Abstract
Lt. Commander Laura M. Cobb was a chief nurse in the U.S. Navy during WWII who was imprisoned by Japan for more than three years in the Occupied Philippines. Under her direction, eleven other navy nurse POWs maintained rank and provided medical care to thousands of civilian inmates. Early in the war, Cobb courageously mislabeled quinine as baking soda in order to stop enemy medical corps from stealing the supply. She is credited with saving inmates from malaria. In 1943, she oversaw the creation of an infirmary at the Los Baños concentration camp where her nurses relied on scavenged supplies and local resources to provide medical care to more than 2,400 men, women and children. In U.S. military medical history, she is one of seventy-eight nurse POWs; and the only chief nurse in navy medical history to continue her duties while in enemy captivity. She received the Bronze Star with a gold star device and her citation honored her “dauntless determination, zealous efforts and unselfish devotion to duty in the face of unprecedented hardship.”
Introduction
In January 1942, twelve U.S. navy nurses were taken prisoner of war in the Philippines by the Empire of Japan. Under the direction of Chief Nurse Laura M. Cobb, the nurses maintained rank and provided medical care for thousands of civilian concentration camp inmates. During her captivity, Cobb successfully hid lifesaving medicine from the enemy medical corps as well as critical records. 1 In May 1943, Cobb and the other navy nurses agreed to transfer to a countryside camp near Los Baños where they were initially the only medical care providers. At Los Baños, Cobb oversaw the creation of a makeshift infirmary using scavenged items and locally sourced supplies. The nurses continued to provide care to an increasingly diseased and starved inmate population. Toward the end of the war, inmates died daily from beriberi and other starvation related conditions. 2 By liberation in February 1945, few inmates weighed more than one-hundred pounds. Cobb and her navy nurses were honored with the Gold Star and the Bronze Star medals for their “zealous efforts” in unprecedented hardship. Cobb was just one of seventy-eight nurses in U.S. medical history to be taken prisoner of war; and only one of two chief nurses to continue her duties while held captive. 3
Early years
Laura M. Cobb was born in 1892 in Kansas. Cobb grew up near Wichita, 4 where her family had a unique commitment to education. Whereas most of the U.S. did not have an eighth grade education, Cobb’s parents sent their five daughters and one son to high school. Cobb graduated from Mulvane High School in 1910 and initially began her career as a teacher before enrolling in a three-year registered nurse program at the Wesley Hospital & Nurse Training School in Wichita. Upon graduation in 1917, she enlisted as medical corps with the U.S. Navy Reserve. She was assigned to naval hospital at Fort Lyon, Colorado. (The hospital specialized in tuberculosis treatment and the dry climate of the Great Plains was considered beneficial to TB patients). After fourteen months, Cobb transferred to the Navy Nurse Corps and was assigned to Cañacao Naval Hospital near Manila Bay in the Philippines. Cobb returned to the U.S. in 1921 and served at the Mare Island Naval Hospital until her honorable discharge five months later. For the next three years, Cobb held several civilian nursing positions but returned to the Navy Nurse Corps in April 1924. In 1927, she completed a nine-month training program in physical therapy. For the next fourteen years, Cobb served at naval hospitals in the U.S., Guam, and the Philippines. 5 In 1940, she was serving as chief nurse at the naval hospital in Guam when the island was devastated by a typhoon. Cobb received a commendation for her heroic efforts to provide emergency care to injured sailors and civilians. In February 1941, she reported to Cañacao Naval Hospital in the Philippines as chief nurse where her experience with triaging mass casualties was soon required. 6
Cobb at the onset of WWII
Cobb was woken in the early hours of December 8, 1941 with news of the attack on Pearl Harbor. 7 The U.S. military anticipated the Japanese would soon attack U.S. military bases in the Philippines. For the next two days, Cobb ordered her nurses to ready the wards at the Cañacao Naval Hospital in preparation for casualties. As Cobb soon realized, the hospital was not well-designed for war. There was no general area to triage casualties, and the surgical suites were on the third floor. During peacetime, an elevator conveniently transported patients. But the electricity was cut during the bombing of the naval base on December 10 in order to prevent an explosion from the widespread fires. 8
