AS THE TRAIN FROM LE HAVRE steamed doggedly toward the black tails rising from hundreds of coastal chimneys, Anna lowered her seat’s window for a better view of the towering chalk cliffs that sheltered her new home from the harsh Normandy gales. Her first impression of the seaport village, aspersed now by the dimming light of dusk, was how thoughtful the French had been to brighten the track platforms with planters filled with white magnolias and lilies. Yet when the locomotive rumbled closer to the small station, her appreciation turned to horror. The rectangular flowerbeds were not planters at all, but rows and rows of wounded men shrouded in blankets and linens.
Behind them, at the far end of the platform, sat stacks of pine coffins waiting to be transported across the Channel. This very car, she realized, would soon be filled with bodies bound for grieving loved ones in England. The wheels of the train hissed to a crawl, and she looked down at the bandaged faces passing below her. A few soldiers looked up and smiled weakly at her, but most just stared blankly off into the distant waves of the Atlantic.
The train finally jerked to a stop, and she climbed down from the stairwell. Accompanied by thirty fellow reserve nurses from America, she hurried for the exit, passing the hundreds of British wounded who had been brought here to Base Hospital Number Ten from the Flanders Front. She searched the civilians huddled around their piles of trunks and portmanteaus, hoping that Helen Fairchild, who had been sent over in July, might have come to greet her.
Finding no sign of her friend, she carefully stepped around the prostrate men, offering a hand of comfort whenever a groan stopped her short. There was none of the order and discipline here that she had become accustomed to in the military hospital in London. Many of these broken soldiers looked to be only a few days from the battlefield; some fidgeted nervously, flailing at imaginary enemies and yelling commands as if still in the trenches; others sat or lay inert, as if the flame of hope inside them had been extinguished.
She was grateful now that God, altering her orders, had not sent her over with Helen and the first volunteers. The officer in charge of medical support in London had assigned her to Queen Alexandra Hospital, and there the Brits had been so short of medical staff that the chief nurse had endured her ignorance, blaming it on poor American training. During these past weeks, she had managed to pick up the bare rudiments of nursing by secretly studying a borrowed training book at night.
She and the nurses rode up the precipice to the cliffs on a precarious cable car pulled by chains. Reaching the summit, they stepped out onto a green flatland filled with tents and wooden medical barracks. Hooded and bent against the gusts, the others headed straight for the nursing barracks, but she lingered behind. Curious to know what awaited her in the morning, she took a detour and walked around the perimeter of a tent marked Surgery.
She lifted the flap and stepped inside. The place looked like a macabre puppet show. Rows of cots were lined up against both sides of the pavilion, with just enough space between them for one person to stand. Hundreds of men—she assumed they were men, for most were so bandaged that she could not see their faces—lay in various contortions, with their cast-encased limbs dangling from ropes. Some had wounds that were being disinfected with tubes dripping sodium hypochlorite from bags. The poor fellows were constantly shifting and struggling to find respite from their agonies, giving the place an unsettling white shimmer. At the far end of the tent, a doctor worked over a convulsing, gray-cheeked soldier who looked to be no older than sixteen. A nurse assisting the procedure at the operating table tried to restrain the wounded soldier long enough for a rancid bandage to be removed from his thigh.
Anna raised a sleeve to her mouth. The wound gash, dark and puffy, gave off a sickening smell, like that of a dead mouse. All around her, other soldiers who were waiting on cots for their turn under the knife began praying the Lord’s Prayer. The doctor stopped his digging into the boy’s leg and stood mute with arms folded, but the attending nurse continued to work furiously, pressing her thumb against the flesh of the wounded soldier, just above his knee. His skin crackled, as if bubbles under it were being popped.
The writhing boy heard the snapping on his leg, and became eerily still. He looked up at the doctor and begged, “Please, sir, don’t take it off!”
The doctor shook his head wearily. “Not coming off, lad. It’s too late for that.” He turned and walked on down the aisle as if he had done nothing more than prescribe a dose of aspirin.
The soldier wouldn’t let go of the nurse’s hand. “What’s he saying, mum?”
The nurse knelt down aside the cot. “You have gas gangrene, Alfred. You don’t have more than an hour, I’m afraid.”
Anna hurried to a bucket and vomited.
The nurse turned, only then aware of another presence. “Anna?”
Anna wiped her mouth, ashamed. How did this nurse know her name?
“Are you ill?”
Anna blinked with sudden recognition. Before she could utter the name, the doctor shouted from the far end of the pavilion. “Fairchild!”
She grasped Helen’s hands and felt them trembling. Her friend had lost a frightening amount of weight, and her face was a sickly shade of yellow; she looked as if she had aged twenty years. “What has happened to you?”
