Facial Injuries and Care in World War I

Today’s post is from Eilis Boyle, a PhD student at the University of Leeds who is funded by the European Research Council as part of the Men, Women and Care project. Eilis writes: ‘My research looks at the ways in which facially-wounded and war-neurotic ex-servicemen were cared for in interwar Britain, and analyses the effects of stigma and normative conceptions of gender in shaping how these wounds and their care have been imagined, perceived and experienced by veterans and caregivers. This builds on my MA by Research, which examined the social and psychological impact of facial injuries during and after the First World War.’

‘Nothing was more painful than the sense of loneliness of those mutilated, since these deformities repelled even their wives and children. I understand that many, faced with the horror of the situation, committed suicide’.[1]

Thus wrote Sir William Arbuthnot Lane, consulting surgeon at the Cambridge Military Hospital during the First World War, where soldiers with facial injuries were treated and received reconstructive facial surgery. This statement echoes the common view of facially-disfigured ex-servicemen, but how accurately does it reflect their lived experiences?

The facial injuries produced by the First World War were unprecedented in their numbers and severity.[2] Whilst modern mechanised weaponry resulted in severe, disfiguring wounds, medical advancements meant that men’s lives were saved.[3]  Over the course of the conflict 60,500 British soldiers were wounded in the head or eyes, and in 1917 a specialist hospital was established at Sidcup to meet the demand for facilities to treat facially-wounded servicemen.[4] What happened to these men after they were wounded? How did they cope with their injuries, and what were the social, psychological and physiological implications for soldiers and their carers? These are some of the questions I addressed in my MA and continue to consider in my PhD.

Amongst the more prominent surgical textbooks and the memoirs of medical personnel, it can be difficult to locate the voices of facially-wounded servicemen and their families. Whilst research has examined the ways in which disfigurement was represented in wartime and post-war visual culture, my interests lie in the ways in which servicemen and those who cared for them perceived, experienced, and dealt with their injuries.

The macabre stories offered in the memoirs of medical carers make for emotional reading, and indeed, researching First World War facial injuries can sometimes turn up tales of isolation, rejection, and in the extreme, suicide. In studying ex-servicemen’s experiences, however, I have often found their stories of life after wounding to be less bleak than these accounts infer. This post explores the experiences of some of the war’s facial casualties, and the ways in which they dealt with their injuries, hopefully lending a more balanced account of First World War facial injury than the one which is commonly portrayed in contemporary accounts and modern popular culture.

British First World War servicemen before and after plastic surgery.
Credit: Photo copyright Army Medical Services Museum, Keogh, supplied by Wellcome Collection, licensed under CC-BY-NC 4.0, cropped versions of original images.

Whilst it is essential to recognise the difficulties resulting from facial wounds (in terms of social stigma, but also difficulty eating and speaking), reports such as Arbuthnot Lane’s, which emphasise rejection and suicide, obscure, to a certain extent, the reality of men’s experiences of living with facial injuries. At a national level, as Suzannah Biernoff demonstrates, images of disfigured servicemen were excluded from wartime visual culture.[5] In the majority of cases I have researched, however, facially-wounded ex-servicemen achieved some level of domestic or local reintegration. Many returned to their families and wives or formed new relationships, married and had children after being wounded. Reg E, for example, writing to his mother whilst receiving treatment for a bullet wound to the jaw, informed her: ‘I get well away with the girls now you know, so don’t get nervous’.[6] J.K W, too, testified that his wife was ‘there shortly after I got to the hospital and as far as I can remember she visited quite happily. She was quite happy to have me home in any case’.[7] The social support offered by friends and relatives was, in fact, a key factor in the rehabilitation of many facially-wounded soldiers. Family acceptance could reassure disfigured men of their continued identity, as they maintained their pre-war domestic roles regardless of aesthetic changes.

