JOHN MCCRAE: A SOLDIER AND A SURGEON
Doctor, soldier, teacher, poet — Lieutenant-Colonel John McCrae had many roles in a life that spanned only forty-five years, from November 30, 1872, to January 28, 1918. Best known today as the author of the poem “In Flanders Fields,” he was inducted posthumously into the Canadian Medical Hall of Fame in 2015 for his valuable contributions to the field of pathology.
This year, Guelph Museums commemorates the 150th anniversary of McCrae’s birth with special programming that includes an exhibition of his poems and drawings, two theatre plays, an academic symposium, a poppyplanting campaign, and a memorial tour through Belgium and France.
Born in Guelph, Ontario, McCrae joined the Guelph Highland Cadet Corps as a teenager. While studying at the University of Toronto, he continued his military involvement as a member of the Queen’s Own Rifles militia regiment. He graduated from medical school in 1898 but put his career as a doctor on hold when Britain went to war in South Africa in 1899. Although the colonial war was controversial in Canada, McCrae believed in the British Empire and volunteered as a gunner in the Royal Canadian Field Artillery from December 1899 to January 1901.
After studying in the U.S., McCrae began his medical career in Montreal, where he worked at several hospitals and in private practice. An expert in pathology, he lectured at McGill University and at the University of Vermont in Burlington. He penned and published poetry and short stories, joined social and literary groups, and became a founding member of the University Club of Montreal.
When the First World War broke out, he enlisted as a medical officer. It was during the Second Battle of Ypres in the spring of 1915 that he penned “In Flanders Fields,” although the exact circumstances of its creation are unclear and have become the stuff of legend. Some accounts have him writing it on a dugout step, others inside the dressing station, still others at the grave of his friend Lieutenant Alexis Hannum Helmer, whose funeral McCrae had conducted. What is known is that the poem was first published, anonymously, in the December 8, 1915, edition of the British magazine Punch. It quickly became so popular that it was reprinted, translated, and recited around the globe. McCrae was later identified as the author and became famous throughout the English-speaking world.
Both a reflection on death and a call to arms, “In Flanders Fields” was used to sell war bonds, recruit soldiers, and commemorate the fallen. It enshrined the poppy as a symbol of grief and loss, especially in the context of war. The poem remains a traditional part of Canadian Remembrance Day services.
“THE BOYS ARE VERY CHEERFUL AND MAKE JOKES ABOUT THEIR MISSING LIMBS.” —A.Y.JACKSON
the patients, who often scoffed at their wounds. A.Y. Jackson, the famous painter who was wounded in battle in early June 1916, wrote to his mother: “The boys are very cheerful and make jokes about their missing limbs.”
The fighting in 1916 intensified, as conscripts filled the European armies by the millions. Canada’s primary combat arm, the Canadian Corps, expanded to a third and a fourth division, reaching about one hundred thousand soldiers. Along the front, there was constant “wastage” in the trenches — as the daily losses were clinically and sometimes callously referred to in official reports — as well as larger and more costly battles at St. Eloi and Sorrel in Belgium and on the Somme in France.
“All night I washed dirty, bloody, lousy boys,” wrote a private from the hospital in his diary. “I finished just at dawn, and, looking out of the window, saw passing on a stretcher a still figure, covered with the Union Jack — another name added to the long roll who die for Canada.”
Many soldiers were too far gone by the time they arrived at the operating rooms, while others succumbed to infection in the recovery wards, and this unending death created a deep emotional burden for the caregivers. Some of the soldiers were never known beyond their names; others became friends and shared stories. Nurses often wrote letters home for soldiers near death and even held their hands through the long night as they slipped from this world.
The doctors and nurses of the McGill hospital were overrun in these big battles. There were, for example, 4,600 patients who passed through the hospital between July 1 and July 15, 1916, the first two weeks of the Battle of the Somme. With these waves of wounded, observation and experience dictated that the more lightly injured — those who might recover in six weeks — could remain if there was bed space. But most patients, after undergoing operations, had to be further “cleared” by sending them across the English Channel to more hospitals in Britain.
There the patients underwent additional surgery, amputations, and, if they survived, a period of recovery that lasted several months. At any given point from 1916 onwards, there were thousands of Canadian soldiers being treated or recovering in Britain, although those who would never return to the front were sent back to Canada for rehabilitation and, if possible, training in how to live with their new, scarred bodies.
