To hold the hot hand of the man who talks wild

There have been a lot of war metaphors thrown about since the start of the Covid-19 crisis. Donald Trump has styled himself as a ‘war’ president; commentators compare Boris Johnson to Churchill, both favourably and unfavourably; the ‘Blitz spirit’ has been invoked (and critiqued) as the public response to social distancing and lockdown; and manufacturing has, in an echo of the economic mobilisation of total war, been rallied to supply ventilators and other necessary medical supplies. Our language has become military  with talk of care workers and food supplier being on the ‘front line’, of shirkers and spivs and black markets. In my own home, having reached the end of fourteen days in self-isolation during which we were unable to get any food delivered other than milk and eggs (blessings be on our milkman!), my children have learned a great deal about the history of rationing – and how to bake bread.

But there is another, more difficult way in which the history of war has echoes in today’s crisis. Because, like so many battlefield casualties, those dying with or of Covid-19 are doing so far from their families. The emotional burden that this fact brings with it is something that the history of both British mourning practices and medical care in the First World War can tell us about.

The Victorian ideal of a ‘good death’ – the individual dying in bed surrounded by their loved ones with time to utter final profound, pious words – was, of course, always a myth. [1] That myth, however, was utterly demolished by carnage of the First World War. Men died in large numbers, far from their families. The technology of war had the power not merely to kill but to destroy, even obliterate bodies. The recording and reporting of deaths in such circumstances meant that official news could take time to reach families, often contained only the barest details and could, in some cases, be inaccurate. The result was the reinforcement of the importance of one mourning practice of the pre-war era, that of writing letters of condolence.

While official notification of death could be brief and brutal, a telegram informing the family that their loved one had been killed in action, died of wounds or was missing, it would almost always be followed, or indeed occasionally preceded, by a letter from a commanding officer. In many cases, this would then be followed by letters from the deceased man’s comrades; in some cases, particularly where a man was missing, presumed dead, extensive correspondences grew up between men’s families and the men of their military unit.

These letters were more detailed than the initial announcement, not only celebrating the character of the man in question, but also telling the story of his death. Depending on how well known the man was to his officer and comrades, these letters could be generic or personal in their description of men as individuals. But the detail they contained acknowledged the importance for families of knowing both that their loved one had been known as an individual and also how he had died. As E. K. Smith’s platoon sergeant wrote to his parents, he was ‘only too tell you what actually happened, & being as you say a parent myself, I know you would like even the smallest details concerning the sad event.’ [2]

The descriptions of the death itself could vary in detail, depending on when and where it happened. A death in the midst of an action could be more difficult to describe than one which occurred on quiet day in the line. Almost all, however, had one thing in common – the depiction of the death as ‘clean’ and usually quick. Gerald Stewart’s parents were reassured, for example, that ‘Your son was killed by a bullet and died without suffering any pain. He was not one whit mutilated, and as I looked down at his face as he lay in the battle field I remarked how bonny he looked.’ [3] W. Lindsey ‘was at the time of being wounded splendidly advanced and skilfully leading his men’ while A. R. William’s ‘died a soldier’s death giving his live saving the lives of his comrades.’ [4] Wartime letters of condolence did not seek to tell the truth of death to families who could not be there when their loved one died. Rather they sought to bring emotional solace by emphasising lack of suffering and even heroism in the face of death. While deaths from coronavirus may not lend themselves as clearly to stories of heroic action, the daily newspaper columns giving brief descriptions of those who died points to the need, both of families and society more broadly, to construct a narrative around individual deaths. The need to articulate death as meaningful only becomes more powerful when it occurs at a distance.

Not all or even most of those who died during the First World War did so on the battlefield, however. The system of medical evacuation, which emphasised clearing the ill and wounded from the field in order to leave it clear for combat, meant that many men died in one of the sites of medical care that made up the chain of evacuation. For men who made it as far back as a base or home hospital, there was the potential for their families to be by their sides. Wealthy families could pay to travel to and stay near where their loved one was hospitalised, even as far as the base ports in France. For the majority of families, such travel was beyond their means; in the case of fatal wounds and illness, grants were made available for families to travel to be with their loved ones at the point of death. The importance of such connections was acknowledged by the British state and society at the time.

However, even where money was available and families were able to travel, only a tiny minority were able to be at there for men dying in hospitals. And for men dying in Casualty Clearing Stations or dressing stations, family visits were never an option. For the vast majority of men dying in sites of care during the war, those by their sides at the end were care providers – nurses, chaplains and medical orderlies. To these men and women fell the task of ensuring not only that the story of a man’s death was told to his family but, even more importantly, that he did not die alone.

