“She is Lost to Time and Place”: Women, War Trauma, and the First World War

A dissertation presented

by

Bridget E. Keown

to The Department of History

In partial fulfillment of the requirements for the degree of Doctor of Philosophy

In the field of

History

Northeastern University Boston, Massachusetts April 2019

1 “She is Lost to Time and Place”: Women, War Trauma, and the First World War

A dissertation presented

by

Bridget E. Keown

Abstract of Dissertation

Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in History in the College of Social Sciences and Humanities of Northeastern University April 2019

2

Abstract

This work investigates the gendered construction of war trauma during the First World

War, and seeks to reclaim the experiences of those whose suffering was not included in established diagnoses and definitions. Specifically, I analyze British and Irish women’s testimonies and expressions of trauma as a result of their experiences during the First World

War, and the manner in which their suffering was interpreted and treated by medical and military professionals. I conclude by discussing how women’s individual emotional suffering has been marginalized and forgotten in the history of the First World War.

In my Introduction, I discuss the lack of data into women’s lived experiences and emotions during the First World War and up to the present day. This lack of awareness continues to harm women physically and psychologically. My first chapter looks at the origins of the modern study of trauma during the outbreak of the First World War. I argue doctors and military officials were forced to redefine trauma due to the enormous number of soldiers exhibiting symptoms as a result of their combat experiences. However, because these definitions were constructed to reflect the experiences of men, they implicitly excluded the experiences, suffering, and symptoms of women. Instead, military and medical officials often fell back on older conceptions of women’s emotionality and mental instability, rather than to their lived experiences. This prevented women from accessing care and treatment for their symptoms, and also resulted in their experiences being excluded from the historiography of war trauma up until the present.

Chapter Two turns to women’s lives on the home front. I examine case notes of female patients treated in London asylums and public hospitals who related their trauma to the war, such as air raids and grief over the death of male relatives in war. These case notes reveal the fault

3 lines between the gendered expectations of women in wartime and the realities of their lived experiences. In Chapter Three, I review the case notes from the Richmond Asylum in Dublin, where women who experienced trauma during the Easter Rising of 1916 were treated. This research not only emphasizes that Dublin was both a home front and a war zone during this period, but reconceptualizes the Easter Rising as a period of traumatic wartime violence that had physical and psychological repercussions for all those forced to endure it. In addition to discussing the testimony of women on the English and Irish home front, I also use these chapters to focus on doctors’ resistance to recognizing women as psychological victims of war, and the consequences this had for women’s care in asylums and hospitals.

In Chapter Four, I study the private papers of professional and volunteer nurses to understand how they incorporated experiences of trauma into a subjective narrative, as well as the sources of emotional resilience they identified during their service. This analysis offers the potential to scrutinize women’s emotional subjectivity, as well as their linguistic depictions of their unique war experiences, overcoming the authority and tension of doctors’ interpretations found in case notes. In Chapter Five, I study at nurses’ pension files to see how these narratives of trauma were read and interpreted by medical and military officials in the postwar period.

Because women were not allowed to apply for disability pensions until after the war had ended, they were forced to navigate a stubborn bureaucratic maze that was not designed to recognize their service or their suffering. Though some women were successful in demonstrating and describing their trauma for medical boards, many more were rejected, severely affecting their ability to return to civilian life. This chapter concludes with consideration of the potential for care and healing available to female veterans from private institutions and charities. I look specifically at the Nations’ Fund for Nurses, which funded the Cowdray Club, an all-women

4 nurses’ and veterans’ organization that provided personal care, professional assistance, and pensions to women veterans. The Epilogue considers how the study of trauma has influenced the narrative history of the First World War in the west, and continues to influence the understanding and treatment of people in war to this day.

My research is theoretically informed by feminist critiques of psychology, the history of emotions, and feminist memory studies. It is driven by my determination to illuminate historically gendered assumptions of trauma and to reclaim women’s subjective emotional narratives. By focusing on women’s descriptions of their own pain, fears, and traumatic memories, I intervene in a robust historiography to insist on women’s individual emotional experiences and reactions to their personal war experiences. I also contribute to a feminist history of the First World War by identifying the sources of resiliency, especially the friendships with other women, that sustained women during and after the war. In addition, my work specifically addresses the struggles of female veterans for pensions and social recognition in a way that has not yet been attempted. In my work, their testimony and trauma moves from a position of subjugated memory to the forefront, enriching and complicating the historic narratives of the First World War as a whole. This work has far-reaching implications, calling into question the gendered diagnostic criteria for war trauma today, and the stigmatization of women’s emotions that continue to affect the ways in which their testimony of emotional suffering and trauma is heard in our present moment.

5 Acknowledgements

The process of writing a dissertation, especially in the humanities, can often feel downright Sisyphean and lonely. But there are people who help to clear the path, to ease the burdens, and who make the journey easier, and it is an honor to mention them here, and to celebrate all they did to bring this process to a successful conclusion.

First and foremost, my thanks to my parents. My mother believed in this work even before I knew the shape it would take, and that belief sustained me when my own began to waver. My father proof-read every word of this dissertation, more than once, in every one of its forms and permutations, and his patience, diligence, humor will never be forgotten. Moreover, whenever I doubted this work or its message, he was there to remind me why it was important.

This work is his, in its own way, too.

To John Donovan, my grandfather, who showed me the power of listening to others, and to my grandmother, Mary Josephine Petra, who showed me that ladies don’t take guff from anyone. Thank you both for helping to make me who I am. To George and Charlie Donovan, of the American Expeditionary Force, and John Magee, of the Royal Inniskilling Fusiliers, thank you for the inspiration. I hope I made you proud.

To my extended family on Wahtera Road, especially Albeta Gately and her incredible family. Thank you for believing in me. Thank you for loving me. Thank you for letting me be me. And to Eileen, I know you’re here, because you promised you would be.

My thanks also to the many mentors and colleagues who showed me the way during this labyrinthine journey. My committee members at Northeastern, Heather Streets-Salter and Laura

Frader provided honesty, insight and their time during many difficult semesters. Peter Leese, at

6 the University of Copenhagen, was the first person to give this work a vote of confidence during an unforgettable (for several reasons) conference in Helsinki, and continued to offer advice, clarification, and opportunities for presenting my research to scholars around the globe. In addition, Jason Crouthamel, Susan Grayzel, and Jason Knirk all offered commentary and advice on this work that improved it enormously. My research and conference travel was funded through the generous support of the Larkin Graduate Fellowship in Irish Studies from the

American Conference of Irish Studies, the Zanghi-Dow Grant, and funding from the

Northeastern History Department. I sincerely hope that this work justifies your generosity and faith in me. Looking further back, to those teachers at the Pingree School who fed my initial curiosity in the First World War, and taught me to fight for my own dreams: to Ms. P, Ms.

Dolan, and Zach Lyman, I am honored to be part of your legacy.

And to those who didn’t buy my research, thank you, too. Your resentment told me I was on the right path. Your dismissal was all the impetus I needed to keep working.

To the many archivists and librarians whose dedication and enthusiasm made the research for this project possible, especially Anthony Richards, Sabrina Offord, and Simon Offord, who welcomed me to the Imperial War Museum, and whom I am honored to call friends. Also, my thanks to Roderick Suddaby, Keeper of the Department of Documents when I worked at the

Imperial War Museum, and a true gentleman. Thank you for letting me sit at your desk, and thank you for believing in me. Every day was an honor. Additionally, I would like to thank

Charlie Turpie and the staff at the London Metropolitan Archives, Sean Tone, who provided permission to consult the records of the Richmond Lunatic Asylum at the National Archives of

Ireland, and the staff who helped me access them, the staff at the Queen Square Library and

7 Archives, the London School of Economics Women’s Library, the National Archives at Kew, the

Public Records Office of Northern Ireland, the Royal London Hospital Archives. and the

Wellcome Trust.

Nothing about this process would have been worthwhile, or indeed even possible without the friends and fellow graduate students at Northeastern University who created a haven in the midst of hell. I must mention especially my two officemates, Liz Lehr and Debra Lavelle (in whose incredible powers of awesomeness I shall always believe wholeheartedly), and my other- side-of-the-wall mates, Matt Bowser and Jamie Parker, who balance their remarkable scholarship with humor, compassion, and tolerance for the hijinks that happen at our end of the hallway. To the #crumburglars: you defy every negative stereotype of graduate school and foster a supportive, thriving, and resourceful community that has saved me in more ways than I can count. Thank you for listening, for believing in me, and for believing in each other. Never forget how important this is.

To Katharina Neissl, who defines what it means to be a friend, a mentor, and a feminist, I thank you, and I cannot wait for our lighthouse retreat.

To the friends who have been on this path with me from the beginning, including Capi

Anderson and Laura Carroll. I lift a teacup in your honor. To Nancy, Jaimee, Aladdine, and

Michael Joroff, the family of my heart, for the love, inspiration, books, tea, and shelter over many, many years.

And to my students—you were a shining light when this process was at its darkest. The students in HIST 2376 showed me the power of studying the quirky, the funny, and the garish in history, and helped produce a Menu of the British Empire that continues to astound me with its

8 insights and complexities to this day. The first group of students to comprise HIST 2373 taught me how to be a teacher with grace and honesty. The second group that made up HIST 2373 taught me how to be a historian. In an assignment where they were given anonymized case notes to analyze, they responded “We didn’t like her not having a name, so we called her Alice.” That moment of humanity is one I will never forget, and I hope to live up to it in any future endeavor.

To those students who continued to work with me after our time in the classroom was done, particularly Sawyer Hammond and Kim Noe, I am the wiser and the smarter for your influence on me. And to Amanda Stayton and Anabella DeLoach, who are both students and friends, the world is so much richer for your dedication and energy.

I don’t think this dissertation would have been completed without the opportunity to write blog posts for the American Historical Society, Lady Science, and, especially, Nursing

Clio. I have been truly fortunate to work with such insightful, careful, and kind scholars, and my writing and argument have benefitted enormously from all of our interactions. Thank you for trusting me and believing in my work, even as I was in the process of figuring out precisely what

I was talking about.

I would also like to thank the numerous conferences at which I shared this work, and the attendees who offered insight, commentary, and support. I would especially like to mention the wonderful people at the American Conference for Irish Studies, Comhfios at Boston College, the

Mid-West Conference for British Studies, the Western Conference of British Studies, the

Memory Studies Association, and the participants of both the “Fragmentary Lives” Conference at the National Archives in London and “Militaries and Memorialization: The Turn to

Resilience” conference at the Danish Institute for International Studies in December 2018. Your

9 comments and insight made this work far better than I could have alone, and I am grateful for your collegiality and support.

To the scholars whose work is cited in the following pages, I thank you for forging a path for me to follow.

To Doctor Christine Blasey Ford, and Dr. Anita Hill, thank you for speaking up for so many of us.

Thanks is also due to my co-workers at the Peabody Institute Library in Peabody

Massachusetts, especially Cary Cyr, who is missed every single day. Also, thanks to our remarkable patrons who brought me sporks in support of my work, chatted at length about The

Odyssey and Chekov’s plays and the qualities of a good feminist mystery. And to the libraries of

Massachusetts, you made this dissertation possible, especially once my own educational institution decided to rely too heavily on interlibrary loans. You, glorious public libraries of

Massachusetts, forgave my late fines, worked to find texts that remained elusive, and maintained a sense of humor about the entire process, which is a gift that cannot be counted.

To the therapists who provided support, counselling, and sanctuary during my graduate school career, Deenie and Amy. I am a testament to your dedication and compassion.

To the Beverly Athletic Center, you provided me a place to get my reading done, a space to work out my anxiety, and the women in the locker room provided laughter and a few inspiring body-positive discussions that I try to remember every day.

10 To Steve and to Punters, which closed in December 2018. You were a haven for the graduate students of Northeastern, and the place where I met some of the most important friends in my life. I hope retirement is good to you.

To Frieda and Franziska, the two laptops on whom this work was composed. You trundled to archives and libraries with me, you balanced on buses and survived the indignities of airline travel. You were both more patient with me than I deserved.

To Otto, who got me where I needed to be and kept me safe—I’m sorry I spilled espresso in you. Thank you for storing all the books that wouldn’t fit in my office.

To Polar Seltzer, thanks for keeping me hydrated.

To the makers of Mystery Science Theater 3000 and RiffTrax, thanks for making me laugh even when I thought I forgot how to.

To the Food Network and Cooking Channel, who provided my cat and I hours of soothing entertainment and delicious recipes during the process of writing this dissertation.

To OW, FM, and KCM, who found me.

To Watson, Oscar, Lucy, and Blackie, who have been watching over me. And to Retired

Captain, now Dr. Fintan Francis MacBochra, who was by my side, and purring, through every word of this work. I’m so glad we found each other.

This dissertation is dedicated to Amelia Gagnon and to Charlotte Hayden, who was born on the day I completed this work. I hope this makes you proud of your godmother. I hope your lives are filled with the joy you bring to me.

I love you, always. Your Godmother, ~Bridget~

11

TABLE OF CONTENTS

Abstract 2

Acknowledgments 6

Table of Contents 12

Chapters Introduction: “Indelible in the hippocampus, it was the laughter” 13

Chapter One: “Very depressed…since the air raids”: Trauma, Gender, and the Memory of the First World War” 24

Chapter Two: “She talks to the Kaiser and has promised him not to strike back”: Trauma on the British Home Front 48

Chapter Three: “She was in the midst of the Trouble area during rebellion of ’16”: Trauma on the Irish Home Front During the Easter Rising 77

Chapter Four: “Really such awful things one sees and hears are included to rack one’s nerves”: Nurses’ Descriptions of Trauma and Resiliency 105

Chapter Five: “An act of justice and gratitude for their services”: Care For Disabled and Traumatized Nurses in the Postwar 150

Epilogue: The Underbelly of Memory 195

Bibliography 208

12

Introduction: “Indelible in the hippocampus, it was the laughter”

“Ah! The strength of women comes from the fact that psychology cannot explain us…Science can never grapple with the irrational. That is why it has no future before it, in this world.”1 (Oscar Wilde, An Ideal Husband, 1893)

On September 27, 2018, Christine Blasey Ford appeared before the United States Senate to offer testimony regarding her allegations of sexual assault against Brett Kavanaugh, then a nominee to the Supreme Court. I watched on television, along with millions of other Americans, along with an uncounted number of abuse survivors, as she closed her eyes, collected her thoughts, and proceeded to give voice to the lived experience of her own personal trauma over the course of some six hours of testimony and cross-examination. The event was a harrowing one, for Dr. Ford as well as for the many survivors who watched, who avoided, and who were force-fed discussions of the case across multiple social media platforms, news outlets, and passing conversations.

Even though, as a white woman, “Ford had access to wells of public sympathy that

[Anita] Hill did not,” she still encountered the doubt and suspicion that typically greets women offering testimony against men in western society.2 Public and private spectators cast doubt both on Dr. Ford’s memory and on the motives that brought her and her supporters to make her allegations public. When asked to describe the “strongest memory” she had of her assault, Dr.

Ford replied, “Indelible in the hippocampus, it was the laughter. The uproarious laughter between the two…I was underneath one of them while the two of them laughed. Two friends

1 Oscar Wilde, An Ideal Husband: A Play, https://www.gutenberg.org/files/885/885-h/885-h.htm, accessed March 29, 2019 2 Moira Donegan, “What Christine Blasey Ford reveals about womanhood,” The Guardian, September 27, 2018, https://www.theguardian.com/commentisfree/2018/sep/27/what-christine-blasey-ford-reveals-about-womanhood, accessed March 26, 2019. See Leigh Gilmore, Tainted Witness: Why We Doubt What Women Say About Their Lives (New York: Columbia University Press, 2017).

13 having a really good time with one another."3 Although few questioned Brett Kavanaugh’s memory of the night apart from the role alcohol played in the event, Dr. Ford’s memory was challenged and disputed by the Senate, as well as by national and social media. She was judged on whether she was a credible witness to her own trauma. One editorial, which insisted that “an innocent man should not be denied all he’s worked for based on allegations from someone who can’t remember key details,” also queried whether Senator Diane Feinstein had “plotted to cause this chaos,” by withholding her knowledge of Dr. Ford’s allegations until the proverbial eve of

Kavanaugh’s confirmation.4 Following Dr. Ford’s testimony, Kavanaugh launched into an angry defense, portraying himself, and in turn being portrayed by his Republican supporters, as the true victim in the case.

I did not watch that testimony live. I cared too much to watch objectively, and I had known too many men like Brett Kavanaugh to feel the need to expose myself willingly to his aggressiveness or his anger. Instead, I walked from my office at Northeastern University to the

Boston Public Library in Copley Square, a haven that has sheltered me (and countless others) through the darkest of days. As I made my way from Huntington Avenue to Boylston Street, I became aware of how many other women were dressed in black, as I myself was. Earlier that week, Tarana Burke, who had originated the phrase “Me Too” to help victims of sexual violence, had posted a tweet calling for a national walkout “in solidarity w/survivors of sexual violence.”5

3 Bianca Seidman and Dr. Jonathan Steinman, “Kavanaugh accuser Christine Blasey Ford describes memory science, hippocampus in emotional Senate testimony,” ABC News, September 27, 2018, https://abcnews.go.com/US/kavanaugh-accuser-christine-blasey-ford-describes-memory- science/story?id=58122643, accessed March 26, 2019. 4 Penny Nance, “Kavanaugh, too? Christine Blasey Ford’s account is missing key details of assault,” USA Today, September 19, 2018, https://www.usatoday.com/story/opinion/2018/09/19/brett-kavanaugh-hearing-dr-christine- blasey-ford-sexual-assault-column/1346536002/, accessed March 26, 2019. 5 @TaranaBurke, “We believe Dr. Blasey Ford. We believe survivors. Join us for a national walkout in solidarity w/ survivors of sexual violence on Mon., Sept. 24 @ 1PM EST by wearing black and posting a message to say #BelieveSurvivors #MeToomvmt https://www.facebook.com/events/2132578240149628/ …” Twitter, September 24, 2018. 8:35am, https://bit.ly/2FmpTpG

14 Within hours, Planned Parenthood, the National Association for the Repeal of Abortion Laws

(NARAL), the National Center for Transgender Equality, the Human Rights Campaign, and nineteen other organizations, along with companies across the country, had all announced their support and participation in the day of action.6 However, the silent solidarity with Dr. Ford, and with victims of sexual violence everywhere, continued past the date of the walkout, as evidenced by the number of women from a diverse range of ages, races, visible class, and personal style who turned out that Thursday dressed in black.7

While the wardrobes were striking to those who knew the statement they made, what struck me even more profoundly was the silent communication that took place on the streets that day. Bostonians are not known for making eye contact, much less with initiating conversations with strangers, as a rule. But as women in black passed each other, they met each other’s gaze; they nodded; they offered a grim smile of recognition. Outside the library, I saw one woman offer another a tissue when she noticed her red-rimmed eyes. As I watched these small exchanges, I recognized a conversation was unfolding beneath the current of everyday events between the women that was going almost entirely unrecognized, or, at the very least, unremarked by the men around them. It was a conversation that recognized the survival of trauma, and that acknowledged the difficulties of life following the experience of trauma. It was also a conversation between people whose trauma had been overlooked, ignored, mocked, or explained away repeatedly. There was solidarity in their silent acknowledgements, and support to be found in those quiet nods. As one contributor to The Guardian noted after Dr. Ford’s testimony:

6 Opheli Garcia Lawler, “Everything to Know About the #BelieveSurvivors Walkout in Solidarity with Christine Blasey Ford,” The Cut, September 23, 2018, https://www.thecut.com/2018/09/kavanaugh-sexual-assault-walkout- monday.html, accessed March 18, 2019 7 Needless to say, there were a number of people who did not identify as women who were wearing black in solidary, as well.

15 We grouped together in our black clothes and mourned the people we might have been if we hadn’t been carrying around so much trauma…We had all been there. We felt her fear and we felt our own…When she had finished it was as though we had been through one long massive therapy session. Things were definitely different, but not necessarily better.8

As this woman’s comment shows, Christine Blasey Ford’s testimony gave voice to the experiences of a large number of women globally.

The issue of sexual violence and trauma is one for another dissertation. However, what this moment in time also highlighted for me, watching and participating in the act of wearing black, was that women were experiencing the world, and the traumas it caused, in a way that was different from the experiences of many men. Furthermore, I realized to what extent women’s traumatic experience within patriarchal systems of power, privilege, and propaganda often go unrecognized and misinterpreted. Women’s intersectional positions to power, including their race, class, religion, sexual and gender expression, and age, affect their experiences and the manner in which their stories are heard and treated. This dissertation looks at women’s trauma and military, medical, and social reactions to trauma, within the context of the First World War.

In this work, I argue that the widescale suffering of soldiers during the First World War forced doctors and military officials to redefine trauma in a manner that favored the symptoms and experiences of combatant men. This practice contributed to a gendered narrative of service and suffering that continues to obscure the lived experience of women in wartime.

As Caroline Criado Perez observes, “Seeing men as the human default is fundamental to the structure of human society.”9 From language and literature to music and medicine, male experiences, male bodies, and male consciousness are used to express a default human

8 Guardian Readers, “‘You are not alone’; your reaction to Christine Blasey Ford’s testimony,” The Guardian, October 5, 2018, https://www.theguardian.com/us-news/2018/oct/05/kavanaugh-christine-blasey-ford-hearing- testimony-reactions, accessed March 18, 2019 9 Caroline Criado Perez, Invisible Women: Data Bias in a World Designed for Men (New York: Abrams Press, 2019), 1

16 experience, body, and consciousness. When women’s experiences, health, and history are discussed, they are considered niche, circumscribed, and somehow outside the traditional boundaries of the typical. It is why bookstores carry “women’s fiction” and “fiction.” It is why there are “chick flicks” and “movies.” It is why, as Perez points out, “in 2013 Wikipedia divided writers into ‘American Novelists’ and ‘American Women Novelists.’”10 Because the categories designated as by, for, or belonging to women are placed outside the norm, they are seen as weaker, sillier, and less important than those things belonging to men. Moreover, the process of isolating women and excluding them from data becomes a kind of self-reinforcing process. As

Perez notes, “worth is a matter of opinion, and opinion is informed by culture. And if that culture is as male-biased as ours is, it can’t help but be biased against women. By default.”11 It also explains the hostility toward any attempts to promote equity through the inclusion of women, or attempts to change the structures of power that limit their visibility and inclusion.

When women force themselves into the narratives, whether it is over debates about representation in video games, the inclusion of women’s faces on currency, or, indeed, when a women’s discussion of a traumatic attack threatens the advancement of a man’s career, they are often met with anger, threats of violence, and described as over-emotional, mentally incapable, or the ever-popular, “hysterical.”12

10 Perez, 13 11 Perez, 17 12 For more on videogame culture, gender, and #Gamergate, see Simon Parkin, “Zoe Quinn’s Depression,” The New Yorker, September 9, 2014, https://www.newyorker.com/tech/annals-of-technology/zoe-quinns-depression-quest, accessed March 27, 2019; for information over the debate on women on currency, see Alize Philipson, “Woman who campaigned for Jane Austen bank note receives Twitter death threats,” Telegraph, July 29, 2013, https://www.telegraph.co.uk/technology/10207231/Woman-who-campaigned-for-Jane-Austen-bank-note-receives- Twitter-death-threats.html, accessed March 27, 2019; for further updates on the abuse endured by Dr. Christine Blasey Ford, see Tim Mark, “Kavanaugh Accuser Christine Blasey Ford Continues Receiving Threats, Lawyers Say,” NPR, November 8, 2018, https://www.npr.org/2018/11/08/665407589/kavanaugh-accuser-christine-blasey- ford-continues-receiving-threats-lawyers-say, accessed March 27, 2019.

17 For historians, the results of this data gap and cultural bias against women have numerous implications. First, it means that women often remain in circumscribed roles, categorized by their relationships to men. Their worth is generally posited on their value to the male protagonists of the story, without considering in real depth the emotional, psychological, and physical effects of such a role played on women’s individual experience or sense of self. In such frameworks, women are no longer categorized as fully human, but as something lesser. For example, in her history of women’s work in military entertainment in the twentieth century,

Karen Dixon Vuic quotes from a YMCA publication, which advocated that women employed for soldiers’ entertainment near the front needed to “shed the personal tributes [of soldiers] without appropriating them, as unconsciously as a duck sheds rain.”13 While zoomorphism is a common literary tactic, the dehumanization of such comparisons, of reimagining women as ducks, has wider implications for the ways in which specific people are viewed within the context of an historical narrative.14 Indeed, a good deal of the history of women in the First World War remains focused not on women’s individual experiences of war, but rather on the “evolution of wartime gender ideologies and connects women’s work…to their changing place in the nation.”15 In such framework, women’s individual agency is subordinated, and their willingness to embody specific roles is taken for granted. Rarely is women’s agency to resist identities, to fail to live up to the ideals of an identity, or their self-consciousness within that identity discussed. These histories, while shedding critical light on the role of women in history, does

13 Kara Dixon Vuic, The Girls Next Door: Bringing the Home Front to the Front Lines (Cambrdge: Harvard University Press, 2019), 23. 14 Such zoological comparisons are common—and extremely effective—tools for diminishing the humanity of individuals and groups. As Paul G. Bain notes, scholars have been increasingly concerned with “how viewing others as nonhuman allowed us to morally “disengage” from them—justifying treating them as animals as undermining the legitimacy of their views and needs.” (Paul G. Bain, Jeroen Vaes, and Jacques-Philippe Leyens, “Advances in Understanding Humanness and Dehumanization,” Humanness and Dehumanization, edited by Paul G. Bain, Jeroen Vaes, and Jacques-Philippe Leyens (New York: Psychology Press, 2014), 2). 15 Vuic, 3.

18 little to challenge or subvert the power structures inherent in society. They also fail to move women’s historical experiences to the forefront. Award-winning playwright Vicky Featherstone recalled advice she was given early in her career: “We’re really used to living in a society where the main narrative—politicians, kings, judges—the main narratives on-stage and in our lives are male-led. And, actually, we don’t know whether we’re very good yet at watching a female narrative, especially a flawed character.”16 Histories that do not seek to access women’s lived and emotional experiences cannot help society learn the multi-layered, non-linear, fascinatingly complex experiences that might shape a “feminine narrative” of history.

The second implication of this data and knowledge gap is the challenge of empathy.

Women are never truly free from the historical context of their own bodies and minds.17 As

Moya Bailey has shown, beauty, wellness, and health all work together to create a concept of wellness that cannot be separated from classed, raced, and gendered hierarchies of power and knowledge.18 Thus, even while language and theories surrounding health evolve, leading us to

“believe that we know better now, that today’s rational minds...have access to better scientific evidence than ever before,” the reality is that medicine continues to support the idea that

“females were deficient or inferior versions of males,” physically, mentally, and especially psychologically.19 During the period including the First World War, psychologists explored the concept of empathy as a tool of diagnosis. As elucidated by E.E. Southard, who also published

16 David Hutchinson, “Vicky Featherstone: ‘Critics are harder on women’,” The Stage, September 29, 2015, https://www.thestage.co.uk/news/2015/vicky-featherstone-critics-are-harder-on-women/, accessed March 27, 2019. 17 Amanda Stayton and Bridget Keown, “Golden Girls, Chronic Fatigue Syndrome, and the Legacies of Hysteria,” Nursing Clio, September 25, 2018, https://nursingclio.org/2018/09/25/golden-girls-chronic-fatigue-syndrome-and-the-legacies-of- hysteria/, accessed March 29, 2019. 18 Moya Bailey, “The Flexner Report: Standardizing Medical Students Through Region-, Gender-, and Race-Based Hierarchies.” American Journal of Law & Medicine, 43(2017), 209 (209-223). 19 Amy Koerber, From Hysteria to Hormones: A Rhetorical History (Philadelphia: The Pennsylvania State University Press, 2018), 101-2, 106

19 widely on the study of shell-shock, doctors needed to strive to see themselves in their patients, and thereby to understand their patients’ feelings and decisions.20 Empathy was also the emotion, psychologists believed, that made social bonding possible, both on the individual level, and within large groups, such as military units.21 Rather than cutting through the structures of knowledge to create a bond of understanding between doctor and patient, however, Susan

Lanzoni explains that “Southard’s empathetic index…drew uncritically from common social, gendered, and ethnic biases.”22

While Southard’s methods were contested even during his time, Stephanie Shields’ research has shown that social biases surrounding gender, as well as class, ethnicity, and culture, all influence the ways in which “explicit and implicit indicators of status, especially gender, class, age, and race” affect patients’ treatment and diagnoses.23 As she points out, women were and are linked with “the ever-present identification of female/feminine with the ‘merely emotional.’”24 In Britain and Ireland, as we will see, women were not allowed to access the same language of suffering that men were because of their gender, the stereotypes and assumptions made about their positionality to war and the wider world, as well as their inherent emotional instability. As a result of this “lack of a publicly sanctioned language to describe aspects of women’s suffering which did not fit the conventional feminine mould …these forms of traumatic experience have not become an established part of the ‘cultural circuit’ of historical and public discourse.”25

20 Susan Lanzoni, Empathy: A History (New Haven: Yale University Press 2018), 106 21 Lanzoni, 123 22 Lanzoni, 106. 23 Stephanie A. Shields, Speaking From the Heart: Gender and the social Meaning of Emotions (Cambridge: Cambridge University Press 2002), 146 24 Shields, 174 25 Tracey Loughran, “A Crisis of Masculinity Re-Writing the History of Shell-shock and Gender in First World War Britain,” History Compass, 11/9 (2013), 733: 727-738.

20 This issue is, and was, not limited to a particular nation, however. While this dissertation focuses on the experience of British and Irish women, women were omitted from the literature and study of war trauma by doctors and media across the combatant nations. Gregory M.

Thomas shows how French medical professionals attributed many civilians’ mental distress to hereditary issues, or the over-emotionality typically expected of women who had “a husband, son, brother, or relative in the armies.”26 Likewise, Laura L. Phillips has discussed how Russian soldiers and their physicians would often use feminine phrases and comparisons to “peasant women” to describe soldier-patients who exhibited seemingly irrational or incurable symptoms, explaining that though “patients and doctors both preserved the masculinity of soldiers who experienced fear, depression and melancholy in response to the terror and horrific demands of war, inexplicable weeping was a sign that reason itself had left the body.”27 To this day in the

United States military, female veterans are repeatedly shown to be at a disadvantage with regard to getting adequate care for their war trauma and diagnosed post-traumatic stress disorder.28 A

2002 study concluded that while men and women veterans displayed similar PTSD symptoms,

“men were 2.5 times more likely to be clinically diagnosed with PTSD than women” as a result of “gender bias and error pertaining to definitions of combat-related PTSD in female veterans.”29

Assumptions about the nature of women’s minds that is discussed historically in this dissertation continue to do harm to women today.

26 Gregory M. Thomas, Treating the Trauma of the Great War: Soldiers, Civilians, and Psychiatry in France, 1914- 1940 (Baton Rouge: Louisiana State University Press, 2009), 90. It is unfortunate that Thomas does not more explicitly connect the term “civilian” with “women,” however the quotations he employs show that doctors were largely discussing women in their writings on wartime melancholia and sadness. 27 Laura L. Phillips, “Gendered Dis/ability: Perspectives from the Treatment of Psychiatric Casualties in Russia’s Early Twentieth Century Wars,” Social History of Medicine, Vol. 20, No. 2, 2007, 344 (333-350). 28 Josephine Chaimba MSW and Brian W. Bride MSW PhD, “Trauma Experiences and Posttraumatic Stress Disorder Among Women in the United States Military,” Social Work in Mental Health, Vol. 8, No. 3 (2010), 296 (280-303). 29 Quoted in Chaumba and Bride, 296

21 While medical beliefs on empathy have changed, such practices continue to influence the ways in which patients’ expressions of pain are understood. Even as physicians and psychologists develop more advanced and potentially objective methods for measuring patients’ pain and expressions of suffering, the fact remains that the reception of patients’ pain is as subjective as the patients’ own accounts of pain.30 In creating diagnoses, medical records, medical texts, and controlling the dissemination of information, medical professionals contribute to the construction of history, and the manner in which patients are “seen” in the historical record. The gendered construction of “shell shock,” which will be discussed in the next chapter, is just one example of how women were isolated from medical study and care as a result of social and cultural biases. While my work looks at women’s expressions of mental trauma as a result of their experiences in the First World War, it is critically important to recognize that the biases to which they were subjected, and the biases implicit in diagnoses developed around the experiences and symptoms of white men, continue to effect victims of trauma to this day.

Additionally, it is critically important to analyze how and why their testimony of pain and trauma goes unnoticed.

Leigh Gilmore explains that women’s testimony “is frequently associated with unreliability because it is women’s testimony. Doubting women is enshrined in the law, represented in literature, repeated in culture, embedded in institutions, and associated with benefits like rationality and objectivity.”31 Yet, as Dr. Ford’s testimony demonstrated, and as I hope this dissertation shows, women’s testimonies of trauma have power. Their testimonies of emotional experiences emphasize the stress and harm caused by patriarchal systems of power, like war, medicine, and government policies. They indicate women’s potential to challenge and

30 Sander L. Gilman, Illness and Image: Case Studies in the Medical Humanities (New Brunswick: Transaction Publishers, 2015), 123 31 Gilmore, 19-20

22 potentially subvert those systems of power by speaking against them, even while they suffer as a result of them. They also help us access women’s individual experiences of life outside of their relationship to that patriarchal power, and demonstrate the resilience of women’s interpersonal relationships. In their descriptions of loss, fear, pain, and worry, as well as in their memories of friendship, I hope the women I discuss emerge outside of the contexts of their sources, and apart from the gendered constructions of trauma and mental illness that are used to describe them.

Ultimately, I hope that this work continues the discussion that was taking place on the streets of

Boston during Dr. Ford’s testimony before the United States Senate: that women’s trauma, in all forms, is real and valid, and that the consequences of avoiding, ignoring, or overlooking it are very real.

23

CHAPTER ONE: “‘Very depressed…since the air raids’: Trauma, Gender, and the Memory of the First World War”

So much has been written on the nervous and mental troubles induced by conditions of service in the Great War that the subject seems almost threadbare at this time of day.32 (W.R. Dawson, “The Work of the Belfast War Hospital 1917-1919”)

During the night of September 7, 1915, two Imperial German Army airships executed a bombing raid over London. One of the airships bombed Millwall, Deptford, Greenwich, and Woolwich, while the other ended up dropping the majority of its bomb load on greenhouses in Cheshunt, about twelve miles north of central London.33 It also dropped an incendiary bomb on a shop on Fenchurch Street in central London before returning to Germany. The next night, four more German Zeppelins attempted another raid. Two suffered engine troubles, and one was unable to cause damage to its intended target, a Yorkshire benzole plant.34 The fourth ship sailed to London, dropping a 661lb (300kg) bomb on a residential home at 61 Farringdon Road, killing twenty-two people. This bomb, at the time the largest dropped on Britain, inflicted the most damage by a single airship or airplane bombing raid over the course of the First World War.35

In reporting the incident, British newspapers emphasized the ‘uncivilized’ nature of the attack, pointing out that none of the damage inflicted in the course of the two raids could be construed as accomplishing a single military objective. The Western Times, a paper located in

Plymouth, noted:

In every case where damage has been caused it is private property that has suffered, and in most cases this private property has been of the small residential kind. Almost all the unfortunate people who have been killed have not only been non-combatants, but non- combatants of a kind which it has been hitherto the honourable practice of civilized warfare to exempt from attack. That is to say, women and children, small shop-keepers,

32 W.R. Dawson, “The Work of the Belfast War Hospital (1917-1919), British Journal of Psychiatry 71(1925), 219 33 Arch Whitehouse, The Zeppelin Fighters (New York: Ace Books, 1966), 108-9 34 Benzole is a coal-tar product used as a ‘motor spirit.’ 35 Whitehouse, 109-111

24 and working men, the sacrifice of whose lives can affect no military purpose whatever, either morally or materially.36

Yet, the same report explained, despite the savagery of these attacks and the massive damage that they inflicted in residential areas, the people of London were not only unafraid, but very nearly unaffected by the air raids:

So far as the moral effect of the raid was concerned it is to be feared that from the standpoint of Berlin it was a complete failure. If Count Zeppelin himself accompanied the raiding aircraft…he will be disappointed to learn that only a minority of the vast population of London was aware of the presence of his airship at all, and that amongst those who heard the guns fire or saw the Zeppelin the feelings everywhere aroused were of interest and curiosity, rather than of fear.37

Multiple newspaper reports throughout the war attested to the fascination that the London populace displayed towards Zeppelins, as well as their apparent lack of fear.

However, several weeks after this air raid, a sixteen-year-old woman, whose initials were

AW, was admitted to the Colney Hatch Asylum located in what is now the London Borough of

Barnet.38 AW was working as a machinist and, according to her mother, had been “very depressed…since the air raids”.39 Doctors at the asylum noted that “On admission she was actively depressed…She is stated to have threatened suicide and apparently she is just emerging from a very acute attack which is attributed to the recent Zeppelin raids.”40 AW remained at

Colney Hatch until June 17, 1916. During her treatment there, her doctors noted that she was

36 “The Air Raids,” Western Times September 18, 1915. 37 Ibid. 38 London Metropolitan Archives, H71/FH/B/01/02/002, Royal Free London NHS Foundation Trust, Friern Hospital, Patient Records/ Sample of Case Notes of Patients Admitted to Colney Hatch Asylum, Friern Hospital, 1915-1916. Because the final date of the information contained within these files is less than 100 years ago, access to the records is prohibited under British Data Protection legislation. I obtained special permission from London Metropolitan Archives to consult these archives, and the archives at the Richmond Lunatic Asylum. As a result, I have only used patients’ initials in these sections, and avoided using any specific details about them in order to protect their identity as much as possible. 39 Ibid. 40 Ibid.

25 often “distressed”, and frequently combative. It was only toward the end of February that it was noted that she “Has been quieter lately and not so difficult to manage”.41

Reports at the time largely overlooked cases like those of AW, only noting women’s reactions to the war when they resulted in sensational and violent actions, such as suicide or murder.42

Whereas men’s trauma was called ‘shell shock’, women’s breakdowns were generally not linked to the war, but rather to hereditary conditions or the patient’s own inherent weaknesses. There simply was no war-related diagnosis for A.W.’s condition, so doctors resorted to their traditional beliefs in the patient’s inherent gendered weakness to explain her breakdown.

The ‘shell-shocked soldier’ remains one of the most enduring images of the First World

War. Indeed, shell shock has remained such a powerful way of describing the lived horror of combat in the First World War that, as Peter Leese notes, it has “transcended the experience of the individual soldier and become a symbol of the anguish the troops suffered” in the uniquely hellish world of the trenches.43 As Western collective memory of the First World War has been affected by the experiences of other wars and even more horrors, ‘shell shock,’ Jay Winter explains, has become “an essential element in representations of war”, providing a term to describe the trauma that soldiers suffer as a result of their combat experience. 44

But, though ‘shell shock’ and the related medical diagnoses that all described war-related psychological trauma have become a defining characteristic of the First World War in popular

41 Ibid. 42 For example, the Lincolnshire Echo reported the case of one Margaret Richardson of Brentwood, “who threw herself out of a window 35ft. from the ground, after suffering from depression caused by reading about air raids.” 42 Susan Grayzel also mentions the case of Elizabeth Huntley, who was accused of decapitating her young daughter during a fit of insanity brought on by “air raid shock.” (Susan Grayzel, Women’s Identities at War: Gender, Motherhood, and Politics in Britain and France During the First World War (Chapel Hill: University of North Carolina Press, 1990), 46-48). 43 Peter Leese, Shell Shock: Traumatic Neurosis and the British Soldiers of the First World War, (New York: Palgrave MacMillan, 2014), 180. 44 Jay Winter, “Shell-Shock and the Cultural History of the Great War”, Journal of Contemporary History, 35:1 (2000), 7.

26 memory, these conditions excluded a number of people, and, in so doing, also excluded them from the history of the war and the history of trauma more broadly. This is a work that considers memories—the individual, the public, the recorded and the incommunicable. In it, I consider

British and Irish women’s testimonies and expressions of trauma as a result of their experiences during the First World War, the potential for understanding and treatment they received for that trauma, and the ways in which their war experiences were remembered and forgotten within the history of the war.

The object of this work is not specifically to detail the history of diagnosis of shell-shock, as a great many exemplary works have made that history a rich and enlightening one. Instead, it will explore what happened to those who were outside the diagnostic criteria, or did not fit the patient model that developed as a result of the war. How were their symptoms defined and described? What access did they have to care or the potential for healing? In order to consider these questions, this dissertation focuses on one category of patient who were excluded from the diagnosis of war trauma that emerged as a result of the First World War: adult women, both on the home front and those who served as nurses at sites of war. To be clear, women represent only one category of patient who were excluded from these diagnoses, as colonial subjects, soldiers of color, and others were also excluded for various and important reasons. Focusing on women’s experiences exclusively offers the chance to analyze the gendered assumptions that are still applied to diagnoses and treatment of war trauma up to the present, and to consider the ongoing stigmatization of women’s emotions that affect how their testimonies of suffering and pain are received, interpreted, and explained today.

This work is important because it considers how and why women’s symptoms of trauma were disregarded within the context of ‘shell shock’ and war trauma. In so doing, it provides

27 insight into contemporary notions of who was allowed to access the language of suffering and, thus, to access care and public concern. Additionally, women’s expressions of trauma and testimonies, recorded in case notes, in their autobiographical writings, and in their pension files, help shape a history of the war that enriches and complicates traditional histories by lifting a previously subjugated form of history out of obscurity and placing it at the forefront. This chapter will consider the gendered and social assumptions regarding diagnosis of war trauma, in order to better elucidate the process by which women were excluded from these diagnoses, as well as from the broader histories of the First World War, and of war trauma more broadly. The rest of this work will focus on the traumatic experiences of women in order to demonstrate that trauma was far more widespread than traditional narratives of ‘shell shock’ and war trauma have considered. By focusing on these women’s testimony regarding their trauma and the treatment they received, I hope to expand the story of women in the First World War by acknowledging their emotional and psychological experiences, as well as their physical, economic and social experiences. Too often, women have been used historically as a mirror to reflect the experiences of men; their work as caretakers is in service of men, their labor is in support of men, their experience of violence is the result of men’s anger and trauma. This work looks at the emotional toll that war took on women, and how they expressed it to doctors, pension officials, themselves and to each other. It also considers how that testimony was received by those in power, and the consequences of that interaction for the woman patient and the woman veteran attempting to access care in the postwar world.

At the heart of this study is an understanding that trauma is a performance that is culturally, socially, and temporally scripted. A successful performance is one that is recognized by medical officials and society, and results in the traumatized person receiving access to care,

28 treatment, and, potentially, healing. An unsuccessful performance results in the person in question being ostracized as mentally unstable, as ‘other’, and, often, isolated from society in a mental institution, lunatic asylum, or in their home. Over the nineteenth century, and up to the opening of the First World War, an enormous amount of study and literature had been produced by medical professionals who had devoted their careers to defining the causes of trauma, the appropriate reactions to trauma in men and women, and successful courses of treatment to heal trauma victims. It was the First World War that shattered the foundations of that understanding, forcing medical professionals from every combatant nation to reformulate definitions of trauma in order to cope with the enormous number of soldiers who were returning from the front with symptoms including “withered, trembling arms, paralysed hands, stumbling gaits, tics, tremors and shakes, as well as numbed muteness, palpitations, sweaty hallucinations and nightmares, all of which might constitute the outward signs of mental distress.”45 The result was a reframing of trauma that continues to affect our understanding of psychological distress in warfare to this day.

At this point, I would like to note that, in the discussion that follows, I will be using ‘shell shock’ frequently to stand in for the many diagnoses offered to describe combatant soldiers’ trauma symptoms during the First World War. Though it was determined to be ineffective, if not downright distracting, during the war, it is also the most commonly used and familiar phrase that remains from this period. In using the phrase ‘shell-shock’, I do not ascribe to it any authority or veracity; it is instead used out of expediency, and because it is a phrase which current readers and the historical subjects about whom I write can both understand.

Although most combatant nations proved remarkably adept at organizing medical services to evacuate wounded soldiers from the front and to medical facilities, their

45 Peter Leese, Shell Shock: Traumatic Neurosis and the British Soldiers of the First World War (London: Palgrave Macmillan, 2014), 3

29 understandings of the physiological and psychological conditions caused by war injuries was neither quick in coming nor complete in its definitions and treatment. As Geroulanos and

Meyers have argued, despite the intense work performed by doctors during the war, no hard-and- fast theories regarding war-related conditions like shock (both physical and mental) emerged by the war’s end. Indeed, as they note, there were many who “developed misgivings about whether the condition even existed as anything more than a misshapen medical hermeneutic caused by the poverty of old medical categories.”46 In many cases, doctors continued to rely on pre-war theories of gendered behavior, emotional disposition, and self-control to define the symptoms and treatment of patients, only developing new tactics and theories where necessary, such cases being the waging of war, the staffing of the front lines, and achieving ultimate victory. Those who did not contribute to these objectives were not included in studies or resultant theories of practice. For this very reason, when it came to descriptions and treatments for ‘shell shock’ and other war-related trauma conditions, women were generally overlooked. It was only in the postwar world, as we shall see, that (some) women veterans were allowed to seek disability pensions and thus express their own experiences of psychological trauma as a result of their service. While some of those who pursued disability pensions were successful in navigating the linguistic, medical, and bureaucratic maze, and in performing their trauma adequately to receive pensions and access to care, many were not. Women, particularly women of working age, who remained on the home front were largely excluded from the evolving studies and understanding of war trauma, particularly those lower-class women whose experiences in London and Dublin are documented in this work. Indeed, it is in many ways conceptually impossible to compare women in asylums to male soldiers in psychological, neurological, and military hospitals,

46 Stefanos Geroulanos and Todd Meyers, The Human Body in the Age of Catastrophe: Brittleness, Integration, Science, and the Great War (Chicago: The University of Chicago Press, 2018), 67

30 because the understanding and conceptualization of their treatment was so divorced from the world and world events taking place outside the asylum walls. If it were not for the women’s own testimony in case notes relating their suffering to the loss of family members in the war, to their fear of air raids, or to their experiences as refugees fleeing from the German invasion of

Belgium, it can be difficult to remember that the war was happening at all. However, the presence of nurses and soldiers within the pages of those same case notes show that the war was indeed intruding into every aspect of home front life.

Recognizing the limits of the contemporary war trauma diagnosis adds emphasis to the argument put forth by a number of historians that challenges the axiom that war is good for medicine, by exposing the disorganized and often unfocused nature of the work that doctors undertook. Histories of military medicine have celebrated the scientific developments and structural changes that resulted from the demands placed on medicine in wartime—or, as Roger

Cooter and Steve Sturdy have explained, “pressing questions about the impact of war on the aims, concerns and social configurations of medicine have been ignored in favour of simple and self-serving narratives of technical and organizational advancement.”47 These histories see wartime as a “a ready-made experimental situation in which research and physiological experimentation came under the heading of care, therapy, and rehabilitation.”48 To an extent, this sentiment is true. The First World War saw the development of techniques that not only saved lives in wartime, but in peace, as well, such as blood transfusions, plastic surgery, and burn treatments. However, the goal of medicine during war is to facilitate victory, not to effect healing. As Fiona Reid observes, “medics had little power against the over-riding logic that a

47 Roger Cooter and Steve Sturdy, Introduction to War, Medicine and Modernity, ed. Roger Cooter, Mark Harrison and Steve Sturdy (Stroud: Sutton Publishing, 1998), 6 48 Geroulanos and Meyers, 37.

31 systematized military health service was required to deal with systematized military slaughter.”49

In such scenarios, doctors were forced to work quickly, in poor and uncontrolled conditions that did little to advance either medical knowledge or overall patient care. Thus, previous assumptions of race, gender, ethnicity, class, and ability influenced the development of diagnoses and treatment far more than they were overturned by wartime medical practices. War, Cooter and Sturdy remind us, cannot be wholly separated from the societies in which it is waged.50

Additionally, doctors’ own professional limits affected the type of care they were able to provide. Tracey Loughran reminds us that “many ‘shell-shock’ doctors were not specialists in mind, nerves, and brain,” and thus, the evolution of their theories were developed out of the

“useful chaos of the diagnostic strategies of the pre-war psychological medicine.”51 In addition to this, the breakdown of international communications during war hampered the development of a single, unified theory or method of treatment for war trauma. There were some points of similarity and agreement amongst men and medical professionals, a critical one being to displace responsibility for men’s breakdowns from the war to the individual. Essentially, it was acknowledged that war could cause anyone to break down, but typically reacted most strongly and visibly on those who were already predisposed to mental and emotional weakness. Despite the myriad complex and contradictory explanations for ‘shell shock’ and related conditions, most shared this tendency to exculpate the war itself as the cause. In Britain, especially, such rhetoric took hold in the second half of the war, around the commencement of the Battle of the Somme; a period when the composition of the military shifted from career-soldiers to conscripts, and also when it became unavoidably clear that the war would not be easily won. The deepening of the

49 Fiona Reid, Medicine in First World War Europe: Soldiers, Medics, Pacifists (London; Bloomsbury Academic, 2017), 7. 50 Cooter and Sturdy, 7 51 Tracey Loughran, 80

32 crisis influenced doctors across disciplines and fields of study to reframe war trauma “as a pathological individual reaction rather than an unavoidable response to the environment of war.”52

Finally, wartime necessity limited the kind of patient around whom doctors were developing theories and treatment. These patients, as Geroulanos and Meyer point out, “were male, mostly white, relatively young, comparatively fit…Indeed, it would be difficult to overstate the intensity with which the young male body became the model of patienthood and the criterion for treatment.”53 Such a practice would have serious and long-lasting consequences for those who fit the criteria of ‘patient,’ and for those who were excluded from it. For example, the experience of those whose conditions were determined not to be the direct result of the war, were judged to be malingering, “hysterical” or cowardly, labels which could affect their experience of service, ability to acquire pensions, and their own self-image in ways that have yet to be fully explored. The silence that often accompanied these derogatory labels could last for a lifetime.

