By Paul Theerman, Ph.D., Director of the Library

A hundred years ago this week, medical doctor Lt. Charles Terry Butler (1889–1980) entered Germany with the Army of Occupation. Yes, the Armistice had been signed a full three weeks prior, but “Charlie’s war” was not yet over. He would remain in uniform for over four more months. Through his detailed memoir, A Civilian in Uniform [1], we have   insight into his war service and the work of Evacuation Hospital #3, which followed the American war effort across France and into Germany in 1918 and 1919.

As detailed in a previous blog entry, in 1916, Butler, newly graduated from medical school, spent six months as a volunteer surgeon in a British-French military hospital outside Paris, the “war before the war” for Americans.  His experience at Ris-Orangis turned out to be crucial for his later war service. Three months after he returned home, the United States entered the war on the side of the Allies. Butler’s adventures over the next two years capture much of the American medical experience of the Great War.

Butler’s first “battle” was to avoid getting drafted into the infantry so that he could serve in the medical corps.  A draft started right upon declaration of war on April 6^th, and as a young man of 27, Butler was likely to be called up. He instead volunteered for the Army Medical Reserve Corps, where, with a medical degree, he received a commission as a first lieutenant in August. He was directed to go to Camp Greenleaf in Fort Oglethorpe, Georgia, by September 15^th for additional training. [2] Afterwards, Butler shipped from Hoboken on January 12, 1918, bound for Saint-Nazaire, France, at the mouth of the Loire River, arriving on the 27^th. Within a few weeks, Butler’s medical contingent was sent up the Loire and was divided, half to a hospital in Tours and half to one in Blois, both well behind the lines. He would serve separately in these locations over the next five months.

In early July, as part of “Evacuation Hospital #3,” he was moved to Rimaucourt, in the département of Haute Marne, close to the front. On July 29^th, the operation moved to La Ferté-Milon “70 K. from Paris, about 23 K. from the Front.” [3]

The sound of guns was plainly audible; the signs of war were everywhere about. The station was almost wrecked—one end blown to atoms by a shell that had come through the roof. Everywhere were shell holes; among the tracks, in the platforms, and in the fields.… Houses everywhere were gaping ruins—roofs knocked off, holes in the walls, windows smashed. For, until the first Allied counteroffensive started, the enemy were within 4K. of the town. [4]

That afternoon he and his comrades explored the devastated town; less than a week later, the hospital was moved to Château-Thierry and then Crezancy. Butler’s hospital formed part of the medical services supporting the first major American military action in the War. “The camp at Crezancy was the first at which the organization came face to face with all kinds of casualties straight from the front.” [5] His unit remained close to the fighting, treating the wounded of the many battles of the Meuse–Argonne offensive, up until the Armistice on November 11^th that marked the War’s end. On that day, Butler wrote to his mother from behind the lines at Verdun:

Everyone is wild with joy! The war ended this morning at eleven. But it’s hard to realize. Automatically we camouflage our lights, but I don’t doubt will get out of that habit before long. . . . They had a big bonfire after supper [tonight] to celebrate with speeches, song, etc. . . . Now we are wondering what will happen to us. There is some talk of our going into Germany with the Army of Occupation, but we have as good chance of getting home fairly early. [6]

Home early was not to be: in December the unit moved north through Luxembourg to Trier, Germany. There it provided medical services for Allied soldiers held in a military prison hospital. For the first time, Butler noted the Spanish Flu in his war reminiscence:

Worn out by months of fighting, their resistance exhausted from the long march, hundreds fell easy prey to the virulent flu-pneumonia bug that was epidemic. While I was in charge of the pneumonia ward, of the 153 admissions, 50 died—one-third. A soldier would come in on his feet and be dead in 48 hours.  The work was utterly frustrating. . . . [7]

After four months, the unit was ordered home. It left Trier on March 27^th and arrived in Brest, France, on the 31^st, then embarked by ship on April 12^th for Hoboken, arriving on the 20^th. On April 27^th, Butler was discharged from the military at Fort Dix. Between his volunteer service in 1916–1917, and his military service in 1917–1919, he had served over two years, or half of the war.

