Jonathan Kaplan is a soldier in his own private war. Expatriate by choice from his home in South Africa, he wanders the world looking for other people's wounds to stitch. He has spent time in the battlefields of the late twentieth and early twenty-first century, Angola and Iraq being primary among them.
What does a war surgeon on temporary assignment do? "Acute war surgery is crude but straightforward: stop the bleeding, cut away the lacerated tissue." Seems simple enough, and Kaplan continually stresses that he is no genius, a man who became a doctor, he claims, because med school was a long course and he figured he'd enjoy college life. Much of what has happened in his thrown together life has been the result, to hear him tell it, of serendipity or mischance. But his modesty is an obvious cover-up. The man is brilliant, dedicated and brave. His excellent writing style is icing on the cake.
The book takes us through Kaplan's journey as a teenager to an Israel wracked by recent war, his first experience of trying to live sane in a landscape of chaos. Exploring the underground bunkers in the kibbutz below the Golan Heights, the young Kaplan saw medical supplies laid out and understood "the truth at the heart of the practice of medicine: that there was no mystery, that learning and skill turned these ordered bits of equipment into the means of stopping bleeding and bringing together shattered tissue to make a greater order, to save a life."
Kaplan got his medical education in South Africa during the apartheid years when dedicated whites practiced their craft in deprived and dreary township clinics under haphazard conditions. His residencies included an aborted stay in the Seychelles, where a casual affair with a girl linked to the dictatorial president "Jimmy" Mancham sent him to ground. Returning to Cape Town he barely squeaked through his finals. Feeling less than confident in his ability to actually practice medicine, he was advised by a friend to "listen a lot, look sympathetic, and nod slowly."
From Kaplan's adventures, you get the impression that medical temping may be a final frontier for people who need to live on the edge. Everywhere he goes he finds broken bodies and heart-rending human wreckage. He deals with each case as it comes before him and leaves with some regret to move on to the next crisis. The MASH-side humor glues the tragedies together: the dog that ate the condom, the incident of the piece of finger among the shrimp. Somewhere along the way, without drawing much attention to it, Kaplan became an expert consultant as well as a surgeon. "I worked on an investigative documentary in Japan about the hunting of dolphins on an industrial scale for their meat…then as a doctor in an embattled Burma's Shan State." He spent a relaxing and generally exhilarating time as medical adviser to an English doctor series on the telly. "Doubts that stalked my career progression were forgotten."
One of the sadder portions of the memoir concerns Kaplan's companion Andrew, who went on a mission that he himself had deferred, ending with the discovery of his friend's corpse in the jungles of Madagascar. Though Kaplan could easily overcome fear, queasiness, and the big questions as he skimmed from war zone to war zone, he had lingering sorrow and guilt concerning Andrew's loss that continued to haunt him.
This is a book for realists, graveyard comedians and armchair saw-bones. Maybe it will inspire someone to get out of their chair and follow in Kaplan's intrepid and erratic footsteps. But one suspects that when they made Kaplan, they broke the mold.
Reviewed by Barbara Bamberger Scott on December 28, 2010