SIX
From his pre-deployment briefings at Millbank, Watson was aware that the British Army and the Royal Army Medical Corps had, by a system of trial and bloody error, created a brutally efficient way of dealing with the hundreds of thousands of casualties it took in any given campaign. A man wounded on the front line would first either find his own way or be taken by stretcher-bearers to a Regimental Aid Post. This was the most advanced of the outposts, staffed by a medical officer and three or four orderlies. Minor wounds were dressed there and then.
However, those with not-so-minor injuries were stretchered or walked or sometimes trollied down on an overhead railway system a few hundred yards to the Advanced Dressing Station, usually situated in a cellar or farmhouse. Some men would be patched up and returned to their units, some were allowed to rest overnight and received food and water. The more seriously injured would be passed down the line by horse or motor ambulance to the Main Dressing Station, where some emergency surgery was possible.
Eventually, motor ambulances would transfer the worst cases to the tents and ancillary buildings of the more permanent Casualty Clearing Station, where the doctors and nurses readied them for evacuation, by train or barge, to a base hospital. There, conventional care could take place, before, if they were lucky, the injured were shipped back home.
It was, at least on paper, a well-drilled system. There was little that felt smooth or efficient about the scene that greeted Watson at the reception tent, though.
A steady procession of battered motor ambulances was emerging from the thin, unnatural fog that shrouded the countryside. They halted long enough for orderlies to grab the stretchers or help down the walking wounded before turning round and heading upstream against the tide of new arrivals. The CCS unloading area was quickly overwhelmed as row upon row of stretchers began to fan out. Most occupants were bandaged or had limbs encased in a Thomas splint, evidence of hasty care at the advanced stations.
Groups of ‘walking wounded’, caked with blood, yellow mud and black earth, had spread out their capes and sat, with whatever rifles and kit they had managed to bring lying next to them. It had always amazed Watson just how much the modern Tommy was expected to carry – a backbreaking ninety pounds of gear; a sodden greatcoat added another sixty in conditions like this. A Lewis gun or the ammunition for one increased the burden even more.
Almost every soldier who could manage it was smoking, and a fug of Woodbine and Gold Flake mixed with the petrol fumes that hung over the whole scene. Some leaned over and put a cigarette between the lips of a prone comrade, letting him suck in smoke until the patient gave a grateful thumbsup. The eerie thing was, no man spoke or cried out. It was as if they had been robbed of the ability to speak or utter any sound. All they could do was smoke their gaspers as if their fragile lives depended on it. As Watson examined the men, some of the soldiers stared back at him, eyes hooded with fatigue or shock or a mixture of the two.
Orderlies moved among them, collecting up rifles and Mills bombs to be transferred to a kit store. Some argued, not wanting to be parted from their lucky rifle or talismanic bayonet. The orderlies explained that they could hardly sleep with them in a medical ward. In a few cases a label was attached, so a man could reclaim his own weapon.
And still the ambulances came, gears grinding, cabs rocking and twisting on the rutted road. Some of them were the new Vauxhall and Humbers – often bearing the name of the organization or individual from back home who had funded its purchase – but mostly they were of the original generation of ambulance: a lorry chassis with a makeshift body bolted on the rear. There were even some horse-drawn carts with stretchers loaded where once hay, turnips or potatoes would have been transported.
And this a quiet section of the front, Watson thought. What must—
‘Major Watson!’ Staff Nurse Jennings beckoned him from the open sides of the triage/reception tent, where long trestle tables received the stretchers and each case was assessed before being moved on to the appropriate ward or, in some cases, the mortuary.
‘Yes, how can I help?’ he asked, hurrying over.
‘Over here.’
He stepped into the tent and into a miasma of stale sweat, tart chemicals and fresh blood. A series of barked instructions rang out, mostly coming from a man in a white coat who, beneath it, was seemingly dressed for a round of golf. The accent was American or Canadian, Watson wasn’t certain.
‘Re-suss! This guy needs morphine. Where’s his label? What do you mean it’s fallen off? Re-suss! Are the surgical teams in place? Pre-op now. Now! Staff Nurse – get this wound cleaned and irrigated. I’ve seen farms in Idaho with less soil in them.’
