Medic: Saving Lives - From Dunkirk to Afghanistan

by John Nichol

  Introducing these new methods of treatment was not easy. Brooke had to restrain nurses of the old school from constantly re-dressing injuries, as they had been trained to do. He had to force them against their instinct to leave bandages in place, even if they had begun to smell. Even the presence of wriggling maggots under a bandage could be ignored as nature’s way of cleaning deep wounds, however revolting to witness or repulsive for the patient to endure. ‘As long as the patient is a good colour, not in undue pain and his temperature and pulse are normal, he should be left alone,’ he told the nurses, though he could tell they were not all won over. Another doctor told a patient who complained that maggots were crawling out from under his plaster, ‘That’s good! We like that,’ but agreed to change the dressing because the man was so distressed. When the plaster came off, maggots and flies fell out, but the wound itself was salmon-pink, whistle-clean and infection-free.

  However, the major problem with the Trueta method was logistical. Its clinical success depended on patients being immobilized – and in what was now a war of intense mobility, with most medical units constantly on the move and overwhelmed by the number of casualties needing urgent treatment, that was a luxury that had to go by the board. Instead of letting nature take its slow course, many doctors out on the road – literally cutting, then running – were reduced to slapping on antiseptic, doling out morphine and hoping for the best.

  Other doctors, though, had new medical weapons to deploy. At the Atlantic coast resort of La Baule, where operating tables were set up in the casino, RAMC Major J. S. Jeffrey swore by the new anti-bacterial agent sulphonamide for controlling infection. This was a recently developed synthetic chemical, from the laboratories of the pharmaceutical firm May and Baker in Dagenham, Essex. Its original military use had been as a treatment for gonorrhea, the army’s biggest scourge, as tens of thousands of boys away from home for the first time in their lives were suddenly thrust into manhood in the brothels of northern France before the fighting began. But sulphonamide was equally effective for battlefield injuries if packed, in its powder form, into infected wounds and fractured joints. Jeffrey plugged a hen’s-egg-sized cavity in a man’s brain tissue with it, with good results. He was delighted when his resourceful colonel devised a foot-activated air pump that could spray the powder into the corners of even the deepest wounds.

  Another life-saver was stored blood, donated back in England and kept in pint bottles for up to a fortnight. It came from the Army Blood Transfusion Service, which had been set up in Bristol just a year earlier. Here was another breakthrough in military medicine being tested for the first time. To historian Mark Harrison, this development was crucial. ‘Britain was the only nation that went to war with a fully functioning transfusion service.’8 The Germans had nothing to compare with it. The promptness with which donated blood could be given saved many lives.

  *

  Twenty-five miles outside Dunkirk, an outer defensive ring was being established. Here, the 1st Bucks battalion of the Ox and Bucks Light Infantry was ordered to stand its ground and delay the enemy as long as possible to protect the retreat. As the men knocked slits in farmhouse walls and mounted Bren guns, the medical officer, Lieutenant Trevor Gibbens, who had qualified as a doctor a little over a year ago, set up his aid post in the basement of a girls’ school. While there was time, he toured the deserted town and stocked up with whatever supplies came to hand. In a doctor’s house he found an American Red Cross basket from the First World War. Inside were the finest linen bandages, cut on the cross-weave in such a way that they would lie flat and unwrinkled against the patient’s skin. He consoled himself with the thought that, in the battle ahead, his casualties would at least be perfectly bandaged.9 Their first use was on an officer who drove up in a jeep and said quietly, ‘I seem to have got one in the elbow, Doc.’ Gibbens cut off his sleeve and saw that his elbow joint had been completely shot away, leaving a two-inch gap between the bones. ‘I put a long wire splint on the whole arm and sent him off in the last of the ambulances.’

