The Oath : A Surgeon Under Fire - Hardcover

Khassan Baiev

Hardcover

ISBN 10: 0679311564 ISBN 13: 9780679311560

Publisher: Walker & Company, 2003

Synopsis

Book by Baiev, Khassan

About this title

About the Author

"I wrote The Oath for two reasons. I wanted the world to know that war is a hellish thing, which victimizes the innocent. In war there are no winners. Second, and equally important, I wanted to introduce my readers to the Chechen people."

Khassan Baiev was born in Alkhan Kala, a suburb of the Chechen capital Grozny, in 1963. Plagued by illness growing up, Baiev was propelled into athletics, in particular martial arts, to overcome his frailty. By the late seventies he was a black-belt, champion judoist who won Russian competitions and faced a promising career as a coach in the sports-obsessed Soviet Union.

Instead, Baiev, whose sisters were nurses and father was an herbalist, desired to be a doctor. "However, I never talked about it out loud because of my school grades. I was sure people would laugh and think me arrogant if I suggested it," he recalls. In 1980 he convinced the Krasnoyarsk Medical Institute in Siberia to accept him, despite their efforts to exclude non-Russians. Admitted provisionally, Baiev was forced to study and sleep in the waiting room of the local railroad station for the first six months.

Graduating in 1985 and returning to Chechnya in 1988, Baiev became a successful reconstructive surgeon, particularly in the aftermath of the Soviet Union's collapse. But when President Boris Yeltsin issued the order to invade Chechnya a few years later, Baiev gave up his lucrative practice to perform trauma surgery. As the wars raged on, he was persecuted as a criminal by both sides. When he treated Chechen fighters, the Russians accused him of being a traitor. When he treated Russian soldiers, factions of Islamic extremists accused him of the same. Determined to uphold the Hippocratic oath, Baiev operated on all in need, from Russian soldiers to Chechen fighters. But, as he is always quick to point out, it is the civilians caught in between who are the main victims.

During the first war (1994-1996), Baiev treated thousands of civilians. He also operated on and saved a Chechen field commander in a secret underground hideout with the assistance of a Russian doctor the Chechen fighters had taken prisoner. When a Chechen field commander threatened to kill the Russian doctor in retaliation for the murder of his brother, Baiev helped him escape. Thrown into a pit for nine days where the relatives of the field commander tried to force a confession, Baiev barely escaped execution himself.

During the second war (1999-present), Arbi Barayev, a notorious Chechen thug, tried Baiev in a kangaroo court for treating Russian soldiers. Facing execution yet again, Baiev was saved at the last moment by the Russian bombardment of his town.

The Russians, in turn, issued their own order for Baiev's arrest after he saved the life of Shamil Basayev, one of the Kremlin's most wanted field commanders. "With a million dollar bounty on Shamil's head, I could have been a rich man if I had let him bleed to death," Baiev noted.

Realizing that Baiev was a man wanted by both sides, Physicians for Human Rights helped him seek political asylum in the United States. He reluctantly emigrated in 2000, telling The New York Times: "Nobody likes to recall that I was saving elderly civilians by the thousands. The only thing they remember is that I was the surgeon who operated on Basayev."

In the past three years Dr. Baiev has become an outspoken advocate for human rights who has been honored by Human Rights Watch, Physicians for Human Rights, and Amnesty International. He has even returned to competitive sports after a break of 13 years and in 2001 and 2002 he won the world championship in sombo (a Russian form of martial arts). "If it weren't for my athletic training, I don't think I ever would have survived the two Russian-Chechen wars."

Dr. Baiev lives today in Massachusetts with his wife and six children. His youngest child, a girl named Satsita, was born in 2003 in Boston. "She is our American daughter. All my family here and in Chechnya are delighted. And maybe one day she will grow up to be a U.S. senator!"

