Dangerously Ill - Life before antibiotics

Mary Watson was a trained nurse and member of the Territorial Force Nursing Service and was mobilised on the 13th August 1914 with her unit, No.5 Southern General Hospital, Portsmouth. In early February 1915 she was admitted to a ward of her hospital suffering from influenza and a chest infection. Unusually, her case notes survive in her service file held at The National Archives (WO399/15365) and give a stark and rather frightening insight into how severe illness could be in the days before antibiotics. Not only was she very near death, but even when improving her full recovery took several months. Two of her brothers died during the Great War, one at Gallipoli and one on the Somme on July 1st, 1916. Her family were fortunate that their daughter survived.

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Surname: WATSON 
Rank:  Sister
Unit:  Territorial Force Nursing Service, 5th Southern General Hospital

1915:
5th Southern General Hospital
Disease:  Acute Bronchitis and Influenza

9.2.15
Patient admitted complaining of pain in limbs, severe cough and headache. Temp. 102.6.  Rales all over chest and back. Hyper-resonance.  Influenza contracted in Ward.

10.2.15
Cough very severe, and cyanosed. Temp. 104.2

14.2.15
Temp. 102.8.  Pains in limbs severe.

20.2.15
Cough very distressing. Steam kettle.

25.2.15
Patient has had bad night and cough has been very distressing.

4.3.15
Dullness base of both lungs.

9.3.15
Very bad night. Very blue. Heart dilated. Breathing very bad.

11.3.15
Patient feels a little more comfortable and breathing easier.

15.3.15
No change but patient holding her own.

21.3.15
Complains of sickness and motions foetid.

28.3.15
Cough loose and expectorating freely. Patient feels better.

4.4.15
Respiration keeps easier and has fallen to about 24 [respirations per minute].  Temp. for three days has been but little over 99.

1.4.15
Improving steadily.

18.4.15
Patient doing well. Heart's action steadier and dullness at both bases somewhat less.

23.4.15
Patient able to sit up for 4 hours without distress.  Patient left hospital on 28 April 1915.

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     On June 4th, 1915, a memo was sent from the War Office arranging a medical board for Mary Watson. It was hoped that it could be held near her home as she was still not able to travel far. It included the phrase 'I understand she is able to get about a little,' showing that even four months after her initial illness she was still far from well.

     A second nurse, Agnes Swanson, had a similarly severe illness that today could be easily treated with antibiotics. She first became ill in Salonika in November 1918 as the influenza epidemic raged. Eventually she arrived home, but even six months later remained unwell. Some intriguing itemised chemist's bills survive in her service file, showing the range of treatments that were available at the time for ongoing chest infections. We certainly need to give thanks for the discovery of Penicillin and all that came after. Anyone for a creosote capsule?

The National Archives WO399/14835

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The Photos Left Behind

     Last week I was at the Royal College of Nursing in London listening to Professor Christine Hallett talking about her new book ‘Veiled Warriors.’*  In part it explores the myths surrounding nurses during the First World War – the nurse as a romantic figure, the nurse as heroine, and the myth of the overworked, mistreated V.A.D.  At the end, someone posed a question about the images used to accompany the talk. They asked, why, when trying to dispel myths, were the images used all supporting those same myths? Why were they showing a romantic view of the nurse and her patients; where were the wounds, the horrors – why were there no images of those to accompany the words of the women involved?

     As someone who relies heavily on images to add colour and detail to my own talks, it caused me to consider the whole range of photos, drawings and fine art that portray hospital life and medical care during the Great War. My first thought was how lucky we are to have them. So many snapshots of nurses, patients, hospital buildings, ships and trains; glimpses of the great variety of equipment used at the time – the operating theatre, beds, lockers, tents and huts; interiors, exteriors, wards, kitchens, nurses at work, nurses’ leisure time – reading, writing, walking, relaxing, tennis and tea. They provide a unique view of nursing and medical care in a form never seen before or since the Great War.

