Soldiers Don't Go Mad A Story of Brotherhood, Poetry, and

Mental Illness During the First World War

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—Siegfried Sassoon,
“Repression of War Experience,” 1917
 CONTENTS

Introduction

chapter one. The Hydro

chapter two. The War Hospital

chapter three. Interpreting Dreams

chapter four. A Complete and Glorious Loaf

chapter five. Out of Place

chapter six. A Young Huntsman

chapter seven. The Protest

chapter eight. Poet by Day, Sick by Night

chapter nine. High Summer

chapter ten. Mentors and Novices

chapter eleven. Who Die as Cattle

chapter twelve. The Celestial Surgeon

chapter thirteen. A Grand Gesture

chapter fourteen. Fight to a Finish

chapter fifteen. Love Drove Me to Rebel

chapter seventeen. A Second Chance

chapter eighteen. Drastic Changes Were Necessary

chapter nineteen. Mad Jack Returns

chapter twenty. The Loathsome Ending

epilogue

Photographs
Acknowledgments
Notes
Image Credits
Index
 INTRODUCTION

A ll the armies in the Great War had a word for it: the Germans
called it “Kriegsneurose”; the French “la confusion mentale de la
guerre”; the British “neurasthenia” and, when Dr. Charles Samuel
Myers introduced the soldiers’ slang into medical discourse in 1915, “shell
shock.” Twenty-five years later, it was “battle fatigue.” By the end of the
twentieth century, it became post-traumatic stress disorder (PTSD).
In December 1914, a mere five months into “the war to end war,”
Britain’s armed forces lost 10 percent of all frontline officers and 4 percent
of enlisted men, the “other ranks,” to “nervous and mental shock.” An
editorial that month in the British medical journal The Lancet lamented “the
frequency with which hysteria, traumatic and otherwise, is showing itself.”
A year later, the same publication noted that “nearly one-third of all
admissions into medical wards [were] for neurasthenia”—21,747 officers
and 490,673 enlisted personnel. Dr. Frederick Walker Mott, director of
London’s Central Pathological Laboratory, told the Medical Society of
London in early 1916, “The employment of high explosives combined with
trench warfare has produced a new epoch in military medical science.”
This development need not have surprised Britain’s military physicians.
Major E. T. F. Birrell of the Royal Army Medical Corps (RAMC) had
observed nervous breakdowns in surprising numbers while supervising a
Red Cross medical mission to the Balkan Wars between Turks and
Bulgarians in 1912 and 1913. The new heavy weapons that Germany’s
Krupp and other European industrialists sold to both sides inflicted carnage
that doctors had not witnessed before. Modern science was creating modern
war. Explosive rifle cartridges penetrated flesh more deeply than balls from
single-shot muskets. High-explosive artillery shells released not only the
shrapnel shards of old, but ear-shattering thunder, blinding light, and a
concussion so fierce that it sucked the air away. The shells demolished the
strongest ramparts, leaving no refuge. Rapid-fire machine guns mowed
down hundreds of men in an instant. Hospital wards received, in addition to
those who had lost arms or eyes, disabled soldiers without marks on their
flesh. They suffered unexplained blindness, mutism, paralysis, shaking, and
nightmares. A surgeon from Belgium’s Saint Jean Hospital, Dr. Octave
Laurent, documented the Balkan wounds in his book La Guerre en Bulgarie
et en Turquie. Laurent removed metal shards from broken bodies, but
surgeons could not cure paralysis, trembling, nightmares, blindness,
stammering, and catatonia.
Laurent posited physical causes for the symptoms. This accorded with
medical and military doctrine of the day that fighting men did not become
hysterical. Practitioners in the new field of psychiatry shared the view of
Sigmund Freud in Vienna that hysteria, a word derived from the Greek for
“uterus,” was a female condition. Laurent referred to the soldiers’ malady as
la commotion cérébrospinale, a variant of what American Civil War doctors
had called “windage,” undetectable molecular disruption of the spinal cord
from the vibration of speeding bullets and shells. Concussion had caused
some, but not all, of the neuroses. Laurent’s and the RAMC doctors’ denial
of the emotional causes of physical disabilities would influence the military
