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Photography in the Great War
Facialities: Interdisciplinary Approaches to the Human Face Series Editors: Suzannah Biernoff Mark Bradley David H. Jones David Turner Patricia Skinner Garthine Walker In this series, historians of all periods, experts in visual culture and literary scholars explore the many ways in which faces have been represented in the past and present, and in particular the issue of facial difference, disfigurement, beauty and ‘ugliness’. Faces are central to all human social interactions, yet have been neglected as a subject of study in themselves outside of the cognitive sciences and some work on aesthetics of the body. Titles in the series will range across themes such as approaching the difficult history of disfigurement, how facial difference and disability intersect, the changing norms of appearance relating to the face and other features such as the hair (facial and otherwise), violence targeted at the face, and the reception and representation of the face in art and literature. Published: Approaching Facial Difference: Past and Present, edited by Patricia Skinner and Emily Cock (2018) Concerning Beards, Alun Withey (2021) Forthcoming: Facial Disfigurement in Ancient Greece and Rome, Jane Draycott
Photography in the Great War The Ethics of Emerging Medical Collections from the Great War Jason Bate
BLOOMSBURY ACADEMIC Bloomsbury Publishing Plc 50 Bedford Square, London, WC1B 3DP, UK 1385 Broadway, New York, NY 10018, USA 29 Earlsfort Terrace, Dublin 2, Ireland BLOOMSBURY, BLOOMSBURY ACADEMIC and the Diana logo are trademarks of Bloomsbury Publishing Plc First published in Great Britain 2022 Copyright © Jason Bate, 2022 Jason Bate has asserted his right under the Copyright, Designs and Patents Act, 1988, to be identified as Author of this work. For legal purposes the Acknowledgements on pp. x–xi constitute an extension of this copyright page. Cover design: Terry Woodley Cover image: Victory Group, Benjamin Margerison, the RAMC albums All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage or retrieval system, without prior permission in writing from the publishers. Bloomsbury Publishing Plc does not have any control over, or responsibility for, any third-party websites referred to or in this book. All internet addresses given in this book were correct at the time of going to press. The author and publisher regret any inconvenience caused if addresses have changed or sites have ceased to exist, but can accept no responsibility for any such changes. A catalogue record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data Names: Bate, Jason, author. Title: Photography and facial difference : the ethics of emerging medical collections from the Great War / Jason Bate. Other titles: Ethics of emerging medical collections from the Great War Description: [New York] : [Bloomsbury Academic], [2022] | Series: Facialities: interdisciplinary approaches to the human face | Includes bibliographical references and index. Identifiers: LCCN 2021029858 (print) | LCCN 2021029859 (ebook) | ISBN 9781350122048 (hardback) | ISBN 9781350122055 (pdf) | ISBN 9781350122062 (ebook) Subjects: LCSH: World War, 1914-1918–Veterans–Great Britain. | Disfigured persons–Great Britain. | World War, 1914-1918–Veterans–Great Britain–Care. | Disabled veterans–Great Britain– History–20th century. | Medical photography–Great Britain. | World War, 1914-1918–Social aspects. | War and families–Great Britain. | Post-traumatic stress disorder. Classification: LCC D639.V48 G7 2022 (print) | LCC D639.V48 (ebook) | DDC 362.4086/970941–dc23 LC record available at https://lccn.loc.gov/2021029858 LC ebook record available at https://lccn.loc.gov/2021029859 ISBN: HB: 978-1-3501-2204-8 ePDF: 978-1-3501-2205-5 eBook: 978-1-3501-2206-2 Series: Facialities: Interdisciplinary Approaches to the Human Face Typeset by Integra Software Services Pvt. Ltd. To find out more about our authors and books visit www.bloomsbury.com and sign up for our newsletters.
Contents List of Illustrations Acknowledgements
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Introduction 1 The wards with no mirrors: RAMC photography and the new era of medical communications 2 Glass soldiers in the lantern. The Royal Society of Medicine, 1914–19 3 Mobilizing the camera as therapy: The amateur photographers at work: organization, equipment and business 4 Family-led care and the shortcomings in state provision 5 The ‘medical collections’ and ‘family collections’ of the archival ecosystem Conclusion
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Notes Bibliography Index
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29 59 85 111 141 169 176 202 215
Illustrations I.1 Butcher family christening, 1949, photographer unknown. Reproduced by kind permission of the Dewhurst family 1.1 Glass photographic plate from the Albéric Pont Collection, 1915–18, 90 × 120 mm, photographer unknown. Reproduced by kind permission of the Archives of the Bibliothèque Interuniversitaire de Santé, Paris 1.2 Glass photographic plate from the Albéric Pont Collection, 1915–18, 90 × 120 mm, photographer unknown. Reproduced by kind permission of the Archives of the Bibliothèque Interuniversitaire de Santé, Paris 1.3 Glass photographic plate from the Albéric Pont Collection, 1915–18, 90 × 120 mm, photographer unknown. Reproduced by kind permission of the Archives of the Bibliothèque Interuniversitaire de Santé, Paris 1.4 Title page of the thirty-sixth volume of the Journal of the Royal Microscopical Society (1916). Reproduced with kind permission of University Museum of the History of Science, Oxford, and the Royal Microscopical Society Archives 1.5 Privates Westwood, 1918–19, and Harper, 1916–19, photographs by Dr Albert Norman, 1915–19. RAMC album 2, RAMC 760. Wellcome Library. Reproduced by kind permission of the trustees of the Museum of Military Medicine 1.6 Thornton-Pickard Cameras, advertised in Amateur Photographer and Photographic News 61. 1579 (3 May 1915): vi. N. 1709 d. 2. Reproduced by kind permission of the Bodleian Library, University of Oxford 1.7 Half plate glass negative of Private Bob Davidson, 30 March 1917, ‘R.J. Davidson. 7’, written along the top edge of the plate in black marker pen, photographed by Sydney Walbridge. Gillies Archive, the British Association of Plastic, Reconstructive and Aesthetic Surgeons, BAPRAS/Sidcup/6/4, from the Archive of the Royal College of Surgeons of England, London
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2.1 Frontispiece of the tenth volume of the Proceedings of the Royal Society of Medicine (1916–17). Reproduced by kind permission of the Royal Society of Medicine, London, and Sage Publishing 2.2 Photograph of the Robert Barnes Hall, The Royal Society of Medicine: Opening of the New Building by His Majesty the King Accompanied by Her Majesty the Queen (1912): 4. Cat no. WZ 1 (ROY). Reproduced by kind permission of the Royal Society of Medicine 2.3 ‘Wrench’ series lanterns, cinematographs and accessories (1908): 167. EXEBD 36621/3. Reproduced by permission of the Bill Douglas Cinema Museum, University of Exeter 2.4 Page from ‘Optical Lanterns’ advertisement, The Amateur Photographer 45 (1907): iii. N. 1709 d. 2. Reproduced by kind permission of the Bodleian Library, University of Oxford 2.5 Page from The Art of Projection and Complete Magic Lantern Manual (1893): 130, of incandescent lamp for electric light lanterns. EXEBD 29785. Reproduced by permission of the Bill Douglas Cinema Museum, University of Exeter 2.6 Page of photographs for J. L. Payne in A. E. Rowlett, Case of Facial Restoration by Means of Mechanical Appliance, ‘Odontological Section. Discussion on War Injuries of the Jaw and Face’, Proceedings of the Royal Society of Medicine, 12. 3 (1916–17): 40. Reproduced by kind permission of the Royal Society of Medicine and Sage Publishing 2.7 Page from G. Northcroft, ‘A Short Account of a Year’s Work at One of the Jaw Injuries Centres of the London Command’, Proceedings of the Royal Society of Medicine, 11. 3 (1918): 19. Reproduced by kind permission of the Royal Society of Medicine and Sage Publishing 2.8 Photographic lantern slide of Private Slater, circa 1918. Photographed and reproduced by Sydney Walbridge. Gillies collection, the British Association of Plastic, Reconstructive and Aesthetic Surgeons, BAPRAS/G/31/5/Box 3, from the archive of the Royal College of Surgeons of England, London 3.1 The Newman and Guardia ‘Sibyl’ Camera (Advertisement), The Photographic Industry of Great Britain (London: The British Photographic Manufacturers Association, 1920): 256. LBY 85/3294. Reproduced by kind permission of the Imperial War Museum, London 3.2 ‘Pictorial History’, Boots Photographic Section (Advertisement), Amateur Photographer and Photography, 46. 1545 (7 August 1918): 2.
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Illustrations
N. 1709 d. 2. Reproduced by kind permission of the Bodleian Library, University of Oxford 3.3 ‘Service’, Boots Photographic Section (Advertisement), Amateur Photographer and Photography, 46. 1545 (4 September 1918): 2. N. 1709 d. 2. Reproduced by kind permission of the Bodleian Library, University of Oxford 3.4 Photograph Albums by William Johnson & Son (Advertisement), The Photographic Industry of Great Britain (London: The British Photographic Manufacturers Association, 1920): 175. LBY 85/3294. Reproduced by kind permission of the Imperial War Museum 3.5 Two nurses processing X-ray plates in the developing room, from photograph album of the King George V Military Hospital, 1915–19, photograph by Benjamin Disreali Margerison, RARE B[0] ac no. 16685. Reproduced by kind permission of the Imperial War Museum 4.1 George Butcher on holiday at Cliftonville, Margate, 1932, photograph by Emily Butcher. Dewhurst family collection. Reproduced by kind permission of the Dewhurst family 4.2 George Butcher on holiday at Cliftonville, Margate, 1932, photograph by Emily Butcher. Dewhurst family collection. Reproduced by kind permission of the Dewhurst family 4.3 George and Emily Butcher on a day’s outing, 1968, photographer unknown. Dewhurst family collection. Reproduced by kind permission of the Dewhurst family 4.4 Studio photograph of Twinn family, c. 1917. Reproduced by kind permission of the family of Sidney Twinn 4.5 Twinn family picnic, 1959, photographer unknown. Reproduced by kind permission of the family of Sidney Twinn 4.6 Sidney Twinn and his wife Minnie, with their granddaughter Anita and Sid’s nephew John, c. early 1940s, photographer unknown. Reproduced by kind permission of the family of Sidney Twinn 4.7 Hugh (centre), his nephew-in-law John Phillips (left), and another family member (right), Suffolk, c. late 1930s. Reproduced by kind permission of the family of Hugh Goddard 4.8 George Butcher decorating at home, c. 1938–9, photograph by Emily Butcher. Dewhurst family collection. Reproduced by kind permission of the Dewhurst family
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5.1 Storage boxes of photographs from the Gillies Collection. Reproduced by kind permission of the archive of the British Association of Plastic, Reconstructive and Aesthetic Surgeons 5.2 Photographic postcard of Arnold Wayte and his Ward 5 friends at Queen’s Hospital, Sidcup, sent to his mother on 6 November 1917. Reproduced by kind permission of the Gedye family 5.3 Photographic postcard of Arnold Wayte and his Ward 5 friends at Queen’s Hospital, Sidcup, sent to his mother on 6 November 1917. Reproduced by kind permission of the Gedye family 5.4 Page of photographs of Private George Edwards, 1917–19, photographs by Dr Albert Norman. RAMC album 2, RAMC 760. Wellcome Library. Reproduced by kind permission of the trustees of the Museum of Military Medicine 5.5 George Edwards with his granddaughter Kathy on her wedding day, July 1975, photographer unknown. Reproduced by kind permission of the family of George Edwards 5.6 Broken half plate glass negative of Private Bob Davidson, 30 March 1917, photographed by Sydney Walbridge. Gillies Archive, the British Association of Plastic, Reconstructive and Aesthetic Surgeons, BAPRAS/Sidcup/6/2, from the Archive of the Royal College of Surgeons of England, London
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Acknowledgements This book has been shaped and reshaped over a number of years and through the guidance and support of many people. The bulk of the research was developed while I was a PhD student at Falmouth University where I had the great fortune of being supervised by Nancy Roth, Fiona Hackney and James Ryan. Without their generosity and spirit of giving time, dedication and support for my work this book would have looked very different. Both Falmouth University and the University of Exeter provided highly supportive and stimulating academic environments that have shaped my thinking in profound ways. As with any research project, my work was made infinitely easier by the support of many archivists and research professionals, including those at the Royal College of Surgeons of England, London; the Imperial War Museum, London; the Wellcome Library, London; the Museum of Military Medicine, Aldershot; the London Metropolitan Archives; the British Library, London; the Bodleian Library, Oxford; the Bill Douglas Cinema Museum, Exeter; the Archives of the Bibliothèque Interuniversitaire de Santé, Paris; and the Royal Society of Medicine, London. I am particularly grateful to David Wiggins from the Museum of Military Medicine, Robert Greenwood and Lilian Ryan from the library of the Royal Society of Medicine, Ruth Neave, formerly of the British Association of Plastic, Reconstructive and Aesthetic Surgeons at the Royal College of Surgeons, and Andrew Bamji, honorary archivist of the Gillies Archive, for generously sharing expertise and allowing unfettered access to the collections. I am indebted to many friends and colleagues at the University of Exeter and elsewhere for their help, encouragement, as well as critical feedback over the years, that have shaped the work in many ways, including David Jones, Joe Kember, John Plunkett, Phil Wickham, Suzannah Biernoff, Wendy Gagen, Jessica Meyer, Sara Dominici, Beatriz Pichel and Kat Rawling. I would also like to acknowledge my myriad debts to the scholars whose names populate the endnotes of this book; their work has provided the inspiration and the foundation for this study. Throughout this project I have benefited enormously from a number of instances of academic collegiality which have improved my writing. I appreciate
Acknowledgements
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the thoughtful feedback on chapters provided by the students and staff of The History and Theory of Photography Research Centre in a seminar at Birkbeck. Presenting at Birkbeck has additionally led to a number of important conversations which have shaped this book. Chapter 2 is based on another article published in the Science Museum Group Journal in 2020; I am grateful to the journal’s editor for his permission to rework the material. Gil Pasternak kindly shared his thoughts on ethics and the challenges of engaging medical photograph collections before publication, and Michael Roper, Jennifer Tucker and Elizabeth Edwards all provided encouragement and insight in discussions of my work. They have made this a better book than it would otherwise have been. I owe a particular debt of gratitude to the family descendants of the small group of facially injured ex-servicemen from the Great War discussed in this book, who provided me not only with invaluable personal information but also large numbers of family photographs of their ancestors relating to postwar domestic life. I have had the good fortune to present many of the ideas contained in this book at a number of conferences and workshops as they have developed. I am particularly appreciative of the opportunity to present my work at a series of workshops on the cultural legacy of les gueules cassées offered by the international research project 1914 Faces 2014 funded by the EU scheme Interreg at the University of Exeter, led by David Jones for the UK team between 2013 and 2015, a French team was led by Professor Bernard Devauchelle, Institut Faire Faces, Amiens; and the AboutFace workshop ‘Emotions and Ethics: the Use and Abuse of Historical Images’, organized by Fay Bound Alberti at the University of York and held online in June 2020, for the chance not only to present but also to refine the central thesis of this book. I would like to thank Bloomsbury for the publishing of this book, with particular gratitude to the series editors for their attentive editing and Abigail Lane and Viswasirasini Govindarajan for their calm guidance throughout the process. I also thank the two anonymous peer reviewers of this book for their thorough and constructive reader reports. This book has also been made possible by and benefited greatly from a generous grant provided by the Scouloudi Foundation in association with the Institute of Historical Research. I would also like to thank my friends for their support and patience during the writing of this book. Unwittingly, they have been required to listen to the stories of the ex-servicemen and the photograph collections for the past twelve years. And finally, my deepest thanks to my parents, for their support. Their passion and compassion have been, throughout my life, a source of inspiration and encouragement.
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Introduction
In August 1916, the Ministry of Pensions wrote a short article in the British Journal of Photography, calling upon local employers to take on soldiers who had been disabled during their war service. Among the obvious postwar problems was that of finding employment for many ex-soldiers who had been injured more or less seriously but were still capable of doing certain classes of work: There are many ways in which a man may be incapacitated from returning to his own trade or occupation without rendering him unfit for a lighter business. A railway guard who had lost a leg could hardly take up his old job, but as a photographic printer or darkroom assistant he would feel the handicap very slightly. A man who had lost both legs might, if he possessed the necessary delicacy of touch, develop into a successful retoucher or take up the finishing of prints and enlargements.1
For the British government and state authorities, the photographic industry seemed to offer suitable openings for disabled ex-service workers to earn a living, and they assured employers of subsidies to support any training, ‘so that the photographer need not be at a loss during the period of tuition’.2 The Ministry’s plea to the photographic industry, to retrain in the shadows of darkrooms or printing departments, serves as a reminder of how the government sought to reintegrate disabled and disfigured ex-servicemen back into society. By 1921, 1,182,000 First World War ex-servicemen in Britain were receiving a disability pension paid for by the Ministry of Pensions.3 The severity of an ex-serviceman’s disablement and pension rate was calculated by percentages. Severe facial disfigurement, for example, qualified as 100 per cent disability.4 Local War Pensions Committees were responsible for organizing training and medical treatment after discharge.5 In addition, benefits extended to exservicemen’s wives and children, and were provided using a complicated set of rules.6 Awarding disability pensions was controversial, as government wanted to minimize costs. Although the state assumed responsibility for provision for its
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war disabled, regional committees undertook administration. The government did not stifle individual enterprise. One handbook noted: ‘It means that a department of governance with a Cabinet Minister is charged with seeing that the state’s responsibility is carried out, but that this department is expected to fulfil its function largely by stimulating local and private effort.’7 The hitherto unprecedented scale of pension infrastructure was the result of the intense and lethal reality of the First World War involving mass citizen armies experiencing static trench warfare, poisonous gasses, advanced heavy artillery and machinegun fire. ‘The science and technology of the First World War simultaneously destroyed and recreated the male body.’8 The British government presented a return to industry and the workforce as a symbol of physical and moral recovery, and the means by which the disfigured would regain their place in society and reassert their hegemonic masculinity. The rehabilitation and policy of disabled ex-servicemen’s rights as workers in which the Ministry of Pensions immersed itself was shaped by the national economy and the availability of finances, with a large emphasis on social exchanges and emotional bonds and philanthropic bodies to help reintegrate British veterans back into civil and domestic life. One prominent scheme was the King’s National Roll, a state programme that encouraged employers to ensure at least 5 per cent of their workforce were ex-servicemen in receipt of a disability pension. Launched in Britain in September 1919, employers who participated were included on a national ‘Roll of Honour’ and able to use the King’s Seal in correspondence. Previous research into the scheme highlights its worthiness as almost 24,000 employers participated in helping 259,000 disabled ex-servicemen attain employment in 1921. Such effort helped to create a national sense of duty and appreciation to the disabled ex-service community and emphasized the significance of the sacrifices they had made for their country.9 This book aims to address the British government’s task of returning facially injured soldiers to industry by questioning medical photography’s place in the broader history of the economic and cultural concerns of their domestic reintegration. Focusing on the context of the photographic departments and services of maxillofacial war hospitals, I aim to unveil how photography participated in the domestic reintegration and professional rehabilitation of disfigured ex-servicemen and how attempts were made to place these men back into employment and even to give them pensions enabling them to live as well as they might have had they not been disabled. On 1 May 1915, James Dundas-Grant formally recognized the importance of photography to the British scheme of care for the facially injured in a Lancet
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article. Dundas-Grant was a laryngologist and had visited French war hospitals with the British Army, to gain a better understanding of facial injuries and obtain information on their treatment. Dundas-Grant quickly realized the lack of sufficient documentation and material on this new type of war injury held by the British Medical Services. The author described his observations to British colleagues in the hope that ‘the same kind of work may be carried out in our home military hospitals’.10 Over the course of the Great War the British Army and the Ministry of Pensions had to contend with 60,500 British servicemen wounded in the head or eyes.11 Whilst exact numbers are unknown, over 4,000 servicemen from the British and imperial armies were treated at Sidcup alone between 1917 and 1925,12 often for many months or years, with 1 per cent of pensioned ex-servicemen in the National Archives cited as suffers of a facial condition or injury.13 The facial injuries produced by the conflict were unprecedented in their numbers and severity. The state was a key player in the business of war hospitals, both as a regulator and as a market for labour and services, which inevitably applied to photography. Scholars of both medical history and photographic history have so far not suggested that the military, as a business industry, was a client for photographic services. Indeed, the photographic departments in the various facial centres can be characterized by the polymorphic nature of their industrial organization and small and medium-sized production units.14 The British Army’s production of photography in the facial wards, which include before and after images of soldiers undergoing surgical reconstruction, encouraged previous scholars to closely link these disfiguring wounds to loss of social function such as the difficulties of feeding and speech and returning to work in the postwar era. I widen the focus to conjoin the British Army and Ministry of Pensions’s surgery and aftercare activities and Army Medical Services photographic production in order to reveal how the event of photography as a caregiving process attended to ex-servicemen’s ‘future employment’ so that ‘they might become good citizens’.15 The social exchanges and the practicalities and logistics of working in busy facial wards and the introduction of easy-to-use portable cameras, improved lightsensitive plates and the smells and stains of the chemicals and the toxins of the darkroom define this photography. With this social and economic restoration of ex-servicemen’s faces in mind, the Medical Photographic Services production yields an additional and different narrative that integrates this ideological devotion to reintegration aims – for example, the rights of workers, and group recognition from governments and state authorities, with these photographic processes and practices, reassessing
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them in light of these reform-minded views. I argue for an appreciation of the Royal Army Medical Corps’ (hereafter RAMC) photographic production as a broad network of actors, organizations and institutions relevant to militarymedical photography – a cooperation network encompassing not only the military and the state but also a hierarchy of professional and commercial photographers, photographic manufacturers, local camera clubs, individual darkroom workers and assistants, small companies and micro-businesses. This infrastructure for managing patients, labour, capital and information produced for the Army Medical Services a photographic field that could engage with the complexity of facial injuries and fix the image of healing after surgery – as an invaluable apparatus that gave doctors a newfound visual, portable and experimental independence to tackle the fast pace of thousands of patient admissions to hospital. The image-making processes in the war hospitals index the environments in many interesting ways, allowing us to see the transition from amateur or commercial practice to professional engagement, how photographers extended their activities to hospital services, dealt with medical photography and tried to master the techniques, its durational qualities, its state of expectancy, as well as its translations and distributions and the signs of production and decisionmaking which medical staff were keen to repress, with all the workings hidden under perfectly engineered scientific images. By focusing on the fluid material events to the production and transmission of medical information, the chapters in the first part of this book deal with the emergence and evolution of wartime medical communications as a particular matter that helps to develop adequate alternatives to the discursive objectification and hardening of materials. This book encourages us to see the complex ways in which surgical innovation, business, commerce and industry in photography, and military welfare and rehabilitation configured one another. In particular, this book represents the military complex underlining medical photography of the Great War as a cluster of workers and a series of events servicing the wards. Technology adoption can be seen not as oppressive but as an important part of the duties of caregiving – despite a lack of informed consent by patients to have their pictures taken – whereby surgeons, photographers, nurses, darkroom workers and local camera clubs creatively and pragmatically transformed a promising technology into a workable and working process within a new military market. The patients in the facial wards never consented to have their pictures taken. If they did, it is impossible to know because there is no evidence to suggest exactly what happened when the pictures were taken. However, because the treatment of
Introduction
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British facially injured ex-servicemen was coordinated and brought under military and government jurisdiction and subject to the Ministry of Pensions for aftercare for civil life, a patient was legally bound to undergo rehabilitation and ‘to their control in all matters relating to their pension’, with penalties being imposed upon them ‘if they failed to avail themselves of the surgical course prescribed’.16 By granting consent to perform surgery, a soldier-patient was automatically authorizing the surgical team to take photographs of any surgical outcomes as photographic practice was defined as part of this treatment. At the same time, once photography’s feats were captured and contained (to document, preserve, and reproduce cases of facial injury), surgeons well understood what educational purpose the camera would serve, and how it would integrate into the wards, societal practices, and social uses. That would become clear in the institutional clarifications of the Royal Society of Medicine (RSM). Everything in the meetings of the RSM points to ‘formalizing’ and ‘institutionalizing’. Not only are the terms of photographic production in the various specialisms of surgery brought together to treat facial injuries in the Society used, but its practicality is specified, mastered and fixed to the name of the departments of knowledge. If there is a Section of the Society that is because the institutionalization of photography is under way. The new era of medical communications was also the new era of photography in the ward. In the lives of facially injured ex-servicemen, from the moment of their wounding, and in many cases for the remainder of their lives, these men were regulated by societal judgements about the visibility of facial difference and its appropriateness. Disfigurements could be, and should be, as Marjorie Gehrhardt notes, culturally visible (through literature, newspaper reports etc.), but were not supposed to be literally visible and were largely absent from the visual culture of the war, despite being extensively photographed for medical purposes.17 Newspapers during the war played a pivotal role in shaping the real and imagined destinies of facially injured ex-servicemen, and helped motivate concerns to police their visibility. There was a significant spatial dimension to the visibility of facially injured Great War ex-servicemen. The boundaries of what was considered appropriate were dictated by the space in which one was being seen and who was witnessing/observing. At the Queen’s Hospital in Sidcup, for example, patients were encouraged to ‘take the air’ along the road which ran between the hospital and the town of Sidcup. Specific benches were designated for patients’ use, identifiable by the blue paint which served to warn passersby of their facial wounds.18 The benches embody the complexities surrounding the visibility of facial injuries and attempts to curb it. Drawing attention
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to facially wounded patients so that civilians might avoid looking at them reinforced (and arguably legitimized) the relationship between disfigurement and social isolation. This also highlights, however, the imagined difference between civilian society and the hospital, as the benches only existed outside its grounds; they were not considered necessary within the hospital itself. In this institutional environment, as opposed to in ‘polite society’, seeing and observing disfigurement was permitted. This conceptualization of disfigurement was also underpinned by an assumption that soldiers with facial differences would, or should, want to hide, reinforcing the concept of an innate passivity ensuing from their injuries. Whilst this could mediate potentially negative social treatment, this demonstrates how men’s interaction with the outside world was regulated and controlled owing to ideas about the (in)appropriateness of their visibility. The key aspect in this interaction is the agency of the observer – the choice over whether or not to look at the facially wounded individual. The cultural norms and conventions in Britain, during and after the war, acted to disenfranchise facially injured ex-servicemen over the years. Against this background, presenting them as ‘the most tragic’, and therefore, the ‘most worthy’ recipients of support, paradoxically acted to emasculate disfigured veterans and render them passive.19 But the ex-servicemen showed an awareness of the passivity and socioeconomic impotence, both in how they were framed and contained. Facially injured veterans not only conceptualized their disfigurements as part of the contingent of war-disabled veterans, and conforming to the behavioural expectations placed upon ex-servicemen such as amputees; they also ameliorated (to an extent) the potential impact of their injuries, thus altering their appearance as ‘injury to honour’. By framing their disfigurements within the context of the Great War, and the rhetoric of heroic sacrifice, they reclaimed their entitlement to visibility. But a real shift in the relationship between photography and long-term caregiving required something different.
The camera as therapy By 1914, changes in industry had made photographic apparatus, plates, films and chemicals readily available, and new businesses were in operation to service the population of amateur and novice photographers with developing and printing. The arrival and mass-production of roll film also made possible new designs of camera that a waiting market was keen to buy. For both sensitized goods and
Introduction
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camera manufacture the introduction of standardization to the manufacturing process and techniques of mass-production ensured that prices fell in the early 1900s and this supported new markets for photography. For families who photographed, the combination of a hand camera and daylight loading film was crucial in boosting demand as they started to use these cameras to process and print their domestic films. While the separation of picture taking from the processing and printing of the photograph was a significant step in supporting a mass market, the relative cost of photography meant that even after the war, the only groups who could realistically afford the technology was the growing body of middle-class photographers, who enthusiastically embraced the hobby as it facilitated individual expression and leisure activity. Many households could not afford cameras, or to have photographs taken. Class becomes a significant factor within the complexities of understanding this kind of study and the difficulties inherent in this topic, for it is fundamental not only in relation to who had access and means to photograph others in the hospital but also in the home. I argue the need for an expanded conception of the aftercare of facially injured Great War ex-servicemen which encompasses photography by families as a psychological tool for recovery and the presentation of healing made by photographic companies when embracing the reform ideas emerging in a postwar era. I argue for an appreciation of the family archives and the acts of caregiving in the domestic setting that have otherwise been elided by photographic histories. Because many of these disfigured men underwent a difficult renegotiation of their own male identity, recovery cannot be fully understood without addressing how veterans conformed (and were seen to conform) to the stoic ideal, commonly thought to be unattainable to disfigured ex-servicemen20 and we cannot adequately understand the function and position of photography in the postwar era if we do not consider that a facially injured ex-serviceman’s masculinity depended upon conformity to certain ‘goals’, such as ensuring economic independence, displaying gendered traits such as stoicism or physical strength and establishing marital and sexual relations. The site of the face is ascribed a cultural and personal value and sudden facial injuries had the power to undermine and alter ex-servicemen’s self-perception as well as his socioeconomic position. Disfigured veterans could be objects of disgust, as Suzannah Biernoff shows,21 and were commonly conceptualized in terms of what Heather Laine Talley argues ‘the specter of disfigurement’, the belief that disfigurement, coupled with the importance accrued to physiological functions of the face, signifies an exceptional ‘social disability’.22 Thus, the claim of facially wounded veterans to the heroically wounded masculine ideal
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was contested. The role of the photographic within disfigured ex-servicemen’s conformity to idealized expectations of the economic provider and family man, as well as masculine stoicism, allow us to better understand how they reestablished themselves in domestic life and interacted directly with the real and imagined destinies of disfigurement, situating themselves as family men, corporeally altered but nonetheless maintaining an intact masculine status and identity. Although forms of facial impairment might have been visibly present even in the remote towns and villages of Britain at that time, ex-servicemen would likely consider themselves a burden for their own family and community, destined to function simply as an object of pity and a recipient of charity. Yet, these men roundly rejected the idea of losing the social ability that facilitated their preferred performance of masculinity as a successful provider and a physical labourer. Thus, using family photography to validate the idea of a conventional association between masculinity and economic productivity started to thoroughly change how family members interacted with their ex-service partners and learnt ‘how to care’. The Great War marked a watershed in the public perception of disability, as well as in the words used to refer to physical ‘defects’. The sheer numbers of permanently injured soldiers who returned from the front line during and after the conflict made bodily impairment much more visible in society. Importantly, these bodies also carried a widely recognized patriotic prestige, which distinguished them from the disabled civilian.23 They were, in a sense, an ‘other’ that nonetheless wore a badge of honor.24 Their wartime service entitled them to forms of healthcare and social welfare that would otherwise be unavailable at that time in Britain, such as state-sponsored medical aid, rehabilitation, vocational retraining and war pensions. Driven by the idea that they deserved the gratitude and support of the nation for what they had experienced and what they had sacrificed during the conflict, disabled and disfigured veterans depended on a material and moral obligation for compensation as well as rights, assistance, and group recognition from governments and state authorities.25 In particular, the second part of this book seeks to disentangle the intersection between masculinity and facial difference by focusing on a series of contacts and encounters between the wounded soldiers and family members from the moment of their discharge from hospital. Through an analysis of these interactions, it is possible to grasp the complexity of the experience of adjusting to a violently altered facial injury, while it also allows us to reveal a range of reactions that those males evoked. Among others, this book draws on post-injury relationships to examine the type of emotions and desires that fuelled the dealings between
Introduction
9
wounded ex-servicemen and women. In addition, it will illustrate how and to what extent facially disfigured veterans negotiated and shaped their gendered identities. It will do so by paying attention to the interactions that took place in veterans’ households or communities of origin. We will thus observe a variety of intimate and social exchanges and emotional bonds that animated the individual and collective lives of those who had been disfigured, often severely, as a result of military service.
The photography complex The case of medical photographic services indicates that photography’s intersection with state-sponsored healthcare in wartime did not simply make it easier for surgeons and photographers working in the facial wards to communicate with each other, but, most importantly, it also transformed the form of their communication in a way that impacted on photographers’ perception of their own role within this process. As Shannon Mattern argues, ‘People have not been mere beneficiaries of infrastructure; they have actually served as integral links within those infrastructural networks’26 in ways that ‘create another role for individual and collective human agency’.27 In this sense, to be transformed was not simply what and how RAMC personnel of the Army Medical Services could communicate, but also the role of individual agency within such a modern infrastructural system. In order to explore this transformation, this book considers medical photographic services in the facial wards as sociotechnical networks that emerged from the confluence of everyday practices of surgeons, photographers and nurses, surgical and caregiving strategies and rehabilitation programmes and photographic materials. This means, in the context of my analysis, that the intertwining of people and modern medical communication and caregiving systems created the conditions for RAMC personnel of the facial wards to assert themselves as modern actors.28 Redefining medical photography makes thinkable the many ways in which visual technologies, processes, chemicals, materials and their production and interpretation – what can be referred to as ‘visual and material practices’ – connect to the experience of state-sponsored healthcare in wartime. I suggest it is helpful to conceptualize photography in the facial wards as a complex of interactions entwining the fields of culture, commerce, medicine, philanthropy, government and the military. This complex encompasses not simply photographs and photographers but also technologies, processes, chemicals and materials, markets, companies and
10
Photography in the Great War
institutions, as well as surgeons, nurses, military personnel, charities, families, publishers and politicians, all of whom are engaged with negotiating caregiving strategies and rehabilitation programmes for the disabled ex-service community. Historian James Hevia offers a further useful conception for approaching the complex interactions of diverse agents, institutions and technologies. In his consideration of the Boxer Uprising of 1900–1 and imperialism in relation to China at the turn of the twentieth century, Hevia draws from Bruno Latour to define the photography complex as ‘a network of actants made up of human and non-human parts’.29 For Latour, networks enable a different story of photography, one that avoids the problem of teleology, or the ‘asymmetry between the realizable and the unrealizable’, that plagues traditional photographic histories.30 Since photography was never simply one thing, it could not be realized as an original, unified conception. The crucial insight of Latour’s actor-network theory is that technology makes users as much as users make technology; in making this assertion, actor-network theory grants objects (including photographic ones) a degree of agency. Within this mutual entanglement of ‘humans and non-humans’, Hevia suggests, is comprised the camera and related equipment; negatives and chemicals, including gelatin emulsions and dry plates; the photographer and the subject that is photographed; transport, communications and distribution networks that deliver the image to the end-user; and finally the system of storage and preservation that enables redistribution of, and subsequent encounters with, the image.31 What is clear from his early-twentieth-century example is that ‘When put in these terms, photography seems to be more like a heading under which a range of agencies, animate and inanimate, visible and invisible are clustered’.32 The infrastructure of the Army Medical Services had created a new way for photographers to come together. This book thus investigates the influence that the RAMC had on photographic practices and, consequently, on the cultural production of what, I will argue, were emergent photographic networks. Whilst there are many aspects of the photography complex that might be examined, among the most pressing and fruitful is its caregiving dimension. In terms suggested by Hevia, we might, therefore, see the Medical Photographic Services in the war hospitals as a web of relations established between the RAMC, the government, the disabled ex-service community, surgeons, caregivers, policymakers, publishers, workers, families and even archivists, and sustained by the various practices and materials flowing across them. The intertwined relationship between war and medical care encompasses the working
Introduction
11
environment of the wards, photographic and X-ray departments, operating theatres, the medically trained, commercial, and amateur photographers, photographic manufacturing and the Ministry of Pensions’s rehabilitation programmes and the economy of family households and the workplace. These diverse performative practices are easily brought under the same rubric; they represent the material events and the currents of interrelated photographic practices and processes entangled in the caregiving for British facially injured Great War ex-servicemen.
War, medicine, photography and industry Business and industry shape the progress of conflict and the innovations of medicine, so too does war shape the development and direction of specific businesses and industries. Wars, as business historian Patrick Fridenson observes, are ‘major episodes in the learning of people and organisations, in the modifications of their representations, in the change of their products, markets, and performances, and in networks and trade associations’.33 The intertwined relationship between war, medicine and activity of the photographic industry encompasses numerous aspects: raw materials and chemical development and manufacturing; the adoption of pioneering war technologies to civilian markets (and vice versa); the connections between firms and government agencies; and the adaptation of civilian firms to business conditions in wartime, amongst others. However, both business and photography historians have largely overlooked the business of photography in the context of military hospitals of the Great War. Indeed, the conception of the materials of photographic industry as fluid events entangled in the production and performance of matter and the transmission of information need to be considered carefully in photographic history. As photohistorian Kaja Silverman observes, the conception of photography as a liquid intelligence, taken from Jeff Wall’s essay ‘Photography and Liquid Intelligence’ 1989,34 in which the production of images as well as the active role various liquid materials play in the respective photographic processes, is linked to the controlling power of technology and the modern attempt to master and oppress nature.35 Silverman argues that it is possible to develop a ‘wetter’ ethos by acknowledging the recurrent practical involvements with photography’s ‘liquid intelligence’, and invites us to interpret the concept both literally and metaphorically: ‘as a quality that liquids have and also as the fluidity of what we imagine to be solid forms’.36
12
Photography in the Great War
As she points out, the liquid intelligence of photography is associated with lability and incalculability, in spite of its mechanical ability to bring different kinds of movement to a halt in front of the lens. Here, practitioners’ interactions with the chemicals, emulsions, developing-solutions and photographic fixers during the process of photographic image-making raise questions of the bounds and dictates of technological constraint. The notion of photography’s intelligence as liquid and performing a fluidity in the world rather than being dry and static offers a potent means of recovering the histories, participation and viewpoints of marginalized groups in the facial wards. This liquidity not only reveals a form of visual encounter in which military power is not yet fixed but also uncovers how the economics of wartime presented opportunities for the expansion of markets and product development. At the outbreak of the war, Britain’s photographic processes were destabilized by industrial chemistry, and manufacturers were not in a strong competitive position with respect to European and American companies, being assailed on the one side by American mass production technology and sophisticated marketing and, on the other, by German scientific innovation.37 In the first two years of the war, photographic manufacturing in Britain was greatly affected by the disruption of imports from Germany, France and Belgium, which impacted on the supply chain of raw photographic materials for military needs. Before 1914, German, Belgian and French firms dominated the world market in gelatin photographic emulsions and raw photographic paper, both complex and specialized products.38 In Britain, small firms, most of them private, characterized the industry. Thus British firms were unable to produce a wide range of cameras, chemicals or most of the raw materials bound up with the supply of light sensitive products. These firms were a very long way from providing the cheap cameras and complete processing service, which accounted for much of Kodak’s success.39 These diverse instances demonstrate how state and military clients, consumer demand, market forces and innovation in the war hospitals help to shape photographic materials, objects, technologies and practices produced in the context of conflict. Whether the imperial strategy of the British Army; the collective drive of the RAMC; or the day-to-day pressures of the individual surgeon, photographer and nurse caught up in the extraordinary conditions of wartime, ‘the business of militarymedical photography’ must be considered as a decisive factor in motivating action and medical intervention. The mobility of raw materials, chemicals, or plates, prints and slides in the photographic departments and their unpredictable properties are an expression of infinitesimal metamorphoses of quality. Marcel Finke and Friedrich Weltzien
Introduction
13
argue that the fluids of such photographic practices possess characteristics and behaviours which necessitate particular ways of handling and precautions.40 Whilst most of the mutable and fugitive photographic materials come to a standstill in the course of production, drying and reifying into photographs, fixed and contained in order to stay in place and keep a preconceived shape, Finke and Weltzien remind us that these materials are always ready to overflow or break through their external boundaries.41 It is from photography’s ongoing processes and ‘generative fluxes’, they suggest, that forms and things emerge or arise, and since the productivity of these ‘currents of materials’ never really stop, forms and things are sustained only temporarily.42 But the camera also mediated the practitioner’s encounter with the patients and the wards. These medical personnel were consequently still at the mercy of the device’s liquid intelligence, and with the industrialization of chemical photography.43
Social, psychological and professional reintegration While Sophie Delaporte’s acclaimed study narrates facially injured soldiers’ experiences of surgery in France,44 Suzannah Biernoff ’s landmark account Shame, Disgust and the Historiography of War further buttressed facial injuries as an essential cultural reference point in ex-servicemen’s memory of the First World War.45 Attention in these works, however, is exclusive to the rapid changes in medical practices and impact of facial injuries and surgery while the workingclass private’s individual hardship is comparatively concealed. While the singleperson experience of veterans of conflict has been described as neglected figures in histories of war and medicine, the historical disregard of British Army veterans of the Great War has been manifested for those who had facial injuries and who were members of the non-officer class.46 Photography historians of the First World War accept a similarly overarching notion for its entire Great War veteran population. Only Biernoff, Marjorie Gehrhardt and Beatriz Pichel have engaged with the public visibility of facial mutilation and addressed questions of the social function of the face.47 This book expands these narratives with an analysis of eight facially injured ex-servicemen who returned to Britain and one to Canada. Biernoff ’s work has paved the way for analysing personal understanding of facial injury photography of the Great War, with the politics, ethics and emotions raised by historical medical collections of disfigurement being a prevalent case study for thinking through some of the responsibilities of care
14
Photography in the Great War
for the wider community who came into contact with badly wounded soldiers and their traumatized bodies and their views and projections on the soldiers’ present and future. Despite the significance of facial injuries as a cultural symbol of Britain’s involvement in the First World War, Gehrhardt offered the first indepth and exclusive analysis of the French and British soldier’s experience of disfigurement in 2015 to reveal the traumatic struggles of facially wounded Great War servicemen. While the importance of Gehrhardt’s work is undeniable, the under-appreciation of the postwar lives of facially injured veterans remains within the historiography. Only one other academic has subsequently engaged with a postwar analysis. Andrew Bamji’s work largely focuses on the postwar experiences of English veterans of Queen’s Hospital.48 This book is able to show how facially injured Great War veterans reclaimed visibility and masculine status, and exercised an agency which was denied them within wider understandings and cultural representations of disfigurement. In addition to perceived methodological shortcomings, the politicization of the memory of disabled veterans in Britain has influenced the absence of a postwar analysis of facially disfigured Great War veterans. With the heightened cultural attention and value ascribed to the male body, its destruction and reconstruction during and after the war, disabled ex-servicemen were represented as a symbol of patriotism and masculine heroism in the immediate postwar world.49 Injuries to the face, whilst part of this wider ideological framework, were also represented and interpreted in unique ways. The face is, at once, an important site of personal identity and social interactions, dictating how one is perceived by others and how an individual understands their own identity.50 Disfigured veterans could signify an exceptional and absolute removal from ‘ordinary’ human existence, but were at the same time exploited and perpetuated for the individual agenda of writers and journalists propagating a particular perception of the war, selling memoirs, in celebration of the medical advances of plastic surgery, or by institutions or philanthropic donors for fund-raising purposes.51 Presenting facially injured veterans as worthy victims was part of a postwar method of inciting pity for financial gain and charitable donations. The greater his independence an injured British veteran was deemed to have lost during his war service, the more deserving he was seen to be of social, financial and emotional support. Although despondent pity was presented as the natural and appropriate response to facial injuries, an especially awful experience rather than as a variation of human life,52 this discourse was complicated by explicitly gendered understandings of rehabilitation and the imagined need
Introduction
15
for masculine autonomy.53 Representing disfigured veterans as objects of pity worked to exclude sufferers from the narrative of heroic wounding and framed these individuals within the lens of passive disability. This representation was, instead, imprinted upon these men by observers of their injuries who failed to incorporate examples of ex-servicemen’s non-conformity or resistance to this narrative, and whose observations and musings, since wartime, have dominated the discourse of disfigurement. The voices of facially wounded veterans are conspicuously absent from this historiography. These wounded veterans were not offered generous or liberal compensation packages in Britain. Panels of the Ministry’s physicians carried out pension assessments based solely on the degree of physical disfigurement or illness and did not take account of a man’s capacity to return to work. Even the seriously disabled received pensions below the minimum needed for survival. Insufficient provisions for the disabled ex-serviceman provided a rallying cry for veterans’ organizations in the immediate postwar years. Despite meagre financial compensation and government failure to meet their needs, British veterans remained loyal to the King and state and did little to complain or lobby to secure their own rights. Throughout the 1920s and 1930s, political decision making in Britain shifted from legislatures incapacitated by the burdens of total war and inflation to powerful interest groups of industry and labour bargaining directly through new and influential state ministries.54 Charged with the task of arbitrating between industry and labour, officials in government ministries in Britain gained unprecedented authority. Although coming home was stabilized for wounded soldiers by the achievements of the state and powerful interest groups, the reality of the return was attained and maintained by the public. The Ministry of Pensions, ‘pleading fiscal stringency and adherence to the principles of sound governance’, sought to restrict the state’s liability for disabled soldiers.55 The reintegration of veterans into nonmilitary society also presented other challenges: difficulties in reconnecting with family members, in relating to people who did not understand what military personnel had experienced, in returning to a job and in adjusting to a different pace of life and work. The reentry, challenging for any serviceperson, was made all the harder when the veteran has suffered permanent physical or psychological trauma. The return to their households often exposed veterans to the distress of coming to terms with their own transformed body and functionality, as well as to the material and psychological uncertainties such transformations would probably cause them and their families.
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Photography in the Great War
Ethics and the archive Sophie Delaporte has observed that in contrast with veterans in general, the disabled left far fewer personal accounts of their traumatic experience and that ‘mutism rather prevailed’ among those who had been physically traumatized at the front.56 While war represented an exceptional period in terms of letter and postcard writing, times of injury, hospitalization and coping with permanent impairment are rarely, if ever, referred to in written testimonies. In the case of the facially disfigured, shame, fear, anger or difficulties in coping with the sudden disability may have played an additional role in their silence. Indeed, coping strategies in response to trauma varied from action-oriented to reflective, and from emotionally expressive to reticent. In contrast, members of the medical services not only kept records of their professional responsibilities but also annotated and photographed their activities, encounters and thoughts in daily diary entries, photographs or, later, in memoirs and albums. Red Cross nurses, who worked in close contact with badly wounded soldiers, produced some of the most revealing and instructive materials that shed light on wartime facial injury. Although imbued with assertive patriotism, thousands of medical photographs and bureaucratic reports assembled into official collections, preserved and catalogued in army museums, betray a horrified realization of the destructive nature of industrialized war as observed in the damaged bodies of male combatants, and placed at the disposal of medical officers as historical and educational sources for future study. A family descendant of the Great War pensioner Sidney Twinn recently stressed the importance for her grandfather in restraining from talking to anyone about his recurring problems: ‘With his mouth and nose in later life and his hearing… significantly impaired and his one remaining eye constantly weeping’. Despite the profound effect on the Twinn family, any pain and distress was kept hidden and not talked about.57 The dearth of relevant historical family source material further obscures British facially injured veterans. Approximately 4,414,202 enlisted in the British Army during the First World War in England, Wales, Scotland and Ireland. This number equated to around twenty-three percent of the male population. These recruitments statistics impacted upon subsequent veteran communities including the facially injured community. This case study of facial injuries utilizes a range of British sources to overcome these limitations. This book draws upon the Gillies Archive and the Army Medical War (AMW) collections currently held in the archives of the Royal College of Surgeons of England and the Museum of Military Medicine in Aldershot; the extensive collections of
Introduction
17
medical journals and textbooks held in the Wellcome collection and the RSM in London, and the Ministry of Pensions’s archival collection held at the National Archives of England and Wales in London. The British Army and the Ministry of Pensions established a system of national, regional and local war hospitals and administrative centres across the United Kingdom. In conjunction with medical societies and associations, private agencies, charities and employers, they administered pensions and medical care to the disabled pensioner.58 These institutional archival records provide a wealth of data dedicated to the disabled pensioners in Britain including those in receipt of aftercare and a pension for facial disfigurement. There has been opposition to using institutional sources as they have an inherent source-bias being written from the viewpoint of the non-disabled official interacting with the disabled person. As a result, they have been claimed to be inevitably one-sided in their account of the disabled, presenting them as depersonalized objects of institutional care. This book reinforces the thesis of Penny Richards and Susan Burch, who stress the importance of thinking ethically about historical preservation of sources, particularly in places outside of authority, in the relationship between disability and the archive.59 While recognizing the immense historical value of the institutional collections, consistently portraying an image of progress and professionalization regarding in-patient and out-patient care, and the treatment of facially injured pensioners and bureaucracy between local, regional and national medical and pension staff, the family source material and popular periodicals like the Amateur Photographer reach into the personal and everyday details of domestic life in ways that distilled, official sources cannot. It is also possible to grasp the complexity of the experience of adjusting to a violently altered face through an analysis of local newspaper articles to integrate the records of the British Army and the Ministry of Pensions, including its policymakers, welfare officials, medical practitioners and pensioners, alongside charity records, patient case file records and family archives. These materials give the facially injured veteran community the chance to show their struggles in relation to postwar recovery, and can even, often, contradict institutional archives in important ways. Private photograph collections present a particularly valuable, but generally underutilized, source base for medical historians. Their identification and access can be problematic. Nevertheless, I have been able to locate and correspond with surviving relatives of many facially injured ex-servicemen thanks to the support of the honorary archivist of the Gillies Archive, Andrew Bamji, who kindly passed on the details of several family members who have made contact
18
Photography in the Great War
with the archive over the past two decades in search of their ancestors’ wartime experiences. Through intimate dialogues with eighteen families associated with the Gillies Archive, I chose to follow eight families in particular because of their compelling postwar stories of strength and resilience and whose ancestors’ lives were left thoroughly upturned as a result of their wartime injuries. These families present the impact of the Great War on the bodies and minds of the men who fought but also the difficult return to family life and the struggles some families relatives experienced when readjusting to living and raising their children together. In the narratives of these intriguing histories, family materials show how particular meanings of scientific possibility and postwar recovery became naturalized, and as such can be linked to issues surrounding the pressures imposed on these families to return to established gender and economic ideals and norms of bodily functionality. To understand the emotional toll of first-generation war victims on medical staff, friends, siblings and later generations, it is crucial to understand the way in which they and other family members coped with their condition, and how descendants became attuned to the emotional state of their elders and developed a heightened awareness of their needs and dependence. This is especially so when those experiences were more present in historical subjects’ everyday lives than in a medical file or journal page. For example, the photograph featured in Figure I.1 illustrates the Butcher family in Oxfordshire celebrating Jill Dewhurst’s christening in 1949. While this work in retrieving personal stories of facial difference may stir questions of privacy and ownership and an alertness to the materials that have been lost, hidden or destroyed, they also challenge dominant and oppressive narratives of facially injured servicemen and takes a step towards recognizing the ways this community lived outside medical collections and admissions records. ‘The family ties that bind these materials are characterised by a constant confrontation with suffering, questions of ownership or (a lack of) control thereof.’60 Nevertheless, one of the possible limitations and bias is that soldiers whose reintegration was less ‘successful’ are less likely to have left family photographs or personal papers. As a consequence, the surviving family sources add to an over-reliance on affluent disfigured servicemen who had a ‘successful’ family life and whose relatives wanted to not only take photographs, but also preserve them. The family sources sometimes also contain pension receipts of individuals who were assisted by the Ministry department. Family sources include a host of relevant information including on men’s employment, domestic arrangement and conduct in civilian society. Of course, each pensioner’s life and understanding of facial injury would have been a subjective and individual experience.
