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  “And supplies, doctor.”

  He reached in the box and handed the colonel a syringe.

  “Four of us, doctor?”

  “I need these for my patients. You can share with your men.”

  He stared at Paul for a moment, his face serious. His fingers slowly moved to the gun in the holster.

  “If you shoot me, Colonel, you won’t get any more morphine.”

  The colonel considered for a moment. “Go ahead.”

  Paul hopped in the driver’s seat and rolled through the blockade. He waved to the militiamen as he passed and they nodded back. He hadn’t looked at Ellen. He knew she wouldn’t have given up the morphine to them, that she would have stood by her principles. Sure, they would have felt good about themselves, but they’d probably be dead, too.

  The cellular phone on the dashboard rang and Paul answered it. As he listened to Abedi, a normally unflappable nurse, relay the patient history to him in almost hysterical fashion, his expression changed and his stomach turned. His mind worked fast to try and keep up with her.

  “Okay, start an IV, wide open, and put pressure on it. We’ll be there in a couple of minutes.”

  “They won’t let me,” she said. “They said they only want you.”

  4

  The Jeep skidded to a stop in front of the clinic. Paul and Ellen ran across the dirt parking lot toward the entrance. They cut through the line of locals, looping around the one-story concrete building. A wood panel hung on the front doors, painted with the words: Bosaso Medical Center – Northern District .

  The inside was an auditorium—prior to having been transformed into a clinic, the building was an abandoned gymnasium. They passed rows of patients who lay in cast iron beds, IV poles standing next to them. The hum of ceiling fans dampened the patients’ groans and retches. Nurses buzzed around the room.

  Paul swept aside the canvas curtain that divided the room in two. On this side was the ten-bed intensive care unit and the two surgical suites.

  Within seconds of laying eyes on the scene in front of him, Paul realized it was probably too late. A young man in charcoal military fatigues stained darker by blood lay motionless on the gurney. He took rapid, wheezy breaths.

  Paul touched the man’s chest and felt his ribcage rise and fall. Under his palm, Paul felt crusty blood on the man’s shirt. This man had been bleeding for hours. Somehow he was still alive.

  There were two men standing against the wall, staring at Paul. The young one had on fatigue jacket too big for him, unbuttoned halfway down his chest. Paul stopped at the sight of the older one, bearded, tall, and muscular. Paul didn’t see a sign of recognition in the man’s eyes so he turned to Ellen: "Could you get me a tray of—“

  “Not her.” The bearded man stepped forward. “Just you, doctor.”

  “This is my clinic,” Paul said. “She’s a doctor too.”

  “Just you.”

  “Listen here, I make the—” Paul noticed the two AK-47s propped up against the wall, then turned to Ellen. “It’s okay, I can take care of this alone.”

  Ellen shook her head slowly.

  “It's fine. It's fine.”

  Ellen glared at the man, let out a huff, then turned and left the room. The bearded man motioned for the young man in the jacket to leave as well.

  “There’s a surgical center on the other side of town.”

  “I want someone I can trust. We understand you offer some discretion in these matters.”

  “I can take care of this more quickly if I have someone assisting me,” Paul pointed out.

  “You have me.”

  Paul walked past the bearded man, scrubbed his hands in a metal bucket of soapy water, and snapped on a pair of gloves. Paul had seen more than his share of gunshot wounds come through the doors since word had spread that he was willing to do work without getting authorities involved.

  “Bring that over,” Paul pointed towards the oxygen tank and mask in the corner of the room. Paul checked his patient’s blood pressure. He slid the oxygen mask over the young man’s face and opened the valve.

  Paul cut the patient’s shirt open with a pair of scissors and lifted it off of him. He examined his chest. Two holes on the right side oozed blood. The wounds at least eight hours old, Paul figured, judging by the amount of dried blood on their edges. How had this man survived that long? He turned the patient over and saw one hole, likely an exit wound, covered with a bandage. It was taped on three sides, called a flutter valve, which prevented air from entering the chest cavity and collapsing the lung.

