One nurse while I was there had a very lovely voice (you kept thinking how much pleasure she must have been able to give the men in her ward) and after she had sung the verse of some popular song, every one joined the chorus. And it was at one of these singsongs, in the big white-paneled drawing-room, with the yellow light falling on many faces about the piano, that I had a glimpse of a gray hospital ward and one of those tragic commonplaces that make up the life of a nurse in times of war.

"The singer had been singing a favorite song of the British Tommies with a strong c.o.c.kney accent:

"'Oi want go 'ome, Oi want to go 'ome, Now that Belgium is Belgium again, Now that France has got Alsace-Lorraine, Carry me over the sea, Where the Allymand cannot get me, Oh my, I'm too young to die, I want to go 'ome,'

when a girl near me, who had been rather silent, spoke for the first time:

"'That song reminds me of a boy I used to have in my ward. He had a broken back and it was just a question of time, but he didn't know that.

He sang that song until I thought I couldn't stand it.'

"The singing was still to be heard as I slipped into my coat a few minutes later and went out of doors. Down on the rocks the water slipped against them softly, overhead were a million stars in the dark sky.

"And so, war--hideous and relentless--intrudes even on the peace of beautiful places, as it always will for most of us as long as we live.

But even if the memories of what lay behind them came back to the nurses who had their leave at Cap d'Antibes, the days there were mostly happy ones. Nothing that the Red Cross has done has been more worth while than this place that they have had for the nurses who needed rest and recuperation. There were the creature comforts of hot water, good food, and soft beds; there was sunshine after an eternity of rain; peace after war."

CHAPTER IX

THE RED CROSS IN THE HOSPITALS OF THE A. E. F.

At no time was it either the object or the ambition of the American Red Cross to build or equip or operate all the hospitals of the United States Army in France. For a more or less privately organized inst.i.tution to have taken upon its shoulders, no matter how broad they might be, the entire hospitalization of an army of more than 2,000,000 men would have been suicidal. So our Red Cross in its wisdom did not even make the attempt; it was quite content to build and equip hospitals in the early days before the American Expeditionary Forces had completed their organization and so were themselves unable to work out their hospital problem as they were forced to do at a later time. The Red Cross did more; it conducted hospitals during the entire period of war--as you have just seen--and attempted to make these models, experiment stations, if you please, from which the medical experts of the army might derive inspiration and real a.s.sistance. But at no time did it seek to usurp any of the functions of the Surgeon-General's office of the army--on the contrary.

"When the army was ready to tackle the hospital problem in fine theory we should have gotten out," Colonel Burlingame told me; "but we did not.

We were following out the first clause of our creed, which was to meet emergency whenever or wherever it arose and no matter at what cost. And at all times during the progress of the war the emergency compelled the Red Cross to at least maintain its hospitals. And so it did, with a total capacity up to the time of the signing of the armistice of some 14,000 beds. After that we dropped off pretty rapidly. Our pay-roll lists of personnel show that. On November 11, 1918, these contained the names of 1,771 men and women; by the first of the following March this total had dropped to a mere 270."

So it was that upon the heels of the first established Red Cross hospitals in France there came the huge hospitals of the United States Army in great size and profusion. Sometimes these were gathered in groups--as at Savenay or Allerey or Dijon or around about Brest or Bordeaux--and at other times they stood alone and at comparatively isolated points. Even these last were sizable inst.i.tutions, huge even according to the hospital standards of our largest metropolitan cities in America; while, when you came to a point like Savenay--halfway between Nantes and St. Nazaire--you beheld a group of seven individual hospitals which, shortly after Armistice Day, attained a total capacity of 11,000 beds and were planned, in fact, for some 9,000 more, with a further capacity of another 10,000 feasible and remotely planned. Into this great group of inst.i.tutions there came between August, 1917, and May, 1919, some 85,000 wounded American boys. Its maximum staff consisted of 500 officers, 500 nurses, and a general staff of 4,000 enlisted men.

When I visited the place--at the end of April, 1919--it still had some 6,500 patients, the most of whom were well out of danger and were enjoying the warm sunshine of a rarely perfect day in France. I found the headquarters staff ensconced in a group of permanent stone buildings which, in the days before the war, were part of a normal school standing alongside the highroad to Nantes. This, itself, formed a hospital for general cases. Some of those that were grouped with it in the open fields around about specialized in serious bed surgical cases, in contagious diseases, in tuberculosis, in mental cases. This last had handled 7,500 cases in the progress of the war.

