Knife Edge: Life as a Special Forces Surgeon (5 page)

By the end of my second week in Sennybridge I was a reformed person. I had learned more than I had thought possible. It was not something I could brag about, as personal security was always a problem. As far as my medical colleagues were concerned I simply belonged to the Territorial Army. Mention ‘SAS’ and people would either raise their eyebrows in disbelief or ask inappropriate questions. It was best to avoid the subject. The IRA didn’t help, as mainland attacks were fast becoming a regular feature of the mid to late 1970s. Territorial SAS soldiers are very exposed in this respect. They do not have a barbed-wire encampment behind which they can hide. Nor do they go overseas for weeks on end, making themselves impossible to detect.

Returning from one weekend away, early in my SAS career, I was tired and I was dirty. Exhausted, I dumped my Bergen in the locker room, picked up my holdall and started to walk towards the nearest Underground station. It was still light, there was little traffic for London, so I wandered at a casual pace, mind on other things. As I walked, I saw a line of five people standing at a bus stop. Two were in a tight clinch. To all intents and purposes they were already in bed. I glanced and smiled at the remaining three individuals who were trying to ignore it all. As I did so I felt a low, but very distinct, rumbling coming from my holdall. By then, with SAS training well under way, I was braced for the possibility of a terrorist attack. My father was also in Intelligence at the time. I had every reason to be a target.

It had to be a bomb. Like a fool I had left the holdall unattended all weekend and the bastards had got me. I had to get rid of the holdall fast. It could blow at any time. I knew my only hope, indeed the only hope for the civilians around me, was to throw the thing away, as far as possible. The bag was heavy, so like an Olympic hammer thrower I turned a rapid full circle, the bag in my outstretched arms, released it and shouted, ‘Get down! Bomb! Get down!’ As I dived for the security of the gutter, I glanced up at the flying holdall. Thank God, I thought. It had been a good throw. Provided the explosive was not too powerful, the small wall for which I had aimed should protect us all. No one else moved, though the elderly woman at the end of the queue did look somewhat astonished. Then, as the holdall tumbled through the air, straps and handles flapping loose, the awful realization hit me. It was a sick feeling at first, that rapidly turned into uncontrollable mirth. I lay in the gutter laughing. It wasn’t a bomb at all but my electric razor. For some reason it had chosen that moment to discharge itself. ‘Just testing,’ I said to the bus queue as I sheepishly picked up the bag, ‘Just testing,’ and went on my way. SAS service does wonders for your reflexes.

‘If you cut that artery, Villar, I will personally crucify you.’

‘This one, sir?’ I pointed towards a pulsating tube with the trembling ends of my long, curved, surgical scissors.

‘No, you daft idiot. That one. Look. Here. I’ll show you.’ My tall, intolerant instructor deftly pulled the patient’s stomach to one side to reveal the engorged blood vessel behind it. With a perfectly steady hand he took his surgical forceps and rested their blunt tips on it. ‘This one. Can’t you see? This is the one I want you to avoid. Your scissors have lurched near to it several times. If you damage it by mistake we’re all in trouble.’

‘Oh! I see. Thank you, sir. Y-Yes, sir. Of course, sir,’ I replied uncertainly as I struggled through the operation. I think the instructor felt he was being kind when he let me act as first surgeon. Coming near to full qualification, I would normally have been the assistant, standing where he was now, but for some reason we had today swopped around. It is astonishing how easy an operation can seem when you are assisting, but how difficult it can be when you are at the sharp end, the first surgeon. It was the first occasion I had been allowed to operate on a living patient. Until then I had been confined to laboratory-frog dissections, dead human-body dissections and copious assisting at the real thing. Nothing can ever prepare you for that first day. It often comes when you least expect it. Suddenly, to have prime responsibility for the life of a patient makes the task appear harder. My hands were all over the place. I could barely control them. A tiny tremor of your finger is magnified a hundred times if you are holding long scissors or forceps, six inches from end to end.

It was meant to be a simple task. Find a small nerve, called the vagus nerve, lying near the stomach and cut it. Called vagotomy, it was a treatment for stomach ulcers. We would scarcely do it now, as tablets do the same job admirably, but there was a time when vagotomies were performed by the dozen, every day, in operating theatres throughout the world. This was one of them.

