NB: All sources quoted in notes are available on publicly accessible sources apart from those where the author is given as ‘anonymous’ and the document is unpublished.
Introduction
1.Ewert, K., Henry V: A Guide to the Text and Its Theatrical Life (Basingstoke: Palgrave Macmillan, 2006), pp. 70–74.
2.Cohort: an ancient Roman military unit; a band of warriors, persons banded together especially in a common cause; a group of persons with a common statistical characteristic; in epidemiology, a group of individuals sharing a common symptom, condition or characteristic acquired at the same time and observed over time as a group.
3.Solomon, E., and Jones, S., ‘Defusing the Isis bomb industry’, Financial Times, 29 October 2016.
The War in Afghanistan: Timeline
1.MoD factsheet from 2009, cited in Ledwidge, F., Losing Small Wars (New Haven, CT: Yale University Press, 2011), p. 63. See also Ledwidge, F., Investment in Blood (New Haven, CT: Yale University Press, 2014).
1. ‘Blood is the argument’: The Pathophysiology of Shock
1.Hodgetts, T., Mahoney, P., and Clasper, J. (eds), Battlefield Advanced Trauma Life Support, Joint Services Publication 570, 5th edn (2008).
2. Scott Meenagh
1.Unlu, A., Kaya, E., Guvenc, I., et al., ‘An evaluation of CAT on training military personnel: changes in application times and success rates in three successive phases’, Journal of the Royal Army Medical Corps (JRAMC), 11 November 2014. Also any article found under the keyword search ‘Tourniquet’ in the archives of the JRAMC.
2.Hodgetts, T. J., ‘A Revolutionary Approach to Combat Casualty Care’, unpublished PhD thesis, City University of London, October 2012, p. 45.
3.Sheers, Owen, The Two Worlds of Charlie F (London: Faber & Faber, 2010), p. 31.
4.Hodgetts, T. J., ‘A Revolutionary Approach to Combat Casualty Care’, p. 68.
5.A tourniquet features in both the trauma and the psychiatric injury sections of the Science Museum’s exhibition ‘Wounded: Conflict, Casualties and Care’ (2016–18).
6.The sound archive of Terrence Rymer in the Imperial War Museum (IWM), no. 33806, reels 1–2.
7.Evriades, D., Jefferey, S., Cubison, T., et al., ‘Shaping the military wound: issues surrounding the reconstruction of injured servicemen at the RCDM’, Philosophical Transactions of the Royal Society B, 2011; 366: pp. 219–30, p. 221.
8.NHS news archive, ‘Independent review of major trauma network reveals increase in survival rates’, 25 June 2013. At least three hundred unexpected survivors per year since 2012, according to the Nottingham Trauma Centre (emailed conversation with DNRC, 2017).
9.This section is adapted from Croucher, Matt, Bulletproof (London: Arrow Books, 2010), pp. 68–91.
10.Roberts, D., and Aldington, D., ‘Why pain relief is important: the physiological response’, in Mahoney, P., and Buckenmaier, C. (eds), Combat Anaesthesia: The First 24 Hours (Houston, TX: The Office of the Surgeon General, Borden Institute, 2015), p. 200.
11.Definition by the International Association for the Study of Pain, cited in Sanders, G., ‘The physiology of acute pain’, in Mahoney and Buckenmaier (eds), Combat Anaesthesia, p. 194.
3. Mark Ormrod (1)
1.Sheers, Owen, Pink Mist (London: Faber & Faber, 2013), p. 31.
3.Hamlet (more Shakespeare), Act III, scene i: ‘But that the dread of something after death,/The undiscovered country from whose bourn/No traveller returns.’ Also used as a subtitle in a Star Trek film.
4.Fairweather, J., The Good War (London: Jonathan Cape, 2014), p. 310.
5.Fairweather, The Good War, p. 314.
6.Ormrod, Mark, Man Down (London: Corgi, 2010), p. 102.
7.This section is taken extensively from Ormrod’s own remarkable accounts of his wounding in Man Down, pp. 15–27 and 231–9.
4. The Medical Emergency Response Team (MERT)
1.See Alex Duncan, Sweating the Metal (London: Hodder, 2011), pp. 20–23.
2.Kotwal, R., Howard, J., and Orman, J., ‘The effect of a Golden Hour policy on the morbidity and mortality of combat casualties’, Journal of the American Medical Association (Surgery), 2016; 151(1): 15–24; doi: pp. 10.1001/jamasurg.2015.3104.
3.Ormrod, Man Down, p. 237.
4.Mahoney and Buckenmaier (eds), Combat Anaesthesia. All technical information for this chapter is primarily taken from this volume.
5.Taken from the testimony of Robert Moore, IWM sound archive 32509.
6.The Eyes Verbal Motor assessments are made as part of the Glasgow Coma Scale, which is commonly used to assess coma and impaired consciousness. A score for each component is given, and then a larger score. One assessment written on the knee pad was E3 V1 M6, but then the score was crossed out because the patient had died despite the work of the team. See Teasdale, G., and Jennett, B., ‘Assessment of coma and impaired consciousness: a practical scale’, The Lancet, 1974; 2: pp. 81–4.
7.Mahoney and Buckenmaier (eds), Combat Anaesthesia, ‘Introduction’.
