War Doctor Surgery on the Front Line:

by David Nott

medical heroism is mainly a matter of hard work and long hours—inevitable parts of medical practice—even though in countries such as America and England there is now talk of the need for unheroic “work-life balance” and the dangers of “physician burnout.”

In March 2011 some children sprayed anti-government graffiti on walls in the southern city of Daraa; Assad’s response was to have his security forces detain the children and torture them.

staff still loyal to Assad would routinely deal with minor injuries by carrying out amputations as a form of punishment.

“Dave, Dave—other side!” I’d been drilling on the wrong side of the head.

I wanted to be a humanitarian doctor, in severe and stressful situations, using my knowledge to intervene and make a difference.

I had no desire whatsoever to be someone safe in London, commuting to work, knowing what I would be doing and when months in advance.

That part of it, the feeling of living on the edge, was fun. The only constraint was making a mistake that could get you wounded or killed, which was straightforward in a way that I liked.

executed him by hanging him from a lamppost in the city center.

As we stood by the bed one of them nudged me. I looked down as she lifted the hem of her burka to show me a flash of her ankle. She was wearing fishnet tights, perhaps even stockings. I don’t think she did this because she liked me, I think it was an act of defiance against the terrible rule of the Taliban.

The boy driving the vehicle wore a chain around his neck. Hanging from the chain, like an amulet, was a severed finger.

Helping people who can’t help themselves and taking a risk to do it.

the snipers were playing a game: they were being given rewards, such as packs of cigarettes, for scoring hits on specific parts of the anatomy.

This sick competition reached its lowest point toward the end of my time there when it appeared that one particularly vicious and inhumane sniper had a new target of choice: pregnant women. One such casualty arrived in M2, shot in the abdomen.

an X-ray of the pregnant woman’s near-full-term fetus, clearly showing the bullet lodged in its head. It remains one of the most shocking images I have seen.

In the grand scheme of things, it didn’t much matter whether I lived or died; at least I would be doing something that I loved, and I might even save this girl in the process. I made a conscious decision to stay.

I was prepared to die, and I would rather have died than lived with myself knowing I’d left her alone.

The playground had been converted into a graveyard