Stephen awoke in the middle of the night with a slight start, shouting a little as his bulging eyes adjusted to the darkened room around him. His breathing was fast, gulping as he tried to slow it down; heart pounding in his chest. What had happened? Images floated before his eyes, images that he’d hoped to never see again. Stephen’s breathing has finally slowed down to a normal rate. Getting up from his army issued bed, Stephen wanted to go and splashed some water onto his face. Instead, returned to his bed pulling over the itchy blanket over his body. Turing onto his side, apprehensive to go back to sleep.
A few hours later Stephen woke to screams coming from near by, loud screams echoing through the night sky. Looking around Stephen realised that the screaming was coming from him. In front of his eyes he could see dead soldiers with limbs hanging by a thread of skin. Stephen couldn’t stop screaming, starting to hyper ventilate. His eyes were bulging as he shook and rocked back and forth trying to avoid the bodies. In the distance was a sudden bang, men entered his barracks, pinning Stephen to the floor. A needle was jabbed into Stephen, the screams and bodies started to fade.
The next morning, Stephen woke, his head foggy from the contents of the syringe that had been used on him the night before. Stephen turned his head, looking around the barracks; he was still in his own sparse bunk. Alone, Stephen tried to remember what had happened the night before. But try as he might, the memory was hazy at best. Stephen knew that he had been screaming but could not remember why. Stephen was due to start as one of the few army doctors soon. Working in the middle of a war zone, was nothing like working back home. Limited medical supplies and more casualties then they could keep up with, meant that they were under pressure to get soldiers back to the front line of the trenches.
Stephen started his duty in the medical unit of the army camp, still confused about the activities of the night before. He tried to focus on the day ahead. Throughout the night more injured soldiers had arrived from the front line. In pain and scared. Everyone around Stephen were getting on with the tasks in hand, Stephen was standing outside one of the medical tents, cigarette in hand. Trying to steady his nerves before amputating someone’s leg, already partly shot off by enemy fire. Inhaling, Stephen could hear the screams of pain coming from inside the tent.
As Stephen stubbed out the cigarette and walked into the tent, he saw for the first time the extent of the injury. The soldier was now silent after being knocked out with cocaine, by the other doctor; Dr Mason. Stephen looked again at the leg and saw that the femoral artery had already been clamped, stopping the blood loss:
“How much blood has he lost?” Stephen asked.
“Too much, the artery has been completely severed. He’s lucky to make it to us alive.”
Stephen took another look at the leg and saw that it was hanging by a thread of skin. Seeing Stephen’s face go pale, Dr Mason decided to carry out the procedure and allow Stephen to move onto the next soldier who had just been brought in.
The soldier was in a bad state, machine gun fire had torn open his body, and was already unconscious. Dr Mason looked up from the other table:
“There’s nothing that you can do for him, just make him comfortable.” He said as a matter of fact, handing over a syringe of morphine. Stephen knew that Dr Mason was right, no matter how much he wanted to protest. Stephen had gone into medicine to help people not to kill them off. But they just didn’t have the supplies or time to put the body back together. Reluctantly, Stephen administered the dose of morphine, knowing that it wouldn’t be long.
Stephen was screaming again and thrashing about in his sleep. Dreams were haunting him. The face of the soldier that he couldn’t save earlier in the day was staring at him:
“You didn’t even try.” The dead soldier screamed.
“I did” Stephen replied. “It was the other doctor who said that you wouldn’t survive.” Stephen was pleading with the ghost in his dream. Stephen’s screaming was starting to wake up the rest of the military base. Stephen was thrashing his arms and legs so much that he fell from his bunk, waking him up. Although Stephen was now awake, he was still screaming and shaking. The dead soldiers were standing around him so that he could not escape.
Dr Mason entered Stephen’s barracks with the captain and two other personnel:
“Hold him still.” Dr Mason commanded. The two men held Stephen down whilst Dr Mason administered a sedative. Quickly the screaming and shaking began to subside and the silence of the night returned to the base. Slowly the two personnel men lifted Stephen back onto his bunk:
“I can’t keep sedating him, he needs help.” Dr Mason said.
“So, do most of the men here.” The captain replied shortly.
“I know, but he is one of two doctors, he needs help so that he can help others.”
“Okay, I’ll see what I can do.” The captain said reluctantly, taking one last look at a silently sleeping Stephen.
As Stephen slept, guards were placed outside, partly to keep an eye on him, but mostly to rush in if he started screaming again. Meanwhile, Dr Mason was trying think of the best way to help his colleague. The symptoms being shown by Stephen and other men were becoming more common, and yet they had little knowledge of treating it. The last thing Dr Mason wanted was Stephen to be carted off to a local asylum.
