Tommy (65 page)

F. P. Roe had the good fortune to be wounded at Shrapnel Corner, just east of Ypres, in December 1916, when there was no major battle in progress and the chain of evacuation was working well. He remembered nothing of being treated at a dressing station, and:

Some soldier patients remained at hospitals on the continent, convalescing in special centres, some of them so tautly run that, as Harry Ogle observed: ‘they must have been designed to make soldiers desire fervently to get away … even back to the very line itself'.
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They were posted back to their units when passed fit. The more seriously ill went back to Britain, and were distributed about a range of hospitals and nursing homes, public and private, throughout the country. On 8 October 1918 Albert Bullock was operated on at No. 6 General Hospital in France: he came to and found that they had kindly stuck the bullet that had hit him, wrapped in muslin, to his chest. He crossed the Channel aboard
Gloucester Castle
and was in a military hospital in Weymouth on 11 October, five days after being wounded. His wound became infected and he nearly died, but he had nothing but praise for his treatment. When he was able to eat again he wrote that ‘the Staff Nurses are as pleased as me, especially Nurse Beanell who was a real trump to me'.
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Real trumps indeed. From 1916 nurses – military nurses of Queen Alexandra's Imperial Military Nursing Services and the Territorial Force Nursing Services and a wide range of auxiliaries such as the Voluntary Aid Detachments (which had a total strength of 82,857 by the war's end) – were increasingly numerous in France, although the sight of five English nurses behind the Somme in 1916 was so unusual as to persuade all around to stop work ‘to behold the fair “visions”.' Sister May Tilton testifies to the fact that there was an extra dimension to female nursing. In May 1917 she was running a sixty-bed surgical ward with one VAD and ‘sometimes two orderlies' to help.

Bluey, an eighteen-year-old Australian with ginger hair, told her: ‘Mine is not an Aussie Blighty, so of course I'll be going back again, and I know it won't be my luck to get out of it again. Will you kiss me good-bye before you go?' And when her clearing station on the outskirts of Ypres was bombed in 1917 (German aircraft were very active over the salient at night), one wounded man complained that they had no right ‘to send you nurses so far up here in the danger zone', and an appallingly wounded Scot urged her to get under his bed, as she might get hit. Her patients kept in touch when they left hospital though sometimes the news was bad. ‘A brave mother' wrote to say:

Second Lieutenant Mellersh, carried into a clearing station at Corbie, was surprised to find:

Lancelot Spicer, in No. 1 Red Cross Hospital, reported that it was a ‘most amusing place' because its volunteer staff were rather blue-blooded: ‘nothing but Duchesses and Countesses – they really are very nice and work awfully hard'.
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And Harry Ogle found the matron of No. 6 General Hospital ‘efficient, kind and friendly, interested in us as persons but had no favourites'.
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Albert Bullock's matron wrote to his mother to report his progress, and on 15 November 1918 confessed that: ‘I feel so cheerful that no more boys are being killed and maimed and we have ceased the fighting. You may be sure I will send you word of your boy very shortly. Yrs very truly, Matron.'
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Officers and men recovering from wounds or sickness appeared before medical boards, generally composed of three doctors, who decided whether they were fit for active service, home service, or should be discharged. Soldiers passed fit for home service only were periodically re-examined. As Britain's manpower situation worsened in 1917 and on into 1918, travelling medical boards toured the country re-examining men who had previously been placed in a low medical category: many were ‘combed out' and posted to France.

War is often the handmaiden of beneficial change, and the First World War was no exception. Advances in medicine and hygiene meant that sick rates on the Western Front, at 1.3 sick to 1 wounded, were lower than on other fronts, and far lower than the 24 to 1 of the American Civil War, and 10 men died from enemy action for every 1 that died of disease, a dramatic reversal of the traditional ratio. Saline drips became routine to reduce the damage done by shock; blood transfusions, cutting-edge in 1914, were used in the clearing stations from 1917 and the advance dressing stations in 1918; gas-gangrene, common in wounds inflicted in areas where the soil was heavily manured, affected 10–12 percent of wounds in 1914 but only 1 percent in 1918, and ‘meticulous primary surgery', and the delayed suture of wounds, proved real life-savers. Abdominal wounds were still hard to deal with, and their mortality rate ran at about 50–60 percent, with some specialist surgical units getting it down to 40 percent by the war's end. The army took delivery of its first X-ray machine in 1913: by 1918 they were in regular use at clearing stations and occasionally further forward. Some apparently simple inventions had profound consequences: the Thomas splint brought the death rate for fractures of the femur down from about 60 percent to some 30 percent.
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Venereal disease, so long a scourge of armies, was described by an official history as causing ‘the greatest amount of constant inefficiency in the home commands…'.
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It estimated that the admission rate of Australian and New Zealand troops was as high as 128 and 130 per 1,000 of strength compared with 24 per 1,000 amongst British troops. The British army reported 416,891 hospital admissions for VD during the war, and as a stay in hospital averaged some fifty days for a soldier with syphilis the issue was as much about manpower as medicine. Soldiers who contracted VD were obliged to declare it, and were then sent to special hospitals, where their pay was stopped: as most married men made ‘allotments' to their wives, marriages were often put at risk. Failing to declare VD was an offence under military law, punishable with up to two years' imprisonment with hard labour. The establishment of early-treatment centres where men were able to disinfect themselves went some way towards helping, as did the politically-contentious use of licensed brothels. One in Rouen was visited by 171,000 men in its first year, and there were only 243 reported cases of VD; however, opposition at home led to its closure.

