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War Doctor: Surgery on the front line, by David Nott 

28 June 2019

Pat Ashworth finds this account from the front line an education

DAVID NOTT, a vascular and general surgeon, is widely acknowledged to be the most experienced trauma surgeon in the world. Since 1993, he has been taking unpaid leave from his position in three NHS hospitals to work in the conflict zones and places of humanitarian crisis that continue to dominate the news — Afghanistan, Sierra Leone, Liberia, Darfur, Congo, Iraq, Yemen, Libya, Gaza, and Syria, the place to which he is most drawn.

This is a book of extraordinary honesty. He acknowledges himself to be driven by a mix of altruism and selfishness, an endorphin rush that comes from “chasing the high of intervening to save lives but also of living my life closer to the edge”. Man’s inhumanity to man is laid bare: the child made pregnant by rape suffering days in labour; the male nurse imprisoned by the Taliban for cutting his beard to fit inside his surgical mask; the terror tactic of mass amputations; amateur explosives designed to inflict ghastly damage on the human body.

There are glimpses, too, into the day-to-day privations: discovering a python writhing in the cesspool beneath a rudimentary loo; sitting in pools of sweat after operating in extreme temperatures. His accounts of surgical procedures carried out under the most challenging of circumstances are graphic, eye-opening, and wondrous for what we learn about the complexities of the body and the split-second interventions that, in the hands of a skilled surgeon, can bring it back from the brink of death.

It has all taken its toll: physically exhausted and brutalised by the psychological trauma of seeing too much suffering, Nott had a breakdown, recorded in the book. He has battled to get humanitarian corridors in place: during the siege of Aleppo in 2016, he confronted the Russian Embassy and tried to talk directly to President Assad. With his wife, Elly, he set up a charity, the David Nott Foundation, to sponsor surgeons worldwide to attend the course on surgical training for austere environments that he runs at the Royal College of Surgeons.

The book is enlightening, sobering, compelling. It is a marvellous read, an education in itself.

War Doctor: Surgery on the front line
David Nott
Picador £18.99
Church Times Bookshop £17.10

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