The Oslers and the development of life-saving medical techniques during the Great War
A Featured Article from Stand To! No 93 by Peter Starling
In today's military medical environment interoperability is a regular occurrence. During the Great War a small group of eminent medical men from England and America combined their skills to endeavour to save the life of the son of another eminent physician. Edward Revere Osler was born on 28 December 1895 in Baltimore, Maryland, the son of the eminent physician Sir William Osler and his wife Grace Linzee Revere Osler. Grace was the great granddaughter of Paul Revere, a Boston silversmith and engraver, who, dressed as a Native American, took part in the Boston Tea Party. Revere gained everlasting fame as the American patriot who, during the American Revolution in 1775, rode all night to warn of the approach of the British. Paul Revere also had some connections to medicine; he made false teeth and, in an advertisement in an edition of the Boston Gazette of July 1770, assured the readership that his replacement teeth were ‘of real use in speaking and eating'.(1)
‘Strong and durable specimen'
Sir William and Grace had married in May 1892 and Revere, as he was known, was not their first child; Grace had previously given birth to another son who had died within a week of his birth.(2) At his birth, Revere was described as ‘a strong and durable specimen'.(3)
The Oslers moved to England in June 1905 when William took up the chair of Regius Professor of Medicine at Oxford and they lived at 13, Norham Gardens. In 1905 their son went to the Lynam's School in Bardwell Road, Oxford as a Day-Boy. Whilst at the school he was awarded prizes for Illustrated Diaries, English Essay and Drawing. (4) (5) He left the school in 1909 and in June 1910, on his second attempt, he was accepted for entry into Winchester where he joined Mr. Little's House. Whilst at Winchester he gained a place in the 2nd House XI for both cricket and football. (6)
At the outbreak of the Great War Grace and Revere were in Canada and immediately sailed for England to join William at Oxford; Revere was about to start as an undergraduate at Christ Church College. Although he would be old enough to enlist he really had no interest in matters military, preferring to spend his time reading, fishing, swimming and boating. Once at the college he joined the Officer Training Corps (OTC) and his attitude to the war began to change; he felt he ought to ‘do his bit'. After failing to gain a commission due to being ‘too immature', as the OTC officer put in his report, he applied to enlist in the Public Schools Battalion. (7) He eventually dropped out of Christ Church in January 1915 and, using some of his family connections, he was attested into the Canadian Expeditionary Force (CEF) on 24 February 1915 and joined the Canadian Red Cross, Duchess of Connaught Hospital, at Cliveden, as assistant Quartermaster. (8) His Attestation papers describe him as 5ft 10½ inches tall with a chest measurement of 37 inches. His complexion was fair and he had blue eyes. It is interesting that his year of birth is given as 1896. (9)
The Oslers entertained many visiting friends at their Oxford home and one such guest during the spring of 1915 was another eminent Canadian doctor, John McCrae, on leave from the front. He was followed in May by another old friend of the family, the American Neurosurgeon, Harvey Cushing.
Conscience
The McGill hospital unit, known as No. 3 Canadian General Hospital, including Revere, went to France in June 1915 and set themselves up at Camiers, on the coast. It was a quiet time for the hospital, with very few patients coming their way. This had a profound effect on Revere and his conscience began to bother him. He felt that perhaps he should be more actively employed in the war effort and he considered a move to a field ambulance.
In November 1915, with the McGill hospital moving to Boulogne, Revere became even more disillusioned with life behind the lines and continued to long for a transfer. This was discussed at length with his father whilst on leave in November.(10) Eventually, with his inability to organise a transfer to a field ambulance on 3 March 1916, he left the unit to return to England to take a commission in the Royal Artillery. (11) Even this took some months to organise, which kept him from the Somme offensive of the summer of 1916. It was eventually on 17 October of that year he finally found himself at the front as a Second Lieutenant in A Battery, 59 Brigade, Royal Field Artillery. His record of the transfer notes his qualities as ‘being a good horseman and being accustomed to mechanical drawing and the use of tools'. (12)
Revere spent his 21st birthday in Belgium and on his birthday his parents transferred £6,500 into his bank account to allow him some financial independence on his return from the war. Both William and Grace worried constantly about their son and Grace seriously felt she would never see him again. They wrote to him frequently and worried if there was no immediate reply. Eventually, in May 1917, Revere came home on ten days leave. William was amazed at the transformation of Revere into a man, complete with moustache. (13)
After spending the ten days fishing, reading and enjoying the company of his parents, he returned to Belgium, secretly hoping that he would get a ‘Blighty' wound, which would take him out of the hell which was the Western Front. In mid-August he was slightly gassed but soon recovered.
