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The letters begin much in the fashion of any young man away from home, perhaps in a quite exciting country, writing back to family and friends to tell them of his experiences, the sights he's seen and the people he's met. It's just a little different in ''Surgery on the Shoulders of Giants'' though: Saqib Noor is a junior doctor, training to be an orthopaedic surgeon and over a period of ten years he visited six countries, not as a tourist but to give medical assistance. They're countries which Noor describes as ''fourth world'' - third world with added disaster - and their need is desperate.