[dropcap]O[/dropcap]n the morning of September 3, 1940, Pilot Officer Richard Hillary climbed into his Supermarine Spitfire and took off with his squadron, ascending to 12,000 feet. The Luftwaffe had brought the war to British soil two months earlier, and the Australian-born Hillary was a proud, 21-year-old Royal Air Force (RAF) fighter pilot—one of Churchill’s “Few,” defending Britain from German bombers. Squinting through the bright sunlight, he briefly admired the morning clouds that spread out below the formation “like layers of whipped cream.” Moments later, dozens of German Messerschmitt 109s engaged the squadron. Hillary shot one down but another simulta-neously attacked him; his cockpit burst into flames. Struggling, he managed to force open his canopy to bail out, but the heat and pain was too much—he blacked out.
At around 10,000 feet, Hillary’s limp body slipped out of the inverted aircraft. He regained consciousness to find himself spiraling in midair, falling toward the North Sea. With his body shaking and air roaring in his ears, Hillary managed to pull the ripcord and open his parachute. After he landed in the water, his navy-issue life jacket kept him afloat. Instinctively, he lifted his wrist to check the time; his watch was gone. Then Hillary noticed his hands. “The skin was dead white and hung in shreds,” he later recalled. The smell of his own burnt flesh—grotesquely reminiscent of charred pork, some airmen have said—curdled his stomach. Helplessly, he bobbed up and down on the ocean, his teeth chattering from hypothermia. He shouted for help but none came. When he looked at his hands again, he realized he could no longer see them—he had gone blind. Considering the end was imminent, Hillary fumbled to unfasten his life jacket and hasten his demise; he had heard that drowning was a peaceful death. But the parachute straps wrapped around his limbs kept him afloat. Three hours later, a lifeboat plucked him from the sea.
In the previous world war, such injuries were rare. Early pilots flew without parachutes and rarely survived crashes. For the few who did emerge alive from wrecks, a lack of antibiotics meant their wounds would likely turn fatal. Up until World War II, aviation technology rapidly advanced, but flying remained a dangerous task. The RAF’s early frontline fighters—the Spitfire and the Hawker Hurricane—suffered from a critical weakness: a fuel tank placed directly in front of the pilot. In the event of a crash, or if bullets or shrapnel pierced the tank, the pilot would take the full brunt of the explosion. Of the 4,500 RAF airmen rescued from their crashed planes, 3,600 of them sustained serious burns to their hands or face. Of these, 200 were so badly burned that they lost most or all of their facial features and became known as the “faceless ones.” These pilots now faced a new and even greater challenge—living with faces so disfigured that they were barely able to convey love, laughter, sadness, or even pain.
When Britain’s “boys in blue,” on average just 20 years old, signed up in the wake of Hitler’s rapid advance across Europe, they envisioned tailored jackets, white silk scarves, and plenty of female attention. They did not expect to one day look in the mirror and see
a raw, melted, scabbed, and badly swollen face—sometimes three times its normal size—peering back at them.
In 1939, Britain was home to just four full-time plastic surgeons, who spent most of their time reconstructing cleft palates and treating car-crash injuries. One of them, a New Zealander named Archibald McIndoe, had been appointed plastic surgery consultant to the Royal Air Force in 1938. Within two years, his skill at treating burns and reconstructing faces was so renowned that the RAF gave him his own facility—Ward III at the Queen Victoria Hospital in East Grinstead, Sussex. There, he received the most drastically burned and maimed airmen, many wounded during the Battle of Britain.
Set about 50 yards away from the main hospital building, Ward III was a long hut with 20 beds on each side. In each bed lay a young man with severely disfiguring injuries: one missing a jaw and mouth lay next to another whose raw, red eyelids were in the process of being reconstructed. Bones protruded from what was left of arms and faces. Some men had charred stumps in place of hands. Others lacked noses; many had bandaged arms attached to their chests.