After the war, Butler married, had children, and entered private practice, but by 1923 rheumatoid arthritis led him to retire. Moving to the Ojai Valley of Ventura County, California, he became a prominent civic and cultural leader. In 1975, after many years of work, he privately published A Civilian in Uniform as perhaps “the most complete account of one of the most active large mobile evacuation hospitals” in the First World War. Butler died in 1980.

Reading through A Civilian in Uniform one learns the reason for its writing: to combine the historical and the personal. Throughout the work, Butler mixed his letters and diary entries with understanding of the war and the official account of his hospital unit. He was justly proud of that unit:

This outfit, through trial and error and after many varying experiences in battle areas, had reached a state of efficiency in all departments that may have served as a useful guide for the structure and administration of evacuation hospitals in World War II. [8]

And of his role:

Yet when, from the multi-thousands of wounded who passed through the portals of these two hospitals, are sorted out the hundreds who owe much of their future physical well being to the professional performance of one single individual, and perhaps that man’s work during those years of bloodshed warrants, in philosophical perspective, a place a notch or two above the microscopic level. [9]

For many, the attraction of war may come from the desire to play a role in a venture of world-wide consequence. For Butler, this played out through his medical work in World War I.

The New York Academy of Medicine Library also houses Butler’s papers.

References:

[1] Charles Terry Butler, A Civilian in Uniform (Ojai, CA: “Private edition,” 1975).
[2] Butler was expected to outfit himself for his service, in the amount of $275.00 for uniforms, insignia, blankets, cots, and incidentals such as mirrors, electric lights, and candles. He received $2,000 a year in compensation, from which were deducted the premium for War Risk Insurance—life and disability insurance provided through the government—and $1.00 a day for officers’ mess! Butler, A Civilian in Uniform, 123–24.
[3] Butler, “Diary,” July 30, 1918, A Civilian in Uniform, p. 230.
[4] Butler, “Diary,” July 30, 1918, A Civilian in Uniform, pp. 230–31.
[5] Butler, A Civilian in Uniform, p. 248.
[6] Butler to “Mother” [Louise Collins Butler], November 11, 1918, in A Civilian in Uniform, pp. 312–13.
[7] Butler, A Civilian in Uniform, p. 332. There also Butler was assigned the task of writing the history of Evacuation Hospital #3, which formed much of the basis of A Civilian in Uniform.
[8] Butler, A Civilian in Uniform, p. 364.
[9] Butler, A Civilian in Uniform, p. 355–56.

By Paul Theerman, Associate Director

The centenary of the United States entry into World War I was this past April. But wars—even those having such sharp cease-fires as this one did, on November 11, 1918—rarely have well-defined beginnings and endings. Even before the official American entry, Americans served in France from the outbreak of the war in 1914. Expats in Paris formed the American Ambulance (the term then meant field hospital), which spun off the American Field Service, charged with transporting wounded soldiers from the front line and providing immediate care. In direct combat, the famed Lafayette Escadrille was founded in 1916, made up of volunteer American air fighters under French command, who battled the Germans up until actual American military deployment two years later. And in the realm of battlefield medicine and surgery, Americans served as volunteers in France from 1914 up to 1917. One of the most noted was Dr. Joseph A. Blake (1864–1937) who, at the outbreak of war, resigned from his prominent surgical positions at Presbyterian Hospital and Columbia College of Physicians and Surgeons, and went to France. There he successively headed up three volunteer hospitals in Neuilly, Ris-Orangis, and Paris, up until his induction to the American military medical corps in August 1917 where he continued his work.

Blake had an outstanding reputation, so much so that he readily attracted both funds and workers. One such surgeon was Charles Terry Butler (1889–1980) whose memoir, A Civilian in Uniform (1975), and personal papers are held in the Academy Library. Butler was born in Yonkers, New York, to a prominent family. He was the son of lawyer William Allen Butler, Jr., whose father, William Allen Butler, Sr., both lawyer and author, was himself the son of Benjamin Franklin Butler, U.S. attorney general in the Andrew Jackson and Martin Van Buren administrations. Charles Butler led a life among the New York elite. As one example, he remembers that his family hosted William Howard Taft to dinner during his presidency.[1] Butler went to Princeton University, where he graduated in 1912, and then to medical school at Columbia University College of Physicians and Surgeons. After his graduation in 1916, he was due to take up an internship at Presbyterian Hospital that July. He postponed it to January in order to serve under Blake, then at the Anglo-French volunteer hospital in Ris-Orangis, France, some 25 miles southeast of Paris. As Butler put it:

