Lindsey Fitzharris - The Facemaker: A Visionary Surgeons Battle to Mend the Disfigured Soldiers of World War I

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To my dad, Mike Fitzharris, who has always believed in me, even when I did not believe in myself

He would show himself to the little guys and to their mothers and fathers and brothers and sisters and wives and sweethearts and grandmothers and grandfathers and he would have a sign over himself and the sign would say here is war and he would concentrate the whole war into such a small piece of meat and bone and hair that they would never forget it as long as they lived.

Dalton Trumbo, Johnny Got His Gun

Only the dead have seen the end of war.

George Santayana, 1922

A significant challenge for any nonfiction writer is not to overwhelm the reader with too many detailssomething that is easily done when charting the immense scale of events that took place between 1914 and 1918. This book is by no means a definitive history of plastic surgery during the First World War. Nor is it a comprehensive biography of Harold Gillies, the surgeon who dedicated himself to rebuilding the faces of soldiers maimed during that time. For that, there are many articles and books written by scholars who have devoted their entire careers to these subjects, as my endnotes will attest. Rather, what follows is an intimate account of the daily struggles Gillies and his team faced at the Queens Hospital, as well as the men who suffered the double trauma of injury on the battlefield and the painful process of recovery.

In their own time, disfigured soldiers were often hidden from public view. The decision to include their photographs in this book was not made lightly. I consulted various experts, including a disability activist with a facial disfigurement. The photos are undoubtedly graphic, and many people will find them difficult to view. But it is impossible to grasp the severity of these mens injuries and the reactions they elicited without seeing their faces. Equally, it is hard to appreciate fully the skill with which Harold Gillies and his team reconstructed soldiers faces without seeing the surgical progress chronicled in these photographs. However, there is an exception: I have not included pre- or post-operative images of injured men who died in Gilliess care, as their reconstruction was never completed.

It bears stressing that this is a work of nonfiction. Anything placed between quotation marks comes from a historical documentbe it a letter, diary, newspaper article, or surgical casebook. Any descriptive references to gestures, facial expressions, emotions, and the like are based on firsthand accounts.

It is my hope that through the telling of this tale, readers will gain a new perspective on the terrible consequences of trench warfare, and the private battles that many men fought long after they put down their rifles.

NOVEMBER 20, 1917

Brilliant shards of crimson and gold pierced the eastern sky as dawn broke over Cambrai. The French city was a vital supply point for the German army positioned twenty-five miles from the Belgian border. On the dewy grass of a nearby hillside, Private Percy Clare of the 7th Battalion, East Surrey Regiment, was lying on his belly next to his commanding officer, awaiting the signal to advance.

Thirty minutes earlier, he had watched as hundreds of tanks rumbled over the soggy terrain toward the wire entanglement surrounding the German defense line. Under the cover of darkness, British troops had gained ground. But what had the appearance of a victory soon deteriorated into a hellish massacre for both sides. As Clare prepared himself for this dawn attack, he could already see the motionless, broken bodies of other soldiers scattered across the blasted landscape. I rather wondered if I should even see another sun rise over the trenches, he later recorded in tightly lettered script in his diary.

The thirty-six-year-old soldier was no stranger to death. A year earlier, he had been holed up in the trenches of the Somme, where tedious stretches of inactivity were punctuated by frenzied bouts of terror. Every few days, wagons arrived to exchange rations for corpses. But the sheer number of bodies made it impossible to keep up. They lay in trenches where theyd fallen, one soldier remembered. Not only would you see them, but youd be walking on them, slipping and sliding.

These rotting bodies became structural fixtures, lining trench walls and narrowing passageways. Arms and legs protruded out of the breastwork. Corpses were even used to fill in blasted roads that were essential for military vehicles. One man recalled that they just shovelled everything into the crater and covered it over [with] dead horses, dead bodies anything to fill up and cover it over and keep the traffic going. Common decencies were abandoned as burial parties tried to keep pace with the body count. The dead hung like laundry over barbed wire, covered inches deep with a black fur of flies. The worst, remembered one infantryman, was the bubbling mass of countless worms which oozed from the corpses.

The horror of these sights was exacerbated by the stench that accompanied them. The sickly-sweet scent of rotting flesh permeated the air for miles in all directions. A soldier could smell the front before he could see it. The stink clung to the stale bread he ate, the stagnant water he drank, the tattered uniform he wore. Did you ever smell a dead mouse? asked Lieutenant Robert C. Hoffman, a veteran of the First World War, when warning Americans against involvement in the second a little over two decades later. This will give you about as much idea of what a group of long-dead soldiers smell like as will one grain of sand give you an idea of Atlantic Citys beaches. Even after the dead were buried, Hoffman recalled, they smelled so horribly that some of the ofcers became extremely sick.

Clare had grown accustomed to the dead, but not to the dying. The tremendous amount of suffering he had witnessed was etched into his mind. Once, he had stumbled upon two Germans cowering in a trench, their chests ripped open by shrapnel. The soldiers bore an uncanny resemblance to each other, leading Clare to conclude that they were father and son. The sight of their facesghastly white, their features livid and quivering, their eyes so full of pain, horror and terror, perhaps each on account of the otherhaunted him. Clare had stood guard over the wounded men, hoping that medical assistance would arrive soon, but eventually he was forced to move on. Only later did he discover that a friend named Bean had thrust his bayonet into their bellies after Clare had quit the scene. My indignation consumed me, Clare wrote in his diary. I told him he would never survive this action; that I didnt believe God would suffer so cowardly and cruel a deed to go unpunished. Shortly afterward, Clare came upon his friends decomposing remains in a trench.

Now, as he peered out over Cambrais battlefield from his position on the hillside, Clare wondered what fresh horrors awaited him. In the distance, he could hear the faint staccato of the machine guns, and the whistle of shells as they sailed through the air. Clare wrote that upon impact, the earth seemed to quake, at first with a jerk, like a giant startled out of sleep; afterwards with a continuous trembling communicated to us through our bodies lying there in contact with it. Shortly after the shelling began, his commanding officer gave the signal.