Triage: Dr. James Orbinski

A review of the documentary, "Triage:  Dr. James Orbinski's Humanitarian Dilemma," 2007, on NetFlix now.

Dr. James Orbinski worked with Doctors Without Borders for many years, eventually ending up as their president.  He treated hundreds of people in Somalia, Rwanda (during the genocide), and elsewhere.

This man -- this clear-eyed, kind, intelligent man -- knocked my socks off with his combination of softness; caring; controlled, focused rage; courage; and stamina.  He kept showing up in the most hellish, needful places on earth.

There are many ways to be of service.  There are those who look at the enormous, rickety machine we call the world, and study it for years, looking for the one bolt that, if turned, would effect the most positive change.  The one gear box that, were it to be replaced, would increase the performance of the machine ten-fold. 

This is not Dr. Orbinski's approach.  He looks at the globe, finds the area seething with the most human suffering, grabs his black bag, and dives in head first, bandaging, suturing, injecting, amputating, balming.  Every few hours, covered in blood from head to toe, he pauses, lifts his head up, takes a breath and a sip of water, only to plunge back into the melange of guts and gore.

Below I quote a few passages from the documentary which, dare I allow my authoritarian side to speak, ought to be required viewing for every human being on earth.  You may also like to read the doctor's book -- "An Imperfect Offering:  Humanitarian Action for the Twenty-First Century."

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"To be politically neutral, you have to be the most political of animals.

"Everything depends on information, and trying to be as clear as possible about who you are, what it is you are trying to accomplish, what risks you are NOT prepared to take, and so on."

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A professor interviewed in the film:

"When the battle is raging, NGOs (non-government organizations) simply cannot function.

"[You need security.]

"You need the military, but if you are identified with the military, you lose that independence which is absolutely crucial to actually serve populations on all sides of a conflict.  How do you walk that fine line?"

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"The genocide (in Rwanda) was a collective act.  What made it possible, what made that final political crime possible, was the absence, the erasure, of seeing the other.  Of knowing, of feeling, of being with the other.  And when that's removed, then politics
can become genocidal."

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A Rwandan woman with children:

"People would say, 'Everyone that went this way died.'  People would say, 'Everyone that went that way were killed.'  And I said, 'My God, what can I do?'  I was all mixed up because I was scared.  I didn't have any money to support my kids.  My youngest was only a month old and I was still too weak to do anything.  So I was panic-stricken."

(This family managed to get into the hospital compound.  At night they would sneak into Dr. Orbinski's room and sleep in the closet.  He never objected -- rather, he became friends with them.  Many years later, when he returned for a visit, the woman told him about her stealth.  She said, "we snuck in every night and you never knew."  He replied with a smile, "I knew.")

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[This next is an accurate paraphrase]

"I was operating on a woman in Rwanda.  She was macheted.  I pulled a piece of skin with my forceps -- it hurt her.  She touched my arm.  I looked up from her abdomen, and looked into her eyes....

"She had had both of her ears cut off.  And both of her breasts cut off.  And both of her Achilles tendons sliced.  And she had a pattern of cuts etched into both of her cheeks and her forehead -- a delicate pattern -- someone had taken his time doing this.  And there was dried semen between her legs.

[Long pause]  "And suddenly I was no longer a dispassionate doctor, a skilled technician.  Her humanity flooded into me.  I turned away and vomited."

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(About a girl not leaving her nearly-dead mother in the midst of corpses and shit and blood):

"I don't think it's heroic -- I think it's decent."

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"The very existence of MSF (Doctors Without Borders) is predicated on the refusal to accept the unacceptable, and that by definition means being free, and using your liberty in a very particular way.  And trying to stay out of the established corridors of power...which doesn't mean you don't walk through them...but it means you don't become them."

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Being free.  And using your liberty in a very particular way.

My experience of this simple statement is enormously complex; rife with dozens of conflicting thoughts and feelings and emotions and sensations.  Dr. Orbinski must certainly have shared a few of them.  And yet, he found a way to get up and go on.  He found his way to serve.  This fearless surgeon inspires me to continue on.