It was hard to say if the woman was angry or was crying with sorrow writ large on her face. She complained in her broken English, ‘Four hours. My son inside operation room. Just appendix…simple surgery…Dr Mohammad tells. Why so late? Why long cut on belly? Dr Mohammad tells appendix keyhole surgery.’ Her voice displayed less interrogation but more of anxiety, expectation, fear, sincerity and honesty. She appeared genuinely concerned.
O’Reilly looked at me and said, ‘How can I answer such questions? It was already late when they came to the hospital. His appendix had already ruptured, and his abdomen was filled with pus. This woman does not understand. It was a miracle that this boy even survived! Even before the surgery, she was asking me how long would the incision be and how many stitches her boy would get. She didn’t get it when I tried to explain that I couldn’t answer those questions before the surgery. With all the complications he had, it was impossible to operate in forty-five minutes.’
‘Mohammad Mohammad do that.’
‘You should have taken your son to him. Why did you bring him here?’
She started wailing loudly, ‘Kid. Too much sick.’
Powell tried to scoot away from there sensing that there was nothing for him to do. I asked him to stay for a moment and went near the woman. ‘Look here ma’am, the kid is alive now, right? He was going to die, and this doctor has saved your son. You should be happy about that. Operations like these take more time. Dr O’Reilly is a good doctor. There is absolutely no doubt about it. Moreover, where is Dr Mohammad Mohammad now? If you would like, you can call him. Dr O’Reilly or I will talk to him. He is also a doctor. He will understand.’
She seemed shaken and said, ‘Don’t know phone number.’
Nobody seemed to know the whereabouts of Dr Mohammad Mohammad. That being so, the fear she displayed at my simple question surprised me. I understood the futility of digging any deeper and said, ‘Okay, what can we do to make you feel better?’
‘CT scan,’ she replied with no hesitation.
O’Reilly looked at me.
I asked her, ‘The kid just had the surgery, why do you want a CT scan? Do you want to see if there is any more pus inside?’
‘No, no,’ she hesitated a bit.
I looked at O’Reilly, frustrated.
‘I know why she is asking for a CT scan. She suspects that I may have removed her son’s kidney or any such useful organ when I had opened his abdomen. Is it not so ma’am? Now I must show that the boy’s organs are safe, and none are missing.’
She nodded her head crying, ‘Yes.’
‘O’Reilly, what kind of madness is this? Is this something new? ’
‘Welcome to my world. Whether I remove an appendix or a gallbladder, I must swear before these people that I’ll remove the appendix, the whole appendix and nothing but the appendi. And after the operation, I’ve to show them the proof that I’ve done so!’
‘Entitlement?’
‘Guru, it cannot be called an entitlement. Can she really think on those lines? Don’t you think that someone else is feeding into her head?’
I didn’t even know the woman’s name. She understood only a smattering of English. It made me uncomfortable that O’Reilly was speaking about her right in her presence.
‘I know it all. First son…kidney stone. They take him surgery. One kidney gone!’ the woman started sobbing.
O’Reilly said, ‘I’ve heard such stories many times over. Where was this surgery done? In America or in Sanghaala?’
‘Sanghaala.’
‘I rest my case. Look, I can’t do a CT scan of your son’s belly. I think you know that too many CT scans can cause cancer. If you do not know, go ask your Mohammad Mohammad. I’ve done my job here. If you have any complaints against me, then these two standing here, are my bosses. You can complain to either of them.’ Almost immediately, he left.
That woman stood there crying.
I spoke to her, ‘Look ma’am. You may have had a bad experience in Sanghaala. But here in America, nobody can remove kidneys or other body parts that easily. Let the boy rest for a while now. We can watch him. You talk to him when he is more awake. If you continue to have your doubts, let us talk again.’
It was not clear if my words consoled her or made her feel that any further discussion was futile. She went inside crying.
