The rain came swishing down. Water gathered on the canvas above, and
heavy drops fell splashing on to the floor with monotonous regularity.
Somebody was muttering curses in his sleep. Others were snoring loudly.
I lay awake for a long time, staring into the black darkness of the
marquee. Suddenly--it must have been two or three o'clock in the
morning--the familiar rumbling noise broke out in the distance. It
seemed to spread along the whole horizon. The "stunt" had begun.
A drowsy voice growled: "They're at it again--why can't they stop it
once and for all." Another groaned deeply and muttered: "Awful--awful
slaughter--blackguards, blackguards."
The uproar increased. I was filled with a terrible dejection, but I went
to sleep in the end.
It was broad daylight when I woke up to the sound of innumerable
motor-cars coming and going out on the road. The wounded were streaming
in.
The operating theatre was alive with figures clothed in white,
blood-stained garments, bustling up and down, or standing in groups
around the other tables. At the far end of the theatre someone was
blubbering like a little child.
"Here, come on--hold this man's leg up. What d'you think you're here
for?" It was the surgeon at the next table who was speaking to me.
I grasped the leg by the foot--it was quite cold--while the orderly
removed a bandage from the thigh. The bone had been shattered. A bullet
had also entered the man's chest, making a small round puncture. A shell
fragment had struck his upper lip, leaving a jagged triangular hole
below the nose. Several teeth had been knocked out. The upper palate had
been gashed and partly separated from the bone. It hung inside the
half-open mouth like a shrivelled flap. He breathed feebly and
irregularly. The surgeon bent over him and asked him if he had been
wounded long. He answered in low, hoarse whispers that he had been lying
in the mud and rain for several days. Then he turned his eyes up so that
only the whites were visible. They remained rigidly fixed in that
position. He received a dorsal injection, being too weak for chloroform.
The shattered thigh was painted with picric acid and the tourniquet
tightened above the injury. The surgeon cut through the leg with a
circular sweep of the knife, the splintered bone offering no resistance.
The limb came off in my hands. I held it for a moment, being awed by it.
It seemed very heavy. Then I dropped it into the pail below. When the
surgeon had dressed the stump, he made a slight incision in the forearm
in order to inject a saline solution. The man, who had not uttered a
sound hitherto, winced and gave a faint cry.
"Come along--hold this leg up!"
I darted to the next table and seized another foot and ankle. There was
a greenish festering hole so high up the leg that it was impossible to
use a tourniquet. So the surgeon laid bare the main artery by a
longitudinal incision and tied it up with catgut to prevent excessive
loss of blood. With a rapid stroke of his knife he then made a shallow
cut right round the limb above the injured spot, and depressing the
blade cut deeply down to the bone. The blood gushed up suddenly, formed
a pool on the towels and sheet underneath, overflowed the edge of the
table, and splashed down on to the floor in a cascade. The operator
paused a moment and then, while the blood continued to stream from the
wound, he cut round the bone until flesh was entirely severed from
flesh. The upper periosteum was pushed back and held by means of a metal
plate. The bone was sawn through--the saw grated and jerked and jarred
in a horrible manner. The leg came off and I dropped it into the white
enamelled pail. The toe-nails clicked against the enamel, and the thigh,
bumping against the rim, overturned it and flopped into the pool of
blood under the table.
"Come on--look sharp--never mind that leg--give a help here and remove
this man's bandages."
I was looking at a head that resembled a huge football made of soiled
linen. In place of the mouth there was a small, dirty hole through which
the fetid breath came and went. Above the hole was a big red patch. I
unwound the bandages one by one. Gradually the face was revealed.
Between the mouth with black, swollen lips and the bruised eyes, closed
by grey greenish lids, there was, where the nose should have been, a red
hole big enough to contain a human fist.
The wounded came and went in an unbroken stream. The tables were always
occupied. I went from one to another, unwound bandages, held up limbs
for amputation, fetched splints, padding, gauze, or new bandages. I was
too busy to think or to feel any horror. I was vaguely conscious of
nausea and of a hot, stifling atmosphere heavy with the fumes of
chloroform and ether.
Some of the wounded had arms that hung by shreds of muscle and sinew.
Others had feet that were nothing but masses of clotted blood, lumps of
torn flesh, and bits of bone tied up in blood-sodden linen parcels. Some
had deep holes in their backs, others had gashes in their heads from
which soft, pink matter oozed.
