Thousands of First World War nurses wrote about their experiences: in letters, diaries, memoirs, and in works of autobiographical fiction published during and after the war. Their accounts and unique perspectives offer valuable sources for historians, and many of their works have interested literary critics specialising in women’s life-writing.[1] In this article I will begin by identifying the British and French women who nursed during the First World War, outlining the ways in which their differing backgrounds, motivations and experiences influenced the written accounts they left behind. Cultural constructions of nursing circulating in wartime Britain and France failed to account for the diverse realities of women’s experiences. These cultural myths have been reinforced, furthermore, in more recent evocations of the First World War nurse.[2] Understanding the variations in the ways nurses understood both their nursing work and their writing helps us to uncover some of the diversity of experience masked by the dominance of certain cultural myths.

One of the key ways in which nurses interacted with popular understandings of nursing was in meta-textual discussions of their wartime roles within their writings. Nurses played dual roles during the First World War. On the one hand, they functioned as witnesses to men’s war, acting as a link between home and front, for example by writing letters on behalf of their patients to families and loved ones at home. On the other hand, they were active participants in the conflict, offering vital medical care, and operating closer to the front than the majority of their sex, which sometimes blurred the line between (male) combatant and (female) civilian. In order to explore this further, I refer to literary critic James Campbell’s concept of ‘combat gnosticism’, which he defines as:

[An ideology] that gives us war experience as a kind of gnosis, a secret knowledge which only an initiated elite knows. Only men (there is, of course, a tacit gender exclusion operating here) who have actively engaged in combat have access to certain experiences that are productive of, perhaps even constitutive of, an arcane knowledge. Furthermore, mere military status does not signify initiation, but only status as a combatant. It is not the label of “soldier” that is privileged so much as the label of “warrior”.[3]

We can find this privileging of male combat experience not only, as Campbell notes, in 1970s and 1980s literary criticism of First World War writing, and in particular in Paul Fussell’s 1975 pivotal study The Great War and Modern Memory, but equally in attitudes to war-writing during the immediate post-war years.[4] The presence of the ideology of combat gnosticism helps to contextualise and, at least to some extent, to explain the choices made, and some of the hesitations expressed, by nurses in relation to their roles as war-writers. While both historians and literary critics have become increasingly interested in what these accounts tell us about the development of nursing practice, women’s war experiences or women’s life-writing, scholars have rarely considered the question of how nurses themselves viewed their roles as chroniclers of the war and its consequences in their writings. In their published memoirs, nurses often foreground their role as ‘witnesses’ to a ‘warrior’s’ war. They do so, I will argue, not only out of respect for the combatants’ suffering and bravery, but equally as a means of endowing themselves with the authority to speak. This is always combined, however, with another voice, that of ‘active participant’, which makes a claim for the importance of women’s war narratives on their own terms. The relationship between these two roles can, therefore, be a conflicted one in nurses’ writings.

Myths and realities of nursing

The kinds of women who worked in hospitals, both at home and nearer to the front, varied considerably in terms of their skills, motivations, age and social and professional backgrounds. In France, a nation in which political battles between Catholics and Republicans over control of the hospitals had dominated discussions over nursing as a profession in previous decades, Catholic nuns from nursing orders, trained secular nurses and volunteer Red Cross nurses worked side by side. However, the majority of French nurses, around 100,000, worked for one of the three societies that made up the French Red Cross: la Société de Secours aux blessésmilitaires (SSBM), l’Association des Dames de France (ADF), and l’Union des Femmes de France (UFF). In Britain, the main dividing line was between the 20,000 or so professional nurses – either those belonging to one of the military nursing organizations, or trained nurses who had worked in civilian hospitals before the war but who were mobilized for war work – and the volunteer VAD (Voluntary Aid Detachment) nurses, of whom there were more than 70,000 by the end of the war.[5] The latter underwent some first aid training and many became highly skilled by 1918, but, at least in the first two years of the war, their role was to perform the ‘domestic’ work of the wards – preparing and serving meals, cleaning, dressing and undressing patients, letter-writing and so on – under the supervision of the trained nurses who performed more of the skilled nursing work. The perspective of a trained professional who had already experienced medical trauma was bound to differ from that of an inexperienced volunteer, and this is evident in the memoirs, letters and journals that both categories of nurse left behind.

