Few American women experienced the Great War as vividly as did New Yorker Shirley Millard.

Shortly after General John J. Pershing arrived in France in 1917, he issued a decree: No American woman related to a soldier would be tolerated in Europe. This was soon escalated to no women, period, except army nurses and a cadre of female telephone operators. Seldom has a military order been more flouted. The women came anyway, first in a trickle, then in a flood. Before the war ended, no less than 25,000 skirted Yanks from age 21 to 60-something had made it “over there.”

This little-known fact underscores another equally neglected reality: The modern woman strode onto history’s stage not in the Roaring Twenties but in the Tempestuous Teens. The Progressive movement liberated a lot more than wage slaves from the tyranny of big business. As one writer put it, “Sex o’clock in America struck in 1913, about the same time as the repeal of reticence.” Articles on birth control, prostitution, divorce, and free love filled magazines and newspapers. Women were becoming doctors and lawyers and journalists. Theodore Roosevelt was telling every male in America that the war was the “Great Adventure” of his generation. These modern women were determined to share it.

Few of them experienced the war as vividly as did New Yorker Shirley Millard. In her memoir, she recalled the way her heart “thumped admiringly to the tune of ‘Over There’ ” after President Woodrow Wilson called for a war to make the world safe for democracy. Her alarmed parents kept telling her she was much too young to go to war, and she did not have an iota of training to drive an ambulance or nurse wounded men. But she had two valuable assets: “a fair knowledge of French and the determination that goes with red hair.” When she heard the French were recruiting Americans to serve in their depleted nursing corps, Millard instantly volunteered. On March 16, 1918, her awed fiancé, Ted, about to begin training as a lieutenant at New York’s Camp Upton, saw her off with kisses and presents, urging her “not to win the war” before he got there.

Millard enjoyed every minute of her eight-day voyage across the Atlantic, despite the threat posed by U-boats. She read a handbook on nursing in secret, still pleased that she had managed (so she thought) to bluff the French recruiters into taking her. She assumed she would be given some sort of training when she got to France. She had no idea that the French army had been chronically short of nurses since the war began. Nursing was not an accepted profession for Frenchwomen. It had mostly been left to nuns—and in France’s on-going war between the secular left and the religious right, many religious nursing orders had been driven out of the country.

On March 24, 1918, Millard and the nine other members of her unit landed in Bordeaux. They were instantly ordered aboard a train to Paris, where they were told they were needed at an emergency hospital near the front. Soon they were in an odoriferous covered camion, or truck, which had just carried a load of mules to the front. They shrugged into their uniforms as the camion roared headlong through the night, telling each other how lucky they were to get to the front without boring delays.

As darkness fell, they reached their hospital, a big, rambling old château near Soissons. On its lawns were numerous barracks for wounded enlisted men. Wounded officers were treated in the château. In the distance they could hear the boom of artillery. Heavy fighting was obviously in progress. On the grounds between the château and the barracks were hundreds of men, whom they assumed were sleeping.

A French doctor looked the nurses over and beckoned them out the door. Often they had to step over the men on the ground as they hurried toward the barracks. Their ears picked up pathetic cries for water, food, a priest. They realized the prone soldiers were all wounded, lying there waiting for treatment. Moments later, an airplane exploded and burned in the black sky above them. By that time Shirley Millard was at the door of Barracks 42. The doctor opened it only wide enough to shove her inside. She would soon learn that lights drew German bombers.

She found herself in a long, low room, with cots so jammed together it was hard to walk between them. Light came from flickering candles. Nurses, doctors, orderlies rushed up and down the center aisle. Someone shoved a huge hypodermic needle into her hand and told her every man who came in must have a tetanus shot. Then she was to get them ready for the operating table. Millard stared at the hypodermic. She had no idea how to use it. “I’ve never even had one [an injection],” she later wrote. “And what did ‘get them ready’ mean?”

She watched another nurse snap on the glass tube containing the antitoxin, fill the syringe, and give a man his injection. She followed the same procedure, but when she tried to plunge the needle into her man’s arm, the needle bent. A passing orderly told her the man was an Arab, with skin as tough as leather. She found another needle and tried again. It worked! Ditto the second, third, and fourth times. “Soon I am going like lightning,” she remembered.

Then she found out what “getting them ready” meant. She watched a French nurse as she undressed several wounded men, “removing all their clothing, boots, leggings, belts, gas-masks.” Then she washed their wounds and wrapped them in a clean sheet to prepare them for surgery. Taking a deep breath, Millard went to work. Most of the men were caked with mud from head to foot, and they screamed and cursed her as she struggled to undress them without causing more pain.

