‘Don’t be too hard on yourself, son. You’re doing okay. I’ll get on the net and ask them to hurry the fuck up.’ Partridge half-ran back to the radio operator to get him to give the Ops Room the good news.
Corporal Colin MacDonald — known universally as ‘Ronald’ for obvious reasons which was just as well as he hated the name Colin — unclipped his flying helmet from the cord attached to the side of the Chinook. It cut off his ability to talk to the helicopter crew but from what he’d just heard on the radio, they were about five minutes out from the landing site. Catching Adams's eye, Ronald pointed to the floor with one index finger and then held up his hand with his fingers and thumb splayed to indicate they were five minutes away from landing. He then looked across at Lizzie, and she gave him a thumbs up indicating that she’d seen the message. Colonel Nick, who was sitting next to Lizzie, also gave him a thumbs up, mouthing ‘five minutes’ to confirm that he understood.
Around them, Ronald watched the soldiers who formed the Force Protection team getting themselves ready, picking up their SA80 rifles and checking each other’s kit, buddy-buddy style. When they landed, they would be the first ones off the ramp to form a protective cordon facing outwards in a wide semicircle around the helicopter, closely followed by Lizzie and Adams. Not for the first time, Ronald thought how reassuring it was that if the shit hit the fan, there were quite a few well-armed people in between the medics running off the back of the helicopter and whatever or whoever it was that was making the shit hit the fan.
Ronald glanced out of the small rectangular window towards the ground; they were losing height fast. He knew what would happen next — the Chinook would lazily circle around the proposed landing site in a clockwise direction. This aimed the machine gun on the side window towards the ground, meaning that if there was a threat on the ground it could be dealt with. The only problem was that if Ronald knew how the helicopter was going to approach the landing site, then so did the insurgents on the ground.
A few thousand feet below them, Staff Sergeant Partridge heard the familiar sound of the Chinook in the distance. Slapping Rowley on the shoulder, he shouted to the rest of the platoon.
‘Right boys, the TRT’s incoming. Unless you want to tab back to the FOB, best we all climb on.’ Partridge wasn’t one hundred per cent sure that this was the best decision, as technically they should go back to the Forward Operating Base, but in the absence of any backup from them, they could fuck off as far as he was concerned. He could get his team back to Bastion and then get them back on one of the regular supply drops that went out pretty much every day to the FOBs. With any luck, there’d be a bit of a delay getting a lift back, and they could all have a spot of downtime and some relatively decent scoff. He waited until the black speck in the sky became the recognisable silhouette of a Chinook and pulled the pin on the smoke grenade before lobbing it into the middle of the field.
Ronald plugged his comms cable back into the side of the helicopter just as the pilot finished talking.
‘Say again,’ Ronald said, thumbing the switch so that he could be heard by the rest of the aircrew.
‘Two minutes out,’ the pilot repeated his message. ‘Smoke seen. We’re coming in hard over the top of the trees. No obvious threat, but get him in as soon as. No point hanging around.’
‘Rodger dodge,’ Ronald said before flicking the switch back again. He looked in the general direction of the rest of the TRT and held up two fingers in the air. No one acknowledged him this time; there was no need. A few of the Force Protection team shuffled their buttocks forwards on their canvas seats, getting ready to get up and go the minute they touched down. Ronald could see Lizzie struggling to get her latex gloves on. She finally managed to get the second glove on and was trying to pull the ends of the gloves down onto her fingers when Ronald tapped her on the shoulder.
‘You okay?’ Ronald mouthed at her as she looked up at him. She gave him a wan smile, looking grateful but annoyed at the same time. They’d talked through the first few jobs they’d been on many times, both agreeing that this was the worst bit of the whole shout. At least when they had a casualty or two in front of them they could focus on the wounded, but this part — before they had a casualty — was the worst. It was the unknown that was the difficult part — not knowing what was wrong with whoever they were going to pick up, not knowing if there was someone in the trees with a rocket-propelled grenade waiting to have a pop, and not knowing what was going to happen in the next few minutes. Ronald watched Adams as he moved across the back of the Chinook towards Colonel Nick. He gave a quick thumbs up to Ronald on the way. On the other side of the helicopter, Ronald saw Lizzie close her eyes and take a deep breath.
