For Stephan, even though his naval career was all but over, it felt like a strange sort of deliverance. ‘So I’m not alone?’ he said.
‘No,’ she replied. ‘You’re definitely not alone.’
The impact of car against bike knocked Maurillia Simpson out cold, but only for a few moments. When she came round she was under the wheels of the car, and the first thing she did was get to her feet – ‘I got hit and I got up, jumped up like nothing had happened.’ She was about to deploy to Afghanistan and nothing was going to stop her, least of all some fool who’d bust a junction.
They wanted to take her to hospital. No, she said, she was fine. They insisted: hit by a car and knocked cold, even momentarily, she had to go whether she wanted to or not. And now the shock was wearing off and the pain was taking over, she knew they were right, and she knew too that she didn’t want to go to hospital for fear they’d find something which would mean she wouldn’t be able to go to Afghanistan.
The doctors examined her and took X-rays. She’d ruptured the whole left side of her body: her femur was so badly damaged that it would need realignment surgery. Afghanistan? Don’t be daft. She should worry about walking properly again, not going to a war zone. Afghanistan was out of the question. They put her left leg in a cast which stretched from her groin to her ankle.
Simi was furious, the kind of fury which came so hard and fast and overwhelmingly that it threatened to submerge her. She was furious at the driver, she was furious at herself for having been in the wrong place at the wrong time, she was furious that her buddies were going off to Afghanistan without her, she was furious that she’d be stuck in Germany on her own, like Simi-no-mates, learning to walk again as though she were a damn toddler.
She hadn’t seen the worst of it yet.
That groin-to-ankle cast would in the end stay on her for an entire year. The doctors cut her femur and reset it with metal pins, but the bones refused to fuse again properly and the metal wouldn’t hold. The Army sent her to the Defence Medical Rehabilitation Centre (DMRC) at Headley Court in Surrey (whose work is explored more fully in Chapter 3), where she underwent four separate physical rehabilitation courses. In between she was stationed at the Royal Artillery Barracks in Woolwich, south-east London, and she was there when her colleague, Lee Rigby, was run down and murdered by two Islamic extremists on a nearby street in May 2013, a killing so brutal that it reverberates through the nation’s psyche to this day.
Headley Court did what it could for Simi, but it wasn’t enough. In 2013 she received a call from her commanding officer. ‘He asked me, “Are you sitting down?” I said I was. He told me that the rehab tests showed I wasn’t improving, and that there was only a certain amount of times you could go back. I said, “No, sir, you can’t do this.”’
But Simi was being medically discharged. She couldn’t even be given a desk job, as everyone in the Army has to be able to walk a mile and a half and leave a building unaided, and she was now using a stick full-time.
It was November 2013. Simi’s Army career was over. More than that her dream, her vocation, her life’s work was over. She felt robbed and cheated, like she had nothing else to live for – ‘I didn’t see myself as being anything else but a soldier, because that’s all I ever wanted to do.’
The Army gave her a basic invalidity pension but – her three tours in Iraq notwithstanding – not a war pension, as she wasn’t technically at war when the accident happened. She applied for accessible council accommodation, but the waiting list was more than a year, Forces or not.
This wasn’t a sideshow to her recovery, it was central – ‘What people might not realise, as I didn’t, is housing’s direct effect on mental and physical well-being. Without a fixed address, no surgeon would consent to perform the operations I desperately needed to move forward. Where could I have gone afterwards to mend? My doctors weren’t convinced the sofa of a friend was an appropriate place to get better. And nor were my friends.’
But that – friends’ sofas – was all she had. It was better than being on the streets, but a long way off what she needed to help her recover, both physically and mentally. ‘When you’re without a home, or in a home that poorly suits your needs, the preoccupation and panic about your situation smothers your thinking. It becomes impossible to pick yourself up, look forward and reconfigure your future. It’s also virtually impossible to find a job, when most employers want to hire someone with predictable living arrangements.’
