Friday, 20 February 2015

Medicine, War, and (fictional) Murder

[A look at half a dozen detective yarns from 1939-45]
Health Professionals in English Detective Fiction of the Second World War
From its beginning, detective fiction in the classic tradition, in English, has been closely connected with the medical profession. Most famously, not only Sherlock Holmes's fictional chronicler and partner in detection, Dr John Watson, but also his creator (Sir Arthur Conan Doyle) and real-life prototype (Dr Julian Bell) were medical men. Doctors featured frequently, often prominently, in the classic detective story of the 1930s, indispensable in the cast of village characters, necessary to the investigative process, occasionally detecting themselves1, and in a few celebrated cases as villains of the piece. It is not giving anything away to cite one example of the last category (no spoilers here), the excellently 'noir' study Malice Aforethought (1931), by Frances Iles, which opens with the sentence: "It was not until several weeks after he had decided to murder his wife that Dr Bickleigh took any active steps in the matter."

Although historians have paid serious attention to such novels in recent decades, analysing their significance within cultural production and attempting to decipher their less apparent, possibly subversive messages in relation to war among other issues3, their relevance for medical history has not come under comparable scrutiny.
The Whodunit does its Bit
While the outbreak of war in 1939 may have put an end, by definition, to the pre-war world, including the country-house settings and paradoxical "cosiness" associated with the murder mystery, it did not entirely revolutionise the nation's reading habits.4 To begin with, more of the same was produced by established and new writers, as the demand for literary distraction and solace increased, but the war soon became integrated into new narratives with realistic settings, and in these the health professions would often, naturally, feature. The 'Queen of Crime', Agatha Christie, epitomised the ideal of involvement, working in the dispensary at University College Hospital and simultaneously writing books like the wartime spy story N or M? (1941) and The Body in the Library (1942).

