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.

After the Crimson Field

7 General Hospital, Malassises, Imperial War Museum

     According to the Economist there have been more than 25,000 books and scholarly articles written about the United Kingdom's part in  the Great War since 1918. I can't vouch for the figure, but it seems perfectly plausible to me. Most relate to the soldiers' story, to strategy and tactics, to organisation and administration and every detail of life in various armies during the conflict. If you need to know how a soldier enlisted, what he was paid, how he was transported, fed, equipped; how he washed and relaxed and 'went over the top' there's plenty of choice on where to find the answer, in official records, books, film, TV and increasingly on the web. If official accounts become a bit dry they can be supplemented by thousands of surviving first-hand accounts and memoirs. There must currently be hundreds of historians and researchers of the Great War who would have no difficulty at all in instantly giving chapter and verse on all aspects of a soldiers' life.

     This is far from the situation in relation to any area of women's service. A relatively tiny number of books have been published on nursing during the Great War and the majority of those are personal accounts in which the facts cannot always be verified or substantiated. In recent years female academics have tried to close the gap a little but however well-researched, the results are often unappealing to the general public and inaccessible due to the high cover prices set for the academic market. These books also appear to turn their back entirely on giving the same grass-roots information about the fine detail of nurses' service which can be so easily found in similar books relating men within a military setting. The result is that to the question 'Can you recommend a good book about nurses' the answer will invariably settle first around Lyn Macdonald's 'Roses of No Man's Land,' Vera Brittain's 'Testament of Youth' and occasionally something else that probably doesn't even relate to a British nurse's experience of war. It seems almost impossible to find the answer to same questions of organisation and administration relating to women's service that are so clearly defined for men.

     The fine detail of military nurses' service during the Great War is largely lost - it's a yawning gap waiting to be filled. In some respects you could fill it with anything and few people would be any the wiser. There would be few opponents to a statement that nurses earned £20 a year, or £50 a year or £200 a year because it's information that's hidden and difficult to find. There would be few opponents to comments that Great War nurses could marry, or maybe couldn't marry, or if they could marry they had to leave - or perhaps they were allowed to stay? And did VADs actually spend their time outside washing bandages or collecting sticks in the woods? Who is there who knows? So when the BBC decided to commission 'The Crimson Field' they had a gap to fill and unfortunately it was a gap that to the viewing public was an 'unknown.' They had the freedom to fill it with whatever they felt was suitable regardless of whether it was historically correct. And by 'historically correct' I don't mean the tiny things like fine details of uniform and kit, but the basic knowledge of what life was like for nurses and doctors and how hospitals worked in France at that time. What's missing from the programme is any deeper understanding of the nurses and hospitals - their foundations are missing and experience and integrity have been removed.

     To those who say 'it's only drama' I'd reply that it's historical drama and has been heralded by the BBC as an important part of their Great War Centenary programming. Because of that it has a duty to be as historically accurate as possible. To those who say that it's no different to believing that 'Holby City' is an accurate portrayal or that crime drama fails to reflect modern policing, I insist that there is an enormous difference. Hospital life and police procedure today are part of our current knowledge. If we watch modern hospital drama we have experience to judge it by, either our own or that of our friends and family. We can dismiss what is unbelievable because we have the personal knowledge of what it's really like. In 'The Crimson Field' the BBC have produced a programme that has filled an existing gap in history that is outside people's experience and they have filled that gap with stories that could not and would not have happened.

     Because of the high regard in which the BBC is held, the programme has made itself historically correct and has set a model for the future. It has given a representation of nurses, doctors and hospitals that will now be followed, honoured and repeated for decades. Mention of the programme is already being used to give credence to many serious centenary projects and books in order to boost visitors or sales regardless of whether it has any relevance or validity.  In my opinion it has set the serious research of nursing in the Great War back to a point where there may be no hope of ever resurrecting it - why bother in the future when it can be wiped out at a stroke and with such ease?

Versailles - The British Hospital, 1914

Following the events of the Boer War where hundreds of wealthy female 'camp followers' invaded British hospitals in attempt to claim some involvement in nursing the sick and wounded, the War Office made every effort to ensure that in any future war strict controls would ensure that only authorised and approved workers were allowed to be employed in British hospitals. I've recently acquired a copy of a book written by Maud Sutton-Pickhard, who seems to have followed in the footsteps of her South African sisters in gaining admittance to places that she should not really have been.  Her sheer nerve and arrogance are a sign that life, particularly for the rich, was rather different a hundred years ago.  Having been refused a job by the American Ambulance in Neuilly on account of her lack of qualifications or experience, she wanders around Paris seeing the sights, and one morning took the train to Versailles 'to see the big English hospital there.' As there are so few accounts of the hospital I guess she should be thanked for writing about her experience.


