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.
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