At Work in a War Hospital

From The War Illustrated, 18 May 1918

Sentimental magazine stories of the wounded represent, as a rule, only one background to hospital life. The drama—which concerns itself, according to recipe, with that rare occurrence, a love-match between a patient (hero) and a nurse (heroine)—is staged in a ward.

Hospitals altogether consist of wards—this is the idee fixe of the lay public, and even of the majority of those who have actually penetrated into the interiors of hospitals. Ward life, at all events, occupies the forefront of the picture, with, perhaps, a vague middle-distance of operating-theatre, recreation-room, cook-house, and dispensary.

The visitor, it is true, passes many closed portals in his long walk down the corridors to the bedside of the friend whom he has come to cheer. He catches sight of officials who would seem to have no direct connection with the arts of healing. But what goes on behind those portals, and how the officials are engaged, he seldom inquires.

Yet to the extensive male and female staff of a military hospital there is much more to think of than the wards and the getting well of those wards' inmates. A man may enlist as an R.A.M.C. orderly and be exceedingly busy, yet never once bandage a wound or even. witness the flow of blood. A girl may volunteer as a V.A.D. and never do any nursing.

When the Wounded Arrive

Behind the Scenes

A big war hospital is a complex machine, and needs for its smooth running a host of behind-the- scenes activities. Your friend whose arm is full of pieces of shrapnel, or who has had his leg amputated, is being served not only by skilled physicians and kindly Sisters, but also by clerks and registrars, accountants and card-index damsels, steward's-store men and sanitary squad, and electricians and bacteriologists; from the commanding officer and the matron down to the grimy individual who stokes the furnaces, or the Abigail in the pantry of the nurses' mess, there are troops of folk whose ministrations appear rarely to be appreciated ; but each of whom, in some remote and roundabout way, is reacting upon the restoration to health of that stricken soldier in the ward.

That soldier, even though he be laid low, is still a member of the Army; his existence is still the concern of the State; the War Office must keep track of him, as long as he is in the land of the living; his regimental depot has to hear about him, either now or when he emerges from hospital.

Every .move he makes involves the filling-in of documents. Before he reached the hospital his name and his particulars had been noted, in France, on the steamer, and in the ambulance trains; each separate step that he took, from battlefield to "Blighty," can, if necessary, be traced.

The moment he alighted at the hospital a clerical V.A.D. obtained from him his name, number, rank, age, length of service, religion, and a dozen other intimate details, and he was hardly bestowed in bed before another clerical V.A.D. was entering these in " Field Service Army Book" while yet a third clerical V.A.D., in charge of a filing system, was tackling on his behalf, "Army Form W3243" which is a printed card to fit a drawer in the admission and discharge index ; meanwhile, a fourth clerical V.A.D. is writing less elaborate memoranda upon a smaller card, which will be dropped, into its niche in the archives of the Inquiry Bureau.

The Patients Are Kept Busy on a Typical Ward

An Army in Miniature

All this is obvious enough, when you come to think of it. A hospital with a fluctuating population which, at its fullest, rises to 2,000, and with a salaried staff amounting to several hundreds, would fall into chaotic confusion were it not run systematically. It is itself an army in miniature. Its lines of communication must be maintained; the stream of supplies, whether of equipment or food of money, must flow, day after day and month after month, with absolute evenness.

Behind those shut portals, which the visitor passes so negligently, there is a never-ceasing clatter of typewriters and the whir of telephone bells; a glimpse within shows khaki-clad men who, though they have red crosses on their arms, are seated at desks much in the manner of city quill-drivers; or maybe women wearing the uniform of the V.A.D. attending to parcels letters, stamps, and telegrams in the hospital's own private post-office. Here, again, is the telephone room. It has the switchboard familiar in all large establishments—rows of little signal-holes and flexible snakes of connecting wires.

The hospital is not only linked with the outer world by half a dozen lines but also owns an intricate internal system of telephones—wards and offices and departments, and operating- theatres, and M.O.s' huts and sergeants' mess and kitchens and stores, and board-room and dental-room, as wells as a pathological laboratory and sentry-box, and paymaster and fire brigade. They can all speak to each other in an instant and all are thus dependent on the V.A.D. who by day, or the orderly who by night, presides at this central switchboard. And here and there, in the corridors of the hospital, you will remark an ordinary public telephone call-box; this is for the use of inmates, whether staff or patients, who wish to converse with their friends on matters unconcerned with hospital business. For the hospital's own lines must not be used for private affairs.

A Patient at Manchester Hospital Receives Visitors and a Mandolin Serenade from a Wounded Comrade

Task of the Pay Office

It may be that, in .your journey to the ward, you pass a door outside which is a queue of convalescents in blue uniforms. They are waiting to receive their pay. For the soldier who is in hospital has not, for that reason, ceased to be supported by the efforts of the tax-collector.

During his sojourn in the hospital the soldier is allowed to draw, for pocket-money, a small advance from the pay which accumulates for him elsewhere. I wonder how many civilians envisage the complications of the army bookkeeping which this system causes? Every regimental paymaster must be advised of each of the doles of a few shillings that concerns him. And the note which is handed to the soldier, with his railway warrant, when he leaves us —this, too, must be notified and duly deducted.

Our Pay Office staff pilots a department whose accountancy demands expert knowledge; it is a bank in miniature, handling some thousands of pounds weekly—for it not only advances these odd sums to patients, but distributes the salaries of the Sisters and the nurses, the probationers, the clerical V.A.D.s, the masseuses, the scrubwomen, and the unit of the R.A.M.C.

When it is realized that these disbursements vary, in all sorts of manners, owing to differences of lengths of service and gradations of rank (e.g., a 1st Class orderly gets more than a 2nd Class orderly, to mention only one example out of a score), and that if a man is absent on duty for 24 hours he receives a cash allowance for his food accordingly, and that there are allowances (or deductions) for upkeep of clothes, for washing, and heaven knows what other technical minutiae—all calculated in pence per diem—it will be seen that the Pay Office of the hospital is by no means a place of repose for the slacker.

The Night Staff

The Pay Office employs some women clerks, but its main pillars arc men. Like all the other male employees of the hospital, these men are "unfits" in the lowest medical category. Even were they not, it would be easy to justify their retention here; for, as has been said, they are experts in a routine which, if muddled, would mean an appalling waste of the country's money as well as of labour. But I touch upon the fact of their "unfitness" because I have heard some nonsense talked (generally by comfortable civilians, too!) about this and similar berths being safe and easy sinecures for youngsters who should be in the trenches. Sate, admittedly; but easy—no. The work is a never-ending grind.

If the visitor, instead of quitting the hospital building, were to linger till ten or 11, or even 12 at night, and peep into the Pay Office—or, for that matter, the staff clerks', or admission and discharge, or registrar's offices—he would generally find the electric lamps still blazing and some of the khaki-wearers, white-faced and worn, still toiling at their army forms and ledgers.

At night no hospital ever pauses. In each ward there is a wakeful Sister or curse. There are night-duty orderlies and night-duty doctors; also a specialist surgeon ready to be called at a minute's notice. There is a night dispenser, a night ward-master, a night convoy squad, a night sentry at the gate, a night operator on the telephone, a night Sister, a night corporal.

The hospital, qua hospital, never sleeps. But it should be noted that some of its retinue, awake at uncanny hours, are doing without their sleep not because the time-table so ordains, but because they are conscientious slaves of allegiance to a "cushy job" more cruel in its tyranny than the onlooking critic conceives.

Thanks to Tony Langley for this contribution from his wartime periodicals collection.