At Versailles I had an omelette at the little station inn called the " Lion d'Or," and then I went to a tabac  and bought all the French cigarettes I could find as there were no English ones, and some tobacco and cigarette papers. (Horrid cigarettes they are too ! — but the "Tommies" seemed pleased to get them, as smoking is their one solace.)

Walking up the fine avenue called the Boulevard de la Reine, with its noble trees, I came to the magnificent hospital, formerly the Trianon Palace Hotel. It is a truly ideal spot for a hospital, and it is a marvel of English efficiency and organization. I was one living exclamation point of admiration from the moment I entered the gate until I left. The grounds were filled with convalescents in khaki, all looking happy and cheerful. I passed them and went to the front door, where a Red Cross soldier asked me very politely whom I wished to see. I had been asked the same question in the grounds. I said I wished to look over the hospital; so he called the Colonel. The latter was exceedingly courteous, but it was obvious that he was somewhat puzzled at my unexpected arrival. (I seemed to be the only visitor except one old French Sister with a basket of food.) He asked me if I knew any of the officers, if I knew anyone in the hospital. I said I was awfully sorry, but I didn't — that I had just heard about the hospital, and had come up to look it over and take some Kodak pictures.

He said, "You want to take Kodak pictures of the wounded?"
"Of the hospital and grounds — of the whole thing in fact," I replied.
"What do you want to do with the pictures?"
“Oh, send them to my friends to show what a nice place the wounded have over here."

He seemed satisfied, and said, “It is rather unusual, but you don't look like a German spy! "I laughed and got out my passports for him. He examined them, but he still seemed a trifle puzzled. Finally he said he would show me round, and he told me there was going to be a funeral that afternoon, and asked me if I wanted to go to it. We met the old French woman in the hall, and he asked if I knew what she wanted.
I said, "Why, don't you speak French?"
He said, "Not a word."

The interpreter had come forward, but I found out that she just wanted to give the things in her basket to the soldiers in the garden, only she wanted to distribute the stuff herself, and it was against the regulations. The Colonel looked in her basket, and told me to tell her that she could do so to those out of doors but not to those in the wards. Then he shook hands with her, and we wandered through the ground floor ward, while I distributed the cigarettes among the Tommies. The Colonel stopped to give some directions about a wounded man, so I said I would go on upstairs. He told me to knock at any door before I went in, but I preferred to get hold of a Sister, and she took me in to see an officer in the Worcestershire Regiment. I offered my own private cigarettes to the young man, who was evidently pleased to see visitors. The poor boy had been shot in both arms and one leg.  His right arm was paralyzed. But, in spite of this, he was most anxious to get well and return to the Front. I started to go, and he said, " Oh, don't go yet ! " I replied that I feared conversation would tire him, but he said that on the contrary it took his mind off himself. So I sat down on an adjoining bed while he told me the history of his battles and wounds. It was quite thrilling, yet so simply told, with only the barest necessary mention of himself — all about his men, and the Germans and the fighting. He had crossed a branch of the Aisne, by wading, in order to take a farmhouse on the opposite bank ; there he found he was trapped, with the Germans at his back, behind some trees. He had taken sixteen prisoners, but they had surrendered only in order to lead him into a deadlier place in which he was ambuscaded. There was no way out but to hurry back through the fire. He had been the first to cross, so he was the first to discover the trap, and hastily called to his men to get back as quickly as they could. Though wounded in both arms, he managed to get away, but was again hit in the leg at the last moment. He was helped out of danger by some of his men, but it was hours before he could see a doctor. He had to lie on straw and freeze until he could get medical assistance, and finally be moved to a hospital. He told me a lot about the Germans. They are very tricky, but the men only obey orders. One German prisoner told him that he did not know he had been fighting the English!

Fearing to fatigue him by letting him talk too much, I went upstairs and gave the Tommies on the top floor the rest of my cigarettes, helping them to light them, and trying to say some words of comfort. They seemed so pleased to have someone to talk to, and so grateful for the wretched cigarettes. Some had just arrived from the trenches, and they looked most horribly weak and ill. But all of them were so brave and patient and cheerful, although they brought tears to one's eyes when they said how glad they would be to see wife and children again.