  “You put that on?” Paul said.

  The man nodded cautiously.

  “That probably kept him alive.”

  “So he will live?” The man’s eyes twitched.

  “I said it kept him alive. I didn’t say he’d stay that way.”

  Paul continued working on the patient, listening to his chest with his stethoscope and examining the rest of his body. He grabbed a saline bag and tried to start an IV several times. He was unable to thread the needle into the man’s vein on four separate tries (once in each hand, then the pit of the elbows). The patient was profoundly dehydrated and his veins had collapsed.

  Paul threw the needle to the ground in frustration. “When did he get shot?”

  “One hour ago.”

  “But he’s got dried blood all the way down his leg. I don’t understand how the bleeding has stopped in under one hour.”

  “There was a lot, but we were able to stop most of it.”

  “In an hour, that’s impressive.”

  Paul grabbed a chest tube and made a small incision through the skin, then through the space between his ribs and into the chest cavity. The patient didn’t react. Paul inserted the chest tube and attached it to the suction apparatus. A small amount of blood dripped off the tube.

  “He’s lost a lot of blood. I can’t get a vein to start an intravenous.” Paul glared at the bearded man, who didn’t react to Paul’s diagnosis. “How did this happen?”

  “We were practicing shooting and he got caught in the crossfire.”

  “Bullshit,” Paul said under his breath.

  Paul threw open a drawer and found an intraosseous needle. He rolled up the patient’s pant leg and twisted the needle into the man’s shinbone. The bearded man winced.

  “What are you doing?” He asked.

  “I can’t get an intravenous started, so I have to do this.”

  The man stared blankly as though he were waiting for an explanation.

  “Or he’ll die.” Paul glanced up. “He’s lost a lot of blood, more than anyone could in an hour without dying. He’s got two bullets in his chest from what looks like an Uzi, a machine gun that is rare in Somalia. I’ve lived here for over a decade, so I’m not fucking stupid, okay? Cut the bullshit already and give me some straight answers.”

  Paul took a few deep breaths. Only then did he regret what he said. Here he was with a young man with bullet holes in his chest who had come in with two men carrying machine guns and he was telling them how to run the show. But the bearded man didn’t become angry or defensive.

  He sighed: “Last night. It happened last night.”

  Paul nodded and continued working on the man. He attached the saline and let the fluid run. He opened a suture tray, removed the forceps, and began digging in the holes in the man’s chest. He removed a piece of shrapnel that clanged as it dropped on the metal tray.

  Paul tied the final suture, closing the man’s chest wound. The third bag of saline dripped into the man’s veins. His blood pressure had improved and the vacant look in his eyes was now more of a glossy stare. The bearded man sat in the corner observing, puffing away on his tenth cigarette. He hadn’t moved from the stool during the past two hours.

  Paul washed the man’s chest with a wet cloth. Then his weakness returned. His vision became blurry and his legs became rubber. The entire room seemed to spiral around him and he fell onto his backside.

  “Are you okay?�
�� the bearded man hopped up and grabbed him, helping him to a stool.

  “Yeah. I just need to eat,” Paul said.

  The man dipped a cloth in a bucket of water and handed it to Paul. Paul placed it on his forehead.

  “Thanks.”

  He offered Paul a cigarette. Paul thought about saying no, but instead pulled the cigarette from the package and lit it up.

  “Do you think he will be okay?”

  “I think so. He’s stable now. He’ll have to stay here for a while; there’s a risk of infection.”

  “You saved his life, Doctor.”

  “You can call me Paul.”

  “I know. I am Sami.”

  “I know,” Paul muttered under his breath.

  Sami looked at the young man on the gurney, whose breathing had settled into a gentle rhythm. He placed his palm on his boy's forehead. He leaned in and whispered something in the young man's ear that Paul couldn’t quite make out. Then he looked up at Paul. “Do you have a family?”

