Wednesday, January 25, 2012

Plastic Surgery and the Great War

World War I seems like only yesterday this year:
Steven Spielberg's "War Horse", based on a novel by Michael Morpurgo, sweeps into the cineplex this month. The stage phenomenon of the same name, brilliantly realized by Handspring Puppet Company, continues on Broadway.
Susan Orleans tells the true life and legend of Rin Tin Tin, Dog Star of stage and screen, born on a World War I battlefield, delivered from it by a doughboy. Orleans writes that animals were deployed to the front in staggering numbers — some sixteen million horses, dogs, oxen, camels, donkeys, mules and pigeons went to the front—including “8 million horses that were killed… or sold to French butchers at the end.” 
War has come to the public television hit Downton Abbey in its second season. And HBO's Boardwalk Empire is haunted by characters like Richard Harrow, decimated by the unexpected savagery of that conflict.

The Great War was a wanton slaughter of innocence and innocents, none more so than the boys who fought from a 6-foot ditch scarred into scorched earth. It was, writes William Boyd in a recent editorial, “a conflict between 19th-century armies equipped with 20th-century weapons...in which millions of soldiers on both sides slogged through...a 500-mile line of trenches...to meet their deaths in withering blasts of machine-gun fire and artillery...."
Eager boy soldiers faced “a battlefield dominated by tanks, machine guns, howitzers, aircraft and poisonous gas...," exposed from the neck up.

In fact, the signature wound of the war was facial disfigurement. Unimaginable, mutilating wounds, once mercifully unsurvivable. And in the vestigial Victorian aesthetic of the times, unspeakably hideous. In her article, “The Rhetoric of Disfigurement,” social historian Suzannah Biernoff writes that an estimated 60,500 British soldiers suffered head or eye injuries... at the specialist hospital for facial injuries...over 11,000 operations were performed on some 5,000 servicemen between 1917 and 1925. "Many soldiers were shot in the face simply because they had no experience of trench warfare." One contemporary surgeon wrote, "They seemed to think they could pop their heads up over a trench and move quickly enough to dodge the hail of machine-gun bullets....”

One who had seen the carnage first hand was Harold Gillies, a battlefield medic who returned to Britain in 1916 to devote his life to finding a way to restore to these patients the “perceived loss of humanity.” Gillies would become known as the “father of modern plastic surgery". But in that first year—after the Battle of the Somme, when he expected 200 casualties and got 2,000—even the physician felt "fear, disgust and shame surrounding facial disfigurement, both for the men who suffered these injuries, and for those...who came into contact with them....”

Subsequent blogs will explore how Dr. Gillies, and the post-war world with him, came to terms with the bodily and spiritual carnage in the wake of The Great War, what it has meant to the science of facial reconstruction, and how it has shaped 21st century concepts of beauty and worth.