No subject

Kurdish guerrillas in Northern Iraq at the end of the Gulf War, Dr. Jonathan 
Kaplan has saved (and lost) lives in the remotest corners of the world under 
the most extreme conditions. Now he delivers The Dressing Station, a 
brilliant and often harrowing narrative that reveals the crucial work of 
field doctors all over the world, and the devastating realities of the zones 
of conflict in which they operate. Dr. Jonathan Kaplan has been a hospital 
surgeon, a ship's physician, an air-ambulance doctor, and a trauma surgeon. 
He has worked in locations as diverse as England, Burma, Eritrea, the Amazon, 
Mozambique, and the United States. He has operated on wounded straight off 
the battlefield, treated obscure tropical disease, and helped victims of 
corporate stress and industrial poisoning. Whether running medical research 
programs in high-tech laboratories or caring for children wasted by famine 
and war, he has seen his skills used and sometimes abused. A pivotal lesson 
early in his career was the experience of a friend and medical colleague who 
had been required to save the life of a prisoner so that he could be 
subjected to torture. It anticipated the doctor's greatest challenge -- to 
maintain his humanity even when that option does not seem possible. Dr. 
Jonathan Kaplan's life in medicine has been one of unforgettable adventure 
and tragedy. The Dressing Station provides a haunting insight into the nature 
of human violence, the shattering contradictions of war, and the complicated 
role of medicine in the modern world. "An enthralling look into the craft of 
a surgeon." -- Jennifer Crocker, The Cape Times (Capetown, South Africa)


-------------
The Dressing Station: A Surgeon's Odyssey
http://books.guardian.co.uk/reviews/biography/0,6121,563963,00.html 

If there's a sure-fire vision of hell on earth, it can be found in an 
underequipped and understaffed hospital in Africa or elsewhere in the 
developing world just after a massacre or an epidemic. Most journalists and 
television crews spend as little time as they can in such places, collecting 
the facts and pictures they need before retreating from the stench and the 
misery. It's hard to forget the clinic in Zambia that was so overwhelmed with 
those dying of Aids that almost all the patients were crammed on the floor, 
with their relatives fighting over the beds whenever a death allowed one to 
become vacant. 

Jonathan Kaplan has worked in such clinics across the world, but he was able 
to provide help. As well as a journalist he is a trained surgeon, and has 
used his skills to take him to both war zones and tourists' haunts. He has 
had an odd, varied and colourful life, and this is an odd, varied and 
colourful autobiography. It is a bloody wartime travelogue, a layman's guide 
to surgery (not for the squeamish), and an analysis and description of a wide 
range of different medical lifestyles. It's also a potted history of the 
politics of the different countries and conflicts he has visited, and a 
vehicle both for his best after-dinner medical stories and for his often 
angry thoughts and fears on medicine, morality and mortality. 

It's not easy to keep the right balance between so many disparate elements 
and styles, but - for the first quarter of the book at least - Kaplan manages 
astonishingly well. Stories of a white boy growing up and studying in 
apartheid-era South Africa are combined with vivid and compelling first-hand 
reports of anti-apartheid demonstrations and the police brutality used to 
counter them. There are graphic, detailed descriptions of the resulting 
injuries that he was called on to treat. Working as a doctor in the townships 
gave him a close-up view of the workings and realities of apartheid and the 
moral dilemmas confronted by doctors asked to patch up the "victims of 
preventable suffering". 

Kaplan's solution was to flee to England, rather than be called up for 
national service in South Africa's increasingly bloody border campaigns. He 
became an exile and a wanderer, with a detached, bemused and often horrified 
view of what he found. He observed the intricate politics of the British 
medical establishment and the decline of the NHS in the Thatcher era; his 
analysis is balanced against a wince-making explanation of how to carry out a 
vasectomy, or a poignant and painfully honest confession of the mistakes he 
made that led to a patient's death. Moving to the US, he casts an equally 
cool and critical eye over the workings of commercial medicine, the deals 
that are made between medical research and big business, and the practice of 
slaughtering pigs so that first-year students can gain a little surgical 
experience. Subsequently he moves to a war zone, operating on wounded Kurdish 
fighters in northern Iraq in the period between the ending of the Gulf war 
and the establishment of "safe havens". His descriptions of life under fire 
in a squalid makeshift field hospital are among the best passages in the 
book. 

So far, very good indeed. But Kaplan keeps on travelling, and his life and 
writing both begin to drift. There's a mildly amusing but over-long section 
dealing with his time as a ship's doctor on a cruise liner in the South China 
Seas, where he treated typhoid, alcoholic passengers and crew members with 
VD. There's his experience working with an unhappy film crew in Mozambique, 
his more interesting adventures with the opium warlords in Burma, and - for 
yet more contrast - a stint accompanying sick passengers around the world for 
a travel-insurance concern. He takes on an assignment to research 
mercury-poisoning cases in South Africa for the late, lamented World In 
Action . At this point, Kaplan seems to have become more interested in 
investigative journalism than surgery. 

