VinRouge
26th Jul 2009, 09:33
Blood brothers scarred by war - Times Online (http://www.timesonline.co.uk/tol/news/world/asia/article6727670.ece)
Dad, I’m sorry,” were my brother’s first intelligible words, whispered through swollen lips and an oxygen mask. Dad leant in close and told his son how proud he was of him. For three days we had hovered around Jim’s bedside in Birmingham’s Selly Oak hospital — as he lay doped up on a cocktail of opiates, antibiotics and general anaesthetic — since I had arrived with him on an emergency flight from Afghanistan.
“I am having some pretty weird dreams,” Jim murmured as we strained to hear him.
I had always wanted to be a war correspondent. Ironic, then, that the first casualty of war I saw was my younger brother lying limp and lacerated in a field hospital in Helmand.
Related Links
The medics saving lives at Camp Bastion (http://www.timesonline.co.uk/tol/news/world/asia/article6727798.ece)
It was last Sunday that I received the news I had feared but never thought I would actually hear. I was on assignment for The Sunday Times, covering the largest ground operation launched by British troops in Afghanistan.
In four hours I was meant to be on a Chinook helicopter, air assaulting into a Taliban stronghold as part of operation Panther’s Claw with soldiers from the Black Watch, Royal Regiment of Scotland.
Body armour and bags packed, I was waiting in Camp Bastion, the British base, counting down the hours until we were due to fly and worrying about whether I would be able to understand the Jocks’ thick accents.
Jim, recently arrived in Afghanistan as a second lieutenant in the Rifles, was on another operation.
The telephone in the camp’s media tent rang and I was called in. I thought it would be the press team querying an article I had written.
“I’m sorry to have to tell you this, but your brother has been badly wounded in an explosion,” said a voice I did not recognise.
The body goes numb and the mind races. How badly wounded? Images of my brother with no legs, no arms — worse — left me nauseous.
That morning, mum had sent me an e-mail from England saying she felt “wobbly”. Around the time she e-mailed, in a deadly and uninhabited Helmand town called Wishtan, her 24-year-old younger son had walked onto an “improvised explosive device”.
I HAVE always been proud of Jim. When I was four and he was two, I stopped strangers as I pushed him through Windsor park and told them: “This is my brother James.”
Friends and family say we are strangely close for brothers. We have been so since we were little. I can remember having only one fight with him. I stole his toothpaste and he was furious with me.
I have always been there when things have gone badly for him and he looked up to me when he was younger — before he struck out on his own.
Our father was a soldier before I was born and the family’s military tree dates back centuries. My grandfathers and grandmothers served during the second world war. Other relatives have been dotted all over the world in the service of Queen and country. Pictures on the walls at home depict men in battledress.
The images fired our young imaginations. During a game of soldiers, aged six and four, I announced to Jim that I would be the lieutenant. He turned and promptly said: “Well I’ll be the right-tenant.” Mum once caught him, aged seven, trying to blow up the house with petrol and a long rope “fuse”.
Our uncle, who had of course served in the army, bought us gas masks and webbing from army surplus stores. During the holidays we visited military exhibitions and air shows. When we hit our early teens, we would dress up in combat gear and gas masks, load up our BB guns and race around the garden shooting each other.
Jim was very bright and had an extremely independent mind. I don’t think he saw the value in education and he was easily distracted when young.
Constantly changing schools, girlfriends and jobs, he lived his life in a pretty much constant state of flux. He was a rebel who kicked against all forms of authority.
Some of our friends could never understand why someone who had done his best to rub authority up the wrong way for most of his life would suddenly join an institution like the army in his early twenties.
I wasn’t surprised. I think he had wised up. He was prepared to deal with the petty rules imposed by the military because he ultimately saw the value in becoming a soldier.
For Jim it meant he could escape the confines of a desk job, pursue a life of adventure and follow in his father’s footsteps. In the weeks and months that passed after he went to Sandhurst, the turbulent relationship that had once existed between my father and his younger son grew from strength to strength as they swapped common tales of military life.
They became solid friends and my father, who had fought in the Dhofar war and Borneo, clearly found it fascinating to learn how the military had changed.
Jim came back from Sandhurst sporting a new language like a badge of honour — “gleaming”, “crack on”, “start sparking” seemed to slip into his vocabulary overnight.
