First Day of Casualties

The First Day of Casualties is the pivotal event in which the war in France arrives directly at St. Thomas's Hospital, transforming Briony Tallis from a sheltered trainee into a nurse confronted with the full horror of combat wounds. It is the moment when the abstract war becomes a visceral, overwhelming reality, and when Briony's personal guilt and professional ambition are tested against the scale of collective suffering.

Background and Buildup

Throughout May 1940, the hospital had been preparing for a catastrophe. Wards were emptied, non-urgent cases sent home, and supplies of dressings, morphine, and Bunyan bags were stockpiled. The senior staff moved with a grim, secretive purpose, and the probationers, including Briony, sensed an unease that rose with the brown river and lay across the blacked-out city like a mental dusk. On the afternoon of the day the casualties arrived, Briony and her friend Fiona had been given a rare half-day off. They walked across Westminster Bridge to St. James's Park, rented deck chairs, and listened to the Salvation Army band play Elgar. The scene was dreamlike in its normality—prams drifted along the paths, children played on the grass, and deck chairs still cost twopence. It was hard to believe that barely a hundred miles away was a military disaster. Briony's thoughts remained fixed on her own themes: the marriage of Lola Quincey and Paul Marshall, and the fate of Robbie Turner, who might already be captured or dead. She gripped the wooden sides of her chair, closed her eyes, and understood how the war might compound her crime. The only conceivable solution would be for the past never to have happened. As they walked back toward the hospital, arm in arm, laughing at Fiona's mimicry of patients, they saw a line of army lorries drawn up outside the main entrance, and then the field ambulances, and the stretchers—scores of them, set down haphazardly on the ground, and an expanse of dirty green battle dress and stained bandages.

The Arrival of the Wounded

Briony and Fiona began to run. In less than a minute they were down among the men. The brisk air of spring did not dispel the stench of engine oil and festering wounds. The soldiers' faces and hands were black, and with their stubble and matted hair, and their tied-on labels from the casualty-receiving stations, they looked identical, a wild race of men from a terrible world. The ones who were standing appeared to be asleep. A consultant was taking charge, and a rough triage system was in place. Briony found herself addressed by a registrar she had never seen before. "You, get on the end of this stretcher," he said. The doctor himself took the other end. She had never carried a stretcher before, and the weight of it surprised her. The soldier was a sergeant, without his boots, his bluish toes stank, his head was wrapped in a bandage soaked to crimson and black, and on his thigh his battle dress was mangled into a wound. She thought she could see the white protuberance of bone. Each step they took gave him pain. Her left wrist could not hold up, and she knew that if her left hand failed, the stretcher would certainly tip. Her fingers were loosening as they reached the lift. She willed more strength to her left arm, and willed the doctor to go faster. She would not bear the disgrace if she were to fail. They turned into the ward, and an emergency bed was ready by the door. Her fingers went slack, she had no control over them, and she brought up her left knee in time to catch the weight. The wooden handle thumped against her leg. The sister leaned in to steady the stretcher. The wounded sergeant blew through his lips a sound of incredulity, as though he had never guessed that pain could be so vast. The doctor muttered, "For God's sake, girl." Briony waited to find out if she was needed, but the sister was annoyed to find her still there. "Well don't just stand idle, Nurse Tallis. Get downstairs and help." She came away humiliated, feeling a hollow sensation spreading in her stomach. At the first moment of pressure, she had failed. If she was made to carry another stretcher, she would not make it halfway to the lift. But if she was told to, she would not dare refuse.

