"Our cruelest moments are when we get a child whose foot or part of his leg is only held by skin and we have to amputate," according to Osman, who said he was jailed and tortured by the Syrian regime twice since the start of the uprising in March 2011. "In the early days, we used to cry when we had a child with a severe injury, then recharge our psychological energy before we return to work.
"Now, there is just no time for that."
When AP journalists first arrived Wednesday afternoon, there were only a handful of patients being treated. Dr. Abu Rayan, who studied medicine in Moscow, stood in one corner chatting with two members of the hospital's pharmaceutical team. The doctor asked to be identified by his nickname for fear of retribution.
A man approached him, complaining of pain from shrapnel lodged in his right leg.
"Forget it, it will never come out," the 35-year-old doctor told him with a smile.
Nearby, Zakariya Khojah lay on a gurney, a tube draining a wound in his side. He had a lifeless stare fixed on the ceiling. Standing at his side was his 13-year-old son, Bashar.
"Papa, is there anything hurting you beside your chest?" the boy asked. The father replied with a slow shake of his head.
"I was walking just ahead of him when a bomb fell close to us," Bashar said. "He's all I got. My mother died three years ago."
The patient was later moved to a chair because the gurney was needed for someone else. Several hours later, he was brought outside to a pickup.
"I fear that my father may not get better," Bashar said before climbing in beside him.
Around 3:10 p.m., shortly after artillery blasts were heard nearby, a wave of wounded arrived. Frantic men screamed, "Emergency! Emergency!" as they carried the casualties inside.
In minutes, the small, three-bed intensive care unit was filled, and the overflow of patients had to be treated on the floor of the lobby.
"Where are you guys? Hurry up, please, guys!" yelled one of the escorts. Others shouted, "God is great!"
Word quickly spread that the wounded, about 15 in all, had been standing in a bread line when a shell fell nearby.
A fighter carrying an RPG launcher on his shoulder walked over the wounded on the floor as he made his way to the narrow staircase leading to the X-ray room in the basement. A woman wearing the Muslim hijab and a blood-soaked black coat was on a gurney waiting for someone to attend to her. A man on the floor had a hole in his back the size of a tennis ball.
"May God curse Bashar Assad until he goes to his grave!" yelled a man in a loose gray robe. "He is a pig and son of a dog! May Allah curse his father, tanks and guns!"
The lobby was swiftly cleared of the wounded. Relatives took them away, either to their homes or to better-equipped hospitals in northern Aleppo province or in government-controlled areas of the city.
The respite did not last long. A series of blasts shortly after 4 p.m. brought a fresh wave of wounded, many of them children.
"Uncle, please take me to my mum at home," said one of them, a 9-year-old named Fatimah, pleading to a journalist.
Fatimah only had shrapnel wounds to her arms and lower torso, but she clearly was in shock. She had been shopping with three aunts and several cousins when a shell fell on the street nearby. One of her aunts died in the hospital.
"It's OK, sweetie. Just ask God to exact revenge on Bashar," a fighter told the girl, who wore her long brown hair in two ponytails.
She grimaced every time she looked at the other patients nearby. A man lying on the floor with a back injury repeatedly shouted, "There is no God but Allah, and Muhammad is his prophet."
Addressing the medic treating him, he said in a heart-wrenching voice: "May Allah have mercy on the eyes of your parents."
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