Iraqi Surgeon Returns Home to Help the Wounded Get Back in the Fight

Iraqi Surgeon Returns Home to Help the Wounded Get Back in the Fight

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BAGHDAD — A young Iraqi soldier wheeled himself into a makeshift examination room in Baghdad’s best government hospital and used his elbows to climb onto the bed. Ripping off an array of straps, he removed a worn prosthetic leg so Dr. Munjed al-Muderis could examine his stump.

Dr. Muderis, an Iraqi-Australian orthopedic surgeon, was back in his hometown for the first time since he escaped in 1999 after being ordered to cut off the earlobes of army deserters. He had come at the personal behest of Iraq’s prime minister, Haider al-Abadi, who has an army full of soldiers with limbs lost in the relentless battle against the Islamic State.

Some 200 such amputees had been summoned to be triaged over two days. As he worked through the throng, Dr. Muderis, 45, never sat or even so much as leaned on a desk. When I asked at one point if this was the most amputees he had ever seen in a day, he replied, “It’s the most amputees anyone’s seen in a day.”

He was looking for candidates for osseointegration, a surgical procedure that eschews the centuries-old approach of fitting a socket over a stump. Instead, doctors drill titanium rods into the remaining bone and attach them to advanced prostheses, creating more dynamic limbs.

The technique originated with tooth implants, and Dr. Muderis has helped pioneer its use on arms and legs, operating on dozens of veterans of the wars in Iraq and Afghanistan at hospitals in Australia, Britain, Cambodia, Germany, the Netherlands and Lebanon.

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“It’s very important for them to feel like they are back to normal again,” Mr. Abadi told the doctor, speaking of the injured soldiers. Later, Mr. Abadi said that Dr. Muderis “shows that Iraqis are very resilient.”

For the Iraqi government, the hope is that Dr. Muderis can return to Baghdad, equipment in hand, and get wounded soldiers back on their feet and back into battle. Credit Adam Baidawi
Dr. Muderis, scion of one of Baghdad’s nine original ruling families, escaped a brutal regime only to face what he described as a dehumanizing asylum system in Australia. Now he lives in a harborside mansion in Sydney and drives an Aston Martin to a private hospital, where he performs common hip and knee surgeries as well as osseointegration.

For me, having grown up in Australia with an immigrant family that traces at least 18 generations back in Iraq, Dr. Muderis represented a fascinating hybrid of cultures and languages, trauma and recovery, science and religion. I followed him on a three-day visit to Baghdad in May to inspect the wounds of a country I’d known only from a distance, and to see if one surgeon could really help stop its bleeding.

A Torturous Journey

Dr. Muderis’s wealthy Sunni family was considered “sadeh” — descendants of a bloodline of the Prophet Muhammad. Young Munjed grew up with servants and chauffeurs, part of what was called the Nestlé generation — which, like chocolate, might melt at the first sign of hard times.

At age 12, after watching “The Terminator,” he became fascinated by the idea of robotic limbs. He went on to study medicine at Baghdad University, though the first Persian Gulf war delayed his graduation until 1996. He married a fellow student and had a son named Ahmed, but the marriage was quickly annulled.

Dr. Muderis was a first-year resident at Saddam Hussein Medical Center in Baghdad in 1999 when, he said, the military police marched a queue of rogue soldiers into the dingy operating theater. The police ordered the doctors to amputate the soldiers’ earlobes, citing decree 115/1994, Dr. Muderis recalled; when the lead surgeon refused, citing the Hippocratic oath, he was shot dead in the hospital parking lot.

“If anyone shares his view, step forward,” Dr. Muderis recalled an officer saying. “Otherwise carry on.”

Dr. Muderis, then 27, said he slipped into the women’s changing room and locked himself in a cubicle. Hunched over porcelain, he listened to each passing voice and footstep with dread. Five hours later, he heard a group of women enter and wash their hands, and decided it was safe to sneak away.

Dr. Muderis during a TEDx event in Baghdad in May. Credit Wathiq Khuzaie for The New York Times
Less than a week later, his family smuggled him into Jordan with about $20,000 taped to his stomach. From there, Dr. Muderis said, he flew to Malaysia, then Indonesia, where he handed over his passport and $2,000 for a spot on a fishing boat bound for Australia. He described a harrowing 36-hour journey in which he cared for pregnant and elderly passengers in a sardined mass of humanity, urine and vomit.

After docking on Christmas Island, an Australian territory in the Indian Ocean, Dr. Muderis was vacuumed up into Australia’s refugee system and given a number: 982. He said he was not called by his name for a nearly a year at the Curtin Immigration Detention Center in remote Western Australia.

In his autobiography, “Walking Free,” written with Patrick Weaver, Dr. Muderis told stories of squalid conditions, emotional and racial abuse and cruelty toward children. In the book, he recalled an immigration official telling him bluntly that “the Australian people do not want you here.”

“You will be detained here indefinitely,” he quoted the woman as saying. “However, if you choose to go back to your homeland, we can help facilitate your return.”

