0:00:08 > 0:00:11BOMB WHISTLES AND EXPLODES
0:00:11 > 0:00:15CRACK AND RATTLE OF MUNITIONS
0:00:18 > 0:00:19Look at the walls.
0:00:20 > 0:00:21And the little slits.
0:00:22 > 0:00:24So we're just going
0:00:24 > 0:00:27along the perimeter of the abbey, at the moment.
0:00:27 > 0:00:29Just seeing it from the outside.
0:00:29 > 0:00:34Probably seeing it for the first time in the way that...
0:00:34 > 0:00:39many of the wounded soldiers, who were arriving here, would've seen it.
0:00:41 > 0:00:44I'm kind of imagining all the ambulances
0:00:44 > 0:00:47and the chauffeurs, the lady chauffeurs,
0:00:47 > 0:00:51driving their mock-up ambulances along this road...
0:00:52 > 0:00:54..arriving at the big entrance.
0:00:59 > 0:01:00'This is Royaumont,
0:01:00 > 0:01:05'a 13th-century Cistercian abbey to the north of Paris.
0:01:05 > 0:01:09'At the beginning of WWI, it was home to a revolutionary medical movement -
0:01:09 > 0:01:14'a hospital run entirely by women determined to prove
0:01:14 > 0:01:16'they had as much to offer as men
0:01:16 > 0:01:18'when it came to the tough business of war medicine.
0:01:20 > 0:01:23'After my experiences as a doctor in Syria,
0:01:23 > 0:01:25'I can really relate to their story.'
0:01:25 > 0:01:29I think there's more coming. As you can see, it is just chaos.
0:01:29 > 0:01:31Has he had any painkillers?
0:01:31 > 0:01:33Painkiller? Morphine?
0:01:33 > 0:01:34INDISTINCT
0:01:34 > 0:01:37OK, that's better than nothing. OK.
0:01:40 > 0:01:42I first came across the story
0:01:42 > 0:01:44of the Scottish Women's Hospital in Royaumont
0:01:44 > 0:01:47when I was travelling out to Syria to work as a doctor.
0:01:47 > 0:01:50Whenever I go to work in a conflict zone, I'm filled with
0:01:50 > 0:01:53some anxiety and trepidation.
0:01:53 > 0:01:56But when I learnt about this place
0:01:56 > 0:01:58and the women that worked here,
0:01:58 > 0:02:03it was like meeting kindred spirits separated by a hundred years.
0:02:03 > 0:02:07And that's why it was so important for me to come here today,
0:02:07 > 0:02:09to see it for myself.
0:02:11 > 0:02:14'The Scottish Women's Hospital of the First World War
0:02:14 > 0:02:18'was set up by doctor and suffragette Elsie Inglis.
0:02:18 > 0:02:22'Turned down somewhat dismissively by the British War Office,
0:02:22 > 0:02:26'her idea of an all-female-run hospital to help the war effort
0:02:26 > 0:02:28'was snapped up by the French.
0:02:29 > 0:02:32'Royaumont Abbey was to be the first,
0:02:32 > 0:02:35'and Dr Frances Ivens was put in charge.
0:02:35 > 0:02:37'Over the course of the war,
0:02:37 > 0:02:41'the organisation set up 15 similar units across Europe.'
0:02:41 > 0:02:43Isn't it stunning?
0:02:43 > 0:02:46It's such a beautiful abbey.
0:02:46 > 0:02:50Imagine if you were a soldier and you'd been injured
0:02:50 > 0:02:54in a trench in the Western Front and that was your last memory,
0:02:54 > 0:02:57and you were brought here - unconscious for a few days -
0:02:57 > 0:02:59and then you woke up to this!
0:02:59 > 0:03:05You would literally think that you had died and gone to heaven.
0:03:08 > 0:03:12'When the hospital opened in January 1915,
0:03:12 > 0:03:14'there were seven doctors, ten nurses,
0:03:14 > 0:03:19'seven orderlies, two cooks, a clerk, a maid and two administrators -
0:03:19 > 0:03:21'all women.
0:03:21 > 0:03:25'There were even two female chauffeurs to drive the ambulances.'
0:03:25 > 0:03:27This is the refectory.
0:03:27 > 0:03:29Just look at it. It's stunning.
0:03:29 > 0:03:31Those ceilings...
0:03:31 > 0:03:34I can just imagine that people were lying in here
0:03:34 > 0:03:35looking up at those ceilings.
