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The Facemaker

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Lindsey Fitzharris, the award-winning author of The Butchering Art, presents the compelling, true story of a visionary surgeon who rebuilt the faces of the First World War’s injured heroes, and in the process ushered in the modern era of plastic surgery.

From the moment the first machine gun rang out over the Western Front, one thing was clear: humankind’s military technology had wildly surpassed its medical capabilities. Bodies were battered, gouged, hacked, and gassed. The First World War claimed millions of lives and left millions more wounded and disfigured. In the midst of this brutality, however, there were also those who strove to alleviate suffering. The Facemaker tells the extraordinary story of such an individual: the pioneering plastic surgeon Harold Gillies, who dedicated himself to reconstructing the burned and broken faces of the injured soldiers under his care.

Gillies, a Cambridge-educated New Zealander, became interested in the nascent field of plastic surgery after encountering the human wreckage on the front. Returning to Britain, he established one of the world’s first hospitals dedicated entirely to facial reconstruction. There, Gillies assembled a unique group of practitioners whose task was to rebuild what had been torn apart, to re-create what had been destroyed. At a time when losing a limb made a soldier a hero, but losing a face made him a monster to a society largely intolerant of disfigurement, Gillies restored not just the faces of the wounded but also their spirits.

The Facemaker places Gillies’s ingenious surgical innovations alongside the dramatic stories of soldiers whose lives were wrecked and repaired. The result is a vivid account of how medicine can be an art, and of what courage and imagination can accomplish in the presence of relentless horror.

315 pages, Hardcover

First published June 7, 2022

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About the author

Lindsey Fitzharris

3 books838 followers
I am the author of The Butchering Art: Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine, which won the PEN/E. O. Wilson Award for Literary Science Writing and has been translated into multiple languages. My TV series The Curious Life and Death of . . . aired on the Smithsonian Channel in 2020. I contribute regularly to The Wall Street Journal, Scientific American, and other notable publications, and hold a doctorate in the History of Science and Medicine from the University of Oxford. My next book, The Facemaker, will be released in June. It follows the harrowing story of Harold Gillies, the pioneering surgeon who rebuilt soldiers' faces during the First World War.

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Displaying 1 - 30 of 837 reviews
Profile Image for MarilynW.
1,386 reviews3,511 followers
September 22, 2022
The Facemaker: A Visionary Surgeon's Battle to Mend the Disfigured Soldiers of World War I
by Lindsey Fitzharris, narrated by actor Daniel Gillies

This is such an interesting and informative book featuring pioneering surgeon, Harold Gillies, but also relating the stories of other doctors, nurses, soldiers, artists, and people who came into contact with Gillies, and the work that he and others did to reconstruct faces for soldier who suffered unimaginable injuries and pain. I knew this would be a difficult audiobook to listen to but the voice of actor Daniel Gillies, great, great nephew of Harold Gillies, made the story easier to hear.

This story cast a very wide net. At times I wished it would hone in on one person or event for longer but the author knew where she was taking us and I appreciate the story, just the way it's told. I have already been doing some research myself, while listening to the story and afterwards, and know I want to do more. There are so many people mentioned that I want to know more about and there are events in history that I want to further explore. I like it when a book lights sparks for further investigation.

I can't do justice to the people and the work they did so I'll just say a few things about what I learned in this book. Doctors and nurses worked so hard to help the unending flow of casualties coming from the front to faculties that were meant to treat and help these men. It's so sad that many men were in the midst of having their face wounds stabilized and then reconstructed when they would often be called back to the front, still in pain, still sick, still weak, with open wounds, not able to open or close their mouths or with other disabling problems afflicting them.

I know we don't even get a fraction of the horrors of war in this story but what little we get is so heartbreaking. Still, I hung on to the stories of great sacrifice of men to try to help their fellow men. Many of the soldiers who made it to Gillies operating table made it there because one or more men lost their lives getting that person back from the front. Also, the stories of the strong spirit that Gillies and other doctors' patients showed, despite insurmountable injuries that would never allow them to go unnoticed by others, is so inspiring. I want to remember the sacrifices of all who helped these men and I want to remember these soldiers.

Pub June 7th 2022 by Macmillan Audio
Profile Image for JanB.
1,211 reviews3,481 followers
June 30, 2022
As a nurse who also enjoys history, I appreciated the extensive background on reconstructive facial surgery set during WWI, and the pioneer physicians and other specialists who led the way. The personal stories of the injured soldiers brought the book to life.

I would have enjoyed it a bit more without the details of specific battles, and with a focus that was more narrow. 3.5 stars

This was a buddy read with Marialyce. Do check out her review to see what she thought!

* I received a digital copy of the book via NetGalley. All opinions are my own.
Profile Image for Jill Hutchinson.
1,522 reviews103 followers
August 16, 2022
WWI, the Great War, was so full of horrors that it is hard to grasp them........the first use of poison gas, trench warfare, the introduction of the flame thrower, and much more. More men died than in any other war. And then there were the maimed......facial injuries that blew men's faces apart and turned them into pathetic reminders of what war could do. The badly disfigured were doomed to a life in hiding as the public avoided them, causing not only physical trauma but mental issues as well. To quote the author....."Losing a limb, made a soldier a hero but losing a face made him a monster....."

This book follows the career of one plastic surgeon (there was no such specialty in those days), Harold Gillies, who was a pioneer and who dedicated the war years to rebuilding the faces of these horribly wounded men. It should be noted that he was not the only physician who was developing procedures for facial reconstruction and he learned about bone and skin grafting from a controversial French dentist. He took that knowledge and perfected it with amazing results.

Dr. Gillies set up a hospital in Britain which was specific to plastic surgery and operated on hundreds of men. The book contains before and after photographs of these men and readers should be warned that they are very graphic, as is some of the text. One of the men in the photos stayed with the doctor for years as his secretary to show his thankfulness.

This book gets my highest recommendation and it is both depressing and uplifting. Kudos to the author.
Profile Image for Marialyce (back in the USA!).
2,073 reviews694 followers
June 29, 2022
This was an amazing story about a plastic surgeon, a pioneer to this field, named Harold Gillies. The amazing things he was able to accomplish giving many young men their faces back after the devastating wounds they received to their face on the battlefield during World War 1 was awe inspiring.

