Fastest Service in Egypt? Organ Removal

Despite the rather preoccupying pain in my side, a droll thought occurred to me as I waited outside the As-Salaam Hospital emergency room: I had actually had an easier time communicating with the staff here in Cairo than with the heavily African-American staff at the Brooklyn Hospital Center right down my block in Fort Greene last year. To be fair, my visit to the latter had been for sudden loss of hearing in one ear, which may have had an effect; but linguistic comparisons aside, As-Salaam Hospital looked all-around cleaner and less chaotic then the zoo at the BHC. I tentatively relaxed.

Then my summoned boyfriend Aaron wheeled in, looking much more worried than I had yet allowed myself to get. He had originally guessed that the odd pain in my side might be appendicitis, and had no doubt been working himself up about it all morning while I stubbornly prepared to have a normal day at class. A stop by the university clinic had however revealed that such was not to be:

“So it might be appendicitis?”
The doctor shuffled papers and blinked at me with the lackadaisical expression that was to define my day of seeking diagnosis.
“Well . . . either it is an appendicitis . . . or it is something else.”
“So I should go to the hospital.”
“Yes . . . you will go to As-Salaam Hospital, in Mohandisin. A very good hospital.”
“Okay . . . and um, when should I go?”
“Oh . . . right away, of course . . . But do not worry!”

So it seems the Egyptian tradition of sugar-coating, the culture of ma‘lesh (meaning both “Sorry about that” and “No big deal”) extends even to the realm of medical emergencies. Perhaps it is very American of me to want to hear a suitable degree of urgency in the voices of my caretakers, but I found this persistent nonchalance quite unnerving.

Of course Aaron’s presence in the waiting room shattered the outer defenses I had summoned up in my solitude. I crumpled into his shoulder and sniffled. Fortunately, we didn’t have too much time for boo-hooing because they called my name almost immediately.

A skinny, mustached doctor offered us chairs and, gathering that we were American, began questioning me in clipped, business-like English. I didn’t protest; this was no time to show off. He then became the second of what turned out to be many medical employees who needed to press down on the sensitive spot on my abdomen just to make sure it really hurt. In this and in all following check-ups, there was no ritual donning of hospital robe; indeed, there was no removal of clothing at all. When I moved to pull down my skirt he nipped it in the bud: “Ah ah ah! That won’t be necessary.”

Still making no certain proposals as to what might be causing the pain in my side, the doctor dismissed us to get a blood test, which required another hour’s wait, and revealed nothing. Befuddled, the doctor called in his senior (both in age and mustache growth). Taking a more jovial approach to his foreign charge, Doctor Number Two (Bushy Mustache) addressed me in Arabic. When I responded, First Doctor (Skinny Mustache) did a double take.

“But . . . you speak Arabic?”
“Well, yes, I just . . . I’m not at my best today,” I accompanied this excuse with a broad gesture that I hoped would express my general state of disrepair.
“Lovely! Let’s speak Arabic then,” tinkled Bushy Mustache, and escorted me to the bed to run the same series of pokes and questions, now bil-'arabiyya. As I responded in kind, Skinny Mustache quipped to Aaron that I spoke Arabic better than English. It may indeed have seemed so, since somehow speaking about such personal things as your insides can be easier when concentrating on relaying it in code. Bushy Mustache decided that I needed an ultrasound, although I had sworn before Skinny Mustache’s doubtful eyes that I was not pregnant or suffering from any venereal diseases.

The giggling gatekeeper of the ultrasound room let us in after another hour’s excruciating wait, throughout which she provided mild entertainment by flirting with a lone older man, also ostensibly "waiting" although for no apparent reason. The ulstrasound medic did not see fit to remove any of my clothing for the ultrasound either; instead, his young female assistant pulled back both shirt and skirt as far as possible without revealing anything PG-13, then tucked a white towel modestly around my waist. Woe betide the loose woman who dares to show her panties during her ultrasound! Not here at As-Salaam.

