Medic: Saving Lives - From Dunkirk to Afghanistan

by John Nichol

  The other casualty, it should be said, is already there. At the bottom of the hill, the trainee medic in charge of him had come prepared with a piece of American kit he found in an army supplies store and bought with his own money. It is a lightweight, roll-up canvas stretcher, easy to stow and carry and a godsend in this situation. The instructors, all hardened NCOs and not given to unnecessary praise, are impressed – by the equipment itself, which they have never seen before, and by the youngster’s initiative in seeking it out.1 It is important that, as well as doing everything by the book, a good medic knows instinctively when to throw the book away and do what needs to be done. The stretcher is laid out, the casualty is eased on and, with a medic at each corner, they virtually charge up the slope. The girls join in now. Some are a foot shorter than the men and physically couldn’t carry a casualty single-handed, as their lanky male colleague has done. But they can share the load of a stretcher, another point in favour of this revolutionary roll-up version. We all wonder why it has taken so long to come up with this simple and obvious answer to a perennial battlefield problem. In the Falklands conflict, troops took to using their waterproof poncho capes to evacuate the wounded from the battlefield, and this is really just a purpose-made version of that makeshift solution from a quarter of a century ago. We all wonder too why the MoD isn’t making them standard issue – and why our young soldiers are having to shell out from their own pockets to equip themselves to do their job properly. Surely no such expense – and this is a small one – should be spared on kit that will save lives on the battlefield? It is hard to resist the conclusion that, as a society, we are shortchanging those we send to war on our behalf and those we task to save their lives

  Everyone is now collected at the top of the hill, where the casualties are loaded into the field ambulance, essentially a Land Rover with a long wheel-base and a high cabin on the back. It is unwieldy and basic, verging on the obsolete. It bears the same relationship to the top-notch civilian ambulances on our streets as the army’s Green Goddesses do to modern fire engines. As it bumps along the forest track and grinds through the gears on its way to the aid post, the medics appear unfazed by any Fred Karno comparisons. At the aid post they cluster around the casualties, apply dressings, practise emergency CPR (cardio-pulmonary resuscitation), discuss the use of painkillers and putting in lines for intravenous fluids. Soon enough they will be in Iraq or Afghanistan and what becomes second nature now in the drizzle of a grey English winter will stand them in good stead on a red-hot, sunburned street in Sangin or Musa Qala when bullets are flying and bodies falling. This is a serious business and they take it seriously, focussing, learning, preparing for the real thing.

  The tradition these young people are heir to is a long and honourable one, though often overlooked. The garlands of war are usually awarded to those who win battles or die in the attempt to do so. Those who go on to the battlefield not to take life but to save it attract less attention. Their deeds are what this book is about. It is a story worthy of telling, not least because it is not often told. As one experienced medic told us, not with rancour but with a sigh of resignation, ‘We tend to get ignored, even sneered at, by the rest of the military – until the shit hits the fan. Then all of a sudden we become a popular commodity. The fact is that we have the most difficult job in the army, but this is not a truth that is often acknowledged.’2

  As the history we tell advances from the Europe of 1940 to the Afghanistan of 2009, the very nature of modern warfare changing radically along the way, what binds together the individuals in it is an amazing humanity and compassion, a selflessness that, in the worst of circumstances, seeks out and finds the best in people. Medics experience war at its rawest. Gore, not glory, is their stock in trade. They deserve our respect and our admiration but also our understanding of the extra courage it takes to do the supremely testing job they have volunteered for. What I do, one veteran medic told us, is to run into the middle of a firefight to help someone else, and that is neither easy nor natural. It takes a conscious decision. It is a personal battle every time. ‘But the plain fact is that someone is hurt and may be dying and you have the skill to help him. Are you going to go to him or not?’ On that question hangs what you are about to read.

  The battlefield is not a pretty place, and in what follows the authors have not pulled any punches. What a high-velocity bullet or a roadside bomb does to human flesh and bone is horrendous and not for the squeamish. That horror, though, is what we expect our servicemen and women to face on our behalf and the military medical services to deal with. Their bravery cannot be properly understood if the truth is softened, and we have not sought to do so.

