Medic: Saving Lives - From Dunkirk to Afghanistan

by John Nichol

  But, all too often, in that jungle nightmare, sacrifice and dedication were not enough. Nothing was or could be. Medical orderly Temple, his worldly possessions down to a loincloth, a banana-leaf sunhat and a pair of wooden clogs, felt helpless most of the time. If a man went down with cerebral malaria he would rave and groan until he either died or recovered, ‘and there was nothing we could do about it.’ Under these awful conditions, without supplies and subject to uncaring captors, many medics found themselves at a loss – without the consoling thought that they were at least saving lives. Sergeant Joe Blythe was one of these. The ‘Death Railway’ was not the only place the British prisoners had been sent to work, and Blythe ended up in one of the myriad of other slave camps around Japan’s Pacific gulag. He was the sole medic among a work detail of eighty men from the Royal Artillery on the island of New Britain, off Papua New Guinea. His diary, written in secret and hidden from the Japanese under a pile of bloody bandages he knew they would not search, was a litany of death as, one by one, his comrades succumbed to illness. With nothing but first-aid training in the St John Ambulance to call on, he could do little medically but ease their passing.

  On Good Friday, 1943, a significant day for the strongly religious man that he was, he recorded the death of Gunner B., ‘only a young man of twenty-two, who died in his sleep, another victim of beri-beri. He has been ill a long time and also had severe attacks of malaria. He had a lovely tenor voice and would try to entertain us with a few songs. Our total of dead is now forty-two, more than half.’21 At their Good Friday service, Blythe, who was a lay preacher at home in Nottinghamshire, took as his text Jesus’s words on the Cross: ‘It is finished.’ But it wasn’t. On Easter Saturday he was forced to record two more deaths, one of a man with beri-beri and malaria who had lost his reason and been out of his mind for a month. ‘We had tried to get a tarpaulin from the Japanese to make him a small tent so he could be separated from the other lads who were seriously ill and distressed by his condition. But in vain.’ The countdown of deaths continued remorselessly. ‘We all begin to wonder if and when it will end. Who will be next? Shall I fall victim? Will any of us survive?’ Six weeks later, the party of eighty was down to just twenty-six. Sickness caught up with Blythe himself, first malaria, then an outbreak of ten tropical ulcers on his legs and a deep abscess on his back. ‘I cannot stand but managed to crawl to a patient to give him his injection. What am I going to do? I cannot neglect them.’

  Even the little comfort doctors could offer was often snatched away. RAF medical officer Aidan MacCarthy – who had escaped one enemy at Dunkirk only to be imprisoned by an even more vicious one in Java – was nursing an airman dying of dysentery. ‘Severe abdominal cramps make this a most painful way to die, and I watched as his wasted body stiffened with each spasm. There was no medicine to be had and all that I could do was to pray and hold his hand and whisper encouragement.’ A Japanese guard entered the hut and, lost in his terminal task, MacCarthy failed to stand up and bow. ‘He rushed towards me screaming, with his rifle raised. In a mixture of Japanese, Malay and English, I explained that the patient was dying, but he smashed his rifle butt on to my elbow and fractured all the bones in the joint.’ The injured doctor was taken to a civilian hospital for repairs. ‘A Japanese surgeon examined me and seemed reasonably competent. He said he needed to operate. In the theatre, I was told to lie on the table and an orderly strapped my legs and arms to the table. I thought this a rather odd preliminary to the anaesthetic – and then discovered there was to be no anaesthetic.’ The surgeon, who MacCarthy later learned was a third-year medical student, began to make his first incision, ‘when I suddenly realized he was making it in the wrong place. Then the blinding pain hit me and I fainted. When I came to, I saw this butcher proudly holding half the head of my radius bone in his forceps.’ The cut was stitched and dressed, the arm put in a sling and MacCarthy was swung off the operating table and marched back to the ward. He survived this ordeal and learned never to trust Japanese medicine. When he and other doctors were ordered to inject fellow prisoners with a vaccine they were told was for their benefit but which they suspected was a guinea-pig trial for an untested anti-plague drug intended for Japanese troops, they pinched the skin into a fold and pushed the needle harmlessly though it and out of the other side.