8.Thank you to Martin Bricknell for emphasising ‘what is it like for those left behind?’ in a conversation with the author at Imperial College, 24 April 2015.
9.Fairweather, The Good War, p. 300.
10.Terrence Rymer, IWM sound archive 33806.
5. The Deal
1.Stewart, I., Sosnov, J., Howard, J., et al., ‘Retrospective analysis of long-term outcomes after combat injury: a hidden cost of war’, Circulation, published online, 2 November 2015.
2.Stewart, Sosnov, Howard et al., ‘Retrospective analysis of long-term outcomes’, p. 2129.
3.Xiao, W., Mindrinos, M., Seok, J., et al., ‘A genomic storm in critically injured humans’, Journal of Experimental Medicine, 19 December 2011; 208(13): 2581–90; see Abstract.
4.Neunaber, C., Zeckey, C., Andruskow, H., et al., ‘Immunomodulation in polytrauma and polymicrobial sepsis – where do we stand?’, Recent Patents on Inflammation and Allergy Drug Discovery, January 2011; 5(1): pp. 17–25.
6. Field Hospital Camp Bastion (Bastion)
1.Unpublished diary, anonymous junior trauma surgeon.
2.Author’s conversation with anonymous anaesthetist, 30 March 2015.
3.Author’s conversation with anonymous anaesthetist, 30 March 2015.
4.Horne, S., and Smith, J., ‘Preparation of the resuscitation room and patient reception’, JRAMC, vol. 157, 3rd supplement, vol. 1, pp. S267–72.
5.Mahoney and Buckenmaier (eds), Combat Anaesthesia, p. 695.
6.Mercer, S., Fraser, S., and Via, D., in Mahoney and Buckenmaier (eds), Combat Anaesthesia, p. 33.
7.Tai, N., and Russell, R., ‘Right turn resuscitation: FAQs’, JRAMC, vol. 157, 3rd supplement, vol. 1, pp. S310–14.
8.Hodgetts, ‘A Revolutionary Approach to Combat Casualty Care’, pp. 42–4.
9.Levine, Joshua (ed.), Forgotten Voices of the Somme (London: Ebury Press, 2008), pp. 102–3.
10.Hoffman, Annie, Operation Paperclip (New York: Little, Brown, 2014), p. 214.
11.Roach, Paul, Citizen Surgeon: A Memoir (Chicago, IL: Bookbaby 2016), pp. 91–2.
12.Scott, R., ‘Eyes’, in Brooks, A., Clasper, J., Midwinter, M., et al. (eds), Ryan’s Ballistic Trauma (London: Springer, 2011), pp. 349–60.
13.Francis, Gavin, Adventures in Human Being (London: Profile Wellcome Collection, 2015), p. 73, and Kirkman, E., ‘Blast injury’, in Brooks, Clasper, Midwinter et al., Ryan’s Ballistic Trauma, pp. 90–98.
14.Tunnicliffe, I., and Mackenzie, B., ‘Blast injuries to the lung: epidemiologies and management’, Philosophical Transactions of the Royal Society B, 2011, p. 366.
15.Aurora, H., Rankin, S., et al., ‘Blast lung injury’, in Royal British Legion Centre for Blast Injury Studies Annual Report (London: Imperial College, 2014).
8. Bastion’s Medics
1.Birds have been punctuation points for those at war for a century and perhaps beyond. See Steven Heyde, ‘History as a source for innovation in landscape architecture: the First World War landscapes in Flanders’, in Studies in the History of Gardens and Designed Landscapes, 35:3, pp. 182–97. The author cites the memories of birds during the First World War from Frank Hurley and Robert Night.
2.One of the first papers by British specialists to describe blast injury in the modern era: Edwards, D., Lane, T., Pathak, G., et al., ‘Penetration of the Warrior armoured personnel carrier by shaped charge explosive devices (IED) – emerging injury patterns’, Journal of Bone and Joint Surgery, vol. 91-B 2009, Orthopaedic Proceedings, Supplement II.
3.Pannett, C., ‘Medical aspects of modern warfare with special reference to hospital ships’, British Journal of Surgery, 1914: pp. 470–71.
4.Pannett, ‘Medical aspects of modern warfare with special reference to hospital ships’.
5.Parker, Harry, Anatomy of a Soldier (London: Faber & Faber, 2015), p. 2.
6.Maitland, L., Lawton, G., Baden, A., et al., ‘The role of military plastic surgeons in the management of modern combat trauma: an analysis of 645 cases’, Plastic & Reconstructive Surgery, April 2016; vol. 137: 4: 717e–724e.
7.Wood, P., Haldane, E., and Plimmer, S., ‘Anaesthesia at Role 4’, JRAMC, no. 156 (4th supplement, vol. 1): pp. S310–12, p. 310.
8.Sella, Amnon, The Value of Human Life in Soviet Warfare (London: Routledge, 1992), pp. 194–6, for a discussion of the role of medical provision and military morale.
9.Patsy Beesley, sound archive of the National Army Museum.
10.Hodgetts, T. J., ‘Lessons from the Musgrave Park Hospital bombing’, Injury, April 1993; 24(4): pp. 219–21.
11.Arul, G., Pugh, H., Mercer, S., et al., ‘Optimising communication in the damage control resuscitation – damage control surgery sequence in major trauma management’, JRAMC, 158(2): pp. 82–4.
