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A Novel

About The Book

In this critically acclaimed debut novel, the aftermath of war in all its power is revealed in the lives of survivors and their loved ones. Mark, a young war photographer, returns to New York after being injured in a brush fire. Shell-shocked, torn apart by grief and guilt, he finds that his experiences have created a gulf between himself and his loved ones. The first to notice is his girlfriend, Elena, who grows increasingly alarmed as his condition continues to deteriorate. She is the most surprised when her grandfather, Joaquin, the last person from whom Elena wants to accept help, turns out to be the one to understand Mark's trauma. The two men -- bearers of grievously deep secrets -- forge an extraordinary relationship that will ultimately lead to life-altering revelations.
This stunning novel is informed by Scott Anderson's experiences reporting on combat around the globe. Triage introduces a major new voice in American fiction.


Chapter One

He lay beneath a blanket of torn flowers. They were scattered over his chest, gathered about his neck like a garland. Occasionally, the wind found his resting place; stems shifted, loose petals took flight.

Above him, Mark saw a sky that was gray. He searched this sky for something to orient him -- a patch of blue, a border of white -- but the gray was unending. He thought of the land that surrounded him. It was brown and spread away for hundreds of miles, tumbled to ravines, smoothed to plain. He felt stone dust settle on his skin, licked it from his lips.

It occurred to him that maybe the flowers had caused it, that maybe here even flowers could destroy you. He envisioned the gunner, bored, gazing across all those empty miles beneath the gray sky, hour after hour, day after day, his eyes suddenly drawn to the colors Mark held in his hand. He imagined the joy the man must have felt at that moment.

At the outset, Mark had been thankful for the sky. Gray was the color of a good day in Kurdistan; the sun would not burn his skin, the glare would not hurt his eyes. Upon reaching the hilltop, he had stood on the highest rock and looked in all directions at the mountains. Not a building or a road. He had climbed down from the rock and begun picking wildflowers. The stalks were brittle, and he felt them snap beneath his fingers.

He didn't hear the artillery shell, but he believed he saw it. When it dug into the hill just below him, little bits of metal and stone had sprayed into the air like a fan. He had stood there amazed, watching the shards arc high before fluttering lightly down to earth.

But not standing, Mark now decided. He had almost certainly been flung to the ground at that very first instant -- before sound, before sight. It was while lying beneath the flowers that he had watched the spray against the sky.

No pain. Only a vague, prickly sensation, as if his whole body was asleep. He lifted his head and looked over his chest. He saw that he rested on a large flat rock. His left arm was stretched out to the side, and he studied it carefully. There didn't appear to be anything wrong with it. The right arm lay on his chest, the hand rising and falling as he breathed. Mark watched the hand for a moment. The fingers trembled, and he felt their nervous little taps on a rib.

"Colin?" he called.

He lifted his head a bit more to see his legs. They were splayed over the rock, rigid, the feet turned out to either side. His left foot twitched back and forth. He was troubled by this movement, tried to make it stop, but the foot would not respond to his will.

A dripping sound close to his right ear. Mark twisted to see that his head had rested in a slight bowl in the rock. A pool of blood there. He felt it trickle through his hair, tickling his scalp. He watched it fall from him in quick droplets.

He lay back on the rock. Blood seeped into his ears. Mark took comfort in its warmth and looked up at the gray sky that was eating all sound.

He wasn't sure what to do. If he left the rock, it would only take a few minutes of desert air to dry his pool, and then all that would remain of him would be a small crucible of brown powder, a powder the wind would find and scatter. He wished to stay there, to protect the pool.

But after a time, he thought differently. He understood that if he stayed upon the rock, he would simply disappear as well. And so, he rose.

The sounds, the smells, the things that touched his skin that night, of these details, his memory would part with none. Coming down off the hilltop and across that empty valley, and Mark would remember every step, the slope of the ground beneath his feet, the weight upon his back, the brush of meadow grass on his fingers. A sky of infinite darkness -- not a star, not a sliver of moon -- and Mark would remember every time he fell to the ground and listened to the wind and imagined it to carry the voices of soldiers, every time he forced himself to rise again, to stand out of the soft, velvet safety of the grass and move on. Seeing himself as he would appear in the nightscope of a soldier's rifle, lit up, a chest and a head floating above the meadow, a target as big and white as the moon. Trying to raise a hand to show he was unarmed, that he was coming off the mountain in peace, trying to forget that none of that mattered in this war. Falling again, forcing himself up, moving on. After a time, the strength of his chant -- "stay calm, stay calm" -- giving out. Just a half-mad fugitive then, swollen hands sliced by sawgrass, leaden feet that tangled on unseen roots, a chest and throat choking under the weight of its tether, a mind emptied until all it held was the last plea of a thousand dead men -- "I don't want to die here, I don't want to die here."

