Medic: Saving Lives - From Dunkirk to Afghanistan

by John Nichol

  The issue of giving succour to an enemy was not always so happily resolved. Out on the peat, Hughes had encountered helicopter pilots who turned away Argentinian wounded, particularly after losing some of their own men in action. ‘No Argies, no Argies,’ they would shout as they landed to pick up casualties. The doctor was appalled. ‘The Geneva Conventions are very clear that all wounded are to be treated equally, regardless of whether friend or enemy. I worked on the basis of the most serious first, regardless of nationality.’ One lad, sixteen years old with a gunshot wound in the arm, was refused twice and kept slipping to the back of the queue. He died in the night, still waiting to be taken to hospital. ‘I felt I’d failed him,’ Hughes recalled, haunted by the thought that he should have ordered the pilots to comply, at pistol-point if necessary.

  Corporal Tom Howard, a medical assistant at Ajax Bay, had more success in pressing the humanitarian case. In his care he had an Argentine sergeant peppered with gunshot wounds, including one in his groin. A bullet was actually lodged beside his testicles. ‘He was babbling in Spanish, which one of the guys translated. He had a little three-year-old son back at home and didn’t want to die without seeing him again.’ Howard was deeply moved. He had a child of his own. ‘I wanted to do everything in my power to get him to see his son again – because I wanted to get back to see my little girl.’ The man got through surgery but, afterwards, his condition deteriorated. His lungs filled with fluid and he couldn’t breathe. A doctor examined him and told Howard to get the padre to give the sergeant the last rites. The English corporal was furious. ‘I knew this guy could be saved, so I got a different doctor, who told me to give him a broncho-dilator drug and a diuretic to remove the blood leaking into his lungs. He was cold, and all the hot-water bottles were in use with other patients, so I filled my canteen with hot water, wrapped it in a towel, placed it on his stomach and covered him with a sleeping bag.’

  Howard went to grab some sleep – he’d been on duty for sixteen hours – but was warned that the Argentinian would almost certainly be dead by morning. ‘I was gutted, feeling that I’d failed.’ But the next day, when he returned to the ward, the man was propped up on his elbow, smoking a cigarette and talking to his mate in Spanish. ‘I couldn’t believe it. I went over to him and clapped him on the shoulder saying something like, “God, you fucking gave me some problems yesterday,” and laughed and smiled. He stopped talking, stared at me and just said, “Que?” I didn’t mind. I was just happy he was going to make it back to his son.’6

  *

  The day after the surrender of Goose Green, a Wessex helicopter touched down at Ajax Bay with a special cargo – the Para dead, limbs frozen in rigor mortis, a poncho pulled over each face. Jolly organized the unloading, and watched, sombre and silent, as eleven stretchers were lined up side by side on a concrete strip. It was a grim, sad business as their clothes were cut away and their personal possessions bagged to be returned to relatives. Not everything would be sent home – some maroon berets were too soaked in the blood of the men who had worn them for loved ones to see. It fell to the doctor to examine each body, pronounce on cause of death and complete a field death certificate. He crouched down as he went from man to man and called out his conclusions to a clerk, who scribbled them down – gunshot wounds to the heart, multiple wounds to chest and abdomen, blast injury. On Colonel ‘H”s face, Jolly saw a quizzical smile. His eyes were still open, but he looked peaceful. A single bullet had killed the CO, entering just above his right collarbone, travelling downwards at an angle and exiting through his stomach. ‘When I had finished, we stood for a moment in silence, while I remembered my last conversation with him. Then I kneeled down beside his body, closed his eyes very gently, and whispered: “We didn’t let you down, Colonel. We really were good enough, and so were you.” Then we lifted him up carefully, and placed his body into a plastic shroud and then into a body bag.’

