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When Doctor Meets Dictator

BRITISH MEDICAL JOURNAL

January 13, 2007

Where does a doctor's responsibility as a civilian begin and his duty as a doctor end? Chloe Veltman is impressed by a film that grapples with this uncomfortable issue

When a homely, Scottish general practitioner raises a glass to toast his son's graduation from medical school, he little expects the heir to the family's doctoring tradition to wind up administering care to sick children in a remote part of Uganda, let alone becoming complicit in the local despot's killing spree. But with the prospect of treating little old ladies for gout in Edinburgh appealing to Nicholas Garrigan about as much as his mother's watery stew, The Last King of Scotland's adventurous, young protagonist goes to Uganda to offer his services as a physician, with little notion that he'll be arriving smack bang in the middle of a military coup.

It is this mixture of spirited gung ho and political naiveté that makes Garrigan a dictator's medical wet dream. As director Kevin Macdonald demonstrates in his taut screen adaptation of Giles Foden's 1998 novel, the combination can be lethal in a doctor thrust into the limelight at a time of civic unrest.

When Garrigan (played with boyish bravura by James McAvoy) first meets Ugandan autocrat Idi Amin (personified with frightening verité by Forest Whitaker) the two instantly hit it off. Amin is as much impressed by Garrigan's no nonsense approach to bandaging his sprained wrist as he is by the young man's roots: as a fervent admirer of all things Scottish (the real life Amin even went as far as to bestow the title of "King of Scotland" upon himself) the president sees in Garrigan the ideal confidante. Meanwhile, the doctor, susceptible to flattery and always on the lookout for an adventure, is easily won over by the affable African with the medal festooned chest. It isn't long before Garrigan decides to abandon his position as a medical relief worker at an impoverished village mission for the chance to live in luxury at the president's residence in Kampala.

During an eight year reign of terror between 1971 and 1979, Amin was responsible for the deaths of more than 300 000 Ugandans. Although Macdonald's film blends historic fact with a fictional premise (Garrigan, for one, is a made up character loosely based on a real life British soldier who became Amin's closest adviser during his presidential years) its understanding of human psychology rings devastatingly true. As such, The Last King of Scotland's shock value owes more to Garrigan's unwillingness to confront the fact that his patient is a bloodthirsty tyrant than any of the film's depictions of Amin's murderous stampedes.

For as long as he can, Garrigan clings to the tenets of the Hippocratic Oath, as if he believes it will somehow shield him from having to face a greater reality beyond that of his patient's petty medical complaints. "I'm a doctor. Everything that passes between us is confidential. I've taken an oath," he reassures the deeply paranoid Amin. For at least half of the film, the havoc Amin wreaks on his country flickers only faintly at the borders of Garrigan's conscience as he dutifully gets up in the middle of the night to deal with the president's many hypochondriac episodes. (At one point, Amin thinks he's been poisoned, but Garrigan correctly diagnoses a bad case of wind and advises his patient not to mix beer with aspirin.) Bombs explode and government officials mysteriously go missing, but Garrigan remains coolly professional, dispensing tough medical advice where necessary, but trying not to get politically involved.

Inevitably, Garrigan finds himself unable to untangle medical affairs from those of state. It doesn't help that from the start of their relationship, Amin treats Garrigan as a close adviser, broadening the physician's job description with a wide range of private and public responsibilities that include driving the president to the airport and selecting an architect to design a building for the upcoming Pan-African Congress. But Garrigan's professional crisis is not all Amin's fault. The doctor brings about his own downfall when his thrill seeking nature leads him into an adulterous tryst with one of the president's wives.

In an interview about his novel for the online review Boldtype, Foden called Amin a "greedy schoolboy." It's fascinating to see how the dictator and doctor—though very different people—share some of the same fundamental personality traits in Macdonald's film. The abuse of power isn't just Amin's in The Last King of Scotland; the grossly negligent Garrigan could also be accused of the same thing. If it weren't for the fact that McAvoy and Whitaker both manage to imbue their characters with so much sympathy, we wouldn't care about either man's fate. But the film leaves us grappling with the uncomfortable issue of where a doctor's responsibility as a civilian begins, and where his duty as a doctor ends.

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