Although McIndoe was immensely busy—typically performing at least four surgeries per day—he spent time with each of his new patients, inquiring about how they were injured, what protective gear they had been wearing, and how long they floated in the water before being rescued. From behind his horn-rimmed glasses, McIndoe projected a calm air of confidence and practicality. Tom Gleave, who destroyed five German planes in one day before being shot down in August 1940, recalled how McIndoe’s “clear, candid gaze…gave one immediate strength. You had an instinctive feeling that this man was not going to fool you.”
For each of the 720 burned airmen treated at East Grinstead during the war—200 of them severely disfigured—McIndoe designed a personalized reconstruction plan. On average, each patient underwent 10-50 operations over the course of three years. During these prolonged periods of treatment, McIndoe insisted that special care also be given to the airmen’s state of mind. He would inform each patient about which surgeries were required, what they would accomplish, and the phases of recovery. This created, he said, “a degree of trust and confidence…between surgeon and patient” that was “absolutely essential for a successful outcome.”
In addition to caring for his young patients’ psychological health, McIndoe also had to tackle physical complications that arose from previous treatment the airmen may have received in the field or at emergency hospitals. Throughout much of the war, burned servicemen had been treated with outdated coagulation therapy. This involved covering burned areas with a formula made from tannic acid that hardened, creating a thick black crust that theoretically allowed the burned skin to heal. McIndoe realized that coagulation therapy was not only painful, but destroyed potential skin graft sites and led to gangrene. Worse, when tannic acid was applied to the eye area, it could permanently damage eyelids, leaving them unable to close or, in severe cases, cause blindness.
At McIndoe’s suggestion, the RAF adopted a new protocol for treating burns. The injury was to be kept clean, dry, and loosely covered in Vaseline-soaked gauze so it would not stick to wounds. McIndoe also realized that saline baths helped the healing process after he noticed that patients who had floated in the ocean prior to rescue recovered from burns better than those who had crashed on land. He installed a saline bath in his burn ward and patients used it regularly to keep their skin clean and supple. Finally, McIndoe and his team worked with the latest techniques of plastic surgery. Through careful handiwork, he created new eyelids, lips, cheeks, noses, necks, foreheads, eyebrows, and ears.
During the reconstruction period, some of these new features were nourished by pedicles—trunk-like flaps of grafted skin that were then “anchored” to blood supply flowing from elsewhere in the body. Although McIndoe was recognized for pioneering the use of pedicle tubes, he never forgot how patients might feel waking up to find what looked like an elephant trunk sprouting from their nose or cheeks. McIndoe realized a bandaged and swollen patient might understandably feel that “the immediate results are often more horrifying than the original condition.”
WHILE MCINDOE’S INNOVATIONS in burn treatment and surgical techniques earned him international recognition in the medical community, the community he created for the burned airmen proved equally important to his legacy. Ward III showed signs of the men’s indomitable spirit. Distributed about the room were a radio, a piano, and an ever-full keg of beer, from which the ward’s members were encouraged to help themselves; McIndoe reasoned that any liquids would aid in the recovery of their dehydrated bodies. The patients talked and argued amongst each other, swearing prodigiously and even telling jokes. When McIndoe told Paul Hart, one of the “faceless” men, that it would be understandable if he occasionally groaned from pain, Hart quipped, “that would never do! You’ve got to keep a stiff upper lip in this ward even if you haven’t got one.” On another occasion, while joking around with a squadron leader, Hart told him: “I’d punch you in the nose…if I didn’t think it was going to fall off anyway.” His superior retorted: “I’d clout you back, if you had a face to hit and I had a hand to hit you with!”
McIndoe also encouraged Ward III’s occupants to socialize with members of the East Grinstead community. He led excursions to local pubs, parties, and dances. Ladies visiting from East Grinstead brought flowers and decorations to brighten the men’s spirits. Townspeople welcomed the patients into their homes for tea or beer, but many of the airmen refused these invitations until they were outfitted with zippered—rather than buttoned—trousers: much easier to manage with their wounded hands when the inevitable restroom visit called.