Beneath one set of blood-and-mud-soaked bandages she found an arm hanging by a tendon. “Roses Are Blooming in Picardy,” the plaintive British war song, started wailing in her head as she went on to the next man. She bathed a “great hip cavity” where a leg had been. Next was a man with no eyes. She could see into the back of his head.

She stared at a chest ripped open by a shell as the exposed lungs slowly shuddered to a stop. Next came a burly Breton, who reminded her of the porter in the hotel in Dinard where she had stayed with her parents years before. “I slit him open!” he babbled. “Open I tell you! God-damn his soul!” She wondered: Is it delirium, or horror at what he’s done?

For three sleepless days and nights, Millard lived this nightmare close to the lines. She watched Dr. Le Brun, a young surgeon from Lyons, who stayed on his feet, gulping black coffee, operating, operating, for the entire 72 hours. Toward the end, he  hung onto the door of the operating room and muttered: “La gloire, la gloire! Bah! C’est de la merde!” (“Glory, glory! Bah! It’s all shit!”) When he saw Millard trying to get past with water and gauze, he was embarrassed. “Pardon, Mademoiselle,” he said, and stepped aside.

Then came word that the salient was broken and the front line had been pushed back two miles. Two miles! Millard thought. Her brain went round and round on the words like a scratched phonograph record. Two miles of what? Finally, one of the French nurses led Millard to a bedroom in the château. She lay there, listening to “Roses Are Blooming in Picardy” wailing in her head and Dr. Le Brun saying, “La gloire…La gloire….” She thought of her fiancé at Camp Upton. She felt years and years older than he. She had crossed a river of blood since she had seen him. “How would I feel about him when we met again?” she wondered.

Millard soon settled into the life of a nurse. “The big [German] drive is over, and the terrific rush has stopped, at least temporarily,” she told her diary, “but the hospital is still filled.” Most of the men were too badly wounded to be moved. The hospital desperately needed their beds, because they were being swamped by a new horror: influenza.

“I thought influenza was a bad cold, something like the grippe but this is much worse than that,” Millard wrote. “These men run a high temperature, so high that we can’t believe it’s true, and often take it again to be sure. It is accompanied by vomiting and dysentery. When they die, as about half of them do, they turn a ghastly dark gray and are taken out at once and cremated.”

The hospital had become better organized. There were special wards for influenza, others for gangrene cases, major gas burns, meningitis, fractures, and spinal injuries. “I have worked in all of them and cannot make up my mind which is worse,” Millard told her diary.

Another worry was the German air force. Planes bombed the hospital almost every night. Often as many as 40 aircraft were overhead. Millard’s heart went out to the wounded men, “helpless in bed, with arms strapped up or down…or legs in casts.” They knew the sound of German motors. “Boche planes have quite a different noise from ours,” she wrote. “It is a dismal groan, several tones deeper than the French.”

One day at dawn, Millard was on duty when the barracks next to hers took a direct hit. She rushed out to stare at “an unforgettable sight.” A tree that spread its bare wintry branches over the barracks had “blossomed horribly with fragments of human bodies, arms and legs, bits of bedding, furniture, and hospital equipment.” It looked, she thought, like a Christmas tree in a nightmare. Heightening the horror was “the blood red sky of sunrise.”

During the lull at the front, Millard got acquainted with the other nurses, particularly a French nurse named Suzanne Mercier. She had helped Millard through the first three appalling days. Mercier, who had been at the hospital two years, had a lovely soprano voice and had been training for the concert stage. The wounded men liked to hear her sing, and she always obliged them. Millard taught her several American songs, which she sang with a “delightful” accent.

One day, the owner of the château, a wrinkled aristocrat dressed in black, accompanied by a peasant woman wearing the same somber color, visited Millard’s ward. The nurses were introduced to Madame de Merret and her maid, who curtsied almost to the floor as they met. Madame de Merret thanked the Americans for their help. The old peasant blessed them with tears in her eyes. When they left, Millard felt as if she had somehow had a “priceless decoration” pinned to her bib.

A week later, Madame de Merret led Millard and the other American nurses on a tour of the château and grounds. The building was a wreck. The Germans had used it as their general headquarters in 1914, when they almost got to Paris, and had slashed to ribbons priceless tapestries in the halls and salons. The inlaid piano in the music room had been filled with wine bottles from the cellar. Exquisite floors were scarred and marred beyond repair. Trees and flowering plants, which had taken 150 years to perfect, had been destroyed.

