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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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