HARVEY CUSHING
From A Surgeon's Journal, 1915-1918
I
THE HARVARD UNIT AT THE
AMBULANCE AMÉRICAINE
IN August 1914, a group of Americans resident in Paris, under the leadership of Ambassador Herrick and his predecessor, Mr. Robert Bacon, undertook the organization of a military hospital and motor-ambulance service in connection with the existent American Hospital at Neuilly-sur-Seine of which Dr. G. W. du Bouchet and Dr. E. L. Gros were the well-known surgical attendants. For the purpose of this "Ambulance"---the usual name for a French military hospital---the French Government put at their disposal the Lycée Pasteur, a school building in process of erection at Neuilly which was altered and equipped to provide beds for some five or six hundred patients.
A staff of auxiliaires, orderlies and helpers who volunteered their services, was soon recruited, and on September 7 the first wounded were received. The expenses of this American Ambulance were met by voluntary subscriptions, and a subsidiary 200-bed hospital at Juilly, northwest of Meaux and nearer the line, was later established through the generosity of Mrs. Harry Payne Whitney. It had a rotating professional staff supplied chiefly by the College of Physicians, New York.
Certain universities in the States were subsequently asked to participate in the project by successively supplying the professional personnel capable of caring for a certain number of wards in this Ambulance Américaine at Neuilly for a three-months period. The first of these units, from Western Reserve University, under the direction of Dr. G. W. Crile and financed by Mr. Samuel Mather of Cleveland, began its three-months term of service in January of 1915. A Harvard unit organized by Drs. Cushing and R. B. Greenough and financed by Mr. William Lindsey of Boston followed in April 1915.
[THE EDITOR]
Thursday, March 18, 1915
SHE seemed very low in the water---the Canopic ---when we found her hidden behind the new Commonwealth Pier yesterday afternoon, with two interned Hamburg-American ships on the opposite side. Strange company! And when, after our false start at 4.15 we returned again at eight for the sailing, she was still lower. Ammunition for the Allies, it is said. What a temptation it must have been to die Leute across the dock! A stowaway with a bomb would do it---and there seemed to be no precautions such as one would perhaps expect on an English ship under existing circumstances.
It was a cold blowy March night by the time our pilot was dropped outside of Boston Light, and though the merrymakers, Benet and Barton, marched the decks with tin flutes tuned to "Tipperary," blue noses soon drove us in and to bed. There are only fifty first-cabin passengers, seventeen of them constituting our immediate party, to which three or four others are c'est à direallied. So there's plenty of room, though no place to go but out, and no place to stay but in---with one's overcoat on in either case.
Friday, 4 p.m.
It still blows hard from the N.W. quarter. These people who talk about getting one's sea legs make me ill. Greenough says it's all in your head, but I know better: it lives just under your diaphragm, halfway in, and is intensified by culinary odours---Englished with a u.
March 20th, Saturday
We seem to be a musical "unit"---at least the average is high, with Barton and Benet together at the piano. The orchestra grows apace and last evening Osgood appeared with a fine bass drum made of an amputated barrel with canvas stretched over the ends for drumheads---improvised by the cook. I'm told it's the kind of drum sailors are accustomed to take ashore when they want to smuggle tobacco and other forbidden things aboard. Then two tin plates with some adhesive-plaster handles make useful cymbals; a large tin pan and a soup spoon; a kettledrum ingeniously fabricated out of a huge tin candy box by Osgood; and finally the steward, who summons us brazenly to meals six or eight times a day, could stand it no longer and appeared with his cornet and an old mandolin which it was found Strong was able to pick. With the two B.'s as ringleaders, it was carried off with the true music-hall touch.
Sunday, the first day of Spring
Overcast and dirty. A boat drill this a.m., and such a lot of pirates you never saw---shanghaied, I judge, from anywhere and everywhere. Transatlantic voyages just now are not too popular with deck hands. They were too funny in their cork life belts and we were not permitted to look on from the upper deck. I doubt if the ship's officers cared to have us see them. It was our unanimous decision to commandeer a lifeboat or two for ourselves rather than trust to any such aggregation, individually or collectively. Some of them would have made fine models for Howard Pyle.
We have been in Marconi communication both with Cape Cod and with the Azores, so it is rumored, but the Captain keeps mum. 'Tis at his discretion, we're told, that the sending of messages lies. They say he does not wish to be located---but by what? TheKarlsruhe is in the South Atlantic. Perhaps by the auxiliary cruiser which is reported to have slipped out of her internment in the Azores the day before we sailed. Our lights have been fully blanketed every night since sailing---the storm canvases are stretched along the promenade deck and towels tacked over our cabin windows.
The service this morning was conducted by the Purser---a companionable chap named O'Hegan. He read from Psalm CV: "O give thanks unto the Lord . . . he increased his people exceedingly, and made them stronger than their enemies, whose heart turned so that they hated his people." One wonders to-day who are hispeople---if perchance He still takes sides---the hated or the hating. Doubtless the one of the combatants that would do the most after peace for the betterment of mankind and his abiding place. But which would?
Such thoughts were aroused by O'Hegan's reading; nor was his mind solely on his text, for, having interrupted his prayer to send a steward to stop the noise of a creaking timber, he couldn't find his place again. .
Monday, the 22nd March
Our steward's announcement that the glass was falling and that we are likely to find it damp in these parts comes true. There is a hurricane---they call it "a half gale"---out of the southwest which is tearing things up considerably---a veritable "white squall" which only lacks the scratching Jews to larboard.
4 p.m. Though it was enough to wipe out our wireless apparatus, the old boat has held surprisingly steady in the trough of the big seas. Most of the party also hold out well.
Tuesday, March 23rd: noon
We are still feeling the effect of yesterday's blow and the wind holds in the same quarter . . . . We have had a conference under Strong's direction on les infections gazeuses, and he went over seriatim the various organisms which have been known to be productive of emphysematous lesions. We had many therapeutic proposals to make and wonder what they may be doing for these cases in Paris. Strong has blossomed out in his olive-drab Red Cross uniform. A Dr. Metcalf aboard, who is conducting a group of seasick nurses bound for Hungary on a Red Cross mission, referred to him respectfully as a "five striper," for he wears on his sleeves the insignia of a Director in the R.C. With his broad-brimmed hat he looks like Oom Paul.
