No matter what he and his team did, they would be performing under constant video scrutiny in order to document every step of the long and complex series of operations that were only getting started on that day. The video record would be useful in making presentations to teaching institutions all over the world, but he was well aware that if anything went bad under his care, it would also be scrutinized frame by frame.
He made the very first incisions knowing that the Grossman Burn Center’s role in this story was one that he had vehemently insisted upon, overriding his father’s initial concerns. Thus the full weight of anything that might go wrong rested entirely upon his shoulders, and the Grossman Burn Center as an institution would take the painful hit if he allowed any preventable mistakes. His father had already spent years in building up the Burn Center and had already begun spreading its renown back while Peter was still a youngster in school; it would be an untenable disaster for Peter if he failed here. The anguish would be all the more intense with so many people looking over his shoulder.
On the heels of his original impulse to provide charitable help and surgical expertise for a terribly injured child came the present situation wherein the images recorded in the operating room would also represent the interests of the U.S. State Department, the U.S. Army’s Central Command and an entire NGO community of charitable organizations, plus a sizeable number of the Middle Eastern ex-patriot community in California.
They would all be standing in line to review the tapes if Peter allowed anything to go wrong. In Zubaida’s weakened condition, there were plenty of things that could, in this operation or in any of the others that would follow.
* * *
The day of Zubaida’s first operation also happened to be the 227th birthday of the United States Army, which was first called the “American Continental Army.” Back then, the first official American soldiers were taken from the numerous local militias that were already organized throughout the New England colonies. The Continental Army’s most successful tactic in repelling English and French combat forces was to dress in woodland colors and hide behind any sort of cover—keep up a constant stream of small attacks—deny the enemy the chance to face off in a formal battlefield engagement—hit and run—and to launch surprise attacks on supplies and structures. Then they melted back into the local civilian populations from which they came, who collectively helped to hide and to shelter them. Most of all, the early American insurgents loved to hide out while they opened fire on those neat rows of well-uniformed Imperialist soldiers who tromped across the countryside begging to be killed. The Imperialists’ over-confidence in their superior forces became their fatal weakness.
Two hundred and twenty seven years later, control in Afghanistan had been wrested from the hands of the Taliban, although Osama Bin Laden and many of his Al Qaeda fighters remained at large and Taliban insurgents continued sporadic ambush attacks. Media pundits remained shrill and sharply divided as to whether or not America’s military commanders had the wherewithal to learn from the nation’s own history, while the military solution to the human condition scrambled for a foothold on the slippery world stage.
Also on June 14th of 2002, while Zubaida lay on the surgical table being carefully split open, wire reports out of St. Louis, Missouri, stated that a former Southern Baptist Convention president had just infuriated Muslims around the world by publicly stating at the SBC Pastor’s Conference: “Christianity was founded by a virgin-born Jesus Christ. But Islam was founded by Mohammed, a demon-possessed pedophile who had twelve wives—and his last one was a nine year-old girl.”
For a brief period, the world’s Jewish population had the chance to stand back and watch radical elements of Christianity and Islam slug it out over that taunt. The breathless media ran back and forth between representatives of both sides to encourage the hurled invective and the veiled threats, while the religious solution to the human condition fought to turn the rowdy into the righteous.
By the time that this day had arrived, the Special Forces squad of the 96th Civil affairs unit had already lost track of Zubaida’s story. So had the other soldiers in Kandahar and Kabul who carried Hasan and his daughter during those first weeks, back when the pair had little or no official support. Each one of those soldiers had faced the choice of ignoring the Perfectly Good Reasons not to get involved, as well as the possible consequences if things went bad somehow, but in spite of that they each also found themselves compelled to add their own link to the domino chain. They did it knowing that they wouldn’t be around to see how it all turned out after Zubaida was passed on to other hands. Even so, it was on their shoulders that she was carried until those next moves down the line became possible.
When Zubaida’s first operation finally rolled around, every ground soldier and medical officer involved in her story had already been pulled back to the countless invisible front lines in the combat against the ongoing guerilla tactics of determined insurgent forces who then melted back into the local population and were sheltered and hidden among them.
* * *
On the afternoon of June 14th, with the first procedures over, Zubaida began to regain her first flutters of consciousness under the bright florescent lights of the surgical recovery room. Her thoughts stuttered like broken bits of film; even the certainty of physical sensations eluded her. She thought that she could feel herself lying on a bed, but she couldn’t get a fix on where she was—or on what had happened to her.
It seemed that ghosts hovered all around her, wispy creatures covered in gowns and masks. They talked in an Other language, in quiet, short exchanges. Sometimes the words sounded familiar, like American words, with their smoothed-out throat sounds and their flat, nasal tones. She couldn’t be sure.
In between pieces of grayish blur that caused time to jump forward, she was aware that bits of some sort of story were being played out right in front of her. She felt that she should know what the story was, but her brain couldn’t put anything together out of the bits.