0:03:35 > 0:03:38So this used to be the original place
0:03:38 > 0:03:42where staff from the hospital used to eat and drink.
0:03:42 > 0:03:45'But it couldn't stay a refectory for long,
0:03:45 > 0:03:48'every square inch was needed for patients -
0:03:48 > 0:03:51'as within two years, as the war intensified,
0:03:51 > 0:03:57'the unit expanded into a crushingly busy 600-bed hospital.
0:03:57 > 0:04:00'Its reputation for innovation and getting results
0:04:00 > 0:04:02'had spread throughout France.'
0:04:02 > 0:04:06During the summer months, the doctors would bring the patients out
0:04:06 > 0:04:09and line the beds all along the cloisters.
0:04:09 > 0:04:13They'd dress the wounds in gauze soaked in saline,
0:04:13 > 0:04:16and then expose the wounds to the sunlight.
0:04:16 > 0:04:19And what I really love about this,
0:04:19 > 0:04:23is that the doctors were seeing the patient as a whole.
0:04:23 > 0:04:29War medicine isn't ONLY about operations and fighting infections,
0:04:29 > 0:04:32it's about a holistic approach -
0:04:32 > 0:04:36it's the top-to-toe therapy of the patient -
0:04:36 > 0:04:40and these women doctors were doing just that.
0:04:45 > 0:04:48When the women arrived in this hospital,
0:04:48 > 0:04:51they were an all-girl team,
0:04:51 > 0:04:58and it meant that they had to lift and carry everything up to
0:04:58 > 0:05:01where they were going to have the wards.
0:05:01 > 0:05:05And that included heavy beds and heavy benches.
0:05:05 > 0:05:07SHE PUFFS
0:05:07 > 0:05:09And...
0:05:09 > 0:05:14I want to see if us modern-day girls can do it.
0:05:17 > 0:05:19Blimey!
0:05:19 > 0:05:24To begin with, they had about a hundred beds to distribute
0:05:24 > 0:05:26and some of them were going to be on the fourth floor -
0:05:26 > 0:05:28right at the top of this building -
0:05:28 > 0:05:31where they first proposed to have the ward.
0:05:34 > 0:05:38Ew! So they must've been up and down all day
0:05:38 > 0:05:41carrying and lifting these beds.
0:05:41 > 0:05:42It's exhausting.
0:05:42 > 0:05:46If there was any doubt about whether these women were tough enough,
0:05:46 > 0:05:48well, they clearly were.
0:05:52 > 0:05:57I owe a huge amount to the women who worked out here in Royaumont.
0:05:57 > 0:06:00They pushed the boundaries and they demonstrated
0:06:00 > 0:06:02that women doctors and nurses
0:06:02 > 0:06:06could work in the harshest environments in wartime.
0:06:06 > 0:06:10'And it's thanks to them that women doctors like me
0:06:10 > 0:06:12'can work across the board in medicine.'
0:06:13 > 0:06:16BOMB WHISTLES AND EXPLODES
0:06:23 > 0:06:26'In WWI, industrial warfare
0:06:26 > 0:06:30'caused unprecedented damage to soldiers' bodies.
0:06:30 > 0:06:33'The challenges to medics were HUGE.'
0:06:38 > 0:06:42'The Royal Army Medical Corps, or RAMC, was in charge of
0:06:42 > 0:06:45'looking after the health of the British Army's forces,
0:06:45 > 0:06:49'treating the wounded and saving lives.
0:06:49 > 0:06:52'As a doctor myself, it's amazing to look at
0:06:52 > 0:06:56'what seems, to my modern eyes, the very crude equipment
0:06:56 > 0:06:59'I would have had to use back in WWI.
0:07:01 > 0:07:05'Today, I'm being allowed to examine close up
0:07:05 > 0:07:07'the kit used by my predecessors.'
0:07:10 > 0:07:13I'm just looking at a picture of
0:07:13 > 0:07:16two stretcher-bearers - just young guys actually -
0:07:16 > 0:07:20standing there very straight and proud with their stretchers.
0:07:20 > 0:07:23One of them is John Hill.
0:07:23 > 0:07:24And this...
0:07:24 > 0:07:26is his satchel,
0:07:26 > 0:07:28and I'm going to have a look inside
0:07:28 > 0:07:32to see what a stretcher-bearer from WWI would've been carrying.
0:07:32 > 0:07:35"Silk sterile tubes".
