by Peter Hart
I opened my eyes and had a minute or two to realise I was still alive. After a while I began to feel about my chest, for I didn’t know how bad I had been wounded, or what had got me. I felt my left breast pocket sticky with blood, managed to undo the button, and pull out what was in it. It was my pay book, stained with blood and a bullet hole through it. I knew then it was ‘only a bullet’ that had got me, not a cannon ball as it had felt like. Elation at finding myself still alive helped greatly to ease the pain and sense of helplessness I felt, but fear of loss of blood began to take hold of me. It was then I remembered the first aid dressing carried in the little pocket at the bottom of my tunic, and I reached down to feel if it was still there—it was. I got it out. It comprised two small pads with bandaging. Gingerly I opened up my tunic and shirt, located the wound with my finger and placed one of my pads over—and buttoned up again. Already aware of more blood under me, I hoped I could get the other pad on to the wound that must also be there—the hole where the bullet had gone out. It had clearly gone right through my chest. I finally managed by bending my left hand to slide the other pad far enough under to what I hoped was the right spot. Then I just lay still. How long I lay like that, I had little idea. The sun was going down when I became aware of footsteps.6
Sergeant William Kerr, 5th (Western Cavalry) Battalion, 2nd Canadian Brigade, 1st Canadian Division
It was essential to stop any bleeding because the wounded would almost certainly be left out until darkness fell. There were very few battalion stretcher bearers to pick the wounded up from the battlefield and as they followed behind an attack they were soon swamped.
Up they went and then we stretcher bearers went over with them. We were quickly very busy: picking up the wounded, taking them to regimental aid posts. As the day went on there were other regiments going through and other wounded. As you were going along with the stretcher you’d hear faint calls, ‘Stretcher bearer, stretcher bearer!’ from the wounded men. You’d go over, look on his shoulder; you were concerned with your own regiment, ‘Sorry chum, we’re Yorks!’ If you collected all and sundry back to your aid post, your medical officer had his hands full already with his own wounded. If you’re going to take every wounded man back—they were strewn all over the shop like. Going backwards and forwards, picking up. A hell of a noise.7
Private Basil Farrer, 2nd Battalion, Green Howards, 21st Brigade, 30th Division
Despite his apparent indifference, Basil Farrer was merely trying to do his best in impossible circumstances. He had to have some criteria to sort out the collection of so many wounded. He was a brave man; nearly all the stretcher bearers were. Alongside them, the more conscientious chaplains and padres would often scour the battlefield trying to bring what comfort they could to the desperately wounded in the long hours before they could be picked up.
I have a confession to make that may sound ghoulish and brutal. If I had to be on a battlefield, the more dead and wounded there were, the happier I was. This was not due to lack of sympathy or imagination, but, I think, to a simple psychological fact. As a non-combatant, a chaplain was under no definite orders, and with nothing to do, he had nothing to think of but his own skin. But with work, and the highest work, abounding, he might to some extent forget his own fears in ministering to the needs of others. In going from one wounded man to another, he would have endless opportunities of ministration. He could often relieve the torment of thirst, perhaps by a drink from the man’s own water bottle which he was unable to reach (never, of course, giving spirits to a man with an open wound lying out in the open). He could take down a message from dying lips. I recall one lad in the Shropshires, lying in a shell hole, whose one thought was, ‘I don’t know what my mother will do’. I could at least write to that mother and tell her how her boy had forgotten his pain in his thought for her. And one could speak, often in dying ears, the Saviour’s precious Name, and of the Blood that cleanses from all sin.8
Chaplain Roger Bulstrode, Senior Chaplain, 20th Division
When at last the injured were picked up by the stretcher bearers they would often be taken to the regimental aid post where the medical officer attached to each battalion would roughly bandage and administer palliative morphia. In Sergeant Kerr’s case he was carried by stretcher to a deep German dugout, which was being used as an advanced dressing station. Here he was laid on a rough wire-mesh bed, surrounded by other seriously wounded men.