One of my worst fears about Jim joining the army was that we would lose some of the closeness we had. I was worried he would come back feeling that he didn’t want to tell me things he had seen. I’m still not sure why I didn’t become a soldier, too, as I have always wanted to see war up close.
I guess it might have something to do with our military background and a desire to see what some of them saw, to be able to relate to it all, that I set out to be a war correspondent.
After working in the local press in Berkshire I managed to get out to Afghanistan to start reporting on a shoestring as a freelance two years ago — at around the same time that Jim started to attend Sandhurst. I realised there was a chance he would end up out there, too.
He passed out from Sandhurst just before Christmas and joined my father’s old regiment, the Royal Green Jackets, which had recently been swept up and amalgamated into the Rifles. Destined for Afghanistan, he went straight into an intensive course for platoon commanders.
In May, I came home to spend the final two weeks’ leave with him before he flew out to the war.
We spent the nights getting drunk, ending up on park benches at eight in the morning still clutching empty bottles of whisky. We avoided talking about anything serious.
I had never seen him as confident, as happy or as mentally sharp as he was after he had joined the army. But for all the fulfilment he gained from his training at Sandhurst, in the jungle in Belize and on the Brecon Beacons in Wales, and the bonds he built with other young cadet officers, there was always the knowledge of the inevitable risks he would face.
The dangers had always hung over every conversation we had about his career but were not mentioned.
On the last whisky-drenched night of our reunion, we sat in the loft at home — with its spray-painted walls, collection of junk picked up on travels abroad and worn sofa — which we used to escape to after dinner as we grew up together in Windsor. We spoke at last of the possibility of his getting injured.
“I don’t want it to change anyone’s life,” he said.
TWO weeks ago Jim and I were together in Sangin, a heavily mined district in Helmand where in the past three months 11 British soldiers have been killed and many more wounded, largely by the improvised explosive devices (IEDs) that have proved so effective in slowing down the army’s movements.
My brother was serving in Sangin as Second Lieutenant James Amoore, a platoon commander with 2nd Battalion The Rifles.
Between foot patrols into a lush fertile strip of land known as the Green Zone, the two of us swapped jokes, caught up on each other’s news and swam in the canal that runs through the main base in Sangin. He poked fun at my “civvie beard”; I told him that all he had managed to do since coming to Helmand was to work up a good tan.
We watched with amusement as the French female photojournalist I had taken with me tried to escape the cameras of Afghan soldiers as she bathed in the canal. We spoke a bit about home and the girls we knew back in England, but mostly Jim was bursting to tell me what he’d been up to.
His knowledge of the situation seemed to be pretty strong and I quickly got a good sense of what the army was trying to do in the district.
He told me some of his soldiers were frustrated with the lack of head-on clashes with the Taliban. “They’re laying IEDs like mines here,” he said. “Some of the men haven’t even seen the Taliban.”
We went out on a company-sized operation together. The officers in charge understandably didn’t want me in Jim’s platoon, so I was attached to a section just south of his.
As soon as we left the base, teenage Taliban scouts were monitoring our movements. We fired off a handful of warning shots and they fled. We continued the patrol through ploughed fields and along waist-deep irrigation canals, careful to keep our distance from the man in front to limit the impact of an explosion if someone stepped on an IED.
About eight hours into the operation, Jim’s platoon came under direct fire. One of his men was shot in the leg. Later, back on the base, Jim’s sergeant approached me and said my brother had handled the situation with considerable calm, securing a helicopter landing site before organising the extraction of the casualty.
I relayed the sergeant’s words back to my brother. All Jim said was: “Imagine a duck on a lake. On the surface, the duck looks pretty calm; underneath it’s flapping like a lunatic.”
After I returned to Kabul, where I live and work, I spent nights without sleep, imagining the worst. The thought of losing him crippled me.
Jim wrote me an e-mail from Sangin on Friday, July 17, saying he was being sent to Wishtan, a remote area to the east, to take over command of 9 Platoon. Five of the platoon’s riflemen had just been killed in a series of explosions and their commander was badly wounded. (He now lies next to Jim in intensive care at Selly Oak.) In all, in the 10 days before Jim was sent to Wishtan, 15 British soldiers had died in Afghanistan, prompting an intense debate back home about the purpose of the war and the resources devoted to fighting it.
“I’m fairly worried about going, mate, it’s not a nice place,” Jim confessed in his e-mail, expressing the first sign of any fear I had ever heard from him. “Mum and dad don’t need to know I’m going there.”