Before me lay a man with a blackened face, a shattered knee, and
festering holes all over his body. Gas-gangrene had set in and the
stench was almost unendurable. The surgeon gently felt the injured leg,
but the man gave such long-drawn piercing shrieks that he had to be left
alone. He was sent to the resuscitation ward to recover strength a
little, for he was very weak through loss of blood. In the evening he
began to rave--he asked for whisky in a boisterously jovial voice, and
then he yelled and cried: "Sergeant, Sergeant, Sergeant, you've ruined
my career." In the night he died.
The wounded were often perfectly silent. But more often they would groan
or wail or shout. Sometimes they would all howl in chorus like cats on a
roof. Indeed the weird and terrible howling of wounded men is more like
the howling of cats than any other sound I know.
Men regaining consciousness after an operation would sometimes laugh
uproariously or cackle fiendishly. Or they would break into torrents of
filthy language. One man yelled in a crazy voice that England was the
most glorious country on earth and that he had done his best to be a
good soldier. Then he was seized by a fit of violent weeping, while
someone at the other end of the theatre was shouting with intense fury:
"If I had Lloyd George here, I'd shoot the blighter," and another man
was carried out with his head lolling from side to side and saying in
mad, amiable tones: "Zig-zag, zagazig, zig-zag," and so on without a
break.
A man who had undergone an operation some days previously was brought in
to have his wound redressed--a deep laceration, that reached from knee
to hip and exposed the thigh-bone. The padding was removed, but as soon
as the raw flesh was touched he threw back his head, bared his teeth,
and uttered shrill, piercing cries in sudden blasts, and nothing could
be done to comfort him.
Near by a wounded man had been lying quietly on a table when all at once
he gave a yell and, before we could rush to the spot, he plunged head
foremost and crashed down on to the floor. We picked him up, but his
mind seemed too confused to realize what had happened. He did not
struggle any more, but gibbered and whimpered piteously.
If the chloroform and ether were not administered with great care and
skill, the patients would choke and kick and make furious efforts to
tear the mask from their faces. And so great was the number of wounded
and so rapidly was it necessary to perform each operation, that it was
not humanly possible to devote sufficient time to each individual case.
Gas was the most merciful anodyne, but it could only be used for brief
operations. Under its influence men became unconscious quickly and
without a struggle, and they recovered consciousness without the fearful
retching and vomiting that always followed the use of chloroform or
ether. And yet, even with gas, haste and carelessness and defective
apparatus added suffering to suffering.
On the table lay a man with a shattered gangrenous knee. He received gas
and became unconscious, but, just as the bone was being sawn through, he
regained his senses. His face was ashen pale and the sweat ran down it
in big drops. He was too weak to struggle, but his eyes were staring in
a way that was terrible to see. I held the foot and an orderly held the
stump while the saw grated harshly as it cut through the bone, and the
man moaned in piteous drawling tones: "Jesus Christ have mercy upon me,
God Almighty have mercy upon me, and forgive me _all_ my sins." When
the operation was over, he was carried out, making unintelligible
sounds.
He was followed by a man from whose chest I removed a filthy,
blood-sodden mass of padding. I observed that his breathing was becoming
weaker and weaker. The anæsthetist shouted:
"Fetch the oxygen--look sharp!"
An orderly brought a long black cylinder along, but the rubber tubing
was knotted in a bundle and several seconds passed before it could be
disentangled. At last the end of the tube was pushed into the mouth of
the dying man. The tap of the cylinder was turned on, but there was no
sound of gas running through. The anæsthetist glared angrily around and
shouted: "Corporal Chamberlain!"
The Corporal came and the anæsthetist thundered:
"Go and get a new cylinder--this one's empty--your damned carelessness
again--look sharp about it."
It was the Corporal's business to see that the cylinder in the theatre
was always full. He fumbled in his pockets for the key to the cupboard
in which the reserve cylinders were kept, but he could not find it. He
walked out and searched in the shed opposite the theatre. He came back
without it.
"Hurry up for God's sake--the man's dying--it'll be too late in a
minute!"
He looked round the theatre with affected deliberation, for the angry
shouting of the anæsthetist had wounded his pride. At last he found the
key on a shelf. He unlocked the cupboard, fetched out a new cylinder,
and placed it beside the table. The tube was pushed into the open mouth,
the tap was turned, there was a rush of gas. But it was too late. The
man was dead.
