United by war, 2 doctors operate on a high level

Under bright surgical lights, dressed in blue scrubs, two doctors from countries at war stand together, one offering medical knowledge to the other.

Dr. Benjamin Starnes, director of vascular surgery at University of Washington's School of Medicine, is showing Dr. Nadim Haddad, a thoracic and vascular surgeon from Azady hospital in Kirkuk, Iraq, the latest vascular surgical techniques.

Starnes makes a minute incision and inserts a small catheter into a patient's forearm, navigating the tube through the artery all the way down toward the kidneys, where the patient has a leaky artery.

"Watch this," Starnes says and points above the patient to an X-ray screen, which he uses to track the catheter. "You can see the whole kidney flushing with blood."

Haddad nods, taking mental notes to later scratch into his notebook and take home to other Iraqi physicians.

The doctors last scrubbed together in Iraq in 2003 after the U.S. invasion.

Starnes, serving with a U.S. Army surgical unit in Kirkuk, met Haddad at the Azady hospital in Kirkuk, where Haddad was the only vascular and thoracic surgeon in the entire city of 1.2 million people.

Few supplies

Azady's situation was dire. Because of a U.N. embargo, the hospital lacked even the most basic medical supplies.

"We had no arterial grafts, no stitches, nothing," Haddad said. "We even lacked paper and pens."

During his year in Iraq, Starnes and his surgical team made 60 missions to the Azady hospital assisting Iraqi doctors with everything from trauma wounds to cancer.

Just traveling to and from the hospital was a life-threatening task.

"We'd ride in an open Humvee with full bulletproof gear, holding M-16s with our eyes to the rooftops looking for snipers," Starnes said.

But the rewards of saving lives were well worth the risk, according to Starnes.

During one mission, Starnes was working side by side with Haddad on a lung-cancer patient while down the hall a baby girl was born with an abnormal esophagus — a potentially fatal condition that obstructed her ability to feed.

A newborn with this condition would usually be sent to Baghdad, a four-day trip the baby would never survive. Starnes, whose wife was at home six months pregnant with a baby girl, knew a simple procedure to fix the baby's throat.

Together, Starnes and Haddad performed the procedure and the little girl remains healthy today.

A vision to share

When Starnes left Iraq, the doctors stayed in touch via e-mail.

After 15 years of military service, Starnes was recruited by UW to be chief of vascular surgery at Harborview Medical Center.

Since then, he has been trying to bring Haddad to the hospital.

"I wanted to share with him a vision of the future of vascular surgery and expose him to new techniques he could bring back to the Middle East," Starnes said.

"He's a very good surgeon, but doesn't have the same access to resources."

It took nearly three years for Haddad to get permission to travel here. He finally came to Harborview earlier this month, with funds from a global educational grant.

He has viewed 30-plus procedures so far, including repairs of severed aortas and surgeries to resolve aneurysms and internal bleeding. Traditionally, these conditions required intensive surgery — opening a patient's internal cavity, exposing him or her to greater risk of infection and delayed recovery. But Starnes specializes in repairing vascular conditions using minimally invasive technology.

In the case of the renal patient, Starnes uses X-ray technology, cast up through the patient's body and displayed on a screen in front of him.

With this "X-ray vision," the doctor navigates the arteries via catheter and wires.

By infusing the patient's blood with iodine, he spots the leak on the X-ray screen.

He then inserts a stent through the catheter, which he inflates with a tiny balloon.

The surgery took just about an hour, and the patient left for home with a Band-Aid and repaired artery.

'One of the best'

"I learned so many things from this trip that I can transfer back to my country to help patients," Haddad said. "Its been an incredible opportunity to train with Dr. Starnes. He's one of the best endovascular surgeons in the world."

Iraq now has the infrastructure and funding to enhance its medical capabilities, according to Haddad. Before the U.S. invasion, Haddad made only $2 a month.

Because of the lifting of the embargo, he now makes $2,000 a month.

"Iraq now has an improved and good economy," Haddad said. "We [the Iraqi government] can fund, and want to fund this new technology, especially in the northern region."

When he returns home, Haddad plans to hold lectures, conferences and workshops to share his new knowledge with colleagues.

"Its incredible how war can separate two countries with people fighting on separate sides," Starnes said.

"But medicine and caring for people can bring them together."

Cassandra Brooks: 206-464-2311 or cbrooks@seattletimes.com