12.Mahoney, P., Hodgetts, T., and Hicks, I.: ‘The deployed medical director: managing the challenges of a complex trauma system’, JRAMC, 157 (3rd supplement, vol. 1): pp. S350–56, p. 351.
13.Trauma Bay 5 had an abdominal case that had arrived earlier in the day.
14.Moy, R., ‘Ethical dilemmas in providing medical care to captured persons on operations’, JRAMC 158(1): pp. 6–9.
15.Duncan, Sweating the Metal, pp. 194–6.
16.Hodgetts, T. J., ‘Sniffer Dogs’, unpublished poem.
17.Helphand, Kenneth, Defiant Gardens (San Antonio, TX: Trinity University Press, 2006), p. 234.
18.Helphand, Defiant Gardens, conclusions.
19.Trauma at War, presented by Kevin Fong, BBC Radio 4, episode 2 (first broadcast March 2014).
20.Hodgetts, T. J., ‘A Premonition of Death’, unpublished poem.
9. History
1.Carless, A., ‘Preface’ to Deane, H. E., Gymnastic Treatment for Joint and Muscle Disabilities (London: Hodder & Stoughton, 1918), p. 16.
2.Notes from the Medical Society of London, ‘Re-education of the amputated’, The Lancet, 3 April 1920, p. 769.
3.Actually shudder. I’ve seen them.
4.Huggins, G. M., ‘The surgery of amputation stumps based on the experience of 2,000 cases’, The Lancet, 28 April 1917.
5.Carless, ‘Preface’, p. 13.
6.See the report on ‘Demonstrations: fractured femurs, facial surgery’, British Medical Journal, 26 April 1919, pp. 528–9.
7.Please note that, because I work there, this section is primarily focused on the work of scientists and clinicians at Imperial College London, but there is a range of other universities researching the effects of severe casualty, and they can be found by the usual subject-matter searches.
8.Gay, Hannah, The History of Imperial College London, 1907–2007 (London: Imperial College, 2007), p. 133.
9.And I’m watching.
10.Jones, E., and Wessley, S., ‘Interwar’, in Shellshock to PTSD (London: Maudsley Series, 2005).
10. Critical Care
1.No shit. Taylor, C., Hettiaratchy, S., Jeffery, S., et al., ‘Contemporary approaches to definitive extremity reconstruction of military wounds’, JRAMC, 155(4): pp. 302–7.
2.This section is drawn from Romanelli, R., Vowden, K., and Wir, D., ‘Exudate management made easy’, Wounds International, 2010; 1(2). Also, Royal College of Defence Nursing, ‘Challenges of training military wounds’, in This is Defence Nursing, RCN online publication, November 2015.
3.Hill, N., Fallowfield, J., Price. S., et al., ‘Review of military nutrition’, Philosophical Transactions of the Royal Society B, 2011, pp. 234–7. Jansen, S., Turner, S., and Johnston, A., ‘Nutritional management of critically ill trauma patients in the deployed military setting’, JRAMC, 157 (3rd supplement, vol. 1): pp. S344–9. Haenboehler, E., Williams, A., Leinhase, I., et al., ‘Metabolic changes after polytrauma: an imperative for nutritional support’, World Journal of Emergency Surgery, 2006, 1:29.
4.Exhibit 22–1, ‘Potential benefits of regional anaesthesia’, in Mahoney and Buckenmaier (eds), Combat Anaesthesia, p. 242.
5.Parker, Anatomy of a Soldier, p. 26.
6.Edgerod, I., and Christensen, D., ‘Analysis of patient diaries in Danish ICUs: a narrative approach’, Intensive and Critical Care Nursing, 25; 2009: pp. 268–77; ‘The casualty clearing station as a working unit in the field’, JRAMC, 32; 1916: pp. 45–6; Thomas, J., and Bell, E., ‘Lost days: diaries for military intensive care patients’, Journal of the Royal Naval Medical Service, 97; 2011: pp. 11–15; Charon, R., ‘Narrative medicine: a model for empathy, reflection, profession and trust’, JAMA, 286; 2001, 15: pp. 1897–902; Di Gangi, S., Naretto, G., Cravero, N., et al., ‘A narrative-based study on communication by family members in an intensive care unit’, Journal of Critical Care, 2013, 28, pp. 483–9. Philips, C., ‘Use of patient diaries in critical care’, Nursing Standard, 2011, 26: pp. 34–43, p. 43. See also Mayhew, E., and McArthur, D., ‘A special book kept for the purpose: writing patient diaries, a century of skill in the silence, from the Great War to Afghanistan and beyond’, Intima: A Journal of Narrative Medicine, October 2015.
7.Author’s email exchange with RAF Emergency Nurse Sgt Nicola Blake, 14 March 2015.
11. Critical Care Air Support Team (CCAST)
1.Mahoney and Buckenmaier (eds), Combat Anaesthesia, p. 398.
2.A key source for this section is http://www.cotterrell.com/download/4267/war-and-medicine-artists-diary
3.Brooks, Clasper, Midwinter et al., Ryan’s Ballistic Trauma, p. 607.
4.http://news.bbc.co.uk/1/hi/wales/8621691.stm
5.‘Bastion: an ATC’s view’, Gateway Magazine, March 2010.
