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‘Daniel Garland, sir!’ I muster my best salute. ‘11th Battalion MO.’
‘Do stand at ease, Captain.’ Lieutenant Colonel Arthur Marrable eyes me through curls of smoke rising from his pipe. Mid-forties, with swept-back hair and a kindly face, he is standing at the hotel reception counter, which now serves as his HQ. Behind him an orderly bangs on a typewriter beside a radio operator, headphones clamped on ears, who is busy twiddling knobs.
‘11th, you say?’ Marrable continues. ‘I hear they’ve had quite a time of it.’
‘Yes, sir. Do you have any news? We lost touch this morning.’
‘Very little I’m afraid, of the 11th, or indeed anyone.’ He nods at the radio operator. ‘Communications problems.’
‘What about Brigade? Might they know something?’
‘They might. HQ’s across the square at the Hartenstein Hotel, but I warn you, Brigadier Hackett’s in no mood to be bothered with lost doctors. Especially as his boss has gone missing.’
‘General Urquhart? Missing?’
‘Apparently. Nor can he contact Division up at the bridge.’ He puffs smoke and lowers his voice. ‘Frankly, Garland, it’s a bit of a mess.’
‘30 Corps?’
‘No news. No radio contact.’
‘Only the thing is, sir, I really need to get back to the 11th.’
‘I could badly use you here.’
‘Yes, but they’re without their MO.’
‘I’m afraid it may be too late. Rumour is they’ve been over-run. I’m sorry.’
At this point the conversation stalls rather, together with my great plan to grab Bowyer and Sykes, sprint back to Barrett’s mob and head off in search of the 11th.
Marrable takes pity. ‘Look, old chap, here’s what I suggest. There’s stew and spuds in the kitchens, coffee too. Go and eat, then head upstairs and find a room, freshen up and get some rest. Meanwhile I’ll try and speak to Hackett. Maybe we’ll have firmer news in a few hours. If I hear anything of the 11th I’ll wake you, I promise.’
It’s too good an offer. Weary to my bones suddenly, I find and brief Bowyer and Sykes, eat my fill in the kitchens and clump upstairs. Choosing the first empty room, and barely pausing to loosen my tie and kick off my boots, I’m asleep before I hit the mattress.
To be woken, having slept like the dead, at precisely six the next morning, by an express train hurtling past the window. A massive explosion follows, the whole building shakes, my window shatters, a picture falls from the wall. I jerk upright, wondering what on earth has happened, and hear it again, a sound like the sky tearing apart followed by the explosion of a hundred cars crashing. Then another, and another. This is shelling, I realize, scrambling beneath the bed, and no piddly 3-inch mortar stuff, this is big, heavy artillery, 75-millimetre or even the dreaded 88s, fired from miles back. They’re shelling the hospital, I curse in disbelief as the next rounds crash in, the fucking Germans are deliberately shelling a clearly marked hospital, with red crosses on roof and walls, and filled with unarmed wounded, non-combatant doctors and female nurses.
But then maybe not. For as the bombardment goes on, the walls tremble and plaster settles from above like snow, I gradually sense that the barrage, although thunderous and terrifying, is not aimed directly at me, but perhaps a little way off. Crawling to the window, I risk a peep. Outside the scene is hellish: smoke, dust and desecration, rubble and craters, a truck in flames, trees blasted asunder, their torn limbs stark white. But as the next salvo crashes in, it does appear to land a few hundred yards away, in the direction of the Hartenstein Hotel and Brigade HQ. Five minutes pass. I keep watching, the barrage goes on, some of it in our vicinity, some of it not, the Schoonoord shakes, the din is appalling, and then through the smoke I glimpse khaki-clad figures in a doorway, weapons at the ready, and watch as they sprint off at the crouch. Our boys, and they’re still fighting. A lull comes; I grab my boots and dash downstairs.
Colonel Marrable is at his reception desk, calmly puffing his pipe and studying a clipboard. Around him stands a cluster of medical officers.
‘Ah, Garland, there you are. Sleep well?’
‘Um, I – Well, yes, thank you, sir, but—’
Another explosion rocks the building. Everyone ducks; Marrable carries on regardless. ‘Good, good. Now, this is Dixon, Cartwright, Spencer and Poutney. Chaps, this is Daniel Garland, come to lend a hand from the 11th.’
