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Medical text invokes photographic power

20th November 2008
a sick business

Medical textbooks rarely make news, but a new volume from the US Army has done just that, with more headlines sure to follow.

The book is titled, drily enough, War Surgery in Afghanistan and Iraq: A Series of Cases, 2003-2007, and the text is clinical and cold. It’s the photos that freeze you in your tracks - documentary evidence of what 21st century warfare does to living, breathing human bodies.

Faces are burned and bleeding, wound gush, limbs are torn to shreds, the victims mainly US soldiers but Iraqi and Afghan civilians appear too.

It’s intended as a guidebook of significant and advanced new techniques for surgeons on the battlefield, but the cases and photos testify to the brutal new nature of warfare in the 21st century.

A US military official recently described to me the case of a young marine undergoing surgery here for battlefield injuries that almost defy description. Most of his torso had been blown out by high-powered explosives that ripped right through a full suit of body armour. The assailants who effected this damage live in an Afghan cave.

Welcome to a brave new world of combat, in which explosive devices, not bullets, do the lion’s share of the maiming and killing.

Almost under wraps

War Surgery in Afghanistan and Iraq: A Series of Cases, 2003-2007 won’t be easy to find, and in fact nearly stayed under wraps entirely.

US Army surgeons general reportedly had to overrule military censors who wanted to quash the book out of fear its contents could be manipulated politically - just as journalists decry new curbs on their access to troops and combat.

Governments have always understood the power of battlefield images. And so, I would add, do guerrillas and insurgent leaders.

Decades before television cameras turned angry Americans against the quagmire in Vietnam, a German anarchist named Ernst Friedrich published a gut-wrenching collection of photos of German soldiers gruesomely disfigured in World War I.

Friedrich used donated funds to set up the world’s first anti-war museum in Berlin, whose collection stood for years as a quiet testament to the hideous ruin of war - until the Nazis came to power, seized the museum, burned its collections, and turned the building into a barracks, neutralising one of the most powerful anti-war statements the world had ever known.

Neither Friedrich’s collection nor this new textbook shows the hidden wounds - the traumatic brain injuries and post-traumatic stress disorder, often resulting in depression and suicide - that can follow soldiers for years after combat.

Wars destroy bodies, brains, and lives. Civilians too have always paid a terrible price - usually simply because they found themselves in the wrongest of places, at the worst of times - though they are now targets as well as collateral victims.

As a professional journalist, I am always inclined to seek and share more and not less information. I don’t believe in pulling punches.

Grisly photos of what happens to human bodies when despotic regimes or rogue commanders aim to destroy or disfigure them, once those photos are verified, should in many instances be published, with suitable warnings. Keeping them out of sight simply aids and abets the perpetrators.

War Surgery in Afghanistan and Iraq: A Series of Cases, 2003-2007 makes a powerful statement not only about the destruction wrought by violence but also about the extraordinary, often heroic, work of military medics to undo it.

Rebuilding human bodies requires vast, extraordinary, and innovative labor. My fondest wish right now is that every leader with the authority to destroy them would read this book and gape in wonder at what we humans are, and what - for better or for worse - we are capable of doing to one another.

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