Combat Doctor: Life and Death Stories from Kandahar’s Military Hospital (RCAF Journal - SUMMER 2014 - Volume 3, Issue 3 - Book Reviews)

 

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Cover of Combat Doctor: Life and Death Stories from Kandahar’s Military Hospital By Marc Dauphin

Combat Doctor: Life and Death Stories from Kandahar’s Military Hospital
By Marc Dauphin

Toronto: Dundurn, 2013
301 pages
ISBN 978-1-4597-1926-2

Review by Major Mark Nasmith, CD

Military non-fiction covers most aspects of conflict throughout history. There are tales and accounts of army, navy and air force personnel across the rank spectrum. The majority of these are oriented toward experiences and events on the battlefield itself. When a soldier is wounded, they are carted off to a hospital tent or whisked away in a Huey. What is usually left unwritten is what comes next; the struggle for survival and healing as well as the medical support and infrastructure, and the realization that the cost of war is not only paid on the front lines. It is this “what comes next” element that was Captain Marc Dauphin’s (Retired) experience.

Early in reading Dauphin’s book, it felt less like a memoir or historical account and more like a conversational recounting his experiences on deployment. His is the tale of a Canadian Forces’ (CF) reservist and civilian trauma surgeon running a North Atlantic Treaty Organization hospital in a combat zone, including many peripheral experiences a reader may not expect. One would anticipate accounts of wounded soldiers, but reading about the high number of civilian casualties, a record number of allied wounded, logistical difficulties and the seamless interconnectivity of multinational personnel brings the reader behind the scenes.

The anecdotes and events paint a vivid picture of the author’s life in Kandahar, 2009. The narrative captures Dauphin’s self-awareness; that what he and his team were doing and seeing would come at a cost. As the black humour, broken bodies and burned children became commonplace, so too did the awareness that they were fundamentally changing as people. Once the unimaginable became routine, could Dauphin and his team simply return to Canada and rejoin a polite society? This will strike a chord with anyone who has witnessed changes in themselves or friends after one, two or more operational tours. Nothing comes for free, and the author is commendably honest about the price he and his team paid in serving their nations.

Dauphin provides insight into the lives of Afghan civilians in this time of violence and poverty. I had anticipated the stoic and practical nature of the Afghan people; nevertheless, the situations and outcomes related were often tragic, and emotional reaction was unavoidable. There are vignettes of particularly enlightening events, both rewarding and disturbing, and the author consistently avoids the disservice of sanitizing his reality for the unquestionable benefit of the reader.

A positive aspect I will take from Dauphin’s story regards genders and military roles. When I speak to family or the public about military life, there are often questions about gender equality and employment opportunities. Through his words and pictures, Dauphin turns the issue of gender equality into one of gender irrelevance. From the female United States Army flight medic (a trade that is well-armed and committed to defending their patients at any cost), to the “Five-Foot-Two Crew” (a highly proficient all-female Canadian Forces surgical team), to the male United States Navy nurse who lovingly held a dying child in her last hours, the concept of gender has no place in Dauphin’s operational experience. The only metric was performance, and the performance of the staff of the role 3 hospital[1] and their peers speaks for itself.

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The photographs in the book are a welcome embellishment to the text. Seeing the faces of many role 3 staff allows the reader to better empathize with the staff as peers and professionals. While there are few explicit pictures of wounds and medical procedures, they are tastefully chosen, and perhaps more should have been considered: many in uniform are aware of the havoc a bullet or shrapnel can make of a soldier’s body, but civilian readers are likely unaware of this simple yet brutal reality.

Lacking in the book was the opportunity to learn more about the care and treatment of our Canadian wounded. What medical lessons may be inferred from the increasing use of improvised explosive devices (IEDs)? How does a young, healthy Canadian soldier react to a fearful wound? Does training truly sustain the soldier through the worst of it, or is there an inevitable moment when training is forgotten and we all regress to become frightened humans? Dauphin acknowledges some of these questions, but states his opinion that those moments in life are intensely personal and it is for each of our wounded to tell their own story when they are ready. While I cannot disagree with his opinion, it may leave 158 stories of our lost Canadians largely untold.

If I was to offer advice as a reader, I would caution against the overuse of running jokes and satire. Most were amusing, and even informative in a single instance, but became disruptive with repetition. Regardless, I found at least one that was particularly effective: the author highlights how all CANADIAN FORCES trades get pulled into the grim aspects of war despite job titles and assignments. He suggests that some trades are perceived as notable or headline-worthy (such as pilot, surgeon and soldier) but that the story is incomplete without all members of the team (other medical professionals, logisticians, administrators, etc.), though there will be little recognition for them.

Canadian veterans should be encouraged by Dauphin’s candid and frank accounts (most notably when he openly discusses his own post-traumatic stress disorder [PTSD] experience). In finishing their own narratives, they may enable others to understand that, for so many of our brothers and sisters, the battle did not end when they were AIREVAC’d (air evacuated) to the role 3. For many, the wounded and their saviours alike, it had just begun.

If you are looking for an academic account of Major (acting) Dauphin’s tour as the Officer Commanding Role 3 Multi-national Medical Unit (MMU), Kandahar, complete with unit annotations, chronological accounts and operational analysis, this book is merely a curiosity. If you are interested in what happens to fellow Canadians as they become immersed in the bloody realities of life and death in a desperate country, this book is worthy of your time.


 Major Mark Nasmith, a Sea King airborne combat systems officer, is currently Officer in Charge of Electronic Warfare Operational Support with the Canadian Forces Aerospace Warfare Centre Detachment Ottawa.

Note

[1]. In general terms, a role 3 hospital is normally found at a larger unit, base or on-board a hospital ship. It has virtually all of the medical capabilities you would associate with a civilian facility and could include specialist diagnostic resources, specialist surgical and medical capabilities, operational stress management teams, etc.  (return)

 

 

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