In her Afterword to War Doctor: Surgery on the Front Line, Eleanor Nott writes eloquently about heroism and our need for heroic stories:
"[they] give us hope, make us feel better about our sometimes wretched world, and serve as inspiration and aspiration. We may not have those qualities ourselves, but knowing they are out there gives us comfort.
Society demands heroes, but we don't necessarily want them to be too human. We don't want messiness. To remain pleasing to us they should exist in a sphere of goodness and virtue we ourselves find impossible to attain. At the first hint of failing, the first chink in the armour, the bubble is burst and the search for perfection begins afresh."
Perceptive words from the wife of a man whose very humanness comes across in his memoir as clearly as does his outstanding heroism, for David Nott's story is one of selfless determination, of skill and dedication in extremis, and of tenacity and a humanitarian impulse so strong that no matter the apparent hopelessness of a situation he never gives up.
A vascular surgeon based in London, David has for many years taken unpaid leave to go, under the auspices of charities such as MSF and the ICRC, to work in war zones or at sites of natural disasters. Typically operating in what are called 'surgically austere environments', lacking equipment, resources, and often manpower, he has endured extreme personal danger to help both the innocent people caught up in conflict and, on occasion, those committing the violent acts. "It is the vulnerability of human life that makes us all the same," he says, commenting that "you can't take your normal NHS mindset to a war," while discussing the moral conundrum implicit in giving medical care to the patient in front of him, regardless of that person's identity, past, or - likely - future actions.
David Nott's descriptions of the terrible injuries he treats on his postings make hard reading, but don't shy away from them. You will learn more from this book than from a television news report or a broadsheet article, for dealing as he does with the consequences of terrible violence against civilians, the author shows what it means to live in Aleppo, say, or Gaza, or Darfur, places where his patients' lives and deaths are "synonymous with despair". His concise and graphic accounts of the extraordinarily difficult and distressing conditions in which he and his colleagues work show also the particular characteristics necessary to do the job he does. "You need to radiate serenity," he says of leading an operation, even while under bombardment, but keeping calm under pressure doesn't mean he is unaffected by what he has seen and undergone, and he is candid in describing the effect his work has had on his mental health, something he discusses (as I mentioned recently) on his Desert Island Discs.
Away from the front line, David Nott teaches other doctors to do what he does, directing The Definitive Surgical Trauma Skills course run by the Royal College of Surgeons in London, extending that into Surgical Training for Austere Environments and the Hostile Environment Surgical Training Course, raising funds through his charity The David Nott Foundation to sponsor attendees. Beyond the operating and lecture theatres, his mission to help those in need led him to seek a ceasefire in Syria in late 2016. His media appearances, advocacy at the highest levels and relentless petitioning of those with the power to direct events eventually resulted in a cessation of hostilities sufficient to evacuate Aleppo's sick, injured, and the medical staff caring for them. He is a hero through and through.
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