A Surgeon in Belgium

by Henry Sessions Souttar

As we approached Contich a soldier came running up and told us that two people had just been injured by a shell, and begged us to come to see them. He stood on the step of the car, and directed us to a little row of cottages half a mile farther on. At the roadside was a large hole in the ground where a shell had fallen some minutes before, and beside it an unfortunate cow with its hind-quarters shattered. In the garden of the first cottage a poor woman lay on her back. She was dead, and her worn hands were already cold. As I rose from my knees a young soldier flung himself down beside her, sobbing as though his heart would break. She was his mother.

Behind the cottage we found a soldier with his left leg torn to fragments. He had lost a great deal of blood, and he was still bleeding from a large artery, in spite of the efforts of a number of soldiers round who were applying tourniquets without much success. The ordinary tourniquet is probably the most inefficient instrument that the mind of man could devise—at least, for dealing with wounds of the thigh out in the field. It might stop haemorrhage in an infant, but for a burly soldier it is absurd. I tried two of the most approved patterns, and both broke in my hands. In the end I managed to stop it with a handkerchief and a stick. I would suggest the elimination of all tourniquets, and the substitution of the humble pocket-handkerchief. It, at least, does not pretend to be what it is not. Between shock and loss of blood our soldier was pretty bad, and we did not lose much time in transferring him to our car on a stretcher. The Croix Rouge dressing-station was more than a mile farther on, established in a large villa in its own grounds. We carried our man in, and laid him on a table with the object of dressing his leg properly, and of getting the man himself into such condition as would enable him to stand the journey back to Antwerp.

Alas! the dressing-station was destitute of any of the most elementary appliances for the treatment of a seriously wounded man. There was not even a fire, and the room was icy cold. There was no hot water, no brandy, no morphia, no splints, and only a minute quantity of dressing material. A cupboard with some prehistoric instruments in it was the only evidence of surgery that we could find. The Belgian doctor in charge was doing the best he could, but what he could be expected to do in such surroundings I do not know. He seemed greatly relieved to hear that I was a surgeon, and he was most kind in trying to find me everything for which I asked. From somewhere we managed to raise some brandy and hot water, and a couple of blankets, and with the dressings we had brought with us we made the best of a bad job, and started for home with our patient. Antwerp was eight miles away. It was a bitterly cold evening, and darkness was coming on. It seemed improbable that we could get our patient home alive, but it was perfectly certain that he would die if we left him where he was. It seemed such a pity that a little more forethought and common sense could not have been expended on that dressing- station, and yet we found that with rare exceptions this was the regular state of affairs, whether in. Belgium or France. It seems to be impossible for our professional brethren on the Continent to imagine any treatment apart from a completely equipped hospital. Their one idea seems to be to get the wounded back to a base hospital, and if they die on the way it cannot be helped. The dressing-stations are mere offices for their redirection, where they are carefully ticketed, but where little else is done. Of course, it is true that the combatant forces are the first consideration, and that from their point of view the wounded are simply in the way, and the sooner they are carried beyond the region of the fighting the better; but if this argument were carried to its logical conclusion, there should be no medical services at the front at all, except what might be absolutely necessary for the actual transport of the wounded. I am glad to say that our later experiences showed that the British influence was beginning to make itself felt, and that the idea of the wounded as a mere useless encumbrance was being modified by more humanitarian considerations. And in a long war it must be obvious to the most hardened militarist that by the early treatment of a wound many of its more severe consequences may be averted, and that many a man may thus be saved for further service. In a war of exhaustion, the ultimate result might well depend on how the wounded were treated in the field.

The road was crowded with traffic, and it was quite dark before we reached Antwerp. Our patient did not seem much the worse for his journey, though that is perhaps faint praise. We soon had him in our theatre, which was always warm and ready for cases such as this. With energetic treatment his condition rapidly improved, and when we left him to go to dinner we felt that our afternoon had not been entirely wasted.

XII The Bombardment—Night

We had had plenty of notice that we might expect a bombardment. On Saturday a boat had left with most of the English Colony. On Tuesday morning the Germans sent in official notice that they intended to bombard the city, and in the evening the Government and the Legations left by boat with the remainder of our countrymen who lived in Antwerp. We had faced the prospect and made every preparation for it, and yet when it did come it came upon us as a surprise. It is sometimes fortunate that our capacities for anticipation are so limited.

