DEVIL’S WORK?

The fact that surgery was out-sourced to civilian professionals suggests that SOE saw the practice as valuable. Today, enough documentation survives to confirm the identities of two of these surgeons. The postwar recollections of one of them provide an intriguing impression of how he perceived his wartime role and the justifications for it, at least insofar as he articulated them for public consumption in 1950. Underlining the importance of context when considering the rationales for interventions of this sort, his account prompts discussion, too, of ethical and legal implications of modifying bodies for state and wartime purposes.

Several surgeons feature in published accounts. Hutchison remembered his as ‘Mr Mowlem, who carried out his surgery at the London Clinic’.49 Langelaan’s was a ‘Mr. Norton, a civilian who had little to say’,50 while Levy’s was ‘a Bulgarian surgeon, Dr. Bankoff’.51 A fourth described in print as engaging in this work was Sir Harold Gillies, the most distinguished plastic surgeon in Britain at the outbreak of the Second World War. His biographer, Reginald Pound, mentions two occasions at Rooksdown House, a plastic surgery unit set up to treat army and civilian casualties, when Gillies operated on the faces of men apparently engaged in secret work. In a 5-hour operation on a subject of whose nationality he was unaware, Gillies altered the shape of an eyebrow, rounded the tip of the nose and slightly dilated the nostrils. The second operation was on a young Englishman. This time Gillies removed part of the chin, which he implanted in the patient’s hip so that it could be replaced if he survived the war. According to Pound, this man did not return for that procedure.52

Corroboration of Gillies’s involvement has still to surface from contemporary paperwork. No evidence of a wartime surgeon called ‘Mr Norton’ has come to light anywhere; probably that name was a pseudonym. But ‘Mr Mowlem’ and ‘Dr Bankoff’ do appear in SOE files.

The former was Rainsford Mowlem. Like Gillies, Mowlem was a New Zealander with an established career in Britain as a professional plastic surgeon. For much of the Second World War, he worked at Hill End Hospital in Hertfordshire, principally with injured servicemen.53 He also shared with Gillies a Harley Street practice close to the London Clinic, which was where James Hutchison would claim to have undergone his surgery. Today, the declassified file of one French agent confirms Mowlem’s connection to SOE. This agent was Henri Derringer, a 38-year-old cavalry officer brought out from France to Britain in 1943. ‘There is no question but that Mr Derringer’s scar can be improved’, Mowlem assured SOE in a surviving letter. ‘The chief advantage will be the elimination of surface irregularity as well as improvement in colour & texture. I will want him for a day and a night in the Clinic and then he can go and return for dressing’.54 How Mowlem’s services were enlisted remains unclear. Hutchison indicates that SOE’s chief medical consultant, a respected London physician, had helped secure Mowlem for his operation.55 That was months after Derringer’s proposed treatment, however. It was also long after an occasion when SOE sent a recruit to Mowlem’s hospital for secret treatment to a training injury.56

Less established, perhaps, was SOE’s connection to George Bankoff. Born in Bulgaria in 1903, he had worked in Italy and Germany before moving to Britain in the early 1930s and securing British nationality in 1938.57 Three years later, he came to SOE’s attention as a prospective agent, after apparently telling a friend that, if he could reach Switzerland, he ‘could arrange to become one of Hitler’s medical attendants’.58 ‘He is a highly qualified surgeon and was connected for a number of years with the Italian Hospital in London’, SOE noted.59 That venture was not pursued, due apparently to an MI5 report that Bankoff, at some unspecified time, had held ‘very strong pro-Italian sympathies’.60 When, 2 years later, Section XV engaged him as a plastic surgeon, that engagement, too, did not last long, due, again, to doubts about his background. ‘The work for which you propose to use him is extremely confidential’, an SOE security officer advised Section XV, ‘in that, if anyone describes [publicly] the nature of the operations performed, their whole object is lost… I think that this type of work should be performed by a man with entirely British outlook and I should have thought that there were some such surgeons available’.61 In 1946, J W Munn, wartime head of SOE training, recorded his belief that Bankoff had been employed long enough to handle two SOE matters: one was a surgical operation (of which no corroborating details have surfaced, though the timings fit with Jean-Pierre Levy’s stay in London); the other was a prescription for someone’s heart tablets.62 But it is likely that Bankoff did more than this. Flemming Muus did not name his surgeon, but the Imperial War Museum holds in its archives, among the private papers of the SOE representative who countersigned it, a consent form, signed by Muus, agreeing to surgery at Bankoff’s hands ‘the object of which is to alter my face’.63 Perhaps Munn had forgotten or never heard about some of Bankoff’s services. It is also conceivable that Bankoff—and, indeed, Gillies and Mowlem—had worked for other organisations that sent agents into enemy territory, like SIS.