In each of these hospitals--as in each and every one of the United States Army hospitals in France and the occupied areas of Germany--the Red Cross functioned. At Savenay it had not only erected recreation huts for the men of each of the individual hospitals, but a huge auditorium or amus.e.m.e.nt hall, permanently fabricated of brick and steel and gla.s.s, equipped with a complete theater stage, and capable of seating between 1,500 and 2,000 doughboys and their officers. This super-playhouse was in use every night of the week--for cinema, for drama, sung or spoken, for dances, and, from time to time, for meetings and for religious services.

To this entertainment phase of the American Red Cross in the hospitals we shall presently return. For the moment I shall ask you to consider the part it played in the essential job of supplying hospital supplies.

It was not, of course, either practicable or possible for our Red Cross to supply all of these--or even any tremendously large part of them. But it could--and did--supply goodly quant.i.ties of all of them when they were most needed, and so worth ten times their value and quant.i.ty at any other time.

Time and time again it furnished materials, both for their regular and for their emergency necessities. Sometimes the army itself did not function properly--there were instances of red tape disgraceful and some, too, of red tape inevitable. And yet there were other times when all the tape cutters in the world could not have saved the situation, but the American Red Cross, with its emergency warehouses and its well-organized transportation system all the way across the face of France, did save it. A truckload, two, three; perhaps even four or five truckloads of beds or bedding--perhaps even a small camionette filled to the brim with dressings and drugs or surgical instruments could, and did, save precious lives--by the dozens and by the hundreds. Do you remember, in the preceding chapter, the several instances where our Red Cross played its part--and no small part at that--in the winning of the big fight at Chateau-Thierry? Those were not unusual instances; they were fairly typical.

There came one day when the commanding officers of the U. S. A. hospital center at Allerey--one of the largest in all France--sent for Captain James C. Ramage, the American Red Cross representative in the district.

He told the Red Cross man that a tremendous convoy of wounded soldiers from the Soissons-Rheims district was expected within a few days and asked his help in securing a real bulk of medical supplies. Those were the days when the Surgeon General's department of the army was not always able to furnish even drugs and dressings when they were most needed.

Ramage lost no time in discussing the thing. He said that he would do his best and caught the first train into Paris; spent several days there in getting together the necessary supplies, personally supervised the loading of them into a freight car, and then performed the unheard-of feat of inducing the French railway authorities to attach the freight car to a fast pa.s.senger train bound down to Dijon. Camions were rushed from Allerey to Dijon, and two days later the necessary supplies were all at the hospital center--and well in advance of the coming of the wounded soldiers. On another night in that same summer of 1918, some 2,250 wounded Americans poured into that selfsame army hospital center of Allerey. The hospital warehouses were exhausted. The Red Cross's were not; do you remember what we said at the beginning--that the fullness of its job lay in its being forever ready to meet any emergency which might arise?

It was being ready that made it able that hot August night to turn into the crowded hospital in a s.p.a.ce of time to be measured in minutes rather than in hours, 10,000 blankets, 10,000 sheets, 8,000 towels, 8,000 pairs of pajamas, 2,000 yards of Dakin tubing, 1,000 operating gowns, 1,000 helmets, and two whole carloads of surgical dressings.

Emergency work! How it always does count!

The securing of these supplies in the beginning was, of itself, a master problem. It involved not alone purchase but manufacturing--manufacturing upon a really enormous scale. We saw at the beginnings of the Red Cross work in France the various workrooms in Paris which devoted themselves to the making of dressings--of one sort or another and in tremendous quant.i.ties. Yet the actual beginnings of this work antedated even the establishment of the Paris workrooms; immediately on the outbreak of the European War, a special department was established at the National Headquarters of the American Red Cross in Washington for giving advice concerning hospital garments and supplies for European relief and furnishing patterns and samples for the same. A New York City committee, organized for the same purpose by Mrs. Mary Hatch Willard, began the sending of old linens to French hospitals. This work grew into a unit known as the Surgical Dressings Committee of the United States, for the making of dressings by volunteers in this country, and finally led to the establishment of the first of the Paris workrooms. By the time that Pershing had first arrived in France this work in America had grown to a point where it employed more than two thousand committees and subcommittees. Its output increased so rapidly that in the week ending August 27, 1917, ninety-two hospitals were supplied and 155,261 dressings were made in the Paris workroom alone. And that, of course, was long before there were any American wounded. In the summer of 1917 the National Surgical Dressings Committee entered into cooperation with the American Red Cross and from that date its efficient distribution service in France became the Surgical Dressings Service Department of the American Red Cross.