Wednesday the 24th. Off the Azores
8 a.m. We were called at an early hour this morning expecting to land, but find ourselves wallowing in the trough of a high rolling sea a few miles off the open roadstead of Ponta Delgada. We have been told various things---we're to wait for calmer seas; we're to go around to the north of St. Michael's and land our 160 second-class passengers there; we're to try and put them ashore here and take their baggage on to Gibraltar.
The wind has held in the S.W. for three days and it's still lowering. Certainly they will not let us land and I doubt if the "Portugees" we are to put off can like the looks of it, for the waves are breaking over an ugly-looking coast and sending up great puffs of white spray.
1 p.m. "At Flores in the Azores Sir Richard Grenville lay," and "the water continued to heave and the weather to moan." We've been drifting broadside the length of São Miguel all the morning in rain and mist and now have turned our nose toward home---no one knows why.
I have come in to get warm and dry in the library and find Mr. Souli here attentively studying some coins of the Empire which he pulls out of his various pockets wrapped in much handled bits of tissue paper. He explains his satisfaction by saying they are rare. Mrs. Souli is limp alongside of him. They are Americans who have lived years abroad and have just come from San Francisco, her home, and the opening of the Exposition which they say is quite wonderful; but the new America seems to them a place inhabited by foreigners. We think of consulting the barometer or of asking the Captain what the prospects are. Mr. Souli says from his coins---"You might as well ask the lob-lolly-boy as the Captain."
6 p.m. Golly! It's sure enough the real thing. The glass is still going down and at 45 miles an hour it's blowing, Billy be damned, from the same old quarter. We are barely holding our own---our nose pointed into the west. A great sight it is, to stand up on the hurricane deck in the lee of the bridge and see the steady Canopic actually poke her bows into a solid green wave and toss it in spray up to the crow's nest.
11 p.m. Sixty miles an hour and as dirty a night as one can imagine. We are hanging on with the Ponta Delgada flashlight about 10 miles off our starboard quarter and our nose pointing into the gale. O'Hegan says someone forgot to pay his washer-woman.
Sunday, March 28
6 p.m. Such a gloomy landing! In a perfect downpour we had a hazy glimpse of the African shore, were bespoken by a destroyer and told to go ahead, and then were carried down far beyond Gibraltar so that when it came dimly into view it was off the starboard bow, which was very confusing. But after all, the rock of which so much is said and written was mantled by a heavy cloud. Damp, cold, forlorn, and huddled together on deck, we finally, about ten o'clock, steamed into the Bay of Algeciras and came to anchor. In a wretched little boat we were then put ashore on the north mole---our luggage likewise.
After fiddling about for some time and learning that we must wait for a 2.20 boat to Algeciras, we clambered into strange littlefiacres holding four on a pinch, and with flapping wet curtains and such individual protection as each of us had---'t was not much ---we started to see Gibraltar. There was a long delay at the end of the wharf while our passports were viséed, and in return we were presented with a water-port pass. Meanwhile a fine Welsh bobby who stood in the downpour told us, as did others, that there had been nothing but rain---fifty-two inches for the season instead of the usual fourteen, according to his calculation. We could see up on the Rock only as far as the old Moorish castle.
The converted Cunarder Carmania, in her gray war paint, was lying alongside the south mole in the British harbor. It was she who sank. the Cap Trafalgar. On the whole, there seemed fewer men-of-war than one would expect, even in times of peace. We rode along Church and Southport streets, rubbering at what we could see of the Rock in the rain and mist---enough to assure us of its fascination and interest in better weather---past the sad and dripping little Trafalgar cemetery as far as the Alameda, a park laid out a century ago. At its far end is a flight of steps surmounted by a bronze bust of General (or was it Admiral?) Elliot---hero of the great siege of 1780 or thereabouts.
Our later arrival at Algeciras, across the Bay, was the worst of all---simply drenched, we were landed on a long pier without cover and walked into the customhouse, our soaking baggage following after us. The jabbering officials finally satisfied, Strong, Boothby, and I, being about the only ones with overshoes, started out bravely for a promenade in the town. We were soon joined by a fascinating boy named Diego who attached himself to us for the rest of the afternoon. He took us first to a high point from which we had a lovely view of the distant hills---the Sierra de los Gazúles---with the winding Miel between us and the town itself. The clouds were breaking, and the light on the roofs of the houses crowning the opposite hill made a stunning picture. It was good to see and feel the sun again. Next---and most important to Diego---was the bull ring, where there was to have been a fight this afternoon, postponed owing to the rain, for the seats are without shelter. As we were strolling through the narrow cobbled streets lined by little, close-packed, unpretentious Spanish houses with their barred windows, there was an approaching sound of an excited rabble. Soon a crowd of small boys appeared, then a carriage, and then a mob of people shouting, "Belmonte! Belmonte!" It was the local hero---the bullfighter.
Tuesday, March 30. Madrid
6.30 p.m. Impressions of Madrid consist largely of trips sidestep fro Cook's central office and this Hotel with an occasional sidestep to the local hospital, the American Ambassador, the Prado, the French Consul, and an antiquariat. But Cook's and the Consul were the most time-consuming.
We got in about 9 a.m. and had the usual palaver with officials at the station---Strong coming in as usual most handily and politely for he has the gracious manners as well as the tongue, cultivated by his long stay in the Philippines and Spanish America . . . . At the American Embassy, which did not open till 10, we were informed that a new order was issued two days ago by the French Government---to wit, that no one may cross the border without a new passport issued by the French Consul here; and this required newly made duplicate photographs---all to-day!!
Our Washington papers from Jusserand, etc., mean nothing, as some official at the border will have to pass on our things, not the Foreign Office itself.
After lunch Strong and I managed to look in at the Prado for a short hour and I rather liked the Antonio Moros the best. Then at 3 to the Consul's where he made out a blanket passport for us---a formidable document with all our signatures and photos, with seals and stamps on a single sheet.
