2nd phase of the Battle of Arras April 23rd 1917

On Sunday, April 22nd, 1917, Kate Luard wrote “No one knows when we shall fill up again but it can’t be far off with this din”. The following day the wounded come flooding in – but when there is a lull in the taking in, nursing and evacuating of the wounded Kate goes for a ramble in a nearby wood beside a stream to revive herself both physically and mentally.

                                           Casualty Clearing Station ward by J Hodgson Lobley

Monday, April 23rd, 10 p.m.  We have filled up twice. The men say our guns are so thick that they’re wheel to wheel; the earth-shaking noise this morning did its work; the wounded Germans tell me there are a great many dead.  I’ve been looking after 100 stretcher cases in the tents to-night; they are all ready for evacuation.

Tuesday, 10.30 p.m. It has been a pretty sad day, 12 funerals, including four officers, all fine brave men. One mother wrote thanking me for writing to tell her about her son, but “it would relieve the news somewhat if she knew which son it was, as she has three sons in France”.

Two given-up boys whom no effort of yesterday or last night would revive – after more resuscitation are now bedded in one of the Acute Surgicals, each with a leg off and a fair chance of recovery. The others, with torn kidney and spleens and brains, are no good, I’m afraid. The people who have been coming in all day are left-outs since Monday, starved, cold, and by some miracle still alive, but not much more. This last 300 has taken 16 hours to come in. It is piercingly cold again and looks like rain.

Monday, April 30th. We have had a whole week without snow or rain – lots of sun and blue sky. I went for a ramble yesterday to a darling narrow wood with a stream at the bottom, a quarter of an hour’s walk from here. Two sets of shy, polite boys thrust their bunches of cowslips and daffodils into my hand … Also banks of blue periwinkles like ours and flowering palm; absolutely no leaves yet anywhere and it’s May Day to-morrow. Very few left in the wards to-day, but what there are, nearly all tragedies.

May Day and a dazzling day and very little doing. Celebrated the occasion by going to the woods in the morning, starry with anemones and never a leaf to be seen, but blue sky and fresh breezes and clear sunshine. It is all a tremendous help, both physically and psychically.

My boy with both legs off is safe now and a man dragged back from imminent death from a femoral haemorrhage has begun to live again. (Died later). A Suffolk farmer boy is dying to-night, who has hung on for a week. (Died on Wednesday). Another boy on the extreme edge of dying of shock and internal haemorrhage ….

Thursday, May 3rd, 11.30 p.m. They went over the top this morning and have been pouring in all day. We are now taking in for the third time – to-day …

Saturday, May 5th. A boy was brought in to-day with his leg blown off – “I wonder what Mother’ll say when she hears of this,” he said. “It’s only a little thing really, losing your leg in this War, but she won’t think that”. A poor old Boche with the lower part of his face missing came in this morning (no tongue or lower jaw) …

Tuesday, May 8th. I am engaged in a losing battle with gas gangrene again. I believe the general toxaemia begins long before they operate. When they have been lying out long, G.G. is practically a certainty.

Wednesday, May 9th. And what do you think we’ve been busy over this morning? A large and festive picnic in the woods, far removed from gas gangrene and amputations, … on a slope of the wood, above the babbling brook, literally carpeted with periwinkles, oxlips and anemones.

Saturday night, May 12th. … nothing outside the Hospital for miles but shell-holes, dug-outs, old trenches, old wire, unexploded shells and bombs, blackened tree-stumps and not a leaf to shade under.

     Gommécourt trench 1917

Monday, May 14th. The view from the Corps Main Dressing Station is a vast desert of treeless waste,cut up by trenches and shell-holes ….

Friday, May 25th. There is a boy in with his spinal cord exposed, lying on his face, who was wounded on Sunday and not picked up till Thursday morning. He was in a shell-hole crying to four other wounded in it all the first night. They took no notice and in the morning he saw they had all died.

Monday, May 28th. Still taking in slowly. We have five badly wounded officers. One is coming round now but not quite out of the wood. He has lost one eye and one leg, besides other severe wounds.

Tuesday, May 29th. We are Taking in, Evacuating, Detaining and Packing up all at once. The C.O. had another message to-day to “prepare to move to another Area at short notice”.

Friday, June 1st. We are rather full just now, but shall be left with only four unfit to travel after the Evacuation this afternoon.

Sunday, June 3rd. The last patient cleared yesterday and there are only the huts left standing. The tents are packed and waiting by the siding. We are off to-morrow.

The Battle of Arras was a British offensive on the Western Front from 9 April – 16 May 1917 when British troops attacked German defences near the French city of Arras.

Kate’s casualty clearing station at Warlencourt is at long last ready to receive the wounded and she describes how the group of casualty clearing stations alternate in taking in the casualties and the worst cases are evacuated by ambulance trains.  Conditions are still primitive and the harsh weather continues …

 Battle of Arras – ruins at Gommécourt

 Friday, March 23rd … then you come to what was Gommécourt. It must have been, when it existed, full of orchards, and half in and half out of a wood. Now there is one wall of one house left. The woods and orchards are blackened spikes sticking out of what looks now like   a mad confusion of deep trenches and deep dugouts battered to bits. On the right of this wood, the other side of the Germans’ wire, is the No-Man’s Land, where the Salvage men are busy burying our skeletons who have been there since July.

 The D.M.S [Director of Medical Services] was very pleased with the hospital yesterday, especially with our arrangement of the Dressing Ward.

Monday night, March 26th. The Quarter-Master paddled me round all his soak-pits,      incinerators, thresh disinfectors, ablution huts, bath huts, laundry etc., etc., this morning. They are primitive but clever.

Tuesday, March 27th. At last we’ve taken in our first convoy. The two new Sisters arrived in the nick of time. It has been the usual poisonous weather again, biting N.E. wind, driving storms and deep slush. We take in from 6 a.m. to-day to 6 a.m. to-morrow – in rotation with the other two [casualty clearing stations] in this group.

Wednesday, March 28th. We are bombarding them harder than ever; it is a continual din. We took in another Convoy in the  night and had a busy morning, but the train came before tea, so our first venture is admitted, operated on, treated and evacuated within 36 hours; all but the worst Surgicals and Medicals unfit for travel, and a handful of walking cases, soon fit for duty. I’ve already had to begin writing the Break-the-News Letters to the wives and mothers.

Tuesday, April 3rd. We are in the middle of terrific work, so I can’t write much; 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. So many die that I shan’t possibly be able to write to their mothers, and some have no trace of next of kin.

Wednesday, April 4th, 10.30 p.m.  … The increased Mess makes extra work and catering is appallingly difficult. We all eat whatever comes, whether cold or hot, raw or cooked, nice or nasty, and do very well on it. The kitchen range is made of petrol tins, cement, and draughts.

Thursday, April 5th, Midnight. Just got to bed after my last round. Had a very big take-in; a Gunner Major with his leg off nearly died this morning, but I hope he’ll do now. A boy with his right leg off nearly at the hip, and his right arm all in pieces, is not so well to-night. I found three dying ones on stretchers to-night on one of the wards … two died but one revived and still lives.

[On arrival] all the layers of sodden or caked stiff clothing are cut off, pyjamas or long flannel pinafore gowns put on, taken from a blanket and screen enclosure kept heated by a Perfection Lamp. Hot blankets, hot-water bottles, hot drinks, subcutaneous salines and hypodermics are given here.

A man with his right arm in fragments, a penetrating chest-wound and a piece of shrapnel in his abdomen, said he was ‘a bit uncomfortable, but nothing to talk about’. After six hours we had him fit for operation; they whipped off his arm and dug the shrapnel out of his inside … now he’s in bed with a pulse (died next day).

Good Friday (April 6th). 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.

Easter Tuesday, April 10th. The 3rd Army went over the top yesterday and a wire came through by mid-day that we’d taken Vimy and 4000 prisoners and 30 guns. The Cavalry are after them, and the Tanks leading the Infantry, and all is splendid, but here are horrors all day and all night. The three C.C. S.’s filled up in turn and each then filled up again, without any break in the Convoys: we take in and evacuate at the same time.

Stretchers on the floor are back-breaking work, and one’s feet give out after a certain time, but as long as one’s head and nerves hold out, nothing else matters.

Evacuation has been held up to-day for some hours and the place is clogged. The wards are like battlefields, with battered wrecks in every bed and on stretchers between the beds and down the middles. We take in to-night, but there are two trains in to clear.

The transport of the wounded is extraordinarily well worked out. The walking-cases come in lorries and buses and the lying-cases in electric-lighted Motor Ambulances, which look like lights on the Embankment as far as you can see down the road.

 Stretcher cases awaiting transport to a casualty clearing station, near Arras 1917

Friday, April 13th. The D.M.S. came  to-day and said the Push was held up by this extraordinarily inopportune burst of bad weather. It blew and raged all Wednesday night, and there was deep snow in the morning. Last night and to-day, we have been getting the poor boys in who have been lying out in it for two days, and many of them have died since of the exposure and gas gangrene.

The Strafe is over for the moment … the most tragic part, though – dozens who have been evacuated will die, too.

Sunday, April 15th. We’ve had a very busy day, some of it very disheartening … the work in the Wards, cutting off the caked khaki and the clammy socks and heavy boots, and the everlasting saline infusion and men being sick or delirious or groaning or haemorrhaging.

It poured and galed all last night and most of to-day with the usual alternations of heavy rain, snow and sleet, with a driving bitter wind. What the men in the trenches, and the wounded are like you can imagine. I have never seen anything like the state they are in, mud caked on their teeth and under their eyelids.

Sunday, April 22nd. This continued bombardment is shaking the earth tonight. I took some Lent lilies to the Cemetery this evening; it is rapidly spreading over a high open field; there must be nearly 2,000 graves there now.

No one knows when we shall fill up again but it can’t be far off, with this din.

 The 2nd phase of the Battle of Arras begins on April 23rd.

The Battle of Arras was a British offensive on the Western Front from 9 April – 16 May 1917 when British troops attacked German defences near the French city of Arras. The battle cost nearly 160,000 British and almost 125,000 German casualties

                                                    Cuthbert Crater, NE Arras, April 1917

Kate arrives in Warlencourt (now known as Warlincourt), a Camp about six miles from the line behind Gommécourt. They sleep on stretchers at a CCS just over the road whilst setting up their own casualty clearing station under difficult and bitterly cold conditions with the noise of shells and guns close by.

Chapter 4 Unknown Warriors

BATTLE OF ARRAS

MARCH 3RD TO JUNE 3RD 1917

WITH THE 3RD ARMY (SIR EDMUND ALLENBY)

LETTERS FROM WARLENCOURT

Warlencourt. Saturday, March 3rd 1917. We left St Omer on Thursday morning and travelled all day round by Calais and Boulogne to Étaples … from there yesterday we came here by Motor Ambulance … The Colonel has made a little compound for us, walled in with canvas all round, including a kitchen, Armstrong huts to sleep in and a small Nissen hut … Sister R. and I are going to search the country round for a cottage to take our laundry, and to look for possibilities of milk, eggs and butter.

A place a mile away is shelled every day. The guns sound very close, and last night one heard again the big shells reverberating through the air. There was a very hard frost again last night and it was hard, or rather impossible, to get warm.

Sunday, March 4th. Still hard frost; ice all night … in bed with dozens of blankets and oil stoves burning … Enemy shells came whizzing overhead from two directions.

 Monday, March 5th. Woke up this morning with ½ inch of snow on our beds inside our huts, and 6 inches outside. Melting now and a terrible mess.

Tuesday, March 6th. Had a busy morning putting in for extra surgical equipment that we shall need … No one here except the C.O. and myself has had any experience of a Strafe. We are also to take gassed cases, and there seem to be a good many bad ones.

Wednesday, March 7th. A biting N.E. wind to-day verging on the blizzard. I thought lovingly of indoor slippers and the dining-room fire. What with the wind bashing your canvas walls and the 9.2s roaring their loudest, and the lorries and caterpillars lorrying incessantly on the high road, it is not exactly soothing, but you soon get used to it.

Sunday, March 11th. The DMS (Director of Medical Services) rang up the Colonel last night to say that we should have to be ready to take in patients in three days, so things have got to get a hustle on to-day. The Engineers have sent 60 men to finish the wards and get on with the Theatre, the Kitchen and the road for evacuation. Neither the water supply, nor the lighting are done, so both will have to be improvised at first.

Monday, March 12th. It poured cats and dogs last night and you can’t imagine the state of the camp. No one could who hasn’t wallowed in it. Feeding them is going to weigh heavily on my chest. It is one person’s job to run a Mess at the Back of Beyond, and I have this Hospital (700 beds) to run for night and day, with the peculiar difficulties of a new-born unfinished Camp. For the mess you settle a rice pudding but there is no rice, the cows have anthrax, so there’s no fresh milk, and the canteen has run out of Ideal milk.

So far we have only 70 beds and mattresses – all the rest will have to be on stretchers … The C.O. and the Sergeant-Major go and steal planks from the road when I want boards for ward tables …

Wednesday, March 14th. Pouring cats and dogs all night and most of the day; quagmires everywhere. The other five sisters arrived today. They have dug themselves in cosily into their halves of the Armstrong huts – they are all old campaigners.

Tuesday, March 20th. The gale last night was terrific – our compound was a wreck this morning. Sheets of rain all day and more mud. Orders came this morning to be ready to take in large numbers of wounded at short notice, and the guns are busy again. The kitchen is not going – some water laid on – wards equipped and Theatre improvised in one of the Dressing  Huts; 1000’s of lbs. of dressings are stocked, but they soon run out. Lotions, dressings and clothing will all run out, I believe, because things take so long coming up.

Our official strength is 7 sisters – far too few for any battle, but that will become obvious.

The first convoy of wounded was taken in on Tuesday, March 27th. More extracts from Kate’s chapter on the Battle of Arras will follow.

GARDENS BEHIND THE LINES 1914-1918 Gardens Found and Made on the Western and Eastern Fronts

 by Anne Powell. Published by Cecil Woolf Publishers, London, 2015.

