Highlighting NYAM Women in Medical History: Emily Dunning Barringer, MD

Posted on November 16, 2020 by nyamhistory

By Paul Theerman, Director

Academy Fellows lead by serving, now during the COVID-19 crisis as in the past. This is the sixth entry in our 2020 series on early women NYAM Fellows and their contributions to society. For earlier posts, see Sara Josephine Baker, Martha Wollstein, Daisy Maude Orleman Robinson, Sarah McNutt, and Elizabeth Martha Cushier. Please also see our biographical sketch of Mary Putnam Jacobi, the first female Fellow of the New York Academy of Medicine.

While Emily Dunning Barringer (1876–1961) shares many things in common with other early women Fellows of the Academy, she can claim one unique distinction: having her life story made into a feature film. The Girl in White—based on Barringer’s 1950 memoir, Bowery to Bellevue: The Story of New York’s First Woman Ambulance Surgeon—debuted in 1952 and starred June Allyson. In the film as in her life, Barringer overcame both institutional barriers and deliberate affronts as she pursued a career as a woman professional in an overwhelmingly male world.

June Allyson portraying Dr. Emily Dunning Barringer in the 1952 film *The Girl in White*. Promotional photograph from the private collection of NYAM Fellow Patricia Gallagher.

Barringer was born in 1876 to a wealthy family in Scarsdale, New York. Her parents, Edwin James Dunning and Frances Gore Lang, believed that all children, regardless of gender, should be educated and trained to support themselves. The family fell on hard financial times when Barringer was 10, and a well-meaning friend’s suggestion that perhaps the young girl should train as a milliner only served to strengthen Frances Dunning’s resolve for her daughter to receive a college education. With the support of her uncle, Henry Sage, one of the founders of Cornell University, Barringer did so, graduating from Cornell in 1897 before going on to medical school at the College of Medicine of the New York Infirmary, which merged with the new Cornell University School of Medicine during her time as a student.

The NYAM plaque honoring Barringer’s service as an ambulance surgeon in New York City hospitals.

Graduating from medical school in 1901, Barringer applied for a residency at New York City’s Gouverneur Hospital but was rejected despite receiving the second highest score on the qualifying exam. Undeterred, and with the help of Dr. Mary Putnam Jacobi, she reapplied the following year and this time was accepted, becoming the first woman to earn a position as surgical resident. Acceptance into the program, however, did not mean acceptance by other residents or their supervising physicians, and in her autobiography, Barringer recounted that she had been harassed and given the most difficult and unpleasant assignments and schedules. One difficult role, however, she sought herself, that of ambulance physician, and when she was given the position, she achieved a second “first”: the first female ambulance surgeon. Overcoming the skepticism of her male colleagues who felt that a woman would not be able to withstand the physical challenges of the role, she went on to earn not only their respect, but also the respect of city firefighters, police officers, and the patients she treated in Manhattan’s Lower East Side tenements.

She fell in love with fellow doctor Ben Barringer during her residency, and they married in 1904 when her residency ended. She immediately experienced frustration because her opportunities for work and further training were so much more constrained than her new husband’s. The pair lived for a short time in Vienna where both attended class, and then returned to New York City. Barringer took a position on the gynecological staff at New York Polyclinic Hospital and worked as an attending surgeon at the New York Infirmary for Women and Children, where she specialized in the study of venereal diseases.

Poster for the 1952 MGM film *The Girl in White*. From the private collection of NYAM Fellow Patricia Gallagher.

During World War I Barringer served as vice chair of the American Women’s Hospitals War Service Committee of the National Medical Women’s Association (later the American Medical Women’s Association). In that role, she spearheaded a campaign to raise money for the purchase of ambulances to be sent to Europe. When the war ended, she became an attending surgeon at Brooklyn’s Kingston Avenue Hospital and subsequently its director of gynecology. She was a member of the American Medical Association and a fellow of the American College of Surgeons and The New York Academy of Medicine. In 1941 Barringer was elected president of the American Medical Women’s Association (AMWA).

