Knife Edge: Life as a Special Forces Surgeon (29 page)

As I tore up the twentieth piece of scrap paper, covered in illegible, inaccurate, mathematical jottings, a forceful, feminine voice disturbed me from behind. There was a trace of Scottish about it.

‘Why don’t you ask a paediatrician?’ it said. ‘We do it all the time.’

I turned to greet the voice, ready to defend the rights of orthopaedic surgeons worldwide to solve their own problems. How dare she? I’ll show her, I thought. She wouldn’t know a hip joint if you hit her with one. What did she know anyway? There is a traditional, longstanding war between surgeons and physicians that has existed since the beginning of time.

Then I saw her and knew instantly I could not argue. She was brunette and beautiful, with a smile as broad as they come. Her tight Army uniform covered an immaculate body, a major’s crown decorating each shoulder. ‘Hi!’ she said, before I could gather myself. ‘I’m Louise. Who on earth are you?’

You never believe in love at first sight until it happens. It did for me. That very second I knew I was smitten. You sit in a pleasant, isolated tunnel, oblivious of the world outside. You forget everything that has gone before, sometimes cruelly so, and the future appears irrelevant. It is a most intense disease. One day I shall invent a tablet as cure, so deeply physical are the feelings.

Over the next few weeks Louise and I saw each other regularly. The more I learned about her, the more involved I became. She was a living legend in the RAMC. The five simultaneous boyfriends in Hong Kong? That was her. Refusal to carry a pistol despite being a crack shot? That was her too. Wearing high-heeled shoes on active service, combined with her encyclopaedic knowledge of all things medical, made me realize what a formidable creature I had met. Asking her to marry me - and thank God her acceptance - was the most natural act of my life.

Since that day we have stayed as tight as tight can be, which is something of a record in modern society. We have had differences by the dozen, and misdeeds when we should not. Even so, Louise is, and was, the girl for me.

My remaining months in the Army passed in a haze. The girls take over once they agree to marry you. I still had residual duties to perform with the SAS and would somehow have to fit them into my now very changed life. For the first time I had to think of someone else, not just my self-important ego. The duties on this occasion were not concerned with armed conflict, so the chances of being shot were nil. They were nevertheless very hazardous. High mountains, my next port of call, can be the most vicious opponents on earth.

The damned knee would not come straight. I had tried everything I knew, but it was still locked tight, bent in its agonizing position. Mark was one of our best climbers and had been doing well on the approach to Alaska’s Mount McKinley. Disaster had struck suddenly when he had unexpectedly twisted his knee.

‘Come on Doc! Pull the bastard!’ he shouted as I struggled to manipulate his knee in the tiny tent. As I heaved hard I could tell I was hurting him, pain written on his face. It was a simple condition, a torn ligament. Split in two it had displaced into the centre of the joint itself, locking it from any movement. Why here, I thought? Stranded in the middle of McKinley’s Kahiltna glacier.

Though I had ketamine anaesthetic with me, I was frightened to use it. Fearful what would happen if Mark lost control of his breathing, something anaesthetics were prone to cause. I needed him to relax, to eliminate the power of his huge thigh muscles, which were preventing me from applying the necessary force on his joint. My eventual compromise had been a mixture of rum and sedative. I had hoped this would overcome his impressive muscle tone, but it did not. Mark simply insisted I drank some too. He was a social type of man. The result had been an intoxicated doctor trying desperately to unlock the knee of an unanaesthetized SAS operative. Needless to say I had failed.

‘I’m sorry, Mark,’ I eventually confessed. ‘There’s not a hope. We’re going to have to evacuate you from the mountain. You’re no use to anyone like this.’ I could tell he was disappointed despite his acceptant nod. Mount McKinley, at 6200 metres, is America’s highest peak. Reaching the summit was vital for those of us who wished to try Everest’s North Face the following year. I was partly to blame for Mark’s predicament, making me feel even more guilty. I had known about the ligament tear before we had left Hereford but had taken a gamble it would not displace. I had been wrong. My friendship with the popular SAS man had overridden medical considerations. I resolved to be more self-disciplined should the same happen again.

