Saving lives on frontline, rebuilding them at home

FROM the cold waters of a Scottish loch when he was a child to the arid expanses of the Middle East as a man, Anthony Lambert has spent his life fighting to save others.

The Forces surgeon has had two deployments to Afghanistan where he has repaired bodies torn apart by bombs.

That, plus the spare time he has devoted to the aftercare of wounded services personnel, helped earn him an OBE in the 2013 New Year's Honours List.

He is no stranger to the appalling effects of life-changing injuries, then.

But he still speaks with a sense of shock at how much the lives of amputees are affected by their injuries.

"I don't think we really understand what they go through every day," he says.

"I was at a motorway service station with a Royal Marine who has lost an arm and a leg.

"I watched people stare when he bit at the end of a sausage he stabbed with a fork because he could not cut it up with one arm.

"They thought it was just bad table manners.

"I shared a room with him and watched him hop to the toilet in the night, saw how he struggled to squeeze the toothpaste on to his toothbrush, tried to shower – all those things that we take for granted."

That sense of wonder mixed with admiration at the determination of seeing wounded troops re-set their goals and carry on with full lives helps drive Anthony on in turn.

The surgeon's care for his ex-patients and others like them extends to ensuring they get the help they need to rebuild shattered lives.

The annual rugby matches between Royal Marines and the Peninsula Medical School that he organises at Plymouth Albion have raised tens of thousands of pounds for Forces' charities.

Anthony's other efforts also encompass organising confidence building adventure pursuits including surf training sessions at Polzeath.

But don't think that there might be a touch of the "holier-than-thou" about the man.

He is full of the humour, much of it dark, that is a character trait of many medics and members of the military.

There is a refreshing "what you see is what you get" air to him.

That ranges from talking bluntly about his own shortcomings, his struggles to re-adapt to NHS priorities after a deployment – his "normal" job is with the Ministry of Defence Hospital Unit at Derriford, operating on civilian patients – to admitting to being a bit arrogant.

If he chose to puff his chest up – which he doesn't – he would have a lot to be arrogant about.

Take the glowing terms in which his achievements are discussed in the letter which announced the OBE award.

"Your dedication to the continuous well-being of those who have benefited from your clinical skills knows no bounds," wrote Naval Secretary Rear Admiral Jonathan Woodcock.

"In particular, your unrelenting support for Royal Marines injured on operations is exceptional.

"Tireless in your efforts to provide not only physical but psychological care during the long rehabilitation process, your determination and dynamism are remarkable."

He is demonstrating at 52 the kind of selfless devotion to others that he first showed aged 12.

He was awarded the Scout Silver Cross for Gallantry and the Royal Humane Society Testimonial on Vellum for his brave but unsuccessful attempt to save a man from drowning in a Scottish loch.

The latter award is reserved for those who the society judges has put themselves "in considerable danger" in a rescue.

Some would argue that he has put himself in jeopardy many times during his career as a Royal Navy surgeon. In Iraq in 2007 the base where he worked was mortared 12 times a day and Camp Bastion, where has spent his two Afghanistan deployments, has also been attacked.

Don't talk to him about bravery, though.

"I do a job," he says. "That job is to operate on the wounded. There are lots of guys with weapons who are there to look after us.

"If I ever had to use my weapon we really would be up **** creek without a paddle.

"I have never feared for my life."

As in the case with many in the services, he is following a path previously trodden by his family.

His late father, Wally, was a submariner and his grandfather, Jack, was also in the senior service.

Family connections tend to extend to medicine, too, but in Anthony's case the only link is back to his grandfather who was a sick bay attendant.

He was born at Freedom Fields Hospital and raised in the city, with the exception of a couple of years spent in Helensburgh when his father was posted to Scotland.

Anthony went to Plymouth College and then to Charing Cross Hospital Medical School in London where he qualified as a doctor in 1985.

While there he joined the Royal Navy, helping him along the way to his double ambition.

"I had always wanted to be a surgeon and to be in the Navy," he says, adding quickly, to show how practical a choice it was, "in those days it was a job for life – and you got paid through medical school."

As for the surgeon part of the career option, "I chose that because I enjoy it.

"Put me beneath the bonnet of a car and I could no more repair an engine than I could jump and touch the moon.

"I'm no good with gizzits and gadgets. I am crap on the computer."

He's warming to the task of self-criticism and so volunteers: "I am not good at admin, therefore I don't want to leave a clinical job, therefore I am unlikely to be promoted from surgeon commander.

"I am happy to remain in a clinical role because that is what I enjoy."

But back to the start of his career. He worked initially at Royal Naval Hospital Stonehouse and was later posted to the 5th Destroyer Squadron.

He was on HMS Southampton when the Type 42 destroyer was in a collision with a merchant ship while keeping vital oil supply route the Straits of Hormuz open during the Iran-Iraq War in 1988.

The incident put Southampton at grave risk of sinking and led to 50 of the ship's company being injured.