The dead and the walking wounded would be somewhere else. That was to be a terribly long night, pitch dark as it was down in the depths of the place. Two of the most seriously wounded screamed with their pains for most of the night, until one of them passed away. He was at the far end of the dugout, but I could hear the murmur, ‘He’s dead. He’s gone.’ His passing brought a hush in the darkness, a kind of two minutes silence, in which even the remaining demented one seemed to join. In no time, though, he was at it again, but only for a few minutes longer. ‘For Christ’s sake can’t you stop that bawling, you are not the only one who is suffering!’ Strange to say this reprimand from a hitherto quiet one was to do the trick. From then all that could be heard was the utter silence of the underground darkness. For myself, with a dull pain all over my chest, I just lay without moving all through the night.9
Sergeant William Kerr, 5th (Western Cavalry) Battalion, 2nd Canadian Brigade, 1st Canadian Division
Such advanced dressing stations were operated by the men of the Royal Army Medical Corps. While the men on both sides sought to destroy the lives of their enemies, it was their task to try and patch up the results of the general mayhem. The crunching, flensing power of the shell splinters, the scything of machine guns, the sudden shattering impact of the sniper’s bullet—all caused bodily wounds that needed urgent medical treatment. It is not surprising that the RAMC was one of the most hard-pressed units in the whole of the British Army on the Somme. Its work never ceased for a moment. Someone, somewhere always needed to be swiftly diagnosed, tended, bandaged, splinted, vaccinated, stitched, operated upon, or simply drugged with morphine till all pain and life ebbed away. The medics’ efforts went largely unsung, but they are worthy of earnest admiration.
One field ambulance unit—the 45th Field Ambulance, RAMC—can stand as an example of all these brave men trying their best to stem the tidal wave of death on the Somme. The field ambulance was the basic unit. It was the staging post between the regimental aid posts and the casualty clearing stations further back. Early in August a group of its officers moved forward to examine the sector on which they had been assigned to operate in the service of their parent body the 15th (Scottish) Division. At their head was one Captain Hamilton.
Fricourt is to be our headquarters. There is an excellent big deep dugout made by the Hun as a headquarters. There is a long passage and from it open off numerous rooms. There is room for about fifty officers and men. The mess is nearer the surface in a cellar, not very big, but light and airy compared to other rooms. From the passage run several shafts which serve as bolt holes and also air shafts. For patients there is very poor accommodation as one couldn’t get a stretcher down into the big dugout. There is a more or less sheltered spot where one could put half a dozen stretchers or perhaps twenty sitters who would be safe, except for a direct hit which would clean them out. Of course there is no idea of keeping patients here. It is only a place for our headquarters and a reserve of men.10
Medical Officer Captain Eben Hamilton, 45th Field Ambulance, Royal Army Medical Corps, 15th Division
The headquarters was in fact just a staging post; a link between the advanced dressing station post and the main dressing station situated still further back in Albert. The organisation for relays of ambulances was crucial if they were not to maroon the wounded at the front or leave them lying in the open at Fricourt.
Two cars are kept here and one at the advanced dressing station at Contalmaison. As the car from Contalmaison comes down, it is loaded by a medical officer who sees that all patients are properly ba
ndaged etc. and does anything necessary for them. This car goes on at once back to Albert, and one of the other cars goes up to Contalmaison. As the first car passes the wagon lines which are back a couple of miles on the road to Albert, another car there moves up to Fricourt. When the first one discharges its patients at a main dressing station, it returns to the wagon lines.11
Medical Officer Captain Eben Hamilton, 45th Field Ambulance, Royal Army Medical Corps, 15th Division
The advanced post was to be stationed at the Contalmaison Chateau. Captain Hamilton went forward to check whether it was suitable for their specific needs as medics. He found that little remained of the chateau.