It had started with a simple question from Bronco two years earlier. I had been coming to the end of my time in full SAS service. ‘How about Everest?’ he had asked. Bronco was a remarkable individual. You would be forgiven for thinking he was the SAS. He had been everywhere, done everything and knew everyone. The wealth of experience he had amassed after many years in the Regiment was impressive. In 1976 he and Brummie had slept the night out near Everest’s summit, surviving perilous temperatures with the loss of several fingers and toes. Despite this, they both wished to return, though on this occasion with a team drawn entirely from the SAS.

I was astonished to be asked, knowing almost nothing about climbing and being terrified of heights. I was well able to experience vertigo on top of a bunk bed. Everest? No way. That was stupid. I think Bronco noticed my initial hesitation. ‘Have a think on it,’ he added. ‘Let me know.’

As he walked away I had to smile. He knew very well I would eventually accept. From my first day with the Regiment I had resolved always to say ‘Yes’, whatever was asked of me. Saying ‘No’ might mean I would miss an important part of life. Within hours I had decided to support the 1984 SAS Everest attempt, irrespective of the fact I could not distinguish a karabiner from a kettle, nor a rope from a rucksack. I had several years to learn.

One advantage of medical examinations, for whichever qualification, is that they demand instant recollection of long factual lists. How many of the 234 causes of bloody diarrhoea do you know? Tell me the forty-six ways appendicitis can kill? I applied this acquired skill to climbing. I went on courses, talked to instructors and read every book written on the subject since time began. Within two years I was theoretically sound, though practically very inexperienced.

The first stop was not Everest, but McKinley. Our visit there was to sort the wheat from the chaff. Climbing is not everyone’s forte. Masquerading as a military exercise, Exercise ‘Top Slap’, it was to be my first experience of high-altitude snow and ice climbing. McKinley was well known to be one of the world’s fiercest peaks, especially when the weather turned sour. Twenty-nine of us went to Alaska. The subsequent Everest attempt only required fourteen.

By the time we left for McKinley, my climbing knowledge was well-ordered, but my personal life in chaos. Being in love does that to you. Louise and I had decided to live together before we were married, though we had set the wedding date for soon after my return from Alaska. This was a difficult situation for the RAMC, which did not know how to handle two officers, in the same Mess, falling in love. Even the Queen’s Regulations - Queen’s Regs - had no advice to offer. The Army is run on the Queen’s Regs. If you perform an act that lies outside the text in those massive tomes, all manner of disciplinary horrors can befall you. It has opinions on homosexuality, rape and other assorted deeds, but nothing covered Louise and me co-habiting in Farnham. It was to our advantage. We simply did it and in no time it became accepted as normal.

Alaska is a long way from Hereford and Hercules aircraft very slow. The first stop after leaving the UK was a Royal Air Force base in Newfoundland. It must be the loneliest place on earth. I felt desperately sorry for the RAF ground crew stationed there. There was nothing to do. Nothing except fantasize about life elsewhere in an attempt to enjoy one’s own company. My memories of the base are now limited, but I do remember lots of snow, miles of forestry and an endless supply of pornographic videos. For most of our twenty-four-hour stay we saw nothing of our hosts. They remained locked away in a darkened room looking at assorted views of the same act of procreation.

Staging through Vancouver, we arrived eventually in Anchorage and were transported from the airfield to the US Army base of Fort Richardson. It was an interesting introduction to the eating habits of our American partners. I cannot recall seeing so much high-fat food being squeezed on to a plate before. Having queued, you would eventually be confronted by a massive, overweight chef, frying pan in each hand, furiously cooking omelettes. Not one- or two-egg omelettes, but six- or seven-egg ones. He was surrounded by rows of stainless steel pots and containers filled to the brim with dietary extras: hash browns, syrup, waffles, cream. The temptation was too great. I was in Fort Richardson for two meals and put on half a stone. I knew then I would have to climb to great heights, simply to expend the calories I had gained.

My impression of Alaska was like something from the great Wild West. The area surrounding McKinley, the Denali National Park, is home to many wild, fully bearded trappers. Moose are their favoured prey. ‘One that got away’ stories abound and bars really do have chest-high saloon doors. Town names, and local behaviour, are wonderfully traditional, as shown by the near shoot-out in Moose Creek. One night, almost at closing time and before we had gone anywhere near the mountain, I was sat at a small round table in a bar being interviewed by a journalist for a climbing magazine. He was becoming quite intense, quizzing me in minute detail on the various tablets available to deter mountain sickness. Scattered around were similar tables of SAS climbers, each deep in discussion. The atmosphere seemed friendly. Suddenly I heard a female voice shout, ‘Get the hell out of here or you’ll regret it!’ It was the bartender.