 REVIEW

 This is a gem of a book and these extracts from Anne Powell’s introduction outline it perfectly:

“During the First World War the ground over which the battles were fought was devastated. Towns and villages lay in shattered ruins, trees were uprooted, fields and roads became quagmires of mud scarred with deep craters and shell-holes. However wild flowers grew on wasteland and waysides, larks flew and sang overhead. Bitter cold, torrential rain, and intense heat caused endless discomfort, but the seasons still provided solace to the weary soldier when he found an isolated copse with the promise of green shoots, blossom, flowers and soft fruit which had miraculously escaped destruction. Men wrote in nostalgia of gardens that they had loved at home; in wonder of gardens and orchards discovered in the grounds of deserted chateaux and demolished houses; and in delight at the gardens they created as sanctuaries of order and peace behind the lines”.

Many of the famous names of WW1 poetry, prose and letters such as Rupert Brooke, Edmund Blunden, Robert Graves, Siegfried Sassoon are included in this book but I was most moved by the extensive entries from the letters of Alexander Douglas Gillespie, a Second Lieutenant in the 2nd Battalion Argyll and Sutherland Highlanders, who arrived in France in February 1915, whose letters are enriched with accounts of shell-torn orchards, pear, plum and cherry trees in blossom, bird’s song defying the sniper’s rifle, wild flowers found in desolate places. He created a garden in a trench outside his dug-out in the grounds of a shattered farmhouse and on 21 March asked his parents to send some nasturtium seeds.

April 2, 1915. I have been out in the orchard again, and have started a garden with a clump of sweet violets which I found growing on the bank of an old flooded trench. …..

May 2, 1915. I watered our garden; the pansies and forget-me-nots are growing well. I found a nest full of young hedge-sparrows too beside the stream.

On September 25, 1915, the first day of the Battle of Loos, Alexander Gillespie led his company of Highlanders in an attack near La Basse. They went through terrible fire and Gillespie was the only officer to reach the German trenches. He was seen to fall but his body was never recovered.

George Sedding, who also died at the Battle of Loos, served as a Lance Corporal in the 7th Norfolk Regiment and found time and enjoyment in collecting wild flowers.

June 27, 1915. … The gardens are full of great clumps of Madonna lilies and red and pink roses. One has to make trenches  right across them sometimes which seems a great pity.

July 12, 1915 … We have been having a quiet time lately out of the trenches. There are lots of wild strawberries about here and jolly honeysuckle and willow-herb or rosebay.

July 23, 1915. … I enclose a bit of St John’s Wort of sorts, isn’t it? I picked some and stuck it in a glass jar with some crimson sorrel and hemp agrimony …

Siegfried Sassoon at the end of March 1916 went to the frontline for the first time in the Somme area. From the motor-bus to a month’s training course at Flixecourt he described ‘green trees, apple-blossom nearly out – magpies in orchards, a small round pool in a garden with vivid green blades of iris growing along the edge’ and along a track from Flixecourt he walked into a bluebell wood where the birds were singing and the trees were newly in leaf.  The following day he heard a nightingale singing in the garden-copse close by ‘Chestnut- trees are in their wonderful new liveries of bright green; an apple-tree looks over an old lichened garden-wall, with blossom showing and pink buds’.

Glimpsed on the return journey ‘… vivid patches of clover-red, silver of daisies in lush grass, and the yellow of buttercups. Acres of green barley and rye and wheat and oats…leagues of rust-coloured ploughland’.

Amelie (Amy) Neville a VAD who worked at No.24 General Hospital, Étaples.

March 1916. The woods round here are perfect. We got heaps of wild daffodils. The undergrowth was all periwinkle and the anemones beginning … presently there will be a mass of hyacinths.

Captain T P Cameron Wilson, 10th Battalion Sherwood Foresters, arrived in the trenches at  Armentières where he later found consolation in the world of nature amid all the destruction of war.

3 May 1916. It is utterly peaceful now. Evening, with birds singing their hearts out, larks over the fields, lilac in the garden of the poor ruined farms around us, a wonderful sea of brilliant yellow turnip-flower which smells like meadow-sweet, swallows flying high and happy …

Sister Katherine Luard, No.32 Casualty Clearing Station

17 March 1917. No sign of any buds out. I’ve got a plate of moss with a celandine plant in the middle, and a few sprouting twigs of honeysuckle that you generally find in January, and also a bluebell bulb in a jam tin …

21 March … it is still snowing and yesterday was the first day of spring. It is unspeakably vile – biting wind – driving snow and deep slush …

Ivor Gurney, musician and poet, served with the 2nd/5th, Gloucestershire Reserve Battalion.

26 March 1917. On the march not many days ago we passed a ruined garden, and there were snowdrops, snowdrops, the first flowers my eyes had seen for a long time.

Edward Thomas enlisted and joined the Artists’ Rifles and was then commissioned in the Royal Garrison Artillery in August 1916. From a new position in an old chalk pit in France:

March 24th … A young copse of birch hazel has established itself … It is almost a beautiful spot still & I am now sitting warm in the sun with my back to the wall of the pit. Fancy an old chalk pit with moss & even a rabbit left in spite of paths trodden all over it. It is beautiful & sunny & warm – the chalk is dazzling. The sallow catkins are soft dark white …

Stephen Graham, 2nd Battalion Scot’s Guards which as a relief from the front-line trenches was sent to build a railway at Péronne. The battalion arrived in snow and pitched its tents in mud. Sergeant-Major Armstrong had been a gardener on a Scottish estate and he rescued plants and shrubs, including narcissus, primroses, tiger lilies, auricular, pansies, roses, Solomon seal, forget-me-nots from the abandoned and ruined houses in the town and gradually with the help of the men in their free time created various gardens.

Frances Ivens, Chief Medical Officer, Scottish Women’s Hospital - and an advance clearing station close to the front line near Royaumont which was a deserted, desolate and muddy evacuation centre where by the end of May 1918 staff and patients were enjoying fresh vegetables planted the previous year.

. … Between each hut were growing potatoes, lettuces, peas, cabbage etc., and in front of the laboratory, office and kitchen huts there were tiny flower gardens, tended by the staff of these huts with the greatest care …

After the war many thousands of the dead, some still unburied, were taken from original burial grounds and scattered graves, and were reburied in cemeteries planned by the War Graves Commission. Sir Edward Lutyens designer/architect of some of these believed there was ‘no need for the cemeteries to be gloomy … Good use should be made of the best and most beautiful flowering plants and shrubs’.

Gardens Behind the Lines is available from Amazon and Cecil Woolf Publishers.

Kate Luard vividly describes her experiences on the ambulance trains of World War One in her first book ‘Diary of a Nursing Sister on the Western Front 1914-1915’. She arrived in Le Havre on 20 August 1914 and after a frustrating wait she received orders on 13 September to go by train to Le Mans where she arrived two days later.

Ambulance trains in WW1 were a crucial part of the medical evacuation. They transported the wounded from the casualty clearing stations in France and Belgium to base hospitals near one of the channel ports or directly to a port for transfer to a hospital ship.

In 1914 some trains were composed of old French trucks and often the wounded lay on straw without heating and conditions were primitive. Others were French passenger trains which were later fitted out as mobile hospitals with operating theatres, bunk beds and a full complement of QAIMNS [Queen Alexandra’s Imperial Military Nursing Service] nurses, RAMC [Royal Army Medical Corps] doctors and surgeons and RAMC medical orderlies. Emergency operations would be performed despite the movement of the train, the cramped conditions and poor lighting. Hospital carriages were also manufactured and fitted out in England to be shipped to France.

In the early trains there was often lack of passage between the coaches and it was necessary for a nursing sister to pass from coach to coach along the outside footboards, whether the train was in motion or not, carrying a load of dressings, medicines etc on her back in order to tend to the wounded.

Sunday, 20 September. The fighting for these concrete entrenched positions of the Germans behind Rheims has been so terrific since last Sunday that the number of casualties has been enormous. Three trains full of wounded, numbering altogether 1,175 cases, have been dressed at the station today. The train I was put to had 510 cases. You boarded a cattle-truck, armed with a tray of dressings and a pail; the men were lying on straw; had been in trains for several days; most had only been dressed once, and many were gangrenous.  If you found one urgently needed amputation or operation, or was likely to die, you called an M.O. [Medical Officer] to have him taken off the train for Hospital. No one grumbled or made any fuss. The platform was soon packed with stretchers with all the bad cases waiting patiently to be taken to Hospital. The Blackwatch and Camerons were almost unrecognisable in their rags. The staple dressing is tincture of iodine; you don’t attempt anything but swabbing with lysol, and then gauze dipped in iodine. They were nearly all shrapnel shell wounds—more ghastly than anything I have ever seen or smelt; the Mauser wounds of the Boer War were pin pricks compared with them.

M. and I are now—9 p.m.—in charge of a train of 141 (with an M.O. and two orderlies) for St Nazaire; we jump out at the stations and see to them, and the orderlies and people on the station feed them: we have the worst cases next to us.

Thursday, 24 September 3pm—Taking 480 sick and wounded down to St Nazaire, with a junior staff nurse, one M.O., and two orderlies. The train is miles long—not corridor or ambulance; they have straw to lie on the floors and stretchers. The M.O. had been two nights in the train already on the way down from the front (four miles from the guns), and we joined on to him with a lot of hospital cases sent down to the base. I’ve been collecting the worst ones into carriages near ours all the way down when we stop. Got my haversack lined with jaconet and filled with cut-dressings, very convenient, as you have both hands free. We continually stop at little stations, so you can get to a good many of them, and we get quite expert at clawing along the footboards ….

On Sunday, September 27th Kate is told that she is for permanent duty on an ambulance train (equipped):

 Tuesday, October 13th. At last I am on the train and have just unpacked. There is an army sister and two reserve, a Major, O.C. [Officer Commanding], and two junior officers.

We each have a bunk to ourselves, with a proper mattress, pillow, and blankets: a table and a seat at one end, lots of racks and hooks, and a lovely little washing-house leading out of the bunk, shared by the two Sisters.

The train is one-third mile long. The ward beds are lovely: broad and soft with lovely pillow-cases and soft thick blankets; any amount of dressings and surgical equipment, and a big kitchen, steward’s store, and three orderlies to each wagon.

Medical officers, nurses and orderlies cared for the wounded. The medical staff consisted of three RAMC medical officers including a Commanding Officer, usually a major, and two lieutenants, a nursing staff of three or four complemented by 40 RAMC other ranks and NCOs [non commissioned officers]. The ambulance trains were up to 1/3 mile long and included wards, pharmacies, operating ward, kitchens and staff accommodation.

An average load was 400-500 patients with a large number in critical condition. Often they were transferred to the train still in full uniform in shocking condition caked with mud and blood and owing to the cramped conditions their uniforms had to be cut away. Many journeys were long such as the one from Braisne to Rouen taking at least 2 ½ days. There were deaths on all journeys. The nurses’ workload was heavy and they worked under dangerous conditions with the barest necessities and no comforts.

Staff worked regularly through the night and came under constant risk of catching lice or infectious diseases and of being targets of enemy fire. They dealt with horrific wounds caused by shell and shrapnel—loss of limbs, abdominal wounds, severe head injuries and loss of sight, gangrene, frostbite, trench foot, rheumatism, pneumonia & bronchitis and the aftermath of gas attacks as well as infectious diseases such as enteritis, dysentery, typhoid fever, diphtheria, scarlet fever, measles, mumps and influenza; also the psychological effects of war and shell shock. Medical staff and soldiers were plagued with lice which caused much discomfort and which transmitted diseases such as trench fever.  Without constant heating intense cold had to be endured.

Tuesday, 20 October, 6pm. Just leaving Rouen for Boulogne. We have been busy today getting the train ready, stocking dressings etc. All the 500 blankets are sent to be fumigated after each journey, and 500 others drawn instead. And well they may be; one of the difficulties is the lively conditions of the men’s shirts and trousers (with worse than fleas) [lice] when they come from the trenches in the same clothes they’ve worn for five weeks or more. You can’t wonder we made tracks for a bath at Rouen.

Sunday, 25 October (Ypres).—Couldn’t  write last night:  the only thing was to try and forget it all. It has been an absolute hell of a journey. … We had 368; a good 200 were dangerously and seriously wounded, perhaps more. The compound fractured femurs were put up with rifles and pick-handles for splints, padded with bits of kilts and straw; nearly all the men had more than one wound—some had ten..

They were bleeding faster than we could cope with; and the agony of getting them off the stretchers and on to the top bunks is something to forget. All night and without a break till we got back to Boulogne we grappled with them and some were not dressed when we got into Boulogne. The head cases were delirious, and trying to get out of the window, and we were giving strychnine and morphia all round. The outstanding shining thing that hit you in the eye all through was the universal silent pluck of all the men; they stuck it all without a whine or complaint or even a comment.

It took from 4 – 10pm to unload our bad cases and get them into hospitals on motor ambulances; they lay in rows on their stretchers on the platform waiting their turn without a grumble. There have been so many hundreds brought down this week that they had suddenly to clear four hotels for hospitals.

We are now in the filthiest of sidings, and the smell of the burning of our heaps of  filthy débris off the train is enough to make you sick.

Sunday, 15 November. The cold on this train is going to be rather a problem. Our quarters are not heated, but we have “made” (i.e. acquired, looted) a very small oil-stove which faintly warms the corridor, but you can imagine how no amount of coats or clothes keeps you warm in a railway carriage in winter. A smart walk out of doors would do it – I did walk round the train for an hour in the dark and slime in the siding yesterday evening, but it is not a cheering form of exercise. Today it is pouring cats and dogs, awful for loading the sick.

Tuesday, 17 November. 7 A.M. Our load is a heavy and anxious one – 344; we shall be glad to get them safely somewhere. The amputations, fractures, and lung cases stand these journeys very badly.

Thursday, 19 November. Spent the day in a wilderness of railway lines at Sotteville—sharp frost; horizon bounded by fog. This afternoon raw, wet, snowing, slush outside. If it is so deadly cold on this unheated train, what do they do in the trenches with practically the same equipment they came out with in August?

