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  Radhika grabbed a chair and sat next to Fadhuma. I was not certain if I needed to be there. I couldn’t help but feel that I have got myself into a pickle. I felt that I should have left them to their ways. As I turned around towards the door and started to leave, Radhika waved at me signaling me to stay.

  I stood there.

  Radhika held Fadhuma’s hand and asked, ‘Does it hurt?’

  Duniya interpreted that to Fadhuma.

  Fadhuma was about to say something but was interrupted by Duniya’s voice. She didn’t bother to continue.

  I felt that Fadhuma didn’t need an interpreter to appreciate Radhika’s concern, but her language came in the way of what could have been a real moment of solace and consolation and instead, lent flippancy to it. Radhika’s touch of healing appeared frivolous. Duniya kept quiet as if she had done something wrong. She probably felt that she was in the way of something that could have been so natural, so simple.

  Radhika continued, ‘If I had not operated, the baby would not have survived.’ Duniya interpreted that again.

  Fadhuma replied, ‘You are thinking only about this baby. What about my future babies?’

  ‘What I did was a C-section, not a tubal ligation. There should be no problems for you to have more children in the future.’

  ‘Doctor, my mother has told me that babies can be taken out by cutting the belly open once or twice but not many times.’

  ‘What does that mean? How many babies are you planning to have?’

  ‘Everyone in our family has eight to ten children. Tell me, can you cut my belly eight times and deliver my babies?’

  Radhika could not answer right away but spoke after about a minute, ‘Again, please do not call it cutting the belly. It is a medical procedure. Anyway, I’ve not done C-section on a single uterus ten times. It is possible that other doctors may have done that. I’ll check and let you know.’

  ‘Can you tell me if I can have children later? We plan to have ten children. Hassan says that more children means that we get more money from the government.’

  Apparently, there’s a law, a welfare scheme, which required the government to pay an allowance of $200 per child for low-income households that have more than two children. Radhika and I had no idea what Fadhuma was talking about.

  Radhika was speechless.

  ‘Doctor, I know that you cut our belly for the first one. You say since the first one was an operation, the second one also must be an operation. How many times can you do this? Three? Four? And then warn us that our lives will be in danger if we get pregnant again.’

  Radhika was at a loss for words. I believe she did not expect this from Fadhuma—from a woman who just had a baby!

  ‘So, in your opinion, what should I have done?’ Radhika asked in a quiet voice.

  ‘You should have left it to god and not done anything.’

  ‘The situation would have turned serious then.’

  ‘So, what if the situation had turned serious?’

  ‘The baby could have died, and your life could have been at risk too.’

  ‘If the baby were to die inside the belly, wouldn’t it be easy to turn the baby?’

  ‘But…that would be a dead baby!’

  ‘If this baby dies for the future children, I would take that as god’s will and go home. If not this baby, then the next, then the next after that…’

  I was shaken for a moment. Radhika also looked stunned by this answer. She did not speak either.

  The just-born infant was joyously sucking the milk from her breast. I was shocked at this utter indifference of this woman talking about the possible sacrifice of the very infant that she was breastfeeding as god’s will. Duniya showed no emotions and continued to interpret Fadhuma’s words.

  Fadhuma’s calm, detached answer angered Radhika. She said, tersely, ‘Fadhuma, what kind of motherhood is this? Isn’t this like sacrificing the baby in the belly to others that may or may not be born later? And isn’t this illegal? What kind of a person keeps having babies for the sake of money? Who taught you to speak like this? Is it your husband?’

  ‘Yes doctor, I know nothing. Nobody has taught me anything. We have delivered and raised children in wars and refugee camps and jails where we had no proper food and water. Did you know that?’

  ‘Fadhuma, these are completely different situations. You are in America now.’

  Fadhuma continued not paying any attention to Radhika, ‘You doctors need to have patience. If you had waited, the baby would have come out by itself. You have no patience.’

  Radhika persisted, ‘What if your life were to be in danger?’

  Fadhuma replied with no emotion whatsoever, ‘That will be decided by my husband, Hassan. I know that he will protect me from any kind of harm.’