Introduction
19
Figure I.1 Butcher family christening, 1949, photographer unknown. Reproduced by kind permission of the Dewhurst family.
Recontextualizing the collections of pensioners like Butcher with those of the wider population in periodicals helps to portray successful and unsuccessful attempts of postwar recovery, the propensity to struggle in times of financial
20
Photography in the Great War
and personal adversity, the importance of domestic caregiving, the stigma often associated with facial difference and the veteran’s acceptance or exclusion from society. The family records provide rare insight into the experience of facially injured veterans who returned to civil society. By the mid 1920s, British disabled veterans witnessed the bureaucracy of the Ministry of Pensions, widespread unemployment, a lack of treatment facilities, long waiting lists and stigma. This study thus compares how facial injuries impacted on men’s civilian life and how the state attempted to rehabilitate and compensate them for their disabilities. In addition to facially injured exservicemen in Britain sharing experiences, a consideration of personal and intimate accounts of war-induced facial disfigurement also helps to foreground differences in their reintegration and recovery depending on their family networks and employment opportunities. This study extrapolates a fuller picture of postwar life via an analysis of the underlying anxieties of medical care including information regarding the slow and difficult recoveries veterans and families endured, how relatives adjusted to the specific challenges posed for veterans returning to the home and workplace, and at times vital clues to whether they supported or complicated men’s reintegration. This information helps to provide ex-service biographies and a voice to the previously marginalized. This methodology is not without its challenges. An awareness of how and why certain sources and collections exist, whether and where they are preserved, and making transparent the ethical issues involved in engaging medical photography in archival and research practices bear witness to a present day self-reflexive attitude and sensitivity towards privacy rights, confidentiality and data protection laws, as well as to the public and relatives of deceased patients. Historical medical photograph collections are sensitive materials.61 When such images travel from private to the so-called public sphere, there is a violation of privacy at play and so we have a duty to stage these stories responsibly and be mindful of the risks that publicly available medical images may entail towards the patients’ descendants. These privacy concerns play a vital role in the public display of the historical medical photography. Ultimately, to decide how to engage the medical photograph collections in the archive and museum is to make a moral judgement that in itself requires care – care in the form of reflection and critique. The limited engagement with the experience of warrelated facial injury echoes the troublesome nature of medical images and the consequences of public access. With respect to ethical obligation towards the ex-servicemen and in a time of growing interest in privacy concerns towards the use and abuse of personal data,
Introduction
21
discussions about medical and family collections should be seen as mutually historically situated and can deepen our understanding of privacy rights and medical ethics. There must be an awareness of these sensitive materials as complex yet similarly worthwhile and valuable to be shown outside of their medical culture. This book is therefore concerned with the ethical ‘whys’ of historical research, not only with the pragmatic ‘hows’. It is not enough to explain how to locate and engage the private and intimate accounts of facially injured British veterans. There is also the question of why – why is it difficult or easy to find certain kinds of materials; why are we reading the medical records of disabled veterans? While the family collections and the stories passed down through the generations may not be catalogued objects, have not been considered as recorded interviews as part of an oral history project and are not first-hand written accounts backed up with archival credibility, they challenge us to think about the ways in which institutions define the boundaries of what is recognizable as part of a collection. Elizabeth Edwards and Sigrid Lien acknowledge just how blurred these boundaries really are.62 Although informal family archives are outside and not of the institution ecologically, the dynamics must be perceived as significant. Indeed, they are invisible. Edwards and Lien’s concept of ‘the photographic ecosystem’ can be used to think about the perceived interconnections and relational actions across practices and collections, as it extends externally out from the institution to others outside the museum or archive, as photographs are distributed and shared. The families of facially injured veterans are part of this ecology. Due to the nature of a museum or archive’s ecosystem, and the valuing of photographs, the boundaries between ‘official’ medical collections and ‘informal’ family collections are often porous and difficult to defend. If we are to write our institutional ethnographies, our histories of material practice, our biographies of objects, this ecosystem is central – the relations between medical collections and family collections have historiographical impact. Despite the family practices being outside the patterns of institutional collection, according to their attributes, provenance and archival undervalue, as ‘informal archives’ accrued through day-to-day domestic life, they make crucial the continuation of care ‘across a multiplicity of agencies and materials’ to support ‘a thick mesh of relational obligation’.63 Adopting this methodology validates Biernoff ’s argument that the historiography of the working-class facially injured serviceman carries ‘a burden of care’ and should be handled with responsibility.64 This re-evaluation applies equally to those who returned to civil society in a fragile state of health and
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Photography in the Great War
to the sensitivity of their family archives. This study does not profess to tell the complete story of these men’s lives. In many ways, the everyday reality of facial disfigurement remains hidden history with descendants of ex-servicemen continuing to struggle in the private domestic sphere. This study instead demonstrates that it has been a mistake to assume the facially injured British Great War veteran remains silent and untraceable. Chapter 1 establishes the emergence and early history of facial injury photography of the Great War as embedded in broader changes concerning medical communication to keep pace with thousands of wounded soldiers being admitted for rehabilitation. How photography governed the behaviour and actions of surgical teams in these departments, however, was unique. This chapter determines that the advent of French facial centres and the introduction into the wards of easy-to-use portable cameras and improved light-sensitive plates marked an expansion of communication in surgical practice. Hand cameras brought with them a newly mobile way to visualize a patient’s everextending treatment and allowed wound care teams to track and manage progression over time. The opening chapter also explains how the divergent but latterly overlapping skills of medical, commercial and amateur photographic practices, and industrialism and imperialism more broadly, with respect to speed and technical processes, raised new concerns and questions about the ethical protocols surgeons were duty-bound to implement. The workflow of photographic activity in the wards was far less exclusive than historians have previously recognized and accomplished by very diverse practitioners. Commercially trained photographers and even amateurs, subsidiary hospital workers and darkroom assistants effectively excluded from the inner sanctum of Royal Societies could produce photographic work for these departments as long as it was constrained by the more formal confidentiality and privacy laws of the medical societies for ethical rigour. This chapter sets the groundwork for the proceeding four chapters as the government’s denial of facially injured ex-servicemen’s right to visibility and proper compensation continued to permeate the relationships between disfigurement and social isolation in postwar Britain. Simultaneous to the continuation of such societal judgements, this chapter also recognizes the establishment of the Ministry of Pensions and its subsequent rehabilitative attempts on behalf of disabled soldiers in Britain from 1916. Exclusive inpatient and out-patient reconstructive treatment was offered in a small number of specialist facial hospitals throughout Britain. This network of experimental
Introduction
23
surgery, photography and new forms of aftercare and therapies were progressive and innovative. Chapter 2 demonstrates the relationship of that infrastructure in the wards to the meeting rooms of the RSM. The RSM, as a hub of research and education in England and with its multidisciplinary membership, became active in lantern projection, circulation and popularization as a scientific teaching practice in First World War Britain. From the interactions it fostered between groups of surgeons during dialogue to its mobilizing of their visual experiences of facial reconstructive surgery and related photographic practices in the wards, the projection services that were made available at the RSM between 1914 and 1919 enabled collaborative and contested debates in immediate exchanges of information and coordinated research from the facial departments and thus a flourishing scientific knowledge community. A study of the RSM library and archival collections demonstrates the lantern and the camera being referred to in conjunction with each other during this historical moment. Further medical journals from the Wellcome collection also reveals that during the war the lantern was received as an extension of photography and toward successful simulation of the spatial and temporal contingency of medical vision. The second chapter examines the care undertaken by the RSM to organize groups of photographers at national level. Ultimately, the RSM was a major institutional catalyst for the development and operation of lantern technology in surgical communities during the Great War, producing modern medical thinking and a cohesive imagined collective that wished to use the camera apparatus in the wards in new ways. The book’s perspective then shifts to domestic practices of recovery of facially injured ex-servicemen. Chapter 3 has a dual geographical focus and examines the nuances and contradictions with Italy to emphasize the impact of underfunding on the economies of labour in the photographic departments of facial centres. The system of care for the facially injured in Italy was, in comparison with the other countries, still in its rudimentary stage.65 The treatment of facial surgery in Italy was much different to Britain; their subsequent experience of rehabilitation and government policy infrastructure was less of a shared one. On her entry into the war in 1915, Italy had almost no hospital facilities for rehabilitating its wounded servicemen and very few social organizations competent to undertake the work. This chapter asks what we can learn about the alternative health care therapies of amateur photography that were practiced in British and Italian wards by nurses, to recuperate young soldiers during convalescence. Drawing
24
Photography in the Great War
in particular on the photographic press and the private photography of hospital workers tasked with caring for the facially injured between 1915 and 1919, this chapter examines the significant but overlooked personal contributions to patients’ health and wellbeing. British and Italian Red Cross nurses experimented with amateur photography as coping strategies to deal with depression and the psychological illnesses resulting from facial wounds. Despite the scope, complexity and novelty of the war hospital networks established during the First World War, the function of the camera to rekindle men condemned to lie in their beds week after week, smothered in bandages, unable to talk, taste or sleep and maintain their health and wellbeing during long convalescence has escaped scholarly attention. Chapter 4 focuses on the psychological impact their homecoming would have had on returning British Great War veterans. The opportunity to work and provide for oneself was a fundamental component in the Ministry’s rehabilitation of disabled pensioners. However, in addition to the stigma regarding facial difference veterans and their families refused to be rendered invisible and thus approached family photography under the rights and entitlement of a ‘honourable war’ fought by a civilian army. The results achieved in this manner are of surprising acts of care. These aspiring family photographers practiced acts of care engaged in much more than a moral stance. Insofar as the affective and hands-on agencies of these practices can be discerned, they express a continuation of care and emphasize an interconnection and interdependency in spite of the aversion to ‘dependency’. This section addresses an omission in the historiography with few facial injury studies extending beyond the initial postwar years. These family practices coincided with the infamous ‘Geddes’ Axe’ enforcing a host of tax increases and economic cutbacks in the British public sector. The austere management of public economies included the Ministry of Pensions’s domestic policy; from 1922 onwards, there was a dramatic restriction in pension outlay and a reduction in exclusive Ministry-run medical facilities including the provision of progressive and innovative surgical treatment. Facially injured veterans were largely ‘pensioned off ’ with meagre state intervention in their recovery and reemployment. Utilizing contemporary photographic periodicals and welfare publications, this work situates the family amateur photography alongside the other therapeutic practices established for solace and recovery. Utilizing the family archives of ex-servicemen, alongside the texts on amateur photography and pension support for the broader ex-service community, the daily family activities celebrated and photographed emotional relationships to give a visual and material body to abstract concepts such as
Introduction
25
postwar healing. The ex-servicemen’s family status would, nevertheless, prove crucial. The years after 1918 were witness to an aspiration for healthy futures and regenerative hobbies as well as reforming kinship bonds and self-identity in an uncertain postwar era. Their photography of the era, grounded in their moral beliefs, and the long-term needs of veterans and how it was managed, envisioned men and their families working on behalf of a new society. They engaged these practices at the time when the labour community was struggling to re-emerge in Britain, and they depict families and community connections in formation, in a project that insistently seeks to refute the market forces that were dismantling such relationships and communities. Chapter 5 offers an analysis of the thousands of medical photographs of facial wounds suffered by men on active service and assembled into AMW collections by the RAMC and bequeathed to national medical and army museums and archives from the 1920s onwards. With facial disfigurement classified attributable to war service, soldier-patients were identified as sensitive with the added protection of legal and ethical obligations to restrict such material to their working context because of patient rights and data protection. This chapter argues that being legally recognized as facially disfigured as a result of war service was the most influential force in dictating the institutional practices of collecting and the complexities and implications of these medical collections. In the late 1980s and early 1990s, partly in response to safeguarding in the public interest, the British collections were transferred from army museums to betterresourced institutions, travelling from closed holdings within a military-medical context and becoming more widely accessible. There were, nevertheless, notable management challenges of public access and sharing constituted through what might be described as ‘secondary level’ ethics of care. The ecosystem extends externally out from the military-medical institution to others outside the archive, as multiple originals or duplicates of a photograph can be found in several collections, weaving and travelling through the social, cultural and commercial entanglements that shape and are shaped by photographic practices. A study of the dense genealogy of ‘caring for’ and ‘protecting’ the privacy, consent, confidentiality and anonymity of these ex-servicemen after their service provides crucial insight into how surgical teams, pension officials, archivists, curators, historians and family members helped to shape the daily lives of disfigured ex-servicemen. Ultimately, there was not a collective understanding of facial injuries amongst medical and family communities of the First World War. To better comprehend the postwar experiences of these forgotten men of British history, this study
26
Photography in the Great War
considers how facial difference was culturally, politically and socially designed. It seeks to understand how British society understood facial difference amongst their service populations, and how medical and pension officials comprehended and interacted with facially injured veterans in Britain in comparison to family members and the wider community. An objective bureaucracy did not always shape practices of recovery. Instead, facial injury and postwar reintegration was a social and cultural experience which was significantly underpinned by political, ethical and moral concerns. The stereotype that the facially injured were predisposed to psychological trauma and socioeconomic hardship continued to permeate in the rehabilitation of ex-servicemen in Britain throughout the inter-war period. This narrative impacted upon the reintegration of wounded pensioners in civil society. An analysis of this lingering narrative foregrounds the crucial variable in family and workplace that has remained overlooked in previous studies into facially injured Great War veterans in relation to selfhood and socialization. This consideration echoes a recent trend within the medical humanities considering the ways in which claims to full social personhood can be, and have been, damaged by looking different in history (through birth ‘defects’, disease, deliberate mutilation or injury).66 Connecting the histories of the British Army, RSM, Ministry of Pensions, individual pensioners and families and the photographic industry, this study delivers a new perspective on photographic history and the medical humanities with an analysis of a previously unaccounted for community. This book reclaims the facially injured Great War veterans and gives them a voice often denied in their own lives. In addition to recovering these forgotten men of British history, this work situates itself within broader photographic and collecting histories centred on new propositions for museums or archives to extend an ecosystem out from the institution to other communities outside.67 Amidst this, the status of the First World War medical photograph collections of facially injured soldiers is seen as precarious and collections management systems must respect the sensitivity of the wider communities who are linked to these specific photographs. With public access to these medical collections, relatives of the injured and disfigured ex-servicemen that were photographed by the Army Medical Services have been taken up in the business of memorialization and reclamation.68 These family practices, and the resulting remediation of museum and archive space within community members’ personal connections, historical knowledge and medical heritage, lead to a further challenge of dominant public histories and to criticism
Introduction
27
of the often limiting context of the institution. Released of contemporary medical relations, these practices contribute to the wider concerns and questions of visibility and occlusion, consent and complicity, of not showing, and about what is publicly present, and to fundamental questions about ‘how to care’ and ‘who has the right to re-present’ in the aftermath of the First World War.
28
1
The wards with no mirrors: RAMC photography and the new era of medical communications
In her story of an injured corporal at the Cambridge Military Hospital, nurse Catherine Black recalls that mirrors were not allowed in the facial wards, although, they invariably found their way in. ‘Mirrors were prohibited in that ward, but to my dismay I found the corporal in possession of one that evening. None of us had known that he had a shaving glass in his locker.’1 Medical staff saw the protection of these patients from unnecessary emotional distress as vital to the rehabilitative goals, and prevented them from seeing their own faces for weeks, even months. Corporal Ward Muir, who worked at the Third London General Hospital, provides a detailed description of the pain and embarrassment felt by facially injured soldiers in the ward. According to Muir, the main emotion associated with facial disfigurement is shame. ‘He is aware of just what he looks like: therefore you feel intensely that he is aware that you are aware, and that some unguarded glance of yours may cause him hurt.’2 In one of the few first-hand testimonies available, British soldier Percy Clare recalls that when he first saw his face, he ‘received rather a shock’.3 Yet the photography for producing these facial injuries for the surgical community was becoming increasingly prevalent in the wards. Unlike banishing mirrors to render these injuries invisible, in order to bring the image of facially injured soldiers into conformity with the one the British Army wanted to obtain, or even to have some sense of the one that surgeons were likely to receive, medical photographers were obliged to open the camera shutter and look intently at these injured and disfigured patients without embarrassment. The patient could only imagine what he looked like at the moment of the plate’s exposure. The demand for medical photographers in the facial ward was at the centre of a much larger debate within the RAMC in Britain at this time. Army Surgeon-General Alfred Keogh raised issues of organization and highlighted
30
Photography in the Great War
the benefits of administrative measures within the surgical profession. By 1916, the RAMC was beginning to turn its attention to matters of organization, leaving specialist medical experts made up mainly of civilian practitioners to focus on the technical work and general care of the sick and wounded, including the employment of medical photographers specially detailed for the task.4 The organization of surgical practice along administrative lines promoted scientific research and enabled medicine to deal with and solve new problems as they arose: Experience has shown, and continues to show, that in such departments research is encouraged, and knowledge acquired and diffused more readily than could otherwise have been the case. One cannot avoid an uncomfortable feeling that if hospitals in civil life had been organised on such a plan, a higher efficiency would have been manifest at the outset.5
The British Army transferred a great deal of responsibility on to surgeons and medical officers in an effort to set the standard for scientific investigation of war injuries. The surgeons had to establish practical methods of organizing and disseminating the identification and classification of war injuries. Although Keogh did not refer to any particular means of visual documentation recording the treatment of patients, the Army Medical Service photographers played an essential role in the recording of wounded soldiers during rehabilitation. As part of their activities, the RAMC sent photographers to every war hospital in Britain. The role in the surgical reconstruction process of photographers not only provided visual documentation recording the evolution of the treatments but also actively contributed to the planning of surgical procedures. The collaboration between photographers and surgeons was a key aspect of the wartime reconstruction of mutilated faces. The RAMC photographer’s treatment of facially injured patients initially pursued an ethos of attaining simple observations. The unpreparedness of the RAMC to accommodate facially disfigured soldiers, and its lack of qualified medical photographers to provide sensitive and comfortable surroundings when taking photographs, quickly became evident.6 A congenial environment and good interpersonal skills thus became crucial in the redress of this imbalance with a facility headed by sympathy and compassion. As RAMC photographers did not receive teaching in professional societies for the treatment of soldierpatients with facial injuries, they would have underwent training by medical officers in residence including for photographs that were to be used in medical boards to assess pension claimants. The RAMC was proactive in training new medical staff, even including articles in medical journals requesting that general
The Wards with No Mirrors
31
surgeons transfer any facially injured patient in their surgeries to them for treatment by their practitioners in training.7 The analysis of the medical photographers of the RAMC as a profession and their role in the facial wards in this chapter will focus specifically on the use and development of photographic services between 1916 and 1925 for two reasons. This was a period in which medical practitioners viewed their specialist task as that of developing new forms of accessible experimental surgical techniques. A new demand for delivering systematized case taking of the most up-to-date results of surgical repair and its operations generated a growth of photographers with access to a variety of photographic technology and processes. Good quality photographs could be taken within fractions of a second and with ease of convenience. As the president of the Section of Odontology explained on 22 October 1917, ‘In the better equipped hospitals the machinery for carrying out such a system already exists, in others it does not, and I would ask anyone who has to do with the organisation of a hospital or department for the treatment of jaw injuries not to fail to demand it.’8 Yet this could only be carried out if the surgeon was provided with adequate assistance, directed to economize his own time. The president of the Odontological Section was pointing to an important question in the specialist facial centres concerning the military economics of restoration, using a broader political debate about government subsidies and public expenditure to reflect a value for photographic services in the facial wards. This chapter will focus on the photographic departments in war hospitals which gained an elevated status as a technology of communication. In doing so, it will explicate the ways in which the camera became much more than a mechanical device brought to life by the photographer to represent and transmit pension claimants. The camera mediated and produced the photographer’s and the surgeon’s encounter with the patients in the ward – while also complicating the duties of care towards them in other ways, transgressing the body in ‘intensely vulnerabilising’ ways and violating the ‘emotional and psychological boundaries of the patient’.9 The complex experimental surgery and aftercare provided by the British Army and Ministry of Pensions required informing the ex-service patient of any potential risks involved in his treatment and obtaining consent to perform a procedure in advance. In both civilian and military practice, surgery without consent was illegal in this period. Surgical teams had to deal with the relationship of informed consent to the elite British Medical Association (BMA), RSM and Royal College of Surgeons (RCS). It made much sense, therefore, in such a historical moment, for surgeons to reflect upon and debate the proximity of these underpinning tensions in military welfare to legal procedure as photography
32
Photography in the Great War
rebalanced certain material approaches to and interventions on the body. The camera capitalized upon dissatisfaction among the new professional audiences within the elite medical societies and their working conditions. Photography’s challenge to the limitations of informed consent to experimental surgery was attested by its immediate application to military service and state and public-sponsored medical care. Each new element in the labours of patient welfare brought to photography impacted directly on the environment of the surgeons and photographers who were working with the technology every day. The role of photography within the politics and economics of state- and publicfunded aftercare for facially injured soldiers raised new concerns and questions about navigating these wards and the ethical protocols the practitioners were duty-bound to act. Thus, the ethical dimensions of this professional group within the medical press represented the opinions of departments of the facial centres expressed through the practices of surgeons and photographers. Alongside this, the presentation of working protocols in society meetings and the pages of medical journals helped to establish a community of scientific professionals who attempted to mediate and contain the rapid growth of photographic technology and a new medical ethics. Whereas publication in a medical journal required a professional author to persuade an existing fellow of the RSM or medical officer to read a paper from a society meeting, the complex photographic production and copying activities in the wards and darkrooms were far less exclusive and accomplished by very diverse workers. Some of these labours were performed by elite medically trained photographers, others non-elite commercial or amateur. Some started out as commercial or amateur, but then evolved into medical photographers. One of the surgeons even harboured international aspirations for his photographer. In 1919, Harold Gillies received an invitation from his American colleagues to give a lecture tour of surgical-dental meetings for the American Dental Association. The following year he sailed from Southampton ‘with seven hundred lantern slides all neatly packed, but after the baggage men had dropped them off the ship… they were soon a shaggy bundle loosely held together with string’.10 These slides demonstrated a position of credibility for Sydney Walbridge, who carefully prepared, annotated and boxed them, but Gillies’ first lecture in Boston was delivered without a slide, as by some mishap they were sent on to Chicago. While there is no evidence of how many were employed in the facial departments, these environments serviced a complex division of labour, including photographers, assistants and darkroom workers, effectively excluded from the inner sanctum of Royal Societies. Moreover, these labour tasks were
The Wards with No Mirrors
33
constrained by the more formal confidentiality and privacy laws of the medical societies for ethical rigour. Photography was essential for keeping pace with the flood of casualties and pensioners being admitted to British war hospitals for rehabilitation and the rapidly escalating need to train surgeons to be ready for them. That essential service manifested itself not just in economizing a department’s time and labour but also in the way in which photographic practices and processes were used to present the shear mass of patients being admitted into facial wards, which could mean the difference between success and failure. Surgeons could consult their patients and photograph them very quickly, and adjust working methods accordingly, before the next similar case came along. Instantaneous photography in the wards, which carried an assumption of directness and spontaneity of observation, met the aims of the surgical agendas because it was seen to enable the immediacy of scientific intervention. Yet equally important as the material presence of photography was the discursive and legal questions relating to medical practice through which photography was discussed by the RSM. Thus, for the society meetings and medical press, the implications of the weekly evening discussions of photography, or – as will be demonstrated in Chapter 2 – the surgeons’ performances of explanation, were intimately linked to the ethical protocols which were always playing catch up with technology and processes. Andreas-Holger Maehle and Johanna GeyerKordesch reminded us in 2002 of a critical division at the core of modern medical ethics, especially when it came to debates surrounding complex science and the problems of technology adoption. When new technologies, like photography, come into play, they create new ethical dilemmas. ‘What may not keep pace with the rapid quest for medical advance is the debate about it’ or the formation of appropriate working protocols.11 Medical ethics, as Maehle and Geyer-Kordesch point out, lag behind the sociotechnical changes at a time of rapid innovation and fast moving and unanticipated crises. Only after addressing the ways in which the practical outcomes of complex facial reconstruction were talked about textually can we understand how the ethical implications of photography were developed in relation to wartime healthcare, social welfare, privacy rights and consent.
Financing the facial wards The Ministry of Pensions was established in 1916. Initially administered by local and mostly volunteer Local War Pensions Committees, arrangements were made
34
Photography in the Great War
to provide financial recompense and medical treatment to disabled veterans. Each committee consisted of around 25 primarily volunteer members with over 300 committees in operation in March 1918.12 With physical disabilities like facial injuries, pension payments generally followed objectively verifiable guidelines. The expansion of the facial wards in British war hospitals from 1916 coincides with the establishment of the Ministry of Pensions to award pensions to those disabled by the war, to look after their care and medical treatment, until such time if ever they were fit to return to civilian life. The Ministry department compensated disabled veterans depending on the severity of their disability. Pensions ranged from 20 per cent awards for the loss of one finger on each hand to 100 per cent pension for the loss of two or more limbs or severe facial disfigurement. The Ministry also provided exclusive rehabilitative and medical treatment for the Great War pensioner. Ministry intervention was at its zenith in 1921, with almost 1,200,000 ex-service pensioners. Segregated hospitals operating throughout Britain offered nearly 150,000 veterans specialist inpatient and out-patient treatment for a range of war-related conditions.13 The public lobbying for political rights on behalf of veterans was influential. Ministry archival documents during its formation during the Great War repeatedly refer to ‘popular sentiment’ and the political necessity to increase generous provisions to returning ex-servicemen.14 A moral claim to care for and compensate facially injured veterans also arose. The development of the new photography in the facial centres was intimately tied to government and public finances, which shaped the British war hospitals facilitating complex and experimental surgery and aftercare. The establishment of photographic departments and their ability to capture faster patient admissions and surgical treatments augured well for the British Army’s bureaucratic record keeping and a medical culture based on the communication of information. In this emergent context, the performance and position of war hospitals within the medical community was of great importance to their claim to surgical credibility. State and public expenditure, in particular, had significant investment in the expansion of the use of photographic services as scientific and technological resources. This investment, articulated through the organization and medical duties of hospitals like the King George V Military Hospital in London (1915–19), was significant in the context of photography’s association with the notable researches in the jaw departments. Through a combination of imperial, national, financial and technological developments, including increased funding for research, the facial centres that epitomized impressive surgical breakthroughs and developed the best photographic services were those
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35
which received the largest amount of public financial support and War Office subsidies. These centres generated enthusiasm and funding opportunities for surgeons who would put the Ministry’s goals in context, pursuing rehabilitative aims that bolstered their teaching hospitals. The differences between hospitals and the background of the photography departments can demonstrate how the most innovative treatments manifested within the facial centres that received the most private funding. There is an indication that the hospitals with the most innovative treatments were the ones where photography departments were already established or the most developed to record innovations. In July 1915, jaw patients began to be concentrated at the Croydon War Hospital, where they were transferred to its Stanford Road section, which was effectively the first special jaw centre in Britain.15 Under the command of this centre, the stomatologist James Frank Colyer treated a small number of British soldiers between 1915 and 1919. The RAMC hospital consisted of five buildings scattered over the district of Croydon, the total number of beds being about 1000, including a division containing 166 beds entirely devoted to jaw injuries.16 In contrast with other war hospitals, the Croydon jaw centre was less well supported by public expenditure. The hospital did not make important advances in connection with facial injuries or photography and turned to commercial photographic services for particular jobs, asking volunteers to undertake the technical work on a regular basis, and as a more cost-effective alternative to purchasing cameras or radiography apparatus for medical staff. Despite radiography being an essential element of dental practice, the Croydon Hospital was not equipped with special radiographic apparatus, and its staff was at a loss without such technology, Colyer wrote.17 In November 1917, Harold Gillies moved from the Cambridge Military Hospital to a purposely built facial centre in the grounds of Frognal House, Sidcup, accommodating 1000 beds for injured patients.18 Gillies and his team sustained photography in a productive way and were able to organize and systematize practice without it collapsing. A specialist hospital for facial injuries of this nature had to contend with very heavy expenses. During the period when its existence and, moreover, its constant expansion was of first importance, the cost of all materials was very high and its budget tended constantly to increase.19 The operating theatres, photographic, radiographic and treatment rooms, together with the dental mechanical workshops attached to them, were all equipped with every modern apparatus. The progress made in special branches of surgery and aftercare treatment in all the British Ministry of Pensions hospitals involved necessitated a constant outlay in this direction in order to
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Photography in the Great War
keep pace with increasing patient admissions and the innovations being made and the improvements suggested.
Organizing photographers The evolution of photography in the facial wards is imaginable on the basis of two stages: the first was the hodgepodge phase of photography before its professionalization, as the medium engaged in a process of ‘discovery’ through various trials and practices. On the other hand is the phase of relative institutional awareness and cultural production proper. The ability of photography to encompass the ethical protocols and conventions for communications that enabled them to be useful in the facial centres constituted an uneasy equilibrium, constantly in flux. But the importance of these new caregiving practices and processes in coming together to crystalize and harden into its institutional shell becomes clear when comparing the ways in which Albéric Pont mobilized photography in Lyon with the photographic services of the KGH and Queen’s Hospital in Britain. In September 1914, the French stomatologist Albéric Pont established the first maxillofacial centre for facial injuries with thirty hospital beds in Lyon. Pont took a prominent role in dental surgery in the early years of the war, and saw photography as a way to renew and to improve his orthodontic practice. By 1915, the Ecole Dentaire (Dental School of Lyon), which he had created in 1899, was transformed into a care centre housing 800 beds to accommodate the facially injured soldiers sent to Lyon.20 Under the direction of the Centre Maxillofacial de la XIVe Région, Pont treated 7,000 facially injured French soldiers between 1915 and 1918. The patients were photographed seated, wearing military uniform or the ward clothes: sometimes upon a plain wooden chair, or at their beds and draped in a white sheet, in front of a screen or interior wall, or in the consulting room, sometimes even outside and against an exterior stone wall, looking at the camera, or at a three-quarter angle, or sometimes in profile.21 The Lumière laboratories manufactured the ‘extra-rapid’ quarter-plates exposed in Pont’s centre (see Figures 1.1, 1.2 and 1.3). All three of these plates were made by the Lumière company, also based in Lyon, as ‘blue’ plate products which improved gelatin silver emulsion sensitivity significantly. These ‘rapid’ and ‘extra-rapid’ glass plates brought a revolution in hospitals, essential for charting the daily changes in a patient’s condition. As the Lumière’s ‘blue label’ plate became more popular among photographers, production increased from a
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37
few thousand a year to more than one million a year by 1886 and fifteen million a year by 1894. By the 1890s, the Lumière company was one of the biggest manufacturers of photographic materials and one of the principal producers globally. By 1914, the manufacture of gelatin-based photographic emulsions had
Figure 1.1 Glass photographic plate from the Albéric Pont Collection, 1915–18, 90 × 120 mm, photographer unknown. Reproduced by kind permission of the Archives of the Bibliothèque Interuniversitaire de Santé, Paris.
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Photography in the Great War
become a massive business dependent on the industrialized slaughterhouses and the large-scale processing of animal materials like hides and bone to shorten the necessary exposure times and contribute to the development of high-speed photography. The photography produced in Pont’s facial wards was a theatrical process, and at the time of exposure the positive print could only be imagined by the photographer or surgeon – the sense of meaning only emerged when that negative was printed. For the patients being photographed, the final print may not ever have been encountered. Photographers could capture on the plate’s surface a patient’s condition that would appear only momentarily in front of the surgeons, seizing moments that were previously inconceivable because thousands of patient admissions would have been impossible to isolate in direct observation. The plates would have been difficult to read at first because they not only reversed the tones created in the initial exposure but also made visible aspects that had never been seen before – like the swelling and dribbling of an immobilized jaw soon after injury. Exposing the glass plates was only the beginning of the photographer’s trials and tribulations. Their complexity made them difficult to predict and control. Indicative of the challenges were the problems liquids posed for photographers in the production process, which were rooted in the standing of fluid substances as elements of chemical photography. As Geoffrey Batchen reminds us, the process of creating an analogue photograph has always consisted of the skilful manipulation of disparate parts – the objects or light that the photograph recorded, the negative produced by the initial exposure and the various prints made from that negative – with each in some way reproducing and transforming the other part.22 Every stage of the developing process was suspenseful, having to be performed within minutes and often in complete darkness or under safelight conditions. Mixing, measuring and pouring the solutions into dishes and agitating intermittently coupled with the waiting times for each chemical stage to be completed, all without the photographer being able to closely check the image emerged on the negative until fully fixed and washed. Making positive prints from these negatives was every bit as messy, laborious and unpredictable. The interaction of these parts was often spread out over time and space and involved more than one person, giving photography the capacity to produce multiple copies of a given image and for that image to have many different looks, sizes and makers. As Luke Smythe has noted, ‘chemicals employed in the production of photographs can be… recalcitrant and are capable of ruining an image if mishandled’.23 In standard darkroom activities, fluids are typically
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39
employed as catalysts that draw forth an image on a sheet of glass or paper, then fixing it in place by rendering it insensitive to light. To achieve this aim, the glass plate on which the image has been captured is passed through a series of liquid baths, including a developing solution (which makes the image visible), a stop bath (which halts the development process at its current level of exposure) and a fixer. Each fluid must be held at a specific temperature and the plate immersed within it for a fixed duration. Failure to control these variables, or the use of improperly constituted chemicals, will interfere with the production of the image, which can easily be ruined through miscalculations or mishandling. The volatile complexities of liquids and the challenges these pose for photography are indicative of a confrontation or active resistance that chemicals and liquids seem to offer in the face of technological advances. Very little is known about who exposed and developed the plates in Lyon, although, we know it was not Pont himself, as he can sometimes be seen in the picture. There is a sense of delay baked into the negatives here, after the encounter with the camera the full meaning of photography can only emerge later in its full event. Photographs in which staff appear alongside patients are a visual reminder of the many relationships and interactions that took place around the camera and inside the ward, and also consolidate photography as a form of reproduction, of work, of commerce and of capital, and of this labour economy as a collaborative exercise that might require the assistance of other members of staff. This point of contact between surgeons, nurses, orderlies, photographers, patients and darkroom workers can clearly be seen in the development of early facial injury photography in Lyon, raising the issue of reproduction and its consequences, and leading to a reflection on multiplicity of agencies that can be hidden in a reiteration of the same. The close proximity of Pont and his orderlies to the patients as they either guided or held them in place to have the photograph taken at first may indicate a potential threat; the medical personnel become a potential prop to allow the patient to sit still and become compliant. They become a part of the picture in order to allow the picturing to take place, in order to hold the patient steady in front of the camera. Surprisingly, in medical photography, especially going back to the nineteenth century, one often finds figures lurking around in the background, when exposure times were relatively slow. But at a time when exposures were much quicker, this gesture says something profound about the nature of caregiving in the facial wards; here the surgeon, photographer, orderly, nurse and darkroom assistant were immersing themselves in the interests of the legibility of the patient.
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Photography in the Great War
Figure 1.2 Glass photographic plate from the Albéric Pont Collection, 1915–18, 90 × 120 mm, photographer unknown. Reproduced by kind permission of the Archives of the Bibliothèque Interuniversitaire de Santé, Paris.
Upon investigating the photographs of French patients from Lyon more closely, we find that there are slight variations that exemplify the different ways in which Pont’s centre mobilized photography on particular occasions when technical and chemical mastery were in question. This is significant as there is
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Figure 1.3 Glass photographic plate from the Albéric Pont Collection, 1915–18, 90 × 120 mm, photographer unknown. Reproduced by kind permission of the Archives of the Bibliothèque Interuniversitaire de Santé, Paris.
an absence of information about who the photographer was in Lyon, making it difficult to identify if it was a member of staff or a hired professional contracted in for the task. There are differences between calculating and controlling the production of some photographs, seemingly taken in the same room, which are
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Photography in the Great War
substantial enough to suggest they were made by different operators, identified from camera reliability and the subjective choices made during the chemical stages of darkroom processing. In the example of the first set of two images at the top of this album page, one figure is directly transposed over the other as a single hand, a kind of phantom limb, appears from nowhere to hold the patient steady, displaying him as a medical puppet or perhaps a ventriloquist’s doll. No attempt had been made to hide or cover over the supporting figure of the surgeon or orderly but simply pushed to the edge. The framing of the second set of two patients is even less conventional than in the first, with the slightly skewed angle of the camera conveying a sense of motion or lack of firm grip at the point of pressing the shutter, or possibly holding the camera at chest level when focusing rather than at eye level, and highlighted by the low viewpoint and uneven border along the wall and chart in the background. The patients sit a fair distance from the camera, rather than filling the frame, the room is in deep shadow. The loose framing and under-exposure along with other examples of insufficient developing or washing of prints within the Pont collection imply not only limited control over these events and processes and the difficulty in bringing the photographs into conformity with the one the surgeon may have wanted to obtain but also a co-production of scientific attention in his team – some acquainted with conventions, and the others either under his instruction or unencumbered by technical rules and chemical processes. We can access the problems that large patient admissions created for the rehabilitative facilities and photographic services in Lyon through the analysis of the workload of amateur photographers. Early on there were indications that the quality of the plastic surgery had not kept pace with the increase in patient numbers. As Julie Mazaleigue-Labaste has noted, the goal of Pont’s administration was economy and efficiency.24 In the face of economic necessity to keep costs down, plus the manageable weight and size of hand cameras, this likely meant that any medical attendant on duty at the time would be expected to take the photographs. Pont’s photography, with accompanying uneven framing, over- or under-exposure, marring of images from scratches on the glass plates and subsequent blotches or fading of the prints over time undermine the perceived perception of objectivity and ‘dry intelligence’ and seem not to meet the operative requirements of mastering the materials and obtaining an accurate visual recording of the patient. Despite the perceived interpretation of inadequate photography, these flaws may have been due to time constraints and real economic costs. Even if Pont’s approach to photography was not intentionally cost-cutting, the practical implementation of the camera, including
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collaboration of other members of staff in photographing patients, challenges the fixity and evidence of medical photography as time-consuming, impractical and incompatible with the working dynamics of high patient numbers and manually handling photographic processes. Pont’s centre was a provincial hospital serving in a very centralized country. The function of the meetings of the Lyon medical and surgical societies that Pont tended to present his results in front of, ‘especially the Société Médicochirurgicale Militaire de la XIVe Région (Medical and Surgical Military Society)’, assumed a local rather than national character inasmuch as they only included members from the immediate area.25 In recognition of the nature of these provincial societies, as local organizations with an interest in the dentistry of only one military region rather than nationally or internationally, Pont’s practice rarely ‘went beyond the Lyon scientific societies and maxillofacial centre’.26 This was not the same for the maxillofacial ward at the Val de Grâce Hospital in Paris, however. As indicated by Beatriz Pichel, each military hospital and maxillofacial centre in France had its own photographic services.27 Dr Hippolyte Morestin at the Val de Grâce Hospital, Léon Imbert in Marseilles, Leon Dufourmentel in Châlons-sur-Marne, Maurice Virenque in Le Mans, Fernand Lemaïtre in Vichy, Emile-Jules Moure in Bordeaux, Charles Auguste Valadier in Boulogne and Fred Albee and Varastad Kazanjian in Neuilly sometimes travelled long distances to attend meetings in centralized medical societies in Paris and Britain. In this cooperative environment, the opportunity for surgeons to enter into dialogue with transnational scientific societies and collaborate across facial hospitals to disseminate the surgical methods of treatment for war injuries was a promising direction to innovate and develop these experimental surgeries.28 By appealing to a ‘quick and efficient’ cure, and underfunded by the French government, it may be that we need to understand how amateur photographers or newcomers moving into Pont’s already equipped provincial hospital environment learnt to use the technologies already in place when they were unfamiliar with them.29 The fact that the quality of the photography had not kept pace with the patient’s treatment to render his progress onto the plate emulsion implies that Pont’s photography was sometimes labile and inconsistent. Struggling with large and frequent patient admissions and limitations of the medium, the medical staff was unable to apply reliability when performing their operative ambitions as set out in scientific societies and medical publications. Moreover, the fact that the environmental and technological realities of attempting to photograph patients undergoing physical changes on a daily basis made it difficult for an
44
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untrained team to finish the process of photographic image-making. Pont was redefining the identity of the amateur.
Professionalizing the camera The KGH’s working pattern was quite different from Pont’s provincial facilities in Lyon. Writing in the pages of the Lancet on 17 March 1917, the surgeon Percival Cole praised Norman’s work as the official scientific photographer in the facial wards. ‘The photographs were taken by Dr. A. Norman, to whom my best thanks are due for the time and labour devoted to their preparation. These have been, in most cases, taken very soon after operation.’30 The production of the photographic images in the medical journal also, however, points to undervalue of the darkroom assistants at the hospital. If the ward’s success depended on the photography, as Cole asserted, he failed to acknowledge the contributions of its technical workers to validate the proficiency of his photographic department. The RAMC organized its photographic services like any other modern business, a recognized hierarchy of skills and a clear separation of procedures and workers. Besides Cole’s talk of time and labour and technical talent, there were also the nurses working in the darkroom, all arranged to ensure an efficient operation and maximum productivity. This cooperation became particularly necessary during the war when different people often performed the work of exposing a negative and making a final print. The division of intellectual from manual labour allowed photography departments to mimic the class structure of industrial capitalism. The photography was embedded in a highly proficient military assembly line, but the individual names of assistants were not seen as important. While the developing of exposed plates in chemicals was left to assistants, the exposure of patients’ injuries in the ward and the printing of photographs drew upon the authority of Norman’s society-based expertise. Dr Albert Norman (1862–1940), having been trained initially as a surgeon in the early 1890s, retired after only six years and retrained as a scientific photographer. It is unclear why he made this change in occupation.31 He evidently shared with surgeons not only an astute awareness of exercising professional judgement and common sense but also the ability to recognize the unspoken sensitivity from the patient that might demonstrate their discomfort during the photography session. Moreover, Norman shared an emphasis on publishing the photographic work of doctors to consolidate professional science focused on distinct subfields of dentistry and surgery. Thus, expertise in this photographic
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department points to the links between Dr Norman’s elite society-based medical and photographic training and the organization and efficiency of its non-elite darkroom workers. As the 1891 census noted, Norman, at the age of twenty-one, was a lodger in Southwark, close to Guy’s Hospital.32 The following year saw him qualify to practice medicine via the Royal Colleges of Physicians and Surgeons of Edinburgh and the Faculty of Physicians and Surgeons of Glasgow. In addition to Guy’s and the Scottish schools, he also studied in Dublin.33 Norman was elected or selected to membership of the Guy’s Hospital Photographic Committee in 1887. Two years later, aged twenty-seven, he retrained as a scientific photographer and qualified as a fellow of the Microscopical Society. In the early 1900s, and now a microscopic photographer by profession, he belonged to several national scientific societies.34 Despite Norman’s skills in microphotography, he appears to have had little subsequent dealings with this practice at the KGH during the war, since the clinical photography work he developed at Guy’s better matched the new types of injuries being admitted to the wards (Figure 1.4). Norman seems to have established a reputation for his photography with the microscope and his presentation of the results as lantern slides. Among the notices for forthcoming meetings in the 29 November 1902 issue of the Royal Photographic Society’s journal, it was announced that Norman would give a paper to the RPS technical meeting, titled ‘Photomicrography in Black and White and in Colours’.35 The talk was given in February 1903 and was well received. The paper was published on 31 March 1903.36 Norman’s skill in making lantern slides with the Sanger-Shepherd Process had been noted by members of the RPS and RMS in 1903, when he was requested to discuss the process.37 In 1904, a Royal commission requested the RPS to send examples of British photography to the St Louis International Exhibition. Amongst the images that were sent to St Louis were Norman’s photomicrograph slides, which were admired sufficiently to be awarded a gold medal.38 Norman was invited to give a lecture to the RPS Technical Section on the Sanger-Shepherd three-colour process in photomicrography. This lecture, or rather demonstration, was given on 1 May 1906 and was greatly appreciated for the thoroughness of the presentation. The paper was published the following month.39 Later, this lecture was added to the Society’s stock of travelling lectures, but with very strict conditions about the care of the fragile slide images: As the slides are valuable, and may easily be damaged by excessive heat in the lantern, they will only be lent on the following conditions: An alum tank must be used to cut off the heat from the lantern illuminant. No slide must be allowed to
Figure 1.4 Title page of the thirty-sixth volume of the Journal of the Royal Microscopical Society (1916). Reproduced with kind permission of University Museum of the History of Science, Oxford, and the Royal Microscopical Society Archives.
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remain in the lantern for more than two minutes. A green safety slide is provided, which must be substituted for the three-colour slide when the descriptive matter takes longer to read than two minutes.
Norman’s slides also had to be insured against loss or damage at the expense of the borrowing Society when travelling from and to the Affiliation. The cost of reproducing the slides was estimated at £41 8s., being £1 1s. each for the threecolour slides, and 2s. 6d. each for those in black and white’.40 Norman was a man on both the inside and outside of the medical community in the early twentieth century. Norman worked for most of his career in hospitals and had valuable scientific credentials, while at the same time immersing himself in both scientific and professional photographic communities. Norman was therefore a man with influence in the medical and professional world of photography. He worked to legitimize photography as a valid scientific pursuit, although he had no previous experience of photographing war injuries of the jaw and face. Norman’s expertise in the use of photography for science, the applications of slide-making and printing processes, as well as a professional understanding of wound care, tissue health, bacteria and microorganisms, precipitated a comprehensive knowledge of research methods and how photography could act as a mechanical tool for the observation of data that was not visible or verifiable with the eye alone. Thus, Norman was able to ‘keep track of… progressive enquiry’ in terms of the cleanliness of wounds, skin infections, abscesses, open cavities, blood-clotting and circulation.41 He was well placed to understand the tonal sensitivity of the manufacturers’ plate emulsions available, and of the important variables in the interpretation of the panchromatic or orthochromatic rendering of a photograph of disease or injury features (Figure 1.5). In order to reinforce this credibility, the RSM was able to publish such surgical innovation and scientific proof more readily than was the RMS. The surgeon on duty would often accompany Norman as he photographed each patient in order to remove the bandages and assess their condition after surgery. The folding hand camera articulated a closer working relationship between medical staff than was possible with the conventional practice of large format photography. Norman’s approach was better suited to addressing the realities of busy working conditions; it required regular visits to the patients’ bedside shortly after operation to record the immediate outcomes. In advertisements in the photography press, folding hand cameras were noted for their simplicity in design and operation, ‘the result of many years’ accumulated experience of the requirements of both amateur and professional workers’.42
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Figure 1.5 Privates Westwood, 1918–19, and Harper, 1916–19, photographs by Dr Albert Norman, 1915–19. RAMC album 2, RAMC 760. Wellcome Library. Reproduced by kind permission of the trustees of the Museum of Military Medicine.