Dawn was breaking over no man’s land, and overnight fighting had bought more soldiers to the casualty area; slightly away from the front line. Over by the medical tents the two guards were still standing outside. No screams could be heard, but there had been a scratching sound being made against the ground. Unbeknown to the guards, the sedative had worn off a few hours ago. And since waking Stephen was trying to leave his barracks. But he had seen the boots of the guards standing outside. Stephen knew that he would not be allowed to leave, so he had tried to dig his way out.
Dr Mason woke from his short slumber. Having to wake in the middle of the night to sedate a fellow doctor was starting to wear on him. Dr Mason did not hold out much hope that help would be secured for Stephen. If anything, if he couldn’t be a doctor then they’ll probably send him to the front line to fight. Dr Mason really hoped that this would not be the final decision. Dr Mason exited his barracks and walked the short distance over to the two guards standing outside Stephen’s barracks:
“Any screaming?” Dr Mason asked.
“No sir, no screaming. There has been an odd scratching sound though.”
Stephen was pacing up and down, blood running from his fingers. A bloody patch of ground was disturbed. In it was as piece of broken off finger nail. There was a manic look across Stephen’s face. A look of someone who had been trying to hold it all together, but there had clearly been something disturbing him:
“Stephen.” Dr Mason said.
“I didn’t want you to die, I wanted to help save your life. But your injuries were too severe. Please believe me.”
“Stephen, who are you talking to?”
“The soldier standing behind you.”
Dr Mason turned around, there was no one there. He and Stephen were the only people in the room. With one of them looking quite insane.
Eventually, Dr Mason convinced Stephen that they were the only two people in the barracks. Cleaning and bandaging Stephen’s hands, there was no way that he could work today. Not just that his fingers were wrecked, but Stephen was still shaking. Dr Mason was convinced that Stephen was not telling him everything that was going on when left on his own. As Dr Mason left, Stephen was starting to go to sleep. Two new soldiers had been placed outside on guard duty:
“Any sound from him, come and get me.” Dr Mason ordered them. As he marched off, resigned to dealing with the day’s casualties on his own.
It was becoming a nightly routine, the screaming. This time the guards tried to restrain Stephen because he was thrashing about, as Dr Mason ran into the barracks. The guards who had been standing outside has rushed in and were trying to pin Stephen to the floor. Dr Mason managed to sedate him. But the routine was starting to become draining on everyone involved at the base. This was especially true for Dr Mason, who had forgotten when he’d last had a decent night sleep. He was starting to hear Stephen’s screams in his own dreams. Thankfully, though, the Captain had agreed for Stephen to be seen by a psychologist. The hope was that the psychologist would get Stephen out of there and back home for some help. By the time the psychologist arrived, Stephen had become completely deranged. Muttering under his breath to the ghosts the he could see, whilst pacing up and down his barracks. It was hard to get Stephen to stay still, unless he was asleep.
The psychologist who arrived at the base, was an academic man who had studied the works of Freud and Jung. Initially, Stephen was told he was to be kept in bed, and rather than continuous sedation, any behaviour that could be determined as ‘troublesome’ was to be treated with bath treatment. Keeping Stephen in a cold bath until he calmed down. This treatment was also to be given to any man in the medical base, who displayed symptoms of shell shock, who was being ‘troublesome.’ Dr Mason’s expectations of the psychologist were some what deflated after hearing this decision. It has also been suggested that Dr Mason should talk to Stephen with compassion about the dreams and nightmares that he was having.
That night, as fighting took place over no mans land, the sky was once again shattered by the sound of Stephen’s screams. Following the advice from the psychologist, rather than sedating Stephen, the guards carried him kicking and screaming to the bath tub. The screams became louder as the cold water lapped over Stephen’s skin. Stephen was thrashing about trying to get out of the bath tub but was being held down by the guards. For Stephen, the cold water was added torture to the ghosts that he could see in front of him. As Stephen started to get use to the coldness of the water, the screams started to die down. Being replaced by fast deep breaths, sounding like Stephen was starting to hyperventilate. Slowly, Stephen’s breathing came under control, the experience leaving Stephen exhausted.
Back at the barracks a sleepy Stephen was in his bunk, Dr Mason was sitting next to him. Calm, Stephen, looked almost peaceful, like his old self. Dr Mason cleared his throat:
“Stephen, when you sleep, what is it you dream about?”
“The soldiers who I could not save when they come here.” Stephen spoke quietly and softly, as if ashamed about having to talk about it. He had been raised to have a stiff upper lip, like many men:
“And what is it about them that make you scream?” Dr Mason asked.
