An Imperfect Offering

National Bestseller “As Albert Camus wrote, the doctor’s role is as a witness–to witness authentically the reality of humanity, and to speak out against the horrors of political inaction. . . . The only crime equaling inhumanity is the crime of indifference, silence, and forgetting.” —James Orbinski In 1988, James Orbinski, then a medical student in his twenties, embarked on a year-long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man. Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption. Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of Médecins Sans Frontières (Doctors Without Borders/MSF). As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, Afghanistan. In April 1994, James answered a call from the MSF Amsterdam office. Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis. While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali. As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties. In fourteen weeks 800,000 men, women and children were exterminated. Half a million people were injured, and millions were displaced. The Rwandan genocide was Orbinski’s undoing. Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man. In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization’s president when it was awarded the Nobel Peace Prize in 1999. An Imperfect Offering is a deeply personal, deeply political book. With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty-first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed. He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives. He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy. Here he is doctor as witness, recording voices that must be heard around the world; calling on others to meet their responsibility. “Ummera, ummera–sha” is a Rwandan saying that loosely translated means ‘Courage, courage, my friend–find your courage and let it live.’ It was said to me by a patient at our hospital in Kigali. She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated. Her face had been so carefully disfigured that a pattern was obvious in the slashes. I could do little more for her at that moment than stop the bleeding with a few sutures. We were completely overwhelmed. She knew and I knew that there were so many others. She said to me in the clearest voice I have ever heard, “Allez, allez. Ummera, ummera-sha”–‘Go, go. Courage, courage, my friend–find your courage and let it live.’ —From An Imperfect Offering

"This book is a series of stories in which I ask, again and again, 'how to be in relation to the suffering of others.' It is a personal narrative about the political journey I have taken over the last twenty years as a humanitarian doctor, as a citizen, and as a man. This is a story about a way of seeing that requires humility, so that one can recognize the sameness of self in the other. It is about the mutuality that can exist between us, if we so choose. I have come to see humanitarianism not as separate from politics, but in relation to it, and as a challenge to political choices that too often kill or allow others to be killed. Speaking is the first political act. It is the first act of liberty, and it always implicitly involves another. In speaking, one inherently recognizes that 'I am and I am not alone.' In this space lies our humanity." Having seen things we hope never to see, confronted suffering, dispassion, and evil we hope never to encounter, and faced deep personal torment, James Orbinski still believes in "the good we can be if we so choose." His chosen medium is stories from his own experience-a form of testimony from the front lines-embodied in which are warnings, hope, and lessons in how we can inject humanitarian activity into our lives. Being political, he has discovered, is not only reserved for politicians; admitting imperfection is essential to compassion. The crystal clarity of Orbinski's voice is matched by the urgency of his message; at a time of great political and moral uncertainty, An Imperfect Offering is invaluable reading for anyone who feels he/she can make a difference.

Describes the author's experiences as a doctor for Doctors Without Borders in countries such as Somalia, Afghanistan, and Rwanda; the conditions he witnessed; and the political roadblocks that prevented aid from reaching patients.

Does life have meaning? Is it possible for life to be meaningful when the world is filled with suffering and when so much depends merely upon chance? Even if there is meaning, is there enough to justify living? These questions are difficult to resolve. There are times in which we face the mundane, the illogically cruel, and the tragic, which leave us to question the value of our lives. However, Iddo Landau argues, our lives often are, or could be made, meaningfulwe've just been setting the bar too high for evaluating what meaning there is. When it comes to meaning in life, Landau explains, we have let perfect become the enemy of the good. We have failed to find life perfectly meaningful, and therefore have failed to see any meaning in our lives. We must attune ourselves to enhancing and appreciating the meaning in our lives, and Landau shows us how to do that. In this warmly written book, rich with examples from the author's life, film, literature, and history, Landau offers new theories and practical advice that awaken us to the meaning already present in our lives and demonstrates how we can enhance it. He confronts prevailing nihilist ideas that undermine our existence, and the questions that dog us no matter what we believe. While exposing the weaknesses of ideas that lead many to despair, he builds a strong case for maintaining more hope. Along the way, he faces provocative questions: Would we choose to live forever if we could? Does death render life meaningless? If we examine it in the context of the immensity of the whole universe, can we consider life meaningful? If we feel empty once we achieve our goals, and the pursuit of these goals is what gives us a sense of meaning, then what can we do? Finding Meaning in an Imperfect World is likely to alter the way you understand your life.

Jessica Alexander arrived in Rwanda in the aftermath of the 1994 genocide as an idealistic intern, eager to contribute to the work of the international humanitarian aid community. But the world that she encountered in the field was dramatically different than anything she could have imagined. It was messy, chaotic, and difficult—but she was hooked. In this honest and irreverent memoir, she introduces readers to the realities of life as an aid worker. We watch as she manages a 24,000-person camp in Darfur, collects evidence for the Charles Taylor trial in Sierra Leone, and contributes to the massive aid effort to clean up a shattered Haiti. But we also see the alcohol-fueled parties and fleeting romances, the burnouts and self-doubt, and the struggle to do good in places that have long endured suffering. Tracing her personal journey from wide-eyed and naïve newcomer to hardened cynic and, ultimately, to hopeful but critical realist, Alexander transports readers to some of the most troubled locations around the world and shows us not only the seemingly impossible challenges, but also the moments of resilience and recovery.

An inspiring story of one doctor’s struggle in a war-torn village in the heart of Sudan In 2007, James Maskalyk, newly recruited by Doctors Without Borders, set out for the contested border town of Abyei, Sudan. An emergency physician drawn to the ravaged parts of the world, Maskalyk spent six months treating malnourished children, coping with a measles epidemic, watching for war, and struggling to meet overwhelming needs with few resources. Six Months in Sudan began as a blog that Maskalyk wrote from his hut in Sudan in an attempt to bring his family and friends closer to his experiences on the medical front line of one of the poorest and most fragile places on earth. It is the story of the doctors, nurses, and countless volunteers who leave their homes behind to ease the suffering of others, and it is the story of the people of Abyei, who endure its hardship because it is the only home they have. A memoir of volunteerism that recalls Three Cups of Tea, Six Months in Sudan is written with humanity, conviction, great hope, and piercing insight. It introduces us to a world beyond our own imagining and demonstrates how we all can make a difference.

Syler explains how she learned to chuck perfection for practicality, offering sage advice and tips on navigating different obstacles while offering real wisdom about mothering that is tempered with humor and warmth.

A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine. Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is -- complicated, perplexing, and profoundly human. Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives. At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor. Complications is a 2002 National Book Award Finalist for Nonfiction.