The incinerator was a large brick oven, outside at back of the hospital. In the bucket beneath the gauze Louisa discovered several repellent, pus-soaked dressings, and under those, an almost-black foot with shrunken toes and overgrown toenails and a black, bloated hand still attached to several inches of forearm with the shattered ulna and radius bones poking out.
The bile rose up in her throat. These were nothing like the bloodless, formalin-soaked cadaver limbs she’d dissected in anatomy lessons. These had all too recently been attached to living bodies, and bore all the hallmarks of having been removed amid terrible pain and suffering.
With a stick, she prised open the heavy iron door and, using the gauze, she lifted out first the foot, then the arm. She threw them into the flames and heard a hiss that was horribly reminiscent of a Sunday joint roasting in the oven. She slammed the door shut, then staggered to a patch of nearby bushes and vomited, the contents of her stomach mixing together on the ground with her tears.
CHAPTER TWENTY-SIX
Men flooded in on a never-ending tide of suffering. Louisa felt as if she was being carried along with it, in a sort of dream, as if her own arms and legs didn’t even belong to her any more. She worked ceaselessly, completing every task allotted to her to the best of her ability and without complaint. The jobs were all among the very grimmest the hospital had to offer, to the extent that even Flora observed one day: ‘Heavens, you really did manage to get on the wrong side of Sister A and Crawfie, didn’t you?’
The days passed in a succession of bugle calls: reveille, breakfast, lunch and supper, then lights out at the end of the day – and the constant call of ‘Fall in!’, which came around the clock, announcing the arrival of yet another new convoy of wounded. Louisa continued her work in the operating theatres, carrying bucket after bucket of mangled body parts to the incinerator, trudging backwards and forwards all day and all night long, past the X-ray room with its continual buzz of sparking tubes. Between the endless surgeries, she tried to scrub everything clean, and her hands were always sticky with blood – no one but the doctors and sisters got to wear the precious rubber medical gloves – or plunged permanently into a bucket of carbolic soap and water.
The rooms were a sea of gore: blood, pus, vomit, faeces, filthy first field dressings, body parts dreadfully torn or cut away from their normal anatomy, pieces of shrapnel. There was an ever-present stench of gas gangrene, foul beyond anything she’d ever smelt, and which seemed to penetrate her skin and hair and sit deep in her throat and sinuses, so that she could smell it even hours later in bed. As she slept, the surgeon’s saw rasped through her dreams.
The cold and the harsh disinfectants made her hands rough and raw, despite her applying liberal amounts of Rose Ashby’s carbolated Vaseline, and her feet grew sore from the long hours spent in hard shoes. The weather turned even colder, and their little bunkroom was like an icebox. Every morning they woke to elaborate frost ferns on the inadequate single-pane windows. Damp clothes or towels left out overnight turned solid, and water froze hard in tumblers and basins.
She’d never felt so cold in her life. And yet there was no simple button to push or switch to flick to produce warmth or light. If the bunkroom was dark when you came in, or if you woke up at night, you must first light a candle, then the paraffin lamp. And heat arrived only slowly. No one wanted to be first out of bed in the morning, and the one to have to light the stove, with fumbling, freezing fingers and misting breath. If you wanted hot water you had to boil a kettle. A box of matches, she soon came to realise, counted among one’s most important possessions.
In the mornings, she got used to putting her clothes by the stove to warm them, then filling her enamel ewer and basin and washing herself bit by bit, because it was too cold to undress completely. Putting on a fresh corset was always a trial because of the cold metal bones inside which the heat from the stove never quite seemed to reach.
She got accustomed to using a chamber pot without embarrassment – and emptying it every morning, along with the slop pail. Menstruation was more of a trial, though. Flora told her that all the VADs used surgical dressings – ‘After all that we do for our country, we think it’s the least that our country can do for us’ – but everything had to be held in place by a complicated belt apparatus.
Every facet of life was slower, more time-consuming. Washing your hair with egg yolk and Castile soap shavings and then drying it in front of the stove took a whole evening, as did the regular job of darning your stockings and mending the tears in your long, blue VAD dress, which seemed to catch on the corner of every cupboard and trolley. And there was so much to remember: fill the reservoir in the oil lamp, scrub the stiff collars and cuffs of your uniform, wind the clock, polish your shoes, grease your chilblained hands and rub your feet with spirit to prevent blisters.
Every morning was the same: reporting to sister for orders and a lecture on the importance of cleanliness; an inspection of your hands and nails, of the length of your skirt – which must always decently cover the ankle, of your stockings and shoes; and warnings not to be too familiar with the men, to never consort with the officers or indeed anyone of the opposite sex, and to be back in camp by seven p.m. or face sanction.
Then Louisa was given the job of helping to wash and lay out the bodies of the dead. Her first was Thomas Jackson, a young private from Jamaica who’d died while the surgeon had been about to amputate his gangrenous leg. He wasn’t much taller than she was. His hair was still wet with perspiration from his fight to stay alive, but his half-closed eyes were already sinking back into their sockets. His face was ashen with blood loss and his left leg was hugely swollen and covered with the hideous black blisters that were the mark of advanced gas gangrene. But his torso was unblemished and, she thought, quite beautiful, making it somehow even worse that he had died so obscenely.
And his parents didn’t yet know that their son had died. Was his mother, Mrs Jackson, thousands of miles away, saying a silent prayer for his safety even now? Poor, poor boy, to die so far from home. And for what? A pack of jingoistic lies. Tenderly, she washed his arms and hands, feeling as if she might choke from pity and anger. It was all so profoundly wrong. As she held his leg, a sough of gas escaped. Immediately, the smell hit the back of her throat, but she found she was no longer as disgusted as she would have been even just a few days ago.
‘Are you all right?’ asked Nina, the VAD who occupied the bunk above Louisa’s and who was also on laying-out duty. ‘The horrors of the front take a while to get used to.’
‘I just feel such pity for him,’ Louisa said.
‘Yes, it’s awful. Near the end he knew he was going to die – the men just know it. But Rose, God is merciful: if He hadn’t taken him into His care when He did, the other leg would most likely have had to come off too. Look.’ She pointed to a purpling patch on the other shin.
Louisa was learning that gas gangrene was as much their enemy as the Germans themselves. The fertile soil of northern France contained many microbes, and these worked their way deep into wounds. The gases the infections produced bubbled up through the tissues, causing a dreadful crackling sound and characteristic dark blisters – along with the most atrocious smell. If you tapped an infected limb, it made a hollow sound. The infection progressed very rapidly, spreading from ankle to knee in twelve hours, and killed a man within a week. The only cure was amputation.