Gladys Mitchell was another well-known author who continued with her normal output, enhanced in the case of Sunset over Soho (1943) by a precise wartime setting,6 Her detective, Mrs Lestrange Bradley, is a psychiatric consultant to the Home Office in peace time and has been called into consultation by the War Office for some special work, the nature of which is left unspecified (possibilities rooted in reality might include some kind of assessment for the armed forces, or for secret operations, or possibly in relation to combat stress or conscientious objection). In any case she proclaims her dislike of commissions of this sort, which she usually finds neither interesting nor particularly useful. (p. 117) At the start of the book, in Chapter 1, 'Blitz', she is making presumably better use of her time by helping to cope with the aftermath of a bombing raid on London, doing the round of shelters she was scheduled to visit and assisting in a Rest Centre. There she observes the extraordinary calmness of the people, surprised at their unexpected acceptance of appalling din and danger, despite the same impression already being familiar enough to have become a commonplace. The reaction is taken at face value rather than as a symptom of shock although people are at the same time "all shaken and stricken".
She is interested too in her own reaction, noting a certain detached preoccupation with effects and results of the air-raid rather than any tendency to focus on an enemy as having caused it. In addition to people being on the whole patient, reasonable and brave, the staff and officers provide "amazingly selfless" service even when "almost rushed off their feet." (p.9) For her they are not anonymous, faceless professionals but a subject for study in themselves. She sees each of the officers, one male and one female, as flouting gender stereotypes (which she herself nevertheless employs in analysing them): the man in her view more of a man, not less, for recognising in himself some of the more penetrating feminine qualities, while the woman appears a natural leader, her accepted female role confirmed by her three sons in the army, yet her mentality allegedly masculine in breadth, feminine in subtlety. The shelter's emergency hospital has a nursing sister on duty, and is equipped with emergency maternity arrangements, described as "marvellously adequate", a judgment reinforced when it emerges later that twin babies have been born there during a raid. (p.177) The Centre is beset by enquiries and business calls from the Town Hall, Borough Engineer and the like, as well as having to deal with the medical and welfare work; interpreters are at a premium due to the racial mix of those attending, and volunteers are always wanted. On a more sinister note, in connection with the murder plot, she learns that it is "becoming a common trick to dump bodes where they'll look like air-raid casualties." (p.17)
Trying To Get In
More mundane but no less authentically of the period is the setting of Josephine Bell's Death at the Medical Board.7 The author had already begun to find her niche with two tales of detection and medical life: Murder in Hospital (1937) and The Port of London Murders (1938), and wrote from an impressive basis of experience, as a practising doctor - she qualified at UCL - from a medical family.
Her 1944 story, set in 1941 in an English country town, is told at the outset from the viewpoint of a woman doctor whose essential war work comprises running the practice while the other partner is with the RAMC in the Middle East, attending the civilian Medical Board of the title, and serving on various wartime committees. Known and respected in her role, she finds herself "quite rightly treated with great consideration" in a local restaurant where she has lunch. (p. 6) Her obvious and secure place within the war effort would arouse envy in some of her contemporaries, and she has the job of helping to decide whether certain young women will achieve similar inclusion, albeit in a different way and at a lowlier level
The Medical Board is for prospective members of the WAAF (Women's Auxiliary Air Force). She notices how seriously the would-be recruits take the occasion, interpreting this not as deference but as a sign of healthy distrust of the authority invested in those with the power to find something wrong and so to undermine the interviewees' choice of wartime role. The Chairman is an Admiral, and a 'Sir', the other doctor on the board a man whose partner is in the Naval Reserve. As usual the candidates are late, not through any fault of their own, but because they have been delayed while their intelligence and psychological fitness were tested - fitness, as she thinks satirically, "for washing dishes or cooking cabbages!" About sixteen, in single file, troop in, regulation dressing-gowns having been handed out to those who had not brought their own. She judges them to be normal girls who, far from suffering visible deprivation, look noticeably plumper than their older sisters did in pre-war days of "banting and slimming". (pp. 14-15). The proceedings are disrupted by the suspicious death of one of them, who has been resisting classification as medically unfit. One strand of the complex plot is concerned with the production of false certificates of exemption from service on medical grounds, as part of a scheme by a "spy gang" to sabotage the war effort.
The male doctor-detective who eventually arrives at the solution has been occupied with "Hush-hush" wartime research and is called to assist the police. His expertise helps to penetrate the "thick blanket of officialdom and routine that seemed to outsiders to characterise Medical Boards" (pp. 24-25) and he is not misled by the "pretty widespread", erroneous assumption that "the doctors at the Board would not know anything." (p.115) In the course of the investigation suspicion falls temporarily at least on a "mad RAF chap", a psychiatric casualty who has very bad shell-shock after being bombed in a hangar at the aerodrome. This man reputedly becomes violent at times and after being discharged from the RAF, he has become the scapegoat for anything unpleasant in the village, and is said to be worried he might be doing things without knowing. (p.139) In the end the author voices her concerns, through her detective's forebodings to his wife, about what she perceived as the threat of post-war bureaucracy, and in particular socialised medicine: "After this war we'll both be middle-aged, respectable citizens, planned into tight corners where we won't be able to stretch our arms and legs." (p. 204) Bell eventually became a full-time writer, continuing to draw on her medical background, and to hanker after pre-NHS days.
In Hospital
A lesser-known writer, G V Galwey, made similarly effective use of his own experience in Murder on Leave (1946), especially with reference to the Royal Navy (RN) in which he had served for six years before being invalided out, and which he tried to rejoin early in the war. Failing at first on medical grounds, he was accepted into the RN patrol service before being declared unfit for sea service in 1941.8 With this record he must inevitably have had repeated contacts with the medical services, and they loom large in his book, published just after the war but set in 1944, with earlier events casting long shadows on the plot and characters. The murder victim is a Voluntary Aid Detachment (VAD) nurse who worked in an RN auxiliary hospital in Inverness, where much of the investigation takes place. The author has an evident grasp of the complexities and nuances of hospital nursing in wartime as subsequently described by historians of the subject9, and presents individuals with their various traits and attitudes, not as stereotypes or stock figures: the Matron, for example, has "a face which has done its best to be sweet for rather too many years [...] but with a certain resilient tenacity to go on doing her job". (p. 66) A colleague describes the dead woman as being very good in the theatre, but not a good nurse, because she was not kind, so that patients "didn't cooperate with her - they didn't feel she cared". (pp. 68-69) One of her patients was a German officer who later convalesced on parole at her father's large house and has now escaped from a prisoner-of-war (POW) camp in the vicinity.