0:07:39 > 0:07:41Oh, wow!
0:07:41 > 0:07:46These are little vials of...silk
0:07:46 > 0:07:48kept sterile in this glass vial,
0:07:48 > 0:07:52and it would've been used for stitching up wounds.
0:07:52 > 0:07:55So that goes to show that even whilst they were scooping up people,
0:07:55 > 0:07:58they were possibly doing first aid along the way, as well.
0:07:58 > 0:08:00And under fire!
0:08:02 > 0:08:04I'm going to carefully put the lid back on now.
0:08:06 > 0:08:08There would've been 12 of them in there.
0:08:10 > 0:08:13I feel like I'm delving into a little treasure trove.
0:08:13 > 0:08:16Could this be a tourniquet?
0:08:17 > 0:08:19I think it is.
0:08:19 > 0:08:24This looks like a tourniquet that you'd use to stop bleeding.
0:08:24 > 0:08:27You'd tie it on the affected limb, where you've got a wound.
0:08:27 > 0:08:30If it's bleeding out, you go above it
0:08:30 > 0:08:33and you tie this on and wrap it round tight.
0:08:33 > 0:08:36I'm guessing that this is a tourniquet.
0:08:36 > 0:08:39I may be wrong, but I can't see what else it would be used for.
0:08:41 > 0:08:43Something else in here.
0:08:43 > 0:08:44It smells so old!
0:08:44 > 0:08:46What's this? Is this a bandage?
0:08:46 > 0:08:49Well, I think they're slings actually. Yep.
0:08:49 > 0:08:52They haven't changed much, still very much the same.
0:08:56 > 0:08:58And this -
0:08:58 > 0:09:00it's a bit heavy - is a lantern.
0:09:02 > 0:09:05Cos obviously, when they went to pick up their casualties at night,
0:09:05 > 0:09:07that had fallen during the day,
0:09:07 > 0:09:09they wouldn't be able to see anything
0:09:09 > 0:09:11so they needed a light.
0:09:11 > 0:09:15Imagine that - illuminating yourself as you went to pick up casualties!
0:09:17 > 0:09:22Just goes to show how brave John Hill and his colleagues were.
0:09:30 > 0:09:32I've also just found this.
0:09:32 > 0:09:36It's John Hill's...
0:09:36 > 0:09:38nursing dictionary,
0:09:38 > 0:09:41and it's got abbreviations
0:09:41 > 0:09:44to all sorts of technical medical terms and equipment,
0:09:44 > 0:09:47in here. And it's really quite interesting
0:09:47 > 0:09:52to note because today, I'm always carrying little aide-memoires
0:09:52 > 0:09:55and pocketbooks of this, that and the other on me.
0:09:55 > 0:09:59And I have my own medical dictionary sitting on my desk at all times.
0:10:00 > 0:10:04And even then, 100 years ago, he wasn't deploying out into the field
0:10:04 > 0:10:07without his little aide-memoire.
0:10:07 > 0:10:10And it's well, well worn.
0:10:10 > 0:10:12I love it!
0:10:20 > 0:10:22This is an Aladdin's cave for me,
0:10:22 > 0:10:25it tells me so much about what it was like a hundred years ago.
0:10:25 > 0:10:28And what we've got going on here,
0:10:28 > 0:10:31is a Royal Army Medical Corps sergeant
0:10:31 > 0:10:35tending to a Royal Army Medical Corps doctor.
0:10:35 > 0:10:39What I like about this is that it demonstrates the reality.
0:10:39 > 0:10:42Just because you're a medic, just because you wear the emblem,
0:10:42 > 0:10:46doesn't mean that you're immune to being hit.
0:10:48 > 0:10:49Guess what this is?
0:10:49 > 0:10:53It's an X-ray from a hundred years ago.
0:10:53 > 0:10:54It's an X-ray of the neck
0:10:54 > 0:10:57and the bottom of the head of a stretcher-bearer.
0:10:57 > 0:11:00And this round, dark circle here
0:11:00 > 0:11:01is shrapnel.
0:11:01 > 0:11:03And how do I now it's shrapnel?
0:11:03 > 0:11:09This is...the exact same shrapnel that you can see in the X-ray.
0:11:09 > 0:11:13And he also got extra bits of shrapnel in his head, as well.
0:11:13 > 0:11:17What became standard was everyone who had suffered
0:11:17 > 0:11:21a head or a neck injury was given an X-ray.