And then, in this, her darkest of hours, her phone rang.
Mike Goody had been trapped under his vehicle for an hour and a half, and as far as he was concerned, enough was enough. It wasn’t the pain in his shattered left ankle which was bothering him the most, it was the fact that his vehicle – this 4.5-ton monster, which was now held off the ground by 22 separate jacks; yes, 22 – that his vehicle had been the lead one in the patrol convoy, and he’d been driving it. That meant it was his own fault he was here, his own fault that his mates were doing all they could to get him out, and most of all, it was his own fault that they were all in danger of being attacked by the Taliban, out here a kilometre from their base at Kandahar Airfield.
A kilometre was hardly anything at all. On a good day he could run it in around four minutes. Right now, however, it might as well have been the other side of the moon, and the people inside that base eating at TGI Fridays and doing spin classes in the gym and all sorts, they seemed as though they came from another life entirely.
Mike was putting his mates in danger, and that just wasn’t on.
More than a century before, when in the flat circle of time round these parts the British had been fighting the Afghanis, just as they were now, Rudyard Kipling had written a verse in his poem ‘The Young British Soldier’, which pretty much every man out here could recite word for word.
When you’re wounded and left on Afghanistan’s plains,
And the women come out to cut up what remains,
Jest roll to your rifle and blow out your brains
An’ go to your Gawd like a soldier.
Mike had a pistol rather than a rifle, but the intent was the same: he’d blow out his brains, his mates could stop worrying about crushing him with the weight of the vehicle, and they could load up his body and get back inside the airfield before anything else went wrong.
He reached for his pistol. It would be quick and easy, a single shot before anyone could react. They’d be horrified, sure, but they’d understand.
Mike’s fingers closed round thin air. His pistol wasn’t where he thought it was. It must have been knocked somewhere else in the impact of IED blast on armoured vehicle. With the limited movement he had, he scrabbled around with his hand, desperately trying to get hold of his sidearm.
He couldn’t find it.
It was another hour and a half before they could winch him out from under the vehicle. He was conscious the whole time. His ankle was in a bad way: he’d broken every bone in his lower left leg apart from his big toe. No more soldiering for him, not on this tour at least. He was back at Selly Oak within 24 hours and spent the next four months there. They operated repeatedly on his leg, securing it with pins, plates and screws.
The surgeons there were becoming increasingly accustomed to the unique patterns of blast injuries. In fact, blasts are a combination of three distinct types of injury: penetration, blunt trauma and pure blast. With every wounded soldier who came back they became more adept at the treatment. It was a ghoulish aspect of surgical medicine, that at certain places and certain times you can become a world expert in a given field simply because you’re being given so much practice in it. The staff at Belfast’s Royal Victoria Hospital found something similar in the 1970s and 1980s, when the IRA’s habit of ‘kneecapping’ people – shooting them in the kneecaps – led directly to the Royal Victoria becoming the ‘go-to’ centre for knee reconstruction, not just in Great Britain but much of Europe too.
Mike had never met Sarah Rudder, but there was a rema
rkable similarity between their conditions: not just their ankle injuries, but what was going on in their heads too. Like Sarah, he began to suffer post-traumatic stress symptoms – ‘I had moods where I would be aggressive. It was a pretty dark time. I shut out my friends and family. You try not to make too big a deal out of it, but inside it’s tearing you apart.’
Fireworks would set him off just as they did her, though in his case it was exacerbated by the fact that the main period for firework displays in Britain (apart from New Year’s Eve) falls around Guy Fawkes Night in early November, which came hard on the heels of the anniversary of his accident. At times it felt as though any loud noise would trigger him – ‘I was in Tesco once and someone dropped a can of baked beans. In a flash I was flat on the floor on my belt buckles, shouting, “Incoming!” Everyone was looking at me like I was nuts.’
And also like Sarah, there was a direct correlation between his leg’s refusal to heal and his ongoing mental trauma. He began drinking to numb the physical pain – he was already on ‘mind-boggling’ painkillers such as ketamine, which is also used as a horse tranquiliser – and this in turn made his stress symptoms worse.
