As a patient I would rather have a good nurse than a good physician. A physician gives his blessing, the surgeon does the operation. But it is the nurse who does the work.
Henry Souttar, No. 1 Belgian Field Hospital1
One night in her office at the No. 5 Casualty Clearing Station on the Normandy coast, Sister Jentie Patterson set aside the last of her official paperwork and started a letter to her sister Martha in Scotland. Even though she was exhausted and a cold wind had found its way through the wooden planks of her hut and had frozen her hands and feet to numbness, she hadn’t written for a long time and felt it couldn’t wait another day. So she lit a candle, wrapped herself in blankets, put her feet on her ceramic hot-water bottle under her chair and started to write. When she had finished, she was amazed to find that two hours had gone by, her candle had burned to a nub and she had poured out all her feelings about her new post and her new life. It was late November 1914.
No. 5 CCS had been set up just outside Tréport to process casualties coming from the front to the hospital ships on the Channel coast. It was an abandoned monastery, with dormitories and some tenting that served as extra ward space. Like all CCSs in 1914, it was intended as a staging post, where dressings were changed and fluids administered before the men were moved on to their next destination. But in ‘the race to the sea’ the German armies tried to outflank the Allies, and now No. 5 was in the thick of it, the furthest medical facility up the line. Sister Patterson could hear the guns roar day and night and she knew it meant they weren’t just a staging post any more.
It hadn’t been a promising start at the CCS when she arrived. The colonel in command had made it pretty clear that he hadn’t wanted female nurses at his station. In his opinion, there was no place for women in France. Yet when they had to care for the first wave of more than 200 casualties he hadn’t apologised exactly, but he’d gone round congratulating the nurses afterwards, admitting that he didn’t know what he would have done without them. Patterson had worked at a general hospital in Versailles, which ran on similar lines to the large metropolitan hospitals back in Britain – formal, planned, organised. In fact, that was the reason she left. It was all a bit too much like nursing at home. She had wanted the challenge of working close to the front, and now she had got it.
At No. 5 she could no longer distinguish between nursing and informed improvisation. There were no shifts, just more work than she would ever have thought possible. On their first 200-patient day, almost all the casualties were on stretchers. The men were too embarrassed to let the nurses undress them, as most were riddled with lice, so the orderlies were needed everywhere at once. They wouldn’t even let the nurses take their boots and socks off, so bad was the state of their trench feet. But the nurses stayed with them until late into the night, when the last ambulance pulled away to take the wounded to the base hospital. Then at last they retired to their dormitories, all of them in agony with backache from nursing bent double over the low stretchers.
The next day, with two hours’ notice, 300 new casualties arrived. By evening they were cleaned and fed and stabilised and ready to move on. The nurses waited up with their patients, but midnight came and went and still no ambulances arrived to take them away. Then they heard that no ambulances would be coming, so the wounded had to stay overnight, no matter that the CCS hadn’t been designed for that. Inside the tented wards there were no beds, sheets or pillows, only stretchers. Sister Patterson and her nurses had to use all their skill and ingenuity to make the men comfortable. They found straw and blankets, and rolled up spare aprons and towels as pillows. They had no pyjamas, either, so the men had to sleep in their uniforms to keep warm, which meant doing the fastest laundry round on record the next morning. And they only had tea and cocoa for one serving per day, so they made that last as long as possible.
All the while the little operating theatre they had converted from a side room was working around the clock. They were dealing with head injuries, abdominal wounds, bad fractures with smashed bones and ragged veins. Many lives were lost on the operating table, but more men came out alive than dead. Sister Patterson realised that it didn’t take a fully equipped base hospital to save a badly wounded man’s life. But you couldn’t do without nurses.
And you needed nurses with some gumption – the ability just to get on with it. Women who weren’t too conventional. Take the CCS’s neatly arranged, full-to-capacity store cupboards, for instance: they’d been scrapped after the second day. Instead, the nurses had got together all the buckets they could find and filled each of them with a selection of dressings, bandages, morphine, scissors and cloths, then lined them up along the wall of the receiving hall. As they escorted the men through to their wards, the nurses could just grab a bucket with the essential equipment, without having to run back and forth to the store cupboard and fill out the supply forms. It was such a good idea that the surgeons soon did the same. Their buckets joined the ones along the wall, filled with swabs and surgical scrubs and instruments, so that they could take one as they followed a patient who urgently needed surgery. Sister Patterson rather liked the look of those buckets. They seemed to symbolise the new type of hospital that No. 5 was becoming: a place where the staff responded quickly, thought on their feet, saved lives.