  Jolly kept his emotions in check for the colonel and was pleased to have done what he could to treat the dead of his battalion with the dignity their sacrifice deserved. But he fell apart, unashamedly and unreservedly, when another body was brought in, a helicopter pilot who was a family friend. He had been dreading this moment since he had heard of the young man’s death. Now, faced with the body, a compulsion came over him. ‘I felt I had to find out if he had died before the crash of his helicopter, and not because of it. It took a few minutes of gentle probing, but I found what I was, in a way, hoping to find. There was a circular hole in the right cheekbone. A ricocheting bullet had penetrated his skull and, an instant later, his brain. This knowledge that he had not suffered helped me to adjust. For all that, I felt very weary, and really sad. As I walked away I crumpled, my body racked with silent, almost convulsive tears.’

  The next day, a tired-looking Steven Hughes, his face grey with fatigue, flew into Ajax Bay for the funerals. He avoided Jolly’s eyes, which surprised the navy surgeon. He knew and liked his 2 Para counterpart, and had heard nothing but praise for their MO from the casualties he had treated in the hospital. Jolly opened his mouth to speak but was silenced by an outburst from Hughes, apologizing, absurdly, for not having done enough at Goose Green and for sending back so many casualties in poor condition. Jolly interrupted this flow of desperate remorse. His colleague had nothing to blame himself for. Every one of the wounded paratroopers ferried from Goose Green to the hospital was alive, he explained. Hughes looked incredulous. All the way in on the Wessex, he had been dreading discovering how many more of his men had died from their injuries. It had to be so. He was certain of it. The only question was how many.

  Jolly gripped his arms and, almost shouting to get home his point, declared, ‘No, Steve, no! They are all still alive.’ The Para MO shook his head. It couldn’t be so. He pulled out his field notebook and picked a name. ‘What about this one? Private Gray…?’ Jolly jumped in: ‘Do you mean Chopsey? He’s fine. I looked after him myself. Virtually ex-sanguinated when he got here, with no recordable pulse or blood pressure. After two pints of blood, the torn femoral artery started to leak. After another three pints he was fit for theatre.’ Hughes stared in amazement as the truth sank in. Then the colour returned to his cheeks, just as it had to Chopsey’s. He was transfused with relief and joy, literally flushed with the success he now realized he had helped achieve. All those battered young bodies he had administered to on the edge of a raging battle, patched up as best he could and then sent back down the line, were ALIVE!

  Jolly would have taken Hughes to see Chopsey if he had still been on the island. But he, like all the wounded from Goose Green, had been helicoptered offshore, to a hospital ship. The Uganda, a hastily converted educational-cruise liner, was floating in an internationally agreed Red Cross safe zone fifty miles from the Falklands. By the rules of the Geneva Convention, once there, the wounded were out of the war and could not be returned to the fight. It was a haven of peace, with carpet on the floor and medical staff in crisp white uniforms, unlike the sawdust and khaki order of the field hospital. There were clean, starched sheets on the beds and even a few female nurses. The doctors on board were busy, not least because most of the casualties arriving had open wounds.

  This was deliberate. As we have seen, during the Second World War, British military surgeons changed the accepted procedure of centuries and adopted the Trueta method7 of treating wounds caused by modern high-velocity bullets. The doctors on the Uganda carefully chopped out every last bit of dead tissue and then left the wound open ‘to breathe’, thereby killing off dangerous anaerobic bacteria that only thrive in the absence of oxygen. The dangers of doing otherwise were now all too apparent in some of the Argentinian soldiers who were arriving at Ajax Bay with complications, having been patched up by their own doctors in the old-fashioned way. Their injuries had been sutured straightaway, locking in infection. Gas gangrene, curse of the First World War, and tetanus were often the result. But not for the British wounded, despite all the contaminating bacterial horrors that lurked in t
he sheep-soiled island earth and were fired deep into flesh on the tips of bullets and shards of shrapnel. The practice known as Delayed Primary Closure – not finally stitching up the wound until a week or more after the original injury – doubled the workload, because every wound had to be worked on twice at least under general anaesthetic, but there is no doubt that it was a life-saver in the Falklands. Men recovered who, in most earlier wars, would have died.