In the eyes of the general public, however, in both nations volunteer nurses were more prominent than their professional colleagues, and this sometimes caused resentment and tensions. Popular postcards and magazine articles offered a highly romanticized image of nursing, with nurses being portrayed on the one hand as saintly paragons of virtue, or, on the other, as romantic heroines, their feminine charms coming as welcome relief to their soldier-patients. In many cases, little distinction is implied in such popular images between trained and volunteer nurses, whereas in other examples it is more likely to be the volunteer nurse who is depicted, as the most respectable, and widely idealised, role-model for middle and upper-class women in both nations. These romanticized images of nursing are evident, for example, in the following popular magazine illustrations. Figure 1 is a French postcard reproducing a drawing by illustrator Pascal Dagnan-Bouveret, originally published in December 1915 in the popular journal L’Illustration. It features a young and striking Red Cross nurse, her role clearly designated as to serve the wounded ‘warrior hero’, prostrate in the bed, who resembles a medieval knight. Her patient’s ongoing military identity and status are symbolised through his cap and the picture of Joffre, while her domestic role – bringing relief and sustenance to a husband or child – is transported into a military setting. Finally, her ardent devotion to her wartime ‘vocation’, and the seriousness with which she is carrying out her patriotic task, is indicated by her direct gaze at the viewer.

Figure 1: Au chevet ces Héros [At the bedside of Heroes], 1915, Pascal Dagnan-Bouveret.

Figure 2 is a British depiction of an attractive young VAD nurse and her soldier patient, who is convalescing. Like many British portraits of volunteer nurses, she seems less saintly than her more idealised French counterparts, who tend to be portrayed as chaste and nun-like. She is intently listening to her patient’s tales of combat. The image betrays the influence of the ideology of ‘combat gnosticism’: the combatant is speaking; he is the one whose heroic deeds are to be heard and respected. This image also, moreover, sets the nurse up as a communication channel between home and front, listening to the voices of the soldiers, and then potentially passing on his stories to those at home.

Figure 2, British First World War Postcard ‘He’s been out on Active Service, Playing a British Hero’s Part’. Date unknown.

In their writings, both trained and volunteer nurses are quick to point out the gaps between the idealised images circulated in popular culture and the realities of wartime nursing. In so doing, they not only reveal the limitations of cultural myths, but they also attempt to present themselves as authentic narrators of the war, who can educate their readers. For example, in the preface to the 1917 published memoirs of a French Red Cross nurse, Geneviève Duhamelet, the author quotes what he claims to have been one of Duhamelet’s letters, which contrasts the rose-tinted public image of the nurse with the more gritty realities:

Ne croyez pas, je vous prie, les aimables contes que la quatrième page des journaux nous dispense, plusieurs fois par semaine: l’hôpital modèle installé dans le vieux château; le blessé souvent officier et toujours décoré de la croix de guerre, dont la blessure est toujours grave, quoique esthétique; la jeune infirmière, blonde et blanche sous ses voiles, qui a trahi, cette année, le tango pour la Croix rouge…j’ai vu passer chez nous plus de 700 soldats, plusieurs ont la croix ; notre plus haut gradé fut un adjudant, fort désagréable.[6]

[Please don’t believe the nice stories that the newspapers dole out to us several times a week: the model hospital installed in the old château; the wounded soldier, often an officer and always decorated with the croix de guerre, with an always serious although aesthetically pleasing injury; the young nurse, blonde and white beneath her veil, who this year has given up the tango for the Red Cross. […] I’ve seen more than 700 soldiers pass through our hospital, several had the croix; our highest ranked officer was a warrant officer, who was most unpleasant.]

Madeleine Clemenceau Jacquemaire, the daughter of the Prime Minister who was a volunteer nurse throughout the war, and who published her memoirs in 1919, is equally scathing about popular fictional versions of nursing:

Une certaine littérature s’alimente du type de la belle infirmière. On n’en voit guère aux armées que dans les journaux illustrés comme La Vie Parisienne. […] Là-bas les infirmières ont beaucoup de peine à être propres, simplement. Elles n’ont pas de salle de bains. Elles n’ont pas de coiffeur pour entretenir leur chevelure qui s’abîme sous le voile. Le blanchissage est un problème toujours posé, jamais résolu.[7]

[A certain kind of literature feeds on the stereotype of the beautiful nurse. You don’t see as many of them in the Army as you do in illustrated magazines such as La Vie Parisienne. […] There the nurses had to make an effort simply to remain clean. They didn’t have any bathrooms. They didn’t have a hairdresser to maintain their hairstyles, which were messed up under the veils. Keeping their clothes white was a problem always posed and never solved.]

