Death had a smell. Chemical processes fired off, each with a distinct order which morphed into such a small, devastating five-letter word. Cadaverine and putrescine smelled like rotting flesh, a decay that can spread for miles. Methanethiol, with an odor akin to rotten cabbage, wafted through the air and coated the back of the tongue. Indole was insidious, a delicate, mothball-like scent that was far outweighed by the others, and yet no less sad. But Fuah made the scent of death sweet. Here, surrounded by skeletal remains of buildings, thick rubble and dust ever present above the ground, death was a by-product, a blessed escape from the horrors that remained.
The small jeep raced over the ruined roads, jostling her from side to side, but she couldn’t stop working. Slick blood covered her gloved hands as she clipped off a severed artery. So much blood. Unable to look into the little boy’s face, Rose couldn’t stomach knowing she could provide no pain medications to ease his suffering as she fought to save his life. This should have been a simple evacuation, an agreed-upon release of the civilian population from both sides of the Syrian Civil War from besieged locations. These people from Fuah and Kafraya should have been safe.
“He’s bleeding out, and he’s going to need a transfusion!” Lacey, an EMT, cried.
“There aren’t any blood bags in the jeep. We’ll have to use his blood. Stay with me,” Rose directed. She’d learned more field medicine since her time in Syria than she ever wanted to deal with again. “Get the fluids ready, and start an I.V.”
Lacey worked fast, feeling for a vein in the boy’s arm and getting the catheter in place. After she flushed the line, she got a bag ready for the blood coming out of his leg. Popping the seal on the syringe, Rose fed the tubing through the hole to clamp into the open wound, working around the ringing in her ears. Scents of chemicals permeating her nostrils, along with the vision of bodies blown to pieces in front of her, filled her mind. The heat of the blast still burned her skin. Blood syphoned into the bag in Lacey’s right hand as she held the fluids and blood bag up in the air. The child’s breathing was too shallow; Rose didn’t like it, but she worked as fast as she could to stop the bleeding and get him stable for transport. They’d have to send him to the hospital in a rebel location. He couldn’t make it all the way to her mobile hospital in Aleppo, but he’d have a chance to live.
The realities of being a doctor in these sorts of situations crashed down around her. Rose didn’t think in cases of what she had on her schedule. She was constantly dealing in triage—marking patients beyond help, those who may be able to survive, and the ones who had the best chance of living. This was the reason she’d joined Médecins sans Frontières—Doctors Without Borders or MSF—but it didn’t make it any easier to stomach. Working in fast-action emergency medicine, the rush of saving a life had long faded under the weight of never knowing what happened once a patient left her care. She bit the inside of her cheek and caressed the boy’s cheek.
“Fight,” she whispered to him, knowing he wouldn’t understand. “Just fight back until you can’t anymore. You are so much stronger than you know.”
And these people were. Amid chemical attacks, airstrikes, and constant turmoil, they still succeeded in smiling. In living some sort of life. They banded together to save others and get them to safety. They told tales of days gone by around campfires and found peace in simple measures of comfort. The resilience they showed in the face of what they were up against lifted Rose’s heart. She could never understand what they went through, no matter how much she tried. She was here—in the line of danger—and could face death just for helping them, but she could leave if she wanted to. She could board a plane and never look back. No one would fault her or tell her she was a horrible person. Everyone would understand she’d done all she could; she had a life she needed to focus on. Everyone, that is, but herself. She’d feel like she’d failed them all—that she’d turned her back when they needed her the most—and she couldn’t do that.
“Checkpoint coming,” the driver called.
“Thank God. He won’t last longer if we don’t get him out of here,” Rose replied.
The jeep slowing to a stop, the back doors were opened, sunlight swelling into the cab. Rose blinked against the sudden brightness. She’d worked under the jeep lighting that hadn’t compared to the intensity of the glare that was now assaulting her retinas. Dark silhouettes filled the space before she heard a very American curse.
“We’ve got injured back here. Get your ass in gear and get them moving.”
Able to make out the U.S. flag on one of his arms, Rose’s shoulders sagged in relief. Three sets of hands reached into the jeep, one steadying Lacey as she continued to hold the bags in the air and stabilize the patient. Her helper grasped the bags from her with one hand and lifted her off the ground with the other, his silver eyes sharpening with anger as he took in the condition of the patient.
“They’re fucking pathetic,” he growled, and Rose whole-heartedly agreed.
An Asian man pulled their charge into his arms, ignoring the blood staining his uniform as he cradled the boy against his chest.