Powell walked in, ‘I don’t know if these people fear Cesarean sections or if they are simply ignorant of any surgery in general? Just get a CT scan done. We can show them that everything looks fine and be done with it. If needed, I will ask our accounts department to waive the charges.’
‘Seriously? You are a typical Administrator. It is wrong to get a CT scan for no reason. What O’Reilly said is right.’
‘You know quite well that everything cannot be done by the book. So far, only those who underwent Cesarean sections have committed suicides. Tomorrow if the kids who were operated by O’Reilly start killing themselves, what do I do?’
This line of thought by itself was scary. But still, this is O’Reilly’s patient. It would be wrong on my part to get a CT scan done. There was no option but to wait.
‘Powell, we have no choice other than praying that no such thing happens. ’
‘Even if these people have no faith in us or in our work, I cannot for the life of me understand why they are killing themselves?’
‘We are physicians. We do our work. You are an MBA and you manage this hospital. The police are there to investigate this mystery and get to the bottom of it. Right?’
‘I don’t think they have any clue at all so far as to what is going on. I believe we should do our part and try to help as much as we possibly can. Guru, has Rick Jackson spoken with you?’
‘He wants to. Has he told you anything?’
‘No. But he made a subtle suggestion. He wants us to prove publicly that Cesarean sections are harmless. I think it would be good to start to come up with ways of doing that.’
It occurred to me that Rick had talked to him about his pet project of the Cesarean section video.
I asked, ‘What exactly did Rick tell you?’
‘Not much. Anyway, he said he will speak to me in detail. By the way, is it true that Razak’s wife Zeba is pregnant? How is she doing?’
‘She is doing fine.’ I ended our conversation.
I was surprised that Razak had shared the news of Zeba’s pregnancy with the management even before he did so with us!
14. Assad Delmar Abdhikarim AKA ‘Kuki’
I had first met ‘Kuki’ under a strange circumstance. Amoka’s police had arrested him. In fact, the police had tased him and brought him to the emergency department. Apparently, they had found three marijuana plants in his car. But ‘Kuki’ tried to flee and had to be tased. Taser use by the police had got a bad rap as there were at least two deaths in Minnesota after police tasing. Amoka County had a strict policy about the use of tasers on unruly offenders. Each time someone got tased, the police had to bring the offender to the emergency department and have the doctor certify that the person was in sound physical and mental state to go to jail, meaning I needed to reassure the cops that the guy wouldn’t die on them in jail. In the absence of such certification, the arrested person could not be detained.
Kuki’s real name is Assad Delmar Abdhikarim. He is thirty-seven years old now. He was a twelve-year-old boy when he came with his uncle to America from Sanghaala as a refugee. His parents had not accompanied him. His uncle had him schooled in Amoka. He had graduated from high school in Amoka and then got a nursing degree from Minneapolis’ Franklin University. Apparently, he had worked as a Registered Nurse at the Amoka General Hospital for a couple of years. He had enlisted himself in the military to get tuition waiver and was posted to Afghanistan as an army nurse. It was said that he had his own misgivings of being able to get into America’s military. However, since he had literally walked into America with his green card, he didn’t have any problems getting recruited to the military.
After serving the American government for about two years in Afghanistan, he had returned to America as a completely changed person. Nobody seemed to know the cause of his metamorphosis. Each time this question was raised, people came up with different stories, most of them probably apocryphal. According to one of these stories, he had visited Sanghaala a few times during his posting in Afghanistan for reasons that were not clear. It was not known whether it was on official work or to visit his parents. If asked as to why he had been to Sanghaala, the conversation would in turn spawn another sub-story.
According to that story, when he was in Afghanistan, he had developed contacts with a terrorist organization. This organization had its operations spread across Sudan, Sanghaala, Ethiopia and other African countries with Al Qaida’s help. American passport holders like Assad working in the military, who could travel from one country to another with no hassles, were a gold mine to such groups. Such groups were ready to pay resources like Kuki any amount of money. And moreover, Assad’s family lived in Sanghaala. There was very little information on their whereabouts. One of these terror groups apparently had persuaded Assad to go to Sanghaala.