8.30 p.m. At the station---an hour ahead of time to make sure of our large collection of baggage. We've had a horrid time with bad infectious colds---apparently the Canopic was infected for the Captain and the Doctor had had influenzal colds on their Westward crossing. One after another of the party has come down and the amount of barking is distressing. Only a few so far have escaped. Strong is filling himself up with aspirin to-night.
Wednesday. March 31st
The Basque provinces. Cold and rainy-but early spring betrayed by fruit trees in blossom. Rugged, semi-mountainous country for we are in the foothills of the Cantabrian range of the Pyrenees. From Vitorja, founded in 581 by the King of the Visigoths, on to Irún-Hendaye Prosperous country---good roads --cultivated hillsides, covered in spots with brilliant yellow gorse. Orchards, beech groves, great ivy-colored walls, deep valleys with terraced sides, trim gardens, stone walls, rows of poplin in their yellow spring dress, dwarfed buttonwoods, limestone cliffs, deep rocky gorges, white stucco or square-built stone houses with red tiled roofs.
Irún and Hendaye. Our elaborate passport pour tout ensemble obtained at Madrid let us through not only without scrutiny but with bows of welcome. A telegram from the Paris Government also helped some. Luncheon at the Restaurant de la Gare heartily enjoyed in view of our scanty breakfast.
4 p.m. After luncheon, despite the cold lowering weather and our various degrees of bronchitis and coughs, we started off in parties to see the little border town of Hendaye---the objective point of some being a Sanatorium pour les Enfants (550 of them) off on the northern shore of the Bidassoa looking out on the Bay of Biscay, where we saw the smoke of what we took to be a row of some 30-odd battleships on the horizon.
It was an interesting though muddy walk of 3 or 4 kilometres but the sanatorium at the end made it well worth while---a place of convalescence for the children, boys and girls, up to 13, from the various Paris hospitals. Clean pavilions with neat gardens, vines, trained buttonwoods for shade, hedges, etc., and a lovely view over the bay. Also a superb beach. No wonder the children looked ruddy and well. M. le Directeur, when he learned who we were, had us shown through many of the playrooms, the kitchen, etc. The children were really too cunning---a much better-looking lot than one could easily find in a children's convalescent hospital at home where our mongrel make-up shows itself plainly. All with their heads closely cropped except the girls old enough to braid their own---their little shoes lined up under the wall benches, their napkins in individual boxes, etc. The girls wore red and white circular caps and one roomful of them we took into the garden, to their great glee, for a chance photo, but it was dark and overcast. Such big, yellow, clean omelettes were being made for them in the neat kitchen as one rarely sees---boxes of eggs by the hundreds. The place itself looked like a regular incubator for a new French race---post bellum.
7 p.m. Bayonne. Encampments for the convalescent wounded and soldiers returning to the line begin to appear. At every station are girls with tricolor buttons and money boxes "pour les blessés." We are going into France by the military back door. The men are still in their blue and red uniforms.
11.30 p.m., Bordeaux. Here they are---soldiers by the number. They look just like the pictures of our old Civil War veterans with their long blue coats and visored képis. Zouaves also, and occasionally a man in a blue-gray uniform, but all with red caps and trousers. They have put on many more cars, and the forward ones are packed with soldiers. They look very small and forlorn---not much élan here. We have wangled a few pillows and rugs and will try to sleep.
April 1, Paris
It was a poor night, and a most bedraggled group of people made some tea in one of our baskets about 6 a.m. But despite the cold, our first bright clear day brought us cheer; and we finally slid into the Gare d'Orléans, where was breakfast, and a chance to pull ourselves together. Very exciting to look out on the streets of war-time Paris---officers speeding by in motorcars---an armored car with machine guns---ambulances and all else---all in gray war paint except for the red crosses and the red splashes of the old French uniforms.
Greenough commandeered three big buses into which we clambered, bag and baggage, and set out across the river, through the Place de la Concorde, where Alsace and Lorraine are still draped in black, out along the Élysées, under the Arc to the Porte Maillot, and through it into Neuilly. A very interesting ride on a crisp, clear, spring morning. But the streets seemed very empty for Paris---children playing whip top on the Élysées paths as usual, showing that it was really not Sunday, though it looked it. Everyone not in uniform seems to be garbed in black.
The converted Lycée Pasteur, now the Ambulance Américaine, is not far from the Porte Maillot, and as we approached it along the Boulevard d'Inkermann it was immediately recognizable: the handsome school building with its courtyard full of Ford motor ambulances, over which a bevy of uniformed drivers, youngsters from home, for the most part, were tinkering, some freshly-arrived chassis being newly assembled. A row of patients and nurses waved a welcome from the upper terraces; Blake and others of the permanent staff, most of them in khaki, greeted us below.
The hospital was quite a revelation, and we met so many people and saw so many familiar faces it's impossible to set it all down. They have admitted no new cases to our 164 beds---indeed, have emptied them as far as they were able, so that we may have a fairly fresh start.
The first man we saw had a dreadful paraplegia, with a huge bedsore, due to a section of the spinal cord. He'd been shot in the back by a pointed French bullet---recognizable in the X-ray. In a Frenchman, too! So war is doubly dangerous for the soldier--- from behind as well as before. Many other minor cases----none of them very bad---we hurriedly glanced at as we were ushered through the several rooms. No Germans. They would require a guard, and the few they have had in the past did not make them very popular.
Good Friday, April 2
It is difficult to say just what are one's most vivid impressions: the amazing patience of the seriously wounded, some of them hanging on for months;the dreadful deformities (not so much in the way of amputations, but broken jaws and twisted, scarred faces); the tedious healing of the infected wounds, with discharging sinuses, tubes, irrigations, and repeated dressings---so much so that grating and painful fractures are simply abandoned to wait for wounds to heal, which they don't seem to do; the risks under apparently favorable circumstances of attempting clean operations, most of which seem to have broken down---a varicocele, an appendix, and, worst of all, a thoracotomy for a bullet in the pericardium which apparently was doing no harm.
Some of this miscellaneous work savors of "souvenir surgery," and doubtless pressure may oftentimes be brought to bear by the wounded, for they are very proud of these trophies. From the man in question the unoffending bullet, which he wanted as an exhibit to show his visitors, was removed from the pericardial sac; but he got a collapsed left lung, a right pneumonia, then in turn a left pneumonia, and now a bad empyema, with a tube in his side which may or may not close some day. Still he seemed very proud and happy.
