Book: A Surgeon in Belgium

H >> Henry Sessions Souttar >> A Surgeon in Belgium



Note: Project Gutenberg also has an HTML version of this
file which includes the original illustrations.
See 11086-h.htm or 11086-h.zip:
(http://www.ibiblio.org/gutenberg/1/1/0/8/11086/11086-h/11086-h.htm)
or
(http://www.ibiblio.org/gutenberg/1/1/0/8/11086/11086-h.zip)





A SURGEON IN BELGIUM

by H. S. Souttar, F.R.C.S.
Assistant Surgeon, West London Hospital
Late Surgeon-in-Chief, Belgian Field Hospital







Preface

To write the true story of three months' work in a hospital is a task
before which the boldest man might quail. Let my very dear friends of
the Belgian Field Hospital breathe again, for I have attempted nothing
of the sort. I would sooner throw aside my last claim to self-respect,
and write my autobiography. It would at least be safer. But there were
events which happened around us, there was an atmosphere in which
we lived, so different from those of our lives at home that one felt
compelled to try to picture them before they merged into the shadowy
memories of the past. And this is all that I have attempted. To all who
worked with me through those months I owe a deep debt of gratitude.
That they would do everything in their power to make the hospital a
success went without saying, but it was quite another matter that they
should all have conspired to make the time for me one of the happiest
upon which I shall ever look back. Where all have been so kind, it is
almost invidious to mention names, and yet there are two which must
stand by themselves. To the genius and the invincible resource of
Madame Sindici the hospital owes an incalculable debt. Her
friendship is one of my most delightful memories. The sterling powers
of Dr. Beavis brought us safely many a time through deep water, and
but for his enterprise the hospital would have come to an abrupt
conclusion with Antwerp. There could have been no more delightful
colleague, and without his aid much of this book would never have
been written.

For the Belgian Field Hospital I can wish nothing better than that its
star may continue to shine in the future as it has always done in the
past, and that a sensible British public may generously support the
most enterprising hospital in the war.

H. S. S.




Contents

To Antwerp
The Hospital
The Day's Work
Antwerp
Termonde
The Chateau
Malines
Lierre
A Pause
The Siege
Contich
The Bombardment--Night
The Bombardment--Day
The Night Journey
Furnes
Poperinghe
Furnes Again
Work At Furnes
Furnes--The Town
A Journey
The Ambulance Corps
Pervyse--The Trenches
Ypres
Some Conclusions





A SURGEON IN BELGIUM


I. To Antwerp



When, one Saturday afternoon in September, we stepped on board
the boat for Ostend, it was with a thrill of expectation. For weeks we
had read and spoken of one thing only--the War--and now we
were to see it for ourselves, we were even in some way to be a part of
it. The curtain was rising for us upon the greatest drama in all the
lurid history of strife. We should see the armies as they went out to
fight, and we should care for the wounded when their work was done.
We might hear the roar of the guns and the scream of the shells. To
us, that was War.

And, indeed, we have seen more of war in these few weeks than has
fallen to the lot of many an old campaigner. We have been through
the siege of Antwerp, we have lived and worked always close to the
firing-line, and I have seen a great cruiser roll over and sink, the
victim of a submarine. But these are not the things which will live in
our minds. These things are the mere framing of the grim picture. The
cruiser has been blotted out by the weary faces of an endless stream
of fugitives, and the scream of the shells has been drowned by the cry
of a child. For, though the soldiers may fight, it is the people who
suffer, and the toll of war is not the life which it takes, but the life
which it destroys.

