The glorious victories and advances of the last week have meant much work for the Royal Army Medical Corps.
Alfred Arnold, September 1916
Alfred Arnold was called up in the spring of 1916. As a school-teacher, and therefore regarded as capable of learning technical skills, he was offered the chance to train as an RAMC orderly. The Army needed hundreds more medical staff for the planned summer offensives, and Arnold needed a post that gave him the weekends off during training. He was the last of his farmer father’s three sons to be conscripted and, once he stopped helping out on the land, there was no one else except his mother. When he finally got his orders for France in May, he told his mother not to worry: RAMC men were almost never put in danger and he would keep an eye on his two brothers already posted there. On a map he showed her that his casualty clearing station was likely to be miles from the action. She still cried without stopping as he boarded the train at Cambridge.
It took Arnold a while to travel through France, via the huge training camp at Étaples and changing trains at identically chaotic railheads, but when he found himself on the last leg of the journey he settled back and looked out of the window at the landscape passing by. He had expected everything about France to be different, but the land looked surprisingly like that at home. His father farmed Cambridgeshire fenland – flat as far as the eye could see – and here too there were flat fields, tall with early-summer crops, and dotted among them he could see men and women working. He even recognised what they were growing (rye mostly) and how long it would take until the crops were ready for harvesting, allowing for the differences in the weather between France and home. But as the train approached the front line, a major difference became obvious: the farmers at home didn’t have to worry about gun emplacements and observation posts, which seemed to punch their way up through the soil like stone fists. But the French farmers evidently ignored them. Arnold could see rye planted right up to the edge of the concrete walls.
At the railhead Arnold was met by a lorry sent from the CCS. There were already nurses and other orderlies in the back, squeezed up on wooden benches, clutching kitbags or little suitcases. Like him, they were part of the preparations for the coming offensive. Hesitant introductions soon turned into chatter as they bumped along a muddy track. Notes were compared. Arnold impressed them all as he listed his skills, courtesy of the new RAMC training. Not only could he treat a range of battlefield injuries, but he was trained to give injections, assist the surgeons and provide basic anaesthetics.
Arnold’s CCS consisted of long, neat rows of sturdy tents pitched near a river so that it had a readily available water supply. All around were the same flat fields of rye he had seen from the train, and the only landmark against the horizon was a concrete observation post, with a single track cut through the crop leading up to it. It was a familiar setting and made Arnold feel a little more comfortable. But it would be weeks before he got to use any of his medical training. They had discovered that the river was polluted with sewage, so holes for water tanks had to be dug, and water brought in lorries from a well at a farmhouse some distance away. Then there was the bumpy track leading to the CCS, which was barely passable for the little traffic that was using it so far; it would be completely useless for the large numbers of ambulances bringing casualties once the offensive had begun. When a unit of French soldiers arrived, Arnold was sent to work with them building a new road. They started at the main highway several miles away – Arnold saw how it was choked with gun crews and supply vehicles – and by the time they had finished there was a smooth, straight road leading directly into the heart of the CCS. Arnold’s technical expertise had ensured that it was wide enough, with parking areas close to the taking-in tents, and that it connected with all the CCS’s paths. It turned out to be an important job and Arnold was proud of his contribution.
But then, just as they finished, orders came for the CCS to move. A map and coordinates were enclosed and, when the officers sat down to work out their destination, it was found to be less than a mile away from where they were now, on the other side of the polluted river. But orders were orders, and they moved their tents and equipment. Arnold went out again with the road-builders and extended the road to their new site. Until June they moved several times to a new location never very far from their old one. It drove Arnold mad, but he learned how to pitch a tent in short order and he now knew every inch of canvas in the CCS. And however much they moved, he could still see the observation post somewhere in the distance. In June he noticed more and more soldiers winding their way through the track in the corn to the concrete tower, back and forth. It was clear that something was coming and it was close.
On the morning of 1 July the staff gathered outside and looked across the fields, towards the sound of the bombardment. They had begun their own preparations sometime before. They had squeezed as many stocks of dressings, drugs, bed linen and food as they could into the storage tents. Fresh graves were dug a discreet distance away, and all the stretchers and blankets that could be found were assembled outside the tents in case they soon filled up. They did one final round of the tented wards, looking at the rows of freshly made beds waiting to be filled. Then they waited. No casualties arrived on the first day of the offensive. Or on the second day. They waited for almost a week, feeling increasingly frustrated, constantly asking each other what they thought had happened because there was no one else to ask. The answer was horribly simple: the many thousands of wounded and dying men had so overwhelmed the casualty retrieval system that it took days before ambulances could begin properly distributing the patients to the CCSs.
