Click here to Download War Doctor Surgery on the Front Line PDF Book by David Nott English having PDF Size 1 MB and No of Pages 274.
In London the 2012 summer Olympics were in full flow, with Team GB winning a record number of medals and the country basking in the reflected glory of our athletes and a successful games. It was hard to imagine that only a few hours’ flight away an entire country was descending into violent anarchy. I was busy with my day job for the National Health Service.
War Doctor Surgery on the Front Line PDF Book by David Nott
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|No of Pages||274|
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About Book – War Doctor Surgery on the Front Line PDF Book
For most of the year I work at three hospitals in London: St Mary’s, where I am a consultant vascular (blood vessels and circulation, from the Latin vas, for vessel) and trauma surgeon; the Royal Marsden, where I help the cancer surgeons from various specialities such as general surgery, urology, faciomaxillary and gynaecology remove large tumours en bloc, which then require extensive vascular reconstruction.
And the Chelsea and Westminster, where I am a consultant laparoscopic (keyhole) and general surgeon. But alongside this work, in most years since the early 1990s I’ve also done a few weeks’ trauma surgery in a war zone. I monitor the television news avidly, keeping an eye out for developing hotspots, knowing at some point soon an aid agency is likely to ask me to help.
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When I get such a call, my heart begins to race and I develop an irrepressible urge to remove any obstacle that might prevent me from going. My immediate response is always, ‘Give me a couple of hours and I will come back to you.’ The call might come while I’m operating or assisting a colleague, or I might be holding a routine outpatient clinic.
Wherever I am and whatever I am doing, the desire to go is always intense and almost overwhelming. But I can’t say yes every time. I might get a couple of requests a month from different agencies, and could easily be a full-time volunteer, but I have to earn a living, too. I do receive £300 or so for a month’s fieldwork, but mostly that’s spent on everyday expenses.
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Before agreeing to anything, I call the surgical manager at Chelsea and Westminster, where my contract is held, and explain that there’s a humanitarian crisis in which I’ve been asked to help. I then request immediate unpaid leave for the time I’ll be away. There is usually no objection, ‘as long as you can sort out your clinics and your operating and your on-calls’.
Indeed, I have never yet been turned down. No doubt the carrot of taking unpaid leave while maintaining all my commitments helps to allay any anxieties the NHS might have! So I didn’t need asking twice when, during the summer of 2012, a call came from the head office of Médecins Sans Frontières (MSF) in Paris, asking if I would be prepared to work in a hospital they’d set up in Syria.
I made the usual arrangements at home, packed my kit and got on a plane to Turkey. Like most people, I knew Syria was a country in the Middle East that had steered clear of the conflicts that had beset many of its neighbours – three of the countries it borders are Iraq, Lebanon and Israel, hardly oases of calm. War Doctor Surgery on the Front Line PDF Book
For most of my lifetime Syria had been a closed, slightly secretive sort of place, but peaceful, with a population known for its warm and hospitable nature and where more adventurous Western tourists sometimes went on holiday. It’s a truism I’ll return to that many of the countries I’ve volunteered in have collapsed into chaos after a challenge to authoritarian rule.
Nature might abhor a vacuum, but warmongers love them. In Syria’s case the authoritarianism was provided by the Assad family, who had ruled over the country since taking power in a bloodless coup in 1970. The current president, Bashar al-Assad, had taken over after the death of his father, Hafez, in 2000 – winning 99.7 per cent of the vote that confirmed his assumption of power.
The Assad family are leading lights in the minority Alawite sect, a branch of Shia Islam in a country where nearly threequarters of the population are Sunnis. There was something of a cult of personality around them, with pictures of Hafez and Bashar the decor of choice in many offices and shops. War Doctor Surgery on the Front Line PDF Book
He was a bit of a local Mr Fixit, always tinkering with something, welding or mending. I remember the air outside being redolent of farmyards, proper rural smells, but also the fresh, clean scent of the countryside, and that I was fascinated by the well fifty yards beyond the garage, which always seemed to produce fresh water.
I can still conjure in my mind the outdoor fragrance of my grandfather’s clothes – I used to love pressing my nose into the folds of his coat, immersing myself in all it represented. It was a simple house, defined by simple things, but no less profound for that. Mamgu would chop wood with an axe and the logs would be used on the stove.
Apart from Mamgu and Datcu, many of my mother’s younger brothers and sisters still lived there, and although it was crowded I suppose I was spoiled rotten, especially by my young aunts. My main memory from those early years is of fun and laughter and love – and also a deep connection with Wales. War Doctor Surgery on the Front Line PDF Book
I didn’t realize it at the time – it was all I knew – but speaking Welsh around the dinner table was another bond, both with each other and with our community. The sense of belonging and being surrounded by family love made us very secure. And the simplicity of the way we lived – not in luxury, by any means, but not hankering after things we couldn’t have.
Or being led astray or feeling we were missing out on anything – was deeply ingrained. It was a very Welsh childhood, and to me completely magical. It was the mould I came from, by which I have always been indelibly marked. It was the making of me. It is only since I have become a father myself, quite late in life, that I have come to understand why I lived with Mamgu and Datcu in Trelech.