Thursday, November 26th. Loaded up with Indians—full load—bad cases—quite a heavy day; back to Boulogne and unloaded by 9 p.m. and off again at 11.30 p.m.  Three hospital ships were waiting this side to cross by daylight. They can’t cross now by night because of enemy torpedoes. So all the hospitals were full again, and the trains were taking their loads on to Rouen and Havre.

Thursday, December 10th. Left for Bailleul at 8 a.m.  Arrived at 2 p.m. Loaded up in the rain, wounded and sick—full load. They were men wounded last night, very muddy and trenchy; said the train was like heaven! One showed us a fearsome piece of shell which killed his chum next to him. There is a good deal of dysentery about, and rheumatism.

Tuesday, December 15th. We were unloaded last night at 9.30, and reported ready to go up again at 11 p.m., but they didn’t move us till 5 a.m. Went to same place as yesterday, and cleared the Clearing Hospitals again; some badly wounded, with wounds exposed and splints padded with straw as in the Ypres days

The mud and floods are appalling. The Scotch regiments have lost their shoes and spats and wade barefoot in the water-logged trenches. This is a true fact.

Hospital siding in Etaples, France 

Monday, December 21st.—got to Boulogne early this morning. Weather appallingly cold and no chauffage. On way up to Choques, where we will take up Indians again. How utterly miserable Indians must be in this eternal wet and cold.

Wednesday, 23rd.—we loaded up at Lillers late on Monday night with one of the worst loads we have ever taken, half Indians and half British. It was a dark wet night, and the loading people were half-way up to their knees in black mud, and we didn’t finish loading till 2 a.m., and we were hard at it trying to stop haemorrhage &c. ….

Xmas day, 11 a.m.—on way up again to Béthune. Sharp white frost, fog becoming denser as we get nearer Belgium. Everyone on the train has had a card from the King and Queen in a special envelope with the Royal Arms in red on it. And this is the message—“with our best wishes for Christmas, 1914. May God protect you and bring you home safe. MARY R.  GEORGE R.I.”

12 Midnight.—still on the road. We had a very festive Xmas dinner, going to the wards which were in the charge of nursing orderlies between the courses.

Saturday, December 26th.  The V.A.D. [Voluntary Aid Detachment] here brought a present to every man on the train this morning, and to the orderlies. They had 25,000 to distribute, cigarette cases, writing-cases, books, pouches, &c. The men were frightfully pleased, it was so unexpected.

January 3rd.—A sergeant we took down to Havre yesterday told me of his battalion’s very heavy losses. He said out of the 1400 of all ranks he came out with, there are now only 5 sergeants, 1 officer, and 72 men left.

Sunday, January 24th, 5 a.m., Versailles.—They’ve had a pretty good night most of them. If you see any compartment with men showing signs of being near the end of their tether, with bad feet and long hours on the train, you only have to say cheerfully, “How are you getting on in this dug-out?” for every man to brighten visibly and a burst of wit and merriment follows.

Sunday, January 31st. The French instruction books have come, and I am going to start the French class for the men on the train; they are very keen to learn, chiefly, I think, to make a little more running with the French girls at various stopping places.

Wednesday, February 3rd. Beyond Rouen, the honeysuckle is in leaf, the catkins are out, and the woods are full of buds. What a difference it will make when spring comes. On this side it is all canals, bogs, and pollards, and the eternal mud.

Tuesday, February 9th.   …… we have had every kind of infectious disease to nurse in this war, except smallpox. The Infectious Ward is one of mine, and we’ve had enteric, scarlet fever, measles, mumps and diphtheria.

Monday, March 15th. 4.30 p.m.—Just time for a scrawl. The train is packed with wounded,  most of whom are now dead asleep from exhaustion. The clearing hospitals get 800 in at a time, many with no dressings on. I have a boy of 22 with both legs off. He is dazed and white, and wants shifting very often. Forty of them were shelled in their billets.

Wednesday, March 31st. We actually acquired an engine [Sotteville] and got a move on at 4 o’clock this morning, and are now well on the way north. Just got out where we stopped by a fascinating winding river, and got some brave marsh-marigolds.

5 p.m.—Just getting into Boulogne.

 In Boulogne on April 2nd Kate received movement orders “to proceed forthwith to report to the O.C. [Officer Commanding] of No. 4  Field Ambulance for duty”.

The ambulance trains not only transported the wounded to hospitals in the base area but from these to the evacuation ports where hospital ships conveyed them to Britain. Most hospital ships were requisitioned and converted passenger liners. Despite the excellent nursing and medical care many patients died because of their severe wounds. The risk of torpedoes and mines as the ships crossed the channel was very real.

ATTACKS ON VIMY RIDGE and VIMY RIDGE – CONTINUED

May 11th – October 12th 1916

With the 1st Army (Sir Charles Munro)

LETTERS FROM BARLIN

Kate devotes two chapters in Unknown Warriors to Vimy Ridge. Here are some extracts from the early entries:

Thursday, May 11th. Barlin We left St Omer at 2.30 by Motor Ambulance and got here about 4 p.m. The officer driving us had some difficulty finding our C.C.S. but eventually landed us in the right place, where a Field Ambulance used to be. … Now  about the Hospital. It is on two sides of a central lane: Surgical one side, Medical and offices the other. The Surgical Division is a theatre building including a good operating theatre and a large ward for acute Surgicals, and four large Red Cross Huts holding 40 stretchers on trestles each. The Medical consists of four, large airy school rooms, and the Colonel’s Office is a hut in the yard; two small huts are requisitioned for me, one for my office, and one for Red Cross Stores. I am going round with the Colonel to-morrow, and shall then have some idea how best to divide the work. We can take 400 lying-down cases, as we are, and there is a huge attic which can take 400 walking cases if we have a push. We are possibly going to have three more M.O.s and three more sisters … In any case the theatre work will be heavy. We are to begin taking in on Monday, so there is a great deal to do yet, between now and then, as the Field Ambulance occupying the site only left to-day.

Saturday, May 13th. It poured cats and dogs all night and all to-day, and the ground is changed into a thick sea of creamy mud where it isn’t a running stream: and we have been wading in it all day …

Friday, May 19th, 10 p.m. The D.M.S. came to see the Wards to-day and said he never expected to see things so well forward.

Monday 22nd, and a black day. This German intense bombardment and occupation of our front trenches here at Vimy Ridge, and our desperate attempts to get them back have filled all the C.C.S. and all the worst cases have been scurried up to us as the nearest C.C.S. and the Special Hospital for Abdominals and Chests (which we now are).

Tuesday night, May 23rd.  The big ward with beds all round and two lines down the middle is a very sad place – quite full of wrecks. … Then there is an overflow hut with stretchers. … We are rather short of men in the detachment, and when eight have to be taken off to dig graves it doesn’t add to the simplicity of the work. … And violent and desperate fighting is still going on. … a whole line of our front trench has been buried with men in it, under thousands and thousands of shells bursting at once on to it.

 Amidst the horrors of the Great War and the often insurmountable pressure of nursing the wounded soldiers Kate found time to note not only the extremes of weather but the landscape and flora. This love of nature must have lifted her spirits during these stressful times.

 Diary of a Nursing Sister on the Western Front 1914-1915 (ambulance trains)

 Tuesday, November 17th, 1914, 7 a.m. Lovely sunrise over winter woods and frosted country. Our load is a heavy and anxious one – 344; we shall be glad to land them safely somewhere. The amputations, fractures and lung cases stand these long journeys very badly.

Wednesday, 18th November, 5 p.m. This long journey from Belgium down to Havre has been a strange mixture. Glorious country with the flame and blue haze of late autumn on hills, towns, and valleys, bare beech-woods with hot red carpets. Glorious British Army lying broken on the train …

Tuesday, 26th January, 1915. A dazzling blue spring day. As we were not going to load at Rouen till 3 p.m., we went for the most glorious walk. We crossed the ferry over the Seine to the foot of the steep high line of hills which eventually looks over Rouen, and climbed up to the top by a lovely winding woody path in the sun and then took a tram down a very steep track into Rouen. I was standing in the front of the tram for the view over Rouen, which was dazzling, with the spires and the river and the bridges.

Wednesday, February 3rd. Moved on last night, and woke up at Bailleul. Some badly wounded on the train. Beyond Rouen, the honeysuckle is in leaf, the catkins are out, and the woods are full of buds. What a difference it will make when spring comes.

Friday, February 5th, Boulogne. Today has been a record day of brilliant sun, blue sky and warm air, and it has transformed the muddy, sloppy, dingy Boulogne of the last two months into something more like Cornwall. We went in the town in the morning and on the long stone pier in the afternoon. On the pier there were gulls, and a sunny sort of salt wind and big waves breaking, and a glorious view of the steep little town piled up in layers above the harbour, which is packed with shipping.

 Sunday, February 7th, Blendecque. We went for a splendid walk this morning uphill to a pine wood bordered by a moor with whins [gorse]. I’ve now got in my bunky hole on the train (it is not quite six feet square) a polypod fern, a plate of moss, a pot of white hyacinths, and also catkins, violets and mimosa!

Wednesday, March 10th. We got to Étretat  at about 3 p.m. yesterday after a two days and one night load. The sea was a thundery blue, and the cliffs lit up yellow by the sun, and with the grey shingle it made a glorious picture to take back to the train. It had been a heavy journey with badly wounded.

We are now full of convalescents for Havre to go straight on the boat. There are crowds of primroses out on the banks. Our infant R.A.M.C. cook has just jumped off the train while it was going, grabbed a handful of primroses, and leapt on the train again some coaches back. He came back panting and rosy, and, said, “I’ve got something for you, Sister!” I got some Lent lilies in Rouen, and have some celandines growing in moss, so it looks like spring in my bunk.

Thursday, March 11th. We are being rushed up again without being stopped at Rouen. The birds are singing like anything now, and all the buds are coming out, and the banks and woods are a mass of primroses.

Tuesday, March 23rd, midnight.  Have seen cowslips and violets on wayside. Train running very smoothly.

(Kate is posted to No.4 Field Ambulance at Festubert on 2nd April – which she calls “Life at the back of the Front” and has no time to observe landscapes or flora.)

Unknown Warriors: the Letters of Kate Luard, RRC and Bar, Nursing Sister in France 1914-1918.  (Casualty Clearing Stations)

 Tuesday, April 11th, Lillers. 1916.  We had all the acute surgicals out in their beds in the sun to-day in the school yard, round the one precious flower-bed, where are wallflowers and pansies. We went for a walk after tea in the woods, found violets, cowslips and anemones.

Wednesday, April 19th. Orders came yesterday for us to take in no more patients and stand by to move.

Tuesday, May 16th, Barlin. Sister S. and I had another ten-mile ramble to-day. It was again a blue day and the forest was lovely beyond words, full of purple orchis and delicate green and the songs of little birds, and ferns. We tracked up through it over the ridge and down the other side looking over Vimy with a spreading view of a peaceful kind.. We had our tea under some pines …

Saturday, March 17th.1917…. and no sign of any buds out anywhere in these parts. I’ve got a plate of moss with a celandine plant in the middle, and a few sprouting twigs of honeysuckle that you generally find in January, and also a bluebell bulb in a jam tin.

Saturday, April 21st.  No rain for once, and the swamp drying up. Went for a walk and found periwinkles, paigles, anemones and a few violets – not a leaf to be seen anywhere.

Monday, April 30th. We have had a whole week without snow or rain – lots of sun and blue sky. I went for a   ramble after tea yesterday to a darling narrow wood with a stream. Two sets of shy, polite boys thrust their bunches of cowslips and daffodils into my hand. Also banks of small periwinkles like ours, and flowering palm; absolutely no leaves anywhere and it’s May Day to-morrow.

Wednesday, May 9th. And what do you think we have been busy over this morning? A large and festive Picnic in the woods, far removed from gas gangrene and amputations. We had an ambulance and two batmen to bring the tea in urns to my chosen spot – on the slope of the wood, above the babbling brook, literally carpeted with periwinkles, oxlips and anemones. We had a bowl of brilliant blue periwinkles in the middle of the table.

Monday, May 14th. … it was Gommécourt over again but in newly sprung green this time. I think it made the hilly, curly orchards and wooded villages look sadder than ever, to see the blossom among the ruins, and the mangled woods struggling to put their green clothes on to their distorted spikes.

Friday, May 25th. Dazzling weather and very little doing. The woods are full of bluebells and bugloss and stitchwort, and the fields of buttercups and sorrel.

 Friday, June 1st. We are rather full just now. There are fields between woods, snowy with the hugest oxeye daises I ever met, like a field in the Alps in June. Early mornings – high-noons – evenings – nights: all are prefect – we haven’t had one death for nearly a week.

Saturday, August 18th. We’ve had two dazzling days, but as there is not a blade of grass or a leaf in the Camp, only duckboards, trenches and tents, you can only feel it’s summer by the sky and air.

Monday, March 4th, 1918. I’ve got some primroses growing in a blue pot, grubbed up out of a ruined garden in infancy before the snow, now blooming like the Spring. The only way of getting into my Armstrong Hut at first was across a plank over a shell hole. The Royal Engineers are fortifying our quarters against bombs.

Friday, April 12th, Nampes. Orders came for me on Wednesday to take over the C.C.S. in Nampes. Two other sisters came too, and we took the road by car after tea, arriving here at 11 p.m., after losing the way in the dark and attempting lanes deep in unfathomable sloughs of mud. It is an absolutely divine spot, on the side of a lovely wooded valley, south of Amiens. The village is on a winding road, with a heavenly view of hills and woods, which are carpeted with blue violets and periwinkles and cowslips, and starry with anemones. Birds are carolling and leaves are greening, and there is the sun and sky of summer. The blue of the French troops in the fields and roads adds to the dazzling picture, and inside the tents are rows of ‘multiples’ and abdominals, and heads and moribunds, and teams working all night in the Theatre, to the sound of frequent terrific bombardments.

Tuesday, June 4th, 10.30 p.m. The weather continues unnaturally radiant. There is always a breeze waving over the cornfields and the hills are covered with woods near the valleys, with open downs at the top. Below are streams through shady orchards and rustling poplars – and you can see for miles from the downs.