All said and done they were all stories with no proof. It was hard to differentiate truth from fiction in these stories. Most of them were gleaned from a few bored cops sipping coffee and tattling with the nurses when they waited for the test results of some unruly inmates suspected of trafficking cocaine into jail.
It was said that Assad had returned to Amoka after spending nearly a year in Sanghaala. Upon his return, he was posted to Iraq almost immediately. Nobody knew what happened to Kuki in Iraq, but it appeared like he had got into some serious trouble. Within three months of his posting, he was dishonorably discharged from the military. According to police gossip, when he was in Iraq, a soldier had stepped on a land mine and injured his leg. They had brought him to Fleet Hospital 6 where Kuki was serving as Combat Medic/ Nurse. Kuki was taking vitals and the doctor had not examined the soldier yet. He apparently was in a lot of pain and asked Kuki for morphine. Assad had apparently given him 1000 mg paracetamol telling him that he had only suffered a toe injury and did not need stronger pain medications like morphine and that he was saving those for some real injuries. Being in a lot of pain, the soldier had retorted, ‘Would you withhold morphine if I were a Muslim?’ This had infuriated Assad, and unable to contain his anger, he had tried to punch him in the face. That was the end of his military career. Everyone had their suspicion if this was enough ground for a dishonorable discharge. Since there were no alternate narratives, this story had stuck. I was able to garner this much of information during Asad’s numerous emergency department visits in the last two years.
Kuki’s another unique accomplishment was that he was instrumental in starting Amoka’s first Sanghaali gang. After he was fired from the military, he was roaming around the streets of Amoka in search of a decent means of livelihood. However, life had other designs for him. He wanted to get back to work at the Amoka General Hospital, but Powell did not hire him again. It was not clear to me as to why he had not gone to Minneapolis or other big cities that could offer many opportunities. According to the police he had then organized gangs of Sanghaali youth and had turned into a peddler of methamphetamines, marijuana and other recreational drugs. In fact, he was one of the main distributors in this part of the country. The name, Assad Delmar Abdhikarim didn’t go well with his newfound profession, so the moniker Kuki stuck to him. Nobody knew if it was the police that gave him this name or if it was his customers. Anyway, whatever that might be, each time the police called to alert us that Kuki was being brought to the ER for ‘medical clearance’, it would cause a flutter of excitement in everyone. The reason was simple: behind his every visit there was an interesting story!
When I first met Assad, he had already transitioned to ‘Kuki’. I remember quite clearly the very first time I met him. The police officer had brought him to the emergency department—profusely bleeding from a scalp laceration. He was arrested for causing a ruckus at Amoka’s infamous bar, Grandpa Bob. The story goes that he had continued drinking up to the bar’s closing and demanded more whisky. The bouncers had to forcibly kick him out. An enraged Kuki apparently had urinated right there at the bar’s entrance. When the bar owner admonished him, Kuki had cursed him and pulled a knife. The terrified owner then had to call the police. The police had picked Kuki up, ostensibly to file a misdemeanor charge. As he was being driven in the police car, he had banged his head all over and started bleeding profusely. The scared police officer had to bring him directly to the hospital instead of jail.
‘C’mon arrest me, you racist motherfuckers. You serve scotch to that white son-of-a-bitch but not to me, huh? I’m a veteran. I worked in the army, you fucktards! Do you really want to mess with me?’
I had given 2 mg of Haloperidol to calm him down. I had introduced myself politely, ‘Hello sir, Mr Abdhikarim.’
He’d looked at me and said, ‘You are not white. Call me Kuki, brother. Where from? Pakistan?’ The Haloperidol was starting to do its job.
‘No, no. India.’ By then he had already gone off to sleep.
After he woke up, mellowed, the police had taken him to jail.
Kuki had a special affection for me. He would calm down the moment he saw me no matter how much of a violent brawl he had gotten into. Apparently, he had not seen any other non-white doctors in Amoka. He could not have possibly known or even seen Razak or Radhika since his business was mostly with the police and the emergency department.
