We know so much about PTSD and the effects of warfare and combat these days, it’s hard to believe that it wasn’t always the case. But during the First World War ‘shell shock’, as it was known back then, was treated with far less compassion. In fact, a soldier presenting with the now-familiar symptoms of panic and anxiety, headaches, mood swings, amnesia or tremors was more likely to find themselves accused of cowardice.
The very term ‘shell shock’ wasn’t even heard of until 1915. It was originally coined in an article in The Lancet by Charles Myers to explain the disturbing symptoms experienced by soldiers from the British Expeditionary Force during the Great War. Doctors believed that shock waves from exploding artillery shells caused some kind of unseen damage in the brain, or even that it might be caused by carbon monoxide poisoning. It wasn’t until 1917 that it was recognised as an emotional rather than physical injury requiring psychiatric treatment.
Prior to that, stricken soldiers would be taken from the trenches for a few days’ rest, if they were lucky. There was a shortage of fighting men, and unless they were physically injured, they would be considered fit to fight. Otherwise they would be labelled cowards, or ‘LMF’ – lacking in moral fibre.
But we’re not talking about a case of the jitters here. Shell shocked patients could suffer from hysterical blindness or deafness, they could lose the power of speech, even forget how to walk. You can find some truly shocking images, including film of such patients, online. But be warned, they’re not for the faint-hearted.
In 1917, after the Battle of Passchendaele, things began to change. Shell shock patients were treated at a dedicated psychiatric centre set up close to the front line. If they could not be helped, they would be sent back home. There were so many officers and men suffering from shell shock that no less than 19 military hospitals were wholly devoted to treating them.
Which is where my book, Nightingale Wedding Bells, comes in. After three years of looking after the horrific physical wounds of the soldiers, the nurses of the Nightingale Hospital now find themselves facing a new challenge with the opening of a new shell shock ward.
Not all of them rise to that challenge. Staff nurse Dulcie Moore shares the view of many ‘genuinely’ wounded patients, that the men on the shell shock ward are malingering cowards working their ticket home. She’s far more interested in Robert Logan, the dashing doctor in charge of the ward. Meanwhile her friend Grace Duffield takes the trouble to get to know the suffering soldiers and quickly discovers their distress is all too real.
It’s all too real for my main character Anna, too. Her experience of shell shock is brought close to home when her fiancé Edward is admitted to the hospital after being injured in battle. As his physical wounds heal, it seems Edward is on the mend. But as Anna discovers, some wounds are more than skin deep…
I hope you enjoy Nightingale Wedding Bells. It’s a book about overcoming odds and finding hope and happiness in the unlikeliest of places.
Nightingale Wedding Bells by Donna Douglas is published by Arrow, priced £7.99, out now.