A Bomb in the Road, a Fork in the Road

We had our first pediatric patient today. A boy appearing to be about 8 years old (most Afghans do not keep track of their age) came in with his thumb and all of the skin on his palm blown off, and a military tourniquet around his arm. As they brought him onto my trauma bed, he looked up at me with stoic brown eyes, trying to be brave despite being surrounded by people with uniforms and guns cutting his clothes off. I tried to speak to him in a soft voice and got some help from our interpreter in reassuring him that we are trying to help him. He asked us, "Can you fix my hand?" We told him we will try.

As is always the case, we treat first and try to put the story together afterward. So once the kid was stable under anesthesia, our executive officer began gathering info from the medics and the "uncle" who accompanied him. Uncle is a term used loosely like in Polynesia, where any adult male family friend is an uncle.

Depending on which story you believe, this orphan boy was either pressed into service by the Taliban to make home-made explosives (which would explain the skin stains on his hands) and plant them in the road so they don't have to, or he was gathering scraps of wood for a fire when he uncovered a land mine (also possible; Afghanistan has the most mines per square mile of any place on Earth, and some of the Soviet and Italian models look a lot like Tinker Toys). In either case, I don't blame the kid for being in the wrong place at the wrong time. I blame people who think it is okay to put bombs in the ground to hurt random people.

The orthopedic surgeon did the best he could to stop the bleeding, but said the child's hand will probably never be functional and most likely need to be amputated within the next few weeks. I wish I could give him his hand back, and give him a home and a family. But I can't. So I gave him what I could: a compassionate anesthetic, some clothes (from the Operation Desert Blossom shed), and a contribution with my other team members for taxi fare to Kabul Children's Hospital.

I don't know if he's too old to overcome hatred towards Americans or not. Will he grow up raised by the Taliban to make explosives, or will this be the event that makes him turn away from them? Will he believe the Taliban if they tell him he will be rewarded in heaven for killing U.S. soldiers and citizens, or decide he wants to find out for himself if a new government will protect him? Will there be anybody around to help him shape his future?

I don't know, but I am going to give Luke and Seth a big hug when I get home.