This Armistice Day, we’re looking at soldiers who suffered horrendous facial injuries during the Great War and how medicine and art worked together to help them.
World War I was arguably one of the most devastating wars the world has ever seen. The weaponry was far more sophisticated than anything ever seen before and included tanks, armed aircraft, artillery and poison gas. Between 1914-1918, around nine million military personnel lost their lives and 21 million more were injured. Countless civilians also died.
When the injured came home, many suffered from “shell shock”, now known as post-traumatic stress disorder. Others lost limbs, were rendered deaf or blind, and some were disfigured beyond recognition, their faces having been literally blown apart by shrapnel. The images of these men are frighteningly confronting. Jaws were blown off; many lost half their faces; noses, eyes, ears, cheeks and chins were obliterated. These were truly horrific disfigurements. While many scars – both physical and emotional – can often be hidden, facial injuries cannot. Soldiers whose faces were destroyed were in a special kind of hell, forced to cover their faces with cloth, wear wide brimmed hats pulled low over their heads and resign themselves to a life in the shadows.
The reason so many men sustained such hideous wounds has been attributed to trench warfare. Bodies were protected, but when soldiers peeked over the tops of trenches they were assailed by waves of bullets fired from machine guns. Shrapnel flew freely and thousands of soldiers were mutilated, their lives changed forever.
At the time, repairing cleft palates was about the extent of cosmetic surgical procedures and doctors were suddenly faced with having to repair wounds the like of which they’d never seen before and to try to create facial prosthetics for severely disfigured men. Doctor Harold Gillies had headed a plastic surgery unit at an army hospital in France and successfully reconstructed the faces of a number of soldiers while in the field. Back in England he worked solely on facial reconstruction. Often called the father of plastic surgery, some of his skin grafting techniques are still employed today. According to Suzannah Biernoff, between 1917-1925, some 11,000 operations were performed on 5,000 patients at Gillies’ hospital in Sidcup, giving them a chance to resume their post-war lives. Gillies and other surgeons also often worked closely with dentists reconstructing jaws and teeth so that wounded soldiers were able to chew and swallow food once again.
Plaster casts of a patient’s face were taken, from which a facial reconstruction was made. A mask was then made, fitted to the injured man and painted a skin colour.
Of course the reality was that surgery was simply not always up to the task of replacing destroyed facial parts.
Many facially wounded returned soldiers lost confidence, succumbed to alcoholism and suffered severe depression. They had to learn how to speak again, how to deal with their acquired disabilities. They were socially marginalised as ordinary people reeled back in terror at the sight of their ruined faces. The wounded themselves were terrified by their appearance and hospitals removed mirrors so they wouldn’t catch sight of themselves and fall into despondency. Many felt unable to return to their families and their previous jobs, some even took their own lives such was their despair.
But there was hope in store, at least for some. In 1916, sculptor Francis Derwent Wood opened a clinic in London called the Masks for Facial Disfigurement Department (often referred to as the Tin Nose Shop) where he began making masks for facially wounded soldiers. Using thin sheets of galvanised copper (weighing about 100 grams) rather than the traditional rubber, and referring to pre-injury photographs, masks were made to closely resemble the shape and look of patients’ original faces.
It was sedulous work, each mask taking many weeks to complete. Following recovery from surgery, plaster casts of a patient’s face were taken, from which a facial reconstruction was made. A mask was then made, fitted to the injured man and painted a skin colour.
The following year, Boston-based sculptor Anna Coleman Ladd heard about Wood’s work and moved to Paris where she opened her Studio for Portrait Masks. Like Wood, she made plaster casts, reconstructing missing features by matching them to the opposite intact feature. Masks were painted to match the individual’s skin colouring. Originally Ladd used oil paint but she soon switched to using enamel because it was closer in colour to skin and better still, it was washable. Eyebrows and eyelashes were made from real hair. Masks were held in place by being tied around the head or hung from spectacles. This four-minute silent video provides a glimpse into the incredible work being done in Ladd’s studio.
Wearing a mask meant that facial expression was non-existent. More significantly, function and movement could never be restored to missing facial parts – even after successful surgery some men had to be tube- or spoon-fed for the rest of their lives – yet the masks made a huge difference to the lives of the few hundred soldiers who were fortunate enough to get them. These men were able to ease back into everyday life, resume relationships with their families and friends, and feel part of a community once more.
Historians know that Ladd’s studio produced 185 masks and Wood’s department made probably more than double that. The exact number of facially disfigured soldiers from World War I runs into the hundreds of thousands, so the work of Wood and Ladd was a mere drop in the ocean. But for those men, some meaning was restored to their lives. They could show their faces once again.
As for the two sculptors, after the war Francis Derwent Wood sculpted some public monuments commemorating the war, notably the Machine Gun Corp Memorial in London’s Hyde Park. He died in 1926.
Anna Coleman Ladd returned to America where she resumed her pre-war work as a sculptor of bronzes. She was made a Chevalier of the French Legion of Honour in 1932 in recognition of her war effort. She died in 1939.
World War I had a significant effect on modern medicine because many of the injuries sustained during that conflict had never been experienced before. Over the following decades, doctors and other health professionals built on the work of those who went before and huge developments were made, and continue to be made, in the treatment of patients both on and off the battlefield. Today, reconstructive surgery is very advanced and doctors are even performing face transplants. Yet it remains a fact that many of the savage facial injuries suffered by soldiers in the Great War could not be repaired even today.
War is hell. It’s always hell. Lest we forget.