"If you've got the strength to complain, trooper, you'll last at least another few minutes. It's the ones who aren't howling louder than the explosions who need treatment first."
- — Guardsman Lond, 92nd Elysian Drop Troopers Regiment
A Field Chirurgeon is a frontline soldier of the Imperial Guard who has received additional training in order to render medical first aid to his comrades when needed in combat. In particular, the Field Chirurgeon's expertise lies in keeping his fellow soldiers standing during a given battle so that the entire squad can survive. Although they intervene to save the lives of their comrades, Field Chirurgeons also perform their operations with the goal of keeping their comrades in the fight, as is their duty to the God-Emperor of Mankind. Though this focus on rapid rehabilitation rather than long-term recovery sometimes means that soldiers fight on with gruesome injuries rather than resting and improving their chances of survival, the Field Chirurgeon's intervention might save the regiment even if it cannot save a patient's life. In the late 41st Millennium, the universe rarely places easy choices in front of any member of the Imperial Guard, and such is the nature of triage.
Highly experienced Imperial Guard regiments, those that have been operational for many years and whose members are considered veterans, are likely to field a great number of Field Chirurgeons in their ranks. While some have assuredly received specific training under the tutelage of the regiment's medics or external Medicae Field Units, others might have simply picked up their skills throughout years of exposure to the horrors of war. Those Imperial Guardsmen who survive their first few battles are all but guaranteed to have sustained a number of wounds, and someone must step forward to treat the injured with whatever skills they possess and whatever supplies are available on hand. Over time, and through loss and strife, some of these impromptu practitioners of combat medicine become knowledgeable enough to be considered qualified menders -- by their squads, at least, if not by outsiders. Almost all veteran Imperial Guardsmen owe their lives to the swift intervention of their comrades several times over, and skilled Field Chirurgeons command the undeniable respect of their comrades, even if they cannot preserve all of their lives.
Soldiers who have learned the arts of stitching flesh and setting bones in the field tend to be extremely resourceful, but some are also more callous than their peers, for those they mend often die shortly thereafter, brought down by enemy fire or xenos creatures despite the Field Chirurgeon's prior intervention. Still, there is little for it but to carry on, saving anyone they can and letting the rest meet the Emperor with the most dignity possible in the field. The presence of skilled Field Chirurgeons can turn the tide of a skirmish, a battle, or even a war. Saving even a single life can occasionally have incredible ramifications, whether it belongs to a common trooper of the line or a Lord General.
The Field Chirurgeon might appear at first glance to be a variant of the Combat Medic, and it is true that the two share a great deal in some regards. Indeed, many Medics might decide to branch out into the Field Chirurgeon Advanced Speciality, and this is in no small part because the two fill similar but nonetheless distinctly different roles. While both are concerned with the treatment of allies and saving squad mates, the Field Chirurgeon is particularly adept at returning a wounded soldier to the field immediately to fight on. Field Chirurgeons frequently do not have the luxury or benefit of support facilities and extra orderlies, and thus rely less upon such things for their treatment methods. While a Medic on the battlefields of the late 41st Millennium can certainly operate under such conditions, the Field Chirurgeon excels when faced with terribly injured allies and scant supplies with which to heal them.
Field Chirurgeon Training
The expertise and training of local Chirurgeons varies enormously across the Imperium and depends on a wide range of factors, from Feral World herbalists to hive sawbones to the field medics of the Imperial Guard. On those worlds possessed of a relatively advanced technological base, the population might have access to many different forms of health care, though in practice this is normally drastically limited by station, class, wealth, and other hierarchical factors. The one resource the Imperium is not lacking in is numbers and so life is cheap on even the most developed world. Only those who are valued by the monolithic local and Imperial institutions of power are generally afforded treatment for any ailment they might contract, while those deemed of little or no worth are denied it out of hand. In the most extreme of cases, individuals are kept alive long past their years simply because they have been classified by some impenetrable rating system as vital to some process, which itself might be obsolete.
On the most primitive of worlds, medical care takes the form of all manner of potions, balms and cures made from whatever sources are to hand. Recruits with proper (or any) experience in basic medical skills and procedures, frequently find themselves continuing to propagate the practices of their homeworld on the battlefield as part of the Imperial Guard. Troopers also often prefer treatments to which they are accustomed, and an Imperial Guardsman tithed from one of the many primitive or low-technology Imperial worlds is likely to refuse unfamiliar treatment but welcome a familiar folk remedy, even if the former is far more likely to save his life. Of course, there are many field medics who ignore their charges' wishes on the matter, using any and all knowledge they possess to save the lives of their stubborn comrades and apologising for saving their lives later.
Field Chirurgeons are generally trained by the regiment's ranking combat medics, and their training usually begins with a focus on how to stabilise a patient who has been grievously wounded until a more experienced individual can enact treatment. Of course, given the chaotic conditions of the battlefield, most troopers with any medical training at all quickly move beyond simply controlling injuries to treating them by simple necessity. Additionally, many formally trained medics possess or develop these rapid treatment skills, which augment their broad base of anatomical knowledge and allow them to perform triage more effectively in the field.
