Plea of war doctor who shot dying woman

AN ADELAIDE surgeon who shot dead a young mother at the site of a massacre to save her hours of agony has called for euthanasia to be legalised in Australia.

Dr Craig Jurisevic, a cardio-thoracic surgeon and author of the memoir Blood on My Hands, volunteered as a doctor and then became a combatant with the Kosovo Liberation Army during the Balkans war in 1999.

On patrol, he came across a civilian woman who had been shot through the legs and partly disembowelled by Serb paramilitaries.

She was moaning in pain and begged him to end her suffering. He says he knew he could not save her, so he put a blanket over her face and shot her with his pistol.

Dr Jurisevic says he has never performed euthanasia in Australia but says it is common: ”You may not get people to come out and admit that it happens, but it happens all the time. Patients with terminal cancer, for example, who aren’t in severe pain but who are uncomfortable and suffering have morphine infusions, and as the dose of morphine is increased their respiration slows down until they stop breathing and they die ?

”That’s why there are people on morphine infusions who aren’t in pain. It happens frequently in terminally ill patients.”

His comments add to similar calls from doctors at a conference of the World Federation of the Right to Die Societies in Melbourne this week.

Dr Jurisevic fears euthanasia laws could be abused by people who want to prevent euthanasia, and by people who want to use it inappropriately, but on balance he believes it is better to have the practice out in the open.

”Now that people are living longer, they are developing cancers and other terminal conditions, which mean they will suffer for a lot longer, too, leading up to their death. Part of our ethos as medical professionals is to ease suffering; not just to save life, but to ease suffering.

”And if we’re to be told that we’re not allowed to ease a terminally ill cancer patient’s suffering because it’s against the law – that they should be forced to suffer in pain and without dignity for weeks or longer – then that’s terrible.”

He has no regrets about his shooting in Kosovo but admits he acted illegally. ”Euthanasia wasn’t legal in Yugoslavia, as it was then, so that was a criminal act. That’s an argument a lot of Serb journalists within Serbia have used. They called me a criminal because I killed that poor Albanian woman. I said, ‘Well, who put her there in the first place?’ ”

