Faces from the Front: Harold Gillies, The Queen’s Hospital, Sidcup and the origins of modern plastic surgery

by Andrew Bamji

Faces from the Front examines the British response to the huge number of soldiers who incurred facial injuries during the First World War. These injuries were produced within a short time span, but (for the first time in a major conflict) did not necessarily lead to death due to developments in anesthesia and improvements in the treatment of infection and blood loss. Casualties were evacuated back to England, where surgeons had an opportunity to develop their skills on a large patient caseload. Harold Gillies, an ambitious young surgeon, developed a new branch of plastic surgery of the face. In 1915, Gillies set up a dedicated ward for patients with facial injuries at the Cambridge Military Hospital in Aldershot, Hampshire. Following the Battle of the Somme and the escalation in the number of casualties with facial injuries, steps were taken to establish a new hospital entirely focused on the treatment of facial injuries at Sidcup in South-East London. The Queen’s Hospital treated more than 5,000 patients between its opening in August 1917 and the mid-1920s; its work was mainly funded by charitable donations. The book uncovers the history of this hospital by analyzing a wide range of sources – including numerous photographs and paintings – which detail the experiences of patients and staff.

A team of surgeons and other specialized staff were brought together at Sidcup who, like the hospital’s patients, came from Britain, New Zealand, Australia, Canada and the US. The book argues that the development and refinement of new surgical techniques was helped by a multidisciplinary approach. Detailed patient records - combined with notes, photographs and paintings - were used to evaluate the efficacy of experimental procedures and to educate new surgeons. Treatment often involved multiple operations and took place over long periods of time, and considerable thought was given to the recovery and rehabilitation of patients. The Queen’s Hospital had two important first, it played a pivotal role in the development of modern medical practice by paving the way for a new surgical specialty – plastic surgery – and by showcasing the benefits of specialist hospitals and multi-disciplinary services; second, the reconstruction of damaged faces had a major impact on the patients themselves. Drawing on a unique collection of personal and family accounts of the post-war lives of patients treated at Sidcup, the author explores surgical and aesthetic outcomes and the emotional impact of facial reconstruction.

Genres: Nonfiction, History

240 pages, Hardcover

Published October 19, 2017

Reviews

[Emilie]

Interesting. Other books about the beginnings of modern plastic surgery have the before and after surgery photos near each other, but they were scattered around more randomly here. There were color pictures in this one, including a few of the pastels drawn by Dr. Tonks. That got to me more than the black-and-white photos did as far as visceral feelings about seeing the damage done by a gunshot wound to the face or the like.

Dr. Bamji greatly admires Dr. Gillies. The author admits that Dr. Gillies had his faults, but clearly explains the good he did in helping many injured men, and working with other specialists, like dentists. I liked the follow-up on how some of the men with facial injuries who were operated on at the Sidcup hospital went on with their lives.

With the passage of time, some of the information about the World War I soldiers, sailors and aviators has been lost, but Dr. Gillies wrote books about the principles of plastic surgery, and what he and the other medical personnel had learned from their efforts to repair some terrible damage. That knowledge wasn't lost, and would be used again a generation later, during World War II.

I believe I started reading about this topic from seeing a newspaper article. Some of the British authors I correspond with here and there have been posting for some time about the one hundred year anniversaries of various events of World War I.

[Joseph Hirsch · Rating 5 out of 5]

This is one of those rare books about the Great War, like "Before My Helpless Sight," which just sort of humbles the reader. The bravery required to endure the kinds of things the men endured in this book, both the medical staff and the soldiers, is nigh-on unfathomable. But it all happened.

Andrew Bamji's book deals with facial wounds in the First World War. The medical aspects, such as reconstruction techniques and innovations in skin grafts, are well-detailed yet explained in terms that the layman can grasp. The deeper implications of wounds to the face (the locus of identity in almost any culture) are just as thoroughly treated. The reactions of men to losing their faces (or at least some of their features) were as myriad and manifold as their personalities before getting hurt. There is horror, sadness, and rage in the book, and in the experiences detailed here, but also unexpected pockets of humor and compassion, stories of love conquering all (as cliched as that can sound, and as cynical as many of us are, myself usually included).

The book is leavened with firsthand accounts from soldiers, doctors, nurses, and the descendants of those who managed to survive the War and sometimes lived into ripe old age, bearing their scars and mutilations to the last, with great fortitude for the most part. The images are among the most disturbing I've ever seen, and they never lose their ability to shock, no matter how many times one views them. And still they must be seen to be believed.

Not an easy book to read or review, but a necessary one to read. Highest recommendation.

[Maggie Toner · Rating 4 out of 5]

Andrew Bamji has drawn together many difficult to find resources about Queen's Hospital at Sidcup in WW1. My copy is full of highlighter marks and notes in the margins. This is the story of how our society came to accept and understand plastic surgery of the face. The men who were treated at Sidcup had lost cheeks, jaws, eye sockets, and almost entire faces, and Dr. Harold Gilles was responsible for the team that attempted to give them back faces that would make them not gargoyles, a name the patients gave themselves, but people who would fit back into society when they went home. Incredibly moving, factual, and awe inspiring.

[Kate Miller · Rating 4 out of 5]

Really interesting history and very detailed!