One of the key clues consists of remnants of a field-dressing, threads of gauze impregnated with picric, and in the course of their detecting the Chief Inspector and his helper each infiltrate the hospital, the young woman assigned to packing up medical chests for the Coastal Forces craft while a colleague sews sheets economically sides-to-middle. The police detective is more elaborately disguised as a badly burned patient, with the reluctant connivance of Matron. Although it "seems unethical to admit [him] to a bed when there's nothing the matter" (p. 94), it is only for one night, so he is dressed in a coarse yellow flannel nightshirt, swathed in bandages - "a wicked waste" - and decorated with gentian violet. On the pretext that the freshest possible air is needed to rest his lungs, his hospital bed is pushed out on the verandah of what might once have been the drawing-room of the house, but is now a surgical ward, to supervise proceedings at a social in the grounds. Nevertheless the hospital environment, although important,  remains secondary to the Navy as the main context of Galwey's book.
Doctors and Nurses
In Christianna Brand's classic Green for Danger (1945) on the other hand, it is at the heart of everything that happens.10 An Author's Note to the Pandora paperback edition (p. vi) confirms, putting it modestly, that (as any reader would have guessed) she had "some acquaintance" with the inside workings of a military hospital, having spent the whole of the London blitz in a heavily bombed area, largely among VADs. No less than five London hospitals were actually hit during the heaviest raid of 1941.11 The assertion is made in the process of refuting criticism of the way she has depicted her characters as reacting coolly to the air-raids. This is not to play down the effects of the bombing, in fact the plot hinges on the physical and psychological damage it causes, but there is a great deal more in her work.
A prefatory chapter indicates what has brought the doctors (male) and nurses (female) to this former children's sanatorium, "hurriedly scrambled into shape" as a military hospital: "one had put one's name down during the Munich crisis, and already it was becoming a tiny bit uncomfortable to be out of uniform"; “Eat, drink and sleep together... for tomorrow we join the V.A.D.s!” (pp.1-2) There are illuminating conversations and detailed descriptions of the physical and social scene on the wards, in the "modern" operating theatre, in the nurses' accommodation, and off-duty at a Mess party. Murder methods, clues and the double-twist dénoument are dependent on medical equipment and supplies, ingeniously deployed. Motives are intimately connected with the wartime circumstances. Gender, class and status differences emerge from dialogue and through changing relationships, modified by the prevailing imperative of comradely cheerfulness and getting on with the job, which does not of course preclude complaining. A nurse describes her shared quarters as "our slum", the "best a grateful nation can do for its Florrie Nightingales in the year 1940." (p.101) 
Post-traumatic stress (not of course so named at the time) is apparent in at least one key character, and all admit to being under a strain.
Altogether this is a key text for the subject of this article. Fortunately it is (probably) still to be found without too much difficulty in public libraries at least, having achieved and sustained a deserved if fairly low-key popularity and gone through several editions/ A quite memorable film (1946), starring Alastair Sim as the Detective Inspector, can still crop up on television. The film inevitably omits some of the detail and nuances of the book, as in the subsuming of Brand's panegyric to bravery under bombardment (p.100) in the brief exchange: "The nurses have stood it awfully well." "So have the doctors."
Why Read Wartime Whodunits?
No doubt crime fiction likewise inevitably omits much of the detail and nuances of reality, not to mention the possibility of any given book being written not as a chronicle of the times but perhaps as a pot-boiler, as part of the morale boosting internal propaganda effort, or merely as ephemeral entertainment. By that very fact, however, the incidental background material included to add topicality, verisimilitude and atmosphere can have an enhanced validity. Reading detective stories is obviously no substitute for study and research when it comes to understanding the interactions of medicine and war in the 20th century.12 Nor are the novels directly comparable with the personal reminiscences accumulated in the past 60-odd years and now being increasingly collected, although these can provide interesting comparisons and resonances.11 That said, and without seeking to blur the distinction between fact and fiction, record and imagination, these books can provide one way for generations who did not live through the war years to acquire insights into what it may "really" have been like.

See also: E. A. Willis,  ‘English detective fiction and the “People’s War”’. Forum for Modern Language Studies, vol.42, no.1, 2006: 13-21.

SmothPUBS online  
February 2015
Dates of first publication are given in brackets in the text; page numbers in the text refer to the editions cited below.
1 Binyon T J. "Murder Will Out" The Detective in Fiction. Oxford: OUP, 1989.
2 Iles F. Malice Aforethought. London: Pan Books, 1948.
3 Rowland S. From Agatha Christie to Ruth Rendell:British Women Writers in Detective and Crime Fiction. Basingstoke: Palgrave, 2001.
4 Munton A. English Fiction of the Second World War. London: Faber & Faber, 1989.
5 Christie A. Agatha Christie: An Autobiography. London: Fontana/Collins 1978.
6 Mitchell G. Sunset over Soho. London: Michael Joseph Ltd., 1943. 
7 Bell J. Death at the Medical Board. London: Longman, Green & Co. Ltd., 1944.
8 Galwey GV. Murder on Leave. Harmondsworth: Penguin, 1949.
9 Starns P. Nurses at War: Women on the Frontline 1939-1945. Stroud: Sutton, 2000.
10 Brand C. Green for Danger. London: Pandora, 1987.
11 Wicks B. Waiting for the All Clear: True Stories from Survivors of the Blitz. London: Guild Publishing, 1990.

12 Cooter R, Harrison M, Sturdy S, eds. War, Medicine and Modernity. Stroud: Sutton, 1998. 

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