Introduction: A Frontline Perspective
I am a surgeon bearing witness to a familiar, deeply wrenching scene: crowded corridors, exhausted colleagues, and patients whose futures hang in the balance. Since late December, Iran has seen a wave of protests rooted in calls for political change. By early January, the demonstrations had spread nationwide, drawing a brutal response from security forces. This is not an abstract conflict for me; it is the daily reality of emergency rooms, operating theaters, and the quiet moments when hope flickers against overwhelming odds.
What the Crisis Looks Like in Hospitals
Hospitals have become both sanctuary and battleground. We treat a surge of injuries linked to clashes in city streets: people shot, crushed, or struck in ways that test every line of medical protocol. Our teams work around the clock, triaging patients, stabilizing vitals, and preparing for surgeries that must be performed with the precision of life-or-death chess. The sheer volume challenges supplies, staffing, and the mental stamina of all involved. Each healer faces a choice—to push through fatigue or to risk compromising a patient’s chance at survival.
Patterns of Injury and Medical Response
While every case is unique, a pattern emerges: blunt force trauma from crowd-control measures; penetrating injuries from projectiles; burns and respiratory distress from exposure to smoke and tear gas. Imaging departments operate at a rapid tempo; surgeons must decide when to intervene and when to conserve resources for those with better odds. The tension between immediate resuscitation and definitive surgical repair is a constant negotiation. In many wards, trauma teams coordinate with anesthesiology, radiology, and nursing staff to maximize every chance a patient has to recover.
Ethical Struggles in a Time of Crisis
The ethical questions extend beyond the operating room. We weigh the risks of treating patients who may have participated in demonstrations against the medical obligation to treat all patients who arrive in need. We confront the limits of hospital space and the reality that resources are finite. In moments of crisis, the duty to preserve life becomes more demanding, not less, even when every decision carries political or personal consequence. The work demands not only technical skill but resilience—the ability to compartmentalize fear long enough to save a life, then process what remains after the patient is safe, and the room is quiet.
The Human Cost and the Global gaze
The human cost of the crackdown extends beyond the wards. Families gather outside hospital doors, awaiting news, while colleagues around the world watch with concern and solidarity. Documentation from doctors, nurses, and witnesses helps translate a national story into human terms that the international community can grasp. The stakes are high: how the world responds can influence the course of events on the ground and the safety of medical personnel who insist on treating every patient who comes through the door.
What Comes Next for Patients and Providers
As protests continue or evolve, the healthcare system must adapt. We need sustained support to maintain essential services, protect staff, and keep emergency care accessible to all who need it. The road ahead is uncertain, and the burden will fall on those who stand on the front lines—surgeons, surgeons-in-training, nurses, paramedics, and hospital administrators—who bear witness while keeping the doors open for the next patient in need.
Conclusion: A Call for Humanity
What I have witnessed is not a political abstraction but a human story of fear, courage, and compassion under pressure. The consequences of the crackdown extend far beyond the protests themselves. They touch every patient who arrives seeking care, every clinician who chooses to stay, and every family hoping for healing. In reporting and reflection, we honor that resilience and remind the world that medicine is a bastion of humanity—even in the darkest hours.
