Hospital train

“ I thought things were difficult in the hospitals at Le Mans owing to lack of equipment, but that was child's play compared to the structural difficulties of working a hospital on a train, especially when it stands in a siding several days. One man will have to die on the train if we don't move soon, but we are not full up yet. Twenty-seven men—minor cases—bolted from the church yesterday evening on to the train when the shells were dropping, and were ignominiously sent back this morning. ”

“ Once the patients have been taken as far back as the field hospital at railhead, their subsequent conveyance to the Red Cross hospitals, or any other required points, can be carried out by train supplemented by local motor ambulance services from the termini to the hospitals. ”

“ The nurses on the hospital trains have a fine record of service. Though less monotonous than the life in a stationary hospital, it is a curious existence to be living permanently in a train, continually travelling to and fro on one stretch of line, nursing in cramped quarters and under particularly tiring conditions. ”

“ It is of no value to bring in a wounded man, unless there is a field hospital to give him swift and wise treatment, unless there is a well-equipped hospital-train to run him gently down to Paris, unless there are efficient stretcher bearers at the railroad station to unload him, and ambulances to transport him to new quarters. And finally, most important of all, the base hospital that at last receives him must be furnished with skilled doctors, surgeons, nurses and orderlies, or all the haste of transportation has gone for nothing. ”

“ At first there are few men in them; most of the wounded that have been treated are still at the field ambulances. In the evening they arrive more rapidly; next day they come in crowds, and the hospitals are encumbered with them. And now the railway system of the country comes to the help of the overburdened medical staff. Hospital trains—that is to say trains fitted with hanging-beds or stretchers, and provided with nurses and surgeons—carry back to the hospitals of great cities in the rear, all those of the wounded who can safely bear the journey. ”

“ The business of getting the "lying down" cases into the carriages is considerable, and everybody lends a hand, the surgeons being the most active of any. The berths in the train are placed one above the other, and the room for manipulating stretchers is small. The equipment of the train was very complete, and every luxury was at hand, from hot soup to iced "lemon-squash," and even to champagne. Many generous ladies in the Colony had seen that the train should want for nothing, and Major Brazier-Creagh took as much pride in his travelling hospital as if he had built it himself. ”

“ We depart from our usual practice of excluding the writings of those who are the subjects of our narratives, to give the following sprightly description of one of the hospital trains of the Sanitary Commission, communicated by Miss Brayton to the Cleveland Herald, not so much to give our readers a specimen of her abilities as a writer, as to illustrate the thorough devotion to their patriotic work which has characterized her and her associates.
ON A HOSPITAL TRAIN.
"Riding on a rail in the 'Sunny South,' is not the most agreeable pastime in the world. ”

“ If a railway company sent an engineer to conduct a train to its destination as ignorant of, and inexperienced in, the working of the whole train system as some graduate nurses are, who have the responsibility of a hospital, small or large, placed upon them, the public would raise its hands in horror, and brand the railway officials with criminal carelessness. ”

“ The kitchen car was supplied with a small cooking range, boilers, and other requisites for the feeding of from 175 to 200 patients. The cars were warmed and lighted in winter, and special attention was paid to ventilation, so that Dr. F. L. Town, of the United States Army, was able to report of them:—"In visiting these hospital trains, the air is found sweet and pure, the wards are neat and inviting; and it may unhesitatingly be said that men on hospital trains are often as comfortable and better fed and attended than in many permanent hospitals." ”

“ These are discomforts hard to bear even when one is well and [548] strong; how much worse for a sick or wounded man. But thanks to the United States Sanitary Commission and to those gentlemen belonging to it, whose genius and benevolence originated, planned, and carried it out, a hospital-train is now running on almost all the roads over which it is necessary to transport sick or wounded men. These trains are now under the control of Government, but the Sanitary Commission continues to furnish a great part of the stores that are used in them. ”

“ As we approached the turning of the road we could see in the distance the flashing headlights of other motors from the English hospital, as they too sped toward the train.
When we reached the station a constant stream of vehicles was pouring through the gates, and as fast as each car or ambulance arrived, it was backed into the waiting line. Every few yards carbide jets spluttered in the wind, adding their fitful glare to the strangeness of the scene. ”

“ They have no water on trains or at stations, except on the engine, which makes tea in cans for you for the men when it stops.
We are to rest to-day, to be ready for another train to-night if necessary. The line from the front to Rouen—where there are two General Hospitals—is cut; hence this appalling over-crowding at our base. When we got back this morning, nine of those we took off the trains on Sunday afternoon had died here, and one before he reached the hospital—three of tetanus. I haven't heard how many at the other hospital at the Jesuit school—tetanus there too. ”

“ It was one of those days on which invalids are especially fractious, and hospital nurses murmur at their vocation; a day on which third-class passengers travelling long distances by excursion train are savagely clamorous for beer at every station, and hate each other for the narrowness and hardness of the carriage seats, and for the inadequate means of ventilation provided by the railway company ”

“ If the surgeon in charge of the train decides that he has a case which [56] should be hastened to a hospital he wires ahead, so that when he reaches that point the surgeon or the agent there is on hand with an ambulance to rush the patient to a local hospital.
Where it is possible, red tape has been eliminated. The cots in which the patients are carried are sent with the patient from a hospital or ship, and the patient is only taken out when he arrives at the hospital of his destination. For the cot bearing the patient, the train surgeon receives in exchange a clean cot. ”

