A Volunteer Nurse on the Western Front

by Olive Dent

  Certain nicknames are given as a matter of course – Jock to Scotchmen, Geordie to North countrymen, Taffy to Welshmen, Pat to Irishmen, ‘Aussy’ to Australians or otherwise ‘we from Kangerland,’ ‘Dads’ to any old – or rather should I say ‘old-looking’ man, – ‘Sonny’ and ‘Chikko’ to ‘youngsters,’ ‘Boy’ to all and sundry. A man too, is often addressed by the name of the district from which he hails. ‘Now, Lancashire [or Warwick – or Gloucester, etc.], muck in. D’yer think yer a blooming sergeant-major?’

  Nicknames spring up rife in these happy-go-lucky, soldier gatherings. The main thing is to possess one, for a nickname is a sign of good fellowship, bon camaraderie, popularity, a sign that the owner is admitted to the coterie of pals, a sign that he is ‘in the swim.’

  Chapter XII

  ‘Blighty’

  ‘GET THE TEMPERATURE down and then …’ The Medical Officer pauses significantly and smiles. Whereat the patient grins broadly at him and at the sister, and, as they move to the next bed, his thoughts have already landed in England.

  A couple of days later, probably, he receives his tickets, and the congratulations of the ward. ‘Two tickets,’ he is warned by the waggish one of the party, ‘one to go with and one to come back with.’

  ‘That’s all right, Sour Grapes. So long as I get there, I’m willing to come back and give old Fritz one in the neck, for doing it down on me now. What would you give me for my chance of England, Home and Huddersfield?’, glancing up at the suspended tickets.

  Meantime his ‘going-away costume’ is stowed into the bottom of his locker – pyjamas, warm undershirt, bed socks, helmet and muffler. Were he a ‘sitting case’ with a slight G.S.W. of the arm or head, or a ‘sick’ case with a slight disease of the heart or debility, he would have a full, khaki, clothing kit drawn from the stores, this kit being supplemented if necessary, with an extra muffler, or an extra pair of woollen mittens or similar comfort, from the Red Cross Stores.

  These kits are put in readiness almost immediately, for a patient has often been warned, and evacuated within an hour of receiving tickets. Some cases are occasionally given tickets but their evacuation is delayed for a time owing to their not being in a fit condition to travel. The tickets are, however, given them for the excellent mental effect their possession has upon the patient, and consequently in great measure upon his progress.

  There are three headings which a medical officer uses when filling in tickets for England cases. Each patient, as most people know, receive two tickets resembling luggage labels, and bearing in addition to the name of the hospital or the number of the CCS. – casualty clearing station – the patient’s name, number, and regiment, together with the date and the name of the hospital ship by which the patient travels.

  On the reverse side of the ticket are chronicled the diagnosis, any treatment required en route, the man’s age, total service, service in France and religion, – all items of information sometimes required. If anything additional is to be forwarded, such as a history of the case, a medical case sheet, an X-ray photograph, etc., it is enclosed in a special envelope. Certain cases are indicated in a particular manner, e.g., nephritics have a yellow label distinctive of nephritis, and hence ensuring a ‘nephritic diet’ en route.

  Each ticket has a further inscription in block letters, ‘C SITTING’, ‘L.T.B.’ and ‘L.T.A.’ ‘C SITTING’ means a seat on the ambulance car, a seat on board ship, unless, of course, the length of the journey demands a cot, and a seat on the train and ambulance car in England. It is also further understood that the man, after inspection on embarking, needs no special attention beyond the usual nursing care and supervision.

  ‘Lying train B’ patients are stretcher cases throughout the journey. They are brought from the ward on a stretcher, have a stretcher place on the ambulance car, a cot on board, and lying accommodation to the hospital in England.

  ‘Lying train A’ patients are conveyed in similar fashion to those marked ‘L.T.B.’ except that being more serious cases, they have the best positioned cots on board. The greatest number of cots, by the way, are swing cots.

  THE ‘BLIGHTY’ SMILE – AN L.T.A. CASE

  Helpless cases – one is thankful to say they are infrequent – have a red cross diagonally across their tickets, and the word ‘helpless’ printed in block at the foot of the ticket. Why are such cases sent? Because the patients get to a stage when the longing for ‘Blighty’ is retarding their progress, the bed is wanted and the particular case is tedious, and requires long home nursing as distinctive from A.S. nursing, e.g. baths, electrical massage, certain prolonged treatments.