Thus, folding hand cameras ‘always proved their superiority when subjected to the test of real, practical photography’.43 Without the intrusive and disruptive working methods of a large format camera and tripod, Norman could avoid many technical difficulties between focusing and exposure and obviating the need to replace the ground glass with the photographic plate, giving him an immediate sense of what the camera would be ‘seeing’ (Figure 1.6). The exposure of plates in a large format camera was cumbersome, requiring the photographer to close the shutter after focusing. The individual plate is loaded into the frame, and the shutter is reopened for the image to be received. The rigidity of patients who were always photographed seated in the photographic studio sat uncomfortably with the desired methods of research and treatment sought by surgeons like Cole, who immersed himself in the day-to-day tasks. The relationship between Norman and Cole highlights the alignment of the photographer’s skills and approach with that of the surgeon. Norman may
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Figure 1.6 Thornton-Pickard Cameras, advertised in Amateur Photographer and Photographic News 61. 1579 (3 May 1915): vi. N. 1709 d. 2. Reproduced by kind permission of the Bodleian Library, University of Oxford.
have come to work with Cole through a deliberate choice rather than a happy coincidence. Cole had also trained at Guy’s so it is reasonable to suggest that the two men knew each other because of the professional connection and reputation they held with this teaching hospital. Cole trained initially as a dentist at Guy’s in 1899 and later as a surgeon under the Royal College of Surgeons. Cole took
50
Photography in the Great War
a conjoint examination in 1904 to become a Licentiate of the Royal College of Physicians, going on to serve as house surgeon at Guy’s and then in Birmingham as a demonstrator of anatomy in the medical school, taking his fellowship in 1906, then as a sub-warden of Queen’s College. Cole then took an additional qualification of M.B, Bachelor of Medicine, and Ch.B in Birmingham in 1909, and the following year he returned to London to teach anatomy at the Middlesex Hospital, aged thirty-two. In 1911, he was appointed surgical registrar at the Cancer Hospital and assistant surgeon at the Queen Mary’s for the East End. In 1912, he was promoted to assistant surgeon at the Seaman’s Hospital, Greenwich. During the war, as well as working at the KGH, Cole also worked at The Brook War Hospital in Shooter’s Hill, Woolwich, as operating surgeon. In highlighting the open and collaborative nature of Norman’s photographic practice and Cole’s innovation, this relationship shows not only that photography was intricately linked to that of dentistry and surgery but also that peer production facilitated communication between photographers and surgeons and provided reputational advantages to photographers willing to share their skills. Comparatively, the photographic department at Sidcup under the command of Sydney Walbridge (1883–1954) offered an even greater level of privacy in a more congenial environment for patients. Walbridge was a commercial studio photographer by profession.44 Called up in 1915, aged thirty-three, he initially joined the Machine Gun Corps as a Private attached to the Hampshire Regiment. In December 1916, he transferred to the RAMC and was appointed as medical photographer to the Cambridge Military Hospital, Aldershot, where he presumably encountered Gillies. During his time in the facial ward at Aldershot, Walbridge mostly photographed patients at their bedsides before they were escorted to the operating theatre. Walbridge’s photography of Bob Davidson aimed to test the functional elements, such as the effect of nerve injury which caused a facial palsy, following the rebuilding of his upper lip, the central portion of his palate and the considerable loss of muscle and bone in his left cheek. Active and passive views were obtained to demonstrate muscle weakness or recovery of function. Figure 1.7 is an example of a visit Walbridge made to Davidson’s bedside on 30 March 1917. The photographer exposed at least two glass plates of the results of a recent operation to lift the angle of Davidson’s mouth and attach new tissue to the left nostril. Notwithstanding the obstacles of bulky cameras and tripods to maintaining the sense of spontaneity experienced when undergoing innovative surgical procedures, the fine detail in tissue health and scarring which Walbridge was able to capture on his half-plates was unrivalled in their dry intellect and took the forensic study of wound care one step further than
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those photographers working with handheld cameras. Hemming in the agency of liquids, Walbridge controlled the chemical sensitivity of his glass plates and appeared to constrain the tonal range of tissue and scarring satisfyingly, making accessible a panchromatic spectrum of ingenious skin flaps grafted from
Figure 1.7 Half plate glass negative of Private Bob Davidson, 30 March 1917, ‘R.J. Davidson. 7’, written along the top edge of the plate in black marker pen, photographed by Sydney Walbridge. Gillies Archive, the British Association of Plastic, Reconstructive and Aesthetic Surgeons, BAPRAS/Sidcup/6/4, from the Archive of the Royal College of Surgeons of England, London.
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different parts of the body, which was an essential feature for charting tissue transplantation and blood supply soon after insertion. When Gillies moved to Sidcup in November 1917, Walbridge was provided with his own photographic studio and darkroom, equipped with artificial lighting and a large format camera which took interchangeable full, half and quarterplates, and a selection of lenses.45 Photographic practice had also changed. Walbridge had systematized the photographic procedures, so patients were not photographed in their ward anymore but at the photographic studio instead. All the elements of his studio, including its glass-panelled roof, size, location next door to the operating theatre and darkroom, use of neutral backgrounds and processing techniques, were measured and calculated with precision. Walbridge’s aim was to produce images that not only represented darkroom time held in abeyance to stabilize the liquid activity in his practice but also secured easy comparison across patient records.46 This is significant as Walbridge’s recognition of photography as a business industry was the primary focus of his service. The reproduction of innovative surgery as a photograph allowed a fresh approach to the challenges of thousands of out-patient admissions to hospital, making productive commercial and technical skills viable enough to the work of medical science.47 This specialized enterprise was founded on technical and commercial expertise to pattern the assembly line of its service to meet the demands of an international team of surgeons. Walbridge would have commanded a small group of assistants working busily behind the scenes, purchasing and preparing the chemistry, producing and storing negatives and slides, printing and mounting photographs, and arranging and annotating them for the case files and the museum. There is evidence that at least one resident patient at the hospital became a photographic assistant of Walbridge. Albert Roberts (1894– 1986), who was admitted to Sidcup in 1918, subsequently took up medical photography as part of his rehabilitative therapy. The photography that Roberts produced of his fellow patients has survived and is now held in two collections in the Imperial War Museum.48 One final aspect that links Norman and Walbridge is their arrangements of ethical governance when interacting with patients during the photographic session. As appointed photographers to the RAMC, Norman and Walbridge were required to work in accordance with principles that related to the maintenance of professional standards and good practice. These included good interpersonal skills and working procedures that avoided causing harm or distress to a patient to ensure that fundamental privacy was not compromised. The characteristics of
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a good working practice was the inclusion of bed sheets discreetly covering parts of a patient’s body, or screens pulled around their beds, or being escorted to a consulting room or studio. As a background to these working procedures, however lacking these may seem to us today, Norman and Walbridge took seriously the accountability of their actions. This included any omissions of detail in a patient’s treatment stages and recovery that a surgeon deemed of scientific interest. These photographers would have been required to recognize any deficiencies in their working practice and take appropriate action to rectify it. While Norman never worked in the commercial studio business, Walbridge was able to establish the pose of a patient in a way that qualified their compliance within this relationship, even though the interaction was one of the commissioning surgeon’s control. However, this photography was typically recorded under tense conduct prior to or following surgery, and the patients were obliged to notice the scientific attention given to them. They had to contend with it, and could only guess how they looked when the shutter was released. Moreover, this interaction was not rehearsed or guided by mutual consent or the ceremonious occasion of studio or domestic photography. Unfolding in an un-consenting exchange, these patients could not negotiate the encounter defensively. Without instinctive artifice, the in-patients and out-patients were staged by ideas of appropriate complacency and governed by the legal definitions of military property.
Service patients as legal objects The consequence of those added strains brought by military rule to the practices of surgery and photography in the facial ward becomes clear when examining how the soldier-patients’ civil legal rights and conditions were compromised under the workings of the Pensions Ministry. These strains in turn affected the way in which the surgical community struggled to maintain an exclusive elite culture engaging with the British Army. On 25 November 1918, Cole delivered a lantern demonstration on post-operative outcomes to a meeting of the Section of Odontology. Discussing war pensioners as legal objects that proclaim the British Army and Ministry of Pensions’s property right, Cole used information collected from a questionnaire sent out to discharged patients ‘to better assess experimental bone-grafting operations in fractures of the mandible’.49 Cole was particularly dismissive of this small group of patients. Cole expressed the view that the legal control enforced by the military was hampering the very functioning and conditions of his relationship with these men, framing
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Norman’s photography in a context where informed consent was becoming a hindrance and increasingly impractical. Passing the blame on to his patients, Cole described many of them as ill educated, often unable to make an informed decision about the benefits of surgical intervention. ‘Ten replies only have been received. From conversation with our most intelligent patients we are convinced that disability is a muscular failing.’50 Cole found that the most difficult patients to assess were those who had given negative answers in the questionnaires. In his opinion, and from the evidence represented in his slides, these men lacked the intelligence to fully understand their disability. The results had, Cole noted, been disappointing… as the ‘question of subjective evidence’ was ‘beset with difficulties’. When the evidence was positive, ‘when a man states that he can eat anything, that statement obviously can be accepted without demur. The same cannot be said of negative evidence’.51 In several patients, from investigation, Cole found such negative statements open to question and at variance with what clinical examination had led him to expect. ‘The reasons for this are obvious’, Cole added, ‘and will be appreciated by all those present who have knowledge of the working of the Workmen’s Compensation Act’.52 Furthermore, Cole was accusing his patients of intentionally downplaying any restored functional capacity in their rebuilt jaws, in an effort to claim a higher rate of pension compensation for a more severe impairment. Following the legally bound military contract that guided the doctor-patient relationship, consent to surgery was proving problematic because the economics of restoration was in the forefront of the British Army’s rehabilitation.53 A stressed priority which, Cole confessed, ‘has at times forced us to adopt temporary expedients, with unavoidable lapse from planned perfection’.54 Central to the production of this lantern demonstration was the written text, the questionnaires, which were widely acknowledged as more important than the photographic slides themselves to support legal procedure. The important point is that it was the discussion at this society meeting that had enabled Cole’s lantern demonstration to emerge, and this was because the group debate did not simply make it easier for these society members to communicate with each other but it also transformed their information in a way that then impacted on the photographic role in the legal contract. Cole noted with dissatisfaction the difficulty in repairing fractured mandibles because a considerable portion of the jaw and muscles as well as facial nerves were lost and could not be rebuilt using grafts or their function restored. He agonized over the ten replies received, which he found seven to be completely successful. Dental splints had been removed from patients after three to six months, progress was slow and firm jaw
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consolidation was not expected in less than six months to a year. Cole explained that on examining each of these patients their jaws felt solid, but only five of them were eating an ordinary solid diet. Of the other five men, one could eat meat only if stewed and the other four could only eat meat if minced.55 Surgeons at the KGH were unable to standardize this treatment.56 Functional impairments were permanent. We can surmise from the president’s address to the Section of Odontology on 27 November 1916 that the dental community was asked to promptly publish papers on the long-term complications of experimental bone-grafting. W. B. Paterson described his concerns tersely: ‘What I desire to refer to more particularly, in these cases of considerable loss of bone, is the question of the patient’s future.’57 The key aspect of the functional impairment is the assertion by Paterson that the pensioner was tied much more explicitly to ‘a minced diet for life’, while he also brought forward key concerns involved in sharing and looking at examples of effective treatments: calling upon society members ‘at future meetings to show patients exhibiting successful results’.58 This address both justifies the surgeons’ experiments in bone-grafting of the mandible which brought risks and ensured the society member that photography could reinforce his perception of uncertain outcomes. Writing in the Lancet in 1919, another surgeon offered a typical description of managing such reparative decisions under military contract. ‘The ordinary social and ethical relationship and obligations, as between doctor and patient, do not then obtain; military administration and disciplinary necessities alone are involved, and the civil issue of professional secrecy cannot arise.’59 Such was the undercurrent of professional resentment against military authority that the dental community feared that their ethical and social judgements and their patients’ rights were being sanctioned and ultimately erased under the British Army’s hierarchical and highly paternalistic law.60 Moreover, breaking the civilian legal contract between doctor and patient in order to meet the British Army’s bureaucratic business officers of department resulted in sacrificing the interests of ex-service claimants to protect public expenditure. The manifestation of this challenge to formal consent through entitlement to forms of healthcare and social welfare that would otherwise be unavailable at that time demonstrates how military power and control, and property claims on the wounded male body, contributed to make material and legal compensation for war injuries dependent upon group recognition from governments and state authorities rather than surgeons. These obligations in turn affected the way in which scientific evidence of functional impairment was presented through the images.
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The conflict of interests between civilian and military approaches to medical ethics within the institutional demands of the medical societies did not signal a blanket acceptance by in-patients and out-patients to undergo all surgery. Exservice pensioners and patients who were sent back to active duty could refuse to undergo forms of healthcare involving experimental surgery. In fact, many patients did indeed take the decision not to continue a course of treatment. One of Cole’s patients ‘refused further operative treatment, as, in his own words, “he can do anything”’ following twelve months of surgery to restore the functional capacity of his jaw.61 As the stomatologist Frank Colyer dryly noted, one of his outpatients ‘refused treatment and was not seen again until December’, two months later, when ‘an external splint [was] applied to be worn during Christmas leave’.62 By publishing the society discussions on wartime ethical duties, the Lancet was suggesting a familiarity with the British Army and government’s bureaucratic obstacles that the readership would have had if they were regular attendants to the weekly meetings. Moreover, it led swiftly to the recognition that these legal conditions were hard to manage. ‘The duties of the practitioners in his relationship to the State has increased enormously’, and ‘he has now constantly to consider the application of laws imposed in the interest of the public health or of the public morality, where once he would have been concerned only with the primary duty… towards the patient’.63 Although photographs and slides could not be used to depict every legal situation, the content of the image was used to legitimize the pressures of extensively discussing the issues of consent to surgery, as well as the broader economic concerns about restoration in which those innovations emerged, drawing in experienced surgeons to discuss patients who in normal circumstances would not have come under their care and the delicate situations arising out of the performance of their work. At times photography bound the doctor-patient relationship to the limitations of legal issues of consent, seeking to roll back the patient’s existing civil legal rights. Their wartime service had, after all, effectively entitled them to state and privately financed healthcare and social welfare that was unavailable to the civilian population at that time, state-sponsored medical aid, rehabilitation, vocational retraining and war pensions that prioritized their full citizenship and future employment.
Conclusion As Maehle and Geyer-Kordesch have reminded us for ethical problematizing specifically, the differential and thus institutional phase of technology adoption
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in the rapid quest for medical advance not only raises questions of healthcare and how we attain it but also implies that the medical profession know what the implications of whatever scientific decisions made will be.64 Maehle and GeyerKordesch noted that ‘no matter how complex the science, we still need to know what its practical outcomes are’.65 Photography offered ways of catering for the growing and diversifying experimental surgeries in the facial wards in relation to the implementation of state subsidizes and publicly funded healthcare, but with the development of increasingly efficient reconstructive surgery came the large number of society meetings that sought to define the balance between potential benefits of rebuilding mutilated faces and the inevitable risk research on soldiers incurs. Speaking of the wards in French military hospitals, Pichel has noted that ‘facial injuries were profusely photographed in the medical context’.66 The impact of photography and technological developments was not realized solely in French war hospitals but included the production of a new group of camera users in Britain. Although photography was introduced in hospitals well before the advent of French facial centres during the Great War, the information relayed through easy-to-use portable cameras and improved light-sensitive plates marked an expansion of communication in surgery. To assist the rise of new photographers at the interface of what had been known as ‘clinical photography’ and dentistry and surgery, nurses and subsidiary workers joined the photographic departments of war hospitals and patterned the everyday mechanics of mass-produced photography to keep pace with the thousands of patient admissions. Commercial and amateur photographers and local darkroom workers and assistants seemed transformative of production relations, and carried a large concentration of labour. This chapter has investigated the divergent but latterly overlapping skills of medical, commercial and amateur photographic practices and processes, and industrialism and imperialism more broadly, in the facial wards of British war hospitals during the Great War. The RAMC took care of organizing photographers at national level – the local or provincial war hospitals oriented themselves in relation to the RSM even when they were not formally linked to it. In other words, war hospitals saw as part of their caregiving duty the organization of their photographers into groups of workers, whether it be into more formal divisions, as in the case of the KGH and the Queen’s Hospital, or more informally into smaller groups, like Pont’s centre in France and Colyer’s in Croydon. This provided commercial and amateur photographers with a medical role, and helped to affiliate them with the circle of elite medically trained photographers through the way their relationship was defined to the medical societies.
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For the darkroom workers and RAMC orderlies of the Medical Photographic Services, we can see that their everyday duties were patterned by the practical demands of the wards rather than upon any scientific work submitted by medical instruction. While the groups of surgeons could write articles on how to photograph patients and discuss ethical protocols and conventions of experimental surgery raised by military matters, this rising new professional group of interdisciplinary practitioners was using photography to facilitate exchanges between dentists and surgeons, artists and photographers, helping the fields of odontology, laryngology, rhinology, ophthalmology and surgery to form closer interaction and to communicate with each other to bridge their knowledge and skills. Technology may have been the vehicle through which the British Army and the medical profession purged photography of liquidity, but the intelligence behind this evacuation was shaped by a military and professional power which sought control over the immediate production-process. By eliminating the liquid activities of local and provincial darkroom workers from the immediate production process and liberating the dry part of the medium, the surgical community presented photography’s intelligence as ocular and technical, not liquid, in order to ‘control’ and ‘rationalise’ their workspaces.67 The application of photography within the working environment of the facial wards emphasized and authenticated photography in the pensions system – which was largely dependent on success or failure of the surgical aftercare achieved.68
2
Glass soldiers in the lantern. The Royal Society of Medicine, 1914–19
Speaking at a special meeting of the Section of Odontology at the RSM on 28 February 1916, the president of the British Dental Association addressed 300 members and fellows and thirty-five visitors. In explaining how the ‘section of surgery’ could ‘establish a working partnership with the odontological section and contribute to the discussion of facial injuries’, Harry Baldwin established a role for photography and the lantern within the ecology of ‘the group’s knowledge of the subject’.1 He thanked four Parisian doctors for their contribution to an exhibition of material on display at the Royal College of Surgeons museum, which showed facial injuries that had been treated in French war hospitals.2 Several Red Cross surgeons, including Baldwin, travelled to France in 1914 and 1915 to study the conditions under which British soldiers with face and jaw injuries were being treated in specialist centres in the military regions. One noteworthy claim in Baldwin’s address suggests that he thought that French and American slides were somehow different from those taken by British surgeons. If the presentation’s success depended on ‘show[ing] lantern slides of a few typical cases that have come under my care’, to convey to his colleagues his personal views of seeing the patients recover from operations, and ‘being aware that the greatest amount of clinical material available to us was to be seen in France’, the success of the British sections, and therefore of British facial centres, depended on the photography of these patients. The experience of photography actually transformed how surgeons studied their patients’ treatment and, consequently, how they wished to represent this experience.3 In Britain, Baldwin was not alone in drawing a connection between the surgeons’ new experiences of patients and surgery; many other surgeons were similarly commenting on the influence that photography was having on their visual experiences. Since early 1916 a growing body of British odontologists, the first group who could realistically stabilize the conditions of facial injuries,
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had enthusiastically embraced the magic lantern as it facilitated collaborative and contested debate in immediate exchanges of information and thus early intervention. In the process, these physical projections shaped surgeons’ visual experiences by enabling a new technology-enhanced relationship with the doctor-patient environment in the facial wards. It made sense, in such a historical moment, to refer to the lantern and the camera in conjunction with each other, as surgeons did, using the projected photographic image as exchangeable, and interchangeable for the patient and for the surgeon’s experience. In recent years, historians of medical photography have been engaging photographic practices as a vital element of scientific education, which involved the critical dimension of learning to make images in an effort to improve understandings of surgery and the body,4 as well as addressing questions of war disfigurement in relation to politics, government and postwar reintegration.5 Yet, despite the fact that photography has been acknowledged in hierarchies of science-based military-medical care in the historical period and notwithstanding the pre-eminence of surgery in visual experiences of medical effectiveness, photographic and lantern practices have remained a marginalized subject in the medical and rehabilitative treatments of the Ministry of Pensions and the struggles to accommodate disabled ex-servicemen.6 Conversely, medical historians have underestimated the extent to which photography interacted with lantern projection and assisted in concentrating care to prevent a serviceman’s injuries from deteriorating. The complex relationship between photography and other media practices raises questions over the social groups engaged in scientific exchanges on behalf of the British Army and war hospitals.7 The intersection and interaction between surgeons and departments discussing facial injuries as a pensionable diagnostic category opens up a history through which the forms of judgement on facial reconstructions and correlations with recovery can be understood to help manage the Ministry’s treatment of disfigured soldierpatients through magic lantern technology. The RSM’s primary aims throughout the war were to serve the British Army, with all scientific investigations into war injuries and the meetings and special reports published paid for at its own expense, which was gratefully acknowledged by the Ministry of Pensions at the time.8 While understanding this centralized society’s commitment to serving the needs of the government, the bureaucracy of the national Ministry set up in Britain in the immediate war years was insufficient. Staff regularly proved unable to cope with the vast swathes of discharged men, and in 1919 the situation became even worse, with as many as 30,000 demobilizations occurring daily. It could often take over twelve months
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for ex-servicemen to receive a reply regarding a disability query. During this early phase, the jurisdiction for assessing pensioners rested on the largely autonomous Local War Pensions Committees. This provincial system also proved imperfect with varying standards and policies enforced on a regional basis. Accusations of regional differences in the interpretation of Ministry guidelines and bias were commonplace amongst high-ranking Ministry officials.9 A subsequent desire to streamline workloads and Ministry control of expenditure blunted the department’s most overburdened and benevolent elements with a policy of decentralization and the establishment of eleven regional centres across Britain.10 Upheld by the modernization of its aims and members, the RSM sought to bring together all branches of medicine and encouraged collaboration across disciplines. The technical infrastructure of the lantern demonstrations at the RSM between 1914 and 1919 was adopted and adapted from a pre-existing practice, establishing continuity with the long tradition of scientific lectures and association with glass slides. Projection services long pre-dated photography and were used to enable collaborative interaction. Besides their display in lantern projection, slides were easily reproduced in printed material. The Proceedings of the RSM, its twice-yearly printed journal, capitalized on the society’s organizational innovation: the establishment of sections. The Proceedings contained an account of the meetings by members in each section and included the papers read there as well as the remarks and questions that followed. The principle behind the sections was cooperative, as they depended on the hearty support of its members for success. The sections were key to the society’s success as they were in alignment with the move towards specialization. The publication considerably extended this sphere by facilitating discussion and interaction among a geographically dispersed community of fellows and members, shaping their ideas into scientific disciplines.11 The development of the special care and medical treatment of those facially disfigured by the war is encapsulated in the implementation of the Ministry’s treatment provisions that filled the pages of this society-based journal. It is here – in these debates between members of this surgical community – that we can evaluate the arrangements that were made and administered in war hospitals to provide medical treatment to disabled veterans and reinforcement of photographic practice in rehabilitative care (Figure 2.1).12 When collective discussion and cooperation took place in the RSM, the facial wards, and in the Proceedings, injured ex-servicemen’s treatments were efficiently transformed into key stages of expertise, allowing multiple participants vying for space within these departments to contribute at different levels of
Figure 2.1 Frontispiece of the tenth volume of the Proceedings of the Royal Society of Medicine (1916–17). Reproduced by kind permission of the Royal Society of Medicine, London, and Sage Publishing.
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effort consistent with shared epistemic and rehabilitative goals. Following the conscription of men into military service and the establishment of the Ministry of Pensions in 1916, the realization that surgical solutions to facial injuries had to be resolved in order to prepare for the uncertainties that further fighting and more pensioners would bring contributed to the surgical community’s desperate need to understand these medical treatments and socioeconomic problems quickly. Surgeons conceived of the lantern and photography as group-based, co-produced technologies subsumed into the regular textual flow of meeting minutes. Production was group-based as populations of surgeons, departments and photographic services shared the same reparative aims and technical values that served to provide a collective commitment to the government and to advance group needs. The Ministry faced a huge challenge in assessing facially injured veterans. The Ministry’s assessment boards often included a range of medico-pensions officials, and specialist military and civilian doctors who assessed claimants and pensioners by payment per report.13 Approval for pensions and treatment relied solely on the judgement of a region’s Commissioner of Medical Services and the Special Medical Boards who examined facially injured ex-servicemen.14 Vital to this population functioning as a community, as David Cahan has observed, is their engaging in concerted action and sharing a distinctive sense of social cohesion.15 The mediated correspondence networks of war hospitals via medical boards, Local War Pensions Committees, society meetings and journals allowed facial centres to develop and manage surgical and photographic possibilities in the state’s treatment of injured and disfigured soldiers, the pre- and postoperative results could then be quickly collated, reported and published.
Projecting surgery around 1916 From 1914, the society’s lecture and meeting rooms, at its premises at No. 1 Wimpole Street, were at the disposal of medical officers of the Army Services. With no choice in this arrangement, an awkward compromise was worked out, whereby society members transitioned into military duty. Some members objected that they found themselves no longer able to avoid ‘the thorny subject of medical politics’.16 In spite of its hazards and expense, the lantern rapidly gained a footing as part of routine teaching practice within the society (Figure 2.2).17 While this fact alone may seem inconsequential, the placement of the lantern at the heart of research debate is not. Weekly evening meetings and
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Figure 2.2 Photograph of the Robert Barnes Hall, The Royal Society of Medicine: Opening of the New Building by His Majesty the King Accompanied by Her Majesty the Queen (1912): 4. Cat no. WZ 1 (ROY). Reproduced by kind permission of the Royal Society of Medicine.
presentations to the RSM that appear in the volumes of the Proceedings bear out this pedagogical focus. Attendance at these meetings was crucial so that existing fellows working in the facial wards could gather at Wimpole Street to perform efficient lantern projections, interact and discuss their experiences, and use sets of slides to teach the outcomes of experimental surgeries. These meetings were a critical aspect of community participation, which became pivotal in developing and managing the Ministry’s medical treatments in facial centres, enabling different groups in the various war hospitals to contribute in debates over the difficult aftercare of patients. More than that, these practices relied on the importance of physical meetings to explicate new findings of scientific merit and validate their evidence. The society then carried these weekly interactions to the Proceedings by reviewing and publishing speakers’ papers and a selection of the slides. Its contents were aiming to lead the activities and interests of the rising group of readers by highlighting what they ought to know in order to practice their medical and rehabilitate treatments more effectively.
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The lantern was used in the society meetings to make it easier for the surgeons to believe that they were ‘in control’ of the situation. The lantern also made the camera easier to use inside the wards, a topic regularly discussed by surgeons to support their attempts to master the complexities of facial injuries with the controlling operations of photography. George Northcroft from the First London General Hospital, Camberwell, argued that ‘photographic records where any plastic work is involved are well worth the time and trouble… It is astonishing how quickly one forgets the original appearance of a wound after seeing the patient for two or three months progressively improving.’18 To this end, the lantern and camera were used as a kind of ‘orthodox technological intelligence’, which surveyed the different healing times of skin and bone and the healing properties of new tissue.19 Groups of surgeons could then subject the images to precise analysis of patients’ results – gauging the best time to introduce dental splints, how long to wait inbetween operations, and to evaluate the practicality of borrowing skin from other parts of the body. It was by means of such analysis that the patients’ injuries and photographic processes could be rationally controlled. Through a ‘performance of explanation’, speakers at society meetings could not only validate military and professional power, or rather control the surgical processes, but could also instruct photographers on how plates should be exposed and slides reproduced in the first place to register the good practice to which they gave rise. Photographers were keen to be seen as managers of the immediate production process rather than simply operators. The periodical pages in Figures 2.3 and 2.4 show lecture lanterns for both professional scientific practice and popular home entertainment from the early 1900s, giving a sense of the projectors on the market at the time. By 1914, electricity was the most commonly used source of power for lantern projections and had replaced older, less reliable and highly flammable means of illumination, such as limelight, oils and compressed gases. In an early history of the electric light for the lantern, Lewis Wright reasoned that electric light bulbs ‘consist[ing] of an incandescent filament of carbon have lately been applied with some success to the ordinary slide lantern, and where the electric current can be laid on, is a very convenient and handy radiant’.20 In 1878, the American inventor and businessman Thomas Edison was granted a patent for an electric lamp, and in 1883 he joined forces with the Englishman Joseph Swan and formed the Edison and Swan Electric Light Company, and introduced a lamp through which a current being received provided the light source for lantern projection, though it took various forms, such as the new incandescent Ediswan ‘“Pointolite” glowlamp’.21 The innovative nature of the electric light lantern, and its safer form of illumination, was sometimes underlined by mentioning its relations to the bulky
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Figure 2.3 ‘Wrench’ series lanterns, cinematographs and accessories (1908): 167. EXEBD 36621/3. Reproduced by permission of the Bill Douglas Cinema Museum, University of Exeter.
batteries or dynamos, or the availability of supply, and suitable voltage, whether it was continuous, constant or direct. For instance, as Wright explained, ‘the current available from a public supply may be… unlimited so far as our purpose
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Figure 2.4 Page from ‘Optical Lanterns’ advertisement, The Amateur Photographer 45 (1907): iii. N. 1709 d. 2. Reproduced by kind permission of the Bodleian Library, University of Oxford.
is concerned, and the amount actually used depends only on the total electrical resistance of our circuit’.22 In an age when electricity had not yet taken the place of house gas, and a current was still not always available in as simple a form as gas then was, an arc or incandescent lamp had to be carefully selected to match the available current, or the circuit to suit the particular lamp, see (Figure 2.5).23
Figure 2.5 Page from The Art of Projection and Complete Magic Lantern Manual (1893): 130, of incandescent lamp for electric light lanterns. EXEBD 29785. Reproduced by permission of the Bill Douglas Cinema Museum, University of Exeter.
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For J. L. Payne, the innovative nature of the electric light lantern and its safer form of illuminating his slides not only came in the discovery that he made – the physical nature of fractured mandible patients that had come under his care at the Croydon and Wandsworth war hospitals – but also the scientific validity he attached to the images shown on the screen. The opening paragraphs in his paper demonstrate the authority of these slides: ‘I propose… to deal briefly with the types of cases met with, the nature of the displacements, the general lines of treatment.’24 This sentence indicates that photography mattered because its production-process could be traced to his individual experiences of the patients he had seen. This page of photographs shows the side and front face view of a patient who had lost all the anterior portion of his maxilla from the second molar on the left side to the second premolar on the right, with loss of substance to his upper lip and lower portion of the mandible on the left side (Figure 2.6). After projecting his slides for society members to see, Payne then described what they were seeing: ‘In so many patients there was serious loss of substance, bony union could not reasonably be hoped for; only in the slighter cases was the error in occlusion not likely to be serious.’25 This is an example of how surgeons presented restorative value through the images to control and rationalize multiple patients and communicate scientific evidence of new discoveries.26 Speakers used slides to highlight and explain specific characteristics in types of injury or to contrast the differences in a range of patients, so that those present at the meeting could recognize their nature and comprehend recovery times. Projecting the slide on to the screen allowed for illuminating and enlarging to facial details several feet in diameter. The lantern demonstration was presented in such a way as to encourage society members to rethink embodied perception/ technology in the sections by submitting their machine-operated observations. The comparison of photographic results on the screen, for example, emphasized the importance of principles which demanded accurate early treatment and careful planning, and even surgery that could go wrong, so that surgeons could gain an understanding of the possibilities and limitations of treatment.27 Those who were interested in participating were instructed on the information that should be photographed – including date, time, duration of recovery – and offered suggestions on how intervals between surgeries could be shown. Visual differentiation not only taught other surgeons and photographers how to recognize some of the predictable, and therefore avoidable, problems and complexities in treating and photographing these particular injuries in advance. Stimulating such a dialogue also provided access to first-hand experience of these patients to society members who had not yet had direct contact or
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Figure 2.6 Page of photographs for J. L. Payne in A. E. Rowlett, Case of Facial Restoration by Means of Mechanical Appliance, ‘Odontological Section. Discussion on War Injuries of the Jaw and Face’, Proceedings of the Royal Society of Medicine, 12. 3 (1916–17): 40. Reproduced by kind permission of the Royal Society of Medicine and Sage Publishing.
enough experience of their own. This interchangeable relationship meant that practitioners were taught to read living processes into these surgeries and were given new and immediate proof of the efficiency of these experimentations.
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Thus, projected images carried enough information for surgeons to assess treatment or to plan out their own sessions; photography came to define surgical activity, showing how much skin, muscle or bone surgeons needed to remove or attach in theatre. There was much professional and technical knowledge to be attained by these projections. Learning to make and read slides in the meeting room involved the full understanding of the procedural stages of the surgical operations and photography’s production-process. Through the lantern, surgeons could harness their slides to develop sophisticated visual strategies to portray operative movements and sequencing, for example, to inform society members of the working practice necessary to a safe operation. As Palfreyman and Rabier have noted, photography and image-making challenged surgeons to rethink their approaches to surgery and body vision, to both master new technologies and instrumentation and to relearn their fundamental skills of hand-eye coordination.28 Good teaching practice comprised the picturing of space and time as well as accessing clinical evidence of the surgical outcomes, so as to piece together the material and the immaterial actions to perceive the invisible techniques, steps and procedures in theatre, ward and darkroom. These dynamic processes of interaction and exchange between visible and invisible matter taught groups of surgeons to extend the textual communication of scientific evidence, into an imaginative and sensory space where mental projection, like the lantern, illuminated the steps and timings they wished to rewrite to join up the sequenced exposures thrown on to the screen.
From cameras to lanterns Although taking photographs in the facial wards and presenting a patient’s prolonged course of treatment via lantern technology were clearly considerably demanding activities, the society’s publication encourages us to look at these media in concert with each other, rather than in isolation.29 This section follows this encouragement by pointing to relations between photography and the lantern that legitimized scientific communications during wartime Britain: offering groups of surgeons and departments first-hand accounts of treating facial injuries within the guidelines of state-funded rehabilitation, reinforcing these scientific findings by leading society members through the assessments arrived at and establishing claims to pension diagnosis and a justification for treatment. For instance, the shared technologies of photography and the lantern
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became not only a mediation of the Ministry’s care and medical treatment until such time an injured serviceman was fit to return to civilian life but an extension of the research activity in the specialist centres, as an embodiment which was at once an instrument, an analytical category and a methodological orientation.30 The exchange of slides by Payne in 1916, discussed in the previous section, also supports this interpretation of photographic and lantern technologies as an extension of the surgeon’s body as these were not only meant to illustrate or prove the point he was making but also to pose the research question of how to effectively treat the patient. With sets of slides, groups of practitioners could compare their own experiences of patients and working protocols, the correlating of which helping to elucidate many of the difficult surgical and mechanical problems that awaited solution. Norman Bennett had received under his care similar patients resembling Payne’s ones, with not much loss of bone. The fractured parts of jaw were allowed to consolidate a little before separating them rather than using fixed caps or splints. The cases were also similar to patients that J. G. Turner had treated. He chose to immobilize his patients’ jaws, with the possibility of regeneration of new bone.31 The handheld camera’s lighter weight meant that a larger number of plates could be carried in the wards, and exposures were short enough to allow photographers to hold the apparatus against their body, and up closer to the patient, without a tripod, which was a bulky and restrictive component of the equipment. This design element in relation to the body facilitated a new portability and visuality in the wards and influenced what surgeons thought of photography and what they came to expect of it. Indeed, Baldwin’s comment ‘to favour nature’s efforts at repair by every means in our power’ suggests that he did not consider his photographs to be sufficient alone in recreating such an overview, something that, we can assume, he attempted to address with the lantern by sequencing the slides in a particular way and by adding his commentary.32 As was the case with many surgeons, the visual experiences that they talked about when they came into the meeting rooms do not seem to match the photographs they took if viewed individually (Figure 2.7). The conversations that took place in the society meetings revolved primarily around the usefulness of photography in advancing the lantern effect. When, for instance, J. L. Aymard contributed an article on his working practice to the Lancet, he was quite clear that assessing the results of grafting techniques required one ‘to discard the first photograph’, but ‘to examine carefully’ the final image ‘depicting the result of nature’s efforts prior to operation’.33 Aymard noted with dissatisfaction that the artificiality of photographic vision rendered single
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Figure 2.7 Page from G. Northcroft, ‘A Short Account of a Year’s Work at One of the Jaw Injuries Centres of the London Command’, Proceedings of the Royal Society of Medicine, 11. 3 (1918): 19. Reproduced by kind permission of the Royal Society of Medicine and Sage Publishing.
photographs inconclusive with reading that encouraged a studying of patients, first-hand, on a daily basis. To present a photograph of the original condition of the patient and to miss out the second photograph is, Aymard wrote, ‘from
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my point of view, more than misleading. To the experienced plastic surgeon some of the largest facial wounds which appear sensational before and behind the camera present few difficulties by the time nature has completed her part.’34 Aymard’s response to photography’s capacity to bring everything to a halt as a form of physical measurement of the spatial and temporal contingency of human eyesight was to reaffirm the lantern in the interpretation process. If the camera’s instantaneity was incapable of registering the daily changes in a patient’s condition, it was necessary for the surgeon to exaggerate the temporal and spatial dimensions and effects of reconstruction. For Aymard, the lantern effect retrained or redisciplined surgeons’ perceptual habits of surgery and the camera. In this sense, slides presented to society members and the community of readers needed to control the imagination as much as possible, so that the exaggerated sense of space and time was evident and led back to the camera. By 1917 photographers had gained even more control over the camera, sufficiently quick to secure good pictures of performed techniques in theatre – photography that implicitly links surgeons’ experiences of time and space of the surgical technique and healing process and bringing the photographs that would later emerge into conformity with the one they wanted to obtain. By far the clearest articulation of this ‘time held in abeyance’ is in a presentation Percival Cole delivered to the Section of Odontology on 3 December 1917.35 Once the patient’s progress was exposed on to the sensitized plate and reconstruction was sequenced and underwent translation and transmission into the slides, the reproductions constituted a visual encounter in which recovery is fixed into key stages of treatment and assessment, and opened up, as Liz Orton puts it, ‘new possibilities for algorithmic image calculation’.36 Judging the success of his methods and evaluating his decisions retrospectively, Cole questioned whether he should have postponed the treatment of his patients or operated sooner. He also considered whether a different method would have worked better in light of the facts secured by the slides. In a context where there was a developed and active knowledge community and constant participation, in Cole’s kinematic instructions as an operating theatre encounter one could see a newly configured experience of machines themselves. All of the images in Cole’s article reflect how the scientific value of photography moved to the service of the projection lantern. This was a long-standing technique of reproducing black and white lantern slides by copying glass plate negatives on to glass plate positives by photographic means. Slides could be made from negatives by contact or by reduction. This technology transfer comprised the following steps: using the contact process, in the darkroom, a lantern plate would
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be placed against the back of the negative plate, both of which were placed in a glass-fronted printing frame. The frame was then placed either in direct sunlight or under an enlarger, creating a new, direct exposure of the positive image. The final stage was processing using a developer and fixer in separate dishes to print out the image, then fixing and washing the plate to remove unexposed emulsion and any chemical by-products. Alternatively, the reduction process reproduced the glass plate negative by rephotographing it in the camera on to a lantern plate. The practitioner would take ordinary bromide lantern plates and load them into the camera. He would place the negative from which slides were to be made against a window so that the light from outside would illuminate the plate from behind. He then photographed the backlit negative with the camera using a small f-stop to ensure a short exposure time, creating a direct exposure on to the lantern plate in the camera.37 Cole was invited to take part in the discussion on 3 December 1917, and presented to the group several slides ‘bearing on the treatment of wounds involving the mucous membrane of the mouth and nose’.38 Cole then pointed out photography’s ability to capture, represent and carry this information, ‘pictorially at any rate, its configuration is a more accurate guide to the surgical measures necessary and the result achieved than is the residual deformity’.39 Cole’s attempt to represent such ambitious grafting techniques photographically constitutes a significant methodological bridge between 1916 and 1917 and a site of the working out of the shifting episteme. Cole presented slides of his patients’ results soon after operation, sometimes within hours. All of the slides in the presentation are also displayed as photographs in the RAMC albums.40 Moreover, many photographs that ended up in albums were first produced for projection in meeting rooms and read within the Proceedings. The three photographs of the first patient displayed in Cole’s article are laid out in the same order as in the album, although the photographs in the article have been cropped and enlarged during reproduction to focus the reader’s attention to the scarring on the patient’s cheek. He also published in the article drawings translated from his slides to make the operative stages into a serial form through a succession of movement – numbered and explained in corresponding text. To articulate the problem of kinematic representation rather than more practical reasons having to do with the costs of mechanically reproducing Norman’s photography, the accompanying drawings were spaced out and sorted into individual movements of surgical technique. Drawings after photographs and slides provided Cole with a further means of synthesizing broad-ranging information from different kinds of media and sources. These activities also provided Cole with paper tools
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that went hand in hand with an elaborate research process—one fundamentally determined by its photographic basis.41 The article offered two pages of thirtytwo drawings to illustrate the methods employed and thirty-two accompanying descriptions to support the nine photographs. Theatres of machines might have opened windows onto surgical and technical scenes, but the drawings of operative mechanism that followed promised coverage and mastery.42 Delicate arrows and faint dotted lines helped to indicate the direction of cutting movement or an alternative position, just as shaded areas of the face helped to indicate muscle or fat layers under the skin. Cole had proposed that every picture essentially involves the communication of motion. The mechanisms that were used to illustrate surgical methods of different kinds – the illustrations, that is – could themselves be referred to as ‘movements’ in theatre. Considering his experiences in relation to the physical mobility enabled by a handheld camera, which sometimes even captured patients before they were strong enough to leave their beds, Cole shared with colleagues his patients’ responses to treatment almost immediately. This eagerness to engage with ‘recovery’ should be understood not simply as a desire to capture and thus carry information on the surgical technique into the society meetings and journal. More importantly, this was a way to negotiate and then modify the information carried by the individual, still photograph, with the personal and subjective vision of the surgeon. For surgeons presenting their slides in meetings, the directness and spontaneity of vision of the instantaneous photograph appealed to this new way of seeing and thinking not only because of the savings to national welfare expenditure in the long term but also the embodied sense of technology that it provided. The use of the lantern led to an association of touch and sight and temporal and spatial effects of patients and surgeries that seemed palpable even though they were not. The impulse to solve the problem of representing motion with verbal description and notation underscores how necessary for kinematic knowing it remained to experience mechanical objects visually and even viscerally. The groups of surgeons in the meetings became components in the apparatus. Moreover, surgeons utilised optical devices as tools to lay down fundamental principles of surgery and to advocate an emergency tool kit method that would effectively translate the state’s aftercare into a specifically photographic methodology. The first stage of treatment was when a surgeon should study, research and plan for the operation. The second period was the operating stage when the surgeon would perform a graft or reconstruction in
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theatre. Then came the third stage; the surgeon did not do anything here, he waited. More precisely, the surgeon was involved in both pre-operative studying of the photographic image of the patient and a post-operative assessment of him, at which point he would comprise analysis of the operation with the slide to determine the extent of reconstruction. The surgeon was therefore involved in both pre-surgery studying of the slide or photograph and in the post-operative assessment of how much had been achieved. The surgeons were continuously asked to assess the progress of their patients while also training themselves to acknowledge the artificiality of the photographic slide and image and while also keeping their normal vision in check. Just as the practicality of photographing the patient was fuelled by a desire to see where the surgery was progressing and how the patient was recovering, the lantern helped surgeons to plan out operative sessions because the activities were of such duration and complexity, and the surrounding areas of a patient’s face were altered so significantly. This led to the need for more photographs to be taken to quickly map other parts of the face, which, in turn, led to the planning of additional reconstructive operations, and to further alterations and the need for new photographs. In that way, photography was a feedback loop in regard to the uncertainties which groups of surgeons felt. This cycle can be traced through the development of the surgeons’ overview of a patient’s recovery. However, this could also take the form of a more complicated process, from a certain view or sequencing there are limits to the human eyesight, such as an oversimplified account of restored functional capacity and therefore a lower rate of pension compensation as time and space is foreshortened or bled into one another. Continuities in working protocols between the medical boards, Local War Pensions Committees and war hospitals require mediation and materiality, and this necessary collaboration, necessarily a network of state-funded welfare, is most clearly developed by the RSM, whose precise and targeted analysis of the Ministry’s treatment provisions had the virtue of telescoping many of the qualities of a strong network of exclusive rehabilitative facilities reserved for disabled veterans. What was the lantern’s place in circulating the results of facial injuries across broader modern technologies of communication and longer-term educational concerns? In what way, then, was the chemical photographic image transferred from live lantern lecture to an ink photograph in a published paper? As the next section shows, examining the combined meetings of laryngology, rhinology and ophthalmology between 1917 and 1919 may provide us with key insights to answer these questions.
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From lantern to published papers In his presidential address of 1 November 1918, James Donelan praised the advances of laryngology and rhinology in ‘war surgery and especially the repair of facial injuries’, where research by fellow members had obtained ‘a leading position in the great scientific movement… taking place’.43 Three months later, at a meeting on 7 February 1919, with Donelan in the chair, thirteen society members were carried on a journey through three years of experience caring for patients with combined wounds of the orbit and sinuses by means of lantern slides.44 G. S. Hett, a RAMC major working in the Ear, Nose and Throat Department at Sidcup, invested his work with visual authority by presenting an extensive set of slides as points of investigation and to verify the systematization of ideas he and his colleagues had made (Figure 2.8).45
Figure 2.8 Photographic lantern slide of Private Slater, circa 1918. Photographed and reproduced by Sydney Walbridge. Gillies collection, the British Association of Plastic, Reconstructive and Aesthetic Surgeons, BAPRAS/G/31/5/Box 3, from the archive of the Royal College of Surgeons of England, London.
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Hett invited those members present to assess the surgical outcomes for themselves; the group then interpreted and debated these slides, to open for discussion the possibilities of graft and cartilage supports in the rebuilding of nasal and sinus injuries. This meeting was later published and circulated as twentypage and twelve-page articles and fully illustrated with fifty-eight photographs for the wider community that constituted the Proceedings’ readership. Printed in the article, the ink photographs took on a new meaning that was a constant reflection of their production and their earlier forms of display as photochemical slides in the meetings, as epistemological objects to be conferred. In this way, the community of readers could articulate the lantern at the heart of research debate by tracing the reproductive images, following the photomechanical translation from the ink photograph on the article page directly back to its related item – a chemical positive on glass, and a projection, and allowing a seamless connection back to the treatment provisions aligned with Hett’s department.46 The value given to a photographic image was made explicit through its reproduction in print.47 For society members, a photograph gained meaning through the steps and processes of its translation from a chemical slide in a meeting room to its reproduced ink substitute on the printed page and through its textual documentation,48 an absent original lying behind the copy.49 Elizabeth Edwards and Sigrid Lien’s notion of copy photographs is essential here to understand how these slides, as intermediary analogue copies, became part of a ‘processually invisible layering’ of bureaucratic activity and knowledge formation.50 In response to continuing public and political lobbying on behalf of the disabled veteran, the War Pensions Act of 1919 solidified the state’s responsibility to disabled ex-servicemen. The legislation’s most significant measures entrenched pensions as a statutory right, introduced independent appeal tribunals and secured an increase in the rate of pensions provided. In addition to providing a pension, the Ministry facility provided medical and rehabilitative treatment. The Ministry’s treatment provisions initially revolved around utilizing accommodation in civil hospitals and military hospitals as well as establishing its own specialist facilities, like the Queen’s Hospital in Sidcup.51 Coinciding with the large-scale demobilization of servicemen in 1919, the Ministry would go on to establish a more substantial network of exclusive rehabilitative facilities reserved for disabled veterans.52 Medical and rehabilitative treatment were very much part of the ministry’s philosophy of ‘reconstruction’ which sought to facilitate the full-time employment of a disabled ex-serviceman. This rehabilitation aimed to save national welfare expenditure in the long term by diminishing the need for poverty-stricken ex-servicemen to claim for state-funded welfare.
