Courage Under Fire - US Hospitals at Anzio

US Fifth Army landing at Anzio, Italy, 22 January 1944
(US Army Center of Military History)
Courage under fire.

When we hear that phrase, we picture a soldier in the trenches, a sailor manning his guns, or a pilot dodging enemy fighter planes. But how about nurses and physicians?

In my novel, On Distant Shores, the hero serves as a pharmacist in the US 93rd Evacuation Hospital in World War II. On January 23, 1944, the 93rd Evac landed at Anzio, Italy, one day after American and British forces had landed. The armies succeeded in surprising the Germans and faced very little opposition. Due to overcautious leadership and insufficient reinforcements, the forces waited and consolidated the beachhead before driving inland. That proved to be a deadly delay.

US Hospital Area at Nettuno, near Anzio
(US Army Medical Department)
While the Allies waited, the Germans shored up their defenses. For the next four months, the Allies would remain trapped on a narrow beachhead, and over 4000 American and British soldiers would die.

To care for the 11,000 wounded—and the sick—four US Army hospitals served on the beachhead at Nettuno, just south of Anzio, close to the ocean. While evacuation hospitals were usually set up out of artillery range, the front lines at Anzio were less than ten miles from shore. The khaki hospital tents were marked by enormous red crosses on a white circle, but artillery fire did land on the hospital site—both accidental and deliberate fire.

US 56th Evacuation Hospital after an air raid
(US Army Medical Department)
The Luftwaffe battered these hospitals too. On February 7, 1944, a German fighter pilot, fleeing from US fighters, jettisoned his bombs for greater maneuverability—while over the 95th Evacuation Hospital. Twenty-eight patients and hospital personnel were killed. Ironically, later that day the pilot was treated at the same hospital after he was shot down.

During the four-month period, dozens of patients, physicians, and medics were killed—and six nurses. When the US Fifth Army made noise about evacuating the nurses, the ladies made even more noise. They insisted on staying with their patients, and the Army relented.

US hospital digging in at Anzio, spring 1944
(US Army Medical Department)
So they endured. They learned the “Anzio Shuffle,” a duck-walk to stay low and avoid shells. They leaped into slit trenches half full of water during air raids. They lived, and often slept, in their helmets. And they cared for their patients, performing surgery while bombs fell. Several were killed while shielding patients.

US hospital dug in at Anzio, Spring 1944
(US Army Medical Department)
The water table was too high to dig in the hospitals, but as spring dried out the ground, the hospitals dug down. Conditions were so dangerous that some patients deserted the hospitals for the relative safety of the front line, where at least the soldier could shoot back.

Beach at Nettuno, Italy, looking north to Anzio, July 2011
(Photo: Sarah Sundin)
In July 2011, I was able to visit Anzio. The beaches are now covered with Italian families on holiday and cobalt blue beach chairs and resort hotels. Little remains to commemorate the Battle of Anzio—a single room crammed with artifacts in a local museum and the American cemetery.


But I remember. I am inspired by these men and women who endured, who sacrificed, and who cared. They truly demonstrated courage—and grace—under fire.

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