Category Archives: Orderlies

To hold the hot hand of the man who talks wild

Posted on by
Letter of Condolence

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).

Calm down, dear, it’s only a drama!

Posted on by

We are now three weeks into the six-week run of The Crimson Field, BBC 1’s Sunday night drama set in a First World War ‘field hospital’ ‘somewhere in France’.  The quotation marks around ‘field hospital’ may give some indication as to my opinion of the programme.  It is one of a number of small inaccuracies that, like lice in a uniform, have been driving me (and a number of other historians of British medical care in the First World War) a bit nuts.

In fact, ‘field hospital’ was a term used very little after the Boer War.  I have come across a Territorial medical unit which used the term in relation to the hospital where they trained recruits before they were sent overseas as a field hospital, but the hospitals along the lines of communication were, by 1916, when The Crimson Field is ostensibly set, known as either Casualty Clearing Stations (what would formerly have been referred to as field hospitals) or Stationary or Base Hospitals (of which this appears to be one).

Is this sort of criticism too nit-picky?  Certainly, one of the reactions on Twitter to this type of comment (which I have been making a fair amount of over the past three weeks) has been ‘It isn’t a history lesson, it’s a drama!’ with the implication that criticizing the historical accuracy of the depiction is both unfair and detracts from others’ pleasure in watching.  Essentially, this reaction is a version of ‘If you have nothing nice to say, don’t say it.’

At one level, this is fair enough.  The Crimson Field is a drama rather than a history lesson, and I don’t have any problem with cosy Sunday evening historical dramas.  I actually have a soft spot (as well as remarkably high tolerance for a historian) for such dramas, having recently enjoyed The Musketeers and Call the Midwife, and even, once I had properly suspended disbelief, still relish a good episode of Downton Abbey.  But the BBC itself is creating a block to the sort of suspension of disbelief that I have achieved with Downton by attempting to locate The Crimson Field within its own narrative of historical commemoration.  The programme is part of the ‘World War One’ season and there are regular tweets and links to related factual content on the BBC’s website.  In other words, the BBC is presenting this as both drama and history, even though they are getting quite a lot of that history wrong.

Which brings me to the other reason I have problems with the ‘It’s drama, not history’ criticism.  Because a great deal of my criticism actually is of the programme as a drama.  Having started out quite well, introducing several strong female characters with the potential to develop into interesting individuals opening up new perspectives on the popular understanding of the First World War, the dramatic arc has all too rapidly declined into a series of mythic clichés enacted by stock figures who simply represent modern ideas rather than having any real personality, historic or otherwise.  As Amanda Vickery has pointed out, the plot predominantly involves the imposition of 21st-century ideas and concerns on characters placed rather than fully located in 1916. It is unsurprising, therefore, that the drama feels clichéd and inauthentic as it tries to crowbar issues of class, race and sexuality into story lines that use endless accusations of cowardice as a shorthand for reactions to the horrors of war or attempts to deal with the complicated question of Irish politics in part of one sixty-minute episode.  In other words, The Crimson Field is not only poor history, but also not very good drama, by whatever standards you judge it.

So why do I keep watching?  Why not give it up as a bad job and let those who are enjoying the drama enjoy it in peace?  Two reasons, one superficial, one (I hope) rather less so.  The superficial reason is that, whatever the quality of the drama, the casting is, on the whole, very good.  It is not simply that I would watch Hermione Norris and Suranne Jones in pretty much anything they appeared in, however terrible, but also that they are good enough to bring depth to their parts.  Norris, in particular, has created a believably restrained and awe-inspiring matron, thankfully setting off the bizarre characterization of the hospital CO as a weak and deeply un-awe-inspiring figure.  I will probably keep watching to the end for her alone.

There is, however, a more important reason for why I will keep watching and, for that matter, keep tweeting as I do so.  It might be described as the ‘teachable moment’ excuse, to use a truly abominable American phrase.  Because I am trying to do is not merely criticize for the sake of finding fault, but to explain, insofar as 140 characters lets me, what my research has taught me about the historic reality of medical care in the First World War.  I can not only complain about the representation of a shell shock sufferer in the first episode, but also point out that he would most likely have been treated in isolation for the sake of general morale. Nor is the process only one way.  So far, questions I have had or points I have made have led to interesting discussions of how laundry was done at Base hospitals and the date at which female radiographers began working overseas.  I have thus learned something indirectly from the programme as well as, I hope, giving a little more historic depth to the understanding of a few viewers.