  It was hard to come to terms with the obscene cruelty routinely carried out in the camps. One of MacCarthy’s first experiences was being paraded past a prisoner who, for some minor infraction, was buried up to his neck and then left bareheaded in the sun. ‘The Japanese refused to let me offer him any relief. Instead, they insisted that we walk past him dozens of times each day. In forty-eight hours he changed from a young man to a decayed geriatric. Insect bites set up immediate infection, his eyes closed and his lips set in a permanent snarl. It took two days and a night for him to die.’ Nor was the doctor allowed to help when what he called a procession of ‘scarecrows’, 249 blind men, hands on the shoulders of the one in front, arrived at the camp gates led by the only sighted one left among them. ‘Their blindness was the result of optic papillitis, brought on by prolonged vitamin deficiency. They were emaciated, dirty, and completely demoralized.’ The doctor and his men were not allowed any contact with them, ‘but from our own limited resources we managed to pass clothing, soap and even a little food over to them’. They were all that was left of a working party of a thousand who had been shipped off to a remote coral island to build a runway for Japanese aircraft and been worked and starved to death. More than seven hundred had died, two hundred of them packed into the hold of the tramp steamer bringing them back to Java.

  Soon MacCarthy was to experience one of those ‘hell ships’ for himself as he was transported to Japan to be a slave labourer. The men were sealed below decks in horrific heat. ‘When the air raid alarm sounded, we sat terrified in the steaming darkness, expecting a torpedo at any moment.’ They survived, drew within sight of the Japanese mainland and thought they were safe. Then they were hit. ‘The torpedo exploded right underneath us, blowing off the front length of the keel. The lights went out, and I called to the officers on each side of me, amazed that the noise had not woken them. Then I realized they were dead. The explosion had had a whiplash effect on the iron deck, and the vibration had fractured their necks. The fact that I was sitting up and struggling with a large rat that had been gnawing at my feet saved my life. It was an incredible escape and one that continues to haunt me.’ The ship, its engines still turning at full revolutions, was plunging beneath the waves, and MacCarthy made his way up a ladder as water cascaded into the hold over him and almost knocked him off.

  I felt someone’s hand clasp my ankle and, spurred on by terror, I managed to pull the two of us to the top. Then I swam for it, putting as much distance as possible between me and the rapidly sinking ship. A small island of wreckage floated by and I clung to it in thankful relief. Cries and screams came from all around me. I heard an Australian voice calling ‘That you, Doc?’ I swam towards the voice and found two bedraggled Aussies, one of whom was badly injured. It was the beginning of a most unusual sick parade. I swam from one piece of wreckage to another, binding broken collar bones, roughly splinting broken arms and legs, using bits of rope and string and timber picked up from the drifting flotsam. The surrounding sea was a heaving oily swell, and as we clung to the wreckage our bare feet often touched a soft yielding mass, the bodies of women and children whose refugee ship had also been sunk. I had a great shock when I dragged the first of them to the surface and found myself looking into the staring and sightless eyes of a dead child, with its mouth forever fixed in an eternal scream.

  The doctor was in the water for twelve hours, ‘human flotsam, dumbly bobbing up and down’, before he and about twenty others were picked up by a Japanese destroyer, and he thought he was saved. ‘We were given rice balls and a drink of water. But then they turned on us, beat us up and began throwing us back overboard.’ MacCarthy jumped rather than wait to be pushed. ‘We sw
am back to the wreckage, now some distance away, and reached it exhausted and terrified.’ He had almost given up hope when a Japanese whaling boat came by, stopped, picked them up and brought them to a port. ‘The authorities there wanted the whalers to go back to sea and drop us back where they had found us, but the crew were anxious to see their families and refused. Grudgingly we were allowed to disembark, eighty-two of us standing naked on the dock, a strange-looking bunch covered with cuts and abrasions from the nails and sharp edges of the wreckage. Salt encrusted our bodies and our skins were wrinkled like new-born babies.’ They were marched through the streets, some dragged on makeshift litters, others on sticks. Japanese crowds jeered at them as they were led to a flea-infested labour camp outside a steel factory. It was only later that MacCarthy realized the ominous significance of the place that was to be his home – Nagasaki. As a doctor at war, it seemed he was destined always to be a participant in the very worst of human suffering.