He was granted asylum in August 2000. When he inquired about a job at the Royal Perth Hospital, Dr. Muderis said, he was told his Iraqi medical license was nearly meaningless there.

He moved to Melbourne and married an Iraqi refugee he had met on the boat journey. Within a year, he became accredited as a doctor. He worked in an emergency department, a demanding schedule that he blamed for his divorce a few years later, after the birth of two sons, Adam and Dean.

He later married a Russian-born doctor, Irina, with whom he has two daughters: Sophia, 8, and Amelia, 1. In 2009, he moved to Berlin for a year to study osseointegration.

Dr. Muderis with attendees after speaking in Baghdad. Credit Wathiq Khuzaie for The New York Times
Among his patients was Michael Swain, a British soldier who lost both legs to a Taliban bomb in Afghanistan and is now a long-distance cyclist.

“He’s quite a character, to be honest,” Mr. Swain said about the doctor. “He’s funny. A bit silly, as well. Like us soldiers.”

Reinhabiting Iraq

When Dr. Muderis first received a phone call from the Iraqi prime minister’s office in February, he joked that the invitation was a ruse — a plot to kill him for fleeing two decades earlier. He went anyway, he said, out of insatiable curiosity and a distant sense of duty.
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Mr. Abadi said his goal was to get amputee soldiers back into battle. “It is very important psychologically for them,” he told Dr. Muderis. “If they are fit, they can fight again.”

Dr. Muderis is scheduled to return to Baghdad in August to operate on at least 50 patients. During the May visit, he and two Australian assistants examined patients and collected X-rays, searching for surgical candidates.

He spoke to patients in rapid-fire Arabic, punctuated occasionally with a blunt word in English: “Really?”

One middle-aged man was missing one leg and struggling to make the other work. His injuries had robbed him of something fundamental: He could stand on crutches or lie down, but could no longer really sit. Yet the man still worked every morning in a pastry shop.

Dr. Muderis chose every detail of the interior of the Aston Martin he drives to work in Australia. Credit Brook Mitchell for The New York Times
Dr. Muderis, shaking his head and swearing as he interviewed the man about his condition, promised to operate to give him more flexion, more bend, through his hip. “It will fix some of his suffering,” he explained.

But the doctor was troubled to find that many injured men smoked as much as three packs of cigarettes a day; he generally refuses to operate on anyone who has smoked within three months, for fear of infection.

When he told one Iraqi he would have to quit immediately, the man gave the Arab world’s ubiquitous response: “Inshallah,” or God willing.

“God? God did this to you!” the doctor said in Arabic, only half-joking.

“It was a religious fanatic,” Dr. Muderis pointed out, and the room full of Iraqi veterans, doctors and government officials fell quiet. “I better shut up before you guys take me and hang me, too.”

Dr. Muderis is secular, and sometimes glibly uses religion as a punching bag. Back in Sydney, he begins mornings in the operating theater by proclaiming in Arabic, “God curse you all!” — a reflection of his belief that medicine relies on skill, not faith.

In Australia, Dr. Muderis said, some fellow orthopedists have called him a terrorist, and he just won a defamation lawsuit against a former patient who had waged an online campaign that accused him of negligence in a 2010 hip arthroscopy.

But in Baghdad, he was welcomed as a hero, giving a TED talk to a crowd of eager fans in a hotel, and having an audience with the prime minister.

Dr. Muderis in Sydney last month with his daughter Amelia. Credit Brook Mitchell for The New York Times
Dr. Muderis said he had visited the palace before, as something of a child prop during a ceremony for Saddam Hussein. All these years later, we walked through a gaudy series of rooms filled with marble and chandeliers to see Mr. Abadi, who quizzed him about the safety and details of osseointegration.

“Have you seen ‘The Terminator’?” the doctor asked.

The prime minister looked lost.

“What about ‘RoboCop’? Have you seen ‘RoboCop’?”

“Yes, yes, I have,” Mr. Abadi replied.

“It’s just like that.”

As we left the palace, its pristine gardens unwilted despite the intense heat, Dr. Muderis closed his eyes for a minute. Then an armored S.U.V. rolled up to take us back to the hospital, where he saw patients until 11 p.m.

The day’s stories of heartbreak and trauma had begun to blur together, but one had silenced the small exam room.

A former soldier recounted running toward an Islamic State car bombing to pull a young child out of harm’s way. As they sprinted from the scene, he said, there was a second explosion.

The child, in the soldier’s arms, became an unwitting shield against the mass of shrapnel. He was killed, but the soldier survived, losing most of his right arm.

As he told the story, the soldier demonstrated how he had held the child, wrapping his remaining arm and half arm around his chest. Dr. Muderis translated the story to his staff and placed a hand on the soldier’s good shoulder.

“We can help him,” he said.

Correction: July 28, 2017
An earlier version of this article omitted one of Dr. Munjed al-Muderis’s daughters. In addition to 8-year-old Sophia, Dr. Muderis has a 1-year-old daughter, Amelia.

 

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