They say, as a doctor, empathy is important. Yet sometimes such feelings simply go too far. No more so, perhaps, than for practitioners serving in the army, navy and air forces who live in close proximity to their patients, who suffer alongside them, and who are exposed to similar risks. For many medics who have sworn Crown allegiance, their patients are more than sick people, they are friends and colleagues as well. 

It was D-Day that reminded me, the anniversary celebrations, when I went to my Regimental churchyard to pay my respects. I am a veteran as well, not of D-Day but of more recent conflicts, and soldiers and victims of man’s inhumanity have been how I have spent much of my clinical life. I am a surgeon, too, and know a war wound when I see one, and really have witnessed societies and families shattered into tiny, distressing fragments. I have not always taken it well.

As I stood in the churchyard looking at a line of perfectly positioned plaques, memories flooded through me, and faces flashed past. Beside the plaques stood the graves, at least 30 of them; almost all carried the names of once good friends and patients, yet each had died doing what soldiers do. Fighting, so the rest of us can continue our cushioned existence. I had been their surgeon.

There was Jimmy who had talked to me only hours before his death, convinced he would not be a survivor. I had told him not to be daft, that men like him never perished. I was wrong, as ten hours later he was a statistic. Or Pete, whom I had physically tried to carry, slinging him over my shoulder after he had sustained serious head and chest injuries. He was heavy, I was light, and I barely made it a hundred metres. But somehow, we reached home, from the other side of the world, only for Pete to die three months later. Or Lofty, who in another life had been a poacher. If you were out there in the wild, Lofty was your man. He would disappear after dark and reappear shortly before dawn, wearing a broad smile, and clutching enough wildlife to stock a butcher. Lofty, too, came to an unexpected, traumatic end. He was only 32.

Somehow, and it seems unfair, I have been allowed to survive. But as I stood and talked, yes talked, with Jimmy, Pete and Lofty, and many others lying beside them, another thought ran past. It was something I could not explain. Revisiting a churchyard to meet with old companions was one thing, to return to the scene of former, violent action was different.

From time to time, especially at anniversaries such as Remembrance Sunday, some veterans return to areas where they fought. Perhaps they were bombed, torpedoed, shot at, bayonetted, or did the same to others. I see old doctors, too, reminding themselves of the occasion. Where they practised, where they operated, patients they lost and those they saved.

But when I look closer at these veterans, I see a distant expression, and behind their eyes lies sadness. Why is it, I thought, that veterans return to places where the horrors were unspeakable? I cannot return to locations where good friends quite simply vanished, or where I operated on wounded individuals and in many instances failed. What is it about my fellow veterans, medic or soldier, some older, plenty younger, that makes them different? Perhaps they have withstood the rigours of conflict so much better than me. 

War does truly take its toll. You lose real friends, who are real people, while the destruction conflict creates is indescribable, and the way human beings behave is unrecognisable. Do not, for one moment, think you will be exempt. I have seen the inside of too many chaotic operating theatres, some are barely more than a tent. I have witnessed too many families destroyed, good friends maimed and decimated, orphans created, and have had numerous sleepless nights, to find anything beneficial in warfare. 

So, when I see veteran colleagues return to locations of earlier suffering, I wonder how they do it. Indeed, I wonder why they make the journey at all. Because when I stand in my Regimental churchyard, and read the names of so many friends, I see them just as they were. I have no wish to remember how they got there. They were young men with a future, and young women, too. Friends who joked, laughed, drank too much on occasion. As patients, soldiers and colleagues, they were the best. None of them chose to die that day, when nature decided it was their moment. It is a moment I have no wish to recall. 

Richard Villar is an orthopaedic and war surgeon and formerly the Regimental Medical Officer to the Special Air Service. He has served with the UK’s disaster response, has been clinically active in more than 30 countries, and is currently working in the Middle East.

Competing interests: None declared