The windows of her little hut rattled. It wasn’t the wind; it was the guns, still going hard. She wouldn’t get much sleep tonight. Sister Patterson finished her letter. She was pleased with how well she had been able to describe her experience, and with how much she was coming to understand.
On 7 December they took in 300 wounded at one o’clock. Fortunately this time enough ambulances had arrived to take away most of them by supper time, but twenty were left, and they were all in a bad way, so each man was looked after by a nurse all night. The days that followed were quiet. The twenty patients were stable and Sister Patterson got to know them. One of them had been wounded at the first battle of Ypres and had been shuttling around various aid posts before arriving at No. 5, where the surgeons had finally put him right. He was relieved to be on his way home and grateful for the good care. He even gave Sister Patterson an elaborate belt buckle that he had taken off a Prussian. She talked to him about the war and the soldier told her she needed to visit the front line herself, if she really wanted to understand what was going on. So she found an orderly to accompany her and together they hopped into an ambulance that was on its way to the trenches. There she saw for herself how cold it was and why her patients’ feet were in such a bad state. She saw what rations they were on and why so many arrived hungry. She saw how filthy the conditions were, the mud and the stink. She saw the daily struggle for survival in the trenches and out on the battlefield. And she saw how CCS No. 5 was part of that war.
Back at home in Scotland, Martha was proving to be just as capable as her sister. In response to her sister’s letter she had mobilised the local community, and now regular supply parcels were arriving at No. 5. There were large quantities of soap, for washing people and floors. And the knitters were off: the women had taken out their needles and yarn when Martha read them her sister’s letter, and now they were knitting socks and scarves for the patients. One day Sister Patterson gave out 200 pairs of socks and she never missed an opportunity to encourage more from Martha. She wished everyone would be as efficient as her sister. At the CCS the colonel continued to make a fat ass of himself. He was fine at giving the orders, but most of the time he got them wrong. Like most doctors, he didn’t have the patience or the attention to detail that was needed for effective nursing. All the nurses had found themselves saving his reputation more than once. It was difficult not to heckle when he made a patriotic speech during a dinner held for the nurses in the New Year.
January 1915 was extremely cold and Jentie got bad chilblains all over her feet. They had received a visit from a specialist who gave them a series of lectures on how to look after the feet of men with frostbite, trench foot or marching injuries. He told them to dress them only lightly and, where possible, to get them aired. Sister Patterson had attended a massage therapy course, so the specialist showed her how to adapt her knowledge to the special needs of soldiers’ feet. He warned her that, from now on, she would never be without work. The nurses started paying attention to their own needs as well, asking their families to send them wellington boots to protect their feet as they rushed along the muddy paths between the long, tented wards that were now a permanent fixture at No. 5.
The cold continued well into March. The colonel summoned all his senior staff to warn them that battle was about to be rejoined, at Neuve Chapelle, later that month. They would be one of the hospitals receiving and treating casualties in the new tented wards. None of them needed telling. They had all noticed the increase in traffic on the roads. But there was some good news too: they were to be sent equipment for an extra eighty-eight beds. The delivery lorries brought the mattresses only to the front door, so the nurses spent all day dragging them up steps and through corridors, along the muddy paths and into the wards. It was exhausting, but at least they now had proper beds. There would be no more back-breaking days bent over stretchers.
The battle began on 10 March and they got their first casualties that evening. On the second day the hospital’s well gave out, and by evening they were seriously short of water. On the third day Sister Patterson found herself almost overwhelmed by the weight of it all, so she went for a short walk into the woods nearby. When she heard a lark, it brought a smile to her face. She realised that she hadn’t smiled since the first ambulance full of shattered soldiers had pulled up three days before. She decided she would smile as much as she could from now on. She would try to be cheery, both for the sake of the wounded men and for herself. On the evening of the fourth day the nurses attended a short service, during which they sang the hymn ‘Peace, Perfect Peace’. Not much of that, Sister Patterson thought. After the service the colonel congratulated them on how well they had coped with the first wave of patients. They knew what that meant: there was about to be a second wave.
There was a couple of days’ breathing space, during which they mended the well and cleaned the wards. Then the second wave of Neuve Chapelle casualties arrived. Fifteen of them were suffering from enteric conditions, the like of which Sister Patterson had never seen before, and one of the tented wards was quickly converted into a special enteric block. What must it have been like for them out there, in the mud and filth, she thought. They were still receiving patients at the end of March. These were the worst casualties of all: some had lain on the battlefield for days and their wounds were rank and rotting. Most of them were unable to speak, so the staff had to work out what was wrong with them from their ticket, if they were lucky, or by guesswork. Many came in with high fevers, and all of them had to be nursed constantly to keep them alive. Patterson had one soldier to care for who had the highest fever she had ever experienced in her professional life – 105.4 degrees Fahrenheit. Saving his life became her way of fighting back against it all. She sat with him all through the night. By the morning his temperature was slightly down and it continued to fall, little by little, all day. He would survive.
