The Third Battle of Ypres saw many heroic acts, by our brave soldiers, but equally important by our nursing staff too. The following short excerpt, taken from Professor Christine Hallett’s book Nurses of Passchendaele: Caring for the Wounded of the Ypres Campaigns, 1914-1918 provides a fascinating glimpse into the many acts of heroism that took place during this brutal campaign, and the reason that our original volunteers were inspired to found the League of Remembrance.
“THE NURSES OF PASSCHENDAELE” – PROFESSOR CHRISTINE HALLETT PhD
In preparation for the assault that was to be known as the ‘Third Battle of Ypres’, the bed capacities of casualty clearing stations (CCSs) close to the so-called Ypres Salient were increased. New CCSs were established and patients not requiring immediate surgery were evacuated to base hospitals in France. It was already quite common for individual CCSs to specialize in particular types of wounds: abdominal or chest wounds, limb fractures or head injuries. There were even special units for cases of shell-shock and for patients with self-inflicted wounds.
Medical science had been struggling to keep pace with advances in industrial weaponry. The experiences of the previous two and a half years had taught senior medical officers and nurses that speed was a key element in the treatment of traumatized casualties. If wounded men could be stabilized quickly they were less likely to be overwhelmed by wound-shock. Haemorrhage must be stemmed, fluid must be pumped through wide-bore needles into the soft tissues beneath the skin of the axillae and groins and morphine, anti-tetanus serum and stimulants must be injected into the muscles. Some of this work could be done in a regimental aid post, but most of it had to wait until the patient reached a casualty clearing station. The work was intricate, demanding immediate one-to-one attention, yet everyone knew that during the assault, patients would arrive in rushes several hundred at a time – unloaded from convoys of ambulances until the floors of reception huts were thickly covered with narrow stretchers.
In July 1917, No. 32 British CCS, where Kate Luard, a highly experienced Queen Alexandra’s Imperial Military Nursing Service Reserve Sister was in charge, was moved to Brandhoek, about three miles from the front lines. No. 44 British CCS was also moved forward; one of its sisters, Yorkshire nurse, Minnie Wood, had just been promoted to sister-in-charge.
Australian nurse, May Tilton, was transferred to No. 3 Australian CCS in July. As June 1917 opened, the Allies were finalizing plans for the Ypres campaign. The opening battle captured the Messines Ridge, a long rim of raised land to the south-east of the city. Just before 3 a.m. on 7 June, more than 20 ammonal-packed devices in mines beneath the ridge and nearby lower-lying hills were detonated, creating a series of explosions so immense that they were felt and heard in London. In their bell tents in CCSs within ten miles of the lines, sleeping nurses woke in shock as the ground shook beneath them. They knew they could soon expect to receive enormous numbers of casualties. In reception huts and resuscitation wards, fully trained nurses moved from patient to patient prioritizing the work, stabilizing waiting men by warming them with blankets and gas heaters, and pushing fluid into their bodies. Patients were rehydrated as rapidly as possible, using sterile saline solution or colloid preparations made from ‘gum Arabic’, a natural compound produced from the sap of the acacia tree. Some of the earliest techniques for blood transfusion were also adopted.
Nurses arriving at CCSs found their first experiences of being under shellfire both fascinating and terrifying. Shell after shell flew overhead towards Allied artillery emplacements. The bombardment seemed to form a peculiar pattern: first came the faint boom, and the suspense of waiting, knowing that a shell had been fired; this was followed by a distant whine as it began to approach; then the whine became a scream, which amplified and intensified as the shell drew nearer; next came the deafening crash and the shaking of the earth beneath one’s feet, as it landed; finally, the zip and whizz of splinters, as shrapnel and shell fragments of many sizes tore through the air in all directions.
Nurses were becoming adept at the work of triage: assessing their patient’s needs. Those most in need of life-saving surgery – including those with smashed limbs from which large vessels were still leaking blood, torn abdominal and chest walls, and heads in need of trepanning to relieve pressure on damaged brains – were sent straight to theatre, until the floors outside operating rooms became as crowded as those of reception huts. Surgeons worked steadily through multiple operations, supported by theatre nurses, anaesthetists and orderlies.