To our partial relief, the ultrasound revealed nothing decisive as to the source of the pain. However, we were not yet free: leave from the ultrasound wing was only granted upon receipt of ones “official” folder of internal photographs. We had seen multiple exemplars painstakingly assembled by Giggles and her ever-shifting Girl Crew; although as far as we could tell this task consisted only in a bit of cut and paste, the artistes performed it with evident pomp and relish. My file was no exception. Giggles laid out her implements (photos, scissors, gluestick) one at a time, chattering away all the while with the omnipresent Lone Dude. Snip, snip. I felt each unskillful clip as if nicking away at my now very besotted nerves. Snip, snip. My appendix is going to explode! Let me do the arts and crafts for the love of Allah!

Oblivious to my mounting ire, Giggles abandoned the task entirely to exchange travel agent numbers with Loner. Rather than stop the conversation to expedite this process, the blithe pair continued their banter, such that the digits botched and piecemeal in its midst required multiple repetitions. I watched the glue dry on the back of one of my pictures. With the slowness of a sleepy or perhaps disabled child, the charged receptionist resumed her snipping, noticed the dried glue, and in bewilderment laid her work aside once again, just in time to intercept a phone call (“Izayyak? Winta izayyak? Al-humdu-lillah, al humdu-lillah, izayyak inta, ‘amal eh? Al-humdu-lillah, kwoyiss . . .” and variations thereof, forever).

Just when my will to restrain myself from ripping the photographs away from their incompetent captor had dwindled almost to nothing, the final piece appeared: a printout from the ultrasound medic, which apparently had been the hold-up all along. Oops. Sorry I hated you, Giggles. We made good our escape.

Back downstairs with my new photo album, we still had no conclusive evidence of what might have gone wrong in my lower right abdomen.
“In this case,” mused Bushy Mustache with a whimsical smile, “I suppose we cannot rule out appendicitis.”
“So it is appendicitis.”
“Well . . . probably . . .”
“And what does that mean? I need surgery? When? Here?” By this point I was finally in tears, surrounded by the quizzical faces of B. Mustache’s team.
“Hmmm, yes. Do not worry. Why are you worrying? Do not cry.”

Still smiling pleasantly to himself, Bushy Mustache began dialing up surgeons’ numbers. Each contact triggered the obligatory litany of greetings, queries after children and wives, a few inside jokes, and ended on a ma‘lesh, sorry, no can do. But somewhere in this light-hearted chattering Bushy found his man, and sent me off to be admitted.

“You must not worry,” he implored me once more. “He will do a lathroscopy, an exploratory surgery to see if the appendix is really the problem. If it is, we take it out, khalass!”

And if it isn’t? “Exploratory” surgery? I have never before had any kind of surgery, much less an ambiguous reconnaissance mission of my still mysteriously embroiled organs.

Fortunately, I was so glad to be done waiting that I didn’t really care. One Egyptian surgery, coming up. In the meantime, I discovered that my otherwise impeccable hospital room had no toilet paper.

***

Nasim Gerges, my surgeon, strode in flanked with assistants (admirers? minstrels? there were a lot of them). Tall, clean-shaven, and clad in a black button-up shirt, his presence demanded confidence and credibility. Upon a brusque reprise of the now-familiar jabs to the abdomen, he declared that indeed I was suffering from acute appendicitis and must be operated upon at once. He swept from the room with an order that I must not eat or drink. Someone handed me a hospital robe and told me to suit up.

All systems finally appeared to be “go,” but by this point the director of my Arabic program and my friend Justin had arrived, and much fretting and catching up ensued. After a whole day of waiting around, I had at last slowed my nerves to a less excitable pace. However, someone behind the scenes must have turned the green light on the As-Salaam staff, because suddenly we were the obstruction to progress. The nurse who had given me my robe and cap poked his head into our room for the third time, only to find me still in street clothes gabbing with my visitors.

“Yella! We’re ready!”

Wow, I guess he’s serious. I donned the hospital robe with characteristic lack of skill and hoisted myself onto the waiting mobile bed.