  I thought it was futile. I looked at Radhika. She was getting ready to leave. Fadhuma was screaming, ‘What do you people know about the consequences of your actions? Don’t you ever do this to any Sanghaali mother again! I did not want to have this baby. Doctors always tell me that my life will be in danger. How do I make you understand? Whether I get surgery or not, my life will always be in danger.’ There were only three of us in the room. But Duniya was interpreting Fadhuma’s outbursts in the same angry tone that could be heard all over the hospital.

  I wondered if Fadhuma could really say the things that she did while feeding her newborn or was it a faulty translation.

  I tried to console Radhika, ‘You are a good doctor. You did everything you could. The circumstances were beyond your control.’

  ‘What can I say, Guru? She says that she is fine having a dead baby so long as it is a normal delivery! She is what, just a twenty-five-year old? She believes that she can have ten more children. Didn’t I tell you? This C-section is like a death sentence to them. If they have one C-section, it is considered an affront to their motherhood. They seem set on the belief that if they can’t deliver normally, then life is not worth living.’

  ‘My god, Radhika! What kind of logic is this?’

  ‘Guru, I only work here. I’m not an anthropologist. I’ve not studied their culture in depth. Neither am I interested in doing so. And I was totally unaware that this child allowance can be a factor!’

  ‘What kind of reasoning is this? The government doles out money only if the baby lives, not when it dies.’

  ‘Well, what do I know? She wants ten children. Since we can’t operate ten times, she perhaps wants to keep her uterus strong for the remaining nine children.’

  ‘Come on Radhika, I don’t believe any mother will sacrifice her child for the sake of money.’

  ‘Guru, we think of this as sacrifice, but they look at it as saving their next ten children. All I do is deliver babies. Sometimes normal ones. Sometimes Cesarean. It shouldn’t be this difficult. I would be happy if I can stay in my job for the next three years. I do not know the reason for their shenanigans. I wish I did, my job would be much easier. Apparently, Hassan determines if she lives or dies. I’m not even clear about what he understands, and what he does not.’

  I was concerned that if we stayed there any longer, she would break down. I drove Radhika home in my car.

  4. O Sanghaala…

  ‘Sanghaali refugees started migrating to America in the 1920s. It began as a trickle at first and then went up substantially in the 90s owing to the internal strife in the country and conflicts with neighboring countries. Most of them live in Minnesota, almost to the tune of at least one hundred thousand,’ Srikantha was trying to explain the demographic and social changes in Minnesota after the surge of Sanghaali immigrants. He was reading us a United Nations Report, Radhika and I listened quietly. She was picking at her food. Srikantha had cooked greens curry for supper.

  Srikantha was trying to educate us. He was preparing us for a meeting scheduled for the next day with Dr Mohammad Mohammad. Srikantha continued, ‘Decades of poverty, civil war, famine, violence, and ethnic cleansing have made the citizens of Sanghaala very tough an
d resilient. Now this freedom here has overwhelmed them, and they are having a tough time handling the very freedom that they fought for. It is like if you let a bird out of a cage after long captivity, it will bite the savior. I’ve been observing them since I came here, they are extremely suspicious of everyone, sometimes even paranoid. When my parents moved to England, they were first generation immigrants too. They were educated and well employed, but they did not exercise any entitlement just because they came from a foreign country. Most importantly, they listened to their doctors’ advice and complied with their treatment. And these Sanghaalis? No. Never. They always act as if someone is trying to harm them.’

  It was a month since Fadhuma’s incident. Things had taken a turn for the worse. Hassan had called the Human Resources for as many as ten times and demanded justice. In addition, apparently, he had written long emails to the chief administrative officer of the hospital, Jack Powell. Powell had no idea what these emails meant. He asked me to either help him understand the issue or take care of it by myself. I called Hassan and enquired what exactly was he looking for and how we could help him. He demanded that copies of Fadhuma’s records be sent to their family physician, Dr Mohammad Mohammad. They would seek his opinion on the appropriateness of Fadhuma’s care at Amoka General Hospital. I did try to explain what happened at Amoka General Hospital as best as I could. It was as if all my explanation fell on deaf ears. Neither Fadhuma nor Hassan was convinced. Haplessly, we ended up sending copies of her medical records to Hassan.