And not with my parents. My mother had gone to Newport to pursue her dream of becoming a nurse, and it was while she was there that she met my father, Malcolm Nott, a junior doctor. Malcolm was born in the city of Mandalay, right in the middle of what was then Burma, the son of an Indian army officer and a Burmese mother. War Doctor Surgery on the Front Line PDF Book
This was 1955, and of course there were some raised eyebrows at her beginning a relationship with a man from south Asia. Nott is hardly a typical south Asian name and even now my father’s surname makes no sense to me. There have been many stories of how he acquired it. My father’s father told me that during the first Afghan war, in 1840, General Sir William Nott led the British forces.
He had an Indian batman who took his name. Another story was that my father’s greatgrandfather was a railway engineer from Hereford who was seconded to help build the Indian railway and stayed in India and married a local woman. I’ve tried, but haven’t been able to substantiate either story.
After Japan’s invasion of Burma in 1942, Malcolm led his mother and younger brother across the dangerous mountain border into India, where Bangladesh is now. His elder brother was in the army, and was captured by the Japanese and forced to work on the Burma–Siam railway. He died of malnutrition at the age of twenty-two. War Doctor Surgery on the Front Line PDF Book Download
His father, my paternal grandfather, was a communications officer who had been seconded to the British army as a Japanese–English interpreter, working in Singapore among other places before the invasion. His close liaison with the British promised him a better life after the war.
Once in India, my father trained at Madras Medical School, and when he qualified his father told him to go to England to seek his fortune – and also to find him that better place to live that he’d been promised (or promised himself). So my father left home and everything he’d ever known, to sail to a new life in Britain, part of that great influx of post-war immigration.
He worked for the Post Office in London before landing a job at the Royal Gwent Hospital in Newport. Almost immediately, he met my mother. A few months later they were married and she soon fell pregnant. In the operating theatre we were often on the floor, with the patient still on the operating table, while missiles were raining down. It was just pure luck that we survived the day. War Doctor Surgery on the Front Line PDF Book Download
The surgical team was as exposed as everyone else to this onslaught, but it had the benefit of bonding us together. In fact, one of the things that made the mission enjoyable was the camaraderie I experienced as part of a medical military team. On aidagency missions, I was often the only surgeon in whatever facility I found myself in, and sometimes the only Brit, which could be lonely and sometimes led to tensions.
Here, though, there were no such cultural differences, and what I really enjoyed about the military setting was that everybody was trained to the same level. We all went through pre-deployment training, including weapons handling and learning how to deal with an ambush. We also understood the authority of commands during an attack.
The battlefield medicine training involves an advanced trauma life-support course and the management of casualties during firefights. Later, the defence medical service would set up a military operational surgical training course, and all surgeons and theatre staff went through it prior to deploying to Afghanistan. But this was not available before I went to Iraq in 2007. War Doctor Surgery on the Front Line PDF Book Download
The surgical support at the Basra air base consisted of a general surgeon, an orthopaedic surgeon, anaesthetists, an operating team of nurses and a nursing team to manage the wards. We also had junior doctors, radiographers and physiotherapists. We were all kept very busy, and our field hospital operating theatre sometimes looked like the back of a butcher’s shop.
Many times we operated in helmets and body armour as rockets pounded the base. One terrible day encapsulated the intensity of the mission. I had moved rooms as my air-conditioning unit had broken down, and my new room was next to an accommodation block near an area called the Trenchard Lines. This was where many of the RAF ground crew stayed.
That day, 19 July 2007, I was for some reason playing with my camera in my room when the alarm sirens went off. I still have the picture of the moment when a large mortar shell landed on the accommodation block next door. On that day, there had already been at least half a dozen indirect-fire attacks and luckily nobody had been injured, so the hospital was fairly quiet. War Doctor Surgery on the Front Line PDF Book Download
But the moment the mortar landed I knew that there would be huge casualties. Senior Aircraftsmen Matthew Caulwell, Peter McFerran and Christopher Dunsmore were all killed immediately, and many others were injured. My bleeper went off and I hurried to the emergency department.
Although there was a general tension in the air, the hospital in Rutshuru turned out to be a rather peaceful and tranquil place, set in a beautiful part of the jungle with a mud road leading to a gate surrounded by high brick walls. In the briefing I was told that I would really enjoy this mission, as it had a steady throughput of patients.
A Congolese surgeon was already there, and he turned out to be extremely good and technically very sound. He told me one evening that he had been there continuously for six months, and was desperate to see his family, who lived in the west of the country. I immediately replied that of course he must have a break. War Doctor Surgery on the Front Line PDF Book Free
There was a junior expat surgeon with me and I was certain that the two of us would manage quite happily. The team also comprised two nurses and a physiotherapist who were living down the road, again in the most idyllic setting. My own hut was surrounded by palm trees and spectacular undergrowth, and I grew to love the walk of a hundred or so yards to the shower room.
Which had nothing but a cold water tap and a bucket. But we were in the tropics; it was exhilarating to fill up the bucket and wait for a moment before I summoned enough courage to throw the whole lot over my head and body. Before the local surgeon left to see his family, I did some ward rounds with him so that he could hand over the patients to me.
He was very worried about one of the young men, who’d had his arm bitten off by a hippopotamus several weeks before. He was lying in bed on the ward being fed by his mother with fufu, a dough made with boiled cassava and flour, which was also to become our staple diet over the coming weeks. War Doctor Surgery on the Front Line PDF Book Free
His mother told us that he had gone off his food in the last twenty-four hours and that she was very worried about him not eating. After I had looked more closely, I began to fear that both mother and son were unaware of the gravity of his situation. The young man, who was about sixteen years old, had been operated on several times, each procedure taking off a bit more of his left arm.