She wasn’t aware of any physical pain, at least anything that came near what she knew from her past, but she began to realize that something was holding her body in one position, as if she were paralyzed. Whenever she was able to focus upon the sensations coming from her nerves, she had the feeling of being tightly wrapped in soft blankets, with her arms isolated away from her torso. That impression frightened her, because even in a dream state Zubaida knew that her left arm was fused to her chest.
She could hear a low, constant wailing sound coming from somewhere close by. It was a single voice, crying out in a continuous wail of fear. Zubaida could tell that it was a girl’s voice, but the girl didn’t try to speak or do anything other than sustain that long, weak, wailing cry.
Zubaida’s ingrained social instinct was to leave the girl alone, whoever she was, because one of the finer points of the Afghan tribal code is to show your respect for a stranger who is in a private moment of torment by quietly ignoring them. She could only wait for the cries to stop while she pressed her consciousness to distinguish between dreams and reality—or to even remember what reality was supposed to be.
As quickly as she grasped onto a single clear thought or one convincing bit of memory, a wave of physical nausea rolled through her body and carried all of her thoughts and sensations away with it, leaving her dizzy and confused. Each time, she re-started a process as fundamental as a single cell’s drive to divide, straining for any glimpse of an answer to what was going on inside and around her.
She knew from long experience that the realization of a single true thing was enough to anchor her wandering brain and pull it into the world. She had already developed the skill of anchor-hunting, during her long year of escalating nightmares. In the first days and weeks, her worst dreams were pain-induced hallucinations, devilish replays of the fire itself, and she dragged herself out of them like someone crawling from burning wreckage. But before long the worst of her nightmares, waking or sleeping, began t
o include images of her suffering family. That was where she got the most practice of escaping their grasp.
Most of those dreams took place because Zubaida was aware that the family’s ability to survive was being sorely jeopardized by the demands of her burned condition. She had always justified her willful personality by the extra value that she brought to the family with constant willingness to pitch in with whatever needed doing. Her self-declared role as a caretaker in the family gave her a bit of the personal power that it was in her nature to crave. Now the family had not only lost the benefit of her help, but she was well aware that she was draining more of their resources than the rest of them put together.
Once the plans to go to America began to form around her, new nightmares appeared. Her sleep was constantly ruined by dreadful scenarios of her father’s torture at the hands of the Others: doctors, soldiers, Americans…then it hit her.
This is the American hospital.
The ghosts are doctors.
This is part of their magic.
I don’t hurt now, but I can’t move, either.
Why can’t I move?
As soon as that girl quiets down, I’ll ask for my father to come and explain.
* * *
Peter Grossman was sure that everything had gone well during Zubaida’s opening round of surgery, and he knew that her worried father was eager to see evidence of improvement, but immediately following the at first operation, he didn’t have much more than verbal assurances to offer him—while Zubaida slowly emerged from the anesthesia in the recovery room, all Mohammed Hasan could see was a tiny child swathed in thick cotton pads and countless yards of bandaging.
Speaking through the interpreter, Peter explained that the operation had gone well and assured Hasan that his daughter would quickly be semi-awake and would soon recover. He explained that she would need to stay in the hospital for the next four days, until she had enough strength to go through the second round of surgeries, when grafts from her own healthy skin would be placed over the raw wounds left in her flesh today by the severed and removed scar tissue.
Peter promised Hasan that after the second round of surgeries in another four days, he would be able to remove Zubaida’s bandages because then the skin grafts would be safely in place. At that point Hasan could see the effect of the initial surgeries for himself.
For today, once Zubaida was awake and alert, her father could at least explain the progress of her operations to her, himself. When Hasan heard this, he nodded to Peter in gratitude—however his expression made it clear that he was going to have to see these promised results before he agreed to get back on a plane to Afghanistan.
Blood temperatures dropped at the State Department. Their absolute worst case scenario was that Mohammed Hasan would attempt to defect before returning to Afghanistan, creating an impossible political situation and potentially putting an end to Peter’s twelve-month treatment plan, long before Zubaida was ready to be safely returned home with any realistic chance for long-term survival.
Two days after those first operations, Rebecca came back to the hospital to see her again. Zubaida was still swaddled in bandages, but spoke readily through the interpreter. She confirmed to Rebecca that her pain was minimal, and that she was happy that Dr. Peter had kept his promise not to hurt her. Rebecca’s gentle warmth made her feel comfortable with brief bursts of conversation, but when Rebecca produced a large teddy bear she brought for a bedside companion, Zubaida was so uneasy with the strange object that Rebecca moved it to the other side of the room to let her get used to it slowly. When Zubaida saw the small courtesy extended on behalf of her feelings, she immediately felt a wave of the same warm feeling that Rebecca had hoped the stuffed toy would provide.
