The Dead Nurses' Society

     The men and women who died on military service during the First World War are invariably  the group who attract the most publicity, most column space in newspapers and by far the most mentions on the web. Maybe that's understandable, not only because of the emotions that death during wartime arouses in people, but also because they are so much easier to research. Their names are on war memorials nationwide and the majority of those names are listed on the database of the Commonwealth War Graves Commission. With a couple of clicks it's possible to find relatives or local men and women who died while serving their country between 1914 and 1921. Their names truly 'Liveth for Evermore'.

     However, most of those who served their country didn't die but returned home again to take up employment, to marry and to prosper, or possibly to suffer from the effects of war throughout their lives, blighting their happiness. The majority of women were employed on the Home Front and although their work might have been demanding and stressful it rarely put them in immediate danger, though I must exclude munition workers here who often worked under dangerous conditions and who history has chosen to sideline more than any other group of women. The figures I'm using as examples are just a rough estimate but hopefully serve to make a point.

     Between 22,000 and 24,000 trained nurses served with Queen Alexandra's Imperial Military Nursing Service, it's Reserve and the Territorial Force Nursing Service. The lack of service records in the public domain makes an exact figure impossible to estimate. The number of untrained nurses - members of Voluntary Aid Detachments -  is even more difficult to work out. They included not only VADs who performed nursing duties but also General Service VADs who from 1917 worked as drivers, orderlies, waitresses, clerks, typists, and store-women in military hospitals. Then there were the members of War Hospital Supply Depots whose work involved the sewing of garments, the preparation of dressings and packing of stores and comforts for distribution both at home and abroad. Together the Red Cross workers are likely to have totalled well in excess of 100,000.  If you include nurses working in the military wards of civil hospitals the total figure for nursing staff engaged in caring for military personnel during wartime is likely to have totalled more than 150,000. In addition to these it's believed that nearly a million women were working in engineering and munitions.

     Of this multitude of women workers, only a tiny percentage died during wartime, less than 1% of the total - and of those, very few deaths actually resulted from war service. Most died due to illness or disease that would have proved fatal in any conditions, such as influenza, pneumonia, diabetes, gastric ulcers and cancers of many types. Dead women are now 'celebrated' on websites such as Facebook where many pages are dedicated to women who served during the First World War.  But far from remembering them all, these pages are frequently crammed with information solely on those who died and resulting in bland, throwaway comments such as 'RIP,' and of course, 'We will remember them.' No, I don't think you will - another couple of days and you'll have trouble remembering what you ate yesterday and certainly not the names or causes of death of women whose pictures you briefly looked at. Photos of headstones on Twitter may tell us a woman died, but say nothing about the work she did and what her life was like.

Victory Parade, London, July 1919.  They lived!  They lived!

     Why, why, why can't we celebrate what nurses DID during the war without this mawkish tendency to concentrate almost exclusively on the tiny percentage who died?  After all, they're all dead now, and  deserve the same respect and remembrance. Make nurses famous for their deeds, their endeavour and their dedication, not just famous for dying.

A Question of Equality?

Two Canadian Nurses [Imperial War Museum Q30392]

     Right at the start I have to say that I admire the work done by Canadian military nurses during the First World War - every pair of hands was sorely needed. My problem is with the way their working lives have been interpreted and reported in recent years, in particular the comparisons made between nurses of the Canadian Army Medical Corps and British nurses of Queen Alexandra’s Imperial Military Nursing Service and the Territorial Force Nursing Service. I've been aware for years that many Canadian reports, while understandably desperate to promote the virtues of their own nurses are, at the same time, lacking in knowledge of the British military nursing services that they seem so keen to misrepresent. This week I was sent a link to this recent article:

Women in North Bay's Great War

Although it’s brief and contains no references or sources, it repeats a frequently-out-of-the-mouths-of-Canadians passage:

In July 1917, Marian applied for (and was granted) a transfer to the Canadian Army Military Corp, as a lieutenant. Most Canadian nurses applied for transfer since, in the Canadian Army, the nurses were given the rank, pay and privileges of an officer.

