Medic: Saving Lives - From Dunkirk to Afghanistan

by John Nichol

  *

  ‘S’arnt major, we’ve got you a truck!’ Here at last was the shout Andy Stockton of the Royal Artillery had been waiting for. It was his Hawk that had gone down in the desert and prompted an operation now escalating by the minute into a pitched battle. A simple recovery mission had spiralled into two firefights, one dead officer, badly wounded soldiers. And it was not over yet. Four men from his own detachment – ‘one of them younger than my own son’ – had gone in the first search party and were still out there. A professional soldier for fifteen years, intelligent and well informed, he had feared this eventuality ever since arriving in Afghanistan – not for himself but for the young recruits under his command. He had never bought into the idea that this could be a campaign in which not a single shot would be fired.3 He knew all about the toughness of Afghan guerrillas. For a promotion exam, he had researched and written a paper on the mujahedin resistance to the invasion by the Soviet Union in the 1980s. The superpower had been worn down and eventually kicked out. ‘I had a good idea of the sort of people we were up against. Fighting was their bread and butter. I knew what they were capable of.’4

  He had known too, as his artillery unit trained for Afghanistan with grenades and ammunition usually reserved for combat troops, that the Hawk’s limited radio range meant they would be operating, if not on the front line, then as close behind it as to make no difference. ‘We heard rumours that 16 Air Assault Brigade, to whom we were attached, were packing enough body bags for losses of one in six. So we didn’t scrimp on first-aid training! At FOB Robinson we were nearer the front than artillery men ever expected to be. But the lads loved it. We felt as though we were manning an outpost of the Empire in the early 1900s. It was real soldiering. Even so, I never expected to be fighting with an enemy just a few metres away.’

  The day the Desert Hawk was lost it was being used to observe ferry crossings on the Helmand river during the Sangin evening ‘rush hour’, monitoring which vehicles were using them and where they headed when they got to the other side. ‘We could see it going down on our screens and we knew exactly where it was. We had its grid reference.’ Nothing seemed easier or more routine than recovering it. And then everything turned pear-shaped as the search patrol was ambushed – ironically, at one of the very crossings the Hawk had been spying on – and then the rescue force. Stockton felt helpless – and guilty. ‘These guys were under fire, and I’d sent them out there. I felt really responsible. I should have been out there with them.’

  He pleaded with the ops officer to be allowed to go with the second rescue force that was now assembling at top speed at the gates of FOB Robinson. ‘At first he ordered me to remain behind and to prepare to receive any casualties when they returned. But then he changed his mind. They needed anyone who could be spared, and I got that shout I had been so desperate for. So off we went. Such is fate!’ He was apprehensive as the convoy of five heavily armed Land Rovers and two American Humvees drove out into the desert night and on into the outskirts of Sangin. ‘I had always wanted to see action. This was what I had joined for. But there was still a knot in my stomach.’

  They moved slowly down a track so narrow it was impossible to turn or to reverse. On one side was an irrigation ditch, on the other a canal. On the far bank, trees were clearly visible in the moonlight, but there were ominous dark shadows between them, ideal hiding places for ambushers. They came to a halt by a bridge, watching silently in a limbo of apprehension, the uneasy stillness before the storm. ‘Movement front right!’ yelled a voice through the radio receiver in Stockton’s ear, and he heard the loud woosh of an RPG rocketing from the other side of the canal. He hurled himself out of the vehicle. ‘Bullets were going across our heads and tracer was flying out into the night. Our top-cover gunners blazed back. I crouched behind the bonnet of my Land Rover, saw people through my sights running alongside the canal and opened up on them.’ His fear was gone. He was in his element, the adrenalin pumping through his body, his heart thumping with excitement. ‘There was a lot of fire going down, and it was really noisy. I was shouting orders at the guys and radio messages were pouring into my ear.’ The last of these was another urgent warning – ‘Movement rear left… Contact rear left!’