Over the course of her long medical career, Barringer advocated for legislation that would control the spread of venereal disease and authored numerous articles on gynecology. As Chair of the Special Committee of the American Medical Women’s Association, Barringer was decorated by the King of Serbia for championing the service of female physicians during World War I. As co-chair of the War Service Committee, she helped to organize the American Women’s Hospital in Europe, which provided medical and surgical care during the war and postwar reconstruction. During World War II, Barringer successfully lobbied Congress to allow women physicians (who had been allowed to work only as contract physicians and were consequently denied the benefits earned by their male counterparts) to serve as commissioned officers in the medical corps of the Army and Navy.

After World War II, Emily Barringer and her husband retired to Connecticut. She died there in 1961.

_____

References

Changing the Face of Medicine: Dr. Emily Dunning Barringer; National Library of Medicine. https://cfmedicine.nlm.nih.gov/physicians/biography_23.html. Accessed November 10, 2020.

Women Physicians in WWII: Dr. Emily Dunning Barringer; American Medical Women’s Association. https://www.amwa-doc.org/wwibios/dr-emily-dunning-barringer/. Accessed November 10, 2020.

Dr. Emily Dunning Barringer; Connecticut Women’s Hall of Fame. https://www.cwhf.org/inductees/emily-barringer. Accessed November 10, 2020.

Women in Medicine: Dr. Emily Dunning Barringer; Mental Floss. https://www.mentalfloss.com/article/63610/women-medicine-dr-emily-dunning-barringer. Accessed November 10, 2020.

Highlighting NYAM Women in Medical History: Elizabeth Martha Cushier, MD

Posted on October 15, 2020 by nyamhistory

By Arlene Shaner, Historical Collections Librarian

Academy Fellows lead by serving, now during the COVID-19 crisis as in the past. This is the fifth entry in our series on early women NYAM Fellows and their contributions to society; for earlier posts, see Sara Josephine Baker, Martha Wollstein, Daisy Maude Orleman Robinson, and Sarah McNutt. Please also see our biographical sketch of Mary Putnam Jacobi, the first female Fellow of the New York Academy of Medicine.

When Elizabeth Cushier (1837–1931) was elected a Fellow of the New York Academy of Medicine in 1889, she was only the third woman to be invited into the Academy, joining two of her colleagues from the New York Infirmary for Women and Children, Dr. Mary Putnam Jacobi and Dr. Sarah McNutt.

Cushier was born in Jamaica, New York, on November 25, 1837, a daughter of John Henry and Martha Lumley Cushier. She was the sixth of eleven children, but three of her older siblings had died before she was born; five other younger siblings followed. In her autobiography, published as an appendix to Kate Campbell Hurd-Mead’s Medical Women of America, Cushier said this about her childhood: “We were brought up in the strictest economy, as my father’s income was a very limited one, but we were, as I remember, a happy, healthy lot, quite enterprising and consequently often trying.”[i] When she was sixteen, the family moved to Little Falls, New Jersey. Cushier quickly became friendly with the Hinton family, who had also relocated from New York, and forged a life-long friendship with Ione Hinton. The family’s wide-ranging intellectual interests, along with their support of abolitionism and women’s suffrage, resonated with her and encouraged her independent spirit.

After her mother died in 1859, Cushier took on much of the household responsibility, caring for her father and her four living younger siblings. His remarriage a year later freed her to go to New York, where she got a position singing with a church choir and gave private voice lessons. In the summer of 1868, she happened to read a medical article that sparked her interest, and she enrolled in the homeopathic New York Medical College for Women before transferring a year later to Elizabeth and Emily Blackwell’s Woman’s Medical College of the New York Infirmary, graduating in 1872.

