In August 1917, a British World War I soldier named John Glubb was hit in the face by a shell. He recalled blood flowing in “torrents” and he felt something that looked like a chicken bone moving around his left cheek. It turned out to be half of his jaw, broken from the impact.
Glubb wasn’t the only unfortunate World War I soldier to sustain a disfiguring facial injury. Shrapnel-filled shells were designed to inflict the most damage possible, and the need to look over trench parapets to assess the battlefield or fire meant a greater risk of being hit in the face by pieces of flying metal. Unlike the loss of a limb, these soldiers faced great social and professional stigma when they returned from the front due to their disfigurement. They were usually reduced to taking night shifts and relegated to special blue benches when in public – a warning to others to look away.
Luckily for these men, a New Zealand surgeon named Harold Gillies dedicated his life to developing innovative techniques to reconstruct faces after witnessing the carnage while serving at the front. Once home, he set up a special ward for soldiers with facial injuries at Cambridge Military Hospital in Aldershot, eventually convincing his superiors that a dedicated hospital was warranted. He is often referred to as the “father of plastic surgery” because of his pioneering work at Queen’s Hospital (later renamed Queen Mary’s Hospital) at Frognal House in Sidcup.
Gillies is a key character in a new book by author and medical historian Lindsey Fitzharris, titled The Facemaker: A Visionary Surgeon’s Battle to Repair Disfigured WWI Soldiers. A renowned science communicator with a great Follow Twitter and a penchant for the macabre medical, Fitzharris published a biography of surgical pioneer Joseph Lister, The art of butcheryin 2017 – a great read, if at times macabre.
His work quickly caught the attention of the Smithsonian Channel, which tapped Fitzharris to host its 2020 documentary series revisiting infamous historical cold cases, The curious life and death of…. Fitzharris usually has several book ideas simmering on the back burner at any given time. For example, she has a children’s book coming out next year illustrated by her husband, cartoonist/cartoonist Adrian Teal, and is already working on a third book about a 19th-century surgeon named Joseph Bell, who inspired Sherlock Holmes’s Sir Arthur Conan Doyle.
The Facemaker was not his first choice for the follow-up to The art of butcherybecause she didn’t know the First World War very well. But his publisher loved Gillies’ story, so Fitzharris gave himself a crash course in the history of this period. “The art of butchery is hyper-focused on one man, Joseph Lister, who applied germ theory to medical practice,” Fitzharris told Ars. “This book is not about one man, but about several men. It’s about Harold Gillies, the pioneering surgeon who reconstructed soldiers’ faces during World War I, but it’s also about those disfigured men. I hope their voices really shine in the narrative.”
Ars spoke with Fitzharris to find out more.
(Attention: some photos and graphic descriptions of facial reconstruction follow.)
Ars Technica: It’s such a vast subject. How did you reduce the scope so the range was manageable?
Lindsey Fitzharris: True, it was a much more complicated story. I think that’s why it took me five years to write, just to understand the magnitude of the First World War, with military medicine at the time, with all these complicated advances. One of the challenges of the First World War is that there is so much material: so many diaries and letters from soldiers recounting their experiences. Someone asked me what the difference is between academic history and the business history I write. A lot of what I do now is rejecting information. I absorb a lot in my research, but I push that away because I don’t want to overwhelm the reader. I want to find the pulse of the story.
I knew I wanted to knock the reader into the trenches from the start. There’s a man by the name of Percy Clair who wrote this beautiful diary that allowed me to tell the story of what it was like to be wounded, punched in the face and lay on the battlefield for quite long before being recovered. I wanted readers to understand how difficult it was to first leave the battlefield and then get to Gillies because Clair was sent to the wrong hospital first.
There were also complications with accessing patient records in the UK and what you can and cannot say regarding a patient’s name. When I use a patient’s name in The Facemaker, it is because this knowledge is public, or that Gillies himself had published it at some point. If Gillies posted about a certain patient, if I went into the records and found other information that he did not include, I could not use that information in connection with that person’s name. . The art of butchery didn’t have that complication because it was set in the 19th century. Everything was old enough that we didn’t have to worry about any of that. But much of the material for The Facemaker is copyrighted. I had to contact members of Percy Clair’s family for permission to cite his diary to the extent that I did.