Contalmaison: a ruin with a dead and very stinking horse at the crossroads. The advanced dressing station is in the cellar of the chateau, there is still a bit of wall standing. There are four small rooms in the cellar: the patient goes down the stairs through A’ and ‘B’ where he waits his turn, to the dressing room ‘C’ where there are trestles on which to set the stretchers and chairs for the sitters. Then when dressed and labelled, he is sent through to ‘D’ there to be fed and await evacuation. ‘D’ might hold nine stretchers and about a dozen sitters on a bench down the side. The whole place is lumbered up with beds and quite unnecessary stuff, which I shall clear out. The officers’ room is small but beautifully finished, all boarded over with a fixed table and a bed. Two stretchers can just fit in, so it holds three people with a squeeze. There is a blow hole for air and a certain amount of light. But artificial light is necessary all the time.12
Medical Officer Captain Eben Hamilton, 45th Field Ambulance, Royal Army Medical Corps, 15th Division
The ‘facilities’ seemed adequate for their requirements, although the absence of a functioning water supply meant that all they needed would have to be laboriously sent forward in petrol tins. The advanced dressing station also needed to be kitted out with all the medical supplies they would need once the casualties started to flood in. Large numbers of stretchers were necessary and plenty of blankets, for even in summer wounded men suffering from shock could feel cold. Huge numbers of bandages and splints of all different shapes, types and sizes were obviously essential as were oceans of simple medical stores such as disinfectant. All this had to be brought forward across some of the most dangerous ground on earth.
After Hamilton had scouted out the position, the rest of the 45th Field Ambulance moved up a few days later. As they approached their destination, Lieutenant Lawrence Gameson found that the directions given to him by Hamilton, although eccentric, were peculiarly effective at guiding them through the last stages of their journey.
Contalmaison is quite completely ruined. We were told to turn left at the second bad smell. The directions proved to be as accurate as a precise map reference. We live in the remains of a chateau. A few chunks of wall and part of one room is all that is left above ground. The cellars are sound. There are German dugouts many feet below the original cellars. Our mess is at this depth. It is a small, square, boxlike room having connection with the relatively fresh air outside by means of a long wood-lined shaft; which, being of German make, naturally faces the enemy. A good shot would lob down the shaft and burst in our box. Already a shell has exploded almost on the edge of the opening—it sent down a great ‘whoof’ of smoke, stink and dust which put out our lamp. Seems an odd place for a living quarters; but I always anticipate the worst. I am not always wrong. Here at Contalmaison I feel most curiously and disturbingly isolated, as if one was going to be stuck here forever.13
Medical Officer Lieutenant Lawrence Gameson, 45th Field Ambulance, Royal Army Medical Corps, 15th Division
These miserable, claustrophobic surroundings were to be their home for the next month. Whatever the gloomy prospects down below, the world outside was rather more dangerous as the shells rained down, making no discrimination between fighting men and those wearing the Red Cross brassard.
Soon the wounded began to arrive: some walking, some carried, some just helped along; the usual bloody, patient battered crowd, without a grouse and with scarcely a groan.14
Medical Officer Lieutenant Lawrence Gameson, 45th Field Ambulance, Royal Army Medical Corps, 15th Division
The arrival of the wounded converted the cellars into a macabre combination of waiting room, surgery, abattoir and crypt. For the wounded men and the desperate doctors who tended them it was a subterranean hell.
The flow of work in our cellar was uncertain. Times of slackness alternating with times of great stress, when the place was filled with scores upon scores of reeking, bleeding men. These times of great stress were not isolated incidents, to be dealt with, cleaned up, then forgotten, like a railway accident. They recurred regularly. They went on and on and on. Stretchers blocked the cellar floors, the passages, the battered shelter that remained above ground and the approaches outside. Often we worked for hours on end without respite; at the crude dressing tables, at men grounded on stretchers, at men squatting or sticking. It was emphatically not sheer muddle, but the congestion beggars description. Our working space was limited. We got in each other’s way. There was a constant movement of bearers shuffling and staggering with stretchers, negotiating the cellar stairs, seeking a way in or out and a bare space whereon to deposit their burdens. Walking wounded sat on benches or squatted between the stretchers on each available foot of floor, patiently waiting their turn to be dressed or get their shot of anti-tetanus serum. Sometimes a man on a stretcher would vomit explosively, spewing over himself and his neighbours. I have seen mounted troops brought in with liquid faeces oozing from the unlaced legs of their breeches. Occasionally a man would gasp and die as he lay on his stretcher. All this was routine and the waiting crowd looked on unconcerned. No one spoke much during these seemingly endless periods of congestion. For the most part, the wounded showed little tendency to talk and to exchange the customary quips. They waited patiently, while we got on with our work with no needless words. This was done in the poor light of candles and reeking lamps. There was little water and of course no running water. Dressings and filth accumulated, to be burnt outside with the minimum of smoke. The air became rank; worse when gas was about for airways had to be partially blocked. Blood was the general background: dried, drying or wet. With the means then available we did our best for the wounded’s immediate needs and for their rapid evacuation by ambulance to Fricourt.15
Medical Officer Lieutenant Lawrence Gameson, 45th Field Ambulance, Royal Army Medical Corps, 15th Division
Even simple tasks became complicated beyond belief by the extreme nature of the situation. Tetanus was a constant threat on the ravaged battlefield and injections were given to almost every casualty. This in itself posed a problem.
