A Syrian woman looks back while walking with another woman past a pile of garbage left on a roadside in Aleppo, Syria, Tuesday, Sept. 11, 2012. ((AP Photo/Muhammed Muheisen))

Osman said the rebels he treats mostly have gunshot wounds from the ubiquitous snipers scattered over the many front lines.

The hospital itself has been hit directly twice by shells, demolishing two of the upper floors. Bombs fell nearby several times, spraying the entrance with shrapnel and debris.

The hospital has a staff of only five doctors and no surgeons, so difficult cases are often farmed out to other facilities, including a hospital in the town of al-Bab, about 40 kilometers (25 miles) to the northeast.

While there are enough drugs in the hospital so far to deal with the daily violence—which on Monday killed 25 and wounded dozens in shelling believed to be in retaliation for the rebel capture of an army barracks—the staff is overstretched.

“What day is it? I don’t know. What time is it? I don’t know,” Osman said, adding that he goes to sleep at 4 a.m. and wakes up at 8 a.m.—unless he’s roused earlier for an emergency.

“My life is just the wounded and the dead,” he said.

Outside the hospital, in the surprisingly bustling neighborhood of Tareeq al-Bab, there is the sound of gunfire. A helicopter gunship is lazily circling the neighborhood and rebels on the roofs of the apartment buildings are futilely emptying the clips of their inadequate Kalashnikovs into the sky.

Abu Hassan, who was once a carpenter, sells vegetables on the street facing the hospital because there is no other work. He navigates the tortuous jigsaw of rebel- and government-controlled neighborhoods every day.

“When we are under bombardment, the water and electricity can be cut for days,” he said, explaining that if he had the money, he would try to follow the hundreds of thousands of other Syrians who have fled for the border. Since the uprising against Assad began 18 months ago, activists estimate that at least 23,000 people have been killed.

The streets between the shattered apartment buildings are choked with garbage that can no longer be collected.

Although meat is scarce, residents of Aleppo are eating adequately, said Alaa Mursi, gesturing at the eggs, chickpeas, tomatoes and other produce being sold. Many, however, are surviving on handouts.

“People give us food to eat,” he said. “There are rich people who distribute food for us.”

Just a few blocks away is the neighborhood of Hanano, on the city’s edge, where the rebels began their assault two months ago. The streets are largely deserted because most residents were recent immigrants who could flee to relatives in the comparative safety of the countryside.

A few men lounge in the shade of a scraggly tree in the otherwise grim vista of cheaply built concrete five-story buildings.

Overhead is the whirring noise of a jet’s engines—a mundane sound in the West that can mean sudden, inexplicable and random death in Aleppo.

“We are afraid to stay in the houses, so we hang out on the street,” said Abu Alaa, a jovial 30-year-old who hasn’t worked in months. “We sent our families to the countryside and we stay here to look after the place, in case of thieves.”

The sound of the jet suddenly builds to a crescendo and there is a muffled crump, mercifully in the distance. Another airstrike. The men gesture in the direction of the explosion and say that just this morning, a bomb fell a block away, killing a woman.

“We can’t sleep here during the night or day,” said Abu Abed, who looks much older than his 40 years. “In the morning, it’s the jets. In the afternoon, it’s the helicopters. And at night, it’s the shelling.”