Battleworn: The Memoir of a Combat Medic in Afghanistan Page 16

  Scotty Pew confirms six kills, and it looks like they were setting up for an attack on us later, moving mortar rounds before randomly engaging Gaz Wilson’s position.

  Morale is dented amongst the soldiers of PB Argyll: the makeshift shower has taken a 7.62 mm round at head height, so everyone is to revert back to being feral – no washing again. Mega!

  I am desperate to call home to alleviate any fears that my mum may have had, but when I call all is well. I don’t think that she understood what all the noise meant, so I don’t tell her; my family would have to wait for me to write a book in order to find out what I had been up to in Afghanistan.

  CHAPTER 7

  MASS CASUALTIES

  THE ARRIVAL OF THE THROATCUTTER CALL SIGN INTERRUPTS THE peace that morning habitually brings. The boss welcomes the news that the turbine move to Kajaki is complete, as it brings all lead elements to the CP for a much-needed reorg. Planning will become more focused in light of the success. Everyone’s favourite ‘big picture’ is looking just peachy, and a switch in the brigade’s main effort means that the priority is now the handover of all areas of operation to 3 Commando Brigade.

  Maj. Clark, along with 2IC Capt. Wood, is busy devising plans for offensive operations tomorrow. With areas surrounding Nad-e Ali becoming increasingly unstable, 16 Brigade has deployed the PF platoon to operate in and around Marjah to our south. Small groups of Afghan special ops teams are patrolling the desert to our north. The kandak’s main effort is to push into the areas proving to be the most problematic. In recent weeks, Shin Kalay and Luis Barr have been highlighted as insurgent strongholds.

  Monty is back in action so he, under the command of 2Lt Du Boulay, will reinforce the Afghans should the need arise. The fighting platoon will conduct low-level ops just over a click away from the PB. Monty’s mood is light this morning; he is far happier back with his men and not stretcher-ridden in the aid post. The Throatcutters will assume the role of a roving quick reaction force; they will satellite the area and be on hand to provide mutual support to our fighting patrols and/or to serve as a casualty extraction team along with us. These are going to be significant and dangerous operations that will see us through to our end of tour. Suffice to say that 3 Commando Brigade can’t get here quick enough.

  I detect through levels of banter that the soldiers of B Company are more resolute than ever. This tour has already claimed the life of one member of the regiment. He was killed by a legacy mine left here by the Russians, and every man of the company is still grieving his loss. (His family, still very much grief-stricken, do not want his name mentioned. I respect their wishes and fully understand the devastation of losing a loved one.)

  The thought of going home has motivated the Jocks to finish their very personal battle to hold Nad-e Ali. Every step invested in this mission has safeguarded the ground, making sure that the district has not fallen to the Taliban. This AO is our main effort, and every soldier is committed to the mission. Despite our loss, we shall persevere.

  Flashheart prepares for his big day out, engaging in his now-customary process: his knee pads are pre-positioned, fresh coffee has been pressed, and Marlboro Lights are at the ready. His hair is more bouffant than normal as he pops into the CP for a quick shit chat prior to his departure. I have grown fond of his once-irksome character. Flash doesn’t take life too seriously, and he has the ability to laugh at himself. He is genuine and kind-hearted. I will probably read about him one day for having just won a Victoria Cross or something equally outrageous. Needless to say, the kandak is more than happy to follow Flashheart into battle.

  Sgt Maj. Tony Mason of the RI will deploy alongside the kandak, medic Gurung is assigned to the mentoring team, and Sean will deploy with Monty and his crew. I’ll keep Abbie and Jen with me. We prepare our medical room as we normally would, and then we see Sean and Gurung off as they leave camp.

  The moment both patrols deploy, a dicker (or spotter) is located through binoculars by Scotty Pew on the roof. A spotter will often be the eyes for waiting insurgents prior to any type of attack or ambush. A good dicker is one that is not seen. This one must have learnt his craft at the school of arse-clownery; he must have been skiving off or asleep during the covert dicker/spotter lesson. Unarmed, the male is noted and followed until he disappears into the thick vegetation that surrounded him.