The study of these men who were determined to be malingering, consciously or unconsciously, has created a false idea about the understanding and treatment of ‘shell shock’ and related conditions. The problem was not that doctors uniformly and intentionally “created a silent protective box, a categorical silence, around shell shock” in order to ignore its existence, as has been claimed by some historians.54 To make such a claim utterly overlooks the ways in which the medical understanding of ‘shell shock’ and related trauma changed, evolved, and settled over the course of the war. Rather than seeing the condition as a scenario of ‘doctor vs. patient’, it is more useful to see it as a process by which doctors identified their patients. Those

52 Loughran, 90 53 Geroulanos and Meyer, 81 54 Winter, War Beyond Words: Languages of Remembrance from the Great War to the Present (Cambridge: Cambridge University Press, 2017), 177

33 who fit the eventual criteria could access treatment and (in theory) be cured. Those who did not fit the criteria of patient, and who did not respond adequately to treatment once they were included in the in-group of patients, were stigmatized.

As Hazel Croft notes, in the case of shell shock, “[t]here was not a straightforward diagnosis on the basis of gender.”55 Rather, the diagnosis developed in the wake of prewar studies into “male hysteria,” which, generally speaking, attempted to address psychological, physical, and social behavior that European doctors deemed ‘unmanly’ according to prevailing gender norms, from psychological trauma to physical injury due to railway accidents to homosexual activity and effeminate behavior.56 To distinguish these conditions from female hysteria, doctors often ascribed physical or organic causes to men’s conditions, which, primarily, preserved “the prevailing model of middle-class masculinity and the Victorian-Edwardian sex/gender system that it underpinned,” and also reinforced the notion that women were different from, and inherently inferior to, men. As a result, Micale notes, ‘male hysteria’ was, like ‘shell shock,’ ‘fraught with evasions, tensions, and contradictions.”57

In constructing shell shock, doctors similarly attempted to distance themselves from previous discussions of hysteria in women. Indeed, as Tracey Loughran points out, “‘shell- shock’ doctors deliberately jettisoned the feminine heritage of hysteria.”58 With rare exceptions, doctors avoided comparing soldiers diagnosed with ‘shell shock,’ and took pains to differentiate the symptoms of soldiers with both civilians and women.59 One way of accomplishing this was by emphasizing the desire of the male ‘shell-shocked’ patient to be cured, to overcome his

55 Hazel Croft, “Emotional Women and Frail Men: Gendered Diagnostics from Shellshock to PTSD, 1914-2010” in ed. Ana Carden-Coyne, Gender and Conflict Since 1914: Historical and Interdisciplinary Perspectives (London: Palgrave Macmillan, 2012), 112 (110-123) 56 See Mark S. Micale, Hysterical Men: The Hidden History of Male Nervous Illness (Harvard: Harvard University Press, 2008), 207 57 Micale, 208. 58 Loughran, 137. 59 Loughran, 138

34 symptoms, and to once again assume the mantel of martial masculinity. By focusing on aspects of will—both the soldiers’ to get better and the doctors to affect a cure, doctors were able to

“neutralize the potentially radical challenge of ‘shell shock’ to Edwardian masculine ideals.”60

According to A.F. Hurst and J.L.M. Symns in an article published in The Lancet in 1918, “the patient is fully convinced the hoped-for cure will take place: as the medical officer is equally convinced that he will cure the patient.”61 In such cases, they explained, “trophies in the shape of discarded splints and crutches” would attest to the soldiers’ heroic success over his condition.62 Likewise, Grafton Elliot Smith and Thomas Pear noted that ‘shell-shocked’ patients were marked by “the desire to be cured or to be active,” whereas hysterical women were marked, according to Silas Weir Mitchell, by their desire “to lie abed half the day and sew a little, and read a little, and be interesting and excite sympathy.”63 The other was to emphasize the total difference between soldiers and women (and civilians who did not enlist). Becoming a soldier made one into the highest form of a ‘man’.64 Thus, there could be little to no comparison between such a soldier and a woman on the home front. As Smith and Pear explained, “the soldier is in a position very different from that of the wealthy society lady,” and therefore “must not be given the same treatment as the society lady suffering from lack of honest labour.”65

Charles Meyers, who first provided (and later denounced) the phrase ‘shell shock’ noted a discussion with a fellow medical officer who argued that the symptoms he witnessed among his patients “were not in this hospital regarded as part of hysteria: they did not occur, he maintained,

60 Loughran, 159 61 A.F. Hurst and J.L.M Symns, “The Rapid Cure of Hysterical Symptoms in Soldiers”, The Lancet, Vol 192 (4953), 1918, 139-141 62 Ibid. 63 Grafton Elliot Smith and Thomas Hatherley Pear, Shell Shock and Its Lessons (Manchester: Manchester University Press, 1917), 33Quoted in LMS Pearce, “Silas Weir Mitchell and the ‘rest cure,’” Journal of Neurology, Neurosurgery and Psychiatry, Vol. 75(3), 2004: 281. 64 As discussed in Jessica Meyers, “Separating the Men from the Boys: Masculinity and Maturity in Understandings of Shell Shock in Britain,” 20th Century British History, Vol. 20:1 (2009), 1-22. 65 Smith and Pear, 33 & 102.

35 in hysteric women!”66 A final example can be found in Arthur Hurst’s Medical Diseases of the

War, in which he emphasizes that a soldier who had been tested repeatedly in battle could not be compared to “the quite abnormal nervous system of the young woman.”67

At the same time, as Amy Koerber reminds us, scientists and medical professionals were further separating women and men by language that insisted on women’s unique, mysterious, and, ultimately, inferior physiology. Even as the concept of hormones developed, which promised to revolutionize the ways in which the body and its processes were understood, “a more scientifically credible version of the uterus-brain connection became possible…old ideas about the uterus percolated into the female brain discourses, and traits that were previously assigned to the uterus were assigned to the female brain.”68 As such, even as the diagnosis of

“hysteria” lost credence within the medical community, doctors continued to develop “medical metaphor[s] for everything that male observers found mysterious or unmanageable in the opposite sex.”69 Because it was constructed as a result of women’s unique physical and hormonal makeup, there was no simple comparison between men’s reactions to trauma and women’s hysterical outbursts and emotional imbalance. Instead, when men broke down, doctors tended to use the language of regression—to children, to beasts, or to primitive, instinctive man, rather than to women, whose sexuality and emotionality set them apart. As William H.R. Rivers explained, men in battle fell prey to the most basic instincts of self-preservation: “Warfare makes fierce onslaughts on an instinct or group of instincts which is rarely touched by the ordinary life of the member of a modern civilized community…they are far simpler both in their nature and

66 Charles S. Meyers, Shell Shock in France, 1914-1918: Based on a War Diary (Cambridge: Cambridge University Press, 1940), 121. 67 Quoted in Loughran, 138 68 Amy Koerber, From Hysteria to Hormones 69 Micale, 159

36 their effects than the instincts which are concerned in continuing the species or maintaining the harmony of society.”70

While many descriptions of shell-shock have emphasized how the diagnosis infantilized men, numerous scholars have argued effectively that this did not reflect the reality of shell-shock treatment. Laurinda Styker argues for example, that “British psychologists did not brand their patients as effeminate, homosexual or cowardly…[instead] shell-shock theory framed soldiers’ breakdowns in ways which served to militate against such understandings and forestall such reflections.”71 Shell-shock was described by contemporary observers as a temporary condition that afflicted healthy men who found themselves in emotionally extreme circumstances.72

Recovery—which meant the return to self-control and, often, to the status of breadwinner, was proof of his inherent strength and resolve. Men who failed to prove their symptoms, who were deemed malingerers or the result of hereditary condition, were effeminized and shamed, just as

‘hysterical men’ were shamed in the prewar years. The ability to tell the difference between genuine sufferers and malingerers was a reserve of the professional medical community.

Doctors thus overcame their inability to understand “shell shock” by defining what it was not.

Those men that were successful in proving their condition was war related were rewarded not only with pensions, but with a condition that was described in ways that emphasized, rather than threatened, his masculinity. As Fiona Reid notes, wartime publicity on shell shock “was largely sympathetic, and it generally attempted to emphasize that nerve-damaged soldiers were

70 W.H.R. Rivers, Instinct and the Unconscious: A Contribution to a Biological Theory of the Psycho-Neuroses (Cambridge: Cambridge University Press, 1920), 5 71 Laurinda Styker, “Mental Cases: British Shellshock—Politics of Interpretation”, in ed. Gail Braybon, Evidence, History and the Great War: Historians and the Impact of 1914-18 (New York: Berghahn Books, 2005), 159-60 72 Often, such patients were also thought to suffer from microscopic brain legions or injuries, which served both to explain some of their physical symptoms, such as limping or mutism, as well as to overcome the ambiguities of the theory of mind-body connectivity that was emerging during this period.

37 wounded, rather than weak, incapable or mad.”73 Publications on shell-shock emphasized the difference between malingerers and hysterics—those unable to assert self-control over their emotions and behavior—and those who were, in effect, mentally wounded by war.74 According to Norman Fenton, who was attached to Base Hospital 117 of the American Expeditionary Force,

“the typical war neurosis—notably the concussion, gas, and anxiety types—rank very high in percentage of successful re-adaptation, while the more pronounced constitution types rank lower.”75 Of these, he goes on, the worst off were “the hysteria”, of whom “the majority are having difficulty getting along in civil life…On the whole, the hysteria retain enough of their old condition to handicap them seriously in their personal lives, though not always directly in their business activities.”76 Manuals published to aid in the recovery of shell-shock urged afflicted veterans to reassert their (manly) self-control in order to re-achieve emotional balance.

According to one such text by J.S. Milne, “There must be but one ‘great’ effort (‘great means calmest). There must be confidence that, with patience in such an effort, all will be ‘brought back.’ Not ‘come back’” (emphasis in text).77 The emphasis here being that it was the duty of the patient “to keep control of himself”, which was possible for shell-shocked patients “if they will only make the effort”.78 Similarly, a manual on speech-therapy for shell-shock patients explains:

73 Reid, Medicine in First World War Europe, 33. 74 It is important to note the influence of class in the treatment of patients, both male and female, and in the interpretation of their symptoms. As many scholars have observed, officers tended to receive better treatment, and less condemnatory diagnoses than enlisted and conscripted men. To quote from Frederick Mott’s work on shell shock, “Anxiety-neurosis is a far more common condition in officers than hysteria. In non-commissioned officers and men hysteria is common.” Frederick W. Mott, War Neurosis and Shell Shock (London: Hodder & Stoughton, 1919), 139. 75 Normal Fenton, Shell Shock and Its Aftermath (London: Henry Kimpton, 1926), 104. 76 Fenton, 105. 77 J.S. Milne, Neurasthenia, Shell-Shock, and A New Life (Newcastle-on-Tyne, R. Robinson & Co., Ltd., 1918), 40. 78 Milne, 43; 39. This book is both a guide and a description of Milne’s own recovery from neurasthenia. His first account of finding some relief from his symptoms comes in the form of a physical stretching exercise which helps him “divert what was said, from my mind” (sic) and return to his physical labors. That his wife was the one

38 During the past few years we have realized, more than ever, that we have within us a power to assist us and to get well if we cultivate it; I mean the power of the will...Now, as the vitality of the shell-shock patient is below normal, he is often a prey to worry and what we may call “fear thoughts,” and I am going to ask him to exercise his will power to put these worries and thoughts resolutely away from him.79

Throughout the study and treatment of ‘shell-shock’, the masculinity of the patient was established in comparison to the (naturally) hysterical woman. For example, Sir Grafton Elliot

Smith and Tom Hatherley Pear explained in their 1919 book Shell Shock and Its Lessons, “The intelligent, highly moral, over-worked business man must not be given the same treatment as the society lady suffering from lack of honest labour”.80

In the postwar, the British government made an attempt to define shell-shock, primarily in the hopes of putting concerns over the condition to rest. Despite public assurances that military and medical officials were competently managing the diagnosis and treatment of ‘shell shock’, public concern over the treatment of veterans and lingering doubts over the execution of potentially shell-shocked soldiers kept debate over the condition high in the postwar world. As

Fiona Reid observes, the War Office Committee of Enquiry into ‘Shell-Shock’, commissioned by Lord Southborough in 1920, was established in response to this concern, “to reassure the public that all issues connected with the diagnosis and treatment of shell shock had been managed effectively,” and to identify preventative measures and effective treatments to avoid such concerns in any future wars.81 The committee’s work, though creditable in terms of its aims, was severely hindered by the general inability of doctors and military officials to actually

speaking to him at the time seems relevant. That he could put her words aside and return to physical exercise implies a return to the proper gender roles of the relationship. (Milne, 15). 79 Rose I. Patry, Daily Drill for the Voice:a book of exercises composed to help men whose speech has been affected by shell-shock, etc. (London: W. Patching & Co., 1917), 1. 80 Grafton Elliot Smith & T.H. Pear, Shell Shock and Its Lessons (Manchester: Manchester University Press, 1919), 102. 81 Fiona Reid, Broken Men, 71.

39 define ‘shell shock,’ or any other diagnoses that were used to describe war trauma.82 However, there was never a challenge to the gendered construction of the condition. The focus remained entirely on men in combat and plans for training future troops in order to mitigate the number of mentally shocked patients that would return from battle. Women were not present in the study, or as part of the Committee. Only one nurse was invited to give evidence to the War Office

Committee of Enquiry into “Shell-Shock”, and her testimony was limited to her observations of the patients in her hospital.83

Likewise, very little changed regarding the gendered identity of the shell-shocked patient.

As Fiona Reid notes, wartime publicity on shell shock “was largely sympathetic, and it generally attempted to emphasize that nerve-damaged soldiers were wounded, rather than weak, incapable or mad.”84 However, the debate over shell-shock remained focused on men. Over and over again, doctors refused to connect women’s war service at home or abroad with symptoms of genuine mental trauma. While women’s contributions to the war were valued, the effect of the war on them as individuals was not taken into account. As Tracey Loughran describes, though women were praised for taking on ‘masculine’ roles in the war, “conceptions of sacrifice and suffering remained deeply gendered. In the careful construction of ‘shell-shock’ as a masculine category of diagnosis, through the exclusion of the feminine and the writing out of potentially emasculating symptoms, doctors reaffirmed traditional gender roles.”85 When breakdown occurred in women, doctors tended to ascribe pre-war notions of emotionality and instability to

82 Reid, Broken Men, 81-85. 83 Miss Cockrell, R.R.C., late Matron, Maudsley Neurological Hospital. In her testimony, she described the many symptoms that men exhibited when they were first admitted to her hospital, and how sensitive they remained throughout their stay to “the slightest excitement”: “‘I have seen them all sitting at dinner quite quietly, and perhaps there would be a clap of thunder, and immediately they would all go under the table or tumble down.” (Great Britain, and Anthony Richards, Report of the War Office Committee of Enquiry into "Shell-shock" (cmd. 1734): featuring a new historical essay on shell shock (London: Imperial War Museum, 2004), 83. 84 Reid, 33 85 Loughran, 142

40 women, rather than applying the (slowly) evolving ideas occasioned by the war. It was only in the postwar period that some nurses were understood to be affected by shell-shock. But, as shall be discussed later in this work, women were always seen as exceptions to the general rule that men were the actors in war, those responsible for winning victory. Thus, men were the only patients who could be considered as victims of that war.

The experience of those treated for war-related trauma, successfully and unsuccessfully, has become an important focus for historians of the First World War. In their symptoms and suffering, larger points about the war and its aftermath have emerged. Scholars of trauma, such as Peter Leese, Fiona Reid, and Jessica Meyer, have studied the treatment traumatized soldiers and veterans received, and the diverse and complex ways that trauma both defined and changed men’s identity.86 This work contributed to a wider, more globalized understanding of war trauma across the twentieth century, drawing on evolving knowledge about the effects of battle on the minds of combatants.87 Additionally, Peter Barnham has addressed the politicization and medicalization of British soldiers’ trauma in the postwar world, and the dawn of the modern veterans’ rights movement.88 Finally, Jay Winter’s work speaks to the ways in which ‘shell shock’ has served as a metaphor in popular memory for the overall suffering that soldiers endured.89

86 Peter Leese, Shell-Shock: Traumatic Neurosis and the British Soldiers of the First World War (New York: Palgrave MacMillan, 2014); Jessica Meyer, Men of War: Masculinity and the First World War in Britain (New York: Palgrave Macmillan, 2012); Fiona Reid, Broken Men: Shell Shock, Treatment and Recovery in Britain, 1914-1930 (London: Continuum, 2010) 87 For example, see Ben Shephard, A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century, (Cambridge: Harvard University Press, 2003); Paul Lerner, Hysterical Men: War, Psychiatry, and the Politics of Trauma in Germany, 1890-1930 (Ithaca: Cornell University Press, 2003); Peter Barham, Forgotten Lunatics of the Great War (New Haven: Yale University Press, 2004); Edgar Jones & Simon Wessely, Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War, New York: Psychology Press, 2005) 88 Peter Barham, Forgotten Lunatics of the Great War (New Haven: Yale University Press, 2004) 89 Jay Winter, “Shell-Shock and the Cultural History of the Great War,” Contemporary History, 35:1(2000), 7-11.

41 However, though the history of trauma and the First World War has evolved to incorporate and consider the gendered implications of men’s’ symptoms and conditions, the focus remains on men and masculinity. In the history of the First World War, “the soldier is framed as the hero, victim and perpetrator”, with his body, “its corporeal experience and material affects, shaped by class, race and gender constructs” at the center of the historical discussion.90

Elaine Showalter’s 1985 analysis of shell shock provided a critical gender analysis of men’s situation, noting that during the war, “many combatants felt themselves rendered powerless, unmanned by the barrage of horror to which they were subjected and by their uncontrollable physical and emotional responses to it.”91 By forcing men into the position of helplessness and physical immobility of the imagined “hysterical woman”, “the Great War…feminized its conscripts by taking away their sense of control.”92 In her analysis, Showalter introduced the image of women, specifically ‘hysterical’ women, into the framework of shell shock. However, actual women are nowhere to be seen in her discussion. Instead, her model perpetuates the image of the suffering male, who is healed by being returned to masculine individuality.93

Joanna Bourke crafted a similar image, describing how ‘cures’ developed for shell shock were

“not only intended to teach the disabled how to become productive workers, but also to become

‘men’, shrugging off what was regarded as the feminizing tendencies of disability.”94

The gendered assumptions regarding shell shock, and the patients who suffered from it, contributed significantly to the construction of the memory of the First World War. To this day, popular history and academic studies remain focused on men’s suffering as a result of their

90 Ana Carden-Coyne, “Masculinity and the Wounds of the First World War: A Centenary Reflection”, Revue Française de Civilisation Britannique, Vol XX:1 (2015), http://journals.openedition.org/rfcb/305 ; DOI : 10.4000/rfcb.305, accessed January 23, 2019. 91 Showalter, 173 92 Showalter, 173 93 It should be noted that Showalter’s male patient is implicitly white, in addition to being male. 94 Joanna Bourke, An Intimate History of Killing: Face-to-Face Killing in Twentieth Century Warfare (London, Granta Press, 1999), 253

42 service, and their emotional and psychological reactions to war.95 These examples all contribute to a highly visible narrative of male service and suffering, with women remaining in the background, as supporting characters, or as a story apart from the world of men—if they appear at all. Peter Jackson’s internationally acclaimed film They Shall Not Grow Old, which aired over

Remembrance Day weekend in Britain to mark the 100th anniversary of the armistice, was praised for presenting, “in full digital clarity … ‘the truth untold,’” about the war.96 However, at no time in the ninety-minute film did Jackson include the voice or face of a woman. To keep the film as close to traditional constructions of the history as the war as possible, Jackson chose to focus specifically on men, like his own grandfather, who served on the Western Front. “Give me two and a half hours and sure,” Jackson explained, “the nurses would have been there.”97 Such films emphasize the fact that the traditional cultural memory of the First World War is one that does not require women or colonized soldiers, or where they exist only as a footnote. This memory is able to function outside the world of men because the stories of women and imperial

95 See for example, Peter Barham, Forgotten Lunatics of the Great War (New Haven: Yale University Press), 2004; Wyatt Bonikowski, Shell shock and the Modernist Imagination: The Death Drive in Post-World War I British Fiction (London: Ashgate, 2003); Deborah Cohen, The War Come Home: Disabled Veterans in Britain and Germany, 1914-1939 (Berkeley: University of California, 2001); Trevor Dodman, Shell Shock, Memory, and the Novel in the Wake of World War I (Cambridge: Cambridge University Press, 2015); Anthony Fletcher, Life, Death, and Growing Up on the Western Front (New Haven: Yale University Press, 2013); Paul Fussell, The Great War and Modern Memory (Oxford: Oxford University Press, 2000); Suzie Grogan, Shell Shocked Britain The First World War;s Legacy for Britain’s Mental Health (Barnsley: Pen and Sword, 2014); Nigel C Hunt, Memory, War and Trauma (Cambridge: Cambridge University Press, 2010); Samuel Hynes, A War Imagined: The First World War and English Culture (New York: Athenaeum, 1991); Brendan Kelly, ‘He Lost Himself Completely’: Shell Shock and Its Treatment at Dublin’s Richmond War Hospital, 1916-1919 (Dublin: The Liffey Press, 2014); Eric Leed, No Man’s Land: Combat and Identity in World War I (Cambridge: Cambridge University Press, 1979); Toby Thacker, British Culture and the First World War: Experience, Representation and Memory (London: Bloomsbury Academic, 2014). 96 Geoffrey Macnab, “They Shall Not Grow Old review: Peter Jackson’s astonishing WW1 documentary is like no other”, The Independent, November 11, 2018: https://uk.movies.yahoo.com/not-grow-old-review-lff- 221312775.html, accessed February 2, 2019; see also Mark Kermode, “They Shall Not Grow Old review—an utterly breathtaking journey into the trenches,” The Guardian, November 11, 2018: https://www.theguardian.com/film/2018/nov/11/they-shall-not-grow-old-peter-jackson-review-first-world-war- footage, accessed February 2, 2019. 97 Luke Buckmaster, “Interview: ‘The faces are unbelievable’: Peter Jackson on They Shall Not Grow Old”, The Guardian, November 10, 2018: https://www.theguardian.com/film/2018/nov/10/the-faces-are-unbelievable-peter- jackson-on-they-shall-not-grow-old, accessed February 2, 2019.

43 subjects are presented so often as tangential to the “real” story of white, European, combatant men.

All histories, Marita Sturken reminds us, “are forged in a context in which details, voices, and impressions of the past are forgotten. The writing of a historical narrative necessarily involves the elimination of certain elements.”98 Such an idea was also put forth in more detail by Michel Foucault, who explained that those exorcised parts of history that do not serve the constructed, dominant narrative, become, “subjugated history”, which he defined as “historical contents that have been buried and disguised in a functional coherence or formal systemization…beneath the required level of cognition or scientificity.”99 As Richard Jackson explains, the subjugation of memory means that:

… certain knowledge claims rooted in theoretical or empirical research remain unacknowledged in the scholarship or texts of the field. Such work is neither mentioned nor systematically engaged with, and if it is mentioned, it is dismissed as inappropriate, naïve, or irrelevant. By contrast, what is ‘known’ is acknowledged, engaged with, and referenced, and therefore, legitimized.100

It is only in revealing these subjugated memories, in focusing on that which has been previously forgotten or suppressed, or, as Foucault notes “through the re-emergence of these low-ranking knowledges…that criticism performs its work.”101

Feminist historians and historians of gender and sexuality have offered critiques of this memory constructing a history of women that stands beside that of men. They have shown how images of women were used to inspire, or manipulate, enlistment, or to comment on how the war threatened social purity and traditional gender roles. Others have shown how women defined

98 Marita Sturken, Tangled Memories: The Vietnam War, the AIDS Epidemic, and the Politics of Remembering (Berkeley: University of California Press, 1997), 8. 99 Michel Foucault, Power/Knowledge: Selected Interviews and Other Writings, 1972-1977, ed. Colin Gordon (New York: Pantheon Books, 1980), 81-2. 100 Richard Jackson, “Unknown Knowns: The Subjugated Knowledge of Terrorism Studies,’’ Critical Studies on Terrorism, 5:1(2012), 20 (11-29). 101 Foucault, 82

44 their citizenship through their support of the war, or through their war work. Others have noted how women’s narratives of the war offer insight into aspects of the war to which men did not have access.102 Some works even touch on women’s subjective emotional experiences, though generally in the form of fiction and literature, rather than the lived experience of emotion and its medical consequences.103 This work advances that history by using women’s experiences to actively critique the diagnoses constructed by men to define the war experience of men, and uses women’s expressions of emotion to construct a history that acknowledges women’s individuality and subjective expressions of fear, pain, grief, anger, and, in some cases, joy and humor, as well.

It insists on women’s ability and right to feel and to express those feelings, while at all times being mindful of the consequences of expressing those emotions, particularly in ways that were deemed harmful or excessive.

Placing women’s trauma at the center of a history of the First World War changes the relationship of the home front to the battle front and contests simple notions about women’s relationship to the state during and after the war. In looking at the experiences of Irish women, it also shows how traditional historiographies of the Easter Rising can be critiqued, enriched, and complicated by the inclusion of civilian women who neither saw it as a moment of emancipation or feminist liberation. It also reconceptualizes the experiences of nurses, ambulance drivers, and

102 For example, Gail Braybon, Women Workers in the First World War. The British Experience (New York: Routledge, 2014); Belinda Davis, Homefires Burning (Chapel Hill: University of North Carolina Press, 2000); Nicole Ann Dombrowski, ed. Women and War in the Twentieth Century: Enlisted With or Without Consent, (New York: Garland Publishing, 1999); Laura Lee Downs, Manufacturing Inequality: Gender Division in the French and British Metalworking Industries, 1914-1939 (Ithaca: Cornell University Press, 1995); Susan Grayzel, Women’s Identities at War: Gender, Motherhood, and Politics in Britain and France During the First World War (Chapel Hill: University of North Carolina Press, 1990); Nicoletta F. Gullace, ‘The Blood of Our Sons’: Men, Women, and the Renegotiation of British Citizenship During the Great War (New York: Palgrave Macmillan, 2002); Janet S.K. Watson, “Khaki Girls, VADs, and Tommy’s Sisters: Gender and Class in First World War Britain”, The International History Review, 19(1997): 32-51. 103 Margaret R. Higonnet, ed. Nurses at the Front: Writing the Wounds of the Great War (Boston: Northeastern University Press 2001); Sharon Ouditt, Fighting Forces, Writing Women: Identity and Ideology in the First World War (New York: Routledge, 1993); Angela K. Smith, ed. Women’s Writings of the First World War: An Anthology (Manchester: Manchester University Press, 2000); Claire M. Tylee, The Great War and Women’s Consciousness: Images of Militarism and Womanhood in Women’s Writing, 1914-64 (Iowa City: University of Iowa Press, 1990).

45 other female medical professionals, seeing their war experience disentangled, if not completely independent from, the patients for whom they cared, and exposes the difficulties of their return to civilian life after the war. Seen as volunteers and not as veterans, women’s access to postwar care and recognition was significantly diminished. While this led many to despair, it led others to organize, resulting in postwar institutions that assisted women veterans and promoted women professionals—organizations that have gone generally overlooked until this study. Challenging the categories of diagnosis around shock and trauma reveal a new history of war that has until now been under-researched, if not wholly overlooked.

In the interest of clarity, I wish to emphasize, first, that I do not claim that the women whose stories I present in the following chapters were free from any mental health conditions before entering the asylum. I have no desire to recreate the system of observation and judgement to which they were subjected during their lifetimes by male professionals who valued “what symptoms [their patients] had rather than how they processed these symptoms, what they made of them, how they bestowed meaning—or not—on their experience.”104 Instead, my focus remains on their words, and the fact that the women, their family, friends, and sometimes doctors, all attributed their current suffering to the war in some way, without attempting to impose meaning or medical structure on the testimony provided. Secondly, I do not claim that women who were not diagnosed with ‘shell shock’ or any related diagnosis should have been diagnosed as such. The diagnoses themselves were flawed, marked by social, cultural, political, and economic biases, and quickly deemed useless even by those doctors who had helped develop them. Instead, my work shows that diagnoses themselves are acts of power. Names are given by those with authority and recognition not only to a medical condition, but also to the patient who is diagnosed. The performance of a treatment and the effecting of a cure is a demonstration of

104 Darian Leader, What Is Madness? (New York: Penguin Press, 2012), 75

46 human, and very often male, mastery over an aspect of the lived environment. They also tend to infuse public and political institutions with new or renewed power; in the case of ‘shell shock’, the military and medical establishments that claimed the right to name and treat the conditions made private emotions and reactions a matter of public health and policy, and publicly stigmatized those whose conditions did not meet their criteria. While useful for many, diagnoses can also be a method of ‘othering’. Those who are considered outside of diagnostic criteria are often those whose lives and health are the most precarious and whose futures are the most uncertain, two qualities from which societies, particularly capitalist societies, tend to turn away.105 As Avram Finkelstein, explained so eloquently, “Witnessing ignores the ship, and studies what rides in the wake of it. It’s the glow on the horizon after the sun has left it and no one is looking. Witnessing is the underbelly of memory. It also happens to be the utter gist of history; it’s the entire human point.”106 Thus, I wish to recognize these women’s suffering specifically because they were not recognized as ‘shell shocked’. I want to bear witness to these women’s experiences because they were left outside of the diagnosis and study of ‘shell shock’, yet they still suffered. I want to bear witness because their story speaks to a long history of gendered thinking about women, their bodies, their minds, and their emotions, that continues to do harm today.

105 I am indebted to Garnette Cadogan, Avram Finklestein and the New York Academy of Medicine, where these ideas were discussed at a panel event entitled “Remembering the Dead” on February 6, 2019. 106 Avram Finklestein, “Remembering the Dead,” New York Academy of Medicine, February 6, 2019, personal recording.

47

CHAPTER TWO: “‘She talks to the Kaiser and has promised him not to strike back’: Trauma on the British Home Front

“You heard last night? Yes, I heard! Had you fear? No fear! And the women? No! Wonderful, the nerve of the women.” (Daily Herald, October 16, 1915) 107

When the hospital closed in 1993, my patient records travelled to the London Metropolitan Archives along with the rest of the hospital’s files, which today occupy more than eighty linear metres of shelving at the LMA. Perhaps one day some future chronicler of Friern will take my records down from the shelf and peruse them alongside those of my fellow Friernites, and so see for herself something of the story I am about to tell here… (Barbara Taylor, The Last Asylum) 108

In July 1941, the British Psychological Society (BPS) held a meeting focused on issues of home front morale during the Blitzkrieg. Many of the papers offered drew comparisons between the current situation in London and the air raids of the First World War, particularly public fears over shelter, evacuation, and survival during air raids. In one such paper, a BPS member named

Paul Senft described a primary difference between the air raids of 1914-1917 and the more recent Blitzkrieg:

The most striking psychological surprise of the present war is the fact that individuals and groups have not exhibited symptoms of an acute psychotic reaction to any marked extent. Arrangements in mental hospitals all over the country proved, in a fortunate way, inappropriate. The population indeed seemed able “to take it”….But what does this mean? I am afraid it means that we were still thinking in terms of the last war.109

107 “Zeppelins—Baptism of Fire,” Daily Herald, October 16, 1915. 108 Barbara Taylor, The Last Asylum: A Memoir of Madness in our Times (Chicago: University of Chicago Press, 2015), 103. 109 Wellcome Library and Archives, Leslie Spencer Hernshaw Collection, PSY/HEA/3/9, Paul Senft, “Shelter Problems and Morale” in The British Psychological Society: Shelter and Evacuation Problems: Being papers read at a meeting of the Society held on July 26th, 1941, and a short summary of the ensuing discussion, November 1941.

48 Senft’s intention in this passage, clearly, was to convey the impressive resilience of the

British public during the Blitz; however, his observations also strongly suggest that this resilience was not on display during the First World War. This was because, he further explained, no “defence mechanisms” had yet been developed by the public during the First

World War due to a lack of exposure to such events previously, and “The well-known results were traumatic psychosis and war neurosis”.110 Senft’s entire paper intimates that the years

1914-1918 saw a significant rise in “traumatic psychosis and war neurosis”, not only among the soldiers who were fighting, but among the civilians on the home front. Yet the issues of war trauma on the home front during the First World War remains a generally unexplored topic.

This chapter utilizes case notes from public hospital and lunatic asylums in London and

Dublin to reconstruct the home front as a place intimately familiar with the fear, danger, and trauma of war for the women who lived and worked there.111 In examining the testimony women provided to their families, doctors, and medical staff, I then demonstrate how doctors misunderstood women’s descriptions of trauma. The study of war trauma in combatant men during this time represents a watershed moment in the history of psychology. However, those advancements were not available to civilian women, who were constructed as both non-

110 Ibid. 111 The sources that inform this chapter are case notes, admission records, and superintendents’ reports from seven public hospitals and asylums in London (Banstead, Bethnal Green, Bexley, City of London Mental Hospital, Colney Hatch, Horton, Hanwell, and St. Luke’s), as well as the case records of the physicians at Queen Square Hospital, and the Richmond Asylum in Dublin. The records of the London Hospitals were deposited at the London Metropolitan Archives, often when the hospitals closed following the move toward deinstitutionalization in the last quarter of the 20th century. The extent of the holdings for each hospital varies widely, from a few volumes to multiple boxes; as a result, a quantitative study of these records would be incomplete and generally, unhelpful to the purpose of this study. Instead, I will be using the material available to analyze general trends, including doctors’ interpretations of women’s symptoms and the treatment female patients received. I would like to express my deep thanks to Ms. Charlie Turpie of the London Metropolitan Archives for her dedication, patience, and assistance with the archival research from which this chapter was built. Some of this chapter has appeared online as: Bridget Keown, “Fear, Pain, and the Representation of Women’s Wartime Trauma”, Lady Science No. 46, July 19, 2018: https://thenewinquiry.com/blog/fear-pain-and-the-representation-of-womens-wartime-trauma/, Accessed October 12, 2018.

49 combatants and as overemotional beings whose psyche was inherently unstable. Women described very real traumas caused by the war, including the terror caused by air raids and overwhelming worry and grief over the loss of male relatives to the war. Nevertheless, doctors continued to employ pre-war thinking of women’s inherent emotional fragility and poor mental health to describe their symptoms. Their diagnoses and descriptions of women in these case notes isolate women from the historical moment in which they were involved, and uncouples their trauma, which was often lifelong, from the war that caused it.

These descriptions placed women at a distance from the worst effects of the war, and contributed to a prevailing assumption that women were unaffected by their wartime experiences.112 When the war experiences of civilian women are discussed, it is primarily as a

‘side-show’ to the ‘real’ story of war in the trenches; though scholars have discussed how women’s lives changed as result of the war, most works emphasize the temporary nature of these changes, failing to consider in depth the complexity of women’s experiences, or the long-term effects they had on their lives.113 This section overall will seek to reconnect women’s war experiences on the home front with the mental distress described in the case notes, and to emphasize the ways in which the war affected everyday citizens. It will conclude by briefly reconsidering the porous nature of the boundary between the home front and the battle front by discussing the presence of military nurses and soldiers in home front hospitals. By questioning whose expressions of suffering were allowed to be heard, it is possible to identify the fault lines of wartime gender constructions and social expectations. The representation of women in wartime, as non-combatants, as supporters of heroic combatant men, and as gendered bodies

112 Current studies of veterans’ mental health continue to treat women as anomalous in their experiences, seldom acknowledging the history of gendered biases that construct them as both inherently different and inferior to men. See, for example, Helen Thorpe, “The V.A.’s Woman Problem”, The New York Times August 15, 2015: https://www.nytimes.com/2015/08/16/opinion/sunday/the-vas-woman-problem.html, Accessed October 14, 2018. 113 Susan R. Grayzel, Women and the First World War (New York: Routledge, 2002), 5-6.

50 within a strictly controlled patriarchy all affected the ways that their mental health was understood, and how their pain was heard and respected.

Just as the First World War redefined combat and military strategy, it also changed the relationship between individuals and the state “intensely and irrevocably”.114 Tammy Proctor has demonstrated that the gendered concept of the ‘civilian’, understood as “a person protected from war or an innocent victim of war,” was solidified during the First World War.”115 Although the “home front,” where civilians lived, was constructed as “a domestic noncombatant zone”, the reality was that the absolute hunger of total war for arms, supplies, money, and soldiers demanded that every person in a combatant nation participated in, and contributed to, the war.

Following the outbreak of war in August 1914, British society as a whole re-oriented toward the goal of victory. Women’s individual and collective identities were also expected to change to reflect the needs of the state, and to more clearly represent their role as wartime civilians. Susan

Grayzel describes how “during the war, the ‘maternal body’ and its labor became the focus of both family policy and the state regulation of work.” 116 Government, media, and social expectations provided guidelines for women’s socially acceptable behavior, and also performed scrutiny to ensure women’s compliance. At the same time, the emphasis on women’s domestic roles also led to increased surveillance for women as mothers and potential mothers. Growing concerns over declining birthrates led the government to intrude even farther into mothers’ and potential mothers’ lives, not only in the payment of separation allowances for wives and unwed

114 Susan Grayzel, At Home and Under Fire: Air Raids and Culture in Britain from the Great War to the Blitz (Cambridge: Cambridge University Press, 2012), 2 115 Tammy M. Proctor, Civilians in a World at War, 1914-1918 (New York: New York University Press, 2010), 5. 116 Susan Grayzel, Women’s Identities at War: Gender, Motherhood, and Politics in Britain and France during the First World War (Chapel Hill: University of North Carolina Press, 2014), 87.

51 mothers, but also in the active regulation of women’s behavior and consumption during pregnancy.117

In such domestic settings, women were seen as ‘innocent victims’ of military aggression, and silent supporters of the war effort. However, outside the home, Grayzel and others have argued that women were increasingly seen as threats to men—specifically, military men—and their physical health. During stressful periods, such as the First World War, when individual and gendered social roles were undergoing change and scrutiny, the risk attached to ‘abnormal’ behavior was increased. Women’s inability to adhere to wartime gender norms was not only seen as ‘unhealthy,’ but as a threat to the war effort. Grayzel has highlighted the use of the

Defense of the Realm Act “to legislate the behavior of women with reference to immoral behavior and prostitution”, sanctioning the imprisonment of women thought to be prostitutes, who might tempt and infect soldiers.118 Fears of this ‘behavior’ only intensified as the war continued, leading to further legislation and intrusion into women’s lives. For example, Laura

Lammesniemi’s research into Regulation 40D, an amendment to the Defense of the Realm Act which allowed the state to remand and imprison women for transmitting venereal disease to a member of the British armed forces, demonstrates how the state “empowered magistrates to conflate chastity and patriotism and thereby control women’s sexuality in the name of national security.”119 Such laws codified and solidified the idea that women outside the home, and in positions of comparative power on the home front, posed a danger, not only to the military, but to society in general. Indeed, it was this ambiguity over women’s roles, intentions, and influence

117 Grayzel, Women’s Identities at War, 87-8. 118 Susan Grayzel, “The Enemy Within: The Problem of British Women’s Sexuality during the First World War” in Women and War in the Twentieth Century: Enlisted with or without Consent, edited by Nicole Dombrowski (New York: Taylor and Francis, 1999), 72. 119 Laura Lammasniemi, “Regulation 40D: punishing promiscuity on the home front during the First World War”, Women’s History Review 26:4(2016), 585.

52 on society that made them such a focus of government, media, and social attention during the war, and has helped to focus historians’ gaze on the debates that swirled around their actions and activities.

What is lacking from this historiography is a consideration of the emotional toll that the war took on women as individuals. During the war itself, representation of women as civilians, and therefore exempt from the immediate danger of war, also made it politically contentious to discuss their trauma publicly. Women’s breakdown as a result of war trauma reflected the failure of the state to provide adequate protection for civilians on this new home front, and threatened to lower morale, both at home and at the front. The First World War was a critical time for the advancement in the understanding of mental trauma and psychological suffering, but it is imperative to understand whose trauma, whose pain, and whose experiences were valued — and what the implications were for those who were left out of such studies. Ultimately, the representation of women in wartime, as non-combatants, as supporters of heroic combatant men, and as gendered bodies within a strictly controlled patriarchy all affected the ways that their mental health was understood, and how their pain was heard and respected.

Women who were treated in public asylums on the home front entered a medical system that had existed for centuries in Britain, and was structured to reinforce patriarchal ideology and forms of knowledge. Though the Lunacy Act of 1890 attempted to make it more difficult to commit private patients to asylums, it did very little to change the process of incarceration for paupers. Those who could not pay for treatment were forced to apply to the Poor Law authorities in order to secure treatment, instantly creating a classist and patriarchal relationship between doctors and patients. The problems inherent in such relationships surface in case notes, particularly where doctors use pejorative terms and expressions to describe a patients’

53 appearance, educational level, or ability to communicate. Even when read “against the grain” for information about the patients and their subjectivity, one encounters the patriarchal control exhibited over women, especially those who were deemed mentally abnormal. Facts about the patient and the behavior that led to her incarceration were often relayed through the husband, a child, a nurse, or a neighbor, in the “Statement of Particulars” required by law for anyone petitioning to have another person admitted to an asylum. These testimonies offer insight into the patients’ life experiences and behavior prior to admission. Usually, the reasons provided at committal were directly related to women’s ability to live up to social and cultural expectations; phrases such as “she will not do as she is told” and “she is entirely self-centered” are utilized regularly. No discussion of mental conditions, psychological theory, or scientific reasoning is provided in the diagnoses or subsequent notes.120

As Joseph Melling and Bill Forsythe point out, “gender differences…figured in the curative regime of the asylum”.121 Once a woman was committed, the asylum itself functioned to control her by rewarding socially acceptable behavior, including deference to doctors, remaining quiet, and exhibiting industriousness in assigned work in the kitchens or laundry.

Male patients, in comparison, were generally expected to take part in activities that would allow them to re-enter the workforce upon their release, and were encouraged to take part in gardening and sports such as cricket in order to build up their strength and endurance.122 The emphasis on

120 According to the British Medical Journal, in a 1906 article discussing the Seventeenth Annual Report of the Asylums Committee, “Owing to the different methods of classification of the forms of mental disorder adopted by the various medical superintendents it is not possible to summarise the returns made under this heading [etiology] with any approach to accuracy, and we shall, therefore, not attempt the task.” This sentence indicates the extent to which diagnostic terms were non-standard, and therefore, unreliable. (“Lunacy in London”, British Medical Journal, 2:2393 (1906): 1311. 121 Joseph Melling and Bill Forsythe, The Politics of Madness: The state, insanity and society in England, 1845- 1914 (London: Routledge, 2006), 130. 122 Helen Goodman, “‘Madness and Masculinity’: Male Patients in London Asylums and Victorian Culture” in Insanity and the Lunatic Asylum in the Nineteenth Century, edited by Thomas Knowles and Serena Trowbridge (London: Pickering & Chatto, 2015), 151.

54 preparing men for release is also an indication of the influence of gender on the understanding of madness. Men were generally understood to be temporarily afflicted by symptoms, and could be cured by re-asserting their masculine control over their emotions and body. Women’s symptoms were generally assumed to be inherent and chronic.

In cases where patients could not learn to act “cheerful”, or work quietly, the potential for release significantly diminished over time, especially if they did not have family advocating for them outside of the asylum. Behavior that was perceived as deviant, including loud talking, refusal to work, or stubbornness, was punished with physical isolation, and renewed observation by doctors and staff. Such behavior was presented in case notes as a symptoms of a patients’ diseased psyche, and rationale for further treatment within the asylum. Remaining in the asylum carried dangers of its own. Asylums were sites of contagion and disease, which posed particular threats for the elderly and already-infirmed. Moreover, the asylum itself posed a threat to the mental health of those forced to remain inside it. As one senior hospital medical officer noted,

“life in the asylum” could cause patients “to become institutionalized and detached from reality”, as their world and social interactions shrank to the interior of the asylum.123 This process can be noted in the records by a patient’s emotional withdrawal, disinclination to converse with doctors, and inability, or unwillingness, to measure their time within the asylum. At this point, doctors often noted that patients were “weak-minded”, further justifying their continued incarceration.

The result for some of these patients was death by pneumonia, phthisis, or bronchitis, but many lingered on for years in the asylum, outliving their doctors as well as the family and friends that affected their incarceration.

123 London Metropolitan Archives (LMA), CLA/001/B/01/029, City of London Mental Hospital [Later Stone House Hospital], Patient Records, Female Case Books, 1913 Jul – 1927, Letter inserted in record, dated 13th June 1980.

55 By the outbreak of the First World War, most of these hospitals were also operating at, and usually over, capacity. Conditions were poor, food was extremely basic, and due to understaffing, patients were often restrained to their beds as punishment and to ensure their personal safety. Conditions further deteriorated as a result of the war. Understaffing was a regular occurrence in public hospitals and asylums in Britain and Ireland during this period, as men and women alike departed to enlist. Indeed, several asylums noted that, according to regulations, they did not have enough staff to function according to regulations.124 Furthermore, the designation of several London public hospitals as War Hospitals meant that the patients normally housed there had to be moved to accommodate military patients. This was the case with Horton Hospital, which was taken over by the Army in 1915, displacing its 2,143 inmates.125 It fell to the other London Hospitals to find room for these patients, which only added to the overcrowding. As the Superintendent’s notes at Bexley Hospital revealed, in July

1915, after taking in some three hundred men and women from Horton Hospital, “the number of total patients now resident in the Asylum is 2544, comprising 1289 males/and 1255 females. As the total accommodation in the Asylum is estimated for 2198 patients, the excess now amounts to 346.”126 In order to accommodate these patients, men were housed in the visiting room, and women were placed in the day rooms and laundry rooms.127 Housing became such a critical issue during the war that the Asylums and Mental Deficiency Committee, founded in 1889 to oversee all of the City of London’s Asylums, decreed “the London County Asylums shall be

124 LMA, H65/A/01/004, Bexley Hospital, Medical Superintendent’s report book, 1914-1916. 125 Horton was originally built to accommodate 2,000 patients, further demonstrating the extreme over-crowding taking place in asylums at this time. 126 LMA, H65/A/01/004, Bexley Hospital, Medical Superintendent’s report book, 1914-1916. 127 Ibid.

56 deemed to be full,” except for cases of “acute insanity or cases of chronic insanity which are urgently in need of asylum treatment and cannot be dealt with otherwise.”128

Patients and staff were not spared the stress of war, either. For those hospital staff left behind, asylum work was physically demanding, not to mention, as the British Medical Journal observed, “monotonous, and, when taken as seriously as it ought to be, is distinctly trying”.129

Food shortages were frequent, difficulties in securing sufficient amounts of coal and other fuel within the hospitals’ budgets were considerable, and the fear of air raids became constant after

1915. With such strained resources, the entertainments usually scheduled for patients and staff had to be cancelled, adding to the drudgery of day-to-day life experienced by everyone within the asylum. Superintendents’ records and inter-hospital communications paint a picture of asylums as loud, crowded, and stressful spaces that were hardly conducive to rest or healing for women who were recovering from war-related trauma. However, despite all the changes that were taking place within such asylums over the course of the war, the ways in which doctors treated civilian women’s conditions did not change in noticeable ways during this period.

Though they may have noted the effects the war had on women, traditional assumptions about women’s mental health and susceptibility to breakdown continued to inform treatment. Doctors routinely misapprehended women’s outbursts and disruptive behaviors as the source of disorder, rather than an indication of a wider, more systemic, problem.130 Susan Bordo has explained that

“the psychopathologies that develop within a culture, far from being anomalies or aberrations, to be characteristic expressions of that culture; to be, indeed, the crystallization of much that is

128 Ibid. 129 “The Asylum Service of the London County Council”, British Medical Journal, 2203:1 (1903): 682. 130 As Anna Harpin notes, this framework echoes Sara Ahmed’s thinking around the ‘feminist killjoy,’ who, she writes, “is usually the one who is viewed as ‘causing the argument,’ who is disturbing the fragility of the peace.” In such cases, she observes, “The exposure of violence becomes the origin of violence.” (Anna Harpin, Madness Art and Society: Beyond Illness (New York: Routledge, 2018), 141; Sara Ahmed, The Promise of Happiness (Durham: Duke University Press, 2010) 65 & 68).

57 wrong with it.”131 Building on this understanding, I, like Anna Harpin, find “acute sociocultural critique in women’s apparently pathological behaviors.”132 Such investigations, however, require deep investigation into patients’ lived experiences. Patients’ life histories were frequently discounted or overlooked—the mind/body connection that we understand today was a result of studies of men in combat during the First World War. As a result, even when women’s breakdowns were directly attributed to events related to the war, doctors generally refused to adjust their diagnoses or treatment. Though it is impossible to declare that all patients whose case notes will be analyzed below were not coping with a psychological or neurological case that may have benefitted from medical intervention, the fact that women and their families recognized the war as a cause or contributing factor of mental distress and decline must be acknowledged. The rest of this chapter will investigate specific instances of women’s war trauma, and the treatment they received in asylums to emphasize this point.

Traumatic Grief and Worry

In December 1914, a fifty-eight-year old woman whose initials were MC was admitted to

Dublin’s Richmond Lunatic Asylum, suffering from an attack of “melancholia”. According to her admission papers, her condition had been brought about by “shock resulting from information that her last hope, lasting 2 months, of seeing her dead son would never be fulfilled, as the saving of the submarine in which he was lost had been abandoned.”133 Her son was a crew member on the HMS A7, which sank in a training accident earlier that year, with the loss of the entire crew (and to this day, the wreck remains a protected site, as it proved impossible to raise).