It was an early Tuesday morning and my brain was still fogged from an arduous weekend away with 21 SAS. I had not slept from Friday to Monday and was only just beginning to recover. Certain that all I would have to do was assist, pulling gently on a surgical retractor or swabbing the occasional blood vessel, I had looked forward to a relaxing morning while the first surgeon took the strain. It was as I walked through the doors of the theatre coffee room that I realized this particular Tuesday was going to be different.

‘Ah, Villar,’ the outspoken instructor had exclaimed, as he lounged in his armchair, booted legs crossed and outstretched. ‘You want to be a surgeon, don’t you?’

‘Well … yes … but…’

‘Then
you
can do it. Why not? Excellent idea!’

‘Do what, sir?’ I asked, still suffering from extreme sleep deprivation, eyes half closed.

‘The operation, of course! You can do it. I’ll show you. Come on then!’ The instructor leapt to his feet, towering over me.

‘But…’

‘Come on, man! Do you want to be a surgeon or don’t you?’

‘Yes… but…’

‘Look. It’s a vagotomy. Even a blind man could do that. Follow me. The anaesthetist has already put the patient on the operating table so we’ve got to scrub up. Let’s go.’

I followed him along the corridor to the operating theatre. That sick feeling, again, ate away at my stomach. A vagotomy? I hadn’t a clue. I had no idea what to do. Where was the bloody vagus nerve anyway?

Even scrubbing up, the thorough washing process that all perform immediately before operating, was an ordeal. You may think it is a simple matter of washing your hands - it is not. Scrubbing up is a ceremony. The object is to wash from fingertips to elbows with disinfectant soap, but without touching anything other than running water and soap solution. Afterwards, try donning a pair of rubber gloves without touching their outer surfaces, for example. I can do it now, instinctively, but that morning I was all fingers and thumbs. I dropped gowns, contaminated gloves and knocked over a complete trolley of instruments before taking my position on the first surgeon’s side of the operating table. I knew it was not going to be a good day.

Anaesthetists have a habit of making junior surgeons feel unwanted. The vagotomy was no exception. With my instructor bellowing orders from in front, the elderly, eminent anaesthetist did the same from behind. Glasses perched on the end of his nose, he leant over my shoulder, muttering comments like ‘Come on, Villar, we haven’t got all day. There’s a whole operating list to finish by lunchtime.’

Two hours into this normally sixty-minute operation, I was exasperated. My initial fear was becoming anger. With the two of them shouting at me, one in front and one behind, I could have thumped either. I was unable to do so, of course, as that would have contaminated my sterile hands on their unsterile jaw bones. I was not impressed. If this was the type of training you had, it was no surprise it took most doctors a decade or more to become surgical consultants.

My mind was also on other things at times. Now I was badged, and held the Regiment’s lowliest rank of Trooper, it was proving difficult to juggle my medical studies with SAS commitments. I would frequently find myself drawing outlines of Soviet tanks on the back of a patient’s notes, or calculating ways of penetrating high-security establishments instead of concentrating on ward rounds. Those early SAS days were immensely demanding, mixing my two chosen careers, and yet highly enjoyable.

I knew I was out of my depth. In retrospect it was the instructor’s fault, letting someone so junior perform an operation so ill-prepared. Surgical training then frequently meant leaping in at the deep end without detailed experience beforehand. We would shudder at the prospect now, as I barely let juniors do anything unfamiliar without my gloved hands clamped firmly around their wrists. As I struggled with the vagotomy, I realized I had met my match, even if I had passed SAS Selection. I felt a surge of anger overtake me as I turned towards my two superiors, instructor opposite and anaesthetist beside. I tried to look each hard in the eyes simultaneously, though masks prevented me from seeing their full faces. ‘Sod you both,’ I said, spitting out the words. ‘Do the bloody thing yourselves.’ With a metallic clatter, I banged my forceps on to the instrument trolley to my left and in a few, short strides moved to the opposite side of the table. My two critics remained silent and motionless, dumbfounded by my behaviour. Medical students were the lowest form of human life in teaching hospitals, and I was no exception. But my blood was up. ‘Come on!’ I shouted, ‘If it’s so simple, show me. How the hell else do you expect me to learn?’ My instructor took the hint, quietly moving to the first surgeon’s position, completing the task with consummate, annoying ease. Needless to say, he never spoke to me again.