“Tetanus shot!” the doctor shouted at Helen. “Bed Fifty-Eight!”
Helen rushed Anna down the aisle with a hand at her elbow. “Stay with me. We’re short of nurses. I’m sorry I couldn’t get away to meet you.”
They stopped at the bed of a soldier whose head was bent back, his neck arched in pain. His throat muscles were spasming, and his dirty teeth were bared like those of a snarling dog. The doctor loaded up a syringe with the serum, and handed it to Helen.
Helen turned aside to prevent the soldier from overhearing them. “Why put him through the suffering?”
Anna put a hand up to shield her eyes, unable to watch. “What is happening to him?”
The doctor glared suspiciously at her. “Who is this?”
Helen tried to calm the manic soldier in the bed. “One of our new nurses.”
The doctor snorted his disgust. “Another American lass has come looking for a war adventure. Saint George help us.”
Helen kept pleading against giving the soldier the painful tetanus shot. “He’s in the advanced stages of lockjaw. The injection will do nothing for him now. All we can do is to ease his suffering as best we can.”
“Give it to him. There is a chance it may spark the antibodies.”
Another patient down the row cried out for help.
The doctor turned, distracted. “Fairchild, come with me.” He nodded toward Anna. “Let her give him the injection.” He spun on his heels and marched down the row toward the screaming soldier.
Helen slipped the tetanus syringe into her own pocket and brought out another needle. She secretly gave the second syringe to Anna and whispered, “Morphine. Give him the full dose.” She took off running for the doctor.
Left alone with the dying soldier, Anna stood terrified with the needle thrumming in her hand. The poor boy stared pleadingly at her, his mouth stretched in a silent scream. She managed to restrain his flailing arm and turned it over to look for a vein, just as the training manual had demonstrated in the drawings. She was so dizzy with nervousness that she couldn’t stop her own tremors long enough to get the needle to the thin blue line. Finally, she took a deep breath and whispered, “Lord, please help me.” Opening her eyes, she plunged the needle into the suffering boy’s arm. She pressed on the syringe, but the morphine refused to release.
My God!
She had bent the needle on the man’s skin, tough as leather. Breathing hard, she finally managed to pull the needle out. She saw another syringe on the table. Helen and the doctor were walking back toward her. She yanked the needle from the man’s arm and quickly snapped the new one onto the morphine syringe. With no time to hesitate, she drove the second needle into the vein and plunged the morphine into the man’s bloodstream.
Blessedly, his spasms eased.
The doctor was now only a few steps away. She extracted the needle and dropped it into her pocket. And then she remembered: she hadn’t emptied the other syringe. She slipped her hand into her pocket and drained the tetanus fluid as the doctor and Helen arrived. She pulled out the empty syringe and affected indifference as she dropped it into the kidney dish on the table.
The doctor glared at her, then walked away.
Helen pulled her aside, away from the patients. “We don’t have much time. Another barge came in this morning with two hundred wounded.” Anger thrummed in her hoarse voice. “The winter fighting is usually slower, thank God. They’re casualties from the practice shelling and the useless sorties ordered when the officers get bored. The generals call it normal wastage. They give sanitized names to every horror to keep the poor folks back home from knowing what really happens here.”
Anna was already lost. “You said we don’t have much time. For what?”
Helen’s eyes were fluttering, windows to her racing heart. “Staff Headquarters could send you to an advance clearing station any hour now. You’ll be the only nurse there. I won’t let them put you through what I endured.”
“I’ve learned—”
“You’ve learned nothing!” Helen walked faster down the aisle, talking frenetically. “Forget everything they taught you. Nothing prepares you for what you will face out there.”
Anna was frightened by her frenetic behavior. “Helen, you need to rest.”
Helen stopped at the bed of a soldier who appeared asleep. She picked up his limp hand and gestured for Anna to feel it in a test. “First thing, when the men are brought in to the clearing stations, sort the dying from those who are near death but can be saved. You won’t have time for laboratory tests. Many will be in shock. They will seem dead, but their bodies have just retreated into a cocoon of protection. You must learn to triage them by touch alone. All will come in feeling cold. Some will be cold from just the chill of the night. Others will be cold because their life force is ebbing away. Don’t use your mind. Think with your fingers. And don’t second-guess yourself. Delay costs lives.”
Anna struggled to comprehend the rapid-fired instructions. They came to a man resting on his side with his back exposed. Helen gently removed a corner of a large bandage that covered the crease between his left buttock and upper thigh. Under the gauze lay a seething white mass. Anna nearly gagged. “Are those … maggots?”