Officers suffering VD were sometimes able to persuade a considerate regimental medical officer to treat them privately, but for most men there was no choice between shameful hospitalisation or untreated disease. And it was difficult for the latter to remain undetected for long due to periodic inspections. On 4 May 1918, Captain G.O. Chambers, AADMS of the Cavalry Corps, informed the camp commandant that a sapper of the topographical section:

Most controversially, the war did much for the recognition that not all wounds were to the body. A condition broadly defined as shell shock, because it was initially believed to result from the physical impact of a nearby shell on the brain, was increasingly recognised by the authorities, although the term covered a variety of traumatic neuroses. Symptoms presented in different ways. Some men, like Private Alfred Moss in F. P. Roe's platoon, became ‘withdrawn, untypically quiet for long periods, and eventually even morose'.
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Second Lieutenant William Carr found one of his sergeants, the sole survivor of a gun detachment hit by a shell, ‘in a terrible state, shaking and incoherent. We spent some time talking to him trying to calm him down and comfort him, but to no avail.'
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Others developed hysterical conversion syndromes, in which a mental condition had physical symptoms like paralysed limbs, blindness or deafness. Some men went berserk: Frank Hawkings and his comrades were only saved from one who jumped out of his trench and fired at friend and foe alike because the Germans machine-gunned him.

At first, as R. H. Ahrenfeldt acknowledged in his history of British military psychiatry, it was almost a matter of chance whether a man with psychiatric illness was considered to be genuinely ill, a malingerer, or even a deserter. By August 1916 the BEF had its own consulting psychiatrist and consultant neurologist, and by the year's end there were psychiatric centres in every army area and ‘mental wards' in base hospitals. Treatment in the United Kingdom improved in parallel, and the work of Dr William Hales Rivers, who developed treatment for ‘anxiety neurosis' at Craiglockhart Military Hospital in Edinburgh, is perhaps the best known, not least because Siegfried Sassoon, declared shell-shocked after publicly protesting about the war, was one of his patients. In 1922 a War Office inquiry into shell shock concluded that physical concussion caused few cases, that exhaustion was more common, and that there was a range of wholly genuine ‘war neuroses'.

Although shell shock is often seen as
the
disease of the war it was, in its various forms, less common than we might think. In 1917 psychiatric admissions ran at 1 per 1,000 for the civilian population, 2 per 1,000 for troops in Britain and 4 per 1,000 for the BEF. Some shell-shocked men did not get as far as hospital because, as the 1922 inquiry made clear, the incidence of shell shock could be reduced by good discipline and leadership within units. Wise regimental medical officers could often deal with many mild cases by resting men in safety not far from the battlefield, and giving them the firm expectation that they would recover, pointing the way ahead to the effective treatment of what modern military psychiatrists would describe as ‘battleshock'.

Yet there was more than pure logic at work where this terrible response to a shocking war was concerned. The shell-shocked victim, unable to gain employment after the war, became one of the period's most enduring icons. And, as Peter Leese has written: ‘The memory of shell shock has remained potent too, because it has become the first and most powerful expression of the destructive effects of industrialised warfare on the mind …'.
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It marked the military revolution just as surely as the heavy gun, tank or aircraft.

W
hat modern military theorists call ‘the moral component of fighting power' is always more difficult to define than its fellows in the trilogy, the physical and conceptual components. It can neither be counted and costed, nor can it be accurately assessed through drill books, training manuals or pamphlets on doctrine. In the First World War, difficulties are especially acute because the whole issue of motivation is intimately linked to our interpretation of the war more widely. For some historians, combat motivation primarily reflected a draconian code of discipline which made the officer's pistol and the firing squad the army's natural response to personal failure: for others, decent fellows, proud of their cap badge and bravely led, did their job without flinching.

Of course the truth is more complex: motivation on the Western Front reflected a whole host of factors which varied from man to man, unit to unit, place to place and time to time. It is in this area that deconstructivist history is most dangerous, because by focusing on particular aspects of this complex mosaic, perhaps to meet an understandable personal or political demand (or simply to sell more books), writers often paint a picture that the men of 1914–18 would look at with disbelief. We have already seen that they were not lions led by donkeys. But so too were they neither thugs led by nincompoops, nor weaklings coerced by brutes, nor yet warriors led by heroes. Yet if we look hard enough we can find evidence of all these types – perhaps even in the same battalion on the same day.

In
Redcoat,
my study of the British army in the eighteenth and nineteenth centuries, I focused on what I saw as the two prime factors in motivating in the army of the age, and called them stick and carrot. Under stick I reviewed the coercive aspects of morale, and under carrot its persuasive aspects. The First World War requires a wider analytical framework, including a broader assessment of what men thought about their world, themselves and their enemy.