Hijab Page 5

  I looked out of the window. It was a moonlit night. It was muggy and hot inside the house. I opened the window. Being the month of June, even the breeze that drifted inside at ten in the night was warm. There was deathly silence all around. No sound of a vehicle honking, no bird calls, not even the buzz of flies. This weather would only last for the next four months. Later, it will be bone chilling cold. One cannot venture out without an armor of coats. The cold would be intense enough to freeze tears.

  What am I doing here? In a town like Amoka fighting to save people who do not want to be saved—people cavalier enough to drive drunk in below temperature on dangerous icy roads, people swimming in enough alcohol to make a breathalyzer tipsy, people reciprocating with a ‘Fuck you dude’ just because they had to wait for an hour in the emergency department before getting their nasty head gashes sutured.

  Boy, I hate my job!

  Is this why I am seeking out Mohammad Mohammad? To give myself a worthy excuse to sleep better at night?

  Does this elevate my job? Does it invest more nobility into it?

  Why am I doing this?

  Is this because Amoka is in America?

  5. Dr Mohammad Mohammad

  The next morning, I was getting ready for work. I didn’t have to see patients in the ER. My calendar showed a meeting with Dr Mohammad Mohammad lined up for the first three hours of the day. This was my administrative day.

  Radhika was up early at five and feverishly washing the dishes in the sink.

  I handed her a cup of fresh coffee and asked, ‘Did you talk to Giri?’

  ‘I did. He cannot make sense of anything that is going on around here. He naively asks me, like a child, “You haven’t done anything wrong, have you?” What can I tell him? Guru, I’ve been wanting to ask you for a while. Why do we need to meet this Mohammad Mohammad guy? The complaint has been filed by Fadhuma and Hassan. My business is with Fadhuma. Technically I don’t have to talk to Hassan either. Then, why not handle everything officially? Why doesn’t Dr Mohammad come through the proper channels? Why do we have to meet with random people, as if we did something wrong? ’

  I could not come up with a response. I thought for a moment. I felt that Radhika made sense. ‘Radhika, our best bet is to exercise restraint and be a little tactful. After all, we do not have to apologize to anyone. All we need to do is explain that what we did was what is considered as standard of care. He will understand. He is also a physician. He also underwent residency training here in America, just like us.’

  ‘I do not know who understands what. My gut says that this is not going to be as simple as you think.’

  I assured her rather pompously, ‘Don’t worry Radhika, I’m here for you. I’ll take care of everything.’

  She laughed and left. It was obvious that she neither had the belief in my words nor the bravado they sought to express.

  Meanwhile I noticed that Srikantha was getting ready to leave. I told him, ‘I need your help. Please make yourself available at ten. Call me if possible. I will keep my mobile on.’

  Srikantha said, ‘Dude, keep me out of this. I’m an Internist. I have no idea about child births, let alone Sanghaali ones. If you need any help with some research and pulling up relevant background information, I am your guy,’ and left.

  As soon as I arrived at the hospital, I went directly to the conference room on the third floor. Radhika went to see a couple of her patients. To me, the most perplexing part in this sordid affair was that Dr Smith as the senior-most physician in Radhika’s department had nothing to say. Dr Smith has been practicing in Amoka long before any of us came to this town. I had reached out to him the previous week thinking that he might have some answers.

  ‘Look Guru, I’m gonna be blunt. I’ve seen Amoka change colours in the last ten years. I’ve stopped treating them. I have heard that their anatomy is different. And weird. Weird maybe a politically incorrect term. I don’t want to pretend to understand their unique distortions or anomalies or by whatever fancy words you call it. “Female Genital Mutilation.” Yuck! I hate even saying that word. I am too old for this bullshit. At my age buddy, I have no interest or the energy to learn either. I’m not sure if this whole business of “cutting” is their culture or their religion. I always fear that I may end up doing something wrong. And I’m very close to retiring! As the old saying goes, “You should earn your keep”. I simply am not looking for any trouble. That is why you have Radhika and Razak. Please ask them.’ He washed his hands off.

