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In the Land of Invisible Women

Page 16

by Qanta Ahmed


  “Ana Doctora.” (I am the doctor.) I offered to her the Muslim greeting to other Muslims, “Salaam alaikum, Khaala.”

  “Wa alaikum Salaam Doctora,” she replied trying to smile. She winced with an acute onslaught of pain. I noticed she was gripping her back. I was relieved she did not point to her flank. From afar, as she lay writhing, my first impression had been renal colic. For that she would need hospital transfer and who knew how that could be accomplished.

  “Fi wajja, hinna?” (Is there pain here?) I asked, placing my hand gently over hers. It felt warm and dry though the knubbly joints of her fingers were deformed with telltale signs of osteoarthritis. At least her chubby hand, alabaster pale, didn't feel febrile to my touch. I was reassured. I didn't have the means to take vital signs.

  She directed my hand lower, towards either side of her lumbar spine. I palpated her spine through her thin clothing. I could feel her muscles tensed in spasm on either side of her spinal column; paravertebral muscle spasm, common after hours of back pain. Possibly she had needed pain relief hours earlier, which would have prevented these painful knots. Judging by her weight and the signs in her hands, she probably had arthritis in the vertebral joints as well. The hard, stony floor underneath was doubtless agonizing for her crumbly spinal column.

  Rashida talked to the woman and reported to me she did indeed have a history of severe arthritis. She had brought with her usual medications, one of which was an injectable pain reliever, an anti-inflammatory. I raised my brows in surprise. This was not typical at all. There were far better ways to take these drugs. An intramuscular injection was usually reserved for those too ill to swallow tablets, patients who were normally hospitalized for more serious illness. Normally, the woman explained, her daughter would administer the injection for her, but here at Hajj she was traveling only with her husband, who couldn't possibly enter the tent and who didn't know how to inject the medicine anyway. She had made inquiries, but no one in the tent knew how to give an injection either. News had traveled that there was a woman doctor with a group of ladies from Riyadh, and so I had been sent for. I was amazed anyone could know anything here, but here at Hajj, just like everywhere else, women talk and try to find solutions for problems by networking! If only I could speak Arabic, I thought to myself.

  The patient struggled to sit up and began searching through her bag. At last, with a flicker of triumph in her hazel eyes, she pulled out a packet of glass vials still encased in their plastic packaging. She also produced a syringe, thankfully still in its sterile packet, and soon a packet of alcohol swabs followed. I smiled. The patient was well-prepared. Looking at the vial, it was a large dose of non-steroidal, just as I had expected. The labeling of the medicine and the dose was in English. I checked the expiration date. It looked fine, though I would have to give it even if it had been outdated. Old habits die hard even when they are impractical.

  Without being able to wash my hands immediately before the procedure, I carefully wrapped the tear-dropped tip of the glass vial in the end of my abbayah scarf and, with the familiar satisfying yield of thin glass, I snapped it open at the neck. I unraveled the fractured glass from my scarf, shaking the tiny splinters into the dusty durries where they glinted in the dark. I instructed to Rashida to hold the opened vial still, without spilling any of the precious liquid. Gravely Rashida assisted, while I next readied the syringe. Before drawing up the liquid, I instructed the patient to prepare for the injection. Because the dose was so big, it was best to inject her in the gluteus maximus muscle (in her rear) but the patient, so well-practiced at her role, was already prepared.

  When I looked up, she had struggled onto swollen feet and turned to face away from me. Her dimpled right buttock, gleaming white in the dark, was already exposed, waiting patiently for the shot. In her right hand she had gathered her abbayah and dress, lifting them high around her waist, while her left hand clutched at her lower back. She wore no underwear. Perhaps she had removed them for bedtime, or perhaps this was the norm for the hot weather and difficult conditions of Hajj. I didn't know the details, because in Riyadh I had been treating only critically ill patients, who arrived mangled from car wreckages or so gravely ill that they were covered in cloaks of equipment, rendering clothing impossible. I didn't know these details. When I returned to Riyadh, I would have to ask my nurses about the customs of underwear in older matron Kingdom dwellers. For now, I finished aspirating the medicine, squirting a tiny amount out of the needle to avoid injecting any air into the patient. Drops of medicine glinted in the torchlight.