I suppose, and I hope, that there is not a man amongst us who has
not in his heart wished to go to the front, and to do what he could.
The thought may have been only transitory, and may soon have been
blotted out by self-interest; and there is many a strong man who has
thrust it from him because he knew that his duty lay at home. But to
everyone the wish must have come, though only to a few can come
the opportunity. We all want to do our share, but it is only human that
we should at the same time long to be there in the great business of
the hour, to see war as it really is, to feel the thrill of its supreme
moments, perhaps in our heart of hearts to make quite certain that we
are not cowards. And when we return, what do we bring with us? We
all bring a few bits of shell, pictures of ruined churches, perhaps a
German helmet--and our friends are full of envy. And some of us
return with scenes burnt into our brain of horror and of pathos such as
no human pen can describe. Yet it is only when we sit down in the
quiet of our homes that we realize the deeper meaning of all that we
have seen, that we grasp the secret of the strange aspects of
humanity which have passed before us. What we have seen is a
world in which the social conventions under which we live, and which
form a great part or the whole of most of our lives, have been torn
down. Men and women are no longer limited by the close barriers of
convention. They must think and act for themselves, and for once it is
the men and women that we see, and not the mere symbols which
pass as coin in a world at peace. To the student of men and women,
the field of war is the greatest opportunity in the world. It is a
veritable dissecting-room, where all the queer machinery that
goes to the making of us lies open to our view. On the whole,
I am very glad that I am a mere surgeon, and that I can limit my
dissections to men's bodies. Human Anatomy is bad enough,
but after the last three months the mere thought of an analysis
of Human Motives fills me with terror.

Our boat was one of the older paddle steamers. We were so fortunate
as to have a friend at Court, and the best cabins on the ship were
placed at our disposal. I was very grateful to that friend, for it was
very rough, and our paddle-boxes were often under water. We
consoled ourselves by the thought that at least in a rough sea we
were safe from submarines, but the consolation became somewhat
threadbare as time went on. Gradually the tall white cliffs of Dover
sank behind us, splendid symbols of the quiet power which guards
them. But for those great white cliffs, and the waves which wash their
base, how different the history of England would have been! They
broke the power of Spain in her proudest days, Napoleon gazed at
them in vain as at the walls of a fortress beyond his grasp, and
against them Germany will fling herself to her own destruction.
Germany has yet to learn the strength which lies concealed behind
those cliffs, the energy and resource which have earned for England
the command of the sea. It was a bad day for Germany when she
ventured to question that command. She will receive a convincing
answer to her question.

We reached Ostend, and put up for the night at the Hotel Terminus.
Ostend was empty, and many of the hotels were closed. A few bombs
had been dropped upon the town some days before, and caused
considerable excitement--about all that most bombs ever succeed
in doing, as we afterwards discovered. But it had been enough to
cause an exodus. No one dreamt that in less than three weeks' time
the town would be packed with refugees, and that to get either a bed
or a meal would be for many of them almost impossible. Everywhere
we found an absolute confidence as to the course of the war, and the
general opinion was that the Germans would be driven out of Belgium
in less than six weeks.

Two of our friends in Antwerp had come down to meet us by motor,
and we decided to go back with them by road, as trains, though still
running, were slow and uncertain. It was a terrible day, pouring in
torrents and blowing a hurricane. Our route lay through Bruges and
Ghent, but the direct road to Bruges was in a bad condition, and we
chose the indirect road through Blankenberghe. We left Ostend by
the magnificent bridge, with its four tall columns, which opens the way
towards the north-east, and as we crossed it I met the first symbol of
war. A soldier stepped forward, and held his rifle across our path. My
companion leaned forward and murmured, "Namur," the soldier
saluted, and we passed on. It was all very simple, and, but for the one
word, silent; but it was the first time I had heard a password, and it
made an immense impression on my mind. We had crossed the
threshold of War. I very soon had other things to think about. The
road from Ostend to Blankenberghe is about the one good motor road
in Belgium, and my companion evidently intended to demonstrate the
fact to me beyond all possibility of doubt. We were driving into the
teeth of a squall, but there seemed to be no limits to the power of his
engine. I watched the hand of his speedometer rise till it touched sixty
miles per hour. On the splendid asphalt surface of the road there was
no vibration, but a north-east wind across the sand-dunes is no trifle,
and I was grateful when we turned south-eastwards at Blankenberghe,
and I could breathe again.

