Sani Abu al-Rem traces his finger down the blood-spattered pages of his patient register at Dar al-Shifa hospital's reception in Syria's northern city of Aleppo, counting the dead and wounded.
A few hundred metres (yards) down the road, a rebel commander set up in what was once a beauty salon complains of a lack of ammunition.
A four-year-old boy next to Abu al-Rem, his head wrapped in a white bandage and with an injured arm, cries as his father attempts fruitlessly to console him.
In front of the hospital, which is in the eastern Shaar district of the city, a corpse shrouded by a blanket awaits removal. A man shouts and struggles with security staff -- he wants to take away his dead wife's body himself.
A large crater in the road, ripped open by a falling shell three days ago, has filled up with the ruins of crumbling buildings near the hospital destroyed by the airstrikes of President Bashar al-Assad's forces.
Amid the devastation of the war, of which civilians have borne the brunt in Syria's former commercial hub, there is a glimpse of "normal" life.
A shopkeeper has set up bird cages on the pavement that house tweeting yellow and orange canaries. Nearby a cabinetmaker has opened his shop and polishes a newly made cupboard door.
Fruit stalls open for those who have not fled the city, although most of the shops remain firmly shut, metal blinds pulled down.
Abu Amar, a commander in the important rebel brigade Liwa al-Tawhid, sits in his makeshift office in the hair salon.
The rebels lack ammunition, he say, despite a large-scale assault they launched that resulted in the destruction of a considerable part of the city's ancient UNESCO-listed souk and without any major success.
"We don't have enough bullets or weapons. The United States and Europe are forgetting us," he says.
Another commander forages among a pile of bullets on the carpet of the shop, picking out selected rounds which he puts in a plastic bag. The next commander in line waits his turn, anxious he will not obtain enough ammunition.
Abu Amar consults a notebook and tells him that for 40 fighters he has received the correct quota for the day.
There is no place for firing at random and wasting bullets.
At the junction of two narrow streets in the old city, where a group of rebel fighters prepare for an assault on the Umayyad Mosque that has thus far escaped their grasp, warcries of "God is greatest" are heard more frequently than any shots fired.
Further to the south, in the Salaheddin and Saif al-Dawla districts where the fighting is less intense, the rebels are trying out psychological warfare.
They have put up a black flag and pointed two loudspeakers towards buildings held by regime forces, pumping out revolutionary songs to "defy Assad's army."