Our police escorts drove between 70 to 100 miles per hour, with only four to ten feet between their cars, swerving across the dirt road, the “highway” leading into Grozny. This tactic aimed at reducing the chance of being hit with sniper fire or blown up with a landmine. In our car the tension mounted with every second. Alek, our Chechen driver and host, followed closely behind, swerving along with the police cars. The tires tuned up clouds of dust behind us on the highway which had been closed a week earlier due to heavy sniper fire from the Chechen forces. It was August 20, 2005, and we’d already spent six days in the North Caucasus.

Despite feeling weak and dizzy, I felt determined to stick with our mission to assist the injured and ill in Grozny. It had been an anxious morning for our group. We’d already driven across the border from Nazran, Ingushetia, our home base, to the volatile outskirts of Grozny, the capital of Chechnya. Crossing the border from between Nazran, Ingushetia and Grozny, we passed through three army checkpoints, manned by Russian guards in helmets and Kevlar vests and armed with AK-47s. Huge men with ruthless eyes, they looked like they’d pull the triggers of their automatic weapons at the slightest hint of provocation. They narrowed their eyes and stared at us, slowly scanning our faces then comparing them to our passports. Each time their icy eyes lifted from the passports to us, the rope of tension between us and them pulled a little tighter. Their suffocating gaze pressed down hard on us, and their angry silence held the possibility of explosive violence. It made it hard to breathe. Fear was something I had rarely experienced directly. Finally, they waved us through. By the time we cleared the third checkpoint, the car smelled of sweat.

As we entered Grozny, we passed a fortress that stationed thousands of Russian troops and hundreds of large tanks, a military base that put the city in a stranglehold. No one came into or out of Grozny without Russian approval. And the consent at best felt grudging and reluctant.

After clearing the check points, we met our local escorts, who’d bring us further into Grozny—two young, Chechen policemen, scrawny, wide eyed, and dwarfed by the brawny slit-eyed Russians. The thin duo greeted us with grim expressions. Their uniform pants ended around their ankles and were tightly belted to keep them from falling. Their shirts hung loosely around their emaciated bodies. Now they drove at breakneck speed and swerved all over the dirt road. I winced at the expectation of a bullet crashing through the window or a bomb exploding beneath the car. The feeling of that trepidation still reemerges in my nightmares.

Americans are prime targets for kidnappers in poor, war-torn countries. We found out later that simply by escorting us, the Chechen policemen had put their lives at grave risk. Grozny means “fearsome” in Russian, as in Ivan Grozny or Ivan the Terrible. The name fits the city perfectly. Death and destruction were everywhere. Block after city block in Grozny showed a ravaged wasteland scarred with the detritus of bombings and battles: soldiers, guns, tanks, rocket launchers, maimed civilians, and everywhere the wreckage of buildings and streets.

By now I was rethinking the wisdom of coming. It had taken three years of waiting before we were finally cleared and “invited” by the Russian government into the volatile and war torn area of the North Caucasus and Chechnya. I had no idea it would be this bad, nor did Dennis, my partner in this undertaking. We’d never imagined this level of human suffering and physical devastation. Back in New York, Dennis had asked me to book a nice hotel in Chechnya on-line and, scanning the Google images, I told him, “Dennis, there are no hotels, only bullet ridden buildings of the few left standing.” Still, seeing that in pictures and videos and being there in it are as different as a breeze against the face is to a kick in the stomach.

Dennis should have asked me to book us a foxhole. There we were: two New Yorkers putting our lives on the line and those of our hosts to burst into a war zone so we could start a running program for the disabled and give help to the sick. If not for the fact that the program enabled us to obtain medical aid for the isolated and forgotten, our venture would have been patently absurd.

We’d also hoped our visit to Chechnya would transcend cultural barriers and be a small contribution toward peace. More than 30,000 children had died in the Second Chechen War for independence from Russia. Children here experienced war, terrorism, and kidnappings on a daily basis, while their country remained isolated from the rest of the world. The Consolidated Appeals Process, an advocacy tool estimated more than 2,000 children under the age of three would die each year as a result of inadequate medical care. As foolish and risky as the trip might have seemed to my family and friends, I felt I had been blessed with much and had a duty to reach out to those suffering. If only my motives had been that simple and pure.

We arrived at the former press house in Grozny, now a collapsed pile of rubble surrounded by bomb craters. Everything looked gray. The few bullet riddled buildings left standing, showed gaping holes, craggy and jagged walls, and sagging foundations. From blown-out windows women hung clothes to dry on lines. Amidst this appalling squalor, 90,000 to 190,000 Chechens made their home. When the USSR collapsed in 1991, Grozny bustled as a gorgeous modern city, proud of its culture and education. Now as I watched from the car window, the destruction left me feeling stunned and confused. You look at ruin, you feel ruin, you can become ruined.