  1. Saving Sergeant Major Stockton

  He was out in the open, alone and exposed on a dusty Afghan road, and the full moon seemed to search him out like a spotlight. Crack! So did the enemy snipers. Crack! He felt as if the whole world was shooting at just him. Crack! Ping! What he recalled most vividly later, what embedded itself in his memory, was that sound of bullets exploding from unseen rifles, then glancing off the metal sides of the armoured trucks he was running past as fast as his legs would carry him and his medical pack. Ping! Such a puny noise for something so deadly, no different from the tinkle of pellets in a fairground rifle range. Crack! But this shoot-out was not for amusement. It was in deadly earnest. Those were Kalashnikovs, not air-rifles, and everyone else in the patrol kept low, seeking cover from the murderous volley coming at them from the trees on the other side of a canal, lifting their heads only to fire back a burst and then duck down again. Lance Corporal Gary ‘Loz’ Lawrence of the Royal Army Medical Corps (RAMC) stayed on his feet. He had a special job to do, whatever the danger. The hard hat on his head offered some protection, as did the Kevlar body armour. But all that really kept him alive was the poor shooting of the Taliban that particular night. The Afghan insurgents had lured his patrol of British soldiers into an ambush on a narrow tow-path in the desert town of Sangin, bandit country, a no-go area where the writ of the Afghan government and its allies from Britain and the United States meant nothing. They were now pinning down the patrol with fire from all sides. A man was down, struck by an RPG, a rocket-propelled grenade, the Taliban’s deadliest weapon. He was badly wounded, very badly. Down the radio net had come the soldier’s call from time immemorial: ‘MEDIC! We need a medic! Here! Now!’

  Lawrence had responded instantly. This was what he was trained for, his calling. He grabbed the Bergen rucksack containing his supplies and was out of the truck, dancing his way through the bullets, racing back down the convoy, dodging from vehicle to vehicle to where a comrade needed his help. At one stage the line of Humvees and Land Rovers lurched forward and, before he caught them up, he was left even more exposed, a lone figure in the middle of the night in the middle of nowhere with mayhem and murder breaking out around him. ‘You’re a medic, and you think you’re bulletproof,’ he said in explanation. ‘But that night people out there were trying to kill me. At one point, I was running along, and there were bullets flying all around me, and I was thinking, “What am I doing here? I could die, I really could.” Oh yes, that feeling was real, very real.’1

  And yet the day that led to this nightmare had begun pleasantly enough. ‘Loz, I’m making a brew. Do you want some?’ Lawrence had stirred from his pit and said yes. A cup of tea made by the captain himself, Jim Philippson… no bad way to start another long, hot, dusty day in the featureless scrubland of Helmand province in southern Afghanistan. Camaraderie like this, mucking in together regardless of rank, helped make life a little more bearable here in Forward Operating Base [FOB] Robinson, a sorry, fly-blown outpost in the desert that was home to the British detail. Sitting in the Snake Pit, a shaded dug-out scraped from the sand and circled by the rusting metal hulks of freight containers that made up this makeshift mini-fortress, Lawrence contemplated the hours ahead, as featureless as the surroundings. He would take a sick parade of his own blokes, if any had ailments that wanted treating, then
he would wander over to the neighbouring compound of the ANA, the Afghan National Army, and supervise a similar parade there. As resident medic in a unit whose specific task was to tutor and mentor the Afghan soldiers, that was his main job. It was dull work in a hateful climate and a landscape that well earned the name the locals gave it – the Desert of Death. ‘You tried to keep busy,’ he would recall, ‘tried to occupy yourself. But there was not a huge amount to do during the day because it was so hot. We kept in the shade as much as possible.’