131 Susan Bordo, Unbearable Weight: Feminism, Western Culture, and the Body (Berkeley: Unviersity of California Press, 2008), 141. 132 Harpin, 140 133 National Archives of Ireland, PRIV1223/5/28/C1-C12

58 The circumstances of this woman’s treatment in the asylum posit her grief over the loss of her son as a medical condition that necessitated incarceration, away from the rest of her family. Her words are not recorded in her case notes. Instead, it is another son who speaks for her, removing, or at least challenging her subjectivity in her own narrative. Her case notes remain a testament to the ways in which traumatic grief was viewed during the First World War.

The First World War thoroughly and permanently disrupted public and private Victorian mourning rituals.134 The sheer number of families suffering bereavement during this time lessened the power and significance of mourning clothes, and women engaged in war work were unable to vary their habits enough to accommodate traditional mourning dress and customs.135

As a result, as Sarah Tarlow and Pat Jalland both argue, the war accelerated a shift in mourning practices away from the flamboyant to the “intensely personal”, leading to “minimal public expressions of private grief”.136 But while these practices may have grown less visible, demonstrative, or time-consuming as a result of the war, their importance within society remained significant. Lucie Whitmore has described how mourning dress provided an immediate visual symbol of a war widow’s changed status, or of a family’s loss.137 David

Cannadine has shown how obsession over memorializing and commemorating the dead in the postwar helped assuage the grief and loss of families across Britain.138 Essentially, mourning

134 Lou Taylor, Mourning Dress (London: George Allen & Unwin, 1983), 266; Geofrrey Gorer, Death, Grief & Mourning in Contemporary Britain (London: The Cresset Press, 1965), 6; Valerie Mendes & Amy de la Hay, 20th Century Fashion (London: Thames & Hudson, 1999), 269. 135 See Geofrrey Gorer, Death, Grief & Mourning in Contemporary Britain (London: The Cresset Press, 1965). 136 Sarah Tarlow, “An Archeology of Remembering: death, bereavement and the First World War”, Cambridge Archeological Journal, 7:1 (1997), 105; Pat Jalland, “Death and bereavement in the First World War: the Australian Experience”, Endeavour, 38:2 (2014), 70. 137 Lucie Whitmore, “‘A Matter of Individual Opinion and Feeling’: The changing culture of mourning dress in the First World War,” Women’s History Review, DOI: 10.1080/09612025.2017.1292631. 138 David Cannadine, “War and death, grief and mourning in modern Britain” in ed. Joachim Whaley, Mirrors of Mortality: Studies in the Social History of Death (New York: St. Martin’s Press, 1982), 187-242.

59 practices established a code of acceptable behavior in the wake of death. Though the standards evolved over time, their power remained.

At the outbreak of war, posters and advertisements aimed at women used themes of maternal sacrifice, stoicism, and devotion to the war effort, encourage (or shame) women into

“giving” their sons to the nation via enlistment, and to focus public energy during times of increasing danger and uncertainty. The mobilization of motherhood can be seen in newspaper articles that encouraged women to send their sons “Cheerfully on their way and enter fully into their enthusiasms.”139 Mothers who were seen to be holding their sons back from enlistment were portrayed in propaganda campaigns as both selfish and emasculating. For example, a

British recruitment poster (which also appeared with slightly different wording and color scheme in Canada and Australia) was addressed “To the Women of Britain.” The poster contained four questions regarding the highly publicized (and highly sexualized) violence against Belgian women by the invading German army, and stating “that the safety of your home and children depends on our getting more men NOW.”140 The final question on the poster asks women

“When the War is over and someone asks your husband or your son what he did in the great

War, is he to hang his head because you would not let him go?”141 Such propaganda played— and preyed—on women’s social roles as wives and mother to achieve the state’s need for more manpower.142 Moreover, it also served to provide guidelines and incentives for women regarding their expected behavior in wartime.

139 “The Call to Arms”, Evening Standard, Aug. 26, 1914. 140 Imperial War Museum (IWM), PST 11675, “To the women of Britain…” London : Parliamentary Recruiting Committee, 1915. 141 Ibid. 142 Suzanne Evans, Mothers of Heroes, Mothers of Martyrs: World War I and the Politics of Grief (Montreal: McGill-Queen’s University Press, 2007), 78.

60 As in the sending of their sons to war, women’s public displays of grief and mourning were also shaped, controlled, and dictated by the needs of a state at war. Bereaved women, as

Claudia Siebrecht has observed, occupied—and continue to occupy—a prominent place in the social and cultural environments of wartime and post-war societies.143 During the First World

War, new mourning practices and rituals ensured that the needs of the state were not overshadowed by personal emotional ties. Instead, wartime societies co-opted women’s displays of grief, transforming them into emblems of the nation’s grief in posters, monuments, and books.

Thus, the portrayal of stoic, brave mothers became the standard to which individual women were held.144 Though practices and displays of grief may have varied according to class, location, or ethnicity, women, especially mothers, were expected to meet the news of loss of male relatives, particularly sons, with endurance, their grief tempered by patriotic pride. Dr. William Graham, resident medical superintendent of the Belfast District Lunatic Asylum, noted in a 1914 address:

When the first onset of grief is past and nature has taken her due toll of pain and tears, a noble pride will still the heart to endurance, pride that it was given to a kinsman to lay down his life, a freely willed sacrifice, for his land and people. As Shakespeare says, “We must all pass through nature to eternity,” but the manner of our passing affects those left behind…and the memory which such a man leaves behind…is potent enough to turn their last despair into a glad and gracious peace.145

Essentially, women were expected to “sacrifice” their sons and husbands to the war effort, making these family members the property of the state. To reclaim their children in death through excessive grief threatened to disrupt the war effort by demolishing the imposed barrier between ‘civilians’ and ‘soldiers’. Women who could embody such a reaction were rewarded with respect, political recognition, and financial compensation for their child’s death. Those who

143 Claudia Siebrecht, The Aesthetics of Loss: German Women’s Art of the First World War (Oxford: Oxford University Press, 2013), 12 144 Grayzel, Women’s Identities at War, 227. 145 “War and Mental Diseases”, Belfast News-Letter, August 6, 1915.

61 were unable to perform their expected duties because of their emotions disrupted their home lives and also threatened the larger needs of the state in wartime.

To be clear, excessive grief was recognized as a medical diagnosis before the war, though it would be nearly three decades before Erich Lindemann’s “Symptomatology and Management of Acute Grief” provided the language to discuss the needs of those suffering from debilitating grief.146 However, it is a diagnosis that has always carried political, social, and class-based assumptions and ramifications. Moreover, Freud’s notions of a “normal mourning period” being

“from one to two years” was based on Victorian notions of bereavement for a close relative—an inherently middle and upper class tradition.147 For less wealthy women, time, money, and public opinion all limited their acceptable forms of expression, and the interpretation of their overall mental health. While more wealthy women had the time and resources to go to private hospitals, or to perform artistic or charitable work in their children’s names, lower class women were often sealed off from access to outlets for their emotions. For them, there were few other options than the asylum.

How, then, was this grief presented? During the war, I argue, women’s grief first became

problematic when it disrupted, on a small scale, their domestic lives. For example,

women’s debilitating concern and distress over their male relatives’ well-being were

frequently perceived as detrimental to their familial obligations, as well as their social

duties. Upon admitting his wife to Dublin’s Richmond Asylum, a man listed his wife’s

symptoms as “Listless in manner, inattention to household duties which required looking

146 Erich Lindemann, “Symptomatology and Management of Acute Grief,” American Journal of Psychiatry, 101 (1944), 141-148. 147 Susan Bennett Smith, “Reinventing Grief Work: Virginia Woolf’s Feminist Representations of Mourning in Mrs. Dalloway and To the Lighthouse”, Twentieth Century Literature, 41:4(1995), 318 (310-327).

62 after and nervous anxiety of matters of little account…careless in dress…”148 It was only

mentioned in passing by the husband (who was the woman’s second husband) that “there

is also a son of her in the Army at present” that was the primary cause of her

preoccupation and worry.149 Another woman who had lost children was admitted to the

Asylum because “she sits up in bed talking incessantly and wandering from one subject

to the other.”150

On the large scale, women’s individual grief similarly disrupted their public role as a stoic, patriotic mother, and their relationship with the state to whom they sacrificed their son.

And to emphasize, the burden of grief was very much one that lay with the mother. Though this is not to imply that the death of a child did not affect men, it is also true that women’s behavior was policed independently from their husbands, as can be seen in the example of ES, a fifty-eight year old woman who was admitted to the City of London Mental Hospital by her husband, who stated that she had been suffering for the past fourteen months with “shock from loss of her two sons in the War.”151. According to notes made at the time of her admission, ES “has auditory hallucinations and the voice says ‘don’t you believe it’. She is also deluded. For instance, she talks to the Kaiser and has promised him not to strike back”.152 According to her husband, she had been exhibiting signs of depression since hearing about her son’s death in combat and had

“been unmanageable for two days and refuses food and medicine.”153 Throughout her case notes, the emphasis on her role, her identity, and her failure as a mourner is hers, and hers alone.

The sons, whose loss caused her such anguish, are described as hers, even in the section devoted

148 National Archives of Ireland (NAI), Richmond Asylum Case Notes, PRIV1223/5/28/C46-63. 149 National Archives of Ireland (NAI), Richmond Asylum Case Notes, PRIV1223/5/28/C46-63. 150 LMA, CLA/001/B/01/021, City of London Mental Hospital [Later Stone House Hospital], Patient Records, Female Case Books, 1915 Jun – 1916 Dec. 151 LMA, CLA/001/B/01/023, City of London Mental Hospital, Patient Records, Female Case Books, 1918 Oct – 1920 Jan. 152 Ibid. 153 Ibid.

63 to her husband’s testimony. Census records show that she and her husband had been married approximately thirty-four years, and that both the sons referenced in the case notes were born after their marriage.154 Nevertheless, her husband is an outlier in the record. His emotional and familial burden extends only to suffering his wife’s symptoms of grief, and the burden he undertook in caring for a woman who was “unmanageable.”155

Although doctors described her as “noisy and incoherent in her conversation”, it is possible to consider another reading. Her speaking directly to the Kaiser in her talk not only oversteps her boundaries as an individual, and a lower-class woman, but also challenges the authority of the state by confronting the head of state of a enemy power. Moreover, one wonders if her words to the Kaiser are a kind of bargaining: if she promised “not to strike back,” might her dead son might be returned to her? It is only recently that scholars and medical professionals have begun to explore a richer and more nuanced explanation for “voice-hearing,” like the kind that was reported in ES’s case. As Angela Woods explains, voice-hearing is very much an interpersonal experience, that reflects relationships around the patient and is

“fundamentally constituted through a network of social relations.” Though doctors largely saw

ES’s voice-hearing as proof positive of her madness, there is also the potential to hear the voice saying “Don’t you believe it” as an expression of her deepest desire to have her son restored to her; of how thoroughly her world had been destroyed by the message that her son was no longer present in it. Without a grave to visit, or a body to mourn, it must have been almost inconceivable to accept that her child was gone. Doctors consistently referred to ES as “frail” or

154 Census Returns of England and Wales, 1911, Kew, Surrey, England: The National Archives of the UK (TNA), 1911. 155 LMA CLA/001/B/01/023.

64 in “poor health,” in their notes, describing her as a mental and physical invalid.156 Nevertheless,

ES survived in the City of London Mental Hospital until well after 1930. She never left the asylum, however. To what extent she was ever able to understand, rationalize, or heal from the loss of her children and the life she had before her admission, is unknown.

There were many women who were unable to bear the burden of this pain, or to express the emotions expected of them. The traumatic grief they express is deeply personal, often describing a loss of identity and self-perception that goes beyond language, or beyond thought of appropriate behavior. Take, for example, the case of KB, a patient who was brought to the asylum by her daughter and son-in-law as a result of “grief at loss of son [who appears to have been named Richard] and illness of husband [who apparently had incurable cancer].”157

According to the statement of particulars, in which the witnesses attested to the patients’ behavior, it was noted that “She is fidgety and nervous—very agitated…Keeps on telling me of her son’s death and that since she can do nothing never will read or hear any music, which she was exceptionally fond of…tells me she is disfigured by her loss of hair.”158 Later, the doctor noted that KB herself “tells me that she cannot go out on account of having lost her hair (she wears a wig and is quite presentable).”159 Grief like this is not the kind that can be rendered in recruitment posters or fashioned into statues on which others can inscribe their grief. KB’s losses are destabilizing her identity, and, in her case notes, we can see her personally unwinding, forsaking the music and literature she once loved, and focusing on the hair, another tangible form of loss. This loss appears to have rendered her as something unpresentable in her own mind, her appearance a physical manifestation of her inner turmoil. Although doctors noted that she was

156 LMA CLA/001/B/01/023. ES survived in the asylum until well into the 1930’s, by which time she had become institutionalized and incapable of leaving. 157 LMA CLA/001/B/01/023 KE Ballard [March 9 Folder 2, DSCN5982] 158 Ibid. 159 Ibid.

65 “depressed”, they further noted “she had various hypochondriacal ideas, saying that her heart and uterus are displaced.”160 One wonders how much of this complaint was physical, and how much was related to her grief. She was removed from the asylum after three weeks by her family, after doctors noted that she was “Quiet and well behaved.”161 Indeed, “healing” in this sense is very much gendered, as well. Patients who could embody acceptable gendered behavior—in this case, being ‘quiet and well-behaved’—could be released.

Though the experience of grief and worry was not a new one, the changing relationship between civilian women and the state changed the context in which women’s emotional reactions to the loss of their children and husbands was perceived. Women were expected to

“sacrifice” their sons and husbands to the war effort, as emphasized by propaganda, political publications, and even medical officials. To reclaim their children in death through excessive grief threatened to disrupt the war effort by demolishing the imposed barrier between ‘civilians’ and ‘soldiers’. Further, by becoming unable to perform their expected duties because of their emotions, women also disrupted their home lives, and contradicted traditional gender performances. In the case of women whose grief was pathologized, their condition was often a lifelong one. With their emotional reactions treated as chronic symptoms of their poor mental health, women were fixed forever, both within the pages of an asylum case book, and within the grief that they were unable to escape.

Air Raids and ‘Air Raid Shock’

In February 1916, a fifty-two-year-old woman, MW, was brought to St. Luke’s Hospital in London by her husband, who stated that she “has not had a lucid interval for a week, will not

160 Ibid. 161 Ibid.

66 undress at night goes to bed in her boots, ready for a Zeppelin raid. Will not take her meals.

Harks on above ideas all day long.”162 Doctors noted that “during the air-raid on Dec. 13th she became greatly alarmed and not been the same since. She refused to take off her clothes at night for fear there would be another. She has steadily for worse (sic) and has been almost impossible to manage during the last fortnight.”163 Despite her frequent references to her fear of air raids and her statement that she believed “The Germans will kill everybody,’ doctors generally relied on her family history, noting that “Mother was insane before she died. One brother died of epilepsy.”164 MW remained at Saint Luke’s for approximately six months, when she was released on trial. They declared her “Recovered” in November, citing the fact that she “appears to have managed the house quite well.”

MW’s experiences serves as a reminder that the “Home Fronts” of the First World War were sites where civilians were subjected to the violence and danger of war in many ways identical to soldiers on the battle front. Advancements in aerial weaponry and transport led to the first air- raids, which were intended to destroy supply lines and damage morale, both among the civilian targets at home, and the soldiers at the front. For those living in London, air raids began in

January, 1915, and continued sporadically until May, 1918, with German airships and Zeppelins conducted over 50 bombing raids on the United Kingdom. While these raids were not terribly successful in terms of destroying military sites, they caused enormous destruction to residential and community areas –– and caused an enormous amount of emotional trauma to those who

162 LMA, H64/B/06/015, Saint Luke’s Hospital [Woodside Hospital], Patient’s Records: Case Books, Case Book: Arranged Alphabetically by Surname (not duplicate), 1912-1916. 163 Ibid. 164 Ibid. Doctors also relied on traumatic injury to MW’s brain, noting that “pt. fell backwards and rec’d concussion of brain about 10 years ago and bad double vision for at least 3 mos afterwards. Any vibration such as driving in a trap without rubber tyres would give her a bad headache.”

67 were forced to endure them. For those on the ‘home front’, homes, city streets, and work places became another front in a global war.

The staggering losses and physical damage wrought by the air raids and fire-bombings of the Second World War have come to overshadow the experience of the First World War.

However, recently, historians have turned to the “First Blitz”, in order to understand public responses to the second generation of air raids and postwar civil defense measures that were intended to protect civilians in the future.165 Such studies emphasize the enormous changes that air raids wrought in people’s daily lives, as well as the ways in which citizens’ relationship to the state changed. With the home front now a site of battle, it was vitally necessary for morale that the state be shown as protecting innocent civilians from harm, and for civilians in turn to remain optimistic about their chances for survival against such aerial attacks. Susan Grayzel has discussed how public condemnation of German bombing campaigns emphasized the remarkable resiliency of the populations who survived them.166 Where suffering was publicized, it was to highlight the death or maiming of the most ‘innocent’ victims, especially children and the elderly, in order to drive home the image of the German ‘barbarian’. Jerry White points out the many ways in which “normal” life changed for civilians, particularly in London, where the intense darkness of anti-air-raid blackouts caused disorientation, even for those who were natives to the City.167 However, he also emphasizes the consistent attempts, particularly of Londoners, to maintain normalcy and to engage in increasingly diverse kinds of ‘war work’ to show their

165 For the use of the term “First Blitz”, see Neil Hanson, First Blitz: The Secret Plan to Raze London to the Ground in 1918 (London: Doubleday, 2008) and Andrew Hyde, The First Blitz: The German Bomber Campaign Against Britain in the First World War (Barnsley: Pen and Sword, 2014); For the history of air raids on civilian populations, see: Stéphane Audion-Rouzeau and Annette Becker, 14-18: Understanding the Great War, trans. Catherine Temerson (New York: Hill and Wang, 2002), Susan R. Grayzel, At Home and Under Fire: Air Raids and Culture in Britain from the Great War to the Blitz (Cambridge: Cambridge University Press, 2012), Susan R. Grayzel, “’The Souls of Soldiers’: Civilians under Fire in First World War France”, The Journal of Modern History, 78:3 (2006), 588-622, Jerry White, Zeppelin Nights: London in the First World War (London: Vintage Books, 2014). 166 Grayzel, At Home and Under Fire, 25-63. 167 White, 118-9.

68 patriotism and dedication.168 Stories of suffering and pain were focused on enlisted men, where the “real” dangers of war were allegedly to be found.169 As previously noted, the historic focus on collective groups tends to obscure the real strain, fear, and trauma that air raids caused individuals on the home front. As Stéphane Audion-Rouzeau and Annette Becker rightly observe, “the war against civilians, the civilians’ war, was in itself a genuine war,” and the emotional and psychological effects of that war were very real, too.170 Considering the emotional expressions of women traumatized by air raids helps bring these effects to the forefront, and drive home the stressful, even overwhelming lived experience of the home front for many who were unable to leave urban areas during the war.

Women on the home front, like soldiers, were expected to “appear calm and unconcerned in the midst of danger,” even as their day-to-day schedules social interactions, and even fashions were affected by the threat of air raids.171 Curfews and blackouts limited women’s ability to move around the city, and proved disorienting for many who relied on the lights in London to navigate. As Mary Coules, the daughter of a news editor at the Reuters Press Agency, noted in her wartime diary, the city she in which she had grown up was rendered unfamiliar and oppressive by the omnipresent threat of air raids:

We dreaded going home…for we had heard that London was so depressing and sad. All the lights were lowered and the streets practically dark, for fear of the Zeppelins. I shall never forget the first time I ever saw the stars above Picadilly’s; ordinarily the lights are so bright that it is impossible to see them. There were searchlights, too, sweeping the sky

168 White, 144. 169 This behavior would appear to be in direct contrast to the tendency in Germany, where, as Belinda Davis points out, women on the home front saw themselves in a ‘war’ against food shortages, man-made hunger, and deprivations, apart from, and as a result of, the war being fought on the battle fields: Belinda Davis, Home Fires Burning: Food, Politics, and Everyday Life in World War I Berlin (Durham: University of North Carolina Press, 2000). It is also interesting to note that, as a way to keep up morale, those serving at the battle field often discussed the suffering of—and danger to—civilians—as greater than their own. 170 Audion-Rouzeau and Becker, 58. 171 Dr. W.H.R. Rivers, Instinct and Unconscious, (Cambridge: Cambridge University Press, 1920), 218.

69 in great circles—and on the top of the Gresham College, at the back of Daddy’s office, there is an aeroplane gun.172

Even inside the home, air raids were omnipresent fears, with physical precautions against fire and gas serving as constant reminders of the threat. Newspapers advocated that civilians keep water and sand on hand to help themselves, as no aid could be given during periods of intense danger. According to a notice placed in the Dover Express,

In all probability if an air raid is made it will take place at a time when most people are in bed. If the aircraft is over a town or village, no alarm will be sounded as it would warn the enemy of the proximity of a town or village which otherwise might be passed with without damage…In many houses there are no facilities for procuring water on the upper floors. It is suggested therefore, that a supply of water and sand might be kept there so that any fire breaking out on a small scale can be dealt with at once…All windows and doors on the lower floors should be closed to prevent the admission of noxious gases [sic]. An indication that poison gas is being used will be that peculiar and irritating smell may be noticed following the dropping of the bomb.173

Simiarly, newly fashionable pyjamas were advertised for women as a safety precaution for women, to make it “convenient to be able to run out into the street at all hours” in case of an air raid.174 Such safety measures were intended to inform the public, and thus assuage their fears of the unknown. Nevertheless, the acknowledgement that air raids victims were expected to defend themselves reflected the failure of the state to provide adequate protection for civilians.

Admitting that women were psychologically affected by air raids would expose such failures, and threatened to lower morale, both at home and at the front, where soldiers eagerly awaited news from home. As such, media reports emphasized civilians’ resilience in wartime. When discussions of “air raid shock” were permitted, they often focused on children and the elderly,

172 IWM, Department of Documents, 97/25/1, Private Papers of Ms. M Coules. 173 “Notice to the Public in the Event of Air Raids,” Dover Express, July 2, 1915. 174 “Pyjamas from France,” Yorkshire Evening Post, August 16, 1915. See also Lucie Whitmore, “Boudoir Caps & Zeppelin Nighties: How fashionable women dressed for air raids in the First World War,” Twitter feed: https://twitter.com/LucieWhitmore/status/951771143194796032, accessed March 10, 2018.

70 like MW, whose contributions to the war effort were minimal, and whose propaganda value was high. Even in such cases, however, doctors tended to rely on women’s personal history and eccentricities to diagnose their symptoms, minimizing the effects of the war on their condition.

Case notes demonstrate, however that “Air Raid Shock” affected far more than the young and the very old. Women from a wide range of ages were admitted to asylums with symptoms of trauma related to their experiences of air raids. While some of these women lived in areas directly impacted by the bombs, many lived outside of immediate danger. Nevertheless, their symptoms and expressions of psychological strains emphasize the fear that had become a part of daily life on this new front of the war . The fear of attacks, increased by German propaganda as well as the British press, placed strain on all those living in the path of the German air ships and

Zeppelins. For example, in October 1915, a resident of Westcliff was admitted to St. Luke’s

Hospital, having been ill for about ten days due to the combined strain from the “illness of sister and Zeppelin Raids”. The raids referred to in the notes took place in May of 1915, when some eighty bombs were dropped over Southend and Westcliff. These raids caused extensive residential damage, much of it less than two miles from the patient’s house. According to The

Globe, “Almost every part of the town appears to have been bombarded”, while the Daily Mirror observed that the “night sky was illuminated by the lurid glow of the conflagrations”.175 It was also reported that “the visiting Zeppelins…dropped a message with the words— “You English, we have come, and will come soon again.”176 For those suffering mentally and physically as a result of the raid—and those whose homes had been destroyed—the news that further air raids were imminent could only have added further stress to their attempts to resume a semblance of

175“Raiders’ Route”, The Globe, May 10, 1915; “Zeppelin’s Trail of Death, Fire and Damage in Raid on Southend”, Daily Mirror, May 11, 1915. 176 “We Will Come Again”, Sunday Post, May 30, 1915 .

71 daily life. Those fears were realized three weeks later when another air raid struck Southend and

Westcliff, though without causing nearly the same level of damage.

For the patient from Westcliff, the strain of living under air raids and the threat of future stress was evidently overwhelming; the behavior described by her family was consistent with attempts to escape. According to her sister-in-law, “[the patient] sprang out of bed, tried to break a window.”177 She further had to be restrained “for 3 hours to prevent her doing damage to herself and others”, and was “continual[ly] talking and rambling on little else but religious subjects.”178 Doctors dutifully recorded her words quoting her as saying, “I am making terrible faces, but Jesus says it is wartime, but I daren’t show my faces it is coming now”.179 However, rather than trying to parse this phrase (and the suggestion that the patient may have been aware of, and disturbed by, her own abnormal behavior), her doctor instead focused on the fact that one of her sisters “had been certified in an institution, but is now well again…Two of her sisters that

I have seen present ‘stigmata of degeneration’. One is deformed.”180 The mere presence of this phrase in the case notes is a warning that the patient would not be receiving treatment based on her experience in the Westcliff air raids, but would instead be seen as a case of hereditary inferiority. This is born out in the notes in the patient’s personal history, where it is noted that

“present illness is ascribed to no definite cause”.181 She would remain at St. Luke’s until June,

1916, when she began to show “mental improvement”, evidenced, apparently, by her “playing draughts with another patient”.182 Here again, the concept of “healing” was one premised on gendered behavior and obedience to medical authority.

177 LMA, H64/B/06/015. 178 Ibid. 179 Ibid. 180 Ibid. 181 LMA, H64/B/06/015. 182 Ibid.

72 While the fear of air raids drove many families to leave the city, this was not an option for women who were employed in war-work, or did not have the financial resources to leave the city. This might very well have led to an increased feeling of entrapment by the bombs and the war in general. One such woman, AW, was a sixteen-year-old munitions worker from North

London, who was admitted to Colney Hatch Asylum in November 1915. Of her mental state, doctors recorded, “She states that she had been upset with the recent Zeppelin Raid…[which] impressed her with a feeling of terror and depressed her.”183 The raid referenced took place over the night of 7-8 September 1915, during which two German Zeppelins dropped bombs over

Cheshunt, Bermondsey, Rotherhithe, and New Cross. Census reports indicate that AW lived within a mile of bombing site with her widowed mother and grandmother.184 She was thus the main source of financial support for the family, which most likely made evacuation impossible.

AW remained in hospital until June of 1916, after doctors noted with apparent approval that she

“is conducting herself much better, quiet, cheerful”.185

Belgian refugees being housed in England also faced renewed symptoms of trauma from living through air raids without any option of leaving their temporary dwellings. The refugee experience was in itself traumatic for many; however, air raids often forced many refugees to recall their flight from their homes in graphic detail, and rehearse their traumatic memories anew. For example, CB, 47 years of age, and her husband, were Belgian refugees who found sanctuary with a family friend in London. Following the 1915 air raids, CB developed a number of troubling symptoms, including:

Delusions as to persecution, hearing voices and being pursued by some unknown persons. Previously she has been active and intelligent but now takes no interest and refuses to

183 LMA, H71/FH/B/01/02/002, Royal Free London NHS Foundation Trust, Friern Hospital, Patient Records, Sample of Case Notes of Patients Admitted to Colney Hatch Asylum, Friern Hospital, 1915-1916. 184 TNA, Census Returns of England and Wales, 1911, Class: RG14; Piece: 1108 (Microfilm 534 of 711). 185 LMA, H71/FH/B/01/02/002.

73 answer question and takes no note of what is said. During the night of 9th Nov and morning of today, had to be restrained in bed. The husband…states that she has been highly nervous and difficult to control for the past month and that she has had delusions of being pursued. On 8th Nov she tried to run away.186

CB refused to eat the hospital food, believing it to be poisoned. As a result, she was frequently tube fed and confined to her bed, punitive measures that could may have very well contributed to her feelings of entrapment and anxiety. Though doctors were dubious about her progress, her husband petitioned for her release in January 1916, stating that he, and the people with whom they were living, were “very desirous of giving her a change.”187 Her condition was listed as

“Not improved” due to her continual refusals to follow the doctors’ orders and to behave properly, rather than because of her symptoms.

The effects of air-raid related trauma were felt long after the air raids - and, indeed, the war itself - was over. Admission records to London Asylums show that “air raids” was noted as a primary cause of a female patients’ symptoms upon admissions well into the 1920s.188 Though men were not immune from being affected by air raids, they were usually provided as a secondary or tertiary cause, with alcoholism or trauma from their war service being provided as primary indicators of mental distress. But despite the fact that trauma related to air raids was a widespread and prevalent cause of incarceration in asylums, there is no indication that air-raid related trauma was treated with the same concern or immediacy that “shell shock” was. Instead, media reports and state propaganda insisted on the British public’s stoicism and emotional strength in order to sustain morale on both the home and the battle front. Women, particularly, were expected to embody such strength, and carry on with the work of supporting the war. For example, in 1918, a news report noted proudly:

186 LMA: H64/B/06/015. 187 LMA: H64/B/06/015. 188 For example, see LMA, LCC/PH/MENT/04/024, List of patients admitted, died and recommended for discharge, Long Grove Asylum, Jul 1916 – Dec 1925.

74 Wherever we go and to whomsoever we talk, we hear nothing but praise of the behavior of the women in the air raid of Whit Sunday night. I refer particularly to the women in public capacities such as Government clerks and telephone girls, who displayed the utmost coolness and resource; but the same must be said of the nurses in the hospitals, whose nerves are tried in a way that those of none other are; because they are responsible at the same time for those who are helpless under their care…They stand at their posts like the soldiers that they are, and brave and share every danger.189

However, when women did not or could not live up to such ideals, the comparison between women and soldiers failed. Those suffering the effects of air-raid-related trauma were treated in civilian asylums, where, despite the fact that their symptoms were war-related, their symptoms, fears, and testimony went generally unrecognized as part of the effect of the war on the home front.

Reality changed for those who endured the First World War. On the home front, the loss of beloved family members became a constant concern; day-to-day life became more dangerous; for those driven from their homes by war, life became a constant struggle to recover their lost identity. Yet, social mores and medical assumptions were slower to adapt to this changing environment, particularly when it came to the treatment of women. Women who were brought to asylums were not only judged by their inability to react in “appropriate” ways to the changes of war but, upon being brought to the asylum, were observed and treated according to strict and unchanging medical guidelines that still emphasized their emotionality and mental weakness.

Their attempts to define their own subjectivity was met with hostility and mistrust, doctor’s inability or unwillingness to connect women’s experience of war to their symptoms has helped to obscure the emotional toll that life on the home front took on the women who lived there. While medicine, including psychology, made a number of improvements and innovations over the course of the war for the betterment of their fields and patients, it was very rare that women who were not a part of the military establishment benefitted from these improvements. The next

189 “Women and Air Raids”, Linlithgowshire Gazette, June 7, 1918.

75 chapter will consider the traumatic experiences of another home front—namely, Dublin during the Easter Rising in 1916. Though many of the broader themes explored in this chapter, including how the emphasis on women’s emotionality obscured their testimony of trauma, the next chapter will also consider the specific cultural circumstances that made the experience of trauma in Irish society unique.

76

CHAPTER THREE: “She was in the midst of the Trouble area during rebellion of ’16”: Trauma on the Irish Home Front During the Easter Rising

“At a meeting of the committee of the Richmond Lunatic Asylum to-day it was stated that three women were admitted to the asylum during the rebellion. Their breakdown was due to fright. It is feared that a number of other people, both men and women, lost their reason during the rising.” (Belfast Newsletter, May 19, 1916)190

On May 20, 1916, a forty-four-year old Anglican woman, KM, was brought to Dublin’s

Richmond Lunatic Asylum. Her husband testified that for the past ten days, she “believed her husband wanted to poison her. Refused food.”191 Moreover, it would appear that KM had been seriously affected by the events of the Easter Rising. She and her husband lived approximately

500 meters away from Sackville Street, in a house to which they had only recently moved.192

Houses were leveled by fire, looting and artillery shelling, and though it would appear that KM’s house escaped destruction, the noise and chaos were no doubt near constant. According to her case notes, KM “was alone at the time” of the Rebellion, but that at some point in the aftermath, her husband had “threatened to put her out,” further increasingly her fears for her personal safety.193 Even after the formal end of the rebellion, mass executions continued until about three weeks before KM’s admittance to the asylum, and public retaliation on the part of the British government kept the violence of the Rebellion ever-present and inescapable.

When they attempted a physical examination on KM, doctors were surprised to see that, even in the warmth of May, she was wearing heavy under-clothing, perhaps out of persistent fear

190 “Motor Journey to Cork”, Belfast Newsletter, May 19, 1916. 191 National Archive of Ireland, Richmond Lunatic Asylum Case notes, PRIV1223/5/28/M1-/M14. These case notes were accessed by permission of Mr. Sean Tone, to whom I am enormously grateful. My gratitude, also to the archivists at the National Archives of Ireland, who were extremely helpful in helping me navigate these collections, and for offering emotional supporting during the often difficult process of researching these women’s experiences. 192 According to the 1911 Census of Ireland, KM and her husband lived on the other side of the Liffey. 193 Ibid.

77 that she would have to flee her home or that her husband would indeed “put her out.” Someone in the room, most likely the attending physician, noted conversationally that “she must be smothered” in so much clothing. To KM, who was convinced that her life was under constant threat, the remark was interpreted as a threat—that her doctors had determined that the only way to treat her was to smother her. Several weeks later, it was noted by the same physician that KM

“became very apprehensive and excited when I spoke to her. ‘Now what are you going to do to me?’ ‘Don’t kill me, please’. Whispers to the Nurse when she thinks I am not looking. ‘Is he going to smother me. [sic]’”194

Over the course of her 20-month stay at the Richmond Lunatic Asylum, KM appears to have suffered periods of anxiety and depression; she was described as “restless…Fidgets and looks around her apprehensively” and also as “quiet and depressed”.195 Though it was repeatedly reported that she did not take food well, or ate badly, she gained at least twenty-two pounds over the course of her stay, which may be more of an indication of the kind of sedentary lifestyle she was forced to live in the asylum than the amount of food she was consuming.196

Throughout her stay, she referenced her fears over the food in her home being poisoned, and of her husband, who she believed was the poisoner. In February 1917, she confided to her doctor that she “Thinks her husband excited her. He was very bad-tempered and threatened to put her out…Sometimes thinks he tried to poison her”.197 Despite her lingering fears over the doctors’ intentions towards her, her fear of returning home appeared to have been even greater. At one point, she is reported to have asked “Can’t you let me stay here?”198 Doctors, however, do not appear to have given credence to her fears or pleas. Instead, she was labeled “dull and

194 Ibid. 195 Ibid. 196 In June 1916, KM’s weight was given as 8 stone; by November 1917, it was noted that she weighed 9 stone 8lbs. 197 Ibid. 198 Ibid.

78 unintelligent.”199 She was released in January 1918 with the note that she was now “quiet and works.”200

In KM’s case notes, it is possible to see a number of broad themes that emerge from a study of the case notes of women admitted to the Richmond Asylum during the period of the

Easter Rising and First World War more generally. First is the fact that the Rising itself was a source of trauma for many women who were overwhelmed by its violence, and by fears for their own safety. In the spring of 1916, Dublin became at once a home front and a battle front, making it a unique site within the United Kingdom. As a result, negotiating relationships and day-to-day life proved overwhelmingly stressful for many, especially women and families with fewer financial resources on which to draw. Second is the ways in which doctors interpreted women’s expressions of suffering and performance of trauma. Doctors in Ireland had fewer connections to the sites of war and discussions of war trauma than those in Britain, and as a result, they appear to be even less willing to interpret women’s symptoms as related to the Rising or the wider war. Finally, in analyzing these case notes, I wish to show how emphasizing these women’s voices, witnessing their fears and concerns highlight aspects of the Easter Rising that have typically gone overlooked in the historiography of this period, and how these testimonies challenge traditional constructions and themes within the broader scope of Irish history.

The Easter Rising in Irish History

Briefly, the Easter Rising, which took place between April 26 – April 29, 1916 was an insurrection launched by Irish Republican Socialists with the stated goal of ending British rule in

Ireland and establishing an independent Irish Republic. Rebels managed to take large parts of

199 Ibid. 200 Ibid.

79 the city of Dublin and defend their position, despite being comparatively poorly armed and thoroughly outnumbered. The event itself was ultimately a failure, resulting in British reprisals, public executions of the Rising’s leaders and suspected accomplices, and some 3,500 arrests.

However, the drawn-out and highly public nature of the British military response, and the violence with which suspects were treated successfully won over a number of people who had been initially opposed to the Rising itself. Over the next two years of war, Irish political life became radicalized, not only as a result of the optics of the British retaliation, but from public advocacy for the independence movement from public charities such as the Irish National Aid

Association and Volunteer Dependents’ Fund, as well as the work of women’s organizations such as Cumann na mBan.201 By the 1918 election, Sinn Féin, who claimed and were afforded responsibility for the Rising, won a majority over the Irish Parliamentary Party, and rendered the

Irish revolutionary movement legitimate and authoritative. As a result, the Rising has been claimed by many as the founding act of the Irish Republic.

As Ireland (and, after 1921, Ireland and Northern Ireland) has struggled with ethnic, religious, nationalist, and colonial tensions, the Easter Rising became, like so much of Irish history, “burdened by the weight of its own myth.”202 Over the course of the twentieth century, key events and participants of the Rising have been invoked by politicians, historians, and activists to give legitimacy to their cause, “whether seeking to acquire political power or to justify the use of violence for political ends.”203 Each of these invocations that engage with the

Rising also help shape the public memory of the events into a highly simplistic talisman of

201 See Caoimhe Nic Dháibhéid, “The Irish National Aid Association and the Radicalization of Public Opinion in Ireland, 1916-1918,” The Historic Journal, Vol. 55(3): 2012, 705-729. 202 Fearghal McGarry, “1916 and Irish Republicanism: between Myth and History” in eds. John Horne and Edward Madigan, Towards Commemoration: Ireland in War and Revolution 1912-1923 (Dublin: Royal Irish Academy, 2014), 46 (46-53); Ian McBride, Introduction to History and Memory in Modern Ireland, edited by Ian McBride (Cambridge: Cambridge University Press, 2001), 5. 203 Richard S. Grayson & Fearghal McGarry, Introduction to Remembering 1916: The Easter Rising, the Somme and the Politics of Memory in Ireland (Cambridge: Cambridge University Press, 2016) 1.

80 revolution, anti-imperialism, and republicanism. The result is a history that is both widely known and as Ruán O’Donnell notes, “typically narrow in focus, as if it stood apart from the

First World War and the trends of international socialism,” not to mention trends in feminism and anti-colonial struggle.204 Indeed, as Kieran Allen observed how the Rising “is a living tradition that becomes a reference point in times of social crisis…Official Ireland tries to deal with this subterranean revolutionary tradition by canonising and mummifying the leaders of

1916.”205

These leaders, according to popular history, remain male, with only a few select exceptions. Indeed, the inclusion of women like Countess Markievicz and Kathleen Lynn usually serve to emphasize their exceptional contributions to an otherwise masculine Irish nationalist movement, further emphasizing what Danine Farquharson vividly explains as a narrative of,

“manliness, power, virility, glory, violence and sexuality…knotted together in an anti-romantic narrative about the birth of the modern Irish nation.”206 Since the 1960’s, socialist and feminist historians have argued for more comprehensive histories of the Rising that includes the class and gender struggles that were an intimate part of the event, and of the Irish nationalist movement more broadly. However, in a space that was riven by so many debates over various notions of freedom, liberty, and self-determination, opening the story of the Rising to other historical themes, or recognizing the actions of non-military, non-male participants remained—and remains to this day—a ‘side show’ or secondary narrative to the hypermasculine narrative of nationalism, sectarianism, and defense that emerged from the Rising and was sustained throughout the revolutionary period by emphasizing and enforcing female chastity, purity, and

204 Ruán O’Donnell, The Impact of the 1916 Rising: Among the Nations (Dublin: Irish Academic Press, 2008), xiii 205 Keiran Allen, 1916: Ireland’s Revolutionary Tradition (London: Pluto Press, 2016), 55 206 Danine Farquharson, “Sexing the Rising: Men, Sex, Violence and Easter 1916” in eds. Danine Farquharson & Sean Farrell, Shadows of the Gunmen: Violence and Culture in Modern Ireland (Cork: Cork University Press, 2008), 63.

81 subservience. These practices, which were enforced through politics, religion, and cultural practices, ensured that women’s subjective experiences of the Rising remained stifled.

As Olivia O’Leary noted in an opinion piece for The Guardian during the centenary commemoration of the Rising, “So long as Ireland was isolated and inward-looking, women did badly.”207 Armed protest over the twentieth century in the Republic and Northern Ireland kept the narrative of Irish history insular, politically opportunistic, and sacrosanct to those who would invoke it for defense of their beliefs. However, the signing of the Good Friday Agreement in

1998, and subsequent amendments to the Irish Constitution that removed claims of all-Ireland sovereignty, created a historical moment in which traditional narratives and ownership of Irish history could be disrupted and reconsidered. As Jim Smyth explains, “in history, as in politics, it is at times more productive to change the question. The answers to different sorts of (skillfully devised) questions—subaltern, gendered, or postmodern, for example—can only but complicate and enrich our understanding of the past.”208 At the same time, Kevin Bean notes, this also threatened to create new forms of sectarianisms by placing “new and contested understandings of culture and identity at the heart of politics.”209 It is with these new questions in mind that that historians have considered the events in Dublin, 1916, producing texts that consider the events of the Rising within the context of the global First World War, as well as within broader political, social, cultural, economic, medical, and gender frameworks.210 These works helped excavate the

207 Olivia O’Leary, “Why, 100 years after the Easter Rising, are Irish women still fighting?”, The Guardian, March 25, 2016, https://www.theguardian.com/commentisfree/2016/mar/25/100-years-after-easter-rising-irish-women-still- fighting-gender-equality, accessed February 23, 2019. 208 Jim Smyth, Introduction to Remembering the Troubles: Contesting the Recent Past in Northern Ireland (Notre Dame: University of Notre Dame, 2017), 3. 209 Bean, 229. 210 For example, see Years of Turbulence: The Irish Revolution and Its Aftermath, edited by Diarmid Ferriter & Susannah Riordan (Dublin: University College Dublin press, 2015); Irish Feminisms: Past, Present and Future, eds. Clara Fischer and Mary McAuliffe (Dublin: Arlen House, 2015); Keith Jeffery, 1916: A Global History (London: Bloomsbury, 2016); Keith Jeffery, Ireland and the Great War (Cambridge: Cambridge University Press, 2000); Joe Duffy, Children of the Rising: The untold story of the young lives lost during Easter 1916 (Dublin: Hatchette

82 Rising from the geographic borders of the Irish republic. Moreover, feminist historians and activists in Ireland have contested the intensely masculine history of the Rising by highlighting the voices and actions of nationalist women who contributed, fought, and resisted during the

Rising and the subsequent British retaliation. These works have emphasized the gendered politics of nationalism, and the difficulties that women experienced defining their role in the conflict, both with British authorities, but also with nationalist men who “have not always understood or sympathized with the particular experiences and aspirations of women within the movement.”211

However, there is still a great deal of work to be done to fully understand the effects of the Easter Rising, the First World War, and militaristic, masculine nationalism on women in

Ireland. What is needed are more histories that explicitly connect women’s individual lived experienced during the Easter Rising with larger national, imperial, and international movements in order to understand how women influenced and were in turn influenced by the world in which they lived. This involves moving beyond the narratives and experiences of the exceptional women who donned uniforms and fought in the Rising, such as Constance Markievicz and

Margaret Skinnider, whose activities during Easter Week have been the subject of intense academic focus.212 Though valid and important, their experiences are arguably not

Ireland, 2015); Sexual Politics in Modern Ireland, eds. Jennifer Redmond, Sonja Tiernan, Sandra McAvoy, Mary McAuliffe (Dublin: Irish Academic Press, 2015); Margaret Ward, Unmanageable Revolutionaries: Woman and Irish Nationalism (London: Pluto Press, 1989); Jennifer Redmond & Elaine Farrell, “War Within and Without: Irish women in the First World War era”, Women’s History Review, Special Issue 2017, 1-14 DOI: 10.1080/09612025.2016.1223311; Lucy Delap, Louise Ryan, Teresa Zackodnik, “Self-determination, race, and empire: Feminist nationalists in Britain, Ireland and the United States, 1830 to World War One”, Women’s Studies International Forum, 29:3(2006), 241-254. 211 Louise Ryan and Margaret Ward, Introduction to Irish Women and Nationalism; Soldiers, New Women and Wicked Hags, edited by Louise Ryan and Margaret Ward (Dublin: Irish Academic Press, 2004), 5. See also Ann Matthews, Renegades: Irish Republican Women 1900-1922 (Dublin: Mercier Press, 2010); Lucy McDiarmid, At Home in the Revolution: What Women Said and Did in 1916 (Dublin: Royal Irish Academy, 2015). 212 For example, Marian Eide, “Maeve’s Legacy: Constance Markievicz, Eva Gore-Booth and the Easter Rising,” Eire-Ireland 51(3): 2016, 80-103; Lisa Weihman, “Doing My Bit for Ireland: Transgressing Gender in the Easter

83 representative of the many women’s experiences during this period. As such, this chapter will consider not only the effects of the Rising on civilian women, but it will also seek to analyze these women’s gendered experiences within the asylum and Irish society. First, I will place the

Richmond Lunatic Asylum within a historical context, describing it as a site of patient care, imperial power, and local Irish culture. I will then move on to consider the experiences of the patients in the asylum during and after the Easter Rising, and discuss how their experiences can shed light on Irish history, as well as a broader history of trauma and medicine. Irish women were not only experiencing the fear, danger, and loss of the larger war, but many found themselves suddenly thrown into the middle of a pitched battle on the streets, in the shops, and sometimes in their own homes. Nevertheless, both doctors and historians of the Rising have failed to recognize women’s reactions as trauma when they did not conform to narrow and gendered interpretations of performance or causation.

The History of the Richmond Lunatic Asylums

At the intersection of military, civilian, and gendered histories of the Easter Rising lies the Richmond District Lunatic Asylum.213 In response to the dire need for more facilities to treat patients in Dublin, monies were made available in 1810 for the construction of a public asylum, to be named Richmond Asylum, after the Duke of Richmond, Lord Lieutenant of Ireland. The name was changed slightly in 1830 to Richmond District Lunatic Asylum. It was then known as

Grangegorman Mental Hospital and, from 1958, as St. Brendan’s Hospital.214 As with asylums

Rising”, Eire-Ireland, 39:3-4(2004), 228-249; Feargal Whelan, “All hats and moustaches: Commemorating and performing 1916 in 2016,” Estudios Irlandeses—Journal of Irish Studies 12:11(2017), 140-150. 213 For further discussion about the ways in which Richmond Asylum lies at the crossroads of Anglo-Irish historic imagination, see Barry Ryan, “’I’m sick of my own country’: ethics and aesthetics in James Joyce’s ‘The Dead’”, Nordic Journal of English Studies 11:2(2012), 166-188. 214 Brendan Kelly, Hearing Voices: The History of Psychiatry in Ireland (Dublin: Irish Academic Press, 2016), 37.

84 in England and continental Europe, upon its opening in 1811, the Richmond Asylum was intended to be a place where the ill could be treated with enlightened care, without restraints or undue confinement. Indeed, in an 1828 tract on the state of lunatics and lunatic asylums throughout Great Britain, Sir Andrew Halliday observed that “Ireland is the only portion of the

British Empire where just views have been entertained of what was necessary for the comfort and cure of her insane population, and where these views have been fully carried into effect.”215

He later went on to assert that “the system is so excellent, and has been found to work so well, that I am anxious it should be imitated in this country.”216 In 1846, the Inspector of Lunatic

Asylums reported that the Richmond Asylum “continues to maintain its high character as being one of the best-managed institutions in the country.”217 An 1862 report from The British Journal of Psychiatry noted, with both jealousy and imperial condescension, the enormous expenditure of funds that contributed to the success of Richmond Asylum: “it appears that the imperial treasury

(as one might have guessed in Ireland) pays the piper to the tune of £17,000. We have no such establishments allowed in England; even the princely foundation of the royal Hospital of

Bethlehem has to sail nearer the wind than do our friends in the Richmond District Asylum.”218

This way of life within the asylum would soon change, as the patient population swelled exponentially, due to legal changes, economic catastrophe, and social necessity. The Dangerous

Lunacy Act of 1838 increased the number of people whom the state was responsible for

215 Sir Andrew Halliday, A General View of the Present State of Lunatics, and Lunatic Asylums, in Great Britain and Ireland, and in Some Other Kingdoms (London: Thomas and George Underwood, 1828) 33. For later comparisons, Halliday also states that in the Richmond Asylum, there were 168 “Lunatics” and 112 “Idiots”, for a total number of 280 patients. (Halliday, 39). 216 Halliday, 46. Halliday was specifically referring to the creation of a board and the appointment of several Inspectors General to oversee the operation of all public and private asylums, as well as the establishment of county asylums, rather than private institutions that were difficult to regulate. That such a bureaucratic and hierarchical institution should exist in a colony instead of the metropole is not surprising. 217 Quoted in Kelly, Hearing Voices, 38. 218 “Richmond District Asylum, Dublin—Report of the medical superintendent for the year 1862”, The British Journal of Psychiatry, 04/01/1863, 9(45): 115

85 incarcerating in asylums, and periods of famine and extreme poverty rendered large numbers of people to become reliant on the state for survival.219 By the end of the nineteenth century, as a result, the asylum population was a mix of the mentally ill, the physically sick, alcoholics, and the poor who could not be contained within workhouses. This rapidly increasing asylum population, and the fact that their stay in the asylum grew longer as time went on, put strains on the asylums’ infrastructure that cannot be underestimated. According to a report assembled by

Valerie Flynn, between “the Famine and the outbreak of the First World War, Ireland’s population declined by a third, but the number of “insane” people in public asylums increased sevenfold.”220

Doctors who worked at the Richmond Asylum were educated in the same manner and within the same school of thought as British doctors who worked in London. Thus, assumptions about women’s emotionality and instability did not vary greatly between England and Ireland.