I went over the grounds and inspected the tents, which are ideally clean and well arranged. The entire place struck me as the perfection of efficiency and comfort. Before I left I had an opportunity of seeing the funeral. It was a most imposing and solemn sight. When the hearses were drawn up in front of the gates everybody stood, the convalescents, who were sitting on chairs in the sunshine and under the lofty trees, rose and leant against their seats, or else they were helped up and supported by their comrades. There were six men buried, all English soldiers. Hundreds of French people crowded outside the gates, and the great majority of them followed the funeral to the cemetery as a tribute of respect to their brave Allies.

France in Wartime 1914-1915: Maud Sutton-Pickhard: Methuen & Co. Ltd., London, 1915
(and freely available on the web)

My Wish

Is it time for New Year Resolutions yet? Never mind. May I offer up a prayer that at some future time there will be more awareness about military nurses. There seems to be a common misconception that their story starts and ends with Florence Nightingale, Edith Cavell and Vera Brittain, none of whom were military nurses of course. Those three have a lot to answer for!

Downton Abbey - More Tales of the Unexpected

Julian Fellowes was rather upset last year about criticisms pointing out inaccuracies in the first series of Downton Abbey:

"There was also an assumption in the media that the complainant was automatically correct and we were wrong, which was frustrating... When there was a television aerial in shot, as there was once, I was happy to hold my hands up. But I expended a lot of energy getting agitated about accusations that such-and-such piece of music wasn't released until 1922, when in fact it was being played in 1910. Or the butler should have been in uniform when they came out of uniform in the Regency period - I mean, just shut up!"
Fellowes added: "This year I think it might be nice to have a column called 'This Week's Downton Blunders', where I have the right of reply and can say either, 'It's a fair cop' or, 'No, we got it right, they did wear bathing costumes in 1761' or whatever. That might be a much better way of handling all the excitement."

In the absence of such a column, I once again feel the need to comment on one or two of the latest blunders. Now the Abbey itself has opened as a convalescent home for officers there’s no improvement in the sardine-tin formation of the beds, and still no room for lockers or anywhere to keep personal items. Mrs. Crawley seems to be conducting affairs at Downton, and with Major Clarkson and Lady Sybil spending every waking minute there as well, it makes me wonder what’s happening down at Downton village cottage hospital. It was chaos there last week, and with 50% of the staff gone, things must be reaching a critical point. I say 50%, but with Thomas moving down the road as well, more like 75%.

Thomas Barrow. In the first series he was exposed at Downton as a thief. With war on the horizon he decided to jump before he was dismissed and joined the Territorial branch of the Royal Army Medical Corps. This ensured (so he thought) that he would get a cushy number when the wartime chips were down. Somehow he ended up in the thick of the fighting, having a few fags in a trench under constant bombardment. I can’t quite work out what he was actually doing in that trench. Was he attached to a Regimental Aid Post, or attached to a Field Ambulance perhaps? If it was ever explained, I missed it. Apologies. He intentionally exposed himself to sniper fire and after recovering from his self-inflicted injury, and by the miracles of modern television script-writing, he ends up in charge of the convalescent home at Downton Abbey.

Thomas Barrow. Thief, liar, manipulator, coward. Just the man for the job. Well, not exactly, as no UK convalescent home had RAMC staff. There was absolutely no way a RAMC corporal (sorry, Acting-Sergeant) would work in that type of unit or give orders to sick officers. Complete drivel and tosh. There should at least have been a trained nurse, but unfortunately no provision has been made for even one in this series.

The surprise of the week (errors no longer being surprises) came when Lady Mary announced that a friend of the family wanted to come to Downton from Middlesbrough to convalesce, and both Mrs. Crawley and Major Clarkson were up in arms.
‘Middlesbrough General will have their own arrangements about where their officers convalesce’ declared Mrs. C. And Major C. agreed:
‘Downton must function as part of the official system or it can’t function at all.’

So Lord Fellowes KNOWS there was an official system – that rather took my breath away. Is it better to know about something and choose to ignore it, or make errors because you failed to do the research and never knew about it at all? (Vote NOW). And I must just add here (pedant that I am) that there was only one military hospital in Middlesbrough, not the General Hospital, and no officer beds in the town at all.

However I did notice one bit of light flickering in the drawing-room when the near-exploding Carson exclaimed:
‘So we just make it up as we go along?’
Spot on, Carson.

Downton Abbey - Hospital or Bedlam?