Another sound then, louder than the whispering grass or his shuddering breath, a roar, and Mark reached the bluff and the river lay black before him. He rushed into it, felt the ice water rise to his knees, his hips, and he would always remember that instant when the current caught him, the interminable, slow-motion moment of both sorrow and relief at his own helplessness. Feet slipping on smooth rocks, arms flailing for balance, spinning and down, into the river. Stunned by the cold on his chest, his temples, a light flash of shock and that was too long. Carried under, body hitting rocks, scraping along the riverbed, mouth gasping for air and finding only water, fingers scrabbling for something to hold but going too fast for that, dying now, the dead weight on his back pinning him down, sending him deeper and colder. The strap pulls taut against his neck, the weight is all on his throat, and he is strangling now, dying quicker, moving downstream, pinned to the bottom, the rocks sliding under his back, and the clutch on his throat won't loosen, won't even let him scream as the life is pinched out of him. Both hands clawing at the strap, no strength, almost finished now, and then he hits something in the water, hits it hard, and the force sends him sideways and the grip on his throat lets off for a moment, the strap goes slack, and Mark gets out and he is done with it and he is in the air again and he is free and alive and all alone, hurtling down this river beneath the deep blue dark of a coming dawn.

Reaching shore, the silhouette of a tree in the fading night, and Mark sat beneath its bare branches to lick the bloodwater from his hands, from his arms, like a dog. Not a shadow of wind then, not an insect or a bird or a swaying reed, only the running of the river. The sky softened to silver, eastern hills emerged from the night, and Mark rested his head against the trunk of the tree and shivered. Shivered from the chill of the wet clothes that clung to him. Shivered at having left the dark behind him, at seeing day break on the land before him.

He lay beneath a ceiling of stone. A yellow light played over the uneven surface, outlining its pits and gouges. Mark saw a series of straight, flat-tipped scars in the rock and recognized them as the marks left by pickaxes. He didn't know where he was.

Sound filled his ears. He raised his head and peered into a murk of smoke and dust.

dA long narrow room lit by kerosene lanterns. A Pesh Merga barracks with men lying in army cots, two rows that extended along either wall as far as Mark could see. The aisle between the rows crowded with men sitting cross-legged, leaning their backs on the cot frames. Hundreds of men in the room, and they all seemed to be making noise -- shouting, calling, muttering to themselves.

A boy sat in the aisle at the foot of Mark's cot. He was young -- fifteen or sixteen -- and the sleeves of his olive drab coat were rolled up over his thin arms. He appeared to be the only other silent one in the room. His hands were raised and cupped below his chin, and he stared into his palms. The boy was so transfixed that Mark thought he cradled something -- a small animal, perhaps, or a baby bird fallen from a nest -- and he felt an urge to call to him, to ask what he held. Then he saw the hands were covered in bandages from which blood was seeping.

Mark looked about the room again. Now he understood the voices, knew where he was. He lay his head back and heard straw crinkle by his ears.

The Harir cave. A forty-bed ward and an operating theater carved out of solid rock, with no ventilation, no running water, no medicine. During his five weeks in Kurdistan, Mark had made a half-dozen visits to the cave for a photo-essay he was thinking of calling, "The Worst Hospital in the World." Each time, he had been shaken by the sights, the stench, had counted the minutes until he could return to the air and sunlight that waited beyond the cave mouth. This desire now seized him with urgency. He tried to rise.

His arms and legs would not move. Mark stared at the wool blanket that covered him. He checked the sides of the cot, but there were no straps or ropes holding him. He again tried to rise. Nothing.

He looked to the ceiling and thought back to the river. Fragments of memory, of being shaken awake and looking into the faces of two Pesh Merga guerrillas, the sky gray above them, the ground cold beneath him. They had asked him something in Kurdish, but Mark couldn't remember if he answered before going back to sleep. Nothing after that, nothing until now.

Mark felt the first knotting of panic and tried to calm himself. He imagined crawling, out of his cot, over those filling the aisle, crawling until he had slipped beneath the black curtain and reached the outer world. But this was beyond him. Even falling to the ground was beyond him. He could do nothing but lie in the cot and wonder why his body felt made of stone.