6.See Flutter, C., Ruth, M., and Aldington, P., ‘Pain management during RAF strategic aeromedical evacuations’, JRAMC, 155(1): pp. 42–67, p. 61.
7.Jansen, J., Turner, S., and Johnston, A., ‘Nutritional management of critically ill trauma patients in the deployed military setting’, JRAMC 157 (3rd supplement, vol. 1): pp. S344–9.
8.Conversation with anonymous military nursing sister, 14 September 2015.
9.Freedman, L., The Official History of the Falkland Islands Campaign, Government Official History series (London: Routledge, 2007), vol. 2, p. 662.
10.Lawrence, J., and Lawrence, R., When the Fighting Is Over: Tumbledown, A Personal Story (London: Bloomsbury, 1988), p. 41.
11.Lawrence and Lawrence, When the Fighting is Over, pp. 50–53.
12.The Strategic Defence Review: Defence Medical Services, House of Commons Defence Committee, 7th Report (London: The Stationery Office, 1999), p. viii.
13.Defence Medical Services: A Review of the Clinical Governance of the Defence Medical Service in UK and Overseas, Commission for Healthcare Audit and Inspection (London: The Stationery Office, 2009), p. 13.
14.‘The experience can be stark and long-lasting. Returning to the UK after my first deployment, I shared the flight home with three critically injured British soldiers, all in induced comas, and the body of a Danish soldier killed in action. It hit me then that this flight was one of many, carrying home men and women whose lives would be changed for ever, and some who had made the ultimate sacrifice.’ Prince Harry, in a speech to launch the Invictus Games in the USA, 28 October 2015. The prince was referring to a flight in March 2008 where Ben McBean, who would be a room-mate of Ormrod’s at Headley, was among the seriously injured. See Ormrod, Man Down, pp. 35, 331.
15.Conversation with anonymous CCAST nurse, May 2015.
12. Birmingham
1.Letters from Earnest Douglas, IWM archives, quoted in Mayhew, E., Wounded: From Battlefield to Blighty (London: The Bodley Head, 2013).
2.Evison, M., Death of a Soldier (London: Biteback, 2012), p. 507, and Harnden, T., Dead Men Risen (London: Quercus, 2011), pp. 369–10.
3.Ormrod, Man Down, p. 240.
4.Nutbeam, T., and Keene, D., ‘Critical care management: the patient with ballistic trauma’, in Brookes, Clasper, Midwinter et al., Ryan’s Ballistic Trauma, p. 626.
5.Dutton, C., ‘Critical care nursing at role four’, in Brookes, Clasper, Midwinter et al., Ryan’s Ballistic Trauma, p. 630.
13. The Duty Critical Care Nurse
1.Email correspondence with anonymous military nursing sister who conceived the DCCN role, 9 June 2015.
2.Ormrod, Man Down, p. 243.
3.Wood, S., and Winters, M., ‘Care of the intubated emergency department patient’, Journal of Emergency Medicine, 2011; 40(4): pp. 419–27.
4.Conversation with Edward Spurrier, orthopaedic surgeon at Birmingham, 2011.
5.See Jardeleza, T., ‘Intensive care unit sedation in the trauma patient’, in Mahoney and Buckenmaier (eds), Combat Anaesthesia, pp. 359–70.
6.Jardeleza, ‘Intensive care unit sedation in the trauma patient’, p. 361.
7.The process of agitated waking by soldiers in Birmingham is dramatically re-enacted in Owen Sheers’s play The Two Worlds of Charlie F. The play draws directly on the experience of the wounded for its material, and the parts of casualties were played by former servicemen and -women. See http://www.charlie-f.com/about.php
8.Davies, P., Scott, T., Dutton, C., et al., ‘Intensive care follow-up in UK military casualties: a one-year pilot’, Journal of the Intensive Care Society, 15(2), April 2014: pp. 112–16.
9.Berney, S., ‘Physiotherapy in critical care in Australia’, in Cardiopulmonary Physical Therapy Journal, 23(1); March 2012: p. 19.
10.Schweickert W. D., Pohlman, M. C., Pohlman, A., et al., ‘Early physical and occupational therapy in mechanically ventilated critically ill patients: a randomised control trial’, The Lancet, 2009, 10: p. 1016.
11.Millett, R., ‘Structured rehabilitation within critical care’, in Critical Response: Queen Elizabeth Hospital Birmingham’s Critical Care Physiotherapy Team, Chartered Society of Physiotherapy, Frontline article, published online, 1 January 2014. See also McWilliams, D., and Pantelides, K., ‘Does physiotherapy led early mobilisation affect length of stay in ICU?’, Journal of the Association of Chartered Physiotherapists in Respiratory Care, 2008; 40: pp. 5–10.
12.Evriviades, D., Jeffery, S., Cubison, T., et al., ‘Shaping the military wound’, Philosophical Transactions B, 2011, p. 225, and Taylor, C., Hettiaratchy, S., Jeffery, S., et al., ‘Contemporary approaches to definitive extremity reconstruction of wounds’, JRAMC, 155(4): pp. 302–7, p. 306.
13.Taylor, Hettiaratchy, Jeffery, et al., ‘Contemporary approaches to definitive extremity reconstruction of wounds’, p. 305.
14.Jeffery, S., and Porter, K., ‘Role four and reconstruction’, in Brookes, Clasper, Midwinter et al., Ryan’s Ballistic Trauma, p. 667.