Cushier’s 1872 graduation noted in the Annual Announcement of the Woman’s Medical College of the New York Infirmary, noting her thesis topic as “Endometritis.” Woman’s Medical College of the New York Infirmary (N.Y.). *Annual catalogue and announcement.* New York: S. Angell, 1871.

Cushier stayed on at the Infirmary, beginning as an intern before becoming a resident physician. Her practice was devoted to obstetrics and gynecology, but an interest in normal and pathological histology led to eighteen months of study in Zurich with a Professor Ebert, who offered her laboratory opportunities that were not yet available to women in the United States. Laboratory research, pathological and post-mortem study, lectures, and bedside clinics all enriched her knowledge before she returned to New York.

The Woman’s Medical College of the New York Infirmary on Stuvvesant Square. Woman’s Medical College of the New York Infirmary (N.Y.). *Annual catalogue and announcement.* New York: M.J. Rooney, 1891.

On her return, Cushier went right back to the Infirmary, and worked to expand the practice of gynecological surgery there. Thomas Addis Emmet and T. Gaillard Thomas, who were on the staff at the Woman’s Hospital (and both of whom were NYAM Fellows), allowed her to attend clinics there, and the Infirmary, in its larger home on Stuyvesant Square, eventually added a modern operating room for both gynecological and abdominal surgeries. As her work at the Infirmary and her private practice continued to grow, she published articles and case studies, mainly about gynecological and obstetrical subjects.[ii]

In 1882, Cushier’s personal life changed significantly when she and Emily Blackwell (1826–1910) began to live together in Blackwell’s home on East 20^th Street. Cushier and Blackwell also bought a summer home, Seawold, near York Cliffs, Maine, in 1893. After the Woman’s Medical College closed its doors in 1899, both women retired from practice and headed to Europe, where they spent eighteen months. On their return, they gave up their city home, moving to Montclair, New Jersey, where Cushier’s niece, Dr. Emily Mercelis, also lived. When Blackwell died in September 1910, just a few months after her older sister Elizabeth (1821–1910) died in England, Cushier called the moment “an irreparable break in my life.”[iii]

Elizabeth Cushier and Emily Blackwell’s home in Montclair, NJ. Photograph by Elisa Rolle, originally published in her *Queer Places: Retracing the Steps of LGBTQ People around the World.* CreateSpace Independent Publishing Platform, 2017.

Cushier lived for another 20 years, going to Maine in the summers and living in Montclair for the rest of the year. No longer engaged in the practice of medicine, she felt her days were not useful, until the First World War brought the opportunity to do relief work for French and Belgian women and children and for servicemen through the Red Cross. She died on November 25, 1931, her 94^th birthday, and is buried, alongside her parents, in Green-Wood Cemetery in Brooklyn.

________

Notes

[i] Kate Campbell Hurd-Mead, MD. Medical Women of America: A short history of the pioneer medical women of America and a few of their colleagues in England. Froben Press; 1933: 85.

[ii] A full list of Cushier’s publications can be found in Creese, Mary RS. Ladies in the Laboratory? American and British Women in Science, 1800–1900: a survey of their contributions to research. Scarecrow Press, 2000: 392.

[iii] Hurd-Mead. Medical Women of America, 92.

Charles Terry Butler: An American Doctor in World War I

Posted on December 10, 2018 by nyamhistory

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.

1st Lt. Charles T. Butler, MRC, US Army Sept. 1917

Image: A Civilian in Uniform, b/t. pp. 124-125.

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.

Postcard showing Evacuation Hospital #3. Image: Charles Terry Butler papers, New York Academy of Medicine.

Index to MOTC training lectures and notes. Image: Charles Terry Butler papers, New York Academy of Medicine.

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]

Entire route of Evacuation Hospital #3, 1/27/1918-4/12/1919.

Entire route of Evacuation Hospital #3 in France, where Butler served, from St. Nazaire to Brest. Image: A Civilian in Uniform, b/t pp. 354 and 355.

