20th January 1916 Thursday

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While Douglas is enjoying a much earned rest from the front line, it provides a good opportunity to take a look at what it was actually like in a field hospital during war. Whichever side you were on the reality would have been the same. The hospitals had one primary function. That was to repair the repairable and return them as quickly as possible to fighting condition and return them to the front line. Everything else was of a secondary nature. The dying and the dead were dealt with as humanely as possible, but the priority with them was to pass them on to the process of disposal and burial.

Some medical staff saw the attempts to save or prolong the lives of the mortally wounded as futile and a distraction. Some clever and able physicians were seen as wasteful and only out to further their own careers, when they should have been concentrating their efforts on the men that could be saved and had the chance of fighting again. It was not only the military that would find themselves in a field hospital. Civilians, even children would be treated when necessary, but again it was seen as unnecessarily wasteful of resources. Civilians had their own places of treatment, but occasionally it would prove expedient to treat some cases in a military field hospital.

America wasn’t to enter the war as a belligerent until finally provoked into declaring war against Germany on April 6th 1917. Many Americans, mostly ex-pats living in the American community in Paris, set up a voluntary Field Ambulance service almost from the outset of war in France. By 1915 American philanthropists, both men and women began to make their way across the Atlantic Ocean to volunteer for service in aiding France and her allies. The American Field Ambulance was originally set up attached to the American Hospital in Paris. The purpose of the A.F.A. was to aid the transportation of the wounded and sick from the front lines for treatment at the American Hospital. Eventually it transformed to being a more general field ambulance, attracting some 2000 volunteers and spread its wings from the Western Front to much of the battle areas of Europe, including Italy, Greece, Serbia and Albania.

In 1915 a well to do American woman had taken herself to France to follow a career as a nurse and eventually found herself only ten kilometres behind the battle on the Western Front.

The following may not be for the easily offended or the squeamish.

Ellen N. La Motte was 42 years old and got herself a posting to a French Army field hospital. She came from a successful Louisville family with a French background and on the outbreak of the war in Europe sought to find a nursing position for herself. It wasn’t long before she found the horror of the effects of war.

When things were quiet hospitals would have been bad enough, but following a battle would have been chaotic. The injuries of battle would have ranged from the explosive effect of blast injuries that could kill or blow limbs clean off. Gunshot wounds could be equally traumatic with catastrophic internal injuries or less life threatening bullet wounds to a limb. The devastatingly destructive injuries caused by shrapnel shells with a payload of small balls and metal fragments were designed to cause as much human injury as possible.

Established as a nurse in a French field hospital in Flanders in 1915, not far from the front line and close to the area that Douglas was in, Ellen describes the scenes quite dramatically in her book “The Backwash of War”.

An injured French soldier had been brought in with severe injuries to his abdomen. He was an experienced campaigner, 40 years old and a big strong man. His stomach was ripped open by a shell and his bowels were hanging out. He was brought into the ward full of injured men, some of them would recover, many would die. All of these injuries could become subject to infection, in some cases very rapidly. In the case of this unfortunate man his injuries were almost certainly fatal. He lay cursing and shouting, disturbing the rest. For three days this went on, infection had set in and the stench from the wound that filled the ward became intolerable. He was moved into a room with other abdominal wounds next to a man with a faecal fistula, which also gave off a terrible smell, but the man with the fistula had become used to his own terrible odour and so complained about the stench from the old soldier. The old soldier had been infected with gas gangrene.

Gas gangrene is a terrible bacterial infection that rapidly advances in the infected tissue and produces a rancid red fluid that emits a vile odour. It is easily recognisable by the cracking noises it makes beneath the skin and the rapid discolouring that occurs, often in minutes. The gas created under the skin produces large black blisters. Even modern day treatment requires amputation or removal of all the affected tissue area and it is virtually untreatable with antibiotics. One hundred years ago the outcome was in most cases almost certain death.

Ellen also describes the unfortunate admission of a ten year old Belgian boy that had been injured by a shell fragment that had ripped through his stomach. Brought in to the French hospital in agony by a British ambulance crew, he was seen as an unwelcome distraction to the already overburdened staff. The boy was in poor condition and the surgeon was angry at this imposition upon him and his staff. They cursed the British for their action of bringing him to a French field ambulance and not a British one, but had no option but to treat him. If they didn’t he would die. If they operated he could die, or he could die after the operation. After operating he was taken to the ward where he cried incessantly for his mother. The men on the ward were greatly unsettled by the intrusion of the boy and the Directrice (Matron) ordered that his mother be brought from Ypres. Despite protest that she had 3 other children and her husband’s busy bar to attend, the mother arrived in time to spend a short while with her son before he passed away. After which she immediately returned to her duties in Ypres, leaving the medical staff to take care of her son’s burial.

The book that Ellen N. la Motte wrote of her exploits was banned in the USA in 1918 for fear that it was affecting the American public’s appetite for war.

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