RogerBW's Blog

2019 non-fiction. Nott is a general and vascular surgeon who uses his leave to volunteer with MSF in combat and disaster zones.

I "read" this as a Book of the Week condensation last year, but I'd definitely recommend this fuller version. Here Nott does talk about lost patients, friction with other volunteers, and so on, that were elided from the radio programme; there's also some material about the gradual accumulation of stress and how he's ended up reaching an accommodation with it.

One gets a much more solid impression of Nott as a person here: a particular sort of adrenaline junkie, who justifies it to himself as doing good (which he undoubtedly is), but who perhaps enjoys it a bit too much for his own good – and gradually becomes aware of that.

Nott isn't much of a philosopher, but he doesn't need to be. Repairing people is good; causing them to need repair, whether that's deliberate or through carelessness, is bad. (And of course in most situations he's in territory held by one faction, so what he sees is the injuries caused by the other factions.)

Some side notes are interesting. In most of these hellholes, nobody has trouble getting enough bandwidth for video calls… but for reference texts they rely on Nott's (illicit) photographs of medical books, stored on his laptop. He talks about setting up a training course for other surgeons working in "austere environments", and the expense of getting people to travel to and live in England to go through it… but there's no mention of doing it remotely. I suspect that may have shifted now.

Nott is a surgeon, of course. In the moment he is always right, even if he admits afterwards that he might not have been, and whether that's in the theatre, flying a helicopter when he knows he's not up to the job, or blatantly taking photographs when he's been told not to. And there's a certain amount of great-white-saviour about the whole business: his Syrian fellow-surgeons didn't get to fly back out to a nice book deal after six weeks in-country.

Even so, there's good stuff here. As a gamer, I naturally think about how one might implement these ideas and images in an interactive way, and I think it might be doable: even if games don't get into the details of just how surgery works, there's plenty of interaction with local powers, and manipulation of the young and macho (and indeed the old and macho) to get to one's goals. While your staff may occasionally be armed, there are a lot more of the local powers, and if you were armed more than trivially they wouldn't let you into the country in the first place.

In spite of some problems, thoroughly recommended.