The Sidcup Collection, held by the Royal Australasian College of Surgeons Museum, tells the story of how modern facial reconstructive surgery was born.

In the Face of Uncertainty illuminates the surgeons who pioneered these new techniques after the mechanical warfare of the First World War. It tells of the men who left Australian shores to serve their country and how their resulting facial wounds were treated.

This film is a tribute to the men and women who rebuilt the faces of these men as best they could and a tribute to the men who underwent multiple painful surgical procedures and suffered terribly. These are the faces that are never seen in photographs of early ANZAC Day parades, hauntingly sad yet a marvel of scientific innovation. These are the faces of uncertainty.

Thank You

Thank you to Geoff Down and Elizabeth Milford from The Royal Australasian College of Surgeons and Dr Andrew Bamji from the Gillies Archive, British Association of Plastic, Reconstructive and Aesthetic Surgeons.

Music Credits

New Idea For Rohan, written and performed by Cavanagh and Argus, copyright Cavanagh and Argus, 2012. Bask in this Light, written and performed by Cavanagh and Argus, copyright Cavanagh and Argus, 2012. Keep Up, written and performed by Cavanagh and Argus, copyright Cavanagh and Argus, 2012.

Image Credits

1. Film Collection Online: The First World War, Australian War Memorial. 2. Photograph - Wounded soldiers lying on stretchers on the ground waiting to be carried onto the hospital train for Cairo, A01740, Australian War Memorial. 3. Wounded soldiers in France, Sidcup Collection, Royal Australasian College of Surgeons. 4. Photograph - The interior of ward No. 7, No. 14 Australian General Hospital (AGH) with patients and staff, 1918, B00655, Australian War Memorial. 5. Photograph - Kent, England. Queen Mary (centre) escorted by an unidentified officer, Sister Edith Horton (far right) and another unidentified nurse visiting a patient with a heavily bandaged face at Sidcup Hospital in Kent, P03040.001, Australian War Memorial. 6. Photograph - A group of five men from No. 9 Ward, soldiers wounded during the First World War, playing cards sitting outside one of the verandahs of the Keswick Repatriation Hospital, 1925, P03845.001, Australian War Memorial. 7. Photograph - A nurse at Antwerp Hospital tending to a heavily bandaged Belgian patient whose face and arms have been severely wounded by shell splinters, P02693.004, Australian War Memorial. 8. Postcard of the Queens Hospital Sidcup (1917-1929), permission of Dr Andrew Bamji, Gillies Archivist, British Association of Plastic, Reconstructive and Aesthetic Surgeons. 9. Postcard of the Queens Hospital Sidcup (1917-1929), permission of Dr Andrew Bamji, Gillies Archivist, British Association of Plastic, Reconstructive and Aesthetic Surgeons. 10. Postcard of the Queens Hospital Sidcup (1917-1929), permission of Dr Andrew Bamji, Gillies Archivist, British Association of Plastic, Reconstructive and Aesthetic Surgeons. 11. Australian medical staff at Sidcup, Sidcup Collection, Royal Australasian College of Surgeons. 12. Photograph - Portrait of Major (Maj) Henry Simpson Newland, Australian Army Medical Corps (AAMC), at No 1 Australian Stationary Hospital, c. 1915, C02293, Australian War Memorial. 13. Henry Newland in his office at Sidcup, Sidcup Collection, Royal Australasian College of Surgeons. 14. Photograph – One of a series of thirteen photographs showing stages of surgical reconstruction in the case of a man wounded in the face, particularly the jaw. The imperial or queens hospital at Sidcup, Kent, 1918, P01077.006, Australian War Memorial. 15. Private Arthur Mears diagnostic diagram, Sidcup Collection, Royal Australasian College of Surgeons. 16. Private WH Thomas watercolour by Daryl Lindsay, Sidcup Collection, Royal Australasian College of Surgeons. 17. Private WH Thomas diagnostics photograph, Sidcup Collection, Royal Australasian College of Surgeons. 18. Etching of Sidcup Surgery by Lionel Lindsay, Sidcup Collection, Royal Australasian College of Surgeons. 19. Daryl Lindsay and colleagues, Sidcup Collection, Royal Australasian College of Surgeons. 20. Private GJ Wallace watercolour by Daryl Lindsay, Sidcup Collection, Royal Australasian College of Surgeons. 21. Private Kearsey watercolour by Daryl Lindsay, Sidcup Collection, Royal Australasian College of Surgeons. 22. Private GJ Wallace diagnostic photograph, Sidcup Collection, Royal Australasian College of Surgeons. 23. Private GJ Wallace post surgery photograph, Sidcup Collection, Royal Australasian College of Surgeons. 24. Private Kearsey diagnostic photograph, Sidcup Collection, Royal Australasian College of Surgeons. 25. Private Kearsey diagnostic photograph, Sidcup Collection, Royal Australasian College of Surgeons. 26. Daryl Lindsay in his studio at Sidcup, Sidcup Collection, Royal Australasian College of Surgeons. 27. National Archives of Australia: First Australian Imperial Force Personnel Dossiers, 1914-1920; B2455, PRITCHARD Charles Ernest, 1914 – 1920, 1023540. 28. Private Charles Pritchard watercolour by Daryl Lindsay, Sidcup Collection, Royal Australasian College of Surgeons. 29. Private Charles Pritchard diagnostic photograph, Sidcup Collection, Royal Australasian College of Surgeons. 30. Patients in the snow at Sidcup, Sidcup Collection, Royal Australasian College of Surgeons. 31. Patients at Sidcup, Sidcup Collection, Royal Australasian College of Surgeons.32. Postcard of the Queens Hospital Sidcup (1917-1929), permission of Dr Andrew Bamji, Gillies Archivist, British Association of Plastic, Reconstructive and Aesthetic Surgeons. 33. Henry Newland and patients at Sidcup, Sidcup Collection, Royal Australasian College of Surgeons. 34. Patients at Sidcup, Sidcup Collection, Royal Australasian College of Surgeons.