0:11:21 > 0:11:23Before WWI started,
0:11:23 > 0:11:25it was a brand-new technique -
0:11:25 > 0:11:27some people had adopted it, others hadn't.
0:11:27 > 0:11:30But as a consequence of WWI,
0:11:30 > 0:11:33and the way that it was used so extensively,
0:11:33 > 0:11:37propelled the use of X-rays throughout medicine.
0:11:45 > 0:11:47'One of the RMAC's most important jobs
0:11:47 > 0:11:50'was evacuating the wounded from the battlefield.'
0:11:52 > 0:11:54This is a stretcher cart.
0:11:54 > 0:11:57And I have to say I'm pretty relieved I don't have to use this
0:11:57 > 0:11:59to transport my patients around.
0:11:59 > 0:12:03But this is precisely what the medics during WWI
0:12:03 > 0:12:06were using to transfer their patient around
0:12:06 > 0:12:08in the field hospital area.
0:12:08 > 0:12:10For a patient to get to the field hospital -
0:12:10 > 0:12:13they'd had a whole journey beforehand -
0:12:13 > 0:12:14from the point of injury,
0:12:14 > 0:12:17they'd be picked up by the stretcher-bearers,
0:12:17 > 0:12:20taken to a regimental aid post
0:12:20 > 0:12:22and then, further back,
0:12:22 > 0:12:24to a dressing station and then, further back still,
0:12:24 > 0:12:26to the field hospital.
0:12:26 > 0:12:29One of the developments during WWI
0:12:29 > 0:12:34was the idea that, for a patient to really recover fully,
0:12:34 > 0:12:38you had to take them away from the chaos
0:12:38 > 0:12:42and the frightening sounds of a front-line area,
0:12:42 > 0:12:44to a place where they'd have some peace and quiet,
0:12:44 > 0:12:48some good nursing, so that that could enhance their recovery.
0:12:49 > 0:12:51And what we have here
0:12:51 > 0:12:56is an original operating table from WWI.
0:12:56 > 0:12:59And it's a portable one at that. Look at this, look at these.
0:12:59 > 0:13:03These are the handles that were used, and it folds down
0:13:03 > 0:13:06so that it could've been moved around easily.
0:13:06 > 0:13:09What I find really profound about this, as I touch this,
0:13:09 > 0:13:11is that on this table...
0:13:12 > 0:13:15..the wounded soldiers were being operated on
0:13:15 > 0:13:19by my predecessors in medicine and surgery.
0:13:19 > 0:13:21I find that really...
0:13:21 > 0:13:25quite profound and very moving actually.
0:13:25 > 0:13:27This is where
0:13:27 > 0:13:31techniques were developed that have gone on to help us
0:13:31 > 0:13:33in the way that we practise medicine today.
0:13:34 > 0:13:35BOMB WHISTLES AND EXPLODES
0:13:39 > 0:13:41HUBBUB OF VOICES
0:13:41 > 0:13:44No, he's already tubed. He's already tubed. It's fine.
0:13:44 > 0:13:49'As an emergency medicine doctor and a former army officer,
0:13:49 > 0:13:52'I'm really fascinated to learn about the challenges faced by
0:13:52 > 0:13:54'front-line war medicine'
0:13:54 > 0:13:56a century ago.
0:13:56 > 0:14:01During WWI, we saw devastating injuries caused by gunshots,
0:14:01 > 0:14:03shrapnel and poisonous gas.
0:14:03 > 0:14:07But one of the major killers of the time was infection,
0:14:07 > 0:14:09and it always had been.
0:14:09 > 0:14:11Misconceptions about how to
0:14:11 > 0:14:15successfully treat and manage war wounds
0:14:15 > 0:14:19had often led to doing more harm than good.
0:14:22 > 0:14:26'Today, I have an amazing opportunity to look at
0:14:26 > 0:14:28'original WWI research into infection
0:14:28 > 0:14:31'at the Army Medical Services archive.
0:14:31 > 0:14:33'There's all sorts of information
0:14:33 > 0:14:36'about the treatment of common infections such as trench foot -
0:14:36 > 0:14:38'a really nasty fungal infection
0:14:38 > 0:14:42'caused by cold, damp and unclean conditions.'
0:14:54 > 0:14:56One of the things that you realise,
0:14:56 > 0:14:58when you start looking into this area,
0:14:58 > 0:15:01is that many of the problems that were being faced
0:15:01 > 0:15:04were linked with real, practical situations.
