Knife Edge: Life as a Special Forces Surgeon (2 page)

‘Sir?’

‘Orthopaedics is
fun
.’ Then he turned and the clinic began, as he smiled and chatted, greeting each patient as a long-lost friend. I was hooked, firmly and securely. Orthopaedics has been fun since that day.

It is a young specialty when compared to medicine overall. It was only in 1894 that it became recognized in its own right. Until then, bones and joints were handled by general surgeons, who would also deal with the abdomen, chest and other body parts. The situation persisted in the United Kingdom well into the 1950s, and still continues in certain parts of the world.

As a student, I began also to realize that not all surgeons work in major teaching hospitals. Many operate from very primitive establishments, often in basic, unhygienic parts of the world. Third World countries are classic examples. Perhaps it was my restless childhood - my father’s postings had sent us to North America, Greece and Malta - but I decided within three months of starting my medical studies that teaching hospitals were not for me. They were too laborious, too political, over-constrained affairs. Or so I thought. I laugh about it now, working in one of the most eminent centres in the globe, but in those days I had set my heart on orthopaedics in the Third World.

How to do it - that was the problem. A London teaching hospital prepares you for many things, but Third World orthopaedic surgery is not one of them. A large part of orthopaedics involves the management of broken and shattered bones, injured as a result of accidents. I not only had to train myself to deal with such things, but also to cope with them when facilities were non-existent or sparse. I thought about it for months. How much easier it would be, I reflected, to be less restless and stay in teaching-hospital surgery. I even felt guilty in the presence of my instructors for considering life outside that of a spotless white coat and gleaming hospital corridors. Then, one day, something happened to send me on my way.

As with most medical students, I seemed permanently short of money. Educating and enjoying oneself always appear to cost more than the sums coming in. To supplement an appalling student grant, I decided to join the University of London Officer Training Corps, the ULOTC. A part-time Territorial Army unit, they not only paid me for what I did, but took me away from London at weekends. This prevented me from spending what I had.

I was surprised to find that I enjoyed the ULOTC. Joining them had initially been a purely financial exercise. Yet here I was having fun on ranges, heavy-goods driving courses and cross-country navigation tests. My time with them reinforced my ambition to do something different with my life. What the ULOTC could not do was show me how to realize my ambition - until my Commanding Officer decided I should parachute. I was horrified. Parachuting. What a pastime. To think that some do it for pleasure.

I was sent on the military light-bulb course. The light bulb is a parachutist’s badge, not proper wings, issued to soldiers from non-airborne units after seven static-line descents. Thus it was that I found myself hanging on for dear life in the back of a C-130 Hercules, waiting to leap through the door into the thin air beyond. With me, along one side of the aircraft, lurching round the skies over RAF Abingdon, sat a handful of equally terrified men. Jim T, a good friend from Hull, was one of them. A solid, muscular man, he had approached our earlier ground training with real determination. Right now even he looked scared. Opposite us sat four very confident men. Chatting to each other in a relaxed way, they could have been on the London Underground.

They were dressed differently to us, in blue boiler suits, oxygen masks hanging loosely around their necks. Their parachutes were also different: steerable Paracommanders in their thin, compressed packs rather than our bulky, standard-issue affairs. We were the basic static-line course, scheduled to be thrown out over Weston-on-the-Green at any moment. Eight hundred feet was as high as we would go. They were the HALO group - High Altitude Low Opening - scheduled for a 12,000-foot freefall, learning advanced parachuting techniques for infiltration behind enemy lines. I had naturally heard of them, but never seen them. I thought again. Here were SAS men in the flesh. SAS? Of course! What a brilliant idea.

The parachute jump instructor, the PJI, barely gave me time to think further. The moment the red light glowed to one side of the exit, he pulled open the door. When that happens, your insides work overtime. I was terrified. My legs shook as I felt the slow trickle of urine down the inside of my thigh. Jim also looked bad as I saw him struggle to control a vomit. We were both very frightened. We knew also that we could not go back. I looked across at the HALO team. One of them, the taller of the group, sensed my distress. Smiling, he winked and gave me a cheery thumbs up sign. ‘Go for it, lad!’ I heard him shout over the din of the aircraft’s engines. It was his encouragement that got me out the door, of that I am certain.