35. Film Collection Online: The First World War, Australian War Memorial. 36. Photograph – One of a series of thirteen photographs showing stages of surgical reconstruction in the case of a man wounded in the face, particularly the jaw. The imperial or queens hospital at Sidcup, Kent, 1918, P01077.010, Australian War Memorial. 37. Photograph – A wounded AIF soldier receives an affectionate welcome home at the Anzac Buffet in The Domain in Sydney, 1918, H11574, Australian War Memorial. 38. Photograph – A seriously wounded AIF soldier being carried off a hospital ship just arrived in Australia, 1915, H11573, Australian War Memorial. 39. Private Charles Pritchard diagnostic photograph, Sidcup Collection, Royal Australasian College of Surgeons. 40. Private Charles Pritchard post surgery photograph, Sidcup Collection, Royal Australasian College of Surgeons. 41. Private Arthur Mears diagnostic photograph, Sidcup Collection, Royal Australasian College of Surgeons. 42. Private Arthur Mears post surgery photograph, Sidcup Collection, Royal Australasian College of Surgeons. 43. Australian medical staff at Sidcup, Sidcup Collection, Royal Australasian College of Surgeons.

Further Information

TRANSCRIPT

NARRATOR: The following film contains themes and graphic imagery that may disturb or offend some viewers.

GEOFFREY DOWN: My name's Geoffrey Down and I am the Curator at the Royal Australasian College of Surgeons. I look after all the historical collections in association with archives and collections.

The College of Surgeons was founded in 1927 and it's an educational institution. It was founded to establish and maintain a certain level of standards in surgery. The most significant possession I think is the Sidcup Collection. So this collection here is now the most complete collection, I think, in the world of maxillofacial surgery of the First World War.

NARRATOR: Maxillofacial surgery relates to injuries of the mouth, teeth, jaws and face.

The Sidcup Collection comprises patient files, photographs, x-rays, facial casts and sketches, which all relate to the facial reconstructive surgery pioneered during the First World War. Some of the material is quite graphic and confronting.

GEOFFREY DOWN: The First World War is different from just about all other wars that went before because it was war on an industrial scale and it was, you know, death, carnage and destruction on an industrial scale.

There were two major types of injury in the First World War both of which were mechanical. One was from bullet wounds and the other was shrapnel. If you stuck your head up above the trench you were likely to get a bullet in the head.

NARRATOR: Doctors had never seen such horrific injuries of this scale and nature before and lots of soldiers died from wounds that could have been treated.

As the war progressed, so did medical science and practice. As a result Soldiers suffering horrific facial wounds began to come off the battlefield alive, but these men were in a terrible condition and required specialised treatment.

