Knife Edge: Life as a Special Forces Surgeon (15 page)

‘I can’t do much from here, Doc,’ came the sorrowful reply. ‘I’ll just have to make a new start when we get back. She says she’s got a new bloke. Doesn’t ever want to see me again.’

I put my hand on his shoulder, as reassurance. It seemed the right thing to do. This large, powerful operative was completely shattered by what had happened. The frustration of being able to do nothing in response, stranded deep within humid jungle, was naturally immense.

As I stood beside him, uncertain what I should say next, I saw Mark’s saddened form slowly begin to change. He was well known to be a very determined soldier. I could almost sense his renewed strength course through my hand. I withdrew my arm as he stood up, his jaw now set. ‘Bloody hell, Doc. It’s ****ing ridiculous. What the **** can I do about it anyway? Come with me. I’ve got an idea.’

I followed him through the jungle to a spot fifty metres from our base, in jungle terms a very long way. He stopped by a large, knurled tree stump, perhaps four feet high. It was black, half-rotten and stood beside its decaying trunk, the result of a deadfall months or years earlier. This was the area of our jungle range. I stood behind him, fascinated, silent and completely motionless. I watched Mark slide the long combat knife from its webbing pouch, hold the now sodden letter from Tracy against the stump, and plunge the knife through the paper into the rotten wood behind. Then he took six steps backwards, flicked his M16 safety to automatic and fired. It was frustrated fire, not aggressive. Gunfire in tight jungle surroundings is explosive. I winced with the agony of the noise, thanking Heaven that the nearest non-SAS person was reported as many miles away. I tried to remain impassive as I watched Mark empty several rounds into the letter, softened bark, sharp wood splinters and pieces of paper flying everywhere. Then, as rapidly as the noise had started, it stopped. Total silence once more. The letter hung in tatters from the trunk, though still held secure by the ugly combat knife. Mark turned, his face now smiling, contentment in his eyes as he looked directly at me. ‘Doc,’ he said, removing a full magazine from his ammunition pouch, ‘here are some rounds. Let’s have the letter. Now it’s your turn.’

I have to admit a sense of warped satisfaction, returning my ‘Dear John’ letter to its sender full of bullet holes. It was a wonderful therapy. I did it twice, on two successive jungle trips. When upset, the Dear John tree saved the day.

Much of a jungle doctor’s work is to do with worms. These tiny creatures, frequently invisible to the human eye, show no mercy. SAS operatives are certainly not exempt. Nor am I, I am ashamed to say. Worms form a very diverse family - tapeworms, hookworms, guinea worms, threadworms. The list is long. You get them either from infested food or by walking through contaminated water. Take Brian, for example. His small stature belied an enormous, hidden strength. On patrol he could keep going for days while others might stop and rest. One morning he came to me. Overnight he had developed several large, red, linear streaks on his legs. I looked at them. Almost like marker pen lines on the skin, I was sure they were getting longer as I watched. They were also very itchy. Great weals and skin flakes littered the area where Brian had scratched furiously in his sleep. I was annoyed with him for that. Break an intact skin surface in the jungle, by whatever means, and you are assured an infection. High humidity and filth are a wonderful breeding ground for bacteria.

‘Creeping eruption,’ I explained. ‘That’s what it is.’

‘Creeping what?’ he asked, somewhat unconvinced.

‘Creeping eruption. It’s a type of hookworm.’ I went on to explain the problem. Certain types of animal hookworm do not have the power or strength to penetrate the human body. A normal human hookworm can get anywhere — lungs, guts, everywhere. Animal hookworm, particularly from cats and dogs, penetrates the skin from infested water and stays just under the surface. It wanders anywhere it wants, leaving long red weals wherever it goes - the creeping eruption. The difficulty is in establishing the direction the worm is headed. At which end of the red line is the beast to be found? The best way, and the one I used for Brian, is to mark each end with a black, indelible pen. Then send the patient away and ask him to return the following day. The direction of travel is then obvious, remembering the red line follows the worm and does not go ahead of it. Brian was easily cured. Once I had found the worms, they were quickly killed when I injected local anaesthetic into the skin around it. The process was painless and over within minutes. I think Brian was somewhat disappointed when I eventually killed his uninvited companions. By the time he had marked the red streaks and followed their movements, he was beginning to become quite fond of the little horrors.

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.