Even after leaving Selly Oak, he needed repeated operations on his ankle: 14 of them, in fact, over a period of two and a half years. In trying to take the weight off his bad leg as much as possible, he was walking poorly, damaging his knees, hip and lower back. His posture and mobility were all over the place. Solve one problem and cause three more.
In 2011 a surgeon gave him the news straight: ‘He told me I might have to have another two years of operations, with no guarantee of success at the end of it. I knew what I had to do.’
He looked the surgeon straight in the eye. ‘Take it off,’ he said. ‘Take it off below the knee.’
It was a year after her symptoms – the rages, the crying jags – first developed in earnest that Darlene Brown was medically discharged from the Australian Navy. After so long away at sea, so long constantly on the move, she went in the diametrically opposite direction and retreated to the place she felt safest: home.
She tried to remain connected, even in small ways. A few visits to psychiatrists, which didn’t do any good. A friend of hers had a son serving in Afghanistan, so she sent him a parcel. Then she began sending his friends parcels too – ‘I became obsessed with sending parcels. I reckoned most people had no idea what life was really like for them out there, and so I wanted to help.’
But in general ‘retreating home’ meant just that. Sometimes she wouldn’t even go outside the house for two or three weeks at a time, let alone beyond the garden and the front gate. Rather than go to the shops, she got as much stuff delivered as possible. When she did dare to step through that gate, she would conduct a full-scale risk assessment beforehand. She felt she was going mad and she had no idea why. She became paranoid that she was being watched and so she had a six-foot wall built, blinds installed so that no one could see in and three locks put on the door – ‘I was an island without a moat.’
And in the way that so many people can do when suffering with behavioural-altering conditions, she managed to spin it so that to the outside world at least nothing seemed wrong. She set up in business as a masseuse, which meant that clients had to come to her house and that she could work on them for half an hour or an hour at a time without needing to say much. They’d tell her their problems, the intimacy of the massage table loosening their inhibitions, and she’d just respond noncommittally while crying silent tears and wanting to scream, ‘YOU THINK YOU’VE GOT PROBLEMS? I’LL GIVE YOU PROBLEMS!’
She was angry because she couldn’t feel happy, no matter what she did. Even items on the news could set her off – ‘Just to survive the day was an achievement.’ Life was chunks of 12 hours, no more. Get to sunrise. Get to sunset … Get to sunrise. Get to sunset … There was no question of doing anything other than that, anything wider or more exciting. And the more she stayed in, the more she walled herself away, the more fearful she became of ever breaking out of that mould – ‘There was just this constant white noise in my head. You think people could see that, but of course they couldn’t.’
Couldn’t, or wouldn’t? Certainly many people suspected the latter, at least when it came to the armed services. As Stephan Moreau had found on Vancouver Island, men and women in uniform weren’t good at dealing with what they couldn’t quantify, especially when it began to smell of weakness too. In some ways it was even worse for women, who’d worked harder than the men to prove themselves in a male-dominated world and now didn’t want to be the one to let the side down by going to the doctor with psych issues.
There was glory in heroic acts of battlefield bravery but there was no glory in post-traumatic stress, no medals for just getting through the day in one piece, no attempt to take on and defeat an enemy which came in the form of thick living-room blinds shutting the world off from Darlene, and Darlene off from the world.
Then one day she saw an officer on TV. He was talking about PTSD. Darlene stared at him, open-mouthed. It was like looking in a mirror. Everything he said, everything he was describing, literally everything, he could have been talking about her. It was the first time she realised what was wrong with her.
Now all she had to do was take the first step to fix it.
The veterans support network Mates4Mates – the concept of ‘mateship’ is at the heart of what it means to be an Aussie, civilian and military alike – had its headquarters in Brisbane. It offered services in five key areas, one of which was psychological support. Darlene knew she needed to go there. From her home in northern Brisbane, it was 15 miles – half an hour’s journey, more or less. Most people wouldn’t think twice about it.
