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War Doctor: Surgery On The Front Line Quotes

War Doctor: Surgery On The Front Line by David Nott

War Doctor: Surgery On The Front Line Quotes
"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 the first year of the uprising a documented fifty-six medical workers were either targeted by government snipers or tortured to death in detention facilities."
"War zones are completely different from routine life at home, and it is very easy to become blinkered and not to take care of oneself, such is the focus on the patients."
"You have to have a different bit of your head switched on – you can’t take your normal NHS mindset to a war."
"But actually it’s quite simple: I don’t get to choose who I work on."
"I rationalize it by thinking, 'Well, maybe that Taliban guy or this ISIS fighter will find out his life was saved by a Western, Christian doctor, and that might make him change his outlook'."
"Every night I watched the news from Sarajevo in a state of high anxiety, transfixed by the horror of what was happening."
"The bombs and bullets would usher people into our care, but in many ways the biggest problem was the temperature."
"It was above all a sense of power. First the exercise of power, when I overruled the professor of surgery, making a call on whose case was more important."
"In the cold silence I called out to the anaesthetist, but there was no response."
"The only thing I could sense was the tide of wetness as the boy’s blood left his body."
"That boy’s death, and in particular the way my colleagues reacted to the attack, changed me."
"I was hardened by it, and understood more of the intense pressure my colleagues had been under."
"The importance of self-preservation was brought home to me a couple more times on this first mission."
"The danger was a buzz. I felt that nothing could touch me. I was invincible."
"I had never felt more alive; it was as if I had been reborn."
"The images of what I saw all those years ago still flash through my head sometimes: so easy to view, so hard to shake."
"I felt so wretched about my time in Adré, that – perhaps perversely – I decided I wanted to go back to Darfur the following year."
"Start on clavicle. Remove middle third. Control and divide subsc art and vein."
"It’s all well and good doing the operation, but many of these patients require intensive post-operative monitoring and support."
"If I didn’t perform the surgery, the boy would definitely die."
"I went to his mother and explained to her what I wanted to do, as well as the risks and the dilemmas."
"I was unable to sleep that night for worrying about whether I was making the right decision."
"I don’t know how many lives I have saved over the course of my career."
"For the surgeon faced with someone in need, the instinct to fix that person is powerful."
"I hadn’t been able to save my mother, and it was horribly tempting to indulge in the what-if of identifying her problem earlier."
"I realized that giving up surgery completely was not an option I could countenance."
"The trick is knowing when to stop, as any ex-junkie will tell you."
"The patients don’t know who I am – I just fly in and fly out, having hopefully made them better."
"I kept coming back to the nurse in the Congo with his vacuum-popping trick, and Meirion Thomas’s text message."
"It is also why bed-bound patients need to be turned from side to side every few hours, to stop pressure being applied to one particular area of the skin for too long."
"Maintaining kidney function is therefore one of the first life-saving manoeuvres after rescuing any survivor pulled from a fallen building."
"I couldn’t get this little girl out of my head. Knowing that she was likely to die, and that there seemed to be nothing we could do about it, left me feeling impotent and angry."
"If this isn’t addressed, renal failure and death follow."
"I was told that, while they respected my humanitarianism, if I were to pursue this course I would have to cease being an MSF volunteer in Haiti."
"I tried to offer a defence on both incidents, but was unable to penetrate the wrath directed at me, which felt completely disproportionate."
"The role of the triage officer is crucial to the running of a mass casualty."
"As I walked around trying to take in the enormity of what had just happened, there were probably sixty people lying on the floor with another twenty or so sitting propped up against the walls of the emergency department."
"I decided to say nothing; it would only have inflamed the situation."
"However, if a type-O person receives a blood transfusion from any of the A, B or AB blood groups, then the antibodies in his or her plasma will attack the antigens on the surface of those red cells and cause those red cells to stick together and subsequently burst."
"I am, however, absolutely certain that the mortality risk of operating on a patient with worsening malaria must be extremely high."
"I watched as the windows went down and the barrels of their guns were carefully positioned to show that we were fully armed."
"The surgeons got better and better at managing the arterial and venous wounds from gunshots, and also vastly improved their understanding of damage-control surgery."
"Soon enough, patients no longer routinely died after a significant trauma, and it became quite rare for anyone to die."
"The bottom line is that if the ampulla of Vater is destroyed the patient will die, unless a heroic operation called a Whipple’s procedure is performed."
"The pancreatic duodenal complex is one of the most difficult areas in the body to deal with, especially if it has been disrupted by trauma."
"Our discussion ranged far and wide and I talked about the need to set up humanitarian corridors, policed by the UN, to supply aid and food to the civilians who were being cut off and besieged by the Syrian regime."
"I had returned to my usual NHS work straight away, as I almost always do – I rarely took any time off after a mission, and found it easier just to get straight back to work."
"I was prepared to die, and I would rather have died than lived with myself knowing I’d left her alone."
"The most burning thought was that I could not leave this little girl to die on her own, having suffered the most extreme injuries."
"It wasn’t a logical decision, it was based purely on emotion – compassion for her, and anger at the forces of war ranged against her."
"The nature of the risks I was taking had grown without my really noticing. I was prepared to die, and I would rather have died than lived with myself knowing I’d left her alone."
"There was an intense battery of incoming artillery."
"I was quite reconciled to the idea that I might die."
"A week after the war began, my mobile phone rang. It was the International Committee of the Red Cross: would I go to Gaza City?"
"It was a no-brainer. A couple of phone calls to the managers at various hospitals confirmed that they were happy for me to leave immediately."
"The situation in the hospital and staff was enormous."
"The chances of survival deteriorate with every passing second."
"We decided to rush him into theatre and do all we could to save him."
"The operation went well and within half an hour or so his heart was beating nicely."
"We slowly watched him die, knowing that if he had been anywhere else in the world he would probably have survived."
"The mission in 2013 had been hard, but ultimately successful and rewarding."
"I had a near-constant pain in the middle of my chest, which I could ignore only when I was immersed in an operation."
"The shooting lasted around an hour, with the Free Syrian Army firing from positions all around us."
"The world around you is configured anew. You are no longer the end-point of a genetic chain, but merely a link along it."
"We have trained more than seven hundred local surgeons."