First Day in Basrah

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We head through security and we check in to our VERY nice hotel. At this point, I break and beg for lunch. I kick myself for not eating the breakfast on the flight. We ate at 5:30am and have been travelling for 10 hours. And I’m a wuss. A buffet for all 3 meals comes with the hotel so we sit for lunch with Ali. Ali is an orthopaedic surgeon and Thamer’s son-in-law (Scott previously told me that Thamer “groomed him” to marry his daughter). He is very kind. The buffet is large and includes many fresh salads (Fatoosh, etc), lentil soup, kabobs, grilled fish, beans, yogurt, hummous and tea. I’m going to be happy here.





I feel much better. It’s around 3:30pm and the next scheduled event is a dinner at 8pm. Time for a shower and a nap. We are then informed that we are going to run a clinic from 4-8pm prior to dinner. Oh. We drop our things off and head to the clinic. Iraq, remember: go with the flow.



We meet at the public hospital with a full waiting room. Scott, Rick and I each get our own room and we have 3-4 residents working with us. I jump right in. Patients are shuttled in one after another and the resident gives a brief presentation. Often the patient has xrays, or even a CT or MRI. All are terrible quality, none are weightbearing. I see kids and adults, one woman informs me she is a pediatrician. I see Charcot and polio and arthritis and subtalar coalitions and pediatric congenital defects. I try to teach as well. The residents are eager to learn. I am later joined by 2 seasoned Iraqi orthopaedic surgeons. They are very helpful. I saw a case of tibial hemimelia with deformity and I try to get creative and one of them looks at me and says, “In Iraq, this gets an amputation.’ He’s right. I needed that.



I’m surprised by the delayed presentations. I saw two wheelchair bound sisters, ages 30 and 32 (they look 20 and 22), with progressive loss of function in their legs. This is the first time they have sought any treatment, and are far past anything I can do to help. They likely have tethered spines or a neurological disorder which is and maybe always was irreversible. I see a lot of polio, but the doctors inform me that fortunately polio has been mostly eradicated in Iraq over the past 10 years given a big push in vaccination, though in Lebanon, there has been a rise in polio as people are refusing vaccines because of rumors that vaccines cause infertility. (Jenny McCarthy anyone?)



At all points, I am treated with respect and just like a fellow physician/surgeon. I have thus far been overwhelmed by the welcome. The medical school is 60% women, though I’m informed there are no female surgeons and most women doctors are pediatricians and OB-GYN. My mistake was saying I was going to use the restroom when we had a break, and all the men looked at each other and made it clear I didn’t want to use the bathroom at the clinic. They then spend the next half hour trying to convince me to get driven to one house or another to use the facilities, despite my constant insistence that I really don’t have to go that badly. Awkward and weird. You can tell they are very nervous I will feel uncomfortable. I finish the clinic and I’m immediate chauffeured to Ali’s house. A few turns over terrible roads and we arrive at Ali’s house, a mansion in Basrah terms. There is a gated entrance and I learn after that the small one room house across the street is where their bodyguard lives.



I am greeted very warmly by the family – Zena, her 4 children, their nanny and their bodyguard. Zena’s oldest child is 13 and speaks almost perfect English. She states she learned from movies and she wants to move to the States. English is taught to all kids in the primary school. The kids remind me of the kids in the States- they are a bit overweight, they like television and video games. Her youngest is 1 ½ and is a bit of a terror, but the nanny chases him around. I am there for about an hour. The interactions are a tad forced from a combination of unfamiliarity, my tiredness, their onus to entertain me, and the language barrier, but overall is nice and warm. Zena takes off her head scarf when I am there. Her 13 year old daughter doesn’t wear one either. I don’t quite know the rules but I feel okay having my hair exposed. The living room is very ornate with light blue velvet furniture and Iranian rugs. It’s hard for me to explain the house. It’s ornately decorated, but the bones are still raw. It’s like the Fairmont Hotel: ornate, fancy, full of history, obviously a lot of money went into it – but still feels old and maybe a bit worn. Am I making any sense?



The rest of clinic finally wraps and we head to dinner. In any other situation, I would have bowed out and called it a night, but a) I was again starving and b) no way that would fly. We drive to the restaurant and Zena parks the car (TERRIBLY) so I ask her if she wants some help. She hands her keys to her bodyguard and says he will fix it.



We arrive at the restaurant and outside there is a long table for about 30. It’s Thamer’s grandchild’s, Dena’s, first birthday. The large floral arrangement has now found its home. I should have brought my vase. At one end are the men, some family and some orthopaedic surgeons, and the women are at the other end. Dena is dressed in a full princess get-up in a high chair at the head of the women’s end of the table. Behind her is a pink table of treats and decorations and a cake with “Dena is One!” inscribed. To add to the scene, there is a table of 6 young boys who are singing spiritual songs into a microphone. Think Bollywood-esc chants. Loudly. For hours. I let Ali order for me and the food was indeed delicious and I was starting. We all started with trays of hummous and baba ganoush and tabouli with huge pizza crust sized naan breads. I was then served a plate of kabobs with MORE naan. All tasty except for the liver chunks. Found that out the hard way. I prefer more spice in my food, but it’s very flavorful. No alcohol on the menu - this trip is probably going to be good for my liver. Ali asks me if I will miss the afternoon portion of the conference tomorrow to operate on Zena (she has very severe posterior tibial tendon dysfunction, and this was discussed before the trip). I ask her if she’s ready and she’s says she’s not, but she trusts me. Okay then. I agree.





At this point, I have sort of had it. I am tired and I am not a good schmoozer anyway, and this is a very unique schmoozing situation. I am seated with the women at the far end of the table whom I don’t know, and small talk is difficult with the loud Arabic melodies drubbing in my ears. Part of me is a bit resentful of Scott and Rick leaving me to my own devices at the female end of the table while they talk shop with the orthopods. However, I do realize this is a once in a lifetime experience, so I chastise my internal bad attitude and I hunker down and smile. That said, I feel very relieved when Scott comes over and asks Ali to take us back to the hotel as Scott is the first speaker tomorrow and needs to work on his talk. When all is said and done, I am in bed at 11:30pm and I pass out hard.

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