Those sources also support Bankoff’s postwar claim to have carried out exactly this kind of wartime work. A prolific writer of popular fiction and fact, he would pen over 100 books during his lifetime. He also used a series of pseudonyms: his first book, The Healing Knife, a well-received account of his early career, was written as ‘George Sava’.64 It was as ‘George Borodin’ that he wrote No Crown of Laurels, published in 1950, which purported to be the memoir of a plastic surgeon who, during the war, had been employed to change agents’ appearances.65 The book described the stories of a dozen or so individuals, their backstories and their missions, and the bespoke techniques used on each one; for example: nose-shortening, by removing a piece of the septum; nose-narrowing, by removing cartilage from the sides of the nose; nose-broadening, by inserting extra cartilage between the skin and mucous membrane; face-lifting, to smooth cheeks and forehead creases; skin grafts, to erase or fabricate scars; making ears less prominent by pinning them back and removing skin and cartilage; and inserting fat to fill out fleshier parts of the face. The intelligence historian Nigel West has dismissed those stories as ‘bogus’ and Bankoff’s claims for his wartime career as ‘entirely spurious’.66 West argues that none of Bankoff’s tales can be independently corroborated and that he could not have learnt such intimate details about his subjects’ identities and secret exploits. But then, No Crown of Laurels does not claim to be accurate. Overlooked by West, an opening Publisher’s Note explains that ‘the author… actually operated on various Resistance leaders [but] has cast this story in a fictitious mould by giving imaginary names to the leading characters and by adapting events and circumstances’.67

No Crown of Laurels is the only published account of this practice from a surgeon’s point of view. It also presents its author as a shocked victim of circumstance, dismayed when the ‘War Office’ compelled him to do work conflicting with standard justifications of his craft.

Plastic surgery is an art, a science, a skill – call it what you like – which aims at restoring human beings to the semblance and functions of normal men and women when they have been ravaged by disease or accident or by the hand of Nature. It strives to make normal bodies out of abnormal ones, to turn ugliness into comeliness.

It was none of these things that I was being asked to do. My new task was something very different, a gross distortion that was horrible in all its implications. For I was to receive normal people and maim their faces and their limbs so that they were no longer the same people to look upon.

[I]t seemed then, as it was to seem through all the years of war, and does still seem in retrospect, a grinning mockery of all that surgery stands for.

Bankoff claimed that he had had to comply: it was ‘an order’. In later pages, he repeated his belief ‘that it was a debasement of surgery and a denial of the whole of the ethics of medicine. It was nothing but the force majeur of national necessity that had won my consent. I still feel that it was a prostitution of the science of healing’. Elsewhere in the book, however, he framed this work as valuable and ‘justified’: ‘in war, ethics do not count. It is the end not the means that matters’. He had gained satisfaction from contributing ‘to a greater cause, a finer effort, than most of the affairs of peace’ and dedicated his book ‘to those with whom I had the honour to be associated in a small degree’, praising ‘their undaunted courage and their great humanity which made them see themselves small and insignificant in comparison with the freedom and happiness of all men’.68

It is impossible to tell if Bankoff’s conflicted feelings, as expressed here, were genuine. He did not expand on what he meant by ‘ethics’, but little in the way of formal standards or regulations for cosmetic surgery had existed during the war: as one historian of bioethics has written, ‘there were no official British guides to good (ie, ethical) medical practice until the 1980s… Through the end of the twentieth century medical ethics in Britain tended to be conceptualized in terms of an ethos of honor and a discourse of “the done thing”’.69 Possibly Bankoff’s views were influenced by those of 1950, a time of growing awareness of principles like informed consent, though still long before the birth of bioethics as a field. It can also be noted that, both during and after the war, Bankoff was a man with books to sell and a living to make, a vested interest in promoting cosmetic surgery as a respectable enterprise, and, perhaps, a few other points to prove, given that the authorities had not always considered him trustworthy.

Grounds exist on which to interpret Bankoff’s unease as convincing, nevertheless. Describing himself as ‘the devil’s make-up man’, he had accurately identified a paradox that, by transforming bodies into forms able to work in enemy territory, surgery exposed them to conditions of heightened danger. ‘The preparation was mine [and] it meant opening the way to death rather than the sunlit path to life’.70 Possibly, its implications were more serious than this. Surgery, as OSS put it, made a ‘valuable’ man ‘less noticeable, harder to describe, more one of the crowd’.71 This deception was designed to preserve life; but it also risked making its recipients vulnerable, if they were captured and their true identities became known, to legal charges of perfidy and espionage.