The Wounding
On Wednesday, 27 August 1917, A Battery was preparing to move its 18pdr guns forward to a new position at Hindenburg Farm. This involved filling in shell holes and preparing a track up to the farm. At about 5.00 pm, Revere Osler in company with Major Batchelor, the Battery Commander and Captain Lynn Taverner, the Battery Captain, were standing in a shell-hole, when, without warning, a German 4.2 in shell landed amongst them. (14) Major Batchelor, seven men and Osler were wounded. Osler, who received fragment wounds to the chest, abdomen and thigh, was quickly carried into a gun pit by Captain Taverner and Major Batchelor, despite his own wounds. After having his wounds dressed Revere Osler was put on a stretcher and carried to the Advanced Dressing Station of 131 Field Ambulance located at Canadian Farm (15) and then via Essex Farm to 47 Casualty Clearing Station (CCS) at Dozinghem by ambulance, arriving there at 7.00 pm. Major Batchelor, his own wounds in need of treatment, accompanied him in the ambulance to Dozinghem. The staff at 47 CCS immediately got a message off to Harvey Cushing, now a Major in the US Army Medical Corps who was at 46 CCS located close by at Mendingham, and he immediately made the journey through the pouring rain by motor ambulance. When he arrived he found Osler in extreme shock and no time could be lost if they were to save him and send him home to his parents. As Osler drifted in and out of consciousness he was gladdened to see his father's old friend, Harvey Cushing standing over him and, as Cushing later wrote, Revere ‘smiled and said, "so glad you are here" '.(16)
All was lost
Other eminent American surgeons, all friends of Osler's father, rushed to Dozinghem to offer assistance, one of whom was George Washington Crile, an expert of wound shock and blood transfusion, working at 17 CCS, located at Remy Sidings. (17) Crile was given the message at 10.20 pm and travelled the short distance to Dozinghem in the company of Lieutenant A. B. Eisenbrey, another US Army Surgeon. (18) Crile took with him his blood transfusion apparatus and immediately began to replace some of the precious blood that had already been lost. By the time the transfusion was completed it was almost midnight and the surgery commenced.
Crile gives the account of the subsequent surgery and the death of Osler.
Brewer, (19) Cushing and I were in consultation, the splendid Durrach (20) in charge. The long marquee tent was quiet and dim; the end was fast approaching. The boy's features were serene and a faint smile illuminated his face when he was told that his father's American friends were there...Durrach and Brewer operated, Harvey held his pulse and I continued the transfusion...Large rents were found in the colon, much blood in the chest and a large wound in the thigh...Obviously all was lost. (21)
A second transfusion was given which did cause some improvement but this was short-lived and, despite the attention from such experts in their field, he died before sunrise the next morning. (22) He was buried in a grave lined with Alder branches, wrapped in a blanket and covered in a Union Jack. (23) Buglers sounded the Last Post and the American surgeons who had fought so hard to save him now mourned him. How would his great, great grandfather have felt, seeing the flag he campaigned and fought to rid from his country, now covering his young descendent?
Cushing sent a telegram to William Osler telling him his son was wounded, not having the heart to tell him he was already dead, but Osler feared the truth. He immediately made plans to travel to Belgium but the War Office urged caution and advised the Oslers to await further word. They were waiting with packed bags when the telegram with the official notification of their son's death arrived. This was followed over the next few days by numerous letters of condolence, from friends and from his fellow battery officers, in which Sir William was told of a recommendation for a Military Cross which, sadly, did not materialise. (24) The Battery Commander, Major Batchelor, wrote on 31 August:-
‘He was simply splendid the whole time. Your son was as delightful and cheery a member of the mess as he was reliable. Hard-working and efficient at his work. Nothing was too much trouble to do for the Battery. It was never too dark or wet or late to go out to the guns and do the various small duty jobs which abound out here, and the doing of which well, makes all the difference to the battery. He worked with all his heart and looked for no praise. He had not an atom of conceit and never lost his head or his temper with the men when things went wrong, which so many do.' (25)
Brewer and Cushing also wrote giving details of the surgery and their efforts to save Revere.
Eventually Revere's effects and the balance of his pay were sent on to his parents.
For the Oslers there was not any major show of mourning, their life had to go on but they secretly grieved for their only son, especially Sir William who was prone to bouts of weeping. He busied himself with his work but it is said that he never recovered from the loss of his son. He eventually died from influenza 2 years later but some say he died of a broken heart.
Revere Osler is buried in Dozinghem Military Cemetery, plot 4, row F. His parents would eventually be sent his British War and Victory Medals and his bronze memorial plaque.
