282. Hanna Bishara
When Dr. Bishara came into the consultation room on Monday morning after two weeks of vacation, the staff were discussing the new admissions: one was a case of emotional menopausal depression in a recently divorced woman patient of fifty-two, with abuse of medicaments and suicidal tendencies. The second case was one of acute recidivism of chronic schizophrenia with delusions, patient not responsive at present.
Hanna Bishara was not asked to take on either of these two new patients that morning. Nor did she offer to; she was thinking of her old patient in the closed women’s ward who had jumped out of a window two days earlier, breaking a leg and three ribs.
After a short discussion, her colleagues left the room. Dr. Salam beckoned to Hanna Bishara to follow him into his office.
“Young woman, late twenties, married, no children, chronic depression and severe lack of appetite, borderline anorexic with a weight of forty-three kilos and height of one metre sixty, high degree of anxiety,” explained Dr. Salam, glancing several times at the papers in front of him. He seemed very glad to have this particular patient here. A slight smile showed on his face. “Rana Shahin is my patient. You’ll need to go particularly carefully with her. Her father — an excellent lawyer — is a good friend of mine, her husband a high-ranking army officer. Would you please get to know the young woman? And tell me how you’re doing with her now and then,” he said in an unusually gentle tone, making preparations for his daily rounds.
Dr. Bishara knew that Edward Salam had a particularly soft spot for young women patients, whom he treated with paternal care. He had always wished he had a daughter, but his wife gave him four sons, and he didn’t get on well with any of them. However, that wasn’t the only reason for Rana’s preferential treatment. The medical director needed her and other patients with relatively slight mental disturbances to raise the reputation of his psychiatric hospital and rescue it from the derogatory associations of a “nuthouse” — not altogether easy in view of the condition of the majority of patients, about whom no one asked any more.
Hanna Bishara, a specialist in neurology, also saw a good opportunity for herself in these endeavors of the medical director. She had spent years doing further training in psychoanalysis and psychotherapy, and Salam had made her his closest confidant, in preference to five older doctors. And she would get no chance at all outside this hospital. There wasn’t a single private psychiatric practice in the whole of Damascus.
283. Mother
When Hanna Bishara entered the room she saw a deeply disturbed young woman: the curtains over the window were drawn, leaving only a tiny gap between them, and Rana was sitting in a corner in the semi-darkness. When the doctor came in she visibly took fright, but immediately tried to recover her self-control and sit up straight in the chair at the small desk. At the same time, however, she turned away and said nothing, so there was no eye contact between them, and no conversation. Dr. Bishara was clearly surprised by the sight of the fragile, delicate figure, sensed her great fear of all intruders, and sat down at a suitable distance. After a while she broke the silence and spoke gently: she’d like to get to know Rana, she said, so that she could form a picture of her life and the time before her admission, and then perhaps she could help her to understand the inner reasons for her own suffering better. Rana stood up as if she felt pressure being put on her, and took refuge on her bed, where she sat wrapped in a blanket to protect herself from further questions. The doctor said quietly that she respected Rana’s reserve, and then rose, adding as she left the room that she would look in again that afternoon.
But she had no luck that afternoon either. I’m getting nowhere at all, thought Hanna Bishara in the evening, feeling disappointment and perplexity. A beautiful young woman from the best circles of society, practically without a care in the world — and now this happens to her. What could have caused it? In the corridor she met her older colleague Hisham.
“Well, how are you doing?” he greeted her, as usual.
“It’d be easier opening an oyster with your bare hands,” she said, quoting his own dictum about mute patients. He smiled. “Just as I always say. I’ve come from a similar case. Two hours, and it’s not just my tongue that’s all furred up.”
Hanna Bishara went to the ward office to take a closer look at Rana’s case notes and the medical director’s admission report on her. But they were not much help either over the next few days. Dr. Bishara felt Rana’s distrust as a personal failure, particularly as the young woman reacted to the medical director himself in a remarkably positive, almost confidential way. Hanna Bishara began to suspect that on a deeper plane Rana’s distrust of her related to her mother.
This idea was fully confirmed in their next session. The doctor very cautiously broached the subject of Rana’s childhood and her relationship with her mother. At first the young woman just shook her head with a wry twist of her mouth, but then, after a silence, she began to talk after all, and at the end of their hour together she found relief in a fit of tears.
“I suspect your mother felt so hurt that her first child was ‘only’ a girl that she never forgave you, and was always taking her disappointment out on you,” said Hanna Bishara.
Rana looked up. She felt that the doctor was not just quoting from medical textbooks but speaking from her own experience. She smiled at her.
When Hanna Bishara came next afternoon, everything seemed just the same as at their first meeting — except for her patient’s shy, questioning look, as if the young woman had been waiting for her.
Hanna Bishara recollected that, in passing, Rana had told her how as far back as she could remember her mother had never let her have anything she said she wished for. So she began by asking if there was anything that Rana would like just now. After a short pause the answer came in a soft but very clear voice, “Could someone tell Dunia I’d like to see her?” Dr. Bishara learned that Dunia was a very good friend whom Rana had known since childhood. The doctor promised that she would see about it. “But perhaps we ought to discuss your medicaments first, and work out a plan together to improve your appetite,” she said, and was astonished when Rana quietly but audibly agreed with her.
Unfortunately the experienced Dr. Salam was right when he said he doubted whether Rana’s friend would comply with her wish. Dr. Bishara had been more optimistic, but her phone call to Dunia was a disappointment. Dunia wasn’t going to visit a psychiatric hospital; like many Arabs she seemed to be afraid of them, although she didn’t say so. But still, she was ready to talk to her friend on the phone.
Rana smiled quietly when the doctor said that, sad to say, Dunia couldn’t visit her. “I ought to have known it,” she murmured, “but I was being silly.”
284. Liking
“Would you like to go into the garden?” she asked. Rana looked up, and was surprised to find the doctor reading her own thoughts. A little later she was walking in the garden with Dr. Bishara, shyly exchanging greetings with the other patients.
No, she had certainly not been a highly gifted girl, Rana thought, before carefully answering that question from the doctor out loud. She’d just worked hard, that was why she had done well in school and passed all her examinations without much difficulty.