Most individuals who receive limited training on these methods remain with their own units instead of serving with higher-ranking squads, their primary duties staying the same as the rest of their comrades. Many regiments expect their Field Chirurgeons to receive periodic training from their more formal medics, but others rely upon their members to learn through putting their skills into practice. In truth, life in the Imperial Guard is usually short and brutal and those wounded are very rarely released from service. In battle, the most attention wounded troopers can expect is the staunching of any immediate blood loss followed by the administration of a stimm shot powerful enough to get even the most wounded man up and charging at the enemy, though he will invariably die from system shock not long after the battle is concluded.
Field Chirurgeon Tactics
Like many other specialised roles in the Imperial Guard, that of the Field Chirurgeon is carried out in addition to the trooper's normal duties. In battle the trooper must fight as fiercely and righteously as his comrades, all the while listening out for the cry of the wounded so that he can rush to their aid, saving their lives that they can fight on once more. Like the combat medic, the Field Chirurgeon is dedicated to keeping his squad mates alive and fighting for the glory of the God-Emperor. The main difference between a Field Chirurgeon and an Imperial Guard Medic is typically the focus of expertise, though the two are hardly mutually exclusive. Most medics aim to promote the long-term recovery of their patients, but for a Field Chirurgeon, the proper time and equipment for such operations are frequently unavailable. Instead, their primary goal is returning a comrade to the fight as quickly as possible, as that one more Lasgun could make the difference between the squad's survival and even more casualties -- or worse, a total rout.
As such, many Field Chirurgeons are formally trained medics who have grown accustomed to stitching up soldiers, injecting stimulants, and whispering a Litany of Recovery before sending them back to fight once again. Others pick up all of their skills under such circumstances, learning through bloody experience which methods can save a life and which ones can keep a soldier in fighting condition long enough to fulfil a key objective critical to the rest of the squad. While both must make difficult decisions in action, triage is an unfortunate speciality of most Field Chirurgeons. It is notable that casualties amongst Field Chirurgeons are often higher than might be expected -- most intelligent enemies target those capable of treating the wounds of their comrades first, to guarantee that the fallen stay as such. However, many Field Chirurgeons also develop the tendency to readily risk their own lives to reach and to treat downed comrades on the battlefield, even if doing so endangers their own safety.
Most of the Imperial Guard regiments active in various Imperial campaigns employ Field Chirurgeons. Some do so as a matter of long-established regimental doctrine, others as a matter of necessity. The Maccabian Janissaries are an unusual regiment in that their Field Chirurgeons are much more than line troopers with some additional medical training. The Janissaries are noted for their zealousness and the depth of their faith, venerating Saint Drusus as the font of all holiness beside the Emperor Himself. The Chirurgeons of the Maccabian regiments are therefore as much faith healers as they are medical personnel. When a comrade is wounded, the Chirugeon's first recourse is to pray over him, and then to apply the sacred unguents of purification. On occasion, a Maccabian Field Chirurgeon might even gather a fallen trooper's entire squad around the wounded man so that they can all lay their hands upon him and call for the blessing of their patron saint. In a galaxy where gods and daemons are very real phenomena and stalk the battlefields alongside war machines of unutterable destruction, miracles do actually happen from time to time, and countless wounded men have been saved in such a way.
Other regiments are far more practical in their approach. Some, the Catachans and the Elysians amongst them, are blessed with numerous individuals already skilled in combat medicine when they were recruited and well able to perform such duties on the battlefield. The more veteran Elysian Drop Trooper and Catachan Jungle Fighter regiments might include several Field Chirurgeons in every platoon or even squad, in part because of the prevalence of such skills, and in part because of the experience such individuals have amassed throughout numerous campaigns.
Far closer to standard practice -- at least as far as such a thing can be defined in an interstellar empire of a million worlds and more -- are the Cadian Shock Troopers and the Mordian Iron Guard. Many of these regiments hold it as a matter of tradition and doctrine that every sub-unit should have within its ranks a number of designated Field Chirurgeons. Should one fall in battle another trooper must undergo the necessary training to take his place.
- Standard Imperial Guard Regimental Kit
- Diagnosticator (Diagnostor) - The Diagnostor is a sophisticated medical cogitator used across the human-settled galaxy. It can detect and diagnose almost every ailment known to the Imperium, and can be incorporated into medical kits, Servo-skulls, and other dedicated medical Servitors. Any individual trained in medical knowledge in the Imperial Guard understands its use.
- Injector - Most specialised drugs require injectors. These can take many forms, from low-technology, disposable syringes up to sophisticated hypo-sprays. An injector can hold one dose of any drug.
- Medikit - Small, compact, and reliable, medi-kits are essential gear for every Imperial Guard squad. Each comes with a diagnostic cogitator called a Diagnosticator complete with bio-scanner and bioprobes, along with chemicals, drugs, and other means to treat a variety of injuries and ailments.
- 4 Field Sutures - Common implements found on battlefields across the Imperium, field sutures are used to quickly sew shut wounds to prevent blood loss. They can vary in form, from a simple needle and thread to archaic devices which staple shut the injury.
- Only War: Core Rulebook (RPG), pp. 201-202
- Only War: Hammer of the Emperor (RPG), pp. 66-69