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]

Charles Terry Butler July to December 1918 personal diary

Pages from Butler’s diary, which was written from July to December, 1918. Image: Charles Terry Butler papers, New York Academy of Medicine.

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.

Charles Terry Butler in July 1975. Image: A Civilian in Uniform, p. 399.

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.

Charles Terry Butler and the “War before the War”

Posted on October 6, 2017 by nyamhistmed

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.

“Merry Christmas to J.A.B” [Joseph A. Blake, chief surgeon and hospital director], December 1916. Image: Charles Terry Butler papers, New York Academy of Medicine Library.

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]

Charles Terry Butler identity card for Ris-Orangis hospital, June 1916. Image: Charles Terry Butler papers, New York Academy of Medicine Library.

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.

Charles Terry Butler dressing a wound with the aid of two nurses, 1916. Image: Charles Terry Butler papers, New York Academy of Medicine Library.

A recovery ward, 1916. The flags of Britain and France are mounted at the window, as this hospital was a joint effort: operated within the French military hospital system, sponsored by private British philanthropy, and staffed by American surgeons. Image: Charles Terry Butler papers, New York Academy of Medicine Library.

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.

The staff of the Ris-Orangis Hospital, 1916. Dr. Joseph A. Blake, director, is the central figure (second row, seated); Charles Terry Butler is the third man to his left. Image: Charles Terry Butler papers, New York Academy of Medicine Library.

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.

Transporting the wounded by train, 1916.

Ambulances and drivers of the Ris-Orangis, 1916.

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.

Crimson in Memory

Posted on May 3, 2017 by nyamhistmed

By Emily Miranker, Events and Projects Manager

In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

Canadian doctor John McCrae wrote this poem on a May morning in 1915 in Ypres, what had been a stunning Belgian medieval city then horribly bombarded in the ghastly slaughter of the First World War. The evening before McCrae wrote In Flanders Fields, he presided over the burial of his friend Lt. Alexis Helmer, who died by German shellfire on May 2.[1]

John McCrae in uniform circa 1914. Source: William Notman and Son – Guelph Museums, Reference No. M968.354.1.2x

McCrae was one of many soldiers serving in WWI who found writing poetry an outlet for the horrors and grief, hope and homesickness of the conflict; others include Wilfred Owen, Siegfried Sassoon, Rudolf Binding, and Laurence Binyon. In Flanders Fields may be among the best known poems from the era today, in part due to the power and symbolism of the poppy flowers he evoked.

The flowers McCrae was looking at that May were Papaver rhoeas, the corn poppy beautifully shown in The British Flora Medica by Benjamin Barton. The sensation caused by the publication of McCrae’s poem got the flower rechristened the Flanders poppy.

Barton-Castle_BritishFloraMedica_1877_poppy_watermark

Red or corn poppy. Source: The British flora medica: a history of the medicinal plants of Great Britain by Benjamin H. Barton and Thomas Castle (1877).

In the popular mind, the corn (or Flanders) poppy is often confused or conflated with its cousin, Papaver somniferum –bringer of sleep- the opium poppy. Papaver somniferum pods contains a resin that has morphine and codeine (the only flowering plant known to contain morphine).[2] Both species spread to Europe and across Asia from the Middle East, helped along by trade routes as well as the Crusades. Since ancient times the opium poppy was used as a pain killer, making it a constant companion throughout history to the battlefield wounded, to veterans, and to civilian populations. In high enough doses, it can cause death. By contrast, the corn poppy’s milky sap contains alkaloid rhoeadine, a sedative. From ancient times to the present, the corn poppy has been used to make soporific tea, a milder respite than that offered by its cousin.

Opium poppy. Source: Medical Botany by William Woodville (1793).

The corn and opium poppies have had a long relationship with people and war. Indeed, the opium poppy gave its name to conflicts over British trade rights and Chinese sovereignty in the min-19^th century, called The Opium Wars.

