I asked, ‘Is this a religious practice?’
‘Doctor, it is interesting that you ask this question. In my opinion, nowhere in Islam is this practice prescribed. In fact, several religious clerics oppose such practices. Only a few women may contend that getting a Sunna done is a religious practice. As they say, “Belief: To each, his own”.’
Razak, ‘Not true. This has nothing to do with Islam, let’s not bring in religion here.’
‘Dr Razak, I thought you did not know how to speak at all! Look, I said the same thing. Did I not say that religious clerics oppose this practice? But isn’t it fun to put a religious spin on everything? The idea of religion is scarier than faith or culture.’
I was getting a feeling that the discussion was going a bit off-track. Even Radhika who had professed to discuss only Fadhuma’s case and nothing else, sat there listening with complete attention to Mohammad’s words.
‘Look. I’m a physician too. I’ve given several seminars on this topic. This practice is illegal in America. In the seventies, people’s awareness of Sanghaala was through National Geographic magazines and the BBC. And even this awareness, which was not flattering to the country, was mainly centered around two things. The misery of its people with pictures of young children with bloated abdomen and emaciated bodies displayed prominently, and, of course, this practice of female circumcision. Back then, everyone assumed that these are medieval practices of underdeveloped tribes living in caves. Now these people live right here in America and, they practice what they believe. Here in Minnesota, you see circumcised women visiting hospitals. It is tough for doctors, who are ignorant of this practice of circumcision, to handle their pregnancies, and their child births. Please excuse me, if this makes you doctors uncomfortable, how would Fadhuma and Duniya feel about it? Fadhuma and Hassan are simple folks. They are not smart enough to speak with you. That’s why they come to me and I represent them. Now, you decide if this discussion is relevant to Fadhuma’s case or not.’
It seemed a little surreal and I felt I was in some unfamiliar world. I was at a loss for words. Radhika herself continued, ‘Dr Mohammad, thank you for enlightening us with all this information. But I did a C-section not just because of her abnormal genital anatomy but the baby was a breech. No matter how hard we tried, normal delivery would have been impossible.’
‘Dr Radhika, let me ask you a question. Is the baby’s life more important than the mother’s?’
‘Both are equally important to me.’
‘Ah, this is how America has brainwashed you. On the way from Minneapolis to here, there were at least ten billboards. Each one displayed anti-abortion messages. These neon-lit billboards probably sponsored by local churches—that looked like commercial—almost proclaimed that if you get an abortion you’ll go to hell. Since when did the baby turn more important than the mother? When did we forget that someone pregnant is also a human being? Why do you spend millions of dollars trying to save a five-hundred-gram baby born to a teenage mom? Just because it is against your religious beliefs? Isn’t it a Christian belief that people go to hell if they get an abortion? Why do we not circumspect why a mother would take the extreme step of sacrificing the baby in her belly? Instead we tag such women as murderers and Sanghaalis oppose such blind labeling.’ Radhika remained stunned. Seeing this, Razak chimed in, ‘Dr Mohammad, we doctors are always trying to save lives but when the life of a mother or a baby is threatened, we have to do whatever we can. Shouldn’t we?’
‘Tell me frankly. Was Fadhuma’s life in any danger here? Or let me ask the same question in a different way, if you decided to get a court order to get this C-section done on her if it was against her beliefs, do you think any judge would have granted you the permission to perform C-section against her will?’
‘We can’t discuss just keeping this one case as a reference. There was nothing wrong in saving the baby here.’
‘Ah! this is clearly what I call cultural imperialism. It’s not just the current pregnancy that is important to the Sanghaalis. But they care for their next ten pregnancies. And so is the mother who can bear them. They value the land more than its harvest. They oppose anything that reduces their fertility. So much so, that they are ready to sacrifice their pregnancies. Just like the way weeds are cleared from the land before healthy crops can be grown. They oppose America’s health care system that exploits this science to cater to its “lesser the better” culture. But they are not able to express this sentiment. It is somehow gone into their heads that only weak women get operated to have children. I’m only asking you to respect their beliefs.’