  For the defenders, the waiting went on for another two days, and then, coming up the road, they saw their first German tanks. The battle was furious and lasted days. The Bucks’ CO was shot down while trying to run across the road and the second-in-command killed by a burst from a machine gun. Floor by floor, the four-storey girls’ school was reduced by mortars and shells. Down in the cellar, Gibbens could hear the rumble of falling masonry overhead as he did what he could for the wounded and eased the pain of those beyond help. ‘I soon learnt the First World War trick of putting the dying at one end, and at quiet times I did the rounds, giving them plenty of morphia and sips of water.’ In that confined space, where the cries of broken men were drowned out by the boom of the bombardment outside, he felt himself like a surgeon below decks on one of Nelson’s ships.

  One man was brought down with his abdomen completely opened up and his bowels pouring out. ‘There was nothing I could do but put wet, warm packs on him and fill him up with morphia. He died quietly the next day.’ But Gibbens’s surgical inexperience was cruelly exposed when another soldier was carried in with blood pumping from a wound below his shoulder blade. It could be stopped only by pressing the artery against his top rib, but the moment the pressure was released, it spurted again. The doctor had a terrible decision to make. ‘If I had been an experienced surgeon, I could have cut down on the artery and tied it off or clamped it with forceps.’ But this was work beyond his ability. ‘The man was virtually unconscious and I decided it was hopeless. We maintained the pressure, each of us in turn, but his life ebbed away.’ Of the fifty men he treated in that hell-hole of a cellar while a battle raged above, this was the death that would always haunt him.

  By now, bodies were piling up around him as the Germans continued a merciless barrage, ‘trying to shell us out of existence’. The Bucks had put up incredible resistance, but when darkness fell it was time for those who could to make a break for it and try to reach Dunkirk. Gibbens opted to stay. ‘The fifty wounded were my responsibility, and there was nothing much that I could do by dodging about the fields in the night.’ The next day, as the roof collapsed, showering rubble over the men left on their stretchers on the floor, he walked up the stairs and out into the open air. Everything was deathly quiet. Around him, in the blinding sunlight, was a moonscape. Tentatively, he held up his haversack, a red cross on it. ‘A German officer with forage cap and a grey mackintosh was in the middle of the road, and he waved for us all to come out. I went up to him and said in my best German, with great urgency, “Fünfzig Verwundeten im Keller”. He nodded and sent a young lieutenant back down with me to check.’

  When the doctor resurfaced with his wounded, they were waved to a wall and made to line up. Three soldiers faced them with tommy guns. Gibbens thought they were about to be shot – a realistic fear given that some British troops who resisted to the end had been massacred in cold blood by Waffen SS units. But these were regular Wehrmacht soldiers, ‘and after a few minutes we were ordered off to various trucks’. They had survived, but they were prisoners of war, and a long incarceration lay ahead.

  Elsewhere along the line, Private B. C. Miller’s 10th Casualty Clearing Station had also been overrun and forced to surrender. After days on the move, stopping and starting, the unit had set up in a small village and taken over virtually every building to house the wounded. The operating theatre was in the school, seven stretchers laid across the desks and, with fierce fighting nearby as the BEF struggled vainly to stem the German tide, in almost constant use. ‘Time for me ceased to exist,’ recalled Miller, a theatre orderly. ‘My days blurred into an endless pattern of work, sleep, work. We were strafed, the cook was killed and I went to my bed to find bullet holes in it.’10 Theatre debris was cleared only when it actually obstructed movement around the stretchers. Discarded ampoules of Pentothal, used as an anaesthetic, piled up three feet high in a corner. Then a cruel order was passed down the line: ‘Bridgehead at Dunkirk can take
no further wounded,’ it read. ‘Therefore, the 10th Casualty Clearing Station will remain where it is. It is realized that this will mean inevitable capture but it is hoped that the traditions of the Royal Army Medical Corps will be upheld.’ The women nurses were ordered to leave, and reluctantly they did. The Germans were not going to get their hands on them. But as for the men, ‘we carried on treating the wounded,’ said Miller, ‘easing the pain of the dying and burying the dead.’ Retreating troops passed by in trucks and offered lifts to the coast. ‘Not one of us took advantage of them. We had a job to do, and to the best of our ability we did it.’