What is important to note, is the way in which asylums in Ireland began as a site of imperial power, which, according to Damien Brennan “served to further consolidate and embed the administrative structures” of British rule, to becoming gradually more representative of Irish culture.221 In Britain, rising populations within Irish asylums was used as proof of the degeneracy of the Irish ‘race’. Irish nationalists, in turn, pointed to issue as proof of the poison of British rule in Ireland, which fostered poverty and insanity, while driving the fit and capable to emigrate. As John Redmond argued in the House of Commons in 1906, “Under your rule, it

220 Valerie Flynn, “Unlocking our dark secrets; Ireland’s past treatment of mental illness is maddening, and questions remain today”, Sunday Times, January 8, 2017. Pauline Prior provides more details on this population change, noting that the population in Ireland decreased from eight million in 1841 to 6.5 million following the Great Famine, to 4.5 million in 1900. Pauline Prior, “Psychiatry and the Fate of Women Who Killed Infants and Young Children, 1850-1900”, Cultures of Care in Irish Medical History, edited by Catherine Cox and Maria Luddy (New York: Palgrave Macmillan, 2010), 95. 221 Damien Brennan, “A Theoretical Explanation of Institution-based Mental Health Care in Ireland”, in Asylums, Mental Health Care and the Irish 1800-2010, ed. Pauline Prior (Dublin: Irish Academic Press, 2017 reprint), 310.

86 has been the survival of the unfittest in Ireland.”222 Eager to avoid blame, as well as the rising cost of asylum upkeep, the British government devolved funding for asylums and the appointment of staff to local authorities. This process began with the Local Government Act of

1898, a largely symbolic gesture, but one that did result in Irish asylums more closely reflecting

Irish culture and gender norms.223

Amidst extreme overcrowding, poor sanitation, and strain on staff, the quality of life within the asylum grew worse and worse. To provide just one statistical example, by 1879, the death-rate at the asylum was 19%, a combined result of poor sanitation, over-crowding and the ill-effects of poverty and poor law regulations in Ireland.224 In 1888, there was an outbreak of dysentery in the asylum that the Resident Medical Superintendent, Conolly Norman, attributed to defective drainage throughout the asylum.225 Later, in 1896, patients suffered an ‘epidemic’ of beri-beri, though it was noted that the condition was contained largely within the female population of the asylum that resulted in thirteen deaths. Although beri-beri was later found to be a non-infectious condition caused by an acute deficiency of the B-1 vitamin, at the time of the outbreak, doctors at the asylum blamed the outbreak on “the large number of patients in crowded and badly-ventilated rooms,” further demonstrating the diminished quality of life within the asylum.226 The British Medical Journal noted around this time that “the asylum can properly

222 Quoted in Mark Finnane, Insanity and the Insane in Post-Famine Ireland (London: Croom Hill, Ltd., 1981), 73. 223 Finnane, 77. 224 Beri-Beri at Richmond Lunatic Asylum”, British Medical Journal, 31 July 1897, Vol. 2(1909), p. 292. Though the statistic sounds grave, according to Dr. O’Farrell, the Inspector for Lunatic Asylums, noted that “the death-rate in that asylum had been lower than that of any big asylum in the United Kingdom so far as he was aware.” (Ibid.). For administration of the poor law in Ireland, and its effects on penitents, see Helen Burke, The People and the Poor Law in Nineteenth Century Ireland (West Sussex: The Women’s Education Bureau, 1987). 225 “Dysentery in Ireland”, Medical and Surgical Reporter, 58:13 (March 31, 1888), 408. 226 “Beri-Beri at Richmond Lunatic Asylum”, British Medical Journal, 31 July 1897, Vol. 2(1909), p. 292, “Epidemic in a Dublin Lunatic Asylum”, British Medical Journal, 6 October 1894, Vol.2(1762), p.767. Though it is possible now to guess that the poor diet of the patients resulted in the outbreak of the condition, at the time, it was thought that beri-beri “was eminently one that attached itself to localities. It had been observed to haunt certain rooms of buildings, and even certain definite portions of wards. Those observations tended to the conclusion that beri-beri spread itself by contamination of the soil of the buildings and other such surroundings.” At the time, it was

87 accommodate 1,100 patients. At present there are about 1,500 in the institution.”227 In 1900, an outbreak of typhoid swept the asylum, affecting both the patients and the nursing staff.228

Construction work and modernization projects were undertaken in the early twentieth century in the hopes of isolating contagious patients. Nevertheless, the number of patients in the

Richmond District Asylum continued to outpace expansion. In a 1907 report to the Richmond

District Asylum Joint Committee, the body responsible for overseeing the general operations of the hospital, Dr. J.M. Redington and assistant medical officer Dr. P.J. Dwyer observed that:

…for the year 1898, preceding the date on which we took office, the daily average number of patients on our books was 1,958, as compared with 2.878 that daily average number resident during 1906. In a period of eight years, therefore, there has been as increase of no less than 920 patients…I say it with all deliberation and intense regret, and with experience of the last ten years, that we have already reached a grave and alarming crisis.229

At the same time, Dr. Conolly Norman noted with concern the widening ratio of staff to patients in asylums across Ireland, stating “there should be one Medical Officer for every hundred patients….In Ireland the proportion is generally low, often dangerously so.”230 In fact, the ratio of medical officers to patients in Richmond was 5:1,498, or approximately one officer for every

300 patients.231 Efforts were made to improve the patients’ day-to-day life in the asylum, ranging from the purchase of cheap paintings to decorate the walls to the organization of sports

feared that if the “disease” returned, “the questions of the entire abandonment of the site would arise.” (“Beri-Beri at Richmond Lunatic Asylum”). For more information, see E. Margaret Crawford, “A Mystery Malady in an Irish Asylum: The Richmond Epidemic of the Late Nineteenth Century”, Asylums, Mental Health Care and the Irish 1800-2010, edited by Pauline M. Prior (Dublin: Irish Academic Press, 2012), 185-204. 227 Ibid. 228 A.E. Wright, “Note on the Results Obtained by Typhoid Inoculation in the Case of an Epidemic of Typhoid Fever Which Occurred in the Richmond Asylum, Dublin”, The British Medical Journal, 26 October 1901, Vol.2 (2130), pp. 1226 (1226-1228). 229 Quoted in Kelly, Hearing Voices, 132. 230 Quoted in Kelly, Hearing Voices, 135. 231 Kelly, Hearing Voices, 136 (Table 2).

88 teams and games. However, the sheer size of the asylum and the volume of patients made wide- spread improvements nearly impossible.232

Discussions among the Richmond Asylum staff reflected the stress and bleakness of their situation. In an 1894 address to the Medico-Psychological Association, Dr. Norman noted:

Our calling is in its nature a depressing and trying one. We live among our patients, in the midst of disappointed expectations, shattered hopes, blighted lives—the ruin and wreckage of existence…The peculiar combination of worry and monotony which characterize asylum life often torture us.233

Implicit in Norman’s description is a concern for the staff, but that concern clearly did not extend to the patients under his care. In addition, there is evidence that the staff at Richmond did not always treat patients in a manner that pleased their families. In a letter to the asylum authorities dated January 1918, the father of an eighteen-year-old female patient railed against his daughter’s treatment:

…[when] she entered you institution her limbs were quite normal and free from sores or Blisters which I can prove to your satisfaction I had her medically examined before she entered your Institution you also state she was supplied with Special Shoes and Slippers which is faulse (sic) on one occasion I paid her a visit and she was wearing old hard shows (sic) two sizes small for her feet pressed into them worn by patients two or ten years previous to her admission you also state her feet were free from blisters on her removal did you see her beet before she left or do you examine the patients before they are removed or so you believe what the nurses or Torturers tell you… 234

Whether this patient’s experience is reflective of the way all patients were treated is impossible to know. However, this letter points to a lack of concern for the comforts of the individual patient in an overburdened and underfunded institution, and offers hints as to the stress that patients and staff alike were enduring during, and as a result of, the events of the Easter Rising and the First World War.

232 Kelley, Hearing Voices, 137-8. 233 Conolly Norman, “Presidential Address, delivered at the Royal College of Physicians, Dublin, June 12th, 1894”, The Journal of Mental Science, Vol. XL, No. 171 (October 1894), 492 (487-499). 234 Letter dated 26 January 1918, signed P.J. Burke, National Archives of Ireland, PRIV1223/5/28/A1-A; B1-B8.

89

The Easter Rising and the Richmond Asylum

The Easter Rising represented a particularly momentous period within the history of medicine in Dublin. Caught in the midst of a war for which they were not prepared, doctors, nurses and even patients mobilized in ways never before necessary. Hotels, shops, and other large buildings were transformed into makeshift triage units to deal with the overflow of wounded from traditional hospitals. Women trained in nursing distinguished themselves by providing exemplary medical care to Irish and British soldiers alike.235 Doctors, like those in the

Temple Street Children’s Hospital, were forced to work through constant bombardments, treating wounds more commonly seen on the battlefields of France. 236

Richmond District Asylum was likewise caught up in violence of the Easter Rising. The

First Battalion of the Irish Volunteers occupied several buildings in the Four Courts, located directly to the south and west of the hospital. King Street North, a site of some of the fiercest and most prolonged fighting of the Rising, was located some several hundred yards away from the hospital’s grounds. Consequently, the surgical hospital attached to the asylum consequently treated a number of civilian gunshot wounds, though it does not appear that the hospital was pressed into military service.237 Nevertheless, the violence of the Rising still penetrated the walls of the asylum—quite literally. In a report to the Board of Commissioners, Dr. John O’Conor

Donelan, who had succeeded Conolly Norman as Resident Medical Superintendent, described

235 For examples, see Lucy McDiarmid, “Uncomfortable Bodies in Women’s Accounts of 1916” in Tina O’Toole, Gillian McIntosh, and Muireann O’Cinneide, eds. Women Writing War: Ireland 1880-1922 (Dublin: University College Dublin Press, 2016) 118-132. 236 Benny Kennerk, “War on our doorstep: Temple Street Hospital and the 1916 Rising” in David Durnin and Ian Miller, eds., Medicine, Health and Irish Experiences of Conflict 1914-45 (Manchester: Manchester University Press, 2017), 81-93. 237 A. Collins, “The Richmond District Asylum and the 1916 Easter Rising”, Irish Journal of Psychological Medicine, 30: September 2013, 280 (279-283).

90 that belligerents were firing into the grounds of the hospital.238 As a result, patients were moved from peripheral areas of the hospital and mattresses were used to blockade the windows from errant projectiles. The preventative measures were successful. As Donelan noted in his report dealing with Easter Week, “It is a matter of satisfaction at being able to state that neither amongst the patients or staff was there a single casualty, nor did the buildings suffer in any way, although the belligerents on both sides were constantly firing through the grounds.”239

The fighting in the area was indeed so violent that those outside the hospital, both doctors and potential patients, were unable to access the hospital between April 24 and May 1. When a cease-fire was declared, the renewed admissions to the asylum give some indication as to the psychologically damaging effects of the Rising on the general population. According to Collins,

“[b]etween 1 May 1916 and 31 May 1916 there were 45 admissions. The average monthly admission rate for the 15 months, January 15 until March 1916 (inclusive) was 26. Thus, the number of admissions in May 1916 represented a 42% increase in the previous 15 months.”240

One of the women admitted on May 1 was a thirty-six-year old from Seville Place, who was admitted at the request of a second lieutenant of the Royal Irish Regiment. No medical certificate was filled out for her admission, but her diagnosis was given as “recent melancholia due to shock.”241 Several texts reference this woman and her diagnosis, noting that her ‘shock’ diagnosis “may be the first occasion that the word ‘shock’ appears as a diagnosis in the admission books of Grangegorman.”242 As Collins explains, “the admission papers of those admitted during Easter week 1916 with ‘shock’ leads to the conclusion that patients appear to

238 Ibid. 239 Quoted in Brendan Kelley, ‘He Lost Himself Completely’: Shell Shock and Its Treatment at Dublin’s Richmond War Hospital, 1916-1919 (Dublin: The Liffey Press, 2014), 27. 240 Collins, 281. 241 Collins, 280. 242 Collins, 280; see also Kelly, ‘He Lost Himself Completely, 27.

91 have been given the diagnosis if their experiences in the conflict were part of their presenting complaint.”243

Here again, the historical emphasis on “shock,” and expectations that a gendered and poorly-defined diagnosis is the only way to interpret and validate the suffering of a civilian and female patient body wholly obscures the complexities of women’s experiences and their subsequent interactions with doctors in the asylum. A closer view at the case notes of women demonstrates first, the varied experiences of women on the Dublin home front, their observations, their memories, and their fears. Second, they show that the emotional and psychological effects of the violence of the Rising and the Great War could take months or years to come to doctor’s attention, emphasizing the lingering effects of trauma among civilian populations during warfare. Finally, they further prove that, for those women who did not fit the diagnostic criteria of “shock,” doctors tended to employ older diagnoses, which relied on female instability and assumed weakness. As a result, diagnoses varied considerably, and patients’ treatment again highlights both the contemporary medical view of women’s psychology generally, as well as the state of gendered power relations with Ireland specifically. In the following pages, I will analyze a number of these patients, examining their case notes for information regarding the individual experiences of Easter Week and within the asylum, and also considering what their testimonies can convey regarding the reality of the Easter Rising for those who were forced to endure it. Again, in considering these women’s cases, I make no assumptions about the state of their mental health beyond what is noted by doctors at the time. Whether they would be classified today as mentally ill is not as important to this study as the fact that they tied their own suffering to their experiences in Dublin during these critical weeks in 1916.

243 Ibid.

92 Identity and Belonging During the Easter Rising

The Easter Rising was the opening battle in a long conflict that largely affected civilian communities, enacted by those who were alleged to be defending them. That violence isolated neighbors who did not take part in the violence from the rest of the city, cutting off access to supplies, friends, and family. It also left many feeling personally isolated, unsure of their place in a politically fraught, violent space where spies were feared and hated. Even after the violence of the Rising was over, case notes show that many women were left feeling completely out of control of their own identity and place in their community. Take, for example, the case of MR, a

46-year-old Protestant who was admitted in February 1918, allegedly having been suffering from

“Delusional Insanity” for the past 18 months.244 The supposed cause of her suffering was excitement and “Fright at SF [Sinn Fein] Rising.”245 MR spoke repeatedly during her admission about people who “called her Sinn Fein and tried to make out she was not a married one [sic].”246

The danger she describes was not one of a physical attack, but was rather one to her identity, both as a Protestant and as a married woman who would be assumed to be both virtuous and protected. MR’s feelings of persecution further extended to feeling that “there were electric wires at the back of her” that her persecutors would use “when they wanted to attract her attention”.247 Though modern psychologists have often described haptic hallucinations like the sensation of electricity as a presenting symptom of schizoid thinking/schizophrenia, the real

244 National Archives of Ireland, PRIV1223/5/28/R1-R11. 245 Ibid. 246 Ibid. 247 Ibid.

93 significance of MR’s description is the way in which the electricity she felt rendered her helpless, and at the whim of those who “wanted to attract her attention”.248

Taking the legacy of ethno-religious tensions within Ireland into account, and MR’s fear of reprisals and persecution, it may be assumed that Protestant women suffered fear and stress in higher numbers than Catholic women, or felt more alienated from the stated goals of the

Rising.249 Peter Hart and Roy Foster, for example, emphasize the “atavistic ethnic conflict” that resulted in widespread persecution of Protestants in southern Ireland.250 Additionally, Robin

Bury has used demographic shifts in southern Ireland in the early twentieth century to support an argument for increasing feelings of persecution among Protestants because of their religion.251

He quotes a letter from Lloyd George to Andrew Bonar Law about the position of Protestants in the south in 1918, describing “the little Protestant community of the south, isolated in a turbulent sea of Sinn Féinism and popery.”252 However, a closer analysis of sources reveal a much more complex network of social and cultural identities at work on the ground that relied far more on neighborhood loyalties and family ties than religious or political affiliations. An analysis of the

Richmond Asylum case notes bears out the view that Protestants did not feel persecuted on account of their identity—instead Protestant and Catholic women alike feared accusations of spying or informing against Sinn Fein and the leaders of the Rising. For example, CE, a Baptist, was admitted to Richmond Asylum in September 1917 in part because she “imagined she was

248 Murray Jackson, “Learning to Think About Schizoid Thinking” in Psychosis: Understanding and Treatment, edited by Jane Ellwood (London: Jessica Kingsley Publishers, 1995), 17 (9-22). 249 This question was helpfully raised during a presentation at Comhfhios - An Irish Studies Conference held on the 24th of February 2018, in Connolly House, Boston College, MA. 250 Quoted in Brian P. Murphy, OSB, “The Wind that Shakes the Barley: Reflections on the Writing of Irish History in the Period of the Easter Rising and the Irish War of Independence,” The Impact of the 1916 Rising: Among the Nations, ed. Ruán O’Donnell (Dublin: Irish Academic Press, 2008), 212 (200-220). 251 As Bury notes, “between 1891 and 1901, the Protestant population had decreased by 7.1 per cent and between 1901 and 1911 by 4.8 per cent. However, there was a 33 per cent collapse in the Protestant population of the 26 countries that became the Irish Free State between 1911 and 1926…During this period, Roman Catholic numbers remained almost static, falling by just 2.2 per cent in the island.” (Robin Bury, Buried Lives: The Protestants of Southern Ireland (Dublin: The History Press Ireland, 2017), 13). 252 Bury, 23.

94 being watched by Sinn Feiners who wanted to do her an injury.”253 According to her case notes, she had been suffering from these fears for over a year, with “shock caused by SF rising alleged as cause.”254 Additionally, SO, a member of the Church of Ireland, was admitted to the

Richmond Asylum by her husband who stated that she “had delusions that people who lived over us were saying both of us were spies and we would be shot by Sinn Feiners. Used to think she was being followed by people.”255 When examined by doctors, she explained that she “thinks she was accused of being a spy by Sinn Fein…She takes great trouble to explain that she really wasn’t but in sympathy with the movement.”256

This isolation and fear of persecution is also reflected in the case notes of AL, who was admitted to Richmond Lunatic Asylum in June 1917, suffering from what doctors described as

“Delusional Insanity,” with “Worry of Easter Week 1916 alleged as cause.”257 The fifty-seven- year-old woman “has delusions that she is being continually pursued by a number of strange persons,” and “that young men are all going round following her and using very bad expressions.”258 When asked to describe these men, the patient replied she thought they were

“Sinn Feiners.”259 Throughout her time at the Richmond Asylum, SR reported hearing noises and voices that doctors did not. They noted in August 1917, “She hears voices on the telephone giving her little directions”, and in September, “Hears voices saying ‘I wish you were going to the dead out of this.’”260 In 1918, doctors noted that “She is reported to hear voices and when questioned says, “the only voices I heard, are those who are here to watch the robbers.’”261

253 National Archives of Ireland, PRIV1223/5/28/E1-E6; F1-F8. 254 Ibid. 255 National Archives of Ireland, PRIV1223/5/28/O13-23. 256 Ibid. 257 National Archives of Ireland, PRIV1223/5/28/L1-L14 258 Ibid. 259 Ibid. 260 Ibid. 261 Ibid.

95 According to her case notes, AL’s home was only some 800 meters from Mountjoy Square, and within easy walking distance of Sackville Street, a site of major fighting, destruction, and public looting during and after the Rising. It is thus entirely possible that the “robbers” to which she referred were the looters who, it was reported, “went round with hammers smashing in the windows of jewelers’ premises, drapers, bootmakers, and, indeed, all business,” and made off with sweets and toys, as well as clothing, shoes, and, in one noteworthy case, a piano.262

Whether it was these actions that inspired AL’s concern over “robbers,” or perhaps her increasing mistrust of the people around her in the asylum, it is clear throughout her case notes that her “agitated and restless” state was the result of the jarring experience of the Easter

Rising.263 Her isolation from, and fear of, her neighbors and those around her preyed very deeply upon her mind, and also provides insight into the kind of alienation that many women felt from the violence occurring around them—and from those who were willing to perpetrate it.

That same feeling of being trapped by the events of the Rising can also be seen in the case notes of TB, a Catholic who was admitted to Richmond Asylum in January 1917 and diagnosed with confusional insanity caused by the “S.F. Rising.”264 Rather than expressing a fear of “Sinn Feiners,” however, TB’s outbursts demonstrate the disorientation and overwhelming fear caused by the violence of the Rising, and, possibly, of the British reprisals in her neighborhood. She displayed no history of illness, although her husband did note that she had suffered a nervous attack “in 1915 due to mental stress.”265 According to doctors, TB was

262 Ballymena Observer, “Looters with Carts,” May 5, 1916; According to the testimony provided by Michael O’Flanagan, who had been active with the IRB in Glasgow before taking part in the rebellion, “On Wednesday afternoon we noticed four or five men and women coming from the direction of Mary’s Lane. Between them they were carrying a piano which we concluded they had stolen from the premises. We called on them to halt but they refused to do so. We fired a few shots over their heads as a warning and they dropped the piano and made off.” (Bureau of Military History, Witness Statement #800, Witness: Michael O’Flanagan, page 19); 263 National Archives of Ireland, PRIV1223/5/28/L1-L14. 264 National Archives of Ireland, PRIV1223/5/28/A1-A; B1-B8. 265 Ibid.

96 “So troublesome after admission that she had to be put in the padded room for an hour.”266

Doctors were unable to understand all of her exclamations, but did record that she “Does not answer questions but incessantly reiterates something that sounds like “I’ll stay for ever,” and

“Reiterates, ‘Far away you never never can get me out, go away.’”267 There was no attempt to understand the cause of TB’s exclamations, or how her reactions may have been related to her experiences in the Rising. However, the information provided on her intake form indicates that

TB and her family lived less than one half-mile from the Sheehy-Skeffington family in

Rathmines, and may very well have been at home during the attack led by British Army Officer

Captain Bowen-Colthurst of the Royal Irish Rifles on the night of April 26. This attack involved the detonation of hand grenade, soldiers shooting in the streets and through the windows of homes, a level of violence that must have been overwhelming, not only for the Sheehy-

Skeffington family, but for those neighbors who had lived in a state of siege for days on end.268

For TB, it may very well have seemed like the violence would never end. Moreover, her incarceration in Richmond Asylum, and in the punitive padded room, clearly only further added to the feeling of being trapped and out of control of her surroundings and personal safety. She remained deeply troubled, anxious, and physically unhealthy for months. Doctors recorded that she “Reiterates in a sort of chant, ‘Kill me—You may kill me,’” and “Take me out and hang me.”269 By 1918, she was showing signs of improvement, however, and told doctors she thought

“it was loss of sleep at the time of the rebellion upset her.”270 While this is entirely possible, it is also clear from TB’s case notes that it was also the feeling of being trapped, out of control, and

266 Ibid. 267 Ibid. 268 Francis P. Jones, History of the Sinn Fein Movement and the Irish Rebellion of 1916 (New York: P.J. Kennedy and Sons, 1917), 377. 269 National Archives of Ireland, PRIV1223/5/28/A1-A; B1-B8. 270 Ibid.

97 without any sense of support or safety that drove her to such an acute state of fear. Doctors countered her own assumptions about her psychological health by nothing “She does not seem very intelligent but I think is coherent.”271

The Easter Rising transformed Dublin from a home front to a battle front overnight. For many civilians, including the women discussed here, that change was a deeply traumatic one.

The level of violence employed, and the anger displayed both by Irish rebels and the British

Army, was overwhelming, causing many women to feel absolutely out of control in spaces they had once considered familiar. Indeed, one women’s case notes explain all her physical, mental, and emotional symptoms by stating “She was in the midst of the Trouble area during rebellion of

’16…and felt the strain.”272 In some cases, the Rising also caused women to question their relationships and identity, as they were forced to reconsider their own position within their community. Their expressions of powerlessness, fear, and disorientation offer unique insight into the deep and lasting impact of the Easter Rising on those trapped on this new battle front against their will.

The Effects of the First World War on Irish Women

In addition to demonstrating how the events of the Easter Rising affected women, the case notes of the Richmond Lunatic Asylum also offer insight into the experiences of women within the context of the First World War, and the effects that loss, worry, fear, and grief had on them. Jennifer Redmond has explained how “the war had a direct and immediate impact on Irish citizens, transcending political, social, geographic, generational and economic boundaries as it did elsewhere,” however there is still a great deal about Irish women’s home front experience

271 Ibid. 272 National Archives of Ireland, PRIV1223/5/28/R24-R34

98 that has yet to be explored by historians.273 This is in part because, as Adrian Gregory and Senia

Pašeta emphasize such experiences do not “fit neatly into the mainly political studies of unionist and nationalist responses to the Great War.”274 Additionally, they do not support the hypermasculine narrative of service and nationalism that are so frequently found in Irish historiography. Additionally, Mandy Link explains how the “failure to incorporate war memory and commemoration in the [Irish] nation story was largely based on the separation of British and

Irish identities.”275 While many men had the power to choose their nationalist affiliation through their military service, women were forced to negotiate challenging and competing identities during the war, as well as to navigate the highly masculine, deeply misogynistic nationalism that emerged in its aftermath. With relatives fighting in both the British Army and with the rebels on the streets of Dublin, women’s identities and loyalties were tested in unique ways, and their struggles are frequently reflected in the expressions logged in their case notes.

Take, for example, the case of MK, who was admitted to the Richmond Asylum in March

1918.276 Doctors put great stock in the fact that MK reported “to be temperate but she herself says that she drank heavily up to 2 or 3 weeks ago,” and that her “Mother was of flighty nature.”

Both pieces of information pointed to a hereditary condition exacerbated by the patient’s own poor habits. However, her friend who supplied the testimony at her admission explained that her symptoms were the result of “Fretting about husband, [who] been in France and nerves affected

273 Jennifer Redmond, “War Within and War Without: Irish women in the First World War era,” Women’s History Review, 18(1): 2017, 3 (1-14). 274 Adrian Gregory & Senia Pašeta, Introduction, in Adrian Gregory & Senia Pašeta (Eds.) Ireland and the Great War: ‘a war to unite us all’? (Manchester: Manchester University Press, 2002), 1. 275 Mandy Link, “Specters of empire: Remembrance of the Great War in the Irish Free State, 1914-1937” (Unpublished doctoral dissertation), (Pullman: Washington State University, 2015), iv. 276 National Archives of Ireland, PRIV/1223/5/28/K1-K14. This patient has two intake forms, one incomplete and dated 1919, and another complete one dated 1918. Because this case note is complete with doctors’ notes, I have accepted the 1918 date as the correct one.

99 after father’s Death. Son killed accidental during rebellion [sic].”277 Later, MK told doctors that

“she got a shock when her Father was killed in the Sinn Fein Rising,” making it somewhat unclear how many deaths she had endured.278 Nevertheless, it is clear that MK was suffering the as a result of a violent death of a loved one at home, while simultaneously coping with the fear of knowing her husband was in danger in France. Upon hearing of the death of her family member during the Rising, MK suffered a breakdown that was significant enough to warrant the police being called to her home—an event that only deepened her trauma. According to her notes, “her

Father was killed in the Sinn Fein Rising; that it upset her nerves and that she did not know what she was doing. Says she has a faint recollection of breaking glass and things when she was upset and then of the police coming and taking her away.”279 Later in her notes, she confided in her doctors that “she was frightened of the soldiers. Thought they would kill her.”280 In MK’s case notes, it is possible to see the detrimental effects of living between two war fronts—the smaller front in Dublin and the larger fronts of the First World War. MK was both the wife of a soldier in the British Army and related to a man killed in the course of the Easter Rising. Yet neither her affiliation with the British Army nor to the Irish nationalist cause seemed to have brought her comfort, resiliency, or protection from loss, fear, or grief. Histories of the First World War and the Easter Rising emphasize the actions of women in the Rising, and the pride and solace their participation provided. Many more women, however, experienced the war as MK did, trapped between two fields of battle, forced to confront the violence committed around them without having a voice in the matter, or having their emotional stress acknowledged by either the British or the Irish. MK’s grief, too, went unheard, both by the police who took her to the asylum, and

277 Ibid. 278 Ibid. 279 Ibid. 280 Ibid.

100 by asylum doctors. The emphasis in her case notes remains on her (temporary) intemperance and on her own personal and hereditary shortcomings, rather than on the overwhelming fear and loss she was struggling to bear. This lack of acknowledgement of the First World War, and its effects on those living in Ireland, would be reflected in the postwar refusal to incorporate the war into Ireland’s national memory. For women whose sense of identity was affected both by the fighting in Ireland and the larger war fought by the British Army, this national failure to acknowledge their suffering could result in both emotional suffering and a lack of recognition for that suffering that only compounded their traumatic war experiences.

In addition to negotiating British and Irish nationalist identities and violence during the war, many women were forced to endure physical displacement. Several case notes refer to women who were brought to Dublin from London in order to avoid the dangers of the air raids.

Such displacement, however, in addition to the stressors of war, often proved extraordinarily harrowing, as it did in the case of ED, who was brought to Richmond Asylum by her daughter in

1917. In addition to suffering the terror of the German air raids in London, ED also endured

“Worry and grief, first losing husband, only son being called up for the army, selling up home.”281 As a result, ED’s daughter noted that the forty-seven-year old woman was suffering

“nerve storms the last four weeks, but not violent,” accompanied by “delusions that the Germans have her and are torturing her by cutting off her hands and taking out her eyes,” 282 In her case notes, it was noted that ED’s mother “had prolonged insanity,” which seems to have colored doctors interpretations of her conversations with them .283 However, in considering her history

(which was not a part of traditional treatment at this time), ED’s expressions of fear and worry tend to sound less “delusional,” and more the expected fears of a recent immigrant forced to

281 National Archives of Ireland, PRIV1223/5/28/D1-D12. 282 Ibid. 283 Ibid.

101 leave her home against her will. According to doctors, ED “says she wanted to go back to

London and they would not let her…She says she left things in London for someone else to see to and that worried her…she expressed a fear of the Germans landing.”284 The cultural and social differences she experienced, or perhaps feared, in Ireland are also hinted at in her testimony; ED, a Protestant, expressed fear that “she is put here as a Roman Catholic,” a statement that shows a distrust of the area in which she had come to live, but also an increasing lack of self-identity and loss of control over her situation.285 Additionally, she expressed a fear that “she is to be thrown down the sewerage.”286 Throughout her stay, doctors noted her refusal to eat, and her fears of a looming death, to be indications of her mental imbalance.287 However, both symptoms might also have been indicative of the uterine cancer from which she was suffering. Doctors noted that a “malignant growth can be felt” on March 24, and two days later,

ED passed away in the asylum.288 Her experiences of displacement and dissociation as the result of the war emphasizes the physical and social upheavals caused by the war that went overlooked because they did not conform to contemporary notions of war trauma. Instead, doctors relied on tried-and-true assumptions of heredity, especially evident in ED’s case, and scientific theories on female emotional imbalance to explain their symptoms.

For those active participants, the Easter Rising of 1916 was a powerfully unifying act that helped define individuals and groups both as nationalists and militant defenders of the imagined

Irish nation. However, the case notes of the Richmond Asylum show that, for many civilians, the Rising was a terrifying, traumatic event that transformed Dublin into a strange, deadly, and

284 Ibid. 285 Ibid. 286 Ibid. 287 Ibid. Case notes indicate that ED stated she was “going to hell,” and praying out loud to Jesus in the weeks before her death. 288 Ibid.

102 inescapable space, a hybrid war-zone and home front, that many women found overwhelming.

Their case notes attest to the fact that women suffered fear for their personal safety, as well as fear for their relations who were fighting in the streets of Dublin, and on the fronts of the First

World War. The failure to incorporate these memories into the Irish story of the First World

War, or a broader history of women in the war is a direct result of their cases being ruled as non- war related. As female civilians, women did not fit the criteria of a patient who might suffer war shock; those women who did remain the exception, both in the case books and the historiography of the war. Hence, their experiences went overlooked in favor of more familiar notions of heredity and mental instability, and their behavior regulated according to traditional gender norms.

In addition to contributing to the history of medicine and trauma, this chapter has also shown how the case notes of the Richmond Asylum can be utilized to shed light onto personal experiences that have generally gone unrecognized in the historiography of Ireland during this period. These case notes challenge the triumphal, masculine history of the Easter Rising by describing the experiences of women civilians who were caught in the middle of the Rising, subjected to its violence without understanding or supporting its rationale, and the toll that fear took on them. They also show the challenge that women faced navigating their identities as Irish women and as the wives and mothers of British soldiers. Because the postwar Irish republican memory, which was inherently masculine in its focus, excluded the Irish experience of the First

World War, women’s wartime experiences were even further marginalized. By bearing witness to these women’s experiences outside the asylum, and within the context of Irish society, this chapter has also contested these women’s marginalization, in their own time and in subsequent

103 historical analysis of the period, as well as the medical and masculine authority that attempted to define these women and their memory.

104

CHAPTER FOUR: “Really such awful things one sees and hears are included to rack one’s nerves”: Nurses’ Descriptions of Trauma and Resiliency

Dear Capt. Forth, I was so glad to get your letter but you do not tell me much news… I hardly have time to eat for the past 2 or 3 weeks, and the strain is very awful, but doubtless you may have seen some few things in the papers. I am certainly having a most wonderful experience for a V.A.D.” Elsie Williams, VAD (Letter dated 21st April 1918, 30th General Hospital, France)289

On November 27, 1915, a thirty-three-year-old Canadian nurse named Beulah Duncan, a member of the Queen Alexandra Royal Army Nursing Corps, was admitted to St. Luke’s

Hospital in London.290 A fellow nurse, Margaret Brown, who worked in the hospital where

Duncan had previously been a patient attested, “she had been violent all night except for a short period after an injection of Hyoscine. She had had several screaming fits and that the condition observed had been going on for many hours.”291 The matron of the same hospital testified “that

Beulah Duncan was violent and had fits of screaming, that she talked in a rambling and incoherent manner and had to be placed in charge of two nurses.”292 Even at St. Luke’s the patient was too agitated for doctors to attempt a physical examination. When asked if she knew where she was, Nurse Duncan repeatedly stated, “she was sure she was in Hell.”293 From Ernest

289 Public Records Office of Northern Ireland, BCT/8/5/3/8, Letter from Elsie Williams to Captain Forth, 21st April 1918. Versions of this chapter also appear in Bridget E. Keown, “‘I think I was more pleased to see her than any one ‘cos she’s so fine’: Nurses’ Friendships, Trauma, and Resiliency During the First World War,” Family and Community History, DOI:10.1080/14631180.2018.1555955, and Bridget E, Keown, “‘A perfect hell of a night which we can never forget’: Narratives of Trauma in the Private Writings of British and Irish Nurses in the First World War,” in Languages of Trauma, ed. Jason Crouthamel and Peter Leese (Toronto: University of Toronto Press, 2019) PAGES TO BE DETERMINED UPDATE THIS. 290 Nurse Duncan’s case has also been considered in Chapter 1, where she is referred to as “Nurse D.” 291 LMA, H64/B/06/015, Saint Luke’s Hospital (Woodside Hospital) Records, Patients’ Records: Case Books, 1912- 1916. Hyoscine, also known as scopolamine is an alkaloid used between approximately 1900 and 1960 in conjunction with opioids such as morphine to put women in labor into “twilight sleep”, numb to pain while retaining a state of consciousness. 292 Ibid. 293 Ibid.

105 N. Snowden, who served as the other witness to her certification, “She said that she was in Hell and that she must remain there to save her sister’s soul.”294

Dr. William Rawes, the Medical Superintendent of St. Luke’s, noted that Duncan’s breakdown had come while she was serving at the front; given the timeline provided in the case notes, it is most likely that she was treating casualties at the Battle of Loos, which took place between 25 September – 8 October 1915. The British Army suffered nearly 60,000 casualties during the battle, forcing doctors and nurses to work around the clock to clear the wounded soldiers that continued to pour in from the trenches. As one medical orderly recalled during that time, “This week—the busiest since we opened—is a confusion to me of blood, gaping wounds, saline, and bichloride. Few particular events remain clearly in my mind.”295 However, as discussed in previous chapters, the damages that war could cause patients seldom intruded into the asylum, especially when those patients were female. Dr. Rawes’ notes on Nurse Duncan’s history attests to this. As he noted:

She had been in France for some months nursing soldiers. She was brought home on account of her illness… During her period of training as a nurse she took no vacation or holiday of any kind and went straight from her ordinary work to France to Nurse in June last. Noticed to be odd and peculiar about the middle of Oct.296

Although Nurse Duncan showed periods of lucidity and calm during the fourth months she spent at St. Luke’s, doctors generally noted that her mental condition remained “very variable and uncertain.”297 It was only in March 1916 that they noted she was “showing mental improvement and is now able to read and otherwise amuse herself.”298 This change in her

294 Ibid. 295 Quoted in Tim Cook, “Forged in Fire” in In Flanders Fields: 100 Years: Writing on War, Loss, and Remembrance, ed. Amanda Betts (Toronto: Alfred A. Knopf, 2015), 46 (17-59) 296 Ibid. 297 Ibid. 298 Ibid.

106 behavior may have been due to the fact that she was reunited with her sister, who also worked as a nurse somewhere along the Western Front. The two went for walks almost daily in the weeks preceding Beulah Duncan’s release on March 21, 1916, and the two left Europe for the United

States later that summer.299

NURSE DUNCAN’S EXPERIENCE REPRESENTS A LOT OF THIGS I’D LIKE TO

DISCUSS, WHICH IS A PARAGRAPH THAT SHOULD GO IN HERE.

The women who served during the First World War were part of a highly literate war generation, providing a wealth of written sources from which to analyze their emotional responses to war.300 However, much of the work that exists on the history of women and trauma, specifically within the context of the First World War, largely focuses on how women witnessed and reflected on the trauma of male soldiers for whom they provided care. Santanu Das, for example, describes the interaction of male and female bodies in a hospital setting, where the

‘shattered male body is a central concern’, women respond ‘with their own bodies responding, recoiling or rarefied’.301 Das further argues ‘for the importance of the tremulous, private body of the young female nurse as a way of knowing and representing historical trauma,’302 without, to any great extent, considering that there were aspects of the nurses’ lives that did not involve soldiers, and trauma that did not exist within the male form. In such studies, women serve, to paraphrase Joan Scott, as “the other” who confirm the male’s individuality.303 Scholars of gender and nursing have enriched this viewpoint, and have analyzed nurses’ writing for a more

299 John A. Connor, SS New York, Passenger Manifest; Written page 5 (stamped page 20), line 3; List or Manifest of Alien Passengers for the United States Arriving at New York, 1897-1957 (National Archives Microfilm Publication T715, Roll 2462); Records of the Immigration and Naturalization Service, Record Group 85. 300 Peter Grant, Philanthropy and Voluntary Action in the First World War: Mobilizing Charity (New York: Routledge, 2014), 19 301 Santanu Das, Touch and Intimacy in First World War Literature (Cambridge: Cambridge University Press, 2007), 178. 302 Ibid. 178-9. 303 Joan Wallach Scott, Only Paradoxes to Offer: French Feminists and the Rights of Man (Cambridge: Harvard University Press, 1997), 8.

107 nuanced view of their experiences. Christine Hallett, for instance, acknowledges nurses’ roles as both witnesses to trauma and as suffering themselves from war, as evidenced through their private writings. As she explains, “Nurses wrote to bear witness to their patients’ suffering. Yet, they also could not help but reflect on the trauma they themselves experienced as a result of their proximity to such physical pain and suffering.”304 Margaret Higonnet’s work has also considered the dual, competing and complementary types of trauma to which medical professionals were subjected during the war, considering how noncombatant medical staff “not only dealt with soldiers’ physical and psychological traumas, but were themselves exposed to situations that triggered breakdowns similar to those experienced by combatants.”305

Nevertheless, their analyses still largely rest on their interactions with men and the masculine sites of war. Consequently, they also overlook the ways in which women developed resiliency and supportive relationships to cope with this trauma.

This chapter seeks to expands the study of women’s emotion experiences of wartime through a close reading of their diaries, letters, and memoirs. In so doing, it seeks to understand the nature of women’s traumatic experiences, how they coped with the overwhelming physical and emotional stressors of their service, and the relationships that they developed in order to survive the hell of war. This study relies on the frameworks provided by scholars such as Jason

Crouthamel, Graham Dawson, Peter Hodgkinson, and Michael Roper.306 In their analysis, the aforementioned scholars bypass the politicized interpretations of historical trauma provided by

304 Christine E. Hallett, “Portrayals of Suffering: Perceptions of Trauma in the Writings of First World War Nurses and Volunteers”, Canadian Bulletin of Medical History, 27:1(2010), 75. 305 Margaret R. Higonnet, “Authenticity and Art in Trauma Narratives of World War I”, Modernism/modernity, 9:1(2002), 95 (91-107). 306 Jason Crouthamel, An Intimate History of the Front: Masculinity, Sexuality, and German Soldiers in the First World War (New York: Palgrave Macmillan, 2014); Graham Dawson, Making peace with the past?: Memory, trauma, and the Irish Troubles (Manchester: Manchester University Press, 2007); Peter Hodgkinson, ‘Glum Heroes’: Hardship, Fear and Death—Resilience and Coping in the War British Army on the Western Front 1914- 1918 (Solihull: Helion & Company Limited, 2016); Michael Roper, The Secret Battle: Emotional Survival in the Great War (Manchester: Manchester University Press, 2004).

108 government officials and doctors in the postwar. Instead, they turn their focus to the ways in which individuals express their emotions, and “engage in a struggle to shape the traumatic event into narrative form, to integrate it with their world of meaning, to fashion words that are in some way adequate to the dislocation and the horror.”307 Ultimately, these studies do not insist on a specific cause or reaction to trauma, but rather on the individual experience and expression of those emotions, sensations, and physical reactions that indicate a traumatic event. As such, they help expand the study of trauma outside the contentious power relationships inherent in the doctor-patient relationship, and liberate the individual from the biases and constructions of case notes. However, none of these scholars have turned their focus to the expressions and writings of women. This chapter, therefore, extends the scholarship of the history of emotions by studying women’s narratives and subjective experience of trauma, in all their complexity and subjectivity. In order to situate nurses’ roles in the history of medicine and caregiving, as well as the state of the field during the First World War, this chapter will begin with a brief overview of the history of nursing before moving on to women nurses’ experience in the First World War.

Nursing Before the First World War

Especially in Britain, which developed a highly organized volunteer nursing field following the Crimean War, nursing could be both a calling and a hobby. For elite, upper-class women, nursing was less a lifelong calling than it was a secondary occupation that would prove useful in the fulfillment of their social duties as wife and mother. Such training provided these elite women with useful skills, from treating minor injuries and dressing wounds to preparing

307 Dawson, 66.

109 food for recovering patients, and it was a chance for socialization and escape from the isolating life within an upper-class Victorian and Edwardian household.308 Nevertheless, “the universal attitude was that girls who didn’t need to work should not take jobs away from those who did.”309 These volunteer nurses generally remained under the control of her father (and would later be under the control of her husband) at home. They ministered to lower-class patients who turned to hospitals for care rather than hiring professional home care staff. In this way, upper class nursing recruits challenged neither the professional nor the social order around them.

For those women of more humble background, nursing offered both a source of income and personal pride, but it also carried wider social and professional implications within the milieu of fin-de-siècle society. Though less well-off, professional nurses were educated and, through training, acquired an impressive level of competency. In order to ensure that such women did not disrupt the gender hierarchy, either within the hospitals at which they worked or in the wider world they inhabited, it was necessary to circumscribe their work along gendered lines. As Emily Friedman notes, nursing was structured as a profession that was inherently female: “Caring was assumed to be a women’s duty…As a result, what had once been socially expected of women became bound up with what they started to do for a living.”310 Irish writer

Mary Costello encapsulated the link of nursing and gender when she remarked that “with most good women, nursing is an instinct, fed…from the great maternal artery.”311 By tying women’s work to their essential maternal, feminine essence, women in need of income were able to access paid, professional work in the public sphere. At the same time, tying women’s nursing work to their gender limited women’s roles and duties, by forcing them to provide constant emotional

308 Lyn Macdonald, The Roses of No Man’s Land (New York: Penguin Books, 1993, reprint), 15 309 Macdonald, 15. 310 Emily Friedman, “Troubled Past of ‘Invisible’ Profession”, JAMA 264(22): 1990, 2851. 311 Quoted in Fealy, 79.

110 support as well as physical care to their patients, and to remain subordinate to their male superiors.

Key among the skills that professional nurses were trained to develop was the ability to control their emotions. This involved not only maintaining deferential behavior with doctors, matrons, and other superiors, but also with patients. As Christine Hallett explains, professional nurses “valued emotional containment, believing that not only was such containment important for the well-being and healing of their patients; it was also what those patients desired.”312 This was particularly important in dealing with male patients. In terms of their professional duties, women were charged with seeing men at their most physically vulnerable and caring for their personal bodily needs in a way that would be otherwise considered taboo. Thus, moral and professional propriety, exhibited through a lack of reaction or emotion in the course of their duty, was paramount. The need for emotional and personal restraint was drilled into volunteer nurses during the war as well. A circular distributed in 1915 by the Red Cross to the Women’s

Voluntary Aid Corps in Belfast noted, “Perfect silence is one of the best evidences of good discipline and good drill.”313 Such behavior was critical for women who did not have experience on which to fall back and would, instead, be relying on the experience and authority of other professional nurses to guide them through a crisis. It would also prove a difficult obstacle for some women to overcome in trying to describe their own suffering during the war.

From a personal standpoint, nurses were deeply concerned with proving their worth and their skill in the hospital setting, and thus sought to avoid any indications of weakness whatsoever—particularly feminine weakness. While this was a source of professional pride for

312 Christine E. Hallett, “‘Emotional Nursing’: Involvement, Engagement, and Detachment in the Writings of First World War Nurses and VADs” in eds. Alison S. Fell & Christine E. Hallett, First World War Nursing: New Perspectives (New York: Routledge, 2013), 99. 313 Public Records Office of Northern Ireland (PRONI), BCT/8/5/3/4, Women’s Voluntary Aid Corps and Red Cross, 1915-1917, “Inspection by the President, Tuesday, 22nd June 1915, at 7.45pm,” dated 21 June 1915.

111 many, it also had negative consequences for nurses who did suffer breakdown. According to

Debbie Palmer: “One of the consequences of linking maternal qualities with the image of the nurse was to obscure the perception of nursing as a health hazard.”314 It was only as a result of their service in the First World War that nurses were able to access unemployment benefits and pensions.

At the outbreak of the First World War, British nurses were an ideologically heterogeneous group, divided on the issue of suffrage as well as professional registration for nurses, which would provide state legislation via a General Nursing Council to regulate nurses’ training, certification, and working conditions.315 In both these issues, the debate focused on the role of women as nurses within a gendered society. While some nurses perceived their skill and usefulness to society as qualification for full citizenship, others considered those same accomplishments rendered them “equal but different…as better educated, abler, greater women” who “must contribute to the wellbeing and richness of society” within their maternal role as caregiver.316 As a result of the deep ideological divide over registration and the upheaval caused by the war, there was no nationally recognized examination and certification of nurses in Britain until 1925. Until that point, each training institution awarded its own certificate, and the value of such certifications lay in the reputation of the issuing hospital or infirmary.317

314 Debbie Palmer, Who cared for the carers? A history of the occupational health of nurses, 1880-1948 (Manchester: Manchester University Press, 2014), 80-1. 315 Like suffrage, the debate over registration was deeply affected by the First World War. Trained nurses, concerned that their profession was being compromised by volunteers and untrained society ladies, largely united to advocate for registration after the First World War in order to ensure a high level of training and a standard of education for the field. See Kathleen Rawls, Power Plays: The politics of creating a British nursing profession, 1888-1919 (Ph.D. thesis, University of California, Irvine, 2002). 316Wellcome Library and Archives, MS. 8034, Dr. Nora Naish, Unpublished biography of Dr. Lucy Naish (alternatively titled Look Back in Thankfulness” or “Memoirs of a Dutiful Doctor”) 317 Robert Dingwall, Anne Marie Rafferty, and Charles Webster, An Introduction to the Social History of Nursing (New York: Routledge, 2002), 67.

112 The experience of the First World War permanently changed the nursing profession, as well as the individual women who served as nurses, by challenging previous notions of gender performance, authority, and emotionality. Nurses, both those trained professionally and those who volunteered during the war, found themselves called upon to develop new skills, master new techniques, and, generally, to cope with circumstances, sights, and experiences for which no peace-time training could prepare them. The constant demands of caretaking, especially in wartime, further added to women’s strain. As Debbie Palmer has observed, “[j]ust as mother cannot go off duty or report in sick because of a cold, so nurses were expected to show the same level of self-sacrifice even when work conditions threatened their health.”318 For both professional and volunteer nurses, the types of injuries they saw in service were certainly different and generally far more catastrophic than any they had dealt with previously. The feelings of horror and helplessness that the sight of such wounds caused, even in professional nurses, was inescapable. Such feelings were compounded by the changing nature of the patient- nurse relationship that developed during wartime, evolving into a much closer one than was typical for a civilian hospital. Professional nurses often saw soldiers as fellow comrades in service, while volunteers formed bonds with patients that were maternal, romantic, and friendly by turns. Regardless, however, of the nature of these relationships, the bonds that formed between nurses and patients made men’s suffering, and the inability to alleviate that suffering, all the more difficult to bear. This was especially true as the increased responsibility that fell to women within the hospital setting brought them into closer and more constant contact with their male patients than before. In addition to their work, the very real issue of safety from the dangers of war and from the violence of soldiers, was a constant concern that weighed on the

318 Debbie Palmer, Who cared for the carers? A history of the occupational health of nurses, 1880-1948 (Manchester: Manchester University Press, 2014), 80-1.

