SHEPHERD’S BUSH

 

WITHIN eighteen months of the outbreak of War I the influence of Robert Jones was permeating military surgery, by deed and word on the front line, and in the hospitals at home. With the dawn of 1916 he determined to prevail upon the War Office to provide adequate provision for the treatment and cure of those cases of gunshot wounds which were ultimately, by his persuasion, to be given adequate care in special institutions all over the British Isles, called by the then unfamiliar name of “ Orthopaedic Centres.” It was a bold step to propose at a time when a policy of rapid evacuation and a return to the front seemed the only vital problem before the country.

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In 1916 was the costly battle of the Somme with its wasting operations afterwards ; it was the year of Verdun and Jutland.

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The whole world was drenched with blood, and the pressure on hospital accommodation became more and more intense. The call for more men was insatiable. Of the future of the wounded or even their present needs there could be no calm consideration.

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All that the War Office required was men and more men, and it was in that atmosphere of distracting public apprehension and national crisis that Robert Jones sat down and wrote a letter to Sir Alfred Keogh, Director General of Medical Services. This was February, 1916 : “ It seems to me,” he said, “ after twelve months’ work at Alder Hey, that at present we are only able to touch the fringe of the orthopaedic problem, and that this is due to a want of knowledge on the part of the profession as to fundamental principles, prophylactic and curative, and due also to the fact that there is no systematic supervision of orthopaedic cases by men of special shepherd’s bush knowledge. The general surgeon, however brilliant, when confronted with these cases, is unable to steer them in the right direction or to prognose their future.

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“ There is also a want of cohesion between departments of treatment, such as massage, physical exercises, electricity and manipulative and operative groups of cases, all of which properly controlled make for success in orthopaedic surgery.

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It appears to me that we want one large orthopaedic hospital combining all these departments, and staffed by expert men under a director, who should be the final arbiter as to the conduct of treatment. This hospital should contain at least eight hundred beds and should be a military hospital. Every

facility should be offered in order to secure good men and for the adequate equipment of the institution. This hospital should deal with the more complex type of cases, gathered from all parts of the country.

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“ The collection of orthopaedic cases presents a difficult problem, details of which will require considerable thought. I have had long conversations with Gray and Lynn-Thomas, and we agree that a clearing house scheme offers perhaps the least objection, and would not invite friction amongst the members of the staffs. A clear definition of the scope covered by the term ‘ orthopaedics * should be supplied to the C.O. of each general hospital in the Command, making him responsible for evacuation of orthopaedic cases from his hospital and its auxiliaries into a clearing house, to which should be attached a good surgeon of orthopaedic training.”

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This letter was not a little revolutionary. It harked back to the long experience of Nelson Street, and openly declared that the general hospital was not competent to handle a large percentage of the wounded. It could not be anticipated that its proposals would be accepted without a struggle. And

it is in the ebb and flow of that prolonged fight for the disabled soldier during the next four years that Robert Jones proved loyal to his principles, and remained quite unmoved or unshaken by opposition.

 

He urged as a start the creation of one large orthopaedic hospital in which the more complex type of case might be sent from all parts of the country. What he desired was a demonstration institution in London, which might convert sceptical or hostile opinion. For this hospital he required a staff composed of the younger generation of surgeon, either trained in his methods, or, as he put it, “ with minds sufficiently flexible to grasp new ideas, and with sufficient energy to bear the strain that orthopaedic work involves.”

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The War Office was throughout sympathetic. But its immediate problems were concerned with the prosecution of the war, and it was at its wits’ end to accommodate the train loads of wounded arriving by every boat. As a compromise Hammersmith Workhouse at Shepherd’s Bush was authorised as a hospital for orthopaedic cases, and the negotiation of the enterprise was facilitated by a grant from

the Red Cross funds.

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Shepherd’s Bush ultimately proved more than a demonstration hospital to familiarise the methods of orthopaedic surgery. It was destined to become a concentration camp for the organisation of similar centres all over the British Isles. That the War Office foresaw the future is improbable. But one  problem was certainly not foreseen. The War Office could only interest itself in crippled soldiers so long as they were undischarged.

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Immediately it was clear that a soldier could not be sent back to the front, the rule was that he should be discharged and obliged to leave the military hospital. In many cases this would occur in the middle of treatment, when, if a man were to receive any benefit he would probably require some months  more. Here threatened a conflict of aims. 