“ The train carrying the hospital and its possessions moved on to Frere Station, where it took up the equipment of officers and men. There was a passenger carriage with one compartment in which were accommodated the nurses and three others. The officers, sergeants, and orderlies rode on the piles of baggage which filled the open trucks.
The day was blazing hot, and thirst proportionate. The heat oppressed one with the sense of something that had weight. Any breeze that moved was heavy with heat. ”

“ I reported to the Ambulance Headquarters this morning and found that I had been assigned to duty in assisting Captain Kipling with the executive details of the organization of the new ambulance trains. In future every train is to be composed of five ambulances, one repair car, and one scout car, and is to be manned by an officer and thirteen men. Each such unit is to be complete in itself and is called a “squad.” As such it will be assigned to duty with the Paris Hospital, with field hospitals, or with the French, British, or Belgian armies. ”

“ Once the men have the surgeons' permission to go, they are off; and there may be an interval of a day, or two days, should any of them be too weak to reach the train in time, during which these poor fellows belong to no one,—the hospital at one end, the railroad at the other,—with far more than a chance of falling through between the two. The Sanitary Commission knew this would be so of necessity, and, coming in, made a connecting link between these two ends. ”

“ When the last ambulance train came up about 2 P. M. the patients were first put in, and then every portable object that could be removed was packed into the train too. At the last moment, when the train was just about to start, one of the sanitars ran back and triumphantly brought out a pile of dirty soup plates to add to the collection. Nothing was left in the hospital but two dead men we had not time to bury.
The wounded were all going to Warsaw and the other Russian Sisters went on in the train with them. But our destination was Zyradow, only the next station but one down the line. ”

“ The train has just arrived and even now some few wounded are being removed from the waggons, the gravest of all being given treatment in an improvised hospital by the sidings, others less serious, though bad enough in all conscience, are carried on stretchers to the central goods shed, where the commandant, aided by a large staff of excitable, bearded assistants, directs to what hospital they are to be sent. ”

“ Just as in a large department store, every yard of ribbon sold has its relation to the whole establishment, or in a great railway system every train dispatched influences the running of every other train, and system is necessary to insure the success of the business or the safety of human lives, so in a hospital every part is vitally related to the great whole. ”

“ I ask, I demand that the train be started at once. In the name of humanity all haste must be made to get the wounded into a hospital as soon as possible. Every moment with some of them means life or death. ”

“ Now, as he is borne off out of hearing, the medical officers whisper, "poor chap, there is no hope for him; he cannot last the night."
Gradually the armoured train disgorges its unhappy load, the stretchers receive their burdens, the marshalled procession goes slowly over the line (p. 195) towards the hospital, the medical officers in close attendance, and the engine pushes and pulls its bullet-proof trucks back through the night to fetch another cargo. ”

“ The sufferer is raised carefully upon a stretcher or carried off in an ambulance waggon to a "dressing-station" somewhere in the rear. If there are not enough stretchers, or the wound is merely a slight one, the disabled soldier is borne away on a seat made of the joined hands of two bearers. A second row of ambulance waggons is loaded from the dressing-station—each waggon holds nine—and goes lumbering off to the field hospital. Here the men are laid on the ground with perhaps a waterproof sheet under them and a blanket over them. ”

“ It is from this station that the American Hospital receives its patients, invariably cases whose condition is so grave that they are thought to be incapable of enduring further travel without fatal results.
Upon entering the service of the Ambulance all volunteers, no matter what their ultimate position is to be, are required to attain a certain efficiency and practical knowledge in the actual handling of wounded. I am now taking my turn at this service. One train of ambulances is always stationed in Paris and carries wounded from the Aubervilliers station to the various city hospitals. ”

“ There were others who had been severely wounded; some with broken arms or legs; some shot through the head or chest. It was wonderful to see the gentleness and kindness of our own rough lads as they lifted them tenderly from bed to stretcher, and carried them from the train to the waiting ambulances.
I stepped inside the train for a moment. It was a marvel of a hospital on wheels. ”

“ The French inhabitants would turn out en masse to see us pass, and were rather proud of us on the whole, I think. Arrived at the big railway siding, we all formed up into a straight line to await the train. After many false alarms, and answering groans from the waiting F.A.N.Y.s, it would come slowly creaking along and draw up. The ambulances were then reversed right up to the doors, and the stretcher bearers soon filled them up with four lying cases. At the exit stood Boss and the E.M.O., directing each ambulance which hospital the cases were to go to. ”

“ It was told by an army surgeon with whom he was having his peripatetic breakfast. On the track alongside stood a so-called Red Cross train, consisting of a combination of well-equipped hospital coaches with their triple rows of berths slung one above the other as in a sleeper; attached in the rear were a few coal carriages and freight trucks. This train was waiting for the outbound traffic to pass by. You see, the outbound traffic consisted of fresh troops, being rushed to the front in one of those quick transcontinental shifts which have played so important a part in German strategy. ”

“ There was no real confusion about the whole day, owing to the good organising of the No.— Clearing Hospital people who run it. Every man was fed, and dressed and sorted. They'll have a heavy time at the two hospitals to-night with the cases sent up from the trains.
M. and I are now—9 p.m.—in charge of a train of 141 (with an M.O. and two orderlies) for St Nazaire; we jump out at the stations and see to them, and the orderlies and the people on the stations feed them: we have the worst cases next to us. ”