by Sheri Fink
In Yugoslavia’s first post-Communist elections in 1990, Nedret’s father won an opposition seat on the Tuzla city parliament as a member of the Muslim-dominated Party of Democratic Action. Nedret and other Socialist Youth Party leaders ran, too, and won, having reinvented themselves as members of the Liberal Party. Tuzla was the only city in Bosnia where a coalition of non-nationalist parties, including Nedret’s, was elected to power.
The smelly, oft-maligned city was known for the kindness and solidarity of its people. While people in the capital, Sarajevo, relaxed in quaint coffee shops and browsed the old market quarter, practical Tuzlans mined salt, coal, and oil, extracting so much from the briny bowels of their city—200,000 tons a year—that they undermined its very foundation. One by one the most dignified buildings in the center of Tuzla sank into the earth. Newer Socialist-era shops and apartment buildings sprouted in their place, lining the streets in every rectangular incarnation of gray, beige, and white. In winter, the silos that loomed from Tuzla’s coal-fueled power station turned the snow black. The wind pushed a chemical-tainted haze over the city that burned the lungs and smeared the horizon with a red-brown smudge.
As the months passed and war broke out in Yugoslavia’s other republics, Tuzlans, too, began to feel the pressure. Nedret’s father, suspicious of the Yugoslav National Army since it had “spoiled” his son, joined the underground Patriotic League, preparing the city for a potential attack by the country’s own military. On March 22, 1992, soon after Bosnia’s declaration of independence, he and Nedret’s younger brother were forced into Tuzla’s police station for questioning. He grabbed his chest and doubled over, dying of a heart attack before officers could rush him to the hospital. Nedret called his pathology chief, who lived in Serbia, for comfort.
By the following week, so many physicians had left Bosnia that Nedret was asked to lend a hand in the operating room of Tuzla hospital. The pathology chief called Nedret and told him that he was afraid to commute from his home in Serbia to the hospital in Bosnia, because Serb forces had barricaded the routes. He instructed Nedret on preparing students for their final exams, assuring him he would return the following week when all of this had blown over. It was the first week of April 1992. Nothing blew over. Nedret’s mentor did not return to Tuzla. Nedret never left the surgery department.
The phone lines to Belgrade stopped working. Nedret packed his professor’s belongings carefully in a brown cardboard box and sealed it with tape. A few weeks later, perhaps trying to outdo one another, Nedret and one of his former medical student classmates and political rivals jumped up at a meeting of Tuzla doctors and volunteered to work at a field hospital where Bosnian government loyalists of mixed ethnicities were battling Serb nationalist soldiers in the midst of civilians.
At first the skirmishes moved frequently and the field hospital followed. Eventually, the front lines stabilized and the medical team situated itself four miles behind in a quaint village restaurant, Two Lions. Nedret performed first aid and an occasional amputation in its kitchen, sharing surgical duties with his boastful colleague.
As spring stretched into summer, other villages near Tuzla needed mobile surgical units. Injured civilians and soldiers were dying before they could reach the city for medical procedures and operations. They required qualified doctors to stabilize and treat them in the field.
Leaders of the newly organized Bosnian Army Second Corps in Tuzla appointed a team of physicians and military experts to organize what had, until then, been spontaneous attempts to meet the health care needs of civilians and soldiers in northeast Bosnia. Its members were bewildered by the task. The Yugoslav Army Medical Academy’s detailed plans for a wartime health service were of little use to them, designed as they were to provide medical and surgical care to Yugoslavia’s citizens during an attack from abroad. The country had fractured instead. Hundreds of unanticipated front lines crisscrossed anticipated medical evacuation routes. Physicians often had no way to reach the towns where, according to the pocket Yugoslav Army Reserve cards they carried, they were supposed to report in case of war.
The team of physicians appointed to organize the army’s health service in northeast Bosnia chucked the painstakingly handwritten organizational flow charts of the Yugoslav Army Health Service and began to reinvent their own health service from scratch. They scrutinized U.S. Army texts written about previous wars and settled on one basic principle: Get aid to the injured as quickly as possible. This meant locating surgical teams in highly populated areas and near front lines, even in several parts of northeast Bosnia that were difficult to reach because of fighting. They largely succeeded. Srebrenica was the one exception. The surrounded area was almost completely inaccessible.