One of our troubles was the shortage of serum needles. It was impossible to keep sharp what we had. To shove a large, blunt needle into a man already tried almost beyond endurance was no nice task, but it had to be done. It was then that orders came from a distance, forbidding all but medical officers to inject serum. The orders would have been more convincing had the supply of new needles been increased. It was not.16
Medical Officer Lieutenant Lawrence Gameson, 45th Field Ambulance, Royal Army Medical Corps, 15th Division
The endless hours at work up to their arms in other men’s innards left them looking like apprentice butchers.
There is a continuous stream of wounded through at all hours. The pips on my tunic cuffs are shiny with polished blood, blood of someone else, of infantry mostly. Although but a middleman, one gets sick of blood’s smell and of the endless procession of red raw human meat passing through our hands.17
Medical Officer Lieutenant Lawrence Gameson, 45th Field Ambulance, Royal Army Medical Corps, 15th Division
The blood, the ‘meat’, the vomit, the ripped, torn and loosened bowels brought into sharp focus a further pest—swarms of bloated flies. In a world filled with 5.9-in shells it might be considered that little harm could result from the buzzing of a few flies. But
the flies, with their natural predilection for faeces, accelerated the spread of disease and somehow amplified the overall horror simply by dint of their ceaseless buzzing and thoroughly nauseating lifestyle.
This evening I killed fourteen flies with one swipe with a rolled up copy of an ancient Times. They are infinitely numerous, leisurely and deliberate in movement, and have large sticky feet. The neighbourhood is an incubator for them. Eggs are laid in corpses of Germans and horses, hatching in the rotting semi-liquid flesh. The rest of their lives, for the most part, is an ephemeral gluttonish revel amongst all that is most revolting in this revolting region of putrefaction and decay. They swarm upon food, they buzz. Night and day this room resounds with their buzzing. The drone becomes a background, it even steals into one’s sleep.18
Medical Officer Lieutenant Lawrence Gameson, 45th Field Ambulance, Royal Army Medical Corps, 15th Division
Behind the all-pervasive background buzzing lay the horror of fly eggs hatching out in the bodies of the wounded and the dead. It was almost too horrible to bear for boys brought up with heroic, fictional images of superficial arm wounds. The reality of war could turn, or indeed colonise, the stomach.
I saw more torn human tissues than one would have thought possible in so short a time. There was hardly any part of the body I did not see cut or exposed. Maggot invasion was common. One unconscious man arrived with part of a frontal lobe protruding from a hole in his skull. The protruding portion of his brain was moving with maggots. There was a man with a loop of gut sticking out of a gash in his uniform. It was a bayonet wound. The loop of gut had been lightly dressed with gauze, beneath which there was a wriggling mass of maggots. The man had been lying out wounded and the flies never missed a chance. His condition was deplorable. When men had been left out wounded for some time, often their shoulders, buttocks or whole back were invaded by the creatures in the areas of skin compressed by the weight of their immobilised bodies. One man I saw had been lying out because both legs were wounded. Prolonged pressure had caused necrosis of the skin over his buttocks and of the superficial portions of muscle beneath it. Maggots had invaded the deeper tissues, I had to pick them out with a long forceps. The man was unaware of his condition. Maggot invasion was always accompanied by a foul smell, since it flourished only in tissues undergoing some degree of decomposition. As a rule, the patient did not notice the stink, or did not know that it came from his own body, if sensitive enough to notice it.19