Lizzie watched from her seat in the back of the Chinook as the loadmaster lowered the ramp when the helicopter started to settle on the ground. Over the top of the noise in the back of the helicopter, she heard someone screaming, ‘FP! Go! Go! Go!’ Without any further prompting, the Force Protection team swarmed past the crewman, jumping from the ramp.
Fanning out into a perfect semicircle around the rear of the helicopter, they all went to ground and brought their weapons up into the aim, scanning both the immediate vicinity and the horizon for anything that looked as if it was remotely threatening. It was a well-practiced and effective manoeuvre, designed to show anybody in the area with less than honourable intentions that there was a whole bunch of well-armed, well-trained people ready to neutralise any threats quickly and without prejudice.
Lizzie coughed as debris, dust, and God only knew what rushed into the back of the Chinook, partially blinding the medical team despite the protective goggles over their eyes. With Adams right behind her, Lizzie moved down towards the ramp clutching a canvas stretcher with wooden handles that was good enough for the Cold War, so considered by senior officers — who’d never carried one in their lives — more than good enough for Afghanistan.
With Adams right behind her, Lizzie paused at the base of the ramp, waiting until some of the dust had died down and the FP team had got themselves into position. She turned around and looked back into the rear of the Chinook to see what the other two members of the TRT were doing. Colonel Nick was on his knees, getting an intravenous line ready, and Ronald was flicking at a syringe, probably a flush for a cannula, to get any bubbles out of it. As she watched, he put the plastic ampoule back onto the end of the syringe so that anyone who picked it up could look at the ampoule and instantly tell what was in it. If it was an Emergency Room back in the United Kingdom, before it was used the ampoule would be checked by at least two people, who would check the contents, the expiry date, and then sign and countersign when it was used with the exact details; but they weren’t in an Emergency Room, so it would just be used and binned.
Colonel Nick shuffled on his knees, and Lizzie noticed that he didn’t have any knee pads on, which was a fail on his part. Maybe no-one had told him how useful they were, though. She was currently on her fourth set in as many weeks, and her Mum was sending out a box with a bunch of knee pads from a local DIY store so that she had a decent supply. They didn’t last for long, especially when they got soaked in blood.
Lizzie felt a tap on her arm and looked around at Adams, who was nodding in the direction of the ramp at the loadmaster pointing away from the Chinook. As the dust started to clear, they stepped off the ramp and started moving in the direction that the crewman was pointing. Lizzie looked up to see a small group of soldiers dragging a casualty towards them. Holding on tightly to the stretcher, she crouched down and ran as fast as she could underneath the fast-moving rotors with Adams a couple of feet behind her. Fifty feet away from the helicopter, they reached clear air. Lizzie shouted at Adams above the noise of the helicopter as the searing air from the rotors and exhaust buffeted her arms and legs.
‘Must be a ground patrol caught in the open. They’ve not even got a stretcher between them.’
‘Medic’s front left!’ Adams shouted back. ‘I’ll talk to him; you have a
quick look at the casualty.’
Lizzie nodded as they set off towards the slow-moving group through the dry earth, their feet kicking up clouds of fine brown dust with every step. Even though she knew there was a bunch of lads behind her who were all very well-armed, this didn’t make her any less scared. Even though it probably wasn’t, it felt safe back in the Chinook. It was a thick metal shell around her, and the power in the engines was reassuring. Lizzie glanced back over her shoulder at the helicopter, sitting with its rotors spinning. Every step she took through the dust was a step further away from safety.
4
Adams and Lizzie were both exhausted by the time they reached the small group of soldiers, and Adams cursed under his breath at how hard he was blowing. Throwing the stretcher onto the ground, they helped the two soldiers who were trying to drag the casualty towards the helicopter manhandle their wounded colleague onto the stretcher. Kneeling down, Lizzie started quickly assessing their casualty, but Adams knew that she was only interested if he was still alive or not. A proper look would have to wait.
‘What have we got?’ Adams asked the soldier with a red cross on his arm.
