by John Nichol
1. Eric Harden VC. This was taken in 1940 and sent to his wife inscribed, ‘To Darling Maude From Eric xx’
2. Eric Harden’s widow Maud and their son Bobby at the Victoria Cross investiture at Buckingham Palace, 9 April 1946
3. The telegram sent to Maud Harden informing her of Eric’s death, 29 January 1945
4. Thailand, August 1945. An emaciated British prisoner at the hospital camp at Nakhon Pathom. If the Japanese had not surrendered on 15 August he could have died within days
5. Jungle medicine in a bamboo hut lined with mosquito netting. One POW, Jack Chalker, made this drawing as a tribute to two legendary doctors: ‘Weary’ Dunlop (with moustache) and Jacob Markowitz. They never actually operated together, but they were loved by all their patients
6. Wounded soldiers arriving home from France in summer 1944. The evacuation teams had to make use of whatever transport facilities were available
7. British and Canadian forces help a wounded soldier in a forest clearing in the Nijmegen area, Holland, February 1945
8. Falklands, 1982. Surgeon Commander Rick Jolly during a TV interview with ITN journalist Jeremy Hands at Ajax Bay. Jolly had just told Hands about the unexploded bombs in the field hospital
9. 3 Para medical personnel treating Argentinian wounded at Mount Longdon. Captain John Burgess is on the right at the rear, with Private Kennedy holding the drip
10. Major Roger Nutbeem, who died aboard Sir Galahad, and his young daughter Kathryn
11. Kathryn Nutbeem, waiting to sing at the ceremony commemorating the 25th anniversary of the Falklands War in June 2007
12. Survivors of the Sir Galahad coming ashore at Fitzroy
13. A medical assistant at Ajax Bay field hospital applies Flamazine to a burned Welsh Guardsman from Sir Galahad
14. RAMC Medic Eleanor Dlugosz, killed by an IED in Iraq, 5 April 2007
15. Sergeant John Jones, killed by an IED in Iraq, 20 November 2005. Holly Percival was one of the first medics on the scene
16. Medics of 4 General Support Regiment provide medical attention to the father of a young Iraqi child, Basra, 2003
17. Colonel Tim Hodgetts briefs the medical team as casualties arrive after an incident in Afghanistan
18. British medics evacuate an injured Iraqi soldier from a forward operating base in southern Iraq, 26 March, 2003
19. RAF fire crews in Afghanistan race to a Chinook helicopter to help unload casualties as ambulances stand by
20. The MERT after an operation in Afghanistan. Flt Lt Damien van Carrapiett is third from left and Sgt Rachel McDonald is far right. The Afghan interpreter’s face has been disguised for security
21. Falklands, 1982 – the 2 Para Regimental Aid Post during the battle for Goose Green. The smoke is caused by burning gorse set alight during the attack
22. Afghanistan, 2006 – 3 Para doctor Captain Harvey Pynn treats the ‘wheelbarrow’ casualty during the battle at Now Zad
23. Falklands – the medical notes sheet from a casualty treated by 2 Para doctor Steven Hughes during the battle at Goose Green. The notes are clearly stained with blood
24. RAF Sergeant Rachel McDonald aboard the MERT helicopter in Afghanistan. Rachel was awarded the ‘Paramedic of the Year – 2007’ award for her courage during a mission to evacuate mass casualties from FOB Robinson
25. Private Holly Percival during her tour in Afghanistan, 2009. Holly was part of the medical team sent to the IED incident in Basra, November 2005, where Sergeant John Jones was killed
26. Iraq, March 2003 – an RAF medic tends to two British marines from 42 Commando after they were injured during the conflict. The Puma helicopter crewman keeps a constant vigil, checking for threats from the ground
27. Iraq, September 2005 – a soldier escapes from a burning Warrior during the incident at a Basra police station where two undercover SAS soldiers were being held captive
28. RAF Flight Sergeant Frank Mincher, far right, treating other casualties in an ambulance during the same incident in Basra
29. Troops under attack at the police station in Basra
30. Surgeon, Lieutenant Colonel Paul Parker attends to the ‘smallest casualty’ of his time in Afghanistan. Parker also operated on Sergeant Major Andy Stockton