‘Rank, pay and privileges of an officer.’ These are the things often held up as elevating the Canadian nurse above the British during the Great War, but they fail to accurately reflect the situation as it existed at the time. Canadian military nurses had been active for a many decades prior to the Great War, but only in tiny numbers - a few here, a few there. In 1914 there were just five regular members of the Canadian Army Nursing Corps. That must be compared with Queen Alexandra’s Imperial Military Nursing Service, formed and firmly established in the mid-19th century and which in 1914 had 300 regular members serving throughout the world in permanent, pensionable posts and who formed an elite nursing service of mature well-educated, well-trained women working under contract to the War Office. From the earliest days they had officer status even if they lacked military rank. Few British 'gentlewomen' of the time would have welcomed military rank - they knew their place and didn't yearn to be soldiers. Their place was assured, and everybody respected that.  The Library and Archive of Canada states that:

… only the Canadian nurses were under the direct control of the army and held a military rank. In comparison, the British nursing services were affiliated with the army, but not integrated into it. The higher status accorded to the nursing profession in Canada than in Great Britain may explain, at least in part, this breach of tradition by the Canadian military authorities. Most Canadian nurses with diplomas had gone to high school, and in Canada, training in a nursing school was seen as a sign of prestige.[1]

What does ‘affiliated with the army, but not integrated into it’ mean? During the Great War more than 22,000 British trained nurses served under contract to the War Office. In what way did the military rank afforded Canadian nurses make their position different from their British counterparts? And the reference to the 'higher status' of nurses in Canada is also puzzling - a turn of phrase that might be difficult to prove. The same website goes on to explain that:

... their [Canadian Nurses] authority as officers was limited to the functions that they executed in the hospitals. They had no decision making power at the military level, unlike medical officers. In addition, although they were lieutenants, they were known simply as "nursing sisters," a title reminiscent of the religious vocation with which caregiving tasks were often associated. [1]

That sounds remarkably similar to every other trained military nurse, and of course, it was. Whatever the Canadians thought was the correct title for their nurses, the fact remains that their status, work, responsibility and accountability was identical to their counterparts in the British, Australian, South African and New Zealand nursing services, all of whom were considered to have officer status. Even the Canadian Gazette made a distinction when announcing appointments - the male officers given as ‘To be Captain’ or ‘To be Lieutenant’ while the women were ‘To be Nursing Sisters.’

     There were differences.  Canadian nurses received higher pay; as a group they were younger than their British colleagues and their length of service was often short, many serving one-year contracts before returning to Canada. Canadian sources suggest that the average age for their own members was twenty-four and I assume this was their age on enlistment. The British were a good deal older and a random sample of 500 nurses from my own database give an average age in 1916 of thirty-four years. So the British were a considerably older group and most would have been trained longer as nurses and acquired a far greater depth of experience. I have rarely read any personal account or memoir by a British nurse which suggests any ill-feeling or tension existing between them and the Canadian nursing sisters, and it might be something which was perceived only by the latter, but it has worked its way into Canadian history:

More tense, it seems, were the relations between Canadian and foreign* nurses, particularly the British ones. These tensions were due to the more advantageous conditions that Canadian nurses enjoyed. Their higher salaries, more distinctive uniforms, and apparent popularity with the officers seem to have inspired jealousy among their foreign colleagues. However, the greatest source of frustration with regard to the Canadian nurses had to do with their military rank. Indeed, their officer status gave them greater freedom of movement and a higher level of prestige, two elements that their foreign counterparts did not enjoy. The rules of the Canadian and British armies required that officers, female or male, communicate only with their peers unless they were in civilian clothing, so the British military nurses, without a military rank, could not spend time with their own officers or with those of the CAF if they were in uniform. On the other hand, the Canadian military nurses could spend time only with other officers because of their rank as lieutenants. It is thus understandable that the British nurses perceived the arrival of the Canadians with some apprehension. What is more, the Canadians' rapidly acquired reputation for compassion, gentleness, and hospitality made them formidable rivals. [1]

*Foreign here appears to refer not only to the British but also to the other Dominion nurses from Australia, New Zealand, and South Africa and a strange and inappropriate word to use in this context.

The paragraph above is truly confused waffle.  Who does the writer think the British nursing sisters' peers were? They had always had officer status from the earliest days. I often wonder how it was that so many British nurses married officers if they were barred from all contact – but yet another myth of course.