GEOFFREY DOWN: The problem was that they found that these men would have large tracts of bone taken away, they would lose their jaws, they'd lose their noses and there was no was no way they could be properly fixed. They couldn't eat properly, they could breathe properly, they couldn't speak, they couldn't do anything basic and so this was an emerging problem in the First World War. So by 1917 they decided to do something about it and set up this hospital.

NARRATOR: It was the passion and determination of New Zealand Surgeon Harold Gillies that led to the establishment of a specialised hospital for soldiers suffering facial injuries.

The Queen Mary Hospital, in Sidcup, Kent, just outside of London, operated from 1917 until 1925 for this purpose.

GEOFFREY DOWN: The Sidcup Hospital was arranged by country according to, virtually according to the Divisions of the British Empire basically. Australians and New Zealanders, British, Canadians. The person in charge of the Australian section was Sir Henry Simpson Newland and he was really the first person in Australia to perform plastic surgery seriously. He'd got involved in it and interested in it before the First World War in Adelaide.

There were virtually no rules and they had to make it up as they went along. They had to rebuild faces from scratch. Now there's some faces which could not be rebuilt. We have here in our collection some very horrific and confronting images of men that whose faces completely blown away and there's only a fragment left. There is nothing you can do about that. You had to put on a mask that looked like the phantom of the opera basically, to, to hide the disfigurement.

NARRATOR: The surgeons working at Sidcup used trial and error to undertake the reconstructive surgery. They knew a little about ancient rhinoplasty techniques and how to reset teeth and used bone plates to patch fragmented jaw bones back together again.

They used basic materials like leather, cast iron and brass and developed various diagnostic tools so they could better understand their patients... injuries.

GEOFFREY DOWN: They had Daryl Lindsay for example, in the Australian section, doing full colour drawings of the wounds. Daryl Lindsay was recruited as a war artist and later in life he became Director of the National Gallery of Victoria. And of course, there were copious photographs, photographs from every single angle of it. And there were various things too, before, during, after. That's always a bit of a, something that intrigues people, why when you've got photographs, why would you do such a thing? The watercolour sketch gives you something about the patient's whole being, about the internal life, as an artist can see.

And also most importantly the casts because in the days before computer imaging the cast was really the only way that you could get a three dimensional image of what you were dealing with, they really had to get some idea of how they were going to reconstruct this person, (a) to make, make them functional again, being able to breath and being able to eat and drink and be able to speak and then make them look good. Now making them look good was only secondary.

NARRATOR: One of the men treated at Sidcup Hospital was Australian soldier Charles Ernest Pritchard. He was barely 23 when he enlisted, and left Australia for the battlefield in April of 1916, not knowing that he would come back a changed man.

GEOFFREY DOWN: He was wounded twice... he had a chest and finger wound first off and then he had a very serious facial wound and he suffered a significant facial wound. A gunshot wound to the jaw which did a considerable amount of damage to him but it's not nearly as horrific as some of the images that we've got both in, in Daryl Lindsay's sketches and in the photographs.

NARRATOR: Sidcup was surrounded by quaint English countryside, but for the patients life was far from idyllic. They spent months or years undergoing multiple surgical procedures and recovering from the horrors of their wartime experience.

GEOFFREY DOWN: One of the ladies, she was an American nurse, she said ...there are bits and pieces there but there are no men... That's a rather sad thing to say. But some of these men understandably were quite devastated not just physically, but emotionally, by what had happened to them and it was just lots and lots of TLC to get these men back into some sort of shape inwardly so they could get out and face the world.

And I think there was lot of camaraderie between them because in any situation like that where you've got men who've suffered, similar injuries, they will sit around and talk about them and I think that's how maybe they got them started, to just talk to each other about their injuries.

A lot of them suffered when they came back because you know, before iphones were invented, you could go away to the war and no-one would see you for four or five years and when you came back home, with these sorts of disfigurements, the reaction from your family and community would be highly unpredictable. Some families and communities said, yes you've gone away, you've suffered this terrible injuries when fighting for King and Country, yes you've done your duty, that's fine, others were, were totally rejected and there are some very sad stories came out of that. Nevertheless these surgeons at Sidcup had done their level best to try and get these people back into some sort of working condition, functioning order.

The whole of modern plastic reconstructive surgery comes from this period and the collection here, as I've said, is significant because it now constitutes the most comprehensive complete archive of what they did.