The riflemen in Sangin describe Wishtan as a ghost town. They run a deadly gauntlet every day dodging the IEDs and remote-controlled bombs in a maze of narrow alleyways fenced in by high mud walls. They call it the “Pac-Man challenge” in reference to the old computer game that was popular before many of them were born. Soldiers who have returned safely from Wishtan have all had their brush with death.
I did not sleep at all on the night of Jim’s e-mail.
TWO days later I was being rushed to the intensive care unit at Camp Bastion’s hospital — and mum was discovering that her “wobbly” fears had been justified.
At home in Berkshire, dad saw a man at the door wearing a Parachute Regiment tie. He knew immediately that something had happened to his son. He assumed the worst. “Is my son dead?” he asked.
James was badly wounded, the Para told him. But he would not say how badly, leaving my parents in the dark with thoughts of every type of injury racing through their minds. It was not until they got my e-mails from Helmand that they found out the extent of Jim’s injuries.
When I first saw him as I entered the intensive care unit, my brother was on a hospital bed, his eyes closed, a ventilation tube in the side of his mouth and IV drips dangling from his right arm. A swollen tongue poked out of inflamed lips.
As I got closer, the extent of the damage became clear. His bloody, puffed-up face was lacerated with dozens of small shrapnel wounds, his left arm was bandaged and his legs were in plaster. Large metal staples ran in a line from one ear to the base of his neck. His left eye had gauze dressing over it and there was a bloody bandage near his heart.
The blast had clearly hit him from the left side of his body. His right hand was icy cold when I squeezed it. Sedated with morphine and ketamine, he could not hear me. I spoke to him anyway, whispering into his ear that he was going to be okay and would have war stories to tell once he pulled through.
“You’re doing great, mate. Just hold on in there and fight it. You’ll have one hell of a story to tell your grandchildren once this is all over,” I said. Despite the damage to his face, he still looked like the brother I have known and loved for 24 years.
The large team of doctors, nurses and specialists dedicated to Jim quickly filled me in on the extent of his injuries. The lacerations on his face were mainly superficial, they said. He had broken his left ankle and right leg. Some of the muscle was missing from his calf and thighs where pieces of shrapnel had torn into him. Shrapnel from the IED had also pierced his neck, inflating the muscles so they restricted his airway. His left eye was a serious concern. It still had shrapnel lodged inside.
“His body has been through a lot so we’re not going to operate on the eye immediately. He needs to get some rest and recover before we start work on it,” one of the doctors said. “He’s doing remarkably well. He’ll get the use of his legs back and the wounds to his face will heal fast. He is very lucky.”
The doctors’ optimism was comforting. Jim had been talking drug-induced nonsense hours before I’d got to the hospital. When his neck started to swell, they had to sedate him and stick a plastic tube down his throat to help him breathe.
As I stared at his face, I tried to imagine him having a bright array of psychedelic dreams, hoping the drugs had knocked him out of the corporeal world and into a realm free of pain.
Once I’d got used to the wounds on his body, it was hard not to think about what impact the trauma of the blast might have on his mind. I prayed he’d still be the brother I remembered when he woke up.
The army did all it could to get me on the same flight back from Helmand last Monday. Most of the patients were sedated for the flight, strapped to and supported by metal stanchions that stuck out of the aircraft’s gutted belly. Exhausted, I collapsed on my body armour and passed out while a team of army doctors and nurses tended to Jim for the nine-hour journey to Birmingham.
As soon as the rear hatch dropped after landing, the wounded soldiers were carried out on stretchers and taken to Selly Oak. I met mum and dad in the hospital grounds where they were steeling themselves for their first visit.
We walked through the swing doors and into the critical care ward. Jim was lying in a hospital bed still strapped to drips and ventilation tubes. Five other soldiers lay nearby. Some talked or struggled to talk and others, like Jim, were heavily sedated. It was calming to see him in such a serene environment. Smiling nurses buzzed around the beds changing drips, washing patients and preparing some for further operations.
“Tell the nurses I’m sorry for swearing at them,” mumbled Jim as he came round at last on Thursday. I asked the nurses if he had sworn at them. They laughed and shook their heads. He had dreamt it.
As his drugged mind switched between Britain and Afghanistan, he thought there were Taliban snipers hiding in the ceiling of the ward. The nurses moved his bed to help him cope with the morphine-induced hallucinations.