These two French Red Cross nurses were no doubt voicing common frustrations among their colleagues when they confronted misconceptions based on unrealistic cultural myths. At the same time, however, they are also bolstering their status as women who were working close to the action, in difficult conditions, and who could therefore be trusted by their readers as authentic chroniclers of the war.[8]

In Britain, where there were more trained nurses, there was some frustration expressed in the pages of professional journals that their work was less recognised than that of the volunteer women that they trained and supervised on hospital wards. For trained nurses in both nations the war represented an opportunity to prove their worth in an ongoing fight for greater professionalization (particularly for the state registration of nurses), and they therefore sought public recognition of their training, service and value. An Australian military nurse, Gretta Lyons, for example, wrote in the British Nursing Journal in October 1916:

In justice to [military nurses] I should think the voluntary Red Cross workers would choose some title other than that of ‘Military Nurse’. […] At this crisis what immense value legal status with the protection of the title of “Registered Nurse” would have been to us. […] To make heroines of these [Red Cross] girls, who are not inspired by the real spirit of nursing which is nothing if not inspired by self-denial, is fostering in them a most sickly, not to say dangerous sentimentality.[9]

Not all trained nurses were as critical of their Red Cross colleagues, but the objection to the popular stereotype of the volunteer nurse as romantic heroine is evident in Lyons’ comments. Occasionally, the relationship between British VAD volunteers and trained nurses was exacerbated by differences of social class. The former, and especially the ones who served abroad, tended to come from wealthier families, whereas as the numbers of the military nursing services rapidly grew the social classes from which they were drawn became more diverse. However, this difference of social class should not be exaggerated as the backgrounds of both VADs and trained nurses varied. The differences and tensions that sometimes existed between the two groups of women stemmed more from their different motivations and experiences. We can see this if we examine the ways in which volunteer VADs and trained nurses wrote about their experiences both during and after the war. Christine Hallett notes that while VADs often saw themselves as women who ‘brought a spark of humanity to the harsh discipline of the military hospital ward’, professional nurses were often suspicious of their motives and classed them as ‘romantic adventuresses’. Trained nurses had been taught the importance of setting strict emotional boundaries, whereas volunteer VADs were more likely to treat the soldiers as potential friends or comrades.[10]

Witness or participant?

Both the French Red Cross nurses attacking popular stereotypes of the war-nurse, and the British trained nurses keen to underscore the value of their expertise and service, present themselves as participants in the war in their own right. They refute the accusations often levelled at them in the press and in popular fiction in both nations that nurses were fashionable young women simply ‘playing at war’. These criticisms were often class-based. As Margaret Darrow notes in relation to France: ‘The image of the society lady as nurse informed almost all the critics of Red Cross nurses’, who was portrayed as a sexualised, inexperienced, selfish and trivial ‘false nurse’ in relation to the chaste, silent, obedient and nun-like ‘true nurse’.[11] In Britain, Mary St John Swift Joly’s popular novel Those Dash Amateurs (1918) gives a similarly unflattering portrait of society ladies drawn to war nursing for less than noble reasons, with a trained nurse, set up as a ‘true nurse’, declaring: ‘It makes me sick when [society ladies] talk of nursing soldiers as if ‘twas a fashionable game. God knows our men have enough to contend against without being pawed by these pests.’[12]

In the light of these criticisms, and of the ideology of ‘combat gnosticism’ in which male combat experience was valued above all other war experiences, nurses needed in their writing to find ways of justifying the value of both their roles and their written testimony. One way they did this was by drawing connections between nurses and combatants, even suggesting a degree of equivalence in their experience. Madeleine Clemenceau Jacquemaire, for example, recounts an episode in which nurses are waiting for a convoy of wounded soldiers. She describes the nurses using terms normally reserved for combatants: ‘lasses, courbaturées, avec des piedsbrûlants. [...] Certaines ne sont pas allées en permission depuis sept mois et ce soir le cafard fait son mauvais travail dans plus d’un cerveau surmené.’[13][‘weary, stiff, with throbbing feet […] Some of the nurses hadn’t been on leave for seven months and that evening more than one overtired brain was plagued by ‘le cafard’ (depression).] A trained French nurse, Juliette Dyle, who nursed in Serbia, also claims in her 1926 published memoirs to be suffering from the same ailments as front-line soldiers:

J’ai le cafard! … un cafard monstre ! Cette maladie, fort commune à présent, attaque principalement ceux que les exigences de la vie actuelle ont métamorphosés en amphibies, et qui végètent dans les tranchées lacustres. La médecine et le dictionnaire l’ignorent. […] Vous devenez un être dangereux, ne pouvant supporter vos semblables que la moindre contradiction vous donne envie d’étrangler ; et peu à peu vous tombez dans un abattement tel qu’il est impossible de vous arracher une parole sensée, vous êtes gélatineux des pieds à la tête, indifférent à tout.[14]

