‘[The wounded soldier is] at once evacuated to a first-line ambulance just beyond artillery fire; here he is again studied, his bandage changed and he may be operated on if necessary, but if his condition warrants it he is at once evacuated to the railway and shipped south on a ‘sanitary train’. On such trains the wounded reach Paris and the great distributing centres, and are at once divided among the local hospitals. From the station they reach the hospitals by motor ambulance.
It seems complex, but we often got patients in the hospital in Paris within 12 to 14 hours after they have been hit, even when coming from Arras or the line farther north toward Ypres. On arrival in the hospital patients are at once seen by the receiving officer, who, in our service, was one of the residents, and by him sent either to the ward direct, to have a bath first, or to the operating room, as each single case demanded… Of the 383 cases on which we have full records 318 received actual wounds by missiles – as follows:
Rifle ball – 128
Shrapnel ball – 31
Shell fragment – 133
Shell fragment and rifle ball – 5
Shell fragment and shrapnel – 1
Doubtful – 5
Bomb fragments – 9
Hand grenade – 3
Barbed wire – 1
Mine explosion – 1
Revolver ball – 1
Of the 65 cases in which no actual wounds were produced by missiles, a large number were due to falls, chiefly from horses or into trenches, and to men being thrown down by a mine or large shell or bomb explosion nearby. Also there were a few simple surgical conditions, such as appendicitis and hernia, demanding surgical treatment. Many of the cases presented more than one wound, there being 670 instances of medical or surgical conditions in 383 cases. A glance at the following table shows a rough estimate of the location of wounds, but, of course, it must be kept in mind that this is not a true measure of the proportion of wounds received in battle, for most of the head and abdominal injuries are fatal at the front, and never reach the great base hospitals:
Skull fractures – 20
Spinal cord injuries – 7
Superficial wounds, head and face – 10
Fractures, upper and lower jaw – 63
Diseases and injuries of the abdomen – 13
Injuries of the pelvis – 4
Peripheral nerve lesions – 39
Joint lesions without fracture – 13
Fractures of extremities (13 required amputation) – 140.’
Florence adapted quickly to this work, nursing with great skill and dedication. After her death, a letter to the London newspapers soliciting donations to a memorial fund highlighted her particular affinity for work with the most vulnerable and marginalised of her patients (and reflected the colonial attitudes of the day to men of different races):
‘She took work from which many a white woman instinctively shrinks, that of tending coloured patients. But very calmly and courageously, setting a superb example to the younger nurses with her, she took charge of hundreds of the most gravely wounded of the French African troops, Turdos, Sanegalese [sic] and the rest.’
A doctor who had worked with her in France confirms this in his own tribute:
‘The death of Miss Florence Nightingale Shore under such tragic circumstances will be deplored by everyone, but more especially by the doctors and nurses with whom she worked in France during the early months of the great war, when she was attached to the French Red Cross Hospital serving the 10th French Army at Fort Mahon, Somme. Among a devoted band of workers, Miss Shore proved herself to be one of the best nurses, always calm, helpful and self-sacrificing. She cheerfully took her share of the many privations, and always tried to make the best of difficult circumstances. She had a splendid influence over the younger nurses. The patients in her special ward were French African troops, Zouaves, Turcos, Arabs and Sengalese. The ‘White Queen’, as they called her, endeared herself to them by her constant care and kindness.
As one of the doctors who worked with her in France from October, 1914, onwards, it is to me a sad privilege to pay this small tribute to the memory of one of the most unselfish and self-sacrificing women I have ever met.’
There is an intriguing reference to a nurse who might have been Florence Shore in the account by Kathleen Burke of her visits to Red Cross hospitals in France. She too noted the large number of Algerian and Senegalese soldiers who had been wounded fighting for France; and she described the work of one particular Sister who was noted for her kindness to them:
‘The Senegalais and Algerians are really great children, especially when they are wounded. I have seen convalescent Senegalais and Algerians in Paris spend hours in the Champs Elysees watching the entertainment at the open-air marionette theatre. The antics of the dolls kept them amused.