There is also an element of ‘Know thy enemy’ to this.  Yes, I despaired when the one fully-formed orderly character was revealed to be gay in the most historically unlikely of circumstances.  But this particular bit of trite 21st-century plot does provide an opportunity to explain that, while the masculinity of medical orderlies might be (and often was) impugned, it was, as far as I have been able to uncover, never in terms of suspect or criminal sexuality, but rather in terms of age and physical health.  Homosexuality as a pathology affecting war service was an accusation more commonly (although still not very often) leveled at men who failed to enlist or were diagnosed with shell shock, another symptom of an inherent physical and moral insufficiency which signified male degeneracy.  Exploring these distinctions in masculinity is a key element of my research project; finding and exploiting the opportunities to disseminate my research and analysis more widely, in whatever unlikely form, is thus part of my professional remit.  In other words, I watch and critique because it is my job.

This is, of course, fundamentally the same defense for using Blackadder as a teaching tool about the history of the First World War.  The drama or comedy is the starting point, not the destination, and they probably have  more to tell us about the social and cultural context in which they have been created than about the historic realities of the period that they represent.  Using them in this way is not always comfortable.  For historians it means tackling popular historical misconceptions head on and sitting through the itchy discomfort of historically inaccurate dramas to find out what, exactly, has been portrayed and how.  For non-historians who wish to engage, it can mean having assumptions and beliefs punctured and deflated. At the very least, it means being forced out of a comfortable Sunday night of suspended disbelief.  Not everyone wants to spend their Sunday evening leisure engaging critically with what they are watching, and that of course is their prerogative. No one has to either watch and critique or read critical commentary if they choose not to. But I have to admit to enjoy bringing my practice of critical analysis to The Crimson Field of a Sunday, so I will carry on. And maybe in doing so I can also make a not very good drama at least a slightly better history lesson.

Catching up

Posted on by

Last week my husband and I sat down and updated our diaries and (more importantly) the family wall planner for the rest of the year, or at least until November.  A household that consists of two academics and two young children poses some challenges when it comes to attending conferences, seminars and the like.  Remarkably, we seem to be doing quite well, with only one major conflict where both of us are due to speak at different events at the same time.  Fortunately, mine is the Social History Society Conference which takes place in Leeds this year, so I will have skip the evening events to look after the children while my husband swans off to, well, Sweden. (I would be a lot more resentful if it was the South of France, but that isn’t until later in the year.)

Seeing all my commitments written down (bar the yet-to-be scheduled meetings and the workshop I haven’t confirmed funding for but which hopefully will take place in October) has brought home to me just how much writing I have to do.  With a rising sense of panic, I realise that I am giving three conference papers this year, on three different subjects, only one of which I have spoken on before.  The fact that the first of these is the one based most firmly in my primary research topic and will be the first time I have presented at a society’s general annual conference since speaking at the IHR’s Anglo-American conference in the final year of my PhD, getting on for eight years ago, does not help matters.  Last week I found myself facing a blank page, in a state of complete and utter academic paralysis.

This was not helped by the fact that, along with realising just how much work I had set myself to do, I was also put into contact at that time with Dr Emily Mayhew, who is currently working on a narrative history of stretcher bearers during the war.  Her work sounds fascinating and will, quite rightly, introduce the public to this all-too-often forgotten group of servicemen, which is rather what I hoped my work was going to do.  Having also found out that Amanda Vickery will be presenting a new radio series on gender and disability, a subject central to my research since I began it, I started to panic about being seriously behind the curve.  For the first time in my career I began to wonder if my years’ maternity leave, wonderful as it was, might have been a bad idea.