  Stockton swung round to the back of his vehicle, trying to spot where this fresh enemy attack was coming from. He saw nothing, turned back to the Land Rover, ‘… and I felt a blow to the upper part of my left arm – as if somebody had hit me hard with a sledgehammer.’ An RPG had struck him. Amazingly, it had not exploded – if it had he would have been dead – but the force of it threw him to the ground. ‘I had no idea I was injured until I rolled over, reached for my arm and it wasn’t there. I had grabbed the stump, which felt like a piece of warm, sticky steak. I knew straight away my arm had gone.’ He managed to haul himself off the ground, ‘and what was left of my arm came up with me, dangling on a thread of tissue. There was not much pain, just a dull ache. I could see the grenade, lodged in the side of the Land Rover, its tail protruding. My first thought was how lucky I had been – another couple of inches and it would have been my chest, and that would have been goodbye! Then I realized blood was spurting everywhere and I knew I had to act fast if I wanted to stay alive. I shouted into the radio: ‘ “I’m down! MEDIC!!” ’

  *

  A thousand miles and four and a half time zones away, it had been a sweltering summer’s day in England. Stockton’s girlfriend, Emma, spent much of it on a lounger in the garden of their house in Wiltshire, playing with their Westie dog. In the evening, for some reason, she found herself reading through the pile of ‘bluey’ airmail letters they had sent to each other in the three years they had been together. She was ‘Army’ too. They had served together in Iraq during the first phase of the invasion, she as the military clerk in his battery and one of just a handful of British women in the entire operation. ‘I ended up being everyone’s mother, auntie, sister, someone that they can tell their troubles to and confide in.’5 She left in 2004 when her tour was up. ‘I’d done four years in the army and I was ready to move on. I was in a relationship with Andy and we’d bought a house in Wiltshire. He had another four years to go and then the world would be our oyster – we could travel, or start a family, whatever we wanted.’

  Afghanistan stood in the way of her dreams. They both knew it was going to be a tough mission, the intensity of the pre-operation training indicated as much. ‘He told me: “Where we’re going, it’s going to be bad.” We talked about the worst, if he didn’t come home. He went over his will with me. We were both realistic and practical. You have fears, of course, but there’s no point in voicing them.’

  They talked on the telephone, and emailing was an easy option, but both of them preferred to communicate the old-fashioned way with handwritten letters. ‘They take a little bit longer, but they’re more personal, aren’t they?’ Their whole life together was measured in ‘blueys’. These had been their main form of communication even when they were in Iraq together. ‘It was difficult to have a proper relationship out there,’ she explained, ‘so we’d write to each other and leave the letters on each other’s desk, or even post them in the internal mail to each other. So that evening I was sat out in the garden and reading all the ones he’d ever written to me. I was thinking about him…’ She didn’t know it but ‘the stark reality of war’ (as Gary Lawrence had put it) was about to change her life for ever.

  *

  As the blood flowed from his shattered arm, Stockton pinched the artery underneath to try to staunch the flow, ‘squeezing for all I was worth’. Surprisingly calm and practical in the circumstances, he yelled to his stunned driver to find something to tourniquet the stump. In training, they had been given new instructions about the use of tourniquets. For years, doctors, both military and civilian, had gone round in circles of debate about this most fundamental of first-aid techniques. Tourniquets were disapproved of (if not actually banned) in general medical practice and in hospital Accident and Emergency depart
ments because, if applied too rigorously or for too long, they could starve limbs of blood, causing serious long-term damage and leading to unnecessary amputations. But a battlefield had different priorities, as RAMC doctors had come to appreciate. ‘Tourniquets had been off the map for a long time,’ said Stockton, ‘but now we’d been instructed that the benefits outweighed the risks. They were life-savers.’