The bombing occurred around noon when many of the medical corps were on their lunch break. For more than an hour, Cobb and her nurses hid under their dormitory with only a wall of sandbags to protect them from debris. When the all-clear sounded, Cobb directed her nurses to run to the hospital and begin emergency care. The nurses divided their efforts into the surgery and the two wards. Each ward held only seventy-eight beds, all of which were quickly filled. Within minutes of the bombing, hundreds of marines and sailors were brought to the hospital. Corpsmen placed several patients into the same bed or positioned them on the floor or upright in chairs. The navy nurses were directed to inject each patient with a quarter-gram of morphine under their skin. The nurses had to prioritize patients with the greatest injuries. Patients had second and third-degree burns from the fires that erupted in the naval yard. Men also presented with severe dislocations, head injuries, gashes, and missing limbs. Shortly after the military patients arrived at the hospital, civilian casualties were brought by survivors, who used makeshift stretchers such as doors or tin roofing to carry their injured to the hospital. 9
Cobb circulated between the wards and the surgery, solving issues and giving directions. The largest concern was the inability to get patients to the third floor surgery due to elevator being inoperable from the power outage. Cobb directed the ward nurses to create a queue beginning at the top of the stairs. Patients were balanced on each step, and surgeons were able to access the line and adjust as needed to prioritize more critical patients. In some instances, the surgeons performed simple surgeries on the risers such as amputating a hand or foot that was connected by a lone ligament. Another great concern was the overwhelming amount of patients packed into the wards. There were only three nurses per ward and they were struggling to remember whether they had yet triaged a patient. Cobb directed the nurses to come up with a system, however crude, to begin marking the patients. In one ward, the nurses used lipstick to mark patients’ foreheads to indicate they received a morphine injection and an initial assessment. In the other ward, the nurses used toe tags from the morgue to write down the patient’s information, initial assessment, and care given. The tag was tied around the wrist, as opposed to the toe. 10
Within twelve hours, the Admiral ordered the medical corps to begin evacuating the hospital. The Japanese military had sent a warning the hospital would be bombed within the day. The twelve navy nurses were divided and sent to makeshift hospitals at convents, schools, and a former racquetball club. By December 25, 1941, the sixty-six U.S. army nurses in Manila received orders to evacuate to either the peninsula of Bataan or the island of Corregidor. One navy nurse was reassigned to the army, and the remaininng eleven navy nurses were sent to Santa Scholastica, a former women’s college that was being used as hospital for both army and navy patients. By December 31, the U.S. army evacuated all their patients to Australia. General Douglas MacArthur declared Manila an “open city,” and the navy nurses awaited the eventual capture.
At Santa Scholastica, Cobb accepted Filipina nurse Basilia Torres-Steward into her ranks. Torres-Steward was a registered nurse and a former chief nurse at a Manila Hospital who was married to a U.S. naval officer. 11 In addition to Torres-Steward, age twenty-eight, the other navy nurse POWs included: Susie Pitcher of Iowa, nurse anesthetist, age forty; Goldia O’Haver of Iowa, age thirty-nine; Bertha Evans of Oregon, nurse and dietitian, age thirty-seven; Helen Gorzelanski of Nebraska, age thirty-four; Margaret ‘Peg’ Nash of Pennsylvania age thirty; Carrie ‘Edwina’ Todd of California, age thirty; Mary Rose Harrington of South Dakota, age twenty-eight; Eldene Paige of South Dakota, age twenty-eight; Mary Frances Chapman of Illinois; age twenty-eight; Dorothy Still of California, age twenty-seven. 12
Cobb’s consistent pattern of courageousness
The navy medical corps were taken prisoner on January 2, 1942. In addition to the twelve nurses, there were 305 prisoners, twenty-five officers, five pharmacists, 102 corpsmen, and 161 patients (both Filipino and American). 13 The medical corps anticipated their captors would comply with the Geneva Convention, which dictated that medical corps must be repatriated. However, Japan signed but did not ratify the Third Geneva Convention, which meant they would not regard medical corps as noncombatants. 14 The hospital was converted to a prison, and the medical corps were introduced to the Japanese military’s culture of violence, which included daily beatings and starvation. 15 Although the twelve nurses did not report being physically assaulted, one navy nurse was slated for execution after two patients escaped. A guard ordered the summary execution of the four medical corps who were on duty at the time of the morning roll call, but the military police first insisted upon an investigation and then determined executions were not warranted. 16