  After everyone else had gone, a deep but unnerving silence settled over the unit. Then the Germans rolled by in large numbers, with scarcely a glance at the field hospital, now behind the lines. A German officer eventually took charge but left Miller and his colleagues to complete the job until all their patients were well enough to go to a prison camp or into a German hospital.

  *

  The time the rearguard had bought – thousands with their lives, thousands more with their freedom – had been a godsend for those hundreds of thousands who had made it to Dunkirk and the wide beaches that ran for a dozen miles northwards and over the border into Belgium. One of these was Corporal Montague, who on reaching the outskirts of the port came across a Signals sergeant with a long shard of shrapnel in his eye. He cleaned the wound with the last of his water and led him to a French hospital. The scene that greeted him was horrific – ‘every corner and passageway was filled with wounded and dying.’ The sergeant lay on the floor to await his turn for a doctor. Stepping outside, Montague surveyed devastation. ‘The town had been subjected to attack of every kind from the air. The roads were blocked with vehicles on their sides, burnt out and useless. Overhead billowed dense black smoke from a burning oil refinery near the docks.’ Not a single building had escaped damage, but still the planes continued their unceasing attacks.

  Standing on Dunkirk’s esplanade, its once-grand hotels now shattered behind him, he stared out to sea. ‘Just off shore was a Royal Navy destroyer with a broken back, smoke pouring from her and no signs of life aboard.’ His eyes took in the beach and the untidy rows of soldiers, some standing, others sitting, all with nowhere else to go, at the end of the line. Queues stretched out to the edge of the docks and along the concrete breakwater, the Mole, jutting three quarters of a mile out into the sea, which was the only place the big evacuation ships could berth. Dive bombers wheeled over, their wing-mounted machine guns peppering the sand and the helpless troops with thousands of bullets every minute.

  In rare lulls in the lethal onslaught, Montague went to work. He got down on his knees and dug with his bare hands in the sand, carving out shallow graves for the growing piles of dead. ‘We stuck each man’s rifle into the sand at his head and tied his identity disc to the trigger guard.’ Night and a thick mist off the sea halted the planes, and the thousands of soldiers – their ranks swelling constantly as more and more desperate stragglers ducked and weaved their way through the shattered streets of Dunkirk and crowded on to the beach – tried to sleep through the cold and damp and the hunger in their bellies. Many had had nothing to eat for days.

  A few miles along the coast from Dunkirk, the promenade of the pretty holiday resort of La Panne11 had transformed into ‘a sort of military Harley Street’, in the words of Colonel C. M. Finney of the RAMC.12 A large force of field ambulances and clearance stations congregated there at the end of their retreat and set up for the last time in seafront hotels. Their lobbies became giant casualty areas, the floors a carpet of stretchers and human misery. The kitchens became operating theatres. Every room and corridor on every floor was filled with bandaged bodies and the groans of men in pain. Hospital ships were anchored offshore and were taking away as many casualties as they could, but with no proper pier the operation was slow, difficult and dangerous. Lorries had been reversed into the water to form makeshift jetties, but generally stretcher-bearers had to struggle out through the waves and put their patients on to small boats for transfer to the bigger ships. Others were dispatched in ambulances to the Mole at Dunkirk, where stretchers could be more easily manhandled on board. Some of the ambulances turned round and came back for more. But not all. Some were ditched as their drivers and orderlies joined the evacuation, putting self-preservation first, to the disgust of those who believed their duty lay in staying, not fleeing.13 Not everyone, it seemed, wanted to be a hero.

