Friday, September 1, 2017

Archibald McIndoe

Per ardua ad astra, or "Through adversity to the stars"

Growing up, most of the adult men whom I knew, my father and uncles, my teachers and coaches, were veterans of either World War II and/or the Korean War.  They never spoke about it, of course; their reticence is well-known to anyone who has ever lived with "The Greatest Generation".  Silence was the chief feature of their military service.  I recall, after their deaths, looking up the service record of Dad and my favorite uncle and whispering to myself, "Wow."

These were usually very good men, not haunted by their experiences nor debilitated by them, who returned to the United States after their uniform days, found jobs, got married and had children, bought homes and cars and gas grills; and left the horror behind them to be re-integrated into a society that needn't know of what it was really like.

When I moved to the United Kingdom at the age of fifteen, I found myself in the company of the British version of these men; my mother's cousins, my teachers and coaches.  They, too, were quiet about the wars.  A few wore their regimental ties, some bore a small ribbon of some import on the lapels of their jackets, others would march in parades and enjoy some pints with their veterans organization.  Otherwise, they, too, would marry, work, build homes, live a normal life uncluttered with issues from the past.  In both cases, society welcomed their return and, unconsciously or not, aided in that re-integration.  In the U.K., though, I noticed one startling difference.  I had never before seen so many men who bore the marks of war.

One of my favorite teachers had one arm; the empty sleeve of his suit jacket would be neatly tucked into the jacket's pocket.  [He wore a Black Watch tie each day, so I had a pretty good idea of how the arm had been lost].  Another was missing a leg; still another an eye.  One of my rugby coaches had a channel that had been blown through his ear in the perfect shape of a bullet.  One of my mother's cousins, who would wear long-sleeve shirts even when playing tennis on those rare, hot days in Scotland, once rolled up his sleeves to work on something in the yard, only to reveal horrific burn scars.

When his wife noticed that I had noticed, she said, "Bill was in the Royal Navy".  That was all she said; that sufficed.

These lasting signs of trauma had been, to use a contemporary term, "normalized".  To be missing a limb, eye, or 50% of one's flesh did not mark or otherwise stigmatize the victim.  Like the war itself, it was something that needn't be discussed.  It was accepted and life continued.

But what of those whose injuries were not so easily normalized?  What about those who regarded themselves as grotesque and, if we are to be honest, were sometimes found hard to look at?  For them, a remarkable physician had a brilliant idea on which much of our contemporary treatment of the disfigured is still based.

Archibald McIndoe was born in 1900 in the city of Dundin, New Zealand.  An exceptional student with an aptitude for medicine, he graduated from the University of Otago in his home state and served out the remainder of his medical training as a surgeon at the largest hospital in New Zealand.  His superlative ability took him to the Mayo Clinic, to private practice in London, back to the United States and back again to England.  By 1938, he had become a world-recognized expert in reconstructive surgery.  At the outbreak of World War II, his services became more in demand than ever.

Realizing that healing involved more than just repairing the body, McIndoe sought changes in the quality of life of those in recovery from horrific burns and facial destruction.  To that end, he dispensed with hospital clothing and permitted the soldiers and sailors to wear their uniforms, instead.  He prevailed upon local townspeople to invite the wounded to dinner in their homes, enabling them to be treated as human, and not as creatures from a horror film.

Noting the differences in those who had suffered burns at sea rather than on land, McIndoe, after due research, realized that immersion in saline would speed the healing of burns.  With ample opportunities to try new skin graft techniques, the art of facial reconstruction would be aided by the development of what has come to be known as the "McIndoe Nose".  It is a process still in use.

However, his best idea may have been The Guinea Pig Club.

An aside: Early in my ordained ministry, just days after I first became the rector of a parish [I was 29 at the time], I visited one of my parishioners in the burn ward of a hospital in Pittsburgh.  He had entered a tool shed that was filled with gas fumes from a leaking container while he was smoking a cigarette.  Most of his skin melted in the very hot, very quick and, according to witnesses, very quiet explosion.

When I first saw him he was in a saline bath washing his own dead flesh from his arms.  He was in remarkable pain, but was more worried about his appearance than anything else.  His primary concern was that his wife and young daughter would find him too grotesque to love.  It was heartbreaking.  I recall noting at the time that the success or failure of his treatment would have more to do with how he would be regarded by those whose love he needed than by the capable ministrations of his healthcare team.

The good news is that he was, and is still, loved by his wife and daughter; and, I know, by the two subsequent children they had.  While still heavily scarred, he has recovered in all the ways that matter.

The Guinea Pig Club was designed to be a mutual aid society for those maimed and disfigured in the war.  It was, for all intents and purposes, a drinking and social club, nothing more or less.  Besides the obvious physical qualification for membership, the GPC members were all patients of McIndoe's at the hospital in Sussex that became the center for the treatment of such grievous injuries.  Through the Club and the hospital, McIndoe used his considerable charm and massive reputation to engage the citizens of the local community in the healing process.

The Maestro and The Guinea Pigs
McIndoe insisted that the Guinea Pigs leave the hospital during the day and go into the world, even if the world simply meant the village of East Grinstead.  He sent them out to local shops, groceries, and pubs.  So used to his patients did the townspeople become that East Grinstead, Sussex became known as "the town that did not stare".  No longer stigmatized by their wounds, the young soldiers, sailors, and airmen were able live normally and heal greatly.  Some of them even wound up marrying local women.  All of them received perhaps the greatest gift, however.  They regained their sense of humor.  Witness it on display in the song the Guinea Pigs wrote of themselves:

We are McIndoe's army,
We are his Guinea Pigs.
With dermatomes and pedicles,
Glass eyes, false teeth and wigs.
And when we get our discharge
We'll shout with all our might:
"Per ardua ad astra"
We'd rather drink than fight.

It goes on a bit, as each member of the Club often added his own verse or two, some of them rather ribald.  Anglicans and Episcopalians should note that it is sung to the tune of Aurelia, better known from its opening verse, "The Church's one foundation...."

McIndoe became a loving figure to these men.  They called him "Boss" and "The Maestro"; he called them his "boys".  A whole generation's worth of wounded and their medicos learned of and benefited from McIndoe's true sense of healing.  After the war, the Guinea Pig Club continued to meet annually into the next century.

Archibald McIndoe would continue his work in plastic surgery and healing methods at his hospital in Sussex after the war and until his sudden death from a heart attack in 1960.  He would receive a knighthood in 1947.  The hospital remains in service and is recognized as a leading center for the treatment of burns.  Other treatment and research centers may be found in England and New Zealand bearing McIndoe's name in his memory and honor, carrying forward his manner of patient care and Christian love.

Recently, a statue of McIndoe was unveiled in East Grinstead.  The sculpture displays an airman, with ruined hands and a scarred face.  Standing behind him, resting a supporting hand on each shoulder, is the figure of McIndoe.

Some of the surviving Guinea Pigs by the statue of The Maestro.