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While the main object of the army hospital was to restore men to the fighting line, the specific object of the Red Cross, working hand in hand with Robert Jones, was to enable those who would never fight again to return as useful members to civil life.

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Of this disconcerting problem, he said nothing at the time. Instead he started the work and looked to the future to strengthen his hands for the discharged soldier. A practical illustration shepherd’s bush 

of his scheme to correlate the requirements of war and peace is seen in the curative workshop.

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“ Our first experiment,” said Robert Jones, “ in devising work having a direct curative bearing upon the recovery from injuries was started by permission of Sir Alfred Keogh at Shepherd’s Bush Military Orthopaedic Hospital. The plan was rapidly extended to other centres. It has proved a very

valuable adjunct to the other departments. Theoretically we have the power to compel men to adopt this curative agency.

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In practice that power is never needed. We depend largely upon the psychological element to help in the recovery. The result is that there is an ever-increasing demand for work, so that at Shepherd’s Bush we have had largely to increase the plant and shops. There is a great advantage in a persuasive over a compulsory attitude towards the worker. The unwilling pupil, the rebellious, were shown the advantages of submitting to treatment. Great sympathy and patience were exhibited

by the staffs. The cured comrade added his persuasion, and the men began to show a growing spirit of trust. Secondly, there came the direct benefit both mentally and physically derived from Curative Workshops . . . Give the soldier inspiration in regard to his physical improvement, and he soon

appreciates the line he should take. Let him go to work happily, and he is happy in work.”

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That was the pleasantly simple note peculiar to Robert Jones in speaking of his work. But in 1916 it was not by any means so easy. It was in fact an experiment in which the War Office took little interest, and the soldier regarded with a good deal of hesitancy. The curative workshop acted in a process both of psychological and physical restoration. In 1916, in his preface to “ Notes on Military Orthopaedics,” Robert Jones remarks :—“ By the time a soldier has passed through various phases of recovery from septic wounds in several different hospitals, and is finally transferred to an orthopaedic centre for treatment to correct deformity and restore the use of injured joints and muscles, his spirit is often broken. The shock of injury, frequently in itself severe, followed in succession by a long period of suppuration, and then by a wearisome convalescence, during which he receives treatment by massage or electricity, or by monotonous movement with mechanical apparatus of the Zander type, too often leaves him discontented with hospital life, its monotonous round of routine, and its long periods of idleness. In the Orthopaedic Centre he finds his fellow-patients busily engaged in employments in which they are doing something, and it is not many days before he asks for a ‘ job.’ In the Military Orthopaedic Hospital at Shepherd’s Bush alone, out

of eight hundred patients, about five hundred are employed at some regular work, which fosters habits of diligence and self-respect, and converts indolent and often discontented patients into happy men, who soon begin to feel that they are becoming useful members of society and not mere derelicts. Thus, when the preliminary stages of operative and surgical treatment are over, there is a steady gradation through massage and exercise to productive work, which is commenced as soon

as the man can really begin to use his limb at all. If his former trade or employment is a suitable one, he is put to use tools he understands, otherwise some occupation suitable for his disability, and curative in its character, is found for him.

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“ Men with stiff ankles are set to drive a treadle, lathe or fretsaw. If put on a treadle-exercising machine the monotony soon wearies the mind, but if the mind is engaged not on the monotony of the foot work, but on the interest of the work turned out, neither mind nor body becomes tired. Men with

defective elbows and shoulders find exercise and mental diversion in the carpenter’s and blacksmith’s shops. If their hands and fingers are stiff, working with a big swab to clean windows or with a paint brush is a more interesting occupation than gripping spring dumb-bells.

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“ Those of us who have any imagination cannot fail to realize the difference in atmosphere and morale in hospitals where patients have nothing to do but smoke, play cards, or be entertained, from that found in those where for part of the day they have regular, useful and productive work.”

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Shepherd’s Bush created more interest and aroused more enthusiasm than any hospital during the War. The sense of despair was lifted. Like Baschurch or Chailey it possessed an air of hope and occupation, which was unexpected in men crippled and undergoing a long period of operative treatment. 

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The King took a great interest in the Hospital from the start, and in July, 1916, visited it, and was taken round by Robert Jones.