The voices of the wounded rose in volume and tempo, took on a fearful edge. A sudden infusion of light in the far recess of the cave, and Mark knew what it meant even before turning his head. There, a mere silhouette against the brilliant light of the operating lamps, Talzani stepped from the surgery room. The lamps were shut off then, but Talzani's white coat retained their glow as he made his way down the rows of wounded.

Triage. Mark had already seen it, photographed it. He felt fatigue wash over him, push him down toward sleep. He shook his head violently to keep it at bay.

To be alert, that was the important thing. You had to be alert when Talzani came for you, because triage was done quickly. If you were asleep when he came, if you were too slow with your answers, these could be taken as signs and the blue plastic tag placed on you. Your fate decided by the color of plastic. Get a yellow and be shunted aside. Get red and be treated. Get blue and die. On several occasions -- when Mark had been a photographer in Harir instead of a patient -- he had seen those given blues beg Talzani, cry to him, offer him money and houses and wives, but the doctor was incorruptible.

He turned to see the white coat draw nearer, just seven or eight beds away. The dark at the edge of his eyes grew, took more and more of his vision. Voices in the cave took on a flat clarity.

He tried to raise his right arm. A slight motion under the blanket. He lifted his left leg, then his right. The blanket shifted each time. His body was coming back to him. Talzani would notice this, surely. Mark took deep gulps of air to steady his breathing. In the corner of his eye he saw him, four beds away now.

The ceiling had lost its features, had become a solid mass of blanched yellow. It seemed to be descending, closing on him. Mark looked into a far corner. It was away from the light, the darkest spot in the cave, as dark as sleep.


Mark jerked awake when the hand touched his shoulder. He stared with wide eyes, the face above him a blur. First the black moustache, then the thin, young face of Ahmet Talzani came into focus. He was smiling.

"Ah, Mr. Walsh," he said in English, "you've decided to visit me again. And to what do we owe the honor?" A holstered gun poked through a flap of his stained white coat. He drew closer, his smile easing away. "What happened, do you remember?"

Mark didn't answer, just stared up at him. The orderly, an aged, white-haired Pesh Merga, muttered something in Talzani's ear.

"They found you down by the river. Do you remember that?"

Mark nodded.

Talzani pulled the blanket back. He gazed at the bruises on Mark's chest and legs, whistled softly through his teeth. "Good heavens. Did someone beat you?"

"I fell crossing the river," Mark said. "I was swept down."

The doctor took a cigarette from his coat pocket and lit it, cocked his head to the side. "You were on the other side of the river? Where were you coming from?"

Mark watched the burning tip of the cigarette. "I went out hiking in the morning. I got lost. And then it turned dark."

Curiosity left Talzani's face, and he smiled again. "A dangerous area to go hiking, Mr. Walsh, so close to the contested zone."

The orderly became impatient and whispered in Talzani's ear once more.

"He says you can't walk. Is that so?"

"I don't know," Mark said. "I just woke up and -- I think I'm just stiff."

Talzani handed his cigarette to the orderly. He put a hand on each of Mark's shoulders and pushed down. "Does that hurt?"

Mark shook his head.

"But you can feel it?"

Mark nodded. The doctor traveled down, pressing here and there, as if giving a desultory massage. He dug his hands under Mark's back, felt along the spine. He cupped the hip bones and kneaded them, rubbed around the knees, then went to the feet and squeezed hard.

"No pain?"

Mark shook his head again.

Talzani straightened and took back his cigarette. He stared at Mark's body, sent twin streams of smoke out his nose. "Can you move your arms?"

Mark bit his lip and slowly raised his elbows a little off the mattress.

"Your legs?"

He tried to lift his legs clear from the bed but couldn't; he brought his feet in, pushed the knees up a few inches.

"Very good."

The orderly muttered something else. Talzani raised his eyebrows.

"A head wound, as well? I don't think our rivers agree with you, Mr. Walsh." Holding the cigarette between his teeth, the doctor came forward and began turning Mark's head to the side, but then noticed the thin, straight cut across his throat. He frowned, traced it with a finger.

"A chafing wound. How did you get that?"

"I don't know," Mark said.

Stifling a sigh, Talzani twisted Mark's head until it was flat against the pillow, ran his fingers through the matted hair until he found the cut in back. Mark gritted his teeth as he felt it being spread open, the fresh blood spilling down his neck. A trail of cigarette smoke curled around his head to roil and disperse before his eyes. Talzani let go and stepped away. He flicked blood from his fingertips, took the cigarette from his mouth.

