Gory but gripping details of frontline medics

BOOK OF THE DAY: MedicBy John Nichol and Tony Rennell Viking /Penguin, 408pp, £20: THE WAR in Afghanistan rumbles on, with President Obama recently committing 30,000 additional troops to the war effort. Listen to the BBC news, and several nights a week you will hear of another soldier's death at the hands of the Taliban.

Naturally, the focus is primarily on the valour of individual troops or the (in)adequacy of military equipment; but there are other, often unsung, heroes operating on the front line and in bases not far behind.

These are the medics – nurses, doctors and paramedics – who must respond quickly and selflessly as soon as an improvised explosive device detonates. Their stories are not often told; as one medic tells the authors of this engaging book, “we tend to get ignored, even sneered at by the rest of the military . . . then all of a sudden we become a popular commodity.”

John Nichol and Tony Rennell tell a gripping, if sometimes gory, story. From the beaches at Dunkirk to current events in Iraq and Afghanistan, a thread of gallantry runs among shattered bodies and severed limbs. Once the cry “Medic!” goes up, the soldier with the red cross armband must venture into minefields, while ducking rockets and mortars, to reach a colleague who could be near “bleeding out” from a severed artery.

Cpl RH Montague was in charge of a four-man stretcher party retreating towards the Belgian coast at the beginning of the second World War. Among his recollections was the amputation of a lieutenant’s bullet-ridden, gangrenous leg. Another English officer had his jaw and tongue shot away; all that could be done was to ease him into the arms of Morpheus.

Among those who made it back across the Channel from Dunkirk was Cork-born RAF doctor Squadron Leader Aidan McCarthy. However, he soon found himself in a Japanese prisoner-of-war camp in the Far East.

As Japan was not a signatory to the Geneva Convention, the privations were far worse than for prisoners in Europe. He describes not being allowed to help “a procession of scarecrows”, 249 blind men who arrived at the camp gates led by the only sighted one among them.

Their blindness was the result of optic papillitis, brought on by vitamin deficiency.

One of the ironies of war is its role as a driver of medical innovation. In the second World War, doctors learned the technique of debridement; instead of stitching wounds tightly, they were first cleaned of all dead tissue and foreign bodies.

The wound was dressed lightly with gauze, thus minimising infection and the dreaded gas- gangrene of the first World War.

Transfusion with blood originally had to be carried out directly from the donor to the patient. By the time of the desert campaign in North Africa, medical units carried pre-donated blood in oil-burning fridges.

Fast forward to Iraq and a revolutionary product, QuikClot, helped save battlefield lives. QuikClot did what the name on the sachet promised: derived from high-absorbent volcanic ash, it accelerated the clotting by soaking up water in the blood while speeding up platelet activation.

By the time of the Afghanistan conflict, one in four British soldiers was trained to give advanced first aid. They now include women, who play a front-line role alongside men as doctors, nurses and troop medics. Exposed to the full horror of war, their contribution is summed up by the epitaph of one young medic: “She helped.”

Dr Muiris Houston is a medical doctor, health analyst and Irish Timescolumnist.