This was not an easy book to read as Lindsey Fitzharris brought into the story details of battles and the horrible wounds the men suffered. In her telling, she made the battle scenes, the operations, the novel approaches come alive. It was a story of innovation, a story of venturing into an unknown region, a story of the brave men and a doctor who gave them hope.

Gilles was an amazing man, not only as a doctor, but also as a man who believed in the men he treated and strived to be able to remove them from the "monster" image so many had. It was a horror that Gillies and others were able to remove from these boys so that they were able to lead normal lives and not be shunned in a public forum.

Without men like Dr Gillies, the art of plastic surgery would not have progressed so far and be what it is today. The courage, the belief in one's fellow man, and the ultimate work of Gillies and his team made life bearable and wonderful for so many boys who gave so much for their country during the war.

Fascinating story and thanks to Lindsay Fitzharris, Allen Lane, and NetGaley for a copy of this story.
Profile Image for Olive Fellows (abookolive).
662 reviews5,696 followers
July 12, 2022
A well-written narrative history of the brutality of WWI, the damage it did to mens' bodies, and how one pioneering plastic surgeon did life-changing work reconstructing the faces of former or current soldiers. It was an interesting read, but I think it would have benefitted from being a little more narrowly focused - I see why some WWI history was necessary as background, but sometimes the focus on the broader history made me forget I was reading a book about a plastic surgeon.

Click here to hear more of my thoughts on this book over on my Booktube channel, abookolive!

abookolive
Profile Image for Angela.
506 reviews167 followers
August 7, 2023
The Facemaker by Lindsey Fitzharris

Synopsis /

From the moment the first machine gun rang out over the Western Front, one thing was clear: mankind's military technology had wildly surpassed its medical capabilities. The war caused carnage on an industrial scale, and the nature of trench warfare meant that thousands sustained facial injuries. In The Facemaker, award-winning historian Lindsey Fitzharris tells the true story of the pioneering plastic surgeon Harold Gillies, who dedicated himself to restoring the faces of a brutalized generation.

Gillies, a Cambridge-educated New Zealander, established one of the world's first hospitals dedicated entirely to facial reconstruction. At a time when losing a limb made a soldier a hero, but losing a face made him a monster to a society largely intolerant of facial differences, Gillies restored not just faces, but identities and spirits.

The Facemaker places Gillies's ingenious surgical innovations alongside the dramatic stories of soldiers whose lives were wrecked and repaired. The result is a vivid account of how medicine and art can merge, and of what courage and imagination can accomplish in the presence of relentless horror.

My Thoughts /

On April 30, 1993, four years after publishing a proposal for an idea of linked information systems, computer scientist, Tim Berners-Lee, released the source code for the world’s first web browser and editor. Originally called Mesh, the browser that he dubbed WorldWideWeb became the first royalty-free, easy-to-use means of browsing the emerging information network that developed into the internet as we know it today.

Fast forward to 2023, and our insatiable appetite to scroll the WorldWideWeb seems to have no bounds. It seems that we cannot quench our constant thirst for information - whether truthful or, misinformation and disinformation (otherwise known as 'fake news'), it's like a drug and it appears that most of us are addicted to some form or another. Part of our fascination with the internet is the social media content and, whilst it has its advantages, a lot of what purports to be social media content portrays pretty privilege.

In a world where we are constantly told what products to buy, what clothes are the most flattering, and what foods not to eat, it becomes clear that we are expected to be nothing short of beautiful. Beauty is of course subjective; however, it manifests itself in varying ways through societal beauty standards. Beauty standards are fluctuating ideals with extremely narrow criteria, ensuring that only a few can actually attain them - (Saltzberg & Chrisler, 2006).

Picture this. Four people are standing next to each other in a picture. The first one is young, unblemished skin, gorgeous hair and facial features, an athlete's body shape; next to them is also someone young, skin like milk, lovely facial features, but this young person is missing an arm. Next to them is someone very similar in appearance but missing a leg; and lastly, the fourth young person is similar in all body shape respects to the previous three, except, number four has massive facial deformities - nose blown off, jawbone shattered, eyeballs dislodged. In a digital world which portrays that 'pretty' is the societal standard, how does person number four in our picture stack up??

In this book, Lindsey Fitzharris explores the life and work of Dr Harold Gillies, a pioneering reconstructive surgeon who specialised in mending those who survived their debilitating injuries sustained from their life in the trenches during World War I.

A face is usually the first thing we notice about a person. It can signify gender, age, and ethnicity - all important components of an identity. It can also convey personality and help us communicate with one another. The infinite subtleties and variety of human expression comprise an emotional language of their own. So, when a face is obliterated, these key signifiers can disappear with it.

Unlike amputees, Fitzharris says, disfigured soldiers weren’t celebrated as heroes so much as they were met with revulsion. The damage to their faces was a graphic reminder of wartime carnage. Bodies were battered, gouged, and hacked, but wounds to the face could be especially traumatic. Noses were blown off, jaws were shattered, tongues were torn out, and eyeballs were dislodged. In some cases, entire faces were obliterated. In the words of one battlefield nurse, 'The science of healing stood baffled before the science of destroying'. Fitzharris went on to write, that instead of being celebrated for their service, disfigured soldiers often suffered self-imposed isolation from society following their return from war.

Harold Gillies was born in Dunedin, New Zealand; he studied medicine at Cambridge, and was an excellent sportsman with a penchant for golf. Following the outbreak of WWI, Gillies joint the Royal Army Medical Corps, where he acted as medical minder to French-American dentist, Charles Valadier. This was Gillies' introduction to a new kind of wound - facial fractures. Indeed, Gillies and Valadier would often 'butt heads', but Gillies quotes 'The credit for establishing the first Plastic and Jaw Unit, which so facilitated the later progress of plastic surgery, must go to the remarkable talents of the smooth and genial Sir Charles Valadier.

