I’m a boy, 10 years old. Walking, running, talking. I can count. I remember stuff. There’s my own self somewhere within me. I’m aware of myself. My name is Rahmudin.
I’m running down the street. A car. A blow to my head. My kite is falling out of my hands… First, the darkness. The fear. And pain. Who am I? Can’t connect the confusing flashes. Can’t move. Someone I know is by my side. My dad. It’s coming back slowly. Hands. Feet. Movements. Food. Good, tasty food…
Two weeks and it’s back. Walking again. Badly, but I enjoy it anyway. The sun is shining on the hospital. There’s that bold guy with a camera. They say he tinkered with my head. He’s laughing out loud when I’m trying to count from one to 10. I’d like to tell him something but I can’t. So I’m laughing, too.
My name’s Rahmudin, I was hit by a car. I had head surgery, and I’m going home tomorrow. Next round, I may tell that doctor he’s not very good looking, and he should wash his pants.
The morning report is fun. Since I’m really tired after a sleepless night I run the meeting actively so not to fall asleep instead of letting Timori do it though it’s normally his job. I wanna get to bed. But when it comes to pictures of a guy who broke all his subtalar bones, the discussion runs away like a Tuk-Tuk, the local tricycle taxi. A bike and a car in one – when it moves, you’re inside and outside at the same time – and this guy was involved in a Tuk-Tuk accident.
When Sebastiano from Italy asks about the details of the accident, a quarrel begins – was the passenger was in or out when the vehicle was moving? The Afghans are laughing their heads off at the meaningless questions from the foreigners, even though we consider the very same questions quite important back home in Europe. But this doesn’t really matter here. Just a broken leg, another one among thousands of similar cases. What we're really looking for is a way to immobilise it.
At 11:30 pm, I’m off to bed. At 1:15 am, the phone’s ringing. A guy was shot. He’s coming to the operating theater, and so are you. Hell no, not today! In the evening, I was so weary I had trouble keeping myself up during the regular jogging around the house. Now that I’m running on reserve, it’s about time to admit it and take some time off.
I’m routinely dressing up trying to remember two things: don’t forget your glasses to avoid your face getting sprayed! And polythene apron!
A guy of around 60 is already waiting in the operating theatre. A thief shot him point blank. He must have been a jerk with no anatomical knowledge. Couldn’t have let the bullet pass the shortest way through the body, to make the surgery easier. Nope, he had to shoot the guy from the left side of the stomach, so the bullet left the body at the right buttock. Then the gunman shot the guy’s left femur off, and the bullet went out through the left buttock.
When I open him up, there’s a litre of blood inside, completely torn small intestine and its mesentery, and a hole in the colon. A tired male nurse is sleeping at the table, and so is a young assistant. Roleček, the anaesthetist, is upset behind the screen, and what awaits me is another endless night full of language barriers, buckets of sweat (the air-conditioning is out of order), anger, despair and manic effort in order to make ends meet.
I cut off five feet of the small intestine. After closing the incision, I need to provide temporary traction for thigh fracture, before we fix the leg for good. Roleček does his usual wonders, and after a while the vital signs of the previously half-dead patient start improving. The room around me is bloody.
In the wee hours I’m back at the base, so weary I forget to go to sleep before heading off to the Kunduz Trauma Center an hour later…
It’s spring, and my head is waking up. I really like the intensive care unit. That’s why I’m part of it back home without any inclination to move to the standard ward. It’s sort of a detective story. Tiny adjustments of a fragile device that’s prone to break down when you throw it a hostile look. Two craniotomies (head surgeries) are slowly waking up. I’m happy about that. Last days were rather depressing here, we weren’t really getting anywhere.
The boys are gradually disconnected from the ventilators; they open their eyes, regaining their consciousness. For me, it’s hard to understand what these two brains – one shot, one beaten by rods – can stand, but I’m happy: these patients are in a much better way than others whose brains weren’t so damaged, or so it could seem. One of the other head injured patients with basilar skull fracture won’t be here today. He’s gonna die because of the severity of the head injuries. But these two, they’re going to the specialist ward – the 'head department', as I call it.
Our colleagues, Samsoor and Timori, are deep in an interesting discussion. The former is a big patriot, blaming the other that he’s depressed by the current state of Afghanistan. Timori asks how to raise kids in this mess, and what their future can look like. It’s been years of nothing but fighting. Samsoor says in Dari that he was born here, so he’s going to live his goddamn life here, whatever it takes and tells him to be happy to have such an interesting job, taking care of patients. Then he leaves, looking annoyed. Both are right. And it’s hard enough for both of them. One of them sees a country in agony, the other sees zero chance for normal life.
We have a psychologist in our team, Helena from Iceland. Every day, she meets dozens of people in various wards who have already given up hope. Unfortunately, the situation is not improving. This is a nation of hard and proud people suffering from the atrocities of the endless war. I keep telling myself how lucky we are, it only takes to be born in a bad place, just an accident, and your life can be but an endless and hopeless struggle for survival.
I’m not a neurosurgeon. I’m not an average surgeon either, but Rahmudin and patients like him they are the reason why I do what I do. I’m so terribly lucky to have a job that I fully enjoy. I believe I have the healthiest motivation, the best you can have in any kind of work. The results are worth every effort. Rahmudin came in a really bad state. I didn’t believe he’d ever wake up from a coma. And look at the little bugger walking around!
When I take his picture and video in the morning my sight is dimmed, unlike the camera lens. I’m probably a bit sentimental about this. When the boy smiles at me, I begin to cry openly. He’s walking, moving all limbs, his muscles are gaining strength, he can count on his fingers, understands everything, recognizes things, is happy to go home soon. His facial nerve in the right side is partially paralysed, but he’ll learn to whistle again in due course. And I believe he’ll talk as well. A permanent scar will remain on his head.
Our paths crossed for a fortnight. A few minutes of surgery, and endless hours of fantastic work of a local rehab staffer. Yes. This work is worthy! Fantastic cooperation of expats and local healthcare professionals, under the flag of my beloved MSF.
Me and Rahmudin ©MSF