     It’s only right that Canada should be proud of its nurses and their work in the Great War, but there's no place for sloppy and incorrect reporting relating to British and other ‘foreign’ nurses. Canadian accounts should take care not to denigrate and demean British nurses who were easily the equal of their own and in most cases were more experienced and with a longer period of war service. Do your research Canada – find out about the history of the nursing services you seem so happy to belittle, and provide some solid and reputable sources.  Queen Alexandra’s Imperial Military Nursing Service was long-established, elite and confident in itself. It’s members were educated, well-trained women with a wealth of experience both in nursing and life in general.

Lucy Liptrot, a QAIMNS Reserve Staff Nurse

     The last word must go to Mabel Clint a Canadian nurse who served France during the First World War and who in my opinion got it exactly right:

Next to us in the fields was an English Stationary Hospital, and as Harold Begbie had some months before criticized our uniform very severely, and gratuitously assumed we would not be worth much professionally, I'm afraid the English Sisters looked upon us at first with some prejudice. Discipline and routine were carried out by them exactly the same as in the barrack military hospitals, and it did seem that some of the "Regulars", trained with a certain rigidity, perhaps failed to allow for front-line conditions, the immense mental strain, and the fact that the Territorials, and afterwards "Kitchener's Army" were different material, and not accustomed to strict regulation of their actions. If ever the "human touch" was needed, it was in the Great War. We allowed our patients more liberty, but our wards looked less orderly. We often heard men comparing systems, and sometimes had several guests at tea-time crawling under the ropes, because our Sisters were accustomed to supplement the rations with fruit, eggs, or other extras. For steady, efficient service however, sacrifice of personal comfort, ability to work without recreation, the English personnel could not be surpassed. Many of their Matrons, as someone said were "Personalities" in their own right. They had a great deal of authority, and the Sisters also completely controlled their wards, subject only to the Medical Officer. We had the military rank, and they the real, established position. Personally, I met many at home and abroad, and fraternized with them equally as with Dominion Sisters, and I think they remember us with kindness. [2]

     A clear and astute summing up and yes, you may have had the military rank Canada, but ‘the real, established position’ was ours.  There were undoubtedly differences between individual nurses but all the allied nations provided the same high-class nursing service over the course of a long and difficult war. We must celebrate the art of nursing and all that was done during the hardest of times without looking for problems which were really very unimportant.

***

For a fuller article on the women who made up Queen Alexandra's Imperial Military Nursing Service see:

A Suitable Woman for the Job

[1]  Library and Archives Canada: Caregiving on the Front: The Experience of Canadian Military Nurses during World War 1.

[2]  Our Bit: Memories of War Service, Mabel B. Clint

Nurses and Bravery - two years on

Two years ago I wrote about nurses being regarded as 'brave' for their work during wartime and suggested that they were many other things above 'brave.'  Since then, with the coming of the Centenary of the First World War, a great deal more has been written about nurses, mainly untrained VADs, and the concept that nurses were angels and heroines has become a strong thread running through their stories in books, the popular press and on television.  So two years on I'm taking the liberty of repeating my thoughts of August 2013 on what motivated nurses to engage with the war and where bravery stood on their list of attributes. 

***

     I've always had quite strong views on Great War nurses being described as angels and heroines, and the assertion that they were all  'brave.'  So I was interested in a thread on Twitter which went as follows:

Tweeter A.  Army Nurse Corps took hot water bottles to bed with them then made tea with that hot water next morning!
Tweeter B.  Some WW stories would be amazing to collate a brave history that we are loosing [sic] day by day
Tweeter C.  Perhaps bravery comes behind professionalism, stoicism, determination and skill
Tweeter A.  Bravery, the right choice under terrible circumstances, against all odds.

     Obviously A. felt that brave was the best word to describe these military nurses but it made me think again about war, nurses, and bravery. The early 20th century was a time when British nurses were fighting to have their qualifications officially recognised through a process of registration, to ensure that poorly trained and inexperienced women could no longer pass themselves off as fully-trained nurses. Many of them relished the chance that war gave them - to know that they would at last have a platform to show off their skills in a public and wide-ranging manner - the eyes of the nation and the wider world were on them as they were released from the anonymity of their peacetime role.