When the ham radio operators in Srebrenica started calling for a surgeon, the responsibility for finding one fell to Tuzla’s surgery department chairman, an Orthodox Christian in a still-mixed but increasingly Muslim city being attacked by separatist Orthodox Christian Serbs. He hadn’t joined the army’s medical service, and because of this he had lost much of the authority a chairman normally has over his apprentices. He knew he had little chance of convincing any surgeons to go to Srebrenica against their will, and, with 40 percent of the surgical faculty in Tuzla having fled at the start of the war, he didn’t have much of a selection. After an unsuccessful search for volunteers among the better-trained surgeons, he landed on Nedret, one of his last hopes.
The chairman summoned Nedret from his field station to the hospital and made his request. Would Nedret go to Srebrenica? Nedret was flattered to be asked, but how could he get there given the intervening sixty miles of territory controlled by the nationalist Serb military? Over the summer, several groups had set out for the isolated enclave with supplies and military equipment but had turned back without even crossing the first set of front lines. He’d have to wait and see what happened.
“It can’t wait. Are you willing to accept this assignment?” the chairman asked.
Nedret remained silent. A half minute or so ticked by.
“I accept.”
The chairman’s eyebrows shot up.
“Do you really accept?” he asked.
“Yes.”
“You have until eight tomorrow morning to decide,” the chairman responded, as if he couldn’t trust his ears. “We’ll meet here at eight to confirm.”
That night Nedret went home to his rectangular government-appointed apartment. He really had no idea why he had agreed to the surgeon’s request, and a nervous energy infected him. How could he possibly make it across all that enemy territory alive? He spent the evening with his three-year-old son and his wife, who also seemed to be on edge. He didn’t want to talk with her about his decision. When they had met in the late 1980s as students, her boisterous and dramatic manner—shaking it up on the disco floor or speeding through books written by impressive-sounding British and American authors—had thrilled him. But Nedret found marriage hard; it was hard to be with the same person for many years. His wife worked, like women in the West and unlike his mother, whom he idealized. He regretted the loss of family closeness that resulted from not having a woman at home to cultivate it. To make matters worse, his exciting field work upset his wife. He often lost his temper with her.
Nedret turned on the radio and heard a man’s panicked voice, transmitted over ham radio from Srebrenica. The man pleaded for help. Wounded people were dying from simple causes because Srebrenica lacked enough competent doctors and necessary medications.
Nedret later liked to say that it was the reporter’s words that crystallized his decision to attempt the trip. Of course, there were a myriad other possible reasons, conscious and unconscious. Adventure. Escapism. Thirst for a new challenge. Going to Srebrenica offered Nedret a chance to one-up his medical school rival, earn glory, get away from his wife, and honor the memory of his dead father. But these weren’t the motivations he’d later remember. He insisted that it was simple. He wanted to help, and like his old hero, Sava Kov
ačević, he would risk death for the opportunity.
10
PROFESSIONAL DUTY
IT ISN’T LONG AFTER NEDRET’S ARRIVAL in Srebrenica before his colleagues at the hospital begin asking him, casually, about his qualifications. How much surgical training has he done? Fatima tries to come across as curious, rather than suspicious.
“When did you pass your surgery exam?” she asks.
“You know… I haven’t taken it yet.” He will only say that he has worked at a war hospital on the front lines near Tuzla since April.
In fact, some of the doctors begin to suspect the truth, that Nedret has had almost no formal surgical training. At the moment, though, there doesn’t seem to be a reason to prod him. Nedret’s arrival has boosted the town’s morale so much that, though the doctors whisper amongst themselves about his lack of surgical training, they don’t broadcast it to the townspeople. Besides, from the instant he arrived, Nedret has taken charge of all the surgeries in Srebrenica. He is bold. He attempts operations, particularly abdominal repairs, that the rest of them never would have dared to try. Wounded and dying Bosnian peasants don’t ask to see their surgeon’s diploma.