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Queen Alexandra came on July 13th, 1917, and sent the following letter, so very typical of her kindliness and insight:— “ I am desired by Queen Alexandra to tell you how exceedingly pleased Her Majesty was with her visit to the Military Orthopaedic Hospital this afternoon.

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“ The planning of the Wards, the Workshops, the Rooms and appliances for specialised treatment, in fact the whole system on which the Hospital is conducted—giving not only comfort and relief by the most modern and up to date appliances to the patients, but also providing all those who are in any

way able to work with employment, which enables them to assist each other and to help in the construction of nearly everything that is required in the Hospital—appeared to Her Majesty to be admirable.

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“ The value and advantage of this work is shown in its appreciation both by those who are employed on it, and those who are able to benefit by their labours.

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“ Queen Alexandra was deeply interested in all she saw, and the general impression left on Her Majesty’s mind was that everything that science and skill could suggest, combined with the most tender, zealous care, was being done for the wounded soldiers who deserve everything that can be done for them, and the appearance and general tone of the patients bore testimony to the happy relations that seemed to exist between the Medical and Nursing Staff and the wounded soldiers who are under their care.”

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But a charming instance of Queen Alexandra’s deep intuition and knowledge of human nature may be added. There was a lame patient who felt in despair about his future. The Queen hearing this took him as it were aside, and compelled to use a stick herself, pled with him the importance of making

the best of his handicap.

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This wide interest led men and women in every walk of life to visit Shepherd’s Bush between 1916 and 1919. Such publicity served very definite ends. The possibility of recovery whether for war or peace under the orthopaedic scheme became more and more recognised, the old traditional ideas about the cripple gave way, and the future return of the wounded soldier to civil life was gradually evolved.

 

The first experimental curative workshop was opened at Shepherd’s Bush, on March 1st, 1916, and in the same month Robert Jones was appointed Inspector of Military Orthopaedics.

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He was now authorised to establish orthopaedic hospitals upon the same principles as Shepherd’s Bush in other parts of Great Britain. “ It was only after a long probationship,” he said in 1917, “I succeeded in persuading the War Office to allow me to start ‘ curative ’ workshops in all my centres,

and these are being pushed forward. ...”

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The magnitude of the problem affecting the wounded had by 1916 gravely perturbed the nation. Robert Jones started to organise his centres without delay. Apart from the younger orthopaedic surgeons, he called upon many friends of peacetime days to assist him. There was Berkeley Moynihan of Leeds, Harold Stiles of Edinburgh, John Lynn-Thomas of Cardiff, and whenever possible he had taken them into consultation. To these colleagues in particular he owed an immense debt for their sympathy, allegiance and advice.

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Difficulties and problems confronted them in abundance. At the onset the type of case admissible as “ orthopaedic ” had to be settled and specified in the War Office circular to hospitals at home and abroad. Robert Jones on March 14th, shepherd’s bush 1916, begged the War Office to “ take a somewhat broad view of military orthopaedics.” There were quite evidently grave controversies ahead upon what was to be included in the orthopaedic camp. It was, as a consequence, necessary to 

create a confidence amongst general surgeons in the orthopaedic scheme, to staff each centre with surgeons trained in orthopaedic methods, and to extend provision for the wounded all over the

British Isles. If these main steps are followed the long struggle for the best curative treatment of a large percentage of the war casualties will be seen to have been no easy task.

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There was at the start a universal spirit of incredulity regarding the whole matter. Both by professional soldiers and general surgeons that hapless term “ orthopaedics ” seemed either a joke or an affront. “ I remember,” says Robert Jones, “ General French coming to inspect one of our centres and reading on a board ‘ Military Orthopaedic Hospital.’ He asked his A.D.C. what ‘ orthopaedic ’ meant. The young officer blushingly admitted he was not quite sure, but presumed it came from the Greek, and had to do with ‘ straight ’ and ‘ foot.’ To which French snorted, not unreasonably, ‘ What a damned silly name to give a military hospital.’ ”

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There arose an instant and steadily increasing problem of how to staff these new centres. In April, 1916, the French were complaining that Great Britain had not sufficient men under arms, conscription was under discussion, and the enlistment of 200,000 married men was imminent. The War Office was faced by the insistent demand of public sentiment that every able-bodied man, including medical men passed for military service overseas, should go abroad. In June, 1916, there was an urgent call for five hundred doctors overseas. 