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The Lycée Pasteur (Ambulance Américaine) at Neuilly
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Decoration of a Convalescent Officer at a Ceremony in the Court
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The histories are all interesting, citing, as they do, the man's name, regiment, the place where he received the injury and under what circumstances, how long he had had on his clothes without changing them, where he got his first, second, and possibly third dressing before reaching our ambulance, and so on---each item full of horrible, though fascinating, possibilities. No doubt this will all seem very commonplace after we have been here a few days.
I was going over a man this afternoon with a facial paralysis from a bullet wound in the mastoid. He got hit during an engagement on September 7 at a place called Croult, and, with a field full of other wounded, was left for dead. The enemy came over them a day or so later; a soldier poked at him and, finding him alive, swung at his head with the butt end of his musket, breaking his jaw. He was finally picked up during a counter-attack and, after a bad otitis media and erysipelas, is now ready---after seven months!---for a nerve anastomosis. It seems hardly worth while, under present circumstances, to attempt cosmetic operations. What's a simple facial paralysis, after all?
Then, too, there are those not badly hurt who simulate worse things. For example, one strapping minor officer, a gymnasium instructor in peacetime, threw out his chest and made a great fuss about a trifling crackle in his shoulder which Osgood immediately identified as a subacromial bursitis.
Many of the men have deformed toes (possibly from sabots?) and they complain that their military shoes are bad, though those we saw seemed sensible enough. But there are other bizarre troubles with the men's feet of really serious nature. There are erythromelalgia-like feet---painful, blue, cold, macerated-looking extremities; and indeed the whole circulatory condition of many of the blessésis very bad. It is presumable that the worst of this is over, with the return of not only dry but warm weather. The standing in cold water, even though above the freezing point---one cause of the so-called water-bite---is as bad as frostbite itself, especially when helped by the too-tight application of puttees which may shrink. Some of these poor devils must have so stood for days in hastily dug trenches without a chance of getting off their boots.
Almost from the start, the majority of the men have been admitted with bronchitis, and many with influenza-like colds. Then, too, the African troops may have brought with them underlying tropical disorders of which we know little. One of them was a fine Turco in a gay Zouave uniform, with a through-and-through thoracic wound made by a German "ball," the wound of entrance so small it could hardly be found.
Can you picture him, with no one around he can understand or who can understand him, industriously putting together the biggest and most intricate jig-saw puzzle "made in America" you ever saw, on a table in an American hospital in France, with Americans taking care of him? What can his thoughts of us be? They tell us the Germans don't take the blacks prisoners;but then, what may or may not we believe about all this business? Here we are as near the worst affair in history as Boston is to Worcester, and everyone appears to take it as though it had always been so, and always would be, and meanwhile goes about his own little business unconcernedly.
April 3rd
A continuous rain. Morning passed at the Ambulance combing out and indexing the neurological cases. As a matter of fact, few of the wounded escape from a nerve lesion of one sort or another. Although we have been discharging rapidly (20 out of 81 in Cutler's division), so that some of the rooms contain only two or three patients, a partial list even now shows:---
Eleven upper-limb nerve injuries varying from wounds of the brachial plexus to minor ones of the hand; five of them musculospinal paralyses with compound fractures of the humerus.
Two painful nerve injuries of the leg; operated on by Tauer with suture.
Three facial paralyses. One of them had had "un morceau d'obus" as big as the palm of the hand driven into his cheek which he proudly exhibited---i.e., the morceau.
A cervical sympathetic paralysis in a man shot through the open mouth.
Two fractures of the spine, one dying, the other recovering. A beam supporting the "tranchées d'abri" had fallen on him when a shell landing near by blew up the section where he was stationed.
Only one serious head injury; this in the case of Jean Ponysigne, wounded five days ago in the Vosges and brought in here to the Ambulance in some mysterious fashion.
All the wounded from the S.E. part of the lines are supposedly routed to Lyon and the South of France---those from the centre come here; those from the North, including the British, go to Dunkerque, etc. There are very few Tommies in our wards. One of them to-day was playing checkers with a Turco and said his black friend had learned the game so quickly he could now almost always beat him---but he thought he had him this time.
One of the hospital attendants told me at lunch that on passing the Invalides the other day he saw an old veteran of 1870 in his long blue coat balancing on his two wooden pegs with the aid of two crutches, in order to salute a victim of the present war, years younger, but in the same condition.
A visit to the dental department this afternoon with Dr. Hayes ---doubtless the most impressive work we have thus far seen--- new, ingenious, effective. It is remarkable what they are able to do in aligning the jaws and teeth of an unfortunate with a large part of his face shot away; and there must be as many of them in the wards as there are neurological cases. It's a pity that we could not have brought a capable dentist with us.
Easter Sunday, April 4
Our first batch of newly wounded received to-day-only seven in all. We saw them brought in and bathed, an interesting performance. They were not so terribly filthy, this lot, as I had expected, though one of them, a beautiful creature, a French peasant, had not had his clothes off for a month. He had come all the way from Flanders, wounded last Friday in the leg---only forty-eight hours from the firing line---to a hot bath, a shampoo, and a universal lather in a comfortable hospital.
Lunch at the Ambulance and a visit from Roger Merriman, who has had an interesting time over here helping in the Embassy while giving his French lectures. He has recently visited the Front at Nancy, watching the 75's in action, and dodging under an abri when a German shell gave warning, by its whistle, of near approach. He has first-hand information of atrocities---of which there may be something to say on both sides--- stories about a few wild German regiments in particular whose course can be traced through Belgium. But M. Marty has just told me at tea of the Turcos who broke loose one night in Versailles and made away with some German officers who were there; also of the Turco in hospital at the College who presented a little girl, to whom hhad taken a fancy, with the ear of a German soldier. But there are always points in these stories where they don't quite hold together.