Sunday, June 16th. We emerge about 7.30 from our dug-outs, to a loud continuous chorus of larks, and also to the hum and buzz of whole squadrons of aeroplanes, keeping marvellous V formations against a dazzling blue and white of the sky. The hills are covered with waving corn, like watered silk in the wind, with deep crimson clover, and fields of huge oxeye daisies, like moving sheets. To-day there is no sound of guns and it is all Peace and loveliness.

Wednesday, August 7th, 11.15 p.m. All is ready for Berlin. I’m hoping breathlessly that they hold back my leave to see this through.

One hundred years ago Kate returns from leave to her casualty clearing station in France. Here are some extracts from her book ‘Unknown Warriors’ during January and February 1916:

Saturday, January 15th 1916. 10 p.m. Found everything very quiet when I got back from leave on Wednesday night. They hadn’t taken in all the time. We started taking in yesterday and are pretty full up now … a poor little boy officer, unconscious with his brains blown out was operated on to-day and it was a terrible sight – quite hopeless. Another Black Watch officer with fearful abdominal wounds is slowly recovering.

Sunday, January 16th. The boy with the head wound has been peacefully dying all day; his hand closes less tightly over mine to-day, but his beautiful brown eyes look less inscrutable as he gets farther from this crooked world. His total silence and absolute stillness and unconsciousness have already given him the marble statue look.

Wednesday, January 19th. A padre from the trenches turned up at 11 last night to see the boy, his sister’s only child, but he had been buried that afternoon.

Friday, January 28th. One very nice feature of being here is that one gets to know some children. There are two tiny gamins about three and four, in the slummy alley I go up and down some dozen times a day, who sight one afar off, and immediately ‘line the street’, wherever they happen to be, stiffen themselves with their infant heels clicked together, and fling their little black hands to their little black foreheads, long before and long after one has gone by. They only get washed on Sundays apparently. Then there is a boy of about seven who goes nearly mad when any drilling is going on. He rushes into the line of men and does all the drill, echoing all the words of command with loud yells.

Wednesday, February 2nd. It has set in for a cold spell, and has been freezing since Monday. Coming on the top of dry weather it’s not so bad for the trench people as it is when it catches them with soaked feet. Now they get the braziers going everywhere and brew extra hot drinks, and thaw themselves without getting so wet.

Tuesday, February 15th. It has been pouring cats and dogs for hours, and the streets are rivers of slush and just an hour ago the 1st Division matched in to the front line trenches to relieve the men there.

There is an officer of the 1st Camerons who was brought in to-night with possible pneumonia. He promised his mother never to take off his identity disc, because his brother was killed without his. A dying boy in medical is putting up a tremendous fight.

Tuesday, February 22nd, 10.30 p.m. It has been snowing inches deep all day and now there is a sharp frost and stars, and you tread on crackling slush. It is not the night one would choose to stay out in the garden all night, still less in a trench of any sort – I’m afraid there’ll be some frozen men in the morning.

We are very full everywhere to-night. Last night the Boche made an attack and used gas, after a din of a day of bombardment on both sides.

Thursday, 24th February. The world is still fast bound in frost and snow and we have some very sick men in. The poor boy in the Medical succeeded in dying this afternoon after a hideous illness of a fortnight. ‘The Flying Boy’ is better, thank Heaven. The drip treatment is doing wonders with is leg, and he is getting over the shock.

Monday, February 28th. The Flying Boy is not enjoying himself, it is a bad bit, and it is not over yet: the rest of his leg is to come off on Wednesday, when Capt. R. comes back.

The weather is unmentionable, and the world carpeted with slush.

(The Flying Boy – Lieutenant Malcolm Henderson RFC did not after all need a further operation. Whilst on photographic reconnaissance, his plane had been hit by an anti-aircraft shell and his left leg severed. Once safely landed, he and his observer continued firing at the enemy from a nearby trench whilst under enemy shell-fire. He was awarded the D.S.O. and had many distinguished visitors at the Casualty Clearing Station. He later became an Air Vice-Marshal and was Air Officer Commanding No14 Fighter Group during the Battle of Britain).

EVACUATION OF THE WOUNDED IN WW1

Stationary Hospitals, General Hospitals & Base Area

 Under the RAMC were two categories of base hospital serving the wounded from the Western Front.

There were two Stationary Hospitals to every Division and despite their name they were moved at times, each one designed to hold 400 casualties, and sometimes specialising in for instance the sick, gas victims, neurasthenia cases & epidemics. They normally occupied civilian hospitals in large cities and towns, but were equipped for field work if necessary.

The General Hospitals were located near railway lines to facilitate movement of casualties from the CCS’s on to the coastal ports. Large numbers were concentrated at Boulogne and Étaples. Grand hotels and other large buildings such as casinos were requisitioned but other hospitals were collections of huts, hastily constructed on open ground, with tents added as required, expanding capacity from 700 to 1,200 beds. At first there was a lack of basic facilities – no hot water, no taps, no sinks, no gas stoves and limited wash bowls. The staff establishment was normally thirty four medical officers of the RAMC, seventy two nurses and 200 auxiliary RAMC troops.

Some general hospitals were Voluntary Hospitals supplied by voluntary organisations, notably the Red Cross and St John’s Combined Organisation who ran one at Étaples. In the base areas such as Étaples, Boulogne, Rouen, Havre and Paris, the general hospitals operated as normal civilian hospitals with X-ray units, bacteriological laboratories etc. The holding capacity was such that a patient could remain until fit to be returned to his unit or sent across the channel in Hospital Ships for specialist treatment or discharge from the forces. Some of the general hospitals were handling the treatment of patients until well into 1919; in March 1920 there were still four active medical units in France – one General Hospital, one Stationary and two CCS’s.

Within months of the Americans entering the war in 1917 the medical assistance they had promised the BEF [British Expeditionary Force] began to arrive in France and the first units took over 6 British General Hospitals.

 Although for most of the WW1 Kate Luard served on the Ambulance Trains, in Casualty Clearing Stations and a Field Ambulance- intermittently she worked in various Stationary and General Hospitals in the base area.

Hospital Ships and Military & War Hospitals at home

 Most hospital ships were requisitioned and converted passenger liners. Despite the excellent nursing and medical care many patients died aboard because of their extreme wounds. The risk of torpedoes and mines as they crossed the channel was very real.

On arrival at a British port the wounded were transferred to a home service ambulance train and on to Military and War Hospitals which were divided into nine Command areas.

Note

Not included are numerous people and organisations who were also involved in the evacuation chain. The nursing staff were supplemented by trained BRCS (British Red Cross Society) nurses and by volunteers of the Voluntary Aid Detachment (VAD’s). The VAD’s worked in the general hospitals and in the last two years of the war in stationary hospitals. In the early days of the war there was a Red Cross train and No.16 Ambulance Train was staffed by the Friends Ambulance Unit. The VAD’s with trained Red Cross nurses were also employed right through the war on many railway stations and provided food, drinks, comforts and some first aid facilities.

References

RAMC in the Great War: ‘The RAMC Chain of Evacuation’ www.ramc-ww1.com

Making the Modern World – World War One ‘Processing the Wounded on the Western Front’  www.makingthemodernworld.org.uk

The treatment of Wounded and Sick Soldiers; The Great War WW1 1914-18: ‘The Evacuation Chain’ www.ramsbottomwarmemorialproject.co.uk

QARANC (Queen Alexandra’s Royal Army Nursing Corps) ‘Ambulance Trains’, ‘Hospital Barges’  ‘Hospital ships’  www.qaranc.co.uk

www.scarletfinders.co.uk   excellent reference for all aspects of nursing, ambulance trains and casualty clearing stations in the Great War.

Susan Cohen, Medical Services in the First World War.   Shire Books, 2014

Christine Hallett, Containing Trauma: Nursing Work in the First World War. Manchester University Press, 2009.

Website: www.kateluard.co.uk    Twitter: www.twitter.com/unknownwarriors

EVUATION OF THE WOUNDED IN WW1

From the CCS men were transported en masse in ambulance trains, road convoys or by canal barges to the large base hospitals near the French coast or to a hospital ship heading for England.

Ambulance train (AT)

These trains transported the wounded from the CCS’s to base hospitals near or at one of the channel ports. In 1914 some trains were composed of old French trucks and often the wounded men lay on straw without heating and conditions were primitive. Others were French passenger trains which were later fitted out as mobile hospitals with operating theatres, bunk beds and a full complement of QAIMNS nurses, RAMC doctors and surgeons and RAMC medical orderlies. Emergency operations would be performed despite the movement of the train, the cramped conditions and poor lighting. Hospital carriages were also manufactured and fitted out in England and shipped to France.

In the early trains there was often a lack of passage between the coaches and with only a few nurses it was necessary for a nursing sister to pass from coach to coach, whether the train was in motion or not, usually carrying a load of dressings, medicines etc. on her back in order to tend to the wounded on each coach. During the night she also had a hurricane lamp suspended from her arm. The medical staff consisted of three medical officers of the RAMC including the Commanding Officer, usually a major, two lieutenants, a nursing staff of three or four with a sister taking on supervision of the whole train, complemented by 40 RAMC other ranks and NCO’s [non-commissioned officers].

An average load was 4-500 patients with a large number in critical condition. Often they were transferred to the train still in full uniform in shocking condition caked with mud and blood and owing to the cramped conditions their uniforms had to be cut away. Many journeys were long such as the one from Braisne to Rouen taking at least 2 ½ days. There were deaths on all journeys. The nurses’ workload was heavy and they worked under dangerous conditions with the barest necessities and no comforts.

In Kate Luard’s first book published anonymously in 1915 she vividly describes in her letters home her experiences working on the early ambulance trains 1914-1915 transporting wounded soldiers back from the Front to hospitals in the base area.

Hospital barges

Many wounded were transported by water in hospital barges. Although slow, the journey was smooth and this time allowed the wounded to rest and recuperate. The barges were converted from a range of general use barges such as coal or cargo barges. The holds were converted to 30 bed hospital wards and nurses’ accommodation. They were heated by two stoves and provided with electric lighting which would have to be turned off at night to avoid being an easy target for German pilots. Nurses would have to make their rounds in pitch dark using a small torch. Outside the barges were painted grey with a large red cross on each side with the flag poles flying the Red Cross to signify they were carrying wounded soldiers. The interior was painted white with ventilators in the side roofs and later skylights built in to the barge. There would normally be at least one QAIMNS sister, a staff nurse and RAMC orderly per barge but with a full load of patients an RAMC sergeant, corporal, three nursing sisters, two orderlies, a cook & cook’s assistant. The skipper of each barge was usually a Royal Engineer [RE] sergeant and the barge would be towed by steam tugs.

As the war progressed many soldiers were evacuated straight onto the barges from the trenches and battlefield and were ridden with lice and filthy. Due to the lack of ventilation there were problems with gas attacked patients with the smell of gas remaining on their clothing and breath which caused sickness, sore eyes and breathing problems to the nurses and patients.

Kate Luard mentions hospital barges on many occasions and in May 1915 she assists the staff on a RAMC barge which was packed with all the worst wounded in blood- soaked clothes – two died and more were dying.

Part 4: ‘Hospitals in the base area, hospital ships & hospitals at home to be posted on Friday 13 November

EVACUATION OF THE WOUNDED IN WW1

 Casualty Clearing Station (CCS)

These were the next step in the evacuation chain situated several miles behind the front line usually near railway lines and waterways so that the wounded could be evacuated easily to base hospitals. A CCS often had to move at short notice as the front line changed and although some were situated in permanent buildings such as schools, convents, factories or sheds many consisted of large areas of tents, marquees and wooden huts often covering half a square mile. Facilities included medical and surgical wards, operating theatres, dispensary, medical stores, kitchens, sanitation, incineration plant, mortuary, ablution and sleeping  quarters for the nurses, officers and soldiers of the unit. There were six mobile X-ray units serving in the British Expeditionary Force [BEF] and these were sent to assist the CCS’s during the great battles.  CCS’s were often dangerously vulnerable with large depots containing munitions and supplies alongside which were targeted by enemy aircraft and artillery.

A CCS would normally accommodate a minimum of fifty beds and 150 stretchers and could cater for 200 or more wounded and sick at any one time. Later in the war a CCS would be able to take in more than 500 and up to 1000 when under pressure. In normal circumstances the team would consist of seven medical officers, one quartermaster and 77 other ranks, a dentist, pathologist, seven QAIMNS [Queen Alexandra Imperial Military Nursing Service] nurses and non-medical personnel. Major surgical operations were possible but sadly, men who had survived this far often succumbed to infection. The CCSs were usually in small groups of two or three to enable flexibility: one might treat cases for evacuation by train, ambulance or waterways to the base area, leaving one free to receive new casualties and another was able to treat the sick who could be moved in order to receive battle casualties in an emergency.

Initially the wounded were transported to the CCS in horse-drawn ambulances – a painful journey, and over time motor vehicles or even a narrow-gauge railway were used. Often the wounded poured in under dreadful conditions, the stretchers being placed on the floor in rows with barely room to stand between them. The admissions and evacuations were incessant and almost all that could be done in the time was to feed the patient and dress his wounds. One of the greatest boons was the provision early in 1915 of trestles on which the stretchers were placed. Comforts such as sheets, pillow cases and bed socks were obtained from such organisations as the BRCS [British Red Cross Society]. As the number of casualties grew so the need for experienced staff increased. In the first Battle of Ypres difficulties were highlighted with an influx of between 1,200 and 1,500 casualties in twenty four hours and in the Battle of the Somme of July 1916 there were between 16,000 and 20,000 casualties on the first day of the offensive.  By August 1916 selected CCS’s had as many as twenty five nurses on the staff.

Gas was first used as a weapon at Ypres in April 1915 and thereafter as a weapon on both sides. Patients were brought in to the CCS suffering from the effects and poisoning of chlorine, phosgene and mustard gas among others.

The seriousness of many wounds and infection challenged the facilities of the CCSs and as a result their positions are marked today by military cemeteries.

Kate Luard was posted to a number of CCS’s including one as Head Sister of No.32 CCS which specialised in abdominal wounds and which became one of the most dangerous when the unit was relocated in late July 1917 to Brandhoek to serve the push that was to become the Battle of Passchendaele, and where she had a staff of forty nurses and nearly 100 orderlies.