  5. Desert Doctors

  In the past century, weapons of war have changed out of all recognition, but what has stayed much the same throughout this explosion of ever deadlier arms is the experience of being wounded, which, it seems by most accounts, is initially not always a matter of searing pain. That comes soon enough. But, to begin with, there is a blow like a jolt of electricity that can hurl a man to the ground or drop him slowly and gracefully in a heap. The chief sensation as he lies there is usually neither resignation nor anger but utter surprise – which seems odd, given the dangerous environment he knew he was entering when he went to war. Yet few soldiers, airmen or sailors go into battle thinking about being wounded. Killed, yes. That’s the occupational hazard. But the half-way house of being damaged, badly, often seems harder to contemplate and so is ignored – until it happens. After the surprise comes the shock, which is numbing, and many will remember the calmness of that almost matter-of-fact moment when they looked down and saw a mangled leg or felt their insides tumbling out. Then the realization sets in and, with that, possibly the pain begins, but more likely the fear, sudden and overwhelming, particularly if he is alone and with no one to call on. With fear comes stress, heightened to screaming pitch by the noise of battle around him. Then the human reaction is the same as with any hurt animal – to want to crawl away to some quiet place.1 Except that, to your horror, you cannot move.

  Private Maiki Parkinson’s experience was a classic case. In the battle for Tunis, in North Africa, the New Zealand soldier – one of Montgomery’s ‘Desert Rats’, who were confronting Rommel’s apparently invincible Afrika Korps – was caught by the blast of a German mortar that landed next to him and knocked him over. One leg was hanging on by a thread, ‘and blood was pissing out everywhere, just pumping away’2. He tried to get up, but his strength was ebbing and the weight of his pack, his tommy gun and his ammunition was holding him down. He wanted to take off his belt but could not undo it. ‘I just lay there,’ he recalled. ‘I had my hand inside my groin and I could feel the bone. I wasn’t in pain. They say your life swims before you, and I found myself thinking of home.’ Two stretcher-bearers picked him up and carried him along a trench, ducking bullets the whole way, to an aid post, which was where he finally passed out. He woke in a military hospital in Tripoli, still not grasping what had happened to him. In the next bed was a young soldier whose leg had been amputated at the thigh, and Parkinson commiserated with him. ‘At least we’ll get decent pensions,’ the soldier said. We? The truth suddenly hit him every bit as hard as that mortar shell had done. ‘I looked down and realized my leg had gone too. It was the most devastating thing that ever happened to me.’

  The doctors who had to deal with the tens of thousands of casualties like Parkinson had had little or no specific training for the work they were required to do. Malcolm Pleydell had been thrown into the deep end professionally at Dunkirk3 and swam rather than sank, but it was a close call. ‘I honestly was scared,’ he told his girlfriend in a letter. ‘The noise is the worst thing when you aren’t used to bangs.’ But at least now he had ‘a rough idea’ of what to expect next time. A rough idea – that was as much as most of them ever got beforehand about the business of saving lives on the battlefield. Martin Herford’s exploits were to encompass Alamein, the conquest of Sicily and Italy, Arnhem, escape from a prisoner-of-war compound and the liberation of the Belsen concentration camp, and make him the RAMC’s most decorated doctor of the entire war.4 Yet at the outset he was a greenhorn graduate from university medical school in Bristol with just a year’s surgical experience as an ear, nose and throat houseman in a hospital. He was, in his own words, ‘guileless’, and so far removed from the grizzly realities that he took his tennis racket with him when he went to war.5 His graduation from tonsils to traumatic amputations was a crash course at the university of life (and death). And he, unlike many of his contemporaries, at least had an inkling of war’s horrors beforehand. As a student he had been to Barcelona with a Quaker aid mission during the 1936–39 Spanish Civil War, come under shell fire, watched lines of hard-pressed doctors operating on victims of bombing, seen ribs removed under nothing stronger than a local anaesthetic.

