Knife Edge: Life as a Special Forces Surgeon (25 page)

Two hours later, in the vague vicinity of the airport, I pulled to the side of the road to check the map. It was dark, very quiet and with barely any traffic to see. As we discussed which way to go next, each of us similarly confused, none of us noticed the flashing blue light of the police car draw up behind. It was only when the police officer leaned through my window that I realized he was there.

‘Evening all,’ he said in classic Dixon of Dock Green fashion. Apart from nearly jumping out of my skin at the shock, I had to kick one of my colleagues to stop him from laughing out loud.

‘Um… hello. We’re a little lost,’ I said.

‘Oh, are you, sir,’ came the reply. ‘And where might you be wanting to go?’

‘Um…’ I had no idea what to say. I knew SMTs were meant to be highly classified and did not know whether the policeman was aware the SAS were at the airport at all. I could see lines on his forehead as the poor fellow tried to work out what was going on. Then, suddenly, it dawned on him.

‘You’re SAS, aren’t you? That’s who you are, isn’t it?’ ‘Um…’

‘Come on, gents,’ added the policeman. ‘You’ve got it written all over you. You’re bleeding SAS. You must be.’

‘Um…’

‘Look, you silly buggers. Stop mucking me about. Just tell me. Are you SAS or aren’t you?’

I decided to give in at that point. It was obvious the policeman knew what was happening, though I was not certain that four large men sitting in a battered Renault 5 was a recognized mode of SAS transport. ‘OK. Yes, we are,’ I said, not wishing to explain that I was the only one of the group who had had the opportunity to take SAS Selection. The remainder were sturdy fellows, but not truly badged. It did not matter in any event. It was much easier J that we each adopted the same mantle.

‘Well, why didn’t you say so? Stupid bastards,’ said the policeman, now thoroughly exasperated. ‘Follow me. I’ll take you in.’

The airport was busy. The main passenger terminal had been shut off, with television cameras placed as far away as possible. Even so, you had to walk directly in front of them to reach the holding area — not a good introduction to antiterrorist security. One of the team whispered in my ear as we walked immediately in front of a large telephoto lens, ‘Hey, Doc! What say you and I turn round on the count of three and shout “Hey Mum, it’s me!”‘ I had to elbow him in the ribs, a well-known method of military control, to stop him doing it.

By the time we had arrived, the airplane had been on the ground for several hours. SAS assault teams were busy making plans in case they were needed, their Regimental Medical Officer, Captain L, being with them. The SMTs were relegated to the main terminal area where we set about organizing a casualty evacuation chain. A chain involves the organization of several steps along which a casualty will travel after injury, treatment being available at every
stage
. At the time of wounding, the ‘buddy buddy’ system applies. The injured man will be cared for immediately by his military partner, assuming safety allows it. At this stage the object is basic life-saving manoeuvres - shell dressings to wounds, morphine injections, maintenance of breathing. The soldier is next treated by his Regimental Medical Officer. Either the RMO will go forward to the casualty or the casualty will be brought back to him. Either way, it is the RMO’s job to ensure basic life-saving manoeuvres are as good as they can be, before sending the injured man to the next stage in evacuation - the SMT. The SMT provided a further level of treatment sophistication. If we had to, we were in position to open a belly, split a chest, or apply electric-shock therapy to a failing heart. Once a casualty was stabilized, he would be evacuated to the nearest hospital, civilian or military. There he would stay until recovered.

The object of this step-by-step evacuation was to ensure an increasing level of medical sophistication at each stage. Ideally, you would want the complete facilities of a major teaching hospital within 100 metres of an SAS assault. This was obviously impossible. A casualty evacuation chain was the next best thing.

Successful evacuation is based on a procedure known as
triage
. Triage describes the separation of casualties into groups of differing priorities. It is the job of the most senior medical person present to run triage. He, or she, stands at the receiving door and immediately divides casualties into one of four categories: Priority 1 (treat as urgent), Priority
2
(treat as fast as reasonable), Priority 3 (take your time), Priority 4 (don’t bother). Senior people are needed for the task as they will generally have the breadth of experience needed to make rapid, accurate assessments. Just because a casualty looks badly injured does not mean he is classified as Priority 1. A gunshot wound to the head, for example, if it does not immediately kill the soldier, may still be classified as Priority 4. As the man is likely to die anyway, medical efforts are best aimed at those with some chance of survival.