Fortunately, at this point one I had what I can only describe as a stroke of luck, or rather several small strokes.  In rapid succession I discovered that there are copies of the Gazette of the 3rd London General Hospital in the Bamji Collection here at Leeds as well as in the Wellcome Library and, via an unrelated Twitter conversation, began following Sue Light who blogs about the Happy Hospital, as the 3rd London General was known.  The name comes from the title given by Ward Muir, one of the hospital’s orderlies, to his second collection of columns and vignettes, published in 1918.  (His first, and better-known collection, Observations of an Orderly, was published in 1916 and is now available print on demand.)  Co-incidentally, and in my third small stroke of good fortune, I was reading this volume, and worrying that my forthcoming paper was going to be overly weighted to the 3rd London General, when I came across the following:

‘the case of two of our orderlies, both privates, whose sons are officers: these youths will have to be saluted and Sirred if by any chance they ever turn up here as patients and are waited on by their fathers.’

This one sentence contains so much of what my work is about: rank and authority, maturity and age, medical and combat roles.  All at once I was excited again about not only my forthcoming conference paper, despite the narrower-than-desired focus, but also about my project as a whole.  If this is what the experiences of one (very articulate) orderly in one (slightly unusual) hospital have to offer, the potential for unpacking a great deal more about the masculinity of men serving in these roles is still there.  And while the work of Dr Mayhew and Liana Markovich, who is writing on Australian stretcher bearers, will do much to open up the subject of these remarkable men, there is still so much to say about them in relation to courage under fire, the bearing of arms in warfare and the strength necessary to be a soldier.  In fact, I have started toying with the idea of a definition of masculine courage in wartime as endurance of danger in direct and explicit contrast to armed attack. (This will need a lot more work, but given the disproportionate number of medals awarded to RAMC personnel there does seem some basis for exploring this further.)

So I may not have caught up with my year off, or even with my schedule for the next month (the conference paper has yet to be written), but I have come out of the dip in research energy which, along with my fear, was holding me back.  Now to turn my new-found engagement into a decent paper…

From the archives

Posted on by

I have had now had over a week to assimilate the material I gathered from my week in the Wellcome Library and very useful it is turning out to be too.  Of course, I called up a four-volume collection of magazines from the 5th London General Hospital in Wandsworth at 10:30 on my final morning which are filled with stories of hospital life, etchings by C.R.W. Nevinson, who happened to serve as an orderly there until 1915, and the most amazing series of cartoons starring the figure of ‘The Orderlim’ (as opposed to the ‘Orderlette’, female orderlies who were drafted in to replace some male orderlies in 1915).  I was only able to finish about a quarter of the collection, so now I am panting to get back, something that unfortunately won’t happen until the summer at the earliest.

There was a lot more material as well, including the memoirs of two nursing orderlies which were slightly unexpected as they were listed in the catalogue as ‘Field Ambulance stretcher bearers’.  Similarly a man who was initially enlisted as a nursing orderly trained for work with a sanitary unit before embarking for Egypt, a vital role, but one that made for rather dull reading in his diary records of the repetitive disinfection of ambulance train carriages.  I was struck by the extent of this category slippage, which presents me with something of a problem.

The slippage, I suspect, exists not only within roles of within the RAMC but also between combat and non-combat roles. Non-commissioned servicemen in the RAMC were subject to regular comb-outs throughout the war, especially as the manpower shortages grew more acute from 1917.  In the other direction, combat servicemen whose injuries left them at a lower medical classification could find themselves assigned to non-combatant (including medical) roles.  So for many individuals combatant and non-combatant roles both formed part of their service, something that is going to complicate my analysis.  It will also, I suspect, make it harder for me to track down relevant archives as I imagine that most catalogue listings will give precedence to any combat role taken, at whatever stage in the individual’s service.  I will just have to hope for as much good fortune with the archive as I had at the Wellcome!

Looking Ahead

Posted on by

Happy New Year! I hope you have all had very merry and happy holiday seasons. Mine was lovely, marred only by sickness which struck on Boxing Day and has affected one or other member of my household ever since. Still, sore throats notwithstanding, we KBO.

Today is my first back at work since the holidays, although given the silence in the corridors, most of my colleagues have decided that this half a week is a bit pointless and have sensibly stayed away. With only one day in the office, I have mainly been concentrating on clearing my desk in preparation for the new year and, having almost succeeded (there is one proposal still to draft that is proving so intractable that I think yet another cup of tea will be needed to crack it), I thought this would a good opportunity to take a look ahead at what 2013 has to offer.