  For Robert Debenham, at forty older than most of the others, and a lieutenant colonel, the steepest do-or-others-die learning curve was in a network of damp and dirty sea caves, a truly bizarre site for a hospital. He was at Suda Bay on the northern coast of the Greek island of Crete, which, in May 1941, was about to fall to the Germans. An advance force of paratroopers had dropped from gliders and captured his hospital in the town of Canea. While he watched from a slit trench in the grounds, the red cross flag and the union jack were hauled down and replaced with a swastika. The conquest was short-lived, because Commonwealth troops fought back and ejected the invaders. But this was only staving off the inevitable: the Germans would be back in overwhelming numbers. And this was why Debenham had relocated to the caves, with several hundred patients and staff, to hide and carry on as best he could. ‘All hospital work now done in caves,’ he recorded in his diary.6 Stretcher-cases were brought in along the beach or via a tunnel from a ledge in the cliffside. There were good caves and bad. ‘Cave 5 is difficult to approach and only walking wounded can get to it, through a rather winding crack through rocks,’ he noted. ‘But when reached it is a good cave and opens out right on to the sea.’ The dysentery cases were all sent to a special ‘isolation’ cave, some way off from the others. Outside, on the main part of the island, more German parachutists were dropping and enemy planes were shooting up anything that moved.

  The doctor was ensconced in what had been designated the surgery cave and, with his caseload increasing by the hour, hardly left it. The operating table was set up close to the mouth, because this was the only source of light. The floor sloped beneath his feet and was so fouled with goat droppings that he and the other surgeons frequently lost their footing in the slimy mess. In the confined spaces of the ‘wards’, the fetid stench of decomposing wounds was overpowering. At least British Red Cross nurse Joanna Savridi was able to get some respite from this. As a new recruit to medicine, she had wondered whether she would be able to stand the smell of ether and the sight of blood and gore. Now she had no time to think about such niceties or turn up her nose. There was a monumental job to do, and she got on with it fearlessly. She did get to leave the shelter of the caves, risking the constant bombardment outside. As she darted away to fetch badly needed medical supplies from the town, she breathed in the fresh air as if it were pure oxygen.7

  Wounded men were arriving all the time, two hundred in one night alone. Breaking off from a non-stop stream of surgery, Debenham pulled down his face mask, wiped the sweat from his brow and gazed out at the savage blitzing of the island. Yet more ‘customers’ would soon be on the way. He could see the hospital buildings they had so recently evacuated taking a terrible pounding from the air. He had not been able to get all the patients away to the cave, and he knew some were still there. Lying in their beds, how could they survive the raking
machine-gun fire and the bombs? But at least his underground sanctuary was being respected. He had decided to gamble and advertise its presence with a huge red cross made from white hot-water-bottle covers and red hospital screens laid out on the clifftop. It appeared to be working. To underline that this was a place for non-combatants, when out in the open ‘between caves’, he and his staff took off their steel helmets so they wouldn’t be mistaken for soldiers by marauding German fighter pilots, and held up their arms to display their red cross bands. But the enemy’s ground troops were closing in. Their line was now just four miles away. ‘Things don’t look too good,’ the doctor noted. ‘Capture seems very likely.’

  They had not been abandoned, however. Word came that rescue ships were on their way from Egypt, four hundred miles away. With the caves about to come under assault from the ground, Debenham assembled a line of walking wounded and loaded stretcher-cases on lorries to cross the island’s southern shore. Not everyone could go. Four hundred patients were unfit to be moved, and thirty orderlies stayed behind to look after them. As in northern France at the time of Dunkirk, there were agonizing decisions to be made and tough orders given to those medics whose duty was about to cost them their liberty. Debenham had to choose men to stay behind knowing that, as senior surgeon, his own duty was elsewhere, with the main body of evacuees. He left with them to trek to the other side of the island, but there was no let-up in the demands made on him. The Germans were superbly well armed, with sub-machine guns and the latest field artillery. He set up a temporary dressing station in a little church among the olive groves and performed twenty operations beneath the altar. ‘The font was an excellent receptacle for scrubbing up,’ he recorded, ‘but water was in short supply so we could only change it once.’ From the church wall he prised out a six-inch nail to use as part of an improvised splint for a broken leg. It was pushed through the sole of the man’s boot as an aid to traction and worked well, ‘with the help of a bit of string’, just as wood from the pews made good tops for crutches.