*

I met Dennis at the 2000 New York City marathon. The president of a running club for the disabled, he struck up a conversation with me, after seeing me guide a disabled athlete across the finish line. Acting as an disabled running guide, I supported Jim, an above the knee amputee from Jamaica, through the last half of the marathon. Although I was not an official runner, this inspiring experience marked my first running race and half marathon. After finishing, I was hooked on the running bug. Eventually I would compete in ultramarathons and Ironman.

After we got to know each other, Dennis kept trying to have sex with me. A short, fat aggressive man, he rarely stopped pursuing what he wanted. “Dennis,” I’d say, “It’s never gonna happen.” Yet, when not having to resist his unwanted advances, we worked well together, and I loved volunteering. I enjoyed serving as a guide to disabled athletes through many running races. In 2001, I was tethered to lead a blind man, who weighed twice as much as me, to summit Mount Kilimanjaro.

Dennis, an above-the-knee amputee, had started a running club for people with all kinds of disabilities, and membership in this club has been a life-changing event for many who lost a limb, suffer blindness, or battle chronic illness. It was certainly life-changing for me. Being born legally blind in my right eye due to a post lenticular cataract, I ran my first marathon in New York City, as an disabled running athlete, in 2001. My race time for the New York City marathon was 3 hours and 43 minutes and I qualified for the Boston marathon, which was my second one and finished it, in 2002. I was stoked after finishing the Boston Marathon in a time of 3 hours and 30 minutes, which was running an average of an eight-minute mile flat for 26.2 miles.

As a trauma expert who ran the psychiatric emergency room at St. Vincent’s Hospital Medical Center in New York City, I’d seen plenty: patients who were psychotic, suicidal, violent, homicidal, homeless, mentally ill, and chemically addicted. The day after September 11, 2001, I crossed police barricades to volunteer at Ground Zero and offered crisis counseling to firefighters and family members who’d lost loved ones. Before that, I helped cancer and AIDS patients die with dignity and comfortably free of pain.Yet, none of that would prepare me for the desolation of the Chechen genocide.

Lying between Eastern Europe’s Black and Caspian Seas within the Russian Federation, the North Caucasus comprises seven ethnic homelands and is a mosaic of 50 different languages. Chechnya has struggled for centuries under Russian domination, and its declaration of independence in 1991 led to war, the most recent in 2005. Aside from issues of territory and resources, a major cultural difference responsible for the ongoing conflict is religion. Instead of the Russian Orthodox religion practiced in much of Russia, the majority of Chechens are Sunni Muslims.

*

In August 2005, I traveled to Chechnya with Dennis, not simply as an disabled running club athlete and ambassador, but as a physician. We met our hosts at the Moscow Airport. Natasha, who was corpulent with cherubic, high cheekbones, welcomed us with open arms. She presented herself as a Czech crusader for the Chechens and functioned as our interpreter. Igor Smirnov was ostensibly a Reuter’s sports journalist. Igor, who finally got permission from the Russian government for us to enter Chechnya, shadowed us for the entire ten-day stay in the North Caucasus. He reminded me of Napoleon: small, 5’ 4”, very stout and muscular, in his early 40‘s with blue-gray cold, soulless eyes; I had never, before, looked into any living creatures eyes, even a crocodile, and never recognized a soul. I didn't like him on sight.

We were tired and hungry when we arrived in Moscow. Igor hurried us along into a waiting black sedan with a driver in the front. He ignored my request for water. When Dennis handed me his bottled water, Igor smirked and barked, “Dennis, we have a long drive and you’ll get thirsty.” Almost immediately I noticed that my presence annoyed Igor. I’d later learn that Igor and Dennis were old buddies, working together to set up many disabled running club chapters in Russia. Dennis had reciprocated by helping Igor get into Bronx Community College and find an apartment in Coney Island.

After piling in, Dennis in the front seat and me in the back between Natasha and Igor, we drove off for a farmhouse in the countryside in order to rest before our early morning plane that would take us to our final destination, the North Caucasus. The car windows were tinted and I had a hard time seeing through them.

It felt like I’d entered a coffin. My chest became tight and cold sweat trickled down my ribs. I felt cramped between Natasha and this swarthy, sneering man. When my request to use the bathroom, fell on deaf ears I became nervous. But I was right back in my childhood where I felt invisible. I glanced over at Igor who had a sardonic smile plastered on his face. I leaned forward and whispered to Dennis, “Say you need to use the bathroom.” In seconds, we raced to the closest bathroom. Deep down, I knew something was not right. But what could I do? I was here already and unless I grew wings and flew out of the car and across the ocean, here is where I’d be for awhile.