  For a brief moment now, the needs of the living were put to one side and the dead took centre stage. At Ajax Bay, the final batch of bodies had arrived from Goose Green, bringing the toll to seventeen, and a grim parade lined up to escort them all to a trench scratched out of the peat and earth on a hill above the bay. The procession passed a hastily erected barbed-wire enclosure, filling with Argentinian prisoners of war. Around the mass grave stood two hundred men of the Task Force. Jolly looked up at a perfectly blue sky and at the snow on the mountain peaks in the distance. Out in the Sound, helicopters were buzzing between the ships in the fleet and the only sound on that silent hillside was the far-away whirl of their rotors. The first body bag, draped in a union flag, was passed into the ground, then another, ‘and by the time you got to seventeen,’ Hughes recalled, ‘the effect on everyone was devastating. I was crying. So were many others.’ A Marine played a lament on a fiddle, an aching melody. ‘Ashes to ashes, dust unto dust,’ intoned the padre, as the Regimental Sergeant Major marched forward to throw handfuls of earth on the body bags. The sound of the clods on the plastic ‘echoed like thunder’, remembered Jolly. ‘Then we all saluted and slowly turned away.’ As ever, once the mourning was over, there were lives to be saved.

  However, the events of the past seventy-two hours could not be easily forgotten. ‘We had been through an experience none of us had ever expected,’ Hughes would recall. ‘For three or four days everyone was just ticking over, lights on but nobody much at home.’ He felt himself shutting down inside, blanking out the awful pictures of suffering that threatened to overwhelm him. ‘I couldn’t afford to take anything more on board. I detached myself from what was happening. I felt as if somebody else was doing the job, and I was watching from a distance. I was outwardly functioning in the same way, but I was an automaton. This is a common psychiatric defence mechanism.’ He was learning what few soldiers realized – that medics are steeped in the horrors of war in a way that no one else ever can be. All the carnage comes funnelling through them. They cannot look the other way or go charging ahead and relieve their aggression and frustration in the next firefight with the enemy. Other soldiers may see a few mates wounded or be injured themselves. But only the medics see the whole picture, the non-stop pain and misery of war. They run their eye over the entire butcher’s bill and, in Steven Hughes’s case, there would eventually be a large price to pay.

  10. Fire Down Below

  At the Goose Green settlement in the Falklands, now under the British flag again, medical officer Steven Hughes set up his aid post in the mess hall of a sheep-shearing station, a proper roof over his head at last. A sorry procession of complaining soldiers, the adrenalin of the fight gone out of them, came by, with gippy tummies and loose bowels, bruises, trench foot. After the inferno of battle, it was back to the slow burn of routine medical work. But not for long. The mail had arrived from home, and Hughes was just sitting down to open a letter when there was a huge explosion outside, rattling the windows. A group of Argentinian prisoners of war had been detailed to clear up a pile of ammunition jettisoned by retreating comrades and move it to a safer position. Maybe they were careless, or perhaps it had been booby-trapped but, either way, the dump blew up. Two PoWs died instantly, and seven others were badly injured. Bullets were exploding in the fireball and flying off in all directions. There was the constant crump of more charges detonating in the heat. One man was dragged clear, and Hughes slammed a morphine line into the twitching body. Both legs had been blown off, one above the knee, the other below. The flesh had been stripped and bones were sticking out. An arm was missing and there was a massive chest wound. The whole body was charred and smouldering and the gagging smell of burnt human flesh choked the air.

  Another victim could not be reached. Corporal John Geddes saw him running from the flames, blazing from head to foot, his body turning charcoal-black. The Argentinian lost his way, stumbled and, instead of escaping to safety, turned back into the fire. Geddes instinctively darted to pull him away, but his friends restrained him. It would be madness to try to get to him, and the man was so far gone that saving his life might not be a blessing anyway. But dying this way was an abomination. Someone shouted, ‘Fucking do something somebody!’,1 and an RAMC sergeant, who had already pulled one PoW from the flames, grabbed a rifle and put two rounds into the writhing, screaming figure, ending his misery.