Days after Nedret’s arrival, the fighting around Srebrenica intensifies. Groups of local soldiers launch offensives and others fend off Chetnik advances. On August 8, with the hospital already full, the staff overwhelmed, and part of the enclave under fire, a group of soldiers plans a surprise raid on the Serb village of Ježestica, where Serb soldiers have directed cannon fire at a neighboring Muslim village for months. The action begins around noon. Some Srebrenicans stumble into a minefield and are carried back to the hospital. The remaining soldiers, many of them friends or family members of the dozens of Muslim men executed by Serbs in nearby Glogova at the start of the war, fire off a grenade and rush the village. Hand-to-hand fighting ensues and casualties mount. Serb civilians flee. Eight Serbs are killed. The Srebrenica soldiers take livestock and other valuables and set fire to homes. The Serbs counterattack, injuring and killing many of the withdrawing Muslims.
By mid-afternoon wounded men—thin, dirty, and sunburned—are pouring into the hospital. The medical staff rushes about in a frenzy, unprepared for the influx. At 3:45 P.M., two white-coated men carrying one of the injured push through the hospital doors, brush past a man in green, and enter the makeshift operating room where they deposit the patient, moaning, on the operating cot. Ilijaz stands beside the cot wearing gloves and a short, dirty white coat. His hair is stringy with sweat and his beard is thin and unkempt. The patient moans as other white-coated doctors and nurses lean over his injured left leg. The room’s shiny green floor reflects the light pouring in from two large windows.
Ilijaz steps back from the cot, shoulders hunched, holding his gloved hands slightly away from his sides. He looks as if he’s not sure what to do. The patient moans again and Ilijaz looks away from him, bringing his glance to rest on the room’s other cot. The man on top of it is completely naked except for a cloth placed over his genitals.
Ilijaz turns back to the man with the injured leg. Across from him on the other side of the cot stands Nedret, tall and authoritative, clad in a green surgeon’s gown and cap. His mask dangles from his neck instead of covering his attractive, clean-shaven face. He moves to the patient’s upper arm as nurses start an IV.
Ilijaz leans over to hold the patient’s leg while someone else ties it with a tourniquet. He can hear Fatima’s voice, strong and shrill, coming from the corridor. She sounds like a teacher trying to get a student’s attention.
“Haso! Haso! Look at me! Keep your eyes open! Keep your eyes open! Haso, don’t die! Listen to us! Listen to me, don’t lose consciousness!”
She kneels beside a young man lying on the hallway floor, giving his chest a few hard pumps and then drawing her stethoscope to her ears. Her long black hair fans over the lapels of her white coat. Someone takes hold of the man’s head and shakes it.
Outside, the sun shines on the upper hills, but in the narrow valley, the hospital driveway is already in shadow. More injured men move toward the hospital. Boys in tracksuits stand and watch the commotion.
In the operating room, leaning over his patient’s partially amputated leg and holding a file-like knife, Nedret slashes at some bloody muscle. He needs to cut it so that it fits under the skin flap that will cover the patient’s stump. The patient lows softly, like a cow. Then Nedret prepares to shorten the leg bone. He attaches two scissors-like hemostat clamps to the top edge of the skin flap and hands one of them to Ilijaz to hold steady. With his left hand, Nedret grips the protruding leg bone, the tibia, with a tool that looks like a giant pair of pliers. His right hand lifts a zhaga, a p-shaped saw. As he saws, the patient moans and bucks, and Ilijaz and the others holding him rock back and forth.
Nedret steps back from the table and erupts in anger.
“Hold it more steadily! I can’t operate like this!”
The doctors and nurses reposition themselves. Nedret yells for more gauze rolls and sutures and a curly-haired instrument nurse, who’s never worked in an operating room before this week, lets go of the patient’s leg, ducks down, and scurries away to find them.
* * *
AT 4:05 P.M. FATIMA IS STILL KNEELING in the corridor trying to rouse her patient. Somewhere a woman screams. From somewhere else comes a terrible moan. The men leaning around Fatima’s patient keep slapping his face and throwing water on him.