     In the spring of 1915 an Army Order decreed that it was forbidden for members of the British Expeditionary Force to carry a camera in order to take photographs of life overseas, except those acting in an official capacity and authorised to do so. For nurses, using a camera and passing personal photos to the press, even though they may have been taken in all innocence, was likely to result in them being returned to the United Kingdom or even in dismissal. Luckily for those of us who came after, many women were willing to risk the consequences of breaking this rule, and collections of these personal photographs have survived the years though many more must have been lost over the decades.

     What’s left today falls mainly into two categories; official images taken on behalf of the War Office, and personal images taken by the brave. Some photographs of wounds and various aspects of surgery and treatment were kept for clinical purposes and survive in archives and in the pages of medical journals and textbooks. Other than those, why would anyone have wanted to publicise the surgical horrors of war?  Official photos were important for propaganda purposes and were essential for showing the organisation and depth of our medical services to the British public, relatives, the men themselves, and also to the watching enemy. They display good care in calm surroundings; clean, well equipped hospitals and disciplined soldiers, happy though wounded. They show that our women were eager to be part of the war, professional and willing; they provide a picture of the British soldier as bloodied but definitely unbowed, ready to re-join the fight. Within this framework there was no place to display the brutality of what came before the wounded were transformed once again into upright, smiling figures – who would have benefited by it?

     With regard to personal photos taken by members of the nursing staff, they would have been well aware that there was a line that must not be crossed. The majority of their photos are also of happy groups, off-duty time, tennis, walks and holidays. Though it might be acceptable to go inside a ward with a camera, would anyone really have taken a photo of a wounded man in the process of having his dressing done to send home, or to grace newspapers or magazines?  Would any nurse think that was appropriate then, or even today, other than perhaps for specialist clinical reasons?

     We have to be content with what survives, which is so much, though of course it will never be enough. The full picture can only be reconstructed by adding in official accounts and the personal testimony of all participants.  But the calm and smiling groups will always remain the outward image of the Great War even though they may support a myth, because that’s what was created at the time and therefore remains the gift that is left behind.

*Veiled Warriors; Christine E. Hallett; Oxford University Press, 2014

Mauretania as a Hospital Ship

The 'Mauretania,' built for Cunard and launched in 1906, had a multi-faceted history during the First World War, some of which was as a hospital ship.  There is a war diary of her medical work during that time held at The National Archives in WO95/4146, and although very brief, a transcription is reproduced here in its entirety. It does give some small idea of how the time of a hospital ship was divided over the course of its five months in service.

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His Majesty’s Hospital Ship ‘MAURETANIA’

War Diary, 10th October 1915 to February 29th 1916

The National Archives, WO95/4146

1915

10th October:  In accordance with War Office instructions proceeded to Liverpool to arrange details as regards the fitting up of the R.M.S.S. “Mauretania” as a Hospital Carrier. Arrived Liverpool 6.30 p.m.  Visited ship and after, P.N.T.O.

11th October:  Inspected ship with Commander Currie R.N., arranged such matters as bulkheads, lavatory accommodation etc., etc.  Indented for Ordnance Stores, Clothing, Stationary, Red X Stores.

12th to 20th October:  Work in the ship.  Arrival of Stores.

21st October:  Detachment arrived, also a portion of the staff of No.27 General Hospital.  Stores embarked.  Officers addressed on their respective duties.

22nd October:  Anchored in Mersey and sailed at 7 p.m.  Weather – thick.

23rd October:  Off Scilly 12 noon.  Weather – clear.

24th October:  Off Lisbon.  Weather – clear.

25th October:  Passed Gibraltar.  Weather – clear.

26th October:  At Sea

27th October:  At Sea

28th October:  At Naples. Coaled.

29th October:  Left Naples.

31st October:  Arrived Mudros.

1st November:  Coaling.

2nd November:  Embarked wounded from H.S. “Galeka” and H.S. “Delta”.

3rd November:  Embarked wounded from shore hospital.

4th November:  Embarked wounded from shore hospital.  Pte. T. Calderbank, 1/5 Manchester Regt., died. Left Mudros 4 p.m.

5th November: No.3765 Pte. Parker F., 3rd Field Ambulance, R.N.D., died and was buried at sea. Pte. Lee operated on for appendicitis.

6th November:  At Sea.

