INTRODUCTION

At the Battle of Second Ypres in April 1915, Lieutenant-Colonel Walter Langmuir Watt wrote in his diary about the carnage at his medical aid station. It was “one never-ending stream which lasted all day and night for seven days without cessation: in all some five thousand two hundred cases passed through our hands. Wounds here, wounds there, wounds everywhere. Legs, feet, hands missing; bleeding stumps controlled by rough field tourniquets, large portions of the abdominal walls shot away; faces horribly mutilated; bones shattered to pieces; holes that you could put your clenched fist into, filled with dirt and mud, bits of equipment and clothing, until it all became like a hideous nightmare, as if we were living in the seventh hell of the damned.” Awful scenes like this were repeated time and time again in the large-scale battles along the Western Front, the smaller operations in between them, and the warfare in the trenches, where soldiers were killed, maimed, and forced from the line by illness and disease.

This is a story of the fighting Canadian soldiers and of those men and women in the Canadian Army Medical Corps (CAMC) who sought to save them from pestilence, injury, and death. It is a history of killing and curing—of the entwinement of the fighting units and the medical services. In response to the unimaginable wounds caused by this new industrialized war, medical treatment was undergoing a steady progression, from developing surgical techniques and diagnostics to using relatively new X-ray machines to engaging with mental injuries. New interventions through blood transfusions and facial reconstruction were radical departures from past treatment. While there were amputations for traumatic injuries or as a result of infection—a relentless killer of soldiers before the age of antibiotics—the surgeons were astonishingly good at saving lives. “Amongst all the misery of war and within easy distance of its relentless activities are found the more civilized and humane endeavors of humanity; the desire to alleviate suffering,” observed one Canadian soldier, stressing the seeming contradictions of medicine and war. “On the one hand it is science straining every nerve to accomplish man’s destruction, on the other hand it is science working overtime to save his life.” The battle for life was an ongoing struggle, braided with and inseparable from combat at the front.

Despite the extraordinary slaughter on the Western Front that was swept and saturated by the firepower of artillery, machine guns, and rifles, medical personnel also fought unseen adversaries in viruses and bacteria. “In every war the soldier faces two enemies,” wrote CAMC lieutenant-colonel John W.S. McCullough. “The one is the armed forces of the foe, with their terrible engines of destruction, the other the silent and in the past the far greater foe, the grim purveyor of death, disease. The history of warfare for centuries has shown that of these two enemies the latter or silent enemy causes much the greater mortality.” During the American Civil War from 1861 to 1865, with its increased fire-power and over 2,000 land battles, disease still killed five times as many soldiers as conventional shot and shell. And in almost every war in human history, disease claimed more lives than human weapons. Death by disease was a significant concern at the start of the Great War, and the fact that the Canadian forces (and all Allied or enemy armies) along the Western Front did not waste away from the scourge of bacteria and viruses was a marvel of preventative medical care.

Soldiering in conditions of dirt, deprivation, and hardship, the medical forces also played a key role in sustaining morale. This lesson had been learned by the time of the Great War, partially because of the foul blight of the British army’s neglect of the wounded during the Crimean War of 1853–1856, which was a lasting cause of reproach. In that war far from Britain, the medical services had been overwhelmed, with hospitals filled with dying men left unattended. The abandonment of soldiers to perish in agony from festering infections was an appalling revelation that led to a far-reaching public scandal that shook faith in the military. In response to that health disaster, widespread reforms in the medical support of armies and vast improvements in civilian medicine began in the mid-nineteenth century, so that by 1914 there was a firm belief in the need to offer the best care possible for the citizen-soldiers who enlisted to serve their country. Indeed, a social contract held sway between the state and the citizen-soldier in almost all armies, and those who enlisted had expectations that they would not be abandoned on the battlefield. While soldiers came to understand the high probability of death and maiming at the front, and generally accepted this or found ways to choke back the fear and continue in their duty, a well-functioning medical system was crucial to the war effort. This maintenance of morale through prevention and treatment was an acknowledged role of all doctors and nurses; at the same time, the high command relied on the medical services to keep their soldiers in the line, no matter the human cost. Individual suffering would be subsumed to the larger war effort. The medical practitioners were thus thrust into the role of ensuring that soldiers’ motivation did not collapse, but also of acting as the gatekeepers who refused to let soldiers exit the front with all its horror and tragedy. These twin motivations—to repair the soldier and to keep him in the line—often pushed non-combatant doctors and nurses into agonizing ethical dilemmas.

Medical practitioners were forced to carry an emotional weight as they fought to save lives and bore witness to untold misery. It was said that no one could understand war without first setting foot in a military hospital. The images of human bodies torn apart or eaten alive by infection imprinted themselves on the medical service personnel. These healers were deeply affected by their many interactions with wounded soldiers, who often had tremendous faith in the nurses and doctors that their flesh could be mended, that their nightmare-plagued minds could be restored, and that they would return safely to loved ones. And yet thousands still died of their wounds in the medical units. Private Ralph Watson, a Canadian CAMC orderly who was later a stretcher-bearer, shared a glimpse into the medical war when he wrote to his wife, “I have done things I never believed I could possibly do. I have seen wounds that you cannot bear to look at. . . . But I’m not going to tell you about all that.”

