A LETTER HOME FROM A CASUALTY CLEARING STATION

     During the Great War some hospitals invited their nurses 'on active service' to write letters home, to give a first-hand account of  life overseas, and to keep their colleagues up to date on how they were.  This letter was written to the Nurses' League of St. Bartholomew's Hospital, London, by Kathleen Mary Latham, who trained at the hospital between 1906 and 1909. Although the unit is not named in the account, it is almost certainly No.3 Casualty Clearing Station, initially in Hazebrouck, but at the time of this letter in Poperinghe, moving to the asylum at Bailleul after bombing raids.

     I am sending you a sketchy account of work at our Casualty Clearing Station from February to June 1915. It all seems very far away, after being at the base for six months.Five of us joined one of the 'clearing hospitals,' as they were then called, in November, 1914. It was about 20 miles behind the firing line, and as we were the first Sisters to go up so far, except those working on trains, we proudly considered ourselves pioneers. We worked there through the winter, never very busy for more than a few days at a time. In fact, when no active fighting was going on, it was a 'cleaning' rather than a 'clearing' hospital.

      In February we moved across the Belgian frontier to a mean little town which boasted, however, a fine square and three large churches. The country round is ugly and flat, only hop-poles breaking the monotony of the brown fields. Various scattered buildings, including two convents, were requisitioned for our patients. We were billeted, at first, in separate houses, but later most of us moved into a Carmelite Convent. Miss Appleton and I had adjoining cells, tiny white rooms, with texts in black printed on the walls. The windows looked out on a little green garden, with a great tulip tree in the centre white with flowers. We sat on the high sill one night, when there was continuous heavy firing, thinking our big guns must be doing tremendous execution. The sky was ablaze with gun-flashes and rocket flares, and three searchlights were industriously weaving cross-patterns in search of hostile aircraft. The guns thundered on till early morning. We heard at breakfast that we had lost a village and the Germans had nearly broken through the line.  In the same Convent were lodged several Nurses working at a Red Cross Hospital under Madame O'Gorman. they sought out civilian enteric cases, with the medical officer, and brought them to a chateau near. It was very hard work, as most of the patients had been ill some time, and they did a great deal towards staving off the epidemic that threatened to work havoc in that part of the country.

      Our serious cases, trephines, chest and abdominal wounds, amputations etc., were kept in one ward, which we called 'the nursery,' as they were all so helpless. Ambulance convoys usually arrived about 10 am, the men in their muddy clothes as they left the trenches, very good and patient, taking everything as a matter of course. The medical officers started on their dressings at once, and we changed their wet things and washed faces and hands, and more if there was time. Then came dinner and a short rest before the ambulances arrived to take them to the hospital train. The serious cases remaining were then taken to the acute ward, and we kept them for three days to a week, or longer if necessary. After the evacuation we cleared up the wards, had the floors scrubbed, cut dressings for the next day, and took turns of duty. It was quite a satisfactory programme.  Taubes paid us frequent visits, and the French gunners always greeted them with a salvo from their anti-aircraft guns. It was most exciting to watch the trail of little white or black puffs following the aeroplanes, and thrilling to see them come down or waver when hit. If they were overhead they generally dropped bombs in or near the town, sometimes doing considerable damage. On one occasion two fell in the middle of a cobbled street, just off the square, killing and injuring many civilians and soldiers. They were all brought to us at first, but it was difficult to deal with the women, and we were very glad when they were removed to the civilian hospital that night.

      A very useful institution in emergencies, and when convoys arrived, was a St. John Ambulance Motor-kitchen, which lived temporarily outside one of our convents. Water was always boiling, and we had only to ask for Bovril, tea, milk, etc., to get it at once, steaming hot. We missed that kitchen sadly when it moved elsewhere. During a fairly quiet time I got a lift one afternoon into a famous old town, about 11 kilometres away, which it had long been my ambition to see. We went all over ... Most of the other buildings were intact, and the business went on in the back premises if the fronts of the shops were damaged. There were plenty of civilians about. A few weeks later, however, during heavy bombardment, the place was absolutely wrecked.

      Shortly after, we had our hands full. Convoys arrived at all hours of the day and night and evacuations went on simultaneously. It was as much as we could do to feed the men and change their dressings. Those who remained got as much attention as possible, but it was often tragically little. Our staff was gradually increased to thirteen, but even that was not much when the number of patients through the day reached 1,100. The orderlies worked splendidly, and of course no one thought of off-duty time, and not much of meals. Our quietest time was when we left the night Sisters to tackle the work, and sat down and cut dressings, about 9.30 pm.