  ‘All L.T.B.s due at the point at 10.30, sister. Ambulance train in,’ comes the message; 9.30 now, no time to lose. Dressing sheets, bandages, lotions, cotton wool, drums are brought out, instruments and lotion bowls boiled or fired, and one sets to work to do the necessary dressings, and make the wounds as comfortable and safe as possible. The wounds finished, one helps to dress wounded lying patients, and inspects the sitting cases. This inspection is most necessary, for ‘men are but children of a larger growth,’ which was just another way of saying that men are as irresponsible as naughty boys.

  Thus the masculine sex, as a class, has a rooted objection to fastening the neck of its shirt, preferring on a bitterly cold, January day to invite pneumonia as ardently as any foolish flapper with the veriest V-shaped blouse. It delights too, in hurrying into its nether garments and making a brave show to the world in well-pulled-down khaki, brightly burnished buttons and well-rolled puttees, even though its cardigan is guiltless of a button, and its socks are only fit for the waste-wool bag.

  Finally, all are fixed and rounded up, and the ‘sitting cases’ potter about first on one impatient leg then the other, like so many little boys keen to be off to a party, and privately thinking no doubt that we are frightfully fussy when we insist on every string and buckle being fastened.

  Good-byes and handshakes are over, and they troop out in charge of an orderly who takes them to the point. I stand at the tent door half a minute, and wave to them as they look back. Poor lads, bruised in the battle, heads bandaged, arms in slings, shuffling feet in great trench slippers, limping footsteps aided by a couple of walking sticks – poor boys! But in England there is rest and peace, and time to pause and take breath … I turn to help stretcher bearers and orderly move the lying cases on to the stretchers, and to see blankets tucked snugly round feet and throat, treasure bag tucked under the pillow, and any little needful accessory supplied, – a jaconet-covered pillow on which to rest a wounded arm, a small pillow under the shoulder, or, as has sometimes happened, to tie or to bandage in place a little ring pillow we have specially made to relieve pressure on an injured surface.

  Then an onslaught on the beds, this bedding and mattress to the fumigator, that fracture board to be scrubbed with cresolis, this bedstead to be carbolised, this mackintosh sheet to be carbolised, these bandages to be soaked in a disinfectant and then to go to the wash, this cradle to be wiped with strong carbolic, these beds to be re-made with clean linen. And so we speed the parting guest, and make ready for the newcomers.

  Ambulance train No. X is drawn up in a siding. Standing there on a curve of the rails its fourteen coaches all absolutely uniform in height, shape and colour – khaki with the Red Cross – it looks from the distance ridiculously like a toy, a child’s plaything rather than the meeting place of hopelessness and hope, despair and thankfulness, sorrow and joy, tragedy and comedy.

  The train is ready to receive its load, beds made, pillows freshly tossed, clean linen laid out, the cooks already preparing the dinner, the theatre absolutely ready for any emergency operation, the dispensary looking spick and span, the orderlies putting in readiness sundry drinks, the sisters walking up and down supervising, seeing to any deficiencies and adding any little touch of brightness or extra comfort to the wards. The Medical Officer in charge of the train, and the Train Officer are on the platform ready to see all patients pl
aced on board. The ambulance cars arrive, two or three at a time. It is wonderful how steadily the stream of cars is maintained, avoiding both congestion and the slightest loss of time. The cars are drawn close to the door of the compartment, the stretchers drawn out, lifted on level with the floor of the carriage, drawn in, then raised to the bed which is either at the level of the ordinary compartment seat or, in case of the upper berth, on level with the smaller and lower luggage rack found in an ordinary train. This unloading from car and loading on train is done extremely deftly, most expeditiously, and with the minimum of movement. Of course, the nature of the cases determine in great measure the length of time taken to load a train, but three hundred cases have often been entrained in less than an hour.