Firstly we have a great line-up of speakers for the Legacies of War seminar series. Final confirmation of titles is pending (and the full list will be posted in a week or so), but Adrian Gregory and Santanu Das have both agreed to speak, on ‘Did God Survive the Somme’ (!) and on ‘India, Empire and the First World War’. Both should be fascinating.

Before then I will be heading off to London, to the Wellcome Library where I will be on the hunt for memories of and about medical orderlies. Having had my proposal on the experiences of orderlies accepted for the Social History Society’s annual conference in March (see here for details), I am now looking for material to support the conclusions I have been drawing from reading Ward Muir’s Observations of an Orderly.  There is at least one orderly memoir at the Wellcome, plus a long list of potential manuscript sources, so it will be a busy.  I am also hoping to attend the IHR conference on open access, The Finch Report, open access and the historical community while I am there (there is a waiting list).

Also coming up is a meeting at the Imperial War Museum North for academics across the North of England to discuss plans for the centenary commemorations and I will be taking the opportunity to go round the ‘Saving Lives’ exhibition while I am there.

There are also a couple of long term plans that are starting to take shape – workshop for the autumn on the history of medicine and warfare, a journal special issue that I have been putting together for years now that hopefully will find a suitable home this year, plans for a primary school class on First World War medicine that may or may not include an accurate reproduction of a stretcher and work with some of the All Our Stories projects relating to Leeds hospitals during the war that have received funding.

And in the interim there will be reading and writing – lots of both.  There is the article on voluntary medical services and their relation to the military that I have been trying to write for a couple of months now, and the stack of books on the Territorial Army sitting seductively on my desk which will, hopefully, inform it.  There is the aforementioned conference paper on medical orderlies and the related research.  There is a beautiful (literally – the cover image is gorgeous) book from Ashgate to review.  And there is the ever-growing reading list, not including the ten books sitting disconsolate on my ‘to read’ shelf awaiting my attention.

So all in all it looks as if this will be a very busy and hopefully productive year in the annals of Arms and the Medical Man.  I will, of course, keep you updated as I go along.  I hope you enjoy the ride as much as I think I will.

The Wood for the Trees

Posted on by

The Wood for the Trees

 

And what, you may well ask, has been happening with my official research project in between watching Parade’s End and musical tributes to Richard III?  Quite a lot as it happens, mainly involving list making.

 

The terrifying and exhilarating part of being at this early stage of a research project is the sheer number of potential sources and useful books that emerge as you start to delve into the subject.  No one, and I really mean no one, has written about the RAMC Other Ranks.  There is plenty of stuff about doctors and nurses but stretcher bearers and orderlies and ambulance drivers get a passing mention by academics or are completely subsumed in discussions of conscientious objectors.  Which isn’t to say that they didn’t write about themselves.  Many did, most notably Ernest Hemingway and Ward Muir, as well as many, many others whose letters and memoirs were never published but are now accessible in various archives.  All of which leaves me with a book and sources list that is now running to seven single-spaced pages and counting.

 

Even more excitingly my list making has uncovered the pleasing fact that the Special Collections at the Brotherton Library now includes the recently donated Bamji Collection of medical books relating to the First World War.  Having applied for my grant on the basis of the well-known Liddle Collection of First World War documents and artefacts, to suddenly have all this directly related material at my fingertips feels like serendipity.  Part of me is aching to get into the archive to start uncovering what it there.  Part of me is also scared.  How much of this mass of material will actually be useful remains unknown and it will take a lot of very hard work to properly investigate, assimilate and understand it all.  As I say, terrifying and exhilarating.

 

So I have been procrastinating on actually digging into the archive by making other lists: lists of speakers for a seminar I am helping to organise (although one of my co-organisers has proved to be list-maker extraordinary and put my efforts shame), lists of potential contributors to a special issue of a journal that I am trying to put together, lists of related projects and the bodies that might help fund them, lists of potential topics to be included in a call for papers for a conference I want to run.  At some point I am going to have to start actually doing something about these lists – reading books, sending e-mails, writing articles and reviews.  But that will have to wait for next week.  In the meantime I am revelling in all the exciting possibilities that my lovely lists represent.