Guinea Pig Club
In 1941, a group of Allied aviators formed the most exclusive club in the world.
This club had the most stringent membership requirements: Its members had to have suffered severe burns and undergone experimental plastic surgery treatment at the Queen Victoria Hospital in the town of East Grinstead, south of London, England, in Sussex. Given the experimental nature of their treatment, the founding members decided to call themselves, the Guinea Pig Club.
While most of the Guinea Pig Club members were British, Canadians represented the next largest group. During the war, many Canadians served with both the Royal Air Force (RAF) and the Royal Canadian Air Force (RCAF). In fact, there were so many Canadians treated at the Queen Victoria Hospital, the Canadian government built a separate wing just for them.
The Queen Victoria Cottage Hospital, one of four emergency medical specialist hospitals at the start of the war, was home to the Centre for Plastic and Jaw Surgery, which opened in September 1939. It housed three wards: Ward I was set aside for dental and jaw surgery; Ward II was for women and children injured during air raids; and finally, Ward III—the home of the Guinea Pigs—was for officers and severely burned or injured aircrew.
And in charge of it all was Archibald McIndoe, a New Zealand surgeon who specialized in the reconstruction of hands and faces. McIndoe was an unconventional doctor ; not only did he develop new techniques for treating burns and repairing the damage, but he also understood that his patients, despite their serious and disfiguring injuries, were people. He refused to run the hospital—specifically Ward III—as a cold institutional environment; instead, laughter, music, and free-flowing beer were the hallmarks of that ward.
It was all part of McIndoe's plan to ensure the physical and mental health of his patients given the extreme nature of their injuries. He encouraged his patients to wear their uniforms instead of the hospital "blues" to bolster their confidence. McIndoe also encouraged his patients to leave the hospital and go to East Grinstead's pubs, cafes, along with its theatre and dance hall.
But he didn't stop there; he worked tirelessly to help the people of East Grinstead accept the aviators as men and not oddities or freaks. At first, the sight of horribly burned men in the streets of East Grinstead shocked the locals, but McIndoe's tireless public relations campaign paid off.
The people of East Grinstead accepted McIndoe's challenge, and they came to treat the patients of Ward III as honoured guests, celebrities, and heroes. East Grinstead, meanwhile, became known as "The town that didn't stare".
Aircraft first appeared over the battlefields during the First World War. At first, the warring nations used planes for observation, but it didn't take long before planes were outfitted with bombs and machine guns. The use of planes intensified during the Spanish Civil War (1936–39). Germany, which was rearming following the First World War, used the Spanish Civil War to train its pilots and test aircraft and air combat strategies, such as strategic bombing. Even though Britain stayed out of the Spanish Civil War, the aerial combat quickly showed what injuries to expect among the flight crews.
Of all the injuries the aviators faced, burns were the most common given the highly flammable nature of aircraft fuel: planes hit by enemy fire, or those that crashed, often burst into flames. Prior to the second World War, there were no effective medical treatments available, victims rarely survived due to the cumulative effects of fluid loss, shock and organ failure.
An American doctor, Edward C. Davison, developed the first burn treatment in 1924 using tannic acid, a compound commonly used to tan leather. Tannic acid, either sprayed on the burns or applied as a gel, created a hard protective shell over the burn area, successfully reducing the mortality rate of burn victims by 23 percent. However, tannic acid had its own complications: the protective shell tannic acid created was hard to remove and doing so was painful for patients. Tannic acid also caused the skin to contract and tighten as it healed, which made recovery and reconstructive surgery more difficult.
Dr. Archibald McIndoe, meanwhile, advocated for a novel approach. Instead of covering burns in a shell, McIndoe found that burns healed better when kept clean and the dressings (soaked in petroleum jelly) were changed frequently. McIndoe also used baths filled with saline and plasma for his patients, a technique first developed in the 1930s, to keep aviators from becoming dehydrated, which could be fatal. Daily saline baths also helped to keep healing skin flexible and ready for the skin grafts that McIndoe and his staff used to repair the damage.
