On the 4th August, 1914, Great Britain declared war against Austria-Hungary and her German allies, thus plunging Europe into the beginnings of what would become known as World War I. This war gained fame not only for its length, mechanisation of armaments, battles of bloody attrition, and staggering death toll but also for the creative human outcomes it inspired. The poetry of Wilfred Owen and Siegfried Sassoon stand out as brutally honest encapsulations of what was the darkest moment in history up to that point. However, for as much as these works stand out, they also stand relatively alone. Despite the power of these men’s commentaries on what was daily life and death for millions on the front lines of World War I, their insights and the survival of a scattering of letters from various other soldiers are all that remains in writing of the generation that fought in the trenches.

At least that’s how it would seem on the surface. While the day-to-day lives of ordinary soldiers live on in this small sample of literature and letters, still more resides in the nostalgia of the children’s literature written shortly after the end of the war in 1918. Alan A. Milne and Hugh Lofting were two soldiers who fought in the trenches of World War I. Respectively, they wrote Winnie the Pooh Adventures and The Story of Dr Dolittle; two pieces of work that have endured in the hearts of adults and as nursery bedtime reading for decades. This literature is quieter and more fantastical than the realism portrayed by Owen and Sassoon; however, the realities it portrays is the same. While not written out in slaughterous stanzas or metres of marching, these works of children’s literature portray the physical and psychological damage of the men who fought in this war using nostalgia and caricatures. Because of the gentle engenderment of these texts into the mainstream literature of the time—texts that have indeed remained as mainstream literature to the present day--the social commentaries woven within these texts helped to ensure that the atrocities of post- World War I Britain would never happen again. Using the nostalgic rural setting for their stories as set out in World War I propaganda posters and physical and psychological maladies in their fictional children’s characters, Milne and Lofting were able to write about their war experiences whilst encompassing the pre-war innocence that many people longed for. This was an important step forward in how medicine began to be represented in children’s literature, and these works redefined the boundaries around what children are exposed to regarding mental and physical health. Milne and Lofting’s writings discuss illnesses, healthcare --and the lack of healthcare,-- more openly than many of the children’s literary works that came before them, and opened the way for writing about psychological and social issues in a way that touches a common psyche.

Before World War I, Alan Alexander Milne was a writer and a scholar. He undertook his education at Henley House School, the public school where his father was the Headmaster, and later Westminster School, followed by Trinity College, Cambridge to study mathematics. Milne was a gifted author and editor as well as a mathematician. He edited for the Cambridge student magazine, Granta, while he undertook his studies. He later wrote for Punch magazine and became an assistant editor there. Milne married in 1913. While married men were initially exempt from volunteering for the British Expeditionary Forces after the outbreak of World War I in 1914, Milne was eventually conscripted to fight with the Royal Warwickshire Regiment in 1915. He served much of his frontline military service in France. A debilitating illness caught on the front lines left him unable to continue rendering service in a regular regiment, and he was then assigned to the Royal Corps of Signals (Dennis 1999). Later wounded at the Somme in 1916, he was invalided back to England, where, it has been recently discovered, his writing skills were put to work for the Ministry of Information: Section 7b (MI:7b). MI:7b was a classified propaganda unit that operated in London, writing the articles and drawing the posters which supported the war and were distributed to the people of England (Flood 2013).

Despite his constant work for the military during this time, Milne remained a rather open pacifist. Even during his work at MI:7b, he made no effort to hide his hatred of the war or of the work he was forced to do. In an in-house magazine called “The Green Book,” MI:7b authors and artists were able to write down their honest feelings about the war. This magazine was kept strictly in-house, but a surviving copy illustrates Milne’s open opposition to the war itself. In a poem he wrote for this magazine called “Captain William Shakespeare, Of a Cycling Battalion,” Milne writes:

In MI:7B/Who loves to lie with me/About atrocities/And Hun Corpse Factories./Come hither, come hither, come hither,/Here we shall see/No enemy,/But sit all day and blether. (Flood 2013)

His stinging rebuke of war in general entitled, Peace with Honour, written in 1934, denounced the abiding preference many people still held that war was a necessary and tenable state of affairs. “I want everyone to think (as I do) that war is poison, and not (as so many think) an over-strong, extremely unpleasant medicine,” he said when asked why he wrote this book (Flood 2013). His propaganda work in MI:7b, however, had instilled in him a respect for the common need for retrospection and an idealised, rural existence. Though it is currently unknown exactly what published articles Milne would have written for MI:7b, the propaganda posters and articles of this time built on Britain as a landscape of green fields, countryside, and blue skies; the idea behind this being that it was expected that men should go forward not only to protect their families and the King but also this beautiful land and their idyllic way of life. However far the reality of living in Edwardian England was from the ideal portrayed in the posters and articles, these images would have defined the perceived purpose of the war.