My two year internship would be put off six months, but here was the opportunity to learn the treatment of serious war wounds under a great surgeon, perhaps my only chance to have such training, and if the United States were forced into the war, I would be much more useful to the Army.[2]

Blake promised Butler scant remuneration, 400 francs travel expenses each way, and 100 francs a month salary, relying on his “contribution” to aid the cause.[3]

Butler left for Liverpool on May 27, and—after a long period of negotiating his credentials to enter France, as authorities were concerned about German infiltrators—he arrived at the Ris-Orangis hospital on June 10. A converted college, long empty before its refitting, the hospital was organized by two English patrons and operated by private donations and support from the French military. The hospital held about 200 beds, with a surgical theater and supporting radiology and bacteriological facilities, as well as, of course, kitchens and laundries.

Butler’s letters home trace his awakening to war and medicine. Within a week, he wrote to his uncle Clare:

The hospital has about 200 beds, and on my arrival I was put in charge of two wards with over 90 beds and some 80-odd patients. It was some contract to start with, and for two or three days I hardly knew whether I was coming or going. I did about forty dressings a morning with three nurses to help me, and two getting their patients ready for dressing ahead of me and bandaging up when I was through. It took over three hours of hard, steady work.[4]

After a month, to his mother:

Last Sunday, 65 new blessés arrive—the majority of them frightfully wounded. They come by ambulance from a distributing railroad station some 6–7 kilometers away. Arriving in bunches of four or eight, they are sent immediately to their beds. Most of the orderlies had been given leave that day, so we doctors had to turn to and help carry them to the wards. (It isn’t particularly easy carrying a large man on a heavy stretcher with his trappings up three flights of stairs.) There they are undressed; their clothes put in a bag, tagged, and sent to be sterilized and cleaned; and then bathed. . . . The next thing is food. Many have not had anything for 24 hours or more while en route from the front or the last hospital. Then the surgeon comes along. Dressings, casts, splints, etc. are removed so as to see the condition and nature of the injury. It would be impossible to describe the state of some of the wounds—many not having been dressed for several days, some even for 10 or 14 days. A hasty and rather superficial cleansing must suffice for the time being, until the patient comes back from the X-ray room. … All the wounds are terribly infected, and a large percentage have foreign bodies (balls, pieces of shell, clothing, stones, dirt, etc., etc.) lodged…. [Surgery followed, aided by X-ray and fluoroscopy.] The recoveries are wonderful. Men whom no one would expect to live, ordinarily, in a civil hospital, hang by a hair for days and come around O.K.[5]

Butler noted that the average length of stay at the hospital was almost 50 days.

Ris-Orangis was considered one of the most successful hospitals in the war. [One of the founders, Harold J. Reckitt, wrote a detailed history of the hospital, V.R. 76: A French Military Hospital (1921)]. Butler spent most of his time dressing wounds, with little occasion for actual surgery. He returned to New York in January 1917 to take up his internship at Presbyterian. But upon the American entry into the war in April 1917, he was commissioned a first lieutenant with the United States Medical Corps, serving into 1919—the topic of a future blogpost. Butler’s experience at Ris-Orangis was crucial to his surgical accomplishments in this second phase of war service. After the war, he entered private practice, but by 1923 ill health—apparently resulting from wartime conditions—led Butler to retire. Moving to the Ojai Valley of Ventura County, California, he became a prominent civic and cultural leader up to his death in 1980.

References:
[1] Butler, Charles Terry. A Civilian in Uniform. Butler, 1975, p. 28.
[2] A Civilian in Uniform, p. 49.
[3] Blake to Butler, 29 April 1916, A Civilian in Uniform, p. 49.
[4] Butler to “Uncle Clare” [Clarence Lyman Collins (1848–1922)], 17 June 1916, A Civilian in Uniform, p. 57.
[5] Butler to “mother” [Louise Terry Collins (1855–1922)], 7 July 1916, A Civilian in Uniform, p. 62–64.

Images:
Charles Terry Butler, “Ris-Orangis, France, 1916,” photographic album. Charles Terry Butler papers. New York Academy of Medicine Library.