As I said, that road by the dunes is unique. The roads of Belgium, for
the most part, conform to one regular pattern. In the centre is a paved
causeway, set with small stone blocks, whilst on each side is a couple
of yards of loose sand, or in wet weather of deep mud. The causeway
is usually only just wide enough for the passing of two motors, and on
the smaller roads it is not sufficient even for this. As there is no speed
limit, and everyone drives at the top power of his engine, the skill
required to drive without mishap is considerable. After a little rain the
stone is covered with a layer of greasy mud, and to keep a car upon it
at a high speed is positively a gymnastic feat. In spite of every
precaution, an occasional descent into the mud at the roadside is
inevitable, and from that only a very powerful car can extricate itself
with any ease. A small car will often have to slowly push its way out
backwards. In dry weather the conditions are almost as bad, for often
the roadside is merely loose sand, which gives no hold for a wheel.
For a country so damp and low-lying as Belgium, there is probably
nothing to equal a paved road, but it is a pity that the paving was not
made a little wider. Every now and then we met one of the huge,
unwieldy carts which seem to be relics of a prehistoric age--rough
plank affairs of enormous strength and a design so primitive as to be
a constant source of wonder. They could only be pulled along at a
slow walk and with vast effort by a couple of huge horses, and the
load the cart was carrying never seemed to bear any proportion to the
mechanism of its transport. The roads are bad, but they will not
account for those carts. The little front wheels are a stroke of
mechanical ineptitude positively amounting to genius, and when they
are replaced by a single wheel, and the whole affair resembles a
huge tricycle, one instinctively looks round for a Dinosaur. Time after
time we met them stuck in the mud or partially overturned, but the
drivers seemed in no way disconcerted; it was evidently all part of the
regular business of the day. When one thinks of the Brussels
coachwork which adorns our most expensive motors, and of the great
engineering works of Liege, those carts are a really wonderful
example of persistence of type.

We passed through Bruges at a pace positively disrespectful to that
fine old town. There is no town in Belgium so uniform in the
magnificence of its antiquity, and it is good to think that--so far, at
any rate--it has escaped destruction. As we crossed the square, the
clock in the belfry struck the hour, and began to play its chimes. It is a
wonderful old clock, and every quarter of an hour it plays a tune--a
very attractive performance, unless you happen to live opposite. I
remember once thinking very hard things about the maker of that
clock, but perhaps it was not his fault that one of the bells was a
quarter of a tone flat. At the gates our passports were examined, and
we travelled on to Ghent by the Ecloo Road, one of the main
thoroughfares of Belgium. Beyond an occasional sentry, there was
nothing to indicate that we were passing through a country at war,
except that we rarely saw a man of military age. All were women, old
men, or children. Certainly the men of Belgium had risen to the
occasion. The women were doing everything--working in the fields,
tending the cattle, driving the market-carts and the milk-carts with
their polished brass cans. After leaving Ghent, the men came into
view, for at Lokeren and St. Nicholas were important military stations,
whilst nearer to Antwerp very extensive entrenchments and wire
entanglements were being constructed. The trenches were most
elaborate, carefully constructed and covered in; and I believe that all
the main approaches to the city were defended in the same way.
Antwerp could never have been taken by assault, but with modern
artillery it would have been quite easy to destroy it over the heads of
its defenders. The Germans have probably by now rendered it
impregnable, for though in modern war it is impossible to defend
one's own cities, the same does not apply to the enemy. In future,
forts will presumably be placed at points of strategic importance only,
and as far as possible from towns.

Passing through the western fortifications, we came upon the long
bridge of boats which had been thrown across the Scheldt. The river
is here more than a quarter of a mile wide, and the long row of sailing
barges was most picturesque. The roadway was of wooden planks,
and only just wide enough to allow one vehicle to pass at a time, the
tall spars of the barges rising on each side. It is strange that a city of
such wealth as Antwerp should not have bridged a river which, after
all, is not wider than the Thames. We were told that a tunnel was in
contemplation. The bridge of boats was only a tribute to the
necessities of war. We did not dream that a fortnight later it would be
our one hope of escape.




II. The Hospital



Antwerp is one of the richest cities in Europe, and our hospital was
placed in its wealthiest quarter. The Boulevard Leopold is a
magnificent avenue, with a wide roadway in the centre flanked by
broad paths planted with trees. Beyond these, again, on each side is
a paved road with a tram-line, whilst a wide pavement runs along the
houses. There are many such boulevards in Antwerp, and they give
to the city an air of spaciousness and opulence in striking contrast to
the more utilitarian plan of London or of most of our large towns. We
talk a great deal about fresh air, but we are not always ready to pay
for it.

