top of page
  • Thomas Bowers

The Hidden Disability of The First World War

Updated: Sep 27, 2020

The First World War left both physical and psychological scars on the soldiers who survived service with their lives. Those who had physical disabilities such as a facial disfigurement were looked upon as different by society. Facial reconstruction surgeon Major Harold Gillies pioneered surgery to enable these men to go back to society and face everyday life once more (Burdett, p 181). Gillies paved the way for modern reconstructive plastic surgery and his work on injured soldiers as part of the Royal Army Medical Core is documented in his book Plastic Surgery of the Face. The book features powerful images of his patients including medical drawings of the procedure undertaken on each individual. With soldiers missing part of their face, the reconstructive surgery made their physical scars less visible, and this helped them to feel confident about going back to their life and to enter human interactions (Bamji). These encounters would at times involve some unwelcomed staring from inquisitive individuals; however, this would ease overtime as their scars healed up. Gillies realised the importance of patient recovery after the initial operation and how pivotal it felt for some of them to look the way they did prior to injury. The closer the patients looked like their self prior to injury, the less negative mental impacts would be placed upon the patient mitigating their psychological scars.

The Impact of ‘Shell Shock’

Men who returned from the frontline physically healthy and uninjured would suffer psychological scars and did not receive the same empathy given to those with physical scars. The attitude of the time was that these men should ‘buckle up and get on with life’. With a lack of societal acceptance for men talking about their feelings, these men would be forced to carry their mental trauma through their life. This trauma was a constant in their life, a hidden, invisible disability they were forced to conceal from society and their family. They were suffering from ‘Shell Shock’. The term Shell Shock became prominent after it featured in The Lancet medical journal on the 13th of February 1915, under the title ‘A Contribution to The Study of Shell Shock’. British Phycologist, Dr Charles Samuel Myers, highlighted that constant trauma could cause a progressive debilitating mental illness. The term Shell Shock derives from the trauma caused to a soldier from the terror of an impending artillery shell bombardment. The roaring sounds caused from explosions and physical threat to life at any moment would cause a negative impact to the mental health of a soldier. Prior to the battle of the Somme on 1st July 1916, a seven-day bombardment of German Lines began on the 24th of June. The week prior to the battle, 1.5 million shells were fired, obliterating the French landscape, turning the picturesque fields and forests into desolate wastelands. In fact, the post-apocalyptic landscape shaped the writings of author J.R.R. Tolkien and clear influence can be seen in the Lord of The Rings trilogy. The description of an area called the ‘Dead Marshes’ in The Two Towers is reminiscent of no-man’s land; this area in middle-earth is barren and devoid of life.

No sun pierced the clouded sky…a shadowy silent world…an endless network of pools, and soft mires, and winding half-strangled water-courses. It was dreary and wearisome.

J.R.R. Tolkien, The Two Towers: The Passage of the Marshes (London: Unwin Paperbacks, 1954 p288-289.)

J.R.R. Tolkien joined the Lancashire fusiliers as a second lieutenant fighting in the battle of the Somme and participated in three assaults on enemy positions. He witnessed devastation and the loss of his close friends and comrades. The dead marshes described by Tolkien were riddled with corpses from a historic battle, the souls of which have been trapped in this mystical marsh. Tolkien would have been familiar with the sight of corpses and these horrific images would have stayed with him. Perhaps, writing was an outlet for him to channel his mental trauma and turn it into something creative.


In 1922, a report was issued by the war office called ‘The Report of the War Office Committee of Enquiry into “Shell-Shock”’. This enquiry stated that the term ‘Shell-Shock’ should be abolished and that those suffering from trauma should be treated separately from those with physical wounds. The committee also stated that only concussion victims should be recorded as battle casualties whilst other forms of mental illness should not. This decision seems to have been made in order to reduce the official figures of PTSD amongst those serving on the frontline. This statement does not take into account those soldiers who did not suffer from concussion; however, the horrors of war would undoubtedly leave their mark on everyone serving on the frontline. A key point made by the enquiry is that ‘no solider should be allowed to think that the loss of nervous or mental control provides an honourable escape from the battlefield.’ Ted Bogacz wrote about the work undertaken by the committee in War Neurosis and Cultural Change in England, 1914-22: The Work of the War Office Committee of Enquiry into 'Shell-Shock’. He stated that ‘many of these conclusions reassert pre-war military values’ (Bogacz. p248). It seems that the attempt to diagnose the trauma of war as a recognisable illness had been overshadowed by the military. The military asserted that if one stated that they suffered from shell shock in order to evade military service, it would be seen as cowardice and dishonourable. This statement created a negative stigma around mental illness amongst soldiers and impaired the care and treatment of this debilitating illness.

It fuelled the fire of prejudice against anyone suffering from mental illnesses.