From The New England Journal of Medicine

The manifest theme of this revealing and fascinating book is the inherent and perpetual conflict between the universalism of the Hippocratic oath and the particularism of selecting patients on the basis of any number of criteria (age, sex, race, color, class, nationality, religion, wealth, and so on). What makes this book exceptional is that the ground on which this conflict is played out reflects the struggle between Chechnya and Russia at the end of the 20th century. The author is a Chechen physician who put his life on the line, time and again, because he chose to honor the oath and treat both Chechen people and Russian people. It is unfortunate that the book's title does not reflect the venue and the substance of the story; the subtitle states only "A Surgeon under Fire." (Figure) The surgeon is Khassan Baiev, and the book first provides valuable background information on Chechnya, a small region of the Caucasus, incorporated against its will into the Tsarist and Soviet empires, of the Muslim faith, and striving for some kind of independence or autonomy. In 1944, during World War II, the region's entire population was deported to Kazakhstan, Kirghizia, and Siberia on Stalin's orders (as were those of other, neighboring ethnic regions), on the grounds that they were sympathizers of the Germans and thus branded as traitors by the Russians. At the present time, the epithet has been replaced by "bandits," although the author also qualifies for the "traitor" appellation because of the formula "Whoever helps my enemy is my enemy." Dr. Baiev's parents were allowed to return in 1959 to their native land, where he was born in 1963. He chose a career in medicine, specializing in facial surgery, and successfully practiced as a cosmetic surgeon in Moscow. At the outbreak of the first Russian-Chechen war (1994 to 1996), he decided to return home and served as a doctor and surgeon. After a few years of uneasy truce, hostilities resumed in 1999, and again Baiev found himself on the front lines and performed thousands of operations (mostly amputations) and treated all, civilian and military, Russian and Chechen. In one period of two days, he performed 67 amputations and 7 brain surgeries. He often lacked surgical instruments and worked with ordinary carpentry tools (saws and drills) that were difficult to sterilize and keep sharp. What was most appalling was that his patients were primarily civilians, children, women, and the elderly: "innocent victims sacrificed on the altar of power-hungry leaders on both sides of the conflict." He thus holds no brief for the Chechen warlords who looted or extorted or kidnapped people to enrich themselves any more than for the Russians who shelled indiscriminately and pillaged and killed at random. "Bullets, rockets, mortars, shrapnel -- each produces its own kind of wound," he writes. Lethal fragmentation bombs caused "shredded intestines, livers, kidneys, and sexual organs reduced to ground meat." Dr. Baiev adds that he and his staff gave blood every two weeks, sometimes once a week. Because he treated patients from both sides, he was condemned to death for being not only a "traitor" but also a "bandit-doctor" (for treating Chechens) or a "pig-doctor" (for treating Russians). The fact that he survived can only be called miraculous, as there is no other word to convey that meaning. In one episode he describes, he escaped death twice in a single day. Because of the stressful conditions of his life and his work, he suffered, at times, severe depression and was even hospitalized for several weeks. He attributes his recovery, among other things, to his faith in Allah and his devotion to his work. Eventually it became clear that his life continued to be in danger, and several organizations (including Physicians for Human Rights and Amnesty International) managed to arrange for his emigration to the United States, at first on a temporary basis and then permanently as a political refugee. The description of Baiev's departure to New York from the Moscow airport, where he was stopped, interrogated, and eventually allowed to board the plane as the doors were being closed, is so suspenseful that it revived in me similar feelings of anxiety -- which I experienced when I left the Soviet Union -- at the idea of being arbitrarily detained. Baiev's description of the nature of medical and surgical practices in the United States as compared with what he experienced back home is itself a reason to read the book. This is a unique story. It teaches us a great deal about the Chechen situation today, and particularly about the effects of the wars on the civilian population. Recent media accounts of what goes on in Chechnya are consistent with what the author describes in the book. This is an important testimony that belongs in the annals of the history of medicine. Mark G. Field, Ph.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About this edition

• Publisher: Walker & Company
• Publication date: 2003
• ISBN 10: 0679311564
• ISBN 13: 9780679311560
• Binding: Hardcover
• Edition number: 1
• Number of pages: 400