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A Surgeon in Arms

CHAPTER X THE SICK PARADE
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the handling of the sick is not so easy a matter as the caring for the wounded in the lines, for the reason that it is not what disease the man has that the medical officer must decide as much as whether he has any disease, or has simply joined the independent workers of the world. in other words, is he really ill, or is he just suffering from ennui, has he at last become so "fed up" with it all that he has decided to go sick, running the gauntlet of an irate m.o. with the hope of receiving a few hours or days of rest at the transport or in the hospital? it may be a lucky father who knows his own son, but it is a fortunate medical officer who knows his own battalion. if he does it is fortunate for the m.o., for it makes his toils lighter. but it may not be so fortunate for the poor devil who has just decided that once again he will endeavor to "put it over" the doctor. for the latter gets to know the regular parader, and meets him with a suspicious look of recognition.

"well, jones, and what is it this time?" asks the m. o. in tones so cold that the poor victim can almost taste pill no. 9, or castor oil as he listens. if he is not ill, but is simply sick and tired of the mud, dirt, rats, lice, discipline, and discomfort—as we all get at times—he will have to tax his ingenuity and his acting ability to convince the doctor that his pains in his legs and back are real, not imaginary; or that his right knee is swollen, when the practised eye of the physician says it is not. if he is an old soldier and knows the game well, he may get away with it, sometimes with the tacit consent of a sympathetic medical officer.

tommy is not the only one who endeavors at times to get out of the lines with imaginary ills. his officers, and some medical officers for the matter of that, occasionally set him the example. it is very human on occasions to long for comfort instead of discomfort; cleanliness in place of dirt; a decent, white-sheeted bed in exchange for a hard, uncomfortable, and possibly vermin-infested bunk; and to wish to indulge in peace, quietness, rest, safety, and civilization after the noise, fatigue, dangers, and barbarism that give truth to the saying that war is hell. but the officer gets the same treatment as does his men. on one occasion i saw a colonel removed from an ambulance to make room for a badly wounded tommy.

and it may safely be said that if the ordinary soldier hates the sick parade, his abhorrence of it is mild in comparison to that felt for it by the battalion representative of the army medical corps. it is a thorn in his side that makes itself felt daily. and the reason is that he is between three fires,—the assistant director of medical services who expects a low sick rate in the different units; the battalion and company commanders who expect the men on parade, which means fit and on duty, while at the same time insisting, quite rightly, that the men get every attention at the hands of the medical department; and a certain small percentage of the men for whom the novelty and glamour of the war has worn off and who have become tired of the food, and find the work arduous and monotonous. it is this small percentage of the men—not large in numbers, but present in most units—who make the work difficult, for they begin to wonder how they can escape the working parties or the dangers and hardships of the trenches, and if by any chance they have varicose veins, flat feet, rheumatism, short sight, or any of the thousand and one ills that man is heir to, they immediately begin "swinging the lead," as the boys call malingering. in the royal army medical corps they call it "scrimshanking."

the m.o. is not popular with leadswingers or scrimshankers. a witty tommy once said that all you can get from an officer of the medical department is a pill number nine—made up mostly of calomel—"an' if 'e hain't got a pill nine 'e'll give ye a four an' a five."

no doubt the man who "swings the lead" is to be sympathized with at times. often he is given work to do almost beyond human endurance, his dugout may be a mudhole, his clothes soaking from a downpour of rain, his rations short, and, finally, perhaps the rum ration, the one cheery thing on a dark day, is missing. he has done his bit anyway—or thinks he has—and his only possible relief is to say that he is too ill to go on the next day. occasionally, he has an attack of what a sharp little french canadian sergeant called frigidity of the feet, and he dreads his next tour in the front line. at any rate, for one cause or another, he decides to go before the m.o. and many funny stories are told of the attempts made by men to get a few days' "excuse duty," which means a few days with nothing to do. two men are overheard at the following conversation:

"say, bill, what are you goin' to tell the croaker?"—a common name for a stern m.o.

"oh, i've got bad rheumatic pains in my back."