A static line is a broad webbing strap attaching the parachute apex to a thick wire hawser inside the aircraft. Naturally, but unnecessarily, I checked that my own was still firmly attached. Behind me I noticed Jim still looking pale, concentration etched on his petrified face. Then the light changed from red to green. ‘Go!’ shouted the PJI at the top of his lungs, as he thumped me on the shoulder. That was not the time to turn, as I have seen done, and ask ‘Do you mean me?’ I jumped firmly through the door, feet first, arms folded on top of my reserve. The brave-hearted look back up as they depart, to be sure the main parachute opens properly. I did not. My eyes remained firmly closed throughout. Before I had time to think, I had plunged through the buffeting slipstream into the quieter air beyond. Slowly, hesitantly, I opened my eyes and looked upwards. Thank God! There above me was the perfect hemisphere of my open parachute. The relief was overwhelming. Unfortunately, full parachute deployment does not always happen. A number of things can go wrong.

The commonest problem is the ‘twists’. This is what happened to Jim. As he exited the aircraft, the slipstream spun him like a top, rotating him rapidly as his parachute opened. This narrowed the canopy’s dimensions, making him fall faster and the parachute impossible to steer. He hurtled past me, thrashing his legs wildly in an attempt to untwist himself. Ground training had taught us to do this, emphasizing how important it was not to panic. Jim seemed to be doing well. As I drifted downwards, I felt how unfair it was that his first aircraft jump should face him with an air emergency. With less than eight hundred feet to go he had to untwist himself fast.

Fortunately, Jim was successful. Though he had left the Hercules after me, he had landed well before me. After my own, very inept, parachute roll, I found him lying on the grass looking up at the sky. His parachute was collapsed, though still attached to him. ‘Thank ****, thank ****, thank ****,’ was all he could say.

As well as the twists, parachuting problems are numerous. They can include failure to open at all, in which case you are dead; rigging lines caught over the top of your canopy; or someone going below you and stealing your air. That, too, can kill you. In fact your worst enemies in a military static-line jump are your colleagues. It is fortunate the average military canopy is only steerable to a limited extent. A Hercules disgorges more than sixty parachutists in under a minute. Some will have their eyes open, some will have their eyes shut, whatever they are told in training. The thought of sixty soldiers careering round the sky under their parachutes, each with independent steering, is terrifying. It is best to allow the wind, and Mother Nature, to let each one down in a safe, orderly fashion. Full control is reserved for freefallers. There are fewer of them, jumping from a greater height, allowing more room for error.

The final danger is landing. A significant percentage of any parachuting course is spent on how to hit the ground and roll. It is roughly equivalent to jumping off a wall, twelve feet high. Grandly called ‘ground training’, the various parachute centres are wealthily endowed with devices to simulate heavy landings. Once a freefaller, life is different. It is possible to turn into wind just before ground contact. The lift this provides should give a soft landing. Static liners take what comes. Knees together, feet together, elbows in, chin tucked down and roll. Most of the time they get away with it. Unfortunately casualties do occur, particularly broken ankles, broken heel bones, broken shin bones and the occasional broken back. Alastair, a very good friend and an excellent doctor, managed to break the lot in one go. Parachutists can also develop awful spines by the time they reach middle age as a result of repeated injuries and arthritis. For certain active-service scenarios, to ensure soldiers are not exposed for too long to enemy fire, jump height can be as low as 350 feet. This gives no room for error. Casualty rates of over 10 per cent have been associated with this.

In later years, once I qualified as a doctor and had joined the SAS, my parachuting skills made me fair game for dropping-zone, or DZ, medical cover. I would be thrown out first, wherever we might happen to be, medical kit in hand. Not in hand really. Equipment was attached to two large hooks in front of me, just beneath my reserve. Once clear of the aircraft I would open the two hooks, the equipment falling away, though remaining attached to my harness by twelve feet of sturdy rope. This was useful, particularly when jumping at night. I could hear the equipment strike the ground first, giving time to brace before Mother Earth leapt up and grabbed me for her own. The problem is who provides DZ medical cover for the medics? No one, I am afraid. The first out is on his own.

