Late Friday night, Dr. Tom Catena was feeling optimistic about the child he'd operated on at Mother of Mercy Hospital in the Nuba Mountain region of Sudan.

One of dozens of patients Catena saw that day, the child had been injured as kids in the war-torn region sometimes are, Catena said: He and a friend were out herding goats, and the friend found an artillery shell and banged it against a rock to see what would happen. The explosion killed the friend. The injured child made it to the hospital.

Catena repaired the child's urethra, which had been split in two. The outlook was positive. It was a good day.

"The best part is watching somebody get better," said Catena, who communicated with a reporter through the video messaging system Skype. "That's incredibly gratifying."

Catena, a native of Amsterdam, was named one of Time's 100 Most Influential People last month. Filmmaker Andrew Berends, whose movie "Madina's Dream" is about the Sudan war, described meeting the 50-year-old doctor as "the closest I have come to meeting a saint" in his write-up in Time magazine.

Mother of Mercy Hospital is in a country in which humanitarian organizations are not allowed. Catena has been there eight years, connected not to any such organization but to the Catholic Church. In the rebel-held territory in which the hospital is located, the medical staff is welcome, but not by the Khartoum government, he said.

He is the sole doctor in the 435-bed hospital, working with a staff of about 60 people, including nurses, pharmacists and lab and operating room staff. Only a handful have had formal schooling. The others have been trained on the job. He is the only surgeon in a region the size of the state of Georgia, serving 750,000 to a million people.

His days are long and busy. On Friday night, he'd spent 11 hours in the operating room and thought he might need to go back to perform a cesarean section on a woman who was having troubled labor.

In any given week, people come in with malaria, tuberculosis, pneumonia and leprosy. Soldiers arrive with battle wounds, villagers with injuries from government bombing. Catena recalled that last week a 10-year-old child stepped on a land mine but died before finishing the hourlong trip to the hospital.

"By far, the hardest part is losing a patient, especially a child," Catena said.

Asked how he copes with the stress of his work, without another doctor for backup or to ask advice, Catena said: "It's a terrible feeling when you're faced with the end of your knowledge. It's terrible and demoralizing; there's no good way around it."

The doctor has little time to ruminate over the losses, however. He has to "keep his head straight," he has said, to avoid paralysis and help the others. That's when Catena turns to the inspiration that got him to Sudan in the first place: his Christian faith.

"I'm really not in control of who lives and who dies. I'm here to do my job," he said. "In the end, God is in charge of who lives and who dies."

Catena said he always knew he would do some kind of mission work. After earning a degree in mechanical engineering, it "popped into my head that I should go to medical school," he said. As the fifth of seven siblings, he felt bad about the burden on his family, but his parents were supportive.

Felix Catena, an older brother who is a Montgomery County judge, recalled that the family was surprised to learn Tom had always had his mind on serving people in underdeveloped countries. Today, Judge Catena said it is hard to fathom the inner strength that keeps his brother going.

"I'm just so amazed and blown away at his daily existence. It's a 24/7 thing," Felix Catena said.

Dr. Catena has been in Africa for more than 15 years, starting in northern Kenya. When he heard the local bishop was interested in building a hospital in the Nuba Moutains, Catena was drawn by the challenge and the desire to serve an area in so much need.

He gets home once every couple of years, he said. The last time was at Thanksgiving, when the trip coincided with his acceptance of an award for his work from the National Football Foundation. (Catena earned honors on the football field as an undergraduate at Brown University.)

The award from Time surprised him, he said.

"I'm kind of embarrassed; I really am," Catena said. "I don't really like being the center of attention."

More Information How to help Donations for Dr. Tom Catena's work can be sent to Comboni Missionaries. By check: 1318 Nagel Road, Cincinnati, OH 45255. Include a note that it is intended for Dr. Catena's work. Online: Click "Donate Now" on the Comboni website at www.combonimissionaries.org and include a note under "special instructions" that you want to support Dr. Catena. See More Collapse

Yet the recognition gives him an opportunity to tell people about the injustice that infuriates him. He wants people to understand, for instance, that official international organizations like the United Nations do not get any medications, even vaccinations, to the people in his region. That's because they work through governments. Catena looks at the children who need basic vaccines, he said, and cannot understand the logic of it.

"If I can try to shine some light on what's happening in the mountains of Sudan, then I am happy for that reason," Catena said.

chughes@timesunion.com • 518-454-5417 • @hughesclaire