  Dr Mohammad Mohammad arrived ten minutes prior to schedule. We had asked Duniya to attend the meeting as well. I had invited Razak to the meeting. He declined initially but later, when I told him that he didn’t have much of a choice since his name is also on the medical records, he had agreed to come with some reluctance.

  Ever since I woke up in the morning, a mysterious anxiety came over me, I felt uneasy and nauseated. I had used the restroom four times. I couldn’t help feeling like an upstart, not equipped to prepare for a meeting like this. Had I known that Mohammad was coming over to discuss only the case of his cousin I would have possibly felt differently. After all he was also a physician, a kindred spirit for most of us. This sketchy awareness that Mohammad was not just a physician, but perhaps had other indulgences made us apprehensive and intimidated. Besides Razak and I weren’t fully convinced that Radhika had followed the standard of care. We thought she had stepped out of her comfort zone when Fadhuma’s care needed expertise such as Version. I had not seen Radhika try a Version before.

  Could she have agreed with Hassan and Fadhuma and not done the surgery regardless of the outcome?

  I didn’t know what my role was. What kind of power did I have as the chief of staff? Nobody had explained this to me and I couldn’t find the right answer in the hospital bylaws. I had contacted the hospital board before the meeting and they had given the go-ahead. But should I have reached out to our legal counsel? Why did we need lawyers for this kind of a meeting? Isn’t this supposed to be an informal, cordial affair?’

  I could sense that I was sweating lightly before the meeting. And I had two more restroom visits after coming to the hospital.

  Dr Mohammad Mohammad looked pretty much the way I had imagined him to be. I had looked at his picture on the computer the previous night. His beard was grayer than that in the picture. He was dressed in a spiffy suit. The tint on his eyeglasses quite clearly adapted to the ambient light inside. He held a Starbucks coffee cup in his hand. Fadhuma and Hassan were with him. There was no sign of the baby.

  ‘Hello, how do you do?’ Dr Mohammad had a clipped British accent.

  I shook his hands, ‘Please take your seat,’ and addressed all three. ‘Would you like some coffee?’ even as I was pouring a cup for myself. Dr Mohammad flashed his Starbucks cup. The coffee in the Styrofoam cup that I had filled from the old coffeemaker in the conference room looked bland against his bubbly cappuccino. Radhika declined the coffee and sat down and straightened her eyeglasses. She looked sharp in her new suit and makeup. Razak arrived a bit late and took his seat. Dr Mohammad spotted Razak’s name tag hanging down his neck and extended his hand, ‘O Dr Razak, assalam walekum brother!’ Razak hesitated for a moment, and said, ‘Hi.’

  I adjusted my tie knot and addressed the group, ‘I call the meeting to order. Tell me gentlemen and ladies, how may I help you?’

  Dr Mohammad Mohammad smiled, ‘Hello doctors, it is unclear as to who can help whom, who should be helping whom, but let us help each other.’ I was not expecting this philosopher-like posturing to my general conversational opening to the meeting. I simply nodded and looked at Radhika and Razak. They stared back at me. An awkward silence filled the room along with a strong odor emanating from Hassan and Fadhuma. Dr Mohammad was chewing gum and looking at us with a smile on his face.

  I thought to myself, ‘This guy can create a great first impression on people.’ It occurred to me that this meeting could drag along with no end in sight. I said, ‘Dr Mohammad, let�
��s cut to the chase here. Why are we here today? What is the agenda for this meeting? If Hassan and Fadhuma have grievances against us, we have a department that can handle them. We have our own Standard Operating Procedure. Instead, you have asked us to meet here. We have squeezed some time out of our schedule to get to this meeting. Please tell us, what can we do to help you?’

  Mohammad got up from his chair and said, ‘Doctor, are you suggesting we come through the proper channels? Certainly, by all means. I can find the right channels.’

