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War Hospital: A True Story of Surgery and Survival

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Whether you are interested in contemporary history, war, medicine, morality and hope, you should read War Hospital. This nonfiction book about the siege of single town is an inspiring chronicle of true heroism by physicians and nurses in the face of war and its assorted horrors including internecine carnage, genocide and malign indifference. However, I first looked at this site not to see whether others enjoyed reading the book but because I wanted to see whether War Hospital had affected anyone else as much as it had me. I see that it has, and so I feel it's important to acknowledge the achievement of this book because I want everyone to have the experience I had.

What was that?

Well, as a social worker I was always quite skeptical of people who complained of `compassion fatigue' or bemoaned their inability to care deeply about the unspeakable assorted cruelties and human rights abuse that scar the globe. I looked at such complaints as little more than excuses for choosing not to care. Yet I couldn't ignore the fact that I was becoming inured to the news of genocide in the Balkans, especially because it was being rapidly supplanted by genocide in other areas such as Rwanda. Although genocide is equally evil throughout the world and suffering itself has no color, I resented the fact that Africans were getting less press and global outrage. and because journalists were also tiring of the Balkans they began to desert it for the next hotspot du jour. In the age of information overload these were all competing for our attention and the surfeit of shocking details were producing a sort of ennui. I would never have admitted to compassion fatigue, but it was becoming harder to access my outrage and easier to fall into a melancholy desire to not know more.

War Hospital proved just the medicine for this sense of paralysis.

First, the book is no preachy lecture: It is entertaining and a gripping story, very well told, that quote effectively puts a human face and universalizes the experience of genocide. And this face is a heroic face, an inspiration. This taut story is as powerful and intoxicating as any mystery novel. It is the story of a group of heroes, but heroes not in the diluted newspaper sense of a fireman saving a child but heroes in the classic sense of people who survive seemingly impossible personal tests as they mature from naïve, idealistic youths to flawed but ultimately successful saviors.

A small corps of very inexperienced young physicians including Drs. Alic, Dachy, and Dautbasic find themselves trapped in the besieged city of Srebnenica, where they must care for an unstemmed flood of Bosnian Muslims. Worse, their patients are brought in suffering from gruesome traumatic war injuries-- shredded arms and legs, and devastating head injuries for which the pediatricians and internists are ill prepared to cope: There are no surgeons. Even anesthetics and disinfectants are in short supply. When the eagerly awaited surgeon finally cheats death through a hazardous odyssey to join them, he is revealed as just another young general practitioner, Dr. Ilijaz Pilav, without surgical training. This ill-equipped band faces the challenge of providing medical and surgical care, hope and inspiration to the remaining residents of the Eastern Bosnia area, including Srebnenica, a former resort town now physically ravaged by war, haunted by snipers and tottering on the brink of despair as it is seemingly abandoned by the world. And outside, the world remains mute as genocide overtakes the country and the city: When the former resort town falls, 8,000 people are massacred .

All this is just the beginning. As Dr. Fink takes us on the roller-coaster descent of Srebnenica's fortunes, she fully fleshes out the individuals, telling their stories and illuminating their characters, warts and all: We know and care for them all by the end of the book. One man stumbled onto medicine because the engineering program he initially wished to attend was in a dull area that would not give him, a village boy, the urban experience he craved. Another must battle his own professional crisis of confidence-- is he really skilled enough to help all these people?-- as he seeks to allay the skepticism of others.

Because we know and care about them, Fink's subtle gradual introduction of ethical and moral issues as the doctors and nurses confront them is very powerful. She avoids the pitfalls of introducing thorny medical ethics issues too early and in too much depth. This means that when characters with whom we empathize ask themselves how to triage the young vs. the armed, when they ask whether they will save more lives by arming themselves against aggressor or how they can morally justify treating an enemy soldier who will turn to genocide or massacre again these concerns become immediate moral crises, not abstractions. When some doctors decide that medical measures are not enough and they decamp to take up arms to rejoin former comrades or simply to abandon their work in the clinic as hopelessly inadequate, this becomes more than a political or ethical argument.

An unexpected virtue of the book is its luminous language. It is written in a clear forthright voice that eschews semantic tricks but unerringly chooses each perfectly apt word in fresh combinations that are at once lyrical and evocative of a disturbing atmosphere: For example, a ravaged leg is `filleted' by a young surgeon in preparation for amputation. A hazard-fraught nocturnal trek to freedom by the survivors is rendered in language that contrasts brute violence with wondrous depictions of the wondrous nightscape.

In the hands of a capable writer this gripping story would have made a rousing book: In the hands of this writer who achieves rich characterization, keen ethical insight, and lyrical prose, it is an inspiration, and the cure for compassion fatigue.