Letters from his fellow riflemen and friends started to arrive, giving details of what had happened in Wishtan. One of them talked of the respect my brother had earned among the men in his company.
It appears that he was hit as he tried to attend to a group of wounded engineers who had been caught in a separate explosion. “Your rush to assist the wounded at the scene of such devastation does credit to your courage and respect for the lives of the soldiers around you,” one letter to him said.
We also know the bomb exploded while his platoon was escorting a digger along a dirt road leading from Wishtan to the main base in Sangin.
One rifleman, sent to console and help relatives of the regiment’s wounded soldiers, pointed out that if the army had more helicopters perhaps they could have airlifted the digger instead of forcing platoons to run the area’s maze of IEDs.
One evening, after returning from Jim’s bedside to the free accommodation the military provides to relatives of wounded soldiers, I watched Gordon Brown on television telling the nation that the army has enough helicopters for operation Panther’s Claw.
A clever piece of politics. Panther’s Claw is taking place in a tiny corner of Helmand known as Greater Babaji. My brother and other riflemen before him were nowhere near Babaji when they were wounded or killed.
Jim now lies in the critical care ward next to other soldiers, the overwhelming majority injured by IED blasts. Some have lost limbs and friends in the bombings.
The first time Jim set eyes on me after waking up, he asked who I was. I told him I was his brother. It took a moment and then he said: “Oh yes. Sorry, mate. I’m in a bit of a K-hole [affected by ketamine].”
During one of his more alert moments, I told him he had been pumped full of narcotics.
Although he still could not talk, he shook his shoulders from side to side, mimicking a dance. The corner of his mouth turned up in a lopsided smile.
I knew then for the first time that his mind was as tough as ever, that he would come out the other side. Beneath the stitches, the bandages and the tubes, the body and mind still belonged to Jim.
‘Intense, aggressive surgery’: the medics saving lives at Camp Bastion
WORKING up to 18-hour shifts with his team at Camp Bastion hospital, Lieutenant-Colonel Nigel Tai, a consultant surgeon, is often the first to operate on soldiers after they are flown in from the front line.
Tai, 41, who will return to his base at the Royal London hospital in east London this week after a six-week tour in Afghanistan, says soldiers who are victims of a roadside bomb often need their first blood transfusion while still in flight. Medics aim to keep blood pressure up by giving the wounded troops blood every 90 seconds.
The pace of the surgeons’ work is extraordinary. “If we hear there is a ‘T1’ casualty coming in — a double amputation — then we pretty much know this patient is going require 20 units of blood, a surgical team on standby, intensive care and early medevac access,” he said.
“We may have a pair of consultant surgeons operating on one limb, a pair operating on another limb, a pair operating on the head, the belly, the neck. It’s incredibly intense.
“We know that if these patients can be salvaged then they will be salvaged by this intense, aggressive combined transfusion and early surgery.”
Speed is of the essence. The quicker the emergency surgery, the more likely it is to be a success. There is no equivalent of the National Health Service accident and emergency ward. Injured soldiers are rushed from the helicopter into the operating theatre. Typically, they can be operated on 30 to 45 minutes after they have been wounded.
“The helicopters will pick them up off the ground as soon as they can,” said Tai. “In flight they will get blood if necessary. When they’re brought to our resuscitation room they will be attended to by a full trauma team consisting of a panel of eight to 10 doctors who are specialists in their field. If necessary, the resuscitation can begin straight away in the operating theatre.”
There is a general team of five surgeons, working with another three orthopaedic surgeons. With anaesthetists, emergency doctors and junior doctors, there could be 20 staff working on a single patient.
Multiple amputations are the most challenging, said Tai: “Sometimes there’s difficult questions about preserving a limb. The more effort you put into preserving a limb, the longer it takes to operate on it and the sicker a patient will get.
“You have to balance it very carefully. But we are at the same time aware this is a fit young man who wants to return to normal life.”
Hospital stays in Camp Bastion can be measured in hours rather than days. “We can get them out of the door within 12 hours of finishing operating on them,” said Tai.
“We aim here to do as little as possible to ensure we leave as much tissue as possible for the surgeons at Birmingham to work with.”
Apart from wounded British soldiers, the hospital also treats anyone who comes through its door, including local people, civilian contractors and Afghan police officers and soldiers. “Of course, we treat suspected insurgents as well,” said Tai, “and they get exactly the same treatment and same quality of care as everyone else.”
