Medic: Saving Lives - From Dunkirk to Afghanistan

by John Nichol

  He turned his attention from the dead to those he could still help, the living, a dozen of whom were crowded in and around his tiny aid post for treatment. The place was a mess of bodies, blood and stained bandages. Some had small wounds – a slashed thumb, a stone chip in the chin – and could be patched up and sent back into the fray. Others needed more extensive treatment. They were Priority 2s, with serious but not acute injuries, and ideally needed to get to a hospital as soon as possible. That was out of the question. Pynn made them as comfortable as he could while, around him, the battle continued. The thunder of mortars and the echoing clatter of the .50 cals never stopped and seemed to get closer and closer. ‘I was scared stiff and sweating profusely in my body armour and helmet. From the ops room I could hear chatter over the radio to expect further assaults, so we cleaned up the RAP and readied ourselves for the next wave of destruction. It went through my mind that we might be overrun by the enemy.’ This was his greatest fear. ‘I did not want to be taken prisoner… be tortured… probably beheaded. I would rather have shot myself. I had an escape plan, which was to jump in the fast-flowing canal at the back of the compound and hopefully wind up somewhere safe. I didn’t know whether it would work, but…’

  It never came to that. Apache helicopters and fighter planes flew in to drive off the attackers. But the rest of the night was filled with anxiety, the fear of another assault. Dawn came, ‘the most welcome I’ve ever witnessed. The birds sang, as usual, but there was a grim atmosphere around the blokes. I forced some breakfast down my face through the knot in my stomach.’ Pynn knew that, with three dead and seven wounded, he and his medical team had come close to being swamped. If there had been many more casualties, he would have had to prioritize treatment, and to make the agonizing decision of who he could save and who he must let die. ‘It had all taken place in the dark as well, the most austere conditions one could imagine for treating the seriously injured. This was a real blooding.’

  Nor did it stop there, as the next night the garrison took the initiative and laid down a lethal rain of mortars and automatic fire on anything in the town that moved. ‘Groups of Taliban advanced from all directions, and were repelled or vaporized.’ Wild foxes scavenged on the bodies strewn everywhere. Aircraft circled overhead, pouring down heavy cannon fire. Pynn lay on the floor of the RAP, deafened by the constant barrage but growing in confidence that the worst might be over. Once again, dawn brought some respite from the battle, and weary soldiers were able to stand down, but it was noticeable that the bravado had gone out of them. They were quiet, thinking their own thoughts, eyes glazed over in what Pynn called ‘the thousand-yard stare’, as the death of comrades sank in. He thought of Caroline, his wife of less than a year, to whom he regularly spoke on the satellite telephone. But he couldn’t phone her now. After fatalities, there was an immediate lock-down on communications, to stop the names of the dead slipping out until next of kin had been told.

  Back in London, Caroline was more aware than other soldiers’ wives that something was up. She worked as a news editor on ITN and saw the agency reports coming in of the battle at Sangin and the British deaths.

  I didn’t know he was in Sangin as such but I knew he was off base [Camp Bastion] and was probably in some pretty dangerous situation. But then everything went quiet, and for a long time all we heard from the Ministry of Defence was that they were trying to contact next of kin. The thought flashed through my mind that they were trying to get in touch with me but couldn’t because I hadn’t told the army welfare people where I worked and they didn’t have my mobile number. That day I chewed my nails down to the quick. I was convinced it was Harvey. I remember being worried about how I was going to be told and how I would react in that moment. That was something I used to dream about all the time he was away. I really worried about that… funny, isn’t it? That night there were still no names from the MoD when I left work. ‘We still can’t find the next of kin,’ was all they would say, and I thought it had to be me. I remember driving home and, as I turned into our road, I was trembling and hyperventilating. I was convinced there was going to be a car outside waiting for me with two men in it, bearing the worst news.5