113 mind of all nurses. The next section of this chapter will analyze several specific sources of trauma that nurses, both professional and volunteer, describe in their wartime narratives, and the ways in which they coped.

Helplessness

The extreme suffering of war held emotional complications for nurses, both volunteer and professional. This was especially true when their knowledge and training proved no match for the wounds and suffering they witnessed in the course of their service. This could happen, first, when the wounds of soldiers exceeded the nurses’ capacity to provide care and effective healing, and secondly, when the patient themselves defied nurses’ understanding of war violence. This section will consider both of these examples.

For both professional and volunteer nurses, the types of injuries they saw in service were certainly different and generally far more catastrophic than any they had dealt with previously, and the feelings of horror and helplessness that the sight of such wounds caused was inescapable.

Such feelings were compounded by the changing nature of the patient-nurse relationship that developed during wartime, evolving into a much closer one than was typical for a civilian hospital. The feeling that nurses and their soldier-patients shared the same goal of winning the war, as well as the close and often difficult circumstances of their interactions, forged bonds between women and their patients that could often make men’s suffering (and the inability to alleviate that suffering) particularly troubling for nurses.

These memories of suffering often led to what is now recognized as ‘survivor guilt’ in nurses, a form of trauma that results not from the reaction to any horrible event but, rather, “the

114 peculiar and perplexing experience of survival.”319 Soldiers suffered such experiences in combat, and nurses suffered them when their patients died before them. In both cases, the utter helplessness to relieve another persons’ suffering proved emotionally overwhelming, and led to expressions of trauma, be they physical or verbal. Perhaps the most often-remarked example of such a reaction from nurses is Vera Brittain’s account of her own postwar breakdown, predicated by her belief that her face revealed “the signs of some sinister and peculiar change. A dark shadow seemed to lie across my chin; I was beginning to grow a beard, like a witch?”320 As a result of this vision, Brittain lamented, “Why couldn’t I have died in the War with the others?”321

Brittain’s experiences, though unique, are representative of many women’s expression of horror and helplessness at the sights and events they witness and endured during their service.

The diary of Hilda Mary Wells provides a very useful example of this. Wells received her training at the London Hospital School of Nursing, and was working at a military hospital in

Antwerp in October 1914. In her diary, she described the exhausting process of evacuating patients in advance of the German invasion of the city, and her subsequent journey in a motor bus to the comparative safety of Ghent. While she noted her shock at the destruction wrought on the city by German bombardment, she was chiefly concerned with the suffering of her patients, and her own helplessness mitigating their pain:

The suffering of our own wounded inside those awfully jolty buses are beyond words to describe—one poor man died—after about 3 hours of our journey—and he had to lie for the remainder of the way until we got to Ghent—He was taken out at the first hospital there—It took 14 hours—we arrived just as it was beginning to get light about 4.45 in the morning—a perfect hell of a night which we can never forget.322

319 Cathy Caruth, Unclaimed Experience: Trauma, Narrative, and History (Baltimore: Johns Hopkins University Press, 2016), 60. 320 Quoted Sandra M. Gilbert & Susan Gubar, No Man’s Land: The Place of the Woman Writer in the Twentieth Century, Volume 2: Sexchanges (New Haven: Yale University Press, 1989), 320 321 Ibid. 322 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1

115 Further evidence of the stress and strain this journey caused can be found in subsequent passages, where Wells’ narration devolves into a series of short bursts of recollection, each of which recall the many agonies she and her patients endured, including “Man with stump—with bedsore—held stump in his two hands all the way. Fearfully painful. Bus driver with broken leg which hadn’t been set—screamed aloud at intervals when he could bear it no longer.”323 Such vivid sensory details, related out of a narrative context, are indicative of psychological trauma caused as much by women’s personal feelings of horror, fear, and helplessness as by the sight of wounded men.324 In these descriptions, women serve not only as a mirror to men’s suffering, but as full participants, thinking, feeling, and reacting subjectively as well as sympathetically.

Another example can be found in the diary of Florence Elizabeth Ford, who trained at

Guy’s Hospital before the war, and who was assigned to convert the Belgian Convent of Les

Soeurs de Notre Dame de Namur into a surgical hospital in the early months of the war.

Confident in her own abilities, Ford noted just after her arrival that “I think we shall be able to cope with any difficulty except trephining. We have had to improvise very much, for instance, our retractors are two spatulas; on the other hand, we have plenty of saline equipment.”325

However, by November, she was forced to confront the realities of war:

Frightful rush…A very brave man died—he walked two miles with despatches after receiving a fatal injury—he knew he would die so Lady Dorothy promised to write his wife—he wished her to tell her he considered it an honor to die for Belgium as she had done so much for France—he ought to have a VC—he was conscious until about half-an- hour before he died when we gave him morphine; really such awful things one sees and hears are included to rack one’s nerves.326

323 Ibid. 324 For more on sensory descriptions as an indication of trauma, see Maria Crespo and Violeta Fernandez-Lansac, ‘Memory and Narrative of Traumatic Events: A Literature Review’, Psychological Trauma Theory Research Practice and Policy 8, no. 2 (2016): 149-156 325 Imperial War Museum, Private Papers of Miss F E Ford, Documents.17247; trephining is the process of drilling into the skull in order to relieve pressure on the brain. Nurse Ford later developed a make-shift trephine using a spatula. 326 Ibid.

116 Nurse Ford was confronted with suffering so great that there was no option but providing enough morphine to allow the patient to die without pain. The pain that this caused her was increased by having an opportunity to talk with the patient and understand the depth of his own pain and concern over his family. In assisting this soldier compose his final letter, Nurse Ford, like many other nurses in similar positions, placed herself in a surrogate position of mother or sister, assuming an intimate, familial, and distinctly one-sided relationship with patients that caused a great deal of sorrow when it was inevitably terminated through the patients’ death.327 She described the conflicting emotions such relationships could cause later in her diary, as she attempted to cope with the loss of another patient for whom she had come to care:

The awfulnesss of this war—it made me weep this morning and yet, last night, we laughed with one patient who came in with a very bad arm because he was so pleased that he bayoneted the Boshe who shot him and killed him. He says their cries are awful as they lie on the filed [sic] wounded, but can you wonder…328

Male combatants were not the only patients that nurses were called upon to treat; refugees and civilians were often frequent visitors to military hospitals. Such occurrences flew in the face of women’s training, and were often the cause of surprise and horror on the part of the nurses who were called upon to witness the widespread destruction warfare could cause. Nurse

Wells was one such nurse. She notes on November 8, 1914, after taking a tour of the trenches around the Ypres battlefield, that “we meant to have got close to the Yser to see the German corpses floating but there were so many shells bursting and shrapnel screaming overhead that they didn’t think it was safe.”329 However, her mental preparation was clearly directed towards, and built up by, seeing soldiers wounded as a result of the war. Civilian patients, on the other hand, repeatedly caused her significant and noteworthy concern and discomfort. On December

327 See Hallett, Containing Trauma: Nursing Work in the First World War, 177. 328 IWM Department of Documents, 09/66/01. 329 Royal London Hospital Archives, PP/HWE/1.

117 8, she wrote, “Lots of happenings today…Crowds of refugees lodging at our Hospital on straw from Ypres—Little boy age 10—wounded by bursting shrapnel (sic) at Ypres had leg amputated—went into theatre and had quite a shock to see child on table.”330 Throughout the diary, she notes in detail the sights of helpless suffering, especially of children and mothers; never, apparently, becoming used to the sight, or to the pain that these civilians endured.

Dorothy Minnie Newman, a woman Sanitary Inspector who was assigned to the Balkan

Front, expressed similar distress at the sight of wounded and suffering civilians. Newman was attached to the Stobart Field Hospital and was involved in the mass retreat from Serbia in 1915.

During this period, she recounted the treatment of soldiers with professional detachment, noting the types and locations of wounds and her own ability to treat these injuries effectively. For example, she described in early November 1915:

We were sitting by the roadside, playing bridge, when suddenly three bullock carts of wounded came up. I had to get into the carts to dress them, as they were too bad to move. The wounds were full of dirt and shrapnel, and one was shot through the liver, lungs, stomach and arm. Another was wounded in the lungs and the legs, and had the toes off both feet. We finished about 5 o’clock, and I went to see the sunset with the French doctors. It was glorious tonight, and well worth while the climb we made to see it.331

In such cases, where her professional skills helped her to treat the suffering caused by the war, Newman was able to describe the events and recall injuries in a straightforward chronology of her day and her overall war service. These events appear to be a routine part of her war service, which was easily recalled and just as easily put aside afterwards, tempered by the views of a sunset with friends. However, there were also events that disrupted this chronology, typically sights of civilian or animal suffering or death to which Newman reacted with horror and revulsion. For example, she recounted the graphic death of three horses who were “killed by

330 Royal London Hospital Archives, PP/HWE/1. 331 Wellcome Library, Typescript ‘Diary of a Trekker in Serbia, covering service with Mrs St Clair Stobart’s hospital at Kragujevatz and with the Field Hospital on the retreat’, GC/165/1

118 a bomb yesterday, and after being skinned were thrown into the valley, where the horrible wild dogs are eating them up.”332 Newman, like many other veterans, used descriptors like ‘horrible’ to attempt to come to terms with the indescribable sights of war, and unrelenting feelings that such memories evoked. Despite Newman’s desire to turn away from such sights, the smell of the horse carcasses and the sights of their dismemberment lingered in her mind, forcing her to attempt to record and thereby to attempt to overcome them.

Similarly, at the end of November, she described her experiences of retreat, and the views of human suffering and death that she could neither alleviate nor forget. On November 25, she noted that “There was a snow blizzard blowing strongly against us, and the corpses along the road were ghastly. Among them was a mother, dead with her dead baby in her arms.”333 Her use of descriptors in this reference, specifically the word ‘ghastly’, indicate a rejection of this kind of suffering and death that disrupted the pattern of Newman’s days, and challenged her descriptive abilities, even hours later. That night, as she tried to sleep in a motor car for shelter, she noted,

“It was very cold, and we thought of the horror we have seen to-day—five convicts in chains, shot through the head and lying dead in the snow, to say nothing of the corpses innumerable.”334

The next morning, she noted that “It was a bitterly cold night, which I passed in having nightmares.”335 Here again, the unforgettable and unredeemable sights of war challenged not only Newman’s descriptive abilities, but also challenged her own self-identity as a caretaker.

Such memories therefore could not be reconciled within a narrative of her day, and remained to haunt her dreams.

332 Ibid. 333 Ibid. 334 Ibid. 335 Ibid.

119 This helplessness was not only for patients; nurses worried about other nurses and the toll that service took on their health and wellbeing. In her wartime diary, New Zealand nurse Louisa

Higginson confessed her worry for her companion, Maria, who had contracted an illness: “I feel

I don’t know what to do for Mary is sick, with the Malta complaint, she looks so bad.”336 For a medical professional whose resiliency was at least in part rooted in being able to respond in the case of an emergency, not being able to assist her suffering friend was clearly a source of serious distress. Though Mary recovered from “the Malta complaint” (doubtless a kind of gastrointestinal infection), her recovery was slow, and Louisa continued to record her condition with concern, noting that Mary was “almost delirious with headache, also been vomiting.”337

Nurses were also very aware of the emotional suffering of their colleagues. Enid

Bagnold describes one of the nurses with whom she served, a woman whom she referred to as

“My Sister.” This woman, she explains, was “afraid of death. She told me so. And not the less afraid, she said, after all she has seen of it. That is terrible.”338 It wasn’t long before the Sister was entirely overwhelmed, and tells Bagnold: “‘I am going away to-morrow. They are sending me home; they say I’m ill.”339 Bagnold offered no criticism of her Sister for her ‘illness’.

Rather, her reaction was one of despair, first to be losing her friend, but also to realize the depth of her friend’s suffering—and her own inability to help:

Her collar, which was open, she tried to do up. It made a painful impression on me of weakness and the effort to be normal. I remember that she had once told me she was so afraid of death, and I guessed that she was suffering now from that terror. But when the specialist is afraid, what can ignorance say…?340

336 Quoted in Hallett, Containing Trauma: Nursing Work in the First World War, 209. 337 Quoted in Hallett, Containing Trauma: Nursing Work in the First World War. 338 Enid Bagnold, A Diary Without Dates (London: Virago, 1978, reprint), 18. 339 Bagnold, 19. 340 Bagnold, 22.

120 The inability to alleviate suffering was just as trying when it was a friend as a patient. The added stress of losing a good friend to that suffering was an added burden on the narrator of Bagnold’s tale.

As Potter and Acton observe, medical professionals who served during the First World

War “had little or no precedent for articulating their experiences,” or any kind of tradition or training that could provide “means of negotiating the emotional and physical impact of their experience.”341 For volunteer and professional nurses alike, their training and feelings of competency, whether acquired before the war or in volunteer training after the outbreak of hostilities, provided a strong buttress to the challenging sights and memories of war. However, the extraordinary injuries and extreme suffering they witnessed, and the lack of control they felt in witnessing such events, often disrupted their ability to narrate their own lived experiences of war. This was especially true when women were called upon to witness the suffering of innocent people and animals, experiences that were outside the realm of nurses’ expectations and military training. Such sights and interactions lingered, challenging women’s control over the situations in which they found themselves, as well as their own feelings of competency and self-identity within the context of the war. In such cases, women often turned to their diaries and private writings to attempt to record, and thus, to distance themselves from the visceral and disruptive memories, providing insight into the deeply emotionally troubling experiences of their wartime service.

ISSUES OF PHYSICAL DANGER

Among the clearest explanations for postwar trauma symptoms in nurses’ pension files, as exemplified by Nurse Pigott’s account at the beginning of this essay, is the fear and stress

341 Potter and Acton, 32,33

121 caused by threats to their physical safety and well-being. While the vast majority of deaths among British nurses were the result of contagious diseases, specifically pneumonia and influenza, rather than from wounding, the threat of death and physical injury was an omnipresent and serious source of concern.342 Women wrote about their fear of enemy action, including air raids, long-range guns, and artillery fire, all of which were frequently trained on or near hospitals and medical areas. Moreover, the terror that air-raids caused to nurses was considerable. In event of air raids or enemy action, nurses were charged not only with keeping their own fear in check, but also for preserving the safety of their patients. As trained nurse Mary E.C. Love noted in an unpublished postwar memoir, “the habit of the British Military Service is to ‘Carry on as Usual’ whenever possible under all circumstances. All fuss and excitement was reduced to a minimum and we were not encouraged to dwell on the ‘danger of the night.’”343 Yet despite women’s best intentions and most stringent devotion to duty, air-raids and similar enemy action forced women to cope with feelings of extreme fear for their own personal safety and the well- being of their patients. Nurse Love wrote about the emergency procedures taken at her hospital in Etaples when German air raids became frequent late in the war:

The second time the Bosch appeared, the nurses and personnel who were off duty and all patients who were able to walk were ordered to go into the hills behind the hospitals. It must have been an unusual sight to see us scattered on the slopes in the moonlight, taking shelter where the ground afforded it and staying out in the open until early dawn.

At that time we had no underground bomb-proof shelters and during several succeeding raids all the day nurses were ordered into a large empty ward where we folded cots flat on the floor and lay prone on them. The young nurses of the Volunteer Aid Detachment, who might have been expected to lack the self-control of the graduate sisters, behaved exceedingly well, and although our limbs shook at each detonation and someone would occasionally cry out, there was no case of hysteria or cowardice.344

342 “VAD casualties during the First World War”, redcross.org.uk/WWI: http://www.redcross.org.uk/~/media/BritishRedCross/Documents/Who%20we%20are/History%20and%20archives/ VAD%20casualties%20during%20the%20First%20World%20War.pdf, Accessed March 17, 2018 343 Wellcome Library, Mary E.C. Love, “Through shadows and sunshine, 1914-1918”, GC/258/4: Box 1. 344 Ibid.

122

As conditions in the Etaples hospital deteriorated, patients and nurses alike were forced to spend the night in trenches dug outside the wards of the hospital in order to protect them from air raids on the hospital. In addition to the highly unsanitary conditions of these trenches, the smells and heat generated by so many bodies in such a small space was overwhelming. Nurse Love recalled that “I remember fainting one night in the heat and stuffiness of the underground chamber and being laid on the ground and revived by a friendly Canadian doctor.”345

In addition to being emotionally challenging, air raids could often prove physically exhausting for nurses, who were called upon to care for and, in extreme cases, to carry wounded patients to safety. Eva M. Smith, a trained nurse who served with the Joint War Committee of the British Red Cross and the Order of St John in France for the duration of the war, described the increased workload that nurses faced when air raids were eminent:

…we had early morning evacuations and if Fritz was knocking around we could not show a light. Every man had to have breakfast, his wound dressed, his clothes—pyjamas, pants, shirt, sweater, cap, muffler, socks and if winter, gloves all to be put on. Then if he had a splint, that had to be tied firmly to the stretcher.346

On several occasions, multiple evacuation orders were given in a single day, creating an enormous amount of work and stress for staff. Smith herself described such a day as one “never to be forgotten. Started with an evacuation at 8 A.M. Take in at 9 A.M. Evacuation again at 12.

Another take in at 3 and another evacuation at 4. The men were coming before the leaving ones were out of the beds. Serious dressings to be done and careful fixings of splints to do before they left.”347 In the event of poor weather, during which evacuations were impossible, or in the case

345 Wellcome Library and Archives, GC/258/4: Box 1. 346 Imperial War Museum, Private Papers of Miss E M Smith, Documents.16098. 347 Ibid.

123 where patients were too ill or injured to be moved, Smith described how “we put mattresses over the patient to keep bits of falling shrapnel from hitting him.”348 This physical toll such work must have put on nurses is considerable, but the amount of emotional strength it must have taken to remain calm and resourceful during nighttime aerial attacks was considerable.

Dorothy Newman, who was working in Serbia, recounted her own experience of aerial attacks, emphasizing the constant strain caused by the threat of enemy action, as well as the physical hardships she and her comrades endured as a result:

We are settled in a field about a mile out of Racha, where we have put up the hospital tent…Three aeroplanes passed over us, two French and a German, the latter dropping bombs, and a captive balloon is over us all the time. The guns are so near us that we can gather shrapnel, and they have never ceased for a moment…As I am writing this the German plane suddenly came down, recovered itself within forty feet from the earth, and flew away. At half past six order came that we were to be ready to retreat at any minute. We packed everything up, had dinner, and awaited orders to move…Suddenly a large convoy of wounded appeared, and as we were packed up there were no dressings ready. We had to unpack with the Germans within a few kilometres of us, and after much excitement we managed to make the men remain and help us…there were so many that we were at our wit’s end to know how to evacuate them.349

Not only was the threat of enemy action an obvious source of stress for Newman, the knowledge that she and her fellow nurses were alone in helping the convoy of wounded (at least, until they were able to convince other members of their convoy to stay behind and assist) added significantly to the stress that is evident in these descriptions. The constant threat of danger, in addition to the work that nurses were called upon to perform under such threat of peril, proved, unsurprisingly, extremely exhausting. As a result, such incidence formed a critically important, and unavoidably memorable, part of their war experiences and narratives.

348 Ibid. 349 Wellcome Library, Typescript ‘Diary of a Trekker in Serbia, covering service with Mrs St Clair Stobart’s hospital at Kragujevatz and with the Field Hospital on the retreat’, GC/165/1

124

Threats of Physical Attack

In addition to recounting the stress and fear brought about by working in life-threatening conditions, nurses also wrote about the threat posed to them by the men with whom they lived and for whom they cared. Considering this aspect of their service changes the traditional nurse- patient relationships as it has been described by numerous academics. Typically, nurses have been portrayed as holding a position of power over injured soldiers, even if that power was maternal rather than martial. Scholars also tend to play up “the true spirit of friendship that could exist between them and their patients.”350 This should not detract, however, from the threat that soldiers could pose to nurses’ physical safety. Even in an injured and physically weakened state, soldiers were capable of overpowering nurses, especially when their injuries left them mentally unstable or deranged with fear. Nurse Hilda Wells was faced with just such a patient, who she wrote about at length in her diary:

There was a bad head case—He appeared perfectly quiet when I went on duty, just lying log-like, but for precaution, as head cases often try to get out of bed, I put the one empty bed up against his bed to keep him more securely in. Half-way through the night when I was busy at the other end of the ward with a bad haemorrhage I saw this man up on all fours & crawling across to the other bed—I went across to him and gently tried to persuade him back into his own bed—But he got violent immediately struck me a blow full in the face & then sprang out of bed & all my force was as nothing against his collosal [sic] strength & I was absolutely powerless—Then I tried to hold on to him so that he didn’t escape or do something desperate to the other patients—But he got me by the throat—one hand in front & the other at the nape of my neck & literally tried to strangle the life out of me!

I’ve never had a worse moment in my life—never more nearly dead—or rather thought I was!

I screamed & screamed &…I strained to get near the open window to yell “help” as I’d heard a chauffeur out in the garden with his ambulance car only a few minutes before—

350 Quoted in Hallett, Containing Trauma: Nursing Work in the First World War, 177.

125 But no help came and nobody heard—the utter helplessness of it was awful—Then suddenly the door opened & Miss Barron came in quite by accident to borrow something—The man loosened his hold & fell exhausted on to the bed. How my head swam & ached for hours afterward—but I had to go on just the same with all the other patients bad & needing treatment & attention as tho’ nothing had happened.351

This incident is significant for two reasons. First, it shows the very real danger that a soldier could pose to a nurse, especially if she were by herself on her rounds. Second, is Wells’ realization that she had no choice but to continue her rounds after this attack. This diary entry thus became an outlet for the fear and pain she repressed in order to carry on with her work.

Other recorded cases of soldiers attacking nurses show that the violence was enacted consciously, as well as a result of delirium. Much has been written about the ‘brutalization’ of soldiers during the war, though these studies have tended to focus more on issues of public violence, such as postwar riots, public brawling, and political revolutionary action.352 However, some feminist scholars have considered the sexual and gendered forms of violence this brutalization could take.353 Susan Kingsley Kent, for example, states that “front soldiers returned home in a violent frame of mind” that manifested in “innumerable accounts of sexual attacks upon women.”354 Further examples of the sexual and physical threat posed by soldiers, both comrades and allies, can be found in nurses’ writings. For example, Sister Joan Martin-

Nicholson wrote about her encounters with German soldiers during her service at the Hôspital

Militaire in Brussels. Sister Martin-Nicholson worked in the Hôspital as a prisoner of the

351 Royal London Hospital Archives, PP/HWE/1. 352 For examples, see Jon Lawrence, “Forging a Peaceable Kingdom: War, Violence, and Fear of Brutalization in Post-First World War Britain,” The Journal of Modern History, 75(3): 2003, 557-589. 353 Judith Lewis Herman, Trauma and Recovery: From Domestic Abuse to Political Terror (London: Pandora, 2001); E. Kuhlman, Reconstructing Patriarchy after the Great War: Women, Gender, and Postwar Reconciliation between Nations (New York: Palgrave Macmillan, 2008); Elizabeth Nelson, “Victims of War: The First World War, Returned Soldiers, and Understanding of Domestic Violence in Australia,” Journal of Women’s History, 19(4): 2007, 83-106 354 Susan Kingsley Kent, Making Peace: The Reconstruction of Gender in Interwar Britain (Princeton: Princeton University Press, 1993), 97-8.

126 Germans and was informed that she should not be alarmed to find male “sentries posted outside her door and window.”355 However, when she attempted to retire to her room, she found herself confronted by a German soldier:

As I put my key into my door one night, it was rudely snatched from me by a second lieutenant. “I have orders to see that you are comfortable!” I vigorously protested, but without avail, and he passed into my bedroom before me. I had just time to beckon to the sentry, praying that his years and the gold ring on his marriage finger might incline him to help me, when the officer, seizing me by the wrist, pulled me into the room and slammed the door. With my back to the wall I waited. The officer took one step towards me when the door opened, and the sentry stood there, leaning silently on his rifle and seemingly oblivious of the situation. “Get out of here!’ roared the lieutenant. “I cannot,” the man replied stolidly, “the Herr Colonel has given me strict orders to look after the Schwester.” The officer hesitated for one brief second, then, taking me roughly by the arm, threw me across the room, picked up my crucifix and dashed it on to the ground, and, cursing vehemently, stormed out of the room.356

Although the intentions of the German soldier cannot be known, Martin-Nicholson’s account of his violent outburst after the sentry interrupted this exchange indicates both the potential for violence inherent in the situation, and her own sense of personal danger within the context of this exchange.

Nicoletta Gullace has demonstrated that attacks by enemy combatants were reported more frequently and widely reported because they “provided British propagandists with a vivid and evocative set of images” that could be used to stir and encourage the British public to supporting the war.357 However, British nurses’ diaries show that the threat of violence against women was far more widespread and frightening, and also far less straightforward than the

355 Quoted in Anne Powell, Women in the War Zone: Hospital Service in the First World War (Stroud: The History Press, 2013), 32. 356 Quoted in Powell, 33-4. 357 Nicoletta F. Gullace, “Sexual Violence and Family Honor: British Propaganda and International Law during the First World War,” American Historical Review, Vol.102: 3 (June 1997), 716

127 public press implied. Eva Smith, for example, noted in her diary how she and her fellow nurses often felt threatened by the soldiers around them, specifically at night. She described how she and many of her fellow nurses had taken to sleeping outside when not on duty in order to escape the stress of the hospital and enjoy the fresh air. However, in September 1917, she and her friend Agnes Boys learned that the dangers they fear in the hospital could not be escaped outside of it:

Matron had a nasty shock. We were awakened in the middle of the night by her shouts for help. She had wakened up suddenly feeling somebody was in her tent, her lamp which she always kept alight was out. She put out her hand to feel for some matches but someone caught hold of it saying “Don’t strike a light and do not shout” She promptly yelled for help and the person dashed away. Boys and I were sleeping in the woods just behind her tent (we always did all through the summer) After that night we had a guard round the Camp. Matron never slept by herself afterwards and we were stopped from sleeping in the woods, much to our sorrow. It was such a treat to get away from the cubicles, where one was never quiet, never got away from the sound of voices and one could never talk without being overheard.358

While many women felt a spirit of camaraderie, maternal or sororal devotion to their patients, there were many who also noted the dangers they faced at the hands of the men in their care. As

Smith’s diary shows, not only were attacks themselves deeply troubling, to the extent that the hospital Matron didn’t sleep alone for the rest of their service together, but the realization of unstable power dynamics at play in the hospital setting was a jarring one, as well. Nursing probationer Elsie Fenwick echoed these sentiments in her own diary while she was working at a

Belgian Red Cross Hospital where a nurse was attacked in the middle of the night by a soldier:

She was in a villa close to ours and alone in a room. A soldier climbed up the balcony, got in, knocked her down because she screamed, and tried to gag her. Luckily the nurses next door heard and got into the room. He hid under the bed and was caught! The poor nurse is the ugliest in the hospital, and is suffering from terrible shock! I think the man

358 Imperial War Museum, Private Papers of Miss E M Smith, Documents.16098.

128 will get several years as he is going to be tried by court martial. What dangers we go through...359

Fenwick describes the incident as a shocking, almost scandalous bit of news that is, effectively, over, as a result of the soldiers’ arrest and potential court martial. However, her final sentence, regarding the danger she and her fellow nurses face, shows that this attack was personal to her, despite her attempts to separate herself from the victim of this attack by referencing her ugliness.

Her exclamatory bravado breaks down with the realization that, the threat of future personal violence could never be mitigated completely.

These personal narratives expose the sources of fear that women felt during the war service, the ways in which they coped with them, and managed the feelings that troubling or threatening events provoked. They also show the processes by which women sought to incorporate troubling and traumatic events into an autobiographical narrative that allowed them to regain a sense of control over their experiences and reactions. In the next section, I will analyze the friendships and sources of resiliency that women nurses noted in their wartime narratives. Considering these descriptions of resiliency and bonding contribute to an understanding of women’s holistic war experience and unique subjectivity. It will also help demonstrate how critical interpersonal relationships among other women were during wartime.

Such relationships may not have survived the war, but the need for understanding, camaraderie, and support was very necessary for women veterans once they returned to civilian life. A deeper understanding of these sources of resiliency will aid this discussion.

Louise Harms explains that, ‘resilience is an interactive process,’ which involves the ability to construct a narrative that locates the individual within a specific time, place, and in

359 Quoted in Powell, 135. There is a wealth of commentary to be made on Fenwick’s observation that this nurse “is the ugliest in the hospital,” and how patriarchy, particularly militant patriarchy, induces women to compete for men’s attention.

129 relation to other people.360 In order to fully understand women’s lived experience of warfare, it is important to probe the causes of trauma and the sources of resilience, both inside and outside the hospital. Medical service in war time meant unpredictable hours, frequent interactions with men in severe pain, ghastly injuries, and the constant threat of physical harm from air raids and infectious diseases. Thus, professional nurses and volunteers alike had little choice but to learn to cope as best they could, and develop a functional resiliency as quickly as possible. For many women, their training at home, as well as their faith in their own competency provided a reliable source of resilience. However, when such self-confidence broke down, nurses often found support in their fellow nurses; women on whose competence and resourcefulness they could rely, as well as friends who understood the strains of war service. Female friendships also provided outlets for emotions that women were not permitted to display during their interactions with their patients. While such a study should not ignore the friction that developed between professional nurses and volunteer nurses during the First World War, this article contends that this friction was not constant, and could be overcome.361 Professional nurses and volunteers spent time together when off-duty, and participated in performances and celebrations together throughout their service.362 This sense of “solidarity and collective friendship” not only helped anchor women during their grueling service, but also aided in navigating the transition to civilian life and establish a postwar identity.363 In order to emphasize how these friendships helped women, this section will rely primarily on the diaries of two specific nurses, Nurse Hilda Wells, whose diary is held at the Royal London Hospital Archive, and Eva Smith, whose diary is held by the

360 Louise Harms, Understanding Trauma and Resiliency (New York: Palgrave Macmillan, 2015), 108. 361 Christine E. Hallett, ‘Emotional Nursing’, in First World War Nursing: New Perspectives, eds. Alison S. Fell & Christine E. Hallett (New York: Routledge, 2013); 87-103. 362 Janet Lee, War Girls: The First Aid Nursing Yeomanry in the First World War (Manchester University Press, 2005), 212. 363 Lee, 15

130 Imperial War Museum. Both women’s diaries provide excellent examples of how nurses developed friendships, created spaces of solitude and support, and crafted entertainments for each other to make their war experiences endurable. Focusing on their specific wartime experiences emphasize the critical importance of friendships during their wartime service.

Hilda Mary Wells was born around 1892. After working as a governess, she joined the

London Hospital School of Nursing as a probationer nurse in March 1907.364 According to the notes provided by the Royal London Hospital Archive in the catalog entry for her diary, Wells’ personality was described by her instructors as ‘very gentle and quiet,’ while as a student she was noted to be ‘persevering and hardworking’.365 Her training was interrupted several times when she returned home to care for family members who had fallen ill, but she eventually left the London Hospital School of Nursing in August 1911 with her training certificate, taking up work at a Lying Hospital in Glasgow.366 She enlisted early in the war, and was working in

Antwerp by October 1914.367 Over the course of the war, she was assigned to the French Red

Cross, as well as the American Ambulance Hospital of Paris in Neuilly Sur Seine.368 She wrote faithfully in her diary, and although the volume at the Royal London Hospital Archives only covers the years 1914-1915, there is still a great deal of interesting detail in her writings, not only regarding events taking place within the hospital, but also her personal experiences and relationships, and especially her close friendship with an American Red Cross Nurse whose first name was Glory.

364 Royal London Hospital Archive Catalog Entry for Papers of Hilda Wells SRN, available online: http://www.calmhosting01.com/BartsHealth/CalmView/Record.aspx?src=CalmView.Catalog&id=RLHPP%2fHWE , Accessed September 15, 2018 365 Ibid. 366 Ibid. The catalog also notes that Hilda Wells died on 11 December 1987. 367 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1 368 National Archives, Women’s Services, Distinguished Conduct Medals and Military Medals, Hilda Mary Wells WO/372/23

131 It is unclear when Wells first met Glory, whose surname is not provided in the diary. The first reference to her in Wells’ diary occurs while both women were passengers on a ship from

Ostende to Folkestone in October 1914. In addition to nurses and troops, the ship contained a large number of Belgian refugees. When one Belgian woman went into labor with her first child, a call went around the ship for a doctor. According to Wells, ‘I told him ‘no’—we knew of no doctor on board but I was a sage-femme [midwife]—would he lead me straight to the woman’.369

After settling the woman in a salon, Wells found Glory. Together, the two women assembled a meal for the refugees, and delivered the baby safely. As Wells noted, ‘…everything went on beautifully straightforwardly, with Glory to help run and fetch and carry and empty slops overboard and the little one appeared at 10 o’c—’.370 This is the first of many examples of how

Glory’s professional assistance and emotional support helped Wells carry on through her service, though there would be many more, even in the short time covered by Wells’ diary.

Eva Marion Smith was a trained nurse who served with the Joint War Committee of the British

Red Cross and the Order of St John in France throughout the First World War.371 She volunteered for service on 4 August 1914, and departed for the Arc en Barrois Hospital in

Chaumont, Haute Marne, on 1 January 1915, noting with some dismay later that she ‘missed the

1914 medal by 8 hours!’372 It was while waiting for her ship to depart that she met Agnes Fanny

Boys, a fellow trained nurse whom she would later describe as her ‘greatest friend,’ and who became the focus of many narratives and recollections within her diary, which she kept until

369 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1. 370 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1. 371 The National Archives, Medal Card of Smith, Eva Marion Corps: British Red Cross Society, WO 372/23/38405; Imperial War Museum Catalog Entry for Private Papers of Miss E M Smith, available online: https://www.iwm.org.uk/collections/item/object/1030018221, Accessed September 30, 2018. 372 Imperial War Museum, Private Papers of Miss E M Smith, 08/112/1

132 1918.373 Like Hilda Wells and Glory, Smith and Boys made a concerted effort to remain together throughout the war. When she learned that Boys’ mother has passed away suddenly in

October 1915, for example, Smith declined an assignment to Serbia, noting in her diary, ‘Agreed to wait till we should work together again as she did not want me to go to Serbia without her’.374

The emphasis in both women’s diaries regarding these close personal relationships with other women emphasize how critical these components of their service were to them, especially during the most harrowing points in their war service. Additionally, it is also possible to consider how profoundly these women’s sense of personal identity was defined by their friendships with other women.

Trauma and Healing

Close readings of war diaries provides a revelatory and rich source from which to study the lived, emotional experience of trauma, as well as the potential for healing and closure that made it possible for an individual to carry on in the aftermath. Such a reading does not insist on a specific cause of, or reaction to trauma, but rather on the individual experience and personal

‘struggle to shape the traumatic event into narrative form, to integrate it with their world of

373 Imperial War Museum, Private Papers of Miss E M Smith, 08/112/1; The National Archives, Medal Card of Agnes F. Boys: French Red Cross, WO 372/23/4383 374 Imperial War Museum, Private Papers of Miss E M Smith, 08/112/1.

133 meaning, to fashion words that are in some way adequate to the dislocation and the horror’.375

Neither Hilda Wells nor Eva Smith, so far as is known, was treated medically for symptoms of trauma, but the narratives in their diaries indicate that they, like so many other women and men, were both exposed to traumatic incidents in the course of their service, and struggled to record these situations adequately in their diaries.

The first entry in Hilda Wells’ diary is undated, but based on context and dates noted several pages later, it was most likely written in early October 1914, when Wells was stationed in a hospital in Antwerp. The German Army began bombarding the fortified city on 28 September; by 1 October the Belgian government decided to evacuate the city. By 8 October, the city fell to the advancing German Army. Wells’ hospital was given notice to evacuate and, according to her first entry had ‘about 1 ½ hours to wind up’.376 Wells recalled that patients were loaded into busses, while the staff was ‘helping to get in wounded as quickly as possible—shells bursting all round about’.377 She was placed in charge of a bus of wounded that had been converted into a make-shift ambulance with ‘boards across between seats and patients crosswise—heads and feet alternatively like sardines!’378

The journey out of Antwerp was harrowing, in part because Wells was separated from the six friends with whom she had served since departing London. ‘We were a jolly party then & meant to keep well together,’ she noted, months after the evacuation.379 In addition to her personal sense of loss over the support and assistance of her friends, Wells was also deeply troubled by the sights of absolute destruction she witnessed on her journey, including ‘some

375 Graham Dawson, Making Peace With the Past?: Memory, Trauma and the Irish Troubles (Manchester: Manchester University Press, 2007), 66 376 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1 377 Ibid. 378 Ibid. 379 Ibid.

134 houses blown right in and some burning –nearly all the overhead tram line were broken + lying across the streets’.380 Later in the same entry, her descriptive abilities broke down almost entirely, both as a result of time constraints and an inability to adequately depict the experiences of her journey across Belgium: ‘Man with stump—with bedsore—held stump in his two hands all the way. Fearfully painful. Bus driver with broken leg which hadn’t been set—screamed aloud at intervals when he could bear it no longer’.381 [and this one too] The sensory descriptions in these passages, from the sight of a man’s amputated leg to the sound of the bus drivers’ screams, are symptomatic of clinical psychological trauma, brought on not only by

Wells’ lack of control over the situation and her patients’ comfort, but by the personal fear of harm and exhaustion that the journey produced.382 In these descriptions, Wells also positioned herself against the groups of male patients in the bus with her. From an emotional standpoint, stress, and resultant expressions of trauma, isolated her from any emotional engagement with her patients, and her ongoing sense of separation and vulnerability is present throughout her descriptions of this retreat. The repeated references to ‘fleeing form Antwerp’ throughout her diary, especially the troubling sights and sounds of the experience, emphasize what a deeply traumatic period this was in the course of Wells’ service.

Even after the journey was completed, Wells continued to record her memories of the

Antwerp hospital, specifically the patients whose suffering had so troubled her. According to

Christine Hallett, ‘Nurses were among the first to realise the true meaning of the First World

War: the extent of the destruction that could be wreaked by industrial warfare; the fragility of the

380 Ibid. 381 Ibid. 382 For more on sensory descriptions as an indication of trauma, see Maria Crespo and Violeta Fernandez-Lansac, ‘Memory and Narrative of Traumatic Events: A Literature Review’, Psychological Trauma Theory Research Practice and Policy 8, no. 2 (2016): 149-156

135 human body and mind in the face of its chaos’.383 The realization of the wounds of war was, in itself, a source of enormous emotional stress for nurses, as evidenced by the entries in Nurse

Wells’ diary entries following her arrival in Ghent. For example, she wrote at length about a

Lieutenant Foote, whose death would linger in her memory, as evidenced by occasional references to him throughout her diary. As she recalled,

Lieutenant Foote was shot badly in intestines by one of his own men—operation Oct 8th—day of bombardment which began at midnight—had 9 feet of gut removed—that same night the poor fellow was hauled down on his mattress into the cellar with the rest (Doctor had given orders during the day that on no account was he to be moved or disturbed for 24 hours after operation) & yet he was one of those who the next day after his op. was jolted & shaken over the rough roads for 14 hours in one of those motor buses from Antwerp to Ghent—we got him settled up in the first Hosp. we stopped at—but he was very ill & would probably die from the effects of the journey.384

This passage emphasizes the psychological burden that such sights of suffering placed on nurses, and the stress caused by being unable to perform their duty to their patients. Knowing that

Lieutenant Foote was not supposed to be moved, and understanding his precarious medical health made the sight of his pain that much more difficult for Wells to endure, especially as the measures she had to take to protect him from shellfire may very well have hastened his death.

It was a result of her close female friendships that Wells was able to find emotional closure from the trauma of her evacuation and the sites of suffering she endured during the process. In early November 1914, she and her friend Glory were serving under the Belgian

Military authority and transferred to a hospital in Furnes where, Wells noted with delight, three members of the party with whom she first enlisted were also working. Among their number was

Nurse Ashley-Smith, a close friend who provided, first, a hearty welcome to Wells and her friend

Glory, and an emotionally comforting end to the story of Lieutenant Foote:

383 Christine Hallett, Containing Trauma: Nursing Work in the First World War (Manchester: Manchester University Press, 2010), 161. 384 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1

136 We fell on each other’s necks—I think I was more pleased to see her than any one ‘cos she’s so fine & when all of us were leaving Ghent because some of our patients were left behind she stayed too—& when the town evacuated she still stayed on because Lieut. Foote was left behind too ill to be moved. The Germans came and she faced them all in her Kharki [sic] without any fear. In a car one day a German was insolent & called the English ‘Sweinen’ & she ordered him out--& he did get out! The Belgian peasants in same car were just wild with delight. She has just been in my cubicle telling me all about Lieut. Foote’s death & funeral—She went herself to American consul to try to get Union Jack & make arrangements for the funeral…and she herself read the burial service, 2 nurses were there & a few Belgian peasants, that was all.385

Not only is it clear that Nurse Wells was overjoyed to have a friend who shared her experiences, but that Nurse Ashley-Smith returned her glee. The fact that Ashley-Smith was also able to provide emotional closure by telling Nurse Wells about the death and proper burial of a patient they both clearly held in high regard is also very significant. This can be seen, first in the return to traditional sentence structure and narrative in relating the events surrounding the flight from

Antwerp, indication that Wells had finally processed her trauma enough to record it in detail. It is also possible to see Wells’ natural sense of humor resurfacing in her memory of Ashley-

Smith’s defiance of the German soldier in the motorcar.

Although Eva Smith did not experience an event as demonstrably traumatic as Wells, a close reading of her diary reveals that her service was similarly marked by periods of highly distressing incidents that affected her both personally and in her professional capacity. This is especially evident when the filth and the fear of war invaded the space of No 9 General Hospital in Calais where she and Agnes Boys served from 1916 to 1918. Smith seldom referred to individual patients under her care, or the conditions from which they were suffering. A nurse with some fourteen years’ experience before the outbreak of the war, Smith was adept at taking her work in stride.386 Consequently, when she made exceptions and discussed the cases that

385 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1. 386 Imperial War Museum, Private Papers of Miss E M Smith, 08/112/1.

137 came into the hospital, it is generally because they were so seriously injured, or because the injuries themselves were so grotesque in nature, that she was unable to forget the interaction. In these instances, she turned to her diary to attempt to work these memories into a coherent narrative. For example, in July 1916, she noted that the wards were particularly ‘heavy’:

So many Australian and so badly knocked about. Some of them had been out in No Man’s Land for two or three days. Them could not crawl in and no-one could bring them in. The flies had been at their wounds and the maggots had hatched out. They were most repulsive by the Dakin treatment soon killed them. A good number of the lads died from the exposure.387

For a professional nurse who valued cleanliness, the presence of maggots in her ward must have been troubling enough; that they had to be cleaned from the wounds of her patients clearly caused Smith lasting distress.

As is evident from her description of these patients, Smith was able to rely on her medical proficiency and growing knowledge of advanced treatments, like the ‘Dakin treatment’ mentioned above, for which she and Boys were sent on a course to Paris. However, the physical threat posed by air raids to Smith and her patient alike was often too much for her to cope with alone. This was especially true as the war continued on, and the area around her hospital became the target of frequent air raids. Four days after the arrival of the injured Australians, Smith described ‘bad air-raids during the night. Bombs were dropped in Calais causing a big fire and doing a lot of damage’.388 On several occasions, multiple evacuations, during which nurses had to dress and look after the safety and comfort of their patients, took place in a single day,

387 Ibid. The ‘Dakin treatment’ refers to the Carrel-Dakin Treatment, developed by Alexis Carrel and Henry Drysdale Dakin. This form of wound care treatment combatted sepsis by flooding a wound surface with ‘Dakin’s fluid’, an antiseptic containing sodium hypochlorite. Nurses were vital in administering this treatment, and represent one of the many medical advancements made during the war in which nurses claimed unique proficiency. Smith noted the whole treatment in her diary to ensure she did not forget: ‘Carrel-Dakin treatment of wounds’ British Medical Journal 2 no. 2966 (1917): 597-9 388 Ibid.

138 creating an enormous amount of work for the staff, who were forced to work despite their own fear and the threat aerial bombing posed to their physical safety.

It was during such stressful times that Smith turned to her friend Boys for help, as confident in her friends’ support as she was in her medical expertise. As she describes:

After August 17th we had some heavy work again. At one time there was 9 on the D.I. List (danger list)…During air-raids we put mattresses over the patient to keep bits of falling shrapnel from hitting him. Sometimes a storm would come up suddenly and then men and we got a good drenching[.] One night it was even worse than usual and I sent for Boys to help. She arrived in her petticoat having got soaked in her ward through a leak in the roof. That was alright till the lights came on suddenly. Then she bolted. That night it was so bad that even the Doctors came along to see if help was wanted.389

In her descriptions of these moments, it is obvious that Smith trusted Boys enough to call on her specifically for assistance. This trust clearly extended to Boys’ professional competence, as well. This is noteworthy, because Smith freely noted in her diary when she didn’t approve of the other nurses at the hospital, noting how one Sister was ‘an awful muddler, besides being a liar, and not too kind to the men,’ while another was ‘most trying. Not doing her share of work’.390

That she could rely on Boys’ friendship and professionalism at all times was a source of comfort and reassurance, especially in circumstances that offered little of either. Once again, in this passage, it is possible to see Smith’s sense of humor returning in her description of Boys

‘bolting’ from the room when the lights came on. It is also a mark of their friendship that Boys would endure such discomfort to come to Smith’s aid soaking wet and out of uniform.

Throughout their service in the First World War, nurses were exposed to highly disturbing incidents, were forced to perform in stressful and often physically dangerous circumstances, and were called upon to witness suffering on a scale that was outside the scope of their previous professional experience. These instances were each traumatic in and of

389 Ibid. 390 Ibid.

139 themselves, isolating in their emotional extremity, and often overwhelming. In many cases, the self-confidence provided by their training provided the foundation and confidence that women needed to cope with the professional challenges they encountered. However, it was often through their friends that women received the emotional support they needed to cope and carry on. Their friendship offered comfort as well as the closure necessary to overcome traumatic memories, or to prevent a troubling moment from leaving a lasting psychological mark. The detail with which women like Wells and Smith recorded their interactions with their friends, and the positive impact these friendships had on their emotional state in the course of their service show what a crucial part of their war experiences these friendships were.

Creating Gendered Spaces in Wartime

Although generally framed as a feminine space, hospitals were nevertheless sites focus on the healing of male bodies and minds. Through their feminine presence, nurses (and especially volunteer nurses) were expected to provide a clean, supportive, and domestic space for men, and, as Kirsty Harris describes, to ‘create a psychological link to home that male nursing orderlies or doctors could not’.391 Alison Fell further describes how nurses were popularly portrayed as ‘extending their ‘feminine’ influence, bringing the home/domestic front to the soldiers’.392 However, in their diaries, women also describe the ways in which they reclaimed space within the hospitals for their own during leisure time, and worked to create the same sense of domestic peace and comfort for each other. Locating and analyzing these descriptions further helps to re-center women’s experiences, demonstrating how even the most harrowing of hospital

391 Kirsty Harris, ‘‘All for the Boys’: The Nurse-Patient Relationship of Australian Army Nurses in the First World War’ in First World War Nursing: New Perspectives, eds. Alison S. Fell & Christine E. Hallett (New York: Routledge, 2013), 75 392 Alison Fell, Women as Veterans in Britain and France After the First World War (Cambridge: Cambridge University Press, 2018), 53

140 experiences could be at least temporarily assuaged through shared moments of pleasure.

Additionally, these diary entries also complicate histories that emphasize tensions between professional and volunteer nurses during the war, confirming Janet Lee’s observation that

‘women’s service conditions encouraged the making rather than the loss of friends’.393

The presence of other nurses provided the promise of physical safety for women, both inside and outside the hospital, as well as emotional solace and stability. The normalcy, routine, and reliability of their relationships grounded women during their service, which was frequently marked by sudden emergencies, brutal shocks, and unforgettable episodes of suffering. Part of this process involved creating private, feminine spaces of peace and comfort distinctly separate from the hospital wards in which they worked, and where they could escape the physical hardships and emotional turmoil of war service. An example of this can be found in Hilda

Wells’ diary, during the period when she and Glory were serving at a hospital near Dunkirk. The journey to the hospital had been a harrowing one, marked by sight of several hospital trains with wounded British soldiers:

As our train came into Dunk[irk] we saw several hospital trains—2 passed us full of slightly wounded, & in Dunkirk station itself were trains full of badly wounded, lying in stretchers—some were slung from the ceilings (took a photo) went over some barracks where were a lot of wounded—a big pile of uniforms all soiled & stained & cut up, sleeves out, etc. was heaped up against the wall—we used to have to hack up the wounded’s clothes like that at Antwerp.394

Nurse Wells found relief from these memories, as well as from the chaos of the Dunkirk hospital in the rented hotel rooms near the hospital that she shared with Glory. In these private rooms, the two women made a concerted effort to create a haven of domestic peace and personal comfort, complete with a ‘lovely fire all day & hot water from hot tap into wash-hand basin in

393 Janet Lee, ‘Sisterhood at the Front: Friendship, comradeship, and the feminine appropriation of military heroism among World War I First Aid Nursing Yeomanry (FANY)’ Women’s Studies International Forum 31(2008): 20. 394 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1.