Surgeon at arms

THE soldiers could hear a woman crying out in a house at the other side of the village. Two of them peeled off to investigate. Unluckily for them, Serb paramilitaries had left a booby-trap.
In Kosovo, Muslims take off their shoes before they enter a house. It is a gesture of respect for the home. But during this Balkans war, Serbs used shoes at the doorstep to disguise a tripwire that triggered fragmentation grenades. The moaning woman had been spared for one reason only: as bait to lure whoever would come next to this hamlet, site of a massacre by advancing Serbs.
Craig Jurisevic is an Australian doctor who had volunteered as a medic to help the victims of the Balkans War. This day, for the first time, he had picked up guns to go on patrol with soldiers of the Kosovo Liberation Army. He realised this was the moment when he crossed the line to become a soldier who could practise surgery, rather than a surgeon who knew how to hold a gun. What he did not know, when he holstered his pistol that morning, was that the doctor in him would feel forced to use it on a patient.
Hearing an explosion, he raced over to the house. He checked their pulses and confirmed the deaths of the soldiers and the woman. He had already found 15 bodies of women and old people riddled with bullets. He moved cautiously towards a second house that held another woman whimpering in pain. He inspected the doorway carefully; yes, there was the wire. It was snipped and he entered.
The woman was sitting up against a wall. Near her lay the body of her husband, his head in a pool of darkening blood. In her arms she cradled a dead child, a boy of about four or five — the age of Jurisevic’s own son, back home in Adelaide. The child had been garrotted.
The woman had been shot in both legs to prevent her moving and was sitting in a massive pool of blood. She had been partly disembowelled and the coils of her innards spilled from the gash.
“The wound to her lower abdomen is meant to cause enough pain to make her cry out without killing her too quickly,” Jurisevic later wrote.
She clutched his wrist and begged him to bury her son before the next day, as is Muslim custom. Then a soldier translating for her said, “Doctor, she is asking us to kill her.”
“To kill her?”
“Yes. That is what she is saying. Doctor, I am sorry, I cannot do this.”
Jurisevic knew he must be quick because the Serbs would have heard the explosion and would return. If they found her still alive, he was sure, they would torture her even more.
In his book Blood on My hands: A surgeon at war, this is how Jurisevic describes what happened next: “I move the woman as gently as I can and place her beside her dead husband. From the bedroom I fetch a thick blanket. I think she sees clearly enough what is to follow, and she nods and manages something like a smile. I turn her head to one side, gently place the blanket down on it, point the barrel of my pistol down and pull the trigger. I wait for a few seconds, then reach for the woman’s wrist. The pulse is gone. I slide the pistol into its holster and take my leave.”
That was 11 years and half a world away. Today, Jurisevic sits at an outdoor cafe in Adelaide, his camouflage gear swapped for an immaculate navy pinstriped suit — he has been in his consulting rooms all morning — looking every inch the successful medical man. We are in the shade but all through lunch his eyes are hidden behind mirrored sunglasses, the dark, shiny lenses reflecting the outside world and shielding the responses of his inner one. Despite his ready answers to questions, the shades give the impression of a surgeon who doesn’t fancy the prospect of a journalist cutting too deeply into him.
At 45, Jurisevic is still lean and handsome, with chiselled cheekbones, blue eyes that crinkle at the corners when he laughs and teeth that must be the despair of his dentist; they seem to be quite naturally Hollywood-perfect. Here, as on the battlefield, he makes quick, decisive choices; this cafe, this table, this chair are all picked out in very short order. He immediately notices any need and swiftly moves to fill it; a glass of wine, a menu, the salt and pepper, tomato sauce for the burgers. He radiates energy, and action provides opportunities to release it. It also seems that, if there’s a need or a problem, Jurisevic believes it is up to him to solve it.
This deeply seated sense of responsibility has combined with what he calls an “adolescent hunger for stirring times in exotic climes” to make for an exciting life — but a life with episodes that he sometimes looks back on with doubt and remorse. Not putting the pistol to that poor woman’s head. The decision was so clear-cut that, in a book where he debates every other moral dilemma he was faced with at the front, this incident is only briefly described.
“It wasn’t as hard as most people think,” he says, “because, if you take away the method I used, it would just be euthanasia for someone who is dying. But because it wasn’t a drip with morphine, because it was a pistol, people say it’s terrible . . . She would have been dead in a few hours. She’d been shot in both knees and she’d lost a huge amount of blood. She’d been cut open and her bowels — ” he gestures expansively. “We had no blood, and we would have had to carry her, and we couldn’t carry her. I had just a little bit of [anaesthetic] but I was going to keep that for the people who would survive. Also because she had lost a lot of blood, there was no way you could put a drip in and then wait for her to die with [anaesthetic]. And besides, we had to get out within minutes because the Serbs were coming . . . they would have tortured her more.
“I knew, it was instinctive, that’s what I had to do. She wouldn’t have suffered . . . It would have been a lot harder if she didn’t consent or didn’t ask.”
But he concedes that even if she hadn’t begged him, he would still have considered putting her out of her misery. “Even if I was a rampant anti-euthanasia activist, I can’t see how I could not have ended her life. I couldn’t have walked away saying, ‘I feel good about myself because I believe euthanasia is wrong, so I am walking away and leaving her to suffer more and to be tortured again, but I can live with that.’ You couldn’t!”
Jurisevic feels strongly driven to be a good man, and his idea of manhood was powerfully shaped by his childhood experiences. Although they later reconciled, he was estranged from his father for some time. He changed his surname from his father’s name, McLachlan, to his mother’s maiden name, Jurisevic.
His mother was a Yugoslav refugee who taught herself English and trained as a psychiatric nurse in Australia. It was she who told him inspiring stories of the wartime heroism of his Slovenian grandfather, Franc, who “put his life on the line for a cause, and was sent to concentration camps, then came back and saw corruption in Yugoslavia and spoke out against that, and was put in prison again by the people for whom he’d fought. So he had a very strong hatred of injustice.”
JURISEVIC volunteered to work with the International Medical Corps in the Balkans after being moved by the suffering of thousands of refugees pictured on TV news reports. He had previously done a stint with the Israelis, including about 40 medivacs in Gaza; there, too, he had picked up a gun because he came under fire when rescuing the wounded. “I saw taking up a weapon and using it to protect the patients as just part of my job, an extension of treating the disease,” he says.
