Abstract
Urban ethnographers have been accused of “poverty porn,” with their fixation on documenting the plight of the black urban disadvantaged to advance academic careers. I didn’t think there was a medical ethnography equivalent form of exploitation, but apparently there is: gore porn. And boy, did we find an iconic example. For Doctors at War: Life and Death in a Field Hospital, Cambridge University business school sociologist Mark de Rond embedded in a military hospital in Afghanistan and wrote about the gruesome carnage of surgery in a war zone. Wide-eyed, he observes the surgeons trying to save life and limb of Afghans and soldiers alike maimed by self-inflicted, friendly, enemy, and formerly-friends-but-now-enemies fire of anything from homemade explosives to the Hellfire missile kind.
This is a book without a sociological warrant. No research question, no puzzle, no engagement with any literature or community of inquiry; just a curious, voyeuristic look behind the scenes. De Rond touches on potential hooks when he notes, all in passing, how surgeons struggle to reconcile their medical and military obligations, the recurring ethical conundrums when the standard of care for Afghans is the under-resourced local health care system, the ironies of trying to kill and fix up the same people, life or death decisions of civilian children, or coping with war-related stress. Even de Rond’s bread and butter topic, collaboration (his website mentions that he and a mate rowed down the Amazon river to study collaboration under trying circumstances), would have had potential for development. Instead, we get a lot of quick impressionism from someone who hasn’t put much thought into why he ventured into the desert or how to build on what came before.
It’s clear from the beginning that de Rond is in way over his head. The book is based on six weeks of research in Afghanistan preceded by some prep time, a great start for an MA thesis at most U.S. research universities. De Rond’s untrained gaze lingers momentarily on the issues that strike novices in any trauma area. The short chapters read like scorecard ethnography: three casualties came in, two survived, one didn’t make it even through triage, and a couple of limbs disposed of in the incinerator. Ninety-one pints of blood to stabilize a Marine. A slug through the buttocks with a big exit wound up front. It’s the kind of stuff you pick up from reading the white board in any large emergency department. Add some quoted jocular or stressed banter between doctors to lubricate transitions and you can imagine the book.
To be fair, de Rond has an appreciative ear for sexual joking and innuendo—the more juvenile, the better. A nurse, for instance, pins a post-it note with the word “cock” on his chest, which he interprets as an invitation for sex but may as well have been one of the most desperate attempts to put an obtuse ethnographer in his place and grant him some weeny functionality in a setting where he obviously does not belong. De Rond inserts an e-mail message to a friend recalling that his twelve-year old daughter caught him reading a doggerel about dicks, which, of course, he quotes. Not sure anyone, including him, knows the point of that. To compensate, de Rond writes in faux spicy British slang, the overwrought kind that makes you stop every couple of sentences to figure out what he means. For instance, “Brook’s fag sprang to life at 0514, the pulsating Chinook audible already against the higher-pitched purring of its trigger-happy chaperone” (p. 82).
Tellingly, de Rond’s pseudonym for the main general surgeon he follows is Hawkeye, which, he explains in a footnote, is a reference to the main character of the venerable MASH book, movie, and TV series. This is telling because rather than engaging any thoughtful reference point, this book is a clichéd version of TV representations of war zones. The simulacrum is mind boggling. De Rond notes repeatedly that during breaks medical staff watch war movies and reruns of M*A*S*H. His ethnography noir is an imitation of a real life-and-death situation, itself given meaning by decades-old TV shows. Yet, tracking the observations through popular culture and closely imitating the surgeon’s lingo and moral spectrum also forecloses the opportunity to bring fresh insights. It’s déjà vu of something that was much better in the original.
A high-ranking medical officer encouraged this gritty scholarly work on medicine in war zones. Things soured quickly when de Rond shared his drafts and lawyers had to be called in to parse out what could and couldn’t get published. He mentions how the British Ministry of Defense bought up the entire printing of another book it didn’t want to get published to pulp it. Here, I think they can save their money. This book does not reflect negatively on the military surgical service; it’s just a bloody joke.