Monday, March 10, 2014

The surgeon soldier: Las Vegas urologist escaped civil war in Ethiopia, has served American military in Iraq

Urologist Mulugeta Kassahun uses the robotic da Vinci Surgical System unit to operate on people with bladder, testicular, prostate or kidney cancer.
Hiding in the mountains of Ethiopia, teenage rebel fighter Mulugeta Kassahun, armed with an AK-47, waited to attack.

He and his Marxist comrades would trek at night to a town and blend with locals to avoid suspicion. All the better if it was cold and raining, as government soldiers were sure to be snug in their barracks. When the moment came, the rebels burst into action, attacking the unsuspecting troops with rifles and explosives — and then quickly run off. Safe to say, it’s not how most future doctors spend their high school years.

Kassahun, a Las Vegas urologist, came of age in violent, revolutionary east Africa, leaving home to join a rebel group that fought Ethiopia’s military junta with street assassinations and guerrilla warfare.

After the war was lost, he came to the United States as a refugee. Despite some tough times here, he has achieved a lot in his adopted country.

He graduated with honors from college, worked as a pharmacist, became a surgeon and even joined the U.S. Army Reserve, which took him to Iraq. In his Las Vegas practice, he operates every week — sometimes with an elaborate robotics system — on people with bladder, testicular, prostate or kidney cancer.



“He’s so not your typical doctor,” said former classmate Ali Borhan, an Arizona urologist.

Kassahun, whom friends call “Mulu,” moved to the valley 10 years ago to join Urology Specialists of Nevada. He is blunt-spoken; has a deadpan sense of humor without seeming to try; and wears thick, gold jewelry adorned with images of both the castle in his native city and the Lion of Judah.

“People, when they see it, they know where I come from,” he said. “For Ethiopians, they know.”

•••

Kassahun was born in the 1960s, probably 1964 — he does not have a birth certificate and is not exactly sure of the year — in Gondar, a historic city in northwest Ethiopia near the Sudan border that was once the capital of Ethiopia. His mother, Yezena Ferede, was a housewife, and his father, Kassahun Dessie, worked for the ministry of finance. Kassahun was the fifth of 13 children, and the middle-class family lived comfortably.

The oldest boy in the family, Kassahun excelled in school and played soccer, volleyball and basketball. But when he was about 10 years old, his country was thrown into violent turmoil.

In fall 1974, long-reigning emperor Haile Selassie was deposed by a military coup. At first, Ethiopians supported the new regime — Selassie had tried to cover up a drought that killed 100,000 people — but things quickly went south.

The leftist military rulers, known as the Derg, nationalized companies; confiscated land; and imprisoned, tortured and murdered opponents. Selassie, for one, was said to have been strangled to death a year after his ouster, and his remains were found years later under a palace toilet.

Opposition groups sprang up to fight the Derg. The Ethiopian People’s Revolutionary Party, one of the most powerful of the bunch, formed cells in schools, factories, farms and police departments. Kassahun, 12 or 13 at the time, joined its youth league.

He distributed articles and pamphlets, tied EPRP flags to rocks and threw them over electrical lines, and gave party flags as blankets to the homeless.

Not realizing the seriousness of it all, he thought the underground political activity was fun. He soon found out what he had gotten into.

Within a few years of taking control, the Derg, backed by the Soviets and Cubans, unleashed a wave of killings known as “Red Terror.” Ethiopian soldiers stormed into houses, markets and buildings, executed people seemingly at random and left the bodies where they were or in front of their homes. Families, faced with the bloody corpses of loved ones, were forced to sing revolutionary songs or reimburse the military for the spent bullets. Many times, the Derg wrote “Red Terror” on their victims.

Much of the violence targeted EPRP members. Many of Kassahun’s friends were killed, and Derg forces were looking for him. They came to his house a few times; once, he happened not to be there, but another time he was hiding with relatives.

Kassahun knew where the EPRP’s guerrilla army was based, so he left home and joined the rebels in late 1978. After a month of training, he joined the fight.

He was in eighth grade.

•••

On Sept. 23, 1976, Ethiopia’s military ruler, Maj. Mengistu Haile Mariam, was driving home when assassins attacked his car in downtown Addis Ababa, the capital.

He survived — but there was speculation that the EPRP was the one gunning for him.

A Marxist outfit composed of students, teachers and union workers, the EPRP wanted a return to civilian rule. The group had issued a “death list” against the military, gunning people down in Addis Ababa in broad daylight, news reports said.

“Sources say its membership includes 700 snipers who have launched a campaign to pick off the (Derg) ‘one by one,’ ” according to the Los Angeles Times, which also noted that hundreds of EPRP members had been executed, killed in gunfights or jailed.

Kassahun, armed with a Kalashnikov, was hundreds of miles north of the capital. Hiding in rural areas, he and fellow rebels waged guerrilla warfare with rifles, bazookas and explosives. They hit government convoys and barracks and ran off amid the confusion. Sometimes, with dead soldiers scattered about, they took the enemy’s uniforms, weapons and, even if covered in blood, cigarettes. At one point, Kassahun helped the rebels capture a town, which they lost to the Derg and then fought to reclaim. The battle lasted a few days.

Despite some early progress, the rebels, torn apart by infighting and defections, failed to overthrow the junta. Kassahun fled to neighboring Sudan in 1983.

He lived in a squalid refugee camp near the border for about a month but snuck out early one morning with two other refugees, paying for a ride to the nearest city, Gedaref. He lived in a grass-roof hut with some other people, cooking in shifts and using open fields as a bathroom. Former EPRP members helped him get a job in the International Rescue Committee’s pharmacy department. He provided security, passed out medication to doctors and nurses, and distributed oil for IRC vehicles.