We planned that casualties should be brought to us from the aircraft, in whichever order they emerged, directly to the triage point. From there the triage officer would direct the casualty to one of a number of resuscitation stations. Ambulance crews would take the wounded thereafter to the nearest civilian hospital. I telephoned their casualty department to warn them of the likelihood of heavy casualties and left them to their own arrangements. I had to be careful what I said. If an assault went in, it depended upon an element of surprise. Telling a civilian hospital they could be overwhelmed within the next few hours is the type of information the media love. From there, to the terrorists being given advance warning of an SAS assault, is not a huge step.

To our astonishment we discovered we were not the only medical team at the airport that evening. In the terminal with us was a civilian team, already setting up shop. I believe it was their first hijack. As we were not supposed to exist, and yet were physically in the presence of civilian medics, our cover was blown. This breach of security did get me into trouble afterwards. An irate telephone call from the Ministry of Defence challenged my organization at the scene, particularly when the civilians later requested joint training with us. However, during the hijack we had to cope with the security implications as they stood. It had been the police who had positioned us. They had also summoned the civilian teams without talking to us first. There was nothing we could do.

The other SMT members rapidly set up our resuscitation station while I went to find out what was happening aboard the aircraft. As is usual with these situations, it appeared there would be no sudden solution. Antiterrorist forces were busy establishing ways of best gaining the intelligence they needed, while the SAS already had their immediate action in place. The immediate action, or IA, is prepared from the moment troops arrive. It is the instant response to anything that might go wrong while more formal, effective plans are made. It is a high-risk option and best avoided.

I learned the terrorists on board the aircraft had already shot the co-pilot, or claimed to have done so. Quite what their demands were I did not know. During such events the requirements of the terrorists are not a major issue to you. You do not enter into the politics of the situation. You assume that troops
will
assault and make preparations accordingly. It is better to waste effort than to be surprised by developments, creating unnecessary casualties on both sides as a result. On the one hand, such sieges will have police and negotiating teams trying hard to bring the thing to a peaceful end. On the other will be the SAS, ready and raring to go from the moment it arrives. Control and use of these two extremes is the key to successful siege handling.

Within thirty minutes of arrival we were fully set up and ready to receive casualties. I knew that numbers could vary from nothing to a full plane load. Everything had to be ready for an instant response. Haemaccel drips were prepared, artificial airways laid out, shell dressings arranged in perfect order for easy access. I could see the civilians looking at us slightly perplexed, dressed in our black overalls and working well as a team. Two of our number, having set up their part of the resuscitation kit, had already climbed into their sleeping bags and curled up on the floor. In the Services you have to sleep when you can. On SAS operations anywhere in the world, a clear eight-hour snooze is unlikely.

Seeing their inquisitiveness, I went over to the civilians and talked with them, introducing myself but leaving out details I knew would make security worry. It was when I asked them, in the event of an assault, to deal with SAS casualties as well as civilians that I could see I was on icy ground. ‘If we do get casualties,’ I said, ‘it would be good to see anyone in a black suit and respirator being treated rapidly.’ There was a slight double take at that by the civilians, but to their credit they accepted the concept. Whether they would do it was another matter.

With such events there are highs and lows. One moment you are being stood to, expecting an assault at any minute. The next you are feeling interminably bored. The airliner hijack was largely one of boredom - until our first casualty appeared. There had been no gunfire, so I was surprised to be disturbed from my sleeping-bag slumbers by a tap on my shoulder.

‘Are you the doctor?’ came a voice I could hear through a rapidly resolving sleeper’s fog. I looked up to see the huge frame of a policeman, clad in fluorescent jacket, leaning over me.

‘Yes,’ I answered, hand on my forehead to ward off the bright lights. ‘That’s me. Are we on?’ As I spoke I could feel an instant adrenalin rush to my chest and leaped out of my sleeping bag. The things are designed for a rapid exit with a long, free moving zip fastener from top to bottom at the front. I could feel the policeman’s hand on my shoulder gently restrain me, but by then I was into overdrive. With a loud shout of ‘Stand to!’ I kicked the sleeping bodies of my SMT colleagues, each tucked away in his own peace and solitude. Instantly each man sat upright and then leaped from his sleeping bag, ready for action. I was delighted with their response. Within less than three seconds my SMT had changed from a dozing outfit to one prepared for anything. I could see the policeman looking concerned.