  Conditions were spartan. Some men, the lucky ones, bunked inside the stifling, sand-scarred containers. Newcomers – and the base was now bursting at the seams – had to doss down in improvised lean-tos, thrown up in shanty-town style against the giant wire mesh and canvas sandbags that formed the six-foot-high bomb-proof perimeter wall. With one washroom for 120 men, many chose to dunk themselves in a huge barrel fed by a well in the corner of the compound, jumping in fully clothed and washing their combat fatigues at the same time. For exercise, there was some gash gym equipment cannibalized from old tins and a broomstick. As billets went, there weren’t a lot worse than this. It made Camp Bastion, thirty miles away, the main base for the British, American and Canadian forces who made up the NATO task force, seem almost palatial, with its neat rows of tents, vast communal marquees, solid flooring and air-conditioning. But Lawrence could comfort himself, perhaps, with the knowledge that he and his detachment were where it mattered. What they were doing was central to why the British Army was back here on the ground in Afghanistan in 2006 – as trainers and instructors rather than combat soldiers, helping the locals learn how to carry on their own fight against the Taliban insurgents threatening their country.2

  But that day, Sunday 11 June, everything was about to change. What had started out as a hearts-and-minds operation – one, indeed, that the politicians in London who sanctioned it hoped could even be completed without a single shot fired in anger – turned deadly. By the time night fell on the desert and the harsh terrain began to cool, a real war, hot and horrific and deadly, would begin, and Gary Lawrence would be wondering whether he would ever see home again. There had been ‘contact’ with the enemy before, firefights in which the Paras and the Gurkhas, with their superior weaponry, had come out on top. The Taliban – a clever and brave enemy, not to be underestimated – had taken substantial casualties. But apart from a few broken bones and shrapnel wounds, the British forces deployed in Helmand had come through unscathed. No longer. That day the very first British soldier would die. As the death count rose inexorably in the coming months and years, first into double figures, then into hundreds, it fell to medics – from the various grades of combat medical technicians such as Lawrence, right up to the most highly skilled cutters, the surgeons – to keep the tightest possible lid on that toll of British soldiery.

  They displayed skills that are often taken for granted, even by the military themselves, until the dire moment, the life-or-death emergency, when they are needed. Then they are called on to perform miracles – and they do. Medics and military doctors fight their wars with stretchers and splints, saws and scalpels, but also with superhuman endeavour and courage. Their importance is not just that, in the thick of the action, they are there to save lives. Without the promise, the pledge, of their presence and commitment, few troops would care to advance into battle. The much-vaunted ‘covenant’ between society and its soldiers begins with medics, the unsung heroes of modern warfare. The tragedy that first fatal day in Afghanistan was that a brave soldier died. For us, the story is that another one was brilliantly saved.

  It was evening, and Lawrence was once again hanging around the Snake Pit when the shout went up from the Ops Room (another container). A patrol was in trouble. Help was urgently needed. Earlier that day, a miniature robotic spy plane carrying high-tech video equipment had been sent flying out over the area around Sangin, a Taliban stronghold, to send back pictures of the build-up of enemy forces. The Desert Hawk UAV (unmanned aerial vehicle) was the military’s latest star turn, a relatively cheap – at £12,000 each – and safe way to gather intelligence. But this Hawk, instead of flying back home at the end of its hour-long surveillance, lost height unaccountably and ditched out in the desert. A patrol was about to go out from Robinson on a routine sweep and it was re-directed to recover it.

  ‘I watched them go,’ said Lawrence. ‘There wasn’t any sense that they were going into a major contact.’ The patrol found nothing at the coordinates they had been sent to and widened their search before learning from locals that the Hawk had been captured and spirited away. Frustrated in their mission and with the sun setting, they started back to base. They had had to cross to the far side of the Helmand river, which they now re-crossed. On the bank, the Taliban were waiting. Tracer bullets lit up the night sky. The crackle of machine-gun fire – not unlike the sound of plastic bottles being crushed underfoot, as one soldier recalled – shattered the desert silence. A soldier took a bullet through the chest. The patrol radioed frantically for back-up.