The old woman gazed across a muddy jumble where her tulip beds and English phlox had once been. In slow, precise English, she said, “These were only my flowers…but the fine flower of the world—those [are] in there.” She stared toward the nearby church and cemetery. The guns rumbled in the distance. Millard never forgot “the white despair of her face.”

A few weeks later, Millard was assigned to the German ward. The captured wounded were admitted to the hospital like everyone else. Millard found them “thoroughly unpleasant.” The officers were especially difficult, partly because the French mixed them in with the enlisted men, supposedly to give them a “taste of democracy.”

Some of the officers were members of the kaiser’s crack Prussian Guards Division, and they were particularly sulky. They gave orders to the nurses in a way that made Millard’s “blood boil.” She decided that they were a perfect picture of what one imagines the enemy to be: insolent, cocky, and rude. She was always afraid one of them might have a hand grenade or some other weapon concealed under his pillows.

She had good reason to be afraid. A few nights after she went on duty in their ward, a stretcher-bearer was admitted to the hospital. A German officer whom he was helping to carry to safety had shot him through the leg. The badly wounded captive, perhaps thinking he was dying, could not resist firing one last shot from his stretcher.

One day an especially obnoxious officer roared at her: “Schwester! Ein trinken wasser!” (“Sister! A drink of water!”) Millard had begun to obey when an English Tommy in a nearby bed shouted, “Say please, you bloomin’ Boche!”

The German replied obscenely in his own language. Nevertheless, Millard got the water. As she approached the German’s bed, the Tommy cried: “Don’t do it, sister. Don’t give ’im a bloomin’ drop till ’e says please. If I only had me two feet so I could get up and wring ’is bloody neck.” Millard gave the German his water and was surprised to hear him say sullenly, “Danke schoen” (“Thank you very much”).

The German enlisted men were more tolerable. Millard grew to like one, a 16-year-old boy who had once visited relatives in Milwaukee and spoke English. He had wide, gentle eyes and pale, stubby hair shaved close to his head. He told Millard he did not hate America. He had liked Milwaukee and planned to return when he “grew up.” Millard almost wept for him. His right leg was gone above the knee, and his right arm was so shattered he would never use it again. He told Millard confidentially that he hated the war.

In May a wounded German gave Millard a glimpse of another side of the war. As she began undressing him, he whispered in French: “Don’t bother. I’m too far gone. Get me the Agent de Liaison immediately.” Struggling for breath, he added: “Il n’y a temps à perdre” (“There’s no time to lose”). The Agent de Liaison dealt with the larger world of the fighting army. He knelt beside the bed, and the wounded man whispered to him. The agent, a Major Berthiot, patted the man gently on the shoulder and said, “Oui, oui, mon brave, je comprends” (“Yes, yes, my brave fellow, I understand”).

With the help of an orderly, the wounded man was wheeled to a curtained-off section of the ward, and the head surgeon and his nurse followed them. They stayed in this dressing room with the wounded man for more than an hour. When the cart was wheeled out, the man’s face was covered. The surgeon’s nurse was weeping, and Major Berthiot was wiping tears from his glasses. He told Millard that the man was a spy who had slipped behind enemy lines in a German uniform. A French shell had mortally wounded him. The doctor had kept him alive with saline injections long enough for him to pass on the information he had gathered about German troop movements.

Several weeks later, Millard’s closest friend among the French nurses, Suzanne Mercier, stopped in to say goodbye. She had volunteered to work in a mobile hospital, which got as close to the front as possible. Millard wished she had been invited to go along.

The next day, Dr. Le Brun took Millard’s hand and sadly told her that Mercier was dead. They had barely reached the forward trenches when German artillery smashed the hospital, killing Mercier and two orderlies. Millard was devastated.

In June 1918, when another German offensive reached the Marne, Millard saw Americans going into action. “They were all grinning like youngsters on the way to a picnic,” she wrote. One of them shouted at her, “Hey listen, where is all this trouble, anyway?” The phrase stuck in her mind, interfering with her sleep. They don’t know what they are in for but I do, she thought almost guiltily.

At the same time she was glad and proud to see the doughboys heading for the front. How can I be glad? she asked herself. It was all very puzzling. War turned everything upside down and inside out.

Among the items in upheaval was her heart. She realized she was slowly falling in love with Dr. Le Brun, the handsome French surgeon who operated for 72 hours at a stretch. She admired him for his artistry with the scalpel, and for the sympathy and passion he brought to his work. He began inviting her for walks in the fields and woods around the hospital. Le Brun had a delightful sense of humor, which Millard warned herself was a “dangerous thing to find out about someone you already like a lot.”