The Advent of Plastic Surgery
Along with specializing in burn treatment, McIndoe also developed innovative plastic surgery techniques designed specifically to reconstruct burn ravaged faces and hands. At the start of the Second World War, those techniques, such as the tubed pedicle graft and staged operations, were still experimental.
McIndoe learned both techniques from his mentor, Sir Harold Gillies, whom McIndoe trained under; however, Gillies, a New Zealand surgeon known as the “father of plastic surgery”, developed the tubed graft during the First World War to treat facial wounds not burns. Gillies set up a hospital in England in 1917 where he reconstructed the faces of gravely wounded soldiers using cartilage, bone, and skin grafts.
However, Gillies wasn't the only one to discover the benefit of stitching a pedicle flap into a tube: Vladimir Petrovich Filatov, a surgeon in Odesa, Ukraine, began using pedicle tubes in 1916. Both Gillies and Filatov discovered that a tube had better blood flow and was less likely to become infected compared to a flap of skin.
A surgeon created a pedicle tube by making two parallel incisions and then stitching the edges into a tube that surgeons could swing or move up the body in gradual steps from the donor site to the wound. The tube was less prone to infection, as well. That was important as antibiotics, specifically penicillin, were not readily available until 1944.
The Guinea Pig Club
As Gillies' developed his techniques to treat facial wounds, McIndoe had to refine them for the treatment of burns. Given the experimental nature of McIndoe's work, his patients referred to themselves as his guinea pigs, and one July morning in 1941, a group of patients decided to form a social club, which they called the Guinea Pig Club. McIndoe, who was so fully committed to his patient's physical and mental health, became the club's president. He held that position until he died in 1960, at which time His Royal Highness Prince Phillip, The Duke of Edinburgh, became president.
Ward III was known for its lively party-like atmosphere, and the humour found among the patients of that ward found its way into the Guinea Pig Club. The founding members decided the secretary couldn't have any fingers so that there'd be no notes taken during the meetings and the treasurer had to be a double leg amputee so that he couldn't run off with the notes.
At first, the club simply introduced a little frivolity into what was otherwise a serious and sobering experience, but its formation shows how McIndoe's work to rehabilitate his patients' bodies and souls worked. The humour was all part of McIndoe's efforts to fully treat his patients. Without his work, the burn victims could expect a ruined life of disfigurement and severe depression and anxiety; instead, he helped his patients come to believe in themselves and each other.
And McIndoe's unorthodox ways worked: the Guinea Pigs were very much full of life, as can be seen in the following story told in the Christmas 1953 issue of The Guinea Pig Magazine about a group of Guinea Pigs who “borrowed” East Grinstead's fire engine. They wanted to show it off to their friends back at the Queen Victoria Hospital.
"How long ago was it that, two dear old ladies shed tears and murmured, 'Oh, those poor dear brave boys; how terrible to be ruined...' as they saw a cohort of Pigs hobble down the street, trailing donor-area bandages? Five minutes later the dear old souls were scared out of their wits: the poor, dear, ruined boys (who had been having a few quick 'uns that day) roared by on a fire-engine they had borrowed, screaming like maniacs and clanging the bell like fury."
But it wasn't just a drinking club; instead, it became a support group, a means to keep the Guinea Pigs connected, and a way to ensure their health and wellbeing. The Club organized annual reunions and money collected in dues was used to help Guinea Pigs or their families.
Perhaps McIndoe's greatest success was that he gave the Guinea Pigs the tools to take care of themselves and to control their own destiny. The Guinea Pigs became productive members of society. In 1953, he told Guinea Pigs gathered at East Grinstead for the annual reunion that, "I am filled with amazement and deep respect at the way in which practically all of you have become men in your own right, standing on your own feet and facing the world fearlessly. Such are the truly satisfying results of our organization, our Guinea Pig Club."
