A Surgeon in Belgium

by Henry Sessions Souttar

Our personnel had undergone considerable alteration, for while several of our original members had dropped out, we had joined forces with Dr. Hector Munro's Ambulance Corps, and four of their doctors had joined our medical staff. Dr. Munro and his party had worked in connection with the hospitals of Ghent till the German advance forced both them and ourselves to retreat to Ostend. There we met and arranged to carry on our work together at Furnes. The arrangement was of the greatest possible advantage to both of us, for it gave us the service of their splendid fleet of ambulances, and it gave them a base to which to bring their wounded. We were thus able to get the wounded into hospital in an unusually short space of time, and to deal effectively with many cases which would otherwise have been hopeless. Smooth coordination with an ambulance party is, in fact, the first essential for the satisfactory working of an advanced hospital. If full use is to be made of its advantages, the wounded must be collected and brought in with the minimum of delay, whilst it must be possible to evacuate at once all who are fit to be moved back to the base. In both respects we were at Furnes exceptionally well placed.

We were established in a large straggling building of no attraction whatever except its cubic capacity. It was fairly new, and devoid of any of the interest of antiquity, but it presented none of the advantages of modern architecture. In fact, it was extremely ugly and extremely inconvenient, but it was large. Two of the largest classrooms and the refectory were converted into wards. At first the question of beds was a serious difficulty, but by the kind intervention of the Queen we were able to collect a number from houses in the town, whilst Her Majesty herself gave us twenty first-class beds with box-spring mattresses. Later on we got our supplies from England, and we could then find beds for a hundred patients. Even then we were not at the end of our capacity, for we had two empty classrooms, the floors of which we covered with straw, on which another fifty patients could lie in comfort until we could find better accommodation for them. We could not, of course, have fires in these rooms, as it would have been dangerous, but we warmed them by the simple plan of filling them with patients and shutting all the windows and doors. For the first few nights, as a matter of fact, we had to sleep in these rooms on straw ourselves, and in the greatest luxury. No one who has slept all his life in a bed would ever realize how comfortable straw is, and for picturesqueness has it an equal?

I went into the Straw Ward on my round one wild and stormy night. Outside the wind was raging and the rain fell in torrents, and it was so dark that one had to feel for the door. Inside a dozen men lay covered up with blankets on a thick bed of straw, most of them fast asleep, while beside one knelt a nurse with a stable lantern, holding a cup to his lips. It was a picture that an artist might have come far to see—the wounded soldiers in their heavy coats, covered by the brown blankets; the nurse in her blue uniform and her white cap, the stable lantern throwing flickering shadows on the walls. It was something more than art, and as I glanced up at the crucifix hanging on the wall I felt that the picture was complete.

Above the two larger wards was a huge dormitory, divided up by wooden partitions into some sixty cubicles, which provided sleeping accommodation for the bulk of our staff. They were arranged in four ranks, with passages between and washing arrangements in the passages, and the cubicles themselves were large and comfortable. It was really quite well planned, and was most useful to us, though ventilation had evidently not appealed to its architect. Two rows were reserved for the nurses, and in the others slept our chauffeurs and stretcher-bearers, with a few of the priests. Our friends were at first much shocked at the idea of this mixed crowd, but as a matter of fact it worked very well, and there was very little to grumble at. The only real disadvantage was the noise made by early risers in the morning, convincing us more than ever of the essential selfishness of the early bird. A few of us occupied separate rooms over in the wing which the priests had for the most part reserved for themselves, and these we used in the daytime as our offices.

But the real sights of our establishment were our kitchen and our chef; we might almost have been an Oxford college. Maurice had come to us in quite a romantic way. One night we took in a soldier with a bullet wound of the throat. For some days he was pretty bad, but he won all our hearts by his cheerfulness and pluck. When at last he improved sufficiently to be able to speak, he told us that he was the assistant chef at the Hotel Metropole in Brussels. We decided that he ought to be kept in a warm, moist atmosphere for a long time, and he was installed in the kitchen. He was a genius at making miracles out of nothing, and his soups made out of bacon rind and old bones, followed by entrees constructed from bully beef, were a dream. He was assisted by the nuns from Louvain who had accompanied us to Poperinghe, and who now worked for us on the sole condition that we should not desert them. They were very picturesque working in the kitchen in their black cloaks and coifs. At meal-times the scene was a most animated one, for, as we had no one to wait on us, we all came in one after the other, plate in hand, while Maurice stood with his ladle and presided over the ceremonies, with a cheery word for everyone, assisted by the silent nuns.