  But it was other families who would be hearing the doleful truth that night. Her doctor husband was alive, though wishing with all his heart that he was somewhere other than hunkered down in the Sangin compound. ‘The guys who’ve been to Iraq say they’ve never encountered battles like this,’ he noted. ‘This is by far the toughest deployment that even the most hardened modern-day paratrooper has ever endured.’ It was on a par with the legendary fighting 3 Para had done in the Falklands, ‘and I’m proud to have been part of it. But I can’t wait to get back to the comparative safety of Bastion and then on to England.’ Not only was his tour nearing its end, with just a few weeks to run, but he and his men were about to be relieved. Another group of Paras could step up to the mark. A Company had done its bit. But getting home was not going to be quite as easy as Pynn hoped.

  *

  A Chinook was incoming, arriving with replacements and to take out a batch of tired troops from A Company. They were in high spirits. The fighting had died down, and not only had they just had their first uninterrupted night’s sleep for a week, they were also thinking of home comforts. A patrol edged out of the gate of the compound and across a wadi to secure the landing site. This was a quick task, and as routine as any operation at Sangin ever could be, so they hadn’t bothered with helmets, just their maroon Para berets. Medic Stu Giles went with them. ‘We were a little anxious, but who wouldn’t be? We were in one of the most dangerous places on the planet at that time, and you could never be sure what was going to happen. But we had the machine guns on the outer fence at our backs, so we felt pretty safe.’

  They fanned out left and right to form a box, ‘and then everything kicked off. Rounds came wanging round our heads. We were ambushed.’ He threw himself flat on the ground, ‘the adrenalin pumping, the heart going, looking to see where the shots were coming from and returning fire’. Instantly, a man was down, and the cry went up for help. Giles and the platoon sergeant, Dan Jarvie, leapt to their feet and ran two hundred yards through the bullets to where Jacko – Private Damien Jackson – lay in a heap in the dust. ‘I don’t know whether that was brave or stupid,’ the medic reflected later. ‘But in the Paras the guys are family and so it’s shit or bust to help them.’ He had braved bullets for a wounded enemy – how much more would he risk for one of his own?

  I didn’t stop to think. Frankly, you wouldn’t make a very good medic if you did at times like that. Dan and I just got up and ran, and it was as if we had blinkers on. All you can see is that one of your mates is hurt and you have to get to him. Dan was the best running companion I could have had. I’d known him my entire army career and I totally trusted him. Only after it was all over did I stop and say to myself: ‘Christ, I could have left my wife with no husband and my kids with no dad.’ But at the time it didn’t enter my mind. We just ran.

  They skidded to the ground and crawled the last few yards to Jacko, who had been dragged down into a small depression which gave very little shelter from the enemy snipers. Corporal ‘Prig’ Poll was lying with him, going through the drills, checking his airways, making sure he had not swallowed his tongue. He couldn’t detect breathing. ‘Take over,’ he urged Giles, though he believed Jacko was dead.6 Giles set to work. ‘There was just enough cover to lie prone, but if you put your head up you were a target. I shielded Jacko with my own body so I could examine him without him being hit again. It was obvious he had serious wounds. A bullet had gone in through the lower part of his stomach and out through his buttock. He had bad internal injuries, was bleeding heavily and was in shock.’ There was, as always, an expectation of almost superhuman abilities placed on the medic. ‘You’re supposed to have all the answers. Everybody looks at you to take control. I got one of the lads to apply direct pressure on to the front wound while I went through the first-aid checks.’ Dan
Jarvie was frantic. Later, he would recall this as the worst thing he’d seen in his life. ‘He was lying back and I was shouting at him, “Jacko, look at me, don’t fucking go, stay with me.” But he was quiet, really quiet. He had gone white and he was looking up.’7

  All the time Giles was working away on Jacko, trying to resuscitate him, the Taliban were keeping up a withering hail of fire. A guerrilla could be seen with an RPG launcher; there were machine-gun nests up on the roof of a nearby building. The other Paras in the patrol were shooting back from whatever cover they had been able to find, giving as good as they got. ‘Obviously, I was too busy to join in the firing, and I was vulnerable. I was totally reliant on the others. It was like being a passenger in a fast car as opposed to being at the wheel and in control. But, as you get on with your job, you trust your mates with your life.’