That day Sister Patterson was put in charge of one of the extra surgical wards that had been set up in the new tents. It had 100 beds, three nurses, five orderlies, and every single bed contained an acute case. Despite having been up all night with her fever patient, she worked for twelve hours straight. When someone finally came to relieve her, she stood for a moment at the tent entrance and looked back at her ward. She didn’t feel much satisfaction or pride. After twelve hours she hadn’t even been able to see all the patients. But before it all threatened to become unbearable again, she set off for another walk in the woods. Spring had arrived and everywhere she looked there were bright-green and yellow daffodils poking through the undergrowth. She started to pick them – and the time passed softly, until she had picked enough for all the wards. When she returned she found all the spare jugs they had and set the daffodils out on tables: a little sunshine brought in from the woods.
In April a specialist surgeon arrived to open an eye ward at No. 5. Sister Patterson spent as much time there as she could, learning from him. When she wrote to Martha now, she marvelled at how expert they had all become. One day they had taken in 103 cases in mid-morning and by 5 p.m. all the patients were admitted and comfortable. It was almost satisfying. And they did it with an ever-changing staff. Other CCSs were always asking No. 5 to loan them their expert nurses, so they were usually short-handed. The new nurses who arrived on a monthly basis took a lot of training to get up to speed and often they weren’t worth much in the first couple of days, when their immunisations made them tired. Sister Patterson was almost always an orderly or two short as well. When she looked at her letters to her sister, she saw that she was constantly grumbling – about lazy orderlies, convoys arriving at half an hour’s notice, ambulances coming to collect patients in the middle of the night. She hoped Martha didn’t mind, but she tried never to let the patients see how she really felt. With Martha’s support, and the quiet hope of the woods, she could go on with the work of the war.
When Winifred Kenyon applied for nursing service in France, she never considered going anywhere else but a casualty clearing station. She wanted to be as close to the war as possible, to share in the adventure and excitement and to make her contribution. She wanted to nurse – really nurse – not mop floors and take orders all day. A friend had told her that most of the CCSs were in fields, with grass or canvas for floors; not much mopping needed there. When her posting came through in the late summer of 1915, it was just what she had hoped for: she would be sent to a casualty clearing station for serious cases behind the front at Verdun. It meant a long lorry hop from the French coast, changing transport several times in towns and army camps.
The driver of the last lorry swore he was going to take her right up to the front door of the CCS, but as they pushed deeper and deeper into the countryside, Kenyon began to worry. Surely there couldn’t possibly be a hospital out here, in the fields and woods, hours away from any towns or villages? Then the road turned and headed straight for a wood. In the distance she could see yards of washing hung out on a line that disappeared into the trees. That must be it, Kenyon thought, and it’s laundry day. As they got closer she realised that these weren’t linen sheets, but row upon row of white canvas tents stretching in and around the wood. They had arrived at the casualty clearing station, right there in the middle of nowhere. The lorry pushed along a gravelled track and stopped in a circular driveway. There were tents all around it and a huge signpost, with arrows pointing every which way. It was, as the driver had promised, the front door. Kenyon jumped down, thanked him and went over to the signpost, looking for the arrow showing the way to the nurses’ quarters. It seemed like the sensible place to start.
It was a long way to the nurses’ quarters and, on the way, Kenyon looked around her new home. She had never worked in a hospital where you looked up to see the sky instead of the ceiling as you walked between wards. As she passed nurses darting in and out of the tents, she knew how much she would have to learn from them, to get used to this strange new world. Then, as her first weeks and months at the CCS slipped by and she became one of those nurses darting between tents, she realised that there was just as much to learn outside the wards – basic things that didn’t require a nursing exam, but were every bit as fundamental to her work.