Some patients stop breathing as if paralyzed while their hearts continue beating and blue blood oozes from their wounds. The doctors suspect that the Serbs used chemical weapons in the counterattack. The Yugoslav Army is known to have weaponized several chemical agents, including the nerve agent sarin. Doctors try injecting some of the patients with atropine, a medicine that blocks nerve receptors overstimulated by the chemical agent. It helps some of the men, but not the one Fatima is trying to save, who dies.
* * *
IN THE OPERATING ROOM, Nedret makes a last-ditch effort to save the life of another man with a destroyed leg who has nearly bled out before getting here. What the patient needs most is impossible in Srebrenica: a blood transfusion to improve his circulation and deliver oxygen to important tissues. While blood transfusions were pioneered back in World War I to combat the second major cause of death for amputees—blood loss—Srebrenica still has no working laboratory, no reagents to check blood type, no bags for blood storage, and no stable sources of electricity to keep blood cold.
Nedret operates as quickly as possible in an attempt to stop the bleeding. Ilijaz assists. The man dies in their hands. There is no time to process feelings of guilt or responsibility. The hospital overflows with patients whose varying injuries require urgent treatment.
Ilijaz turns next to a thirty-five-year-old man who, like the man who just died, is hemorrhaging from a leg injury. He is awake, in pain, and asking quietly for help. Ilijaz believes he is verging on shock, and expects Nedret to amputate his leg immediately.
Multiple-casualty work has its rules. Every physician learns how to triage in medical school. Those with small, non-life-threatening injuries must wait. Those with devastating injuries are given comfort. And those in danger of dying, who might be saved with a quick operation like an amputation, take the highest priority.
Ilijaz finds Nedret cleaning the wounds of an elderly man whose skin is punctured by dozens of tiny shrapnel marks. Nedret carefully cuts away injured tissue. The work is slow and methodical; it seems to calm him. He doesn’t want to rush to operate on the critically injured patient. Ilijaz wonders why. Is Nedret afraid to see another patient die beneath his knife? Is he recognizing his limitations, questioning his decision to pass himself off as a qualified surgeon, thinking about the medical tenet “first do no harm”?
Ilijaz does not know it, but what troubles Nedret are thoughts of Josef Mengele. Mengele, who “researched” human pain tolerance in Holocaust concentration camps, was convicted of crimes against humanity. And Nedret thinks—al
though his own motives are quite different, although he has no other choice and is working with his patients’ consent—that when he cuts into a living person without anesthesia he is in fact doing what Mengele did, committing torture. What bothers him above all else is the thought that he is doing something unacceptable in the view of modern humanity.
Since Nedret’s arrival three days ago, Ilijaz has tiptoed quietly around him. He has held clamps, listened to moans that made him want to faint, and remained impassive in the face of Nedret’s eruptions. In the hierarchy of medicine, the surgeon is the boss, and Ilijaz knows his place. But watching a patient dying just feet away from the surgeon who might be able to save him lights a fuse inside of Ilijaz. He yells for Nedret to take care of the man with the injured leg.
“Just give him an infusion and we’ll see,” Nedret replies, continuing to dab at the old man’s superficial wounds.
In vain, Ilijaz screams back at Nedret, and then he can’t stop screaming. He spins around like a machine gunner firing at everyone in the room, yelling until he’s hoarse, lashing out in a way he can’t remember ever lashing out before. In the back of his mind he knows the situation is futile. The man will probably die no matter what Nedret does or doesn’t do. But Ilijaz has seen one too many young men die. He roars with anger. Anger at Nedret, yes, but also anger at the war, anger at the injustice of so many young, promising lives taken away by war’s stupidity. Anger that nobody is helping them in Srebrenica. Anger, perhaps most of all, at his own inability to stop the suffering.
Fatima, witnessing the conflagration, tries to rouse Nedret to action. “What are you doing?” she asks him. “That patient and others are waiting.” She tells him she can take care of the old man while he does the surgery. He tells her that the old man’s wounds are also important and he has to finish treating them. He can’t do everything at once.