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This assignment consists of a 3,000-word (maximum) essay detailing a negotiating strategy. For details on assessment, please see Marking Guidelines. The project will be given in session 1 for submission at 9am Tuesday on 7th March.
What follows is a description of an ongoing quarrel between an academic (“The Author”) and the UKs Ministry of Defence (“MoD”), through the office of the surgeon general (“SG”), around the publication of a controversial new book. The book details the lived experience of a surgical team in Camp Bastion’s field hospital during a tour of duty in 2011. An abstract and some early reviews of the book are provided below and a Legal Opinion appended.
Partly as a result of the threat of legal action by the MoD, no publisher in the UK has been willing to take on the book manuscript. Thus, it will initially be published in the US in March 2017. Upon discovering that the book is about to be published, the MoD has called for an urgent meeting between The Author, representatives of his University, and the SG. Based upon an earlier visit, the SG is likely to be accompanied by several members of his team, another general, and in-house legal counsel. The summons to Whitehall includes a restatement of the MoD’s strong objection to publication of the book (in any form). The University’s legal team have suggested the MoD might be planning to file an injunction and/or DA-Notice and be preparing a libel case against The Author. The University’s legal counsel also reiterated a view originally communicated to The Author two years previously, namely that “if the MoD doesn’t want to the book to be published, it won’t be published” but without offering any details. They discouraged The Author from pursuing publication then, and are highly unlikely to be supportive now. It is unclear who will represent the University at the meeting but it is safe to assume that the party includes legal counsel.
The meeting is scheduled for next week. Prepare an evaluation of each of the party’s (The Author, the University, and the MoD) negotiating position. Then, prepare a detailed negotiating strategy for The Author.
Doctors at War: Life and Death in a Field Hospital
Cornell University Press (ILR)
March 2017
Doctors at War is a candid account of a trauma surgical team based, for a tour of duty, at a field hospital in Helmand, Afghanistan. The author tells of the highs and lows of surgical life in hard-hitting detail, bringing to life a morally ambiguous world in which good people face impossible choices and in which routines designed to normalize experience have the
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© 2017. Mark de Rond
unintended effect of highlighting war’s absurdity. With stories that are at once comical and tragic, the author captures the surreal experience of being a doctor at war. He lifts the cover on a world rarely ever seen, let alone written about, and provides a poignant counterpoint to the archetypical, adrenaline-packed, macho tale of what it is like to go to war.
Here the crude and visceral coexist with the tender and affectionate. The author tells of well-meaning soldiers at hospital reception, there to deliver a pair of legs in the belief that these can be reattached to their comrade, now in mid-surgery; of midsummer Christmas parties and pancake breakfasts and late-night sauna sessions; of interpersonal rivalries and banter; of caring too little or too much; of tenderness and compassion fatigue; of hell and redemption; of heroism and of playing God. While many good first-hand accounts of war by frontline soldiers exist, this is one of the first books ever to bring to life the experience of the surgical teams tasked with mending what war destroys.
Early (invited) reviews
“In Doctors at War, the author shines a light on a reality we are not supposed to see. It is a reality, especially in an age of endless techno war, we must confront if we are to recover the human.”—from the Foreword by Chris Hedges
“Brilliantly written, brutally honest and often very funny, this is a powerfully affecting book. Think ‘House of God’ with its tired, funny, sometimes cynical but totally dedicated medics; mix in some ‘Dispatches’ add a handful of MASH and you have ‘Doctors at War’. The book shows the other side of the vapid myth-making surrounding ‘our troops’ and deserves a place as one of the best books to come out of the Afghanistan debacle … In order to get the book published, The Author needed to endure the threats and obstruction of the British Ministry of Defence … The very fact of that obstruction tells you that this is a book that needs to be read by anyone still under the misapprehension that there is anything positive in the delivery of high explosives. “—Frank Ledwidge, former military intelligence officer, barrister, and author of Losing Small Wars.
