Neil Pollock reviews Frontline Surgeon: New Zealand medical pioneer Douglas Jolly by Mark Derby for Health and History:
‘This is a superbly written book about an advanced New Zealand surgical trainee who delayed his surgical qualification exams to undertake humanitarian surgical activities in the Spanish Civil War of 1936–9. Frontline Surgeon then follows his activities after the war ended.
Jolly entered Otago University Medical School in 1924, having been raised in Cromwell, Central Otago with early education at Otago Boys High School, Dunedin. At medical school he was near the top of his class, and in his house surgeon and resident surgical years, he excelled with his surgical skill. A good athlete, he was selected for a New Zealand Universities rugby team. A member of the Student Christian Movement, his conservative Presbyterian upbringing came under challenge and he developed a non-doctrinal practice of Christian socialism. This belief system resulted in contact with Reverend Donald Grant and his family, an association that continued for the remainder of Jolly’s life. He joined their Christian Left group in the early 1930s.
Jolly left for London in January 1932 and worked and trained in London hospitals for the next four years. Derby provides excellent details covering Jolly’s subsequent activities. Unmarried and uncommitted and, consistent with his Christian Left thinking, he volunteered for surgical service to the Republican government of Spain, fighting the Nationalist rebels led by General Franco. He sacrificed sitting his final surgical examination with a similar attitude to that of his father who in 1916 joined the First World War effort, leaving at home a family of five young children. The author details Jolly’s surgical commitment in Spain and this evokes a certain amount of admiration, especially his establishment of a mobile field hospital capable of moving at short notice, staffed by volunteers from different countries. The field hospital treated wounded individuals, such as those with chest and abdominal injuries, who could not be moved a great distance. These mobile theatres could be set up in a matter of hours in buildings, tents, disused tunnels and mines. The description of a field hospital set up in a large cave, regarded as the safest place in Spain, demonstrated the innovation of Jolly and his surgical team. The mobile theatres were complemented by a blood donation and transfusion service, so important for the treatment of chest and abdominal injuries. Jolly was a rapid, extremely capable, and diligent surgeon driven to some extent by his Christian socialist values and antifascist views. Prepared to operate on troops of the opposing force, one assistant commented that he never seemed to tire or lose his concentration. One wonders how many injured defenders and indeed attackers had their lives extended because of this skilful surgeon.
The conditions of surgery could be extreme—severe cold in winter, heat and flies in summer, few sealed roads for transport of the injured, limited sources of running water, and inadequate sewerage systems. At times, lighting with candles and pocket torches was necessary to avert the inadvertent disclosure of building locations during nighttime Nationalist air raids.
Derby gives a detailed description of the Spanish Civil War, especially helpful to those with limited knowledge of this event. He briefly mentions anaesthesia with ether and Evipan, a barbiturate, the first short-acting intravenous general anaesthetic. Penicillin, recently introduced, was dusted on wounds as a powder, resulting in eighty to ninety percent of patients healing without infection.
In November 1938, Jolly left Spain with a reputation as an excellent, courageous, and totally reliable surgeon, returning to New Zealand where he tried to raise support, particularly amongst communist groups, for the declining Republican effort. On returning to Britain in February 1940 he enlisted with the Royal Army Medical Corps, opposing German fascism until the end of the Second World War. Jolly’s surgical exploits are again detailed by Derby including his development of a two-stage standard of wound treatment; progress in combatting sepsis, particularly with the use of penicillin; reduced mortality; and the publication of his manual Field Surgery in Total War (1941), used by many army leaders.
Derby details Jolly’s subsequent life, including his work in English hospitals. Regrettably, he was never able to practice surgery again. This incredibly talented surgeon did not pass his final qualifying exam which he almost certainly would have done had he not left New Zealand for the Spanish Civil War. He subsequently undertook non-surgical posts in London hospitals and was involved in the field of rehabilitation. He married in 1964 and suffered an intermittent deterioration in his health. Nonetheless he was able to continue working.
The first efforts to honour Doug Jolly’s achievements began in the early 2000s. A plaque honouring him was placed in the grocery store in Cromwell which had been owned by his father and relocated to dry ground after a hydroelectricity dam was constructed on the Clutha River to create the artificial Lake Dunstan.
Frontline Surgeon is a very readable, extensively researched, book. The author is to be congratulated on bringing to light the exploits of this relatively unknown Otago University medical graduate.’