Monday, April 5, a holiday
10.30 p.m. At the Ambulance, working on histories all the afternoon. Some of our recent cases have appeared tagged with pink cards, which are tied on at a poste de pansement or at the poste de secours, and I gather that there are two zones of these first-aid stations, primary and secondary, the wounded being gathered up from the battlefields or trenches usually at night and taken to the primary line. There are several kinds of labels---pink (those capable of transportation), yellow, blue, and so forth. From the postes de secours they are taken in peasants' carts or ambulances to an evacuation centre (ambulance de tri) which may be anywhere, preferably some railroad station, and there the sitting and lying cases are separated, the serious from the minor cases, the medical from the surgical. The petits blessés remain and ere long go back to the Front; the bad cases---chest, abdomen, head, spine, and so forth---are sent to the nearest base hospitals. The attempt is already being made to concentrate particular kinds of wounds ---as might well be the case here for fractures of the jaw. This programme will doubtless become perfected in time, and more efficient work will then be done.
In the early days things were badly disorganized, and the conditions were shocking. The wounded were all rushed south as rapidly as possible and the more seriously ill were put off whenever and wherever the trains stopped. They were picked up in any way chance might favor---luckily if by an ambulance, but more often by a cattle or provision train returning from the Front. One of these trains had dumped about five hundred badly wounded men and left them lying between the tracks in the rain, with no cover whatsoever. Blake spoke of one English officer who had been six days thus in transport, with a musket for a splint tied to a compound fracture of the femur, no dressing whatsoever, almost no food or drink; he was in delirium when he arrived. Fortunately the wounded were young and in the pink of physical condition; few would otherwise have pulled through.
Thursday, April 8
Our admitting day brings in only ten cases, though there were about two hundred at La Chapelle station last night. Still, this must have been more than our proportion, for there are many hospitals strung along the Champs-Élysées alone, and in all Paris heaven only knows how many.
One of these men had had his spinal cord divided by a piece of metal driven off by a German bullet from the bayonet case at his hip. The vagaries of the foreign bodies are many. Not only may one find the projectiles themselves, but often pieces of equipment which have been detached, and which acquire the full velocity of the bullet itself and are really more dangerous. Sometimes these secondary missiles may have come from someone other than the person actually hit, even a piece of the skeleton of a neighboring soldier, or a bit of stone or wood.
The actual surgery itself, it would seem, is not very difficult, but the judgment of knowing what and how much to do, and the wheres and whens of intervention---these are the important things, only to be learned by experience. First or last, most of the missiles apparently must come out.
Some of to-day's wounded were very dirty, with the mud of the trenches on them, and though they acknowledged some pain and great fatigue they were cheerful and uncomplaining even gay. "C'est la guerre," is all they say. It's a great sight to see them get their hot bath and fall into a deep sleep the moment they strike their beds---but not so deep either, for they are wide awake at any call or noise. A temporary restful sleep is a desirable thing before X-rays, dressings, and ether anesthesia---should the last be necessary, as it was for two bad shoulder cases today.
Everyone, of course, tells us that we know nothing yet of what it can really be like. After the battle of the Marne the wounded came in sixty at a time, with the operating room in continuous performance and not enough beds to go around.
Friday, April 9
One comes upon many examples of hairbreadth escapes. In our wards is a man who got off with a slight burn of the forearm when a German contact shell exploded near him, and yet many of his companions were killed. Another man had both bones of his forearm broken in similar fashion without being actually hit, and yet his more distant companions suffered heavily from shrapnel. One man was blown into a tree and hung there for a long time by his trouser leg. Another was blown out of a trench and found the timing piece (fusée) of a shell in the seat of his trousers. Many have barely escaped because they happened to be stooping when a shell exploded near by. One artillery officer was knocked down three times in succession by shells landing only a metre or two away from him; he suffers from a severe nervous concussion---what the British call "shell shock."
Sunday night, April 11th
Strong somehow secured from the Ministère de la Guerrea coveted pink paper "good for three days" permitting him and a companion to visit the Amiens sector on a mission spéciale itinéraire facultatif. Before leaving for Serbia to-morrow, what he wished particularly to see were the provisions for the wounded near the Front and the methods of disinfecting for lice, scabies, etc. Parasites, human and otherwise, play an important rôle in the war.
He attributes the privileges partly to the five stripes on his sleeve and partly to the effectiveness, when making an unusual request in a foreign tongue, of demanding an interpreter. This conveys the impression that one knows what he is about and adds dignity to the scene. Preserve therefore your Parisian small talk for shopkeepers and waiters, but express your compliments and desires to officials through someone conversant with les verbes irréguliers et défectifs---and you may get a "pink paper" and visit the 2ème Armée.
After endless days of rain and influenzal colds, we were given a Sunday, raw though it was, for the most part in sunshine and without a shower. With the aid of a pension alarm clock I tumbled out at dawn and climbed into a brand-new ambulance uniform, well padded out with an extra sweater, two pairs of socks, and me, heavily armed with two kodaks and appropriate rolls of ammunition. Luckily, considering the hour, a taxi was encountered and I was delivered at the Crillon at the appointed time.
There had been difficulty at the Ambulance in regard to the military number of our car, which on our permis read 21243, whereas its actual number was 22060; but fortunately most of the sentries simply bowed before the magic paper without wasting time in scrutinizing it. At the suggestion of Alan Muhr, our Ambulance Corps driver, we stopped to fill the bottom of the car with cigarettes and should have bought more---a few hundred, packages of 10-centime Caporals don't go far among a thousand men. Showing our paper at the Porte de la Villette, we took the Route Flandre toward Senlis, past the new aviation field at Le Bourget where there are hangars for innumerable planes, some of which were up---enough easily to defend Paris were it not, according to Muhr, that the Taubes can circle all around them; and when Zeppelins come on a Saturday night the flying men are likely to be at their club dinner!
A cool hazy morning and, as the spring is late, we were glad to be well wrapped up. Soon signs of neatly made trenches and entanglements were seen on either side of the road---unoccupied and never to be, let's hope---prepared doubtless to protect Paris long after they were needed. At Survilliers, only 15 miles out, Muhr waves at the little cluster of buildings---the nearest point to Paris reached by the uhlan cavalry. Then on across open farming country and through the Forêt de Chantilly until Senlis----or what is left of it---with its graceful twelfth-century spire comes in sight. A. little town of importance in mediæval history and until last autumn a pleasant place in which to have a country home.
