by Amy Waldman
“Many weeks. I don’t remember,” she answered in a high voice. “We’re poor people.”
“And your husband? Has he also not had meat for weeks?” There was no hint of sarcasm in Dr. Yasmeen’s tone.
“Not much more, but when we can buy meat I give it to him,” Anisa said. “He needs strength to work in the fields.”
“And you need it to work in the house and feed your child,” the doctor said, this time with firmness, trying to transfuse strength into this weakened young woman as another practitioner might transfuse blood. She turned to Parveen. “This is common—they give the best food to their husbands, who then hold the women’s fatigue, their inability to complete their household work, against them. You see the result,” she said, pointing to the bruises.
“I bruise easily,” Anisa said. “He’s not a bad man.”
Anemics did bruise easily, the doctor conceded, which made judging the strength of Anisa’s husband’s anger difficult. But he’d been angry enough.
AT LUNCHTIME, THE WOMEN vacated the clinic, and Naseer came in. In the waiting area he spread a mat on which he set kebabs, naan, and cucumbers for the three of them. Parveen, confident in the safety of the meat, consumed more than her share.
Naseer drove her to the village each week, the doctor said, the two of them leaving home at dawn and making sure to return to the highway by dusk. Though traveling the road to the village was excruciating, they used the hours well, discussing her cases and patients. Her great frustration was that, as a male, Naseer wasn’t allowed to help her with patients, even though he’d been studying medicine for two years already.
He wanted to be a cardiologist, like his father, Naseer told Parveen, and he hoped to study in America.
“This is his roundabout way of asking if you can help him with this,” Dr. Yasmeen said good-humoredly.
“I’ll help if I can, but only if you promise to come back to Afghanistan to work,” Parveen said to Naseer, then regretted her words. Who was she to decide where he should use his skills? “I’m joking,” she added.
“It’s my home and I’m needed here,” he said, taking her seriously. “Of course I’ll come back.”
“Maybe you could work in this village,” Parveen suggested.
Only someone like him, young and eager for experience, would come live here, Dr. Yasmeen agreed. But the women needed a female doctor, and too few women attended medical school, and even if they did, the culture would not accept them living on their own in a village. Nor was it clear that there was a salary for a doctor here, since Gideon Crane’s foundation and the government each claimed the other should pay it. Dr. Yasmeen herself came as a volunteer. “That’s why I was hoping you were a doctor or medical student,” she told Parveen.
Parveen, self-conscious about having disappointed the doctor, tried to explain why she wasn’t pursuing a career in medicine. The problem, she said, was that blood, all bodily fluids, made her queasy. She’d twice fainted as a child when the doctor had drawn blood. She preferred thinking about people to tending to them. In her physical anthropology class, she said, they had studied pictures of Neolithic bones, which demonstrated signs of tuberculosis such as collapsed vertebrae and lesions on the ribs. This fascinated her, the long history of such diseases, the telling traces they left over thousands of years. Why had tuberculosis come to be? How had it spread? Actual disease interested her only insofar as it presented questions like these. The treatment itself was best done by others.
“Like Naseer,” she said, hoping to change the subject.
Embarrassed, perhaps, by her referencing him, Naseer fumbled his tea glass, spilling a bit, then spilled more as he leaped up to fetch a towel.
“But I’ve told you, Naseer can’t help here.” Dr. Yasmeen sounded exasperated. There was a brief silence, then she returned to her usual good cheer, impressing upon Parveen how extraordinary it was for the villagers to see a woman travel by herself to live among them. “You’ll be in their stories for generations,” she said, although she acknowledged that those stories might not be true. She herself had assumed, upon hearing that Parveen was coming, that she was meant to be another bride for Waheed. “But now I know that you have a fiancé in America.”
Parveen had heard one of the women—who must have learned it from Bina or Shokoh—telling the doctor this, with great authority, as if Parveen weren’t standing right there. There was no fiancé, she admitted to Dr. Yasmeen and Naseer, other than the one she’d invented. Seeing their astonishment, she giggled nervously and added, “I made him up so the men here would leave me alone.”
There was an odd silence during which she sensed that they were both wondering whether she could be trusted, which made her wonder the same thing about herself.