The Ward Transformed

Briony's own ward had been redesignated as an overflow to acute surgical. It could have been a clearing station on the front line. Sisters and senior nurses had been drafted in to help, and five or six doctors were working on the most urgent cases. There were two padres, one sitting and talking to a man lying on his side, the other praying by a shape under a blanket. All the nurses wore masks, and they and the doctors had rolled up their sleeves. The sisters moved between the beds swiftly, giving injections—probably morphine—or administering transfusion needles to connect the injured to the vacolitres of whole blood and the yellow flasks of plasma that hung like exotic fruits from the tall mobile stands. Probationers moved down the ward with piles of hot-water bottles. Every bed was occupied, and new cases were left on the stretchers and laid between the beds to take advantage of the transfusion stands. Two orderlies were getting ready to take away the dead men. At many beds, nurses were removing dirty dressings. Everywhere, a soup of smells—the sticky sour odor of fresh blood, and also filthy clothes, sweat, oil, disinfectant, medical alcohol, and drifting above it all, the stink of gangrene. Two cases going down to the theater turned out to be amputations. With senior nurses seconded to casualty-receiving hospitals further out, the qualified nurses gave orders freely, and the probationers were given new responsibilities.

Briony's First Procedures

A nurse sent Briony to remove the dressing and clean the leg wound of a corporal lying on a stretcher near the door. The corporal was facedown, and grimaced when she knelt to speak in his ear. "Don't mind me if I scream," he murmured. "Clean it up, Nurse. I don't want to lose it." The outer bandaging looked relatively new. She began to unwind it, and when it was impossible to pass her hand under his leg, she used scissors to cut the dressing away. "They did me up on the quayside at Dover," he said. Now there was only gauze, black with congealed blood, along the length of the wound which ran from his knee to his ankle. The leg itself was hairless and black. She feared the worst and breathed through her mouth. She made herself sound chirpy. "Now how did you do a thing like that?" He explained that a shell had knocked him back onto a fence of corrugated tin. She gently lifted an edge of the dressing, and the corporal winced. He asked her to count to three and do it quick. She took the edge she had freed, gripped it hard between forefinger and thumb, and pulled the dressing back in a sudden stroke. The dressing came away in one, with a gluey rasping sound. The wound was eighteen inches long, perhaps more, and curved behind his knee. The stitches were clumsy and irregular. Here and there one edge of the ruptured skin rose over the other, revealing its fatty layers, and little obtrusions like miniature bunches of red grapes forced up from the fissure. She soaked cotton wool in alcohol and made a gentle pass around his calf, two inches above the wound. She pressed the cotton wool until he flinched, and took away her hand to see the swath of white skin she had revealed. The cotton wool was black. Not gangrene. She couldn't help her gasp of relief. She even felt her throat constrict. It was oil, or grease, mixed in with beach sand, and it did not come away easily. She cleaned an area six inches back, working her way right round the wound. A hand rested on her shoulder and a woman's voice said in her ear, "That's good, Nurse Tallis, but you've got to work faster." The corporal was asleep by the time she began to clean around the stitches. She was set to taking water around to the soldiers who had collapsed with battle exhaustion. She held a little white enamel teapot and let them suck the water from its spout while she cradled their filthy heads against her apron, like giant babies. She scrubbed down again, and did a bedpan round. She had never minded it less.

The Airman and the Shrapnel

Briony was sent with forceps and a kidney bowl to an adjacent ward, to the bedside of an airman with shrapnel in his leg. He watched her warily as she set her equipment down. "If I'm having them out, I'd rather have an operation," he said. Her hands were trembling, but she was surprised how easily it came to her, the brisk voice of the no-nonsense nurse. She pulled the screen around his bed. "Don't be silly. We'll have them out in a jiff." While he explained that his job was building runways in the fields of northern France, his eyes kept returning to the steel forceps. She pulled back his bedcovers. Several pieces of shrapnel were spread across a twelve-inch area on his thigh. There was swelling and slight inflammation around each rupture in the skin. He said he didn't mind them, he'd be happy leaving them where they were. "They're getting infected," she said. "And they could sink into your flesh. Into your bloodstream, and get carried to your heart. Or your brain." He seemed to believe her. She steadied her right hand with her left. She chose the smallest piece she could find on the edge of the cluster, gripped it, paused a second, then pulled it clear, firmly, but without jerking. The airman shouted "Fuck!" The escaped word ricocheted around the ward. Sister Drummond whisked the screen aside. "How dare you speak that way in front of one of my nurses," she said quietly. The airman apologized. Sister Drummond looked with disdain into the bowl. "Compared to what we've admitted these past few hours, Airman Young, your injuries are superficial. So you'll consider yourself lucky. And you'll show some courage worthy of your uniform. Carry on, Nurse Tallis." Briony continued to pull the pieces clear. He sweated, his whole body shook, and his knuckles turned white round the iron bedhead, but he did not make a sound. She saved the largest until last. It did not come clear in one stroke. He bucked on the bed, and hissed through his clenched teeth. By the second attempt, the shrapnel stuck out two inches from his flesh. She tugged it clear on the third try, and held it up for him, a gory four-inch stiletto of irregular steel. He stared at it in wonder. "Run him under the tap, Nurse. I'll take him home." Then he turned into the pillow and began to sob. She slipped away to get his brandy, and stopped in the sluice to be sick.

