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Smith's medical teams generally hold patients until they're stable. Sometimes they keep them longer, knowing that—for the gravely injured—chances of recovery drop outside Ibn Sina. When patients can no longer stay, they're collected by family or loaded into military ambulances and trucked to the gates of the Green Zone, the walled and guarded enclave that houses Iraq's government and the U.S. bureaucracy. At the gates, patients transfer to Iraqi ambulances. Sometimes the ambulances are merely old vans, the drivers not paramedics but repairmen or cabbies. Packed aboard, patients hurtle through Baghdad, hoping for safe passage.

The doctors, nurses, and medics don't follow patients as they are ferried to new hospitals. It's too dangerous. For the Americans, who rarely see Iraq beyond the walls of the Green Zone, it is as though their former patients had fallen into a dark void. Sometimes they hear stories, rumors, about what happens to the Iraqis, about the ambulance drivers who don't know enough to keep squeezing a patient's lung pump, or nurses who steal their patients' food. None of it can be confirmed, but it might as well be true. Anything is possible in the void.

In the Intensive Care Unit, the burned boy's father sits bedside, anxiously scanning the faces of the nurses. He speaks no English, has the pimpled face of a teenager. At a nearby bed, nurses haul an Iraqi man up on his side. A large hole, like an angry mouth, gapes behind his left shoulder. A piece of shrapnel about as big as half a credit card tore through him, leaving him a paraplegic.

The burned boy has lain here six days. Eventually he will be turned back into the care of his parents. The nurses in the ICU worry. Nearly all of them say the worst part of their job is treating injured children, and lately there have been many. The boy's odds of infection and other complications will jump when he leaves. And there is more: The nurses suspect the boy's parents abuse him.

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