Medic: Saving Lives - From Dunkirk to Afghanistan

by John Nichol

The next step was to cross the Straits of Messina to mainland Italy. Herford and his men stocked up their medical supplies and equipment for an even tougher battle. He came ashore unopposed at night at Pizzo, 80 miles north of the main landings at Reggio, and established a dressing station on a hillside overlooking the bay. Once again, he had been lucky, because in the morning he discovered that his unit had landed ahead of everyone else. The main assault force was only now arriving on the beaches – and was in trouble, under a continuous barrage from German gun emplacements and peppered with bombs from the air. As the troops struggled ashore, casualties were high. In the dressing station, the doctor and his team worked frantically on the wounded who were brought up to them.

  From his vantage point he looked down and saw one particular landing craft take a terrible pasting. Bodies were everywhere and the stretcher-bearers were overwhelmed. Down the hill Herford raced, on to the beach and out, waist-deep, into the water, to the landing craft wallowing in the waves. Badly hurt men were lying inside, and, as gunfire splattered the sides, he climbed on board, treating and soothing them until the overworked stretcher-parties could return to carry them to safety. Once they had been taken away, he jumped back into the water and, still under fire, scoured the beach for casualties before returning to the dressing station. On the way back up the hill, a bomb nearly got him, and he took cover behind a stone wall. As chunks of debris thudded into the ground around him, he covered his head with his hands. In the rush to get to the beach, he had forgotten to put on his steel helmet. He really was pushing that luck of his.

  The shelling was showing no sign of easing, and an ambulance outside the dressing station was hit, causing several fatalities. The whole brigade was pinned down and wounded soldiers were being brought in all the time. Politics saved the day. Just when all seemed lost, over the radio came the news that the Italian government had surrendered. A large force of American troops had also landed, 150 miles along the coast at Salerno. The German forces ceased firing and withdrew, to fight their key battles further up the peninsula. The battle here was over, and Herford and his medics joined the swelling Allied army heading northwards to pursue the enemy. There was still much fighting – and much saving of lives – to do before this war would be over. A bigger invasion than Sicily or Italy was on the planning boards, one in which the medical services would be instructed to prepare for a possible bloodbath. Their biggest test was yet to come.

  6. Stout Hearts

  The mighty force of ‘stout hearts’ – as General Montgomery called his troops in his commander-in-chief’s address to them on the eve of D-Day – crossed over from England to the Normandy beaches in June 1944 protected by the prayers of half the world and the promise of penicillin. Carried in the task force’s medical packs, the newly mass-manufactured, quick-acting antibiotic meant that more of them had a good chance of returning alive, of not dying from their wounds. The ‘very rare drug’ that SAS medical officer Malcolm Pleydell had been entrusted with on his secret missions in the Western Desert eighteen months earlier was now in general use. It proved an extraordinarily important life-saver that gave the Allied armies an edge over their German adversaries.

  Discovered in 1928 by the British scientist, Alexander Fleming, the drug’s practical uses had been developed in wartime by an Australian-born Oxford professor of pathology and adviser to the British Army, Howard Florey. In trials on wounded soldiers in North Africa in 1943, he established that penicillin did a better and quicker job of killing infections than sulphonamides, and with none of the toxic side effects that sulphonamides could have. Large-scale manufacture in powder form (and later as a liquid for injection and intravenous drip) got underway in the United States, and Allied soldiers fighting their way up through Italy were the first to benefit.

  ‘Marvellous stuff,’ declared RAMC colonel Robert Debenham as he watched a casualty with the usually fatal gas gangrene in his thigh sitting up and eating a hearty breakfast. Here was the ‘Holy Grail’, as one leading bacteriologist called it,1 a wonder weapon against the greatest killer of all on the battlefield – infection. In their field hospital in Italy, Lorna Bradley and her fellow nurses hailed it as ‘gold dust’. As they puffed the powder into wounds with a special ‘gun’, sparingly because it was still in short supply, they felt privileged to be using it. ‘We could see it was going to alter the whole treatment of the wounded and save millions of lives.’2 It even gave a chance to the ‘abdominal’ cases – those with guts spilling out, on whom surgery was so complex and time-consuming that they were often put to one side so doctors could concentrate on patients with simpler problems and a better chance of survival. Crucially, the Germans did not have penicillin – an irony given that Florey’s co-researcher, Ernst Chain, was a Jew from Berlin who had fled to Britain to escape Nazi persecution. As a result, their wounded troops were slower to recover and get back to the front line. Advantage to the Allies.