All of the Great War fighting services, from infantry and gunners to engineers and airmen, learned during the conflict, processing lessons through defeat as much as victory. A clear trajectory of knowledge and professionalization was also evident within the medical services, including advancements in surgical techniques, preventative care, and public health awareness, all of which were brought back to Canada after the war. The unlimited war effort that demanded so much from Canadians over four long and costly years also conditioned the public to expect the state to provide aid to address postwar health challenges. Following victory, the medical practitioners who were now veterans were at the sharp end of new medical battles, and the legacy of treatment during the war profoundly shaped medicine and public health initiatives for decades to follow. “The war gave us a new social conscience,” said one doctor after the war. “It taught us a new standard of generosity and impressed upon us the practical value of individual and community health.”

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The Great War of 1914 to 1918 was a conflict of unprecedented scale and destruction. By war’s end, over 9.4 million soldiers were killed, at least 21 million more were wounded in body, and countless millions would carry mental scars. From Canada, a country of not yet 8 million, at least 620,000 served or were conscripted, with about one in three adult males in uniform. A total of 2,845 nursing sisters also contributed to the war effort, and almost all of the men and women who formed the Canadian Expeditionary Force (CEF) were drawn from civilian life rather than the professional armed services. Coming from across the Dominion, from every city, town, and village, English, French, new Canadians, and Indigenous people came together in a common cause.

Canada was not prepared for the Great War, with only 3,000 professional soldiers in uniform and a scarcity of modern weapons. The CAMC was no different, and it consisted of twenty officers in 1914. Attesting to their importance during the war, however, the medical services expanded to over 20,000 men and women, with about half of all Canadian doctors in uniform and about a third of the country’s nurses. There was no shortage of patients. Of the 424,589 Canadians who went overseas, around 140,000 were wounded at the front, and most of these injuries fell to the 345,000 Canadians who served in Europe along the Western Front. And yet despite the long odds against the soldiers, nine out of ten wounded soldiers survived their injury if they were cared for by a medical practitioner, attesting to the skill of the doctors and nurses. That figure does not diminish the grievous losses at the front, where over 66,000 Canadians were killed during the war and in the immediate aftermath, although the butcher’s bill would have been much higher without the medical services. Canada’s doctors and nurses, noted an official 1919 report, came together to form a “great machine of healing.”

After the Great War, the Canadian medical services enlisted the aid of the country’s most accomplished medical writer, Sir Andrew Macphail, to pen the services’ official history, The Medical Services (1925). Readers will see later in this book how the war veteran and McGill University professor excited much controversy, but The Medical Services remained the standard text for understanding Canada’s medical war into the twenty-first century. Almost a hundred years later, and written in the midst of the coronavirus worldwide pandemic, Lifesavers and Body Snatchers draws together old and new research, connects it to other international historiographies, and offers a new way to understand the incredible challenges of this generation of Canadians who faced the Great War apocalypse. While this is a book about medical advances and failures, it is always centred on the experiences of soldiers, medical practitioners, and other eyewitnesses to history.

Combat and care are the focus in these pages, but the shocking story of the harvesting of human body parts, organs, and bones from slain Canadian soldiers will also be exposed. I have spent more than a decade investigating the story of Canadian doctors harvesting body parts of soldiers on the autopsy table and then using their brains, lungs, and other organs or bones for scientific study. While stretcher-bearers were sometimes described as body snatchers for their courage in carrying off the wounded from the battlefield under fire, this collection of body parts was another form of body snatching. This story has never been fully told, but my research into the nation’s archives has revealed that almost 800 individual Canadian body parts, organs, and skeletal remains were extracted from Canadians killed at the front and sent to London, England, where they were stored, conserved, and put on display at the Royal College of Surgeons. Even more incredible, the first transfer of these Canadian body parts was sent to Montreal in 1918 to form a founding collection for a planned military medical museum that was to have been built in Ottawa. While little known at the time, this program of harvesting body parts was not a nefarious secret, and I have uncovered how the federal government even devoted significant funds in the immediate postwar years to the preservation of these organs and bones. This revelation is all the more surprising when one considers how Canadians after the war were seeking to make meaning of the nation’s service and sacrifice by erecting memorials to the fallen in almost every community across Canada and overseas at former battlefields like Vimy Ridge. Riven with grief and hollowed out by sorrow, Canadians ennobled the fallen soldiers and they murmured “Lest We Forget.” Few imagined that many of their loved ones who were slain overseas had been reduced to scientific specimens that would be transported back to Canada and put on display in jars as medical teaching tools and scientific oddities. This story, laid bare here for the first time in any book, is a wartime medical mystery that is startling and disturbing, calling into question what we know about the bodies of fallen soldiers.