Repairing British and Australian soldiers after WW1

In the article "Horrors of Anzac aftermath laid bare",  The Age Newspaper in Melbourne tried to uncover WW1 soldiers' personal stories. The timing was perfect - just in time for the 100th anniversary of the war in 2014. Private Bertram Byrnes' war service record, for example, is on the Australian National Archives website. It tells, in sparse, bureaucratic language, that Byrnes enlisted at 24, served in France and was twice wounded in action. The last injury, a gunshot wound to the face in September 1918, saw him invalided home. But there is only one letter from him in the records, written in 1938, the year before the war broke out. Byrnes asked for duplicates of service medals lost in a bushfire; he wanted to wear them on Anzac Day.

Mind you, reading the service dossier tells us very little about Private Byrnes or his family, or his wound and what it actually did to him and those he loved. A medical report by Repatriation doctors refers to ''much facial disfigurement''. The wound was so severe that he dribbled constantly and had to live on what was called ''slop food''. His disfigurement, altered little by a series of painful operations, was such that most employers rejected him - he was shunned, ostracised, took up a remote block of land as a soldier settler, and found himself too weak to work it.

In the Repatriation Reports you can hear the hushed voices of what they called ''the whispering men'', men whose lungs were corroding, who died years after the war from the effects of being gassed. You can see the shaking bodies of the nerve cases - a war-wrecked generation crippled by physical and psychological scars. And women's voices are threaded through this extraordinary archive; wives struggling to survive on inadequate pensions; mothers pleading the case of disabled sons; daughters afraid of violent, traumatised fathers.

But history is much more than an endless catalogue of horrors. Like a generation of our countrymen and women, their battles didn't end in 1918.

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After WW1 ended in Britain, tragedy continued for a lifetime for those who never saw their husbands, sons or fathers again. Even for those soldiers who managed to return home alive, the armistice offered little consolation to those who were indelibly marked by war, with their missing legs and their horribly scared faces. But in Britain and elsewhere, the misery couldn't be avoided - those physic­ally damaged by the fighting could not be locked away in asylums or prisons. Somehow those young men had to get civilian jobs, find a wife, have babies and run normal homes.

Ex-serviceman wearing a prosthetic plate attached to spectacles. 

Photo credit: Gillies Archives, Queen Mary's Hospital Sidcup. 

In discussing the public rhetoric of bodily and facial reconstruction, Suzannah Biernoff concent­rat­ed on the written evidence - newspapers, magazines and the records of medical staff. The response to facial disfigurement was defined by an anxiety that was specifically visual. Patients refused to see their families and fiancés; children reportedly fled at the sight of their fathers; nurses and orderlies struggled to look their patients in the face. Some soldiers were so severely mutilated that passengers got out of their train seats and moved to other carriages.

How many soldiers were physically devastated as a result of the war? Joanna Bourke (BBC History 4, 14, April 2013) says 41,300 British soldiers had one or more of their limbs amputated. That number did not include Australians, New Zealanders, Canadians, South Africans, Indians or anyone else who came to the rescue of the motherland. Nor does it include injuries other than limb amputations.

One New Zealand plastic surgeon, Dr Harold Gillies, was a man who had worked in France during the war with the Red Cross. With a team of artists and sculptors back in post-war Britain, he developed many techniques of plastic surgery on 5,000+ soldiers with facial injuries. Dr Gillies slowly and carefully rebuilt the human wrecks he met in his Queen Mary’s Hospital in Roehampton, and gave them new lives. 

The limbless men were also treated at Queen Mary’s Hospital where most were fitted with artificial limbs. With convalescence and physiotherapy, the men could walk again and rejoin the land of the living as equals. I am assuming the government agreed to paying the enormous and endless health care costs for two important reasons: a] to honour the soldiers' sacrifice in war and b] to make them productive members of an integrated, post-war society. The quid pro quo, as Professor Bourke noted, was that the limbless men had to take responsib­ility to practise endlessly with their artificial limbs and to "pass" as able-bodied citizens.

The Royal Pavilion in Brighton was converted into The Pavilion Hospital for Limbless Men, quickly opened in 1916 to accommodate this sudden flux of devastating wounds and modelled on the Roehampton House hospital. A workshop was built on the grounds of the Pavilion so that patients could learn new skills in carpentry and engineering, to help in their future careers. Open spaces allowed the men to play team sports.

A plaster cast is made in order that the eventual mask will perfectly cover all facial injuries 

General Hospital, Wandsworth
Photo credit: Imperial War Miuseum

Fiona Reid, in Broken Men: Shell Shock, Treatment and Recovery in Britain 1914-30, found that the men suffering shell-shock had the most difficult recovery, because their wounds were impossible to see. Many military commanders believed the shell-shocked soldiers were simply malingering, while civilians back at home thought the wide eyed, jittery men were lunatic. After the war, the situation was made worse because many of the shell-shocked strug­gled with a pension system that failed to give them security. Thus the conflict between the political rhetoric and the lived experience of many wounded ex servicemen continued for 20 years. How could the nation memorialise the war and remember the unending sacrifice made by the men, while at the same time forgetting the shell-shocked?

How strange, since the first medical study of shell shock appeared in The Lancet in 13th Feb 1915. It was estimated that already by December 1914, 10% of British officers and 4% of enlisted men were severely injured by nervous and mental shock.

Professor Bourke believed that the absent limbs of amputees came to exert a special patriotic power, to the extent that the disabled soldier could be hailed as ‘not less but more of a man’. Facially injured men were horrific to look at and were avoided by civilians at all cost, but those men were also recognised for their sacrifice. In fact almost all the physically wounded bore the visible proof of their valour and sacrifice. Men who were _mentally_ disturbed by war were the only ones who had to live with the suspicion of malingering.