Gillies went on to establish a new hospital devoted entirely to 'facial injuries'. The Queen's Hospital opened in June of 1917 and grew to house more than 1,000 beds. The hospital not only employed surgeons, but physicians, dentists, radiologists, artists, and sculptors (mask makers), and it was this team of people who were the first pioneers of what is known today as plastic surgery. Facial reconstruction had to be carried out incrementally, often making it worse before it could be made better. Many of Gillies patients required dozens of painful procedures, in some cases these procedures were done over many years. Not all were successful. But just as impressive as his technical skills, was his bedside manner - Gillies approached each case with good grace and light-hearted banter, telling each patient Don’t worry, sonny. You’ll be all right and have as good a face as most of us before we’re finished with you.

The detailed explanations of surgical procedures make it clear that the author has researched the subject matter well.

Gillies was knighted in June 1930, twelve years after the war ended. He reflected that the award was less "a personal honour, but as one shared by all those who had been with me in the pioneer work.

The Facemaker is a story of extraordinary men and women and one man's vision to advance medical progress to make his patient's lives better. In the end though, perhaps the highest compliments came from his grateful patients.

One solider remarked [about Gillies] 'I don't suppose for one moment that you remember me, for I was only one of many, but that matters little, for we remember you'.

I can never forget your wonderful kindness to me and all that you have done to make my life worth living,” one recovered soldier wrote. “I am looking so well that people are beginning not to believe it when I tell them that I was nearly burnt to death eleven years ago.
Profile Image for Alwynne.
732 reviews958 followers
September 28, 2022
Award-winning writer and medical historian, Lindsey Fitzharris tells the story of pioneering WW1 surgeon Harold Gillies, his extensive team and the men they treated. WW1 presented unprecedented challenges for British medicine, plunging medical staff into near-uncharted territory where, as one nurse remarked, “The science of healing stood baffled before the science of destroying.” New or “improved” warfare technologies from ferocious flamethrowers to penetrating bullets, as well as the trench as a central, organising space, resulted in enormous levels of severe facial injuries. Injuries, as Fitzharris underlines, that meant, for those who survived, the chances of being welcomed back into society were slender,

“Whereas a missing leg might elicit sympathy and respect, a damaged face often caused feelings of revulsion and disgust. In newspapers of the time, maxillofacial wounds—injuries to the face and jaw—were portrayed as the worst of the worst, reflecting long-held prejudices against those with facial differences. The Manchester Evening Chronicle wrote that the disfigured soldier “knows that he can turn on to grieving relatives or to wondering, inquisitive strangers only a more or less repulsive mask where there was once a handsome or welcome face.”

Fitzharris, who strikes an impressive balance between erudite and accessible, tells the story of a group of these injured men, and the people who searched for practical ways to help them. Initially, her story focuses on Harold Gillies, a surgeon who's associated with developing concepts of plastic surgery as we know it today. But she broadens out from Gillies to stress the crucial role of teamwork in the formulation of intricate, creative, treatment protocols. Gillies’s own team included nurses, dentists, and even artists including Henry Tonks, later famed for his work at the Slade, and Kathleen Scott, widow of the explorer, who produced drawings, paintings, and sculptures to aid in visualising the pre-injury faces of shattered patients.

Men who received extensive facial wounds during the war, were dealing with far more than the immediate consequences of catastrophic injuries. They were also haunted by the prospect of becoming outcasts, as well as grappling overwhelming feelings of loss of their very identities. In their culture, as in many others, the face was laden down with symbolic meaning, linked to the self, even the soul. For many years a scarred face - or any face perceived as somehow deviating from supposed norms - was connected to notions of villainy or signifiers of degeneracy, Fitzharris recounts how during the Napoleonic War there was a widespread practice of comrades killing any facially disfigured battle mates, “mercy killings” to save them from later shame or ostracism. In many WW1 narratives from news reports to fiction, those with significant facial wounds were commonly represented as passive, nameless victims,

“In France, they were called les gueules cassées (the broken faces), while in Germany they were commonly described as das Gesichts entstellten (twisted faces) or Menschen ohne Gesicht (men without faces). In Britain, they were known simply as the “Loneliest of Tommies”—the most tragic of all war victims—strangers even to themselves.”

Fitzharris sets out to document and combat these kinds of accounts, attempting to recentre Gillies’s wounded patients, in order to reinstate their individuality, attempting wherever possible to recover their ‘lost’ voices – drawing from an impressive array of drawings, diaries and memoirs. Overall, I found Fitzharris’s book persuasive and compelling, a well-crafted, insightful and meticulously researched, narrative - although it could also be quite harrowing to read, so definitely not one for the squeamish.

Thanks to Netgalley and publisher Allen Lane for an ARC

Rating: 3.5
Profile Image for Anthony.
248 reviews76 followers
May 1, 2023
We Will Remember Them.

The First World War changed the world. From it was born the most evil and horrific experiences in human history. But also, some of the most heroic actions imaginable. Human capabilities were stretched to both sides of the spectrum. This is the story of the latter, the story of Harold Gillies, the pioneering surgeon who was willing to tackle what few others would dare.

As war fever and the sense of adventure wore off for the young men who fought in the trenches in WWI wore off, they had to face being killed, suffering from a life changing disability or worst of all, being permanently disfigured with a facial injury. Shunned by a society not ready for such a mass influx of men destroyed in a cruel way by the war, mothers hide their children as they walked down the street, fiancés called off engagements and pity closed its doors to them. In the past many suffering such injuries would not have survived (it is important to note that war has always caused such suffering and I felt Fitzharris insinuated WWI was almost unique with few exception), but with the scale of the war and modern technology enabled more men to be brought off the battlefields and back into life at home.

The hero of the hour is Harold Gillies, a golf loving man of anglo descent from New Zealand. Initially headhunted before the war to the height of his profession. With his work at Queens Hospital, Sidcup he helped thousands of men and some woman gain faces and their identities again. He was an extraordinary man, extremely talented and compassionate. From building his team in the Cambridge Hospital in Aldershot, which included surgeons, dentists, nurses and anaesthetists he set about helping those who others could not.