  Radhika curtly raised her voice, ‘Dr Mohammad, let us stop this nonsense and get it over with.’

  ‘Dr Radhika, have you read Sun Tzu’s Art of War?’

  ‘What?’ Radhika was taken aback a little.

  ‘Art of War? Sun Tzu? Do you know what he says? “In order to defeat your enemy, you must become your enemy first.”’

  ‘What’s your point?’ I intervened. ‘Are you implying that we are your enemies? I’m sorry, we won’t get anywhere with this kind of attitude.’

  ‘Well, you might not consider us as your enemies, but we may not be generous enough to share the same feeling. I bring this up because in our Sanghaali community, there may be a few who may hate you, right? And for their own reasons…isn’t it?

  None of us spoke.

  ‘You see where I’m coming from? I agree “enemy” may be a bit melodramatic. If you want to take care of our patients, you need to know them better. I’m here today to make you aware of that. If you have no idea who you are treating, there can be a lot of misunderstandings.’

  I got a sense that if left to himself this guy can go on and on. Before I could say anything, Radhika interjected, ‘Let’s keep this discussion confined to Fadhuma. We have enough resources to learn about the Sanghaali community. I’ll read about them and if I do not understand, I will reach out to you on my own.’

  ‘Ok, let’s start from there. Alright? Let me ask you a question. Do you watch Bollywood films?’

  His elliptical style of speaking around the topic annoyed me. ‘Dr Mohammad, I think it is better not to lose focus as much as possible.’

  ‘I’m asking this question precisely because these things are related. Please do not get me wrong. But you should know one thing, we Sanghaalis watch a lot of Bollywood movies. I watched a movie last year with my daughter. I don’t recall the title of the movie. The lead star of the movie is a college student who gets coached over the internet to deliver a baby with the help of a vacuum cleaner.’

  Radhika smiled, ‘Dr Mohammad, what’s your point? Are you suggesting that I use a vacuum cleaner?’

  ‘Of course not! That is in the movies, and this is real life. All I’m trying to say is that this phenomenon of childbirth is so natural and so beautiful. This has been happening for a long time and will continue in the future. Whether it is Cesarean or Vacuum or anything else, it will happen. As doctors, all we do is grease and ease. And that pain! Ah that labour pain! The fifth vital sign; we control it a little.’

  ‘Dr Mohammad, just because things were done in a certain way in the past does not mean we should do the same now. Do you know how safe the deliveries are now? I can reel out the statistics to show this clearly.’

  ‘Ok. Statistics. Ah, the numbers! I love numbers. Dr Radhika, do you know what percentage of the American babies are delivered by Cesarean section? ‘

  ‘I can’t tell you right off the bat. Maybe 10 to 15 per cent?’

  ‘32 per cent! I am not pulling this number from my ar… sorry.’ He winked. ‘This is the WHO report. This includes all women. This number is much more for Sanghaali women. I’ve not come here to bore you with these numbers. For a variety of reasons, in America, C-sections are done much more frequently than in other countries. There might be plenty of reasons for this, including Friday evening date nights of OB GYN docs. Do not laugh, there are lots of surveys to prove this. Anyway, let us not solve all of world’s problems today. Fadhuma, who’s here, is my cousin Hassan’s wife. What was your reason for doing a C-section on her?’

  Radhika said, ‘I cannot discuss this without Fadhuma and Hassan’s consent.’

  Then Dr Mohammad talked to Hassan for a bit in Sanghaali.

  I said, ‘Dr Mohammad, whatever it is that you wish to speak, please do so in English. We have Duniya here to interpret.’

  Then Hassan said, ‘Dr Mohammad can ask any question on my behalf.’

  Radhika said, ‘I’ve documented everything in the chart. She had a breech; the baby’s head was upright in her uterus. Usually it is down, as you are aware. We tried everything we could, including external Cephalic Version, which is to turn the baby upside down, without success. We didn’t have any choice other than C-section.’

