Freight Car Friday – A Hospital on Rails

24 05 2013

With their special tank cars, marked cabooses and other equipment, the railroad fire and police forces have some of the most distinctive cars. But medical teams have used the rails too. In remote areas, the railroad may still represent the fastest or only connection to major medical centers. And in times of heavy casualties, the capacity of a train has many advantages.

Early Hospital Trains

While the speed of early trains compared to roads undoubtedly led to many early uses of the railroad to rush medical care for individuals, the first large-scale use of trains as life-saving tools came during the American Civil War. The use of the railroad to evacuate the wounded was just one of many impacts of trains on the war.


Conventional coaches became the first hospital cars.

In the North, Union General Herman Haupt developed special hospital cars that could begin treating as well as transporting the wounded. These trains were staffed with nurses and surgeons. Often the cars were converted from existing passenger cars or even freight cars. Most were outfitted with bunks or cots for the wounded. Hospital cars also had operating rooms with tables and surgical tools. Whenever possible, these operations were performed while the train was stopped. Although much has been written about the gory details of Civil War medicine, advances like mobile field hospitals would help pave the way for modern treatment.

The ability to get the wounded back from the front lines to more established facilities quickly is credited with saving thousands of lives. These return trips were just as important to the overall effort as trains carrying fresh troops and supplies to the lines.

Into the 20th Century

As railroads and medicine both modernized in the 20th Century, so too did the hospital train. Although the equipment grew larger, heavier and safer, the concepts and railroad operations remained much the same.

hospital car

By 1944, the hospital car had evolved into a more specialized piece of equipment. This restored car can be seen at the North Carolina Museum of Transportation.

In the United States, although the trains did not serve the front lines directly during our wars overseas, they remained an important link in the supply and relief chains back home. Here both purpose-built hospital cars and hastily reconfigured cars for the wounded were pressed into service for returning heroes.

There were simply not enough beds in the port cities where soldiers arrived home to treat all of the wounded. Trains met ships at the ports and then rushed to inland cities where the soldiers could be transferred to local hospitals. It was not uncommon for men to take several train trips around the country before finally coming home.

The Army ordered 200 hospital cars from American Car and Foundry in 1944 and 1945. These cars are perhaps the best-known of the railroad hospitals and were equipped with kitchens, 36 bunks and operating rooms. The cars had a larger side door so that stretchers would not have to navigate the small vestibules. Steam from the locomotives was used for everything from heat to sterilization.

hospital car

Lionel has made models based on the hospital cars to make it easy to add a hospital train to your layout.

In addition to these cars, many other coaches and Pullman cars were stripped of their interiors and fitted with rows of bunks to transport the wounded. (Other cars were similarly stripped and fitted with tightly spaced wooden benches to accommodate larger numbers of troops headed into battle as well.) Together with the new hospital cars, these rebuilt cars and often conventional equipment that could be spared made up dedicated hospital trains.

circus train

Although modifications and rebuilding have made it harder to tell, many of the cars in this circus train were once Army hospitals.

Following the wars, conventional equipment was returned to its regular uses. As air transport improved, the need for the hospital cars also diminished. Most were declared surplus in 1969. Some were retained by the Department of Defense for use as transport and guard cars or simply for storage. Many found an ironic second career with the Ringling Brothers and Barnum and Bailey Circus who outfitted the cars for their circus trains. Several more have found their way into museums around the country.

Many modelers enjoy the busy “transition era” of the 1940s and 1950s on the rails. In addition to all of the new diesels and big steam, special trains like a hospital run can add a lot of interest to any layout. A mix of Olive Drab, Pullman Green and just about any other color you can imagine in the form of borrowed cars would be an interesting consist as it raced around your railroad behind the fastest power available. Don’t forget the waiting ambulances and nurses at the station platforms as well.

In addition to being an interesting model, it would be a great way to pay tribute to the many who have given so much to this country. And what better time to share that than  this weekend?



5 responses

24 05 2013

Lionel, time to make a “scale” WWII troop train with scale hospital cars, pullmans etc. Use those scale heavyweight dies.

24 05 2013
Louis Bruette

Thank you Lionel, I love freight car Fridays!

24 05 2013
Philip Monteith

Thanks for the informative piece on hospital trains – a moment in history.

24 05 2013
Fred Overly

I’m new to the hobby. Are there O scale US Hospital Train cars available retail?

24 05 2013
William E. Fritz Sr

Not a comment but a question is Lionel going to produce this Hospital car?
I for one would like to have one for my Army Train.

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