A Brief History
The idea of writing something that would bring the lived experience of doctors at war closer to the general public was originally that of a high-ranking medical officer (“The Officer”). He had been instrumental in helping to secure permission for the author’s deployment to Afghanistan. He had read one of The Author’s previous books, The Last Amateurs, based on an ethnography of a Cambridge University rowing crew and was keenly aware that no such work existed on rear-located medical staff. Might The Author be persuaded to write a similar book about them? Given that he was a veteran of many tours, a senior military officer, and well versed in the contemporary literature on war, The Author considered himself in good hands. What began as a suggestion, over time, became resolve: over the next couple of years
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The Author was to receive more than twenty e-mails, and about the same number of text messages, to remind him specifically of the book project. Following are some examples:
I do think the whole military team issue is ripe for a “last amateurs” type book. Thoughts?
Upon The Author’s return from Camp Bastion, and again with reference to his rowing ethnography:
Hope CCAST flight was useful- pse give me a call when you are rested and we can discuss your thoughts about the whole experience. There are lots of parallels with the “last amateurs” I think; although the conflict is still ongoing you joined a particular group in their own race preparation and saw them out on the ground
And ten days later:
Any more thoughts on the “last bastion amateurs” project?
As if The Author needed reassurance that it did not need to be a scholarly text but one that would speak to the general public:
The “last bastion amateurs” is a distinct project to your academic study
The Author had promised, upon his return, to write a report for the SG on his observations of teamwork during his deployment. This report included detailed descriptions of examples of the consequences of boredom, of the lack of psychological safety, and of the experience of futility among medical staff. The Officer perused a draft of it and wrote:
Excellent—the vignettes are v strong—the basis of a book!!!
To be confronted daily with the human consequences of war had left The Author feeling disillusioned with what he felt was a pedestrian, low-stakes, egocentric game of academia. For a while afterward he toyed with the idea of abandoning his academic post and retrain as a surgeon instead:
Never too old for med school; but in the first place tell our story with the book!
As The Author began drafting the book based on his field notes, he became aware that some of the material, upon reading, might not curry favor with the MoD). When he shared his reservations about some of the material with The Officer, worrying that not all of it would
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make for comfortable reading, The Officer dismissed his concerns, insisting that The Author write candidly and without fear of censorship. The Officer sent him a link to a piece in the Spectator magazine by Toby Harnden, that told of how the MoD were so keen to prevent his own book, Dead Men Risen, from publication that they bought, and pulped, the entire print run at a cost of £151,450 to the British taxpayer.
Unlike The Author, Harnden had signed “an inch-thick contract agreeing to submit any book manuscript to the Ministry of Defence for it to be checked for “operational security” and “accuracy.” The review process that ensued “felt like the literary equivalent of undergoing several colonoscopies a week,” Harnden wrote, and resulted in requests for 493 changes to be made. Many of these changes were inconsequential and designed to burnish the reputations of certain officers. Threats of an injunction and DA-Notice later, the ministry finally dropped the matter but not before deleting a notable clause in their settlement with Harnden, namely to deal with the publisher and author “on a fair and transparent basis” in the future. As Harnden wrote, there was at least some honesty and consistency in that. His excellent article is worthwhile reading in full.
The Author wondered as to The Officer’s intentions in sending him a link to the Harnden article. Should he worry, The Author, upon which The Officer replied:
No—just educational . . .
There was quite clearly a sense that a candid account of the everyday experience of combat surgical teams would be a welcome addition to the war literature. This was also The Author’s impression from others during his deployment in Camp Bastion, and indeed his field notes contain several references to discussions with doctors and nurses about the idea of writing a book about their experience of war. In addition, The Author had left a copy of The Last Amateurs in the Doctors’ Room for anyone to pick up and read, which several did, and which they commented on and appeared to have enjoyed. Sometime after the deployment, he started drafting the book, realizing full well how much is riding on publications in the academic community. While the original research proposal developed in collaboration with two senior MoD officers did not mention the publication of a book, it did not explicitly exclude this possibility either. It is often difficult to foresee beforehand what publication opportunities the fieldwork will provide.