  One of those who stayed was RAMC Corporal F. C. Adams of the 11th Casualty Clearing Station, whose diary was a frank admission of how tough it was, both physically and mentally, to treat the ceaseless flow of wounded under these conditions. There were no beds or sheets, and the blankets covering the patients were soaked with dead men’s blood. The doctors were fully occupied in carrying out surgery, and all the difficult post-operative care had to be left to orderlies like him. Inside, the noise of hurt, bewildered and angry men was constant. Only the unconscious slept. From outside, the sound of guns and bombs shredded what few nerves were still intact, and some patients went mad with fear when planes roared over. He took to subterfuge to keep some semblance of order. He would pretend to be the wife of a soldier who kept calling out for her in his delirium. Another was loudly and disruptively demanding an operation for a bladder wound. Adams gave him morphine, put a plaster on the wound when he fell asleep and told the man when he woke that he had had his operation. It calmed him, which in many cases was the most the medic could hope to do. Adams appalled himself by wishing that the hopelessly wounded would hurry up and die so that space would be released for the hundreds waiting outside for treatment. How had he become so callous, he wondered to himself.14

  But now La Panne was about to be overrun, and it fell to the RAMC’s Colonel Finney to order those under his command to make for Dunkirk to be evacuated. Not all could go, however. There were wounded who were not fit enough to be moved again, let alone go through the ordeal that lay ahead on the beaches. They would have to stay and be captured, and so would a certain number of medics to look after them. The colonel visited the units one by one with written instructions to that effect. It was, he knew, ‘a terrible order’ to have to give to anyone, but one doctor and ten orderlies would remain for every one hundred patients. The choice of who stayed was settled by drawing lots.

  Similar situations had arisen (and would continue to arise) in clearing stations and hospitals all over northern France and Belgium. At the Chapeau Rouge château just outside Dunkirk, surgeon Philip Newman’s heart pounded as papers were shuffled for the ballot. Three of the seventeen officers were to stay. He had a pretty good chance of getting away. It wasn’t to be. ‘I was number seventeen and down the drain.’15 As the others made their preparations to leave, he tried to look efficient and ‘don’t care-ish’. He noticed that every one of them guiltily avoided catching his eye. At La Panne, the lucky ones lined up and trudged off towards the smoking ruins of Dunkirk away in the distance, the medics among them with rifles in their hands, aware that they might have to fight if they wanted to survive. Into his haversack, Major L. J. Long packed his ambulance unit’s admissions book with the names of all those they had treated and the one hundred graves registration forms he had accumulated, each marked either ‘brought in dead’ or ‘died of wounds’, his very own book of the dead. Those medics who had drawn the short straw settled down with their patients to await their fate in what was now the BEF’s last casualty clearing station, in the casino. Given how many lives had been gambled and lost in the past three weeks, it seemed appropriate.

  At Camiers field hospital outside Boulogne, Sergeant W. Simpson was awaiting his fate too. As the hospital was evacuated, six officers, three NCOs and twenty-seven men were required to stay, and volunteers were called for. He stepped forward. He was single, and he felt it only right that married men should have first chance at getting back to their families. Besides, he ruminated, there was still hope of an ambulance train turning up to evacuate them
all in time. He was wrong about that. There was no escape. As he sat with his patients, waiting for the Germans to arrive, he had ‘an overwhelming sense of desolation’.16 Medics who stayed behind had some consolation in being protected by the Geneva Convention as non-combatants. Theoretically, they could hope to be repatriated once the wounded soldiers they were looking after were well enough to go into a PoW camp. Simpson had no confidence that this tradition would be respected. ‘It was clear from what we had seen and heard that the Germans were trigger-happy and shooting at anything that moved. Our chances of survival seemed very small. I recall the regret I felt that I had not really lived and that my parents might never find out what had happened to me.’ But there were patients to treat, and he put his fears to one side and did what so many medics do at times of greatest stress – he got on with his job.

  When the Germans arrived he was surprised by the correctness of their behaviour, though they seemed inordinately concerned to establish if any ordinary soldiers were masquerading as medics. In his office, Simpson secretly collected all the pay books and endorsed each one with an official-looking certificate of his own devising confirming their status. The ruse worked. It also may have saved lives. The unit included a number of Jews, and Simpson, with an inkling of what dangers might lie ahead for them if their identity was known, destroyed their pay books and issued new ones stating their religion as ‘C of E’.17