7th November:  At Sea.  Pte. Lee, 9th W. Yorks died of Enteric with perforation. P.M. showed gangrene of the bowel.  Pte. Marchant, 5th R. Fusiliers died of Dysentery.

8th November:  Off Gibraltar 7.35 a.m.  Received signal (Wireless) asking accommodation for convalescents.  Replied 19 Officers and 81 other ranks.  Message received at 7.45, replied 7.52 a.m. Wireless instrument broke down.  Message reported delivered at 8.15 a.m.  Ship’s fireman Bowen died at --- of Dysentery and pneumonia.

9th November:  At Sea.

10th November:  Docked at 1.45, Southampton.

11th November:  Ship commenced re-fitting.

12th to 22nd November:  Ship in dock.  Improvements are almost completed the chief of which have been (1) Gutting E Deck and erection of Double Tier berths.  (2) Gutting C & D Aft, Double Tier berths.  (3) Officers dining saloon to C1 and old dining room converted into a ward for 51 swing cots.  (4) Altering aseptic theatre.  (5) Altering men’s dining room and fitting of antiseptic tank and washstands. (6) Various sanitary improvements.  (7) Additions to disinfector and increase of laundry machinery.  (8) Erection of Sisters’ Duty Rooms.

23rd November:  Left Southampton with R.A.M.C. details and nurses.

24th November:  At Sea.

25th  to 27th  November:  At Sea.

28th November:  Arrived Naples.

29th November:  Visited British Consul General at Naples. Ship inspected by Consuls of U.S. America, Denmark, Switzerland (representing Germany) accompanied by British Consul General.  Statement in writing given me signed by 4 Consuls, that this ship has no combatant troops or war-like stores on board and that the rules of the Geneva Convention are being strictly carried out.  Left Naples.

3rd December:  Arrived Mudros – Embarked sick from H.S. “Devana”, H.S. “Nevassa”, H.S. “Delta”, H.S. “Soudan” and shore hospital.

4th December:  Left Mudros.  No.10369 Pte. Poole H., died of Dysentery yesterday 1 hour after embarkation and was buried at sea today. (8th Cheshire Regt.)

5th and 6th December:  At Sea.

7th December:  Arrived Naples for coal and water.  Visited British Consul General at 10 a.m.

8th December:  Pte. J. Cuddy, Lancs. Fus., died at 1.45 a.m., from Dysentery.  Left Naples at 7.30 a.m.  Inspection 10 a.m. with Sanitary Officer and Medical Director General of Cunard S. S. Line.  Several matters connected with Sanitary improvements enquired into and a list of these prepared for authorities at port of disembarkation.

9th December:  At Sea.

10th December:  At Sea.  Passed Gibraltar 8 p.m.  Entered bay and stopped – Naval officers boarded vessel and brought papers appertaining to number of sick on board for signature.  Proceeded at 9.10 p.m. westwards.

11th December:  No.1849 Pte. Foot, 1/8 Hampshires died and was buried at 4.35 p.m. – Acute Dysentery.  N.W. Wind – ship rolling.  No.34552 Gr. J. Drawfield R.F.A. developed Tetanus and was isolated.

14th to 16th December:  Arrived Southampton 7 a.m.  Invalids disembarked at 9 a.m.  In Southampton.

23rd December:  Staff Nurse Miss Stanley died in Netley Hospital of Dysentery.

1916

7th January:  Left Southampton 12 noon.  Boat Stations and life-belt parade 2 p.m.

8th January:  Complaints re Sgts Mess.  Reported to Ship’s Officials.

9th and 10th January:  At Sea.

11th January:  At Sea.  Communicated with Master re linen of R.A.M.C.

12th January:  Naples 7 a.m.  Left at 10.15 p.m.

13th January:  At Sea.

14th January:  Arrived Mudros 4.45 p.m.  Visited “Aragon”.  No ships ready to transfer patients.  S.E. breeze freshening.

15th January:  Strong breeze from S.E.  Ship moved to new anchorage 8 a.m.

16th January:  At Mudros.  Loading patients from Hospital Ships “Morea”,  “Panama”,  “Gloucester Castle”,  &  “Essequibo”.