With this deeply engrained wartime propagandist mentality embedded, Milne, even before he began openly criticising war, began writing about it in a more subtle way. Winnie the Pooh Adventures, written in 1926, embraced and, indeed, enhanced the common “need” for an idealised rural society flawlessly. The same green fields and wooded forests portrayed in World War I propaganda posters mirrored The Hundred Acre Wood, described in Winnie the Pooh Adventures as “an enchanted place” and being “[full of] violets” (Milne 1926, 49). But The Hundred Acre Wood, as written in Winnie the Pooh Adventures, goes so far as not only to separate itself from the bustling city life by presenting itself as a perfected rural setting but also from the human world almost completely. The only human allowed to enter in (apart from the reader) is Christopher Robin—a child. Apart from Christopher Robin, the cast of characters is entirely comprised of animals based on the stuffed animals that live in Christopher Robin’s bedroom. In real life these characters are relegated to inanimate toys; in the Hundred Acre Wood, however, they lead lives independent of humans and even relatively independent of each other.

The physical semi-autonomy enjoyed by these characters in their individual homes in the Hundred Acre Wood seems to foster an interesting dynamic; each character, relatively independent of each other, harbours traits that, to this point, had not been seen in children’s literature. These traits would now, with the development of psychological medicine, seem to engender various psychological anomalies similar to those now associated with Post-Traumatic Stress Disorder (PTSD). These anomalies would most likely have been found in the trenches of World War I but would have been known as “shell shock.” Anxiety, perfectionism, depression, anger, even Obsessive Compulsive Disorder exhibit themselves in the characters of Pooh Bear and his friends and would have also been widely displayed in soldiers fighting and returning from war (Timms 2013).

The amplification of psychological traits because of the unending fear of death and the never-ending pain of life on the front lines of World War I caused a rapid increase in cases of shell shock. From 1914-1915, frontline physicians recognised shell shock as a diagnosable physical illness. This meant that those diagnosed as suffering from this condition could be invalided home with full military honours. When doctors began recognising the psychological connections to the physical symptoms, the British military stopped recognising shell shock as a valid war injury and recommended that sufferers get rest—sometimes home rest—before they were returned to the front. Those with severe symptoms were sent to specialist hospitals like Craiglockhart Hospital—where Owen and Sassoon wrote some of their best poetry—but were often returned to the front lines when and if they were deemed physically able. Little credence was given to their psychological wellbeing. These medical treatments indicated a small nod towards recognising psychological maladies and treating them, but, for the most part, the illness itself and those who suffered from it were branded with debilitating stigmas of cowardice from the military and even from society at large (Winter 2000). This led to a mass social tendency of those who fought in the Great War not to speak about the experience of being on the front lines as “shell shocked men joined others labelled as deviants...[and] located [them] within the degenerate categories well known at the time” (Mosse 2000).

There is no physical pain or death in the Hundred Acre Wood. Unlike frontline veterans, the characters in Adventures of Winnie the Pooh would have had no reason to fear for their lives. “...Because Pooh is a toy bear, his life is not imperilled by gunfire or by falling from great heights...” states Robert Hemmings (2007) in his look at nostalgic literature. This is an important point as the lack of physical pain allows these characters to form personalities completely unhindered, it would seem, by fear of death or pain—a luxury that soldiers at the front lines would not have had. This fact calls into question why, if Milne was not writing about the psychological effects of the war directly, characters would have displayed “deviant” characteristics as depression as part of their individual personalities. These psychological characteristics existed outside of the “golden age...the myth of an Arcadian rural England” (Hemmings 2007). The idealised image existed in children’s literature up to this point, Hemmings argues, and Milne’s subversive displacement of this ideal, at least with regards to his characters, places his work directly in the modern age of medicine and children’s literature (Hemmings 2007). And yet, however, characters are secreted enough within the landscape and are lovable enough to make them palatable for their time (Hemmings 2007).

The duality—making the horrific palatable—meant that people who existed outside the frontlines of World War I could gain, at least in small part, an understanding of the psychological difficulties of the men who had returned from the trenches. While this understanding would have been cursory and perhaps still stigmatised, it was a hopeful beginning in helping to people to understand, as Milne put it, “that war is poison” (Flood 2013).

While Milne was relatively inverted about his social commentary on post World War I healthcare in his children’s writing, Hugh Lofting was rather more overt in his children’s book, The Story of Dr Dolittle, written in 1922. The Story of Dr Dolittle was derived entirely from letters Lofting wrote to his children from his service on the front lines at Flanders. He wrote these letters, he said, because “If we made the animals take the same chances as we did ourselves, why did we not give them similar attention when wounded? But obviously to develop a horse surgery as good as that of our Casualty Clearing Station would necessitate a knowledge of horse language” (Townsend 1990, 12). The observation carried over into his longer work, written when he returned from the front.

