The situation she faced now, however, was unlike anything she had faced before—or would again, she thought. The man in the bare room somewhere near Mosul was the leader of a terror network that had carried out devastating attacks in Paris and Amsterdam. Natalie had successfully penetrated that network as part of an operation to identify and decapitate its command structure. And now, owing to an American air strike, the life of the network’s mastermind rested in her well-trained hands. As a doctor she was morally obligated to save his life. But as an inhabitant of the civilized world, she was inclined to let him die slowly and thus fulfill the mission for which she had been recruited.
But what would the men of ISIS do to the female physician who allowed the great Saladin to perish before his mission of uniting the Muslim world under the black banner of the caliphate was complete? Surely, she thought, they would not thank her for her efforts and send her peacefully on her way. The stone or the knife would likely be her fate. She had not come to Syria on a suicide mission and had no intention of dying in this wretched place, at the hands of these black-clad prophets of the apocalypse. What’s more, Saladin’s predicament provided her with an unprecedented opportunity—the opportunity to nurse him back to health, to befriend him, to earn his trust, and to steal the deadly secrets that resided in his head. You must not let him die, the Iraqi had said. But why? The answer, thought Natalie, was simple. The Iraqi did not know what Saladin knew. Saladin could not die because the network’s ambitions would die with him.
As it turned out, the supplies were only ninety minutes in arriving. The woman, whoever she was, had managed to secure most of what Natalie needed. After pulling on gloves and a surgical mask, she quickly inserted an IV needle into Saladin’s left arm and handed the bag of solution to the Iraqi, who was looking anxiously over her shoulder. Then, using a pair of surgical scissors, she cut away Saladin’s soiled, blood-soaked clothing. The stethoscope was practically a museum piece, but it worked well. The left lung sounded normal but from the right there was only silence.
“He has a pneumohemothorax.”
“What does that mean?”
“His left lung has stopped functioning because it’s filled with air and blood. I need to move him.”
The Iraqi motioned toward one of the fighters, who assisted Natalie in easing Saladin onto his left side. Next she made a small incision between the sixth and seventh rib, inserted a hemostat clamp, and pushed a tube into the chest cavity. There was an audible rush of escaping air. Then the blood of Saladin flowed through the tube, onto the bare floor.
“He’s bleeding to death!” cried the Iraqi.
“Be quiet,” snapped Natalie, “or I’ll have to ask you to leave.”
A half-liter or more of blood spilled before the flow slowed to a trickle. Natalie clamped the tube to prevent outside air from entering. Then she eased Saladin carefully onto his back and went to work on the chest wound.
The piece of shrapnel had broken two ribs and caused significant damage to the pectoralis major muscle. Natalie flooded the wound with alcohol; then, using a pair of angled surgical tweezers, she removed the shrapnel. There was additional bleeding but it was not significant. She removed several bone fragments and threads of Saladin’s black garment. After that, there was nothing more she could do. The ribs, if he survived, would heal, but the damaged pectoral muscle would likely never regain its original shape or strength. Natalie closed the deep tissue with sutures but left the skin open. Twelve hours had passed since the original wound. If she closed the skin now, she would be sealing infectious agents into the body, ensuring a case of sepsis and an agonizingly slow death. It was tempting, she thought, but medically reckless. She covered the wound with a gauze bandage and turned her attention to the leg.
Here again, Saladin had been fortunate. The lump of shrapnel had been discriminating in the havoc it had wreaked, damaging bone and tissue but sparing major blood vessels. Natalie’s procedure was identical to the first wound—irrigation with alcohol, retrieval of bone fragments and clothing fibers, closure of deep tissue, a gauze bandage over the open skin. In all, the crude surgery had taken less than an hour. She added a heavy dose of antibiotic to the IV and covered the patient with a clean white sheet. The chest tube she left in place.
“It looks like a burial shroud,” the Iraqi said darkly.
“Not yet,” answered Natalie.
“What about something for the pain?”
“At this point,” she said, “pain is our ally. It acts as a stimulus. It will help him regain consciousness.”
“Will he?”
“Which answer do you want to hear?”
“The truth.”
“The truth,” said Natalie, “is that he’s probably going to die.”
“If he dies,” said the Iraqi coldly, “then you will die soon after.”
Natalie was silent. The Iraqi looked at the once-powerful man shrouded in white. “Do everything you can to revive him,” he said. “Even for a moment or two. It is essential that I speak to him.”
But why? thought Natalie as the Iraqi slipped from the room. Because the Iraqi did not know what Saladin knew. Because if Saladin died, the network would die with him.
With the surgery complete, Natalie dutifully covered herself with her abaya, lest the great Saladin awaken to find an unveiled woman in his court. She requested a timepiece to properly chart the patient’s recovery and was given the Iraqi’s personal Seiko digital. She checked Saladin’s pulse and blood pressure every thirty minutes and recorded his intake of IV solution. His pulse was still rapid and weak, but his blood pressure was rising steadily, a positive development. It suggested there were no other sources of internal bleeding and that the IV was helping to increase his blood volume. Even so, he remained unconscious and unresponsive to mild stimulus. The likely culprit was the immense loss of blood and the shock he had suffered after being wounded, but Natalie could not rule out brain trauma. A CT scan would reveal evidence of brain bleeding and swelling, but the Iraqi had made it clear that Saladin could not be moved. Not that it mattered, thought Natalie. In a land where bread was scarce and women carried water from the Euphrates, the chances of finding a working scanner were almost zero.
A pair of fighters remained in the room always, and the Iraqi appeared every hour or so to stare at the prostrate man on the floor, as if willing him to regain consciousness. During his third visit, Natalie pulled at Saladin’s earlobe and tugged the thick hair of his beard, but there was no response.
“Must you?” asked the Iraqi.
“Yes,” said Natalie, “I must.”
She pinched the back of his hand. Nothing.
“Try talking to him,” she suggested. “A familiar voice is helpful.”
The Iraqi crouched next to the stretcher and murmured something into Saladin’s ear that Natalie could not discern.
“It might help if you say it so he can actually hear it. Shout at him, in fact.”