This is news to me and I’m about to query it, when another shell bursts and a ceiling light crashes to the floor. So we all shake hands instead, as though it’s a pub social. ‘How d’you do, delighted, jolly good, what-ho.’
Marrable consults his clipboard. ‘Now, Garland, we’ve a busy day ahead, quite a list for surgery. So I’ve rostered you in with Clifford Poutney here. We’ve got a little operating theatre going in a storeroom round the back – a bit rudimentary but I’m sure you’ll manage…’ He breaks off, regarding me quizzically.
‘Sir?’
‘Ah, your tie, Garland old chap, is askew rather. And you might want to shave before you start seeing patients. Boots could do with a brush-up too.’
I can scarcely believe my ears. Here we are being bombed to buggery, and he’s complaining my tie’s not straight. It’s like being back at medical school; even the others, all smartly turned-out, I note, are smirking like schoolboys. I open my mouth, desperate to ask about the 11th, but now suddenly doesn’t seem the moment, and Poutney is catching my eye and shaking his head. So with no other option, and with everyone watching in amusement, I plod off upstairs to clean up.
Ten minutes later, tidy and fragrant, I descend once more. Poutney is waiting.
‘Sorry to keep you, Captain,’ I mutter.
‘Think nothing, old boy,’ he replies from behind an impressive handlebar moustache. He extends a hand. ‘I’m Cliff, and don’t worry about the old man, he’s a stickler and likes a tight ship, but he’s a solid CO and terrific doctor. Come on, I’ll show you around.’
We do the tour and, I admit, despite the mayhem outside, all looks immaculately ordered. The Schoonoord’s dining room has been converted into a large ward, with rows of stretchers occupied by tidily arranged casualties sporting clean bandages and tucked-in blankets. Orderlies move smoothly from bed to bed checking pulses and temperatures, adjusting drips and jotting notes. The nurses I’d seen last night are evident too, straightening blankets, mopping brows, bathing faces and sweeping up debris. Everything appears calm, well organized and spotlessly tidy.
‘This ward’s full now,’ Cliff says. ‘We’ve a second in the lounge but it’s filling fast. After that we’ll have to start using the bedrooms upstairs.’
Another salvo crashes in. As one, everyone breaks off, cringes, then dusts themselves off and carries on as before. Like some surreal parlour game.
‘When did this lot start?’ I ask.
‘Yesterday. Brigade says they’re softening us up for a counter-attack. But our boys are giving as good as they get. Apparently.’
‘Terrific.’ Overhead a light bulb swings. ‘Power’s still on, I see.’
‘Yes. Water and drains too. God knows how long for though.’
‘Medical supplies?’
‘Enough basics – blood, morphia and penicillin – for about forty-eight hours. After that we’re in trouble. Air drops are promised but we’ve seen none yet.’
We continue our rounds, occasionally stooping to offer encouragement or light cigarettes for casualties, who in the main seem remarkably chipper. The resilience of the British Tommy. Eventually we find ourselves at the rear of the hotel, and Cliff pushes open a door to reveal a small storeroom. Inside stands a trestle table covered by a rubber sheet. Masks and gowns, anaesthetics, dishes of instruments, disinfectants and other surgical paraphernalia lie ready. To one side is a basin for scrubbing up.
‘Right.’ Cliff hands me a gown. ‘I suppose we’d better get started.’
*
The long day passes. As the war rages outside, Cliff a
nd I work in that cramped little storeroom on its victims. Borne in on stretchers, some are unconscious, others have to be anaesthetized. Some cry out in their pain; most endure it with grace and forbearance. Even occasional humour: ‘Don’t take the foot off, Doc, it’s one of a pair.’ In short, the job of the battlefield surgeon is to save life and stabilize the patient for rearward evacuation to better facilities. Casualties fall into three categories: firstly those needing urgent resuscitation or surgery for severe bleeding, respiratory obstruction, open chest or head wounds and penetrating abdominal wounds. Second come those needing early surgery, such as those with multiple wounds, compound fractures or large muscle-tissue injury. Thirdly come all the others. Most (but not all) combat injuries are caused by blast and/or missile penetration, they just vary in location, severity and complexity. A bullet might pass right through soft tissue and cause little damage, but the same bullet hitting chest or abdomen can wreak havoc to vital tissues and organs. If it hits the head the results can be catastrophic. Bullets are famously indiscriminate. Many battlefield injuries involve orthopaedic trauma, with around 70 per cent musculo-skeletal. Fractures account for a quarter of all injuries, while abdominal wounds have the worst recovery rate. These are mere statistics. Shock and blood loss are the principal killers, as are contamination and infection, particularly if injuries are allowed to fester. Debridement, which is the cutting away of infected tissue, plus the use of anti-bacterials such as sulphanilamide and the antibiotic penicillin are effective. Time above all is crucial. Get them on the table as quick as possible and work fast: that’s their best chance. We do our best to. And soon, as is the way with surgery, the outside world retreats, and horizons shrink, until nothing remains but the man lying there, his injuries and needs, and brief muted exchanges.
