(Above) Patient in plane. © David Cotterrell, 2008
Chris Broughton immerses himself in War and Medicine, which continues at the Wellcome Collection, 183 Euston Road, London until February 15 2009.
An all-pervading bass hum is the first thing I’m aware of on entering the War and Medicine Exhibition, throbbing at a level of intensity that can be felt as much as heard. Leaning into the display cabinets I can feel the glass vibrating. It’s deeply unsettling and causes a sense of anxiety that never lets up as I move through the exhibits, many of which cause their own pangs of discomfort.
Entering a darkened room, I discover the source of the sound, now a muted roar. The interior of a Hercules troop-carrying aircraft is projected onto three walls, giving me the alarming sensation of being trapped with the medics tending wounded soldiers in the gloom.
Filmed by artist David Cotterrell, who spent a month in Afghanistan gaining first-hand experience of life beyond the front line, the scene is only a training exercise but nevertheless gives an unnerving insight into the squalor of modern conflict. “It acts as a sort of prologue about the strange and intense relationship between medicine and warfare,” says Curator James Peto.
World War I: stretcher bearers. © Wellcome Library, London
“I suppose what the exhibition is really about is the struggle of doctors, nurses, surgeons and research scientists to keep up with the pace of development of weapons and armaments.”
Mounted in collaboration with the Hygiene Museum in Dresden, War and Medicine traces this “strange relationship” through 150 years, starting with relics from the Crimea.
“Because this is such a huge subject, we decided to focus on the modern era, and the Crimean War seemed the best place to start,” Peto explains. “Thousands of people were sent out to a very remote place, and the disastrous effects of the conditions in which they were housed was one of the biggest influences on their poor survival rates.”
The Crimean exhibits include a very striking graph outlining deaths during a year of conflict. Like a pie chart divided into 12 slices, the diagram demonstrates the number of mortalities during each month, as well as their causes. Overwhelmingly, these involve disease rather than wounds.
“That was devised by Florence Nightingale,” says Peto. “Alongside her nursing, you could argue that she was also a pioneer of graphic design. Obviously, she’s best known for her care work, but I think her real contribution to medicine was in convincing influential people that there was a greater problem than soldiers getting limbs blown off – far greater numbers were dying of diseases that were passed from one to another.”
A soldier within a blood-flask. © Wellcome Library, London
Nightingale’s is not the only unlikely artistic contribution to the exhibition – among the Second World War exhibits are health and safety notices very recognisably drawn by Doctor Seuss. Other triumphs of design include a ‘malingerer’s handbook’ disguised as a matchbox and a chart which appeared in air raid shelters detailing the treatment of every conceivable type of injury.
Elsewhere, War and Medicine is unflinching in its willingness to show us the physical trauma caused by warfare. A group of schoolchildren stand open mouthed before a series of photos showing the cumulative effects of pioneering skin grafts on a soldier with a missing nose, and a beautifully painted but eerie tin face mask speaks volumes about the condition of its recipient.
In very broad terms, says Peto, each major conflict has influenced great strides in a particular branch of medicine. “For example, triage is attributed to a large extent to a Russian surgeon working during the Crimean War, and facial reconstruction became a priority during the First World War. It’s been argued that each area of conflict throws up particular medical needs, which will receive special attention as a result.
Tin face, 1918 Credit:Gillies Archives, Queen Mary’s Hospital, Sidcup UK
“I suppose at the centre of this exhibition is the uncomfortable idea that while war is a terrible thing, medicine clearly benefits from it in some ways. That’s because of the awful fact that war produces so many casualties who have to be dealt with urgently, so doctors and nurses have to learn fast how to deal with them and some important lessons are learned through that process.”
As a result, the health of troops is increasingly assured, though it could be argued that other victims are taking their place. “Survival statistics among soldiers are hugely improved, but civilian casualties of terrorist attacks and bombs apparently intended for soldiers seem to be growing,” Peto concurs.