Private Latimer and the Face Wound

Briony was ordered to dress Private Latimer's face. She had already tried to feed him earlier with a teaspoon into what remained of his mouth, trying to spare him the humiliation of dribbling. He had pushed her hand away. Swallowing was excruciating. Half his face had been shot away. What she dreaded, more than the removal of the dressing, was the look of reproach in his large brown eyes. His form of communication was a soft aah sound from the back of his throat, a little moan of disappointment. She said cheerily, "Hello, Private Latimer. It's me again." He looked at her without recognition. Using a pair of surgical tongs, she began carefully pulling away the sodden, congealed lengths of ribbon gauze from the cavity in the side of his face. When the last was out, the resemblance to the cutaway model they used in anatomy classes was only faint. This was all ruin, crimson and raw. She could see through his missing cheek to his upper and lower molars, and the tongue glistening, and hideously long. Further up, where she hardly dared look, were the exposed muscles around his eye socket. So intimate, and never intended to be seen. Private Latimer had become a monster, and he must have guessed this was so. She began repacking his face with clean gauze soaked in eusol. As she was securing the pins he made his sad sound. She inserted the little teapot spout into the small corner of his lips that remained and poured. With each swallow he winced, which in turn caused him agony around the missing muscles of his face. He could stand no more, but as she withdrew the water pot, he raised a hand toward her wrist. He had to have more. Rather pain than thirst. And so it went on for minutes—he couldn't bear the pain, he had to have the water.

Corporal MacIntyre and the Burn Case

Sister Drummond sent Briony to help apply the Bunyan bags to Corporal MacIntyre's arms and legs, and to treat the rest of his body with tannic acid. He was one of a number of men overwhelmed by burning oil on a sinking ferry off Dunkirk. The viscous oil clung to the skin and seared through the tissue. It was the burned-out remains of a human they lifted onto the bed. She thought he could never survive. It was not easy to find a vein to give him morphine. The Bunyan bags were big cellophane containers; the damaged limb floated inside, cushioned by saline solution that had to be at exactly the right temperature. A variation of one degree was not tolerated. Corporal MacIntyre lay on his back under a bed cradle because he could not bear the touch of a sheet on his skin. He was whimpering pathetically for water. His lips were too ruined, too swollen, and his tongue too blistered for him to be given fluid by mouth. His saline drip had come away. The needle would not hold in place in the damaged vein. A qualified nurse told Briony, "He's suffering too much. I don't want him treated until I get him hydrated. Go and find something else to do." Later, Briony saw the nurse standing near the entrance to the duty room, unobtrusively crying. Corporal MacIntyre was dead. His bed was already taken by another case.