Part 3: ‘Ambulance trains and hospital barges’ to be posted on Wednesday 11 November

Part4: ‘Hospitals in the base area, hospital ships & hospitals at home’ on Friday 13 November

EVACUATION OF THE WOUNDED IN WW1                        

The First World War created major problems for the Army’s medical services. A man’s chances of survival depended on how quickly his wound was treated. In a conflict involving mass casualties, rapid evacuation of the wounded and early surgery were vital.

Regimental Aid Post (RAP)

The RAMC [Royal Army Medical Corps] chain of evacuation began at a rudimentary care point within 200-300 yards of the front line. Regimental Aid Posts [RAP’s] were set up in small spaces such as communication trenches, ruined buildings, dug outs or a deep shell hole. The walking wounded struggled to make their way to these whilst more serious cases were carried by comrades or sometimes stretcher bearers. The RAP had no holding capacity and here, often in appalling conditions, wounds would be cleaned and dressed, pain relief administered and basic first aid given. The Regimental Medical Officer in charge was supplied with equipment such as anti-tetanus serum, bandages, field dressings, cotton wool, ointments and blankets by the Advance Dressing Station [ADS] as well as comforts such as brandy, cocoa and biscuits.

If possible men were returned to their duties but the more seriously wounded were carried by RAMC stretcher bearers often over muddy and shell-pocked ground, and under shell fire, to the ADS, sometimes via a Collecting Post or Relay Post to avoid congestion.

Advanced Dressing Station (ADS)

These were set up and run as part of the Field Ambulances [FA’s] and would be sited about four hundred yards behind the RAP’s in ruined buildings, underground dug outs and bunkers, in fact anywhere that offered some protection from shellfire and air attack. The ADS did not have holding capacity and though better equipped than the RAP’s could still only provide limited medical care. Here the sick and wounded were further treated so that they could be returned to their units or, alternatively, were taken by horse drawn or motor transport to a Field Ambulance. The Main Dressing Station [MDS] roughly one mile further back did not at first have a surgical capacity but did carry a surgeon’s roll of instruments and sterilisers for life saving operations only.

In times of heavy fighting the ADS would be overwhelmed by the volume of casualties arriving and often wounded men had to lie in the open on stretchers until seen to.

Field Ambulance (FA)

These were mobile front-line medical units for treating the wounded before they were transferred to a Casualty Clearing Station [CCS]. Each Army Division would have three FA’s which were made up of ten officers and 224 men and were divided into three sections which in turn comprised stretcher-bearers, an operating tent, tented wards, nursing orderlies, cookhouse, washrooms and a horse drawn or motor ambulance. Later in the war fully equipped surgical teams were attached to the FA and urgent surgical intervention could be performed to sustain life. By the autumn of 1915 some FA’s had trained nurses posted to them.

In these early stages men were assessed and then labelled with information about their injury and treatments. As in a casualty clearing station, medical officers had to prioritize using a procedure known as triage. Many of the wounded were beyond help; morphia and other pain killing drugs were the only treatment.

During Kate Luard’s first year as a nursing sister in France and Belgium in WW1 she served on the ambulance trains until on 2 April 1915 she received movement orders to report to the Officer Commanding at No.4 Field Ambulance then located at Festubert. This brought her close to the front line and she referred to this in her diary as ‘life at the back of the front’. Here she worked in close contact with an Advanced Dressing Station.

Part 2: ‘Casualty Clearing Stations’ to be posted on Monday 9 November

Part 3: ‘Ambulance trains and hospital barges’ on Wednesday 11 November

Part 4: ‘Stationary and general hospitals in the base area, hospital ships & hospitals at home’ on Friday 13 November

During the Great War of 1914-1918, Kate served principally on ambulance trains, in casualty clearing stations and a field ambulance but was also posted at times to Stationary and General Hospitals in the base area.

Her second book ‘Unknown Warriors’ commences on 17th October 1915 when she was sent up line to take charge of N.6 Casualty Clearing Station at Lillers in France following four months at a base hospital (probably No.16 General Hospital).

In ‘Unknown Warriors’ her letters home 1915-1918 are a record of her time in various casualty clearing stations; which included one as Head Sister at No.32 CCS which became one of the most dangerous when the unit was relocated in late July 1917 to serve the push that was to become the Battle of Passchendaele, and where she had a staff of 40 nurses and nearly 100 orderlies.

Chapter 1 in ‘Unknown Warriors’ is:

WINTER UP THE LINE

October 17th 1915 – April 25th 1916

With the 1st Army (Sir Douglas Haigh)

LETTERS FROM LILLERS

For those of you who wanted to know about Frank and Ellie’s daughter who appears in the photograph with them on the steps at Forton Barracks – here is more about the family.

This photograph was taken in July 1898 seventeen years before Frank was killed in action at Gallipoli on 13 July 1915. He and Ellie had two daughters: Elizabeth (Betty) Francis Clare b.1897 and Joan Anstace de Beauregard b.1899. So the daughter in the photograph is Betty then aged about one year.

Ellie (Eloise) was to suffer another tragedy when Joan died in the influenza epidemic of 1919 losing both her husband and a daughter within four years. Betty married Captain J M Howson RN in 1922 and they had three children a son Richard Montagu, and two daughters Clarissa Juliet b.1924 and Jennifer (Jebber) b.1929 all of whom married. Betty died in 1993 on her 95th birthday.

(I keep in close touch with Juliet, Jebber and one of Betty’s grandsons—Caroline Stevens great-niece to Kate and her brother Frank)

The Portsmouth Battalion were at Forton Barracks, Gosport, when the decision was made to take the Dardenelles. The battalion marched 60 miles to Blandford where Frank wrote to his father on 18 January 1915: “ I march by road with my 30 officers and 1000 men for Dorsetshire—my men are to be lodged and fed by Dorsetshire villagers—a new departure in English rural life.”

On Saturday 27 February 1915 the battalion was paraded in pouring rain, followed by a two hour march to Shillingstone Station, from where 30 officers and 944 other ranks were transported to Avonmouth to board the GloucesterCastle—setting sail on 28 February for the Greek island of Lemnos, arriving there on 11 March. They anchored off Gaba Tepe where they witnessed the shelling of 19 March. They expected to land but instead sailed back to Lemnos where they were diverted to Alexandria. After further problems the battalion landed at Port Said, leaving Port Said on 9 April for Lemnos but were diverted to Skyros. On 28 April 1915 the Portsmouth Battalion was ordered to disembark at Anzac Cove to take over No.2 Section of the defences held by the Australian and New Zealand forces at the Western edge of Lone Pine plateau. The Portsmouth Battalion led by Colonel Luard came under immediate attack. Ordered to relieve the Chatham battalion at Pope’s Hill they came under continuous machine gun fire; and at this point Colonel Luard was hit in the right leg. The cost to the battalion over these initial few days was heavy, ten officers killed and seven wounded, with 98 other ranks killed, 305 wounded and 28 missing.

Back in Gallipoli after having been treated in Alexandria for the wound he had received two months earlier, he wrote to his family in a letter dated July 11th 1915 saying: “We did not go back to the trenches as expected … the men however don’t get much rest as we are digging new communication trenches … We lose a man or two each day as the enemy are shelling where they think we are working … The middle of the day is very hot—too hot for sleep—and pervaded with myriads of flies which cover your food, face and hands. We are in a good deal of trouble with diarrhoea—one part of the treatment is brandy and port …”

Two days after writing this letter Frank was killed in action. According to the official records he ‘died most gallantly at the head of his battalion whilst leading his men’. His grave remains in Gallipoli, his widow Ellie having said: “I wouldn’t take Frank’s body from the field of glory for anything—what could be finer than to lie there where his work was done that day.”

TOC   H   JOURNAL: JULY, 1930

 Very little has ever been said or written about the devoted band of women—a handful of them Foundation Members in their own right—who were the first nurses a wounded man encountered as he came out of the Ypres Salient. Many a man is alive to day because of their ministry, and Talbot House received them, as its only women visitors, with special welcome on their strictly unofficial visits. What their job was and how they did it is best told by one of themselves, and Tubby here commends to us the modest and splendid story.

 IS it an examiner’s fable, or did some schoolboy really say that when Aladdin rubbed his ring a Guinness appeared? The discerning will realise that I am on a holiday in Ireland, where ruins old and recent are far more numerous than they now are in Flanders. There are few Guide-books to South Ireland; so I lived for a fortnight with the only war-book permitted in my luggage, and this quite captured me.

It is the diary of Sister K.E. Luard, R.R.C., one of the six nurses who made their way to Talbot House in Poperinghe. When I first went to France, I found her at Le Trepot, and had the joy of working with her there. Then she went up the line, and specialised in a peculiar post, as dangerous as it was devoted. She had charge of Advanced Casualty Clearing Stations, set up before each battle area in turn; and for the next three years worked nearer to the line than many men, and saved more lives thereby than any one can reckon. Her hospitals in the Salient were at Brandhoek and at Elverdinghe; and both were shelled and bombed—no doubt by accident; for troops and guns and dumps lay all around them. Yet the risk was worth the running; for the presence of her unit with its marvellous equipment and magnificent team-spirit meant that men who would have died of their wounds on a longer journey, were succoured and saved by immediate operations, conducted on the fringe of the battle itself. Miss Luard is the only woman who came down the line to reach Talbot House. Very few surviving men served in more constant danger.

Small mention is made of this in her Diary, though there are glimpses here and there of being “ordered back”, and of winning hesitating consent to the return of herself and her nurses to their forward position, Lord Allenby’s Preface pictures the matter perfectly. The work was indispensable: the danger must be run.

But of the book itself, what can I say which will not mar its meaning? If you would know the truth about these men, here is a witness who disguises nothing. Each page is vibrant with the two great themes—the awful waste of men, the shy splendour that was in them. Here is an eye and pen at work upon the spot: it is no trumped up act of distant recollections. If only all the folk who have spent so much in 1930 in search of the realities of war would mark and read this record, they would be furnishing themselves with the true facts. Here is the evidence of a noble and acute mind, put down without rose spectacles. No one can read it without hating war; no one can read it without a deepened reverence for ordinary men. I trust that it will become a landmark in every Toc H library, and a source of inspiration throughout our membership. Here is a magic key to the spirit in which Toc H was born, that is, the true Active Service spirit in which there is neither pettiness, gossip, nor grumbling; such is the influence of common interest and effort in a crisis long-continued.

The book is wholly free from morbid sentiment; Toc H, for the sake of its own soul, must without more delay, enrich itself with this amazing record.

TUBBY

TUBBY CLAYTON

Rev Philip Thomas Byard Clayton, Anglican Clergyman and the founder of Toc H, was born 1885 in Australia to English parents who returned to England when he was two. He was educated at St Paul’s School, London and Exeter College, Oxford, where he gained a 1st in Theology. He died in 1972.

In 1915 he went to France as an Army Chaplain in the First World War. He and Rev. Neville Talbot opened Talbot House, a rest home for soldiers at Poperinghe, Belgium, known as Toc H (being the signal terminology for T.H. or Talbot House) which was a unique place of rest and sanctuary.

After the war he founded a new Toc H House in Kensington in 1919 followed by others in London, Manchester and Southampton; and travelled throughout the British Empire promoting Toc H. which expressed the spirit and intent of Talbot House.

Kate Luard’s time in the Ypres Salient was clearly an intensely stressful one and the comfort she gained from her visits to Talbot House made a huge impression on her. Kate was one of the first communicants, climbing the steep, almost perpendicular stairs to the tiny chapel built into the roof of the house. Her friendship with its founder Chaplain ‘Tubby’ Clayton outlasted the war and in 1922 she set up, with others, the ‘Toc H League of Women Helpers.’

If you want to know more about Tubby Clayton and Talbot House there is a great deal of information online – Google ‘Tubby Clayton’ or ‘Talbot House, Poperinge’.

 ”Removing the wounded, 60 Yards from the Enemy”                                   

Pencil, watercolour and conte crayon 1918                                                                                        by Harold Sandys Williamson (1892-1978)                                                                             Copyright: Imperial War Museum

 Four British stretcher bearers lift up a wounded man lying on a stretcher from a trench. All the men are exposing themselves to the possibility of enemy fire from the left, towards where the flag bearer looks with concern. They do so in wintry conditions.

 The story behind this picture:

Extracts of letters from the Department of Documents: A letter to his parents, 7 January 1918 -  “I thought it was going to be quite decent on Xmas day, but unfortunately a sad thing occurred about 1 a.m. Captain Brownsword came round visiting. He bent down to drop in my post. I said “Hurry up, get down quick” but unfortunately he was not quick enough; there was a crack & I knew he was hit in the back, & he just toppled down and I caught him with my arms. Then the difficulty, imagine it, of looking after a man of 6 foot 3, in a bit of trench half the width of your kitchen, and no longer; partly filled too with a fire step. I had to sit on the step, and hold him across my knees, while the stretcher bearer dressed him. Our stretcher was broken, & with difficulty we got another, one bearer being shot through the head bringing it …”

“Ultimately we got the Captain on a stretcher on the fire step. Then there was nothing to be done but wait for daylight, being too risky to get him out then, in view of the snow and the bright moonlight, the Germans being as near as 60 yards. It seemed a very long time till 7.30, & we could not keep him warm. I could feel that his arms were just as icy cold as his hands, & feared for his life. When daylight came we put out the Red Cross Flag (a mutual arrangement of that part of the front) & four men being told off for the work, we hoisted the stretcher out of the hole & got him safely away. I heard afterwards that they carried him miles without incident, but only to have him die from exhaustion within sight of the dressing station.”

Kate’s first book ‘Diary of a Nursing Sister on the Western Front 1914-1915′ ends on  May 26th 1915 when she is posted to a Base Hospital.  Her second book ‘Unknown Warriors’ begins on October 17th 1915 ending on August 11th 1918. This is now available in a new edition published in 2014 by The History Press.

Many interesting topics about WW1, in particular related to WW1 nursing, the evacuation of the wounded and Kate’s family will be posted from time to time – these will all be announced on www.twitter.com/unknownwarriors .