Our hospital occupied one of the largest houses on the south-east
side. A huge doorway led into an outer hall through which the garden
was directly reached behind the house. On the right-hand side of this
outer hall a wide flight of steps led to inner glass doors and the great
central hall of the building. As a private house it must have been
magnificent; as a hospital it was as spacious and airy as one could
desire. The hall was paved with marble, and on either side opened
lofty reception rooms, whilst in front wide marble staircases led to the
first floor. This first floor and another above it were occupied entirely
by wards, each containing from six to twelve beds. On the ground
floor on the right-hand side were two large wards, really magnificent
rooms, and one smaller, all these overlooking the Boulevard. On the
left were the office, the common room, and the operating theatre.
Behind the house was a large paved courtyard, flanked on the right
by a garden border and on the left by a wide glass-roofed corridor.
The house had previously been used as a school, and on the
opposite side of the courtyard was the gymnasium, with dormitories
above. The gymnasium furnished our dining-hall, whilst several of the
staff slept in the rooms above.

It will be seen that the building was in many ways well adapted to the
needs of a hospital and to the accommodation of the large staff
required. We had in all 150 beds, and a staff of about 50. The latter
included 8 doctors, 20 nurses, 5 dressers, lay assistants, and motor
drivers. In addition to these there was a kitchen staff of Belgians, so
that the management of the whole was quite a large undertaking,
especially in a town where ordinary provisions were becoming more
and more difficult to obtain. In the later days of the siege, when milk
was not to be had and the only available water was salt, the lot of our
housekeeper was anything but happy. Providing meals for over 200
people in a besieged town is no small matter. But it was managed
somehow, and our cuisine was positively astonishing, to which I think
we largely owe the fact that none of the staff was ever ill. Soldiers are
not the only people who fight on their stomachs.

The management of the hospital centred in the office, and it was so
typical of Belgium as to be really worth a few words of description. It
was quite a small room, and it was always crowded. Four of us had
seats round a table in the centre, and at another table in the window
sat our Belgian secretary, Monsieur Herman, and his two clerks. But
that was only the beginning of it. All day long there was a constant
stream of men, women, and children pouring into that room, bringing
letters, asking questions, always talking volubly to us and amongst
themselves. At first we thought that this extraordinary turmoil was due
to our want of space, but we soon found that it was one of the
institutions of the country. In England an official's room is the very
home of silence, and is by no means easy of access. If he is a high
official, a series of ante-rooms is interposed between his sacred
person and an inquisitive world. But in Belgium everyone walks
straight in without removing his cigar. The great man sits at his desk
surrounded by a perfect Babel, but he is always polite, always ready
to hear what you have to say and to do what he can to help. He
appears to be able to deal with half a dozen different problems at the
same time without ever being ruffled or confused. There is an
immense amount of talking and shaking of hands, and at first the
brain of a mere Englishman is apt to whirl; but the business is done
rapidly and completely. Belgium is above all things democratic, and
our office was a good introduction to it.

The common room was large and airy, overlooking the courtyard, and
a few rugs and armchairs made it a very comfortable place when the
work of the day was done. Anyone who has worked in a hospital will
know what a difference such a room makes to the work--work that
must be carried on at all hours of the day or night; nor will he need to
be told of the constant supply of tea and coffee that will be found
there. We go about telling our patients of the evils of excessive tea-
drinking, and we set them an example they would find it hard to
follow. We do not mention how often tea and a hot bath have been
our substitute for a night's sleep.' A good common room and an
unlimited supply of tea will do much to oil the wheels of hospital life.

But to myself the all-important room was the operating theatre, for
upon its resources depended entirely our opportunities for surgical
work. It was in every way admirable, and I know plenty of hospitals in
London whose theatres would not bear comparison with ours. Three
long windows faced the courtyard; there was a great bunch of electric
lights in the ceiling, and there was a constant supply of boiling water.
What more could the heart of surgeon desire? There were two
operating tables and an equipment of instruments to vie with any in a
London hospital. Somebody must have been very extravagant over
those instruments, I thought as I looked at them; but he was right and
I was wrong, for there were very few of those instruments for which I
was not grateful before long. The surgery of war is a very different
thing from the surgery of home.

