Profiles In Nursing

Helen Fairchild (1885-1914), Witness to the Horrors of WWI Poison Gas Attacks

Why chemical weapons were banned by the Geneva Convention

Helen Fairchild in nursing uniform and cap stands smile at the camera

Originally from a small town in Pennsylvania, Helen Fairchild later became the first American nurse to die in service during World War I, a casualty of that war’s most horrifying weapon: poison gas.

The Pennsylvania 64

Helen Fairchild was 26 years old when she left farm life in rural Pennsylvania to enter nursing school in Philadelphia. When she graduated in 1913, the average life expectancy of a white woman in the United States was about 49 years. The women’s suffrage movement was in full swing, still fighting to ratify a constitutional amendment granting women the right to vote. President Woodrow Wilson was trying to remain neutral in the evolving conflicts in Europe.

For the next four years, Fairchild practiced nursing at Pennsylvania Hospital while beginning the course of prolific letter-writing to her family that would become the foundation of her legacy. Early in 1917, Fairchild and 63 of her colleagues joined the U.S. Army Reserve Nurse Corps.

On April 16, 1917, Congress declared war on Germany. Instead of the usual continental U.S. assignment, the nurses volunteered for deployment to Europe.

The “Pennsylvania 64” sailed to England in May 1917 as part of the American Expeditionary Forces, about to bear witness to what became known as “the chemist’s war.”

“Oh, I Shall Have Books to Tell When I Get Home”

In late July, Fairchild was assigned to Casualty Clearing Station No. 4 in the Ypres-Passchendaele area of Belgium. The weather was miserable, with constant wind and rain. In a letter to her mother in August, Fairchild wrote, “We all live in tents and wade through the mud to and from the operating room where we stand in mud higher than our ankles.”

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Bad weather was the least of her worries. As John H. Gibbon, a physician on Fairchild’s unit, later told historian Paul Hoeber, “The casualty clearing stations were frequently the scene of the most distressing sight which a human eye can witness, that is the re-wounding of already wounded men by an enemy’s bomb dropped suddenly in the dead of night.”

Bombs and shells were bad enough, but gas attacks were the stuff of nightmares. Despite treaties banning the military use of poison, World War I saw the first large-scale use of poison gases on the modern battlefield, including chlorine; phosgene; and “the king of battle gases,” mustard gas, which the Germans first deployed in Ypres only two weeks before Fairchild arrived.

By that time, poison gas could be reliably delivered by artillery; on average, at least one in every 10 shells was gas. Some of the poisons used could kill or maim long after the shelling stopped, and available gas mask technology was still rudimentary. During an attack, nurses had to worry not only about putting on their own gas masks, but also masking their patients. Nurses and patients alike often suffered “gas fright” or “gas mania” even when no gas was present.

“Don’t Worry If You Don’t Hear from Me”

Despite all this, Fairchild performed admirably, ministering to soldiers under the most horrific conditions. However, by November, she had developed tonsillitis and then intractable abdominal pain and vomiting. An X-ray revealed that the pain was due to a severe stomach ulcer, probably related to poison gas exposure.

According to one account, Fairchild had been exposed when she gave up her gas mask to protect a soldier in her care, although it may also have been repeated incidental exposures.

RN Career Events

Now confined to a hospital bed, Fairchild kept asking to be allowed to return to work. “I am glad to be here to help take care of these poor men,” she wrote in her final letter to her mother on December 28. “If you could only see what the boys here have to go through sometimes, you would see they need all the comfort possible.”

In mid-January 1918, Fairchild underwent surgery for the ulcer, but her condition worsened and she died a few days later of acute liver atrophy.

Although nurses were not granted military rank at that time, Chief Nurse Margaret Dunlop assured Fairchild’s family that Fairchild “was buried in her uniform of the American Army and given [a] most honored military funeral.”

Dunlop described Fairchild as “one of my most beloved of nurses.” Gibbon later declared, “Nurse Fairchild represented the truest type of womanhood and stood for the very best in the nursing profession.” Today, she is registered in the Women in Military Service for America Memorial at Arlington Cemetery in Virginia.

About Mustard Gas

First used on the battlefield in July 1917, dichlorethyl sulfide — mustard gas — was arguably the most horrifying weapon of mass destruction of World War I. This heavier-than-air gas is usually delivered by artillery shell, covering people, animals and equipment with sulfur mustard, a powerful vesicant. Gas masks offer little protection.

Sulfur mustard can be lethal, but mustard gas attacks are more likely to maim than kill. They pose a serious threat to noncombatants like nurses because contact with casualties or their contaminated clothing can be as dangerous as battlefield exposure, causing skin blistering, lung irritation and acute conjunctivitis.

According to medical historian Robert J.T. Joy, M.D., FACP, “a single man with mustard on his uniform could easily contaminate an entire ambulance or dugout.” Worse, sulfur mustard can linger in an area for months or even years. Decontamination requires neutralizing the mustard with a bleaching solution and then thoroughly scrubbing anyone or anything the mustard may have touched.

In 1925 the Geneva Protocol was signed, banning the use of chemical weapons during wartime.

CLAIRE SANTOS, RN, M.S., NHDP-BC, is a burn care and emergency nurse and an ANCC-certified national healthcare disaster professional. Reach out to her at .

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