The wounded, carried on stretchers or helped by comrades back to casualty stations, lying in rows in field hospitals, or coming to terms with amputated limbs, blindness or shell shock in country houses converted into convalescent homes, are among the defining images of the First World War. This is due far more to novels such as Sebastian Faulks’ Birdsong and Pat Barker’s Regeneration than to histories of the war. How best then can the historian do justice to one of the war’s most common experiences, and to those who cared for the dying and nursed those who survived?
In Wounded, Emily Mayhew eschews what she calls the “conventional” approach, researching the records of the Royal Army Medical Service or hospital archives. If enough of these records had survived, such an approach might have resulted in a useful, if perhaps dry, study, but we must be thankful that instead she wrote this powerful book, which does justice to the experience of the wounded and the dedication of the doctors, nurses, orderlies, stretcher bearers and volunteers who cared for them, by weaving together the testimonies of individuals into a moving history.
What made the psychological and physical agony bearable was the professionalism and volunteerism
The British Army’s medical branches were not unprepared in 1914 to meet the challenge of the heavy casualties of modern warfare. The problem was that, just like the generals, they were not prepared for the type of warfare they soon had to cope with. Medical staff had the experience of the 1899-1902 South African War to call on, but discovered that the trench warfare that set in after the first months of conflict required a reassessment of their approach and new thinking about a new war and new wounds. They were perhaps more successful than the military commanders in adapting rapidly to the challenge.
It became clear that a well-organised system of modern hospitals well behind the front was of little avail, as too many wounded men failed to survive the journey from the battlefield. As Mayhew demonstrates, it was not just the new weapons – poison gas and high-explosive shells – that presented the challenge, even the bullets had changed: “the neat round holes made by rounded ammunition” were no more and “instead the cylindro-conical bullet fired by the new powerful weaponry hit fast and hard, went deep and took bits of dirty uniform and airborne soil particles with it”. The answer was to bring surgeons and nurses as close to the battlefield as possible, and the casualty clearing stations – often in tents and intended to provide little but a change of dressing and a comforting drink – became, in practice, field hospitals. It was more important that surgical treatment was available quickly than that operations took place in a tent rather than a purpose-built hospital.
The wounded soldier, who had made his way by stretcher or been carried on the back of a comrade to the casualty station, still had a long way to go, and the chapters of Wounded follow him on his journey from battlefield to a hospital in Britain. Such journeys could take days, for the hospital trains, with each carriage forming a ward staffed by nurses and orderlies, could be left in sidings for long periods. What made the psychological and physical agony more bearable and resulted in increased survival rates was a combination of professionalism and volunteerism: the rapidity with which Army doctors and nurses learned new techniques; the way in which stretcher bearers acquired medical skills and were formed into a corps of their own; the patriotic spirit that saw a vast increase in the number of nurses sent via the Voluntary Aid Detachment to France and large houses turned into hospitals; and the selfless spirit with which members of the London Ambulance Column came, after a working day, to London mainline stations to ensure that the arriving wounded were taken to the correct destinations.
All these factors resulted in 82 per cent of the wounded in the British Army being eventually able to return to duty, a great gain for the war effort and a considerable achievement. Yet even the war’s end was not without its cruel ironies, as Mayhew’s account of Claire Tisdall, a volunteer in the London Ambulance Column, attests. On the final day of the war, Tisdall, her driver and the recently wounded patients in their care, were surrounded by drunken, jostling crowds, celebrating the impending victory but refusing to make way for some of the injured men who had made it possible.
Wounded: From Battlefield to Blighty, 1914-1918
By Emily Mayhew
The Bodley Head, 288pp, £20.00
Published 12 September 2013