The Author finished a thinly disguised first draft in December 2012. The Officer meanwhile was on his own tour of duty to Camp Bastion and asked to see a copy of it. The Author explained that he could only ever show him the text on the explicit understanding that this would be for The Officer’s eyes only, and not to be passed on in any way, shape or form. With a written promise of confidentiality under his belt, The Author sent him the work-in-progress. The Officer read the draft, expressed concern and, without further consultation, sent the confidential manuscript straight on to the office of the SG who, in turn, made a bee-line for the vice chancellor of The Author’s University. He wished to discuss what The Author could, and could not, write about. The vice chancellor’s office passed the baton to The
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Author’s department head, and both were summoned to Whitehall—where the ministry resides—for an urgent meeting. In a preparatory meeting, the University’s legal team made it clear they would not be supportive. While at Whitehall, The Author and his department chair were told in no uncertain terms that the ministry opposed the book in its current form and would continue to do so in any form, even fictionalized. They worried the book might damage the interests of the United Kingdom internationally, seriously obstruct the promotion or protection by the United Kingdom of those interests, or endanger the safety of British citizens abroad. They suggested that any misconduct as reported in the manuscript could mean they might investigate these individuals. One of the deployed doctors most at risk wrote to the SG of his own accord, telling him that “there is nothing in the Bastion story that is made up” and expressing the “hope that the ‘Bastion story’ is accepted as a true representation of those six weeks, as I believe it is.” The Author subsequently sent this doctor a more developed version of the manuscript for his perusal, accommodated the few minor concerns he had, and was given the doctor’s blessing to proceed with publication.
In a separate letter, and after having delayed the matter for many months, the SG expressed his concern that it would be “extremely difficult to provide a reader in a work of this nature with the necessary depth and background to understand complex clinical decision-making in a war zone. This may lead to excerpts being read out of context which is my principal concern regarding the publication of this manuscript.” The Author thought this a fair concern and did his best to fill in at least some of the background. The final manuscript contains only a few examples of clinical decision making, and where they do exist they are described principally in terms of how these decisions were experienced by the doctors and nurses involved.
In his letter, the SG also included a list of objections—something The Author had asked for eighteen months earlier. This list, when it finally did arrive, contained fifty-five numbered objections organized along four categories: reputation, patient confidentiality, staff identification, and coalition/operational security. Perhaps unsurprisingly, of these objections, 90 percent related to concerns with the Ministry of Defence’s reputation.
In truth, The Author’s worry was never really with the legal implications of publication: he insists that he did what he did in good faith and without violating any signed agreement (which was easy enough to do, as The Author was never asked to sign any paperwork, not even the Official Secrets Act). He says he took care to disguise the identities of patients as best he could. Where people told him things in confidence—whether patients or staff—he always respected this confidence. An independently commissioned opinion (“legal read”) by a reputable London-based law firm that specializes in libel law made it clear that the ministry would likely have insufficient legal basis on which to file an injunction against, or otherwise prohibit publication of the book, and reassured The Author that the MoD’s bravado and bullying were entirely true to type.
The lawyer for the US publishing house explained that s/he thought the manuscript publishable provided The Author made whatever changes were recommended in the (by The Author) commissioned “legal read”. This was all done. The Author also accommodated
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several of the more pressing concerns of the SG, as per his letter. The publishing house explained that any legal action would remain the responsibility of The Author.
Legal obligations aside, The Author worried about his moral obligations towards those he embedded with. He was concerned not to put them in harm’s way by means of a straightforward, descriptive account of life in, and behind, the scenes in a war hospital, even if this is what they themselves seem to have wished for. To achieve that The Author did what he could to render the manuscript unreliable if it were ever used as evidence in a witch hunt, by obscuring identities and, in very rare cases, by means of deliberate misattribution. He also destroyed the hard drive that contained his original field notes.

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