  Mates – that was one of the Paras’ great strengths. But it also put an extra burden on Giles. A mate’s life was ebbing away in front of him… a mate.

  You’re trying your hardest, and what makes that more difficult is that it’s one of your friends. I’d known Jacko for years. He was someone I was used to having a laugh with, sharing a beer, and he was in deep trouble. I controlled his bleeding as best I could, but then I saw he’d stopped breathing. I gave him mouth-to-mouth and got him breathing again, and by then a stretcher party had arrived. I manoeuvred him on to the stretcher and briefed the lads on what I’d done and what to tell the doc when they got him back to the RAP. I didn’t go with them. My job was to stay with the patrol in case there were other casualties. I was on the ground another ten to fifteen minutes, though it felt a lot longer, before we were able to head back to the safety of the compound. Then I raced off to the RAP to see how Jacko was. I wanted to help the doc with his treatment.

  Inside the compound, Pynn had gone to meet the stretcher as it was hurried through the gate. He knew Jacko well too – the private was one of the team of medics the doctor had schooled in emergency first aid when the battalion first arrived in Afghanistan. Now, one look was enough. He was ‘blue and unresponsive’, his arm hanging limply down from the stretcher. The doctor knew nothing could save him. ‘We couldn’t stop his internal haemorrhage. The bullet entry and exit wounds were so small I was unable to probe inside and find the site of the bleed. The speed at which he died suggests that the abdominal aorta had been hit. We tried resuscitating him for half an hour, pumping his lungs and his heart until I was drenched in my sweat and his blood. But it was no use. The luck that 3 Para had been having had run out.’

  Pynn was devastated to have lost a comrade.

  I sat with my head in my hands as Jacko was put into a body bag and it was sealed up. I stayed inside the RAP for some time because I couldn’t bear to look his mates in the eye. I’m the doc, and I felt ultimately responsible for losing him. I struggled to hold back the tears as I finally went into the ops room. Stu Giles was there, and the look on my face told him his patient had died. He broke into floods of tears, blaming himself. Jacko had been breathing when Giles put him on the stretcher, but must have gone into cardiac arrest due to loss of blood on the way back to the compound. A catastrophic haemorrhage in this part of the body was extremely difficult for him to control, especially as he himself was under fire at the time. I tried to reassure him. Even if I had been next to Jacko when he was shot, it is unlikely I’d have managed to save him. It was his bad luck that the round struck a major artery.

  But neither captain nor corporal could stop torturing themselves with what might have been. ‘The thought goes through your head. What if I’d been with Stu, next to him, could we have done something more? It’s not guilt, just that, seeing Jacko’s lifeless body, I felt useless. As soon as he came through that gate, the doctor in me knew he was dead. But, as a soldier and a comrade, and with all the effort Corporal Giles and the stretcher-bearers had put in, I had to give it a try, just in case. They were all looking at me with that look in their eyes that says, “Come on, Doc, save him.” And I couldn’t. I just couldn’t.’

  Giles will never forget the agonized look of loss on the doctor’s face as he emerged from the RAP.

  He’s a man who normally stands proud, but he looked shattered. He didn’t have to say anything for me to know that Jacko hadn’t made it. I broke down, and I was inconsolable. I blamed myself – did I give him enough care, could I have done better? I know now that I gave him the absolute best I could at that time but, in the heat of that moment of knowing he was dead, my emotions took over and I questioned my own ability. I’d never lost a patient before. I shouldn’t really have broken down in front of the younger blokes. Seeing me so emotional wasn’t going to help them. So, straightaway, I had to pick myself back up and try to set an example. But I found that hard, very hard. The really devastating thing was knowing that everyone had done their best, yet it didn’t work and Jacko was dead. But you have to get past the sadness and the doubt – for the sake of the next patrol you go out with. You have to get on with your job.

