospital.

The heart of these things were long rubberized half-pipes that were inflated and then supported by compressed air, sort of like ginormous kiddie pools laid out on their sides. Here's how it is described in the Wiki entry for "combat support hospital":

"MUST...contained all necessary functions to provide care for 250 beds, including 2 intensive care units, 8 medical wards, emergency room, 4 operating rooms, orthopedic room, laboratory, X-ray and pharmacy. It consisted of hard containers which housed the operating rooms, laboratory, X-ray, and pharmacy. Inflatable shelters were used to provide double wall insulated areas for the patient care areas of the hospital.

These "inflatables" required a power system called a Utility Pack (also known as a U-Pack or power station) to provide utility services. The U-Pack provided electricity, heating, air conditioning, compressed air, vacuum, and hot (and) cold (running) water. At 250 beds the hospital required 8 U-Packs. Each consumed 30 gallons of jet fuel per hour. After several years of using inflatables they were abandoned in the mid 1980s, largely due to the weight of the inflatables, and the amount of fuel required just to keep the tents from collapsing."

The other problem that this entry doesn't mention is that, just like the kiddie pool, the inflatable "buildings" would DEflate if you put a hole in them by, say, shooting rockets or mortars at them.

Can't imagine how THAT'd happen, eh?

The MUST system was more than twenty years old when I met it, and had been deployed to Vietnam with somewhat mixed results, including the whole "collapses when holed by shrapnel" thing.

(Nice little article about one of the Vietnam MUST units here at the 25th ID page, by the way, and here's a link to the 45th CSH page that provides some PDF documents by Garrett, the MUST system manufacturer...)

By the late-ish Eighties these things were almost out of the RA inventory; the DEPMEDS system of hard shelters was first fielded sometime around 1984.

What was true then (and is probably still true today ) is that the USAR was the poor, raggedy-ass, neglected-when-forgotten-and-beaten-when-remembered stepchild of the regular Army.

Without the powerful lobby that the state National Guard organizations had and have the Reserve had to make do with and mend whatever hand-me-downs they got from the regulars. The MUST system was one of these hand-me-downs and remained in place for at least as long as I served with the 99th CSH and probably much longer.

I have to say that I thought the the MUST was actually sort of ingenious, in a Sixties-Space-Age-y-Tang-and-dehydrated-meal kind of way.

The ORs, labs, and other technical facilities had their own containers that would travel and arrive ready to go. The containers had a pair of wheeled dollies that you'd shove up against the ends, lock in place, and then raise the container off the ground ready to roll, a very neat gimmick.

The ward units were, even in peacetime and stateside, something of a nightmare and that was without the whole "collapses when holed by shrapnel" thing.

Hard to move, physically demanding to set up, and once inflated a bit of a maintenance headache, but for all of that they had a couple of huge, immense, unbelievably, incredibly wonderful advantages.

They were usually warm.

And dry.

And clean; it's hard to express what an amazing feeling it was to go "to the field" and remain clean.

I had been living a bit of a pampered life as a medic in Panama, running the Evacuation Section and having a six-wheeled house to live in. The line medics lived like grunts, which means like domestic livestock only without the pampering.

But the notion of sleeping on a cot, and taking a daily shower with actual hot water? That was unspeakable luxury, and one that I'm not embarrassed to say that I took to like a Republican presidential candidate to wog-bashing, hippie-punching, and slut-shaming.

So for all their drawbacks I got okay with the MUST gimmick most quick smart.

The thing that was harder to adapt myself to were...well, the "soldiers" of the Army Reserve circa 1987.

Because at the time it was unusual for prior-service people to come out of the regular Army and want to keep serving part-time. Most guys who ETSed just wanted to be actual civilians again; it wasn't that we worried about going to war, as Reservists and Guardsmen do now. Most of us had just had our fill of playing soldier and wanted to grow our hair and beards and lie around getting fat.

There was little in the way of institutional memory from Vietnam left in the USAR by the late Eighties and there was little in the way of new-hewn experience coming in from the Regular army, so the vast, seething primordial mass of USAR soldiers of the day were, very often, "soldiers" only in the sense that they kept tree-colored clothing somewhere in their closet to wear once a month.

Don't get me wrong; they were good people. They wanted to serve, and they wanted to soldier; that alone set them apart from most Americans of the time, who could have cared less - the Army just wasn't the sort of place where an ambitious, real up-and-comer, sort of person could be found in January 1987. The ones who DID want to soldier went on into active duty.

Many of the people who made up the Reserves had gone to nothing more than the Basic and Advanced Individual training - the same I had gone through back in 1980 - and it showed. They wanted to soldier; they just just didn't know how to soldier.

The only net positive about the USAR's combat support hospital staff - for me, anyway - was that about half of them looked, and as often as not smelled, far better than my former battle buddies.

Because they were women.

The notion of serving along with female troops wasn't really a problem for me.

For one thing, I didn't expect them to look like this:

We'd had female medics in Division, and I'd had a lot of female pals in the maintenance outfit of the 210th Aviation Battalion in Panama. Good troopers, most of them.

I expected female troops to soldier and was seldom disappointed. It sure didn't hurt that they were both less-inclined to dick-wave and more-inclined to bathe and wash their uniforms regularly than the hairy-chested types I'd been serving with.

The Reserve female troops, though, had the same problems their male counterparts did; most of them had only the sketchiest idea of what actual soldiers did and how they did it.

I wasn't Sergeant Rock, exactly - I'd scampered off Active Duty just to get the fuck out of the Pearl of the Pacific, remember - but I sure as hell could tell that these people weren't exactly ready for prime time.

As an E-5 buck sergeant I had barely clambered onto the lowest branch of the NCO tree. In an infantry unit I would have been considered capable - barely - of supervising three or four privates...but under the constant supervision of my squad leader from his august dignity of E-6 staff sergeant and the benign (but ruthless) authority of my E-7 platoon sergeant.

But in the land of the blind, or the Eighties U.S. Army Reserve, the one-eyed man - or the prior-service buck sergeant - is king.

And so it was that I found myself in a very peculiar position of having the least rank but the most actual military knowledge and understanding of any of the NCOs in the 99th CSH, and in the completely unauthorized but ridiculously-badly-needed position of "Assistant to the Chief Wardmaster".

(Next; The Unspeakable in Pursuit of the Untrainable, or, (seriously, no shit for-real-this-time, I promise) Lucy in the Sky With Diamond Earrings)