They are admitted to the enclosure free, and there is no longer any room for the children who frequented the show in happier days. These latter form a disconsolate circle on the outside, whilst the younger ones, who do not suffer from colour prejudice, scramble on to the knees of the black soldiers.
The sister in charge was a true daughter of the ‘Lady of the Lamp.’ Provided they are really ill, she sympathises with all the grumblers, but scolds them if they have reached the convalescent stage. She carries a small book in which she enters imaginary good points to those who have the tables by their beds tidy, and she pinned an invisible medal on the chest of a convalescent who was helping to carry trays of food to his comrades. She is indeed a General, saving men for France.
Not a man escaped her attention, and as we passed through the tents she gave to each of her ‘chers enfants’ – black or white – a cheering smile or a kindly word. She did, however, while talking to us omit to salute a Senegalais. Before she passed out of the tent he commenced to call after her, “Toi pas gentille aujourd’hui – moi battre toi.” (“You are not good to me today – me beat you.”) This, it appears, is his little joke – he will never beat anyone again, since he lost both arms when his trench was blown up by a land mine.’
Alongside the serious wounds and grinding hospital work of the war, Burke’s account also provides a cheering snapshot of the provision of more pedestrian healthcare cobbled together for the troops by the Red Cross:
‘It was at Triancourt that I first saw in operation the motor cars that had been sent out fitted with bath tubs for the troops, and also a very fine car fitted up by the London Committee of the French Red Cross as a moving dental hospital.
I regret to add that a ‘poilu’ nearby disrespectfully referred to it as “another of the horrors of war”, adding that in times of peace there was some kind of personal liberty, whereas now “a man could not have toothache without being forced to have it ended, and that there was no possibility of escaping a dentist who hunted you down by motor”.’
Florence was in touch with her family by letter throughout her time in France. Early in 1915, she wrote to Caroline Shore, her sister-in-law in India, describing her work, and asking ‘Do you know anyone who will help us along – we are badly in need of funds to carry on and we should be glad of gifts – of socks, pyjamas and dressings.’ Caroline passed on the request to her aunt and uncle, saying ‘Perhaps Uncle Joe will drop a line to the right person and ask them to send to Florence’s hospital.’
Florence made a huge impact on the French Red Cross during her single year with them. Five years later, the British Committee of the French Red Cross would send a floral tribute to her funeral, and Mabel Rogers received letters ‘of sorrow and regret’ from the Matron-in-Chief, the State Matron-in-Chief in France, the French Red Cross, doctors, matrons, sisters, nurses, VADs (members of the Voluntary Aid Detachment) and orderlies who served with her in France.
After her year with the French Red Cross, Florence returned to England in 1915 – just too late to see her sister Urith before she died. Urith had been working in a camp at Woking, as part of the ‘Emergency Corps’. Caroline Shore wrote that her younger siste
r-in-law
‘… had been working among the soldiers in a great camp … and I am afraid in her eagerness and energy the work has been too much for her. She seemed so very happy in her work and had reached the very pinnacle of her desire – to be at work among and for Lord K’s new army – dispensing warm clothes and comforts to them and looking after their welfare in a great camp at Woking … when the cable came to say she was dangerously ill with meningitis at Woking Cottage Hospital – and shortly after a second cable came saying she had died that night. Poor Florence came back from France but was too late.’
Caroline describes Urith in her letters as Offley’s favourite sister, and describes how deeply her husband felt his sister’s loss.
‘Urith was a beautiful pianist’ Caroline recalls, ‘and was clever and accomplished and an excellent linguist. She was one of those very reserved very proud English natures, that it is so difficult to know and understand. Very very sensitive, and she adored and admired Offley extravagantly. She was very petite and with a marvellous quantity of brown hair, and there was always a sense of brilliance – real brilliance in this delicate little woman. Ugly – and yet not really ugly – more plain – but always with an alert eager expression that was very charming. I was very attached to her – and she to me – and yet I never felt I understood her – and I should have liked to so much.’