‘Retract there a little, please, Dan.’
‘Debride more anteriorly?’
‘Yes, and irrigate above and below. That’s it.’
The patients come and go. The mental effort is intense and wearying, so much so that soon I’m barely noticing the incessant thunder of barrage. Time swiftly passes. At one point Marrable pops in to check on progress; Sykes and Bowyer also make an appearance. Then we suffer our first fatality. A stretcher is carried in, unusually accompanied by one of the Dutch nurses, who is holding the injured man’s hand.
‘Shell burst,’ says the orderly. ‘Hit in the chest.’
‘What’s she doing here?’ Cliff’s fatigue is showing.
The orderly shrugs. ‘He begged her to stay with him.’
‘Well, it’s damned cramped in here, you know…’
‘I will not be in your way,’ she says quietly in English.
Cliff and I exchange glances. She looks pale, and young. But determined.
‘Oh very well, but please keep out of the way.’
I examine the patient, who is unconscious, unresponsive, has a thin irregular pulse, a sickly grey pallor and is breathing fast and shallowly. A large and bloody bandage surrounds his chest. He has freckles and tousled black hair and looks barely twenty.
‘What blood has he had?’ I ask the orderly. A bag lies on the boy’s stomach with a drip into his arm.
‘Three units so far.’
‘Bring more please, quick as you can.’
We set to work, but as I cut away the bandages it’s clear the damage is extensive and severe. A deep and gaping chest wound is revealed, packed with blood-sodden field dressings, the tissue shredded, rib bones smashed. Carefully removing the dressings with forceps, fresh blood quickly wells beneath, filling the cavity until it overflows and drips to the floor. I probe with my fingers. Somewhere inside a major artery has been severed; to have any hope we must find it, clamp it, then set about repairing it and the other damaged vessels. Meanwhile the boy is hypotensive, his blood pressure plummeting; he’s also suffering shock, hypovolemia – catastrophic blood loss – and associated organ failure. We do our best, working fast, shoulder to shoulder, three-, sometimes even four-handed within the wound. More blood arrives, we connect it to his drip and set it flowing, his heart keeps pumping it, for a while, but mostly into his chest. Then it fails altogether. I can sense this because my fingers are touching it.
‘Tachycardia!’
‘We need more time, bugger it.’
But we don’t have more time, and there’s little more we can do. Battlefield medicine does not allow for complex and protracted attempts at resuscitation: there isn’t the equipment, manpower, skills – or the time. As a last resort I stretch my fingers further into the heat of his chest, feel for the muscle of his heart, and begin squeezing. A minute or two passes in silence, but the organ remains unresponsive.
‘Leave it, Dan.’
‘Adrenalin?’
‘No. Pointless. We did what we could.’
And that’s that. We jot a note on his card and begin clearing up. There’s a lot of mess, including pools of blood on the floor. I’m about to start mopping when a voice breaks the silence.
‘Please don’t do that, Doctor, I will get bucket.’
She has not moved or said a word throughout. Nor did her hand leave the patient’s. Her face is still wan, her mouth small, expression downcast yet composed.
‘Yes, well – yes, all right, that would be a help. Thanks.’
She nods and exits, leaving me, Cliff and the dead boy alone. The mood in the storeroom is sombre suddenly, sombre and angry. ‘For God’s sake!’ Cliff explodes, and throws down his gown. Then the door opens and Marrable appears, as if by sixth sense.