Dr. Yasmeen stood and began to wrap up the leftover food. “I suppose it’s for the best,” she said. “This way you won’t have villagers trying to marry you. Tell them your fiancé is a frightful man with a militia of his own.”
“No one in America has militias. Well, almost no one.”
“The villagers don’t know that.”
Capitalize on their ignorance, she seemed to be saying. Parveen found the notion slightly demeaning to the villagers, which didn’t mean she wouldn’t take the doctor’s advice.
More women came after lunch. Ghazal, who was middle-aged and had a nose so large and magnificent it seemed to precede her into the room, entered and kissed both the doctor and Parveen effusively. She was healthy, she said, patting her girth, and indeed Parveen hadn’t seen a stronger-looking woman in the village; it was as if fat and meat had flown from the other women to her. The problem was her husband, she said. Lately he drooped like a dying flower; he had no strength for love. She mimed his failed erection by slowly curling a finger down. “He says he’s tired from working so much, but I work and I’m not tired. If he cannot fix this I will have to go to his brother or the neighbor.”
“My specialty is women’s bodies, not men’s,” Dr. Yasmeen said, hiding a smile.
“In America there’s a medicine to help men with that,” Parveen volunteered, then wished she hadn’t. She didn’t want to make it sound as if America had solved all of its problems, down to erectile dysfunction.
“Ah, so the Americans make missiles as well as bombs,” Ghazal quipped with a wicked smile. “Please ask your family to mail some.”
Latifa, the woman who entered next, held a girl of less than a year in her arms. Another girl, perhaps a year older than that, toddled behind her, and behind her came yet another, perhaps four years old. And Latifa was three months pregnant. When she put her girls in Parveen’s care, the older ones looked wary, as if sensing that Parveen was an outsider.
Latifa didn’t know the sex of her unborn child, she told Parveen as the doctor examined her. But she was praying for a boy. Her husband often said he wanted her to bear children until she had one, and she wasn’t sure whether he was joking. “As you can see, I’ve made only girls,” she said, giving her brood a crooked smile.
The doctor offered a proverb: “Mothers shake the cradle with one hand and shake the world with the other.”
“May it be so,” Latifa said, sighing. She sounded unconvinced.
“Your own mother must be so worried about you!” Dr. Yasmeen said to Parveen once Latifa had left.
Not wanting to speak, Parveen nodded and felt the tears come to her eyes. When they began to leak down her face, Dr. Yasmeen hugged her fiercely, asking no questions, and Parveen sagged in her full arms, inhaling her scents of soap, roses, astringent alcohol. At last she described her mother’s death. The doctor hugged her again, wiped Parveen’s tears with her thumbs, as Parveen’s mother used to, and ordered her to write to her father often, even offering to take pictures of her letters and e-mail them. (The Afghan postal service was better internally than one might imagine, she said, but international mail might be dicier.) She would print out and bring Parveen any replies.
Afterward, Parveen felt as if a space in her had o
pened up, some blockage cleared.
PARVEEN HEARD THE NEXT woman before she saw her, as the sound of unusual, high-pitched breathing entered the room. Unlike the other women, this one waited until she was in the examining room to remove her chadri. A large bump, like a balloon of flesh, swelled in the middle of her neck. Goiter, her ailment was called—a gross enlargement of the thyroid. It was common in the village, Dr. Yasmeen said, as were miscarriages, stillbirths, deafness, and cretinism (a child born with this condition was called diwana, “the mad one”), all resulting from a lack of iodine. The Afghans had a name for it, the “sadness sickness,” and sadness did drape over this woman, Nadia. Barely able to swallow, she subsisted on yogurt and broth. Her affect was wan, her ribs pronounced. After the examination, she crumpled in a chair, naked but for the dress she clutched over herself.
“As I’ve said before, you need surgery,” Dr. Yasmeen told her gently.
The high pitch of Nadia’s breathing intensified.
“But you don’t want to leave the village.”
“No,” Nadia agreed in a whisper.
Parveen asked why the surgery couldn’t just be performed at the clinic.
It wasn’t her specialty, Dr. Yasmeen said. Nadia needed a surgeon of the head and neck. Then she turned to Nadia to ask what her husband thought.