It was almost midnight on Wednesday, the 7th of October, and two of us were sitting in the office writing despatches home. The whole building was in absolute silence, and lit only by the subdued light of an occasional candle. In the distance we could hear the dull booming of the guns. Suddenly above our heads sounded a soft whistle, which was not the wind, followed by a dull thud in the distance. We looked at one another.

Again it came, this time a little louder. We ran up to the roof and stood there for some moments, fascinated by the scene. From the dull grey sky came just sufficient light to show the city laying in darkness around us, its tall spires outlined as dim shadows against the clouds. Not a sound arose from streets and houses around, but every few seconds there came from the south-east a distant boom, followed by the whistle of a shell overhead and the dull thud of its explosion. The whole scene was eerie and uncanny in the extreme. The whistle changed to a shriek and the dull thud to a crash close at hand, followed by the clatter of falling bricks cutting sharply into the stillness of the night. Plainly this was going to be a serious business, and we must take instant measures for the safety of our patients. At any moment a shell might enter one of the wards, and—well, we had seen the hospital at Lierre. We ran downstairs and told the night nurses to get the patients ready for removal, whilst we went across to the gymnasium to arouse those of the staff who slept there. We collected all our stretchers, and began the methodical removal of all our patients to the basement. In a few minutes there was a clang at the front-door bell, and our nurses and assistants who lived outside began to arrive. Two of the dressers had to come half a mile along the Malines road, where the shells were falling thickest, and every few yards they had had to shelter in doorways from the flying shrapnel. The bombardment had begun in earnest now, and shells were fairly pouring over our heads. We started with the top floor, helping down those patients who could walk, and carrying the rest on stretchers. When that was cleared we took the second, and I think we all breathed a sigh of relief when we heard that the top floor was empty. We were fortunate in having a basement large enough to accommodate all our patients, and wide staircases down which the stretchers could be carried without difficulty; but the patients were all full-grown men, and as most of them had to be carried it was hard work.

I shall never forget the scene on the great staircase, crowded with a long train of nurses, doctors, and dressers carrying the wounded down as gently and as carefully as if they were in a London hospital. I saw no sign of fear in any face, only smiles and laughter. And yet overhead was a large glass roof, and there was no one there who did not realize that a shell might come through that roof at any moment, and that it would not leave a single living person beneath it. It made one proud to have English blood running in one's veins. We had 113 wounded, and within an hour they were all in places of safety; mattresses and blankets were brought, and they were all made as comfortable as possible for the night. Four were grave intestinal cases. Seven had terrible fractures of the thigh, but fortunately five of these had been already repaired with steel plates, and their transport was easy; in fact, I met one of them on the staircase, walking with the support of a dresser's arm, a week after the operation! Some of the patients must have suffered excruciating pain in being moved, but one never heard a murmur, and if a groan could not be kept back, it was passed over with a jest for fear we should notice it. It was a magnificent basement, with heavy arched roofs everywhere, and practically shell-proof. The long passages and the large kitchens were all tiled and painted white, and as the electric light was still running and the whole building was well warmed, it would have been difficult to find a more cheerful and comfortable place. Coffee was provided for everyone, and when I took a last look round the night nurses were taking charge as if nothing had happened, and the whole place was in the regular routine of an ordinary everyday hospital.

Upstairs there was an improvised meal in progress in the office, and after our two hours' hard work we were glad of it. It is really wonderful how cheerful a thing a meal is in the middle of the night, with plenty of hot coffee and a borrowed cake. It is one of the compensations of our life in hospital, and even shells are powerless to disturb it. After that, as we knew we should have a heavy day before us, we all settled down in the safest corners we could find to get what rest we could. The staircase leading up to the entrance hall was probably the safest spot in the building, covered as it was by a heavy arch, and it was soon packed with people in attitudes more or less restful. A ward with a comfortable bed seemed to me quite safe enough, and I spent the night with three equally hedonistic companions. At first we lay listening to the shells as they passed overhead, sometimes with the soft whistle of distance, and sometimes with the angry shriek of a shell passing near. Occasionally the shriek would drop to a low howl, the note of a steam siren as it stops, and then a deafening crash and the clatter of falling bricks and glass would warn us that we had only escaped by a few yards. But even listening to shells becomes monotonous, and my eyes gradually glued together, and I fell asleep.