4/09/2004 - Chechnian doctor Khassan Baiev had a decision to make: Save the life of a man with a million dollar price on his head, or let him die to collect the money.
Baiev amputated the Chechen field commanders foot to save his life, and found himself a wanted man.
Baiev shared his difficulties upholding the Hippocratic Oath as a doctor in the midst of the Chechnian/Russian war with students and faculty last week during the final installment of World Health Week. He told of his experiences as the only doctor serving 80,000 civilians and 5,000 refugees in a once abandoned hospital in Chechnya.
When I flew a Red Cross flag above my hospital it only showed the Russians where to bomb. Medical facilities were targets because Russians assumed the hospitals contained wounded Chechnian fighters. When my hospital was reduced to rubble, I moved patients to the basement of my house. A few days later my house was bombed, Baiev said.
Baiev, who left a promising practice to serve his native people in Chechnya, faced conditions most medical professionals cant imagine.
Mostly I worked without electricity, without water or heat. I operated outside in the snow, in cellars, on kitchen tables and on the floor. I had to find ways of working with diminishing supplies. For example, when my antiseptic solutions ran out, I made salt solutions. Sometimes I told my patients to use urine to treat wounds.
I had no surgical saw, so I did amputations with an ordinary hand saw. I did brain operations with an ordinary drill. When my suture thread ran out, I used ordinary household thread soaked with alcohol.
Baiev said he had no general anesthesia, so he did all amputations with local anesthesia. And even more, the award-winning Judo competitor did all this with bombing going on all around him.
It is my strong belief that in addition to mental study, students must train their bodies as well as minds Without my athletic training, I would never have survived. In between operations, I would do push-ups; then I would recite a prayer from the Koran and begin again.
On one occasion, Baiev performed 67 amputations and eight brain operations in 48 hours. For all his efforts, Baiev was wanted by both sides in the war.
The Russians wanted me dead because I treated Chechnian fighters. The other side wanted me dead for treating wounded Russians In the year 2000, I was forced to flee for my life.
Baiev received political asylum in the United States, but his heart remains in his homeland.
Unfortunately I am not able to return to Chechnya to help my people. I am heading up a non-profit organization to help the children of Chechnya. I hope to raise funds to buy equipment such as artificial limbs and hearing aids for children with hearing loss from the bombings.
Beyond the injuries suffered from bombings, Baiev told of the other atrocities Chechnians face: land mines have injured thousands, mostly women and children; poison used during the war has led to increased rates of cancer and blood disease; infant mortality during the first year is very high 26 per 1,000 Chechnian children die before the age of 1; and Chechnian pediatricians estimate that one child in three has a birth defect.
I recall a mother coming in to me with a child who was born with two extra eyes, two extra ears and a hole instead of a nose.
In my opinion the whole nation is suffering from post-traumatic stress disorder. People suffer memory loss, insomnia and depression. Suicide and suicide attempts are up. Men in their 20s are having heart attacks. General stress is drying up mothers milk. The incidence of tuberculosis in children is high, Baiev said.
Baievs efforts are now focused on raising awareness for those suffering in Chechnya. He put his experience into a book, The Oath: A Surgeon Under Fire. The book also tells of his experience in the United States, where he is not a licensed physician.
When asked if hell ever practice medicine again, Baiev responded, Its the most painful question I am asked. I dream of it but it is not easy.
Baiev ended his lecture by offering advice to the medical students.
Be patient, careful, dont hurry, and feel the pain of your patients for doctors this is the most important characteristic.©2014 Vanderbilt University Medical Center