No patient is transferred from a hospital in a critical condition if it can be avoided. But sometimes this is necessary, as it was following the Jutland Battle. Then the most serious cases were held in the hospitals; while, where it was possible, hundreds of cases were despatched to institutions at other ports.
The route of these ambulance trains may differ every round trip. One ambulance train may go to the North of Scotland, while the next one will only go to Glasgow or Edinburgh if there is no call further north. The wonderful organisation not only undertakes to relieve hospitals, but also to ship the patients to institutions unlikely to be suddenly burdened with many cases; and consideration is also given as to where the patient can receive the best attention, such as in southern hospitals.
Fleet-Surgeon A. Stanley Nance is the Medical Transport Officer for Scotland. He is ever on the alert for what is going on in the hospitals in his territory. In the event of a great sea conflict, he receives orders from Sir James Porter and information concerning all the trains which are by that time racing to the ports nearest to the scene of the engagement.
In London, the Medical Transport Officer can place his finger on a railroad map at any time and tell within a mile or so where his trains are. If by any possible chance they are delayed he receives word from the train surgeons.
Knowing the probability of further engagements in the North Sea, quite a number of wealthy private individuals have interested themselves in the hospitals on the East Coast from north to south. And these persons take especial interest in the trains, many of them making it a point to be at the railroad station whenever a Royal Naval Ambulance train pulls in. What with sick men and accidents, the trains now and again may have a full quota of patients without there having been a fleet engagement. In war time no man who is not physically fit is kept aboard ship, for he may not take up another man's place without being able to perform his work.
Exigencies of war have caused the speedy transformation of buildings in many parts of England into hospitals. There also are institutions constructed in temporary form, architecturally not works of art, but wonderfully useful. The surgeons at these latter places have wrought marvels in obtaining good light in the wards and operating-rooms, and creating a comfortable atmosphere in the exteriorly dingy places.
The starting-point or headquarters of the ambulance trains is in the South, and when they plough their way North they carry no patients. The complement of these trains is from forty to fifty hands, and they all look upon the train as a ship, and use sailors' terms. It is the "Sick Bay Express."