What of the doctor’s Hippocratic oath, which warns, “First, do no harm”?
“When they say ‘do no harm’, it’s in reference to do no harm to your patient, not do no harm to anyone,” he argues. “So if somebody’s trying to kill the patient, you have to defend the patient. You can’t just say, ‘Sorry, do no harm,’ and stand by. That’s just ridiculous.”
Jurisevic has decided views; words such as “terrible”, “ridiculous” and “absolutely” punctuate his sentences. He says he is drawn to war zones because he has an abhorrence of injustice. He was alerted to the potential of this war when the Serbs began using medical terms and the phrase “ethnic cleansing” as euphemisms for atrocity.
He writes, “Whenever national leaders start applying metaphors of ablution and disinfection to human beings, you can expect killing on a large scale to follow . . . [they rationalise] murder by talking of cancer . . . of scalpels and intervention.”
When he arrived in the Albanian town of Kukes, 200 kilometres north-east of Albania’s capital, Tirana, Jurisevic was appalled. His gorge rose at the stench of untreated gangrene even before he entered the decaying ruin of a hospital. Inside, blood spattered the theatre walls, equipment was dirty, instruments were rusty and nurses were drunk, drugged or cruel. He caught a doctor hacking with blunt scissors at exposed muscle and tendons in the hand of a small child who had been given no anaesthetic. When the boy screamed and writhed, nurses slapped him.
He spent long days operating on refugees — women, children, old people — with horrific wounds. “So many amputations!” he writes. “Reports of casualties don’t fully convey what war does to people. Imagine if I were to give a weekly surgeon’s report to the news services and display the limbs that had been lost, the metres of bowel discarded, the eyes blinded.”
At times he found it hard to hold on to the surgeon’s clinical distance. Of retrieving wounded children from a bombed kindergarten littered with body parts, he writes: “I’d like to vomit or tear my teeth out or shut my eyes and fall to my knees.”
Jurisevic could not understand why supplies were so poor despite a flood of international aid. He learned that medicines and equipment were shut away in cupboards, to be sold on the black market. Patients with no money were turned away. The hospital chief was in cahoots with the local mafia, and they were using the flood of wounded as a revenue stream.
Jurisevic exposed the corruption with the help of the American military magazine Stars and Stripes. He was then warned the mafia would kill him, so he resigned from the International Medical Corps and accepted an offer from the KLA to run one of their field hospitals. There, he was alarmed by the lack of training that left the idealistic, untried young soldiers around him utterly unprepared for what they were to face. He set up his own combat training. The doctor there to save lives taught recruits the art of killing. He was practised with guns from his teenage years when he hunted and culled goats, roos and rabbits in the hills around Adelaide.
He puzzled over how to reconcile all this with his role as a healer. He decided to amend the Hippocratic oath with a principle laid out by Bassanio in The Merchant of Venice: “To do a great right, do a little wrong.”
JURISEVIC learned that the young volunteer soldiers at the front, Mount Pastrik, had been abandoned by their commanders and their doctors, who feared for their own lives. His book paints ultra-nationalist Serb troops as alcohol and amphetamine-fuelled war criminals, but he slams the KLA too, for cowardice.
Jurisevic decided that he would go to the front himself. He set up his own aid centre in a cave on a ridge line at Mount Pastrik, sometimes evacuating the injured down the mountain under a hail of sniper fire. At night, he slept with dead bodies in the cave waiting for burial. Day and night, he endured the Serb shelling.
And it was at this point that he made the decision that would trouble his sleep long after he returned to Australia. Jurisevic led a small patrol closer to the Serb positions. He mapped their co-ordinates in detail and sent the figures off to NATO troops. The next morning, those Serb units were heavily shelled by NATO. Later that day, a ceasefire was declared.
Years later, Jurisevic discovered that that last round of NATO shelling had killed up to 600 people. “I still don’t know whether or not the co-ordinates I gave resulted in that bombing,” he says. “And whether or not that bombing in the area of Pastrik ended the shelling, or whether it was just the ceasefire that resulted in the end of the shelling. But up to 600 people died. It’s still not a good feeling, even if they were all war criminals and baby-killers.”
Then his language hardens, and suddenly he is using the same ugly euphemisms he heard on television in Adelaide: “I realised that certain paramilitaries in the area were a hard bunch. They had no respect for human rights. So basically — it sounds terrible — I saw them as a disease. They were inflicting harm and illness on innocent civilians so they had to be stopped.”
The book makes clear that Jurisevic did suffer some kind of post-traumatic distress after he returned. He says, “One thing that I’ve realised is that I still can’t actually remember arriving in Adelaide and seeing [my wife and my son]. I still can’t remember several days, which can’t be a good sign.”
He did not seek professional help but found writing the book was therapeutic. He says he has had death threats since its publication, mainly from ultra-nationalist Serbs living in Australia. It is not because he shamed them, he says: “If you expose war crimes they don’t deny the war crimes, or even express remorse. They say ‘Yes, this happened, we did this because this happened 800 years ago.’ You can’t justify crimes against humanity now by crimes against humanity in the past.”
Jurisevic has now joined the Australian Defence Force reserves and has been to East Timor and Afghanistan but says he would like to spend the next few years in Australia with his wife and three sons.
He is on another campaign, though: he wants to mount a class action against the federal government to force the banning of cigarettes. As a cardiothoracic surgeon, more than 90 per cent of his work involves trying to remove lung tumours from smokers. He says tobacco kills up to 18,000 people a year but the government won’t ban it because it earns $4 billion more in taxes than it costs in healthcare.
“Of all lung cancers diagnosed each year, only 15 per cent will be early enough to be cured by surgery and chemo-radiotherapy . . . The death rate from lung cancer has not changed significantly in the past 30 years,” he says. “The greatest threat to Australian lives today is not terrorism, road trauma or knife crime. It is tobacco.”
The man who loves causes will never lack for one.
Blood on My Hands: A surgeon at war, by Craig Jurisevic, $32.95, e-book $11.25 from

BORN 1965.
FAMILY Married Donna, also a medical specialist; three sons.
WORK IN CONFLICT ZONES Israel and Gaza 1992-3; Albania and Kosovo 1999; East Timor 2006; Afghanistan 2008.
CAREER Cardiothoracic surgeon, senior lecturer at the University of Adelaide, member of the International Humanitarian Law Committee of the Australian Red Cross.