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Ex-servicemen who required in-patient treatment were provided with a maximum pension entitled a ‘treatment allowance’, regardless of the grading and severity of their disability, to entice them to undergo rehabilitative care.53 On 7 March 1919, Hett shared twenty-eight slides of a further seven patients under his care amongst laryngology members. Adding precision to his February paper, Hett ‘sketch[ed] out further principles which he had not yet touched on’.54 He sequenced his slides so as to replicate his experience of continuously observing these patients for two or three months progressively improving, projecting ‘before and after’ images for each, including admission shots, newly formed grafts recorded within hours of insertion and healing times spanning several months. The slides that Hett had projected on to the screen certainly stimulated debate, and reinforced the lantern as a fundamental technology of visual validation for his methods. The members praised Hett’s care for these patients and for obtaining uniform good results. Somerville Hastings, having also treated many such patients, had found it useful to adopt a method of making up the new nose first with wax, before having it recast in metal by the dental department.55 Herbert Tilley interjected with a further option, to use portions of cartilage removed from one patient on the day before it was implanted in a second patient, as long as the piece was kept in sterile saline solution during the intervening night.56 The society members drew from their own personal observations and experience to corroborate the slides and evidence of Hett. Lawson Whale found Hett’s slides striking, for allowing one ‘to see how the scar tissue softens and the colour and texture of the skin approximates to that of the surrounding skin’, and recounting cases that had not proved so successful. He commended Hett’s work in tissue transfer, and affirmed, ‘I made some noses in France earlier in the war, and those which are not lined do not do so well.’57 Owing to the costs of reproduction, the printing of so many slides was only made possible by Hett’s collaboration with the editorial committee, who had to submit a statement of the costs of reproduction to the council of the sections before publication could be approved.58 One week after Hett presented his second of a two-part paper the Council of Laryngology met on 14 March 1919, whereon Donelan announced, ‘Mr Hett was willing to bear the cost of the blocks himself.’59 For Hett and for the Proceedings, the slides acted as an essential part of transporting and sharing his personal experiences to his section colleagues and the wider community of members. The cost of labour involved in reproducing photographs in the Proceedings was expensive, and relatively few slides were photomechanically printed in the articles. Due to wartime rationing, supply shortages, and increased workload for the government, the printing and publishing company John Bale, Sons, and
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Danielsson, Ltd, 83-91 Great Titchfield Street, wrote twice to the RSM seeking financial assistance to offset an increase in wages and printing materials. By March 1916, the firm was printing the Proceedings at a loss. The RSM council granted a request for a 15 per cent increase. At a council meeting on 6 February 1917, the society committee was reluctant to choose between two equally unappealing choices: reduce the size of the publications or raise the subscription price. The financial problems of producing the Proceedings exceeded the entire annual income from members’ subscriptions. The committee agreed to place a large notice in the front hall, requesting fellows living in the neighbourhood to collect their Proceedings to save on postage costs. At the next monthly council meeting, the secretary reported to the committee that nearly 400 journals had been collected in person, at ‘a saving of about £6’. Yet the subscription rate for 1917 was subsequently increased to £1 1s. per annum.60 In July of 1917, the printing company wrote again to the society requesting a further increase of 5 per cent owing to additional printing and material costs. After consideration, this was also agreed.61 Photomechanical processes played a useful part in the war effort. Process blocks and process printing became an industry of national importance. But workmen were being rapidly absorbed into the Army, and there was a grave prospect of supplies of chemicals, zinc, copper and dry plates being either wholly stopped or severely rationed. Because of the high demand for process and photolithographic plants on various fronts overseas and at home, the regular process houses did a great deal of work for the military authorities for intelligence, propaganda, instructional and official purposes. Hett was called back to Wimpole Street to present again on 2 April 1919, this time at a joint meeting of the Sections of Ophthalmology and Laryngology.62 The Ophthalmology Section had called this joint meeting out of a desire for new ways to learn about the dangers which beset the optic nerve. The emphasis that Hett placed on the lantern was compounded in this joint meeting when he projected a total of forty slides as a topic of debate to bring these communities of practice together. The slide’s value within this meeting lay in the way it posed questions of coordination for ophthalmologists and laryngologists. All members in attendance at the joint meetings acknowledged Hett’s slides as a shift in the understanding of combined ophthalmic and plastic work. With the experiments carried out at Sidcup, the slides demonstrated to both sections that the treatments should actually be sequenced in a field of action and not performed in isolation. In order for the laryngology and ophthalmology communities to form a cohesive group and prove to their readership that these images were valid, their argument needed to be one of coordination, and for the articles and
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images to be read together. This cooperation, a key aspect of their overlapping practices, makes for a distinct reading of the texts. The first two articles from the February and March meetings, which contained in total eighteen patients and fifty-eight photographs, provided an in-depth visual analysis, thus targeting a laryngology readership, as well as indicating the purpose of the images to ophthalmologists. This coordination of ophthalmic and plastic arguments was unique at the time, and augments the way they began to interact and adhere around all the elements that were connected or mutually implicated in a field of action and being presented to them. Two additional joint meetings were held in April and the subsequent publications moved further beyond the confines of a single discipline, and the reader had to move across different epistemological boundaries. While these sections of the society were distinct disciplines, in that they were divided into two communities, the discussions in the meetings and articles interlock. While some of the readers of the Proceedings may have attended the society meetings in person, other members could be equally informed. The slides, allowing the free transit of teaching objects to the journal publications, library open shelves and homes of subscribers, were entangled in the active training of a much broader network of society members and communities of military welfare through their replication in printed media. The translation of the slide into forms of publication helped to establish their sequencing into courses of treatment and recovery times that could be conceptualized and followed, thus, reinforcing the scientific authority and legitimacy that was attached to the lantern slides in the original debate, and consolidating the Ministry’s financial liability of these disfigured veterans. As material objects, the Proceedings are able to circulate rules and guidance on facial reconstructive procedures and predicted outcomes. Through a series of slides, publications and albums, it becomes apparent that these facial injury photographs do not just emerge from their negatives and travel on completely disconnected and divergent paths. Wilder is surely correct to underscore the usefulness of thinking about proximity of these objects as they come into contact with one another through catalogues, or on shelves, or in albums or books, as ‘more than a physical attachment, since they influence one another across decades and across collections’.63 With the absence of slides in most medical collections, due in part to bureaucratic problems with storing large numbers of fragile glass objects compared with the ease of storing and displaying prints in albums or journals on open shelves, the physical absence of these slides is shaped by the practicality of preserving one and not the other – as part of a museum’s ecosystem. The slide’s
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apparent efficacy in the RSM, its utility within the meeting rooms and how it travelled and was put to work, was valued only as a means of reproduction. Indeed, as Edwards and Lien argue, the volatility, instability and even disposability of the material forms of photographs, as required by their traditional roles in museums and archives, reinforce this undervalue.64 Thus collections become as much about what can be inferred from absence as what is present. Many institutions such as the Royal Geographical Society and Royal Photographic Society kept their slides and still have vast slide collections, preserved as useful objects for learning and tending to have long lives circulating around classrooms and lecture halls. Yet the slides from the RSM were transformed by their exit from the meeting room by only being reused in the short term, then later archived and forgotten, reproduced in Proceedings – for ease of collecting, display and access within the library.
Conclusion The Great War induced a fundamental change in the state’s treatment of disabled ex-servicemen. The newly created Ministry of Pensions established legal pension rights and acknowledged accountability for the treatment and rehabilitation of disabled veterans. Nowhere is this development better exemplified than in the treatment of facially injured ex-service personnel. From 1916, the rapidity of injured and disfigured ex-servicemen being admitted into specialist centres produced in surgeons an attempt to streamline Ministry policy and consult and photograph these patients very quickly. New findings of reparative work could then be projected and clarified alongside and to fellow members, and also extending out from the society meetings in the form of cooperation with the library and the reproduction of slides in the Proceedings. For example, speaking about photography and the wards of the First London General Hospital, Northcroft argued that ‘such systematised case taking is worth while, and saves its cost over and over again, in that it tends to better results and quicker results’, even though an accompanying footnote to his article reads: ‘owing to the costs of production, all illustrations of splints and several photographs shown in the epidiascope have been omitted’.65 Among the advantages of knowledge sharing was the creation of common working protocols in relation to the implementation of state-subsidized and public-funded healthcare, which would then end up having real economic savings during rehabilitative care as well as fostering interdisciplinary exchange, just as the RAMC and Pensions Ministry recognized.
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The medical sciences had a distinct and increasingly consolidated professional community in early twentieth century Britain, and, as discussed in this chapter, journals became pivotal in developing and managing specialist communities of practice. At the same time, camera and lantern technologies enabled different groups of practitioners to participate in debates over patient care. In the increasingly important subfields of surgical science, these technologies were central to the organization of groups involved in the Ministry’s rehabilitative strategy and in gathering information about patient health, pension rights and financial recompense. Freely placing itself at the service of the government during the war had also proved costly for the RSM. It absorbed almost all of the income generated by subscription and membership fees, and in the eyes of the society’s finance committee ‘a deficit of not less than £1500 for their yearly work since 1918’.66 On 12 February 1921, at the request of the committee, the secretary sent a letter to the government asking for financial assistance, pointing out the society’s dedicated activities during the war, and the threat to its very existence by reasons of the enormously increased cost of printing its Proceedings and additional duties that had been incurred during that period.67 In what would become a constant ethos underlying most ministry ventures, an austere policy shift was deemed necessary throughout Britain: ‘In a department which requires the taxpayer to provide an annual sum of over £100 million, financial control is obviously of first class importance.’68 Local powers were subsequently reduced from 1920 onwards. The Ministry transferred significant jurisdiction regarding policy and expenditure, including the certification and arrangement of treatment, to the eleven regional officers headquartering the eleven areas of the United Kingdom.69 Under the jurisdiction of a regional headquarters’ director-general, much of the medical-related work was now placed under the authority of a commissioner of medical services and deputy commissioner of medical services. These commissioners oversaw the function of medical pensions, treatment and the general bureaucracy of all medical-related matters.70 Despite the increased state intervention in the wellbeing of returning disabled veterans, voluntarism, philanthropy and employment remained central to the Ministry’s rehabilitative strategy. This societal involvement would fatally compromise the Ministry’s attempts to rehabilitate facially injured veterans. While recognizing the financial assistance and opportunity for medical treatment offered by the Ministry, the unpredictable nature and pervasive stigma attached to facial difference often prevented many facially injured pensioners attaining employment.
3
Mobilizing the camera as therapy The amateur photographers at work: organization, equipment and business
Instead of encumbering photographers with heavy equipment and the impractical restrictions of the trade, photographic manufacturers provided compact and pocket cameras, just in time for the Great War. At the outbreak of war, there was a boom in camera sales.1 The military markets these cameras served were littered with other media and technologies, some new, others not so new, and their uses were determined in reference to, and sometimes through, these other media. Amateur photography was also, crucially, a practice increasingly tied to the performance of war hospitals. It offered light consumer-durable products that could produce and communicate personal and intimate experiences of the war. Small, convenient, handheld cameras, like the ‘Sibyl’ models made by Newman and Guardia, complete with glass plates or reloadable films that one could send away to be developed, encouraged and facilitated a much wider segment of the population into amateur photography – nurses, orderlies and patients among them (Figure 3.1).2 During the Great War, the photographic periodicals of England brought a change to amateur practices. They were typified by advertisements which became from 1914 the mouthpiece for light folding cameras like the Vest Pocket Kodak or Newman and Guardia’s Sibyl, which took plates, film packs or roll films. The photographic press was filled with instructions on how to mobilise the camera for soldiers’ rehabilitation. Amid the stories of aiding the war effort pervading the periodicals lay a set of practices that operated to affect the relations of care and which were simultaneously topics of that care. These included amateur photographers and professionals, and cooperation between photographic clubs in the localities where war hospitals were established. Together, these caregiving communities met the wartime public appeals for financial and voluntary support to keep the Red Cross hospitals running and to meet the sick and wounded
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Figure 3.1 The Newman and Guardia ‘Sibyl’ Camera (Advertisement), The Photographic Industry of Great Britain (London: The British Photographic Manufacturers Association, 1920): 256. LBY 85/3294. Reproduced by kind permission of the Imperial War Museum, London.
men’s needs. Yet while official photographers tried to conceal the horrific wounds and diseases inflicted on the average soldier, amateur and unofficial practitioners went their own way. The struggles that facially injured patients
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experienced in war hospitals not only allowed for this emerging community to shape new concepts of rehabilitation but also challenge the military economics and propaganda which sought to efface it. This chapter asks what the role was of the camera, the periodical and the album in shaping new and alternative health therapies for groups of medical personnel and patients for a more personal experience of rehabilitation in the facial centres. When the photographic presses discussed photography they did so in very different ways from the medical press. Unlike the Lancet and the Proceedings of the RSM, when periodicals such as Amateur Photographer, which began in October 1884, discussed new technology the value of photography was its ability to give control to the amateur photographer. In other words, photographic manufacturers and services took the worry of being at the mercy of the camera’s liquid intelligence out of the hands of amateur photographers. Only through understanding the changes in photographic technology and the availability of mass-produced materials in the popular photographic periodicals can we conceptualize how the innovations in camera design and High-street photographic services made the camera easier to use. These notable changes contributed to an increase in amateurs and underpinned a wider interest in photography as a leisure pursuit for the expanding middle classes. The general perception of what defined an amateur photographer also shifted. It moved away from one who practiced photography and had an understanding and practical knowledge of all aspects of its operation to one that simply made photographs. Periodicals like Amateur Photographer were more than just a weekly publication; they sought to make it easier for amateur photographers to believe that they were ‘in control’, promoting a medium that was increasingly concealing the user’s look and exposure of the plates and films and separating these events from the chemical processes of image-making. As the Photographic Section of Boots the Chemist wrote in the Amateur Photographer and Photography in August 1918, ‘So many things happen everyday, visits from friends on leave, parties for blue boys, that our cameras seem always on the click’. For Boots, it was clear that ‘We’re recording history, and one print of every picture we take should be carefully preserved in some sort of an album for the benefit of future generations… So if you are recording history, get an album from Boots and keep your pictures safe’ (see Figures 3.2 and 3.3).3 As with other photographic services at this time, there was a growing tendency to advertise photography as a therapeutic pursuit to meet consumer demand for personalized histories of the war, and the periodical press expressed and facilitated this form of social activity as an important lifestyle choice. Furthermore, the nursing staff,
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Figure 3.2 ‘Pictorial History’, Boots Photographic Section (Advertisement), Amateur Photographer and Photography, 46. 1545 (7 August 1918): 2. N. 1709 d. 2. Reproduced by kind permission of the Bodleian Library, University of Oxford.
orderlies and patients participating in this activity can be treated as an extension of the instruments they carried, considered one with the therapeutic device they bore, as the camera becomes co-extensive with the camera’s use. Similarly, the nurses who carried a camera to picture groups of patients in the facial wards did so from the perspective of ‘a commitment to care’, and gained better capacity
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Figure 3.3 ‘Service’, Boots Photographic Section (Advertisement), Amateur Photographer and Photography, 46. 1545 (4 September 1918): 2. N. 1709 d. 2. Reproduced by kind permission of the Bodleian Library, University of Oxford.
to practice care and evolved the work of convalescence by visually as well as emotionally recuperating the men under their charge. This chapter will follow photography as it entered these new military markets, marked by a major increase in the number of amateur photographers between 1914 and 1918, and through the establishment of a diverse community of
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photographers and businesses in aid of the war effort. With the introduction of cheaper and easy-to-use cameras like those produced and marketed by Kodak or Newman and Guardia, the number of unofficial photographers grew to exceed the number of official photographers. Yet conditions that were previously good enough for civilian or amateur photographers were no longer appropriate during the war. With an increase in supply difficulties and shortages of photographic raw materials as the war progressed, the highest purity materials were all being commandeered for war purposes and official military work. With the added encroachments of the camera under the Defence of the Realm Act (DORA), the period ushered in a variety of social measures and simultaneously undermining the value of ‘go-as-you-please photography’ in the streets without a permit.4 Hedged in by the control and censorship of government restrictions, the public only had authority to take photographs in their own garden.5 Amateur and unofficial photographers ran the risk of encompassing a claim to illegal practice, and independence rarely available to their professional peers. The risk of trying to skirt the boundaries between bureaucrats and editors and government censorship was that amateurs would have breached state and medical legislation if circulating such images at the time. Despite the emphasis on the agendas of the market, which can assume a causal relationship between what is being sold and what is being used, the amateur practices of nurses were not automatic. Just because companies like Boots and Kodak sold ideas about photography on the British High-street and advertised their services in a particular way, people did not necessarily practice photography accordingly.
Relieving the monotony of the ward Emerin Keene and her sister Carolyn were both volunteer nurses for the American Red Cross. In the spring of 1918, the sisters received a letter requesting them to report for duty at the Ospedale Stomatoiatrico, the hospital for facial surgery, located at Villa Massimo in Rome. In her album and diary, the role of photography as a tool for scientific communication and as therapy to relieve the daily monotony of facially injured soldiers is particularly evident. Keene’s photography altered the experience of her time in a facial ward caring for young injured Italian patients. Keene was not a trained medical photographer but an enthusiastic amateur of photography tasked with picturing the patients before and after surgery, and moonlighting as a family photographer for the men during convalescence.6 The resulting images were not intended for public display, but
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nor were they completely private. Instead, they were objects to be shared with participants as tokens of friendship, added to an album which would, in turn, be shared with family and friends. In so doing, she was undergoing major transformations in her own family. She was, according to Patrizia Di Bello, producing a mother’s investment in representations of the hospital family as a fantasy of her success as a nurse, as an album-making practice in which she attempts to gloss over the denials of work, unhappiness, conflict, separation, illness and daily drudgery.7 After Italy’s entry into the war in May 1915, it had almost no facilities for such medical and rehabilitative work. She had no artificial-limb factories, scarcely any disability homes or system of education for the injured and very few social organizations competent to undertake it.8 As in Britain, the government of Italy built up this new work and made efforts to provide employment and training assistance, and carefully studied the experience and methods of countries like France. Re-education courses began in scattered private efforts which were later coordinated and brought more or less under government control. The governmental employment schemes were enforced in close cooperation with the military authorities. After disabled Italian ex-servicemen were discharged from the re-education schools and from the army the national board was expected to provide for their future. For all disabled Italian veterans capable of earning their own living, they were expected to find their own positions. Government policy merely stated that the national board had to make every effort to aid men’s transition back into employment and that all public officials, civil service, tram and railway companies had to render every possible assistance. Public employment bureaus subsidized by the Italian government and also provincial and communal employment bureaus were to attend to the placement of the war disabled. Tracing the therapeutic use of the camera in this facial centre in Rome offers a contrast with the treatment of facial surgery in Britain, providing a vantage point for evaluating the impact of underfunding in Italy. It seems that occupational rehabilitation was very limited in the Italian facial centres, due to the primacy of dental surgeons in this work, whose experience of dealing with major injury, in contrast to medically qualified surgeons, may have limited their understanding of the need for both rehabilitation and psychological support. Much of this latter work was left to the nurses. In Britain, the commercially successful photographic periodicals struck a balance between broad community participation and the performance of war hospitals. Keene’s use of photography during her short appointment helped to establish and reinforce the intimacy of relationships in the ward. This reinforcement relied
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upon the creative energies of scientific and amateur photographic practices. In their creation and circulation in an album, the Keene images offer an example of photography as a collaborative, social and therapeutic activity (Figure 3.4). She wrote, ‘My own personal contribution to the general morale of the soldiers was my very much overworked camera. The first time I appeared with it there was a roar of delight and before I knew it I had about seventy-five following me to the front terrace, though I had only requested a small number to make up a characteristic group.’9 Writing about the considerable enthusiasm among the patients to be photographed, Keene noted, ‘Our progress was like a “snowball” – in a few minutes I had used up all my films with the different groupings. After that, seeing how much real pleasure it gave, in the anticipation of sending a photograph to “mother”, “wife” or “sweetheart”, I appeared at regular intervals on the same smile-bringing mission.’10 Through the forms of collaboration and co-creation of photography which took place, Keene and the patients worked towards a positive experience together. Her photography captures a hospital family’s recovery ‘in the making’ in a more literal sense, recording times when they were subject to involuntary dislocation and displacement as a matter of rehabilitative policy. Soon after Keene printed a photograph, the soldier’s portrait was already circulating within a letter to his family network, through the postal service, and through visitors to the hospital. When reproductions of these photographs were finally compiled in Keene’s album, copies of the group shots and individual portraits of the soldiers would have also been kept in numerous households in the region. What is particularly interesting about Keene’s album is that she was inadvertently making her frustrated desires and aspirations visible. Her rationalizing impulse to master both the complexities of the facial wards and the problems labour-intense liquids posed for her as a photographer were inescapably tied to the image-making process. Almost every one of the surgical prints has small bleached patches in each of their corners, an indication that Keene sparingly applied dabs of glue onto each print to stick them to the pages. The silver bromide surface of each print has reacted with the glue and faded over time. This could indicate a low-grade printing paper with impure silver or insufficient fixing and washing of the photographs and hints at the technical challenges of Keene’s wartime photography. Failure to control the variables in the development process, or the use of improperly constituted chemicals interfered with the production of the image.11 In her darkroom activities, Keene did not enact these failures deliberately but could easily have under- and over-exposed her images by leaving them too briefly or too long in the developing solution,
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Figure 3.4 Photograph Albums by William Johnson & Son (Advertisement), The Photographic Industry of Great Britain (London: The British Photographic Manufacturers Association, 1920): 175. LBY 85/3294. Reproduced by kind permission of the Imperial War Museum.
unevenly developing them or improperly fixing or washing them. By means of such mishandling of standard photographic technique, she increased the scope of permissible liquid activity in her practice.
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It is clear from Keene’s diary entries that she wrestled with adverse material and atmospheric difficulties. The dust floated around in the air while she processed her films and prints at home and clearly interrupted the materials and subsequent activities. Keene’s photography was accidental, and possessed local and physical markings which registered her makeshift darkroom and absorbed the humidity of springtime in the duration of its making, creating scratches all over the plates and films, fogging emulsions and chemically staining, fading, and discolouring the prints. Keene wrote: [I]t kept me busy while at home, printing countless photographs, as it would have soon developed into an expensive luxury had I not done the work myself. Generally every article of furniture became covered with drying photos, and my family complained at not finding a corner in which to rest. At one time I thought of teaching the soldiers to do their own printing, but decided to refrain lest the acid bottles get mixed with the medicine bottles.12
It is with regard to the ongoing creation and becoming of the practices that Keene’s story highlights the sensitivity and susceptibility of fluid processes and questions the bounds and dictates of technological and medical constraint. Plates and films exposed soldiers onto the emulsion but also the effects of touch, humidity and variations in temperature or washing times. These blemishes, anomalies and mixing of different fields of practice are blurred by the over- or under-exposure to light, or insufficient processing, omitted from scientific publications and deselected from the writing of reparative narratives. This damage speaks of the instabilities in the processing chemicals and the form-dissolving actions of fluid agency, and of the confines of Keene’s scullery darkroom and parlour drying room, not to mention the drama of the raw materials. Such mishaps made their behaviour unpredictable and their pictorial effects unforeseeable. Through their embrace of fluid agency, they echo the resistance to dry intelligence. For an account of how cameras and photographic materials should work, we can consult the photographic press. However, in challenging environments, characterized by limited darkroom space, time and labour, constant pressures of ward duties, or humidity, or even battling with light and dark and sensitivity, the particular use of fluid materials in this case draws into question the epistemological status of medical images, challenging the fixity and evidence of photography. Attempts to control liquid agency in the photographic process under demanding conditions became an essential way in which this nurse confronted the struggles of the facial ward and performed as a psychological stimulus to
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cope with facial difference and the lengthy treatments the wounded were undergoing. Keene epitomizes the unexpected relationship between different fields of practice. She wrote, ‘[I]n this nurse’s life one becomes so much attached to the helpless ones that when they finally leave as strong soldiers again, we find ourselves following them with really affectionate memories – in spite (or because of?) – the anxiety and trouble they have caused us.’13 Dealing with depression and the psychological illnesses resulting from facial wounds were a source of constant unease for Keene. The severely disfigured bodies appeared to have lost any connotation of stoic manliness, so that their sexual desirability was also in peril of fading. Such a prospect frustrated and, at the same time, terrified some soldiers, according to Lina Andreotti, an Italian nurse serving the Red Cross. She wrote in her diary on 29 August 1915: Wounded men forever crippled and disfigured ask us with such a worry: ‘will my fiancée still desire me though in such a shape?’… The distant girl does not see his deformity; she thinks of her handsome boyfriend as he appeared at their last farewell. But once she will face this rotten beauty and the harsh reality that her crippled, damaged and sickly betrothed will put her on view, what will her instinct suggest her to do?14
These concerns reinforce Keene’s photography as an emotionally charged experience. The photographic event, in this instance, was therapy, for Keene as much as for her patients. When the time came for one particular patient to leave the hospital, Keene had to send for him to bid him goodbye. The soldier was not in a condition to return to the front, so he resumed the uniform of his former occupation. Upon her asking why he had not come to see her, he replied, ‘signorina, I wanted to remember you as you were when I was merely a convalescent soldier in your charge. I feared you might not be so eager to say farewell to a simple tram conductor.’15 Keene then went on to describe another patient with whom she held great affection, Private Moroni. She wrote, ‘at intervals during’ a particularly ‘tedious four-hour operation, the surgeon would speak to Moroni in a slow voice, and always received an intelligible reply… When the strip of carefully measured skin from his neck had been grafted onto the cheek, experimentally and without cutting it off from the blood supply, a new eyelid had been formed to welcome the glass eye’. After the operation, she leaned over and uncovered Moroni’s eye: ‘just wait until you see yourself in the glass,… do I look human again, signorina’, he asked. ‘[I]ndeed you do’, she replied, and swallowed a lump in her throat, which threatened to belie her cheerfulness. She ‘hoped that the
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grafted skin would resume its normal colour before he could see himself without his bandages’.16 Keene was transferred away from the hospital before the twentytwo operations on Moroni were completed, but on her departure he had already started to chew and eat hard foods for himself. The camera served as an activity to build caring relationships as well as a form of self-expression for the participants to make sense of the difficulties they were going through. Moreover, Keene’s photography evolved over time in response to particular duties and obligations of care support, changes in recognizing vulnerability as an ethical stance and corresponding changes in the practices of recovery that followed engagements with technologies of touch. Right from the beginning amateur photography in the facial ward changed professions and practices far beyond those of the photographer and the institution, beyond the military, the hospital and the family. These ward activities did not straightforwardly supersede old practices or render them obsolete – rather it altered them. It joined with them to produce a new hybrid mode of operating, a new hybrid technology. Old practices survive alongside new ones, and old relationships are bound in new practices. Keene’s photography speaks of the ways in which a technologically altered experience of facial injury had seeped into everyday practices that overtly positioned themselves outside, and against, the devastation of modern and industrial warfare.
War hospitals and the photographic press The British photographic press sought to unite a growing but also diversifying community of amateur and professional photographers and small and mediumsized manufacturers in aid of the war effort. Early in the war, a shortage in the key constituents of raw photographic materials created a global price rise in the market and threatened the greater part of the requirements of military and government departments who were using photography for war purposes, principally as a weapon of war in the form of aerial reconnaissance, propaganda and training films, followed by scientific work by the Medical Services.17 The Great War represents an important juncture in reexamining Britain’s photographic industry and the energy and resources of its manufacturers to meet the requirements of all photographic sections of the forces.18 By 1915, the supply of raw photographic materials for official military work was nearly exhausted. With the supply of bromide practically limited to Germany and the United States, the almost complete block of German exports had caused the price to rise
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from 2s. to as high as 25s. per pound, although, by the end of the year, the price had settled down to a fairly steady 5s. per pound.19 Chemicals such as metol and amidol were not made in Britain even though they were vital for the developing of plates and papers. Gelatin had also gradually increased in price since the war broke out and by 1915 was double its pre-war cost. There was a considerable quantity of German gelatin in use, and the British, Swiss, and French gelatins did not have the same purities. Although the production of British emulsions had been very much increased, manufacturers experienced difficulties owing to the shortage of high-quality raw materials, and with very few supplies being imported from US factories. Gelatin was a specialized industrial process, and not only had to be sourced from boiling animal skin, cartilage and bone, which was subject to a nationwide food shortage, but also had a very limited application. In addition, the price of glass, for lenses, plates and slides, which had already risen before the war, had risen further by 70 to 100 per cent, the complete withdrawal of Belgian supplies being partly responsible.20 The supply of photographic raw paper had also been reduced, and although a certain increase in British output had resulted, both of paper and baryta coating, there had been a distinct shortage and as a result the price had risen significantly. As in other industries that were, or became, crucial to the war effort, the shortages or poorer quality products led to an increase in home production of key photographic raw materials. During the first year of the war, military hospitals would use insignificant quantities of British glass plates, photographic paper and chemicals. David Edgerton argues that by 1914 the British photographic industry was characterized by relatively small firms, most of them private, supplying glass plates and paper to professional photographers and amateurs. These firms did not produce chemicals or most of the sophisticated raw materials that went into photographic materials.21 The businesses forged by the photographic press must be viewed in relation to this broader context of industry formation in the Great War, and for the specific ways that its editors and publishers fostered a sense of collective identity among the enterprises and their readers. It was by drawing the collective enterprises into a cohesive imagined community, a conversation begun within the confines of the War Office, that Britain’s photographic industry expanded to a national and even imperial scale. The technologies mobilized in the photographic and radiographic departments became a life-saving asset in the war hospitals. By the time the KGH closed in May 1919, its departments had performed over 6,500 examinations, with its team of subsidiary workers making several thousands of X-ray and photographic plates (Figure 3.5).22 Photography had been here turned into a regimented production
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Figure 3.5 Two nurses processing X-ray plates in the developing room, from photograph album of the King George V Military Hospital, 1915–19, photograph by Benjamin Disreali Margerison, RARE B[0] ac no. 16685. Reproduced by kind permission of the Imperial War Museum.
process available to any patient of the hospital. In another hospital ‘in a little over two years 56,000 X-ray negatives were made. The total supply of special X-ray plates issued to the RAMC in twelve months amounted to over one million 12 × 10 and 15 × 12 plates’.23 In 1918, 6,500,000 negative and X-ray plates were used and 5,800,000 prints were made across the UK for war purposes.24 The editor-in-chief of the Amateur Photographer, F. J. Mortimer, was relieved to find ‘some occupation in photography where there are no limitations whatever, other than the extent of the time at one’s disposal and the length of one’s purse to provide the campaign’.25 In the attempts to advance photography scientifically, socially and nationally in Britain, Mortimer was a key character in facilitating the cooperation of photographic societies and camera clubs in and around war hospitals. Mortimer was at the meeting point of camera clubs and war hospitals and therefore offers a unique perspective on the relationship between them and the practical and moral facets of the photographic trade. Mortimer encouraged camera clubs to assist in the war effort. Using his knowledge of scientific work for the war hospitals as well as regular entertainment for the patients through the organization of travel lectures and shows, he strongly
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urged amateurs and professionals ‘to communicate at once with the officer commanding their local military hospital, and ascertain if their services are required’.26 If camera clubs were to assume not only ‘the social side of the war service’ but also ‘the serious side’, Mortimer wrote, a lesson could be learnt from ‘the efforts of the Croydon Camera Club’, whose members where ‘develop[ing] the plates made by the radiographs of wounded soldiers’ from the nearby Croydon War Hospital.27 The stress here was on both the bigger clubs to take the lead in photographic work for war hospitals and calling upon the neighbouring smaller clubs for their help as needed. This latter point is particularly important as it demonstrates the complexity of the relationships between enterprises of different scales and how they shaped the medical work. While some members of the small clubs fought to be recognized as skilled photographers, the fact that their work for the RAMC was not large-scale manufacture but understood as small mechanical and voluntary outfits their activities tended to situate them as machine operators, tradesmen at best. The other important point about this cooperation is that in a context where the nature of industrial organization is polymorphic and consists of a cluster of small and medium-sized camera clubs and businesses acting as production units, the RAMC did not see it as necessary for voluntary workers to be highly skilled in radiography in order to assist a war hospital. Mortimer then continued to explain that above all else what was required was a network of small outfits with ‘clean, careful, and methodical technical knowledge to help in carrying the surgical work to a successful result’.28 This division of intellectual from manual labour was also explicitly stated within the Croydon Camera Club itself. The club organized a rota of capable members to develop the constant order of radiographs: Four out of the twelve are qualified to assist with the X-ray apparatus if required. The duties are divided into the six days, Monday to Saturday – one on duty in the mornings from ten to one, and one on duty from two to five in the afternoons, with a second helper in each division of duty who is regarded as a reserve, to be called on duty only in the event of pressure of work.29
For the RAMC, the technical and voluntary outfits demonstrated a clear separation of procedures and workers, which would allow only surgeons to make the lantern slides and print from the radio negatives. Mortimer pointed out that ‘roughly, it works out that a dozen workers will do what is necessary at one military hospital, taking one duty each and one reserve duty also per week’.30 For the Croydon Camera Club, the hospital’s use of photography was both scientific and an achievement of micro-businesses. This work was seldom carried out in comfortable conditions. Members of the Croydon Camera Club frequently complained of pressure to perform their
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duties quickly, with plates being handed back to an impatient surgeon not quite fully fixed and in many cases not even washed. What this shows is the constraints that medical officers often imposed on the camera club. There was a clash of personalities between these two groups, offset against constant patient admissions, shortage of time and labour and limited budget. This relationship reeked of class snobbery. In a particularly revealing entry in the club’s minutes, one member recounted one Saturday afternoon when he and his colleagues were fitted up shelving in a small room that had been assigned to them as a darkroom: We explained to the bright genius who came down from HQ that we should need water for washing plates. He looked rather puzzled when we pointed out that to wash the plates we should need running water nor was he quite convinced that this was necessary, but in the end orders were given that a piece of piping should be fixed to the sink, a hole knocked in the wall, and the waste water allowed to flow down the nearest gully.31
Adequate working conditions for the photography and radiography spaces required constant negotiation and compromise; many requests were dispensed with as mere luxuries. What is particularly striking about this jaw centre is that it was not equipped with a dedicated photographic department. This is a far cry from what was happening in other hospitals. The main distinction in Croydon highlights the lack of public expenditure with which photographic facilities relied rather than with the commanding officer’s views on technology adoption. Photography sits ambiguously in this context. On the one hand offering the small camera clubs a way to contribute to the organizational infrastructure of war hospitals, and on the other being the means by which the liquid elements of the photographic process is denigrated, anonymized and its intelligence ultimately rendered ‘dry’. This lack of cooperation extended to the chemical supplies that club members also required. On one occasion when they received an order of materials and unpacked them, the wrong items had been delivered for the job, while other essentials like Hypo fixing salts were missing altogether. ‘We were in despair, especially as a big wig surgeon was coming that day to inspect some new X-ray installation.’ One of the club members hurried off and after a long search managed to find a pound of Hypo, at a cost of 1s. 6d. Sometime later, the army radiologist was able to drop off his exposed X-ray plates, the volunteers developed and fixed them and ‘the great man went away satisfied that his particular hospital was well served (if not too well equipped)’.32 Whereas ‘in 1914 a few thousand ounces of developer were used and a ton or two of hypo-fixer’, in ‘1918, nearly six tons
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of the developers were used and 220 tons of hypo-fixer’.33 The responsibility of amateur photographers within the specialist medical teams becomes much more interconnected in the Croydon War Hospital regarding the image-making process in the wards – a relationship that is missing from the medical press reproductions where the static and captioned images are attributed to societybased expertise.
British industry and the photographic press Mortimer was a staunch advocate of the economic implications of Britain’s photographic industry. In a special Empire Number issue, published in March of 1916, Mortimer related a series of industrial improvements and developments in British manufacture during wartime. The periodical, Amateur Photographer and Photographic News, published articles on the prominence of the industry and prospects for future research in scientific processes. Mortimer had appealed to all leading British manufacturers for their opinions on how the war impacted on business, and his narratives point to the place of Britain’s photographic trade in the broader consumer community of the Empire. While the Empire Number was aimed at reinforcing the imperial duty of Britain’s photographic world, it is important to note that having a clear intention to cultivate a working assemblage of firms, government agencies and readers who shared a strongly cohesive sense of patriotism and identity, and from whom supplies and loyal buyers could be sustained gave the products and performances a much broader market. For Mortimer, a good deal more trade had been done in camera apparatus than had ever been expected when war broke out. He believed that ‘[i]t is the same story wherever one makes inquiries’, and as the British firms had explained, ‘we are held up by the demands of the government, more particularly with regard to metal work… We have to turn away a good deal of our normal business.’34 While the market had gradually grown and was virtually stable by the end of 1916, with many firms having to increase their production to meet wartime as well as a growing domestic demand, it did cause difficulties with ‘over-pressure’ of work. The Empire Number was therefore based on the broader opportunities which the economics of wartime presented for the expansion of markets and product development but also reliant on expelling the market from cheap German products in place of homemade production. When Mortimer received a large number of inquiries from wholesale photographic houses in neutral countries
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for particulars of British firms who could supply lenses, cameras and accessories, he made an important point to the industry beyond the strains of war work. Mortimer was quite clear to the British firms and general readers that these neutral countries – who were able to obtain their supplies from Germany, as they had in the past – were specifically interested in buying British products.35 By 1918, home production of all the key raw photographic materials was sufficient to meet demand as a result of a concerted effort by the state.36 The example of sensitizing dyes is particularly interesting because the successful production of these dyestuffs, and the further research this stimulated, had a significant effect on the postwar development of the British industry. In 1917, the British government turned to Cambridge University for help, and employed eminent scientists as bench chemists to engage in war work and produce sensitizing dyes. Under the command of William Pope, professor of organic chemistry at Cambridge, his laboratory formed the Department of Scientific and Industrial Research and began producing and supplying raw photographic materials to meet the needs of the British Army.37 For the Wellington factories in Hertfordshire, the firm successfully met the needs of the British and Allied forces by evolving sensitive plates and papers especially suited to the demands of the Air and Medical Services. The government’s demands for enormous quantities of British photographic papers, added to the fact that the raw base paper had to be produced in British mills, taxed the makers to the utmost. Baryta coating the base paper was almost a new industry for British sensitized paper makers. Forty million sheets of sensitized paper, representing about 300 tonnes in weight, were supplied to the military by British firms.38 The enormous advances made in British lenses during the war also synchronized with the production of special emulsions. British glass manufacturers patriotically contributed their share of scientific investigation and were able, with increased plant and factory methods brought rapidly up to date, to perfect and repeat the new types of glass in an ever-increasing quantity, and thus made it possible for lenses of new and improved design and greater precision to be introduced.39 By the end of the war, Britain’s photographic industry had become, potentially, stronger that it had been before its onset.40 Indeed, William Pope boasted, in his Presidential Address to the Chemical Society on 27 March 1918, that Britain was capable of producing the best photographic materials in the world, but warned that for the production of the photographic, synthetic pharmaceutical and chemical industries to remain successful they would have to keep looking ‘to the scientific investigation for inspiration and new directions for enterprise’.41 This cluster of businesses demonstrate how state and military clients, consumer
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demand, market forces and scientific competition have long helped shape photographic technologies and practices produced in the context of conflict, whether the imperial strategy of the multi-national market, the singular drive of the self-made entrepreneur or the activity of the individual photographer caught up in the wartime situation.
The Red Cross ‘compassionate fund’ The year 1915 marked a turning point in the – at that point still relatively short – running of British war hospitals. Opened in the previous year, these hospitals were sponsored and maintained by the generosity of the public to aid the recovery of sick and wounded ex-service patients.42 The British Red Cross Society (BRCS) asked the public to donate money to what would soon come to be known as the ‘Compassionate Fund’ to support the war effort. In thus organizing a nationwide campaign, the society emphasized the two key values they associated with war hospitals: a sense of community and patriotism, intrinsically forging kinship bonds between wounded ex-servicemen and those who set about helping them. With that, the BRCS published regular articles in the press reporting on the work carried out at the hospitals and of the patients’ progress – being to a large degree accountable to its subscribers. In addition to weekly appeals to the public for financial help to keep the Red Cross hospitals running, the presses published regular updates during the war on the Compassionate Fund and how public subscriptions were being spent to meet the sick and wounded men’s needs whilst in hospital. Support for the Compassionate Fund by newspapers such as The Times is evidence of the public concern for patients’ rehabilitation. The newspapers explain the social and political impact of wounded servicemen’s recoveries and reveal how supportive the local communities were. Government and press agencies could not show the value of the medical photography across media forms but told the human story in textual communication. There is a mixture of absence and presence in the printed media. The wounded men, and the visible effects of their injuries, are out of reach from public view. As Biernoff had pointed out, there was an official ‘censorship of facially disfigured veterans in the British press and propaganda’ because the wounded face ‘presents the trauma of mechanised warfare as a potentially contaminating, and shameful, loss of identity and humanity’.43 Britain did not unlawfully represent the horrors of facial mutilation visually outside the professional contexts of clinical medicine and this is characterized as a visual
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anxiety and aversion to such injuries.44 Thus, Britain’s war propaganda was abiding to medical legislation on the circulation of images of patients’ injuries and with what was being portrayed to the public about wounded servicemen and their recoveries. The presses and official photographers focused on the costeffectiveness and economics of the war hospitals, but despite the support for ex-servicemen in rehabilitation, they were very isolated. The longer they were in hospital, the more difficult their situation became and the harder their struggles back to normal life.45 The Waverley and Frognal albums, held in the Antony Wallace collection in the archive of the BAPRAS, are significant for they embody these press appeals and public funds and help to explain the challenges that long periods of rehabilitation imposed on patients’ psychological wellbeing. Now detached loose-leaf pages, with their covers missing, the light-brown Waverley album made by Dr Horniblow and dark-brown Frognal album attributed to Sister Agar propagate a narrative of everyday life while waiting for the next operation. In the Evening Standard in June 1918, the BRCS made an appeal to the public to help alleviate patients recovering from facial injuries by giving donations. ‘[D]uring long days of treatment the majority cannot go into public places, cannot receive friends and visitors, and have to fight acute depression.’ The national appeal was being made to alleviate this and to provide recreation and amusements; ‘The alleviation of suffering is a national matter’, and the business of the general public to ‘directly aid the nation in the war’.46 Agar and Horniblow were here encouraging the patients to recover by altering the practice of nursing itself. The camera was used as a therapy lesson; it was both a device to help patients regain their health and a new mode of operating which embodied group strategies to cope with boredom and depression. In addition to the special national appeal made by the BRCS within the newspapers to provide recreation and amusements, the position of these humanitarian and moral acts of care become apparent upon examining the amateur photographers in the facial wards. The preponderance of group photography of patients in the Waverley album from the Cambridge Military Hospital and Frognal album from the Canadian ward of the Queen’s Hospital raise suggestive supplementary possibilities for interpreting the struggles for recuperation, especially when they depict men on day outings, or playing sport or other leisurely activities. Together these two albums position the value of amateur photography for seeking alternative health therapies. Horniblow’s and Agar’s cameras thus operate under the auspices of the medical and rehabilitative treatments of the
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surgeons and the public’s generosity and gratitude. By working alongside the surgical interventions and national relief funds to maintain the morale and wellbeing in the wards, amateur photographers were able to use photography’s unique position to model the behaviour of wards and stimulate interaction during the lengthy treatments the wounded were undergoing. Thus, therapeutic photography involved taking photographs of groups of patients for the purpose of personal and collective healing, helping bring focus to positive experiences whilst in hospital and relieving their preoccupation with their injuries. Such meaningful acts of bonding could build resilience, support recovery and make sense of their experiences communally whilst underdoing treatment. The benefits of photography within healthcare were extensive due to the portability of hand cameras and the availability of High-street processing services, not only in taking photographs but also looking at the photographs together. The use of photography as a therapeutic tool within healthcare held particular value in the affirmation of self-identity. The use of photography in exploring self-image could support a patient to develop a positive self-image, which in turn could impact on confidence and self-esteem. In addition, using photography induced conversations that allowed these groups of patients to control how they told their story and validated their own experiences. Furthermore, photography could provide a practice to communicate and express what could not be verbalized. One article calling for public financial help in the Evening Standard described a walk through the blue-curtained wards of the Queen’s Hospital as a mixture of emotions, of affection and pain. For a fleeting instant ‘one saw the dreadful abyss into which the wounded servicemen had fallen. Not every one of the sailors and soldiers who have been severely wounded in the face or jaw at Frognal suffer from acute depression, but most of them do.’47 Similar appeals for public support took place in France and Germany. Press publications in these countries called for public action, especially for donations to relief funds.48 There is a very different story emerging here, one that exposes cracks in the smooth surface of propaganda as the personal suffering of facially injured patients is allowed to seep through in order to directly appeal to public sympathy. In June 1918, another article described ‘depression of the most acute kind’ in the facial wards and ‘one of the greatest enemies for the surgeons’. Many patients ‘suffered from depression and refused to return to their homes, families, friends, until they were convinced everything possible had been done for them’, but the public ‘did not hear much about facial wounds, for all severe cases were taken directly to Frognal’.49 The press published long-running stories on the recovering patients at Frognal, long after the war had ended. This editorial approach raised the awareness of
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public subscribers, as part of a national appeal to keep the convalescent hospitals open, and in the early 1920s, journalists wrote articles addressing patients’ two or three year rehabilitations: ‘when they first went out again they were hypersensitive and insisted on screened vehicles and curtained boxes’, and could not ‘function well outside anymore’.50 The press expose the tensions involved in the war veterans’ isolation, their fear, shame or humiliation. In the 1920s, articles reveal a change in tone and suggest a shift in public sentiment, patients were soon being forgotten and fewer funds were being donated to the voluntaryaid organizations. The publication of printed material served as a means to remind the public that there were patients still under treatment that needed their help, but support for these men began to wane. While rehabilitation in the war hospitals had acknowledged the importance of returning wounded soldiers to civilian life as soon as possible, this reintegration had relied heavily on the support of the public to make this transition. Due to limited funds being donated from the public after the war, and thousands of patients still in need of several more years of surgical treatment before they were fit enough to rejoin society, reintegration into civilian life was proving an expensive task for the government, war charities and the public. The longer these patients remained in hospital, the more difficult it was for them to adjust back into public life or return to a normal existence.
Conclusion In the years that followed, the government sought to manage the postwar domestic and professional reintegration of facially injured British ex-servicemen of the Great War, directing them toward new occupations and standards of living. As these ex-servicemen adjusted back into society and the workplace, they became reminders of war’s devastation. These veterans personified the question of how to come to terms with the struggles of care, their war-damaged faces and perceived deficiencies read as visible signs of a broken society. Although there were unquestionable economic rationales at stake in their rehabilitation, underpinning the key strategy of the plastic renormalization of war-damaged faces was the desire to present a manifest symbol of the reconstruction of social and political order. The surgically reconstructed ex-serviceman fixed by and fitted with prostheses was a figure of renewal, and ethos of renormalization and reintegration into society visibly staged on a scientifically rebuilt body. The British Army and Ministry of Pensions’ rehabilitation thus bore more than just
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a personal meaning; it was seen as reflecting wider socioeconomic, ethical and democratic rebuilding. Nevertheless, it was during the war where the interactions of amateur photographers and the facial wards reflect an important example of how the camera could be mobilized as therapy to elicit caregiving to wounded soldiers during convalescence. During the war and afterwards, women were avid consumers and producers of photographic items. The development of family photography of servicemen following their return from the war was a mass industry, and cameras and commercially produced photographic albums were marketed towards women who produced and displayed pictures of their menfolk. Album manufacturers appealed directly to such individuality of personal taste in the photographic press to share their tweaked album features and designs. For example, Houghton-Butcher Ltd, a London stationer, implemented instructive methods of album assembly through pictures, where they frequently offered products that they had designed with extra durability for sustained handling and exchange. Their ‘Perpetual’ series came with flexible leather covering, available in either crocodile grain hide and brown leaves or fine black Morocco with pocket and black leaves. Alternatively, the ‘Chancery’ series offered a rich brown-black alligator skin pattern, bound together by adjustable bronze screws, holding up to fifty pages and costing 5s.51 Manufacturers offered albums with embellished and personalized designs that promised to revive the ‘habit of collecting portrait photographs in the orderly fashion of the old days’.52 Such activities register women’s interest in the political and economic reconstruction of ex-servicemen, as well as domestic pursuits in caregiving relations. The work of war gave a stimulus to amateur photographic pursuits, this chapter has shown, and became increasingly tied to the influence of photographic periodicals. Periodicals afford a large additional body of detailed evidence about the workings of the communities of both scientific practice and the public realm during and after the war. In particular, periodicals themselves played a crucial role in constructing, negotiating and consolidating such communities. Periodicals such as Amateur Photographer and Photographic News, in particular, gave amateur photography a value and encouraged women photographers to ‘hone their technical skills’, and ‘sally forth with… cameras strong in the knowledge that’ when the ‘boys come home’ and wartime censorship is lifted, and peacetime ‘snapable incidents arrive’, we ‘shall have the confidence and training necessary to record any happening’.53 With that, nurses made a claim on the camera as a collaborative group experience in the ward, which meant, at a time of trauma, photographing everyday life during convalescence not
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for profit or for propaganda but simply to share their ordeals within private family circles. The war offered women opportunities to expand their roles, technically, professionally and socially. Some developed their photography in new directions; others took over from husbands, brothers or fathers. Taken as a whole, these activities indicate the broad range of ways in which women actively engaged with photography in order to understand, comment upon and adapt to the course of the war. Periodicals played a key role in not only enabling readers to imagine and engage with national and local communities of practice but also gave them the chance to share and reflect upon the techniques and processes of photographic image-making. These amateur photographers are characterized not by the shared activity within a club or hospital, like the photographic societies and the regular, weekly community of practice in camera clubs. Nor are they characterized by the amateur photographer as a strange loner, as someone who is not working as part of a community. Instead, this photography is an area where what might be considered to be casual and what might be considered to be aspirational is especially complex; the agenda is different because there are public and private dimensions to the practice. The periodicals were publications in which new communities of readers could be developed, who shared common interests in and concerns towards the maintenance of war hospitals and the recovery of wounded ex-servicemen, negotiated in an ongoing conversation between editors, publishers, writers and readers. The photographic periodicals, like the medical publications, established a clear intention to cultivate a working assemblage of readers who shared a strongly cohesive sense of national purpose and identity, and drawing individuals who rarely or never met into an imagined community.54 At the other end of the spectrum, medical journals played a key role in developing tightly bound communities of practice with shared epistemic and rehabilitative goals and a strong professional body. Journals such as the Lancet and the Proceedings were being marketed as strictly for doctors. The work of surgery in medical journals reflected a more general turn among doctors towards the role of communication processes in the making of scientific knowledge for official military work. As we saw in Chapters 1 and 2, the medical sciences had a distinct and increasingly consolidated professional community in First World War Britain, and this period emphasizes the role of journals in the emergence of interdisciplinary medical specialisms. At the same time, popular periodicals also became pivotal in enabling local groups and societies to keep abreast of what was happening in their regional hospitals, while also fostering a sense both
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of community and common cause for those who were labouring, in diverse societies and multiple scientific and practical fields, to improve the disabled exservicemen’s rehabilitation. War and medicine impacted directly upon photographic production, materials and products. It has been interesting to see how the photographic development and working protocols of small outfits like the Croydon Camera Club responded to military demands, underfunding and restrictions. And perhaps, most crucially, how military power and influence distributed between club members, hospital departments and the specialist consumers and audiences. Given the intricacy of the photography complex, it is not a phenomenon that can be charted in its entirety. It is a multi-directional network of participation, encompassing a myriad of interest groups that reveal not only how the demands of war shaped the workings of commercial organizations, camera clubs and civilian production but also their relationships with the government.
