The playwright Anthony Shaffer has been quoted as saying that a man should have a new career e-very five years. Jonathan Kaplan has done just that and more. Forsaking the comfort and security of conventional medical practice, he has pursued his own personal search for a meaningful professional life in remote corners of the globe. He began his extraordinary career as a hospital surgeon, then became a researcher, a field trauma surgeon on the front lines in a number of war zones, a ship’s medical officer, a flying doctor, a freelance journalist, a documentary filmmaker, and an occupational health doctor. Chapter headings—“South Africa,” “England,” “America,” “Namibia and Zululand,” “Kurdistan,” “The South China Sea,” “Mozambique,” “Burma,” “South Africa and Brazil,” and “Eritrea”—serve as an itinerary for his odyssey.
Kaplan’s reflections on the social and political situations he encounters in his travels, his strong sense of social justice, and his romance with adventure and risk-taking set this well-written book apart from the usual medical autobiography. Moreover, he provides an intimate portrait of what it is like for him to be a doctor. Kaplan is able to communicate his respect for human anatomy and his love for the art and skill of surgery in terms that are often lyrical and sometimes gory. In one passage he tells how he learned to “set fractures, strip out varicose veins, scoop tonsils from little throats, and whip out an inflamed appendix in sixteen minutes from the first incision to the final skin-stitch.” In another, he relates how “considerable physical power is needed to wrench an arthritic hip-joint from its socket so that it can be sawed off and a replacement fitted . . . the power-drills hurl pink bone- froth against the face-masks of those around the operating table.” However, his compassion for his patients always comes through.
Raised in apartheid-era South Africa, the son of a military surgeon in a respected and privileged family of physicians, Kaplan grew up with the expectation that he would serve. His first experience with trauma medicine came when he was a medical student in Cape Town, treating student casualties at an antiapartheid demonstration. He gained more experience in the accident and emergency department and during his internship at a military hospital near Cape Town soon after the South African army invaded Angola in 1975 and bloody uprisings were spreading across South Africa. However, to avoid the draft, he left for England. Although he admits that cowardice was a factor in his decision, he could not support the politics and violence of the South African government.
In London he studied for the fellowship of the Royal College of Surgeons, working as casualty officer at the cold and run-down East End Hospital, which provided all medical services for the area’s “grimy fringe.” In some of his best prose, Kaplan describes the patient population. There were drunks, misfits, violent men, drug abusers, black gang members and their victims, “the frankly mad,” and the “put-upon patients of the local GPs.”
All too often the Casualty department here was simply a refuge for the desolate and bereft, those with no one to care about them. In the small hours it hosted the sad teenage girls with their token overdoses of vodka and ten of mum’s Valium, their mascara smeared; a whimper for help.
Kaplan’s descriptions of the old London hospitals and his insider’s view of the National Health System and the British system of surgical training at the time—a kind of “feudal patronage,” where networking and connections were more important than skill—are amusing but cynical.
After a series of six-month jobs in various casualty and orthopedic posts and three years as senior house-officer, Kaplan qualified as a senior registrar. His description of losing his first patient at his first post after qualifying is touching. He passed the English fellowship examination and was admitted to the Royal College of Surgeons, but without the proper connections, he found advancing up the career ladder in London difficult. When he failed to qualify for a grant to work on the master’s degree in surgery needed to become a consultant (severe budget cuts limited the number of awards), he accepted a research post in a hospital vascular laboratory in the United States. There he was able to write his thesis and earn a Master of Surgery degree.
He spent two years in America, enjoying his work and “the good life,” but he was not comfortable with the commercialization of medicine in America. He...
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