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Ha’aretz Daily Newspaper (Israel)
Doctor without borders
By Eran Dolev
"The Oath: A Surgeon Under Fire" by Khassan Baiev, with Ruth and Nicholas Daniloff, Walker & Co., 320 pages, $26 ("Izmel - sippuro shel rofe checheni," Carmel, NIS 340)
History shows us that the number of years of war have far exceeded that of the years of peace. All through the centuries, one war has followed another: One day it's here, another day it's there, or - as the Israeli poet Yehuda Amichai so beautifully put it in his poem "Shir le'il shabbat" ("Poem on a Friday Evening) - "a war that can never have its fill, now it's in another place." One would think we have tired of reading about wars, here and elsewhere. After all, what all wars and violent conflicts have in common is human suffering. Regardless of who is to blame and who started, who is right and who has won, every violent conflict brings injuries, disabilities, death and loss in sometimes epidemic proportions.
The ancient Romans and Greeks already understood that the scope of suffering, injury and death on the battlefield could be diminished. And thus doctors joined the warriors and did their best - their very limited best - to treat those wounded in combat. It is interesting to note that the recognition that led to improved care of battlefield casualties never actually ripened in various societies into movements that opposed war in general. From antiquity to the present day, violence has remained with us as a means of resolving political problems.
There would seem to be no greater disparity than that which exists between war and medicine: The one tears and destroys, the other saves lives. Yet the two seemingly antithetical practices also have a certain commonality: It was in the course of various wars that the medical profession enjoyed some of its more glorious moments. Many innovations and organizational and professional breakthroughs - in medicine in general and in surgery and disease prevention specifically - were devised by military doctors during a great many campaigns.
In the past, most military campaigns took the form of a violent clash between fighting forces. Capturing the vanquished enemy's capital city was usually the last phase of a war. In recent years the nature of fighting has changed. Not only do terrorist organizations consider the civilian populace a primary target for their activities; so do sovereign states, which regard inflicting severe harm on civilians in the rear as a proven method of obtaining political goals. The disintegration of states comprised of different ethnic groups has caused old animosities to explode into violent and bloody clashes. This happened in the former Yugoslavia and in the former Soviet Union.
It is doubtful whether the average reader would ever have heard of republics such as Ingushetia, north Ossetia or Chechnya had the region not been a site where ethnic and separatist desires collided, causing prolonged bloodshed and drawing considerable media attention. The Chechens, a small Muslim people proud of its heritage, fought and is still fighting against the Russian giant. Since the Chechens' chances of victory were meager to begin with, they embraced the typical methods of terrorist organizations around the world and even moved the fighting into areas distant from Chechnya itself, such as the Russian capital of Moscow. The Russian reaction was massive and extremely cruel, targeting not only the Chechen warriors, but their moral and logistical base: civilians.
The Chechen cities, primarily the capital, Grozny, were almost obliterated, and the populace suffered terribly from the three famous afflictions of war: violence, pestilence and hunger. Many were the victims of Russian fire; the breakdown of the water-supply and sanitation systems caused outbreaks of plague among even more civilians; and yet even more people found themselves without food.
Even if the active fighting against the Russians has subsided, the Russian giant has not been able to end the war in Chechnya; nor, apparently, has it succeeded in breaking the Chechens' fighting spirit and their longing for ethnic independence.
Dr. Khassan Baiev, a top surgeon and proud Muslim Chechen, is the author of "The Oath: A Surgeon Under Fire." He describes growing up in the Chechen village of Alkhan-Kala; reading his story, the reader inadvertently learns about the Chechens and their culture and about Islam far from the Middle East. The boy who excelled at martial arts and wanted to become a doctor fulfilled his dream by studying medicine in the Russian Krasnoyarsk Medical Institute. Despite the many economic and professional temptations Russia had to offer, he returned to his country and village - the only place where he felt he was truly in his natural environment. There the war caught up with him.
Dr. Baiev is not a zealous Muslim, nor does he belong to any of the radical groups fighting the Russians. At the same time, as a Chechen patriot he has little sympathy for the Russian occupying forces that are oppressing his people, trampling his culture and destroying his country. In a time of extreme events, it is hard for an individual not to identify with some idea or political movement. Baiev forges his own kind of allegiance: an absolute commitment to the medical profession. This means he will care for any person needing treatment, Chechen or Russian, regardless of religion, nationality, ethnicity or group affiliation.
An absolute commitment of this kind is not common even among doctors working under difficult conditions of destruction and mass casualties. And so the author finds himself treating both Russian soldiers and the leader of an infamous Chechen guerrilla organization. Time and again he risks his life for the principle of offering medical care to whoever needs it. He watches his close friends die while doing all that he can for them and recognizing the limitations of the medical profession.
The book's title alludes to an uncompromising devotion to the Hippocratic oath. The name given to the Hebrew edition of the book, translated by Merav Miller, is literally "The Weapon - Scalpel: Story of a Chechen Doctor Under Fire." This name indeed captures the crux of the plot - the use of surgical tools to save lives under fire - but it obscures the main point: After all, Baiev's skilled use of the scalpel is first and foremost the result of his total commitment to the medical profession as reflected in the physician's oath.
The book's many human descriptions are among the most beautiful that can be found in literature on this kind of reality. The dedication of the nurses, the relationships within the family, the dilemma of how far a doctor must go, at risk to himself, to help his patients - these are only some of the touching subjects whose description fills this special book. Baiev takes his commitment to saving lives to a nearly absurd extreme when he tells us plainly of how he treated a wounded cow - the sole source of livelihood for a woman who came to him for help. Baiev shows in his actions that he is a real doctor, without borders or restrictions of time and place, a man who sees his profession as a calling and considers his ability to heal to be a privilege given to him for the benefit of others.
As in any good story, the reader sense the dark clouds that gather: Baiev refuses to discriminate between people who need medical care, and this ultimately enrages both the radicals among his own people and the Russian authorities, which consider him a "bandit," a bona-fide criminal. At the end of the story the author, suffering from post-traumatic stress disorder, having been repeatedly injured and come to the point of utter exhaustion, has to flee to the United States.
As an Israeli doctor who has had the opportunity to treat both fighters and civilians during different campaigns, I find Baiev's book very interesting. I cannot help but identify with his dilemmas, respect his reasoning and share his concerns. I would not wish any physician the kinds of tests that, in my opinion, Baiev weathered admirably, remaining a complete man in the process.
As a reader, I found myself pondering the analogy between this book and Khaled Hosseini's "The Kite Runner." Both offer a very private perspective on the reality of life in a distant Muslim land and on the tragedies suffered by its people as a result of political developments. But while much of "The Kite Runner" is a story of charming naivete, "The Oath" offers almost nothing of that innocence. It is perhaps the story of a country without innocence, told from a doctor's point of view. The doctor's belief in his own way of doing things, which is the only one leading to a better, saner reality, is also what allows us to hope for a better world.
Prof. Eran Dolev, former surgeon general of the Israel Defense Forces, teaches on the history of military medicine at Tel Aviv University. |
