13th January 2031
There is a certain weary comfort to a Monday morning here; despite the horrors in the prefabs and the faintly gamma-positive sleet pocking the poly roof of my office, I take some solace from the generic, familiar schlep of the starting week.
I had been up for three hours already, a nagging occipitalis ache dragging me neck-first from an uneasy sleep on my surplus noncom cot. In contrast to my usual fractious, broken dreams, my office looked the same as always: a small pokey appendix epoxied to the back of the main ward. One small desk; one half destroyed chair, the seat as hard as permafrost; one semi-opaque sheet of plastic masquerading as a window; and one extremely modern laptop—my sole luxury—it’s probably the single most expensive item in a hundred kilometre radius. There’s over a thousand carbon- and partially-silicon-based entities within effective sniper fire range that would cheerfully kill me for it, but so far I think I’ve kept it a secret. A beautiful distillation of thirty years of west coast technofetishism, the computer fortunately doesn’t look anything like a computer does here in the technological doldrums of the Middle East—they still coo over a Macbook in these parts.
I have no fixed schedule here, but many demands on my time. My charges have the sweet plaintive demands of the truly helpless, raggedy stick-and-bone shapes only faintly tenting the rough blankets that are the only bedclothes available in the chilly main ward of the hospital. As usual I make a morning tour of the ward, a depressing euphemism for a shuffling survey of the two small bays that are the full extent of the hospital.
Zalmai is awake—I’ve never seem him asleep—his sightless head tracking every small sound I make as I negotiate the defunct medical clutter he insists on heaping on and around his bed, a pitiful hedge against further pain. We found Zalmai about a month ago; he had crawled over twenty kilometers from the Mahipah Pass to the suburbs of Jalalabad. I was led to where he lay by one of the filthy interchangeable urchins who hang around the compound and who know we will pay a few afgani for information on the latest unfortunates to stagger out of the western mountains. Zalmai had heard me coming, the chill winter morning air telegraphed my approach clearly to his undamaged ears. Mewling pathetically he had scrabbled backwards, bloodied palm prints darkening the cracked, dried mud of the grubby no man’s land of the road verge. He looked up at me—his excised, bloodless, empty eye sockets somehow a much worse horror than the terrible battle gore I had seen and treated—they had taken his eyes.
The Pardis Hospice is a mean, swingeing annex shoehorned into the small space that used to optimistically be called the Jalalabad Hospital main car park. Now a gomied dumping ground for shrapnel-ruined medical equipment and discarded prosthetics striking improbable vogues, the park is also home to our three ex-NATO inflatable medical tents. Transitory structures long past their half-life, the prefabs are home to that most contemporary of war victim: the organ thieved.
We’ve been here for a little over three months and I’ve already seen, treated, consoled, and sometimes watched die over seventy victims of the mountain gangs. It’s a hard road from Kabul, and all are fair game: scooter punks who think they know it all, Medicins sans Frontieres newbies, economigrants nomading their way to the Pakistan border and back in tattered annual caravans of privation.
The gangs seem to prize Christian aid workers most of all. Last week, a shattered Isuzu pickup dumped the legless, not yet lifeless, torso of a Jesuit priest right at the entrance to the main prefab; he was also missing his eyes, and as we found out later, both his kidneys and liver. He died with his eyelids pinned back, never saying a word, his fists hiding a crushed rosary.
The ones that live are harder to bear, so many stories of whitewashed caves, dentist chairs, chugging Honda generators, blank, black eyes—and so much pain. Oddly, these surgeons are curiously attentive to the aseptic technique: only a handful of our patients ever seem to develop opportunistic infections and, judging purely on surgical finesse, these butchers seem to wield their antique scalpels with aplomb.
The ward stirs as more breakfast grumblings join Zalmai’s quiet demands for flatbread and black tea. Several dislodged dressings add to the night fart miasma with the high sweet smell of putrefaction, and the splosh-clatter of a bed pan hitting the floor adds to the fun. I dispense some gloves, filter up and get to work.