In wider British society, men’s appearances could elicit stigmatised responses in the form of avoidance or unwanted and invasive attention from civilians. In more socially intimate spaces, however, where ex-servicemen and the wartime circumstances of their disfigurement were known, a certain amount of acceptance appears to have taken place. In many cases, men with war-attributable disfigurements found support within specific social networks and communities. A number of facially-wounded men whose lives I followed through wounding and post-war rehabilitation maintained links to the army, or to groups such as the British Legion, after their service ended, perhaps finding comfort through the maintenance of martial or quasi-martial identities within communities which valued visible wounds as markers of manly courage and worthy war service.

Many facially-wounded veterans also re-established their socio-economic positions within local communities. One local of Alnwick, who suffered a gun-shot wound to the face in 1918, returned to the town after his discharge from the Queen Mary’s Hospital. Discussing the local’s response to his wound, he recounted: ‘ah, they got used to it […] I find gradually if you’re not the one that talks about what’s the matter with you nobody’ll be bothered with it’.[8] Reintegration could involve overcoming the perceived handicap of disfigurement, but facially-wounded ex-servicemen were also welcomed home as heroes. Reg E’s return was marked by a ceremony, organised by his former employer, to honour his ‘individual courage’ and contribution to the war effort.[9] He later returned to the town that he’d had familial ties to before the war, establishing himself as an active and integral part of the local community and its social and economic networks.

Within particular social and cultural spaces (for example, the home, the workplace, the local community, and wider society), war-related disfigurements were perceived, experienced, and responded to in different ways. Local and domestic environments often provided the necessary support and acceptance for rehabilitation, acting as the primary support networks and fostering a sense of belonging which could combat potential isolation and mediate anxiety. This was particularly important in light of the unwanted social responses which could be experienced in wider British society. Whilst wider discourses and perceptions of disfigurement are key to understanding the ways in which facial abnormality has been imagined, constructed and stigmatised, it is therefore important to reconcile these wider discourses with personal experiences.

Foregrounding these stories by no means suggests that reintegration was always smooth. Nor does it negate the difficulties faced by servicemen and their families, in what could be experienced as one of ‘the worst afflictions that can befall any person’.[10] What I hope to highlight, however, is that whilst their injuries have been depicted as a fate worse than death, and used as an emblem of the horrors of war, the reality was that many facially-wounded veterans found a way to live with the effects of their injuries. They reconciled their altered appearances with their identities as sons and husbands, secured employment, formed new relationships, and established themselves within local communities. However difficult it was to do, many of Britain’s facially-wounded ex-servicemen were able to build lives for themselves after being wounded.

You might enjoy these other posts about World War I on Effaced from History?.

References

[1] Quoted in Reginald Pound, Gillies: Surgeon Extraordinary: A Biography (London: Michael Joseph, 1964), p.42.

[2] Katherine Feo, ‘Invisibility: Memory, Masks and Masculinities in the Great War’, Journal of Design History, 20 (2007), 17-27, p.18.

[3] Ibid.

[4] Statistics from Joanna Bourke, Dismembering the Male: Men’s Bodies, Britain and the Great War (London: Reaktion Books Ltd., 1999), p.33.

[5] Suzannah Biernoff, ‘The Rhetoric of Disfigurement in First World War Britain’, Social History of Medicine, 24 (2011), 666-85.

[6] [Reg E], Special Collections, University of Leeds, LIDDLE/WW1/GS/1816, letter to mother [n.d.].

[7] [J.K. W], transcribed interview with Peter Liddle, 1975, Special Collections, University of Leeds, LIDDLE/WW1/TR/08/69, tape 286.

[8] [Joseph P], Oral History, 1986, Imperial War Museum collection, 8946, reel 18, minute 14.

[9] ‘Sergt. [E] Welcomed Home’, The Gazette Soul, 30 September 1916 [n.p.].

[10] ‘6 Mss essays by patients with facial injuries in Sidcup Hospital’, 1922, Special Collections, University of Leeds, LIDDLE/WW1/GA/WOU/34, essay two, p.7.