  “Bismillah ir-Rahman ir-Rahim! Bismillah ir-Rahman ir-Rahim!” (In the name of God, most Gracious, most Compassionate!) recited my patient, loud enough for both of us to hear.

  With my left hand, I gripped her buttock, raising a meaty fold of flesh. The shot had to be intramuscular, not subcutaneous. I would have to dive through a lot of fat to reach the muscle tissue. Satisfied I was finally pinching her muscle rather than the layers of fat encasing it, I briskly plunged the steel needle into a fold. The patient winced but luckily did not move. Drawing back for a moment to check for the absence of blood, I emptied the syringe. The drug was in. Removing the needle, I wiped over the tiny puncture wound with an alcohol swab that Rashida had torn open in anticipation. We had no Band-Aid, so after it dried in a few seconds, I touched the patient's hand, and she allowed her clothing to fall, covering herself once more. She turned around. Her face was tired, but the relief was already evident. She hugged me tight and thanked me.

  “Alhumdullilah! Alhumdullilah! Shukran Doctora! Shukran!” (Thanks to God, thanks to God! Thank you doctor! Thank you!) I struggled to emerge from her heavy embrace. I was embarrassed at her profuse thanks and blessings, which Rashida excitedly translated. All tension among the three of us was instantly gone, leaving us with euphoria.

  Taking responsibility for a woman who wasn't my patient, administering a drug I had not prescribed, trusting the patient who guided me to give her this medicine, all this was novel for me, and scary. But I was glad I could still be useful at Hajj, where so far I had felt woefully incompetent.

  We bid farewell to the patient who was already relaxing back onto her bedroll, easing herself into a much-needed sleep after many restless hours. Retreating the way we came, we returned to our own tent-home. I nodded to the sleeping, squatting army of pilgrims who lined our route, still swaying on their haunches. I couldn't be sure how long we had been gone. Inside, the women remained unrousable. Rashida retreated to her separate tent where she slept with the other maids, leaving with her flashlight. The Saudi woman who had guided us to the patient returned to her bedroll against the near corner of the tent and I went back to my spot, slumping against my suitcase. Covering myself with my angora cardigan (the only warm clothing I had) I lay down, sinking into a deep sleep myself. Looking at my watch, it was 3:45 a.m. Soon I would be waking up for Fajr (morning prayer).

  ***

  “Salaat! Salaat!”

  I opened my eyes, heavy with fatigue. It was the same woman who had cried Haram. Now she peered at me intently, bending her arthritic back low, to see if I was awake. Today her eyes had lost their hostility. I almost detected affection. I wondered why. Seeing I was awake, she began to straighten up. Before she left, gruffly, she greeted me with salaams. This was a first! I quickly got to my feet, pulled on my abbayah, and hurried to make my ablutions.

  Returning to the tent I prayed, this time (following the custom of the women surrounding me) I covered my ears. There were no catcalls of “Haram.” I was pleased. I was learning to be a better Muslim and perhaps, maybe because of my eagerness to improve, so too were others. As I sat counting off my “Alhumdullilahs,” my “Allah hu Akbars,” and my “Subhan'allahs,” a Saudi woman passing by corrected me, signaling me to keep count on my right hand, not my left, which in my distraction I had forgotten. This time I didn't take offense but accepted the corrections. This was part of Hajj, to be allowed to improve and develop one's skills of worship. I finis
hed my prayer and readied myself for breakfast, which was already in progress.

  I noticed Randa walking in from her morning ablutions. As she wandered the tent, she dried her hair with sporadic rubs from her towel, leaving her damp red locks standing awry. She returned to her place in the tent and waved a friendly hello.

  As I returned the greeting, I couldn't help noticing all eyes were on me. A line of teenage Saudi girls followed my every movement. In a silent row, still wrapped in their full-length scarves which they wore, as though mummified, while praying earlier in the morning, they tracked me with their dark eyes. Each smiled at me shyly. One bespectacled girl even called, “Salaam alaikum, Qanta!” I responded, unsure how she could know my name. Elsewhere, older Saudi matrons nodded to me in acknowledgment, showing signs of actual approval. Overnight, something had triggered a volte-face.

  “Salaams, Doctora Qanta!” Rashida sang, beaming even more than usual.

  Randa grinned, explaining. “We all heard about your midnight rounds, Qanta,” Randa called out, “Rashida told us. Everyone has been talking about it since early this morning! News travels fast. They are impressed you are a doctor!”