Fitzharris tells Gillies’ tale through the story of a handful of individuals, some pilots, some sailors and other who had been left on the Somme battlefield for days before being rescued. She takes the reader of a guided tour of how he did it, with skin and bone grafts, but also the pioneering psychological aftercare with the men having some sort ‘life’ mixing with each other, as no one else could. From the end of the war, Fitzharris shows how Gillies’ work has given birth the the plastic surgery and medical knowledge we know today. Gillies went private after the war and performed the first female-to-male gender reassignment procedure in 1949. Millions are helped due to his work and for this he should be remembered in history. But also lest we forget the tales of these brave individuals who faced the unimaginable, having everything taken away. This is the real life Johnny Got His Gun by Dalton Trumbo.

This is not a book for a casual reader due to the intense and heavy nature of the subject. There are photos of Gillies patents and drawings by war artist Henry Tonks, it is hard to imagine what they went through and even more difficult to not care about them even after all of this time. Poignant and uplifting all at the same time. This is a lesser known story of the Great War and what happened to those gave everything in that most wasteful and pointless of struggles.
Profile Image for Darya Silman.
328 reviews138 followers
June 23, 2022
The story of Harold Gillies, whose innovative practices allowed him to grant new faces to the wounded soldiers.

The Facemaker: A Visionary Surgeon's Battle to Mend the Disfigured Soldiers of World War I provides a graphic account of the infancy of plastic surgery, born in the fires of the merciless war.

The people who save lives during wars are often overlooked in favor of people who destroy lives. Lindsey Fitzharris counterbalances the common narrative by focusing on doctor Harold Gillies and his team, whose main field of expertise was reconstruction surgery, specifically facial reconstruction. Wounds to the face became more severe due to the technological advances, yet frequently, they were a source of shame, contrary to the injuries of other body parts. During the war, Harold Gillies established a unique hospital in Sidcup, where the wounded soldiers could recover physically and mentally.

The book combines everything a geek wants to see in a history book: an engaging writing style, comprehensive research, and a delicate equilibrium between gruesome details and hope. The author uses soldiers' diaries to bring facts closer to the reader's heart. Along with reconstruction plastic surgery, the story also gives an overview of cosmetic plastic surgery, blood transfusion, anesthesiology, X-rays, and epidemics. The most significant battles of WWI provide a frame for technical information, linking types of actions (aerial, navy, ground) to particular injuries.

I recommend The Facemaker to people interested in the history of medicine and/or World War I. The wide range of topics, from narrowly medical to general war overviews, implies that every reader can find something new in the book.

(This is my first ever audiobook. I'm good at visualizing the information. Thus, the audiobook's disadvantage against an ebook is that I'm unsure about spelling personal names/surnames/names of places.
And the war horrors in my head from now on speak in Daniel Gillies' voice.)
Profile Image for Ergative Absolutive.
443 reviews16 followers
March 18, 2022
I love the history of science and medicine. I also love voyeuristic gruesomeness about horrible things happening to people who are long dead, especially if it includes all the gooey details. They’re skeletons by now, regardless of what happened to them, so I don’t feel bad about it. My fascination with this topic began in middle school, when I ran across some history textbook in the school library that included a picture from Antonio Branca’s 15th-century approach to rhinoplasty. (Google it--it's an engraving, so not too terribly gruesome.) In retrospect, it was a weird image to put in a book for 11-year-olds, but at the time I was blown away by how clever that strategy was to preserve tissue viability until it had grown attached to its new home. This fascination has persisted into adulthood: A history of murder by poison? Awesome, count me in. An account of the Great Plague of 1665? Super, I’ll take two, please. A history of antisepsis, before which cutting off a single guy’s leg could have a 300% mortality rate? I’m still telling that anecdote to anyone who will listen. I have a tag on my blog just for this sort of thing—’Gushy ways to die’. So, naturally, when I learned that Lindsey Fitzharris—the very same from whom I first learned about the triply deadly amputation—had a written a new book about advances in facial reconstruction surgery during the First World War that developed out of the need to address the needs of soldiers who’d had their faces blown up in the trenches, I jumped on the chance, settled down with a glass of wine, and started to read.

Reader, it is still too soon. That voyeuristic gruesomeness that gives me such pleasure only works if the people are long dead, and the worse the things that happened to them, the longer dead they need to be. These boys are dead now, and their children are dead too, but they are not long dead, and their experiences are all the more immediate because Fitzharris makes heavy use of first-hand accounts. We don’t start with dry or clinical descriptions of what happened once they got into the hospital. We get first person narrations of what it was like to lie in the mud for three days, unable to scream without a jaw. And after that, those who survived lived to marry, have careers, have children and grandchildren, and were still playing with their grandchildren while my parents were in school. It is impossible to approach this topic with the sort of gallows humor that leads to jokes about 300% mortality rates. I think this is why Fitzharris leans into the gruesomeness so hard: There was absolutely nothing funny about World War I, and it is impossible to separate the astonishing medical reconstructions from the barbarity that made them necessary in the first place.

For this reason, the book is not comfortable reading. You can’t settle down with it to enjoy with a glass of wine the way you might settle down with an account of the murder of Sir Thomas Overbury (Chapter 18 in The Royal Art of Poison if you’re curious). But it is fascinating reading. It focuses on the career and work of Harold Gillies, a surgeon who rebuilt countless soldiers’ faces after they had been exploded in battle. Everything you think would be relevant is included: Gillies’s education and professional training, the context of medical knowledge at the time, case studies of individual soldiers, from the moment of injury to their experiences getting from the battle to Gillies, to step by step descriptions of their treatment—including a collection of pictures showing the progress of the surgery. These pictures are, naturally, quite difficult to look at, but the end result is astonishing. You can still tell that the poor fellows had been through a bad time, but they have mouths and noses and jaws again, and the only holes in their faces are where holes are supposed to be.