"Very lucky, Mr. Walsh -- a flesh wound, maybe a concussion. Kurdistan isn't a good place for a skull fracture. You might want to get stitches though." Reaching into his coat pocket, he withdrew the stack of plastic tags. "As for the rest, it's difficult to say. Your body took quite a jolt, but you're not paralyzed and there don't seem to be any broken bones. You have some neural disruption but, God willing, it's temporary. We'll know soon enough."

The plastic tags were thin and Talzani held about fifty -- yellows, reds, and blues. He cradled them in the palm of his left hand, brought up his right, and began to absently shuffle them.

"The legs will be the biggest problem. That's always the case. Legs, legs, legs. For every arm I've amputated up here, I've probably taken ten legs. Puzzling, isn't it?" He waited for a response, but Mark was watching the plastic, watching how the topmost tag changed with each shuffle: red, blue, yellow, blue. "I'm not sure why this is. I think human legs simply weren't designed for modern war."

Talzani stopped his shuffling. He looked at the tags in his palm and, with a careful surgeon's hand, reached in to pull out a yellow. He dropped it on Mark's chest. "Take it easy. Get some rest."

But Mark still stared at the plastic in Talzani's hand.

"You're going to be all right," the doctor said, leaning over, trying to meet Mark's eyes. "Do you understand?"

But Mark couldn't stop looking at the tags.

"You're going to be all right." Talzani turned and moved on to the next man.

He awoke to find he was being shifted onto a stretcher by two orderlies. They took him out of the cave, and Mark shut his eyes tight against the sudden light. He felt himself drift with the lulling motion of the stretcher -- head rising and falling, feet rising and falling -- and listened to the regular scrinching sound of the canvas each time his weight shifted.

They carried him to the recovery ward. At some time in the past, the building, standing on a level stretch of land sixty feet from the cave mouth, had been a shepherd's hut. Now it more closely resembled a beachside cabana, with a makeshift reed roof and only two walls, and it was filled with those who didn't require the cave's warmth to survive the cold nights. The orderlies moved several of the other wounded to clear a space, then hoisted Mark off the stretcher. They settled him on the stone floor, threw a thick blanket over him, and walked away.

Through the gaps in the roof, Mark saw a pallor of sun. He breathed the fresh air in deeply, but occasionally the smell of the cave came to where he lay. Each time, the stench of waste and disease lingered, seemed to cling to his clothes and nostrils. He would wait, taking short, shallow breaths through his mouth until he felt steady enough to inhale deeply once more.

In late afternoon, he heard the sound rise within the cave. It was low and indistinct at first, like the hum of a generator, but it grew in pitch until Mark could pick out individual voices, individual cries. Others in the recovery bay began to pray. Mark looked to the cave.

The orderlies brought the blues out on stretchers, lined them up in a neat row. There were five of them, and their mouths gulped at the sky like feeding fish. One could move his hands, and he used them to shield his eyes against the daylight.

The mullah from Harir came over the bluff. He went to the stretchers and walked among them, squatting down to speak, leaning close to hear a whisper. Talzani emerged from the cave. With a nod from him, two orderlies lifted up the first stretcher. The mullah took a Koran from his robe and read aloud from the holy book as his right hand went out to touch the forehead of the dying Pesh Merga. Mark watched the procession move away, the mullah still reciting, still touching the man's forehead, Talzani following, his hands clasped behind his back, his head slightly bowed.

The prayers of the men in recovery grew louder. Mark closed his eyes. The report of a gunshot. Mark twitched but kept his eyes shut. Four or five minutes later, another shot. Then another. Another. After the last one, Mark opened his eyes and stared into the reed roof.

A shadow fell over him. Talzani. Holding the revolver at his side, he gazed down at Mark. His face was white and his eyes were clouded glass.

"Do you know what Pesh Merga means?"

Mark nodded, but Talzani seemed not to notice.

"It means 'those who face death.' A romantic name, don't you think? Poetic. I myself have never seen one face death; they all turn away at the end."

The doctor looked to the ground, ran a trembling hand through his short black hair.

"It's not so easy, is it?" he asked quietly. "Without your camera, it's not so easy."

He started back to the cave, holstering the gun as he went.

The cloud cover blew off that night. Beyond the reeds, Mark saw a thousand stars.

