Knife Edge: Life as a Special Forces Surgeon (33 page)

A caving ladder makes an excellent stretcher. Once padded with sleeping bags and sleeping mats, a casualty is as secure as can be. It took eight of us six and a half hours to reach the American research camp. We only dropped Peter once, though he was fortunately asleep. I had sedated him for the journey as I had felt anything could happen on the way. In reality, evacuation went smoothly. The moment we arrived, out came the tea, soft drinks and an endless supply of American candy. Meanwhile Peter was taken off my hands, being thoroughly examined and assessed by their resident specialists. Despite his broken bones, head injury and disorientation, I was now happy he would survive.

I do not envy Bronco the terrible decision he next had to make. Should we now go back up the mountain and try again? Whatever conclusion he reached was bound, in someone’s eyes, to be wrong. Tony was dead. It was obvious that Peter, and Brummie, should not continue. Likewise the climber with frostbite. Brummie’s neck could still paralyse him and Peter could barely speak. They would have to return to more sophisticated medical care. Four men down, from a fourteen-strong team, and significant quantities of equipment destroyed, it was unlikely the SAS would succeed. Failure is not a word that comes easily to the Regiment, but I am sure the decision to abandon Everest was correct. Exercise Pilgrims Return was over.

Four days after the avalanche, the UK still did not know of our predicament. Satellite communication was only just coming into service and our team did not have it. The Tibetan driver tasked to take us from the Roadhead to Lhasa appeared overcome by events and decided to drive like an ambulance on a blue-light emergency run. Second only to the avalanche, he was unquestionably our greatest hazard. Within minutes of leaving the Roadhead, two casualties and me on board, he ran off the track, half overturning the Land Rover. I can hear my companion’s screams now. We were fortunate not to sustain further injury and wasted no time in telling the driver what we thought of him. SAS operatives are a class apart when it comes to insults. He took the hint at that point, driving sedately thereafter.

The village of Xgur was our first stop. At first sight the place had little to its name. Dusty, primitive houses, overlooked by the tatty remains of the town’s walls, perched erratically on the side of a mountain. Despite this, Brummie found a telephone, so together we tried to ring Hereford. It was not easy, though we eventually made contact with the Orderly Room. This is the one location, in any military barracks, where you can be certain someone can be found at all times. The line was terrible, the only way of passing the message being to spell it out, letter by letter, using the signaller’s phonetic alphabet. A is Alpha, B is Bravo, and so on. It was painfully slow, and enormously expensive, taking four hours to notify the SAS and the Defence Attache in Peking. I also tried telephoning Louise - no answer. The first she heard of the avalanche, I subsequently learned, was when a friend telephoned her to say it had been reported on the news.

As we travelled through Tibet towards Lhasa, I was relieved to see Peter steadily improve. The lower we went, the better he became. Even so, his behaviour was far from normal. He staggered rather than walked, demonstrating that the head injury was still having a profound effect. As a matter of urgency, I felt it was important he was admitted to the nearest Western-style hospital, probably Hong Kong. The Chinese Mountaineering Association, despite the expense, pulled out all stops to help, taking us through the land at phenomenal speed. Medically this was ideal, but I felt there might be more to their cooperation than simple medical urgency. A telephone conversation I had when we reached Lhasa, with a high-ranking officer in Hong Kong, explained all.

‘The Commander of British Forces wants to send in an aircraft to pick you up,’ he said.

‘What? Into Lhasa?’ I asked.

‘Yes. He’s negotiating with the Chinese now.’

‘There’s no real need, sir,’ I replied. ‘Peter is doing pretty well now. I’m sure he’ll recover.’ I could tell I was saying the wrong thing by the hesitation at the other end of the line.

‘As I said, Richard,’ came the top brass’s reply. ‘The CBF will send in an aircraft. He thinks it’s important.’

‘But… but…’ I was interrupted.

‘The aircraft
will
come. He’s talking to them now. The CBF says it’s vital. I’m sure you can understand what I’m saying.’

