War Medicine WW1 Uncut

BOMB WHISTLES AND EXPLODES

CRACK AND RATTLE OF MUNITIONS

Look at the walls.

And the little slits.

So we're just going

along the perimeter of the abbey, at the moment.

Just seeing it from the outside.

Probably seeing it for the first time in the way that...

many of the wounded soldiers, who were arriving here, would've seen it.

I'm kind of imagining all the ambulances

and the chauffeurs, the lady chauffeurs,

driving their mock-up ambulances along this road...

..arriving at the big entrance.

'This is Royaumont,

'a 13th-century Cistercian abbey to the north of Paris.

'At the beginning of WWI, it was home to a revolutionary medical movement -

'a hospital run entirely by women determined to prove

'they had as much to offer as men

'when it came to the tough business of war medicine.

'After my experiences as a doctor in Syria,

'I can really relate to their story.'

I think there's more coming. As you can see, it is just chaos.

Has he had any painkillers?

Painkiller? Morphine?

INDISTINCT

OK, that's better than nothing. OK.

I first came across the story

of the Scottish Women's Hospital in Royaumont

when I was travelling out to Syria to work as a doctor.

Whenever I go to work in a conflict zone, I'm filled with

some anxiety and trepidation.

But when I learnt about this place

and the women that worked here,

it was like meeting kindred spirits separated by a hundred years.

And that's why it was so important for me to come here today,

to see it for myself.

'The Scottish Women's Hospital of the First World War

'was set up by doctor and suffragette Elsie Inglis.

'Turned down somewhat dismissively by the British War Office,

'her idea of an all-female-run hospital to help the war effort

'was snapped up by the French.

'Royaumont Abbey was to be the first,

'and Dr Frances Ivens was put in charge.

'Over the course of the war,

'the organisation set up 15 similar units across Europe.'

Isn't it stunning?

It's such a beautiful abbey.

Imagine if you were a soldier and you'd been injured

in a trench in the Western Front and that was your last memory,

and you were brought here - unconscious for a few days -

and then you woke up to this!

You would literally think that you had died and gone to heaven.

'When the hospital opened in January 1915,

'there were seven doctors, ten nurses,

'seven orderlies, two cooks, a clerk, a maid and two administrators -

'all women.

'There were even two female chauffeurs to drive the ambulances.'

This is the refectory.

Just look at it. It's stunning.

Those ceilings...

I can just imagine that people were lying in here

looking up at those ceilings.

So this used to be the original place

where staff from the hospital used to eat and drink.

'But it couldn't stay a refectory for long,

'every square inch was needed for patients -

'as within two years, as the war intensified,

'the unit expanded into a crushingly busy 600-bed hospital.

'Its reputation for innovation and getting results

'had spread throughout France.'

During the summer months, the doctors would bring the patients out

and line the beds all along the cloisters.

They'd dress the wounds in gauze soaked in saline,

and then expose the wounds to the sunlight.

And what I really love about this,

is that the doctors were seeing the patient as a whole.

War medicine isn't ONLY about operations and fighting infections,

it's about a holistic approach -

it's the top-to-toe therapy of the patient -

and these women doctors were doing just that.

When the women arrived in this hospital,

they were an all-girl team,

and it meant that they had to lift and carry everything up to

where they were going to have the wards.

And that included heavy beds and heavy benches.

SHE PUFFS

And...

I want to see if us modern-day girls can do it.

Blimey!

To begin with, they had about a hundred beds to distribute

and some of them were going to be on the fourth floor -

right at the top of this building -

where they first proposed to have the ward.

Ew! So they must've been up and down all day

carrying and lifting these beds.

It's exhausting.

If there was any doubt about whether these women were tough enough,

well, they clearly were.

I owe a huge amount to the women who worked out here in Royaumont.

They pushed the boundaries and they demonstrated

that women doctors and nurses

could work in the harshest environments in wartime.