141 rooms’.395 This space was intentionally created and carefully maintained to provide a sense of stability and solace in the midst of a war service that was both disrupting and disturbing. In her detailed descriptions of the evenings spent in these rooms, there is a shift in both Wells’ narrative focus and tone, away from the horrors of wounded men, and linguistic connections between their mutilated uniforms and their mutilated bodies. Instead, she focuses on the familiar and domestic comforts of things like tea, clean beds, and warm fires. Following a difficult day at the hospital, it was clearly a relief to return to this space with her friend, and gave her cause to note, ‘Have had such a jolly evening round our fire—cooked eggs & made coffee, eat cold chicken & sardines & delicious French bread & butter & then I ironed a lot of uniforms whilst Glory mended her corsets by the fire’.396

Nurse Smith and her friend Boys were not able to travel often due to a lack of staff and a constant influx of patients in need of critical and constant care; as Smith noted in her diary, ‘This

Hospital was unique—because it only took in the worst cases. For the 2 ½ years we were there we never had a walking case’.397 This period was made even more stressful when the air raids became a daily reality, forcing nurses to physically carry patients to safety on a regular basis. To make matters worse, a longterm lack of fresh vegetables led to widespread suffering among patients and staff. According to Smith, in early September 1916 there was an ‘epidemic of colic in the Camp. Everyone went down more or less with colic. They told us it was due to not having enough green stuff and too much tin food. It was hard work going on with one’s job when bad, and very often nothing but a dose of castor oil and a day in bed would cure it’.398 In the midst of such constant stress and physical discomfort, Smith and Boys remained nearly

395 Ibid. 396 Ibid. 397 Imperial War Museum, Private Papers of Miss E M Smith, 08/112/1, emphasis in original text. 398 Ibid. Essentially, adult colic is caused by the consumption of processed foods that do no introduce the enzymes and probiotics necessary for digestion. As a result, the patient can suffer debilitating stomach cramps and nausea.

142 inseparable, aligning their schedule so that they could be on- and off-duty together on a regular basis. During these periods of time off-duty, the two women used the resources available to them to create makeshift spaces of rest and comfort for each other. Though smaller and far less luxurious than those described by Wells, these spaces still provided highly-valued privacy, personal security, and respite from the stress of war. As Smith described:

One thing about it was good, that was, Boys and I were nearly always on and off together. We went for walks when inclined in the woods or on the dunes, or we played bezique if too tired before going to bed. We nearly always slept in the open, day or night. I fixed a mackintosh over our heads on each bed, so we could pull them up or down without getting out of the bed. They were like pram covers. Then we each had a big ground sheet all over the rest of the bed…It was such a treat to get away from the cubicles, where one was never quiet never got away from the sound of voices and one could never talk without being overheard.399

The act of creating private space for her and Boys required a bit more ingenuity, but the effect was the same: Smith and Boys ensured that they had a retreat from the stressors of the hospital where they could rest and speak privately together away from the rest of the staff and the men in their care. Moreover, they were also able to provide each other with physical protection from drunken soldiers one of whom stumbled into the matron’s tent late one night.400

In addition to creating private spaces away from the hospital, nurses also reclaimed the space inside the hospital for themselves as sites of celebration, levity, and comradery. Such activity was Nurse Smith’s specialty. In September 1917, No. 9 hospital endured several air raids, one of which, she noted, ‘started at 9 P.M. and they kept it up till 2 A.M.’401 The medical staff at the hospital were strained and reaching exhaustion, as they had no choice but to work through the air raids, keeping patients calm and safe. 17 September was also Agnes Boys’ birthday, and Smith determined to ensure it was a memorable one by transforming the hospital

399 Ibid. 400 Ibid. 401 Ibid.

143 into a space of pleasure and companionship for the overworked hospital staff, as well as the staff of nearby hospitals. As she described later:

Boy’s birthday. Had great fun in the evening. Some of the F.A.N.Y Convoy came to dinner. Did not know what to do with them. They said they would bring some music to amuse us. We made up our minds that we would amuse them. So we got up a village concert. Everyone was someone in it, if onlt [sic] one of the audience. No-one had much talent but the whole thing was a scream. Almack (V.A.D.) and Pemberton (staff cook) were the vicar and his wife. The vicar conducted the affair. Hannah (V.A.D.) was a conjurer—never having done anything like it before, produced eggs from people’s pockets which had been put there before. May V.A.D. was a filthy old man who played a supposed coronet solo on a gramophone funnel, Maxwell-Stuart (Sister) was a professional dancer who came on as Salome and shocked the Vicar and his wife. Others sang or played the piano some dressed up as wounded Tommies and other dressed up as a Charity Home Girls School...Toderick (Sister) was the school-marm. One orphan recited a childish poem in a silly way and they all sang…Three blind mice. The F.N.Ys [sic] said they had never laughed so much.402

Christine Hallett describes how nurses ‘‘spoiled’ their patients’ whenever possible, and Kirsty

Harris emphasizes how important it was for nurses to ‘make their wards ‘a home’’ for the men in their care.403 Nurses also made similar efforts for each other in birthday celebrations and other special events. Such festivities provided the opportunity to reclaim space within the hospital, as well as time in the midst of their service to others. In this passage especially, it is also possible to see how in their leisure time entertainment, women overcame the professional tensions that may have divided them while on duty. The familiar format of a ‘village concert’ and the associations with home helped the staff overcome the tradition hierarchies of service, and the general lack of performance experience seems to put VAD’s, Sisters, and cooks on an equal footing, permitting what appears to have been a highly memorable evening for all involved.

402 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1. 403 Hallett, Containing Trauma, 177; Kirsty Harris, ‘Health, healing and harmony: Invalid cookery and feeding by Australian nurses in the Middle East in the First World War’, in One Hundred Years of Wartime Nursing Practices, 1854-1953, ed. Jane Brooks and Christine E. Hallett (Manchester: Manchester University Press, 2015), 114)

144 The Nature of Wartime Friendships

The nature of friendships in wartime was unique in many ways from the kind of relationships established at home. Like Nurses Wells and Smith, the friendships that many women formed developed quickly, but were very deep. Personal boundaries, so carefully maintained between nurses and their patients, were not required between female nurses. As a result, women found comfort in both physical and emotional closeness. Hilda Wells, for example, described how physical proximity to Glory made the difficult journey from Bruges to

Ostend at the opening of the war a little easier to bear: ‘Glory and I got on the floor and wrapped ourselves in blankets but it was too bitterly cold and too jolty to sleep—but we were cheerful and enjoyed it for all that!’404 These friendships had the depth and strength of long-term relationships, and helped form a significant part of women’s wartime identities. The diaries kept by Nurses Wells and Smith bear out Janet Lee’s observation that women formed a ‘‘sisterhood’ that rivalled the brotherhood or fraternity of soldiers [that] helped develop a collective war experience’.405 Their descriptions of their friends are as emotionally insightful and detailed as their writings about themselves, and show how much of their wartime identity and experience were tied up with their interactions with each other.

Because Hilda Wells’ diary ends in 1915, it is not clear how long she and Glory were able to remain in service together. However, Wells took pains to capture many of her friends’ characteristics in her diary, along with specific memories of her. In October 1915, she noted that

Glory ‘wrote in her report book when there was nothing in the world doing ‘All patients O.K.’,

404 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1. 405 Janet Lee, ‘Sisterhood at the front’, 27.

145 G…H..’406 This entry must have inspired Wells to ensure that she captured as many of her

American friends’ unique sayings and exclamations as she could remember. The following page in her diary contains a list of the ‘Sayings of G.H.,’ which includes ‘Isn’t she a peach,’ and

‘‘Sudden rush of food to the face’ when anybody chokes’.407 Below this, in a different hand

(which may very well be Glory’s) is a minstrel song. Wells often had other people record poems and songs in her diary so that she would not forget them, but this is the only piece entirely unrelated to the war. Instead, this rhyme, and this page, linked her with Glory, emphasizing the interconnected nature of their war experience.

In February 1918, both Smith and Boys departed the hospital to spend their two week leave in Cannes. Though most of their time was very enjoyable, Boys, who had been unwell for much of their leave, grew increasingly ill as their leave drew to an end. Wells describes how

Boys ‘failed with the Fever and Lady Gifford, whose house we were in kept me to nurse her’.408

Even after two more weeks of care, Boys was no better, but the woman resolved to get closer to the Front and medical attention. Smith recalled the details of Boys’ illness, and her fury at being shut out of her friends’ suffering:

On our way back we stayed one night in Paris. The next morning Boys was really very ill, almost unable to move with lumbago. We could not get a Doctor so with much difficult and great pain managed to get to Boulogne. There she was so bad we got out and reported at the hotel Christol. There the Doctor saw her and she was sent at once to the Sussex at Wimeraux. I was not allowed to go with her. Supposed to be joy riding to see one’s greatest friends go into Hospital! We never received any help or sympathy from the B.R.C. as I found out when I was sent down from Harzebroke [sic] in an ambulance. I spent the night at the Cristol and was allowed to go with the Doctor the next morning, to see her. This was not joy riding!409

406 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1. 407 Ibid. 408 Imperial War Museum, Private Papers of Miss E M Smith, 08/112/1 409 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1.

146 It is striking in this passage that Smith does not differentiate between herself and Boys when discussing the physical pain that Boys’ illness caused; her use of ‘we’ as a subject implies that whatever Boys was suffering in the course of their travel to Boulogne was shared, at least sympathetically, by Smith. Smith’s subsequent anger over the doctors’ implication that her wishing to travel to be with Boys was ‘joy riding’ shows both how concerned she was to be at her friend’s side, as well as how women’s relationship could be discounted by those outside those relationships. Smith and Boys were reunited at the end of March, when Smith was sent to

Boulogne in preparation for returning to England on leave. As ever, she and Boys traveled together on the ship home. It would appear that this was their last experience of traveling together, however. At the end of March, Smith was preparing to return to the front. She noted later, ‘Everyone said I should not get across to France, but…I did. Boys did not get back to

France again’.410 Nevertheless, Smith’s diary, like Wells’ formed a sort of talisman, connecting these women to their friends and their wartime experiences together, even years after that service ended.

The presence of other nurses provided safety for women, both inside and outside the hospital. In addition, women’s relationships provided emotional support during the stressful and emotionally challenging aspects of their service. These relationships, along with women’s individual sense of duty and feelings of competency combined to provide the emotional strength necessary to endure the stresses of service. The memories of these bonds, and the accomplishments these women made together, provided a lifelong source of memory. Nurse

Mary Love wrote in her unpublished war memoir about a friend whom she met while enduring service and air raids in Calais, who gave her a small token of friendship during the war. That gift

410 Royal London Hospital Archives, Papers of Hilda Wells SRN, RLH/PP/HWE/1; Boys would be demobilized in April 1919: British Red Cross records, https://vad.redcross.org.uk/Card?fname=Agnes&sname=Boys&id=24855&last=true, Accessed September 30, 2018.

147 served as a talisman of memory that helped Lowe feel close to her friend, even after their demobilization separated them permanently:

A friend from another hospital had sent me a statuette of a little naked boy looking into a mirror. He was called “Reuben”. He stood on a shelf in my bedroom at Etaples and during the first [air] raid was knocked to the floor, smashing his left arm. After all these years he is sitting on my mantelpiece today, looking into his mirror and still smiling; a little war souvenir I shall always treasure.411

When the war was over, these friendships tended to dissolve, as women returned home and sought to re-integrate into civilian life. The loss of these relationships, and the end of service, duty, and a sense of personal competency and fulfillment, removed the emotional and psychological support that nurses needed in order to keep their experiences and symptoms of trauma at bay.

The case of Beulah Duncan, discussed at the opening of this chapter, reflects many of the themes discussed in this chapter. A trained nurse, she was part of a profession that prided itself on its knowledge and competency. Nurses also strove to suppress their emotions, providing efficient, considerate care that put the patients’ needs and concerns above their own. For her to breakdown in the course of her service points to the overwhelming stress of work, as well as, no doubt, the helplessness that she felt in attempt to alleviate the pain and suffering of the soldiers under her care. Her cries that “She thought she was in Hell” speak to the internal, emotional struggles that she endured during her service, as well as the physical stresses of life on or near the battlefields. Beulah Duncan’s case also points to the importance of female relationships.

Her primary concern, as stated in her case notes, was for her sister, who was also serving along the Western Front. She was cared for before her incarceration by her fellow nurses in the Queen

Alexandra Royal Army Nursing Corps. These nurses accompanied her to the hospital, and offered information on her case to the doctors. Her emotional equanimity seems to have

411 Wellcome Library and Archives, GC/258/4: Box 1.

148 coincided with the arrival of her sister to St. Luke’s Hospital, showing the significance of a support network to the healing process. Ultimately, she was one of the lucky ones.

The next chapter will consider the postwar experience of nurses who applied for pensions as a result of war trauma, and the way in which their symptoms and service were understood by military and medical authorities. It will also consider the ways in which women created a support network for female veterans, creating a space where these relationships that had helped nurses in wartime could be reproduced and preserved, especially within a society that was distinctly unwilling to recognize the service and resultant suffering of female veterans of the

First World War.

149

CHAPTER FIVE: “‘An act of justice and gratitude for their services’: Care For Disabled and Traumatized Nurses in the postwar

“These applicants are people who have devoted their own lives in helping and nursing their fellow country folk in their hour of need and suffering, surely it does seem ironical that when they, in their turn, are in some distress, so little can be done to bring them aid and comfort.”412 (Nation’s Fund for Nurses Annual Report, 1929)

On November 11, 1918, the day of the signing of the Armistice in Compiègne, Dr. Isabel

Emslie was working at the Scottish Women’s Hospital in Serbia. She had spent weeks dealing with the stress of maintaining an over-crowded hospital, full of wounded soldiers and victims of the influenza epidemic in a town where there “were neither candles nor oil.”413 Of her experiences on the day the Armistice was signed, she wrote:

On 11 November 1918, we heard it was Armistice Day, but nobody seemed happy about it, and we hardly seemed to realise what it meant. We had now got up nearly all our equipment and our hospital was clean. The whole building had been wired up by Rose West and her assistant, and our Lister engine gave us electric light—a circumstance that gave us far more delight than the Armistice. On the afternoon of this Armistice Day a great convoy of Bulgar prisoners was waiting for treatment at the out-patients’ entrance...they were like hungry wolves and looked scarcely human, fighting, wounding each other, snarling, hissing, swearing, and devouring what they could. Then, as they spied the refuse pail in a corner, they overturned it and groveled on the ground, devouring the potato skins, bones and garbage it contained. What a gruesome sight it was, and this on a day when all should have been happiness and relief…414

As Dr. Emslie’s memoir implies, the various armistice agreements signed in late 1918 may have put an end to the state-sanctioned violence of the First World War, they did little to end the physical and emotional suffering of those enlisted in the war—particularly the women working in hospitals where “the sick and debilitated were pouring into their hospitals in their thousands

412 Wellcome Library and Archives, SA/NFN/B2/1-2, The Nation’s Fund for Nurses Report for January 1 to December 31, 1929. 413 Quoted in Anne Powell, Women in the War Zone: Hospital Service in the First World War (Stroud: The History Press, 2013), 384. 414 Quoted in Powell, 385-6.

150 and the work…was as difficult as it had ever been.”415 It would be months after the November

Armistice that many nurses were able to demobilize.

Audoin-Rouzeau and Becker have noted the incomplete “knowledge of how soldiers resumed their peacetime lives with their emotional, family, social and professional connections.”416 While a number of histories focus on wider themes within the postwar veterans’ movements and organizations, the personal and intimate details of veterans’ life, their family’s resiliency, and their interpersonal relationships remain somewhat obscure. This is especially true in the case of female veterans. To provide some context for the number of women who were part of the demobilization process, it was estimated by the end of the war that approximately 13,124 members of the Queen Alexandra Imperial Military Nursing Service

(Reserve) (QAIMNS(r)) were demobilized in February 1919 with a further 10,549 members from the Territorial Forces Nursing Service (TFNS) and over 2,783 members of the Territorial

Army Nursing Services (TANS). The women's Voluntary Aid Detachment's (VADs) constituted some 82,857 of the demobilization figures from April 1920.417 Although women returning from war no doubt endured transitions that were as psychologically difficult, emotionally fraught, and economically stressful as their male comrades, society generally overlooked the physical and psychological suffering of women, as well as the difficulties that they faced in their transition from war to peace and civilian society. Instead, the public focus on men’s position as

415 The Armistice of Salonica, signed on September 29, 1918, ended hostilities between Bulgaria and the Allied Powers. The Armistice of Mudros, which ended hostilities between the Ottoman Empire and Great Britain (representing all the Allied Powers), was signed on October 30, 1918. The Russian Empire had sued for peace in 1917, officially ending their involvement in the First World War under the Treaty of Brest-Litovsk, signed on March 3, 1918. Thus, by November 11, 1918, Imperial Germany and the Habsburg Empire remained the only Central Powers involved in the war, and the Western Front the only site of land-based warfare; Christine Hallett, Veiled Warriors: Allied Nurses of the First World War (Oxford: Oxford University Press, 2014), 249. 416 Stéphane Audion-Rouzeau and Annette Becker, 14-18: Understanding the Great War, trans. Catherine Temerson (New York: Hill and Wang, 2002), 166-7. 417 Poynter, 75. It is unclear how many of these women were Irish; although they were initially considered within the British pension scheme, Irish women would find themselves especially marginalized in the postwar world.

151 breadwinners in the peacetime economy took precedence. It thus remained with private organizations to ensure that women’s war service and suffering was not forgotten. This chapter will look at the postwar challenges that traumatized women faced in attempting to get recognition and compensation, and the private enterprises established to help female veterans and professionals. Specifically, it will consider the Cowdray Club, founded in 1922 by Annie

Pearson, Lady Cowdray, as an example of just such an organization. As a result of the Cowdray

Club and its associated funds, female veterans of the First World War found recognition and compensation for their services. They were also provided the opportunity and encouragement to define and improve their profession for generations. The research in this chapter intersects with

Denise Poynter’s excellent unpublished dissertation on nurses and shell-shock. While it echoes

Poynter’s argument that women, “much like the ex-servicemen, were often at the mercy of a new, uncoordinated and complex system,” it challenges the notion that “nurses, in their path to repatriation, were not particularly discriminated against in their struggle to claim a war pension.”418 Instead, my work insists that the construction of ‘shell-shock’ and war trauma as a masculine condition inherently made it more difficult for women to access pensions and receive care for this psychological symptoms. Moreover, the designation of women as ‘volunteers’ rather than ‘veterans’ further challenged their ability to achieve recognition from the government in the postwar period. It thus fell to individuals and private organizations to do what the government could not, or would not, do; namely, to consider women as veterans, and offer them care and compensation in recognition of that service.

The use of the term “woman veteran” in this chapter is a conscious one that reflects my desire to disrupt the traditional historiographical narrative focuses on the rehabilitation of men,

418 Denise J. Poynter “'The Report on her Transfer was Shell Shock', A Study of the Psychological Disorders of Nurses and Female Voluntary Aid Detachments who served alongside the British and Allied Expeditionary Forces during the First World War, 1914–1918”, PhD Diss., University of Northampton, 2008, 37-8.

152 specifically the ways in which “wounds and disabilities feminized the male body…[and r]ehabilitation was a re-masculinizing process” has marginalized women.419 Histories of ‘shell- shock’ that focus on the feminization and re-masculinization of men and thereby isolate women; the historiographic narrative of the postwar functions in a very similar way. Essentially, the relationship between ex-servicemen and the state was a symbiotic one; the state was able to re- establish authority in peacetime providing care for the men who had risked their lives to defend it. As Amy Tector explains, the “drive to rehabilitate was powered by ideological considerations: if the soldiers who fought in the war could be returned to health, the combatant nations could also be rebuilt.”420 In turn, ex-servicemen believed that “as a group they had the right, founded on their war service, to be heard on the public and political stage.”421 The works of Deborah Cohen, Fiona Reid, and Jeffrey Reznick all show how British veterans’ groups advocated for “the principle of the right of ex-servicemen to priority and consideration” for medical care, as well as permanent and well-earning jobs.422 For a woman to assume such a similar relationship with the state and an equally public presence threatened to destabilize both the masculine category of ‘veteran,’ and the states’ ability to return society to imagined prewar gender norms and social stability.

The public focus on male suffering and entitlement went hand-in-hand with attempts to push women out of the public sphere and back into the roles of wife, mother, and caretaker within the home. As such, women faced personal and public condemnation for attempting to

419 Ana Carden-Coyne, “Gendering the Politics of War Wounds since 1914,” in Gender and Conflict Since 1914: Historical and Interdisciplinary Perspectives (New York: Palgrave, 2012), 85 420 Amy Tector, “‘Mother, Lover, Nurse’: The Reassertion of Conventional Gender Norms in Representations of Disability in Canadian Novels of the First World War,” in ed. Sarah Glassford & Amy Shaw, A Sisterhood of Suffering: Women and Girls of Canada and Newfoundland during the First World War (Vancouver: University of British Columbia Press, 2012), 295. 421 Allison S. Fell, Women as Veterans in Britain and France After the First World War (Cambridge: Cambridge University Press, 2018), 6 422 Quoted in Reznick, 129; see also Cohen, The War Come Home: Disabled Veterans in Britain and Germany, 1914-1939.

153 continue in their wartime jobs. As early as 1917, the Association of Disabled Sailors and

Soldiers “levelled harsh criticism at women workers who took jobs from deserving veterans.”423

Susan Grayzel notes that any public discussion of male unemployment, “particularly of veterans unable to find work, was seen as demonstrating that women were depriving men of work by refusing to leave it and return home.”424 At the same time, Laurie Kaplan argues, “Women who had trained to give medical and nursing care to the wounded became anonymous when the war ended.”425 Charitable organizations that, in the immediate postwar period recognized women’s service, quickly evolved their advocacy, and championed the cause of male veterans almost exclusively. Fiona Reid has produced an in-depth study of one such organization, the Ex-

Services Welfare Society (ESWS), now known as Combat Stress.426 This study is extremely useful in understanding how postwar British society became increasingly concerned with the status and fate of male veterans, to the direct exclusion of female veterans. Likewise, Peter

Barham has argued that postwar Britain witnessed a revolution in the concept of ‘citizenship,’ when “citizen soldiers without discrimination were seen as meriting the responsibilities and obligations of the state,” emphasizing that full citizenship remained a deeply gendered, and highly politicized concept.427 According to Peter Leese, “while some citizens’ rights were tentatively given out, others were at the same time taken back.”428 Indeed, the majority of women who gained the franchise in 1918 were not female veterans, but were, typically, the mothers of servicemen. This decision was made in part to avoid the threat that “the men who were coming back from the Front would have their votes swamped by the great number of new voters who

423 Reznick, 129-30. 424 Susan R. Grayzel, Women and the First World War (New York: Routledge, 2013), 107. 425 Kaplan, 66 426 Fiona Reid, Broken Men: Shell shock, Treatment and Recovery in Britain 1914-1930 (London: Continuum, 2011). 427 Peter Barham, Forgotten Lunatics of the Great War (New Haven: Yale University Press, 2004), 42. 428 Peter Leese, “Shocked and Forgotten”, History Workshop Journal, 63(1): 2007, 333)

154 would be put on the register.”429 It was also a part of a general effort that Susan Pedersen identifies in the postwar period, which reflected “the ideal of a male breadwinner and dependent wife.”430 This chapter will study how women were from the discussion over veterans’ rights, but also how specific women and groups of women claimed the status of veteran “in order to have greater access to public life, to have a voice in a political climate in which women were rarely heard on the public stage.”431 Thus, the use of the phrase “women veteran” also engages with the ongoing need to recognize the post-war experiences of women who served in the First World

War, and the ways in which they claimed their service in public as well as private spaces.

The Ministry of Pensions, Shell Shock, and Postwar Gender Norms

Pension records offer a clear record of the postwar realities of veterans, of their struggles to return to civilian life, and the wounds—physical, mental, and emotional—that they carried with them. However, these records also demonstrate how the memory of war, and the wounds of those who served in it, were politicized. In the case of women veterans, ministers’ opinions of their service and compensation, as evident in inter-departmental communications and memoranda, was an especially fraught topic. These records demonstrate that women were not seen as veterans, but rather as volunteers. The debate over whether their service entitled them to remuneration or financial assistance led to the gradual evolution in understanding and an increased commitment to welfare of women veterans in the postwar period. However, in every instance, women were forced to navigate bureaucratic structures that were not designed to take

429 Quoted in Kent, 160. 430 Susan Pedersen, “Gender, Welfare, and Citizenship in Britain during the Great War,” American Historical Review 95:4(1990), 985. 431 Fell, 4

155 their war experience into account, and were never revised to include them as full and equitable participants in the war effort, or the postwar movement for veterans’ rehabilitation.

Established in December 1916, the Ministry of Pensions assumed the powers previously held jointly by the Admiralty, Chelsea Hospital and the Army Council, and declared its authority to make awards “where disablement…is due to, or aggravated by, military service.”432 The

British government’s goal in establishing the Ministry was to avoid the scandals and embarrassment that had surrounded the awarding of pensions and benefits to veterans after the

Boer War. By ensuring that men received compensation for their wartime injuries, the government hoped to inspire faith in the civilian population to continue sending its sons, fathers, and husbands into the war.433 However, the Ministry of Pensions also owed a duty to the state to regulate expenditures, and “to preserve the social system as it had functioned before the Great

War.”434 This final charge may have been the most important. While revolution, mass desertion, and civilian unrest threatened the populations of other combatant nations, in Britain, the Ministry of Pensions remained an institution that regulated social order and gender hierarchies.

The sheer number of wounded and disabled men with which it was forced to cope forced the Ministry to devise criteria that compensated veterans for physical injuries. Despite insistence by the Ministry that “disablement is assessed without reference to its effect on employment,” pension awards remained directly related to a man’s ability to find and perform in the post-war world.435 For example, compensation for the amputation of one leg at the hip was scaled at 80% disability, while amputation of the arm at the shoulder was scaled at 90%. Ana Carden-Coyne

432 Edgar Jones, Ian Palmer, and Simon Wessely, “War pensions (1900-1945): changing models of psychological understanding,” British Journal of Psychiatry, 180(2002), 375. 433 Anne Summers, Angels and Citizens: British Women as Military Nurses 1854-1914 (London: Routledge & Kegan Paul, 1988), 220. 434 Peter Leese, “Problems Returning Home: The British Psychological Casualties of the Great War”, The Historical Journal, 40(4): 1997, 1056. 435 TNA PIN 15/33, Disabled men unemployable on account of their disability: proposed examination by Commissioners of Medical Services, Memorandum by W. Sanger dated 10 August 1920.

156 explains that this was due to the fact that officials “believed that the leg amputee was more capable of earning full wages, whereas few occupations were available to a shoulder amputee.”436 The compensation scale for veterans also emphasized the notion of ‘wholeness’ that was an intimate part of masculinity. Facial wounds, for example, were regarded at 100% disability. According to members of the Ministry of Pensions Appeals Tribunal, this was because facial injuries were so totally deforming that such injury “unequivocally lowers the sufferer’s economic value…A blemish which cannot be hidden entitles the man to an evaluation more liberal than is called for the incases of scars on parts of the body which are usually clothed.”437 Soldier’s rank and race affected the scale and value of their disability award, with non-white soldiers receiving less money for a 100% disability rating, further emphasizing how the Ministry of Pensions continues to uphold the social and imperial status quo by enforcing pre- war hierarchies even among veterans.438

For veterans suffering from psychological and mental conditions, “disability was emotional as well as physical,” and the Ministry of Pensions was continuously grappling with ways to adequately judge and compensate men for the mental symptoms they suffered as a result of the war.439 The process reflected contemporary social and scientific views of ‘shell-shock’ and masculinity. Nevertheless, there was treatment, compensation, and social safety-nets in place to aid the mentally-afflicted soldier in returning to civilian life and work. This was because ‘shell-shock’, and related war trauma diagnoses were constructed as conditions that could affect men engaged in battle.440 Such a construction also preserved traditional gender

436 Ana Carden-Coyne, “Gendering the Politics of War Wounds Since 1914,” in ed. Ana Carden-Coyne, Gender and Conflict Since 1914 (New York: Palgrave Macmillan, 2012), 86. 437 Quoted in Carden-Coyne, 86. 438 Carden--Coyne, 86. 439 Jessica Meyer, “’Not Septimus Now’: wives of disabled veterans and cultural memory of the First World War in Britain”, Women’s History Review, 13:1(2004), 124. 440 Charles Samuel Myers, ‘A Contribution to the Study of Shell Shock’, The Lancet, 185, 4772 (1915), 316–20.

157 boundaries during a time when gender roles were explicitly being questioned by creating boundaries and unique difficulties for women to access pensions as a right of physical, and especially mental injuries.

The debate over compensation for nurses began around 1915. At this point, however, funding came from public donations to charities such as the War Nurses Relief Fund, which appealed for donations in order to assist nurses “who have suffered, or may suffer, from attendance upon the sick and wounded during the war.”441 However, the focus of the state and on public charities remained on sick and wounded servicemen throughout the war, ensuring that nurses’ remuneration or rehabilitation would remain largely rhetorical for some time. Even in debating the need to reward women for their service, members of Parliament framed women as broken, suffering, and in need of male authority to rescue them. For example, in 1916, Mr. John

Hodge, asked in Parliament:

The matter I desire to mention was referred to in a cursory way yesterday, namely, What are the Government going to do for the nurses? The House and the country as a whole have been anxious to do the best possible for those broken in the War, and a great many cases have come under my personal observation of nurses who have been broken in the War, but the Army Department are doing nothing for these women.442

The result of such debate was the Royal Warrant of 1917, which largely established Britain’s pension policies. For nurses, this Warrant established the Special Grants Committee, which had the power to award “certain grants and allowances...made in special cases to war disabled nurses and their dependents.”443 While these grants represented a small success for female veterans, their remuneration still relied on “heartrending cases of misery and want” rather than the rhetoric

441 Quoted in Poynter, 172. 442 UK, Hansard Parliamentary Debates. March 16, 1916, 2415. https://api.parliament.uk/historic- hansard/commons/1916/mar/16/army-estimates-1916-17#column_2415, accessed February 27, 2019.

443 Quoted in Poynter, 180

158 of service and moral responsibility that was used in discussions of male veterans’ pensions and rehabilitation.444

It was only with the Royal Warrant of 1920 that nurses were fully incorporated into established pension schemes. The debate over their inclusion offers insight into how

Parliamentary officials understood the role of women in war, and the obligations owed to them by the state. Many in Parliament and the Ministry of Pensions stated that they were in favor of incorporating women into a scheme that would provide compensation equal to “proved pre-war earnings.”445 However, such an idea met with swift objection by those who argued that there was no way of truly understanding a nurse’s earning capacity, especially in comparison to that of a man. A memo from the office of the Secretary of the Ministry of Pensions noted that:

An estimate of earning capacity in these cases will be extraordinarily difficult. If she remains a nurse after discharge from the service she will probably only be capable of private work, but how are we to estimate what amount of private work she can do. This will depend on the amount she feels inclined to do or feels capable of doing. There is no standard as in the case of men in recognized occupation by which to judge the earning capacity.446

Such statements demonstrate how the concept of women’s work remained both exceptional and completely unclear to ministry officials, which would make further discussions of women working in the postwar world even more difficult for women seeking financial assistance from the ministry. Indeed, those who supported the scheme did so, largely, because it was assumed the number of cases with which the Ministry would have to contend would be few. As one minister observed, “There is no logical reason why nurses should not be eligible for alternative

444 Quoted in Debbie Palmer, Who Cared for the Carers?: A History of the Occupational Health of Nurses, 1880- 1948 (Manchester: Manchester University Press, 2014), 84. 445 1920 [Cmd. 811] Royal Warrant for the retired pay of Officers (Army) disabled, and for the pensions of the families and relatives of Officers deceased, and for the pensions of Nurses disabled and of the relatives of Nurses deceased in consequence of the Great War. 446 TNA, PIN 15/956, Pensions for nurses: eligibility for grant of alternative pensions, Memo from the Secretary dated 7th May 1920.

159 pensions…the cases in which they would be gratified are likely to be rare.”447 The assumption was, instead, that a nurse would marry, and that the responsibility for her “maintenance” would fall “primarily on her husband.’448

Such internal wrangling over the issue of compensation helps clarify two points regarding the Ministry of Pensions and its outlook during the postwar period, over and above the constant need to keep costs and payments to a minimum. The first is that women’s work and service was not considered equal or commensurate to a man’s. Even after the life-saving and indispensable role of nurses, both at home and in the field, were established, debates still filled memorandum pages in the ministry of pensions over whether women’s work was even legitimate enough to receive recognition. As one member of the Ministry of Pensions described women’s service,

“The nurses were either in military service and could leave at any time or volunteered for it,” the rationale being that because they were not duty-bound to continue their war work, the state was not duty-bound to ensure women the same pensions that the government provided for men.449

The second point is that women’s work was never considered a part of her identity in the way that a man’s was. As a result, many in the Ministry did not believe in compensating them for their war service, or for a loss of potential earning sustained during the war. Further, nurses’ pensions were reduced upon their marriage, as it was assumed that their husband would provide financially. The need or desire that women felt to continue working after the war often went overlooked or misunderstood by ministry officials who did not recognize women’s work as anything other than exceptional.

447 PIN 15/956, memo dated 22nd April 1920. Alternative pensions were paid off when a pensioner could prove their pension was less “his retired pay together with any wounds pension of which he is in receipt, and together with the average earnings of which he remains capable, are less than his proved pre-war earnings.” (1920 [Cmd. 811] Royal Warrant for the retired pay of Officers (Army) disabled, and for the pensions of the families and relatives of Officers deceased, and for the pensions of Nurses disabled and of the relatives of Nurses deceased in consequence of the Great War.) 448 TNA, PIN 15/3919, Amendment: Nurse 449 TNA, PIN 15/956, War Pensions Records, note dated 10th May 1920.

160

Women Veteran’s’ Disability Claims

An examination of disability pension records provide further evidence of the ways women’s service was interpreted by pension officials. These records demonstrate how women were forced to fit themselves into a system that was designed for combatant male veterans, and often relied on a comparison of men’s experiences to validate women’s testimony. The pension records of soldiers and nurses held at the National Archives at Kew in the PIN 26 section represent a 2 per cent sample of the files that were handled within the London Region of the

Ministry of Pensions, which represented sixty per cent of the total awards. When the Ministry of

Pensions was being decentralized after 1919, staff members preserved every fiftieth file in order to acquire an unbiased, representative sample of cases. There are 302 files for women in total, but there is no confirmation that these files represent 2 per cent of all women’s files from this period.450 I have identified approximately fifty files in which some kind of psychological condition is listed as a primary complaint, including neurasthenia, hysteria, and nervous breakdown. However, in studying the records in this sequence, a number of women who claimed physical wounds and disabilities were judged to be suffering from hysterical conditions, as will be discussed. Thus, it is difficult at times to judge whether diagnoses of mental conditions were brought by women to the Ministry of Pensions, or if the diagnoses were imposed on them by doctors and officials who were unable to justify a physical cause of their suffering.

As Denise Poynter has emphasized, there were women who were diagnosed with ‘shell shock’, and many others who received pensions for psychological symptoms.451 However, their

450 Poynter, 40. 451 Poynter, 105.

161 ability to secure compensation relied on their ability to successfully navigate a system that was established without a clear understanding of their war experiences, or the stressors that they encountered in the course of their service. This lack of specificity extended to the most mundane aspects of the pension process; even after women were able to apply for disability pensions forms were never changed to incorporate women’s specific physical conditions, or to identify their rank. Instead, words such as “officer” had to be physically crossed out and “nurse” written in its place. In such circumstances, “completing such forms for women presented the medical authorities with difficulties, largely because the terminology did not apply to both sexes and there was no room for gender specific ailments to be included.”452 Although Poynter sees such issues as indicative of “the Ministry’s continuing stringent fiscal policies,” rather than discrimination, I argue that such examples show the unwillingness of the Ministry of Pensions to recognize women as veterans of equal status to men. Just as their performance and narratives of trauma did not conform to official definitions of ‘shell shock,’ women’s service did not conform to gendered expectations of service, thus putting them in a different, and inequitable category for

Ministry officials.

The lack of space on pension forms for gender-specific medical conditions in itself was a source of extreme worry and stress for women—especially those with medical training, who were thus aware of what was happening to their minds and bodies. For example, Lilian Atkins’ pension records from 1919 list her as suffering from menorrhagia, or severe menstrual bleeding, as well as feelings of “nervousness” and “peculiar subjective symptoms—head bursting.”453

According to her own testimony, the condition came on “whilst in Germany,” and she underwent

452 Poynter, 200. 453 TNA, PIN 26/19994, Lilian Atkins.

162 surgery to remove fibroids.454 Her disability was listed as “Constitutional Stress—aggravated by service,” and she was awarded a 100% pension for a period of three months in 1920. That payment was renewed continuously until 1925 as a result of Atkins’ “neurasthenia,” which was also determined to be brought on by her service, and for which the pension board recommended psychological treatment.455 In addition, in 1924, the medical board noted that:

…her physical condition has further improved and she is capable of doing anything. She still remains in bed however, talks of nothing except her past ailments, eats well and expects her mother of over 70 years to wait upon her hand and foot…The Board are of the opinion that if circumstances were such that it was necessary for her to make the required efforts for self preservation, she would not fail to do so.456

In accordance with the Board’s recommendations, Nurse Atkins’ diagnosis was amended to

“Severe Hysterical Neurasthenia”.

Clearly infuriated by this change in diagnosis, Nurse Atkins wrote back to the Board, noting, in part:

I consider it a direct insult to diagnose it as hysteria. Since if it is hysteria and I know it isn’t it is due to your inhuman and cruel treatment both mentally and physically and as for saying I had it before the war it is a downright lie. It is only to the mercy of God above that I have kept my sanity so far not to the doctors and homes you have placed me in…I have been worn out with rheumatism and pain ever since I left Birkenhead…If I had had hysteria I could not have nursed during the war with only 1 day sick for 4 ½ year [sic]…I am not making an appeal but being classed as hysterical upsets me every time as it is untrue.457

There is no way to know medically what the real root of Nurse Atkins’ complains were, nor to what extent her service contributed to her physical or mental state. However, her swift and deeply emotional response to the ‘hysteria’ diagnosis she received indicates that she was well

454 Ibid. 455 Ibid. 456 Ibid. This passage is also quoted in Poynter. 457 Ibid. The “Birkenhead” to which Nurse Atkin refers is probably the Manor Hill Auxiliary Hospital on Upton Road, Birkenhead .

163 aware of the negative (and gendered) implications of the diagnosis. It is also likely that having to discuss her menstrual cycle and fibroids in front of the all-male medical board was a source of stress, even for a woman who was well acquainted with the complications of the human body. In addition, Atkins makes a reference to her work throughout the war, noting with evident pride that she was sick for only one day in more than four years. To have that service overlooked or ignored was a further source of frustration.

The misunderstanding of both women’s war work and trauma meant that a number of women’s applications for compensation were rejected for not meeting the criteria set by the

Ministry of Pensions for trauma performance and symptoms. Such was the case for Gertrude

Pigott, a thirty-six-year-old woman from Dublin. In March 1917, Pigott was serving as a VAD at 29 General Hospital in Salonika when the hospital sustained its second air raid in a week.

According to the matron of the hospital, “in the next tent to where she was on duty a bomb was dropped, completely wrecking the tent and causing several casualties...The one Miss Pigott was on was perforated...all over.”458 Upon her return to Dublin in 1919, Miss Pigott reported to her doctor that she was suffering from “nervousness, waking with a start, pain about her heart” and ongoing tremors. Each of these conditions, she noted were only growing more acute over time.

According to the doctor’s letter in her pension file, Nurse Pigott:

…consulted me first on Jan. 7, 1919 for pain about her heart and palpitation. From Feb. till May 1922 she was in bed with nervous symptoms (a feeling of weakness and inability to take any exertion) and again attended her in Dec. ’23 for similar symptoms. Also in Jan 1925—She has had pains in various parts of her body and limbs—probably of the nature of muscular rheumatism—since 1922…She has never been in anything like good health since she ceased her V.A.D. work; and she is not improving. I am fully satisfied she is not malingering.459

458 TNA, PIN 26/20203, Gertrude L. Pigott. 459 Ibid.

164 Nurse Pigott applied for a pension on account of her rheumatism, which she stated she contracted while working in Reading Hospital in 1916, and for a heart condition, which she attributed to neurasthenia, or exhaustion of the nerves, which, she stated, “is attributable to the Great War to two raids on the 29th Gen Hospital Salonika Feb. 28th 1917, March 1, 1917. 3 patients were killed in next tent to the one that I was on duty in with a bad heart case.”460 Furthermore, she stated, she had suffered from no symptoms of either condition before her service In reviewing her case, the Medical Board noted that it was “satisfied that this nurse suffered from the effects of several ‘Air Raids’ and that her claim for Neurasthenia is established.”461 However, because she remained on duty at the hospital in Salonika and did not report any symptoms until after her discharge, the Board also noted that it “did not feel justified in recommending entitlement on account of Neurasthenia,” ruling that “there is no evidence that she sustained any serious shock.”462

While it was apparently indisputable that Nurse Pigott suffered as a result of her experience in the air raids, the pension board interpreted the fact that she continued to work as a sign that she was not harmed enough, or not displaying her symptoms properly, and thus was not deserving of a pension. Pigott attempted to appeal the ministry’s decision, stating in a 1926 letter “It is very clear to those who have known me before and since the “Great War” that what I am suffering from is attributable to my “military nursing service”…I fear that I must not have given enough particulars.”463 The testimony that the board had believed was Pigott’s supervisor.

Perhaps realizing that her own accounts of service had not met with the board’s definitions of suffering, she was offering to bring others to verify her account. Moreover, this letter implies

460 Ibid. 461 Ibid. 462 Ibid. 463 Ibid.

165 that she was also doubting her own presentation of her symptoms, taking the blame on herself for the board’s ruling. In response to her letter, the Ministry of Pensions replied, assuring her that

“the medical evidence in your case has been most carefully and exhaustively considered, but the department is unable to vary the decision that your disabilities are neither attributable to nor aggravated by your military nursing service during the Great War.”464 The reality was not that

Pigott’s presentation was to blame, but that her symptoms and behavior were not commensurate with those that Ministry officials and doctors were trained to see.

Another example of nurses’ war-related symptoms not meeting the standard diagnostic criteria can be found in the pension file of Jessie Scott, who served as the Sister-in-Charge of the

Caird Red Cross Hospital in Dundee for a year, from April 1917 to 1918.465 According to Nurse

Scott, she had suffered from headaches most of her life, but following her service, these headaches grew more frequent and severe, causing indigestion and vomiting at times.466 She requested information from the Ministry of Pensions in 1921 “as to ‘Pensions for Nurses,’ having a breakdown owing to severe work in hospital during the War at home.”467 In her application for a disability pension, Scott explained not only that her war service compromised her mental and physical health, but that her symptoms were also making it increasingly difficult for her to earn an income:

Dear Sir or Madam: I have consulted Dr. McVicar of Tay St Dundee, who’s panel I am on. I have had very little treatment from any Dr during my nursing career or before, as I have had fairly good health, only severe indigestion and very bad sick headaches. My first visit to Dr. McVicar was while in the Caird Mess; Red X Hospital, Dundee, my work there was very strenuous, as we had secondary haemorrhage cases, I arrested one case by pressure of the subclavian artery until the Dr. arrived, we had no resident medical. Now being at private nursing, I feel a little help would be a great benefit between my cases, as I don’t feel able to keep at work continuous (sic).

464 Ibid. 465 TNA, PIN 26/20235, Jessie Scott (Sister). 466 Ibid. 467 Ibid.

166 Yours very obediently, Jessie Scott468

The pension files of both Gertrude Pigott and Jessie Scott emphasize that nurses placed a great deal of personal pride on their work, and the financial hardship that their infirmity caused. This, the inability to work in the postwar was both a source of personal shame and economic worry.

In order to verify her claims, officials were obligated to establish a history of patients’ illness.

However, because women were not allowed to apply for disability pensions until 1920, establishing that history often proved difficult. Officials relied on doctors’ and hospital matrons’ memories to provide the details necessary to verify a claimant’s testimony of illness. In the case of Nurse Scott, it proved impossible to establish that history. Pension officials noted that “The late Matron of the hosp [sic] states that she has no recollection of Sister Scott ever being ill or of her requiring to consult a medical man during this period.”469 Doctor C. Martins wrote to the

Ministry in response to their query, attesting that “Sister J. Scott consulted me for headache last week. It is some considerable time since she first consulted me but I can’t remember what it was for and I have no record.”470 Furthermore, he noted, “The headaches are associated with the climature and in my opinion are not likely to have been caused by war service.”471 As a result of this letter, the Ministry informed Nurse Scott that “the medical authorities are of opinion that the disability on account of which you claim compensation was neither attributable to nor aggravated by your nursing service. It is regretted that you are, therefore, not eligible for any grant from the Department.”472

468 Ibid. 469 Ibid. 470 Ibid. 471 Ibid. 472 Ibid.

167 Not only did Nurse Scott’s case suffer from a lack of established history, but, as she herself noted, it also suffered because she served in Scotland during the war, rather than abroad.

The conception of ‘shell shock’ and war trauma was very much premised on exposure to the materiel and dangers of warfare. Thus, the notion that a woman who was not exposed to such an environment could suffer trauma was untenable. Though her work was very clearly just as stressful—perhaps even more so, given the lack of qualified personnel left in domestic hospitals to assist her—those nurses who had not served abroad were not perceived to have suffered the same stressors as those who served in field hospitals. Thus, her headaches and indigestion were even further minimized in the eyes of the Ministry. In her final letter, Jessie Scott acknowledged this fact, stating that “Your letter of Oct. 14th I very much regret the decision of the Medical

Board, but not surprised as I was told beforehand I would not receive anything, being a nurse on home duty.”473

Pension official required verification from witnesses and medical authorities in order to verify nurses’ long-term trauma, and verify the forms that trauma took. Yet even when such verification was present, it was not a guarantee that a nurse’s application would be successful.

Take, for example, the case of Nurse Mary Cleverly, a professional nurse who had worked before the war and who served in Salonika during the war.474 Nurse Cleverly experienced her breakdown first in 1920 while on duty, suffering what was described as an “acute mental disorder, necessitating her removal to Bethlem Hospital.”475 Her matron at St. Thomas’ Hospital explained her breakdown in a report to the Ministry of Pensions:

After a holiday Miss Cleverly returned in August 1919 to St. Thomas's Hospital (No. 5 London (City of London)) General Hospital and worked in the ward for Limbless Officers. It would appear that she was put on light duty and there was no overstrain, but

473 Ibid. 474 TNA, PIN 26/20035, Nurse Mary Cleverly. 475 Ibid.

168 she showed increasing desire to avoid responsibility and this became much more marked during the month of February 1920. On February 23rd she reported sleeplessness, and was on the Nurses' Sick Floor. On February 25th, she was transferred to Christian Ward and on February 27th to Bethlem Hospital. The report on her transfer was "Shell Shock, Hallucinations; Delusions accompanied by considerable violence. Acute insomnia. Refusal of food. Threats of suicide.476

In addition to this report, Cleverly’s parents and sister advocated for her to the Ministry of Pensions, stating that she was not well enough to write, or appear in person for evaluation. Her sister specifically noted that Cleverly had been healthy all through her prewar service and, as such, “I presume there is sufficient medical evidence to prove the initial breakdown was caused by shell shock—due to service in the Great War?”477 Cleverly’s doctor was also able to verify her symptoms were attributable to her war service. According to a note in an official report on her mental state in 1931:

When questioned about her experiences in Salonika she became emotional and refused to tell about them, but admitted that she used to have nightmares about them and dreaded going to sleep. In my experience this reaction is diagnostic of those cases in which the stress of war has played an active part in inducing mental breakdown …. She is unfit for responsibility but should have her physical health cared for and be saved as much as possible from stress and anxiety.478

Cleverly’s family also submitted a letter of support from the Ex-Soldiers’ Welfare Society, which advocated for her need and worth as a war participant. Nevertheless, the Ministry refused to grant her a pension. As one official noted in the Minute Sheet of her file, “If the mental condition had been due to service it would have been expected to show itself earlier than eleven months after discharge.”479 Thus, it was determined that “No good grounds are disclosed in the present submission which would warrant further consideration.”480

476 Ibid. 477 Ibid. 478 Ibid. 479 Ibid. 480 Ibid.

169 In the case of Nurse Cleverly, as was the case for so many other veterans, both male and female, the written dialogue that took place among members of the ministry offers insight into how the patients’ symptoms were interpreted by medical boards and government officials. This dialogue took place apart from interactions with patients, doctors, family, and pension boards. In the case of women especially, these notes and memoranda demonstrate an understanding of gendered thinking and performance that often affected the way women’s symptoms were interpreted. In cases like that of Nurse Cleverly, ministers exercised the privilege of discussing the patient, and how their symptoms fit their personal definitions and understanding of trauma.

Often, these discussions ended up reinforcing patriarchal notions of “proper” women’s behavior as much as they reinforced traditional ideas about the performance of war trauma.