  Winning the war was the thought in everyone’s mind in that spring of 1944, but first there was a massive hurdle to climb, a Channel to cross. Getting a foothold back on the north European mainland was not going to be easy. One hundred and fifty thousand Allied troops were assigned to take part in the initial assault. Back home, civilian hospitals throughout Britain were emptying wards to make space for as many as a third of them. Beds were stripped of their white sheets and spread with grey blankets on which to lay soldiers in dirty, bloody uniforms, as one nurse recalled. ‘A large trolley was ready with piles of towels, soap, flannels, razors and pyjamas for men with no possessions.’3 The medical preparations and provisions were bigger and better than in any other military operation – or so the generals and the official histories came to believe. ‘Never before in history has a British expeditionary force left the country so well equipped medically,’ one senior medical officer stated.4

  The men on the ground were more sceptical. Dr Bill Helm, joining the RAMC from a casualty department at Middlesex Hospital in London, was not so confident about his own preparation. He had found the military training hard going. There were tough assault courses and terrifying mock-battle exercises using live ammunition in which he was warned that sometimes there were fatalities. ‘I was horrified that I might have to face some terrible casualty,’ he remembered, and what he had not been given was specific medical instruction in what to do.5 His training was in how to be a soldier but not in being a battlefield doctor. It was assumed he knew how to treat wounds but, like so many drawn into the fight for the first time, he had to learn the essentials as he went along. The only practical advice he ever got was from his father, who had been a doctor in the trenches in the First World War: never move a wounded man without splinting him first.

  The ranks were getting more help than Helm did. The War Office issued a folded card of first-aid instructions for ‘the fighting man’ to carry into battle, ‘to help him to go on fighting and to aid his friend in that cold interval between getting hit and getting help’. With a cartoon on the cover of a smiling Tommy and a heavily bandaged Hun, it was part manual, part propaganda. ‘Courage in disaster,’ it demanded. Don’t panic, was its message. ‘Wounds can look frightful. Be prepared for this. Remember modern surgeons can do wonders. Nature does her best to heal all wounds. But give Nature a chance. Stop wounds getting worse. That is your job. That is First Aid.’ Think first, it urged. ‘There may be three men wounded at once. Treat the most urgent first. Keep under cover. If mechanized, turn off petrol. Look out for falling walls. Any fool can be brave and get killed. Be brave, don’t get killed, and save your friend instead.’6 It advised on how to stop bleeding (‘put your fist into the wound’), how to apply (and ease) a tourniquet and how to tie down a broken limb. Don’t give water to a man with a belly wound, it instructed, because it will kill him. To carry a wounded man off the battlefield under fire, ‘tie his wrists together, crawl on hands and knees on top of him, put your neck under his wrists and drag him underneath you’. You can go a long way like this, it told its perhaps less than convince
d readers, aware now of the hell they were about to descend into and rightly concerned whether, once in this inferno, they would have the time or the cool presence of mind to consult the instruction card’s wise words and follow its diagrams.

  More tangible help was the sheer weight of trained medics lined up for the operation. The service had been massively pumped up, and it was decreed that there would be at least one medical orderly with advanced knowledge of first aid in every landing craft that approached the beaches. Seventy landing craft were reserved exclusively as water ambulances for evacuating the wounded. Doctors, accompanied by stretcher-bearers and blood-transfusion units, would be going in just behind the very first assault teams to set up instant dressing stations on the beaches. The biggest uncertainty was that almost all these newly recruited medics, from doctors to stretcher-bearers, were going into action for the first time. However well trained they were, how would they react under fire? Would they perform or collapse? The brigadier in command of one beach dressing station hit the nail on the head. ‘There remains a world of difference,’ he said, ‘between handling and caring for an exercise casualty labelled “GSW [gunshot wound] abdomen” and a real man with his intestines protruding from a gaping wound in his stomach.’7