One of the most horrifying elements of the Third Battle of Ypres was the use, for the first time, of mustard gas, or dichlorethyl sulphide – the ‘new gas’ that was to become so familiar to staff throughout the lines of evacuation. Stealthy in its action and terrifying in its effects, mustard gas burned any piece of skin or mucous membrane it touched – including the tissues of the airways and lungs, and the walls of the gut.
Men were given morphine to relieve their agony, and oxygen was administered through masks to ease their laboured breathing – but many pushed the masks away in desperate attempts to gain more fresh air. Persuading them to take the oxygen required a skill and tact that was difficult to muster after a sleepless night, when one was so exhausted that it was difficult to talk at all. Many patients were on the edge of collapse; they were prescribed stimulants, which nurses injected into their muscles through carefully sterilized and sharpened needles. All gas-damaged eyes were protected by pads soaked in bicarbonate of soda; nurses circled the wards constantly, removing these and bathing the gluey and inflamed eyes beneath. They tried to reach each patient every two hours – but found themselves racing against time.
As bombing raids increased, CCSs became more vulnerable. By 1917 specially designed ‘Gothas’, each of which could carry over 500 kilograms of bombs, were being used. May commented that the experience was
“More terrifying than anything we had yet known. The explosion was terrific in its unexpectedness, like a frightful peal of thunder, and was followed by a rain of shots from our archies [anti-aircraft guns]. Hardly had we recovered from the shock, than there was another ear-splitting explosion nearer. They came again at 10pm, and all through the night peppered us with bombs, though none fell directly on our camp … It was terrifying lying in bed, expecting every minute to be blown to pieces … I could not control the violent trembling of my legs. My knees positively knocked together. I could laugh at myself, but I could not stop the trembling”.
On Monday 20th August May Tilton, and her friend, Emma Slater, came off night duty ‘almost dropping with fatigue’. Around 10 a.m. a squadron of Gothas came over Brandhoek. Two bombs exploded close to the hospital compound, where staff nurse Elizabeth Jane Eckett, who was in charge of the one of the wards, was doing her morning round. A piece of shrapnel just missed a night sister getting into bed, and several shards ripped through the canvas walls of Elizabeth Eckett’s ward. For her courage that day Elizabeth Eckett was awarded the Military Medal. Her citation described how: ‘although the ward was twice riddled by enemy aircraft, she continued attending the patients, and by her example prevented many of them from injuring themselves’.
In No. 3 Australian CCS Alice Kelly ran to her ward sluice, grabbed a supply of enamel washbasins, placed one over the head of each patient to protect them from flying shrapnel and then stood in the middle of the ward encouraging and reassuring them. She, too, was awarded the Military Medal, along with the Royal Red Cross.
Minnie Wood ran to her own sisters’ bell tents, to find Nellie Spindler still lying where she had fallen asleep an hour earlier – now awake, shocked and bleeding profusely. Several medical officers arrived, but even as matron and doctors struggled to stem Nellie’s bleeding, they knew she had no chance of survival. A piece of shell casing had ripped through her body from back to front, just below the level of her heart, tearing at least one major blood vessel, and releasing a catastrophic haemorrhage. All Minnie could do was hold Nellie in her arms as the young nurse lost consciousness. Twenty minutes later the twenty-six-year-old staff nurse, who had struggled all night to save the lives of her patients only to become, herself, a target for enemy shellfire, was dead. Her body was taken to Lijssenthoek, near Remy Siding, where it was later interred.
Minnie Wood achieved the evacuation of her nurses with great rapidity. She was later awarded the Military Medal, her citation describing how ‘this lady never lost her nerve for a moment and during the whole of a most trying day, carried out her duties with the greatest steadiness and coolness. Minnie later wrote later to Nellie Spindler’s parents:
“Before you receive this letter I expect you have heard of your great loss. I don’t know what to say to you, for I cannot express my feelings in writing, and no words of mine can soften the blow. There is one consolation for you; your daughter became unconscious immediately after she was hit, and she passed away perfectly peacefully at 11.20am – just twenty minutes afterwards. I was with her at the time, but [after] the first minute or two she did not now me. It was a great mercy she was oblivious to her surroundings, for the shells continued to fall in for the rest of the day