No time to write yesterday; had a Clearing Hospital Field day. The left-out-in-the-field wounded (mostly Canadians) had at last been picked up and came pouring in. I had my Tent Section of eighty beds nearly full, and we coped in broiling sun till we sweltered into little spots of grease, finishing up with five operations in the little operating tent.

The poor exhausted Canadians were extraordinarily brave and uncomplaining. They are evacuated the same day or the next morning, such as can be got away to survive the journey, but some of the worst have to stay.

In the middle of it all at 5 P.M. orders came for me to join No.—Ambulance Train for duty, but I didn’t leave till this morning at nine, and am now on the Ambulance Train on way down to old Boulogne again.

Later—These orders were afterwards cancelled, and I am for duty at a Base Hospital.

Kate’s first book ‘Diary of a Nursing Sister on the Western Front 1914-1915’ ends here and her next book ‘Unknown Warriors’ begins on October 17th, 1915.

No entry in Kate’s diary today.

Very few in to-day again. I have only six, and am making the most of the chance to rest in the garden; one doesn’t realise until after the rush how useful a rest can be. There has been a fearful bombardment going on all last night and yesterday and to-day; it is a continual roar, and in the night it is maddening to listen to; you can’t forget the war. Mosquitoes, nightingales, frogs, and two horses also helped to make the night interesting.

8 P.M. Wounded have been coming in, and we’ve had a busy afternoon and evening

In bed—in my tent, not a bell, but an Indian tent big enough for two comfortably which I share. We have nothing but the camp furniture we took out. It is a peerless night with a young moon and a soft wind, frogs croaking, guns banging, and a nightingale trilling.

It has been a funny day, dazzling sun, very few patients.

Things have been happening at a great pace since the above, and we are now in our camp-beds in an empty attic about three miles back.

Just as I was thinking of getting up yesterday evening they began putting shells over into the town, and soon they were raining in three at a time. The orders came to evacuate all the patients. At the French Hospital, about six minutes away, three wounded had been hit in a Motor Ambulance coming in, and the Officers’ Mess had one and they were dropping all round it.

Then the order came from the D.D.M.S. [Deputy Director of Medical Services] to the A.D.M.S. [Assistant Director of Medical Services] to evacuate the whole of the 3 Field Ambulances, and within about two hours this was done. Everybody got the patients ready, fixed up their dressings and splints, gave them all morphia, and got them on to their stretchers. Their [the officers] servants appeared by magic, each with every spot of kit and belongings his officer came in with, and the place was empty in an hour. The din of our guns, which were bombarding heavily, and the German guns, which are bombarding us at a great pace, and the whistle and bang of the shells that came over while this was going on, was a din to remember.

We got to bed about 2 A.M., but slept very little owing to the noise of the guns, which shake and rattle the windows every minute. At about four this morning I heard a nightingale trilling in the garden.

2 P.M. In the Château garden. It is a glorious spot, with kitchen garden, park, moat bridge, and a huge wilderness round it, full of lilac, copper beeches, and flowering trees I’ve never seen before, and birds and butterflies and buttercups. You look across and see the red-brick château surrounded by thick lines of tents, and hear the incessant thudding and banging of the guns, and realise that it is not a French country house but a Casualty Clearing Hospital, with empty—once polished—floors filled with stretchers, where the worst cases still are, and some left empty for the incoming convoys. Over two thousand have passed through since Sunday week. The contrast between the shady garden where I am lazing with innumerable birds singing and nesting, and the nerve-racking sound of the guns and the look of the place inside, is overwhelming

10 P.M. In bed. We have now been temporarily attached to the staff here. I have been given charge here of the Tent Section, which can take eighty lying down.

Last night the rush began to abate. I’ve lost count of how many have died, – I think about twenty-four.

The Guards’ Brigade here went by to-night from the trenches to rest, singing “Here we are again”, and the song about “The girls declare I am a funny man”.

11 A.M. The little Canadian sister has just been recalled, I’m sorry to say. Five Canadian officers came in last night. The guns are making the dickens of a noise, very loud and sudden. Yesterday they shelled the town again.

No entry in Kate’s diary today.

Mr—has been working at full pitch for twenty four hours on end, and had just got to bed when they sent for him there again. They are nearly all dead, and so are the orderlies at both places; but they never dream of grousing or shirking, as they know there’s not another man to be had.

Two more officers died last night, and three more were dying.

-It has been about the worst night of all the worst nights. I found the wards packed with bad cases, the boy of 18 is dead, and the other boy died half an hour after I came on. Two more died during the night, two lots were evacuated, and had to be dug out of their fixings-up in bed and settled on stretchers, and all night they brought fresh ones in, drenched and soaked with clayey mud in spadefuls, and clammy with cold.

Another night of horrors; one more died, and two young boys came in will die; one is a Gordon Highlander of 18, who says “that’s glorious” when you put him to bed. It was a long whirl of stretchers, and pitiful heaps on them. The sergeant stayed up helping to 3, and a boy from the kitchen stayed up all night on his own, helping.

The Boches have been heavily shelling our trenches all day. Our big guns have been making the building shake all night. The Germans are trying to get their trenches back by counter-attacking.

They began coming in at 3.30, and by 8 A.M. the place was full to bursting. We managed to get all the stretcher cases to bed, and as many of the others as we had beds for. There are hundreds more to come in, and the seriously wounded generally get brought in last, because they can’t get up and run, but have to hide in the trenches and shell holes. One man wounded on Sunday and found on Friday night had kept himself alive on dead men’s rations. They were all sopping wet with blood or mud or both.

After breakfast I went to the Cathedral and then boldly bearded the big dressing station at the French hospital, where all the dressings are done and the men evacuated, armed with a huge linen bag of cigarettes, chocolate, and writing cases which came in last night. Every corridor, waiting-room, ward and passage was filled with them, the stretchers waiting their turn on the floors, and the walking cases in groups and queues. No one was fussing, but all were working at full pitch; and very few of the men were groaning, but nearly all were gruesomely covered with blood. And they look pretty awful on the bare gory stretchers, with no pillows or blankets, just as they are picked up on the field. Many are asleep from exhaustion.

What cheered me was one ward full of last Sunday’s bad cases, all in bed, and very cheery and doing well. They loved the writing cases &c.

A great many of this morning’s had already been evacuated, and they were still pouring in. One has to remember that a great many get quite well, though many have a ghastly time in store for them in hospital.

7 P.M. Only one officer has died at the Officers’ Dressing Station to-day, but there are two or three who will die. They have evacuated, and filled up three times already.

Tension up again like last Sunday. Another TAG [The Day] is happening to-morrow. Everyone except three sick downstairs has been evacuated, and they have made accommodation for 1000 at the French Hospital, which is the 4th Field Ambulance main dressing station and headquarters.

Now we have got some French batteries of 75’s in our lines to pound the earthworks which protect the enemy’s buried machine-guns, which are the most deadly of all their clever arrangements. We have also got more divisions along the same front, and all our heavy guns and all our batteries in better positions. Some more regiments have been called up in a hurry, and the empty ammunition-carts are galloping back already.

This morning I took some white lilac to the graves of our 12 officers who died of wounds. Their names and regiments were on their crosses.

10.30 – Just admitted a gunner suffering from shock alone—no wound—completely knocked out; he can’t tell you his name, or stand, or even sit up, but just shivers and shudders. Now he is warm in bed, he can say “Thank you”. I wonder what exactly did it.

The arrangements the 4th Field Ambulance happen to have the use of at the French Hospital, with its up-to-date modern operating theatre for tackling the wounds in a strictly aseptic and scientific way within a few hours of the men being hit, are a tremendous help. But, of course, there are a great many of the seriously wounded that no amount of aseptic and skilled surgery or nursing can save.

There was one more, near enough to make you jump, and a few more too far off to hear the whistling. The sky on the battle line to-night is the weirdest sight; our guns are very busy, and they are making yellow flashes like huge sheets of summer lightening. Then the star-shells rise, burst, and light up a large area, while a big searchlight plays slowly on the clouds.

5 A.M. Daylight—soaking wet, and no more shells since 2 A.M. We have admitted seven officers to-night; the last—just in—says there have been five people wounded in the town by this peppering—one killed. I don’t know if civilians or soldiers.

Nine officers have “died of wounds” here since Sunday, and the tenth will not live to see daylight. There is an attack on to-night. This has been a ghastly week, and now it is beginning again. There is an officer in to-night with a wound in the hand and shoulder from a shell which killed eleven of his men.

Can’t face the graves to-day; have had an awful night; I found the boy who brought his officer in from between the German lines and ours, on Sunday night, crying this morning over the still figure under a brown blanket on a stretcher. Of the other two, brought in from the other dressing station, one only lived long enough to be put to bed and the other died on his stretcher in the hall.

The O.C. [Officer Commanding] said last night, “Now the War has come we’ve got to tackle it with our gloves off,” but it takes some tackling. It seems so much nearer, and more murderous somehow in this Field Ambulance atmosphere even than it did on the train with all the successive hundreds.

We can see Notre Dame de Lorette from here; the Chapel and Fort stand high up in that flat maze of slag-heaps, mine-heads, and sugar factories just behind the line on the right.

9 P.M. Officers Dressing Station. Everything very quiet here. A gunner just admitted says there will probably be another big bombardment to-morrow morning, and after that another attack, and after that I suppose some more for us. It is very wet to-night, but they go up to the trenches singing Ragtime.

11 P.M. Just heard a shell burst, first the whistling scream, and then a bang—wonder where? All the men on the top floor have been sent down to the cellar; another shell has busted. Then  another at 12.15, right overhead.

Slept very well. I hear that they have had a hard day at the O.D.S.; not new cases, but all the bad ones very ill.

My little room is crammed with enormous lilac, white and purple, from our wee garden, which I am going to take to our graves to-morrow in jam tins.

In bed. I went to bed pretty tired this morning after an awful night (only a few of the less seriously wounded had been evacuated yesterday, and all the worst ones, of course left).

The fighting seems to have stopped now, and no more have come in to-day Last night a stiff muddy figure, all bandages and straw, on the stretcher was brought in. I asked the boy how many wounds?  “Oh, only five” he said cheerfully. “Nice clean wounds—machine-gun—all in an out again”!

One of these officers was hit by a German shell on Sunday morning early, soon after our bombardment began. He crawled about till he was hit again twice by other shells, and then lay all that day and all that night, with one drink from another wounded’s water-bottle; everyone else was either dead or wounded round him. Next morning his servant found him and got stretcher-bearers, and he got here.

I don’t know how they live through that.

We have had a night of it. Every Field Ambulance, barge, Clearing Hospital, and train are blocked with them. The M.O.’s [Medical Officers] neither eat nor sleep. I got up early yesterday and went down to the barge to see if they wanted any extra help, and had a grim afternoon and evening there. It was packed with the worst cases—dying and bleeding and groaning. After five hours we had three-fourths of them out of their blood-soaked clothes, dressed, fed, haemorrhage stopped, hands and faces washed, and some asleep. Two died and more were dying.

At 11 P.M. four sisters arrived, two for each barge; so I handed over to them and went to the O.D.S. [Officers’ Dressing Station] to relieve the other two there. The place was unrecognisable: every corner of every floor filled with wounded officers – some sitting up and some all over wounds, and three dying and others critical; and they still kept coming in.

4 P.M.  – In bed. It seems quiet to-day; there are so few guns to be heard, and not so many ambulances coming. All except the hopeless cases will have been evacuated by now.

The Lions are roaring in full blast and lighting up the sky. Have been busy to-night. I hope these magnificent roars and rumblings are making a mess of the barbed wire and German trenches. There seems to be a pretty general opinion that they will retaliate by dropping them into this place if they have time, and pulverising it like Ypres.

5.25 A.M. – It has begun. It is awful – continuous and earthquaking.

Had a busy night, and in every spare second getting ready for the rush. It is to-night they’ll be coming in. Must try and sleep.

This is Der Tag [the day].

I have been cutting dressings all night. One of the most stabbing things in this war is seeing the lines of empty motor ambulances going up to bring down the wrecks who at this moment are sound and fit.

10.30 P.M. Der Tag was a wash-out, but it is to begin at 1.15 to-night. (It didn’t!). The tension is more up than ever.

ay].

The noise is worse than anywhere in London. The din that a column of horse-drawn, bolt-rattling waggons make over cobbles is literally deafening. And the big motor-lorries taking the “munitions of war” up are almost as bad. These processions alternate with marching troops, clattering horses, and French engines all day, and very often all night, and in the middle of it all are the guns. To-night the rifle fire is crackling.

Sir John French and Sir Douglas Haig have been up here to-day, and everyone is telling everyone else when the great Attack is going to begin.

There are three field ambulances up here; one established in a huge school where it runs a great laundry and bathing establishment. A thousand men a day come in for bath, disinfection, and clean clothes; 100 French women do the laundry work in huge tubs, and there are big disinfectors and drying and ironing rooms. The men of the field ambulance do the sorting and all the work except the washing and ironing. And the beautifully-cared-for English cart-horses that belong to the F.A., and the wagons and the motor ambulances and the equipment, are all kept ready to move at a moment’s notice.

My blackbird has laid another egg.

May 7th, 1915. 10 P.M. A pitch black night, raining a little, and only one topic – the attack to-morrow morning.

The first R.A.M.C. [Royal Army Medical Corps] barge has come up, and is lying in the canal ready to take on the cases of wounds of lung and abdomen, to save the jolting of road and railway.

The news to-day of Hill 60 [Flanders, South of Ypres] and the gases is another spur to the grim resolve to break through here. The town, the roads, and the canal banks this morning were so packed with men, waggons, horses, bales, and lorries, that you could barely pick your way between them.

They get awfully sick at the big-print headlines in some of the papers –“The Hill 60 Thrill!” Thrill indeed! “There’s nothing thrilling about ploughing over parapets into a machine-gun, with high explosives bursting round you, it’s mere beastly,” said a boy this evening, who is all over shrapnel splinters.

There is a good lot of firing going on to-night.

Yesterday at 4 A.M., I couldn’t resist invading the garden opposite which is the R.A. [Royal Artillery] Headquarters. It is full of lovely trees and flowers and birds. I found a blackbird’s nest with one egg in. From the upper windows of this place it makes a perfect picture, with the particularly beautiful tower of the Cathedral as a background.

