Marie Allitt, Medical Caregiving Narratives of the First World War: Geographies of Care

Marie Allitt, Medical Caregiving Narratives of the First World War: Geographies of Care (Edinburgh: Edinburgh University Press, 2023), 264 pp. £85 Hb. Open Access Ebook. ISBN: 9781474489928

Marie Allitt’s Medical Caregiving Narratives of the First World War makes a significant contribution to critical medical humanities and First World War studies by offering the first extensive study of caregivers’ points of view in this context. She draws her thesis primarily from the writings of British, American, and Canadian caregivers and these narratives mainly draw on medics’ experiences on the Western Front. The primary texts are chosen in a way that can familiarise the readers with a diverse range of caregiving experiences, from those written by stretcher bearers and ambulance drivers who are typically closest to the frontline of fighting to those penned by the nurses, orderlies, and doctors who work in different aid posts, clearing stations, field hospitals, and general hospitals during war. Allitt’s text furthers our understanding of the medical landscapes in general and the caregiving experiences of medics working within First World War spaces, in particular.

The book is divided into five chapters. The first two chapters focus extensively on the landscape of the military-medical environment. Chapter 1, ‘Corpography: Reconceptualising Somatic Geographies’, deploys Derek Gregory’s geographical concept of ‘Coporgraphy’ to study the experience of medics, arguing that, like combatants, the medics’ bodies are directly affected by the spatial and sensuous geographies of the war landscape, which extends into the overlapping medical spaces. Gregory’s approach to the phenomenology of the battlespace suggests that in order to survive in a battleground, military personnel often improvise their knowledge of the pre-war landscape, adjusting it according to its post-war changes and mutilations: an impersonal cartography converts into a personal experience-based corpography.[1] In this chapter, Allitt argues that caregivers’ bodies are affected similarly and this constant vulnerability and the threat of destruction enforces a state of continual stress and trauma upon them, the experience of which is often ‘more wearing than the physical strain involved’ (32). Additionally, in Chapter 2, ‘Layering: Appropriating Medical Spaces’, Allitt talks about a second aspect of medics’ interactions with physical sites of military-medical care: their negotiations with places that are disrupted, ruined, and often altered beyond their original identity to be used for medical purposes in the time of war. The medical uses of buildings and spaces which were not previously used to this end create a sense of an uncanny contrast and the chapter attempts to investigate how the caregivers deal with this strangeness of layered military-medical sites.

Chapter 3 of the book, titled ‘Protrusions, Openings, and Depths: A Medical Grotesque’, moves on to focus on the wounds and bodies of patients and the subsequent effect this has on the medic applying care in a war zone. Here, while considering medics’ representations of wounds and wound care in their narratives, Allitt develops the idea of a ‘medical grotesque’, arguing that rethinking the clinical gaze through this concept could illuminate the representational strategies medics adopt to convey the complexities and tensions of medical care. Both chapters 4 and 5, on the other hand, centre on the articulation of painful experiences by caregivers. Chapter 4, ‘Countering: Representing Coping Strategies’, explores techniques of countering distress employed by caregivers while providing care during war. Here, Allitt cites examples from and analyses several medics’ memoirs and argues that to emotionally cope during the First World War, medics move figuratively between the real and imaginary spaces which allows them ‘a place of refuge’ where they can shift their perspectives and self-reflect (145). Chapter 5, ‘Surfaces: Articulating Pain and Trauma’, on the other hand, explores the narrative shape of caregivers’ accounts to consider the absences and silences in the communication of traumatic experiences. Distancing herself from the idea which suggests that the ‘gaps’ and ‘blanks’ in writing are symptomatic of trauma, Allitt instead contends that, by exploring the ‘blank’ in medics’ memoirs, we can discover in it a mode of articulation which can, in fact, help further our understanding of caregivers’ experience of suffering during the First World War.

Through these five strong chapters, Allitt presents a rich and convincing argument that makes a significant and timely intervention in critical medical humanities. While the ‘first wave’ of medical humanities has successfully shed light on patient experiences, there has often been a potential risk of losing sight of the person in the role of the doctor (and other caregiving roles), as well as neglecting the fact that, as she acknowledges it too, the medical encounter must at its heart, be ‘interpersonal’ (5). Even though many critics, for instance, Roy Porter, have emphasised the many ways laypeople have historically challenged the pervasive authority of doctors, the trend in the first wave of the scholarship has often been to prioritise patients’ narratives using the lens of marginalisation. As valuable as this has been in broadening our understandings of human health, Allitt rightly contends that in order to understand the human connection within medical interactions, ‘we need to examine the people beneath the labels of both “doctor” and “patient”’ (5).

This reorientation indicates that rather than thinking of both of these bodies as on entirely different ends of the pain or trauma spectrum where the ‘patient’ undergoes it and the ‘caregiver’ treats and diagnoses it without really experiencing any of it, it would be more productive to see in what ways each experience of trauma interacts with, sheds light on, and nuances the other. By illuminating the distinctive experiences of caregivers – doctors, nurses, stretcher-bearers, orderlies, and ambulance drivers, among others – and crucially, the ways they represent those experiences in their writings, this book complements ongoing efforts by the scholars in the ‘second’ wave of medical humanities to understand human health from perspectives that have not traditionally been considered ‘patients’.

Vinita Singh, University of Leeds

[1] Derek Gregory, ‘Gabriel’s Map: Cartography and Corpography in Modern War’, in Peter Meusburger, Derek Gregory, and Laura Suarsana (eds), Geographies of Knowledge and Power (Dordrecht: Springer, 2015), p.91.