  David Cooper, the 2 Para chaplain who witnessed this, considered it ‘the best thing to have done in the circumstances’.2 The killing was judged merciful by those who saw it, but not by others. There was a complaint from the Red Cross and questions asked in Parliament in London. To Steven Hughes’s disgust, ‘people without the faintest idea judged him and found him guilty.’ The sergeant was even investigated for a possible murder charge, though he was exonerated.

  Afterwards, Hughes thought long and hard about the ethical issues. Was it wrong for a medic to shoot somebody to put him out of his misery? It was an impossible conundrum for those whose commitment was to the saving of life but also to the relieving of agony. He concluded that the sergeant’s action had been not only humane but brave. He doubted he would have had the courage to do it himself. Many who knew the horrors of war as intimately as he did wished that, in similar circumstances, someone would do as much for them.

  Flames hold a particular dread for those who fight wars. Bomber crews of the Second World War, going into battle sitting on tankfuls of highly inflammable kerosene while being shot at with incendiary shells, lived in fear of a fiery death or – worse still, as some of them saw it – of disfigurement. Sailors had nightmare visions of being adrift in burning oil. Every one of these primal fears would explode into awful reality in the next stage of the war, with scenes of destruction and suffering that would be the most searing of the entire Falklands campaign.

  Reinforcements – contingents of Welsh Guards and Scots Guards, plus a new medical team, the RAMC’s 16 Field Ambulance – had now arrived from the UK in a second flotilla, to bolster the ranks for the final phase of the assault, the advance on Port Stanley, the Argentinian-held island capital.

  The irrepressible and affable second-in-command of 16 Field Ambulance, Major Roger Nutbeem, set his men to work at the Ajax Bay hospital. In a moment of leisure he sat and picked out a folk tune on the battered guitar he carried with him everywhere. Then he reached for a pen and wrote to his wife, Patricia, hoping she and the children were coping in his absence. ‘I’m expecting to move forward in the next few days. Wish us luck. I miss you all more than I can say and will be very happy to get back. It shouldn’t be too long now.’3

  To avoid the newly arrived guards having to tab an exhausting eighty miles across the island interior, which some say they were not up to anyway, they were taken by sea to be dropped off in Bluff Cove, a bay just a day’s march away from Port Stanley. The medics of 16 Field Ambulance, as the major had predicted, went too. Steven Hughes was already ahead of them. He had been helicoptered to the settlement at Fitzroy, above Bluff Cove, to set up an aid post in the tin-hut village hall there. Now Goose Green was behind him, his principal concern was trench foot, which was hobbling a good half of many platoons. He was worried. He had thirty cases resting in makeshift beds, with bundles of kit on top to keep them warm and their bare swollen feet poking out and raised up to let them recover naturally. The alternative was to evacuate them to the Uganda for treatment, but in that case they would be out of the war for good – and it looked as though every last man would be needed to defeat the Argentinians.

  At least there were more able bodies ar
riving. Down in the bay, Hughes could see the landing ships Sir Galahad and Sir Tristram at anchor, fully laden with Welsh Guardsmen. The only problem with this otherwise cheering sight was that no one seemed in a hurry to get the men off, even though it was broad daylight. Those watching began taking increasingly anxious bets on how long it would before the ships were bombed. As if on cue, two Skyhawks and two Mirages roared over at mast level and a 1,000- pounder plunged into the belly of the Galahad and exploded. Hundreds of men waiting below for orders to disembark were caught in the inferno. To the watching doctor, the seriousness of the situation was instantly obvious. He tipped out all the trench-foot cases from the aid post. ‘Eff off back to your companies,’ he told them. They would have to fend for themselves. An avalanche of emergencies would be on the way any minute.