Conclusion
Sir William Osler enjoyed an international reputation for his medical teachings and as such had attracted great loyalty from his former students and fellow clinicians. This loyalty was to be severely tested in August 1917 when the Osler's only child was severely wounded in the Ypres Salient and a small group of eminent surgeons rushed to his bedside to try to save his life.
Despite this expertise being on hand they were not able to save the life of Revere Osler. It should not be forgotten that, in 1917, survival from abdominal wounds was low and surgery on the abdomen, blood transfusion and the treatment of wound shock was in its infancy. It should also not be forgotten that the ordinary soldier brought into 47 Casualty Clearing Station with similar wounds would not have enjoyed the attention of such experts in their fields.
Acknowledgements
The author would like to thank the following for their help during the research into Edward Revere Osler:
Dr. David E. Lounsbury MD, formerly US Army Medical Liaison Officer to the British Army, who first brought this story to my notice. Mr. James Banks, Director of the Crile Archives, Parma Ohio for his assistance with the career of G.W. Crile. Professor William C. Hannigan, MD, PhD, Pamela Miller, Osler Library of the History of Medicine, McGill University, Montreal for her great help and for permission to reproduce the photographs. The Western Front Association for permission to use the map. Gay Sturt - Archivist, Dragon School Oxford.
Peter Starling is a retired RAMC Officer and now Director of the Army Medical Services Museum. He has a great interest in the role of the Army Medical Services during the Great War and holds a MA in First World War Studies from the University of Birmingham with a dissertation examining the improvements of surgery during the war. Married, he lives in Surrey.
References
(1) Hibbert, C: Redcoats and Rebels, The War for America 1779-1781. (London: Classic Penguin, 2001), p.28.
(2) Dictionary of Canadian Biography, online entry for Sir William Osler.
(3) Bliss, M: William Osler, a Life in Medicine. (Oxford: Oxford University Press, 1999), p. 240.
(4) The school was founded as the Oxford Preparatory School in 1877 and run by Skipper and Joc Lynam. It eventually changed its name to the Dragon School in the early 20th Century. Dragon History, www.dragonschool.org accessed 7 Feb 2011.
(5) Dragon School Roll of Honour. Entry for Osler E. R.
(6) Dragon School Roll of Honour.
(7) Cushing, H: Sir William Osler, (Oxford: Oxford University Press, 1926), Vol.II, p.455.
(8) Keyes, Thomas E: ‘Edward Revere Osler, 1895-1917'. Archives of Internal Medicine, Vol. 114 (2) 1964, pp.284-293.
(9) Canadian Expeditionary Force Attestation Papers. Osler E.R.
(10) Cushing, H: Sir William Osler. p. 500.
(11) Cushing, H: Sir William Osler. pp. 568-9.
(12) Library & Archives of Canada. War Diary, 3 Canadian General Hospital. March 1916.
(13) The National Archives (TNA).. WO399/124886, Personal File, Osler E. R.
(14) TNA WO95/1802, War Diary 59th Field Artillery Brigade. The diary for the months of July and August 1917 is missing.
(15) TNA. WO95/2550, War Diary 131 Field Ambulance.
(16) Cushing, H: From a Surgeon's Journal. (Boston: Little Brown & Co, 1936). Cushing was the Consultant Neurosurgeon to the American Expeditionary Force and a long time friend of the Osler family.
(17) George Washington Crile. Born 11 November 1864. Served in the Spanish American War as a Brigade Surgeon Major. In 1906 he performed the first human blood transfusion. In the Great war he was Chief Consultant General Surgeon of the AEF.
(18) TNA. WO95/343, War Diary 17th Casualty Clearing Station.
(19) George Emerson Brewer. Original Director and Chief of Surgery at Base Hospital Unit No 2, then Consultant Surgeon 42nd Division, US Army and later 1st Corps, US Army. Annals of Surgery, October 1940, pp. 795-7.
(20) Lieutenant Colonel William Durrach. Base Hospital No.2, then 47 C.C.S. Finally Senior Consulting Surgeon 3rd Army Headquarters, U.S.A.
(21) Crile, G. (ed): George Crile an Autobiography. Vol. 1. (Lippicott Company, 1947).
(22) Letter from Cushing to ‘Susan' dated 30 August 1917. Osler Library, McGill University, Montreal.
(23) Cushing, H: Sir William Osler. p.577.
(24) Letter from Major V. A. Batchelor RA to Sir William Osler, dated 1 September 1917. Osler Library, McGill University, Montreal.
(25) Cushing, H: Sir William Osler. p. 579.
Photographs:
Edward Revere Osler 1915 . By kind permission The Library of the History of Medicine McGill University, Montreal, Canada