Then came the imminent necessity of standardizing these surgical dressings--which was accomplished by a special board which Pershing appointed at the end of August, 1917. Its standards were followed, but its energies only dimmed at the time when it was actually seen that they were quite exceeding the necessities of the situation. And the volume of those selfsame energies is perhaps the better understood when it is realized that from October, 1917, to January 22, 1919, 147,230,777 cases of surgical dressings alone, both donated and manufactured, were received at the Red Cross warehouses in Paris.

Splints, of which an immense number were necessary even for the very short period in which we were actually engaged in the conduct of the war, formed a real Red Cross specialty. Our army hospitals were entirely dependent upon the American Red Cross for these necessities--the total orders for which in July and August of 1918, totaled some 15,000 to 20,000 weekly. For that entire year the output was 94,583 splints, the factories often working from eighteen to twenty hours a day to keep pace with the requisitions upon them. Our Red Cross also supplied all the nitrous oxide used in American hospitals of every type in France. The use of this ultra-modern anaesthetic, to the increasing exclusion of ether and of chloroform, forms one of the fascinating chapters of the medical conduct of the war. Although it had been employed as an anaesthetic in the United States for a number of years before the beginning of the war, its first use in Europe was when Colonel George W.

Crile--the distinguished surgeon from Cleveland, Ohio--introduced it into operations in the then American Ambulance Hospital at Neuilly--afterward the American Red Cross Military Hospital Number One.

That was in 1915. Nitrous oxide as an anaesthetic immediately attracted the attention of a number of eminent British surgeons.

"It is good," said Colonel Crile, tersely.

And so it is--good. It is so good that Colonel Alexander Lambert, at that time chief surgeon of our American Red Cross, immediately made it the standard anaesthetic of its medical service. For, like so many other American surgeons, he quickly concurred in the opinion that nitrous acid, used in combination with oxygen, three parts to one, is the least dangerous as well as the best adapted for use when operating upon cases of chest surgery, abdomen wounds, or of shock. Under this anaesthetic the percentage of recovery is seventy-two per cent, as compared with fifty per cent for either chloroform or ether. Moreover, it has none of the disagreeable after effects which come almost invariably with the use of chloroform or ether. To quote Colonel Lambert:

"The use of nitrous-oxide anaesthetic to the exclusion of ether or chloroform in case of at least the seriously wounded seems to me not only advisable but beyond the advisability of discussion."

Its official use, therefore, was predicated. It was first supplied to the casualty-clearing stations; American and British cooperating for the sake of an exchange of ideas as to its best use. Our Red Cross supplied an apparatus of special design that had gradually been evolved from those already devised. This allowed the separate administration of the nitrous oxide, of oxygen, or of ether--which at times was used in small quant.i.ties--or of the three in various combinations. And all our American nurses were trained as anaesthetists in its use.

The making of the nitrous-oxide gas itself was one of many similar tasks a.s.signed to the Manufacturing Department of our Red Cross, of which Major Arthur W. Kelly was department chief. He ordered a huge gas-making plant from America which, after some considerable delay, finally was set up at Montreau, fifty miles distant from Paris. In the meantime the Red Cross had discovered a man in the French Army who had had some experience in the making of nitrous oxide. He was released from active army service and at once started to work making an emergency supply, the limited quant.i.ties carried to France by Colonel Crile having become completely exhausted. This small plant had a daily capacity of about 4,000 gallons. But when the bigger machinery from America had finally been set up--in the midsummer of 1918--this output was increased to 75,000 gallons a day. This could easily have been doubled, had it not been for a single limiting factor--the extreme difficulty of securing 3,280 gallon cans in which the gas was transported. Finally the Red Cross secured some hydrogen tanks that had been captured from the Germans in their first July defeats. It was then and not until then that the nitrous-oxide plant began running at anything like its real capacity. And with the definite result that from September, 1917, to October 23, 1918, our Red Cross was able to supply our army with 699,420 gallons of this precious anaesthetic, its own hospitals with 405,620 gallons, and some miscellaneous inst.i.tutions with an additional 251,110 gallons, while it saw Great Britain formally acknowledge nitrous oxide as an anaesthetic _par excellence_ and even conservative France making the first steps toward its adoption.

A few of the medical and surgical requisitions of a typical American Army Division--the Second--upon our Red Cross are before me as I write.

They are indicative of the overwhelming demands that were made upon it, not only from every corner of the front, but from every corner of France that was occupied by our fighting men--and what corner was not?