Radhika asked, ‘Is there a connection between this and the government’s child allowance?’
‘How dare you? You are a woman too. Do you seriously believe that a woman sacrifices her baby for money?’ Mohammad’s voice was shaking.
Radhika did not flinch, ‘Fadhuma herself told me about it.’
‘What would she know? She is an illiterate woman.’
‘Exactly my point.’
‘What do you mean?’
‘Dr Mohammad, don’t you think that this child allowance the government pays for every child is more relevant and makes a more compelling case for her to have more children than any of these cultural reasons that you are giving us?’
‘You can make whatever sense you wish to out of this but let them be themselves.’
‘Meaning?’
‘If she does not want an operation, don’t do it.’
‘The baby has rights too.’
‘That baby is yet to be born, doctor.’
I was a bit shaken by this whole line of argument, ‘As a doctor what do you feel about this whole affair?’
‘I don’t feel anything. I serve my clients. My job is to serve them by giving them what they are looking for. Do you know my clinic is also licensed for doing abortions?’
I sensed that this fellow is not an ordinary person. He does abortions. He has declared a virtual war against Cesarean sections. May be he does circumcisions too. I asked him softly, ‘Why don’t you deliver babies?’
‘Do you think that I haven’t given it a thought? But what can I say? You can’t teach new tricks to an old dog.’
This meeting needed a closure. Not knowing what else to say, ‘Dr Mohammad, now what do we have to do to make Fadhuma and Hassan happy? Should we apologize? Should we assure them that we will be more sensitive the next time? Would they believe us if we did so?’
Radhika, who was quiet till then said, ‘Guru, I have done nothing wrong. I’m not going to apologize to anyone. Dr Mohammad, I do not know who you are. I think you are a big crook. You have brainwashed these people. No matter what, I’m not going to change the way I practice Medicine. It’s not just me but all the other doctors and the medical community agree that I am doing the right thing. I’m not going to apologize to anyone. Neither will I promise anything about my future practice. Do whatever you guys want to do. If you want to take us to court, go ahead.’ And she got up.
Hassan, ‘You have to apologize to us. You have operated on my wife. And not just that, you should not do any more operations on us Sanghaalis in the future. If you do, there will be consequences.’
Radhika said, ‘What? Will you sue us?’
Hassan replied, ‘No. Lives will be lost. Heads will roll.’
‘Do whatever you want. I’ll keep doing my job. You can look for other doctors if you don’t like me. How dare you threaten me? I can report you.’
Hassan was continuously blabbering in Sanghaali.
Dr Mohammad said, ‘Ma’am, nothing can be accomplished with this rage. He is not a harmful person. I will talk to Hassan. Give this matter some thought. Nobody is dictating anything to you. Keep today’s discussion in mind when you do your work in the coming days. And everyone can be happy.’
Radhika said, ‘Whatever happens, I’m not going to apologize.’
‘In that case you shall be responsible for any disasters that may happen in the future. Th
anks for your time,’ he picked up his water bottle, drank from it and walked out. Fadhuma and Hassan followed him. A little later, Duniya also left. I noticed that on the sign-up sheet for the day, she had not signed her name.
6. Postpartum Depression
Dr Mohammad Mohammad was right.
Within three weeks, some dramatic events beyond our wildest imagination, beyond anybody’s comprehension happened in Amoka.
A news report was published in Amoka Daily Herald, the town’s only newspaper:
A twenty-four-year-old Sanghaali woman named Rukhiya Abu-Bakr was found dead in her home. She had hanged herself. Paramedics had rushed to the scene when her husband Abdhi Abu-Bakr called 911 for emergency assistance. Despite their best efforts, they could not save the woman. Police are conducting further investigation.
