The Dressing Station: A Surgeon's Chronicle of War and Medicine

by Jonathan Kaplan

The Dressing Station is a searing portrait of devastation on the battlefield that "illuminates the consequences of war and the ambiguities of relief work at a time when these issues couldn't matter more." (Caroline Fraser, Outside) From treating the casualties of apartheid in Cape Town to operating on Kurdish guerrillas in northern Iraq at the end of the Gulf War, Jonathan Kaplan has saved (and lost) lives in the remotest corners of the world in the most extreme conditions. He has been a hospital surgeon, a ship's physician, an air-ambulance doctor, and a trauma surgeon. He has worked in locations as diverse as England, Burma, Eritrea, the Amazon, Mozambique, and the United States. In this story of unforgettable adventure and tragedy, Dr. Kaplan explores the great challenge of his career -- to maintain his humanity even when that option does not seem possible. The Dressing Station is a haunting and elucidating look into the nature of human violence, the shattering contradictions of war, and the complicated role of medicine in this modern world. "A unique mix of biography and reportage, both personal and clinical," it is "a rare insight into the mind of a surgeon." -- Sue Cullinan, Time "Eloquent ... Beautifully written ... Provides a startling glimpse of battlefield surgery in those conflicts that CNN does not cover." -- Abraham Verghese, The New York Times Book Review "Kaplan ... has a keen sense of the smaller moments that leaven the agonies of daily life." -- Julian B. Orenstein, The Washington Post

Genres: Nonfiction, Medicine, Medical, Memoir, History, War, Biography

416 pages, Paperback

First published February 1, 2002

About the author

Librarian note: There are multiple authors with this name on GR. This profile is for Jonathan^Kaplan, South African surgeon.

Reviews

[Petra X · Rating 5 out of 5]

Jonathan Kaplan trained as a doctor in Durban, South Africa and then left for London rather than serve in an army dedicated to upholding apartheid.

But he never settled, neither in his career nor in his soul. His existential angst led him to work on the frontline of wars across the world and eventually into documentary film-making exposing the horrors of armed conflict.

Kaplan is most at peace in the Homelands of South Africa treating the poorest of the poor with the most disgusting of diseases, these people he regards as his compatriots. Every now and again there is a diversion from his stressful choice of career as when he serves as a cruise ship surgeon aboard a rust bucket bobbing around the South China seas or is up the Amazon investigating mercury poisoning.

But it is the ending, the last page and a half that illustrates Kaplan's supreme humanity when he links the richest and the poorest through the body's common responses to stress, something he knows about from many angles. As he writes the final words, perfect words, its the 'ahh' moment, the moment you understand, we are all the same.

Rewritten 25 March 2013

[Mike · Rating 5 out of 5]

If you want to know what combat surgeons deal with just behind the lines, Kaplan will tell you. Graphic, bloody, detailed accounts of bodies torn by bullet or shrapnel. Even when he isn't performing the role of doctor, he can't help but jump in when a situation presents. The book starts in South Africa. The author is a medical student during a time of true systemic racism, i.e., apartheid. His spends time at a morgue along the dividing line between segregated white, colored and black neighborhoods:
The white bodies tended to be tidier. There was a regular attrition among young men in that society, who went scuba diving and hang-gliding and rock climbing, or drove too fast on winding mountain roads. A few, beaten down by loneliness or the fear of failure, would hang themselves or take fatal overdoses. In the ‘non-white’ mortuary (here too the principle of racial segregation was observed) the corpses were less reposeful: dead from spear-thrust, gunshot and axe. Bodies were disembowelled, bled dry from multiple chop-wounds, or contracted and charred by fire. They came from a place beyond the frontier of our known lives, where other rules of death appeared to prevail.
After finishing med school, the author flees SA just days before he is about to be drafted into the SA Army and sent to the front lines of the Angolan War. He goes to England and spends time in the NHS. Reaching a plateau (class rules), he heads to America and becomes a researcher, helping develop a medical treatment only to see his efforts go to waste as a competitor buys the company he was working for and put the new treatment on the shelf (the competitor had a more expensive, more techie treatment). A short return to the UK and then back home to South Africa. Now he starts his long career of jumping between medicine at the edge of civilization and other odd jobs.
He takes a job in a Zululand hospital and the various diseases and afflictions are just jaw-dropping. We next meet him as he patches peshmerga in Northern Iraq after the Gulf War ends. That episode needed more details (the book also lacks photos and maps). He takes other jobs:

Ship’s doctor for a (third-rate) cruise line plying the waters from Manila to Jakarta.
Film crew in Mozambique, documenting the slaughter of elephants in the civil war going on
Air ambulance doctor escorting sick people to health facilities for the travel insurance providers
Investigating an opportunity to provide health care to the Burmese Shan "narco-state" (this was one of the most informative sections)
Investigating mercury poisoning in South Africa and again in Brazil
Reporting on and providing medical care in Eritrea during an attack by Ethiopia

At the end, he is back in London, providing stress relief to overworked bond traders, financial wizards, etc trying not to lose their jobs yet breaking down under extreme pressure.

Have to give him 5 Stars

[The Final Chapter · Rating 4 out of 5]

Low 4. From the opening chapter on Kaplan's medical studies in Cape Town, the author reveals an unerring ability to deftly relate his exploits within surgical practice around global hot-spots. Learning his trade with the mangled victims of the state enforcement of apartheid, the author went into exile to escape military service. His time in the NHS illustrates the gruelling workload of a doctor within the system, but also the iniquities of nepotism and malpractice, before the auhor set off to the States to pursue research interests denied by the cutbacks unleashed by Thatcherism. Kaplan also decries the commercialisation of American medicine, before returning to practice surgery on the front-line across the war-torn regions of the world. The book is chock-full of captivating human stories, perhaps, none more so than the author's experiences treating casualtes on the Turkish-Iraqi border. At the onset of the first Gulf War, George Bush had entreated the Iraqi people to rise up against their dictator, but with the end of hostilities in March 91 leaving Saddam Hussein in power, the latter was free to wreak vengeance on those who had answered the Allied call. Chief amongst these were the Kurdish cities in the north, who were left unprotected by Allied powers, and the ensuing exodus of refugees were denied entry into Turkey, amassing in huge camps pitched on the border. What emerges from the pages is a man of great integrity and accomplished story-teller.

[Nancy · Rating 3 out of 5]

Jonathan Kaplan has plenty of drama, danger and excitement to report in this book. Just as the title promises, he travels the world mostly treating soldiers in bloody civil wars. Almost every chapter is interesting but each pretty much stands alone. He hopscotches from one war to another (with an occasional side trip as a cruise doctor) weaving no overarching theme. I wondered what pulled this man into so many dangerous situations. He offers no insight into that.

[Sandra · Rating 5 out of 5]

Excellent book. I read it a few years ago. I am ready to read it again. It is fascinating and very sad at times.

[Cameron · Rating 4 out of 5]

Anyone hoping to write a memoir on working overseas should read this astonishing and totally engrossing autobiography. Kaplan has led the life of a wandering surgeon, pursuing his career on five continents over the course of 30 years, and dabbling in fields as diverse as filmmaking, medical research, and battlefield trauma surgery.
South African by birth, Kaplan fled to the U.K. during the turbulence of the late 1970s and then did medical research in the US. Only boredom and curiosity led him to volunteer to work on the Iraq-Turkish border during the Gulf War, an experience that inspired him to seek out dangerous and bizarre jobs in Kurdistan, Mozambique, Eritrea, Burma, and the Brazilian Amazon. In every case, his consummate skill as a surgeon serves him well and allows him to save lives under the most desperate circumstances. Moreover, his humanism, compassion and intuition lead him to record vivid insights into human behavior under these extreme situations.

The descriptions of his surgical procedures are elegant but thoroughly clinical, intended for other professionals, and yet flavored with a kind, earthy sense of humor and even modesty. Strangely, he is often silent in regard to his own personal growth during these many years of globetrotting, and the reader is sometimes left trying to grasp Kaplan's own motivations.

Although the book contains few dates, I gathered from other clues that Kaplan worked in Brazil and Mozambique at the same time as I did, and so I can confirm his tale of nearly being killed by bandits on the road to Swaziland-a common occurrence-and of children poisoned by mercury in the Amazon. His prose is graphic, imaginative and evocative; he leaps breathlessly from one adventure to the next in a career so filled with horror and beauty that you just know it has to be true.