“That prayers and spells will cure me,” Nadia said. The balloon jiggled a bit when she spoke. It was hard to look at but also hard to look away.
“Her husband is the mullah,” the doctor explained, then crouched before Nadia and gazed into her eyes. “If I speak to him, will he let you go for the surgery?”
Nadia nodded.
The doctor adjusted herself from squatting to kneeling and took her patient’s hand, as if in a parody of a marriage proposal. “And will you go?”
Nadia shook her head.
This was often the case, Dr. Yasmeen said, the women not wanting to leave their husbands or children or houses. They feared the long journey; they feared their honor being compromised.
“I fear I won’t come back alive,” Nadia rasped.
“MY MOST POWERFUL FEELING, most of the time, is helplessness,” the doctor said after Nadia left. She began to tell Parveen about a pregnant woman in the village whom she had been monitoring and treating for preeclampsia, with typical symptoms: high blood pressure, sudden weight gain, swelling, little urine. Then, between the doctor’s weekly visits, seizures began. This was an indication that she now had eclampsia, which would affect the placenta and be very dangerous both for her and the baby. But her family, without the doctor there to advise otherwise, believed the seizures indicated that she had become possessed.
Parveen opened her mouth to speak, but Dr. Yasmeen’s hand staved off the interruption. Even if they had known what was wrong with her, what were they to do? They took her to the mullah, Nadia’s husband. “He choked her,” the doctor said, with anguish, “and he beat her with a small whip to drive out the demons. The djinns.” She paused. “He beat a woman who was pregnant and sick.” Him, the doctor said, she condemned. Bruises disfigured the woman’s neck, legs, and palms when she next came to Dr. Yasmeen. The seizures were continuing. In rural areas women were lost to eclampsia all the time, the doctor knew, so she and Naseer put the woman in their car to take her to a hospital where she could be induced or have a cesarean. The woman was in such grave danger that her family had agreed to let Dr. Yasmeen and Naseer take her.
“But why couldn’t you deliver the baby here?” Parveen asked. “In that beautiful operating room.”
“A beautiful operating room that has never been used,” Dr. Yasmeen replied.
Parveen shook her head. “That’s not true. They’ve done C-sections, fistula repairs, all kinds of things there.”
“Who has?”
“I don’t know, whoever the doctor was before you, I guess. Gideon Crane said so.”
Dr. Yasmeen shrugged. “Well, I haven’t done an operation here. I couldn’t, because I have no one to do the anesthesia, not even a spinal, and I wouldn’t do an operation here anyway because there’s no one to give follow-up care, and what happens if an incision opens or becomes infected?” In Afghanistan, C-sections were very rare, she told Parveen, even in Kabul. In villages, they were almost never done. That was not the only time she and Naseer had driven a woman in trouble out of here to get care. “My son has scrubbed blood out of the back seat more than once,” Dr. Yasmeen said.
Parveen was confused, but the doctor had more to tell. There was a heaviness to her face as she spoke, and she kept one hand on the exam table. Two hours into the journey with the pregnant patient, just when they reached the highway, the woman died. Parveen pressed her hands to her temples, trying to absorb this. This had happened only eight months ago, Dr. Yasmeen said, and, like Fereshta, the woman had left motherless children behind. Yet beyond the village, her passing had gone unnoticed.
All of these women dying, Parveen thought, their stories buried with them. A life flames out and the darkness rushes in.
“We had to turn around and bring her body home, two hours in the car, on that road, with the corpse of a woman we couldn’t save,” the doctor finished. “I don’t think we spoke. After you pray, what words are left for an end like that? We spent the night in the mosque. By morning she was in the ground.”
Chapter Six
Two Melons
DR. YASMEEN AND NASEER WERE HURRYING TO PACK UP AND GET on the road when the door to the clinic opened, and a small figure in the head-to-toe green of the chadri glided in. When the garment lifted, Parveen was surprised to see Shokoh. Her panting suggested she had hurried. So stubborn at home, she seemed bashful here, although the doctor was quick to put her at ease. When Parveen explained who Shokoh was, the doctor, despite her eagerness to get on the road, became unhurried, patient. She made small talk, asking Shokoh how it was having a new friend in the house.