The case file of Nurse Laura Mary Donovan provides an interesting example of this. In the spring of 1918, Donovan served as a VAD in Salonika. During her off-duty time, she accepted a ride with a group of nurses who were enjoying an outing. While en route, a delivery van sideswiped the car and forced them off the road. Donovan was thrown from the car and suffered a skull fracture. While recovering, she contracted malaria, a condition that flared up frequently after her military service. Following her discharge in 1919, Nurse Donovan won a pension commensurate to 30% of her wartime pay for life as a result of her physical injuries and resultant long-term damage to her health. As she was not well enough to continue nursing, she found work as a clerk at the Ministry of Pensions. She also married a veteran of the East Africa Campaign.481

In 1926, Donovan applied to the Ministry for an increase in her disability award, as psychological symptoms were making day-to-day life difficult. In her examination, she reported that she suffered from debilitating headaches and, more recently, a miscarriage. Additionally, she also noted that she had been suffering from insomnia and nightmares. According to her

481 TNA, PIN 26/20053, Laura Mary Donovan nee Watts.

170 physician’s notes, “Sleep delayed and easily broken—unrefreshed by sleep—has nightmares…Feels asocial when these attacks occur and ‘everything seems wrong’”.482

Following a medical board, she was described as “Mentally—anxious and apprehensive. Very emotional—depressed.”483 Donovan refused to visit a hospital for observation unless she could bring her daughter with her—a demand that the Ministry was unwilling to fund.484 A medical board convened to consider her claim determined that Donovan was suffering from

“Neurasthenia—of emotional type, moderate severe.”485

In his observations of Donovan, the medical board doctor, one Dr. R.M. Vatch, noted that she was “very Nervy and easily upset—suggests there are domestic troubles and she does not get on well with husband.”486 That such an observation would be considered worthy of comment in her file emphasize how much social and cultural expectations of gender and performance played into the gendered performance of a medical board. Although it was accepted that some women did suffer trauma as a result of their war experience, like civilian women, they were also judged by how well they performed as wives and mothers; where they failed to perform these roles, women often found themselves the subject of institutional punishment.

Unbeknownst to her, Nurse Donovan’s husband also paid a visit to the Ministry. A memo describes his statement that, “Mrs. D. is vy [sic] peculiar in her manner…Husband contests that she is mental and he will not be able to continue living with her or to be responsible for her.”487 In response to this interview, the Ministry representative determined that “Mrs. D. certainly appears to be unreasonable in her general attitude towards her husband”, and her

482 Ibid. 483 Ibid. 484 Ibid. 485 Ibid. 486 Ibid. 487 Ibid.

171 request for an increase was denied. In one of the final notes in her file in 1926, a member of the ministry acknowledged her current pension and asked, “In view, however, of the report…which indicates that the lady has domestic troubles, does not get on with her husband and is described as very hypochondriacal…do you consider that she should be regarded as being actually disabled to the extent of 30% as the result of her service during the war and of the accepted condition?”488

In the end, the Ministry decided to keep her 30% pension, but it was more a result of a lack of precedence and because her skull fracture had been well-document than as the result of any feelings of duty to or concern for Nurse Donovan.489 The following year, however, it was noted that “‘Malaria’ attacks probably hysterical,” demonstrating the extent to which the ministry’s confidence in Donovan’s performance of health and gender had been shaken by her husband’s testimony.490 As Donovan worked at the Ministry of Pensions, the men discussing her case presumably knew her personally. Nevertheless, her husband’s testimony about her attitude and behavior held more sway in their decisions.

Nurse Donovan’s file also contains a letter from her husband, dated 1930, regarding the continued difficulties in their marriage. The letter is worth quoting at length in order to more fully understand how her trauma was understood—and resented—by her husband:

I regret that I have to reopen this matter to ask you to consider (a) making Mrs, Donovan's pension permanent and (b) increasing the amount thereof. I would also be glad of any advice you can give me as to how I can cope with a difficult situation.

Mrs. Donovan's disability takes the form of an abnormal attitude of mind and it makes it impossible for me to earn a living whilst I live with her. A year ago I secured an appointment here and I think I can say I was doing well, as my employers paid my wife's fare here (£97.0s.0d) a few months ago. This, I am told, is most unusual in the case of men on their first contracts. Since Mrs. Donovan's arrival I have been unable to do my work and I am continually being involved in situations, which make my employers consider me an idiot. In fact I am given to understand that I am now regarded as

488 Ibid. 489 Ibid. 490 Ibid.

172 unsatisfactory. I append a cutting from a letter from my brother, (Rev. M. Donovan, All Saints Vicarage, Kennington Park, SEll) from which you will see that Mrs. Donovan's most peculiar unhinged behaviour causes people to question my sanity. The whole thing seems a deadlock. For if I tell my employers that Mrs. Donovan IS suffering from a War disability which places me in curious situations (& if they believe this) there is the probability that they will cease to employ a man who tells them, in effects, that he cannot be depended upon for punctuality and work. Please have the kindness not to advise Mrs Donovan of this communication. I am not prepared to withstand the disgusting scene which would ensue should she be informed that I have written to you. Incidentally, you will see that I have the interest of Mrs. Donovan and her child at heart when you understand that, since 1921, I have paid £36 per annum for a Widow's and Orphan's Insurance and shall continue this payment as long as I can do so.491

Denise Poynter cites this letter in her dissertation, arguing that it shows how the war could create a “void” between husband and wife, and his “inability to comprehend her experience and resulting condition.”492 Her point is well taken, and speaks to Jessica Meyers’ research into the strain that male veterans’ physical and mental injuries could place on their wives and their marriage.493 However, this letter also speaks to the fact that women’s war trauma did not fit comfortably with the gendered assumptions that shaped the postwar society. Mr. Donovan expresses concern about what people, especially his employers, will think of him as a result of his wife’s “most peculiar unhinged behaviour”, and is concerned that he will be stigmatized as a result of her needs. In a society where literature, propaganda, and media portrayed women as caretakers of wounded and traumatized men, it must have been difficult for Mr. Donovan to find himself in the role of both a veteran and a caretaker to his traumatized wife. That he was forced to care for her was a challenge to every notion of postwar masculinity. Moreover, he notes that trying to explain his wife’s trauma places him “in curious situations.” This is in large part due to the fact that ‘shell-shock’ had been so firmly fixed as a male, masculine condition.

491 Ibid. 492 Poynter, 213. 493 Jessica Meyer, “’Not Septimus Now’”, 124

173 Laura Donovan lived until 1937. Until her death, she, her husband, and the Ministry of Pensions remained engaged in a battle over the real nature of her symptoms and the legitimacy of her claims for compensation. Her voice almost never comes through in her file. Instead, her husband and military officials interpreted her statements and behavior, making Donovan sound irrational and like a selfish malingerer. Her physical injuries and their repercussions played almost no part in their analysis, nor did her psychological trauma. Instead, ministers emphasized her inability to fulfill her postwar role as a wife to her veteran husband.494 Her case is no doubt representative of many others, whether they were reported to officials or kept private. Although there were women who successfully worked through the complex and confusing pension system to earn compensation for their war trauma, all women veterans were forced to deal with a system that did not intend to assist them, or to recognize their service and resultant suffering.

Women Veterans, the Nation’s Fund for Nurses, and the Cowdray Club

Although women, specifically battlefield nurses, were accepted to some extent as psychological victims of war, ‘shell shock’ remained a gendered condition, focused on men, and, more specifically, white, English middle- and upper-class men. The work of the Ministry of

Pensions to assert and defend the status quo, in terms of racial, class, and gender hierarchy, was, ultimately successful in maintain the social and economic status quo after the First World War.

However, the postwar world also offered opportunities for those who were eager to affect change by recognizing women veterans’ service and suffering, and offering them financial, emotional,

494 A slightly different version of Nurse Donovan’s experience can be found online: Bridget Keown, “‘Everything seems wrong’: the Postwar Struggles of One Female Veteran of the First World War,” Nursing Clio, https://nursingclio.org/2018/11/29/everything-seems-wrong-the-postwar-struggles-of-one-female-veteran-of-the- first-world-war/, accessed February 27, 2019.

174 and social support. The majority of veterans’ groups established in the postwar world were for the benefit of men, but there were a few select organizations that specifically concerned themselves with the needs of women veterans. Among the largest of these was the Nation’s

Fund for Nurses, which provided the funds and personnel to establish the Cowdray Club and the

Royal College of Nursing. These institutions not only offer assistance for nurses who were coping with the effects of trauma in the postwar world, but also ensured that nursing remained a profession populated and controlled by women for some five decades after the war.

As noted, Parliament officials, as well as private charities relied on “heartrending cases of misery and want amongst … nurses” to collect funds for women who were unable to complete their service or work following their return to civilian life.495 For example, the editor of the

Daily Telegraph established a Shilling Fund that solicited donations from military personnel for sick nurses. The campaign emphasized women’s helplessness and need for charity and assistance from combatant men in order to survive.496 The tone of the Shilling Fund was resented by many women who saw it as playing into outdated assumptions regarding women’s helplessness, and standing in as “a poor substitute for justice and…a menace to the economic position of nurses.”497 In response to such portrayals, many nurses engaged in public advocacy, assuming a public voice in the debate over compensation as a right following their war service.

In an editorial that appeared in the Morning Post in July 1919, for example, one nurse wrote to defend and advocate for the rights of “these long-suffering women [who] get but scant, if any,

495 Quoted in Palmer, 84. 496 Ibid. 497 Ibid.

175 justice at the hands of the Pensions Ministry.”498 She continued, “The nurses do not want doles.

They are out for official acceptance of their just claims.”499

Women also faced difficulties in receiving postwar support as veterans’ groups that had once championed them as veterans forgot about their needs. For example, the Ex-Services

Welfare Society (ESWS), which was founded in 1919 initially supported the needs of both male and female veterans.500 The ESWS published a pamphlet in 1924 entitled “6,000 Ex-Service

Men and Women Nurses In Lunatic Asylums”, which solicited donations from the public in order to establish homes in which “to treat and train (where necessary) all ranks of all branches of H.M. Forces, with whom are included Ex-Officers and Men of the Mercantile Marine, suffering from the severer forms of Neurasthenia and Mental Breakdown”.501 The pamphlet stipulated, as its last “Aim and Objects” that “The benefits of this Society are extended to Ex-

Service Women.”502 However, Fiona Reid’s research has proven that the organization became successful in its aims to assist veteran only after it “became a group led by businessmen and military figures”.503 These men explicitly turned the organization away from rhetoric about veteran’s suffering and towards the ways in which capitalism could help men recreate meaningful lives for themselves after their mental collapse.”504 The removal of women from leadership in the organization and the emphasis on men as breadwinners successfully excluded

498 “War Nurses’ Hard Case,” Morning Post, July 28, 1919. 499 Ibid. 500 The organization exists today as Combat Stress, which continues to provide therapeutic treatment and residential care to UK veterans with PTSD. 501 TNA, PIN 15/2499, Ministry of Pensions and successors: War pensions, Registered Files, “Ex-Services Welfare Society: public appeals for funds on behalf of broken ex-servicemen”, 1922-1924. 502 Ibid. 503 Reid, Medicine in First World War Europe, 137. 504 Reid, Medicine in First World War Europe, 6.

176 women from the group, and discussions of traumatized women thoroughly died away from this point in their publications.505

For professionally trained nurses, the issues of employment was a serious one. As

Christine Hallett explains, for professional nurses, “the interwar years were a time of frustration, when their hard-won expertise and proves was once again buried within a patriarchal society.”506

Women’s careers were disrupted by ill health, and the demands of families in need of care. Most of all, the end of war also meant that trained nurses were not in as high demand as they had been, leading to a stagnation in pay and a lack of job opportunities for many, especially those whose health had been compromised as a result of their war service. Indeed, officials in Ireland noted that “the chief class of unemployed women requiring training is the ex-servicewomen.”507 The government did establish training schemes for disabled ex-servicemen and ex-servicewomen, as well as war widows in need of employment. However, it was lamented by those in charge of disseminating the information about these schemes that “it has been very difficult to bring to the notice of Disabled Nurses the benefits which are available, both, if I may say so, in regard to

Treatment and in regard to Training.”508 To make matters worse, in Ireland, “no notice appeared in the Irish press” regarding the re-training scheme, and, as a result, applications from women there were officially estimated to be “extremely small.”509

Private organizations also attempted to find employment for women with technical and professional skills. Often, such projects were undertaken in support of state employment and migration schemes designed to maintain the social, economic, and racial status quo throughout

505 This has been verified through a study of PIN 15/2499. 506 Hallett, Veiled Warriors, 260. 507 TNA, LAB/2/1224/TW491/Amended, Training Department (Women’s Training Branch): Correspondence with Haire Forster, Ministry of Labour, Irish Department, concerning training in Ireland, Letter to Miss Durham, December 5, 1919. 508 TNA, LAB/2/1224/TW491/Amended, Letter to Miss Haire Forster, September 16, 1921. 509 TNA, LAB/2/1224/TW491/Amended, Letter to Miss Clapham, September 5, 1921.

177 Britain and the empire. The Empire Settlement Act of 1922, for example, was “an exercise in state-controlled labor migration which also sought to meet certain social and population ends,” especially increasing the number of white settlers in the empire, which encouraged skilled women to leave Britain and take up work in the Commonwealth.510 The Society for the

Overseas Settlement of British Women supported women’s migration under the Act, touting a specific feminist message that portrayed British women as representatives and bulwarks of white supremacy in the Empire. Noting that “Many women of brains and capacity are losing important posts which they have held during the war,” members of the Society worked with the Red Cross,

VAD organizations, and the War Office to encourage nurses to emigrate as an alternative to looking for work in Britain. 511 As a sign of their dedication to all ex-servicewomen, the Society developed a special questionnaire that specifically addressed issues of women’s pensions, and the nature of their disabilities to help determine where nurses should be sent.512 The positions available for medical professionals were decidedly limited, however. According to the meeting minutes of the Society in 1922, women doctors who wanted to emigrate were told they “must be young and possess a private income of at least £150 p.a. They should in addition have specialized in work with women and children.”513 Moreover, the society noted repeatedly that

“no demand exists at the moment for hospital nurses,” unless they were willing to work as “Lady

Helps.”514 Overall, state-sanctioned programs and scheme for disabled and unemployed servicewomen were more concerned with serving the needs of the postwar state than with

510 Janice Gothard, “‘The healthy, wholesome British domestic girl’: single female migration and the Empire Settlement Act,” in Emigrants and Empire: British Settlement in the Dominions Between the Wars, edited by Stephen Constantine (Manchester: Manchester University Press, 1990), 72 (72-95). 511 London School of Economics Women’s Library, 1SOS/01/01, Records of the Society for the Overseas Settlement of British Women Minute Book, July 25 1919 – January 30, 1920. 512 Ibid. 513 London School of Economics Women’s Library, 1SOS/01/20Records of the Society for the Overseas Settlement of British Women, Various Committees and Sub-Committees 514 Ibid.

178 actually improving the lives and employment prospects for women veterans. It thus fell to ex- servicewomen themselves, and their supporters in the private sector, to advocate for the needs of disabled nurses.

Women’s private ex-service organizations were uniquely political and socially active.

According to Kritsztina Robert, “women’s veteran associations adopted a series of political causes in collaboration with bodies that went beyond the ex-service agenda,” which included the reformation of female employment in postwar society.515 One example of just such an organization is the Cowdray Club, which officially opened in 1922. As a result of its emphasis on assisting and supporting women, this club served as a firm basis of support for women veterans of the First World War, nurses, and the nursing profession for over fifty years. The groundwork for the Club was laid by Queen Alexandra, wife of King Edward VII. In 1918,

Queen Alexandra wrote a letter to Sir Arthur Stanley, the Conservative Member of Parliament for Ormskirk, and a member of the Nation’s Fund for Nurses, a charity established by the British

Women’s Hospital Committee in 1915.516 In her letter, quoted here at length, Alexandra expressed not only her eagerness to assist nurses, but also her insistence that their service was equal to that of men in terms of sacrifice and suffering, thus justifying their claims for assistance in the postwar:

I have received your letter of June 27th, and hear with much interest of the scheme which has been started by the British Women’s Hospital Committee to raise a “Tribute Fund” on behalf of our Nurses.

I recognize the need of providing a Fund for the care of those Nurses who through this great War have worked so magnificently and unselfishly, and who through strain and overwork have broken down in health and require special care and attention. I further realize that though these noble women, in many cases, will be granted State pensions,

515 Kritsztina Robert, “‘Still in the ranks of the old Corps, though not on active service’: Women’s veteran organisations in interwar Britain,” in Veterans of the First World War: Ex-Servicemen and Ex-Servicewomen in Post-War Britain and Ireland, eds. David Swift and Oliver Wilkinson, (London: Routledge, 2019), 123 (122-141) 516 Palmer, 85.

179 still their pensions must of necessity be upon the same scale as in the case of our pensioned Soldiers and Sailors.

It is, therefore, I think all the more necessary that we should be in a position to promote their future welfare, not in any way as a charity but as an act of justice and gratitude for their services towards our sick and wounded Soldiers and Sailors and to the civil population.517

The result of this letter, and Alexandra’s vision, was a massive public appeal for funds that would endow a college of nursing and a “Tribute Fund” that would assist individual nurses in the case of sickness or disability.518

While the Nations’ Fund for Nurses advocated for individual nurses in need of case, the

College of Nursing advocated for reforms in the nursing profession, as well as for the passage of the 1919 Nurses Registration Act.519 Rather than seeing nurses as needy and helpless, the founding committee emphasized the “magnificent record of the nursing service in the war, and the devoted and valorous work of its heroic women.”520 In speaking with the press, the committee treasurer, Viscountess Cowdray “observed with regard to the great work the nurses had done for the country that it was not realized how little had been done for the nurses…Even

517 Wellcome Library and Archives, SA/NFN/B/9, Correspondence with committee members and donors, 1917- 1938, Letter to Sir Arthur Stanley, July 3, 1918. 518 See Palmer, 85-6. 519 The Nurses Registration Act of 1919 established the General Nursing Council and a register for all those who had training in general nursing and supplementary registers for other positions, such as mental nursing, and pediatric nursing. Nurses were to be admitted to the Register if they had, for three years before 1 November 1919, been bona fide engaged in practice and had adequate knowledge and experience of the nursing of the sick. For more, see Brian Abel-Smith, A History of the Nursing Profession (London: William Heinemann Ltd, 1960). The debate over the Nurses Registration Act was a heated one that divided many in the nursing profession and medical community in general. By standardizing the training for nurses, many of those in positions of authority at prestigious institutions were opposed to the Act, as it meant the end of their own control over the profession and the training they thought best. For those nurses concerned over the deregulation of the nursing profession as a result of the war, the Act signified a major shift towards preventing “false” nurses from taking jobs from “real” nurses, thereby tarnishing the profession and causing financial and professional harm to those who had dedicated their lives to the profession. For more on this, see Hallett, Veiled Warriors, 259, and Helen M. Sweet with Rona Dougall, Community Nursing and Primary Healthcare in Twentieth-Century Britain (New York: Routledge, 2008), 35-62. 520 Wellcome Library and Archives, SA/NFN/B/9, News clipping, “Helping the Nurses”

180 with the franchise very few nurses, living in hospitals, would have the vote. There was a need for real organization.”521

Annie Pearson, Viscountess Cowdray, and her husband swiftly became major forces within the administration of The Nation’s Fund for Nurses. Their youngest son, Francis

Geoffrey Pearson, was a motorcycle courier in the Motor Transport Division of the British

Expeditionary Force, and died after being captured in France on September 6, 1914.522 The family’s support of veterans was therefore very personal. However, Lady Cowdray was a woman with uniquely visionary ideas. The daughter of a self-made merchant who married Weetman

Pearson, 1st Viscount Cowdray, in 1881, Annie Pearson (nee Cass) was described as “possessed of a driving social ambition, a determination, with her husband’s wealth and achievements, to surmount Victorian and Edwardian barriers of caste.”523 Though she embraced her duties as a member of the nobility to engage in socially-acceptable charities, her advocacy for working women gave her charity work a uniquely feminist air. Lady Cowdray was also involved in the

Women’s Institute, which organized women to meet Britain’s food supply shortages during the

First World War, the London Committee of the Scottish Women’s Hospital, and the South

London Hospital for Women, as well as supporting a number of women’s suffrage organizations, and the Northern Men’s Federation for Women’s Suffrage.524

The involvement of Lady Cowdray with the Nations Fund for Nurses resulted in the inspiration to form a social club for nurses and professional women which "should provide a centre for intercourse and recreation and which should also furnish some of those creature

521 Ibid. 522 Commonwealth War Graves Commission website, https://www.cwgc.org/find-war- dead/casualty/578884/PEARSON,%20The%20Hon%20FRANCIS%20GEOFFREY, Accessed 03/04/2018. 523 Quoted in Elizabeth Crawford, The Women’s Suffrage Movement: A Reference Guide, 1866-1928, (Psychology Press, 2001), 145. 524 Crawford, 145.

181 comforts which we associate with the word 'Home'".525 The Club also offered a site of support and advocacy for female veterans who had suffered breakdowns as a result of their service. The

Club that Lady Cowdray helped to organize, which would ultimately bear her name, demonstrated not only her drive to help women’s professional advancement, but also a keen understanding of how to do so in a way that would attract positive press (and financial contributions) from influential sources.

Lady Cowdray was joined in her fundraising by (among others) Dame May Whitty, a

British actress named to the New Year’s Honours List 1918. Together they organized social evenings, concerts, and similar events that brought upper-class society together in refined settings. During these soirées and performances, the two women emphasized the cost of securing a good, reputable address for the new club, and the need for donors’ support. Their message often met with misunderstanding, and even hostility. In a letter from May 1919, one of the fundraising committee members wrote to Dame Whitty, describing a fundraiser that was imperiled by nurses who opposed the Nurses Registration Act, and noting the way the members of the Nation’s Fund for Nurses overcame the vocal opposition they encountered:

I have done my last Meeting for the Nation’s Fund this afternoon. I think it was rather in the way of a triumph, as our hostess informed me before we went in that there were several matrons and nurses who intended to make trouble. However, Jack spoke for the College and I for the Tribute Fund and we came off splendidly, and the ladies made no remarks of any kind whatever… This time last year we made £100 a day, including Sunday… However, I think we shall end up with nearly £200, and now, at any rate, Bradford knows something of the organization of the College and its Tribute Fund. Jack gave them three recitations and even the hostile Matrons were melted. I think it would be wise of the Committee to send Mrs. Cutliffe Hyne a letter of thanks, because she really did put her back into things.526

525 LMA, A/COW/087, Agnes L. Douglas, “The First Viscountess Cowdray and Her Connection with the Royal College of Nursing and The Cowdray Club”. 526 Wellcome Library and Archives, SA/NFN/B/9, Letter to Dame May Whitty dated May 7, 1919.

182 The emphasis on ensuring professional training for nurses, as well as the dedication of the

College to the highest standards of training, aided in overcoming opposition to the Fund’s political advocacy, and sometimes succeeded in winning over new recruits to their cause.

Nevertheless, postwar tensions within the United Kingdom presented challenges to the

Fund’s fundraising efforts. Another letter to Dame Whitty, written by actor M. Martin Harvey, described how growing nationalist sentiment threatened fundraising attempts:

I am afraid there is not much hope of any results here in Glasgow, except just the money we shall get in the house. It is extraordinary the feeling of antagonism and misunderstanding there seems to be with regard to the Fund. It is perfectly useless to send them letterpress, or try to explain that it is a National Fund. They will persist in demanding that any money that is given should be earmarked for the use of Scottish Nurses alone. I have had a fearful day, and feel thoroughly disheartened. It is useless regretting it now, but had I any idea of the bitter feeling there seems to be with these people here, and what they call “a London charity”, I certainly should never have dreamed of giving the Matinee in Glasgow. I had hoped to get cheques, apart of course from what the Matinee itself will bring, but in every case it is the same thing, that unless I can undertake that the money shall be used exclusively for Scottish Nurses they are not forthcoming.527

Despite these local concerns, and the political hostility, the administrators of the Nations’ Fund for Nurses were able to raise enough money to purchase a site for the social club and make the residence imagined by Lady Cowdray a reality. After a great deal of negotiations and several years of correspondence, Viscount Cowdray purchased the land and building located at 20

Cavendish Square from former Prime Minister H.H. Asquith for £14,000.528 He immediately handed control of the house—and of the club that it would house—to his wife. Though Viscount

Cowdray provided financial, professional, and, no doubt, emotional support to the endeavor, The

Cowdray Club remained his wife’s project in both name and deed. In this way, as well, the Club

527 Wellcome Library and Archives, SA/NFN/B/9, Correspondence with committee members and donors, 1917- 1938, Letter to Dame May Whitty dated March 12, 1918. 528 Wellcome Library and Archives, SA/NFN/B/19/1, Lady Cowdray’s Papers, 1916-1928, Letter to Lord Cowdray dated November 18, 1920.

183 conformed to established codes of gender and class, yet found ways to subvert them in order to allow women a voice and agency.

Newspaper reports of the club emphasized its elegance and refinement, as well as the gendered work that Lady Cowdray performed in decorating the interior of 20 Cavendish Square.

Numerous reports discussed the fact that Lady Cowdray brought things to the club from her home, and that “she took pleasure in deciding on and choosing furnishings.”529 Other articles described the opulence of the club, including the dining room, which was fitted with “busts of

Florence Nightingale, Nurse [Edith] Cavell, and Viscount and Viscountess Cowdray.”530 The

Aberdeen Press and Journal described Lady Cowdray’s “characteristic liberality and thoughtfulness for the welfare of others,” in establishing the club, and praised the fact that she

“spared no expense equipping the residence.”531 The same article also championed the idea of assisting nurses, who is described as the perfected ideal of womanhood:

Nurse—the figure in neat outdoor uniform, familiar in every city, town, and village of our land—has, whether tending broken bodies within a war-swept zone, or watching by the bedsides of sufferers in cottage hospital or city infirmary, ever proved, in the truest sense, ‘a noble type of good, heroic womanhood’—and the fact that in Lady Cowdray’s club and residence preference is to nurses will be approved of by all classes of the community, who intimately recognize the invaluable self-sacrificing services rendered by members of that profession.532

In describing the Cowdray Club, such news reports emphasized women’s traditional role as care- taker, praising their service without acknowledging specifically the emotional labor such work required. But it is important to that behind these very classist and gendered reports, behind the

529 LMA, A/COW/087, Agnes L. Douglas, “The First Viscountess Cowdray and Her Connection with the Royal College of Nursing and The Cowdray Club”. 530 “Cowdray Club,” Nottingham Journal, June 20, 1922. 531 “The Cowdray Club,” Aberdeen Press and Journal, April 28, 1921. 532 Ibid.

184 elegant knick-knacks and the ornate furnishing, the Cowdray Club was working to change the perception and treatment of nurses in society.

The first way the Cowdray Club accomplished this was through their advertising and outreach. The Cowdray Club described nurses not as selfless, anonymous caretakers. Instead, their advertisements and public reports emphasized the service that nurses performed in society, and the debt that society owed them. The language in which nurses were described, and the rhetoric surrounding their service was closer to that used to discuss male veterans, normalizing the need to support women veterans. For example, in their Report for 1929, an appeal was put out for the public to help support the Nurses’ Fund, explaining:

Much more could be done but for shortage of Funds;…these applicants are people who have devoted their own lives in helping and nursing their fellow country folk in their hour of need and suffering, surely it does seem ironical that when they, in their turn, are in some distress, so little can be done to bring them aid and comfort. The Committee appeal most earnestly for donations to start a Subscription List that might enable this very necessary work to be continued, on a far more generous scale than ever before.533

Rather than leaning on the public’s charity, and portraying nurses as helpful or pitiful, the

Cowdray Club insisted that there was a debt owed to nurses by society, and extolled British and

Irish civilians to pay that debt with donations.

Additionally, the women organizers of the Nations Fund for Nurses, who also served as administrators of the Cowdray Club and other subsidiary organizations, were dedicated to assisting individual women veterans financially, socially, and emotionally. A significant portion of the Fund’s endowment was reserved for service pensions to women who were unable to access state pensions, with specific attention being paid to women who were coping with symptoms of trauma and “mental breakdown.” By 1922, the Fund was paying out pensions of

10 shillings weekly to twelve nurses, and was actively investing £1376:13:3 in the hopes of

533 Wellcome Library and Archives, SA/NFN/B/2/1, Irish Branch, The Nation’s Fund for Nurses Report for January 1 to December 31, 1929.

185 increasing the number of pensions that could be offered in the future.534 These pensions were offered not only to women in Britain, but in the larger Commonwealth. For example, in 1924, the committee voted to provide a Miss Kate Gossage of Johannesburg, South Africa, who had served under the Joint War Committee, a pension of £26 per annum, when she was unable to secure a state pension.535

These pensions were particularly meaningful for aging nurses coping with symptoms of trauma and declining physical health in the years and decades after the war. One such pensioner was Edith Kew, who served with the Territorial Force Nursing Service from August 1914 to

March 1915.536 While working as a staff nurse at the 4th London General Hospital, she developed sepsis in her left hand, which led to her discharge.537 Though she received a gratuity as a result of her injury, in 1922, she applied to the Joint Nursing and VAD Services Committee of the United Services Fund, stating that she was “suffering from nervous debility and heart trouble.’538 Like many nurses, her trauma symptoms seem to have become more noticeable after the war, perhaps triggered by the stress of returning to civilian life, as well as the collapse of the support networks and friendships she had developed during the war. Her letter was forwarded

(after a long delay) to the Ministry of Pensions, though there is no information available as to whether she was awarded any compensation.539 However, in 1929, the Nations Fund for Nurses stepped in, accepting Edith Kew as a new pensioner, and also including her in their system of

534 Wellcome Library and Archives, SA/NFN/D/4/1, The Queen Alexandra Relief Fund for War Nurses, Minutes of Meeting held on Tuesday, October 10th, 1922. 535 Wellcome Library and Archives, SA/NFN/D/4/1, The Queen Alexandra Relief Fund for War Nurses, Minutes of Meeting held on Tuesday, December 16, 1924. 536 TNA WO/399/12571, Edith Kew. 537 Ibid. 538 Ibid. 539 Ibid.

186 care. By this point, Nurse Kew was sixty years of age, and still suffering the effects of “nervous breakdown” that she and the Fund understood as a result of her service.540

Another example can be found in the service record of Nurse Mabel Whiffen, who also served with the Territorial Forces Nursing Service, Her service lasted from May 1915 until the end of 1919, and throughout, she was described by her superiors as an exemplary nurse. 541 Her service file contains several letters attesting to her abilities, including one from RAMC Col. F.H.

Westmacott, under whom she served at the 57 Western General Hospital from July 1918 until her return to England:

Miss Mabel Leigh Whiffin (sic)…joined this unit on 11th July 18 and left on 6th December 18 for leave in the United Kingdom and did not return. Miss Whiffen possesses the highest professional ability and administrative capacity. She is an excellent organizer and always has an intimate knowledge of the work going on in the hospital and of the capabilities of her nursing staff. She possesses a calm temperament and is invariably bright and cheerful. Her tack and judgment together with her broadmindedness have the best possible influence on all her staff and will ensure the high efficiency and smooth working of any hospital where she may be appointed Matron. She is well fitted for promotion.542

This report was verified by two other recommenders under whom Nurse Whiffen had served in

France during the course of the war. These recommendations were put forward in the hopes of securing employment outside of the military for Nurse Whiffen following a “complete mental breakdown” during her leave at the end of 1919.543

According to a letter directed to Dame Maud McCarthy the Matron-in-Chief of the

TNFS, Whiffen’s case was so urgent that “it was decided that she must be taken to a Hospital for

540 Wellcome Library and Archives, SA/NFN/D/4/1 The Queen Alexandra Relief Fund for War Nurses, Meeting Minutes, 10th September 1929. Incidentally, Nurse Kew received her pension following the death of Kate Gossage. When news of her death was received, it was determined that the funds which had been allocated for Kate Gossage should be used to support Nurse Kew. 541 There seems to be some confusion on the spelling of this nurses’ surname. The records of the National Archives give her name as “WHIFFEN”, though numerous official documents in her service record give it as “WHIFFIN.” Because her obituary provided her name as “WHIFFEN,” I have used that spelling here. 542 TNA, WO/399/15442, Whiffen, Mabel. 543 Ibid.

187 cases of that kind. The Doctors felt that was her only chance.”544 This letter describes in heartrending detail the kind of effects that war service could have on a nurse who was burdened not only with the stress of caring for patients in difficult conditions, but also concern for her own physical safety and well-being:

It is a tragedy, because I am sure no woman could have had a more active and acute brain. She was so clear and definite in everything, as I am sure you know. I found her a very great help and had a very great admiration for her and felt that one could always trust her opinion and advice. It is heart breaking to see her as she is now. She has had many worries during all her war service and altho’ we did not realise at all at the time, as she never thought of herself, things must have made a deep impression on her. In some of her wanderings she imagines and talks of air raids and yet the doctors who were in France with her tell me no one was more calm & collected & full of care for others…the Doctors consider that her condition is due to the great strain of work during the War and since, and we do hope that she will have a pension…if she recovers she will not be fit for her work again.545

Although there is a note in Nurse Whiffen’s file that her case was referred to the Ministry of

Pensions, no record exists of how or whether her case received attention.546 It is entirely possible that her file was not one of those retained in the National Archives. It does seem that she found work as a hospital matron thanks to the intervention of her friends and colleagues. Though

Nurse Whiffen may have found solace and purpose in her work to aid her recovery, it is also possible that she was financially unable to retire after her war work, despite prolonged health issues. In the summer of 1928, she resigned from her position with the TFNA as Matron of the

2nd Northern General Hospital on account of age, and died suddenly on November 3 of the same year.547 The place of her death is listed as the Cowdray Club.548

544 Ibid. 545 Ibid. 546 Ibid. 547 Ibid. 548 I am indebted to the assistance of Mrs. Jessamy Carlon, Partnerships & Programme Manager for the First World War 100 Project for her assistance in identifying Nurse Whiffen’s place of death and helping to connect her story to my larger work.

188 It is not certain when Nurse Whiffen became a resident of the Cowdray Club, however this note shows how the club was able to assist her, regardless of the intervention of the Minitsry of Pensions. As these women veterans aged and their health continued to deteriorate, the rest homes and residences established by the Cowdray Club throughout the United Kingdom and

Ireland became increasingly significant sources of care. Many nurses, like Nurse Whiffen, did not marry after the war, and thus had fewer options available for care, or financial comfort as they grew older. The Cowdray Club provided not only a safe haven for these women, but also a place where they could interact with other people who had similar wartime experiences. In a world that was not quick to acknowledge the range and difficulty of nurses’ work (especially in the same way it remembered the service of men), sites like the Cowdray Club were especially important sources of identity and discourse for women veterans. Critically, in supplying funding, housing, or rehabilitation for women veterans, the executive committee of the Cowdray

Club appears to have relied on those veterans’ testimony as proof of their suffering. Rather than hold women up to gendered medical or social standards that skewed the perception of the service and health, the Cowdray Club listened and trusted the women who appealed to them for care.

This in itself was a revolutionary practice that not only aided many women veterans, but showed that it was possible to provide trauma care and treatment without being beholden to ineffective and highly gendered standards, such as those exhibited by the Ministry of Pensions.

The second way in which the Cowdray Club challenged the status quo and public perception of nurses was through its public and private advocacy of women. Rather than operate as a charity, the Nations’ Fund for Nurses and, by extension, the Cowdray Club, operated as a professional organization run by professional nurses, as well as elite members of society (who provided the prestige and publicity necessary to keep donations coming into the club’s coffers).

189 As one of the Cowdray’s solicitors noted, “Certainly, if I were a woman, it would take some time to convince me that I ought to belong to a Club which could not be regarded as containing members of sufficient experience and gravity to manage its own affairs.”549 Membership to the

Cowdray Club was limited to women, with a rule stating that 55% of the membership roster should be comprised of nurses, 35% “high-class professional” women, and 10% women without professional qualifications who could utilize the experience of the professional women around them to advance their careers.550 Such numbers were determined after consulting ‘the

Secretaries and Stewards of three important London Clubs”551 In this way, the Cowdray Club consciously modeled itself along the lines of traditional men’s clubs, which had consolidated power and professional knowledge within its walls for generations. By excluding women as

“unclubbable”, these men’s clubs also excluded women from professional connections and power; the Cowdray Club consciously contradicted such practices by creating an all-female professional environment that guarded power over the nursing profession in similar ways.552

Sometimes, their gate-keeping took some unique forms. For example, in 1932:

It was pointed out that the Club clocks were intentionally kept five minutes fast and had been ever since the Club opened, and that in the course of the week between the regular windings they often gained two minutes. The Committee agreed that it would be a difficult matter to alter this well known practice now, but that when the junction was made with the New Building the question of keeping at least one clock at Greenwich Time electrically synchronized would be considered.553

Though such practices were apparently quite confusing to new members, they also provided a sense of common knowledge among long-term members that forms a core of knowledge and

549 Wellcome Library and Archives, SA/NFN/B/19/1, Letter to Mrs. Douglas, March 10, 1921. 550 Wellcome Library and Archives, SA/NFN/B/19/1, Lady Cowdray’s Papers, 1916-1928, Letter to Lady Cowdray, December 31, 1921. 551 Wellcome Library and Archives, SA/NFN/B/19/1, Lady Cowdray’s Papers, 1916-1928, “Cowdray Club London, An Analysis by Mr Comyns Berkeley”. 552 A. Milne-Smith, London Clubland: A Cultural History of Gender and Class in Late Victorian Britain (New York: Palgrave Macmillan, 2011), 11. 553 LMA, A/CO/034, The Cowdray Club: Minutes of House Committee, January 1928 to December 1934, Volume 2

190 understanding among members. The recognition of the time within the Club was an inculcation that was apparently appreciated by most, if not all, the women who checked the club clocks.

Within this environment, women who were suffering the effects of trauma found a recognition of their symptoms that was not generally present in the larger postwar world.

Indeed, as the Cowdray Club expanded, opening branches and rest homes across the United

Kingdom and Ireland, preparations were made to care for nurses coping with both the physical and mental effects of war. In one letter to the Matron of Coombe House in Surrey, another site of the Cowdray Club, it was noted that "we have been anticipating that now nurses are being demobilized in large numbers, many of then [sic] who have borne up for the period of the war will be liable to collapse and we have already one or two rather severe neurasthenia cases in our other Homes.”554 While it was necessary to care for women who returned home sick, overwhelmed, and exhausted, the Cowdray Club also recognized that breakdown could occur at any time after demobilization, and was careful to provide long-term care and support for its members. Rather than portraying such actions as charity, the Cowdray Club insisted that it was caring for women veterans out of respect for their service to the profession and to the nation in war.

Soon after the Cowdray Club was opened, Lady Cowdray acquired the building next door and other nearby properties for the purposes of establishing the Royal College of Nursing on the

Club’s grounds. Once again, public attention to the gendered nature of nurses’ work obscured a much more progressive agenda on the part of the College’s founders and its members. As the

Sheffield Independent noted on the day the College was officially opened by the Queen, “The

College of Nursing…like so many progressive movements of the last ten years, was established

554 Wellcome Library and Archives, SA/NFN/C/8, Edith Cavell Rest Home for Nurses, Correspondence and Memorabilia, Mrs. Coventry, Letter to Mrs. Coventry dated 17th February 1919.

191 to meet a need greatly emphasized by the European War if 1914—the mobilization of a national service essential to the care of the civil population, as well as the sick and wounded during the war.”555 Here again, women’s roles as feminine caretakers was emphasized. Such a public framing of the college and its work allowed the women students to operate without appearing to pose a threat to the gender hierarchy.556

At the same time, however, the founding of the College of Nursing was a deliberate move to ensure both that the Nations Fund for Nurses retained its standing and legitimacy for the long- term, and that its members would be able to define and control the nursing profession in Britain for years to follow. The same article in the Sheffield Independent explained:

The leaders of the nursing profession have co-operated in establishing an organization whose policy is to unite all trained nurses in the endeavor to provide a uniform standard of training, to improve the quality of the nursing service and the conditions under which nurses work, and to further, in every possible way, the advancement of the profession through legislation, post-graduate study, theoretical and practical scholarships, and specialized training.557

With such a headquarters, the Royal College of Nursing was able to provide a curriculum that would “raise the educational and professional standards of nursing in the future,” ensuring jobs and economic advancement for another generation of women from fairly diverse backgrounds.558 A testament to the prominence and political power of the organization is in reports over the election of members to the General Nursing Council, established in 1919 to oversee the registration process and design the national nursing curriculum. According to a 1923 news report, the two nurses who received the most votes were:

Miss Margaret Sparshott, R.R.C., of the Royal Infirmany, Manchester, with 5,331 votes…in next place comes Miss Musson, R.R.C., the popular matron of the Birmingham

555 “Queen Opens College of Nursing”, Sheffield Independent, June 1, 1926. 556 Virginia Nicholson, Singled Out; How Two Millions Women Survived Without Men after the First World War (London: Viking Press, 2007), 261. 557 “Queen Opens College of Nursing”, Sheffield Independent, June 1, 1926. 558 Wellcome Library, SA/NFN/B/1/1, The College of Nursing, Ltd. Fifth Annual Report, 1920.

192 General Hospital. She, too, is a prominent member of the College of Nursing Council and of the Council of the Cowdray Club, and those who act with her on the latter body know well how they can rely upon her direct good sense and practical views.559

In addition, the College remained dedicated to providing at least moderate access to the nursing profession for those unable to afford the tuition. The College approached the Minister of Labor

“with a view to obtaining grants for the training of disabled nurses in other occupations, and approved a scheme…from which many of our members have already benefitted.”560 In so doing, the College showed itself capable of addressing problems the government was not, specifically, the training of disabled nurses in diverse fields. Grants were apparently also provided for nurses to receive training to qualify as tutors at the College, and to pursue a career in midwifery.561

During a period when many women were forced to return to their homes, and had their contributions to the war effort overlooked, the Cowdray Club provided assistance for women veterans as well as professional opportunities for women of varied backgrounds and abilities to ensure that the nursing profession could thrive in peace, as well as in war. By insisting on maintaining the Club and the College as women-run institutions, the administrators ensured that the nursing professional remained both respected and predominantly female until the closure of the Cowdray Club in 1974.

In many ways, the Cowdray Club was a product of its time, and reflected the predominant assumptions regarding class and gender. Members and the media alike placed great emphasis on the importance of establishing the Club at a “good” address and filling the headquarters and its branch homes with luxurious furnishings and elegant decorations. There were strict rules about members’ behavior and propriety, and though pro-rated fees and

559 TNA, ED 50/58, Recruitment and training: Nurses Registration Act 1919: Board of Education representation on General Nursing Council. Memorandum on election of registered nurses to General Nursing Council. 560 Ibid. 561 Ibid.

193 scholarships aided some women, the organization remained very much focused on “proper” middle- and upper-class women, and maintaining very high levels of propriety and virtuous behavior within the Club walls.562 However, the Cowdray Club was also an institution that specifically cared for women veterans at a time when their service was being systematically overlooked by military officials and the public alike. The Club not only provided a haven for women who were suffering the effects of war trauma, but also offered them a community in which they could share their experiences and be with others who understood their experiences.

As women veterans grew older and their health declined, the physical and emotional support provided by the Cowdray Club—and the financial support provided by the Nations Fund for

Nurses that oversaw it—was critical to nurses’ well-being.

The general tendency of national and international powers was to re-assert the dominance of men, specifically those who were veterans, in the postwar, and to return women to their prewar subservience. This led to women’s war service being anonymized, their suffering downplayed or outright ignored, and their recovery overlooked. In these circumstances, the

Cowdray Club represented a site that supported and empowered women veterans and nurses by offering companionship, safety, and the opportunity to take control of their profession for decades to come. Additionally, by recognizing women’s war trauma as legitimate and worthy of help, the Cowdray Club offered a model of acceptance that many veterans’ organization of the time, and in, indeed, up to the present day, have yet to adopt in their recognition of women’s war trauma, which still suffers from gendered bias and the stigma of women’s emotional instability.

562 LMA, A/CO/034, The Cowdray Club: Minutes of House Committee, April 1922 to December 1927, Volume 1.

194

Epilogue: The Underbelly of Memory

By now I had developed an allergy to the word ‘trauma’. The term was on everyone’s lips and yet told one nothing. One problem was that the word itself had become meaningless through overuse. So when colleagues or friends at home said ‘Poor you, dealing with all that trauma,’ I had to stop myself from saying bitingly: ‘Please define your terms. Are you referring to the events—torture, shelling, kidnapping or whatever, to which people have been exposed? Or are you referring to their reactions to these events? And if the latter, are you talking about their physical or mental reactions? And are you talking about normal or abnormal reactions, because that one word is now used for all of the above.’”563 (Lynne Jones, Outside the Asylum: A Memoir of War, Disaster and Humanitarian Psychiatry, 2017)

On July 1st, 2016, I was in London on a research trip. Having promised to meet a friend at Charing Cross for a dinner date, I took the District Line from Kew Gardens to Embankment and began making my way up the hill towards Charing Cross Station. About halfway up the slope I saw a line of men coming towards me wearing khaki uniforms and puttees. The man in the lead had on an officer’s cap, while the rest of the men wore tin helmets. Their hobnail shoes rang out on the pavement, marking the time of their silent march. They looked straight ahead, marching through crowds of commuters who swiftly and automatically parted for them. They did not look to the right or left, they did not meet the gazes of those spectators who gaped at them. They marched down to the station and disappeared inside, leaving nothing but the jangling of their shoes ringing in the air behind them.

They were ‘ghost soldiers’, volunteers participating in a unique, living memorial to the

19,240 men who died on the First Day of the Somme. A UK-wide event commissioned by 14-18

NOW, the official arts program for the First World War centenary, conceived and created by artist Jeremy Deller in collaboration with Rufus Norris, the program saw some 1,400 volunteers don the uniforms of British ‘Tommies’, and walk through, sit in, and generally inhabit public

563 Lynne Jones, Outside the Asylum: A Memoir of War, Disaster and Humanitarian Psychiatry (London: Weidenfeld & Nicolson, 2017), 92-3

195 spaces.564 They were not allowed to speak to any of the people they encountered in the course of their public performance.565 According to the project’s website, each participant in the event represented an individual soldier who was killed on that day.

The resulting spectacle was haunting, indeed. These men moved through a developed landscape that arguably looked wholly unfamiliar to any actual soldiers who had departed a century earlier, yet their presence in streets, in railway stations, and in public squares served as a reminder to all those who observed them that the memory of the war was still very much alive.

That our relationship to the war, as observers, as descendants of veterans, and as inhabitants of the same places from which they had departed, was a real and tangible one. One re-enactor from

Belfast recalled how witnesses to the performance reached out to share those memories, or made connections between the performers and their own histories:

In the railway station, I sat down beside a lady and she tapped me on the shoulder and began to tell me about her grandfather, who had been at the Somme and survived. Then on the train to Ballymena, I was interrogated by four children. The children were trying to figure out what was going on. 'Are you alive? Are you a ghost? Are you going to heaven?' 'Who are you going to see in heaven?'" they asked. They eventually got it, and said, 'Okay, he's respecting his comrades who died, so we should respect them as well'. That was a poignant moment.566

In describing the soldiers’ presence on the train in such a way, the children who interacted with the off-duty performer described memory as an act of sharing space with a spirit. The image is a poignant one that speaks to the ways in which the memory of the First World War has been manipulated, used for political objectives, rehearsed and forgotten for specific reasons in the century since its conclusion.

564 For more information, see https://becausewearehere.co.uk/, accessed February 10, 2019 565 David Young, “Somme: How ghost soldiers brought haunting images to Belfast,” Belfast Telegraph, July 2, 2016: https://www.belfasttelegraph.co.uk/news/northern-ireland/somme-how-ghost-soldiers-brought-haunting- images-to-belfast-34850621.html, accessed February 10, 2019. 566 Ibid.

196 But as I walked through London that sunny July day, I found myself looking for women.

For someone who would be bidding these soldiers farewell, or turning away from their departure; for women who might be similarly traveling to the Somme in uniform preparing for the aftermath of the battle to come. Even in Embankment Station, I looked for women who might be working as porters, guards, or inspectors. Those positions had become open to them in

1915, despite warnings from medical officials that taking such jobs would cause women to

“suffer mentally and morally,” since “there were psychological and physiological reasons which barred women from certain kinds of employment.”567 As I watched these men march into the station, fading from the present back into the past, I realized how deeply gendered the history of the Somme, indeed, of the First War World, truly had become. In Britain especially, these men’s service, their suffering, and their eventual death, stood in for the national experience of the First

World War in a way that required no speech, no explanation, and no contextualization. Their subjectivity and individualism existed even in death, and was able to stand in for any individual and collective experience of this battle and of the whole war.

This work, in large part, has attempted to challenge the historiography that treats the

“generic man as the human norm” by looking at the experiences of traumatized women that have been overlooked as the result of a focus on combatant men’s wartime psychological conditions.568 In order to make this point as clear and as personal as possible, I have limited my study to the experiences of women in Britain and Ireland. That does not mean, however, that the exclusion or isolation of women within the history of warfare, the history of emotions, the

567 From The Guardian Archive, “Women tram guards in wartime,” https://www.theguardian.com/world/2015/jul/02/first-world-war-women-work-railways-1915, accessed Feb 16, 2019 568 Harry Brod, “Introduction: Themes and Theses,” in The Making of Masculinities: The New Men’s Studies, ed. Harry Brod (Boston: Unwin Hyman, 1987), 2

197 history of psychology, from public spaces, and from military history, is a problem that existed only in the past. The First World War set a precedent for the understanding and treatment of war trauma that continues to affect military and medical treatment to this day. Terms such as “shell shock,” neurasthenia, and numerous related diagnoses have been jettisoned from the medical lexicon, and more intricate, historically contingent and culturally representative terms such as

PTSD, combat stress, and traumatic brain injury have been developed to represent the reality of present-day combatants and veterans. However, the assumed patient, the ideal for whom treatment is developed and by whose standards a cure is defined, remains male.

