War and medicine - 100 years after the Great War

From 1914's grim reality to today's virtual reality, this mini documentary looks at how health care played a key role in the 1914-18 war. It hears how most soldiers actually survived the trenches, but were at great threat from infection and disease. Today's combat treatment can often be traced back to improvements made in the Great War. But does this mean that war is good for medicine?
This photostory shows what a soldier fighting in World War I could expect in terms of weapons he could face, injuries he could expect and healthcare he would receive. Warning: some may find certain images disturbing.
There were many medical challenges to the military over the last century. One of them, sexually transmitted diseases, may seem trivial to today's eyes. But in the days before penicillin, this kind of condition could take thousands of men out of action. Isabel Fernandez reviews essays on this and other lessons from 'Medicine and Modern Warfare'.
How do developments of military medical care in the last century look to a military medic? NATO Review asked the medical advisor to the NATO International Military Staff to provide an outline of how he sees the changes in treatment, approach and attitude to treating injuries over the last century - and the effect they've had on how the military works.
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The quote for this edition of NATO Review comes from the war poet Siegfried Sassoon, who served on the Western front during World War I. Despite multiple attacks and battles costing millions of lives, the front’s battle line barely changed during the war. Seeing the industrialised carnage and futility of that combat turned Sassoon from a patriot who had voluntarily signed up for the army to a man who conscientiously objected to being sent back.

The quote for this edition of NATO Review comes from the war poet Siegfried Sassoon, who served on the Western front during World War I. Despite multiple attacks and battles costing millions of lives, the front’s battle line barely changed during the war. Seeing the industrialised carnage and futility of that combat turned Sassoon from a patriot who had voluntarily signed up for the army to a man who conscientiously objected to being sent back.

When he refused, rather than being court martialled, he was sent for treatment for shellshock. This highlights how shellshock was a catch-all term for many conditions.

In this edition’s video, we hear how some doctors even officially described shellshock as a sign of femininity. That it was applied to Sassoon, who was not only decorated for his daring attacks on the enemy but was seen as almost suicidally brave by some of his fellow soldiers, shows how flexible and inaccurate the term ‘shellshock’ was.

Today, we know a lot more about how combat affects soldiers. But it’s not just medical advances that have changed. It’s that we also want to know more. Today, with fewer soldiers and doctors to go round, this kind of understanding is not a luxury.

The efforts invested into understanding and addressing post traumatic stress disorder (PTSD) contrast greatly with the treatment of soldiers with shellshock 100 years ago. Then, many sufferers were simply removed from society, seen as weak links. Today, attempts at doing the opposite – a full reintegration into society – is the goal.

Whether we can trace this kind of advance back to what happened in World War I is still debated. But what is clear is that medical lessons learned in World War I – such as quicker treatment, the need to stem bleeding, the importance of controlling infections, etc – played some kind of role in pushing forward the medical innovations which continue today. And that perhaps is one of the few good things to come out of what has been called ‘the Great War’.

Paul King