Knife Edge: Life as a Special Forces Surgeon

by Villar, Richard

  One must be patient to deal with worms, especially the guinea worm infesting our storeman. Like the creeping eruption, this is to be found just beneath the skin. A small lump appears, then a hole, then the worm sticks out its head. Somehow it never appears when you want it. Like a watched pot, you can sit for ever looking at the hole with nothing happening. The beast must be coaxed out. In the storeman’s case, I covered the hole with an antibiotic ointment. This distresses the worm sufficiently to force it further out than it would normally wish to go. As soon as a decent length of worm has appeared - they can be several inches long - you stick its head to a piece of sticking plaster. Once firmly stuck, its body is then wrapped around a matchstick, the stick being turned 360 degrees each day. Slowly the entire worm will be pulled free. It is important not to break the beast’s body as the piece that stays behind will fester and become infected.

  Worms are usually little more than a nuisance, though if you are trying to remain motionless in an ambush position, the last thing you need is a creeping eruption irritating your leg. Occasionally they can be life-threatening. Some migrate to the lungs and stay there. The patient may be unaware of their presence. At worst he might have a mild, dry cough. Give that patient an anaesthetic to treat a major illness or gunshot wound and before you know it the worms break loose and clog the breathing tubes or airways. Obstructing a patient’s airway is a killer - I have seen it happen. It was for this reason I insisted jungle troops were dewormed before returning to Hereford, just like household pets. Many different medicines exist to do the job, some good, some not so good. My favourite was Alcopar, little granules delivered in a small sachet. It tasted filthy, but was effective. The only way to ensure my patients took it was to promise a tot of whisky to wash the granules down. They might arrive home drunk, but they were at least parasite-free.

  My function in the Far East was to keep the operatives fighting fit. Unfortunately there was one operative who did not do particularly well. I am ashamed to say it was me.

  It began as soon as I arrived. Having settled Jock’s centipede bite, I spent the remainder of the first day erecting my A-frame. The A-frame is a permanent, home-made jungle shelter. Designed from carefully cut wooden logs, it comprises a hammock, built-in food store and rifle support. Everything is kept off the ground, the whole arrangement being covered by a waterproof poncho. I say waterproof, but the daily jungle rain can penetrate almost anything. Certainly a standard Army poncho leaks like a sieve. The experienced jungle bunnies make their own from impermeable material, the kip sheet, normally used for lining nuclear fall-out shelters. Even the kip sheet can leak jungle rain on occasion.

  That first night I slept like a log, waking at dawn to hold my sick parade. There was only one patient - me. Something had decided to make a feast of my right eye, though I had not felt a thing. As a result my eye had puffed up like a football in such a way that I could hardly see. I did my best to put on a brave face. I was not in pain, so coped with sorting out the Squadron’s other medical conditions as best I could.

  The next day the same thing happened again, though this time affecting my left eye. That, too, swelled up enormously. As the Squadron commander highlighted, I now looked more like a moth than a soldier. Trying not to be downhearted, I volunteered to join a patrol into the surrounding jungle. The object was to identify the various tracks and paths, and to make sure we were alone. It was hot, and very humid, so I patrolled with my sleeves rolled up rather than down. That was a mistake. We had gone barely fifty yards, creeping our way forwards with me in the rear, when I scraped my right arm against a rough, irregular tree trunk. Immediately, almost within seconds, my arm began to swell. Not to be outdone, it appeared, my other arm, and then my cheeks, began to swell in sympathy. In a very short time I was stranded like an inflated whale in the heart of the jungle. Huge, swollen arms, puffy cheeks, bulging eyes. It was impossible for the operatives to take their task seriously as they delivered their doctor back to his A-frame, looking more like a Michelin man than a human being.

  I now know that a small jungle fly, with a predilection for eyeballs, had caused one part of my troubles. My swelling arms had been in response to an allergy against a variety of jungle tree. At the time I was worried, not fully understanding what was happening. As soon as I realized I still felt healthy, despite looking very odd, I relaxed. Slowly my various swellings settled and within four days I had recovered. The Squadron loved it. Each morning they would meet, the so-called Orders or ‘O’ group, to discuss the activities of the day. Their prime concern, and a source of high amusement, was not patrolling tasks or ammunition supplies, but what illness their doctor had today acquired. I think they were rather disappointed when I returned to peak fitness.