'And it's thanks to them that women doctors like me

'can work across the board in medicine.'

BOMB WHISTLES AND EXPLODES

'In WWI, industrial warfare

'caused unprecedented damage to soldiers' bodies.

'The challenges to medics were HUGE.'

'The Royal Army Medical Corps, or RAMC, was in charge of

'looking after the health of the British Army's forces,

'treating the wounded and saving lives.

'As a doctor myself, it's amazing to look at

'what seems, to my modern eyes, the very crude equipment

'I would have had to use back in WWI.

'Today, I'm being allowed to examine close up

'the kit used by my predecessors.'

I'm just looking at a picture of

two stretcher-bearers - just young guys actually -

standing there very straight and proud with their stretchers.

One of them is John Hill.

And this...

is his satchel,

and I'm going to have a look inside

to see what a stretcher-bearer from WWI would've been carrying.

"Silk sterile tubes".

Oh, wow!

These are little vials of...silk

kept sterile in this glass vial,

and it would've been used for stitching up wounds.

So that goes to show that even whilst they were scooping up people,

they were possibly doing first aid along the way, as well.

And under fire!

I'm going to carefully put the lid back on now.

There would've been 12 of them in there.

I feel like I'm delving into a little treasure trove.

Could this be a tourniquet?

I think it is.

This looks like a tourniquet that you'd use to stop bleeding.

You'd tie it on the affected limb, where you've got a wound.

If it's bleeding out, you go above it

and you tie this on and wrap it round tight.

I'm guessing that this is a tourniquet.

I may be wrong, but I can't see what else it would be used for.

Something else in here.

It smells so old!

What's this? Is this a bandage?

Well, I think they're slings actually. Yep.

They haven't changed much, still very much the same.

And this -

it's a bit heavy - is a lantern.

Cos obviously, when they went to pick up their casualties at night,

that had fallen during the day,

they wouldn't be able to see anything

so they needed a light.

Imagine that - illuminating yourself as you went to pick up casualties!

Just goes to show how brave John Hill and his colleagues were.

I've also just found this.

It's John Hill's...

nursing dictionary,

and it's got abbreviations

to all sorts of technical medical terms and equipment,

in here. And it's really quite interesting

to note because today, I'm always carrying little aide-memoires

and pocketbooks of this, that and the other on me.

And I have my own medical dictionary sitting on my desk at all times.

And even then, 100 years ago, he wasn't deploying out into the field

without his little aide-memoire.

And it's well, well worn.

I love it!

This is an Aladdin's cave for me,

it tells me so much about what it was like a hundred years ago.

And what we've got going on here,

is a Royal Army Medical Corps sergeant

tending to a Royal Army Medical Corps doctor.

What I like about this is that it demonstrates the reality.

Just because you're a medic, just because you wear the emblem,

doesn't mean that you're immune to being hit.

Guess what this is?

It's an X-ray from a hundred years ago.

It's an X-ray of the neck

and the bottom of the head of a stretcher-bearer.

And this round, dark circle here

is shrapnel.

And how do I now it's shrapnel?

This is...the exact same shrapnel that you can see in the X-ray.

And he also got extra bits of shrapnel in his head, as well.

What became standard was everyone who had suffered

a head or a neck injury was given an X-ray.

Before WWI started,

it was a brand-new technique -

some people had adopted it, others hadn't.

But as a consequence of WWI,

and the way that it was used so extensively,

propelled the use of X-rays throughout medicine.

'One of the RMAC's most important jobs

'was evacuating the wounded from the battlefield.'

This is a stretcher cart.

And I have to say I'm pretty relieved I don't have to use this

to transport my patients around.

But this is precisely what the medics during WWI

were using to transfer their patient around

in the field hospital area.

For a patient to get to the field hospital -

they'd had a whole journey beforehand -

from the point of injury,

they'd be picked up by the stretcher-bearers,

taken to a regimental aid post

and then, further back,

to a dressing station and then, further back still,

to the field hospital.

