Dr David Nott: What It’s Really Like Being a War Doctor

Dr David Nott is a specialist in vascular and trauma surgery and author of the bestselling memoir War Doctor: Surgery on the Front Line. 

Recently he’s carried out life saving operations in Ukraine, where he also taught local doctors how to perform a range of procedures. Despite leaving the country, Dr David Nott continues to help doctors save lives in Ukraine by providing guidance remotely through the use of technology such as video calls.

Dr David Nott is known particularly for:

• Spending the past 25 years volunteering for international aid agencies to provide surgical treatment in conflict and catastrophe zones.
• Launching the Surgical Training for Austere Environments UK course which equips doctors with the skills needed to help people while working in, or travelling to, conflict and catastrophe zones.
• Founding the David Nott Foundation with his wife to train war doctors around the world. They set up the Hostile Environment Surgical Training overseas course which provides life-saving training to countries and doctors that need it most.

We’ve gathered information from interviews with Dr David Nott, where he’s spoken about various topics in this article. These include his experience of feeling like a failure at school, what motivated him to become a war doctor, the characteristics needed to become a war doctor, and his advice for those who dream of following in his footsteps. 

Overcoming challenges to achieve success

I was a useless student and hopeless at school. When I got 3 E's at A-level, someone rang me and asked what it was like to be a failure. Everyone in my class went to university but me.

My father was an amazing person. He sat me down and said: 'Do you want to feel like a failure or do you want to get on and do it?'. He was instrumental in changing my 3 E's to 3 A's and getting into medical school. 

I needed that push. I needed someone to say to me you’re not a failure. It made me determined to prove to everyone that I could be successful.

Why Dr David Nott decided to become a war surgeon

After I’d qualified as a consultant surgeon, I remember seeing footage of the siege of Sarajevo on television. There was a man who found his daughter underneath a load of rubble – he took her to hospital as she was seriously injured. There was no doctor there, no one to help her, so she died.

I felt this fire start in my heart and thought to myself, 'I’ve got to go and help them'. I felt a huge obligation to use the skills that I’d been taught over the past 10 years to become a consultant. If there wasn’t a surgeon there, then I was going to be that surgeon.

Advice for aspiring war doctors

Develop a speciality which you enjoy doing so you have something to fall back on. Humanitarian work is not like being in the NHS – you might be the only doctor for hundreds of thousands of people. 

It’s very difficult to go to a war zone when you have a spouse and children. If you want to get it out of your system, do it before you make any big life decisions such as getting married or buying a home. Do it as a young person. 

You have to be trained to do the job, probably at consultant level, and if you’re a surgeon you’ll need to be able to go out and operate safely (which requires a significant amount of training). 

What it takes to be a humanitarian doctor

As a humanitarian doctor, you’re dealing with head problems, chest problems, tracheal problems, orthopaedics, paediatrics, obstetrics, and so on. You need to develop a global response to the body and understand the various specialties you don’t understand at the moment. 

They’re not too difficult because there’s only a certain amount of things you can do without specialist equipment. You can do third world surgery – bread and butter surgery to allow a patient to survive their illness.

It is an extremely risky job going into a war zone so you have to be very savvy. You have to understand the situation that you’re in and put a different head on your shoulders. You can’t go in as the big person who knows everything. You’re going there as someone who will help, so you need to be subservient and diplomatic. 

You’re going to come across all personalities. The issue is everyone’s in a hyper-emotional state as they’re under pressure and worried about their life. What you have to understand is if you say something wrong or make a mistake, your life could be over. 

You might be assisting a surgeon who’s not that good, but you’re there to help, even if it’s just holding equipment for them. Over time, you can offer to help more and start to build trust. Before you know it, you start becoming friends.

Dr David Nott’s experience of being a war doctor

I know what people are suffering from and going through in various war zones across the world. I’ve experienced post-traumatic stress because of the things I’ve seen. 

I know what it’s like to be in those environments, but of course these people have to stay there, while we can come in and out and back to calmness. For a lot of people life is really hard. And we don’t really see or understand that - what hardship is like for many people. 

I visited Yemen when we heard people were requiring help in Marib. Marib is under government control with intense fighting going on. A group of us found that there were so many patients that had problems that weren’t treated, like holes in bones and arms and legs.

Some people were festering for 3 or 4 years at home, which means they can’t go out and work, so the family receives no support or help. I operated on 45 people and got them going again. I turned into a plastic surgeon, working alongside orthopaedic surgeons to reconstruct bones and cover the bones and skin. 

The beauty of being a war doctor is the ability to change people’s lives - the people we help can get back to some sort of reality. That’s why the David Nott Foundation is so important. It provides doctors with the knowledge of orthopaedics, plastics and general surgery to reconstruct not only people, but their lives too.

‍Take a look at our Admissions Guide for more information on each step of the journey to becoming a doctor.

Sources:

• David Nott: The war surgeon helping doctors save lives in Ukraine
• RSM In Conversation Live with Dr David Nott
• War Doctor: surgeon on the front line | David Nott OBE
• Dr David Nott, Conflict zone surgeon