The navy nurse POWs were also introduced to the Japanese military’s culture of stealing. Soldiers were sparsely furnished with food and supplies and they relied on taking from civilians or prisoners. Early in their captivity, guards ordered Cobb to make an inventory list of the pharmaceuticals. Cobb knew the guards would use the list to identify valuable medicines and vaccines. Cobb was specifically worried the guards would take the nurses’ supply of the antimalarial drug quinine. Cobb suspected their captivity would endure throughout the defense of the Philippines, which she anticipated would take several months. In an effort to preserve the life-saving drug, Cobb mislabeled it as baking soda. When the guard was presented with the inventory list, he indeed looted the quinine supply. Due to Cobb’s label change, the guard left with baking soda while the prisoners maintained the quinine. In the coming years, Cobb’s salvaging of the quinine supply was credited with saving many inmate lives. 17
In addition to mislabeling the quinine, Cobb was also credited with maintaining secret records on behalf of her nurses. Maintaining records or diaries was forbidden in the prisoner of war camps. When the navy nurses were transferred to a civilian concentration camp in March 1942, Cobb secreted the documents underneath her uniform and wore a flower lei to disguise the incriminating square that formed across her chest. Cobb could have faced punishment or execution for the records, which later entitled her nurses to pay, promotions, and honors after liberation. 18 The civilian concentration camp was located in Manila at the University of Santo Tomas. The camp held more than 3,200 men, women, and children. On the morning of the nurses’ arrival, Cobb appointed herself director of nursing services and ordered her nurses to care for the diseased and desperate inmates. 19
Life at Santo Tomas was crowded and stressful. Inmates received two sparse meals per day. They waited hours in line to use the toilet or shower. 20 Inmates presented at the infirmary with early stages of malnutrition. Female inmates described symptoms of amenorrhea, and men spoke quietly of impotence. Inmates showed bleeding gums and wounds that were slow to heal. In addition to providing medical care, the navy nurse POWs also comforted inmates who were alone in the camp, as well as those who had transferred from the peninsula of Bataan and described troublesome stories about the U.S. military’s defeat. 21 As Bataan and then Corregidor fell to the Japanese, the U.S. army nurses were transferred into the camp. The army women were permitted to join the general population in August 1942. The arrival of sixty-six army nurses relieved the nursing shortage that had overwhelmed the camp infirmary. 22
In May 1943, the inmates learned the camp commanders were sending eight-hundred able-bodied men to build a second camp in the countryside, near Los Baños. A civilian physician approached Cobb and asked if the navy nurses would transfer with him to serve as the camp’s only medical care providers. Their captors were not trustworthy, and the nurses were not certain whether a new camp was truly forming or if the guards were deceiving them into a mass grave. But without the navy nurses, there would be no medical care providers at Los Baños and the physician would have to rely on untrained volunteers. The navy nurses agreed to the transfer. 23 They packed their limited supplies and climbed into flat-bed trucks to take them to the train station in Manila. At the train station, Cobb and the nurses were alarmed to see a row of unventilated boxcars waiting on the track. The guards began loading one-hundred men per car and then shut and locked the door. Cobb realized the men would quickly die from carbon dioxide poisoning. The medical corps urged the guards to open the train cars to allow for ventilation. After explaining the perils of carbon dioxide buildup, the guards agreed to open the boxcar doors after the trains left the city limits. The inmates reported losing several pounds of water weight in the extreme heat, but they were able to ventilate the boxcars and survive the trip. 24
Ingenuity and the infirmary