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The medical profession itself was strongly opposed to any exceptions. But to Robert Jones, the necessity to retain surgeons who were competent to handle orthopaedic cases was equally imperative for the return of the wounded soldier either to the trenches or to civilian life. It was, in short, no time for him to claim preference for young surgeons, and yet young surgeons he must have if the scheme was to succeed.

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An instance may be given in his letter to the War Office, upon Alder Hey, Cardiff and Leeds. It shows ironically how keenly he felt that the structure must be preserved in direct opposition to the hysterical clamour for sheer man power.

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If the corner stones went the whole orthopaedic building of the future was jeopardised.

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“ I do not wish to embarrass you at a time when you have so much on your mind. Indeed I am prepared to strain every faculty I have to help you. It is necessary, however, for me to put before you clearly, that if the emergency order in regard to overseas service is left without the possibility of modification it will be quite impossible to run certain of the orthopaedic centres. In each of these centres as an emergency measure certain men can be released, but there are some who are

absolutely indispensable for skilled operative and educational work. For the moment I will not discuss the case of Shepherd’s Bush, but will refer to the provincial centres, Liverpool, Cardiff, and Leeds. At Alder Hey we have eight hundred orthopaedic patients, and between forty and fifty operations

are performed there every week. The whole of the responsibility of this great concern in its surgical bearings rests on the shoulders of two expert orthopaedists, Captains Armour and McMurray. These men by their special aptitude and training are able to organise and direct the work efficiently

with a surprisingly small assistant staff. They perform all the complicated operations, and on account of the shortage of men they are responsible for several hundreds of extra military beds in the city. If Alder Hey is to exist as an orthopaedic centre neither of these men should be taken from me, however great the pressure from abroad. Whatever is done with any other members of this staff I may regret, but I shall not complain. Both these men are at work from eight in the morning until late at night. . . .

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“ If any of these men are taken the orthopaedic work at these institutions must cease, unless we are to bring these particular centres into discredit. The essential men at Shepherd’s Bush are well known at the W.O. I hope my importunity will not be misunderstood—I am really not adding to trouble by trying to save the orthopaedic scheme from wreckage. No matter how many hospitals are started

abroad, these centres will become more than ever in demand, and the very few men I ask for can do more work than thirty or forty who have not been specially trained.”

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It was at this period that Robert Jones toured the country to visit cases in general military hospitals and develop his orthopaedic centres. Two years of war were having their inevitable result. Cases urgently in need of highly skilled care, whether for restoration for active service or discharge into civil life, were being kept indefinitely without adequate treatment in all kinds of military hospitals, auxiliary hospitals, or Command depots. He was more determined than ever to do what was possible for these shattered men before it was too late. It was no easy matter. In those days the wounded soldier had passed too often from the vortex of war into a backwater of stagnation. He was bewildered and disheartened.

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To make it possible for him to be saved depended far more upon personality than pensions. A very eminent man who was officially connected with Robert Jones between 1915 and 1918 has written, “ A friend was talking to me of Lord Roberts and said that he was the meekest man he had ever known. I thought it a curious epithet for a great soldier, so looked up the word in a good dictionary. It was the right word, and it is the right word for Sir Robert Jones.

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“When I first met him in 1915 at the War Office, I was attracted at once by his charming voice and his kindly face. I had not heard of his fame and his achievements, and I was meeting daily new men, most of them warranted organisers with a genius for co-ordinations. In such a galaxy it was

difficult for me to pick out the man who was going to win the war. But I marked two in my mind, and one was Sir Robert Jones ... I write as a layman, knowing little of the divine art of healing. But I travelled much with Sir Robert, helping to acquire suitable buildings for his orthopaedic work, and

listening to him as he spread the gospel through England and Scotland ; and I became his advocate with the War Office. Sir Alfred Keogh realised the genius and the value of Sir Robert’s labours, but none realised in 1915 and 1916 that this quiet, patient man from Liverpool, this man with vision,

was going to win in his great fight for the men with the consolidated wounds. There they were in large numbers in hospitals all over the country, waiting for him to coax them back to activity, to recall them to life. I remember many scenes. A long ward of unhappy, disgruntled men, in their blue clothes. Sir Robert takes the hand of one of them.