On the evening of September 3rd, the German right wing had reached the line of Creil-Senlis-Nanteuil fully expecting to enter Paris on the following day. On the memorable 4th, however, it was learned that von Kluck for some unaccountable reason was swinging to the east, possibly to outflank the British or because he had come too far and too fast from his base of supplies, or because he was misinformed about the strength of the French in Paris--- who knows? At all events, it was on the 5th that Galliéni's taxicab-delivered troops crumpled up this turning movement by suddenly landing on its flank with the result which one doesknow---the subsequent battle of the Marne and the German retreat to the present---or approximately the present---impregnable line of trenches. It was apparently on this high-water line of von Kluck's advance that the looting and burning took place from which Amiens, Montdidier, and places farther in the rear seemingly escaped---places the Germans expected to retain? or places where they met with no resistance or sniping? or where the troops were kept in better control? Someone better informed must answer.
Showing the German Advance at the Outbreak of the War
between August 20 and September 3, 1914
Senlis at least shows what can be done in a short time. All the descriptions and photographs I have seen of pillaged villages fail to give any conception of what it all meant; and here seven months have elapsed---ample time to clear the streets of the débris.
At a little shop where some picture postcards were on display, an old woman wiping her hands on her apron finally answered to Muhr's bangings and let us in. Yes, she had three sons in the army --all good boys---one of them dead and another reported missing. She told us excitedly how the wine cellars were promptly broken into and the soldiers got very drunk on champagne. With the Eiffel Tower in sight from Senlis, they were as good as in Paris and demanded the names of the best restaurants, where they expected to be dining in a day or two. Then came the systematic burning---incendiary pellets carried by the soldiers being thrown in through the broken windows as they departed. This at least was Madame's belief.
They had time to wreck the Senlis railroad station, which was not the case farther west at Creil---but then, were these not Sherman's methods? The Allies have not had a chance to show what the Turcos and Cossacks might do under similar circumstances if let loose in Germany.
On through Creil, an important railroad junction on the Oise, much knocked about by the German artillery; but the turning movement from here appears to have been too rapidly executed to give time for the sort of systematic demolition from which Senlis suffered. Only one street on the northern bank---the rue Gambetta, I believe---was badly gutted. The iron bridge, presumably destroyed by the French when first driven out, has been replaced by a makeshift structure and we crossed by a guarded wooden footbridge, finding the town full of soldier people---old reservists doing sentry duty, not a few cripples, others possibly home on sick leave---surrounded by their women and children. The Oise is quite a sizable stream here, and from the northern bank one gets a lovely view in the bright sun---for it grows warmer---of St. Médard, another old church of an early century. It has known other wars. Happily these were the last we saw of demolished towns, until we passed through them again like carcasses in the night on our return.
From Creil on to Clermont over roads in excellent repair in spite of what they've been put to. And such beautiful country! From the appearance of the well-cultivated fields there have been plenty of hands, even though old or female, to do the work. Some of the fields are newly ploughed and some even show a few inches of early spring wheat. It looked more like our Middle West so far as the wide unbroken stretches were concerned---but far better groomed and intersected by good roads lined by double avenues of buttonwood or elm. A great shooting country, too, when harvests are in, says Muhr, who explains that the frequent copses of trees and undergrowth are left as coverts for sportsmen to whom the owners let out their places. For good reason there was no hunting last autumn and game is plentiful---pheasants fly across the way---we see countless partridges---and a rabbit now and then barely gets across the road in front of us in time to save his skin. Another evidence of a war last Christmas is shown by the great nest-like tufts of mistletoe on the roadside trees, much of which would have been gathered in normal times and sold in the Paris markets.
It seems strange that the French did not remove their road signs as the Belgians are said to have done. They are at every crossroad, and what with a stone marker every kilometre giving the distance to Paris or to the nearest large town in the other direction, small chance that an invading force would lose its way, especially with a Taride motor map easily purchased at any shop and in every German officer's pocket. We passed what Muhr---whom I will cease quoting, as most of our information may be taken as coming from him---called a company of "Rats"---i.e.,Réserves de l'Armée Territoriale; but otherwise, apart from a gray military car or two that whizzed by with some officers on the way to Paris, we had the road to ourselves and kept on through a far-flung, pastoral region in utter peace, with not a soul in sight except an occasional lone worker in some distant field. Larks and song sparrows could be heard even above the noise of the car, and innumerable crows and magpies were scared up from the fields as we chased by.
Through Clermont-de-l'Oise, a beautiful town on a hill slope, also with old churches and a mediæval Hôtel de Ville. The Germans were here also and indeed reached a point 17 miles to the west---at Beauvais on the other side of the Forêt de Hez. On through St. Just, and then Breteuil fairly eating up the road---the towns full of reservists in their long blue coat-like mantles with the corners buttoned back, red trousers, and military caps, looking for all the world, were it not for the red splashes, like our veterans of 1865 as they appear in Brady's old photographs of that time.
There are said to be 2,500,000 men on the Western Front with a million and a half reservists; and the 1916 class with another half million boys has been called up to-day. Then on through Flers-sur-Noye and other places, breathlessly passing mile on mile, as far away as one can see, of newly ploughed fields---prepared for planting beet-root, according to M.---till we finally reach Dury and the headquarters of the 2ème Armée, a little town just short of Amiens, where begin our real adventures.
The 2nd Army holds the line from Thiépval to Tracy, i.e., to a point about opposite Compiègne, and consists of three corps, each of them an army in itself. It is in command of Général Castelnau, who, in his shirt sleeves, didn't much resemble the pictures of him shown in the Paris windows. At the battle of Charleroi one of his sons, a junior officer, had been killed by a shell before his eyes. News of the death of a second son was brought to him during a recent council of war at these Dury headquarters, and without showing the slightest recoil he quietly said, "Gentlemen, we will continue with our business." There's still another son---a football friend of Muhr's, which doubtless helped us some . . . .