Once badged, life opens up for the SAS soldier, be he Territorial or Regular. Enormous opportunities exist, plus a level of comradeship and support unrivalled elsewhere. Training continues throughout a man’s career, liberally interspersed with operations and lifelike exercises. You cannot get more convincing than SAS training.

Interrogation is a typical example. I have now been interrogated several times. It gets no easier. The first occasion was late one Friday night. It had been a heavy week in the hospital, allowing little time to concentrate on anything other than medicine. Twenty of us were thrown from the back of a four-ton lorry outside a small village near Hereford. We had each been given specific instructions not to use tracks but to make our way to an RV the far side of some woods. Further orders would be issued when we got there. There were two routes to the RV. One, a safe, tactical journey around the outside of the woods used the available cover of hedgerows, farm buildings and tumbledown walls. The other was a broad, well-trodden bridle path through the woods themselves. This latter choice led directly to the RV and was very quick.

Despite specific instructions to the contrary, another operative and I chose the track. We calculated it would be possible to dash through the woods to the RV before the enemy had got into position. It was the very start of the exercise and we both knew how long such things took to get under way. Unfortunately we guessed wrong. It was the last time I ever used a track for any form of SAS service.

Leaping from the back of the lorry as soon as it stopped, the two of us ran as fast as we could towards the start of the track. I remember how inviting it looked. Quiet, seemingly undisturbed, a haven of peace and tranquility. It was as straight as a Roman road, allowing us to see moonlight at its far end, no more than 300 metres away. The remaining trainees chose to skirt the wood.

I remember the exhilarating feeling of knowing we would be first to the RV and thereby ahead of the entire field. The gamble was not worth taking. Within fifty metres of entering the wood, from the blackness to our right came the unmistakable command ‘Halt!’ My immediate reaction was to turn and run. As I did so, three large figures emerged from the undergrowth. One took my neck, the other my waist, another my legs. There was no arguing, their combined weights being more than 600 pounds. I was thrown sharply to the ground, face down and by then severely winded. ‘Keep still you bastard, and don’t speak,’ one said. A large boot pressed down on the back of my neck, a rifle barrel stuck under my left ear, while my hands were handcuffed behind my back. I can still feel them as I write this. Handcuffs are painful things. My colleague, an accountant at the time, was being manhandled in the same way. I never asked him what he felt, even when we eventually returned to London, but I imagine he rated himself as foolish as I. We had been out of the lorry for barely thirty seconds before being caught. Not what is expected of a trained SAS operative.

We were dragged, blindfolded, along the track to a waiting vehicle. Once a prisoner is captured the aim is to totally disorientate him in time and space. Hooding, or blindfolding, is one such way. I was terrified. My mouth was dry, my heart racing. It was not a pleasant experience. I could sense our captors were experts, but I had no idea what was in store for me. All I knew was that I could only give my name, rank, number and date of birth. I shall call them the ‘vital four’.

The UK now has a number of locations specifically designed for interrogation. I was to see them develop in later years. On this occasion, however, such facilities did not exist. It was dark and I was blindfolded. Much of what I describe is thus based on subsequent experience, when I was on the issuing rather than receiving end. I am afraid even doctors who have taken the Hippocratic oath do have a part to play in suspect interrogation.

By now I had lost contact with my colleague. For all I knew he could have been right beside me, but neither of us was going to speak to find out. Once caught, I knew I should say nothing to anyone, except the vital four when faced with my interrogator. I was taken first to the prisoner holding area, a dilapidated barn fifty metres from an equally dilapidated country road. An indelible marker pen was used to write my prisoner number on my forehead, my handcuffs were removed and I was placed in the stress position.

The stress position is the official term for wallstanding. Still blindfolded, your hands are placed at head height, palms forward, a shoulder width apart on the wall before you. Feet are positioned a metre from the wall and a metre apart. There you stand, seemingly forever. When you first adopt the stress position you wonder what all the fuss is about. After twenty minutes you begin to understand. Your hands go numb, your thigh muscles shake and your shoulders feel as if lead weights are attached to them. Slowly, quietly, in the hope that no one will notice, you let your elbows bend and hands slide downwards to a more comfortable position. What you do not know is that you are in the permanent company of at least one guard. He, or she for all I know, stays silent. No one hits you, no one threatens to kill or drown you, they simply put you back in the stress position whenever you lapse. They do not speak at all.