31. Flight Lieutenant Andy Smith after an emergency evacuation mission in Afghanistan, 2009. Medical kit is positioned for easy access on his body armour
32. Andy Smith and the MERT in action in Afghanistan – this casualty was a Royal Marine with serious leg injuries
33. Sergeant Major Andy Stockton three days before the incident where he lost his arm in a firefight with insurgents in Afghanistan, 2006
34. Andy Stockton with his partner, Emma, following a parade where Afghanistan campaign medals were presented at the Royal School of Artillery, Larkhill
35. Lieutenant Colonel Paul Parker examines the remnants of Sergeant Major Andy Stockton’s arm after his evacuation from the battlefield
36. Corporal Stuart Hale with his sniper rifle before the mine strike at the Kajaki Dam, Afghanistan, 2006
37. Corporal Stuart Hale and Sergeant Stuart Pearson – both were injured in the Kajaki minefield incident
38. The Queen presents Corporal Paul ‘Tug’ Hartley with his George Medal. This was awarded for ‘his courage and complete disregard for his personal safety’ during the Kajaki Dam minefield incident
Glossary
A&E – accident and emergency department
ABC – airway, breathing, circulation
ADS – advanced dressing station
ANA – Afghan National Army
ATO – Ammunition Technical Officer (a mine-clearance team)
cannula – a needle for delivering fluids
casevac – to evacuate casualties
CAT – combat application tourniquet
CCP – casualty collecting post
CPR – cardio-pulmonary resuscitation
FART – Forward Advanced Resuscitation Team
FOB – forward operating base
Hesco – defensive blast walls, designed by Hesco Ltd
IED – improvised explosive device (a bomb)
Intel – Intelligence Corps
IPE – individual protection equipment
KIA – killed in action
MASH – Mobile Army Surgical Hospital
MERT – Medical Emergency Response Team
PTSD – post-traumatic stress disorder
OPA – oral pharyngeal airway
RAP – regimental aid post
REME – Royal Electrical and Mechanical Engineers
RPG – a rocket-propelled grenade
RSM – regimental sergeant major
NBC – nuclear, biological and chemical
SOE – Special Operations Executive
Spencer Wells – artery forceps
Tab – tactical advance to battle
TIC – troops in contact
UAV – unmanned aerial vehicle
Notes
Where a reference is given for an interview, book or document, that reference applies for the remainder of the chapter.
Preface
1. They weren’t the only ones to be impressed by the new stretcher. The equipment has now been tested in action and is due to become standard equipment, according to army sources.
2. Medical officer in conversation with JN, April 2009.
Part I: INTRODUCTION
Chapter 1: Saving Sergeant Major Stockton
1. JN interview, 2008.
2. Their detachment was part of OMLT, the Operations Mentoring Liaison Team, and consisted of men from various different regiments. Philippson, for example, was from 7 Parachute Regiment Royal Horse Artillery. Lawrence was from the Royal Army Medical Corps, had been sent to Afghanistan with 16 Close Support Medical Regiment and then been seconded to OMLT.
3. John Reid, then Defence Secretary, in a radio interview after authorizing the deployment of British troops in Afghanistan, explained that its purpose w
as to help reconstruct a Taliban-free country and to bolster the democratically elected Afghan government. ‘If we came for three years here to accomplish our mission and had not fired one shot at the end we would be very happy indeed,’ he said. This was generally taken as a reassurance that this was to be a relatively risk-free operation – though, to be fair to Reid, in the same interview he did also point out its dangers and complexities. ‘The terrorist will want to destroy the economy and legitimate trade and the government that we are helping to build up.’ It was the reassuring impression that the press chose to go with, and the consummate politician in Reid, if he believed that was wrong, did not rush to correct it.
4. JN interview, 2008, plus interview in Gunner magazine, February 2007.
5. JN interview, 2008.
6. JN interview, 2008.
7. Abbreviation for ‘casualty evacuation’, used as a verb.
8. JN interview, 2008.
9. Quoted in Combat Surgeons, John Laffin (Sutton Publishing, 1999).
Chapter 2: Inhumanity
1. ‘Tommy’, by Rudyard Kipling (1865–1936).