Suddenly the mail contained a letter from her fiancé, Ted. He had leave from artillery school and hoped to see her in Paris. When she told Le Brun she would be going to Paris to see “a friend,” Le Brun asked if that meant a man. When she said yes, he suggested going for a walk. In a field of wildflowers, he told her how much he admired her. “You can work like a man and at the same time you are soft and sweet and very brave.”

She thanked him and he replied, “What would you say if I told you I loved you very much?”

She was too stunned to reply. He kissed her hand and asked her if she loved the man she was going to see in Paris. “I don’t know,” she said.

Ted seemed like a person from another life. The river of blood that separated them had become an inland sea. Le Brun led her back to the hospital, saying: “Never mind! We shall see when you return.”

As they approached the hospital, Le Brun kissed her. She spent the next 24 hours in a romantic daze, unable to think of anything else—including her fiancé. The surgeon asked her if she had ever been in love. She started wondering how Ted would react if she changed her mind about their engagement. But everything with Dr. Le Brun remained on a “spiritual plane.”

That was more than Millard could say about another French doctor, who invited her to Paris for the weekend and followed up the suggestion with a passionate kiss. He added all sorts of pet French names, to which Millard replied, “Absolument jamais!” (“Absolutely never!”) It was not very good French, but she hoped he got the message. Suddenly, in mid-July 1918, the hospital filled with Americans. They lay outside on the ground, “a sea of stretchers, a human carpet.” Millard hated to see them pouring in. But she was overwhelmed by their gallantry and pluck. Despite their pain, they never complained. It was “Thank you for every little thing” or “Help him first, he has waited longer than I have.”

“I felt they were mine, every last one of them, and their downright grit makes me want to cry all over them,” she told her diary. Her “efficient detachment of mind”—something every good nurse needed—was demolished. She was no longer a compassionate sympathizer. She was an “active combatant.” From now on “the guns shook our blood; the shells exploded in our very hearts.”

As she unwrapped the bandages around the stomach of a Nebraska boy, he told her he had been hit four days earlier. Millard recoiled in horror at what she saw: The huge wound was a seething, writhing mass of maggots. She thought the soldier was doomed. But an orderly matter-of-factly handed her a can of ether and told her to spray the strange little organisms. Maggots were a good sign, the orderly told her. They prevented  gangrene.

Another soldier, this one from Idaho, had been blinded in both eyes and lost both feet to shrapnel. She gave him morphine and tried to stop him as he fumbled under the covers to find out what was wrong with his legs. She held him while he screamed and screamed and screamed in despair. Finally the morphine hit and he was still as death.

When one of the older nurses collapsed, Millard volunteered to assist Dr. Le Brun with the surgery. To get the job she had to memorize the French names for dozens of knives, scissors, saws, pincers, and probes, any one of which she had to hand Le Brun the instant he asked for it. Soon she was watching amputations, stomach resections, skull trepanning, probing for bullets and shrapnel—the hundreds of medical emergencies created by lethal metal.

One of Le Brun’s more memorable explorations was on an American officer who had been shot in the hip. The bullet had hit a watch, smashing it to pieces and driving the fragments down into the man’s thigh as far as his knee. Le Brun spent an hour extracting tiny bits of crystal, wheels, and springs. He did not get them all and remarked that as the officer grew older, he would be surprised to discover little metal souvenirs of the Western Front sprouting through his flesh.

The coming of the Americans did not mean that the French ceased to suffer. One night, after operating until dawn, Millard began sterilizing the instruments while Dr. Le Brun smoked one more of his innumerable cigarettes. Into the operating room an orderly wheeled one more case. The man’s face had been shattered by shrapnel from an exploding shell. His entire lower jaw and tongue were gone.

For a moment Le Brun examined the “hideous wound,” Millard wrote in her diary. Then his weary eyes flickered to the man’s gleaming black hair, his straight proud nose. He glanced up at Millard, “his face ghastlier than it had ever been from fatigue.” He knew the man—and so did she. This was René, one of the surgeon’s closest friends. Millard recalled his last visit to the hospital in the uniform of an Alpine chasseur. Le Brun had introduced him. René seemed the personification of the proud, confident young soldier. He had showed her a picture of his fiancée, who lived in Dijon, and jokingly told Millard that she too had freckles. Now there was only “the hideous cavernous wound…where the laughing mouth had been.”

Le Brun ran his fingers through his sweat-soaked hair and cursed for a full minute. Millard felt for René’s pulse. It was still fairly strong. But there were a half-dozen blue crosses elsewhere on Rene’s body, where the examining doctor at the entrance to the operating room had found other wounds. One of his legs was “completely crushed.”