The purpose of jumping at night is to lessen the chance of detection by the enemy. Even if a parachutist breaks a leg as he lands, he is unlikely to scream about it in the middle of a war zone. He will lie there and suffer, or should do, until help arrives. As a doctor, I became accustomed to listening for the sound of breaking limbs. It is unmistakable once you have heard it. You can see nothing, it is all done on sound. As a parachutist lands there should be two thumps. The first is his equipment, the second is himself. A third sound, usually a high-pitched ‘click’, following close behind the second, is the fracture. The moment I heard that tell-tale sound, I would prepare my splints, ready to immobilize what I was sure would be a broken bone.

That first day, as Jim and I staggered from the DZ, I began to relax. The intense emotions I had gone through, the total fear, were subsiding. I started to think once more, my head bowed to the ground, as I carried the heavy weight of the parachute in its large green bag on my shoulders. Jim disturbed my thoughts.

‘Penny for them.’

‘They’re not worth it.’

‘Go on. Try me,’ came the challenging reply.

‘The SAS. What do you know about them?’

‘Bugger all. Bunch of lunatics I reckon. Why?’

‘I’d like to join them. What do you think?’

‘You must be ****ing mad, Richard. They’re all brawn, no brain and you’ll get yourself killed. Anyway, you’ve got your medical career to think of.’

‘It was my medical career I was thinking of. It could be ideal. Why not do both? I mean, why can’t you be a doctor
and
join the SAS? Someone must look after them if they get hurt. Just think of all the experience you would get.’

I heard Jim grunt with disbelief beside me. At that point I doubted there was anything he could have said to change my mind. The moment I had seen the small group of HALO parachutists in the Hercules, I resolved that, one day, I would join them and become their doctor. Rumour had it the SAS spent much of their time on active service and real-life exercises. If so, they were bound to have broken bones, twisted knees, dislocated shoulders and all manner of orthopaedic conditions. A major part of orthopaedics was in the management of injuries and major trauma. What better training than with the SAS? Rumour also said they worked extensively overseas. Any doctor with them would be as far away from a teaching hospital as it is possible to go. I would learn how to deal with injuries, from the moment a patient was wounded, until he was evacuated to hospital and taken to the operating theatre. For a young, ambitious orthopaedic surgeon, with his eye on the Third World, I could do no better. For sure, the SAS it would be.

The moment I returned to London, I sought advice about leaving mainstream medicine from a few, highly selected advisers, all of whom were sworn to secrecy. They, and my parents, sided with Jim. They thought the idea mad. I was, after all, already established on the first rung of a major teaching-hospital career. Was it really worth giving up all that for such a whim? I still knew very little about the SAS, but anything I heard convinced me that nowhere else in the world would I obtain such excellent training. I was also young enough to take a risk, barely twenty-one, and had time on my side.

Jim and I parachuted together on several occasions after our basic Abingdon course, though he never fully recovered from the twisting episode at his first jump. His tale of the event, told with a charming accent in various pubs, became more unbelievable at each telling. Whenever we met he would take me to one side and ask, ‘Have you thought more about the SAS?’

‘Continually,’ I would reply. I barely thought of anything else and had read every book available on the subject. There were not many. I daydreamed on ward rounds, endured endless sleepless nights and talked to myself incessantly. To most who knew me, I must have gone mad. It took several months to build up courage and take the plunge. ‘I’m going to join soon,’ I told Jim on one occasion. ‘Now I’m a third-year student, I have a few skills I can offer if they want.’

I remember Jim’s look of astonished disbelief. ‘So you’re doing it after all? I thought you were joking. But no, I can see you’re serious. You are mad, Richard. Completely scarpers.’

It was too late by then. I was hooked.

My trouble was that I had no idea how to go about joining. Quite rightly the SAS does not advertise, or didn’t in those days. You had to seek them rather than the other way round. There will never be a shortage of people wishing to join the Regiment. That hidden something gripping me, grips thousands of others as well. If you were to believe everyone who says they have been, or are, in the SAS you would have enough manpower for a thousand Regiments. In reality, there are only three Regiments, two Territorial and one Regular. The Territorials are part-timers who combine a civilian job with military service. The Regulars are fully committed, day in and day out, to the SAS. To some extent that still applies now, though a high-readiness Territorial reserve has been created to assist the Regulars on occasion. Selection weeds out the unworthy from both, with more than 80 per cent falling by the wayside. The odds are worse for officers.