15.Metcalfe, J., Grimer, R., and Eiser, C., ‘Orthopaedic protocols for hemipelvectomy’, Journal of Bone and Joint Surgery, 2003, vol. 85: pp. 1–50.
16.Devonport, L., Edwards, D., Edwards, C., et al., ‘Evolution of the Role 4 UK military pain service’, JRAMC 156 (supplement 1), p. 403.
17.Elaine Scarry’s classic The Body in Pain (Oxford: Oxford University Press, 1985).
18.http://www.who.int/cancer/palliative/painladder/en/
19.Davies, P., Scott, T., Dutton, C., et al., ‘Intensive care follow-up in UK military casualties: a one-year pilot’.
20.Scott Meenagh’s patient diary, entry for 25 January 2011, 2020 hrs.
14. Mark Ormrod (3)
1.Ormrod, Man Down, pp. 244–60, for this section. The RAF’s burned aircrew formed themselves into The Guinea Pig Club, whose membership was extremely exclusive, and no one cared to pay membership voluntarily. See Mayhew, E., The Reconstruction of Warriors (London: Greenhill, 2004).
2.Tallis, R., The Hand (Edinburgh: Edinburgh University Press, 2003), pp. 90–92.
3.‘For like a hectic in my blood he rages, And thou must cure me: till I know it’s done How’er my haps, my joys were ne’er begun.’ Claudius, in Hamlet, Act IV, scene iii.
4.Kucisec-Tepes, N., Bejuk, D., and Kosuta, D., ‘Characteristics of war wound infection’, Acta Medica Croatica, September 2006; 60(4): pp. 353–63.
5.Sheers, Pink Mist, p. 51.
6.BBC Radio Wiltshire interview with Jon Le Galloudec by Ashley Heath, recorded at Tedworth House, June 2014 for The People’s War, BBC First World War centenary commemoration.
7.See Taylor, Hettiaratchy, Jeffery et al., ‘Contemporary approaches to definitive extremity reconstruction of wounds’, p. 306, and Pfaller, M., Pappas, P., and Wingard, J., ‘Invasive fungal pathogens: current epidemiological trends’, Clinical Infectious Diseases, 2006; 43 (supplement 1): pp. S3–14. See also Parker, Anatomy of a Soldier, p. 58.
8.Jones, C., Chinery, J., England, K., et al., ‘Critical Care at Role 4’, JRAMC, December 2010; 156 (4th supplement, vol. 1): pp. 342–8, p. 347.
9.See Wong, J., March, D., Abu-Sitta, G., et al., ‘Biological foreign body implantation in victims of the London July 7th suicide bombings’, The Journal of Trauma, 2006; 60(2): pp. 402–4. Also Patel, H., Dryden, S., Gupta, A., et al., ‘Human body projectiles implantation in victims of suicide bombings and implications for health and emergency care providers: the 7/7 experience’, Annals of the Royal College of Surgeons of England, 2012; 94(5): pp. 313–17.
10.Halachev, M., Chan, J., Constantinidou, C., et al., ‘Genomic epidemiology of a protracted hospital outbreak caused by multidrug-resistant Acinetobacter baumannii in Birmingham England’, Genome Medicine, 20 November 2014; 6(11): p. 70.
11.Ormrod, Man Down, pp. 257–8.
12.Ormrod, Man Down, pp. 263–4.
13.‘The casualty clearing station as a working unit in the field’, JRAMC, 32, 1916, p. 45.
14.The correspondence of Captain Charles McKerrow and others to his wife, Jean, the archives of the Imperial War Museum: 93/20/1, p. 285.
1.Black Dog, ‘The Great Leveller’, in Enduring Freedom (Brighton: FireStep Publishing, 2011), p. 41.
2.Ormrod, Man Down, p. 267.
16. Rehabilitation: Headley Court
1.Jones, R., report on a lecture to the Hunterian Society of London, The Lancet, 12 January 1918, pp. 59–61.
2.For the definitive history of the development of modern orthopaedics, see Cooter, R., Surgery and Society in Peace and War (London: Palgrave Macmillan, 1993).
3.Deane, H., Gymnastic Treatment for Joints and Muscle Disabilities (Oxford: Oxford University Press, 1918), p. 13.
4.Deane, Gymnastic Treatment for Joints and Muscle Disabilities, p. 13.
5.Etherington, J., ‘Conflict rehabilitation’, in Brookes, Clasper, Midwinter et al. (eds), Ryan’s Ballistic Trauma, pp. 669–90.
6.This section, and this set of quotations, from Etherington, ‘Conflict rehabilitation’, pp. 669–90.
7.David Henson, lecture at Imperial College, 1 June 2016.
17. Sockets and Stumps
1.See http://www.channel4.com/programmes/were-the-superhumans
2.Guyatt, M., ‘Better legs: artificial limbs for British veterans of the First World War’, Journal of Design History, 2001, 14(4): pp. 307–25.
3.Artists of the Italian Renaissance, not Ninja Turtles.
4.Harry Parker took particular care with the way he communicated with his prosthetist and physios, explaining in close, personal detail how his new limbs were working for him, and you can see how well this translated into his fictional account of a wounding, in Anatomy of a Soldier. Author’s conversation with Harry Parker, 16 February 2016.
