A Surgeon in Belgium

by Henry Sessions Souttar

In Antwerp, as we saw her, it was almost impossible to realize the vicissitudes through which she had passed, or to remember that her present prosperity was of little more than fifty years' growth. On all sides we were surrounded by wide boulevards, lined by magnificent houses and public buildings. There are few streets in Europe to eclipse the great Avenue des Arts, which, with its continuations, extends the whole length of the city from north to south. The theatres, the Central Station, the banks, would adorn any city, and the shops everywhere spoke of a wealth not restricted to the few. The wide streets, the trees, the roomy white houses, many of them great palaces, made a deep impression upon us after the darkness and dirt of London. Even in the poorer quarters there was plenty of light and air, and on no occasion did we find the slums which surround the wealthiest streets all over London. In the older parts of the city the streets were, of course, narrower; but even here one had the compensation of wonderful bits of architecture at unexpected corners, splendid relics of an illustrious past. They are only remnants, but they speak of a time when men worked for love rather than for wages, and when an artisan took a pride in the labour of his hands. If it had not been for the hand of the destroyer, what a marvellous city Antwerp would have been! One likes to think that the great creations of the past are not all lost, and that in the land to which the souls of the Masters have passed we may find still living the mighty thoughts to which their love gave birth. Are our cathedrals only stones and mortar, and are our paintings only dust and oil?

The inhabitants of Antwerp were as delightful as their city. On all sides we were welcomed with a kindness and a consideration not always accorded to those who are so bold as to wish to help their fellow-men. Everywhere we met with a courtesy and a generosity by which, in the tragedy of their country, we were deeply touched. They all seemed genuinely delighted to see us, from the Queen herself to the children in the streets. Our medical confreres treated us royally, and the mere thought of professional jealousy with such men is simply ludicrous. They constantly visited our hospital, and they always showed the keenest interest in our work and in any novelties in treatment we were able to show them; and when we went to see them, we were shown all the best that they had, and we brought away many an ingenious idea which it was worth while going far to obtain. Wherever we moved amongst the Belgians, we always found the same simplicity of purpose, the same generosity of impulse. Everywhere we met the same gratitude for what England was doing for Belgium; no one ever referred to the sacrifices which Belgium has made for England.

The one thing which so impressed us in the character of the Belgians whom we met was its simplicity, and the men who had risen to high rank did not seem to have lost it in their climb to fame. But it was just this, the most delightful of their characteristics, which must have made war for them supremely difficult. For strict discipline and simplicity are almost incompatible. None of us tower so far above our fellows that we can command instant obedience for our own sakes. We have to cover ourselves with gold lace, to entrench ourselves in rank, and to provide ourselves with all sorts of artificial aids before we can rely on being obeyed. These things are foreign to the Belgian mind, and as a result one noticed in their soldiers a certain lack of the stern discipline which war demands. Individually they are brave men and magnificent fighters. They only lacked the organization which has made the little British Army the envy of the world. The fact is that they are in no sense a warlike nation, in spite of their turbulent history of the past, and, indeed, few things could be more incompatible than turbulence and modern warfare. It demands on the part of the masses of combatants an obedience and a disregard of life which are repellent to human nature, and the Belgians are above all things human. Germany is governed by soldiers, and France by officials. Unlike the frogs in the fable, the Belgians are content to govern themselves.

It was our great regret that we had so little time in which to see the work of the Antwerp hospitals, but we made use of what opportunities we had. There are many of them, and those we saw were magnificent buildings, equipped in a way which filled us with envy. The great city hospital, the Stuivenberg, was a model of what a modern hospital ought to be. The wards were large and airy and spotlessly clean, and the nurses seemed to be extremely competent. The kitchens were equipped with all the latest appliances, steam boilers, and gas and electric cookers. But the show part of the hospital was the suite of operating theatres. I have always felt the pardonable pride of a son in the theatres of the London Hospital, but they were certainly eclipsed here. Each theatre was equipped with its own anaesthetizing room, its own surgeon's room, and its own sterilizing rooms and stores, all furnished with a lavishness beyond the financial capacity of any hospital in London. Perhaps some of the equipment was unnecessary, but it was abundantly evident that the State appreciated the value of first-class surgery, and that it was prepared to pay for it. I have never heard the same accusation levelled at Great Britain.

At St. Camille we had the good fortune to see M. Xambotte at work. His reputation as a surgeon is worldwide, and it was pleasant to find that his dexterity as an operator was equal to his reputation. It is not always the case. He is an expert mechanic, and himself makes most of the very ingenious instruments which he uses. He was fixing a fractured femur with silver wires, and one could see the skilled workman in all that he did. There is no training-ground for one's hands like a carpenter's bench, and the embryo surgeon might do much worse with his time than spend six months of it in a workshop. When medical training emerges from its medieval traditions, manual training will certainly form a part, and no one will be allowed to attempt to mend a bone till he has shown his capacity to mend a chair-leg. Here, again, the surgeon was surrounded by all the appliances, and even the luxuries, that he could desire. The lot of the great surgeon abroad is indeed a happy one.

But there is one thing in which we in England are far better off—in our nursing staffs. In most of the hospitals we visited the nursing was carried on by Sisterhoods, and though some of them were evidently good nurses, most of them had no idea whatever of nursing as it is practised in our country. Fresh air, for example, is to them full of dangers. One would almost think that it savoured of the powers of evil. We went into one huge hospital of the most modern type, and equipped lavishly, and such wag the atmosphere that in ten minutes I had to make a rush for the door. One large ward was full of wounded soldiers, many of them with terrible wounds, gangrenous and horrible, and every window was tightly shut. How they could live in such an atmosphere is beyond my comprehension, but the Sisters did not seem to notice it at all.

Some of the surgeons have their specially trained nurses, but nursing as a profession for the classes who are alone competent to undertake it is a conception which has yet to dawn upon the Continent, for only a woman of education and refinement can really be a nurse.

The absence on the Continent of a nursing profession such as ours is not without its influence on medicine and surgery abroad. The individual patient meets with far less consideration than would be the case in this country, and is apt to be regarded as so much raw material. In Belgium this tendency is counteracted by the natural kindliness of the Belgian, but in other countries patients are often treated with a callousness which is amazing. There is in many of the great clinics a disregard of the patient's feelings, of his sufferings, and even of his life, which would be impossible in an English hospital. The contact of a surgeon with his hospital patients as individuals is largely through the nursing staff, and his point of view will be largely influenced by them. There is no one in our profession, from the youngest dresser to the oldest physician, who does not owe a great part of his education to Sister.

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