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Family-led care and the shortcomings in state provision
Saturated with pathos, the government and the British Army influenced public perceptions of injured ex-servicemen, the evocation of isolation and desperation, men rendered pathetically passive, encumbered by their wounds in all aspects of their life. Following the state’s promise to reintegrate injured and disabled veterans of the Great War back into society, however, these men were obliged to reiterate ideas of gender-specific social roles.1 The public shared the patriarchal views that wounded ex-servicemen should not be confined to the domestic sphere and that breadwinning was essentially the male role. This was a reintegration, in other words, that had to conform to cultural practices of masculinity and influenced the way injured and disabled ex-servicemen behaved and saw themselves and their role in postwar Britain.2 As a result of the physical changes experienced by men due to war violence, though, injured and disabled ex-servicemen and civilians were forced to rethink the male body, its function and its appearance.3 The potential reshaping of the male body due to bodily limitations created anxiety for facially injured ex-servicemen returning to the job market and pursuing social status. The image of long-term care was therefore faint, and focusing it required the moral judgements of family relatives towards how recovery was managed. While a not insignificant group was left with life-altering facial injuries that signalled a challenged return to society, many veterans and their families were taking up photography, and as such their familiarity with using the camera was not unusual. Their recovery from the traumas of war and return to domestic life coincided with the rapid proliferation of photography for average users thanks to firms like the Eastman Kodak Company and popular and affordable cameras like the Box Brownie or the ‘Sibyl’ models by Newman and Guardia. The use of cheaper portable cameras by novice photographers in the home increased the visibility of small groups,4 like facially injured veterans, at the same time that their visibility decreased as they became cautious about being seen in public. This new
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visual economy of photography was bolstered by sophisticated ad campaigns wherein companies like Kodak taught consumers how to photograph, that is, how to see families, in a process that laid the template for visual conventions of postwar family conventions.5 What was the significance of family photographic practices for the everyday lived experiences of facially injured Great War exservicemen in Britain? Although photography within the family home is a practice embedded in a specific place which has its own defining set of behavioural codes and protocols, as Gillian Rose for example has noted,6 within the studies that have addressed the intimate relationships of family, friendship and other social networks that are fluidly constituted in practice, family photography has been discussed primarily as a bonding activity ‘central to the maintenance of family togetherness, and often of friendship networks as well’.7 However, the case of cameras in the homes of facially injured ex-servicemen indicates that photography’s intersection with practices of care did not simply make it easier for family members to participate in the recovery process, but, most importantly, it also transformed the form of their relationships in a way that impacted on family photographers’ perception of their own role as care providers and in making recovery visible.8 Because many disfigured ex-servicemen underwent a difficult renegotiation of their own male identity, the domestic offered a familiar space when in an uncertain postwar world. Yet Gabriel Koureas observes that in an attempt to reestablish acceptable norms ‘formed by the pre-war standards of [working-class] masculinity…, of self-sacrifice, devotion to duty, emotional strength and selfsufficiency’, injured and disabled ex-servicemen asserted traditional gender roles when previously uncontested norms of masculinity were under dispute (with regard to disfigurement, unemployment, loss of citizenship, marriage).9 Such attempts to move toward the re-creation of pre-war professional and familial spheres, as Jessica Meyer points out, not only transformed perceptions of the male body and a man’s place in society but also the ways in which wounded and traumatized veterans related to others.10 In order to explore how disfigured exservicemen re-established themselves in civil and domestic life and interacted directly with the real and imagined destinies of facial difference, to situate themselves as family men, corporeally altered but nonetheless maintaining an intact masculine status and identity, this chapter considers family photographies as practices of domestic caregiving that emerged not only from what was seen and experienced in their everyday expectations as economic providers and
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family men but also from what was said and discussed within family circles. Within this making visible of oral communication, a whole set of photographic practices became deeply co-existent with domestic life as conversations between family members, as Martha Langford puts it, as dialogue and verbal exchange within family and friendship networks articulated and negotiated a postwar recovery.11 This means, in the context of my analysis, that the intertwining of facially injured ex-soldiers and novice photographic practices created the conditions for family members to resist the received memory of the war-disabled as helpless and reliant on state provision. What follows thus investigates the fears of emasculinations which accompanied men’s bodily encounters with state provided medical care after the war, and the potential mitigation or exacerbation of such anxieties through state intervention and, consequently, the home as a site of healing for the creation and reinforcement of male identity which,12 I will argue, the families attempted to make visible from any memory of the war. Recent years have seen photographic studies paying long-due attention to people’s ordinary lived experiences of and with photography.13 This chapter seeks to contribute to our understanding of such proliferation of practices by showing how photographic studies can benefit from taking into account the parallel commitments to care and capacities to practice care and evolve aspirations of recovery that were affecting people’s lives in post–First World War Britain. To examine the affects of these practices, and emphasize in particular the social relations and subjective identities that family photography practices produce, I draw on Gil Pasternak’s study of the Eastman Kodak Company and how the firm encouraged early twentieth-century camera users to think of snapshots as pictorial biographies. The growth in the importance of photography for families seeking solace and recovery during the postwar years, as Pasternak notes, made sure that companies like Kodak encouraged members of the public to integrate picture-taking into everyday life, and regard photographs as self-contained repositories of biographical details.14 The increased availability of cameras, films and photo-processing services as domestic products on the High-street helped lay the foundation for Britain’s economic recovery and shaped how the industry would develop during the postwar years. British production expanded rapidly as companies became skilled in the production of mass-produced goods directed at the amateur and novice markets, which further popularized photography. It is important to recognize that while facially injured British exservicemen were, owing to their physical differences, ‘othered’ or stigmatized,
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they also, however, possessed the social skills which made it possible for them to exercise agency. Their ability to claim a status of visibility came from the social power to which their war service entitled them. What follows thus investigates the co-existence of the government’s postwar domestic campaign to overcome the disabled and disfigured ex-service communities’ perceived helplessness, disadvantage and reliance on the state, and how the photographic practices of ex-servicemen and their families reflected the complications in this politics of masculinity. I start by considering the role that photography played as a tool that facilitated new ways of forgetting the traumas of war. I then explore how family photography in this particular context gave credibility to family practice as ‘an aspiration for healthy futures’, and a ‘regenerative’ hobby.15 We may find novice photography in the home as aesthetically naive and technically wanting, with fingers on the lenses or under-exposure, in comparison to camera club photography which is technically accomplished. But what was important to the family photographers was not so much the picture alone. It was more the whole practice of photography, their participation in and enjoyment of the group activity. The strict definitions of masculinity at the time made it difficult for traumatized and disfigured soldiers who may have experienced different forms of masculinity at home to recover. It also made it difficult for them to come to terms with the return to the pre-war codes of masculinity that the government and British Army attempted to impose. The result was an acting out of masculinities in the postwar years.16 The complications of the politics of masculinity can also be found in the insistence of the wives, mothers, sisters on re-establishing the pre-war tropes of masculinity that had relied on clearly defined boundaries for their existence. Such boundaries were a prominent feature in the photographic act, designed to bond family members and reinstall a hegemonic masculinity. Finally, I discuss how this impacted on the social interaction between family photographers and relatives and friends in a way that transformed the perception of each relative’s individual caregiving role, in shaping veterans’ resilience and in the production of photographic meanings and values. As this chapter will show, the domestic duties of care were a cultural expression of moral judgements towards the long-term needs of disfigured veterans and how it was managed that formed the conditions for family photographers to maintain their own obligations and endurance of love in the postwar era.
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Difficulties with state-offered aftercare When facially injured British Great War ex-servicemen re-entered society, questions over the constant care that they would need throughout their lives were at the fore. The British Treasury was fearful of being burdened by the financial consequences of non-war-related ill health or of ageing veterans.17 How these complex and ongoing war injuries were later managed must therefore also be understood within the context of non-specialist doctors in civilian hospitals who had little understanding of how to treat them, although, many doctors who served during the war then returned to civil practice so could lay claim to being both civilian and military doctors. The aftercare which ex-servicemen later received in non-specialist or civilian hospitals was also centralized under the administration of the Pensions Ministry, and at a time before free healthcare was introduced under the NHS. From 1921, overall spending for the department was reduced by almost 50 per cent from £106,367,000 in 1921 to £54,066,000 in 1930. This reduction was achieved in numerous ways. By 1925, almost half a million pensioners, with around 50 per cent of those in receipt of a pension scaled at 20 per cent or less, were given a lump sum or gratuity defined as a ‘Final Award’. There was a subsequent reduction in medical facilities: while 332,000 disabled pensioners were undergoing treatment in 1921, this figure stood at just 41,000 by 1930. The Ministry then often covered the cost of a veteran’s health care via capitation grants for treatment in public hospitals or via their personal General Practitioners.18 A subsequent associated reduction in Ministry staff resulted in 21,685 departmental staff in 1921 being reduced to just 3,795 a decade later.19 In 1930, the Ministry summarized the difficulty facing Britain and its rehabilitation of disabled war veterans: ageing and associated impairments of health, and the difficulty in objectively assessing the impact of war service. Pensions and aftercare treatment became a battleground in which a ‘protracted civil war was fought’ between veterans, families and charities versus the state.20 In Britain, the government’s increased austerity and integration of social responsibility amongst its citizens in their welfare and rehabilitation programmes were fundamental. With these cutbacks, societal assistance was integral to the Ministry’s rehabilitation of disabled veterans, but their legal and political rights could not be protected or improved. The story of wives and mothers’ photography is not just about using the camera as an agent of personal and social change for their ex-service partners. Rather, the interactions between relatives during a family’s camera activities
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would likely have helped an ex-serviceman’s self-esteem while giving him the confidence to be as self-supporting as possible. The psychologist Judy Weiser has argued that it is through the use of photography as a therapeutic activity, self-initiated and conducted by a married couple or a domestic group that improvements could be made in individual and community wellbeing.21 This activity is demonstrated through family members establishing an intended goal to produce positive change in injured ex-servicemen, couples, and families. This informal therapy occurs as families actively engage photography to improve healthcare, group dynamics and reduce social exclusion. Women encouraged participation amongst family members by privileging the picture-taking process, and also other photo-interactive activities, such as viewing photographs together, planning, discussing or even just remembering or imagining photographs, to develop ways of looking at themselves reflectively. This democratization of participation in the domestic sphere allowed for the photographer to better understand the impact of disability on their loved one’s male identity, the idea of regaining the physical ability that facilitates his preferred performance of masculinity as a successful provider and a physical labourer. Thus, using photography to validate the idea of a conventional association between masculinity and economic productivity started to thoroughly change how families interacted and learnt ‘how to care’. Arnold Wayte was wounded at the battle of Arras by a sniper’s bullet in April 1917. He underwent numerous plastic operations in Sidcup over a nine-month period to rebuild his jaw, but declined Gillies’ offer of bone graft surgery. After his discharge, Wayte returned to his old job as a clerk with the Leicester-based spinning company Fielding Johnson. Wayte and his wife Ellen could resolve their concerns about war service and its potential effects on their romantic life and verify the recovery they imagined. As keen amateur photographers, the couple used the camera to place domestic life into particular recoveries to make certain rehabilitative motivations obtainable.22 This difference in verification affected the way that photography was used. The everyday experiences of recovery, therefore, enabled the Wayte family to develop and hone the necessities of care and to see the labours of love that got them through it all. Arnold Wayte’s jaw injury was not sufficiently disabling to qualify him for a full pension and his claim was eventually calculated at 60 per cent. Wayte was supported by a war pension of 24s. plus an additional allowance of 6s. for Ellen from 1919 to 1923, increased to 28s. plus 7s. from 1924. To assure his eligibility to continue receiving this compensation the Ministry’s medical board for the East Midlands Region reviewed his pension claim annually. As with many
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facially injured patients, Wayte was given copies of his surgical photographs on his discharge from Sidcup as they were valuable for their ability to visualize the complex work that non-specialist doctors could understand in the event of further treatment in the future. The emphasis that the surgeons placed on photographs was made clear when later in the articles of the War Pensions Gazette the government compared the value of specialist surgery offered by the British Army and the follow-up care available from local civilian medical services. ‘A man is entitled to make a claim under Article 9 of the Warrant on the sole ground of dental deterioration’.23 The periodical devoted the whole of its June 1920 issue to follow up institutional treatment, with articles on how to apply for suitable aftercare through the medical referees and local committees. Pensioners qualified for additional denture work ‘if the medical referee certifies that the dental defect is due to or aggravated by service’, the ‘local committee can [then] provide treatment urgently required without waiting for the decision of the Ministry on the claim’.24 Wayte only ever went to the one dental practitioner in Leicester in the postwar years as that dentist was the only one he found who could deal with his specific dental care needs.25 Although Wayte superficially dealt well with his injury, he smoked heavily and sought solace in the local Ancient Order of Foresters, a charitable organization with founding roots in assisting men and providing support in particularly desperate times. Nevertheless, with a good job and a supportive wife and two children Wayte and his family prospered and were able to buy a house and a car and share regular family holidays throughout the British Isles. He died on 5 October 1969, aged 74.
Compensating for the state’s shortcomings George Butcher was born in Oxford in January 1894. Butcher began his career as a collotype machine minder in 1908. He joined the Oxfordshire and Buckinghamshire Light Infantry Territorial Battalion in 1911, and enlisted immediately when war broke out in 1914. As a Sergeant in the Fourth Oxfordshire and Buckinghamshire Light Infantry, Butcher felt lucky to survive war service when so many of his comrades died.26 After the war, he returned to his pre-war job at the Oxford University Press until his retirement in 1959. Although men like Butcher were promised ‘a comfortable living over and above the pension to which their sacrifices in the war had entitled them’, he only received a pension of 27s. 6d. weekly from 14 December 1921 to support himself and his wife and first child.27 Having undergone several years of operations at three separate facial
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hospitals between 1918 and 1921, to rebuild the greater part of his mandible and soft tissues in both cheeks and upper half of his mouth, with permanent deformity of the face and nose, Butcher found himself having to take regular fresh air and UV treatments to aid his breathing and help his scars to heal. Seeing small photographs such as Figures 4.1 and 4.2, of George Butcher at the beach during a family holiday to Margate in 1932, would have followed his wife Emily’s use of the camera as a therapeutic device which privileged ‘care-giving’ and ‘care-receiving’ and made it possible for her to affirm responsibility for her husband’s wellbeing. Some of the most profound changes photography brought about were not visual ones. These changes had much more to do with what family photography meant and how one acted as family and with what families were than with what families looked like in the resulting image. Butcher underwent seven extensive operations at Queen’s Hospital, Sidcup, between October 1920 and September 1921. After admission, he stayed there for four months as his injuries were assessed and two complex procedures performed to rebuild his cheeks using fat graft implants. On 10 December 1920, Butcher was
Figure 4.1 George Butcher on holiday at Cliftonville, Margate, 1932, photograph by Emily Butcher. Dewhurst family collection. Reproduced by kind permission of the Dewhurst family.
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Figure 4.2 George Butcher on holiday at Cliftonville, Margate, 1932, photograph by Emily Butcher. Dewhurst family collection. Reproduced by kind permission of the Dewhurst family.
discharged to home and granted twenty-eight days furlough on medical grounds so that he could recover and spend Christmas with his family. In January 1921, he was readmitted as a war pensioner, having been assessed by the Army Board. The following month he underwent two further operations to cover the fat grafts
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in his cheeks with skin flaps, followed by massage treatments. In May, further plastic operations were performed to realign the downward displacement of his mouth and draw up the soft tissues of his lower lip. Surgeons noted that the results of these procedures were ‘satisfactory’, although, his masticatory disability was described as ‘very severe’. Butcher was discharged to home at the end of May for one month. On his return to hospital in June 1921, his condition had greatly improved, although surgeons described his scarring as very extensive. He spent the next three months at Sidcup having prosthesis measured, cast and fitted. On 3 September 1921, he was discharged on the recommendation that he return periodically for alteration or readjustment of dentures. No further entries exist in the Sidcup medical records.28 Due to the strong anesthetics used in surgery and nasal damage, Butcher suffered from breathing difficulties in later life, and could not eat hard foods for his masticatory disability. Despite these impairments, Butcher had not considered himself so seriously disabled as to wholly renounce domestic life, presumably thanks to his wife’s caregiving after the war, his war pension as a seriously injured veteran, and resuming his pre-war occupation as a lithographer. A number of factors thus ensured that he was able to live in relative comfort in the postwar world, in contrast with those disabled veterans who had no relatives to care for them, or found themselves unemployed. Emily’s photographic practice went further than capturing family holidays and became a therapeutic activity that carried traces of participation and a shared burden. The story of a loving wife who coped well despite her husband’s difficulties is recapitulated in the photography as Emily becomes competent at looking after him. Jill Dewhurst, a granddaughter of George and Emily, points out that the couple ‘were married for over fifty years and I believe that one of her main aims in life was to ensure that he was well looked after and lived as normal a life as possible. He was very much a family man, and in later years always interested in what his five grandchildren were up to.’29 Emily’s ability to bear her husband’s suffering is reflected in the support of her husband’s career and by encouraging him to do tasks around the home that a man would normally do, such as painting, decorating and gardening (see Figure 4.8). The psychological benefit of this emotional support was as important as its practical effects. Emily’s work of caring for George while managing the domestic work and care of their two daughters evidences her ability in keeping things going and helping her husband go about his career. Despite his persistent bronchitis, debilitating blind eye, and a minced diet for life, spending time with his wife and children was the most effective remedy to soothe George Butcher’s impairments.
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Emily’s photography resurrected the image of an able-bodied husband and father. Her consideration as a wife gave George the confidence to reconfigure his masculinity and claim the sole right to be the breadwinner. Her activities of care helped George to reassert his hegemonic masculinity and reclaim the benefits of patriarchy. One narrative in particular embedded in the practice of family photography in the homes of facially injured ex-servicemen reveals the importance of coming to terms with their changed appearances after wounding, and what this meant more broadly to their own pre-war civilian and post-wartime domestic identities.30 One consideration is essential when examining the impact of these facial injuries. The working environment in which ex-servicemen like Butcher returned is an important factor to the wellbeing of their recovery. Fortunately, Butcher was able to resume his pre-war occupation in the lithographic department, where he had served his apprenticeship and worked since 1908. At the outbreak of the war, 356 of the approximately 700 men that worked for the Oxford Press were conscripted. The reduction of half of the workforce and the ever-present uncertainty of the return of friends and colleagues must have made the press a very difficult place to work. Women filled many of the gaps in the workforce, both on the print floor and in the offices. Previously, women could only be found in the bindery. A total of forty-five men from the press were lost to the war. Many more returned wounded or traumatized, and few talked of their experiences.31 After the war, Oxford Press employees began to take a keen interest in preserving their history. A staff magazine called The Clarendonian, first appeared in 1919, and featured many articles on the craftsmen’s social activities and local families who had been involved with the press for generations. After Butcher’s retirement on 2 October 1959, a small article was published on his long career as a lithographer, and commended his long periods in hospital undergoing numerous operations, before returning to the press in 1921. ‘A keen footballer in his younger days, he has also been interested in gardening, and of later years in motoring… We wish him a long and happy retirement.’32 What this later photograph taken in 1968 demonstrates is that retirement was a pleasant and shared experience for George and Emily (see Figure 4.3). The fundamental motivation in shaping George’s daily experience was the care and support of his wife rather than his honourable and legal status as a war pensioner. This photograph of Sidney Twinn and his young family was taken at a photographic studio in Cambridge shortly before he was posted to France in 1917 (Figure 4.4). The demand for photographic portraits of both civilians and
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Figure 4.3 George and Emily Butcher on a day’s outing, 1968, photographer unknown. Dewhurst family collection. Reproduced by kind permission of the Dewhurst family.
soldiers surged during the war. High-street photography studios continued to serve customers, but as local regiments were established a number of enterprising photographers took advantage of captive markets. The commissioning and exchange of portraits prior to a soldier’s departure was a mass industry, predicated on the memory function and emotional power of photographic objects to recall the absent sitter. There was a notion that photographic portraits might function as poignant records of loved ones who would not return home, and later in the war this was generally acknowledged. After being wounded in November 1918, Sidney Twinn’s homecoming was difficult. Sidney’s granddaughter Mary Russell recounts that ‘his injuries were very obvious’, and ‘when he arrived home after discharge from hospital his two children, Mary and Frank, didn’t recognise him because of his injuries and hid under the table from him’.33 In 1922, Twinn was finally awarded a pension by his local medical board and admitted to Sidcup for specialist treatment. Between June and November 1922, Twinn underwent four operations over a one-month period, during which time a nasal reconstruction was carried out. At the end of July, he was discharged to home to recuperate, with the recommendation that he return in one month for consideration of advisability or otherwise of extensive
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Figure 4.4 Studio photograph of Twinn family, c. 1917. Reproduced by kind permission of the family of Sidney Twinn.
plastic restoration around his left eye socket. He returned to hospital two months later, on 2 September. Twinn’s condition had much improved, although,
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surgeons also noted that his oral sepsis was ‘very bad’. Twinn subsequently had several teeth extracted under local anaesthetic and was measured and fitted for dentures. On 18 November 1922, he was discharged to home.34 In the years that followed, younger members of the community would sometimes call out unpleasant names to Twinn as he and his wife Minnie walked down the street. In another instance, Mary wrote, ‘my grandmother told how, when she had her third child, Eric, soon after the war, people crowded around the pram, expecting the baby to have inherited his father’s deformities’.35 Significantly, for veterans like Wayte, Twinn and Butcher, family relationships were not only important in terms of internal ‘success’ or self-reliance, in finding a wife and settling anxieties, but also about being seen to conform. Facially injured British ex-servicemen were, Eilis Boyle and Marjorie Gehrhardt have argued, expected to adhere to rather than challenge assumptions about masculine stoicism. The cultural representations of wounded ex-serviceman as unfailingly cheerful was prolific in the later war-years and in postwar Britain, and focused on the idea that wounded ex-servicemen, as examples of British manhood, would deal with pain and adversity in a courageously cheerful manner as opposed to openly expressing fear, disillusionment or sorrow.36 While these cultural representations created potentially unattainable expectations and imagined standards, they were also useful, however, as they provided an ideal for how men and their loved ones should act, encouraging them to cope in a dignified way.37 Demonstrating conformity to this heroic and honourable ideal could reinforce disfigured men’s own sense of their masculinity, increase their self-esteem and help them to express their emotions whilst restoring masculinity through their behavioural responses and self-representation. Twinn’s career was greatly affected by his injuries, being unable to return to his pre-war job as a delivery driver for a hat outfitter in Cambridge. His wife Minnie came up with the idea of a shop keeping business. Twinn entered into a joint enterprise with his mother-in-law and together the family ran a successful small business selling groceries and animal feed in Cambridge. At first, Twinn worked behind the scenes, dealing with the stock, while Minnie and her mother would serve the customers. Eager to build up her husband’s confidence to face people, Minnie would pass customers on to him by pretending to be busy whenever anyone entered the shop. Twinn was encouraged to interact with the regulars to nurture his independence, ‘eventually he gained the confidence to serve customers all day’.38 It appears that family members helped to restore and reinforce Twinn’s own masculine status. Such efforts indicate not just the difficult circumstances in which facially injured ex-servicemen found themselves but
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also how family members compensated for the British Army and Ministry of Pensions’ negligence, hovering on the fringes of an adequate war pension, and gaining the respectability and security of a wage and his own business. Despite these conducive factors, dominant state neglect for the role of disfigured ex-servicemen in retail or other service industries remained formidable barriers. Twinn’s decision to establish himself as an independent shopkeeper would have demanded a high degree of confidence and determination. Broad support from his family and the community would have led him to believe that his fellow citizens had honoured his sacrifices. A sense of local belonging demonstrated social cohesion and integration drawn from a public eagerness to prove its gratitude to soldiers. Pointing to the problematic undersides of rehabilitative politics is not to devalue the humanitarian impulse and political imperative altogether. Rather, it is to emphasize that while the state failed to fully provide for its disabled ex-service community, the very strength of British families ensured that the country’s veterans were domestically reintegrated. Deborah Cohen rejects the idea of ex-servicemen being alienated from postwar society in Britain. Hers is a more nuanced argument that the failure of the state to provide for disabled veterans may have led to disillusion with regard to politicians but it actually bound them more closely to the rest of society where ‘British philanthropists brokered a lasting peace between a public eager to prove its gratitude to soldiers and a conservative ex-service movement looking for signs that the country cared’.39 Shoddy treatment at the hands of the state did not shake disabled veterans’ belief that the public had appreciated their sacrifices. Voluntarism shielded the British state from the consequences of its unpopular policies, binding veterans closer to their society.40 It may come as no surprise, then, that some injured ex-servicemen did not always so enthusiastically welcome photography. After the war, Twinn was reluctant to have his photograph taken during family occasions. ‘Granddad’, Mary wrote, ‘was very self-conscious about his appearance and avoided cameras if he could’. There ‘are many photographs that survive of Minnie in the family collection but very few of him’. There were, however, other family occasions when he could not avoid the camera, such as picnics (see Figure 4.5), and his own golden wedding anniversary. Mary recalls her grandfather often wearing a trilby hat: ‘whenever my uncle or another family member took a photograph, Sidney would pull his trilby down over his face to cover his missing eye’.41 Thus, family members embarked on an unspoken arrangement to sensitively record Twinn at family get-togethers while respecting his uneasy relationship with photography. The wider community generally accepted his appearance: ‘he was well respected.
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Figure 4.5 Twinn family picnic, 1959, photographer unknown. Reproduced by kind permission of the family of Sidney Twinn.
Customers in the shop, and in the church where he worked as caretaker in later life, chatted and joked with him. He had a good sense of humour’.42 Although Twinn tried not to appear to let his injury affect his life, his suffering in silence clearly impacted on his family and especially his children. As Michael Roper has suggested, as well as parental and gender roles being disrupted the children’s relationships with war disabled fathers and their experience of disability also challenged generational norms of care, as ‘experiences of humiliation, shame and loss – which survivor parents were often unable to vocalize – were, in the face of silence, passed to the children in various forms of unconscious enactment’.43 At the same time, the stresses in getting by financially and in managing the day-to-day running of the household and the experience of being close to suffering made these children alert to how their parents were coping. The returned soldier’s plight thus often tended to take centre stage, while the children’s subjectivities were shaped in the wings. The Twinn children tended to possess a deep sense of responsibility towards their father, and feelings of guilt when they could not help. They developed a heightened awareness of their father’s needs and dependence.
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Mary referred to the sensitivity which her mother developed towards the suffering of her father: ‘she was a sensitive child and always very protective of her father, and would regularly pray for him to make a full recovery’.44 The second generations become repositories for unbearable feelings, which the disabled veteran projected into his children.45 Although Twinn’s facial injury placed conventional gender roles and expectations of parenting under stress, what the photograph in Figure 4.6 demonstrates is that photography was used to help address key concerns about emotional security within family life. Sidney found peace within the support of relatives and friends in Cambridge and he passed away in 1973, aged eighty-seven. It was vitally important for families like the Waytes, Butchers and Twinns to provide a protective shield for their injured ex-service loved ones. Families
Figure 4.6 Sidney Twinn and his wife Minnie, with their granddaughter Anita and Sid’s nephew John, c. early 1940s, photographer unknown. Reproduced by kind permission of the family of Sidney Twinn.
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and local communities filled the gaps and stepped in to make up for the shortcomings of state provision for disabled veterans. Indeed, such caring relationships played a vital role in the making of these families and helped to bridge the gap between the British Army and the government’s ideals on caregiving and what was expected of disabled ex-servicemen, and the local reality of what Great War veterans and their families had to live with and what they were able to do or actually did to recover. Rather, such local acts of care changed how the disabled war pensioner’s relationship to the state was perceived.46 The family photography therefore plays a very complicated role in this postwar recovery. As a technology it was subsumed in the larger experience of domestic life after the upheavals and contradictory welfare policies of the government, shaped by a transition from medical and military property to a shared family identity in the wake of disastrous war injury and medical interventions. While searching through a popular photographic periodical such as the Amateur Photographer and Photography, one of the most common accounts of amateur photographers in the home is found within the context of photographing family members, close friends and leisure occasions. One example from 1925 is particularly revealing. ‘[T]he most expressive pictures of our friends and kiddies are those taken unawares’, thus ‘depicting their natural movements and expressions’, wrote Arthur Corlett. Not only did a fast camera allow for a family member or friend to be represented naturally, the desire to produce one’s own photography and be a better photographer than someone who merely pressed a button was seen as liberating. In this narrative, photography established new ways for the serious amateur to take instruction and technical criticism. There was a considerable amount of commentary on the practicality of cheap cameras for everyday use to the amateur readership.47 Of particular interest was an ongoing discussion of cameras fitted with direct vision viewfinders. With slight patronizing overtones, Corlett wrote, ‘[i]t does not really matter how poor a picture is from a technical viewpoint, or how faulty its composition, if the features are at all recognisable it is enough to re-create for us the pleasurable companionship found during those few days’.48 What is intriguing about this quotation is that although it is inherently criticizing the amateur’s photography as technically incompetent, it is the very mechanical nature of photography that gives it its legitimacy. We can see that co-creation and technical accessibility in the photograph of Sidney Twinn and his family enjoying a picnic in 1959.
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Arthur Corlett was pointing to the camera as much more than a mechanical device brought to life by the photographer. It was an instrument that was woven into and with the bodies of families and their postwar world. While a family’s private and local initiatives are absent from the works of governmental policy, their expressions of closeness and togetherness in family photography calls attention to a new caregiving practice. The negotiation of these experiences echoes and also materializes the resilience and pride for the families and local communities whose lives were left thoroughly upturned by the British state’s lack of compensation for those permanently injured during service. A striking concentration of attention becomes apparent in this relationship between pleasurable companionship and photographic validation. Amongst family desires and aspirations, the camera was used to lodge claims about happiness and make personal judgements about regained health, connectedness and resistance to stigmatization. Within the photographic press, the inspection and criticism of one’s own photographic work was encouraged. The authors of these articles taught readers how to submit one’s own practice to scrutiny, which was unanimously judged by contemporary commentators to be of remarkable technical value to amateurs and novices because it could teach them how to think about portable cameras as a prerequisite for capturing the spontaneity of family interaction. ‘I have endeavoured to show in previous articles’, Mrs May Belben told her readers in 1926, ‘and from my own experience, that the simplest box form film camera is an instrument of very wide capabilities. It can be used quite effectively for portraits indoors, and all sorts of figure subjects out in the open, and for securing good pictures.’49 This perspective allows us to better understand the ways in which a shift in technology affected the co-creation, sharing, and preservation of photography on which the families came to depend. Thus, what made a family photograph good or bad, or simply what should be captured during family occasions, had to be discussed amongst members of the group themselves as part of their leisure activity and as part of their self-identity. The photography press fostered the emergence of a bottom-up and practicebased model of visual learning where meaning and value were created within a performance of explanation. For instance, this is how Fred Bird, a regular writer in the weekly Amateur Photographer and Photography, described his intentions in 1927. Bird touched very briefly on the sensitivity some people felt towards being photographed, when posing for the camera. To many beginners it is a ‘ticklish problem’, for ‘camera consciousness is very hard to overcome on the
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part of some people’.50 The lady in the photograph that Bird had included to illustrate his article was ‘rather nervous’, he wrote, ‘so we introduced the dog’. After the dog had been ‘coaxed for a minute or so to stand in the correct position’, Bird explained, ‘my friend suddenly straightened up,… and, seeing that her expression was now correct, I “snapped”’.51 The dog had been successful as a prop in diverting the lady’s ‘thoughts from the camera’. William Winter, having trained as a bioscope projectionist for the Gramophone Company in Hayes, Middlesex, before the war, experienced difficulty in finding full time employment after his discharge from Sidcup. Born in Staines in Surrey in 1890, Winter served as Sergeant in the 8th (Reserve) Middlesex Regiment. In December 1914, shortly after joining the Army, Winter married Ethel Warby and together the couple went on to have seven children, one of whom died in infancy. Winter did not have a comfortable transition back into civilian life after the war and experienced his share of hard times financially, especially in the 1920s and 1930s, and could only find temporary jobs, to feed and support his young family. Although the Winter family are unsure exactly of William’s postwar occupation, other than he must have had a regular income because he brought up the whole family in rented accommodation, after the Second World War he found permanent work as an electronics technician at the EMI Company, remaining there until his retirement in 1955. He and his wife shared an active and fulfilled life until his death in 1961 at the age of 71. Although Winter undoubtedly was not among the severest cases, his injury did cause disfiguring scars even if it did not impede his capacity to eat, speak or work. David Commerford, a grandson of Winter, says that he was very selfconscious of his injury and disliked being photographed from his right side. This account demonstrates the psychological difficulty with appearance which a number of the patients struggled to cope after their injury. Winter often turned his head away from the camera when being photographed to conceal his injury. Other veterans declined to be photographed at all after their injury. There are very few surviving photographs of Winter and those in the family collection were taken at a distance or only showing his ‘good side’.52 Discussing the topic of consent within the family group would have been the most crucial characteristic of this photographic activity, concerning privacy and complicity, as a family sensitively navigated a practice of co-production. Photography became a domestic activity that carried the traces of a plurality of family conversations, and became particularly important with regard to which occasions and gettogethers were worthy of capturing. Moreover, family photography brought new
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questions of postwar identity and how families wished to control the visual and narrative dimensions of injured ex-servicemen’s disabilities. None of the family members would have cared about what was acceptable or unacceptable in ‘polite society’ – for in their photographic activities, it was acceptable to observe a loved one’s facial injuries within the social group. Aside from the expressions of photographic validation of domestic rehabilitation and professional reintegration, the daily struggles with disability were rendered invisible in some spaces of the home. Photography in the Goddard family embodies the complexities surrounding the visibility of facial injury and attempts to accept it (Figure 4.7). After Hugh Goddard was discharged from the KGH in 1918, he returned to his young family in Honington, Suffolk and his pre-war occupation as a farm labourer. Goddard spent his days cutting corn and carrying our manual work in the fields until his retirement in 1948. Kym Tobie recalls that while her great-uncle Hugh’s fractured jaw injury did not bother him, and many portraits of him survive in the family collection, he had trouble eating hard foods and had a slurred speech, and would often take meals in a separate room from the rest of his family, embarrassed by his inability to eat quietly.53 For Goddard, his appearance was of much less concern to him than his masticatory disability. Kym’s recount of meal times when Goddard would often eat in another room and away from the family so as ‘not to be seen or heard’ grants him, who was averse to this presentation, the choice not to put himself on display, and took control and full agency in the observation of himself and in the withdraw from interaction between family members. The meaning ascribed to disfigurement was reconfigured by the space being occupied and the identity and motivations of the veteran, rather than the observers. After the completion of medical treatment, upon returning to society, a new set of cultural practices and expectations shaped Goddard’s social interactions, which were less orchestrated than in the hospital ward and could be unpredictable. While some veterans did harbour reclusive social tendencies postwounding, for Goddard and many other individuals, whether through choice or necessity, their facial injuries were visible.54 The camera in the households of disfigured ex-servicemen emphasized the importance of a ‘strong, practical base of assistance from family and especially from female caregivers – most notably, concerned mothers, sisters, and wives’, through the creation of a shared recovery.55 Families maintained an ambiguous relation with the shortcomings of state-provided aftercare. The acts of caregiving embedded in such family practices allow even facial difference to be reframed (Figure 4.8). Focusing on personal photography and expressions of closeness and togetherness demonstrates the amateur photographer’s motivations while also prompting viewers
Figure 4.7 Hugh (centre), his nephew-in-law John Phillips (left), and another family member (right), Suffolk, c. late 1930s. Reproduced by kind permission of the family of Hugh Goddard.
Figure 4.8 George Butcher decorating at home, c. 1938–9, photograph by Emily Butcher. Dewhurst family collection. Reproduced by kind permission of the Dewhurst family.
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to acknowledge personhood amidst disfigurement, and ‘makes of ethics a hands-on, ongoing process of recreation of “as well as possible” relations’.56 Beyond simply identifying facial wounds like Butcher’s as a product of the Great War, he was explicitly tied to his corporeal being as Ministry policy – proclaiming his face and own physical suffering as a material marker of both class identity and incompetent services to British society. When George Butcher went for one of his many hospital appointments in Oxford in the postwar years to monitor his breathing difficulties he saw Dr William Stobie, a chest physician. This doctor was extremely surprised to see Butcher as he had treated him in hospital in France when he was initially wounded and had not expected him to survive.57 This demonstrates a militarized ownership of the body. Through baring (very visibly) the evidence of national service on one’s face, an injured and disfigured British Great War veteran became marred by, and inextricably linked to, his sacrifices during enlistment. Arguably, the very context in which he was disfigured, and the evocation of consenting relationships in the home, was the determining factor in families exerting the veterans’ right to be seen. The refusal to be rendered invisible, and the rights and entitlement which ex-servicemen like these claimed through the framing of their facial difference as ‘injury to honour’ fought by a civilian army, challenged the dominant narrative of emasculation and dehumanization. Their lived experiences and personal photography and testimonies demonstrate a self-awareness and repossession of discourses of disfigurement, which were reconfigured and redefined to situate themselves within the wider group of British war-wounded veterans, and further, within dominant narratives of masculinity. Through the reclaiming of visibility and masculine status, facially injured ex-servicemen exercised an agency which was denied them within wider understandings and cultural representations of disfigurement. The impetus for care remained local.
Local histories and military identities Facially injured ex-servicemen in Britain were one of many groups on a list of service-related impairments to receive review and cutback after 1921. The key assessment here was as an injury which did not disable men from earning full wages at the work at which they were employed. This raises the question of where the medical support was for these men after the war, and if their followup aftercare simply fell apart in the postwar years, as they struggled to find the medical expertise and ongoing care they needed. There are examples in the National Archive Pension Records of facially injured ex-servicemen who actually
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rejected the Ministry’s recommendations for treatment because the hospital or General Practitioner was too far away from their home. With work commitments and family responsibilities or additional costs to pay upfront for train or travel expenses, some veterans found it difficult to attend follow-up aftercare. Further evidence of the pensioners’ ongoing medical needs is found in the War Pensions Gazette’s letters from Ministry representatives to the editor. The periodical offered space for contested pension claims by the reading community and gave the readership direct access to the debates and updates within the pension system. After treatment, a pensioner and his doctor submitted a claim to the Pensions Ministry to reimburse the financial costs of travelling to a hospital as an out-patient and for the medical work carried out. ‘Subject to certain exceptions, authority is given for the issue to men under treatment away from home for free railway tickets to their homes at the rate of one for each six months’ treatment.’58 The author of the article, after first pointing to veterans undergoing concurrent treatment and training, went on to explain travel allowances: [T]he period of absence from home is usually longer than where treatment only is undertaken. For these reasons the Minister has decided that, as regards such men, the periods of three months and six months may be reduced to two months and four months respectively, so that three free tickets or six half-fare tickets may be provided at proper intervals, in the course of a year.59
The public correspondence between the Pensions Ministry and war pensioners thus represents the struggle for personal rights between national and local obligations of care. The Ministry’s provisions of aftercare, while rooted in the state-funded medical treatment for injured soldiers, had a much wider association with related civil hospitals (and exclusive rehabilitative facilities reserved for disabled veterans). Private Joseph Pickard from the Norhumberland Fusiliers began his treatment in a war hospital in Wales shortly after losing his nose to a bullet in 1918. Pickard was later admitted to the Ear, Nose and Throat Department at Sidcup for specialist reconstructive surgery, under the consultation of G. S. Hett. For Pickard, wider social responses to his facial wound were defined initially by a curiosity, which manifested in behaviour perceived as invasive and unwanted. First-hand testimony from Pickard, in a 1986 interview recorded for the Imperial War Museum collections, vividly demonstrates this reaction, and the emotional distress it was capable of inflicting. While convalescing in Wales, Pickard ventured, for the first time, beyond the confines of the hospital, where he encountered some children playing. ‘All the kids in the blinking neighbourhood had gathered. Talking, looking, gawping
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at ya… I knew what they were looking at, so I turned round and I went back to hospital. I’d got no confidence’.60 Although Pickard returned to the hospital immediately after this experience, he confessed that he did this ‘only once’. For a time after this ordeal, Pickard became reclusive, then, one day, he thought, ‘well it’s no good, I could stop like this for the rest of me life. I said you’ve got to face it sometime, so I went out again, and after that I just walked out anytime I was going anywhere.’61 The clarity with which he recalled this encounter decades later reveals the psychological impact of such experiences. While Pickard does not mention his responses to being photographed in the hospital or in the domestic setting, this story of invasive looking did not interfere with the visibility of Pickard in the interview. Quite the contrary, Pickard was encouraged by the interviewer to articulate a flurry of other visual activity. Pickard continued to think through this aversion to looking by describing his weekly attendance at football matches, recalling ‘knocking about London with no nose and no teeth’.62 Using his particular emotional acuity of social encounters, Pickard developed a way of reclaiming control and rebalancing the power relations. For Pickard, the encounters into which he was forced and which threatened his composure and privacy was mainly tied to insensitive onlookers, as the teasing children made clear. Pickard found the responses of adults in society less distressing in the years that followed. He spoke more generally of adults avoiding invasive responses to his facial injury, although, he did recall people’s fleeting glances at him. In response to any invasive attention he received, he would ‘just turn around and look at them’.63 Thus, invasive responses were not limited to any particular social scenario or class. This finds support in psychological scholarship, which shows that strangers often exhibit overly familiar behaviour towards individuals with facial differences, such as pointing and asking intrusive questions, which would generally be considered inappropriate in interactions with non-disfigured people.64 Unable to be addressed by photography, the visibility of these exchanges is compensated for by its recording as an interview conversation. In 1921, after his discharge from Sidcup, Pickard returned to his hometown of Alnwick, Northumberland, and the locals got used to his injury, ‘I never used to mention it, to talk about it’, and so people ‘never used to bother with it, that’s the way I lived my life’.65 The performative nature of this recorded interview provided the opportunity to reclaim autonomy in his own narrative and seemingly justify his actions, and his character, to an audience who may harbour judgements or preconceived assumptions about disfigurement. This must be viewed as performative behaviour, and not necessarily indicative of internal responses to
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stares. However, Pickard’s reaction to starers was one of defiance, a refusal to be presented a spectacle or recluse by his visible difference. The process of retelling this story in his interview adds a further visibility, another group of witnesses to his rejection of passivity. In reclaiming visibility despite attempts, unconscious or otherwise, to marginalize him, Pickard appeared to take a certain pride, and consider this a measure of masculine resilience. Indeed, facially injured exservicemen could gain confidence from their ability to overcome the potential ‘handicap’ of their altered appearances and to cope with negative responses to their war wounds. Facially injured British veterans were subject to such social responses if they failed to conform to idealized expectations of masculine stoicism, the economic breadwinner and family man. While demonstrating conformity to idealized social and gendered conventions was useful in this way, owing to their overt difference and the importance of the face in self-perception and socialization, facial injuries could have serious consequences for men’s identities and their roles within society. As David Gerber has put it, ‘even the most generously conceived martial citizenship was never intended to provide resources wholly to replace private ones, whether of emotional support or ordinary, daily material support’ (see Figure 4.8).66 By investigating the particular ways in which Pickard insisted on ‘manly independence’, and how he communicated this within the community, we can understand more explicitly the correlation between local responsibility along lines of care and resuming masculine roles in the home. Families encouraged and aided their facially wounded loved ones’ ‘cheery’ response. Relatives, as observers of facial injury and their responses to it, played a key role in veterans’ early ability to claim agency and masculine status, as recognition from others, and particularly from other men, was a necessary part of the ideal. For Bob Hart, a veteran and singer he found his disfigurement ‘very embarrassing’ at times, an embarrassment which was antagonized when performing to strangers. On these occasions, Hart would recite a comical song, recognizing that if he ‘got them in a good humour… I can laugh with them then’.67 Fortitude and humour allowed him to transcend the stigma and pity he expected, placating his embarrassment and publicly claiming autonomy and control of the situation by exploiting the ‘happy though wounded’ narrative – thus levelling the power dynamics in interactions, which might otherwise be underscored by shame. By acting as witnesses to the prevalence of masculine values, the public (specifically other men) rewarded disfigured ex-servicemen’s efforts at cheerful stoicism, validating their position and status as part of the idealized male camaraderie. These responses were shaped and amplified
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by the fact that these were ex-servicemen, many of whom framed their wounds as the burden of a patriotic war, as ‘injury to honour’, and who, therefore, were entitled to be seen and respected.
Conclusion Wider society largely appreciated war service with assistance provided for disabled and disfigured veterans in the form of voluntary employment schemes such as the King’s National Roll, which encouraged employers in Britain to take on disabled ex-servicemen to a minimum of 5 per cent of their workforce. By 1926, 28,000 firms were participating in this scheme, employing 365,000 disabled exservicemen.68 The sustained efforts of the Ministry of Pensions to accommodate Britain’s Great War veterans, at the expense of the British Treasury, became critical. In 1938, the British Treasury and Ministry of Pensions discussed the possibility of transferring financial responsibility of British ex-servicemen on to the British taxpayer. With no change in the pension infrastructure, the Ministry of Pensions estimated that the cost of expenditure with regard to Great War pensioners would continue well into the second half of the twentieth century. The everyday recovery of disfigured Great War veterans that I have described was instrumental in affording to family photographers a new practice of care that created the conditions for family members to intertwine their desires and imaginaries with the apparatus to overcome their hardships and struggles. As I have argued, the family photographers resisted the received memory of the war-disabled as passive and reliant on state provision and made their own duties of care and endurance of love valuable, providing a counter-narrative to the dominant expectation of passivity and asserting agency through their own self-representation. Furthermore, this demonstrates that situating the family photography of a small group of facially injured ex-servicemen within the broader context of the Ministry’s domestic campaign of rehabilitation, the camera for average users played a central role for the refusal to be rendered passive and socioeconomically impotent, how they were framed and contained in the public sphere. This assessment also casts new light on the emergence of family photographic practices themselves, despite being a domestic space that has been widely theorized already. Specifically, it draws attention to the technology-enhanced everyday experiences of postwar life more generally – the embedded behavioural codes and protocols – and the central role played by the support of family and friendship networks. Family photographers as care
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providers for disfigured veterans indicate that being able to share the traumas of war brought a family a sense of confidence and self-empowerment and made them feel united in the domestic life they led. Crucially, this participation and a shared burden is demonstrated through wives’ intended goals to produce positive change in their injured ex-service husbands’ sense of self-worth. As keen family photographers, wives used the camera to place domestic life into particular recoveries to make certain rehabilitative motivations obtainable.69 The motivations of using photography for activating experiences of recovery may have been very different for families, but when it came to co-creating private and local initiatives to move on with their lives and from the state’s abandonment of responsibility as a matter of governmental policy, the same expressions of closeness and togetherness were performed.
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The ‘medical collections’ and ‘family collections’ of the archival ecosystem
In 1922, the museum of the RCS became one of the first museums to collect medical photographs from the Great War and in 1923 began to exhibit them to its members. ‘From the annual report of the conservator of the RCS of England we learn that the council of the college has become the custodian of “the Army Medical War Collection”’.1 The preservation of the collection was ‘dealt with by the staff of the museum, the council of the college having placed its staff and premises at the disposal of the Director-General of the Army Medical Services’.2 Interestingly, although the value of the collection is inferred by the RCS to be a historical record of medical and surgical experiences, the ‘work of mounting and cataloguing… had not proceeded very far when it was perceived that the collection was of immediate and permanent value for the education of army medical officers’.3 For the AMS, and for the photographers working in the war hospitals – whether scientifically or commercially trained or keen amateurs – the value of surgery and the ceaseless activity and circulation that characterized their labour came not only in the scientific advances that surgeons made, the visible evidence of the effects of facial mutilations, but also the mediums through which recovery could be articulated. Photography, as this report suggests, changed professions and practices far beyond those of the photographer. It joined with old practices to make possible the conveyance of new forms of surgery and healing. Thus, the collection of the RAMC’s photographic endeavour was, for the RCS, transformed into teaching objects and used to represent research questions in new and divergent ways, the result of careful selection in the technological importance of surgical or treatment questions. In 1923, a proportion of the Sidcup records had also been transferred to the RCS. It was assumed that the British section’s records had been destroyed in 1941 when the college was bombed in the Second World War, although, the Canadian section’s records are believed to have disappeared during transit when they were
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being shipped to Toronto in packing cases in 1918. The New Zealand records resurfaced when rescued from imminent destruction in 1989, and were donated back to the Gillies Archive. The British and New Zealand collections are now housed in the archive of the BAPRAS, while the Australian section’s records are deposited in the archive of the Royal Australasian College of Surgeons, Melbourne. Although the Canadian records have disappeared, presumed lost in shipment transport, an admissions book does survive in the Canadian National Archives. These photographs are material objects with an intended longevity of some sort, with a purpose, for a medically trained audience, within a disciplinary framework. Certainly, nobody had thrown them out. They tell us something about that framework and something of the social activity of the image that they reproduced and projected across a dispersed plain of meaning. The photographs cannot simply be reduced to just copies, mere duplicates, because they had a clear epistemological purpose in their own right. Recent notions of the ‘visual ecosystem’ of the museum can clarify this claim, showing how photographs underpin the establishment of collections as collections of worth.4 Edwards and Lien have convincingly demonstrated that photographs ‘transform… the meaning of objects’ and act to bolster the value of the objects they depict, while at the same time complicating the relationship between knowledge and the object.5 However, Edwards and Lien have also pointed out that photographs in museum collections are there but not there, materially present, previously dynamic, yet now obsolete as teaching aids and intellectually invisible. They sit outside the hierarchical structures that render some practices preservable and others not. The fact that the lantern slides and case notes of patients in the RAMC albums cannot now be located in the Museum of Military Medicine, but I am sure were kept, somewhere, rather reinforces this argument. The idea of analysing collections and disciplinary infrastructures aligns with the increasing analytical emphasis on photographs, not as singular objects but as assemblages in social and institutional contexts, as sets of social relationships. But how is that assemblage of photographs constituted as a conceptual entity? Where is it located in institutional hierarchies? What are its boundaries? And what happens at those boundaries? Such questions are important because the current interest in the materiality, biography, multiple forms and fluidity of the collection cannot be contained merely in the study of what has been institutionalized and managed as ‘the AMW collection’. The collection is instead also located in the photographic actions around it, which continually activate that collection through an ecology of multiple practices that are materially present but institutionally invisible. Furthermore, it is in the material presence
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of family photographs of injured Great War veterans taken by relatives and capturing them going about their everyday lives at home that a clear connection to the infrastructure of the AMW collection can be recognized. Moreover, the family collection cannot be separated from the AMW collection and must be seen as of it in material terms. It is in this interrelationship that thoughts can be raised about the assumptions and hierarchies of value and economy that shape the very existence of elite medical collections. Consequently, this connection is intended as a heuristic device to bring our boundaries of analysis to the fore. The AMW collection that came out of the Great War has been transferred from closed holdings within a military-medical context to publicly accessible archives. Seen through a broader analysis, the AMW collection offer an opportunity for surviving relatives of ex-service patients to repurpose the medical photography, where they fulfil a role for a family, as part of their self-identity and history. It is the contention of this chapter to document and preserve this historical landscape as an act of family ‘validation’, and a continuation of care on the part of family members. Beginning in the late 1980s and early 1990s, the British medical photograph collections from the Great War were gradually released to public archives and slowly circulated, lifted from the silencing of the military and medical archives, where the worst injuries from the war were hidden from communities. As a result, the collections travelled from closed holdings within a military-medical context and became accessible to the public. The military and medical museums showed a willingness to dispose of objects when this would better ensure their preservation, ensure that they would be more widely used and enjoyed, or placed in a context where they would be more valued and better understood. In the earliest phase of collecting images, the RAMC and the medical museums largely controlled meanings because photographs were generated or acquired for the educational purposes of the institution. But the evolving second life of the photographs has been reflected in changing archival and museological practices. As British Army and Ministry of Pensions rehabilitation, the photography of disabled ex-servicemen was originally classified and filed by surgeon and technique, according to where those depicted were treated. During the last two decades the name of the patient and the photographer has assumed prominence and become a key ‘handle’ for such images. These most recent names of patients and regional or local affiliations with regiments added to the records allow family descendants to search for images related to their ancestor’s war service. Yet despite this adaptation of archive and museum documentation to evolving meaning there has always been a tension between the institution’s
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internal definition of its collections and external interests and perceptions; between what suits the bureaucratic and commercial needs of the archive and museum and broader fields of investigation and understanding. For example, at present there is still the paradoxical situation of a scientifically mandated and elitist RCS museum only allowing family relatives (among other audiences) access to images of ex-service ancestors after filling out an image request form and proving their identity, because these photographs are deemed too sensitive for unrestricted public access.
