Casualty Clearing Stations

My name is Geoffrey Keynes and I was a surgeon in a Casualty Clearing Station in France during the First World War. My clearing station was located behind enemy lines, away from the bombing and shooting, although sometimes we did find ourselves under attack.

It was always busy in the Casualty Clearing Station. There was a constant flow of men coming into our station. They arrived straight from the front line, after they had received care from the dressing stations and field ambulance staff. Many men had had a very uncomfortable journey to the Casualty Clearing Station, because they were usually brought to us via horse drawn carriage. They would be placed on their stretchers into the carriage, wrapped in only a blanket, and then would have to travel over awful roads. Most of the time they didn’t even have real roads to travel over, instead mud tracks or fields. They had to be brought to the Stations as quickly as possible, so comfort was no option.

I had tremendous admiration for the nurses and the other staff who helped with the general running of the clearing station (ALLEN). One of the men who helped out was a young man named Boyd. His duties were to change the beds, clean the men, change their dressings and sometimes deal with common abdominal wounds (BOYD). Without the staff, I don’t think I would have been able to cope!

The casualties were brought straight from the frontline, so I saw some truly awful cases. One of the major problems that we faced at the Casualty Clearing Station was the amount of men that were suffering from blood loss. The dressings used at the dressing stations were not strong enough for the major injuries, so when men arrived, their bandages were often soaked in blood and the men had become extremely weak. The first thing we had to do was get them into the operating theatre to give them a blood transfusion, a revolutionary technique which saved many lives. Once we had given them the transfusion, we could then go on to operate on their injuries, operations which ranged from repairing head and abdominal wounds to limb amputation. Hopefully we would manage to save their lives, although sometimes it did feel like we were operating on men who did not stand a chance.

Casualty Clearing Station

We had to operate in small, dark and overcrowded tents, and it was a one-man-in, one-man-out process. We were absolutely stretched to the limit. We didn’t have enough staff, and we were constantly busy, so it was slogging work. I remember operating one time for 21 hours continuously, then having 3 hours sleep, and then operating for another 21 hours. I had adapt to having very little sleep but still had to remain focused so that I could concentrate on the operations I was performing.

I did a large amount of amputations during my time in the Casualty Clearing Station. When a patient came in, I had to use my judgement immediately, and decide if I was going to amputate there and then. There was usually no time for thought-out decisions, it was a matter of life or death. Amputating limbs was a serious operation, and many of the younger surgeons at the station did not want to do it, but as I said, I had little choice, a soldier’s life was in my hands.

I remember performing Robert’s amputation. He had been brought to the station by a horse and carriage, and I was informed that his leg was in a really bad way. The dressing station had done their best to bandage up and hold in place what they thought was a broken leg. However, when he reached me and I examined his leg, it was clear his lower leg was beyond repair.. The bones below his knee were completely shattered and it appeared that the journey to the station in the carriage had made the situation a lot worse. The only option I had was to amputate the poor soul’s leg, so I did what I had to do. After the operation he was given a bed within the station and looked after by our nurses and men such as Boyd.

Once the men were in a stable condition, they would either be sent to a convalescent camp to continue their recovery, or else would be sent on to a Base Hospital to receive further treatment. Robert was sent to a Base Hospital. Click on the next page to learn about his time in hospital.

(GEOFFREY KEYNES)