Strong had a letter from the recent Surgeon General of the 2nd Army to a Col. La Bade, his successor, asking that he accompany us wherever we wished to go and extend to us all courtesies, etc., etc. Col. La Bade, alas, was away for the day in Compiègne, and we were confronted at the office of the Service de Santé by a not very cordial medical officer gorgeously attired in one of the new horizon-blue uniforms, who suggested that we look for Col. La Bade in Compiègne. Sizing him up as not caring to act as a cicerone for us on this pleasant Sunday, in La Bade's absence, Strong suggested that we be escorted to the local commanding officer. This to my surprise was promptly acted upon, the M.D. meanwhile muttering things about the uselessness of going to headquarters and our not having le mot---though what le mot had to do with it I couldn't imagine, unless it was that our French was highly defective; but this was the last thing that bothered Strong.
Well, we got by several sentries and arrived at a little house further down the village street full of soldiers and soldiers' things, and were ushered into a room where was a billiard table covered with big envelopes, maps, and documents, while the walls were lined with the greatcoats and military caps of the staff officers. Strong requested an interpreter, a rôle Muhr was asked to play, and the next thing I knew we were being ushered upstairs and being greeted by a pleasant old man---Castelnau himself---who seemed really glad to see us and asked many questions of how we happened to be over here, which Muhr told him, and what we wanted, which Muhr told him also, adding that he had played on the French football team with his son. And before it was over---and it didn't take long---we were wringing each other's hands, bonne chancing, and so on, while the Médecin Majordownstairs was let know that he was to take us to see everything that we wished to see. Whereupon we were given le mot---which password for the day was "Franceville"---whispered to us as though somebody might steal it. Strong later insisted thatle mot by any other name would have served as well and been easier to remember, but we Franceville'd our way along until 6 p.m., when we got another.
Our guide---the reluctant M.O.---wanted us to go first to Amiens, apparently as a convenient place for déjeuner, which we did, and at the Hôtel du Rhin he was provided with a copious one. We were meanwhile informed that the medical situation which had promised to be most serious was rapidly improving. In the 4000 beds at Amiens there were now only 2000 sick and only (sic) about 500 cases of typhoid. At one time there had been 9000 cases!! in the 2nd Army alone, and some 70,000 in all the armies with about the usual 13 per cent mortality. During November and December cases were being brought in to Amiens at the rate of 300 a day, but since vaccination of the troops had become compulsory their number was rapidly diminishing. It might otherwise have been disastrous. Meanwhile, the British Army had been almost entirely exempt---only an occasional case among those unvaccinated.
He wanted us to stop long enough to see the Amiens Base Hospital and disinfecting plant, but as Strong had already been there (and says they were very bad) we begged to move along. So, having wasted considerable time over food, we got away about 2 p.m. and took the straight road which, almost without a kink, leads due east all the way to St. Quentin---or once did. To-day one can go scarcely half the way, some 50-odd km., before coming to the Boche.( 1 )
Some ten miles out we stop at Villers-Bretonneux to inspect an ambulance de première ligne in a medium-sized two-story house where a pleasant upstanding young officer was directed by our guide to show us things. The place was utterly makeshift but there were barely 50 wounded, whereas their accommodations were for 150---it's this way everywhere during the present lull. The 50 were mostly head and chest cases---apparently doing well. Head injuries are frequent from imprudent peering over the trenches, and that's why the Algerian Zouaves are not sent into the line as much as formerly, for they "want to see." The doctor, recognizing my uniform, said the wounded men all beg to go to the Ambulance Américaine, where on dit they are pampered and spoiled. Some cigarettes were distributed and one poor chap raised up on his elbow and said, "I tank you."Bonne chance, mes amis.
Then, with Muhr touching it up to 90 km., on to a small hamlet called Warfusée, where we began to see rows of trenches and entanglements and at one place, for at least a kilometre, an intersecting (communication) trench zigzagged beside the road, a clean-cut ditch five or six feet deep, the soft earth held up by coarse wire netting and scarcely wide enough for a man's shoulders---certainly no stretcher could traverse it.
Soldiers were gathering sod and stripping bark from the trees for the trench arbors and concealments; and alongside of them old men and women were working in the fields at their peaceful occupations, as unconcerned as though the sound of cannonading and the drone of aeroplanes were a normal accompaniment of their day's work. Warfusée had seen serious fighting in September; great ditches had been dug for the dead behind the little church burying plot---too small to hold them all; and scattered along the road and through the fields were little mounds with a wooden cross at the head---too many to count.
We got out to investigate the empty trenches, which appeared to be newly made and prepared as a second line of defense in this sector. They connected directly under the highway and were of a rectangular pattern to prevent enfilading, with shelters at frequent intervals, and in front of them were some crude entanglements(chevaux de frise). It's amazing to think that these ditches extend all the way from Flanders to Switzerland, and not only one but several successive lines of them probably on both sides. Strange warfare, fit only for weasles, moles, or rats . . . .
At a place called Foucaucourt a sentry held us up, saying it was the limit of motor traffic, and we found ourselves under cover of some trees where the road runs along a slight ridge with a declivity on each side. On the right, drawn up before a shed, well protected in the arms of an old limestone quarry, was a company of soldiers who filed into the makeshift barrack and disappeared. We climbed out of the car and descended the sharp slope to find, running under the road, an old bricked-in tunnel which had once served as a poste de premier secours but was now being used for officers' quarters. A most engaging young officer stepped up, saluted, introduced himself as Lieutenant Woerner, and asked in perfect English if we wished to see his men, with whom he had just come out of the trenches after an eight days' period---for in this comparatively quiet area they are alternating eight days in and eight days out.
The moment we entered the door every man jumped to his feet at salute from the straw mattresses on which they'd been sprawling. They seemed well fed and husky, but looked rather done up, and we were told that, owing to frequent alarms, they had had a sleepless 48 hours. They were of varied ages---one a boy of 20 and the others ranging up to 40---all in the 23rd Infantry. It was pleasant to see and feel the camaraderie, with each in his own place, which evidently existed between the men and their young officer, whom they addressed possessively but deferentially. This characterizes the French Army throughout, one is led to believe. Lt. Woerner was obviously proud of them and seemed well pleased when Muhr scrambled back to the car returned with an armful of Caporals.