Helen sprayed the larvae with a can of ether. “If a soldier comes in with these blessed creatures, leave them on the wound for twenty-four hours. They help fight the gangrene.” Anna hurried to keep up as Helen rushed from bed to bed. “Vaseline for the burned ones. Drop almond oil on their eyelids. Sometimes they will come in with their skin stuck to the stretchers. You have to soak them first with warm water before trying to move them. If you see blue crosses on their body, the poilus found them. That’s the French sign for wounds.” Helen held up her right hand, revealing one of the fingers swollen with a cut. “Wear gloves. Worse thing that can happen to you is a septic finger. You’re no good for weeks. If you get an infection, bathe it in iodine. If you don’t have iodine, use urine.” Her thrumming voice was rising in stridency. “Many times you will have to inflict a lot of pain early to save them months of pain later.”
“Please, Helen. Sit down a moment.”
Helen found a pack of cigarettes on a bed table. Pulling one out, she dipped it in a bottle of vinegar and thrust it into Anna’s mouth. Anna tried to spit it out, revolted by the taste, but Helen demanded that she endure it. “Give one of these to each gas victim when they first arrive. If they do what you just did, they are lying about being gassed. The mustard masks their taste of vinegar.”
“But—”
“They will put you in the Salle de Morte first.”
“The what?”
“The Death Room. It’s where they keep the hopeless ones.” Helen’s quivering lips came to Anna’s ear. “Some doctors will tell you to save the morphine. The good ones, the ones who would have given Christ the hyssop on the Cross to ease His suffering, will tell you to be free with it.”
“You mean … ”
Helen stopped her cold with a hard look warning against easy judgment about the merciful speeding of life’s end. “When you draw the night shift, you must be on guard around four in the morning. That is the time hemorrhages are mostly likely to—” She doubled over in pain.
Anna helped her to a chair. “What’s wrong?”
Helen coughed up blood. She lurched back and fainted.
“Doctor!” Anna screamed.
The flap flew open, and the physician who had dismissed her so callously before came running. He checked Helen’s pulse and felt along the front and sides of her abdomen.
“I don’t think she has slept in days,” Anna said.
The doctor motioned the orderlies up with a stretcher. “It’s not from lack of sleep.”
TWO WEEKS LATER, ANNA AND the other nurses brightened with relief when Helen opened her eyes in the recovery room of the operating tent. Called over with the good news, the surgeons arrived and hovered over Helen, testing her vitals and checking the X-rays.
“Nothing to worry about,” Anna assured her groggy friend. “They found a gastric ulcer blocking your stomach valve. No doubt caused by too much worrying. You are finally going to get that rest you deserve.”
Helen smiled weakly; then, her face shadowed. “How many have died?”
Anna patted her hand. “You mustn’t think about that right now.”
“How many?”
Anna sighed, driven to the admission. “Thirty-seven since you went under. Lt. Cornishon in Tent Eight was asking about you this morning. He said the men stayed up all night praying.”
The surgeon brought down the X-ray from the light. “The obstruction is gone. Now we must let the healing take place.”
Helen looked up at him with an admonishing glare. “I have a bitter taste in my mouth. Chloroform. You should have saved it for the men.”
The surgeon smiled. “Fairchild, I’m surprised you didn’t rise up on the table during the operation and tell me which knife to use.”
The nurses nodded at the friendly reminder of Helen’s perfectionism.
“Right,” the surgeon said. “Let’s give her some rest. Do you ladies of the cape not have other patients to attend, or did the Kaiser suspend the war for Miss Fairchild’s benefit?”
As the other nurses filed out of the tent, Helen held onto Anna’s wrist. “Stay a moment with me, won’t you?”
Anna looked to the surgeon for permission.
“Not long.” He departed and shut the flap behind him.
Helen indicated for her to pull a chair up. “Do you remember that theatrical we saw on Charing Cross Road?”
Anna nodded, sitting aside the bed. “‘Maid of the Mountains.’”
“Yes, that’s the one. How wonderful an evening it was.”
Anna smiled. “As I recall, you let loose with a catcall so loud that the lead actor halted his performance and gave you the evil eye.”
“He deserved it with that lackluster effort.”
Anna fussed at her nurse’s apron, still a little ashamed that she had allowed Helen to talk her into seeing such a profane performance. If her father or Micah ever learned that she had spent good money on such frivolous nonsense, they might shun her for a year.
Helen turned serious. “Anna, you must protect yourself.”
“I wash my hands after every patient.”
“No. I mean … you must protect your heart.”
“My heart? Helen, I told you in London. I am betrothed to Micah. He will be waiting for me when I return. He is the reason I am doing this.”
“I am not speaking of romance. You will become the mother of every soldier who is brought to you now. They will call for you with their final breaths. You have to find a way to rise above it all, to look down on what you will endure as if you are watching that play on Charing Cross. Try to treat it as just a bad dream. One that you will soon awake from.”