"the devil you have; that's what i had. well, i'll go strong on diarrhea."

each tells his story. it depends on how sick they appear or how often they have been before his medical majesty in the past as to the result. the latter at least may work a day off, at the expense of a nauseating dose of castor oil, taken at once, and some lead and opium pills, consigned to the gutter as soon as the sick man is out of sight. the former probably gets m.&d., that is medicine and duty, which translated means, carry on, with perhaps a good rubbing of his back with a strong liniment.

my corporal told me a story of two men who opened a can of bully beef and for four days left it standing on the parapet during hot weather. then they ate it with the hope of getting ptomaine poisoning.

another chap is said to have feigned insanity by giving all his attention to snatching up every bit of paper he could find in the trenches or out of them, and studiously endeavoring to make the bits of paper into some important document. he carried out this apparently foolish search so long that at last he was pronounced insane and given his discharge from the forces. on receiving his discharge papers he studied them carefully as he walked away. another soldier heard him murmur:

"why, that's the paper i have been searching for all the time."

deafness is one of the commonest complaints of a soldier who is scrimshanking. the soldier tells the m.o. that for some months past his hearing has been lessening and that at last he is so deaf that he cannot carry on. he claims that while on sentry duty or "standing to" in the front line he has already nearly shot one officer and three different men because he could not hear them giving him the password. the m.o. in a loud voice questions him as to his name, place of birth, age, and so on, and so on, keeping his face straight and his lips hidden, to avoid allowing the soldier, if really deaf, to read his lips. gradually the voice of the officer is lowered, and the man who at first had difficulty hearing his loud tones, unconsciously, if faking, answers the lowered voice till he is answering to a voice that is almost a whisper.

then comes suddenly a change in the manner of the "croaker." he becomes stern and rebukes the man, ordering him forth to do his duty like the other men of his battalion, and not ever again to dare to come on parade with a plea of deafness, under a threat of marking him plain "duty," which means criming and a likelihood of twenty-eight days first field punishment.

looking backward one can think of many amusing incidents in which some chap tried to get out of the lines, and perhaps succeeded in so doing, by an imaginary ill. a soldier named jones who had not been long in the lines became a regular caller upon me. as usual at first every consideration was shown to him, but as his face appeared and reappeared almost daily, and as the said face was suffused with the glow of health, his form of the robust type, and his complaints always functional—that is, consisting of symptoms only, with no signs of a real disease to cause them—i began to feel certain that he was a "lead-swinger." on his first call or two he had been "excused duty," but as my suspicions grew firmer that he was simply shifting his work onto the shoulders of some other poor tommy, my manner toward him grew rather reserved, and finally antagonistic.

about this time he came to see me at one of my daily morning sick parades. he tried to look as ill and dejected as his very healthy appearance would permit.

"well, jones, what is the trouble this time?" i asked harshly when his turn came.

"i can't swallow, sir. i can't get any food down my throat. i don't know what's the matter, sir, but i had this happen to me ten years ago, and i nearly died. i was in the hospital for three months."

"how long since you have swallowed any food, jones?"

"well, i managed to get down a little, night before last, but not a bite since then, not a bite. and i'm feeling awful weak. i don't think i could carry on long like this. but of course i'll do my best, sir."

"yes, i suppose so, jones," i answered, feeling certain that he was lying. "of course a few days without food really does most of us good. a friend of mine regularly goes a week on nothing but water whenever he feels a bit 'livery,' as the english say. and then you remember there was a man once who went forty days fasting. he became quite famous. so another day or two won't hurt you, jones. however, if it went too long it might become serious. so i want you to report back here tomorrow morning, sure, if you have not succeeded in swallowing by that time. i have in my panier a stomach tube, and we'll pass it down through your esophagus and open it up. it's a very tender passage," i continued without smiling, "and you must expect severe pain from the passing of the tube; unfortunately we have nothing to deaden the pain, but you can stand it if you make up your mind to do so. now you do your best to swallow like a good fellow, and i think you will succeed, but be sure to come back tomorrow if you don't. that'll do, jones. next."

as a matter of fact i had no stomach or esophageal tube, but i was just trying out a little christian science treatment, for, as dooley says, if the christian scientists had a little more science and the medical men a little more christianity it would not matter much which you called in, so long as you had a good nurse. and the moral treatment proved effective in this case, for jones did not come back next day; nor did we see him again till nearly a week had passed when he came in on parade again.

