Saturday, 1 December 2012

A glimpse from Iraq at my GP practice

Nothing unusual was about that day at the walk-in centre until I met him. I even did not think this consultation will bring back forgotten memories and evoke the lingering nostalgia about homeland and exile. I was going through the patients’ waiting list as I did hundreds of times before and clicked on the next-to-be-seen name. An old Asian Muslim man in his late seventies and that’s all the information I had before I called him in. He was accompanied by his daughter who also booked to be seen after her father. The daughter was in her forties. I walked down to the waiting area and invited him to come inside. He was neatly-dressed frail elderly man who met me with a smile, but there were signs of concerns when I looked at his daughter’s face as they sat down on the chairs opposite to mine. So far there was nothing unfamiliar with this consultation. As we were taught at the medial school I spent the first ten minutes going through the history, or better to say the story of his illness. The main problem was swallowing difficulty. I spent the next ten minutes going through the list of possibilities and gradually trying to introduce the likelihood of cancer as a cause of his symptom and the need that he has to see his family doctor to have a camera test for his food pipe and stomach. Interestingly, when I mentioned the words “growth”, “tumour” and later at the end “cancer” did not stir any anxiety, anger or denial response on his face or his behaviour. Instead he maintained that same smile while listening and looking at this stranger’s face in front of him. On the contrary, his daughter’s anxious look just grew bigger and bigger as I was carefully trying to explain the problem. Nearly twenty five minutes already through the consultation when I started to ask few questions about his life. He lives alone and his daughter lives a walking distance from his house. I asked if he is taking any regular medications, he mentioned the names of two drugs but his daughter suddenly interrupted our conversation and said “sorry doctor but my dad has a memory problem, he takes few other tablets”. It might have taken only two seconds for the daughter to tell this sentence but the effect was striking on the father who gradually bent his face down to avoid looking at my eyes. The smile disappeared and a sense of loss, despair and defeat prevailed on his expressions. I apologised for the inconvenience caused by my question and to relieve them from my boring questions, I excused myself to have a look at his records for a minute or two. While I was going through his computer records, the gentleman suddenly asked:  Doctor, are you from India? “No, I am from Iraq” I replied. There was an instant sense of relief on his facial expressions and both himself and his daughter, relaxed and laid their backs on their chairs and took a deep breath. The smile returned on his face just like a child who suddenly found his missing toy. He said with joy “yes I said to myself you are from Iraq”. “I lived in Iraq from 1974 to 1977. It was the best time of my life doctor and the people there were very nice and kind to us”. I smiled with respect to them but again there was nothing really surprising about what he said. I have met several patients here who have worked and lived   in Iraq at some time in their life. The daughter then added “my ancestors are from Iraq”. This caught my attention and I turned to her “really?” He then interrupted and answered my question with a face full of pride “Yes we are from Z family; did not you see the name on your screen?” I did not say anything and turned my chair towards him and kept attentively listening to him. “We are originally from Wassit and members of our tribe travelled to India in the late eighteenth century”. “So what was your profession in Iraq sir?” I asked with curiosity. “I was an oil engineer and I used travel all over the country. I worked in Rumeila, Simawa, Ur, Hilla, Beiji and many other places”. “And where did you live sir?” I kept on asking. “I lived in Baghdad doctor. In Al-Mansoor” and when I asked where exactly there, he struggled to remember the details so I stepped in and helped him “were you near the race course?”  He nearly jumped with laugh from his seat “yes, yes but believe it or not doctor, three years there and I never made it to see the race on Wednesdays”. At that point we both indulged in bringing back memories and interestingly his daughter who looked relaxed watching her father’s uplifted spirit, appeared estranged from our “Iraqi spirit”. When the consultation came to an end, Mr Z stood up slowly with the help of his walking stick and grabbed my hand firmly and said with the same smile “Shukran d-i-ctor as you say in Iraq and Fi-mallah” and his smile turned into a laugh. In these few moments, my head raced with snapshots from childhood, teenage years, and our old house in Al-Dawoodi district and through my exile journey. Images were flickering rapidly and saw their reflections in Mrs Z eyes. I shook his hand and bowed in respect. He slowly walked out of the room and I turned to my computer and typed: swallowing difficulty but in my mind it was: Nostalgia. 


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