Author: Associate Professor Felix Behan, AM

More than 420,000 British and empire troops died in the Battle of the Somme. The devastation and annihilation with such catastrophic loss of human life is still recorded in memorials as a necessary adjunct reminder for their contribution.

The Antiques Roadshow recapped some of these events with the pencil note in longhand on aging foolscap paper from the Morse code operator of the mutual agreement between the warring factions to end the war on the 11^th hour on the 11^th day of the 11^th month in 1918.

In the musical sphere, Edward Elgar was at the height of his fame in the 1900s when someone asked him to write a memorial piece of music for the lost souls in WWI.

Snippets like these are meaningless when the British high command had ordered the troops to capture trenches where the German machine guns were housed—pure suicide—but how could they question order from the high command and then be accused of treason? 

Elgar could only write music with a soulful flavour that touched the heart, and his cello concerto epitomises this analogy and  Jaqueline du Pré’s (who had multiple sclerosis) performance gives a double significance.    

The Antiques Roadshow program featured the Battle of Fromelles war memorials with the family of a Victoria Cross recipient visiting their grandfather’s grave for the first time. His efforts of bravery, retrieving injured soldiers from no man’s land was the basis of his award, before he was killed.

The program also featured the Bible Reverend David Railton used throughout the conflict of WWI and it looked worn and torn. Then the story of the unknown soldier was featured, as indicated by a tin plaque on the grouped coffins. Brigadier Wyatt put his hand on one tin plaque and said, "this can be the coffin of the unknown soldier".  

This was followed with correspondence to the Dean of Westminster Abbey, Herbert Ryle, requesting to have the coffin of the unknown soldier buried in the Abbey as a memorial. The body was an unidentified British serviceman retrieved from one of the battle fields of Aisne, the Somme, Arras or Ypres and was transported back to England.

The funeral procession was a royal occasion with King George V in full regalia, with prancing black steeds leading the black hearse, which stopped for the unveiling of the Cenotaph, a 'symbolic empty tomb', and then proceeded to Westminster Abbey where the coffin of the unknown soldier was interred.

This war story invites me to recap some of the WWII events including the story of Archibald McIndoe, an Aotearoa New Zealand plastic surgeon and his Guinea Pig Club.

At the 2023 Annual Scientific Congress (ASC) Dr Michael Klaassen, another Aotearoa New Zealander, presented this history and recently conveyed to me the sad news about the death of the last surviving member, Jan Stangryciuk-Black at the age of 101.  

Why the name Guinea Pig Club? Guinea pigs featured in experimental biology in those times and some of McIndoe’s research and procedures could only be classified as possibly experimental.  McIndoe founded the club in 1941 recognising patients’ contributions to their WWII efforts, when they suffered from burn injuries. McIndoe observed that when their planes crash landed into the English Chanel, the saline drenching reduced the depth of the burns—now the first management line in any burns management.

Surgery is a technical gift and those that can mould and fashion reflect various facets of their personality. Never forget, surgery also has a psychological twist and plastic surgeons are sometimes called psychologists with knives—doing the right operation, on the right patient, at the right time is significant.  

In surgery, every busy surgeon looks for manoeuvres that can cut corners successfully.      

During the ward rounds McIndoe would view a patient’s staged reconstructions and assess their tolerance for more surgery. He acted on his instinct and invited them for a beer. The patient would respond, “I am too embarrassed to go into a public bar because of my scarring deformities.” McIndoe would say, “You have almost given your life for your country, the locals would love to acknowledge this and buy you a beer. Get into the Roller and we’ll go down to the Pig and Whistle.”

This became the genesis of the Guinea Pig Club and McIndoe would take the patients down to the local tavern as a form of postoperative psychological therapy—it worked. They drank in a communal gathering again, for the first time in months with life returning to a type of normal. And rather than hide their heads behind their hands in embarrassment, they became garrulous, repeating stories of their wartime crashes into the English Channel.

Mentally balanced patients have this unique facility of healing well and it is a clever surgeon who can pick if and when to operate. McIndoe’s Guinea Pig Club reflected this intrinsic intuition and instinct in patient care, where his psychological treatment went hand-in-hand with surgical ventures.  

Finally, McIndoe’s experiences of a good surgeon reflect the following:
-    When to operate
-    How to operate
-    When not to operate.