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“War at its rawest is their domain, an ugly place of shattered bodies, severed limbs and death. Theirs is the most selfless of acts. They fulfil society’s vital pledge to its warriors that they will not be abandoned on the battlefield. Yet, more often than not, what they do goes unnoticed – except by those who survive because of the extraordinary courage and skill of their rescuers”.
The invading armies of Julius Caesar and William the Conqueror travelled with surgeons and physicians: not for humanitarian reasons, but because fighting men were valuable commodities, worth saving.
In the following centuries however, that simple philosophy was either forgotten or ignored. The revered Duke of Wellington thought that medical personnel had no place on or near a battlefield, and was openly contemptuous of them – in striking contrast to Napoleon Bonaparte, whose enlightened attitude to the welfare of his troops put the neanderthal Iron Duke to shame.
Nor did things improve during the Crimean War. British generals, with their eyes only on military glory, left medical supplies behind as ‘useless’ encumbrances’. There were no stretcher-bearers to take wounded men away from the battlefields, no hospital ships to bring them home, no evidence at all that the lives of the men fighting and dying for a cause they barely understood were in any way valued by those moving the chess pieces. The appalling conditions that Florence Nightingale famously discovered in the hospital at Scutari were absolutely typical of the callous disregard with which the wounded were treated: which is not to say that those medical personnel who were there didn’t care – they did, and went to extraordinary lengths to preserve life and ease suffering with what few resources they had, resulting in three doctors eventually being awarded Victoria Crosses for their heroism under fire.
But the national disgrace that was the Crimean War failed to be the turning point it should have been. Although attitudes to battlefield medicine improved in theory – partly in response to public pressure – man’s ability to invent better, faster and more devastating weapons with which to inflict catastrophic injuries upon fighting men meant that medical science was, and is, forever playing catch-up.
During the First World War the recently-formed Royal Army Medical Corps (RAMC) went into battle with a plan: to remove injured men from the conflict zone as quickly as possible, administer field first aid and then despatch them to safe zones for medical treatment and surgery. The plan fell apart in the unimaginable slaughter and chaos of trench warfare. If the stretcher bearers managed to drag the injured men into dugouts, the chances of the beleaguered medical orderlies being able to prevent death from blood loss or disease were minimal and surgeons found themselves operating in equally impossible and insanitary conditions on injuries they had never even imagined in their worst nightmares.
It’s too easy to say that lessons were not learned; no-one who has not been through it can begin to understand the full horror of all out war. When the War to End All Wars failed to live up to its grandiose title and Britain found itself preparing for conflict yet again, the medical services thought they were going in better prepared …
When dealing with such a vast topic, painting with a broad brush would dilute the impact of the narrative and from the Second World War onwards through the Falklands, Iraq and Afghanistan, Nichol and Rennell sensibly start to concentrate on telling the stories of just a handful of people and the actions they were involved in. We’re told a little about each of them – no more than a thumbnail sketch really, but enough to give personality and, most importantly, a human face to each. We then walk in their footsteps and follow them into war. Through their extraordinary stories of quiet corage we learn about the ebb and flow of battlefield medicine: how thinking on whether it’s better to have medics up at the front line with the troops or safely away from the fighting has changed with each new conflict.
When stories of war are told, the emphasis is always upon the fighting men – the leaders, the heroes, the ordinary troops who did far from ordinary things. Seldom do we hear about the men and women who respond to the constant cries of ‘Medic! Medic! We need a medic!’ and run towards danger when others are taking cover.
Medic is a much-needed and powerfully written corrective, and every story in it leaves you speechless with an admiration that is mingled with both disbelief and the nagging feeling that, in similar circumstances, you would not be capable of demonstrating a fraction of their self-deprecating humanity and raw courage.
It’s also an angry book, informed by both personal experience (John Nichol was an RAF pilot shot down and taken prisoner during the Iraq War) and a profound respect for the service personnel who live and work in the shadow of fear, death and disability. Yes, they’re paid to do a job – but how many jobs are there in the world that can leave you maimed, traumatized or dead?
“In the United States, wounded veterans of Vietnam returned to a nation that was embarrassed by their existence. And so it has gone on into the twenty-first century. Iraq and Afghanistan are whirlwinds of human tragedy, the full consequences of which we are yet to reap.”
Medic is not a book for the faint-hearted or squeamish. Many of the stories are life-affirming and even touching, the heroism is understated and some of the rescues near-miraculous, but the authors rightly pull no punches, and one of the photographs in particular graphically illustrates what happens when a human being is hit by a rocket-propelled grenade. The victim – Sergeant Major Andy Stockton – actually survived. His story opens the book and is a testament to both his own bloody-minded determination and the skill and dedication of the RAMC personnel who saved his life.
We fail to value both at our peril.
Penguin Viking. 2009. ISBN: 978-0-670-91604-7. 422pp.