  Dr Mohammad asked, ‘Dr Razak, do you agree?’

  Razak said, ‘Yes. I was there too. Now, Dr Mohammad, why do we have to answer all of your questions?’

  ‘So that you don’t have to answer in the court later, Dr Razak. Anyway, ma’am, on the records you have also documented that since Fadhuma was cut below, it is impossible for her to have a normal delivery.’

  Radhika was annoyed. ‘Guru, how is this related to the case in any way? I will not talk about it. What’s going on here? Who is he to question my competence? Is this a courtroom? Should we be sitting here tolerating all his shenanigans?’

  I spoke to Radhika in Kannada, ‘Radhika, the board members have given their approval to this meeting. Please cooperate. Let’s have a quick chat and wrap up. I do not know what his agenda is. Razak is here, anyway. Srikantha is one of the members of the medical staff. I’ll page him. We can answer questions that we would like to and ignore the others. Let us tell everyone that a provisional meeting was held, send out the minutes and make this official. I’ll also inform Karla. Once these board members read these minutes, they will get out of your hair. This can save us the hassle of internal enquiry and outside review. What do you say?’

  Dr Mohammad looked at us and laughed. ‘Hello, now I’ve to ask for an interpreter.’

  Radhika did not say anything. She and Razak excused themselves for five minutes and left the room. Once they returned, Radhika said, ‘Alright, I’m ready. But only on one condition. I will only speak about those issues that are relevant to Fadhuma’s case. I don’t want to listen to any lecture on Sanghaali culture.’ I paged Srikantha and asked him to get there. I needed at least another doctor to get the right quorum to the meeting. But he did not answer at all.

  Radhika spoke, probably realizing that there is no point in waiting for Srikantha anymore, ‘Ok, without getting into too many details, I can only say this much. But, before we start, we all need to know that we shall be discussing Fadhuma’s C-section. Has she consented to discuss her case?’ and looked at Fadhuma. Fadhuma said yes once Duniya translated Radhika’s question to her. I had completely forgotten the fact that Fadhuma did not understand English. This entire meeting was supposed to be about Fadhuma, it was surprising that everyone except her spoke and made their points.

  Radhika had to respond, ‘Fadhuma has had a circumcision. She cannot have a normal delivery.’

  Dr Mohammad said calmly, ‘Don’t get me wrong. I have spoken to Fadhuma about this. What she has had is sunna, where they take out just a little skin outside the vagina, to be specific the vulvar area. There will not be any problems for her to have a natural delivery. Child births are difficult only for people who have had Pharaonic circumcision which is otherwise called infibulation. Do you know what that means?’ he directed his question to both Radhika and Razak.

  They shook their heads. I said that I did not know anything about it.

  Mohammad said, ‘I apologize for discussing these sensitive issues here. In Pharaonic circumcision, all soft tissues in and around the genitals including clitoris and labia are excised and the edges of the vulva are stitched together. Only a small opening is left for passage of urine and another one for menstrual blood flow. One could say it is a kind of physiologic chastity belt. Those who are totall
y ignorant of these practices think of them as cruel and a severe type of female circumcision. It is not clear where this practice originated. One of the beliefs is that this started in the jungles of Egypt to prevent the rapes of women from marauders. All Sanghaali girls have had some sort of circumcision. There are several reasons for this. Community pressure or peer pressure is one of them and possibly the most important one. It’s like everyone does that and so shall we. And the second reason is that, all Pharaons are virgins unless proven otherwise. In fact, mothers on their own initiative get Pharaonic circumcision done to their daughters to protect their virginity. Let alone bear children, these girls cannot even have intercourse. Sometimes they need surgical procedure called deinfibulation before childbirth. Yes, Pharaons always find a way around, have sex and get pregnant, which you Americans classify legally as rape because of the act. What can I say? Law is only provincial.’ We looked at each other as the only American in the room was Dr Mohammad himself.