Pickerill and Gillies Great War Story

The video for this story about the work of surgeons Dr Henry Pickerill and Harold Gillies screened on TV3 News on 8 August 2014.

Harold Gillies and Henry Pickerill’s pioneering treatment of soldiers with facial wounds during the First World War helped form the basis of modern plastic and facial reconstructive surgery. Gillies was born in Dunedin, New Zealand, and made a career in England; Pickerill was born in England and became the first director of the University of Otago’s dental school in Dunedin. During the First World War the two served at Queen Mary’s Hospital at Sidcup, Kent, a specialist hospital for facial injuries, where Gillies led the British section and Pickerill the New Zealand section. The two men were highly competitive and Pickerill, in particular, refused to acknowledge his Kiwi colleague’s contribution. But they each contributed to the development of plastic surgery.

Henry Pickerill and Harold Gillies: the changing faces of war

Henry Pickerill’s early life

Born in Hereford, England, on 3 August 1879, Pickerill was educated at the universities of Oxford and Birmingham. He gained a qualification in dentistry from the Royal College of Surgeons in 1903, and followed this with a Bachelor of Dental Surgery and Bachelor of Surgery in 1904, a Doctor of Medicine and Master of Dental Surgery in 1911, and a Master of Surgery in 1923.

After completing his bachelor degrees, Pickerill worked in a dental practice in Hereford and in the dental department of Birmingham General Hospital. In 1907, aged 28, he became the first director (and later dean) of the University of Otago’s School of Dentistry in Dunedin, New Zealand. His academic expertise and personal drive made him well suited for the position, and he was a prolific author, researcher and teacher during his tenure.

Pickerill took leave from the university in 1916 to join the New Zealand Dental Corps. Arriving in England in March 1917, he transferred to the New Zealand Medical Corps and established a unit for the treatment of facial and jaw injuries at No. 2 New Zealand General Hospital at Walton-on-Thames in Surrey.

Harold Gillies’s early life

Harold Gillies was born on 17 June 1882 in Dunedin. At the age of eight he was sent to Lindley Lodge, a preparatory school near Rugby in England, where ‘the prefects took every opportunity to beat me up’. Four years later Gillies returned to New Zealand to attend Wanganui Collegiate School.

In 1901 Gillies left New Zealand again to study medicine at Cambridge University and then St Bartholomew’s Hospital, London, where he was one of the top students. After qualifying for surgery in 1910, Gillies joined the hospital’s newly established Ear, Nose, and Throat Department.

Gillies was 32 years old when war was declared. He volunteered for the Red Cross and in 1915 joined a Belgian ambulance unit as a commissioned officer. While serving in France, Gillies became aware of the many soldiers suffering jaw and facial wounds. On his return to the United Kingdom, he persuaded the military authorities to establish a specialist ward for facial injuries at Cambridge Military Hospital in Aldershot.

On 1 July 1916 the Somme offensive took place and, although the hospital had been allocated an extra 200 beds, it was overwhelmed when 2000 patients turned up – ‘a stream of wounded, men with half their faces literally blown to pieces, with the skin left hanging in shreds and the jawbones crushed to a pulp that felt like sand under your fingers.’

Queen Mary’s Hospital at Sidcup

It was decided to create a purpose-built facility for soldiers with facial injuries – Queen Mary’s Hospital at Sidcup in Kent, which opened in July 1917 with around 300 beds. Its capacity was quickly increased to 560 beds, but eventually nearby hospitals and private houses were also pressed into service. Some of the benches in Sidcup were painted blue, indicating that they were for patient use only – and to warn the public that they might be occupied by someone who was distressing to look at.

Gillies, in command of the hospital, decided to open it to soldiers and staff from Britain’s dominions, and to divide it into units. The British section was led by Gillies and the New Zealand section by Major Henry Pickerill.

Restoring faces

The two major innovations that Gillies introduced were the tubedpedicle method and the epithelial outlay technique for reconstructing eyelids. He famously trialled both procedures on 20-year-old Able Seaman Willie Vicarage, who had been badly burnt in an explosion during the battle of Jutland in 1916. Tube pedicles were created by cutting out a flap of healthy skin from the chest, shaping it into a tube, then attaching it to the graft area on the face. This resulted in a ‘pipeline’ of living tissue with a good blood supply, and it also closed off the graft area to infection. Gillies developed the eyelid technique after worrying about Vicarage, who had to spend all night during an air-raid trying to sleep with his eyes open because his lids had been burnt off.

The New Zealand section, led by Pickerill, treated over 200 New Zealand, British and other Commonwealth troops. Pickerill quickly earned a reputation as a first-class plastic and maxillofacial (jaw and face) surgeon. Supported by surgeons, dentists, anaesthetists and medical illustrators, he was part of a team that helped pioneer new techniques of tissue transfer, higher standards of hygiene to combat infection and new methods of administering anaesthesia.