"what's doing this time, jones? can't swallow again?"

"oh, no, sir. i got my swallowing back all right." i could hardly resist the temptation to smile. "but since then i vomit all my food. haven't kept a thing on my stomach since i saw you, sir. i saw your man, kelly, the other day, and he was so unkind as to tell me that i had better take something with claws in it. he seemed to think i was swinging the lead, and i'm a sick man, sir," with an injured air which, however, did not take any of the healthy red from his cheek. i stepped outside and asked the corporal in charge of the sick from his company what diet jones was able to eat.

"diet! he don't eat no diet, sir. he eats every darn thing in sight and looks for more," was the sneering reply.

"i thought so. now, jones," i said sternly, "if you come on sick parade again, when you are not sick i'm going to put in a crime charge against you for malingering. now, get out."

and he got out, and that was the last time i saw him on sick parade.

the chaps who fake are nearly always new arrivals in the line. one such came hopping into my dugout in the middle of the night, with his boot, sock, and puttee, off one foot which he carefully kept off the ground. he said he had been blown up by a shell and buried, severely injuring the foot he had bared. i examined the foot tenderly and found a swelling half the size of an egg just over the inner side of the ankle. he howled with pain when i touched it, so my examination was rather cursory—that is hurried. without diagnosing the condition, i swabbed it with iodine, merely to do something, and applied a dressing, telling my assistant to make out a hospital entry card for him. after leaving him to go back to my bunk, for i was tired, i happened to glance around and saw a broad grin on his face. stepping back i took off the dressing, and carefully examined the swelling notwithstanding his protest that it was very painful. i found then that it was simply a fatty tumor—an excess, but harmless, growth of fat in a localized area—which had probably been there for years. he then admitted the fact that the swelling had been there for years, but of course still claimed that he had hurt his ankle a few minutes before. as it showed no sign of it, he went back to duty!

every medical officer has many such incidents after a few months of service. they often add a bit of humor to a dull business. rather strangely, the parades are always larger out of the lines than in them, for the vast majority of the men hold it as a point of honor to stick it out, no matter how rough it may be, while in the line. but as soon as the battalion gets out of the line and hard training, route marches, equipment cleaning and inspection begin, the parades increase in size. often the men hope that they will be given excuse duty, which means that they have nothing to do for that day. or, should the parade be held at a late hour, some few of them prefer to stand about the m.o.'s tent awaiting their turn, to doing some drill or route march. the sick parade is held daily at a fixed hour, and as a rule the earlier the parade the smaller the number who come. if it is held before all other parades, only the really ill come, for the others would but add to their daily number of parades if they came pretending to be ill.

a medical friend of mine had an interesting way of keeping down the numbers at his parade. he was a young man with a ministerial air, wore eyeglasses, and was apparently very serious, though underneath the outer covering was a rich vein of humor. when his numbers grew too large to suit him, in other words when fifty to one hundred came, to practically all he gave an ounce of castor oil, to be taken in his presence. one day the colonel came to him and said that he had had some complaints from the men that the only thing they got from the m.o. for all complaints was castor oil. the medical officer's face remained long and serious, and looking at the colonel over his spectacles, he said:

"well, do you know, my dear colonel, that castor oil is a wonderful remedy, marvelous, almost miraculous. can you believe it on my sick parade a week ago today there were seventy-five sick who came. i have given them nothing but castor oil, and so many are cured that today only seventeen came to see me. it's really an astonishing remedy. wouldn't you like to take an ounce of it, sir?"

"no, damn you, i wouldn't," roared the colonel, as he made his exit.

i was sitting in his tent one day when a lieutenant came in to see him, saying that ten years before he had broken his clavicle—"collar bone,"—and that over the old fracture he was having so much pain at times that he feared he would have to get a month off.