American, then.
‘Is the X-ray trailer up and running? Good. OK, soldier, let’s see. Well, I’m guessing that hurts like hell, but it’s a Blighty. Yup, even the British Army doesn’t need men with one knee. Orderly! Get this man to X-ray, please.’
He was striding between the tables, assessing soldiers in the blink of an eye before moving on, but Watson noticed there was always purposeful activity left in his wake. He caught Watson’s eye and gave a mocking two-fingered salute.
Jennings pulled at Watson’s arm and he swung round and followed her pointing finger. Watson swallowed hard and, for one mortifying second, he thought he might swoon. The man’s khaki jacket was covered in blood and ochre-coloured mud. But it was the source of the blood that was so horrifying. Most of the soldier’s face, from the nostrils down, had simply disappeared. It reminded Watson of the demonstration models of coloured wax used by his professors at the University of London.
But this was not wax – it was flesh and bone, a series of spongy surfaces, glistening tubes, raw muscle, cotton-like nerves and hard bone, the human workings exposed by the removal of the jaw. Most of the palate had gone, too, and he could see up into the dark corridors of the sinuses.
The sight made him appalled, angry. The wounds from the round bullets used in Afghanistan had caused nothing like this damage. His own intact limbs were witness to that.
‘Lieutenant Cornelius Lovat. RC. Sniper wound. He’s stopped breathing,’ said Staff Nurse Jennings, her voice quavering. ‘He was breathing just a second ago. Then he gave a spasm. I took away the dressing, thinking it was suffocating him and . . . that. Shall I call the padre?’
Watson leaned in close towards the ghastly wound, the clinical part of his mind noting the teeth and bone that had been forced into the remaining flesh, the dull shards of metal that would need extricating. And there were the patches of the wound that had been cauterized to shiny circles of seared flesh by intense heat. As he came close one of the man’s eyes snapped open, causing him to start, but he held his ground. There was no sight in it, no spark of consciousness. Lovat, thank God, had been rendered senseless. He gently brushed away a pair of lice, no respecters of rank, that had emerged from the lieutenant’s hairline.
‘It says “M” on his label,’ Jennings said. ‘They gave him morphia. Could that have depressed his breathing?’
‘Possibly.’ And perhaps, Watson thought, somebody at one of the dressing stations of the field ambulance had decided they might perform a mercy and given him a larger-than-necessary dose. It would have been understandable.
Watson took the Wilsdorf & Davis from his wrist. They might be considered a touch feminine in London circles, but a wristwatch, especially one with a shrapnel guard like the W&D, made more sense that his usual half-hunter, now he was back in uniform. He unbuttoned the top pocket of his tunic and swapped the timepiece for the ivory-handled magnifying glass he always carried about him, the one with the inscription he valued so much. ‘Can you fetch that lantern, Nurse? I need more light.’
She did as instructed and soon he was looking at the damage in even greater detail. It was a struggle to keep a growing feeling of revulsion in check, both at the wound and the weapon that had made it. He was used to the sight of injuries, but this was of a far greater magnitude than he had experienced in his previous life. Perhaps Tiger Mac had been right . . .
Watson straightened up, took a deep breath, focused his mind. He was out of practice, that was all, grown soft. Too much fanciful writing, not enough doctoring. He summoned the dispassionate clinician of old and moved in closer once more.
‘I need some forceps,’ he said, taking off his jacket and rolling up his sleeves. ‘You were right, Staff Nurse Jennings. There’s gauze or similar from the dressing occluding the trachea.’ Or what was left of it.
There’s something else.
The voice in his skull was so burnished and clear, he almost looked over his shoulder for the speaker. But that would have been ridiculous. He knew it could not be his old friend. It was just an echo of times past.
You are looking but not observing. Or rather, not observing with all your senses. Think, Watson, think.
Then he had it, the sensation almost overwhelmed by dozens of others. He concentrated on it alone, slowly isolating it, stripping away the competition, pinning down the few stray molecules in his nostrils. He could smell burned garlic.
