Lieutenant Arjuman of the Kirkuk police lay unconscious in the recovery room after a successful operation to remove an insurgent's bullet from his chest. His weary surgeons had gone home for the night, satisfied a life had been saved.
Al-Jumhuriya hospital - Kirkuk's largest and busiest - was quiet. At 10.30pm, a doctor moved along the corridor on the second floor and entered the recovery room. He leaned across the bed and turned off the oxygen supply. Half an hour later, Lt Arjuman was dead.
The deputy commander of the city's Miqdad police station was the first of 43 victims of the doctor whom Kirkuk residents are calling Doctor Death. Over a six-month period, beginning in October, Dr Louay Omar Mohammed al-Taei, moved among the puddles of blood and crowds of wellwishers in al-Jumhuriya's hectic emergency unit, quietly dispatching police officers, soldiers and officials who had been wounded, some only lightly, by insurgent attacks.
There was no apparent reason to suspect him. The enthusiastic 26-year-old, who had graduated from Mosul University in 2003, was always on hand when there was a major incident, an explosive attack or a gun battle, that resulted in mass casualties. Though Kirkuk has been relatively quiet since the US invasion in 2003, the past year has seen a surge in violence across the province. Police say more than 1,500 people have been killed or injured. The medics at al-Jumhuriya were glad of any help.
Ten days after he killed Lt Arjuman, Dr Louay struck again. This time he used a method that would become his favoured killing method - the injection of a lethal cocktail of drugs. His victims were four members of the Iraqi national guard, brought to the hospital after being wounded in roadside bomb attack.
"They came to the hospital to be cured, but instead they were killed," said Kirkuk's police commander, Yagdir Shakir. "I can understand a doctor may have personal sympathies with the insurgency, but to use his professional position to become an instrument of death turns sense and humanity on its head."
'Killed without fuss'
Since his arrest last month by Kirkuk security forces, Dr Louay has reportedly confessed to at least 19 crimes. He killed, he said, because "I hate the Americans and what they've done to Iraq." He said he was convinced he could get away with it because he "killed without fuss, and there were no facilities at the hospital to perform proper autopsies".
As well as killing the wounded, Dr Louay attended members of the insurgency and helped wounded militants escape their armed hospital guard. Kurdish intelligence officers said his interrogation had already yielded valuable information about a network of doctors and health workers across the Sunni triangle who are prepared to assist the insurgents.
News of the doctor's killing spree has shaken this tense, contested city of 750,000 Kurds, Arabs and Turkomans. Excerpts of the doctor's taped confessions have been broadcast on local television. "How can we feel safe to send our sick and injured to hospital?" one resident, Ala Mohammed, asked yesterday outside the hospital, which is one of only a few modern structures in this dilapidated city. "I have a son in the Iraqi national guard. He's a good boy who wants to help his country. If he gets hurt and comes here, who is to say that another doctor won't be ready to kill him?"
Relatives of Dr Louay's victims are only now realising how their loved ones died, and are coming forward for compensation. Hospital officials declined to discuss the case in detail, but acknowledged its reputation in Kirkuk had been "severely compromised".
Another doctor, who has since fled south to the insurgent hotspot of Hawija, was suspected of helping Dr Louay. Investigations are continuing, but the hospital's management is not under suspicion, say the Kirkuk police.
The Guardian has obtained the film made by Kirkuk security officials of Dr Louay's "confession". It has also seen medical records that appear to tally with Dr Louay's claims. Wearing a grey polo-neck and seated on a sofa, the doctor speaks calmly and confidently into the camera. He looks to be in good physical condition, saying at one point that he has been treated well by his interrogators. His detailed recall of names, dates and places does not appear to be forced. Dr Louay says he was recruited into the ranks of Ansar al-Sunna, one of Iraq's most lethal Islamist groups, in August 2005 during a stint at Kirkuk children's hospital.
"A father brought in his four-year-old son, who was quite ill," Dr Louay says. "The boy stayed for some time in the hospital, but we couldn't provide the right medicine."
The father confronted him about the lack of supplies. Dr Louay replied: "We live in an occupied country, and this is the condition that prevails in an occupied country." According to Dr Louay, the father said: "We should not stay indifferent, we should do something." There were some people who were already taking action, he said, and "you seem to be fed up with the current situation, so why don't you help us?" Then the man, whom Dr Louay knew as Abu Hajer, said: "We are from the resistance. Whenever we want your help we will ask you."
The group, which was active in Kirkuk and the nearby towns of Pirde and Tuz Khormatu, needed his skills as a doctor, "to treat our injured members and help us in emergency cases". "I told them I was not a surgeon, but they said I should do first aid treatment and then, if needed, the wounded fighters could be transferred to other provinces or countries for surgery." Abu Hajer promised his group would target US forces only. He left, saying: "When we need you, you will hear from us."
The call came a few weeks later. An Ansar militant had been wounded while planting a bomb by the road south of Kirkuk. "I said at first I had no first aid supplies, but that I might be able to get a bag of stuff taken from the hospital," Dr Louay says. "But they said not to worry, they had all the supplies they needed. And they did. I was taken to one of their hideouts in caves near Kirkuk to treat the wounded man."
Then came the killing of Lt Arjuman. "Abu Hajer called me and said, 'A senior policeman is coming to your hospital tonight.' That they had shot him but failed to finish the job. He said, 'You can do it for us.' I knew what he meant."
Experimented with dosages
Ten days later Dr Louay was instructed to do the same with a group of Iraqi army officers who had been wounded by a roadside bomb. "They had flesh wounds to different parts of their bodies. So I made a mixture of Valium, Voltaren and Decadron and injected them. They were dead in three hours. The medical department does not have the modern equipment to analyse their blood, so nobody knew why they died."
Over the next months, Dr Louay says he experimented with varying dosages and cocktails of drugs available at the hospital. "Sometimes if their injuries were really serious and they were bleeding a lot, I used Voltaren to keep them bleeding and they would bleed to death in two hours."
One day a member of his cell rang to congratulate him and to tell him that he was one of three candidates picked to conduct suicide bombings against Iraqi army bases in the city. "I agreed," he says matter-of-factly, "but later there was another call from another senior member saying, 'Forget about it, we need you as a doctor.'"
Dr Louay says before his arrest he had become aware of a network of doctors in Mosul, Hawija and Tikrit to which wounded members of the Kirkuk cells would sometimes be sent for surgery. "I got the impression they had money and equipment," he says. "I asked to be introduced to them, and Abu Hajer agreed."
Dr Louay's killings ended after Kurdish security officers in nearby Sulaimaniya arrested a senior member of Ansar al-Sunna, Malla Yassin, on February 24. Yassin was a former member of Ansar al-Islam, the militant Kurdish-led group that reportedly hosted Abu Musab al-Zarqawi in the run-up to the invasion in 2003. A number of former Ansar al-Islam fighters have since joined Ansar al-Sunna.
According to officials from the Patriotic Union of Kurdistan, which controls Sulaimaniya, Malla Yassin "confessed immediately". Such intelligence helped smash a network of at least 15 militants, Arabs and Kurds, who were behind some of the deadliest attacks in Kirkuk province, and to Dr Louay's arrest.
At the end of his filmed confession, the doctor is asked whether he betrayed his profession. "We thought we could do something to liberate the country," he says. "Later our network went astray, but we had to keep working, and we had to keep committing these crimes."
He is then asked: "Did you ever think of giving up and helping the government to arrest these criminals?" He replies: "I never considered how terribly brutal my crimes were, and I never thought ... I would be so easily captured. I got on so well with all the people at the hospital. They seemed to like me."