One of the developments during WWI

was the idea that, for a patient to really recover fully,

you had to take them away from the chaos

and the frightening sounds of a front-line area,

to a place where they'd have some peace and quiet,

some good nursing, so that that could enhance their recovery.

And what we have here

is an original operating table from WWI.

And it's a portable one at that. Look at this, look at these.

These are the handles that were used, and it folds down

so that it could've been moved around easily.

What I find really profound about this, as I touch this,

is that on this table...

..the wounded soldiers were being operated on

by my predecessors in medicine and surgery.

I find that really...

quite profound and very moving actually.

This is where

techniques were developed that have gone on to help us

in the way that we practise medicine today.

BOMB WHISTLES AND EXPLODES

HUBBUB OF VOICES

No, he's already tubed. He's already tubed. It's fine.

'As an emergency medicine doctor and a former army officer,

'I'm really fascinated to learn about the challenges faced by

'front-line war medicine'

a century ago.

During WWI, we saw devastating injuries caused by gunshots,

shrapnel and poisonous gas.

But one of the major killers of the time was infection,

and it always had been.

Misconceptions about how to

successfully treat and manage war wounds

had often led to doing more harm than good.

'Today, I have an amazing opportunity to look at

'original WWI research into infection

'at the Army Medical Services archive.

'There's all sorts of information

'about the treatment of common infections such as trench foot -

'a really nasty fungal infection

'caused by cold, damp and unclean conditions.'

One of the things that you realise,

when you start looking into this area,

is that many of the problems that were being faced

were linked with real, practical situations.

Take, for example, the trenches.

They were dug mainly in France on farmland.

And what does farmland have?

Soil enriched in manure.

So imagine that.

Dirty wounds, open wounds

contaminated by manure and in the soil.

So once they'd identified this,

they could really work towards

finding a solution to deal with the problem.

One of the specific infections caused by the bacteria in manure

was gas gangrene,

which frequently resulted in amputation,

and sometimes loss of life.

A solution was needed.

For me, one of the most important figures in WWI medicine

was the British bacteriologist Almroth Wright.

Now, he proposed revolutionary methods

in how to treat war wounds

and his research was dedicated to that.

The thing about war,

unfortunate and tragic though it is,

it forces medical research to accelerate through need,

but it also provides a huge number of subjects to research with.

Wright was vigorously opposed to the traditional method at the time

of pouring antiseptic into a wound and then closing it up.

His research, from these vast number of case studies

from the battlefields of Europe,

was vital in persuading his peers

that his approach was the way ahead.

His method suggested that "wounds would be opened,

"all foreign bodies removed,

"a wide-bore drainage tube inserted,

"and a sterile, hypotonic, 5% saline solution be used

"to promote the flow of lymph."

Basically, what he was saying was, get rid of all the shrapnel,

get rid of all the grubby bits of French soil,

give it a really good clean,

and then leave the wound open,

and then allow the body's natural healing process to work.

And what I find really interesting is that,

to me, reading that now as a doctor today,

it seems so obvious.

Hindsight is a wonderful thing.

And I know there are things that we are doing today

maybe that doctors in the future will go,

"Oh, I can't believe they were doing that!"

Well, I am kind of having that moment now,

with the techniques that were originally being used by

the surgeons until Wright pushed forward

the frontiers of medicine with his research.

'Because of the resistance to Wright's research,

'it wasn't until after the war

'that his theory on wound cleaning was fully adopted.

'In WWII, they contributed significantly

'to the lower rates of infection and amputation.

'Wright's methods on wound cleaning

'are one of the great medical legacies of WWI.'

RATTLE AND CRACK OF MUNITIONS

WHISTLE OF BOMB

EXPLOSION

BUZZ OF AIRCRAFT

RAPID GUNFIRE

MILITARY DRUMBEATS