By contrast a later deployment on another Type 42, HMS Gloucester, to the West Indies was "a jolly". The ship's doctor enjoyed 18 trips ashore in one of the most idyllic parts of the world.

Surgical training in Plymouth was next in 1989 before a war deployment.

The low casualty count among UK forces during the first Gulf war in 1991 meant his stint on hospital ship RFA Argus would be nothing like his experiences in Iraq and Afghanistan later.

The change for Anthony was experiencing life away as a married man. He'd met Ana when she was a student nurse and they were married in September 1990 but spent their first Christmas apart when Anthony was posted to Argus.

Ana's career took in intensive care and paediatrics before she stopped work in 1992, the year before their first child, Alex, was born.

Anthony's last deployment pre-family began in 1992 on the carrier HMS Invincible which was stationed in the Adriatic helping enforce the "no-fly" zone in the civil war following the break up of the former Yugoslavia.

The first piece of mail he opened from Ana told him she was pregnant.

He was home for the birth, then deployed again soon after, giving him an insight into the lives of so many other services personnel who juggle family life with deployments to war zones.

"When you don't have a family you can be away 11 months for the year and nobody really notices," he says. "But when you have wife and a child it is so different.

"I saw Alex only every few months when he was a baby. I missed so much, but without really realising how much I was missing."

Fortunately was home throughout the early years of his other children, as further surgical training meant he was based in the UK.

Alex, now 19, is studying French and Spanish at Cardiff University. Lily, 18, is training as a dancer in Essex, while Emma, 15 and Hannah, 13, both seem set on creative careers when they leave school.

The language skills come from Ana – her mother is Spanish and her father Hungarian. "The creativity certainly does not come from me. I am Mr Black And White, with nothing in between." The family lives in Hartley.

His next overseas deployment saw him serve on HMS Ocean in Sierra Leone in 2006 – there much of his work was more conventional medical, taking the chance to do elective surgery, cutting waiting lists in the process.

Iraq 2007 was not as busy as that incoming fire would suggest.

"Things were starting to calm down then. We had a few casualties but we weren't that busy."

But deployments to Afghanistan in 2008 and 2011 were different. Role 3 in Camp Bastion, the main British base in Helmand Province, is the biggest trauma hospital in the world.

"We were busy every day. There were lots of trauma cases.

"You are not only treating our guys, but with Afghan National Army, children and insurgents, in total up to 20 a day.

"Our job is to save lives without question. But there is a special air when it is one of our guys, in some cases somebody you know."

Pressures tell on all the medical staff.

"You do think back. You are making decisions that you look back on. Sometimes to save a life you have to take off a limb.

"But I've never looked back and thought I should have done it differently."

He is proud to be able to report that all of the servicemen who came into the hospital alive left alive.

That is a tribute to the care from the frontline through to all at the hospital.

"I am only doing job, part of the medical care, and that starts on the front line when the guy is injured. The buddy system is crucial: if their buddy can stop the bleeding, there is a chance.

"The Chinooks (helicopters) are next, with the medical team including a very senior doctor on board, picking them up and the protection team (troops) who fly with them and secure the ground for landing.

"They get the casualty to us and we take over."

As for the effects on him, "I have had my moments. You have a few beers and you pick up the pieces. It can be a struggle."

One struggle, ironically, including coping with down time on the 2011 deployment. The bigger teams then meant more time off which he found difficult.

"Waiting around or watching somebody else do something that you know you can do better is difficult.

"It sounds arrogant, but in this (job as a surgeon) you have to think that you are the best to be able to do the job."

Getting back into civilian life is not straight-forward, he says. That includes moving from the fast pace and high rate of trauma cases in Afghanistan to the non-urgent operations that come with the mix of NHS work at Derriford

When he hears that a minor operation needs to be done by Thursday or the waiting list target will be breached, there is a temptation to think, "who gives a damn?", he says.

Life-saving practices developed by military surgeons such as Anthony in Afghanistan are now being used in the NHS.

Techniques such as giving patients blood rather than crystalloid – mineral salt solutions – to help maintain normal physiology are allowing surgeons to keep operating on trauma patients for up to five times as long in a session, he says.

Part of his way of coping is to keep in touch with many of the service personnel he has operated on. He began by seeing them in recovery at centres elsewhere including the specialist military facilities in Birmingham.

His love of rugby, as a former player and now a youth coach with Devonport Combined Services, provided the inspiration to start the Medics versus Marines fundraisers. The fifth annual match is scheduled for November 5, 2013.

Many wounded former and serving troops have become friends.

"Sometimes you've known them before the are injured and you wonder after multiple amputations if they are gong to have any sort of life.

"But I have never ever met anyone who has wished they were dead.

"Seeing them re-set their lives and re-set their goals is amazing.

"You see them at home with their families and you realise that what the (medical) team does – the whole team right the way through – is worthwhile."

He admits to apologising to some he meets over the OBE award.

"I tell them I didn't do anything to deserve the OBE.

"They say, 'it's not your fault – you just owe us a beer'."