Perhaps the responsibles at As-Salaam Hospital had not bothered to measure the actual width of their hallways and elevators before ordering the wheely beds, because we had quite a rugged ride to the operating room. A fellow at once tall and roly-poly had gotten the job as transporter, and he navigated my unwieldy vehicle as well as he could. After each big bump he would grunt or ask if I was okay, then interrupt himself to intone, “Bismillah alrahman alrahiiiiim” whenever we passed through a doorway. I could not decide whether I found this reassuring. Once we were on less treacherous ground, he began to chat down to me with warm, fatherly interest.

“Amrikiyya! Wi tikkalammi il-‘arabiyya!”
“Yes, I am trying to learn Arabic.”
“You live in Egypt then? How long have you been here? Almost six months! Well my dear, you must go out, must see Egypt! Egypt is beautiful! What have you seen in Egypt?”

One would almost think he was reproaching me for wasting my time in this boring old hospital when such marvels awaited. I began telling him about my trip to Luxor and Aswan to reassure him, but he had worked himself into high fervor and cut me off.

“Ah, Luxor! Wonderful, isn’t it wonderful? But there is so much more! Hurry, you must get out and see Egypt!”

I tried to express enthusiasm and promise to fulfill this vague task from my prostrate position on the bed, now being wheeled into the operating room proper. My escort’s jolly face was joined by a team of others, peering down and murmuring until they realized I could understand.

“An American who speaks Arabic! I don’t believe it!”
“And look at her, what are the men supposed to do with her around? She’s zay al-amar, lovely as the full moon!”

Since I had not eaten all day, was suffering from an unprecedented pain in my side and was dressed all in white, this traditional idiom had probably never been truer of me. I gave my admirers a wan smile. Still exclaiming and gossiping about their exotic patient, they transferred me onto the operating bed and began to examine my abdomen. A robust, grandfatherly fellow, introduced to me as Sharif, fingered my navel piercing.

“Eh da, what is this? This needs to come out.”

I began trying to unscrew it, and explained that I had never tried to remove it before. Members of the surgery team took turns leaning in to peer at this latest evidence of American oddity. I joked sheepishly that it had been a sort of eighteen-year-old rebellion thing. Well, now it was rebelling against us. Sharif boomed that I should relax, he would give it a try. He brandished his thick fingers and began twisting.

The crowds were starting to turn on my raciest piece of jewelry. The surgery needed to begin; this little thing wasn’t expensive, was it? Couldn’t we just cut it off? But Sharif, now deaf to them in his determination, renewed his efforts. When at last he held the little bugger aloft, I fear his colleagues did not empathize with his sense of triumph.

“Ha HA! Who got it out? Sharif got it out! Miss Anna, I expect you’ll be needing me when the time comes to put it back in! Either way, look: she’s got the incision already for us in the right place!”

I laughed and liked Sharif a whole lot. The next thing I remember they were showing me my appendix.
“They put it in a kohsery container!” I heard someone guffawing. Figures.

This is koshery, a popular Egyptian streetfood that comes in a distinctive plastic bowl.
While many disagree, I think that an infected appendix thrown in this putrid mix may even constitute and improvement.

Back upstairs in my room, I tried through a haze of drugs to assure a full room of well-wishers that I felt great, then (rather stupidly) to wrestle past Aaron to get a drink of still-forbidden water. Then they were gone and I was left starring in my first but strangely familiar hospital-room scene. Dripping I.V.; iodine-stained-sheets; fading in and out. You know, Bushy Mustache was right: what was I so worried about? Maybe Egypt isn’t so different. They seem to have figured out surgery, anyway; nothing to turn one’s nose up at.