  There was a meeting scheduled in the hospital to discuss their grievances. Fadhuma and Hassan were scheduled to meet with us along with Dr Mohammad Mohammad. We were very uncomfortable meeting someone not directly related to the case. I told Fadhuma and Hassan, that it was not only inappropriate but illegal to discuss patients’ case histories with parties not related with patient care. Hassan surprised us by putting an end to our legal conundrum by declaring that Dr Mohammad Mohammad was his cousin.

  This precipitous morphing of Dr Mohammad into Hassan’s cousin remained an enduring mystery. We had to agree to include him in our meeting. Patients have the right to bring their family members to such meetings.

  Besides, now aware of the lack of English language skills of Hassan and Fadhuma combined with their questionable understanding of the gravitas of the situation, I reasoned, looking at Radhika, ‘That might be the reason they are bringing along Dr Mohammad to the meeting.’

  To which Radhika said, ‘I could care less about who they bring along. I’m convinced that I’ve done nothing wrong.’

  I looked at her with a mentor’s pride, approving of her assertiveness. She looked the other way indicating that she detested my appreciation as rather bossy and patronizing.

  ‘I’ve seen many Sanghaali immigrants while I was in Birmingham, but not to this extent,’ Srikantha said.

  ‘Why do these people move to other countries and make our lives miserable?’ Radhika deplored.

  ‘Radhika, we have no moral right to raise this question.’

  ‘But we are different. We went to college. We all have jobs. We pay our taxes. We are not refugees. And we have not illegally crossed the border like the Mexicans. Once they are here in America, they should live like Americans. If they continue to display their entitlement—likes, dislikes and what not—and turn into stumbling blocks, how are we supposed to do our jobs?’

  Srikantha smiled, ‘We eat rice and curry. Radhika, are we living like Americans here?’

  ‘I don’t think you guys are getting my point. You do what you want in your home. It’s not okay to decline scientifically proven treatments like C-sections in the name of faith. What do we do then?’

  ‘We can argue both ways, Radhika. You may be familiar with a group called Jehovah’s Witness. They never consent to blood transfusions even when lives are in grave danger. Well, even in India, people don’t always agree with what doctors recommend, especially surgeries.’

  ‘There is no point in talking to you two. My only concern is that I should be able to do my job with no hassle.’ Radhika got up, went in to her room and locked the door.

  Srikantha looked at me. I looked at him hoping that he may have more information to share. I asked him, ‘Do you know anything about this Dr Mohammad Mohammad?’

  ‘Not much, but as far as I know he is kind of a godfather to all the Sanghaalis here. He has been living in the Minneapolis area for the last fifteen years. He did his Residency here. Of course, he is a Sanghaali and is believed to understand their special health needs. In fact, this was the reason that the Minnesota Department of Health hired him as an immigrant health officer in 2003. He has since quit the job and was moonlighting in other hospitals. For the last four years, he is into private practice. Almost all the Sanghaali residents of Minneapolis consult with him. There are also some shady secrets about him.’

  I continued to listen.

  ‘It is rumoured that in his clinic, he cuts Sanghaali women below. About six months ago, there was an article about him in Tribune. He apparently has ties with some Sanghaali terrorist organization. It was mentioned in the article that he recruits Sanghaali young men from Minneapolis and sends them to Syria, Sudan and Sanghaala to fight against their governments. In fact, this article was written by another Sanghaali. Dr Mohammad Mohammad took the author and The Tribune to court and filed for damages. He won the case. He is supposed to be highly active and rather flamboyant in their community.’

  I said, ‘Sounds like a character straight out of a Tom Clancy novel. You had mentioned that you did not know much about him?’

  ‘Everyone living in this area will be aware of at least this information about Dr Mohammad Mohammad. Just Google his name.’

  ‘This “cutting below” that you referred to, is this circumcision? Do women get this thing done too?’

  ‘You work in the emergency department and you ask me?’

  ‘I have heard about it. I haven’t seen it myself, even once.’

  ‘Dude, that is a sexy topic. I do not know much about it. You must ask Radhika. It’s getting late. I’ve got to go. I’ve outpatient clinic tomorrow.’ Srikantha went to bed.

  I was curious about Dr Mohammad Mohammad and wanted to learn more about him. I came up with about one hundred and sixty-four hits when I googled ‘Dr Mohammad Mohammad Minneapolis’.