‘I’m going for my gun!’ came the swift reply from a well-oiled trapper. Two men, both trappers, had been arguing furiously, in subdued tones, for some time. I had not realized: it seemed the only solution, if you were Alaskan, was a shoot-out.

At the mention of the word ‘gun’ the bar emptied instantly. People dashed everywhere. Being somewhat slow about these things it took me a while to realize why the journalist was now under the table. By the time I had thought to join him, one trapper had already charged from the bar into the street outside to get his gun.

From beyond the saloon doors I heard a whispered voice, as I cowered, trembling, beneath the table, hugging the journalist for extra security.

‘Doc! Come over here. We need you.’ I looked around me and tiptoed out through the doors. The only person left standing in the bar was the other trapper, lounging against the counter in an astonished, alcoholic way. Outside, I was greeted by a number of smiling SAS faces. Fifty metres away I could see the trapper in his four-wheel drive wagon, scrabbling through assorted bags to find his weapon. I was immediately grasped by a dozen hands and pushed to the front of the group. ‘Go on, you walk first. We’ll follow behind,’ I was urged. Our accommodation was the far side of the intoxicated trapper in his vehicle. Despite the distance, I could see the satisfied smile on his face as a large Magnum revolver appeared from the depths of a light brown holdall. So much for not getting shot on the mountains, I thought.

‘What’s this about?’ I asked. ‘You’re the professionals. You’ve done this sort of thing before.’

‘That’s the point,’ one SAS operative replied. ‘He knows you’re a doctor. He won’t shoot
you
. With one of us out in front he’s bound to have a go.’

So I was frogmarched past the trapper, as a form of friendly hostage. The gun-toting drunk barely spared me, or my SAS colleagues, a second glance. For the first, and perhaps only time of my life, I could claim to have saved the SAS.

There are many routes to McKinley’s summit. Our chosen one, the West Buttress, is perhaps the simplest of them all. A long, winding glacier, the Kahiltna, finishes at the base of an almost vertical ice Headwall. Once up the Headwall it is a long, dangerous trudge to the top. We flew in to our base camp on the Kahiltna glacier, a paltry 2150 metres above sea level. Bumping through the sky in a tiny, single-engined Cessna we negotiated the fearsome One Shot Pass, whose name speaks for itself, before landing smoothly on skis.

My first feeling was wonder. Clear blue sky, perfectly white snow and the overpowering image of the summit, miles away, leaning over us. My second feeling was terror. Avalanches. Fresh snowfalls had covered all slopes with a thick layer of unstable snow. By midday, our time of arrival, the sun had warmed the area and the snow began to slide. Avalanches were everywhere. Wherever I looked I could see another one - dozens of them. From a distance an avalanche is a beautiful thing. Nearby, the impression is different. It starts as a feeling of the mountainside moving. Then comes a high-pitched rattle as the smaller ice blocks and snow particles begin to move. The rattle is followed by a rumble, becoming louder and louder as, quite possibly, a whole mountainface gives way. As the avalanche picks up speed it can push before it a great wave of air, well able to pick up a man and throw him down again. Then follow the larger ice blocks and mass of snow, covering everything in their path. After I counted twelve avalanches in the first hour, I realized what a dangerous game high-altitude climbing was. The advance climbing party, highly experienced in such things, had sited our base camp well out of harm’s way. With luck the experts would see me through.

Snow and ice are not the only hazards of altitude climbing. The environment is a major problem - a medical nightmare. As you ascend, so the pressure of oxygen in the air gets less. At the top of Mont Blanc (4807 metres) the pressure of oxygen is half that found at sea level. On the summit of Everest (8848 metres) it reduces to a third. It is this reduced oxygen pressure that causes so many of the problems climbers can suffer. Red blood cells, responsible for carrying oxygen around the body, simply do not have enough of it available to do their job properly. Brain and lungs swell, the so-called high-altitude oedema, blood thickens in the legs and clots, while blood vessels in the eyes can burst. The process of acclimatization is therefore vital. This long word describes the body’s adjustment to the strange high-altitude environment. In principle, the more rapidly a climber ascends, the more likely it is that medical disaster will follow. It is worthwhile climbing slowly at altitude.