Throughout the night, a veritable gaggle of adolescent-looking nurses filed through my patchy consciousness, changing my IV bags and asking me how I was doing. Then suddenly, two of them doubled up to oust me from my bed so they could change it. I could barely move. They shoved me into a chair and proceeded to turn the bed-making into a doozy of a brainteaser. Then they urged me to use the bathroom, a trip that I pointed out with a mute gesture to my arm would require unhooking the I.V. After some whispered conferring, one of them unscrewed the tube strapped to my vein. I watched with some interest as blood began immediately to spurt from the opening. After a few more moments’ flutter and argument, my ladies-in-waiting stanched the flow and I hobbled wordless into the bathroom.

Moments later, one of them bustled in and proceeded to fiddle with my arm tube again and tie a clean hospital robe on me before I could rise from the toilet. Throughout these exchanges I made a futile intra-lingual sounds of surprise and objection, but I didn’t really seek to protest. The Egyptian health care system had gotten me this far, after all; I may as well see it through to the end.

But as those bickering youngsters jerked my bleeding arm back and forth, I couldn’t help but surmise that the folks down at As-Salaam Hospital have some details to iron out. I hope they do; I may just want to come back next time I need a shotgun surgery.

Madam Afaf Strikes Again

When the landline rings at 8 a.m. on the 2nd of the month, one can be fairly certain who’s calling.
However, I feigned delighted surprise through my morning gravelliness to hear Madam Afaf, our landlady, on the other end.

“Izzayyik?”
“Winti izayyik?”
“Al-humdulillah, bikhayr!”
“Al-humdulillah.”

As the cordialities unfurled and ran their normal gamut of repetition and variation, I began to prepare myself for the inevitable question. Where was the rent money? My answer: Tomorrow. But it turned out Madam Afaf had other fish to fry.

“Habibti, you speak such good Arabic. Listen: a man will be coming around to take the census,” she began. “He will want to know how many people are living in the apartment and who it belongs to.”

How sweet of Madam to make sure that her half-wit foreign tenants got an advance warning to reflect on these puzzles. I eagerly solved them on the spot to put her soul at ease:
“Well, there are still just three of us . . . and the apartment belongs to you.”
Not so fast. As it turns out, all is, as usual, not as it seems.
“No, no habibti . . . Tell him, this apartment belongs to Mohammad Fahim, but he is traveling and you are guests in his home.” She spoke as clearly as possible. I was not to fuck this up.

Huh?

“Do not say you are residents. You are guests. He will be traveling for a few months, then he will be back.” I detected a shade of affected conspiratorial hush.

Duh, okay. My sluggish morning brain, fully charged with the task of linguistic decoding, did not manage to articulate any of the rather obvious relevant questions regarding this enigma (e.g. Who on earth is this absent and endlessly generous Mohammad Fahim?). Instead, I repeated back the command to her evident delight, as if we had plotted out this grand government trumping (or tax evasion, or whatever) together. Well, lucky you, Afaf. This one follows directions. As our chat was going quite swimmingly so far, she threw out what she now staged as an incidental interest: our paying the three months of rent we owed her.

Last time we had been late too. I had explained to her that as soon as my other roommates returned from America we would pay immediately, to which she cooed that she certainly hoped so, or we would have to leave the apartment at once. Madam Afaf doesn’t mess around. Then she showed up a day before we had agreed upon, only to be greeted at the door by one of the Italian boys I had met in Dahab and was harboring during their stay in Cairo. Shirtless and singing, as was his wont, Umberto slung the door wide, then ran off to fetch me with his tail between his legs. By the time I got there, Afaf had already turned on her heel and informed me primly over her shoulder that she would return tomorrow. Now, she implied when I protested, I was quite ostentatiously indisposed.

The next day as she sat in our de-Italianoed and re-ladied living room, I blubbered an explanation for my rambunctious and plentiful male company, but the impeccable, fashionable-purse-clutching Afaf seemed unfazed. Her voice still honeyed beneath what just might have been a derisive curl of her lip, she prounounced,
“Inti hurra.”
"You are free." You are free to commit whatever sins you want on the old-lady couches I bought for your apartment.
“As long as you give me the money!” she snipped, then forced an accompanying gale of titters at once both girlish and shrewd, in which we were invited to join. The fat wad of bills exchanged hands amidst this eruption of shared mirth.

