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CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 2004 Nov 9;171(10):1225–1228. doi: 10.1503/cmaj.1041581

The salt of tears

Stephen Workman 1
PMCID: PMC524955

Some of the best memories I never had are of visiting my Great-Uncle Donald Ross at his home in Grafton, just a short drive from Kingston. We would pull up the tree-lined drive to the family farm, Katie still young and vital at 72, and me, her grandson, beside her. I remember my legs sticking to the textured vinyl seats of her '69 Volkswagen Beetle as we bounced up the potholed drive. Once we stopped I would jump out of the car, race up the steps and pound on the door. Then I would press my ear against it, listening. Sometimes I would hear Alice's soft footsteps. At other times I would hear a rhythmic thumping before the door opened. Once my Great-Uncle Donald let me hold his wooden leg and told me what happened to his real one.

Jan 22 16 Mr. Donald Ross Grafton Ontario

Dear Donald just a few lines to let you know that I think you did right in joining the army and if I had a son I should want him to do as you have. Now Donald you are going to two wars the one against the Germans you will look after I know but the other one is the hardest to win the battle of life. The two things that make a good man is to keep clear in mind and clean in body and the only way to do so is to keep a clear head don't let hooch fuddle your brain always remember first you are a Canadian and a Ross and if you want to you can come home an officer. I hope you will not be offended at this old cripple who knows what you will have to go through.

Well Donald Good Luck and God speed you all join in sending love and good wishes

I am as ever

Your Uncle Caleb Mallory 238 River Avenue Winnipeg Man

Dear Mother

Here I am writing a letter which I am going to try and get somebody at some of the stations we pass to mail to you.

We left Valcartier camp about ten A.M. The country is very wild along the railway you see nothing but woods and swamp between stations it is generally quite a distance between stations. It is about 9:30 P.M. now some of the boys are asleep and a couple of my old tent mates are bothering the life out of them. Everybody is putting on a lighthearted smile although we all feel we are leaving home for some time. But everyone is cheerful and happy including myself. Tell dad I received his letter. I did not get the one I expected from you but will likely get it in Halifax before I leave. Tell Dad I will write as soon as we land. It may be a matter of weeks before I get a chance to write again so Good Bye.

Yours Lovingly

Donald

(It is mighty hard writing on the train)

The heavy canvas tent flapped in the cold and moist spring wind, creating an insistent noise that soon became lost to awareness but continued to aggravate. The mud from the half-frozen ground reached well up the side of the tent, the fading red cross slowly being covered by the creeping muck. “Targets,” some of the orderlies called the crosses. Cursing as he struck his head on the tent guy wire yet again, Clarke pushed aside the tent flaps and entered the casualty area. The tent was empty. A scene of calm and control, always in contrast to the following days when nothing would remain free of blood and muck and in which any semblance of organization would be incessantly challenged by the need to finish one case in order to get on with the next. The wounded had been sent down the line to make room for the deluge of men who would follow. The walls and floor had been cleaned in anticipation of the next “big push” — a primarily colonial effort and one, it was hoped, that would finally penetrate the German lines. The time before a battle always intensified his doubts about the sanity of the entire effort. The single amputations were endurable; it was the odd double or quadruple amputee that caused him nightmares. Fortunately they rarely, almost never, survived.

The operating room was clean and orderly, the instruments neatly laid out, awaiting the arrival of mangled flesh. The retractors (large sizes only, since there was no such thing as a small incision) would hold back the damaged flesh so bits of bone and metal, or worse, mud, excrement and filth could be extracted from the penetrating wounds produced by shrapnel. Radical aggressive and ruthless excision was the order of the day; there was often little opportunity to go back and revise the surgery, and once gas gangrene set in — well, he avoided these patients as much as he could. The bone saws had their newly sharpened blades in place; nothing was worse than cutting with a dull saw. Twenty limbs to a blade, roughly; fewer of course if one had to cut through a femur or struck shrapnel. “Screamer femurs,” they were called in the field. Most died of shock before they could reach help, hemorrhaging into thighs that ballooned outward. The bone saws made a peculiar sound, much like a hacksaw cutting through soft iron. Hacking — that's what it was anyway, hacking the limbs off. Whenever he amputated below the knee the vibration transmitted up the tibia to his other hand made him uncomfortable, reminding him of his aborted efforts at carpentry.

The boxes of morphine were lined up along one wall and the glass syringes laid out. Without morphine it would be impossible to fight the war. It was said that the guns could be heard in London if the weather conditions were right. So too would the screams of the wounded, he thought. The morphine presented some temptation; you saw the glassy-eyed look come over men when they received enough to relieve their pain, how they relaxed for the first time in days or weeks. The temptation to escape to the same place was always present. There was a story circulating about a Major, a surgeon, who suffered a severe withdrawal reaction after the truck carrying a week's supply for the casualty station was directly hit by a coal box. By the time more arrived he was white, sweating profusely and vomiting. Sent back to Blighty in some disgrace as well, so the story went. An enlisted man would have been court-marshalled of course.

The syringes were laid out along with vials of antitetanus horse serum, which always could be counted on to produce an intense and painful local reaction when given to a man more than once, as it often was. Still, thank God for it. It worked, and only a few died in the spasms of tetanus, their mouths twisted into an obscene imitation of a smile, extensors overpowering flexors and backs twisting and breaking.