     I doubt if they were thinking about being brave when they first put on their new uniform and entered the doors of a military hospital. More likely they were thinking about being tested in a strange environment; about what skills they would need; how this new experience would give them an advantage in years to come as they climbed the nursing ladder. They must have wondered who would be working alongside them? Would there be any familiar faces from their training days? Would their pay and conditions be comparable to what they were already getting and would Army discipline defeat them? And when a few months later they added their names to the list of those wishing to go on active service overseas, did they do it because they were brave? I suggest that most of them were desperate to get nearer the action; to feel closer to their brothers, fathers and friends who were already abroad; to grasp the opportunity to visit places and see things they had never contemplated before. Nursing in France had an urgency and importance about it which was lacking in home hospitals - it made them special. And they wanted to be seen as special.

     They knew how hard the work could be - the rushes, the pushes, the pauses; the long hours and early mornings; the boring patches and the restrictions.  They knew that if they asked to be considered for duty nearer the front, at a casualty clearing station, they were nearer the guns, nearer danger, nearer the most badly wounded men. Did they go because they wanted to be brave?  My view is they went because they wanted to make a difference, and to be seen as making a difference.

     One of the few nurses who died as a result of enemy action is universally described as 'brave.'  Nellie Spindler died in her bed, while sleeping, the result of a shrapnel wound during an enemy bombing raid on her casualty clearing station. Can 'brave' be the best word to describe her? Unlucky, certainly, but hardly brave.

     There were nurses of all sorts, good, indifferent, and some very bad - bad behaviour, poor nursing skills, lack of tact, no sense of discipline. They were not all heroines, and of course, none of them were angels. Angels don't actually exist and trained nurses are very much of the real world. While there were undoubtedly individual acts of bravery by nurses during the war, it was not the lot of the majority. When they were in dangerous and difficult situations, being bombed or shelled or retreating with the enemy at their heels, they relied on their long experience, their skill, their confidence, determination, dedication and fortitude, and on an instant learnt response to emergencies. I would still say that all these came before bravery.

Ministering Angels - A History of Nursing from the Crimea to the Blitz

     A new edition of Stella Bingham's 1979 book 'Ministering Angels' has just been released by Dean Street Press in e-book format.  It covers the history of nursing from its early beginnings through to the 1970s and brings together most of the important advances within the British nursing profession during that time. It's an informative and well-written account ranging over four major wars, and presents the facts clearly and in depth without relying on a mass of over-sentimentalised or dramatic quotes. The nursing services of the First World War are in fashion at present and this book places them in the context of what came before and after, thus giving a fuller and more rounded view. Although it lacks the photographs which appear in the original, this e-book version is a welcome addition and makes it easily available to a new and modern audience.

Cover of original 1979 edition

Ministering Angels, Stella Bingham

Dean Street Press, May 2015

ISBN: 978 1 910570 13 5
For Kindle, Kobo, Nook, iPad and GooglePlay

*****

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.

*****

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.

*****

     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

*****

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.

*****

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.

*****

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.

*****

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.

*****

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

The VAD - For Better or for Worse

VADs at Royal Naval Hospital, Chatham [IWM Q18925]

 

     The centenary of the start of the Great War has brought with it many projects associated with hospitals active throughout the United Kingdom at that time providing care for sick and wounded soldiers. Almost all of these centre on the small auxiliary hospitals which were opened and run under the auspices of the Joint War Committee of the British Red Cross Society and Order of St. John.  In the main these hospitals were staffed by members of Voluntary Aid Detachments (VADs) the majority untrained or partly trained nursing assistants who had little pre-war experience of having to work outside the home and a minimal, if any, background in nursing.  They were supported by other volunteers who helped with housekeeping duties and by male orderlies who provided ambulance and other transport services and night staff for the hospitals.

     The VAD has become the Florence Nightingale of the Great War; all things to all men, beautiful, caring, patriotic and devoted to the cause of healing. I'm trying to think whether I've ever seen mention of one who was plain, unintelligent, lacking in common sense, rude, disrespectful or just plain hopeless.  Actually I have, mainly in reports on their work and behaviour by trained military nurses, but to cast a slur on this icon of womanhood might not go down too well ... well, just one little mention maybe ...  In a report on a VAD from the Matron of No.1 Southern General Hospital, Birmingham, under 'Nursing Capabilities' is written:

Have seen no evidence of any.  She is lazy, very noisy, and has very little idea of discipline.  Talks a great deal. 