Then, on 7 July, it all happened at once. From a never-ending stream of ambulances coming up the new road, 330 men were admitted in just one day. Suddenly Arnold was needed everywhere at once, running from the operating theatre to the receiving area and back again. He opened the back of one ambulance after another to supervise the unloading and taking-in of the wounded men. The delay in getting casualties to the CCSs meant that most of the vehicles were full of men who had dressings that were two or three days old, and who had eaten nothing but biscuits and the scrapings of old bully-beef tins for a week. One of the drivers warned him that when he opened the back of the ambulance the smell would make him reel backwards, let alone the sight of men torn apart. Arnold hadn’t had time for breakfast and he was grateful for it.
From the ambulances, Arnold brought the casualties to one of the receiving tents, where he joined the other orderlies and nurses in removing the rags of uniforms and cleaning the wounded men. A doctor assessed each patient, and Arnold usually followed those who needed immediate surgery into the surgical tents. The operating theatre was running twenty-four hours a day. More often than not, a surgeon looked up as Arnold brought in a man on his trolley and told him they were short of surgical orderlies, or could he get the patient under. Arnold had to find enough water to wash himself and clean a set of anaesthetic equipment. Then, after surgery, it was back to the receiving tent. If he was lucky he got a bit of dinner over the next few days, a sandwich from the padre or a tin of stew, but often he went to bed hungry, with no certainty of having time for breakfast the next day.
The CCS had changed beyond recognition from the silence just a few days earlier. Now everything was noise. There was the crying and choking of the patients, staff calling out to each other, trying to find equipment, dressings or a spare pair of hands. Only one tent in the entire place was silent. It was where he and the other orderlies prepared the dead for their funerals. Inside there were three long tables and a pile of cloth bags, each containing a printed form. For each corpse Arnold took a bag and a form. He removed the dead man’s uniform, if it was worth saving, and any possessions that he had in his pockets and placed them carefully in the bag. Then he filled out the form using the soldier’s identity tags or tickets. If the uniform needed laundering before it was returned to the family, he stored it separately. Then he washed the body, smoothed down the hair, straightened out the stiffened limbs. Finally he took one of the neatly folded brown blanket coffins. With another orderly, he bundled the dead man in it, and together they took his body round to a cart waiting outside the tent and wheeled it to the cemetery.
Arnold hated the death tent. He hated the silence that bore down on him as soon as he stepped inside. He hated it more than opening the back of the worst-smelling ambulance, more than taking a barrowful of amputated limbs from theatre to the incinerator. As bad as all those things were, they were about living men. Death was gaining power over Arnold, and he tried to resist by growing himself a hard shell behind which to retreat. But he never quite managed it. Only the death tent made him cry. By the eighth day of the Somme offensive, most of the ambulances contained nothing but the dying and the dead. Arnold rarely went into the receiving tent now, but brought the men straight to the awful silence of the death tent. There he and the other orderlies worked, all day and late into the night, the silence interrupted only by the faint sound of their crying as they loaded watches, diaries and photographs into the simple cloth bags marked with the names of the dead.
It took a fortnight to clear the first batch of patients, with staff sleeping when they could on legged stretchers that kept them up off the wet grass. When the last patient had gone, they heard that another wave was on its way, so the whole station had to be cleaned. Arnold shared the mopping and scrubbing work with the most senior surgeons and MOs, down on their knees, muddying their theatre scrubs. No one spoke of the blood that stained the water in their buckets for sweep after sweep.