Take the weather, for instance. Weather dominated the lives of the men and women working at CCSs on the windswept plains of France. The wide-open landscape looked wonderful in the sunshine, but when the wind blew, it blew hard, and it blew almost all year round. Nurses got used to the sound of the canvas tents buffeting in the wind wherever they worked. CCS tents were firmly pegged down, so it sounded worse than it was, but now and again cyclones ripped down rows of tents, injuring the men in their beds all over again and terrifying everyone with their destructive power.2
When winter came, all the nurses had their families send extra woollens. As the temperature dropped, they gave up on night-wear and slept in their uniforms and multiple layers of socks to keep warm. There was always a sturdy stove in their quarters, which they kept going all night. Sometimes when the nurses came on duty in the morning it was red-hot and you had to be careful not to start the day with a nasty burn from brushing past it. Hot-water bottles were the best, pushed down the bottom of a camp bed to banish the damp, although there were never enough to go round. Then there were the nights when everything in the entire CCS would freeze: milk, butter, cooking oil, ink – even the chilblain lotion. Everyone gathered round the stoves, wrapped in all the clothes they could find, and waited for their world to thaw.3
Whatever time of year it was, rain always meant trouble. The paths between the tents became swamps, boots got stuck in the mud, and if they tripped, that was it for their clean uniforms. Pushing trolleys along the paths was almost impossible, so everyone waited until the rain cleared up before moving patients from one ward to another. In some places it rained for weeks on end, and nurses gave up trying to stay dry and clean. One made herself a waterproof uniform skirt out of tarpaulin, another mended a hole in her tent roof by pushing an umbrella through the vent and opening it up; it worked, so they left it until the summer before patching up the roof.4 Rain also created a great deal of extra work in the wards themselves. Rain at the front meant mud, and mud meant long carries, trench foot and infection.5 Trenchfoot, Kenyon would learn, was a wound inflicted by the battlefield itself. It could bring a man down as hard and long as a bit of shrapnel and could take just as much effort to nurse.
Most nurses thought about the weather as soon as they woke up and listened, to guess what the day would bring. If there was no sound of wind buffeting their tent, or rain drumming on the canvas, it might be a good day to do the laundry themselves rather than send it into town. If there was a river nearby, doing the laundry could be fun in the summer, all the nurses rolling up their uniform sleeves, laughing and chatting as an infinite number of sheets were pegged to infinite lengths of washing line. There was so much laundry to do, with some men needing a change of bedclothes several times a day, that it could be disheartening. But then the nurses remembered how much their patients appreciated the luxury of clean linen – a fresh sheet, a white pillow case, fluffed blankets – so they scrubbed and pegged and folded, understanding that this too was an act of nursing and healing.6
Perhaps the most unexpected thing Kenyon learned inside the ward tents was how much was left up to the nurses themselves. There were several wards that they ran without doctors, and they taught their skills to the new arrivals like Kenyon. ‘Resus’ was one of them. The men there were too weak to raise their heads, let alone be operated on, and it was the nurses who brought them back from the brink. Kenyon learned to administer the magic mixtures of hot saline, brandy and coffee, and that you could never have too many hot-water bottles. Sometimes you put ten or twelve around a man close to death from hypothermia and gradually watched him come back to life. Men came in grey and went out pink. The first time a surgeon congratulated her on saving a man’s life and making it possible for him to operate, she was delighted. Then she did it again, and then every day after that. Eventually it didn’t seem like anything at all.
Kenyon was pleased to have started her work in the resus ward. She felt she was making an immediate contribution. And it was such a good place to learn. While she waited for her patient to revive, she asked the other nurses about the entries on the casualty tickets. She could work out some of what the MO back at the aid post had written, but some of the acronyms were new to her. ‘ICT’, for instance, stood for ‘I Can’t Tell’ – it was the MO’s way of saying that the man was so badly injured that he couldn’t work out what needed doing first. What it really meant was: ‘Nurse, sort it out, please, and come and get a surgeon when the patient is stable.’7 Then there was ‘SI’ and ‘DI’ – ‘Severely Ill’ and ‘Dangerously Ill’. These patients might be warmed up and rehydrated in resus, but as soon as they were stable they were brought to the moribund ward.
Studying tickets was a really good way to learn about the nuts and bolts of casualty. Kenyon thought what a good system it was: one bit of paper that stayed with you all the way to the hospital or home. It was good until it failed. If you lost your ticket, that meant all manner of trouble. You could end up in the wrong place, getting treatment for the wrong condition, or simply end up getting ignored. People had died for want of a ticket. And it was good until someone wrote it up incorrectly. That was something all the nurses knew: whatever you do, don’t let doctors write up tickets unsupervised, especially tickets for patients going on the ambulance trains. All they do is write what operations the man has had. They don’t fill in any of the really useful information, like the diet and drinks required, and whether the patient can sit or lie. And they never remember to mark the ticket with the big red X that means the patient has to be given twenty-four-hour care, if he is to survive the journey.