Dad, I’m sorry,” were my brother’s first intelligible words, whispered through swollen lips and an oxygen mask. Dad leant in close and told his son how proud he was of him. For three days we had hovered around Jim’s bedside in Birmingham’s Selly Oak hospital — as he lay doped up on a cocktail of opiates, antibiotics and general anaesthetic — since I had arrived with him on an emergency flight from Afghanistan.
“I am having some pretty weird dreams,” Jim murmured as we strained to hear him.
I had always wanted to be a war correspondent. Ironic, then, that the first casualty of war I saw was my younger brother lying limp and lacerated in a field hospital in Helmand.
Related Links
The medics saving lives at Camp Bastion (http://www.timesonline.co.uk/tol/news/world/asia/article6727798.ece)
It was last Sunday that I received the news I had feared but never thought I would actually hear. I was on assignment for The Sunday Times, covering the largest ground operation launched by British troops in Afghanistan.
In four hours I was meant to be on a Chinook helicopter, air assaulting into a Taliban stronghold as part of operation Panther’s Claw with soldiers from the Black Watch, Royal Regiment of Scotland.
Body armour and bags packed, I was waiting in Camp Bastion, the British base, counting down the hours until we were due to fly and worrying about whether I would be able to understand the Jocks’ thick accents.
Jim, recently arrived in Afghanistan as a second lieutenant in the Rifles, was on another operation.
The telephone in the camp’s media tent rang and I was called in. I thought it would be the press team querying an article I had written.
“I’m sorry to have to tell you this, but your brother has been badly wounded in an explosion,” said a voice I did not recognise.
The body goes numb and the mind races. How badly wounded? Images of my brother with no legs, no arms — worse — left me nauseous.
That morning, mum had sent me an e-mail from England saying she felt “wobbly”. Around the time she e-mailed, in a deadly and uninhabited Helmand town called Wishtan, her 24-year-old younger son had walked onto an “improvised explosive device”.
I HAVE always been proud of Jim. When I was four and he was two, I stopped strangers as I pushed him through Windsor park and told them: “This is my brother James.”
Friends and family say we are strangely close for brothers. We have been so since we were little. I can remember having only one fight with him. I stole his toothpaste and he was furious with me.
I have always been there when things have gone badly for him and he looked up to me when he was younger — before he struck out on his own.
Our father was a soldier before I was born and the family’s military tree dates back centuries. My grandfathers and grandmothers served during the second world war. Other relatives have been dotted all over the world in the service of Queen and country. Pictures on the walls at home depict men in battledress.
The images fired our young imaginations. During a game of soldiers, aged six and four, I announced to Jim that I would be the lieutenant. He turned and promptly said: “Well I’ll be the right-tenant.” Mum once caught him, aged seven, trying to blow up the house with petrol and a long rope “fuse”.
Our uncle, who had of course served in the army, bought us gas masks and webbing from army surplus stores. During the holidays we visited military exhibitions and air shows. When we hit our early teens, we would dress up in combat gear and gas masks, load up our BB guns and race around the garden shooting each other.
Jim was very bright and had an extremely independent mind. I don’t think he saw the value in education and he was easily distracted when young.
Constantly changing schools, girlfriends and jobs, he lived his life in a pretty much constant state of flux. He was a rebel who kicked against all forms of authority.
Some of our friends could never understand why someone who had done his best to rub authority up the wrong way for most of his life would suddenly join an institution like the army in his early twenties.
I wasn’t surprised. I think he had wised up. He was prepared to deal with the petty rules imposed by the military because he ultimately saw the value in becoming a soldier.
For Jim it meant he could escape the confines of a desk job, pursue a life of adventure and follow in his father’s footsteps. In the weeks and months that passed after he went to Sandhurst, the turbulent relationship that had once existed between my father and his younger son grew from strength to strength as they swapped common tales of military life.
They became solid friends and my father, who had fought in the Dhofar war and Borneo, clearly found it fascinating to learn how the military had changed.
Jim came back from Sandhurst sporting a new language like a badge of honour — “gleaming”, “crack on”, “start sparking” seemed to slip into his vocabulary overnight.
One of my worst fears about Jim joining the army was that we would lose some of the closeness we had. I was worried he would come back feeling that he didn’t want to tell me things he had seen. I’m still not sure why I didn’t become a soldier, too, as I have always wanted to see war up close.