17th January:  Loading continued.  Left Mudros at 4 p.m.

18th January:  At Sea.

19th January:  Naples 4.30 p.m.  Nominal Rolls sent to 3rd Echelon, Alexandria.  Cable to D.D.M.S. Southampton.

20th January:  Coaling and taking in water at Naples.

25th January:  Arrived Southampton.

9th February:  Left Southampton.  Anchored in Solent.

9th to 23rd February:  In Solent.  At 4 p.m. the Officers, Nursing Sisters and Detachment disembarked at Southampton.

24th February:  8.30 a.m.  Ship proceeded to Liverpool.

25th February:  Arrived Liverpool.

29th February:  Ship being no longer required I handed over charge.

F. J. Brown
Lieut. Colonel, R.A.M.C.
O. C. Troops, H.M.H.S. “MAURETANIA”

Vera Brittain and the Old Dug-out

     I admit to not being a fan of Vera Brittain. Over the decades she has forged a prominent position both in biographies and items throughout various media, but I've never understood exactly why. She worked as a VAD during the First World War and wrote a considerable amount about her experiences, her life and her losses. Because of that, she has emerged as an icon among nurses during the Great War, eclipsing almost all others, trained or otherwise. She’s become a national model for the ‘war nurse’ despite her story being one shared by thousands of other women. Many worked for a far longer period during wartime; many were honoured in a number of ways with commendations and awards; thousands suffered the loss of loved ones due to enemy action; hundreds suffered more personal loss than did Vera Brittain. And of course, she was not a trained nurse, but an amateur – an inexperienced volunteer.

     However articulate, however smooth and emotive her writing, my relationship with her stuttered and came to a very rocky end when I got to a passage in ‘Testament of Youth’ in which she resorted to a spiteful and vindictive attack on one of the most honourable, brave and trustworthy members of Queen Alexandra’s Imperial Military Nursing Service. On her way to Malta in 1916 on board the ill-fated hospital ship Britannic she described the Matron as ‘a sixty-year-old dug-out with a red cape and a row of South African medals.’ Later, recounting the tale of another nurse who had been on board the ship when it was torpedoed the following year, she wrote:

The old Matron, motionless as a rock, sat on the boat deck and counted the Sisters and nurses as they filed past her into the boats, refusing to leave until all were assembled. None of the women were lost … In one of the boats sat the Matron, looking towards the doomed Britannic while the rest of its occupants, with our friend among them, anxiously scanned the empty horizon. She saw the propeller cut a boat in half and fling its mutilated victims into the air, but, for the sake of the young women for whom she was responsible, she never uttered a sound nor moved a muscle of her grim old face. What a pity it is, I meditated as I listened, that outstanding heroism seems so often to be associated with such unmitigated limitations! How seldom it is that this type of courage goes with an imaginative heart, a sensitive, intelligent mind!

British nurses on board a hospital ship : Australian War Memorial

     The words of an arrogant, twenty-something young woman, failing to grasp much of life beyond her own narrow perspective were barely excusable in a diary entry of 1917, but unfortunate and telling that they were considered suitable in a book published by a mature woman in 1933. I suspect that she might have grown in years but not in outlook.

South Africa during the 2nd Anglo-Boer War

     So who was the ‘old dug-out’?  Elizabeth Ann Dowse was born in Bristol in 1855, and trained as a nurse at St. Mary’s Hospital, Paddington, where she worked for seven years between 1878 and 1885. She was chosen by H.R.H. The Princess of Wales as one of a group of nurses to serve in Egypt with the Nile Expedition that year, and on her return she joined the Army Nursing Service in 1886 where she remained for the next twenty-five years. She served in South Africa during the Anglo-Boer War including being present at the Defence of Ladysmith, and also in Malta, Egypt, on board hospital ships and at various stations in the United Kingdom. She was compulsorily retired from Queen Alexandra’s Imperial Military Nursing Service on reaching the age of fifty-five in 1910, but returned voluntarily to serve during the Great War, by then fifty-nine years of age. During the years between 1914 and 1919 her postings included hospitals in the UK, France, Italy, and of course on the Hospital Ship Britannic. She was one of only one hundred women ever to receive both the Royal Red Cross and a Bar to the award. Every note about her, every report on her work speaks in the highest terms of her meritorious and devoted services. She was hard-working, tactful, zealous, never lacking in energy; she showed self-reliance and common-sense of the highest order; she displayed the best influence over others, both nurses and male orderlies. A personal letter from the Matron-in-Chief at the time of her second retirement in 1919 said:

I am sure that you know that I am much more grateful than I can possibly express for all you have done for the last very strenuous five years. The loyalty and devotion to duty of the retired Matrons of the Q.A.I.M.N.S. who so readily returned to do their bit as soon as we were involved in this War will never be forgotten.

     There were, of course, thousands of other trained members of the British military nursing services, but few with such a long and impressive history as Elizabeth Ann Dowse. I cannot tell whether, as Vera Brittain inferred, she was unimaginative, unintelligent and insensitive, though I suspect she was none of those. What I am quite sure of is which of the two women I would trust in life, especially in a sticky situation, and which of the two I would choose to meet with and talk to today.

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Testament of Youth; Vera Brittain; first published by Victor Gollancz Ltd., 1933 and in many later editions

From Small Acorns Mighty Oaks Grow

Gertrude Madley in France, 1919

     Gertrude Madley was born in Wales in December 1892, living most of her early life in Llanelli.  Her story shows the changes that were taking place in recruitment to the military nursing services by the middle of the war.  When Queen Alexandra's Imperial Military Nursing Service was formed in 1902 applicants had to be well-educated, of high social status, and trained in one of a small, select group of prestigious hospitals. As the war progressed and increasing numbers of nurses were needed for military hospitals, the net had to be cast wider to find large numbers of staff nurses and nursing sisters for QAIMNS Reserve.

     The 1911 census shows Gertrude Madley as an eighteen year old, living with her family in Llanelli.  Her father’s occupation was given as ‘tinplate rollerman’ and she herself was working as a factory hand in a tin plate factory.  She was not destined to remain as a factory worker and in 1913 she started a three year nurse training course at Swansea General and Eye Hospital before joining Queen Alexandra's Imperial Military Nursing Service Reserve as a Staff Nurse in September 1916.  At just twenty-three years of age she was one of the youngest nurses to serve with the Reserve during the Great War, the age limit of twenty-five having been lowered as the shortage of trained nurses was so great.  She initially served in Malta before going to France in 1918, and was finally demobilised in May 1920.  Her report from No.35 General hospital, dated 30 April 1920 reads:

Staff Nurse Madley served with this unit from 15.6.19 to the present date leaving on demobilisation.  Her general professional ability, power of administration and initiative is quite up to the standard of her rank.  Good tempered, tactful, always obliging and helpful. Devoted to her patients.  Her influence generally is all for good.  Nurse Madley has had charge of a surgical ward and has fulfilled her duties of Sister in a most satisfactory manner.

     Gertrude Madley never married and during the Second World War worked as a Chief Nurse with the American Red Cross at the Harvard Field Hospital Unit, Salisbury. An article written by her can be found here:

My Assignment as a Red Cross Nurse

     It seems almost impossible that this could be the same person as the shy young woman in the photo above, and after her demobilisation she must have spent many years in the USA between the wars. However, the General Nursing Council Register for 1942 confirms both her training in Swansea and her appointment with the American Red Cross, so certainly one and the same.  There are many other references to Gertrude Madley on the web and she appears to have become a prominent 'American' nurse of the time. She died in April 1990 at the age of ninety-seven.  What a great example of a young woman from a humble, working-class background who forged an independent and inspiring life as a professional nurse.