  The sergeant major’s life certainly needed saving. A traumatic wound like this could kill, and quickly. ‘But my driver could find nothing to tie round my arm so I told him to help me back into the Land Rover in case the convoy started moving again. The bottom of my arm was hanging on by a sinew, and I placed it on my lap. As he climbed over me into the driving seat, I remember yelling at him to watch out in case he broke the fingers of the hand, as if that mattered any more. Then I tried to shut the door, and my arm fell off my lap and was hanging down. It got trapped, so I picked it up and placed it between my knees to keep it out of the way.’ Another soldier appeared from the back of the Land Rover holding up a ‘Plasticuff’ he had found, a loop of thin plastic normally used like handcuffs to restrain detainees. He tied down Stockton’s shattered arm with this, leaving the sergeant major’s other hand free to grip his rifle, jam it into his armpit and prepare to shoot anyone who came too close.

  For what seemed an eternity, they remained stationary while gunfire continued to crackle all around them. Then the order came to drive on and they lurched forward, but the gunfire followed them, as fierce as ever. ‘We were being pursued, and the situation looked pretty dodgy. The RPG tail was sticking out of the shattered window and I worried that it might detonate.’ He stuck his foot hard against it just in case. It was then, as they drove on down the narrow track, that real pain first began to kick in. An increasingly dizzy Stockton cracked a few tasteless jokes at his own expense, anything to take his mind off the agony of his arm. ‘I suppose this means I’m going to have to cancel my guitar lessons,’ he grunted. They crunched to a halt again, and seconds later he saw a breathless Gary Lawrence at the window, un-slinging his Bergen.

  The medic had been in the second vehicle in the rescue convoy, sitting behind the driver. The seat next to him, he remembered all too vividly, was still covered with Captain Philippson’s blood. ‘We were going along by the canal when suddenly it all kicked off. I saw a fizz of orange light and the streak of an RPG coming across the back of us. It hit a wall and exploded. “What the fuck’s going on here?” I thought. Then I realized we’d been ambushed and we were in a real battle.’ Almost immediately, he heard the call for a medic. There was a casualty in one of the vehicles behind. ‘I had to get to him. I could hear the gunfire and see the tracer, but it didn’t seem to register. My job was to get to him.’ He had worried about this moment of truth. To his relief, the training and the adrenalin kicked in together. ‘I didn’t have time to be scared,’ he remembered. He dropped out of the Humvee as the furious firefight raged around him. But the track was so narrow and the American vehicle so wide he was pitched straight into the canal.

  It was fast-flowing and the only thing that stopped me being carried away was that my Bergen got caught on the Humvee. I dragged myself up and started heading back along the convoy. I’d gone about 20 yards when the vehicles began to move again, leaving me out in the open. I sprinted back and jumped in. The convoy halted again and I was out once more, dashing the longest 40 yards of my life, being fired on from all directions, until I got to Andy Stockton’s Land Rover. He was holding his arm in his lap. A dark, wet patch was seeping out around it. He wasn’t totally with it.

  The dazed sergeant major was alert enough to register Lawrence’s arrival and feel the sense of relief all soldiers seem to experience, no matter how badly wounded, when they are in the hands of a trained medic. ‘I didn’t know Gary at the time, but he was a welcome sight. I knew now I’d get some proper treatment,’ Stockton remembered, though Lawrence’s recollection is that the last thing he felt at this moment was a safe pair of hands. ‘To me it seems I stood for ages, thinking about what I had to do and what needed to happen. But the guys who were there said, no, I got on with it straight away. Andy’s arm was almost totally amputated mid-bicep, held on by a bit of skin and muscle little more than an inch thick. But in the dark I didn’t realize that, and when I tried to loop the tourniquet over the stump, it kept getting tangled up. I finally managed to get the tourniquet on, but he was still bleeding heavily. I wound the tourniquet as much as I could and also pulled the Plasticuff tighter.’

  Over the radio net, a voice asked: ‘Is the medic in the vehicle?’, and someone mistakenly replied, ‘Yes.’ At that point the convoy started up again. In fact, Lawrence was out of the Land Rover and kneeling on the ground getting more kit out of his bag.