Canadian Guinea Pigs
Canadians made up the second largest group at Queen Victoria Hospital: of the 649 men treated there, 125 were Canadians. The first Canadians, members of the RAF, arrived at the QVH as early as 1939, followed by the earliest members of the RCAF, who fought as fighter pilots in the Battle of Britain during the summer of 1940. As the number of Canadians serving with the RAF and RCAF grew (Canada would have the fourth largest air force by the end of the war ), the number of Canadians who suffered from burns also grew.
As a result, the Canadian government decided to bring Canadians to East Grinstead under the care of Ross Tilley, who began working at the Queen Victoria Hospital alongside McIndoe in January 1942. In March 1942, Canadian burn casualties, initially treated at other hospitals, began to arrive at East Grinstead.
Additional Canadian staff members joined Tilley creating an all-Canadian contingent that included an anesthesiologist, two nursing sisters, and two orderlies. By 1943 it was clear that the Queen Victoria Hospital needed more staff and beds for the Canadian patients. As the Queen Victoria Hospital was full, the only choice was to build a wing just for Canadian aircrew.
The Canadian government supplied the funding while the Royal Canadian Engineers built the wing. When it opened in the summer of 1944, the Canadian wing had 50 beds, two saline baths, and a staff of 51 medical personnel with Ross Tilley in charge.
Tilley moved his Canadian patients into the new wing in July, and he also sent orders stating that any Canadian who needed plastic surgery should be brought to East Grinstead. At the end of the war, the Canadian wing became a full extension of the Queen Victoria Hospital.
Although the Canadian government wanted to look after its own, the Guinea Pig Club — in its irreverence — decided the Canadians chose to leave Ward III simply to get away from the British. For proof, read the last verse of the Guinea Pig Anthem below!
The Legacy of the Guinea Pig Club
In 2001, at the 60th anniversary of the Guinea Pig Club, only 44 known Canadian Guinea Pigs survivors were still alive; three years later, 10 of those men had died. (In all only 132 Guinea Pigs remained worldwide by 2004. ) The last reunion was held in 2007, and by 2016, when Dr. Sandy Saunders, himself a Guinea Pig, unveiled a memorial at the National Memorial Arboretum in Staffordshire dedicated to the Guinea Pig Club, only 22 Guinea Pigs remained worldwide.
Even as the number of Guinea Pigs dwindled, the club continued to "ensure that Guinea Pigs or Widows in need of financial assistance are taken care of and if medical advice is needed the good services of our Honorary Plastic Surgeon are sought and generously given."
And in all that time following the war, the Guinea Pigs, with their confidence, compassion, and empathy, turned to help a new generation of burn patients, showing them that “through adversity a full life can be lived."
They also inspired a new generation of severely wounded veterans to pick up their mantle and continue their work. In 2017, inspired by the work of the Guinea Pig Club, a group of wounded British veterans founded the CASEVAC Club (pronounced “cazzyvack”, which is short for "casualty evacuation"). Only veterans of Iraq and Afghanistan who suffered severe wounds are eligible to join.
CASEVAC Club members work with the Scar Free Foundation Centre for Conflict Wound Research at Queen Elizabeth Hospital Birmingham, and, like the Guinea Pigs, help others understand and accept their traumatic injuries.
Today, because of the legacy of the Guinea Pig Club, the Queen Victoria Hospital is an "internationally renowned specialist centre for reconstructive surgery."
Guinea Pig Anthem
The camaraderie born from the sharing of similar, difficult circumstances, led the Guinea Pig Club - in true wartime spirit - to write their own anthem:
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
John Hunter runs the gas works,
Ross Tilley wields the knife.
And if they are not careful
They'll have your flaming life.
So, Guinea Pigs, stand steady
For all your surgeon's calls:
And if their hands aren't steady
They'll whip off both your ears
We've had some mad Australians,
Some French, some Czechs, some Poles.
We've even had some Yankees,
God bless their precious souls.
While as for the Canadians -
Ah! That's a different thing.
They couldn't stand our accent
And built a separate Wing
We are McIndoe's army,