“Naneun neoleul jab-assda,” he said softly to the boy. She couldn’t hope to understand, but she heard the caring in his tone.
The last set of hands gripped her shoulders and helped her slide from the jeep into a rock-hard chest. Once she had her feet under her, he shifted and wrapped one arm behind her back, the other under knees, and took her weight. She sagged in relief, his musky scent calming her.
“We’ve got you,” he whispered, and she released a pent-up breath. “Dr. Delgado?”
“Y-Yes,” she said. So tired. She hadn’t realized how tired she was, until her job was done. The men raced from the jeep and stuffed them all into another, better-equipped ambulance, with Humvees surrounding them. As the cool air inside the vehicle licked across her sweat-covered forehead, she breathed a sigh of relief.
“I’m Welsh. The pretty bastard over there is Snake,” he said, and the silver-eyed man nodded. “That’s Big Boss with your patient. We’re the part of the SEAL team with orders to escort you to the Médecins sans Frontières facility your mobile unit has been moved to. We came to assist when we heard the reports of the explosion. My team leader, Heim, is there with the other two guys on the team. Can your patient make it with the gear in here?”
Rose forced her head from his shoulder and looked around. Ambulance wasn’t the right word for the mobile hospital in which she was currently sitting. Having never seen an ambulance with this level of equipment, her mind kicked into overdrive.
“Lacey, we’ve got work to do,” Rose prompted.
“Yes, Doctor.”
The women surrounded their patient and Rose started working, calling out for an O2 sat reading, morphine for pain, a proper transfusion set up with the refrigerated blood they’d found in the mobile facility, and sutures to properly close the wound.
As the ambulance raced on, they worked until sweat dotted her brow and she could barely focus. Someone dabbed a cool rag at her forehead, and she froze momentarily before her hands started moving again.
“Thank you,” she whispered.
“Anytime. You tell us what you need, and we’ll assist.”
His voice. She couldn’t see Welsh, but his accent rolled over her, steadying her shaking hands and clearing her frantic thoughts. He sat behind her, not in the way, but his was a supporting presence she appreciated. Her heart kickstarted as he dabbed her forehead again. When was the last time someone had taken care of her? She couldn’t remember. But his soft support, the way his men spoke quietly as they traveled the miles back to safety, all soothed her in a way she hadn’t felt in weeks since coming to Syria.
“Just get us to safety,” she said.
“Hooyah.”
Showering outside under a waterfall showerhead was much better than it sounded in practice. Though they’d set up decent living arrangements for the workers and military personnel who stayed in the newly appointed medical zone in Aleppo, they didn’t have top-class accommodations. Everything functioned on generators because of the disruption to the electrical grid, running water was spotty, at best, and a strict shower regimen had been put in place in order to ensure there was enough water for cleaning for medical procedures. Each medical professional had their own tent, and the military guys slept in an erected barracks, though Rose noted the SEALs had been stationed in the hospital structure, like the doctors, so they took up individual rooms. The medical building also housed the cafeteria and recreation area. It wasn’t the best, but they made it work.
As the water sluiced over her form, Rose imagined the darkness and grim reality of the day washing away from her skin. Her patient had survived, but for how long? In this war-torn part of the world, he could die any day from rebel force attacks as they fought to take control of the country. Shuddering, she choked back a sob. An explosion ricocheted in the annals of her mind, blood and matter spraying around her in slow motion. She stood there, on the edge of the destruction, the heat from the blast scorching her eyelashes, but she was frozen to the spot. The very earth shook with the force, the screaming metal drowning out wails of anguish. Rose witnessed everything—the specks of dirt and body parts mixing into a dark-red slush, the air sucked from her lungs as she gasped for breath—and knew she could have died. Had she been a couple buses ahead, she’d have been blown to nothing.
As a doctor, she’d seen death in so many forms. Was trained to prolong it, stave it, and even knew how to cause it. She was there, one with those who’d died, but yet a bystander. Exsanguination. Asphyxiation. Blunt force trauma. Crushed trachea. Ruptured Diaphragm. She catalogued each injury possible, knew the levels of pain, the fear, and knew the victims her expertise would never have helped. And when she could finally move, when her limbs jerked into motion, Rose had bypassed those dying to find ones she could save—it was every doctor’s worst nightmare, but it was the truth of their station. She let them die because she had no chance to see them live.
A keening cry pierced her ears, the sound reverberating in her chest as she was jolted from her thoughts and returned to the present. Rose cried because there was nothing else she could do.