Among my neighbours I’ve acquired a reputation as an amateur doctor. I guess as an American, I’m considered effective in administering Western medicine in the same way an Italian might be expected to make a better plate of pasta than a Pole. It’s true that I sometimes translate the information enclosed in people’s prescription medications, a long list of which constitute the only treatment they can hope for from most local (underpaid, overworked) doctors. I always counsel them to ask more questions about their illnesses and about why they should be taking seven kinds of medicine at once. I also administer intramuscular injections, using alcohol and cotton (having noisily washed my hands), and the rumour that I have ‘a light touch’ has gotten around.
Over time I’ve lost some patients, whether to old age or disease beyond pharmaceutical repair. But when winter comes, I think of Anwar (whose name means ‘the most radiant’), my friend and building guardian who died of diabetes-related complications several Novembers ago. I can see him standing at my door, proffering both a loaded hypodermic, and his right foot, which was wrapped in a large ball of gauze.
‘I’m not a doctor, Anwar,’ I told him. But he persisted, so I agreed to look after his injection. He came inside, closed the door, then turned and lifted his clothes. The days were still relatively warm but he was wearing a trench coat over a turtleneck, plus his galabiyya (traditional tunic) over a T-shirt, a pair of long-johns – and white cotton underpants, which he lowered to reveal a glum, rectangular behind.
Ah, the rear-ends I’ve seen – almost the entire family’s. His wife Rahima bared but a bit of upper flank, glistening with stretch marks from childbearing, and took the needle with studied indifference. His daughter Selwa would earnestly hoist her skirts and lower her bloomers, revealing a pillar of solid brown leg and a boulder-sized butt that eyed me and the syringe defiantly. Her skin, like a dolphin’s, was rubbery sleek and needle-repellent; many a Chinese-manufactured one had bent on its way in. Madame Aziza from across the hall, pious widow of a high-ranking sheikh, had a paler derrière, slightly draped and twitching as if accustomed to begging for mercy. Rahima’s Nubian mother had an ass as patterned with cracks as the bed of a dried lake. Anwar’s backside was smooth and acquiescent.
After the injection we sat on facing chairs and I took his foot in my lap. Halfway through the unwrapping I detected the renowned stench of decay. I have a weak stomach, but Anwar’s Florence Nightingale projections emboldened me to unwind past the pus-sodden gauze closer to the toes concerned: the lesser ones; two of which were melded together, suppurating quietly, while the baby one was just black and dead. The problem with diabetes, a common affliction here, is that it shuts down your circulatory system; Anwar’s toes had long been left behind. More worrisome was the greenish-grey cast of his foot and lower leg.
‘You need to see a doctor, Anwar.’
‘I just did.’
‘He said to take the injections and some pills and to change the bandages and see him next week.’
‘I think it may be more serious than that.’
‘You mean gangrene? That’s what I told the doctor. My uncle had the same thing, so did Rahima’s sister.’
‘What happened to them?’
‘What did the doctor say?’
‘“God makes it easy”.’
‘You need to find another doctor.’
Anwar smiled, thanked me and limped through the door, and that was our last conversation.
What haunts me about Anwar’s death was not his mental and physical disintegration throughout the ensuing months, especially following the amputation of his leg, but the unflinching way his family cared for him as he disappeared before their eyes; the tireless determination with which they fed and washed him, as if willing him to absorb their strength and vitality. Beyond an expression of love, their behaviour reflected the belief that the spirit in which they nursed their father was even more important than the act itself, not only for him but for them; if they failed to save him, they’d find solace in this practised fortitude.
Fatalism is often understood as surrender, but acceptance is an active, transforming process. Western medicine may not acknowledge the subtle energies that can ease another’s suffering, or prepare oneself and a loved one for death; but I’ve witnessed this ‘lightest of touches’ more than once in Egypt, in all its grave and lingering beauty.