I was a keen follower of the first series of Downton Abbey. As someone from a working-class background I’ve never been too keen on toffs, but I’ve been persuaded over the past few years that as a researcher of Great War nurses, a basic knowledge of upper-class whims, desires and inter-marrying might be useful background. And so it has been. When I heard that the second series was going to see the Abbey as a hospital I was very aware that it would be too easy for the writer(s) to get it wrong. But I was unprepared for just how wrong it could be. I’ve read that the first series cost approximately £1 million an episode, so presumably this second series is no cheaper, and with that budget it might be hoped that a few pounds would be spent on decent research into the formation, organisation and administration of military hospitals during the Great War.

Not a bit of it. The portrayal falters at every step. I can see only too clearly that there are not a lot of sources out there to punch a writer in the face, and it might need a bit more digging to uncover the real story, but come Lord Fellowes, with a million an episode this is poor stuff.

During the Great War military ‘hospitals’ were divided into two types, central hospitals and auxiliary hospitals. The former were the larger units run under the auspices of the War Office. They were staffed in the main by officers of the Royal Army Medical Corps and nurses of Queen Alexandra’s Imperial Military Nursing Service and the Territorial Force Nursing Service. Men were admitted to a central hospital, assessed and treated, and when appropriate (days, weeks or months) transferred out to one of the many satellite auxiliary units for which each central hospital had responsibility. The auxiliaries came under the control of the Joint War Committee of the British Red Cross Society and the Order of St. John, and were staffed by nurses under contract to them. Downton village cottage hospital could be nothing but an auxiliary hospital. And as a small, local, auxiliary hospital, it would still have conformed to the very high standards set by the Joint War Committee. So where does it fail?

Auxiliary hospitals did not employ Royal Army Medical Corps orderlies. Thomas could never have worked there. But then, the whole tale of Thomas’ return is pure fantasy.

Auxiliary hospitals did not, except in the rarest of circumstances, admit men direct from disembarkation. Their patients would already have been treated and cared for at a local central hospital. The raggle-taggle stream of wounded officers, shirts hanging out, blood oozing from their dressings, arms in slings bandaged over their uniforms was less likely than Haig riding in on his horse. Are these supposed to be men ‘straight from Arras.’ Quite ridiculous.

So many beds would never been crammed into such a small space. How does the writer imagine that nurses would have walked between the beds? Washed the patients and dressed their wounds? Fed them? Cleaned the floors? The ward looked worse than the worst of the casualty clearing stations on the Western Front in 1914. Far worse than Bedlam. Is Lord Fellowes aware that officers were treated rather differently from other ranks? His ‘ward’ is barely fit for pigs, let alone soldiers, and never officers.

Why is there no uniformed trained nurse? I’m afraid Mrs. Crawley, for all her wise words and ‘experience’ simply won’t do. She might act in an administrative role as Commandant, but wouldn’t be allowed to take part in giving out drugs or patient care. Mrs Crawley and the Major moving patients on stretchers was laughable (if it wasn’t so tear-inducing). And rookie VAD Miss Sybil doing a medicine round – complete poppycock. She’d have been lucky if she’d been allowed to wash the lockers or set trays.

The VADs were in the wrong uniform. They wore the grey dresses of St. John’s Ambulance Brigade VADs, but with the armlets of the British Red Cross. If they were supposed to be BRCS VADs, then they should have been in blue dresses, if St. John VADs, they should have been wearing the appropriate armlets. But of course, nobody ever gets the uniform right – only nurses so it’s hardly important.

It was fun to see Thomas being asked by Mrs. Crawley to stand in for Lady Sybil and do her VAD duties so she could go home for dinner. Fun? Nonsense.

And finally (for now), a blind officer would never, not in a million years, wash up in a tin-pot cottage hospital in Yorkshire. From fairly early in the war all blind officers were treated at No.2 London General Hospital (Territorial Force), Chelsea, where they received the most up to date and experienced care available, later almost certainly being transferred to one of the London hostels of St. Dunstans.

I suppose there’s always next week. I wonder what a ward in Downton Abbey itself will add to the hospital picture? I feel sure that it has to be better – I pray it couldn’t be any worse. And to exit where I entered, there are so few sources on Great War hospitals, and so much inaccuracy and misinformation spread around, both in books and on the web, that there is a great need for intelligent research. This Downton portrayal will now whip around the world and be used as a model of the truth by one and all, especially those who misguidedly believe it’s a fly-on-the-wall documentary. It will leave a legacy of falsehoods. Julian Fellowes has the background, he has the money, but unfortunately he lacks the knowledge.