A Surgeon in Belgium

by Henry Sessions Souttar

At Selsaete, only a mile from the Dutch frontier, we turned southwards towards Ghent, and for an interminable distance we followed the bank of a large canal. A few miles from Ghent we met Commander Samson, of the Flying Corps, and three of his armoured cars. The blaze of their headlights quite blinded us after the darkness in which we had travelled, but the sight of the British uniforms and the machine guns was a great encouragement. The road was so narrow that they had to turn their cars into a field to let us pass. We had just come up with a number of farm waggons, and the clumsy Flemish carts, with their huge horses, the grey armoured cars, with their blazing headlights, and our four red motor-buses, made a strange scene in the darkness of the night. At last we reached Ghent utterly tired out, though personally I had slept a sort of nightmare sleep on the top step of a bus which boldly announced its destination as Hendon. It was five o'clock, and day was breaking as we got our patients out of the buses and deposited them in the various hospitals as we could find room for them. To our unspeakable relief, we found that the rest of our party had come through by much the same road as we had taken ourselves, but they had reached Ghent quite early the night before. Their earlier start had given them the advantage of clearer roads and daylight. With good fortune little short of miraculous, we had all come so far in safety, and we hoped that our troubles were over. Alas, we were told that though Germans were expected to enter Ghent that very day, and that all British wounded must be removed from the hospitals before ten o'clock. There was nothing for it but to collect them again, and to take them on to Ostend. One had died in the night, and two were too ill to be moved. We left them behind in skilled hands, and the others we re-embarked on our buses en route for Bruges and Ostend.

The First Act in the story of the British Field Hospital for Belgium was drawing to an end. Our hospital, to which we had given so much labour, was gone, and the patients, for whom we had grown to care, were scattered. Yet there was in our hearts only a deep gratitude that we had come unharmed, almost by a miracle, through so many dangers, and a firm confidence that in some other place we should find a home for our hospital, where we could again help the brave soldiers whose cause had become so much our own.

XV Furnes

A week after we had reached London, we were off again to the front. This time our objective was Furnes, a little town fifteen miles east of Dunkirk, and about five miles from the fighting-line. The line of the Belgian trenches ran in a circle, following the course of the River Yser, the little stream which has proved such an insuperable barrier to the German advance. Furnes lies at the centre of the circle, and is thus an ideal position for an advanced base, such as we intended to establish. It is easy of access from Dunkirk by a fine main road which runs alongside an important canal, and as Dunkirk was our port, and the only source of our supplies, this was a great consideration. From Furnes a number of roads lead in various directions to Ypres, Dixmude, Nieuport, and the coast, making it a convenient centre for an organization such as ours, requiring, as we did, ready means of reaching the front in any direction, and open communication with our base of supplies.

We crossed from Dover in the Government transport, and arrived at Dunkirk about ten o'clock on Tuesday morning. There we met Dr. Munro's party, the famous Flying Ambulance Corps, with whom we were to enter on our new venture. They had not come over to England at all, but had come down the coast in their cars, and had spent the last few days in Malo, the seaside suburb of Dunkirk. The Belgian Government very kindly lent us a couple of big motor-lorries in which to take out our stores, and with our own motors we made quite a procession as we started off from the wharf of Dunkirk on our fifteen-mile drive to Furnes. It was late in the afternoon when we reached our new home. It was a large school, partly occupied by the priests connected with it, partly by officers quartered there, and one of the larger classrooms had been used as a dressing-station by some Belgian doctors in Furnes. For ourselves, the only accommodation consisted of a few empty classrooms and a huge dormitory divided into cubicles, but otherwise destitute of the necessaries for sleep. Several hours' hard work made some change in the scene, mattresses and blankets being hauled up to the dormitory, where the nursing staff was accommodated, while straw laid down in one of the classrooms made comfortable if somewhat primitive beds for the male members. Meanwhile, in the kitchen department miracles had been accomplished, and we all sat down to dinner with an appetite such as one rarely feels at home, and for which many of our patients over in England would be willing to pay quite large sums. The large room was lit by two candles and a melancholy lamp, there was no tablecloth, the spoons were of pewter, with the bowls half gone, and the knives were in their dotage. But the scales had fallen from our eyes, and we realized what trifles these things are. Madame, the genius who presided over our domestic affairs, and many other affairs as well, and her assistants, had produced from somewhere food, good food, and plenty of it; and what in the world can a hungry man want more? Truly there are many people who require a moral operation for cataract, that they might see how good is the world in which they live.