"D'you see what you've done?" shouted the infuriated anæsthetist.
"Here's a man dead through your neglect. Don't you bloody well let it
occur again, else I'll put you under close arrest and have you up for a
court martial."
The Corporal walked sulking out of the theatre and muttered something
about a "bloody fuss."
One of the orderlies went to the door and shouted:
"Another slab for the mortuary!"--Those who died on the operating tables
were facetiously called "slabs."
Two bearers came in with a stretcher. The corpse was pushed on to it and
carried away to the mortuary. There it would be sewn up in an army
blanket, ready for burial. And then a telegram would be sent to a wife
or mother, informing her that her husband or son had "died of wounds
received in action."
There was amputation after amputation. The surgeons were tired of
cutting off legs and arms--it was "so monotonous and uninteresting," as
one of the sisters put it.
Then there came a little variety in the shape of a man with a bullet
wound in his throat. He breathed quite normally, but when the bandage
was removed, his breath rushed bubbling through the aperture and
bespattered all who stood around with little drops of blood. "A most
unpleasant case." He was quickly replaced, however, by another who lay
on a stretcher white and motionless. His tunic had been unbuttoned. His
shirt had been pulled loosely over a big, round object that appeared to
be lying on his belly. The surgeon drew back the shirt. The round object
was still concealed by a dirty piece of lint. The surgeon lifted it off
and revealed a huge coil of bluish red entrail bulging out through a
frightful gash in the abdomen.
"Here, Crawford, here's something for you!"
Captain Crawford was an abdominal specialist, at least he was
particularly interested in abdominal cases, or "belly cases" as they
were humorously termed. Captain Wheeler, who had called him, was
interested in knee cases. Captain Maynard, who was working at the far
end of the theatre, had a fondness for head cases.
"Such a delightful tummy, isn't it?" said Captain Wheeler, who spoke in
the affected drawl of our public schools and universities.
"Rather," replied Captain Crawford, who had come over from his table
holding a blood-stained scalpel in his hand. He added:
"Just my rotten luck--I've only had amputations."
He looked at the bulging entrail admiringly and went back to his work.
In a few minutes he was ready for the next case--a man whose head was
thickly swathed in bandages.
"That's a bit of a change, anyhow--I'm fed up with legs and arms."
The bandages were removed. Amid a mass of tangled, blood-clotted hair
was an irregular patch where a piece of bone had been blown away,
leaving the brain-matter exposed.
The Sister looked at it with eager curiosity and said:
"A _most_ interesting case. I'm _sure_ Captain Maynard would so _love_
to see it! Captain Maynard!"
"One moment, Sister!" He was busy with a delicate knee operation. After
a little delay he came over and inspected the damaged head.
"You've got all the luck," he said. "I haven't had a decent head for
ages. Still, I s'pose we have to put up with these annoyances--horrors
of war, you know!" He laughed and the Sister smiled. Then he went back
to his knee while Captain Wheeler attended to the head.
It must not be supposed that the surgeons, sisters and orderlies of the
----th C.C.S. were particularly cruel and heartless. They were simply
ordinary human beings and the ordinary human being, however he may be
horrified by the first sight of wounds and suffering, soon gets used to
them and accepts them as facts of everyday life.
It was growing dark outside and the electric light was switched on. The
wounded still arrived in multitudes. Towards eight o'clock the
day-shift came to an end and the night-shift began. We had no time to
clear the theatre. The new surgeons continued where the old had left
off. They were in high spirits and set to work merrily, exchanging jokes
all the time.
The bearers were utterly exhausted and several of them had blue rings
round their eyes through lack of sleep.
"Poor bearers," said one of the Sisters, "I _do_ feel so sorry for
them--they have an awfully hard time!"
Captain Dowden--another "head specialist"--said to me:
"Give the bearers a bit of a rest. Go to the Prep. yourself and bring me
a nice head case."
I went accompanied by an orderly. The Prep. was a long marquee and on
either side was a long row of stretchers, one close up against another.
A man was lying on each, generally silent and motionless. Only a few
were groaning feebly. We selected one whose head looked like a parcel of
blood-sodden bandages. We carried him into the theatre and laid him on
to the table.
