Lease of Life
The Civil Defense Improvised Emergency Hospital
New York State Civil Defense Commission
The Office of Public Education
The New York State Department of Public Health
1957
From the moment of its inception, Cold War civil defense in America placed a heavy emphasis on providing continuity of medical care. This could be through volunteers, trained in crucial first-aid techniques, or professional medical personnel staffing makeshift hospitals and emergency rooms during an emergency situation. An early example of the latter can be found in the 1955 motion picture Lease of Life. Subtitled The Civil Defense Emergency Hospital, the film was sponsored by The New York State Civil Defense Commission under the approval of The Office of Public Education and The New York State Department of Public Health. In detail, a no-nonsense narrator explains New York state's plan to establish emergency hospitals far removed from areas subjected to enemy atomic attack. The opening scene, set to an up-tempo musical score, focuses on an aerial still photo of a bustling cityscape which is suddenly ripped to pieces by the roar of an atomic detonation. At the narrator's urging, the picture is quickly reassembled. This would be the effect of an organized civil defense effort, particularly one with dedicated medical volunteers, keeping order and structure in place during "that dark hour of disaster!"
New York, perhaps more than any other state in the Union, was at risk of falling victim to enemy bomber planes. In the event their atomic payloads dropped over the population centers, coastal ports, or economic focal points of the Empire State, officials were prepared to implement a four-step plan to disperse hundreds of improvised emergency hospitals away from projected target areas. Supplied through both state and federal agencies, these hospitals were 200 bed units containing all the elements of a fully functioning medical center. Equipment for surgery bays, obstetrics wards, X-Ray labs, burn treatment, recovery rooms and even cafeterias was carefully crated in depots, ready to be loaded into semi-trucks on short notice. The film explains that the first step in the dispersal plan is to select sturdy buildings suitable to house the hospitals and patients. Preference should be given, suggests the narrator, to empty school buildings. Ominously, the scene cuts from cheerful students leaving school to a doctor performing triage on mock victims complete with gory make-up. At this point steps two and three of New York's plan, organization of supplies and staff, are depicted. Triage, placing medical professionals at the front of the improvised hospital to determine which patients need emergency treatment, which can wait, and which are beyond saving, is the most important process of the hospital. This will allow the next most vital section, the surgery rooms, to operate without being inundated with burn, trauma and radiation victims who cannot be helped. 
Key to all functions of the hospital is electricity, provided by portable generators, two are shown being uncrated and assembled. Large gas burners, also shown being assembled, are used to boil water for sterilization of equipment and bandages. Volunteers trained with autoclave pressure sterilizers can clean a batch of surgical instruments in thirty minutes. Once it is up and running, the laboratory will take blood and urine samples to diagnose radiation sickness. Interestingly, New York's plan called for a portable X-Ray machine, towed by a special trailer and staffed with a technician who would travel among the emergency hospitals. According to the film, one traveling X-Ray unit and technician would provide imaging services to trauma patients in four geographically close hospitals. Overseeing the set-up of these technological services, along with the surgery bays and secondary medical wards, is an administrative team. They also oversee resupply and food service. Administrators are encouraged to utilize existing spaces in their adaptive buildings, including offices and cafeterias. As the narrator runs through the steps of the plan again, several scenes are shown of volunteers unloading a packaged hospital at an empty school and tending to mock victims. Like many civil defense films, the final scene serves as a call to action, encouraging viewers to enlist in emergency preparation services and to learn every detail of their duty to "ensure their Lease of Life". Because Lease of Life was release by a State agency, its official fate is difficult to determine. It does not appear to have been distributed by the Federal Civil Defense Administration like some state produced films, and references to it seem restricted entirely to New York State civil defense publications. The ideal of the improvised emergency hospital certainly prevailed for the next several years, however, and several films were made about them. Two in particular, Emergency Hospital, released by the the F/C/D/A/ in 1959 and Disaster Hospital from the Office of Civil Defense and The Department of Health, Education and Welfare in 1965, depict how New York's plan was ultimately adapted by Federal Authorities across the United States. Lease of Life: The Civil Defense Emergency may be viewed, in its entirety, HERE.
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