An afternoon cool and clear, the clefts of the surrounding mountains dark with the runoff of melted snow. Mark sat on the edge of the promontory, a hundred yards from the cave mouth, and slowly opened and closed his hands. It felt as if thin needles were being stuck deep into his joints, but the fingers were bending, straightening, coming back to him. He reached for his knees. Even through his heavy trousers he felt the swelling. He rubbed them until the pain made his eyes water. It had been five days since the explosion, four nights since the river. That morning, he had sent a boy to settle his account at the hotel and collect his things; his camera bag and knapsack were now in the shade of a rock outcropping beside the cave.

Below him was the road. It hairpinned down the mountainside to disappear amid the stone homes of Harir. At the far end of the town it reappeared, twisting past fields and hills before turning north to slip behind a mountain. Somewhere beyond that mountain, the Turkish frontier. The Jeeps would leave at nightfall. Mark was determined to be on one.r

He tucked his feet under him, set his right hand on the ground, and rose again. His knees wobbled but held. He waited for the trembling to subside, then took a small step. His legs felt disembodied. Another small step, his body teetering to either side.

"You are doing well."

Mark turned to see Ahmet Talzani coming over the broken ground. In the daylight, his doctor's coat appeared splashed with brown paint. Mark looked back at his own feet and took two more timid steps. Talzani's feet scraped on the ground close by.

"Very good. Very good, indeed."

Mark stumbled and came down hard on his right foot. The pain shot through his hip, into his head. He inhaled sharply.

"It hurts today?" the doctor asked. "Excellent. Pain is always preferable to numbness."

Mark resumed walking and Talzani fell in alongside, watching the tentative steps.

"You should have crutches," he said.

Mark knew this wasn't an offer but an observation. "I'll be okay."

When he tripped again, Talzani caught him by the arm.

"You're overanxious, you're making mistakes. Here, rest." Talzani gently helped him into a sitting position on a boulder. He sat alongside and took a cigarette pack from his coat. "Maybe you should wait another day."

"No," Mark said, "I have to get going. I'm late as it is."

"Suit yourself." Talzani lit his cigarette with a small gold lighter, tilted his head back, and released a plume of smoke. He sniffed at the air. "Spring. A wonderful time of year here. Living in that cave, I would even forget there are such things as seasons if I didn't force myself to take these breaks." He held the cigarette up. "Breathe air, look at the world. And, of course, one reaches the point of diminishing returns; if I stay too long in there, I begin killing more patients than I save." He laughed lightly, looked to Mark. "And the other photographer, he is leaving with you?"

"Colin? No, he's staying a few more days."

The doctor nodded. "I haven't seen him come by. I would have thought he'd visit you after your accident."

"I doubt he knows about it. He left for the lowlands the day before it happened."

"Ah, that explains it." Talzani smiled. "Anyway, all you war people think you're immortal -- probably not good for morale to see a colleague end up in Harir cave."

Mark smiled back. "No, probably not."

They fell into a comfortable silence. For some minutes, they gazed out at the mountains, Mark rubbing his sore hands, Talzani nursing his cigarette, raising it to his lips, rolling it between his fingers. "Still," he said, finally, "I trust you've had an enjoyable visit."

Mark studied the doctor's profile, realized he was serious. "Oh, it's been a real treat, Talzani. I can't understand why you don't get more tourists up here."

Talzani laughed. "Sorry. It's the Moslem in me -- a point of honor with us to make sure strangers are content."

They watched a shepherd moving his flock up to pasture on a distant hillside. The sheep were white with black feet, and they looked almost dainty scrabbling over the rock-strewn slope. Talzani folded his arms over his chest, lolled back on the boulder.

"Probably the way the whole world was two thousand years ago," he said, "this kind of life, this kind of beauty. But a cursed place. Beautiful and cursed. I wonder sometimes how that works. Do we see its beauty despite the war, or because of it?"

Mark remembered other places. Afghanistan, Mozambique, Cambodia. Jungle, mountains, desert, savanna. In each one, he had found beauty. In each one, he had felt the land held something sacred. He was thinking of this when Talzani spoke again:

"We're about to be crushed," he said. "The BBC is reporting the Iraqis have expanded their offensive. Already they have taken most of the plains, and now they will come into the mountains. Every hour the news is worse. More dead, more wounded." He looked to the western horizon, as if for a sign of the invaders. "As you can imagine, the world is outraged. The Americans are giving speeches about it in Congress. The UN is debating a resolution of condemnation." Talzani sighed. "But that's okay, that's okay, it's not their fault. We've been losing wars forever; it's what we Kurds do best."