5.This section is drawn from Gillian Conway’s excellent presentation at Imperial College during the Rehab Research Seminar series, 3 February 2016.
6.McGregor, A., Hopkins, M., et al., ‘Blast injury rehabilitation’, Royal British Legion Centre for Blast Injury Studies, Annual Report 2014 (London: Imperial College, 2014), p. 30.
7.Ormrod, Man Down, p. 305.
8.Author’s conversation with Harry Parker, 16 February 2016.
9.Jones, R., ‘An address on the orthopaedic outlook in military surgery’, given at the Hunterian Society, Royal College of Surgeons, 2 January 1918.
10.http://www.findabetterway.org.uk/news/fabw-funded-surgical-course-huge-success/
11.Ormrod, Man Down, pp. 308–10.
18. Mark Ormrod (5)
1.Ormrod, ‘Parenting with a disability’, 15 September 2015, www.markormrod.com
2.Ormrod, Man Down, p. 320.
19. A Short History of Headley Court and Its Garden (neither of which is as old as it looks)
1.See Gruber von Arni, E., Justice to the Maimed Soldier: Nursing and Medical Care for Sick and Wounded Soldiers and their Families in the English Civil War and Interregnum (London: Routledge, 2001).
2.http://www.epsomandewellhistoryexplorer.org.uk/Weather.pdf
3.Land Use Consultants, ‘Historical Development’, in Headley Court Development Plan, section 2.0, pp. 1–11 (author’s own copy).
4.Hodgson Burnett, Frances, The Secret Garden (London: Vintage Classics, 2012), p. 281.
5.http://www.londonskateparks.co.uk/skateparks/southbank/
20. Sockets and Stumps and Pain
1.Jon Kendrew, lecture at Imperial College, London, 1 June 2016.
2.‘The problem of the disabled soldier’, editorial in The Lancet, 18 November 1916, pp. 867–8.
3.Jones, R., Hunterian Society lecture on wartime orthopaedic surgery, reprinted in The Lancet, 12 January 1918, pp. 59–61.
4.Hsu, E., and Cohen, S., ‘Post-amputation pain: epidemiology, mechanisms and treatment’, Journal of Pain Research, 2013; 6: pp. 121–36.
5.Aldington, D., Small, C., Edwards, D., et al., ‘A survey of post-amputation pains in serving military personnel’, JRAMC, 2014; 160: pp. 38–41.
6.Le Feuvre, P., and Aldington, D., ‘Know pain, know gain’, JRAMC, 2014; 160: pp. 16–21.
7.See Edwards, D., Mayhew, E., and Rice, A., ‘“Doomed to go in company with miserable pain”: surgical recognition and treatment of amputation-related pain on the Western Front during World War One’, The Lancet, 8 November 2014; 384: pp. 1715–19.
8.Devonport, Edwards et al., ‘Evolution of the Role 4 UK military pain service’, p. 403.
9.Thank you to Peter Berg and the writers of the film Deepwater Horizon (Summit Entertainment et al.) for that one.
1.This section on the planting of the walled garden is taken from Thomas Meenagh’s own unpublished record, ‘The Headley Court Garden’.
2.William Shakespeare, Troilus and Cressida, Act III, scene iii, line 175.
3.Miller, Clarence, ‘On A Man for All Seasons’, Thomas More Studies (1), 2006, pp. 27–9, and The Complete Works of St Thomas More (New Haven, CT: Yale University Press, 1967–93). Miller clarifies that the original phrase ‘A man for all seasons’ is taken from Erasmus’ original Latin, which precisely translates as ‘a man suited to all hours, times, occasions’.
4.The student was Marie Jacobsen, who has since graduated and returned to her home town of Adelaide in Australia (email correspondence with Thomas Meenagh, October 2015).
5.This is called animal therapy. Scientists are looking at this now because it works. See Levinson, B., ‘Human companion animal therapy’, Journal of Contemporary Psychotherapy, 14(2); 1984: pp. 131–44, and Fine, A., Handbook on Animal Assisted Therapy (London: Academic Press, 2010).
6.Poultry farming was used in the aftermath of the First World War as part of the rehabilitation and retraining of casualties. There was a poultry farm in Welwyn Garden City where casualties learned the skills required and could keep a small flock domestically as a potential source of income. Thank you to Jenna Stevens-Smith, whose grandfather William Lane was one of them.
7.Wilson, E., Biophilia (Cambridge, MA: Harvard University Press, 1990), p. 101.
8.Jeff Goldblum as chaos theory specialist Ian Malcolm in the film Jurassic Park.