When looking into Igor’s eyes there was a steely, rancor that sent shivers down my spine. Even cold blooded murderers who were imprisoned in Bellevue forensic unit that I psychiatrically evaluated had glimmers of humanity. I sensed almost right away that Igor was a professional killer and most likely KGB. My fantasy was that he resented the relationship I had with Dennis and the fact that I genuinely cared and provided medical and psychological care to the Chechens.

My nervousness started to creep into the terror zone. The people I was traveling with were supposed to be friends. Dennis remained impervious to my rising discomfort. I’d prepared myself to be ignored by the Muslims. But this? Already? Suddenly, I felt crushed between Natasha and Igor and could not get my breath. My throat closed up. My heart jackhammered in my chest. I broke out into a fresh pool of cold sweat. My mind screamed, Nina what have you gotten yourself into now! Although I was terrorized as a kid, my childhood experience was puny in comparison.

Struggling to clear my throat, I cried out, “I need to get out of this car right now!” My companions were shocked. I climbed over Igor, who sneered at me and did not move, jumping over him, and out of the back seat. I told Dennis I was claustrophobic and wanted to switch with him. When I got into the front seat of the sedan, the atmosphere became sullen. My being a woman and having a voice was not welcomed by my Russian hosts. They now regarded me as a pampered, silly little American woman who did not know her place in life.

Once in the front, I breathed easier, though I could feel Igor’s hostility searing a hole through the upholstery behind me. Natasha, suddenly shouted, “Nina, pull your seat up as far as it goes.” I rushed to comply, not wanting to take up any more room.

More than half of the Chechen population had fled and now lived in the refugee camps. At one, the smell of human waste permeated the air. A lonely farm field, under electric wires, littered with abandoned Soviet train cars, was now home to more than 3,000 Chechens. These deeply traumatized refugees knew they’d been discarded and forgotten by the world. They did not even have basic sanitation. We were introduced to the chief of the refugee camp who told us his 13-year-old daughter had a viral infection and was unable to fight it, and had subsequently developed viral congestive heart failure. The refugees, he said, complained of constant headaches, which they believed were caused by the close electric wires overhead. Each evening, after providing medical care to those living in the camps, we returned again to our safe haven.

At another refugee camp, I met Makka, a 15 year old blind girl. She’d lost her vision at the age of nine playing outside her house when a car bomb exploded. No medical resources existed here to provide her treatment. Upon learning we could offer medical intervention, she was taken by the deputy minister of sports to a hospital in Moscow. Her medical assessment revealed that a corneal transplant would restore her vision; we facilitated her surgery to regain her sight. Helping girls like Makka was why I had come.

I felt at odds with my American traveling companion. Dennis’s altruism was tarnished. He wanted good press for his disabled running club to appear in the local papers back home, with photos depicting his brave heroism. After a few beers, he’d get a little too flirty. “Dennis,” I would say, reminding him of the rules we’d set out before we boarded the plane in New York. “No.” We had agreed that during this humanitarian trip, Dennis would leave me alone, respect my feelings, and stop trying to sleep with me.

While Dennis looked for Chechen photo ops, Igor looked for someone to hate. He seemed to dislike everyone, except Dennis, but he reserved a special hatred for me. It’s not hard to tell when someone harbors such feelings for you. Sometimes a single glance reveals envy and hatred. I was an athlete, a successful physician and an American woman, less subject to the extremes of patriarchal oppression so common in Russia. When Dennis told Igor that I was doing my first Ironman in three months, Igor became belligerent, “Dennis, you're exaggerating the distance,” and started cursing in Russian. He went outside and began furiously throwing a ball against the outside of the general’s house. Jana, who was our Chechen cook and host, became alarmed and disappeared into the house. Igor’s temper tantrum continued for several hours.

While using the downstairs bathroom, the door was suddenly opened and Igor appeared. Despite being fully clothed, I became enraged and screamed, “Get out!” Igor smiling ruthlessly said, “Get out of my bathroom and do not use it again.” Violent homicidal fantasies crossed my mind.

Avoiding Dennis and Igor, I spent time with four Chechen girls to whom Jana introduced to me, her daughter and relatives between the ages of five and twelve. The girls enchanted me, teaching me Russian words by drawing pictures and then suddenly grabbing my hand to guide me through several ethnic dances. I felt free in my body with them as we twirled together on the patio inside the gates around the house, then collapsed in laughter. Their joy and passion was contagious, but the back of my mind darkened with fear for their future. I wondered if this place might break their spirit. Upon our departure, they gave me jewelry and other trinkets, and I kissed them on the tops of their heads where they parted their hair.