Though the Pashtun-Wali was devised centuries ago and by elders of a different tribe, the code was so effectively blended into Zubaida’s home region that it had melded with her perceptions and her personality. Now, in this new location on the other side of the planet from its point of origin, one of the code’s main tenets was activated in Zubaida’s mind and in her heart, by a stranger’s clear gesture of courtesy. The respect that it conveyed compelled Zubaida to accept the kindness. Because of it, a bewildered and out of place ten year-old girl who could only hear American words as a series of bleats and hoots that sounded to her like a herd of sheep with head colds, had her first moment of genuine personal communication with this American woman called Rebecca, with the sun-colored hair and sheep-crème skin. From that moment forward, Rebecca was going to be perceived as having stepped over to Zubaida’s side of the campfire. Zubaida’s sense of openness with Rebecca would continue to rise up to equal Rebecca’s kindness, as long as Rebecca avoided doing anything that could be constituted as a threat.
Threats, in the Pashtun-Wali, are an altogether different matter.
* * *
Throughout the four days that elapsed between Zubaida’s first round of surgery and the second, the international war of words persisted between leaders of extremist Christian, Jewish, and Muslim organizations around the globe. The verbal sparring alternated with surprise attacks from every side: bombs, bullets and sabotage.
At the end of that four day period—and at about the same time that Zubaida was being anesthetized, early on the morning of June 18th—an international conference of astronomers was getting underway at the Carnegie Institution in Washington. Part of the conference involved the ongoing search for intelligent life anywhere in the Universe. The relentless pursuit of intelligent life now reached out across distances so great that they are better expressed by the amount of the time it would take a single beam of light to reach them.
The starlight touching down upon the surface of Earth today left those impossibly far places back during the age of the dinosaurs, before there were any mammals, long before the earliest humans. Throughout all of the eons and ages, before and during all of the concerns of humanity, it has been speeding in this direction. It has been on its way here all during everyone’s life who ever lived until today, and during every one of the shifting political and religious Causes for which so many have proven willing to destroy humanity. That little bit of light has been racing toward this planet, perhaps on a search for intelligent life of its own. Depending where it landed, the answer to whether it found any or not remained wide open.
Meanwhile, more and more people down on the surface of the planet were feeling essentially that these new arriving bits of starlight were getting here just in time for there to still be anybody around to see them land, such was the state of the human condition.
* * *
For Zubaida’s second round of surgeries, Peter Grossman and his medical team went through the delicate process of harvesting skin grafts from Zubaida’s unburned skin, splitting the thickness of some of the grafts to double their surface area, and then stitching each one into place over the large bare areas left by the first round of surgery.
His choices as to whether to use a full graft or a split graft on any given area were determined by the needs of each burn site. A full thickness graft will allow itself to stretch and mold to the rest of the body while the healing process continues. However, although a split graft will be effective enough to seal a wound with tissue that the body doesn’t reject, it won’t do much more than that—one of the properties that a graft loses when it is split is the ability to stretch with the surrounding flesh.
For that reason, every moment of Peter Grossman’s surgeries upon Zubaida actually took place in four dimensions—while the usual three dimensions were enough to define the surgical site on any patient, he was also operating in the fourth dimension of time, in choosing the thickness of each graft and the direction of its placement. He visualized each graft through the dimension of time by including all of the known stages of a body’s recovery, as well as the expected patterns of healing along with his surgical considerations for every wound site. While he split skin and sculpted flesh, the real medium of his art was in
visualizing and manipulating the healing process over large amounts of time.
He had to look at each burn area and do more than merely see what lay open and brightly lit in front of him; he had to accurately visualize how that wound might be expected to look in a week, a month, a year, ten years. He had to visualize each graft’s function in its particular location, long after the wound itself has healed. How would the grafted skin move with the body’s motion? How would it react while the rest of her continued growing?
Zubaida didn’t have enough unburned skin to provide Grossman’s preferred level of skin grafting, so he went into the operating room knowing that every square millimeter of each graft was vital to her recovery, both in the short run as a defense against infection and in the long run as an integrated part of her healed flesh.
The list of potential mistakes was nearly endless, as far as those severely limited grafts were concerned. If he allowed any single one of those mistakes to take place, it would represent an error made under the glare of international attention as well as the critical eye of Zubaida’s anxious father.
Meanwhile, Mohammed Hasan waited only a few steps down the hall from the operating room. He was determined to see for himself that everything was all right with the frail daughter. Out of respect for Zubaida’s fierce grasp on her life, he had taken her halfway around the planet, but Dr. Peter had made Hasan a promise. And in Hasan’s world, a man does not forgive himself for breaking a promise, and he is not easily forgiven by anyone else, either. Hasan knew that if Dr. Peter didn’t do what he said he was going to do for Zubaida, he would never agree to return to Afghanistan without her, leaving her here alone in the presence of the Others.
It didn’t matter about all the signed papers that the Americans loved to wave around. Those weren’t real promises. When a man says to you, I can arrange possible miracles for your suffering child, you just have to sign this paper that promises you will give me your child. You are never expected to follow that insane demand to give your child away. When you have to save your daughter, there could be no honor in anything other than doing or saying whatever had to be done or said in order to secure miracles for her.
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