Chapter VIII: Part 8

The Committee, which was formed by M. Millerand at the Ministry of War in the early days of hostilities, to effect reforms in the army medical service, fixed the number of sixty motor-cars per army corps. This number was in direct relation with the accommodation of the hospital trains. But when the war took on the character of a war of manoeuvres it became necessary to employ trains used for ammunition and even for food supply--returning empty to their base--for the evacuation of the wounded. In a general fashion it may be said that the great preoccupation of the military command is to transport the wounded away from the scene of action as rapidly as possible in order to remain unhampered. One could draw a melancholy picture of the first victims of the war and its shambles being sent right across France in crawling trains--the word is applicable in a double sense, a long-drawn-out agony--before the arrival at the base hospital. Never shall I forget the first trainful of British wounded I encountered coming from Mons. The goods train, without seats, benches or beds, crawled and jolted by, passing my train going in the opposite direction. We shouted words of cheer, to which many of the Tommies replied, gaily enough. Some even jumped off the creeping train to pick up the fruit we threw (one fellow, I remember, with a bandaged leg, hopped on one foot in the permanent way, determined not to lose a pear that had fallen there). But others, again, made no reply, and we hushed our voices and bowed our heads as we saw recumbent figures, stretched in cattle trucks on bundles of straw, figures that gave no sign. Would they ever speak again, these men lying alone, untended, in the creaking, jarring train? But these terrible conditions were quickly changed. At the beginning of the war there were only five regular hospital trains provided with beds for the wounded, and a hundred improvised trains, formed to a large extent of the rolling stock of goods trains. The wounded could not be properly attended in such trains, because there was a lack of communication between the different parts, but afterwards, corridor trains were adopted almost exclusively. Nevertheless the number of the wounded was so great, after some of the battles, that every sort of train possible and imaginable had to be pressed into the service. But the Committee, by its wise and careful dispositions, rendered a great service in providing train accommodation for sixty thousand wounded to which the Minister of War added twenty thousand; and which again, I believe, was considerably increased by General Gallieni during his brief but strenuous period at the Ministry of War.

As originally conceived the ambulance of the Front was equipped for major operations as well as the hospital in the rear, but afterwards it was found inadvisable to perform operations in these conditions where the surgeon had not the time or the tranquillity of mind necessary for the purpose; and so by a later arrangement the hospitals for the major operations were placed fifteen or twenty miles to the rear. And so it happened that the first mistakes were rectified. Instead of great and important operations being conducted on the field of battle, subject to the dangers and interruptions from such a propinquity, the more gravely wounded, whose state required amputation, were rapidly transported to these hospitals in the rear after their wounds had been attended to in the first place, and an examination made in the field hospital, or ambulances as they are called in France. This system gave much better results than that adopted in the beginning, whereby the _ambulances de l'avant_ (or advanced ambulances) and the reserve ambulances, the divisional ambulances, and the army ambulances, were interchangeable. They were intended to serve for all the purposes of attending to the wounded. They were used either as a place of temporary relief for the wounded or took on a _quasi_ permanent character according to the necessities of the case. When the advanced ambulances in certain circumstances became stationary, the reserve ambulances followed the army on the march. It seemed in many respects an excellent system, and certainly was very supple and ingenious, for these ambulances became interchangeable; but they possessed the inconvenience, to which I have already alluded--that is to say, the proper sort of attention could not be given to the important cases. Hence the change that the Committee brought about, whereby the _grands blesses_ were transported to the hospital at the rear, where the necessary skill and the instruments required were at their disposal. The present system works in this manner. The battle takes place. The chief medical officer fixes the spot in the rear where the formation ought to be established. The formation establishes itself there in a couple of hours with its motor-cars. An hour after, it has pitched its first tent and is ready to shelter the first wounded which come to it from the ambulances, perhaps in the space of three or four hours. Instruments sterilised in advance permit the surgeons to commence to operate three hours after having received their orders to establish the hospital tent. Other tents can be established to the number of five. A hundred wounded persons can thus be taken care of and treated in the open country. Reserve ambulances can be called upon in case of need. As soon as operated upon, and out of immediate danger, the wounded, in the majority of cases, can be evacuated to permanent hospitals further back in the rear.