response to mental illness when Europe’s Great War began in the summer
of 1914.
Industrial-era weaponry deployed on a mass scale from August 1914 to
November 1918 exacted a greater toll in dead and wounded than in any
previous war. For the first time in history, millions of men faced high-
velocity bullets, artillery with previously unimaginable explosive power,
modern mortar shells, aerial bombardment, poison gas, and flamethrowers
designed to burn them alive. British casualties soared on August 26, 1914—
a bare three weeks into the war—when German artillery ravaged the British
Expeditionary Force (BEF) at Le Cateau in northeast France. In October,
the Battle of Ypres produced so many cases of mental shock that the War
Office dispatched a leading neurologist, Dr. William Aldren Turner of
London’s National Hospital for the Paralysed and Epileptic, to France to
discover the causes. Examining otherwise healthy men afflicted by
deafness, deaf-mutism, blindness, stammering, palsies, spasms, paraplegia,
acute insomnia, and melancholia, he concluded, “In many instances he [the
soldier] may persevere with his work until a severe psychical shock—such
as seeing one of his friends killed beside him, severe shelling, an upsetting
experience, or bad news from home—unsteadies him, and precipitates a
definite attack of neurasthenia, requiring rest and treatment at home.” As
the war progressed, doctors recorded an escalating proportion of mental
breakdowns alongside the usual statistics of killed, wounded, and missing.
The percentage increased as the war froze along a static cordon of opposing
trenches from the English Channel south more than four hundred miles to
the border of neutral Switzerland. Along this deadly frontier, troops of both
sides endured the relentless hammering of devastating artillery in a dark
underground world from which the only escape was injury or death.
Debate among military physicians and between doctors and senior
officers raged over how to deal with the unblooded wounded. Dr. Myers
criticized the military for regarding shell-shocked soldiers as “either insane
and destined for the madhouse or responsible and should be shot.” The
question persisted throughout the war: should men who broke down on the
field of battle be disciplined or receive medical attention? By war’s end,
firing squads had executed some, practitioners had administered punishing
electric shocks to others, and psychiatrists offered Freudian psychoanalysis
to a lucky few. But even then, the treatments’ purpose was to thrust
shattered boys and men back into the violent conditions that had caused
their breakdowns, troubling physicians who had to weigh duty to patients
against military necessity.
The problem of soldiers’ mental health became a crisis in the summer of
1916, when British general Sir Douglas Haig launched an all-out assault to
break the German line in northern France’s Somme Valley. Preparatory,
uncamouflaged massing of forces and supplies, together with a weeklong
artillery barrage to reduce enemy defenses, alerted the Germans to the
impending onslaught. At 7:27 on the morning of July 1, British artillery
subsided and an eerie silence prevailed. Two minutes later, a mountain of
earth rocketed into the sky from a spot behind the German lines called the
Hawthorn Redoubt, where British sappers detonated a 40,000-pound
underground charge. That was the signal for thousands of men laden with
66-pound backpacks to climb over the parapets of the British trenches and
march into No Man’s Land. German defenders, who had sheltered deep
under the surface during the barrage, emerged to fire machine guns,
artillery, and mortars at their attackers. Twenty-one-year-old Captain
Wilfred Nevill, known fondly as Billie to the men of his East Surrey
Regiment, kicked a soccer ball onto the battlefield and charged forward. As
he dribbled the ball into the barbed wire, German gunners cut him down. A
fellow officer, Lieutenant Robert Eley Soames, followed with another ball,
urging the men to kick it into goal. Few of them made it.
Novelist and official war propagandist John Buchan, whose
swashbuckling imperial heroes like Richard Hannay had inspired many
youngsters to volunteer, described the carnage in his 1917 book, The Battle