‘It’s OK. It’s OK. Don’t worry,’ he said.

‘What do you mean, don’t worry?’

‘There’s no assault yet. It’s just me. Have you got an aspirin for my headache?’

‘No assault? Aspirin?’ I stuttered. My heart sank. Here we stood, ready for anything terrorism could throw at us and all the man wanted was an aspirin. Sheepishly I turned to my colleagues. ‘Sorry gents,’ I said. ‘My fault. Stand down.’ Worse still, we had no aspirin. The equipment stood prepared to receive anything from full thickness burns to massive blast injuries. But an aspirin? Not a hope.

The hijack fizzled out in the end. Within twelve hours of our arrival the terrorists had given in. The so-called gunshot wound to the co-pilot turned out to be a knife attack. He was lucky, as the blade had passed perilously close to his spine. I recall how quiet and controlled he was when I examined him. You would not have imagined he had been in a hijack at all. One very brave man, I thought. The same applied to the passengers, all of whom came off the aircraft in perfect control. No one was hysterical.

Several hours later we had returned to London and were tucked safely away in our beds. Though nothing dramatic had occurred, preparation and anticipation can be more exhausting than action itself. The hijack had highlighted basic faults with the SMT system. Call-out was unpredictable, transport unreliable and function at the scene ill-prepared. I sent my comments upwards to the RAMC hierarchy, but imagine they have been lost without trace in the bowels of the MOD.

Terrorism, and hence antiterrorism, should be taken very seriously. It invariably catches you by surprise. One major problem is that it follows you everywhere. You are unable to leave it behind. Even though I cannot imagine why any group would be interested in a doctor, the fact is one never knows. Special operations in far-flung lands do not expose the operative to risk once he has left the area, apart from any diseases he brings home. The same does not apply to terrorism. The other side, whatever cause they believe in, are frequently a passionate lot and aim to achieve their end in large part irrespective of the consequences. You cannot assume, simply because you carry a red cross or are in a caring profession, that you are exempt from being targeted. Admittedly the risks are low, but they are nevertheless there. For many years after leaving full-time SAS service I would receive strange telephone calls, sometimes two or three a day. Threats would be made to send my details and full identity to Heaven knows who. Who it was I do not know, except to say, for the moment at least, such things have ceased. Whoever you are, and I imagine Special Branch now know you, please be sure you had the desired effect. I was at times very worried and even now answer the telephone with caution.

Back in London I worked hard at my orthopaedic training. It was a strange world, this life of hip replacements, keyhole operations and broken bones. Though orthopaedic surgery was my ambition, I still yearned for the SAS and their adventurous, outdoor existence. Their strange, unpronounceable illnesses; the singlehanded responsibility; the ability to pick up the telephone and talk to whoever I wished in the land. My colleagues saw me daydream as I began to feel frustrated and, to a degree, disregarded. Surely there was more to life than this? I need not have worried. The Regiment had not forgotten me. Within months, Argentina invaded the Falkland Islands.

It is difficult to tell this story. Difficult because I have never been so scared. I think about it even now, more than a decade later. When I read what others have to say about the Falklands War, it is a conflict I do not recognize. Either I was somewhere different or they are unable to feel fear.

The story behind the war is clear. Argentina felt passionately the Malvinas were theirs - the British Government, and hence us, felt differently. On the 2 April 1982 the Falkland Islands were invaded, South Georgia suffering the same fate the following day. By 5 April, 22 SAS was on its way south, throughout the campaign conducting its operations both vigorously and professionally. However, with every war there is much classified activity behind the scenes of which the public, and many senior Service personnel, are unaware. One such operation involved the Regiment. In retrospect I was privileged to be part of it. I learnt more about myself than I thought possible. We are alive, I believe, thanks to the merciful indecision of the nation’s politicians. As a soldier you consider the politics of the situation at your peril. Your job is to undertake the task you are contracted to do. You can pass comment on how a job is to be done, but not on why it should be performed. The reasons are for the politicians. You can only pray that your military superiors have sufficient leverage on Government to influence the final conclusions.