Helena Schrader's Historical Fiction: The Most Exclusive Club in the World -- The Guinea Pig Club

Speaking of it after the war, the celebrated plastic surgeon Dr. McIndoe claimed: “It has been described as the most exclusive Club in the world, but the entrance fee is something most men would not care to pay and the conditions of membership are arduous in the extreme.”

The Guinea Pig Club

One of the greatest hazards in flying a in WWII was the risk of fire. The combination of high-octane aviation fuel and incendiary bullets meant that many aircrew burned to death in their aircraft before they could escape. Yet some managed to escape the flames and live — often with first degree burns covering their faces, hands and other parts of their bodies. Crash-landings also sometime resulted in complete disfigurement. In an age when plastic surgery was still in its infancy, reconstructing faces was largely an experimental process. So, the pilots treated by the pioneering and talented New Zealand plastic surgeon Archibald McIndoe called themselves the “Guinea Pigs.”

Over 600 patients benefited from the then experimental surgery techniques employed by Dr. McIndoe. By the time Dr. McIndoe’s Ward at the Queen Victoria Hospital in East Grinstead closed in 1948, 80% of the patients had been aircrew from Bomber Command and most of the rest aircrew from Fighter Command. Only a handful of patients had been Royal Navy or Army victims of burn or other accidents requiring plastic surgery. It was Battle of Britain pilot Geoffrey Page started the Guinea Pig Club; membership was restricted to those who received Dr McIndoe’s medical care and the staff that worked in his ward. Another Battle of Britain pilot, Richard Hillary, made McIndoe’s work famous in his wartime classic, The Last Enemy. (Below a photo of Hillary before being shot down in flames on September 3, 1940.)

McIndoe's patients had all sustained such severe injuries as to require a series of operations to reconstruct facial features and replace skin. Skin grafts were taken from other parts of the patient’s body and sewn in place to create eyebrows, eyelids, lips, and ears. Hands also sometimes had to be reconstructed. In one case, Dr. McIndoe created fingers from the bones of the back of the hand. In nearly all cases, skin grafts were required for the hands as well as the face.

Throughout the slow reconstruction process, the risk of infection was great. Furthermore, some grafts simply wouldn’t take, meaning that the operation had to be repeated until it worked. Because operations had to be spaced out to allow the body time to recover between interventions, patients spent many months and sometimes several years in treatment.

In addition to experimenting with medical techniques to treat burns and conduct plastic surgery, McIndoe pioneered methods to treat the psychological impact of such disfiguring injuries. While all severe wounds have a psychological impact on a patient, the loss of one’s face was particularly shattering because human identity is strongly tied to what we see in the mirror.

Battle of Britain ace Bob Doe's face was crushed into his gun-sight during a crash landing, tearing out one eye and ripping off his nose as well as "redesigning" his upper jaw and the right-hand side of his face (as Doe worded it in his memoir). Bob Doe remembered:

I suffered every time I looked in a mirror and was sure that I had been quite handsome. But now, to me, I was unrecognisable. I have found that to some extent, your face creates your character and your character creates your face. Either way, I had changed, and I did not know what I was. [Bob Doe. Fighter Pilot. CCB Aviation Books, 2006, 54.]

Below Doe before the plastic surgery.

Geoffrey Page describes the following incident:

One of the prettiest girls I’d seen in my life came into the room to help [the matron] with the dressings. Attired in the cool, colourful uniform of a V.A.D. Red Cross nurse, she personified the wounded warrior’s vision of the ideal angel of mercy. Standing beside the dressing trolley assisting the professional nurse, she was unable to hide the expression of horror and loathing that registered on her lovely face at the sight of my scorched flesh. [Geoffrey Page. Shot Down in Flames. Grub Street, 1999, 86.]

Page requested a mirror and was denied it by the matron. She told him bluntly:

“You will be allowed to look in a mirror, Pilot Officer Page, when I see fit to permit it and not before.” [Geoffrey Page, 87.]

After the nurse had left, Page with great difficulty managed to drag himself out of bed and stagger to washbasin beside his bed above which hung a mirror. He writes:

“Tottering in front of the mirror, I squeezed the moisture out of my eyes and surveyed the image in front of me. The shock of the swollen face three times the normal size was almost too great to comprehend…. [Geoffrey Page, 88.]

Below Page before the plastic surgery.

Clearly, McIndoe’s patients were facing exceptional psychological stress — and most of them were hardly out of their teens. He responded by encouraging an informal atmosphere that including barrels of pale ale in the ward. Between treatments, the patients were sent to convalescent homes or allowed to stay with family and friends. They were encouraged to wear their own clothes or service uniform rather than hospital attire, and they were encouraged to be social. That meant going to the pub, the theatre, flicks and nightclubs. While they often encountered pity and horror, some of the local barmaids were up to the challenge. Doe still remembers with affection the barmaid at the local pub, noting in his memoir:

Can you imagine five or six chaps, some of whom were in a ghastly state with severe burns, walking into a large comfortable bar full of people, (who tended to edge away from this frightful sight!) and being greeted by — ‘My darling — how lovely to see you!” and being given a big kiss! She deserved a medal if anyone did. [Doe, 53]

Yet as time wore on, East Grinstead became so used to the sight of McIndoe’s patients that it was known as “the town that didn’t stare.”

Meanwhile, McIndoe worked wonders. While it was largely up to family and friends to help the young men come to terms with their new faces, McIndoe also worked to find ways to assist in the reintegration of patients in normal life. Very few men were invalided out of the service. Many found non-flying jobs as controllers, intelligence officers, adjutants and the like. Others, however, sought and were allowed to return to full flying duties. Hilary, Page and Doe all returned to full operational flying. Hilary was killed in action in January 1943. Page and Doe both rose to the rank of Wing Commander and survived the war. Below, pictures of all three after their surgery.

Richard Hilary 1942

Wing Commander Doe 1943

Wing Commander Page (second from left) 1944

A Stranger in the Mirror tells the story of a pilot shot down in flames in September 1940. Not only is his face burned beyond recognition, he is told he will never fly again. While Dr McIndoe recreates his face one painful operation at a time, the 22-year-old pilot must discover who he really is. Although fictional, the novella draws heavily on autobiographical accounts of Hilary, Page and Doe in describing his treatment and physical recovery.