Politically it would be desirable to have an RAF aircraft landing on Chinese soil, at a time when such things were diplomatically forbidden. To use Peter as an excuse would be perfect. I was having none of it, irrespective of the consequences. There are times in one’s medical life when you must make a clear decision between what is best for the patient, and what is best for everyone else. I have always chosen the patient. Peter was recovering, I was in control and the Chinese were doing well. I bade the top brass farewell, ignored the politics and had the climber in Hong Kong within thirty-six hours. I was damned if any patient of mine was to be used as a political pawn.

Six days after the avalanche I managed to talk to Louise by telephone for the first time. I told her I was alive, uninjured and on my way home. Wasn’t that good news? No one could accuse my wife of being passive - perhaps it is her Scottish roots. Her reaction was typical. ‘Do you mean you’re giving up?’ she asked incredulously. ‘Seems a waste to me.’ What else, after all, would you expect of an SAS spouse?

Despite her initial doubts, by the time we reached the UK’s Brize Norton airfield, she had accepted our failure. As I burst through the terminal doors to greet her, my arms spread wide for a welcoming hug, I saw the look of disbelief in her eyes. Her usual smile had disappeared, replaced by a tiny frown that puckered the middle of a normally smooth forehead. What’s wrong, I thought? Hasn’t she missed me? Isn’t she pleased to see me in one piece? I slumped my arms in disappointment. Then I realized the problem. The beard! I had grown a respectable, hairy affair that now covered most of my face. Recognition slowly dawned as she peered through my heavy disguise to see her husband beneath. Together we spread our arms, big grins on our faces as we now hugged. ‘Darling,’ she whispered in my ear, ‘I do love you. It’s wonderful to see you again.’

It is difficult to re-enter an orthopaedic career after climbing Everest. Your mind dwells so much on other things. If I were to succeed, taking absence from mainstream surgery would not be possible for a few years. You have to become part of the system, and the system is not found perched on the world’s mountainsides, even though by now the high-altitude life was firmly in my blood. My ambition to work in the Third World still remained, but for the time being I had to become familiar with a wide range of orthopaedic operations to be of any use. Fractures, replacements, funny feet, funny knees, funny hips and so on. There was much to be done. I resolved to stay based in the UK for several years, learning the various tricks of my trade. However, I would still visit the Third World on occasion, both to refresh my ambition to make a life there and to teach others what I could. In my shaky stumble up the orthopaedic career ladder I spotted what I thought was an ideal surgical job in Cambridge, that unusual centre of learning in an otherwise barren landscape.

The Cantabrigians did not make it easy, giving me an interview that made interrogation seem like child’s play. I struggled through it, relieved when it came to an end. Most of the questions asked were impossible. Having sent me from the room, the panel duly deliberated, summoning me from my cold cup of tea to receive their decision. I was sure I had failed. I entered the room, took my seat and waited for the axe to fall. Before me sat the eight, sombre-looking men who had grilled me. The chairman spoke first.

‘Mr Villar, we are delighted to offer you the post as an orthopaedic surgeon here in Cambridge. Do you accept?’

‘Me? Are you sure?’

‘Yes, Mr Villar. You. We’d like
you
. Do you want the job?’ I nodded enthusiastically at that point, detecting an irritated tone in the Chairman’s voice.

‘Excellent.’ I saw the sombre heads nod sagely, their faces still serious, though one did wink. At least I think it was a wink, it might have been a nervous tic. ‘Do you have any questions for us, Mr Villar?’ the Chairman added.

This was a strange turn of events, the interviewee asking the panel questions, rather than the other way around. What was I meant to say? Ask them about orthopaedics? The time? The weather? The pay? I struggled to think of a question, if for no other reason than to look intelligent. ‘Yes, I do have one,’ I eventually said to the eight pairs of raised eyebrows sitting before me. ‘Your mountains. Where are they?’ I could not imagine life without them.

The eight faces looked simultaneously shocked and confused. I saw them look left and right, conferring in low, deep voices. Slowly each shook its weary head. One even raised its eyes to Heaven, as if to beg forgiveness for the error they had made in offering me the job. The Chairman eventually spoke.

‘Mountains, Mr Villar? We don’t understand. Cambridge doesn’t have any mountains. Surely you are aware of that? You might mean the Gog Magogs. Keep driving south-east from Cambridge. You can’t miss them. That will be all. We look forward to you starting one calendar month from today.’

