A Surgeon in Arms

by R. J. Manion

The only difference between the handling of the wounded during actions and during stationary warfare is the fact that in the former more unavoidable congestion takes place, though this is prevented as far as possible in the forward areas by rushing the cases to the rear or to England. In big actions, where many wounded are expected, this is always done.

After hospital treatment in England or Scotland the men are sent to convalescent homes in Ramsgate, Herne Bay, Whitstable, Sturry, Brighton, or any of the hundred and one other points that are suitable in the British Isles. Later these men are sent before medical boards which decide as to their disposal thereafter. They may be sent directly back to duty; to prolonged rest; to have some weeks, P.T.—physical training—which is not popular with the men, but is often needed; or, they may be marked P.B.—permanent base duty—which means that they are not fit for general service, but are able to perform some duties at the base or at home. Lastly, they may be discharged as permanently unfit for further service, the amount of their pensions being decided by the pension board.

Until the wounded man reaches the C.C.S. his wounds are dressed in very rough surroundings, not the aseptic dressing rooms of peace times. Dugouts, cellars or open trenches are employed for dressing stations. After the battle of Vimy Ridge my boys and I dressed our men for four days in an open, muddy trench, with the shells dropping about all the time. Dugouts are simply holes in the ground, and may be most primitive dressing rooms. Everyone knows how aseptic the ordinary cellar could be made, even with the greatest care on the part of an M.O.'s assistants. But our dressings are folded and wrapped in such a manner that they can be applied, even though the dresser's hands are covered with mud, without the aseptic part of the dressing, which is applied to the wound, being in any way soiled. I have given one hundred and fifty inoculations hypodermically for the prevention of typhoid in a tent in which the men and myself stood ankle deep in mud. Not one case of infection of the point at which the needle was inserted occurred. This illustrates the efficiency one reaches from being accustomed to working in filthy surroundings. Your stretcher bearers and dressers become as skilled in this art as yourself, so that the men really get good attention in spite of the many difficulties in the way. Of course, at the C.C.S., which is five to ten miles from the trenches, the surroundings are as good as they are in the average city hospital. And the base hospitals are often elaborate in their equipment, though they may be situated in large tents or newly constructed wooden huts with stoves to lessen the raw cold of the French winter weather. The base hospitals in England are the highly scientific city hospitals, simply put under military control.

CHAPTER XII
CHEERFULNESS

Something that is noticed by all who have served at the front is the drollery of the men in dangerous or uncomfortable surroundings. Sometimes it is good-natured, sometimes ill-tempered and critical, but it is ever present. One cannot but believe that the wag of the company is better than a tonic to the men, in fact is almost as good a pick-me-up as the rum ration. Who has not felt the benefit of a good laugh? Who has not seen a well-developed sense of humor save a difficult situation, or at least alleviate it?

With Tommy the humor crops out in the most unexpected situations. Under circumstances in which the ordinary man would turn ghastly pale, Tommy cracks a joke. Crossing an open space toward a railway embankment I was fifty yards or so from a culvert through which I had intended passing, when a soldier reached it. He was carrying a load on his back, and was sucking on a pipe, his head bowed in thought. A whizz bang shrieked by me, and struck just at the entrance to the culvert, missing him only by inches. Fortunately it banged into the earth four or five feet beyond his position at the moment, so that the fragments spread from him, not towards him. He had escaped death by a hairbreadth. He stopped in his path, took his pipe from his mouth, raised his head and looked with a surprised air at the hole in the ground made by the bursting shell. His only comment was uttered in a slow voice:

"Well, I'll—be—jiggered!" And putting his pipe back into his mouth, he coolly resumed his walk and his meditation, without altering his course by one inch. Thus do men come to accept narrow escapes from death as a matter of course, where such escapes are as common as is plum jam in the rations.

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The men are plodding along in thick tenacious mud, carrying sixty-pound trench mortars, each foot with its accumulated mud weighing at least twenty pounds, and feeling as if it weighed a ton. They are sweating, and blowing, and tired. They halt for a rest and lean up against the wet, muddy wall of the trench, carelessly chucking the heavy mortars into the mud. Then the wag begins by cursing the bally war, consigning the officers to perdition, condemning the food as unfit for "villyuns," and wishing the Kaiser "wuz in 'ell." "And the blighters hexpect hus to stand an' face the henemy. An' ye betcher life we'll do it too, coz we couldn't run if we want to: we're stuck in the mud!" A smile passes along the tired faces; their rest is over, and more or less rejuvenated, they take up their burdens and pass on.