     Needless to say, her contract was not renewed. But this type of comment is not uncommon among the VAD service files which still survive at The National Archives. My point is that it's neither accurate nor productive to constantly paint VADs as perfect women. They were not. They were young women from a variety of backgrounds and life experience and with very differing personalities. Most had no nursing experience, nor would they have ever considered nurse training in peacetime.  Only a very tiny number went on to train as nurses after the war, with those that had to earn a living finding employment they considered more suitable to their social station, such as medicine, teaching, public health and social work, and infant welfare. Marriage became by far the most popular post-war occupation.

     The VAD was essential to the running of the nursing services during wartime; she had her place; she did her best though it must be faced that in some instances that was not quite good enough.  She was not the universal panacea that cured all men and all ills. She simply played her part alongside the tens of thousands of experienced doctors and fully-trained nurses, the administrative staff, the clerks and secretaries, male ambulance workers, orderlies and many more. Maybe during the next four years she deserves a little bit less of the limelight and should move over a pace or two to let some of the others stand in the spotlight.

Unknown Warriors

     When Diary of a Nursing Sister on the Western Front* was published by William Blackwood in 1915, the author, Kate (Evelyn) Luard, had to remain anonymous.  As a member of Queen Alexandra’s Imperial Military Nursing Service Reserve it was not acceptable for her to comment publicly on her work with the British Expeditionary Force in France. As a result, the book shed its copyright restraints some time ago, allowing thousands of readers to enjoy one of the few accurate accounts of the work of a trained military nurse during the Great War.  In 1930 Kate Luard published her second book, Unknown Warriors, under her own name, picking up where she left off in 1915 and completing her wartime story.  That book only appeared in one edition and over time has become a rare entity, difficult to track down and increasingly costly to buy.  In this Great War Centenary year, members of the author’s family decided to take up the challenge and re-publish Unknown Warriors and by doing so bring joy to many people who have so far been denied the pleasure of this further account.

     The typesetting of the new edition matches the original and gives it an old-fashioned authenticity, but there are also many additions which offer extra detail and information. A new introduction by Professor Christine Hallett and Tim Luard explains the background to the author’s personal and working life and also to her family connections in Essex. An index and bibliography have been added together with photographs and a glossary of terms which may otherwise be unfamiliar to readers.

     The book is composed of letters sent by Kate Luard to her family in Essex, recounting her life and experiences during wartime on the Western Front. She was an exemplary nurse, admired and appreciated by her colleagues and with the resilience to cope with everything that war threw up. Although there are now a number of diaries and accounts available written by the untrained nurse – the ‘VAD’ – those of trained military nurses are rare and must be valued. This book describes in plain terms the difficulties of both nurses and patients, the desperate conditions, and also the periods of rest and pleasure. Much of her wartime service was in Casualty Clearing Stations including the Advanced Abdominal Centre (No.32 CCS) at Brandhoek during the Third Battle of Ypres in 1917, working in both the busiest and most dangerous conditions that a nurse could encounter.  Her words are never exaggerated or overblown, nor do they underplay the personal and professional difficulties that she faced. It is perhaps one of the very best examples among First World War nursing  accounts of ‘How it  really was.’

     The final ‘Postscript’ chapter is a wonderful extra and includes previously unpublished letters both from the author to family members and also from her close relatives in reply which provide a keen insight into how the war was viewed in rural England. On one occasion her brother Percy wrote, ‘Your letters continue to be thrilling …’ and suggests they would make an excellent book, and later, ‘Your letters are absolutely IT … and they fill me with awe and wonder and admiration and joy …’.

I have to agree with him!

*****

Unknown Warriors: The Letters of Kate Luard, RRC and Bar, Nursing Sister in France 1914-1918
Caroline and John Stevens (Editors)
The History Press, August 2014
ISBN-10: 0750959223
ISBN-13: 978-0750959223

*Diary of a Nursing Sister on the Western Front 1914-1915
If you've never read it, then probably a good idea to start at the beginning with this first book, available in many inexpensive printed editions and also as a free download on the web via the link.