All the while, the costly fighting at the front continued, with Canadian victories in 1917 at France’s Vimy Ridge in April
and Hill 70 in August, and through the mud of Passchendaele, Belgium, in October and November. To respond to the carnage, the McGill hospital raised its capacity to two thousand beds, because even in victory there was terrible bloodshed: 10,600 Canadians were killed or wounded at Vimy, around 11,000 at Hill 70, and 16,000 at Passchendaele.
Further evolutions in treatment centred around the X-ray machine that became increasingly important in assisting surgeons in locating and removing pieces of metal in patients’ bodies. The McGill hospital had an acknowledged expert in Major Alexander Pirie, who published widely about his findings and was recognized as a leader in the emerging field.
The examination of patients and how they died revealed the killing effects of shock from loss of blood. The McGill hospital carried out its first blood transfusion in late 1915, and the Canadians became pioneers of these transfusions at the Somme the following year. Several experts and practitioners would continue to experiment throughout the war, with identifiable results in saving soldiers’ lives.
Many of these lessons — especially in how to treat infections — were learned through trial and error. But with so many professors in the McGill hospital, there were formal and informal lectures about the lessons learned, as well as instruction in life-saving techniques. New doctors were mentored with almost daily instruction, and many doctors in the CAMC published academic articles in the Canadian Medical
Association Journal (which was edited by the pioneering heart specialist Maude Abbott of McGill during the war) and in the
Bulletin of the Canadian Army Medical Corps, a new journal for service officers that began publication in 1918. Experienced doctors, surgeons, and nurses — especially the Canadian nursing sisters who were in the forefront of specializing in providing anaesthesia for patients — often took temporary posts with other hospitals to share their experiences. There was everpresent learning amid the destruction, and there were always new weapons that demanded rapid reaction.
The injuries caused by gas warfare proved extraordinarily difficult to treat in hospitals. The chlorine and phosgene gases of 1915, which attacked the lungs, gave way to mustard gas beginning in July 1917. This new German chemical agent burned and blinded soldiers while also causing enormous skin blisters that were frequently infected in the unsanitary environment. The McGill hospital received hundreds of cases. Patients arrived blinded from the gas, with their heads wrapped in bandages to protect their eyes. Doctors and nurses soon learned that uniforms had to be cut away, as they were contaminated with the gas. The potent chemical plague could blind and burn caregivers, who sometimes had to work on the injured patients with protective gloves. Even then, medical personnel suffered weeping eyes and wheezed through raw lungs, with their hair sometimes turning yellow and burns developing along their hands and forearms.
Despite the horror of the wounds, the doctors and nurses exhibited great skill in saving lives. There was a constant evolution of techniques and practices. Over the course of the war, fewer than one per cent of patients who arrived at the McGill hospital succumbed to their wounds. It was a great medical victory, even if hidden in those statistics are the many soldiers who died in no man’s land, or on a stretcher being carried to the rear, or in the many medical units along the way, from the aid post, to the field ambulance, to the casualty clearing stations.
The final year of the war witnessed more titanic battles, first with a series of German offensives in the West starting on March 21, 1918, that made deep inroads into the British lines and then with a strategic Allied counterattack, whose first strike was spearheaded by Canadian and Australian soldiers at Amiens, France, on August 8. Throughout this period, all of the Canadian medical units, from those on the front lines to the convalescent homes in England, supported the fighting units of the Canadian Corps. At No. 3 Canadian General Hospital, the personnel treated, cared for, and saved thousands of soldiers.
By 1918, new surgical techniques and more effective approaches to combatting infections — practised at the McGill hospital and at other Canadian and Allied hospitals — meant that once-fatal wounds now had much higher survival
rates. Wounds to the abdomen were all but a death sentence in the early part of the war, but better surgical treatments led to increased survival in 1918. In another example, the amputation rate for gunshot wounds to limbs dropped from twentyfive per cent in 1916 to seven per cent in 1917.
Doctors continued to be posted to and from No. 3 Canadian General Hospital, including a young Frederick Banting, who would discover insulin, and Francis Scrimger, a surgeon who had received the Victoria Cross at the Second Battle of Ypres. Both would return to Canada after the war to bring home important lessons. Scrimger taught at McGill University, and Banting became one of the most famous doctors of the twentieth century for his co-discovery of insulin as a treatment that would save millions around the world from the lethal disease of diabetes.
Beginning in September 1918, a new plague descended on the armies fighting in Europe. Known as the Spanish flu, H1N1 was a virulent and lethal strain of mutated influenza