Our Part in the Great War. Gleason Arthur
the final and greatest work with the wounded man is wrought out, which will let him go forth a whole man, with limbs his own and a face unmarred, or will discharge him a wrecked creature, crippled, monstrous, because of bungled treatment. It is a chain with no weak link that must be forged from the hour of the wounding at Verdun to the day of hospital discharge at Neuilly. And that final success of the restored soldier is built upon the loyalty of hundreds of obscure helpers, far back of the lines of glory. That which is fine about it is the very absence of the large scale romantic. It is humble service humbly given, with no war-medals in sight, no mention in official dispatches – only a steady fatiguing drive against bugs and dirt and germs and red tape.
So I begin my story with the work of the Scotch-American at the entrance of the American Ambulance Hospital at Neuilly-sur-Seine. He is the man that gives every entering wounded soldier a bath, and he does it thoroughly in four and a half minutes. He can bathe twelve inside the hour. He has perfected devices, so that a fractured leg won't be hurt while the man is being scrubbed. He has worked out foot-rests, and body-rests and neck-rests in the tub. This man has taken his lowly job and made it into one of the important departments of the hospital. And with him begins, too, the long tale of inventive appliances which are lessening suffering. The hospital is full of them in each branch of the service. Everywhere you go in relief work of this war, you see devices – little things that relieve pain, and save time and speed up recovery. That is one of the things differentiating this war from the old-time slaughters, where most of the seriously wounded died: the omnipresence of mechanical, electrical, devices. Inventive skill has wreaked itself on the sudden awful human need. The hideously clever bombs, and big guns, all the ingenious instruments of torture, will shoot themselves away and pass. But the innumerable appliances of restoration, the machinery of welfare, suddenly called into being out of the mechanic brain of our time, under pressure of the agonizing need, will go on with their ministry when Lorraine is again green.
The Ambulance is the cheeriest, the cleanest, the most efficient place which I have visited since the beginning of the war. There is no hospital odor anywhere. Fresh air and sunshine are in the wards. A vagrant from Mars or the moon, who wanted an answer to some of his questions about the lay-out of things, would find his quest shortened by spending an afternoon at the American Ambulance.
What does America mean? What is it trying to do? How does it differ from other sections of the map?
The swift emergency handling of each situation has been American in its executive efficiency. Things have been done in a hurry, and done well. In eighteen days this building was taken over from a partially completed school, with the refuse of construction work heaped high, and made into an actively-running hospital ready for 175 patients. That, too, in those early days of war, when workmen had been called to the colors, when money was unobtainable, transportation tied up, and Germany pounding down on Paris.
The skillful surgical work, some of it pioneering in fields untouched by former experience, has been a demonstration of the best American practice.
The extraordinarily varied types of persons at work under one roof in a democracy of service presents just the aspect of our community which is most representative. Millionaires and an impersonator, Harvard, Dartmouth, Tech, Columbia, Fordham, Michigan, Princeton, Cornell and Yale men, ranchers, lawyers, and newspaper men – all are hard at work on terms of exact equality. A colored man came in one day. He said he wanted to help with the wounded. He was tried out, and proved himself one of the best helpers in the organization. He received the same treatment as all other helpers, eating with them, liked by them. Some weeks later, one of our wealthy "high-life" young Americans volunteered his services. After the first meal he came wrathfully to the surgeon.
"I've had to eat at the same table with a negro. That must be changed. What will you do about it?"
"Do about it," answered the surgeon. "You will do one of two things – go and apologize to a better man than you are, or walk out of this hospital."
Recently this black helper came to the director in distress of mind.
"Have to leave you," he said. He held out a letter from the motor car firm, near Paris, where he he had worked before the war. It was a request for him to return at once. If he did not obey now in this time of need, it meant there would never be any position for him after the war as long as he lived.
A day or two later he came again.
"My old woman and I have been talking it over," he said, "and I just can't leave this work for the wounded. We'll get along some way."
A little more time passed, and then, one day, he stepped up to the director and said:
"I want you to meet my boss."
The superintendent of the motor car factory had come. He said to the director:
"I have received the most touching letter from this darkey, saying he couldn't come back to us because he must help here. Now I want to tell you that his position is open to him any time that he wants it, during the war, or after it."
Visitors, after walking through the wards, smelling no odors, hearing no groans, seeing the faces of the men smiling back at them, are constantly saying to the director:
"Ah, I see you have no really serious cases here."
It is the only kind of case sent to Neuilly – the gravely wounded 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