‘Pools of blood, hundreds of gunshots’: I am a surgeon in Iran – this is the horror I’ve witnessed in the crackdown

The Guardian-Jan 25th2026

I’ve worked as a surgeon in disaster zones. Nothing compares to the nightmare I saw in Iran’s hospitals when the state started shooting protesters

By 8 January, Iran’s anti-regime protests that began in late December had spread across the country with reports of at least 45 people killed by security forces. Over the next three days the regime appears to have instigated a brutal crackdown on protesters that is now estimated to have led to the deaths of more than 5,000 people.

By the time I reached the hospital in Tehran on Thursday (8 January) night, the sound of the city had already changed.

Up until a few hours earlier, doctors and patients were still sending me photos on WhatsApp; pellet wounds to the back, the hands, the head. Painful injuries, frightening injuries – but survivable. The kinds of wounds that could be treated, that suggested the violence still had limits. Then, at eight o’clock, everything went dark. Internet, mobile phones, messages, maps – all gone.

Minutes later, the gunfire started. From about 8.10pm or 8.20pm, I could hear shots echoing through the streets, along with screaming and the sound of explosions. I was called into the hospital. By the time I arrived, it was immediately clear that we were no longer dealing with the same situation.

The patients coming in now were not hit by pellets – they had been shot with live ammunition. War bullets. These were not warning shots. These were bullets designed to pass through the body. Bullets that entered on one side and exited from the other.

I am a surgeon who deals mostly with torso injuries, and that night the operating rooms filled with wounds to the chest, abdomen and pelvis. I did not see arms or legs, others dealt with those, but I saw the injuries that decide whether someone lives or dies within minutes. The injuries where there is no margin for delay, no room for error. Many of the shots had been fired from close range. The damage they caused was severe. In some cases, catastrophic.

Very quickly, the hospital became a mass casualty zone. We did not have enough of anything: not enough surgeons, not enough nurses, not enough anaesthesiologists, not enough operating rooms, not enough blood products. Not enough time. Patients kept arriving faster than we could treat them. Stretchers lined up. Operating rooms turned over again and again.

In a hospital that would normally perform two emergency surgeries in a night, we carried out about 18 operations between 9pm and 6am. When morning came, some patients from that night were still on the operating table.

There was no pause. No moment to step back and assess. You moved from one patient to the next, from one operating room to another. I have worked through earthquakes and seen mass casualties after major accidents. I have never experienced anything like this. Even in disasters, you might receive 20 or 30 injured patients over several hours. That night, and the night after, it was hundreds: gunshot wounds; severe trauma. One after another.

The exhaustion was total. Physical exhaustion, yes, but more than that, mental. As surgeons, our job is to save lives. That night we were saving people who had been shot by their own government. That contradiction stays with you. You keep operating because you have no choice, because people are still arriving, because stopping is not an option; but part of you is breaking.