He spent a year in Gedaref working for the relief group, giving him a taste of what lay ahead.

•••

U.S. officials granted Kassahun political asylum, and he took classes to prepare for his new home — he learned some English, how to use a modern bathroom, how to shop at a supermarket and how to apply for a job.

Immigration officials initially planned to send him to Maryland, which has a sizable Ethiopian community, but after he found out that a few relatives lived in Denver, he was switched there. He arrived in Colorado in spring 1984 and initially lived with one of his relatives, sleeping on the couch of a one-bedroom apartment.

He took English-language classes for a few months and got a job in housekeeping at a Sheraton hotel in a business park outside Denver. He was later promoted, becoming a busboy in an Italian restaurant there.

He also started taking classes — math, chemistry, biology — at local colleges and worked in a chemistry department answering phones, photocopying papers and preparing labs.

Kassahun eventually enrolled in the University of Colorado, Boulder. He had little money, slept on a pullout couch and tapped scholarships, loans and grants to afford school.

In 1990, around the time he became a U.S. citizen, he earned a bachelor’s degree in pharmacy, graduating magna cum laude. He wanted to be a pharmacist.

In Ethiopia, the Derg was ousted from power in 1991, but the country was divided a few years later into ethnic-based regions. In 1999, it went to war with neighbor Eritrea. Today, the country is more stable than in the Derg era but has been rocked in recent years by more armed clashes and drought.

In college, Kassahun figured things would change for the better in Ethiopia. He had left his entire family behind when he joined the rebels, and he dreamed of returning home to start a pharmacy career.

But every year, the dream slipped further away. Kassahun said ethnic minorities took charge of the country and, though not as brutal as the Derg, have ruled with a corrupt, violent hand. As a member of the Amhara, one of the largest ethnic groups in Ethiopia, Kassahun couldn’t be sure if authorities would leave him be or target him.

“I did not want to take that chance,” he said.

•••

Kassahun was a pharmacist in Denver for four years, working weekdays at a hospital and weekends at a retailer. He could make IV bags and mix drugs at the hospital, but for the most part, being a pharmacist meant taking orders and counting tablets. The career had become boring, fast.

At the suggestion of an Ethiopian doctor in Colorado, he applied to medical school. He enrolled in the University of Wisconsin, Madison, in 1994.

Kassahun had wanted to be a cardiologist but took to urology after learning about laparoscopic surgery — a minimally invasive technique — and other aspects of the field.

He graduated in 1998, then spent two years in general surgery training at the University of Rochester in New York and another four years in its urology program.

At Rochester, he and classmate Borhan were known as the “TP,” or Terrible Pair, an aggressive duo who had great results in medicine but occasionally ruffled some feathers.

“We weren’t very quiet and demure, and that didn’t sit well with a lot of people,” Borhan said.

In 2000, Kassahun signed up for the Army Reserve after recruiters came to Rochester looking for doctors. He was deployed to San Antonio for basic training some years later, was deployed to a military hospital in Germany for four months in 2005 and did the same in Iraq in 2007. He has the rank of lieutenant colonel and is assigned to the 807th Medical Command, a deployment support unit based in Utah.

Kassahun wasn’t looking to join the military — he’d fight if necessary, but he wanted to help as a doctor only. Carrying a big guy over his shoulders in training was out of the question.

He had to spend a few days outside in the fields as part of boot camp, but overall, training was pretty easy.

“Actually,” he said, “it was fun.”

•••

Kassahun visited Las Vegas twice over the years for vacation. In 2003, after staying at the Mirage, he figured he might want to live in a city with warm weather and blue skies; living in cold climates dampens his mood and makes him not want to leave the house.

He rented a car in Las Vegas and drove around town, stopping at an Ethiopian restaurant to see what people thought of the place and whether people have families here or if everyone lives on the Strip.

He was hired by Urology Specialists of Nevada in 2004. In a typical week, he takes 150 or so patient visits and does about 20 surgeries.

For some surgeries, Kassahun uses the da Vinci robotics system. Tiny robot hands are inserted in the patient, and Kassahun, sitting at a simulator, uses them for suturing and other delicate tasks.

He is a self-described workaholic, putting in 10 to 12 hours a day when seeing patients and up to 16 hours a day when he’s in surgery. He is single with no children, though one day he would like to have a family.

Even though his home plunged in value during the recession, Kassahun enjoys Las Vegas. He hikes in the Red Rock Canyon National Conservation Area or Mount Charleston, and he reads a lot of books — history, psychology, politics, biographies. No fiction for him. Even though it’s for leisure, he underlines, takes notes and criticizes the authors’ findings.

Despite his constant learning, Kassahun, like many immigrants, misses the meaning of English colloquial phrases.

“If a patient says, ‘I have a bone to pick with you,’ he doesn’t know what that means. He has no idea,” friend and fellow urologist Mike Finkelstein said.

Kassahun takes a vacation once a year, around Christmas, to visit family members scattered around the country. Some siblings still live in Ethiopia, but others are in Seattle, Maryland, Atlanta, Chicago, Minnesota and Pennsylvania, along with two in Las Vegas. His father died in 1997 in Gondar after a stroke, and his mother lives in Pennsylvania with his sister.

Kassahun has told people that he was a guerrilla fighter but doesn’t normally give details of his roughly five years in combat. Ethiopian refugees are haunted by the Derg and Red Terror, and Kassahun doesn’t want to relive the days when government soldiers threw corpses at families’ doorsteps.

“That memory will never go away from you,” he said.
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