On occasion, even their return to the ward could be chaotic. Nurse Mary Rea recounted her first night at Ward III, when one patient arrived home after a night of drinking and tripped while making his way back to his bed. He landed bottom-first in a bucket of Lysol. Rea promptly introduced herself to the airman, stripped him of his trousers, turned him over, and began to treat his new burns—which, fortunately, were only first degree.
ON SUNDAY, JULY 9, 1941, after a particularly hard night of drinking, the men of Ward III decided to honor their exploits by incorporating themselves into an official “grogging” society. With the table in front of them crowded with glasses of beer and sherry, they named themselves the “Guinea Pig Club.” After all, their faces and bodies were the sites of McIndoe’s experimental plastic surgeries. One of the members’ wives drew up a club logo—a guinea pig with wings. They printed membership cards, created a dues schedule (two shillings annually), and decided membership would be limited to three groups: the patients of the ward, the East Grinstead medical staff, and the auxiliaries who made up the “Royal Society for the Prevention for Cruelty to Guinea Pigs,” meaning “those friends and benefactors who…make the life of the Guinea Pig a happy one.”
Tom Gleave, the senior-most ward patient, would serve as “Chief Guinea Pig.” Peter Weeks was named treasurer, since his badly burned legs were in casts and “he was therefore incapable of running away with the club funds.” The members then invited McIndoe to serve as honorary leader of the club. “Dear Boss,” read the note they sent him. “Will you be our President?”
The membership dues helped other Guinea Pigs by covering medical costs or assisting with unemployment. In later years, the Guinea Pigs made substantial contributions to the RAF Benevolent Fund that had long helped individual members in need. They helped each other find employment when they could. They even published a magazine, The Guinea Pig, which included cartoons and line drawings by Henry Standen, who completed them despite burns to his hands. The Club also hosted holiday dinners, enjoying plum pudding, roasted potatoes, and turkey—which McIndoe himself carved while wearing surgical scrubs—on Christmas 1944.
Each year, they mounted a “Lost Weekend”—a reunion for former Guinea Pigs who had finished their course of surgery. And, of course, they drank. At a 1949 reunion dinner, 225 former Guinea Pigs put away no fewer than 3,000 bottles of beer, 125 bottles of whiskey, and 72 bottles of sherry. During their revelry, they sang their own theme song:
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!
The Club’s rowdy antics exemplified how McIndoe wanted his ward to function. He knew that fighter pilots were, by nature, aggressive, alpha-male types who did not respond well to the rules and restrictions that governed most hospital wards. McIndoe explained that though “their bodies may be broken…their youthful spirits are still with them.” The surgeon therefore tolerated the “boys will be boys” behavior common among 20-year-olds, much of it in the form of pranks and romantic overtures directed at the nursing staff. To the nurses who complained, McIndoe said: “these men have put up with a hell of a lot, and so you can put up with just a little nonsense.”
As a civilian doctor, McIndoe was unafraid to challenge service rules he felt were unsuited to the Guinea Pigs. He did away with hierarchical military rank in his ward; officers and enlisted pilots equally shared facilities. Though patients at military hospitals were normally required to wear “hospital blues,” McIndoe successfully lobbied for the Guinea Pigs’ right to wear their RAF uniforms whenever they chose. “The RAF Uniform,” he wrote to air staff chief Sir Charles Portal in 1944, “is the accepted reason for [the Guinea Pigs’] disfigurement, and to continue wearing it for as long as possible saves the injured man from considerable embarrassment and awkward explanations.”