"ah, yes, my dear mr. blank. would you kindly divest yourself of your clothes till i examine the shoulder?" and the half of his face on my side screwed itself up into an exaggerated wink, which meant to me that he considered that this officer was trying to "put one over." he probably knew him!

when the officer had stripped, capt. smith asked him to show the exact spot of tenderness, and the lieutenant put his finger with exactitude on a certain point. captain smith touched the spot with his fingers, the officer exclaiming, "oh, that hurts, doc," and drawing back in pain.

"ah, yes, i'm sorry, but i'll be careful, mr. blank," and he examined gently the shoulder, arm and chest, but always finished the examination by pushing in fairly hard with his finger and saying, "now that's where it hurts, mr. blank?" and mr. blank would each time cringe with the pain of the touch. he repeated this again and again, but i noticed that each time he came back to the tender spot he chose a point an inch or so from that which he had chosen the last time. finally he had poor blank saying, "yes, that's the spot," when the spot touched was nearly six inches from the original sensitive point. at last the doctor said, very seriously:

"yes, yes, mr. blank, that painful condition must be attended to. it is a strange condition, don't you know, for as i go on examining it, the tenderness shifts about a great deal, and i feel sure that with a little rubbing it may be driven out altogether. now this liniment is the very thing, the very thing. yes, yes, twice daily, night and morning. good afternoon, my dear blank. don't fail to come back if it troubles you any more;" and blank went out looking a bit sheepish, while the doctor turned to me again with his face wearing that exaggerated wink. then he continued, as if he were just carrying on an interrupted conversation, "you know, manion, some of these officers are exceedingly troublesome, exceedingly so, when they happen to swing the lead, for one must appear to have the greatest consideration for them. now i have one extremely interesting case of laryngitis in one of the officers. it goes every now and then to the extent of complete loss of voice. troublesome condition, for he cannot give his orders to his men, and to hurry him back into condition i have sent him twice to the hospital. now, though this officer's courage is absolutely unquestioned, i find myself at times wondering if it may not be just that general fed-up feeling that we all get rather than laryngitis that affects him. captain thompson is a great friend of mine which makes it all the more difficult, but you know, my dear chap, really it's so easy to quit speaking aloud, and just whisper instead. i wonder does he talk in his sleep? by jove, that would be interesting. i must make inquiries.

"but," he continued, "i told him off a bit a couple of nights ago. one of our companies was putting on a raid at daybreak, and the officer in charge of the raid is not overburdened with nerve. one-half hour before the raid he started to groan, when we were all in headquarters dugout together, and said he had a very severe pain in his stomach or bowels. though i doubted the pain, i examined him carefully, and finding no real cause for it i allowed him to carry on, and, to do him justice, he went over the top like a man and did his bit in the raid as well as anyone could have done.

"but just after i had examined him thompson stepped up familiarly to me and said: 'do you really think, smith, that so-and-so did have a pain?' 'damn you, thompson,' i replied, 'what right have you to ask me such a question?' 'oh, come now, smith, really, do you think he did have a pain?' 'well, frankly, thompson,' i answered, in a low, confidential tone, 'i am losing so much of my faith in humanity, don't you know, that i find myself doubting if you have any laryngitis when you lose your voice!' and with a good-natured burst of laughter he left me. but i somehow feel that he won't have laryngitis again for some time!

"but honestly, manion, my great surprise always has been, and still is, not that so many try to get out of the line, but that in spite of the dangers and hardships 95 per cent. of officers and men do their hard, dangerous, trying jobs with a smile and without complaint. how very little cowardice there is in the world!"

and anyone who has served out there must agree with that opinion, particularly when he remembers the great numbers who have remained at home, facing no guns, braving no dangers, enduring no hardships. the above stories are told to illustrate the humorous side of the life; for all praise and gratitude is due to the men who have served out there in the noble cause of the allies. if at times some officer or man gets tired of the mud, rain, lice, shells, dirt, and dangers that he is daily encountering, and tries to get a few days in civilized surroundings, he is but showing a very human side to his nature.

diagram showing route of wounded from firing line to base hospitals.

diagram showing route of wounded from

firing line to base hospitals.

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