Doctors, Kenyon soon concluded, were all very well, but without nurses there wasn’t really any point even pitching the tents. Inside the long canvas wards she walked for miles each day, checking charts, giving out medication, changing dressings and linen.8 She had to be alert to the slightest change in her patient – his colour, his breathing, his temperature – and then take the decision about whether to call a busy surgeon. It was also worth knowing how full her wards were going to be in the days to come. She learned that the best people to ask about that were the ambulance drivers. They were the only people at the front who had any idea about what was really going on.9
Then there was the kind of work she hadn’t been trained for before she came to France. It was nurses who waited for a young soldier to wake up from an operation so that they could console him when he realised that his legs had been amputated.10 It was nurses who held the hand of a man whilst they guided him to a mirror so that he could see for the first time his empty pyjama sleeve, neatly folded and pinned up high where he had lost his arm. They carried a good supply of handkerchiefs at all times. Men cried in their arms until the fronts of their aprons were wet. And while a man cried, the nurses discreetly looked about the ward to see what else needing doing – where pillows had fallen or blankets had got tangled around broken limbs; who needed a drink or salve on dry chapped lips; who needed a smile and some reassurance. Kenyon was surprised at how quickly she got used to the gentle, comforting lie. Yes, you will get better. No one at home has forgotten you. Anaesthetics really aren’t that bad. Everything will be all right. The war won’t go on for ever – or at least, it can’t possibly get any worse.
She stopped telling that lie in the summer of 1916. The CCS was full to bursting by the end of the first day of the Somme offensive. It was sunny and warm, so they could at least leave the sides of the tents open, but the heat had caused some men to be baked in carapaces of mud from the battlefield.11 Inside the receiving tent, one nurse and an orderly spent the whole of the first week just chipping off mud. Sister called a quick meeting in the mess: they couldn’t break, no matter what. The men who had managed to survive long enough to get here depended on them. Don’t let them see you cry, whatever happens. So Kenyon greeted each soldier who arrived, whether he could hear it or not, with a cheery ‘Good morning’ or ‘Good afternoon’. There wasn’t much time for telling lies, but she smiled all day long until that, too, felt like lying.12
Normal duties and postings were ignored for the first weeks of the Somme offensive. Everyone did what they needed to do. Kenyon went into the kitchen once and found an MO making sandwiches and coffee, because everyone in his ward was starving but too busy – and he was the only one not needed at that precise moment. In another ward the chaplain was shaving patients who were going for surgery. One of the men winked at a nurse and asked what sort of tip she thought he ought to give the padre. Suddenly the entire ward was convulsed with laughter.13
Kenyon saw the staff working together more closely than ever before. They worked as one, desperate to save lives, and crushed when they failed. They were so close to the front that they felt part of it, fighting alongside the soldiers. But their work was taking its toll. It was boiling hot, and their uniforms stuck to their bodies, clammy with sweat and dirt.14 No one was getting enough to eat or drink. By the fourth day Kenyon knew she couldn’t go on and tried to find a quiet bed in the nurses’ quarters. When she collapsed, still dressed, she had difficulty going to sleep, with the day’s events racing through her head. But then she thought of how they had survived and held their part of the line. There was satisfaction in that. Then she fell asleep.
It hadn’t been like that everywhere. Into the second week of the offensive, Kenyon heard from friends at other CCSs who had simply been overwhelmed by patients. One nurse wrote that it had been like Scutari. She had done twenty-four stretches of theatre duty in two weeks and it had nearly defeated her.15 Another noticed a sudden lack of abdominal cases coming into the moribund ward and suspected that RMOs were leaving them as moribund at the aid posts, so as not to swamp the CCSs with yet more desperate cases.16 But there was no stemming the tide. From another CCS came stories of how hundreds and hundreds of men on stretchers had simply been abandoned outside their tents, with little hope that the staff would get to all those who lay there. Instead the nurses made up little packages of morphine and dressings and handed them to the men on stretchers each time they rushed past them on their way from one ward to another, leaving them to treat themselves. It would be days before all of them could be seen by a nurse, and over a week before a bed was found for the last of the survivors. By then many had died, their bodies tipped onto the ground by bearers desperate for stretchers. Kenyon understood why nurses were always running in CCSs that were overwhelmed by the influx of patients: it was not just because they were needed everywhere at once, but because they couldn’t bear to stop.
By late autumn of 1916 the last of the Somme’s wounded were quietly recovering in the wards or being put on trains bound for Britain. Slowly the CCSs returned to normal. At last the nurses had time to gather in the evening in one of the dormitory tents to laugh at each other’s dressing gowns and slippers and to swap stories. Kenyon found that she had missed this time for friendship and laughter more than anything else during the summer.17 This was when they nursed each other. They made rounds of cocoa and read out their letters, telling each other about their families and their lives at home. They reminded each other to eat properly, because life in the fresh air made them ravenous. They shared their food parcels, and when Kenyon got sent a simnel cake they threw a party in its honour, toasting it with mugs of cocoa and finishing it to the last crumb on the greaseproof-paper wrapping. If they had the energy and sufficient light, the nurses sewed while they talked, mending stockings and tears on their uniforms and sewing buttons on shirts.