Supplies were low and Arnold was sent to find more. Go towards the front, someone said, there’s plenty of stuff lying around where it was dumped, where they couldn’t find anyone to deliver it to. He took a lorry and soon found several abandoned supply dumps full of food and water. When he got out of the cab to load them up, he stopped in his tracks as the battlefield spread out before him. He didn’t know how long he stood there on an otherwise beautiful summer’s day, staring at the dead, the wire, the fields blown to pieces. Surely no one could ever sow or plough again on that land. Then there was the smell. The whole place reeked of decomposition, as if there was not enough wind in the world to blow it all away.1 Arnold pulled himself together and loaded up the lorry. He made several other stops whenever he saw anything that looked useful but tried not to let his eyes wander across the landscape and focused on the road, instead. A railhead was his last stop and there he thought he saw the worst sight of all. An ordinary train, similar to the one that had brought him to the front, was at one end unloading reinforcements, while at the other end it was filling up with wounded men.
Back at the CCS, the next 300 casualties that had arrived were in far worse condition than the first lot. Almost all of them died before making it even to the moribund ward, so day after day Arnold was either at the cemetery with the padre or working in the death tent, sorting through possessions, labelling them for home and crying silently. There were so many sets of belongings to be sorted that they had to ask the bearers to help them. They tried not to cry in front of them when they saw their rough hands filling a bag with ID tags, pay books and all the personal things that would have meant so much to the dead soldier. Arnold had great respect for the bearers. They saw so much more death than he did, and still they would help him in the death tent. Then they would help the padre with the funerals, filling in the graves and paying their respects at the short ceremony.
One afternoon he went for a walk in the fields when suddenly he realised that it was August. Harvest had already begun here, earlier than at home. He stood on the edge of a rye field and reached out to feel the grain in the palm of his hand. It was extraordinary how the French farmers harvested with the noise of the guns in the background. If he concentrated on them swishing slowly against the rye with their scythes, perhaps he could forget the war, too. He watched a farmer putting a sheaf on a pile. It wasn’t sheaved as neatly as it was at home, he noticed, so it wouldn’t be as easy to stack. Then he looked beyond the field to the road and he could see another line of ambulances driving towards the CCS. He needed to go back.
A third ‘great push’ at the Somme filled the hospital with more casualties and Arnold soon forgot about the fields and the harvest. He didn’t forget about home, though, and sometimes the hope of a parcel or letter with a Cambridge postmark waiting on his bed in his tent was the only thing that kept him going. They had all been ordered not to keep letters, and accordingly he burned them – but only after reading them so many times that the paper was almost worn through. His family also sent provisions. His mother’s home-made cake, gingerbread, biscuits and chocolate all found their way from the Fens to the French rye fields in time for his birthday in September. One morning a little square cardboard box arrived, containing a slice of fruit cake from the wedding of a childhood friend. He sat alone in his tent and ate it to the last crumb, toasting the couple as he went.
In September the casualties continued to come thick and fast. It was still hot and the heat and the blood brought swarms of flies. It felt worse than being in a butcher’s shop. For one whole week the heavy guns pounded day and night, far closer than ever before, adding terror and exhaustion to the woes afflicting the CCS staff. One day a film crew pitched up and filmed a couple of scenes for a film they were making about the battle of the Somme. Arnold thought it was ridiculous – surely no one would pay to see the kind of work he did every day.
On Sundays they got their cigarette ration and a delivery of fresh fruit. If there was time, Arnold would go to one of the padre’s services – one that wasn’t a funeral – and he felt that those moments of worship in the fields sustained him remarkably. The farm, the family and the church had been the cornerstones of his life in Cambridgeshire and, in a strange sort of way, they remained so in France. His parents did their best to support him. They kept up with all his requests: for pen nibs, underwear, mousetraps, brilliantine for his hair, and sausages to cook on a little grill that had been rigged up in his tent. They sent so many parcels that he asked for the postage to be paid out of his wages, which his family were looking after, but they never did. In return he did his best to keep them up to date with the progress of his brothers at the front. One had been wounded at Thiepval, so Arnold tracked him down and visited him at the CCS. His brother’s wound wasn’t severe, he was happy to report, and he went back to his unit after a couple of weeks.
October brought lighter loads, and the weather changed almost overnight. With the cold and rain came requests home from Arnold for warm clothes and underwear. The little grill in the tent worked tirelessly, producing toast, cocoa and sausages for the grateful staff who gathered around it, once the theatres were closed and the patients asleep. Such moments lifted Arnold’s spirits. Above all, happiness had the power to astound him more than any of the human misery he witnessed on a daily basis. He felt it when he was sitting down with his colleagues, joking about the day, pouring out cocoa. And when he walked through a town amongst local people going about their business, with not a single soldier in sight, he was surprised to feel peaceful and relaxed. The world still turned, and he realised he was still capable of happiness. Such small miracles almost took his breath away.
