This book stands out as distinctive and different among the many other books being published in the centenary year of the outbreak of the First World War, most of which will concentrate on the tumultuous battles of the period. This was war that embraced virtually the whole planet, involved all the people of the combatant nations and employed every resource, knowledge and skill in the war effort. Leonaur intends to recognise the contributions of all people—men or women, soldiers or civilian volunteers, on the battle front or the home front—who were involved in the Great War, and is releasing material covering subjects that may well be absent from the catalogues of most other publishers. Today we take for granted the expert medical staff who support our armed services, but at the time of the First World War, only 50 or so years had elapsed since her concern about terrible conditions in the Crimea brought Florence Nightingale to public notice, and where a wound was a death sentence and disease killed more men than enemy fire. In the Great War, Army surgeons had to cope with tremendous workloads when the weapons of the industrial age inflicted ghastly injuries as they scythed down men in their thousands. This book contains two first-hand accounts—brought together for interest and good value—by British military surgeons, who risked their own lives to save others.
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Next day we proceeded to unpack our stores, and to try to make a hospital out of these empty rooms, and then only did we discover that an overwhelming misfortune had overtaken us. By some extraordinary circumstance which has never been explained, we had lost practically the whole of the surgical instruments which we had brought out of Antwerp with such trouble and risk. They were tied up in sheets, and my own impression is that they were stolen. However that may be, here we were in as ludicrous a position as it is possible for even a hospital to occupy, for not only had we none of the ordinary instruments, but, as if Fate meant to have a good laugh at us, we had a whole series of rare and expensive tools. We had no knives, and no artery forceps, and not a stitch of catgut; but we had an oesophagoscope, and the very latest possible pattern of cystoscope, and a marvellous set of tools for plating fractures. It reminded one of the costume of an African savage—a silk hat, and nothing else. Some Belgian doctors who had been working there lent us a little case of elementary instruments, and that was absolutely all we had.
Scarcely had we made this terrible discovery, when an ambulance arrived with two wounded officers, and asked if we were ready to admit patients. We said, “No,” and I almost think that we were justified. The men in charge of the ambulance seemed very disappointed, and said that in that case there was nothing for it but to leave the wounded men on their stretchers till an ambulance train should come to take them to Calais, which they might ultimately reach in two or three days’ time. They were badly wounded, and we thought that at least we could do better than that; so we made up a couple of beds in one of the empty rooms, and took them in. Little did we dream of what we were in for. An hour later another ambulance arrived, and as we had started, we thought that we might as well fill up the ward we had begun. That did it. The sluice-gates were opened, and the wounded poured in. In four days we admitted three hundred and fifty patients, all of them with injuries of the most terrible nature. The cases we had seen at Antwerp were nothing to these. Arms and legs were torn right off or hanging by the merest shreds, ghastly wounds of the head left the brain exposed. Many of the poor fellows were taken from the ambulances dead, and of the others at least half must have died.
For four days and four nights the operating theatre was at work continuously, till one sickened at the sight of blood and at the thought of an operation. Three operating tables were in almost continuous use, and often three major operations were going on at the same time; and all the instruments we had were two scalpels, six artery forceps, two dissecting forceps, and a finger-saw. Think of doing amputations through the thigh with that equipment! There was nothing else for it. Either the work had to be done or the patients had to die. And there was certainly no one else to do it.
The rapid advance of the Germans had swept away all the admirable arrangements which the Belgian Army had made for dealing with its wounded. The splendid hospitals of Ghent and Ostend were now in German hands, and there had not yet been time to get new ones established. The cases could be sent to Calais, it was true, but there the accommodation was so far totally inadequate, and skilled surgical assistance was not to be obtained. For the moment our hospital, with its ludicrous equipment, was the only hope of the badly wounded. By the mercy of Heaven, we had plenty of chloroform and morphia, and a fair supply of dressings, and we knew by experience that at this stage it is safer to be content with the minimum of actual operative work, so that I think it was we, rather than our patients, who suffered from the want of the ordinary aids of surgery. In the wards there was a shortage, almost as serious, of all the ordinary equipment of nursing, for much of this had been too cumbrous to bring from Antwerp; and though we had brought out a fair supply of ordinary requirements, we had never dreamt of having to deal with such a rush as this.
Ward equipment cannot be got at a moment’s notice, and the bulk of it had not yet arrived. We only possessed a dozen folding beds, in which some of the worst cases were placed. The others had to lie on straw on the floor, and so closely were they packed that it was only with the greatest care that one could thread one’s way across the ward. How the nurses ever managed to look after their patients is beyond my comprehension, but they were magnificent. They rose to the emergency as only Englishwomen can, and there is not one of those unfortunate men who will not remember with gratitude their sympathy and their skill.
During these first days a terrific fight was going on around Dixmude and Nieuport, and it was a very doubtful question how long it would be possible for the Belgian and French troops to withstand the tremendous attacks to which they were being subjected. The matter was so doubtful that we had to hold ourselves in readiness to clear out from the hospital at two hours’ notice, whilst our wounded were taken away as fast as we could get them into what one can only describe as a portable condition. It was a physical impossibility for our wards to hold more than a hundred and fifty patients, even when packed close together side by side on the floor, and as I have said, three hundred and fifty were dealt with in the first four days.
This meant that most of them spent only twenty-four hours in the hospital, and as we were only sent cases which could not, as they stood, survive the long train journey to Calais, this meant that they were often taken on almost immediately after serious operations. Several amputations of the thigh, for example, were taken away next day, and many of them must have spent the next twenty-four hours in the train, for the trains were very tardy in reaching their destination. It is not good treatment, but good surgery is not the primary object of war. The fighting troops are the first consideration, and the surgeon has to manage the best way he can.
One of the most extraordinary cases we took in was that of the editor of a well-known sporting journal in England. He had shown his appreciation of the true sporting instinct by going out to Belgium and joining the army as a mitrailleuse man. If there is one place where one may hope for excitement, it is in an armoured car with a mitrailleuse. The mitrailleuse men are picked dare-devils, and their work takes them constantly into situations which require a trained taste for their enjoyment. Our friend the editor was out with his car, and had got out to reconnoitre, when suddenly some Germans in hiding opened fire. Their first shot went through both his legs, fracturing both tibiae, and he fell down, of course absolutely incapable of standing, just behind the armoured car. Owing to some mistake, an officer in the car gave the order to start, and away went the car. He would have been left to his fate, but suddenly realising how desperate his position was, he threw up his hand and caught hold of one of the rear springs. Lying on his back and holding on to the spring, he was dragged along the ground, with both his legs broken, for a distance of about half a mile.
The car was going at about twenty-five miles an hour, and how he ever maintained his hold Heaven only knows. At last they pulled up, and there they found him, practically unconscious, his clothes torn to ribbons, his back a mass of bruises, but still holding on. It was one of the most splendid examples of real British grit of which I have ever heard. They brought him to the hospital, and we fixed him up as well as we could. One would have thought that he might have been a little downhearted, but not a bit of it. He arrived in the operating theatre smiling and smoking a cigar, and gave us a vivid account of his experiences. We sent him over to England, and I heard that he was doing well. There is one sporting paper in England which is edited by a real sportsman. May he long live to inspire in others the courage of which he has given such a splendid example!