‘Right, you two, time for a break. Stew and spuds in the kitchen. Off you go.’
*
The rest of the day passes similarly. The Schoonoord is increasingly busy, while around it our circumstances worsen. After a hasty meal of rather less bully beef stew and tinned potatoes than yesterday, Cliff and I split up, he to ‘Lounge Ward’, me to ‘Dining Ward’ where I find to my shock that the earlier orderliness is fast disappearing. In fact it resembles a disaster scene more than a hospital. The first matter of note is the smell, which is badly foetid from blood, pus, bedpans and insufficient air. The windows, by now all blown out by the shelling, have been covered by wood and mattresses to prevent further injury from flying glass. As well as making the room stuffy, this casts it into deep shadow, relieved only by wall-lights which flicker feebly in the failing power. Meanwhile the number of injured has soared, with recumbent men filling every inch of floor space, on stretchers, bedroom mattresses, even the bare floorboards. Crossing the room is a tiptoeing affair, a hesitant two-step, yet even so it’s hard to avoid standing on the occasional finger or foot. And even as I begin examining the newest arrivals, yet more stretchers appear at the entrance. ‘Not in here!’ shouts one of the doctors, his tone fraught. ‘Put them in the corridor. We’ll get to them when we can.’
And others I speak to during the afternoon sound similarly overwhelmed, including the wounded.
‘How’s the shoulder, Corporal?’
‘Not so bad thanks, Doc.’
‘Good. We’ll soon have you out of here.’
‘Fat chance. We don’t stand an earthly, you know.’
‘No?’
‘They keep coming and coming, heavy machine guns, mortars, grenades, the lot. What bloody use is a rifle against that!’
‘Not much I should imagine.’
‘Too right. Three of my mates bought it.’
‘Try not to worry.’
Later I spot Jack Bowyer picking his way through the stretchers.
‘Hello, Captain.’ He grins. ‘Where the hell you been hiding?’
His good-natured insolence is almost heart-warming, but I ignore it, pumping him for news instead. ‘What about Battalion? Any gen?’
He grimaces. ‘Cut to ribbons is what I heard. Everything’s to pot, practically the whole division. All the talk’s of falling back here and making a stand.’
‘Jesus. What about Colonel Lea?’
‘In the bag.’
&nbs
p; ‘What!’
‘Injured apparently, then Jerry nabbed him.’
‘Christ.’ I picture the scene. No first-aid post, no dressing station, no hope of evacuation, no damn medical officer. All a casualty can do is throw himself on the mercy of the enemy. And I can’t help feeling responsible, at least in part.
‘Major Lonsdale’s our CO now,’ Bowyer says. ‘Did you speak to Marrable?’
‘I tried, but he says we’re more use here. I’ll try again later. Is Sykes all right?’
‘He says we should make a break for it, with or without permission. I agree.’
‘But you can’t do that! It’s desertion.’
‘No, it’s finding Major Lonsdale and rejoining our unit. That’s proper.’
I’m stunned, but can see he’s serious. ‘No, Sergeant, I can’t allow it. In fact I order you not to. Please, just hang on, at least until I get a chance to see Colonel Marrable.’
But it’s late in the evening before that chance arises, and the outcome is no better. At dusk, the German barrage finally lifts and a glorious peace descends on the Schoonoord. The relief all round is palpable, and with the patients fed, medicated and settled for the night, the medical staff retreat to the kitchens for sustenance and respite. Cliff Poutney is there, together with others I met earlier. We haven’t spoken since the blood-soaked ordeal in the storeroom, but he catches my eye and winks, clearly in better spirits. Talking of which, after supper (bully beef and biscuit) someone produces brandy, pinched no doubt from the Schoonoord’s bar. Bottles circulate, cigarettes light up; soon the mood is lifting. And by the time Marrable arrives, pipe in mouth and clutching a sheaf of papers, it’s almost optimistic.
He soon puts paid to that.
‘Hello, chaps.’ He gazes round, eyes narrowed. ‘Everyone all right?’
Murmurs in the affirmative. Across the kitchen the Dutch nurses stand in a group, the young one from the storeroom among them. Our eyes meet briefly; she manages an ashen smile.
‘Good.’ Marrable shuffles papers. ‘You’ll be wanting the latest from Brigade.’