He stood up, flicked the cigarette out over the escarpment. He stepped to the edge and peered down.

"You know, in my lifetime -- just my lifetime -- we have fought eight wars: the Turks twice, the Iranians and Iraqis three times each. If you go back to my father and my father's father, you cannot even count them all -- Turkey, Iran, and Iraq but also Syria, Russia, the British, the French, everyone. We are like the little guy at the bar who wants to fight all the big men. We get beaten up by one, then get up off the floor and go after another. Over and over. A lifetime of war. Can you imagine?"

"Why do you stay?" Mark asked.

Talzani looked to him and shrugged. "Where am I to go, Mr. Walsh? I am only from one place." He kicked at a large stone, as if trying to dislodge it from the ground. "Not that I always accepted that, of course. When I was studying in Michigan, I hated Kurdistan, hated the war, the leaders who always kept it burning. I wanted nothing to do with it. I was going to stay in America and have a good life. I was going to be a surgeon -- a real surgeon -- find a wife, live in a great big house." He chuckled, shook his head. "Great big house. If I had kept all the limbs I've cut off here, I could have built a mansion with them."

The rock was too large or the earth too dry. Talzani stopped his kicking and strolled back to the boulder.

"Homeland. It doesn't matter what you do or even what you believe, you never escape the homeland. It always keeps you. They talk of free will, but we are all just homing pigeons in the end."

With the doctor again beside him, Mark gazed down at the village. A breeze was coming up from the valley and it brought sounds -- the tinkling of goat bells, a shouting child, a calling vendor -- across the miles of air.

Mark saw a figure in black appear on the road below, leaving Harir and walking toward them. He sensed Talzani's attention fix on the figure as well. After a time, Mark recognized the mullah. He looked to the cave mouth and saw that a stretcher had been brought out.

"How many today?" he asked.

Talzani reached into his coat for another cigarette. "Just two. And one burial."

He motioned with his head toward the cave; off to one side was an odd-shaped bundle of dark plastic about six feet long, tied off at either end with white rope.

"They found it by the river this morning -- badly decomposed but a man. I had it wrapped in plastic for the smell." Talzani rolled the cigarette back and forth between his fingers as he stared at the bundle. "A curious case. The feet were severed -- very jagged wounds, the bones shattered, so clearly an explosion of some sort, a land mine, most likely -- but then his hands were tied together. A bootstrap. Someone had tied his hands together like this" -- Talzani crossed his own wrists -- "with a bootstrap. I cannot account for this." The doctor looked to Mark, gave a quick, incredulous laugh. "You see? It's very puzzling, isn't it?"

"Yes, I guess it is."

Talzani flipped a hand in the air, as if shooing a fly. "Ah well, these little mysteries, morbid curiosities, war is full of them."

In silence, they watched the mullah ascend. He held a Koran in his hands and seemed to be reading from it. His black robe curled and billowed in the wind. Mark smelled the burning tobacco, heard its dry crackle when Talzani inhaled.

"What do you bring with you, Mr. Walsh?"

Mark turned to him. The doctor held the cigarette poised, close to his lips, as he watched the approaching mullah.

"What do you mean?"

"When you come to a place like Kurdistan, a dangerous place, what do you bring?"

Mark shrugged. "Cameras, some filters. The clothes depend on the climate."

Talzani shook his head. "No, no, I mean what charms?" He looked to Mark with a tired smile. "Surely you carry some talismans to keep you safe."

Mark reached into his jeans pocket and brought out a small, silver-black coin. He held it out to the doctor. "An Indian head nickel. Over sixty years old. My grandfather gave it to me when I was a boy. It's been through every war with me."

Talzani took the coin and studied it, turned it over and over between his fingers. The mullah was passing just beneath them, almost to the crest. Talzani handed the coin back.

"I'll tell you something I've learned from being here, Mark. I think it might help you."

Mark felt himself draw back a little, his toes curling in his shoes; it was the first time Talzani had ever used his first name.

"There is no pattern to who lives or dies in war. Most of us, we can't accept that. We invent all kinds of explanations and superstitions for why things happen. 'He died because he lost his nerve, he died because he forgot his lucky coin.' None of it is true. In war, people die because they do. There's nothing more to it than that."

He reached into his coat pocket and took out the stack of plastic tags. He held them up, as if offering them to Mark.