The Los Baños concentration camp was located at the former site of the University of Philippines College of Agriculture. The guards permitted the nurses to use the former infirmary as both a hospital and outpatient clinic. The nurses found the infirmary had been stripped bare, first by U.S. troops and then by Occupying forces. Even cupboards had been pulled off the walls. Only two items remained – an operating table bolted to the floor and an instrument sterilizer that had been damaged when someone tried to use it as a rice cooker. 25 Cobb directed her nurses to begin creating a functioning infirmary. Within weeks, the twelve nurses were the only medical care providers. The civilian physician who had asked the nurses to accompany him to Los Baños was repatriated in a small prisoner exchange between U.S. and Japanese forces. It took three months for the camp commander to arrange for a civilian surgeon to be transferred from another camp. Under Cobb’s direction, the nurses functioned on their own. 26
The nurses first focused on creating the supplies they needed to provide basic care. Inmates had to bring their own bedrolls if they were admitted into the infirmary. 27 The guards at Santo Tomas had restricted which medical supplies the nurses were permitted to bring. Upon arrival, the nurses did not have any basic supplies. In addition to lacking anesthetics, medicine, and preventatives, the nurses also lacked adhesives, bandages, plaster of paris, slings or sutures. 28 The nurses were able to scavenge badly needed medical supplies using two crucial methods. First, the nurses relied on local resources to replicate medical necessities. Bandage adhesive, for example, came from a rubber tree that was mixed with various saps. The nurses also relied on local remedies, of which nurse Torres-Steward possessed an understanding. The nurses combined sugar and onion juice to treat coughs. They used guava leaf tea to treat bacillary dysentery. 29
Not all ailments could be remedied with natural treatment. The nurses had heard the locals relied on mango leaf to treat diabetes. 30 However, the approach was not effective and the nurses used their second crucial method for gaining supplies – negotiation with a Japanese medical officer. The officer lacked a medical background but was tasked with caring for the seventy-five man garrison who guarded Los Baños. The officer routinely turned to the nurses for advice, aid, or help interpreting dysentery slides. Cobb and her nurses negotiated with the medical officer. In exchange for their medical advice, the officer provided badly needed medicines. The nurses prioritized the most needed items in their scant pharmacy including insulin for the diabetics, anesthetics for surgery, and bichloride of mercury to treat jungle rot. For a time, the nurses were also able to secure vitamin tablets and prevent malnourished inmates from developing beriberi. 31
With the help of volunteers, the nurses built a crude but functioning infirmary using discarded or repurposed items. Pipes, for example, were fit together to create bedframes. Old bottles were strung into call bells. 32 Cobb was able to secure a bolt of denim, which she turned over to nurse Goldia O’Haver who possessed exception skills as a seamstress. O’Haver used an antiquated sewing machine to create two new uniforms for each nurse. In turn, the nurses gave O’Haver their old uniforms. Along with donated scraps, O’Haver used the fabric to create bandages, slings, and surgical gowns. 33 The nurses used the stringy fibers found inside banana leaves to weave mosquito nets and create pillowcases and bedrolls. The bedding was stuffed with a soft fiber that came the seed pods of bulak trees. Volunteers used bamboo to create tongue depressors, applicator sticks, and drinking straws. Inmates with electrical skills were able to repair the instrument sterilizer, which functioned from a bicycle-powered battery charger. 34 Surgical instruments were acquired when the new surgeon transferred in September 1943 and was permitted to bring equipment.
In the early months, the infirmary had twenty-five beds for inpatient care and the clinic saw an average of fifteen men daily for jungle-rot treatment. In 1944, the prison population increased from eight-hundred to 2,400 inmates. The inmates included men, women, and children who ranged in age from birth to late-sixties. 35 The nurses expanded the hospital in order to accommodate the growing need for medical services. Cobb permitted nurse Dorothy Still to begin an orderly training program in which twelve volunteers were taught fundamentals in order to assist the nurses. The extra help was needed because the nurses experienced their own maladies. 36 Toward the end of 1943, Nurse Still had to undergo surgery to repair a hernia. Still had been hesitant to undergo surgery, but Cobb encouraged the young nurse to do so while the infirmary still had access to disinfectants and anesthetics. 37 Cobb had heard through sources that the army nurses at Santo Tomas were struggling without iodine and basic disinfectants. Cobb anticipated the same shortage would soon effect Los Baños. During Still’s surgery, the surgeon found an inflamed appendix on the verge of bursting.