9.For the benefits of horticultural therapy see: Mitchell, R., Astell-Burt, T., and Richardson, E. A., ‘A comparison of green space indicators for epidemiological research’, in Journal of Epidemiology and Community Health, October 2011; 65: pp. 853–8; Lewis, C., ‘Human health and well-being: the psychological, physiological, and sociological effects of plants on people’, Acta Horticultura, 1995; 391: pp. 31–40; Wichrowski, M., Whiteson, J., Haas F., et al., ‘Effects of horticultural therapy on mood and heart rate in patients participating in an inpatient cardiopulmonary rehabilitation program’, Journal of Cardiopulmonary Rehabilitation, 2005, 25(5): pp. 270–74; Van Den Berg, A., and Custers, M., ‘Gardening promotes neuroendocrine and affective restoration from stress’, Journal of Health Psychology, January 2011; 16: pp. 3–11; Hartig, T., Evans, G., Jamner, L. D., et al. ‘Tracking restoration in natural and urban field settings’, Journal of Environmental Psychology, 2003; 23: pp. 109–23; Kaplan, R., and Kaplan, S., ‘Preference, restoration, and meaningful action in the context of nearby nature’, in Bartlett, P. F. (ed.), Urban Place: Reconnecting with the Natural World (Cambridge, MA: The MIT Press, 2005), pp. 271–98; Hartig, T., and Cooper Marcus, C., ‘Healing gardens: places for nature in health care’, The Lancet, 2006; 368: pp. S36–7; Pretty, J., Peacock, J., Sellens, M., et al., ‘The mental and physical health outcomes of green exercise’, International Journal of Environmental Health Research, 2005; 15(5): pp. 319–37; Barton, H., and Grant, M., ‘A health map for the local human habitat’, Journal of the Royal Society for the Promotion of Health, 2006; 126(6): pp. 252–3; Burls, A., ‘People and green spaces: promoting public health and mental well-being through ecotherapy’, Journal of Public Mental Health, 2007; 6(3): pp. 24–39; Gerlach-Spriggs, N., and Healy, V., ‘The therapeutic garden: a definition’, ASLA Healthcare and Therapeutic Design Newsletter, 2010 (online); and Greenberg, N., Iversen, A., Hull, L., et al., ‘Getting a peace of the action: measures of post traumatic stress in UK military peacekeepers’, Journal of the Royal Society of Medicine, February 2008; 101(2): pp. 78–84. Thank you to Peter Le Feuvre, who compiled this index so I didn’t have to.
10.Hickman, C., Therapeutic Landscapes (Manchester: Manchester University Press, 2013), and Dixon Hunt, J., A World of Gardens (London: Reaktion, 2012).
11.Helphand, Defiant Gardens, pp. 2–6.
12.Dixon Hunt, A World of Gardens, pp. 21 and 83–91, and Dixon Hunt, J., Historical Ground (London: Routledge, 2014), p. 21.
13.Fox, J., ‘Conflict and consolation: British art and the First World War, 1914–1919’, Art History, vol. 36, 2013: pp. 810–33, for details of Howard Kemp-Prosser’s visionary formulation of colour therapy.
22. The Engineer: Dave Henson
1.See Craig Miller, B., Empty Sleeves: Amputation in the Civil War South (Athens, GA: University of Georgia Press, 2015), p. 146.
2.Guyatt, M., ‘Better legs: artificial limbs for British Veterans of the First World War’, Journal of Design History, vol. 14, no. 4, pp. 307–25, p. 321.
23. A Centre for Blast Injury Studies
1.Probably not just theoretical physics, also quantum physics, high-energy physics and engineering to build the actual machine, and this is not as funny as you think it is – there are applications to investigate time-travel possibilities. Thank you to Dr Simon Foster, solar physicist and physics outreach officer, for these insights.
2.Letter from Sir Arthur Sloggett to Sir Alfred Keogh, 9 December 1915, p. 1. Archives of King’s College London. Thank you to Dr Tom David, who found this extraordinary source, recognised it for what it was and told me about it.
3.Kotwal, R., Howard, J., and Ormon, J., ‘Effect of Golden Hour policy on the morbidity and mortality of combat casualties’, Journal of the American Medical Assocation (Surgery), 2016; 151(1): pp. 15–24. doi: 10.1001/jamasurg.2015.3014.
4.The history of how Imperial got its Blast Lab, which eventually became the TRBL Centre for Blast Injury Studies, cannot be adequately summed up in two lines, obviously. But an account of that particular history is in progress.
5.Thank you to Hari Aurora and Phil Pearce, who provided the concept of the car alarm of blast injury in the human body during their Imperial Festival lecture, May 2016.
6.Edwards, D., Lane, D., Pathak, G., et al., ‘Penetration of the Warrior armoured personnel carrier by shaped charge explosive devices (IED) – emerging injury patterns’, Journal of Bone and Joint Surgery, vol. 91-B, 2009, Orthopaedic Proceedings, Supplement II; Ramasamy, A., Harrisson, S., Clasper, J., et al., ‘Injuries from roadside improvised explosive devices’, Journal of Trauma, 65(4), 2008: pp. 910–14; Ramasamy, A., Harrison, S., Lasrado, M., et al. ‘A review of casualties during the Iraqi insurgency 2006 – a British field hospital experience’, Injury, 40 (2009): pp. 493–7.
7.Ramasamy, A., Hill, A., Masouros, S., et al., ‘Evaluating the effect of vehicle modification in reducing injuries from landmine blasts: an analysis of 2212 incidents and its application for humanitarian purposes’, Accident Analysis and Prevention, 2011; 43(2): pp. 1878–86.
8.Author’s conversation with Spyros Masouros and Adam Hill, September 2015.
9.Spyros Masouros, conversation with the author, November 2015.
10.For a full round-up of all Imperial’s Centre for Blast Injury Studies research programmes see Bull, A., Clasper, J., and Mahoney, P., Blast Injury Science and Engineering: A Guide for Clinicians and Researchers (London: Springer, 2016).