of the Somme: “The British moved forward in line after line, dressed as if
on parade; not a man wavered or broke rank; but minute by minute the
ordered lines melted away under the deluge of high explosive, shrapnel,
rifle, and machine-gun fire.” The Germans pitied the boys falling before
their bullets, calling them Kannonenfutter, cannon fodder.
It was not combat so much as slaughter. Between dawn and dusk, nearly
twenty thousand British soldiers died, while another forty thousand suffered
wounds or went missing in action—the highest one-day loss in British
military history before or since. The men and boys who straggled back to
their trenches had witnessed unprecedented horror. Close friends, in some
cases their own brothers, had been cut to pieces before their eyes. It was
more than many could bear. Thousands turned up in Casualty Clearing
Stations (CCS) without visible wounds but unable to speak, hear, walk, or
stand still. Many were incoherent. Some, fearing terrifying nightmares,
dared not sleep. They came from all ranks, a high proportion of them junior
officers. Haig pressed the Somme offensive for four bloody months of
mounting casualties without breaking through.
 Dr. Arthur Hurst, a physician in Britain’s RAMC, filmed many of the
broken men. His War Neuroses and The Battle of Seale Hayne depicted men
and boys trembling, blinded, paralyzed, babbling, hiding under beds, and
frozen in what Americans in Vietnam fifty years later would label “the
thousand-yard stare.” Hurst’s motifs resembled those of the epoch’s silent
horror movies, stricken creatures struggling with deformities, spectral
figures casting sinister shadows against white backgrounds, eyes bulging
and transfixed, paralyzed limbs, shaking bodies, all so terrifying that the
images were not shown to the public. Although the British Army High
Command was reluctant to acknowledge that war wounds could be mental
as well as physical, it could not avoid addressing a phenomenon that was
depriving the fighting forces of the men needed to prosecute the war.
Many of the broken men recorded their experiences in diaries, letters,
illustrations, and poems. Two young officers treated for shell shock,
Siegfried Sassoon and Wilfred Owen, rank among the finest poets of the
war. Yet much of their verse would not have been written but for their
psychotherapy. Chance brought the two poets together, and chance assigned
each to a psychiatrist suited to his particular needs. These analysts acted as
midwives to their works by interpreting their nightmares, clarifying their
thoughts, and encouraging them in their creations. Owen, who in another
context might have been left to languish in trauma, benefited from intensive
therapy under Dr. Arthur Brock. Brock’s interest in science, sociology,
folklore, Greek mythology, and nature studies accorded with Owen’s. It was
Brock who expanded Owen’s horizons and gave him the self-confidence to
tackle sundry outside tasks and restore his mental balance. Sassoon, in
contrast, enjoyed intellectual engagement with his psychiatrist, Dr. William
Halse Rivers, who did not trouble him with the outside activities that Brock
imposed on Owen. Had Rivers treated Owen and Brock been responsible
for Sassoon, this would have been a different story. Had both young officers
been sent to different hospitals, they would not have met, and the poems
they wrote would have been vastly different from the masterpieces the
world knows.
 Following the disaster of the Somme, the War Office opened new
hospitals expressly to deal with shell shock and treat what had become an
epidemic. The best was a place in Scotland called Craiglockhart.
. . . in this battle of Marathon . . . Epizêlus, the son of
Cuphagoras . . . was in the thick of the fray, and behaving himself as
a brave man should, when suddenly he was stricken with blindness,
without blow of sword or dart; and this blindness continued
thenceforth during the whole of his after life. The following is the
account which he himself, as I have heard, gave of the matter: he
said that a gigantic warrior, with a huge beard, which shaded all his
shield, stood over against him; but the ghostly semblance passed
him by, and slew the man at his side. Such, as I understand, was the
tale which Epizêlus told.