Poppies have been on many battlefields as relief from pain, a resource to fight over, and as a vivid, little sign of hope or remembrance. The flower as an official symbol for remembrance has roots in New York City.

University of Columbia professor and humanitarian Moina Belle Michael wrote a response to McCrae’s poem, We Shall Keep the Faith, in 1918. Inspired by McCrae’s imagery, she wore a silk version in remembrance of the war’s dead, and spearheaded the American movement to have the flower officially recognized as a memorial symbol, and for money from its sale to help veterans. Across the Atlantic, another Poppy Lady, Anna Géurin, campaigned for selling flowers particularly to aid the women and orphans of France.[3]

curtis-botanical-v2-1788_plate57_EasternPoppy_watermark

Eastern poppy. Source: The Botanical Magazine, v2, plate 57 (1788).

Poppies grow most readily in churned earth, so they flourish around people who constantly disturb, till, and work soil for various reasons: to build, to garden, to bury the dead. Before the upheavals of trenches and bombardment, poppies grew in Flanders, but not to the extant described by American William Stidger working for the YMCA in French battlefields in WWI:

“a blood-red poppy…[by the millions] covering a green field like a blanket…I thought to myself: They look as if they had once been our golden California poppies, but that in these years of war every last one of them had been dipped in the blood of those brave lads who died for us, and forever after shall they be crimson in memory of these who have given so much for humanity.”[4]

A grisly fact underlay the profusion of poppies on the Western Front. The soil of Flanders had not been rich enough in lime to sustain massive numbers of poppies. The infusion the earth received from the rubble of towns and the calcium from human bones allowed the poppies to flourish in greater numbers than ever before; a fitting beacon of regeneration as well as an ever present sign of the dead and destruction.

References:
[1] David Lloyd. Battlefield Tourism: Pilgrimage and the Commemoration of the Great in Britain, Australia and Canada. Oxford: Berg; 1998.
[2] Nicholas J. Saunders. The Poppy: A History of Conflict, Loss, Remembrance & Redemption. London: One World; 2013.
[3] The Story Behind the Remembrance Poppy. The Great War 1914 – 1918. Accessed April 13, 2017.
[4] William Stidger. Soldiers Silhouettes on our Front. New York, Scribner’s Sons; 1918.

War Wounded

Posted on April 6, 2017 by nyamhistmed

Paul Theerman, Associate Director

On April 6, 1917, the United States entered the Great War on the side of the Allied powers. By the following fall, those powers were victorious, in part due to the American presence, adding industrial might and men to the stalled conflict and making up for the Russian withdrawal after the October Revolution.

Combat is the most vivid part of war. Victory often depends, however, on maintaining the military effort, and this meant mobilization, training, logistics, supply, and above all, the “medical front.” Armies had to take the wounded soldier, help him heal, and return him to battle. For World War I, that front was where men’s wounds met the medical machine.

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From a training book for stretcher bearers. Image source.

How were men wounded in the war? The strain and the boredom of trench warfare are part of our collective memory; the drama of that war comes from two sources: mustard gas and machine guns. The use of chemical weapons and the mechanization of shooting brought horror to men’s lives at the front. Yet they were not the greatest source of casualties. By far, artillery was the biggest killer in World War I, and provided the greatest source of war wounded.

In his book Trench: A History of Trench Warfare on the Western Front (2010), Stephen Bull concluded that in the western front, artillery was the biggest killer, responsible for “two-thirds of all deaths and injuries on the Western Front.”[1] Of this total, perhaps a third resulted in death, two-thirds in injuries. Artillery wounded the whole body. If not entirely obliterated, the body was often dismembered, losing arms, legs, ears, noses, and even faces. Even when there was not superficial damage, concussive injuries and “shell shock” put many men out of action. Of course, shooting—in combat as well as from snipers—was another great source of wounding. Gas attacks were a third. Phosgene, chlorine, mustard gas, and tear gas debilitated more than killed, though many ended up suffering long-term disability. Overall the war claimed about 10 million military dead, and about 20–21 million military wounded, with perhaps 5% of those wounds life-debilitating, that is, about a million persons.[2]

Moving the wounded. Image source.

