Dorothy's Report

Outline of the Life and Work of Sisters at Casualty Clearing Stations in France

Life and work of a Casualty Clearing station takes the Sister out of the ordinary routine of Hospital life in an instant; she is given a charge where the success of the ward must depend upon her own initiative and resource.

Before the retreat of March 21st 1918 the Casualty Clearing Stations in the front area had become well established and wonderfully equipped, they might indeed have been regarded as Stationary Hospitals near the front. They had remained stationery for some period, clearing stations thought they were. In slack times the patients would be retained to utilise the accommodation and ease any pressure of work at the Base. It would be remembered that at all times in a Clearing Station the seriously wounded patients were never evacuated unless passed by the Medical officer as fit to travel.

The ambition of almost every Sister at the Base was to be sent for duty at a Casualty Clearing Station. When they came it was noticeable that a certain few were disappointed; they had never realised that the work was strenuous as to routine and as to off-duty time frequently curtailed; that the C.C.S. was probably in a devastated area, very romantic to think of, but in reality ‘dull’ and heavy. There was a social blank outside the work. The sordid side, the endless stream of wounded men, the depressing atmosphere of unsatisfactory news from the line, the mud and cold, the noise of the guns, and nightly bombing preyed on their nerves and they were not happy. But as for the majority there was never a happier set of whole-hearted strenuous workers. Individualities were called out, and they exercised a different line of thought to that which they had been accustomed. There was ample scope for originality and initiative, the frame-work of ordinary Hospital routine had to be used as a background for guidance but could never be adhered to. Character once given scope for responded to new aspects of work; the results of these efforts were excellent and the community was bright and cheerful withal.

The relationship between the Sisters and the Medical Officers had a tone of comradeship; moreover, working with our sisters from Australia, United States, South Africa, New Zealand and Canada broadened our ideas, perhaps we learnt to find our level.

Everybody knows the awful tales of March 31st. 1918 and the dreadful week that followed. I would like to recall one instance out of the Kaleidescopic events of that week. Two Casualty Clearing Stations which had been doing back area work all the winter suddenly found themselves most terribly in the front area. Sisters arrived from various clearing stations, which had already had an awful tale of hurried evacuation, until as many as 83 were there working amongst the wounded. It was quite impossible to cope with the enormous number of patients who were pouring in, the severity of their wounds was terrible. The attitude of those heroic men can never be forgotten with their warm appreciation for the very little which could be done and their expressed concern for the sisters. The road was one stream of our guns and retreating troops, the sky filled with German bombing planes, the thundering noise of the German guns getting louder and obviously nearer; first shells bursting everywhere around, and then over our heads as the Germans advanced nearer; the untold awfulness in the atmosphere called for supreme endurance, and the grim picture of those suffering men, utterly heroic comes visibly before one’s eyes.

Of all the 83 Sisters each one was at her post, no sign of fear was visible on any face, there was a splendid grandeur about them which can never be recorded. The wounded, in all some 7,000, were overflowing the tents and were occupying a large area in the field.

With no transport by road or rail available for evacuation, telephone wires cut and no communication, the tension and sense of being abandoned was at its height, when the Matron-in-Chief arrived in her car, which had nearly been shelled before reaching the hospital. With her arrival came the sense of security and hope, she took two Sisters in her own car and as she went away instinctively the feeling prevailed that somehow or other the danger of being taken prisoner would be averted.

Work in a Casualty Clearing Station after the awful retreat was more of the definitely clearing station type, constantly moving and setting up again as the armies advanced, with reduced equipment after the various adventures of March 21 to 31.

With the masses of wounded it was often difficult to realise that at last we were on the way to victory; without this thought the sustained effort necessary could hardly have been maintained. The conditions as such were an uncomfortable make-shift. The weather was often bad. Marquees had to be converted into wards while still being pegged down, the ground bare even of tarpaulin. Yet the patients never lacked the utmost skill that the experience of war surgery and nursing could contribute. The bell tents occupied as quarters for Medical Officers and Sisters were dug in; when it rained there was no opportunity of getting dry, the tents being struck and restruck so frequently made the term ‘water-tight’ inapplicable. The barrages would be intense, the bombing a nightly horror, the immediate vicinity frequently shelled. Theatre teams developed to the acme of usefulness would be hurriedly moved to the severest point on the fighting line, five to seven tables would be in continuous work with 16 hours on duty and 8 hours off. There is the splendid knowledge that although no luxuries were forthcoming, the patients had all that precisely skilled surgery and treatment could effect to save lives and limbs as the case might be.

The picture is drawn purposely rather than from a Sister’s point of view, the bare outline are given, so much more might be said of the nature of the work. The impression left as a whole is that of a strenuous and grim life with an undefined and delightful sense of good comradeship between Medical officers, Sisters and orderlies, and the satisfaction that as a result, in spite of everything, the best work was accomplished and the best in the individual was strengthened.

Who can say how much of this spirit was infused and inspired by our Matron-in –Chief, whose individuality and enthusiasm struck the key note and evoked nothing but the best from each and all.

D.P. Foster
Sister T.F.N.S.
August 1919