At the same time Still recovered from her surgery, nurse Peg Nash had dengue fever. 38
All the nurses experienced an infectious disease or malnutrition-related ailment as 1944 progressed and the camp commander intentionally restricted the food supply. By early 1945, inmates received about 900 calories a day and were still forced on work details. 39 Few inmates weighed more than one-hundred pounds and most were suffering from wet or dry beriberi. At the infirmary, the nurses continued to report for twelve-hour shifts. The infirmary no longer had medicine, vitamins, or insulin to offer patients. Inmates began to die each day from beriberi, intestinal obstructions, and malaria. 40 Two inmates were executed after foraging for food; one died from injuries sustained during torture and interrogation. 41
For Cobb and the nurses, providing care became physically straining due to their weakened state. Nurses and orderlies struggled to move or lift patients. Nurses reported collapsing while trying to perform simple movements such as climbing stairs or bending over a patient bedside. 42 During this time, the nurses confided to Cobb a concern that the U.S. military had forgotten about the prisoners and had no plans for liberation. Nurses later recalled Cobb as consistently encouraging during the final weeks leading up to liberation. She assured her nurses the army was coming and liberation was near. On February 22, 1945, the guards set up machine guns around the perimeter of the camp and began digging graves directly outside the barbed wire. The inmates correctly surmised the guards had plans to execute the entire prison population of 2,400. Cobb directed her nurses to report to the infirmary and continue as usual. 43
Cobb after liberation
Liberation came the next day at dawn. U.S. and Filipino forces successfully raided and evacuated the entire prison population to safety. Army intelligence later revealed the guards had indeed been planning to massacre the prisoners and were waiting for a backup unit to arrive on the afternoon of the February 23. During evacuation, Cobb coordinated the transfer of the most ill and fragile patients. 44 The inmates were transferred across the freshwater lake and then driven to Bilibid Prison outside Manila, which was in Allied territory and being used as a staging area for soldiers as well as liberated inmates. At Bilbid, the U.S. Army immediately employed the services of the navy nurses. After several days, Cobb insisted the U.S. military send her nurses back to the U.S. for their own recovery. 45 Most of the navy nurses weighed around eighty pounds. The most ill, nurse Peg Nash, weighed sixty-eight pounds and had undiagnosed tuberculosis. Nurse Susie Pitcher had suffered a heart attack while in captivity and had poor health. Several of the nurses also had dry beriberi. Cobb weighed thirty-five pounds less than when she was captured and had an undiagnosed heart condition as well as arthritis. 46
On their journey home, the nurses were interviewed by newspaper reporters who noted their selfless service but downplayed the heroics. Several reporters commented on the women’s appearance and suggested they were in need of a trip to the beauty parlor. 47 Cobb learned after liberation that the navy had begun considering nurses as officers. Without knowing it, Cobb had been promoted from chief nurse to Lieutenant Commander. In March 1945, the U.S. Navy honored the nurses with a Bronze Star Medal for their “… meritorious achievement, while in the hands of the enemy, in caring for the sick and the wounded.” Later in the year, the U.S. Army awarded the nurses a Gold Star in lieu of a second Bronze star. The Army citation described the women as “steadfast and courageous throughout the long hazardous period of internment …” The citation also noted the women demonstrated “… unfailing sympathy and resolute fortitude in the face of exceptional hardships” and “served as an inspiration to both patients and nurses.” 48
Cobb told newspaper reporters that she hoped to return to the Philippines to finish the war. 49 The navy forbid any of the liberated nurse POWs to return to the South Pacific but permitted them to choose their next assignment. Cobb chose the naval hospital at San Diego. She remained in the navy but was forced to retire in 1947 due to her continued health issues. 50 She retired as a commander and returned to civilian nursing. She died in 1981 at the age of 89. 51
Footnotes
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Author biography