On the third day of our stay in the North Caucasus, Dennis, Igor, and I had lunch on the patio, enclosed by the towering brick walls. I love beer, and had been known to opt for a lager, rather than Gatorade, after a workout. The sun shone brightly that afternoon. I took a sip of an exotic Russian beer that Igor brought me in a glass. Usually Jana would bring Dennis and I the bottle, which I drank out of directly without a glass. This time I noticed a strange sediment at the bottom of the bottle.

Sitting in the bright sun on the patio ringed by the protection of 20-foot walls, I noted the sediment, but I did not entirely trust my intuition that something was wrong. I excused myself to go to the bathroom, and when I returned, I had one more sip, but refrained from consuming any more. After drinking that beer, my health, a robust friend I’d always taken for granted, deserted me.

Later in the day, I developed flu-like symptoms, fever and muscle soreness. In a couple days, I became violently sick, with projectile vomiting and bloody diarrhea, high fever, intense abdominal pain, dizziness, lethargy, extreme weakness and headache. I was delirious and unable to get of bed for three days. I never had a doubt about what was happening to me. I understood instinctively, almost impassively, what had occurred, as if I were my own emergency room patient. I knew I had been poisoned, but I did not know with what. In the morning, weakened, while still in bed, I informed Natasha and Dennis that I had been poisoned. They seemed nonplussed and had no response at my self-diagnosed condition, both perhaps genuinely unable to process this information. Five years later through various research and explorations, I discovered that many of my symptoms were consistent with anthrax exposure.

“Where is Igor?” I asked, and Natasha said he had left to report a story for Reuters at a local building in Ingushetia. Natasha and Dennis left shortly after this conversation, so Natasha could take pictures of Dennis milking a cow on a nearby farm. I remained in bed for several days, slipping in and out of consciousness, too sick and weak to move. I continued to have dizziness, high fevers, headache, and severe abdominal pain. Jana brought me lovely, thoughtfully prepared meals on a tray, but I was too sick to eat them. She wiped my head and sat by my side the entire three days. There was no medical help available. I was the only available medical care. Even if there had been doctors, there were many others who also needed acute intervention. In three days, I lost ten pounds that I could not afford to lose.

I simply could not get up, could barely even lift my head. Dennis showed little concern. It was food poisoning, he opined. On our last day, weak and still running a fever, I determined I’d go to Grozny, even if I had to crawl. That Russian bastard would not win; he’d see me on my feet again.

After struggling to get out of bed, I came downstairs. Seeing me standing, Igor looked shocked. Dennis confided, “Igor told me the others did not like you.” I laughed at the absurdity of this. While I was sick they had visited a refugee camp. The leader of the camp had offered two of his wives to Dennis. Dennis politely refused and told me that the women were fat and unattractive, “but they missed the best time they would ever have.”

Dennis’ obliviousness to the depth of my plight allowed him to pursue his sophomoric, obsessive mission to pursue me sexually. I remain haunted by Dennis being unfazed when learning that thousands of Chechen children will die each year from lack of medical care. Despite Dennis’s indifference, I continued to fight for three additional years to get three Chechen children we had met in Grozny approval to travel to the United States to receive 6 weeks of medical care that was sorely needed. I refused to abandon these Chechen children. Beefy Dennis’ insatiable hunger for the spotlight overrode any concern he might have for the nightmarish mayhem to which these Chechen children were subjected. After all, I had chosen to medically assist him on this mission. Both Dennis and I carried a certain blindness. Dennis’ narcissism had seduced me because I had romanticized his power and been blind to his cruelty.

In Grozny, we met four emaciated Chechen girls who were part of a local winning soccer team. Anna was a 14-year-old Chechen who had lost her left leg and hand to a land mine while playing outside. She told us she lived with her mother and that the Russian army had kidnapped her father. In a shy, humble demeanor, she explained her love of computers. We brought sneakers and shirts for her and the other children we met so they would be able to race with their new disabled running chapter. Meeting Anna powered me through the day, though I had to take frequent rests to catch my breath on low-stone walls and benches. As soon as we returned home to the general’s house, I collapsed back into bed.

On our last night, we heard a loud explosion from outside our protective wall. I asked Natasha what the explosion was. She answered it was fireworks. I did not believe her. While boarding our plane from the North Caucasus to Moscow, in the local newspaper, we learned that there had been an assassination attempt on Ingush’s Prime Minister, Ibragim Malsagov, who had been responsible for permitting us to enter the North Caucasus. The two roadside bombs killed his driver and wounded two others. The prime minister was hospitalized with wounds in his hand and leg. The two explosives, placed ten meters apart, detonated within ten seconds of each other as the prime minister’s motorcade passed.

It was one more sign that it was time for us to leave Ingushetia. Russia had robbed me of my health but I was still alive. It was time to go home.