“You’re scaring me with talk like this.”
“In my trunk, there is a letter I wrote to my mother. I meant to post it, but didn’t have a chance. Would you mind sending it for me?”
“Of course.”
Helen’s eyes lidded. “I think I’ll sleep a little now, if I can remember how.”
Anna pressed a kiss to her forehead. “I will look in on you in the morning.”
LATE INTO THAT NIGHT, ANNA awoke from a nightmare. She looked around, not knowing where she was, but then saw the other nurses in their cots, sound asleep. She wondered how the soldiers slept in a different hole every night. In the horrid dream that she had just escaped, seven medics had been walking down the aisle of the gassed pavilion, firing off corks from wine bottles in a twenty-one-gun salute. The poor faceless boys in the ward had sat up in their cots to sing the Star-Spangled Banner with Cockney accents, and the worst injured of the lot, a Leicester boy whose bottom jaw was blown off, had brought a bugle to the gaping hole in his face to play “Taps” through his nose.
She shivered with dread from the lingering effects of the vision. Then, she remembered promising Helen that she would mail her letter before the train left that morning. Fearful of forgetting, she climbed from her cot and walked softly across the tent to Helen’s small station. She lit a candle and quietly opened the trunk, careful not to wake the others. She dug through the toiletries until she found a single folded page. There was no envelope with it. She hoped the address for Helen’s mother was written on the return for the letter. She opened it to find the address. She couldn’t help but read it, holding her breath on the last paragraphs:
Gee but I’ll be glad to see you all by the time this war is over, but at the same time I am glad to be here to help take care of these poor men, and I’ll be doubly glad when our own U.S. boys will be with us, for they will be so far from home, and they will have no one but us American nurses to really take any genuine interest in them, for their own friends will not be able to reach them.
What the Red Cross and the YMCAs are doing for us here means so much to us. Really, it would be awful to get along without the things they send us. Most of the pleasure that the troops get are the ones provided by the YMCA.
If you could only see what the boys here have to go through sometimes, you would see they need all the comfort possible. Without the supplies sent to us by the Red Cross Society, we could not do half as much for them as we are.
Please tell me what it was that everyone seems to have heard concerning me at home. Of course, whatever it was, as you know, is not correct, for as I have told you often, anytime anything should happen, you would be notified.
Heaps of love, your very own, Helen.
“Miss Raber.”
Startled, Anna straightened on her knees and turned to find Major Mitchell, the chief surgeon, standing behind her. The other nurses, awakened, climbed from their cots and came hovering around the surgeon.
“I’m sorry to report that Miss Fairchild has slipped into a coma.”
A WEEK LATER, ANNA STOOD with the ranks of British and American nurses as a military honor guard lowered Helen’s casket into the frozen ground of Mont Huon Cemetery. Helen was being given the full salute reserved for soldiers killed in action, and every officer who could be spared that morning had come to see her buried in her uniform. The British nurses whispered that it was the most well-attended funeral they had ever witnessed on the Front. Against orders of the doctors, several of the recuperating men in the wards had insisted on coming out. Limping and bundled against the cold, they supported each other with hands to their shoulders.
Acute failure of the liver had been the official cause of death, but several of the nurses said they knew better. No one dies from an ulcer. Helen’s constant exposure to the mustard gas at the clearing station in Passchendaele had eviscerated her immune system. They had witnessed the same grisly fate played out in thousands of wounded soldiers in the hospital. About a month ago, one of the boys who survived the Third Battle of Ypres had come back again. After seeing the jaundice in Helen’s eyes, he had cried a tearful admission that she had given up her gas mask after he had lost his.
Anna, you must protect yourself.
She had seen many dreadful things since arriving in France, but what scared her most now had nothing to do with blood and guts. She didn’t know why, but she was having trouble remembering Micah’s features. She had looked into so many mangled and mutilated faces during these past weeks that something inside her seemed to be turning off the capacity to see him.
As the honor guard turned to depart, she lingered near Helen’s casket and raised a cheek toward the sea to let the howling wind dry her tears. She reached into her jacket and pulled out a letter that had arrived that morning from Chaumont. She had delayed reading it, fearing that it would contain what seemed inevitable. But now, feeling Helen’s prodding presence, she forced herself to open it.
Her eyes fell upon the last paragraph: The Army Nursing Corps of the AEF was transferring her to a base hospital in a town called Rimaucourt near the Marne River. The American boys were coming over by the thousands, the order advised, and they would soon be going into action. Looking down at Helen’s grave again, she wondered what she would encounter at this place called the Marne. It had a peaceful-sounding name, at least. Whatever was waiting for her there, she was certain it could be no worse than what she had witnessed here at Le Treport.