      About April 22nd, victims of the first gas attack were brought in. I could not imagine what was the matter with the first patient. He was in great pain, cyanosed and vomiting, and could tell us nothing. Then a Staff Officer came up with the Doctor and compared the man's green buttons with one he had in his pocket, telling us of the Germans' new weapon. We had many cases, but comparatively few were fatal, unless they succumbed after they had left us. Stimulants and oxygen were tried with varying success; the medical officers differed a good deal in their treatment.

      On the 24th, a patient asked me curiously if the place were ever shelled. I told him no, although we were used to bombs, and immediately afterwards heard the whistle of a shell overhead (he must have heard a previous one), and knew the Germans had got within range. we only got small shells that day and the next, and most of them fell beyond us, though there was one hole in the road opposite the College which we had taken over from the French Red Cross. As I was coming from our billet to the hospital on passed directly over my head, and my hair seemed to rise up to meet it, a most unpleasant sensation. Next day there was a pause in the stream of patients, and with much satisfaction we had the floors scrubbed, and cleaned out the Red Cross boxes which did duty as cupboards. Suddenly there was a tremendous crash, and the air was so thick with red dust that we had to shut the doors. Others followed but none seemed so loud as the first, perhaps because it was so unexpected. A fresh convoy arrived, and at the same time they brought in men injured by the shells. They had received no first aid, and were smothered in dust from bricks and plaster. we were too busy to mind the explosions, which occurred regularly every five minutes for about an hour and a half. One fell somewhere in the hospital. we heard the tinkling of falling glass, and found afterwards it had made a hole in the roof of one of the wards and hurt no-one.

      Three of the men in my ward died that afternoon, and four more were in a desperate condition, when orders came that we Sisters were to pack up at once and be ready to leave in half an hour. It was useless to remonstrate, so we hurriedly collected our belongings and bundled them in somehow. In the end it was 11 pm when we left. Another clearing station had started work a week earlier, and their Sisters came with us, among them Miss Waterman and Miss A. M. Jones from Bart's. We were packed into two ambulances and a motor. I was one of the lucky ones in the latter, and enjoyed the drive through the night air immensely. We heard shells falling behind us, and hoped the hospital was safe. Crowds of refugees trailed wearily along the road, meeting convoys of empty ambulances returning to the firing line. Our progress was slow until we reached Cassel - up through the town asleep on its hill, then down to the plain again and on to the twinkling lights of St. Omer. They put us in an empty ward in a stationary hospital for the rest of the night. We slept on stretchers, and wondered we had never noticed before how much they creaked.

      There were a few welcome days to rest before our clearing station started work again. It was established in a fine lunatic asylum on high ground outside an old market-town. the original patients remained, but we occupied a block separated from the rest of the building by a wooden barricade. We saw them occasionally and heard them often. The surrounding country is quite pretty and was then at its best. From wooded hills within walking distance we could see right across the plains to the sea and beyond the firing line far into Belgium. Trenches could only be made out with glasses.  We got many cases of gas poisoning in May and June - worse on the whole than in the first attack. Fortunately the wards were ideal for nursing them - tiled floors, large windows the whole length of each side wall, and no superfluous furniture. Lights were strictly limited at night, and it was rather ghastly on night duty. Most of us agreed that we would rather nurse double the number of seriously wounded. After the second gas attack, convoys of wounded generally reached us about 4 am, and as the hospital train left at 9.30 am, we had our work cut out to get them ready in time.

      I left for duty at another clearing station in July but got the chance occasionally to go back and see old friends. Shortly after one visit I was horrified to hear that a 17 inch shell had made a direct hit on the night orderlies' tent and blown it to pieces. Four were killed and two wounded - one of the former was to have gone on leave that very day and he was the best orderly we had. The Sisters were sent away again and the hospitals in the town at once emptied of patients but, curiously enough, the place has never been shelled again.  Sir Anthony Bowlby and Sir Wilmot Herringham were consultants to the clearing stations and came round very frequently when active fighting was going on. Of course, as happens everywhere, we were continually meeting Bart's men and nurses. I thin we must be as well represented in France as any of the London Hospitals.
To quote Tommy's almost invariable ending to a letter:
'I must now draw to a close, hoping this finds you as it leaves me at present'

With best wishes to the League
K. M. Latham