Urith left all her belongings, worth just over £5,600 net, to her sister. Florence herself made a Will in April, using part of her sister’s legacy to set up a trust fund for the benefit of one of her cousins, Stuart Hobkirk. He was by now a reputed St Ives artist, and living in Tonbridge with his mother, Florence’s aunt, the Baroness Farina. But Florence was not to be in England for long. By 1915 the War Office was making special appeals for nurses, and Florence and Mabel were amongst many Queen’s Nurses who joined Queen Alexandra’s Imperial Military Nursing Service Reserve.
The ‘QAs’ had not been in existence for long. In 1897, Princess Christian, one of the daughters of Queen Victoria, had formed the Army Nursing Reserve that carried her name. One hundred of these reserve nurses, including Florence and Mabel, had been to South Africa during the Boer War and were joined by nurses from the London Hospital, organised by Princess Alexandra, wife of the future King Edward VII. When the British and Indian army nursing services were amalgamated, the now Queen Alexandra gave her name to the Queen Alexandra’s Imperial Military Nursing Service, in March 1902.
In 1908, the QAIMNS took over the reserve force and members of this force were employed on a contract basis for the duration of the war. By 1914, there were 297 regular members of QAIMNS, the numbers limited by the requirement that members be unmarried, aged over 25, and of higher social standing. These criteria were changed during the War. By the end of 1914, there were more than 2,000 regular and reserve QAs. By the time the War ended, more than 10,000 qualified nurses had worked with the QAs, including those working for the Territorial Force Nursing Reserve.
The nurse in overall charge of the British nurses in Europe during the war was (Emma) Maud McCarthy. An Australian by birth, and educated there, she had trained as a nurse in London in 1891, and was a ward sister at the London Hospital, Whitechapel by 1894. She was one of the select group of London hospital nurses chosen to go to South Africa to nurse the wounded of the second Boer war in 1900 with the Army Nursing Service Reserve, of which Florence and Mabel were both members. In 1910, Maud McCarthy was appointed Principal Matron at the War Office. As head of the British Expeditionary Force of nurses, she arrived in France in August 1914, and left in August 1919, to be awarded honours (including being made a Dame) and medals from Britain, France and Belgium for her work.
Florence’s service with the QAs began when she signed up on 10th August 1915 at the Hopital Militaire, Fort Mahon, Somme, France. She was 50 years old. She was sent as a staff nurse to 14 General Hospital at Wimereaux, a coastal town three miles north of Boulogne, where a Red Cross hospital had been set up very early in the war. In October that year, she went to 14 General Hospital for six months, before a fortnight’s leave in England the following April. A report in August 1916, describes her health as good, her conduct, excellent, and her character as ‘very contented and has a good influence’. Cryptically, the report notes that she is ‘considered especially suitable for duties on barges.’ (Barges were used to transport cases that would suffer most from the jolting of road transport, including ‘wounds of lung and abdomen.’) Under ‘Remarks’, it notes that ‘Miss Shore is a very capable nurse and quite fit for charge duties, but she does not wish for responsibility or promotion.’