Two years after the end of the great war, 65,000 veterans were drawing disability pensions for neurasthenia (impacts of shell shock); 9,000 of these were still undergoing medical treatment in hospital (Bogacz, p 1). The mental impact of the war did not discriminate, and social class and wealth did not prevent someone from the hidden illness created by warfare on an unprecedented scale. Officers in charge of their men would often feel personal responsibility for soldiers’ survival and each loss could impact them severely. An officer would certainly be wondering if any given assault would be guiding his men to death. The dread of writing a ‘killed in action’ telegram to a relative would fester inside their minds causing further mental distress. Bogacz refers to the ‘crushing sense of responsibility and the fear of showing fear…which might lead to mental collapse’ (Bogacz, p233). Sharing a common illness in the form of ‘shell shock’ would unite men across hospital rooms who would otherwise not necessarily relate to one another due to a gap in wealth or social class.

Those who survived the war suffered from survivor’s guilt syndrome, asking themselves the question: why did I survive? Most veterans did not talk about their traumas until late in their life. My own great-grandfather, 7027 Private Joseph Cyril Pagdin of the West Yorkshire regiment, was one of those veterans.

Report of the War Office Committee of Enquiry into "Shell-Shock", 1922, RAMC/739/15/19. (image description: a turquois-blue colored booklet cover, with the title 'Army. Report of the War Office Committee of Enquiry into "Shell-Shock")

The 306

306 British and Commonwealth soldiers were executed after courts-martial for cowardice and desertion during the great war. These men were executed by firing squad without fair and just trials. The execution of these soldiers was to benefit the propaganda of the British Army, acting as a deterrent to discourage any other members of the armed forces from questioning their role in the service.

The mental health of these men had greatly suffered from witnessing the graphic horrors of war over a prolonged period of time. This resulted in shell shock: they would behave irrationally whilst under this severe stress and in doing so, be in no fit state to continue military service. Some of these men refused to fight or hid away from the stresses of combat in order to find a safe mental space for themselves. It was only in 2007 that the Armed Forces Act 2006 was passed, allowing the 306 soldiers to be pardoned posthumously. A memorial honouring these men can be found in the National Memorial Arboretum in Staffordshire, England. Some of the men executed were not adults yet, they were under the age of 18 and had lied about their age when enlisting. Private Herbert Francis Burden (East Surrey Regiment /South Northumberland Fusiliers) was 16 at his time of enlisting, Private Abraham Bevistein (11th Battalion Middlesex Regiment) also lied about his age and enlisted at the age of 16. Both soldiers were shot by firing squad behind the frontlines without a fair trial.

Private Harry Farr (1st Battalion West Yorkshire Regiment) continuously suffered from severe shell shock. A few weeks after involvement in the first major attack launched by the British Army at the Battle of Neuve Chapelle, he spent more than five months hospitalised. He was admitted to the hospital in 1915 for shaking and trauma and was later refused treatment in September 1916 as he was not physically injured. Farr would often go missing as he did not want to return to the frontline and worsen his trauma. At 6 am on the 18th of October 1916, near Carnoy in northern France, he was executed by men from his own regiment. He had been found guilty the day before after an unfair mock hearing that only lasted 20 minutes. Private Harry Farr refused to wear a blindfold during his execution as a last act of defiance against the injustice he received.

These men were wrongly executed and had their names tarnished. The executed soldiers were suffering from a hidden mental illness that was debilitating, thus leading to their actions. The mental impact of the great war would stay with those who survived it. Today, PTSD is recognised as a clinical illness and while it is still invisible to the eyes, it is no longer made to be hidden. Those in the armed forces and veterans who have left are offered therapy to address this mental illness and improve quality of life.

As Emmeline Burdett rightly states,

‘Viewing invisible disability as “individual tragedy” for the disabled person is entirely insufficient and unhelpful.’ (Burdett, p179)

Memorial modelled on Private Herbert Francis Burden aged 17.

(Dave Green Photo - ) (Image description: the bust of a sculpture representing a man blindfolded).

Further Reading

Bamji, Andrew. Faces from the Front: Harold Gillies, the Queen’s Hospital, Sidcup, and the Origins of Modern Plastic Surgery (Solihull, Helion and Company: 2017)

Bogacz, Ted. “War Neurosis and Cultural Change in England, 1914-22: The Work of the War Office Committee of Enquiry into 'Shell-Shock'.” Journal of Contemporary History, vol. 24, no. 2, 1989, pp. 227–256. JSTOR,

Burdett, Emmeline. “Using Historical Materials to Teach Representations of Disability: A First World War Case Study.” Transformations: The Journal of Inclusive Scholarship and Pedagogy, vol. 25, no. 2, 2016, pp. 179–182. JSTOR,

'Plastic Surgery of the Face' by Harold Gillies – Wellcome Collection

Corns, C. and Hughes-Wilson, J., 2005. Blindfold And Alone. London: Cassell.

Helpful links

310 views0 comments

Recent Posts

See All
bottom of page