[I’m feeling down! … terribly down! This illness, which is very common at present, mainly attacks those who the demands of war have turned into amphibious creatures, stagnating in lake-like trenches. Neither doctors nor dictionaries know what it is. […] You become a dangerous being, unable to put up with your colleagues, as the smallest disagreement makes you want to strangle them; and little by little you fall into such a state of despondency that it is impossible to get a sensible word out of you, you are like a jelly from head to foot, indifferent to everything.]

In presenting themselves in their published memoirs using terms more familiarly adopted by male combatant-narrators (particularly ‘le cafard’, or war-induced depression), these nurses simultaneously highlight the value and difficulties of their nursing work and present themselves as guides to their civilian readers of the realities of military life. Indeed, one reviewer of Juliette Dyle’s account in 1927 commented that women should read it and pass it around to other readers to prove that ‘Les Françaises ne sont pas toutes des poupées’ [‘French women are not all dolls’].[15]

The most well-known British VAD nurse, Vera Brittain, is equally keen to present to align herself with combatant veterans, but in a rather different context. In 1933, when she published her famous memoir Testament of Youth, she was emulating anti-war veteran narratives that used their war experience as a way of adding weight and authority to their political interpretations of the war. Similarly, rather than a middle-class girl ‘playing’ at nursing, Brittainpresents herself in her memoir as a participant, bearing witness to the destruction caused by war:

Only a short time ago, sitting in the elegant offices of the British RC Society in Grosvenor Crescent, I read in the official Report [...] that “The VAD members were not [...] entrusted with trained nurses’ work except on occasions when the emergency was so great that no other course was open.” And there, in that secure, well-equipped room, the incongruous picture came back to me of myself standing alone in a newly created circle of hell during the ‘emergency’ of March 22nd, 1918, and gazing, half hypnotised, at the dishevelled beds, the stretchers on the floor, the scattered boots and piles of muddy khaki, the brown blankets turned back from smashed limbs bound to splints by filthy blood-stained bandages.[16]

In this way, Brittain exploits her experiences of nursing as the means to fulfil her pacifist mission, and deliberately structures her story and colours her descriptions in order to do so. In the same passage, for example, the wounds are described as ‘obscene horrors’ – this is not the perspective of the trained nurse she argues she was, but of the pacifist writer persuading her audience of the futility and horrors of warfare.

The nurses quoted above thus construct themselves as active participants in the war, whose stories and experiences have a value in themselves, which in turn bestows on the nurses the right to speak about the war with political and literary integrity. However, it is equally common for nurses to present themselves as channels through which male suffering and soldier stories can be communicated; as witnesses rather than as participants. These two roles – of witness and participant – are sometimes evident within a single text. For Brittain, for example, her Testament of Youth is as much an elegy to the dead, with her as chief lamenter, as it is female-authored anti-war manifesto.[17] Santanu Das has explored what he terms the ‘impotence of sympathy’ experienced by First World War nurses, the extent to which their accounts suggest a sense of helplessness in the high degree of empathy they had with the men they nursed. This sense of acutely feeling and sharing the patients’ suffering is at the forefront of many nurse memoirs.[18] In a patriotic French text entitled Notes d’une infirmière 1914, published by M. Eydoux-Démains, for example, the nurse-narrator exclaims: ‘Rien ne ressemble à la pitié qu’ils inspirent. Cela vous prend le vif du cœur, vous fait souffrir non pas d’une douleur de sympathie, mais d’une douleur personnelle. Cela vous hante et vous poursuit partout.’[19] [Nothing resembles the pity that [the patients] evoke. This touches your heart deeply, makes you feel their pain not only out of sympathy but personally. It haunts you and follows you everywhere.]

