© 2008 by Qanta Ahmed
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Library of Congress Cataloging-in-Publication Data
Ahmed, Qanta.
In the land of invisible women : a female doctor's journey in the Saudi Kingdom / Qanta A. Ahmed.
p. cm. ISBN-13:978-1-4022-2002-9
Includes bibliographical references.
1. Ahmed, Qanta. 2. Women physicians—Islamic countries—Biography. 3. Women in medicine—Islamic countries—Biography. 4. Muslim physicians—Islamic countries— Biography. I. Title.
R692.A346 2008
610.82092—dc22
[B]
2008009548
Printed and bound in the United States of America.
VP 10 9 8 7 6 5 4 3 2 1
For my parents, who gave me my Islam and my love of words.
And for Joan Kirschenbaum Cohn, who shows me how to live,
as a better woman, as a better Muslim.
CONTENTS
Chapter 1: The Bedouin Bedside
Chapter 2: A Time to Leave America
Chapter 3: My New Home, a Military Compound
Chapter 4: Abbayah Shopping
Chapter 5: Invisible and Safe
Chapter 6: Saudi Women Who Dance Alone
Chapter 7: Veiled Doctors
Chapter 8: The Lost Boys of the Kingdom
Chapter 9: A Father's Grieving
Chapter 10: An Invitation to God
Chapter 11: The Epicenter of Islam
Chapter 12: Into the Light
Chapter 13: The Child of God
Chapter 14: The Million-Man Wheel
Chapter 15: Committing Haram
Chapter 16: Calling Doctora
Chapter 17: Daughters of the Desert
Chapter 18: Next Stop: Absolution
Chapter 19: Prayer under the Stars
Chapter 20: Between the Devil and the Red Sea
Chapter 21: Mutawaeen: The Men in Brown
Chapter 22: Single Saudi Male
Chapter 23: The Calm before the Storm
Chapter 24: Wahabi Wrath
Chapter 25: Doctor Zhivago of Arabia
Chapter 26: Love in the Kingdom
Chapter 27: Show Me Your Marriage License!
Chapter 28: An Eye for an Eye
Chapter 29: Princes, Polygamists, and Paupers
Chapter 30: Divorce, Saudi-Style
Chapter 31: The Saudi Divorcée
Chapter 32: Desperate Housewives
Chapter 33: The Making of a Female Saudi Surgeon
Chapter 34: The Hot Mamma
Chapter 35: The Gloria Steinem of Arabia
Chapter 36: Champion of Children
Chapter 37: 9/11 in Saudi Arabia
Chapter 38: Final Moments, Final Days
Afterword: Rugged Glory
Endnotes
Bibliography
Reading Group Guide
Acknowledgments
THE BEDOUIN BEDSIDE
SEEKING RESPITE FROM THE INTENSITY of medicine, I trained my eye on the world without. Already, the midmorning heat rippled with fury, as sprinklers scattered wet jewels onto sunburned grass. Fluttering petals waved in the Shamaal wind, strongest this time of day.
In a pool of shade cast by a hedge, a laborer sought shelter from the sun. An awkward bundle of desiccated limbs, the Bengali lunched from a tiffin. His shemagh cloth was piled into a sodden turban, meager relief from the high heat. Beyond, a hundred-thousand-dollar Benz growled, tearing up a dust storm in its steely wake. Behind my mask, I smiled at my reflection. Suspended between plate glass, a woman in a white coat gazed back. Externally, I was unchanged from the doctor I had been in New York City, yet now everything was different.
I returned to Khalaa al-Otaibi, my first patient in the Kingdom. She was a Bedouin Saudi well into her seventies, though no one could be sure of her age (female births were not certified in Saudi Arabia when she had been born). She was on a respirator for a pneumonia which had been slow to resolve. Comatose, she was oblivious to my studying gaze. A colleague prepared her for the placement of a central line (a major intravenous line into a deep vein).
Her torso was uncovered in preparation. Another physician sterilized the berry-brown skin with swathes of iodine. A mundane procedure I had performed countless times, in Saudi Arabia it made for a startling scene. I looked up from the sterilized field which was quickly submerging the Bedouin body under a disposable sea of blue. Her face remained enshrouded in a black scarf, as if she was out in a market scurrying through a crowd of loitering men. I was astounded.
The scraggy veil concealed her every feature. From the midst of a black nylon well sinking into an edentulous mouth, plastic tubes snaked up and away from her purdah (the Islamic custom of concealing female beauty). One tube connected her ventilator securely into her lungs, and the other delivered feed to her belly. Now and again, the veil-and-tubing ensemble shuddered, sometimes with a sigh, sometimes with a cough. Each rasp reminded me that underneath this mask was a critically ill patient. Through the black nylon I could just discern protective eye patches placed over her closed eyelids. Gently, the nurse lifted the corner of the veil to allow the physician to finish cleansing. In my fascination, I had forgotten all about the procedure.
From the depths of this black nylon limpness, a larger corrugated plastic tube emerged, the main ventilator circuit. It snaked her breaths away, swishing, swinging, with each machine-made respiration. Without a face at the end of the airway, the tubing disappeared into a void, as though ventilating a veil and not a woman. Even when critically ill, I learned, hiding her face was of paramount importance. I watched, entranced at the clash of technology and religion, my religion, some version of my religion. I heard an agitated rustling from close by.
Behind the curtain, a family member hovered, the dutiful son. Intermittently, he peered in at us. He was obviously worrying, I decided, as I watched his slim brown fingers rapidly manipulating a rosary. He was probably concerned about the insertion of the central line, I thought, just like any other caring relative.
Every now and again, he burst into vigorous rapid Arabic, instructing the nurse. I wondered what he was asking about. Everything was going smoothly; in fact, soon the jugular would be cannulated. We were almost finished. What could be troubling him?
Through my dullness, eventually, I noticed a clue. Each time the physician's sleeve touched the patient's veil, and the veil slipped, the son burst out in a flurry of anxiety. Perhaps all of nineteen, the son was demanding the nurse cover the patient's face, all the while painfully averting his uninitiated gaze away from his mother's fully exposed torso, revealing possibly the first breasts he may have seen.