0:15:04 > 0:15:07Take, for example, the trenches.
0:15:07 > 0:15:10They were dug mainly in France on farmland.
0:15:10 > 0:15:11And what does farmland have?
0:15:11 > 0:15:13Soil enriched in manure.
0:15:13 > 0:15:15So imagine that.
0:15:15 > 0:15:17Dirty wounds, open wounds
0:15:17 > 0:15:21contaminated by manure and in the soil.
0:15:21 > 0:15:23So once they'd identified this,
0:15:23 > 0:15:25they could really work towards
0:15:25 > 0:15:28finding a solution to deal with the problem.
0:15:30 > 0:15:34One of the specific infections caused by the bacteria in manure
0:15:34 > 0:15:36was gas gangrene,
0:15:36 > 0:15:39which frequently resulted in amputation,
0:15:39 > 0:15:40and sometimes loss of life.
0:15:40 > 0:15:42A solution was needed.
0:15:44 > 0:15:49For me, one of the most important figures in WWI medicine
0:15:49 > 0:15:52was the British bacteriologist Almroth Wright.
0:15:52 > 0:15:56Now, he proposed revolutionary methods
0:15:56 > 0:15:59in how to treat war wounds
0:15:59 > 0:16:01and his research was dedicated to that.
0:16:01 > 0:16:03The thing about war,
0:16:03 > 0:16:06unfortunate and tragic though it is,
0:16:06 > 0:16:10it forces medical research to accelerate through need,
0:16:10 > 0:16:17but it also provides a huge number of subjects to research with.
0:16:17 > 0:16:22Wright was vigorously opposed to the traditional method at the time
0:16:22 > 0:16:26of pouring antiseptic into a wound and then closing it up.
0:16:26 > 0:16:30His research, from these vast number of case studies
0:16:30 > 0:16:32from the battlefields of Europe,
0:16:32 > 0:16:36was vital in persuading his peers
0:16:36 > 0:16:38that his approach was the way ahead.
0:16:38 > 0:16:42His method suggested that "wounds would be opened,
0:16:42 > 0:16:45"all foreign bodies removed,
0:16:45 > 0:16:48"a wide-bore drainage tube inserted,
0:16:48 > 0:16:53"and a sterile, hypotonic, 5% saline solution be used
0:16:53 > 0:16:56"to promote the flow of lymph."
0:16:56 > 0:16:59Basically, what he was saying was, get rid of all the shrapnel,
0:16:59 > 0:17:02get rid of all the grubby bits of French soil,
0:17:02 > 0:17:04give it a really good clean,
0:17:04 > 0:17:06and then leave the wound open,
0:17:06 > 0:17:11and then allow the body's natural healing process to work.
0:17:11 > 0:17:15And what I find really interesting is that,
0:17:15 > 0:17:17to me, reading that now as a doctor today,
0:17:17 > 0:17:19it seems so obvious.
0:17:19 > 0:17:21Hindsight is a wonderful thing.
0:17:21 > 0:17:25And I know there are things that we are doing today
0:17:25 > 0:17:27maybe that doctors in the future will go,
0:17:27 > 0:17:29"Oh, I can't believe they were doing that!"
0:17:29 > 0:17:31Well, I am kind of having that moment now,
0:17:31 > 0:17:36with the techniques that were originally being used by
0:17:36 > 0:17:40the surgeons until Wright pushed forward
0:17:40 > 0:17:43the frontiers of medicine with his research.
0:17:45 > 0:17:48'Because of the resistance to Wright's research,
0:17:48 > 0:17:50'it wasn't until after the war
0:17:50 > 0:17:53'that his theory on wound cleaning was fully adopted.
0:17:54 > 0:17:57'In WWII, they contributed significantly
0:17:57 > 0:18:00'to the lower rates of infection and amputation.
0:18:00 > 0:18:03'Wright's methods on wound cleaning
0:18:03 > 0:18:06'are one of the great medical legacies of WWI.'
0:18:07 > 0:18:09RATTLE AND CRACK OF MUNITIONS
0:18:11 > 0:18:16WHISTLE OF BOMB
0:18:16 > 0:18:18EXPLOSION
0:18:18 > 0:18:19BUZZ OF AIRCRAFT
0:18:19 > 0:18:21RAPID GUNFIRE
0:18:24 > 0:18:27MILITARY DRUMBEATS