Due perhaps to this sense of empathy and intense sympathy for the suffering of their patients, nurses frequently claim to be acting as scribes for men’s narratives rather than foregrounding their own stories. They present themselves as proxy-writers for the men they treat, whose illnesses and wounds had robbed them of a voice. Nurses often did write letters to patients’ relatives, acting as a vital communication channel between front and home. British military nurse Kate Evelyn Luard discusses the difficulties she finds in this role in her published letters:

Tuesday, July 11th [1916] [Mothers] almost invariably write and ask if he “said anything under the operation” or if he “left any message” when you’ve carefully told them he was unconscious from the time he was brought in. And when you’ve said the Chaplain took the funeral they write and ask, “If he was buried respectable?” Some of them write most touching and heart-broken letters.[20]

There is clearly a difference of social class at work here: Luard’s mimicking of the working-class mothers’ language betrays a sense of frustration with their inability to understand the medical realities of their sons’ cases. However, there is also a sense of responsibility expressed in the passing on of news, on the need to act as a bridge between front and home. This same anxiety is also evident in another British military nurse’s diaries, Edith Appleton, who notes:

March 8th [1916] My heart is very sore for one poor boy, or for his Mother. We have had him 10 days and he is no better and is in a state to die at any moment. I am writing to his Mother and telling her so. She is evidently a refined old lady – writes back to say she is “so glad to hear Charlie is with us – the rest and good food will do him good.” Have my letters not reached her? Or won’t she understand that the boy is dying. I think he must have been gassed; he is purple and just like a gas patient.[21]

Thus in their texts nurses often present themselves as a channel of communication between combatant and his family, rather than as narrators of their own war experiences, in a manner reminiscent of the way in which early female religious autobiographers presented themselves as a vessel through which the word of God might be communicated, rather than as women daring to speak as individuals in their own right.[22] Ruth Amossy correctly notes in this context that in Clemenceau Jacquemaire’s 1919 memoirs: ‘The narration […] highlights the bravery, in the martyrdom he endures, of the French combatant. In this way the female narrator makes herself the cantor of the heroism of the poilu.”[23] Other nurses also overtly take on this role as ‘cantor’. Grandmother Claudine Bourcier, a volunteer French Red Cross nurse, for example, states: ‘Jamais ceux de l’arrière ne sauront la bravoure et le dévouement de mes chers Poilus et combien ils méritèrent de la patrie.’ [Those on the home front will never know the bravery and the devotion of my dear poilus and how worthy they are of recognition by their homeland].[24] The very title of Kate Luard’s Unknown Warriors, make it clear that some nurses saw their function as witness as much as participant, in that her chosen title refer to her patients’ stories and not to their own. This acceptance of the ideology of ‘combat gnosticism’ is reinforced in the choice of illustration with which she opens Unknown Warriors: a picture by H.S.Williamson entitled ‘Removing the Wounded’ (rather than a picture of herself in nursing uniform, for example). Yet, as in other nursing memoirs, Luard’s desire to tell the stories of her patients exists side by side with a narrative of pride at nurses’ contributions as participants. She notes in 1916, when working at a Casualty Clearing Station in the Somme, for example:

Friday, September 22nd Of course we ourselves have learnt a great deal. There is no form of horror imaginable, on any part of the human body, that we can’t tackle ourselves now, and no extreme of shock or collapse is considered too hopeless to cope with, except the few who die in a few minutes after admission. Some of the most impossibly pulseless people have “done” (the slang word for recover) after hours of coping with every known means of restoration, most of which can be got going in five minutes as we have everything ready for these efforts in every ward.[25]

On the one hand, Luard praises the contribution of nurses to the war effort, and suggests that they have gone through a ‘learning curve’ alongside the rest of the British Army, leading to better outcomes with patients.[26] On the other, she presents herself as educator of her civilian readers, literally translating for them the military language familiar to her as somebody working at the front. I would argue in conclusion that nurse memoirs crystallise the ethical ambiguities and liminality of women’s position as female war writers. As nurses, they often write as participants – or, in postwar texts, as female veterans - claiming their right to speak, and placing themselves in the category of participants who can educate, inform and remind their civilian readers of the lessons of the war. In a climate of ‘combat gnosticism’ they are positioning themselves as quasi-combatants rather than as civilians. As witnesses to men’s suffering, they present themselves as channels for communicating male warrior-heroism, or for lamenting the dead. In this sense, they are not questioning the hierarchy in which male combat experience is placed at the top of war narratives, but taking up the role of comforter, nurturer and supporter that is illustrated in countless popular imagery of the war nurse. In the tension that exists between these dual roles of participant and witness, these nurse memoirs illustrate perfectly what literary critic Dorothy Goldman calls the ‘different and complex double function’ of women war writers, being simultaneously ‘actors in their own war and spectators of the soldiers’ war’.[27]It is a tension that is not resolved within their writings; rather, it reveals the difficulties of being taken seriously as female chroniclers of the war in a post-war climate in which the myriad of diverse war experiences was largely condensed into a culturally dominant ‘War Story’ in which the central protagonist was a ‘warrior’-hero.