The Mobilisation of Maud Hopton

Maud Hopton was born in Aberystwyth in November 1871 and trained as a nurse at Charing Cross Hospital between 1902 and 1905. At the outbreak of the Great War she was a nursing sister at the same hospital, and was mobilised on 5th August 1914 as part of the Civil Hospital Reserve. She went overseas with No.2 General Hospital, arriving in Le Havre on the 15th August 1914. Although her initial appointment was to No.2 General Hospital, over the course of the war she served with many different units. She was an efficient and capable nurse. Towards the end of 1918 she was a candidate for the post of Matron at Charing Cross Hospital and although in the event she was not appointed, a testimonial sent at that time by Matron-in-Chief Maud McCarthy showed how valued she was:

'Miss Hopton mobilised with No.2 General Hospital, and has been a most valuable worker. She is a gentlewoman, with very pleasing manners, and has been thoroughly trained and is a most capable administrator. She has taken charge duties both at the Front and the Base with success, and has recently been Matron of the large Sisters' Hospital at Etaples which she managed in a most satisfactory manner, her staff being composed of V.A.D. workers with the assistance of some French servants. She is capable not only of working happily with everyone with whom she comes in contact, but also of getting the very best out of them. She will be a very great loss to the Nursing service in France.'

She was demobilised in October 1919 and took a post as Matron of a nursing home in the South of France at L’Hermitage, Mentone, where she remained for many years until her retirement in the late 1920s.  In 1919 she wrote an account of her early days in France which gives a fascinating glimpse into conditions at that time.  She was in her mid-forties and had worked in one of the UK’s most prestigious teaching hospitals for many years and it’s amazing to consider how adaptable nurses needed to be, putting their normal, everyday lives behind them and coping with the difficulties of active service with such flexibility and enthusiasm.

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An ambulance train waits at the Gare Maritime, Le Havre, underneath the buildings of No.2 General Hospital

     After nearly five years of work in France it is really wonderful how clearly one remembers every detail of the first few months at a Base Hospital in 1914.  There was no other time afterwards quite like it.  Nothing could equal that first enthusiasm and thirst for work. I came out with No. 2 General Hospital.  We were honoured as we had Sir Douglas Haig and his staff, and Dame Maude McCarthy on the same boat. We had to wait a few days before four buildings were taken in various parts of the town to form the hospital.  During that time we were consumed with impatience as we were firmly convinced that the war would end before we could start work.  I was detailed for duty at the Gare Maritime on the Quai d’Escale.  The building was wonderfully adapted for a hospital, the large first class waiting hall where it was easy to find room for 120 beds, the Douane [Customs Hall] with the tables for luggage that we found most convenient for dressings. The third class waiting hall was as roomy as the first class, and many smaller rooms which we used as Theatre, X-ray room and officers’ wards.

No.2 General Hospital, Havre; the Douane or Customs Hall as a ward

     A wide balcony ran the whole length of the building, open in front with a beautiful view over the harbour. Here, on the balcony, in the early days of the war, nine of us slept.  It was glorious on fine nights, but I can remember when a gale was blowing, and the rain coming down in torrents, exciting chases after my ground sheet in night attire.  Getting up in the morning too was fraught with difficulty.  We seemed to be objects of great interest to the mariners on the boats in the harbour and you had to choose the best moment to spring up from your bed and dive through the window into the waiting room where the others slept and we all dressed. The intense interest taken in us by the sailors on an American Man-of-War made it apparent to the authorities, to our great regret, that it would be better to board us in, and we lost our beautiful view over the harbour.

It was very hot weather when we first started work at the Gare.  The building was singularly dirty.  Belgian refugees in large numbers had recently passed through, and for several days we all scrubbed hard at the paint and every part of the building we could reach, while the beds and the most essential parts of the Hospital equipment were being unpacked.  We had hardly got the beds made up and some dressings cut up, when we were told that in a few hours the first convoy of wounded would arrive.  What a lot of necessary preparation we crowded into those few hours. The theatre was arranged and made ready for operations; every Sister had provided herself with a steriliser, dressing trays, lotions etc.  Endless bread and butter was cut up and hot cocoa prepared, and at last we heard the first train steaming into the station underneath us.  It was a very thrilling moment.  It was just a train made up of cattle trucks.   There were no ambulance trains in those days;  I don’t know how many hours those men had spent in the train, but they were grey with hunger and fatigue.  The hot cocoa and bread and butter we had got ready was eagerly disposed of and almost before we had got them into bed they were asleep.  It seemed hard-hearted to wake them up to do their dressings, but it had to be done.