[Liralen · Rating 3 out of 5]

Kaplan has had the sort of career that will give him stories to tell for the rest of his life. Raised in South Africa during Apartheid, he left the country following his medical training rather than be conscripted into the army and expected to perpetuate atrocities against black South Africans. From there, his work became a bit of everything: semi-rural hospital work in England, and humanitarian work, and work on a cruise ship, and work as a flying doctor, and journalism, and, and, and...

It's fascinating but it's a lot for one book. At times I wondered whether much of this had started as individual essays and articles for different publications: the chapter on working in a cruise ship, for example, seems to come out of nowhere and have almost no connection to the war- and disaster-focussed work Kaplan had done. I can see an argument for including it with very little context or discussion of its contrast to that other work; e.g., perhaps it's meant to reflect a discombobulation Kaplan felt at moving to such a (strange and) structured environment after the chaos of war hospitals. But...even if that's the case, I'd have preferred to see an acknowledgement of that contrast.

Again and again the work shifts. Partly that's because, as Kaplan acknowledges, he'd chosen a less traditional path than a 'safe', work-your-way-up-the-hospital-ladder career path:

My skills were more suited to the crude extremes of suffering I had first encountered all those years before, when I’d stepped from my career path to seek that intimacy with pain at the hospital in Zululand. There was little other market for them, or for the eclectic philosophy of disaster existentialism of which I found myself a sole, curmudeonly exponent. I was just a doctor, with uncertain clinical detachment, the vice of relentlessness and some tarnished shreds of idealism. It was only in the world’s murkiest places that they had any chance to shine. (315)

But partly it feels like he felt the need to cram it all into one book, that this would be his only book. He's since written another (with more of the same?), so I ended up wishing that he'd...not picked and chosen, exactly, but maybe been a different kind of strategic about which stories he told in which book.

Still fascinating and still worth reading. But if reading it was so discombobulating, I can't begin to imagine living it.

[Peter Corrigan · Rating 3 out of 5]

Quite an unusual book. Comes off more as a series of essays for the New Yorker than a stand-alone book. But still very interesting at times, less so at others. He is the ultimate itinerant doctor for hire and chronicles his travels and adventures during the last quarter of the 20th century across the globe from South Africa to England, USA, Iraq (Kurdistan), Namibia, Mozambique, Brazil, Philippines, Malaysia, Burma and Eritrea. You will need Google Maps at times! It is both a medical and geopolitical/social observation journey and is often fascinating. His jobs in the medical field ranged from combat trauma surgeon to cruise ship doctor, flying doctor and even into public health. Along the way he talks about writing stories and making film documentaries on various issues of the time from mercury poisoning in Brazil to elephant poaching in Mozambique. That was one busy guy! I read somewhere he wrote a 'sequel' but he'd be hard pressed to top this. 3.5 stars.

[Magda w RPA · Rating 3 out of 5]

Yes, it did take me 5 years to finish this book. I started reading it a few times and couldn’t go through with it. It should have been a fascinated read but the chapters felt like separate entities. You’d think you’ll learn something about the author after reading 400 pages of his memoir but I know nothing more about him now than what you can learn from the back cover. The book lacks personal touch and is a detailed description of different conflicts all around the world, where the author has been stationed and numerous surgeries that he has conducted. The best chapter (IMHO) of all is the one where he describes his work on a cruise ship because it‘s about actual people.

[pdxmaven · Rating 2 out of 5]

Doctor from South Africa trains as a surgeon, and then spends decades traveling from one war zone to another, ultimately (and sadly?) ending up as the medical doctor for a bunch of over-worked and stressed Wall Street traders. I love doctor books but this guy made it a point to talk about all his travels in each locale, from here to there to another place, all with NO maps. I spent a lot of time confused. Giving 2 stars on Goodreads because it was so hard to follow

[Shane Vontelin Van Breda · Rating 4 out of 5]

Jonathan Kaplan does very well to get you hooked. I couldn’t put it down. Definitely one of the most exciting books I’ve read. Some parts are really emotional and you can only imagine what some of his patients must’ve gone through. It’s a real eye opener.

[Caroline · Rating 5 out of 5]

Fascinating book. Part travelogue, part surgery manual, part war correspondence, part philosophy. I loved it.

[Joelene Draper · Rating 4 out of 5]

A poignant account of a humanitarian's experiences of a dark and cold time in our history. Fantastic, brutal, shocking and realistic account of his time in war zones.