—The History of Herodotus, book 6, chapter 117, translated by George

The Hydro

H istorians surmise that Craiglockhart took its name from the Scots
Gaelic Creag Loch Ard—“crag or hill [on] the high lake,”
although the hill boasts neither lake nor great height. There is a
pond, but men dug it long after the outcrop received its name. Its twin
peaks, known as Easter and Wester Craiglockhart hills, lay claim to the
lowest altitude—a bare two hundred feet above the sea—among seven hills
that, like Rome’s, defined the topography of Scotland’s capital city. A stone
castle protruded from the crag until the thirteenth century, but it played no
significant role in the country’s turbulent history of dynastic and religious
wars. It was already rubble when the Act of Union sealed Scotland’s
connection to England in 1707. By the nineteenth century, a southwestern
suburb of Edinburgh, Slateford, had absorbed the crag while retaining it as a
rural sanctuary.
The crag’s woods and meadows afforded a pastoral retreat from the
somber stone mansions, filthy tenements, and notoriously disputatious
politics of the city. Craiglockhart boasted unpolluted air, pure underground
water, and panoramic views, not only of Edinburgh’s spires a mere three
miles northeast, but of the Firth of Forth estuary and the twenty-mile ridge
of green wilderness known as the Pentland Hills. These natural advantages
of curative waters, smokeless skies, invigorating vistas, and proximity to
the capital’s wealth attracted a company of canny Scots merchants to erect a
health spa of gargantuan proportions on thirteen fertile acres.
 Expense was the least consideration for investors who engaged two of
Scotland’s most prestigious architects, John Dick Peddie and Charles
George Hood Kinnear, in 1877 to design the extravagant Craiglockhart
Hydropathic Institution. This was the era of sumptuous health retreats for
beneficiaries of Britain’s growing imperial bounty to “take the waters.”
More than twenty such establishments sprang up in late nineteenth-century
Scotland beside the lochs and up the glens, promising respite from counting
houses, mills, and coal-infused air. Peddie and Kinnear adopted a design
similar to another luxurious spa they were building forty miles northwest of
Craiglockhart, near the town of Dunblane. Both hydros would be massive
fortresses of fine-cut ashlar sandstone playfully mixing Italian Renaissance
motifs with the stolid mass of a Scots baronial manor.
In 1878, workers demolished an old farmhouse, laid foundations, and
erected scaffolds on a grassy hillock facing west from Wester Craiglockhart
Hill. Over the following months, the villa’s imposing 280-foot-wide façade
took shape, soaring from deep basements up three stories of bay windows
and a classical balustrade to a pitched gray slate roof. Peddie and Kinnear
mimicked fashionable styles from Doric columns on second-floor windows
to a Japanese pagoda capping the five-story central tower’s Italian
belvedere. Wings at either end stretched behind and housed four floors of
long corridors and multiple bedrooms. Turret-like gables and chimneys at
irregular intervals lent the otherwise brooding structure a fairy-tale aura. A
50-by-20-foot swimming pool with Turkish bath in the basement offered, in
the promoters’ words, “all the varieties of hot and cold plunge, vapour,
spray, needle, douche and electric baths.”
Outdoors, gardeners cleared pathways through a forest of beech and
Scotch pine. The landscape provided acres of lawns for an archery range,
bowling greens, tennis courts, and croquet grounds. Harried Scottish
burghers could exercise without straining themselves.
The mock classical exterior belied interior conveniences as modern as
any in Victorian Britain, including indoor plumbing for water closets,
showers, and baths. The Tobin system of interior ventilation, metal tubes
within wall cavities to recirculate the air, filtered smoke from the many
fireplaces in bedrooms and common rooms alike. Guests could tumble out
of bed, step down a marble staircase, and skip along the 140-foot hallway to
the dining room for a full breakfast of porridge, eggs, bacon, sausage, black
pudding, toast, and tea. From there, they could wander into the billiard
room, reading room, or Recreation Hall. Those in need would find the
office of the medical superintendent, Dr. Thomas Duddingston Wilson, on
the ground floor.
The Craiglockhart Hydropathic’s elegant portals opened to Edinburgh’s
“worried wealthy” in 1880. Carriages and hansom cabs deposited patrons
from Edinburgh at the foot of the stone walkway leading up a grass verge to
the villa. Guests, while valuing the Hydro’s amenities, proved too few to
cover the costs of construction, maintenance, staff, and taxes. The owners
sold it in 1891 to a fellow Scotsman, fifty-year-old architect James Bell.
Bell already managed Peddie and Kinnear’s Dunblane Hydro, which he left
to live and work at Craiglockhart as principal shareholder and managing
director. He renamed it the Edinburgh Hydropathic.
Accompanying Bell to Craiglockhart was Dunblane’s head gardener,
forty-one-year-old Henry Carmichael. The rugged and conscientious
Carmichael brought his wife, Catherine, and their eleven children to live in
one of the “Hydro Cottages” on the Craiglockhart property. Two of the
older boys assisted their father with the lawns, shrubs, flowers, and woods.
Catherine bore two more children, Archibald, known as Archie, and
Elizabeth, at Craiglockhart. In tribute to Henry’s employer, Elizabeth’s
middle name was Bell. Soon after the girl’s birth, Catherine contracted
typhoid. No doubt weakened from bearing and rearing thirteen children, she
died on August 1, 1894. Henry cared for the children with the help of his
oldest daughter, Janet, until 1897, when he married again. His second wife,
Mary Comrie, gave the family one more son, John, and another daughter,
Euphemia.
Like the Carmichael family, Craiglockhart’s gardens flourished. Henry
and his older sons seeded and mowed grass fields for the Hydro to host the
Scottish Croquet Championship in July 1897. The precision with which the
Carmichaels nurtured the grounds led to the championships’ taking place