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The Facemaker: A remarkable book about a pioneer of plastic surgery and facial reconstruction

Lindsey Fitzharris tells the story of a visionary surgeon’s battle to mend the disfigured soldiers of the first World War

Doctors create a plaster mould of an injured soldier’s face at 3rd London General Hospital, where Dr Harold Gillies established a hospital for reconstructive surgery after the first 
World War. Photograph: Horace Nicholls/Imperial War Museums via Getty
Doctors create a plaster mould of an injured soldier’s face at 3rd London General Hospital, where Dr Harold Gillies established a hospital for reconstructive surgery after the first World War. Photograph: Horace Nicholls/Imperial War Museums via Getty
The Facemaker: One Surgeon's Battle to Mend the Disfigured Soldiers of World War I
Author: Lindsey Fitzharris
ISBN-13: 978-0241389379
Publisher: Allen Lane
Guideline Price: £20

“From the moment that the first machine gun rang out over the Western Front, one thing was clear: Europe’s military technology had wildly surpassed its medical capabilities”

Sometimes, you just know. From the moment I read this sentence, from The Facemaker’s excellent prologue, I knew I had a book on my hands.

The Facemaker is the second offering from Dr Lindsey Fitzharris – a medical historian with a PhD from Oxford University – and contains two (if not three) biographies, a punchy mini-history of the first World War, and wrestles with societal attitudes toward disfigurement and the inherent conflict (if not contradiction) of military medicine. If that sounds like a lot, it doesn’t read that way: Fitzharris is a gifted storyteller and delights in just about the right amount of detail.

The principal arc of Fitzharris’s narrative follows Harold Gillies (biography no.1), a pioneering surgeon whose work with disfigured casualties of the Great War – “the loneliest of Tommies” – was formative in the development of plastic surgery as a speciality (biography no. 2). After a frontline stint learning from a flamboyant French dental surgeon – picture a silver Rolls-Royce converted into a portable operating theatre – Gillies returned to London and established the world’s first hospital dedicated to facial reconstruction (biography no. 3). Here, Gillies assembled a multidisciplinary crack team – surgeons, dentists, nurses, but also photographers, sculptors and mask makers – and built a hospital committed to the healing art: while convalescing, patients attended vocational workshops, learned new languages, and helped in the hospital gardens or farmland. The one forbidden luxury: mirrors.

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And yet, as a surgeon in the employ of the medical corps, Gillies’ operated with the uneasy understanding that his first responsibility was to the army – “I, whose business it is to save life, in the midst of men whose business it is to destroy life.” This tension exerted itself in several ways. The sheer scale of the war’s carnage afforded Gillies unprecedented opportunities to hone his surgical skills. But irony is cruel, and Gillies’ patients – and society at large – were both beneficiaries and victims of his great success: by remediating the horrors of war and returning his patients to the frontline, Gillies and his colleagues served to prolong it.

The Facemaker lived up to the promise of the prologue. Buy this book (locally) and you too will have a book on your hands.