  The time to put that difference to the test had come. Bugler and stretcher-bearer Len Brown – whom we last came across swimming to a rescue ship at Dunkirk8 – had, like Helm, been through some arduous training, jumping into the water in full kit in a cold Scottish loch and wading ashore. Now he was crouching in the belly of a rolling and pitching landing craft as it raced with hundreds of others towards Sword, one of the five assault beaches on the Normandy coast. He was the first-aid man, with two medical kits on his back and no weapon. Behind him, rocket ships – ‘marvellous’ – were hurling salvoes at pill-boxes on the shoreline ahead, but he had already had his first casualty. A soldier had dropped his spring-loaded Sten gun, accidentally set it off and shot himself dead.

  The landing craft slowed as it reached shallow water, steering round concrete obstructions and lethal mines attached to hop-poles that poked up through the waves, and as the bottom scraped against French sand, the front ramp went down ‘and we just ran off’. Some of his unit were hit instantly by the volley of bullets coming from machine-gun nests on shore and pinging off the craft before it even came to a halt. Another soldier had a vivid memory of racing down the ramp of the landing craft that day into water already dark red with blood and seeing the man ahead of him cut down by machine-gun fire. ‘He screamed for a medic. One of the aid men moved quickly to help him and he also was shot. I will never forget seeing that medic lying next to the wounded soldier and both of them screaming. They died in minutes.’

  Those still on their feet and in one piece crept in behind tanks with flails that were beating a path through the barbed-wire barricades and buried mines on the beach. Brown tried to stay on track, but he saw men who strayed to one side trigger explosions that blew them apart, and he had to risk setting off a mine himself to go to help them. He knelt in the sand with a soldier whose leg was hanging off. ‘I cut the trousers off him and put a bandage and a tourniquet on. I marked a “T” on his forehead and the time the tourniquet was applied so the medics coming behind me would know when to release it. Then I went on to the next man. We were under orders not to stay with the wounded too long but to keep going forward with the front troops as they tried to get off the beach.’ The presence of a comrade with a red cross on his helmet seemed to give the fighting lads an extra impetus to keep going, to stand up and burst forward, guns blazing, through the vicious shell fire falling down on them. ‘It’s nice to have you up with us,’ they told him as they lay in the sand together, waiting for the next dash forward. ‘And I was. I was right up there with them,’ Brown recalled. ‘When they went forward, I went forward. I thought it was necessary. A bad wound needed to be tourniqueted straight away. Then a jeep could come up over the rough ground and take him away. But treating them quickly in those first few minutes after being wounded was vital.’

  Over on Omaha, hemmed in with high bluffs, and the most heavily defended of the beaches, US regimental surgeon Major Charles Tegtmeyer was face down in the shingle after struggling waist-high through water criss-crossed with submarine obstacles and booby-traps just to get ashore. He had already ‘done’ opposed landings in North Africa and Sicily, but this was in a new league of lethality. He cowered behind a small shelf of sand and could hear nothing but the explosions of shells and the sharp whistle of bullets. What he could see as he lifted his head was even worse.

  In every direction were the huddled bodies of men, living, wounded and dead, as tightly packed together as cigars in a box. Some were frantically attempting to dig in, a few were raising themselves and firing towards the concrete-protected enemy on the cliff above, but the majority were huddled together, face downward. Artillery shells exploded. Bullets, like a million angry hornets, buzzed over and plunged into the water behind us with sharp hisses or whined away into the distance as they ricocheted off stones. At the water’s edge, floating face down with arched backs, were innumerable human forms, eddying to and fro with each incoming wave, the water about them a muddy pink in colour. Floating equipment rolled in the surf, mingling with the bodies. Everywhere, the frantic cry, ‘Medics Hey, medics,’ could be heard above the horrible din. Crouching, running, crawling and stumbling, my men and I slowly worked our way up the beach, answering the cry.9

  The doctor had to make snap decisions. ‘The number of dead, killed by mines, shell fragments, machine guns and sniper bullets was appalling. I examined scores as I went, telling the men who to dress and who not to bother with. My men were superb as time and time again they went back and plunged into the surf, regardless of the hail of steel fragments whistling about them, to pull wounded ashore.’ He had to restrain them from crawling into a minefield to haul out the wounded until he could get a sapper with a mine detector to clear the way first.