Women Heroes of World War One

WOMEN HEROES OF WORLD WAR 1

Sixteen Remarkable Resisters, Soldiers, Spies, and Medics

Kathryn J. Atwood

     I found a lot to interest me in this book.  Although intended for the 'young adult' market, I think that description does it a disservice.  With the centenary of the Great War prominent in the United Kingdom and other parts of Europe there is increasing interest in the period among ordinary people, previously neither historically nor academically inclined.  Kathryn Atwood's well researched book gives a factual and straightforward account of sixteen women whose names are unknown to most, written in a relaxed style and uncomplicated language.

     Divided into 'bite-sized' pieces, it can read as a whole or dipped into for information on a particular individual or area. The choice of subjects is wide-ranging and covers spies, resisters, medical staff, journalists and soldiers.  Although many names will be unfamiliar, the stories are compelling and there is a great deal to be learnt about the enormous scope of women’s work during wartime, elsewhere usually confined to a handful of high profile women, organisations and services.   Background information, extra notes and suggestions for further reading are included with each chapter, making it simple to find out more about areas of personal interest.

     The stories act as a reminder to the island nation which is the United Kingdom of how lucky we are not to have suffered enemy invasion during the twentieth century, and how easily our own women could have been in a similar position to the spies and resisters of France and Belgium. Much emphasis has been laid on Edith Cavell in the past but this book makes it clear that many more women were also involved in patriotic espionage and suffered a similar fate.  I would definitely recommend the book as suitable for both young and old alike.


Publisher: Chicago Review Press, 2014
ISBN-10: 1613746865
ISBN-13: 978-1613746868

Back to Blighty, but Which Hospital?

I often get asked how and why an individual man ended up in hospital many miles from home rather than a local unit, and here are a few reasons and pointers, though certainly not the complete picture

*****

     It's highly unlikely that any decisions were made overseas about a patient's destination once back in the United Kingdom except perhaps for a few senior officers, nurses and other women who had special accommodation set aside in London.

     The port of departure, and thus arrival in the UK, would depend on the position of the overseas Base Hospital, which in itself may have been a random choice initially. As the war progressed, specialist units were set up to treat various classes of illness and wounds, and that would have been a deciding factor in the fate of some men on arrival. There was also an enormous concentration of beds in London, Manchester and Birmingham and the chances of being treated in one of those areas was high. There was always a likelihood that men from London or Manchester would end up near home, just by chance.

     Although I have read accounts of men being purposely sent away from home to prevent hospitals being over-run with visitors, it seems that this was never the intention. By September 1914 there were three main aims when men arrived back wounded in the UK – to give priority to those most seriously injured, to clear beds in the largest hospitals as quickly as possible to make room for new arrivals and to ensure that the men were transferred between medical facilities as few times as possible.

     For men disembarking at Southampton, the most serious cases were transferred to the Royal Victoria Hospital, Netley and the Southampton War Hospital, the latter soon earning the reputation of being one of the busiest and 'heaviest' hospitals in the country. From Dover, the sickest men were found accommodation in London. Men needing specialist treatment were separated out and given some priority to admit them to a unit which suited their needs. Lightly wounded men and the walking wounded were often the ones chosen to do the longest journeys and therefore more likely to end up in cities such as Plymouth or Aberdeen.

     Apart from the worst cases the men would be found a place on the next available train whatever its destination – there seemed to be little question of a Highlander turning down the 16.00 to Waterloo because he’d rather wait for the 19.30 to Glasgow. Because men were often wounded in large actions it follows that men of the same regiment would frequently be wounded, treated and evacuated together, and find their way back to England if not ‘en masse’ then certainly in tens, dozens and scores. So it was not surprising that, for instance, fifty Scots ended up in No. 2 Eastern General Hospital at Brighton and fifty Royal Sussex men in Manchester – often it was just the luck of the draw.

