She passed through one more doorway, entered one more room. Its floor was bare and white, as were its walls. Above was a small round aperture through which poured a shaft of scalding sunlight. Otherwise, the shadows prevailed. In one corner, the farthest, four heavily armed ISIS fighters stood in a ragged circle, eyes lowered, like mourners at a graveside. Dust coated their black costumes. It was not the khaki-colored dust of the desert; it was pale and gray, concrete that had been smashed into powder by a sledgehammer from the sky. At the feet of the four men was a fifth. He lay supine upon a stretcher, one arm across his chest, the other, the left, at his side. There was blood on the left hand, and blood stained the bare floor around him. His face was pale as death. Or was it the gray dust? From across the room, Natalie could not tell.
The senior Iraqi nudged her forward. She passed through the cylinder of sun; its heat was molten. Before her there was movement, and a place was made for her among the mourners. She stopped and looked down at the man on the stretcher. There was no dust on his face. His ashen pallor was his own, the result of substantial loss of blood. He had suffered two visible wounds, one to the upper chest, the other to the thigh of the right leg—wounds, thought Natalie, that might have proven fatal to an ordinary man, but not him. He was quite large and powerfully built.
He is everything you would expect . . .
“Who is he?” she asked after a moment.
“It’s not important,” answered the Iraqi. “It is only important that he lives. You must not let him die.”
Natalie gathered up her abaya, crouched beside the stretcher, and reached toward the chest wound. Instantly, one of the fighters seized her wrist. This time, the grip was not gentle; it felt as though her bones were about to crack. She glared at the fighter, silently chastising him for daring to touch her, a woman who was not a blood relative, and then fixed the Iraqi with the same stare. The Iraqi nodded once, the iron grip relaxed. Natalie savored her small victory. For the first time since her arrival in Syria, she felt a sense of power. For the moment, she thought, she owned them.
She reached toward the wound again, unmolested, and moved aside the shredded black garment. It was a large wound, about two inches at its widest, with ragged edges. Something hot and jagged had entered his body at extremely high speed and had left a trail of appalling damage—broken bone, shredded tissue, severed blood vessels. His respiration was shallow and faint. It was a miracle he was breathing at all.
“What happened?”
There was silence.
“I can’t help him unless I know how he was injured.”
“He was in a house that was bombed.”
“Bombed?”
“It was an air strike.”
“Drone?”
“Much larger than a drone.” He spoke as if from personal experience. “We found him beneath the debris. He was unconscious but breathing.”
“Has he ever stopped?”
“No.”
“And has he ever regained consciousness?”
“Not for a moment.”
She examined the skull, which was covered with thick dark hair. There were no lacerations or obvious contusions, but that meant nothing; serious brain trauma was still possible. She lifted the lid of the left eye, then the right. The pupils were responsive, a good sign. Or was it? She released the right eyelid.
“What time did this happen?”
“The bomb fell shortly after midnight.”
“What time is it now?”
“Ten fifteen.”
Natalie examined the gaping wound to the leg. A challenging case, to say the least, she thought dispassionately. The patient had been comatose for ten hours. He had suffered two serious penetration wounds, not to mention the likelihood of numerous additional fractures and crush injuries common to victims of building collapses. Internal bleeding was a given. Sepsis was just around the corner. If he were to have any hope of survival, he needed to be transported to a Level 1 trauma center immediately, a scenario she explained to the clawed Iraqi.
“Out of the question,” he replied.
“He needs urgent critical care.”
“This isn’t Paris, Dr. Hadawi.”
“Where are we?”
“I can’t tell you that.”
“Why not?”
“For security reasons,” he explained.
“Are we in Iraq?”
“You ask too many questions.”
“Are we?” she persisted.
With his silence he confirmed that they were.
“There’s a hospital in Ramadi, is there not?”
“It’s not safe for him there.”
“What about Fallujah?” She couldn’t believe the word had come out of her mouth. Fallujah . . .
“He’s not going anywhere,” the Iraqi said. “This is the only place that’s safe.”
“If he stays here, he dies.”
“No, he won’t,” said the Iraqi. “Because you’re going to save him.”
“With what?”
One of the fighters handed her a cardboard box with a red cross on it.
“It’s a first-aid kit.”
“It is all we have.”
“Is there a hospital or a clinic nearby?”
The Iraqi hesitated, then said, “Mosul is an hour’s drive, but the Americans are attacking traffic along the roads.”
“Someone has to try to get through.”
“Give me a list of the things you need,” he said, extracting a grubby notepad from the pocket of his black uniform. “I’ll send one of the women. It could take a while.”
Natalie accepted the notepad and a pen and wrote out her wish list of supplies: antibiotics, syringes, surgical instruments, gloves, suture material, a stethoscope, IV bags and solution, a chest tube, clamps, pain medication, sedatives, gauze, and plaster bandages and fiberglass casting tape for immobilizing fractured limbs.
“You don’t happen to know his blood type, do you?”
“Blood type?”
“He needs blood. Otherwise, he’s going to die.”
The Iraqi shook his head. Natalie handed him the list of supplies. Then she opened the first-aid kit and looked inside. Bandages, ointment, a roll of gauze, aspirin—it was hopeless. She knelt beside the wounded man and raised an eyelid. Still responsive.
“I need to know his name,” she said.
“Why?”
“I have to address him by his real name to bring him out of this coma.”
“I’m afraid that’s not possible, Dr. Hadawi.”
“Then what shall I call him?”
The Iraqi looked down at the dying, helpless man at his feet. “If you must call him something,” he said after a moment, “you may call him Saladin.”
41
ANBAR PROVINCE, IRAQ
AS A PHYSICIAN IN THE emergency room of Jerusalem’s Hadassah Medical Center, Dr. Natalie Mizrahi had routinely confronted ethically fraught scenarios, sometimes on a daily basis. There were the gravely injured and the dying who received heroic treatment despite no chance of survival. And there were the murderers, the attempted suicide bombers, the knife-wielding butchers, upon whose damaged bodies Natalie labored with the tenderest of mercies.