War Hospital: A True Story of Surgery and Survival
Public Affairs Press (Perseus Books Group), New York, 2003, pp. 431.
This is an important, gripping book about doctors in wartime. And it is an impressive, beautifully written first book by Sheri Fink, a physician and writer in New York who was a student leader for PSR in the 90s at Stanford Medical School where she earned her MD and PhD. Somewhere amidst all that medical training and serious activism -- including a lawsuit against the Defense Department, CIA, and State Department to obtain records that would have showed that the United States had knowledge of the impending Bosnian massacres and did nothing - Sheri Fink learned to write like a prize-winning journalist.
The result, after five years of research, travel, and interviews, is War Hospital, a powerful, haunting narrative presented in fast-paced, present time, first person narrative that unfolds like a Greek tragedy. This is the story of a group of very young, inexperienced doctors amidst the siege and eventual fall of Srebnenica that ended with genocide in Europe as the world stood by. The very fact that our protagonists - humanitarians and idealists-are trapped in the midst of the eventual ethnic cleansing of Bosnian Muslims by Bosnian Serbs poses the book's central questions. Is the traditional role of humanitarian medicine -- neutral, unarmed, detached - sufficient in the face of looming massacre? And are the similarly evolved views of sovereignty and non-intervention in the international community outdated? If so, how and where does one choose sides, decide to intervene, offer medical care, or seek armed protection?
But the strength of War Hospital ultimately lies in Fink's brilliant structural choice to save the analysis, the conclusions, the politics and policy dilemmas for an epilogue thus allowing the reader to become engrossed with the stories of Drs. Ilijaz Pilav, Eric Dachy, Fatima Dautbasic and a handful of others who serve as the only doctors for the 70,000 or so Bosnian Muslims surrounded in enclaves in eastern Bosnia. From the opening scene where Dr. Ejub Alic, a 32-year old pediatric resident with no surgical training, performs an amputation with a razor cleaned in hydrogen peroxide, you will find yourself caught up in a swift, compelling novelistic reconstruction of events worthy of a future film or television series. Like a special episode of ER, but with our cast operating in a very real dilapidated hospital without adequate equipment or supplies, War Hospital makes you care about Bosnians, makes you feel, see, and smell the fear, despair, humor, bravery, betrayal, and confusion that permeate war.
When Dr. Alic finally gets a surgeon to help him out, the new arrival turns out to be the even younger, 28-year old general practitioner, Dr. Ilijaz Pilav, who has no surgical training either. He must brush aside questions on his past and training if he hopes to avoid creating despair or panic in Srebnenica. And so it goes. As our cast of young doctors is fleshed out, we watch their surgeries, their witness to massacres and gas attacks, their love affairs and infidelities, their arguments, and above all, their moral and ethical dilemmas as they try to live up to their calling to "do no harm" and to remain neutral as it becomes clear that active involvement, interposition with imperiled citizens and soldiers, and even occasionally taking up arms may be essential to survival and carrying out their medical missions. In this sense, War Hospital, in the best sense, resembles a high-toned TV survivor series where the outcome actually matters. As you watch some of our doctors join in fighting with Muslim forces, escape to rejoin families, get caught in ambushes, or leave overwhelmed and disillusioned, you will find yourself, if honest, frequently identifying with and then rejecting a number of moral stances and options. There are no easy answers here.
This combination, then, of vivid narrative with a setting and structure that raises the most important ethical questions of our time for doctors and civilians alike makes War Hospital indispensable reading not only for medical students, physicians, nurses and other health professionals, but also for ethicists, historians, psychologists, journalists, foreign policy analysts and more. I can see it used in many, many university courses and, with decent publicity, selling well and giving rise to that movie.
So. Go get War Hospital and read it now. If we had had it in 1992, genocide might have been averted. But its prose and powerful human insights and ethical engagement are as fresh and relevant today as the daily headlines from Iraq.
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