There was still some excitement, even after their sector had eventually gone quiet. Nurses visited the battlefield and brought back reports of tanks and piles of shells wherever you looked. Then, one night, a Zeppelin was shot down right over their wood. All the staff rushed out to watch it burst into flames and slowly drop through the sky, before crashing to the ground. Kenyon got as close as she could and grabbed pieces of twisted aluminium as souvenirs, wrapping them in her apron. She passed the fragments around her ward, still warm from the fire, and the patients wanted to hear every detail of the crash. Kenyon was always amazed at how fascinated soldiers were with mementos of the war. Heaven forbid that the surgeon should forget to save any bits of shrapnel that he’d dug out of them. They wanted to keep them, wrapped in a bit of bandage, pinned to their pillow.
Seeing the remains of the Zeppelin every morning reminded Kenyon that they were closer to the war than to any town or other human habitation. Yet working so closely together and relying on each other, they never felt isolated, and they had created supply lines of their own – long and thin, but resilient – stretching all the way home.18 They all had their sewing circle or community group.19 Kenyon’s group had excellent knitters, but there were others who ensured that the CCS never ran out of pyjamas or pillow cases, scarves or socks. One of the simplest but most important things they needed from home were the linen drawstring bags for the men to store their possessions in. Often a casualty had nothing left but what he carried when he was wounded, and these few things were precious to him. When men came round in the ward, nurses would show them how they had gathered up their things and put them in a bag hanging securely on their bed.
One day, instead of drawstring bags, they received a whole box of tiny lavender bags. They wondered for a while what to do with them, before taking them to their wards.20 There were men whose injuries were rank, despite their best efforts, and the nurses gave them the little bags to hold and sniff, or pinned them to their pillow or sheets. The smell masked the gangrene and the rot, and the scent calmed them and reminded them of home. Farms in Norfolk produced plenty of lavender, so there was no shortage, and the nurses soon requested more.
The period of quiet gave Kenyon and her colleagues time to spend with individual patients. She could see them becoming more stable or recovering, eventually going home or returning to the front line. She wasn’t just looking out for changes in pallor or temperature, she also observed changes to their mood. She noticed who was getting bored or frustrated, and went to look for magazines or books for them. When the rain drummed on the canvas roof, driving some of the patients mad, nurses tried to find a gramophone to play some music that would drown out the sound.21
When mail came, Kenyon noticed that it wasn’t greeted with the same excitement by everyone. Some patients were cast down by news from home that told of hardship and penury, children without Christmas presents, wives with no money left at the end of the week. Kenyon and some other nurses got together to raise money for these families. They contacted local charities in the patient’s home town or village and asked them to check up on his family and pass on their donations. Thus they often caught families who had slipped through the net of larger organisations dedicated to the welfare of soldiers’ kin. Nursing beyond the front, they got families back on their feet from a distance, while they restored their loved ones in their wards.
For Kenyon and the other nurses, the CCS in the wood became a little world of its own. They even spent their off-duty hours around the place: it was too far to travel to a town unless you were staying away for a week or so. So they improvised and created their own entertainment. They borrowed some of the staff officers’ horses and went riding; others went for long walks and got to know the local flora and fauna. Kenyon marked time in the CCS by the natural cyles in the woods: the falling of leaves, the hibernation of the squirrels, the green shoots poking through the moss. Sometimes, when they had only half an hour’s break, the nurses would stand quietly to work out where the sound of the guns was coming from. Then they would head off in the opposite direction, just far enough for there to be silence.22 There they sat while the minutes passed, soft and soundless. Then they got up, brushed off their skirts and returned to work.
Christmas 1916 was celebrated with particular abandon at the CCS. The nurses cooked Christmas puddings for the entire station, using enamel chamber pots. They were the perfect size, and and Kenyon wondered if it would ever catch on at home. It had been quiet in their part of the line and everyone was looking forward to the celebration. Decorating their wards was essential. There would be not a stick of holly or train of ivy left in the wood after the nurses had been through it, and anything that would do as a Christmas tree was dug and potted up. They had even found some mistletoe, and the men became almost hysterical with joy when they hung up a bunch in their ward. In their turn, the patients made enough paper chains to stretch from there to the coast. Kenyon had sown some forget-me-not seeds in the spring and she had pressed the flowers so that the men could put them inside the cards they were sending home.