Well done, Watson, the voice said, rather patronizingly. Nevertheless, as he worked the compacted material free of the windpipe and the poor wretch made a gurgling sound in his throat, he allowed himself a small smile of satisfaction. Which then faded as he remembered what the burned garlic indicated. Yet another perversion of the art of war.
‘Pre-op,’ he said to the nearest orderlies. ‘Adrenaline chloride on the wound to stem bleeding. And ask the anaesthetist to use a rectal infusion of ether. I’ll add it all to his label.’
Watson extracted a stubby pencil from his pocket and wrote the instructions in blocked capitals. ‘Understand? Rectal. Plus GSE. Glandulae suprarenalis extractum. That’s the adrenaline chloride. And I want any shrapnel extracted saved and delivered back to me.’ He wrote that down, too.
He watched as the stretcher was slid off the table, to be immediately replaced by another. He scanned the label attached to the man’s sleeve, next to the ‘wounded’ stripe, which showed the poor devil had been hit before. ‘PAW’, it read, and gave his name and rank. He was with the Royal Scots Fusiliers. Not, Watson noted, from the battledress trousers, a kilted regiment; how those that did wear the tartan managed in the cold and filth of the trenches beggared belief. Watson looked at the abdominal dressing and at the red stains creeping around the side of it.
‘Major Watson. Hello, sir.’
He looked up to see a face full of anguish that he didn’t, for a moment, recognize.
‘De Griffon?’
The man nodded and his face relaxed into the broad, open one Watson remembered from his time in Egypt, where he had been investigating the mechanics of the new blood transfusion methods in field hospitals. De Griffon’s unit had been one of his first guinea pigs. ‘Good Lord, what are you doing here?’
Robinson de Griffon’s head was moving back and forth, as if he were watching an accelerated game of tennis. ‘Looking for my men.’
‘Your men?’
‘Yes. The Leigh Pals. “A” Company.’
‘In this part of the line?’ Watson asked.
‘We are, yes.’ He gave a nervous laugh. ‘Small world, eh, sir?’
In Watson’s limited experience of them, wars made for very small worlds. It was astonishing to him how often he ran into old colleagues from the Berkshires. ‘What’s happened?’
De Griffon took off his cap and ran a hand over his wayward hair, smoothing it down for a few seconds. ‘We were on our way back from the front when a stray shell hit one of the columns. Damned bad—’ He turned to Jennings and shrugged apologetically. ‘Sorry. Bad luck. Two dead. Shipobottom, Carlisle, Morris, all quite seriously injured. Hoped they might be here.’
His lower lip quivered slightly and Watson thought he might cry. He noticed that de Griffon had been promoted since he last saw the young man. He was now a captain. How old was he? No more than mid-twenties, surely. And unlikely to have known anything like war, given his cosseted background. De Griffon was a far cry from one of the ‘Temporary Gentlemen’ they talked about. Still, his heart was clearly in the right place and rapid promotion was, he supposed, another feature of this conflict.
‘I haven’t seen Shipobottom here, no.’ Watson didn’t recall Carlisle or Morris, but the curiously named sergeant was not a man you forgot in a hurry.
‘There’ll be another reception tent taking the overspill,’ said Jennings. ‘About a hundred yards up the hill, on the left. I should imagine they are in there.’
De Griffon looked relieved. ‘Thank you, miss. I hope to see you soon, Major.’
‘I’ll look forward to it,’ Watson said. After he had gone he glanced at his nurse before turning his attention back to the new patient. ‘That is one anxious young captain.’
‘The officers become very protective of their charges,’ Jennings said. ‘Often they are like father figures to men ten or fifteen years older than them. It’s strange to see sometimes.’
‘Right, who do we have here?’
‘McCall, sir. Is it no’ a Blighty, Doc?’ the soldier on the stretcher asked in a broad accent once he realized he had Watson’s full attention. Beneath the mask of filth was a mere boy of eighteen or nineteen.