I guess it might have something to do with our military background and a desire to see what some of them saw, to be able to relate to it all, that I set out to be a war correspondent.
After working in the local press in Berkshire I managed to get out to Afghanistan to start reporting on a shoestring as a freelance two years ago — at around the same time that Jim started to attend Sandhurst. I realised there was a chance he would end up out there, too.
He passed out from Sandhurst just before Christmas and joined my father’s old regiment, the Royal Green Jackets, which had recently been swept up and amalgamated into the Rifles. Destined for Afghanistan, he went straight into an intensive course for platoon commanders.
In May, I came home to spend the final two weeks’ leave with him before he flew out to the war.
We spent the nights getting drunk, ending up on park benches at eight in the morning still clutching empty bottles of whisky. We avoided talking about anything serious.
I had never seen him as confident, as happy or as mentally sharp as he was after he had joined the army. But for all the fulfilment he gained from his training at Sandhurst, in the jungle in Belize and on the Brecon Beacons in Wales, and the bonds he built with other young cadet officers, there was always the knowledge of the inevitable risks he would face.
The dangers had always hung over every conversation we had about his career but were not mentioned.
On the last whisky-drenched night of our reunion, we sat in the loft at home — with its spray-painted walls, collection of junk picked up on travels abroad and worn sofa — which we used to escape to after dinner as we grew up together in Windsor. We spoke at last of the possibility of his getting injured.
“I don’t want it to change anyone’s life,” he said.
TWO weeks ago Jim and I were together in Sangin, a heavily mined district in Helmand where in the past three months 11 British soldiers have been killed and many more wounded, largely by the improvised explosive devices (IEDs) that have proved so effective in slowing down the army’s movements.
My brother was serving in Sangin as Second Lieutenant James Amoore, a platoon commander with 2nd Battalion The Rifles.
Between foot patrols into a lush fertile strip of land known as the Green Zone, the two of us swapped jokes, caught up on each other’s news and swam in the canal that runs through the main base in Sangin. He poked fun at my “civvie beard”; I told him that all he had managed to do since coming to Helmand was to work up a good tan.
We watched with amusement as the French female photojournalist I had taken with me tried to escape the cameras of Afghan soldiers as she bathed in the canal. We spoke a bit about home and the girls we knew back in England, but mostly Jim was bursting to tell me what he’d been up to.
His knowledge of the situation seemed to be pretty strong and I quickly got a good sense of what the army was trying to do in the district.
He told me some of his soldiers were frustrated with the lack of head-on clashes with the Taliban. “They’re laying IEDs like mines here,” he said. “Some of the men haven’t even seen the Taliban.”
We went out on a company-sized operation together. The officers in charge understandably didn’t want me in Jim’s platoon, so I was attached to a section just south of his.
As soon as we left the base, teenage Taliban scouts were monitoring our movements. We fired off a handful of warning shots and they fled. We continued the patrol through ploughed fields and along waist-deep irrigation canals, careful to keep our distance from the man in front to limit the impact of an explosion if someone stepped on an IED.
About eight hours into the operation, Jim’s platoon came under direct fire. One of his men was shot in the leg. Later, back on the base, Jim’s sergeant approached me and said my brother had handled the situation with considerable calm, securing a helicopter landing site before organising the extraction of the casualty.
I relayed the sergeant’s words back to my brother. All Jim said was: “Imagine a duck on a lake. On the surface, the duck looks pretty calm; underneath it’s flapping like a lunatic.”
After I returned to Kabul, where I live and work, I spent nights without sleep, imagining the worst. The thought of losing him crippled me.
Jim wrote me an e-mail from Sangin on Friday, July 17, saying he was being sent to Wishtan, a remote area to the east, to take over command of 9 Platoon. Five of the platoon’s riflemen had just been killed in a series of explosions and their commander was badly wounded. (He now lies next to Jim in intensive care at Selly Oak.) In all, in the 10 days before Jim was sent to Wishtan, 15 British soldiers had died in Afghanistan, prompting an intense debate back home about the purpose of the war and the resources devoted to fighting it.
“I’m fairly worried about going, mate, it’s not a nice place,” Jim confessed in his e-mail, expressing the first sign of any fear I had ever heard from him. “Mum and dad don’t need to know I’m going there.”