  “Once you have finished your breakfast, Doctora, there are some other ladies who need you. They are waiting for your help. You are so kind. I told them you would know what to do for their pains.” Rashida gestured to a row of Saudi women patiently awaiting the end of my breakfast.

  I couldn't help but smile at the age-old appeal of a doctor. The orthodox Saudi women sharing my tent valued the woman doctor and didn't want to miss an opportunity for an opinion. Somehow my failings as a Muslim, one who in their rigid opinions wasn't even expert in the execution of her prayers, were more than compensated by an ability to treat patients.

  Islam places a great emphasis on easing suffering and the privilege of being a doctor. The Quran says it best in chapter 5:32: “If you save one life it is as though you have saved all mankind,” explaining the universally high regard Muslim doctors are held in by their fellow Muslims. Perhaps these women were not able to consult women doctors themselves. Unlike the grandmothers and mothers of Saudi Arabian National Guard military personnel who presented at my hospital in Riyadh, most of these women would have to rely on the local facilities, where fewer personnel were Western and even less likely to be female. I knew the lack of a female doctor was a deterrent to seeking medical care for Saudi women, just as it is in Pakistan or Afghanistan. No wonder they were so excited about sharing a tent with a woman doctor.

  Randa had a different explanation, however, “They are impressed with you, Qanta, because you are a doctor. Until they found out about last night, they thought you were just a Pakistani maid.” She went on, even more bluntly. “They look at your dark skin, Qanta, dark as an Indian, and they noticed your friendliness to Rashida and Haneefa, the Hijazi maids, and assumed like those black girls, you were also a servant. They probably think you serve a family in Riyadh. They looked down on you because of your Pakistani blood and the fact that as a servant they didn't think you belonged in this tent. Don't worry, Sherief, my husband, gets this all the time too. He is dark-skinned and he is constantly mistaken for a Pakistani or Indian too. When they find out he is Egyptian, it's not much better, though.

  “You know the Saudis hate the Egyptians the most and vice versa. It's to do with the economic inequality in our countries. Most Egyptians come to work in the Gulf countries like the Kingdom for economic reasons so Saudis regard them as poor. And on the other hand, the Saudis like to vacation in Egypt, where they unfairly get a reputation of womanizing and drinking, so the Egyptians look down on them, very unhealthy.15 But in your case, you being with Qudsia doesn't help much either. Because she's black, I mean. I think most women here don't know that she is a nurse, and anyway she is very difficult to talk to.”

  Randa went on. “Last night when they heard about your trip to the other tent they were quite shocked to discover you are a doctor. But they are pleased about that now! Now you will find they will all want to talk with you! They don't care about your race!” She laughed, returning to apply more unscented lotion to her drying limbs.

  I was shocked. I had indeed noticed that while I felt terrible about Rashida and her helpers waiting on us in the tent, like maids, retrieving cutlery, serving food, tidying up, serving drinks, preparing our beds, no one else expressed the same concern. I tried to be as helpful as possible, unused to being waited upon. After eating I always returned my plate and utensils to the bucket in which everything was collected and taken away for washing, and would just get up to retrieve my own cold drink from the refrigerator cabinet in the corner of the tent, rather than ask a maid to fetch me one. I had noticed the Saudis dropping half-empty, crumpled cans on the floor of the tent, leaving their litter for the maids to remove. Or worse, signaling to the maids to bring them another soda with a contemptuous and dismissive wave, not even articulating the words, let alone pleasantries like “please” and “thank you.”

  This arrogant behavior made me feel uncomfortable and seemed unnecessarily unkind, especially by pilgrims at Hajj towards fellow Muslims who were trying to ease their Hajj. I had wondered why no one else in my tent seemed eager to help the overworked maids to clear away each meal; and now I understood: it was beneath my fellow pilgrims, who had paid top dollar for this “VIP Hajj.”

  To me “VIP Hajj” meant I was able to travel in buses between the holy sites and stay in air-conditioned comfort in Mina, but to these other Saudi women it meant being waited on hand and foot and enjoying a sense of superiority over these dark-skinned maids from Mecca, poor women who had to work for a living and chose to make a few extra riyals in Hajj season. I felt disgusted. The entire point of Hajj was to remind Muslims of our equal status in the eyes of God and that only God determines if one Muslim is superior to another in matters of the purity of His believers' hearts. Hajj was not an exercise in dominating the weak because of some form of economic power which, unlike each maid attending us, few other women in this tent actually earned for themselves. Worse than this, these women in my tent were feeling racially superior, to the maids and perhaps even to me.