  Paul shook his head and started cleaning the suture tray that rested beside his patient’s body. Paul said something to Sami he had not said to anyone he had met in Somalia. “I used to. I had a son.”

  “I have four daughters. No sons. But Ali has become my son. And I almost lost him today.” Sami’s voice quivered. “I can see that you know how that feels, losing a son.”

  Paul shrugged, turned, and collected the bloody sheets surrounding the gurney.

  “When his parents—my brother—died, he was supposed to go to England to live with my sister,” Sami continued. He placed a hand on Ali’s forehead and shook his head slowly. “But I insisted he live with me. If I had let him go, his life would be different today. Better.”

  Paul wet another cloth, dropped it on the floor, and moved it around with his foot, cleaning the blood that had dried. “Maybe,” Paul considered, “but sometimes you can’t do anything but live with the choices you make.”

  Sami smiled a bit at that, then turned his head to the side and furrowed his brow. “They say you are French, but your accent isn’t French,” Sami said.

  “Who’s they?”

  “People. In town they know you.”

  “They might think so,” Paul said. “I grew up in America.”

  “I’ve lived here my whole life.”

  Paul nodded, then met Sami's gaze. “How long have you been hijacking ships?”

  “I told you, it was shooting practice.” Sami’s phone buzzed in his pocket and he glanced at the screen. He turned to Paul. “You’re a good man. I have to go right now. You kept my nephew alive.” He extended his hand. “Keep him that way.”

  5

  The port in Bosaso was quiet at this hour of night. Red, orange, blue, and maroon metal shipping containers sat on top of each other in rows. The constant buzzing of orange overhead lights almost completely drowned out the gentle slapping of waves against the docks. Towering overhead, rusted ship-to-shore cranes stood dormant in a line along the shore. Since there was very little shipping in Bosaso, there was very little need for shipping cranes. Years of sea spray and no maintenance decayed the gears and rendered the cranes useless and the port almost dead. The port averaged one ship every two and a half weeks. Fewer and fewer ships had come through the port over the years. First, it was because of the clan wars that lasted a decade (and which continued), then it was because of economic collapse, and most recently it was increased piracy that deterred trading to the ports in the Horn of Africa.

  A pickup truck with a patchwork of rusted holes sped along the tarmac between the rows of containers. Sami pressed the gas pedal to the floor. He kept one hand on the wheel and held a cigarette in the other. The smell of smoke mixed with the smell of oil from an oily rag that lay in the passenger foot well. A thin layer of dust, the kind in which you could write a message like ‘Wash Me’ with your finger, coated the dashboard and radio dials.

  He drove to a fenced-off area at the far end of the port bustling with activity. Razor wire coils ran along the top of a twenty-foot chain-link fence. Lookout posts broke the fence every one hundred meters. No intruder could get in unharmed, and if they did, they certainly wouldn’t leave.

  Through the fence, Sami saw the docked Stebelsky. The three cranes on its deck lifted containers off the ship and stacked them on the dock. He stopped the truck at the entrance being guarded by three men with machine guns. He stuck his head out the window.

  “I’m looking for Abu.”

  One of the guards leaned on the window.

  “He’s over by those containers,” he pointed with an outstretched gun. “He’s been asking when you would be here.” The young man looked at Sami with his eyebrows raised. “It sounds like there’s something special on that ship. I’ve never seen him so anxious.”

  Sami ignored the young man’s indirect request for information.

  “Can you let me through?”

  The young man made a motion with his arm and the other two pulled up the bar blocking the entrance. Sami drove through, thinking about what Abu needed to tell him in person that couldn’t wait until the morning.

  He drove to the area where the cranes placed the containers, that’s where he spotted the tall figure of Abu, hardhat on, directing the cranes. He parked the car.

  “Abu,” he yelled over the clang of metal on metal from the containers. “Abu!”

  Abu noticed Sami, yelled out some instructions to another man in a hardhat, and jogged lightly over to him, carrying a clipboard.