  I thought, ‘Fuck, what’s happening?’ I was afraid they were going to disappear without me, and the last thing I wanted was to be stuck out here on my tod. I picked up my bag and hot-footed it back to my own vehicle. I was running as fast as I could, with bullets pinging all around me. Fortunately, the convoy was moving slowly and I was fairly fit, and as I reached the Humvee, the American soldier on top-cover spotted me. I heard him shout down the hatchway: ‘Tommy, that medic of yours, he’s not in another vehicle, he’s running behind us!’ Sergeant Major Tommy Johnson opened up his door and looked out at me. ‘Loz, what the fuck do you think you’re doing? Get back in, you tube!’ And I did.

  It would have been funny, a soldier’s Carry On anecdote to savour, if it hadn’t so nearly been the death of him.

  The convoy found shelter under some trees and paused as Lawrence braved the gunfire again to get back to his patient. ‘I turned my torch on him and for the first time could properly see the damage. He had lost a lot of blood – he was drenched in it. It was vital to get some fluids into him as quickly as possible.’ He found a vein and put in a line for a saline drip – not easy to do while on the move across rough terrain, under continuous fire and with only the dim glow from the vehicle’s interior light to work by. Stockton himself was impressed by the skill with which it was done. Lawrence, on his admission, was improvising. ‘In training, we’re told to administer a maximum of 250 millilitres of saline, but my guess was that Andy had already lost three or four pints of blood, and 250 millilitres was nothing. So I followed my instinct and gave him as much as I thought he needed. Forget the textbook stuff; you’re having to make these decisions in real time with the best knowledge you’ve got. He asked for morphine, but I kept him off it for now, because the only pain he was complaining about was that the tourniquets were too tight. I told him, “Look, if that’s all you’re worried about, you’re fine!” ’

  But the problems were piling up as the wounded sergeant major’s condition deteriorated.

  He was drifting in and out of sleep. His face was grey, he was cold, he was shivering, he was thirsty – all classic signs of shock, and that’s a killer. Then, with the fluids inside him, his arm started weeping again, which meant the tourniquet wasn’t working. I had to tighten it even more, or else he was going to bleed to death in front of me. I also needed to put something round the stump, but he was a big guy with large biceps, and none of the normal limb bandages I had fitted. In the end, I had to use an abdominal dressing to wrap round it. I thought of cutting the strip of flesh that was holding the lower part of his arm but didn’t want the severed bit to get lost. I put a plaster on his other arm. He had a deepish cut there, but it was just a scratch compared with what had happened to the left one. But he was complaining about it, so I patched it for him.

  Stockton was even more concerned for his army-issue watch, which he had signed for and would have to account for to some pen-pusher, to whom his injury in the line of duty would be no excuse for losing it. It was still on the wrist of his semi-detached arm. He asked Lawrence to take it off and take care of it for him.

  The medic worked on, nudging the inert Stockton, swearing at him, insulting him, anything to stop him sinking into a coma. ‘Oy, sir, fu
cking wake up, sir,’ Lawrence bellowed. The sergeant major rallied enough to remember his rank. ‘You talk to me like that again, Lance Corporal, and I’ll fucking kill you,’ he growled. The goading had done the trick. Lawrence kept up a stream of conversation. They small-talked about Stockton’s sons and how he liked playing football with them. ‘It was all just a means of keeping him going. It was like one of your mates is having a bad time and you go down the pub, you have a drink, you have a fag, you chat… anything to keep them up and running.’ Lawrence was buying time. He had done all he could to contain the problem. Now the sergeant major’s life was out of his hands. It hung on a simple issue – stuck out in the wilderness, with the enemy still on their tails, the battle not yet over, how long would it be before he could get to a surgeon?

  *

  At the hospital in Camp Bastion, the four-man airborne Medical Emergency Response Team (MERT) was on standby – in the sort of relative luxury and crew comfort that the lads of FOB Robinson could only dream of. They had their own tent, strewn with newspapers and magazines like any officers’ mess, a kettle, fridge and a television on which they watched DVDs of war films. Platoon and Hamburger Hill were favourites, along with Black Hawk Down, the story of a search-and-rescue mission that went horribly wrong. Their kit was already stowed in a Land Rover waiting outside, ready to rush them to the helicopter take-off and landing site half a mile away, when the call came.