Yet the pictures also contradict, slightly, an otherwise very moving refrain that Gillies would employ every time he met a new patient. ‘Don’t worry, sonny,’ he’d say, ‘you’ll be all right and have as good a face as most of us before we’re finished with you.’ That’s simply false in the case of the pictures in the book. But it seems, from the quotations and reminiscences, to have been true in many other cases. There’s one anecdote about a conversation at a dinner party, in which a lady talks favorably about what she’s read of Gillies’s work to her handsome dinner companion, only for him to say that he takes her approval of Gillies’s work as a personal compliment, since he himself was one of Gillies’s patients. The lady said later, ‘His face bore no sign of ever having been under a surgeon’s hand.’ I would have liked to see pictures of this sort of result. Maybe these cases didn’t start off in such a bad place as the men whose photos are included in the book, and so their transformation was not as astonishing, but the tender reassurance of Gillies’s refrain rings slightly false when the only pictoral evidence we get shows that he was lying through his teeth.

Beyond the primary reconstruction work that Gillies conducted, this book is full of fascinating details about related topics. For example: trench warfare was deadly not just from the shells and gas, but from infection as well, even with modern antisepsis. This is because the mud of the killing grounds was a soup of bacteria, regularly fed by new blood and bodies and rot and decay, and battlefield triage’s first priority was to stop the bleeding. And while this rush to close wounds might stop immediate death by blood loss, it only made it easier for infection to kill later, because sealing the wounds ensured a perfect inoculation of pathogens to find a home deep inside the tissues of the wounded soldier.

For example: rhinoplasty is a very old form of plastic surgery, and has been seen as morally suspect since the beginning. This is because, back in the Renaissance, syphilis dissolved a lot of noses, and people were keen to hide the mark of their infection. But because syphilis was seen as a moral failing, rather than a medical condition, getting surgery to hide it was akin to hiding your mark of shame, and frowned upon. (And it didn’t tend to work very well anyway then, either.)

For example: One groundbreaking technique that Gillies discovered, known as the tubed pedicle, was (a) developed independently at about the same time by two other surgeons and (b) claimed by one of Gillies’s colleagues as his own invention, despite Gillies’ possession of extensive medical records showing that he had used it a week before the colleague used it. As far as I can tell no one ever really believed the colleague, but the colleague nursed a grudge for decades afterwards.

For example: Gillies collaborated extensively with an artist named Henry Tonks, who created many paintings of battlefield medicine, and also painted portraits of Gillies’s patients. These portraits were a useful addition to photographs, because Tonks could capture the colors of the wounds, bruising and infection, in ‘angry crimson, lurid purple, and moldy greens’. Yes, we were turning STEM into STEAM over a hundred years ago.

For example: Long after WWI was over, Gillies continued to pioneer novel plastic surgery, and conducted the first FtM bottom surgery in the UK. This was legal because, although the UK had laws against the removal of a penis (because it didn’t like trans women even then; we have always been TERF island), it did not have laws against the creation of a penis.

It’s rather wonderful to discover that a man who was a hero 100 years ago was not a bigot who must be forgiven because he was ‘of his time’. And, indeed, in other ways, too, he showed values that resonate surprisingly well with current progressive thought. For example, he started carrying out cosmetic as well as reconstructive plastic surgery after the war was over, and although such practice was criticized by people who believed it was just an excuse to make money, Gillies felt no shame about it: Yes, it brings in money, but ‘to see the lasting pleasure that often follows makes me wonder who we are to refuse a patient.’ It was, he concluded, justified by ‘the little extra happiness [it brings] to a soul who well needs it.’ And so important was this desire to bring a little extra happiness to Gillies that he operated on a sliding scale, performing procedures for reduced prices or even for free if the patient needed treatment and couldn’t afford it.

This goal of improving happiness, rather than shaming perceived vanity, strikes me as quite modern and progressive, just as much as Gillies’s lack of transphobia. How does it hurt you if someone gets a nose job? Let people live their lives, and if you help them do that, you are a good person.*

This book is due to be released 7 June, and if you have the stomach for it, it will repay your attention handsomely.

NB: I received an advanced copy of this book from Netgalley. Inasmuch as I can be sure of such things, I believe that this has not affected the content of my review.

*I sincerely hope that Gillies was not a complete misogynistic fascist dick in other domains of his life. If he was, Fitzharris doesn’t mention it.
Profile Image for Geevee.
382 reviews278 followers
January 20, 2024
Some readers may recognise the name Sir Archibald McIndoe, The New Zealand plastic surgeon, who was instrumental in treating badly burned RAF and commonwealth air force personnel in WWII. The men he treated were named The Guinea Pigs, and they even formed their own eponymous club that lasted until 2007.

Sir Harold Gillies, whom is the subject of this book, is perhaps less well-known today, but arguably his patients - men of the British and Commonwealth armies, navies and air forces during WWI - are the earlier guinea pigs given the infancy of plastic surgery at this time. In fact, as Lindsey Fitzharris, mentions at the close of The Facemaker, Gillies introduced his cousin McIndoe to this area and he [McIndoe] would go on to use techniques pioneered by Gillies and others, and expand further the treatments and methods. Although having read much about WWII and being familiar with Sir Archibald and indeed the modern Mcindoe Centre in East Grinstead, Sussex, England, I was unaware of Sir Harold.

Overall, The Facemakers is a readable and informative book providing information on how Gillies started his works, those who supported him with knowledge and managerial/command support to those who worked with him and, of course, those he treated. There are a number of cases and examples cited, and along with some gruesome yet necessary photographs, give some idea of how the men came to Gillies and how he and his wider staff and fellow maxillofacial surgeons worked.

However, the book is also a disappointment. There are, as some other reviewers have noted, lots of digressions and padding that are at best, placed to provide background to war's stages or people's lives, but add little to the work of Gillies and this book's aim in telling The Facemaker's story. Also, the detail on the techniques, approaches and individual cases lacked in many places. In fairness, whilst Gillies kept detailed records and some were destroyed in the WWII London Blitz in 1940, there remains much in the archives of the UK, Australia and Canada, including written notes, diagrams, photographs and artists line drawings and [fewer] paintings, that could have added detail and insight.