In case of retreat, the formation, if warned in time, falls back carrying with it if possible all the wounded and follows the troops. These tent hospitals carry with them the wherewithal to instal an operating theatre and a _section d'hospitalisation_, composed of a hundred beds, five double-walled tents, and the necessary doctors and male attendants. Of course the problem of removing the wounded from these tent hospitals at the Front is always a grave one. When the war took on the character of a siege war, a train acted as a sort of shuttle from the field ambulances to the station where the "army zone" finished and the "interior zone" began. The two were generally seventy or eighty miles apart. Here the wounded were carried to the other train, where the cases were sorted out and sent to the distant base hospitals. But, as I have said, the tendency was to keep the slight cases as near as possible to the lines, and send only to distant parts either medical cases--infectious diseases, and convalescents--or the more serious surgical cases, which were entering upon a secondary phase.

One of the most interesting aspects of the question of the treatment and recovery of the wounded was the utilisation of the mineral waters which exist in such abundance in France, particularly in the Pyrenees; and all the well-known stations of this delightful region were filled with soldiers recovering from their wounds or illnesses incurred in the service of the country. Magnificent results were obtained also by the same means in '70. Strongly impregnated sulphur waters gave then, as they have given during this second war, most admirable results, particularly in combating the infection of wounds caused by fire-arms. It is not necessary to insist upon the dreadful error of the theory that bullet wounds were clean wounds. Before it was discovered that the bullet infected the surrounding tissue much harm had been done. The mineral waters were also invaluable in the treatment of nervous affections arising from wounds and rheumatism contracted in the trenches. Some really remarkable recoveries have been made in this glorious region irradiated by the sun and full of pure air charged with the balsamic odours of a pine-clad district.

Whilst, as I have said, there was rapid improvement made in the various services, the defect inherent in all administrations, English as well as French, but perhaps more particularly French, subsisted. For instance, M. Joseph Reinach, the well-known Deputy, has inveighed especially against the abuse of red tape in the hospitals. All sorts of dreadful formalities were necessary to be fulfilled to obtain a lemon or a bottle of the simplest medicine. There had to be a proper requisition made with several signatures attached, and this entailed visits to different offices situated in different parts of the building--a formidable waste of time. Some string and nails, value 1 fr. 25, appeared in somebody's report. Immediately there was an imperious demand for details, which were supplied, of course--though purely imaginary. The precious document travelled during several weeks from the bottom to the top of the administrative ladder. Papers even pursue the unhappy doctor or stretcher-bearer right into the trenches--though, of course, every reasonable person would admit that records must be kept. M. Reinach, who, furnished with special powers of investigation, has carried his inquiries into every part, points out that even if the high administration decrees simplicity and the different sub-departments apparently incline, they continue their complicated practices just the same. Says M. Reinach, and his words will serve to depict the unhappy state of the public in this country as well as in any other: "We believe we are governed at one time by this party, at another by that. In reality, we are governed by the departments in the interests of a mysterious syndicate of paper merchants. It will require a revolution more profound than that of '89 to rid us of administrative routine." And it must be remembered also--one feels authorised to mention it since it is admitted by M. Reinach, as well as by other thoughtful Frenchmen---that favouritism and nepotism have made terrible ravages in this direction as in so many others; but these abuses have been corrected, we must hope, by the touchstone of war.

One of the most pleasing, and at the same time touching, sides of the war is the heroism in the hospitals. The majority of the patients belong to the class of manual labourer, but they were as dignified, as calmly Stoical, in their way as those who had larger opportunities for education. Though they had never read Epictetus or Marcus Aurelius, and were often just simple labourers, they showed invariably a greatness of soul. Women working in the hospitals have given me pathetic instances of soldiers' gentleness and resignation. They calmly watch the surgeon going about his work probing in their own flesh. They look on apparently unmoved, idly smoking a cigarette. Heroic simple souls of France. They are always joking, even before a most serious operation; one cannot overcome their invincible courage and good humour. Often it is touching enough. In the Metropolitain of Paris I travelled with a man who had lost his leg--one of the numerous army of the mutilated. In conversation he had forgotten to alight at a certain station. The train had already begun to move from the platform, and, to the alarm of those next to him, the poor fellow tried to jump out. He was pulled back just in time. "_J'ai oublie_," he said simply, looking reflectively at the empty trouser leg. In the hospital it is easier, perhaps, to be uncomplaining, to support with appearance of equanimity the pain and suffering of the wounds; it is more difficult in the evacuation stations, where sometimes the wounded have to stay a night exposed to all the discomfort of a provisional arrangement.