It was at the request of the chief surgeon of this Division that one of its field hospitals--originally supplied direct from the army's own sources of supply--was amplified by the American Red Cross, by the use of Bessoneau tents and other equipment so as to become practically a mobile unit, capable of handling far heavier cases. The supplying of the equipment shown by these requisitions began while the division was still in the vicinity of Montdidier and continued until after it had moved to Meaux and was in active preparation for its great role at Chateau-Thierry. In addition to the Bessoneau tents, the following were the requisitions which were delivered to this single formation while it was under heavy pressure:

_June 1_: 1 tortoise tent and 100 collapsible cots.

_June 3_: 12 ant.i.toxin syringes for anti-teta.n.u.s serum, 200 packages of absorbent cotton, 30 feet of gla.s.s tubing, and 25 operating gowns and caps.

_June 4_: 250 single blankets, 100 litters, 5,000 anti-teta.n.u.s serum, 2 autoclaves, 4 thermometers for autoclaves, 50 wash cloths, 1,000 pairs of socks, 50 towels, and 200 comfort kits.

_June 6_: 50 clinical thermometers, 2,000 temperature charts, 1 gallon of green soap, 36 bottles of ammonia, 5,000 Greeley units, 20 syringes, 15 liters of Lysol, 20 chart holders, 100 rubber sheets, 2 small instrument sterilizers, 500 nightshirts, 500 blankets, 1,000 sheets, 500 forks and spoons, 100 bedside tables, 100 folding chairs, 50 hot-water bottles, 36 maps, 50 hand basins, 20 bolts of gauze, 10 bolts of muslin, 100 beds, and 100 mattresses.

_June 7_: 200 litters, 250 blankets, 100 rolls of cotton, 200 rolls of gauze, 144 rubber gloves, 100 operating gowns and caps, 96 tubes of catgut, 500 Carrel pads, 100 gowns for nurses, 20 sterile water containers, 5,000 folded gauze compresses, and 5,000 small sponges.

I rather feel that this record of a single week of the demands of one Division upon our Red Cross will show quite enough the burden which it was forced to bear; and bore most joyously as a part of the opportunity for service which was given unto it in France. In a single day and night during that same great offensive of 1918, 128 different requisitions--each comprising from one to fifty items--were started out on the road from Paris; while on the twentieth of August of that same summer--the day which marked the beginning of the St. Mihiel drive--120,000 front-line emergency parcels and more than fifteen carloads of surgical dressings were shipped to the scene of activity.

From the Paris headquarters of the Red Cross alone, supplies were shipped that summer to sixty-six base hospitals, two naval-base hospitals, fifty-four camp hospitals, twenty-one convalescent hospitals, twenty army divisions, seven evacuation hospitals, nine field hospitals, eight hospital centers, nine mobile hospitals, six medical supply depots, and the central medical department laboratory--all of the United States Army in France. This great record does not, of course, include the supplies sent to the Red Cross's own hospitals or those sent to the A. E. F. hospitals from the nine zone headquarters of the American Red Cross; nor even emergency supplies sent to eighteen detached American Army units, far away from their bases of supplies. In a single month and from one warehouse, our Red Cross made the following shipments to formations operated entirely by our army: 77,101 surgical instruments, 2,820 beds and cots, 24,733,126 surgical dressings, and 15,300 pounds of drugs.

It also supplied specialties, and all for the comfort of our wounded boys over there. Take ice--that simple product of our modern civilization--so indispensable to the American. It is second nature with us to-day and yet little used by the French. Ice is as much an essential to our up-to-date hospitals as drugs or nurses or the beds themselves.

Properly packed, it cools the fever and so greatly eases the sufferings of wounded men as they toss upon their cots. Its beverage use is too universal to even need comment here.

"My, that's good!" more than one sick boy murmured, as the nurse held a spoonful of it to his hot lips. "It's just like home."

Yet, while our government planned ice-making machinery for each of its hospitals, large or small, they were not always ready as quickly as the rest of the plant. There again our Red Cross stepped into the breach, supplying small portable ice-making plants not only to the field hospitals for which they were originally designed, but even for larger installations. Each of these portable plants consisted of a gasoline engine of fifteen horse power, water-cooled and attached to a compressor, which in turn was connected to the water piping in the brine tanks. The capacity of each of these was about two tons and a half each twenty-four hours. And each was accompanied by two Ford camionettes--builded with special ice boxes--to carry its product to the wards roundabout.