The next morning, I think what impressed us most was their extraordinary cheerfulness. Most of them seemed to regard the experiences as an excellent joke. One man, badly wounded through the leg, told me roaring with laughter, how he came by his wound. He said the Germans had surprised them resting, just as they halted for tea, and most of his Company had been taken prisoners, but he and a few others had escaped by running down a ditch.  After having run some distance, they were feeling so pleased with themselves for having escaped that one of them produced a mouth organ, and the rest of them danced a Highland fling, and just as they were dancing he said ‘bless me, if the beggars weren't at us again and copped me in the leg’.  We had a busy day; there were so many operations, but I think our efforts with soap and water were as much appreciated by the men as anything else we did for them.  Not that day, but the next, the hospital ship came in and took them away, cheering as they went and shouting ‘we will soon be back to have another go at them’.

The days that followed were very busy ones.  Train after train brought down fresh convoys of wounded, day and night  and after a time we did not even try to go to bed but just lay down for a sleep when we could.  The hospitals at Amiens and Rouen had closed down and retreated and we knew it would be our turn next.  It became very difficult to find room for the patients as often, before we could get a hospital ship, fresh convoys poured in on us.  The smaller hospital ships in those days carried comparatively few patients.  I can remember one day our CO who had marvellously arranged the accommodation up to then, but felt he was getting to the end of his resources, sent out an urgent SOS for a hospital ship, hoping to get one of the larger ones.  The little St. David steamed in and great was his disgust.  I saw his stamping up the stairs, muttering to himself ‘I sent for a hospital ship and they have sent me a damned canoe!’

Our turn to close came all too soon, and we had a luxurious voyage on the ‘Asturias’ down to St. Nazaire.  We were sent to await orders at La Boule, a really beautiful seaside place where, in spite of our great impatience to be at work again, we spent ten very restful enjoyable days.  Then came a long train journey and we found ourselves back at Le Havre, at the Gare once more. I think we arrived about 4a.m. and started straight away putting up beds and getting the wards ready for a convoy which was expected almost at once.  How glad we were to be back and at work again.  This time everything was unpacked, all the equipment, and the hospital was soon running in such an orderly methodical way that it was hard to realise that it had only started a few weeks and was just an ordinary railway station turned into a hospital.

No.2 General Hospital, Havre; the large waiting-room as a ward

It was perhaps more wonderful how the Nursing Staff adapted themselves to the work and to each other.  We had rather limited accommodation; the first-class waiting room was boarded and curtained to form cubicles, and the balcony, now boarded in, was divided in the same way.  We had a small mess room, so we were rather at close quarters and thrown much together off duty, and yet the whole feeling was one of good humoured, good-natured camaraderie and we all liked each other.  Even a certain lady who in peace time had apparently accustomed herself to eating a little, and often through the night, kept us awake, scratching in paper bags for nourishment, only afforded us amusement, and never annoyed us.

     At the time I knew, and since am absolutely convinced, that, for the well-being of the Nursing Staff, the thing that matters is the Matron.  We had a wonderful one, and it was her personality, enthusiasm and humour (how well I remember her humour, she is the wittiest person I have met) that kept us all going and at concert pitch. You cannot make a Matron, she must be born one.  We were a small staff at the Gare to start with, and when convoys came to us at night, we all got up to help, and when the work in our own ward was finished, we never thought of going back to bed until we had helped where anyone needed us; and what a difference it made!  The one who was always most ready to help us in any way with anything was the Matron, and the men loved her to do things for them; she was so wonderfully sympathetic.  I learnt many things from her and am grateful.

     The work grew and developed.  Huts were built, and an enteric block opened.  It became necessary to have more staff at the Gare and they built us quarters and bathrooms, but I doubt if we were ever happier than in the early days, when we never thought of what there was not, but were quite content with what there was.  It was rather a sad day when I got orders to go elsewhere, I have loved in turn all the work I have been sent to do in France, but I only felt homesick once and that was when I left the Gare.

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Images above courtesy of the Imperial War Museum Collections, Ministry of Information First World War Official Collection, under the licence for non-commercial use