I don't think I really understood what the war in Bosnia was all about before reading Dr. Sheri Fink's fabulous new book. She has a marvelous narrative gift. This book reads like a compelling screenplay, yet is marvelously researched and documented. As Chris Hedges wrote in his glowing review in the December 22, 2003 New York Times, Dr. Fink dramatically tells the story of the war by focusing on a small group of brave young doctors trapped in the beseiged city of Srebrenica with about 50,000 civilians. Without access to supplies, equipment and even electricity, we struggle along with them to deal with the frustrations, ethical dilemmas, rivalries and romances of their lives, while the larger picture of the war, the shocking failure of the UN and the West to intervene, plays out. The targeting of medical aid workers in Iraq (Dr. Fink worked there recently, I have read) takes on new meaning after reading her book and seeing how aid is often another (albeit deplorable) weapon of war. This book deserves wide notice.

This is an important, gripping book about doctors in wartime. And it is an impressive, beautifully written first book by Sheri Fink. War Hospital is 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.

I picked up War Hospital very casually. I hate to admit that I know very little of the Balkans other than a general feeling that it was war torn and had been for pretty much my whole life. This book changed this general apathy to the region in general and the peoples Croat, Serb, and Muslim in particular. I suggest every single person read this book--not only is it a great introduction to a small part of the Balkan conflicts, it is gripping and heart-rending. As I read it I felt chills-- sometimes I had to put it down. It also provides insite into the mindset of the international community who let 50,000 people fighting a better equipped enemy with only five doctors (none specifically trained in surgery). All in all-- a good read. I'm defintely going on to read more about the area and the conflict.

Very well written narrative, exploring the struggles understaffed, overworked, and in a lot of cases under-educated doctors who risk there lives to treat there patients during a time of war, often in EXTREME circumstances. It is a very striking story in that some doctors join the fight, some stay neutral, others just get lost in the horrible world that there previously beautiful home has turned into. It really make you think what you would have done in there position and question ones own moral fiber. It also makes one question governments and there priorities. In some places the book digresses into too much history which was hard in some places to get through, but it was necessary for the overall picture for this true story. I good read for anyone who is interested in medicine, ethics, history or a great dramatic narrative.

A highly graphic and very well written account of physicians carrying on the treatment of patients under fire and under the most difficult and stressful conditions during the largely successful genocidal attack and extermination of non-Serbs by the Bosnian Serbs in Srebrenica and eastern Bosnia during the Bosnian war of the 1990's. Sherri Fink' account is largely a dispassionate depiction that puts the readers on the scene and in the trenches, as it were.

War Hospital follows the lives of a group of doctors and aid workers in the embattled town of Srebrenica during the Bosnian War from '92 to `95. The moving personal account of the protagonists is framed by the political machinations that were part of the Balkan tragedy, giving an emotional context to the horrors of the war and the genocide it spawned. The book is balanced, objective, thoroughly researched and very well written. It is an important read for those interested in the ethics of medicine in wartime, not only as it relates to the Balkans but also Iraq, Afganistan and other regions of conflict.

I am only half way through the book. It is
very well written. Sheri Fink has the ability
to use just the right words to convey the
tension, anxiety, chaos and trajedy in these
dismal circumstances.

The attention to detail, psychological insight,
and reserved language, leaves a deep and
sorrowful impression of true heroism in a
man-made hell.

The story of the life and death of these medical heroes
and their war patients surpasses journalism and
enters biblical tones.

Very impressive!

Squiggles

There are so many good things to say about this wondeful book that it's hard to know where to begin. Sheri Fink's account of the heroic services of a handful of doctors in Srebrenica is an amazing and skillful blend of personal narrative, medical practice, ethical dilemma, and humanitarian concern. It is a rich story that kept me riveted long into the night more than once.

I was deeply drawn into the lives of the doctors portrayed here. I rejoiced in their triumphs, and suffered in their pain. I remain humbled and inspired by their courage, the sacrifices they made, and the risks they took for no personal gain. I was also fascinated by the glimpse given into organizations such as Doctors Without Borders / Medecins Sans Frontieres that so courageously operate on the edge of tragedy and terror, and who face choices of life and death every single day.

I was entranced by the fascinating story of caring for tens of thousands of people in an isolated war zone, of doctors who went beyond their limits, beyond their lack of equipment, to save countless lives and be islands of care in a dark, tragic, turbulent time. And I was reminded of our human frailty when the burdens became too much for them.

I was just as deeply drawn into the account of the tragedy in Bosnia as a whole, and I will never think about this war in the same way. Until now it was a confusing, remote war that I felt sorrow for, but in a distant abstract way. Now, I am touched deeply, and, in a small sense feel that I lived through it myself. It will always be a part of me.

I could go on, but I won't :-) Go get the book; Sherri Fink has done a much better job than I could do here. This book is as rich as any novel I have read, and it is also completely true. I am amazed by this. Great job, and my thanks to the author for a wonderful read.

Fascinating book. It is an amazing story and very well written. I recommend it highly.