This time around, I offered my landlady yet another viable excuse: I had been in the hospital getting my appendix out and hadn’t left the house all week. Madam Afaf was properly horrified and pledged readiness to bring me anything I might need. I assured her that I was well taken care of, that I had a substitute family (Aaron-the-Supermom, for those that know him) here in Cairo and would be just fine.
“But I’m a mother too,” she reminded me, in her sugariest tones. Right, Mama Afaf. As long as we give you the money.
What bothered Afaf most in my tale of woe however was not that I had had emergency surgery but that I had not thought to have her brother, my upstairs neighbor, do it.
“Why did you go through all that trouble? Doctor Sharif was right upstairs, he could have taken care of it right away!”

I have visited Doctor Sharif’s drawing room, in search of a cure for a nasty, face-deforming bugbite. I do not remember seeing sufficient machinery for removing an appendix. Rather than pursue her logic on this one, I decided to simply express my confidence that had I thought more quickly before mincing off to the hospital, Doctor Sharif could have performed an exemplary surgery. His devout sister agreed whole-heartedly. Once again, family connections trump all other rationale. Was I not as good as Doctor Sharif’s territory, living as I did in such convenient range?

The rent now decisively relegated to a comfortably auxiliary role in our conversation, we agreed in passing that I would leave it downstairs with Nabil, tomorrow at 4. We said a cheery goodbye amidst her refrain of “Alfi salaama”s to quicken my healing. It occurred to me as I puzzled through this new shade of sketch shed on our habitation of 40 Sharia‘ Mesaha by the mysterious Mohamad Fahim that I might ought to work my way deeper into Madam Afaf's enigmatic ring, and further master its accompanying rules of etiquette and trickery. For the discussion effecting the retrieval of my security deposit will require an epic performance indeed.

Rock Like an Egyptian

It struck me as a bit strange that Egypt’s most famous pop-rock group, Wust el-Beled (Egyptian slang for “downtown”) would elect to perform at such a stiff venue as the Gomhoriyya Theater. They looked a bit out of their element scattered across the wide stage, playing for an audience trapped in plush folding chairs. What I did not know, until later developments in their set prompted Aaron to inform me, was that a member of Wust el-Beled had recently made a public announcement: his commitment to Islamic morals no longer allowed him to play in venues serving alcohol. Which narrowed down their options to such elegant joints as the Gomhoriyya Theater.

To be fair, the theater’s old-timey sophistication could be interpreted as “hip” if you were looking for it. And many attendees of the Wust el-Beled concert probably were: the high percentage of baggy pants and funny hats and the lower percentage of veils marked a significant divergence from the style of the Cairo masses. However, as I noted the prevalence of English smattered stylishly across their conversations and the decidedly expensive look to their digs, I gathered that these fashion plates had most likely not drawn inspiration to embrace a bohemian lifestyle from a sparse and humble upbringing; no, much like Williamsburg’s “trust-fund hipsters,” most of these cats had probably inherited their access to coolness along with the many privileges of belonging to Cairo’s richest, most Westernized, and incidentally smallest social class.

Fashionable youngsters aside, the large number of elderly concert-goers sparked my curiosity. Do Egyptian music groups tend to cater to all generations, or do these folks simply have season passes to the Gomhoriyya? Either way, their visible enjoyment of the music attested to their capacity to enjoy Egypt’s latest brand of “cool.” And as I was to find out, Wust el-Beled is geared to please adherents to all manner of musical tastes.

The band boasts seven musicians, appearing to range in age from twenties to forties (it’s hard to gauge age around here – people seem to go from nineteen to fifty in one fell swoop), and in skin tones from olive-toned white to dredlocks-black. Wust el-Beled’s three guitarists affirm the Egyptian scene’s adoption of the guitar-heavy ratio ubiquitous in American rock groups. The remaining breakdown: an‘oud, a kind of Oriental lute, an electric bass, two percussionists and a vocalist, although one of the guitarists actually did more of the singing. Half of the group arrived late.

