Our Part in the Great War. Gleason Arthur
man, the "grands blessés," requiring infinite skill to save the limb and life. So sweet and hopeful is the "feel" of the place that not even 575 beds of men in extremity can poison that atmosphere of successful practice. Alice's Queen had a certain casual promptness in saying, "Off with his head," whenever she sighted a subject. And there was some of the same spirit in the old-time war-surgeon when he was confronted with a case of multiple fracture. "Amputate. Off with his leg. Off with his arm." And that, in the majority of cases, was the same as guillotining the patient, for the man later died from infection. There was a surgical ward in one of the 1870 Paris hospitals with an unbroken record of death for every major operation. At the American Ambulance, out of the first 3,100 operations, there were 81 amputations. The death rate for the first year was 4.46 per cent.
These gunshot injuries, involving compound and multiple fractures, are treated by incision, and drainage of the infected wounds and the removal of foreign bodies. A large element in the success has been the ingenuity of the staff in creating appliances that give efficient drainage to the wound and comfort to the patient. The same inventive skill is at work in the wards that we saw on entering the hospital in the bathroom of the Scotch-American. These devices, swinging from a height over the bed, are slats of wood to which are jointed the splints for holding the leg or arm in a position where the wound will drain without causing pain to the recumbent man. The appearance of a ward full of these swinging appliances is a little like that of a gymnasium. Half the wounded men riding into Paris ask to be taken to the American Hospital. They know the high chance of recovery they will have there and the personal consideration they will receive. The Major-General enjoys the best which the Hospital can offer. So does the sailor boy from the Fusiliers Marins.
We had spent about an hour in the wards. We had seen the flying man who had been shot to pieces in the air, but had sailed back to his own lines, made his report and collapsed. We had talked with the man whose face had been obliterated, and who was now as he had once been, except for a little ridge of flesh on his lower left cheek. I had seen a hundred men brighten as the surgeon "jollied" them. The cases were beginning to merge for me into one general picture of a patient, contented peasant in a clean bed with a friend chatting with him, and the gift of fruit or a bottle of champagne on the little table by his head. I was beginning to lose the sense of the personal in the immense, well-conducted institution, with its routine and system. After all, these men represented the necessary wastage of war, and here was a business organization to deal with these by-products. I was forgetting that it was somebody's husband in front of me, and only thinking that he was a lucky fellow to be in such a well-ordered place.
Then the whole sharp individualizing work of the war came back in a stab, for we had reached the bed of the American boy who had fought with the Foreign Legion since September, 1914.
"Your name is Bonnell?" I asked.
"Yes."
"Do you spell it B-o-n-n-e double l?"
"Yes."
"By any chance, do you know a friend of mine, Charles Bonnell?"
"He's my uncle."
And right there in the presence of the boy in blue-striped pajamas, my mind went back over the years. Twenty-seven years ago, I had come to New York, and grown to know the tall, quiet man, six feet two he was, and kind to small boys. He was head of a book-store then and now. For these twenty-seven years I have known him, one of my best friends, and here was his nephew.
"Do you think I'm taller than my uncle?" the boy asked, standing up. He stood erect: you would never have known there was any trouble down below. But as my eye went up and down the fine slim figure, I saw that his right leg was off at the knee.
"I can't play base-ball any more," he said.
"No, but you can go to the games," said the director; "that's all the most of us do.
"I wish I had come here sooner," he went on as he sat back on the bed: standing was a strain. He meant he might have saved his leg.
We came away.
"Now he wants to go into the flying corps," said the surgeon.
He still had his two arms, and the loss of a leg didn't so much matter when you fly instead of march.
"Flying is the only old-fashioned thing left," remarked the boy, in a later talk. "You might as well work in a factory as fight in a trench—only there's no whistle for time off."
I have almost omitted the nurses from this chapter, because we have grown so used to loyalty and devotion in women that these qualities in them do not constitute news. The trained nurses of the Ambulance Hospital, with half a dozen exceptions, are Americans, with a long hospital experience at home. During the early months they served with no remuneration. An allowance of 100 francs a month has now been established. They reluctantly accepted this, as each was anxious to continue on the purely voluntary basis. There are also volunteer auxiliary nurses, who serve as assistants to the trained women. The entire nursing staff has been efficient and self-sacrificing.
We entered the department where some of the most brilliant surgical work of the war has been done. It is devoted to those cases where the face has been damaged. The cabinet is filled with photographs, the wall is lined with masks, revealing the injury when the wounded man entered, and then the steps in the restoration of the face to its original structure and look. There in front of me were the reproductions of the injury: the chin shot away, the cheeks in shreds, the mouth a yawning aperture, holes where once was a nose—all the ghastly pranks of shell-fire tearing away the structure, wiping out the human look. Masks were there on the wall of man after man who would have gone back into life a monster, a thing for children to run from, but brought back inside the human race, restored to the semblance of peasant father, the face again the recorder of kindly expression. The surgeon and the dental expert work together on these cases. The success belongs equally to each of the two men. Between them they make a restoration of function and of appearance.
In peace days, a city hospital would have only three or four fractures of the jaw in a year, and they were single fractures. There are no accidents in ordinary life to produce the hideous results of shell-fire. So there was no experience to go on. There were no reference books recording the treatment of wounds to the face caused by the projectiles of modern warfare. Hideous and unprecedented were the cases dumped by the hundreds into the American Ambulance. Because of the pioneer success of this hospital, the number of these cases has steadily increased. They are classified as "gunshot wounds of the face, involving the maxillæ, and requiring the intervention of dental surgery." These are compound fractures of the jaw, nearly always accompanied by loss of the soft parts of the mouth and chin, sometimes by the almost complete loss of the face.
I have seen this war at its worst. I have seen the largest hospital in France filled with the grievously-wounded. I have seen the wounded out in the fields of Ypres, waiting to be carried in. I have seen the Maison Blanche thronged with the Army of the Mutilated. I have carried out the dead from hospital and ambulance, and I have watched them lie in strange ways where the great shell had struck. But death is a pleasant gift, and the loss of a limb is light. For death leaves a rich memory. And a crippled soldier is dearer than he ever was to the little group that knows him. But to be made into that which is terrifying to the children that were once glad of him, to bring shrinking to the woman that loved him—that is the foulest thing done by war to the soldier. So it was the most gallant of all relief work that I have seen—this restoration of disfigured soldiers to their own proper appearance.
And the work of these hundreds of Americans at Neuilly was summed for me in the person of one dental surgeon, who sat a few feet from those forty masks and those six hundred photographs, working at a plaster-cast of a shattered jaw. He was very much American—rangy and loose-jointed, with a twang and a drawl, wondering why the blazes a writing person was bothering a man at work. It was his time off, after six days of patient fitting of part to part, and that for a year. So he was taking his day off to transform one more soldier from a raw pulp to a human being. There were no motor car dashes, and no military medals, for him. Only hard work on suffering men. There he sat at his pioneer work in a realm unplumbed by the mind of man. It called on deeper centers of adventure than any