Biff! A Personal Reflection on Supporting the Wounded, Injured and Sick
By Andrew Dodson
Let’s face it. It is a word we have all used at some time in our career in the Army. Usually disparaging in nature and frequently preceded by four letter expletives. A word used to describe those on light duties or just an insult for someone who is not doing something the right way. Yet I was a biff. For almost 19 months I was ‘temporarily non-effective’. And my experiences during that exhausting and challenging period of my career taught me some lessons. If you are a recovery officer, or if you need to know how to manage and lead wounded, injured and sick soldiers, then you should understand those lessons too.
But first, let me reassure you. I did not enjoy being a biff. From early on in my career, the biffs were always made to stand out and being a biff was often a source of derision. Making biffs stand out included making them attend sick parade in Number Two dress with an overnight bag, wear white mine tape on their epaulettes, parade at the back of the squad to indicate they were on light duties or having to ritually fablon their light duties certificate and present it to their troop Sergeant. They were special, and not in a good way!
As a JNCO, I thought the biffs were nothing but a pain, especially when it seemed they were playing the system. One in particular stood out. He was not allowed to drive military vehicles due to a knee problem (very helpful when his trade was driving) but he somehow managed to drive five hours each way to home and back on a weekend. As a SNCO they annoyed me as they affect my deployability statistics, Military Annual Training Tests (MATT) statistics, availability for duties and so forth. Again, you still had some playing the system. Prior to a collective training exercise I overheard one Sapper saying to his mate “I can’t be bothered with MATTs so I’ve got the MO to square me away. No MATTs for me!” This individual was “rewarded” with two weeks manning the front desk in the Guard Room whilst everyone else did the training.
‘If I can do it, why can’t the other biffs?’
No doubt many have similar stories and experiences and these experiences shape our views on biffs. My own views were not helped by the fact that whilst I was downgraded, awaiting and then recovering from major hip surgery, I got on and tried to not let my injury limit what I could do. This included deploying on Operations HERRICK 6 and 9. I also rather stupidly climbed Mount Allalinhorn in Switzerland. Therefore, in my eyes, if I could do most stuff as a biff why could other biffs not do the same?
In 2014 whilst posted to the British Army Training Unit Suffield (BATUS) I underwent emergency bowel surgery. Between this, the hip surgery and being knocked off my bike riding into work in Gibraltar my core was not in a good place. Fortunately, I had a very supportive physiotherapist and Royal Army Physical Training Corps rehabilitation instructor who got me loaded onto the lower limbs and core recovery course at the Regional Rehabilitation Centre at RAF Halton in January 2015. Whilst there I developed pneumonia. It then moved up to my heart, resulting in pericarditis (the thickening of the membrane around the heart) and a significant pericardial effusion (a large build-up of fluid between the membrane and the heart). Rightly or wrongly, I was assigned back to the United Kingdom before being fully physically recovered, starting my new post as Operations Warrant Officer. Unfortunately, I lasted a day and a half before I had a repeat performance, albeit that this time rather than pneumonia I had atelectasis, a partially collapsed lung. I was rushed to the Medical Centre where they nearly had to drain the fluid off my heart there and then – think Pulp Fiction but even more brutal. I was blue lighted to the nearest hospital. These two events, combined with the bowel surgery, made it obvious that I was not going to be back in work soon. I was categorized a P0 – temporarily non-effective. I had become what I had despised: an utter biff. To the naked eye there was nothing wrong with me. Internally, my body was utterly buggered.
Managing and Leading the Wounded, Injured and Sick
So, what does this sorry tale and my poor attitude towards those on light duties or downgraded have to do with leadership or management? Why, specifically, will I mention Senior NCOs and Warrant Officers?
The management of wounded, injured and sick personnel is not easy at the best of times. Their needs can be complex, their treatment lengthy and the system that supports them can be challenging to understand. When they are a senior member of a unit it can be quite challenging. Frequently these individuals are in key appointments so their absence is more significant. They are far harder to replace. It is not that difficult to find another junior soldier, but when the position requires a specific skill set, coupled with years of experience it is far harder. You cannot just wave a magic wand and get a replacement Warrant Officer or SNCO. So to have one become P0 is a real burden on a unit. Senior NCOs and Warrant Officers are also determined and driven individuals. They feel guilty about being off work. They can find it difficult to open up.
Based on my experiences, here are some considerations for when you find yourself in the unenviable position of having one of your SNCOs or Warrant Officers categorised as P0. I would like to state that these reflections are in no way a criticism of my unit who were supportive throughout a challenging 19 months.
Think About Their Pride
As a Warrant Officer in the British Army you put certain expectations on yourself and have pride in what you do. You do not want to let your peers, your subordinates or your chain of command think you are anything but fine. You are a leader and you are the one who up until recently was supporting and assisting others. Now you are the one needing the support. The situation has been completely flipped and it can be very difficult to admit this to yourself.