  Dr Mohammad Mohammad migrated to America in 1993. He wasn’t a refugee like other Sanghaali immigrants in Minnesota. Apparently in the seventies, his father had worked as Secretary of Commerce under Syed Abdallah, the notorious dictator. Mohammad was born in 1958, the year Sanghaala got its independence. His elementary schooling happened at the boarding schools of Italy and England. In the fifties his father served as a high-ranking officer in the Sanghaali army at a time when Sanghaala was an Italian Colony. In 1972, Syed Abdallah came to power in a military coup. Mohammad’s father was very much impressed by Abdallah’s socialist ideas and with a strong conviction that Abdallah’s socialism held a bright future for his country, he started serving the Abdallah government. Abdallah had a grand vision for his country. He was greatly influenced by Karl Marx’s ‘Scientific Socialism’. His vision was to have socialism and Islam as the two main pillars that framed the identity of Sanghaala as a country. His statue stood grandly shoulder-to-shoulder with those of Stalin, Lenin and Marx in the country’s capital, Dahir-Bar.

  Another important change brought about by Abdallah was to make the Sanghaali language the country’s national language. This policy made the Sanghaali language mandatory in its schools, colleges and government offices. In the chaos that these policy changes engendered, it was difficult for the administrative class to shed its influence from the colonial languages of Italian and English that were in usage for decades. All the important and plush jobs went to those who were well-versed in Italian and English. The Sanghaali language remained a common man’s language. No one, least of all people like Mohammad’s father who served in government jobs and who educated their children
in Italian and English, was convinced that higher education was possible in the Sanghaali language and children could have a bright future there. The very freedom that they fought for did not make their country worthwhile for their children to have a bright future. Mohammad’s father sent him to England’s boarding schools. He then went on to study at the Cambridge Medical School.

  Further details about him were hazy. He had somehow managed to migrate to Italy. It is rumoured that he was radicalized around this time. For someone who was pub hopping in a pair of denims and Harley jackets, he had suddenly transformed into a character straight out of a radical’s playbook, at least in appearance: shaven moustache, hanging beard down to the chest, mascaraed eyes, tikhiya on the head. He was arrested in connection to a couple of small terrorist operations in Milan but was later acquitted for lack of evidence. He moved back to Sanghaala after a year and started practicing Medicine there. Further details were few and sketchy.

  Those were the last days of Syed Abdallah’s rule. There were escalating internal conflicts all over the country. Small terrorist groups across the country challenged the country’s sovereignty. There was a likelihood of a war with the neighboring Ethiopia or its ally America or with both in tandem. Mohammad’s father had suspected very early that there was a clear existential crisis for the Abdallah government. He advised his son, ‘Governments which come to power with guns in their hand are never secure. Leave this country if you desire a better future.’

  The very next year Dr Mohammad Mohammad had enrolled at the University of Minnesota for his residency.

  I culled all this information about Dr Mohammad and Sanghaala from Wikipedia. The authenticity of this information was, of course, questionable, and I was uncertain whether to believe it or not. The very fact that there is information on Dr Mohammad online was a merit in itself. In fact, I typed mine, Radhika’s and Srikantha’s name. Sure enough, nothing came up.

  I got a hold of the Tribune article that Srikantha had referred to. There were some discrepancies in the details that Srikantha narrated. There was no mention of Dr Mohammad going to Sanghaala to recruit young men from Minnesota. Instead it talked about various fund-raising activities he organized in Minnesota, flying to Dahir-Bar and personally handing over a big amount of money to a terrorist by the name of Aftikar. There were heated discussions about this incident all over the internet and on social media. The person who authored that article had clarified that his article was well researched. Apparently,he had hacked Mohammad’s computer and accessed an email sent to Aftikar. The email supposedly talked about Dr Mohammad affirming that their enemies’ destruction was their goal. Later, in another article Tribune published its editor’s mea culpa. The editor had cited the FBI findings that Dr Mohammad Mohammad was organizing these fundraisers for an NGO who rehabilitated Sanghaali refugees in the city. Dr Mohammad Mohammad was acquitted of all charges and, in addition, Tribune offered him a compensation of twenty-five thousand dollars. That this Mohammad could go up to the FBI’s attention made me more curious about the man.