Some of the most famous factual and fictional accounts of the Great War are by those who fought in it, suffered its horrors, and lived to tell their tales. By coincidence or design, many classic works appeared in a clump in 1929, a decade after the Treaty of Versailles: Robert Graves’s Goodbye to All That, Richard Aldington’s Death of a Hero, Frederic Manning’s The Middle Parts of Fortune and, possibly the best of them all, Erich Maria Remarque’s All Quiet on the Western Front. The same year saw the publication of two very different books by two American novelists who drew on war experience of another nature: A Farewell to Arms by a former ambulance driver on the Italian front, and The Forbidden Zone by Mary Borden, a nurse who ran a French Army field hospital in Belgium—both cases being vital reminders that in war lives can be saved as well as lost.

There was, however, one singular book about the war that was written and published as it raged. Ellen N. La Motte penned the thirteen fictionalized vignettes that comprise The Backwash of War between 1915 and 1916 while working at Borden’s military field hospital. The Atlantic Monthly published some of those sketches separately, and then in 1916 they were collected together in one volume. This year marks the book’s centenary—and yet few know it.

For The Backwash of War remains something of an overlooked or underappreciated curio. La Motte’s current standing is as a minor, marginalized, or downright obscure figure, a pale imitation of better known nurses-turned-writers such as Borden and Vera Brittain. But to ignore her valuable contribution to First World War literature is to be deprived of a graphic, vivid, and incisive portrait of human barbarity and folly, conflict and compassion. One hundred years on, a reappraisal—which for many will be more a case of discovering than revisiting—seems not only apt but also necessary.

La Motte was born in Louisville in 1873 and studied nursing at The Johns Hopkins Hospital in Baltimore. After graduating she stayed on as a supervising nurse, and later moved on to take up nursing posts in both Italy and Missouri. She returned to Baltimore in 1905 to work as an Instructive Visiting Nurse specializing in the treatment of tuberculosis, and it was from here that La Motte’s career took off and her reputation spread. By 1913, she was Superintendant of the Tuberculosis Division of the Baltimore Health Department (and the first woman to hold an executive position there); in the same year she took a leave of absence and widened her expertise by reporting for TheBaltimore Sun on the agenda, and the plight, of suffragettes in London; and in 1914 she combined her writing and medical skills, and consolidated her status, with the publication of her first book, The Tuberculosis Nurse.

A graphic, vivid, and incisive portrait of human barbarity and folly, conflict and compassion.

When war broke out, La Motte became one of thousands of American women who volunteered to help in Europe. She wrote to her friend Gertrude Stein in Paris for advice. Stein gives her a mention in The Autobiography of Alice B. Toklas: “Ellen La Motte was an ex Johns Hopkins nurse, wanted to nurse near the front. She was still gun shy but she did want to nurse at the front.” Following an unproductive stint at the American Hospital in Paris where she felt her efforts were squandered, La Motte met Borden and decided to join her team at her field hospital. Based just ten kilometers from the front line, La Motte quickly overcame her gun-shyness.

In her introduction to The Backwash of War (a book that is dedicated to Borden, “the little boss”), La Motte records the boredom she endured in the hospital during periods of ceasefire and deadlock. “The slow onward progress stirs up the slime in the shallows,” she writes, “and this is The Backwash of War. It is very ugly. There are many little lives foaming up in the backwash. They are loosened by the sweeping current, and float to the surface, detached from their environment, and one glimpses them, weak, hideous, repellent.” And so La Motte starts as she means to go on. Instead of soft-focus, propagandistic tales of valor she shows us “the other side”—gritty, grainy snapshots of war in all its filth, tedium, and merciless waste.

The book begins with a bang. A soldier, unable to tolerate his ordeal any longer, fires a revolver through the roof of his mouth. But he botches his suicide and, screaming in pain due to a torn-out eye and a bullet lodged in his cranium, is admitted to the Salle of the Grands Blessés to join other seriously wounded soldiers—the difference being these men are all fighting to survive. In a later sketch we learn of a young pilot who successfully killed himself by flying while drunk. “There is a dirty sediment at the bottom of most souls,” La Motte notes. “War, superb as it is, is not necessarily a filtering process, by which men and nations may be purified.”