As such, whilst I enjoyed this book, predominantly for learning about Sir Harold, and I believe Lindsey Fitzharris has done the reading public a sterling service by shining a light on this great man -and indeed the men who suffered so greatly but were offered a chance of a normal life - it is to my mind a taster to a better, detailed and more focussed book on her subject that will, one hopes, be written by someone in the future.
Profile Image for Kerry.
894 reviews122 followers
April 8, 2023
Read for the BookTube prize.

Great read about the early days of plastic surgery and how physicians on the front lines in WWI worked to develop methods and surgical procedures to assist soldiers with facial injuries. It can be a difficult subject to read about but there is much here that is both heartening and inspirational. Medical content but it is not overly technical and is interspersed with wonderful human interest stories, some successful and some not that illustrate how difficult and crucial this work was if these men were to return to any kind of a normal life in society.

Highly recommend for anyone who has an interest in this topic. Most readable and it has moved on to the quarterfinals.
Profile Image for Chris Boutté.
Author 7 books211 followers
May 5, 2022
I was fortunate enough to get an early copy of this book. This is the first book by Lindsey Fitzharris that I’ve read, but I’m a big Mary Roach fan, and she always sings Lindsey’s praises. So, when someone from Lindsey’s team reached out to see if I wanted to check out this book, I was excited to get familiar with her work. I’m typically extremely skeptical of books about the history of anything because they often bore me to death, but damn, Fitzharris is a phenomenal writer. She kept me engaged the entire time, and I actually found the stories super interesting.

This book is about the history of facial reconstruction and the origins of plastic surgery as well as the foundation for many other medical techniques. More specifically, the book focuses on Harold Gillies. Prior to this book, although I’m really big on mental health and psychology, I hadn’t put much thought into the stigma and shame around facial injuries. The Facemaker enlightened me as to why the work that Gillies did was so important.

Once I started reading, and the book started getting into World War I and the stories of wounded soldiers, I understood why Mary Roach loves Fitzharris’ books so much. Thank God, I recently became okay with blood and gore. The way Fitzharris describes the injuries, the details of the surgeries, and other bloody details legitimately made me squirm but in a good way. I was blown away at her ability to provide descriptions that made me visualize what was happening during each of these stories from 100 years ago.

I highly recommend The Facemaker. I really think fans of books about history will really enjoy this book. And if you’re into stories with gore, you’ll love it even more. Personally, I learned a ton. Although I don’t usually like books like this, Lindsey Fitzharris made me kind of curious about what else I’m missing.
Profile Image for Sandra Deaconu.
724 reviews112 followers
March 13, 2024
Atât de bine scrisă, încât nici nu îți dai seama când ai învățat atâtea lucruri doar savurând lectura!
Profile Image for Letterrausch.
212 reviews19 followers
October 31, 2022
Zugegeben: Medizingeschichte ist ein Faszinosum. Einerseits ist es natürlich interessant nachzuverfolgen, wann welche wissenschaftlichen Errungenschaften stattgefunden haben. Andererseits spielt auch immer ein gewisser Schauer eine Rolle, wenn man sich vorstellt, wie in der Vergangenheit Krankheiten geheilt oder Operationen durchgeführt wurden. Auch Lindsey Fitzharris’ „Der Horror der frühen Chirurgie“ spielt schon im – sehr irreführenden – Titel mit dieser Dichotomie. Man möchte sich ein bisschen gruseln, aber doch bitte zum Wohle der Menschheit!

Im Original heißt Fitzharris’ Sachbuch „The Facemaker“ und das trifft den Kern ihres Projekts genauer, denn sie verfolgt den HNO-Arzt und Chirurgen Harold Gillies, der während des Ersten Weltkriegs ein Hospital für gesichtsverletzte Soldaten eröffnete, um in oftmals Dutzenden (riskanten und oft auch lebensgefährlichen) Operationen die Gesichter von Männern wiederherzustellen, die z.B. keinen Unerkiefer, keinen Gaumen, keine Nase mehr hatten. Damit begründete er das bis dahin nicht eigenständige Fach der plastischen Chirurgie mit sehr viel Einfallsreichtum, Fantasie und auch learning-by-doing, denn es gab bisher keine Behandlungsleitlinien für derartige Verletzungen.

Fitzharris hat eine sehr gefällige Schreibe und sie versteht es, ihr Laienpublikum auch durch komplizierte Operationsverfahren zu manövrieren. Es gelingt ihr gleichermaßen gut, die Schrecken des Krieges zu Papier zu bringen wie auch den Erfindergeist, der in Gillies’ Krankenhaus vorherrschte. Beides ist für den Leser nicht unbedingt leichter Tobak, denn die Autorin geht sehr nah ran an ihr Sujet. Sie beschreibt die (Lebens)geschichten einzelner Soldaten und schreckt dabei auch vor Gillies’ Rückschritten nicht zurück. Nicht jede Operation gelang, doch offenbar waren sowohl Gillies als auch die betroffenen Soldaten risikofreudig genug, Dinge auszuprobieren, die eventuell noch nie ausprobiert worden waren. „Der Horror der frühen Chirurgie“ ist ein sehr lesbares Sachbuch über den Ersten Weltkrieg geworden, das bei niemandem im Regal fehlen sollte, der sich für das Thema interessiert.
Profile Image for Kathleen.
886 reviews24 followers
February 1, 2022
“Europe’s military technology had wildly eclipsed its medical capabilities.”

The injuries suffered by soldiers in World War l were horrific and far different from earlier wars. Devastating facial wounds were more common, caused by poisonous gas, burns, shrapnel and infections. Death could be caused by actions as simple as placing the soldier on his back on a stretcher which could cause suffocation by blood flow or by sewing large open wound edges together causing necrosis. Changing this world of horror was The Facemaker, Dr. Harold Gilles, whose contributions to the nascent field of plastic surgery saved many lives, invented techniques still used today and resulted in his Knighthood.

Gilles was an ENT who understood facial anatomy. His work was aided by that of naturalized American dentist Auguste Valadier, Henry Tonks, anatomical drawing artist and sculptor Anna Ladd. Although plastic surgery dates back to 1798, these men and women were pioneers who modernized the science.