As two psychologists have noted in a recent study of PTSD and culture, the “connection between trauma and history is unique”, both in terms of the way that both fields are “colored by national medical traditions, institutional cultures, and popular attitudes,” as well as how they affect the ways in which that trauma is understood within an historical context.569 The diagnosis of PTSD was first developed as a result of activism by veterans of the Vietnam conflict. It was because of work on the part of veterans’ groups, consciousness-raising meetings, and political advocacy that the issue of war trauma was brought out of medical and military settings and made into a topic of public debate and wider acceptance. The decision by the American Psychiatric

Association to include the diagnosis “post-traumatic stress disorder” into the DSM-III in 1980 made it possible to recognize the lasting trauma of veterans returning to civilian society, and to develop courses of treatment in the hopes of minimizing the effects of trauma on returning veterans. At the same time, the establishment of diagnostic criteria also provided appropriate language for historians to consider the effects of war on soldiers throughout the 20th century and, indeed, in centuries past. However, while it was acknowledged that PTSD could affect any

569 Allan Young and Naomi Breslau, “What is ‘PTSD’? The Heterogeneity Thesis” in Culture and PTSD, edited by Devon E. Hinton and Byron J. Good (Philadelphia: University of Pennsylvania Press, 2016), 147, 148

198 individual, the emphasis in study and treatment remained on combat scenarios, in which only men could partake at the time. As a result, the historic and the medical study of PTSD and other war-related traumas remained, and remains, a study of men. As I have noted, this is a historical issue because conforming to the official definition of PTSD and similar trauma diagnoses continues to obscure the trauma of those who were deemed outside the diagnostic criteria. In the present day, studies have shown that reinforcing and stressing the validity of the PTSD diagnosis has taken precedence over the actual study and understanding of trauma. Likewise, a focus on the diagnosis has also rendered unnecessary the work that should be done in order to minimize such trauma. The emphasis and international reliance on medical and military authority had ensured that PTSD diagnosis remained sacrosanct, despite the lack of logic behind upholding such a decision.

In 1990, the PTSD diagnosis was added to the ICD-10 (International Statistical

Classification of Diseases and Related Health Problems), a clinical cataloging system compiled by the World Health Organization (WHO) in order to help physicians in member states track epidemiological trends and to note diseases on health records. The category of PTSD included in the ICD-10 was similar to that which appeared in the DSM-IV, but allowed for more flexibility in its causation and its range of symptomatic presentation. For example, the DMS-IV required that the causative event involve “actual or threatened death or serious injury, or a threat to the physical integrity of self or others,” to which the patient must respond with ‘fear, helplessness, or horror,” while the ICD-10 diagnosis specified only that the event had to be “exceptionally threatening or catastrophic,” with no stipulations as to the patients’ response to such events.570

570 Abdelhamid Afana, “Problems in Applying Diagnostic Concepts of PTSD and Trauma in the Middle East,” The Arab Journal of Psychiatry Vol.23(2012), 29 (28-34: supplement pages).

199 Since its adoption, the ICD-10 diagnosis has been applied around the world in response to trauma-inducing events, from natural disasters to man-made acts of violence.

However, despite any attempts to make the diagnosis a universal one, the application of a fundamentally western diagnosis on a people with different cultural values, methods of interpersonal communication, and linguistic idioms renders the application of many psychological diagnoses inaccurate at best. At worst, such attempts at diagnoses lead to a

“category fallacy,” a term was developed by Arthur Kleinman, to describe the “reification of one culture’s diagnostic categories and their projection onto patients in another culture, where those categories lack coherence and their validity has not been established.”571 Such category fallacies can exist across fields of specialization. To quote from an example provided by George L.

Engel, while conditions such as diabetes, caused by a malfunctioning of the pancreas, can be confirmed “by laboratory documentation…how these are experienced and how they are reported by any one individual, and how they affect him, all require consideration of psychological, social, and cultural factors, not to mention other concurrent or complicating biological factors.”572 In the case of physical symptoms brought on my psychological reactions, such as grief, the vast cultural divide in determining “normal” behavior from “abnormal” can be too great to cross, particularly when the power dynamics between civilians and western military/medical authorities is so grossly overbalanced.

After several decades of war, violence, and disease, Arab countries in the Middle East have provided a site for medical professionals to conduct surveys of PTSD rates among civilian

571 Arthur Kleinman, Rethinking Psychiatry: From Cultural Category to Personal Experience (New York: The Free Press, 1988), 14-15. 572 George L. Engel, “The Need for a New Medical Model: A Challenge for Biomedicine,” Science, New Series, Vol. 196, No. 4286 (1977), 132 (129-136).

200 populations. A study conducted in Kuwait immediately after the 1991 Gulf War, for example, reported that more than 70% of Kuwaiti children surveyed exhibited moderate to severe

PTSD.573 Two studies conducted among children in Occupied Palestinian Territories reported acute PTSD rates between 33-34%.574 Yet, despite credible reporting and accurate diagnosis of

PTSD symptoms in these reports, as Abdelhamid Afana cautioned, “the fact that an Arab respondent in Western Sahara has endorsed the same symptom on a standard PTSD questionnaire as a U.S. respondent in West Los Angeles does not mean that they have the same experience, that they interpret it in the same way, or that the symptoms have the same diagnostic meaning.”575 This is because, first, the language used to describe anxious and depressive states vary widely from those used in western cultures and diagnostic criteria. For example, a study conducted among women in the Gaze Strip showed that local expressions used to describe various traumatic experiences and reactions to trauma carried a cultural weight and social importance that “communicate to others within the community about the dimensions of suffering through language that references collective experience and that convey assumptions about the expected bounds of behavior, the likely course of distress, and outcome of clinical or social intervention.”576 As such, the real lived experience of these women’s trauma could not be judged adequately by the imposition of western standards. Judging the prevalence of PTSD may

573 K.O. Nader, R.S. Pynoos, L.A. Fairbanks, M Al-Ajeel, and A.Al-Asfour, “A preliminary study of PTSD and grief among the children of Kuwait following the Gulf crisis,” British Journal of Clinical Psychology, Vol. 32(4):1993: 407-416.

574 V. Khamis, “Post-traumatic stress disorder among school age Palestinian children,” Child Abuse and Neglect, Vol. 29:1(2005):81-95; S. Qouta, J. Odeh, “The impact of conflict on children: the Palestinian experience” The Journal of ambulatory care management, Vol. 28(1): 2005: 75-79. 575 Afana, 29. 576 Abdel-Hamid Afana, Duncan Pedersen, et al., “Endurance Is to Be Shown at the First Blow: Social Representations and Reactions. To Traumatic Experiences in the Gaza Strip,” Traumatology, Vol. 16(4), 2010, 82 (73-84).

201 convey a specific type of suffering, but cannot convey the lived experience of trauma, or offer an insight into the potential for healing available to the sufferers.

Moreover, the medicalization of trauma through the PTSD diagnosis also divorces the experience of trauma from its political significance and socio-cultural reality. As Afana notes,

“events that would be widely perceived as traumatic in countries where there is little violence or oppression may not be perceived as extremely distressing in society living with daily conflict and political violence.”577 Medicalization also tends to diminish the need for humanitarian or political intervention, by making people’s suffering the responsibility of western doctors. In such cases, doctors end up replicating and reinforcing modern imperial domination over civilians by classifying their suffering and declaring authority over their treatment and potential recovery.

As Alfana asserts, “Trauma and traumatic events encompass much wider experiences than the medically constructed label of PTSD.”578 In order to adequately address the suffering of non- western peoples, particularly those in areas of extreme and ongoing violence, it is vitally important to forego the reliance on the diagnostic criteria of PTSD and begin applying a more personally and culturally responsive understanding.

A second example of the current shortcoming evident in the reliance on the PTSD diagnosis can be seen in the experience of women in the US military. As of August 2018, approximately five years after then-Defense Secretary Leon Panetta permitted women to serve in combat jobs, nearly 800 women were serving in the United States infantry, cavalry, and fire support, across five divisions.579 As a result, the issue of PTSD diagnoses among female veterans has become an issue within the Department of Veterans Affairs, who insists that women

577 Afana, 30 578 Afana, 32 579 Lolita C. Baldor, “Mattis: Jury is out on women succeeding in combat jobs,” Military Times, https://www.militarytimes.com/news/your-military/2018/09/25/mattis-jury-is-out-on-women-succeeding-in-combat- jobs/, accessed February 16, 2019.

202 have only begun to suffer from PTSD because they are now filling roles once held exclusively by men. A website for nurses with patients diagnosed with PTSD explains that in “the 1700s, women took on supportive roles such as cooks, nurses, laundresses, and seamstresses,” which is intended to explain why women did not suffer PTSD in the past.580 In the modern day, women are still repeatedly forced to navigate an institution and a legacy that recognizes the actions of men in order to have their service recognized. Obviously, such assumptions obscures the long history of women involved in the military in non-combat roles who suffered trauma, including

First World War nurses, as well as women veterans of the Vietnam conflict and Gulf Wars.581

However, the reliance on the PTSD diagnosis also helps to institutionalize sexual violence in the military, and obscure the culture that permits such crimes to proliferate.

According to the Department of Veterans Affairs, “About one in five women seen in VA report some form of military sexual trauma (MST)…Those who experience MST can develop

PTSD.”582 Endowing such personal, intimate and abhorrent violence with an acronym implies that the military has institutionalized such behavior; a suggestion that is corroborated by the fact that nearly 25% of women veterans who seek healthcare services from the VA report experiencing at least one sexual assault during their service.583 Only 1% of men report sexual

580 “Recognizing Women Veterans with PTSD: A Small But Growing Population,” https://www.elitecme.com/resource-center/nursing/recognizing-women-veterans-with-ptsd-a-small-but-growing- population/, accessed February 16, 2019. 581 Studies of veteran populations from these wars and conflicts show that women and men suffer long-term PTSD in equal numbers. See, for example, CR Marmar, W Schlenger, C Henn-Hasse, et al, “Course of posttraumatic stress disorder 40 years after the Vietnam war: findings from the National Vietnam Veterans Longitudinal Study,” JAMA Psychiatry 72(2015):875–881. 582 “Recognizing Women Veterans with PTSD: A Small But Growing Population,” https://www.elitecme.com/resource-center/nursing/recognizing-women-veterans-with-ptsd-a-small-but-growing- population/, accessed February 16, 2019. 583 Battered Women’s Project, “Military Sexual Assault,” https://www.bwjp.org/our-work/topics/military-sexual- assult.html, accessed February 16, 2019. To be clear, the Department of Defense defines “sexual assault” as “intentional sexual contact characterized by the use of force, threats, intimidation, or abuse of authority or when the victim does not or cannot consent. As used in this Instruction, the term includes a broad category of sexual offenses consisting of the following specific UCMJ offenses: rape, sexual assault, aggravated sexual contact, abusive sexual contact, forcible sodomy (forced oral or anal sex), or attempts to commit these offenses,” quoted in Miriam

203 assault, though it is assumed that a lack of reporting obscures reality.584 Rather than tackling the prevalence of sexual crimes in the military, or the real experience of trauma that results from it, the military has recently revised its pension system in order to ensure that veterans suffering

PTSD as a result of MST are compensated fairly.585 As such, PTSD remains “another

(re)presentation of trauma in a continuing cultural and medical project that aims to bring trauma’s numerous social and health effects under a neatly encapsulated umbrella” that can be neatly processed, without affecting the status quo of the environment that caused the trauma.586

According to the VA, there is no compensation available for MST by itself; veterans must demonstrate that they are suffering from “conditions that result from MST.”587 In this context, as well, the medicalization of rape and sexual assault prevents a discussion about the culture that permits such acts, and, often, the prosecution of offenders. According to Linda C. Watts, CEO of the Service Women’s Action Network, 58% of those who report a sexual assault also report being retaliated against, and only 4% of cases result in conviction.588 Moreover, forcing victims of sexual assault to submit to an analysis for PTSD ensures they remain within the institution that

Matthews et al. “Needs of Male Sexual Assault Victims in the U.S. Armed Forces,” Rand Health Quarterly, Vol. 8(2), 7(2018). 584 Battered Women’s Project, “Military Sexual Assault,” https://www.bwjp.org/our-work/topics/military-sexual- assult.html, accessed February 16, 2019. 585 Kayla Williams, “Changes to MST-related PTSD claims processing means more help for Veterans,” June 26, 2017: https://www.blogs.va.gov/VAntage/38999/changes-to-mst-related-ptsd-claims-processing-means-more-help- for-veterans/, accessed February 16, 2019. 586 Adam Montgomery, The Invisible Injured: Psychological Trauma in the Canadian Military from the First World War to Afghanistan (Montreal: McGill-Queen’s University Press, 2017), 16. 587 U.S. Department of Veterans Affairs,“Military Sexual Trauma: Disability Compensation for Conditions Related to Military Sexual Trauma (MST)”, https://www.benefits.va.gov/BENEFITS/factsheets/serviceconnected/MST.pdf, accessed February 16, 2019. 588 Zachary Cohen, “From fellow soldiers to ‘monster’ in uniform: #MeToo in the military,” CNN, February 7, 2018: https://www.cnn.com/2018/02/07/politics/us-military-sexual-assault-investigations/index.html, accessed February 16, 2019.

204 enabled their attack. Those who refuse find themselves denied access to veterans’ benefits and care.589

Additionally, deeply-embedded gender assumptions regarding combatants and trauma can also be seen in the way PTSD is discussed in the press. On February 7, 2019, The

Washington Post reported on a rising trend of veterans taking their own lives on campuses and in the parking lots of VA facilities, and that some were concerned that such a trend was a form of protest on the part of those veterans to highlight how little, or what inadequate care, they were receiving within the VA system.590 The article described the suicides of men in several states, assumed to be due to a lack of, or poor treatment for their PTSD symptoms. The article was just one of many that covered the lack of adequate services available for veterans. However, the report in The Washington Post, was just one of many that overlooked the disproportionate level of suffering among women. According to a VA report, the suicide rate among female veterans between 200-2014 increased by 62.4%, compared to 29.7% for men.591 While the loss of one life can never be judged more important than any other, the failure to address the unique experiences of women veterans and the psychological effects of their service, in the military and in the press, contributes to an environment of silence that threatens to permit these suicide rates to rise.

589 Jim Absher, “Female Veterans Are Fastest Growing Segment of Homeless Veteran Population,” Military.com, March 28, 2018, https://www.military.com/militaryadvantage/2018/03/28/female-veterans-are-fastest-growing- segment-homeless-veterans.html, accessed February 17, 2019. 590 Emily Wax-Thibodeaux, “Parking Lot Suicides,” The Washington Post, February 7, 2019: https://www.washingtonpost.com/news/national/wp/2019/02/07/feature/the-parking-lot- suicides/?utm_term=.8ab812472df6, accessed February 16, 2019. 591 Paula Broadwell and Kate Hendricks Thomas, “Don’t abandon our female veterans to staggering risk of suicide,” The Hill, September 27, 2017, https://thehill.com/opinion/healthcare/352728-dont-abandon-americas-female- veterans-to-staggering-risk-of-suicide, accessed February 17, 2019. It should also be acknowledged the role that MST, and the failure to adequately address women’s experience plays in suicide rates.

205 The failure to address the experiences and suffering of women in the military today is directly related to my experiences at the centenary of the Somme—the idea of war remains so firmly gendered as a masculine activity that women remain in the shadows. Their history is an afterthought, and their experiences of trauma are treated as an aberrance that needs to be reconciled with the PTSD diagnosis, rather than encouraging a retooling of the diagnosis to reflect a diverse array of lived experiences.592 Moreover, women themselves are further stigmatized by social and medical histories that continue to deny their experiences and punish their emotional expressions. As Leigh Gilmore observed, autobiography in any form gains its legitimacy by conforming to dominant cultural assumptions; when “that narrative conforms to dominant cultural notions of legitimacy, the ‘I’ who narrates it will accrue authority…but telling a dissonant story, one that challenges tolerances around who may appear in public, will place marginalized subjects at greater risk of being doubted.”593 Women whose experiences challenge the dominant understand of war and trauma, including the historical diagnosis of ‘shell shock’ and the current one known as ‘post-traumatic stress disorder,’ often find themselves facing institutional and personal doubt. This is especially true when the voices who tell dissonant stories speak up at times of social precarity, such as war or military conflict. The stories of dissonance and challenge call into question the ability of the state to protect its subject, and of its dominant narratives of power and order to explain and contain the bodily health of its citizenry.594

592 For an example of women’s experiences being treated as unique, see Keren Lehavot, Simon Goldberg, et al., “Do trauma type, stressful life events, and social support explain women veterans’ high prevalence of PTSD?” Social Psychiatry and Psychiatric Epidemiology, Vol 53(9): 2018, 943-953. 593 Leigh Gilmore, Tainted Witness: Why We Doubt What Women Say About Their Lives (New York: Columbia University Press, 2017), 9 594 Mike Aaltola, Introduction to Understanding the Politics of Pandemic Scares: An Introduction to Global Politosomatics (New York: Routledge, 2012), 9, 18

206 This work is an attempt to reclaim the voices of women whose testimony challenged the dominant diagnosis of trauma, as well as the violence in the world around them. Their testimony was discounted during their lives, and their experiences have gone generally overlooked by history, not only because of the medicalization of trauma, but because they were considered inherently weaker and unstable. In so doing, I hope I have managed to critique the medicalization of trauma and the stigma surrounding women’s testimony of suffering. There is a long way to go before these stigmas are vanquished, but in calling out these systems of silence and disbelief, such works as mine can begin to weaken them. In so doing, it will be possible to tell more inclusive, more diverse, and more representative stories that more adequately reflect historical and emotional reality, the harm that war does to all who experience it, and the ways that people, friends, and communities devise in order to endure and survive the violence, oppression, and disbelief.

207

Bibliography

Primary Sources

Archives Consulted Bureau of Military History, Defense Forces Ireland Imperial War Museum London Metropolitan Archives London School of Economics Women’s Library National Archives, Kew National Archives of Ireland Public Records Office of Northern Ireland Royal London Hospital Archives Wellcome Library and Archives

Newspapers ABC News Aberdeen Press and Journal Ballymeana Observer Belfast Newsletter Belfast Telegraph Cable News Network (CNN) Daily Herald Daily Mirror Dover Express Evening Standard Lincolnshire Echo Linlithgowshire Gazette Military Times Morning Post National Public Radio (NPR) Nottingham Journal Sheffield Independent Sunday Post Sunday Times Telegraph The Cut The Globe The Guardian The Hill The Independent The New York Times The New Yorker The Stage

208 The Washington Post USA Today Western Times Yorkshire Evening Post

Government Publications

Census Returns of England and Wales, 1911 Hansard Parliamentary Debates.

Secondary Sources

Online Sources Because We Are Here Project Website Battered Women’s Project Commonwealth War Graves Commission Website Elite Learning Website Lady Science US Military Blog Nursing Clio blog Red Cross Archives Website US Veterans Associated Website

Conference Papers Whitmore, Lucie. “Boudoir Caps & Zeppelin Nighties: How fashionable women dressed for air raids in the First World War,” Twitter feed: https://twitter.com/LucieWhitmore/status/951771143194796032.

Unpublished Doctoral Dissertation Link, Mandy. Specters of empire: Remembrance of the Great War in the Irish Free State, 1914- 1937. Unpublished doctoral dissertation, Pullman: Washington State University, 2015.

Poynter, Denise J. The Report on her Transfer was Shell Shock', A Study of the Psychological Disorders of Nurses and Female Voluntary Aid Detachments who served alongside the British and Allied Expeditionary Forces during the First World War, 1914–1918. Unpublished doctoral dissertation, Northampton: University of Northampton, 2008

Rawls, Kathleen. Power Plays: The politics of creating a British nursing profession, 1888-1919. Unpublished doctoral dissertation, Irvine: University of California, Irvine, 2002.

Journal Articles

209 “The Asylum Service of the London County Council.” British Medical Journal, 2203, No. 1 (1903): 682.

“Beri-Beri at Richmond Lunatic Asylum.” British Medical Journal, 2, No. 1909 (31 July 1897): 292.

“Carrel-Dakin treatment of wounds.” British Medical Journal, 2 no. 2966 (1917): 597-9 “Dysentery in Ireland.” Medical and Surgical Reporter, 58, no, 13 (March 31, 1888): 408.

“Epidemic in a Dublin Lunatic Asylum.” British Medical Journal, 2, no. 1762 (October 6, 1894): 767.

“Lunacy in London.” British Medical Journal, 2, No. 2393 (1906): 1311.

“Richmond District Asylum, Dublin—Report of the medical superintendent for the year 1862.” The British Journal of Psychiatry, 9, No. 45 (April 1, 1863): 115.

Afana, Abdel-Hamid. “Problems in Applying Diagnostic Concepts of PTSD and Trauma in the Middle East.” The Arab Journal of Psychiatry, 23, No. 1 (2012): 28-34, supplement pages.

Afana, Abdel-Hamid, Duncan Pedersen, et al. “Endurance Is to Be Shown at the First Blow: Social Representations and Reactions. To Traumatic Experiences in the Gaza Strip.” Traumatology, 16, No. 4 (2010): 73-84.

Bailey, Moya. “The Flexner Report: Standardizing Medical Students Through Region-, Gender-, and Race-Based Hierarchies.” American Journal of Law & Medicine, 43, no. 1 (2017): 209-223.

Carden-Coyne, Ana. “Masculinity and the Wounds of the First World War: A Centenary Reflection”, Revue Française de Civilisation Britannique, 20, No. 1 (2015). DOI : 10.4000/rfcb.305.

Chaimba, Josephine and Brian W. Bride. “Trauma Experiences and Posttraumatic Stress Disorder Among Women in the United States Military.” Social Work in Mental Health, 8, No. 3 (2010): 280-303.

Collins, A. “The Richmond District Asylum and the 1916 Easter Rising.” Irish Journal of Psychological Medicine, 30, No. 1 (September 2013): 279-283.

Crespo, Maria and Violeta Fernandez-Lansac. “Memory and Narrative of Traumatic Events: A Literature Review.” Psychological Trauma Theory Research Practice and Policy 8, No. 2 (2016): 149-156.

Dawson, W.R. “The Work of the Belfast War Hospital (1917-1919).” British Journal of Psychiatry 71, no. 1 (1925): 219-224.

210 Delap, Lucy Louise Ryan, and Teresa Zackodnik. “Self-determination, race, and empire: Feminist nationalists in Britain, Ireland and the United States, 1830 to World War One.” Women’s Studies International Forum, 29, No. 3 (2006): 241-254.

Eide, Marian. “Maeve’s Legacy: Constance Markievicz, Eva Gore-Booth and the Easter Rising.” Eire-Ireland, 51, No. 3 (2016): 80-103.

Engel, George L. “The Need for a New Medical Model: A Challenge for Biomedicine.” Science, New Series, 196, No. 4286 (1977): 129-136.

Friedman, Emily. “Troubled Past of ‘Invisible’ Profession”, JAMA, 264, No. 22 (1990): 2851- 2858.

Grayzel, Susan R. “‘The Souls of Soldiers’: Civilians under Fire in First World War France.” The Journal of Modern History, 78, No. 3 (2006): 588-622.

Gullace, Nicoletta F. “Sexual Violence and Family Honor: British Propaganda and International Law during the First World War.” American Historical Review, 102, No. 3 (June 1997): 714- 747.

Hallett, Christine E. “Portrayals of Suffering: Perceptions of Trauma in the Writings of First World War Nurses and Volunteers.” Canadian Bulletin of Medical History, 27, No. 1 (2010): 65- 84.

Higonnet, Margaret R. “Authenticity and Art in Trauma Narratives of World War I”, Modernism/modernity, 9, No. 1 (2002): 91-107.

Hurst, A.F. and J.L.M Symns. “The Rapid Cure of Hysterical Symptoms in Soldiers.” The Lancet, 192. No. 4953 (1918): 139-141.

Jackson, Richard. “Unknown Knowns: The Subjugated Knowledge of Terrorism Studies.” Critical Studies on Terrorism, 5, No. 1 (2012): 11-29.

Jalland, Pat. “Death and bereavement in the First World War: the Australian Experience”, Endeavour, 38, No. 2 (2014): 70-76.

Jones, Edgar, Ian Palmer, and Simon Wessely. “War pensions (1900-1945): changing models of psychological understanding.” British Journal of Psychiatry, 180 no. 1 (2002): 374-379.

Keown, Bridget E. “‘I think I was more pleased to see her than any one ‘cos she’s so fine’: Nurses’ Friendships, Trauma, and Resiliency During the First World War,” Family and Community History, 21, No. 3 (2019): 151-165.

Khamis, V. “Post-traumatic stress disorder among school age Palestinian children.” Child Abuse and Neglect, 29, No. 1(2005):81-95.

211 Lammasniemi, Laura. “Regulation 40D: punishing promiscuity on the home front during the First World War”, Women’s History Review 26, No. 4 (2016): 584-596.

Lawrence, Jon. “Forging a Peaceable Kingdom: War, Violence, and Fear of Brutalization in Post-First World War Britain.” The Journal of Modern History, 75, No. 3 (2003): 557-589.

Lee, Janet. “Sisterhood at the Front: Friendship, comradeship, and the feminine appropriation of military heroism among World War I First Aid Nursing Yeomanry (FANY).” Women’s Studies International Forum 31, No. 1 (2008): 16-29.

Leese, Peter. “Problems Returning Home: The British Psychological Casualties of the Great War.” The Historical Journal, 40, no. 4 (1997): 1055-1067. • “Shocked and Forgotten.” History Workshop Journal, 63, no. 1 (2007): 328-335.

Lehavot, Keren, Simon Goldberg, et al. “Do trauma type, stressful life events, and social support explain women veterans’ high prevalence of PTSD?” Social Psychiatry and Psychiatric Epidemiology, 53, No. 9 (2018): 943-953.

Lindemann, Erich. “Symptomatology and Management of Acute Grief.” American Journal of Psychiatry, 101, No. 1 (1944): 141-148.

Loughran, Tracey. “A Crisis of Masculinity Re-Writing the History of Shell-shock and Gender in First World War Britain.” History Compass, 11, no. 9 (2013): 727-738.

Marmar, C.R., W Schlenger, C Henn-Hasse, et al. “Course of posttraumatic stress disorder 40 years after the Vietnam war: findings from the National Vietnam Veterans Longitudinal Study,” JAMA Psychiatry, 72, No. 9 (2015):875–881.

Matthews, Miriam. et al. “Needs of Male Sexual Assault Victims in the U.S. Armed Forces.” Rand Health Quarterly, 8, No. 2 (2018): 7.

Meyer, Jessica. “‘Not Septimus Now’: wives of disabled veterans and cultural memory of the First World War in Britain.” Women’s History Review, 13, No. 1(2004): 117-138. • “Separating the Men from the Boys: Masculinity and Maturity in Understandings of Shell Shock in Britain,” 20th Century British History, 20, No. 1 (2009): 1-22.

Myers, Charles Samuel. “A Contribution to the Study of Shell Shock.” The Lancet, 185, No. 4772 (1915), 316–20.

Nader, K.O., R.S. Pynoos, L.A. Fairbanks, M Al-Ajeel, and A.Al-Asfour. “A preliminary study of PTSD and grief among the children of Kuwait following the Gulf crisis.” British Journal of Clinical Psychology, 32, No. 4 (1993): 407-416.

Nelson, Elizabeth. “Victims of War: The First World War, Returned Soldiers, and Understanding of Domestic Violence in Australia.” Journal of Women’s History, 19, No. 4 (2007): 83-106.

212 Nic Dháibhéid, Caoimhe. “The Irish National Aid Association and the Radicalization of Public Opinion in Ireland, 1916-1918.” The Historic Journal, 55, No. 3 (2012): 705-729.

Norman, Conolly. “Presidential Address, delivered at the Royal College of Physicians, Dublin, June 12th, 1894.” The Journal of Mental Science, 40, No. 171 (October 1894): 487-499

Pearce, LMS. “Silas Weir Mitchell and the ‘rest cure.’” Journal of Neurology, Neurosurgery and Psychiatry, 75, No. 3, 2004: 381.

Pedersen, Susan. “Gender, Welfare, and Citizenship in Britain during the Great War.” American Historical Review 95, no. 4 (1990): 983-1006.

Phillips, Laura L. “Gendered Dis/ability: Perspectives from the Treatment of Psychiatric Casualties in Russia’s Early Twentieth Century Wars.” Social History of Medicine, 20, No. 2 (2007): 333-350.

Qouta, S. and J. Odeh, “The impact of conflict on children: the Palestinian experience” The Journal of ambulatory care management, 28, No. 1 (2005): 75-79.

Redmond, Jennifer. “War Within and War Without: Irish women in the First World War era.” Women’s History Review, 18, No. 1 (2017): 1-14.

Redmond, Jennifer & Elaine Farrell. “War Within and Without: Irish women in the First World War era.” Women’s History Review, 27, No. 3 (2017): 329-342.

Ryan, Barry. “‘I’m sick of my own country’: ethics and aesthetics in James Joyce’s ‘The Dead.’” Nordic Journal of English Studies, 11, No. 2 (2012): 166-188.

Smith, Susan Bennett. “Reinventing Grief Work: Virginia Woolf’s Feminist Representations of Mourning in Mrs. Dalloway and To the Lighthouse.” Twentieth Century Literature, 41, No. 4 (1995): 310-327.

Tarlow, Sarah. “An Archeology of Remembering: death, bereavement and the First World War.” Cambridge Archeological Journal, 7, No. 1 (1997): 105-121.

Watson, Janet S.K. “Khaki Girls, VADs, and Tommy’s Sisters: Gender and Class in First World War Britain”, The International History Review, 19, No. 1 (1997): 32-51.

Weihman, Lisa. “Doing My Bit for Ireland: Transgressing Gender in the Easter Rising.”, Eire- Ireland, 39, No. 3-4 (2004): 228-249.

Whelan, Feargal. “All hats and moustaches: Commemorating and performing 1916 in 2016.” Estudios Irlandeses—Journal of Irish Studies, 12, No. 11(2017): 140-150.

Whitmore, Lucie. “‘A Matter of Individual Opinion and Feeling’: The changing culture of mourning dress in the First World War.” Women’s History Review, 27, No. 4 (2018): 579-594.

213

Winter, Jay. “Shell-Shock and the Cultural History of the Great War.” Journal of Contemporary History, 35, No. 1 (2000): 7-11.

Wright, A.E. “Note on the Results Obtained by Typhoid Inoculation in the Case of an Epidemic of Typhoid Fever Which Occurred in the Richmond Asylum, Dublin.” The British Medical Journal, 2, No. 2130 (26 October 1901): 1226-1228.

Books: Aaltola, Mike. Understanding the Politics of Pandemic Scares: An Introduction to Global Politosomatics. New York: Routledge, 2012.

Abel-Smith, Brian. A History of the Nursing Profession. London: William Heinemann, 1960.

Ahmed, Sara. The Promise of Happiness. Durham: Duke University Press, 2010.

Allen, Keiran. 1916: Ireland’s Revolutionary Tradition. London: Pluto Press, 2016.

Audion-Rouzeau, Stéphane and Annette Becker, 14-18: Understanding the Great War, trans. Catherine Temerson. New York: Hill and Wang, 2002.

Bagnold, Enid. A Diary Without Dates. London: Virago, 1978.

Bain, Paul G., Jeroen Vaes, and Jacques-Philippe Leyens, eds. Humanness and Dehumanization. New York: Psychology Press, 2014.

Barham, Peter. Forgotten Lunatics of the Great War. New Haven: Yale University Press, 2004.

Betts, Amanda, ed. In Flanders Fields: 100 Years: Writing on War, Loss, and Remembrance. Toronto: Alfred A. Knopf, 2015.

Bonikowski, Wyatt. Shell shock and the Modernist Imagination: The Death Drive in Post-World War I British Fiction. London: Ashgate, 2003.

Bordo, Susan. Unbearable Weight: Feminism, Western Culture, and the Body. Berkeley: University of California Press, 2008.

Bourke, Joanna. An Intimate History of Killing: Face-to-Face Killing in Twentieth Century Warfare. London, Granta Press, 1999.

Braybon, Gail. Women Workers in the First World War. The British Experience. New York: Routledge, 2014.

Braybon, Gail, ed. Evidence, History and the Great War: Historians and the Impact of 1914-18. New York: Berghahn Books, 2005.

214

Brod, Harry, ed. The Making of Masculinities: The New Men’s Studies. Boston: Unwin Hyman, 1987.

Brooks, Jane and Christine E. Hallett, eds. One Hundred Years of Wartime Nursing Practices, 1854-1953. Manchester: Manchester University Press, 2015.

Burke, Helen. The People and the Poor Law in Nineteenth Century Ireland. West Sussex: The Women’s Education Bureau, 1987.

Bury, Robin. Buried Lives: The Protestants of Southern Ireland. Dublin: The History Press Ireland, 2017.

Carden-Coyne, Ana, ed. Gender and Conflict Since 1914: Historical and Interdisciplinary Perspectives. New York: Palgrave, 2012.

Caruth, Cathy. Unclaimed Experience: Trauma, Narrative, and History. Baltimore: Johns Hopkins University Press, 2016.

Cohen, Deborah. The War Come Home: Disabled Veterans in Britain and Germany, 1914-1939. Berkeley: University of California, 2001.

Constantine, Stephen, ed. Emigrants and Empire: British Settlement in the Dominions Between the Wars. Manchester: Manchester University Press, 1990.

Cooter, Roger and Steve Sturdy, eds. War, Medicine and Modernity. Stroud: Sutton Publishing, 1998.

Cox, Catherine and Maria Luddy, eds. Cultures of Care in Irish Medical History. New York: Palgrave Macmillan, 2010.

Crawford, Elizabeth. The Women’s Suffrage Movement: A Reference Guide, 1866-1928. Psychology Press, 2001.

Crouthamel, Jason. An Intimate History of the Front: Masculinity, Sexuality, and German Soldiers in the First World War. New York: Palgrave Macmillan, 2014.

Crouthamel, Jason and Peter Leese, eds. Languages of Trauma. Toronto: University of Toronto Press, 2019.

Das, Santanu. Touch and Intimacy in First World War Literature. Cambridge: Cambridge University Press, 2007.

Davis, Belinda. Home Fires Burning: Food, Politics, and Everyday Life in World War I Berlin. Durham: University of North Carolina Press, 2000.

215 Dawson, Graham. Making peace with the past?: Memory, trauma, and the Irish Troubles. Manchester: Manchester University Press, 2007.

Dingwall, Robert, Anne Marie Rafferty, and Charles Webster. An Introduction to the Social History of Nursing. New York: Routledge, 2002.

Dodman, Trevor. Shell Shock, Memory, and the Novel in the Wake of World War I. Cambridge: Cambridge University Press, 2015.

Dombrowski, Nicole Ann, ed. Women and War in the Twentieth Century: Enlisted With or Without Consent. New York: Garland Publishing, 1999.

Downs, Laura Lee. Manufacturing Inequality: Gender Division in the French and British Metalworking Industries, 1914-1939. Ithaca: Cornell University Press, 1995.

Duffy, Joe. Children of the Rising: The untold story of the young lives lost during Easter 1916. Dublin: Hatchette Ireland, 2015.

Durnin David and Ian Miller, eds., Medicine, Health and Irish Experiences of Conflict 1914-45. Manchester: Manchester University Press, 2017.

Ellwood, Jane, ed. Psychosis: Understanding and Treatment. London: Jessica Kingsley Publishers, 1995.

Evans, Suzanne. Mothers of Heroes, Mothers of Martyrs: World War I and the Politics of Grief. Montreal: McGill-Queen’s University Press, 2007.

Farquharson Danine and Sean Farrell, eds. Shadows of the Gunmen: Violence and Culture in Modern Ireland. Cork: Cork University Press, 2008.

Fealy, Gerard M. A History of Apprenticeship Nurse Training in Ireland. New York: Routledge, 2006.

Fell, Alison. Women as Veterans in Britain and France After the First World War. Cambridge: Cambridge University Press, 2018.

Fell, Alison S. & Christine E. Hallett. First World War Nursing: New Perspectives. New York: Routledge, 2013.

Fenton, Norman. Shell Shock and Its Aftermath. London: Henry Kimpton, 1926.

Ferriter, Diarmid & Susannah Riordan, eds. Years of Turbulence: The Irish Revolution and Its Aftermath. Dublin: University College Dublin Press, 2015.

Finnane, Mark. Insanity and the Insane in Post-Famine Ireland. London: Croom Hill, Ltd., 1981.

216 Fischer, Clara and Mary McAuliffe, eds. Irish Feminisms: Past, Present and Future. Dublin: Arlen House, 2015.

Fletcher, Anthony. Life, Death, and Growing Up on the Western Front. New Haven: Yale University Press, 2013.

Fussell, Paul. The Great War and Modern Memory. Oxford: Oxford University Press, 2000.

Geroulanos, Stefanos and Todd Meyers. The Human Body in the Age of Catastrophe: Brittleness, Integration, Science, and the Great War. Chicago: The University of Chicago Press, 2018.

Gilbert, Sandra M. & Susan Gubar, No Man’s Land: The Place of the Woman Writer in the Twentieth Century, Volume 2: Sexchanges. New Haven: Yale University Press, 1989.

Gilman, Sander L. Illness and Image: Case Studies in the Medical Humanities. New Brunswick: Transaction Publishers, 2015.

Gilmore, Leigh. Tainted Witness: Why We Doubt What Women Say About Their Lives. New York: Columbia University Press, 2017.

Glassford, Sarah & Amy Shaw, eds. A Sisterhood of Suffering: Women and Girls of Canada and Newfoundland during the First World War. Vancouver: University of British Columbia Press, 2012.

Gorer, Geofrey. Death, Grief & Mourning in Contemporary Britain. London: The Cresset Press, 1965.

Grant, Peter. Philanthropy and Voluntary Action in the First World War: Mobilizing Charity. New York: Routledge, 2014.

Grayson, Richard S. and Fearghal McGarry, eds. Remembering 1916: The Easter Rising, the Somme and the Politics of Memory in Ireland. Cambridge: Cambridge University Press, 2016.

Gregory, Adrian and Senia Pašeta, ed. Ireland and the Great War: ‘a war to unite us all’?. Manchester: Manchester University Press, 2002.

Grayzel, Susan. At Home and Under Fire: Air Raids and Culture in Britain from the Great War to the Blitz. Cambridge: Cambridge University Press, 2012. • Women and the First World War. New York: Routledge, 2002. • Women’s Identities at War: Gender, Motherhood, and Politics in Britain and France During the First World War. Chapel Hill: University of North Carolina Press, 1990.

Great Britain, and Anthony Richards. Report of the War Office Committee of Enquiry into "Shell-shock" (cmd. 1734): featuring a new historical essay on shell shock. London: Imperial War Museum, 2004.

217 Grogan, Suzie. Shell Shocked Britain The First World War’s Legacy for Britain’s Mental Health. Barnsley: Pen and Sword, 2014.

Gullace, Nicoletta F. ‘The Blood of Our Sons’: Men, Women, and the Renegotiation of British Citizenship During the Great War. New York: Palgrave Macmillan, 2002.

Hallett, Christine. Containing Trauma: Nursing Work in the First World War. Manchester: Manchester University Press, 2010. • Veiled Warriors: Allied Nurses of the First World War. Oxford: Oxford University Press, 2014.

Halliday, Sir Andrew. A General View of the Present State of Lunatics, and Lunatic Asylums, in Great Britain and Ireland, and in Some Other Kingdoms. London: Thomas and George Underwood, 1828.

Hanson, Neil. First Blitz: The Secret Plan to Raze London to the Ground in 1918. London: Doubleday, 2008.

Harms, Louise. Understanding Trauma and Resiliency. New York: Palgrave Macmillan, 2015.

Harpin, Anna. Madness Art and Society: Beyond Illness. New York: Routledge, 2018.

Herman, Judith Lewis. Trauma and Recovery: From Domestic Abuse to Political Terror. London: Pandora, 2001.

Higonnet, Margaret R. ed. Nurses at the Front: Writing the Wounds of the Great War. Boston: Northeastern University Press 2001.

Hodgkinson, Peter.‘Glum Heroes’: Hardship, Fear and Death—Resilience and Coping in the War British Army on the Western Front 1914-1918. Solihull: Helion & Company Limited, 2016.

Horne, John and Edward Madigan, eds. Towards Commemoration: Ireland in War and Revolution 1912-1923. Dublin: Royal Irish Academy, 2014.

Hunt, Nigel C. Memory, War and Trauma. Cambridge: Cambridge University Press, 2010.

Hyde, Andrew. The First Blitz: The German Bomber Campaign Against Britain in the First World War. Barnsley: Pen and Sword, 2014.

Hynes, Samuel. A War Imagined: The First World War and English Culture. New York: Athenaeum, 1991.

Jeffery, Keith. 1916: A Global History. London: Bloomsbury, 2016. • Ireland and the Great War. Cambridge: Cambridge University Press, 2000.

218 Jones, Edgar & Simon Wessely.Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War. New York: Psychology Press, 2005.

Jones, Francis P. History of the Sinn Fein Movement and the Irish Rebellion of 1916. New York: P.J. Kennedy and Sons, 1917.

Jones, Lynne. Outside the Asylum: A Memoir of War, Disaster and Humanitarian Psychiatry. London: Weidenfeld & Nicolson, 2017.

Kelly, Brendan. Hearing Voices: The History of Psychiatry in Ireland. Dublin: Irish Academic Press, 2016. • ‘He Lost Himself Completely’: Shell Shock and Its Treatment at Dublin’s Richmond War Hospital, 1916-1919. Dublin: The Liffey Press, 2014.

Kent, Susan Kingsley. Making Peace:The Reconstruction of Gender in Interwar Britain. Princeton: Princeton University Press, 1993.

Kleinman, Arthur. Rethinking Psychiatry: From Cultural Category to Personal Experience. New York: The Free Press, 1988.

Knowles, Thomas and Serena Trowbridge, eds. Insanity and the Lunatic Asylum in the Nineteenth Century. London: Pickering & Chatto, 2015.

Koerber, Amy. From Hysteria to Hormones: A Rhetorical History. Philadelphia: The Pennsylvania State University Press, 2018.

Kuhlman, E. Reconstructing Patriarchy after the Great War: Women, Gender, and Postwar Reconciliation between Nations. New York: Palgrave Macmillan, 2008.

Lanzoni, Susan. Empathy: A History. New Haven: Yale University Press 2018.

Leader, Darian. What Is Madness?. New York: Penguin Press, 2012.

Lee, Janet. War Girls: The First Aid Nursing Yeomanry in the First World War. Manchester University Press, 2005.

Leed, Eric. No Man’s Land: Combat and Identity in World War I. Cambridge: Cambridge University Press, 1979.

Leese, Peter. Shell Shock: Traumatic Neurosis and the British Soldiers of the First World War. New York: Palgrave MacMillan, 2014.

Lerner, Paul. Hysterical Men: War, Psychiatry, and the Politics of Trauma in Germany, 1890- 1930. Ithaca: Cornell University Press, 2003.

219 Loughran, Tracey. Shell-Shock and Medical Culture in First World War Britain. Cambridge: Cambridge University Press, 2017.

Macdonald, Lyn. The Roses of No Man’s Land. New York: Penguin Books, 1993.

Matthews, Ann. Renegades: Irish Republican Women 1900-1922. Dublin: Mercier Press, 2010.

McBride Ian, ed. History and Memory in Modern Ireland. Cambridge: Cambridge University Press, 2001.

McDiarmid, Lucy. At Home in the Revolution: What Women Said and Did in 1916. Dublin: Royal Irish Academy, 2015.

Melling, Joseph and Bill Forsythe. The Politics of Madness: The state, insanity and society in England, 1845-1914. London: Routledge, 2006.

Mendes, Valerie & Amy de la Hay. 20th Century Fashion. London: Thames & Hudson, 1999.

Meyer, Jessica. Men of War: Masculinity and the First World War in Britain. New York: Palgrave Macmillan, 2012.

Meyers, Charles S. Shell Shock in France, 1914-1918: Based on a War Diary. Cambridge: Cambridge University Press, 1940.

Micale, Mark S. Hysterical Men: The Hidden History of Male Nervous Illness. Harvard: Harvard University Press, 2008.

Milne, J.S. Neurasthenia, Shell-Shock, and A New Life. Newcastle-on-Tyne, R. Robinson & Co., Ltd., 1918.

Milne-Smith, A. London Clubland: A Cultural History of Gender and Class in Late Victorian Britain. New York: Palgrave Macmillan, 2011.

Montgomery, Adam. The Invisible Injured: Psychological Trauma in the Canadian Military from the First World War to Afghanistan. Montreal: McGill-Queen’s University Press, 2017.

Mott, Frederick W. War Neurosis and Shell Shock. London: Hodder & Stoughton, 1919.

Nicholson, Virginia. Singled Out; How Two Million Women Survived Without Men after the First World War. London: Viking Press, 2007.

O’Donnell, Ruán, ed. The Impact of the 1916 Rising: Among the Nations. Dublin: Irish Academic Press, 2008.

O’Toole, Tina, Gillian McIntosh, and Muireann O’Cinneide, eds. Women Writing War: Ireland 1880-1922. Dublin: University College Dublin Press, 2016.

220

Ouditt, Sharon. Fighting Forces, Writing Women: Identity and Ideology in the First World War. New York: Routledge, 1993.

Owen, David and Cristina Pividori, eds. Writings of Persuasion and Dissonance in the Great War: That Better Whiles May Follow Worse. Leiden: Brill, 2016.

Patry, Rose I. Daily Drill for the Voice: A book of exercises composed to help men whose speech has been affected by shell-shock, etc. London: W. Patching & Co., 1917.

Perez, Caroline Criado. Invisible Women: Data Bias in a World Designed for Men. New York: Abrams Press, 2019.

Powell, Anne. Women in the War Zone: Hospital Service in the First World War. Stroud: The History Press, 2013.

Prior, Pauline, ed. Asylums, Mental Health Care and the Irish 1800-2010. Dublin: Irish Academic Press, 2017.

Proctor, Tammy M. Civilians in a World at War, 1914-1918. New York: New York University Press, 2010.

Redmond, Jennifer, Sonja Tiernan, Sandra McAvoy, and Mary McAuliffe, eds. Sexual Politics in Modern Ireland. Dublin: Irish Academic Press, 2015.

Reid, Fiona. Broken Men: Shell Shock, Treatment and Recovery in Britain 1914-30. London: Continuum, 2010. • Medicine in First World War Europe: Soldiers, Medics, Pacifists. London: Bloomsbury Academic, 2017.

Reznick, Jeffrey S. Healing the Nation: Soldiers and the Culture of Caregiving in Britain During the First World War. Manchester: Manchester University Press, 2011.

Rivers, W.H.R., Instinct and the Unconscious: A Contribution to a Biological Theory of the Psycho-Neuroses. Cambridge: Cambridge University Press, 1920.

Roper, Michael. The Secret Battle: Emotional Survival in the Great War. Manchester: Manchester University Press, 2004.

Ryan, Louise and Margaret Ward, eds. Irish Women and Nationalism; Soldiers, New Women and Wicked Hags. Dublin: Irish Academic Press, 2004.

Scott, Joan Wallach. Only Paradoxes to Offer: French Feminists and the Rights of Man. Cambridge: Harvard University Press, 1997.

221 Shephard, Ben. A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century,. Cambridge: Harvard University Press, 2003.

Shields, Stephanie A. Speaking From the Heart: Gender and the social Meaning of Emotions. Cambridge: Cambridge University Press 2002.

Showalter, Elaine. The Female Malady: Women, Madness, and English Culture, 1830-1980. New York: Penguin Press, 1987.

Siebrecht, Claudia. The Aesthetics of Loss: German Women’s Art of the First World War. Oxford: Oxford University Press, 2013.

Smith, Angela K. ed. Women’s Writings of the First World War: An Anthology. Manchester: Manchester University Press, 2000.

Smith, Grafton Elliot and Thomas Hatherley Pear. Shell Shock and Its Lessons. Manchester: Manchester University Press, 1917

Smyth, Jim, ed. Remembering the Troubles: Contesting the Recent Past in Northern Ireland. Notre Dame: University of Notre Dame, 2017.

Sturken, Marita. Tangled Memories: The Vietnam War, the AIDS Epidemic, and the Politics of Remembering. Berkeley: University of California Press, 1997.

Summers, Anne. Angels and Citizens: British Women as Military Nurses 1854-1914. London: Routledge & Kegan Paul, 1988.

Sweet, Helen M. with Rona Dougall. Community Nursing and Primary Healthcare in Twentieth- Century Britain. New York: Routledge, 2008.

Swift, David and Oliver Wilkinson, eds. Veterans of the First World War: Ex-Servicemen and Ex-Servicewomen in Post-War Britain and Ireland. London: Routledge, 2019.

Taylor, Barbara. The Last Asylum: A Memoir of Madness in our Times. Chicago: University of Chicago Press, 2015.

Taylor, Lou. Mourning Dress. London: George Allen & Unwin, 1983.

Thacker, Toby. British Culture and the First World War: Experience, Representation and Memory. London: Bloomsbury Academic, 2014.

Thomas, Gregory M. Treating the Trauma of the Great War: Soldiers, Civilians, and Psychiatry in France, 1914-1940. Baton Rouge: Louisiana State University Press, 2009.

Tylee, Claire M. The Great War and Women’s Consciousness: Images of Militarism and Womanhood in Women’s Writing, 1914-64. Iowa City: University of Iowa Press, 1990.

222

Vuic, Kara Dixon. The Girls Next Door: Bringing the Home Front to the Front Lines. Cambridge: Harvard University Press, 2019.

Ward, Margaret. Unmanageable Revolutionaries: Woman and Irish Nationalism. London: Pluto Press, 1989.

Whaley, Joachim, ed. Mirrors of Mortality: Studies in the Social History of Death. New York: St. Martin’s Press, 1982.

White, Jerry. Zeppelin Nights: London in the First World War. London: Vintage Books, 2014.

Whitehouse, Arch. The Zeppelin Fighters. New York: Ace Books, 1966.

Winter, Jay. War Beyond Words: Languages of Remembrance from the Great War to the Present. Cambridge: Cambridge University Press, 2017.

223