McIndoe’s most meaningful challenge to the RAF was his questioning of the infamous “90-day rule,” which stipulated that if an injured serviceman was unable to return to duty within three months, he would be declared an invalid and given a modest pension based on the severity of his injuries. Such an arrangement not only discouraged the young pilots who dreamed of returning to active duty, but also meant that once discharged, many would be unable to cover the costs of their continued treatment and surgery. McIndoe declared that even though the Guinea Pigs needed repair, they were not permanently disabled. Along with East Grinstead anesthesiologist Russell Davies, he campaigned to have the rule overlooked for his patients. He and Davies also saw to it that the Guinea Pigs who were unable to return to service were pensioned out at an average of 100 percent of their former pay.
MCINDOE’S GREATEST SUCCESSES often came after the Guinea Pigs left his care; by war’s end, 80 percent were sufficiently rehabilitated to return to military service in some capacity. Godfrey Edmonds, his first wartime patient, successfully underwent 20 operations to reconstruct his burned face. He later returned to flying and even trained paratroopers. Geoffrey Page and Richard Hillary were especially keen to get back in the air, with Page secretly strengthening his injured fingers by squeezing a rubber bouncy ball that he hid under his bedcovers. The two begged McIndoe to clear them for duty, but he was reluctant—they had done enough to serve their country. After several weeks of nagging, McIndoe finally gave in. “If you’re determined to kill yourselves, go ahead,” he told them, signing their medical certificates. “Only don’t blame me.”
Page was assigned to noncombat flying duties, with the possibility of returning to active combat in the future. Hillary, whose vision had not yet been fully restored, was initially excluded from flying. In 1942, he again sought certification and was awarded night flying duty. Knowing Hillary’s vision was still recovering, McIndoe wrote privately to RAF medical officials, suggesting “if you could with discretion restrain [Hillary] from further flying, it might save him from a very serious accident.” He received no response. On January 8, 1943, Hillary crashed inexplicably just after takeoff and was killed. He left behind one of the most widely read firsthand accounts of British airmen in the war, The Last Enemy.
Despite the sad end to Richard Hillary’s story, many of McIndoe’s boys found success after their injuries. Several married the young women who had been their nurses at Sussex. Some became commercial airline pilots, others worked in factories. Permanently blinded despite 46 operations on his face and 18 on his corneas, Jimmy Wright was unable to continue his prewar work as a cameraman and opened a production studio; in 1981, he received an award from the British Academy of Film and Television Arts. Inspired by McIndoe’s service to the airmen, Bertram Owen-Smith became a successful plastic surgeon. Colin Hodgkinson, who lost both his legs in a training accident, was fitted with two metal prostheses and went on to have a successful career as a fighter pilot, even surviving a second crash in 1943. Tom Gleave returned to the RAF in nonflying duties, serving until 1953. Geoffrey Page’s exercises with the rubber ball eventually paid off, and by 1942 he returned to full-time flying duty, vowing to shoot down at least one German plane for each of the 15 operations he had undergone during his recovery. While landing at Antwerp, German shells struck Page’s aircraft and he crash-landed. He was pulled from the wreckage and soon found himself back in East Grinstead’s Ward III. “I felt I was almost indeed returning home,” he would later say. Page eventually married, had three children, and lived a full life until his death in 2000.
Archibald McIndoe maintained lifelong friendships with some of the Guinea Pigs. He managed a successful private practice in plastic surgery and continued to operate on club members who needed assistance after the war. The governments of France, Poland, Czechoslovakia, and the Netherlands decorated McIndoe for his wartime service, and he was knighted in 1947. In 1958, McIndoe was invited to address England’s Royal College of Surgeons regarding his work with burn victims. He celebrated the advances in the field of reconstructive surgery, praising modern medicine’s ability to “create order out of chaos and make a face which does not excite pity or horror. By doing so we can restore a lost soul to normal living.” Two years later, at age 59, McIndoe died in his sleep.
His beloved Ward III has since transformed into a medical research center specializing in plastic surgery and wound healing. Thanks to the painstaking efforts of McIndoe and his staff, the support and appreciation of the British public both during and after the war, and the gregariousness of the men themselves, the story of the Guinea Pig Club is one of heroes turned victims who became heroes yet again.✯