There are, too, pathetic instances of self-sacrifice. The "poilu" (as I have said elsewhere in this book) is a generous-hearted soul, very forgiving to his enemies, even when they have done him unspeakable hurt; he will share food with the wounded Boche in the next bed. He will send him his comforts. "Here," he says to the nurse, "take this woollen waistcoat and give it to that chap over there; I have clothes enough." The humanity of the French and their intrinsic civilisation are revealed in the intimacy of the hospitals which are tended by those admirable women whose quiet and unadvertised devotion have inspired the admiration of every beholder.

Another very charming feature is the care taken of the permanently crippled. At Lyons, M. Herriot, the mayor, worked hard in this direction, and established schools where the mutilated could be taught useful trades. M. Maurice Barres in Paris, chiefly by making use of columns in the _Echo de Paris_, worked for the same holy cause. One of the prettiest things is to go into a French hospital and see the semi-convalescents at work upon ingenious and charming little objects wherein they show their taste and inexhaustible ingenuity. They are never at a loss, these sons of France: a cunningly carved flower, an amusing caricature, a doll with articulated limbs, dainty little baskets--all these bear witness to the inherent culture and good taste that are theirs by right of birth, in virtue of having been born on the fruitful soil of France.

I have spoken of the bravery of the soldier as he lies under the surgeon's knife; but let us not forget the signal heroism of the surgeons themselves, and their staffs. They have given proof of a super-human courage and self-forgetfulness, and surgeons and doctors, stretcher-bearers and nurses, have frequently figured in the Army Orders for their absolute devotion to duty. In many cases the enemy granted no truce for the recovery of the wounded, and it was necessary to seek them under a hail of bullets and shell fire. Wounds were dressed on the field of battle during the fight or in ambulances, which the Red Cross flag did not always protect from the bombardment of the Huns. In many cases it was perfectly evident that the building was the positive target of the enemy. The trained nurse, as we understand her in England, hardly existed at the outbreak of the war, but the women of the Red Cross worked in the hospitals and made up for a lack of professional training by a devotion without limits, and a whole-hearted willingness to learn and adapt themselves to the new conditions. It is true that no amount of good-will can supply the want of professional knowledge, but I have the testimony of many doctors that the better-educated Frenchwoman speedily acquired the essential part of hospital practice. The ladies who belonged to the various societies under the Red Cross were unpaid, and had gained their certificates after six-months' service in a hospital. Three societies form the Red Cross organisation in France: the Societe de la Croix Rouge, the Societe de Secours aux Blesses, and Union des Femmes de France. There is a religious basis to the French Red Cross, and before the war, before every woman who had leisure, rushed to offer her services to her beloved country, nursing in France was almost entirely in the hands of the Sisters of Mercy. True, in late years, in the course of the terrible struggle between Church and State, many of these splendid women had been driven from France, banished to carry their beneficence and charity to foreign climes. But when the German hordes swept over the frontier, France was invaded by another silent army, an army of white-capped, calm-browed women, who with exquisite serenity moved to the beds of sickness and suffering. The nursing sisters returned to their kingdom, and the Head of the State bowed to receive them, for their heroism is matchless; they blench at no risks, they falter at no fear of infection; with placid brow they look, undismayed, at the most fearful sights, and the agonised patient, gazing into their steadfast eyes, gains strength and courage from the light of hope and faith that shines there. Never again will the Orders be banished from France.

And the priests on the battle-field showed equal devotion. Those who were of military age fought in the trenches side by side with the "poilu," and prejudice rolled away with the smoke of gunfire. Some again were stretcher-bearers, while those above fifty became chaplains and celebrated Mass in little improvised churches behind the lines. The soldier-priest gave a singular example of Christian courage, an absolute fearlessness which electrified the soldiers who were fighting by his side. I was at Perpignan a few weeks after a priest, who had lost an eye in the trenches, was decorated with the Legion of Honour by the General commanding the district. Truly the blood of these servants of Christ, spilt on the battle-field (and many have been killed), is the seed of the Church, and from their self-sacrifice and heroism will spring a harvest of love and charity, if not actually a revival of religion in France. It is, perhaps, too much to expect a general return to the paths of practising Catholicism, but at least France, having passed through the agony of blood and tears, will have forged a spirit of splendid tolerance; for, as the greatest Healer and Physician came not to bring peace but a sword, the lasting peace that dwells in the heart of a nation is learnt from that supreme teacher, that incomparable healer, the sword.

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