Another sketch, “The Interval,” sees La Motte transcribing the cyclical, mechanical rhythm of war. “This is the day of an attack. Yesterday was the day of an attack. The day before was the day of an attack.” An endless procession of ambulances and stretcher-bearers deliver fresh supplies of “broken, ruined men” to the operating room. La Motte and her team fall in and work like automatons, slaves to an awful, numbing, uninterrupted routine. When men die they replace the bloody sheets with clean ones and wait for “the next agonizing man.” The title of the piece refers not to an eventual lull in hostilities but to the brief stage before a dying breath—a short, messy limbo, a small patch of no-man’s land where a floundering man is rendered “gross, absurd, fantastic.”

In All Quiet on the Western Front, Remarque’s ground-down soldiers are gradually dehumanized, to the point where the narrator declares: “We have turned into human animals.” In Parade’s End, Ford Madox Ford makes his soldiers even more inanimate, showing them tossed around “as if they were nuts willfully picked up and thrown over the shoulder by magpies.” La Motte employs a different technique. While her nurse—clearly modeled on herself—remains anonymous and unknowable throughout, her patients are named and fleshed out. Though barely breathing, they are duly brought alive. The effect is striking. We witness cannon fodder with a face, a personality, a background. In being presented with a fleeting glimpse of a life, there is a particular poignancy when it is ultimately and prematurely snuffed out.

The book’s ragtag cast of shell-shocked, battle-scarred men includes Marius, a Paris taxi-driver in happier days, who pollutes the ward with the stench of his wounds and his foul tirades against anyone in his vicinity, and Rochard (“Little man, gardener by trade, aged thirty-nine, widower, with one child!”), also afflicted with gas gangrene, who dies alone and unloved. Rollin winds down while staring at his medals hanging above him, and Grammont fades out twenty minutes before he is due to receive the Croix de Guerre. Only once, in the ironically titled “A Surgical Triumph,” do we encounter an unknown soldier. La Motte’s focus here, however, is on Antoine, a Paris hairdresser, and his devastation on visiting the hospital and viewing his mangled, limbless wreck of a son.

We witness cannon fodder with a face, a personality, a background.

Not every parent reacts the same way. A ten-year-old Belgian boy is caught in crossfire and bawls for his mother, but when she is summoned to see her dying son she comes reluctantly, annoyed at being dragged away from her family. After giving her son a perfunctory kiss, she asks to be taken back to Ypres—and with that, La Motte’s tragedy in miniature is complete. Other women—wives, lovers—are denied such cameos, for they are deemed bad for the morale of soldiers and so not permitted into the war zone. Prostitutes from Paris are also not admitted, although as La Motte informs us with a rare display of primness, “the Belgian girls made such fools of themselves, the others weren’t needed.”

In the main, La Motte’s tone is simple and direct, bordering on blunt. Her nurse is of the no-nonsense variety, and her duties and her challenges are conveyed starkly, unsparingly, with warts-and-all detail. When cracks appear in the stoic façade and emotion trickles through, it is largely frustration at shoddy conditions and procedures. The dearth of good doctors at the field hospital, all being either too old or too inexperienced, leads La Motte to remark that in order to care for the wounded at all, “it was necessary to furbish up the immature and the senile.” On occasion that frustration hardens into disgust. German shells have made the men in her care “ludicrous, repulsive.” Many moan pathetically for their “stupid little wives.” At one low ebb, while tending to a wounded deserter, she evaluates her “dead-end occupation” and wonders what is more futile: “nursing back to health men to be patched up and returned to the trenches, or a man to be patched up, court-martialed and shot?”

This kind of demoralizing depiction of the consequences of war ruffled feathers once American soldiers began fighting and dying on the Western Front, and in 1918 La Motte’s book was banned—or, as she put it, “suppressed”—by the American government. By that point, she was no longer in Europe. Two years earlier, finally exhausted by frontline nursing, she left for China where she saw first-hand the destruction caused by the opium trade. Over the next couple of decades she went on to publish three books on the topic, together with several collections of stories inspired by her travels in Asia. She died in Washington, D.C. in 1961.

If La Motte’s books on tuberculosis and opium are learned, meticulously researched manuals on how to alleviate human suffering, then at first glance The Backwash of War feels slight in comparison. Rather than an in-depth, far-reaching study, it is a short, restricted, eyewitness testimony—a mere chronicle of chaos. But while La Motte could only do so much, she did it well and charted it powerfully, trenchantly, and memorably. Instead of answers, she gives us insight. Hope is in short supply throughout (no one in the field hospital could have believed this was the war to end all wars), cynicism reigns supreme, and grim scenes are made even grimmer by “the everlasting Belgian rain”—but a century on and the book remains a compelling and original account of the casualties of war.

This article originally appeared in The New Criterion, Volume 35 Number 1, on page 74
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