  The mass exodus of blokes allows me to tend to the small number of troops left in Argyll. I keep busy administering basic physiotherapy techniques on the increasing number of non-battle injuries in the PB. Abbie is first in, complaining of uncomfortable lower back pain.

  I set about the muscles on either side of the lower spine, and Abbie winces in pain as the gristly knots come into contact with bone. We listen to music through the small set of speakers on the old wooden desk, and I start to relax, but I am doubtful that the soothing tones are helping Abbie to do the same. Coldplay’s ‘Fix You’ sets the tone for what is to become the single worst day in Nad-e Ali – for me, anyway.

  The sound of small arms ignites the radio net into action, followed by the thunderous roar of DShKs. The eruption of firepower is ear-splitting.

  Scotty Pew has full view of the surrounding area from the gun position on the roof, and it appears that the kandak are being engaged. Capt. Wood and the JTAC get busy calling for CAS in the shape of the Ugly call sign, and it doesn’t take long for help to arrive. As the Apache gunships circle the sky above, Monty’s crew are holed up in a small compound; they will sit tight until the full picture emerges. The latest information warns of imminent attacks on both call signs: insurgents have pinpointed Monty’s position, and ICOM chatter confirms that the Taliban know which compound and how many men are on task.

  The Afghan kandak caught up in close-quarter fighting are engaging enemy at will. CAS waits for confirmation from the JTAC to neutralise targets. The sound of the hellfire missile from the Apache silences the guns for a split second; at that moment, there is not a better sound anywhere on earth. The hellfire is an air to surface missile (ASM). With the Apache having the ability to carry sixteen of the bad boys, all is well – or so we think!

  The kandak’s glory is short-lived. Radio traffic soon comes to a grinding halt. Abbie, Jen, and I are in the middle of a conversation which comes to an abrupt end, as a panicked voice comes over the net, the stifled words ‘mass casualty’ barely audible. A long silence follows.

  The strangled cry repeats three more times: ‘Mass casualty! Mass casualty! Mass casualty!’ This wasn’t the calm Tony Mason that I was accustomed to.

  Abbie bolts upright, Jen looks at me, and I look at the floor, holding my head in my hands and trying to make sense of what I just heard. Taking a deep breath, I head through to Maj. Clark. My pulse increases, and those sweaty palms are back.

  Capt. Wood calls the Apache off just before it goes in for its second run. The boss and 2IC are wearing the same cold and clammy look that I am.

  As soon as I start to speak, I notice that my mouth has dried up. ‘What’s happened?’ I ask, all but choking on the words.

  In an exhausted but calm voice, Maj. Clark explains, ‘We have an incident involving the kandak and OMLT.’

  Tony’s voice comes back over the net. ‘Topaz zero alpha, ten casualties; most of my team have been hit, including my med call sign.’

  The CP is silenced; it’s the pause that every commander has prior to making a workable plan. Head in hands, focusing on what needs to be done, this way of thinking is what makes the military the best in a crisis. There will be no running around like headless chickens. It’s times like this that all the training and preparation for deployment shows its value. No shouting or foaming at the mouth, this is what controlled panic looks like. You might be at 30,000 feet and rising on the inside, but on the outside you remain stalwart and typically British. I focus on my own mass casualty plan, and of course I have one. Will it work? Only time will tell. The annoying but very true saying of ‘no plan survives the first contact with the enemy’ irrita
tes me when I think about it. I take a few deep breaths – not big obvious sighs, just enough to ensure that my brain is receiving oxygen – and then I set about the task at hand. I reassure the boss that we will square the situation away with the medics that we have before moving next door to prepare for our inbound casualties.

  I gather the two team medics of 5 Scots: LCpl Aaron Wells (‘Wellsee’) and Pte Farrel Foy. These guys can deal with our walking wounded or less needy, and I set them up in an area just outside the aid post. Jen and Abbie will take on the more-serious casualties, and I will oversee the effort, making interventions if required. Medical scene control is as important as treatment itself: if you get it wrong, the situation free-falls, as do the patients. We have set up separate CCPs to house our wounded.