He indicates another David Cotterrell piece, in which three separate films, each covering the same period, are played side by side, showing the evacuation by Chinook helicopter of a wounded Gurkha from a forward base in Afghanistan. The central film is of the inside of the helicopter, the left hand one shows doctors awaiting the soldier’s arrival at a remote hospital, and the right hand screen reveals the 'j-Chat’ messaging system which allows both teams of medics to share information on the injured man’s condition.
“One of the things David found very moving was the extraordinary level of attention which goes into getting soldiers from the point of injury to the field hospital, and the level of treatment they get there, ” says Peto.
“We do see a lot of images about the heroic returning soldier, but we tend to hear far less about what happens to civilian casualties. On the whole, they’re far less likely to have access to much in the way of treatment and care – at the height of the Iraq War, for example, civilian hospitals in Baghdad were desperately short of facilities.”
Ambulance. © David Cotterrell, 2008
While soldiers undoubtedly benefit from improved care, today’s survivors are often left with injuries that can’t be treated by surgery or cosmetics. The section of the exhibition dedicated to psychological trauma includes some of its most distressing material.
On one wall, a black and white film plays. Shot after the Second World War, in 1946, it includes scenes where demobbed soldiers explain their mental turmoil to a psychologist. Their stiff, over-rehearsed demeanour and the syrupy strings on the soundtrack have all the markings of Hollywood fiction, but the tears seem undeniably real.
Says Peto: “That's just the way documentaries were made, then. This was directed by John Huston, who made ‘The Maltese Falcon’ and ‘Under The Volcano’. The stories are all real, but the soldiers would have had to run through them over and over.”
Commissioned by the US army to demonstrate the level of care afforded to its troops, the film was seized by police when Huston arranged a screening and remained banned until 1981. “The army realised that in showing the care, the film also exposed the extent to which people had been damaged,” says Peto.
“What this also highlights is how far we’ve come in terms of taking psychological issues seriously - at the time, these men were referred to as ‘psycho neurotics’. It’s the same condition that led to men being executed for deserting their posts in the First World War.”
Percy Hennell portrait. Courtesy of the Anthony Wallace Archive of the British Association of Plastic Reconstructive and Aesthetic Surgery (BAPRAS)
The exhibition should leave visitors in little doubt that huge medical advances have been made during wartime and in its aftermath, and that citizens have ultimately reaped the benefits. But Peto accepts that those advances have come at a huge cost.
“We wanted to put on an exhibition which didn’t shy away from the awful realities, but at the same time we didn’t want people to run out screaming or spiral into terminal depression,” he says. Nevertheless, he admits that spending time in the exhibition on a daily basis has been “quite hard work.”
By including devices still at the prototype stage, War and Medicine also highlights thorny moral issues yet to be tackled in the public arena. “This is something soldiers will wear on their chests going into battle, which will allow a medic to monitor their vital signs remotely from a laptop,” says Peto, pointing at a small, white object.
“The driving force behind it is the fact that anyone who’s been injured in the field needs to be rescued, which means whole teams can be put at risk going after people who may already be dead. At the risk of sounding brutal, that could be interpreted as throwing good bodies after bad.”
It isn’t difficult to see the monitor’s non-military potential. “It could be a great way of keeping tabs on the health of old people living on their own, for example, irrespective of the reason it was developed,” Peto says.
“It’s important to give both sides of the story - we didn’t want to give some clear-cut impression that while war is terrible, it’s always good for medicine, because some very bad things have been done purely in the name of medicine, in the Nazi period particularly. Working on that, particularly, I found pretty depressing.”
'The Watch Man'. © Shona Illingworth, 2007
The exhibition organisers have, however, attempted to finish on a cautiously optimistic note. War and Medicine ends in a screening room where a number of films can be viewed, including an interview with a group of Second World War burns victims encouraged to form a support club by a forward-thinking surgeon.
By the exit, there’s also a series of pictures drawn by children in Afghanistan demonstrating their hope for a brighter future. Looking at these, I am, for the first time, able to tune out that awful, ever-present hum.
War and Medicine continues at the Wellcome Collection, 183 Euston RoadLondon until 15 February 2009.
‘The Watch Man’, a new video installation by artist Shona Illingworth, will be added to the exhibition on December 16.
For more details, go to www.wellcomecollection.org.
