Earlier this year, a Syrian American orthopedic surgeon was shopping with his two toddlers at a Walmart in Grand Rapids, Michigan, when he heard the familiar ping of a notification from WhatsApp, the encrypted messaging service: A teenager had been shot in the leg and the bullet had passed straight through his tibia. The fractured bone punctured his skin like a spear. Although it was the surgeon’s day off, he took the call—as an expert in complex bone operations, this was his specialty.
But this was no ordinary case. His patient was over 6,000 miles away, awaiting care in a makeshift medical clinic in Madaya, a town in Syria some 28 miles from Damascus. The clinic is only a 45-minute drive from Damascus Hospital, but it might as well be on the other side of the world. Madaya, a rebel-held town controlled by the Islamist group Ahrar al-Sham, has been held under siege by Hezbollah, which is fighting on behalf of the Syrian government, since last July. Hezbollah won’t let anything in or out of the town; it was a Hezbollah fighter, locals say, who shot the teenager in the leg.
At the Madaya clinic that day, two men were on duty: a 25-year-old who had been a first-year dental student when the Syrian civil war broke out in 2011, and a veterinarian in his mid-40s. Gangrene had begun to spread down the patient’s leg, and the dental student, in a series of frantic texts, was asking the surgeon in Michigan what to do. As he walked through the parking lot of the Walmart, the surgeon picked up the phone and called the dental student, guiding him through the steps: Immediately load the patient up with antibiotics. Scrub the wound. Clear away as much dead tissues as possible without agitating the patient. Splint the leg.