  Meanwhile, the Throatcutters move rapidly to the kandak’s position; their task is to get our men back to the PB so that we can treat them. The boss orders Monty’s platoon to finish on task and assist the stricken call sign by providing an all-round defence for them. Things are looking good. Ever optimistic, I wonder if, for the first time ever in history, a plan will survive the annoying ‘first contact’ scenario.

  Like a reliable old Casio watch, the well-thought-out plan survives less than five minutes.

  ‘Man down… Man down!’ Monty screams over the net.

  As soon as they left the compound, the Taliban opened fire. The enemy patiently observed as the platoon conducted low-level ops in and around selected compounds. One of the lads has taken a round straight through the femur. A complicated injury at the best of times, this is news that we could do without.

  ‘What the fuck is happening?’ I say to Abbie.

  My brain is working overtime, and Monty is now pinned down in the compound that they occupied initially. I put those guys to the back of my mind. Our priority is to deal with what’s coming through the door. Sean will be working hard if the femoral artery is hit, but he is more than capable. I gather my medics and brief them on our plan of action; this is the calmest that I have ever seen them. It’s a good feeling for me as commander that there aren’t any doubts in our team.

  Sean is taking care of business, and news from the mentoring team indicates that Gurung is still managing to treat the other injured soldiers in his crew. It’s time to put my plan in action. Grabbing anyone who is free in the PB, I tell them I need help carrying stretchers. It’s no surprise that I am not short of volunteers. Once again up from rest periods, the PB braces itself.

  Brigade HQ back in Lash has started screaming for details of casualties. The boss wants quick and accurate information in order to guarantee the best possible outcome for our injured. One Afghan soldier is confirmed KIA on the ground, and then the first casualties start to arrive.

  With casualties strewn across the tailgates of vehicles, it’s messy. Quick checks tell me we have two cat-Bs so far (plus one KIA). One by one, I triage and assign our wounded. As I work my way through, all the years of training kick in. The head injury to Jen, and the open chest wound to Abbie. The more serious are taken straight through to the CAP. We quickly receive more casualties: four cat-Cs. Wellsee and Foy set about patching them up as best they can.

  The mentoring team are all back in Argyll now, with several wounded. Gurung continues to treat, ignoring the shrapnel in his own legs. I order him to stop so he can receive treatment himself. I’ve never been a fan of pulling rank, but he is starting to look a little pasty. Gurung isn’t the only one of the mentoring team wounded: Tony Mason has fragmentation damage to his arms.

  Flashheart has somehow managed to escape unscathed. Just the sight of him gives me a much-needed morale boost. He is in shit state, and his hair and kit are more dishevelled than ever. The wide-eyed panic in his face is back, so I am laughing at the very sight of him.

  ‘You okay, sir?’ I ask.

  Struggling to breathe, he replies, ‘All good, Sgt T.’ Once again, he adds value at the most-inappropriate time.

  I count up the casualties we have so far: eleven wounded, and one man KIA. Monty has yet to bring in his cat-B, which will make twelve. The boss wants a casualty report, and quick: the MERT are waiting to deploy from Camp Bastion, and brigade HQ is sending two Chinooks for the lift. So I systematically reassess all of our casualties: tourniquets are in place, airways are stable, breathing rates are acceptable, the all-important radial pulses are palpable, and the splints look good. I am happy that we have done all that we can. Our wounded are now stable enough to handover. I confirm with the boss that we as a team are good to go. Monty will meet us at the HLZ, bringing his casualty there to save time.

  The intense overpowering midday sun makes for an interesting pre-lift casualty brief to our stretcher bearers. Wiping sweat from my eyes, I wait for confirmation that both helos are airborne from Camp Bastion. With no time to waste and with everything under control, we begin to move our injured towards the HLZ.