The riflemen in Sangin describe Wishtan as a ghost town. They run a deadly gauntlet every day dodging the IEDs and remote-controlled bombs in a maze of narrow alleyways fenced in by high mud walls. They call it the “Pac-Man challenge” in reference to the old computer game that was popular before many of them were born. Soldiers who have returned safely from Wishtan have all had their brush with death.
I did not sleep at all on the night of Jim’s e-mail.
TWO days later I was being rushed to the intensive care unit at Camp Bastion’s hospital — and mum was discovering that her “wobbly” fears had been justified.
At home in Berkshire, dad saw a man at the door wearing a Parachute Regiment tie. He knew immediately that something had happened to his son. He assumed the worst. “Is my son dead?” he asked.
James was badly wounded, the Para told him. But he would not say how badly, leaving my parents in the dark with thoughts of every type of injury racing through their minds. It was not until they got my e-mails from Helmand that they found out the extent of Jim’s injuries.
When I first saw him as I entered the intensive care unit, my brother was on a hospital bed, his eyes closed, a ventilation tube in the side of his mouth and IV drips dangling from his right arm. A swollen tongue poked out of inflamed lips.
As I got closer, the extent of the damage became clear. His bloody, puffed-up face was lacerated with dozens of small shrapnel wounds, his left arm was bandaged and his legs were in plaster. Large metal staples ran in a line from one ear to the base of his neck. His left eye had gauze dressing over it and there was a bloody bandage near his heart.
The blast had clearly hit him from the left side of his body. His right hand was icy cold when I squeezed it. Sedated with morphine and ketamine, he could not hear me. I spoke to him anyway, whispering into his ear that he was going to be okay and would have war stories to tell once he pulled through.
“You’re doing great, mate. Just hold on in there and fight it. You’ll have one hell of a story to tell your grandchildren once this is all over,” I said. Despite the damage to his face, he still looked like the brother I have known and loved for 24 years.
The large team of doctors, nurses and specialists dedicated to Jim quickly filled me in on the extent of his injuries. The lacerations on his face were mainly superficial, they said. He had broken his left ankle and right leg. Some of the muscle was missing from his calf and thighs where pieces of shrapnel had torn into him. Shrapnel from the IED had also pierced his neck, inflating the muscles so they restricted his airway. His left eye was a serious concern. It still had shrapnel lodged inside.
“His body has been through a lot so we’re not going to operate on the eye immediately. He needs to get some rest and recover before we start work on it,” one of the doctors said. “He’s doing remarkably well. He’ll get the use of his legs back and the wounds to his face will heal fast. He is very lucky.”
The doctors’ optimism was comforting. Jim had been talking drug-induced nonsense hours before I’d got to the hospital. When his neck started to swell, they had to sedate him and stick a plastic tube down his throat to help him breathe.
As I stared at his face, I tried to imagine him having a bright array of psychedelic dreams, hoping the drugs had knocked him out of the corporeal world and into a realm free of pain.
Once I’d got used to the wounds on his body, it was hard not to think about what impact the trauma of the blast might have on his mind. I prayed he’d still be the brother I remembered when he woke up.
The army did all it could to get me on the same flight back from Helmand last Monday. Most of the patients were sedated for the flight, strapped to and supported by metal stanchions that stuck out of the aircraft’s gutted belly. Exhausted, I collapsed on my body armour and passed out while a team of army doctors and nurses tended to Jim for the nine-hour journey to Birmingham.
As soon as the rear hatch dropped after landing, the wounded soldiers were carried out on stretchers and taken to Selly Oak. I met mum and dad in the hospital grounds where they were steeling themselves for their first visit.
We walked through the swing doors and into the critical care ward. Jim was lying in a hospital bed still strapped to drips and ventilation tubes. Five other soldiers lay nearby. Some talked or struggled to talk and others, like Jim, were heavily sedated. It was calming to see him in such a serene environment. Smiling nurses buzzed around the beds changing drips, washing patients and preparing some for further operations.
“Tell the nurses I’m sorry for swearing at them,” mumbled Jim as he came round at last on Thursday. I asked the nurses if he had sworn at them. They laughed and shook their heads. He had dreamt it.
As his drugged mind switched between Britain and Afghanistan, he thought there were Taliban snipers hiding in the ceiling of the ward. The nurses moved his bed to help him cope with the morphine-induced hallucinations.
