BY Lindsey Fitzharris
THE WASHINGTON POST – If the face is the mirror of the mind, as Saint Jerome observed, then what happens when the face is disfigured by the savagery of war? “Whereas a missing leg might elicit sympathy and respect,” Lindsey Fitzharris wrote in her examination of World War I facial injuries and repairs, “a damaged face often caused feelings of revulsion and disgust”.
Her book The Facemaker: A Visionary Surgeon’s Battle to Mend the Disfigured Soldiers of World War I conveys the emotional, physical and psychical effects of having an injured and altered face, directly from those who had to deal with them.
That’s both the soldier-patients and the medical personnel who cared for them, tried to heal them and sometimes could only stand helplessly alongside them.
Medical historian Fitzharris anchors her story around Harold Gillies, an innovative plastic surgeon who dedicated his practice – and indeed his life – to facial reconstruction.
For each of Gillies’ new procedures or experimental interventions, Fitzharris offers a long history of plastic surgery, acknowledging the debts Gillies and others had to, in particular, Indian and Chinese doctors as well as more recent Western approaches.
In many ways, this is the story of a hero. Gillies not only pioneered a number of important plastic surgery techniques but also was profoundly committed to giving disfigured soldiers back their dignity.
He treated their bodies and, Fitzharris makes clear, their minds and souls.
Gillies was, in her rendering, not just a surgical trailblazer but also a key figure in expanding what counts as health and what counts as treatment.
The importance of the face – of appearance – in how we understand ourselves and how others understand us has a very long history; the ability to intervene in such powerful ways, electively or otherwise, is rather newer.
War has always driven developments in medicine and healing, partly because it creates so much need. Gillies met that need in more ways than one.
There are a lot of powerful stories in this book. But Gillies’ heroism isn’t quite enough to drive a narrative.
The soldiers are treated gently and with respect, although we don’t really get to know them enough to distinguish them from one another.
I’m not sure we could, with the limited material available, but there is an ache, a kind of loss in this series of snapshots. Fitzharris is presented with a tricky dilemma: how to honour these men as people in their own right, and not just experimental subjects or links in the chain of Gillies’ research agenda.
Gillies, Fitzharris makes clear, did not view them that way; the research was in service of them rather than them providing an opportunity for research.
Fitzharris sticks close to the procedures, the operations and the soldiers who underwent them.
Gillies’ own life takes a back seat, though we have some biographical details.
We don’t always know what the soldiers thought about it all. That’s understandable: Fitzharris has pieced together this series of vignettes from soldiers’ letters, combined with Gillies’ records and hospital archives.
Along the way, we learn a great deal about hospital administration, health care on the front and the staggering efforts required to save even a few lives in highly turbulent conditions.
We learn about bravery, as well as profound commitment to and respect for human life in a situation designed to eradicate both. We learn straight from the soldiers themselves.
We already knew that pain is real. That faces matter. That disability lies as much in how others treat people and how the world does or does not accommodate differences in bodies and minds. That doesn’t make the soldiers’ testimony any less powerful, empathetic and meaningful.