No entry in Kate’s diary on these days.

No entry in Kate’s diary today.

The weather and the evenings are indescribably incongruous. Tea in the garden at home, deck chairs, and Sweep under the walnut-tree come into one’s mind, and before one’s eyes and ears are motor ambulances and stretchers and dressings, and the everlasting noise of marching feet, clattering hooves, lorries and guns, and sometimes the skirl of pipes. One day there was a real band, and everyone glowed and thrilled with the sound of it. I strayed into a concert at 5.30 this evening, given by the Glasgow Highlanders to a packed house of men and officers

We have had some bad cases in to-day, and the boy with the lung is not doing so well.

Here everything is as it has been for the last few days (except for the weather, which is suddenly hot as summer), rather more casualties, but no rush, and the same crescendo of heavy guns.

We have been busy all day, and so have the guns. When the 15-inch howitzers began to talk it was a stupendous noise, like some gigantic angry lion.

The ambulance trains are collecting the Ypres casualties straight from the convoys at Poperinghe, as we did at Ypres in October and November, and not through the clearing hospitals, which I believe have had to move further back.

We have been admitting, cutting the clothes off, dressing and evacuating a good many to-day, and I think they are still coming in.

There is a great noise going on to-night, snapping and popping, and crackling of rifle firing and machine guns, with the roar of our 9.2’s every few minutes.

Two officers were brought in last night from a sap [a deep narrow trench used to approach or undermine an enemy position] where they were overpowered by carbon monoxide. Three of them and a sergeant crawled along it to it to get out the bodies of another officer and a sergeant who’d been killed there by an explosion the day before; it leads into a crater in the German lines, and reaches under the German trenches, which we intended to blow up. But they were greeted by this poisonous gas last night, and the officer in front of these two suddenly became inanimate. All became unconscious in turn, and only these two survived and were hauled out up twenty feet of rope-ladder. They will get all right.

The noise is getting so beastly I must knock off and read ‘Punch’.

A General came round this morning. He said that the Canadians and another regiment had given the Germans what for for this gas-fumes business north of Ypres, got the ground back and recovered four guns. The Germans laid out a whole trench of Zouaves [members of a body of the French Infantry composed of Algerian troops] with chlorine gas. But this afternoon the medical staffs of both these divisions have been trying experiments in a barn with chlorine gas, with and without different kinds of masks soaked with some antidote, such as lime. All were busy coughing and choking when they found the A.D.M.S. [Acting Director of Medical Services] getting blue and suffocated; he was brought in here, looking very bad and for an hour we had to give him fumes of ammonia till he could breathe properly.

On Saturday I shall be going on night duty for a month.

We were watching hundreds of men pass by to-day, whistling and singing, on their way to the trenches.

News came to us this morning of the Germans having broken through the trench lines north of Ypres and shelled Poperinghe, which was out of range up to now, but it is not official.

The guns are very loud to-night.

No entries in Kate’s diary on these days.

It has been another dazzling day. A major of one of the Indian regiments came in this evening. He said the Boches are throwing stones across to our men wrapped in paper with messages like this written on them, “Why don’t you stop the war? We want to get home to our wives these beautiful days, and so do you, so why do you go on fighting?” The sudden beauty of the spring and the sun has made it all glaringly incongruous, and everyone feels it.

No entry in Kate’s diary today.

This afternoon I saw a soldier’s funeral, which I have never seen before. He was shot in the head yesterday, and makes the four hundred and eleventh British soldier buried in this cemetery. The French gravedigger told me there was to be another buried this afternoon. It was very impressive and moving, the Union Jack on the coffin (a thin wooden box) on the wagon, and a firing party, and about a hundred men and three officers and the Padre. It was a clear blue sky and sunny afternoon. The graves are dug trenchwise, very close together, practically all in one continuous grave, each with a marked cross. There is a long row of officers, and also seven Germans and five Indians.

The birds and buds in the garden opposite make one long for one’s lost leave.

10.30 P.M. It is getting noisy again. Some batteries on our right next the French lines are doing some thundering, and there are more star-shells than usual lighting up the sky on the left. They are sent up in the firing line to see if any groups of enemy are crawling up our trenches in the dark. They give a tremendous light as soon as they burst.

This afternoon has been a day to remember. We’ve had our journey up to the firing line, to a dressing station just over half a mile from the first line of German trenches! It is between the two villages of Givenchy and Cuinchy, this side of La Bassée. The journey there was along the long, wide, straight road the British Army knows so well – paved in the middle and a straight line of poplars on each side. As far as you could see it was covered with two streams of khaki, with an occasional string of French cavalry – one stream going up to the trenches after their few days “rest”, and the other coming from the trenches to their “rest”. On the other side we saw one of our own Field Batteries, hidden in the scrub of a hedge. There were also some French batteries hidden behind the embankment. “The German guns are trained always on this road” said our A.S.C. [Army Service Corp] driver cheerfully. They know it is used for transport and troops and often send a few shells on it. Before long we got into the area of ruined houses – and they are a sight! They spell War, and War only – nothing else (but perhaps an earthquake?) could make such awful desolation.

The communication trench has at its beginning a ruined house which is used by the Field Ambulance as one of its advance dressing stations. It is called No.1 Harley Street. Here we got out, and the first person we saw was Sergt. P, who was theatre orderly in No.7 at Pretoria [South  Africa]. The officer in charge showed us all over his place. We went first into his two cellars, where the wounded are taken to be dressed, instead of above, where they might be shelled. Round the front steps is a barricade of sandbags against snipers’ bullets. The officer’s room above the cellars was quite nice and tidy, furnished from the ruined houses, and with a vase of daffodils! The garden at the back has a row of graves with flowers growing on them, and neat wooden crosses with little engraved tin plates on, with the name and regiment.

I saw three small children playing behind the dressing station, where some men unloading a lorry were killed a few days ago. The women and children are all along the road, absolutely regardless of danger as long as they are allowed to stay in their own homes.

The German trenches captured at Neuve Chapelle, and now occupied by us, are full of legs and arms which emerge when you dig. Some are still caught on the barbed wire and can’t be taken away.

We are not being at all clever with our rations just now, and manage to have indescribably nasty and uneatable meals!

There is something quite fiendish about the crackling of the rifle firing to-night, and every now and then a large gun speaks and shakes the town. All leave has been stopped to-day, and there are the wildest rumours going about of a big naval engagement [off the coast of Norway].

These Medical Officers have always hung on to the most hopeless, both here and at the Hospice, beyond the last hope, and when they pull through there is great rejoicing.

This has been a very quiet day, fewer columns, aeroplanes, and guns, and three bad officers holding their own so far. The others come and go.

This afternoon they shelled Beurvy and wounded eleven women and children; the advanced dressing station of No.—Field Ambulance took them in. There was an air battle just above us this evening.

Another officer dangerously wounded was transferred to my ward to-day from the French hospital.

A small parcel of socks, cigs, and chocs came to-day. Soon after, I found the road below was covered with exhausted trench stragglers resting on the kerb, the very men for the parcel. Streams of columns have been passing all day.

Though it is past 11 P.M. the sounds outside are too interesting to go to sleep: the bangs are getting louder; and those who viennent des tranches are tramping down and transport wagons rattling up!

It is difficult to settle down to sleep to-night: the sky is lit up with flashes and star-shells, and every now and then a big bang shakes the house, above the almost continuous thud, thudding, and the barking of the machine-guns and the crackling of rifle firing; they are bringing in more to-day, both here and at the hospice. We had to rig up our day-room for an operation this evening – they have always taken them over to the Hospice, where they have a very swanky modern theatre.

An empty house was found for us on the same square, left exactly as it was when the owners left when the place was shelled. It was filthy from top to toe, but we have found a girl called Gabrielle and she has made a good start on the cleaning to-day. It is my fourth billet here in a week, and Gabrielle and I have made it quite habitable. We are back in our own rugs and blankets again without sheets, and there is no water on yet, but we filled our hot-water bottles at the hospital, and are quite warm and cosy.

When the wind is in the right direction you can hear the rifle firing as well as the guns – and they are often shelling aeroplanes on a fine day. We have two bad cases in to-night.

Letters are coming in very irregularly.

A General and his Staff are coming to this Château to-morrow and we three have got to turn out.

  On Saturday morning they sent three hundred shells into Cuinchy, in revenge for their trench blown up (see to-day’s Communiqué from Sir John French).

We are busy all day admitting and evacuating officers. A very nice Brigade-Major came in, in the night, with a shell wound in the shoulder. This morning a great jagged piece was dug out, with only a local anaesthetic, and he stuck it like a brick, humming a tune when it became unbearable and gripping on to my hand.

I was off at 5 P.M., and went to dig out Marie Thérèse from my old billet to come with me to Beuvry, the village about two and a half miles away that was shelled last week; it is about half-way to the trenches from here. We met and passed an unending stream of khaki, the men marching back from their four days in the trenches, and all steadily trudging on with the same coating of mud from head to foot, packs and rifles carried anyhow, and the Trench Look which can never be described, and which is grim to the last degree. Each lot had a tail of limping stragglers in ones and twos and threes. They said they’d had a very “rough” night last night – pouring rain – water up to their knees, and standing all night expecting an attack which didn’t come off.; but some mines had been exploded meant for their trench but they only got smothered instead of blown to bits.

I was pretty tired when we got back at 8 o’clock, as it was a good five-mile walk, part of the way on fiendish cobble-stones, and we are on our feet all day at the Dressing Station.

I am writing in bed in my lovely little room overlooking the garden. We had a lovely dinner, served by the fat and trés aimiable Marie in a small panelled dining-room, with oak chairs and real silver spoons. So don’t waste any pity for the hardships of War!

 And an officer with a temperature of 103 degrees explained that he had been sleeping for sixteen days on damp sandbags “among the dead Germans”.

Nothing coming in anywhere, but when it does begin we shall get them.

It is a pouring wet day, and the mud is Flanderish. Never was there such mud anywhere else. A gunner-major has just been telling me you get a fine view of the German positions from the Cathedral tower here, and can see shells bursting like the pictures in ‘The Sphere’. It begins to be ‘unhealthy’ to get into any of the villages about three miles from here, which are all heaps of bricks now.

I am leaving my billet to-morrow, as they want us to be in one house. And our house is the Maire’s Chateau, the palatial one, so we shall live in the lap of luxury as never before in this country! And have hot baths with eau-de-Cologne every night, or cold every morning. And the woman is going to faire the cuisine for us, so we shan’t have to wait hours in the café for our meals.

An officer was brought in during the night with a compound fractured arm. He stuck a very painful dressing like a brick to-day, and said to me afterwards “nothing to write home about”.

Yesterday I had a lovely time taking round chocolate Easter eggs to our wounded in the French hospital. The sweetest, merriest Ma-Soeur took me round, and insisted on all the orderlies having one too. They were a huge success.

The service at 7 this morning in the theatre was rather wonderful. Rows of officers and packs of men.

We have been busy on the ward all morning. I’m off 2-5, and shall soon go out and take chocolate eggs to the men in the hospice. The officers have any amount of cigarettes, chocs., novels, and newspapers. This morning on the ward I suddenly found it full of Gold Hats and Red Tabs; three Generals and their A.D.C.’s [Aide-de-Camp] visiting the sick officers.

Have been on duty all day. They are nearly all “evacuated” in a few days, so you are always getting a fresh lot in. At six this morning big guns were doing their Morning Hate very close to us. Two days ago the village two and a half miles south-east of us was shelled.

I found my own new billet this morning before going on duty; it is a very old little house over a shop in a street off the big Place. It is a sort of attic, and I am not dead sure whether it is clean on top and lively underneath, but time will show. The shop lady and her daughter Maria Thérèse are full of zeal and kindness to make me comfortable.

At 8 P.M. the town suddenly goes out like a candle; all lights are put out and the street suddenly empty. After that, at intervals, only motor-cyclists buzz through and regiments tramp past going back to their billets.

We got to Boulogne on Wednesday from Sotteville at 5 P.M., and as soon as the train pulled up a new sister turned up and I began to tackle my six and a half months’ accumulation of belongings. Someone from the Matron-in-Chief arrived with my movement orders “to proceed forthwith to report to the O.C. [Officer Commanding] of No.—Field Ambulance for duty” so hell became heaven, and here I am at railhead waiting for a motor ambulance to take me and my baggage there.

11 A.M. Had an interesting drive here in the M.A. [motor ambulance] through a village packed with men billeted in barns and empty houses – the usual aeroplane buzzing overhead, and a large motor ambulance convoy by the wayside. We are in the town itself, and the building is labelled No.—Field Ambulance Dressing Station for Officers. The men are in a French Civil Hospital run very well by French nuns, and it has been decided to keep the French and English nurses quite separate, so the only difference between the two hospitals is that the one for the men has French Sisters, with R.A.M.C. orderlies and M.O.’s [medical officers] and the other for officers has English Sisters. There are forty-seven beds here (all officers). One Army Sister in charge, myself next, and two staff nurses; I shall have charge of the top floor.

We are billeted out, but I believe mess in the hospital. All this belongs to the French Red Cross, and is lent to us. The surgical outfit is much more primitive even than on the train. The operating theatre is at the other hospital. As far as I can see at present we don’t have the worst cases here, except in a rush like Neuve Chapelle.  It will be funny to sleep in a comfortable bed in an ordinary bedroom again.

Later. – Generals and ‘Red Hats’ simply bristle around. A collection of them has just been visiting sick officers. The Bishop of London is coming round to-day.

Still Good Friday, 10 P.M. –Who said Active Service? I am writing this in a wonderful mahogany bed, with a red satin quilt, in a panelled room, with electric light, and medallions and bronzes, and oil paintings and old engravings, and blue china and mirrors all about. It is a huge house like a chateau, on the Place, where Generals and officers are usually billeted. The fat and smiling caretaker insisted on pouring eau-de-Cologne into my hot bath. And all this  well within range of the German guns. I hadn’t had my clothes off for three days and two nights. This billet is for one night; to-morrow I expect I shall be in some grubby little room near by.