According to the 1907 Hague Convention, which applied in the 1940s, it was ‘especially forbidden’ to ‘kill or wound treacherously individuals belonging to the hostile nation or army’: an acknowledgement of a general obligation that military forces had to fight wearing a form of uniform distinguishing themselves from civilians, and that donning civilian clothing with a clear intent to deceive—an act of perfidy—would violate the law of war if it was the proximate cause of killing or wounding.72

The same convention defined a spy as a person who, ‘when, acting clandestinely or on false pretenses obtains or endeavours to obtain information in the zone of operations of a belligerent, with the intention of communicating it to the hostile party’.73 Although espionage was not a war crime under international law, neither the Hague Convention nor the 1929 Geneva Convention, which applied in the 1940s to the treatment of prisoners, offered much protection to captives deemed to be spies, except for establishing that no one suspected of spying should be punished without first being tried.74 If a trial was fair, then severe punishment, if properly in line with the captor government’s domestic penalties for a proven offence of espionage, could legitimately follow.75 This was the fate, for example, of Emilio Zappala, who, when interrogated after capture, disclosed Giovanni Di Giunta’s surgery and secret mission. A clandestine agent of Britain’s SIS, Zappala had been arrested in Italian-controlled Sicily while wearing civilian clothes and carrying faked documents. Weeks later, he was put before a Fascist tribunal in Rome, found guilty of committing espionage, sentenced to death for that offence, and shot.76

So far, no agent who received surgery has been identified as being killed or captured, and no evidence suggests that SOE ever felt that modifying agents’ bodies might do them harm as well as good. It is pertinent to note, however, that 10 Australian and British commandos, captured near Singapore in 1944, were found guilty of perfidy and espionage by a Japanese military court—and subsequently executed—partly on the grounds of having used skin dye to look like Malay civilians.77

Also, while the act of enhancing bodies was not illegal, its potential to endanger the rights of those responsible could have extended to surgeons, too. As it applied in the Second World War, the Geneva Convention provided for the protection of medical personnel ‘engaged exclusively in the collection, transport and treatment of the wounded and sick, and in the administration of medical formations and establishments’.78 Surgeons who behaved otherwise, including, conceivably, transforming the bodies of healthy individuals into forms more effective at evading detection, risked undermining their special status as protected non-combatants.

SOE may not have gone as far in this direction as OSS, whose own files reveal how one American-run agent, sent into Germany disguised as a wounded German soldier travelling home from an army hospital, was provided with the medical means of keeping an existing arm injury unhealed, and even appear worse, to make his story more convincing; and how another, ‘desiring to pose as a German SS member’, received, beneath his armpit, the distinctive tattoo by which all SS soldiers recorded their blood type.79 But it remains the case that SOE’s use for facial surgery was not designed to treat physical ailments, restore appearance or counter feelings of mental distress, and, while ostensibly meant to safe life, may have exposed those involved, both recipients and surgeons, to elevated risks of significant harm. As such, and as a novel illustration of the lengths to which states have historically gone to deceive and defeat their enemies, it has relevance to current debates about the implications of similar practices in modern conflict. In bioethics scholar Eric Juengst’s much-quoted definition, ‘human enhancement’ is an intervention designed to ‘improve performance, appearance, or capability besides what is necessary to achieve, sustain or restore health’.80 In a military context, this can include, for example, biochemical developments, such as the use of pharmacological stimulants to counter fatigue, pain, and psychological trauma, and innovations in cybernetics and biomechanics.81 Although historians interested in military enhancement of the body have largely confined their attention to drugs,82 the perceived benefits of all of these developments include improved fighting capacity and reduced casualty rates.83 Their possibilities also provoke concern about ethics and legality.84 From that perspective, and considering the ability of plastic surgery to currently confound, for example, technologies of facial recognition,85 it may be instructive to reflect on the wartime work of surgeons who, at the state’s behest, fashioned bodies into more effective weapons by disguising their identities. A 1977 addition to the Geneva Conventions of 1949, which applies today, specifically deems ‘feigning civilian, non-combatant status’ to be perfidy, since it deliberately takes advantage of claims to protection,86 while at least one specialist in law and war has recently argued that supervising biomedical enhancements, such as drugs to augment the ability of ‘warfighters’ to withstand fatigue, threatens the protected status of medical personnel.87