  I spot an overzealous Afghan soldier driving his truck at speed in the direction that we were now heading. It looks like he may be trying to assist, but his reckless headless-chicken reaction is dangerous; this sort of lunacy will only create more casualties. So back to the start it is for me: scene control. Smashing the butt of my rifle onto his windscreen, I signal for him to stop. Trying to remain calm, I demand, ‘What the fuck are you doing?’ I force my fully armoured frame into his open driver’s window, removing the keys from the ignition. Abbie would later laugh that from her view near the CP she could see me hanging halfway out his window, like a great white hanging out of a shark dive cage, apparently. By this point, I reach for the hand brake, gripping the keys and his collar tightly in my other hand. I wait for the other Afghan soldiers assisting me to sort the soldier out. They drag him from his vehicle before moving him away.

  Staying on task, I call vehicles forward. They are laden with our wounded, and the stretcher bearers follow on foot behind the vehicles. The scene we face takes my breath away: splashes of vibrant red cover the desert camouflage shredded by the blasts, barely covering the bodies of our wounded. People are talking to me; I see their mouths moving, but I can’t hear anything. We have casualties that are physically hurt, but we also have young men in precarious mental states. Making ground slowly, we edge towards the HLZ. I give Abbie one set of handover notes, and I take the other. The four cat-B patients are split. The remaining cat-Cs will be divided equally between the airframes.

  Sean and Monty suddenly appear at the front gate, with the femur fracture and Pte Coakse (‘Coaksee’). The femur has been very well splinted, in light of where they were during point of wounding; he has been extracted, much to the detriment of the call sign. Another fighting withdrawal has created a heat casualty. Coaksee’s eyes are rolling in the back of his head, and he is barely conscious. I can’t risk keeping him here, so he gets evacuated along with the rest.

  Sean tries to administer fluids orally while the rescue birds hover above, but there’s no cover to site an IV. Time just isn’t on our side. The information has already been logged, so I will have to make sure that the MERT don’t miss Coaksee or overlook him. There are no stretchers left, so Sean will carry Coaksee onto the helo.

  We settle the casualties down in the usual position to the side of the landing site, and without warning, one of the Afghan soldiers decides to walk straight across the HLZ. Two Chinooks are hovering above him, coming in to land. By some miracle, the downdraught has disorientated him enough to move him towards my position. I grab him by the scruff of the neck before forcing him face first into the dirt, all the while nursing the vision of him losing his head to the low rotor blades at the front of the Chinook.

  The airframes land simultaneously; the familiar faces on the back of the airframes are a welcome sight. Doctors from my regiment hand us bags full of medical kit and all the good stuff from the store housed in Camp Bastion.

  The casualties go on, and my Afghan medical team get it right this time: they control themselves, and for a moment, I am proud of them. I explain Coakse
e’s situation to the receiving team, and they are all over it. As casualties are systematically handed over, our team move off and take cover from the downdraught.

  The two Chinooks lift off the ground together. It’s incredible, and the buzz from adrenaline is like nothing that I have felt before. As the dust settles, the sound of the engines peters out into the distance. I have a weird moment, wishing that I was on one of those birds, heading home. Running back to the PB, I don’t dwell on my ‘moment’ too much, pretty sure most people are feeling the same.

  The aid post is in chaos; I don’t know where to start. Blood coats much of our equipment, and the sodden clothing from casualties, including their shoes, are still in place where their bodies once lay. Vomit covers the floor where Jen dealt with the head injury. Of all our patients, I was most doubtful of his recovery. Grabbing a pack of water bottles, I pass them around the team. Nobody speaks for ten minutes or so, silently taking in the magnitude of what has just happened. Fiddling with a clinical waste bag, I forget for a second why I have the damn thing in my hand.

  Our solemn mood changes to an angry one as stories emerge about the cause of the carnage today. Our guys weren’t shot up by a well-dug-in Taliban position, nor did they encounter a daisy chain of IEDs, as initially thought. They were hit by the hellfire missile from the Apache gunship (or fragmentation from it) – the same hellfire that we had celebrated hours earlier. No one took the news calmly, least of all Davey and the boss.

  After a tense regroup in the CP with all call signs in attendance, it transpires that friendly grids given over the net have been miscommunicated as enemy grids. The Apache pilot wasn’t at fault; he engaged what he thought were enemy positions. Luckily, Capt. Wood called the Apache off just before he was going in for a second run. The 2IC’s quick reaction stopped the Apache from re-engaging.