‘Well, let’s take a look,’ Watson said noncommittally. Being a Blighty or not was the least of the lad’s worries. He had read papers on the survival rates from abdominal wounds, of the festering caused by the soil and cloth forced into the lacerating wounds by the shrapnel. Of the resulting gas gangrene, which caused the skin to inflate until it was as tight as a drum before it split and released, as Mrs Gregson had observed, a smell of putrefaction that, once inhaled, was hard to forget. Some of the isolation wards at Bailleul had reeked of it even after repeatedly being scrubbed down.
Watson registered the wound stripe on the lad’s soiled tunic. ‘Where did they get you last time?’
‘Bullet in ma shoulder, sir. No real damage.’ Watson’s own, now ancient, wound in the same location stirred in sympathy. ‘I don’t wan’ it to be a Blighty, sir.’
‘Is that right?’ Watson asked, surprised.
‘Aye. Don’t wan’ to leave ma pals. Don’t you believe wha’ you hear. There’s parts o’ this war that’re reet gut fun.’
Watson winked, as if they were sharing a guilty secret. The man was right; there was a dangerous thrill to conflict, and marvellous comradeship. Some thrived on it, no matter how gruesome the conditions. There was much Watson had missed when he left the army. That, however, had been a different kind of war. Although he supposed some things never changed – the thrill of being tested in battle and coming through head held high, eating, sleeping and fighting alongside men you would lay down your life for, the bittersweet elation of a victory, no matter how small. It could be a euphoric mixture. He had rarely experienced anything quite like it since, apart from when Holmes had stirred him out of his comfortable existence.
‘Staff Nurse Jennings, can you fetch me some scissors? Best take a look at what’s under here.’ He rechecked the label. No ‘M’. Just ‘PAW’, name and rank. ‘Did they give you anything, Private, at the dressing station?’
‘Like wha’, sir?’
‘Something for the pain?’
‘MO had a wee bit of rum. It’s naw too bad.’ He managed a cheerful grin, but it soon faded.
‘Lie down now. We’ll get you something. Morphia, please.’
‘There is none left,’ hissed Jennings.
‘What?’
‘No morphine. We have sent to the Big House for more.’
‘Aspirin, then. You have that?’ It wasn’t a given, as phenol shortages had curtailed production of the drug on both sides.
‘We do.’
‘Then we’ll try that.’ Aspirin might be a German drug, but he was sure the lad wasn’t too fussy. ‘Hold on, any tinctura opii camphorata?’
‘Yes, I believe so.’
It was the weakest of all the opium preparations, but had the edge on aspirin.
While an orderly went to fetch the elixir, Watson cut away the top swathe of bandage. More blood began to well from the edges. ‘Doesn’t look too terrible,’ he lied. ‘You lay your head back down, Private McCall. Have a little rest.’ He wrote ‘M REQUIRED’ on the docket. Then ‘X-RAY’.
The boy did as he was told, and as Watson worked at removing the layers of bandaging, he spoke softly to Jennings as she fed the boy the newly arrived elixir. ‘I meant to explain myself earlier. Before Sister interrupted.’
‘You have seen the worst of Sister Spence, Major. She’s a good, dedicated woman.’
‘I’m sure of it.’ He pointed at her neck. ‘I meant about that tiny blemish, although I fear that is too harsh a word for such a delicate thing, at the base of your throat. Only the St Kitts sandfly, Culicoides clasterri, also found on Nevis, leaves such an attractive, star-shaped scar.’
‘Ah, yes. We used to call it the Sweet Itch.’
‘And the only business that would take a British family out there, other than perhaps the Church, is the sugar business.’
She raised a quizzical eyebrow. ‘Tell me, Major Watson, do you always check your nurses’ throats for blemishes?’
Her cheeks dimpled fetchingly as she smiled. He felt himself warming under the collar of his now blood-spattered shirt. He resumed cutting.
‘And how do you know about the sandflies of the Caribbean, Major?’
‘I think we’ll need some towels here. The flies? Oh, I read a monogram. Recommended by . . .’ He paused. ‘I had a very good tutor, Staff Nurse Jennings.’
Good? The very best, Watson. The very best.
He ignored the comment. It was a trace memory, playing tricks on him. He was aware it could have no connection to his former colleague and friend because, should they pass in the street, Watson knew full well that Sherlock Holmes would no longer give him the time of day.