Even though I was physically and mentally exhausted, I would drive 30 minutes to camp for my fortnightly ‘catch up’. In my mind I would be inconveniencing my recovery officer if I asked him to come to my house. This meant shaving, ironing some smart clothes and putting on an act to hide how I was actually feeling. This meant taking an interest in what the sub-units were up to, pretending to care about promotion board results and so on. To quote a friend, I was “getting my Warrant Officer on” because that was what I expected of myself. My pride meant that I could not admit that coming into camp was the last thing I wanted to do. Nor could I admit that such visits would leave me drained for a day or so afterwards. During that time so much of what I did was a front.
If you are the recovery officer in such a situation, it is critical that the fortnightly catch ups take place outside of the work environment. Ideally they should take place in the quarter or wherever the soldier is living, regardless of what they say. By doing this you will see them in their normal environment, away from work. They will be away from their peers and their reporting officers, the very people they put on a brave face in front of. In short, doing this will allow you to make a far better assessment of the individual.
Remember They Will Be Isolated
It is highly likely that a wounded, injured and sick Warrant Officer or SNCO will have spent the bulk of their 15-year career in work every day, mixing with their peers and getting on with their work to the best of their ability. Frequently their success in work defines them as an individual and gives them purpose and meaning. Remove that and this can have a huge impact.
For 17 months my wife left home for work at 8 am every day. I dropped our children at school and that was me done for the day, at home by myself until 3 pm. Being new to my unit and having a married quarter 30 minutes’ drive from camp meant that I did not have anybody immediately close to hand to simply talk with. My isolation, coupled with my ill-health, being off work and my physically inability to do much at all resulted in me suffering from mild depression, something I was not willing to admit at the time.
So check that those who are P0 and away from their unit (either in a remote married quarter, living with their parents or in their own home) are getting regular contact with others. Early engagement with the Army Recovery Capability system opens up a lot of doors. In particular I’d recommend the Core Recovery Events courses held at the Personnel Recovery Units and the Battle Back multi activity adaptive sports courses at Lilleshall. Friendships and networks are formed at these events. They give focus, purpose and structure. They also open up other opportunities such as volunteering, civilian work placements or attachments and introduction soldiers to recovery charities such as Turn To Starboard.
Frequently these courses are over-subscribed and it can take considerable effort to get wounded, injured and sick personnel on these courses. So bid for places on these courses as soon as possible. They have a positive impact on recovery and overall well-being.
You Both Need to be Honest
Honesty is a two-way street. A wounded, injured and sick Warrant Officer or Senior NCO must be honest with themselves and their unit. This is often far harder than it sounds.
It is very easy to skirt around the issue of minimum medical retention standards for trade and cap badge, particularly if the individual in question is making positive noises about returning to work. Even as a Warrant Officer or Senior NCO, if you are below the retention standard for your trade it is pretty much game over for your career. Looking through the Official Army Vacancies List (search via the Defence Gateway and MSWeb) it is pretty obvious that there is not a huge call for Warrant Officers (and to a certain extent SNCOs) who cannot deploy further forward than the front gate unless they have a Tier Two medical facility on stand-by. Transfer is not a realistic option as typically P3 is the lowest most cap badges are willing to accept for transfer.
As a leader you must be prepared to have this exceptionally difficult conversation early on, especially if a full medical board may grade them as below retention standard and lead to a medical discharge. Getting their head around this fact is key to them accepting and then taking ownership of the situation. So be honest. If you believe in your heart that a medical discharge is a possible outcome, regardless of what the wounded, injured and sick individual is saying, then it needs to be discussed at the Unit Health Committee and you need to fight for their medical records to be altered accordingly. Doing this will allow them access to the full suite of resettlement services immediately, rather than waiting for the results of the medical board.
For those who have been in a long time, transition to civilian life can be hard. The more time they have to decide what career they want to go into and getting the qualifications they need to be successful in that career, the better.
Courage, Conviction and Unconscious Bias
Being the recovery officer for any wounded, injured and sick soldier can be challenging. It is even more so if you are looking after a Warrant Officer or SNCO.
You need to have the courage and conviction to support them through what may be the toughest time of their career. Put aside any unconscious bias you may have towards biffs as I can tell you now, they need you to have their back and pull out all the stops for them. You will need to call on all your skills and experience as a leader to engage with them, motivate them and challenge them. Challenge them to be honest with you, put aside their pride and talk about the realities of their condition as this will make your job far easier.
Looking back on my time, if I was honest with my recovery officer I would have made my life easier as well.
If you are a sub-unit commander you can read more advice on looking after wounded, injured and sick soldiers in Dave Godfreys article Don’t Begrudge The Toughest 20% – Advice on Company Command