2. Combat Surgeons, John Laffin (Sutton Publishing, 1999) – the chief source for the historical overview in this chapter, for which the authors are grateful.
3. Ibid.
Part II: THE SECOND WORLD WAR
Chapter 3: Overwhelmed
1. Private and unpublished diary of Ralph Brooke. Supplied by his grandson, Tom Lenon.
2. See Chapter 12.
3. Medicine and Victory, Mark Harrison (OUP, 2004).
4. According to Harrison, ibid., twenty-five field ambulance units were deployed, plus fifteen general hospitals, convalescent depots and medical stores along the lines of communication. These were served by six ambulance trains and motor ambulance convoys, which were controlled by GHQ. Headquarters was also in direct charge of mobile laboratories, hygiene sections and casualty clearing stations (CCSs). The main medical base was at Dieppe, where there were several specialist hospitals and store depots.
5. ‘Ambulance at War’: Account by R. H. Montague. RAMC archive, Keogh Barracks. Box 70.
6. Doctor At Dunkirk, Ian Samuel (Autolycus Publications, 1985).
7. This process was described in the RAMC journal of December 1940 by Major R. S. Jeffrey. ‘All foreign bodies and all devitalized tissue must be removed, particularly muscle. The muscle is cut away until it contracts under the scalpel and is bleeding healthily. Nerves and large blood-vessels are saved if possible, and the infected tissues surrounding. Then dissected off. Fragments of bone which no longer have a periosteal attachment are removed. A minimum of skin is removed, for skin resists infection well and will look after itself. Usually all the skin that needs to be removed is one-eighth of an inch from the wound edge, and this allows approximation without tension, which is so important. As few ligatures as possible are applied to bleeding points, using the finest catgut. In dealing with large nerves that have already been divided, it is a moot point whether one should attempt suture, or simply tie the ends together with silk with a view to making subsequent search for the nerve easier.’
8. Medicine and Victory, Harrison.
9. Private memoir. Captivity, Trevor Gibbens. Museum of the Oxs and Bucks Light Infantry.
10. Private account. RAMC archive.
11. It was in fact just over the border in Belgium.
12. RAMC journal, LXXVI, February 1941.
13. Such as Major L. J. Long – his memoir, RAMC Archive. Box 70.
14. IWM (Imperial War Museum) archive. Also Dunkirk, Hugh Sebag Montefiore, Viking Penguin, 2006.
15. Sebag Montefiore, ibid.
16. Private memoir. Before I Forget, W. Simpson. RAMC Archive. Box 70.
17. Simpson went into captivity and was indeed repatriated. But not until 1944.
18. Diary of Captain M. J. Pleydell, IWM 90/25/1.
19. Second World War Experience Centre, Leeds. Tape 1601.
20. Sebag Montefiore, Dunkirk.
21. ‘Dunkirk Diary’, published in the British Medical Journal, 1990. Doll was to become one of Britain’s most eminent medical experts after the war. His research demonstrated the link between smoking and lung cancer.
22. Estimated at around 14,000.
23. IWM 76/30/1.
24. Journals of Keith Vaughan (John Murray, 1989).
25. Combat Nurse, Eric Taylor (Robert Hale, 1999).
Chapter 4: Bamboo Surgeons
1. A Doctor’s War, Aidan MacCarthy (Grub Street, 2006).
2. Private publication. The Lost Years, George R. Temple, 2005.
3. ‘Massacre and Rape in Hong Kong’, Charles Roland, Journal of Contemporary History, January 1997.
4. Ibid.
5. Singapore Burning, Colin Smith (Viking Penguin, 2005).
6. Major Corbitt, RAMC archive.
7. After the war, it became the QARANC – the Queen Alexandra’s Royal Army Nursing Corps.
8. The Will to Live, Sir John Smyth (Cassell, 1970).
9. Smith, Singapore Burning.
10. Her story was corroborated by Stoker Ernest Lloyd, who had been shot in the massacre of the men further along the beach but survived by diving beneath the water.