I confess that the sight of numerous freshly made shell holes in the field near by was disconcerting, and no less so the discharge. of a cannon every few minutes on the other side of the road. Woerner asked if we would like to see the battery---they were shelling the Germans in Belloy, four kilometres away. Of course. So we climbed over the road and down the slope on that side, where the ground was literally pocked with holes, some of them big enough to bury an ox, while here and there was a wooden cross with a soldier's cap on it. We were reassured with a shrug that ces sales Boches were not wasting the ammunition and these trous d'obus were made a few days ago in an effort to locate the battery. Well camouflaged, it was hidden in a little copse about 150 yards from the road and partly protected by an embankment that was honeycombed with dugouts for the gunners' quarters---like cave men's holes
Our host routed out a business-like young artillery officer who said his commander was away making observations Would he mind our watching the guns?---not at all-and kodaking them?---not in the least---and he scampered off and disappeared in a hole somewhere in the bank.
The guns were well concealed---the third, for there were three side by side, I never made out at all, and the nearest one at the edge of the copse looked just like a fallen tree, for its long muzzle had been carefully wrapped with bark. They were 120-mm. guns, I believe, firing in rotation and meanwhile receiving signals from an observation post somewhere on the embankment a hundred yards away correcting their angulation. The target was said to be the church steeple in Belloy, which was too useful to the Boches to leave standing. I learned that kodaking a heavy gun in action and protecting both ears at the same moment offered an insoluble problem.
We subsequently found Woerner's platoon up on the road getting their mail, for the soldiers' post had just come in, and refusing a Boche helmet which was offered us, and promising to send them a football to amuse themselves with when en repos, we again got aboard---and, everyone at salute, started back for Amiens. It was a wonderful afternoon, with sun and clouds, several aeroplanes up, farmers getting in hay between the lines of rear trenches; and finally the Amiens Cathedral loomed up on the distant horizon, kilometres away in the clear air.
It was about 4 p.m. when we finally dropped our cicerone at Dury, and as Strong had expected to reach Montdidier, then some 40 km. away, by 4.30, we had to make haste. This was not so easy, for we were frequently stopped by armed sentries who would unexpectedly pop out in the middle of the road, and if our "Franceville" did not satisfy them would hold us up while they scrutinized our pink permis in detail. Thus to Rossignol, then across country to Ailly and through Grivesnes---a lovely valley, town, and château---Cantigny---and finally---while going at about 90 km. with Montdidier prettily situated on a hill just before us---we suddenly have a blowout. It fortunately was a rear tire---soon replaced by a new demountable wheel; but what was worse than this, in trying to make up for lost time we bounced over a railroad track just before entering the town, catching our muffler on one of the rails, and the whole pipe was ripped off from the bottom of the car. Such a racket as we subsequently made beggars description, and with the noise of an aeroplane we drew up at the Montdidier station.
Hermann Harjes had told Strong that we would be met by a member of his ambulance corps, but being fully an hour late it was no surprise to find no one was there. The place serves in military parlance as a gare régulatrice par le chemin de ferand the station yard was full of French ambulances mobiles de premier secours which gather the blessésat the forward areas and deposit them in canvas-covered shacks on the station platform to be sorted before further distribution by train to points west and south. There was much bowing and scraping on the part of a robust Dr. Munie, the officer in charge, who finally gave us directions to the Harjes château---Château d'Agincourt ---some ten miles further on; and without waiting for an escort we decided to push along by ourselves. We passed on the way large numbers of African troops---Moroccans---"going in," and could plainly hear heavy cannonading from French batteries on our left said to be at Guerbigny.
Though late for our engagement we were given a pot of tea by some friendly young ambulance drivers---one of them Major Higginson's nephew---while Muhr undertook to see what he could do to repair our muffler---and he could do nothing. One of the ambulance corps---a Mr. Goode from Iowa---then took us out in the dusk to a place called Grivillers only a half hour's walk behind the first line of trenches. It was a little hamlet fairly alive with troops, where, interrupting a game of cards in the officers' mess, one of the players, a young M.O. named Viallet, was told off to show us to the local aid station which he described as practically a poste de deuxième secours. It was in a partly ruined: two-storied stone house where straw bags in lieu of mattresses were laid on gabion frames like camping-out beds---doubtless comfortable enough, in view of what the men must put up with when in the line.
There were some recently wounded---head and chest cases and the corner for emergency operations was in a dark narrow passageway. Dr. Viallet was particularly pleased with a hammock-stretcher he had devised in which seriously wounded men can be promptly evacuated from the trenches without having to wait till dark as has heretofore been necessary. They can be carried through the winding passages, only the hands of the bearers and poles of the stretchers being above the level of the trench when they come to a turn. (In other areas, I believe, canvas chair-like litters are made to serve the same purpose.) In some such way the blessés, after receiving their first-aid dressings, can get back to Grivillers in two hours after being wounded and can sometimes be delivered at Montdidier on the same day.
There were some 3000 troops in this reserve station and they looked double the number as they crowded around our car reaching out for the remaining packages of cigarettes which, alas, didn't go very far. The 16th, 4th, 7th, and 103rd Territorials, the 17th Regiment, and others. Seasoned troops they were, and platoons of them were in formation preparing to move up into the trenches. Viallet urged us to go out with him to see the poste de premier secours in the front lines which by a devious boyauwas perhaps a half hour's walk, though only a kilometre away; but it was getting pretty late too dark to see much of anything---and we were far from Paris.
So we return to the Montdidier station "pour demander le mot"---for the password changes at six, and we're told it is "Hasbrouck." Thus protected, we set off via St. Just, Clermont, Creil, Chantilly, where is Joffre's headquarters, the town dark as a pocket with sentries holding us up about every 100 yards---a bad place to get through---then the ghostly Forest of Chantilly, Euzarches, Écouen, and St. Denis---making a terrific noise all the way like a mitrailleuse. We crept into Paris at the Porte de la Chapelle---and friend Muhr, fearing arrest should he go snorting unmuffled through the city, put us in a taxi somewhere in Montmartre. So home and to bed with a burning face and a bronchitis almost completely blown away.