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‘ You can’t open your hand.’ Then he plays with the hand, takes a finger and moves it. ‘ This little pig went to market; this little pig stayed at home.’ The fingers move and the hand opens, and the crowd in blue gather round, and the unhappy faces begin to smile. I saw many such scenes. I did not so much watch Sir Robert’s skilful manipulation as the faces of the wounded men, and I noticed that most beautiful of all expressions, the dawning of hope. I am no blind enthusiast, carried away by the wonder of seeing many instances of Sir Robert’s healing power. All will admit that he was a

great master of orthopaedics ; but I was more interested in his personal influence, in his magnetism. I have seen some Indians who possessed this power, and once saw in Palestine a great man who wielded such an influence over the Near East. As he walked with his crowds of followers through the

fields, plucking the ears of corn, he brought to my mind a picture of a greater Man talking to His disciples. And as I watched Sir Robert in hospitals and camps, listened to him explaining his methods, or appealing to large audiences in Oxford and other centres for sympathy with, and understanding of, the possibilities of orthopaedic treatment, I am certain that his success was due, not merely to his profound knowledge of orthopaedic art, but was due mainly to his unique personality.

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He infected all with his quiet enthusiasm and infected them personally.

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“ He was fond of everything and found good in everything. And just as in his healing he drew out pain and ill humours from his patients, so did he draw out all that was best in every man he met. He must have been a very happy man, for he made happy all who came near him.”

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Robert Jones was called upon to meet who can say how much hesitancy, opposition and discouragement, both from regular army doctors and general surgeons. But his personality carried

all before him. “ Military starch,” recalls Tait Mackenzie, sculptor, surgeon, and his friend and ally, “ wilted before Robert Jones’s astonishing gift for overcoming antagonism and turning would-be foes into friends.” Visiting a Yorkshire depot one day at the request of the medical officer, the inspecting party were confronted on their arrival by an outraged A.D.M.S., who stiffly informed them that as he had not been properly notified of the visit no inspection could be made without his authority. “ Well, may we ? ” asked Jones, with his friendly smile. Taken aback, the bristling dignitary could not but consent, and made the rounds with them.

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Prejudice and favouritism were alike impotent to sway him in his choice of the best men to command the centres. A surgeon of note, but of inferior orthopaedic experience, published a violent attack on his system of treatment in a professional journal. Robert Jones, bred to controversy and untroubled by self-importance, saw nothing but a colleague intensely interested in the subject, and forthwith

invited him to take charge of one of the new centres, quietly remarking, “ I think he is a good man.

 

When he is more familiar with our methods, he will change his views.” And he did, making an excellent commandant, devoted to his chief. No opposition would stand for long against the logic

of his methods, the skill and sureness of his technique, and the thoroughness of his after-treatment—all joined with the simplicity and generous humour that was a fundamental part of his rich, lovable nature.

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he pin-pricks he accepted with great good humour. It was never his duty to feel discouraged or aggrieved. He was gifted with that most rare quality—a sense of humour, by which one means the capacity to endure with a smile. In 1917, in the midst of his tremendous task to mend the ravages of war, he received one of those genuine minutes which can never be imitated, but which preserve for all time the splendid limitations of the official mind even in the year when England was never so near catastrophe.

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“ P.S. to D.G.A.M.S.,

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.We notice that authority was given for a very extensive tour last August, but hope such a large expenditure of petrol is not contemplated this year in view of the critical shortage. Possibly you will urge Colonel Sir R. Jones to use the railways in every case possible and hire locally at Government expense as a far more economical method from a National point of view.

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8-6-17. (Sd).D.A.D.S.”

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“ Q.M.G. 6.

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“ Colonel Sir R. Jones has been asked to comply, as far as possible, with your Minute, and there is no doubt that he will do so.

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“ The D.G., however, asks me to point out that this tour by motor was arranged to conserve Colonel Sir R. Jones’ time, the value of which cannot be too highly estimated.

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“ He is the only man who can do the orthopaedic inspections on which he is engaged, and which result in the return of so many men to the fighting line far earlier than they would otherwise get there.

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“ With a restricted train service, days would be lost on such a tour as that carried out last year, and such days are invaluable.

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9-6-17. (Sd).P.A. to D.G.A.M.S.”

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This was followed by a personal letter to a good and practical friend in the War Office enclosing a modest account. “ I have,” said Robert Jones, “ tried to keep it as low as possible.

