Military Braced for Onslaught of Wounded GIs : Medicine: Army reservists are in place and hospitals are ready. Physicians fear a mass-casualty situation.

Dr. Richard Powers is boning up on the standard treatment for sandfly fever, hardly the stock in trade of a family practitioner from Sebastopol, Calif. Who can remember the last landmine injury that turned up in the emergency room of Palm Drive Hospital?

But now Powers finds himself in an aircraft hangar in southeastern Germany, his stethoscope slung over a camouflage shirt. He has been transformed suddenly into the senior physician in a makeshift, 250-bed hospital to be used as a way station for the wounded being evacuated from the Persian Gulf.

“I hope it’s never used,” said Maj. Bruce E. Lewis of Ramstein Air Base, watching a dozen reservists practice unloading litters from a cargo plane outside the hangar. “I hope this is an exercise in futility. Nothing would make me happier than to get this over with a minimum of bloodshed.”

Across southern Germany, the U.S. military is steeling itself for the onslaught of patients that a ground war in the gulf could bring. Two thousand medical reservists have arrived, prefabricated hospital wings have sprung up, planners are plotting the maneuvers of an army of wounded.

There have been refresher courses in malaria and exotic snakebites. Psychiatrists and infectious-disease specialists are being brought in. The Army hospital in Frankfurt has tripled its capacity to process and store blood, which is being donated at four to five times the normal rate.

Hundreds of German doctors have offered to care for military dependents, if and when the military hospitals fill up with the wounded. Many said they are eager to support the cause. A few said they agreed to help for humanitarian and professional reasons, but they bitterly oppose the war.

“I belong to the war generation,” said Dr. Ulrich Gottstein, director of the Burgerhospital in Frankfurt and a critic of the fighting. “I know what air raids mean, I remember the attack on Dresden . . . but we all feel very much for suffering people. So of course, my hospital would help.”

Under the current plan, seriously injured combatants would be treated in field hospitals in Saudi Arabia, some undergoing emergency surgery there. Once their conditions stabilized, they would be moved to hospitals in Europe and the United States, depending on their needs and the availability of beds.

That distribution process is to be orchestrated through offices in Saudi Arabia and Germany that will function like central booking agents--matching patients needing services such as neurosurgery or burn care with hospitals offering those specialties and beds.

What many physicians fear most, they said this week, are sheer numbers.

“This can turn into a mass-casualty situation,” said Col. Macy J. Grobe, chief of pathology at the Army’s 97th General Hospital in Frankfurt. “Plane after plane can arrive. And they will disgorge patients. And they will have to be distributed.”

In the meantime, the hospitals wait.

“This waiting business,” Grobe said Monday with some anguish in his voice. “Not knowing what’s going to happen and when--a lot of these things are weighing heavily on everybody. We don’t have any idea, really, what’s going to happen.”

At Ramstein, the order came just 2 1/2 weeks ago for a 50-bed “patient staging” facility in the cavernous hangar, a five-minute helicopter ride away from the Army hospital at Landstuhl. The order was increased within days to 150 beds. Last week, it rose to 250.

Unpacking the beds, workers found the wrapping dated 1952--”pre-positioned assets” stored by the military in anticipation of a European war. Now the hangar has been transformed into a hospital staffed by reservists from California and Hawaii. Appropriately, it is heated to a balmy 72 degrees.

It is equipped with a 32-bed intensive care unit, a cardiac monitor and a defibrillator to calm a frantic heart, tanks of oxygen, a forest of intravenous poles, a small medical library and a pharmacy with everything from Pepto-Bismol to pain-killing morphine and Demerol under double lock.

In charge of the operation is Cmdr. Gerry Esker, 44, in civilian life an employee of the California Purchasing Office in Sacramento. The chief nurse is Kathleen Clancy, a nurse-practitioner at the Menlo Park division of the Veterans Administration hospital in Palo Alto.

If and when the injured come, they will arrive on a few hours’ notice. Cargo planes, carrying up to 78 stretchers, will begin landing outside. Patients will be shuttled by ambulance or helicopter to nearby hospitals; others will be carried into the hangar to wait to be moved somewhere else.

“We’re the link that makes the whole chain stay together,” said Esker.

About 90 miles north of here, the Army has more than doubled the 300-bed peacetime capacity of its 97th General Hospital in Frankfurt, expanding it to newly renovated areas, moving administration activities to make room for patients and shrinking out-patient space.

Two X-ray units, a new blood bank and a 50% increase in the ability to steam-sterilize surgical equipment have been made possible through so-called deployable medical systems--a network of modular shelters and tents used by the military to quickly create temporary hospital space on demand.

The pathology department staff has been doubled. Elective surgery is to be put on hold. Obstetricians and pediatricians may find themselves overseeing the long-term recovery of wounded soldiers. There have been courses in recent weeks on malaria and burn care.

“In this hospital, we don’t usually have the massive burns and orthopedic injuries that you see in a conflagration and mass casualties,” said Col. John Seaman, an internist at 97th General. With a ground war will come burns and internal injuries, he said; with a protracted war, infectious diseases.

Asked what concerns him most, Seaman said grimly, “The numbers. If nuclear is used, if massive chemical warfare is used, it’ll be sheer numbers that will cause the problem.”