The final section, dealing with Kaplan's unexpected return to the front line 
in the war between Eritrea and Ethiopia, at last re-captures the immediacy, 
originality and sense of horror in the opening chapters. His conclusion from 
all this is: "It was among the world's wounded that I had found the essence 
of humanity, without disguise; an exile, I had found a home in the suffering 
of bodies." 

To which one could unkindly ask why he then moved on, yet again, to treat the 
mental problems of the rich overachievers of London. After all that 
travelling and all those stories, it seems that the moral dilemmas Kaplan 
faced as a young doctor have never been fully resolved. 

-------------
Without frontiers
http://www.mg.co.za/mg/art/music/menu-music.htm

South African surgeon Jonathan Kaplan’s experiences around the world have 
added up to a fascinating book. Jane Rosenthal met him in Cape Town

onathan Kaplan, travelling surgeon, journalist, film-maker — and now author 
of The Dressing Station (Picador) — is disarmingly uncertain as to whether he 
has done anything useful with his life. And meeting him is quite a surprise. 
He is slight, younger looking than his 47 years, has a lot of floppy dark 
hair and doesn’t look like someone who’d cope with battlefield surgery or 
similar crises. I’d gone to the interview thinking, “This guy is just too 
cool to be true.” Prepared to be unimpressed, I was won over by his 
simplicity and his seriousness.

The Dressing Station is fascinating yet disturbing reading. Fascinating 
because Kaplan has a real gift for describing medical detail in a clear and 
comprehensible way — enlightening for those of us unlikely ever to wield a 
scalpel — and disturbing because it ruffles that complacent ignorance in 
which we continue our lives while there is so much suffering, bloodletting 
and conflict on the planet. And as to why anyone would go off to where it’s 
all happening if they didn’t have to — well, the answer is not really 
provided in this book. Kaplan is as reticent about his own personal life as 
he is discreet about the privacy of his patients.

He begins his book thus: “I grew up with the expectation that I would serve.” 
Yet he gives the impression that he feels he has led a privileged and 
indulgent life, in the sense that he has been able to use medicine as a way 
to see the world. He has even, he says, made choices out of whim or to escape 
a personal situation. Friends and colleagues are now ensconced in the medical 
hierarchies of Western medicine; he says they are “financially secure to a 
staggering degree”, and have “chosen wisely”. He denies emphatically that he 
means this ironically — “These are friends of mine” — but adds that he has 
better dinner-party stories.

And so he should have. After training at the University of Cape Town, in 
London and in New York, his work in the past 10 years has taken him to 
Kurdistan (in the early Nineties), Mozambique refugee camps, and last year, 
Eritrea, among others. As a film-maker he has investigated mercury pollution 
in Brazil and South Africa. At times he has worked as a ship’s doctor and an 
aeromedical physician. 

To all of this he has brought not only his knowledge and skill, but also 
considerable thoughtfulness. His training in London, he recalls in the book 
at it nears an end, “had been a constant process of eroding certainties. 
First to go had been security: life was tremblingly insecure; death, easy and 
close.” 

Love and repose had also, at that stage, eluded him Asked whether he had ever 
regained these, he says, “I think I have gained a certain equanimity through 
accumulated experience. I’ll try and do the best I can in situations, [but] 
the broader view is that I won’t always be successful and that I cannot 
excoriate myself for the places where I have failed.”

He also shows the reader the inside of situations we see glossed over on TV 
news. His take on aid organisations and interventionists such as Médécins 
sans Frontières is lucid and disillusioning. In Mozambique, for example, he 
speaks of a “plague of altruism” in which the main beneficiaries are often 
the aid organisations rather than the refugees and deslocados. 

And he’s aware that he himself is part of the questionable intervention when 
he goes into these situations. He confesses that he enjoys the “exhilaration, 
the free-fall rush into unpredictability”, and that he would find it 
difficult to go back into the routine of ordinary hospital work.

The book was originally commissioned by a publisher who knew Kaplan had done 
some writing and journalism, and had heard some of his stories from a third 
party. Writing the book was quite gruelling in parts — he had to go back to 
journals he had kept while out in the field. He had written them purely for 
himself, “as a means of recording intense experiences and as a way of 
encapsulating all the frustrations, anger, often fear, that I felt,” forcing 
him to re-live things “that I hadn’t any memory of experiencing and had quite 
clearly suppressed.”

At the very end of the interview, he produced the journal that he’d kept 
while in Eritrea: a modest A5, but closely written and interspersed with 
watercolour sketches and other memorabilia, in itself an extraordinary 
artefact. This daily record-keeping has surely contributed to the elegance of 
the writing and sense of reality in this examination of suffering and how we 
deal with it on the broader battlefield of life. 

He concludes his account with a chapter on occupational health in which he 
makes it clear that not even the wealthy and corporately powerful are exempt.