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I have had to keep cars all day long, otherwise I would never get through the work. Those I have not put down. I have charged for a London and Liverpool railway contract because it is economical. But if there is any difficulty I would, of course, rather forgo the account altogether.”

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IV

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The scheme of curative workshops was quite a simple one* It aimed at getting the men fit again as soon as possible for the army, but it also provided a bridge between military and civil life. To Robert Jones the discharged soldier, whether crippled or cured, must have the chance—if necessary—of

being trained for employment. At Shepherd’s Bush, the great experiment was commenced, and only in time.

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In May, 1917, when the hospital had been running fourteen months, he put the position clearly enough :—“ From the beginning of the War, I have been convinced that the most serious problem for us as a nation is the question of how to deal with the disabled discharged soldier. In the early days

thousands were discharged as unfit for the Army ; and, more is the pity, they were unfit for anything else. A large proportion of them should not have been discharged at all ; for, with orthopaedic treatment, they might have been transferred into useful citizens, instead of forming the nucleus of a discontented and bitter party, large enough to paralyse all efforts at progress.

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This is now being largely remedied, but until an individual interest is taken in the man from his entrance into hospital, until he enters civil life, our material duty will have been left undone. The time to get at him is while he is an inmate of the hospital. ... In going round the ward I often say to a patient—‘ What are you going to do when you are discharged ?’

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He doesn’t know—he often has not thought, and is only worried by the final payment of his pension. A short conversation will almost invariably help him to decide the problem. He is in this way made happy by his new prospects, and the nation is made richer by his physical and mental reconstruction.”

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Shepherd’s Bush was not only a great military hospital for the wounded soldier during the War but the pensioner after the Armistice. It lay at the heart of two signal contributions to War and Peace. It demonstrated the possibilities of orthopaedic surgery in the greatest city in the world. And it preached the gospel of rehabilitation.

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“ I have lived and worked long enough,” said Jones in 1917, “ to realise that the aim and not the end is the main thing. 

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When the end comes and Peace is declared the cry will be for War Memorials. Is not now the time to decide on these ?

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You do not want to wait until the dead are forgotten. Are our memorials to be spiritual or material, living and permanent, or dead and cold ? For my part I have no hesitation in saying that marble or brass has no re-echoing voice to me. My feeling is, that the heroic spirit that sent our beloved dead to

their end should be reflected in an equally heroic effort on our part to make and keep the nation efficient.”

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There were in 1917 immense difficulties before such claims could be openly advanced. The War Office maintained a very definite attitude towards retaining cases for prolonged treatment and training who were not able to be discharged. 

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So early as 1915, Robert Jones had clearly estimated how great a social problem this was to involve. As months passed he took up the cause of the disabled soldier as a social problem, which would soon become critical. He foresaw, long before public agitation, exactly what was coming. In 1916, he

wrote :—“ It is quite true that the most important object of the military mind is to end the War successfully ; but there is absolutely no reason why that desire and determination should clash with the civil one. On the contrary, an early understanding is essential to the full success of either. When the War Office says that men should be discharged from the Army so soon as it is known they will not be fit for service, they cannot really mean it. If they did, it would involve the discharge of half our wounded in the most critical stages of disease, many of them to die, and most of them destined to

deformity and functional disability. It is clear therefore that whatever the War Office says, they would never dare to give effect to so inhuman an act. Orthopaedic hospitals would be at once closed if we had to depend upon patients intended for the fighting line. The Army Medical Service dissociate

themselves from any responsibility in regard to the discharged soldier. But the problem requires a telescope rather than a microscope. Statesmen must and will see that the economic solution is only satisfactory if the wounded soldier becomes a national asset, instead of a discontented derelict. If the

wounded soldier cannot look after himself, it is our duty to see that he does himself no harm. My opinion is, that no soldier should be discharged from the Army until everything is done for him to make him a healthy and efficient citizen, and when the War is ended he should not be discharged until he is declared to be fit and fortified by the necessary help or knowledge which will enable him to take an honourable part in life. If a soldier knows beforehand that we are striving to make him functionally useful, and not necessarily with the intention of sending him to fight, the psychological effect is such as to materially expedite his recovery. When the country knows the economy involved in taking care of the soldier, the fact will soon be accomplished. Unless we begin to train soldiers before they are discharged, we will find that the very large proportion of them will be unwilling to learn

any trade. It is the experience of other countries that not more than twenty per cent, of discharged soldiers will submit to tuition. This is a very serious fact, disastrous to the morals of the country and to the Treasury.