Any excuse for a party was good enough. The nurses most enjoyed fancy-dress parties and paraded their costumes in front of the patients in the ward so that they could judge which was best. Probably the most inspired entry anywhere on the front was that of the nurse who went as ‘A Blighty Case’, a patient who would be returning to England.23 She wrapped herself in an army greatcoat and scarf, bandaged up both legs and arms and her head, and put on a pair of the felt slippers that were given to men with bad trench foot. Then she mocked up a huge ‘Blighty ticket’, properly filled out and tied to the button of the coat. When she entered the ward and skated up and down in her huge slippers, the men cheered and clapped enough to raise the canvas roof. She took bow after bow, before inevitably being awarded the Best in Show prize.
Nurses, like bearers, kept pets under any circumstances. Most CCSs attracted a troop of sturdy dogs and cats that had been abandoned in the smashed French towns and villages. Kenyon’s CCS had two fox cubs, Satan and Prince. Prince had rickets and very bandy back legs. You could spot him a mile off with his odd little gait, shambling down the path to the bins at the back of the kitchen tent. The foxes were joined by the posh French hunting dog rescued by the chief surgeon, and they all paid their way at the CCS by patrolling the food stores and keeping down the rat population. But that wasn’t all they were good for. Kenyon struggled to get patients up and walking once they had recovered sufficiently, but asking them to walk the animals always got them out of bed. And usually after that they looked for other little jobs to pass the hours, so Kenyon got them to do the ironing and boot-polishing that took up so much of her time, or filling up hot-water bottles from saucepans on the ward stove. When they were stronger they helped the bearers to move patients around the ward – although the sight of it also made Kenyon feel sad: if they were able to do that, then they would soon be strong enough to return to the front line.
By 1917 the wards were becoming very well organised. There were bridge tournaments, chess games, concerts and a library trolley. They played netball on the short court marked out at the limits of the CCS, and created a league whose results were followed by all the patients. Sometimes there was so much to do off-duty, Kenyon wondered how they would cope when the offensives began again. Their favourite game was a paperchase, which became the high point of the summer weekends. Staff checked the weather forecast and tried to find out if there would be fighting nearby. If it looked as if there would be a clear, warm and peaceful day, plans went ahead.
On game day, nurses and doctors divided themselves into teams: the Hares and the Hounds; Kenyon was usually a Hare. Everyone who could be moved out of the wards gathered around the start and finish line just outside the station, some standing, others sitting in chairs or lying on stretchers. Over the previous days the patients had ripped old newspaper into small pieces and loaded them into borrowed bearer-panniers. Now each Hare was given a satchel of paper and ran off into the forest, throwing out a trail of paper behind them. Each followed a separate route and, after a set time, the chief surgeon blew a whistle, restrained the dog and foxes, and set the Hounds team after the Hares. The Hounds had to find each individual Hare and march them back over the finish line. The winner was the last Hound or Hare to come in.
The game lasted for hours, sometimes a whole sunny day and into the evening, and the men cheered each time a player was finally brought home. Kenyon was good at the game, eluding capture for hours, and finally getting back to the finish line exhausted and with her muscles aching from all the running. But it made her so happy. As she waited to see who would come in next, she watched the patients cheering in their pyjamas and tunics, laughing, pointing and taking surreptitious bets; and in the wood, young nurses and doctors were darting in and out of the trees, full of laughter and fun. For a time it seemed that was all there was. No CCS, no war, just the wood and the game and the joy it brought. Both Hares and Hounds would limp for days, but it was worth it.
One evening, after a long game, Kenyon wrote home to her family about the day and how she had ended up being the winning Hare. She told them how beautiful the woods could be in summer, and how uplifted she was to hear the cheers of men she tended every day following her through the sunshine, drowning out the distant guns. Her family was horrified. Surely she was not at the CCS to have fun, they replied. She was there on serious business, to nurse the wounded in a war that she was clearly taking far too lightly. They didn’t understand, but Kenyon wasn’t angry with them. In her next letter home she simply wrote that she wished there would be many more games and a lot less war.
Nurse Elizabeth Boon sat up late one night catching up on her correspondence. It was November 1918, four years almost to the day since Jentie Patterson stayed up to write to her sister Martha. The war had finally come to an end. But Nurse Boon’s hadn’t finished: she still had a letter to write.
You will have heard the sad news that your son Pte Joseph Simpson passed away on Tuesday November 12th. The funeral is taking place today at Terlincthun Cemetary. The No. of his grave is 4E Plat 10. We would have liked to have you with him but when we saw he was so acutely ill there was no time to get you here before he died. He passed away peacefully at 5.52 on Tuesday 12th November.
