LONDON – As a barometer of Saddam Hussein’s declining grip on reality, we need look no further than the state of his feet. With bombs raining down on Baghdad, his people poisoned by the water supply, and his enemies being routinely tortured, the dictator’s main preoccupation was getting relief from the corns on his right foot. More revealing still, he would never have had corns in the first place if he had not, out of sheer vanity, worn shoes that were two sizes too small and much too narrow.

Oblivious to impending disaster, his female relatives behaved with just the same petty self-obsession. In the countdown to war in 2003, three of them – including his 16-year-old granddaughter – were lining up, like competitors in a beauty contest, to have plastic surgery to straighten or reduce their noses.

No one is better placed than a personal physician to shatter a tyrant’s self-image with a few well-chosen details, and Dr. Ala Bashir, former head of plastic and reconstructive surgery at Baghdad University, is able to expose the full megalomaniac absurdity of Saddam and his family because he saw them, corns and all, at their dysfunctional worst.

Dr. Bashir was at the mercy of the Hussein clan’s trivial summonses for 20 years, often having to abandon more serious cases to attend to them. He was forced to operate repeatedly on Saddam’s psychotic aunt (“Happiness for her was a general anesthetic”), even though her ailments were entirely imaginary – this was a woman, after all, who had executed two servants she suspected of stealing. “We quite simply dared not stop the nonsense and say enough was enough,” he admits.

Dr. Bashir pieced together Saddam’s psychopathic eldest son, Uday, after a failed assassination attempt in 1996 left him disabled and brain-damaged. “It was more difficult to gauge the extent of any damage to the brain,” he notes dryly. “He was already insane.” At some risk to his own life [since Saddam demanded to be informed of any medical procedure on a member of his family], he performed a secret facelift on Samira Shahbandar, the mistress who was to become the dictator’s second wife, and passed it off as the removal of a small growth from behind her ear. This must have been demeaning for a man who treated the victims of atrocity and rose to prominence as a plastic surgeon during the Iran-Iraq war, when he and his team performed more than 22,000 operations on wounded soldiers from both sides.

When Saddam was involved in a car crash in 1991, Dr. Bashir recalls that the lacerated dictator refused to have his face bandaged because it would have made him look weak on television, but for weeks afterwards he was obsessed by an injury to his little finger. The man who terrorized and tortured his subjects for decades could not bear the slightest physical discomfort or impairment. He even tried to hide the fact that he dyed his moustache. “I am not violating the oath of my profession by telling these trivial stories,” Dr. Bashir says. “I just wanted to show that this family was divorced from reality. These small operations are related to important events in the history of Iraq.”

The provider of so many far from trivial insights into the Saddam psyche is a conspicuously tall, bird-like man with a beakish nose, mahogany skin, and long wispy white hair floating either side of his bald head. The backs of his delicate hands bristle with black hair. His manner is courteous but also infuriatingly oblique, as if he is on a higher mission than answering questions.

Formerly Iraq’s most highly decorated doctor, Dr. Bashir left his country three months after the outbreak of war. From the safe suburb of Nottingham, England, where he now lives with his wife and daughter, he has written a book called “The Insider.” Based on diaries he kept clandestinely and gave to friends in plain envelopes for safekeeping, it is a stomach-churning chronicle of brutality, corruption, casual violence, and intrigue – as well as endless nose jobs.

Dr. Bashir extols his memoir as a salutary study of the corrosiveness of absolute power, rather than the story of a single despot. He must be unique among authors in actually trying to make his book sound less interesting than it is. In fact, Dr. Bashir is a unique witness from Saddam’s inner sanctum, and the devil is in the detail. He recalls Uday’s hundreds of expensive cars being torched by his father as a punishment for killing his valet, and Saddam puffing on a Havana cigar while watching them burn. The women who came to his clinic for treatment after being knifed or disfigured by cigarette burns in Uday’s vodka-fuelled bedtime frolics. Saddam’s superstition about black cats and plastic bags – encountered on the road, either would cause him to divert his motorcade. The municipal redirection of sewage from one neighborhood to another, according to who was paying for a less fetid life.