Once, he had visited the hospital before going to jail. He didn’t appear drunk. According to the police he was under the influence of some drug. But his blood and urine results were negative for any trace of alcohol or any street drugs. I thought that this was such a pain; why couldn’t they take him straight to jail? I sat near Kuki and had warned him, ‘Kuki, if you have drunk or smoked some crap, that’s your problem. I can sign off telling that there were no traces of any drugs in your urine or blood and send you to jail. If you have taken some drugs that cannot be detected by routine tests, then you are inviting trouble for yourself.’
‘Doc, you have to trust me. I am on no drugs. None of us are. I will get all my boys here and ask them to pee, right in front of you, supervised piss, ok. Isn’t that what these motherfuckers call that? Test them for whatever you want. If anyone is positive for anything other than pot, I will cut their dicks off.’
Talk about solving the root of the problem. I didn’t want to talk about it anymore. ‘Kuki, why this gang business? Why can’t you live a decent life? You are not only messing up your life but also that of these kids!’
He had retorted, ‘I’m protecting our boys, doc.’
‘From what?’
‘From these drugs that I sell and from the great United States of America.’
I didn’t get what he was talking about. He’d looked at my blank stare and continued, ‘Doc, you don’t get it. Do you? You people come here with all the education and stuff. Even after these many years, there are no Indian gangs. Why do you think so? We didn’t come here to be gangsters, either. Why do you think there are Sanghaali gangs?’
I was quiet and had no real answer to his question. Kuki had continued, ‘Poverty, doc. We are all poor. No education, no job. America got us here. They welcome us and take care of us for what, six months? Then we are on the streets trying to get a job. Our boys have no education. Back in Sanghaala, getting two meals a day was tough. But poverty in America is different, doc. Nobody is hungry, but a lot of us are poor. Back home, if you are poor, you are hungry. Here it is poverty without hunger. America gives us food stamps but no decent jobs. What do you do when you are not hungry but have no job? You hang out on streets and smoke ganja, hash, marijuana, pot, whatever you call it. When you get a chance, you sell the stuff. Control doc, if I control my supply then I control my distribution and customers. I put my boys to work and show them the money. There is no other way to keep my boys away fr
om pot or coke. It was tough at first but check them out now. I can say for sure that none of my boys do any drugs.’ Kuki had no dearth of stories. Each story had the same strange narratives, the same strange logic.
Kuki was in the emergency department charged with possession of marijuana in his car. I had to examine him and certify that he was medically fit to go to jail.
I had not examined Kuki yet. I was going over his records when Powell came in.
‘Guru, I would like to talk to you for a bit.’
‘Powell, I have to go now to see a patient.’
‘He is the one that I have to talk to you about. This is very important.’
I closed my office door and looked at Powell inquisitively.
‘Guru, I don’t have to tell you how to do your job. But no matter what, do not admit Kuki to our hospital. Let him go to jail. If in case, you think he needs to be hospitalized, send him elsewhere on the pretext that we do not have specialists in this hospital.’
This was funny. I had not yet examined Kuki. I did not think he had anything that needed hospital admission. Even if he did, the decision was mine. Powell was not a doctor, but he was telling me not to admit him.
I smiled, ‘Powell isn’t that supposed to be my decision?’
‘I agree, Guru. Please work with me here. I think this is a high profile case. The real reason that Kuki has been arrested is to enquire about the Sanghaali girls’ suicides. All this marijuana business is just an excuse. The police needed a reason to arrest him. It is suspected that Kuki also has links with a Sanghaali terrorist organization, just like Dr Mohammad Mohammad.’
I did not know what to say. The Sanghaali mothers are committing suicides for apparently no reason. No one was sure if Radhika’s C-sections had anything to do with these suicides. How were Sanghaali terrorists responsible for these suicides? Can a small felon like Kuki engaged in petty crimes be a terrorist?
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