War Hospital, May 3 1917

Dear Katie

No doubt you will be wondering why I have not written. Well you can see by the address that I have been wounded. I have been in bed almost a month. I was shot through the right foot on the morning of April 9, Easter Monday, Vimy Ridge as you now know. I was unable to get to the first aid station until Tuesday morning and then I had to crawl a mile on my hand and knees as I was unable to walk. My foot was very swollen as I was unable to dress it properly in the field. When I got to a clearing station in France I was put under chloroform and the doctors literally cut my foot all to pieces ...

Your loving brother Donald.

In the shadows of the early April evening Donald was revealed from the monotonous background of mud primarily by the white of his teeth and eyes. His face and the rest of his body was deeply saturated with a red-brown mixture of the clay and water that comprised the surface three feet of Vimy Ridge. He raised his head every 30 or 40 seconds to get his bearing and adjust his course for the red flag still visible in the evening light, crawling across a surreal landscape of shell craters, barbed wire and corpses, leaving an odd, asymmetrical track. Soon the red cross would no longer be visible and he would have to trust his luck, dead reckoning his way across the same ground he had traversed only 36 hours before. The pain arose from his foot into his chest, filling his body with a deep and white heat. It came in waves, his endorphins reaching a crest, giving him a moment's respite before they washed away again, leaving his mind to bear the full fury of his disintegrating foot. When the bullet from the Lee-Enfield of the man behind him — who discharged it as he was shot cleanly through the skull by a machine-gun bullet — penetrated his foot, it entrained the mud from the battlefield, teeming with horse feces and rotting flesh, and attached to the outside of Donald's boot. Fortunately the Clostridia were being crowded out by all of the other bacteria present in the wound.

Donald stopped against the edge of a large shell crater. Peering over into the grey water below he could make out the naked corpses of two men, Germans it seemed, floating in the still, cold waters, fragments of ice jutting out into the water, reminding him of the cold, short days of November in Grafton. A shell must have blown their clothes off and thrown their bodies into the water. Their skin, already wrinkling, looking pink and loose and white and soft where it protruded from the smooth surface of the water, reminded him of slaughtered pigs. We slaughtered them just like pigs, he thought, and the sensation of his bayonet scraping in the spine of a dying man who looked up at him in his last few moments of life returned to him.

The pain from his foot began to crest. Jesus, Jesus, Jesus, oh Jesus, he began to intone as he peered back up into the darkening sky and again located the Red Cross banner hanging limply in the distance. Tears overflowed his eyes and ran down his cheeks, increasing slightly the amount of skin visible on his face. He lowered his head and began to crawl, his right foot dragging limply behind him, leaving a straight trail in the soft mud.

Clarke leaned against the mobile surgical tray, trying to keep it from overturning as he took the weight off his aching feet. He had been without sleep for 36 hours, and the euphoria of sleeplessness and caffeine had worn off hours before. His feet ached incessantly, although his flat arches had not kept him out of the service. He lit another cigarette, only his second of the day, while he waited for the next patient to be brought in. A wave of fatigue and nausea threatened to overwhelm him. He thought of his grey louse-infested cot and hoped there would be no more urgent cases for the next six hours and that he would be blessed with a few precious hours of continuous sleep.

Then the nurse appeared at the door. “There's one more to go, a foot wound. Looks pretty nasty, we're just cutting his boot off now.”

Clarke stuck his head around the door. His face beaded in sweat, Donald gazed up at him from the stretcher while two orderlies were busy with a large pair of surgical scissors. Donald whimpered quite piteously every time the tip of the shears was advanced between his boot and his now enormously swollen foot. With an audible suctioning pop the last of the boot was slipped off Donald's foot. He and Clarke looked down at the foot, Donald in disbelief, Clarke in professional appraisal. It was blackened and swollen nearly twice its normal size.

Then Clarke did something he swore early on he would never do. “Do you want to go home?” he asked, continuing to eye the swollen foot, not willing to look Donald in the eye. The nurse looked up, first at Clarke, who ignored her steady gaze, and then down at Donald. Donald met her eyes and then looked back down at his foot. He thought of home, of the farm, of all that was now seemingly lost to him, and of walking through the fields on his way to school with Katie beside him on that first day in 1903. In the silence that followed Clarke tried to think of some way to retract his words. He had decided early on simply to play his small part, to avoid looking at the larger picture and to limit his responsibilities to those that could be managed with a knife. He could not tell if at this time he had gone back against this on principle, or in order to return to bed a half an hour earlier.

After a long silence Donald replied. “You decide.”

The nurse poured chloroform out onto a burlap cloth and fixed a funnel over Donald's mouth as he watched Clarke pass over the bone saw and pick up the scalpel. “Breathe a few deep breaths,” she said, before the sweet, heady scent overcame him.

Donald Ross returned to France on Sept. 1, 1918. He was killed in action six days later.

Stephen Workman Assistant Professor Department of Medicine Dalhousie University Halifax, NS

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Figure. Great-Uncle Donald

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Footnotes

The letters in this piece are excerpted verbatim from a collection of over 275 letters and artifacts kept by Donald's mother until her premature death from cancer and grief in 1938. They are undoubtedly impregnated with the salt of tears shed more than 80 years ago.


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