In a strange way, I was expecting this news in the paper. I was working in the emergency department on the day Rukhiya died. Since the hospital owned the ambulance, I had expected that the paramedics who responded to the emergency call would bring Rukhiya to the hospital. According to the protocol, even if Rukhiya had the faintest signs of life, she had to be brought to the hospital. After hearing on the ambulance radio: ‘Amoka ambulance arriving at the scene for a twenty-four-year-old woman…who is unresponsive after an attempt to hang herself from the ceiling…no further history obtained because of significant language barrier’—I was anticipating Rukhiya to show up. I had the nurses ready, with X-ray and lab technicians on standby.
Rukhiya never arrived.
The paramedics who returned after completing the paperwork said, ‘Doc, I wish you were there. You should have seen the chaos. It was quite a scene. When we went there, they had already brought her body down and had laid her on the floor. Talk about keeping the crime scene intact, doc. They had even started to pray! When we said we were going to check her pulse to confirm if she was alive or dead, her husband looked at us strangely and started crying. I initially thought it was ok, the poor guy is grieving or what not. But you know, I got to do my job, right? I told him, I hear you fella. But I got to know what happened so that I can write my report, you know. But the strangest thing happened, doc. Poor fella who was praying and all, started swaying his body back and forth. I thought he was having a seizure or something. I told him straight out, “Hey buddy, all we are trying to do is to help the lady in case she is still alive.” To which he said, “Please do not do anything else. It’s been a long time since she died. Where are the police? I called the emergency only so that the police can come and do their work. Why are you here?” As if police are the only ones who show up when you call 911. But I have to say doc, I didn’t disagree with him and all, but we had to do our jobs. We called the coroner and waited. Once he arrived, we got the hell out of there.’
The newspaper report read:
The deceased Rukhiya is survived by her husband Abu-Bakr and her two-month-old infant. When our reporter contacted her husband, he refused to comment. We have learnt from unconfirmed sources that the police had responded to few domestic disturbance calls during the last month. Police said that they were considering all angles. When specifically asked about domestic abuse, they said they haven’t ruled out anything. It is still unclear at this point whether Rukhiya’s suicide was due to repetitive abuse by her husband. Her husband Abdhi was arrested and released after a day of interrogation. Minneapolis’ well-known physician Dr Mohammad Mohammad has bailed him out.
I had not uttered a word. I did not know what to say. I was thinking about how Radhika would react to the news.
As soon as she heard the news, Radhika had rushed to the hospital. ‘Oh my god, Guru! It’s a disaster. Did you watch the news? I’m done. They will deport me to India.’ She started rambling and her eyes welled up. ‘Guru, has anybody mentioned in the news that she killed herself because I performed a C-section on her? What do they mean by all angles? They said that her husband was physically abusing her, and she killed herself unable to tolerate that. Even when the police interrogated her husband Abdhi, he didn’t say a word about the C-section. If she didn’t want the C-section, she could have been more assertive and not consented to it at all, right? Instead, if she takes her own life like this, what shall I do?’ she wailed.
I was at a loss for words and softly whispered, out of earshot of the patients and nurses around, ‘Don’t cry Radhika, people may think that you did something wrong,’ and led her to the breakroom.
She appeared extremely traumatized, ‘Guru, let’s say that Abdhi tells the police that his wife took her life because I performed the Cesarean section against her wishes, where would that lead? Are they going to arrest me? My god! I can’t believe that she is dead. I can’t understand what I did wrong. You were with me. You will testify for me, right?’ and she started crying again.