The wards were full when we arrived, and I had a wonderful
opportunity of studying the effects of rifle and shell fire. Most of the
wounds were fortunately slight, but some of them were terrible, and,
indeed, in some cases it seemed little short of miraculous that the
men had survived. But on every side one saw nothing but cheerful
faces, and one would never have dreamt what some of those men
had gone through. They were all smoking cigarettes, laughing, and
chatting, as cheery a set of fellows as one could meet. You would
never have suspected that a few days before those same men had
been carried into the hospital in most cases at their last gasp from
loss of blood and exposure, for none but serious cases were
admitted. The cheeriest man in the place was called Rasquinet, a
wounded officer who had been christened "Ragtime" for short, and for
affection. A week before he had been struck by a shell in the left side,
and a large piece of the shell had gone clean through, wounding the
kidney behind and the bowel in front. That man crawled across
several fields, a distance of nearly a mile, on his hands and knees,
dragging with him to a place of safety a wounded companion. When
from loss of blood he could drag him along no longer, he left him
under a hedge, and dragged himself another half-mile till he could get
help. When he was brought into the hospital, he was so exhausted
from pain and loss of blood that no one thought that he could live for
more than a few hours, but by sheer pluck he had pulled through.
Even now he was desperately ill with as horrible a wound as a man
could have, but nothing was going to depress him. I am glad to say
that what is known in surgery as a short circuit was an immediate
success, and when we left him three weeks later in Ghent he was to
all intents perfectly well.

There were plenty of other serious cases, some of them with ghastly
injuries, and many of them must have suffered agonizing pain; but
they were all doing their best to make light of their troubles, whilst
their gratitude for what was done for them was extraordinary. The
Belgians are by nature a cheerful race, but these were brave men,
and we felt glad that we had come out to do what we could for them.

But if we give them credit for their courage and cheerfulness, we must
not forget how largely they owed it to the devoted attention--yes,
and to the courage and cheerfulness--of the nurses. I wonder how
many of us realize what Britain owes to her nurses. We take them as
a matter of course, we regard nursing as a very suitable profession
for a woman to take up--if she can find nothing better to do; perhaps
we may have been ill, and we were grateful for a nurse's kindness.
But how many of us realize all the long years of drudgery that have
given the skill we appreciated, the devotion to her work that has made
the British nurse what she is? And how many of us realize that we
English-speaking nations alone in the world have such nurses?
Except in small groups, they are unknown in France, Belgium,
Germany, Russia, or any other country in the world. In no other land
will women leave homes of ease and often of luxury to do work that
no servant would touch, for wages that no servant would take--work
for which there will be very little reward but the unmeasured gratitude
of the very few. They stand to-day as an unanswerable proof that as
nations we have risen higher in the level of civilization than any of our
neighbours. To their influence on medicine and surgery I shall refer
again. Here I only wish to acknowledge our debt. As a mere patient I
would rather have a good nurse than a good physician, if I were so
unfortunate as to have to make the choice. A surgeon is a dangerous
fellow, and must be treated with respect. But as a rule the physician
gives his blessing, the surgeon does his operation, but it is the nurse
who does the work.




III. The Day's Work



In any hospital at home or abroad there is a large amount of routine
work, which must be carried on in an orderly and systematic manner,
and upon the thoroughness with which this is done will largely depend
the effectiveness of the hospital. Patients must be fed and washed,
beds must be made and the wards swept and tidied, wounds must be
dressed and splints adjusted. In an English hospital everything is
arranged to facilitate this routine work. Close to every ward is a sink-
room with an adequate supply of hot and cold water, dinner arrives in
hot tins from the kitchens as if by magic, whilst each ward has its own
arrangements for preparing the smaller meals. The beds are of a
convenient height, and there is an ample supply of sheets and pillow-
cases, and of dressing materials of all kinds arranged on tables which
run noiselessly up and down the wards. At home all these things are
a matter of course; abroad they simply did not exist. Four or five gas-
rings represented our hot-water supply and our ward-kitchens for our
150 patients, and the dinners had to be carried up from the large
kitchens in the basement. The beds were so low as to break one's
back, and had iron sides which were always in the way; and when we
came to the end of our sheets--well, we came to the end of them,
and that was all. In every way the work was heavier and more difficult
than at home, for all our patients were heavy men, and every wound
was septic, and had, in many cases, to be dressed several times a
day. Everyone had to work hard, sometimes very hard; but as a rule
we got through the drudgery in the morning, and in the afternoon
everything was in order, and we should, I think, have compared very
favourably in appearance with most hospitals at home.

Copyright (c) 2007. knowncrafts.net. All rights reserved.