  I shouldn't have been stunned. I had already uncovered some racism during my time in the Kingdom. I knew Randa was probably right. Skin color, previously something I had never considered in my years of living in the United States or England, had somehow invited discomfort to me in Riyadh already. It was while I worked among the Wahabis that I first noticed how some Saudis discriminated, first among themselves and then among the expatriates. Discrimination in fact is how many of the Saudis define themselves. Saudi Arabia is about separation of gender, race, tribe, fiefdoms. I had developed a theory based on my crude observations, which explained the Wahabi Saudi ecosystem surrounding me in Riyadh. Perhaps it reached here too, in a tent full of Saudi orthodox Wahabi women from Riyadh.

  The highest position in the Kingdom's racial food chain was occupied by the “pure” Saudi who was from the Najd, the central region, the province of which Riyadh was the first city (and therefore the nation's capital). The Najd was also the historical, geographical, and political node to the current powerbase: the rabidly orthodox Wahabi clergy. I use the word pure as they, the pure Saudis did. I had never heard anyone describe themselves as Pure English, Pure French, Pure Nigerian, Pure Indian, or any such. “Pure American” of course was an oxymoron, an impossibility which endeared America so much to me. “Pure Saudi,” however, I heard repeatedly; first when I stumbled across a gorgeous Saudi woman, settling a check at my beauty salon and “undercover” luxury gym in Riyadh, al-Multaqa.

  Ahead of me in line, I had watched the extraordinarily beautiful Saudi woman at the counter. Her creamy skin, enormous eyes, regal stature, and slim, muscular figure were a breath-taking combination, even for another woman to behold. I surmised her to be of Palestinian origin. By now in Riyadh, I was learning Palestinians are a physically beautiful race. I couldn't wait to tell her this and triumphantly expose her origin, a
testament to my growing sophistication and insight in this unusual world.

  She signed her bill with an elegant twist of her slim wrist, weighed down by the obligatory Chopard “Happy Diamonds” watch, derigueur for the cultivated Saudi lady. She placed her gleaming red cell phone, shiny like nail polish, into an oversized Fendi handbag, and started to fasten her elegant, tailor-made abbayah. She covered her eyes with Dolce and Gabbana shades. Her languid, lean, perfectly manicured, unpolished fingers quickly fastened the jeweled cords to her costly abbayah. Elegant heels, probably Balenciaga, completed the ensemble. I was bewitched by this beautiful creature. I had never seen anything more elegant.

  “Are you Palestinian?” I remembered blurting out to her. “You are so beautiful,” I told her, simply. She smiled a self-possessed smile, which slowly curved open, revealing a mouthful of pristine teeth, made perfect with expensive West London orthodontics. It was a dazzling smile. Compliments on her beauty were evidently commonplace, even here in a veiled Kingdom. She responded coolly, “No, I am Pure Saudi. I am not a Palestinian.”

  Brushing past me, she exited, leaving me puzzled.

  At the time I barely gave it a thought, watching the rich woman leaving in a cloud of fragrance. This was hardly so very different than many Western societies, I thought, recalling frosty, pooch-carrying, anorexic cadavers scuttling up and down Madison Avenue. So Saudi Arabia had a similar culture of frosty exclusion, a claim to superiority based on economics and tribal origins. The purity that the mysterious woman mentioned was actually an expression of Saudi aristocracy.

  Later I realized this was my introduction to the Saudi self-perception of purity. Purity (and the froideur that usually accompanied it) was, in a few short months, already a powerful, recurrent theme in my time in the Kingdom: either one had it or one didn't. I even learned this was a problem for Saudi men, who were forever seen as hybrid races, doomed forever to be migrants because of grandmothers from elsewhere in the Arab world where three generations in the country was “off the boat.” This hybrid breeding would actually limit their ascent in organizations. Men, while Saudi nationals by birth, were of “impure” blood, their races were mixed, and they were excluded from the highest positions of power. “Oh yes, but he is an Iraqi Saudi,” would be a common lament.

 

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