He talked of going to Blighty to see you and then before he died he thought he was with you all and put out his hands to first one and then the other with such a glad smile, he called you by name and then ‘Ada’ but we could not catch what else he said. He was a very good patient and we did all we could for him and he had everything that was possible.
With sincere sympathy
E. Boon
(for Matron)
Boon worked on the moribund ward at her CCS. Moribund wards – the last stop at the CCS for those soldiers beyond help – had been given their own RAMC regulations, and it was according to regulation that special care was taken to safeguard the belongings of the dying, and that the patient’s final messages and wishes should be carefully recorded in a notebook designated for that purpose. So as soon as she could see Private Simpson beginning to slip away, Boon fetched the ward notebook and sat on a little stool by his bed, her head bent in close to hear, writing down as many of his last words and whispers as she could understand. Then, after he was gone, she found the chaplain and made sure she knew the location of his grave. Then she wrote to his mother.
Boon had arrived at the front in 1916, one of the new nursing intake brought over for the Somme offensive. Two years on and she had written so many sympathy letters that she had lost count. All she knew was that she had to make sure she didn’t get behind with them. A colleague tried to write at least a dozen letters a night, but during the battle of Arras he had got behind and had to write almost sixty letters in one night to catch up.24 Another nurse wrote almost 400 letters during Passchendaele, and a German-speaking nurse composed almost as many in the POW ward at her CCS. Battles and deaths in winter were the worst, when the freezing wind blew through their tents and gutted their candles. They had to warm the bottle of frozen ink in their hands or beg a pan of hot water from the kitchen before they could begin the work of writing.
Nurses had come to understand that their letters to the families of the deceased did not mark the end of their care. Families replied with questions and requests for further details. They asked what the weather had been like at the funeral, about what hymns had been sung, how many mourners had been there and what the chaplain had said. Boon had got used to the many questions that families asked about the last hours of her patients – what they had said, whether they had been in pain, where they were buried – and she tried to anticipate them in her letters. But it wasn’t always possible to address all their concerns and sometimes her correspondence with the bereaved would continue for months.25 If their loved ones were buried during heavy offensives, Boon had to make a little information go a long way. And she always hoped they wouldn’t ask about coffins. No family liked to know about the brown blankets in which the dead were wrapped for burial. If they had an image in their head of their loved one being laid to rest in a sturdy coffin of French oak, Boon was happy for them to hold onto it.
Once she had finished the letter, she looked around the quiet ward. It was true when she wrote to the families that the patient’s last hours were spent in warmth and comfort, made largely painless by drugs.26 And, most of all, they weren’t alone. Boon had come to understand quite soon after she arrived in France that nurses were always there at the end. Once a casualty had been given a note of DI or SI, he would receive no further visits from the doctor. Doctors had barely enough time for the men they could save. Those they couldn’t were gently moved into the moribund ward and, from then on, it was the nurses who comforted and cared for them, along with the chaplain. Here death was their responsibility.
It was time for the ward round. But before she set out, Boon turned to the clipboard with the SI/DI patient list that hung outside the Sister’s office. She entered the information for Private Simpson and scanned the list to see if any of the other patients might need morphine or if their condition was likely to worsen. The list was scrupulously maintained so that nurses changing shift and the chaplains could see at a glance who was likely to die on their watch. She put the ward notebook next to the list, so that other nurses could record the last murmurings of their patients. She nodded at the orderlies who came in as silently as they could to take Private Simpson away.
Then she quietly walked past each bed. There were many things she might be called upon to do for her patients. Often it was help with sipping a drink or some balm for cracked lips and drying skin. Some were so weak they couldn’t brush the hair out of their eyes, so Boon always had a comb tucked in her pocket. Once a boy had cried out and she thought she must have missed his morphine dose, but when she got to his bed, he gasped that his lavender bag had fallen on the floor and he could suddenly smell his own decay. She picked up the bag and pinned it on the pillow next to his face. The boy immediately turned his head towards it and began to inhale the clean scent. He died a short while afterwards.
But tonight it was quiet. The dying men slept silently, with no raving or weeping, their shallow breaths occasionally catching before resuming. Boon returned to her desk and began the last job nurses ever did for their patients. In a laundry basket on the floor were the clean uniforms of the dead, and the linen bags that contained their personal possessions. She put each soldier’s uniform and belongings into a bag, carefully pulled the drawstring and then labelled it for the mail office to send it home. Even if she had already written to the family, Boon always tried to put a final letter inside and looked in the ward notebook to remind herself of the dead man. Until her ward was empty, it was up to her to hold each ending in her memory, for as long as she could, so that the families would have more than a drawstring bag and a tattered tunic as the last remnants of their loved one.