‘Official’ medical collections and ‘informal’ family collections Photographs are the only class of archive and museum object that are simultaneously a collectable item (a significant object) and a tool of management (used as a form of currency to distribute information).6 This is compounded by a slippage of language between ‘photograph’ (a thing) and ‘photography’ (a process or activity). These ambiguous and dichotomous relations are manifested through the processes that designate photographs as ‘medical collections’ and ‘family collections’ – that is, between, on the one hand, a sharply articulated material presence defined through institutional relevance, whether it be a patient as surgical technique or a surgeon’s collected items, for instance, in militarymedical museums such as the Museum of Military Medicine in Aldershot or RCS in London (Figure 5.1). On the other hand is the family collection – those myriads of historically located material practices which exist outside archives and official collections. If they are acknowledged, they often exist in a hierarchical relationship and are pushed to the margins of curatorial and historical practice and kept, that is located, as ‘private collections’ or ‘related materials’. They are not seen as servicing ‘official’ collections, but understood as merely supporting, or providing additional information about, for instance, how ex-servicemen dealt with their disabilities, or the social consequences of devastating facial injuries caused by modern warfare. There is still much room for analysis of the family collections since the redemptive practices of domestic love can help shed light on veterans’ struggles for pension compensation in reaction to the government’s unwanted responses, separated from the main business of institutional ‘collecting’.7 The family practices are directed at transforming the status of clinical military photographic collections originally produced under the discourse of science, part of a broad range of acts of re-appropriation being carried out by surviving relatives who
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are reclaiming records of their ancestors made as part of wartime experimental surgery. It is in this context where medical collections are being embraced, repositioned and recontextualized, and placed in local and family histories and in some cases providing the few photographic records available of relatives of a prior generation, profoundly reversing the reduction of that ex-serviceman to only a medical subject, an institutional object. What this implies is that the medical and family collections when brought together house vitally important photographs that undermine teleological narratives of national and local histories. In them resides the history of intersecting institutional and epistemological boundaries; they are images that move rapidly from the domain of scientific records to the realm of personal narrative, and accumulating biography in the process. Yet they are not understood as such in their own right. This also translates into hierarchies of care within institutional guidelines, with certain ethical and legal definitions encompassing the protocols and conventions for communications that enable them to be useful – protecting the privacy, consent, confidentiality and anonymity of facially injured ex-servicemen to ensure that this care is properly maintained, including the consequences of public access – to the descendants of these men expecting the political right to be seen and recognized as a defence against the anonymity of
Figure 5.1 Storage boxes of photographs from the Gillies Collection. Reproduced by kind permission of the archive of the British Association of Plastic, Reconstructive and Aesthetic Surgeons.
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modern industrial warfare, again, invisible. It seems that nobody has asked the intellectual question how do family practices change the medical objects. The novice photography in the family collections – frustrating the common effort among military authorities and G.H.Q. legislation to censor what soldiers and nurses saw and photographed during the war – open broader questions about the relationship between the communication of elite medical or official war experience and non-elite soldiers, nurses or civilians who picked up a camera and designated the activity as being ‘reparative’ on their own terms.8 Official photographers were expected to sanitize war and hide its horrors, so as not to shock the readers of the press. After the war, the Imperial War Museum was keen to get hold of all the good photographic work that had been done unofficially. The museum began a prodigious task of forming a national collection and justifying to ex-service personnel the value of unofficial photography in the Amateur Photographer and Photography: It is notorious that a vast amount of snapshotting went on in the various armies, in spite of orders to the contrary. The results never came before the Censor, and, in consequence, they are very hard to trace. In fact, if the G.H.Q. Censor had had cognisance of them, it would have been his duty to come down on the culprits with a heavy hand. Those culprits may now, however, confess their delinquencies without fear. They will find that their illicit negatives are welcome at Coventry Street, and all will be forgiven – provided that genuinely accurate specifications of place, date, etc, accompany the photographs.9
It should be pointed out, however, that there were also limits to what the amateur photography captured. What this book has shown is that there was also moral and ethical censorship operating on the assumptions that there are boundaries to what should be shown of human suffering, and indeed, of the rights and privacy of the patients being photographed. Thus, making visible is an ethical practice of acknowledging. However, when someone like Emerin Keene reproduced her photography in an album, she was simultaneously making her own private archive of how she felt about her hospital experiences and commenting on a very different notion of disfigurement from that which was evoked for medical and public understandings of facial injuries. Underlying the argument in this chapter are two key papers which offer a useful way to think about the questions that have been outlined. First is Elizabeth Edwards’ essay ‘Thoughts on the “Non-Collections” of the Archival Ecosystem’, in which she discusses how the ecosystem of photographs and photographic practices work in institutions, especially at the boundaries of the museum and archive.10 If photographic practices are a densely compressed performance of
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multiple activities, liquids and material processes and images which make things, including ‘other’ photographs, what they are, then what are the boundaries of its fixity or stabilization? Where does the caretaking of these materials within a meshwork end? This concept works well in determining the complex relations between medical collections and family collections. If we think of photographs not simply as material objects but as a network of entanglements and hybrid forms that can accommodate multiple claims upon them and act as a critique of separations, here between medical collections and family collections, there is the potential for a refigured understanding of the institutional practices that embed photographs in archives and museums. Second, I draw on Christopher Pinney’s essay ‘Things Happen’, which asks from what moment we can say an object comes and to what extent the presences and work of photographic practices emerge from multiple activities and moments that are manifested through processes and materials and temporally dispersed actions and that confront historical and cultural norms, assumptions and categories.11 Behind this are, of course, much wider questions about privacy, consent, confidentiality and the fragility of family archives displayed in the public sphere, as family descendants refuse to allow such reductive interpretations of their ancestors to be separated from ‘injury to honour’. Instead, descendants wave their ancestor’s right to anonymity and privacy to create a sense of family validation, affirming relationships and intersections of care across a range of boundaries. It is not only the acceptance of facial difference but also the recognition of relatedness and belonging that makes these activities material practices that endeavour to constitute a revised understanding of the Great War’s impact on injured ex-servicemen’s faces. Even if the medical collections were primarily conceived of to constitute a distinct and coherent archive, they circulate across the categories of and practices related to medical collections and take on different values, remade to suit the purpose of a specific archive – in the homes of families. Thus conceived, the complexity of the responsibility of care feels even more all-pervasive when we think of how it is sustained in the homes of veterans’ families.
Value and economy in the institution Both the cost and the size of the AMW collection proved challenging for the RCS, the collecting, preserving, mounting and display of the material was subsidized by the Army Council. A grant of £7,500 was offered to the RCS museum to solve
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the problem and enquiries began to be made to move the collection to the Army Medical College at Millbank.12 The acquisition of the collection by the Army Medical College was a complicated affair that stretched over decades and became a source of contention between the RCS and the Army Council. From the 1920s, the library for army medical officers at Millbank and its museum of morbid anatomy specimens became a repository for donations of manuscript and archival materials, including letters, photographs, albums and publication prints, a vast web of dependencies, mostly bequeathed by members of the Corps. The RAMC museum, however, did not inventory the number of acquisitions it obtained until 1952, when a muniment room was established in the library at Millbank, and all materials acquisitioned by its museum and library placed together. The RAMC museum did not yet embrace stringent educational values, displaying their objects without the epistemic ethos the RCS museum had been noted for. The RAMC inventory reveals that some photographs were later transported from the museum back to the library, which would also explain the gaps in the accession register after 1952. Photographs are noted in single entries, and if they were given to the museum as a donation, the name of the donor was considered important and written down. Despite its title, the RAMC Muniment collection is not an ordered accumulation of the Corps’ own records.13 The first, and perhaps most striking, aspect of the collection is the haphazard organization of photographs and materials in archival storage boxes. The cataloguer has imposed an order on the material and pretended to transform it into self-evident facts.14 Its significance lies not only in its institutional dynamics but also in its alignment with established generic categories of classification. Homogeneity has been imposed on to what was originally a very heterogeneous collection of material forms. These poor descriptive practices perhaps testify to a hierarchy of objects in which lesser value was placed on contextual, material and technological qualities of the objects as against, for instance, bureaucratic and corporate aims of the institution. Norman’s RAMC albums, as scientific objects, were intended as essential resources for setting out rules and guidance for other surgeons to learn from and as proof of a complex epistemic economy of images. Cole’s scientific and political value in the RAMC albums was, as with Pont, ascribed not only in photograph but through the handwritten text. Accompanying the 576 photographs were descriptions of Cole’s scientific influence written by Norman, these included the surnames of ex-servicemen and the dates of operations and sequencing of recovery times spanning several months, so that readers could make sense of a course of treatment and to measure and monitor these subtle changes over time.15
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These albums were primarily carried in language, written and spoken. The assembly of albums and their preservation in the RAMC Muniment collection, strengthened by textual descriptions by a scientific authority, reinforced their mercantile character and the spaces of the knowable, solidifying orthodontic expertise and surgical solutions, for their consumers. Norman’s decisions as an album maker were commercially as well as economically driven, based on what his society-based expertise thought readers did not know, but needed to learn from. In Pont’s album 1, which includes 179 photographs of facially injured soldiers, some commercial studio images of ex-servicemen in uniform or civilian dress have been pasted-in after a case had been closed, presumably these are examples where grateful patients kept in touch with Pont, and sent copies of family photographs to show how well they were recovering and integrating back into civil life. It is through examples such as Pont and Norman’s albums and the fate of other collections of photography that we begin to understand both the British and French Army’s lack of institutional engagement with working photographs and the way this built a resistance to test strips, contact sheets, slides and negatives as unique material things alongside other material in the collections. This mindset of perfectly engineered objective images paved the way to disposal. The curators of the RAMC museum responsible for the structuring and preparation of the Muniment collection were always retired officers of the Corps. The interests of these actors defined the creation and standardization of each object, its organization, description, distribution and accession, within the broader educational agenda of the museum. Photographs and albums are marked with different stamps and inscriptions referring to previous owners or uses. A letter accompanying the RAMC albums in the Wellcome collection provides evidence of the photographs being used as teaching aids for many years.16 The letter mentions the albums being bequeathed by Lieutenant-Colonel Vachell to Major-General Sachs, who later donated them to the Army Medical College in 1969.17 However, it is unclear how long Vachell had the albums in his possession before passing them on to Sachs, and if they were kept in a library, a museum or in a personal collection, or even how they had been acquired in the first place.18 Coinciding with this letter is a library stamp in the top lefthand corner of each album’s inside front cover, as an archaeological layer of their shifting value and permanent loan into the college library. Next to this stamp, a handwritten holding reference, the number 760 encircled, indicating past entry within the AMW collection and later RAMC Muniment collection. The Museum of Military Medicine holds no record of Dr Albert Norman, but does preserve biographical records of Vachell and Sachs. Vachell specialized in
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dermatology and skin conditions and this would explain scientific interest in the two albums.19 So, for a time, these albums became a ‘non-collection’, subject to different management practices from the RAMC Muniment collection.20 They were identified only at file level and, spatially separated, kept not in the ‘collection’ but in the library and then the archive. Thus, these various forms of inscription became the organizing practice which establishes the vast heterogeneity of the collection to a single similitude.21 Despite the uneven absorption of these albums into the narrative of the Muniment collection, we can evaluate the dependencies that feed and stabilize the values given to the technologies of observation for surgical events, these are made up of intersecting epistemologies that cluster around the objects in different ways. They may look the same in representational terms, carrying a visual equivalence that elides the workings behind the image-making process. In many instances, the RAMC’s non-collection of photographs looks very like the ‘Muniment collection’ itself, merely with a different material use. But, at the same time, there are historical layers to the representational practices around photographs themselves within the institutional ecosystem. These are significant because they track shifts in evaluation and the making of meaning. For instance, during the Second World War, a number of the facial injury photographs in the RAMC albums were reproduced in a book to train a new generation of dental surgeons.22 In a similar book, the dental surgeons Kelsey-Fry, McLeod, Parfitt and Shepherd addressed surgeons who ‘had little or no experience in the treatment of these injuries, and who may be called upon to treat them at any moment’.23 In these surgeons’ view, photographic technology held a continued pedagogical significance – enabling knowledge sharing and collaboration among generationally dispersed practitioners – with an authority to organize the direction of new innovation. ‘War affords an opportunity for the collection of cases of special types in centres where they can be studied intensively by skilled and experienced surgeons, who are thus able to improve on existing methods of treatment and devise new ones.’24 In fact, further evidence of the RAMC photographs being used as teaching aids in the Second World War comes from the Museum of Military Medicine. Inside a box labelled ‘Royal Army Dental Corps’, an A4 brown envelope titled, ‘early plastic procedures by Percival Cole – King George V Hospital’, contained some of the same photographs that appear in the RAMC albums. The photographs were originally also from the RAMC Muniment collection but had not been sent to the Wellcome along with the rest of the collection in the 1980s. Within the groups of prints were two dental report cards, dating to 1940;
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each with four RAMC photographs pasted on to them in a grid lay out pattern, recording skin grafting techniques on three patients. The envelope also carried a small number of 10 × 8 prints of some of the images represented in the RAMC albums, and each photograph was stamped on the verso with, ‘Army Cinema Centre, Aldershot, 1940’. These were photographs that had been used in the dental department at Aldershot for educational purposes. What is particularly interesting is that it also indicates that the plates of the RAMC photographs must have been available to print from at this time, but have since been lost or destroyed. Meanings are dispersed through multiple material performances. The assumption is that these photographs are series of disaggregated processes and forms that can be rendered collections or non-collections. However, all material players in the ecosystem are subject to the careful negotiated balance of meaning and practice. We are looking at a dispersed flow of related objects that make meanings within a common discourse and ecosystem, some of which are deemed ephemeral, while some are preserved. A series of coincidences resulted in the discovery of the lost portion of the British section of the Gillies collection, which, for unknown reasons, was not bequeathed to the RCS in 1923 along with the rest of the British records. In 1992, Andrew Bamji, a rheumatologist working at the Queen’s Hospital, made a visit to Queen Mary’s Hospital, Roehampton, following a telephone call from the photographer there, and found two overflowing filing cabinets, which contained the supposedly lost portion of records of the British section at Sidcup. The cabinets contained more than 2000 sets of notes, documenting the treatment of approximately half of the British section patients operated on at the hospital between 1917 and 1925.25 The Gillies collection now housed at the BAPRAS contains approximately 5000 case files of patients, including photographs, diagrams and papers, listed alphabetically and recording the extant contents of the notes produced in the wards of the Queen’s Hospital. Almost all of the case files have been retained within their original grey card folders and accompanied by notes that record each patient’s surname and initials, rank and regiment, and the dates of each operation. The large majority of case files record gunshot injuries, and a number of injuries as a result of shrapnel or gas shell bursts. These records consist of typewritten summary notes of each operation that a patient received during their course of treatment, often spanning several years, and accompanied with four mounted 5 × 7 photographs in a grid layout pattern on individual A4 pieces of paper, with dates referring to each operation written by hand at the bottom of each print, and drawings and X-rays. Of course, the different strands of practice forming these micro-histories constitute
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the ecosystem. As Edwards and Lien have noted, these repetitions constitute hybrids of complex epistemologies and value systems at the intersection of the different knowledge systems which sustain institutions. The Gillies collection is exceptionally detailed and the most complete testimonies to the medical care of servicemen facially injured in war.
War collections on the move Forced by open access, the political need to be open and transparent, and digitization, policy dictates that medical archives now make their collections accessible to the public in order to promote the understanding of medicine and its role in society, past and present. To meet the varied and changing demands of its audiences, and provide an appropriate gateway to their resources as well as physical access to the material, institutions are ensuring that collections of long-term historical and cultural value are placed in the most appropriate publicly accessible repository. Military-medical archives and museums have embraced digitization because of the principles that underpin the accessibility of their collections. Yet, these institutions often choose to withhold certain information about a patient, such as omitting their full name, or blocking out the eyes or even the facial features, in line with clear regulations in relation to patients’ consent, privacy and data protection. This is particularly the case with facial injury photographs, where it is otherwise difficult to anonymize patients as individuals. For example, the Wellcome library and the Archive of the Bibliothèque Interuniversitaire de Santé, Paris, both redact the names of facially injured Great War ex-servicemen online in an attempt to protect their right to privacy and dignity. The tension between a desire to share, as publicly accessible repository, and what it means to protect patient rights challenges the hierarchies of value and the categories that sustain these photographs in the institution. Photographs, as already noted, exist as multiple originals. Not only are photographs ‘three dimensional’ objects themselves,26 but taking this idea one step further photographs are not only two-sided objects but are ‘multiple originals’ leading ‘multiple lives’.27 This multiplicity and reproducibility is a defining characterization of the medium. Consequently, a range of museums can hold historical prints of a photograph by, for instance, Dr Albert Norman, or Sydney Walbridge, and still legitimately claim to hold an ‘original’. As already noted, however, photographs spawn further originals, which reside in both institutions and also beyond, for instance, negatives, multiple prints,
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lantern slides, copy and mediated prints (details, crops, enlargements) and digital surrogates. All have legitimate claims to be ‘original historical medical objects’.28 Thus, as noted earlier, the very physical identity is ambiguous in institutional terms as the ‘originality’ and ‘significance’ of ‘a photograph’ might be dispersed across many related but discrete objects. As Pinney has asked, ‘from what moment does this object come?’29 The ubiquity of processes and forms challenges the hierarchies of value and the categories that sustain them. What is a multiple original, what is a reproduction, what is a medical photograph, and when does it become historically or domestically significant? Such categories shape the conditions under which the ecosystem becomes visible.30 The photographs are derived from a certain number of glass plates and they are printed multiple times. But it is necessary to understand their divergent trajectories along this narrative of dissemination, and the uses to which different agents put them along the way. The photographs represent different kinds of material knowledge, both as single prints and as a group. Their multiplicity is not simply a function of reproducibility, in the sense of the making of many prints from the same glass plate. Reproductions become multiples in a more complicated way, exhibiting small but still perceptible differences, like the choice of printing paper, for example. In their small differences are embedded hints of a knowledge economy in which differences are both worth paying attention to, but at the same time insignificant enough that the images can still be exchanged for one another, that is, the ability of a photograph to stand in for one similar to it. The entry of these photographs into new material forms like albums, printed papers, lantern slides, digital catalogues or family folders not only constructs new knowledge but also claims to organizing that knowledge. For instance, the dominant form of photographic collecting for ‘medical collections’ has been the print and album. Conversely, glass plates and slides, or ink photographs in publications are not perceived as having value in and of themselves. Thus, these ‘working’ forms or reproductions tend to be marginalized as archives, as supporting objects of higher hierarchical value, as discussed in Chapter 2. The practical and conceptual challenges to the core assumptions of photographic collecting practices are complicated when the photographic work in journal articles and textbooks have been largely excluded from writing on the technologies of medical communication because not only were they ‘commercial’ and massproduced but their small, questionable print quality devalued them in terms of collectable objects.31 The complex multi-skilled team of staff members; from surgeons and nurses in the wards and theatres to photographers and assistants in the photographic departments, and printers, publishers, editors and workers
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in commercial industries fundamentally pattern the lines of photographic exchange, and situate that exchange in the larger investigation of the formation and regulation of scientific knowledge through photography as a continual process of divisions, multiples and separations.
Blurred boundaries Equally important are the private family photograph collections that cluster around the technologies of medical communication and track the groups of people who lived with war wounds of the face on a daily basis. For instance, a photographic postcard sent by Arnold Wayte to his mother to let her know he was having an operation at 8.45 am the next morning (see Figures 5.2 and 5.3). The history of the British Army and Ministry of Pensions’ rehabilitation programmes are more consequential in these family collections, which are unlisted, uncatalogued – hidden, but represent an enormous force of epistemological performance. Consequently, most family collections are marked by their institutional invisibility. These boundaries are played out not only in institutional practices but also in everyday domestic ones. This situation has only changed with more widely
Figure 5.2 Photographic postcard of Arnold Wayte and his Ward 5 friends at Queen’s Hospital, Sidcup, sent to his mother on 6 November 1917. Reproduced by kind permission of the Gedye family.
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Figure 5.3 Photographic postcard of Arnold Wayte and his Ward 5 friends at Queen’s Hospital, Sidcup, sent to his mother on 6 November 1917. Reproduced by kind permission of the Gedye family.
available digital display technologies, which have brought the photographs into a more active family dynamic. This digitization has allowed descendants of exservicemen to locate and access surgical photographs of their ancestors and take them up as family possessions. Under the care of the families, photographs as bureaucracy in army business have been recovered from the medical collections, reinterpreted and placed into different and new circumstances. The flow of photographs across categories in their multiple and hybrid forms within the ecosystem has to be liberated rather than managed to erase the boundaries between medical collections and family collections, to establish all the moments in-between that make up the photography complex.
In an old tin box As we have seen, institutional categories intervene in the meshwork of photographic flows and dictate what are collections and what are noncollections. Are family collections invisible or merely unacknowledged objects at the boundary of the unknown? What are the responsibilities of care at work as the borders between medical collection and family collection are negotiated?
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For such negotiations are becoming increasingly frequent as the social, cultural and material history of photography in medicine becomes more visible. While there are increasing numbers of families engaging the medical collections, we also have to ask about the terms of that engagement. There is much important work at the edges of the medical collections engaging precisely with that ambiguity, such as living relatives of ex-servicemen reclaiming the patient-soldiers as ancestors, taking on renewed significance as central elements in practices of reparation and the making of family histories. These surgical photographs are removed from their original context of stigma and medical science, now literally embraced in the arms of descendants. Through these images, family collections are being absorbed, not in terms of existing categories of analysis but rather into expanded categories of evaluation and analysis. For instance, it is interesting to watch the trajectory of Dr Albert Norman’s photographs.32 Since their life as prints, these four small photographs remained out of view for decades, kept as family images with a small number of others in an old tin box. These photographs are duplicates of George Edwards printed by Norman and stored in the home of the Edwards family in California, along with other personal photographs and possessions once owned by the patient. These duplicates are not identical to those in the RAMC albums held in the Wellcome collection, but they are almost identical copies. Joan Schwartz defines duplicates aptly as ‘multiple original photographic documents, based on the same image, but made at various times, for diverse purposes and different audiences’.33 The photographs were kept by George Edwards, a Canadian soldier who fought for the British Army and was wounded in August 1917. This small collection only came to light when family members cleared out George’s belongings following his death. This is one of the most compelling postwar stories of a soldier whose injuries resulted in a dislocation of career. George Edwards was born in London in July 1895. In 1906, he was transported to Toronto in Canada as a Bernardo orphan to serve as a child labourer on a Saskatchewan farm, one month before his 11th birthday. In 1916, George enlisted into the Canadian Army in Saskatchewan. The following year, he was wounded during the battle of Passchendaele – shrapnel took out the cartilage from his nose, his hard palate and upper lip. George was admitted to the 83rd General Hospital in Boulogne for initial treatment, one month later he was transferred to the KGH in London. George’s future career plans were at the foremost in his mind during his time at the KGH, and he took the opportunity to enrol on to one of the Ministry’s employment programmes to retrain as an optical technician. George and his long-term girlfriend, Daisy Blantern, married in 1918 in Camberwell, London, Daisy’s place of birth. A year later George and Daisy returned to Toronto, where he underwent several
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more years of treatment at the Christie Street Hospital to stabilize his injuries. Together the couple went on to have four children. George secured a job as a lens grinder at the Toronto Optical Company and was a loyal employee, ‘the firm pretty much had to force him to leave his job’ when he reached retirement age, his granddaughter Lynn Polm wrote.34 We can actually read these agitated boundaries in action. Over seventeen months between September 1917 and February 1919, in the facial wards of the KGH, Norman photographed George Edwards as he underwent a series of operations. The RAMC albums associate the four photographs of George in the Edwards family collection, showing them as directly related items, and allowing a seamless connection between Norman’s album and the individual prints in the Edwards home, eliding Norman’s photomechanical reproduction that stands between the two (Figure 5.4). While Norman’s working practice is self-effacing, the nurses’ darkroom labour in processing the negatives is invisible in a very specific way: aimed at concealing all signs of the handiwork they were performing. The invisibility of female labour in the photography not only mirrors
Figure 5.4 Page of photographs of Private George Edwards, 1917–19, photographs by Dr Albert Norman. RAMC album 2, RAMC 760. Wellcome Library. Reproduced by kind permission of the trustees of the Museum of Military Medicine.
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the way photographic history in medicine is written with a greater emphasis on the ‘original’ doctor’s photograph but also emphasizes how women ‘become seen as channels or conduits for the ideas of men’.35 Arguably, the four photographs were made from what Henning has described as ‘new kinds of labour relations’ under the low paid work conducted by women.36 The photographs have moved, however. The four photographs are small, measuring 85 × 130 mm, and with rounded corners. The productivity of these fluid processes and material movements resonate with domestic and personal display.37 There are no handwritten inscriptions on the verso of the images to give us a clue to the reasons why surgeons at the KGH gave them to Edwards. It appears that these photographs would have had some benefit to any civilian surgeon treating him in the future, so as to understand what work had been done and foresee further complications ahead or to plan out follow-up aftercare. For whatever reason, these photographs meant enough to Edwards to hold onto them for the rest of his life. Then from these ‘currents of materials’ we get the blurring of the boundaries and the movement from medical collection to family collection. ‘Those of us who saw them when David inherited them were all shocked and moved to tears, as you might imagine’, Lynn wrote. ‘It was quite remarkable he survived the injury’, George’s grandson David added.38 The grandchildren speculate that George kept these photographs because they signified a major part of his life, and this was something he had to deal with for the rest of his life. ‘I cannot imagine that his injuries did not affect him every day’, David wrote, ‘but I am sure he was very grateful to the surgeons for the restoration work they were able to do. I remember that he was unable to wear the false teeth he had been given because they were too uncomfortable. I guess they never got the work on the upper jaw reconstruction quite right’.39 This description suddenly changes and the photographs of facial injury become positioned in terms of the history of the Edwards family and caring for George during his lifetime, which simultaneously disrupt generational norms and interpretation of these photographs. While the photographs in question do not directly evidence family care, the conversations with the Edwards family reveal his suffering and the stresses in managing the day-to-day running of the household. All of Edwards’ remaining children moved to the United States in the early 1960s, after one of his sons and his wife passed away. His grandson David wrote, ‘we all loved and revered the man and still cherish his memory. The facial injury he lived with for sixty odd years just made him more remarkable to us’.40 Family admiration like this (see Figure 5.5) could paper over ambivalent feelings.
Figure 5.5 George Edwards with his granddaughter Kathy on her wedding day, July 1975, photographer unknown. Reproduced by kind permission of the family of George Edwards.
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The ecosystem reaches a moment of stasis as familial hierarchies of value, informed by ‘great admiration for how he went through his everyday life dealing with his disfigurement’, intervene and the absences in the official archive are stabilized within this narrative. ‘He had that large yellowish patch of skin on his forehead and I remember as a child asking what that was. It was skin that had been removed to form his upper lip and nose area,’ Lynn wrote.41 Between the many grandchildren, great grandchildren and great-great grandchildren that live in both Canada and the United States, one finds in the Edwards family a ‘celebration and careful preservation’ of George’s medical photographs – not sad reminders of his war injuries. Progress was achieved through cooperation and a close-knit notion of family, the result of relatives working together for the rewards that came from the family’s material and emotional security. ‘We grew up never knowing him to look any other way so it isn’t painful to us.’ Believing that, as Lynn put it, ‘the photographs just remind us of how much we loved having him with us’, the Edwards family value these photographs of George for the sense of duty and sacrifice. Although George superficially dealt well with his facial injuries, daily life became difficult for his wife and children as a result of arguments. On the other hand, he was gentle, kind, and loving towards his grandchildren. Lynn was told of much tension in George’s immediate family life, although this was never experienced or seen by the time the grandchildren got to know him.42 I can’t begin to imagine ‘what pain he endured from both the initial injuries and the numerous months of surgery afterward, and being reminded of it every time he saw his reflection or noticed people staring at him’.43 It is this determination, dignity, and sense of having not only survived but also coped successfully with these difficulties, not the ex-servicemen’s institutional history, which enabled the photographs to shift category. Arguably, following Pinney, this notion of photography is ‘not anchored to a specific historical moment’, but rather to moments that change in substance through shifts from medical collection to family collection, from archive to family object, to quote ‘a further unfolding of the complex identity of the central object’.44 It is clear that the histories of Norman’s glass plates are far from dry, static final prints, with single forward-facing determinations controlled by the constraints of reproduction. In this case, these four exposures of Edwards have the possibility of influencing the creation and becoming of other material events, sometimes subtly, sometimes less so. The continuities might also occur at any moment in the status of the images, challenging the fixity and evidence of medical photography across even the most far-reaching reproductions, as we have seen with the Edwards family in California. The validation of the
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AMW collection by family members once the holdings are deemed ‘national collections’ by their custodial institutions is also a very powerful incentive in acting on the further lives of other, related archival and museum objects. For example, a small number of glass plates, which Walbridge exposed of Private Bob Davidson in 1917, were later taken home by the patient and then re-entered the Gillies collection decades later as part of Shelagh Davidson’s family collection (Figure 5.6, see also Figure 1.7). After their discharge and the completion of medical treatment, a number of ex-servicemen maintained links to the Queen’s Hospital. This may have reflected their unease with social interactions and a lack of confidence with friends and neighbours, or because of relationships that men established with nurses or local girls. One notable case is Bob Davidson, a patient who chose to stay in Sidcup after his treatment rather than return to his pre-war home and political unrest in Ireland. As part of his rehabilitation, Davidson was regularly sent into Sidcup with the hospital mail. He subsequently established a relationship with a local girl who worked behind the post office counter and after his discharge he settled in the town and got married. Gillies later wrote of Davidson, ‘even after the first operation, it was a great satisfaction to hear this man speak with his native brogue again. Before operation he was a man who was so sensitive about his appearance that he did not like mixing with his fellow patients or with the outside public,’45 Gillies’ aforementioned memory of Davidson’s self-consciousness demonstrates a further significance and dimension to this expanded category of collection. It is important to note that, whilst ex-servicemen adapted their identities and their lives to incorporate their injuries, their war experience and the resulting wounds marked their identities. The family practices were therefore part of a reestablished domesticity in which belonging to a locality was to be in possession of an identity. Shelagh Davidson, one of Bob Davidson’s two daughters, recalled her father’s self-consciousness over his palatal defect. Due to the difficulties he had with eating, when family members ate at home Bob would eat alone in another room.46 He was another patient who seems to have acquired a set of photographs that documented his surgical journey, obtaining a set of four glass plates of himself.47 Shelagh Davidson later donated these half plates back to the Gillies Archive to rejoin the collection they were once a part of. Shelagh has since passed away and there does not seem to be any living relatives, so it is unclear how long the Davidson family had the plates in their possession before passing them on to the archive, if they were kept alongside family images in the personal collection, or even how they had been acquired in the first place. Andrew Bamji says ‘Shelagh
Figure 5.6 Broken half plate glass negative of Private Bob Davidson, 30 March 1917, photographed by Sydney Walbridge. Gillies Archive, the British Association of Plastic, Reconstructive and Aesthetic Surgeons, BAPRAS/Sidcup/6/2, from the Archive of the Royal College of Surgeons of England, London.
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Davidson had stayed a local resident, so was the first family member from whom I received anything. She was single, her sister had passed away, so there wasn’t anyone to leave stuff to except us, perhaps,’48 Davidson was one of the patients who stayed on after the war and was still working at the hospital in the late 1950s. As Bamji explained, ‘he may have taken the plates rather that been given them’. When Queen’s closed in 1929, prior to re-opening as Queen Mary’s, ‘a large quantity of glass plates were broken up and junked’. Davidson and the expatients still in residence probably ‘went through them first to see if theirs were among the discarded’.49 Gillies’ recollection of Davidson’s self-consciousness and lack of confidence stresses the difficulties of taking care of relations. Through the actions of the Davidson daughters in looking after these fragile objects within the family home, and securing their preservation by donating them to the Gillies archive, one can read the family care: these are caretaking acts. Bamji believes it is proper for donations to come to appropriate collections when the owners of the material are unsure what to do with it, or want it to have a wider audience or be available for research. He explained: It can change history, certainly the family material that I have received has altered my perception of the psychological aspects of facial injury very significantly. Much of what we have received has filled gaps or expanded our background knowledge. I have no doubt that all curators (I am careful not to call myself an archivist, because I have no archival qualification) feel the same about acquisitions, whether donated, purchased or simply found. I get a similar kick if someone else finds something.
All of this can be read as a commitment to protecting men like Davidson’s legacy by instilling a set of civil and familial values, creating a new micro-collection in the process through cooperation with the archivists. But what do factors such as the fragility and tactility of glass plates mean in taking up these objects in the archive? All four of the Davidson plates are protected in their storage box by individual paper envelopes so that each object is separately wrapped and not stacked on top of each other, to avoid accidentally scratching the brittle emulsions. The decaying qualities of these plates are thus the product of the wholly organic process of gelatin coating. The highly unstable structure of these exposed plates is such that they need to be stored differently from the paper prints produced from them. Two of the Davidson plates are broken and pieces are missing, although it is unclear if these were damaged and lost when thrown away at Sidcup or whilst in the possession of Davidson after he retrieved them from the skip. The multi-tiered material fluxes entangled in these
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objects also tells us much about the organizational infrastructure of retrieval in a medical collection. The fragility of glass accentuates how these objects have to be stored while also saying something about the ephemeral notion of storage, as with the lost slides discussed in Chapter 2. Often, glass objects are left to languish in collections, they become obsolete and people pay little attention to them as they become difficult to use or view. The management of glass plates in collections is a bureaucratic bottleneck, a nightmare for archivists, and public access is complicated by corporate aims of the institution to safeguard these easily broken or decomposing objects against accidental alterations. In this chapter, I am not suggesting that, as we look at the longevity of something made by deep levels of the ecosystem, any of this is necessarily wrong in bald terms – things happen and things happen to images. The processes of photographic image-making have always been bound by technological constraint, highly susceptible to environmental conditions and hostage to their reproducibility and material qualities. These generative fluxes are the root of photography’s ambiguity within the institutional ecosystem. But why this is interesting is because it demonstrates the temporal and category complexities of the ecosystem and how the mediated processes of photographic image-making works over multiple perspectives, the uncontemporaneous activities and circulations which are brought into momentary alignment through institutional and familial collecting practices and the categories that sustain them. The connections made in following the proliferation of photographs of facially injured patients in the AMW collection reveals the personal nature of photographic interactions like collecting, exchanging, and reclaiming photographs. Families like the Davidsons were responsible for both preserving glass plates and circulating them within his family network. Those family members then collected, shared and bequeathed their collection. Tracing the trajectory of a series of plates, photographs, albums and collections, it becomes apparent that prints do not just emerge from their glass plates and travel on completely disconnected and divergent paths, they often reconnect, are remade, interpreted and reclaimed in the process of telling historical narratives.50 In so many of these examples, the names of surgeons, photographers, nurses, orderlies, darkroom assistants and ex-service patients and their relatives are thrown together, so that to treat any one is difficult without the others. The rise of the cultural history of the facial wards of the Great War as centres for experimental and innovative surgery and photography, and the subsequent arrangement of photographic collections within army museums and then public archives with an open access policy, has acted as an incentive to donors who may
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not have initially thought to give their private collections to a national collection. Thus, the location and validation of family connections with the patients in the RAMC photography steered many of these photographs from their disparate and far-reaching private locations back to their collections of origins. The AMW photographic collection is part of a performative meshworked ecosystem, a material and immaterial infrastructure which supports the museum and archive objects within a wider ecology of caregiving which binds domestic and family labours to the institutional practices.
Conclusion The RAMC collected a wide range of photographs and material from the First World War. Acquisitions were made by various means – donation, purchase, exchange – and for a multiplicity of reasons and medical contexts, as documents, as supplementary collecting of surgical techniques or rehabilitative treatments – for instance, photographs of AMS labour and the logistical challenges that the hospitals faced, or as examples of technological advances in medical care. Throughout the 1920s, the acquisition of photographs made during war service also increased within the archives of national licensing bodies such as the BMA and Royal Colleges, reflecting the growing size and importance of the AMW collection. They were seen as resources for largely in-house purposes. However, a read through the medical journals also reveals the scale and scope of photographs now destroyed, such as the working slides and prints from society meetings discussed in Chapter 2. It is clear that the current collection of photographic material is a vestige or shadow of what was once a significant and substantial intellectual relationship with the AMS. The physical remnants of these disposals are now found only as textual ghosts of slides, copy negatives and prints. The positioning of the photographs at point of entry into the archive and museum separated them from related items and created hierarchies of value between photographs and other artefacts.51 What happened to thousands of glass plates and slides in the intervening years is difficult to ascertain. They were not included in the AMW collection, nor do they form part of the personal donations that individual surgeons bequeathed to the national societies. Negatives and slides have largely been absent from collecting practices in the army and medical museums and archives. Pinney argues that to really grasp how the ecosystem of photographs and photographic processes and practices work in institutions, especially at the
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putative boundaries of the museum and archive, it may be more appropriate to consider photographs as ‘densely compressed performances unfolding in unpredictable ways’.52 For family members, the facially injured soldiers seen in the archival photographs can be reclaimed as ancestors through their presences in the archive. The impossibility of tethering such imagery permanently to their foundational frameworks is part of their unruly productivity, as future generations refuse to let unacceptable narratives shape their interpretation, no longer allowing them to objectify and dehumanize men disfigured by war. In the hands of descendants, these images and the ex-servicemen they represent can give a redemptive second life, documenting stories in an entirely different way from the British Army’s original intentions. Through a process of mediated kinship, these photographs work through a logic of existential embrace and reversal of stigma. They speak back to the social, cultural, political and material histories that have defined the lives of disfigured war pensioners and families, in ways that are far more flexible and inclusive. The role of the archival photograph, in socially emplacing ancestors within such familial articulations of history, is obviously one that involves the image in a complex of contemporary politics and ethics of circulation. These narratives are of course perceived as challenging by virtue of their subject matter alone: the agendas they reveal, the political debates they feed into and stem from, the emotions that they engage and the lack of any sense of resolution to be found in their exploration or perhaps exploitation. Nevertheless, as the basis of a biographic presence or lived experience, the photographs in the AMW collection cannot be contained by their representational interpretation as the medical desire to describe and categorize. The presence of contemporary stories and family memory all establish productive routes beyond institutional boundaries and bring the photograph into a new relationship with the present. It is this creative tension, between the archive as a permanent ancestral resting place, and yet as a reproducible, recordable and dynamic historical resource, that lies at the heart of the affective nature of a descendant’s relationship with photographs of ancestors. The archive offers a physical space in which multiple meanings of the photographs are constantly being shaped and reshaped, reframed via contemporary narratives that embrace inclusion of facial difference, and taking on renewed significance as central elements in practices of reclamation and the making of family histories. It is this mutability and open-endedness that makes the RAMC photography resistant to any particular moment. Studies that put photographs (whether analogue or digital) at the heart of their analysis of military clinical collections require a sensitivity to the complete
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ecosystem of images and practices, a meshwork of multiple material forms and performance of images which make things, including other photographs, what they are. This is not merely a celebration of the margins of categories and boundaries but also to the full implications of photography’s mobility – that is, to an accounting of dynamic relationships, not just to static objects, and to a tracing of dispersals across purely medical and hybrid family forms.53 If we think of photography not simply as a static image and end product but as a mesh of hybrid processes and forms that can accommodate multiple claims upon them, acting as a critique of separations, there is the potential for a refigured understanding not only of the institutional practices that embed photographs in archives and museums but also of photography in all its various manifestations, wherever and in whatever form they have appeared. The question is not whether things happen or not, whether there are medical collections, family collections or non-collections, or even whether it is ethical or unethical to make them publicly accessible. Rather, it is a question about the interlocking relationship: What is its resonance? What is the media archaeology of institutions and their collections through which historical and contemporary protocols and conventions are realized and revealed? How do we accommodate what Pinney has called ‘the alien and haunting presence of things that we have made but might, in their institutional presences, also produce disjunction and incoherence’?54 Simultaneously, we need to be aware of the embedded institutional categories and the exercise of institutional rights, which, despite our best efforts, continue to intervene in the meshwork of value, creating a stasis in their own image, within the hybrid flows of medical collections and family collections.
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The experience of facial injury does not sit seemingly alongside existing studies into disabled British Great War veterans. The difficulty of treatment, domestic reintegration and employment after the war ensured that the Ministry’s initial progressive and innovative attempts to rehabilitate disfigured ex-servicemen were compromised. In the Red Cross pamphlets that were circulated to all general hospitals and infirmaries in 1916, the Ministry’s objectives of British facial centres sought to alleviate immediate suffering and manage ex-servicemen’s wounds, with a reassurance of building up and restoring the features of men who would otherwise be permanently disfigured. The Red Cross reminds us in its description that to make these men’s ‘existence more than tolerable’ required ‘continuous and special care during a long period of convalescence’.1 The subsequent experience of facially injured soldiers in both the facial centres and their return to civil and domestic life further diversified experience. Surgeons in their society debates voiced the British government’s social responsibilities of rebuilding ex-servicemen’s injuries and the moral dimensions of these areas of medical practice. Conversely, while discussing the possibilities and limitations of surgery, and the boundaries of social acceptance, the British government prioritized the validity of state and public-funded aftercare to return men to their communities as functioning citizens and family members and society placed much emotional currency on their sacrifices. These facially injured Great War ex-servicemen had medical and welfare committees to decide for them what was good or bad in reconstructive medicine and compensation. This paternalism by interested parties, the British Army and the government, and the charities and businesses attached to research on rehabilitation, required critical debate on serious and fundamental issues about how men with otherwise nonimpedimentary facial injuries would obtain public-facing employment in retail or other service industries. The Ministry’s resulting expenditure provided Great War veterans with an integral source of income during a time of widespread unemployment and economic depression.
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With regard to the camera for rehabilitative treatment, the war hospital photography was innovative in the context of facial reconstructive treatment in implementing surgery and healthcare. A wide cast of photographers and darkroom assistants in specialist departments oriented themselves in relation to the circle of elite medically trained photographers through the way their relationship was defined to the medical societies. The standard of care became much more embedded in network-building relations and in particular the circulation of medical images and photographic materials. The photographic services initiative carried a plurality of group-based production within healthcare and allowed doctors, photographers, nurses, and darkroom and technical assistants to all share the workload. An analysis of the emergence and development of photographic departments in the various facial centres also demonstrates that the diffusion of the technology and the complexity and cost of the services may have discouraged some hospitals from establishing similar services, such as the example with the Croydon War Hospital and Villa Massimo discussed in Chapter 3, where a slimmed-down amateur service was less able to adequately care for the patients, thus presenting ethical concerns with regard to patient confidentiality and privacy rights that could derail the technology. This investigation of facially injured Great War veterans contributes to numerous historiographical debates. First, this study locates itself within the broader historiographical discussion of whether this disabled ex-service community was able to reintegrate back into domestic life and secure longterm employment. Influential works by historians such as Joanna Bourke argue that the facially injured Great War soldier encountered social awkwardness in reaction to disfigurement and combined to both exclude and offend them. The overall effect is alienation.2 Like Pickard, the ex-servicemen would have resented such societal reaction and responded by belligerently asserting their agency. These responses were shaped and amplified by the fact that these were ex-servicemen, many of whom framed their wounds as the product of a patriotic war, and who, therefore, were entitled to be seen. While such injuries could make it difficult for ex-servicemen to resume their pre-war civilian lives, limit employment possibilities and provoke unwanted social responses, the family practices in particular can challenge these representations as ultimately debilitating and demonstrate that they were not always entirely socially restricting. Many facially injured Great War veterans were able to find a place for themselves within the domestic and socioeconomic spheres of postwar British society. The experiences of some facial casualties and how they dealt with their injuries were less bleak than many official accounts infer and lend
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a more balanced account of facial injury than the one which is commonly portrayed in contemporary accounts and modern popular culture. With novice photography, families celebrated new ways of forgetting the traumas of war, and the processes through which relatives managed the long-term needs of veterans and fulfilled their duties of care for these men. The photography for average users lies somewhere’ in-between the families seeking solace and recovery within the postwar era’s discourse on social reintegration and reform and state-provided aftercare that cajoled injured ex-servicemen into treatment and training on the understanding that they could gain employment and ‘earn a livelihood for themselves and those dependent on them’ on completion of a course.3 The Ministry’s ethos proved contradictory. In the 1920s, Local War Pensions Committees began relinquishing their duty to provide for these men and to secure jobs on completion of their treatment and training. While some employers in Britain showed a willingness to take men who had been disabled and disfigured, other works had not even been able to find places for their own pre-war men who had served in the British Army and were now demobilized, for the simple reason that jobs were not available. The conditions of the labour market were such that a number of businesses had taken back the soldiers who were in their employ before the war. The British Army and Ministry’s treatment and training schemes failed to stave off the tendency of private employers to prefer to hire able-bodied and un-pensioned men in the competitive postwar economy. In spite of schemes like the King’s National Roll, employers hesitated to take on disabled ex-servicemen because of the high premiums they thought would be exacted for insuring such employees.4 In addition, the average employer was not prepared to give the additional nine months training to supplement the state’s programmes.5 This study’s focus on the medical photographic collections of one body of ex-servicemen, the facially injured veteran, the medical community, the RSM and government department, the Ministry of Pensions, exemplifies how the treatment and experiences of disfigured Great War veterans depended on locality and family support. This work hopes to contribute to the broader fields of archival studies and ethics by emphasizing the relationship between the uses of historical medical photograph collections and how scholarly research may impact on the surviving relatives of ex-servicemen. With regard to the ethics of using sensitive medical documentation, this study highlights the importance of family sources and their associated connections with the institutional collections of the Great War. Richards and Burch, for example, contend that family sources
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‘reach into the most personal details of life, in ways that… official sources never would. They may even, often, contradict institutional sources in important ways and challenge the historian to interpret multiple perspectives.’6 Thus, the material photographic and historical practices in this study concern themselves with questions of visibility and occlusion, of not showing, and about what is publicly present. Certainly the interlacing of cultural values and sensitivities of war-related facial injuries makes the medical collections more complicated, and even more fragile, preventing certain images from being shown and retaining them in closed stores. Community considerations have to be taken into account by museums and archives because of the impact of their collections on close family members connected to the individuals referred to in the material. This position bolsters the family in this process of making the national local and reflects a way in which amateur family historians are invested with a key role in this ethical debate. Establishing how families were obligated to care for their injured loved ones extends the argument made in this book concerning the value of commitment to care as a certain type of relationship. Through this conclusion, instances like the nature of the family’s own agency in attempting to shape their injured loved one’s relations to the state around his own conception of his needs and aspirations, discussed in Chapter 4 – instead of being discussed solely as a burden of care – can be situated much more explicitly within the scope of what they felt they had to do, when faced with the wrongdoing of politicians and army officials, and to follow through on their best judgements to care. Regarding analysis of veteran communities, this case study reinforces the critical variable of how the state’s formal practices of care assessed facial disfigurement and domesticity and how its administration of welfare impacted families. The motivations for turning to the family histories that I have argued for stem from a duty as a historian to offer readers the capacity and compassion to empathise with those actors in the past on their own terms and through the practices they wished to represent themselves. Prior to digitization, there was much distance between the family and their ancestor’s medical photographic history. There was very little chance that the family would be aware of their ancestor’s existence in the archival photographs, let alone be able to access them. This has meant that researchers, writers and historians have used and published these images over many years, while many family members remained unaware that images of their relatives are held in the medical collections. Importantly, this also means that any family perspectives, history or knowledge in these photographs which have not yet, or only recently, been identified, referenced or acknowledged will now form part of the legacies that the AMW collection finds ones self in.