  “What took you so long?”

  “What is going on here?”

  Abu led Sami away from the cranes.

  “Sami, how did you find this ship?”

  Sami shrugged. “Like any other. Just waited.”

  Abu shook his head. “There’s a sailor inside who says he was promised ten thousand pounds to tell you when he was on duty.”

  “People will do anything for money.”

  “Sami, I need you to tell me if there was anything different about this hijacking.”

  “It was routine.”

  “It was not. This ship was delivering arms from Odessa to Nairobi, probably through a private arms dealer. And you were tipped off about it.”

  Sami shook his head. “I had a bit of information to make it easier. The only thing out of the ordinary was the guy with the Uzi. Your job is to unload this ship and keep the cargo safe until we can sell it.”

  Abu rubbed his forehead. This situation was not sitting well with him. “There’s more. I need to show you something.”

  Abu led Sami through the dark rows between the containers. They stopped in front of one of the containers, guarded by two men.

  “This must be an important one,” Sami laughed. “Two guards with guns.”

  Abu passed Sami the clipboard. “This manifest is very detailed.”

  “And so it should be.”

  “Every single item in every single container was accounted for…” he handed the open book to Sami and pointed at the container with his flashlight. “Except this one.”

  Sami examined the side of the container. R-EX 030862. He scanned through the list of cargo, holding a small flashlight in his teeth.

  R-EX 030860, R-EX 030861, R-EX 030863…

  He cleared his throat and flipped through the other pages, searching for the misplaced entry. Abu put his hand over the book.

  “I’ve looked through it three times. It’s not in there.”

  Sami took a breath in and offered an explanation, “It occasionally happens, that a container is accidentally forgotten in a manifest.”

  Abu shook his head. “I don’t think anyone would forget this one.”

  Abu pushed between the guards and swung the container door open. Sami and Abu shone their flashlights inside the darkened container and stepped inside. A palate of wooden boxes was centered inside the container, with a space just wide enough between the palate and the inner wall to squeeze by.

  “When I was told about the container, I
came to examine it myself.” He pulled a pistol from inside a crate in front. “But nothing strange here. Guns.”

  They walked around the side of the crates to the back of the container. “But what is at the back is what I called you about.”

  On the other side of the palate, at the back of the container, Abu aimed his flashlight and tracked it across stacked aluminum trunks, each the size of a medium rolling suitcase. Sami flicked his flashlight on and pointed it at the metal boxes. He counted a dozen—four stacks, three boxes high.

  Then he stopped, nearly dropping the flashlight. He couldn’t believe his eyes. Plastered around the edges of the suitcases were the unmistakable yellow stickers with three black semicircles.

  Radiation.

  Nuclear.

  “Is? Is… this?” Sami could barely make words.

  Abu nodded and heaved one of the trunks off of the stack, placing it on the ground. He flicked the clasps and lifted the top open. He reached inside, lifted a metal canister that looked like an artillery shell, and held it in front of Sami. “Nuclear weapons.”

  6

  Nine hours and forty-five minutes later, Paul finished his day’s work. By the time he tossed the last pair of latex gloves into the trash, he had sutured nine lacerations, prescribed eighteen courses of chloroquine, four courses of amoxicillin, examined fourteen people with infectious diarrhea, and admitted one person with tuberculosis.

  His legs felt heavy as he walked up the darkened aisle towards the exit. It struck him that he had barely sat down the entire day.

  Most of the patients were asleep in their beds, but a few sat up and waved at him, to which he responded with a nod. One man, an elder in a nomadic tribe, who likely had cholera, dry heaved rhythmically in the far corner of the clinic, as he had been doing most of the day.

  At the entrance, a nurse wearing a crisp white scrub top sat at a desk, reading a newspaper under a small lamp. He said goodnight to her, and she didn’t look up immediately, but instead held her finger up as she finished her sentence. When she did, her face turned to concern.