I had been dismissed. Nodding my thanks, I departed rapidly from the room, returned to my car and drove hastily south-east. I drove for miles and saw nothing that remotely resembled a mountain. Not even a mole hill. After thirty minutes I reached Haverhill, a major conurbation southeast of Cambridge. That, too, was flat. Perplexed, I drew the car slowly to a halt beside an elderly lady, pushing a ropy pram stuffed with shopping bags. In her tatty tweed overcoat she turned to give me a toothless smile as I wound down the window.

‘Excuse me!’ I shouted across to her, raising my voice to overcome the noise of passing traffic. ‘Excuse me! Can you tell me where I might find the Gog Magog Mountains?’

‘What luv?’ came the reply. ‘Gog Magog Mountains? We ain’t got no mountains ‘ere. The Gogs? Yeah. Little pimples just aht of Cambridge. You’ll drive past ‘em if you blink. But they ain’t no mountains. We got none ‘ere.’

Cambridge, how could you do this? I thought, as the terrible realization hit home.

Pain shot up my left arm like an electric shock the moment the needle stabbed my finger. ‘Sod it!’ I yelled, as I disturbed the peace of the normally quiet operating theatre. It had been a difficult, lengthy operation. A rabid boar had attacked the man, thrusting one tusk deep inside his chest. The lung had collapsed and bleeding had been heavy.

By good fortune the attack had occurred near the hospital, so we had been able to treat the patient before blood loss had been too severe. It was as we were closing the wound at the end of the operation, a normally simple task; that the accident happened. The hospital was so poor that I had to reuse the surgical needles. Single-use, disposable needles, commonly used in the West, were unheard-of here. The one I had selected had been used so often it was now blunt. Picking up one edge of the skin wound with my toothed surgical tweezers, surgeon’s forceps, I had tried to plunge the curved needle through it. It would not go. Then, unexpectedly, the skin had given way and the needle had shot through - directly into my gloved fingertip, impaling me, and now buried almost to the hilt.

Such injuries, needlestick injuries, are part of the normal hazard of surgery. Provided neither you nor the patient have some ghastly disease, they are not a problem. But rabies. This man had been assaulted by a rabid boar and rabies was a killer. There was no known cure and no guarantee the inoculations I had received before leaving home would protect me. If any killer virus was left in the wound, however carefully I had cleaned it, there was a strong chance I would be a goner. This was the
terra incognita,
the jungles of India’s Madhya Pradesh state, perhaps the most medically hazardous environment in the world.

I had been surprised by Cambridge. Surprised because I enjoyed it. I had not expected such tolerance of my peculiar ways. Having recovered from the shock of the 100-foot Gog Magogs being considered mountains (there is even a mountain-rescue team, would you believe), I settled into my new life as a fully fledged civilian. For the first time in over a decade I had no involvement with the SAS at all. Occasionally an ex-colleague would arrive in my clinic, seeking opinion on the delayed effects of some earlier war wound. Now and again I would receive strange telephone calls from unidentifiable voices, asking about peculiar tropical conditions that few in the UK had seen. Such contacts served to make me restless. My mind would repeatedly wander, as I gradually amassed experience in orthopaedic surgery.

To my horror, I found my ambitions changing. Whereas I had initially wanted to live and work as an orthopaedic surgeon in the Third World, I began to feel there might be alternatives. Cambridge, a major teaching and research centre, was giving me many opportunities. The chance to pioneer new operations, to instruct enthusiastic juniors and to set up specialist orthopaedic skills. Hips and knees I found particularly interesting, I suppose because so much of my SAS experience had involved injuries to those areas. The operatives were forever twisting knees and banging hips, so I knew a fair amount about them even before I became fully civilianized. Perhaps I would remain based in the UK, offering my services to whichever Third World country needed them, but for limited periods. That way I could maintain the UK connection, yet still be useful to the primitive peoples of the world. Louise also preferred the idea. The last thing she wanted was to be stuck in a mud hut overseas for the next twenty years. I had to sympathize.

After much deliberation, I thought I would try out my modified ambition. I wrote to dozens of charities, some of which are household names, while others are rarely heard of. ‘If it is of any use,’ I wrote, ‘I can give you six months of my time. I am happy to do anything. You do not need to pay me.’