Letters from his fellow riflemen and friends started to arrive, giving details of what had happened in Wishtan. One of them talked of the respect my brother had earned among the men in his company.
It appears that he was hit as he tried to attend to a group of wounded engineers who had been caught in a separate explosion. “Your rush to assist the wounded at the scene of such devastation does credit to your courage and respect for the lives of the soldiers around you,” one letter to him said.
We also know the bomb exploded while his platoon was escorting a digger along a dirt road leading from Wishtan to the main base in Sangin.
One rifleman, sent to console and help relatives of the regiment’s wounded soldiers, pointed out that if the army had more helicopters perhaps they could have airlifted the digger instead of forcing platoons to run the area’s maze of IEDs.
One evening, after returning from Jim’s bedside to the free accommodation the military provides to relatives of wounded soldiers, I watched Gordon Brown on television telling the nation that the army has enough helicopters for operation Panther’s Claw.
A clever piece of politics. Panther’s Claw is taking place in a tiny corner of Helmand known as Greater Babaji. My brother and other riflemen before him were nowhere near Babaji when they were wounded or killed.
Jim now lies in the critical care ward next to other soldiers, the overwhelming majority injured by IED blasts. Some have lost limbs and friends in the bombings.
The first time Jim set eyes on me after waking up, he asked who I was. I told him I was his brother. It took a moment and then he said: “Oh yes. Sorry, mate. I’m in a bit of a K-hole [affected by ketamine].”
During one of his more alert moments, I told him he had been pumped full of narcotics.
Although he still could not talk, he shook his shoulders from side to side, mimicking a dance. The corner of his mouth turned up in a lopsided smile.
I knew then for the first time that his mind was as tough as ever, that he would come out the other side. Beneath the stitches, the bandages and the tubes, the body and mind still belonged to Jim.
‘Intense, aggressive surgery’: the medics saving lives at Camp Bastion
WORKING up to 18-hour shifts with his team at Camp Bastion hospital, Lieutenant-Colonel Nigel Tai, a consultant surgeon, is often the first to operate on soldiers after they are flown in from the front line.
Tai, 41, who will return to his base at the Royal London hospital in east London this week after a six-week tour in Afghanistan, says soldiers who are victims of a roadside bomb often need their first blood transfusion while still in flight. Medics aim to keep blood pressure up by giving the wounded troops blood every 90 seconds.
The pace of the surgeons’ work is extraordinary. “If we hear there is a ‘T1’ casualty coming in — a double amputation — then we pretty much know this patient is going require 20 units of blood, a surgical team on standby, intensive care and early medevac access,” he said.
“We may have a pair of consultant surgeons operating on one limb, a pair operating on another limb, a pair operating on the head, the belly, the neck. It’s incredibly intense.
“We know that if these patients can be salvaged then they will be salvaged by this intense, aggressive combined transfusion and early surgery.”
Speed is of the essence. The quicker the emergency surgery, the more likely it is to be a success. There is no equivalent of the National Health Service accident and emergency ward. Injured soldiers are rushed from the helicopter into the operating theatre. Typically, they can be operated on 30 to 45 minutes after they have been wounded.
“The helicopters will pick them up off the ground as soon as they can,” said Tai. “In flight they will get blood if necessary. When they’re brought to our resuscitation room they will be attended to by a full trauma team consisting of a panel of eight to 10 doctors who are specialists in their field. If necessary, the resuscitation can begin straight away in the operating theatre.”
There is a general team of five surgeons, working with another three orthopaedic surgeons. With anaesthetists, emergency doctors and junior doctors, there could be 20 staff working on a single patient.
Multiple amputations are the most challenging, said Tai: “Sometimes there’s difficult questions about preserving a limb. The more effort you put into preserving a limb, the longer it takes to operate on it and the sicker a patient will get.
“You have to balance it very carefully. But we are at the same time aware this is a fit young man who wants to return to normal life.”
Hospital stays in Camp Bastion can be measured in hours rather than days. “We can get them out of the door within 12 hours of finishing operating on them,” said Tai.
“We aim here to do as little as possible to ensure we leave as much tissue as possible for the surgeons at Birmingham to work with.”
Apart from wounded British soldiers, the hospital also treats anyone who comes through its door, including local people, civilian contractors and Afghan police officers and soldiers. “Of course, we treat suspected insurgents as well,” said Tai, “and they get exactly the same treatment and same quality of care as everyone else.”