  Slowly, the Germans on the clifftop were being knocked back, the attack proceeding. But the cost was horrendous. Tegtmayer had eighty-four casualties laid out on the beach around him, and more arriving by the minute. ‘An infantryman was brought in with a traumatic amputation of the right leg and multiple fractures of the left leg. He was conscious and cheerful but his only hope was rapid evacuation, and at this time evacuation did not exist. An hour later he was dead.’ Some could, however, be saved. The doctor examined a man with a terrible chest wound who looked as if he was about to die. ‘I called for plasma but the God-damned bottle had no vacuum and would not draw up the sterile water [to dilute it for transfusion]. I called for a second, and the same thing happened. But the third bottle worked and we were able to get the stuff into him. A few minutes later, his pulse improved and he felt better.’ Availability of blood was, like penicillin, a key life-saver for the Allies. Against the Germans’ almost negligible blood service, from the start the British forces alone had five transfusion units and more than a thousand bottles of refrigerated whole blood on the Normandy beaches.

  The replacement blood was a drop in a dreadful ocean. The scale and the horror of the casualties – the blood-letting – was deeply distressing to many of the less experienced medics who found themselves on the beaches. One medical officer recalled the overwhelming crush in and around his beach dressing station, with sixty men lying on stretchers waiting for emergency blood transfusions and hundreds of walking wounded. Medics worked non-stop – hours on end, with little or no rest. One young surgeon claimed to have woken up in England at 5 a.m. on Monday (5 June) and not stood down from duty until midnight on Thursday (8 June). Many popped Benzedrine tablets to keep themselves going, just as RAF night bomber crews did for long-distance raids. The pep pills came in the rations.10 But even more debilitating than exhaustion for some tyro medics was the trauma of seeing hideous injuries. This, says historian Mark Harrison, was especially true of unseasoned stretcher-bearers, who, as bandsmen, cooks and clerks, were unused t
o the gore they were now steeped in. One regimental medical officer, Dr Aitken of the 24th Lancers, a conscript on a short-term commission, felt queasy enough himself during D-Day and could only imagine what his inexperienced stretcher-bearers were feeling at their first sight of real injuries. Some ‘hesitate to lift a stretcher unless they can turn their backs on the injured’, he noted.11 That the buglers and batmen stuck to their task was to their lasting credit.

  *

  While the furious fight was going on to capture and hold the beachheads, there were other contingents of Allied troops already behind the enemy’s lines and battling hard for an advantage. Hours ahead of the main frontal attack, airborne forces had dropped by parachute and glider. Dr John Vaughan of the Oxfordshire and Buckinghamshire Light Infantry was in the very first wave, medical officer for a glider strike force detailed to capture the key bridges over the River Orne and the adjacent Caen canal three miles inland and hold them until elements of the main force arrived from the coast.

  They had begun the operation in the knowledge that they would be the very first troops to land in Occupied France – but also that they might be isolated and quickly eliminated. If, that was, they got anywhere near the target in the first place. Sitting, his face blackened, in the narrow fuselage of the third of six all-wooden Horsa gliders as they were tugged silently through the night sky and over the French coastline, Vaughan realized that a single searchlight from the ground below and an ack-ack shell would end the mission and his own life in a trice. ‘I was appalled by our helplessness in this flimsy contraption,’ he recalled. It was his first time ever in a glider and he longed for a parachute, for which he was fully trained. ‘We all of us knew that anybody who survived this day would be very lucky.’12 He peeped through the Perspex windshield and saw the town of Caen below, just as the tow rope was released, ‘and down we dropped, gathering speed. The pilot made two right turns, there was a loud splintering sound directly underneath… silence (we had bounced)… and then nothing.’