‘Gunshot wound left shoulder,’ the young medic replied, glancing down at Adams's rank slides before raising his eyebrows and adding, ‘sir.’ It wasn’t the first time that a soldier on the ground had been surprised by an officer turning up, but at least this medic recognised the rank slides for what they were. He watched as the medic looked at Lizzie, hiking his eyebrows even higher as he realised she was female. ‘It was about forty-five minutes ago. He was okay at first, but he’s gone off on me. I don’t know why,’ the medic summarised. If they’d been in an Emergency Room doing a handover, the medic would be dressed down for such a glib handover, but given the circumstances, this was more than enough for Adams.
‘Okay, thanks,’ Adams replied. ‘Nice one. Lizzie? How’s he looking?’
‘Well, he’s breathing,’ Lizzie said, the strain obvious in her voice. ‘Apart from that, difficult to say.’ She slipped a pair of protective goggles onto the casualty to protect his eyes from the helicopter downdraft.
‘Good enough for government work,’ Adams said. ‘Right then, everyone got a corner?’ He paused to give Lizzie and the soldiers time to move to the handles of the stretcher and grab one each. ‘Okay, three, two, one, lift.’ As they lifted the casualty, he heard Lizzie moan and could feel the strain in his own shoulder. The stretcher was bloody heavy. He looked towards the helicopter which was only about a hundred yards away but could have been a mile. The team moved as quickly as they could towards the rear ramp, all of them anxious not to hang about for a minute longer than was necessary.
When they reached the rear of the Chinook, Ronald and the loadmaster both grabbed the front handles of the stretcher, freeing Adams and Lizzie up to get into the back of the helicopter and go up towards Colonel Nick who was waiting at the front with an oxygen mask in his hands. Adams leaned in towards the Colonel to shout in his ear.
‘GSW right shoulder. Forty-five minutes ago. Medic says he’s gone off.’ Colonel Nick nodded, unfurling the stethoscope from one of the pockets of his combat vest. The stretcher was unceremoniously dumped on the floor of the Chinook, and Colonel Nick knelt down next to it.
Adams pointed towards the rest of the casualty’s platoon, who had followed them into the back of the Chinook, and then pointed towards the webbed seats along the side of the helicopter to indicate where they should sit. As they shuffled onto their seats, Adams reached for the casualty’s dog tags to see what his name was. According to the sweat and blood covered silver discs, this was Private Thomas. He would be nineteen in a couple of months’ time.
In his peripheral vision, Adams saw the loadmaster grabbing the platoon radio operator’s rifle and turning it round so that the muzzle was pointing at the ground. If there was a negligent discharge for any reason, then at least the round wouldn’t go through the roof and into the engine of the helicopter. That was a lesson that had been learnt the hard way on more than one occasion. As the FP team got back on board the helicopter, Adams felt the helicopter start to shudder as the pilot pulled back on the collective. Adams steadied himself and grabbed onto the seat as the helicopter started to rise into the air.
Watched by Adams and the rest of the TRT, Colonel Nick slipped off the casualty’s helmet to make sure that his airway was clear and that he didn’t need any of the toys in the medical kit to stop him suffocating on his own tongue. Beside him, Ronald had the cuff of the automatic blood pressure machine ready and had already attached the clothes peg type clip that measured blood oxygen concentration to one of Thomas's fingers. On the other side of the stretcher, Lizzie was cutting the sleeve of Thomas's uniform from the wrist up to past the elbow, getting ready to put a cannula into one of his veins. The team worked methodically, each of them knowing what to do and what the others were doing, even though it was Colonel Nick’s first shout. It was no different to a trauma resuscitation in an Emergency Room back in the United Kingdom, apart from the fact they were in the back of a slow-moving helicopter that was almost certainly being shot at from the ground.
Adams felt a tap on his knee. Looking up, he saw Ronald pointing towards the screen of the medical monitor, where a small flashing digital display read ‘SaO2 82%’. An alarm on the monitor would be sounding, but none of them could hear it over the noise of the rotor blades above their heads. The reading wasn’t good — the casualty’s oxygen saturation was way too low. It should have read over 95%. Adams tapped Colonel Nick on the knee to make sure that he’d seen the reading, but as the Colonel was already fiddling with an oxygen mask, Adams figured he probably had. Ronald started squirting saline from a plastic ampoule onto some gauze to clean one of Thomas's other fingers, just to make sure that the reading was accurate, but the wave on the screen which showed the pulse looked clear, so it probably was. The wave on the screen started to wobble as the helicopter gained power, and the aircraft’s nose tilted downwards as the helicopter headed back towards Camp Bastion.