By November the number of casualties arriving at the CCS was getting smaller and smaller. There was more of what Arnold called ‘soft time’, with few or no patients and nothing much to do. Yet they had become so accustomed to the heavy loads, to the pressure and the desire to save lives, that without the endless stream of casualties, the CCS seemed to lack purpose. Some staff hoped the lull meant that the war would be over soon. But Arnold thought differently: the war had become routine and a dull one at that, despite all the suffering.
When there was an outbreak of flu, every single member of staff was struck down, one after the other, the rows of beds filling with nurses and orderlies, not soldiers. All of them worried what would happen if another load of casualties suddenly arrived. Thankfully, no ambulances pulled up. By now Arnold was growing bored with the routine of soft time. He got up at six-thirty, had breakfast and then spent most of the day endlessly cleaning the surgical tent and all the instruments. He checked supplies and followed the doctors and surgeons on their ward round. He didn’t like a full operating theatre, but he liked an empty one even less. He felt his training was going to waste and started to think that he ought to be closer to the action.
When Arnold learned that the Somme offensive had finally come to a halt in November, he made up his mind. It didn’t look as if there would be much more for him to do at the CCS, so he asked for a posting to a field ambulance, where he could follow the war and its wounded more closely. When the transfer came through, he burned the last of his letters from home and passed on the little grill that had sustained them all, together with instructions not to burn the tent down and to boil the sausages before grilling them, for safety’s sake. He caught a lift from an ambulance going to the railhead and, as they drove away, his eyes once more turned to the fields around them, full of grey stubble after the harvest, the concrete emplacements still stark and hard against the darkened winter sky. In other fields women dug potatoes, their backs breaking with the work, their men all somewhere in the trenches. When he finally arrived at the front, he found it as he remembered it from his supply runs: the land smashed and barren – a very different harvest scythed down across the valley. Arnold stayed with the field ambulance until the end of the war, working on patients who were alive. He never minded the noise of the battle or the chaos of constant movement. Anything was better than the silence of death.
Easter of 1917 brought heavy snow and freezing temperatures as the Arras offensive ground to a halt over a bloody pile of 20,000 casualties.2 Medical teams were at full stretch, working day and night. Lance Corporal Harold Foakes had been posted as battalion orderly to the 13th Royal Fusiliers stationed outside Monchy-le-Preux. He worked closely with the battalion’s MOs, trying to keep up with the influx of casualties, rolling bandages and checking on supplies. By Easter Monday there were only Foakes, one MO and some bearers left working at the dressing station. Then the devastating news came that their last six stretcher bearers had been killed on a carry by a single shell. Yet the desperate cries of wounded men stuck out on the battlefield continued. Foakes watched as the MO put the strap of one heavy medical pannier over his shoulder and then lifted up a second. He wondered how the man would manage with the two panniers weighing him down like that, as he set out across the mangled ground, in the snow and ice, towards the cries that came through the freezing air.
Foakes was now the only medically skilled man left working at the station, and as the hours went by he realised that the doctor wasn’t coming back. But the wounded were still calling out, in sobs of pain and terror, and someone had to try to reach them. He waited a little while longer, hoping help would materialise from somewhere. When it didn’t, he looked at his supplies. There were three panniers, full of dressings, iodine, bandages, water and morphine; he would try and carry them all. He would also need food for men stuck without supplies. No rations had been delivered for a while, but there were some biscuits that he’d been saving and a jar of jam. He stuffed it all down inside one of the panniers and buckled it up tight. There was a folded tarpaulin in the corner of the station, so he’d take that, too. It didn’t weigh much and you never knew when it could be useful. He took a deep breath as he stood up straight under the weight of his burdens. Then he headed out of the tent.
Outside in the snow some soldiers were waiting for him. They had gone over the top that day and made it back, but they all knew someone who hadn’t, who might still be lying in a shell hole, calling out. Foakes saw big men, grimy-faced, nodding encouragement. There were snipers on the other side, they told him, but they would cover him until he was safe. He had to make it to the boys out there: they depended on him. The soldiers even called him ‘Doc’, giving him a kind of battlefield promotion. As Foakes climbed the ladder out onto the field, men with rifles on either side of him guarded him as far as they could. There was some gunfire, but he made it to one of the shell holes, rolling down and crouching at the bottom. Now he was alone, with no one to protect him.