  Insects and allergies were not my only enemies. The jungle contains many different four-legged animals, most of which steer clear when they know mankind is around. There are exceptions. Late one night I was woken by the sound of scratching metal, very near to my A-frame. It was probably no more than three feet away. Before going to sleep I had made myself a chocolate drink, consumed it in one gulp and left the metal mug on the jungle floor. That was a mistake. Something fancied the dregs and was using its claws to scrape up the chocolate. I was petrified, but could see nothing. The jungle at night is as black as it gets. There is the occasional fluorescent leaf, but otherwise you are unable to see anything at all. Whatever it was, I realized it had sharp claws and was likely to make a meal from me as soon as it had finished the chocolate.

  As quietly as I could, I reached for the M16, perched on two forked sticks beside me. Slowly, I swung it round in the direction of the scratching and flicked off the safety. The clunk of metal echoed through the jungle night as I did so. Immediately the scratching stopped. The animal had heard me, or perhaps sensed me. I imagined it looking around, well able to see in the darkness. I, of course, was completely blind. Then I felt its breath against my cheek. It was a warm, forceful, powerful breath now only inches from my face. I could not shoot. So black was the night that I could easily have shot myself, or a colleague, by mistake. I had no idea in which direction my rifle barrel was pointing. Then the breathing stopped. I sensed that whatever it was had begun to look around him. The next thing I knew, or felt, was a large, reverberating shudder as the beast leapt on to my A-frame. It had obviously spotted my food store and was aiming for that. I had tolerated enough. Against all standard operating procedures, SOPs, I threw my M16 to the ground, grabbed my machete from under my head and flicked on my torch. There it was, the beast in question, rifling through my valuable food supply. A large, very startled, civet cat. As I lunged at it with the machete, nearly amputating my foot as I did so, it snarled and ripped a large hole in my hammock with its claws. Instantly it disappeared into the night, leaving me shaken and blinded by my own torchlight.

  Added to my various illnesses, the Doc’s adventures with the civet cat went through the Squadron like hot gossip. For those who had doubts about the jungle themselves, my misfortunes provided added strength. I was not the only one to suffer, I was pleased to learn. Perhaps the civet had made the operatives more aware of jungle wildlife, perhaps not, but Jack S had one very worrying night indeed.

  Jack was a thin, wiry man, highly expert in CRW, counter-revolutionary warfare. Most of his SAS life had been spent in civilian clothes, trying to blend with the background scenery as best he could. He certainly did not look like the archetypal SAS man. His time in the Far East was to update him in more traditional SAS soldiering techniques. Heavily decorated for his part in a variety of covert wars, nothing could rattle him. Until that night, of course. The night following his return from near the border.

  It was 2 a.m., pitch black and totally silent as he lay in his hammock. Around him, well hidden and tactically positioned, were the other three members of his patrol. As he awoke, Jack knew he was not alone. On his chest he felt the smooth, coiled body of a snake. It was stationary, lying motionless as his chest rose and fell with breathing. Jack
was horrified. He knew he could not move. If he did so, with the snake only inches from his neck, he was sure to be bitten. He had to summon help.

  ‘Pssst!’ he went. ‘Pssst! Pssst!’ trying desperately to wake his colleagues for help. ‘Pssst!’ He was sure the snake shifted slightly in position when he made the noise and could feel his heart thumping uncontrollably in his chest. He was surprised how warm the animal’s body felt, having never been so close to a snake before. He could feel his hands become wet and clammy, his mouth dry. Worse still, he wanted to pee, though knew it was anxiety that made him feel it. ‘Pssst! Pssst! Pssst!’ Still no answer.