     As the war progressed the pressure on beds became more severe and it was even more difficult to find accommodation than previously. However, as there were more trains there may have been several waiting at Southampton and Dover at any one time and always the chance of different outcomes, but it’s said that even the men themselves were often reluctant to make a decision about destination.  Where was nearer, where was more exciting, where were their friends going; where would the soldier from Cornwall choose when he was in the West Yorkshire Regiment and most of his friends were going north? The vast majority of officer beds in the UK were in London, so an officer was very likely to be accommodated there, at least initially, wherever his home was. As the war progressed there were other important decisions to be made about special categories of patient.

     Before the ‘average’ man could be moved, account had to be taken of mental patients, neurological patients, those with venereal disease, enteric fever and dysentery, serious orthopaedic cases, cardiac and rheumatic conditions, eye and facial injuries - an ever lengthening list.  Canadians, Australians, New Zealanders and South Africans also had to be filtered off to their own hospitals and the movement of patients soon became a very intricate and complicated process which didn't always allow a free choice of destination. Where this was impossible, facilities were put in place for seriously ill men who were going to be in hospital for a long time to be moved nearer home when their condition was stable. If a man was expected to be in hospital for more than three months there was a high chance that arrangements would be made for him to be transferred to a hospital in his home area – these transfers were often long-distance, and carried out by fitting extra patients into existing ambulance train journeys.

     Throughout the war the pressure on beds was always enormous and all Home Commands were instructed to expand their hospitals to the fullest limit.  Of course this ‘fullest limit’ was never enough, and the number of beds was still increasing in October 1918. The expansion of the auxiliary hospitals and convalescent homes meant that most soldiers would eventually be transferred out of the main hospital, and this was most likely to be to a facility affiliated to that hospital, and therefore in the same locality.  Initially he bed state nationally was being updated weekly and later on twice weekly but as the situation became critical it was done on a daily basis. At time of the Armistice available beds nationwide stood at approx 364,133 and included 18,378 for officers. Between autumn of 1917 and beginning of 1918 the usual daily occupancy was 317,000.

I'm sure there must have been many a bright young ‘walking wounded’ who, seeing more than one train drawn up in front of him, found some way of making a choice but it was really a question throughout of squeezing casualties in anywhere that had enough room to take them – choice would have put an impossible burden on a massively overstretched system.

*****

The Blue Plaque Has Finally Arrived

Six years ago I contacted English Heritage to propose a Blue Plaque to commemorate Dame Maud McCarthy, Matron-in-Chief in France and Flanders during the Great War. There are so few public tributes to women who served during that period and the trained nurse has fared badly compared to her untrained VAD colleague - anonymity has become her place in history. So by remembering Dame Maud, the Plaque is also a symbol of remembrance for the thousands of nurses of all grades who served under her during her five years in wartime France.

Yesterday was the final step of the journey - the unveiling ceremony at her former home, 47 Markham Square, London, S.W.3, where she lived between 1919 and 1945. As might be expected, all the arrangements were beautifully organised by the Blue Plaques team at English Heritage, and even the weather was smiling. There were a number of speakers and the proceedings started off by Professor Ronald Hutton on behalf of English Heritage. Professor Christine Hallett talked about Dame Maud's professional life and her work during the Great War, and a great-niece, Jennie Newman, related some family memories of a purposeful and unique lady. There was a very strong military presence in Chelsea yesterday evening, with many current day members of Queen Alexandra's Royal Army Nursing Corps and the Territorial Army, the two sister services of which Dame Maud McCarthy was so influential in her time. The Plaque was unveiled by Colonel David Bates, ARRC, the current Director of Army Nursing Services and Matron-in-Chief. When I spoke to him afterwards, we both rolled our eyes at the thought of how Dame Maud would have regarded the prospect of a man ever doing her job - presumably inconceivable in her time.

After the ceremony we were all invited to join the residents of Markham Square at their annual summer gathering, and I must extend grateful thanks to Penelope Russell, who has allowed her home to become subject to a round of upheavals in the long and arduous Plaque process, and also for her hospitality to a raggle-taggle group of guests and visitors - except of course for members of the British Army, who were definitely not 'raggle-taggle'.

Professor Ronald Hutton starts the proceedings

Colonel David Bates before the unveiling

Colonel Bates pulls the string ...

The Photo-Sergeant - didn't look a man to mess with

Thanks from the Chairman of the Markham Square Residents Association

Me and my daughter Hannah with Colonel Bates on her head!

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