Adams looked up at the platoon to see them all staring at their wounded colleague on the stretcher. He could tell from the look in their eyes that they were all thinking the same thing — that could have been me. Adams's eyes locked for a few seconds with the oldest member of the platoon, a man who looked as if he’d seen it all before. They nodded at each other briefly before Adams turned his attention back to Thomas.
Major Robert Clarke hung up the red phone that connected the Emergency Room at Camp Bastion to the main base Operations Room. Unlike the phone in the TRT tent, this phone was red, and gave them a direct line to the Ops Officer who had been talking with the inbound helicopter. There was a similar, smaller, Ops Room in the hospital, but if there was a casualty on the way, then the hospital stood back and let the communication take place directly between the medical team and the main base Ops Room. There had been more than one argument about this in the past, but as the senior nurse running the Emergency Room, Clarke had managed to argue his case that information going from the main base Ops Room, through the hospital Ops Room, to him was one link too many. Especially when the Ops Officers themselves were junior officers with only a first aid course between them.
‘Listen in!’ Clarke shouted to the rest of his medical team milling about the Emergency Room. ‘We’ve got one Category A casualty inbound, ETA ten minutes. GSW to the chest, doesn’t sound too well.’ Pointing at one of the nurses in the room, he said, ‘Corporal. Can you start getting a chest drain kit ready please?’ The nurse nodded and moved towards the back of the Emergency Room to get the necessary equipment together.
Located right at the front of the hospital, the Emergency Room was in fact nothing more than a large tent, branching off the central corridor that formed the spine of the main hospital. Other branches included the radiology department which housed the x-ray machine, a small four bed intensive care unit, an operating theatre, and a couple of wards which could hold up to twenty patients each. Ot
her smaller tents linked to the same complex included a pharmacy, medical stores, and the hospital Ops Room which was nominally running the facility. The biggest problems that they had in the hospital, apart from the egos of one or two of the more senior medical staff, were dust and heat. Both of which were unrelenting.
Clarke swept his hands over his thinning brown hair and took a deep breath. Looking towards the door to the Emergency Room, he could see lots of people standing around, waiting. There had been an air of tension in the whole complex since TRT had deployed. Everyone in the hospital had heard the Tannoy — the ‘giant voice’ public address system that annoyed the entire hospital when it was used — requesting that Lieutenant Colonel Hickman return to the TRT tent, and the second much terser Tannoy a few moments later with the same message.
When word got out that this was a combat casualty, as opposed to a soldier with gut rot, the excitement started to grow. It was a bizarre paradox — the more seriously injured a casualty was the greater the anticipation among the medical staff. Clarke checked off in his head the people he wanted to see standing around. The radiographer was there, and he’d seen the Charge Nurse from the ITU a few minutes ago. She had since disappeared, no doubt back to the ITU to get her team sorted. A passing nurse had told him a few minutes ago that the surgeon had been woken up and was in the shower, no doubt singing while he scrubbed his nails — according to the nurse at least. Looking back towards his team in the ER, he was about as happy as he could be that they were all ready.
The reality was that Major Rob Clarke himself was not happy at all. This wasn’t an unusual state of mind for him though, so nobody else in the ER took too much notice as he well knew. In his late forties, a couple of stone overweight, and with a rapidly expanding area of bare skin on his head, he walked towards the back doors of the ER where one of the doctors, Squadron Leader Andrew Webb, was standing looking through the plastic window. When Webb had arrived in the hospital a few weeks ago, Clarke had taken an instant dislike to him, more so than he usually did with new doctors. Clarke had been working in Emergency Rooms since the Squadron Leader was still doing his GCSEs let alone going to medical school, and the nurse had seen people like him come and go. Rise and in many cases, fall when life — or the loss of it — took them down a peg or two.
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