“He trekked along the service road more confidently than he had that morning, and imagined what those smug search committees would have had to say about it. They probably wouldn’t say anything. They were probably all dead. In this way the war was an equalizer, the first true Chechen meritocracy.”

After Sonja allows Akhmed to work at the hospital, Akhmed remembers the many committees that refused to hire him as a physician. Because the war has made resources so scarce, Akhmed finally has the chance to become a doctor. Akhmed’s bluntness in this passage demonstrates the brutal realities of wartime.

“As he refolded the note and dropped it into the trash can, he wanted to reach out, to snatch the tumbling rectangle before it landed and was lost among the last words of two dozen others who died far from their villages, who were pitched by strangers into furnaces, who were buried in cloud cover and wouldn’t return home until the next snowfall.” 

Many characters, Akhmed included, sew their home address inside their clothing so that their bodies can be returned home if they are found dead. This note was found in an article of donated clothing, meaning the body was unclaimed and cremated. In this moment, Akhmed reflects on the many people separated from their homes and lost due to the war.

“The name of the bone was tibia, and it was connected to fibula and patella. He had studied the names that morning, but what he knew wouldn’t push the saw.”

As Akhmed performs his first amputation, he realizes that his studies haven’t prepared him for the reality of being a doctor. A person can only learn so much from studying; some lessons and skills are only achieved through real-life experience.