"My little tags. A pattern, no? A scientific method to decide who lives and dies." Talzani withdrew the offering, cradled the tags close to his side. "If only it were so."

Mark remembered the evening in the cave, watching as Talzani had shuffled the tags.

"Would you believe that sometimes I am so tired, or the cave is so dark, I'm not even sure of the colors I give them? Would you believe that men have been given blues, have been set aside to die, suffering from nothing more than dehydration or a broken arm? Disturbing, I know, but it's true."

The doctor lifted the flap of his coat pocket and carefully placed the tags back inside.

"Well, those were simply mistakes, of course, but always there is this question of what is a blue, and this is not at all about science or medicine, just mathematics. In quiet times, when there is not a lot of fighting and I have more time, maybe even the man with a stomach wound has a chance. But then more wounded come in and he is out of luck, because now anyone who is going to take up two hours of my time to save is not worth saving. And then more wounded come in, and now the time is down to an hour, a half hour, twenty minutes. You see how it goes? Simple math. Math and luck."

He scraped his foot over the pebble-strewn ground, leaving a swath of cleared dirt.

"But don't imagine I lie awake at night thinking of these things. No. I sleep very soundly. My little tags are for them, because they need to believe there is a system. For me, I know it is all fate. Once you understand this, it makes life here much easier, for you are freed of this idea that you can prevent something from happening. Some live, some die, that's all."

The mullah reached the promontory. He started toward them, but Talzani motioned for him to wait. The mullah stopped, and Mark noticed for the first time that he was middle-aged, with a dark beard and very white skin; as he stood there, thirty feet away, staring at them, he seemed as impassive and still as a statue.

Talzani leaned closer to Mark, rested a hand on his shoulder.

"You were very lucky," he said. "You know that, don't you? The head, the spine, if there had been any complications..."

Mark looked into the doctor's solemn, sad eyes. He forced himself to smile. "What, you would have shot me?"

"Yes," Talzani whispered, lightly patting his shoulder. "Yes, I would have done that for you." He let his hand slide off, gazed over the valley. "Some live, some die. It's the only way to view it. Anything else is just self-torture and arrogance. Because we are not gods, none of us are gods."

He rose, started toward the waiting mullah, then suddenly turned.

"Oh, good news. I secured a place for you in one of the Jeeps to the border. It leaves at eight."

"Thank you, Ahmet," Mark said. "Thank you for everything."

The doctor shrugged, walked away.

Mark stared out at the valley and listened to Talzani's footsteps recede until they were lost on the wind. He looked to the hillside where the shepherd had been. He no longer saw the man or his black-footed animals and assumed they had reached the crest and descended the other side in their search for pasture. Reaching into his vest pocket, he took out his wallet, the photograph he had not viewed in over a month. It had developed a number of creases over the past three years, the colors losing their luster, but her smile was still radiant, her hair still black and soft, and Mark stared at her image with a tenderness and longing that was now safe for him to feel.

He looked out at the road. In his mind's eye, he saw it stretching clear across Kurdistan, over the frontier, all the way to the place where she was.

A gunshot. A soft echo that rolled back from the far mountainside. Mark leaned against the rock, his back to the cave, and waited for night to come.