The getting of supplies became at times a very serious question. Needless to say, Furnes was destitute of anything to eat, drink, burn, or wear, and Dunkirk was soon in a similar case. We had to get most of our provisions over from England, and our milk came every morning on the Government transport, from Aylesbury. For some weeks we were very hard up, but the officer in charge of the naval stores at Dunkirk was very good to us, and supplied us with bully beef, condensed milk, cheese, soap, and many other luxuries till we could get further supplies from home. We used a considerable quantity of coal, and on one occasion we were faced by the prospect of an early famine, for Furnes and Dunkirk were empty. But nothing was ever too great a strain for the resources of our housekeeper. She discovered that there was a coal-heap at Ramscapelle, five miles away, and in a few hours an order had been obtained from the Juge d'Instruction empowering us to take the coal if we could get it, and the loan of a Government lorry had been coaxed out of the War Lords. The only difficulty was that for the moment the Germans were shelling the place, and it was too dangerous to go near even for coal; so the expedition had to be postponed until they desisted. It seemed to me the most original method of filling one's coal-cellar of which I had ever heard. And it was typical of a large number of our arrangements. There is something of the Oriental about the Belgians and the French. If we wanted any special favour, the very last thing we thought of doing was to go and ask for it. It was not that they were not willing to give us what we asked for, but they did not understand that method of approach. What we did was to go to breakfast with the Juge, or to lunch with the Minister, or to invite the Colonel to dinner. In the course of conversation the subject would be brought up in some indirect way till the interest of the great man had been gained; then everything was easy. And surely there is something very attractive about a system where everything is done as an act of friendship, and not as the soulless reflex of some official machine. It is easier to drink red wine than to eat red tape, and not nearly so wearing to one's digestion.

As we were fifteen miles from Dunkirk, and as everything had to be brought out from there, transport was a serious problem. Every morning one of our lorries started for our seaport soon after nine, carrying the hospital mailbag and as many messages as a village carrier. The life of the driver was far more exciting than his occupation would suggest, and it was always a moot point whether or not he would succeed in getting back the same night. The road was of the usual Belgian type, with a paved causeway in the middle just capable of allowing two motors to pass, and on each side was a morass, flanked on the right by a canal and on the left by a field. The slightest deviation from the greasy cobbles landed the car in the mud, with quite a chance of a plunge into the canal. A constant stream of heavy army lorries tore along the road at thirty or more miles an hour, and as a rule absolutely refused to give way. It took a steady nerve to face them, encouraged as one was by numbers of derelicts in the field on the one side and half in the canal on the other. On one bridge a car hung for some days between heaven and earth, its front wheels caught over the parapet, and the car hanging from them over the canal—a heartening sight for a nervous driver. It was rarely that our lorry returned without some tale of adventure. The daily round, the common task, gave quite enough occupation to one member of the community.

XVIII Work At Furnes

Our work at Furnes differed in many ways from that at Antwerp. All its conditions were rougher, and, as we had to deal with a number of patients out of all proportion to our size, it was impossible to keep any but a few special cases for any length of time. We admitted none but the most serious cases, such as would be instantly admitted to any London hospital, and when I mention that in five weeks we had just a thousand cases in our hundred beds, the pressure at which the work was carried on will be realized. There is no hospital in England, with ten times the number of beds, that has ever admitted to its wards anything like this number of serious surgical cases. We were essentially a clearing hospital, with this important proviso, that we could, when it was required, carry out at once the heaviest operative work, and retain special cases as long as we thought fit. Our object was always to get each patient into such a condition that he could be transferred back to the base without injury to his chances of recovery, and without undue pain, and I believe we saved the life of many a patient by giving him a night's rest in the Straw Ward, and sending him on next day with his wound properly dressed and supported. The cases themselves were of a far more severe type than those we had at Antwerp. There, indeed, I was astonished at the small amount of injury that had in many cases resulted from both shrapnel and bullet wounds, and it was certainly worthy of note that we had never once in our work there had to perform an amputation. At Furnes, we drew our patients from the line between Nieuport and Dixmude, where the fighting was for the most part at close range and of a most murderous nature. There were no forts, and the soldiers had little or no protection from the hail of high-explosive shells which the enemy poured upon them. In Nieuport and Dixmude themselves the fighting was frequently from house to house, the most deadly form of fighting known. The wounds we had to treat were correspondingly severe—limbs sometimes almost completely torn off, terrible wounds of the skull, and bullet wounds where large masses of the tissues had been completely torn away. It was difficult to see how human beings could survive such awful injuries, and, indeed, our death-roll was a long one. Added to this, the men had been working in the wet and the mud for weeks past. Their clothes were stiff with it, and such a thing as a clean wound was not to be thought of. Simple cases at Antwerp were here tedious and dangerous, and they required all the resources of nursing and of surgery that we could bring to bear upon them. Still, it was extraordinary what good results followed on common-sense lines of treatment, and we soon learnt to give up no case as hopeless. But each involved a great amount of work, first in operating and trying to reduce chaos to reason, and then in dressing and nursing. For everyone all round—surgeons, dressers, and nurses—it was real hard physical labour.