She seemed convinced that Rukhiya had committed suicide because of the Cesarean section. When it comes to death, reactions can be varied. I work in the emergency department where dealing with deaths, many a times sudden or unexpected, is a part of the job. I have seen rare, almost surreal ways in which people die. I’ve seen burly young men come in with minor fever or body aches and die of something like dengue fever or pneumonia. I have seen patients walk in for what seems to be trivial migraine, get a couple of painkillers, and stroke out in the hospital parking lot! Hence, like all emergency physicians, I assume the worst while treating my patients. My job is not just to rule in or rule out a heart attack in a patient presenting to ED with chest pain, but also to assure him that he won’t have a heart attack once he is out of my ED. This is a statistical game that I play. Most of the times I play it well. Thanks to all the tools of modern medicine. So, when patients come with headache, chest pain, abdominal pain or any sundry complaints, I end up doing all sorts of tests whether they are needed or not. It is easy to confirm the presence of a disease, but insanely difficult to confirm the absence of it. We fancily call it as ruling in and ruling out. I do see a lot of hypochondriacs who strongly believe that there is something wrong with them despite ample evidence to the contrary as shown by a battery of tests. They want something to be wrong with them and are very much disappointed to hear that all the tests are normal. Even god cannot convince that there is nothing wrong with them!
It is perhaps for this reason that we emergency physicians believe in the ‘act of god’ towards unexpected medical gaffes. If a patient who is given antibiotics for ear ache later dies after gushing blood and pus out from his ears, we console ourselves with a prophetic resignation that the patient died because he might have had brain abscess or mastoiditis. It is a sad fact that we accept death easily premised on a rationale that anyone who comes to the ER might end up dying. This easy acceptance of death is unfortunate but something necessary to maintain our sanity. However, Rukhiya’s death did shake me up a little. It was not so much her death but the reason that drove her to it that troubled me.
Radhika, on the contrary, is an obstetrician. Everything in her work has a happy ending. The ambience is that of joy and anticipation of a new arrival. Mothers who sport a grin despite their excruciating labour pains, fathers who are ready to welcome the new born with a video camera, a home with grandpa and grandma waiting to welcome the new family member with its nursery ready, the excitement of selecting a name, and nurses getting an imprint of the infant’s feet on a white paper. There is no sadness here. Even the mother forgets the pain she has gone through. Only merriment everywhere. It’s as if there is no such thing as death. This is possibly the reason that if there is a death—of an infant or of a mother—the doctors and the medical staff treating them are devastated, some go into depression, and some even quit their jobs.
Therefore, Radhika’s reaction to Rukhiya’s death was quite different from mine. I suspected that my senses were numbed due to working in the emergency department as compared to Radhika’s. At that time, it occurred to me that I may not cry even when my parents die.
I must admit that even in that situation, I suspecte
d the sincerity of Radhika’s grief. In retrospect, I’ve felt that this was a shameful thing to do.
I sincerely thought that her grief was not so much for Rukhiya’s death as much as for the fear that she may be responsible for her death and anger towards the way the events unfolded. She didn’t want to even imagine her life as a physician in India. The ridiculous possibility of an investigation which could lead to her deportation had made her miserable. So, her crying and wailing was more due to anger and helplessness rather than gloom over Rukhiya’s death. If she so much as even got a hint of my thoughts, her reaction would be par for the course: she would agonize with extreme guilt holding herself accountable for Rukhiya’s death. Knowing this, I tried to console her to the most extent possible.
We were yet to recover from this shock when another incident happened. Fadhuma drove to Minneapolis alone from Amoka and in broad daylight, even as people around watched, jumped into the Mississippi river. She had driven slowly to the bridge, parked her car on the side of the road, walked gingerly and jumped into the water. There were people all around who watched her jump. Every little detail of this event was telecast on TV. I couldn’t help but feel that among those who just stood there watching her jump, even if one had ventured to help, she might very well have been saved.
After someone from the crowd called the police, their department’s expert divers arrived on the scene and brought her body ashore. When the local TV interviewed a passerby near the incident and asked ‘You could have tried to save her instead of taking a video of the incident, right?’ he replied sheepishly, ‘Are you kidding me? I shot that video from fifteen feet away. I was afraid that the bridge may explode once she jumps. Who knows what they hide underneath that garb?’
I accepted Rukhiya’s death, against my instinct, as a coincidence. I coaxed myself into believing it.
Now Fadhuma’s dead. And how? In the middle of the day, in a busy place, by jumping into the Mississippi river! All the local channels are playing this on and on. They suspected her to be a suicide bomber!
Hijab Page 6