Together they struck a portrait that invoked at once a jam band and a traditional Oriental ensemble. They wore casual clothes, tee shirts, jackets, and jeans, and with the exception of the bongo-player, remained seated and concentrated throughout the performance. The frontman, if he could be interpreted as such (criteria: best-looking, highest voice, most convincing sneer), muttered commentary into his microphone between every song while the members conducted extended whispered conferences about what they might play next. From time to time the audience laughed and someone would shout out his commentary. A group of girls called out his name (Ismaïl) and squealed at the boldness of their anonymity as he squinted into the dark with a permissive smile. As the evening advanced and the band’s conduct less formal, shouted requests for favorite tunes grew more insistent. Basically like a regular rock concert.

Well, sort of. I quickly discovered that Wust el-Beled exemplifies the modern musical identity crisis. They covered styles ranging from Latino rock (inspiring Aaron’s snide nomer “the E-gipsy Kings”) to reggae to schmaltzty Arab pop to traditional Oriental pieces. However, it still came as a surprise when, toward the end of the first set, an upbeat number melted into a meditative and all-too-familiar drone. Is it? could it be? It is:

“Allaaaaaaaaaaaaahu akbar.”

The crowd went wild.

A long, brooding piece followed, in which singing members of Wust el-Beled showcased their prowess in ululation. The concert had transformed in full into a traditional interaction of performer and participant characteristic of Oriental musical occasions. These occasions are of course not concerts, but usually family or community celebrations in which all present have a role to play and certainly join in on the chorus. Yet at the same time the battling soloists and the varying responsive cheers also invoked the interaction at a jazz performance. Either way, I am no expert in Islamic law, but I know that in its most severe interpretations there was some bit about “no music for pleasure,” much less perversion of the fatiHa in rock and roll concerts, however devout the rockers. Such considerations did not seem to concern the members of Wust el-Beled or their fans, who were eating it up.

In the midst of this sacred moment, a rather comical parallel occurred to me, with a Christian rock show I had attended in high school. The concert took place in St. Cloud Technical High School’s South Auditorium, and featured a group of my classmates who called themselves “Manna-fest.” Beneath their searing electric guitars and pounding bass lines, one could make out such inspired rhymes as “Oh baby you know whenever you’re in danger/you’ve got a friend who was born in a manger” and the like. At the conclusion of the show, one of the musicians invited all willing audience members to come up to the stage and welcome Jesus into their hearts, to the accompaniment of a last, heart-wrenching number. Crowds of demonstrative teenagers swarmed to the front of South Auditorium, nno longer the territory of discordant pep band concerts but rather a holy space bathed in the stagelights’ divine beams. Tears flowed and enthused avowals fought to pierce through the amplifiers’ combined roar.

I permitted myself to imagine the corresponding scene in the Gomhoriyya Theater, should Wust el-Beled so invite their fans. They did not, of course; true to its schizophrenic character, the band soon abandoned the sacred section of its concert for more love songs and a crowd-pleasing “Free Palestine” ballad (“You can steal houses/You can steal land/But you’ll never ever steal a nation”). No, unlike Manna-fest, Wust el-Beled did not seem interested in making their religiosity the main event of their performance. To my knowledge, this particular form of inspiring the young faithful, the religious rock concert, remains foreign to Islamic culture. But seeing those hip youngsters grooving to the call to prayer in the same breath as bopping to romantic reggae and rocking out to free-Palestine, one has to wonder whether such developments are much farther off. Perhaps the conservative mullahs issuing futile fatwas against music would change their tune if they could see the extraordinary effects of the religious rock concert. I may just pen a letter to one of the usual suspects with a translation of that exemplary and compelling Onion article, “That Teen Jesus Rally Totally Rocked” to get ‘em thinking. Although the idea of Christian teeny-bopper evangelism spreading throughout this already rather troubled land does not exactly seem like a step forward. Best leave the rock concerts with a tuneful and tasteful half-time prayer break for now.