  Back at Robinson, the whole base came alive. Orders were barked out and men rushed to kit up, grab helmets, throw on body armour. Captain Philippson – commando-trained, extrovert, enthusiastic, popular – was one of a number of officers putting together a rescue force. Lawrence wanted to go with them. His unit, his comrades, ‘my guys’, were going. He should be with them. But the incident sounded serious and the unit’s doctor decided he was going himself. Lawrence was ordered to stay behind and prepare for incoming casualties. In eight lightly armoured Land Rovers, the rescue force roared away, headed for the river, parked up near the ambush site and advanced on foot. It was a trap. Once again, the Taliban were waiting. Under fire, the rescuers made it to where the wounded soldier was lying and began to carry him to safety. But in the eerie half-light of the full moon, Philippson was shot dead. Hearing over the radio the news of a death but not the name, Lawrence, for all his medical experience, felt gutted. ‘It was the first death. We were all desperate to know who it was. We were a small detachment, just twelve of us, all close, colleagues and comrades, all on first-name terms. And now one of us was dead. But who?’ In another container was his medical centre. ‘It was pretty basic – a stretcher and trestles with some bits and pieces of medical gear.’ He prepared it as best he could to receive casualties – and a corpse.

  The rescue force retreated under withering fire, then fought their way back to recover the captain’s body. That was part of the military covenant too. No man wanted to be left to rot or, worse still, for his body to be abused, trailed in the dust as a trophy, as dead American soldiers had been in Somalia not so many years before. Whatever the illogicality, the guarantee of a decent laying to rest was important to morale. So the captain was brought back to FOB Robinson in the back of a Humvee. It was Lawrence’s job to receive him. ‘I opened the door to the vehicle and saw straight away that it was Captain Philippson. I laid him on a stretcher and took him into the med centre. His face was grey and ashen. There was a gunshot wound to his head. It was a shock. I had to be professional about it and I was, but I couldn’t stop thinking how only that morning he’d made that brew for me. Here, staring me in the face, was the stark reality of war.’

  That shocking reality was soon registering itself in many other quarters – with the twenty-nine-year-old Philippson’s devastated parents and girlfriend, mourning ‘a wonderful and brave son’; with those politicians who had ordered men into the political and military quagmire of Afghanistan in the hope that none would die; with other British servicemen who had believed they were there strictly as advisers and trainers of the Afghan Army and now found themselves on the front line of a full-out war. And one for which they were not properly equipped. Later, a coroner would blame the Ministry of Defence for starving the troops of essential equipment. Philippson’s group had gone into battle with no night-vision kits to spot the enemy in the dark nor the Minimi light machine guns and grenade launchers to outgun them with. The captain’s fathe
r put the responsibility higher up the chain of command – to Gordon Brown, then Chancellor of the Exchequer, for starving the MoD of cash.

  But the recriminations were for the future. For now, there was a job to do at FOB Robinson. There were still men out there, the remainder of the rescue force, plus the original patrol, fighting for their lives, in danger of running out of ammunition and of being overrun. Another rescue operation had to be mounted. The unit doctor, who had returned with Philippson’s body, desperately trying all the way to revive him, turned to Lawrence. ‘Right, Loz, you’re the next one out.’ The lance corporal sprang into action, pulling off the red cross armband he wore around the base. Out in the field, it offered him no protection. The enemy took no notice of such niceties, whatever it said in the Geneva Convention, and it might even expose him to extra danger. Its white background would stand out in the dark, while the cross would be a red rag to a bull for fanatical muslims. He was about to face the supreme test, and he could not help wondering, like every soldier who ever went into battle, if he had the balls for what lay ahead.

  As a young adult, he had drifted. Tried a couple of years at college, then stacked supermarket shelves. Tried some more studying, then decided on the military. ‘I wanted to be doing my bit for my country. I’m sentimental like that.’ Even then, he continued to drift – tried the RAF but was turned down for pilot training (he was too tall), then applied unsuccessfully to be a PT instructor (didn’t have the right sporting credentials). ‘So I joined the army instead.’ He opted to be a medic because this was where he felt he could make a real contribution. He was about to discover whether he was man enough for the dangerous job he’d chosen for himself. ‘Until you go into action, until you actually face it, you just don’t know whether you’re going to cope or not. I was worried about just one thing: what if I can’t handle this, what if I can’t do my job properly?’ He was not alone in his apprehension that night, far from it.