Foakes unloaded his panniers and rubbed his aching shoulders. No one had been shooting directly at him, so he reckoned it was safe enough to put up the little red-cross pennant that he found in one of the panniers to show where he was. He tied it to a stick and, crawling up to the rim of the hole, planted it as firmly as he could in some soft mud. The little pennant immediately began cracking and fluttering in the wind, but didn’t attract any fire. Foakes raised his head to get his bearings. He could no longer see the trenches he had come from, or the dressing station. It was as if he had entered another world. The ground was white and brown, snow and mud all around, with more snow falling all the while. He squinted to see more precisely what was around him and thought he could make out an arm waving at him in the distance. There were cries of ‘Over here, Doc, we’re over here’. Then, suddenly, shots rang out, cracking sharply close by. He wriggled back down to safety at the bottom of the hole and thought about what to do next.
Foakes began by turning the shell hole into a medical post. He unpacked the panniers and dug into the frosted earth to store the dressings, bandages and medications. He knelt upright and looked at his work: it would have to do. Now for the casualties. He slowly climbed to the edge of the shell hole and crawled out. He kept as low as possible, moving in the direction of the last cry he had heard. Whoever had been shooting at him didn’t see him, so he kept going. The cry had come from a shell hole, but when he rolled over its rim and landed in the mud, he almost cried out in despair. There wasn’t just one but nine men at the bottom, each badly wounded and some close to death. Foakes gathered himself and stayed with them for a moment, trying to reassure them and leaving behind his water canteen. Then he crawled back to his improvised medical post. None of the men were able to move, so he would have to carry them somehow.
He remembered the tarpaulin he had brought: he would turn it into a stretcher. He crawled out of his post again and, on his journey across the battlefield, it occurred to him that if you worry about snipers you don’t have time to worry about getting wet, cold or muddy. When he returned to the wounded soldiers, Foakes took the first man who called out to him and rolled him in the tarpaulin, tying it round him with a piece of cord. Holding the end of the cord between his teeth and pulling the load over his shoulder, he set out across the battlefield towards his medical post, crawling and dragging the man behind him, and keeping himself as flat as he possibly could.
Five more times he went back and forth. With more snow falling, snipers firing and men crying in pain, each haul was taking an age. The tarpaulin became sodden with freezing water and stained with blood, and his body ached as five more times he braced himself for the weight of the wounded man and clenched the cord in his agonised jaw. When he returned for the seventh time the three remaining men were those most badly injured and least likely to survive the drag across the battlefield. There was nothing he could do for them except speak to them calmly, softly, brushing their hair out of their eyes and giving them a last injection of morphine. Then he waited until each had gone to a better place. He folded up the tarpaulin and returned for the final time to his medical post. It required no real effort this time, yet it felt like the hardest passage of all. When he got back to his shell hole, he got on with distributing supplies and cutting up dressings. No one asked him what had happened to the three men left behind.
It was two days before a stretcher bearer made it out to Foakes’s post to offer his help and tell him that an MO was on his way and the battle had moved on. He found a functioning medical post, the tarpaulin now providing a roof against the snow and the men well cared for, waiting patiently to make the final leg of their journey. Foakes had made a fine medical officer, working almost without sleep, catching only a few minutes here and there. He told the bearer that he was fine, just a bit hungry with only his biscuits and jam to live off for three days. He had rationed them as carefully as his supplies of water and morphine. Carefully Foakes and the bearer started to pack up the post, ready to move it when the doctor arrived.
The doctor had got lost in the snow, but then he had seen Foakes’s red-cross pennant, still fluttering in the icy winds of Arras. With the doctor came bearer teams, and eventually everyone got back to the medical post behind the lines where an ambulance was waiting to move the casualties on. Foakes’s stint as a doctor was over, but he didn’t mind returning to his orderly duties. When he looked back out over the battlefield he wondered how he had ever survived, let alone kept six men alive for three days. Then the MO called to him and he went back inside the tent to dress more wounds.