  The train loaded, it is interesting to walk along it while the M.O. in charge checks numbers, signs documents, and goes through the usual formalities with the Train Officer. Except that all the passengers are khaki-clad, and most of them are bandaged, the compartments containing the sitting cases look much like those of any other train. Here are men spreading an overcoat preparatory to playing cards, there are men unfurling newspapers – a couple of days old – and flicking over the leaves of magazines. Here are men fidgeting about ventilators and fussing about windows. Here is a luggage agitator, misplacing and getting excited about his luggage – all contained in a ‘Sister-Susie’ bag – just as effectually as though he had Saratoga, cabin trunks and portmanteaux galore.

  The lying cases or ‘lyers’ as they often call themselves, clad in great coats and pyjamas, are shorn of their coat and put to bed. Some go into compartments arranged like a four-bunk cabin, the two seats forming two beds, and in place of the customary luggage racks, two more beds. Other coaches are not divided into compartments, but have tiers of beds arranged longitudinally with the train, and thus make a ward of thirty-six or forty beds. Most beds are woven on the hammock principle, and hence are softer and more comfortable than if made of wood and springs. All have conveniently placed straps near them for support. Bells, too, are handy, in case a summons for assistance is necessary. These bells, however, are extremely infrequently used, as orderlies, sisters and medical officers are constantly on duty, passing almost incessantly up and down. An average train staff might consist of forty or fifty orderlies, two staff nurses, a sister acting-matron, one doctor, or two doctors, with the rank of captain and a major in charge. There is also the kitchen staff, for hundreds of dinners, teas, suppers, breakfasts, and diets must be cooked in the spotlessly clean, beautifully tidy, little kitchen.

  A coach provides for the nursing staff, mess room, tiny writing-room and sleeping quarters. One compartment is allotted as living – or, rather, sleeping-quarters to each two nurses, the compartment seat providing the bed, the luggage rack the wardrobe, and the rest of the compartment everything else necessary. Somewhat circumscribed in area, of course, but what would you? It is better than a dug-out, and one is not hypercritical of bed on active service, especially after a long journey, which has, on occasion, lasted thirty hours, and during which time there has only been, exclusive of hurried meal times, an hour off-duty for resting.

  Life for the hospital staff of a train is apt to be a pretty strenuous affair with peeps of a dolce far niente if the train happens to need repairs. Should the repairs take a long time, the nursing staff is drafted for duty to an adjacent hospital.

  Here are extracts from a diary of a ‘train sister’:

  July 2. Loaded at 8 a.m. Arrived E—— 2 a.m. Back to G—— by midnight. Straightened the wards and slept on the return journey.

  July 3. Loaded and arrived B—— by 9 a.m. Back to F—— by 6 p.m. Take on four hundred and sixty stretcher cases.

  July 4. Arrive R——. Left at noon for V——. Five hundred and sixty cases, two hundred of whom were Germans.

  July 5. From V—— to E—— then back to V——, which left at midnight.

  July 6. Arrived C— at 7 a.m. Unloaded and at V—— again at 1.30 p.m. Arrive E—— at 11 p.m.

  July 7. Awoke at A—— en route for D——. Arrive at 11 a.m.

  July 17. Arrive S—— at 9.30 a.m. Town criers telling inhabitants to be in their cellars by 8 p.m. What a curfew!

  Aug. 1. Left 4 a.m. gathering patients at A——, F—— and D——. Total, five hundred cases and weather very hot. Arrive at E—— on the coast. Gorgeous.

  Aug. 13. Loaded rather late to-night. Up all night.

  Aug. 14. Arrive R—— 8 a.m. Bought some bread, fresh butter and fruit. Left 11 a.m. Arrive L—— 8 p.m.

  Aug. 15. In L—— all day. Went for a walk, and passing through a cemetery, found there the grave of ‘Jimmy Anzac’ whom I had nursed in Malta. Poor, poor boy, and what a strange chance I should find his grave.

  Sep. 3. Loaded at A——, B——, R——, on to B——. Arrived 11 p.m.

  Sep. 4. Off again at 8.30. Same journey as yesterday. Arrived back at 9 p.m. Concertina part of train damaged. In garage for repairs.

  Sep. 6. Left for L——. Bored with rations so made cakes for tea on the way. How good they tasted!