Outcomes depended on getting treatment quickly. Evacuation and triage became watchwords of the war-wounded. For the British Army, for example, the Royal Army Medical Corps developed an extensive system to move the wounded from the front to the rear, with triage at each step. Stretcher bearers evacuated the wounded to Regimental Aid Posts (RAP)—or at least those that they had the means to move, for when stretcher-bearers were few, the worst cases were left on the field of battle.

The path from the front to the hospital. Image source.

In one report of a man severely wounded in the abdomen, “Since ‘death awaited him with certainty . . . I gave him a hypodermic of morphia and we propped him up as comfortably as we could’ and left him there.”[3] Behind the RAPs were Advanced Dressing Stations, then further back Main Dressing Stations, and finally, Casualty Clearing Stations. Each move to the rear—always challenging in itself—was based on an assessment of the injury and the chances of survival. The lightly wounded—those likely to recover quickly—and the “moribund”—those likely to die—were kept, and the others sent on. Each station provided stabilization and immediate care, with some basic surgeries, such as amputation, at Casualty Clearing Stations. More advanced treatment occurred at hospitals, either back in Britain or in France. As the war wore on, more of the wounded were kept in France, at hospitals far back from the lines. This was to use less transport and to maintain military morale, with the goal of returning the men to the front as quickly as possible. And indeed, American medical entry into the war came first in the form of hospitals. “The first six [mobile hospitals] to arrive in France took over British General Hospitals and provided hospital level care for the British. Other American hospitals arriving later in the summer of 1917, remained assigned to the American forces.”[4] The Allied pattern of medical triage and evacuation became the model for American efforts.

The fracture ward; the term “machine shop” likely refers to the frames and power belts that characterized such shops at the turn of the last century. Image source.

How well did the system work? “War is a matter of expedients.”[5] The medical operation was persistently understaffed and under-resourced. In the latter part of the war, as the static front changed to a dynamic one, some medical units had difficulty achieving the mobility needed. And inevitably, given the need continually to evaluate the severity of wounds, and the difficulty of transport, some men ended up in the wrong place, some facilities were too crowded, and others were underused. Finally, in 1918 the medical system began to be overrun with influenza cases. Overall, though, the magnitude of the challenge needs to be kept in mind. In just the American experience, for an army that numbered almost 2 million men in France at the end of the war, 1.2 million men passed through the medical system, with about quarter million military wounded.[6] That is an astounding number for which to provide medical services under severe stress.

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Surgery in a Belgian field hospital. Image source.

References:
[1]“Krilling for Company.” Mud Feud [Review of Trench: A History of Trench Warfare on the Western Front, by Stephen Bull (Osprey Publishing 2010)]. Papyrocentric Performativity. Published July 14, 2014. Accessed March 21, 2017.
[2] The total number of killed from the Allied Powers exceeded that of the Central Powers by over a million; the total wounded exceeded by perhaps 4 million. Accurate statistics are hard come by; these are based on Antoine Prost. War losses. 1914-1918-online: International encyclopedia of the First World War. Published August 10, 2014. Accessed March 21, 2017.
[3] Carden-Coyne A. The Politics of wounds: Military patients and medical power in the First World War. Oxford: Oxford University Press; 2014. P. 65.
[4] Jaffin J. Medical support for the American Expeditionary Forces in France during the First World War. Published 1990. Accessed March 31, 2017. Pp. 95–96.
[5] Helmuth Karl Bernhard Graf von Moltke. Wikiquote. Published October 7, 2006. Updated September 1, 2016. Accessed March 31, 2017.
[6] Jaffin J. P. 166.

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