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Ultimately, this study reinforces Ann Stoler and Ariella Azoulay’s theses on the violent nature of institutional archives and the imperial modes of ordering that marginalize and suppress communities.7 In doing so, I hope to induce further enquiry into hitherto overlooked encounters with the historically positioned vulnerabilities in regard to the patients in the AMW collection. First, more research needs to be undertaken into how the Ministry of Pensions’ system of care for the facially injured Great War veteran fortified the gendered order and the hegemony of normalcy. It may be that the flawed efforts of the department were far more influential than has been previously assumed. Faye Ginsburg similarly recognizes the retelling of intimate histories of survivors and goes so far as to question the ownership of such documents. For example, she asks whether these documents should remain in the hands of the archive that houses them or bequeathed to the people represented in the collections? Ginsburg even contemplates whether some army-medical archives should be destroyed out of respect for the dignity of those whose images were made in a humiliating context and without their consent.8 In any process of reclamation, witnessing and the creation of counternarratives, it is also important to account for the impact of cheaper, easy-to-use and widely available cameras. These have had remarkable effects as a technology that enabled the expansion of imagemaking, and as an activity that could encompass and give public visibility to new cultural subjects whose lives previously had been stigmatized and rendered invisible in public space. Further analysis on current protocols surrounding historical medical photographic collections and the particular challenges we face as historians is now necessary. The sensitive handling of historical photographs of patients requires closer scrutiny.9 While a 100 years closure period (aligned with data protection laws) is often implemented by archives and other repositories, further research is required to assess whether the guidelines safeguard contemporary (rather than historical) subjects. Who exactly is being protected by the ethical protocols and conventions here? Is it the institution, the author, the reader, the deceased historical figure or distant relatives? With the passing of time, more and more archives and museums of medicine are opening up to the public and being placed online as their time of closure recedes and the importance of access comes to the fore. Following a theme centred at numerous points in this book, a RAMC photographer or surgeon never sought the consent of a patient in the facial ward to take or re-use his photograph, and I, as a historian re-using the images to make my argument, am fully implicated in this ethical protocol. In fact, the mass circulation of photographic images can hinder
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historical knowledge, as Susan Crane has argued. Writing about photographs of the Holocaust, Crane has defended ‘choosing not to look’ as an ethical choice.10 ‘Choosing not to look’, Crane argues that these sensitive images should not be overshared, for simple exposure to photographs of the Holocaust does nothing to enhance an understanding of what happened. Rather, photographs can create a false sense of familiarity with these events which prevent further examination. To use Crane’s phrase, by using a photograph of an ‘unwilling subject’ I, and we, bear the responsibility to ‘respond to an ethical injunction to find out more about it before I use it, recirculate it, or attempt to pass it off as ‘‘representative’”.11 While this book has analysed the Great War’s impact on family-led care in the postwar years, we need to think carefully about the different statuses of photographs and the information we provide around them. At what point does or should the subject’s confidentiality take effect? When does a person, their name, their image have a right to privacy and anonymity and when not, and who gets to decide?12 In spite of the protection of patient rights it upholds, current protocols and administrative procedures remain a clumsy and impractical solution and can be an obstacle to historical research and to our work of developing a larger collective consciousness of our difficult medical histories. Issues such as whether and when we should use the surgical photographs of patients, if and when people’s actual names should be used, how much about intimate lives should be shared publicly, and our accountability to people who are related to our subjects deserve far closer scrutiny. Contending with these issues and other tensions between consent and a duty of care force us to take stock of our own responsibilities as historians and check our own privileges as moral arbiters. Incorporating current ethical guidelines while also acknowledging the protocols that were in place at the time of photographic production are difficult and require finding the right balance. This study has centred on how the personal details of soldiers in the AMW collection can be discussed despite being barred as medical discourse through retrospective ethical applications. This study aims to be part of the journey to discover the individual exservicemen in the medical photographs and the experience of the traumatized men after 1918. Research into returning veterans should remain open to the challenging juncture between legal transparency and medical restrictions and address the shortage of analysis regarding how family and historical practices work together or against these ethical applications. Archives and museums may not have a problem with researchers using the images, as long as we seek copyright permissions. But often, in addition, they restrict the use of fully
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naming the patients. When I have written and spoken about these men I have been bound by confidentiality and access rules which require me to anonymize their names, and some institutions even require that any identifying details are obscured if the researcher reproduces a photograph or case notes. Our wish to name these men may breach historical and contemporary legal and archival practice. While a family member may grant permission to use their ancestor’s name, this does not mean they have the right to allow this when working with the medical photograph collections. Although we may want to name these patients, we may not have the legal right to do so. Historians should therefore acknowledge and analyse instances of success and purpose evident in the private and professional lives of those patients captured in historical medical photograph collections to recognize their agency in improving their treatment and position within society. Finally, this study seeks to contribute to and advocate for a more holistic understanding of military clinical photograph collections by exploring the rights of privacy, anonymity and consent when retrospectively applied to situations where they did not exist or existed in a different form. While the verdict is still out on how to grapple with the troublesome nature of historical medical photography and the bureaucratization of ethics – via review boards, clearance policies and university research guidelines – medical photograph collections remain an integral part of our institutional and emotional record. While the current protocols in place are not always sufficient and can raise more questions than provide answers, with greater numbers of historical medical collections coming to light after decades in the dark, it has never been more pressing to consider the place of this material in society today.
Notes Introduction 1 ‘Disabled Soldiers’, The British Journal of Photography (1916): 425. 2 Ibid. 3 Seth Koven, ‘Remembering and Dismemberment: Crippled Children, Wounded Soldiers, and the Great War in Great Britain’, American Historical Review 99, no. 4 (1994): 1188. 4 The Disabled Soldiers’ Handbook, 1918. Ministry of Pensions leaflet quoted in Joanna Bourke, Dismembering the Male: Men’s Bodies, Britain and the Great War (London: Reaktion Books Ltd, 1999), 66. 5 Gerrard Harris, The Redemption of the Disabled (New York: D Appleton and Company, 1919), 98. 6 Any children born to a disabled soldier after the war were excluded. Koven, ‘Remembering and Dismemberment’, 1191. 7 Edward T. Devine, Disabled Soldiers’ and Sailors’ Pensions and Training (New York: Oxford University Press, 1919), 183. 8 Heather Perry, Recycling the Disabled: Army, Medicine and Modernity in World War One Germany (Manchester: Manchester University Press, 2014), 1. 9 Meaghan Kowalsky, ‘“This Honourable Obligation”: The King’s National Roll Scheme for Disabled Ex- Servicemen, 1915–1944’, European Review of History 14, no. 4 (2007): 575. 10 James Dundas-Grant, ‘Facial Plastic Surgery, Laryngology, and Stomatology, in French Military Hospitals. Impressions de Voyage’, The Lancet (1915): 926. 11 Bourke, Dismembering the Male, 33. 12 Andrew Bamji, ‘Facial Surgery: The Patient’s Experience’, in Facing Armageddon: The First World War Experienced, ed. Hugh Cecil and Peter H. Liddle (London: Leo Cooper, 1996), 495. 13 This number was calculated based on pension claims referencing ‘face’ and ‘facial’ as a primary disability, as well as specific parts of the face, for example ‘nose’. Entries were only counted once in the total where the claim was for dual injuries, for example ‘face’ and ‘jaw’. Eye injuries were counted if the claim concerned a physical injury to the eye but not for loss of sight. Pensions Records, National Archives.
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14 Steve Edwards, ‘Why Pictures? From Art History to Business History and Back Again’, History of Photography 44, no. 1 (2021): 11. 15 ‘The Queen’s Hospital, Frognal, Sidcup’, The Lancet (1917): 689. 16 See J. Galsworthy, ‘The Gist of the Matter’, Reveille (1918): 7; George H. Barnes, ‘A Fore Word’, War Pensions Gazette 1 (1917): 1. 17 Marjorie Gehrhardt, The Men with Broken Faces: Gueules Cassées of the First World War (Oxford and New York: Peter Lang, 2015). 18 Bamji, ‘Facial Surgery’, 498. 19 Heather Laine Talley, Saving Face: Disfigurement and the Politics of Appearance (New York: New York University Press, 2014). 20 The physical body could be altered, limbs lost or damaged, but within the masculine ideal the face, significantly, was supposed to be whole. See Bourke, Dismembering the Male. 21 Suzannah Biernoff, ‘Shame, Disgust and the Historiography of War’, in Shame and Sexuality: Psychoanalysis and Visual Culture, ed. Clare Pajackowska and Ivan Ward (London: Routledge, 2008). 22 Talley, Saving Face, 12. 23 David A. Gerber, ‘Introduction’, in Disabled Veterans in History, ed. David Gerber (Ann Arbor: University of Michigan Press, 2000), 14. 24 See Catherine J. Kudlick, ‘Disability History: Why We Need Another “Other’”, The American Historical Review, 108, no. 3 (2003): 763–93. 25 For a discussion on veterans’ entitlement see Mark Edele and Mark Crotty, ‘Total War and Entitlement: Towards a Global History of Veteran Privilege’, Australian Journal of Politics & History 59, no. 1 (2013): 15–32. 26 Shannon Mattern, ‘Scaffolding, Hard and Soft: Media Infrastructures as Critical and Generative Structures’, in The Routledge Companion to Media Studies and Digital Humanities, ed. Jentery Sayers (London: Routledge 2016), 321. 27 Ibid. 28 See also ‘Photography and Networks’, a special issue of History of Photography guest edited by Owen Clayton and Jim Cheshire, which includes a number of contributions that discuss the application of Bruno Latour’s work to photographic studies and, more generally, systems of (photographic) knowledge production. See ‘Photography and Networks’, History of Photography 41, no. 4 (2017): 325–411. For a discussion of ‘the war photography complex’ to describe an expanded conception of war photography encompassing numerous uses in wartime of photographic images and technologies, and an appreciation of the broader network of actors, organizations and institutions relevant to war photography – a network created within not only the military and the state, but also photographic companies, weapons manufacturers, individual entrepreneurs, media companies and the public, see Tom Allbeson and Pippa Oldfield, ‘War, Photography, Business: New Critical Histories’, Journal of War and Culture Studies 9, no. 2 (2016): 94–114.
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29 James L. Hevia, ‘The Photography Complex: Exposing Boxer-Era China (1900– 1901), Making Civilization’, in Photographies East: The Camera and Its Histories in East and Southeast Asia, ed. Rosalind C. Morris (Durham and London: Duke University Press, 2009). 30 Bruno Latour, ‘Technology is Society Made Durable’, in A Sociology of Monsters: Essays on Power, Technology and Domination, ed. John Law (New York: Routledge 1991), 117. 31 Hevia, ‘The Photography Complex’, 81. 32 Ibid. 33 Patrick Fridenson, ‘Business History and History’, in The Oxford Handbook of Business History, eds. Geoffrey Jones and Jonathan Zeitlin (Oxford and New York: Oxford University Press, 2008), 9–36, 14. 34 Jeff Wall, Selected Essays and Interviews (New York: Museum of Modern Art, 2007), 109–10. 35 Kaja Silverman, ‘Water in the Camera’, in The Miracle of Analogy or The History of Photography, Part 1 (Stanford: Stanford University Press, 2015), 67–85. 36 Ibid., 68. 37 L. F. Haber, The Chemical Industry, 1900–1930 (Oxford: Oxford University Press, 1971), 132. 38 See Reese V. Jenkins, Images and Enterprise: Technology and the American Photographic Industry, 1839–1925 (Cambridge: Johns Hopkins University Press, 1985), 323. 39 B. V. Storr, ‘Photographic Materials and Processes’, The British Journal of Photography (1917): 353. 40 Marcel Finke and Friedrich Weltzien, State of Flux: Aesthetics of Fluid Materials (Berlin: Reimer, 2017), 9. 41 Ibid., 9. 42 Ibid., 13. 43 Kaja Silverman, The Miracle of Analogy or The History of Photography, Part 1 (Stanford: Stanford University Press, 2015), 74. 44 Delaporte, Les Gueules Cassées. 45 Biernoff, ‘Shame, Disgust and the Historiography of War’. 46 Wendy Jane Gagen, ‘Remastering the Body, Renegotiating Gender: Physical Disability and Masculinity during the First World War, the Case of J. B. Middlebrook’, European Review of History 14, no. 4 (2007): 525–41. 47 Suzannah Biernoff, ‘The Rhetoric of Disfigurement in First World War Britain’, Social History of Medicine 24, no. 3 (2011): 666–85; Portraits of Violence: War and the Aesthetics of Disfigurement (Ann Arbor: University of Michigan Press, 2017); Gehrhard, The Men with Broken Faces; Beatriz Pichel, ‘Les Gueules Cassées. Photography and the Making of Disfigurement’, Journal of War and Culture Studies, Special Issue 10, no. 1 (2017): 82–99. See also Eilis Boyle, ‘An Uglier Duckling
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than Before’: Reclaiming Agency and Visibility amongst Facially-wounded Exservicemen in Britain after the First World War’, European Journal of Disability Research 13 (2019): 308–22. 48 Andrew Bamji, Faces from the Front: Harold Gillies, the Queen’s Hospital, Sidcup and the Origins of Modern Plastic Surgery (Solihull: Helion and Company, 2017). 49 Bourke, Dismembering the Male; Ana Carden-Coyne, Reconstructing the Body: Classicism, Modernism, and the First World War (Oxford: Oxford University Press, 2009). 50 Nicola Rumsey and Diana Harcourt, The Psychology of Appearance and Disfigurement (Maidenhead: Open University Press, 2005); Talley, Saving Face. 51 Biernoff, ‘Shame, Disgust and the Historiography of War’. 52 Talley, Saving Face. 53 Bourke, Dismembering the Male; Julie Anderson, ‘Stoics: Creating Identities at St Dunstan’s 1914-1920’, in Men after War: Gender and History, eds. Nicola Cooper and Stephen McVeigh (London: Routledge, 2013). 54 Michael Robinson, “‘No Man’s Land”: Disability, Rehabilitation, Welfare Policy and the British Ex-Service Migrant in Australia, 1918–39’, Social History of Medicine 34, issue 1 (2021): 214–36. 55 Deborah Cohen, The War Come Home: Disabled Veterans in Britain and Germany, 1914–1939 (Birkeley: University of California Press, 2001), 4. 56 Sophie Delaporte, ‘Le Corps et la Parole des Mutile’s de la Grande Guerre’, Guerres Mondiales et Conflits Contemporains 205, no. 1 (2002): 5. 57 Personal correspondence with Mary Russell, a granddaughter of Sidney Twinn, email conversation, 10 January 2020. 58 The War Pensions Gazette, a monthly journal for War Pensions Local Committees, provides a contemporary discussion of the facially injured pensioner, the disabled veteran and broader ex-service community in Britain. In 1917, the Minister of Pensions George Barnes proclaimed boldly that the journal’s mission was devoted to the improvement of disabled soldiers’ treatment, training and general welfare, see Barnes, ‘A Fore Word’, 1. 59 Penny L. Richards and Susan Burch, ‘Documents, Ethics, and the Disability Historian’, in The Oxford Handbook of Disability History, ed. Michael Rembis, Catherine Kudlick and Kim E. Nielsen (Oxford: Oxford University Press, 2018). 60 Mieneke te Hennepe, ‘Private Portraits or Suffering on Stage: Curating Clinical Photographic Collections in the Museum Context’, Science Museum Group Journal 5 (2016): 1–23, 2. 61 Ibid. 62 Elizabeth Edwards and Sigrid Lien, Uncertain Images: Museums and the Work of Photographs (Farnham: Ashgate Publishing, 2014).
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63 María Puig de la Bellacasa, Matters of Care: Speculative Ethics in More than Human Worlds (Minneapolis: University of Minnesota Press, 2017), 4. 64 Suzannah Biernoff, ‘Medical Archives and Digital Culture’, Photographies 5, no. 2 (2012): 179–202. 65 Douglas C McMurtrie, The Evolution of National Systems of Vocational Reeducation for Disabled Soldiers and Sailors (Washington: Government Printing Office, 1918), 109. 66 Patricia Skinner and Emily Cock, Approaching Facial Difference: Past and Present (London: Bloomsbury Academic, 2018). 67 Edwards and Lien, Uncertain Images; Elizabeth Edwards and Christopher Morton, Photographs, Museums, Collections: Between Art and Information (London: Bloomsbury Academic, 2015); Laura Peers and Alison K. Brown, Museums and Source Communities: A Routledge Reader (London: Routledge, 2003). 68 Faye Ginsburg, ‘Archival Exposure: Disability, Documentary, and the Making of Counternarratives’, in Documenting the World: Film, Photography, and the Scientific Record, eds. Gregg Mitman and Kelley Wilder (Chicago and London: University of Chicago Press, 2016), 150–65.
Chapter 1 Catherine Black, King’s Nurse-Beggar’s Nurse: An Autobiography (London: Hurst and Blackett, 1939), 88. The anecdote is repeated with slight variation in Reginald Pound, Gillies, Surgeon Extraordinary (London: Michael Joseph, 1964), 35. Also see Harold Gillies and Ralph Millard, The Principles and Art of Plastic Surgery (London: Butterworth, 1957), 9. 2 Ward Muir, The Happy Hospital (London: Simpkin, Marshall, Hamilton, Kent and Co, Ltd, 1918), 143. 3 Percy Clare, Private letters (to his mother), Imperial War Museum, London, 06/48/1 [page number omitted]. 4 Alfred Keogh, ‘Introductory: Surgical Organisation in War’, The British Journal of Surgery 4, no. 3 (1916): 8. 5 Ibid., 1. 6 James Dundas-Grant, ‘Facial Plastic Surgery, Laryngology, and Stomatology, in French Military Hospitals. Impressions de Voyage’, The Lancet (1915): 926–7. 7 ‘The Queen’s Hospital, Frognal, Sidcup’, The Lancet (3 November 1917): 689. 8 J. H. Badcock, ‘Section of Odontology, President’s Address’, Proceedings of the Royal Society of Medicine 11, no. 3 (1918): 4. 9 Liz Orton, Becoming Image: Medicine and the Algorithmic Gaze (London: Digital Insights, 2018), 5. 10 Gillies and Millard, Principles and Art of Plastic Surgery, 44–5. 1
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11 Andreas-Holger Maehle and Johanna Geyer-Kordesch, Historical and Philosophical Perspectives on Biomedical Ethics: From Paternalism to Autonomy? (London: Routledge, 2002), 1. 12 Helen Bettinson, ‘“Lost Souls in the House of Restoration”?: British Ex-servicemen and War Disability Pensions, 1914–1930’, PhD Thesis, University of East Anglia, 2002, 159. 13 Third Annual Report of the Ministry of Pensions (1920–21), 23, 35. 14 Cohen, The War Come Home, 24. 15 J. H. Badcock, ‘Section on Odontology. President’s Address’, Proceedings of the Royal Society of Medicine 11, no. 3 (1918): 2. 16 James Frank Colyer, ‘The Treatment of Gunshot Injuries of the Jaws’, Journal of the Royal Army Medical Corps 26 (1916): 597–635. 17 James Frank Colyer, ‘Section on Odontology. Discussion on War Injuries of the Jaw and Face’, Proceedings of the Royal Society of Medicine 9, no. 3 (1916): 87. 18 Frognal House was purchased by the Prince of Wales’ Fund for £16,000. The arrangements had been entirely in the hands of the Hospital Committee, which had collected £60,000 to start up its activities. However, much more money was required in order to purchase and maintain its facilities, equipment and photographic services and the Red Cross Joint War Committee provided additional funds, which ultimately reached £100,000. See Reports by the Joint War Committee and the Joint War Finance Committee of the British Red Cross Society and the Order of St. John of Jerusalem in England on Voluntary Aid Rendered to the Sick and Wounded at Home and Abroad and to British Prisoners of War, 1914–1919 (London: His Majesty’s Stationery Office, 1921), 261. 19 Whereas the first ward huts to be build in 1917 cost on average £1200 to accommodate twenty-six beds, the last wards to be built in 1918 of the same dimensions cost £1800. In addition, the majority of the patients were living on tube feeds or upon a diet of fresh milk and eggs, at a period when both these foods were scarce and very costly. See Reports by the Joint War Committee, 261. 20 Delaporte, Les Gueules Cassées. 21 Included in the Pont collection are six boxes containing around ninety glass plates from which his surgical photographs were printed. These glass quarter-plates measure 90 × 120 mm and are linked to the simplified process offered by the marketing of lightweight and easily transportable hand cameras. The Archive of the Bibliothèque Interuniversitaire de Santé, Paris. 22 Geoffrey Batchen, Negative/Positive: A History of Photography (London: Routledge, 2020), 3. 23 Luke Smythe, ‘Toward a “Wetter” Photographic Ethos: Liquid Abstract Photographs and the Hubris of Technology’, in State of Flux: Aesthetics of Fluid Materials, eds. Marcel Finke and Friedrich Weltzien (Berlin: Reimer, 2017), 75. 24 Julie Mazaleigue-Labaste, ‘Between Care and Innovation. Albéric Pont and the Gueules Cassées: Medical and Surgical Innovations, or Not’, Journal of War and Culture Studies 10, no. 1 (2017): 25–42.
182 25 26 27 28 29
30 31
32 33
34
35 36 37 38 39 40
Notes Ibid., 29. Ibid., 39. Pichel, ‘Les Gueules Cassées. Photography and the Making of Disfigurement’, 88. J. L. Payne, ‘Section of Odontology. Discussion on War Injuries of the Jaw and Face’, Proceedings of the Royal Society of Medicine 9, no. 3 (1916): 63–120. Dubravka Cecez-Kecmanovic., Robert D. Galliers, Ola Henfridsson, Sue Newell and Richard Vidgen, ‘The Sociomateriality of Information Systems: Current Status, Future Directions’, MIS Quarterly X, no. X (2014–15): 11. Percival Cole, ‘Plastic Repair in War Injuries of the Jaw and Face’, The Lancet (1917): 417. The British Medical Directories for England, Scotland and Wales (London: The Offices of The Lancet and British Medical Directory, 1853–present). Royal Microscopical Society Archives, University Museum of the History of Science, Oxford. 1891 England Census. In 1892, Norman took a conjoint qualification and became Licentiate of the Royal College of Physicians of Edinburgh, Licentiate of the Royal College of Surgeons of Edinburgh, Licentiate of the Royal Faculty of Physicians and Surgeons in Glasgow and Licentiate of Medicine from Guy’s and Dublin. The British Medical Directories for England, Scotland and Wales (1853–present). The Royal Microscopical Society Archives, University Museum of the History of Science, Oxford. Norman lived in Earls Court with his wife Julia, assisted by two domestic servants. For many years before he lived in West Brompton, he may have been a general practitioner. In the 1901 census, Norman described himself as a ‘retired surgeon’ and in 1911, as ‘surgeon (not practicing), private means’. His father, James, died in 1899 leaving more than £72,000, and although Albert had living siblings, an inheritance from his father may have facilitated his early retirement from medicine. Albert and Julia did not have children, but as head of the house and living by private means, he was in a position to support his younger wife and employ a cook and parlour-maid. 1901 and 1911 England Census Records. ‘Notices. Meetings’, The Photographic Journal 42, no. 11 (1902): 242. Albert Norman, ‘Photomicrography in Black and White and in Colours’, The Photographic Journal 43, no. 3 (1903): 73. ‘Anniversary Meeting’, Journal of the Royal Microscopical Society 20 (1903): 121–2. ‘International Exhibition, St Louis, 1904’, The Photographic Journal 42, no. 9 (1904): 262. Albert Norman, ‘Practical Demonstration: Making Lantern Slides by the Sanger Shepherd Process’, The Photographic Journal 46, no. 6 (1906): 212–15. ‘New Lecture in Circulation’, The Photographic Journal 47, no. 11 (1907): 18.
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41 E. Heron-Allen, ‘Presidential Address, 1917–18. The Royal Microscopical Society during the Great War’, Journal of the Royal Microscopical Society 38, no. 2 (1918): 153–67. 42 Advertisement for ‘Thornton-Pickard Cameras’, Amateur Photographer and Photography (1918): vi. 43 Advertisement for ‘Thornton-Pickard Cameras’, Amateur Photographer and Photographic News (1915): vi. 44 In 1901, aged 17, Walbridge’s occupation is listed as a photographer and he was residing with his parents and siblings at 4 Latimer Street, Southampton. 1901 England Census. In 1911, he was listed as a photographer’s assistant living at 152 Grosvenor Street, Southampton, with his wife of three years Edith Howes. 1911 England Census. Walbridge is listed in the Southampton electoral roll along with his wife until 1924, but during the war he was living in Gipsy Hill in South London and continued to work as personal photographer to Harold Gillies at Sidcup into the mid 1920s. After the war, Walbridge settled in Gipsy Hill and established his own photographic studio as sole proprietor of a small business at the heart of the local community, until his retirement in the 1940s. Walbridge appears regularly in the local newspaper The Norwood News from 1922 to the 1940s and he became a prominent figure in the local community as the official photographer at College Studio, 37 Gipsy Hill, Upper Norwood, photographing weddings, council and church ceremonies, and official Royal visits. Walbridge was a member of the Rotary Club and a distinguished member of the community. In August 1941, he was asked to give a talk on his life as a photographer. One reporter writing in The News on 15 August 1941 recounted the experiences of this ‘well-known photographer’ during his career. Among his adventures photographing royalty, generals and famous regiments during the early years of the Great War, Walbridge also mentioned his specialist work when ‘he served as personal photographer to Capt. Gillies’. See ‘Adventures with a Camera. Mr. Sydney Walbridge Recounts Some of His Thrills’, The News, August 1941, 4. Walbridge died in Camberwell, in 1954, aged 70. 45 Bamji, Faces from the Front: Harold Gillies, the Queen’s Hospital, Sidcup and the Origins of Modern Plastic Surgery, 123. 46 Harold Gillies recognized that photographing in the studio should be the rule. Gillies’ seminal roll in standardizing photography was recognized by his election to Fellowship of the Royal Photographic Society in 1952. 47 As time passed Walbridge’s working practice became more systematic and ultimately standardized. A number of photographs in the Gillies collection show the headrest against which the patient was positioned, which allowed for precise focusing and lengthy exposure times to record subtleties in mid-tone skin details. Walbridge recorded each stage of a patient’s surgery, often from three or even five angles; full face, side and oblique views were the most common.
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48 Albert Roberts’ photography is now housed at the IWM, titled, ‘the work of Major Harold Gillies in the field of plastic surgery during the First World War’, with the credits: creator: Albert Roberts (private), photographic assistant, Queen’s Hospital, facilitator. Roberts, born in Liverpool in 1894, left school at the age of fourteen, when he became a solicitor’s clerk in the family’s hometown of Nelson, Lancashire. In 1915, he joined the Royal Welch Fusiliers. On 13 November 1916, he was wounded and captured at the Somme. Roberts spent the next two years in a German prisoner of war camp, before being repatriated to the KGH in Stanford Street and eventually referred to Sidcup in 1918. After he was discharged, Roberts returned to his family and his pre-war employer in Nelson, where he continued as a clerk before later becoming an estate agent. In 1924, he married Nellie Woodhouse and had one child, Derek. During the Second World War he joined the Home Guard; however, tragedy struck and Nellie died in 1941. In 1943 he married again, to Maude Robinson, and at the age of fifty he had a daughter, Barbara, in 1944. Despite his facial disfigurement, Roberts was never reclusive or aggressive, although, Barbara recalls that he did sometimes show signs of unfounded jealousy of his second wife. In the 1950s, he completed a correspondence course to become a certified accountant and took a post at Castle Castings in Clitheroe, where he worked until he was eighty. After his retirement, Albert and Maude moved to British Legion Sheltered Accommodation in Wythenshawe, Manchester, where they lived happily until he passed away at the age of ninety-one, in 1986. In 2012, Barbara Prater, Albert’s daughter, donated her father’s photographs to the IWM ‘to be kept safe’. IWM catalogue number HU 110781; and ‘Albert Roberts (private)’, catalogue number 2012-10-13. 49 Percival Cole and Charles Bubb, ‘Bone Grafting in Ununited Fractures of the Mandible: With Special Reference to the Pedicled Graft’, The British Medical Journal (1919): 69. 50 Ibid., 69. 51 Ibid. 52 Ibid. 53 John Galsworthy, ‘The Gist of the Matter’, Reveille (1918): 13. 54 Percival Cole, ‘Ununited Fractures of the Mandible: Their Incidence, Causation, and Treatment’, The British Journal of Surgery 6, no. 21 (1918): 57. 55 Cole and Bubb, ‘Bone Grafting in Ununited Fractures of the Mandible’, 69. 56 On 11 March 1918, Bubb and Cole each presented papers on ununited fractures of the mandible at a meeting of the Section of Odontology. In the discussion that followed, two senior members openly criticized the speakers’ methods of treatment, Odontological Section, Minutes of Council of the Royal Society of Medicine, (1914–20): 240–2. In their defence, Bubb and Cole presented a further joint paper on their revisions eight months later, on 25 November 1918. A lantern demonstration showed twenty-three patients with ununited jaw fractures, from the 1,300 admissions they had treated. Cole and Bubb stipulated that the greater
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57 58 59 60 61 62 63
64 65 66 67 68
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number of these cases had been healed by bone graft. See ‘Odontological Section’, Minutes of Council, 262–4. The speakers published the paper read at this meeting on 18 January 1919, see Cole and Bubb, ‘Bone Grafting in Ununited Fractures of the Mandible’, 67–70. W. B. Paterson, ‘Section on Odontology. Presidential Address’, Proceedings of the Royal Society of Medicine 10 (1918): 5. Ibid., 6. ‘Medicine and the Law’, The Lancet (1919): 171. ‘A Judge on Professional Secrecy’, The Lancet (1915): 28–9. Percival Cole, ‘Treatment of Wounds Involving the Mucous Membrane of the Mouth and Nose’, The Lancet (1918): 12. Frank Colyer, ‘The Treatment of Gunshot Injuries of the Jaws’, 612. In 1916, the General Medical Council passed a resolution with regard to professional ethics, supplementing certain resolutions adopted in 1912. The new resolution set out instruction directly in response to the situation created by the war. See, in this regard, ‘Instruction in Medical Ethics’, The Lancet (1916): 438. Maehle and Geyer-Kordesch, Historical and Philosophical Perspectives on Biomedical Ethics. Ibid., 1. Pichel, ‘Les Gueules Cassées. Photography and the Making of Disfigurement’, 88. Silverman, ‘Water in the Camera’, 69. See R. Cunyngham-Brown, ‘In Parliament’, War Pensions Gazette 38 (1920): 519.
Chapter 2 1
2 3 4
Harry Baldwin noted that French and American surgeons also presented their findings at this meeting, and brought along valuable clinical material such as photographs and albums, skiagrams (X-rays), models and dental splints from France, to demonstrate the benefits of the dental appliances being discussed and contribute to the group’s knowledge of the subject. Drs Hayes and Hotz came over from Paris to present at this meeting in person, Dr Roy sent a remarkable collection of photographs, and Dr Pont contributed an album of photographs of cases ‘before and after’ treatment and accompanied with a typewritten illustrated typescript on the methods employed. See Baldwin, ‘Section on Odontology. Discussion on War Injuries of the Jaw and Face’, 64–5. Baldwin, ‘Section on Odontology’. Ibid., 64. Harriet Palfreyman and Christelle Rabier, ‘Visualising Surgery: Surgeons’ Use of Images, 1600–present’, in The Palgrave Handbook to the History of Surgery, ed. Thomas Schlich (London: Palgrave McMillan, 2017), 290.
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5 Biernoff, Portraits of Violence; Pichel, ‘Les Gueules Cassées, 82–99; Jason Bate, ‘Bonds of Kinship and Care: RAMC Photographic Albums and the Making of “Other” Domestic Lives’, Social History of Medicine 33, no. 3 (2020): 772–97. 6 Daniel M. Fox and Christopher Lawrence, Photographing Medicine: Images and Power in Britain and America Since 1840 (London and New York: Greenwood Press, 1988), 53. 7 This chapter borrows from the work of Nicoletta Leonardi and Simone Natale, who write from a cross-disciplinary perspective and have as their main object of inquiry the complex relationship between photography and other media practices. See Leonardi and Natale, Photography and Other Media in the Nineteenth-Century. 8 Finance and General Purposes Committee Minutes of the Royal Society of Medicine, 4 (1920–23): 92–3. RSM/CM/9/4. 9 Bettinson, “‘Lost Souls in the House of Restoration”?, 178–9, 267. 10 T. J. Mitchell and G. M. Smith, Medical Services: Casualties and Medical Statistics of the Great War (London: H.M. Stationary Office, 1931), 309. 11 For a recent study, see Gowan Dawson, Bernard Lightman, Sally Shuttleworth and Jonathan R. Topham, Science Periodicals in Nineteenth-Century Britain: Constructing Scientific Communities (Chicago and London: Chicago University Press, 2020). 12 The production of this form of media had multiple actors working towards an abridged article for its wider readership. The meetings were transcribed at the society; they did not include everything that was spoken during each presentation or group discussion, nor in exactly the way it was delivered. Pauses and nonverbal utterances were removed during copyediting, and grammar was corrected, although complex technical statements were not always paraphrased for clarity. It is easy to view them as written primarily for the most informed of readers. Each speaker was invited to submit a revised copy of his paper to the editorial committee for further editing and proofreading prior to publication. The extended discussions that followed speakers’ papers were often lively debates and each participant would not have had time to write down their individual comments while these exchanges were going on, or to record everything that was said. A transcriptionist was present in the meetings and went through the process of listening and typing exactly what was heard. 13 Mitchell and Smith, Medical Services, 310. 14 Director General of Medical Services to Regional Directors (All Regions), 23 June 1921. National Archive, PIN 15/54. 15 David Cahan, ‘Institutions and Communities’, in From Natural Philosophy to the Sciences: Writing the History of Nineteenth-Century Science, ed. David Cahan (Chicago: University of Chicago Press, 2003), 291.
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16 ‘The Society During the War’, The Royal Society of Medicine Official Bulletin General Meeting of Fellows 29 (1918): 13. 17 The epidiascopes, microscopes and other scientific apparatus owned by the RSM were all ‘kept in good repair and such repairs as have been required from time to time have been made good by the Insurance Company’, Finance and General Purposes Committee Minutes of the Royal Society of Medicine 3 (1916–20): 69. Accession/class mark H27. From the library of the Royal Society of Medicine, ref RSM/CM/9/3, Shelf B3 Box 2015/91. 18 George Northcroft, ‘Section of Odontology. A Short Account of a Year’s Work at One of the Jaw Injuries Centres of the London Command’, Proceedings of the Royal Society of Medicine 11, no. 3 (1917): 7. 19 Silverman, The Miracle of Analogy or The History of Photography, Part 1, 69. 20 Lewis Wright, Optical Projection: A Treatise on the Use of the Lantern in Exhibition and Scientific Exhibition (London: Longmans, Green and Co, 1891), 42. 21 Wright, Optical Projection, 39. 22 Ibid., 40. 23 Carolyn Marvin, When Old Technologies Were New: Thinking about Electric Communication in the Late Nineteenth Century (New York and Oxford: Oxford University Press, 1988). 24 Payne, ‘Section of Odontology. Discussion on War Injuries of the Jaw and Face’, 68. 25 Ibid., 74. 26 The discussion that followed was so lively that the meeting had to be adjourned until 6 March 1916, so that the British members and fellows could continue the debate and foster collaboration. See Percival Cole, ‘Odontological Section. Adjourned Discussion on War Injuries of the Jaw and Face’, Proceedings of the Royal Society of Medicine 9, no. 3 (1916): 108–13. 27 To deliver a successful performance, it was not enough for the speaker to project a set of slides onto the screen, to let them be seen one by one by those in the room and simply announcing each slide. The success of the projections lay in the surgeon’s skill of presenting the slide, to well-coordinate his ideas with the projected images, as well as to work in synchrony with the lanternist to change each slide when required, to allow the members and fellows to see and hear properly without technical interference. 28 Palfreyman and Rabier, ‘Visualising Surgery’, 294. 29 Simone Natale, ‘A Mirror with Wings: Photography and the New Era of Communication’, in Photography and Other Media in the Nineteenth-Century, eds. Nicoletta Leonardi and Simone Natale (Pennsylvania: The Pennsylvania State University Press, 2018), 36. 30 Annelise Riles, Documents: Artifacts of Modern Knowledge (Ann Arbor: University of Michigan Press, 2006), 7.
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31 When Payne’s article with the photographs finally appeared in the Proceedings, the reproduction of a photographic slide was essential to the judgement of the scientific evidence presented, as long as the readers could attribute the photograph as being from the section meeting. Payne, ‘Section of Odontology’, 106–8, 116–18. 32 Baldwin, ‘Section on Odontology’, 64. 33 Aymard addressed his failures over a twelve-month period at Sidcup. Whilst flaps and methods for reproducing the complete nose had in the past been fully written up in most surgical textbooks, the causes for failure were hardly ever dealt with, and details of the work was deficient. J. L. Aymard, ‘Nasal Reconstruction. With a Note on Nature’s Plastic Surgery’, The Lancet (1917): 888, 891. 34 Ibid., 891. 35 Cole was invited to take part in this discussion by the RSM. After this paper was read before the society on 3 December 1917 the article was subsequently published in The Lancet on 5 January 1918. See Cole, ‘Treatment of Wounds Involving the Mucous Membrane of the Mouth and Nose’, 11–15. 36 Orton, Becoming Image, 6. 37 See Paul N. Hasluck, Optical Lanterns and Accessories: How to Make and Manage Them (London: Cassell and Company Ltd, 1901), 133–5. 38 Percival, ‘Treatment of Wounds Involving the Mucous Membrane of the Mouth and Nose’, 11. 39 Ibid., 12. 40 Dr Albert Norman, as photographer and album maker, assembled the two albums shortly after the King George V Military Hospital closed in May 1919. The albums were used as reference sources for training medical officers of the Royal Army Dental Corps for several years before being donated to the Wellcome Library in the 1980s. RAMC Muniment Collection, Wellcome Library, London, RAMC 760. 41 In particular, this continuous working relationship between the artistically drawn and the photographically inscribed shows the way in which photography and sketching were starting points for the inscription of detail that could later move between technologies in their reproduction, display and dissemination. For a further discussion of how photographs could be enhanced for scientific purposes, such as traced over to create an intermediate object between direct photographic recording in the field and its translation into published illustration, see Chris Morton, ‘The Graphicalization of Description: Drawing and Photography in the Fieldwork Journals and Museum Work of Henry Belfour’, Anthropology and Photography 10 (2018): 1–25. For a discussion on scientific photography specifically in relation to the complex mixtures of visual and material media and intermedial visual practices, see Sara Hillnhuetter, Stefanie Klamm and Friedrich Tietjen, Hybrid Photography: Intermedial Practices in Science and Humanities (London: Routledge, 2021).
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42 Lisa Gitelman, ‘Popular Kinematics: Technical Knowing in the Age of Machines’, History & Theory 58 (2020): 75. 43 See James Donelan, ‘President’s Address. British Laryngology and Rhinology’, Proceedings of the Royal Society of Medicine Section of Laryngology 12 (1919): 1–7. 44 This article was reproduced from the meetings of the Section held on 7 February and 7 March 1919: G. S. Hett, ‘Cases, Casts, Photographs, and Diagrams, Illustrating Some Methods of Repair of Wounds of the Nasal Cavities and Nasal Accessory Sinuses (Part I)’, Proceedings of the Royal Society of Medicine, Section of Laryngology 12 (1919): 115–35. 45 In the Gillies collection in the archive of the BAPRAS at the RCS, they hold five boxes of 700 photographic lantern slides which were originally made by Sydney Walbridge at Sidcup and used by surgeons for teaching purposes. See Gillies collection, BAPRAS/G/31/Boxes 1–5. 46 For a discussion of the chain of translation between the production and reproduction of an image within a print medium and the formation of a claim to the visual authenticity of a scientific experiment within the illustrated scientific press, see Geoffrey Belknap, From a Photograph: Authenticity, Science and the Periodical Press, 1870–1890 (London: Bloomsbury Academic, 2016), 10; and Kelley Wilder, ‘Not One but Many: Photographic Trajectories and the Making of History’, History of Photography 41, no. 4 (2017): 386. 47 Belknap, From a Photograph. 48 The production of photographic authenticity within the Proceedings rested on a combination of both what photographic practice in the ward could be defined by and how this operated in both textual and social spaces; see Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception (New York: Vintage Books, 1973), 95; Bruno Latour, Pandora’s Hope: Essays on the Reality of Science Studies (Cambridge, MA: Harvard University Press, 1999), 24–79; Gerry Beegan, The Mass Image: A Social History of Photomechanical Reproduction in Victorian London (Basingstoke: Palgrave Macmillan, 2008), 12. 49 For a recent discussion on reproduction and how closely photographic processes were bound up with other printing techniques, see Michelle Henning, Photography: The Unfettered Image (London: Routledge, 2018). 50 Edwards and Lien, Uncertain Images, 3. 51 Ibid., 308–9. 52 Ibid. More information on these facilities can be found in the Ministry of Pensions’ annual reports. 53 ‘Treatment of Disabled Soldiers: Work of the Ministry of Pensions’, The Lancet (16 April 1921): 827; James Hogge and T. H. Garside, War Pensions Allowances (London: Hodder and Stoughton, 1918), 301.
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54 G. S. Hett, ‘Methods of Repair of Wounds of the Nose and Nasal Accessory Sinuses (Part II)’, Proceedings of the Royal Society of Medicine, Section of Laryngology 12 (1919): 136. 55 Hett, ‘Cases, Casts, Photographs, and Diagrams’, 133. 56 Ibid. 57 Ibid. 58 See Finance and General Purposes (1916–20), 209. 59 This note regarding the cost of the illustration of Hett’s cases of rhinoplasty was typed at the bottom of the page, under the heading ‘Illustrations for “Proceedings”’, and signed off by James Donelan, ‘A Meeting of the Council of the Section of Laryngology on 14 February 1919’, Minutes of Council of the Royal Society of Medicine: 242. 60 See Finance and General Purposes (1916–20), 47–53. For a discussion on the relationship between the process plants and military authorities during the war, see William Gamble, ‘Photo-process Work in the War’, in The Photographic Industry of Great Britain, eds. William Gamble and George R. Sims (London: The British Photographic Manufacturers Association, 1920), 63–7. 61 Finance and General Purposes (1916–20), 209. 62 G. S. Hett, ‘Epidiascopic Demonstration’, in ‘Discussion on Injuries and Inflammatory Diseases Affecting the Orbit and Accessory Sinuses’, in Proceedings of the Royal Society of Medicine, Sections of Ophthalmology and Laryngology 12, (1919): xi–xxviii. 63 Wilder, ‘Not One but Many’, 393–4. 64 Edwards and Lien, Uncertain Images, 4. 65 Northcroft, ‘Section of Odontology. A Short Account of a Year’s Work at One of the Jaw Injuries Centres of the London Command’, 8. 66 Finance and General Purposes Committee Minutes of the Royal Society of Medicine 4 (1920–23), 90. RSM/CM/9/4. 67 Finance and General Purposes Committee (1920–23), 92–3. 68 Departmental Committee of Inquiry into the Machinery of Administration of the Ministry of Pensions Report to Ian Macpherson, MP, Minister of Pensions (1921): 6. 69 For more information on the complicated process of decentralization see nineteenth Annual Report of the Ministry of Pensions, 1935–1936, Part 2: 3–4. 70 Bettinson, ‘“Lost Souls in the House of Restoration”?’ 210.
Chapter 3 1
‘After Two Years of War. The Present Position of Photography’, Amateur Photographer and Photographic News, Empire Number (1916): 63.
Notes 2
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These portable light folding hand cameras came complete with glass plates measuring 45 × 60mm, and initially selling in Britain at around £1 10s. See ‘The 1912 Vest-Pocket “Vesta”’, Amateur Photographer and Photographic News (1912): 88; ‘The “Baby” Sibyl’, Amateur Photographer and Photography (1918); Advertisement for ‘The Newman and Guardia “Sibyl” Camera’, Amateur Photographer and Photography 46, no. 1545 (1918): iv. 3 ‘Pictorial History’, Boots Photographic Section (Advertisement), Amateur Photographer and Photography 46, no. 1545 (1918): 2. 4 ‘After Two Years of War’, 63. 5 Advertisement for ‘Houghtons Ltd’, Amateur Photographer and Photographic News (1918): 9. 6 Keene’s album includes fifty-four before and after photographs of twenty-five patients and twenty-five group and portrait shots of patients and staff. It would seem that the photographs have been reattached in recent years. Rather than adhering or repairing the images as a conservator might, a member of Keene’s family has applied household tape to the image surface in an effort to hold the prints in place, an action which furthers the patient’s restoration. These rudimentary attempts at remedial care seem to align with the original motives, intimating a reparative process of care. These photographs measure 125 × 178mm and were not contact printed but printed through an enlarging lantern. For instance, at the edges of most of the photographs are white squares of unexposed paper, indicating masking created by sticking small strips of tape to the surface of the printing paper to hold it flat against a wall or at the back of an enlarging lantern to receive the projected light during exposure. The album is housed in the archive of the British Association of Plastic, Reconstructive and Aesthetic Surgeons, Royal College of Surgeons of England, London. BAPRAS/G/26. 7 Patrizia Di Bello, Women’s Albums and Photography in Victorian England: Ladies, Mothers and Flirts (Aldershot: Ashgate, 2007), 22. 8 McMurtrie, The Evolution of National Systems of Vocational Reeducation for Disabled Soldiers and Sailors, 109. 9 Diary of Emerin Keene, 214. Chute Family Collection. 10 Ibid. 11 Smythe, ‘Toward a “Wetter” Photographic Ethos: Liquid Abstract Photographs and the Hubris of Technology’, 81. 12 Diary of Emerin Keene, 214. Chute Family Collection. 13 Ibid., 212. 14 Lina Andreotti, Impressioni. Guerra d’Italia: 1915–1918 (Parma: Officina grafica Fresching and Company, 1917), 62. 15 Diary of Emerin Keene, 210. Chute Family Collection. 16 Ibid., 215.
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17 ‘Photographic Chemicals. A New British Industry’, Amateur Photographer and Photography (1919): vii. See also David E. H. Edgerton, ‘Industrial Research in the British Photographic Industry, 1879–1939’, in The Challenge of New Technology: Innovation in British Business Since 1850, ed. Jonathan Liebenau (Aldershot: Gower Publishing, 1988), 113. 18 The British firms formed a trade association in 1916, and this body was instrumental in pushing for the establishment of a research association under the Department of Scientific and Industrial Research’s new scheme. The British Photographic Research Association was the first of the many research associations to be created, coming into existence in May 1918. In exchange for opening up the military market to British photographic manufacturers, these firms received military contracts in conjunction with large scientific initiatives and government investment in projects to meet the supply requirements of all photographic sections of the forces. Companies such as Butcher and Son, Ilford, Illingworth and Co, the Imperial Dry Plate Company, Marion and Co, Paget, Thornton-Pickard and Wellington and Ward carried out in their laboratories research in photography, photo-chemistry and other related subjects, with a view to the general increase of knowledge and home production in these subjects, improving the methods of manufacturing materials and discovering new processes. The British Photographic Research Association’s laboratory was in close touch with the factories and laboratories of its members to streamline the modern scientific processes and immediately apply the improvements and developments of the industry. The military contracts meant that the position of these firms shifted from having to convince the British government they were patriotic during the Great War to being integral to the government’s effort to consolidate Britain’s postwar photographic status. While effective corporate organization and management combined with competitive innovation were essential to success to the industry, without supportive government policies during the war years, companies in Britain may not have survived. 19 Storr, ‘Photographic Materials and Processes’, 353. 20 Ibid. 21 Edgerton, ‘Industrial Research in the British Photographic Industry, 1879–1939’, 108. 22 The British Farmers’ Red Cross Fund allotted over £4,000 to equip the hospital’s suite of six operating theatres, its costly X-ray installation and to furnish its large dayrooms, and the Commercial Travellers’ Association of Canada cabled £1030. Frederick Treves, The King George Hospital: A Short Pamphlet History (London: Abbey Press, 1915), 26–8. 23 George R. Sims, ‘British Photography in the Great War’, in The Photographic Industry of Great Britain, eds. William Gamble and George R. Sims (London: British Photographic Manufacturers Association, 1920), 20.
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24 Sims, ‘British Photography in the Great War’, 13. 25 F. J. Mortimer, ‘What Societies Can Do to Help in War Time’, Amateur Photographer and Photographic News (1915): 167. 26 Ibid., 168. 27 Ibid. 28 Ibid. 29 Minutes Book, Croydon Camera Club Archive, page number unknown. 30 Mortimer, ‘What Societies Can Do to Help in War Time’, 167. 31 Minutes Book, Croydon Camera Club Archive, page number unknown. 32 Ibid. 33 Sims, ‘British Photography in the Great War’, 14. 34 ‘The Empire’s Opportunity in the Photographic World’, Amateur Photographer and Photographic News, Empire Number (1916): 223. 35 ‘The Empire’s Opportunity in the Photographic World’, 223. 36 Storr, ‘Photographic Materials and Processes’. 37 William J. Pope, ‘The Future of Pure and Applied Chemistry’, Journal of the Chemical Society 113 (1918): 289–300; W. H. Mills and William J. Pope. ‘Studies on Photographic Sensitisers, Part 1’, The Photographic Journal 60 (1920): 183. 38 Sims, ‘British Photography in the Great War’, 14. 39 Ibid., 12. 40 Edgerton, ‘Industrial Research in the British Photographic Industry, 1879–1939’, 113. 41 William J. Pope, ‘Chemistry in the National Service’, Journal of the Chemical Society 115 (1919): 407. 42 ‘The Times Nearing the Eighth Million’, The Times, 15 November 1917: 11. 43 Biernoff, ‘Shame, Disgust and the Historiography of War’, 217. 44 Suzannah Biernoff, ‘The Rhetoric of Disfigurement in First World War Britain’, Social History of Medicine 24, no. 3 (2011): 666. 45 ‘Men Shattered in the War’, Evening Standard, June 1918, 50. London Metropolitan Archives, H02/QM/Y/01/05. 46 ‘Men Shattered in the War’, Evening Standard, June 1918, 50. London Metropolitan Archives, H02/QM/Y/01/05. 47 ‘Public Can Help. Fund for Queen’s Hospital Mounting Up’, Evening Standard, date and page number omitted. London Metropolitan Archives, H02/QM/Y/01/05. 48 Gehrhardt, The Men with Broken Faces, 114. 49 ‘A Fund to Fight Depression and Fill Monotonous Days’, Evening Standard, June 1918, page number omitted. London Metropolitan Archives, H02/QM/Y/01/05. 50 ‘The Men behind the Veil’, The African World, 16 July 1921, 428. London Metropolitan Archives, H02/QM/Y/01/05. 51 ‘Three Albums of Distinction’, Amateur Photographer and Photography (1916): 505.
