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Cross-Country Doctor
By Margaret Black

The Dressing Station: A Surgeon’s Chronicle of War and Medicine
By Jonathan Kaplan
Grove Press, 407 pages, $25

In The Dressing Station, Jonathan Kaplan combines personal stories of war, adventure, medical investigation and documentary filmmaking with thoughtful reflections on life, death and the ubiquitous evils wrought by greed and politics. In the process, he brings a briskly cleansing energy and liveliness—to say nothing of weird humor—to the genre of memoir. His clear insight into his mixed motives for being a “vagabond doctor” never allows him to veer into saintly self-congratulation. On the contrary, he admits quite frankly seeking difficult situations—albeit ones that will usually help the miserable—because of the intense, authentic feelings they arouse in him.

The son of two doctors in South Africa, Kaplan is aimed at medical school from birth, a trajectory he happily follows. But his training takes place just as that country is instituting the final horrible refinements of apartheid, and this environment puts an idiosyncratic spin on his subsequent career. South Africa also exposes him to both the most advanced medical techniques of the industrialized world—the first heart transplant has occurred just a few years earlier in Cape Town—and to illnesses like TB and beriberi, which have all but disappeared from First World populations. Indicative of his later passion for adventure, Kaplan works briefly as an assistant for the Lesotho Flying Doctor Service during his second year of medical school.

The extraordinarily various, intensely needed services he helps provide in Lesotho’s poor mountain kingdom dramatically convince him of “the full potential of . . . medical studies to enrich our lives.”

Mildly radical in his final student year, Kaplan is nonetheless completely unprepared for the violent police suppression of a white student demonstration to end apartheid. As he stumbles around a church jammed with bleeding, teargassed marchers, trying to stanch head wounds and reassure those blinded by tear gas, he begins “to understand a little of what healing involved.” But can he remain to practice in South Africa, especially given his looming obligatory military service? On the one hand, the country clearly needs doctors, and healing is healing regardless of whom one treats. But then a friend who’s been serving in the military escapes from the Angolan front after being forced, as a doctor, to participate in a horrific torture. Kaplan draws the obvious conclusions and flees into exile in England.

From this point forward, The Dressing Station resembles a string of beads, each chapter following chronologically, but each largely a self-contained adventure. Further training in England and America alerts Kaplan to the enormous differences between those two worlds—the one struggling with a National Health Service gutted by Maggie Thatcher, the other in thrall to private and corporate money. Then he’s off as a volunteer surgeon to work with Kurdish refugees and the pesh merga as they battle Saddam Hussein’s Republican Guard.

Forced to leave the battlefield by a violent fever, Kaplan returns to London in a transition so rapid that on arrival his boots are still soaked with blood and his shirt pockets contain “ampoules of morphine, a selection of drip-needles, a spoon and a tin-opener.”

There’s a grotesquely funny yet terrifying stint as a shipboard doctor on a South Seas cruise. There’s an illegal trip to Burma, under the auspices of a small non-governmental organization, to investigate possible hospital sites for refugee hill people. Despairing of making any difference as a doctor, Kaplan turns to journalism and makes a documentary about the role of elephant slaughter in financing Mozambique’s horrendous civil war. He investigates industrial mercury poisoning in South Africa and Brazil. And so on.

Without question, Kaplan has intentionally sought to do good in the world, and he experiences satisfaction when he works with the wretched of the Earth. But he also feels “an obscure guilt about practising this kind of medicine [because] these patients were largely the victims of preventable suffering, inflicted by the policies and actions of their fellow humans.” Surely it would make more sense to prevent such situations from arising in the first place. In addition, he knows that a simple water purification and delivery system will save far more lives in a refugee camp than anything he does. Nonetheless, for whatever reason Kaplan’s in a place, he’s always eager to offer medical help, and he does save individuals, sometimes quite dramatically.

Kaplan is also driven by purely selfish desires to work on the edge, where he must make split-second decisions under appalling conditions. At the book’s start, an abdominal surgery is beautifully described—Kaplan really loves his craft—and this hospital operation stands in stark contrast to those he performs under bombardment with equipment cobbled together out of nothing. It’s impossible not to cheer for these impossible successes, such as the time Kaplan helps a Burmese doctor save a patient by successfully making an instrument out of a shaving razor for slicing tissue-thin layers for a skin graft.

The Dressing Station is a serious book that touches on a host of serious issues, but it’s also a fascinating collection of extreme adventures in locations so well described that you feel you are there—sweating, freezing, dodging bullets, applying pressure dressings—yourself.

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