*
Later, she worked at the No 32 casualty clearing station, Warlingcourt, France. The nurse who ran this station from the time it was set up in March 1917 was Sister Kathleen E Luard, also a veteran of the South Africa war. She kept a diary of her experiences, later published under the title ‘Unknown Warriors’. She describes the station where she and Florence worked, consisting of tents and huts hastily constructed by army engineers, on a ridge about six miles from the battle line. At the beginning of March, in the middle of a freezing winter, there were just seven Sisters for 700 planned beds, though more arrived, supported by orderlies, as time went on. The staff worked in conditions of great hardship, with never enough food, or space for all the wounded brought in to them, and sometimes unexpected personal danger:
‘For the Mess’, Sister Luard wrote, ‘you settle for a rice pudding, but there is no rice, and the cows have anthrax so there’s no fresh milk, and the canteen has run out of Ideal Milk. Well, have a jam tart; lots of jam in the British Army, but no flour, no suet, no tinned fruits, no eggs, no beans or dried peas, not one potato each. But there is bacon, ration bread and tinned butter (when you can get it), jam, marmalade sometimes, cheese, stew, Army biscuits, tea, some sugar, and sometimes mustard, and sometimes oatmeal and cornflour…
We’re in the middle of terrific work. All the casualties from the attack on Hainy and Croisilles came to us; we hadn’t nearly enough Sisters to go round and it never stopped all day and all night and all today until 5pm. So many die that I shan’t possibly be able to write to their mothers, and some have no trace of next of kin. I had to run a ward equipped for 14 officers and had to get 28 in, on stretchers on every inch of the floor, some badly wounded; they were all angels of patience and uncomplainingness…
A boy with his face nearly in half, who couldn’t talk, and whom I was feeding, was trying to explain that he was lying on something hard in his trouser pocket. It was a live Mills bomb! I extracted it with some care, as the pins catch easily.’
In the Spring of 1917, Florence’s brother Offley and his wife Caroline were travelling up through France, returning from India to England. They cabled Florence to see if they could meet up, but by then she was working on a hospital train based in Rouen. Instead, Offley and Caroline visited the hospital at Wimereaux:
‘… where Flo worked for so long… [the town] is a charming place, most certainly a bit of England in France … Nurses of every age and kind in all the varied costumes adopted by this war, hospitals and ambulances and motors everywhere and men and women flying around in equal independence. Many of the nurses with military rank and in khaki and it gives one a very strange feeling and certain shock at first, and coming from the land of so much ceremonial and salaaming as I have so lately.’
Later that year, Florence visited her sister-in-law in London while she was on brief leave. Caroline was missing Offley, now on a mission in Russia, and was not entirely grateful:
‘Florence, who came home on a short leave from France is still here with me – and she is in a way a comfort – but the poor girl she does not make herself very congenial – and I am utterly lost without O.’
During another of Florence’s visits on leave, Caroline wrote to her father:
‘Poor old Florence – she is shy and difficult, though I know she adores O. and takes me into her big, kind heart with the same adoring affection – but she is entirely
wrapped up in her work – a great blessing of course – but I find her so hard to understand. I go on chattering like a magpie and she says nothing but ‘Yes’ and ‘No’. I find she knows several people – I might have had to meet her – but she only tells me all too late.’
Florence’s dedication to her war work was not going unnoticed within the nursing service. In January 1918, with the war more than three years old, the Principal Matron of the QAIMNS reported about Florence:
‘I have found her a very good ward sister, and most devoted to her patients for whom she can never do enough. She is an excellent medical nurse. For a time she had charge of a unit of five wards and they were very well run. She manages her staff and orderlies well – she is always cheerful and ready to give any extra help where it is required and has been very useful to me in my work. Miss Shore is very likeable and most conscientious. Very retiring by nature, it is not until one gets to know Miss Shore that one learns how capable she is – her influence good. She is suitable for promotion.’
Florence’s promotion, and her reluctance to accept it, was soon being discussed at the highest levels of the service. A letter from the Matron in Chief of the British Expeditionary Force, Maud McCarthy, to Dame Becher, Matron in Chief at the War Office, dated 11th November 1918 – the day peace was declared – says:
‘With regard to Staff Nurse F N Shore, QAIMNSR, she has always had quite good reports. She seems to be of a quiet and retiring disposition, and so far has not been promoted as some time ago she herself said she did not wish to be given responsible work. I have been making special enquiries and her present Matron says that Miss Shore seems a very sensible woman, and, I should imagine, capable of more responsible duties. A report on this lady is attached. I will now arrange for her to do a Sister’s duties. I am glad this matter was brought to my notice.’
The Nightingale Shore Murder Page 16