A Doctor from Homs by Wendy Pearlman

Between 2012 and 2016, I traveled across Jordan, Turkey, Lebanon, the United Arab Emirates, Denmark, Sweden, and Germany, interviewing more than three hundred displaced Syrians about their experiences, feelings, and reflections on the conflict in their country. My new book, We Crossed a Bridge and It Trembled: Voices from Syria, weaves these individual narratives into a collective narrative that chronicles the lived experience of the Syrian conflict, exclusively through the words of Syrians themselves. Among the voices in the book is that of “Kareem,” a doctor from the city of Homs, whom I interviewed in Jordan in August 2013. Doctors have been on the frontlines of the conflict in Syria since peaceful demonstrations met with harsh repression in spring 2011, and the conflict descended into a brutal and complex war. Indeed, some analysts argue that the Syrian government has deliberately “weaponized” by carrying out large-scale attacks on medical facilities, targeting health workers, and violently depriving civilians access to care. Kareem’s testimonial, complementing other selections from his story featured in We Crossed A Bridge, offers one window into these issues, as well as the overall humanitarian crisis devouring Syria.

My loyalty is to medicine. I speak to you as a doctor.

Before 2011, people in Syria were suffocating. There was so much corruption. If you had a business, government agents would stop by and demand part of the profits. They’d say, “Give me a bribe or we’ll write you up for committing some infraction.” There was no freedom. If you dared to talk about politics, the next day men from the Intelligence Service would come and ask why.

The first demonstration in Homs was in March 2011. We couldn’t believe it was happening. The barrier of fear broke. People went into the streets to say “no.”

Demonstrations continued every Friday. They went out from mosques, because that was the only place where people could gather. Even people who do not normally pray would go to the mosque just to participate in demonstrations. There were Christians, communists, liberals. Everyone was thirsty for the chance to stand up and express themselves.

Most massacres occurred after Friday prayers. Some people were going to die and some were going to get hurt, but people still went out to demonstrations. We’d go to the hospital and wait. This was every Friday, every Friday, every Friday.

The demonstration would begin. A little while later, a pick-up truck would arrive at the hospital loaded with people, with dead and injured as if they were sheep. We’d fill all the hospital beds and then lay people on the floor to examine them. There were so many people that sometimes we would get confused: Did we examine this person or not?

Within hours, security agents would descend upon the hospital to arrest the injured on the grounds that they had participated in demonstrations. So we would provide first aid and send patients home as quickly as possible. During the rest of the week, we’d prepare pseudonyms. We had to notify the security forces of the names of our patients, so we’d use the names of dead people. That’s how we worked.

The regime considered us in league with the opposition because we were treating people. From its perspective, if you treated the brother of someone who walked in a demonstration, then you both deserved to be punished. But as a doctor, I can’t deny treatment to anyone.

The revolution continued, and the regime’s repression intensified. People learned to differentiate between the sounds of bullets: a regular bullet, a sniper’s gunshot, machine guns . . . The regime started shelling with tanks, and then used missiles, rockets, and airplanes. No one in the international community said anything. And so it continued.

The hospital was located next to an ancient fortress. A sniper was stationed there, and he fired on anything that moved on the streets below. One day he shot a young man walking in the area.

We managed to get him inside the hospital. The bullet had punctured the main vein leading back to the heart. It was my task to stop the bleeding, but we didn’t have the necessary tools. All I could do was press down with my fingers. They would get so tired that I had to release them. But then blood would gush out, and I’d apply pressure again.

In Homs there are only four vascular surgeons qualified to perform the operation that the patient needed. But none could come because regime forces had blockaded the area. So we called one of the surgeons, and he gave us instructions over the phone. We followed the steps until the patient stabilized.

Still, his lower extremities were going to fail if we didn’t transfer him to a specialized hospital quickly. I called the Red Crescent. The officer said, “If we come, the sniper will shoot us. I can’t sacrifice a crew of five for one patient.” He suggested an alternative: if we could transfer him outside the blockaded area, they would get him from there.

The patient’s brother and friend decided to take the risk. We moved him to the back of the truck; he was still anesthetized and connected to a ventilator. His brother stayed with him and we explained to him how to hold the machine to keep the patient alive. And the friend drove the car.

They sped by the sniper. We heard shooting, but they weren’t hit. The patient made it to the designated place and then to the other hospital. But he died there on the operating table.

The regime placed checkpoints around the city, and it became more and more difficult to move around. Once I was working in the operating room, where my patient was on a ventilator. Downstairs another patient was on a ventilator. The technician informed us that our oxygen supply was almost out, and that I was going to have to choose: which patient gets the oxygen and lives? Which one dies?

We made several phone calls for help. The honorable people of Homs tried to help us. A car came carrying oxygen from another part of town, but the security forces at the checkpoint wouldn’t let them pass. And then, one of the patients passed away. And this relieved us of having to make that choice.

Most doctors stopped working in their usual hospitals and instead started working in the hospitals closest to their homes. I was just 500 yards from a hospital, but I couldn’t get there because there were snipers along the way. Once the hospital was inundated with casualties and they told me I was needed. I said farewell to my wife and son because I knew I might not see them again. They sent someone who took me by foot on a back road where there were only two snipers. Along the way, he shouted: “Sniper! Run!” And then, “OK, relax.” And again, “Sniper! Run!” That’s how it was until we got to the hospital.

The situation continued to worsen. I took my wife and son to live at my parents’ house, which was safer. One Sunday I spent the night at the hospital and woke up to intense shooting. Regime forces were shelling and occupying the whole neighborhood.

During the siege, they arrested many people, including people I’d worked with. It was just a matter of time before they came for me, too. I weighed my options. I could be arrested or be killed, in which case I’d be of no benefit to anyone. Or I could leave Syria. I did not want to leave until I knew that another doctor would take my place. When that was assured, my family and I left. After that, the siege on Homs continued to intensify. Eventually, people became so hungry that they resorted to eating leaves from the trees.

I don’t usually tell these stories. I performed my role and there’s no need to talk about it. But I have a duty to speak if it can help others know the truth.