Book review

Fact and fiction:

Medical Women at War

Wendy Moore is a prize-winning journalist and author of fi ve non-fi ction books on medical and social history. She writes for the Lancet, Guardian and Times Literary Supplement. Her second book, Wedlock, was a number one Sunday Times bestseller. Endell Street: The trailblazing women who ran World War One’s most remarkable military hospital (Atlantic Books, £17.99) was published in April.

Headshot credit: Colin Crisford

Elizabeth Garrett Anderson battled discrimination to become the first woman trained in Britain to join the UK Medical Register in 1865. But almost 50 years later there were still only about 1,000 women doctors registered in Britain and almost all of them worked in hospitals run by women to treat only women and children. Women had won the right to qualify in medicine but they were still barred from training in most medical schools and from working in most mainstream hospitals. The First World War changed everything. When war broke out on 4 August 1914, women doctors immediately offered their services to the country. While they were just as keen as men to do their patriotic duty, medical women also saw war as a unique opportunity to gain experience and prove they were equal to their male colleagues. The Association of Registered Medical Women, forerunner of the Medical Women’s Federation (MWF), was at the forefront of this drive. Ten days after the outbreak of the war, the MWF collected the names of more than 60 women doctors willing to volunteer at home or overseas. Others approached the War Office directly with offers of help. At first the government was adamant that women doctors were not wanted. The Scottish surgeon Elsie Inglis was famously rebuffed with the words, ‘My good lady, go home and sit still.’ Determined they were not simply going to sit out the war, women such as Inglis took matters into their own hands and immediately began organising allfemale medical units to serve abroad. The first such unit, which set out for France on 17 September 1914, was the Women’s Hospital Corps led by Flora Murray and Louisa Garrett Anderson. Anderson, a surgeon and daughter of Elizabeth Garrett Anderson, and Murray, a physician and anaesthetist, had more than 10 years’ experience apiece. Both had trained at the London School of Medicine for Women (LSMW) although Murray finished her degree at Durham. Both had been active suffragettes – Murray was Emmeline Pankhurst’s doctor and Anderson had served time in prison for breaking a window – and they were also life partners. Knowing it was pointless approaching the War Office, they volunteered their services instead to the French Red Cross. Within weeks Anderson and Murray had raised £2,000 for medical supplies and recruited a unit of 18 personnel comprising of three more women doctors, eight nurses, three female orderlies and four male helpers. Kitted out in military-style uniforms, they sailed for France where they established a hospital in a luxury new hotel, Claridge’s, in Paris. Two days later they accepted their first wounded – British and French soldiers from the nearby frontline – and within days Claridge’s was full. Army officials who came to visit were initially sceptical but were so impressed they invited the women to run a second military hospital near Boulogne under army authority. Then in early 1915, Anderson and Murray were asked by the War Office to run a major military hospital in the heart of London.

Operating theatre credit Cook-Dickerman Collection, National Park Service, US.

‘War had changed everything. Despite their complete lack of experience in treating men, or dealing with war injuries, the two women had decided to set up their own emergency hospital to treat wounded soldiers plucked from the battlefields in France. Gathering together a team of young recruits, including three more women doctors, eight nurses, three women orderlies and four male helpers, they were bound for Paris. It was a gamble. They were not only heading for unknown dangers in a war zone with eighteen young people under their command but their medical inexperience meant they were seriously unprepared for the challenges ahead. As committed to the women’s cause as they were to each other, Murray and Anderson saw the unfolding drama in France as their first chance to prove that women doctors were equal to men.’

Endell Street Military Hospital opened in May 1915 in a former workhouse in Covent Garden with 520 beds, later expanded to 573. By now other medical women had set up hospitals and medical units in warzones across Europe. Led by Elsie Inglis, the Scottish Women’s Hospitals founded hospitals in France and Serbia and later worked in Russia. But Endell Street was, and would remain, the only hospital run and staffed by women under the authority of the British Army. Apart from 20 male orderlies, later reduced to 13, the entire staff of 180 was female. These included 14 doctors, 29 trained nurses and more than 80 orderlies. Endell Street stayed open throughout the war, treating more than 26,000 wounded – most of them men – and performing some 7,000 major operations. Since the hospital was close to major railway stations, many of its patients were serious casualties who arrived in convoys of up to 80 at a time, often in the middle of the night. As news of this unique hospital spread women flocked from across the globe to work there, including four surgeons from Australia and one from Canada. Endell Street was declared a triumph by the press, the public and the profession. Suddenly medical women were in demand. Spurred by the success of Endell Street, in 1916 the army appealed for 40 women doctors to join the Royal Army Medical Corps. The response was so large that 85 women sailed for Malta that July and the following year more followed them to work in Greece, Egypt and India. At home, women doctors took up posts left vacant by men in hospitals, private practices and factories. Dr Jane Walker, the MWF’s first president, became consulting physician at the Ministry of Munitions and Ministry of Food while Dr Florence Stoney took over the X-ray department of Fulham Military Hospital. In 1916, the magazine of the LSMW noted that ‘at present practically every appointment is open’ to women. Many medical schools opened their doors to women students for the first time. Yet acceptance was a double-edged sword. Women doctors in the army were denied commissions, uniforms and privileges and paid lower rates. Without proper authority, their orders were ignored; they had to travel third-class on trains as ‘nurses’ and were turned out of army messes. One described the experience as a ‘daily humiliating annoyance’. Worse still, when the war ended women doctors were no longer required. Winston Churchill, Secretary of State for War, told the MWF that women doctors were no longer needed in the army since it was ‘beyond refutation that medical women cannot perform all tasks which are at present undertaken by Medical officers’. Hospitals, which had relied on women doctors throughout the war, ended their contracts and refused to appoint them to new posts. Medical schools, which had only survived in wartime due to women students, shut their doors again. The war had proved the worth of women doctors – but peace brought their value to an end. Endell Street remained open for a year after the war ended, treating the victims of the 1918-19 influenza epidemic, before closing in December 1919. Most of its women doctors returned to low-status jobs treating women and children or retired. Murray died in 1923 and Anderson lived on alone for another 20 years. The hospital building was demolished in the 1970s and today the only reminder is a plaque on the wall.