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“It is quite clear that, whatever view special departments take of the problem, if we are to get adequate results, both civil and social discipline is an essential element, and before any other details are decided we must secure a definite pronouncement on this point. It is suggested by some to keep

a tight hold upon the soldier by means of his pension. This will never answer. Can we imagine Mr. Lloyd George answering a democracy when charged with interfering with a wounded soldier’s pension ? It seems to me that a pension should be inviolate, and all these constant efforts at periodic

revision defeat their ends. If I were wounded and received a full pension of 25/- a week, and was asked to learn a trade by which I could make 15/- and be paid 10/- pension, I should probably prefer to remain idle. The discharged soldier should have every incentive to work, so that his industry should add to his wealth. The productivity of his labour becomes the important asset to the Nation, not the number of shillings paid out to him.”

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In this pioneer scheme he had an unexpected and deeply enthusiastic ally in King Manuel of  Portugal, who, representing the British Red Cross, was able to support his project with funds and personal and unremitting labour. Between them grew up a close friendship which lasted until death. Upon the work of King Manuel for the disabled soldier much could be written, and not sufficient said. His position was a difficult and not an enviable one. Exiled monarchs are seldom accorded more than tolerance in foreign countries, and are rarely given full credit for their qualities. Shrewd and hardworking, a persuasive platform speaker, and with a very charming personality, King Manuel certainly did as much for the wounded soldier in Great Britain as lay within the power of any layman.

He took the whole problem to heart long before it had occurred to many in the Government that the Armistice was not the earliest moment at which to consider the future of disabled men. His devotion to Robert Jones was intense and not a little affecting, because it was the loyal reciprocation of one who, by his peculiar position, might never have been afforded a chance of hard and continuous labour. And it was in steady concentrated work that he found his real vocation. He was a fine musician, a first-rate tennis player, but most of all a student. To those who have experience of such things the completion of his catalogue of Portuguese books will forever declare him no royal idler or disillusioned exile. 

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For several years King Manuel worked at Shepherd’s Bush from early morning till late evening, simply and solely for the cause of the disabled. He raised large sums of money by public appeal. But his happy relationship with Robert Jones, was, one cannot doubt, his greatest solace. To the last he fought so far as possible in his cause.

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The historical importance of Shepherd’s Bush is that it became the first experimental hospital in training the disabled. 

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By 1917 Lord French had ceased to ask with a laugh what “ orthopaedic ” meant, and accompanying Robert Jones round the workshops congratulated him upon instituting the first scheme for training the disabled soldier. As a pioneer institution Shepherd’s Bush became the model for centres at

Manchester, Leeds, Newcastle, Oxford, Reading, Cardiff, Birmingham, Bristol, Bath, Edinburgh, Glasgow, Aberdeen, Dublin and Belfast.

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From 1916, until the problem was shouldered by the Ministry of Pensions in 1918, Robert Jones struggled to preserve the disabled discharged soldier from disaster. It was an heroic crusade. Thousands of men would never have regained their capacity for work had he not consolidated, against all misunderstanding and indifference, his scheme of hospital training. The more it is considered the finer it appears in every sense—technical, statesmanlike, humane—magnificent

in power, vision, resolution and courage. Here, for the first time in the history of War, was a man who knew that broken men could be restored, knew how to do it, and was ready to introduce it on Armageddon scale.

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Shepherd’s Bush was for these reasons a landmark in the history of the disabled soldier. Here, as at Baschurch sixteen years before, the structure of recovery was laid and demonstrated. It was at Shepherd’s Bush that Robert Jones consolidated the framework upon which the whole national

scheme for cripples originated and took form. It was an experimental plant for the restoration of sound bodies. As months passed it took on a sense of permanency, it gathered about it a tradition, it might with a little imagination have become a permanent national institution ; instead of which it

was ordained by some inscrutable fate that it should arise from the mediocrity of a Poor House, and to that forlorn destiny return.

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The above Chapter was taken from: -

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THE LIFE OF SIR ROBERT JONES
BY
FREDERICK WATSON

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