11. Medicine and Victory, Mark Harrison (OUP, 2004).
12. Much of the detail in this section is from Surviving the Sword, Brian MacArthur (Time Warner, 2005).
13. Lieutenant W. W. Tilney, quoted ibid.
14. Lieutenant Colonel Cary Owtram, quoted ibid.
15. His account on www.cofepow.org.uk
16. The husks, which contain thiamine (B1), had been removed, leaving just the solid, indigestible grain.
17. Saliva breaks the rice down into sugar, which in turn encourages the growth of yeast.
18. The Secret Diary of Dr Robert Hardie (Imperial War Museum, 1983).
19. Ibid.
20. War Diaries of Weary Dunlop (Nelson, Australia, 1986).
21. Survival through Faith in Adversity: The Wartime Diaries of Joe Blythe, supplied by Cedric Blythe.
Chapter 5: Desert Doctors
1. Scars of War, Hugh McManners (HarperCollins, 1994).
2. Together We Stand, James Holland (HarperCollins, 2005).
3. See Chapter 3.
4. He was awarded an OBE, the Military Cross and bar and the Distinguished Service Order.
5. A Doctor at War, Matthew Hall (Images Publishing, Malvern, 1995).
6. Wartime diary of R. K. Debenham. RAMC archive.
7. Front-Line Nurse, Eric Taylor (Robert Hale, 1997).
8. Diary and letters of Captain Malcolm Pleydell. IWM MC 90/25/1.
9. A Health Memorandum for British Soldiers in the tropics spelt out the gruesome details. ‘The dysentery germs leave the sick man in his excreta (urine and dung). Flies feed on the excreta and pick up some of those dysentery germs. The infected flies feed on some cooked food and leave some dysentery germs in the food. A healthy man eats that food and those germs. The germs now attack his intestines and make him a case of dysentery. He in his turn passes out dysentery germs which are taken in by some other healthy person in the same manner.’ – quoted in Medicine and Victory, Mark Harrison (OUP, 2004).
10. Surgeon At War, Lieutenant Colonel J. C. Watts (George Allen & Unwin Ltd, 1955).
11. General Sir Ronald Adam – quoted in Harrison, Medicine and Victory.
12. Ibid.
13. Mansion House speech, November 1942.
14. Taylor, Front-Line Nurse.
15. Hall, A Doctor at War.
Chapter 6: Stout Hearts
1. Lieutenant Colonel G. A. G. Mitchell, adviser to the RAMC, in A Guide to Penicillin Therapy, 1945.
2. Combat Nurse, Eric Taylor (Robert Hale, 1999).
3. Margaret Jackson Browne, quoted in Front-Line Nurse, Eric Taylor (Robert Hale, 1997).
4. Quoted in an article entitled ‘If your man is wounded, this is how they care for him’, in the Evening News newspaper, and in Medicine and Victory, Mark Harrison (OUP, 2
004).
5. Personal diary – family archive. The authors are grateful to the late Dr Helm’s family for permission to quote from it.
6. ‘First-aid for Fighting Men’, RAMC archive.
7. Brigadier E. H. Lessen, commander of No. 21 FDS, 5 Beach Group, quoted in Harrison, Medicine and Victory.
8. See Chapter 3. Second World War Experience Centre, Leeds. Tape 1601.
9. Personal Wartime Memoir of Major Charles E. Tegtmeyer, Medical Corps Regimental Surgeon, 16th Infantry Regiment, 1st Infantry Division. Surgeon-General’s Office of Medical History. www.history.amedd.army.mil /booksdocs/wwii/Normandy/Tegtmeyer/ TegtmeyerNor mandy.html
10. Tests had shown they had no serious adverse side effects, according to Harrison, Medicine and Victory.
11. Ibid.
12. All Spirits, John Vaughan (Merlin Books, Devon, 1988).
13. The Pegasus bridge, as it became known thereafter, taking its new name from the emblem of the airborne forces.
14. Surgeon At War by Lieutenant Colonel J. C. Watts (George Allen & Unwin, 1955).
15. Red Devils, by members of 224 Parachute Field Ambulance. Private memoir. RAMC archive.
16. The Doctor’s Story, David Tibbs. Private memoir. RAMC archive.
17. From daily entries in the army book of Colonel Cyril Helm of the King’s Own Yorkshire Light Infantry. Private collection.
18. Quoted in Harrison, Medicine and Victory.