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Saving faces and lives

Cover of The Facemaker:  A Visionar
A review of The Facemaker: A Visionary Surgeon’s Battle to Mend the Disfigured Soldiers of World War I by Lindsey Fitzharris

It can sometimes be easy to forget how transformative World War I was to the course of history. A war that began with nineteenth century visions of cavalry charges to glory fatally collided with the reality of the technology of the twentieth century. The brutal carnage that the war became soon revealed that medicine, like army tactics, would have to change radically in order to address the wounds—physical and mental—of the casualties returning from battle. Particularly transformative—literally and figuratively—was the field of plastic surgery, and much of the progress was thanks to one remarkable doctor, Harold Gillies. It is not a name likely to garner much public recognition today, but that might change with Lindsay Fitzharris’ fine account of Gillies’ World War I work in The Facemaker:  A Visionary Surgeon’s Battle to Mend the Disfigured Soldiers of World War I.

Advances in medicine had progressed enormously during the nineteenth century, but plastic surgery had hardly advanced since its origins in ancient times. Better hygiene and advances in surgery led many men to survive the sort of wounds that would have killed them in the past. But for men who survived facial wounds, survival could be a mixed blessing. Soldiers missing limbs might be seen as heroes, men who would forever bear the mark of their sacrifice for country. A man missing a nose or jaw, or with severe burns to the face faced the prospect of a lifetime of shocked reactions, even horror, at the sight of their mangled faces. Not only were face and jaw cases at risk for unemployment and lost relationships, the mental toll of losing such a part of personality and means of communication led many to suicide. Gillies recognized how badly reconstructive surgery was needed for such wounds, but how to get overworked front line doctors to send him patients? He lit upon an unlikely idea: he printed his name and hospital on cards labeled for facial wounds, distributed them to medical stations along the front and waited for patients to arrive. Remarkably, they did. Fitzharris writes how Gillies marshalled fellow doctors, dentists, and some unlikely players such as artists and socialites to his cause. With facial reconstruction still in its nascent stages, the keys to Gillies’ success was collaboration and experimentation. Each patient was a case study scrupulously documented and studied, as each man necessarily needed individual procedures that sometimes required months of healing. Even relative basics like how soldiers with facial injuries were transported from the field had to be reconsidered, with every failure—of which there were many—heartbreaking to the teams of doctors and nurses. Fitzharris handles the progress of the patients sensitively, avoiding turning patients into curiosities and only identifying by name those who successfully completed treatment. The individual stories of each soldier’s injury and transformation, as well as efforts by doctors and nurses to make the men whole mentally as well as physically, make for gripping reading.

Fitzharris writes with a clarity that makes complicated procedures understandable to the layperson, and a sense of storytelling that makes her writing fly by. Readers wishing to follow up on particulars can check the comprehensive notes Fitzharris provides. Fans of popular science or history authors such as Sean Kean, Mary Roach or Erik Larson will find plenty to like here, nor will history buffs and general readers of nonfiction won’t be disappointed.

Sep 19, 2022