The bandages were unwound. The man's hair was matted and caked with
gore. There were three deep gashes in the skull. The head was washed and
shaved and then painted with picric acid. The brilliant electric light,
the clean white garments of the fresh teams, the bare head painted
bright yellow and the three thin streaks of red blood trickling down
made a strange picture. The largest wound was just above one ear. A
local anæsthetic was injected and the skin round the injury pushed back.
With a pair of curved pincers the surgeon broke away bits of bone from
the edge of the hole. Then he pushed his little finger deeply into it
and fetched out a large bone fragment and a quantity of soft matter,
coloured a pale red, which he allowed to flop down on to the floor. The
man was motionless except that he violently wagged his left big toe. And
all the time he made a continuous cooing, purring noise, like that of a
brooding hen.
The surgeon working at the next table, Captain Wycherley, received a
"case" with a shattered right arm and a right thigh. He called his
colleague, Captain Calthrop, over, and the two operated together, the
one amputating the arm and the other the leg.
Meanwhile the head case was replaced by a boy who came walking into the
theatre and mounted the table unassisted. His right eye was bandaged. As
he became unconscious under gas the bandage was removed. With a few
dexterous strokes of his scalpel Captain Dowden removed all that was
left of the eyeball, a dark, amorphous mess. The wound was cleaned,
dressed and bandaged. The boy regained consciousness. For a moment he
looked vacantly round. Then he slowly raised his hand to the bandage,
and, turning down the corners of his mouth suddenly broke into bitter
weeping. He was gently helped down from the table and led out of the
theatre, crying: "They've done for me eye, oh, oh, oh, they've done for
me eye!"
"Poor kid," murmured the Captain sympathetically, and began to operate
on the next man, who had a wound in his shoulder about as large as a
hand. In the middle of the raw flesh a short length of undamaged bone
was visible. Nothing serious, and only a flesh wound. The man inhaled
the chloroform and ether fumes without choking or struggling. His wound
was excised, "spirit bipped," dressed and bandaged. Then he was whisked
off the table and carried away to a ward.
In the doorway appeared a man with his arm in a sling. He was dazzled by
the electric light and put his hand over his eyes. Captain Wycherley
called out to him: "Come along, my lad, and hop on to this table." He
walked up to the table with uncertain steps. An orderly helped him on to
it. He lay back and turned his head to one side and looked towards the
next table on which Captain Calthrop was amputating an arm. It came off
in the hands of an orderly who dropped it into the bucket. The newcomer
followed it with horror-stricken eyes. He continued to gaze, as though
fascinated, at the half-closed hand that projected above the edge of the
bucket. Then he trembled violently.
Captain Wycherley observed what was happening and said:
"Come on, don't worry about the next man. Let's have a look at your
wound."
"Yer not goin' ter take orf me arm, are yer, sir?"
"No, of course not, don't be so silly!"
"Yer won't 'urt me, sir, will yer?"
"No, no. Pull yourself together now. Be a man! You won't feel anything
at all."
The orderly untied the sling and began to unwind the bandage, but the
man drew his arm away and cried:
"Oo, oo, oo,--very painful, sir, very painful!"
The orderly, pleased at being mistaken for an officer, said in a
soothing, patronizing voice:
"We'll just have this bit o' bandage orf an' then we'll give yer some
gas and send yer orf to sleep. You won't feel nothin' and yer a sure
Blighty. I wouldn' be surprised if yer got acrorss termorrer."
He went on unwinding the bandage, but the man began to shout and
struggle again.
Thereupon the surgeon intervened:
"For God's sake be quiet. Pull yourself together and don't make such a
fuss."
"I can't 'elp it, sir--I couldn't never stick no pain, sir, no, sir,
never, sir--it's very painful, sir, very painful. I'll try 'ard, I'll do
me best--but it _is_ painful, sir."
However, as soon as the bandage was pulled a little he yelled and
writhed. The surgeon at last lost patience and said: "Hold him down."
Two orderlies and two bearers seized his hands and feet while the
bandage was quickly removed. He shrieked and struggled violently, but he
was firmly held.
