“These frightful sights would work havoc with one’s brain”: Subjective Experience, Trauma, and Resilience in First World War Writings by Medical Personnel

In “Mental Cases,” First World War poet Wilfred Owen depicted the “men whose minds the Dead have ravished,”¹ and in “Strange Meeting,” pointed again to the psychological suffering engendered by war: “Foreheads of men have bled where no wounds were.”² What became popularly referred to as “shell-shock” or neurasthenia was stigmatized during the first World War—it is argued that Owen returned to the front after his time at Craiglockhart in part to prove his sanity—in the late twentieth and early twenty-first centuries, the shell-shocked soldier who embodies the psychological trauma of war has been accorded the status of victim-hero.³ The Shot-at-Dawn campaign achieved pardons in 2006 for the 306 men executed during the first World War for desertion, mainly on the basis that these men were suffering from shell-shock engendered by the extreme conditions of trench warfare.⁴ Historians, from Anthony Babington (Shell-Shock: a History of the Changing Attitudes to War Neurosis) and Ben Shephard (A War of Nerves) to Edgar Jones and Simon Wessely (Shell-Shock to PTSD: Military Psychiatry from 1900 to the Gulf War) among others, have sought to document and understand the psychological trauma wrought on soldiers. Literary works, too, have valorized the suffering of the shell-shocked soldier, most prominently Pat Barker’s Regeneration trilogy, and have thereby redefined heroism as stoic endurance. In contrast, Michael Roper’s The Secret Battle: Emotional Survival in the Great War offers an important move towards foregrounding resilience and survival as alternative responses to traumatic breakdown, exploring the tactics soldiers employed to avoid breakdown and maintain emotional well-being. These analyses focus on the combatant experience; however, there is a marked lack of discussion of the response to extreme emotional stress borne by medical personnel who treated these casualties of war.⁵

Our work seeks to redress this lack, and in this article we foreground the autobiographical writings of both men and women from the First World War to investigate how healers have described their emotional responses to service that puts them in the front lines of caring for the wounded and the dying. Our reading of published and unpublished accounts written during and after the war draws on medical history, psychology, and life-writing theory, as well as more literary textual analyses, to examine how the individuals we study represent their traumatic experience and the resilience that offers an alternative to the narrative of traumatic breakdown. Alternative narratives, at times fragmented, ambiguous, and contradictory, defined as much by what is left unsaid as by what is said, legitimize an aspect of the war experience that remains largely unheard: how medical personnel perceived and negotiated the physical and psychological context in which they worked. What we find when we examine the way these men and women articulate the psychological stresses of their situations are responses that range from the heightened language of sacrifice and duty and the desire to endure to utter despair at the apparent futility of the war as it is manifested in the thousands of dead and wounded who pass through aid posts, casualty clearing stations, ambulances, and hospitals. Drawing on subjective experience offers a way of understanding the nuances and contradictions involved in highly complex responses to extreme psychological strain as well as a way of highlighting the extent to which medical personnel bear a huge burden of the psychological cost of war. Yet, while their experience is undeniably traumatic, their writings do not invite a reading through theories of trauma that see such experience as defined by a breakdown in meaning or by a lack of a coherent narrative. In spite of silences and fragmentation, the life-writings of doctors, nurses, and ambulance drivers demonstrate a determination to make meaning of their experiences and, alongside the possibility of breakdown, indicate remarkable resilience and the ability to endure.

Medical care in war zones positions personnel as both witnesses to and participants in the carnage of war, and nowhere, arguably...