[Rachel · Rating 4 out of 5]

This is a gripping memoir of a surgeon's career covering a dazzling range of contexts. As well as medical training in South Africa, England and the US, Kaplan candidly recounts his work in South Africa during apartheid and beyond, Namibia and Zululand, Mozambique and Eritrea (during respective recent wars), Kurdistan during the war with Iraq, Burma's Shan State during unrest, and researching mercury poisoning in rural Brazil, as well as medical work on board a cruise ship in the South China Sea and work as a flying doctor in both Lesotho and with aeromedical repatriation companies around the world. Alongside his work as a doctor he has worked as a journalist and documentary film-maker. Descriptions of operations are given in tangible detail - making you both squeamish and fascinated by surgical processes. As well as intimate portraits of the repair of human bodies, Kaplan offers striking insights into humanity as a whole, and unique presentations of conflicts as well as observations on the work of international medical aid agencies and healthcare more broadly. Upsetting and uplifting all at once.

[Sue · Rating 5 out of 5]

I was blown away by this compelling account of a South African surgeon's work and adventures in conflict zones. Jonathan Kaplan writes beautifully, yet with no-holds-barred in the often horrific detail of poverty, gore and suffering. This is no sensational memoir, however; he questions often, without real resolution, the contribution he is making in war zones when fighters who are patched up after their injuries hurry back to the front lines; whether an engineer installing clean water access in villages is not doing more for the local populace. The story ends (with a shocking last line) in one more - familiar - context, where Kaplan's medical battles continue. Here's a brilliant, creative career surgeon - one of many from South Africa - who has left his homeland, leaving our country poorer but who has surely made his mark in more ways than he gives himself credit for.

[Lisa · Rating 5 out of 5]

There are some writers who try to make a story from their experiences; there are others who simply have astonishing and electrifying stories to tell. From both groups, there are a handful that bring compelling lucidity and convincing sincerity to the page. This book feels effortlessly written - the doctor's experiences pour onto the page. His experiences are sometimes galling, sometimes confounding, but all very compelling. I struggled at times as some of the stories are a llittle scant on context, and you find yourself flung from one war zone to another without warning. Though perhaps that was part of the disjointed experience he was trying to convey. Totally engaging.

[Sheriene · Rating 4 out of 5]

An interesting memoire in which Jonathan Kaplan takes us through his varied medical career, from training to be a doctor in South Africa, to medical research in USA, working for the NHS, working onboard a cruise ship and through several countries torn apart by war (such as Mozambique, Eritrea and Burma).

I found the recent history of war torn countries fascinating, as well learning about the diffculties that workers encountered in such places and I learnt alot from reading this book about areas I knew little about.

[Anita · Rating 5 out of 5]

Interesting account by a restless surgeon. Worldly, taking many different roads and exploring his craft, war, and a wide range of cultures. Told in an objective voice and for the most part, unemotional, until caught in war in Eritrea. Somewhat self-reflective and ultimately wise in a "seen too much, know too much" kind of way. Filled with details of wars and places I know little to nothing about. It took me a long time to read but it was worth it.

[Benjiman Miles · Rating 4 out of 5]

I was fascinated by Kaplan's experiences of surgery and medicine on the front lines of conflicts in South Africa, Kurdistan, Eritrea, as well as in the (supposedly) more altruistic arena of medical research and other areas. Not common subjects of interest, but perhaps that's why it makes for such an intriguing story.

[Laurie · Rating 3 out of 5]

This South African surgeon travels the world in various jobs that lead him to Eritrea, Indonesia, Britain, Mozambique, etc. He has a detached, unemotional writing style that lets the reader make their own judgements. I enjoyed it a lot and envied his ability to help others in an important way.

[Tatiana · Rating 4 out of 5]

CRAZY stories of an isolated chip on the shoulder surgeon in war-torn areas. i found it fascinating.

[Ryan · Rating 5 out of 5]

Outstanding.

[Jo · Rating 3 out of 5]

I registered a book at BookCrossing.com!
http://www.BookCrossing.com/journal/13865286

[Giskin · Rating 5 out of 5]

Kaplan is a war surgeon who grew up in apartheid South Africa. He writes exceptionally well about practising medicine in extreme conditions.

[Josh · Rating 4 out of 5]

This is a bracingly well written travel book about a surgeon who works to improve his well of knowledge and experience while doing good work for people who need it. I loved this book.