The idea that Lofting held of equality in healthcare and being able to expertly communicate with those you care for was, seemingly, a rather novel idea during the post-World War I era. It’s not difficult to see why this was. Up to this point, healthcare was a privilege of the upper classes. Those in the lower echelons either died of contracted illnesses, survived them, or were treated by Quack apothecaries or homespun remedies of the time (Navarro 1978). Such remedies and the class division within healthcare is written about widely within the works of Charles Dickens. Great Expectations and A Christmas Carol are two examples of how health and healthcare were portrayed within Victorian English society at that time. However, the Great War had changed many men’s perception of what healthcare should be. On the front lines, men were treated by the best doctors and nurses and were given the best care regardless of rank, title, or wealth. However, men who were invalided back to England because of their wounds were largely left to their own devices. Many men who had served in World War I had not served in the military long enough to be eligible for a military pension. They had no access to military medical help after the War (Hetherton 1993). For those who had money to pay for the care that they needed, this was not a problem. For the vast majority, however, this meant that they now not only were unable to work due to loss of limbs, burns, internal injury, and so forth, but that they were also completely unable to access any sort of healthcare for their newly acquired health needs. Charities were set up across the United Kingdom to help combat this need, however demand far outweighed available resources. As many women left or were kicked out of their jobs when the men returned from the front, this meant that many households were left entirely without income, and poverty rates in Britain soared by approximately 16.5% (Alesina 2004).

It is this problem that Lofting’s Dr Dolittle outlines and discusses. Dr John Dolittle is a doctor living in the small village of Puddleby-on-the-Marsh. He begins his work as a people doctor, but, as he continues to acquire animals as pets, and gives them free reign of the house and grounds, people eventually stop coming to see him when they’re ill. He’s not particularly heartbroken by his lack of human patients, as he prefers to spend his time with the animals; however, his income suffers. Despite this, he sets about to become an animal doctor instead of a people doctor. As he practices and gains experience with various animals, he comes to acquire knowledge of their various languages and how they express pain and illness. He learns how to treat them perfectly because of his insights into their expressions and eventually becomes the best animal doctor in the world.

The parallel between Dr Dolittle and Lofting’s view of what medical care should be is quite clear: it should not cost anyone money to gain access to the best healthcare they can receive. Dr Dolittle even goes so far as to say, “money is a nuisance. We’d all be much better off if it had never been invented. What does money matter, so long as we are happy?” (Lofting 1934, 24). Practitioners, while they do still have to make a living, should not only practice solely for gain, but also to help those in need—whatever race, creed, colour, or background they may be. Doctors should work to gain experience in being able not only to treat people, but also to be able to communicate with them. Dr Dolittle’s acquisition of his communication and treatment skills does eventually gain him great fame and fortune, signifying to the readers that, if you care for others long enough and well enough, your fortune will eventually come. However, as Lofting asserts throughout The Story of Dr Dolittle, money is a useful commodity, but it can, indeed, be a “nuisance.” Being happy should be of far more importance.

It was largely this work, along with others like it, that changed the way the public viewed what healthcare should be. So much so that, after the end of World War II, Churchill lost the election for Prime Minister, and the Labour government with their promise of a welfare state came to power. The After much debate, the National Health Service was instituted in 1948. For the first time in English history, healthcare became free for everyone at the point of delivery. Money was no longer a deciding factor in who received help and who did not. This was a godsend for those who had returned from the front lines of World War II. It meant that the healthcare they required for any wounds they may have sustained was carried on regardless of whether or not they were able to pay for it. Changes were made to the way the military awarded pensions and these same men were also able to get the help they needed from the country they had served. This same system, despite many changes over the years, still exists today and stands as one of the proudest examples of British ingenuity and humanity. It provides one of the highest standards of health care in the world inclusive of both physical and psychological care (Culzac 2014).

In their own ways, both Milne and Lofting contributed to how we view and practice healthcare within our society. Their tales of fantastical characters continue to touch the hearts of children and adults alike. But what these literary works have achieved as they have moved on with society is immeasurable. Their warm, friendly and familiar faces and settings continue to comfort us while also reminding us that we have a right to seek further comfort and help if we need it. Their works gave a voice to those who psychologically suffered in silence and was a rallying call that healthcare should be more than it then was. They redefined what children’s literature was capable of. By writing in a way that even children could understand, both Milne and Lofting were able to touch the common psyche and reinvent the way we see pain, trauma, and healthcare, which, in turn, changed us and our relationship with medicine for the better.