One hundred years ago this November 11, World War I, the “first calamity of the 20th Century,”1 ground to a close. In its wake lay 16 million dead, the collapse of four empires, the weakening of two others, and the seeds of subsequent tragedies. Alone among the great powers, the U.S. emerged a stronger nation.
The war ended what economic historians have called the first age of globalization—a period of increasing international trade and communication. Surgeons participated actively in this interconnected world, and by the first years of the 20th century, a network of knowledge exchange existed among the world’s leading surgeons.2 For example, in 1913, prominent European surgeons paid 12 visits to the Mayo Clinic, Rochester, MN, and William Mayo, MD, FACS, a founder of the American College of Surgeons (ACS), himself made two separate trips to Europe. The war shattered this network, to the regret of many. As British surgeon Berkeley Moynihan, KCMG, CB, FRCS, FACS(Hon), wrote to Dr. Mayo in August 1914, “Many of us…are sorry to be at war with Germany—for individually we have many friends there.”3
ACS enters the war effort
The sympathies, however, of many leading College figures, particularly Franklin H. Martin, MD, FACS, lay with the Allies. From early 1915, several hospital units organized by Fellows, including ACS Regent George Crile, MD, FACS, served in France.4 The loss of Marie Depage, wife of the well-known Belgian surgeon, Antoine Depage, in the Lusitania sinking on May 7, 1915, strengthened these sentiments (see Figure 1). Madame Depage, a nurse, had been touring the U.S. to raise funds for the Belgian Red Cross and her husband’s war hospital. While touring, she received enthusiastic support from Drs. Martin and Mayo. Her death personalized the tragedy of war for many American surgeons. Preparing the medical profession for the U.S.’ possible entry into the war took on more urgency for Dr. Martin and the Regents.5
And preparation was vital. The destructive power of modern weapons and the scale of casualties challenged the medical capabilities of all belligerent countries. By war’s end, neurosurgery for brain injuries, laparotomy for abdominal wounds, and forward surgery had become routine.6-8 Research into shock by Dr. Crile, physiologists Walter Cannon and William Bayliss, and other investigators contributed new approaches to the treatment of the wounded. A debate about the relative merits of colloid, crystalloid, or blood in resuscitation intensified and continues to this day.9
But these scientific and practical advances needed to be communicated to the civilian surgeons who would enter service. As U.S. forces mobilized, the College devoted the 1917 Clinical Congress to war surgery to help prepare its American membership for the challenges to come (see Figure 2)—challenges that many of the College’s Canadian Fellows had been bearing since autumn 1914. The Convocation featured patriotic music from John Philip Sousa’s band and a stirring speech by Sir Berkeley Moynihan, now a colonel in the British Army. Practical sessions included talks on medical organization, treatment of wounds, rehabilitation, and the control of venereal disease. By November 11, 1918, approximately half of the College membership had seen active service in the U.S. or Canadian armed forces. ♦
The author gratefully acknowledges the assistance of Meghan Kennedy, Archivist, ACS Division of Member Services, and Renee Ziemer, coordinator, W. Bruce Fye Center for the History of Medicine, Mayo Clinic, Rochester, MN.