The Facemaker is full of facts but reads like fiction. It is perfectly illustrated by the story of Private Percy Clare, wounded in Cambrai, France. His survival was at first accidental. He was helped by a friend, passed from hospital to hospital and finally had reconstructive surgery at Gillies’ Queen’s Hospital. Clare lived until 1950. This is a fascinating look at an unknown (to me) part of medical history. 5 stars.

Thank you to NetGalley, Penguin Press UK and Lindsey Fitzharris for this ARC.
744 reviews20 followers
January 15, 2023
Such a wonderfully researched homage to a great man. Gilles gave so much to the horrifically facially mutilated soldiers of The Great War, and continued his work for years afterwards with compassion and great innovation. It is a sobering read, naturally, war is brutal, and the numbers injured are terrible to imagine, but what Gillies gave these men, which is effectively their lives back, is to be applauded. There are few photographs, and the author does not seek to shock unnecessarily, and I found this book absolutely fascinating.
Profile Image for Czytająca  Mewa.
975 reviews197 followers
October 11, 2023
Szczątkowonie informacji, niewyczerpanie poszczególnych tematów oraz rozbiegana uwaga to jedne z najbardziej uwierających mnie wad książki. Lindsey Fitzharris zapisała się w mojej pamięci jako fanka nieładu, a jednak udało się jej mnie zainteresować. Nie odpowiadał mi poziom jej warsztatu, ale też nie sprawiał on, że miałam ochotę tytuł odłożyć. Był ciekawy, wiele z niego wyniosłam, ale uwa��am go po prostu za luźniejszą literaturę faktu (oryginalna okładka nawet tę półkę sugeruje i tym razem warto jej posłuchać). Luźniejszy przez warsztat oraz styl autorki, nie sam temat. Temat, w którym do powiedzenia zostało jeszcze wiele.

[Psst, Nie rozumiem, dlaczego wydawnictwo Znak uparcie zmienia oryginalne tytuły Lindsey Fitzharris w takie, które przypominają tanią sensację. „Facemaker“ i jego „Historia człowieka, który stworzył chirurgię plastyczną“ zamiast podtytułu „One Surgeon's Battle to Mend the Disfigured Soldiers of World War I“ miał większe szczęście niż „Rzeźnicy i lekarze“, ale wciąż nie jestem zwolenniczką takich zabaw.]
Profile Image for Nancy.
398 reviews87 followers
August 24, 2022
What there was of plastic surgery cases and practices was fascinating, but the book suffered from a merely adequate writing style and a whole lot of padding in an already short book. The latter consisted not only of potted histories of various events during the war that were shallow and unnecessary in this context, it also veered into absurdities at times with the entirely irrelevant. As one example: “Valadier moved to New York City, where he opened a dental practice at 39 West Thirty-Sixth Street, not from from where the Empire State Building would be erected several decades later.”

There was a powerful story here, but it could have used more pertinent information and lost a lot of the clutter.
Profile Image for Will B.
249 reviews10 followers
August 14, 2022
“The Facemaker” by Lindsey Fitzharris was an okay book, but I felt like something was missing from this book. I am a fan of Lindsey Fitzharris and her first book “The Butchering Art” but “The Facemaker” is not like her first book at all. “The Butchering Art” was engaging, scary, suspenseful and eye-opening, but “The Facemaker” focused more on WWI history and logistics rather than plastic surgery itself. Granted, there are multiple chapters in the middle of the book that focus on Harold Gillies and how he became a pioneer in plastic surgery and how he had to learn from scratch how to repair and reconstruct soldier’s faces. The rest of the book was not as interesting. The WWI chapters should’ve been used as anecdotes throughout the book instead of becoming their own chapters because you lose the reader’s interest in what the topic is which is plastic surgery. I wish I could’ve liked this book more, but I couldn’t. I do respect the art of plastic surgery and Harold Gillies, but I think this book didn’t really do it justice.
Profile Image for simona.citeste.
253 reviews244 followers
June 2, 2023
Foarte mult mi-a plăcut, mai ales că domeniul medicinei nu-mi este total străin și îmi face plăcere să citesc despre bazele oricărei ramuri.

Aici vorbim despre bazele și începuturilor a ceea ce numim astăzi chirurgie plastică/estetică.

Încă din vremea Primului Război Mondial a existat un chirurg vizionar care împins de curiozitate, dorința de a ajuta și înțelegerea traumei soldatului desfigurat, a lucrat fără încetare ca să-și dezvolte tehnicile și metodele potrivite pentru a trata rănile feței.

Până la rinoplastii și alte proceduri cosmetice foarte des întâlnite astăzi, chirurgia plastică însemna operații care constau în reconstrucția fețelor distruse pe câmpul de luptă: soldații aveau găuri pe chip, le lipseau nas, ochi, mandibule sau orice alt țesut de la nivelul feței.
Profile Image for Cass (only the darkest reads) .
367 reviews33 followers
June 30, 2022
Life is worse than any horror novel my friends.

I’ve read military histories and written essays on WWII, but I feel like the actual brutality of war in many of these recounting are sanitized. You know it’s bad, but hearing about a bullet firing from a gun is different from reading how it brutalizes a body.

The Facemaker pulls no punches. The prologues GOES SO HARD, and has some of the most gut-wrenchingly grotesque depictions of the horrors of war. If you haven’t read about the facial injuries that resulted from the development of trench warfare you’re in for a surprise.

I will forever find the science behind rebuilding someone’s face to be fascinating, and learning about the successes and failures in the development of facial reconstruction and how it lead to modern plastic surgery as we know it.

Every depiction of war should be as brutal, terrifying and pungent as this book. And I wholeheartedly recommend it if you have the stomach for it.
Profile Image for Sophy H.
1,458 reviews77 followers
September 18, 2022
This was an amazing book.

Lindsey Fitzharris has put together a tremendously researched account of the absolutely horrific experiences of those men and women of the First World War; the victims of unspeakable injuries caused by the machines of war, and the doctors and nurses consigned with attempting to put these men back together again or ease their suffering in their final moments.