The French Boy, Luc Cornet

Toward three-thirty in the morning, Sister Drummond told Briony to go and sit with a soldier who spoke French. "Find a chair, go and sit with him. Hold his hand and talk to him." Briony felt offended. "But I'm not tired, Sister. Honestly, I'm not." "You'll do as you're told." He looked like a boy of fifteen, but she saw from his chart that he was her own age, eighteen. He had a fine, delicate face, with dark eyebrows and dark green eyes, and a soft full mouth. His face was white and had an unusual sheen, and the eyes were unhealthily radiant. His head was heavily bandaged. As she brought up her chair and sat down he smiled as though he had been expecting her, and when she took his hand he did not seem surprised. "Te voilà enfin," he said. He mistook her for a girl from his past, a girl from Millau who had come into his family's bakery. He spoke of his mother, his sisters, the baguettes and croissants, and of a girl with an English accent. Briony went along with the delusion, answering his questions about his imaginary life. He asked her, "Do you love me?" She hesitated. "Yes." No other reply was possible. Besides, for that moment, she did. He was a lovely boy who was a long way from his family and he was about to die. She gave him some water. He asked her not to leave. "Of course not. I'll stay with you." Still smiling, he half closed his eyes. Suddenly, he jerked upright as if an electric current had been applied to his limbs. He was gazing at her in surprise, with his lips parted. Then he tipped forward, and seemed to lunge at her. She jumped up from her chair to prevent him toppling to the floor. His forehead was pressed into her shoulder, his cheek was against hers. She was afraid the sterile towel would slip from his head. The grating sound from deep in his throat resounded in her ear. She eased him onto the bed and settled him back on the pillows. "It's Briony," she said, so only he would hear. His eyes had a wide-open look of astonishment and his waxy skin gleamed in the electric light. She moved closer and put her lips to his ear. Behind her was a presence, and then a hand resting on her shoulder. "It's not Tallis. You should call me Briony," she whispered, as the hand reached over to touch hers, and loosened her fingers from the boy's. "Stand up now, Nurse Tallis." Sister Drummond took her elbow and helped her to her feet. On the other side of the bed, a nurse drew the sheet over Luc Cornet's face. Pursing her lips, the sister straightened Briony's collar. "There's a good girl. Now go and wash the blood from your face. We don't want the other patients upset."

Consequences and Aftermath

The First Day of Casualties fundamentally changed Briony. She had seen men crying, and it shocked her at first, and within the hour she was used to it. The stoicism of some soldiers amazed and even appalled her. Every secret of the body was rendered up—bone risen through flesh, sacrilegious glimpses of an intestine or an optic nerve. From this new and intimate perspective, she learned a simple, obvious thing she had always known, and everyone knew: that a person is, among all else, a material thing, easily torn, not easily mended. She came the closest she would ever be to the battlefield, for every case she helped with had some of its essential elements—blood, oil, sand, mud, seawater, bullets, shrapnel, engine grease, or the smell of cordite, or damp sweaty battle dress whose pockets contained rancid food along with the sodden crumbs of Amo bars. When she returned to the sink with the high taps and the soda block, it was beach sand she scrubbed away from between her fingers. Sometimes, when a soldier she was looking after was in great pain, she was touched by an impersonal tenderness that detached her from the suffering, so that she was able to do her work efficiently and without horror. That was when she saw what nursing might be, and she longed to qualify, to have that badge. She could imagine how she might abandon her ambitions of writing and dedicate her life in return for these moments of elated, generalized love. The experience also gave her a new perspective on her own guilt. She thought how one of these men might be Robbie, how she would dress his wounds without knowing who he was, and with cotton wool tenderly rub his face until his familiar features emerged, and how he would turn to her with gratitude, realize who she was, and take her hand, and in silently squeezing it, forgive her. The day ended with the probationers being sent to their lodgings to sleep, told to report back at eleven. Briony walked with Fiona. Neither girl spoke, and when they linked arms it seemed they were resuming, after a lifetime of experience, their walk across Westminster Bridge. They could not have begun to describe their time in the wards, or how it had changed them. It was enough to be able to keep walking down the empty corridors behind the other girls. When she entered her tiny room, Briony found a letter on the floor. It was from Cyril Connolly of Horizon, rejecting her novella Two Figures by a Fountain. The letter praised her writing but criticized its static quality, its lack of narrative development. "Might she come between them in some disastrous fashion?" Connolly asked. Briony saw that the evasions of her little novel were exactly those of her life. She had been hiding from the truth. The First Day of Casualties had stripped away her pretensions and forced her to confront the reality of suffering and her own complicity in a crime. It was the beginning of her long, imperfect journey toward atonement.