For men missing parts of their face and jaw, treatment was a slow and gradual process, sometimes taking several years to complete. To avoid sepsis (blood infection), surgical procedures were carried out in stages. Depending on the severity of the wound, a patient at Sidcup could undergo as many as a dozen operations. Pickerill kept meticulous records of his section’s work. Photographs, watercolour sketches, diagrams and wax models recorded each stage of treatment.

Rivalry

Pickerill and Gillies enjoyed a ‘healthy’ rivalry at Sidcup. Both men had strong personalities and this led to differences of opinion on occasions. After the war, Pickerill and Gillies jealously guarded their reputations by claiming ownership of developments and techniques pioneered at the hospital.

Pickerill’s later life

Pickerill, his team and 59 patients returned to New Zealand in 1919, where treatment continued at the facial and jaw department of Dunedin Hospital. Pickerill also resumed his position as dean of the dental school. Later he decided to specialise in plastic surgery – first in Sydney, then in Wellington and Auckland, and finally at Bassam Hospital in Lower Hutt, which he and his second wife, Cecily, also a surgeon, established in 1939. It specialised in treating cleft lips and palates in children. He died in 1956.

Gillies’s later life

After the war, Gillies continued to perform reconstructive surgery and also pioneered transgender and cosmetic surgery. He was awarded a knighthood in 1930, before returning to medical service during the Second World War. In 1946 he was elected the first president of the British Association of Plastic Surgeons.

In 1956, at the age of 73, he returned to New Zealand for a two-month holiday after 51 years abroad. He said he wanted ‘to smell the New Zealand bush on a wet day … I want to hear the tui, catch a brown trout, do a little painting, and perhaps play three or four holes of golf. And I want to see the pohutukawas in full bloom.’

He was never good at saving, which is why he was unable to retire after the Second World War, and he kept working until shortly before his death on 10 September 1960. He was 78 years old.

Primary Sources

Newspapers

• ‘New Men’, Observer, 29 September 1917
• ‘New Faces for Old’, Press, 18 January 1918
• ‘Maimed Soldiers’, Press, 8 February 1919
• ‘Damaged Faces’, Dominion, 22 March 1919
• ‘Facial Disfigurement’, Wanganui Chronicle, 24 May 1919
• ‘Plastic Surgery’, Otago Daily Times, 6 September 1919
• ‘New Faces for Soldiers’, Northern Advocate, 19 January 1922
• ‘Modern Miracle”, Auckland Star, 21 January 1927
• ‘Making Human Faces’, Auckland Star, 16 August 1927
• ‘Miracle of Surgery’, Auckland Star, 27 April 1929
• ‘Scalp Grafting’, Evening Post, 15 June 1934

Archives personnel file

Harold Pickerill

Images

For images and other digitised material relating to this Great War Story from Archives New Zealand and the National Library of New Zealand see the related set on Digital New Zealand

Further sources

Books

• Brown, Harvey. Pickerill: Pioneer in Plastic Surgery, Dental Education, and Dental Research. Dunedin: Otago University Press, 2007.
• Fitzharris, Lindsey. The Facemaker: one surgeon's battle to mend the disfigured soldiers of World War I. Penguin, 1922.
• Gillies, H. D. Plastic Surgery of the Face: Based on Selected Cases of War Injuries of the Face, Including Burns. London: Henry Frowde, 1920.
• Gillies, H. D., and D. Ralph Millard. The Principles and Art of Plastic Surgery. London: Butterworth & Co., 1957.
• Meikle, Murray C. Reconstructing Faces: the Art and Wartime Surgery of Gillies, Pickerill, McIndoe and Mowlen. Dunedin: Otago University Press, 2013.
• Pound, Reginald. Gillies, Surgeon Extraordinary: a Biography. London: Michael Joseph, 1964.

Articles

• Bamji, Andrew, and others. ‘Plastic Kiwis – New Zealanders and the Development of a Speciality.’ In Journal of Military and Veterans' Health 17, no. 1 (2008): 11–18.
• Bamji, Andrew. ‘Sir Harold Gillies: Surgical Pioneer.’ In Trauma 8 (2006): 143–156.
  Callister, Sandy. ‘Broken Gargoyles: the Photographic Representation of Severely Wounded New Zealand Soldiers.’ In Social History of Medicine 20, no. 1 (2013): 111–130.

Websites

• Gillies, Harold Delf, a biography of Harold Gillies on Te Ara.
• Pickerill, Henry Percy, a biography of Henry Pickerill on Te Ara.
• Henry Percy Pickerill’s record on Auckland War Memorial Museum’s Cenotaph Database.
• The Gillies Archives from Queen Mary’s Hospital, Sidcup, a website that provides detailed information about Harold Gillies’s medical work during the First World War.
• Harold Gillies: Aesthetic Reconstructor, a short biography by C. J. Williams on the NZEDGE website.
• Project Façade, a website about an art project that used patient records and photographs from the Gillies Archive.