There was a flicker of distress that went across Stephen’s face, it was not something that he wanted to talk about. Reluctantly though, after a long pause, he said:
“They’re like ghosts, they look the same as they did when they arrived here. Limbs hanging off, they are in pain and I cannot help them.” Stephen was starting to talk faster as his heart beat started to rise:
“They tell me that I am not a good doctor, that I should be doing some real work, fighting alongside them rather than being hidden away from the front line.”
“Is that what you want, to be on the front line?”
“No, I’m a doctor. I want to make people better. Help those who are sacrificing their lives.”
Becoming distressed, Dr Mason tried to sooth Stephen, calm him back down. Dr Mason just wanted Stephen to just have a decent night. Show the psychologist that talking was helping. He was doubtful though. Dr Mason rested his hand on Stephen’s shoulder as he got up to leave.
Back in his own barracks, Dr Mason was worried. He knew that he wasn’t the right sort of doctor to help Stephen. And wondered if this was even helping or was it still too raw. Dr Mason got into his bunk and closed his eyes. It appears his eyes were closed only moments, before he was being woken up by a guard; who simply said:
“He’s screaming again.”
Dr Mason didn’t have time to get Stephen to the bath tub and do what the psychologist had recommended. Returning to the short-term relief of sedation. Dr Mason knew that none of this was going to work. He knew that Stephen needed to be in an institution back in England. As Stephen slept, Dr Mason went to see the Captain. Knowing that now dawn had risen, he would be up and aware of the latest outburst.
Knocking on the door of the Captain’s office, a voice calls from inside, letting Dr Mason know that it was okay to enter. Dr Mason walked into the office:
“Captain, sir, I’d like to talk to you about Stephen.” Dr Mason said confidently.
“Ah yes, the mad doctor. What about him?”
“I’d like to send him back to England, so that he can get proper help. Him being here, so close to the front line is not helping him or the other men at the base.”
“What about what the psychologist recommended?” the Captain asked.
“We’ve tried the recommendations from the psychologist. But he needs more long-term help.”
“You know that I cannot guarantee that we’ll get another doctor here right away?”
“Yes sir, I understand. But now I must put that to one side and focus on what is best for my patient.”
“Very well, I’ll get the paper work together to send him home and get him institutionalised at an army medical facility.”
“Thank you, sir.” Dr Mason saluted and turned to leave the Captain’s office. Surprised at how easily it had been to convince the Captain. Dr Mason wondered if he was sick of hearing about Stephen’s outbursts.
The paper work came through a couple of days later. It could not have come sooner, as Stephen’s outbursts had started to become longer and more frequent throughout the night. To the point where Dr Mason was spending much of the night with Stephen. Talking to him, trying to calm him down and getting him to open up about what he was experiencing. Alternating between the bath treatment that had been recommended and sedating him with cocaine. The day Stephen left the base Dr Mason had mixed feelings, happy that Stephen was finally going to get help. But also, sad knowing that he will never be the same person that he uses to be.
Back in England a lucid Stephen was met by two doctors as he got off the ship. On the ship home had been the first time that Stephen had been able to relax, thinking that he was going home to his family. One of the doctors put his hand on Stephen’s shoulder:
“Dr Stephen Thomas, you need to come with us.” The doctor said.
“Excuse me? I’m going home to my family.” Replied Stephen.
“Please sir, do not make this any more complicated than it already is.” The doctor said guiding Stephen towards the carriage, eventually getting him to sit in the back. The two doctors either side of him.
“What is going on?” asked Stephen.
“We have orders from your Captain and Dr Mason to take you to a hospital for the insane.” The word insane made Stephen try to lunge forward and get out of the carriage. But he was held back by the two doctors. Struggling against the weight of the two stronger men, Stephen hadn’t noticed a third man sat opposite him. The third man remained silent but leaned forward, injecting Stephen with a sedative. Soon Stephen stopped resisting and fell asleep.
Waking up, Stephen’s eyes had to adjust to the darkness. He was in a small cell like room. Stephen’s head had been shaved and he had been changed out of his military uniform. The door to the room was locked from the outside. Frantic, Stephen started to bang on the door. But nobody came. Getting more and more worked up, Stephen started to scream, kicking and punching at the door. Eventually, the third man who had been in the carriage with Stephen came to the door. Unlocking and opening it slightly, so a solo beam of light was visible in the cell:
“Stephen, the longer you keep this up, the longer you will stay here.” With that the door was slammed shut and locked. Stephen was in darkness again. Stephen was never seen in society again.