11.Ulgen, B., Brumblay, H., Yang, L. J., et al., ‘Augusta Déjerine-Klumpke, M.D. (1859–1927): a historical perspective on Klumpke’s palsy’, Neurosurgery, August 2008; 63(2): pp. 359–66.
12.Edwards, D., Clasper, J., and Patel, H., ‘HO in victims of the London 7/7 bombings’, JRAMC, 5 December 2014.
13.‘Kabul attack offers a grim test to a tiny ambulance crew’, New York Times, 21/22 April 2016.
1.Mark Ormrod, blog post: http://www.markormrod.com/2015/07/17/de-cluttering-organisation
2.Mark Ormrod, blog post, de-cluttering, p. 3.
3.Mark Ormrod, blog post, ‘Tips for better health (part two)’, 19 May 2016.
25. Sockets and Stumps and Science
1.Haufner, S., ‘Considerations for development of sensing and monitoring tools to facilitate treatment and care of persons with lower limb loss: a review’, Journal of Rehabilitation Research and Development 2014; vol. 51, n0.1: 1–14, p. 3.
2.Thank you to Dr Claire Higgins for her remarkable insights in this section.
3.Claire does this sort of thing: Topouzi, H., and Higgins, C. A., ‘Expression map of three distinct skin fibroblast populations isolated from human skin’, 45th Annual Meeting of the European Society for Dermatological Research (Nature Publishing Group, 2015).
26. Complex Outcomes, Chronic Pain and PTSD
1.Author’s conversation with Dominic Aldington, Winchester, 2015.
2.See Grichnik, K., and Ferrante, F., ‘The difference between acute and chronic pain’, Mt Sinai Journal of Medicine, May 1991; 58(3): pp. 217–20, p. 217 (abstract).
3.Stephens, R., Atkins, J., and Kingston, A., ‘Swearing as a response to pain’, NeuroReport, 2009; 20(12): pp. 1056–60.
4.Latremoliere, A., and Woolf, C., ‘Central sensitization: a generator of pain hypersensitivity by central neural plasticity’, Journal of Pain, September 2009; 10(9): pp. 895–926 (a very long article, very complicated, with the longest bibliography I’ve ever seen, but possibly the most important reference in this book).
5.Anything by Lorrimer Moseley and his brain team explains this process beautifully.
6.Van der Kolk, B., The Body Keeps the Score (London: Penguin, 2014), pp. 1–2. Thank you to Matthew Green, who drew my attention to this work, and also for his own definitive study of PTSD in the contemporary era: Green, M., Aftershock: Fighting War, Surviving Trauma, Finding Peace (London: Portobello, 2016). If you only read two books about pain and PTSD, make sure they are both by Steve Haines: Trauma Is Really Strange and Pain Is Really Strange (both London: Singing Dragon, 2016). From them you will understand how therapy for chronic pain and PTSD is really well done.
7.Otis, J., Keane, T., and Kerns, R., ‘An examination of the relationship between chronic pain and post-traumatic stress disorder’, Journal of Rehabilitation Research and Development, September/October 2003; 40(5): pp. 397–406, p. 397.
8.Risdall, J., and Menon, D., ‘Traumatic brain injury’, Philosophical Transactions of the Royal Society B (theme issue, ‘Military Medicine in the 21st Century: Pushing the Boundaries of Combat Casualty Care’), 2011; 366: pp. 241–50.
9.Cassandra Jardine, interview with Robert Lawrence: ‘Angry, my wife calls me Social Semtex’, Daily Telegraph, 3 April 2007.
10.Risdall and Menon, ‘Traumatic brain injury’, p. 247.
11.Sofroniew, M., and Vinters, H., ‘Astrocytes: biology and pathology’, Acta Neuropathologica, January 2010, 119(1): pp. 7–35.
12.Shively, S., Horkayne-Szakaly, I., Jones, R., et al., ‘Characterisation of interface astroglial scarring in the human brain after blast exposure: a post-mortem case series’, The Lancet Neurology, published online, 9 June 2016. Professor Perl and his research are mentioned at an early stage in Mary Roach’s brilliant Grunts: The Curious Science of Humans at War (London: Oneworld, 2016).
13.Worth, R., ‘What if PTSD is more physical than psychological?’, New York Times Magazine, 10 June 2016.
14.Shively, S., Horkayne-Szakaly, I., Perl, D., et al., ‘Research in context’, editorial comment on ‘Characterisation of interface astroglial scarring in the human brain after blast exposure: a post-mortem case series’.
Epilogue: Medics
1.Jones, E., Thomas, A., and Ironside, S., ‘Shell shock: an outcome study of a First World War “PIE” unit’, Psychological Medicine, 2007; 37: pp. 215–23.
2.Arul, G., Bree, S., Sonka, B., et al., ‘The secret lives of the Bastion Bakers’, British Medical Journal, 349, 18 December 2014. Thank you to Alan Kay, who brought this excellent source to my attention, and to the BMJ’s Christmas editors for their usual deft touch with content.
3.Roach, Citizen Surgeon.
4.Royal Navy, So You’re Going on Decompression? (Fleet Graphics Centre, 10/408).
5.Roach, Citizen Surgeon, p. 188.
6.Roach, Citizen Surgeon.
7.Brown, J., ‘The moral matrix of wartime medicine’, Intima: A Journal of Narrative Medicine, September 2015.