Copyright © 1998 by Scott Anderson

Reading Group Guide

Discussion Questions

1. Initially, Elena is "able to live with the worry by telling herself that what Mark did was important, even noble." Is a war photographers's job admirable? Or could it be considered exploitive? How do Mark's experiences highlight the difficulty of being an observer -- instead of a participant -- in war? Compare and contrast Mark's career with Elena's job as a refugee program coordinator at the UN.
2. Is it wrong for Colin to travel into a war zone and endanger his life while Diane is pregnant with their first baby? Discuss the impact of dangerous careers on spouses and children. Why do you think Mark is so adamant about wanting to have a baby with Elena when he returns from Kurdistan?
3. When did you begin to suspect that Mark might know more about Colin's fate than he first admits? Do you think he deliberately withholds his knowledge of Colin's death or subconsciously blocks it from memory?
4. Joaquin Morales is disdainful of traditional psychotherapy and dismissive of Elena's suggestion that Mark see a "real" doctor. Yet Joaquin's "cure" helped patients at his institute and seems to work for Mark as well. What do you think of "Dr." Morales' unique approach to therapy? How would you describe his methods? What does the book as a whole seem to say about the field of psychology and the nature of expertise?
5. Joaquin Morales says: "There is no salvation, Mark. There is no God to forgive you and there is no psychiatrist who can cure you. This Western idea that we can pass over our pains, how absurd! You never pass over them. You carry them with you forever. That is what it means to live." Do you agree with him? Does traditional therapy seek to eliminate pain instead of helping people accept it?
6. "Triage" -- the prioritizing of who will get medical treatment under extreme circumstances -- seems rather ruthless as practiced by Dr. Talzani in the Harir cave. Discuss the ethics of this selection process and how it relates to fate and the randomness of war. Why did Anderson choose Triage as the title of his book?
7. Compare and contrast Dr. Talzani's mercy killings of the "blues" in the Harir cave with Dr. Morales's murder of dangerous "incurables" at his institute. How does each man justify his dual role as healer and murderer? Do you find their reasons compelling or repugnant? Compare their killings with Mark's hastening of Colin's death. Can murder -- or euthanasia -- be a moral act?
8. After revealing the secret of Carlos Perez's fate, Joaquin says to Elena: "What to make of old Papa now? Not just the 'Fascist Father Confessor' but the killer of killers. Better or worse?" Answer his question. Why does Elena finally forgive her grandfather for his past? Do times of war require unique or altered ethical codes?
9. Dr. Talzani says: "There is no pattern to who lives or dies in war. Some live, some die. It's the only way to view it. Anything else is just self-torture and arrogance." Dr. Morales says: "We invented history for the same reason we invented God, because the alternative is too terrible to imagine. To accept that there is no reason for any of it, that we are only animals and there is no explaining the things we do, that happen to us -- too awful, no?" Do you agree or disagree with these statements? Are both men fatalists? Compare and contrast their philosophies about life and war.
10. Do you think that Mark Walsh will continue with his career as a war photographer after his traumatic experiences in Kurdistan? Why or why not?
Note from the Author
While I've never thought of Triage as an autobiographical novel, the fact is I started writing it in circumstances quite similar to those facing Mark at the beginning of the book. I had just returned to the United States from a war zone -- Sri Lanka -- where I had gone through a rather traumatic experience, and found that I was incapable of talking about it to any of my family or friends. Instead, I moved to a city where I knew no one -- Baltimore -- holed up in a squalid little apartment, and spent four months feverishly writing the first draft of the book.
That was eleven years ago, and that first draft, frankly, wasn't very good. The problem, I gradually realized, was that I was writing with the same sort of emotional numbness that I felt. It took a long time, and many more drafts of the novel, for me to be able to articulate what I truly felt about my experiences in war and to bring what I hope was a deeper emotional honesty to the novel.
Now, if I had to try to describe what I think Triage is about, I would say it is about searching, a search for redemption and a search for belonging. In their own way, the main characters of the book are war-orphans, either physically displaced from their homeland or emotionally displaced from their loved ones; in their own way, they are trying to return to what existed before. What they ultimately discover is that redemption and belonging are part of the same thing, and this discovery holds out the hope that there is a path they might follow to better, happier lives.
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About The Author

Product Details

  • Publisher: Scribner (November 23, 1999)
  • Length: 240 pages
  • ISBN13: 9780684856537

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Raves and Reviews

Charles Jaco USA Today Triage will make your palms sweat....Despite the brutality of battle and the terror of surviving, it is not a novel about despair; it is about hope...tightly plotted and unflinchingly unsentimental.

Christopher Dickey The New York Times Haunting...into the sere landscapes of a Hemingwayesque novel about men at war comes [a] conscience straight out of Graham Greene.

New York magazine Triage opens with a stunning set creepy as Saving Private Ryan's D-Day scene.

Devin Friedman GQ [An] emotionally intelligent novel.

Dan Cryer Newsday Remarkable...riveting...surprise is a key element in Anderson's storytelling....The shocking conclusion is both a dramatic and moral triumph...that such a thoughtful, provocative book also provides so much pleasure is a tribute to Anderson's already formidable talents.

The New Yorker Suspenseful.

Susan Salter Reynolds Los Angeles Times Thrilling.

David Nicholson The Washington Post A sensibility that understands the seriousness of love and life.

Allen Salkin New York Post A brilliant, gripping new book...there are passages in the book that leave a reader's heart beating hard.

Anthony Brandt Men's Journal Triage looks human savagery in the face and doesn't blink....But this is not a despairing book, and that is what makes it so strong....[Anderson] has crafted a story that is acute and moving, one that strips away obfuscation and illusion and tells powerful truths.

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