The Triple Agent

Alley rushed over to look. On the operating table was a young blonde wearing a red tank top and necklace. He judged her to be twenty-five or perhaps younger, and she had no pulse. Alley was used to seeing American soldiers and ordinary Afghans with frightening wounds. He had performed hundreds of hours of what he called meatball surgery, picking shards of shattered bone from legs that had been blown apart by land mines, but this beautiful, intact young girl was a first. Alley found the pea-size opening in Elizabeth Hanson’s chest and decided to immediately operate to explore what could be extensive damage within. He cut quickly through bone and muscle and then, with his finger, found the aorta, the main artery leaving the heart. It was flattened and empty. Desperately, he began squeezing and massaging the woman’s heart while an assistant inserted a tube into the opening in her chest. The tube filled instantly with bright red blood, a sign of massive internal bleeding.

He had run out of options. A single piece of shrapnel smaller than a marble had shredded the veins and arteries closest to her heart and snuffed out her life.

“Does anyone know her name?” Alley called out. No answer.

There was no time to think. Another patient was brought in, this time an older woman in cargo pants with extensive injuries from shrapnel. Like Hanson, Jennifer Matthews had stopped breathing during the short chopper ride from Khost, but Alley would try to save her.

He assessed quickly. Shrapnel had torn away a large chunk of the woman’s neck. One of her legs, just below a field tourniquet, had been nearly stripped of skin and muscle, exposing the bone. A small piece of shrapnel had penetrated her abdomen, and the wound had swollen in a way that suggested internal bleeding. Alley pressed an ultrasound probe against the woman’s chest to get a look at her heart. It was motionless.

He couldn’t fix this.

The frantic efforts continued for hours without letup. Working in tandem with another surgeon, Alley patched up severed veins and mangled legs. He treated, as best as he could, a young officer who had a piece of shrapnel lodged dangerously in his brain. All the others were stabilized and placed on helicopters for the one-hour flight to the U.S. military’s Bagram Air Base near Kabul, where other doctors would take over.

It was late when the last of the wounded had cleared out. Alley went outside and, drenched with sweat from the adrenaline and the eighty-five-degree operating room, sat in the cold for a few minutes. Other bodies, those of fallen CIA officers who had been instantly killed in the explosion, were still arriving, to be brought to Salerno’s morgue. Among the remains, he learned, were a few fragments of Humam al-Balawi, collected, he presumed, for DNA testing.

Alley gnawed on a Popsicle to soothe his parched throat. More than 90 percent of the American soldiers who made it alive to his field hospital ended up surviving. At Khost that evening, Alley knew, each of the dozens of factors that were subject to human control had worked perfectly, from the first aid by battlefield medics to the availability of the helicopter to the presence of a first-rate surgical team less than five minutes from the scene of the explosion. Everything had gone right, and it still had not been enough.

He thought again about the two civilian women he had been unable to save. He still didn’t know their names. Were they aid workers? Journalists? Each day brought a fresh dose of human suffering to his operating room, and he was used to dealing with it and pushing on. But war was usually men fighting men. This felt different.

More helicopters were heading to the landing zone now. Alley got up and turned to go back to work.

16. FALLEN

Langley, Virginia—December 30, 2009

At the moment of the bombing—it was still early morning in Washington—Michael V. Hayden happened to be in Langley visiting his old office. The former CIA director had been asked to give a policy speech in Pittsburgh, and he wanted to do some research. It was usually quiet at headquarters between Christmas and New Year’s, although this week was far from usual. There had been a near disaster on Christmas night when a Nigerian youth named Umar Farouk Abdulmutallab tried to blow up an airliner over Detroit. The case, like so many others lately, made no sense. How does a smart, highly educated kid from a wealthy family decide to kill himself and a couple of hundred strangers with a bomb hidden in his underwear?

Hayden finished his work and decided to check in on some friends on the executive floor. Director Leon Panetta was away for his holiday vacation, and so was Hayden’s old deputy, Steve Kappes, so he headed down the hall to say hello to Mike Sulick, the man he had promoted to run the agency’s Clandestine Service. At that moment two other managers were walking out of Sulick’s office. They looked sick.