  In his heart of hearts, Pynn suspected that he, the doctor, had been in the wrong place. ‘The speed at which Jacko died made me realize that, to be of use, I needed to be located as far forward as possible.’ He had nothing but admiration for his medics, but their clinical skills were limited. He could do so much more than they could. ‘It obviously puts me at risk to go that far forward, but my job is to support the fighting men.’ As it was, he had gone further into the front line and exposed himself to more danger than some in authority in the army thought advisable. A dead doc was no good to anyone; other lives might be jeopardized if he was killed. It was his duty to stay alive. That was one argument.

  But Pynn had made his choice to go up-country with his men, and not out of bravado or misplaced machismo.

  I had no wish to see action for its own sake. Firing a rifle doesn’t sit comfortably with me; my role is to save lives, not to shoot people. But the days of the doctor being with the quartermaster and the supplies at the back of the battle group are gone. If a guy gets injured, there’s no point in me being two hours away by patrol. You need to be there with them. That’s the reality of modern warfare. The Medical Emergency Response Team can come in and pick up casualties, but someone has to be on the ground to treat casualties at the point of wounding, and I didn’t feel comfortable just leaving my medics to it.

  Even so, he still wondered if he could have done more. He was not God, he knew. Life or death was not his choice to make. That decision had been taken out of his hands by the chance bullet that sliced through Jackson’s artery. But could he have saved a life if he had been out with the patrol rather than back behind the walls of the Sangin compound? The remotest possibility – and it was no more than that, not even a probability – was a cross he would continue to bear. And the doctor and the medic were not the only ones whose emotions overwhelmed them in the wake of Jackson’s death. The dead soldier’s platoon came to pay their respects. They were hurting, each in his own way. One placed the dead man’s beret – every Para’s proudest possession – on the body. Dan Jarvie, fifteen years a paratrooper and hard as nails, wept. Pynn was startled. ‘To see the sergeant with the reputation as the toughest man in 3 Para reduced to tears was devastating. I went outside and sat under a tree with a brew. I had to recompose myself to deal with any further casualties that tonight might bring. We were expecting another attack and, if we were contacted, the guys would be hungry for revenge. This mission takes on a new meaning now. This is war. May the soul of Private Jackson rest in peace. I said a prayer for his parents and his girlfriend before putting this whole experience behind me to concentrate on what lay ahead.’

  In the sadness and the anger of Jacko’s death, the doctor felt a newly intensified sense of camaraderie for ‘this band of brothers’. As efforts were now directed to shoring up the defences of their ‘fortress’, the doctor took his turn filling sandbags for the sangars. ‘No job is too menial for anyone. It’s one big team, and everyone mucks in together. Some of o
ur guys were on the roof as an RPG whizzed overhead from the bazaar. It missed, but we returned fire with interest, as usual, and the starlit sky glowed with red and orange as mortars and artillery rained in on the bazaar and a few shops burst into flames, but probably long after our enemy had fled.’

  It was to be his last encounter with the hostilities for a while. He left the compound that had been his beleaguered home and hospital for eighteen long days and even longer nights. The Chinook climbed up and out over the hills of the Sangin valley, and he hoped he’d never return. Just twenty minutes later, they were back in Bastion – had it really been so close all along? ‘It was a relief knowing I was out of immediate danger and that I was going to be able to sleep without the prospect of being attacked. I realized how much weight I’d lost and how pleasant it was to be back on fresh rations. I also realized how angry and pent up with aggression I’d been.’

  A memorial service was held for Jacko, with three hundred sombre Paras crammed into the cookhouse to say their farewell. He would have been twenty today, Pynn remembered thinking. ‘Some people may find it curious that these tough guys turn to some sort of God in times of stress. But it’s not desperation. It’s a clinging to someone or something that may help them. They find it cathartic and comforting. All those hardened Toms were there, praying, because they’d lost a friend.’