  Sep. 7. Made arrangements for more permanent cross over Jimmy’s grave. Off loaded to B——. Very big load, third of which Germans.

  H.M. Hp. S. D … lies straining at her moorings, a great, big, white beauty with the distinctive green band and the three red crosses – one amidships, one to stem, one to stern – painted on her bows, and above, on deck, the great red crosses to be lighted at night. Sailors pass leisurely to and fro in the detached, desultory manner that sailors have. A batch of R.A.M.C. orderlies stand idling by a heap of brown blankets. A couple of sisters lean over the taffrail lazily gossiping. Not a medical officer is to be seen.

  There she lies, as idle as a painted ship upon a painted ocean.

  Then the snorting of an engine, and the thunder of heavy wheels, and round the curve of the railway comes a long khaki-coloured hospital train. The ship immediately becomes a bustle of activity. Stretcher bearers run down the gangway to the stretchers waiting in readiness on the platform, for this particular ship happens to be moored alongside the railway station of a great French port.

  The ship’s medical officers come down to receive their cases from the care of the train’s officers. Any patient who has been ill on the train journey and is liable to be adversely affected by the sea-journey is detained for a few days, and sent into a hospital which adjoins the station, and which has been housed in the premises of the gare, the buffets, waiting-rooms, douane, etc. Here a patient who has had, perhaps, a haemorrhage brought on by the jolting of the train can recuperate, and have a further rest before proceeding on his journey.

  The cases are sorted, the heavier ones, i.e., those needing most assistance, being detailed to the top decks so as to be more quickly got off the boat in case of accident. The lighter cases, i.e., those able to help themselves, go to the lower decks and in the downstairs wards. Cases possible to haemorrhage or to require dressing are put into lower berths, while bad travelling cases, e.g., those with abdominal injuries or with gastric trouble are given the best placed berths with the least amount of rocking attendant. Even spinal cases are carried, – and carried most successfully too, – splinted from head to foot, of course, and subject to every precaution and care throughout the journey. Splints, by the way, are quite freely used when dressing the cases for England, not merely for fractures, but wherever jolting or movement of a limb is likely to cause pain.

  The walking cases, meantime, with huge Blighty smiles which broaden in superlative fashion as they greet us, have ensconced themselves on board, and have either found cushy chairs or seats and magazines, – which they show little inclination as yet to read, – or are watching the stretcher cases taken on board and sent by lift to the deck specified. These lifts combine the maximum utility with the minimum of space and elaboration. They consist of a grooved wooden support to take the ends of the stretcher with a webbed surface underlying the stretcher itself and their raising or lowering is worked by
a belt.

  All patients duly aboard and comfortably settled, tea is served. Then comes a walk round the ship which has not yet started her journey on account of certain sailing restrictions. One peeps in at the dispensary with its lotions and potions, its ungents and palliatives; then another peep at the operating theatre, a beautiful, white room fitted with two tables for emergency work, and, fortunately, not often required – unless in case of a long journey or in a heavy rush of patients.

  The open door of the ‘wireless room’ shows a small cabin where all night long an operator will do his little bit towards ensuring a safe journey for the poor, broken boys aboard. One eyes somewhat more than inquisitively the stacked rafts, the open boats and the two motor launches, the latter known as Puffing Billy and Snorting Lizzie, Lizzie being the one into which the wireless operator and his batteries are to go in case of necessity.

  Many people who realise how enormous is the task of moving wounded will have marvelled at the proportionately small number of casualties when hospital ships have been torpedoed. This is undoubtedly due to the fact that every member of the staff of the ship knows his or her duty in such circumstances, each has been drilled in his or her particular work, and routine, and the realisation of the importance of that duty have done the rest.

  So far as preparedness goes, it is somewhat amusing to note that many of the nursing sisters when on long journeys used to sleep in their swimming costumes.

  The autumn afternoon has waned in a purple-red splendour and darkness falls. Supper has been served, and we walk round each ward. We are not carrying officers on this journey, and the L.T.A. boys have the officers’ cots, placed in what was formerly the ladies’ drawing-room. The lights are shaded and the little cream curtains drawn where requested. ‘Cushy, sister,’ we are assured, ‘if it warn’t for the island at the other side of the water, I could stay here for the duration.’