The emotional labour that this entailed was immense. George Swindell, a Royal Army Medical Corps stretcher bearer recalled the period he spent seconded to a moribund ward, nursing men whose wounds were too serious to treat alongside a chaplain, as one of the most difficult of his military service. [5] As Alice Kelly has noted in relation to nurses, ‘A large part of the … role was comforter, and all of the nurses’ accounts record the men seeking comfort from the author, both physically and mentally.’ [6] Chaplains, working in religious traditions of death bed visiting and vigil, might have some experience with this form of labour. Nurses and orderlies as a rule did not. Yet throughout the war they acted as bridges between the dying and their families, taking final messages to pass on to loved ones, reassuring the dying that they were cared for and not alone.

If the conditions reported on hospital wards in Spain and Italy are anything to go by, this is a form of labour that hospital staff will increasingly be required perform as part of their care for Covid-19 sufferers. The nature of the illness is such that they must be isolated from their family in extremis, and treated by carers shielded, where available, by extensive personal protective equipment. In such circumstances, where the dying sufferer is isolated, with limited physical contact with other people, the importance of communicating emotion between the sufferer and their loved ones becomes even more important. This will come, as it did for caregivers in the First World War, on top of immense physical strains to simply provide care for all those suffering.

Are there lessons to be learned from this history? Until comparatively recently, the emotional labour of carers was not the subject of much discussion. [7] And, as the late Sir Michael Howard noted, ‘historians may claim to teach lessons …. But “history” as such does not.’ [8] But in acknowledging the significance of the role that care providers, not just doctors and nurses but nursing assistants, orderlies, even cleaning staff, can potentially play in bridging the distance between the dying and those they love and who love them, we can, perhaps, more fully appreciate the care being given not only to the bodies of individual patients but to the psyche of society as a whole.

In 1917, Private W.H. Atkins wrote a poem in praise of the quiet heroism of the men of the Royal Army Medical Corps, including the nursing orderly:

Oh! it’s weary work in the white-washed ward,

Or the blood-stained Hospital base,

To number the kit of the man who was hit

And cover the pale, cold face,

To hold the hot hand of the man who talks wild

And blabs of his wife or his kids,

Who dreams he is back in the old home again,

Till the morphia bites, and he loses his pain

As sleep settles down on his lids. [8]

Today, in hospitals up and down the country and across the world, carergivers will be doing similar weary work. It may not earn as much recognition as the physical labour of medical caregiving or the danger that they will be putting themselves in of catching a potentially fatal illness. But this necessary emotional work is heroic nonetheless.

[1] Pat Jalland, Death in the Victorian Family (Oxford: Oxford University Press, 1996); David Cannadine, ‘War and Death, Grief and Mourning in Modern Britain’ in Mirrors of Mortality: Studies in the Social History of Death, ed. Joachim Whaley (London: Europa, 1981), pp.187-242.

[1] G. Gould, letter to Mrs. E. Smith, 24th January, 1916, Letters of E. K. Smith, Documents.2535, Imperial War Museums, London (IWM).

[2] Lt.-Col. S MacDonald, Letter to Mr Stewart, 14th April, 1917, Papers of G. Stewart, Documents.8572, IWM.

[3] W. Gillam, letter to Mr Lindsay, 4th August, 1917, Papers of W Lindsay, Documents.11765, IWM; Lt. Collinson, letter Mr Williams, Papers of A. R. Williams, Documents.4436, IWM.

[4] George Swindell, ‘In Arduis Fidelus: Being the story of 4 ½ years in the Royal Army Medical Corps’. TS memoir, RAMC 421, The Wellcome Library, pp. 118–19.

 [5] Alice Kelly, ‘”Can One Grow Used to Death?”: Deathbed Scenes in Great War Nurses’ Narratives’ in The Great War: From Memory to History, eds. Kellen Kurschinski, et. al. (Waterloo, Ontario: Wilfred Laurier University Press, 2015), p.338.

[6] Carol Acton and Jane Potter, ‘”These frightful sights would work havoc with one’s brain”: Subjective Experience, Trauma, and Resilience in First World War Writings by Medical Personnel’, Literature and Medicine 30(1), 61-85, here 62.

[7] Michael Howard, The Lessons of History (New Haven: Yale University Press, 1991), p.11.

[8] W. H. Atkins, ‘The R.A.M.C.’, The ‘Southern’ Cross 2 (June 1917).

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