He had a small, deep wound in the fleshy part of the forearm. He
received gas and soon lost consciousness. The surgeon pushed a probe
into the hole. There was a metallic click, whereupon he inserted his
forceps and pulled out a jagged piece of steel, the fragment of a German
shell. When the wound had been excised and dressed, the man was carried
away and replaced by another whose right leg was thickly wrapped up. The
wrapping was removed and revealed a shattered knee and two toes dangling
from the foot. Captain Wycherley snipped them off with a pair of
scissors. The man winced and they dropped on to the floor. The
anæsthetist administered gas. It was some time, however, before the
patient lost consciousness, for the balloon that adjoined the mouthpiece
leaked badly and once the rubber-tubing was blown off the nozzle of the
cylinder.
Captain Dowden was busy with a foot, or all that was left of a foot, a
number of crimson shreds hanging from an ankle over a projecting piece
of bone. Captain Calthrop was attending to a "belly case"--he had cut a
longitudinal slit in his patient's abdomen and both his hands were
groping inside it, buried up to the wrists, while the stomach-wall
heaved up and down with the breathing of the unconscious man.
The "case" lying on the end table had been in the C.C.S. for several
days. He had undergone operation as soon as he arrived. At that time he
only had a small surface-wound below the knee, but it was slightly
gangrenous. The next day the gas-gangrene appeared above the knee-joint.
The wound was excised a second time. But soon afterwards gangrene
appeared again, still higher up, and a third operation was necessary.
And now the wound stretched from below the knee almost as far as the
hip. It was shallow, but as broad as a hand and of a greyish-green
colour. The man breathed feebly and his eyes were turned up so that
only the whites were visible. He received gas. Amputation was impossible
for the gangrene had reached too far. The wound was excised, but the
surgeon said: "I'm afraid he's done for, poor fellow." The man's
breathing became almost imperceptible. The oxygen cylinder was sent for,
the rubber tube was pushed in between the blue lips, and the gas rushed
through. In a few seconds he had revived and gave loud and regular
snorts, jerking back his head and shaking his body with each ingoing
breath. He was taken back to the ward and put back to bed. He began to
talk volubly about his wife and children. Within half an hour he was
dead.
"Just go and see if there are many left in the Prep.," said Captain
Dowden to his orderly.
The orderly came back and reported that there were hardly a dozen.
"Any Huns amongst them?"
"Four or five, sir."
"Are we still receiving?"
"No, sir, we stopped about an hour ago. There won't be any more cases
arriving to-night, sir."
"Good--we shall be able to get off early, at two or three in the morning
if we're lucky. We can take things easy a bit."
The bearers came in with a stretcher.
"Take it easy, bearers. There's no hurry--we haven't got many more to
do. Just put him on that table there."
The newcomer's left leg was thickly bandaged, but the blood was oozing
through and forming a pool on the table. When the bandage was removed,
Captain Dowden examined the limb, but no injury was visible on the upper
surface. I grasped the foot--it was blue and cold. I raised it, so that
the surgeon could look at the under-surface of the leg. As I did so, the
calf gave way in the middle. He told me angrily to pull harder. I pulled
until the leg was taut again. The muscles and the sinews squeaked
faintly as they stretched. Underneath the calf was a big hole and the
bone had been completely shattered. The man was strangely quiet. His
bare chest did not move. I looked at his face and suddenly I saw his
lower jaw drop. He was dead.
"Another slab for the mortuary!"
The remaining tables were empty and no more wounded were brought in for
a while. The bearers were obeying the surgeon's order and were taking a
rest. The officers and sisters in the theatre were in high spirits. They
were trying to speak French and ridiculing each other's efforts. Captain
Wycherley began to hum a tune and wave his amputation knife like the
conductor of an orchestra, whereupon the others locked arms and danced
up and down the theatre, talking and joking. Then Captain Calthrop broke
away and danced by himself, kicking his legs up in the air. The Sisters
watched him and laughed loudly. One of them could hardly control
herself, and shrieking with laughter, cried:
"Oh, Captain Calthrop, you really are _too_ funny!"
Captain Dowden had not joined in the merrymaking. He was standing by the
table on which the corpse was lying. He smiled uneasily and said to an
orderly: "Tie up his jaw and his feet and hands and take him away. And
tell the bearers to get a move on. Let's get finished as quickly as
possible."
The orderly pushed the dead man's lower jaw sharply against the upper,
so that the teeth clicked, and kept it in position by tying a bandage
right round the head. Then he crossed the dead hands and feet and tied
them together also.