Wounded: From Battlefield to Blighty 1914-1918 tackles the story of First World War battlefield medicine in an ingenious and effective way. Instead of giving top-down history – describing the development and structure of official military and medical organisations – it tracks the likely progression of a wounded man from the mud of Flanders to a London Hospital, giving an idea of the very various men and women who would help him on his journey, and who would do their best to preserve his life.
Successive chapters deal with stretcher-bearers, regimental medical officers, surgeons, nurses, orderlies, chaplains, those who served on the Ambulance trains that crawled though France, and the volunteers who helped with the London Ambulance Column that took wounded men from the railway to hospital. Interspersed with these chapters are accounts of individual wounded soldiers. We are left in no doubt about the terrible results of high-velocity bullets and jagged fragments of shrapnel, or about the difficulty of treating the wounded under adverse conditions.
Emily Mayhew has done her research thoroughly, and the book makes effective use of the Imperial War Museum archive, as well as memoirs by participants in the War. She is at her best when describing the physicality of military medicine: In her reminder, for example, that stretcher-bearers’ hands were ‘a mix of blisters and calluses, first rubbed raw and then scar-cracked and worn’, or in her depiction of the exhaustion of an Ambulance volunteer, doing this demanding work after finishing her day job.
The story she has to tell is of men and women coping with unprecedented situations, improvising a response to a medical emergency greater than any had imagined. It is a story well worth telling, and she tells it in a style as immediate and readable as a novel.
Occasionally this novelistic immediacy worries me. Emily Mayhew often takes on the privileges of a novel’s omniscient narrator, and has a habit of telling us, very definitely, what people were thinking:
Young thought he had never seen anything worse [….] But Young kept steady, reassuring the wounded men they’d all son be in a nice warm hospital bed or back in Blighty, not to worry. But all the while he knew that many of them would end up on the amputation table or in the moribund ward.
What she typically does is to take a first-person account, from a letter, or a memoir written some time after the War, and turn it into dramatic (and effective) free indirect discourse. The effect of this is to make the writing immediate, but it can disguise from the reader that what she is telling us comes from a document that may or may not be the complete truth and may or may not have been written for a particular purpose. Perhaps I’m being picky, but several years of looking at WW1 documents of various kinds has made me wary. Can one ever be quite certain that a document is telling the exact truth about someone’s thoughts at a particular time? Letters are written for a particular audience and with a particular intention; they may be less than the complete truth; they may be trying to impress, to console or to shock. Memoirs written later may be subject to the fallibility of memory, and the memories described may have been subtly altered by later understandings of the events described.
Rather often, Emily Mayhew seems to be taking her sources at their own valuation. Probably this does not matter in most cases, but I was particularly uncertain in the chapter on chaplains. She presents half a dozen accounts of exemplary chaplains: dedicated, heroic, useful, humble, loved by all. One does not need to read far into the literature of the Great War to discover that many chaplains were not seen as fitting this template (a nickname for the chaplain in some quarters, apparently, was ‘the unnecessary evil). Wartime and postwar accounts of chaplains often have an axe to grind, sometimes a denominational one, and I think that in this chapter some scepticism about sources might have been useful. In the description of John Lane Fox, for example, Emily Mayhew takes material from Patrick MacGill’s The Great Push, without revealing that this is a novel, or that it had originated as a serial in the Daily Mail. (And she refers to Patrick MacGill as Pat, for some reason.)
So, to sum up, this is a very readable and informative account of how casualties on the Western Front were treated by the medical personnel. I learned a lot from it, and so will most people. Parts of it may need to be taken with a pinch of salt, though.
The American edition has a different, and potentially misleading, subtitle.