This book brings home how truly destructive and pointless war is and how the results are heartbreakingly devastating.

The compassion shown by Harold Gillies and his team is outstanding; the amount of time, effort and soul put into their work is inspiring.

Brilliant, sad, inspiring.

Highly recommended for anyone with a modicum of human compassion.
Profile Image for Claire.
98 reviews132 followers
August 26, 2022
A very engaging read but one I feel would have been even better with a tighter focus. The author does flag up the potential problems of such a broad outlook in the introduction so I wasn't disappointed as such. It feels strange to say this about a book covering The Great War but I was just left wanting more. Which is, of course, no bad thing.
Profile Image for Dana.
469 reviews2 followers
August 28, 2022
Interesting topic and well researched, but poorly structured. Takes 100 pages to really get into it. Lots of mini tangents that are related, but could be whole books themselves. Military weaponry, the politics of medical training, Spanish flu, etc. Mention them, or do a full dive, but her 2-3 pages on each is a poor middle ground choice. Even with non-fiction you have tell a story, and she achieves this only in short bursts.
Profile Image for LenaExplorer.
71 reviews1 follower
November 17, 2023
第一次世界大战前,工业革命兴起,科技大爆炸,一战成了各国新武器的竞技场。而各国的参站军队,从装备到训练,到心理,都没有做好面对这些大规模杀伤性武器的准备。
一战,也成了历史上人类伤亡最多、最惨痛的战争😞
在这个时代背景下,很多医疗领域却有需求和契机大大进步、创新—-比如外科整形!
这本书就描述了在一战时期,英国外科医生Dr. Harold Gillies结集各领域专家,救治在战争中毁容的士兵们,发展整形科的历史。
本书作者是一位历史学家,史实详尽,但有那么一点点🤏缺乏故事线的连续性。

过来人建议:书里的插图(毁容🤕️手术前后对比图)一开始建议眯眯眼看🥺
过来人建议2:Dr. Gillies发明的一些手术技术,最好不要去网上搜图🥺🥺🥺

PS:感谢介绍这本书给我,并跟我一对一buddy read这本书的小伙伴😙😙
Profile Image for Kalle.
177 reviews3 followers
February 1, 2023
The Facemaker is a nonfiction book covering facial reconstructive surgery during World War I. The book focuses on the work of Harold Gillies, one of the surgeons who pushed the boundaries of plastic surgery during this time. I'm the granddaughter of a plastic surgeon who specialized in hand reconstruction and am generally interested in the history of medicine, so I was excited to request this book and to read it! What I was not expecting was how blown away I was by this story and the compelling writing.

I loved this book. I never thought that I would look forward to reading about facial reconstruction or surgery before going to bed but Fitzharris proved me wrong! I had such a good time reading it that I was upset when it ended because I wanted to know more. The story was so compelling, the writing so good, the time period so interesting, and the subject so new to me that I couldn't put the book down. And nonfiction is usually the hardest for me to get through!

As you can imagine, this book is pretty gruesome. If you have ANY issues with blood, gore, detailed medical procedures, or anything of that ilk, this is NOT the book for you. I felt like the descriptions weren't overly gratuitous or macabre, but it definitely goes into detail throughout the book.

I HIGHLY recommend this book if you are at all into nonfiction, the history of medicine, biography, or just a good story. 5/5 stars from me. Thank you to Farrar, Straus and Giroux and NetGalley for the electronic advanced reader's copy of this book in exchange for my honest review!

CW: Violence, medical procedures, blood, detailed descriptions of surgery, war, death
Profile Image for Jenny.
1,041 reviews96 followers
February 6, 2023
*****4.5*****
I rate this a four, and my dad rates it a five, so 4.5 it is.
I read this book with my dad, the first we've read together in a while. I chose it because I saw it on Goodreads, and the title caught my attention. I like weird nonfiction books that are about strange topics I never would have thought about, so this was right up my alley. Add to that that I also love the show Botched, and this makes even more sense.
This book was fascinating right from the start. Fitzharris does a great job of setting the scene in the prologue. From there, she takes us through Harold Gillies' career, from removing scissors from a ballerina's bottom to repairing the faces of World War I soldiers. The prologue continues through the rest of Gillies' career and explains how he shifted from reconstructive to cosmetic surgery, using the information and knowledge he gained during the war. When the war began, many medical fields were still in their infancies, including plastic surgery. There were some aspects of plastic surgery developed before the war, but nothing was really set in stone or modernized. Much of what Gillies learned and innovated went on to inspire later plastic surgeons and contribute to the field as a whole. Of course, plastic surgery wasn't taken seriously, as it still isn't in many ways, but Gillies didn't care--he cared about his patients and their happiness, and he wanted the discipline to develop, but he was going to work hard for his patients, whether those who needed reconstructive work or those who wanted cosmetic surgery, either way. Overall, this book was fascinating. I learned a lot about World War I and plastic surgery and the connections between the two. There are pictures, which can be harrowing, but to me, they were so interesting. I love seeing the before and after pictures and how, in most of them, you can't even tell there was work done. Gillies' patients loved him and said that many people didn't even believe they'd been wounded because Gillies' reconstructions were so thorough.
Overall, I'm really happy I read this book. I learned a lot, and I was entertained and moved from beginning to end. My dad really liked it as well and said that it was entertaining and interesting. I'm happy we read it together and had some good talks about it as well.
Profile Image for Beth.
173 reviews31 followers
September 5, 2023
"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."

Not sure what prompted me to pick this up but so glad I did -- simply fascinating and so well done! This is, ostensibly, about the advances in plastic surgery by one man, Harold Gillies, during WWI, and while it does center on his story and the developments in the field of plastic surgery, reconstructive work to be exact, it's also a great primer on the war and state of the world at the time. Fitzharris manages to weave in historic details and anecdotes in such an approachable way, building a complete picture that provides deep context to the work being performed and its importance.

I would love to find more nonfiction work like this - her book The Butchering Art is definitely on my list for near future reads! *I will caution that it can be a bit gruesome so I wouldn't recommend if you consider yourself squeamish.
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