The birth of modern plastic surgery and the face equality campaign

The centenary of the cataclysmic Great War is happening all around us but is liable to be drowned out by last week’s European events. Let me call for a moment of reflection.

We say on Armistice Day every November ‘we will remember them’ and we should this week. Lest we forget. On Friday 1st July, I will remember the sacrifices of the men and women of the Great War, 1914-18, who gave their lives or were injured in that dreadful event.

One hundred years ago on 1st July, the Battle of the Somme began. There were 60,000 casualties that first day – yes, 60,000 – and by the time the Battle was called off in November, the allies had gained six miles of territory with 420,000 British casualties, 200,000 French and 500,000 Germans. One eye witness account captures the horror on this site.

The reason why this matters to me is that 1st July 1916 is held by those in the dressing stations and hospitals behind the lines on both sides as being the birth day of modern facial and plastic surgery. Never before had so many men been seen with severe facial injuries – and thanks to methods that had evolved in the previous two years of war, never had so many men survived. Governments on both sides were forced to bring together the most ingenious surgeons of the day to tackle the challenge.

On the allied side in the early days of the War, the British New Zealander ENT surgeon, Harold Gillies, worked with Charles Auguste Valadier, a French-American dentist and the French surgeon, Hippolyte Morrestin, to invent new techniques for closing facial wounds and treating the loss of skin and tissue. But as soon as the Somme’s casualty toll became obvious, Gillies was given a whole hospital – Queen Mary’s in Sidcup – to find ways to help the thousands of facially-injured soldiers arriving back in Britain.

Queen Mary's Hospital Sidcup, with Harold Gillies on the right

Queen Mary’s Hospital Sidcup, with Harold Gillies on the right

He assembled an exemplary multi-disciplinary and international team – perhaps better, ‘force’ – and every one of us who have received facial surgery since then owe Gillies and that team a huge vote of gratitude. Gillies’ seminal textbook, Plastic Surgery of the Face, published in 1920 remains a masterpiece.

And it gets even more personal for me because in the Second World War, Gillies again was at the forefront of treating the many casualties and this time created a ‘force’ at Rooksdown House in Basingstoke. My surgeon, Jim Evans, was trained by Gillies there – and when the war ended, the whole team moved, with their archives, to Queen Mary’s Hospital, Roehampton, where I was treated in 1970-75. My last operation in 1974 was a Gillies pedicle, the longest ever attempted according to Jim Evans, from my back to my chin. I wear it with pride.

And it was in the basement of that hospital, next to the medical photographer’s studio which I recall very well, that the archives were found in 1993 and thanks to the brilliant work of Andrew Bamji, have been created into a beautiful archive.

I will also celebrate the work of Henry Tonks, the war artist in Gillies’ work. I count myself privileged to have seen the originals in the vaults of the Royal College of Surgeons in England in connection with a film about Simon Weston’s portrait going on display at the National Portrait Gallery.

But perhaps most of all, my sombre reflection will be about the lives of the men who, after the horrors of the Somme, then went through the pain and agony of those early surgical experiments and then had the strength to try to get back into civvy street. They are the real pioneers, the first generation working for face equality in all walks of life, for respect and fair treatment.

Lest we forget. RIP.

PS: For interest: many books have tried to capture this human experience like Marc Dugain’s The Officer’s Ward (also a fine film), Pat Barker’s Life Class trilogy, The Crimson Portrait by Jody Shields and Louisa Young’s My Dear, I Wanted To Tell You.

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