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52 ‘Albums Again?’, The British Journal of Photography (12 October 1917): 213–14. 53 See ‘Peace Photographs’, Amateur Photographer and Photography 46, no. 1545 (1918): 21. 54 Dawson, Lightman, Shuttleworth and Topham, Science Periodicals in NineteenthCentury Britain.
Chapter 4 ‘Disabled Soldiers’, The British Journal of Photography (4 August 1916): 425–6. Jessica Meyer, Men of War: Masculinity and the First World War in Britain (Basingstoke: Palgrave Macmillan, 2009). 3 Bourke, Dismembering the Male. 4 The distinction between the amateur, domestic and the family ‘snapshot’ photographer was not well defined even by the early 1900s. There remained issues over amateur users being attracted to photography as a hobby and the average user who only took out their cameras on special occasions which occasionally clouded the issue for a few. For an analysis of the parallel growth of amateur photographers and British photographic industry in the late nineteenth and early twentieth centuries, see Michael Pritchard, ‘The Development and Growth of British Manufacturing and Retailing 1839–1914’, unpublished PhD dissertation, De Montfort University 2010; and Michael Pritchard, ‘Who Were the Amateur Photographers?’ in Either/And, ed. Annebella Pollen and Juliet Baillie (Bradford: National Media Museum, 2013). Accessed October 17 June 2021. http://eitherand.org/reconsidering-amateur-photography/who-were-amateurphotographers/. 5 Kodak framed the speedy pace of life that characterized the practice of being in the industrial world as a reality that allegedly weakened the human eye and mind’s ability to process the experience of life itself, introducing the idea of the camera and picture-taking as the ultimate cures for this purported human deficiency. See Don Slater, ‘Consuming Kodak’, in Family Snaps: The Meaning of Domestic Photography, ed. Jo Spence and Patricia Holland (London: Virago, 1991), 49–59; and Jennifer Orpana and Sarah Parsons, ‘Seeing Family: Introduction’, Photography and Culture, Special Issue on Seeing Family 10, no. 2 (2017): 95–8. 6 Gillian Rose, Doing Family Photography: The Domestic, the Public and the Politics of Sentiment (Farnham: Ashgate Publishing Group, 2010). 7 Ibid., 3. 8 Bate, ‘Bonds of Kinship and Care’, 772–97. 1 2
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Gabriel Koureas, Memory, Masculinity and National Identity in British Visual Culture, 1914–1930: A Study of ‘‘Unconquerable Manhood’’’ (London: Routledge, 2007), 5. 10 Meyer, Men of War. 11 Martha Langford, Suspended Conversations: The Afterlife of Memory in Photographic Albums (Montreal and Kingston: McGill-Queen’s University Press, 2001), 122. 12 Jessica Meyer, An Equal Burden: The Men of the Royal Army Medical Corps in the First World War (Oxford: Oxford University Press, 2019), 5. 13 For a discussion of dominant approaches and new directions, see Gil Pasternak, ‘Popular Photographic Cultures in Photographic Studies’, in Photography Reframed: New Visions in Contemporary Photographic Culture, ed. Ben Burbridge and Annebella Pollen (London: I.B. Tauris, 2018), 39–61. 14 Gil Pasternak, ‘Taking Snapshots, Living the Picture: The Kodak Company’s Making of Photographic Biography’, Life Writing 12, no. 4 (2015): 431–46. 15 Orpana and Parsons, ‘Seeing Family: Introduction’. 16 Koureas, Memory, Masculinity and National Identity in British Visual Culture, 1914–1930, 7. 17 Bettinson, ‘Lost Souls in the House of Restoration’, 86. 18 The subsequent annual outlay of medical costs was reduced from £15,000,000 to £1,600,000; Nineteenth Annual Report of the MoP, Part Two (1935–36), 37; see also Bettinson, “‘Lost Souls in the House of Restoration”: British Ex- Servicemen and War Disability Pensions, 1914–1930’, 70–7, 91; Meyer, Men of War, 101–2. 19 Expenditure of the Ministry of Pensions, PIN 15/2601, National Archive. 20 Kate Blackmore, The Dark Pocket of Time: War, Medicine and the Australian State, 1914–1935 (Adelaide: Lythrum Press, 2008), 156. 21 Judy Weiser, Phototherapy Techniques: Exploring the Secrets of Personal Snapshots and Family Albums (Vancouver: Phototherapy Centre, 1999). 22 Judith Butler, Frames of War: When Is Life Grievable? (London and New York: Verso, 2010). 23 Cunyngham-Brown, ‘In Parliament’, 520. 24 Ibid. 25 Personal correspondence with Jan Gedye, a granddaughter of Arnold Wayte, email conversation, 18 May 2018. 26 Personal email correspondence with Stephen Dewhurst, a great-grandson of George William Butcher, 2011. 27 Basil Williams, ‘Pensions’, Recalled to Life 1 (1917): 109. 28 Case file of George William Butcher in the Gillies collection, 1920–1, register no. 4434. British Association of Plastic, Reconstructive and Aesthetic Surgeons, from the Archive of the Royal College of Surgeons of England, London. 29 Personal correspondence with Jill Dewhurst, email conversation, 15 January 2021. 9
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30 Jay Winter, ‘Families’, in The Cambridge History of the First World War: Volume 3: Civil Society, ed. Jay Winter (Cambridge: Cambridge University Press, 2006), 46–68, 60–1. 31 ‘Retirements. Mr. G. W. Butcher’, The Clarendonian (1959), page number unknown. 32 Ibid. 33 Mary Russell, email conversation, 14 February 2018. 34 Case file of Sidney Twinn in the Gillies collection, 1922, register no. 4434. British Association of Plastic, Reconstructive and Aesthetic Surgeons, from the Archive of the Royal College of Surgeons of England, London. 35 Mary Russell, email conversation, 14 February 2018. 36 Boyle, ‘An Uglier Duckling than Before’, 316. 37 Gehrhardt, The Men with Broken Faces, 118–20. 38 Mary Russell, email conversation, 22 May 2018. 39 Cohen, The War Come Home, 7–8. 40 Ibid., 8. 41 Mary Russell, telephone conversation, 25 June 2020. 42 Mary Russell, email conversation, 10 January 2020. 43 Michael Roper, ‘Subjectivities in the Aftermath: Children of Disabled Soldiers in Britain after the Great War’, in Psychological Trauma and the Legacies of the First World War, eds. Jason Crouthamel and Peter Leese (Baskingstoke: Palgrave Macmillan, 2016), 167. 44 Mary Russell, email conversation, 10 January 2020. 45 Roper, ‘Subjectivities in the Aftermath’, 168. 46 John Galsworthy, ‘The Gist of the Matter’, Reveille (1918): 1–15. 47 H. Mugford, ‘Direct Vision Finders and a Natural Viewpoint’, The Amateur Photographer and Photography (1 August 1923): page number omitted. 48 Corlett, ‘The Charm of Holiday Portraiture’. 49 May Belben, ‘Interiors with a Box Camera’, Amateur Photographer and Photography (1926): 73. 50 Fred G. Bird, ‘Snapshot Portraits’, Amateur Photographer and Photography (1927): 549. 51 Bird, ‘Snapshot Portraits’, 549. 52 Personal correspondence with David Commerford, a grandson of William Winter, email conversation, 1 March 2018. 53 Personal correspondence with Kym Tobie, a great niece of Hugh Goddard, email conversation, 2011. 54 Hugh Goddard died in 1979, aged ninety-six. It was a peaceful end to a life that seems to have been largely unimpaired by the jaw injury he suffered in 1916. 55 David A. Gerber, ‘Disabled Veterans and the Wounds of War’, in The Oxford Handbook of Disability History, eds. Michael Rembis, Catherine Kudlick and Kim E. Nielsen (Oxford: Oxford University Press, 2018), 492. 56 María Puig de la Bellacasa, Matters of Care, 6.
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57 Personal email correspondence with Jill Dewhurst, a granddaughter of George William Butcher, January 2021. 58 ‘Ministry of Pensions Circulars. New Series. Circular 1025. May 17th 1920-Journeys Home during Treatment’, War Pensions Gazette, 38 (June 1920): 538. 59 ‘Ministry of Pensions Circulars. New Series. Circular 1025. May 17th 1920-Journeys Home during Treatment’, 538. 60 Imperial War Museum online, 8946. Pickard, 1986 Pickard, J. Oral interview, 1986, reel 18, minutes 11–13. 61 Imperial War Museum online, 8946. Pickard, J. Oral interview, 1986, reel 18, minute 13. 62 Ibid. 63 Ibid. 64 Patricia Neville, Andrea Waylen and Aidan Searle, ‘From “Staring” to “Not Staring”: Development of Psychological Growth and Well-Being among Adults with Cleft Lip and Palate’, in Approaching Facial Difference: Past and Present, eds. Patricia Skinner and Emily Cock (London: Bloomsbury Academic, 2018). 65 After attending a medical board examination in 1921, Pickard was discharged from the army, received electrical and massage treatment between 1921 and 1922, attended a course as a watchmaker at Birtley instructional factory between 1922 and 1923, and enjoyed a successful career as a watchmaker in Alnick until retirement in 1959. Imperial War Museum online, 8946. Pickard, 1986 Pickard, J. Oral interview, 1986, reel 18, minute 14. 66 Gerber, ‘Disabled Veterans and the Wounds of War’, 492. 67 Leeds University Library Special Collections, LAVC/SRE/A331R. Sound Recording of Hart, 1974, tape 2, minute 45–6. 68 Gerald DeGroot, Blighty: British Society in the Era of the Great War (New York: Longman, 1996), 260. 69 Deborah Cohen, The War Come Home: Disabled Veterans in Britain and Germany, 1914–1939 (Berkeley: University of California Press 2001).
Chapter 5 1 ‘A Museum of War Wounds’, The Lancet 200, no. 5163 (1922): 405. 2 Ibid., 405. 3 Ibid. 4 Edwards and Lien, ‘Introduction: Museums and the Work of Photographs’, in Uncertain Images: Museums and the Work of Photographs, eds. Elizabeth Edwards and Sigrid Lien (Farnham: Ashgate, 2014), 4–5. 5 Ibid., 8.
198 6
7 8 9 10
11
12 13 14
15
16
Notes For the most compelling histories of the ‘lives’ of photographs in a material sense in archives and museums, see Edwards and Lien, Uncertain Images; Edwards and Morton, Photographs, Museums, Collections; Julia Bärnighausen, Costanza Caraffa, Stefanie Klamm, Franka Schneider and Petra Wodtke, Photo-Objects: On the Materiality of Photographs and Photo Archives (Florenz: Max Planck Institute for the History of Science, 2019). Ginsburg, ‘Archival Exposure’, 150–65. “Filing the War Photographs’. Amateurs May Help. All Will Be Forgiven’, Amateur Photographer and Photography (1919): 469. ‘Filing the War Photographs. Amateurs May Help. All Will Be Forgiven’, 469. Elizabeth Edwards, ‘Thoughts on the “Non-Collections” of the Archival Ecosystem’, in Bärnighausen, Caraffa, Klamm, Schneider and Wodtke, Photo-Objects. Available online: https://mprl-series.mpg.de/studies/12/ (Accessed 14 August 2020). Christopher Pinney, ‘Things Happen: Or, From Which Moment Does that Object Come?’ in Materiality, ed. Daniel Miller (Durham and London: Duke University Press, 2005), 256–72. ‘A Museum of War Wounds’, 405. Shirley Dixon, ‘The Royal Army Medical Corps “Muniment Collection”’, Medical History 38 (1994): 459–69. The physicality of the photograph and in particular the cataloguing, labels, mounting and storage boxes give a functional context through which the photograph is transformed into an authoritative, archival document. See Joan Schwartz, ‘“We Make Our Tools and Our Tools Make Us”: Lessons from Photographs for the Practice, Politics, and Poetics of Diplomatics’, Archivaria 40 (1995); Tiziana Serena, ‘The Words of the Photo Archive’, in Photo Archives and the Photographic Memory of Art History, ed. Costanza Caraffa (Berlin: Deutscher Kunstverlag, 2011); Elizabeth Edwards, ‘Photographs, Mounts, and the Tactile Archive’, Interdisciplinary Studies in the Long Nineteenth Century 19, no. 1 (2014). From outside appearance, the RAMC albums look like domestic photographic albums, their covers dark-brown suede with the word ‘photographs’ in gold gilt. On the inside back cover of these albums, in the bottom left corner, is stamped ‘photo department Harrod’s Ltd’. The Harrod’s store in Brompton Road, Kensington, is only 1.4 miles away from where Norman lived in Coleherne Road, Earls Court, and would have been a convenient local store for him to purchase the albums. Wellcome Collection, London, RAMC 760. This short letter was written by Brigadier James Howden Robertson, a consulting dental surgeon to the army from the Royal Army Dental Corps. In the letter, dated 6 August 1969, he thanked Colonel John George Eric Vachell, from Hove, for the gift of the two albums, which he proposed to retain in the Department of Dental Science in the Royal Army Medical College, Millbank.
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17 Sachs specialized in pathology and skin burns and was a surgeon in the RAMC from 1927, became Captain in the RAMC in 1930, major in 1937, and rose to the rank of Colonel in the 1940s. After retiring from the army in 1956, Sachs was appointed consultant pathologist to the Queen Victoria Hospital, East Grinstead, where he took a leading role in the development of the new burns unit, which had become a specialist hospital for the facial burns of air force casualties during the Second World War. 18 In the 1930s, a historical museum was in existence at the Royal Army Medical College, Millbank, origins unknown. In the Second World War, this pathology and teaching museum was largely destroyed by air raid bombing and subsequently dismantled and evacuated. In 1952, a RAMC historical museum was established at Queen Elizabeth Barracks, Crookham, Hants, at the same time as the Muniment room in the library at Millbank. 19 Vachell worked his way up through the ranks of the RAMC, becoming a Lieutenant during the First World War, a Captain of the RAMC in the late 1920s, and Lieutenant-Colonel in the 1940s. He finally retired in 1949 and in 1978 he died in Hove, aged eighty. The Museum of Military Medicine. 20 Edwards, ‘Thoughts on the “Non-Collections” of the Archival Ecosystem’. 21 Serena, ‘The Words of the Photo Archive’, 59, 63, 65. 22 Benjamin W. Fickling and James Warwick, Injuries of the Jaw and Face: With Special Reference to War Casualties (London: John Bale and Staples Ltd, 1940). 23 William Kelsey-Fry, Alan McLeod, Gilbert Parfitt and Percy R. Shepherd, The Dental Treatment of Maxilla-Facial Injuries (Oxford: Blackwell Scientific Publications, 1942), vi. 24 Kelsey-Fry, McLeod, Parfitt and Shepherd, The Dental Treatment of Maxilla-Facial Injuries, v. 25 Bamji, Faces from the Front, xv. 26 Elizabeth Edwards and Janice Hart, ‘Introduction’, in Photographs, Objects, Histories: On the Materiality of Images, ed. Elizabeth Edwards and Janice Hart (London: Routledge, 2004), 1. 27 Schwartz, ‘“We Make Our Tools and Our Tools Make Us”’, 46. 28 Ibid., 40–74; Edwards, ‘Thoughts on the “Non-Collections” of the Archival Ecosystem’. 29 Pinney, ‘Things Happen’. 30 Edwards, ‘Thoughts on the “Non-Collections” of the Archival Ecosystem’, 73. 31 Jason Bate, ‘Projecting Soldiers’ Repair: The ‘Great War’ Lantern and the Royal Society of Medicine’, Science Museum Group Journal 13 (2020): 1–21. DOI: http:// dx.doi.org/10.15180/201307. 32 Six photographs of Private George Edwards (1895–1989) are displayed on one page of RAMC album 2, Wellcome Collection, London, RAMC 760.
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33 Schwartz, ‘“We Make Our Tools and Our Tools Make Us”’, 46. 34 In 1963, Daisy Edwards died, aged sixty-one. George remained active and was very sociable, yet chose to spend the rest of his life alone without remarrying. George had good eyesight and never needed glasses. However, when Lynn used to write to him, George would always ask her to write in red ink so that he could read the letter more clearly. Personal correspondence with Lynn Polm, a granddaughter of George Edwards, email conversation, 16 May 2018. 35 Henning, Photography, 54. 36 Ibid., 52. 37 Tim Ingold, Being Alive: Essays on Movement, Knowledge and Description (Abingdon: Routledge, 2011), 24. 38 Personal correspondence with David Edwards, a grandson of George Edwards, email conversation, 16 August 2018. 39 Ibid. 40 George never returned to a ‘normal’ life. In the words of David, he was ‘profoundly different after the war’. Personal correspondence with David Edwards, email conversation, 16 August 2018. 41 Personal correspondence with Lynn Polm, email conversation, 15 August 2018. 42 Ibid. 43 George Edwards passed away peacefully on 31 March 1989, in Toronto, aged 92. Personal correspondence with Lynn Polm, email conversation, 25 November 2018. 44 Pinney, ‘Things Happen’, 267. 45 Harold D. Gillies, Plastic Surgery of the Face: Based on Selected Cases of War Injuries of the Face Including Burns (London: Hodder and Stoughton, 1920), 85. 46 Shelagh Davidson, communication with Andrew Bamji, early 2000s. 47 Bamji, Faces From the Front, 190. 48 Personal correspondence with Andrew Bamji, email conversation, 23 April 2021. 49 Andrew Bamji, honorary archivist of the Gilles Archive, email conversation, 7 January 2020. 50 See Wilder, ‘Not One But Many, 376–94. 51 Geoffrey N. Swinney, ‘What Do We Know about What We Know? The Museum “Register” as Museum Object’, in The Thing about Museums: Objects and Experience, Representation and Contestation, eds. Sandra Dudley, Amy Jane Barnes, Jennifer Binnie, Julia Petrov and Jennifer Walklate (London: Routledge, 2012), 30–4. 52 Pinney, ‘Things Happen’, 266–9. 53 For a further discussion of the photographic image in all its various manifestations, see Edwards, ‘Thoughts on the “Non-Collections” of the Archival Ecosystem’, 80. See also Geoffrey Batchen and Lisa Gitelman, ‘Afterword. Media History and History of Photography in Parallel Lines’, in Photography and Other Media in the
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Nineteenth-Century, eds. Nicoletta Leonardi and Simone Natale (Pennsylvania: The Pennsylvania State University Press, 2018), 205–12 – a detailed discussion and methodology for addressing photography as a continual process of divisions, multiples and separations. 54 Pinney, ‘Things Happen’, 256.
Conclusion 1
By 1916, even though few war pensioner patients in Britain initially applied for admission to specialist facial centres, the government was certain that there were many discharged men in the country in need of such facilities. See Reports by the Joint War Committee and the Joint War Finance Committee of the British Red Cross Society and the Order of St John of Jerusalem in England on the Aid Rendered to the Sick and Wounded at Home and Abroad and to British Prisoners of War, 1914–1919 (London: His Majesty’s Stationery Office, 1921), 259. See also Colyer, ‘Section on Odontology. Discussion on War Injuries of the Jaw and Face’, 84. 2 Bourke, Dismembering the Male. 3 ‘The Training of Disabled Soldiers and Sailors. “Recalled to Life:” A Cinema Talk’, Hamilton Advertiser, 9 February 1918: 3. 4 McMurtrie, The Evolution of National Systems of Vocational Reeducation for Disabled Soldiers and Sailors, 105. 5 E. C. Hardy, ‘The Disabled Man and Industrial Life’, War Pensions Gazette (1918): 229. 6 Richards and Burch, ‘Documents, Ethics, and the Disability Historian’, 163. 7 Ann Stoler, Along the Archival Grain: Epistemic Anxieties and Colonial Common Sense (Princeton and Oxford: Princeton University Press, 2009); Ariella Azoulay, Potential History: Unlearning Imperialism (London: Verso, 2019). 8 Ginsburg, ‘Archival Exposure’, 153. 9 Hennepe, ‘Private Portraits or Suffering on Stage’, 1–23. 10 Susan Crane, ‘Choosing Not to Look. Representations, Repatriation and Holocaust Atrocity Photography’, History & Theory 47, no. 3 (2008): 309–30. 11 Crane, ‘Choosing Not to Look’, 311. 12 Ibid., 309–30.
Bibliography Archive and museum collections Albéric Pont Collection, Archives of the Bibliothèque Interuniversitaire de Santé, Paris. Gillies Collection, BAPRAS, RCS of England, London. Lantern slides from the Queen’s Hospital, Sidcup, 1917–25. Gillies Archive, BAPRAS/G/31/5/Boxes 1–5; glass plates of Private Bob Davidson, 1917. Gillies Archive, BAPRAS/Sidcup/6/2; the Waverley album, BAPRAS/G/26/5; The Frognal album, BAPRAS/G/26/85, the Emerin Keene Album, uncatalogued, Antony Wallace Collection, BAPRAS, RCS of England, London. Ministry of Pensions Administrative Records, PIN 15, Ministry of Pensions Individual Records, PIN 26, National Archives, Kew. Periodicals collection, N. 1709 d. 2. Bodleian Library, University of Oxford. RAMC/CF/3/3/4/2/Cole, Museum of Military Medicine, Hampshire. RAMC Muniment Collection, Wellcome Collection, London. Royal Microscopical Society Archives, University Museum of the History of Science, Oxford. Scrapbook of newspaper cuttings relating to the Queen’s Hospital, Sidcup, dating from 1917 to 1930. H02/QM/Y/01/05, London Metropolitan Archives. Three photograph albums of the King George V Military Hospital, 1915–1919, RARE B[0] ac no. 16685, Imperial War Museum, London.
Family collections Chute family Collection. Commerford family Collection. Dewhurst family Collection. Edwards family Collection. Goddard family Collection. Twinn family Collection. Wayte family Collection. Winter family Collection.
Periodicals Amateur Photographer Amateur Photographer and Photography
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Amateur Photographer and Photographic News British Journal of Surgery British Medical Journal Guy’s Hospital Gazette Journal of the Royal Army Medical Corps Journal of the Royal Microscopical Society Proceedings of the Royal Society of Medicine Recalled to Life Reveille The British Journal of Photography The British Journal Photographic Almanac and Photographer’s Daily Companion The Lancet The Photographic Journal War Pensions Gazette
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Index aftercare 3, 5, 7, 17, 23, 31–5, 64, 76, 115–17, 131–5, 158, 169–71 albums 16, 164 amateur 87, 92, 104, 107 in making practices 91–3, 106–7, 153 nurses’ 86, 90–2, 98, 103, 146–8, 191 surgeons’ 41–2, 75, 82, 142, 149–53, 156–7, 186, 188, 199 amateur photography 4, 6, 47, 86–7, 92, 97–8, 108 authorizations 90 camera clubs 32, 57, 85, 89, 98–101 in domestic context 116, 128–9, 133, 171 in wards 11, 22–4, 32, 42–4, 57, 85, 89, 96–105, 107–8, 141, 170 (see also camera as therapy) archive 16–22, 26 See also collecting practices administration 147–52, 174 blurred boundaries 21, 142–7, 154, 157–8, 166–7 categories 147–8, 152–3, 155–6, 160–1, 164, 166–7 catalogue 16, 21, 82, 141, 148, 153–4 family practices of 7, 21–2, 147 materiality of archival photographs 25–7, 144–67, 172–5 materiality of the photo archive 25–7, 141–67, 172–5 medical 25, 104, 83, 143–4, 152–3, 164–7, 172–3 military 18–20, 25–6, 111, 134, 142–4, 146–7, 152, 160, 161, 163–5, 166–7, 173–4 organization 148–50 origins of 148, 199 Army Medical Services 3–4, 9–10, 16, 31, 63, 102, 141 Army Medical War (AMW) collections 16, 25, 141–3, 147, 149, 161, 164–6, 172–4
Azoulay, Ariella 173 Bamji, Andrew 14, 17, 151, 161–3 Batchen, Geoffrey 38, 181, 201 Biernoff, Suzannah 7, 13, 21, 103 Bone-grafting 53, 55, 72, 116 Bourke, Joanna 170 British Army 3, 12–13, 17, 26, 29–31, 53–60, 102, 106, 111, 116, 125, 128, 141, 149, 154–6, 166, 171 British Empire 101 British Medical Association, London (BMA) 31 British Photographic Manufacturers Association 86, 93, 192 bromide lantern plates 75 Brook War Hospital, The, Woolwich 50 business of medical photography 3–4, 9–11, 29–31, 36–53, 57–8 amateur 42–4, 58, 90–101, 170 commercial 4, 12, 36–7, 97, 32, 35, 50–2, 57, 107, 153–4 professional 4, 30–6, 44–50, 57–8, 85, 97–8 Butcher, George viii, 18–19, 117–22, 124, 127, 133–4, 196 cameras 3, 5, 10, 12–13, 23, 29, 31–2, 35–9, 60, 74–5, 84, 88, 92–6, 102, 115–18, 139 box-form 129 camera-consciousness 125, 129–30 cheap 12, 90, 101, 111–12, 128, 173 control of 90 See also censorship; Defence of the Realm Act (DORA); government easy-to-use 3, 22, 57, 60, 87, 90, 128–31, 173 hand held 7, 22, 42, 47–9, 51, 72, 76, 85, 105, 111–13 large format 47–8, 50–2
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manufacturers of 4, 7, 12, 85, 87, 96–7, 101–3, 192 (see also British Photographic Manufacturers Association) new designs of 6, 87, 102 Newman and Guardia 85–6, 90, 111 portable 3–4, 22, 57, 111–13, 129 professionalizing the 36, 44–53 shutter 29, 42, 48, 53 Thornton-Pickard 49, 192 camera as therapy 6, 85, 95, 104–5, 107, 116 alternative health therapies 87, 104 rehabilitative therapy 53 therapeutic tool 88, 90–2, 105, 118–20 (see also rehabilitation; recovery) therapeutic practices 24 care 27, 112–15 See also ethics of the archivist 45, 145–7, 163 burden of 21 caregiving practices 3–4, 6, 10–11, 36, 39, 85, 107, 114, 120, 128–9, 165 domestic 20, 112 continuation of 21, 24, 141–3, 155 commitment to 88, 131, 172 community responsibilities of 13–14, 87, 104, 128, 134 duties of 114, 138, 171–2 family-led 8, 24, 111, 116, 118, 120–1, 138, 155, 163, 174, 191 generational norms of 126 of the historian 171–5 institutional 17, 22–3, 36, 47, 50, 72, 145–7, 169–70, 172–3 medical 17, 20, 30–2, 34, 60–1, 113, 117, 152, 163–5, 169 nurses’ 89, 96 obligations of 96, 172 rehabilitative 61, 80, 169 relations of 85 struggles of 106 of the surgeon 2, 59, 69, 72, 80, 84, 163 touch technology and experiences of 96, 111–14 censorship 25, 90, 103, 107, 146, 174 See also government and propaganda 81, 87, 96, 103–5, 108 Cohen, Deborah 125 Cole, Percival 44, 48–50, 53–5, 74–6, 148, 150, 184–5
collecting practices archival 17, 143–8, 171–5 familial 21, 144, 164–5, 171–2 institutional 25, 34, 141–4, 147, 153, 164–5, 171–5 museological 143–8 photographic 153 collections management 26, 141–4, 164 Colyer, Frank 35, 56–7 communication long-distance 10, 77, 145, 152–65 mediated 10, 50, 76, 145, medical 4–5, 22, 29, 36, 57, 77, 90, 108, 146, 153–4 new forms 5, 31, 76, 145 oral 113 personal 50, 127, 146, 152–65 technologies of 9–10, 33–4, 57, 71, 77, 153–4 textual 34, 71, 103, 108 transformation of 5, 9, 22, 29, 76, 127, 152–65 visual 31, 34 communities See also networks disabled ex-service 2, 10, 16, 24, 114, 125, 135, 172–9 facially-injured ex-service 16–8, 87, 105, 114 imagined 5, 8, 23, 98, 108, 112 local 8–9, 14, 25–6, 97, 108–9, 116, 124–5, 128–9, 137, 169, 170, 172, 183 national 103, 108–9, 116, 143, 172 photographic 47, 89, 91, 96, 101, 107–9 professional 3–5, 29–33, 44–50, 53–6, 59–84 scientific 23, 32–4, 47, 53, 55, 58–64, 74, 79–84, 107, 171 camera clubs 4, 98–100, 108–9, 114 Centre maxillofacial de la XIVe Région (Lyon) 36, 43 Chemical Society 102, 193 club members 109 compassion 30, 103, 172 convalescence 23–4, 89–90, 95, 106–7, 135, 169 Crane, Susan 174 Croydon Camera Club 99–100, 109, 193 Croydon War Hospital 35, 57, 69, 99–101, 170
Index Davidson, Bob iv, ix, 150–2, 161–4, 203 darkroom workers 1, 4, 22, 44–5, 52, 57–8, 74–5, 98–101, 157, 170 makeshift darkroom 94 Department of Scientific and Industrial Research 102, 192 Di Bello, Patrizia 91 disability pensions 1–2, 34, 61, 80, 91, 176 physical 8, 15–7, 54, 116, 120, 126, 131 social 7–8, 16–7, 116, 126, 131 disfigurement 1–2, 5–9, 13–26, 29, 30, 34, 60–3, 82–3, 95, 103, 112–14, 124–5, 131–9, 146, 160, 166, 169–72 doctor-patient relationship 54–6, 60 domesticity 2, 7–8, 17–18, 21–4, 116, 120–1, 125, 128–39, 161, 170–2 domestic acts of caregiving 20, 106–7, 11–14, 144 (see also care; ethics) dry 10, 12–13, 42, 51, 58, 81, 94, 100, 160, 192 domestic rehabilitation 2, 18, 20, 23–5, 106, 111–39, 161, 169–72 East Midlands Region Medical Board 116 Edgerton, David 97 Edwards, Elizabeth 21, 79, 83, 142, 147, 152, 198 Edwards, George ix, 156–60 embarrassment 29, 131, 137 embodiment 72 employment 1–3, 18, 20, 24, 30, 56, 79, 84, 91, 112, 130, 138, 156, 169–71 economy of the workplace 11, 20, 26, 106 job market 111, 171 unemployed 20, 112, 120, 169 ethics 13, 16 See also care the application of laws imposed by the military and 21, 32–3, 53–6 of circulation 166 care as affective concern and 25, 171 in civilian practices 56 ethical responses 171–5 ethical relationships and obligations 55, 134 ethical obligations to remediate neglect 12, 20, 171–5 as responsibility 171, 175
217 secondary level 25 working protocols and 22, 32–3, 36, 58
families 7–8, 15–22, 24, 91–2, 107–8, 111–14, 116–39, 143–7, 154–66, 171–5 caregiving practices of 8, 24, 111–14, 118, 124–6, 128–31, 138–9, 143–7, 155–65, 172, 174, 191 See also care First London General Hospital, Camberwell 65, 83 funds 104–6, 181 See also healthcare; military welfare; public expenditure Geddes’ Axe 24 Gehrhardt, Marjorie 5, 13–14, 124 Gerber, David 137 Gillies, Harold 16–8, 32, 35, 50, 52, 116, 161, 163, 183 Gillies Archive vi, ix, 16–18, 51, 142, 162–3, 203 collection vii, ix, 78, 145, 151–2, 161, 203 glass plates 3, 6, 10, 12, 22, 29, 36–48, 50–2, 57, 65, 72, 74–5, 81–5, 87, 94–102, 112, 151, 153, 160–5, 173, 181, 203 See also Lumière brothers; sensitized goods broken 162–4 rapid and extra-rapid 36 unfixed 100 unwashed 100 Goddard, Hugh viii, 131–3, 197 government 2–3, 5, 8, 60, 63, 114 See also military welfare; Ministry of Pensions agencies 11, 101, 103, British 1–2, 80, 102, 117, 128, 169, 192 bureaucracy of 56, 115 censorship 90, 103 (see also censorship; Defence of the Realm Act (DORA)) control 91, 103, 111 departments 96 failures 15, 22, 106, 144 finances 34, 84, 106, 115 French 43 Italian 91 policy and makers 23, 91, 115, 128–9, 139
218 restrictions 90, 103, 114, 169 state authorities 3, 8, 109, 111 subsidies 1, 31, 35 Hart, Bob 137–8 healing 4, 7, 25, 65, 74, 80, 105, 113, 118, 141, 185 healthcare 8, 34, 55–7, 105, 115–16, 170 See also military welfare public-funded 55–7, 83–4 state-sponsored 9, 55–7, 76–7, 83–4, 115 Hevia, James 10, 178, 212 historiography 14–5, 21, 24 homes 15, 20, 24, 94, 105, 107, 111–14, 119–28, 131–5, 137, 147, 156–9 hybrid technology 96 image-making 12, 71, 108, 164 processes of 4, 44, 87, 92, 101, 150 Imperial War Museum, London vii–viii, 52, 86, 93, 98, 135, 146, 180, 197, 203 imperialism 10, 22, 34, 57, 97, 101–3, 173, 201, 209 See also British Empire industrialism 22, 57 industry 2, 3, 4, 6, 11, 15, 81, 101–2, 113, 178 See also industrialism; photomechanical processes; photography complex photographic 1, 11–12, 26, 89, 52, 86, 95–7, 101–2, 107, 122, 178, 190–4 invisible photographically 10, 21, 47, 71, 79, 142, 146, 155, 157 socially 24, 29, 105–6, 131, 134, 173 (see also visible) Journal of the Royal Microscopical Society 46 Keene, Emerin 90–2, 94–6, 146, 191 King George V Military Hospital, London (KGH) 34, 36, 44–5, 50, 55, 57, 97–8, 131, 155–8, 184 King’s National Roll 2, 138, 171 kinship 25, 103, 166 Kodak 12, 111–13 box brownie 111
Index marketing 90, 194 vest pocket 85 Koureas, Gabriel 112 Lancet, The 2, 44, 55–6, 72, 87, 108 Langford, Martha 113 lantern vii, 23, 45, 47, 59–60, 63, 65–6, 71, 74, 76–81 demonstration 53–4, 61, 184 electric light vii, 65, 68–9 illuminant 45 lanternist 188 magic vii, 60, 68 optical vii, 67 practices 60 projection 23, 60–1, 64–5 technology 23, 60, 71–2, 84 lantern slides 32, 45, 59, 75, 78, 82, 97, 99, 142, 153, 164, 188–9 circulation of 23, 32, 45–7, 59–82 in lectures 23, 54, 59–77 lost and destroyed 165 making slides 45–7, 74–5, 99 projection of 23, 45–7, 59–74, 83, 187 in published papers 61–4, 78–83 Latour, Bruno 10, 177–8, 189, 213 See also networks; photography complex Lien, Sigrid 21, 79, 83, 142, 152 liquid intelligence 11–13, 38–9, 42, 50–2, 58, 87, 92–4, 100, 147 Local War Pensions Committees 1–2, 33, 61, 63, 77, 117, 171 See also Ministry of Pensions provincial system 61 Lumière brothers 36–7 See also glass plates masculinity 2, 7–8, 111–16, 121, 124, 134 Mattern, Shannon 9, 177 maxillofacial 2, 36, 43 medical boards 63, 77, 91, 116, 119, 122, 175, 197 medical culture 21 medical knowledge 5, 23, 47, 59, 74, 108, 154 medical societies 5, 17, 32–3, 43, 45, 56–7, 61–3, 170 centralized 23, 61 ethical rigour of 22, 33
Index meetings of 5, 32–3, 43, 55–7, 60–5, 72, 76–83, 165–7, 186–7 members 23, 54–5, 59, 61–3, 69–74, 79–84 national 43, 45 provincial 43 Meyer, Jessica 112 microphotography 45, 47 military ownership of the body 134 military property 53–6, 128, 139 See also military ownership of the body military welfare 4, 17, 24, 31–4, 55–6, 79, 82, 115, 128, 139, 169, 172 archival policy 152, 164, 175 British state policy 2, 17, 24, 61, 83–4, 91–2, 125, 128, 134, 139 Italian state policy 23–4 Ministry of Pensions 1–5, 17, 26, 63, 173 bureaucracy of 20, 31, 33–4, 53–4, 61, 64, 82–3, 115, 171 centralized society 60 cutbacks 24, 115, 134, 171 department 18, 34, 61, 135, 138, 169, 171 expenditure 31, 34, 61, 76, 79, 84, 138, 169 pension assessments 15, 63, 116–17 compensation 8, 15, 22, 54–5, 77, 116, 129, 144, 169 pension infrastructure 2, 4, 9, 138 pensions system 58, 135, 173 property rights 53–6, 82–3, 134 records and archive 17, 134 rehabilitation programmes 11, 22–4, 35, 60, 72, 77, 84, 106, 115, 135, 143, 154, 169 retraining schemes 156 shortcomings of state provisions 115–17, 125, 128, 135 travel allowances 135 modern infrastructural system 2, 4, 9–10, 23, 61, 100, 138, 142–3, 164–5 See also Army Medical Services; communication; communities; government; Medical Research Council; Ministry of Pensions; Local War Pensions Committees; networks; Royal Society of Medicine Mortimer, F. J 98–9, 101–2
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Morton, Chris 189 museum acquisition 148, 163, 165 museum disposals 18, 83, 149, 151, 165, 173 Museum of Military Medicine, Hampshire 16, 48, 142, 144, 149–50, 157, 199, 203 mutilated faces 30, 57 national 2–3, 17, 25, 34, 43, 45, 57, 60, 76, 79, 81, 91, 97–8, 103–8, 111, 134–5, 142, 145–6, 161, 165, 172 See also communities; modern infrastructural system; medical societies; Ministry of Pensions local 1–2, 4, 17, 33, 43, 57–8, 61, 63, 77, 84–5, 94, 98, 103, 108, 117, 121–4, 135–8, 139, 143–5, 161–7, 171–2 imperial 3, 10, 12, 22, 34, 52, 57, 86, 93, 97, 101–3, 135, 146, 173 (see also British Army; British Empire) international 32, 43, 45, 52 provincial 43–4, 57–8, 61, 91 regional 2, 17, 61, 84, 108, 143, 187 transnational 43 National Archives of England and Wales, The, Kew 3, 17, 134 networks 2–13, 16–27, 177 commercial 9, 11, 85–7, 96–103, 177 (see also employment) family households and friendships 16–21, 92, 111–13, 117–39, 160–4 institutions 5–10, 24, 43, 61–3, 79, 82–7, 134–5, 164–7 material performances 11, 33, 43, 151, 165–7 military welfare 2–4, 9–13, 61–3, 59–85, 91, 111–13, 115–17, 138, 170–1 photographic 4, 9–13, 44, 85–7, 96–103, 109, 114, 147, 170, 177 scientific 22, 63, 77, 59–84 social 99, 112 Norman, Albert vi, ix, 44–8, 50–4, 75, 148–9, 152, 156–7, 160, 182, 188, 199 patriotism 8, 14, 16, 101–3, 138, 170, 192 peer production 50 performance of explanation 33, 65, 129 permanency of photographs 5, 10, 18,
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42–3, 87–8, 92–4, 129, 141–2, 147–9, 151, 160, 165–6, 191 See also dry; raw photographic materials; wet; museum disposals discolouring 94 fading 42, 94–5 impure silver 92 low grade printing paper 92 fragility of plates 18, 38–9, 42, 45–7, 75, 82–3, 94, 99–101, 142, 151, 163–5 (see also unfixed plates; unwashed plates) staining 94 toxins 3 photographers 4, 6–7, 9–10, 143, 151, 164 amateur 11, 22, 41–3, 85–9, 92, 96–8, 105–8, 128, 131–3, 141 commercial 1, 4, 11, 22, 50, 98–101, 141, 183 family 24, 114, 116, 138–9 institutional 23, 38–9, 44–8, 50, 170, 173 novice 24, 43, 111–13, 129 official 23, 29–32, 38–9, 52–3, 57–8, 65, 69, 72–4, 90, 104, 141, 173 scientific 11–12, 23, 29–32, 38–9, 44–5, 48, 50, 65, 69, 141, 188 unofficial 85–6, 90, 98–101, 146 photography complex 9–10, 109, 155 See also aftercare; archive; care; communities; government; healthcare; industry; Ministry of Pensions; photomechanical processes; photographers; photographic market; photographic press; RAMC photographic ecosystem 21, 25–6, 82, 141–2, 146, 150–5, 160, 164–7, 201 ecologies and relations 21, 59, 142, ecology of caregiving in 165 environment 4, 6, 11, 30, 32, 43, 50, 58, 60, 94, 121, 164 (see also modern infrastructural system) photographic market 4, 6–7, 9, 11–12, 65, 85–6, 90, 96, 101–3, 107, 113–14 photographic press Amateur Photographer 17, 87, 98, 101 and Photographic News 49, 101, 106, 183, 191, 193, 204 (see also
Photographic News) and Photography 128–9, 146 British Journal of Photography 1, 176, 193, 204 British Journal Photographic Almanac and Photographer’s Daily Companion 204–5. Photographic Journal 45, 182 Photographic News 49 photographic services 3, 6, 9, 12, 31, 35–6, 42–4, 58, 63, 87, 89, 98, 170 Army medical 2–4, 9, 31, 36, 42–4, 52, 57–8, 102, 170 local camera clubs 35, 57–8, 98–101 commercial 1, 4, 6, 12, 35, 52, 87, 102 high-street 6, 87, 111–12 industrial organization 3, 12, 63, 102, maxillofacial war hospitals 2, 42, 90–6, 170 production units 3, 33, 44, 58, 63 voluntary 4, 35, 52, 92, 90–6, 97–101, 170 photographic societies 45, 98, 108 photomechanical processes 79–80, 157 costs of reproduction 47, 75, 80–1, 83–4, 99–101 half-tone 78–80 ink photographs 78–80, 153 John Bale, Sons, and Danielsson 80–1, 199 lithographer 120–1 lithographic department 121 photolithographic plants 80–1 print enlarging 1, 69, 75, 153, 191 process blocks 80–1 process printing 47, 79–81 photography as event 3–4, 95 photo-processing services 12, 98, 105, 113 Pichel, Beatriz 13, 43, 57 Pickard, Joseph 135–7, 170, 197 Pinney, Chris 147, 153, 160, 165, 167 practices archiving 20–1, 143–7, 150, 175 cataloguing 142–53, 164 darkroom 3–4, 52, 94, 98–101 family 21, 24–5, 91, 111–14, 120–1, 129–38, 143–4, 146, 155–67, 164, 166 historical 172–5
Index institutional 5, 23–5, 36, 142–54, 165– 7, 142, 147–50, 154, 164–5, 167 observational 3, 30–3, 38, 47, 69, 80, 150 photographic 4–5, 9–11, 13, 22–3, 33, 44–53, 50, 52, 57, 60, 85–96, 111–14, 120, 138, 147, 153, 172 research 17–21, 173–5 surgical 22–3, 30–5, 53–6, 61–3, 65, 69–75, 83–4 visual and material 9, 11, 30–2, 94, 112, 142–4, 147, 151, 167, 172, 189 (see also collecting practices) preservation of photographs 5, 10, 16–20, 82–3, 87, 129, 141–3, 147–52, 156–65 See also museum disposals Proceedings of the Royal Society of Medicine 61–4, 70, 73–5, 79–84, 87, 108, 190 prohibition of private photography 90, 107, 146 See also censorship Pont, Albéric 36–44, 57, 148–9, 181, 186, 203 postwar economy 171 professional reintegration 1–3, 13–20, 24, 79, 84, 91, 106, 111–13, 131, 138, 156, 169–71 public expenditure 31, 35, 55, 61, 100, 138, 169 Queen’s Hospital, Sidcup vi, ix, 3, 5, 14, 35–6, 50–2, 57, 78–9, 81, 111, 116–20, 122, 130, 135–6, 141, 151, 154–5, 161–3 reparation 156 raw photographic materials See also industry; permanency of photographs; photography complex amidol 97 baryta coating 97, 102 bromide 75, 92, 96 chemicals 3, 6, 9–13, 38–44, 51, 75–9, 81, 87, 92–4, 97, 100–2 gelatin 10, 12, 36–7, 97, 163 emulsion 10, 12, 36–7, 43, 47, 75, 94, 97, 102, 163 hypo fixing salts 100–1
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metol 97 paper 12, 39, 97, 102, 153, 163, 191 zinc, copper plates 81 Red Cross 59, 103, 169, 181, 193, 201 British 24, 103–4 Italian 24, 95 nurses 16, 24, 95 recovery 18, 26, 50, 53, 60, 69, 74, 76–7, 82, 103, 138–9, 141 domestic practices of 23, 96, 111–34, 171 economic 17, 24, moral 2, 92 physical 2, 105, 108 psychological 7, 17, 92, 105, 128 repair 31, 54, 72, 78, 191 shared 91, 101–2, 108, 120–1, 128, 131 successful and unsuccessful attempts at 19–20, 128, 139, 152 therapeutic practices of 24, 96, 111–34 (see also camera as therapy; rehabilitation) reconstructive surgery 3, 14, 22–3, 30–3, 53–7, 69–80, 106–7, 135, 158, 169–70 recruitment of photographers 29–30 rehabilitation 2–5, 8–14, 22–6, 30–3, 54–6, 85, 143, 169 See also care; domestic rehabilitation; families; Ministry of Pensions; professional reintegration experience of 87, 91, 103–9, 161 programmes 79, 83, 115, 154 state-funded 71 relatives 17–20, 26, 111, 114–15, 120, 127, 137, 143–5, 156, 160–4, 171–3 See also families reproducibility 5, 38–43, 47, 61, 69–83, 92–5, 101, 108–9, 142–67 See also Schwartz, Joan; Morton, Chris Roberts, Albert 52, 184 Rose, Gillian 112 Royal Army Medical Corps (RAMC) 4, 10, 12, 30, 57, 83, 98–9, 165 albums 48, 75, 142, 150–1, 156–7, 188 collections 148–51 Muniment collection 148–50, 199, 203 hospital 35 museum 143, 148 photographers 29, 31, 44, 50–2, 141, 166, 173 personnel 9, 58, 78
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Royal College of Surgeons (RCS) 16, 31, 45, 49, 141, 147–8, 162, 182, 189 museum 59, 141, 144, 148, 151 Royal Geographical Society 83 Royal Photographic Society 45, 83 See also Norman, Albert Royal Microscopical Society 45–7, 182–3, 203 See also Journal of the Royal Microscopical Society; Norman, Albert Royal Society of Medicine 5, 17, 23, 26, 31–3, 47, 57–64, 77, 81–4, 87, 171, 187 See also Proceedings of the Royal Society of Medicine Sanger-Shepherd process 45, 182 Schwartz, Joan 156 sensitized goods 3, 6, 12, 20–2, 36, 39, 47, 51, 57, 94, 102 shame 13, 16, 29, 103, 106, 126, 136 Silverman, Kaja 11 social function of the face 3, 6–9, 13–15, 22, 26, 111–16, 125, 131, 135–8, 144, 169–71 Société Médico-chirurgicale Militaire de la XIVe Région, Lyon 4 spreadable media 64, 69, 74, 84, 88, 91, 107–9, 112–16, 144–7, 150–4, 160–7 staring 137, 160 stigma 20, 24, 84, 113, 129, 137, 156, 166, 173 Stoler, Ann 173 stoicism 7–8, 95, 124, 137 technology transfer 74 Third London General Hospital, Wandsworth 29, 69
treatment allowance 80 Twinn, Sidney viii, 16, 121–8, 129, 196 Val de Grâce Hospital, Paris 53 visible photographically 10, 29, 38–9, 71, 92, 141, 153, 156 socially 5, 8, 103, 106, 111–13, 135–7 (see also invisible) visual economy 112, 143, 147–8, 153 war experience 8–9, 13–23, 85, 90, 92, 105–8, 134, 146, 161, 169–70 war pensions 5, 15, 34, 61–3, 77, 83–4, 115–19, 122, 135, 138, 171 War Pensions Act of 1919 79 War Pensions Gazette 117, 135 Walbridge, Sydney vii, ix, 32, 50–5, 152, 161–2, 183, 189 War Office 35, 97 Wayte, Arnold ix, 116–17, 124, 127, 154–5 Wellcome collection 17, 23, 48, 149–50, 152, 156–7, 188, 199 wet 11 fluid 4, 11, 12–13, 38–9, 94, 158 liquid 12, 38–9, 51–2, 58, 92–4, 100, 147 (see also liquid intelligence) Wilder, Kelley 82 Winter, William 130–1 x-rays 151 apparatus 99–100 department 11 installation 100, 193 plates viii, 97, 100 radiographic 97 supply and use of 97–8
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