Next day we proceeded to unpack our stores, and to try to make a hospital out of these empty rooms, and then only did we discover that an overwhelming misfortune had overtaken us. By some extraordinary circumstance which has never been explained, we had lost practically the whole of the surgical instruments which we had brought out of Antwerp with such trouble and risk. They were tied up in sheets, and my own impression is that they were stolen. However that may be, here we were in as ludicrous a position as it is possible for even a hospital to occupy, for not only had we none of the ordinary instruments, but, as if Fate meant to have a good laugh at us, we had a whole series of rare and expensive tools. We had no knives, and no artery forceps, and not a stitch of catgut; but we had an oesophagoscope, and the very latest possible pattern of cystoscope, and a marvellous set of tools for plating fractures. It reminded one of the costume of an African savage—a silk hat, and nothing else. Some Belgian doctors who had been working there lent us a little case of elementary instruments, and that was absolutely all we had.

Scarcely had we made this terrible discovery, when an ambulance arrived with two wounded officers, and asked if we were ready to admit patients. We said, "No," and I almost think that we were justified. The men in charge of the ambulance seemed very disappointed, and said that in that case there was nothing for it but to leave the wounded men on their stretchers till an ambulance train should come to take them to Calais, which they might ultimately reach in two or three days' time. They were badly wounded, and we thought that at least we could do better than that; so we made up a couple of beds in one of the empty rooms, and took them in. Little did we dream of what we were in for. An hour later another ambulance arrived, and as we had started, we thought that we might as well fill up the ward we had begun. That did it. The sluice-gates were opened, and the wounded poured in. In four days we admitted three hundred and fifty patients, all of them with injuries of the most terrible nature. The cases we had seen at Antwerp were nothing to these. Arms and legs were torn right off or hanging by the merest shreds, ghastly wounds of the head left the brain exposed. Many of the poor fellows were taken from the ambulances dead, and of the others at least half must have died.

For four days and four nights the operating theatre was at work continuously, till one sickened at the sight of blood and at the thought of an operation. Three operating tables were in almost continuous use, and often three major operations were going on at the same time; and all the instruments we had were two scalpels, six artery forceps, two dissecting forceps, and a finger- saw. Think of doing amputations through the thigh with that equipment! There was nothing else for it. Either the work had to be done or the patients had to die. And there was certainly no one else to do it. The rapid advance of the Germans had swept away all the admirable arrangements which the Belgian Army had made for dealing with its wounded. The splendid hospitals of Ghent and Ostend were now in German hands, and there had not yet been time to get new ones established. The cases could be sent to Calais, it was true, but there the accommodation was so far totally inadequate, and skilled surgical assistance was not to be obtained. For the moment our hospital, with its ludicrous equipment, was the only hope of the badly wounded. By the mercy of Heaven, we had plenty of chloroform and morphia, and a fair supply of dressings, and we knew by experience that at this stage it is safer to be content with the minimum of actual operative work, so that I think it was we, rather than our patients, who suffered from the want of the ordinary aids of surgery. In the wards there was a shortage, almost as serious, of all the ordinary equipment of nursing, for much of this had been too cumbrous to bring from Antwerp; and though we had brought out a fair supply of ordinary requirements, we had never dreamt of having to deal with such a rush as this. Ward equipment cannot be got at a moment's notice, and the bulk of it had not yet arrived. We only possessed a dozen folding beds, in which some of the worst cases were placed. The others had to lie on straw on the floor, and so closely were they packed that it was only with the greatest care that one could thread one's way across the ward. How the nurses ever managed to look after their patients is beyond my comprehension, but they were magnificent. They rose to the emergency as only Englishwomen can, and there is not one of those unfortunate men who will not remember with gratitude their sympathy and their skill.

During these first days a terrific fight was going on around Dixmude and Nieuport, and it was a very doubtful question how long it would be possible for the Belgian and French troops to withstand the tremendous attacks to which they were being subjected. The matter was so doubtful that we had to hold ourselves in readiness to clear out from the hospital at two hours' notice, whilst our wounded were taken away as fast as we could get them into what one can only describe as a portable condition. It was a physical impossibility for our wards to hold more than a hundred and fifty patients, even when packed close together side by side on the floor, and as I have said, three hundred and fifty were dealt with in the first four days. This meant that most of them spent only twenty-four hours in the hospital, and as we were only sent cases which could not, as they stood, survive the long train journey to Calais, this meant that they were often taken on almost immediately after serious operations. Several amputations of the thigh, for example, were taken away next day, and many of them must have spent the next twenty-four hours in the train, for the trains were very tardy in reaching their destination. It is not good treatment, but good surgery is not the primary object of war. The fighting troops are the first consideration, and the surgeon has to manage the best way he can.