I am not to start work until to-morrow. Troops are just marching by in the dark. Hundreds passed the hospital this afternoon. I must go to sleep.

No entry in Kate’s diary today –

On 2nd April Kate reports for duty at a Field Ambulance. This to her great satisfaction brings her close to the front line and here she will also work in an Advanced Dressing Station.

 A Field Ambulance was a mobile front line medical unit for treating the wounded before they were moved to a casualty clearing station. Each division would have 3 field ambulances which were made up of 10 officers and 244 men. A field ambulance would include stretcher bearers, nursing orderlies, tented wards, operating theatre, cookhouse, washrooms and a horsed or motor ambulance.

 An advanced dressing station (ADS) was a basic care point. It was set up and supplied by the field ambulances but provided only limited medical treatment and had no holding capacity. The walking wounded struggled to make their way here, sometimes  supported by comrades or were brought  by stretcher from the Regimental Aid Post (RAP), which was only a few metres behind the front line, in small spaces such as a communication trench.

 Nurses were rare until in the autumn of 1915 when some field ambulances had trained nurse posted to them.

 The following descriptions from Kate’s diary have been shortened. She titles these entries as ‘LIFE AT THE BACK OF THE FRONT’.

 We actually acquired an engine and got a move on at 4 o’clock this morning, and are now well away north. Just got out where we stopped by a fascinating winding river, and got some brave marsh-marigolds.

5 P.M. – Just getting into Boulogne.

 Sotteville. This cold wind has dried up the mud everywhere, and until to-day there’s been a bright sun with it.

The men clean the train and play football, and everybody swears a great deal at a fate which no one can alter, and we are all craving for our week-old mails.

At Sotteville all day. Piercing cold winds and no heating for a month past.

At Sotteville all day.

 9 P.M.. – There are three trains waiting here at Sotteville. There was a day or two after Neuve Chapelle when the number of wounded overflowed the possibilities of “collection”; the stretcher bearers were all hit and the stretchers were all used, and there were not enough medical officers to cope with the numbers (extra ones were hurried up from the Base Hospitals), and if you wanted to live you had to walk or crawl, or stay behind and die. We had a Canadian on who told me last night that he should never forget the stream of wounded dragging themselves along the road from Neuve Chapelle to Estaires who couldn’t be found room for in the motor ambulances. The “ Evacuation” was very thorough and rapid to the bases and to the ships, but in any great battle involving enormous casualties on both sides there must be some gaps you can’t provide for.

 Moved on at 11 P.M. and woke up at Choques; a few smallish guns going. Loaded up there very early and at two other places, and are now nearly back to Boulogne, mostly wounded and a few Indians; some of them are badly damaged by bombs. According to the men, we shall be busy again at the end of the week.

Midnight. – On way to coast near Havre where one of the General Hospitals is. Passed a place on coast where six hundred British workmen are working from 7 A.M. to 10 P.M. building hospital huts for 12,000 beds, a huge encampment.

Have seen cowslips and violets on wayside. Lovely moonlight night. Train running very smoothly.

 9 P.M. – Waiting all day at G.H.Q. [General Headquarters]; things are unusually quiet. This afternoon saw over the famous jute factory Convalescent Home, where they have a thousand beds under one roof: it is like a town divided into long wards, – dining-rooms, recreation rooms, dressing station, chiropodist, tailor’s shop etc. by shoulder high sailcloth screens; they have outside a kitchen, a boiler, a disinfector for clothes, and any amount of baths. The men looked so absolutely happy and contented with cooked instead of trench food, and baths and games and piano, and books and writing etc. They stay usually ten days, and by the tenth day supposed to be fit enough for the trenches again. A more economical way of treating small disablements than sending them to the Base Hospital.

I had a French class after tea. We are now expecting to-day’s London papers. Have got some Hindustani to learn for my next lesson, so will stop this.

No entry in Kate’s diary on these days.

 The hospitals here have been pretty well emptied now, and are ready for the next lot. Here we have been standing all day while a big committee at Abbeville is settling whether our beloved and beautiful Ambulance Train is to be handed back to the French railway; and if so whether it will be replaced by inferior French carriages, or whether one of four new British trains that are coming will be handed over to us, or whether all the personnel will be disbanded and dispersed.

I have been for five walks to-day, including a bask in the sun on the sands, and a bath at the Club and a visit to the nice old R.C. church and the flower market.

 On the way down. Woke up at Bailleul, and loaded early wounded and sick. Not such severe cases amongst the wounded, but several pneumonias, enterics [see 8th March], etc., besides measles, diphtheria, and scarlet fever.

Very cold windy day, with snow on the ground and showers of snow at intervals.

Some of N.’s regiment were badly caught between two ruined houses, each containing Maxims [heavy automatic machine guns] and machine guns. They had just been reinforced by some young recruits of K’s [Kitchener’s] Army. “They come on well, them youngsters”, said an old soldier, “but they got terrible mowed down. We lost nine officers in a quarter of an hour”. One officer on the train has fourteen wounds.

 We have had an off-day to-day at the place of woods and commons, which I hope and trust means that things are slackening off. We had a heavenly ramble this morning, and found blue periwinkles and anemones in the wood but no primroses. Lots of palm and gorse. Robins, willow-wrens, and yellow hammers were singing.

We also had home-made bread and butter to-day out of the village, which caused more excitement than the Russian successes.

 On the way down a little Gurkha happened to get off the train for a minute, and when he looked round the train had gone past him. He ran after it, and perched on one of the buffers till the next stop, when he re-appeared trembling with fright, but greeted with roars of amusement by the other Gurkhas.

We woke this morning at Merville, one of the railheads for Neuve Chapelle, and loaded up very early – guns going as hard as ever. Mine were a very bad lot, including some brave Canadians. They kept me very busy till the moment of unloading, which is a difficult and painful business with these bad ones; but the orderlies are getting very gentle and clever with them. I had among them eight Germans, several mere boys. One insisted on kissing my hand, much to the orderlies’ amusement.

(A truckful of pigs outside is making the most appalling noise. 11 P.M. I am writing in bed. We generally move up about 11.30 P.M.)

Every journey we hear thrilling accounts, rumours and forecasts, most of which turn out to be true. The hospitals at Boulogne are so busy that no one goes off duty, and they are operating all night.

In all this rush we happen to have had nights in bed, which makes all the difference. The pigs still squeal, but I must try and go to sleep.

We loaded up very early this morning with 316 Indians, and are just getting into Boulogne. I expect we shall be sent up again this evening.

 2.30 A.M. Woke up just as we arrived at Bailleul to hear most incessant cannonade going on I ever heard, even at Ypres. The sky is continually lit up with the flashes from the guns – it is a pitch-dark night – and you can hear the roar of the howitzers above the thud-thud of the others. Must try and sleep now, as we shall have a heavy day to-day.

4.30 P.M. – Just time for a scrawl. The train is packed with wounded, most of whom are now dead asleep from exhaustion. The British Army is fighting and marching all night now. The Clearing Hospitals get 800 at a time, many with no dressings on.

I have a boy of 22 with both legs off. He is dazed and white, and wants shifting very often. Forty of them were shelled in their billets. We also have mumps, measles, scarlet fever, and diphtheria in the infectious coach.

10 P.M. – Just got them all off after a strenuous day, and we are to go up again at 11 P.M. It is just as well that this department was prepared for this, as it all goes like clockwork and an enormous amount of suffering is saved. The amount that cannot be saved is grim enough.

Must go to bed.

 4 P.M. Just bringing down another load. I have a hundred and twenty wounded alone; the train is packed. No time for more – the J.J.’s [lice] are swarming.

We unloaded at B. yesterday evening, and were off again within an hour or two.

 We woke at the rail-head for Béthune this morning, and cleared there and at the next place, mostly wounded and some Indians.

It was frightfully interesting up there to-day; we saw the famous German prisoners taken at Neuve Chapelle being entrained, and we could hear the bombardment going on – the biggest ever known in any war. The feeling of Advance is in the air already, and even the wounded are exulting in it.

We are on our way down now, and shall probably unload at B. No time for more now.

11 P.M. We unloaded at B. by 10 P.M., and are now on our way up again; shortest time we’ve ever waited – one hour after the last patient is off. The A.T.’s [ambulance trains] have been tearing up empty and back full all day.

They were an awfully brave lot of badly woundeds to-day, but they always are. A man of mine with his head shattered and his hand shot through was trephined [see 8th March] last night, and his longitudinal sinus packed with gauze. The next time he woke – later on with great difficulty he gave me the address of his girl, to whom I am to write a post-card. I do hope they’ll pull him through.

We came straight through Boulogne in the night, and have been stuck half way to the Front all day; I don’t know why.

 Yesterday we took a long time getting to the ship from Rouen, and unloaded at 10 P.M. Why we had no warning about the departure of the train (and so nearly got left behind) was because it was an emergency call suddenly to clear the hospitals at R. to make room for 600 more expected from the Front.

We are being rushed up again without being stopped at Rouen for the first time on record, so I suppose there is a great deal doing. (There was – at Neuve Chapelle).  It is a comfort to remember that the men themselves don’t grudge or question what happens to them, and the worse they are wounded the more they say, “I think I’m lucky; my mate next to me got killed”.

The birds are singing like anything now, and all the buds are coming out, and the banks and woods are a mass of primroses.

 We got to Étretat at about 3 P.M. yesterday after a two days’ and one night load, and had time to go up to the hospital.

The sea was a thundery blue, and the cliffs lit up yellow by the sun, and with the grey shingle it made a glorious picture to take back to the train. It had been a heavy journey with bad patients, and we were rather tired, so we didn’t explore much.

We woke at Sotteville near Rouen this morning. We are now full of convalescents for Havre to go straight on the boat.

There are crowds of primroses out on the banks. Our infant Officer’s Mess cook (a boy of about twenty, who looks sixteen) has just jumped off the train while it was still going, grabbed a handful of primroses and leapt on to the train again some coaches back. He came back panting and rosy, and said, “I’ve got some for you, Sister!” I got some Lent lilies in Rouen, and have some celandines growing in moss, so it looks like spring in my bunk.

 We are passing through glorious country of wooded hills and valleys, with a blue sky and shining sun, and all the patients are enjoying it. It is still very cold and there is a little snow about. They call their goatskin coats “Teddy Bears”.

 On way down to Étretat, where a GeneralHospital is, which we shall reach to-morrow about tea-time. A load of woundeds this time; very busy all day till now (midnight), and haven’t had time to hear many of their adventures. They seem to all come from a line of front where the Boches are persistently hammering to break through. We heard guns all the while we were loading. A dressing-station five miles away had just been shelled, and a major, R.A.M.C. [Royal Army Medical Corps], killed and two other R.A.M.C. officers wounded.

I have a man wounded in eight places, including a fractured elbow and a fractured skull, which had to be trephined [a trephine is a surgical instrument used to remove a circular area of tissue e.g. bone]. He was one of nineteen who were in a barn when a shell came through the roof and burst inside, spitting shrapnel bullets all over them; all wounded and one killed.

Later. – Just time for a line before I do another round and then call my relief. It is an awfully cold night.

 We are stuck in the jolly place close to G.H.Q. [General Headquarters], but can’t leave the train as there are no orders. I’ve been having a French class, with the wall of the truck for a blackboard, and occasional bangs from a big gun somewhere.

 Instead of being called at 2 for duty, was called at 1, as they unloaded us at that hour.

Last night we pulled up at Hazebrouck alongside a troop train with men, guns, and horses just out from the Midlands. Two lads in a truck with their horses asked me for cigarettes. Luckily, thanks to the Train Comforts Fund’s last whack, I had some. One said solemnly that he had a “coosin” to avenge. They both had shining eyes, and not a rollicking but an eager excitement as they asked when the train would get “there”, and looked as if they could already see the shells and weren’t afraid.

 5 P.M. On way down from Chocques – mixed lot of woundeds, medicals, Indians and Canadians. I have a lad of 24 with both eyes destroyed by a bullet, and there is a bad trachy.

Nothing much has been going on, but the German shells sometimes plop into the middle of a trench, and each one means a good many casualties.

10 P.M. We’ve had a busy day, and are not home yet. My boy with the dressings on his head has not the slightest idea that he’s got no eyes, and who is going to tell him? The pain is bad, and he has to have a lot of morphia, with a cigarette in between.

We shall probably not unload to-night, and I am to be called at 2 A.M.

The infectious ward is full with British enterics [gastrointestinal disease], dips [diphtheria], and measles, and Indians with mumps.

No entry in Kate’s diary today.

There is not a great deal to do or see here, especially on a wet day.

No entry in Kate’s Diary on these days.

9 P.M. Hotel in Boulogne. - All efforts to get my seven days’ leave have failed, as I thought they would.

 We loaded up this morning with a not very bad lot (mine are all sitters except for some enterics [gastrointestinal disease], a measles and a diphtheria), and are on our way down again.

 Moved up to the place with the moor during the night. Glorious, clear, sunny morning. Couldn’t leave the train for a real walk as there were no orders.

9 P.M. – The ways of French railways are impenetrable: in spite of orders for Bailleul before lunch, we are still here. This is the fourth day with no patients on – the longest “off” spell since before Christmas.

 We have been all day in Boulogne, and move up at 8.15 this evening, which means loading up after breakfast and perhaps unloading to-morrow evening. It has given one of the Sisters another day to recover from her attack of influenza.

No entry in Kate’s diary today.

 We got a short walk yesterday evening after unloading at Rouen. There was a glorious sunset over the bridge, and the lights just lighting up, and Rouen looking its beautifulest. We slept at Sotteville.

The lengthening days and better weather are making a real difference to the gloom of things, and though there is a universal undercurrent of feeling that enormous sacrifices will have to be made, it seems to be shaping for an ultimate return to sanity and peace. It is such a vast upheaval when you are in the middle of it, that you sometimes actually wonder if everyone has gone mad, or who has gone mad, that all should be grimly working, toiling, slaving, from the firing line to the base, for more Destruction, in order to get Peace. And the men who pay the cost in intimate personal and individual suffering and in death are not the men who made the war.

No entry in Kate’s diary today.