  Jack lay there until dawn, four hours later, frightened rigid. He could barely breathe and could only urinate by wetting himself. All it would take would be one unexpected movement, the snake would startle and that would be it. He would have to wait until his colleagues awoke, or pray the animal moved on. The more he silently begged it to depart, the more it remained committed to stay. As first light began to appear and the tips of the huge trees turned from black to grey, he tried again. ‘Pssst! Pssst!’ This time he was successful. Lofty, the patrol signaller, sleeping ten metres away to his right, awoke. ‘What’s the matter?’ he inquired, his voice a loud whisper.

  ‘For ****’s sake get this thing off me,’ replied Jack, still not daring to move. Lofty peered through the gloom towards his friend, though could not make out the problem. Quietly, he slid from his hammock, knife in hand, to see what he could do. Getting closer he, too, could make out the grey cylindrical shape coiled on Jack’s chest.

  One could never fault the SAS for indecision, even when faced with problems completely outside their experience. Lofty leapt firmly into action. Grabbing his jungle blanket, he dived across Jack’s chest, seeking to smother the animal before it could retaliate. He braced himself for a ferocious fight, aware that some jungle snakes could struggle harder than a man. It was as he landed across his friend, as the entire hammock collapsed to the ground, that he realized what it was. No snake at all, but a camouflage face veil coiled neatly and tidily on Jack S’s chest. Somehow it had slipped downwards from Jack’s neck as he slept. The jungle can certainly play wonders with the imagination.

  Not everyone was as resilient as Jack or Lofty. For some, the psychological strain of jungle service was more than they could take. The Army has long recognized the mental stress created by long periods of isolation in such a cramped, low-light, diseased environment. Psychologists were even attached to the SAS at one point, to analyse the effects of the jungle on the human mind. The SAS survived, the psychologists did not, having to be treated for stress once back in UK.

  I had one psychiatric casualty in the Far East. Mick, a most unlikely individual for such problems. I had not realized, but he was obviously a man who kept his feelings bottled in. Not one to join in the general banter of SAS life, the continual teasing and cajoling that goes on between men used to long periods away from society. One of his patrol called me to see him in the early morning, several weeks after the incident with the civet cat. I found him lying, rigidly still, in his A-frame. ‘I can’t take it, Doc,’ Mick whispered. ‘I thought I could, but I can’t. I’m feeling all shut in. I’ve got to get out.’

  I had never considered claustrophobia, a fear of confined spaces, to be a problem in the jungle, but with Mick it obviously was. We were so deep within the rainforest I could see how it might happen. The nearest clearing was fifteen kilometres away, the trees tightly packed and tracks non-existent. Progress on foot was painfully slow: 100 metres per hour was considered speedy.

  In the UK I would have given Mick several days’ sick leave and sent him home. Such a course was not open to me now. I tried talking him out of it and for a moment thought I had succeeded. After two hours of quiet counselling he appeared to relax. However, the moment I turned to leave, he grasped my wrist firmly. ‘Don’t go, Doc,’ he pleaded. ‘Don’t go.’ Cruel though it may sound, with an entire Squadron to care for there is a limit as to how long you can spend with one man. I tried counselling again, feeling Mick relax once more. Yet, as soon as I tried to leave, my wrist was clasped tightly. Eventually, the only way of solving the trouble was to sedate him, first by injection and then by tablet. Sedatives are an essential part of any SAS doctor’s toolkit. However controlled and well-trained an operative may be, anxiety always lurks around the corner. Particularly so after gunshot wounds, when a sedative can be life-saving. The Army is well aware of the psychiatric effects of remote and active service and takes such things very seriously. Training for its doctors is now quite detailed. I put Mick to sleep for the best part of two days, just as the Americans did for their battle-stress victims in Vietnam. It cured his trouble, but I could not allow him to stay with us once he awoke. Next time he might not have a controlled breakdown, but an uncontrolled one. That could lead to anything. I thus recommended that Mick be evacuated as soon as possible, waving farewell to him as he was winched to safety by a hovering Huey. I never saw him again. By the time we returned to Hereford the Regiment had discharged him, returning him to his unit. There is no space for those who cannot take it in the SAS.