Millard struggled against a swirling dizziness. Was she about to collapse like many other nurses did when fatigue and accumulated horror pushed them over the edge? She controlled her nerves with a violent act of will and began handing Le Brun instruments. He worked quickly, fiercely, but every few minutes he stopped and stared mournfully into space.

Millard lost track of time. She only remembered Le Brun calling for more anesthesia when René stirred and groaned. “Encore,” the surgeon snarled. His voice was harsh. Abruptly, he stopped asking Millard for instruments. She knew what it meant. There was no hope for René.

Dr. Le Brun stripped off his gloves and stumbled out of the operating room. At the door he asked Millard to find the address of René’s fiancée and write a letter, telling her they had done everything they could. Millard could only nod numbly, wondering if the dying would ever end.

Millard’s relationship with Le Brun underwent what was probably an inevitable change when she met her fiancé in Paris, on his way to the front, and decided that she still loved him. The surgeon accepted the news philosophically, and they remained friends and colleagues in the operating room.

But Millard had a new problem. She could not shake the dread that swept over her as American casualties poured into the hospital. On September 15, she went to a funeral for four American soldiers who had died the previous day: Donnelly, Wendel, Goldfarb, and Auerbach. Millard wept so hard that her fellow nurses became alarmed, fearing she was having a breakdown.

For the first time, Millard found wisdom in Pershing’s decision to ban relatives and fiancées of soldiers from France. Every wounded man she saw made her imagine Ted with similar wounds. “It required enormous effort to perform tasks that had been easy before,” she wrote in her journal.

On September 20 came news that multiplied her dread tenfold: Ted was wounded. Dr. Le Brun gallantly arranged for Millard to make an emergency trip to Paris. In a hospital there, she found him with a fractured leg and a wounded left arm suspended in a frame. “Oh, darling,” she gasped. “Thank God you’re not hurt!”

It took some doing to soothe an outraged Ted into accepting her explanation that “hurt” meant a wound to the head, the chest, or the body. Those were the ones that often proved fatal. A thoughtful nurse drew a screen around Ted’s bed, and soon Millard’s “careless greeting” became something they would joke about the rest of their lives.

Back in the hospital, Millard found she could concentrate on her work again, with Ted in relative safety. But the anguish of seeing Americans with mortal wounds was still acute. One man, a sergeant in the 2nd Engineers named Charlie Whiting, came very close to breaking her heart. He had been shot in the spine and was totally paralyzed. “He is so loveable, clean and sweet as spring water,” Millard told her journal. “He cannot speak more than one or two words at a time, in a gasping whisper, but he manages to say: ‘Thank you’ and smiles with his eyes whenever anything is done for him.”

The doctors put Whiting in the Salle de Mort, the Death Room. There was no hope. “He cannot move a muscle except his eyes and two fingers of his left hand,” Millard  wrote in her journal. One day Whiting tried to say something to her. She bent her head close to his lips and heard: “My mother…” With his two fingers he managed to direct her to his pocketbook, where she found his mother’s name and address.

Millard promised to write to her. Tears filled Whiting’s eyes. It was the first time he had cried. Millard realized he was weeping not for himself but for his mother. “I patted his hand and busied myself, fighting back my own tears,” she wrote.

For a while, Millard was distracted by a deluge of new wounded. Many were mustard gas cases. “They cannot breathe lying down or sitting up,” Millard wrote. “They just struggle for breath. But nothing can be done. Their lungs are gone. Some with their eyes and faces entirely eaten away by the gas and bodies covered with burns….One boy, today, screaming to die. The entire top layer of his skin burned from his face and body. I gave him an injection of morphine.”

On November 10, Charlie Whiting died. Millard held his hand as he stopped breathing and “could not keep back tears.” Near the end he saw her crying and patted her hand with his two living fingers to comfort her. “I cannot describe that boy’s sweetness. He took part of my heart with him,” Millard wrote in her  journal.

Minutes after Whiting died, someone rushed in to shout: “Armistice! The staff cars have just passed by the gate on their way to sign an armistice!” The shouter did not realize he was in the Salle de Mort. Millard angrily shushed him. One of the dying men began to sob. Millard talked soothingly to him. “But what could I say, knowing he would die before night?” The chapel bell began ringing wildly. A nurse burst in to tell Millard they were opening champagne in the dining hall. Millard told her to get out. She sat there, thinking: “My heart is heavy as lead. . . . Can’t seem to pull myself together.”

THOMAS FLEMING was an MHQ contributing editor and the author of numerous military history books, including The Illusion of Victory: America in World War I (Basic Books, 2003).