Dr. Bashir, who first came to Saddam’s notice as an eminent painter and sculptor, says he had no choice but to accept the dictator’s invitation to join his team of personal doctors. “I was really sad. I knew I would lose my freedom – and I did. I knew I would be followed day and night. I was. I knew I would not be able to travel. I knew my telephone would be bugged. All this happened. I was afraid for my life. It was like walking on the edge of a knife or a sword.”

What he didn’t anticipate was Saddam’s method of testing his professional probity by sending him a stream of beautiful women, allegedly to have their hymen repaired. Restoring hymens is big business in a Muslim country where female “virtue” commands a high price. “You can lie and cheat, steal, and kill – and keep your honor intact,” says Dr. Bashir, “but you must never give away a daughter who is without virtue.” The doctor became suspicious when so many of the women stripped off for him and jumped on to the examination couch without shame or embarrassment. “It was all too clear that they had been sent to lead me into temptation.”

While many of his friends paid with their lives for their frank opinions, Dr. Bashir seems to have led a charmed but often humiliating existence as a “Saddam favorite,” whose professional decisions were given a degree of respect. On one occasion, he refused to reshape the face of a would-be assassin employed by the Iraqi secret service. And, nearing the outbreak of war, he declined to perform breast and bottom reductions on prostitutes favored by one of Saddam’s relatives.

Being an artist was another plus. He was required to celebrate the leader’s heroic deeds in paint and monuments as well as operate on his feet and look after his blood pressure. Not surprisingly, Dr. Bashir’s position made him unpopular with Saddam’s conniving inner circle. It was like “swimming among sharks,” he says.

Dr. Bashir’s account of atrocities in Baghdad and the death-throes of a disintegrating regime is almost devoid of personal commentary – although he does allow himself some spleen over Uday’s grisly career. “Saddam’s greatest mistake,” Dr. Bashir says, “was to let his crazy son do what he did. He played a very bad role in the destruction of Iraqi society.”

He describes his book as “a tiny, tiny effort” to offer the Iraqi people honest information without personal animus. “I am describing events I have seen myself which are 100% true. But I try not to explain how or why they happened. I am a witness. I didn’t like Saddam or the regime but I didn’t write under the shadow of hate. The book contains less than 20% of what I know.”

Dr. Bashir demolishes the widely held Western belief that Saddam had many doubles. As a plastic surgeon, he says, he would have known. “Neither I nor any of my fellow plastic surgeons in Iraq had anything to do with altering someone’s face to look like the president. I certainly saw no one like him.”

Dr. Bashir, 64, and his wife, Amel, have three grown-up sons and a daughter. The two eldest sons, Sumer, 32, and Tahsin, 30, are engineers, both born in England where their father worked as a surgeon after gaining his degree from the Royal College of Surgeons in Edinburgh. They all now live in Nottingham. Mrs. Bashir left Iraq 18 months before the war but Dr. Bashir remained until after Saddam was toppled (“my love for my country was greater than my hatred of the regime”), finally leaving in July 2003 when his house was plundered, down to the last teaspoon, in the general mayhem, and his doctor friends were being killed. “There was a total loss of law and order and security. Criminals were free to move and steal and kill.”

He doesn’t expect to practice as a doctor again, preferring to concentrate on his art. He still has a share in a private hospital in Baghdad and a small income from a rented house. “I taught myself to go forward. Looking back is a waste of time. You lose the future.” As for Saddam, vain to the end, Dr. Bashir expects the prisoner to spend the rest of his days trying to “reshape himself in history” and obliterate the image of a confused, disheveled old man being dragged from a hole in the ground by American soldiers. “He is finished,” he says. “What does it matter whether he is executed?”