Shokoh swiveled in Parveen’s direction, and as she did so, her face changed. Her eyes seemed to widen and glow, and a shy smile kept starting and stopping, but it wasn’t Parveen she was looking at but Naseer, who in turn was staring at Shokoh’s exposed exquisite face, which she made no move to cover. Her gaze, direct and lingering, seemed a radical act, as if within the walls of the clinic, the governing codes of the village had been suspended. And yet also ordinary, poignantly so—two teenagers paralyzed by attraction.
“My son, Naseer,” the doctor said matter-of-factly.
When Parveen had asked him, over lunch, if he had a girlfriend, he’d shaken his head, dropping his long lashes. “He needs to finish his studies before marrying,” Dr. Yasmeen interjected. “Besides, he only has eyes for his books now. I pity any girl who wants his heart.”
When the doctor led Shokoh to the examining room, Parveen followed. The girl’s body, small-boned and gently sinewed, was unspoiled by illness, poor diet, labor, or childbirth, other than her hands, which were tanned and chapped. Her stomach was nearly flat and her breasts buoyant. Only a few bruises on her torso and legs marked her milky skin, and Parveen wondered whether they were from a cow’s hooves or her husband’s hands and how she could find out.
On the examining table, Shokoh kicked her legs playfully and told Dr. Yasmeen that she’d been feeling more tired than normal, making it harder for her to do the milking and other work. Parveen assumed Shokoh was merely hoping the doctor could release her from the demands of Bina, who’d been making her grind wheat into flour, a task she considered tedious. The doctor checked Shokoh’s vital signs and asked about her diet and about her relations with Waheed. “As often as he wants,” Shokoh said resignedly, and Parveen grimaced. There were times she woke in the night wondering if Waheed was on Shokoh. She didn’t want to visualize it, but she couldn’t help it.
Shokoh’s bleeding was irregular, she said in answer to another of the doctor’s questions, but Parveen knew, from a day of listening to the women, that in the village this wasn’t unusual. Cycles were easily disrupted by poor nutrition
or hard work.
Shokoh dressed, then peppered the doctor with questions, including where she lived. The provincial capital, the doctor said, and Shokoh exclaimed that she was from there too. Did the doctor know her parents? No, the doctor said, laughing; the city had sixty thousand people. But if Shokoh wanted, she’d be happy to contact them.
Shokoh’s face constricted and she mumbled that she would think about it.
When Parveen opened the door of the exam room, Naseer was in conversation with Waheed in the waiting room. “Your husband,” she whispered to Shokoh, who yanked her chadri all the way down.
The doctor went out first. She told Waheed that Shokoh needed more rest, that she was still a girl, while Shokoh stood silent and immobile, unseen beneath a waterfall of green. Parveen was curious how Waheed would receive the doctor’s admonition. Bina, as well as Waheed’s own daughters, even those younger than Shokoh, worked harder than she did, and no one insisted on their rest. But he nodded as if to show he understood that possessing such a delicate flower was a prize that came at a cost.
They all walked to the courtyard gate, where the doctor’s white car was parked, and Dr. Yasmeen embraced Shokoh in her green polyester envelope. The netting over her eyes made it impossible to tell whether she was looking at Parveen or Naseer. It was the one freedom the chadri bestowed: a woman could look where she wanted.
Behind her stood Waheed, oblivious. Done with talking, he turned and began to walk toward home, knowing that Shokoh would follow.
Dr. Yasmeen opened the door of her car and stared into its interior, sighing as if she were about to climb into her own coffin. She dreaded traveling the road, and yet time and again she did it. This was heroic to Parveen, who hugged the doctor goodbye. Then she ran to catch up with Shokoh, whose hand, from beneath the chadri, fumbled for hers.
This was her first time at the clinic, Shokoh whispered. She’d threatened Bina, saying that if she didn’t let her go, she would tell Parveen, who would tell Dr. Gideon, who would be very angry. Bina, frightened, had relented. Parveen was mostly pleased by this. As she’d hoped, she was motivating the women to demand more freedom. She only wished the demand hadn’t been made of Bina.