Most people hadn’t been through what Darlene had been through.
She had to go.
Get off the sofa, Darlene.
She couldn’t bring herself to go.
Leave the house, Darlene.
She had to go.
Walk to the bloody car, Darlene.
She couldn’t bring herself to go.
Start the engine, Darlene.
Had to. Couldn’t. Had to. Couldn’t. Had to, couldn’t, had to, couldn’t, had to …
Had to.
For Bart Couprie, the next stage after being told that his PSA was, oh, 30 times or so the normal amount was a transrectal ultrasound guided prostate biopsy – ‘It’s as unpleasant as it sounds, yeah.’
A week or so later, the specialist asked him to come back in. Bart was in the early stages of a relationship with a woman named Jude. Those first few weeks and months were heady with excitement and the all-consuming joy of finding out about another person, but they were also delicate and fraught with danger, particularly when emerging from the bruising pain of a divorce. If there was something wrong with Bart, how would Jude react?
Well, there was something wrong with him, and it was exactly what he had feared.
‘Yep,’ the surgeon said, ‘you’ve got prostate cancer.’
So much for it being an old man’s disease.
As for Jude’s reaction, it was threefold. First, she burst into tears. Then she hugged Bart. And finally she told him that he was moving in with her, right now, no ifs or buts, didn’t matter how early in their relationship it was, and he had to get off his prostate-cancered arse and make it happen, and they were going to beat this thing together.
Cancer should have taken Jude on instead – it wouldn’t have stood a chance.
CT and bone scans indicated that Bart’s cancer hadn’t yet reached his lymph system. He was put on a course of external narrow beam radiation with androgen deprivation therapy (ADT). The idea behind this was to shut down his body’s production of testosterone, which in turn would – hopefully – stop the cancer in its tracks.
As so often with medical terms, it gave scarcely a hint at the trauma behind the names. ADT is more or less chemical castration, albeit temporary and reversible. It can cause fatigue, lowered libido and erectile dysfunction
: a less aggressive form of unmanning than the kind Josh Boggi was so fortunate to have escaped, but unmanning nonetheless. For Bart, having a finger up his anus for the prostate examination wasn’t to be the worst of it, not by a long way.
Back when homosexuality was illegal, chemical castration was often the punishment for those who were caught, among them the British scientist Alan Turing, whose cracking of the Enigma code had done so much to win World War Two for the Allies. ‘Punishment is what I call it too,’ says Bart. He had the first injection a month after being diagnosed, and then one every three months afterwards. The narrow beam radiation therapy – well, that was ‘just the icing on a pretty shit cake’.
And in the list of ADT bingo, those side-effects he was warned about, pretty much every one of them came to pass.
Erectile dysfunction? Check, though ‘Luckily I still retained some function, enough to complete the act at least.’
Hot flushes? Check. ‘Saved a fortune on home heating.’
Loss of body hair? Check. ‘Buggered if I know where it’s gone. Got some regrowth on my head, though. Go figure.’
Weight gain? Check.
Loss of muscle mass? Check.
Joint pain? Check.
Mood swings? Check.
Depression? Check. And in some ways this was the hardest of all to deal with. He had ‘a bit of a breakdown’ and was put in the care of a psychiatrist. His GP suggested antidepressants, but Bart flat out refused – ‘It was drugs that got me here in the first place.’ He’d have to find another way round the depression.
He chose to do two things: he chose to exercise, and he chose to proselytise.
The first thing Mary Wilson thought when told that she had multiple sclerosis (MS) was that it was a disease of the people she’d nursed, those poor souls who were bedridden and incontinent, who needed catheters and whose bodies were wracked with spasms they couldn’t control. MS wasn’t the kind of disease she could get, not her. She was too young, too healthy, too fit – ‘I thought I’d rather not be on this earth if I have to be that person. I went outside in tears.’
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