  Returning from the Far Eastern jungle, it was traditional to pass through Hong Kong. At that time, Chinese handover was barely considered, the colony concentrating largely on money-making and enjoyment. It was a wonderful place to be. Particularly for SAS operatives who had been stranded in deep jungle for several months. For the single ones amongst us, doctors included I am afraid, thoughts tended to veer towards the opposite sex. I love my male colleagues, but not in any sexual way. Three months, surrounded by damp and trees, in the company of smelly, unshaven masculinity, does little for male hormones. I had heard that Macau was the place to go. Not only could one gamble, but the Portuguese colony was full of massage parlours. Having received my Dear John letter there was little reason to hasten home, so I decided that Macau it would be.

  Having clambered from the hydrofoil that plies between Hong Kong and Macau, I immediately started searching for a massage parlour. I did not have to look far. The place was stuffed with them. ‘Special Massage’, ‘Total Massage’, ‘Heavy Massage’, ‘Massage With Relief’, were signposted everywhere. I did not understand this strange, new massage language. Guide books were understandably unhelpful.

  Confused, I eventually narrowed my search to one tiny street and three adjacent buildings in particular. Each was a massage parlour and each looked equally attractive. Or disreputable, if you see things in such a way. The choice was impossible. How does one select these things? Eventually I went for the one with a flashing, neon arrow, pointing obliquely downwards at the parlour’s open glass front door. ‘Extra Massage’ it flashed. ‘Extra Massage’ sounded ideal — so in I went.

  The parlour was everything I expected one to be. Behind the stained Formica reception desk sat a full-breasted creature, gorgeous in every outline, filing her nails. Her long black hair curled gracefully over her shoulders, her smooth, crossed legs exaggerated by the tiny red skirt. I doubt she spoke English, or if she did made no effort to communicate. Chewing visibly and obviously on gum, she indicated briefly a wooden panelled door to one side of her desk. ‘Please Enter’ was stencilled in several different languages near its top. I nodded my appreciation, now feeling almost sick with anticipation, as I entered this very unfamiliar world.

  Closing the door behind me, I could see the narrow corridor leading away to my front. To each side were several curtained cubicles. All were drawn closed, save one at the far end on the right. Its striped orange drape lay wide open, beckoning me to enter. Tentatively I walked the short distance to the vacant cubicle, passing the closed curtains as I went. From behind each I could hear the sound of female giggling, or grunting. The air had that distinct smell of bodily sweat. This, I thought, is definitely it. This is ‘Extra Massage’. This is what happens when you receive a Dear John after three months in the jungle. Quickly, and silently, I followed the faded English instructions on the sign above the
cubicle’s black, vinyl couch. ‘Remove your clothes and lie down,’ they proclaimed.

  ‘Remove my clothes?’ I thought as I stood in my underpants. All of them? Every stitch? I looked around briefly in the hope there might be someone to ask. Though I was surrounded by grunting and giggling, by many obviously satisfied customers, there was no one I might disturb. Anyway, it was obvious, I thought. Stop being so damned timid, Villar. You’ve travelled thousands of miles for this. So, with one swift move of my hand, I removed my underpants and lay face down on the icy couch.

  As I lay prone, head in my arms, listening to those around me, I began to think. This was unquestionably a first experience. Life, after all, was a matter of gaining new experiences, was it not? Even so, I was starting to worry. Maybe this was not such a good idea. No one from the Regiment knew I was there, my girlfriend had shelved me and my parents thought I was still safely ensconced under military control. Anything could happen and no one would know. Mugging, murder, Heaven knows what. Then there was VD. God help me if I caught that. I had treated it dozens of times in my medical life, in all manner of individuals. Syphilis, herpes, molluscum contagiosum, Vietnam Rose - one diagnosis after another flashed past me. I began to feel sick, unfolded my arms and gripped the sides of the slippery couch firmly. I needed strength. Then, as I began to relax once more, a wave of doubt flooded back over me. Like the night I nearly failed 21 SAS Selection, I knew I had to escape. I had to get off that mountain, I had to get off that couch. It was a ridiculous idea anyway. I should know better. What on earth was I doing here? The sound of giggling and grunting disappeared into the background as I now concentrated entirely on my predicament. It was time to leave.